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- Turcu, I. C. E., et al.
(författare)
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HIGH FIELD PHYSICS AND QED EXPERIMENTS AT ELI-NP
- 2016
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Ingår i: Romanian Reports on Physics. - 1221-1451 .- 1841-8759. ; 68, s. S145-S231
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Tidskriftsartikel (refereegranskat)abstract
- ELI-NP facility will enable for the first time the use of two 10 PW laser beams for quantum electrodynamics (QED) experiments. The first beam will accelerate electrons to relativistic energies. The second beam will subject relativistic electrons to the strong electromagnetic field generating QED processes: intense gamma ray radiation and electron-positron pair formation. The laser beams will be focused to intensities above 10(21) Wcm(-2) and reaching 10(22)-10(23) Wcm(-2) for the first time. We propose to use this capability to investigate new physical phenomena at the interfaces of plasma, nuclear and particle physics at ELI-NP. This High Power Laser System Technical Design Report (HPLS-TDR2) presents the experimental area E6 at ELI-NP for investigating high field physics and quantum electrodynamics and the production of electron-positron-pairs and of energetic gamma-rays. The scientific community submitted 12 commissioning runs for E6 interaction chamber with two 10 PW laser beams and one proposal for the CETAL interaction chamber with 1 PW laser. The proposals are representative of the international high field physics community being written by 48 authors from 14 European and US organizations. The proposals are classified according to the science area investigated into: Radiation Reaction Physics: Classical and Quantum; Compton and Thomson Scattering Physics: Linear and Non Linear Regimes; QED in Vacuum; Atoms in Extreme Fields. Two pump-probe colliding 10 PW laser beams are proposed for the E6 interaction chamber. The focused pump laser beam accelerates the electrons to relativistic energies. The accelerated electron bunches interact with the very high electro-magnetic field of the focused probe laser beam. We propose two main types of experiments with: (a) gas targets in which the pump laser-beam is focused by a long focal length mirror and drives a wakefield in which the electron bunch is accelerated to multi-GeV energies and then exposed to the EM field of the probe laser which is tightly focused; (b) solid targets in which both the pump and probe laser beams are focused on the solid target, one accelerating the electrons in the solid and the other, delayed, providing the high electric field to which the relativistic electrons are subjected. We propose four main focusing configurations for the pump and probe laser beams, two for each type of target: counter-propagating 10 PW focused laser beams and the two 10 PW laser beams focused in the same direction. For solid targets we propose an additional configuration with plasma-mirror on the pump laser beam: the plasma mirror placed between the focusing mirror and target. It is proposed that the 10 PW laser beams will have polarization control and focus control by means of adaptive optics. Initially only one 10 PW may have polarization control and adaptive optics. In order to accommodate the two laser beams and diagnostics the proposed interaction chamber is quasi-octagonal with a diameter of 4.5 m. A large electron-spectrometer is proposed for multi-GeV electrons. Other diagnostics are requested for: gamma-rays, electrons and positrons, protons and ions, plasma characterization, transmitted and reflected laser beam. Targets will be provided by the ELI-NP Target Laboratory or purchased. The E6 experiments and diagnostics will benefit from the ELI-NP Electronics Laboratory, the Workshop and the Optics Laboratory. In order to ensure radiation-protection, a large beam-dump is planned for both multi-GeV electrons and multi-100 MeV protons.
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- Alfredsson, Joakim, et al.
(författare)
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Predicting the risk of bleeding during dual antiplatelet therapy after acute coronary syndromes
- 2017
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Ingår i: Heart. - : BMJ PUBLISHING GROUP. - 1355-6037 .- 1468-201X. ; 103:15, s. 1168-1176
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patients bleeding risk during DAPT treatment in the post-ACS setting. Methods To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14.8 months. Results We identified 10 significant baseline predictors of non-coronary artery bypass grafting (CABG)-related Global Use of Strategies to Open Occluded Arteries (GUSTO) severe/life-threatening/moderate bleeding: age, sex, weight, NSTEMI (vs unstable angina), angiography performed before randomisation, prior peptic ulcer disease, creatinine, systolic blood pressure, haemoglobin and treatment with beta-blocker. The five significant baseline predictors of Thrombolysis In Myocardial Infarction (TIMI) major or minor bleeding included age, sex, angiography performed before randomisation, creatinine and haemoglobin. The models showed good predictive accuracy with Therneaus C-indices: 0.78 (SE=0.024) for the GUSTO model and 0.67 (SE=0.023) for the TIMI model. Internal validation with bootstrapping gave similar C-indices of 0.77 and 0.65, respectively. External validation demonstrated an attenuated C-index for the GUSTO model (0.69) but not the TIMI model (0.68). Conclusions Longitudinal bleeding risks during treatment with DAPT in patients with ACS can be reliably predicted using selected baseline characteristics. The TRILOGY ACS bleeding models can inform riskbenefit considerations regarding the duration of DAPT following ACS.
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- Dey, Lankeswar, et al.
(författare)
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Authenticating the Presence of a Relativistic Massive Black Hole Binary in OJ 287 Using Its General Relativity Centenary Flare : Improved Orbital Parameters
- 2018
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 866:1
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Tidskriftsartikel (refereegranskat)abstract
- Results from regular monitoring of relativistic compact binaries like PSR 1913+16 are consistent with the dominant (quadrupole) order emission of gravitational waves (GWs). We show that observations associated with the binary black hole (BBH) central engine of blazar OJ 287 demand the inclusion of gravitational radiation reaction effects beyond the quadrupolar order. It turns out that even the effects of certain hereditary contributions to GW emission are required to predict impact flare timings of OJ 287. We develop an approach that incorporates this effect into the BBH model for OJ 287. This allows us to demonstrate an excellent agreement between the observed impact flare timings and those predicted from ten orbital cycles of the BBH central engine model. The deduced rate of orbital period decay is nine orders of magnitude higher than the observed rate in PSR 1913+16, demonstrating again the relativistic nature of OJ 287's central engine. Finally, we argue that precise timing of the predicted 2019 impact flare should allow a test of the celebrated black hole no-hair theorem at the 10% level.
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- Aurand, B., et al.
(författare)
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Manipulation of the spatial distribution of laser-accelerated proton beams by varying the laser intensity distribution
- 2016
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Ingår i: Physics of Plasmas. - : AIP Publishing. - 1089-7674 .- 1070-664X. ; 23:2
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Tidskriftsartikel (refereegranskat)abstract
- We report on a study of the spatial profile of proton beams produced through target normal sheath acceleration using flat target foils and changing the laser intensity distribution on the target front surface. This is done by either defocusing a single laser pulse or by using a split-pulse setup and irradiating the target with two identical laser pulses with variable spatial separation. The resulting proton beam profile and the energy spectrum are recorded as functions of the focal spot size of the single laser pulse and of the separation between the two pulses. A shaping of the resulting proton beam profile, related to both an increase in flux of low-energy protons in the target normal direction and a decrease in their divergence, in one or two dimensions, is observed. The results are explained by simple modelling of rear surface sheath field expansion, ionization, and projection of the resulting proton beam.
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- Chan, Mark Y., et al.
(författare)
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Temporal biomarker profiling reveals longitudinal changes in risk of death or myocardial infarction in Non-ST-segment elevation acute coronary syndrome
- 2017
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 63:7, s. 1214-1226
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are conflicting data on whether changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) concentrations between time points (delta NT-proBNP and hs-CRP) are associated with a change in prognosis. METHODS: We measured NT-proBNP and hs-CRP at 3 time points in 1665 patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Cox proportional hazards was applied to the delta between temporal measurements to determine the continuous association with cardiovascular events. Effect estimates for delta NT-proBNP and hs-CRP are presented per 40% increase as the basic unit of temporal change. RESULTS: Median NT-proBNP was 370.0 (25th, 75th percentiles, 130.0, 996.0), 340.0 (135.0, 875.0), and 267.0 (111.0, 684.0) ng/L; and median hs-CRP was 4.6 (1.7, 13.1), 1.9 (0.8, 4.5), and 1.8 (0.8, 4.4) mg/L at baseline, 30 days, and 6 months, respectively. The deltas between baseline and 6 months were the most prognostically informative. Every 40% increase of delta NTproBNP (baseline to 6 months) was associated with a 14% greater risk of cardiovascular death (adjusted hazard ratio (HR) 1.14, 95% CI, 1.03-1.27) and with a 14% greater risk of all-cause death (adjusted HR 1.14, 95% CI, 1.04 -1.26), while every 40% increase of delta hs- CRP (baseline to 6 months) was associated with a 9% greater risk of the composite end point (adjusted HR 1.09, 95% CI, 1.02-1.17) and a 10% greater risk of myocardial infarction (adjusted HR 1.10, 95%, CI 1.00 -1.20). CONCLUSIONS: Temporal changes in NT-proBNP and hs-CRP are quantitatively associated with future cardiovascular events, supporting their role in dynamic risk stratification of NSTEACS.
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- Hess, Connie N., et al.
(författare)
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Apixaban Plus Mono Versus Dual Antiplatelet Therapy in Acute Coronary Syndromes Insights From the APPRAISE-2 Trial
- 2015
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 66:7, s. 777-787
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Bleeding limits anticoagulant treatment in patients with acute coronary syndromes (ACS). OBJECTIVES We investigated whether background concomitant antiplatelet therapy influences the effects of apixaban after ACS. METHODS This study examined high-risk ACS patients who were treated with aspirin or aspirin plus clopidogrel and who were randomized to apixaban 5 mg twice daily or placebo. In a post-hoc analysis, we assessed whether the effect of apixaban on efficacy and safety outcomes varied by the concomitant antiplatelet regimen by using simple Cox modeling and marginal structural models with propensity scores and antiplatelet therapy as a time-dependent covariate. RESULTS At baseline, of 7,364 patients, 16.3% (n = 1,202) were on aspirin alone, and 79.0% (n = 5,814) were on aspirin plus clopidogrel. A total of 19.2% (n = 1,415) switched antiplatelet therapy during follow-up. No differential effect of apixaban versus placebo was observed for the composite endpoint of cardiovascular death, myocardial infarction, and ischemic stroke in patients taking aspirin (12.21 per 100 patient-years vs. 13.21 per 100 patient-years; adjusted hazard ratio [HR]: 0.91; 95% confidence interval [CI]: 0.62 to 1.32) or aspirin plus clopidogrel (13.22 vs. 14.24; adjusted HR: 0.95; 95% CI: 0.78 to 1.14; p(interaction) = 0.84). Compared with placebo, apixaban increased Thrombolysis In Myocardial Infarction major bleeding in patients taking aspirin (1.48 vs. 0.25; adjusted HR: 6.62; 95% CI: 0.75 to 51.73) and in patients taking aspirin plus clopidogrel (2.58 vs. 1.02; adjusted HR: 2.44; 95% CI: 1.34 to 4.45; p(interaction) = 0.41). Similar results were obtained with marginal structural models and in patients treated with and without percutaneous coronary intervention. CONCLUSIONS Post-ACS treatment with apixaban versus placebo showed no efficacy, but it increased bleeding regardless of concomitant therapy with aspirin alone or aspirin plus clopidogrel. (Apixaban for Prevention of Acute Ischemic Events 2 [APPRAISE-2]; NCT00831441) (J Am Coll Cardiol 2015; 66: 777-87)
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