The Role of Ivabradine in the Management of Angina Pectoris

Stable angina pectoris affects 2–4 % of the population in Western countries and entails an annual risk of death and nonfatal myocardial infarction of 1–2 % and 3 %, respectively. Heart rate (HR) is linearly related to myocardial oxygen consumption and coronary blood flow, both at rest and during stress. HR reduction is a key target for the prevention of ischemia/angina and is an important mechanism of action of drugs which are recommended as first line therapy for the treatment of angina in clinical guidelines. However, many patients are often unable to tolerate the doses of beta blocker or non-dihydropyridine calcium antagonists required to achieve the desired symptom control. The selective pacemaker current inhibitor ivabradine was developed as a drug for the management of patients with angina pectoris, through its ability to reduce HR specifically. The available data suggest that ivabradine is a well-tolerated and effective anti-anginal agent and it is recommended as a second-line agent for relief of angina in guidelines. However, recent clinical trials of ivabradine have failed to show prognostic benefit and have raised potential concerns about safety. This article will review the available evidence base for the current role of ivabradine in the management of patients with symptomatic angina pectoris in the context of stable coronary artery disease

Counting Integer flows in Networks

This paper discusses new analytic algorithms and software for the enumeration of all integer flows inside a network. Concrete applications abound in graph theory \cite{Jaeger}, representation theory \cite{kirillov}, and statistics \cite{persi}. Our methods clearly surpass traditional exhaustive enumeration and other algorithms and can even yield formulas when the input data contains some parameters. These methods are based on the study of rational functions with poles on arrangements of hyperplanes

Going green: does it depend on education, gender, or income?

Sustainable development entails meeting our present needs without compromising the ability of future generations to meet their needs. This requires us to treat economic, social and environmental aspects in an integrated way, but little is known about the nature of individual preferences towards the trade-offs involved in this effort. For the first time, we study individual preferences towards the environment, social wellbeing, and financial wellbeing using a survey of over 1400 households in the Netherlands. Using nonparametric, parametric, and matching methods, we find that gender and education are important factors for sustainability rather than income levels. Moreover results indicate that educated females put the greatest value on going green whilst being socially minded.Sustainability, financial wellbeing, heterogenous preferences