Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Topics in Quantum Chaos and Thermoelectricity

Thesis Advisors: Profs. E. J. Heller and H. Ehrenreich This thesis consists of two parts. Part I is concerned with quantum chaos in two model systems in two dimensions, the stadium billiard and a chaotic doublewell potential. We study the localization properties of eigenfunctions in the stadium billiard, and conclude that there is more localization of the local density of states as a function of position in phase space than can be accounted for on the basis of random matrix theory. A part of this can be attributed to scars, but most of the excess localization is found to be due to symmetry eects originating in the parity and time-reversal symmetries. As for the double-well potentials, we study the connection between scarring of eigenfunctions and tunneling through the barrier, as reected in the level splittings. The level splittings oscillate as a function of energy, with period h in units of action, as expected if scarring plays a role in determining the size of the splitting. Indeed, the size of the splitting is directely correlated with the strength of scarring. Our results are interpreted within the framework of semiclassical theory

Fractal solar panels: Optimizing aesthetic and electrical performances.

Solar energy technologies have been plagued by their limited visual appeal. Because the electrical power generated by solar panels increases with their surface area and therefore their occupancy of the observer's visual field, aesthetics will play an increasingly critical role in their future success in urban environments. Inspired by previous psychology research highlighting the aesthetic qualities of fractal patterns, we investigated panel designs featuring fractal electrodes. We conducted behavioral studies which compared observers' preferences for fractal and conventional bus-bar electrode patterns, along with computer simulations which compared their electrical performances. This led us to develop a hybrid electrode pattern which best combines the fractal and bus-bar designs. Here we show that the new hybrid electrode matches the electrical performance of bus-bars in terms of light transmission and minimizing electrical power losses, while benefiting from the superior aesthetics of fractal patterns. This innovative integration of psychology and engineering studies provides a framework for developing novel electrode patterns with increased implementation and acceptance