Systematic review and meta-analysis of optimal P2Y₁₂ blockade in dual antiplatelet therapy for patients with diabetes with acute coronary syndrome

Background: Patients with diabetes are at increased risk of acute coronary syndromes (ACS) and their mortality and morbidity outcomes are significantly worse following ACS events, independent of other comorbidities. This systematic review sought to establish the optimum management strategy with focus on P2Y₁₂ blockade in patients with diabetes with ACS. Methods: MEDLINE (1946 to present) and EMBASE (1974 to present) databases, abstracts from major cardiology conferences and previously published systematic reviews were searched to June 2014. Relevant randomised control trials with clinical outcomes for P2Y₁₂ inhibitors in adult patients with diabetes with ACS were scrutinised independently by 2 authors with applicable data was extracted for primary composite end point of cardiovascular death, myocardial infarction (MI) and stroke; enabling calculation of relative risks with 95% CI with subsequent direct and indirect comparison. Results: Four studies studied clopidogrel in patients with diabetes, with two (3122 patients) having primary outcome data showing superiority of clopidogrel against placebo with RR0.84 (95% CI 0.72–0.99). Irrespective of management strategy, the newer agents prasugrel (2 studies) and ticagrelor (1 study) had a lower primary event rate compared with clopidogrel; RR 0.80 (95% CI 0.66 to 0.97) and RR 0.89 (95% CI 0.77 to 1.02), respectively. When ticagrelor was indirectly compared with prasugrel, there was a trend to an improved primary outcome with prasugrel (RR 1.11 (95% CI 0.94 to 1.31)) particularly in those managed with percutaneous coronary intervention (PCI) (RR 1.23 (95% CI 0.95 to 1.59)). Prasugrel demonstrated a statistical superiority with prevention of further MI with RR 1.48 (95% CI 1.11 to 1.97). This was not at the expense of increased major thrombolysis in MI (TIMI) bleeding rates RR 0.94 (95% CI 0.59 to 1.51). Conclusions: This meta-analysis shows the addition of a P2Y₁₂ inhibitor is superior to placebo, with a trend favouring the use of prasugrel in patients with diabetes with ACS, particularly those undergoing PCI

A thermodynamically self-consistent theory for the Blume-Capel model

We use a self-consistent Ornstein-Zernike approximation to study the Blume-Capel ferromagnet on three-dimensional lattices. The correlation functions and the thermodynamics are obtained from the solution of two coupled partial differential equations. The theory provides a comprehensive and accurate description of the phase diagram in all regions, including the wing boundaries in non-zero magnetic field. In particular, the coordinates of the tricritical point are in very good agreement with the best estimates from simulation or series expansion. Numerical and analytical analysis strongly suggest that the theory predicts a universal Ising-like critical behavior along the $\lambda$-line and the wing critical lines, and a tricritical behavior governed by mean-field exponents.Comment: 11 figures. to appear in Physical Review

The defect challenge of wide-bandgap semiconductors for photovoltaics and beyond

The optoelectronic performance of wide-bandgap semiconductors often cannot compete with that of their defect-tolerant small-bandgap counterpart. Here, the authors outline three main challenges to overcome for mitigating the impact of defects in wide-bandgap semiconductors

Contemporary Percutaneous Coronary Intervention for Complex Lesions: the Treatment of Chronic Total Occlusions and Bifurcations in the Drug-eluting Stent Era

When used in relatively simple lesions, randomized studies have demonstrated efficacy of drug-eluting stents in significantly reducing restenosis compared with bare metal stents. However, lesions such as chronic total occlusions and bifurcations which are at increased risk of restenosis were excluded. In this thesis, contemporary percutaneous coronary intervention of these lesion subsets are evaluated, including assessment of the efficacy of sirolimus- and paclitaxel-eluting stent implantation

Fabrication of ZnO/Cu<inf>2</inf>O heterojunctions in atmospheric conditions: Improved interface quality and solar cell performance

Zn_1-xMg_xO/Cu_2O heterojunctions were successfully fabricated in open-air at low temperatures via atmospheric atomic layer deposition of Zn_1-xMg_xO on thermally oxidized cuprous oxide. Solar cells employing these heterojunctions demonstrated a power conversion efficiency exceeding 2.2% and an open-circuit voltage of 0.65 V. Surface oxidation of Cu_2O to CuO prior to and during Zn_1-xMg_xO deposition was identified as the limiting factor to obtaining a high quality heterojunction interface. Optimization of deposition conditions to minimize Cu_2O surface oxidation led to improved device performance, tripling the open-circuit voltage and doubling the short-circuit current density. These values are the highest reported for a ZnO/Cu_2O interface formed in air, and highlight atmospheric ALD as a promising technique for inexpensive and scalable fabrication of ZnO/Cu_2O heterojunctions.This is the final published version. It is also available from Elsevier at http://www.sciencedirect.com/science/article/pii/S0927024814005005#