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 .)

The Internationalization Trajectory of Bossini: A Fashion Retailing Enterprise from Hong Kong

Established in 1987 and originating from Hong Kong, Bossini has established itself as a famous casual-wear international fashion retail brand. Based on information and financial data publicly available in Bossini’s annual reports from 2000/2001 to 2013/2014, this chapter investigates the internationalization trajectory of Bossini. By exploring both operational and marketing models, we examine how Bossini has successfully emerged as an international fashion retailing group. We also discuss how Bossini survives and excels under conditions of market disruption, and statistically evaluate the operational performance of Bossini in its four core markets: Hong Kong, China, Taiwan and Singapore. The chapter concludes by analyzing the critical success factors for Bossini.Institute of Textiles and Clothin

A Quadruple and Quintuple Helix Approach to Regional Innovation Systems in the Transformation to a Forestry-Based Bioeconomy

This article aims to understand the possible preconditions for the transformation of a regional innovation system (RIS) into a quadruple and quintuple helix system applied to the development of a sustainable forestry-based bioeconomy in Värmland, Sweden. Research points to the necessity not only of further developing current innovation systems to include more actors than earlier but also of taking concern for the environment as a way towards attaining sustainability. The research was carried out in response to the need to understand he fourth helix and its role in RIS and to transform to a sustainable bioeconomy, as identified by researchers, policymakers and industry representatives. This study was inspired by participatory transdisciplinarity and a transdisciplinary research design, acknowledging the importance of a variety of actors in knowledge production from different spheres of society. Much of the empirical material gathered for this research was based on interviews and a workshop with different stakeholders. The results show that the use of a quintuple helix RIS in Värmland for the transformation to a forestry-based bioeconomy could be a possible way forward towards sustainability. The model proposes that involvement of civil society in the innovation system could contribute to a larger societal transformation that aims to change consumer behaviour, production patterns, technological developments, infrastructure, norms and values. However, the involvement of civil society in the innovation system must still be regarded as part of a vision statement in regional policy documents