Bivalirudin versus unfractionated heparin: a meta-analysis of patients receiving percutaneous coronary intervention for acute coronary syndromes

OBJECTIVE: Acute coronary syndrome (ACS) encompasses ST segment elevation myocardial infarction (STEMI), with generally high thrombus burden and non-ST segment elevation ACS (NSTE-ACS), with lower thrombus burden. In the setting of percutaneous coronary intervention (PCI) for ACS, bivalirudin appears superior to unfractionated heparin (UFH), driven by reduced major bleeding. Recent trials suggest that the benefit of bivalirudin may be reduced with use of transradial access and evolution in antiplatelet therapy. Moreover, a differential role of bivalirudin in ACS cohorts is unknown. METHODS: A meta-analysis of randomised trials comparing bivalirudin and UFH in patients with ACS receiving PCI, with separate analyses in STEMI and NSTE-ACS groups. Overall estimates of treatment effect were calculated with random-effects model. RESULTS: In 5 trials of STEMI (10 358 patients), bivalirudin increased the risk of acute stent thrombosis (ST) (OR 3.62; CI 1.95 to 6.74; p<0.0001) compared with UFH. Bivalirudin reduced the risk of major bleeding only when compared with UFH plus planned glycoprotein IIb/IIIa inhibitors (GPI) (OR 0.49; CI 0.36 to 0.67; p<0.00001). In 14 NSTE-ACS trials (25 238 patients), there was no difference between bivalirudin and UFH in death, myocardial infarction or ST. However, bivalirudin reduced the risk of major bleeding compared with UFH plus planned GPI (OR 0.52; CI 0.43 to 0.62; p<0.00001), or UFH plus provisional GPI (OR 0.68; CI 0.46 to 1.01; p=0.05). The reduction in major bleeding with bivalirudin was not related to vascular access site. CONCLUSIONS: Bivalirudin increases the risk of acute ST in STEMI, but may confer an advantage over UFH in NSTE-ACS while undergoing PCI, reducing major bleeding without an increase in ST

Eigenfunctions of the Laplace-Beltrami Operator on Hyperboloids

Eigenfunctions of the Laplace-Beltrami operator on a hyperboloid are studied in the spirit of the treatment of the spherical harmonics by Stein and Weiss. As a special case, a simple self-contained proof of Laplace's integral for a Legendre function is obtained.Comment: 5 page

Effective Three-Body Interactions in Jaynes-Cummings-Hubbard Systems

A generalisation of the Jaynes-Cummings-Hubbard model for coupled-cavity arrays is introduced, where the embedded two-level system in each cavity is replaced by a $\Xi$-type three-level system. We demonstrate that the resulting effective polariton-polariton interactions at each site are both two-body and three-body. By tuning the ratio of the two transition dipole matrix elements, we show that the strength and sign of the two-body interaction can be controlled whilst maintaining a three-body repulsion. We then proceed to demonstrate how different two-body and three-body interactions alter the mean field superfluid-Mott insulator phase diagram, with the possible emergence of a pair superfluid phase in the two-body attractive regime.Comment: 10 pages, 4 figures, accepted for publication in Scientific Reports; v3 - revised manuscrip

On Business Cycle Asymmetries in G7 Countries

We investigate whether business cycle dynamics in seven industrialized countries (the G7) are characterized by asymmetries in conditional mean. We provide evidence on this issue using a variety of time series models. Our approach is fully parametric. Our testing strategy is robust to any conditional heteroskedasticity, outliers, and / or long memory that may be present. Our results indicate fairly strong evidence of nonlinearities in the conditional mean dynamics of the GDP growth rates for Canada, Germany, Italy, Japan, and the US. For France and the UK, the conditional mean dynamics appear to be largely linear. Our study shows that while the existence of conditional heteroskedasticity and long memory does not have much affect on testing for linearity in the conditional mean, accounting for outliers does reduce the evidence against linearity.business cycles, asymmetries, nonlinearities, conditional heteroskedasticity, long memory, outliers, real GDP, stable distributions

Secure & trusted communication in emergency situations

In this paper we propose SETS, a protocol with main aim to provide secure and private communication during emergency situations. SETS achieves security of the exchanged information, attack resilience and user’s privacy. In addition, SETS can be easily adapted for mobile devices, since field experimental results show the effectiveness of the protocol on actual smart-phone platforms