15 research outputs found
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 .)
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âAnd the winner isâŠâ: Hierarchies of language competence and fashion sense in Tanzanian beauty pageants
This paper discusses how successful Tanzanian beauty contestants mark themselves as educated sophisticates through clusters of semiotic materials. At lower-level and provincial competitions, contestantsâ ability to speak âpure,â if non-fluent and non-standard, English helps them achieve victory. This register is coupled with local, often outlandish, interpretations of international fashions and hairstyles. Yet in the capital city, and especially at the national competition, winning contestants speak a standard, fluent variety of English, a super-elite register that is typically only acquired through tertiary education or through membership in an elite urban household. They also adorn themselves in ways that are in keeping with global trends. When provincial contestants advance through the pageant hierarchy, they find their language skills and agrestic style become indexical a lack of knowledge and sophistication. This paper thus explores the variable and hierarchical formulations of âlanguage competenceâ (Blommaert et al 2005), and emphasizes, using Aghaâs (2007) notion of âmetasemiotic scheme,â that such competence is neither acquired, nor interpreted, in isolation from other symbolic behaviors
âAnd the winner isâŠâ: Hierarchies of language competence and fashion sense in Tanzanian beauty pageants
This paper discusses how successful Tanzanian beauty contestants mark themselves as educated sophisticates through clusters of semiotic materials. At lower-level and provincial competitions, contestantsâ ability to speak âpure,â if non-fluent and non-standard, English helps them achieve victory. This register is coupled with local, often outlandish, interpretations of international fashions and hairstyles. Yet in the capital city, and especially at the national competition, winning contestants speak a standard, fluent variety of English, a super-elite register that is typically only acquired through tertiary education or through membership in an elite urban household. They also adorn themselves in ways that are in keeping with global trends. When provincial contestants advance through the pageant hierarchy, they find their language skills and agrestic style become indexical a lack of knowledge and sophistication. This paper thus explores the variable and hierarchical formulations of âlanguage competenceâ (Blommaert et al 2005), and emphasizes, using Aghaâs (2007) notion of âmetasemiotic scheme,â that such competence is neither acquired, nor interpreted, in isolation from other symbolic behaviors
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The dialectic of racial justice: Maxine Greeneâs contributions to morally engaged and racially just education spaces
Work published in Review of Education, Pedagogy and Cultural Studies
Racial Tokenism in the School Workplace: An Exploratory Study of Black Teachers in Overwhelmingly White Schools
âJust let the worst students goâ: A critical case analysis of public discourse about race, merit, and worth
We present a case analysis of the controversy and public debate generated from a school districtâs efforts to address racial inequities in educational outcomes by diverting special funds from the highest performing students seeking elite college admissions to the lowest performing students who were struggling to graduate from high school. Widespread arguments against the proposed change emphasized the identification of highly successful students as âworthyâ and others as âunworthyâ of resources. Through an analysis of print and digital public texts, we identify a narrative cycle that informed public debate: (a) colorblind rhetoric, (b) academic performance is presumed to emerge solely from talent and effort, so (c) academic performance then becomes a measure of worth, and finally, (d) efforts to address racial disparities are âunfair.â We argue that narratives identifying some students as worthy and others unworthy are highly influential in the outcomes of many educational policy and funding debates