59 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 .)
DESIGN ASSISTANT for SPACECRAFT THERMAL MANAGEMENT SYSTEMS.
The conceptual design of spacecraft thermal management systems and their components is described in order to provide a basis for the development and implementation of future technologies. The components of the spacecraft thermal management system include heat pipes, latent thermal energy storage materials, radiators, and other thermal structures. The design problem becomes one of selecting a combination of these components subject to both spacecraft mission and launch requirements. To facilitate this design process, a knowledge-based design assistant is being developed in the artificial intelligence programming language, PROLOG. The goal has been to amplify the capabilities of an experienced designer by putting significant decision-making, and search and retrieval facilities at his or her disposal
Pharmacokinetics and Subjective Effects of Sublingual Buprenorphine, Alone or in Combination with Naloxone
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Collective and individual voice: convergence in Europe?
This paper uses longitudinal survey data from Britain, Germany and Sweden to examine whether, as some researchers have suggested, there has been a convergence internationally towards individual forms of employee voice mechanism and, if so, to measure the extent and trajectory of change. The paper begins by examining the importance of the employee voice issue. It then reviews competing accounts of the utility of different forms of employee voice and their manifestations within different varieties of capitalism. It is hypothesized that there has been a general trend away from collective and towards individual voice mechanisms; this reflects the predominant trajectory of managerial practices towards convergence with the liberal market model. This hypothesis is largely rejected. The data showed only very limited evidence of directional convergence towards individual voice models in the three countries. Collective voice remains significant in larger organizations, and although it takes a wide range of forms that include but go beyond unions and works councils, this is a positive finding for proponents of those institutions
Uranyl Dication Mediated Photoswitching of a Calix[4]pyrrole-based Metal Coordination Cage
A set of self-assembled tri- and tetrapodal metal coordination cage structures (cage-1 and cage-2, respectively) constructed from the uranyl dication (UO22+) and a dibenzoic acid functionalised cis-calix[4]pyrrole (1) are described. The inherent photochemical reactivity of the uranyl dication mediates the transformation of cage-1 to cage-2via the activation of molecular oxygen
Training and development in the Irish context: responding to the competitiveness agenda?
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