Lower Healthcare Costs Associated with the Use of a Single-Pill ARV Regimen in the UK, 2004–2008

Aim

Investigate the cost and effects of a single-pill versus two- or three pill first-line antiretroviral combinations in reducing viral load, increasing CD4 counts, and first-line failure rate associated with respective regimens at 6 and 12 months.

Methods

Patients on first-line TDF+3TC+EFV, TDF+FTC+EFV, Truvada®+EFV or Atripla® between 1996–2008 were identified and viral load and CD4 counts measured at baseline, six and twelve months respectively. Factors that independently predicted treatment failure at six and twelve months were derived using multivariate Cox''s proportional hazard regression analyses. Use and cost of hospital services were calculated at six and twelve months respectively.

Results

All regimens reduced viral load to below the limit of detection and CD4 counts increased to similar levels at six and twelve months for all treatment regimens. No statistically significant differences were observed for rate of treatment failure at six and twelve months. People on Atripla® generated lower healthcare costs for non-AIDS patients at £5,340 (£5,254 to £5,426) per patient-semester and £9,821 (£9,719 to £9,924) per patient-year that was £1,344 (95%CI £1,222 to £1,465) less per patient-semester and £1,954 (95%CI £1,801 to £2,107) less per patient-year compared with Truvada®+EFV; healthcare costs for AIDS patients were similar across all regimens.

Conclusion

The single pill regimen is as effective as the two- and three-pill regimens of the same drugs, but if started as first-line induction therapy there would be a 20% savings on healthcare costs at six and 17% of costs at twelve months compared with Truvada®+EFV, that generated the next lowest costs.     

Length‐weight relationship of two cichlid fish species,Etroplus suratensis (Bloch, 1790) and Etroplus maculatus (Bloch, 1795) from Lake Vembanad,Kerala, India

The present study describes the length–weight relationships (LWRs) of two cichlid fish species, Etroplus suratensis (Bloch, 1790) and Etroplus maculatus (Bloch, 1795) collected from Vembanad Lake, Kerala, India during the period June 2012 to May 2013 using gill nets with various mesh sizes (3.5–9 cm) and cast nets with a 1.5 cm mesh size. The values of parameters b in the LWR equation were estimated as 2.67 for E. suratensis and 2.72 for E. maculatus, respectively.     

A field-grown transgenic tomato line expressing higher levels of polyamines reveals legume cover crop mulch-specific perturbations in fruit phenotype at the levels of metabolite profiles, gene expression, and agronomic characteristics

Genetic modification of crop plants to introduce desirable traits such as nutritional enhancement, disease and pest resistance, and enhanced crop productivity is increasingly seen as a promising technology for sustainable agriculture and boosting food production in the world. Independently, cultural practices that utilize alternative agriculture strategies including organic cultivation subscribe to sustainable agriculture by limiting chemical usage and reduced tillage. How the two together affect fruit metabolism or plant growth in the field or whether they are compatible has not yet been tested. Fruit-specific yeast S-adenosylmethionine decarboxylase (ySAMdc) line 579HO, and a control line 556AZ were grown in leguminous hairy vetch (Vicia villosa Roth) (HV) mulch and conventional black polyethylene (BP) mulch, and their fruit analysed. Significant genotypexmulch-dependent interactions on fruit phenotype were exemplified by differential profiles of 20 fruit metabolites such as amino acids, sugars, and organic acids. Expression patterns of the ySAMdc transgene, and tomato SAMdc, E8, PEPC, and ICDHc genes were compared between the two lines as a function of growth on either BP or HV mulch. HV mulch significantly stimulated the accumulation of asparagine, glutamate, glutamine, choline, and citrate concomitant with a decrease in glucose in the 556AZ fruits during ripening as compared to BP. It enables a metabolic system in tomato somewhat akin to the one in higher polyamine-accumulating transgenic fruit that have higher phytonutrient content. Finally, synergism was found between HV mulch and transgenic tomato in up-regulating N:C indicator genes PEPC and ICDHc in the fruit.     

Antitumour immune responses

The role of the immune system in combating tumour progression has been studied extensively. The two branches of the immune response - humoral and cell-mediated - act both independently and in concert to combat tumour progression, the success of which depends on the immunogenicity of the tumour cells. The immune system discriminates between transformed cells and normal cells by virtue of the presence of unique antigens on tumour cells. Despite this, the immune system is not always able to detect and kill cancerous cells because neoplasms have also evolved various strategies to escape immune surveillance. Attempts are being made to trigger the immune system into an early and efficient response against malignant cells, and various therapeutic modalities are being developed to enhance the strength of the immune response against tumours. This review aims to elucidate the tumoricidal role of various components of the immune system, including macrophages, lymphocytes, dendritic cells and complement.     

Synthesis of potential purinoceptor antagonists: application of P1-tBU phosphazene base for alkylation of adenine in solution and on solid phase

Alkylation of adenine in solution and on solid phase was accelerated by phosphazene base P1-tBu compared to mineral bases. The reactions in solution afforded regioselectively the appropriate N9-alkylated adenines with high preparative yields while the reaction with polystyrene resin-bound N-bromoacetylated peptides gave three regioisomers (alkylated at the N9, N7, and N3 position of adenine) in a 4:2:1 molar ratio. Ten novel nonphosphate nucleotide analogues were tested in an ADP-induced platelet aggregation assay.     

Reproductive biology of the endemic cyprinid fish Hypselobarbus thomassi (Day, 1874) from Kallada River in the Western Ghats,India

The study provides new information on the reproductive biology of Hypselobarbus thomassi (Day, 1874) an endemic cyprinid fish in the Western Ghats–a biodiversity hotspot of India. A total of 384 specimens (males = 244 and females = 140) were collected monthly from April 2009 to March 2011 from Kallada River of Southern part of Western Ghats, India. Monthly sex ratio indicated that males predominated in the fishery, and an overall sex ratio was significantly different from the expected value of 1:1 (male:female = 1:0.57, x² = 28.17, p < .01). Based on the monthly analysis of gonadosomatic index (GSI) and the proportion of mature individuals, the spawning season of H. thomassi occurred between May to October with a peak in June to August. The length at first maturity (L₅₀) recorded was 290 mm TL in males and 330 mm TL in females. The absolute fecundity ranged between 305 (234 mm TL) to 1,089 (414 mm TL) and relative fecundity oscillated between 77.3–220.69 oocytes/g of fish. The fecundity established a linear relationship with total length, body weight and ovary weight. The findings of this study would be very effective to impose sustainable conservation plan for this threatened species in Kallada River and other Western Ghats river systems.