Reprocessing data to form QALYs.

OBJECTIVES--To determine whether reprocessing data from published sources into quality adjusted life years (QALYs), as recommended in The QALY Toolkit, is a useful method of helping purchasing authorities to determine the most cost effective pattern of care to buy for their populations. SETTING--United Kingdom. DESIGN--The method was tested for six elective surgical conditions; data from published studies were reprocessed into the Rosser index, to obtain values for change in quality of life. These were then used to form QALYs. A small validation exercise was carried out. MAIN OUTCOME MEASURES--QALYs formed from the Rosser index. RESULTS--Published data could not be found for three interventions (cataract surgery, inguinal hernia repair, varicose vein surgery). For the remainder (prostatectomy, hip replacement, and knee replacement) data were found which could be reprocessed to form QALYs, though it was often hard to compare data from different studies and many assumptions had to be made. CONCLUSION--The value of QALY results obtained by this method is questionable, given the large number of assumptions which had to be made. For many interventions published data are unlikely to be available.     

Isolation and characterization of a diuretic peptide from Acheta domesticus. Evidence for a family of insect diuretic peptides.

A diuretic peptide (Acheta-DP) has been isolated from extracts of whole heads of the house cricket, Acheta domesticus. The native peptide increases both cyclic AMP production and the rate of fluid secretion by isolated Malpighian tubules in vitro to an extent comparable with those responses obtained with supra-maximal amounts of crude extracts of corpora cardiaca. The primary structure of Acheta-DP was established as a 46-residue amidated peptide: TGAQSLSIVAPLDVLRQRLMNELNRRRMRELQGSRIQQNRQLLTSI-NH2. Acheta-DP has 41% sequence identity with a diuretic peptide isolated from Manduca sexta, providing direct evidence for the presence of a family of diuretic peptides in insects.     

Influence of body size on oxygen consumption during bicycling

Energy in bicycling is primarily expended to overcome air resistance, which is proportional to a cyclist's surface area (SA). Thus we hypothesized that large cyclists should have a lower O2 consumption normalized to body weight (VO2/BW) than small cyclists because of the former's lower SA/BW. We measured the VO2/BW of small (BW = 59.4 +/- 4.1 kg) and large (BW = 84.4 +/- 3.2 kg) cyclists while they bicycled on a flat road at 10, 15, and 20 mph. The large cyclists had a 22% lower VO2/BW than the small cyclists at all speeds. However, the SA/BW ratio of the large cyclists was only 11% lower than that of the small cyclists. We then photographically determined the frontal area (FA) of the cyclists in a racing posture, and found that the large cyclists had a 16% lower FA/BW ratio than the small cyclists. We conclude that large cyclists are at a distinct advantage, in terms of VO2/BW, while bicycling on level roads, and this advantage is principally due to their lower FA/BW ratio.     

Transactional Sex Risk across a Typology of Rural and Urban Female Sex Workers in Indonesia: A Mixed Methods Study

Context-specific typologies of female sex workers (FSWs) are essential for the design of HIV intervention programming. This study develops a novel FSW typology for the analysis of transactional sex risk in rural and urban settings in Indonesia. Mixed methods include a survey of rural and urban FSWs (n = 310), in-depth interviews (n = 11), key informant interviews (n = 5) and ethnographic assessments. Thematic analysis categorises FSWs into 5 distinct groups based on geographical location of their sex work settings, place of solicitation, and whether sex work is their primary occupation. Multiple regression analysis shows that the likelihood of consistent condom use was higher among urban venue-based FSWs for whom sex work is not the only source of income than for any of the other rural and urban FSW groups. This effect was explained by the significantly lower likelihood of consistent condom use by rural venue-based FSWs (adjusted OR: 0.34 95% CI 0.13–0.90, p = 0.029). The FSW typology and differences in organisational features and social dynamics are more closely related to the risk of unprotected transactional sex, than levels of condom awareness and availability. Interventions need context-specific strategies to reach the different FSWs identified by this study''s typology.     

Comparison of insect kinin analogs with cis-peptide bond motif 4-aminopyroglutamate identifies optimal stereochemistry for diuretic activity

The insect kinins are present in a wide variety of insects and function as potent diuretic peptides, though they are subject to rapid degradation by internal peptidases. Insect kinin analogs incorporating stereochemical variants of (2S,4S)-4-aminopyroglutamate (APy), a cis-peptide bond motif, demonstrate significant activity in a cricket diuretic assay. Insect kinin analogs containing (2R,4R)-APy, (2S,4R)-APy and (2S,4S)-APy are essentially equipotent on an insect diuretic assay, with EC(50) values of about 10(-7)M, whereas the (2R,4S)-APy analog is at least 10-fold more potent (EC(50) = 7 x 10(-9)M). Conformational studies in aqueous solution indicate that the (2R,4S)-APy analog is considerably more flexible than the other three variants, which may explain its greater potency. The work identifies the optimal stereochemistry for the APy scaffold with which to design biostable, peptidomimetic analogs with the potential to disrupt critical insect kinin-regulated processes in insects.     

Beta-amino acid analogs of an insect neuropeptide feature potent bioactivity and resistance to peptidase hydrolysis

Insect neuropeptides of the insect kinin class share a common C-terminal pentapeptide sequence F(1)X(1)(2)X(2)(3)W(4)G(5)-NH(2) (X(2)(3) = P, S, A) and regulate such critical physiological processes as water balance and digestive enzyme release. Analogs of the insect kinin class, in which the critical residues of F(1), P(3), and W(4) were replaced with beta(3)-amino acid or their beta(2)-homo-amino acid variants, have been synthesized by the solid phase peptide strategy. The resulting single- and double-replacement analogs were evaluated in an insect diuretic assay and enzyme digestion trials. Analogs modified in the core P(3) position produce a potent and efficacious diuretic response that is not significantly different from that obtained with the endogenous achetakinin peptides. The analogs also demonstrate enhanced resistance to hydrolysis by ACE and NEP, endopeptidases that inactivate the natural insect neuropeptides. This paper describes the first instance of beta-amino acids analogs of an arthropod peptide that demonstrate significant bioactivity and resistance to peptidase degradation.     

Effect of recovery interval on multiple-bout sprint cycling performance after acute creatine supplementation

The purpose of this study was to examine the effect of varying recovery intervals on multiple-bout, short-duration, high-intensity cycling efforts of adult men supplemented with creatine (Cr) or a placebo (Pl). Thirty subjects underwent 3 trials of a maximal cycling protocol (T(0), T(1), T(2)). T(0) included V(O)2 max testing and familiarization with the sprint cycling protocol. T(1) consisted of 8 15-second bouts of sprint cycling exercise. Subjects were randomly assigned to recovery interval groups (1 minute, 3 minutes, 6 minutes), and Cr or Pl groups (0.3 g x kg(-1) x d(-1)). Posttesting (T(2)) took place 7 days after T(1) and consisted of an identical protocol as during T(1). Changes in mean power (MP), peak power (PP), and fatigue index (FI) were compared between trials. MP was significantly increased in Cr 1-minute, Cr 3-minute, and Pl 6-minute groups (p < 0.05). Significant PP increases were demonstrated in Cr 1-minute and Pl 6-minute groups (p < 0.05), and FI significantly increased in Pl 1-minute group (p < 0.05). Results indicate that Cr supplementation is effective in improving recovery from repeated sprint cycling performances when the recovery interval is of a short (<6 minutes) duration.     

Maasai Socioeconomic Conditions: A Cross-Border Comparison

A single round household survey was conducted between October 1997 and May 1998. Information was collected on 1545 Maasai households in Kenya and Tanzania using a standardized questionnaire. These data represent the first large-scale, cross-border comparable survey of socioeconomic indicators for the Maasai. The structure of the study is similar to that of a natural experiment: one ethnic group living in two very different nation-states. The survey results describe a current snapshot of Maasai livelihoods. Living arrangements are described at both the household (olmarei) and multihousehold (enkang) level, together with changes in housing type. The roles of cultivation, transhumant migration, and employment are described, including a consideration of the prevalence of murranism (warriorhood). The implications of rising levels of sedentarization and cash crop production for Maasai economic diversification are explored. Participation by Maasai in the tourism industry is extremely low despite the proximity of Maasai to major international tourist destinations in East Africa. Levels of formal education show a marked sex bias in completed primary school education in both countries, with far fewer women than men having attended school.     

A C-terminal aldehyde insect kinin analog enhances inhibition of weight gain and induces significant mortality in Helicoverpa zea larvae

The first reported examples of C-terminal aldehyde analogs of an insect neuropeptide are described. They are hexapeptide insect kinin analogs Boc-VFFPWG-H and Fmoc-RFFPWG-H. Activity observed for these modified analogs in an in vitro insect diuretic assay confirms that the C-terminal aldehyde group is tolerated by an insect kinin receptor. The two analogs demonstrate greatly enhanced activity over standard C-terminal amide insect kinins in a larval weight gain inhibition assay in the corn earworm Helicoverpa zea. Treatment with Boc-VFFPWG-H led to significant increases in larval mortality at doses of 500pm (45%) and 5nm (67%). Boc-VFFPWG-H represents a lead analog in the development of novel, environmentally friendly pest insect management agents based on the insect kinin class of neuropeptides.