One world, one hope: the cost of providing antiretroviral therapy to all nations

OBJECTIVE: To estimate the potential direct cost of making triple combination antiretroviral therapy widely available to HIV-positive adults and children living in countries throughout the world. METHODS: For each country, antiretroviral costs were obtained by multiplying the annual cost of triple antiretroviral therapy by the estimated number of HIV-positive persons accessing therapy. Per capita antiretroviral costs were computed by dividing the antiretroviral costs by the country's total population. The potential economic burden was calculated by dividing per capita antiretroviral costs by the gross national product (GNP) per capita. All values are expressed in 1997 US dollars. RESULTS: The potential cost of making triple combination antiretroviral therapy available to HIV-positive individuals throughout the world was estimated to be over US$ 65.8 billion. By far the greatest financial burden was on sub-Saharan Africa. The highest per capita drug cost in this region would be incurred in the subregions of Southern Africa (US$ 149) followed by East Africa (US$ 116), Middle Africa (US$ 44), and West Africa (US$ 42). In the Americas, subregional data indicated the highest per capita drug cost would be in the Latin Caribbean (US$ 22), followed by the Caribbean (US$ 17), Andean Area (US$ 7), the Southern Cone (US$ 6), North America (US$ 6), and Central American Isthmus (US$ 5). In Asia and Europe the percentage of the GNP necessary to finance drug therapy was less than 1% in most countries examined. CONCLUSION: Our results demonstrate that the cost of making combination antiretroviral therapy available worldwide would be exceedingly high, especially in countries with limited financial resources.     

Simultaneous bleaching of vital teeth and an open-chamber nonvital tooth with 10% carbamide peroxide

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of bleaching a nonvital tooth with an open pulp chamber while simultaneously bleaching the other vital teeth with 10% carbamide peroxide. METHOD AND MATERIALS: Ten discolored nonvital teeth were treated. Each nonvital tooth was prepared as in the conventional "walking bleaching" fashion, so that the gutta-percha was sealed from the pulp chamber. The 10% carbamide peroxide was injected into the chamber of the nonvital tooth and loaded into the custom-fitted tray for all teeth. The nonvital teeth were bleached from both the inside and the outside. The patient closed the orifice with a cotton pellet during the day and changed the cotton pellet after meals. The patient applied fresh solution nightly. RESULTS: All teeth were successfully lightened. The time required to lighten the nonvital tooth was related to the duration of the discoloration. CONCLUSION: With proper patient selection and education, this technique can provide an effective way to lighten nonvital and vital teeth simultaneously, especially where extended treatment time may be required for difficult discolorations.     

Post-transcriptional gene silencing in plants

The author demands an introduction of quality assurance in biological research concerning human beings. He sketches systems which can be built into studies as a quality control. By the example of growth studies he illustrates the problems of theoretical considerations and practicability. He gives an overview of 7 questions arising in anthropometric growth studies: Why? Where? Whom? What? When? Who? and How? In connection with the final one, he discusses and analyzes the possibilities and the different ways of quality assurance in such studies.     

Health status of the over 60 years of age population and its relationship with sociodemographic factors (ANCO Project)

OBJECTIVE: To describe the health status of a population over 60 years and to study their relationship with several socio-demographic variables. DESIGN: A cross-sectional study, population based. SETTINGS: A community. PARTICIPANTS: A randomized sample of 1,103 non institutionalized people over 60 years living in the city of Cordoba (Spain). MEASUREMENTS AND MAIN RESULTS: By mean of a personal interview at home we used the OARS-MFAQ-VE questionnaire. Low self-rated health was associated with the age, to be female sex, a low cultural background, and a low income. Only 5.2% of the study people do not suffered any illness and 56% state that their health problems are major problems for doing their current activities. 4.9% declared to have some degree of physical incapacity. 3.7% of elderly population has an important cognitive deficit. CONCLUSIONS: The majority of elderly people has good health. Age is related with a poor health. Women have more health problems than men.     

Evaluation of the effectiveness of continuous renal replacement therapy in critical patients after cardiovascular surgery

The efficacy of continuous methods of renal substitute therapy (RST) in patients with multiple organ failure is assessed. The patients were divided in 2 groups administered different types of PST. Group 1 were 16 patients subjected to RST by peritoneal dialysis, in group 2 (n = 16) GP and/or GDP were used. Hemodynamics, hematological and biochemical values, and clearance of inflammation mediators were monitored and hemohydrobalance and complications of therapy assessed in the course of RST. Both RST methods proved to be highly effective. The possibility of differentiated use of peritoneal dialysis and GP/GDP permits an individual approach to treatment, and equally high efficacy of both methods solves the problem of treating total renal insufficiency in the majority of patients with multiple organ failure following cardiovascular surgery.     

Preparation and properties of heterocyclically conjugated poly(3‐hexylthiophene)–clay nanocomposite materials

A series of heterocyclically conjugated polymer–clay nanocomposite (PCN) materials that consisted of organic poly(3‐hexylthiophene) (P3HT) and inorganic montmorillonite (MMT) clay platelets were prepared by in situ oxidative polymerization with FeCl₃ as an oxidant. The as‐synthesized PCN materials were characterized by Fourier transform infrared (FTIR) spectroscopy, wide‐angle powder X‐ray diffraction (WAXRD), and transmission electron microscopy (TEM). The effects of the material composition on the anticorrosion, gas barrier, thermal stability, flammability, mechanical strength, and electrical conductivity properties of the P3HT and PCN materials were studied by electrochemical corrosion measurements, gas‐permeability analysis (GPA), thermogrametric analysis (TGA), limiting oxygen index (LOI) measurements, dynamic mechanical analysis (DMA), and a four‐point probe technique, respectively. The molecular weights of extracted and bulk P3HT were determined by gel permeation chromatography (GPC) with THF as an eluant. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 91: 3438–3446, 2004     

Improvement on thermal performance of a disk-shaped miniature heat pipe with nanofluid

The present study aims to investigate the effect of suspended nanoparticles in base fluids, namely nanofluids, on the thermal resistance of a disk-shaped miniature heat pipe [DMHP]. In this study, two types of nanoparticles, gold and carbon, in aqueous solution are used respectively. An experimental system was set up to measure the thermal resistance of the DMHP with both nanofluids and deionized [DI] water as the working medium. The measured results show that the thermal resistance of DMHP varies with the charge volume and the type of working medium. At the same charge volume, a significant reduction in thermal resistance of DMHP can be found if nanofluid is used instead of DI water.     

Film instability induced evolution of hierarchical structures in annealed ultrathin films of an asymmetric block copolymer on polar substrates

With an atomic-force microscope and a grazing-incidence small-angle X-ray scattering we studied ex situ the evolution of hierarchical structures in isothermally annealed ultrathin films of asymmetric polystyrene-block-poly(methyl methacrylate) P(S-b-MMA) that dewetted on polar substrates via a mechanism involving nucleation and growth. Film instability causes the surface to acquire an undulating thickness through incommensurability, producing not only the relief structures on a micrometer scale but also mesophase-separated domains on a nanometer scale. The dewetted morphologies strongly influence the ordering behavior of the nanoscale domains. The noncylindrical nanostructures become stable at the curved edges of the relief microstructures in the destabilized P(S-b-MMA) films, for which a preferential wetting of the PS block with the free surface is prohibited. Additionally, the shape of relief structures as result of film instability correlates with the formation of mesophase-separated nanodomains. At early stages of film instability, the formation of parallel-oriented PMMA cylindrical nanodomains increases the deformation energy and it further persists to force the shape of relief structures between irregular holes to have a facet-wedge shape. However, those relief structures are expected to be not at equilibrium. At high temperatures, the relief structures between irregular holes progressively developed to form hemispherical-cap drops accompanied by a transformation of cylindrical into noncylindrical nanodomains at curved surfaces.     

How to manipulate the electrospinning jet with controlled properties to obtain uniform fibers with the smallest diameter?—a brief discussion of solution electrospinning process

Solutions of five different polymers, namely, polystyrene (PS), polyacrylonitrile (PAN), polyhydroxybutrate (PHB), poly(D-L-lactic acid) (PLA), and Nylon6, were used to investigate their rheological properties on the electrospinnability. In order to effectively reduce the diameter of electrospun fibers, polymers with higher molecular weights (MW) were needed to develop entangled solutions at much lower concentrations and with viscosities as low as that of a pure solvent. A minimum polymer concentration 1.0–2.0 times larger than the entanglement concentration was required to prepare the bead-free fibers. Using this strategy, uniform PS fibers with the lowest ever diameter of ∼15 nm were successfully obtained using an MW of 3 × 10⁷ g/mol at a concentration of 0.1 vol.%. For a given electrospinning solution, processing variables of low flow-rate (Q) and high voltage (V) were desirable in obtaining fibers with small diameters. However, Q and V were correlated by a power law relation: V∼Q ^a, wherein the exponent a had a value of 0.1–0.4, which was relevant with the solution types. Based on the finite element analysis (FEA), a significant measure of electric field (E) occurred around the needle tip used in the experiment, and its magnitude decayed with increasing distance from the needle end (z): E∼z ⁻ⁿ. The exponent n was 1.0–2.0, depending on the needle–plate geometry, i.e., needle length, needle diameter (D _o ), plate diameter, and tip-to-plate distance (H). According to FEA results, H exhibited negligible effects on the electric field in the region of interest, i.e., z/D _o ∼1 to 10. Due to the presence of high measures of E at the needle end, approaches to render a shorter and thinner straight jet issuing from the Taylor cone to yield thinner fibers were sought because a more significant jet stretching in the “jet whipping region” can take place. A feasible route to predict the as-spun fiber diameter produced by the manipulation of the electrified jet is provided by experimentally measuring the jet diameter and numerically calculating the electric field for the jet whipping process.