Efficacy, safety and pharmacokinetic of once-daily boosted saquinavir (1500/100 mg) together with 2 nucleos(t)ide reverse transcriptase inhibitors in real life: a multicentre prospective study.

BACKGROUND. Ritonavir-boosted saquinavir (SQVr) is nowadays regarded as an alternative antiretroviral drug probably due to several drawbacks, such as its high pill burden, twice daily dosing and the requirement of 200 mg ritonavir when given at the current standard 1000/100 mg bid dosing. Several once-daily SQVr dosing schemes have been studied with the 200 mg SQV old formulations, trying to overcome some of these disadvantages. SQV 500 mg strength tablets became available at the end of 2005, thus facilitating a once-daily regimen with fewer pills, although there is very limited experience with this formulation yet. METHODS. Prospective, multicentre study in which efficacy, safety and pharmacokinetics of a regimen of once-daily SQVr 1500/100 mg plus 2 NRTIs were evaluated under routine clinical care conditions in either antiretroviral-naïve patients or in those with no previous history of antiretroviral treatments and/or genotypic resistance tests suggesting SQV resistance. Plasma SQV trough levels were measured by HPLV-UV. RESULTS. Five hundred and fourteen caucasian patients were included (47.2% coinfected with hepatitis C and/or B virus; 7.8% with cirrhosis). Efficacy at 52 weeks (plasma RNA-HIV <50 copies/ml) was 67.7% (CI95: 63.6 - 71.7%) by intention-to-treat, and 92.2% (CI95: 89.8 - 94.6%) by on-treatment analysis. The reasons for failure were: dropout or loss to follow-up (18.4%), virological failure (7.8%), adverse events (3.1%), and other reasons (4.6%). The high rate of dropout may be explained by an enrollment and follow-up under routine clinical care condition, and a population with a significant number of drug users. The median SQV Cmin (n = 49) was 295 ng/ml (range, 53-2172). The only variable associated with virological failure in the multivariate analysis was adherence (OR: 3.36; CI95, 1.51-7.46, p = 0.003). CONCLUSIONS. Our results suggests that SQVr (1500/100 mg) once-daily plus 2 NRTIs is an effective regimen, without severe clinical adverse events or hepatotoxicity, scarce lipid changes, and no interactions with methadone. All these factors and its once-daily administration suggest this regimen as an appropriate option in patients with no SQV resistance-associated mutations.

Two mechanisms of caspase 9 processing in double-stranded RNA- and virus-triggered apoptosis.

Viral double-stranded RNA (dsRNA) is a ubiquitous intracellular "alert signal" used by cells to detect viral infection and to mount anti-viral responses. DsRNA triggers a rapid (complete within 2-4 h) apoptosis in the highly-susceptible HeLa cell line. Here, we demonstrate that the apical event in this apoptotic cascade is the activation of procaspase 8. Downstream of caspase 8, the apoptotic signaling cascade bifurcates into a mitochondria-independent caspase 8/caspase 3 arm and a mitochondria-dependent, caspase 8/Bid/Bax/Bak/cytochrome c arm. Both arms impinge upon, and activate, procaspase 9 via two different cleavage sites within the procaspase 9 molecule (D330 and D315, respectively). This is the first in vivo demonstration that the "effector" caspase 3 plays an "initiator" role in the regulation of caspase 9. The dsRNA-induced apoptosis is potentiated by the inhibition of protein synthesis, whose role is to accelerate the execution of all apoptosis steps downstream of, and including, the activation of caspase 8. Thus, efficient apoptosis in response to viral dsRNA results from the co-operation of the two major apical caspases (8 and 9) and the dsRNA-activated protein kinase R (PKR)/ribonuclease L (RNase L) system that is essential for the inhibition of protein synthesis in response to viral infection.

Leptin is an anti-apoptotic effector in placental cells involving p53 downregulation.

Leptin, a peripheral signal synthetized by the adipocyte to regulate energy metabolism, can also be produced by placenta, where it may work as an autocrine hormone. We have previously demonstrated that leptin promotes proliferation and survival of trophoblastic cells. In the present work, we aimed to study the molecular mechanisms that mediate the survival effect of leptin in placenta. We used the human placenta choriocarcinoma BeWo and first trimester Swan-71 cell lines, as well as human placental explants. We tested the late phase of apoptosis, triggered by serum deprivation, by studying the activation of Caspase-3 and DNA fragmentation. Recombinant human leptin added to BeWo cell line and human placental explants, showed a decrease on Caspase-3 activation. These effects were dose dependent. Maximal effect was achieved at 250 ng leptin/ml. Moreover, inhibition of endogenous leptin expression with 2 µM of an antisense oligonucleotide, reversed Caspase-3 diminution. We also found that the cleavage of Poly [ADP-ribose] polymerase-1 (PARP-1) was diminished in the presence of leptin. We analyzed the presence of low DNA fragments, products from apoptotic DNA cleavage. Placental explants cultivated in the absence of serum in the culture media increased the apoptotic cleavage of DNA and this effect was prevented by the addition of 100 ng leptin/ml. Taken together these results reinforce the survival effect exerted by leptin on placental cells. To improve the understanding of leptin mechanism in regulating the process of apoptosis we determined the expression of different intermediaries in the apoptosis cascade. We found that under serum deprivation conditions, leptin increased the anti-apoptotic BCL-2 protein expression, while downregulated the pro-apoptotic BAX and BID proteins expression in Swan-71 cells and placental explants. In both models leptin augmented BCL-2/BAX ratio. Moreover we have demonstrated that p53, one of the key cell cycle-signaling proteins, is downregulated in the presence of leptin under serum deprivation. On the other hand, we determined that leptin reduced the phosphorylation of Ser-46 p53 that plays a pivotal role for apoptotic signaling by p53. Our data suggest that the observed anti-apoptotic effect of leptin in placenta is in part mediated by the p53 pathway. In conclusion, we provide evidence that demonstrates that leptin is a trophic factor for trophoblastic cells.

Benzodiazepinas: riesgos y estrategias para su retirada

Benzodiazepines and hypnotic Z-drugs are indicated for the short-term treatment of insomnia and anxiety (4 weeks maximum) at the lowest dose possible. Despite the recommendations for short-term use and its unfavourable effects, the level of consumption of benzodiazepines in our context is high and it is continually rising. Prolonged medication usage is associated with adverse effects and significant risks, particularly in the elderly, and should, therefore, be avoided when approaching new treatment. If a previous treatment assessed is found to be inappropriate, its possible withdrawal must be considered. Benzodiazepines withdrawal is based on a gradual dose reduction and should be managed by establishing a doctor-patient relationship of trust to encourage and accomplish discontinuation.

Tratamiento farmacológico de la EPOC estable

Pharmacological treatment of patients with stable COPD should be individualised. Inhaled bronchodilators are the mainstay of pharmacological treatment for COPD. Long-acting medications (LABA or LAMA) are recommended over short-acting agents (SABA or SAMA). Short-acting bronchodilators are used on demand to rapidly control symptoms regardless of level of severity. Long-acting bronchodilators are used as maintenance therapy and are the mainstay of treatment in patients with permanent symptoms. Initial treatment for COPD is monotherapy with a long-acting bronchodilator. Clinical practice guidelines do not specify the best bronchodilator to use. The choice should be made on an individual basis, taking into account the patient’s preferences, response to treatment, its potential side effects and cost. When monotherapy fails to control symptoms, the first recommended step is to check medication adherence, inhaler technique and adequacy of inhalation device, and if these are correct but monotherapy is still insufficient, treatment should be intensified with combined inhaled therapies. Most clinical practice guidelines recommend the use of long-term therapy with LABA+inhaled corticosteroids in patients who experience frequent exacerbations and with FEV1 <50%. Long-term monotherapy with inhaled corticosteroids or oral corticosteroids is not recommended, and neither is the regular use of mucolytics nor the use of roflumilast.

Disseny i desenvolupament d'un sistema per la identificació de compradors en processos de subhasta mitjançant IR

Disseny i desenvolupament d’un sistema per a la identificació de compradors en processos de subhasta, integrable dins d’un sistema de subhasta automatitzada

La gestió dels llibres electrònics a la Biblioteca virtual de la UOC

El text que es presenta mostra com es du a terme la gestió dels llibres electrònics a la Biblioteca virtual (d'ara endavant BV) de la Universitat Oberta de Catalunya (d'ara endavant UOC). La BV posa un èmfasi especial en l'adquisició de llibres digitals per millorar l'accés als usuaris als recursos i col¿leccions d'una universitat que es caracteritza per la virtualitat. El document presenta, en primer lloc, l'entorn en què s'adquireixen i s'utilitzen els llibres electrònics: s'expliquen els diferents escenaris d'adquisició en els quals es pot trobar la biblioteca i es defineixen els circuits interns que en permeten la gestió i els processos tècnics dels documents. A continuació es mostren les diferents opcions d'accés i consulta de llibres electrònics que actualment s'ofereixen des de la biblioteca i s'expliquen les anàlisis d'usos d'aquests documents. Finalment es presenten les conclusions a les quals arriba la BV sobre el nou context de llibres electrònics.

Heterogeneity as a coordination device

A model of directed search with a finite number of buyers and sellers is considered, where sellers compete in direct mechanisms. Buyer heterogeneity and Nash equilibrium results in perfect sorting. The restriction to complementary inputs, that the match value function Q is supermodular, in addition coordinates the sellers strategies. In that case, equilibrium implements positive assortative matching, which is efficient and consistent with the stable (cooperative equilibrium) outcome. This provides a non-cooperative and decentralizedsolution for the Assignment Game. Conversely, if buyers are identical, no such coordination is possible, and there is a continuum of equilibria, one of which exhibits price posting, another yields competition in auctions.

Network revenue management with product-specific no-shows

Revenue management practices often include overbooking capacity to account for customerswho make reservations but do not show up. In this paper, we consider the network revenuemanagement problem with no-shows and overbooking, where the show-up probabilities are specificto each product. No-show rates differ significantly by product (for instance, each itinerary andfare combination for an airline) as sale restrictions and the demand characteristics vary byproduct. However, models that consider no-show rates by each individual product are difficultto handle as the state-space in dynamic programming formulations (or the variable space inapproximations) increases significantly. In this paper, we propose a randomized linear program tojointly make the capacity control and overbooking decisions with product-specific no-shows. Weestablish that our formulation gives an upper bound on the optimal expected total profit andour upper bound is tighter than a deterministic linear programming upper bound that appearsin the existing literature. Furthermore, we show that our upper bound is asymptotically tightin a regime where the leg capacities and the expected demand is scaled linearly with the samerate. We also describe how the randomized linear program can be used to obtain a bid price controlpolicy. Computational experiments indicate that our approach is quite fast, able to scale to industrialproblems and can provide significant improvements over standard benchmarks.

Credit constraints in general equilibrium: Experimental results

Our work attempts to investigate the influence of credit tightness orexpansion on activity and relative prices in a multimarket set-up. We report on somedouble- auction, two-market experiments where subjects had to satisfy an inequalityinvolving the use of credit. The experiments display two regimes, characterizedby high and low credit availability. The critical value of credit at the commonboundary of the two regimes has a compelling interpretation as the maximal credituse at the Arrow-Debreu equilibrium of the abstract economy naturally associatedto our experimental environment. Our main results are that changes in theavailability of credit: (a): have minor and unsystematic effects on quantitiesand relative prices in the high-credit regime, (b): have substantial effects, bothon quantities and relative prices, in the low-credit regime.

Dynamic price competition with fixed capacities

Many revenue management (RM) industries are characterized by (a) fixed capacities in theshort term (e.g., hotel rooms, seats on an airline flight), (b) homogeneous products (e.g., twoairline flights between the same cities at similar times), and (c) customer purchasing decisionslargely influenced by price. Competition in these industries is also very high even with just twoor three direct competitors in a market. However, RM competition is not well understood andpractically all known implementations of RM software and most published models of RM donot explicitly model competition. For this reason, there has been considerable recent interestand research activity to understand RM competition. In this paper we study price competitionfor an oligopoly in a dynamic setting, where each of the sellers has a fixed number of unitsavailable for sale over a fixed number of periods. Demand is stochastic, and depending on howit evolves, sellers may change their prices at any time. This reflects the fact that firms constantly,and almost costlessly, change their prices (alternately, allocations at a price in quantity-basedRM), reacting either to updates in their estimates of market demand, competitor prices, orinventory levels. We first prove existence of a unique subgame-perfect equilibrium for a duopoly.In equilibrium, in each state sellers engage in Bertrand competition, so that the seller withthe lowest reservation value ends up selling a unit at a price that is equal to the equilibriumreservation value of the competitor. This structure hence extends the marginal-value conceptof bid-price control, used in many RM implementations, to a competitive model. In addition,we show that the seller with the lowest capacity sells all its units first. Furthermore, we extendthe results transparently to n firms and perform a number of numerical comparative staticsexploiting the uniqueness of the subgame-perfect equilibrium.

Noise and aggregation of information in large markets

We study a novel class of noisy rational expectations equilibria in markets with largenumber of agents. We show that, as long as noise increases with the number of agents inthe economy, the limiting competitive equilibrium is well-defined and leads to non-trivialinformation acquisition, perfect information aggregation, and partially revealing prices,even if per capita noise tends to zero. We find that in such equilibrium risk sharing and price revelation play dierent roles than in the standard limiting economy in which per capita noise is not negligible. We apply our model to study information sales by a monopolist, information acquisition in multi-asset markets, and derivatives trading. Thelimiting equilibria are shown to be perfectly competitive, even when a strategic solutionconcept is used.

Vantagens de uma empresa estar cotada na Bolsa de Valores de Cabo Verde

É de conhecimento de todos, ou pelo menos daqueles que estão mais atentos às questões de natureza económica, que um dos grandes desafios das empresas nos dias que correm, é garantirem a sua sustentabilidade financeira no longo prazo. Nesse sentido, são várias as estratégias elaboradas pelos responsáveis das diversas empresas, e decisores políticos, no sentido colmatar esta dificuldade. Cabo Verde, como país de Desenvolvimento Médio, muito dependente do exterior, apresenta muitas dificuldades em gerar recursos que garantam a sustentabilidade da sua economia. Como forma de reestruturar e dinamizar a economia e o tecido empresarial nacional, foi reaberta em 2005 a Bolsa de Valores de Cabo Verde. E para retratar o impato positivo da sua reabertura, referir que nesse mesmo ano, a Sociedade Caboverdiana de Tabacos, S.A., realizou na Bolsa de Valores de Cabo Verde, uma Oferta Pública de Venda, que segundo os analístas, foi muito superior a oferta, deixando assim, uma ideia clara de que este, com mais incentivo, tem margem de crescimento. Este trabalho visa numa primeira parte caraterizar o mercado de capitais em Cabo Verde, onde está inserida a Bolsa de Valores Local. Num segundo momento, pretendese fazer uma resenha bibliográfica dos principais métodos de avaliação das empresas e de seguida procurar-se, através de um estudo de caso, a Sociedade Cabo-verdiana de Tabacos, identificar algumas possíveis vantagens provenientes da sua entrada na Bolsa de Valores, mediante a avaliação de alguns indicadores de desempenho da empresa. It is known to all, or at least to those who are more attentive to the matters of economic issues, that one of the biggest problems facing companies today is to ensure their financial sustainability. Accordingly, there are several strategies drawn up by leaders of various companies in order to face this difficulty. Cape Verde, as a medium-developed country, is very dependent on other countries‟ help and has great difficulty in generating resources that guarantee a good and healthy economy. As a way to restructure the economy and minimize some financial problems, in 2005 the Stock Exchange of Cape Verde was reopened, to remedy this deficiency. For one to have a clear idea of the importance of this reopening, we can look at the example of Sociedade Caboverdiana de Tabacos – tobacco national company – that, still in this year, has made a bid on Stock Exchange, which, according to specialists, demonstrated an offer a lot greater than the demand, clearly a sign that this company, has a great margin for growth, if it has more financial incentives. This paper seeks to demonstrate and characterize the capital market of Cape Verde, where we will find the National Stock Exchange. Secondly, we intend to make a bibliographical research of the main assessment methods companies use here, to finally, through a case study, at SCT, identify possible advantages that might come from being listed in the Stock Exchange, through the analysis of some performance indicators from this company.

The evolution of conventions under incomplete information

We formulate an evolutionary learning process in the spirit ofYoung (1993a) for games of incomplete information. The process involves trembles. For many games, if the amount of trembling is small, play will be in accordance with the games' (semi-strict) Bayesian equilibria most of the time. This supports the notion of Bayesian equilibrium. Further, often play will most of the time be in accordance with exactly one Bayesian equilibrium. This gives a selection among the Bayesian equilibria. For two specific games of economic interest wecharacterize this selection. The first is an extension to incomplete information of the prototype strategic conflict known as Chicken. The second is an incomplete information bilateral monopoly, which is also an extension to incompleteinformation of Nash's demand game, or a simple version ofthe so-called sealed bid double auction. For both gamesselection by evolutionary learning is in favor of Bayesianequilibria where some types of players fail to coordinate, such that the outcome is inefficient.

Ignorance promotes competition: An auction model with endogenous private valuations

We study a situation in which an auctioneer wishes to sell an object toone of N risk-neutral bidders with heterogeneous preferences. Theauctioneer does not know bidders preferences but has private informationabout the characteristics of the ob ject, and must decide how muchinformation to reveal prior to the auction. We show that the auctioneerhas incentives to release less information than would be efficient andthat the amount of information released increases with the level ofcompetition (as measured by the number of bidders). Furthermore, in aperfectly competitive market the auctioneer would provide the efficientlevel of information.