\n\nMethods: Based on the trial data, a Markov
model was constructed where the risk of myocardial infarction, revascularization procedures and stroke and the long-term costs, quality of life and mortality associated with these events were estimated. Transition probabilities and costs (E, year 2007 values) were based on the patient-level Fludarabine datasheet trial data. Outcomes were reported as life-years gained and QALYs. In the latter case, utility reduction from events was based on a substudy in ASCOT patients. Treatment was applied for the duration of the lipid-lowering arm of the trial (3 years) and patients were then followed to the end of their life.\n\nResults: Amlodipine-based therapy plus atorvastatin was the most expensive but also most effective treatment. Compared with amlodipine-based therapy alone, the cost to gain one QALY was (sic)11965 in the UK and (sic)8591 in Sweden. The incremental cost effectiveness of amlodipine-based therapy compared with atenolol-based therapy was (sic)9548 and (sic)3965 per QALY gained in the UK and Sweden, respectively. Atenolol-based therapy plus atorvastatin was eliminated through extended dominance.\n\nConclusion: Applying the threshold values used by the National Institute for Health and Clinical Excellence
(NICE) and the Swedish National Board of Health and Welfare, a combination of amlodipine-based therapy and atorvastatin appears to be cost effective in patients buy LY411575 with hypertension and three or more additional risk factors.”
“Recent temperature histories and benthic surveys of Madagascar’s coral reefs S63845 are presented from 3 disparate regions in order to develop an understanding of the relationship between sea surface temperature (SST) and benthic cover, coral diversity, and community structure. Results indicate the presence of distinct temperature zones influenced by windward and
seaward positions, latitude, intra- and inter-annual cycles, and local hydrodynamics. Southwest reefs had SSTs with the lowest mean, highest variation, fastest rise, strongest periodicities and highest cumulative degree heating weeks during recent warm events. These reefs were distinguished by a low number of coral taxa and a high cover of erect algae and had recently undergone a major decline in coral cover and change in community structure. Northwestern and eastern reefs had SSTs with moderate means and variation, lower temperature rises, and weaker periodicities. They also had higher coral cover and numbers of coral genera, and communities more typical of Indian Ocean coral communities undisturbed by temperature anomalies.