Relevant gender differences in epidemiological profile, exposure to first antiretroviral regimen and survival in the Spanish AIDS Research Network Cohort.

BACKGROUND The possible differences in the disease spectrum and prognosis of HIV infection in women and men is a major point of concern. Women are under-represented in randomized clinical trials and in some cohorts. Discordant results have often been obtained depending on the setting. METHODS We assessed gender differences in clinical and epidemiological features, antiretroviral treatment (ART) exposure and survival in two multicentre cohorts of HIV-positive subjects in Spain: CoRIS-MD and CoRIS. Competing risk regression models were used to assess gender effect on time to start ART and time to first ART change, and a Cox regression model to estimate gender effect on time to death. RESULTS Between January 1996 and December 2008, 1,953 women and 6,072 men naive to ART at study entry were included. The trend analysis over time showed the percentage of women in the younger (<20 years) and older (>50 years) strata increased significantly (P<0.001) from 0.5% and 1.8% in 1996 to 4.9% and 4.2% in 2008, respectively. By competing risk analysis women started ART earlier than men (adjusted subhazard ratio [ASHR] 1.21, 95% CI 1.11, 1.31) in CoRIS cohort, while in CoRIS-MD none of these differences were observed. In both cohorts women showed a shorter time to the first ART change (ASHR 1.10, 95% CI 1.01, 1.19). Pregnancy and patient's/physician's decisions as reasons for changing were more frequent in women than in men in CoRIS. In the Cox regression model, gender was not associated with differences in survival. CONCLUSIONS In two large cohorts in Spain, we observed relevant gender differences in epidemiological characteristics and antiretroviral exposure outcomes, while survival differences were not attributable to gender.

Uso y percepción social de los recursos naturales en la cuenca media del río Lules, provincia de Tucumán (Argentina)

És conegut que arreu del món hi ha moltes poblacions aïllades que encara viuen a partir de l’agricultura i la ramaderia de subsistència i que utilitzen tots aquells recursos del seu entorn per tal de cobrir les serves necessitats bàsiques. Aquest ús acostuma a ser insostenible, fent que l’entorn tendeixi a degradar-se cada cop més. El projecte representa una peça bàsica en la inserció del desenvolupament sostenible per a moltes d’aquestes poblacions, com és el cas de les comunes el riu Lules (Tucumán, Argentina). Basat en entrevistes i enquestes als pobladors, es fa una anàlisi estadística per determinar l’ús i la percepció de canvi que tenen els habitants, i a la vegada, es relaciona amb altres variables com el nivell socioeconòmic i l’edat, entre d’altres. Aquesta anàlisi juntament amb l’observació directa, permet fer una diagnosi de l’àrea i, conseqüentment, una llista de propostes (i desenvolupament de les més urgents) per tal de crear un pla de gestió de la zona i poder assegurar el seu desenvolupament sostenible

The Relationship between Media and Political Agendas : Variations across Decision-Making Phases

Previous studies have demonstrated that the extent to which media coverage influences the issue priorities of policy makers is contingent on the type of issue, media, and political agenda. This article contends that the relationship between media and political agendas varies across the phases of the decision-making process. Based on a comprehensive dataset on issue attention in media coverage and various policy-making channels covering the years 1996-2003, the article analyses the level of media coverage and, more importantly, the distribution and correspondence of issue attention between media and political agendas across the four successive phases of the decision-making process (initiation, preparatory, parliamentary, and referendum phases) in Switzerland. Despite inversely distributed levels of attention for successive decision-making phases, both media and political agendas are concentrated on fewer issues in the initiation and referendum phases, and they are more strongly correlated in the most decisive stages of the process, that is, the preparatory and referendum phases.

Pigment production by Streptococcus agalactiae in quasi-defined media.

A quasi-defined medium that supports the growth of Streptococcus agalactiae as pigmented colonies has been developed. The medium contains starch, a peptic digest of albumin, amino acids, nucleosides, vitamins, and salts. The presence of free cysteine, which could be replaced with other sulphur-containing compounds and to a lesser degree by reducing agents, was required for pigment formation.

Social media and political change: The case of the 2011 revolutions in Tunisia and Egypt

Throughout the past decade, social media have come on the scene of various popular revolts. Their role as tools of information and coordination of social movements, from the Iranian Green Movement in 2009 to the Arab uprisings in 2011, has been widely debated. In most cases, online activism through blogs, Facebook, Twitter or other forms of social media has allowed citizens to be part of a social networking exercise and to engage in a public sphere that would have otherwise been unreachable to them due to severe repression. In Tunisia and Egypt, social media helped protests start and expand thanks to their ability to coordinate and disseminate information quickly. The new information and communication tools were an influential factor in accelerating the revolutionary processes across the Arab world, albeit they cannot be seen as neither the spur nor the drivers of any revolution.

Aterosclerosis cérvico-cerebral subclínica: evaluación del índice REGICOR, el grosor íntima-media y el índice tobillo-brazo en la detección de sujetos en riesgo en la población

La aterosclerosis cérvico-cerebral es una de las principales causas de ictus isquémico, y por tanto, de morbimortalidad en nuestro medio. La detección de la misma en su fase asintomática mediante instrumentos como la función REGICOR, el grosor íntima-media y el índice tobillo-brazo podría mejorar las estrategias de prevención primaria. Comprobamos que, en nuestra cohorte de 933 sujetos sin antecedentes cardiovasculares, los tres factores (REGICOR≥10, GIM≥0.9, ITB≤ 0.9) se asociaron de forma independiente con la presencia de aterosclerosis cérvico-cerebral y de cualquier localización (extracraneal-intracraneal-combinada). La utilización conjunta de REGICOR e ITB podría facilitar el diagnóstico precoz de la aterosclerosis cérvico-cerebral subclínica.

Salvage Regimen With Autologous Stem Cell Transplantation With Or Without Rituximab Maintenance For Relapsed Diffuse Large B-Cell Lymphoma (Dlbcl): Coral Final Report

Times Cited: 0 References: 0 Citation MapAbstract : Background: Chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard treatment for relapsed DLBCL. No study has compared salvage therapies and evaluated maintenance post ASCT.Methods: DLBCL CD 20+ in first relapse or pts refractory after first therapy were randomized between R ICE (rituximab, ifosfamide, etoposide, carboplatinum) or R DHAP (rituximab dexamethasone cytarabine cisplatinum). Responding patients received BEAM and ASCT then randomized between observation or maintenance with rituximab every 2 m for 1 yr (Gisselbrecht J Clin Oncol; 2010).Results: Analysis was made on 477 pts (R ICE: 243 pts; R DHAP: 234 pts): 255 relapses >12m, 213 refractory/early relapses; 306 pts had prior rituximab; secondary(s) IPI 0-1: 281 pts; s IPI 2-3:181pts. There was no difference in response rate between R ICE 63.6% and R DHAP 64.3%. There was no difference between R ICE and R DHAP at 4 yrs for EFS (26% vs 37% p=0.2) and OS (43% vs 51%, p=0.3). Factors affecting 4 yrs EFS, PFS and OS were: prior treatment with rituximab; early relapse< 12 m; s IPI 2-3. ASCT was performed in 255 pts and 242 randomized for maintenance: 122 pts rituximab (R), 120 pts observation (O). Distribution between R/O arms were respectively: median age 54 /53 yrs, Male 76/83; female 46/37; secondary IPI 0-1: 84/81; sIPI 2-3: 36/36. 89/76 relapses >12m., 33/41 refractory/early relapses. Median follow up was 44 m with 111 events. 4 yrs EFS was 52.8 % (CI 46-59) with 63% (CI 56-69) OS. There was no difference in EFS, PFS and OS between R and O arms. In multivariate analysis, sIPI2-3 significantly affected EFS, PFS, OS (p=0.0004). Women (83pts) had a better 4 yrs EFS 63% than male (159pts) 37% (p=0.01). The difference was only in the R arm (p=0.004). Gender was an independent prognostic factor in the R arm. Toxicity was mild with 12% SAE versus 4% for R /O respectively.Conclusions: There was no difference between R ICE and R DHAP and between post ASCT maintenance with R or O. Women did significantly better after ASCT with rituximab. Early relapses to upfront rituximab-based chemotherapy have a poor prognosis.

Speed of reaction-diffusion fronts in spatially heterogeneous media

The front speed problem for nonuniform reaction rate and diffusion coefficient is studied by using singular perturbation analysis, the geometric approach of Hamilton-Jacobi dynamics, and the local speed approach. Exact and perturbed expressions for the front speed are obtained in the limit of large times. For linear and fractal heterogeneities, the analytic results have been compared with numerical results exhibiting a good agreement. Finally we reach a general expression for the speed of the front in the case of smooth and weak heterogeneities

La geografía en los relatos de viajes castellanos del ocaso de la Edad Media : análisis del discurso y léxico

Résumé Le travail poursuit un triple objectif: A) présenter la place qu'occupe la géographie physique et la géographie urbaine dans un corpus de cinq récits de voyages castillans de la fin du Moyen-Age, en se centrant particulièrement sur le relief, les eaux continentales, les mers, les côtes, le climat, la végétation, la faune et les villes; B) analyser les ressources discursives dont se servent les rédacteurs pour transmettre ces contenus; C) et réunir le lexique géographique des textes, en l'organisant autour des thématiques mentionnées, en définissant les mots et en faisant ressortir leur valeur dans le contexte discursif. L'étude est introduite par une analyse de la situation communicative dans laquelle se forgent les récits du corpus: contexte historique, social, culturel et textuel, d'une part; identité des voyageurs- rédacteurs, identité des destinataires, et objectifs divers aussi bien des voyages que de leur mise en écriture, d'autre part. De cette analyse ressortent quelques intentions et préoccupations communes aux voyageurs-rédacteurs qui pourraient se résumer en: A) une conscience de la difficulté du voyage; B) une conscience de réaliser un mouvement vers un monde éloigné et étrange; C) une volonté de transmettre des connaissances sur le monde; D) un désir de présenter ce qu'ils racontent comme le fruit d'une expérience vécue et de le faire avec véracité. L'analyse introductoire montre également que cette approche du voyage et la conception du récit qui en découle déterminent le choix de certains contenus géographiques et une façon précise d'exposer l'expérience du voyage: les textes transmettent des connaissances sur le monde et construisent un discours informatif sur l'espace, tout en décrivant un univers étrange et en insistant sur leur caractère testimonial. Le corps du travail est articulé en trois parties. Le premier volet permet de faire émerger la place réservée à la géographie, surtout physique, dans les récits. Il dévoile l'intérêt naissant manifesté par les voyageurs-rédacteurs pour la géographie physique et témoigne de la typologie diversifiée des descriptions urbaines. Il éclaire également le rapport intime liant les thématiques privilégiées dans les textes, les intérêts des rédacteurs et de leur public, et les objectifs de chaque récit. La géographie transmise est non-livresque, issue de l'expérience et, par conséquent, partielle. Le deuxième volet montre le fonctionnement d'une description qui est porteuse d'informations sur l'espace et qui véhicule des savoirs sur le monde, en particulier sur le monde inconnu. Les opérations de nommer, mesurer et adjectiver l'espace parcouru, en le comparant ensuite à l'espace connu sont analysées en détail. Cette partie du travail met en exergue les connaissances, les croyances et les valeurs partagées entre rédacteurs et récepteurs sur lesquelles se construit un discours destiné à transmettre de nouveaux savoirs sur le monde. Les textes se présentent, en outre, comme un témoignage basé sur l'expérience des voyageurs: l'importance de l'information acquise par l'ouïe porte les rédacteurs à incorporer dans leurs récits de nombreuses voix qui racontent le monde et fait du discours géographique un discours clairement polyphonique. Enfin, le troisième volet réunit pour la première fois le lexique géographique castillan en usage à la fin du Moyen-Âge. Procédant de textes rédigés par des non spécialistes, il nous permet d'évaluer les connaissances géographiques d'un homme de l'époque et inclut définitions, exemples d'usage des mots en contexte, données étymologiques, diachroniques, morphosyntaxiques, sémantiques et encyclopédiques. Dans son ensemble, la thèse témoigne de l'intérêt d'une approche des récits de voyage par le triple axe thématique, discursif et lexical.

DNA/NYVAC Vaccine Regimen Induces HIV-Specific CD4 and CD8 T-Cell Responses in Intestinal Mucosa

Background: HIV vaccine-candidates based on rare adenovirus serotypes such as Ad26 and Ad35 vectors, and poxvirus vectors are important components of future promising vaccine regimens that in the near future hopefully will move into a number of efficacy clinical trials in combination with protein vaccines. For these reasons, it is important to comprehensively characterize the vaccine-induced immune responses in different anatomical compartments and particularly at mucosal sites which represent the primary port of entry for HIV.Methods: In the present study, we have investigated the anatomic distribution in blood and gut mucosal tissues (rectum and ileum) of memory poxvirus-specific CD4 and CD8 T cells in subjects vaccinated with smallpox and compared with vector (NYVAC)-specific and HIV insert-specific T-cell responses induced by an experimental DNA-C/NYVAC-C vaccine regimen.Results: Smallpox-specific CD4 T-cell responses were present in the blood of 52% of subject studied, while Smallpox-specific CD8 T cells were rarely detected (12%). With one exception, Smallpoxspecific T cells were not measurable in gut tissues. Interestingly, NYVAC vector-specific and HIV-specific CD4 and CD8 T-cell responses were detected in almost 100% of the subjects immunized with DNA-C/NYVAC-C in blood and gut tissues. The large majority (83%) of NYVAC-specific CD4 T cells expressed a4b7 integrins and the HIV co-receptor CCR5.Conclusion: These results demonstrate that the experimental DNA-C/NYVAC-C HIV vaccine regimen induces the homing of potentially protective HIV-specific CD4 and CD8 T cells in the gut, the port of entry of HIV and one of the major sites for HIV spreading and depletion of CD4 T cells.

Broadcast Yourself! Internet and playful media practices

In this paper we want to present a work- in-progress research about video self production on the Internet that is part of a broader research project which explores the ways current media practices convey a 'playful' relationship with digital technologies in popular culture.

Risk Factors in Fatal Cases of Anaphylaxis due to Contrast Media: A Forensic Evaluation.

BACKGROUND: Fatalities following contrast medium exposure are extremely rare in clinical routine, though they may occur as an exception. Some may fall under the purview of the inquiring authorities and forensic pathologists due to their in-hospital occurrence. The purpose of this study was to assess the risk factors for anaphylaxis due to contrast medium administration that can be identified in fatal cases. METHODS: Fatalities occurred during the course of clinical investigations with contrast media described in the literature and fatal reactions to contrast agents that had undergone forensic investigations in our medicolegal center were reviewed with respect to patient characteristics, administered contrast medium, performed biochemical investigations and potential risk factors identified based on clinical history and medical records. RESULTS: Biochemical investigations into the fatal cases examined in our facility revealed increased mast cell tryptase, total IgE and activated mast cells in all subjects. Data obtained from the literature and our own investigations indicated that in only a minority of the fatal cases had there been previous exposure to contrast compounds, while most cases of severe anaphylaxis involved patients who apparently reacted on initial exposure. CONCLUSIONS: Most fatal cases failed to present any identifiable predisposing conditions out of those traditionally considered as risk factors for an anaphylactic reaction to contrast compounds in the medical histories of the patients. Comprehensive clinical histories and thorough reviews of medical data, along with exhaustive forensic investigations, provide information that is relevant in order to better appreciate the interwoven relationships linking all factors potentially involved in the pathogenesis of fatal anaphylaxis to contrast media. © 2014 S. Karger AG, Basel.