Combination antiretroviral therapy -associated lipodystrophy : insights into pathogenesis and treatment

Introduction: Combination antiretroviral therapy (cART) has decreased morbidity and mortality of individuals infected with human immunodeficiency virus type 1 (HIV-1). Its use, however, is associated with adverse effects which increase the patients risk of conditions such as diabetes and coronary heart disease. Perhaps the most stigmatizing side effect is lipodystrophy, i.e., the loss of subcutaneous adipose tissue (SAT) in the face, limbs and trunk while fat accumulates intra-abdominally and dorsocervically. The pathogenesis of cART-associated lipodystrophy is obscure. Nucleoside reverse transcriptase inhibitors (NRTI) have been implicated to cause lipoatrophy via mitochondrial toxicity. There is no known effective treatment for cART-associated lipodystrophy during unchanged antiretroviral regimen in humans, but in vitro data have shown uridine to abrogate NRTI-induced toxicity in adipocytes. Aims: To investigate whether i) cART or lipodystrophy associated with its use affect arterial stiffness; ii) lipoatrophic SAT is inflamed compared to non-lipoatrophic SAT; iii) abdominal SAT from patients with compared to those without cART-associated lipoatrophy differs with respect to mitochondrial DNA (mtDNA) content, adipose tissue inflammation and gene expression, and if NRTIs stavudine and zidovudine are associated with different degree of changes; iv) lipoatrophic abdominal SAT differs from preserved dorsocervical SAT with respect to mtDNA content, adipose tissue inflammation and gene expression in patients with cART-associated lipodystrophy and v) whether uridine can revert lipoatrophy and the associated metabolic disturbances in patients on stavudine or zidovudine based cART. Subjects and methods: 64 cART-treated patients with (n=45) and without lipodystrophy/-atrophy (n=19) were compared cross-sectionally. A marker of arterial stiffness, heart rate corrected augmentation index (AgIHR), was measured by pulse wave analysis. Body composition was measured by magnetic resonance imaging and dual-energy X-ray absorptiometry, and liver fat content by proton magnetic resonance spectroscopy. Gene expression and mtDNA content in SAT were assessed by real-time polymerase chain reaction and microarray. Adipose tissue composition and inflammation were assessed by histology and immunohistochemistry. Dorsocervical and abdominal SAT were studied. The efficacy and safety of uridine for the treatment of cART-associated lipoatrophy were evaluated in a randomized, double-blind, placebo-controlled 3-month trial in 20 lipoatrophic cART-treated patients. Results: Duration of antiretroviral treatment and cumulative exposure to NRTIs and protease inhibitors, but not the presence of cART-associated lipodystrophy, predicted AgIHR independent of age and blood pressure. Gene expression of inflammatory markers was increased in SAT of lipodystrophic as compared to non-lipodystrophic patients. Expression of genes involved in adipogenesis, triglyceride synthesis and glucose disposal was lower and of those involved in mitochondrial biogenesis, apoptosis and oxidative stress higher in SAT of patients with than without cART-associated lipoatrophy. Most changes were more pronounced in stavudine-treated than in zidovudine-treated individuals. Lipoatrophic SAT had lower mtDNA than SAT of non-lipoatrophic patients. Expression of inflammatory genes was lower in dorsocervical than in abdominal SAT. Neither depot had characteristics of brown adipose tissue. Despite being spared from lipoatrophy, dorsocervical SAT of lipodystrophic patients had lower mtDNA than the phenotypically similar corresponding depot of non-lipodystrophic patients. The greatest difference in gene expression between dorsocervical and abdominal SAT, irrespective of lipodystrophy status, was in expression of homeobox genes that regulate transcription and regionalization of organs during embryonal development. Uridine increased limb fat and its proportion of total fat, but had no effect on liver fat content and markers of insulin resistance. Conclusions: Long-term cART is associated with increased arterial stiffness and, thus, with higher cardiovascular risk. Lipoatrophic abdominal SAT is characterized by inflammation, apoptosis and mtDNA depletion. As mtDNA is depleted even in non-lipoatrophic dorsocervical SAT, lipoatrophy is unlikely to be caused directly by mtDNA depletion. Preserved dorsocervical SAT of patients with cART-associated lipodystrophy is less inflamed than their lipoatrophic abdominal SAT, and does not resemble brown adipose tissue. The greatest difference in gene expression between dorsocervical and abdominal SAT is in expression of transcriptional regulators, homeobox genes, which might explain the differential susceptibility of these adipose tissue depots to cART-induced toxicity. Uridine is able to increase peripheral SAT in lipoatrophic patients during unchanged cART.

Divergencies of Perception : The Possibilities of Merleau-Pontian Phenomenology in Analyses of Contemporary Art

Maurice Merleau-Ponty (1908-1961) has been known as the philosopher of painting. His interest in the theory of perception intertwined with the questions concerning the artist s perception, the experience of an artwork and the possible interpretations of the artwork. For him, aesthetics was not a sub-field of philosophy, and art was not simply a subject matter for the aesthetic experience, but a form of thinking. This study proposes an opening for a dialogue between Merleau-Pontian phenomenology and contemporary art. The thesis examines his phenomenology through certain works of contemporary art and presents readings of these artworks through his phenomenology. The thesis both shows the potentiality of a method, but also engages in the critical task of finding the possible limitations of his approach. The first part lays out the methodological and conceptual points of departure of Merleau-Ponty s phenomenological approach to perception as well as the features that determined his discussion on encountering art. Merleau-Ponty referred to the experience of perceiving art using the notion of seeing with (voir selon). He stressed a correlative reciprocity described in Eye and Mind (1961) as the switching of the roles of the visible and the painter. The choice of artworks is motivated by certain restrictions in the phenomenological readings of visual arts. The examined works include paintings by Tiina Mielonen, a photographic work by Christian Mayer, a film by Douglas Gordon and Philippe Parreno, and an installation by Monika Sosnowska. These works resonate with, and challenge, his phenomenological approach. The chapters with case studies take up different themes that are central to Merleau-Ponty s phenomenology: space, movement, time, and touch. All of the themes are interlinked with the examined artworks. There are also topics that reappear in the thesis, such as the notion of écart and the question of encountering the other. As Merleau-Ponty argued, the sphere of art has a particular capability to address our being in the world. The thesis presents an interpretation that emphasises the notion of écart, which refers to an experience of divergence or dispossession. The sudden dissociation, surprise or rupture that is needed in order for a meeting between the spectator and the artwork, or between two persons, to be possible. Further, the thesis suggests that through artworks it is possible to take into consideration the écart, the divergence, that defines our subjectivity.

Clan-based evolutionary approach for solving control problems

This paper presents a dan-based evolutionary approach for solving control problems. Three selected control problems, viz. linear-quadratic, harvest, and push-cart problems, are solved using the proposed approach. Results are compared with those of the evolutionary programming (EP) approach. In most of the cases, the proposed approach is successful in obtaining (near) optimal solutions for these selected problems.

An Optimal Fuzzy Logic Controller tuned with Artificial Immune System

In this paper, a method for the tuning the membership functions of a Mamdani type Fuzzy Logic Controller (FLC) using the Clonal Selection Algorithm(CSA) a model of the Artificial Immune System(AIS) paradigm is examined. FLC's are designed for two problems, firstly the linear cart centering problem and secondly the highly nonlinear inverted pendulum problem. The FLC tuned by AIS is compared with FLC tuned by GA. In order to check the robustness of the designed PLC's white noise was added to the system, further, the masses of the cart and the length and mass of the pendulum are changed. The PLC's were also tested in the presence of faulty rules. Finally, Kruskal Wallis test was performed to compare the performance of the GA and AIS. An insight into the algorithms are also given by studying the effect of the important parameters of GA and AIS.

Les attributs et contextes d'utilisation du travail collaboratif

Résumé: Le travail collaboratif s’invite à présent partout, et est identifié dans des domaines aussi multiples que variés. Dans le monde de l’entreprise, de la prise en charge médico-sociale, de l’éducation / formation, de la recherche, de l’économie, de la politique, de la gestion de carrière… etc. Ce travail vise dans un premier temps à décliner ce qu’est la collaboration, ses caractéristiques, ses contextes d’utilisation, et la façon dont elle se différencie des autres formes d’organisation (coopération et compétition notamment). Dans un deuxième temps, il réexamine la question de la nouveauté du travail collaboratif à la lumière des résultats obtenus. S’il est assez évident que les « ingrédients », les attributs du travail collaboratif ne sont pas nouveaux (le développement informatique mis à part), il semble en revanche que les combinaisons rencontrées et les domaines d’application génèrent de nouvelles questions. Pour finir, en s’inspirant des termes associés à collaboration, il considère quelques-uns des nouveaux enjeux dans la sphère professionnelle.

El poder de la palabra

Resumen: La palabra se presenta para Merleau-Ponty como el vehículo de las vivencias corporales hacia la expresión. En ella reside un poder oculto que permite decir el mundo. Mediante una “secreta torsión” de las significaciones adquiridas es posible instituir una nueva significación. El presente artículo buscará exhibir dicho poder misterioso del lenguaje que se hace manifiesto en una expresión creadora en la que aparece un excedente de lo que se va a decir sobre lo dicho. Ese excedente es la esencia en estado viviente. Para manifestar el fenómeno milagroso del lenguaje nos serviremos de la obra de Proust: À la recherche du temps perdu

Probabilistic inference for fast learning in control

A novel framework is provided for very fast model-based reinforcement learning in continuous state and action spaces. It requires probabilistic models that explicitly characterize their levels of condence. Within the framework, exible, non-parametric models are used to describe the world based on previously collected experience. It demonstrates learning on the cart-pole problem in a setting where very limited prior knowledge about the task has been provided. Learning progressed rapidly, and a good policy found after only a small number of iterations.

Survey of the fatty acid composition of Canadian beef: Backfat and longissimus lumborum muscle

[EN]A survey of Canadian retail beef was undertaken with emphasis on the trans fatty acid (TFA) and conjugated linoleic acid (CLA) isomers, and compared with current health recommendations. Thirty striploin steaks were collected in the winter and summer from major grocery stores in Calgary (Alberta, Canada). Steak fatty acid compositions (backfat and longissimus lumborum muscle analysed separately) showed minor seasonal differences with lower total saturates (PB0.05) and higher total monounsaturates (PB 0.01) in winter, but no differences in total polyunsaturated fatty acids. The ratio of n-6 and n-3 polyunsaturated fatty acid in longissimus lumborum averaged 5.8. The average TFA content in longissimus lumborum was 0.128 g 100 g_1 serving size, and 10t-18:1 was found to be the predominant isomer (32% of total trans), while vaccenic acid was second most abundant (15% of total trans). The CLA content in longissimus lumborum was similar to that of backfat, ranging from 0.43 to 0.60% of total fatty acids and rumenic acid represented 60% of total isomers. Overall, there is still room for improvement in the saturated, mono- and polyunsaturated fatty acid composition of Canadian beef to meet general dietary guidelines for human consumption and additional targets should include reducing 10t-18:1 while increasing both rumenic and vaccenic acids.

Extended ageing time and temperature effects on quality of sub-primal cuts of boxed beef

[EN]Most of the information indicating ageing improves tenderness has been collected on the loin and rib-eye muscles over relatively short ageing times, assuming that all muscles will react similarly. In the present study, the effect of extended ageing times on instrumental texture (56 d) and sensory characteristics (42 d) of six different beef sub-primals [striploin (SL), inside round (IR), outside round (OR), eye of round (ER), blade eye (BE) and chuck tender (CT)] was studied. The effects of two ageing temperatures (1and 58C) were also compared. In general, ageing increased tenderness (P<0.05) of SL, BE, ER and CT sub-primals, although BE shear force increased after 42 d of ageing. On the other hand, ageing had no effect on IR tenderness (P<0.05) and resulted in a decrease in tenderness of OR (P<0.05) until day 35, with a later increase after 42 d of ageing. Increasing ageing temperature (58C) had limited effect on tenderness, but ageing time and temperature increases led to lower flavour and higher off-flavour intensity (P<0.05) of the studied sub-primals. These results suggest that cutspecific maximum ageing times and rigid adherence to temperature maximums would be of benefit to optimize postslaughter processes and meat quality

Labores forestales en Gipuzkoa durante los siglos XVI-XVIII

Número monográfico publicado bajo el título:" Mendia, gizartea eta kultura. Montaña, sociedad y cultura. Montagne, societé et culture".

La historiografía forestal sobre época moderna en el panorama internacional, español y vasco: una revisión bibliográfica

Manex Goihenetcheri omenaldia = Homenaje a Manex Goihenetche = Hommage a Manex Goihenetche

El proceso de institucionalización de las cofradías guipuzcoanas durante la Edad Moderna: Cofradías de mareantes y de podavines

Ejemplar dedicado a: El trabajo en Euskal Herria, VI Jornadas de Estudios histórico-locales.

La cocina del amor: alimentos afrodisiacos en la antigua Grecia

Presentado en el Simposio "La imagen del sexo en la antigüedad: ciclos de renovación de la vida", organizado por el Instituto de Historia del CSIC y celebrado en Barcelona del 21 al 23 de marzo de 2002.

El mito de Safo en el relato decadente

[FR] La femme homosexuelle, reflet d’un désir mythique hermaphrodite, est, pendant la fin du siècle une figure littéraire paradoxale et en même temps obsédante. Sapho est, comme la femme fatale, une des protagonistes de la fin-du-siècle qui répond à une misogynie récurrente dans l’imaginaire créateur. Il s’agit d’un désir artificiel, éros intangible (Péladan 1910: 74), contre nature, un idéal impossible: Sexe initial,sexe définitif, absolu de l’amour, absolu de la forme, sexe qui nies le sexe, sexe d’éternité! Los à toi, Androgyne! (Péladan 1910: 76). Sapho, figure archétypique, androgyne, constitue en définitive le symbole de l’abolition des sexes, de la confusion des genres, de la crise du couple traditionnel. Elle met en évidence la solitude, la peur et un désir inassouvi.

Using the system dynamics paradigm in teaching and learning technological university subjets

2nd International Conference on Education and New Learning Technologies