bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation du risque de transmission du virus de l’arthrite encéphalite caprine (CAEV) par les biotechnologies de la reproduction
Authors: Fieni Francis
Published: November 2014

Evaluation of the risk of CAEV (caprine arthritis encephalitis virus) transmission via assisted reproduction techniques

Caprine Arthritis-Encephalitis Virus (CAEV) has been identified in the tissues of male and female genital tract, in the semen, in uterine and vaginal secretions, and in embryo flushing medias. So a health risk is associated with artificial insemination (AI), In vitro fecundation (IVF) and embryo transfer (ET). However, it has been demonstrated that sperm fraction, oocytes free of granulosa cells, embryo with intact zona pellicida and after ten washing, take off from naturally infected goats are free of CAEV. So with the respect of definite process, IA, IVF and ET are associated with low level CAEV transmission risk and TE can be use as preventive health measure.
Modélisation dynamique théorique de la transmission de norovirus par la consommation d’huîtres contaminées et par transmission interhumaine
Authors: Thebault Anne , Teunis Peter , Kooh Pauline , Le Guyader Françoise , Denis Jean-Baptiste
Published: November 2014

Les norovirus sont impliqués dans les épidémies de gastro-entérites hivernales mais aussi dans les toxi-infections collectives (TIAC) liées à l’ingestion d’huîtres contaminées. L’objectif de cette étude est d’évaluer l’impact de la transmission alimentaire vis-à-vis de la transmission inter-interhumaine dans une population côtière. La transmission alimentaire a été abordée par une Appréciation Quantitative des Risques. Une dose-réponse établie sur des données publiées de TIAC montre la forte infectiosité des norovirus. Un modèle dynamique prenant en compte les deux modes de transmission a été construit. Les premiers résultats montrent que la voie alimentaire peut avoir un impact sur le nombre de cas total en période épidémique et sur les cas attribués au génogroupe I et II. Le modèle, basé sur des hypothèses et des données publiées, devra être poursuivi par un ajustement à des données observées, afin de mieux évaluer la pertinence de mesures de gestion des zones conchylicoles.
Genetic diversity of Talpa europaea and Nova hantavirus (NVAV) in France
Authors: Hugot Jean-Pierre , Hun Gu Se , Feliu Carlos , Ventura Queija Jacint , Ribas Alexis , Dormion Jérôme , Yanagihara Richard , Nicolas Violaine
Published: November 2014

Genetic diversity of talpa europaea and nova hantavirus (NVAV) in France

Nova hantavirus (NVAV) was first identified in a captured European mole (Talpa europaea) in Hungary. Analysis of lung tissues from 94 moles captured in France revealed NVAV in 50% of the animals. Based on the genetic diversity of the cytochrome b mtDNA, moles collected in Poitiers and Bordeaux were more closely related to the Iberian mole (T. occidentalis), a species previously assumed to be restricted to the Iberian Peninsula. Several hypotheses are discussed to explain these observations : 1) the presence of hitherto unnoticed T. occidentalis in southwestern France ; 2) the existence of an ancient mitochondrial introgression phenomenon between the two Talpa species, producing a particular phenotype in some hybrids ; 3) the existence of a hybrid zone between the two species ; and 4) the existence of a new Talpa species. NVAV was not detected in the southwestern moles, which raises the question of the possible presence of a particular Hantavirus species in this population and/ or in the Iberian moles.
Žagar Ž., Igor in Kelava, Polona (ur.): From Formal to Non-Formal: Education, Learning and Knowledge. Cambridge, Cambridge Scholars Publishing, 2014
Authors: Rijavec Klobučar Nataša
Published: November 2014

Monografija z naslovom Od formalnega k neformalnemu: izobraževanje, učenje in znanje nadaljuje tradicijo  interdisciplinarnega raziskovanja teh pojavov. Avtorji prihajajo iz različnih jezikovnih okolij in različnih znanstvenih področij ter uporabljajo pri svojem raziskovanju različne metodološke pristope (akcijsko raziskovanje, participatorno raziskovanje, utemeljena teorija, analiza dokumentov in študije primerov, kvantitativne empirične raziskave z uporabo vprašalnikov, če naštejemo nekatere). Vse troje vodi v pester prikaz spoznanj, hkrati pa nakazuje tudi fluidnost in nepreglednost področja neformalnega učenja in izobraževanja, ki je včasih kaotično.
Izobraževanje in skupnost
Authors: Jelenc Zoran
Published: November 2014

Sociološko in antropološko je skupno različnim opredelitvam skupnosti - kot pravi C. Fletcher - je to lokalno okolje ljudi, ki imajo interes za skupno ne glede na različnost svojih interesov. Izobraževanje je dražljaj za in odgovor na skupnost. Ta odnos je lahko zavesten ali nezaveden, pozitiven ali negativen.
Ali so društva pomembna za učenje starejših v skupnosti?
Authors: Jelenc Krašovec Sabina , Radovan Marko , Močilnikar Špela , Šegula Sabina
Published: November 2014

Dosedanje raziskave v Sloveniji so pokazale, da imajo starejši odrasli, ki se udeležujejo organiziranega izobraževanja, višjo stopnjo izobrazbe, so bogatejši, pogosteje živijo v mestih in so zelo verjetno ženske. Po drugi strani tudi raziskave v Avstraliji in nekaterih evropskih državah kažejo, da se starejši moški redkeje izobražujejo v organiziranih izobraževalnih dejavnostih. Naš cilj je bil raziskati vlogo prostovoljskih organizacij pri druženju in učenju starejših moških v skupnosti v Sloveniji. Pri raziskovanju priložnostnega učenja starejših moških v eni mestni in dveh podeželskih občinah smo uporabili kvantitativni in kvalitativni pristop; proučili smo stanje prostovoljskih organizacij v izbranih občinah v Sloveniji ter v izbranih prostovoljskih organizacijah, v katerih večino članov pomenijo starejši moški (študije primerov), opravili polstrukturirane intervjuje in izpeljali fokusno skupino. Rezultati so pokazali, da obstaja le majhno število prostovoljskih organizacij, v katerih starejši moški pomenijo večino članov. Priložnostno in naključno učenje se pojavlja v vseh prostovoljskih organizacijah, izobraževalne dejavnosti pa organizirajo le nekateri. Članstvo v prostovoljskih organizacijah starejšim moškim daje priložnost, da ostanejo povezani s svojimi vrstniki, se srečujejo z drugimi generacijami in člani lokalne skupnosti, in hkrati priložnost, da ostanejo dejavni ter se čutijo koristne in spoštovane. Članstvo v prostovoljskih organizacijah krepi socialna omrežja starejših moških ter vpliva na njihovo blaginjo. Z izjemo raziskav B. Goldinga s sodelavci, ki opozarjajo na specifičnost potreb starejših moških po izobraževanju in učenju, se zdi, da je ta skupina v izobraževanju odraslih nepomembna (oz. pozabljena) manjšina, zato bi bilo treba okrepiti nadaljnje raziskovanje ter razprave na tem področju.
A 2-year record of atmospheric mercury species at a background Southern Hemisphere station on Amsterdam Island
Authors: Angot H. , Barret M. , Magand O. , Ramonet M. , Dommergue A.
Published: November 2014

Abstract. Although essential to fully understand the cycling of mercury at the global scale, mercury species records in the Southern Hemisphere are scarce. Under the framework of the Global Mercury Observation System (GMOS) project, a monitoring station has been set up on Amsterdam Island (37°48´ S, 77°34´ E) in the remote southern Indian Ocean. For the first time in the Southern Hemisphere, a 2-year record of gaseous elemental mercury (GEM), reactive gaseous mercury (RGM) and particle-bound mercury (PBM) is presented. GEM concentrations were remarkably steady (1.03 ± 0.08 ng m−3) while RGM and PBM concentrations were very low and exhibited a strong variability (mean: 0.34 pg m−3, range: < detection limit–4.07 pg m−3; and mean: 0.67 pg m−3, range: < detection limit–12.67 pg m−3, respectively). Despite the remoteness of the island, wind sector analysis, air mass back trajectories and the observation of radonic storms highlighted a long-range contribution from the southern African continent to the GEM and PBM budgets from July to September during the biomass burning season. Low concentrations of GEM were associated with southerly polar and marine air masses from the remote southern Indian Ocean. This unique data set provides new baseline GEM concentrations in the Southern Hemisphere midlatitudes while mercury speciation along with upcoming wet deposition data will help to improve our understanding of the mercury cycle in the marine boundary layer.
Optic Nerve Head Tubercular Granuloma Successfully Treated with Anti-VEGF Intravitreal Injections in Addition to Systemic Therapy
Authors: Invernizzi Alessandro , Franzetti Fabio , Viola Francesco , Meroni Luca , Staurenghi Giovanni
Published: November 2014

Purpose

To describe a case of optic nerve head tubercular granuloma, unresponsive to conventional therapy (antitubercular drugs and systemic steroids), successfully treated with anti–vascular endothelial growth factor (VEGF) intravitreal injections in addition to systemic drugs.

Methods

Case report.

Results

A 44-year-old patient was referred to our clinic for progressive vision decrease in his left eye during the preceding 4 months. A large granuloma infiltrating optic nerve head was visible at funduscopic examination along with diffuse intraocular inflammation. Workup for granulomatous uveitis supported the diagnosis of presumed intraocular tuberculosis. However, the large granulomatous lesion did not show a good response to conventional therapy for tubercular uveitis (antitubercular drugs and systemic steroids). Anti-VEGF (bevacizumab) intravitreal injections were performed as an adjunct to the ongoing therapy. After 2 injections, the patient showed an almost complete regression of the lesion (demonstrated by optical coherence tomography) and a restoration of vision.

Conclusions

Anti-VEGF intravitreal injections should be considered in the treatment of large tubercular granulomatous lesions in addition to conventional systemic therapy. Optical coherence tomography could be a suitable tool for studying and following optic nerve head granulomas.
Near-Infrared Fundus Autofluorescence in Multiple Evanescent White-Dot Syndrome
Authors: Battaglia Parodi Maurizio , Iacono Pierluigi , Falcomatà Bruno , Bolognesi Gianluigi , Bandello Francesco
Published: November 2014

Purpose

To report the near-infrared fundus autofluorescence (NIR-FAF) pattern in 2 cases of multiple evanescent white-dot syndrome (MEWDS).

Methods

Three consecutive patients with MEWDS underwent a complete ophthalmologic examination, including color photograph, blue-light fundus autofluorescence, NIR-FAF, fluorescein angiography, and indocyanine green angiography (ICGA). Main outcome measure was the identification of NIR-FAF pattern.

Results

Fluorescein angiography showed patchy hyperfluorescence of the whitish dots. Indocyanine green angiography showed hypofluorescent spots throughout the examination. Blue-light fundus autofluorescence disclosed a speckled pattern without extension to the foveal area, whereas NIR-AF showed several hypoautofluorescent lesions involving also the fovea, which corresponded to the whitish dots visible on biomicroscopy and to the hypofluorescent lesions detectable on ICGA.

Conclusions

Near-infrared fundus autofluorescence is characterized by hypoautofluorescent spots corresponding to the inflammatory lesions typical of MEWDS and can be considered as a valuable noninvasive technique to diagnose and monitor patients with MEWDS.
The Surgeon's Eye: A Prospective Analysis of the Anteversion in the Placement of Hemiarthroplasties after a Femoral Neck Fracture
Authors: van Embden Daphne , van Gijn Willem , van de Steenhoven Tim , Rhemrev Steven
Published: November 2014

Introduction

Hip dislocation after hemiarthroplasty performed in elderly patients with a femoral neck fracture is associated with severe morbidity and costs. Optimal anteversion during the placement of the hemiarthroplasty might reduce the dislocation rate. We assessed the surgeons’ intraoperative visual estimations of the femoral anteversion.

Methods

The postoperative femoral anteversion of 20 consecutively performed hemiarthroplasties was measured on computer tomography and compared to the intraoperative visual estimations of the surgeon. Furthermore, the femoral anteversion of the contralateral non-fractured hip, which was considered the ‘ideal’ anatomical reference, was recorded.

Results

The mean postoperative anteversion of the hemiarthroplasty was 20° (SD 8.7°). The mean femoral anteversion of the contralateral non operated femur was 14° (SD 9.5°). The average difference between the anteversion angle estimated by the surgeon and the CT-measured is 9° (1° to 18°). In 14 (70%) cases the measured angle was greater than desired.

Conclusions

The current operation technique in which the anteversion angle is estimated by the surgeon's eye shows relatively good intraoperative precision.
Acremonium Species Combined with Penicillium Species Infection in Hip Hemiarthroplasty: A Case Report and Literature Review
Authors: Wu Cheng-Yi , Huang Hui-Kuang , Wu Po-Kuei , Chen Wei-Ming , Lai Mei-Chu , Chung Lien-Hsiang
Published: November 2014

Objective

To illustrate that Acremonium and Penicillium species are being increasingly recognised in periprosthetic joint infections (PJIs).

Case Report

A 47-year-old male with liver cirrhosis and bilateral hip hemiarthroplasties complained of persistent right hip pain. Bone scan was suspicious for right hip septic arthritis. Laboratory studies revealed an elevated erythrocyte sedimentation rate (ESR; 127 mm/h) and C-reactive protein (CRP; 16.171 mg/L). At surgery caseous necrosis with a yellowish appearance around the hip was noted. Intraoperative cultures were positive for Acremonium and Penicillium species 2 weeks after inoculation. After 4 months of fluconazole monotherapy a successful revision right total hip arthroplasty was performed, the patient is walking without assistance at 1 year after surgery.

Conclusions

We reported a prosthetic hip infection due to Acremonium and Penicillium species. Removal of the prosthesis, antifungal therapy, and re-implantation after 4 months were successful.
Low Alpha-Fetoprotein HCC and the Role of GGTP
Authors: Carr Brian I. , Guerra Vito , Giannini Edoardo G. , Farinati Fabio , Ciccarese Francesca , Rapaccini Gian Ludovico , Di Marco Maria , Benvegnù Luisa , Zoli Marco , Borzio Franco , Caturelli Eugenio , Chiaramonte Maria , Trevisani Franco ,   For the Italian Liver Cancer (ITA.LI.CA) group*
Published: November 2014

Background

HCC patients are heterogeneous in terms of both tumor and liver factors. Alpha-fetoprotein (AFP) is an important prognostic tumor marker for those patients with elevated AFP levels.

Aims

To examine the differences in HCC patients with high or low AFP levels in blood and evaluate the prognostic parameters in low AFP patients.

Methods

A cohort of 2,440 HCC patients from 11 Italian medical centers was studied. AFP-positive patients were compared to AFP-negative ones, and the blood and tumor parameters of AFP-negative patients were examined.

Results

Low blood AFP levels were found in 58% of the total cohort, in 64% of patients with small HCCs, and in 51% of patients with large HCCs. In patients with large tumors, platelet and gamma glutamyl transpeptidase (GGTP) levels, tumor multifocality and portal vein thrombosis (PVT) incidence were all greater than in patients with small tumors, regardless of AFP status. Patients with higher AFP levels had worse survival rates than those with low AFP in each tumor size group. In patients with small tumors, the elevated AFP was associated with significantly increased PVT and worse survival. In patients with large tumors, the elevated AFP was associated with significantly higher GGTP, ALKP, and bilirubin levels, as well as with increased PVT and multifocality, and worse survival. Low-AFP patients with high GGTP levels had worse survival than patients with low GGTP levels.

Conclusion

Patients with low AFP were the majority in this cohort, and patients with elevated GGTP had worse prognosis than those with low GGTP. GGTP may be a useful tumor and prognosis marker in low-AFP patients. AFP-negative patients are important to identify due to their enhanced survival.
Comparative detection of aberrantly methylated DNA in preoperative and postoperative stool from patients with colorectal cancers
Authors: Nishioka Yasunobu , Ueki Takashi , Hokazono Koji , Nagayoshi Kinuko , Tanaka Masao
Published: November 2014

Background

Early detection of colorectal cancer (CRC) is crucial to reducing tumor-related mortality. Evaluating aberrantly methylated DNA in stool is promising for CRC screening. However, DNA methylation in the colonic epithelium of background mucosa may compromise stool DNA (sDNA) test results. Thus, we compared aberrant methylation of cancer-related genes in preoperative and postoperative sDNA, with the aim of demonstrating that a cancer-specific methylated allele in sDNA originates from CRCs.

Methods

Patients who were to undergo CRC resection in Kyushu University Hospital during 2003-2010 were prospectively enrolled. Preoperative (pre) stool samples from 54 patients, postoperative (post) samples from 52 of the patients and tumor samples were collected. Aberrant promoter methylation of CDH4 and GATA5 was assessed in the primary tumors by methylation-specific polymerase chain reaction (MSP) and in stool samples by real-time MSP.

Results

Aberrant methylation of CDH4 and/or GATA5 was detected in 45 of CRC tissue samples (83.3%) and identified in 23 pre sDNA samples (42.3%) from CRC patients. Aberrant methylation was not found in pre sDNA obtained from CRC patients without aberrant methylation of these genes or in post sDNA in any patient. The detection rate of methylated alleles did not correlate with depth of invasion or tumor stage.

Conclusion

Our findings demonstrate that aberrantly methylated alleles identified in sDNA originate from CRCs. Although tumor-specific aberrant methylation is found in sDNA from patients harboring early and advanced CRC throughout the colon and rectum, the sensitivity of this test needs to be improved for early detection of CRC.
Training and Certification in Dialysis access
Authors: Ross John , Dolmatch Bart , Gallichio Michael , Gallieni Maurizio , Slakey Douglas , Vesely Tom , Davidson Ingemar
Published: November 2014

Decreasing and eliminating the gaps in knowledge, skills, and effective communication are the mainstays for a successful dialysis access training program curriculum and at the core of the human factors training philosophy. Many of these skills can be learned in the simulation environment. Education and training will reduce gaps in knowledge and technical skills, before exposing patients to procedure-related risk. For dialysis access, a reliable workplace environment depends upon a culture where safety and accountability are balanced to recognize the human contribution to success or failure in the complex care of patients with end-stage renal disease. Rigorous testing and certification adds value to the participants and validates the training program.
Solitary Fibrous Tumor/Hemangiopericytoma of the Penis: Report of the First Case
Authors: Castellani Daniele , Sebastiani Giancarlo , Maurelli Simone , Andrisano Alessandro , Mazzone Luigi , Feroce Antonio , Primi Francesca , Verrico Giovanna , Rizzotto Antonio
Published: November 2014

Hemangiopericytoma (HPC) is an uncommon perivascular tumor, first described in 1942, occurring most frequently in the extremities (pelvis, meninges, head and neck), and rarely affecting the urogenital system. In 1870, Wagner published the first histological description of a Solitary Fibrous Tumor (SFT) of the pleura. It is now thought that the majority of lesions previously called hemangiopericytomas (HPCs) are essentially indistinguishable from solitary fibrous tumors (SFTs). Nowadays, the new WHO classification of soft tissue tumors categorizes most HPCs as SFTs. We report the first case of penile SFT-HPC in a 44-year-old man, presenting with a 3-year history of slow-growing penile mass. The patient underwent a tumor excision. Six months after surgery he is free of local recurrence and distant metastasis.
A QUESTÃO DA DESINDUSTRIALIZAÇÃO NO BRASIL
Authors: Silva José Alderir
Published: November 2014

O presente artigo tem por objetivo analisar o debate sobre o processo de desindustrialização no Brasil na última década. A redução da participação da indústria de transformação no PIB brasileiro tem provocado um grande debate no meio acadêmico. De um lado, economistas heterodoxos defendem que o Brasil está passando por um processo de desindustrialização, por outro lado, economistas ortodoxos argumentam que na verdade está ocorrendo é um processo natural de desenvolvimento da economia brasileira e, que a desaceleração da indústria se deve mais a orientação excessiva das políticas macroeconômicas para a demanda que, ao reduzir o desemprego aumenta o custo de produção. Portanto, diante desse debate, com pressupostos antagônicos, a análise dos dados permitirá caracterizar a desaceleração industrial brasileira como sendo de desindustrialização precoce ou de desenvolvimento natural e, mostrar quais as causas do respectivo processo. A desaceleração da indústria é evidente, no entanto os dados não são suficientes para afirmar se o país sofre ou não de desindustrialização precoce, devido ao conjunto de subsetores industriais reagirem de forma diferenciada em relação aos indicadores tradicionais da desindustrialização. Estudos mostram que a desindustrialização começou antes que a renda per capita alcança-se nível de país desenvolvido, o que se contrapõe a hipótese de desenvolvimento natural. Portanto, é preciso cuidado ao se afirmar que o Brasil sofre de desindustrialização precoce ou natural.
COINTEGRAÇÃO E CORREÇÃO DE ERRO PARA A FORMAÇÃO BRUTA DE CAPITAL FIXO NO BRASIL PÓS-PLANO REAL
Authors: Fachinelli Angel Dos Santos
Published: November 2014

O investimento em capital fixo é um dos principais componentes gerador de crescimento econômico, promove o aumento da capacidade produtiva e a expansão das atividades. Este estudo analisou os determinantes da Formação Bruta de Capital Fixo com base nas teorias a cerca dos fatores que influenciam os níveis de investimento. As variáveis utilizadas foram o Produto Interno Bruto, taxa de juros real (over-selic) e a Utilização da Capacidade Instalada. A identificação de cointegração entre as variáveis permitiu a modelagem de curto e longo prazo pelo mecanismo de correção de erros de Engle e Granger. As conclusões do estudo apontam para uma forte relação de curto e longo prazo entre a variável PIB e FB, as variáveis apresentaram sinais esperados e foram estatisticamente significativos, o ajuste sazonal mostrou-se adequado para a estimação trimestral dos dados e o mecanismo de erro denotou um ajustamento trimestral de cerca de 13%.
Duitsland en de zigeuners: van uitsluiting tot Endlösung der Zigeunerfrage, 1407-1945
Authors: Croes M.T.
Published: November 2014

Germany and the gypsies: from exclusion to Endlösung der Zigeunerfrage, 1407-1945

This article gives an overview of the persecution of the gypsies in Europe from their arrival in Central and Western Europe in 1407 till the Baro Porrajmos ('great devouring' in some Romani dialects) as the mass killing of gypsies during the Second World War is called. The focus in this article is on Germany.
Draagmoederschap en verlof
Authors: Burri Susanne
Published: November 2014

Draagmoederschap en verlof: De arresten C.D. en Z. over zwangerschaps-en bevallingsverlof van wensmoeders

Rechters worden met nieuwe vragen geconfronteerd. Dit geldt bijvoorbeeld voor de vraag of een wensmoeder in geval van draagmoederschap recht heeft op zwangerschaps- en bevallingsverlof terwijl ze zelf niet zwanger is geweest. De meningen van twee advocaten-generaal verschillen over de betekenis van het Unierecht in dit verband. Hun opinies leveren interessante gezichtspunten. Het Hof van Justitie kiest een voorzichtige benadering.

HvJ EU 18 maart 2014, zaak C-167/12, C.D./S.T, n.n.g. en HvJ EU 18 maart 2014, zaak C-363/12, Z./A Government Department, The Board of management of a community school, n.n.g
Is that all there is?
Authors: Knegt Robert
Published: November 2014

This editorial offers an introduction to the current issue.
Preventie of paranoia?
Authors: Popma Jan
Published: November 2014

Preventie of paranoia? Een parodie op het ‘voorzorgsdenken’

In this feature authors review recently published books on subjects of interest to readers of Recht der Werkelijkheid.
De samenhang tussen fysieke en sociale veiligheid in theorie en praktijk
Authors: Duijnhoven Hanneke , van Buul-Besseling Kim , Vink Nathalie
Published: November 2014

The relation between safety and security in theory and practice

This article discusses the complex relations between the organizational fields of safety (i.e. disaster and crisis response) and security (i.e. crime prevention and public order), and the ways in which disciplinary and organizational boundaries make it difficult to come to a better integration or coordination in the safety and security domain. Based on results of a research project on cooperation and information-sharing between organizations in the fields of safety and security, the authors argue that it is not realistic to refer to safety and security as relatively independent fields. Instead, it would be more useful to approach it as a connected domain, encompassing both safety and security disciplines. Yet, the separation of the two fields is strongly embedded in the culture and responsibilities of organizations in these fields, which reinforces the disciplinary boundaries in the domain. Nevertheless, in the last few years it seems that there is an increasing recognition of the need for multidisciplinary collaboration in the safety and security domain. This paper explores possible directions for creating more coherence and integration in the safety and security domain. The authors believe that much progress can be made if key stakeholders in the safety and security domain are able to adopt a broader, multidisciplinary perspective when approaching safety and security events.
Hors de l’Église, point de salut ? La transmission du sens des oeuvres d’art religieux
Authors: Leconte Alexandra
Published: November 2014

Le présent article est tiré de mon travail dirigé, réalisé dans le cadre de la maîtrise en muséologie à l’Université de Montréal. Intéressée par le patrimoine religieux du Québec, je me penche plus particulièrement sur la conservation et la transmission des oeuvres d’art religieux. Dans mon travail, je cherche à comprendre et à relever ce qui reste du caractère religieux de ces objets une fois devenus patrimoine. Pour ce faire, j’ai fait l’étude de trois cas qui présentent des types de conservation différents, soit la Basilique Sainte-Anne-de-Beaupré et son musée, l’église de Saint-Joachim et le Musée national des beaux-arts du Québec. J’ai étudié le processus de patrimonialisation de chacun d’eux en regard des caractères immatériels intrinsèques au patrimoine religieux que je définis ainsi : la notion du sacré, l’expérience religieuse, l’esprit du lieu et l’identité collective. L’analyse de mes études de cas m’amène ensuite à soulever la nature polysémique et multiforme de l’oeuvre d’art religieux, qui influence dès lors la patrimonialisation et plus encore la transmission qu’on en fait.
Intempérance et piété chrétienne : les voyageurs canadiens et l’implantation des missions catholiques chez les Autochtones d’Abitibi-Témiscamingue 1836-1863
Authors: Marcotte Guillaume
Published: November 2014

Le présent article traite du rôle potentiel qu’ont pu jouer les voyageurs canadiens dans l’acceptation du catholicisme chez les Autochtones d’Abitibi-Témiscamingue entre 1836 et 1863. Ces engagés de la traite des fourrures, malgré certains comportements jugés immoraux qui leur sont reprochés, sont présentés ici comme des auxiliaires des prêtres et généralement favorables à l’implantation des missions catholiques en territoire amérindien. La conversion rapide des Autochtones à la nouvelle foi pourrait être liée, en partie, à la présence soutenue des voyageurs canadiens d’héritage catholique, qui sont les étrangers ayant le plus partagé leur quotidien avant l’arrivée des premiers missionnaires en 1836.
La tradition orale des pêcheurs de homard de Météghan, Nouvelle-Écosse
Authors: Thériault Gisèle
Published: November 2014

Cette note présente une collection de récits personnels recueillie par l’auteur auprès des pêcheurs de homard de Météghan en Nouvelle-Écosse. Ce corpus est un inventaire global et non pas total qui aide à comprendre l’évolution de ce village acadien dont la pêche est l’industrie principale. Sa recherche nécessitait une transformation du regard, afin de remarquer, de préserver et de présenter le trésor que constitue la tradition orale de cette région. L’auteur présente ses récits en se basant sur le concept d’ethnotexte élaboré par l’ethnologue Jean-Claude Bouvier et laisse la parole aux informateurs, ce qui permet d’être fidèle à l’expérience orale. Le protocole suivi pour les transcriptions est un compromis entre la fidélité des enregistrements et l’accessibilité du texte, qui conserve le vocabulaire maritime et les mots archaïques. L’auteur montre l’importance culturelle des anecdotes, un amalgame entre la tradition et la modernité, par lesquelles les pêcheurs se définissent, et commence à éclairer l’énigme d’une identité acadienne moderne.
Safety Evaluation of Highway Tunnel-Entrance Illuminance Transition Based on Eye-Pupil Changes
Authors: Du Zhigang , Wan Hongliang , Wu Chaozhong , Pan Xiaodong
Published: November 2014

Utilizing the EMR-8B eye-tracker system, the pupil changes of eight drivers were monitored when they drove through 26 typical highway tunnels. Based on the test results, the driver’s pupil areas and pupil illuminance were found to be in a power function relationship at tunnel entrances. Furthermore, a quantitative relationship between the pupil area and its critical velocity was established, and the ratio of pupil area’s velocity in relation to its critical velocity was used to evaluate the lighting transitions and to establish the ideal curve of pupil illuminance at tunnel entrances. The results demonstrated that the relationship between the pupil illuminance of the tunnel entrance and the driver’s pupil areas conforms to the Stevens law found in experimental psychology; severe pupil illuminance transition within the range of 10 metres of the existing highway tunnel entrances, which results in great visual load, is in urgent need of improvement.
TRANSPORT MODELLING OF FREIGHT FLOWS ACCORDANCE TO INVESTMENTS: CASE STUDY OF SLOVENIAN RAILWAYS
Authors: Kontelj, M.Sc. Monika , Jakomin, D.Sc. Igor
Published: November 2014

Using specific science methods and through a model, authors have determinated how investments in the railway infrastructure influence the whole railway system. We have based our research on experience and on results that have been found out in Austria, Argentina, Bolivia, Brasil, Chile and Venezuela. Based on scientific studies about the conditions of the Slovenian railway system, on Methodology for determination of the investment's measures and definition of conditions for a justified realisation and on Calculation of the expected number of freight trains, authors give results that confirm our hypothesis.
Multiphase Approach to Developing Model of Logistics for Coastal Tourist Destinations
Authors: Ivanović Željko , Bauk Sanja
Published: November 2014

The process of urbanization of coastal tourist destinations (CTDs) is taking place at high speed and at the same time creating a lot of complex problems. The positive trend of urbanization has resulted in increased volume of freight transport which leads to burdening the traffic network, time losses and causes traffic congestion problems on the streets with increased environmental pollution due to emissions, noise and vibration. These findings brought to some research being started on the EU level, aiming to develop new logistic solutions, so these areas could be developed on a sustainable basis. With this in mind, the paper proposes a method of developing a novel model of logistics (MoL) for CTDs through several stages. The point of proposed MoL lies in achieving optimal connectivity of transportation, warehousing and physical distribution of goods, and making it a single functional model, so as to allow simultaneous optimization of logistic processes in a CTD, and to incorporate logistics in tourist offer.
30 years of HIV: what have we learned?
Authors: Gazzard Brian
Published: November 2014

I saw my first patient with severe immune deficiency in 1979 – a very low CD4 count had been noted, but it was not until the first reports of an epidemic occurred in 1981 that the correct diagnosis was made. Subsequently, I have seen more than 15,000 patients with HIV‐related immune deficiency, and my life has changed from helping terminally ill patients to die with dignity, in the early part of the epidemic to now providing drugs for an eminently treatable condition – a true miracle. I have a number of observations about the epidemic. Firstly, the courage with which many young people faced death and disablement was truly awe inspiring, and was the chief reason many of the earlier doctors treating these patients stayed in the field. Secondly, the role of activists was overwhelmingly positive forcing the epidemic to the top of the scientific and political agenda and keeping it there. It is also important that activism helped move an ethical agenda reducing the stigma of HIV infection and producing a liberal legal framework which allowed testing and treatment to be acceptable. The right of the world population to health as espoused by Jonathan Mann and others is also crucial. Thirdly, the combination of academic research, activist pressure (and scientific input) and mammon in the form of the pharmaceutical industry acting in concert produced knowledge which led to effective treatment in a breathtakingly short time. Particular tribute in my mind needs to be paid to the pharmaceutical companies in this regard. I believe that the scientific achievements of HIV research illustrate two things. First, science builds from one generation to the next and most (but not all of us) need to be humble about our personal contribution. Second, HIV treatment illustrates the primacy of well conducted randomized control trials. While cohort studies can add to our detailed knowledge of the epidemic, randomised controlled trials remain the cornerstone of most major advances. Fourthly, when human beings act in concert towards a common goal, amazing things can be achieved. In the late 1990s, the possibility of treatment for the millions of people with HIV in the developing world was seen as a distant dream. The present situation whilst not perfect is a tribute to individuals, volunteers, government (particularly American government under President Bush) and personal philanthropy (the Bill & Melinda Gates Foundation, and the Clinton Foundation) that have used scientific knowledge to benefit the global population.
Towards an HIV cure
Authors: Deeks Steven
Published: November 2014

Given the challenge of delivering complex, expensive and potentially harmful antiretroviral therapy (ART) on a global level, there is intense interest in the development of short‐term, well‐tolerated regimens that allow individuals to interrupt therapy indefinitely without experiencing a rebound in viremia. This so‐called “cure” or “remission” might be due to complete eradication of all replication‐competent HIV during ART or durable host‐mediated control of persistent virus in absence of ART. Recent heroic interventions such as hematopoietic stem cell transplant and very early initiation of antiretroviral therapy suggest that dramatic reductions in the reservoir size can be achieved, but that complete eradication will be difficult if not impossible to achieve. Most attempts to stimulate effective host‐mediated control of HIV have failed. It is likely that for a true cure to be achieved, both approaches – reductions in the reservoir size and durable immune surveillance – will be needed, a state that is similar to that observed in “elite” controllers and post‐treatment controllers. The implications for recent advances and setbacks in achieving HIV remission for future research priorities will be discussed.
Darunavir pharmacokinetics throughout pregnancy and postpartum
Authors: Lambert John , Jackson Valerie , Else Laura , Lawless Mairead , McDonald Grainne , Le Blanc Dave , Patel Anjali , Stephens Kelly , Khoo Saye
Published: November 2014

Introduction

Antiretroviral therapy is recommended during pregnancy for prevention of mother‐to‐child transmission (MTCT) of HIV. Physiological changes during pregnancy are known to affect the pharmacokinetics (PK) of protease inhibitors (PIs), leading to lower exposures in pregnant women. Here we examine the PK of DRV/r 800/100 mg once daily (OD) over the course of pregnancy and postpartum (PP).

Material and Methods

In this prospective open‐labelled study, HIV‐positive pregnant women receiving darunavir/ritonavir as part of their routine maternity care were enrolled. DRV plasma trough concentrations [DRV] were determined in the first (T1) and/or second (T2) and/or third (T3) trimester and PP using a validated HPLC‐MS/MS methodology (Lab21, Cambridge UK). Where possible paired maternal and cord blood samples were taken at delivery.

Results

To date 20 women (12 black African, 8 Caucasian) have been enrolled. Median (range) baseline CD4 count was 338 cells/µL (108–715), and median baseline plasma viral load was 555 copies/mL (<40–8,188,943). All but 2 women were virally suppressed at time of delivery (114 and 176 copies/mL; 1 sub‐therapeutic at T3) and median CD4 count was 410 cells/µL (92–947). There were 20 live births, all term deliveries and there were no cases of MTCT. [DRV] (geometric mean; 95% CI) was 3790 ng/mL at T1 (n=1); 1288 ng/mL (663–1913) at T2 (n=9); 1086 ng/mL (745–1428) at T3 (n=18, 1 undetectable) and 2324 ng/mL (1369–3279) at PP (n=14, 1 undetectable). There was no significant difference in [DRV] between T2 and PP (p=0.158); however, there was between T3 and PP (p=0.021). Nineteen of twenty (95%) and 16 of 20 (80%) women achieved [DRV] above the estimated MEC for WT (55 ng/mL) and PI resistant HIV‐1 (550 ng/mL) throughout pregnancy. Maternal and cord [DRV] were available for 10 mother–baby pairs. Mean maternal [DRV] at delivery was 2235 ng/mL (±1557 ng/mL), while mean cord [DRV] was 337 ng/mL (±217 ng/mL). The median cord to maternal blood ratio (C/M) was 0.11 (0.06–0.49).

Conclusions

In most cases examined, DRV/r 800/100 mg once daily was effective at achieving adequate therapeutic drug levels (>550 ng/ml) during pregnancy. However, reduced DRV plasma concentrations in the second/third trimesters highlights the need for TDM in this population and warrants further study of pregnancy‐associated changes in DRV pharmacokinetics. The low C/M ratios reported here are consistent with previous reports [1] and suggest low transplacental transfer of DRV.
The challenge: streamlining HIV treatment and care while improving outcomes
Authors: Clumeck Nathan
Published: November 2014

ART coverage among HIV‐positive population varies, depending on the countries, between 10% (e.g. Indonesia) and 65% (Botswana). Death rates and new HIV infections have been linked to ART coverage. Therefore, streamlining tasks and roles to expand treatment and care and to provide quality and equitable health is an ongoing concern globally. One concept that has been applied to improve the delivery of HIV services is that of task shifting. Defined as the systematic delegation of tasks from doctors to cadre with less training such as nurses or lay workers, task shifting has been used as an effective strategy to address the current healthcare worker shortage in many African countries. A body of literature supports the use of task shifting as a successful approach in delivering healthcare services including HIV testing, counselling and ART treatment. In addition, in a time of economic burden and scare resources, task shifting may also help to relieve the situation. This concern is highlighted in recommendation of WHO to strengthen and expand human capacity among healthcare workers. The major issues that are raised are: How can task shifting be implemented in a way that is sustainable? How can clinical care services be organized to maximize the potential of the task‐shifting approach while ensuring safety, efficiency and effectiveness? What preconditions must be met, what are the country‐specific factors that will guide decision‐making in the implementation of task shifting? In addition, task shifting should be implemented alongside other efforts to increase the numbers of skilled health workers. Quality assurances mechanisms should provide the necessary checks balances to protect both service users and health workers.
Cost‐effectiveness analysis of protease inhibitor monotherapy vs. ongoing triple‐therapy in the long‐term management of HIV patients
Authors: Oddershede Lars , Walker Simon , Paton Nicholas , Stöhr Wolfgang , Dunn David , Sculpher Mark
Published: November 2014

Introduction

Protease inhibitors might be sufficient to maintain complete virological suppression when used as monotherapy for HIV‐1‐positive patients who have achieved sustained virological suppression on combination antiretroviral therapy (ART). The present study estimated the cost‐effectiveness of a strategy of switching the ART to protease inhibitor monotherapy (PIM) with prompt return to combination therapy in the event of viral load rebound compared to continuing the ongoing triple‐therapy (OTT) in the long‐term management of HIV‐1‐positive patients.

Materials and Methods

A within‐trial cost‐effectiveness analysis and modelling of lifetime cost‐effectiveness was performed based on a randomized controlled trial of Protease Inhibitor monotherapy Versus Ongoing Triple‐therapy (PIVOT). The setting was HIV outpatient care in the UK National Health Service, and the trial involved 587 patients, aged 18 years or more, who achieved sustained virological suppression and have a CD4+ cell count >100 cells/mm3. Outcomes were NHS costs (2012 UK pounds sterling) and quality‐adjusted life‐years (QALY) with comparative results presented as incremental cost‐effectiveness ratios (ICERs).

Results

Overall, PIM was cost‐effective compared to OTT. PIM was cost‐saving due to large savings in the ART drug costs while being no less effective in terms of QALYs in the within‐trial analysis and only marginally less effective with modelling. In the base‐case within‐trial analysis, the incremental total cost per patient was −£6,424.11 (95% confidence interval:−£7,418.84 to −£5,429.38) and the incremental QALY was 0.0051 (95% confidence interval: −0.0479 to 0.0582) making PIM dominant compared to OTT. Multiple sensitivity analyses were conducted to assess the importance of assumptions surrounding drug costs, missing data, trial protocol driven costs and mortality. In all sensitivity analyses, PIM was cost‐saving and no marked difference in QALY was observed. Modelling of life time costs and QALYs showed significant cost‐savings and marginally less effectiveness such that switching to PIM appeared cost‐effective at accepted cost‐effectiveness thresholds.

Conclusions

The results suggest that PIM is a cost‐effective treatment strategy compared to OTT for HIV‐1‐positive patients who have achieved sustained virological suppression.
Management of drug‐resistant TB in patients with HIV co‐infection
Authors: Meintjes Graeme
Published: November 2014

The World Health Organization estimates that 450,000 cases of drug‐resistant (DR) tuberculosis (TB) occurred worldwide in 2012. In South Africa, over 15,000 cases were diagnosed. Over half of patients in South Africa with TB are HIV co‐infected. The management of drug‐resistant TB is complex, prolonged, costly, associated with multiple toxicities and thus difficult for patients to complete. Disengagement from follow‐up is common. Co‐infection with HIV presents a number of additional challenges in DR TB management including shared drug toxicities between TB and HIV drugs, potential for increased drug toxicity due to underlying HIV‐related organ disease such as nephropathy, pharmacokinetic drug–drug interactions and immune reconstitution inflammatory syndrome including manifestations at extrapulmonary sites. Mortality with multi‐drug‐resistant (MDR) TB is higher in HIV‐positive patients. Mortality is similar for HIV‐positive and uninfected patients with extremely drug‐resistant (XDR) TB, given the current lack of effective therapy, with over 70% case fatality by five years. ART improves survival in patients with DR TB, and timing of ART initiation in relation to TB treatment should be similar to patients with drug‐susceptible TB. New (e.g. bedaquiline and delaminid) and repurposed (e.g. linezolid and clofazamine) drugs promise to improve the prognosis of patients with DR TB. Several clinical trials of new regimens are ongoing and planned, and early data from the Bedaquiline Clinical Access Programme in South Africa suggests much improved short‐term outcomes when bedaquiline +/− linezolid and/or clofazamine are included in the regimen of patients with XDR and pre‐XDR TB including patients with HIV co‐infection. There are important considerations with respect to QT prolongation and ART drug interactions related to bedaquiline that need to be factored in treatment decisions and monitoring plans.
Effects of age on symptom burden, mental health and quality of life amongst people with HIV in the UK
Authors: McGowan Jennifer , Sherr Lorraine , Rodger Alison , Fisher Martin , Miners Alec , Johnson Margaret , Elford Jonathan , Collins Simon , Hart Graham , Phillips Andrew , Speakman Andrew , Lampe Fiona
Published: November 2014

Introduction

The evolving HIV epidemic, coupled with advances in HIV treatment, has resulted in an ageing HIV‐diagnosed population. It has been suggested that adverse physical and psychological effects of HIV may be higher among older people. However, few studies have examined the effect of older age on well‐being for people with HIV.

Materials and Methods

The ASTRA study included 3258 HIV‐diagnosed individuals (2248 MSM; 373 heterosexual men; 637 women) recruited from eight UK clinics in 2011–12 (64% response rate). Participants completed a questionnaire that included standard inventories on symptoms and health‐related quality of life (HrQoL). Associations of age group with: physical symptom distress (reporting significant distress for ≥1 of 26 symptoms), depression and anxiety (score ≥10 on PHQ‐9 and GAD‐7, respectively) and HrQoL problem (reporting problems on ≥1 of 5 Eurqol‐5D domains) were assessed; adjustment was made for gender/sexuality and time with diagnosed HIV.

Results

Of all participants, 87% were taking ART, 76% had VL ≤50c/mL and 19% had CD4 <350/mm3. Mean age was 45 years (range 18–88) with 5% <30, 23% 30–39, 43% 40–49, 22% 50–59 and 7% ≥60 years. The most prevalent distressing physical symptoms were: lack of energy/tiredness (26%), difficulty sleeping (24%), muscle‐ache/joint pain (21%) and pain (18%). With older age, there was no clear trend in prevalence of physical symptom distress, but prevalence of depression and anxiety decreased, while prevalence of HrQoL problems increased. This pattern remained after adjustment for gender/sexuality and time diagnosed with HIV. The increase with age in overall prevalence of HrQoL problem was due to increased problems for “mobility,” “self‐care” and “performing usual activities” domains, not an increase in “depression/anxiety.” Longer time with diagnosed HIV was strongly associated with higher prevalence of all symptoms measures and HrQoL problem (p<0.001 for trend, adjusted models).

Conclusions

Physical and psychological symptoms are common among people living with HIV, but the burden of these symptoms is not highest among the older age group. While HrQoL tended to worsen with older age, physical symptom distress did not, and mental health improved. This may reflect greater resilience in older adults, or the potential for “successful ageing”: maintaining mental health despite age‐related health losses.