bluuebunny/crossref_metadata_2025 huggingface dataset:
Thyroid hormone regulation of Sirtuin 1 expression and implications to integrated responses in fasted mice
Authors: Cordeiro Aline , de Souza Luana Lopes , Oliveira Lorraine Soares , Faustino Larissa Costa , Santiago Letícia Aragão , Bloise Flavia Fonseca , Ortiga-Carvalho Tania Maria , Almeida Norma Aparecida dos Santos , Pazos-Moura Carmen Cabanelas
Published: November 2012

Sirtuin 1 (SIRT1), a NAD+-dependent deacetylase, has been connected to beneficial effects elicited by calorie restriction. Physiological adaptation to starvation requires higher activity of SIRT1 and also the suppression of thyroid hormone (TH) action to achieve energy conservation. Here, we tested the hypothesis that those two events are correlated and that TH may be a regulator of SIRT1 expression. Forty-eight-hour fasting mice exhibited reduced serum TH and increased SIRT1 protein content in liver and brown adipose tissue (BAT), and physiological thyroxine replacement prevented or attenuated the increment of SIRT1 in liver and BAT of fasted mice. Hypothyroid mice exhibited increased liver SIRT1 protein, while hyperthyroid ones showed decreased SIRT1 in liver and BAT. In the liver, decreased protein is accompanied by reduced SIRT1 activity and no alteration in its mRNA. Hyperthyroid and hypothyroid mice exhibited increases and decreases in food intake and body weight gain respectively. Food-restricted hyperthyroid animals (pair-fed to euthyroid group) exhibited liver and BAT SIRT1 protein levels intermediary between euthyroid and hyperthyroid mice fedad libitum. Mice with TH resistance at the liver presented increased hepatic SIRT1 protein and activity, with no alteration inSirt1mRNA. These results suggest that TH decreases SIRT1 protein, directly and indirectly, via food ingestion control and, in the liver, this reduction involves TRβ. The SIRT1 reduction induced by TH has important implication to integrated metabolic responses to fasting, as the increase in SIRT1 protein requires the fasting-associated suppression of TH serum levels.
Fundamental Causes of Colorectal Cancer Mortality in the United States: Understanding the Importance of Socioeconomic Status in Creating Inequality in Mortality
Authors: Saldana-Ruiz Nallely , Clouston Sean A. P. , Rubin Marcie S. , Colen Cynthia G. , Link Bruce G.
Published: November 2012

Objectives. We used the fundamental cause hypothesis as a framework for understanding the creation of health disparities in colorectal cancer mortality in the United States from 1968 to 2005.

Methods. We used negative binomial regression to analyze trends in county-level gender-, race-, and age-adjusted colorectal cancer mortality rates among individuals aged 35 years or older.

Results. Prior to 1980, there was a stable gradient in colorectal cancer mortality, with people living in counties of higher socioeconomic status (SES) being at greater risk than people living in lower SES counties. Beginning in 1980, this gradient began to narrow and then reversed as people living in higher SES counties experienced greater reductions in colorectal cancer mortality than those in lower SES counties.

Conclusions. Our findings support the fundamental cause hypothesis: once knowledge about prevention and treatment of colorectal cancer became available, social and economic resources became increasingly important in influencing mortality rates.
Adversity and Syndemic Production Among Men Participating in the Multicenter AIDS Cohort Study: A Life-Course Approach
Authors: Herrick Amy L. , Lim Sin How , Plankey Michael W. , Chmiel Joan S. , Guadamuz Thomas T. , Kao Uyen , Shoptaw Steven , Carrico Adam , Ostrow David , Stall Ron
Published: November 2012

Objectives. We tested a theory of syndemic production among men who have sex with men (MSM) using data from a large cohort study.

Methods. Participants were 1551 men from the Multicenter AIDS Cohort Study enrolled at 4 study sites: Baltimore, Maryland–Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania. Participants who attended semiannual visits from April 1, 2008, to March 31, 2009, completed an additional survey that captured data about events throughout their life course thought to be related to syndemic production.

Results. Using multivariate analysis, we found that the majority of life-course predictor variables (e.g., victimization, internalized homophobia) were significantly associated with both the syndemic condition and the component psychosocial health outcomes (depressive symptoms, stress, stimulant use, sexual compulsivity, intimate partner violence). A nested negative binomial analysis showed that the overall life course significantly explained variability in the syndemic outcomes (χ2 = 247.94; P < .001; df = 22).

Conclusions. We identified life-course events and conditions related to syndemic production that may help to inform innovative interventions that will effectively disentangle interconnecting health problems and promote health among MSM.
Assessment of Biases Against Latinos and African Americans Among Primary Care Providers and Community Members
Authors: Blair Irene V. , Havranek Edward P. , Price David W. , Hanratty Rebecca , Fairclough Diane L. , Farley Tillman , Hirsh Holen K. , Steiner John F.
Published: November 2012

Objectives. We assessed implicit and explicit bias against both Latinos and African Americans among experienced primary care providers (PCPs) and community members (CMs) in the same geographic area.

Methods. Two hundred ten PCPs and 190 CMs from 3 health care organizations in the Denver, Colorado, metropolitan area completed Implicit Association Tests and self-report measures of implicit and explicit bias, respectively.

Results. With a 60% participation rate, the PCPs demonstrated substantial implicit bias against both Latinos and African Americans, but this was no different from CMs. Explicit bias was largely absent in both groups. Adjustment for background characteristics showed the PCPs had slightly weaker ethnic/racial bias than CMs.

Conclusions. This research provided the first evidence of implicit bias against Latinos in health care, as well as confirming previous findings of implicit bias against African Americans. Lack of substantive differences in bias between the experienced PCPs and CMs suggested a wider societal problem. At the same time, the wide range of implicit bias suggested that bias in health care is neither uniform nor inevitable, and important lessons might be learned from providers who do not exhibit bias.
Influence of Community Social Norms on Spousal Violence: A Population-Based Multilevel Study of Nigerian Women
Authors: Linos Natalia , Slopen Natalie , Subramanian S. V. , Berkman Lisa , Kawachi Ichiro
Published: November 2012

Objectives. We examined whether social norms toward spousal violence in Nigeria, at the state level, are associated with a woman’s exposure to physical and sexual violence perpetrated by her husband.

Methods. Using data from the 2008 Demographic and Health Survey, we fit four 3-level random intercepts models to examine contextual factors associated with spousal violence while accounting for individual-level predictors.

Results. Of the 18 798 ever-married Nigerian women in our sample, 18.7% reported exposure to spousal sexual or physical violence. The prevalence was geographically patterned by state and ranged from 3% to 50%. Permissive state-level social norms toward spousal violence were positively associated with a woman’s report of physical and sexual violence perpetrated by her husband (odds ratio [OR] = 1.80; 95% confidence interval [CI] = 1.17, 2.77), after adjusting for individual-level characteristics. A number of individual-level variables were significantly associated with victimization, including a woman’s accepting beliefs toward spousal violence (OR = 1.11; 95% CI = 1.09, 1.14). Women living in states with Sharia law were less likely to report spousal violence (OR = 0.58; 95% CI = 0.35, 0.95).

Conclusions. Efforts to end violence against women, particularly spousal violence, should consider broader social and contextual determinants of violence including social norms.
Safer Sex Media Messages and Adolescent Sexual Behavior: 3-Year Follow-Up Results From Project iMPPACS
Authors: Hennessy Michael , Romer Daniel , Valois Robert F. , Vanable Peter , Carey Michael P. , Stanton Bonita , Brown Larry , DiClemente Ralph , Salazar Laura F.
Published: November 2012

Objectives. We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents.

Methods. We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009–December 2010) after the intervention began (August 2006–January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events.

Results. All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases.

Conclusions. Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended.
History, Biology, and Health Inequities: Emergent Embodied Phenotypes and the Illustrative Case of the Breast Cancer Estrogen Receptor
Authors: Krieger Nancy
Published: November 2012

How we think about biology—in historical, ecological, and societal context—matters for framing causes of and solutions to health inequities. Drawing on new insights from ecological evolutionary developmental biology and ecosocial theory, I question dominant gene-centric and ultimately static approaches to conceptualizing biology, using the example of the breast cancer estrogen receptor (ER).

Analyzed in terms of its 4 histories—societal, individual (life course), tumor (cellular pathology), and evolutionary—the ER is revealed as a flexible characteristic of cells, tumors, individuals, and populations, with magnitudes of health inequities tellingly changing over time.

This example suggests our science will likely be better served by conceptualizing disease and its biomarkers, along with changing magnitudes of health inequities, as embodied history—that is, emergent embodied phenotype, not innate biology.
It Is Time to Integrate Abortion Into Primary Care
Authors: Yanow Susan
Published: November 2012

The Roe v Wade decision made safe abortion available but did not change the reality that more than 1 million women face an unwanted pregnancy every year. Forty years after Roe v Wade, the procedure is not accessible to many US women.

The politics of abortion have led to a plethora of laws that create enormous barriers to abortion access, particularly for young, rural, and low-income women. Family medicine physicians and advanced practice clinicians are qualified to provide abortion care.

To realize the promise of Roe v Wade, first-trimester abortion must be integrated into primary care and public health professionals and advocates must work to remove barriers to the provision of abortion within primary care settings.
Use and Interpretation of Composite End Points in Orthopaedic Trials
Authors: Busse Jason W. , Bhandari Mohit , Ferreira-González Ignacio , Montori Victor M. , Guyatt Gordon H.
Published: November 2012

Randomized controlled trials in orthopaedics are often underpowered to detect important differences in outcomes. Composite end points (CEPs) hold promise as a strategy to address this issue by combining multiple end points into one summary measure, thus increasing the observed event rate. The use of CEPs by trialists, however, can be problematic when they include components that vary greatly in importance to patients and when differences in apparent effect between components are large. We present an overview of CEPs with a focus on appropriate design and interpretation of results.
Efficient Designs: Factorial Randomized Trials
Authors: Whelan Daniel B. , Dainty Katie , Chahal Jaskarndip
Published: November 2012

As an alternative to conducting multiple parallel group randomized controlled trials, the factorial design is an efficient means of evaluating multiple interventions. This review highlights when it is appropriate to conduct a factorial trial, considers the structure and nomenclature of factorial designs, and discusses various methodological considerations, including sample size calculation, the role of statistical interactions between different interventions, and statistical power. Several pertinent examples in orthopaedics and medicine are used to highlight the key concepts.
Global Randomized Trials: The Promise of India and China
Authors: Perkovic Vlado , Patil Vinodvenkatesh , Wei Liu , Lv Jicheng , Petersen Marisa , Patel Anushka
Published: November 2012

Although modern clinical trials are traditionally conducted in Western countries, currently there is a shift to involve developing countries, particularly China and India. For these trials, the large population size of India and China means that substantial numbers of individuals affected by rare diseases may be found, increasing the likelihood of successfully completing enrollment in a clinical trial. Furthermore, the increasing involvement of Asian countries in global clinical trials is likely to lead to greater appreciation of the value of evidence-based treatment decisions in the region. These sites are more cost-effective, although this advantage is being eroded over time. Asian participants in clinical trials are also typically more likely to complete study follow-up and procedures, and to adhere to their randomized treatment allocation than individuals from Western countries. Challenges include relevance of the proposed trial to the region, capacity limitations because of undeveloped training, and ensuring research implementation quality and different intellectual property practices. There are specific challenges to conducting clinical trials in India, such as the status of ethics committees, health insurance and coverage for participants, and variability in languages and record-keeping. Challenges in both countries are substantial but are able to be managed with appropriate planning.
Participating in Multicenter Randomized Controlled Trials: What’s the Relative Value?
Authors: Tornetta Paul , Pascual Mandy , Godin Katelyn , Sprague Sheila , Bhandari Mohit
Published: November 2012

The value of high-quality, large-scale, multicenter randomized controlled trials (RCTs) in orthopaedic surgery is becoming well recognized; however, the efforts of investigators participating in RCTs are often underappreciated in areas such as academic merit. Within this manuscript, we discuss how involvement in a large-scale RCT can lead to benefits, such as improvements to clinical practice and decision-making as well as personal incentives. We also examined how investigators’ contributions to large multicenter RCTs are perceived and recognized by academic promotion committees. We found that academic promotion committees undervalue contributions to multicenter RCTs as compared with participation in studies that offer lower levels of evidence. The culture of academic promotion needs to evolve to ensure that participation in large multicenter RCTs is appropriately valued by these committees.
The kinetics and mechanism of methanol oxidation on Pt and PtRu catalysts in alkaline and acid media
Authors: Lovic Jelena
Published: November 2012

The kinetic of methanol electrochemical oxidation for a series of platinum and platinum-ruthenium catalysts was investigated. A correlation between the beginning of OHad adsorption and methanol oxidation was demonstrated on Pt single crystals and Pt nanocatalyst. The activity of the nano-structured Pt catalyst was compared with single crystal platinum electrodes assuming the Kinoshita model of nanoparticles. The ruthenium-containing catalysts shifted the onset of methanol oxidation to more negative potentials. The effect was more pronounced in acid than in alkaline media. Based on the established diagnostic criteria, the reaction between COad and OHad species according to the Langmuir-Hinshelwood mechanism was proposed as the rate determining step in alkaline and acid media on Pt and PtRu catalysts. .
Hypoglycemia After Gastric Bypass Surgery
Authors: Singh Ekta , Vella Adrian
Published: November 2012

In Brief

Severe hypoglycemia characterized by neuroglycopenic symptoms is a recently described and relatively uncommon complication of gastric bypass surgery. It occurs several months to years after surgery and may be distinct from the more commonly encountered dumping syndrome that occurs early in the postoperative course and usually improves with time. Nesidioblastosis has been proposed as a possible underlying mechanism for late postoperative hypoglycemia. This syndrome is distinct from noninsulinoma pancreatogenous hypoglycemia and likely has a multifactorial etiology. It responds variably to nutrition and pharmacological interventions. Partial pancreatectomy and reversal of the bypass have sometimes been used to ameliorate symptoms.
Victorian Fashion Accessories
Authors: Beaujot Ariel
Published: November 2012

In Victorian England, women's accessories were always much more than incidental finishing touches to their elaborate dress. Accessories helped women to fashion their identities. Victorian Fashion Accessories explores how women's use of gloves, parasols, fans and vanity sets revealed their class, gender and colonial aspirations.

The colour and fit of a pair of gloves could help a middle-class woman indicate her class aspirations. The sun filtering through a rose-colored parasol would provide a woman of a certain age with the glow of youth. The use of a fan was a socially acceptable means of attracting interest and flirting. Even the choice of vanity set on a woman's bedroom dresser reflected her complicity with colonial expansion. By paying attention to the particular details of women's accessories we discover the beliefs embedded in these artefacts and enhance our understanding of the culture at large.

Beaujot's engaging prose illuminates the complex identities of the women who used accessories in the Victorian culture that created and consumed them. Victorian Fashion Accessories is essential reading for students and scholars of, history, gender studies, cultural studies, material culture and fashion studies, as well as anyone interested in the history of dress. In Victorian England, women's accessories were always much more than incidental finishing touches to their elaborate dress. Accessories helped women to fashion their identities. Victorian Fashion Accessories explores how women's use of gloves, parasols, fans and vanity sets revealed their class, gender and colonial aspirations.
The current status of robotic oncologic surgery
Authors: Yu Hua‐yin , Friedlander David F. , Patel Sunil , Hu Jim C.
Published: November 2012

Answer questions and earn CME/CNE

The use of robotic assistance facilitates minimally invasive surgery and has been widely adopted across multiple specialties. This article reviews the published literature on use of this technology for treatment of oncologic conditions. PubMed searches were performed for articles published between 2000 and 2012 using the keywords “robotic” or “robotic surgery” in conjunction with “oncology” or “cancer.” Although the most common use for robotics was to treat urologic oncologic conditions, it has also been widely adopted for gynecologic, general, thoracic, and head and neck surgeries. For several procedures, there is evidence that robotics offers short‐term benefits such as shorter lengths of stay and lower intraoperative blood loss, with safety profiles and oncologic outcomes comparable to open or conventional laparoscopic approaches. However, long‐term oncologic outcomes are generally lacking, and robotic surgeries are more costly than open or laparoscopic surgeries. Robotic technology is widely used in oncologic surgery with demonstrated short‐term advantages. However, whether the benefits of robotics justify the higher costs warrant large comparative effectiveness studies with long‐term outcomes. CA Cancer J Clin 2013. © 2012 American Cancer Society.
Textile Materials for the Design of Wearable Antennas: A Survey
Authors: Salvado Rita , Loss Caroline , Gonçalves Ricardo , Pinho Pedro
Published: November 2012

In the broad context of Wireless Body Sensor Networks for healthcare and pervasive applications, the design of wearable antennas offers the possibility of ubiquitous monitoring, communication and energy harvesting and storage. Specific requirements for wearable antennas are a planar structure and flexible construction materials. Several properties of the materials influence the behaviour of the antenna. For instance, the bandwidth and the efficiency of a planar microstrip antenna are mainly determined by the permittivity and the thickness of the substrate. The use of textiles in wearable antennas requires the characterization of their properties. Specific electrical conductive textiles are available on the market and have been successfully used. Ordinary textile fabrics have been used as substrates. However, little information can be found on the electromagnetic properties of regular textiles. Therefore this paper is mainly focused on the analysis of the dielectric properties of normal fabrics. In general, textiles present a very low dielectric constant that reduces the surface wave losses and increases the impedance bandwidth of the antenna. However, textile materials are constantly exchanging water molecules with the surroundings, which affects their electromagnetic properties. In addition, textile fabrics are porous, anisotropic and compressible materials whose thickness and density might change with low pressures. Therefore it is important to know how these characteristics influence the behaviour of the antenna in order to minimize unwanted effects. This paper presents a survey of the key points for the design and development of textile antennas, from the choice of the textile materials to the framing of the antenna. An analysis of the textile materials that have been used is also presented.
Bodily Practices as Vehicles for Dehumanization in an Institution for Mental Defectives
Authors: Malacrida Claudia
Published: November 2012

This article analyzes the processes of dehumanization that occurred in the Michener Center, a total institution for the purported care and training of people deemed to be mental defectives[1] that operated in Alberta, Canada. I report on qualitative interviews with 22 survivors, three ex-workers, and the institutional archival record, drawing out the ways that dehumanization was accomplished through bodily means and the construction of embodied otherness along several axes. First, inmates’ bodies were erased or debased as unruly matter out of place that disturbed the order of rational modernity, a move that meant inmates were not seen as deserving or even requiring of normal human consideration. Spatial practices within the institution included panopticism and isolation, constructing inmates as not only docile but as unworthy of contact and interaction. Dehumanization was also seen as necessary to and facilitative of patient care; to produce inmates as subhuman permitted efficiency, but also neglect and abuse. Finally, practices of hygiene and sequestering the polluting bodies of those deemed mentally defective sustained and justified dehumanization. These practices had profound effects for inmates and also for those charged with caring for them.[1] This was the terminology used to describe people deemed to have intellectual disabilities during much of the 20th century in the West.
An Overview of Disease-Free Buffalo Breeding Projects with Reference to the Different Systems Used in South Africa
Authors: Laubscher Liesel , Hoffman Louwrens
Published: November 2012

This paper describes the successful national program initiated by the South African government to produce disease-free African buffalo so as to ensure the sustainability of this species due to threats from diseases. Buffalo are known carriers of foot-and-mouth disease, bovine tuberculosis, Corridor disease and brucellosis. A long-term program involving multiphase testing and a breeding scheme for buffalo is described where, after 10 years, a sustainable number of buffalo herds are now available that are free of these four diseases. A large portion of the success was attributable to the use of dairy cows as foster parents with the five-stage quarantine process proving highly effective in maintaining the “disease-free” status of both the calves and the foster cows. The projects proved the successfulness of breeding with African buffalo in a commercial system that was unique to African buffalo and maintained the “wildness” of the animals so that they could effectively be released back into the wild with minimal, if any, behavioral problems.
Lengthening of Insect Development on Bt Zone Results in Adult Emergence Asynchrony: Does It Influence the Effectiveness of the High Dose/Refuge Zone Strategy?
Authors: Gryspeirt Aiko , Grégoire Jean-Claude
Published: November 2012

The “High Dose/Refuge” strategy (HD/R) is the currently recommended Insect Resistance Management strategy (IRM) to limit resistance development to Bacillus thuringiensis (Bt) plants. This strategy requires planting a “refuge zone” composed of non-Bt plants suitable for the target insect and in close proximity to a “Bt zone” expressing a high toxin concentration. One of the main assumptions is that enough susceptible adults mate with resistant insects. However, previous studies have suggested that the high toxin concentration produced by Bt plants induces slower insect development, creating an asynchrony in emergence between the refuge and the Bt zone and leading to assortative mating between adults inside each zone. Here, we develop a deterministic model to estimate the impact of toxin concentration, emergence asynchrony and refuge zone size on the effectiveness of the HD/R strategy. We conclude that emergence asynchrony only affects resistance when toxin concentration is high and resistance is recessive. Resistance develops more rapidly and survival of susceptible insects is higher at lower toxin concentration, but in such situations, resistance is insensitive to emergence asynchrony.
Interaction of Bacteriophage l with Its E. coli Receptor, LamB
Authors: Chatterjee Sujoy , Rothenberg Eli
Published: November 2012

The initial step of viral infection is the binding of a virus onto the host cell surface. This first viral-host interaction would determine subsequent infection steps and the fate of the entire infection process. A basic understating of the underlining mechanism of initial virus-host binding is a prerequisite for establishing the nature of viral infection. Bacteriophage λ and its host Escherichia coli serve as an excellent paradigm for this purpose. λ phages bind to specific receptors, LamB, on the host cell surface during the infection process. The interaction of bacteriophage λ with the LamB receptor has been the topic of many studies, resulting in wealth of information on the structure, biochemical properties and molecular biology of this system. Recently, imaging studies using fluorescently labeled phages and its receptor unveil the role of spatiotemporal dynamics and divulge the importance of stochasticity from hidden variables in the infection outcomes. The scope of this article is to review the present state of research on the interaction of bacteriophage λ and its E. coli receptor, LamB.
Effect of spherical Au nanoparticles on nanofriction and wear reduction in dry and liquid environments
Authors: Maharaj Dave , Bhushan Bharat
Published: November 2012

Nano-object additives are used in tribological applications as well as in various applications in liquids requiring controlled manipulation and targeting. On the macroscale, nanoparticles in solids and liquids have been shown to reduce friction and wear. On the nanoscale, atomic force microscopy (AFM) studies have been performed in single- and multiple-nanoparticle contact, in dry environments, to characterize friction forces and wear. However, limited studies in submerged liquid environments have been performed and further studies are needed. In this paper, spherical Au nanoparticles were studied for their effect on friction and wear under dry conditions and submerged in water. In single-nanoparticle contact, individual nanoparticles, deposited on silicon, were manipulated with a sharp tip and the friction force was determined. Multiple-nanoparticle contact sliding experiments were performed on nanoparticle-coated silicon with a glass sphere. Wear tests were performed on the nanoscale with AFM as well as on the macroscale by using a ball-on-flat tribometer to relate friction and wear reduction on the nanoscale and macroscale. Results indicate that the addition of Au nanoparticles reduces friction and wear.
Lopinavir/Ritonavir Monotherapy after 24 Weeks of Second-Line Antiretroviral Therapy in Africa: A Randomized Controlled Trial (Sara)
Authors: Gilks Charles F , Walker A Sarah , Dunn David T , Gibb Diana M , Kikaire Ben , Reid Andrew , Musana Hellen , Mambule Ivan , Kasirye Ronnie , Robertson Val , Ssali Francis , Spyer Moira , Pillay Deenan , Yirrell David , Kaleebu Pontiano ,   the DART Virology Group and Trial Team
Published: November 2012

Background

Boosted protease inhibitor (bPI) monotherapy (bPImono) potentially has substantial cost, safety and operational benefits. It has never been evaluated as second-line antiretroviral therapy (ART) in Africa.

Methods

After 24 weeks of lopinavir/ritonavir- containing second-line therapy, DART participants were randomized to remain on combination therapy (CT), or change to bPI-mono maintenance (SARA trial; ISRCTN53817258). Joint primary end points were CD4+ T-cell changes 24 weeks later and serious adverse events (SAEs); retrospectively assayed viral load (VL) was a secondary end point. Analyses were intention-to-treat.

Results

A total of 192 participants were randomized to CT ( n=95) or bPImono ( n=97) and followed for median 60 weeks (IQR 45–84). Participants received median 4.0 years (IQR 3.5–4.4) first-line ART. Median CD4+ T-cell count at first-line failure was 86 cells/mm3 (47–136), increasing to 245 cells/mm3 (173–325) after 24-week induction when 77% had VL<50 copies/ml. Overall, 44 (23%) were receiving second-line therapy with bPI and nucleoside reverse transcriptase inhibitors (NRTI) only, and 148 (77%) with bPI plus non-NRTI (NNRTI) with or without NRTI. At 24 weeks after randomization to CT versus bPImono, mean CD4+ T-cell increase was 42 (CT, n=85) versus 49 cells/mm3 (bPImono, n=88; adjusted difference 13 [95% CI -15, 43], P=0.37; non-inferior compared with predetermined non-inferiority margin [-33]). Virological suppression was greater for CT versus bPImono (trend P=0.009): 77% (70/91) versus 60% (56/94) were <50 copies/ml, and 5% (5) versus 14% (13) were ≥1,000 copies/ml, respectively. A total of 0 (0%) versus 5 (5%) participants had major protease inhibitor mutations and 3 (3%) versus 0 (0%) new NNRTI/NRTI mutations were detected during follow-up. Two participants (1 CT and 1 bPImono) died >24 weeks after randomization, and 5 (2 CT and 3 bPImono) experienced SAEs ( P=0.51).

Conclusions

bPImono following a 24-week second-line induction was associated with similar CD4+ T-cell response, but increased low-level viraemia, generally without protease inhibitor resistance. Longer-term trials are needed to provide definitive evidence about effectiveness in Africa.
Histoire de la honte en dermatologie
Authors: Chevallier Jacques
Published: November 2012

Le dermato-vénéréologue est confronté aux maladies parmi les plus susceptibles d’engendrer un sentiment de honte chez les patients qui en sont atteints. Dans une perspective historique et médicale, l’auteur s’attache à montrer la permanence du rejet social des malades souffrant de maladies de peau et de leur perception honteuse à travers les âges.
David Nebreda, peau en lambeaux et sentiment d'inexistence
Authors: Lebailly Alice
Published: November 2012

L’étude de l’œuvre de David Nebreda, uniquement consacrée à des autoportraits photographiques, nous confronte à une néo-réalité inquiétante. L’auto-destruction s’expose à même le corps de l’artiste lacéré, rachitique. La peau part en lambeau sous les coups d’un homme qui semble chercher perpétuellement à se faire disparaître. Que signifie cette auto-mutilation aussi régulée, inflexible, comme semblant faire partie d’un sacrifice rituel, d’un travail d’annihilation, se dévoilant sous la forme d’un témoignage photographique ? Ses écrits éclairent encore davantage son travail artistique et interrogent quant à un sentiment de non-être premier chez Nebreda ; les problématiques d’un délire d’auto-engendrement, d’informe psychique, de naissance non-désirée et de volonté de ne pas être né transparaissent également de cette création, dernier souffle d’une pulsion de vie défaillante.
La honte d'exister
Authors: Ancet Pierre
Published: November 2012

À la différence de la honte sociale, la honte d’exister se distingue nettement de la culpabilité. Conceptuellement, la culpabilité a trait à ce que l’on fait ; la honte d’exister se rapporte à ce que l’on est (ou à ce que l’on se sent être). Elle est un dégoût de soi profond, qui remonte à la surface de la peau, elle est comme une peau intérieure dans laquelle on ne peut pas se sentir. Cette honte se manifeste sous diverses formes : échecs involontairement entretenus, agressivité, déni, dégoût de soi. Elle atteint l’entièreté de la personne et particulièrement l’image qu’elle a d’elle-même. La honte d’exister sera ici mise en lien, mais non exclusivement, avec la clinique du handicap et l’atteinte congénitale de l’apparence.
La dépigmentation volontaire : tours et détours de la honte
Authors: Petit Antoine
Published: November 2012

À partir de sa clinique de médecin dermatologue, l’auteur postule l’existence de plusieurs phénomènes concernant la dépigmentation volontaire : glissement de la honte liée à la passivité vers la culpabilité liée à l’activité de dépigmentation ; renversement de la honte en fierté ; dimension subversive et de défi de la dépigmentation ; dilution de sa signification « ethnique » dans le champ moderne de la revendication à une auto-détermination strictement individuelle de l’aspect de son corps et de ses signes d’appartenance identitaire.
La toxicomanie : une transmission de soi à soi
Authors: Monraisin Flora
Published: November 2012

Cette étude s’intéresse à la question de la transmission psychique de soi à soi chez les sujets toxicomanes. Autrement dit, qu’est-ce que les sujets toxicomanes cherchent à se transmettre par l’intermédiaire du toxique ? L’auteure travaille ici la question du narcissisme chez les sujets toxicomanes et plus particulièrement la notion d’enveloppe corporelle. Le type de transmission psychique se différencie en fonction du type d’administration du produit, c’est-à-dire en fonction de la manière dont le sujet consomme la substance. Les résultats de cette étude mettent précisément en évidence que le produit n’a pas les mêmes capacités de narcissisation en fonction du mode d’administration. Les sujets non injecteurs seraient plus dépendants d’un produit alimentant leur narcissisme. Le type d’enveloppe crée par la prise de produit sera plus archaïque chez les sujets consommant par injection que chez les sujets non-injecteurs.
Le rêve comme matrice primaire de l'appareil psychique familial
Authors: André-Fustier Francine
Published: November 2012

Résumé « Le rêve comme matrice primaire de l’appareil psychique familial. » La place du rêve et la fonction de l’onirisme familial sont envisagées dans la filiation des travaux d’A. Ruffiot sur le fonctionnement onirique groupal de l’appareil psychique familial primaire. À partir d’une situation de thérapie familiale psychanalytique, l’auteure esquisse l’évolution de la dynamique onirique familiale au fil des séances. La mise en commun des rêves en thérapie familiale, à travers le holding onirique des thérapeutes, permet la remise en circulation du holding onirique familial qui a fait défaut sous l’effet de traumatismes cumulés sur plusieurs générations.
Rêver et jouer en famille
Authors: Kammerer Brigitte
Published: November 2012

Résumé « Rêver et jouer en famille. » Le jeu constitue l’autre voie vers l’inconscient quand le langage ou la « voie royale » du rêve ne semblent pas suffisamment pertinents ou opérants, en particulier quand la paradoxalité domine le mode de fonctionnement familial. Véritable dispositif de « psychodrame familial », la thérapie familiale psychanalytique avec psychodrame est conçue comme un espace « pré-onirique », espace potentiel à la fois contenant et à visée interprétative. Un cas clinique illustre cette hypothèse.
L'onirisme familial à l'épreuve du trauma
Authors: Popper Haydée
Published: November 2012

Résumé « L’onirisme familial à l’épreuve du trauma. L’appel à l’onirisme familial. » À travers un cas clinique et notamment une séance, l’auteure montre comment l’émergence du holding onirique en TFP permet l’apparition d’une circulation fantasmatique et d’échanges psychiques importants aboutissant à des mouvements réparateurs du psychisme des parents ainsi que le renforcement de leur capacité à contenir la haine et la destructivité des enfants.
La géopolitique : un raisonnement géographique d'avant-garde
Authors: Giblin Béatrice
Published: November 2012

Ce numéro se veut une réflexion sur la et les géopolitiques et répond à la préoccupation de l’équipe d’ Hérodote face au succès médiatique du terme géopolitique (souvent utilisé à tort et à travers) même si, dans certains milieux géographiques, la géopolitique est encore tenue en suspicion. Le succès est loin d’être seulement médiatique comme le prouve celui d’ Hérodote et de l’Institut français de géopolitique. C’est l’analyse de très nombreuses situations géopolitiques dues à des rivalités de pouvoir pour prendre le contrôle de territoires qui a permis à l’équipe d’ Hérodote et celle de l’IFG (qui se recouvrent en grande partie) d’avancer dans la réflexion théorique. C’est pour avoir étudié sur le terrain des conflits de toute nature que nous commençons à avancer sur le plan théorique. Nous avançons avec la prudence et la sagesse de ne pas établir de « lois géopolitiques », mais avec la volonté d’établir une démarche rigoureuse fondée sur le raisonnement géographique. Ce numéro est donc une sorte de bilan du long chemin parcouru et envisage les perspectives nouvelles que nous voulons ouvrir.
Les crises géopolitiques et leur cartographie
Authors: Loyer Barbara
Published: November 2012

Les cartes suscitent aujourd’hui un engouement extraordinaire grâce aux possibilités nouvelles qu’offrent les techniques de géolocalisation et la géomatique qui permettent de très rapidement cartographier des phénomènes. Dans les situations de crises géopolitiques, la cartographie géomatique est parfois même présentée comme une nouvelle « arme » pour ceux qui choisissent la non-violence et qui disent pouvoir déjouer la force par la communication sur la géographie des combats. La question de l’efficacité des cartes issues de ce qu’on appelle aussi la « science citoyenne » ouvre sur celle de la fonction des cartes et, dans le cas de conflit, de leur place au sein de stratégies adverses. Les cartes géopolitiques à différentes échelles devraient être la base sur laquelle localiser des phénomènes qui évoluent très vite, à l’aide des systèmes d’informations géographiques, si l’on veut analyser les rapports de forces dans les territoires. Il faut mieux articuler les apports de la géomatique avec le raisonnement géopolitique afin d’aboutir à une cartographie de crise géopolitique. Il est tout aussi important de ne pas se laisser abuser par le pouvoir de la technologie cartographique.
L'OTAN comme phénomène géopolitique
Authors: Mongrenier Jean-Sylvestre
Published: November 2012

Au regard d’une approche de type Realpolitik , la « transformation » de l’OTAN dans l’après-guerre froide pourrait constituer une aberration, un certain nombre de commentaires en France reflétant cette idée. Selon l’école néoréaliste des relations internationales, la formation des alliances n’est censée refléter qu’un état momentané des rapports de puissance. A contrario , l’application à l’OTAN de la méthode géopolitique se révèle féconde et d’une plus grande portée interprétative. Inscrite dans la durée, cette alliance politico-militaire récapitule des héritages et des mémoires qui requièrent une démarche historienne distinguant différentes échelles de temps. L’élargissement de l’OTAN sur les plans géographique et fonctionnel ne saurait s’expliquer par la seule dynamique de la « révolution dans les affaires militaires » et, plus généralement, le progrès technologique des armements. Le processus de « transformation » de l’OTAN renvoie à des situations ainsi qu’à des représentations géopolitiques globales qui doivent être saisies selon différents ordres de grandeur et niveaux d’analyse.
Quatre-vingts ans de géopolitique au Brésil : de la géographie militaire à une pensée stratégique nationale
Authors: Messias da Costa Wanderley , Théry Hervé
Published: November 2012

La géopolitique brésilienne ne se résume pas à celle la dictature militaire (1964-1985), utilisée par les généraux-géopoliticiens pour justifier leurs politiques internes et externes. Sans nier l’usage très idéologique fait de la géopolitique lors cette période, il faut prendre en compte les mutations du Brésil, devenu aujourd’hui un des grands « pays émergents », pour voir à la fois comment a évolué la pensée géopolitique brésilienne et comment le changement de statut du pays se reflète – ou non – dans la vision que les Brésiliens ont du monde qui les entoure et de la place qu’ils y occupent.
The oleic acid esterification of policosanol increases its bioavailability and hypocholesterolemic action in rats
Authors: Haim D. , Valenzuela A. , Brañes M. C. , Fuenzalida M. , Videla L. A.
Published: November 2012

Policosanol comprises a mixture of long-chain aliphatic alcohols from sugarcane wax. More than 50 studies indicate that policosanol decreases serum cholesterol, while others failed to reproduce this effect. The objective of this investigation was to assess the bioavailability of esterified policosanol and non-esterified policosanol (NEP), in relation to their hypocholesterolemic effects. Sprague Dawley rats were given a daily oral dose of 100 mg/kg of NEP, 117 mg kg–1 of butyric acid esterified policosanol (BAEP), or 164 mg kg–1 of oleic acid esterified policosanol (OAEP). Policosanol absorption was evaluated in plasma between 0 and 3 hours after ingestion. To assess changes in total cholesterol, LDL-cholesterol, HDLcholesterol and triacylglycerols in plasma and liver 3-hydroxy- 3-methylglutaryl coenzyme A reductase (HMG- CoA red) phosphorylation, the rats were supplemented with nonesterified or esterified policosanol for 5 weeks. The results indicate that policosanol absorption was significantly greater in OAEP-treated rats than in those subjected to NEP or BAEP administration. OAEP significantly reduced plasma total and LDL-cholesterol in rats, in addition to a 5.6-fold increase (P < 0.05) in the hepatic content of phosphorylated HMG-CoA red over the control values. In conclusion, esterification of policosanol with oleic acid enhances policosanol bioavailability, and significantly improves the serum lipid profile in normocholesterolemic rats in association with the inactivation of HMG-CoA red controlling cholesterogenesis.
Detection of argan oil adulterated with vegetable oils: new markers
Authors: Ourrach I. , Rada M. , Pérez-Camino M. C. , Benaissa M. , Guinda Á.
Published: November 2012

This work aims to contribute to controlling the authenticity of pure argan oil, a valuable Moroccan product. Fatty acids, hydrocarbon fraction, 3,5-stigmastadiene, the alkyl esters of fatty acids, chlorophyllic pigments and physical properties such as viscosity, density and refractive index were studied in order to detect the adulteration of argan oil with edible vegetable oils. The results found in this study show that 3,5-stigmastadiene, kaurene and pheophytin-a can be used as possible new markers for argan oil blends of up to 5% with refined, sunflower and virgin olive oils. Due to the similarity of the fatty acid compositions of the edible oils studied and argan oil, fatty acids can be employed as markers for the detection of argan oil adulteration at levels higher than 10%. Among the physical properties studied, the refractive index shows significant differences for sunflower oil and its blend at 10% with argan oil.
Physalis peruviana pomace suppresses highcholesterol diet-induced hypercholesterolemia in rats
Authors: Ramadan M. F.
Published: November 2012

Physalis peruviana (goldenberry) is a promising fruits that can be an ingredient in several functional foods. No reports are available on the effect of the administration of goldenberry pomace on different aspects of the plasma lipid profile in experimental animals. According to the chemical composition of the fruit pomace which includes high levels of bioactive compounds, the hypothesis was that feeding Physalis peruviana pomace may have health-promoting and hypercholesterolemic impacts on rats fed a high cholesterol diet (HCD). Therefore, the objective of this study was to investigate the effect of feeding goldenberry pomace on hypercholesterolemia by analyzing the changes in lipid profiles in HCD fed rats. The chemical composition, lipid profiles (fatty acids, tocopherols and sterols) and phenolic contents of the fruit pomace were determined. Generally, rats fed the fruit pomace showed lower levels of total cholesterol (TC), total triacylglycerol (TAG) and total low density lipoprotein (LDL) cholesterol as well as higher levels of high density lipoprotein (HDL) cholesterol in comparison with animals fed HCD and cholesterol free diets (CFD). Histological examinations of the liver and kidney were also studied. The results demonstrated that goldenberry pomace consumption provides overall beneficial effects on reversing HCD associated detrimental changes.
Evaluation of cadmium, lead, copper, iron and zinc in Turkish dietary vegetable oils and olives using electrothermal and flame atomic absorption spectrometry
Authors: Acar Orhan
Published: November 2012

The Cd, Pb, Cu, Fe and Zn contents of some edible vegetable oils (soybean, sunflower, flower, nut, corn and olive) and of olives (olive-1, black, green, black crushed with seeds and green crushed with seeds) were determined and evaluated by an electrothermal atomic absorption spectrometer (ETAAS) using an Sc + Ir + NH4H2PO4 chemical modifier mixture and flame atomic absorption spectrometer (FAAS) after microwave digestion. The pyrolysis and atomization temperatures of Cd, Pb and Cu in sample solutions with and without the modifier mixture were investigated. The limits of detection (LOD) for analytes found are 0.1, 0.6, 0.9, 15.0 and 12.0 μg L–1 for Cd, Cu, Pb, Fe and Zn, respectively. The accuracy of the procedure proposed was confirmed by analyzing bovine liver 1577b standard reference material (SRM) and a spiked sample solution. The results of the analytes found were compared with certified and added values. The relative standard deviations of the analytes found were lower than 7% and the percent of recoveries obtained ranges from 96 to 101%. The Sc + Ir + NH4H2PO4 mixture proposed was applied for the determination of Cd, Pb and Cu in oils and olives. The results of analytes found in the samples were compared with international and national food quality guidelines as well as with literature values.