bluuebunny/crossref_metadata_2025_split huggingface dataset:
L'interstitiel et la fabrique de l'équipe
Authors: Fustier Paul 
Published: November 2012

Résumé Dans la vie en institution, il existe des espaces-temps paradoxaux qui sont des lieux où s’entremêlent des échanges concernant les pratiques professionnelles mais aussi la vie privée. Ces zones de « travail-non travail » nommés espaces interstitiels sont des espace-temps qui ont affaire à la fabrique de l’équipe. L’apparente banalité des paroles qui s’y échangent recouvre en vérité des affects puissants ; c’est, en effet, dans les interstices, que les membres d’une institution expérimentent le plaisir de vivre ensemble en se reconnaissant mutuellement comme étant partiellement des semblables. Cette reconnaissance mutuelle dans le « faire équipe » provient du partage d’une même utopie, celle qui s’exprime dans la légende des origines de l’institution. Dans les interstices se produit un travail groupal de la pensée concernant la place que les pratiques professionnelles laissent au Désir.
Les conceptions de la santé chez des collégiens issus de quartiers défavorisés
Authors: Duchateau Guillaume 
Published: November 2012

Résumé Cette étude vise à connaître les conceptions de la santé des collégiens de quartiers défavorisés. La méthodologie est celle de l’entretien. La capacité à assumer ses activités de façon optimale, d’avoir des habitudes de vie saines et la santé mentale caractérisent leur conception. Ils mettent en avant l’absence de pollution, l’importance du paysage et la pratique d’une activité physique comme paramètres indispensables de santé. La mère est la principale informatrice en la matière, et la télévision une des sources d’information médiatique. Les collégiens ont peu abordé les problèmes de santé omniprésents à l’adolescence : traumatismes routiers, suicides, maladies sexuellement transmissibles.
La responsabilité
Authors: Prairat Eirick 
Published: November 2012

Résumé Penser une éthique éducative à l’heure où le droit ne cesse de gagner du terrain, tel est le défi qu’entend relever cet article. Dans la première section, Eirik Prairat montre que l’éthique éducative traditionnelle s’est réfléchie comme une éthique de l’exemplarité, de la responsabilité au sens où répondre signifie répondre de soi. Dans les deux sections suivantes, les pensées de Lévinas et de Jonas permettent d’examiner comment la responsabilité prend une coloration morale, devenant « responsabilité pour autrui ». Dans les dernières sections, inspirées par la pensée lévinassienne, l’auteur définit les contours d’une éthique de la responsabilité.
Enfants du viol : questions, silence et transmission
Authors: Godard Marie-Odile , Ukeye Marie-Josée 
Published: November 2012

Résumé Bientôt dix-huit ans que le génocide des Tutsi a bouleversé le Rwanda. Il a été perpétré en cent jours et a fait plus d’un million de morts. Les survivants tentent de reconstruire un pays, une culture, une vie qui est entachée par le génocide. Si la société rwandaise post-génocidaire s’est attachée à interdire la mention de l’ethnie, à rendre la scolarité obligatoire, à juger les génocidaires par l’instauration des Gacaca, à créer le Fond d’aide aux rescapés du génocide (FARG), certains enfants portent en eux la marque du génocide. Nous voulons parler ici des enfants nés du viol de leurs jeunes (ou moins jeunes) mères. Ils ont entre 16 et 17 ans, et c’est parce que leur parole devient de plus en plus claire que nous les entendons. Que savent-ils de leur histoire ? Qui la leur a racontée ? Que peuvent-ils faire du poids de leurs ascendants ? Nous étudierons le cheminement de ces enfants et de ces mères à partir de l’élaboration menée dans deux groupes thérapeutiques, l’un de ces femmes violées et l’autre de ces enfants issus du viol.
Matched filter separation of magnetic anomalies caused by scattered surface debris at archaeological sites
Authors: Sheriff Steven D. 
Published: November 2012

ABSTRACTRandomly scattered debris, some of it ferromagnetic, on or near the ground surface regularly degrades magnetic data acquired for archaeological purposes. These sources create short‐wavelength high‐amplitude dipolar anomalies in total field magnetic intensity maps and they can dominate maps of the vertical magnetic gradient. Thus, we generally wish to separate longer wavelength anomalies created by features of interest, such as foundations or building perimeters, from the shorter wavelength anomalies created by debris on or near the ground surface. Matched bandpass filtering, employed extensively in the aeromagnetic industry, is an effective way to separate magnetic anomalies arising from different depths. It entails fitting the radially averaged power spectrum of the total field magnetic data with a series of power spectra corresponding to simple equivalent layers at the archaeological site. We show that applying matched bandpass filtering to a set of total field magnetic intensity data yields two equivalent layers with excellent separation of near‐surface sources from deeper sources of interest. The benefit of this approach over enhancing surface features using magnetic gradiometry, analysis by upward continuation, or the analytic signal is that we isolate the source layers without losing information.
Multi-Destination Trips and Tourism Statistics: Empirical Evidences in Sicily
Authors: Parroco Anna Maria , Vaccina Franco , De Cantis Stefano , Ferrante Mauro 
Published: November 2012

AbstractThe knowledge of the actual magnitude and main features of tourism flows in a given destination is an essential prerequisite for the evaluation of tourism impacts and externalities. Indeed, many pleasure trips are often characterized by the visit to more than a single destination. Although the topic is well-documented in literature, the empirical results are limited to a few pioneering studies. The lack may be attributable to the failure of tourism organizations to collect data on multi-destination trip behaviour. This can be seen, for example, in the system of European statistics on tourism (according to the Council Directive 95/57 EC), where information on the average number of visited destinations within a single trip is not provided. This paper aims at discussing the main implications of multi-destination trips, both on tourism statistics and on destination management. It also proposes to describe the research design and main preliminary results of a survey on incoming tourism in Sicily. Some remarks dealing with the positive and negative impacts of unobserved tourism and of multi-destination trips are reported at the end.
Persistence of antiretroviral treatment in emtricitabine/tenofovir (FTC/TDF) users vs other NRTI in ART‐naïve patients>50 years: TRIP study
Authors: Pedrol E , Castaño M , Olalla J , Domingo P , Arazo P , Gómez‐Sirvent J , Riera M , Pulido F , Vera F , Vergara A , Aguirrebengoa K , Portilla J , Blanco J 
Published: November 2012

The major antiretroviral guidelines recommend starting ART in patients>50 y of age, regardless of CD4 cell count. However, no references to the preferred cART for these patients have been described. The combination FTC/TDF is one of the cornerstones of combined antiretroviral therapy (cART) in naïve patients. We studied the persistence of coformulated FTC/TDF in this scenario. National, retrospective cohort analysis of HIV‐infected patients>50 y at the time they began the first cART regimen (January 1, 2006 – December 31, 2009). Patients were selected in a proportion 2:1 to FTC/TDF vs. other NRTI regimens (no‐TDF). We compared the persistence of treatment in FTC/TDF users vs. no‐TDF (main groups). Among TDF users, we compared the persistence in PI vs. NNRTI users and in lopinavir/r vs. efavirenz users. Persistence was defined as the duration of the initial treatment; we analyzed time to any change or discontinuation according to initial regimen. We included 161 patients: median age: 54.6 y, 83% males, median CD4 count 191 cells/μl, median viral load 4.7 log, follow up: median 19 months, max 48 months. Of them, 112 started with FTC/TDF (53 with PIs, 57 with NNRTIs); and 49 with other NRTIs (no‐TDF) (22 with PI, 23 NNRTI). During the follow‐up period 79 patients (49%) modified their treatment, with statistically significant differences among groups, as shown in Table 1.*Adjusted by age, sex, transmission category and baseline CD4 count and viral load.In our study (antiretroviral‐naïve patients>50 y), the persistence of FTC/TDF regimens was significantly higher than other NRTI regimens. According to the third agent, there was a trend to a higher persistence with NNRTI vs. PI. This reaches statistical significance when we compare EFV vs. LPV/r. In the absence of randomized clinical trials, our data may contribute to a better understanding on how cART works in this ageing population, which is progressively increasing.

Proportion and hazard ratio of non‐persistence (any change or discontinuation of any component of initial cART), aOR adjusted by age, sex, transmission category and baseline CD4 count and viral load

Initial cART
Non‐persistence, N (%)
Log rank
Crude HR (95% CI)
Adjusted HR* (95% CI)

No‐TDF vs. TDF
35/49 (71.4) vs. 44/112 (38.6)
0.001
2.04 (1.31, 3.18)
2.10 (1.34, 3.29)

Among TDF users:

PI vs. NNRTI
26/53 (49.1) vs. 18/57 (31.6)
0.108
1.63 (0.89, 2.97)
1.63 (0.87, 3.06)

Lopinavir/r vs. efavirenz
19/35 (54.3) vs. 16/52 (30.8)
0.033
2.03 (1.04, 3.96)
2.05 (1.05, 3.99)
Activation and inflammation markers in HIV‐1‐infected patients in dependency of treatment strategies
Authors: Ehret R , Wienbreyer A , Obermeier M , Baumgarten A , Krznaric I , Ingiliz P , Carganico A , Dupke S , Cordes C , Schulbin H , Claus J , Berg T 
Published: November 2012

Purpose of the studyHIV‐1‐infected patients have elevated levels of immune activation and systemic inflammatory markers which are partially strong predictors of disease progression or are associated with increased cardiovascular risk. The dependency of anti‐retroviral treatment (ART), the usage of NNRTI or PI‐based and the application of non‐nuc regimens is analysed here on the basis of a dataset (Chronic Inflammation Dependency on TREatment: CIDRE cohort) from 1500 patients in Berlin.MethodsIn a retrospective analysis we compared relative CD4+ cell counts, viral load, relative CD8+CD38+DR‐and CD3+DR+cells, concentration of high‐sensitivity C‐reactive protein (hsCRP) and interleukin‐6 (IL‐6) in therapy‐naïve or treated patients dependent on usage or non‐usage of NUCs, PI or NNRTI. Statistics were performed with R (R Core Team; 2012; R: A language and environment for statistical computing) using Wilcoxon rank sum test in two‐sided analysis.Summary of resultsAs to expect, ART‐naïve patients (n=190) had significantly higher viral loads and lower CD4+cell counts (p: both<0.05) and showed higher activation levels than treated patient (CD8+CD38+DR‐ and CD3+DR+both<0.05). But no significant difference was calculated for hsCRP or IL‐6. Nuc‐sparing regimen (n=46) did not show any distinction compared to nuc‐containing therapies (n=1249) for the analysed parameters. Significant differences were detected for PI‐regimen (n=711) with lower CD4+ cell counts and higher activation (CD8+38+DR‐, CD3+DR+) and IL‐6 (p: all<0.05) but not for hsCRP (p=0.39). The opposite was true for NNRTI‐based therapies (n=445) with higher CD4+ cell percentages and lower activation and inflammation markers (p: all<0.05) and as well no difference in hsCRP (p=0.97) compared with all other treated patients.ConclusionsThe lack of differences between therapy‐naïve patients and patients on ART for inflammation markers may be due to the relative good immunological state of the first group, which could be one of the reasons why they are not treated so far. The number of nuc‐sparing regimen is perhaps too low and too undifferentiated to find diverse inflammation states. Although the differences in activation status can be attributed to different treatment strata, there is no clear explanation for this outcome. A possible reason could be a pre‐selection bias either for NNRTI‐based or PI‐based regimens. Additional data is acquired to perform longitudinal analysis to gain further insight.
Pregnant … pause? Is there a difference in the long‐term outcome of women starting ART for the first time in pregnancy?
Authors: Farne H , Russell J , Kegg S 
Published: November 2012

Purpose of the studyThe guidelines on the initial choice of antiretroviral therapy (ART) in women starting ART for the first time in pregnancy have changed considerably over the past 13 years [1,2]. We sought to determine whether these different ART strategies have influenced subsequent clinical, immunological or virological outcomes in our population. Women in our cohort received either zidovudine (AZT) monotherapy, short course antiretroviral therapy (SCART) or continued ART post‐partum. AZT monotherapy in pregnancy was common a decade ago, but its use declined amidst concerns about efficacy and the potential development of resistance with monotherapy. SCART more effectively suppresses viral load (VL) but avoids unnecessary treatment post‐partum in those considered at low risk of disease progression. This is used less now the benefits of starting ART at better‐conserved CD4 counts and the risks of treatment interruption are known.Method30 women who commenced ART during a pregnancy which resulted in a live birth between 1999 and 2004 were identified from a departmental database. Women already on ART or who had previously received AZT monotherapy or SCART were excluded, as were women with less than 2 years follow up post‐partum. Outcomes included time to starting ART, CD4 count and VL on starting ART and at last follow up.Summary of results12 women received AZT monotherapy, 7 SCART and 11 continued ART post‐partum. In total there were 269 years of patient follow up (mean 9, range 2–13).

(mean)
AZT monotherapy
SCART
Continued ART

Baseline CD4
409
359
190

Baseline VL
1,950
6,799
59,566

Time to starting ART
5.2 years*
4.6 years**

CD4 on starting ART
254
178

CD4 <350 on starting ART
3/12
3/7

CD4 at last follow up
519
451
543

1 still not on ART at last follow up; **2 not on ART at last follow up.

None of the women who received AZT monotherapy or SCART experienced clinical disease progression during their time off therapy, which was considerable (mean 4–5 years). All achieved virological suppression and good CD4 recovery on commencing ART. None of the available genotypes in these patients showed resistance mutations. Of the women who continued ART, more than half modified their regimen and a significant number experienced transient VL rebounds.ConclusionsThe clinical choices made a decade ago do not appear to have been detrimental to the longer‐term treatment responses in this group of women. However, the effects of treatment interruption remain unclear and we suggest a cautious approach.
Efficacy and safety of switching double‐boosted protease inhibitors to boosted darunavir in HIV‐infected patients with virologic suppression
Authors: Curran A , Villar J , Burgos J , González A , van den Eynde E , Guelar A , Falcó V , Crespo M , Knobel H , Ribera E 
Published: November 2012

Purpose of the studySwitching to ritonavir‐boosted darunavir (DRV/r) in patients treated with double ritonavir‐boosted protease inhibitors (PI/r) may result in better tolerability, less pill burden, better lipid profile and a lower cost, while maintaining virologic efficacy.MethodsMulticentre, concurrent cohort observational study. HIV‐infected adults with HIV RNA <50 copies/mL for at least the previous 12 months on a double PI/r‐based therapy were offered to switch to DRV/r (DRV group) or to continue on the same regimen (control group). Visits (including blood tests, adherence and side effects assessment) were performed every 3 months, with a follow‐up of at least one year. Descriptive values are described as n (%) or median (interquartile range). Changes from baseline in quantitative variables have been calculated with the Wilcoxon Signed Ranks Test and comparisons between groups have been performed with the Mann‐Whitney test, using SPSS 20.0 statistical package.Summary of results65 patients were included (35 DRV group and 30 control group); median age was 46 (40–49) years, 76% were male. At baseline, double‐boosted PI regimens were lopinavir‐atazanavir/r 24%, lopinavir‐saquinavir/r 46%, lopinavir‐fosamprenavir/r 8%, atazanavir‐saquinavir/r 18% and others 4%. There were no significant differences between groups in baseline characteristics, except for patients who switched to DRV had a higher number of prior antiretroviral regimens [6 (3–8) vs 2 (1–4), p=.002]. Of the patients who switched to DRV/r, 46% received DRV/r once‐daily and 54% twice‐daily. After 48 weeks, one patient in each arm had virologic failure and one patient in the DRV arm stopped treatment due to side effects (depressive syndrome); there were no episodes of rash or clinical hepatitis. Efficacy (HIV RNA <50 copies/mL) was similar in the DRV and control groups by intention‐to‐treat analysis (94 vs. 97%, p=NS). There were no significant differences in laboratory parameters between treatment groups except for a decrease in total bilirrubin in patients who switched to DRV/r (−0.69 vs +0.28 mg/dL, p=.028). Treatment switch represented a median saving of 157 (32–264) euros per patient per month.ConclusionsSwitching from a double‐boosted PI regimen to DRV maintains virologic efficacy, with good tolerability and a lower cost.
Safety and efficacy of a raltegravir‐based dual antiretroviral therapy in clinical practice
Authors: Cenderello G , Penco G , Pontali E , Feasi M , Cassola G 
Published: November 2012

BackgroundHAART has revolutionized HIV disease management and increased life expectancy for most HIV‐infected individuals on treatment. A nucleoside/tide reverse transcriptase (NRTI) inhibitor backbone is a recommended component of standard first‐line HAART. Nevertheless, NRTI‐sparing alternatives are warranted in order to reduce long‐term toxicities in many patients (pts). Aim of the study was to evaluate safety of raltegravir‐based dual antiretroviral therapy (DUAL) in a clinical practice setting.MethodsAll pts on DUAL regimen followed at our outpatient HIV service on May 31st 2012 were recruited. Their clinical files were retrospectively studied. Collected data included: demographics, CDC staging, reason to DUAL switching, cholesterol (total and HDL), creatinine, CK, CD4+ count and HIV RNA were recorded at switch and every six months after for the first year. Change in CD4 count after the switch was evaluated by Student t‐test.ResultsThe cohort included 55 pts (27 M); mean age was 54 years (38–72). HIV infection was acquired through: injective drug abuse (25), unprotected homosexual (24) and heterosexual (16) intercourse. CDC staging was: A=16, B=26, C=13. Mean previous treatment regimens were 4. At time of study pts had been on DUAL regimen for 23 months. They had been switched to DUAL therapy for: drug resistance (14; 25.5%) (DRR) or drug toxicity (41; 74.5%). The most frequently associated drug was darunavir/rtv (19; 34.5%), followed by atazanavir (13; 23.6%; 5 were unboosted); lopinavir/rtv (12; 21.8%), and NVP (11; 20%). DRR pts presented at baseline a mean viral load of 40,153 copies of HIV‐RNA/ml; after at 12 months all but 3 showed undetectable (<40 copies) viral load and a mean CD4 gain of 142 cells/ml. Pts switched to DUAL for toxicity presented persistent undetectable viral load and a mean CD4+gain of 94 cells/ml. The observed CD4+ increase in both groups (DRR and toxicity) presented a statistical significance (p<0.01). Total and HDL cholesterol, and creatinine did not present significant variations. CK remained stable and no toxicity episode was observed.ConclusionDUAL approach showed good safety and also remarkable results in terms of viral suppression and immunological recovery. Notwithstanding the potential low genetic barrier of some combinations (e.g. NVP+RAL) this strategy demonstrated to be effective. The long term reliability of DUAL should be confirmed by studies with a longer follow up and a wider sample.
Predictors of long‐term HIV RNA suppression on darunavir/ritonavir monotherapy in the MONET trial
Authors: Arribas J , Pulido F , Hill A , van Delft Y , Moecklinghoff C 
Published: November 2012

BackgroundIn previous studies of protease inhibitor (PI) monotherapy, patients with higher nadir CD4 counts, baseline HIV RNA<1 copy/mL and high adherence to treatment have been most likely to show sustained HIV RNA suppression<50 copies/mL.MethodsIn the MONET trial, 256 patients with HIV RNA <50 copies/mL at screening switched to DRV/r 800/100 mg once daily, either as monotherapy (n=127) or with 2 NRTIs (n=129). HIV RNA results were classified as either<5 (no detection), 5–49 (virus detected under quantification limit) or >50 copies/mL. Treatment failure was defined as two consecutive HIV RNA levels >50 copies/mL (TLOVR) by Week 144, or discontinuation of study drugs. Additional analyses were conducted (i) excluding discontinuations for adverse events or other reasons (ii) including patients who intensified with NRTIs. Multivariate logistic regression was used to identify factors predictive of treatment failure by Week 144.ResultsBy Week 144, the percentage of patients with HIV RNA <50 copies/mL (ITT, TLOVR, Switch=Failure) was 69% versus 75% in the DRV/r monotherapy and triple therapy arms respectively. In the Switch Included analysis, HIV RNA <50 copies/mL was 84.0% versus 83.5% in the DRV/r monotherapy and triple therapy arms respectively. In the multivariate analysis for the TLOVR endpoint, positive HCV serology correlated with treatment failure (odds ratio [OR]=2.44, 95% CI 1.20–5.00). In the analysis including only virological endpoints, both positive HCV serology (OR=2.77, 95% CI 1.18‐6.67) and baseline HIV RNA >5 copies/mL (OR=2.71, 95% CI 1.21‐6.08) predicted treatment failure. In the Switch Included analysis, only HIV RNA >5 copies/mL was predictive of treatment failure (OR=2.78, 95% CI 1.28–6.01). Nadir CD4 count and prior PI use were not predictive of treatment failure in any analysis. In the ITT TLOVR analysis, the response rates in the DRV/r monotherapy arm at Week 144 were 79% (66/84) for HCV‐ve patients with baseline HIV RNA <5 copies/mL, 63% (12/19) for HCV‐ve patients with baseline HIV RNA >5 copies/mL, 47% (9/19) for HCV+ve patients with baseline HIV RNA<5 copies/mL and 20% (1/5) for HCV+ve patients with baseline HIV RNA>5 copies/mL.ConclusionsIn the MONET trial, patients without HCV co‐infection (based on serology), and with baseline HIV RNA <5 copies/mL by the Roche Amplicor assay (i.e. no virus detected) were most likely to show sustained HIV RNA suppression<50 copies/mL on DRV/r monotherapy.