bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipodystrophy and weight changes: data from the Swiss HIV Cohort Study, 2000–2006
Authors: Nguyen A , Calmy A , Schiffer V , Bernasconi E , Battegay M , Opravil M , Evison J‐M , Tarr PE , Schmid P , Perneger T , Hirschel B ,   the Swiss HIV Cohort Study
Published: February 2008

Background and ObjectivesCombination antiretroviral therapy (cART) is changing, and this may affect the type and occurrence of side effects. We examined the frequency of lipodystrophy (LD) and weight changes in relation to the use of specific drugs in the Swiss HIV Cohort Study (SHCS).MethodsIn the SHCS, patients are followed twice a year and scored by the treating physician as having ‘fat accumulation’, ‘fat loss’, or neither. Treatments, and reasons for change thereof, are recorded. Our study sample included all patients treated with cART between 2003 and 2006 and, in addition, all patients who started cART between 2000 and 2003.ResultsFrom 2003 to 2006, the percentage of patients taking stavudine, didanosine and nelfinavir decreased, the percentage taking lopinavir, nevirapine and efavirenz remained stable, and the percentage taking atazanavir and tenofovir increased by 18.7 and 22.2%, respectively.In life‐table Kaplan–Meier analysis, patients starting cART in 2003–2006 were less likely to develop LD than those starting cART from 2000 to 2002 (P<0.02). LD was quoted as the reason for treatment change or discontinuation for 4% of patients on cART in 2003, and for 1% of patients treated in 2006 (P for trend <0.001). In univariate and multivariate regression analysis, patients with a weight gain of ≥5 kg were more likely to take lopinavir or atazanavir than patients without such a weight gain [odds ratio (OR) 2, 95% confidence interval (CI) 1.3–2.9, and OR 1.7, 95% CI 1.3–2.1, respectively].ConclusionsLD has become less frequent in the SHCS from 2000 to 2006. A weight gain of more than 5 kg was associated with the use of atazanavir and lopinavir.
Hepatitis C virus antibody‐positive patients with HIV infection have a high risk of insulin resistance: a cross‐sectional study
Authors: Squillace N , Lapadula G , Torti C , Orlando G , Mandalia S , Nardini G , Beghetto B , Costarelli S , Guaraldi G 
Published: February 2008

ObjectiveThe aim of the study was to characterize and compare insulin resistance (IR) in hepatitis C virus (HCV)‐antibody (Ab)‐positive and HCV‐Ab‐negative patients with HIV infection.MethodsThis was a single‐centre cross‐sectional study of 1041 HIV‐infected patients (373 HCV‐Ab‐positive; 167 with detectable plasma HCV RNA). Metabolic and anthropometric assessments were performed, including measurement of IR using the homeostasis model for assessment of insulin resistance (HOMA‐IR).ResultsThe prevalence of IR (i.e. a HOMA‐IR score ≥3.8) was significantly higher in HCV‐Ab‐positive than in HCV‐Ab‐negative patients (47.7 vs. 32.7%; P<0.0001). On multivariable linear regression analysis, the following variables were associated with HOMA‐IR score, expressed as an estimate of the percentage variation (Est.): high‐density lipoprotein cholesterol (per 0.3 mmol/L increase: Est.–4.1; P=0.01), triglycerides (per 0.1 mmol/L increase: Est. 0.6; P<0.001), alcohol intake (Est. −12.4; P=0.002), sedentary lifestyle (Est. 14.7; P<0.001), CD4 T‐cell count in the highest quartile, i.e. ≥690 cells/μL (Est. 20.7; P=0.002), body mass index in the highest quartiles, i.e. ≥22.54 kg/m2 (Est. 30.5–44.7; P<0.001), waist‐to‐hip ratio in the highest quartile, i.e. >1 (Est. 30.2; P<0.001) and HCV‐Ab positivity (Est. 24.4; P<0.001).ConclusionsOur data confirm that HCV‐Ab positivity is an independent risk factor for IR. Management aimed at correcting known risk factors for IR should be implemented.
A new strategy based on recombinant viruses for assessing the replication capacity of HIV‐1
Authors: Garcia‐Perez J , Perez‐Olmeda M , Sanchez‐Palomino S , Perez‐Romero P , Alcami J 
Published: February 2008

ObjectiveIn heavily pretreated patients, resistance mutations arise in both protease (PR) and reverse transcriptase (RT) sequences; however, the relative impact of PR and RT mutations on viral fitness cannot be evaluated with the majority of systems. To address this issue we have developed a model based on recombinant viruses (RVs) that allows the analysis of the replication capacity (RC) of viral populations in which PR and RT are cloned either in combination or separately.MethodsRVs were generated for full‐length polymerase (pol) gene, PR or RT sequences from nine naïve and 14 heavily pretreated HIV‐infected patients in therapeutic failure. The relative RC was assessed by comparing luciferase activity between mutant RV and wild‐type (wt) isolates.ResultsA strong decrease (>60%) in the RC of the pol RV population was observed in the 14 heavily pretreated patients as compared with the wt RVs. The analysis of PR and RT RVs from these patients showed that the decrease in RC was mainly attributable to PR sequences in three of these 14 patients and to RT sequences in seven of these patients. In the four remaining patients, PR and RT sequences independently reduced the RC of the RVs to similar extents.ConclusionsDifferent patterns of mutations in either PR or RT have a strong impact on RC in highly experienced HIV‐infected patients.
Cardiovascular risk score change in HIV‐1‐infected patients switched to an atazanavir‐based combination antiretroviral regimen
Authors: Colafigli M , Di Giambenedetto S , Bracciale L , Tamburrini E , Cauda R , De Luca A 
Published: February 2008

BackgroundWe aimed to establish whether the limited impact of atazanavir on the plasma lipid profile could translate into a reduction in the predicted cardiovascular risk in antiretroviral (ARV)‐experienced patients switching to an atazanavir‐containing regimen.MethodsHIV‐1‐infected treatment‐experienced patients, switched to atazanavir for whatever reason and without prior major cardiovascular events, were selected and followed for at least 1 month. An individual cardiovascular risk score (10‐year risk of major cardiovascular events) based on validated events and measurable risk factors in Italian cardiovascular cohorts was calculated using software available online.ResultsA total of 197 patients were selected for inclusion in the study. After switching to atazanavir, the mean changes from pre‐switch to last available measurement were −6.5% (P<0.001) for total cholesterol, −1.7% (P=0.029) for high‐density lipoprotein (HDL) cholesterol, −11.3% (P<0.001) for non‐HDL cholesterol and −8.6% (P<0.001) for triglycerides. The crude cardiovascular risk score was reduced from 3.43 to 3.38% (P=0.51); the analysis normalized by age showed a reduction from 3.43 to 3.14% (P<0.001). Subsets of patients with high baseline total cholesterol or triglycerides showed more marked reductions.ConclusionsA treatment switch to atazanavir caused significant reductions in plasma lipids and a modest but significant reduction in the normalized‐for‐age cardiovascular risk score. Efforts should be made to concomitantly reduce the other preventable cardiovascular risk factors.
A Modern Myth. That Letting Die is not the Intentional Causation of Death: some reflections on the trial and acquittal of Dr Leonard Arthur
Authors: KUHSE HELGA 
Published: February 2008

ABSTRACT If a doctor kills a severely handicapped infant, he commits an act of murder; if he deliberately allows such an infant to die, he is said to engage in the proper practice of medicine. This is the view that emerged at the recent trial of Dr Leonard Arthur over the death of the infant John Pearson. However, the distinction between murder on the one hand and what are regarded as permissible lettings die on the other rests on the Moral Difference Myth, according to which deliberate lettings die in the practice of medicine are not instances of the intentional causation of death.I argue that a doctor who refrains from preventing a handicapped infant's death, causes that infant's death and does so intentionally. He commits an act of murder. But, I suggest, not all instances of the intentional causation of death are morally wrong. To the extent that they are not, killing rather than letting die will often be the preferable option because more economical of suffering. Hence what is required is the abolition of the Moral Difference Myth and legislation to the effect that those doctors who justifiably cause a patient's death—whether by an action or by an omission—commit no offence.
Reductivism, Fatalism and Sociobiology
Authors: MIDGLEY MARY 
Published: February 2008

ABSTRACT When does ‘reduction’ in the harmless sense of relating one science to another involve a sinister devaluing of the valuable? Only when the ‘reductive’ explanation is (1) treated as excluding others, and (2) so chosen as to make a moral point by illicit means.(1) is never legitimate; different kinds of explanation all have their place and do not compete. It is made to look plausible by (2), which can occur in many situations, but is usually called reduction only when it involves the physical sciences. Two different dangers follow—reduction to the unknown entities of physics is chilling, but fortunately seems to have no particular moral consequences.Biological reductions often sound less remote; e.g. when sociobiologists talk of people as ‘survival machines’ for genes. The trouble here is not ‘biological determinism’ but fatalism, with apparent moral consequences, namely, the endorsement of universal competition. This idea is bad biology, compounded by illicit rhetoric. Biology itself cannot be a threat. The biological causes of human behaviour, including those found by sociobiologists in their calmer moments, are perfectly proper material for the social sciences.
Duress and Responsibility for Action
Authors: CAMPBELL ROBERT 
Published: February 2008

ABSTRACTNot all crimes require mens rea, but all serious ones do. Crudely the requirement is that the defendant be able to take responsibility for theactus reusof which he is accused. What must be implied by this is essentially that the agent retain control of his actions. It is unjust to punish actions which are outside of the agent's control since such punishment cannot deter and is, arguably, pointless.Duress does not remove an agent's control of his actions. This does not mean that actions performed under duress should be viewed as fully intentional. For though the agent foresees and wishes for the result of his action performed under duress, it is wished for as the best option out of a range of alternatives manipulated by the one who makes the threats which constitute the duress. The agent is responsible for his choice, but not for what is available for him to choose. He has an obligation to do what is best in the circumstances and should not be blamed if that would, in other circumstances, be accounted criminal.
Collective and Individual Duties to Protect the Environment
Authors: CRANOR CARL F. 
Published: February 2008

ABSTRACT Many environmental harms are produced by the consequences of too many people doing acts which taken together have collective bad consequences, e.g. overuse of an underground aquifer or acid rain ‘killing’ a lake. If such acts are wrong, what should a conscientious moral agent do in such circumstances? Examples of such harms have the general feature that they are produced by individual acts, which taken by themselves may be innocent and morally permissible, but which have disastrous consequences when too many people perform them. Philosophers once thought that the generalisation argument (GA), “If the consequences of everyone's doing acts of kind a are undesirable, then no one ought to do a,” was the appropriate principle to guide a conscientious moral agent in such circumstances. However, there has been considerable literature discussing the shortcomings of this principle. Nevertheless, a proper understanding of the GA suggests that whole groups of people have collective duties to prevent such harms, which duties then provide clues to individual duties to protect the environment.In this paper I consider some major deficiencies of the generalisation argument, the collective duty which follows from the salvageable part of the argument, and the distribution of individual duties a conscientious moral agent has with regard to such environmental harms as a consequence. These duties turn out to be peculiarly political in nature with the result that conscientious moral agents may have a number of political duties to protect the environment heretofore unrealised.
Fairness in Financial Reporting
Authors: HARRIS N. G. E. 
Published: February 2008

ABSTRACT Public companies in most countries are legally required to publish annual accounts, and these are widely used for making financial decisions. To prevent users of accounts being misled into making disastrous decisions, all major Western countries have introduced controls on the ways accounts are presented. By British and EEC law a company's accounts must give a ‘true and fair view’ of its financial state.It has become widely accepted that if accounts are prepared according to standards drawn up by the accounting profession itself, then they can be considered as being ‘true and fair’. In this paper it is argued that such an interpretation of ‘true and fair’ gives inadequate protection to users. How users' interests might be better protected is discussed. Finally, it is suggested that Rawls’ notion of a ‘veil of ignorance’ could be used to ensure that in the preparation of accounts equal regard is paid to the interests of different types of user.
Aggression: myth or model?
Authors: EYKEN ALBERT VAN 
Published: February 2008

ABSTRACT The word, aggression, refers in general usage to unjustified attack, and any serious writer who uses it extensively in some figurative or newly‐coined technical sense should leave his meaning in no doubt. Unfortunately some ethological writers fail to do this and deceive themselves into the bargain.They somewhat naively claim to find aggression built into the fundamental nature of animals, a kind of instinct which cannot be resisted, indeed which must figure in their social cohesion. If the word really retains the moral connotation which I have indicated, then much animal biology is vitiated. Not only are animals misjudged, but, since conclusions are then applied to our human selves, we too are misjudged and recommended to adopt false moral principles.It is possible that ensuing armchair pseudo‐cures may be responsible for a real increase in human violence.
Human Bonds
Authors: ALMOND BRENDA 
Published: February 2008

ABSTRACT There are three kinds of bonds between human beings: biological and natural; legal and artificial; social and voluntary. Marriage can be seen as an artificial and legal means of shifting the loose bonding of the third category of relationship into the deep and inescapable bonding of the first. The desire to create bonds of this type is widespread, but non‐bonding, too, has been recommended either as good in itself—a way of achieving peace of mind or personal emancipation through wider relationships—or as necessary self‐denial for some higher cause. In the latter case, the bonds of family are seen as a positive good, a view shared, though for different reasons, by religious and political conservatives and by revisionist feminists.In contrast to this, three philosophical conceptions which would favour unbonding, or detachment from emotional ties, are categorised here as (a) the Stoic, (b) the Existentialist and (c) the Feminist. Within the Feminist ideal, it is radical, rather than liberal or socialist feminism that has most in common with Stoic or Existentialist ideals. These ideals are considered, together with various alternatives to marriage, and are judged not to override the need for deep personal bonds between human beings. These personal bonds of love and commitment are compared with the alternative bonds of religion and politics and it is concluded that, whatever forms they take, personal bonds have fundamental moral priority in the lives of human beings.
The Ethics of Enforced Medical Treatment: the balance model
Authors: EASTMAN NIGEL L. G. , HOPE R. A. 
Published: February 2008

ABSTRACT When is it right to enforce medical treatment on a patient who is refusing that treatment? English law recognises two ethical principles as of paramount importance: the autonomy of the patient; and the consequences of not treating compared with treating. The law, by and large, operates these principles in succession. Thus, in the case of a patient refusing treatment, the law asks first, is the patient competent? Only if the answer is no, are the consequences considered.We criticise the position taken by English law and argue, first, that competence is a graded and not a binary concept, and secondly, that the two ethical principles should be applied not sequentially but at the same time. These two ideas form what we have called the balance model.This model could be used for an empirical study of individuals’ ethical beliefs, and in particular to test the hypothesis that the ethical beliefs of most individuals conform to the balance model rather than to the position taken by English law.
Intention and Coercion
Authors: WALL EDMUND 
Published: February 2008

ABSTRACT Typically, philosophers have taken an external approach to the problem of defining ‘dispositional coercion’. However, a description of the surrounding circumstances of an allegedly coercive action is not the correct approach. What is required is an account of ‘dispositional coercion’ primarily in terms of personal motivation. ‘Dispositional coercion’ involves an agent threatening someone with a sanction if the latter fails to act as the agent requests. In order to define ‘dispositional coercion,’ I believe, the intentions of both the coercer and the victim need elucidation. In this essay, I defend the following set of necessary and sufficient conditions for defining this concept (where X is the coercer, Y is the victim and A is the action that Y is coerced into performing).(1) X threatens Y, that is, X intentionally attempts to create the belief in Y that X will be responsible for harm coming to Y should Y fail to do A. X's motive for attempting to create this belief is his desire to bring about a state of affairs in which Y's recognition of this possible harm to himself influences Y to do A.(2) X successfully creates the belief in Y that Y may be harmed if he fails to do A, that is, X is successful in causing Y to recognise that harm may come to him should he fail to do A.(3) Y intends to do A, and Y's motive for intending to do A is Y's desire to avoid harm to himself.(4) Y does A.
Love and Lust Revisited: intentionality, homosexuality and moral education
Authors: STAFFORD J. MARTIN 
Published: February 2008

ABSTRACT In his book Sexual Desire, Roger Scruton wrongly maintains that human sexual experience is essentially intentional. His thesis depends on his highly revisionary definitions of ‘sexual arousal’ and ‘sexual desire’, the artificial nature of which I expose and criticise.He admits that homosexual desire is capable of the same kind of intentionality as heterosexual desire, and is therefore not intrinsically obscene or perverted, but he advances reasons why homosexuality is morally different from heterosexuality and is therefore an object of disapproval. His arguments presuppose ‘an impassable moral divide’ between the sexes and are, on his own admission, not very cogent.Since he allows that homosexual desire is a natural and spontaneous phenomenon and also proposes that moral education should guide us towards a state in which our sexuality is entirely integrated within a life of personal affection and responsibility, consistency requires that he adopt a sexual ideology which does not discriminate against homosexuality. For homosexuals are unlikely to achieve the ‘sexual integrity’ which Scruton advocates (and which I endorse) if they are constantly encouraged to disparage their own sexual nature and if social institutions make no positive provision for them.
Terrorism and Morality
Authors: KHATCHADOURIAN HAIG 
Published: February 2008

ABSTRACT The paper addresses the fundamental issue of the morality of terrorism. It distinguishes four types of terrorism—‘predatory,’‘retaliatory,’‘political’and ‘moralistic’—and argues that in all of them terrorism (in a ‘descriptive,’value‐neutral sense of the word) is always wrong. After a short introductory section the paper considers in some detail the conceptual problem of defining ‘terrorism’. Next it considers the possible application to terrorism, with the necessary modifications, of two main conditions of a ‘just war’; viz. the Principles of Discrimination and of Proportion. It argues that these conditions support the paper's central contention. Additional support is then found in the concept and principles of human rights. In the final section the paper evaluates utilitarian arguments brought forth by Kai Nielsen in Violence and Terrorism: its uses and abuses, in support of so‐called ‘revolutionary terrorism’.Throughout the discussion is illustrated by some actual examples from the recent past.
Public Bodies, Private Selves
Authors: MARSHALL SANDRA E. 
Published: February 2008

ABSTRACT A patient whose case notes had been used, without her permission, during a disciplinary inquiry on the conduct of Wendy Savage (her obstetrician) complained that this was a breach of confidentiality. Her complaint cannot be understood as based on a concern about the possible adverse consequences of this use of the notes: rather, her concern was just with the fact that medical information about her had been made known to others.My concern is with the meaning and status of the right to privacy, to which the Savage patient appealed. Such a right cannot be reduced to a property right, since this cannot capture what concerned the Savage patient. A proper understanding of what lies behind her complaint requires us to recognise the way in which facts about oneself—in this case facts about one's body—are intimately bound up with one's self, with one's identity, and thus with one's autonomy. What kinds of fact, and thus what conception of the self, are involved in such a conception of privacy need not everywhere be the same; the crucial point is that privacy and the self are concepts which, whatever their particular content, are internally related [1].
The Case for Pacifism
Authors: NORMAN RICHARD 
Published: February 2008

ABSTRACT I present the case for pacifism by formulating what I take to be the most plausible version of the idea of respect for human life. This generates a very strong, though not necessarily absolute, moral presumption against killing, in war or any other situation. I then show how difficult it is for this presumption to be overridden, either by the considerations invoked in ‘just war’theory, or by consequentialist claims about what can be achieved through war.Despite the strength of the moral case against war, people sometimes say that they have no choice but to fight. In the concluding section of the paper I attempt to identify the relevant sense in which this could be said, and I discuss briefly how this affects the case for pacifism.