Incidence of HIV-related anal cancer remains increased despite long-term combined antiretroviral treatment: results from the french hospital database on HIV.

PURPOSE: To study recent trends in the incidence of anal cancer in HIV-infected patients receiving long-term combined antiretroviral treatment (cART) compared with the general population. PATIENTS AND METHODS: From the French Hospital Database on HIV, we identified 263 cases of invasive anal squamous cell carcinoma confirmed histologically between 1992 and 2008. We compared incidence rates of anal cancer across four calendar periods: 1992-1996 (pre-cART period), 1997-2000 (early cART period), and 2001-2004 and 2005-2008 (recent cART periods). Standardized incidence ratios (SIRs) were calculated by using general population incidence data from the French Network of Cancer Registries. RESULTS: In HIV-infected patients, the hazard ratio (HR) in the cART periods versus the pre-cART period was 2.5 (95% CI, 1.28 to 4.98). No difference was observed across the cART calendar periods (HR, 0.9; 95% CI, 0.6 to 1.3). In 2005-2008, HIV-infected patients compared with the general population had an excess risk of anal cancer, with SIRs of 109.8 (95% CI, 84.6 to 140.3), 49.2 (95% CI, 33.2 to 70.3), and 13.1 (95% CI, 6.8 to 22.8) for men who have sex with men (MSM), other men, and women, respectively. Among patients with CD4 cell counts above 500/μL for at least 2 years, SIRs were 67.5 (95% CI, 41.2 to 104.3) when the CD4 nadir was less than 200/μL for more than 2 years and 24.5 (95% CI, 17.1 to 34.1) when the CD4 nadir was more than 200/μL. CONCLUSION: Relative to that in the general population, the risk of anal cancer in HIV-infected patients is still extremely high, even in patients with high current CD4 cell counts. cART appears to have no preventive effect on anal cancer, particularly in MSM

Managing small-scale fisheries confronted with socio-economic changes in New Caledonia (South Pacific)

International audienc

Perspectives of Executives and Students on Leadership Characteristics for Healthcare Managers: Does a Gap Exist?

Preparing healthcare managers for the complexity of the healthcare industry poses a heavy challenge on healthcare organizations, CEOs, managers, and educational institutions. In order to ensure that future healthcare managers are prepared to enter the workforce, it is important that the characteristics and skills deemed important by current CEOs in the field are similar to those of undergraduate healthcare management students that will be entering the workforce

Apport de la simulation à la conception et l'interprétation de tableaux de bord de back office bancaire (CCP) et à la comptabilité de gestion. / The simulation contribution to the conception and interpretation of backoffice scoreboard and to the management accounting

International audienceCet article traite des apport de la simulation à la conception et l'interprétation de tableaux de bord de back office bancaire (CCP) et de la comptabilité de gestion

The flip-flap puzzle flap: Another recycling option

Post-traumatic soft tissue defects sometimes require sequential flap coverage to achieve complete healing. In the era of propeller flaps, which were developed to reduce donor site morbidity, Feng et al. introduced the concept of the free-style puzzle flap, in which a previously harvested flap becomes its own donor site by recycling the perforator. However, when a perforator cannot be found with a Doppler device, we suggest performing a new type of flap, the flip-flap puzzle flap, which combines two concepts: the free-style puzzle flap and the flip-flap flap described by Voche et al. in the 1990s. We present the cases of three patients who achieved complete healing through this procedure

On feasible and infeasible search for equitable graph coloring

An equitable legal k-coloring of an undirected graph G = (V, E) is a partition of the vertex set V into k disjoint independent sets, such that the cardinalities of any two independent sets differ by at most one (this is called the equity constraint). As a variant of the popular graph coloring problem (GCP), the equitable coloring problem (ECP) involves finding a minimum k for which an equitable legal k-coloring exists. In this paper, we present a study of searching both feasible and infeasible solutions with respect to the equity constraint. The resulting algorithm relies on a mixed search strategy exploring both equitable and inequitable colorings unlike existing algorithms where the search is limited to equitable colorings only. We present experimental results on 73 DIMACS and COLOR benchmark graphs and demonstrate the competitiveness of this search strategy by showing 9 improved best-known results (new upper bounds)

Managing Small-Scale Fisheries Confronted With Socio-Economic Changes in New Caledonia (South Pacific)

On the rural Northwest coast of New Caledonia, the settlement of a world class mining complex has initiated rapid socio-economic changes, linked with a considerable demographic increase (+ 65% between 2007 and 2015) and plentiful job opportunities. In 2007 and 2009, studies on fisheries and commercialization of reef finfish and invertebrates were conducted to assess how these changes could impact resource-use patterns. Results showed that 1) economic, 2) social and 3) ecological changes were expected. 1) The increase in demand (+70%) may strengthen the market for marine products through the increase in local commercial fishing or external supply that would diversify and lessen local fishing pressure. 2) The lagoon uses were strongly linked to the social background of fishers. Subsistence and recreational fishing practises were part of ways of life in this rural area and may be modified by the ongoing local economic boom. 3) The overall fishing pressure (0.26 t/km²/year) was low. However, its spatial distribution showed that some areas were close to overfishing. Results suggested that the expected rise in commercial and recreational fishing could lead to unsustainable exploitation levels in these zones. Given the scope of potential changes, public authorities have to manage changing lagoon uses to balance the indirect effects of economic development on the local natural and social landscape. They will have to choose options that would support the development of local fisheries, representing about 500,000 ¬ of sales a year, or maintain the present social organization and ecological status of reefs.Keywords: Fish and Aquaculture Sectors Development, Small Scale Fisheries, Fisheries Economic

Gravity for FDI

Gravity equations explaining foreign affiliates’ sales are ad hoc and hence, estimated coefficients are hard to interpret. We therefore provide the theoretical underpinnings of the gravity equation applied to the analysis of sales of foreign affiliates of multinational firms. We argue that the success of the gravity equation results from the fact that it can be derived from various theoretical models. We illustrate this point by deriving a gravity equation from three different models of multinational firms. Using data on real affiliate sales, we show how this derived gravity equation can nevertheless be used to discriminate between the different theoretical models

A rating scale to be used as a guide in grade determination for clinical practice of freshman students in the nursing course of a specific school of nursing

Thesis (M.S.)--Boston Universit