Prisons, sida et divulgation de renseignements médicaux. Analyse juridique et éthique

The article addresses some of the issues raised in federal correctional institutions by the generation and communication of personal medical information pertaining the HIV infection. It examines, first, whether medical information pertaining to federal inmates — information considered confidential between medical staff and an inmate — can be disclosed absent the inmate's consent. It then examines what conditions or criteria determine whether or not such disclosure is ethically and legally justifiable, and if disclosure is justified, what conditions apply to its disclosure. Finally, specific situations in which a claim for disclosure may arise are examined.The article concludes that in federal correctional institutions, the disclosure of personal medical information absent consent of the person is seldom justifiable. In most situations, such disclosure is unnecessary and even appears to be counterproductive or harmful. Measures that can be undertaken to prevent exposure to and infection with HIV have to be undertaken regardless of whether an inmate or staff member is or is not known, to staff, wardens, or inmates, to be infected with HIV

The Code of Protest. Images of Peace in the West German Peace Movements, 1945-1990

The article examines posters produced by the peace movements in the Federal Republic of Germany during the ColdWar, with an analytical focus on the transformation of the iconography of peace in modernity. Was it possible to develop an independent, positive depiction of peace in the context of protests for peace and disarmament? Despite its name, the pictorial selfrepresentation of the campaign ‘Fight against Nuclear Death’ in the late 1950s did not draw on the theme of pending nuclear mass death. The large-scale protest movement in the 1980s against NATO’s 1979 ‘double-track’ decision contrasted female peacefulness with masculine aggression in an emotionally charged pictorial symbolism. At the same time this symbolism marked a break with the pacifist iconographic tradition that had focused on the victims of war. Instead, the movement presented itself with images of demonstrating crowds, as an anticipation of its peaceful ends. Drawing on the concept of asymmetrical communicative ‘codes’ that has been developed in sociological systems theory, the article argues that the iconography of peace in peace movement posters could not develop a genuinely positive vision of peace, since the code of protest can articulate the designation value ‘peace’ only in conjunction with the rejection value ‘war’

Modified transarterial chemoembolization with locoregional administration of sorafenib for treating hepatocellular carcinoma: feasibility, efficacy, and safety in the VX-2 rabbit liver tumor model

PURPOSE:We aimed to assess the feasibility, efficacy and safety of a local application of sorafenib within a conventional transarterial chemoembolization in the VX-2 tumor-bearing rabbit model.METHODS:VX-2 tumors were induced in the left liver lobe of 10 New Zealand White rabbits. After two weeks, growth was verified by contrast-enhanced computed tomography (CT). Five rabbits were treated by transarterial chemoembolization using an emulsion of sorafenib and ethiodized oil (referred to as SORATACE; n=5). Rabbits receiving oral sorafenib for two weeks (n=2) and untreated rabbits (n=3) served as controls. After two weeks, contrast-enhanced CT was performed, followed by animal necropsy.RESULTS:The change in tumor diameter between baseline and follow-up was significantly different in the SORATACE group compared with the other groups; tumor shrinkage was observed in the SORATACE group only (P = 0.016). In both control groups, preserved hypervascularity was seen in the follow-up CT in all but one tumor. All tumors in the SORATACE group were devascularized in the follow-up CT. Importantly, substantial parenchymal damage in nontargeted areas of the tumor-bearing liver lobe was seen in rabbits treated with SORATACE.CONCLUSION:SORATACE demonstrated high efficacy in the treatment of experimental VX-2 liver tumors but was also associated with substantial liver parenchymal toxicity

A time-resolved proteomic and prognostic map of COVID-19.

COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. We characterized the time-dependent progression of the disease in 139 COVID-19 inpatients by measuring 86 accredited diagnostic parameters, such as blood cell counts and enzyme activities, as well as untargeted plasma proteomes at 687 sampling points. We report an initial spike in a systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution, and immunomodulation. We identify prognostic marker signatures for devising risk-adapted treatment strategies and use machine learning to classify therapeutic needs. We show that the machine learning models based on the proteome are transferable to an independent cohort. Our study presents a map linking routinely used clinical diagnostic parameters to plasma proteomes and their dynamics in an infectious disease

Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic: a prospective observational study

Purpose: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course. Methods: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed. Results: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10-1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00-16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26-46.75, vs 18 days, IQR 16-46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6-15.5) for non-IMV and 49.5 days (IQR 36.8-82.5) for IMV patients. Conclusions: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19

Termite colonies (Macrotermes michaelseni), tree locations and metrics of 2007 and 2019 in Namibia

This data set contains metrics and coordinates of termite mounds (Macrotermes michaelseni) and associated trees in 1 km2 of Namibian thornbush savanna. Furthermore, all locations of Boscia albitrunca above 1.5 m height within the observatory are listed. Apart from the mound metrics, mound activity status and number of associated trees are provided. For the associated trees we provide data on the species, metrics and the relative position to the termite mound, respectively the coverage by the canopy. Out of all 362 analyzed termite mounds, 203 (56.08 %) were associated with a tree. Mounds with associated trees showed increased activity, growth and height. Mound growth within the study period was correlated positively with the canopy coverage by the associated tree whilst total mound heights were correlated non-linear with medium canopy coverage of about 40 %. Mounds with a tree covering the sun's average zenith (north) were taller, grew most within 12 years and were more likely to be active than those with no northern canopy coverage. Mounds associated with the evergreen Boscia albitrunca attained highest average height (195.06 ± 11.76 cm). Therefore, we used the term “partner tree” for trees associated with Macrotermes michaelseni mounds. The mound metrics have been recorded in 2007 and 2019 and the trees were recorded and measured in 2019. The study observatory “Otjiamongombe” is located in Central Namibia, 120 km north of Windhoek and part of the BIOTA Africa project (Biodiversity Monitoring Transect Analysis). We mapped the observatory twice in order to get temporal data on mound metrics and dynamics with special regard to the associated vegetation. The data on tree parameters and tree distribution allow us to investigate the mutualism between termite mounds and partner trees. All locations were recorded with a handheld GPS (Garmin, Schaffhausen, Switzerland), having an accuracy of ± 3 m. We considered termite mounds as visible above ground mounds and also any presence of remnants of the outwash pediment. Measurements were taken with a measuring tape or stick and in case of large mounds and trees we used a Vertex IV tree height measuring instrument (Haglöf, Långsele, Sweden). Only trees directly adjacent to the termite mounds where measured and defined as partner trees. Mounds with proof of recent building activity were recorded as active

Plant communities and their environmental drivers on an arid mountain, Gebel Elba, Egypt

Aims: Gebel Elba is an arid mountain range supporting biological diversity that is incomparable to any other region of Egypt. This mountain has a vegetation structure and floristic community similar to the highlands of East Africa and the southwestern Arabian Peninsula. We aimed to provide the first classification of the vegetation units on Gebel Elba and identify the environmental factors controlling their distribution. Study area: Wadi Yahmib and its tributaries, which drain the north-western slopes of Gebel Elba, south-eastern Egypt. Methods: On the basis of 169 relevés, we used TWINSPAN to classify the perennial vegetation. We calculated separate GAMs for the deciduous and evergreen species to describe the patterns for each leaf strategy type with elevation. We used CCA to quantify the relationship between the perennial vegetation and the studied environmental factors. To estimate diversity and our sampling strategy, we used rarefaction curves for species richness. Results: We identified seven communities along the elevational gradient of Wadi Yahmib and its tributaries. We found that each community was restricted to a confined habitat depending on its drought resistance ability. Deciduous Vachellia woodland was the main vegetation type on Gebel Elba, while evergreen Olea woodland appeared in small fragments at higher elevations. We analysed the distribution patterns of deciduous and evergreen trees along the elevational gradient. We found a turnover at 500 m, indicating a potential ecotone between the Vachellia and Olea woodlands that was occupied by a Ficus community. CCA revealed the importance of altitude and soil quality in determining the vegetation structure of Gebel Elba. The species richness increased with elevation as a result of reduced stress and increased water availability at the upper wadis. Conclusions: This study identified seven vegetation units in the study area and showed the importance of orographic precipitation, soil quality and the complex topography in determining the habitats. Taxonomic reference: Boulos (2009); names updated according to POWO (2019). Abbreviations: CCA = Canonical Correspondence Analysis; GAM = Generalized Additive Model; TWINSPAN TWINSPAN = Two Way Indicator Species Analysis