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

Détresse psychologique chez les personnes atteintes du VIH à Montréal

Le présent article décrit les préoccupations psychologiques reliées au VIH dans un échantillon montréalais de 128 personnes atteintes du virus, qui ont participé à une enquête nationale plus large sur les besoins et les services en santé mentale en rapport avec cette infection au Canada. Nous avons examiné les problèmes psychologiques causés par le VIH à Montréal, en comparaison d'autres villes du Canada, et dans divers sous-groupes définis selon le sexe, l'âge, le diagnostic et le facteur de risque. Les résultats montrent que même si l'infection au VIH a de fortes et profondes incidences sur la santé mentale, il existe des différences dans les genres de préoccupations et de problèmes qui affligent des groupes particuliers de répondants montréalais. L'incertitude de l'avenir et l'incapacité de réaliser ses buts dans la vie, ainsi que des sentiments d'impuissance et de peur face aux conséquences neurologiques virtuelles du VIH, étaient des sources majeures de détresse psychologique. Les sentiments de dépression, d'anxiété et de colère, de même que les inquiétudes soulevées par une détérioration physique croissante, la douleur, le danger d'infecter autrui, la confidentialité et la situation financière, étaient des sujets d'angoisse prédominants parmi les sous-groupes étudiés. Les différences entre les répondants en termes de sources de revenu, d'âge et de sexe et, dans une moindre mesure, de diagnostic et de facteur de risque, étaient associées à des niveaux variables de détresse psychologique. Bien que les répondants de Montréal (et de Vancouver) étaient moins angoissés que ceux de Toronto et de Halifax, cette divergence semblait tenir principalement à des différences d'âge et de revenu. Les données de l'enquête pourront servir aux décideurs et aux planificateurs du domaine de la santé à mettre au point les services nécessaires pour répondre aux besoins psychologiques des adultes atteints du VIH.This paper describes the HIV-related mental health concerns of a sample of 128 persons with HIV infection in Montréal who participated in a larger national survey of HIV-related mental health needs and services in Canada. We examined mental health distress in persons with HIV infection in Montréal compared to other cities in Canada, and in subgroups of HIV-infected Montrealers defined on the basis of sex, age, diagnosis, and risk factor status. Results demonstrate that although HIV infection has a strong and far reaching impact on mental health, there are differences in the types of concerns and issues that are distressing to specific groups of Montréal respondents. Uncertainty about the future and not being able to realize life goals, as well as feelings of helplessness and fears about potential adverse neurological consequences of HIV disease, were major sources of psychological distress. Feelings of depression, anxiety, and anger, as well as concerns about increasing physical disability, pain, infecting others, confidentiality, and finances were predominant concerns among specific subgroups. Differences between respondents in terms of source of income, age, and sex, and to a lesser extent diagnosis and risk factor status, were associated with varying levels of mental health distress. Although respondents in Montréal (and Vancouver) were more distressed than respondents in Toronto and Halifax, these differences appear to be due primarily to differences in age and source of income. Findings from this study will be useful to policy makers and health planners in developing services to meet the mental health needs of HIV infected adults

Regulatory T Cells in HIV Infection: Can Immunotherapy Regulate the Regulator?

Regulatory T cells (Tregs) have a dominant role in self-tolerance and control of autoimmune diseases. These cells also play a pivotal role in chronic viral infections and cancer by limiting immune activation and specific immune response. The role of Tregs in HIV pathogenesis remains poorly understood as their function, changes according to the phases of infection. Tregs can suppress anti-HIV specific responses and conversely can have a beneficial role by reducing the deleterious impact of immune activation. We review the frequency, function and homing potential of Tregs in the blood and lymphoid tissues as well as their interaction with dendritic cells in the context of HIV infection. We also examine the new insights generated by recombinant IL-2 and IL-7 clinical trials in HIV-infected adults, including the immunomodulatory effects of Tregs. Based on their detrimental role in limiting anti-HIV responses, we propose Tregs as potential targets for immunotherapeutic strategies aimed at decreasing Tregs frequency and/or immunosuppressive function. However, such approaches require a better understanding of the time upon infection when interfering with Treg function may not cause a deleterious state of hyperimmune activation

BRST Inner Product Spaces and the Gribov Obstruction

A global extension of the Batalin-Marnelius proposal for a BRST inner product to gauge theories with topologically nontrivial gauge orbits is discussed. It is shown that their (appropriately adapted) method is applicable to a large class of mechanical models with a semisimple gauge group in the adjoint and fundamental representation. This includes cases where the Faddeev-Popov method fails. Simple models are found also, however, which do not allow for a well-defined global extension of the Batalin-Marnelius inner product due to a Gribov obstruction. Reasons for the partial success and failure are worked out and possible ways to circumvent the problem are briefly discussed.Comment: 49 pages, 1 figure (included

Deep Astrometric Standards (DAS) and Galactic Structure

The advent of next-generation imaging telescopes such as LSST and Pan-STARRS has revitalized the need for deep and precise reference frames. The proposed weak-lensing observations with these facilities put the highest demands on image quality over wide angles on the sky. It is particularly difficult to achieve a sub-arcsecond PSF on stacked images, where precise astrometry plays a key role. Current astrometric standards are insufficient to achieve the science goals of these facilities. We thus propose the establishing of a few selected deep (V=25) astrometric standards (DAS). These will enable a reliable geometric calibration of solid-state mosaic detectors in the focal plane of large ground-based telescopes and make a substantial contribution to our understanding of stellar populations in the Milky Way. In this paper we motivate the need for such standards and discuss the strategy of their selection and acquisition and reduction techniques. The feasibility of DAS is demonstrated by a pilot study around the open cluster NGC 188, using the KPNO 4m CCD Mosaic camera, and by Subaru Suprime-Cam observations. The goal of reaching an accuracy of 5-10 mas in positions and obtaining absolute proper motions good to 2 mas/yr over a several square-degree area is challenging, but reachable with the NOAO 4m telescopes and CCD mosaic imagers or a similar set-up. Our proposed DAS aims to establish four fields near the Galactic plane, at widely separated coordinates. In addition to their utilitarian purpose for DAS, the data we will obtain in these fields will enable fundamental Galactic science in their own right. The positions, proper motions, and VI photometry of faint stars will address outstanding questions of Galactic disk formation and evolution, stellar buildup and mass assembly via merger events.Comment: 41 pages, 9 figures, accepted for publication in PAS

Distinct Tryptophan Catabolism and Th17/Treg Balance in HIV Progressors and Elite Controllers

Tryptophan (Trp) catabolism into immunosuppressive kynurenine (Kyn) by indoleamine 2,3-dioxygenase (IDO) was previously linked to Th17/Treg differentiation and immune activation. Here we examined Trp catabolism and its impact on Th17/Treg balance in uninfected healthy subjects (HS) and a large cohort of HIV-infected patients with different clinical outcomes: ART-naïve, Successfully Treated (ST), and elite controllers (EC). In ART-naïve patients, increased IDO activity/expression, together with elevated levels of TNF-α and sCD40L, were associated with Treg expansion and an altered Th17/Treg balance. These alterations were normalized under ART. In contrast, Trp 2,3-dioxegenase (TDO) expression was dramatically lower in EC when compared to all other groups. Interestingly, EC displayed a distinctive Trp metabolism characterized by low Trp plasma levels similar to ART-naïve patients without accumulating immunosuppressive Kyn levels which was accompanied by a preserved Th17/Treg balance. These results suggest a distinctive Trp catabolism and Th17/Treg balance in HIV progressors and EC. Thus, IDO-induced immune-metabolism may be considered as a new inflammation-related marker for HIV-1 disease progression

LAMOST Experiment for Galactic Understanding and Exploration (LEGUE) The survey science plan

We describe the current plans for a spectroscopic survey of millions of stars in the Milky Way galaxy using the Guo Shou Jing Telescope (GSJT, formerly the Large Area Multi-Object Spectroscopic Telescope - LAMOST). The survey will obtain spectra for 2.5 million stars brighter than $r<19$ during dark/grey time, and 5 million stars brighter than $r<17$ or $J<16$ on nights that are moonlit or have low transparency. The survey will begin in fall of 2012, and will run for at least four years. The telescope design constrains the optimal declination range for observations to $10^\circ<\delta<50^\circ$, and site conditions lead to an emphasis on stars in the direction of the Galactic anticenter. The survey is divided into three parts with different target selection strategies: disk, anticenter, and spheroid. The resulting dataset will be used to study the merger history of the Milky Way, the substructure and evolution of the disks, the nature of the first generation of stars through identification of the lowest metallicity stars, and star formation through study of open clusters and the OB associations. Detailed design of the LEGUE survey will be completed after a review of the results of the pilot survey in summer 2012.Comment: 19 pages, 1 figure, accepted for publication in RA

The ASTRO-H X-ray Observatory

The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes.Comment: 22 pages, 17 figures, Proceedings of the SPIE Astronomical Instrumentation "Space Telescopes and Instrumentation 2012: Ultraviolet to Gamma Ray

The Seventh Data Release of the Sloan Digital Sky Survey

This paper describes the Seventh Data Release of the Sloan Digital Sky Survey (SDSS), marking the completion of the original goals of the SDSS and the end of the phase known as SDSS-II. It includes 11663 deg^2 of imaging data, with most of the roughly 2000 deg^2 increment over the previous data release lying in regions of low Galactic latitude. The catalog contains five-band photometry for 357 million distinct objects. The survey also includes repeat photometry over 250 deg^2 along the Celestial Equator in the Southern Galactic Cap. A coaddition of these data goes roughly two magnitudes fainter than the main survey. The spectroscopy is now complete over a contiguous area of 7500 deg^2 in the Northern Galactic Cap, closing the gap that was present in previous data releases. There are over 1.6 million spectra in total, including 930,000 galaxies, 120,000 quasars, and 460,000 stars. The data release includes improved stellar photometry at low Galactic latitude. The astrometry has all been recalibrated with the second version of the USNO CCD Astrograph Catalog (UCAC-2), reducing the rms statistical errors at the bright end to 45 milli-arcseconds per coordinate. A systematic error in bright galaxy photometr is less severe than previously reported for the majority of galaxies. Finally, we describe a series of improvements to the spectroscopic reductions, including better flat-fielding and improved wavelength calibration at the blue end, better processing of objects with extremely strong narrow emission lines, and an improved determination of stellar metallicities. (Abridged)Comment: 20 pages, 10 embedded figures. Accepted to ApJS after minor correction