Suchergebnisse

BackgroundHIV can spread into the central nervous system (CNS) early in the course of infection and this turns into intrathecal inflammation and neuronal damage. We aimed to investigate clinical and immunological parameters associated with elevated CSF VL in HIV‐infected ART‐naïve patients.Materials and MethodsHIV+ ART‐naïve patients underwent a comprehensive battery of neurocognitive (NC) tests and lumbar puncture (LP) for CSF HIV‐RNA detection. Plasma HIV‐RNA and peripheral T‐cell immune‐phenotypes (CD38/CD45RA/CD45R0/CD127 on CD4/CD8) were also assessed (flow cytometry). High‐CSF HIV RNA was defined as≥10000cp/mL (H‐CSF), while CSF HIV RNA<10000cp/mL characterized low VL patients (L‐CSF). Chi‐square and Mann‐Whitney tests were used. Parameters independently associated with CSF VL were explored by multivariate regression.ResultsA total of 131 patients were retrospectively enrolled. Forty‐two patients (32%) had CSF VL >10000 cp/mL.Table 1 shows the features of H‐ versus L‐CSF patients. Compared to L‐CSF patients, H‐CSF patients displayed lower current CD4+%, lower CD4/CD8 ratio and higher CD8%. No differences in NC tests performance were observed between groups (p=0.6). Regarding T‐cell immuno‐phenotypes, H‐CSF patients displayed a higher proportion of CD45R0+CD38+CD8+ (11 vs 7%, p=0.02) and lower expression of CD45RA+CD8+ % (16 vs 20%, p=0.007), in comparison to L‐CSF patients. In multivariate analysis CD45RA+CD8+ T‐cells % (OR 0.917, CI 95% 0.852–0.987, p=0.002) was associated with H‐CSF, even after adjustment for plasma VL, CD8 and CD4 count. Globally, in univariate CSF VL inversely correlated with CD45RA+CD8+ % (r=−0.223, p=0.0217) and CD127+CD4+ % (r= −0.204, p= 0.0225), while a positive association was found between CSF and plasma VL (r=0.303, p=0.0004) and CD8 % (r=0.211, p=0.016). In multivariate linear regression, in addition to positive association between plasma and CSF VL (β: 0.212, 95% CI 0.02–0.41, p=0.032), also CD45RA+CD8+ % were confirmed inversely associated to CSF VL (β: 0.21, 95% CI −0.5 to −0.002, p=0.036), adjusting for CD4/CD8 and CD4CD127 %.ConclusionsWe hereby describe a 32% prevalence of H‐CSF in a cohort of HIV+ ART‐naïve patients. Subjects with high‐CSF viral replication are mostly with higher systemic immune activation, in particular the percentage of naïve CD8 T‐cell is positively associated with CSF VL, irrespective of plasma VL. In HIV+ ART‐naïve patients, especially if featuring a hyperactivated T‐cell immune‐phenotype, lumbar puncture should be considered to further guide CNS‐targeted cART.

This thesis studies four web games that have been released in Estonia in 2004-2011 and have been sponsored by the Estonian Centre Party. Using video games in political campaigning is a recent and not very widely spread trend. Therefore, these web games provided an opportunity to examine the ways how political messages can be inserted into video games and how the qualities that are unique to video games can form political arguments and persuade the players. The main objective of this thesis was to identify the persuasive components of Centre Party's web games and to compare the persuasive arguments that were found from the games' representative layer to those that were formed on the games' procedural layer. In order to do that, the Centre Party's web games were placed in the wider context of political videogames and analyzed with semiotics, gameplay rhetoric and procedural rhetoric. Ultimately, the goal of the thesis is to emphasize the uniqueness of video game representative qualities which seem to be superseded by the studies of rhetorical potential of game rules

Kaasik-Krogerus scrutinizes the European Heritage Label (EHL) as an authorized heritage discourse (AHD) in the making. She analyses how the discourse is formed in a politics of mobility and stability between the local, national, and European scales resulting from the interplay of europeanization (of the national and local) and domestication (of the European). The chapter asks how this politics of mobility and stability is conducted to manage the scalar dissonance in one of the sites, the Great Guild Hall in Tallinn, Estonia. Kaasik-Krogerus argues that the politics conducted in the exhibitions works in two controversial ways: legitimizing mobility and stability as natural and simultaneously challenging these as problematic. The analysis illuminates the dissonance between the national-scale intents and their consequences on the European scale concerning power relations, multiscalarity, and future imaginaries. ; peerReviewed

Contents Executive summary Summary in Danish Workplan and the activities Focus on housing maintenance VISION 10 – framework for maintenance management From vision to implementation – some findings

Contents Executive summary Summary in Danish Workplan and the activities Focus on housing maintenance VISION 10 – framework for maintenance management From vision to implementation – some findings

The French RACING cohort study is a 24‐month, observational, longitudinal, prospective, multicenter study on HIV‐1 infected patients being treated with an antiretroviral combination therapy containing raltegravir. The objectives of this study are to describe the viro‐immunological course, characterize and document adverse events (AEs), describe patient adherence at M6 (month 6) and examine clinical‐biological data for patients undergoing ARV therapy including raltegravir at M12 (month 12). Demographic, viro‐immunological, safety and clinical‐biological data were collected at M6 and M12 and self‐reported patient adherence to treatment regimen at M6. Data from 478 of 482 patients were available at M12. The median age was 45.9 years (IQR: 40.0–52.2), 64.1% were male and the median duration of infection was 13.2 years (IQR: 5.5–21). At the baseline, 64.1% of patients had a cardiovascular risk factor or a history of cardiovascular events and 65.2% had received concomitant treatment (psychotropic drugs: 33.5%, lipid‐lowering drugs: 30% and antihypertensive agents: 24.8%). The virological response, viral load and CD4 cell count are shown in Table 1 (based on data available at M6 and M12). Of the 134 reported and treatment‐related AEs, the symptoms most frequently described (>5%) were myalgia (6.7%) and nausea (5.2%). A total of 34 serious adverse events were reported, of which 5 were possibly or probably related to raltegravir. Self‐reported patient adherence at M6 is described as follows: 'high' for 56% of patients, 'average' for 36% of patients and 'low' for 8% of patients (205 questionnaires). To conclude, in a real‐life setting concerning patients with a strong proportion of co‐morbidity and variation in adherence, the efficacy and safety data observed after 12 months are comparable to the data observed (not shown) in clinical studies.

Viro‐immunological data












Naïve No previous treatment n=65
Switch Previous treatment with a viral load<50 copies/mL n=258
Failure Previous treatment with a viral load>50 copies/Ml n=151




Median Viral Load (copies/mL) at baseline
64,513
–
1,891


Median CD4 (cells/mm3) at baseline
308
556
365



M6
M12
M6
M12
M6
M12


Virological Response% (HIV‐RNA<50 copies/mL)
77% n=56
87% n=62
92% n=191
94% n=211
70% n=112
73% n=125


Immunological Response Median CD4 count (cells/mm3)
461 n=58
514 n=63
592 n=205
591 n=209
451 n=124
490 n=126

In this paper the stakeholders and most discussed topics of Baltic Sea in the media are examined. Baltic Sea is a fragile ecosystem that provides variety of services to the locals. Not only the locals hold the stake, but also industries and governments. This paper aims to present the complexity of stakeholder network and contradicting interests. Altogether 104 newspaper articles from Estonian and Finnish media on Baltic Sea were used as the data source and the concerning topics, themes and stakeholders were surveyed. The qualitative data was inserted to the textual analysis software QDA Miner 4 Lite. Three main topics were named according to the concept of three pillars of sustainability- economy, environment and society. Themes in these topics were also listed to further investigate the content of articles. Environment proved to be most presented topic whereas widely discussed themes were pollution and co-operation. It was also noted that country, newspaper and time of publishing had impact on the content. The stakeholder analysis was conducted by creating MAW-model and influence diagram for the listed stakeholders. In this research the main results on stakeholders were the list of stakeholders, their relevancy and connections between them. The thesis contributes to the understanding of the complexity of interests hold in the Baltic Sea and the need for integrated and international management approach. Media analysis approach indicates how Baltic Sea issues are presented to the public and which topics and stakeholders are most relevant based on media's presentation.

In The Estonian Straits , Alexander Lott establishes the interrelations between the main legal categories of straits. Through this detailed and exceptional account, he provides legal classifications for the Viro Strait in the Gulf of Finland as well as the Irbe Strait and the Sea of Straits in the Gulf of Riga. Consequently, the passage rights of foreign ships and aircrafts in the northeastern part of the Baltic Sea are determined. The author demonstrates that the legal regime of the Estonian Straits has been and continues to be determined by such factors as the outer limits of maritime zones, treaties, islands, maritime boundary delimitation, domestic law on internal waters and baselines as well as geopolitical implications (particularly the concept of State continuity).

Los años noventa, época en la cual el significado transcultural de la "historicidad" llegó a ser tema candante dentro de la teoría antropológica, alternaron algunos fundamentos de la vocación etnohistórica. ¿Cuánta variación cultural existe entre los diversos conceptos del tiempo y del cambio? ¿Hasta qué punto aquellas diferencias gobiernan la actuación histórica de los pueblos? Al contemplar tales preguntas, el debate teóricodentro de la etnohistoria viró de la posición de crítica metodológica a la de liderazgo heurístico donde quiera que se pretendía investigar las historias de los "otros". Aunque Oceanía fue la zona que llevó la voz cantante durante el famoso debate entre Sahlins y Obeyesekere, los estudiosos andinos y amazónicos aportaron contribuciones no menos creativas.

This report contains the conclusions from the project "Development of the Nordic/Baltic Market for Organic Food" in which public authorities and NGO's from Denmark, Estonia, Finland, Latvia, Lithuania, Norway and Sweden have participated. The objective of this project was to elaborate a joint project proposal in order to promote the development of the Nordic-Baltic market for organic products.The project identifies and describes a range of barriers for a market driven development of the organic sector, including lack of consumer awareness, deficient market data, different standards and labelling, lack of marketing channels, lack of processing and innovation and high prices. Against this background the project points out a range of potential cross-border activities, including an information campaign to raise awareness and induce consumers' trust in organic products, construction of a common information system on the rules and procedures, promotion of the EU-logo and national logos, collaboration between retail chains and representative organic organisations and finally alternative distribution channels. In order to enable the implementation of one or more of these potential activities the project has identified relevant funding opportunities. The most relevant funding opportunity has been identified as the EU promotion scheme (Commission Legislation (EC) 94/2002 of 18 January 2002), which is therefore described thoroughly.

IntroductionGender differences in antiretroviral therapy (ART) outcomes are critical in sub‐Saharan Africa. We assessed the association between gender and virologic failure among adult patients treated in a public routine clinic (one of the largest in West Africa) in Burkina Faso.MethodsWe performed a case‐control study between July and October 2012 among patients who had received ART at the Bobo Dioulasso Day Care Unit. Patients were eligible if they were 15 years or older, positive for HIV‐1 or HIV‐1+2, and on first‐line ART for at least six months. Cases were all patients with two consecutive HIV loads >1000 copies/mL (Biocentric Generic or Abbott Real Time assays), or one HIV load >1000 copies/mL associated with immunologic or clinical failure criteria. Controls were all patients who only had HIV loads <300 copies/mL. The association between gender and virologic failure was assessed using a multivariate logistic regression, adjusted on age, level of education, baseline CD4+ T cell count, first and current antiretroviral regimens and time on ART.ResultsOf 2303 patients (74.2% women; median age: 40 years; median time on ART: 34 months), 172 had virologic failure and 2131 had virologic success. Among the former, 130 (75.6%) had confirmed virologic failure, 38 (22.1%) had viro‐immunologic failure, and four (2.3%) had viro‐clinical failure. The proportion of men was significantly higher among the cases than among the controls (37.2% vs. 24.9%; p<0.001). Compared to controls, cases were also younger, more immunodeficient at ART initiation, less likely to receive a protease inhibitor‐based antiretroviral regimen and had spent a longer period of time on ART. After adjustment, male gender remained strongly associated with virologic failure (odds ratio 2.52, 95% CI: 1.77–3.60; p<0.001).ConclusionsMen on ART appeared more vulnerable to virologic failure than women. Additional studies are needed to confirm the poorer prognosis of men in this setting and to determine the causes for their vulnerability in order to optimize HIV care. From now on, efforts should be made to support the adherence of men to ART in the African setting.

The paper addresses a puzzle resulting from the current global state of alert: the coronavirus pandemic brought us back to the world of the allegedly sovereign nation states with borders and national governments in charge, yet in fact, this retrieved sovereignty looks very vulnerable and precarious. We explain this controversy through a triad of concepts—sovereignty, governmentality, and post-liberalism—that we apply to an analysis of a corona-imposed state of emergency in Estonia and Finland. Based on comparative case study research, we posit that sovereignty is precarious in post-liberalism due to its large dependence on the technologies of responsibilization and agency. From a biopolitical perspective, a major point in the anti-crisis management is to convince people to sacrifice personal liberties for the sake of public safety. These issues of governmentality will be dealt with based on critical discourse analysis and media analysis in Estonia and Finland. ; peerReviewed

The status of use of bioenergy, the current barriers for increased use and the future use of bioenergy in the Nordic-Baltic-NW Russian region is described in this report. In this region, forests are abundant and a long tradition of growing agricultural crops is evident. Therefore, there are sound possibilities for an increased future use of bioenergy, which can become an important part of a sustainable energy supply. However, bioenergy production is a juvenile industry, where political decisions are of prime importance for lifting the utilisation of bioenergy to the full impact on economy and environment. A number of the main technical bottlenecks have already been solved and biofuels are used on a relatively large commercial scale today. A full scale technical development of the bioenergy area must be market driven, but the technology is just below the threshold level where it will attract the large scale investments needed to establish a market. Holistic strategies and interdisciplinary efforts taking all part of the bioenergy chain into account is important. Political support in the form of limited subsidies or mandatory use of bioenergy will have a large positive impact on the creation of a commercial market with committed involvement from the industries.

Resumen Este artículo presenta un estudio sobre el primer símbolo transnacional del movimiento por el derecho al aborto en el Cono Sur: la "mano que vota" a favor del aborto legal. El emblema surge en Uruguay a comienzos de la década del 2000. Alrededor de 2010, el símbolo viró al color verde y fue adoptado por la Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito en Argentina. A partir de 2015, la mano que vota también acompañó el proceso que llevó a la legalización del aborto en tres causales en Chile. El análisis focaliza sobre rol de los símbolos y de los afectos en el activismo por el derecho al aborto. La mano que vota fue central para la construcción de identidad colectiva y sintonía política del movimiento. También este emblema logró imantar esperanzas asociadas con la democracia y un profundo sentido de la obstinación política. Los resultados se basan en el trabajo con diversos archivos y en conversaciones con informantes clave de Argentina, Chile y Uruguay.