Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
BACKGROUND: HIV cohort collaborations, which pool data from diverse patient cohorts, have provided key insights into outcomes of antiretroviral therapy (ART). However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and mortality are unclear. METHODS: We obtained data on adult HIV-positive patients who started ART from 1998 without a previous AIDS diagnosis from 17 cohorts in North America and Europe. Patients were followed up from 1 month to 2 years after starting ART. We examined between-cohort heterogeneity in crude and adjusted (age, sex, HIV transmission risk, year, CD4 count and HIV-1 RNA at start of ART) rates of AIDS and mortality using random-effects meta-analysis and meta-regression. RESULTS: During 61 520 person-years, 754/38 706 (1.9%) patients died and 1890 (4.9%) progressed to AIDS. Between-cohort variance in mortality rates was reduced from 0.84 to 0.24 (0.73 to 0.28 for AIDS rates) after adjustment for patient characteristics. Adjusted mortality rates were inversely associated with cohorts' estimated completeness of death ascertainment [excellent: 96-100%, good: 90-95%, average: 75-89%; mortality rate ratio 0.66 (95% confidence interval 0.46-0.94) per category]. Mortality rate ratios comparing Europe with North America were 0.42 (0.31-0.57) before and 0.47 (0.30-0.73) after adjusting for completeness of ascertainment. CONCLUSIONS: Heterogeneity between settings in outcomes of HIV treatment has implications for collaborative analyses, policy and clinical care. Estimated mortality rates may require adjustment for completeness of ascertainment. Higher mortality rate in North American, compared with European, cohorts was not fully explained by completeness of ascertainment and may be because of the inclusion of more socially marginalized patients with higher mortality risk.
ISSN: 0300-5771

hal-00875138
https://hal.archives-ouvertes.fr/hal-00875138
DOI : 10.1093/ije/dys164
PUBMED : 23148105

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Ecosystems are commonly affected by natural, episodic disturbances that can abruptly and drastically alter communities. Although it has been shown that resilient ecosystems can eventually recover to pre-disturbed states, the extent to which communities in early stages of recovery could be affected by multiple anthropogenic stressors is poorly understood. Pervasive and rising anthropogenic stressors in coastal marine systems that could interactively affect the recovery of these systems following natural disturbances include high sedimentation, nutrient enrichment, and overfishing. Using a 6-month field experiment, we examined the effects of all combinations of these three stressors on key functional groups in the benthic community growing on simulated, post-disturbance reef patches within a system recovering from large-scale natural disturbances (corallivorous seastar outbreak and cyclone). Our study revealed that sedimentation, nutrient enrichment, and overfishing (simulated using exclusion cages) interactively affected coral survival and algal growth, with taxon-specific effects at multiple scales. First, our treatments affected corals and algae differently, with sedimentation being more detrimental to macroalgal growth but less detrimental to coral (Porites rus) survival in caged plots, driving significant interactions between sedimentation and caging for both taxa. We also observed distinct responses between coral species and between algal functional groups, with the most extensive responses from algal turf biomass, for which sedimentation suppressed the synergistic (positive) combined effect of nutrient enrichment and caging. Our findings suggest that different combinations of ubiquitous anthropogenic stressors, related to either sea- or land-based activities, interactively influence community recovery from disturbance and may alter species compositions in the resulting community. Our findings further suggest that anthropogenic stressors could promote further degradation of coral reefs following natural disturbances by inhibiting recovery to coral-dominated states that provide vital ecosystem services to coastal populations worldwide.
ISSN: 0722-4028

hal-01430977
https://hal-univ-perp.archives-ouvertes.fr/hal-01430977
DOI : 10.1007/s00338-016-1489-x

Éditeur(s) : HAL CCSD Nature Publishing Group
Résumé : International audience
Three-quarters of the oceanic crust formed at fast-spreading ridges is composed of plutonic rocks whose mineral assemblages, textures and compositions record the history of melt transport and crystallization between the mantle and the sea floor. Despite the importance of these rocks, sampling them in situ is extremely challenging owing to the overlying dykes and lavas. This means that models for understanding the formation of the lower crust are based largely on geophysical studies1 and ancient analogues (ophiolites)2, 3, 4, 5 that did not form at typical mid-ocean ridges. Here we describe cored intervals of primitive, modally layered gabbroic rocks from the lower plutonic crust formed at a fast-spreading ridge, sampled by the Integrated Ocean Drilling Program at the Hess Deep rift. Centimetre-scale, modally layered rocks, some of which have a strong layering-parallel foliation, confirm a long-held belief that such rocks are a key constituent of the lower oceanic crust formed at fast-spreading ridges3, 6. Geochemical analysis of these primitive lower plutonic rocks--in combination with previous geochemical data for shallow-level plutonic rocks, sheeted dykes and lavas--provides the most completely constrained estimate of the bulk composition of fast-spreading oceanic crust so far. Simple crystallization models using this bulk crustal composition as the parental melt accurately predict the bulk composition of both the lavas and the plutonic rocks. However, the recovered plutonic rocks show early crystallization of orthopyroxene, which is not predicted by current models of melt extraction from the mantle7 and mid-ocean-ridge basalt differentiation8, 9. The simplest explanation of this observation is that compositionally diverse melts are extracted from the mantle and partly crystallize before mixing to produce the more homogeneous magmas that erupt.
ISSN: 0028-0836

hal-00950085
https://hal.archives-ouvertes.fr/hal-00950085
DOI : 10.1038/nature12778