Transplantation for Autoimmune Diseases in North and South America: A Report of the Center for International Blood and Marrow Transplant Research

Hematopoietic cell transplantation (HCT) is an emerging therapy for patients with severe autoimmune diseases (AID). We report data on 368 patients with AID who underwent HCT in 64 North and South American transplantation centers reported to the Center for International Blood and Marrow Transplant Research between 1996 and 2009. Most of the HCTs involved autologous grafts (n = 339); allogeneic HCT (n = 29) was done mostly in children. The most common indications for HCT were multiple sclerosis, systemic sclerosis, and systemic lupus erythematosus. The median age at transplantation was 38 years for autologous HCT and 25 years for allogeneic HCT. The corresponding times from diagnosis to HCT were 35 months and 24 months. Three-year overall survival after autologous HCT was 86% (95% confidence interval [CI], 81%-91%). Median follow-up of survivors was 31 months (range, 1-144 months). The most common causes of death were AID progression, infections, and organ failure. On multivariate analysis, the risk of death was higher in patients at centers that performed fewer than 5 autologous HCTs (relative risk, 3.5; 95% CI, 1.1-11.1; P = .03) and those that performed 5 to 15 autologous HCTs for AID during the study period (relative risk, 4.2; 95% CI, 1.5-11.7; P = .006) compared with patients at centers that performed more than 15 autologous HCTs for AID during the study period. AID is an emerging indication for HCT in the region. Collaboration of hematologists and other disease specialists with an outcomes database is important to promote optimal patient selection, analysis of the impact of prognostic variables and long-term outcomes, and development of clinical trials. Biol Blood Marrow Transplant 18: 1471-1478 (2012) (C) 2012 Published by Elsevier Inc. on behalf of American Society for Blood and Marrow Transplantation

Psychology and psychoanalysis in Brazil - From cultural syncretism to the collapse of liberal individualism

This paper focuses first on cultural syncretism, used to characterize Brazilian culture. The other aspect of this socially and racially blended culture is the unfinished assimilation of liberalism in politics and the economy, which defines Brazilian society. The increased assimilation and dissemination of psychology may be linked with these in cultural and social aspects. During the military period (1964-1974) the major expansion in university-level studies in psychology contributed ideologically to the dissemination of psychology throughout Brazilian society. This introduced a type of psychology that was related primarily to clinical practice and developed in opposition to social work practice. This paper examines the ideological bases for this conflict between clinical and social work. Criteria for understanding the cultural dissemination of psychoanalysis are then discussed, and it is argued that cultural incorporation of psychoanalysis involves the development of discourse complexes to reflect particular aspects of Brazilian society. The criteria (a non-totalitarian society and the displacement of a magical and religious interpretation of mental disturbance by psychiatric interpretation) are evaluated in relation to the peculiarities of Brazilian syncretism. The paper argues that cultural syncretism and the incomplete assimilation of liberal ideology must be included as criteria in understanding the particular cultural incorporation of psychoanalysis in Brazil.

Taxonomic notes, new species and identification key to the New World species of Toxophora Meigen (Diptera, Bombyliidae, Toxophorinae)

Two new species of Toxophora Meigen are described and illustrated-T. paulistana sp. nov. (Neotropical) and T. azteca sp. nov. (Nearctic and Neotropical). An identification key to the New World species is also presented. Morphological differences between populations of T. aurea Macquart (1848) are recorded, illustrated and added to the key. The new species are easily recognized by: scape with long, yellow scales laterally; presence of yellow scales on mesonotum margins; posterior margin of mesonotum with a pre-scutellar pair of setae; and yellow scales forming thin bands on posterior margins of abdominal tergites in T. paulistana sp. nov., and scape entirely covered with long dark-brown scales and yellow scales forming a broad, longitudinal stripe on center of abdominal tergites III-VII in T. azteca sp. nov.

Abrupt changes in high-latitude nutrient supply to the Atlantic during the last glacial cycle

The supply of nutrients to the low-latitude thermocline is largely controlled by intermediate-depth waters formed at the surface in the high southern latitudes. Silicic acid is an essential macronutrient for diatoms, which are responsible for a significant portion of marine carbon export production. Changes in ocean circulation, such as those observed during the last deglaciation, would influence the nutrient composition of the thermocline and, therefore, the relative abundance of diatoms in the low latitudes. Here we present the first record of the silicic acid content of the Atlantic over the last glacial cycle. Our results show that at intermediate depths of the South Atlantic, the silicic acid concentration was the same at the Last Glacial Maximum (LGM) as it is today, overprinted by high silicic acid pulses that coincided with abrupt changes in ocean and atmospheric circulation during Heinrich Stadials and the Younger Dryas. We suggest these pulses were caused by changes in intermediate water formation resulting from shifts in the subpolar hydrological cycle, with fundamental implications for the nutrient supply to the Atlantic.

A hymenopterists' guide to the Hymenoptera Anatomy Ontology: utility, clarification, and future directions

Hymenoptera exhibit an incredible diversity of phenotypes, the result of similar to 240 million years of evolution and the primary subject of more than 250 years of research. Here we describe the history, development, and utility of the Hymenoptera Anatomy Ontology (HAO) and its associated applications. These resources are designed to facilitate accessible and extensible research on hymenopteran phenotypes. Outreach with the hymenopterist community is of utmost importance to the HAO project, and this paper is a direct response to questions that arose from project workshops. In a concerted attempt to surmount barriers of understanding, especially regarding the format, utility, and development of the HAO, we discuss the roles of homology, "preferred terms", and "structural equivalency". We also outline the use of Universal Resource Identifiers (URIs) and posit that they are a key element necessary for increasing the objectivity and repeatability of science that references hymenopteran anatomy. Pragmatically, we detail a mechanism (the "URI table") by which authors can use URIs to link their published text to the HAO, and we describe an associated tool (the "Analyzer") to derive these tables. These tools, and others, are available through the HAO Portal website (http://portal.hymao.org). We conclude by discussing the future of the HAO with respect to digital publication, cross-taxon ontology alignment, the advent of semantic phenotypes, and community-based curation.

He II lambda 4686 IN eta CARINAE: COLLAPSE OF THE WIND-WIND COLLISION REGION DURING PERIASTRON PASSAGE

The periodic spectroscopic events in eta Carinae are now well established and occur near the periastron passage of two massive stars in a very eccentric orbit. Several mechanisms have been proposed to explain the variations of different spectral features, such as an eclipse by the wind-wind collision (WWC) boundary, a shell ejection from the primary star or accretion of its wind onto the secondary. All of them have problems explaining all the observed phenomena. To better understand the nature of the cyclic events, we performed a dense monitoring of eta Carinae with five Southern telescopes during the 2009 low-excitation event, resulting in a set of data of unprecedented quality and sampling. The intrinsic luminosity of the He II lambda 4686 emission line (L similar to 310 L-circle dot) just before periastron reveals the presence of a very luminous transient source of extreme UV radiation emitted in the WWC region. Clumps in the primary's wind probably explain the flare-like behavior of both the X-ray and He II lambda 4686 light curves. After a short-lived minimum, He II lambda 4686 emission rises again to a new maximum, when X-rays are still absent or very weak. We interpret this as a collapse of the WWC onto the "surface" of the secondary star, switching off the hard X-ray source and diminishing the WWC shock cone. The recovery from this state is controlled by the momentum balance between the secondary's wind and the clumps in the primary's wind.

THE INTERSTELLAR MAGNETIC FIELD CLOSE TO THE SUN. II.

The magnetic field in the local interstellar medium (ISM) provides a key indicator of the galactic environment of the Sun and influences the shape of the heliosphere. We have studied the interstellar magnetic field (ISMF) in the solar vicinity using polarized starlight for stars within 40 pc of the Sun and 90 degrees of the heliosphere nose. In Frisch et al. (Paper I), we developed a method for determining the local ISMF direction by finding the best match to a group of interstellar polarization position angles obtained toward nearby stars, based on the assumption that the polarization is parallel to the ISMF. In this paper, we extend the analysis by utilizing weighted fits to the position angles and by including new observations acquired for this study. We find that the local ISMF is pointed toward the galactic coordinates l, b = 47 degrees +/- 20 degrees, 25 degrees +/- 20 degrees. This direction is close to the direction of the ISMF that shapes the heliosphere, l, b = 33 degrees +/- 4 degrees, 55 degrees +/- 4 degrees, as traced by the center of the "Ribbon" of energetic neutral atoms discovered by the Interstellar Boundary Explorer (IBEX) mission. Both the magnetic field direction and the kinematics of the local ISM are consistent with a scenario where the local ISM is a fragment of the Loop I superbubble. A nearby ordered component of the local ISMF has been identified in the region l approximate to 0 degrees -> 80 degrees and b approximate to 0 degrees -> 30 degrees, where PlanetPol data show a distance-dependent increase of polarization strength. The ordered component extends to within 8 pc of the Sun and implies a weak curvature in the nearby ISMF of +/- 0 degrees.25 pc(-1). This conclusion is conditioned on the small sample of stars available for defining this rotation. Variations from the ordered component suggest a turbulent component of +/- 23 degrees. The ordered component and standard relations between polarization, color excess, and H-o column density predict a reasonable increase of N(H) with distance in the local ISM. The similarity of the ISMF directions traced by the polarizations, the IBEX Ribbon, and pulsars inside the Local Bubble in the third galactic quadrant suggest that the ISMF is relatively uniform over spatial scales of 8-200 pc and is more similar to interarm than spiral-arm magnetic fields. The ISMF direction from the polarization data is also consistent with small-scale spatial asymmetries detected in GeV-TeV cosmic rays with a galactic origin. The peculiar geometrical relation found earlier between the cosmic microwave background dipole moment, the heliosphere nose, and the ISMF direction is supported by this study. The interstellar radiation field at +/- 975 angstrom does not appear to play a role in grain alignment for the low-density ISM studied here.

Post-receptor IGF1 insensitivity restricted to the MAPK pathway in a Silver-Russell syndrome patient with hypomethylation at the imprinting control region on chromosome 11

Background: Hypomethylation of the paternal imprinting center region 1 (ICR1) is the most frequent molecular cause of Silver-Russell syndrome (SRS). Clinical evidence suggests that patients with this epimutation have mild IGF1 insensitivity. Objective: To assess in vitro IGF1 action in fibroblast culture from a patient with SRS and IGF1 insensitivity. Methods: Fibroblast cultures from one patient with SRS due to ICR1 demethylation and controls were established. The SRS patient has severe growth failure, elevated IGF1 level, and poor growth rate during human recombinant GH treatment. IGF1 action was assessed by cell proliferation, AKT, and p42/44-MAPK phosphorylation. Gene expression was determined by real-time PCR. Results: Despite normal IGF1R sequence and expression, fibroblast proliferation induced by IGF1 was 50% lower in SRS fibroblasts in comparison with controls. IGF1 and insulin promoted a p42/44-MAPK activation in SRS fibroblasts 40 and 36%, respectively, lower than that in control fibroblasts. On the other hand, p42/44-MAPK activation induced by EGF stimulation was only slightly reduced (75% in SRS fibroblasts in comparison with control), suggesting a general impairment in MAPK pathway with a greater impairment of the stimulation induced by insulin and IGF1 than by EGF. A PCR array analysis disclosed a defect in MAPK pathway characterized by an increase in DUSP4 and MEF2C gene expressions in patient fibroblasts. Conclusion: A post-receptor IGF1 insensitivity was characterized in one patient with SRS and ICR1 hypomethylation. Although based on one unique severely affected patient, these results raise an intriguing mechanism to explain the postnatal growth impairment observed in SRS patients that needs confirmation in larger cohorts.