Cytomegalovirus Serology and Replication Remain Associated With Solid Organ Graft Rejection and Graft Loss in the Era of Prophylactic Treatment

BACKGROUND Cytomegalovirus (CMV) replication has been associated with more risk for solid organ graft rejection. We wondered whether this association still holds when patients at risk receive prophylactic treatment for CMV. METHODS We correlated CMV infection, biopsy-proven graft rejection, and graft loss in 1,414 patients receiving heart (n=97), kidney (n=917), liver (n=237), or lung (n=163) allografts reported to the Swiss Transplant Cohort Study. RESULTS Recipients of all organs were at an increased risk for biopsy-proven graft rejection within 4 weeks after detection of CMV replication (hazard ratio [HR] after heart transplantation, 2.60; 95% confidence interval [CI], 1.34-4.94, P<0.001; HR after kidney transplantation, 1.58; 95% CI, 1.16-2.16, P=0.02; HR after liver transplantation, 2.21; 95% CI, 1.53-3.17, P<0.001; HR after lung transplantation, 5.83; 95% CI, 3.12-10.9, P<0.001. Relative hazards were comparable in patients with asymptomatic or symptomatic CMV infection. The CMV donor or recipient serological constellation also predicted the incidence of graft rejection after liver and lung transplantation, with significantly higher rates of rejection in transplants in which donor or recipient were CMV seropositive (non-D-/R-), compared with D- transplant or R- transplant (HR, 3.05; P=0.002 for liver and HR, 2.42; P=0.01 for lung transplants). Finally, graft loss occurred more frequently in non-D- or non-R- compared with D- transplant or R- transplant in all organs analyzed. Valganciclovir prophylactic treatment seemed to delay, but not prevent, graft loss in non-D- or non-R- transplants. CONCLUSION Cytomegalovirus replication and donor or recipient seroconstellation remains associated with graft rejection and graft loss in the era of prophylactic CMV treatment.

Mallarmé and His Futurist 'Heir' Marinetti

Marinetti is known for his call to arms against Mallarmé's aesthetics, but, in actual fact, he admired the great Symbolist at the beginning of his literary career. Nevertheless, his heritage from Mallarmé was not pure. This becomes most apparent in their diverging attitude towards the book as a cultural attainment and a literariy vehicle. While Mallarmé's Book was organized according to the model of the constellation, where all elements answer each other in a system of echoes, the Futurist text was characterized by the absence of both memory and echoes between the different parts of the book.]

Homogeneous reprocessing of GPS, GLONASS and SLR observations

The International GNSS Service (IGS) provides operational products for the GPS and GLONASS constellation. Homogeneously processed time series of parameters from the IGS are only available for GPS. Reprocessed GLONASS series are provided only by individual Analysis Centers (i. e. CODE and ESA), making it difficult to fully include the GLONASS system into a rigorous GNSS analysis. In view of the increasing number of active GLONASS satellites and a steadily growing number of GPS+GLONASS-tracking stations available over the past few years, Technische Universität Dresden, Technische Universität München, Universität Bern and Eidgenössische Technische Hochschule Zürich performed a combined reprocessing of GPS and GLONASS observations. Also, SLR observations to GPS and GLONASS are included in this reprocessing effort. Here, we show only SLR results from a GNSS orbit validation. In total, 18 years of data (1994–2011) have been processed from altogether 340 GNSS and 70 SLR stations. The use of GLONASS observations in addition to GPS has no impact on the estimated linear terrestrial reference frame parameters. However, daily station positions show an RMS reduction of 0.3 mm on average for the height component when additional GLONASS observations can be used for the time series determination. Analyzing satellite orbit overlaps, the rigorous combination of GPS and GLONASS neither improves nor degrades the GPS orbit precision. For GLONASS, however, the quality of the microwave-derived GLONASS orbits improves due to the combination. These findings are confirmed using independent SLR observations for a GNSS orbit validation. In comparison to previous studies, mean SLR biases for satellites GPS-35 and GPS-36 could be reduced in magnitude from −35 and −38 mm to −12 and −13 mm, respectively. Our results show that remaining SLR biases depend on the satellite type and the use of coated or uncoated retro-reflectors. For Earth rotation parameters, the increasing number of GLONASS satellites and tracking stations over the past few years leads to differences between GPS-only and GPS+GLONASS combined solutions which are most pronounced in the pole rate estimates with maximum 0.2 mas/day in magnitude. At the same time, the difference between GLONASS-only and combined solutions decreases. Derived GNSS orbits are used to estimate combined GPS+GLONASS satellite clocks, with first results presented in this paper. Phase observation residuals from a precise point positioning are at the level of 2 mm and particularly reveal poorly modeled yaw maneuver periods.

Status of the Zimmerwald SLR station

The Zimmerwald SLR station is operated in a monostatic mode with 532nm laser pulses emitted at adjustable frequencies of 90-110Hz with energies slightly less than 10mJ. A rotating shutter protects the CSPAD receiver from the backscatter of the transmit beam. These systems are located below the telescope in an operator room housed within the observatory building with the laser system located in a separated, air-conditioned part of the room. All hardware components may be automatically accessed by the control software and from remote if required. Thanks to the fully automatic and remotely controllable SLR operations, the Zimmerwald station is one of the most productive stations in the ILRS network. Key characteristics of the hardware are shown. Specialities like the tracking of the full GLONASS constellation, one-way ranging to the Lunar Reconnaissance Orbiter, and photon reception from bi-static experiments with the Graz SLR station are highlighted as well.

Loyal to the Game? Strategic Policy Representation in Mixed Electoral Systems

In Germany's compensatory mixed electoral system, alternative electoral routes lead into parliament. We study the relationship between candidates' electoral situations across both tiers and policy representation, fully accounting for candidate, party and district preferences in a multi-actor constellation and the exact electoral incentives for candidates to represent either the party or the district. The results (2009 Bundestag election data) yield evidence of an interactive effect of closeness of the district race and list safety on candidates' positioning between their party and constituency.

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

OBJECTIVE To investigate frequent findings in cases of fatal opioid intoxication in whole-body post-mortem computed tomography (PMCT). METHODS PMCT of 55 cases in which heroin and/or methadone had been found responsible for death were retrospectively evaluated (study group), and were compared with PMCT images of an age- and sex-matched control group. Imaging results were compared with conventional autopsy. RESULTS The most common findings in the study group were: pulmonary oedema (95 %), aspiration (66 %), distended urinary bladder (42 %), cerebral oedema (49 %), pulmonary emphysema (38 %) and fatty liver disease (36 %). These PMCT findings occurred significantly more often in the study group than in the control group (p < 0.05). The combination of lung oedema, brain oedema and distended urinary bladder was seen in 26 % of the cases in the study group but never in the control group (0 %). This triad, as indicator of opioid-related deaths, had a specificity of 100 %, as confirmed by autopsy and toxicological analysis. CONCLUSIONS Frequent findings in cases of fatal opioid intoxication were demonstrated. The triad of brain oedema, lung oedema and a distended urinary bladder on PMCT was highly specific for drug-associated cases of death. KEY POINTS Frequent findings in cases of fatal opioid intoxication were investigated. Lung oedema, brain oedema and full urinary bladder represent a highly specific constellation. This combination of findings in post-mortem CT should raise suspicion of intoxication.

Ethnography of a Land Grab and Gendered Coping Strategies in Northern Sierra Leone

Despite an increased scientific interest in the relatively new phenomenon of large-scale land acquisition (LSLA), data on the implementation of such projects and their impacts on the heterogeneous group of project-affected people are still sparse and superficial. Our ethnographic in-depth research on a Swiss-based bioenergy project in Sierra Leone generates well-documented data and provides insights into gendered access to land and wage employment. In the area where the project is located, customary land tenure applies. Thereby, women are structurally discriminated since they are not entitled to own land. However, user rights grant women and non-landowning men access to land and associated resources. Following the investing development banks’ guidelines, the company considered the local customary law when implementing its project. Nevertheless, the company only consulted and compensated landowners although women and non-landowning men could previously benefit from acquired land as well. Moreover, the company’s policy to enhance employment possibilities for women is barely implemented, and only few local women are hired. In order to cope with the transformed situation some women and non-landowning men continue to engage in subsistence farming on a reduced area of land. Others are involved in informal petty-trade or cooking food for the labourers whereby they subsidize the capitalist production of the company. In one village, women resisted additional land takes of the company. Acting within the framework of a specific power constellation on community level and simultaneously accommodating their claims within policy paradigms on transnational level, they were able to force a landowner to refuse leasing land to the company.

Mitigating the syndromes of desertification: The requirements for transdisciplinary research and information exchange

In developing meaningful mitigation strategies to combat desertification, it is important to address the complex constellation of desertification under different bio-physical, social, demographic, political and economic conditions. In particular, desertification can be described as a cluster of key processes of global change which together form a typical syndrome. A critical reflection on the potential of research to help mitigate desertification will be a useful first step, before addressing the requirements for research partnerships between institutions at local levels and beyond. A practical example from Eritrea, an ecoregion which has been plagued by desertification for many centuries, is given at the end of the paper. It illustrates options for generating the necessary data and developing useful information in order to enhance the impact of research on sustainable development.

Tattoo: a multifaceted medium of communication

This article suggests the systems theoretical distinction of form/medium as a useful tool for distinguishing social phenomena that might look as if they stem from the same process. This is shown to be the case for the tattoo and tattooing. The tattoo is conceived as a medium of communication through which different forms of communication emerge. Tattooing is one of these forms of communication that shapes the medium in a particular way. The current article sheds a special light on its intricate, communicational constellation, for which the concept of parallax is suggested. Law, medicine and cosmetics as other forms of communication use the medium of tattoo in their own way as well. The form/medium distinction allows us to grasp these different forms of communication, while it shows that they share the tattoo as medium. The article’s ultimate goal is to illustrate that the tattoo figures as a multifaceted medium of communication.

The illness narratives of Hispanic American women with coronary heart disease (CHD): An ethnographic approach

Purpose. To provide a descriptive representation of the illness narratives described by Hispanic American women with CHD. ^ Design. Focused ethnographic design. ^ Setting. One outpatient general medicine clinic, one nurse-managed health promotion clinic, and informants' homes in a large metropolitan city located in southeast Texas. ^ Sample. Purposeful sampling from two different sites resulted in 17 interviews being conducted with 14 informants. ^ Method. Focused ethnographic techniques were employed in the designation of participants for the study, data collection, analysis and re-presentation. Audiotaped interviews and fieldwork were transcribed verbatim and analyzed through an iterative process of data reduction, data display, drawing conclusions and verification. ^ Findings. The developing conceptual framework that emerged from the data is labeled after the overarching experience described by informants, the experience of Embodied Exhaustion. Embodied Exhaustion, as described in this study, refers to an ongoing, dynamic, indeterminate experience of mind-body exhaustion resulting from a complex constellation of biologic, psychological and social distresses occurring over the life course. The experience consists of three categories: Taking Care of Others, Wearing Down and Hurting Hearts. Two stabilizing forces were identified: Collective Self and Believing in God. ^ Conclusions. The findings of this study emphasize the importance of framing all research, theory and practice targeting Hispanic women with CHD within a sociocentric paradigm. Nursing is challenged to provide care that extends beyond the physical body of the patient to include the social context of illness, especially the family. ^

A comprehensive framework for evaluating funder's performance

Evaluation methods for assessing the performance of non-profit funders are lacking. The purpose of the research was to create a comprehensive framework that systematically assesses the goals and objectives of a funder, how these relate to the funder's allocation of resources, and the potential impact of programs and services selected by the funder for resource allocation to address organizational goals and objectives. The Houston Affiliate of Susan G. Komen for the Cure, a local chapter of a national breast cancer awareness advocacy organization, was selected as the funding agency whose performance assessment was to assist in the creation of this framework. Evaluation approaches from the government sector were adapted and incorporated into the research to guide the methods used to answer the three research questions corresponding to the three phases of research within the study: (1) what are the funding goals and objectives of the Affiliate?; (2) what allocation scheme does the organization use to address these goals and objectives and select programs for funding?; and, (3) to what extent do the programs funded by the Affiliate have potential long-term impact? ^ Within the first stage of the research, document reviews of the Affiliate's mission-based documents and bylaws and interviews with organizational and community informants revealed a highly latent constellation of broad objectives that were not formalized into one guiding document, thus creating gaps in management and governance. Within the second phase of the research, reviews of grant applications from the 2008-2009 funding cycle and interviews with employees and volunteers familiar with the funding process revealed competing ideas regarding resource allocation in light of vague organizational documents describing funding goals and objectives. Within the final stage of the research, these findings translated to the Affiliate selecting programs with highly varying potential long-term impact with regards to addressing goals and objectives relating to breast cancer education, screening, diagnostics, treatment, and support. The resulting performance assessment framework, consisting of three phases of research utilizing organizational documents and key informant interviews, demonstrated the importance of clearly defined funding goals and objectives, reference documents and committee participation within the funding process, and regular reviews of potential long-term impact for selected programs, all supported by the active participation and governance of a funder's Board of Directors.^

Liberation of hope: An ethnographic study of community-based initiatives in Houston, Texas

This is an ethnographic study about the worldview of community-based initiatives in Houston, Texas, and the people who work in them. People who participated in this study recognize that their direct constructive action is at the heart of authentic social change in their minority communities. Through qualitative data analysis, a constellation of relationships and process patterns were found to constitute themselves into the system of the community-based initiative. The predominant patterns identified from the findings in this study are: the pervasiveness of place, the importance of people, unique initiatory patterns, the concrete local sustainability, the ever-present action orientation, the resourceful use of networks and inter-relationships, the significance of church influence, the core sense of spirituality and the essence of hope. These patterns emerged out of the local knowledge, which is acutely sensitive to the elements of history and lived experience, embedded in the distinctive moral and visionary patterns of meaning and expression. Findings from the research reveal that these community-based initiatives are not programs--they are people--people who keep hope alive in their communities and who, by their daily practice, liberate others. ^

Arqueologías del ¿Futuro? : Cartografía estética aplicada a territorios específicos

Los Territorios Específicos condicionados socioambiental y/o físicoculturalmente son sistematizados en base a sus cualidades éticas y estéticas en su sentido filosófico y formal respectivamente. Los mismos surgen como entidades orgánicamente integradas a nivel de las prácticas culturales en función de una performatividad autopoiética con gradientes y resonancias ampliamente debatidas académicamente y/o, a través de producciones específicas de las artes visuales contemporáneas. La Cartografía Estética propuesta se conforma de un corpus de obras plásticas y teóricas que, en la trayectoria expositiva abordada para este estudio, conforman una constelación de ejes temáticos y procedimentales en vinculación a los modos de producción en artes visuales. Estos nódulos o modos de hacer en artes visuales, se integran en una fascinante e interesante red epistemológica que, a la luz de las obras de arte seleccionadas son transparentadas no sólo en su complejidad epistémica sino que también son confrontados a interesantes gestos y guiños visuales a modo de cita y figuras conceptuales que en sentido moebiano remisionan formas de inscripción de obra y de la legibilidad de la misma conformando un alfabeto visual contemporáneo indispensable a la hora de pensar y entender la producción artística del último siglo en general y de las artes visuales latinoamericanas y chilenas en particular, todas ellas conforman una panorámica global en lo que hoy se conoce y divulga como arte actual. La unidad espacial abordada como Territorios Específicos se constituyen críticamente por conformar zonas y áreas marginales, espacios residuales y limítrofes, a la vez que contenedores y contenido de resistencia asistémica facilitado por un desinterés administrativo consecuente a su calidad de margen residual naturalizado y sus contenidos subyacentes. Metodológicamente, esta investigación ha sido cuidadosamente sistematizada a partir de herramientas de análisis y medición provenientes de las ciencias sociales y otras más afín a las de la ingeniería como arquitectura y urbanismo y de otras ciencias fronterizas de las biofísicas como la arqueología, etnografía y antropología, adaptadas todas a un interesantísimo protocolo instrumental replicable para las artes visuales. Este compendio procedimental comprende acciones de arte de sitio específico realizadas en una franja costera de 30 kilómetros que abarca desde la ciudad de Valdivia hasta 'La Reserva de Curiñanco' en la recientemente inaugurada XIV Región de Los Ríos en Chile. Estas acciones son confrontadas y tensionadas tanto a nivel de la crítica especializada como de sus afluentes epistemológicos colindantes con las ciencias humanas, donde, este corpus de obra contemporáneas, curatorías, proyectos de sitio y debates especializados, aportan considerablemente a la construcción de futuros posibles no solo de las artes visuales en particular y de las ciencias humanas en general, sino que además conllevan un debate ineludible para el desafío implicado en el debate territorio/globalización