ABO blood group incompatible haematopoietic stem cell transplantation and xenograft rejection

The current organ shortage in transplantation medicine stimulates the exploration of new strategies to expand the donor pool including the utilisation of living donors, ABO-incompatible grafts, and xenotransplantation. Preformed natural antibodies (Ab) such as anti-Gal or anti-A/B Ab mediate hyperacute graft rejection and thus represent a major hurdle to the employment of such strategies. In contrast to solid organ transplantation (SOT), ABO blood group incompatibilities are of minor importance in haematopoietic stem cell transplantation (HSCT). Thus, ABO incompatible HSCT may serve as an in vivo model to study carbohydrate antigen (Ag)-mismatched transplantations such as ABO-incompatible SOT or the effect of preformed Ab against Gal in xenotransplantation. This mini-review summarises our clinical and experimental studies performed with the support of the Swiss National Science Foundation program on Implants and Transplants (NFP-46). Part 1 describes data on the clinical outcome of ABO-incompatible HSCT, in particular the incidence of several immunohaematological complications, acute graft-versus-host-disease (GvHD), and the overall survival. Part 2 summarises the measurements of anti-A/B Ab in healthy blood donors and ABO-incompatible HSCT using a novel flow cytometry based method and the potential mechanisms responsible for the loss of anti-A/B Ab observed following minor ABO-incompatible HSCT, ie the occurrence of humoral tolerance. Part 3 analyses the potential of eliminating Gal expression as well as specific complement inhibitors such as dextran sulfate and synthetic tyrosine analogues to protect porcine endothelial cells from xenoreactive Ab-mediated damage in vitro and in a hamster-to-rat heart transplantation model. In conclusion, due to similarities of the immunological hurdles of ABO incompatible transplantations and xenotransplantation, the knowledge obtained from both fields might lead to new strategies to overcome humoral rejection in transplantation.

Progress Report on Iowa State University Burroughs Endowment Activities

Faculty in the Department of Animal Science initiated soliciting of funds in 1987 to establish a permanent endowment to recognize the distinguished career and major contributions of Dr. Wise Burroughs, a distinguished professor in animal science at Iowa State University. The endowment was established in the Iowa State University Foundation in 1991. The purpose of the fund is to support research and graduate education in the areas of fundamental factors regulating growth in food-producing animals, with emphasis on ruminants; to enhance growth of animals with the goal of improving the competitive position of ruminants as food-producing animals; and to develop innovative approaches to ruminant nutrition and/or growth enhancement as a means to improve desirability of meat produced by food animals. Dr. Burroughs’ research resulted in important and significant developments in technology for modern production systems for beef cattle. He was widely known for his ability to communicate complex ideas and research results for use by those involved in the animal industry. The current Burroughs Team has established three research projects: 1) Ghrelin--How does ghrelin affect blood and body composition in rats?; 2) Use of 25- hydroxyvitamin D3 to improve tenderness of beef; 3) Redesigning beef cattle to have a more healthful fatty acid composition.

Commentary on "Child Welfare Waivers: The Stakes for Families"

The purpose of this piece is to provide commentary of an article, Child Welfare Waivers: The Stakes for Your State, that discusses the recent reauthorization of the Title IV-E Child Welfare Waivers. The article provides an overview of funds available to the states for child welfare programs and their intended purpose and restrictions placed on use. As structured, the present system rewards states monetarily for maintaining foster care. Research from waiver programs shows promising results for improved outcomes at the same or lower financial cost by utilizing safe, proven alternatives to the current foster care system. Waiver funds also protect the financial commitment to child welfare because state legislative budget slashing in this area will result in the loss of Federal funding. The independent analysis required with the grant of a waiver must be maintained to provide ongoing analysis and oversight of the increase spending flexibility. Stakeholders must be aware of the program and its results and use these funds as an opportunity to assess new concepts and apply programs best suited to the needs of children in their state. Allowing those “on the ground” to determine appropriate programming and careful result assessment may be the best means for protecting children, preserving families and doing both in a manner that makes the most efficient use of available resources.

A Compensating Anastigmatic Submillimeter Array Imaging System for STEAMR

In this paper, we present a novel technique for the removal of astigmatism in submillimeter-wave optical systems through employment of a specific combination of so-called astigmatic off-axis reflectors. This technique treats an orthogonally astigmatic beam using skew Gaussian beam analysis, from which an anastigmatic imaging network is derived. The resultant beam is considered truly stigmatic, with all Gaussian beam parameters in the orthogonal directions being matched. This is thus considered an improvement over previous techniques wherein a beam corrected for astigmatism has only the orthogonal beam amplitude radii matched, with phase shift and phase radius of curvature not considered. This technique is computationally efficient, negating the requirement for computationally intensive numerical analysis of shaped reflector surfaces. The required optical surfaces are also relatively simple to implement compared to such numerically optimized shaped surfaces. This technique is implemented in this work as part of the complete optics train for the STEAMR antenna. The STEAMR instrument is envisaged as a mutli-beam limb sounding instrument operating at submillimeter wavelengths. The antenna optics arrangement for this instrument uses multiple off-axis reflectors to control the incident radiation and couple them to their corresponding receiver feeds. An anastigmatic imaging network is successfully implemented into an optical model of this antenna, and the resultant design ensures optimal imaging of the beams to the corresponding feed horns. This example also addresses the challenges of imaging in multi-beam antenna systems.

Risk adjustment in aging societies

Background In Switzerland, age is the predominant driver of solidarity transfers in risk adjustment (RA). Concerns have been voiced regarding growing imbalances in cost sharing between young and old insured due to demographic changes (larger fraction of elderly >65 years and rise in average age). Particularly young adults aged 19–25 with limited incomes have to shoulder increasing solidarity burdens. Between 1996 and 2011, monthly intergenerational solidarity payments for young adults have doubled from CHF 87 to CHF 182, which corresponds to the highest absolute transfer increase of all age groups. Results By constructing models for age-specific RA growth and for calculating the lifetime sum of RA transfers we investigated the causes and consequences of demographic changes on RA payments. The models suggest that the main driver for RA increases in the past was below average health care expenditure (HCE) growth in young adults, which was only half as high (average 2% per year) compared with older adults (average 4% per year). Shifts in age group distributions were only accountable for 2% of the CHF 95 rise in RA payments. Despite rising risk adjustment debts for young insured the balance of lifetime transfers remains positive as long as HCE growth rates are greater than the discount rate used in this model (3%). Moreover, the life-cycle model predicts that the lifetime rate of return on RA payments may even be further increased by demographic changes. Nevertheless, continued growth of RA contributions may overwhelm vulnerable age groups such as young adults. We therefore propose methods to limit the burden of social health insurance for specific age groups (e.g. young adults in Switzerland) by capping solidarity payments. Conclusions Taken together, our mathematical modelling framework helps to gain a better understanding of how demographic changes interact with risk adjustment and how redistribution of funds between age groups can be controlled without inducing further selection incentives. Those methods can help to construct more equitable systems of health financing in light of population aging.

Matching Social and Ecological Systems in Complex Ocean Fisheries

This paper considers ocean fisheries as complex adaptive systems and addresses the question of how human institutions might be best matched to their structure and function. Ocean ecosystems operate at multiple scales, but the management of fisheries tends to be aimed at a single species considered at a single broad scale. The paper argues that this mismatch of ecological and management scale makes it difficult to address the fine-scale aspects of ocean ecosystems, and leads to fishing rights and strategies that tend to erode the underlying structure of populations and the system itself. A successful transition to ecosystem-based management will require institutions better able to economize on the acquisition of feedback about the impact of human activities. This is likely to be achieved by multiscale institutions whose organization mirrors the spatial organization of the ecosystem and whose communications occur through a polycentric network. Better feedback will allow the exploration of fine-scale science and the employment of fine-scale fishing restraints, better adapted to the behavior of fish and habitat. The scale and scope of individual fishing rights also needs to be congruent with the spatial structure of the ecosystem. Place-based rights can be expected to create a longer private planning horizon as well as stronger incentives for the private and public acquisition of system relevant knowledge.

Macroeconomic Rationality and Lucas' Misperceptions Model: Further Evidence from Forty-One Countries

Several researchers have examined Lucas's misperceptions model as well as various propositions derived from it within a cross-section empirical framework. The cross-section approach imposes a single monetary policy regime for the entire period. Our paper innovates on existing tests of those rational expectations propositions by allowing the simultaneous effect of monetary and short run aggregate supply (oil price) shocks on output behavior and the employment of advanced panel econometric techniques. Our empirical findings, for a sample of 41 countries over 1949 to 1999, provide evidence in favor of the majority of rational expectations propositions.

Border intervention by Promotores for type 2 diabetes

Purpose of the study. This study had two components. The first component of the study was the development and implementation of an infrastructure that integrated Promotores who teach diabetes self-management into a community clinic. The second component was a six-month randomized clinical trial (RCT) designed to test the effectiveness of the Promotores in changing knowledge, beliefs, and HbA1c levels among Mexican American patients with type 2 diabetes. ^ Methods. Starfield's adaptation of the Donbedian structure, process, and outcome methodology was used to develop a clinic infrastructure that allowed the integration of Promotores as diabetes educators. The RCT of the culturally sensitive Promotores-led 10-week diabetes self-management program compared the outcomes of 63 patients in the intervention group with 68 patients in a wait-list, usual care control group. Participants were Mexican Americans, at least 18 years of age, with type 2 diabetes, who were patients at a Federally Qualified Health Center on the Texas-Mexico border. At baseline, three months, and six months, data were collected using the Diabetes Knowledge Questionnaire (DKQ, the Health Beliefs Questionnaire (HBQ, and HbA1c levels were drawn by the clinic laboratory. A mixed model methodology was used to analyze the data. ^ Results. The infrastructure to support a Promotores-led diabetes self-management course designed in concert with administration, the physicians, and the CDE, resulted in (1) employment of Promotores to teach diabetes self-management courses; (2) integration of provider and nurse oversight of course design and implementation; (3) management of Promotora training, and the development of teaching competencies and skills; (4) coordination of care through communication and documentation policies and procedures; (5) utilization of quality control mechanisms to maintain patient safety; and (6) promotion of a culturally competent approach to the educational process. The RCT resulted in a significant improvement in the intervention group's DKQ scores over time (F [1, 129] = 4.77, p = 0.0308), and in treatment by time (F [2, 168] = 5.85, p = 0.0035). Neither the HBQ scores nor the HbA1c changed over time. However, the baseline HbA1c was 7.49, almost at the therapeutic level. The DKQ, HBQ, and HbA1c results were significantly affected by age; the DKQ and HbA1c by years with diabetes. ^ Conclusions. The clinic model provides a systematic approach to safely address the educational needs of large numbers of patients with type 2 diabetes who live in communities that suffer from a lack of health care professionals. The Promotores-led diabetes self-management course improved the knowledge of patients with diabetes and may be a culturally sensitive strategy for meeting patient educational needs. The low baseline HbA1c levels in this border community suggested that patients in this Federally Qualified Health Center on the Texas-Mexico border were experiencing good medical management of their diabetes. ^

Hispanic incorporation and access to health care in Houston and Harris County, Texas: Adopting an Hispanic perspective to the Aday and Andersen model

This study examines Hispanic levels of incorporation and access to health care. Applying the Aday and Andersen framework for the study of access, the study examined the relationship between two levels of Hispanic incorporation into U.S. society, i.e., mainstream versus ethnic, and potential and realized measures of access to health care. Data for the study were drawn from a 1992 telephone survey of 600 randomly selected Hispanics in Houston and Harris County.^ The hypotheses tested were: (1) Hispanics who are incorporated into mainstream society are more likely to have better potential and realized access to health care than those who are incorporated into ethnic-group enclaves regardless of their socioeconomic status (SES), health status and health needs, and (2) there is no interaction between the levels of incorporation (mainstream or ethnic) and SES, health status, and health needs in predicting potential and realized access.^ The data analysis supported Hypothesis One for the two measures of potential access. The results of bivariate and multiple logistic regression analyses indicated that for Hispanics in Houston and Harris County, being in the "mainstream" incorporation category increased their potential access to care, having "health insurance" and a "regular place of care". For the selected measure of realized access, having a "regular check-up", the analysis did not demonstrate statistically significant differences in having a regular check-up among Hispanics incorporated in the ethnic or mainstream incorporation categories.^ Hypothesis Two, that there is no interaction between the levels of incorporation and socioeconomic characteristics, health status, and health needs in predicting potential and realized access among Hispanics was supported by the data. The results of the logistic regression analysis showed that, after adjusting for socioeconomic status, health status, and health needs, the association between "level of incorporation" and the two measures of potential access ("health insurance" and having a "usual place of care") was not modified by the control variables nor by their interaction with level of incorporation. That is, the effect of incorporation on Hispanics' health insurance coverage, and having a usual place of care, was homogenous across Hispanics with different SES and health status.^ The main research implication of this dissertation is the employment of a theoretical framework for the assessment of cultural factors essential to research on migrating heterogeneous subpopulations. It also provided strategies to solve practical and methodological difficulties in the secondary analyses of data on these populations. ^

La intervención profesional de los/as trabajadores/as sociales en relación con la inclusión laboral de personas en situación de discapacidad en talleres protegidos de la provincia de Mendoza

La temática de las personas en situación de discapacidad ha motivado en los últimos años gran interés en distintos ámbitos tantos académicos como de ejecución de políticas sociales, pero el cambio en la mirada ha comenzado a correr el velo sobre la inserción laboral de las personas que durante años fueron asociadas al concepto de enfermedad. Ello se encuentra relacionado también con diversos modelos conceptuales sobre la discapacidad que conviven en la actualidad. Se hace el aporte desde el Modelo Social de la Discapacidad, que apunta a reconocer la diversidad como un elemento inherente a la condición humana. Se propone un estudio comparado de dos instituciones: la cooperativa de trabajo y taller protegido de producción La Rañatela y el centro de capacitación y rehabilitación laboral Milenio, y se muestran las representaciones sociales que subyacen en relación con la discapacidad e inclusión laboral que sustentan los profesionales del Trabajo Social.

Transmisión oral en la narrativa española contemporánea : Un recurso para la construcción de la memoria de la Guerra Civil y del franquismo

Se propone la descripción y el análisis del empleo de la transmisión oral en la narrativa española actual como un recurso para configurar la memoria de la Guerra Civil española y del franquismo. Para ello se atendió especialmente a las estrategias que intervienen en la representación de la oralidad en relación con los diálogos y los relatos orales, entre otros procedimientos a través de los cuales se transmite el pasado traumático dentro de la ficción. Ha sido analizada la representación de la oralidad en la producción narrativa ficcional de diversos autores españoles de finales del siglo XX y comienzos del siglo XXI que han abordado la temática de la Guerra Civil en una situación particular en cuanto al surgimiento de replanteos y debates acerca del tratamiento del conflicto bélico. Los objetivos generales que guiaron el trabajo han sido indagar la presencia y la función de la transmisión oral en la literatura, profundizar el estudio de la oralidad como voz emergente de colectivos sociales desplazados y analizar la funcionalidad del empleo de la oralidad en textos representativos de la narrativa española contemporánea. A su vez, más específicamente, se propuso profundizar en el estudio de la ficcionalización de la transmisión oral como un artificio para la construcción de la memoria en la narrativa española actual, vincular las posibilidades de transmisión de la historia de la Guerra Civil española con medios propios de la historia oral en la literatura -especialmente en la novela-, problematizar determinadas perspectivas sobre el testimonio en la medida en que son literaturizadas para una concepción de la memoria de la Guerra Civil, de la posguerra y de la dictadura, y estudiar algunas miradas contemporáneas acerca de la Guerra Civil y del franquismo desde el campo de la narrativa como un correlato de ciertos reclamos sociales de la actualidad respecto del pasado reciente. Para esto fueron analizadas diversas propuestas que surgieron esencialmente desde la literatura -con algún detenimiento en un texto fílmico- para abordar el pasado traumático y se consideraron las técnicas de transmisión empleadas para la narración ficcional de aspectos largamente silenciados por la historia oficial. El corpus central de textos literarios ha quedado conformado por O lapis do carpinteiro y Os libros arden mal, de Manuel Rivas, Guárdame bajo tierra, de Ramón Saizarbitoria, Soldados de Salamina, de Javier Cercas, Home sen nome, de Suso de Toro, y Mala gente que camina, de Benjamín Prado. Como corpus complementario, se tornó pertinente incorporar un capítulo que articula un texto fílmico (Muerte en El Valle, de Christina Hardt) con un texto literario (Las esquinas del aire. En busca de Ana María Martínez Sagi, de Juan Manuel de Prada). Esto, que en principio puede parecer un apartamiento del corpus central, favoreció el análisis del tratamiento del testimonio desde la estetización de un texto fílmico o literario. Al realizar la selección, se estudiaron, junto con autores que escriben y publican en castellano, algunos textos escritos originariamente en lenguas minorizadas (gallego y euskera)

Panorama general 1970 al 2005 de la matrícula y el egreso universitarios en México como indicadores de la tensión en el mercado laboral

En este trabajo se presentan algunos avances de un proyecto sobre empleo profesional de egresados de universidades públicas y privadas en México. Concretamente se describen los resultados de la fase de indagación cuantitativa de las características de la matrícula y el egreso de nivel universitario por área de estudio, carrera y régimen, de 1970 al 2005, para la población total a nivel nacional, así como algunas características de la participación laboral de nivel profesional. El trabajo se centra en la población de instituciones públicas y privadas por la presencia creciente de estas últimas en la atención de la demanda y para comprender un mercado laboral que parece cada vez más competido y diferenciado por origen institucional. Partimos del supuesto de que la exploración cuantitativa de la dinámica de la educación superior en México en los últimos 35 años, ofrece elementos para conocer algunas de las características de los mercados laborales de nivel profesional y sus niveles de tensión por saturación. En este sentido, la indagación cuantitativa del estudio es una dimensión, entre otras, que contribuye en cierta medida a la comprensión del papel de la educación en el mercado laboral y, en general, de la función social de la educación, dos de los objetivos más amplios del proyecto en el que se enmarca lo que aquí se expone

Las Moîras y el Laberinto en la lírica borgeana : la fusión de dos mitos griegos

La originalidad literaria de Jorge Luis Borges se advierte, entre otros aspectos, en su particular empleo de los mitos procedentes de los más diversos ámbitos culturales. En este trabajo se consideran, precisamente, las innovaciones que efectúa el autor al vincular dos mitos helénicos: el de las Moîras y el del Laberinto.

Transmisión oral en la narrativa española contemporánea : Un recurso para la construcción de la memoria de la Guerra Civil y del franquismo

Se propone la descripción y el análisis del empleo de la transmisión oral en la narrativa española actual como un recurso para configurar la memoria de la Guerra Civil española y del franquismo. Para ello se atendió especialmente a las estrategias que intervienen en la representación de la oralidad en relación con los diálogos y los relatos orales, entre otros procedimientos a través de los cuales se transmite el pasado traumático dentro de la ficción. Ha sido analizada la representación de la oralidad en la producción narrativa ficcional de diversos autores españoles de finales del siglo XX y comienzos del siglo XXI que han abordado la temática de la Guerra Civil en una situación particular en cuanto al surgimiento de replanteos y debates acerca del tratamiento del conflicto bélico. Los objetivos generales que guiaron el trabajo han sido indagar la presencia y la función de la transmisión oral en la literatura, profundizar el estudio de la oralidad como voz emergente de colectivos sociales desplazados y analizar la funcionalidad del empleo de la oralidad en textos representativos de la narrativa española contemporánea. A su vez, más específicamente, se propuso profundizar en el estudio de la ficcionalización de la transmisión oral como un artificio para la construcción de la memoria en la narrativa española actual, vincular las posibilidades de transmisión de la historia de la Guerra Civil española con medios propios de la historia oral en la literatura -especialmente en la novela-, problematizar determinadas perspectivas sobre el testimonio en la medida en que son literaturizadas para una concepción de la memoria de la Guerra Civil, de la posguerra y de la dictadura, y estudiar algunas miradas contemporáneas acerca de la Guerra Civil y del franquismo desde el campo de la narrativa como un correlato de ciertos reclamos sociales de la actualidad respecto del pasado reciente. Para esto fueron analizadas diversas propuestas que surgieron esencialmente desde la literatura -con algún detenimiento en un texto fílmico- para abordar el pasado traumático y se consideraron las técnicas de transmisión empleadas para la narración ficcional de aspectos largamente silenciados por la historia oficial. El corpus central de textos literarios ha quedado conformado por O lapis do carpinteiro y Os libros arden mal, de Manuel Rivas, Guárdame bajo tierra, de Ramón Saizarbitoria, Soldados de Salamina, de Javier Cercas, Home sen nome, de Suso de Toro, y Mala gente que camina, de Benjamín Prado. Como corpus complementario, se tornó pertinente incorporar un capítulo que articula un texto fílmico (Muerte en El Valle, de Christina Hardt) con un texto literario (Las esquinas del aire. En busca de Ana María Martínez Sagi, de Juan Manuel de Prada). Esto, que en principio puede parecer un apartamiento del corpus central, favoreció el análisis del tratamiento del testimonio desde la estetización de un texto fílmico o literario. Al realizar la selección, se estudiaron, junto con autores que escriben y publican en castellano, algunos textos escritos originariamente en lenguas minorizadas (gallego y euskera)

Panorama general 1970 al 2005 de la matrícula y el egreso universitarios en México como indicadores de la tensión en el mercado laboral

En este trabajo se presentan algunos avances de un proyecto sobre empleo profesional de egresados de universidades públicas y privadas en México. Concretamente se describen los resultados de la fase de indagación cuantitativa de las características de la matrícula y el egreso de nivel universitario por área de estudio, carrera y régimen, de 1970 al 2005, para la población total a nivel nacional, así como algunas características de la participación laboral de nivel profesional. El trabajo se centra en la población de instituciones públicas y privadas por la presencia creciente de estas últimas en la atención de la demanda y para comprender un mercado laboral que parece cada vez más competido y diferenciado por origen institucional. Partimos del supuesto de que la exploración cuantitativa de la dinámica de la educación superior en México en los últimos 35 años, ofrece elementos para conocer algunas de las características de los mercados laborales de nivel profesional y sus niveles de tensión por saturación. En este sentido, la indagación cuantitativa del estudio es una dimensión, entre otras, que contribuye en cierta medida a la comprensión del papel de la educación en el mercado laboral y, en general, de la función social de la educación, dos de los objetivos más amplios del proyecto en el que se enmarca lo que aquí se expone