Individual Recipients Research Articles

Evaluating the Future: Special Collections in Art Libraries

This survey was conducted online, primarily in May 2006. Institutions were selected with the intention of providing a representative sample of art research libraries across the spec trum of academic, museum, and independent research libraries and a broad geographic range of institutions within the United States. Individual recipients were those parties responsible for the administration of the art library within their institution. For the purposes of this study, academic art libraries were limited to those either supporting an independent art institution or physi cally separate libraries within a university library system. From an initial group of fifty art librarians, eighteen surveys were received; however, only fifteen surveys were complete enough to include in survey results. Within the primary group of fifteen respondents were ten art museum libraries (67 percent), four art college or university art libraries (27 percent), and one independent research library. These library varied in size from 15,000 to 920,000 total volumes. Throughout the survey the term collections was used as a generic term for rare books and special collections. Unless rare books and special were treated as distinct collections, libraries were asked to include materials defined as rare books along with special statistics. Though the number of survey responses was limited, certain trends were revealed. More than half of the libraries surveyed do not have written collection development policies in place, just over one quarter have special transfer policies, and only one fifth have special identification policies. Nonetheless, all libraries surveyed indicated that they distin guish their rare books or other special from general collections, and the majority indicated that special identification criteria are used in their libraries, suggesting that many of these libraries are engaging in the selection of special materials in the absence of a written policy. The survey included questions on collection information; collection inclusive dates; types of materials in collections; iden tification of rare and special materials; acquisitions; evaluation and transfer of materials; policies; and decision making. However, this article will emphasize the areas most directly related to the identification of special collection materials. The discussion will be preceded by an overview of how rare books and special are defined and identified in general collections.

High variation of individual soluble serum CD30 levels of pre-transplantation patients: sCD30 a feasible marker for prediction of kidney allograft rejection?

Previous studies have suggested that the pre-transplant levels of the soluble CD30 molecule (sCD30) represent a non-invasive tool which can be used as a biomarker for the prediction of kidney allograft rejections. In order to evaluate the feasibility of sCD30 for pre-transplantation monitoring the sera of potential kidney recipients (n = 652) were collected four times in a 3 months interval. Serum from healthy blood donors (n = 203) served as controls. The sCD30 concentrations of all samples were determined using a commercially available ELISA. This strategy allowed the detection of possible variations of individual sCD30 levels over time. Heterogeneous sCD30 concentrations were found in the samples obtained from individual putative kidney transplant recipients when quarterly measured over 1 year. Total 95% of serum samples obtained from healthy controls exhibited sCD30 values <30 U/ml, whereas most recipients displayed higher serum levels (>30 U/ml). Total 524 patients (80.4%) constantly exhibited serum concentrations of <100 U/ml during the period investigated, whereas 109 patients (16.7%) showed variations by exceeding the proposed 'cut off' of 100 U/ml for one to three times. The frequency of samples exhibiting sCD30 values >100 U/ml was significantly lower than that previously reported. The high degree of variation does not allow the stratification of patients into high and low immunological risk groups based on a single sCD30 value > 100 U/ml. Due to the heterogeneity of sCD30 levels during time course and the high values of SD, its implementation as a pre-transplant marker cannot be justified to generate special provisions for the organ allocation to patients with single sCD30 values > 100 U/ml.

Balancing Organ Quality, HLA-Matching, and Waiting Times: Impact of a Pediatric Priority Allocation Policy for Deceased Donor Kidneys in Quebec

Deceased donor kidney allocation policy must balance the desire for high-quality organs, good human leukocyte antigen (HLA) matching, and minimal waiting times. We describe a 10-fold reduction in waiting times and an improvement in nonimmunologic indices of organ quality for child recipients after a change in organ allocation policy in Quebec, Canada. The new policy gives first priority to children (<18 yr) irrespective of HLA matching or waiting time. HLA matching after the policy change was predictably much worse. This study highlights the trade-offs that must be considered both in setting allocation policy and in decisions for individual recipients. We also consider potential unintended negative effects of such a policy change.

Large functional repertoire of regulatory T-cell suppressible autoimmune T cells in scurfy mice

Scurfy mice which lacks functional Foxp3 transcription factor and CD4 +CD25 +Foxp3 + regulatory T (Treg) cells, spontaneously develop autoimmune responses against skin, lung, liver and tail. However, many organs/tissues are spared from autoimmune attack. Here, we demonstrate that scurfy mice contain dormant autoimmune T cells that induced new diseases such as sialoadenitis, dacryoadenitis, pancreatitis, gastritis, intestinal inflammation, colitis, and myositis in RAG-1 KO mice. Inflammation in as many as 12 organs/tissues was consistently induced in individual recipients with scurfy lymph node cells containing as few as 1.25 × 10 6 CD4 + T cells. Moreover, transfer of the multiple organ autoimmune diseases could be suppressed by as little as 0.5 × 10 6 CD4 +CD25 + Treg cells, mediated by inhibiting autoimmune T-cell expansion. Our study provides evidence for the presence of a large repertoire of autoimmune lymphocytes against various organs/tissues in scurfy mice as well as Treg cells in B6 mice capable of suppressing the expansion of these autoimmune lymphocytes. Various conditions that control the expression of autoimmune T cells are discussed.

Trends in Organ Donation and Transplantation in the United States, 1996–2005

This brief overview of solid organ transplantation in the United States is produced as part of the 2006 OPTN/SRTR Annual Report. The Annual Report is prepared by the Scientific Registry of Transplant Recipients (SRTR) in collaboration with the Organ Procurement and Transplantation Network (OPTN) under contract with the Health Resources and Services Administration (HRSA). The report gathers a large amount of information on many aspects of solid organ transplantation in one publication, making it a valuable resource for patients, the transplant community, the public and the Federal Government.

Using Overlapping Synthetic Peptides from Tumor-Associated Protein Antigens for Breast Cancer Vaccine Development. (41.11)

Abstract An effective vaccine will need to elicit both CD4+ T helper and CD8+ cytotoxic T lymphocytes (CTL) responses in order to maintain effective CTL functions. Peptide vaccines tailored to certain genetic backgrounds are capable of eliciting MHC Class I-restricted (CD8+) and Class II-restricted (CD4+) responses. However, the need to identify specific T-cell epitopes in the context of MHC alleles hampers this approach. We have developed a novel strategy that bypasses the need for epitope mapping for an outbred population: vaccination with overlapping synthetic peptides (OSP), to generate strong antigen-specific cell-mediated immunity (CMI) in individual vaccine recipients with different MHC backgrounds. OSP contain all possible epitopes for the CD4+ as well as CD8+ T cells of a genetically diverse population. BALB/c mice were immunized with OSP derived from a tumor protein, which is overexpressed in 60% in breast cancer specimens. The vaccinated animals developed an in vitro activity of tumor specific- CTL, proliferative response, IFN-g production and CD107 expression. Immunized mice also were challenged with TS/A tumor cells (a murine mammary adenocarcinoma cell) to induce micrometastasis. Vaccination with OSP significantly increased the animal life span. The OSP vaccine strategy provides a novel opportunity to induce cellular immune responses against developing tumors in a genetically diverse population.

The influence of the vibration signal on worker interactions with the nest and nest mates in established and newly founded colonies of the honey bee, Apis mellifera

Honey bees adjust cooperative activities to colony needs, based in part on information acquired through interactions with the nest and nest mates. We examined the role of the vibration signal in these interactions by investigating the influence of the signal on the movement rates, cell inspection activity, and trophallaxis behavior of workers in established and newly founded colonies of the honey bee, Apis mellifera. Compared to non-vibrated control bees, vibrated recipients in both colony types exhibited increased movement through the nest and greater cell inspection activity, which potentially increased contact with stimuli that enhanced task performance. Also, compared to controls, recipients in both colony types showed increased rates of trophallactic interactions and spent more time engaged in trophallaxis, which potentially further increased the acquisition of information about colony needs. The vibration signal may therefore help to organize labor in honey bees in part by increasing the rate at which workers obtain information about their colony. Vibrated recipients in the established and newly founded colonies did not differ in any aspect of behavior examined, suggesting that colony developmental state did not influence the degree to which individual workers responded to the signal. However, previous work has demonstrated that newly founded colonies have increased levels of vibration signal behavior. Thus, the vibration signal may help to adjust worker activity to colony conditions partly by stimulating greater numbers of bees to acquire information about colony needs, rather than by altering the level at which individual recipients react to the signal.

239: Measurement of CMV-specific immunity to risk straitify individual lung transplant recipients with regard to CMV reactivation

239: Measurement of CMV-specific immunity to risk straitify individual lung transplant recipients with regard to CMV reactivation

Hydrodynamic Limb Vein Delivery of a Xenogeneic DNA Cancer Vaccine Effectively Induces Antitumor Immunity

Tumor-associated antigens (TAA) are typically poorly immunogenic "self" antigens. An effective strategy to break tolerance and induce antitumor immunity is by genetic vaccination, employing the orthologous TAA-sequence from a different species. We recently developed a clinically relevant approach for intravascular hydrodynamic limb vein (HLV) delivery of nucleic acids to skeletal muscle. Using the human gp100 xenogeneic TAA in the murine B16 melanoma model, we show that genetic vaccination of mice by HLV plasmid DNA delivery was highly effective at breaking tolerance against the homologous murine gp100 (mgp100) TAA and induced prophylactic antitumor protection. HLV vaccination resulted in an anti-hgp100 humoral and cellular response, with 4-5% of CD8(+) T cells being gp100(25-33)-epitope-specific. Vaccinated animals demonstrated in vivo cytolytic activity against human and mgp100(25-33) peptide-pulsed targets. Antitumor immunity could be adoptively transferred by splenocytes from human gp100-vaccinated animals. Furthermore, a durable antitumor memory response was established as approximately 3% of CD8(+) T cells were gp100(25-33) antigen-specific in mice 6 months after vaccination. Following a single HLV human gp100 DNA boost, this level increased to approximately 17% and protected animals from subsequent B16 tumor rechallenge. Our results warrant further consideration of HLV as a clinically relevant method for cancer gene therapy.

Remittances — Can the industry meet the demands of consumers and regulators?

This paper examines the role of private banking institutions in the worldwide remittance business. Remittances play a significant role in the financial welfare of individual recipients and their families, and on occasion their wider communities, to the point that the G8, along with supra-national financial bodies such as the World Bank, now consider remittances to be an area of public policy. Although the market is currently served by a number of service providers of varying degrees of formality, there is an opportunity for private banks to enter the space and offer parallel services, thus increasing competition and lowering costs. Nonetheless, the remittance business is not one to be undertaken lightly: as well as the opportunities that are presented by remittances, there are a number of challenges to be overcome. This paper considers the advantages to both remitters and recipients brought about by increased involvement of banking institutions — primarily reduced costs, increased financial literacy and a degree of poverty alleviation. It examines the nature of the challenges that banks face, and the infrastructure, systems and processes that are required. Finally, it assesses the likely nature of banking involvement, and presents a view of the collaborative relationships that are likely to develop between different banks to deliver comprehensive remittance services.

Recovery and Utilization of Deceased Donor Kidneys from Small Pediatric Donors

To the Editor: We appreciate the comments by Dr. Martin et al. on our recent manuscript (1Pelletier SJ Guidinger MK Merion RM et al.Recovery and utilization of deceased donor kidneys from small pediatric donors..Am J Transplant. 2006; 6:: 1646-1652Abstract Full Text Full Text PDF PubMed Scopus (103) Google Scholar). In their letter, they highlight the idea that kidneys from small pediatric deceased donors may be underutilized. We agree that a more aggressive approach to the recovery and utilization of kidneys from this population would be appropriate. They describe some of the technical challenges that may be encountered, particularly with the smallest of donors, which have led some transplant centers to avoid using these grafts. However, as described by Martin et al., many of these difficulties can be overcome and our analysis of national data suggests that excellent graft function can be achieved. Because not all recipient patient populations may benefit equally from en bloc kidney transplantation from small pediatric donors, appropriate recipient selection is important. The North American Pediatric Renal Transplant Cooperative Study demonstrated a considerably increased rate of graft thrombosis for pediatric recipients receiving kidney transplants from donors under 5 years old (2Singh A Stablein D Tejani A Risk factors for vascular thrombosis in pediatric renal transplantation: A special report of the North American Pediatric Renal Transplant Cooperative Study..Transplantation. 1997; 63:: 1263-1267Crossref PubMed Scopus (200) Google Scholar). The current data do not support the transplant of small pediatric donor kidneys into small pediatric recipients. The optimal use of kidneys from small pediatric deceased donors remains unclear. Further studies are needed to determine when kidneys from this donor population should be transplanted individually, benefiting a greater number of recipients, as opposed to transplantation en bloc, where results are maximized for an individual recipient. The Scientific Registry of Transplant Recipients is funded by contract number 231-00-0116 from the Health Resources and Services Administration, U.S. Department of Health and Human Services. The views expressed herein are those of the authors and not necessarily those of the U.S. Government.

SHAW'S LETTERS IN OTHER PEOPLE'S BOOKS: THE “ORPHANS”

Three hundred thousand! Dan H. Laurence (personal correspondence) estimates that is the number of letters and postcards written by Bernard Shaw in his some seventy-five years of correspondence. Shaw was perhaps the greatest, most prolific letter writer of all time. In almost 100 years of effort, scholars and publishers have attempted to come to grips with the magnitude of his output, still gargantuan in size despite the many reports of swaths of Shaw letters having been destroyed by their recipients, such as those from the 1880s to his onetime proposed socialist fiancee, Annie Besant, and those to his childhood friend Edward McNulty. Shaw's letters have been published in two broad categories: general collections and collections devoted solely or largely to individual recipients. At the head of the general collections stand the pillars in the field, the four volumes assembled by Dan Laurence as Collected Letters (covering the years 1874 to 1950 and published between 1965 and 1988).1 The four volumes contain some 3,000 letters, thus only about 1 percent of the possible all-encompassing total. Other excellent collections in this category include Agitations (1985), Shaw's letters to the press edited by Laurence and Rambeau; Dear Mr. Shaw (1987), edited by Vivian Elliot, where Shaw's own letters are mixed with letters addressed to him; and Theatrics (1995), Shaw's letters on theatrical subjects edited by Laurence.2 In this essay, I term those parts of the volumes that have already been published recollections and their editors re-collectors, and an item appearing in print for the first time is described simply as having been collected. Over the last eighty years have also appeared books in the second category, correspondence devoted solely or with large sections devoted to recipients: Alma Murray, Ellen Terry, Florence Farr, Mrs. Patrick Campbell, Harley Granville Barker, Sydney Cockerell, Dame Laurentia, and Molly Tompkins; in more recent years, Siegfried Trebitsch, Frank Harris, and

Group Versus Individual Liability: A Field Experiment in the Philippines

This working paper by CGD non-resident fellow Dean Karlan explores whether group liability in lending practices improves lender's overall profitability and the poor's access to financial markets. Group liability is a common microcredit lending mechanism that makes a group, rather than an individual recipient, responsible for repayment. It claims to improve repayment rates by providing incentives for peer's to screen, monitor and enforce each other's loans. But some argue that group liability actually discourages good clients from borrowing by creating tension among group members and causing dropouts, jeopardizing growth and sustainability. Also, bad clients can free ride off of good clients causing default rates to rise. In this paper, Karlan and his co-authors discuss the results of a field experiment at a bank in the Philippines, where they randomly reassigned half of the existing group liability centers as individual liability centers. They find that converting group liability to individual liability, while keeping aspects of group lending like weekly repayments and common meeting place, does not affect the repayment rate, and actually attracts new clients. This paper is one in a series of six CGD working papers by Dean Karlan on various aspects of microfinance (Working Paper Nos. 106 –111).

Demographic Characteristics of Individuals Who Received Project Liberty Crisis Counseling Services

Demographic Characteristics of Individuals Who Received Project Liberty Crisis Counseling Services

Steroid Withdrawal Increases Risk of Acute Rejection but Reduces Infection: A Meta-Analysis of 1681 Cases in Renal Transplantation

Objective To evaluate the safety of steroid withdrawal in renal transplantation recipients. Methods These following databases were searched: Medline (1966 to September 2005), OVID (1966 to 2004), Embase (1984 to 2004), Cochrane library (issue 4, 2005), Highwire (1849 to September 2005), American Transplant Congress (2005), Chinese Biomedicine database (CBM 1994 to 2005). The safety was measured by the following factors: patient and graft survival, acute rejection, chronic rejection, infection, serum creatinine. We performed meta-analysis by using Revman 4.2.7. Results Nine randomized clinical trials were identified to have a steroid withdrawal and a steroid continuing group. They included 1681 patients: 845 with steroid withdrawal and 836 with continuing steroid. The risk of acute rejection after steroid withdrawal was two times higher than steroid-continuing group (RR 2.05; 95% confidence interval [CI]: 1.54, 2.72; P < .00001), while the incidence of opportunistic infection and urinary tract infection of steroid withdrawal group were lower than the control group (RR 0.80; 95%CI 0.64, 1.00; P = .05 vs RR 0.74; 95%CI, 0.60, 0.92; P = .004, respectively). The graft and patient survivals, chronic rejection, and serum creatinine were similar to the steroid continuing group. Conclusion Steroid withdrawal can significantly increase the risk of acute rejection episodes, but reduces the incidence of infection to a certain extent. To prophylaxis against serious infection, steroid withdrawal is worth considering using a sufficient immunosuppressive regimen. The key point is to balance the benefit and harm for the individual recipient.

Recommendations for Outpatient Monitoring of Kidney Transplant Recipients

Clinical and laboratory outpatient monitoring is an important tool in the prevention and management of complications associated with kidney transplantation and immunosuppressive therapy. In the absence of standard protocols for outpatient surveillance of kidney transplant recipients, recommendations for frequency and type of monitoring are determined by the likelihood of problems that are unique to the individual transplant recipient and the particular posttransplantation period. In addition, it is imperative to maintain the transplant recipient's overall health by screening for conditions or diseases that can be linked to prior renal disease, immunosuppressive therapies, and general health maintenance.

Overcoming Barriers to Long-Term Graft Survival

Although short-term kidney graft survival has improved in recent years, the focus has shifted to the challenge of improving long-term graft survival. Acute rejection, chronic allograft nephropathy, and cardiovascular disease are associated with graft loss and patient death. Reducing the potential for such posttransplantation complications may improve long-term graft survival. In addition, gaining a better understanding of the role that various immunosuppressive therapies have in decreasing the risk for graft injury will help clinicians make better-informed decisions about appropriate treatment regimens for individual kidney transplant recipients.

Ethical and equity issues in lung transplantation and lung volume reduction surgery

New medical and scientific disciplines are often developed in haste with rampant enthusiasm and scant regard for the balance between action and thoughtful deliberation. Driven by the desire to prolong life and provide a better quality of life for desperately sick individuals, the twin modalities of lung transplantation and lung volume reduction therapy have only just reached their majority. Both are invested with the capacity to help and to harm so it is right to consider carefully their ethical and equitable distribution. Much has been learned in the last 20 years to assist in these deliberations. First, how can we ensure equity of access to transplant services and equality of outcomes? How do we balance resource allocation of a precious and scarce resource with individual recipient needs? Does the concept of distributive justice prevail in our daily work in this field? How do we honour the donor and their family? How do we as practitioners avoid ethical dilemmas related to personal bias and justifiable reward for services rendered? Finally, how do we learn to incorporate ethical forethought and planning guided by experts in the area into everyday behaviour?

The incidence of nonadherence after organ transplant: Ensuring that our efforts at counting really count

The incidence of nonadherence after organ transplant: Ensuring that our efforts at counting really count

Internet Organ Solicitation, Explained

The growth of internet-based communications and the increasing demand for living organ donors are resulting in more use of Web sites for organ solicitation. Web resources have the capacity to improve public awareness about both organ donations and transplant outcomes. Rules for organ donation and fair allocation must follow legal principles regarding organ solicitation. Categories of internet recipient/donor matching services include "clearing house," "membership," and "individual" sites. All these raise ethical concerns related to the individual recipient/donor relationship and to the current system of organ allocation. However, a lack of rules and regulations regarding internet solicitation exists. Several pragmatic steps are proposed.