European guideline on IgG4-related digestive disease – UEG and SGF evidence-based recommendations

The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6–0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2–4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added

Mononuclear cells modulate the activity of pancreatic stellate cells which in turn promote fibrosis and inflammation in chronic pancreatitis

Background: Interactions between mononuclear cells and activated pancreatic myofibroblasts (pancreatic stellate cells; PSC) may contribute to inflammation and fibrosis in chronic pancreatitis (CP). Methods: Markers of fibrosis and inflammation were concomitantly analysed by immunohistochemistry in chronic pancreatitis tissues. In vitro, PSC were stimulated with TNFalpha and LPS. Primary human blood mononuclear cells (PBMC) and PSC were cocultured, followed by analysis of cytokines and extracellular matrix (ECM) proteins. PBMC were derived from healthy donors and CP and septic shock patients. Results: In areas of mononuclear cell infiltration in chronic pancreatitis tissues, there was decreased immunoreactivity for collagen1 and fibronectin, in contrast to areas with sparse mononuclear cells, although PSC were detectable in both areas. LPS and TNFalpha induced collagen1 and fibronectin levels as well as the matrix degradation enzyme MMP-1. Coculture experiments with PSC and PBMC revealed increased fibronectin secretion induced by PBMC. In addition, donor and CP PBMC significantly induced an increase in IL-6, MCP-1 and TGFbeta levels under coculture conditions. Determination of the source of cytokines and ECM proteins by mRNA expression analysis confirmed PSC as major contributors of ECM production. The increase in cytokine expression was PBMC- and also PSC-derived. Conclusion: Mononuclear cells modulate the activity of pancreatic stellate cells, which may in turn promote fibrosis and inflammation

Kant’s epigenesis: specificity and developmental constraints

In this paper, I argue that Kant adopted, throughout his career, a position that is much more akin to classical accounts of epigenesis, although he does reject the more radical forms of epigenesis proposed in his own time, and does make use of preformationist sounding terms. I argue that this is because Kant (1) thinks of what is pre-formed as a species, not an individual or a part of an individual; (2) has no qualm with the idea of a specific, teleological principle or force underlying generation, and conceives of germs and predispositions as specific constraints on such a principle or force. Neither of these conceptions of what is “preformed”, I argue, is in strict opposition to classical epigenesis. I further suggest that Kant’s lingering use of preformationist terminology is due to (1) his belief that this is required to account for the specificity of the specific generative force; (2) his resistance towards the unrestricted plasticity of the generative force in radical epigenesis, which violates species-fixism; and (3) his insistence on the internal, organic basis of developmental plasticity and variation within species. I conclude by suggesting that this terminological and interpretative peculiarity is partly due to a larger shift in the natural philosophical concerns surrounding the debate on epigenesis and preformation. Specifically, it is a sign that the original reasons for resisting epigenesis, namely its use of specific, teleological principles and its commitment to the natural production of biological structure, became less of a concern, whereas unrestricted plasticity and its undermining of fixism became a real issue, thereby also becoming the focal point of the debate

Succession Planning in Academic Libraries: A Reconsideration

It has been widely projected in the library literature that a substantial number of librarians will retire in the near future leaving significant gaps in the workforce, especially in library leadership. Many of those concerned with organizational development in libraries have promoted succession planning as an essential tool for addressing this much-anticipated wave of retirements. The purpose of this chapter is to argue that succession planning is the wrong approach for academic libraries. This chapter provides a review of the library literature on succession planning, as well as studies analyzing position announcements in librarianship which provide evidence as to the extent to which academic librarianship has changed in recent years. In a review of the library literature, the author found no sound explanation of why succession planning is an appropriate method for filling anticipated vacancies and no substantive evidence that succession planning programs in libraries are successful. Rather than filling anticipated vacancies with librarians prepared to fill specific positions by means of a succession planning program, the author recommends that academic library leaders should focus on the continual evaluation of current library needs and future library goals, and treat each vacancy as an opportunity to create a new position that will best satisfy the strategic goals of the library. In contrast to the nearly universal support for succession planning found in the library literature, this chapter offers a different point of view

Women Librarians' and managers' Experiences in Combining Work and Family

Are women in a female-dominated profession (librarians) more successfully able to combine work and family obligations than women in a male-dominated profession (business managers)? To explore this question, a comparison was made between the marital status and number of children of 447 women managers and 557 women librarians.It was expected that the librarians would marry earlier and have more often married and after controlling for age, there were no differences in number of children. Librarians were marginally less likely to have been unemployed, and more often worked part time. But the reasons in both groups were often lack of work rather than a choice made for family reasons. Librarians salaries were much less. Other analyses assessed the determinants of income for the two groups of women. The negative impact of not working full time was minimal for both groups