Mismatches in Gene Deletions and Kidney-related Proteins as Candidates for Histocompatibility Factors in Kidney Transplantation

Publisher Copyright: © 2022 International Society of NephrologyIntroduction: The genomic mismatch level between donor and recipient may be associated with the risk of rejection and graft survival. We determined the association of genome-level matching with acute rejection in deceased-donor kidney transplantation. Methods: The study cohort consists of 1025 recipient-donor pairs transplanted in a single center from 2007 to 2017 in Helsinki. The associations between the sums of whole-genome missense variant mismatches and missense mismatches in transmembrane, secretory, and kidney-related proteins, with acute rejection were estimated using Cox model. In addition, we analyzed 40 deletion-tagging variants using Cox model. Results: The association analysis between mismatch sums of kidney-related proteins and acute rejection resulted in an unadjusted hazard ratio (HR) of 1.15 (95% confidence interval [CI], 1.01–1.30; P = 0.029) and adjusted HR of 1.13 (95% CI, 0.99–1.28; P = 0.071). In deletion analysis, a mismatch in rs7542235 genotype GG tagging a homozygous deletion at the complement factor H-related (CFHR), proteins locus, predisposed to acute rejection with an unadjusted HR of 3.10 (95% CI, 1.53–6.29; P = 0.002) and adjusted HR of 2.97 (95% CI, 1.46–6.05; P = 0.003). Conclusion: In conclusion, analyses of genome-level mismatches may be useful tools in prediction of transplantation outcome. The relative importance differs between populations, because we found evidence for CFHR deletion but could not replicate the finding of previously reported LIMS1 deletion.Peer reviewe

Common controls driven conceptual leadership framework

The forthcoming social welfare and healthcare reform in Finland with its organizational, financing and steering changes challenges the leadership. All service systems levels of the social welfare and healthcare have to achieve performance objectives whilst at the same time also meeting conformance requirements. However, there are hundreds authority documents (e.g., best practices, guidelines, regulations and standards) the common controls of which are adapted partly manually and partly by leveraging automation in organizations. Leaders review and develop their practices around performance and conformity (i.e., conformance or compliance) within frameworks that are mainly the sets of principles. However, the common controls affect into the main tasks of the governance (i.e., direct, evaluate and monitor). Therefore, we construct a conceptual leadership framework to highlight the meaning of the common controls and the meaning of criteria for performance and conformity. The constructed framework contains the terms (e.g., a control objective, decision criteria, event, insight, and transaction) that are mainly defined in the glossaries of the authority documents. The terms are used to find out terms and definitions for the leadership framework to figure out cognitive meanings for the concepts of the common controls driven leadership

Enter Culture, Exit Arts? The Transformation of Cultural Hierarchies in European Newspaper Culture Sections, 1960–2010

Peer reviewe

The Helsinki approach to face transplantation

Aim: We herein describe the establishment of the Helsinki Vascularized Composite Allotransplantation (VCA) program and its execution in the first two face transplant cases. Methods & patients: The Helsinki VCA program initially required the fulfillment of legal, hospital, financial, and ethical requirements. Thereafter, the assembling of a multidisciplinary team commenced. A team of Plastic, maxillofacial and ENT surgeons comprise the facial VCA team. The protocol involves collaboration with the Solid Organ Transplant (SOT) team, transplant immunology, immunosuppression, microbiology, psychiatric evaluation, well-defined VCA indications and informed consent. Between 2011 and 2017 two patients were selected for transplantation. Both patients had a severe composite facial deformity involving the maxilla and mandible following earlier ballistic injury. Results: Patient 1 was a 35 year-old male who underwent successful near total face transplantation in February 2016 and at 30 months he has a good aesthetic outcome with symmetrical restoration of the central face and good sensory and symmetrical motor functional outcomes. Patient 2 was a 58 year-old male who underwent full face transplantation in March 2018 and at 5 months he has recovered without major problems. Conclusion: A successful facial VCA program requires a well-prepared research protocol, experts from multiple specialties and careful patient selection. The establishment of the Helsinki VCA program required long and thorough planning and resulted in the first two Nordic face transplantation cases. This protocol now forms the platform (as a proof of concept) for other types of vascularized composite allotransplantations. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Development of Human Leukocyte Antigen (HLA) Antibodies Against Vascular Homograft Donor in Pediatric Heart Transplant Recipients

Background: The appearance of human leukocyte antigen (HLA) antibodies after solid organ transplantation predisposes recipients to graft dysfunction. In theory, vascular homografts, which are widely used in children with congenital heart defects, may cause allosensitization. Material/Methods: In this single-center retrospective study, the presence of pre-existing HLA antibodies in pediatric heart trans- plant (HTx) recipients with a vascular homograft was evaluated in a cohort of 12 patients. HLA antibodies were screened before and after HTx and positive screening results were confirmed and identified using the Luminex (R) single antigen bead method. Endomyocardial biopsies (EMB) and coronary angiography studies were re-evaluated to assess the prevalence of acute rejections and coronary artery change in these patients. Results: At the time of HTx, 8 patients (67%) had HLA antibodies detected by the Luminex assay, none of which were heart donor specific (DSA). All patients had negative leukocyte crossmatch. One patient developed DSAs against homograft donor prior to HTx. After the HTx, 5 patients (42%) developed DSAs against the heart donor and 4 patients (40%) against the homograft donor. In 2 patients (17%), the antibodies were against both heart and homograft donors. The rejection rate or prevalence of coronary artery vasculopathy did not differ significantly between the homograft cohort and our historical controls. Conclusions: Our results suggest that the prevalence of DSAs against homograft donor prior to HTx is relatively rare. However, almost half of the patients developed DSAs against homograft post-HTx. The clinical importance of these antibodies warrants further studies.Peer reviewe

The use of fasting vs. non-fasting triglyceride concentration for estimating the prevalence of high LDL-cholesterol and metabolic syndrome in population surveys

<p>Abstract</p> <p>Background</p> <p>For practical reasons it is not easy to obtain fasting samples in large population health surveys. Non-fasting triglyceride (Tg) values are difficult to interpret. The authors compared the accuracy of statistically corrected non-fasting Tg values with true fasting values and estimated the misclassification of subjects with high low-density lipoprotein cholesterol (LDL-C) and the metabolic syndrome.</p> <p>Methods</p> <p>Non-fasting blood was obtained from a population-based sample of 4282 individuals aged 24-75 years in the National FINRISK 2007 Study. Fasting blood samples were drawn from the same persons 3 months later. Non-fasting serum Tg values were converted into fasting values using previously published formula. LDL-C was calculated and classification of the metabolic syndrome was carried out according to three different latest guidelines.</p> <p>Results</p> <p>The median (25^th, 75th percentile) non-fasting serum Tg concentration was 1.18 (0.87, 1.72) mmol/L and after postprandial correction 1.06 (0.78, 1.52) mmol/L. The true-fasting serum Tg concentration was 1.00 (0.75, 1.38) mmol/L (<it>P </it>< 0.001) vs. non-fasting and corrected value. Bias of the corrected value was +5.9% compared with the true-fasting Tg. Of the true fasting subjects, 56.4% had LDL-C ≥3.00 mmol/L. When calculated using non-fasting serum Tg, the prevalence of high LDL-C was 51.3% and using statistically corrected Tg it was 54.8%. The prevalence of metabolic syndrome was 35.5% among fully fasted persons and among non-fasting subjects 39.7%, which after statistical correction of Tg decreased to 37.6% (P < 0.001 for all comparisons).</p> <p>Conclusions</p> <p>Correction of non-fasting serum Tg to fasting values plays a minor role in population studies but nevertheless reduces misclassification of calculated high LDL-C from 5.1 to 1.6% and the metabolic syndrome from 4.2 to 2.1%.</p

Enter Culture, Exit Arts?

Key debates of contemporary cultural sociology – the rise of the ‘cultural omnivore’, the fate of classical ‘highbrow’ culture, the popularization, commercialization and globalization of culture – deal with temporal changes. Yet, systematic research about these processes is scarce due to the lack of suitable longitudinal data. This book explores these questions through the lens of a crucial institution of cultural mediation – the culture sections in quality European newspapers – from 1960 to 2010. Starting from the framework of cultural stratification and employing systematic content analysis both quantitative and qualitative of more than 13,000 newspaper articles, Enter Culture, Exit Arts? presents a synthetic yet empirically rich and detailed account of cultural transformation in Europe over the last five decades. It shows how classifications and hierarchies of culture have changed in course of the process towards increased cultural heterogeneity. Furthermore, it conceptualizes the key trends of rising popular culture and declining highbrow arts as two simultaneous processes: the one of legitimization of popular culture and the other of popularization of traditional legitimate culture, both important for the loosening of the boundary between ‘highbrow’ and ‘popular’. Through careful comparative analysis and illustrative snapshots into the specific socio-historical contexts in which the newspapers and their representations of culture are embedded – in Finland, France, Spain, Sweden, Turkey and the UK – the book reveals the key patterns and diversity of European variations in the transformation of cultural hierarchies since the 1960s. The book is a collective endeavour of a large-scale international research project active between 2013 and 2018

Enter Culture, Exit Arts?

Key debates of contemporary cultural sociology – the rise of the ‘cultural omnivore’, the fate of classical ‘highbrow’ culture, the popularization, commercialization and globalization of culture – deal with temporal changes. Yet, systematic research about these processes is scarce due to the lack of suitable longitudinal data. This book explores these questions through the lens of a crucial institution of cultural mediation – the culture sections in quality European newspapers – from 1960 to 2010. Starting from the framework of cultural stratification and employing systematic content analysis both quantitative and qualitative of more than 13,000 newspaper articles, Enter Culture, Exit Arts? presents a synthetic yet empirically rich and detailed account of cultural transformation in Europe over the last five decades. It shows how classifications and hierarchies of culture have changed in course of the process towards increased cultural heterogeneity. Furthermore, it conceptualizes the key trends of rising popular culture and declining highbrow arts as two simultaneous processes: the one of legitimization of popular culture and the other of popularization of traditional legitimate culture, both important for the loosening of the boundary between ‘highbrow’ and ‘popular’. Through careful comparative analysis and illustrative snapshots into the specific socio-historical contexts in which the newspapers and their representations of culture are embedded – in Finland, France, Spain, Sweden, Turkey and the UK – the book reveals the key patterns and diversity of European variations in the transformation of cultural hierarchies since the 1960s. The book is a collective endeavour of a large-scale international research project active between 2013 and 2018