Inherited Advantage: Comparing Households that Receive Gifts and Bequests with Non-Receiving Households across the Distribution of Household Wealth in 11 European Countries

This study examines the importance of gifts and bequests (‘wealth transfers’) across the distribution of household wealth. Unconditional quantile regression applied to harmonized survey data obtained from 11 European countries reveals that households that receive gifts and bequests own considerably more wealth than non-receiving households, all other things being equal. The wealth gap varies hugely along the distribution of net wealth. At the median, the wealth gap reaches about 119,000 euros and increases to 630,000 euros at the 90th percentile. With regard to the 99th percentile, survey data even indicate differences in wealth levels greater than 2.3 million euros. Further analysis finds evidence that the impact of wealth transfers on household wealth follows an inverted U-shaped pattern: gifts and bequests contribute the most to the stock of private wealth in the broad mid-section and less so at the lower and upper ends of the distribution. Overall, the study provides evidence for a strong nexus between inheritance and household wealth that is not limited to the top.Introduction Exploring the Inheritance-Wealth Nexus: Two Approaches that Go beyond the Average Data, Variables, and Method Results Conclusions Acknowledgements Reference

Ungleiche Mittelschichten: Über Unterschiede im Immobilienvermögen und im Erbe innerhalb der Mitte Deutschlands

The middle class has for the first time in history acquired a significant proportion of private wealth. But is (inherited) wealth rather equally distributed in the middle of German society, or are there noteworthy wealth gaps? To answer this question, this article investigates differences with regard to real estate and inheritance on the basis of the Household Finance and Consumption Survey (HFCS). If one departs from a purely income-based definition of the German middle classes, one finds a very low degree of homeownership and very few inheriting households in the lower middle class (< 80 percent of the median income). The middle class in the narrow sense (< 150 percent of the median income) distinguishes itself from the upper middle class (< 250 percent of the median income) not so much through inheritance or homeownership, but rather through the ownership of other (income generating) real estate. The wealth perspective reveals above all a lower middle class (about 16 percent of the population) that, if not backed by the welfare state, is extremely vulnerable. These are renters who are unable to secure their standard of living in the medium or long term by drawing on private assets or inheritance only. Reduced old-age pensions may endanger these households.Erstmals in der Geschichte hat die Mittelschicht einen bedeutsamen Anteil des privaten Vermögens erworben. Doch sind Eigentum und Erbe in der Mitte der deutschen Gesellschaft relativ gleichmäßig verteilt oder zeigen sich bedeutsame Vermögensunterschiede? Um diese Frage zu beantworten, wird anhand des Household Finance and Consumption Survey (HFCS) Unterschieden im Immobilienvermögen und im Erbe nachgegangen. Geht man von einer rein einkommensbezogenen Definition der Mitte aus, so zeigt sich ein geringer Verbreitungsgrad von Immobilienbesitz und Erbe in der unteren Mittelschicht (60 bis 80 Prozent des Medianeinkommens). Die Mitte im engeren Sinne (< 150 Prozent des Medianeinkommens) unterscheidet sich indes weniger durch Erbe oder den Besitz einer selbst genutzten Immobilie von der oberen Mittelschicht (< 250 über des Medianeinkommens). Das relevante Unterscheidungsmerkmal ist vielmehr der Besitz weiterer Immobilien, die unter anderem Einkommen generieren. Aus einer Vermögensperspektive lässt sich vor allem eine untere Mittelschicht (circa 16 Prozent der Bevölkerung) feststellen, die, soweit sie nicht wohlfahrtsstaatlich abgesichert sein sollte, besonders vulnerabel ist. Es handelt sich hierbei überwiegend um Mieterhaushalte, die ihren Lebensstandard mit Privatvermögen oder durch intergenerationelle Transfers alleine weder lang- noch mittelfristig sichern können. Abschläge in der Altersrente können diese Mittelschichtshaushalte in ihrer ökonomischen Existenz gefährden.1 Einleitung 2 Vermögen und Erbe in der Mitte der Gesellschaft Selbst genutztes Wohneigentum und die Mittelschicht Erbe und die Mittelschicht Die Lokalisierung der Mitte 3 Daten, Methode, Variablen Daten Methode Variablen 4 Resultate Vermögensportfolio und Wohneigentum Erbe 5 Fazit Literatur Anhan

Airway complications after lung transplantation: risk factors, prevention and outcome

PURPOSE: Anastomotic complications following lung transplantation (LuTx) have been described in up to 15% of patients. Challenging to treat, they are associated with high morbidity and a mortality rate of 2-5%. The aim of this study was to analyze the incidence of complications in a consecutive series of bronchial anastomosis after LuTx at our center and to delineate the potential risk factors. METHODS: Between 1992 and 2007, 441 bronchial anastomoses were performed in 235 patients. Indications for transplantation were cystic fibrosis (35.7%) emphysema (28.1%) pulmonary fibrosis (12.8%) and pulmonary hypertension (7.7%). There were 206 sequential bilateral and 28 single transplants including lobar engraftments in 20 cases. The donor bronchus was shortened to the plane of the lobar carina including the medial wall of the intermediate bronchus. Peribronchial tissue was left untouched. Anastomosis was carried out using a continuous absorbable running suture (PDS 4/0) at the membranous and interrupted sutures at the cartilaginous part. Six elective surveillance bronchoscopies were done monthly during the first half-year post-LuTx, with detailed assessment of the pre- and post-anastomotic airways. RESULTS: One-year survival since 2000 was 90.5%. In all 441 anastomoses performed, no significant dehiscence was observed. In one patient, a small fistula was detected and closed surgically on postoperative day five. Fungal membranes were found in 50% of the anastomoses at 1 month and in 14% at 6 months. Discrete narrowing of the anastomotic lumen without need for intervention was found in 4.9% of patients at 1 month and in 2.4% at 6 months. Age, cytomegalovirus status, induction therapy, immunosuppressive regimen, ischemic time, and ventilation time had no influence on bronchial healing. CONCLUSIONS: Clinically relevant bronchial anastomotic complications after LuTx can be avoided by use of a simple standardized surgical technique. Aggressive antibiotic and antifungal therapy might play an important supportive rol

Tissue engineered cartilage generated from human trachea using DegraPol® scaffold

Objective: To date numerous attempts have been undertaken to conquer the challenging problem of reconstructing long segmental tracheal defects, as yet without lasting success. Recently, employing concepts of tissue engineering in animals, cartilage-like constructs were transplanted in vivo. However, both the feasibility of fabricating tracheal replacements and the use of human tracheal chondrocytes (HTC) for tissue engineering are still under investigation. In this study, we optimized isolation and cultivation techniques for human tracheal cartilage, assessing the feasibility of seeding these cells onto a novel, three-dimensional (3-D) polyester-urethane polymer (DegraPol®). Methods: Human tracheal cartilage was harvested from the trachea of lung donors, digested in 0.3% collagenase II, and the condrocytes serially passaged every 7-9 days. Cells were also cultivated over agar plate during the total 6-8 weeks expansion phase. Thereafter, chondrocytes were seeded onto DegraPol® (pore sizes 150-200 μm) with a seeding density of 2.4×107/ml, and chondrocyte-polymer constructs maintained during in vitro static culture. Results: HTC displayed stable proliferation kinetics in monolayer culture with positive expression of collagen type II. Following polymer seeding, both cellular proliferation and extracellular matrix (ECM) production, as measured by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and glycosaminoglycan assays, continued over extended culture. Active growth of HTC on DegraPol® was further demonstrated by Alcian blue staining, with the histomorphological appearance of the construct resembling that of native cartilage. Scanning electron microscopy showed chondrocyte growth and ECM synthesis both on the surface and inside the porous scaffold, with a dense cell layer on the surface of the scaffold and a lower cell distribution in the scaffold's interior. Conclusions: The harvested chondrocytes from human trachea cartilage expand well in vitro and possess the ability to form new cartilage-like tissue when seeded onto DegraPol® matrix. However, improved culture conditions are needed to permit cellular growth throughout cell-polymer construct

Higher throughput quantification of neutralizing antibody to herpes simplex viruses

We report a rapid, higher throughput method for measuring neutralizing antibody to herpes simplex virus (HSV) in human sera. Clinical isolates and sera from the Herpevac Trial for Women were used in a colorimetric assay in which infection of tissue culture (lack of neutralization) was indicated by substrate metabolism by beta-galactosidase induced in the ELVIS cell line. The neutralization assay was optimized by addition of guinea pig complement, which particularly enhanced neutralizing antibody titers to HSV-2. Higher neutralizing antibody titers were also achieved using virus particles isolated from the supernatant of infected cells rather than lysate of infected cells as the source of virus. The effect of assay incubation time and incubation time with substrate were also optimized. We found that incubating with substrate until a standard optical density of 1.0 was reached permitted a better comparison among virus isolates, and achieved reliable measurement of neutralizing antibody activity. Interestingly, in contrast to results in the absence of complement, addition of complement allowed sera from HSV-2 gD-vaccinated subjects to neutralize HSV-1 and HSV-2 clinical and laboratory isolates with equal potency

Corneal Replication Is an Interferon Response-Independent Bottleneck for Virulence of Herpes Simplex Virus 1 in the Absence of Virion Host Shutoff

Herpes simplex viruses lacking the virion host shutoff function (Δvhs) are avirulent and hypersensitive to type I and type II interferon (IFN). In this study, we demonstrate that even in the absence of IFN responses in AG129 (IFN-αβγR−/−) mice, Δvhs remains highly attenuated via corneal infection but is fully virulent via intracranial infection. The data demonstrate that the interferon-independent inherent replication defect of Δvhs has a significant impact upon peripheral replication and neuroinvasion

Circulating Endothelial Progenitor Cells in Kidney Transplant Patients

Background: Kidney transplantation (RTx) leads to amelioration of endothelial function in patients with advanced renal failure. Endothelial progenitor cells (EPCs) may play a key role in this repair process. The aim of this study was to determine the impact of RTx and immunosuppressive therapy on the number of circulating EPCs. Methods: We analyzed 52 RTx patients (58613 years; 33 males, mean 6 SD) and 16 age- and gender-matched subjects with normal kidney function (57617; 10 males). RTx patients received a calcineurin inhibitor (CNI)-based (65%) or a CNI-free therapy (35%) and steroids. EPC number was determined by double positive staining for CD133/VEGFR2 and CD34/VEGFR2 by flow cytometry. Stromal cell-derived factor 1 alpha (SDF-1) levels were assessed by ELISA. Experimentally, to dissociate the impact of RTx from the impact of immunosuppressants, we used the 5/6 nephrectomy model. The animals were treated with a CNI-based or a CNI-free therapy, and EPCs (Sca+cKit+) and CD26+ cells were determined by flow cytometry. Results: Compared to controls, circulating number of CD34+/VEGFR2+ and CD133+/VEGFR2+ EPCs increased in RTx patients. There were no correlations between EPC levels and statin, erythropoietin or use of renin angiotensin system blockers in our study. Indeed, multivariate analysis showed that SDF-1 – a cytokine responsible for EPC mobilization – is independently associated with the EPC number. 5/6 rats presented decreased EPC counts in comparison to control animals. Immunosuppressive therapy was able to restore normal EPC values in 5/6 rats. These effects on EPC number were associated with reduced number of CD26+ cells, which might be related to consequent accumulation of SDF-1. Conclusions: We conclude that kidney transplantation and its associated use of immunosuppressive drugs increases the number of circulating EPCs via the manipulation of the CD26/SDF-1 axis. Increased EPC count may be associated to endothelial repair and function in these patients.