The immunopathology of ANCA-associated vasculitis.

The small-vessel vasculitides are a group of disorders characterised by variable patterns of small blood vessel inflammation producing a markedly heterogeneous clinical phenotype. While any vessel in any organ may be involved, distinct but often overlapping sets of clinical features have allowed the description of three subtypes associated with the presence of circulating anti-neutrophil cytoplasmic antibodies (ANCA), namely granulomatosis with polyangiitis (GPA, formerly known as Wegener's Granulomatosis), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (eGPA, formerly known as Churg-Strauss syndrome). Together, these conditions are called the ANCA-associated vasculitidies (AAV). Both formal nomenclature and classification criteria for the syndromes have changed repeatedly since their description over 100 years ago and may conceivably do so again following recent reports showing distinct genetic associations of patients with detectable ANCA of distinct specificities. ANCA are not only useful in classifying the syndromes but substantial evidence implicates them in driving disease pathogenesis although the mechanism by which they develop and tolerance is broken remains controversial. Advances in our understanding of the pathogenesis of the syndromes have been accompanied by some progress in treatment, although much remains to be done to improve the chronic morbidity associated with the immunosuppression required for disease control

An Assessment of the Exporting Literature: Using Theory and Data to Identify Future Research Directions

Exporting research is an established facet of the field of international marketing. That stated, the radical increase in recent export activity necessitates a sustained research effort devoted to the topic. In this article, the authors provide a qualitative review of the core theoretical exporting areas and evaluate the exporting domain quantitatively over six decades (1958–2016). For the quantitative analysis, they use multidimensional scaling and apply established bibliometric principles to offer an understanding of the field and to provide suggestions for future exporting research. For the evaluations, the authors used data from 830 articles with 52,191 citations from 35 journals. Using cocitation analysis as the basis to evaluate the data, they propose a series of intellectual structure implications on exporting that relate to internationalization process stages, dynamic capabilities, knowledge scarcity, social networks, export marketing strategy, absorptive capacity and learning, and nonlinear performance relationships involving marketing channel relationships

Employee Benefits and Social Welfare: Complement and Conflict

Employee benefits constitute a major vehicle for the provision of income security for Americans. Since the 1940s, wage supplements, particularly in the form of pensions and health insurance, have expanded to provide protections that are the province of public programs in most other Western countries. Building upon the precedents of the welfare capitalism of the early 1900s, the growth of employee benefits has been actively stimulated by federal tax and regulatory policies. The emergence of employee benefits as a major source of income security and health insurance has reduced the aggregate need for public programs, but it has left those in lower-paying, less stable jobs-disproportionately women and minorities—both unprotected and with fewer political allies to press for improved protections. The implementation of the employee benefit programs has also created financial interests in the existing structure that would resist changes that would diminish their role.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67572/2/10.1177_000271628547900107.pd

Cohort study of molecular identification and typing of Mycobacterium abscessus, Mycobacterium massiliense, and Mycobacterium bolletii

Submitted by Sandra Infurna ([email protected]) on 2018-09-25T17:46:16Z No. of bitstreams: 1 elisabeth2_sampaio_etal_IOC_2009.pdf: 1445529 bytes, checksum: 8222b19cc6edf5b2e7fcb87dfd6309bd (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2018-09-25T18:04:55Z (GMT) No. of bitstreams: 1 elisabeth2_sampaio_etal_IOC_2009.pdf: 1445529 bytes, checksum: 8222b19cc6edf5b2e7fcb87dfd6309bd (MD5)Made available in DSpace on 2018-09-25T18:04:55Z (GMT). No. of bitstreams: 1 elisabeth2_sampaio_etal_IOC_2009.pdf: 1445529 bytes, checksum: 8222b19cc6edf5b2e7fcb87dfd6309bd (MD5) Previous issue date: 2009National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Microbiology Service. Bethesda, Maryland, USA / National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Immunopathogenesis Section. Bethesda, Maryland, USA.National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Immunopathogenesis Section. Bethesda, Maryland, USA.National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Microbiology Service. Bethesda, Maryland, USANational Institutes of Health. Clinical Center. Department of Laboratory Medicine. Immunopathogenesis Section. Bethesda, Maryland, USA.National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Tuberculosis Research Section. Bethesda, Maryland, USA.National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Microbiology Service. Bethesda, Maryland, USANational Institutes of Health. National Human Genome Research Institute. Bethesda, Maryland, USA.The University of Texas Health Science Center. Department of Microbiology. Tyler, Texas, USA.The University of Texas Health Science Center. Department of Microbiology. Tyler, Texas, USA.The University of Texas Health Science Center. Department of Microbiology. Tyler, Texas, USA.National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Immunopathogenesis Section. Bethesda, Maryland, USA.National Institutes of Health. Clinical Center. Department of Laboratory Medicine. Immunopathogenesis Section. Bethesda, Maryland, USA / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.Mycobacterium abscessus is the most common cause of rapidly growing mycobacterial chronic lung disease. Recently, two new M. abscessus-related species, M. massiliense and M. bolletii, have been described. Health care-associated outbreaks have recently been investigated by the use of molecular identification and typing tools; however, very little is known about the natural epidemiology and pathogenicity of M. massiliense or M. bolletii outside of outbreak situations. The differentiation of these two species from M. abscessus is difficult and relies on the sequencing of one or more housekeeping genes. We performed extensive molecular identification and typing of 42 clinical isolates of M. abscessus, M. massiliense, and M. bolletii from patients monitored at the NIH between 1999 and 2007. The corresponding clinical data were also examined. Partial sequencing of rpoB, hsp65, and secA led to the unambiguous identification of 26 M. abscessus isolates, 7 M. massiliense isolates, and 2 M. bolletii isolates. The identification results for seven other isolates were ambiguous and warranted further sequencing and an integrated phylogenetic analysis. Strain relatedness was assessed by repetitive-sequence-based PCR (rep-PCR) and pulsed-field gel electrophoresis (PFGE), which showed the characteristic clonal groups for each species. Five isolates with ambiguous species identities as M. abscessus-M. massiliense by rpoB, hsp65, and secA sequencing clustered as a distinct group by rep-PCR and PFGE together with the M. massiliense type strain. Overall, the clinical manifestations of disease caused by each species were similar. In summary, a multilocus sequencing approach (not just rpoB partial sequencing) is required for division of M. abscessus and closely related species. Molecular typing complements sequence-based identification and provides information on prevalent clones with possible relevant clinical aspects

Frontolimbic neural circuit changes in emotional processing and inhibitory control associated with clinical improvement following transference-focused psychotherapy in borderline personality disorder

Aim Borderline personality disorder (BPD) is characterized by self-regulation deficits, including impulsivity and affective lability. Transference-Focused Psychotherapy (TFP) is an evidence-based treatment proven to reduce symptoms across multiple cognitive-emotional domains in BPD. This pilot study aims to investigate neural activation associated with, and predictive of, clinical improvement in emotional and behavioral regulation in BPD following TFP. Methods BPD subjects (N=10) were scanned pre- and post-TFP treatment using a within-subjects design. A disorder-specific emotional-linguistic go/no-go fMRI paradigm was used to probe the interaction between negative emotional processing and inhibitory control. Results Analyses demonstrated significant treatment-related effects with relative increased dorsal prefrontal (dorsal anterior cingulate, dorsolateral prefrontal, and frontopolar cortices) activation, and relative decreased ventrolateral prefrontal cortex and hippocampal activation following treatment. Clinical improvement in constraint correlated positively with relative increased left dorsal anterior cingulate cortex activation. Clinical improvement in affective lability correlated positively with left posterior-medial orbitofrontal cortex/ventral striatum activation, and negatively with right amygdala/parahippocampal activation. Post-treatment improvements in constraint were predicted by pre-treatment right dorsal anterior cingulate cortex hypoactivation, and pre-treatment left posterior-medial orbitofrontal cortex/ventral striatum hypoactivation predicted improvements in affective lability. Conclusions These preliminary findings demonstrate potential TFP-associated alterations in frontolimbic circuitry and begin to identify neural mechanisms associated with a psychodynamically-oriented psychotherapy