49 research outputs found

    The CTLA-4 rs231775 GG genotype is associated with favorable 90-day survival in Caucasian patients with sepsis

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    Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is a surface protein on T cells, that has an inhibitory effect on the host immune reaction and prevents overreaction of the immune system. Because the functional single-nucleotide polymorphism (SNP) rs231775 of the CTLA-4 gene is associated with autoimmune diseases and because of the critical role of the immune reaction in sepsis, we intended to examine the effect of this polymorphism on survival in patients with sepsis. 644 septic adult Caucasian patients were prospectively enrolled in this study. Patients were followed up for 90 days. Mortality risk within this period was defined as primary outcome parameter. Kaplan-Meier survival analysis revealed a significantly lower 90-day mortality risk among GG homozygous patients (n = 101) than among A allele carriers (n = 543; 22% and 32%, respectively; p = 0.03565). Furthermore, the CTLA-4 rs231775 GG genotype remained a significant covariate for 90-day mortality risk after controlling for confounders in the multivariate Cox regression analysis (hazard ratio: 0.624; 95% CI: 0.399–0.975; p = 0.03858). In conclusion, our study provides the first evidence for CTLA-4 rs231775 as a prognostic variable for the survival of patients with sepsis and emphasizes the need for further research to reveal potential functional associations between CTLA-4 and the immune pathophysiology of sepsis

    Effect of the Lymphocyte Activation Gene 3 Polymorphism rs951818 on Mortality and Disease Progression in Patients with Sepsis—A Prospective Genetic Association Study

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    (1) Background: Sepsis is a leading cause of death and a global public health problem. Accordingly, deciphering the underlying molecular mechanisms of this disease and the determinants of its morbidity and mortality is pivotal. This study examined the effect of the rs951818 SNP of the negative costimulatory lymphocyte-activation gene 3 (LAG-3) on sepsis mortality and disease severity. (2) Methods: 707 consecutive patients with sepsis were prospectively enrolled into the present study from three surgical ICUs at University Medical Center Goettingen. Both 28- and 90-day mortality were analyzed as the primary outcome, while parameters of disease severity served as secondary endpoints. (3) Results: In the Kaplan–Meier analysis LAG-3 rs951818 AA-homozygote patients showed a significantly lower 28-day mortality (17.3%) compared to carriers of the C-allele (23.7%, p = 0.0476). In addition, these patients more often received invasive mechanical ventilation (96%) during the course of disease than C-allele carriers (92%, p = 0.0466). (4) Conclusions: Genetic profiling of LAG-3 genetic variants alone or in combination with other genetic biomarkers may represent a promising approach for risk stratification of patients with sepsis. Patient-individual therapeutic targeting of immune checkpoints, such as LAG-3, may be a future component of sepsis therapy. Further detailed investigations in clinically relevant sepsis models are necessary

    Acquired selective IgA deficiency induced by dietary bovine IgA

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    Selective IgA deficiency (sIgAD) is the most common immunodeficiency in humans. Auto-reactive antibodies to human IgA are found in the serum of 20-40% of individuals with sIgAD. It is unknown whether these antibodies play a role in the pathogenesis of this immunodeficiency, and most researchers believe that they are secondary to the onset of sIgAD. However, it is possible that in these individuals, the anti-IgA antibodies are in fact responsible for the removal of IgA from serum, and are originally generated against xenogeneic IgA. To examine this hypothesis, the presence of anti-bovine and anti-human IgA antibodies was tested by ELISA in serum samples from IgA-deficient and control individuals. All 14 of the IgA-deficient individuals that were tested had IgG anti-bovine IgA antibodies (100%), whereas only 8 had IgG anti-human IgA antibodies (57%). Individuals with both anti-bovine and anti-human IgA antibodies always had a higher titre against bovine IgA than against human IgA. Of 18 control individuals who have normal serum levels of IgA and no anti-human IgA antibodies, a surprisingly high proportion (61%) had IgG anti-bovine IgA antibodies in their serum. These results strongly support the hypothesis that the anti-human IgA antibodies found in IgA-deficient individuals are originally produced against xenogeneic IgA, specifically bovine IgA found in dietary beef products. These antibodies can be found in many normal individuals, but only those that cross-react with endogenous human IgA will lead to the removal of IgA from circulation, and to sIgAD. Thus, sIgAD with anti-IgA antibodies is an acquired immunodeficiency, initiated by cross-reactive antibodies consumed in the diet.M.S.Includes bibliographical references (p. 28-32)

    Conceptualizing cognitive-behavioral supervision: an exploratory study of supervising psychologists

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    Although supervision plays a key role in the training of psychologists and in improving adherence to Cognitive-Behavioral Therapy (CBT), there is a scarcity of systematic knowledge on the supervision of CBT therapists. In response, Judith Beck’s supervision model has been a valuable development. However, there remains a dearth of research on the supervision practices of doctoral-level CBT supervisors in the field, and whether they adhere to Beck’s model. The current exploratory study investigated the practices of doctoral-level CBT supervisors along the following five dimensions: (a) the structure of CBT supervision, (b) attending to supervisees’ emotions, thoughts and behaviors, (c) relationship factors, (d) evaluation of supervisees, and (e) self-evaluation. In addition, this study assessed the extent to which supervisors followed Beck’s supervision model. A semi-structured interview was conducted with 10 experienced doctoral-level CBT supervisors. The participants had a median of 10 years of experience as CBT supervisors and 70% attained Diplomate or Fellow Certification with the Academy of Cognitive Therapy. The interviews were analyzed using a content analysis approach based on the five major topic domains outlined above. Case examples were also provided to further illustrate the supervision practices of three individual supervisors. Findings indicated that the supervision practices of supervisors in this sample were very similar along the five dimensions, and were also mostly consistent with Beck’s supervision model. More specifically, supervisors described their supervision structure as mirroring CBT therapy sessions (e.g., check-in, agenda setting, and problem solving); emphasized attending to supervisee’s thoughts if they interfere with the patient’s treatment; and stressed the importance of creating a collaborative and collegial relationship with supervisees. On the other hand, supervisors did not generally listen to entire therapy tapes and use rating scales to assess therapy sessions due to time constraints. Moreover, supervisors emphasized the importance of attending to supervisees’ emotions in supervision as well as the importance of increasing autonomy in CBT supervision, neither of which are explicitly discussed in Beck’s supervision model. Implications for future research are discussed, along with recommendations for CBT supervisors and training programs.Psy. D.Includes bibliographical referencesby Ayelet Katta

    Iconic situations: multimodality, witnessing and collective memory

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    This article deals with the multimodal components of televised situations that the author calls ‘iconic’ and that revolve around a dramatic announcement or declaration delivered on camera as part of a television broadcast. She argues that, in contemporary visual culture, iconic still photographs are gradually being replaced by iconic televised situations that become established as units of memory whose repeated airings and viewings ultimately gain an iconic status. Understanding this re-enactment has crucial importance in understanding the process by which the experience of the individual viewer or listener is interwoven with the narrative of the televised situation and in comprehending the role of witnessing. The article focuses on the spoken text, the roles of those who partake in the iconic situation and on the manner in which the fabric of verbal and visual elements helps to establish these situations as memorable. The author addresses three situations that were aired on Israeli television: the official announcement of the assassination of Israeli prime minister Yitzhak Rabin, the announcement of the death of Israeli singer Arik Einstein and the video message delivered by the abducted Israeli soldier Gilad Shalit from his place of captivity in Gaza.</jats:p

    Photography and Invisibility: Indexicality and Performativity Asia-Pacific War Memory in Tsukada Mamoru's <i>Identical Twins</i> Series (2003) and Suzuki Norio's Photos of Onoda Hiroo (1974)

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    This manuscript engages with two central ideas: the first concerns issues related to the problem of truth value in photography, vis-à-vis issues of fictionality and the powers of the false. This discussion is set forth through the analysis of two photographic series—Tsukada Mamoru's Identical Twins (2003), a series of staged photographs of two young men dressed alternately in Japan's imperial military uniform and modern casual dress, posing in a jungle setting, coinciding with the public debates on Japan's possible involvement in the Iraq war in 2003. The author utilizes the ideas and questions raised through this series to understand the powers and position of the second series, Suzuki Norio's 1974 photographs of Onoda Hiroo, the Japanese straggler who stayed for three decades in the jungles of Lubang Island—photographs that were directly responsible for Onoda's repatriation to Japan. The discussion in the text also illuminates a second idea—how complex is Japan's position toward the trauma of defeat and the specters of war, reflecting the complicated emotions experienced toward war memory and its representation in photographs, films, art, and other visual forms. The analysis of the two series delves into issues of photography theory, on questions of indexicality and performativity, and the relations between photographic images in specific cultural climate. The author analyzes how these images may indicate the political fluctuations between the Asia-Pacific War, the 1970s, and 2003, looking at such issues as indexicality and performativity, ghostly presences and staged scenes, truth and fiction, using photography as an immediate visual reference. Through the text, political, social, and cultural questions concerning wartime Japan are intertwined with an analysis of the visual methods, creating a complex view of visual representation and its means and methods.</jats:p
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