Simultaneous administration of adjuvant donor bone marrow in pancreas transplant recipients

Objective: The effect of donor bone marrow was evaluated for its potentially favorable effect in the authors' simultaneous pancreas/kidney transplant program. Methods: From July 1994 to January 1999, 177 pancreas transplants were performed, 151 of which were simultaneous pancreas/kidney transplants. All patients received tacrolimus, mycophenolate mofetil, and steroids for immunosuppression (azathioprine was used in the first year of the program). Fifty-three simultaneous pancreas/kidney transplant recipients received perioperative unmodified donor bone marrow, 3 to 6 x 108 cells/kg. Results: Overall actuarial survival rates at 1 and 3 years were 98% and 95% (patient), 95% and 87% (kidney), and 86% and 80% (pancreas), respectively. In the adjuvant bone marrow group, 1- and 3-year survival rates were 96% and 91% (patient), 95% and 87% (kidney), and 83% and 83% (pancreas), respectively. For 98 recipients who did not receive bone marrow, survival rates at 1 and 3 years were 100% and 98% (patient), 96% and 86% (kidney), and 87% and 79% (pancreas), respectively. No pancreas allografts were lost after 3 months in bone marrow recipients, and seven in the non-bone marrow recipients were lost to rejection at 0.7, 6.7, 8.8, 14.6, 24.1, 24.3, and 25.5 months. Twenty-two percent of bone marrow patients were steroid-free at 1 year, 45% at 2 years, and 67% at 3 years. Nineteen percent of the non-bone marrow recipients were steroid-free at 1 year, 38% at 2 years, and 45% (p = 0.02) at 3 years. The mean acute cellular rejection rate was 0.94 ± 1.1 in the bone marrow group and 1.57 ± 1.3 (p = 0.003) in the non-bone marrow group (includes borderline rejection and multiple rejections). The level of donor cell chimerism in the peripheral blood of bone marrow patients was at least two logs higher than in controls. Conclusion: In this series, which represents the largest experience with adjuvant bone marrow infusion in pancreas recipients, there was a higher steroid withdrawal rate (p = 0.02), fewer rejection episodes, and no pancreas graft loss after 3 months in bone marrow recipients compared with contemporaneous controls. All pancreas allografts lost to chronic rejection (n = 6) were in the non-bone marrow group. Donor bone marrow administered around the time of surgery may have a protective effect in pancreas transplantation

Genus Bounds for Harmonic Group Actions on Finite Graphs

This paper develops graph analogues of the genus bounds for the maximal size of an automorphism group of a compact Riemann surface of genus $g\ge 2$. Inspired by the work of M. Baker and S. Norine on harmonic morphisms between finite graphs, we motivate and define the notion of a harmonic group action. Denoting by M(g) the maximal size of such a harmonic group action on a graph of genus $g\ge 2$, we prove that $4(g-1)\le M(g)\le 6(g-1)$, and these bounds are sharp in the sense that both are attained for infinitely many values of g. Moreover, we show that the values $4(g-1)$ and $6(g-1)$ are the only values taken by the function $M(g)$.Comment: 14 pages with 6 figures; section 8 rewritten to correct an error in lemma 8.2; published versio

Agricultural Leadership Development: Insights and Experiences from Canada

In Canada, agriculture and its related industries are undergoing rapid and significant changes. Among the many issues facing farmers and other agri-business people are the development of biotechnologies, the decline of on-farm and rural populations, the emergence of new public policies, concerns over food safety, globalisation of markets, sensitivity to environmental issues, and the influence of regional and global trade agreements. Given the complexity of these issues, and the distinctiveness of various regions, sectors and commodities produced in Canada, there is a need for national agricultural leaders who understand the issues, and have the skills and networks to construct effective responses to those issues. The Canadian Farm Business Management Council has supported the development and pilot testing of a national leadership development program known as Canadian Agriculture Lifetime Leadership (CALL). CALL is a two-year program that selects men and women with demonstrated leadership potential and commitment to the agricultural industry, and provides those men and women with an opportunity to become more effective leaders. In addition to CALL, Ontario and New Brunswick have provincial leadership development programs targeted to agriculture. This paper introduces the context of agricultural leadership development programs in Canada. It then provides a short review of the CALL program and its provincial counterpart in Ontario. Based on this review, and on the perspectives provided by program graduates, a vision for the future of agricultural leadership programs in Canada is presented.Agribusiness, Agricultural and Food Policy,

Women's participation in crusades from the eleventh to thirteenth centuries : a thesis presented in fulfilment of the requirements for the degree of Master of Arts at Massey University

This thesis studies the involvement of women in the four great armed pilgrimages, the crusades of 1096-1204. A crusade was a pilgrimage, an act of penance for the sins of its participants, as well as being a holy war. Women were entitled to join pilgrimages because it was an act they had enjoyed for centuries. When, therefore, the armed pilgrimage was preached by Urban II in 1095, women too were permitted to journey although it was not anticipated at first by the papacy that they would. The presence of women in ritually pure camps and on the battlefields was objected to. The biblical beliefs of chroniclers and moralists of the period held that the presence of women on these campaigns compromised their purpose. This thesis will examine in primary sources the beliefs of the moralists and writers of the crusades, and the responses to the presence of women on campaigns

Neurosyphilis presenting with papillitis

Syphilis is one of the oldest described infectious diseases in the world and is caused by the spirochete bacterium Treponema pallidum[1]. Although now a rare disease, incidence is increasing with the number of diagnoses of the disease rising in England from 1688 to 2713 between 2003 and 2012 (a 61% increase)[2]. Major outbreaks of syphilis have been documented in London, Manchester, Dublin, and Brighton particularly among men who have sex with men (MSM)[3]. Diagnosis remains difficult on account of multi-system symptoms, duration of the condition, and social stigma