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While the majority of worldwide hepatitis E viral (HEV) infections that occur in people are from contaminated water or food sources, there has also been a steadily rising number of reported cases of transfusion-transmitted HEV (TT-HEV) in blood donation recipients. For most, HEV infection is acute, self-limiting and asymptomatic. However, patients that are immunocompromised, especially transplant patients, are at much higher risk for developing chronic infections, which can progress to cirrhosis and liver failure, along with overall increased mortality. Because of the rising trend of HEV serological prevalence among the global population, and the fact that TT-HEV infection can cause serious clinical consequences among those patients most at need for blood donation, the need for screening for TT-HEV has been gaining in prominence as an important public health concern for both developing and developed countries. In the review, we summarise evidence for and notable cases of TT-HEV infections, the various aspects of HEV screening protocols and recent trends in the implementation of TT-HEV broad-based blood screening programmes.
The history of how and why remains came to be in museums is important in understanding the points of view of both the scientific and claimant communities. Many remains within museums were collected under conditions that today we would find abhorrent and unethical. It is important to understand this process and that even when such remains seemed legitimate in their acquisition in the past, those from former colonial countries have to be viewed through the unequal power dynamics at the time. For a variety of reasons there may be limited knowledge of the acquisition stories of the remains the museums use in research or care for, the knowledge can be shocking and change the perspective of the staff involved. This is usually because this information has not been included in the basic record of the remains or is outside the information passed from curator to curator. There is a belief from those outside museums, from researchers to indigenous communities, that the records within a museum are complete and fully accurate. However, if information is missing, altered or misrepresented then errors will exist, often without the current curators being aware of this.
Chapter 4 explores which voters – general election voters, primary voters, or campaign donors – legislators fear will punish them for compromise. In-person surveys of state legislators confirm that legislators mostly fear punishment from primary voters. Legislators believe that primary voters would prefer that legislators vote to kill compromise bills, worry that these primary voters would punish them if they supported such legislation, and act in response to this concern. Beyond the patterns in surveys of state legislators, congressional roll call votes from 2011 to 2015 show that greater Tea Party support in a district predicted an increased likelihood that Republican House members voted against compromise bills. Together, these results highlight how legislators’ concerns about how primary voters respond to compromise can dissuade legislators from compromising.
Malagasy society is historically highly hierarchical, endlessly differentiating and ranking individuals in keeping with a hereditary inegalitarian order that has lost none of its symbolism over time. Social inertia is further reinforced by weak formal and informal intermediary bodies, a missing vertical link between president and the population. This phenomenon is accentuated by the subsistence of a traditional political theology that instils the state with a providential quality and attaches Raiamandreny status (duly respected father and mother of their subjects) to those who embody it. The upshot of these elements is a yawning divide between the elites and the people.Social fragmentation is also a factor in the chronic political instability. Madagascar features a lack of stable, long-term coalitions of elites. The scant attention paid the populations and the fragility of the clientelistic connections do not afford broad-based popular support for the men in power.External factors form one last explanatory element for the long-term political instability. The consequences of the donors’ ongoing operational actions, which effectively weakened the state from the early 1980s to the 2000s, were disastrous. This pressure, combined with the people’s poor capacity to demand accountability, brought on the gradual institutional decay and loss of legitimacy.
The adoption of the UN Convention on the Rights of Persons with Disabilities (CRPD) in 2006 engendered a global social movement to promote disability rights around the world. A central aim of this movement has been to support Disabled Persons Organizations’ (DPOs) human-rights work. This focus on advocacy has now become a new organizational norm disseminated from international donors, networks, and NGOs to grassroots DPOs through training and small grants provided to DPOs in the Global South. In many places, however, local DPOs have resisted the changes this new norm implies, instead seeking to continue their traditional focus on addressing their members’ concrete needs through material support and services. In Segovia, Nicaragua, seven grassroots DPOs share an internationally funded grant for rights advocacy. They struggle, however, to use the money to address their local members needs while also keeping the international donor happy. This disconnect between international norms and local associations is the result of Nicaragua’s history of mobilizing people for the purposes of addressing basic needs and promoting community development. Since the 1979 Sandinista Revolution, local citizens, including disabled persons, have joined grassroots groups in solidaridad in coming together for mutual aid and social support.
This chapter argues that reproductive banks provide buyers the option to segregate on the basis of race. I define “segregation” here as discriminating on the basis of race in order to avoid racial integration. In selling sperm and ova, reproductive banks both discriminate against potential donors on the basis of race and steer buyers to do the same. Most notably, these banks engage in racial steering by disclosing the race of the donor. In doing so, they provide buyers the option to form a biological family that is racially homogenous. This allows buyers the option to avoid racially integrating their families. This is how banks sell segregation. Drawing on both the ideal society and actual society approaches to racial justice, this chapter argues that selling segregation is wrong. I also show that this practice is unlawful and unenforceable under the Constitution.
This paper analyzes a hundred Turkish aid recipient countries in order to explore the determinants of Turkey’s foreign aid behavior during the period 2005–2016. By estimating the model with the system-GMM estimator, it is demonstrated that Turkey is a regular donor whose amount of foreign aid is positively influenced by the export-based embeddedness of Turkish firms in the recipient countries. Recipients with low levels of per-capita income attract more Turkish aid. However, this income’s effect diminishes in states that were formerly part of Ottoman territory. Recipient countries in an aid relationship with OECD-DAC members also receive more foreign aid from Turkey. In addition, Turkey disburses more foreign aid to recipient countries that can be classified as Turkic republics. Turkish foreign aid behavior is also motivated by Ottomanism, especially in the Balkans and Eastern Europe. Finally, and interestingly, although Islam has a considerable impact on attracting Turkish aid overall, this impact disappears in former Ottoman states and Turkic republics.
Serosurveys have established data about the distribution of immunoglobulin G (IgG)-antibodies to pertussis toxin (PT) in various populations. We tried to detect whether small serosurveys in blood donors could serve as a simple and inexpensive means to collect information about the circulation of Bordetella pertussis. We screened every donation in 307 adult blood donors aged 19–69 years for IgG-anti-PT by standardised enzyme-linked immunosorbent assays (ELISA), and the donors were followed between 2014 and 2016 for a total of 426 person-years. When we used a vertical survey with cut-offs of 100, 62.5 and 40 IU/ml, respectively, as an indicator for recent contacts with B. pertussis, nine (2.9%), 22 (7.2%) and 54 (17.6%) of donors had IgG-anti-PT titres above the respective levels. During the horizontal observation period of 426 person years, six significant increases and two conversions were found, which lead to an estimate of 1878 contacts/100.000 person-years (1.9% per year). Median and mean IgG-anti-PT concentrations remained relatively stable from year to year during the observation period. Our findings show that small serosurveys of blood donors offer a simple and cheap method for the surveillance of B. pertussis.
This article examines two questions. (1) If prospective living kidney donors knew of the lifetime risk of end-stage renal disease (ESRD) in their remaining kidney, then would they be as willing to give it up? and (2) What should transplant organizations and physicians be telling those who express an interest in donating a kidney about risk? Based on the principle that prospective donors must be fully informed of the risk, I raise the issue of a possible obstacle to closing the gap between the availability and need of transplantable kidneys. Some strategies are offered to address this problem.
Major development projects in many African countries are often financed by development partners through development aid procurement. Development partners implement specific procurement policies aimed at promoting development in countries receiving aid. This article examines the policies of development partners applicable to aid funded procurement. It argues that some development partner policies could limit the policy space available to implement prioritized development goals domestically.
To develop and validate a novel FFQ to assess the daily intake of four methyl-group donors (methionine, choline, betaine and folate).
The relative validity of the FFQ was assessed by comparison with 7 d estimated diet records (n 80) and its reproducibility was evaluated by repeated administrations 6 weeks apart (n 92). Paired Student t tests were used to compare group means and de-attenuated intra-class correlations to investigate the ability of the FFQ to rank individuals according to their methyl-group donor intake. De-attenuated intra-class correlation coefficients were calculated between the test and reference method for methionine, choline, betaine, folate and the sum of methyl-group donors. The weighted kappa (κw) was calculated as a measure of tertile agreement.
The FFQ was validated among Flemish women of reproductive age (18–35 years).
The questionnaire had an acceptable ranking ability (r=0·32–0·68; κw=0·10–0·35), but overestimated the daily intake of folate (280·6 μg v. 212·0 μg) and betaine (179·1 mg v. 147·0 mg) compared with the 7 d estimated diet record. Cross-classification analysis indicated that 20 % (choline) of the participants were grossly misclassified in the validation study. The correlation between repeated administrations was good (r=0·62–0·83) with a maximal misclassification of 7 % for betaine (κw=0·44–0·66).
These results indicate that this newly developed FFQ is a reliable instrument with acceptable validity for ranking individuals according to methyl-group donor intake (except for a poor agreement for choline (κw=0·10) and a fair ranking ability for betaine (r=0·32)) in Flemish women of reproductive age.
The bran and particularly the aleurone fraction of wheat are high in betaine and other physiological methyl donors, which may exert beneficial physiological effects. We conducted two randomised, controlled, cross-over postprandial studies to assess and compare plasma betaine and other methyl donor-related responses following the consumption of minimally processed bran and aleurone fractions (study A) and aleurone bread (study B). For both studies, standard pharmacokinetic parameters were derived for betaine, choline, folate, dimethylglycine (DMG), total homocysteine and methionine from plasma samples taken at 0, 0·5, 1, 2 and 3 h. In study A (n 14), plasma betaine concentrations were significantly and substantially elevated from 0·5 to 3 h following the consumption of both bran and aleurone compared with the control; however, aleurone gave significantly higher responses than bran. Small, but significant, increases were also observed in DMG measures; however, no significant responses were observed in other analytes. In study B (n 13), plasma betaine concentrations were significantly and substantially higher following consumption of the aleurone bread compared with the control bread; small, but significant, increases were also observed in DMG and folate measures in response to consumption of the aleurone bread; however, no significant responses were observed in other analytes. Peak plasma betaine concentrations, which were 1·7–1·8 times the baseline levels, were attained earlier following the consumption of minimally processed aleurone compared with the aleurone bread (time taken to reach peak concentration 1·2 v. 2·1 h). These results showed that the consumption of minimally processed wheat bran, and particularly the aleurone fraction, yielded substantial postprandial increases in plasma betaine concentrations. Furthermore, these effects appear to be maintained when aleurone was incorporated into bread.
Chagas disease is an important emerging disease in Texas that results in cardiomyopathy in about 30% of those infected with the parasite Trypanosoma cruzi. Between the years 2008 and 2012, about 1/6500 blood donors were T. cruzi antibody-confirmed positive. We found older persons and minority populations, particularly Hispanic, at highest risk for screening positive for T. cruzi antibodies during routine blood donation. Zip code analysis determined that T. cruzi is associated with poverty. Chagas disease has a significant disease burden and is a cause of substantial economic losses in Texas.
Methyl donor supplementation has been reported to prevent obesity-induced liver fat accumulation in adult rats. We hypothesized that this protection could be mediated by perinatal nutrition. For this purpose, we assessed the response to an obesogenic diet (high-fat-sucrose, HFS) during adulthood depending on maternal diet during lactation. Female Wistar rats fed control diet during pregnancy were assigned to four postpartum dietary groups: control, control supplemented with methyl donors (choline, betaine, folic acid, vitamin B12), HFS and HFS supplemented with methyl donors. At weaning, the male offspring was transferred to a chow diet and at week 12th assigned to a control or a HFS diet during 8 weeks. The offspring whose mothers were fed HFS during lactation showed increased adiposity (19%, P<0.001). When fed the HFS diet as adults, offspring whose mothers were HFS supplemented had more body fat (23%, P<0.001) than those from HFS non-supplemented. However, they showed lower liver fat accumulation (−18%, P<0.001). Srebf1, Dnmt1 and Lepr liver mRNA levels increased after adulthood HFS feeding. In those animals HFS fed during adulthood, previous maternal HFS decreased Lepr and Dnmt1 expression levels when compared with c-HFS offspring, while the supplementation of control and HFS-fed dams, respectively, induced higher hepatic Mme and Lepr mRNA levels after adult HFS intake compared with hfs-HFS offspring. In conclusion, maternal HFS diet during lactation influenced the response to an obesogenic diet in the adult progeny. Interestingly, dietary methyl donor supplementation in lactating mothers fed an obesogenic diet reduced liver fat accumulation, but increased adipose tissue storage in adult HFS-fed offspring.
The question of who holds responsibility for racial uplift within African American communities is an enduring one. This paper investigates the understanding of racial obligation on the part of Black elite philanthropic donors. Through in-depth interviews with twenty elite donors, I investigate whether African American elite donors use philanthropic activity to realize their racial obligations by supporting Black nonprofit organizations and charitable causes that directly benefit Black people. I find that Black donors are deeply ambivalent about their position as members of a racial group that is marginalized while they are individually privileged because of their class position. They attempt to reconcile this ambivalence through their philanthropic giving. Donors at times embrace the importance of their racial identity as a principle that organizes their giving practices, but in other instances the very same donors reject race as a factor orienting how they think about their charity. Donors express this inconsistency through three different giving strategies. First, Black donors advocate for what they consider to be Black causes within mainstream organizations—initiatives they believe will directly and positively benefit Black people. Second, while they may support Black nonprofit organizations, they qualify the types of Black organizations worthy of their support. Third, donors reject race as an orienting principle altogether. Indeed, while there are few distinctive patterns among Black elite donors, no matter how they give they do so with an eye towards maintaining a mainstream sensibility that emphasizes integration, efficiency, and success. It is perhaps the diversity of contradictory strategies that poses the most fundamental challenge to the notion of community that permeates discussions of race and responsibility. I conclude by arguing that the ability to define when and how race matters to them is a particular privilege of the Black elite.
According to the 2007–2008 National Health and Nutrition Examination Survey, the prevalence of obesity in the US population was 33·8 %; 34·3 % and 38·2 %, respectively, in middle-aged men and women. We asked whether available blood donor data could be used for obesity surveillance.
Cross-sectional study of BMI and obesity, defined as BMI ≥ 30·0 kg/m2. Adjusted odds ratios (aOR) were calculated with logistic regression.
A network of six US blood centres.
Existing data on self-reported height and weight from blood donors, excluding persons deferred for very low body weight.
Among 1 042 817 donors between January 2007 and December 2008, the prevalence of obesity was 25·1 %; 25·7 % in men and 24·4 % in women. Obesity was associated with middle age (age 50–59 years v. <20 years: aOR = 1·92 for men and 1·81 for women), black (aOR = 1·57 for men and 2·35 for women) and Hispanic (aOR = 1·47 for men and 1·49 for women) race/ethnicity compared with white race/ethnicity, and inversely associated with higher educational attainment (college degree v. high school or lower: aOR = 0·56 for men and 0·48 for women) and double red cell donation and platelet donation.
Obesity is common among US blood donors, although of modestly lower prevalence than in the general population, and is associated with recognized demographic factors. Blood donors with higher BMI are specifically recruited for certain blood collection procedures. Blood centres can play a public health role in obesity surveillance and interventions.
Evidence is growing for the long-term effects of environmental factors during early-life on later disease susceptibility. It is believed that epigenetic mechanisms (changes in gene function not mediated by DNA sequence alteration), particularly DNA methylation, play a role in these processes. This paper reviews the current state of knowledge of the involvement of C1 metabolism and methyl donors and cofactors in maternal diet-induced DNA methylation changes in utero as an epigenetic mechanism. Methyl groups for DNA methylation are mostly derived from the diet and supplied through C1 metabolism by way of choline, betaine, methionine or folate, with involvement of riboflavin and vitamins B6 and B12 as cofactors. Mouse models have shown that epigenetic features, for example DNA methylation, can be altered by periconceptional nutritional interventions such as folate supplementation, thereby changing offspring phenotype. Evidence of early nutrient-induced epigenetic change in human subjects is scant, but it is known that during pregnancy C1 metabolism has to cope with high fetal demands for folate and choline needed for neural tube closure and normal development. Retrospective studies investigating the effect of famine or season during pregnancy indicate that variation in early environmental exposure in utero leads to differences in DNA methylation of offspring. This may affect gene expression in the offspring. Further research is needed to examine the real impact of maternal nutrient availability on DNA methylation in the developing fetus.
This chapter focuses on patients with testicular cancer and lymphoma that generally affects younger patients in the reproductive window with an excellent overall survival. The chance of recovery of spermatogenesis depends on the chemotherapeutic regimen as well as the baseline function of the patient. The existence of a previously cryopreserved sperm greatly simplifies the algorithm for the post chemotherapeutic azoospermic man and, essentially, the couple can go directly to in vitro fertilization (IVF). Azoospermia after chemotherapy can be due to the patient's chemotherapeutic regimen, the use of radiation, the extent of surgery, the disease itself, the baseline function of the patient or any combination of the aforementioned factors. Additional counseling is recommended for those patients who choose the assistance of third-party reproduction. Gamete donation has made it possible for participants to cross generational lines and has raised many complicated ethical issues.
Donor insemination (DI) remains a very important treatment option with acceptable pregnancy rates. In order to optimize pregnancy rates with DI, careful consideration should be given to various aspects of this service, including the recruitment and screening of sperm donors, cryopreservation of semen, and the screening and management of recipients. This chapter examines these important aspects of treatment to consider how to optimize DI services in the future. Treatment using DI was initially designed to treat male factor infertility. However, DI remains a therapeutic option for male factor infertility when either too few or no sperm are obtained at surgical sperm aspiration. With the advent of intracytoplasmic sperm injection (ICSI) many assumed that DI would become a very limited treatment. Although the numbers of cycles have reduced considerably there has been an increasing trend for DI to be used for other groups of patients such as single women and lesbians.