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Personal Viewpoint (personal + viewpoint)
Selected AbstractsT Cell-mediated Rejection of Kidney Transplants: A Personal ViewpointAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2010P. F. Halloran In kidney allografts, T cell mediated rejection (TCMR) is characterized by infiltration of the interstitium by T cells and macrophages, intense IFNG and TGFB effects, and epithelial deterioration. Recent experimental and clinical studies provide the basis for a provisional model for TCMR. The model proposes that the major unit of cognate recognition in TCMR is effector T cells engaging donor antigen on macrophages. This event creates the inflammatory compartment that recruits effector and effector memory CD4 and CD8 T cells, both cognate and noncognate, and macrophage precursors. Cognate T cells cross the donor microcirculation to enter the interstitium but spare the microcirculation. Local inflammation triggers dedifferentiation of the adjacent epithelium (e.g. loss of transporters and expression of embryonic genes) rather than cell death, via mechanisms that do not require known T-cell cytotoxic mechanisms or direct contact of T cells with the epithelium. Local epithelial changes trigger a response of the entire nephron and a second wave of dedifferentiation. The dedifferentiated epithelium is unable to exclude T cells, which enter to produce tubulitis lesions. Thus TCMR is a cognate recognition-based process that creates local inflammation and epithelial dedifferentiation, stereotyped nephron responses, and tubulitis, and if untreated causes irreversible nephron loss. [source] The Kidney Allocation Score: Methodological Problems, Moral Concerns and Unintended ConsequencesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2009B. Hippen The growing disparity between the demand for and supply of kidneys for transplantation has generated interest in alternative systems of allocating kidneys from deceased donors. This personal viewpoint focuses attention on the Kidney Allocation Score (KAS) proposal promulgated by the UNOS/OPTN Kidney Committee. I identify several methodological and moral flaws in the proposed system, concluding that any iteration of the KAS proposal should be met with more skepticism than sanguinity. [source] A NEW AGENT MATCHING SCHEME USING AN ORDERED FUZZY SIMILARITY MEASURE AND GAME THEORYCOMPUTATIONAL INTELLIGENCE, Issue 2 2008Hamed Kebriaei In this paper, an agent matching method for bilateral contracts in a multi-agent market is proposed. Each agent has a hierarchical representation of its trading commodity attributes by a tree structure of fuzzy attributes. Using this structure, the similarity between the trees of each pair of buyer and seller is computed using a new ordered fuzzy similarity algorithm. Then, using the concept of Stackelberg equilibrium in a leader,follower game, matchmaking is performed among the sellers and buyers. The fuzzy similarities of each agent with others in its personal viewpoint have been used as its payoffs in a bimatrix game. Through a case study for bilateral contracts of energy, the capabilities of the proposed agent-based system are illustrated. [source] The attitudes of health care staff to information technology: a comprehensive review of the research literatureHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2008Rod Ward Objectives:, What does the publicly available literature tell us about the attitudes of health care staff to the development of information technology in practice, including the factors which influence them and the factors which may be used to change these attitudes? Methods:, Twelve databases were searched for literature published between 2000 and 2005 that identified research related to information technology (IT), health professionals and attitude. English language studies were included which described primary research relating to the attitudes of one or more health care staff groups towards IT. Letters, personal viewpoints, reflections and opinion pieces were not included. Results:, Complex factors contribute to the formation of attitudes towards IT. Many of the issues identified were around the flexibility of the systems and whether they were ,fit for purpose', along with the confidence and experience of the IT users. The literature suggests that attitudes of practitioners are a significant factor in the acceptance and efficiency of use of IT in practice. The literature also suggested that education and training was a factor for encouraging the use of IT systems. Conclusions:, A range of key issues, such as the need for flexibility and usability, appropriate education and training and the need for the software to be ,fit for purpose', showed that organizations need to plan carefully when proposing the introduction of IT-based systems into work practices. The studies reviewed did suggest that attitudes of health care professionals can be a significant factor in the acceptance and efficiency of use of IT in practice. Further qualitative and quantitative research is needed into the approaches that have most effect on the attitudes of health care staff towards IT. [source] Flaws in the assessment of the best interests of the newbornACTA PAEDIATRICA, Issue 4 2009Carlo V Bellieni Abstract We examined the literature on ethical decisions regarding neonates, to assess whether personal beliefs and prejudices influence end-of-life decisions taken by caregivers. Studies show that religion and familiarity with disability influence caregivers' decisions, whereas the influx of already being a parent, age, sex and professional experience is controverse. Caregivers' attitudes towards end-of-life decisions are also affected by personal concerns about litigation, prejudices and their view of disability. The concept of ,poor quality of life' is widely used as a reference in end-of-life decisions, but this can be interpreted differently, leaving room for a wide range of personal viewpoints. In most cases, parents' opinions are considered important and are sometimes the main determinant in decision making. However, it is unclear whether parents' decisions are based on their own wishes or on the best interests of the newborn. Conclusion: In neonatal end-of-life decisions, patients may not receive cures based only on their best interests. [source] | ||||||||||