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November 10, 2005


Spending for building democracy works

Devoting American dollars to democracy-building in more than 100 foreign nations has resulted in significant increases in democratic governance around the globe, according to a new study by professors from Pitt and Vanderbilt University. The findings were presented Oct. 27 at the Woodrow Wilson International Center for Scholars in Washington, D.C.

“We found that when the United States spends money to promote democracy in foreign countries, it works,” said Mitchell Seligson, Centennial Professor of Political Science and a fellow of the Center for the Americas at Vanderbilt.

“Unlike all prior published research, our data set is based upon an exhaustive survey of the entire democracy portfolio of the U.S. Agency for International Development (USAID) since the end of the Cold War.”

Co-principal investigators were professor and Daniel Wallace Chair Steve Finkel and assistant professor Anibal Pérez-Liñán, both of Pitt’s Department of Political Science.

The study, “Effects of U.S. Foreign Assistance on Democracy Building: Results of a Cross-National Quantitative Study,” covers virtually all nations eligible for foreign assistance, and uses a complex statistical model to draw its conclusions.

The study also measured the specific impact of spending on democracy building, rather than the impact of all types of U.S. foreign assistance on increasing democracy, and also controlled for other possible influences on the growth of democracy.

The study, which covers 1990 through 2003, found USAID spending on its democracy and governance programs had a significant positive impact on democracy.

The study also found that the limited amounts of money spent produced only a limited impact on democratic growth. The team speculates that if more of the USAID portfolio had been spent on democracy, the impact could have been greater.

Researchers used data from Freedom House, a nonprofit, nonpartisan organization that promotes democratic values as one of several measures of each country’s level of democracy. They found that for each additional $10 million in U.S. democracy assistance, a country is predicted to be one-quarter of a point higher on the Freedom House general democracy index, which ranges from two to 14.

Using another standard index for democracy measurement called Polity IV, researchers found that $10 million in democracy assistance raised its index by about four-tenths of a point.

“The corresponding increase in the Polity IV model is about one-third of the ‘otherwise normal’ amount of yearly democratic growth,” Seligson said.

Seligson noted that there would be even stronger impacts for heavily funded countries and weaker effects where less money was spent. The average country during the time period of the study received $2.07 million per year for democracy assistance.

The study also found that no other type of assistance — from the USAID or other sources — was shown to have any direct statistically significant impact. “We cannot find any measurable impact when other countries donate money for democracy, but the data from those other sources are difficult to verify for accuracy,” he said.

Specific indicators used by researchers to determine the level of democracy in a particular country include: the effectiveness of legislatures, strength of the judiciary, rule of law and whether there is a free press.

“Our results show that there is a real potential for USAID and other international donors to influence the democracy-building process, but to fully realize that potential, the level of funding for democracy assistance would need to increase substantially over what it is right now,” said Finkel.

“In addition, we find that democracy assistance continues to have effects some two to three years in the future, indicating that there is potential for cumulative impact of these kinds of programs,” Pérez-Liñán said.

The only negative impact the study found for U.S. assistance for democracy building was in the area of human rights. Seligson said.

“It is quite possible that when the U.S. government gives money to foreign nongovernmental human rights organizations, it emboldens them to report or publicize the extent of human rights problems to a greater degree.”

Another explanation could be that authoritarian regimes, when they see the international community putting pressure on them to ease up on human rights violations, react instead by increasing their efforts against the opposition. Seligson said there needs to be further research into the relationship between U.S. foreign assistance and human rights violations.

The study grant was awarded by the Association Liaison Office for University Cooperation in Development, a consortium that includes the American Association of Universities and the American Council on Higher Education, and made in cooperation with USAID, the major contributor to democracy promotion worldwide.

The full study will be available Nov. 30 at


High uric acid may predict higher risk of complications in pregnancy

Pregnant women with high blood pressure and high uric acid levels in their blood may face an increased risk of complications that could be fatal for mother and baby.

Reporting in the Oct. 27 on-line issue of Hypertension, a journal published by the American Heart Association, Pitt researchers note that the greatest risk of high blood pressure during pregnancy accompanies preeclampsia, a disorder that affects some 5 percent of first pregnancies and traditionally is diagnosed by increased blood pressure and the presence of protein in the urine.

The only effective treatment is immediate delivery, which, if done too early, can pose risks to the fetus.

In developed countries where prenatal care is routine, preeclampsia accounts for about 15 percent of premature deliveries a year. Worldwide, in settings without good prenatal care, preeclampsia increases the risk of fetal death five-fold and kills 50,000 women a year, researchers said.

For clinicians, treating preeclampsia is a delicate balance of fetal and maternal risk from the disease and fetal development-associated risk because of premature delivery.

“We used a research database to ask whether inclusion of uric acid levels in the diagnosis of preeclampsia would help us to evaluate risk for complications among patients,” said James M. Roberts, vice chair of research in the Department of Obstetrics, Gynecology and Reproductive Sciences at the School of Medicine and the study’s first author.

Roberts also is director of Magee-Womens Research Institute.

“We focused primarily on fetal outcomes such as gestational age at delivery and birth weight, but also looked at markers of maternal disease, including severely elevated blood pressure during labor.”

The study reviewed the records of 972 pregnant women at Magee-Womens Hospital and divided them into eight groups.

• 431 women had normal levels of uric acid and blood pressure and no evidence of protein in their urine.

• 48 women had classic preeclampsia including high blood pressure and protein in their urine but normal uric acid.

• 141 women had preeclampsia and elevated levels of uric acid in their blood..

• 52 women had high blood pressure and elevated levels of uric acid but no protein in their urine.

• 184 women had only increased uric acid levels.

• 83 women had only high blood pressure.

• 21 women had only protein in their urine.

• 12 women had protein in their urine and elevated levels of uric acid but normal blood pressure.

Analysis revealed that the women with both preeclampsia and elevated uric acid levels had a nearly seven-fold increased risk of premature delivery and delivered nearly four weeks earlier than preeclamptic women whose uric acid levels were normal.

Most of these deliveries were induced to prevent more severe maternal illness and infants tended to be smaller at birth, even adjusted for gestational age, Roberts said.

For women with high blood pressure, high uric acid and no protein in their urine, the risk of early delivery or reduced fetal growth was at least as likely as in women with classic signs of preeclampsia but normal uric acid. Women with high blood pressure who lacked urine protein and had normal uric acid had no increased risk for their babies.

“Irrespective of protein levels, women with high blood pressure had a higher incidence of being delivered early as uric acid increased,” Roberts said.

“For every one-unit increase in uric acid, the odds of preterm birth increased 2.3 times,” he said.

The study suggests that uric acid measures could be useful for predicting risk of adverse outcomes, but more testing is needed, Roberts said.

Other authors of the study are Lisa M. Bodnar, Kristine Yoder Lain, Carl A. Hubel, Nina Markovic, Roberta B. Ness and Robert W. Powers, all of the School of Medicine.


Broccoli may inhibit ovarian cancer

Researchers Sivakumar Loganatan, Ruifen Zhang and Sanjay K. Srivastava of the University of Pittsburgh Cancer Institute and Ian Humphreys of Pitt presented research that indicates a compound found in cruciferous vegetables may help prevent ovarian cancer.

The team exposed human ovarian cancer cells to a concentration of phenethyl isothiocyanate (PEITC) that could be achieved through dietary intake of cruciferous vegetables such as broccoli. They found PEITC inhibited the proliferation of the cancer cells.

The findings were presented at an ovarian cancer symposium held last month.


Pitt lung catheter licensee wins Tech 50 award

Pittsburgh-based Alung Technologies Inc. won a 2005 Pittsburgh Technology Council “Tech 50” award in the Life Sciences category.

Among Alung’s products is the Hattler Catheter, which is based on technology developed at the McGowan Institute for Regenerative Medicine.

The respiratory assist catheter offers a safer, less expensive alternative to mechanical ventilation. The catheter uses a pulsating balloon to promote blood mixing. It allows damaged lungs to rest by oxygenating blood and removing carbon dioxide before the blood reaches the lungs.

The Hattler Catheter is being readied for clinical trials.


Fool cells, fight melanoma

A new type of immunotherapy in which dendritic cells are tricked into action against cancer when they are exposed to harmless pieces of viruses and bacteria is described in the November issue of Cancer Research. Dendritic cells, the pacemakers of the immune system, are known to play a vital role in the initiation of the immune response but are often eluded by cancer.

In the study, Pitt researchers describe the creation of an animal model of an immunotherapy approach that, first used in cancer patients, uses a patient’s own tumor cells to stimulate anti-tumor immunity. The discovery of the animal model will enable researchers to more fully understand and develop the approach.

“Cancer cells are very adept at camouflaging themselves and hiding from the immune system and this makes most cancers, including melanomas and lymphomas of the skin, extremely challenging to treat with existing immunotherapies,” said Louis D. Falo, professor and chairman of the Department of Dermatology at the School of Medicine.

“While we know that dendritic cells are necessary to activate a response against cancer as the first cells to present antigens to other cells of the immune system, they are often ineffective because they fail to recognize growing cancers as dangerous. What we describe is an immunotherapy approach that activates dendritic cells by using an external stimulus that mimics danger. This alerts the cells to activate a type of immune response that is particularly important for fighting cancer.”

In the study, melanoma cells and dendritic cells from mice were removed, combined together in a culture dish and exposed to pieces of viruses and bacteria. The researchers used the most aggressive mouse melanoma tumor, B16, which has multiple mechanisms to escape the immune system that are similar to those used by human cancers. They found that the dendritic cells were able to extract antigens directly from tumor cells.

By exposing the antigen-bearing dendritic cells to harmless pieces of bacteria and viruses that they perceived as dangerous, the researchers “tricked” them into recognizing the tumor as dangerous as well. The alerted cells were then injected back into the mice where they successfully activated a tumor-fighting T-cell response. That response, called Th1, led to a significant reduction in tumor growth in the mice.

“Typically, tumors are able to grow in part by convincing the immune system that they are normal. Our goal was to mimic danger to wake up the dendritic cells and program them to stimulate the right type of immune response against the patients’ own tumor cells,” said Falo.

The researchers further discovered that the Th1 response was enough to stop tumor growth on its own, indicating the importance of Th1-type immunity for tumor therapy.

Prior to their discovery, researchers believed that a Th1 response was important, but that it worked primarily by activating another type of T-cell called a cytotoxic T-cell (CTL). These results suggest that it may be important to monitor Th1-type immunity in addition to CTL immunity when evaluating patients’ responses to immunotherapy.

Falo already found this approach to be successful in a preliminary study in cancer patients, but progress has been hindered by the length and expense of a human clinical trial. Unlike most therapy advances that are developed in animal models and then translated to patients, the danger signals used in this approach were developed using models based on human tissue. He believes that the creation of this animal model will enable further development of immune approaches to melanoma and other cancers, bringing new options to patients who have not responded to available therapies.

The study was funded by the National Cancer Institute. Collaborators included Pitt researchers David A. Hokey, Adriana T. Larregina, M. Geza Erdos and Simon C. Watkins.

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