Transplantation for diabetic nephropathy at Groote Schuur Hospital

Over a period of 6 years, 9 patients with diabetic nephropathy received renal allografts at Groote Schuur Hospital. This low figure represents 2,8% of the total number of renal transplants done at our institution, and is evidence of concern about the apparent poor results of transplantation in these patients. After 2 years, patients and graft survival rates in diabetics were 87% and 62% respectively. Vascular disease was a major problem. Six patients developed limb gangrene, and symptomatic coronary and cerebrovascular disease developed in 2 patients. Infections were common and included wound sepsis, cellulitis, candidiasis and urinary tract infections. Diabetes was poorly controlled after transplantation in 5 patients. Proliferative retinopathy was present in 6 patients but remained stable after transplantation.Despite very strict selection criteria, the results of renal transplantation in diabetic patients remain poor. Better treatment strategies are needed to justify acceptance of these patients for transplantation

Social determinants of content selection in the age of (mis)information

Despite the enthusiastic rhetoric about the so called \emph{collective intelligence}, conspiracy theories -- e.g. global warming induced by chemtrails or the link between vaccines and autism -- find on the Web a natural medium for their dissemination. Users preferentially consume information according to their system of beliefs and the strife within users of opposite narratives may result in heated debates. In this work we provide a genuine example of information consumption from a sample of 1.2 million of Facebook Italian users. We show by means of a thorough quantitative analysis that information supporting different worldviews -- i.e. scientific and conspiracist news -- are consumed in a comparable way by their respective users. Moreover, we measure the effect of the exposure to 4709 evidently false information (satirical version of conspiracy theses) and to 4502 debunking memes (information aiming at contrasting unsubstantiated rumors) of the most polarized users of conspiracy claims. We find that either contrasting or teasing consumers of conspiracy narratives increases their probability to interact again with unsubstantiated rumors.Comment: misinformation, collective narratives, crowd dynamics, information spreadin

How to move ionized gas: an introduction to the dynamics of HII regions

This review covers the dynamic processes that are important in the evolution and structure of galactic HII regions, concentrating on an elementary presentation of the physical concepts and recent numerical simulations of HII region evolution in a non-uniform medium. The contents are as follows: (1) The equations (Euler equations; Radiative transfer; Rate equations; How to avoid the dynamics; How to avoid the atomic physics). (2) Physical concepts (Static photoionization equilibrium; Ionization front propagation; Structure of a D-type front; Photoablation flows; Other ingredients - Stellar winds, Radiation pressure, Magnetic fields, Instabilities). (3) HII region evolution (Early phases: hypercompact and ultracompact regions; Later phases: compact and extended regions; Clumps and turbulence).Comment: To be published as a chapter in 'Diffuse Matter from Star Forming Regions to Active Galaxies' - A volume Honouring John Dyson. Eds. T. W. Harquist, J. M. Pittard and S. A. E. G. Falle. 25 pages, 7 figures. Some figures degraded to meet size restriction. Full-resolution version available at http://www.ifront.org/wiki/Dyson_Festschrift_Chapte

Redefining Clostridioides difficile infection antibiotic response and clinical outcomes

With the approval and development of narrow-spectrum antibiotics for the treatment of Clostridioides difficile infection (CDI), the primary endpoint for treatment success of CDI antibiotic treatment trials has shifted from treatment response at end of therapy to sustained response 30 days after completed therapy. The current definition of a successful response to treatment (three or fewer unformed bowel movements [UBMs] per day for 1-2 days) has not been validated, does not reflect CDI management, and could impair assessments for successful treatment at 30 days. We propose new definitions to optimise trial design to assess sustained response. Primarily, we suggest that the initial response at the end of treatment be defined as (1) three or fewer UBMs per day, (2) a reduction in UBMs of more than 50% per day, (3) a decrease in stool volume of more than 75% for those with ostomy, or (4) attainment of bowel movements of Bristol Stool Form Scale types 1-4, on average, by day 2 after completion of primary CDI therapy (ie, assessed on day 11 and day 12 of a 10-day treatment course) and following an investigator determination that CDI treatment can be ceased.Molecular basis of bacterial pathogenesis, virulence factors and antibiotic resistanc

Psychology and aggression

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68264/2/10.1177_002200275900300301.pd

Improving Genetic Prediction by Leveraging Genetic Correlations Among Human Diseases and Traits

Genomic prediction has the potential to contribute to precision medicine. However, to date, the utility of such predictors is limited due to low accuracy for most traits. Here theory and simulation study are used to demonstrate that widespread pleiotropy among phenotypes can be utilised to improve genomic risk prediction. We show how a genetic predictor can be created as a weighted index that combines published genome-wide association study (GWAS) summary statistics across many different traits. We apply this framework to predict risk of schizophrenia and bipolar disorder in the Psychiatric Genomics consortium data, finding substantial heterogeneity in prediction accuracy increases across cohorts. For six additional phenotypes in the UK Biobank data, we find increases in prediction accuracy ranging from 0.7 for height to 47 for type 2 diabetes, when using a multi-trait predictor that combines published summary statistics from multiple traits, as compared to a predictor based only on one trait. © 2018 The Author(s)

Integrating sequence and array data to create an improved 1000 Genomes Project haplotype reference panel

A major use of the 1000 Genomes Project (1000GP) data is genotype imputation in genome-wide association studies (GWAS). Here we develop a method to estimate haplotypes from low-coverage sequencing data that can take advantage of single-nucleotide polymorphism (SNP) microarray genotypes on the same samples. First the SNP array data are phased to build a backbone (or 'scaffold') of haplotypes across each chromosome. We then phase the sequence data 'onto' this haplotype scaffold. This approach can take advantage of relatedness between sequenced and non-sequenced samples to improve accuracy. We use this method to create a new 1000GP haplotype reference set for use by the human genetic community. Using a set of validation genotypes at SNP and bi-allelic indels we show that these haplotypes have lower genotype discordance and improved imputation performance into downstream GWAS samples, especially at low-frequency variants. © 2014 Macmillan Publishers Limited. All rights reserved

Age at first birth in women is genetically associated with increased risk of schizophrenia

Prof. Paunio on PGC:n jäsenPrevious studies have shown an increased risk for mental health problems in children born to both younger and older parents compared to children of average-aged parents. We previously used a novel design to reveal a latent mechanism of genetic association between schizophrenia and age at first birth in women (AFB). Here, we use independent data from the UK Biobank (N = 38,892) to replicate the finding of an association between predicted genetic risk of schizophrenia and AFB in women, and to estimate the genetic correlation between schizophrenia and AFB in women stratified into younger and older groups. We find evidence for an association between predicted genetic risk of schizophrenia and AFB in women (P-value = 1.12E-05), and we show genetic heterogeneity between younger and older AFB groups (P-value = 3.45E-03). The genetic correlation between schizophrenia and AFB in the younger AFB group is -0.16 (SE = 0.04) while that between schizophrenia and AFB in the older AFB group is 0.14 (SE = 0.08). Our results suggest that early, and perhaps also late, age at first birth in women is associated with increased genetic risk for schizophrenia in the UK Biobank sample. These findings contribute new insights into factors contributing to the complex bio-social risk architecture underpinning the association between parental age and offspring mental health.Peer reviewe