Fidaxomicin is a Superior Treatment to Vancomycin for Recurrent Clostridium Difficile Infection

Clostridium difficile has been historically viewed as a hospital acquired infection. However, the emergence of community acquired infection in low risk populations, the identification of new risk factors, detection of a hypervirulent strain of C. difficile, and increasing mortality have changed the epidemiology if this infection. Current standards of treatment have come into question due to increasing recurrence rates and treatment failures, possible resistance of Metronidazole, and concerns surrounding Vancomycin resistant enterococci (VRE). Fidaxomicin, a narrow-spectrum macrolide, is the first drug approved by the FDA in 20 years for the treatment of C. difficile infection. It has shown good in vitro and in vivo activity, has similar clinical cure rates, lower recurrence rates, and higher global cure rates compared to Vancomycin in non-hypervirulent strains and similar efficacy in all outcomes in the hypervirulent strain. Overall, Fidaxomicin appears to be a reasonable second line treatment option for recurrent C. difficile infection in patients who have failed to respond to treatment under the current guidelines

Economic Stress of International Students: What Counselors Should Know

College students encounter high levels of stress due to intensive demands from developmental and academic tasks. In addition to the stress induced by developmental and academic tasks, economic stress adds substantial distress to college students. Economic contraction is known to bring up mental health concerns in society. Financial stress and diminished optimism are affected by distressful economic conditions. This study examined the different perceptions of economic stress between American students and international students of one English for Speakers of Other Language (ESOL) program. International students in this study sustained equally high economic stress but were more sensitive to the economic downturn. The results provide an opportunity to inform counselors how to better work with international students regarding their economic stress

Membrane-To-Nucleus Signaling Links Insulin-Like Growth Factor-1- and Stem Cell Factor-Activated Pathways

Stem cell factor (mouse: Kitl, human: KITLG) and insulin-like growth factor-1 (IGF1), acting via KIT and IGF1 receptor (IGF1R), respectively, are critical for the development and integrity of several tissues. Autocrine/paracrine KITLG-KIT and IGF1-IGF1R signaling are also activated in several cancers including gastrointestinal stromal tumors (GIST), the most common sarcoma. In murine gastric muscles, IGF1 promotes Kitl-dependent development of interstitial cells of Cajal (ICC), the non-neoplastic counterpart of GIST, suggesting cooperation between these pathways. Here, we report a novel mechanism linking IGF1-IGF1R and KITLG-KIT signaling in both normal and neoplastic cells. In murine gastric muscles, the microenvironment for ICC and GIST, human hepatic stellate cells (LX-2), a model for cancer niches, and GIST cells, IGF1 stimulated Kitl/KITLG protein and mRNA expression and promoter activity by activating several signaling pathways including AKT-mediated glycogen synthase kinase-3β inhibition (GSK3i). GSK3i alone also stimulated Kitl/KITLG expression without activating mitogenic pathways. Both IGF1 and GSK3i induced chromatin-level changes favoring transcriptional activation at the Kitl promoter including increased histone H3/H4 acetylation and H3 lysine (K) 4 methylation, reduced H3K9 and H3K27 methylation and reduced occupancy by the H3K27 methyltransferase EZH2. By pharmacological or RNA interference-mediated inhibition of chromatin modifiers we demonstrated that these changes have the predicted impact on KITLG expression. KITLG knock-down and immunoneutralization inhibited the proliferation of GIST cells expressing wild-type KIT, signifying oncogenic autocrine/paracrine KITLG-KIT signaling. We conclude that membrane-to-nucleus signaling involving GSK3i establishes a previously unrecognized link between the IGF1-IGF1R and KITLG-KIT pathways, which is active in both physiologic and oncogenic contexts and can be exploited for therapeutic purposes

Deep computational phenotyping of genomic variants impacting the SET domain of KMT2C reveal molecular mechanisms for their dysfunction

Introduction: Kleefstra Syndrome type 2 (KLEFS-2) is a genetic, neurodevelopmental disorder characterized by intellectual disability, infantile hypotonia, severe expressive language delay, and characteristic facial appearance, with a spectrum of other distinct clinical manifestations. Pathogenic mutations in the epigenetic modifier type 2 lysine methyltransferase KMT2C have been identified to be causative in KLEFS-2 individuals.Methods: This work reports a translational genomic study that applies a multidimensional computational approach for deep variant phenotyping, combining conventional genomic analyses, advanced protein bioinformatics, computational biophysics, biochemistry, and biostatistics-based modeling. We use standard variant annotation, paralog annotation analyses, molecular mechanics, and molecular dynamics simulations to evaluate damaging scores and provide potential mechanisms underlying KMT2C variant dysfunction.Results: We integrated data derived from the structure and dynamics of KMT2C to classify variants into SV (Structural Variant), DV (Dynamic Variant), SDV (Structural and Dynamic Variant), and VUS (Variant of Uncertain Significance). When compared with controls, these variants show values reflecting alterations in molecular fitness in both structure and dynamics.Discussion: We demonstrate that our 3D models for KMT2C variants suggest distinct mechanisms that lead to their imbalance and are not predictable from sequence alone. Thus, the missense variants studied here cause destabilizing effects on KMT2C function by different biophysical and biochemical mechanisms which we adeptly describe. This new knowledge extends our understanding of how variations in the KMT2C gene cause the dysfunction of its methyltransferase enzyme product, thereby bearing significant biomedical relevance for carriers of KLEFS2-associated genomic mutations

Inactivation of the Euchromatic Histone-Lysine N-Methyltransferase 2 Pathway in Pancreatic Epithelial Cells Antagonizes Cancer Initiation and Pancreatitis-Associated Promotion by Altering Growth and Immune Gene Expression Networks

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive, painful disease with a 5-year survival rate of only 9%. Recent evidence indicates that distinct epigenomic landscapes underlie PDAC progression, identifying the H3K9me pathway as important to its pathobiology. Here, we delineate the role of Euchromatic Histone-lysine N-Methyltransferase 2 (EHMT2), the enzyme that generates H3K9me, as a downstream effector of oncogenic KRAS during PDAC initiation and pancreatitis-associated promotion. EHMT2 inactivation in pancreatic cells reduces H3K9me2 and antagonizes KrasG12D-mediated acinar-to-ductal metaplasia (ADM) and Pancreatic Intraepithelial Neoplasia (PanIN) formation in both the Pdx1-Cre and P48Cre/+KrasG12D mouse models. Ex vivo acinar explants also show impaired EGFR-KRAS-MAPK pathway-mediated ADM upon EHMT2 deletion. Notably, KrasG12D increases EHMT2 protein levels and EHMT2-EHMT1-WIZ complex formation. Transcriptome analysis reveals that EHMT2 inactivation upregulates a cell cycle inhibitory gene expression network that converges on the Cdkn1a/p21-Chek2 pathway. Congruently, pancreas tissue from KrasG12D animals with EHMT2 inactivation have increased P21 protein levels and enhanced senescence. Furthermore, loss of EHMT2 reduces inflammatory cell infiltration typically induced during KrasG12D-mediated initiation. The inhibitory effect on KrasG12D-induced growth is maintained in the pancreatitis-accelerated model, while simultaneously modifying immunoregulatory gene networks that also contribute to carcinogenesis. This study outlines the existence of a novel KRAS-EHMT2 pathway that is critical for mediating the growth-promoting and immunoregulatory effects of this oncogene in vivo, extending human observations to support a pathophysiological role for the H3K9me pathway in PDAC

Microarray Analysis of mRNA Levels from RAW264.7 Macrophages Infected with Brucella abortus

Identification of host responses at the gene transcription level provides a molecular profile of the events that occur following infection. Brucella abortus is a facultative intracellular pathogen of macrophages that induces chronic infection in humans and domestic animals. Using microarray technology, the response of macrophages 4 h following B. abortus infection was analyzed to identify early intracellular infection events that occur in macrophages. Of the >6,000 genes, we identified over 140 genes that were reproducibly differentially transcribed. First, an increase in the transcription of a number of proinflammatory cytokines and chemokines, such as tumor necrosis factor alpha, interleukin-1β (IL-1β), IL-1α, and members of the SCY family of proteins, that may constitute a general host recruitment of antibacterial defenses was evident. Alternatively, Brucella may subvert newly arriving macrophages for additional intracellular infection. Second, transcription of receptors and cytokines associated with antigen presentation, e.g., major histocompatibility complex class II and IL-12p40, were not evident at this 4-h period of infection. Third, Brucella inhibited transcription of various host genes involved in apoptosis, cell cycling, and intracellular vesicular trafficking. Identification of macrophage genes whose transcription was inhibited suggests that Brucella utilizes specific mechanisms to target certain cell pathways. In conclusion, these data suggest that B. abortus can alter macrophage pathways to recruit additional macrophages for future infection while simultaneously inhibiting apoptosis and innate immune mechanisms within the macrophage, permitting intracellular survival of the bacterium. These results provide insights into the pathogenic strategies used by Brucella for long-term survival within a hostile environment

Corporate Responsibility: Insight from a Construction Small and Medium Enterprise (SME) in the UK

Construction organisations (SMEs in particular) are now taking a responsible attitude, going beyond the minimum legal requirements. In line with the UK Government’s innovation objectives under The Strategy for Sustainable Construction, organisations are looking to develop and implement management systems to address the corporate responsibility (CR) aspects of the business. This paper investigates the initiation, development and practice of CR in construction organisations, and presents a case for possible adoption for construction SMEs. By combining key indicators of CR and achieving business success and competitive advantage, the pervasiveness of CR for construction SMEs is determined

Responsible construction?

The ability of the construction industry to innovate in order to improve its practice has been widely debated over the years. As more and more organisations in other sectors, globally, are addressing 21st century consumer challenges: encompassing fair-trade, ethically sourced and more recycled products; and are reporting on their corporate responsibility performance (such as Marks and Spencer's Plan A, The Co-operative, The Body Shop etc), isn't it about time the construction industry followed suit? This paper investigates what really needs to change for the construction to progressively and sustainably improve its position in terms of being 'responsible.'The ability of the construction industry to innovate in order to improve its practice has been widely debated over the years. As more and more organisations in other sectors, globally, are addressing 21st century consumer challenges: encompassing fair-trade, ethically sourced and more recycled products; and are reporting on their corporate responsibility performance (such as Marks and Spencer's Plan A, The Co-operative, The Body Shop etc), isn't it about time the construction industry followed suit? This paper investigates what really needs to change for the construction to progressively and sustainably improve its position in terms of being 'responsible.