Fecal Transplant vs Vancomycin for Recurrent Clostridium Diffile

Objective: To compare fecal transplant and vancomycin in the treatment of recurrent clostridium difficile to determine which has the higher cure rate. Design: Systematic literature review. Methods: Pubmed, Google Scholar, and TRIP database using the search terms “recurrent clostridium difficile.” Filters were implemented in the Pubmed database including: randomized control trials, English, and published in the past 5 years. Records were screened for RCT with fecal transplant and full-text. Results: van Nood et al. revealed an initial cure rate of 81% for the infusion group, and a re-treated cure rate of 94%, compared to the vancomycin alone group of 31% cure rate and the vancomycin plus bowel lavage group of 23% cure rate. Cammarota et al. determined an initial cure rate of 65% for the infusion group, and a re-treated cure rate of 90%, compared to the vancomycin only group of 26% cure rate. Conclusion: An initial abbreviated dose of vancomycin at the start of fecal transplant has a significantly higher cure rate in treating recurrent clostridium difficile infections when compared to standard vancomycin therapy

Using Prior Knowledge and Student Engagement to Understand Student Performance in an Undergraduate Learning-to-Learn Course

This study examined prior knowledge and student engagement in student performance. Log data were used to explore the distribution of final grades (i.e., weak, good, excellent final grades) occurring in an elective under-graduate course. Previous research has established behavioral and agentic engagement factors contribute to academic achievement (Reeve, 2013). Hierarchical logistic regression using both prior knowledge and log data from the course revealed: (a) the weak-grades group demonstrated less behavioral engagement than the good-grades group, (b) the good-grades group demonstrated less agentic engagement than the excellent-grades group, and (c) models composed of both prior knowledge and engagement measures were more accurate than models composed of only engagement measures. Findings demonstrate students performing at different grade-levels may experience different challenges in their course engagement. This study informs our own instructional strategies and interventions to increase student success in the course and provides recommendations for other instructors to support student success

Alternative contingency table measures improve the power and detection of multifactor dimensionality reduction

<p>Abstract</p> <p>Background</p> <p>Multifactor Dimensionality Reduction (MDR) has been introduced previously as a non-parametric statistical method for detecting gene-gene interactions. MDR performs a dimensional reduction by assigning multi-locus genotypes to either high- or low-risk groups and measuring the percentage of cases and controls incorrectly labelled by this classification – the classification error. The combination of variables that produces the lowest classification error is selected as the best or most fit model. The correctly and incorrectly labelled cases and controls can be expressed as a two-way contingency table. We sought to improve the ability of MDR to detect gene-gene interactions by replacing classification error with a different measure to score model quality.</p> <p>Results</p> <p>In this study, we compare the detection and power of MDR using a variety of measures for two-way contingency table analysis. We simulated 40 genetic models, varying the number of disease loci in the model (2 – 5), allele frequencies of the disease loci (.2/.8 or .4/.6) and the broad-sense heritability of the model (.05 – .3). Overall, detection using NMI was 65.36% across all models, and specific detection was 59.4% versus detection using classification error at 62% and specific detection was 52.2%.</p> <p>Conclusion</p> <p>Of the 10 measures evaluated, the likelihood ratio and normalized mutual information (NMI) are measures that consistently improve the detection and power of MDR in simulated data over using classification error. These measures also reduce the inclusion of spurious variables in a multi-locus model. Thus, MDR, which has already been demonstrated as a powerful tool for detecting gene-gene interactions, can be improved with the use of alternative fitness functions.</p

Large-Scale Multi-Omics Studies Provide New Insights into Blood Pressure Regulation

Recent genome-wide association studies uncovered part of blood pressure’s heritability. However, there is still a vast gap between genetics and biology that needs to be bridged. Here, we followed up blood pressure genome-wide summary statistics of over 750,000 individuals, leveraging comprehensive epigenomic and transcriptomic data from blood with a follow-up in cardiovascular tissues to prioritise likely causal genes and underlying blood pressure mechanisms. We first prioritised genes based on coding consequences, multilayer molecular associations, blood pressure-associated expression levels, and coregulation evidence. Next, we followed up the prioritised genes in multilayer studies of genomics, epigenomics, and transcriptomics, functional enrichment, and their potential suitability as drug targets. Our analyses yielded 1880 likely causal genes for blood pressure, tens of which are targets of the available licensed drugs. We identified 34 novel genes for blood pressure, supported by more than one source of biological evidence. Twenty-eight (82%) of these new genes were successfully replicated by transcriptome-wide association analyses in a large independent cohort (n = ~220,000). We also found a substantial mediating role for epigenetic regulation of the prioritised genes. Our results provide new insights into genetic regulation of blood pressure in terms of likely causal genes and involved biological pathways offering opportunities for future translation into clinical practice

CD4 intragenic SNPs associate with HIV-2 plasma viral load and CD4 count in a community-based study from Guinea-Bissau, West Africa.

OBJECTIVES: The human genetics of HIV-2 infection and disease progression is understudied. Therefore, we studied the effect of variation in 2 genes that encode products critical to HIV pathogenesis and disease progression: CD4 and CD209. DESIGN: This cross-sectional study consisted of 143 HIV-2, 30 HIV-1 + HIV-2 and 29 HIV-1-infected subjects and 194 uninfected controls recruited from rural Guinea-Bissau. METHODS: We genotyped 14 CD4 and 4 CD209 single nucleotide polymorphisms (SNPs) that were tested for association with HIV infection, HIV-2 plasma viral load (high vs. low), and CD4 T-cell count (high vs. low). RESULTS: The most significant association was between a CD4 haplotype rs11575097-rs10849523 and high viral load [odds ratio (OR): = 2.37, 95% confidence interval (CI): 1.35 to 4.19, P = 0.001, corrected for multiple testing], suggesting increased genetic susceptibility to HIV-2 disease progression for individuals carrying the high-risk haplotype. Significant associations were also observed at a CD4 SNP (rs2255301) with HIV-2 infection (OR: = 2.36, 95% CI: 1.19 to 4.65, P = 0.01) and any HIV infection (OR: = 2.50, 95% CI: 1.34 to 4.69, P = 0.004). CONCLUSIONS: Our results support a role of CD4 polymorphisms in HIV-2 infection, in agreement with recent data showing that CD4 gene variants increase risk to HIV-1 in Kenyan female sex workers. These findings indicate at least some commonality in HIV-1 and HIV-2 susceptibility

Blending Credit & Non-Credit Courses: Best Practices, Opportunities, Barriers

Community colleges offer an array of programs designed to help students meet different goals. Noncredit education provides training for students seeking targeted, often shorter, courses for personal and professional enrichment (Cohen, Brawer, & Kisker, 2014). Many community colleges are now increasingly emphasizing noncredit workforce education as they support regional workforce development efforts and strive to meet the needs of their local industry partners (Van Noy, Jacobs, Korey, Bailey, & Hughes, 2008). Despite the millions of students enrolled in these courses and their potential to generate revenue for the institutions delivering programs, Voorhees and Milam (2005) refer to noncredit community college education as the “hidden college” and existing research on noncredit offerings is limited. Blending community college credit and noncredit programs with thoughtful and intentional strategies will benefit the students and the institutions. Van Noy, Jacobs, Korey, Bailey, and Hughes (2008) made five recommendations for strengthening noncredit education based on their research. They included the need to expand state funding with clear goals, to increase coordination of credit and noncredit offerings, to promote articulation of noncredit courses into credit programs, to establish non-degree forms of validation for noncredit programs, and to capture more information regarding employment outcomes resulting from noncredit training. These recommendations provide the framework for an analysis of current VCCS programming

Genetic epidemiology of pelvic organ prolapse: a systematic review

Given current evidence supporting a genetic predisposition for pelvic organ prolapse (POP), we conducted a systematic review of published literature on the genetic epidemiology of POP. Inclusion criteria were linkage studies, candidate gene association and genome-wide association studies (GWAS) in adult women published in English and indexed in PubMed through December 2012, with no limit on date of publication. Methodology adhered to the PRISMA guidelines. Data were systematically extracted by two reviewers and graded by the Venice criteria for studies of genetic associations. A meta-analysis was performed on all single nucleotide polymorphisms (SNPs) evaluated by two or more studies with similar methodology. The meta-analysis suggests that collagen type 3 alpha 1 (COL3A1) rs1800255 genotype AA is associated with POP, OR 4.79 (95% CI 1.91 to 11.98, p= 0.001) compared to the reference genotype GG in populations of Asian and Dutch women. There was little evidence of heterogeneity for rs1800255 (p-value for heterogeneity= 0.94; proportion of variance due to heterogeneity, I2= 0.00%). There was insufficient evidence to determine whether other SNPs evaluated by two or more papers were associated with POP. An association with POP was seen in individual studies for estrogen receptor alpha (ER-α) rs2228480 GA, COL3A1 exon 31, chromosome 9q21 (HLOD score 3.41) as well as six SNPs identified by a GWAS. Overall, individual studies were of small sample size and often of poor quality. Future studies would benefit from more rigorous study design as outlined in the Venice recommendations

A Rare Novel Deletion of the Tyrosine Hydroxylase Gene in Parkinson Disease

Tyrosine hydroxylase (TH) enzyme is a rate limiting enzyme in dopamine biosynthesis. Missense mutation in both alleles of the TH gene is known to cause dopamine-related phenotypes, including dystonia and infantile Parkinsonism. However, it is not clear if single allele mutation in TH modifies the susceptibility to the adult form of Parkinson disease (PD). We reported a novel deletion of entire TH gene in an adult with PD. The deletion was first identified by copy number variation (CNV) analysis in a genome-wide association study using Illumina Infinium BeadChips. After screening 635 cases and 642 controls, the deletion was found in one PD case but not in any control. The deletion was confirmed by multiple quantitative PCR (qPCR) assays. There is no additional exonic single nucleotide variant in the one copy of TH gene of the patient. The patient has an age-at-onset of 54 years, no evidence for dystonia, and was responsive to L-DOPA. This case supports the importance of the TH gene in PD pathogenesis and raises more attention to rare variants in candidate genes being a risk factor for Parkinson disease. © 2010 Wiley-Liss, Inc

Prognostic Value of D-Dimer and Markers of Coagulation for Stratification of Abdominal Aortic Aneurysm growth

Abdominal aortic aneurysm (AAA) is associated with high morbidity and mortality and is an established cause of unbalanced hemostasis. A number of hemostatic biomarkers have been associated with AAA; however, the utility of hemostatic biomarkers in AAA diagnosis and prognosis is unclear. The aim of the present study was to characterize the potential prognostic value of D-dimer and markers of altered hemostasis in a large cohort of patients with AAAs characterized by either fast or slow aneurysm growth (frequency matched for baseline diameter) and subaneurysmal dilations. We measured plasma concentrations of thrombin-antithrombin (TAT) complex, platelet factor 4 (PF4), and D-dimer in 352 patients with either fast-growing AAAs (.2 mm/y), slow-growing AAAs (,2 mm/y), subaneurysmal aortic dilations, or nonaneurysmal aortas. Plasma D-dimer and TAT were significantly elevated in both AAA and subaneurysmal dilation patients compared with controls. Individuals with D-dimer levels $500 ng/mL had 3.09 times the odds of subaneurysms, 6.23 times the odds of slow-growing AAAs, and 7.19 times the odds of fast-growing AAAs than individuals with D-dimer level,500 ng/mL. However, no differences in D-dimer concentration were noted between fast- and slow-growing aneurysms. Plasma D-dimer and TAT were strong independent predictors of AAA growth rate with multivariate analysis revealing a 500-ng/mL increase in D-dimer or 1-mg/mL increase in TAT led to additional 0.21-mm and 0.24-mm changes in aortic diameter per year, respectively. Rising levels of plasma TAT, in addition to D-dimer, may predict disease progression and aneurysm growth in patients with AAA or subaneurysmal dilation

Field performance of the Walker Branch throughfall displacement experiment

The authors are conducting a large-scale manipulative field experiments in an upland oak forest on the Walker Branch Watershed in eastern Tennessee USA to identify important ecosystem responses that might result from future precipitation changes. The manipulation of soil moisture is being implemented by a gravity-driven transfer of throughfall precipitation from one treatment plot to another. Throughfall is intercepted in {approx} 2,000 subcanopy troughs (0.3 x 5 m) suspended above the forest floor of the dry plots ({approx} 33% of the ground area is covered) and transferred by gravity flow across an ambient plot for subsequent distribution onto the wet treatment plot. Percent soil water is being monitored with time domain reflectometers at 310 sampling locations across the site. The experimental system is able to produce statistically significant differences in soil water content in years having both extremely dry and extremely wet conditions. Furthermore, comparisons of pre- and post-installation soil temperature measurements have documented the ability of the experimental design to produce these changes without changing the microclimate of the forest understory