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2092 A multicenter study of fecal microbiota transplantation for Clostridium difficile infection in children
- Maribeth R. Nicholson, Erin Alexander, Mark Bartlett, Penny Becker, Zev Davidovics, Elizabeth E. Knackstedt, Michael Docktor, Michael Dole, Grace Felix, Jonathan Gisser, Suchitra Hourigan, Kyle Jensen, Jess Kaplan, Judith Kelsen, Melissa Kennedy, Sahil Khanna, McKenzie Leier, Jeffery Lewis, Ashley Lodarek, Sonia Michail, Paul Mitchell, Maria Oliva‐Hemker, Tiffany Patton, Karen Queliza, Namita Singh, Aliza Solomon, David Suskind, Steven Werlin, Richard Kellermayer, Stacy Kahn
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, p. 64
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- Article
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- You have access Access
- Open access
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OBJECTIVES/SPECIFIC AIMS: Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and an increasingly common infection in children in both hospital and community settings. Between 20% and 30% of pediatric patients will have a recurrence of symptoms in the days to weeks following an initial infection. Multiple recurrences have been successfully treated with fecal microbiota transplantation (FMT), though the body of evidence in pediatric patients is limited primarily to case reports and case series. The goal of our study was to better understand practices, success, and safety of FMT in children as well as identify risk factors associated with a failed FMT in our pediatric patients. METHODS/STUDY POPULATION: This multicenter retrospective analysis included 373 patients who underwent FMT for CDI between January 1, 2006 and January 1, 2017 from 18 pediatric centers. Demographics, baseline characteristics, FMT practices, C. difficile outcomes, and post-FMT complications were collected through chart abstraction. Successful FMT was defined as no recurrence of CDI within 60 days after FMT. Of the 373 patients in the cohort, 342 had known outcome data at two months post-FMT and were included in the primary analysis evaluating risk factors for recurrence post-FMT. An additional six patients who underwent FMT for refractory CDI were excluded from the primary analysis. Unadjusted analysis was performed using Wilcoxon rank-sum test, Pearson χ2 test, or Fisher exact test where appropriate. Stepwise logistic regression was utilized to determine independent predictors of success. RESULTS/ANTICIPATED RESULTS: The median age of included patients was 10 years (IQR; 3.0, 15.0) and 50% of patients were female. The majority of the cohort was White (89.0%). Comorbidities included 120 patients with inflammatory bowel disease (IBD) and 14 patients who had undergone a solid organ or stem cell transplantation. Of the 336 patients with known outcomes at two months, 272 (81%) had a successful outcome. In the 64 (19%) patients that did have a recurrence, 35 underwent repeat FMT which was successful in 20 of the 35 (57%). The overall success rate of FMT in preventing further episodes of CDI in the cohort with known outcome data was 87%. Unadjusted predictors of a primary FMT response are summarized. Based on stepwise logistic regression modeling, the use of fresh stool, FMT delivery via colonoscopy, the lack of a feeding tube, and a lower number of CDI episodes before undergoing FMT were independently associated with a successful outcome. There were 20 adverse events in the cohort assessed to be related to FMT, 6 of which were felt to be severe. There were no deaths assessed to be related to FMT in the cohort. DISCUSSION/SIGNIFICANCE OF IMPACT: The overall success of FMT in pediatric patients with recurrent or severe CDI is 81% after a single FMT. Children without a feeding tube, who receive an early FMT, FMT with fresh stool, or FMT via colonoscopy are less likely to have a recurrence of CDI in the 2 months following FMT. This is the first large study of FMT for CDI in a pediatric cohort. These findings, if confirmed by additional prospective studies, will support alterations in the practice of FMT in children.
9 - “Math is hard!” (Barbie™, 1994): Responses of Threat vs. Challenge-Mediated Arousal to Stereotypes Alleging Intellectual Inferiority
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- By Talia Ben-Zeev, San Francisco State University, Cristina M. Carrasquillo, San Francisco State University, Alison M. L. Ching, San Francisco State University, Tattiya J. Kliengklom, San Francisco State University, Kristen L. McDonald, San Francisco State University, Daniel C. Newhall, San Francisco State University, Gillian E. Patton, San Francisco State University, Tiffany D. Stewart, San Francisco State University, Tonya Stoddard, San Francisco State University, Michael Inzlicht, New York University, Steven Fein, Williams Collage
- Edited by Ann M. Gallagher, James C. Kaufman, California State University, San Bernardino
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- Book:
- Gender Differences in Mathematics
- Published online:
- 05 June 2012
- Print publication:
- 27 December 2004, pp 189-206
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Summary
In 1994, Mattel created a Barbie™ doll that said, “Math is hard.” The Barbie Liberation Organization, a group composed of activists and media personalities, among others, protested against Barbie's perpetuation of gender-based stereotyping. The media publicized the case and discussions on gender stereotyping in children's toys ensued on and off the air, leading Mattel to withdraw the “math is hard” Barbie from the market.
However, did Barbie's frustration with math represent a reality in which girls and women, more than boys and men, find math to be hard? Benbow and Stanley (1980, 1983) found gender differences in performance on the mathematical section of the SAT (SAT-M) in boys and girls under the age of fourteen who were high in math achievement. The boys outperformed the girls by about half a standard deviation and were overrepresented by a ratio of 13:1 among students who scored above 700. Similarly, in a meta-analysis involving over three million participants, Hyde, Fennema, and Lamon (1990) found a gender difference favoring males that emerged from high school (d = 0.29) through college (d = 0.41), and into adulthood (d = 0.59). Finally, Brown and Josephs (1999) reported that the two most widely used standardized tests of mathematics in the United States, the SAT-M and the quantitative portion of the GRE (GRE-Q), revealed a gender difference in the order of half a standard deviation.
This gender difference can also be seen in the types of activities that females vs. males tend to pursue.