Evaluation and classification of severity for 176 genes on an expanded carrier screening panel

Background

Disease severity is important when considering genes for inclusion on reproductive expanded carrier screening (ECS) panels. We applied a validated and previously published algorithm that classifies diseases into four severity categories (mild, moderate, severe, and profound) to 176 genes screened by ECS. Disease traits defining severity categories in the algorithm were then mapped to four severity-related ECS panel design criteria cited by the American College of Obstetricians and Gynecologists (ACOG).

Methods

Eight genetic counselors (GCs) and four medical geneticists (MDs) applied the severity algorithm to subsets of 176 genes. MDs and GCs then determined by group consensus how each of these disease traits mapped to ACOG severity criteria, enabling determination of the number of ACOG severity criteria met by each gene.

Results

Upon consensus GC and MD application of the severity algorithm, 68 (39%) genes were classified as profound, 71 (40%) as severe, 36 (20%) as moderate, and one (1%) as mild. After mapping of disease traits to ACOG severity criteria, 170 out of 176 genes (96.6%) were found to meet at least one of the four criteria, 129 genes (73.3%) met at least two, 73 genes (41.5%) met at least three, and 17 genes (9.7%) met all four.

Conclusion

This study classified the severity of a large set of Mendelian genes by collaborative clinical expert application of a trait-based algorithm. Further, it operationalized difficult to interpret ACOG severity criteria via mapping of disease traits, thereby promoting consistency of ACOG criteria interpretation.

     

Stimulation of aerobic degradation of chlorinated ethenes in soil by microbial inoculation

Degradation of chlorinated ethenes under aerobic conditions has been reported using a cometabolic pathway. A site in Illinois had shallow contamination and sandy soils, which in combination created aerobic conditions. The aerobic conditions prevented the degradation of chlorinated ethenes by reductive dechlorination. Biodegradation of chloroethenes under aerobic conditions does not occur naturally at all sites; however, it can be enhanced if microorganisms capable of cometabolic degradation are introduced into the soil. In this study, trichloroethene (TCE) removal in the soil was enhanced by the injection of a commercially available microbial inoculum (CL‐OUT® inoculum, CL‐Solutions, Cincinnati, OH) and nutrients and was compared to chlorinated ethene removal in soil that had received nutrients only and soil that had received activated sludge and nutrients. Trichloroethene removal was measured after one week, seven weeks, and eleven weeks. After one week, no significant TCE removal had occurred in any of the test microcosms. After seven weeks, a slight decrease in TCE levels accompanied by an increase in cis‐1,2‐dichloroethene (cis‐1,2‐DCE) was seen in the microcosms that had received CL‐OUT®. After 11 weeks, a marked decrease in TCE levels was observed in the microcosms that had received CL‐OUT®. No significant TCE decrease was observed in any of the other microcosms. These data suggest that organisms capable of aerobic TCE degradation were not present at the site; however, the addition of an inoculum containing such organisms enabled aerobic degradation to occur. © 2008 Wiley Periodicals, Inc.     

A plasma display window?-The shifting baseline problem in a technologically mediated natural world

Humans will continue to adapt to an increasingly technological world. But are there costs to such adaptations in terms of human well being? Toward broaching this question, we investigated physiological effects of experiencing a HDTV quality real-time view of nature through a plasma display “window.” In an office setting, 90 participants (30 per group) were exposed either to (a) a glass window that afforded a view of a nature scene, (b) a plasma window that afforded a real-time HDTV view of essentially the same scene, or (c) a blank wall. Results showed that in terms of heart rate recovery from low-level stress the glass window was more restorative than a blank wall; in turn, a plasma window was no more restorative than a blank wall. Moreover, when participants spent more time looking at the glass window, their heart rate tended to decrease more rapidly; that was not the case with the plasma window. Discussion focuses on how the purported benefits of viewing nature may be attenuated by a digital medium.