A scoping review of caregiver burden during allogeneic HSCT: lessons learned and future directions

The extant literature documents burden among caregivers of patients undergoing a hematopoietic stem cell transplantation (HSCT), but little is known about the burden of caregivers of patients receiving outpatient and homebound HSCTs. This scoping study sought to evaluate what is known about the burden of the increasing number of adult caregivers of patients receiving outpatient HSCTs and to create practice guidelines for how to best support this vulnerable group. Online databases were searched for studies that evaluated caregiver burden in adult caregivers of HSCT patients since 2010 (the publication date of the most recent systematic review on HSCT caregiver burden). Of the 1271 articles retrieved, 12 met the inclusion criteria, though none specifically examined outpatient or homebound caregivers. Overall, studies corroborated existing literature on the experience of significant burden among HSCT caregivers across the HSCT trajectory, and highlighted the emotional costs of outpatient transplants on caregivers and the need to identify caregivers at high risk for burden early in the transplant process. Future studies of outpatient caregivers should include a comprehensive assessment of burden and seek to identify points along the transplant trajectory at which caregivers are at particular risk for negative outcomes and when intervention is most appropriate.

Large-scale discovery of novel genetic causes of developmental disorders

Despite three decades of successful, predominantly phenotype-driven discovery of the genetic causes of monogenic disorders, up to half of children with severe developmental disorders of probable genetic origin remain without a genetic diagnosis. Particularly challenging are those disorders rare enough to have eluded recognition as a discrete clinical entity, those with highly variable clinical manifestations, and those that are difficult to distinguish from other, very similar, disorders. Here we demonstrate the power of using an unbiased genotype-driven approach to identify subsets of patients with similar disorders. By studying 1,133 children with severe, undiagnosed developmental disorders, and their parents, using a combination of exome sequencing and array-based detection of chromosomal rearrangements, we discovered 12 novel genes associated with developmental disorders. These newly implicated genes increase by 10% (from 28% to 31%) the proportion of children that could be diagnosed. Clustering of missense mutations in six of these newly implicated genes suggests that normal development is being perturbed by an activating or dominant-negative mechanism. Our findings demonstrate the value of adopting a comprehensive strategy, both genome-wide and nationwide, to elucidate the underlying causes of rare genetic disorders.

Overexpression of ERG in cord blood progenitors promotes expansion and recapitulates molecular signatures of high ERG leukemias

High expression of the ETS family transcription factor ERG is associated with poor clinical outcome in acute myeloid leukemia (AML) and acute T-cell lymphoblastic leukemia (T-ALL). In murine models, high ERG expression induces both T-ALL and AML. However, no study to date has defined the effect of high ERG expression on primary human hematopoietic cells. In the present study, human CD34+ cells were transduced with retroviral vectors to elevate ERG gene expression to levels detected in high ERG AML. RNA sequencing was performed on purified populations of transduced cells to define the effects of high ERG on gene expression in human CD34+ cells. Integration of the genome-wide expression data with other data sets revealed that high ERG drives an expression signature that shares features of normal hematopoietic stem cells, high ERG AMLs, early T-cell precursor-ALLs and leukemic stem cell signatures associated with poor clinical outcome. Functional assays linked this gene expression profile to enhanced progenitor cell expansion. These results support a model whereby a stem cell gene expression network driven by high ERG in human cells enhances the expansion of the progenitor pool, providing opportunity for the acquisition and propagation of mutations and the development of leukemia.

Constraints on cosmic strings from the LIGO-Virgo gravitational-wave detectors

Cosmic strings can give rise to a large variety of interesting astrophysical phenomena. Among them, powerful bursts of gravitational waves (GWs) produced by cusps are a promising observational signature. In this Letter we present a search for GWs from cosmic string cusps in data collected by the LIGO and Virgo gravitational wave detectors between 2005 and 2010, with over 625 days of live time. We find no evidence of GW signals from cosmic strings. From this result, we derive new constraints on cosmic string parameters, which complement and improve existing limits from previous searches for a stochastic background of GWs from cosmic microwave background measurements and pulsar timing data. In particular, if the size of loops is given by the gravitational backreaction scale, we place upper limits on the string tension Gμ below 10(-8) in some regions of the cosmic string parameter space.

Protein Quantification by MRM for Biomarker Validation

In this chapter we describe how mass spectrometry-based quantitative protein measurements by multiple reaction monitoring (MRM) have opened up the opportunity for the assembly of large panels of candidate protein biomarkers that can be simultaneously validated in large clinical cohorts to identify diagnostic protein biomarker signatures. We outline a workflow in which candidate protein biomarker panels are initially assembled from multiple diverse sources of discovery data, including proteomics and transcriptomics experiments, as well as from candidates found in the literature. Subsequently, the individual candidates in these large panels may be prioritised by application of a range of bioinformatics tools to generate a refined panel for which MRM assays may be developed. We describe a process for MRM assay design and implementation, and illustrate how the data generated from these multiplexed MRM measurements of prioritised candidates may be subjected to a range of statistical tools to create robust biomarker signatures for further clinical validation in large patient sample cohorts. Through this overall approach MRM has the potential to not only support individual biomarker validation but also facilitate the development of clinically useful protein biomarker signatures.

C-Terminal region of teneurin-1 co-localizes with dystroglycan and modulates cytoskeletal organization through an extracellular signal-regulated kinase-dependent stathmin- and filamin A-mediated mechanism in hippocampal cells

The pyramidal neurons in the hippocampus are extremely neuroplastic, and the complexity of dendritic branches can be dynamically altered in response to a variety of stimuli, including learning and stress. Recently, the teneurin family of proteins has emerged as an interneuronal and extracellular matrix signaling system that plays a significant role in brain development and neuronal communication. Encoded on the last exon of the teneurin genes is a new family of bioactive peptides termed the teneurin C-terminal-associated peptides (TCAPs). Previous studies indicate that TCAP-1 regulates axon fasciculation and dendritic morphology in the hippocampus. This study was aimed at understanding the molecular mechanisms by which TCAP-1 regulates these changes in the mouse hippocampus. Fluoresceinisothiocyanate (FITC)-labeled TCAP-1 binds to the pyramidal neurons of the CA2 and CA3, and dentate gyrus in the hippocampus of the mouse brain. Moreover, FITC-TCAP-1 co-localizes with β-dystroglycan upon binding to the plasma membrane of cultured immortalized mouse E14 hippocampal cells. In culture, TCAP-1 stimulates ERK1/2-dependent phosphorylation of the cytoskeletal regulatory proteins, stathmin at serine-25 and filamin A at serine-2152. In addition, TCAP-1 induces actin polymerization, increases immunoreactivity of tubulin-based cytoskeletal elements and causes a corresponding increase in filopodia formation and mean filopodia length in cultured hippocampal cells. We postulate that the TCAP-1 region of teneurin-1 has a direct action on the cytoskeletal reorganization that precedes neurite and process development in hippocampal neurons. Our data provides novel evidence that functionally links the teneurin and dystroglycan systems and provides new insight into the molecular mechanisms by which TCAP-1 regulates cytoskeletal dynamics in hippocampal neurons. The TCAP-dystroglycan system may represent a novel mechanism associated with the regulation of hippocampal-function.

Assessing options for the development of surface water flood warning in England and Wales

This paper explores the technical options for warning of surface water flooding in England and Wales and presents the results of an Environment Agency funded project. Following the extensive surface water flooding experienced in summer 2007 a rainfall threshold-based Extreme Rainfall Alert (ERA) was piloted by the Met Office and Environment Agency providing initial steps towards the establishment of a warning for some types of surface water flooding. The findings of this paper are based primarily on feedback on technical options from a range of professionals involved in flood forecasting and warning and flood risk management, about the current alerts and about the potential options for developing a more targeted surface water flood warning service. Providing surface water flooding warnings presents a set of technical, forecasting and warning challenges related to the rapid onset of flooding, the localised nature of the flooding, and the linking of rainfall and flood forecasts to flood likelihood and impact on the ground. Some examples of rainfall alerting and surface water flood warning services from other countries are evaluated, as well as a small number of recently implemented local services in England and Wales. Various potential options for implementation of a service are then explored and assessed. The paper concludes that development of a surface water flood warning service for England and Wales is feasible and is likely to be useful to emergency responders and operational agencies, although developing such a service for the pluvial components of this type of flooding is likely to be feasible sooner than for other components of surface water flooding such as that caused by sewers. A targeted surface water flood warning service could be developed for professional emergency responders in the first instance rather than for the public for whom such a service without further operational testing and piloting would be premature.

Surfactant Protein-A modulates induction of regulatory T cells in the lung via TGFβ (168.8)

TCR signaling plays a critical role in regulatory T cell (Treg) development. However, the mechanism for tissue specific induction of Tregs in the periphery remains unclear. Surfactant protein A (SP-A) is a major immune defense protein in the lung. To determine if SP-A contributes to the normal non-inflammatory status mediated by Tregs in the lung, T cells were activated with various stimuli. Compared to WT mice, on ex vivo culture, T cells from lungs of SP-A deficient mice have impaired expression of Foxp3 and fewer CD25+Foxp3+ Treg phenotype cells. These phenotypic effects could be rescued by the addition of exogenous SP-A. Even as cell cycle progression is blocked, both IL-2 levels as well as active TGFβ levels increase on extended culture. In addition, kinetic suppression assays demonstrate that SP-A enhances the frequency of functional Foxp3+Tregs in responder T cell populations in a TGFβ dependent manner. To induce Tregs in the lung in vivo, we modified the extended LPS model described by d’Alessio et al (1). While the proportion of Tregs increased ≈160% in WT mice ~8d post-exposure, SP-A-/- mice showed a much more modest 50% increase over their near identical baselines. We also observed a strong correlation between FR4 and Foxp3 expression in functional Tregs induced by SP-A. Together, these findings suggest that SP-A exerts long-term effects on T cell immune function by the induction of Tregs during activation. (1) D’Alessio et al J Clin Invest. (2009) 119: 2898

Annealing Study of Ion Implanted MOCVD and MBE Grown GaN

MOCVD and MBE grown GaN were implanted with Ar, Mg, Si, Be, C, and O, and annealed in a conventional oven under flowing NH3 or N2 gas. Absorption measurements confirmed that implantation damage was annealed out after 90 minutes at a temperature of 1000 °C. Surface damage caused by NH3 annealing was evident in absorption and photoluminescence measurements for annealing temperatures of over 1000 °C. Although most of the implants showed no unique luminescence peaks, systematic changes in the relative intensities of the exciton, donor-acceptor pair, and yellow peaks were noted. The Mg implanted samples showed evidence of the acceptor bound exciton line at 3.44 eV, and a unique peak at 3.3 eV possibly due to a Mg free-to-bound transition.

Shot noise suppression at room temperature in atomic-scale Au junctions

Shot noise encodes additional information not directly inferable from simple electronic transport measurements. Previous measurements in atomic-scale metal junctions at cryogenic temperatures have shown suppression of the shot noise at particular conductance values. This suppression demonstrates that transport in these structures proceeds via discrete quantum channels. Using a high-frequency technique, we simultaneously acquire noise data and conductance histograms in Au junctions at room temperature and ambient conditions. We observe noise suppression at up to three conductance quanta, with possible indications of current-induced local heating and 1/f noise in the contact region at high biases. These measurements demonstrate the quantum character of transport at room temperature at the atomic scale. This technique provides an additional tool for studying dissipation and correlations in nanodevices.

Cofermentation of glucose, xylose, and arabinose by mixed cultures of two genetically engineered Zymomonas mobilis strains

Cofermentation of xylose and arabinose, in addition to glucose, is critical for complete bioconversion of lignocellulosic biomass, such as agricultural residues and herbaceous energy crops, to ethanol. A factorial design experiment was used to evaluate the cofermentation of glucose, xylose, and arabinose with mixed cultures of two genetically engineered Zymomonas mobilis strains (one ferments xylose and the other arabinose). The pH range studied was 5.0-6.0, and the temperature range was 30-37 degrees C. The individual sugar concentrations used were 30 g/L glucose, 30 g/L xylose, and 20 g/L arabinose. The optimal cofermentation conditions obtained by data analysis, using Design Expert software, were pH 5.85 and temperature 31.5 degrees C. The cofermentation process yield at optimal conditions was 72.5% of theoretical maximum. The results showed that neither the arabinose strain nor arabinose affected the performance of the xylose strain; however, both xylose strain and xylose had a significant effect on the performance of the arabinose strain. Although cofermentation of all three sugars is achieved by the mixed cultures, there is a preferential order of sugar utilization. Glucose is used rapidly, then xylose, followed by arabinose.

Retinal dystrophies and genetic counselling

Increased patient demand is leading to a corresponding increase in the need for informed genetic counselling in ophthalmic practice which requires refined diagnosis, and a detailed knowledge of molecular genetics. Accurate assessment of risk and visual potential in prospective children is becoming available for a range of retinal dystrophies allowing for more educated decisions to be made by parents.