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Vermeulen LM, Verbist B, Van Meerbeek K, Slingsby J, Bernardino PN, Somers B. Wetness severity increases abrupt shifts in ecosystem functioning in arid savannas. Glob Chang Biol 2024; 30:e17235. [PMID: 38497525 DOI: 10.1111/gcb.17235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/08/2024] [Accepted: 02/22/2024] [Indexed: 03/19/2024]
Abstract
The accelerating pace of climate change has led to unprecedented shifts in surface temperature and precipitation patterns worldwide, with African savannas being among the most vulnerable regions. Understanding the impacts of these extreme changes on ecosystem health, functioning and stability is crucial. This paper focuses on the detection of breakpoints, indicative of shifts in ecosystem functioning, while also determining relevant ecosystem characteristics and climatic drivers that increase susceptibility to these shifts within the semi-arid to arid savanna biome. Utilising a remote sensing change detection approach and rain use efficiency (RaUE) as a proxy for ecosystem functioning, spatial and temporal patterns of breakpoints in the savanna biome were identified. We then employed a novel combination of survival analysis and remote sensing time series analysis to compare ecosystem characteristics and climatic drivers in areas experiencing breakpoints versus areas with stable ecosystem functioning. Key ecosystem factors increasing savanna breakpoint susceptibility were identified, namely higher soil sand content, flatter terrain and a cooler long-term mean temperature during the wet summer season. Moreover, the primary driver of changes in ecosystem functioning in arid savannas, as opposed to wetter tropical savannas, was found to be the increased frequency and severity of rainfall events, rather than drought pressures. This research highlights the importance of incorporating wetness severity metrics alongside drought metrics to comprehensively understand climate-ecosystem interactions leading to abrupt shifts in ecosystem functioning in arid biomes. The findings also emphasise the need to consider the underlying ecosystem characteristics, including soil, topography and vegetation composition, in assessing ecosystem responses to climate change. While this research primarily concentrated on the southern African savanna as a case study, the methodological robustness of this approach enables its application to diverse arid and semi-arid biomes for the assessment of climate-ecosystem interactions that contribute to abrupt shifts.
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Affiliation(s)
- L M Vermeulen
- Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa
| | - B Verbist
- Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
| | - K Van Meerbeek
- Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
| | - J Slingsby
- Department of Biological Sciences and Centre for Statistics in Ecology, Environment and Conservation, University of Cape Town, Cape Town, South Africa
- Fynbos Node, South African Environmental Observation Network, Centre for Biodiversity Conservation, Cape Town, South Africa
| | - P N Bernardino
- Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
- Department of Plant Biology, University of Campinas, Campinas, SP, Brazil
| | - B Somers
- Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
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Lee T, Schuman JS, Ramos Cadena MDLA, Zhang Y, Wollstein G, Hu J. LIMBARE: An Advanced Linear Mixed-Effects Breakpoint Analysis With Robust Estimation Method With Applications to Longitudinal Ophthalmic Studies. Transl Vis Sci Technol 2024; 13:19. [PMID: 38241038 PMCID: PMC10807490 DOI: 10.1167/tvst.13.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/03/2023] [Indexed: 01/23/2024] Open
Abstract
Purpose Broken stick analysis is a widely used approach for detecting unknown breakpoints where the association between measurements is nonlinear. We propose LIMBARE, an advanced linear mixed-effects breakpoint analysis with robust estimation, especially designed for longitudinal ophthalmic studies. LIMBARE accommodates repeated measurements from both eyes and over time, and it effectively addresses the presence of outliers. Methods The model setup of LIMBARE and the computing algorithm for point and confidence interval estimates of the breakpoint were introduced. The performance of LIMBARE and other competing methods was assessed via comprehensive simulation studies and application to a longitudinal ophthalmic study with 216 eyes (145 subjects) followed for an average of 3.7 ± 1.3 years to examine the longitudinal association between structural and functional measurements. Results In simulation studies, LIMBARE showed the smallest bias and mean squared error for estimating the breakpoint, with an empirical coverage probability of corresponding confidence interval estimates closest to the nominal level for scenarios with and without outlier data points. In the application to the longitudinal ophthalmic study, LIMBARE detected two breakpoints between visual field mean deviation (MD) and retinal nerve fiber layer thickness and one breakpoint between MD and cup-to-disc ratio, whereas the cross-sectional analysis approach detected only one and none, respectively. Conclusions LIMBARE enhances breakpoint estimation accuracy in longitudinal ophthalmic studies, and the cross-sectional analysis approach is not recommended for future studies. Translational Relevance Our proposed method and companion R package provide a valuable computational tool for advancing longitudinal ophthalmology research and exploring the association relationships among ophthalmic variables.
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Affiliation(s)
- TingFang Lee
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY, USA
| | | | - Yan Zhang
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY, USA
| | - Jiyuan Hu
- Department of Population Health, NYU Langone Health, New York, NY, USA
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Marashi A, Warren D, Call G, Dras M. Trends in Opioid Medication Adherence During the COVID-19 Pandemic: Retrospective Cohort Study. JMIR Public Health Surveill 2023; 9:e42495. [PMID: 37656492 PMCID: PMC10504620 DOI: 10.2196/42495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 05/09/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The recent pandemic had the potential to worsen the opioid crisis through multiple effects on patients' lives, such as the disruption of care. In particular, good levels of adherence with respect to medication for opioid use disorder (MOUD), recognized as being important for positive outcomes, may be disrupted. OBJECTIVE This study aimed to investigate whether patients on MOUD experienced a drop in medication adherence during the recent COVID-19 pandemic. METHODS This retrospective cohort study used Medicaid claims data from 6 US states from 2018 until the start of 2021. We compared medication adherence for people on MOUD before and after the beginning of the COVID-19 pandemic in March 2020. Our main measure was the proportion of days covered (PDC), a score that measures patients' adherence to their MOUD. We carried out a breakpoint analysis on PDC, followed by a patient-level beta regression analysis with PDC as the dependent variable while controlling for a set of covariates. RESULTS A total of 79,991 PDC scores were calculated for 37,604 patients (age: mean 37.6, SD 9.8 years; sex: n=17,825, 47.4% female) between 2018 and 2021. The coefficient for the effect of COVID-19 on PDC score was -0.076 and was statistically significant (odds ratio 0.925, 95% CI 0.90-0.94). CONCLUSIONS The COVID-19 pandemic was negatively associated with patients' adherence to their medication, which had declined since the beginning of the pandemic.
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Affiliation(s)
- Amir Marashi
- School of Computing, Macquarie University, Macquarie Park, Australia
| | - David Warren
- School of Computing, Macquarie University, Macquarie Park, Australia
| | - Gary Call
- Gainwell Technologies, Tysons, VA, United States
| | - Mark Dras
- School of Computing, Macquarie University, Macquarie Park, Australia
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Hu H, Yang XW, Cheng DH, Li XR, He WB, Hu X, Gao BD, Zhao XM, Zhang QJ, Du J, Liu JY, Lu GX, Ge L, Li W. A DMD case caused by X chromosome rearrangement. Yi Chuan 2023; 45:88-95. [PMID: 36927641 DOI: 10.16288/j.yczz.22-179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Duchenne/Becker muscular dystrophy (DMD/BMD) is one of the most common progressive muscular dystrophy diseases with X-linked recessive inheritance. It is mainly caused by the deletion, duplication and point mutation of DMD gene. In rare cases, it is also caused by the destruction of DMD gene by chromosomal structural rearrangement. Here, we report a case of Duchenne/Becker Muscular dystrophy (DMD/BMD) with typical symptoms but unknown genetic defects after MLPA and next generation sequencing tests in other hospitals. Interestingly, we find a pericentric inversion of X chromosome (Chr.X: g. [31939463-31939465del; 31939466-131765063 inv; 131765064-131765067del]) in this patient. We then use the karyotyping, FISH, long-read sequencing and Sanger sequencing technologies to characterize the chromosome rearrangement. We find that this chromosomal aberration disrupt both the DMD gene and the HS6ST2 gene. The patient present with typical DMD symptoms such as muscle weakness, but no obvious symptoms of Paganini-Miozzo syndrome. Our results suggest that the destruction of DMD gene by structural rearrangement is also one of the important causes of DMD. Therefore, we suggest to provide further genetic testing for those DMD patients with unknown genetic defects through routine genetic testing. Cost-effective karyotyping and FISH should be considered firstly to identify chromosome rearrangements. Long-read sequencing followed by Sanger sequencing could be useful to locate the precise breakpoints. The genetic diagnosis of this case made it possible for reproductive intervention in the patient's family.
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Affiliation(s)
- Hao Hu
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Xiao-Wen Yang
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - De-Hua Cheng
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Xiu-Rong Li
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Wen-Bin He
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Xiao Hu
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Bo-di Gao
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Xiao-Meng Zhao
- 3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Qian-Jun Zhang
- 1. Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Sciences, Central South University, Changsha 410078, China.,2. National Engineering Research Center of Human Stem Cells, Changsha 410078, China.,3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Juan Du
- 1. Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Sciences, Central South University, Changsha 410078, China.,3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Ji-Yang Liu
- 5. Municipal Health Commission of Changsha, Changsha 410023, China
| | - Guang-Xiu Lu
- 1. Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Sciences, Central South University, Changsha 410078, China.,2. National Engineering Research Center of Human Stem Cells, Changsha 410078, China.,3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Lin Ge
- 1. Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Sciences, Central South University, Changsha 410078, China.,2. National Engineering Research Center of Human Stem Cells, Changsha 410078, China.,3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
| | - Wen Li
- 1. Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Sciences, Central South University, Changsha 410078, China.,3. CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410078, China.,4. Hunan Provincial Clinical Research Center of Reproduction and Genetics, Changsha 410078, China
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5
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Bushra N, Rohli RV, Li C, Miller PW, Mostafiz RB. Changing features of the Northern Hemisphere 500-hPa circumpolar vortex. Front Big Data 2023; 5:1009158. [PMID: 36700138 PMCID: PMC9869373 DOI: 10.3389/fdata.2022.1009158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/07/2022] [Indexed: 01/11/2023] Open
Abstract
The tropospheric circumpolar vortex (CPV), an important signature of processes steering the general atmospheric circulation, surrounds each pole and is linked to the surface weather conditions. The CPV can be characterized by its area and circularity ratio (R c ), which both vary temporally. This research advances previous work identifying the daily 500-hPa Northern Hemispheric CPV (NHCPV) area, R c , and temporal trends in its centroid by examining linear trends and periodic cycles in NHCPV area and R c (1979-2017). Results suggest that NHCPV area has increased linearly over time. However, a more representative signal of the planetary warming may be the temporally weakening gradient which has blurred NHCPV distinctiveness-perhaps a new indicator of Arctic amplification. R c displays opposing trends in subperiods and an insignificant overall trend. Distinct annual and semiannual cycles exist for area and R c over all subperiods. These features of NHCPV change over time may impact surface weather/climate.
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Affiliation(s)
- Nazla Bushra
- Department of Oceanography and Coastal Sciences, College of the Coast and Environment, Louisiana State University, Baton Rouge, LA, United States,Coastal Studies Institute, Louisiana State University, Baton Rouge, LA, United States,*Correspondence: Nazla Bushra ✉
| | - Robert V. Rohli
- Department of Oceanography and Coastal Sciences, College of the Coast and Environment, Louisiana State University, Baton Rouge, LA, United States,Coastal Studies Institute, Louisiana State University, Baton Rouge, LA, United States
| | - Chunyan Li
- Department of Oceanography and Coastal Sciences, College of the Coast and Environment, Louisiana State University, Baton Rouge, LA, United States,Coastal Studies Institute, Louisiana State University, Baton Rouge, LA, United States
| | - Paul W. Miller
- Department of Oceanography and Coastal Sciences, College of the Coast and Environment, Louisiana State University, Baton Rouge, LA, United States,Coastal Studies Institute, Louisiana State University, Baton Rouge, LA, United States
| | - Rubayet Bin Mostafiz
- Department of Oceanography and Coastal Sciences, College of the Coast and Environment, Louisiana State University, Baton Rouge, LA, United States,Coastal Studies Institute, Louisiana State University, Baton Rouge, LA, United States
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He W, Meng G, Hu X, Dai J, Liu J, Li X, Hu H, Tan Y, Zhang Q, Lu G, Lin G, Du J. Reclassification of DMD Duplications as Benign: Recommendations for Cautious Interpretation of Variants Identified in Prenatal Screening. Genes (Basel) 2022; 13:1972. [PMID: 36360209 PMCID: PMC9690433 DOI: 10.3390/genes13111972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/1970] [Revised: 10/15/2022] [Accepted: 10/26/2022] [Indexed: 09/09/2023] Open
Abstract
Duplications are the main type of dystrophin gene (DMD) variants, which typically cause dystrophinopathies such as Duchenne muscular dystrophy and Becker muscular dystrophy. Maternally inherited exon duplication in DMD in fetuses is a relatively common finding of genetic screening in clinical practice. However, there is no standard strategy for interpretation of the pathogenicity of DMD duplications during prenatal screening, especially for male fetuses, in which maternally inherited pathogenic DMD variants more frequently cause dystrophinopathies. Here, we report three non-contiguous DMD duplications identified in a woman and her male fetus during prenatal screening. Multiplex ligation probe amplification and long-read sequencing were performed on the woman and her family members to verify the presence of DMD duplications. Structural rearrangements in the DMD gene were mapped by long-read sequencing, and the breakpoint junction sequences were validated using Sanger sequencing. The woman and her father carried three non-contiguous DMD duplications. Long-read and Sanger sequencing revealed that the woman's father carried an intact DMD copy and a complex structural rearrangement of the DMD gene. Therefore, we reclassified these three non-contiguous DMD duplications, one of which is listed as pathogenic, as benign. We postulate that breakpoint analysis should be performed on identified DMD duplication variants, and the pathogenicity of the duplications found during prenatal screening should be interpreted cautiously for clinical prediction and genetic/reproductive counseling.
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Affiliation(s)
- Wenbin He
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Guiquan Meng
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
| | - Xiao Hu
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Jing Dai
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Jiyang Liu
- Changsha Health Committee, Changsha 410006, China
| | - Xiurong Li
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Hao Hu
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
| | - Yueqiu Tan
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Qianjun Zhang
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Guangxiu Lu
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Juan Du
- Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha 410006, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
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7
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Bai Y, Liu J, Xu J, Sun Y, Li J, Gao Y, Liu L, Jia C, Kong X, Wang L. Long-Read Sequencing Revealed Extragenic and Intragenic Duplications of Exons 56-61 in DMD in an Asymptomatic Male and a DMD Patient. Front Genet 2022; 13:878806. [PMID: 35615378 PMCID: PMC9125615 DOI: 10.3389/fgene.2022.878806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Expanded carrier screening (ECS) has become an increasingly common technique to assess the genetic risks of individuals in the prenatal or preconception period. Unexpected variants unrelated to referral are being increasingly detected in asymptomatic individuals through ECS. In this study, we reported an asymptomatic male with duplication of exons 56-61 in the DMD gene through ECS using whole-exome sequencing (WES), which was also detected in a male patient diagnosed with typical Duchenne muscular dystrophy (DMD). Breakpoint analysis was then performed to explore the potential mechanisms of phenotypic differences using long-read sequencing (LRS), PacBio single-molecule real-time (PacBio SMRT) target sequencing, and Sanger sequencing. Complex structural variations (SVs) on chromosome X were identified in the asymptomatic male, which revealed that the duplication occurred outside the DMD gene; whereas, the duplication in the patient with DMD was a tandem repeat. The phenotypic differences between the two men could be explained by the different breakpoint junctions. To the best of our knowledge, this is the first report of a breakpoint analysis of DMD duplication in two men with different phenotypes. Breakpoint analysis is necessary when the clinical phenotypes are inconsistent with genotypes, and it applies to prenatal testing.
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Affiliation(s)
- Ying Bai
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ju Liu
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinghan Xu
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yue Sun
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingjing Li
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Gao
- GrandOmics Biosciences, Beijing, China
| | - Lina Liu
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Xiangdong Kong
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Wang
- Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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