Myelodysplastic syndromes (MDS) are a clonal disease arising from hematopoietic stem cells, that are characterized by ineffective hematopoiesis (leading to peripheral blood cytopenia) and by an ...increased risk of evolution into acute myeloid leukemia. MDS are driven by a complex combination of genetic mutations that results in heterogeneous clinical phenotype and outcome. Genetic studies have enabled the identification of a set of recurrently mutated genes which are central to the pathogenesis of MDS and can be organized into a limited number of cellular pathways, including RNA splicing (
,
,
,
genes), DNA methylation (
,
,
), transcription regulation (
), signal transduction (
,
), DNA repair (
), chromatin modification (
,
), and cohesin complex (
). Few genes are consistently mutated in >10% of patients, whereas a long tail of 40-50 genes are mutated in <5% of cases. At diagnosis, the majority of MDS patients have 2-4 driver mutations and hundreds of background mutations. Reliable genotype/phenotype relationships were described in MDS:
mutations are associated with the presence of ring sideroblasts and more recent studies indicate that other splicing mutations (
,
) may identify distinct disease categories with specific hematological features. Moreover, gene mutations have been shown to influence the probability of survival and risk of disease progression and mutational status may add significant information to currently available prognostic tools. For instance,
mutations are predictors of favourable prognosis, while driver mutations of other genes (such as
,
,
,
) are associated with a reduced probability of survival and increased risk of disease progression. In this article, we review the most recent advances in our understanding of the genetic basis of myelodysplastic syndromes and discuss its clinical relevance.
Recurrently mutated genes and chromosomal abnormalities have been identified in myelodysplastic syndromes (MDS). We aim to integrate these genomic features into disease classification and ...prognostication.
We retrospectively enrolled 2,043 patients. Using Bayesian networks and Dirichlet processes, we combined mutations in 47 genes with cytogenetic abnormalities to identify genetic associations and subgroups. Random-effects Cox proportional hazards multistate modeling was used for developing prognostic models. An independent validation on 318 cases was performed.
We identify eight MDS groups (clusters) according to specific genomic features. In five groups, dominant genomic features include splicing gene mutations (
,
, and
) that occur early in disease history, determine specific phenotypes, and drive disease evolution. These groups display different prognosis (groups with
mutations being associated with better survival). Specific co-mutation patterns account for clinical heterogeneity within
- and
-related MDS. MDS with complex karyotype and/or
gene abnormalities and MDS with acute leukemia-like mutations show poorest prognosis. MDS with 5q deletion are clustered into two distinct groups according to the number of mutated genes and/or presence of
mutations. By integrating 63 clinical and genomic variables, we define a novel prognostic model that generates personally tailored predictions of survival. The predicted and observed outcomes correlate well in internal cross-validation and in an independent external cohort. This model substantially improves predictive accuracy of currently available prognostic tools. We have created a Web portal that allows outcome predictions to be generated for user-defined constellations of genomic and clinical features.
Genomic landscape in MDS reveals distinct subgroups associated with specific clinical features and discrete patterns of evolution, providing a proof of concept for next-generation disease classification and prognosis.
The main goal of the present study was to develop a procedure for the simultaneous GC/MS analysis of a wide range of water-soluble organic compounds (WSOCs, mainly dicarboxylic acids and sugars) in ...atmospheric aerosol as chemical markers of atmospheric processes. The response surface methodology, including central composite design, was applied to systematically investigate and optimize the operating conditions of a solvent extraction method as the most widely used procedure for determining WSOCs in particulate matter (PM) samples. A solvent mixture of methanol/dichloromethane (90:10) and a volume of 10 ml were the optimum conditions that permit the simultaneous analysis of 30 target WSOCs, including dicarboxylic acids and sugars. Recoveries and limits of detection were determined for a standard mixture containing target analytes, and they varied from 79 to 103 % and 0.3 to 1 ng m
−3
, respectively. The optimized procedure was used for the analysis of field PM filters and demonstrated its feasibility in detecting several important environmental WSOCs.
The peak loads experienced by aircraft of all scales will typically be during gusts, turbulence or extreme manoeuvres. Understanding the aerodynamic response to these transient disturbances is ...therefore crucial, particularly when Leading-Edge Vortices (LEVs) occur. This fundamental study investigates the aerodynamic response to a wide range of transient plunging motions. The peak loads exhibited a strong dependence to motion amplitude yet remained relatively insensitive to motion duration. Within the parameter range tested (motion duration of T ¡ 20τ, or equivalent reduced frequency k ¡ 1, and plunge amplitude of αpl,peak≤ 30°), the peak lift did not exceed that of the quasi-static thin airfoil theory prediction, permitting its use as a safe limit for structural design. The normalized peak lift change displayed weak collapse with the timescale of the motion and instead showed better correlation with the non-dimensional plunge rate. The peak pitching moment scales well with plunge rate according to the theoretical prediction due to the added-mass component for plunge-up motions, but quickly diverges for plunge-down motions. At post-stall angles of attack, large-scale vortex shedding was observed and caused decaying oscillations in the loads long after the transient motion ends. For both a NACA 0012 and flat plate airfoil, the first vortex shedding cycle after the transient motion occurs around the subharmonic of the static shedding frequency. Subsequent shedding cycles then increase in frequency and asymptotically approach the static shedding frequency in around 15 to 20 convective times. This is the first study to experimentally quantify this behavior and is an aspect currently missing in existing reduced-order models, which could be significant for the prediction of successive transient disturbances. Finally, Reynolds number insensitivity was demonstrated for transient disturbances between 20,000 and 150,000, even for post-stall angles of attack where large-scale vortex shedding can occur.
Inherited hearing loss is extremely heterogeneous both clinically and genetically. In addition, the spectrum of deafness-causing genetic variants differs greatly among geographical areas and ...ethnicities. The identification of the causal mutation in affected families allows early diagnosis, clinical follow-up, and genetic counseling. A large consanguineous family of Moroccan origin affected by autosomal recessive sensorineural hearing loss (ARSNHL) was subjected to genome-wide linkage analysis and exome sequencing. Exome-wide variant analysis and prioritization identified the
p.C113Y missense variant (rs768484124) as the most likely cause of ARSNHL in the family, falling within the unique significant (LOD score>3) linkage region on chromosome 5. Indeed, the same variant was previously reported in two Tunisian ARSNHL pedigrees. The variant is present in the homozygous state in all six affected individuals, but also in one normal-hearing sibling, suggesting incomplete penetrance. The mutation is absent in about 1,000 individuals from the Greater Middle East Variome study cohort, including individuals from the North African population, as well as in an additional seven deaf patients from the same geographical area, recruited and screened for mutations in the
gene. This study represents the first independent replication of the involvement of
in ARSNHL, highlighting the importance of the gene, and of the p.C113Y mutation, at least in the Northwest African population.
Anisakiasis is an arising zoonosis induced by parasitic nematodes belonging to the family Anisakidae. Anisakiasis is often caused by the ingestion of larval nematodes in uncooked or minimally ...processed seafood dishes, which are regularly consumed by humans. Significant potential sources of infection are raw fish (e.g., sushi and sashimi) that can be found in traditional Japanese cuisine and can be part of the culinary tradition of consumption of raw or marinated fish that is particularly diffused in European countries. During the last five decades, the global prevalence of human anisakiasis has been rising, becoming an emergent major public health problem. Thus, there is an unmet need for well-defined and cost-effective methods aimed at killing Anisakis larvae, thus reducing the incidence of anisakiasis. In this mini-review, we discuss the clinical features of anisakiasis as well as the effectiveness and mechanisms of action of the main methods employed for increasing seafood safety and killing Anisakis larvae, including freezing, heating, use of high hydrostatic pressure, salting process, pepsin digestion method and use of garlic oil.
Diaphanous related formins are regulatory cytoskeletal protein involved in actin elongation and microtubule stabilization. In humans, defects in two of the three diaphanous genes (DIAPH1 and DIAPH3) ...have been associated with different types of hearing loss. Here, we investigate the role of the third member of the family, DIAPH2, in nonsyndromic hearing loss, prompted by the identification, by exome sequencing, of a predicted pathogenic missense variant in DIAPH2. This variant occurs at a conserved site and segregated with nonsyndromic X-linked hearing loss in an Italian family. Our immunohistochemical studies indicated that the mouse ortholog protein Diaph2 is expressed during development in the cochlea, specifically in the actin-rich stereocilia of the sensory outer hair cells. In-vitro studies showed a functional impairment of the mutant DIAPH2 protein upon RhoA-dependent activation. Finally, Diaph2 knock-out and knock-in mice were generated by CRISPR/Cas9 technology and auditory brainstem response measurements performed at 4, 8 and 14 weeks. However, no hearing impairment was detected. Our findings indicate that DIAPH2 may play a role in the inner ear; further studies are however needed to clarify the contribution of DIAPH2 to deafness.
The clinical utility of the QuantiFERON-CMV (QFN-CMV) assay in heart transplant recipients was assessed. Forty-four cytomegalovirus (CMV)-seropositive patients were enrolled: 17 received antiviral ...prophylaxis, and 27 were managed preemptively. CMV-DNAemia monitoring was performed by the use of a quantitative real-time PCR assay. The QFN-CMV assay was retrospectively performed on blood samples collected at five posttransplant time points. A higher proportion of patients with an indeterminate QFN-CMV result after the suspension of prophylaxis than of patients who showed a global T-cell responsiveness developed CMV infection (
= 0.036). Patients who reconstituted a CMV-specific response following the first CMV-DNAemia-positive result (42.9%) showed a median CMV-DNAemia peak 1 log of magnitude lower than that seen with patients with indeterminate results, and all controlled viral replication spontaneously. The 25% of patients with an indeterminate result developed CMV disease. In the preemptive strategy group, no differences in the development of subsequent infection, magnitude of viral load, and viral control were observed on the basis of QFN-CMV measurements performed before and after the first CMV-DNAemia-positive result. Considering both CMV prevention strategies, viral relapse was associated with the failure to reconstitute CMV-specific cell-mediated immunity (CMI) after the resolution of the first episode of CMV infection (
= 0.032). QFN-CMV measurements can be a useful tool for identifying patients (i) at higher risk of developing infection after discontinuing antiviral prophylaxis, (ii) with late CMV infection who would benefit from appropriate antiviral interventions, and (iii) at higher risk of viral relapses. QFN-CMV measurements taken within 1 month posttransplantation (early period) are not revealing.
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