A new scoring system in Cystic Fibrosis: statistical tools for database analysis – a preliminary report

<p>Abstract</p> <p>Background</p> <p>Cystic fibrosis is the most common fatal genetic disorder in the Caucasian population. Scoring systems for assessment of Cystic fibrosis disease severity have been used for almost 50 years, without being adapted to the milder phenotype of the disease in the 21^stcentury. The aim of this current project is to develop a new scoring system using a database and employing various statistical tools. This study protocol reports the development of the statistical tools in order to create such a scoring system.</p> <p>Methods</p> <p>The evaluation is based on the Cystic Fibrosis database from the cohort at the Royal Children's Hospital in Melbourne. Initially, unsupervised clustering of the all data records was performed using a range of clustering algorithms. In particular incremental clustering algorithms were used. The clusters obtained were characterised using rules from decision trees and the results examined by clinicians. In order to obtain a clearer definition of classes expert opinion of each individual's clinical severity was sought. After data preparation including expert-opinion of an individual's clinical severity on a 3 point-scale (mild, moderate and severe disease), two multivariate techniques were used throughout the analysis to establish a method that would have a better success in feature selection and model derivation: 'Canonical Analysis of Principal Coordinates' and 'Linear Discriminant Analysis'. A 3-step procedure was performed with (1) selection of features, (2) extracting 5 severity classes out of a 3 severity class as defined per expert-opinion and (3) establishment of calibration datasets.</p> <p>Results</p> <p>(1) Feature selection: CAP has a more effective "modelling" focus than DA.</p> <p>(2) Extraction of 5 severity classes: after variables were identified as important in discriminating contiguous CF severity groups on the 3-point scale as mild/moderate and moderate/severe, Discriminant Function (DF) was used to determine the new groups mild, intermediate moderate, moderate, intermediate severe and severe disease. (3) Generated confusion tables showed a misclassification rate of 19.1% for males and 16.5% for females, with a majority of misallocations into adjacent severity classes particularly for males.</p> <p>Conclusion</p> <p>Our preliminary data show that using CAP for detection of selection features and Linear DA to derive the actual model in a CF database might be helpful in developing a scoring system. However, there are several limitations, particularly more data entry points are needed to finalize a score and the statistical tools have further to be refined and validated, with re-running the statistical methods in the larger dataset.</p

Drosophila cbl Is Essential for Control of Cell Death and Cell Differentiation during Eye Development

Activation of cell surface receptors transduces extracellular signals into cellular responses such as proliferation, differentiation and survival. However, as important as the activation of these receptors is their appropriate spatial and temporal down-regulation for normal development and tissue homeostasis. The Cbl family of E3-ubiquitin ligases plays a major role for the ligand-dependent inactivation of receptor tyrosine kinases (RTKs), most notably the Epidermal Growth Factor Receptor (EGFR) through ubiquitin-mediated endocytosis and lysosomal degradation.Here, we report the mutant phenotypes of Drosophila cbl (D-cbl) during eye development. D-cbl mutants display overgrowth, inhibition of apoptosis, differentiation defects and increased ommatidial spacing. Using genetic interaction and molecular markers, we show that most of these phenotypes are caused by increased activity of the Drosophila EGFR. Our genetic data also indicate a critical role of ubiquitination for D-cbl function, consistent with biochemical models.These data may provide a mechanistic model for the understanding of the oncogenic activity of mammalian cbl genes

A census of baryons in the Universe from localized fast radio bursts

More than three quarters of the baryonic content of the Universe resides in a highly diffuse state that is difficult to observe, with only a small fraction directly observed in galaxies and galaxy clusters. Censuses of the nearby Universe have used absorption line spectroscopy to observe these invisible baryons, but these measurements rely on large and uncertain corrections and are insensitive to the majority of the volume, and likely mass. Specifically, quasar spectroscopy is sensitive either to only the very trace amounts of Hydrogen that exists in the atomic state, or highly ionized and enriched gas in denser regions near galaxies. Sunyaev-Zel'dovich analyses provide evidence of some of the gas in filamentary structures and studies of X-ray emission are most sensitive to gas near galaxy clusters. Here we report the direct measurement of the baryon content of the Universe using the dispersion of a sample of localized fast radio bursts (FRBs), thus utilizing an effect that measures the electron column density along each sight line and accounts for every ionised baryon. We augment the sample of published arcsecond-localized FRBs with a further four new localizations to host galaxies which have measured redshifts of 0.291, 0.118, 0.378 and 0.522, completing a sample sufficiently large to account for dispersion variations along the line of sight and in the host galaxy environment to derive a cosmic baryon density of $\Omega_{b} = 0.051_{-0.025}^{+0.021} \, h_{70}^{-1}$ (95% confidence). This independent measurement is consistent with Cosmic Microwave Background and Big Bang Nucleosynthesis values.Comment: Published online in Nature 27 May, 202

Proton-Assisted Amino Acid Transporter PAT1 Complexes with Rag GTPases and Activates TORC1 on Late Endosomal and Lysosomal Membranes

Mammalian Target of Rapamycin Complex 1 (mTORC1) is activated by growth factor-regulated phosphoinositide 3-kinase (PI3K)/Akt/Rheb signalling and extracellular amino acids (AAs) to promote growth and proliferation. These AAs induce translocation of mTOR to late endosomes and lysosomes (LELs), subsequent activation via mechanisms involving the presence of intralumenal AAs, and interaction between mTORC1 and a multiprotein assembly containing Rag GTPases and the heterotrimeric Ragulator complex. However, the mechanisms by which AAs control these different aspects of mTORC1 activation are not well understood. We have recently shown that intracellular Proton-assisted Amino acid Transporter 1 (PAT1)/SLC36A1 is an essential mediator of AA-dependent mTORC1 activation. Here we demonstrate in Human Embryonic Kidney (HEK-293) cells that PAT1 is primarily located on LELs, physically interacts with the Rag GTPases and is required for normal AA-dependent mTOR relocalisation. We also use the powerful in vivo genetic methodologies available in Drosophila to investigate the regulation of the PAT1/Rag/Ragulator complex. We show that GFP-tagged PATs reside at both the cell surface and LELs in vivo, mirroring PAT1 distribution in several normal mammalian cell types. Elevated PI3K/Akt/Rheb signalling increases intracellular levels of PATs and synergistically enhances PAT-induced growth via a mechanism requiring endocytosis. In light of the recent identification of the vacuolar H+-ATPase as another Rag-interacting component, we propose a model in which PATs function as part of an AA-sensing engine that drives mTORC1 activation from LEL compartments

Pulmonary exacerbation score in Cystic Fibrosis patients: Reliability and validity.

Background: Lung disease in cystic fibrosis (CF) is characterized by recurrent pulmonary exacerbations (PEs), but consensus on diagnostic criteria for PE is lacking. The use of a consistent definition of PE as an outcome measure in CF clinical trials would allow meaningful comparison across centers. The aim of this study was to assess the reliability and validity of a simplified version of the Seattle Pulmonary Exacerbation Score (SPEX). Materials and Methods: A cross-sectional observational study with review of case notes was conducted on pediatric patients with CF in an outpatient setting. Inter-investigator reliability was assessed using the kappa coefficient of agreement, and intra-investigator reliability was examined following re-evaluation 21 months after the initial assessment. The validity of the SPEX was analyzed using independent clinical assessment as the "gold standard." The performance of the original and simplified scores was compared. Results: Inter- and intra-investigator reliability of SPEX scores were excellent (κ = 0.91 and 0.98, respectively). Validity testing yielded a kappa coefficient of 0.63. The sensitivity and specificity of the SPEX in detecting PE were 89.4% and 84%, respectively. The SPEX performed as well as the original measure. Conclusions: The SPEX is objective and repeatable. This quick and simple-to-use measure performed as well as the original version and is applicable to a real-life pediatric population outside of the context of narrowly defined clinical parameters. The use of the SPEX to diagnose PE consistently in children with CF is thus recommended