Pretransplant HLA typing revealed loss of heterozygosity in the major histocompatibility complex in a patient with acute myeloid leukemia

Introduction Chromosomal abnormalities are frequent events in hematological malignancies. The degree of HLA compatibility between donor and recipient in hematopoietic stem cell transplantation is critical. Purpose of the study In this report, we describe an acute myeloid leukemia case with loss of heterozygosity (LOH) encompassing the entire HLA. Materials and methods HLA molecular typing was performed on peripheral blood (PB) and buccal swabs (BS). Chromosomal microarray analysis (CMA) was performed using a whole genome platform. Results Typing results on PB sample collected during blast crisis demonstrated homozygosity at the -A, -B, -C, -DR, and -DQ loci. A BS sample demonstrated heterozygosity at all loci. A subsequent PB sample drawn after count recovery confirmed heterozygosity. The CMA performed on PB samples collected during and after blast crisis revealed a large terminal region of copy-neutral LOH involving chromosome region 6p25.3p21.31, spanning approximately 35.9 Mb. The results of the CMA assay on sample collected after count recovery did not demonstrate LOH. Conclusions LOH at the HLA gene locus may significantly influence the donor search resulting in mistakenly choosing homozygous donors. We recommend confirming the HLA typing of recipients with hematological malignancies when homozygosity is detected at any locus by using BS samples, or alternatively from PB when remission is achieved

The Building Blocks of Interoperability. A Multisite Analysis of Patient Demographic Attributes Available for Matching.

BackgroundPatient matching is a key barrier to achieving interoperability. Patient demographic elements must be consistently collected over time and region to be valuable elements for patient matching.ObjectivesWe sought to determine what patient demographic attributes are collected at multiple institutions in the United States and see how their availability changes over time and across clinical sites.MethodsWe compiled a list of 36 demographic elements that stakeholders previously identified as essential patient demographic attributes that should be collected for the purpose of linking patient records. We studied a convenience sample of 9 health care systems from geographically distinct sites around the country. We identified changes in the availability of individual patient demographic attributes over time and across clinical sites.ResultsSeveral attributes were consistently available over the study period (2005-2014) including last name (99.96%), first name (99.95%), date of birth (98.82%), gender/sex (99.73%), postal code (94.71%), and full street address (94.65%). Other attributes changed significantly from 2005-2014: Social security number (SSN) availability declined from 83.3% to 50.44% (p<0.0001). Email address availability increased from 8.94% up to 54% availability (p<0.0001). Work phone number increased from 20.61% to 52.33% (p<0.0001).ConclusionsOverall, first name, last name, date of birth, gender/sex and address were widely collected across institutional sites and over time. Availability of emerging attributes such as email and phone numbers are increasing while SSN use is declining. Understanding the relative availability of patient attributes can inform strategies for optimal matching in healthcare

Slow-Speed Supernovae from the Palomar Transient Factory: Two Channels

Since the discovery of the unusual prototype SN 2002cx, the eponymous class of low-velocity, hydrogen-poor supernovae has grown to include at most another two dozen members identified from several heterogeneous surveys, in some cases ambiguously. Here we present the results of a systematic study of 1077 hydrogen-poor supernovae discovered by the Palomar Transient Factory, leading to nine new members of this peculiar class. Moreover we find there are two distinct subclasses based on their spectroscopic, photometric, and host galaxy properties: The "SN 2002cx-like" supernovae tend to be in later-type or more irregular hosts, have more varied and generally dimmer luminosities, have longer rise times, and lack a Ti II trough when compared to the "SN 2002es-like" supernovae. None of our objects show helium, and we counter a previous claim of two such events. We also find that these transients comprise 5.6+17-3.7% (90% confidence) of all SNe Ia, lower compared to earlier estimates. Combining our objects with the literature sample, we propose that these subclasses have two distinct physical origins.Comment: 49 pages, 36 figures, submitted to Ap

Diurnal and Seasonal Variations in Chlorophyll Fluorescence Associated with Photosynthesis at Leaf and Canopy Scales

There is a critical need for sensitive remote sensing approaches to monitor the parameters governing photosynthesis, at the temporal scales relevant to their natural dynamics. The photochemical reflectance index (PRI) and chlorophyll fluorescence (F) offer a strong potential for monitoring photosynthesis at local, regional, and global scales, however the relationships between photosynthesis and solar induced F (SIF) on diurnal and seasonal scales are not fully understood. This study examines how the fine spatial and temporal scale SIF observations relate to leaf level chlorophyll fluorescence metrics (i.e., PSII yield, YII and electron transport rate, ETR), canopy gross primary productivity (GPP), and PRI. The results contribute to enhancing the understanding of how SIF can be used to monitor canopy photosynthesis. This effort captured the seasonal and diurnal variation in GPP, reflectance, F, and SIF in the O2A (SIFA) and O2B (SIFB) atmospheric bands for corn (Zea mays L.) at a study site in Greenbelt, MD. Positive linear relationships of SIF to canopy GPP and to leaf ETR were documented, corroborating published reports. Our findings demonstrate that canopy SIF metrics are able to capture the dynamics in photosynthesis at both leaf and canopy levels, and show that the relationship between GPP and SIF metrics differs depending on the light conditions (i.e., above or below saturation level for photosynthesis). The sum of SIFA and SIFB (SIFA+B), as well as the SIFA+B yield, captured the dynamics in GPP and light use efficiency, suggesting the importance of including SIFB in monitoring photosynthetic function. Further efforts are required to determine if these findings will scale successfully to airborne and satellite levels, and to document the effects of data uncertainties on the scaling

United States Military Fatalities During Operation Inherent Resolve and Operation Freedom\u27s Sentinel.

BACKGROUND: Military operations provide a unified action and strategic approach to achieve national goals and objectives. Mortality reviews from military operations can guide injury prevention and casualty care efforts. METHODS: A retrospective study was conducted on all U.S. military fatalities from Operation Inherent Resolve (OIR) in Iraq (2014-2021) and Operation Freedom\u27s Sentinel (OFS) in Afghanistan (2015-2021). Data were obtained from autopsy reports and other existing records. Fatalities were evaluated for population characteristics; manner, cause, and location of death; and underlying atherosclerosis. Non-suicide trauma fatalities were also evaluated for injury severity, mechanism of death, injury survivability, death preventability, and opportunities for improvement. RESULTS: Of 213 U.S. military fatalities (median age, 29 years; male, 93.0%; prehospital, 89.2%), 49.8% were from OIR, and 50.2% were from OFS. More OIR fatalities were Reserve and National Guard forces (OIR 22.6%; OFS 5.6%), conventional forces (OIR 82.1%; OFS 65.4%), and support personnel (OIR 61.3%; OFS 33.6%). More OIR fatalities also resulted from disease and non-battle injury (OIR 83.0%; OFS 28.0%). The leading cause of death was injury (OIR 81.1%; OFS 98.1%). Manner of death differed as more homicides (OIR 18.9%; OFS 72.9%) were seen in OFS, and more deaths from natural causes (OIR 18.9%; OFS 1.9%) and suicides (OIR 29.2%; OFS 6.5%) were seen in OIR. The prevalence of underlying atherosclerosis was 14.2% in OIR and 18.7% in OFS. Of 146 non-suicide trauma fatalities, most multiple/blunt force injury deaths (62.2%) occurred in OIR, and most blast injury deaths (77.8%) and gunshot wound deaths (76.6%) occurred in OFS. The leading mechanism of death was catastrophic tissue destruction (80.8%). Most fatalities had non-survivable injuries (80.8%) and non-preventable deaths (97.3%). CONCLUSIONS: Comprehensive mortality reviews should routinely be conducted for all military operation deaths. Understanding death from both injury and disease can guide preemptive and responsive efforts to reduce death among military forces

Soil Nitrogen in Response to Interseeded Cover Crops in Maize–Soybean Production Systems

Improved agronomic management strategies are needed to minimize the impact that current maize (Zea mays L.) and soybean (Glycine max (L.) Merr.) production practices have on soil erosion and nutrient losses, especially nitrogen (N). Interseeded cover crops in standing maize and soybean scavenge excess soil N and thus reduce potential N leaching and runoff. The objectives were to determine the impact that pennycress (Thlaspi arvense L.) (PC), winter camelina (Camelina sativa (L.) Crantz) (WC), and winter rye (Secale cereale L.) (WR) cover crops have on soil N, and carbon (C) and N accumulation in cover-crop biomass. The cover crops were interseeded in maize at the R5 growth stage and in soybean at R7 in four replicates over two growing seasons at four locations. Soil and aboveground biomass samples were taken in autumn and spring. Data from the maize and soybean systems were analyzed separately. The results showed that cover crops had no effect on soil NH4+-N under both systems. However, winter rye decreased soil NO3−-N up to 76% compared with no-cover-crop treatment in the soybean system. Pennycress and WC scavenged less soil N than WR. Similarly, N and C accumulation in PC and WC biomass were less than in WR, in part because of their poor growth performance under the interseeding practice. Until PC and WC varieties with improved suitability for interseeding are developed, other agronomic practices may need to be explored for improving N scavenging in maize and soybean cropping systems to reduce nutrient leaching and enhance crop diversification