Molecular regulation of H3K4 trimethylation by ASH2L, a shared subunit of MLL complexes.

MLL complexes are homologs of yeast COMPASS capable of methylating histone H3 Lys4 (H3K4). ASH2L, RbBP5 and WDR5 are conserved subunits of MLL complexes with homology to the Cps40/Cps60, Cps50 and Cps30 subunits of COMPASS, respectively. We report that ASH2L differentially regulates MLL's catalysis of H3K4 trimethylation similarly to Cps40 and Cps60. Furthermore, WDR5 is required to maintain MLL complex integrity, including the stability of ASH2L within the complex. These findings offer insight into the molecular role of ASH2L, and by extension that of WDR5, in proper H3K4 trimethylation.

Phenotype Detection Registry System (PheDRS) - Implementation of a Generalizable Single Institution Clinical Registry Architecture.

Precision medicine requires that groups of patients matching clinical or genetic characteristics be identified in a clinical care setting and treated with the appropriate intervention. In the clinical setting, this process is often facilitated by a patient registry. While the software architecture of federated patient registries for research has been well characterized, local registries focused on clinical quality and care have received less attention. Many clinical registries appear to be one-off projects that lack generalizability and the ability to scale to multiple diseases. We evaluate the applicability of existing registry guidelines for registries designed for clinical intervention, propose a software architecture more practical for single-institution clinical registries and report the implementation of a generalizable clinical patient registry architecture at the University of Alabama at Birmingham (UAB).

Practices and perspectives on building integrated data repositories: results from a 2010 CTSA survey.

Clinical integrated data repositories (IDRs) are poised to become a foundational element of biomedical and translational research by providing the coordinated data sources necessary to conduct retrospective analytic research and to identify and recruit prospective research subjects. The Clinical and Translational Science Award (CTSA) consortium's Informatics IDR Group conducted a survey of 2010 consortium members to evaluate recent trends in IDR implementation and use to support research between 2008 and 2010. A web-based survey based in part on a prior 2008 survey was developed and deployed to 46 national CTSA centers. A total of 35 separate organizations completed the survey (74%), representing 28 CTSAs and the National Institutes of Health Clinical Center. Survey results suggest that individual organizations are progressing in their approaches to the development, management, and use of IDRs as a means to support a broad array of research. We describe the major trends and emerging practices below.

Lost in translation: reviewing the role of the discharge liaison nurse in Wales.

In Wales, the National Leadership and Innovation Agency in Healthcare (NLIAH) Change Agent Team (CAT) has found that its service improvement methodology of Communities of Practice (CoP), where motivated frontline staff in health and social care come together to share issues and develop solutions to mutual problems, is a highly effective and informative tool. Health and social care organizations in Wales are in the process of working to develop processes and solutions to remedy the challenges they have over patients with long lengths of stay. This article shows how by speaking to the frontline staff, whose role it is to help people whose discharge is likely to be complex or problematic, they often have most insight into the solutions required to alleviate the situation. The learning in this article is that there is no one solution to improve the discharge process; however there are a number of small changes and improvements required, which if done consistently can have a significant impact. The findings here have been shared with Welsh government policy leads and health and social care executive teams to inform their planning and actions on how to resolve the challenge of reducing length of stay.