Chromothripsis orchestrates leukemic transformation in blast phase MPN through targetable amplification of DYRK1A.

Chromothripsis, the process of catastrophic shattering and haphazard repair of chromosomes, is a common event in cancer. Whether chromothripsis might constitute an actionable molecular event amenable to therapeutic targeting remains an open question. We describe recurrent chromothripsis of chromosome 21 in a subset of patients in blast phase of a myeloproliferative neoplasm (BP-MPN), which alongside other structural variants leads to amplification of a region of chromosome 21 in ∼25% of patients ('chr21amp'). We report that chr21amp BP-MPN has a particularly aggressive and treatment-resistant phenotype. The chr21amp event is highly clonal and present throughout the hematopoietic hierarchy. DYRK1A , a serine threonine kinase and transcription factor, is the only gene in the 2.7Mb minimally amplified region which showed both increased expression and chromatin accessibility compared to non-chr21amp BP-MPN controls. We demonstrate that DYRK1A is a central node at the nexus of multiple cellular functions critical for BP-MPN development, including DNA repair, STAT signalling and BCL2 overexpression. DYRK1A is essential for BP-MPN cell proliferation in vitro and in vivo , and DYRK1A inhibition synergises with BCL2 targeting to induce BP-MPN cell apoptosis. Collectively, these findings define the chr21amp event as a prognostic biomarker in BP-MPN and link chromothripsis to a druggable target.

Variable digestibility of captive northern greater galagos (Otolemur garnettii) fed experimental "frugivorous" and "invertebrate" diets.

Few studies have addressed the nutritional ecology of galagos. Observations of galagos in the wild reveal that they rely on fruits and invertebrates to varying degrees depending on their availability. We conducted a 6-week comparative dietary analysis of a colony of captive-housed northern greater galagos (Otolemur garnettii), which included five females and six males with known life histories. We compared two experimental diets. The first was fruit dominated and the second was invertebrate dominated. For each diet, we examined dietary intake and apparent dry matter digestibility over the course of 6 weeks. We found significant differences between the apparent digestibility of the diets, with the "invertebrate" diet being more digestible than the "frugivorous" diet. The lower apparent digestibility of the "frugivorous" diet was driven by the higher fiber contents of the fruits provided to the colony. However, variation in apparent digestibility of both diets was found among individual galagos. The experimental design used in this study may provide useful dietary data for the management of captive colonies of galagos and other strepsirrhine primates. This study may also be helpful for understanding the nutritional challenges faced by free-ranging galagos through time and across geographic space.

Amazon Sediment Transport and Accumulation Along the Continuum of Mixed Fluvial and Marine Processes.

Sediment transfer from land to ocean begins in coastal settings and, for large rivers such as the Amazon, has dramatic impacts over thousands of kilometers covering diverse environmental conditions. In the relatively natural Amazon tidal river, combinations of fluvial and marine processes transition toward the ocean, affecting the transport and accumulation of sediment in floodplains and tributary mouths. The enormous discharge of Amazon fresh water causes estuarine processes to occur on the continental shelf, where much sediment accumulation creates a large clinoform structure and where additional sediment accumulates along its shoreward boundary in tidal flats and mangrove forests. Some remaining Amazon sediment is transported beyond the region near the river mouth, and fluvial forces on it diminish. Numerous perturbations to Amazon sediment transport and accumulation occur naturally, but human actions will likely dominate future change, and now is the time to document, understand, and mitigate their impacts.

Author Correction: Insights into Pasteurellaceae carriage dynamics in the nasal passages of healthy beef calves.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Insights into Pasteurellaceae carriage dynamics in the nasal passages of healthy beef calves.

We investigated three bovine respiratory pathobionts in healthy cattle using qPCR optimised and validated to quantify Histophilus somni, Mannheimia haemolytica and Pasteurella multocida over a wide dynamic range. A longitudinal study was conducted to investigate the carriage and density of these bacteria in the nasal passages of healthy beef calves (N = 60) housed over winter in an experimental farm setting. The three pathobiont species exhibited remarkably different carriage rates and density profiles. At housing, high carriage rates were observed for P. multocida (95%), and H. somni (75%), while fewer calves were positive for M. haemolytica (13%). Carriage rates for all three bacterial species declined over the 75-day study, but not all individuals became colonised despite sharing of environment and airspace. Colonisation patterns ranged from continuous to intermittent and were different among pathobiont species. Interval-censored exponential survival models estimated the median duration of H. somni and P. multocida carriage at 14.8 (CI95%: 10.6-20.9) and 55.5 (CI95%: 43.3-71.3) days respectively, and found higher density P. multocida carriage was associated with slower clearance (p = 0.036). This work offers insights into the dynamics of pathobiont carriage and provides a potential platform for further data collection and modelling studies.

Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors.

BACKGROUND: Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships. METHODS: We interviewed trainees and faculty from clinical and research training programmes in addiction medicine at St Paul's Hospital in Vancouver, Canada (N = 26) about barriers and facilitators to implementation of physician training in addiction medicine. We included medical students, residents, fellows and supervising physicians from a variety of specialities. We analysed interview transcripts thematically by using NVivo software. RESULTS: We identified six domains relating to training implementation: (1) organisational, (2) structural, (3) teacher, (4) learner, (5) patient and (6) community related variables either hindered or fostered addiction medicine education, depending on context. Human resources, variety of rotations, peer support and mentoring fostered implementation of addiction training. Money, time and space limitations hindered implementation. Participant accounts underscored how faculty and staff facilitated the implementation of both the clinical and the research training. CONCLUSIONS: Implementation of addiction medicine fellowships appears feasible, although a number of barriers exist. Research into factors within the local/practice environment that shape delivery of education to ensure consistent and quality education scale-up is a priority.

Assessing the Value of the Zebrafish Conditioned Place Preference Model for Predicting Human Abuse Potential.

Regulatory agencies recommend that centrally active drugs are tested for abuse potential before approval. Standard preclinical assessments are conducted in rats or non-human primates (NHPs). This study evaluated the ability of the zebrafish conditioned place preference (CPP) model to predict human abuse outcomes. Twenty-seven compounds from a variety of pharmacological classes were tested in zebrafish CPP, categorized as positive or negative, and analyzed using standard diagnostic tests of binary classification to determine the likelihood that zebrafish correctly predict robust positive signals in human subjective effects studies (+HSE) and/or Drug Enforcement Administration drug scheduling. Results were then compared with those generated for rat self-administration and CPP, as well as NHP self-administration, using this same set of compounds. The findings reveal that zebrafish concordance and sensitivity values were not significantly different from chance for both +HSE and scheduling. Although significant improvements in specificity and negative predictive values were observed for zebrafish relative to +HSE, specificity without sensitivity provides limited predictive value. Moreover, assessments in zebrafish provided no added value for predicting scheduling. By contrast, rat and NHP models generally possessed significantly improved concordance, sensitivity, and positive predictive values for both clinical measures. Although there may be predictive value with compounds from specific pharmacological classes (e.g., µ-opioid receptor agonists, psychostimulants) for zebrafish CPP, altogether these data highlight that using the current methodology, the zebrafish CPP model does not add value to the preclinical assessment of abuse potential.

Equivalence of BCSH and WHO diagnostic criteria for ET.

This corrects the article DOI: 10.1038/leu.2016.318.

Two birds with one stone: experiences of combining clinical and research training in addiction medicine.

BACKGROUND: Despite a large evidence-base upon which to base clinical practice, most health systems have not combined the training of healthcare providers in addiction medicine and research. As such, addiction care is often lacking, or not based on evidence or best practices. We undertook a qualitative study to assess the experiences of physicians who completed a clinician-scientist training programme in addiction medicine within a hospital setting. METHODS: We interviewed physicians from the St. Paul's Hospital Goldcorp Addiction Medicine Fellowship and learners from the hospital's academic Addiction Medicine Consult Team in Vancouver, Canada (N = 26). They included psychiatrists, internal medicine and family medicine physicians, faculty, mentors, medical students and residents. All received both addiction medicine and research training. Drawing on Kirkpatrick's model of evaluating training programmes, we analysed the interviews thematically using qualitative data analysis software (Nvivo 10). RESULTS: We identified five themes relating to learning experience that were influential: (i) attitude, (ii) knowledge, (iii) skill, (iv) behaviour and (v) patient outcome. The presence of a supportive learning environment, flexibility in time lines, highly structured rotations, and clear guidance regarding development of research products facilitated clinician-scientist training. Competing priorities, including clinical and family responsibilities, hindered training. CONCLUSIONS: Combined training in addiction medicine and research is feasible and acceptable for current doctors and physicians in training. However, there are important barriers to overcome and improved understanding of the experience of addiction physicians in the clinician-scientist track is required to improve curricula and research productivity.

Risk-assessment-based approach to patients exposed to endoscopes contaminated with Pseudomonas spp.

Patients exposed to bronchoscopes contaminated with Pseudomonas aeruginosa are at increased risk of pseudomonal infection. The optimal methods for management and mitigation of risk following exposure are controversial. This article describes a two-phase risk assessment following pseudomonal contamination of a family of 75 endoscopes, detected through routine surveillance and attributed to one endoscope washer-disinfector. An initial risk assessment identified 18 endoscopes as high risk, based on the presence of lumens used for irrigation or biopsy. Exposure was communicated to the patients' clinical teams and a further clinical risk assessment of the exposed patients was performed. No patients developed complications due to pseudomonal infection.

Endoscopy supply water and final rinse testing: five years of experience.

BACKGROUND: The penultimate stage in endoscope reprocessing is the final rinse with water following terminal disinfection. This requires a degree of microbiological and chemical control of the quality of the final rinse water. AIM: To report experience gained over five years of testing, reporting and managing the quality of final rinse water for endoscopic devices. METHODS: Three endoscope reprocessing units, each comprising five endoscope washer-disinfectors (EWDs) supplied by two reverse osmosis (RO) water units, were subjected to weekly monitoring and control of final rinse water quality. EWDs were subjected to nightly thermal self-disinfection, and RO units were subjected to periodic sanitization with peracetic acid. Final rinse water samples were processed periodically for total viable counts (TVCs), Pseudomonas spp., endotoxins, conductivity, environmental mycobacteria and Legionella spp. FINDINGS: Over the five-year study period (2008-2013), no Pseudomonas spp., environmental mycobacteria or Legionella spp. were isolated from endoscopy rinse water. All conductivity readings were below 30 µs/cm. Endotoxin levels fluctuated over the recommended cut-off of 0.25 EU/mL, with no correlation with TVCs. Trend analysis of TVCs established alert and action limits. Apart from the supply water of one EWD becoming contaminated with Aspergillus spp., there have been no interruptions to operational capacity of the endoscope reprocessing units. CONCLUSIONS: Quality control principles coupled with appropriate thermal and chemical disinfection of EWDs resulted in the achievement of microbiological standards for final rinse water. A co-ordinated team approach between the microbiology department, infection control department, endoscope unit managers and estates department is required to achieve this degree of success.

Diaphragm remodeling and compensatory respiratory mechanics in a canine model of Duchenne muscular dystrophy.

Ventilatory insufficiency remains the leading cause of death and late stage morbidity in Duchenne muscular dystrophy (DMD). To address critical gaps in our knowledge of the pathobiology of respiratory functional decline, we used an integrative approach to study respiratory mechanics in a translational model of DMD. In studies of individual dogs with the Golden Retriever muscular dystrophy (GRMD) mutation, we found evidence of rapidly progressive loss of ventilatory capacity in association with dramatic morphometric remodeling of the diaphragm. Within the first year of life, the mechanics of breathing at rest, and especially during pharmacological stimulation of respiratory control pathways in the carotid bodies, shift such that the primary role of the diaphragm becomes the passive elastic storage of energy transferred from abdominal wall muscles, thereby permitting the expiratory musculature to share in the generation of inspiratory pressure and flow. In the diaphragm, this physiological shift is associated with the loss of sarcomeres in series (∼ 60%) and an increase in muscle stiffness (∼ 900%) compared with those of the nondystrophic diaphragm, as studied during perfusion ex vivo. In addition to providing much needed endpoint measures for assessing the efficacy of therapeutics, we expect these findings to be a starting point for a more precise understanding of respiratory failure in DMD.

Molecular and cellular effects of oncogene cooperation in a genetically accurate AML mouse model.

Biallelic CEBPA mutations and FMS-like tyrosine kinase receptor 3 (FLT3) length mutations are frequently identified in human acute myeloid leukemia (AML) with normal cytogenetics. However, the molecular and cellular mechanisms of oncogene cooperation remain unclear because of a lack of disease models. We have generated an AML mouse model using knockin mouse strains to study cooperation of an internal tandem duplication (ITD) mutation in the Flt3 gene with commonly observed CCAAT/enhancer binding protein alpha (C/EBPα) mutations. This study provides evidence that FLT3 ITD cooperates in leukemogenesis by enhancing the generation of leukemia-initiating granulocyte-monocyte progenitors (GMPs) otherwise prevented by a block in differentiation and skewed lineage priming induced by biallelic C/EBPα mutations. These cellular changes are accompanied by an upregulation of hematopoietic stem cell and STAT5 target genes. By gene expression analysis in premalignant populations, we further show a role of FLT3 ITD in activating genes involved in survival/transformation and chemoresistance. Both multipotent progenitors and GMP cells contain the potential to induce AML similar to corresponding cells in human AML samples showing that this model resembles human disease.

High performance imaging streak camera for the National Ignition Facility.

An x-ray streak camera platform has been characterized and implemented for use at the National Ignition Facility. The camera has been modified to meet the experiment requirements of the National Ignition Campaign and to perform reliably in conditions that produce high electromagnetic interference. A train of temporal ultra-violet timing markers has been added to the diagnostic in order to calibrate the temporal axis of the instrument and the detector efficiency of the streak camera was improved by using a CsI photocathode. The performance of the streak camera has been characterized and is summarized in this paper. The detector efficiency and cathode measurements are also presented.

The effect of within-crop habitat manipulations on the conservation biological control of aphids in field-grown lettuce.

Within-crop habitat manipulations have the potential to increase the biological control of pests in horticultural field crops. Wildflower strips have been shown to increase the abundance of natural enemies, but there is little evidence to date of an impact on pest populations. The aim of this study was to determine whether within-crop wildflower strips can increase the natural regulation of pests in horticultural field crops. Aphid numbers in plots of lettuce grown adjacent to wildflower strips were compared with those in plots grown in the absence of wildflowers. The presence of wildflower strips led to a decrease in aphid numbers on adjacent lettuce plants during June and July, but had less impact in August and September. The decrease in aphid numbers was greatest close to the wildflower strips and, the decrease in aphid numbers declined with increasing distance from the wildflower strips, with little effect at a distance of ten metres. The main natural enemies found in the crop were those that dispersed aerially, which is consistent with data from previous studies on cereal crops. Analysis and interpretation of natural enemy numbers was difficult due to low recovery of natural enemies, and the numbers appeared to follow changes in aphid abundance rather than being directly linked to the presence of wildflower strips. Cutting the wildflower strips, to remove floral resources, had no impact on the reduction in aphid numbers achieved during June and July, but decreased the effect of the wildflower strips during August and September. The results suggest that wildflower strips can lead to increased natural regulation of pest aphids in outdoor lettuce crops, but more research is required to determine how this is mediated by natural enemies and how the impact of wildflower strips on natural pest regulation changes during the growing season.

Avoidance-suppressing effect of antipsychotic drugs is progressively potentiated after repeated administration: an interoceptive drug state mechanism.

Antipsychotic drugs selectively suppress conditioned avoidance response. Using a two-way active avoidance response paradigm, we examined the role of drug-induced interoceptive state in the mediation of avoidance-suppressive effect. In Experiment 1, we found that rats intermittently treated with olanzapine (OLZ) (1.0 mg/kg, s.c.) or haloperidol (0.03 mg/kg, s.c.) on the 1st day of a 3-day cycle for seven cycles exhibited a progressive across-session decline in avoidance responding, despite the fact that they exhibited a comparable high level of avoidance responding on the 3rd day of each cycle during the drug-free retraining session. In Experiments 2 and 3, rats that were previously treated with OLZ (0.5-2.0 mg/kg, s.c.) or risperidone (0.2-1.0 mg/kg) during the acquisition phase of avoidance conditioning exhibited significantly fewer avoidance responses when they were retested 3 weeks later to the same drug in comparison to rats that were previously treated with nonantipsychotic drugs (chlordiazepoxide, 10 mg/kg, citalopram 10 mg/kg, or sterile water). Overall, these findings indicate a 'drug memory'-like mechanism that maintains the avoidance-suppressing effect of antipsychotics over time. This mechanism is likely driven by the interoceptive state caused by the antipsychotics, which may also be an important behavioral mechanism mediating the clinical effects of antipsychotic treatments.

Large-river delta-front estuaries as natural "recorders" of global environmental change.

Large-river delta-front estuaries (LDE) are important interfaces between continents and the oceans for material fluxes that have a global impact on marine biogeochemistry. In this article, we propose that more emphasis should be placed on LDE in future global climate change research. We will use some of the most anthropogenically altered LDE systems in the world, the Mississippi/Atchafalaya River and the Chinese rivers that enter the Yellow Sea (e.g., Huanghe and Changjiang) as case-studies, to posit that these systems are both "drivers" and "recorders" of natural and anthropogenic environmental change. Specifically, the processes in the LDE can influence ("drive") the flux of particulate and dissolved materials from the continents to the global ocean that can have profound impact on issues such as coastal eutrophication and the development of hypoxic zones. LDE also record in their rapidly accumulating subaerial and subaqueous deltaic sediment deposits environmental changes such as continental-scale trends in climate and land-use in watersheds, frequency and magnitude of cyclonic storms, and sea-level change. The processes that control the transport and transformation of carbon in the active LDE and in the deltaic sediment deposit are also essential to our understanding of carbon sequestration and exchange with the world ocean--an important objective in global change research. U.S. efforts in global change science including the vital role of deltaic systems are emphasized in the North American Carbon Plan (www.carboncyclescience.gov).