Orthotospovirus iridimaculaflavi (iris yellow spot virus): An emerging threat to onion cultivation and its transmission by Thrips tabaci in India.

The yellow spot disease caused by the virus species Orthotospovirus iridimaculaflavi (Iris yellow spot virus-IYSV), belonging to the genus Orthotospovirus, the family Tospoviridae, order Bunyavirales and transmitted by Thrips tabaci Lindeman. At present, emerging as a major threat in onion (Allium cepa) in Tamil Nadu, India. The yellow spot disease incidence was found to be 53-73 % in six districts out of eight major onion-growing districts surveyed in Tamil Nadu during 2021-2023. Among the onion cultivars surveyed, the cultivar CO 5 was the most susceptible to IYSV. The population of thrips was nearly 5-9/plant during vegetative and flowering stages. The thrips infestation was 34-60 %. The tospovirus involved was confirmed as IYSV through DAS-ELISA, followed by molecular confirmation through RT-PCR using the nucleocapsid (N) gene. The predominant thrips species present in onion crops throughout the growing seasons was confirmed as Thrips tabaci based on the nucleotide sequence of the MtCOI gene. The mechanical inoculation of IYSV in different hosts viz., Vigna unguiculata, Gomphrena globosa, Chenopodium amaranticolor, Chenopodium quinoa and Nicotiana benthamiana resulted in chlorotic and necrotic lesion symptoms. The electron microscopic studies with partially purified sap from onion lesions revealed the presence of spherical to pleomorphic particles measuring 100-230 nm diameter. The transmission of IYSV was successful with viruliferous adult Thrips tabaci in cowpea (Cv. CO7), which matured from 1st instar larva fed on infected cowpea leaves (24 h AAP). Small brown necrotic symptoms were produced on inoculated plants after an interval of four weeks. The settling preference of non-viruliferous and viruliferous T. tabaci towards healthy and infected onion leaves resulted in the increased preference of non-viruliferous thrips towards infected (onion-61.33 % and viruliferous thrips towards healthy onion leaves (75.33 %). The study isolates shared 99-100 % identity at a nucleotide and amino acid level with Indian isolates of IYSV in the N gene. The multiple alignment of the amino acid sequence of the N gene of IYSV isolates collected from different locations and IYSV isolates from the database revealed amino acid substitution in the isolate ITPR4. All the IYSV isolates from India exhibited characteristic amino acid substitution of serine at the 6th position in the place of threonine in the isolates from Australia, Japan and USA. The phylogenetic analysis revealed the monophyletic origin of the IYSV isolates in India.

LILRB4 signalling in leukaemia cells mediates T cell suppression and tumour infiltration.

Immune checkpoint blockade therapy has been successful in treating some types of cancer but has not shown clinical benefits for treating leukaemia1. This result suggests that leukaemia uses unique mechanisms to evade this therapy. Certain immune inhibitory receptors that are expressed by normal immune cells are also present on leukaemia cells. Whether these receptors can initiate immune-related primary signalling in tumour cells remains unknown. Here we use mouse models and human cells to show that LILRB4, an immunoreceptor tyrosine-based inhibition motif-containing receptor and a marker of monocytic leukaemia, supports tumour cell infiltration into tissues and suppresses T cell activity via a signalling pathway that involves APOE, LILRB4, SHP-2, uPAR and ARG1 in acute myeloid leukaemia (AML) cells. Deletion of LILRB4 or the use of antibodies to block LILRB4 signalling impeded AML development. Thus, LILRB4 orchestrates tumour invasion pathways in monocytic leukaemia cells by creating an immunosuppressive microenvironment. LILRB4 represents a compelling target for the treatment of monocytic AML.

High-Resolution Characterization of Enamel Remineralization Using Time-of-Flight Secondary Ion Mass Spectrometry and Electron Microscopy.

INTRODUCTION: The aim of this in vitro study was to assess the suitability of high-resolution time-of-flight secondary ion mass spectrometry (ToF-SIMS) for visualizing cross-sectional changes in human enamel microstructure and chemical composition during treatment and remineralization cycling of artificially generated caries lesions underneath an artificial plaque. METHODS: Treatments consisted of exposure to twice daily toothpaste/water slurries prepared from 0, 1,100, and 5,000 µg/g fluoride (F) NaF/silica toothpastes. In addition, treatments with slurries prepared from 1,100 µg/g F SnF2/silica toothpastes were done using 44Ca in the remineralization solution to allow for differentiation of newly formed mineral and exploration of incorporated metal dopants using ToF-SIMS. Complementary microhardness, scanning electron microscopy, and high-resolution transmission electron microscopy (HR-TEM) investigations were performed on enamel cross sections. RESULTS: HR-TEM was used for the first time to determine the change in crystallinity during remineralization revealing distinct microstructural zones within one lesion. Chemical mapping using ToF-SIMS demonstrated that the distribution of F, while observed primarily in the new mineral phase, was widespread throughout the lesion with 44Ca substantially limited to the remineralizing mineral. Both penetrated the inter-rod spaces of the sound enamel illustrating how acid damage propagates into the native mineral as the caries lesion deepens. HR-TEM examination revealed different regions within the lesion characterized by distinct micro- and ultrastructures. Importantly, HR-TEM revealed a return of crystallinity following remineralization. F dose-response observations verified the ability of these high-resolution techniques to differentiate remineralization efficacy. CONCLUSION: The collective results provided new insights such as the visualization of F or calcium penetration pathways, as well as new tools to study the caries process.

Forecasting the future of Fall armyworm Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) in India using ecological niche model.

The Fall armyworm, Spodoptera frugiperda is the most notorious invasive pest species on maize, recently reported in India. The continuous spread of Fall armyworms to new ecological niches raises global concern. The current study is the first in India to forecast the suitability of a habitat for S. frugiperda using a maximum entropy algorithm. Predictions were made based on an analysis of the relationship between 109 occurrence records of S. frugiperda and pertinent historical, current, and predicted climatic data for the study area. The model indicated that S. frugiperda could thrive in different habitats under the current environmental circumstances, particularly in the west and south Indian states like Maharashtra, Tamil Nadu, and Karnataka. The model predicted that areas with higher latitudes, particularly in Uttar Pradesh, Odisha, West Bengal, and some portions of Telangana, Rajasthan, Chhattisgarh, and Madhya Pradesh, as well as some tracts of northeastern states like Assam and Arunachal Pradesh, would have highly climate-suitable conditions for S. frugiperda to occur in the future. The average AUC value was 0.852, which indicates excellent accuracy of the prediction. A Jackknife test of variables indicated that isothermality with the highest gain value was determining the potential geographic distribution of S. frugiperda. Our results will be useful for serving as an early warning tool to guide decision-making and prevent further spread toward new areas in India.

Ultrasound and Photoacoustic Imaging for the Guidance of Laser Ablation Procedures.

The accuracy and efficacy of laser ablation procedures depend on the accurate placement of the laser applicator within the diseased tissue, monitoring the real-time temperature during the ablation procedure, and mapping the extent of the ablated region. Ultrasound (US) imaging has been widely used to guide ablation procedures. While US imaging offers significant advantages for guiding ablation procedures, its limitations include low imaging contrast, angular dependency, and limited ability to monitor the temperature. Photoacoustic (PA) imaging is a relatively new imaging modality that inherits the advantages of US imaging and offers enhanced capabilities for laser-guided ablations, such as accurate, angle-independent tracking of ablation catheters, the potential for quantitative thermometry, and monitoring thermal lesion formation. This work provides an overview of ultrasound-guided procedures and how different US-related artifacts limit their utility, followed by introducing PA as complementary to US as a solution to address the existing limitations and improve ablation outcomes. Furthermore, we highlight the integration of PA-driven features into existing US-guided laser ablation systems, along with their limitations and future outlooks. Integrated US/PA-guided laser ablation procedures can lead to safer and more precise treatment outcomes.

First report on the utility of pupal case for early determination of CRISPR/Cas9 ribonucleoprotein mediated genomic edits in the oriental fruit fly, Bactrocera dorsalis (Hendel) (Tephritidae: Diptera).

The Oriental fruit fly, Bactrocera dorsalis (Hendel), is a highly invasive pest of quarantine importance affecting the global fruit trade. In managing B. dorsalis, methods like cultural, biological, chemical, sterile insect technique (SIT), and semiochemical-mediated attract-and-kill are in use with varying success. The SIT approach is the method of choice for a chemical-free, long-term suppression of B. dorsalis, followed in many countries across the globe. The nonspecific mutations caused by irradiation affect the overall fitness of flies, thus requiring a more precise method for a heritable, fitness-not-compromising approach. In this regard, CRISPR/Cas9-mediated genome editing enables the creation of mutations at the precise genomic location/s through RNA-guided dsDNA cleavage. Of late, DNA-free editing employing ribonucleoprotein complex (RNP) is preferred to validate the target genes at G0 stage embryos in insects. It requires characterizing genomic edits from adults after completing their life cycle, which may entail a few days to months, depending on longevity. Additionally, edit characterization is required from each individual, as edits are unique. Therefore, all RNP-microinjected individuals must be maintained until the end of their life cycle, irrespective of editing. To overcome this impediment, we predetermine the genomic edits from the shed tissues, such as pupal cases, to maintain only edited individuals. In this study, we have shown the utility of pupal cases from five males and females of B. dorsalis to predetermine the genomic edits, which corroborated the edits from the respective adults.

Genome profiling of an indigenous Bacillus thuringiensis isolate, T405 toxic against the fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae).

In this study, we present the molecular and insecticidal characteristics of an indigenous Bt isolate T405 toxic against the maize fall armyworm (FAW), Spodoptera frugiperda. The presence of cry1, cry2 (cry2Aa & cry2Ab) and vip3A1 genes in T405 was confirmed. The SDS-PAGE gel analysis confirmed the occurrence of Cry and Vip proteins with molecular masses of 130, ∼88 and 65 kDa in T405. LC50 estimates of T405 and HD1 were 161.37 and 910.73 µg ml-1 for neonates whereas, 412.29 and 1014.95 µg ml-1 correspondingly for 2nd instar FAW larvae. Scanning Electron Microscopy depicted the existence of bipyramidal, spherical and cubic crystals in T405 spore suspension. The whole genome sequencing and assembly of T405 produced a total of 563 scaffolds with a genome size of 6,673,691 bp. The BLAST similarity search showed that 12 plasmids were distributed in this genome. Genome annotation revealed the presence of 6174 protein coding genes, 13 rRNA and 98 tRNA, in which 6126 genes were completely annotated for their functions through sequence similarity search, domains/motifs identification and gene ontology studies. Further analysis of these genes identified the presence of many insecticidal toxin protein coding genes viz., cry1Ac32, cry1Ab9, cry1Aa6, cry1Ac5, cry1Aa18, cry1Ab8, cry1Ab11, cry2Aa9, cry1Ia40, cry2Aa9, cry1Ia40, cry2Ab35, cyt, vip3Aa7 and tpp80Aa and several additional virulence assisted factors viz., immune inhibitor A, phospholipase C, sphingomyelinase, cell wall hydrolases, chitinase, hemolysin XhlA and seven urease subunit coding genes (ureA, ureB, ureC, ureD, ureE, ureF, ureG) in the annotated genome.

In vitro safety evaluation of a hydrogen peroxide whitening emulsion technology on human enamel and dentin.

PURPOSE: To assess effects of a novel hydrogen peroxide leave-on whitening emulsion on surface hardness, fracture susceptibility, surface erosion, and surface morphology of enamel and dentin. METHODS: Human enamel and root dentin sections embedded in resin were leveled and polished for uniformity. A cycling treatment simulating overuse conditions (60 hours over 10 days), coupled with incubation in pooled human saliva at 37°C and two daily toothpaste treatments were used to evaluate the safety of a 3% hydrogen peroxide whitening emulsion treatment (Crest Whitening Emulsions). Controls included a no treatment group, three erosion controls (water, 0.25% citric acid pH 3.6, 1% citric acid pH 3.6), and a bleaching control (8.25% sodium hypochlorite). Color measurements (b*) were taken on select post-treated specimens to confirm bleaching activity. Effects on enamel and dentin physical properties were determined by surface microhardness, fracture toughness, erosion depth, and surface morphology by light and scanning electron microscopy. RESULTS: The hydrogen peroxide emulsion b* value was significantly different versus water control (P< 0.05), confirming bleaching activity. Microhardness and fracture toughness results for hydrogen peroxide emulsions were not significantly different versus baseline (P> 0.2) and no treatment (P= 1.0), respectively. Erosion loss for the hydrogen peroxide emulsion was not observed on enamel (comparable to water) and significantly less than 0.25% citric acid (P< 0.05) on dentin which was verified by microscopic visualization. CLINICAL SIGNIFICANCE: The hydrogen peroxide emulsion had no significant negative effects on enamel and dentin properties after 60 hours of bleaching over 10 days, confirming safety under simulated overuse conditions.

Application of non-inferiority testing in microhardness and its relationship to erosion: Relevance for hard tissue safety evaluations.

PURPOSE: To use non-inferiority statistical testing with simple microhardness measurements (SMH) as a prediction of potential erosive hard tissue damage of topical treatments on enamel. METHODS: Three independent experiments of a simple acid cycling demineralization (ACD) model were used to screen softening effects of various commercial beverages on dental enamel. The cycling model consists of six repeated exposures of enamel slabs with alternating treatments of artificial saliva over the course of 6 hours. After six repeated cycles, effects on surface microhardness were measured. Softening effects of beverages were evaluated using a statistical non-inferiority test of the positive control (water) and negative control (1% citric acid). To confirm whether softening effects as evaluated by a non-inferiority test translated to like differences in enamel erosion susceptibility, selected beverages then underwent more complex erosion cycling model (ECM) evaluation where enamel blocks were cycled with beverages (vs. historically established citric acid) and pooled saliva over a period of 5 days. The ECM also incorporated dentifrice treatments, sodium fluoride (NaF, Crest Cavity Protection, negative control) and a positive control stannous fluoride dentifrice (SnF2, Crest Pro-Health Advanced), to confirm model performance against historically published results of in situ erosion protection benefits of SnF2. RESULTS: There was a spectrum of softening properties of 16 commercial beverages in the ACD test, ranging from a ΔSMH of -22.6 to -316 vs. baseline. Four beverages were evaluated further in ECM testing. Despite a measurable change in SMH, Sprite and beer treatments in the ACD passed the statistical non-inferiority test and both were evaluated in erosion cycling, showing no enamel surface loss. Vinegar (~5% acetic acid) and Gatorade also showed measurable changes in SMH in the ACD, but they failed statistical non-inferiority testing. Both beverages subsequently showed significant enamel tissue loss (erosion) in further erosion cycling testing. This combined set of data suggests that simple surface microhardness evaluation may be used as a proxy for potential erosion surface loss if properly quantified. SnF2 dentifrice significantly reduced erosion from all erosive beverages with greater efficacy than NaF control dentifrice, consistent with prior clinical and in vitro evidence. CLINICAL SIGNIFICANCE: The ACD model with application of non-inferiority statistical testing is proposed as a simple model of hard tissue safety assessment of treatments, including oral hygiene products. Products that pass the non-inferiority test in ACD (surface softening) are proposed as safe for enamel as there is no suggestion from this data that teeth are at risk of tissue loss due to these products. On the other hand, products failing the non-inferiority test require confirmatory safety qualification in erosion cycling. Products equal or worse than citric acid with ACD or with significant erosion in ECM are suggested to warrant reformulation unless favorable safety data for enamel (lack of erosion) or the appropriate justification are provided.

Efficacy of High Temporal Frequency Photoacoustic Guidance of Laser Ablation Procedures.

Inaccurate placement of the ablation catheter and the inability to monitor the real-time temperature within the tissue of interest such as veins curbs the treatment efficacy of laser ablation procedures during thermal therapies. Our previous studies have validated the efficacy of photoacoustic (PA) imaging during endovenous laser ablation (EVLA) procedures. However, the PA-guided therapies suffer from low temporal resolution, due to the low pulse repetition rates of pulsed lasers, which could cause a problem during fast catheter motion and rapid temperature changes. Herein, to enhance the accuracy and sensitivity for tracking the ablation catheter tip and temperature monitoring, we proposed to develop a high frame rate (500 Hz), combined ultrasound (US), and PA-guided ablation system. The proposed PA-guided ablation system was evaluated in a set of ex vivo tissue studies. The developed system provides a 2 ms temporal resolution for tracking and monitoring the ablation catheter tip's location and temperature, which is 50 times higher temporal resolution compared to the previously proposed 10 Hz system. The proposed system also provided more accurate feedback about the temperature variations during rapid temperature increments of 10°C per 250 ms. The co-registered US and PA images have an imaging resolution of about 200 µm and a field of view of 45 × 40 mm2. Tracking the ablation catheter tip in an excised tissue layer shows higher accuracy during a relatively fast catheter motion (0.5-3 mm/s). The fast US/PA-guided ablation system will potentially enhance the outcome of ablation procedures by providing location and temperature feedback.

A Novel Anti-LILRB4 CAR-T Cell for the Treatment of Monocytic AML.

To effectively improve treatment for acute myeloid leukemia (AML), new molecular targets and therapeutic approaches need to be identified. Chimeric antigen receptor (CAR)-modified T cells targeting tumor-associated antigens have shown promise in the treatment of some malignancies. However, CAR-T cell development for AML has been limited by lack of an antigen with high specificity for AML cells that is not present on normal hematopoietic stem cells, and thus will not result in myelotoxicity. Here we demonstrate that leukocyte immunoglobulin-like receptor-B4 (LILRB4) is a tumor-associated antigen highly expressed on monocytic AML cells. We generated a novel anti-LILRB4 CAR-T cell that displays high antigen affinity and specificity. These CAR-T cells display efficient effector function in vitro and in vivo against LILRB4+ AML cells. Furthermore, we demonstrate anti-LILRB4 CAR-T cells are not toxic to normal CD34+ umbilical cord blood cells in colony-forming unit assays, nor in a humanized hematopoietic-reconstituted mouse model. Our data demonstrate that anti-LILRB4 CAR-T cells specifically target monocytic AML cells with no toxicity to normal hematopoietic progenitors. This work thus offers a new treatment strategy to improve outcomes for monocytic AML, with the potential for elimination of leukemic disease while minimizing the risk for on-target off-tumor toxicity.

Evaluating the Implementation of the EndoTool Glycemic Control Software System.

PURPOSE: The purpose of this study was to compare achievement of glycemic control on insulin drips before and after the implementation of EndoTool, a glucose management software system used in a community hospital setting. METHODS: A retrospective chart review was performed of patients on an insulin drip who were managed before and after implementation of the EndoTool software. Fifty patients were selected for each group. Statistical analyses were run to compare metrics gathered between groups. RESULTS: Patients in the standard care group were on an insulin drip for an average of 23.9 hours compared to 20.9 hours in the EndoTool group (P = 0.38). Hypoglycemia occurred at an average rate of 0.036 events per patient in the standard group and 0.007 events per patient in the EndoTool group (P = 0.17). The average rate of hyperglycemia was 0.358 events per patient in the standard group and 0.283 events per patient in the EndoTool group (P = 0.25). The average time to achieve the blood glucose target was 2.78 and 3.67 hours in the standard and EndoTool groups, respectively (P = 0.27). Total patient values were within target range 45.2% of the time in the standard care group and 47.3% of the time in the EndoTool group (P = 0.71). CONCLUSION: Analysis of the implementation of EndoTool in the community hospital setting found no statistically significant differences between groups, although rates of hypo- and hyperglycemia showed a trend toward improved safety in the EndoTool group. These results could be attributed to the conservative parameters the hospital set in the initial phase of EndoTool implementation.

Thermal Imaging Metrology with a Smartphone Sensor.

Thermal imaging cameras are expensive, particularly those designed for measuring high temperature objects with low measurement uncertainty. A wide range of research and industrial applications would benefit from lower cost temperature imaging sensors with improved metrology. To address this problem, we present the first ever quantification methodology for the temperature measurement performance of an ultra-low cost thermal imaging system based on a smartphone sensor. The camera was formed from a back illuminated silicon Complementary Metal Oxide Semiconductor (CMOS) sensor, developed for the smartphone camera market. It was packaged for use with a Raspberry Pi computer. We designed and fitted a custom-made triplet lens assembly. The system performance was characterised with a range of state-of-the-art techniques and metrics: establishing a temperature resolution of below 10 °C in the range 600⁻1000 °C. Furthermore, the scene dependent aspects of combined uncertainty were considered. The minimum angular subtense for which an accurate thermal measurement could be made was determined to be 1.35°, which corresponds to a 23 mm bar at a distance of 1 m, or 45:1 field-of-view in radiation thermometer nomenclature.

Trends in hospital admissions due to antidepressant-related adverse drug events from 2001 to 2011 in the U.S.

BACKGROUND: Depression is a prevalent mental health disorder and the fourth leading cause of disability in the world as per the World Health Organization. Use of antidepressants can lead to adverse drug events (ADEs), defined as any injury resulting from medication use. This study aimed to examine changes in hospital admissions due to antidepressant-related ADEs (ArADEs) among different socio-demographic groups and changes in lengths of stay (LOS) and hospital charges in ArADE admissions from 2001 to 2011. METHODS: The Healthcare Cost and Utilization Project database was used. ArADE admissions in different socio-demographic groups were examined including characteristics such as age, gender, rural/urban, and income. LOS and hospital charges for ArADE cases were compared between 2001 and 2011. Chi-square test and t test were used for statistical analyses. RESULTS: There were 17,375 and 20,588 ArADE related admissions in 2001 and 2011, respectively. There was a 17.6% increase among the group of 18 to 64 years old and a 64.8% increase among the group of 65 years or older while the other age groups experienced decreased admission rates. Males and females had similar increases. Patients from the lower income areas experienced a two-fold increase while those from the higher income areas experienced a decrease. The mean LOS for all ArADE related admissions increased from 2.18 to 2.81 days and mean hospital charges increased from $8,456.2 to $21,572.5. CONCLUSIONS: There was an increase in ArADE hospital admissions. The greater increase in ArADE admissions among elderly, urban or low-income patients should be noted and addressed by practitioners and policy makers. The large increase in hospital charges needs further research.

A profilometry-based dentifrice abrasion Method for V8 brushing machines. Part I: Introduction to RDA-PE.

OBJECTIVE: This paper describes the development and standardization of a profilometry-based method for assessment of dentifrice abrasivity called Radioactive Dentin Abrasivity - Profilometry Equivalent (RDA-PE). METHODS: Human dentine substrates are mounted in acrylic blocks of precise standardized dimensions, permitting mounting and brushing in V8 brushing machines. Dentin blocks are masked to create an area of "contact brushing." Brushing is carried out in V8 brushing machines and dentifrices are tested as slurries. An abrasive standard is prepared by diluting the ISO 11609 abrasivity reference calcium pyrophosphate abrasive into carboxymethyl cellulose/glycerin, just as in the RDA method. Following brushing, masked areas are removed and profilometric analysis is carried out on treated specimens. Assessments of average abrasion depth (contact or optical profilometry) are made. RESULTS: Inclusion of standard calcium pyrophosphate abrasive permits a direct RDA equivalent assessment of abrasion, which is characterized with profilometry as Depth test/Depth control x 100. Within the test, the maximum abrasivity standard of 250 can be created in situ simply by including a treatment group of standard abrasive with 2.5x number of brushing strokes. RDA-PE is enabled in large part by the availability of easy-to-use and well-standardized modern profilometers, but its use in V8 brushing machines is enabled by the unique specific conditions described herein. CONCLUSION: RDA-PE permits the evaluation of dentifrice abrasivity to dentin without the requirement of irradiated teeth and infrastructure for handling them. In direct comparisons, the RDA-PE method provides dentifrice abrasivity assessments comparable to the gold industry standard RDA technique.

A Profilometry-Based Dentifrice Abrasion Method for V8 Brushing Machines Part II: Comparison of RDA-PE and Radiotracer RDA Measures.

OBJECTIVE: The purpose of this study was to compare the abrasivity of commercial dentifrices by two techniques: the conventional gold standard radiotracer-based Radioactive Dentin Abrasivity (RDA) method; and a newly validated technique based on V8 brushing that included a profilometry-based evaluation of dentin wear. This profilometry-based method is referred to as RDA-Profilometry Equivalent, or RDA-PE. METHODS: A total of 36 dentifrices were sourced from four global dentifrice markets (Asia Pacific [including China], Europe, Latin America, and North America) and tested blindly using both the standard radiotracer (RDA) method and the new profilometry method (RDA-PE), taking care to follow specific details related to specimen preparation and treatment. RESULTS: Commercial dentifrices tested exhibited a wide range of abrasivity, with virtually all falling well under the industry accepted upper limit of 250; that is, 2.5 times the level of abrasion measured using an ISO 11609 abrasivity reference calcium pyrophosphate as the reference control. RDA and RDA-PE comparisons were linear across the entire range of abrasivity (r2 = 0.7102) and both measures exhibited similar reproducibility with replicate assessments. RDA-PE assessments were not just linearly correlated, but were also proportional to conventional RDA measures. CONCLUSION: The linearity and proportionality of the results of the current study support that both methods (RDA or RDA-PE) provide similar results and justify a rationale for making the upper abrasivity limit of 250 apply to both RDA and RDA-PE.

Clinicopathologic features of relapsed CD19(-) B-ALL in CD19-targeted immunotherapy: Biological insights into relapse and LILRB1 as a novel B-cell marker for CD19(-) B lymphoblasts.

INTRODUCTION: The mechanism of relapsed CD19(-) B-ALL after anti-CD19 immunotherapy (Kymriah [CART-19] and blinatumomab) is under active investigation. Our study aims to assess LILRB1 as a novel B-cell marker for detecting CD19(-) B-lymphoblasts and to analyze the clinicopathologic/genetic features of such disease to provide biological insight into relapse. METHODS: Six patients (3 males/3 females, median age of 14 years) with relapsed CD19(-) B-ALL were analyzed for cytogenetic/genetic profile and immunophenotype. RESULTS: CD19(-) B-ALL emerged after an interval of 5.8 months following anti-CD19 therapy. Five of six patients had B-cell aplasia, indicative of a persistent effect of CART or blinatumomab at relapse. Importantly, LILRB1 was variably expressed on CD19(-) and CD19(+) B lymphoblasts, strong on CD34(+) lymphoblasts and dim/partial on CD34(-) lymphoblasts. Three of six patients with paired B-ALL samples (pre- and post-anti-CD19 therapy) carried complex and different cytogenetic abnormalities, either as completely different or sharing a subset of cytogenetic abnormalities. CONCLUSION: LILRB1 can be used as a novel B-cell marker to identify CD19(-) B lymphoblasts. The emergence of CD19(-) B-ALL appears to be associated with complex cytogenetic evolutions. The mechanism of CD19(-) B-ALL relapse under anti-CD19 immune pressure remains to be explored by comprehensive molecular studies.

RNASeq Analysis for Accurate Identification of Fusion Partners in Tumor Specific Translocations Detected by Standard FISH Probes in Hematologic Malignancies.

Background: Fluorescence labeled DNA probes and in situ hybridization methods had shorter turn round time for results revolutionized their clinical application. Signals obtained from these probes are highly specific, yet they can produce fusion signals not necessarily representing fusion of actual genes due to other genes included in the probe design. In this study we evaluated discordance between cytogenetic, FISH and RNAseq results in 3 different patients with hematologic malignancies and illustrated the need to perform next generation sequencing (NGS) or RNASeq to accurately interpret FISH results. Methods: Bone marrow or peripheral blood karyotypes and FISH were performed to detect recurring translocations associated with hematologic malignancies in clinical samples routinely referred to our clinical cytogenetics laboratory. When required, NGS was performed on DNA and RNA libraries to detect somatic alterations and gene fusions in some of these specimens. Discordance in results between these methods is further evaluated. Results: For a patient with plasma cell leukemia standard FGFR3 / IGH dual fusion FISH assay detected fusion that was interpreted as FGFR3-positive leukemia, whereas NGS/RNASeq detected NSD2::IGH. For a pediatric acute lymphoblastic leukemia patient, a genetic diagnosis of PDGFRB-positive ALL was rendered because the PDGFRB break-apart probe detected clonal rearrangement, whereas NGS detected MEF2D::CSF1R. A MYC-positive B-prolymphocytic leukemia was rendered for another patient with a cytogenetically identified t(8;14) and MYC::IGH by FISH, whereas NGS detected a novel PVT1::RCOR1 not previously reported. Conclusions: These are 3 cases in a series of several other concordant results, nevertheless, elucidate limitations when interpreting FISH results in clinical applications, particularly when other genes are included in probe design. In addition, when the observed FISH signals are atypical, this study illustrates the necessity to perform complementary laboratory assays, such as NGS and/or RNASeq, to accurately identify fusion genes in tumorigenic translocations.