Spatial independent component analysis (ICA) applied to functional magnetic resonance imaging (fMRI) data identifies functionally connected networks by estimating spatially independent patterns from their linearly mixed fMRI signals. Several multi-subject ICA approaches estimating subject-specific time courses (TCs) and spatial maps (SMs) have been developed, however there has not yet been a full comparison of the implications of their use. Here, we provide extensive comparisons of four multi-subject ICA approaches in combination with data reduction methods for simulated and fMRI task data.For multi-subject ICA, the data first undergo reduction at the subject and group levels using principal component analysis (PCA). Comparisons of subject-specific, spatial concatenation, and group data mean subject-level reduction strategies using PCA and probabilistic PCA (PPCA) show that computationally intensive PPCA is equivalent to PCA, and that subject-specific and group data mean subject-level PCA are preferred because of well-estimated TCs and SMs. Second, aggregate independent components are estimated using either noise free ICA or probabilistic ICA (PICA). Third, subject-specific SMs and TCs are estimated using backreconstruction. We compare several direct group ICA (GICA) back-reconstruction approaches (GICA1-GICA3) and an indirect back-reconstruction approach, spatio-temporal regression (STR, or dual regression). Results show the earlier group ICA (GICA1) approximates STR, however STR has contradictory assumptions and may show mixed-component artifacts in estimated SMs. Our evidence-based recommendation is to use GICA3, introduced here, with subject-specific PCA and noise-free ICA, providing the most robust and accurate estimated SMs and TCs in addition to offering an intuitive interpretation.

To resolve the genetic heterogeneity within pediatric high-risk B-precursor acute lymphoblastic leukemia (ALL), a clinically defined poor-risk group with few known recurring cytogenetic abnormalities, we performed gene expression profiling in a cohort of 207 uniformly treated children with high-risk ALL. Expression profiles were correlated with genome-wide DNA copy number abnormalities and clinical and outcome features. Unsupervised clustering of gene expression profiling data revealed 8 unique cluster groups within these highrisk ALL patients, 2 of which were associated with known chromosomal translocations (t(1;19)(TCF3-PBX1) or MLL), and 6 of which lacked any previously known cytogenetic lesion. One unique cluster was characterized by high expression of distinct outlier genes AGAP1, CCNJ, CHST2/7, CLEC12A/B, and PTPRM; ERG DNA deletions; and 4-year relapse-free survival of 94.7% ؎ 5.1%, compared with 63.5% ؎ 3.7% for the cohort (P ‫؍‬ .01). A second cluster, characterized by high expression of BMPR1B, CRLF2, GPR110, and MUC4; frequent deletion of EBF1, IKZF1, RAG1-2, and IL3RA-CSF2RA; JAK mutations and CRLF2 rearrangements (P < .0001); and Hispanic ethnicity (P < .001) had a very poor 4-year relapsefree survival (21.0% ؎ 9.5%; P < .001). These studies reveal striking clinical and genetic heterogeneity in high-risk ALL and point to novel genes that may serve as new targets for diagnosis, risk classification, and therapy. (Blood. 2010; 116(23):4874-4884)

Intravenous vitamin D is standard therapy for secondary hyperparathyroidism in hemodialysis (HD) patients. In for-profit dialysis clinics, mortality was higher for patients on calcitriol compared to paricalcitol. Doxercalciferol, a second vitamin D2 analog, is currently available. We assessed mortality associated with each vitamin D analog and with lack of vitamin D therapy in patients who began HD at Dialysis Clinic Inc. (DCI), a not-for-profit dialysis provider. During the 1999-2004 study period we studied 7731 patients (calcitriol: n=3212; paricalcitol: n=2087; doxercalciferol: n=2432). Median follow-up was 37 weeks. Mortality rates (deaths/100 patient-years) were identical in patients on doxercalciferol (15.4, 95% confidence interval (13.6-17.1)) and paricalcitol (15.3 (13.6-16.9)) and higher in patients on calcitriol (19.6 (18.2-21.1)) (P<0.0001). In all models mortality was similar for paricalcitol versus doxercalciferol (hazard ratios=1.0). In unadjusted models, mortality was lower in patients on doxercalciferol (0.80 (0.66, 0.96)) and paricalcitol (0.79 (0.68, 0.92)) versus calcitriol (P<0.05). In adjusted models, this difference was not statistically significant. In all models mortality was higher for patients who did not receive vitamin D versus those who did (1.2 (1.1-1.3)). Mortality in doxercalciferol- and paricalcitol-treated patients was virtually identical. Differences in survival between vitamin D2 and D3 may be smaller than previously reported.

To determine whether gene expression profiling could improve outcome prediction in children with acute lymphoblastic leukemia (ALL) at high risk for relapse, we profiled pretreatment leukemic cells in 207 uniformly treated children with highrisk B-precursor ALL. A 38-gene expression classifier predictive of relapse-free survival (RFS) could distinguish 2 groups with differing relapse risks: low (4-year RFS, 81%, n ‫؍‬ 109) versus high (4-year RFS, 50%, n ‫؍‬ 98; P < .001). In multivariate analysis, the gene expression classifier (P ‫؍‬ .001) and flow cytometric measures of minimal residual disease (MRD; P ‫؍‬ .001) each provided independent prognostic information. Together, they could be used to classify children with high-risk ALL into low-(87% RFS), intermediate-(62% RFS), or high-(29% RFS) risk groups (P < .001). A 21-gene expression classifier predictive of end-induction MRD effectively substituted for flow MRD, yielding a combined classifier that could distinguish these 3 risk groups at diagnosis (P < .001). These classifiers were further validated on an independent highrisk ALL cohort (P ‫؍‬ .006) and retained independent prognostic significance (P < .001) in the presence of other recently described poor prognostic factors (IKAROS/IKZF1 deletions, JAK mutations, and kinase expression signatures

Genital tract trauma following spontaneous vaginal childbirth is common, and evidence-based prevention measures have not been identified, beyond minimizing the use of episiotomy. This study randomized 1211 healthy women in midwifery care at the University of New Mexico teaching hospital to one of three care measures late in the second stage of labor:1) warm compresses to the perineal area, 2) massage with lubricant, or 3) no touching of the perineum until crowning of the infant's head. The purpose was to assess whether any of these measures was associated with lower levels of obstetric trauma. After each birth, the clinical midwife recorded demographic, clinical care, and outcome data, including the location and extent of any genital tract trauma. The frequency distribution of genital tract trauma was equal in all three groups. Individual women and their clinicians should decide whether to use these techniques based on maternal comfort and other considerations.

March 11, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).The BNT162b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine was recommended by CDC's Advisory Committee on Immunization Practices for persons aged 12-15 years (referred to as adolescents in this report) on May 12, 2021, and for children aged 5-11 years on November 2, 2021 (1-4). Realworld data on vaccine effectiveness (VE) in these age groups are needed, especially because when the B.1.1.529 (Omicron) variant became predominant in the United States in December 2021, early investigations of VE demonstrated a decline in protection against symptomatic infection for adolescents aged 12-15 years and adults* (5). The PROTECT † prospective cohort of 1,364 children and adolescents aged 5-15 years was tested weekly for SARS-CoV-2, irrespective of symptoms, and upon COVID-19-associated illness during July 25, 2021-February 12, 2022. Among unvaccinated participants (i.e., those who had received no COVID-19 vaccine doses) with any laboratory-confirmed SARS-CoV-2 infection, those with B.1.617.2 (Delta) variant infections were more likely to report COVID-19 symptoms (66%) than were those with Omicron infections (49%). Among fully vaccinated children aged 5-11 years, VE against any symptomatic and asymptomatic Omicron infection 14-82 days (the longest interval after dose 2 in this age group) after receipt of dose 2 of the Pfizer-BioNTech vaccine was 31% (95% CI = 9%-48%), adjusted for sociodemographic characteristics, health information, frequency of social contact, mask use, location, and local virus circulation. Among adolescents aged 12-15 years, adjusted VE 14-149 days after dose 2 was 87% (95% CI = 49%-97%) against symptomatic and asymptomatic Delta infection and 59% (95% CI = 22%-79%) against Omicron infection. Fully *

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Two different human diseases, X-linked myotubular myopathy and Charcot-Marie-Tooth disease, result from mutant MTM1 or MTMR2 lipid phosphatases. Although events involved in endosomal PI(3)P and PI(3,5)P 2 synthesis are well established and pivotal in receptor signaling and degradation, enzymes involved in phosphoinositide degradation and their roles in trafficking are incompletely characterized. Here, we dissect the functions of the MTM1 and MTMR2 myotubularins and establish how they contribute to endosomal PI(3)P homeostasis. By mimicking loss of function in disease through siRNA-mediated depletion of the myotubularins, excess PI(3)P accumulates on early (MTM1) and late (MTMR2) endosomes. Surprisingly, the increased PI(3)P blocks the egress of epidermal growth factor receptors from early or late endosomes, suggesting that the accumulation of signaling receptors in distinct endosomes may contribute to the unique disease etiologies when MTM1 or MTMR2 are mutant. We further demonstrate that direct myotubularin binding to the type III PI 3-kinase complex hVps34/hVps15 leads to phosphatase inactivation. The lipid kinase-phosphatase interaction also precludes interaction of the PI 3-kinase with Rab GTPase activators. Thus, unique molecular complexes control kinase and phosphatase activation and locally regulate PI(3)P on discrete endosome populations, thereby providing a molecular rationale for related human myo-and neuropathies. INTRODUCTIONHow phophoinositide synthesis and degradation are coordinately regulated remains a key question in endocytic membrane trafficking. The importance of phosphoinositides in endocytic trafficking has been largely studied by inhibiting lipid kinases or overexpressing lipid phosphatases to reduce lipid levels (Futter et al., 2001;Chaussade et al., 2003;Lu et al., 2003;Petiot et al., 2003;Tsujita et al., 2004;Johnson et al., 2006). The fact that inactivation of lipid phosphatases results in disease points to the importance of optimal phosphoinositide levels in homeostasis (Laporte et al., 1996;Bolino et al., 2000;Bitoun et al., 2005;Niemann et al., 2006;Spinosa et al., 2008).Endocytic membrane trafficking is critically dependent on the local synthesis of phosphatidylinositol 3-phosphate (PI(3)P) and phosphatidylinositol 3,5-phosphate (PI(3,5)P 2 ) (Futter et al., 2001;Chaussade et al., 2003;Ikonomov et al., 2003;Lu et al., 2003;Petiot et al., 2003;Stein et al., 2003;Tsujita et al., 2004;Johnson et al., 2006;Shisheva, 2008). PI(3)P is generated on early endosomes as well as on late endosomes by the type III PI 3-kinase complex hVps34/hVps15 (Gillooly et al., 2000;Simonsen et al., 2001;Stein et al., 2003). PI(3)P is responsible for the temporal recruitment of proteins required for endosome fusion and membrane invagination. Endosomal synthesis of PI(3)P is initiated with the activation of the Rab5 and Rab7 GTPases on early and late endosomes, respectively (Christoforidis et al., 1999;Feng et al., 2001;Murray et al., 2002;Stein et al., 2003Stein et al., , 2005. The activated GTPases bind an...