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• Pancreatic cancer organoids recapitulate disease and allow personalized drug screening

  We report derivation of 30 Patient-Derived Organoid lines (PDOs) from tumors arising in the pancreas and distal bile duct. PDOs recapitulate tumor histology and contain genetic alterations typical for pancreatic cancer. In vitro testing of a panel of 76 therapeutic agents revealed sensitivities currently not exploited in the clinic. The PRMT5 inhibitor EZP015556, shown to target MTAP negative tumors, was validated as such, but also appeared to constitute an effective therapy for a subset of MTAP+ tumors. Taken together, the work presented here provides a platform to identify novel therapeutics to target pancreatic tumor cells using PDOs.

  Study EGAS00001003369

• RNA sequencing data of 142 samples from 142 patients with HER2+ breast cancer treated with letrozole or tamoxifen (SOLTI PAMELA trial)

  PAMELA (NCT01973660) is a non-randomized, open-label, multicentric, prospective translational research study in stage I-IIIA HER2+ breast cancer designed to evaluate the ability of the PAM50 intrinsic subtypes to predict pCR in the breast (pCRB) following 18 weeks of neoadjuvant lapatinib and trastuzumab (+/- hormonal therapy if hormone receptor [HR] positive). Patients with HR+ disease received letrozole (if postmenopausal) or tamoxifen (if pre-menopausal). The primary objective was to compare the pCRB rates of the HER2-E versus the non-HER2-E subtypes in the intent-to-treat population.

  Study EGAS00001006410

• TMD_AMKL_targeted_follow_up

  Genomic libraries will be generated from total genomic DNA derived from 200+ patients with childhood Transient Myeloproliferative Disorder (TMD) and or Acute Megakaryocytic Leukemia (AMKL) as well some matched constitutional samples (n < 50). Libraries will be enriched for a selected panel of genes using a bespoke pulldown protocol. 96 Samples will be individually barcoded and subjected to up to two lanes of Illumina HiSeq. Paired reads will be mapped to build 37 of the human reference genome to facilitate the characterisation of known gene mutations in cancer as well as the validation of potentially novel variants identified by prior exome sequencing.

  Study EGAS00001000569

• The_Causes_of_Clonal_Blood_Cell_Disorders_Study___SCOR

  We will take a bone marrow aspirate and peripheral blood samples from a healthy patient aged around 60, and use flow cytometry to isolate 100 HSCs, 50 MEPs, and 50 GMPs. We will grow these up into colonies, then whole genome sequence each colony. Somatic mutations will act as a unique barcode for each clone. We will then design a panel for targeted resequencing of the mutations that we find. It will then be possible to look for these mutations in the peripheral blood over several years, to see the dynamics of how HSCs contribute to the peripheral blood in health.

  Study EGAS00001002132

• TMD_AMKL_targeted_follow_up_part_2

  Genomic libraries will be generated from total genomic DNA derived from 200+ patients with childhood Transient Myeloproliferative Disorder (TMD) and or Acute Megakaryocytic Leukemia (AMKL) as well some matched constitutional samples (n < 50). Libraries will be enriched for a selected panel of genes using a bespoke pulldown protocol. 96 Samples will be individually barcoded and subjected to up to two lanes of Illumina HiSeq. Paired reads will be mapped to build 37 of the human reference genome to facilitate the characterisation of known gene mutations in cancer as well as the validation of potentially novel variants identified by prior exome sequencing.

  Study EGAS00001000732

• "BaTwa" populations from Zambia retain ancestry of past hunter-gatherer groups

  We genotyped and analyzed over two million genome-wide SNPs from two BaTwa populations (40 individuals by population), and from three comparative farming populations (10 to 21 individuals by population) in order to: (i) determine if the Zambian BaTwa carry any genetic material linking them to past hunter-gatherer-groups, and (ii) characterize the genetic affinities of past Zambian hunter-gatherer-groups. We found that both BaTwa populations harbor a hunter-gatherer- like genetic component, representing ∼19% (Bangweulu) and ∼31% (Kafue) of their genetic ancestry, while the rest of their ancestry is similar to western Africans.

  Study EGAS50000000378

• Role_of_Epigenetic_Memory_in_Human_Induced_Pluripotent_Stem_Cells_Pilot

  Fibroblasts have been shown to re-program into induced pluripotent stem (hiPS) cells, through over-expression of pluripotency genes. These hiPS cells show similar characteristics to embryonic stem cells including cell surface markers, epigenetic changes and ability to differentiate into the three germ layers. However it is unclear as to the extent of changes in gene expression through the re-programming process.. This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute (including details of any publication moratoria), please see http://www.sanger.ac.uk/datasharing/

  Study EGAS00001000742

• Transcriptome sequencing of intravenous leiomyomatosis and uterine myoma

  Up to now, there are two hypothesis about the pathogenesis of the relationship of intravenous leiomyomatosis and uterine myoma. One theory suggests that the IVL comes from the smooth muscle cell in the vessel wall.The other theory indicates that the IVL derives from the uterine myometrium. However, limited to the technology, few studies have been deeply explore the underlying relation. In this study, we employ the RNA sequencing to explore the molecule relationship between IVL and uterus myoma. In order to identify the molecule relationship between IVl and uterine myoma we conducted transcriptome sequencing and bioinformaitc analysis

  Study EGAS00001002504

• T-cell reconstitution after reduced dose ATLG induction in kidney transplant recipients

  Pre-sensitized kidney transplant recipients have a higher risk for rejection following kidney transplantation and therefore receive a lymphodepletional induction therapy with anti human T-lymphocyte globulin (ATLG). The time course of lymphocyte reconstitution with regards to overall and donor-reactive T-cell receptor (TCR) specificity remains elusive. In this study we aimed to describe the TCR repertoire in a reduced dose ATLG regimen making it possible to evaluate shifts in the shape of the immune repertoire and to detect the reappearance of donor-reactive T-cells following reduced lymphodepletional induction therapy.

  Study EGAS00001005941

• Human Developmental Biology Resource (HDBR) abnormal fetal samples

  The HDBR (www.hdbr.org) is a human embryonic and fetal tissue bank supplying registered researchers with access to these valuable research materials up to 22 weeks post-conception (PMC4640175). All of the samples collected are analysed for chromosomal abnormalities, and all samples with an abnormal phenotype are either analysed by SNP array, or exome sequenced. This dataset is generated from those abnormal samples that have been analysed by exome sequencing. To request access to this dataset, or if any researcher is interested in obtaining tissue from any of the samples HDBR collect, please email enquiries@hdbr.org.

  Study EGAS00001006300

• NOTCH-mutations drive immune-escape mechanisms in B cell malignancies

  Here we provide access to MCL expression data that were used for interrogating the molecular functions of NOTCH1 and NOTCH2, which are two of the most commonly mutated genes in CLL and MCL and associated with a poor clinical outcome. The mechanisms underlying how NOTCH1 contributes to disease progression, resistance to treatment and Richter’s transformation remain largely unknown. The main goal of this study is to compare the gene expression profile of primary MCL cells transduced with the intracellular part of NOTCH1 or NOTCH2 lacking of the PEST domain vs cells transduced with an empty vector.

  Study EGAS00001005793

• Characterization of chromatin accessibility in metastatic prostate cancer

  The development of resistance to second-generation AR-signaling inhibitors (ARSIs) and progression to metastatic castrate-resistant prostate cancer (mCRPC) represents a huge obstacle to the improvement of patients’ clinical outcomes. Lineage plasticity is a common mechanism that drives the development of mCRPC by changing chromatin conformation at regulatory elements affecting downstream gene activity. ATAC-seq is a popular technique that measures accessible chromatin regions. To better understand of potential epigenomic mechanisms of ARSI resistance in prostate cancer, in this study, we performed ATAC-seq on 70 mCRPC tissue biopsies from the SU2C/PCF West Coast Dream Team (WCDT) cohort.

  Study EGAS00001006698

• SINGLE CELL ANALYSIS OF IN VITRO ERYTHROPOIESIS

  We are developing a protocol to differentiate mouse and human induced pluripotent stem (IPS) and embryonic stem (ES) cells towards the haematopoietic pathway to generate erythrocytes in vitro. This system has many applications such as the study of the role of specific genes and human polymorphisms in infectious diseases such as malaria, as well as haematological diseases such as myelodysplastic syndrome. The nature of the in vitro differentiation process means that a heterogeneous population of cells is generated. In order to understand the types of cells produced with our protocol, we have performed a single cell analysis, which has the power to reveal the different populations of cells and their characteristics. For this, a cDNA library has been made that needs to be sequenced to obtain the gene expression profiles of the different cells. With this information we will be able to assess the quality of the differentiation protocol and improve it in order to produce better cells for the downstream applications.This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute (including details of any publication moratoria), please see http://www.sanger.ac.uk/datasharing/

  Dataset EGAD00001000979

• STAMPEED: Cardiovascular Health Study (CHS) GWAS to identify genetic variants associated with aging and CVD risk factors and events

  The primary aim of the study is to conduct a genome-wide association study to identify genetic variants associated with the incidence of myocardial infarction (MI), stroke, and heart failure (HF) among participants enrolled in the Cardiovascular Health Study (CHS) who were free of clinical cardiovascular disease at baseline. The secondary aim is to conduct genome-wide association study of other phenotypes in CHS. The study is an ancillary study to CHS. CHS is a population-based cohort study of risk factors for heart disease and stroke among older adults recruited at 4 US sites in 1989-1990. Subjects underwent an extensive baseline examination, and annual follow-up examinations through 1988-1999.

  Study phs000226

• Macrophage response in preterm infants compared to term infants

  Preterm infants are highly susceptible to sustained lung inflammation, which may be triggered by exposure to multiple environmental cues such as supplemental oxygen (O2) and infections. The underlying mechanisms are still poorly understood. The hypothesis of this study is that dysregulated macrophage activation is a key feature leading to inflammation-mediated development of bronchopulmonary dysplasia (BPD) in preterm infants. Cord blood samples of preterm infants (n=14) and term infants (n=19) as well as peripheral blood from healthy adults (n=17) were collected. Age-dependent differences in immune responses of monocyte-derived MФ from preterm infants were characterized and compared to term infants and adults after lipopolysaccharide (LPS) exposure.

  Study EGAS00001004974

• The European Bank for Induced Pluripotent stem cells (EBiSC) is designed to address the increasing demand by iPSC researchers for quality-controlled, disease-relevant research grade iPSC lines, data and cell services.In this study Whole Genome Sequencing was performed on a selection of lines from the project.

  Induced pluripotent stem (iPS) cells have the potential to significantly advance drug development and health research, yet collections of stem cells are scattered across the world, their quality cannot always be guaranteed, and accessing them is often difficult. The goal of EBiSC is to establish a European iPS cell bank that will be the ‘go-to’ resource for the characterisation, storage and distribution of high quality iPS cells. Ultimately, EBiSC will become an independent organisation, distributing high quality iPS cells on a not-for-profit basis to scientists worldwide.

  Study EGAS00001002755

• Evolution of Resistance in ER+ Breast Cancer

  While the combination of endocrine therapy and CDK4/CDK6 inhibitors has been shown to be effective in the metastatic ER+ breast cancer setting, to test whether it is effective in an earlier stage neoadjuvant setting, the FELINE trial (NCT02712723) was established to test the efficacy of letrozole and ribociclib in a ER-positive, HER2-negative patients in a randomized, placebo-controlled, multicenter trial. Patients were randomized to one of three arms: those in Arm A received letrozole and placebo, Arm B letrozole and intermittent ribociclib, and Arm C letrozole and continuous ribociclib. Samples were collected at screening (Day 0), Cycle 1 (Day 14), and end of trial (Day 180). Samples from 24 patients, where cancer cells were present at Day 0 and one additional time point, were subjected to whole-exome sequencing profiling.

  Study phs002287

• IGNITE: Implementing GeNomics In practice: Genomic Medicine Implementation - The Personalized Medicine Program

  IGNITE is an NIH-funded network dedicated to supporting the implementation of genomics in healthcare. IGNITE was created to enhance the use of genomic medicine by supporting the development of methods for incorporating genomic information into clinical care and exploration of the methods for effective implementation, diffusion and sustainability in diverse clinical settings. As part of the IGNITE network, the University of Florida Health Personalized Medicine Program partners with health professionals and patients at UF Health and across the state to develop, implement, study and refine methods that allow genetic information to be used as a routine part of patient care. The program's initial focus is on pharmacogenetics. We also aimed to develop and implement innovative genomic medicine educational programs for health-care providers, health professions students, patients.

  Study phs001978

• Developing Targeted Therapy for Patients with Multiple Myeloma and Gain or Amplification of Chr1q (1q+)

  Multiple myeloma (MM) frequently presents with gain or amplification of chr1q (1q+), which is associated with inferior response to treatment and poor outcomes. To develop targeted therapy for MM with 1q+, we leveraged external and in-house dependency screens and drug screens, along with single-cell sequencing of patient tumors with subclonal 1q+. We demonstrated that MM with 1q+ exhibits higher sensitivity to MCL1 and PI3K inhibitors, which may be synergistic and act through established and novel mechanisms. Two human MM cell lines with 1q+, KMS12BM and KMS11, were profiled with either single-cell RNA-sequencing (scRNA-seq) alone (KMS12BM, KMS11) or both scRNA-seq and whole-genome sequencing (WGS; KMS12BM) to understand the factors that determine response to MCL1 and PI3K inhibitors and how these inhibitors work.

  Study phs003886

• Development of humanized mice for human hematopoisis and immunity research

  We obtained peripheral blood or bone marrow samples from 27 FLT3-ITD+ acute myeloid leukemia (AML) patients and created humanized mice engrafted with human AML cells. We sequenced DNA obtained from patient-derived pre-leukemia and leukemia cells and engrafted human hematopoietic cells and leukemia cells en bulk to detect AML-associated mutations and determine mutations contributing to in vivo. From five of these patients, we also performed single cell DNA sequencing to determine clonal heterogeneity and mutational complexity of human pre-leukemic and leukemic cells and to discriminate between permissive and leukemogenic mutations. Finally, inhibition of a leukemogenic mutation led to effective elimination of human AML cells in vivo, and a co-administration of an inhibitor of anti-apoptotic pathway further improved killing of AML cells in vivo.

  Study JGAS000122

• A sequence-based genetic dissection of human immune cell types and implications for immune-related disease.

  The immune system is an intricate biological network mediating interactions with other organisms while preserving the integrity of our tissues. By mounting appropriate responses it protects us from a vast range of pathogens while inadvertent immune system attacks on self result in autoimmune diseases. The project aims to discover whether and to what extent the behaviour of the immune system is genetically regulated and to detect the relationships of diverse immune cells with autoimmunity. The project consists of the genetic analysis using up to ~8.2 Million variants, deriving from high density genotyping data and low pass whole genome sequencing, and quantitative levels of 95 cell types encompassing 272 immune traits, in a cohort of 1,629 individuals from four clustered Sardinian villages belonging to the SardiNIA/ProgeNIA study.

  Study EGAS00001000574

• Genetic landscape of malignant peripheral nerve sheath tumors

  Neurofibromatosis 1 is a hereditary syndrome characterized by the development of numerous benign neurofibromas, a small subset of which progress to malignant peripheral nerve sheath tumors (MPNSTs). To better understand the genetic basis for MPNSTs, we performed whole genome sequencing on four MPNSTs from patients with neurofibromatosis 1 and found that each of them had a somatic, inactivating mutation of SUZ12, a chromatin modifying gene adjacent to the NF1 gene responsible for the benign neurofibromas in these patients. We then performed targeted sequencing on an additional 46 MPNSTs and found that 12 had somatic mutations in SUZ12. Fifteen of the 17 (88%) mutations in SUZ12 were predicted to inactivate protein function, implicating it as a tumor suppressor gene possibly responsible for the progression from neurofibromas to MPNTs.

  Study EGAS00001000974

• Non-Mendalian inheritance of extrachromosal DNA elements can drive disease evolution in glioblastoma

  Genomic heterogeneity of glioblastoma (GBM) is suspected to contribute to the poor response to therapy of this disease. We compared molecular characteristics between primary GBM, neurospheres and orthotopic xenograft models derived from the same parental tumor. Driver alterations were in majority propagated from tumor to model systems. Extrachromosomal amplifications of MET, a proto-oncogene coding for a receptor tyrosine kinase, were detected in three primary GBM, largely discarded in neurospheres cultures, but resurfaced in xenografts. The clonal dynamics inferred by somatic single nucleotide variants (sSNVs) in MET-amplified samples diverged from the pattern delineated by the MET amplification event suggesting that the MET event and sSNVs were inherited in different manners. Our analysis shows that extrachromosomal elements are able to drive tumor progression.

  Study EGAS00001001878

• Profiling_heterogeneity_in_Human_derived_IPSC_neurons

  The impact of genetic variants on molecular pathways that give rise to neurodegenerative diseases such as Alzheimer’s and Parkinson’s is best elucidated in the appropriate cell types and molecular contexts. Existing studies have focused on bulk profiling of mixed cell types, but have ignored assaying genetic effects across development and cell differentiation. At the core of this proposal is the idea to use single-cell assays to study genetic effects during differentiation of dopaminergic and cortical neurons to identify the sequence of molecular events from variants to healthy and diseased cell states in a cell-specific manner. 1) This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute please see http://www.sanger.ac.uk/datasharing/

  Study EGAS00001002885

• Single-cell multi-omics of relapse/refractory multiple myeloma patients (Hipo K08K/H067/K43R)

  Therapy resistance in cancers is ingrained in complex clonal dynamics. While the major clonal population in a tumour might respond well to the employed intervention, minor clones will eventually mutate, consequently acquiring a selective advantage and drug resistance. Hence, to improve cancer therapy, it is crucial to understand the mechanisms behind clonal evolution. Here, we applied single-cell transcriptomics and epigenomics, as well as whole-genome sequencing to 15 patients with relapsed/refractory multiple myeloma (RRMM). By profiling longitudinal samples throughout varying treatment regimens, we were able to interrogate patterns of evolution across patients. In particular, by defining clones based on copy number aberrations (CNAs), we found evidence for the majority of clones being diminished but not fully eradicated during treatment.

  Study EGAS00001006538

• PyEGA3 download client

  PyEGA3 Checks prior to download - Is the dataset available for download? Most datasets are available using the PyEGA3 Download client, except for specific legacy datasets. For these ones, refer to Live Outbox distribution, an alternative way to download these datasets.If the dataset you've been granted access to begins with the ID EGAD5XXXXXXX, please refer to the Live Outbox distribution. If the dataset you have been granted access to contains encrypted data (filename ending in .gpg), contact EGA Helpdesk for detailed information on how to download these files.General Information The PyEGA3 download client is available at its GitHub repository. In its README you will find a step by step guide on how to use it to download files you have been granted access to. PyEGA3 implements the GA4GH-compliant HTSGET protocol supporting requests over genomic ranges. This enables the download of specific regions of interest rather than the entire file. HTSGET is not possible for all the files held by EGA: if the dataset does not contain index files (e.g. filename ending in *.crai), then genomic range requests cannot be performed. The maximum number of connections allowed is 30. If more than 30 connections are used, the download client will encounter 500 errors. The recommended number of connections for maximum output is one. Check out our video tutorial! Frequently Asked Questions General questions How do I download the datasets to which I have been granted access? After setting up your EGA download account, you can proceed to download using the EGA download client – PyEGA3. The pyEGA3 download client is a python-based tool for viewing and downloading files from authorised EGA datasets. This download client is continuously being developed for more user-friendly download experiences. Can I download the dataset’s metadata via the download client? No, the download client cannot be used to download metadata. Registered EGA users can download metadata of an authorised dataset by logging into the EGA webpage and navigating to the dataset of choice. Approximately two thirds down the page you will find the option to download the metadata as a zip file. How do I download large datasets as quickly as possible? The main EGA download client is pyEGA3 download client, a python-based tool for viewing and downloading files from authorised EGA datasets.We could exceptionally consider the option of an Aspera download for users experiencing very slow download rates or facing particular issues.Contact the EGA Helpdesk for further information. Pre-requirement and Installation What are the major requirements for the PyEGA3 download client installation and usage? The PyEGA3 client is compatible with any OS with Python 3.6+ installed. The client requires a connection to the internet, sufficient space on the destination drive, and the EGA download account credentials. Where can I find the PyEGA3 download client installation and download instructions? We strongly recommend checking our video tutorial demonstrating the usage of PyEGA3 from installation to file download. More detailed information is available at PyEGA3 GitHub. What ports are required for the PyEGA3 download client to function? PyEGA3 makes HTTPS calls to the EGA Data API (https://ega.ebi.ac.uk:8443). This port 8443 must be reachable from the location where PyEGA3 is executed to avoid timeouts. PyEGA3 download client How to update the PyEGA3 download client to be on the latest version? Updating the client to the latest version can be achieved by running the following command: pip3 install pyega3 --upgrade I do not have an active EGA account. Can I test the download with the PyEGA3 download client? An EGA download test account (ega-test-data@ebi.ac.uk) has been created for troubleshooting and training purposes. The test account does not require an EGA username and password because it contains publicly accessible files from the 1000 Genomes Project. More information about the use of this account and log in details are available at pyEGA3. I lost my connection while the download was in progress. Does this mean that I have to download the file again from the start? The PyEGA3 download client supports automatic resumption of downloads. To enable quicker download speeds, the API breaks files into up to four segments and downloads them in parallel. With the resume feature, downloads will automatically resume if you encounter any errors or if the connection is interrupted. How can I improve the overall download speed of the PyEGA3 download client? Download speeds can be optimised using the --connections parameter which will parallelise download at the file level. If the --connections parameter is provided, all files >100Mb will be downloaded using the specified number of parallel connections. It is important to note that files are still downloaded sequentially, so using multiple connections does not mean downloading multiple files in parallel. The maximum number of connections allowed is 30. If more than 30 connections are used, the download client will encounter 500 errors. The recommended number of connections for maximum output is one. Why is my file taking a long time to be saved? Please note that when a file is being saved, it goes through two processes. First, the downloaded file "chunks" are pieced back together to reconstruct the original file. Secondly, PyEGA3 calculates the checksum of the file to confirm that the file was downloaded successfully. Larger files will take more time to reconstruct and validate the checksum. Why is the HTSGET protocol not working with my dataset of interest? PyEGA3 implements the GA4GH-compliant htsget protocol for supporting requests over genomic ranges. This exciting new feature means that for data files with accompanying index files (e.g. .crai for CRAM files) users can download specific regions of interest rather than the entire file, saving both time and storage space. Please note that in order for the genomic range requests to work for a BAM, CRAM or VCF file there must be an associated BAI, CRAI or TBI file, respectively. If the dataset does not contain these index files then genomic range requests cannot be performed. After download Do I need to decrypt data files downloaded through the pyEGA3 download client? Files are transferred over secure HTTPS connections and received unencrypted, thus there is no need for decryption after data download. What is the purpose of an MD5 file? After the download completes, file integrity is verified using checksums. The PyEGA3 download client automatically verifies each file’s unencrypted md5 after download to ensure that the file was downloaded correctly from the EGA. Errors Why do I get a “400 Client Error” while trying to access the download client? Ensure that your credentials are formatted correctly. Please contact the EGA Helpdesk if you are unsure about your account’s username (i.e. your email address). Why do I get a “500 Server Error”? It is important to note that files are still downloaded sequentially, so using multiple connections does not mean downloading multiple files in parallel. The maximum number of connections allowed is 30. If more than 30 connections are used, the download client will encounter 500 errors. The recommended number of connections for maximum output is one. Otherwise, 500 server errors are internal server errors from EGA’s end. Retry after some time and, if the 500 error persists: check our homepage or Twitter for any outage information or report it to EGA Helpdesk. Why do I get a “slice error”? This type of error occurs when one slice download was prematurely interrupted. Please re-start the same download. The download client will pick up any partial download and download any missing slices. Why do I get the error “Dataset' EGADXXXXXXXXXXX' is not in the list of your authorised datasets”? Please note that the data access was given to the email (username) provided to the Data Access Committee (DAC) in your official request. Therefore, you shall check that the account that you are using is the same one that you sent to the DAC. Why do I get “ERROR:root:Failed to obtain IP address”? This might mean that the connection ports are blocked. Check that the port 8443 is reachable.In case the port is reachable and the error persists, please try to modify the file pyega3.py on line 44 in the python module installation: Replace endpoint = 'https://ipinfo.io/json' with endpoint = 'https://api.myip.com' Why do I get the error “Invalid username, password or secret key - please check and retry”? Make sure that you are using the correct credentials (username and password) and there is no typo. Contact EGA Helpdesk if the problem persists.

  Documentation access/download/files/pyega3

• Genomic Diagnosis and Individualized Therapy of Highly Penetrant Genetic Diabetes

  The most common and well-known causes of diabetes are type 1 and type 2 diabetes; however, there are many other etiologies of diabetes. At least 1-2% of diabetes cases result from high penetrance single gene defects, most commonly in a gene encoding either a transcription factor involved in beta cell development and function or the enzyme glucokinase (GCK). Others have mutations in transcription factors necessary for beta cell development and function. This subset of monogenic diabetes cases is autosomal dominant and is known as "Maturity-Onset Diabetes of the Young" (MODY). Patients with type 1 diabetes are insulin dependent, meaning they lack insulin production and therefore require multiple daily injections of insulin, as well as multiple times a day blood glucose monitoring. This can be quite burdensome. Type 2 diabetes is predominantly an insulin resistance problem and can often be managed with pills initially, but there are many who also require insulin either at diagnosis or later on in their disease course. Usually, monogenic diabetes is misdiagnosed as type 1 or type 2 diabetes and thus treated suboptimally. Those with monogenic diabetes, due to a defect in a gene encoding a transcription factor, respond extremely well to a class of oral diabetes medications called sulfonylureas. Those with GCK-MODY often have a mild, stable, fasting, nonprogressive hyperglycemia for which pharmacological treatment is often not necessary. It is important to accurately diagnose our patients with the correct etiology to their diabetes for a multitude of reasons. Accurately diagnosing a patient with MODY, for example, can predict their clinical course and we can tailor treatment accordingly. If diagnosed with a transcription factor MODY, we can try switching the patient from insulin to an oral sulfonylurea, and if diagnosed with a GCK-MODY, we can consider discontinuing pharmacological treatment altogether. With specific tailoring of treatment, we would hope to improve quality of life by discontinuing perhaps multiple daily injections of insulin and glucose checking as these may not be necessary. In addition, we would hope to improve glycemic control with an eventual decreased cost to society by decreasing the complication rate of diabetes, resulting in less specialty referrals, lab tests, supplies and procedures. Further, given MODY is an autosomal dominant condition with a 50% chance of inheritance to first-degree family members, we could offer testing to asymptomatic family members which could lead to prevention and/or early diagnosis and treatment. Overall, testing for monogenic diabetes is underutilized clinically. Testing is being done in the U.K., but in the U.S. we are lagging behind. This is most predominantly due to lack of knowledge and concern over cost. In addition, it is difficult to differentiate the relatively small number of monogenic diabetes cases from the larger number with type 1 and type 2 diabetes as each of these etiologies have overlapping characteristics. In fact, many patients with monogenic diabetes are being misdiagnosed with type 1 and type 2 diabetes. There are recommendations set forth by different societies on who to consider screening for monogenic diabetes. However, these recommendations are difficult to employ clinically as they are general recommendations, there is no specific algorithm, and they are based on varying levels of evidence. The purpose of this study is to implement a personalized diabetes medicine program to enhance the identification of individuals and families affected by highly penetrant diabetes gene mutations through a combination of systematic screening and genetic testing at the University of Maryland Center for Diabetes and Endocrinology, the Baltimore VA Medical Center and additional partner centers at Geisinger Health System and Bay West Endocrinology Associates, and other UM outpatient clinics. Our hope is to develop an approach that can be eventually implemented across the United States so that we can more often uncover the correct etiology to diabetes, tailor treatment accordingly, and test asymptomatic family members.

  Study phs001771

• Programmatic submission based on XML

  Programmatic submissions (XML based) For further information please check our Submission FAQs, submission quickguide as well as submission terms! Introduction Besides the Submitter Portal tool, EGA supports programmatic sequence and clinical data metadata submissions. If you are not sure what this means, you may want to explore our brief metadata introduction. Programmatic submissions are recommended for array-based submission. Moreove, it may be of help if your submission is recurrent or it is difficult to manage manually due to its sheer size. Otherwise, we highly recommend using the Submitter Portal to perform submissions. In this page we will guide you through the required steps to programmatically submit data to the EGA. Programmatic submissions require your metadata to be structured for an easy and straightforward validation and archival. It basically consists in formatting your metadata as Extensible markup language (XML) files and submitting them to the EGA using the WEBIN Before submitting metadata to the EGA, it is important to ensure that the information in your XML files is compliant with our standards. You can see further details on how these standards are maintained at EGA at our EGA Schemas documentation page. Using WEBIN, you can validate your XML files against EGA's schemas to ensure that your metadata is compliant before submission. WEBIN services WEBIN production service WEBIN test service We advise you to submit your metadata to the test service when submitting to the production service for the first time. The test service is identical to the production service except that all submissions will be discarded in the following 24 hours. This allows you to learn about the submission process without having to worry about data being submitted. Authentication Authentication is required each time a submission is made. The submission service uses HTTPS protocol for metadata encryption and identification to provide a secure submission environment. Data file upload Both Runs and Analyses reference files (e.g. FASTQ need to be uploaded to the EGA before these metadata objects are submitted. In other words, if you submit a Run that references a file that we cannot find associated with your account, the metadata submission will fail. See further details on how to upload your files in our File Upload documentation. Metadata model of the EGA Our metadata model is formed by multiple metadata objects. Check further details in our documentation at our EGA Schema documentation page. Working with EGA XMLs files Now that the basic concepts of the EGA metadata have been described, you can start preparing your programmatic submission through XML. Here you will find the guidance on how to prepare the XML files. Programmatic Submission Tutorial Video Take a look at the Programmatic Submission Tutorial Video, which explains the workflow of a programmatic submission and goes over an example metadata submission. Programmatic Submission Tutorial Video. When building your XML files, we recommend using text editors (e.g.Sublime Text or VisualStudio) that allow you to visualise the structure of the XML with ease. Furthermore, these editors constantly check the consistency of the XML structure. Alternatively, and if the submission consists of a big number of objects (specially analyses), you may find the tool star2xml handy. This tool allows for a direct conversion between metadata in a tabular format (e.g. a spreadsheet) into XMLs. Identifying objects: Aliases and center names Every EGA object must be uniquely identified within the submission account using their alias attribute. The aliases can be used in submissions to make references between EGA objects. Let us dig into EGA's use of aliases and center names: alias: every object should have a name that is unique within your submission account. Once submitted successfully, every alias will be assigned a unique and permanent accession (EGA ID). refname: when an object references another by its alias, the alias of the referenced object goes into the "refname" attribute of the referencing object. For example, if a sample has the alias "sample1", and an experiment uses this sample, then the experiment's "EXPERIMENT/SAMPLE/refname" attribute should be "sample1". center_name: The "center_name" attribute is required within the submission XML and, if not provided when the object is submitted, it will be automatically filled using your default EGA account center_name. This element is the "controlled vocabulary acronym or abbreviation that is provided to the account holder when the account is first generated". If the submitter is brokering a submission for another institute, the submitter should use their special broker account name in broker_name while the data centre acronym remains in center_name. Log-in details should have been provided when you requested a submission account. Please contact our Helpdesk team if you have any questions. run_center: Many submitting centers contract out the actual sample sequencing to another center. In these cases, the sequencing center should be acknowledged in the run_center attribute. Again, this is controlled vocabulary and the acronym should be sought from EGA helpdesk before submitting. Please contact our Helpdesk team if you have any questions. Prepare your XMLs The goal of this section is to provide sufficient information to be able to create the metadata XML documents required for programmatic submissions. Please note, the EGA utilises the XML schemas maintained at the European Nucleotide Archive (ENA). It is important due to the fact that by using a similar system, some pieces of documentation from the ENA's programmatic submission can also help you with your programmatic submission to the EGA. For example, you can submit programmatically without using a Submission XML by following the steps at Submission actions without submission XML. A submission does not have to contain all different types of XMLs. For example, it is possible to submit only a few samples; or a study that is later to be referenced. You can submit each object one by one, or submit all in a batch: you choose what method of submission works best for you. We do recommend, nevertheless, that you submit the objects to be referenced (e.g. samples or studies) first, and the objects that reference these (e.g. experiments or datasets) afterwards. You can see a graphical view of these objects and their relationships at our EGA Schemas page. Independently of the submission scenario, you will always require a Dataset XML. The entity of a dataset is what is used to control access to the given data, in the form of runs or analyses. In other words, when a requester is granted access, it is through the dataset and the objects (e.g. runs or analyses) that the dataset contains, granting access to them in one go. Given the nature of the EGA, a dataset XML will always be required for the data access. First, we will differentiate between submissions of "raw" and "processed" data: Runs and Analyses, respectively. Run data submissions Raw data derives from instruments "as is". For example, a plain sequence file (e.g. FASTQ or unaligned BAM files) would be considered raw data. A typical raw (unaligned) sequence read submission consists of 8 XMLs: Submission Study Sample Experiment Run DAC Policy Dataset When technical reads (e.g. barcodes, adaptors or linkers) are included in the submitted raw sequences, a spot descriptor must be submitted to describe the position of the technical reads so that they can be removed. The following data files can be submitted without providing spot descriptor information in the experiment/run XML: BAM files (single reads) SFF files (single reads without barcodes) FastQ files (single reads without any technical reads) Complete Genomics files Analysis data submissions Processed data is, in some way, refined raw data. This includes raw data that has been processed by some form of analysis method (e.g. alignment, noise reduction, etc.). For example, an aligned sequence (e.g. BAM file), that was created using raw FASTQ files, would be a processed file. This category includes most types of data: sequence alignment files (e.g. BAM or CRAM), clinical data (e.g. phenopackets), sequence variation files (e.g. VCF), sequence annotation, etc. A typical EGA analysis data submission consists of 7 EGA XML: Submission Study Sample Analysis DAC Policy Dataset We accept three different types of analysis data submissions: BAM files (for multiple read alignments) VCF files (for sequence variations) Phenotype files (in any format) In anycase, keep in mind that samples must be created in order to be referenced in the analyses. In other words, the provenance of the information within the BAM, VCF and phenotype files Example XMLs Below you can find a non-extensive list of example XMLs with descriptive fields (i.e. explaining what to provide in each field). Furthermore, you can also find real examples (i.e. the true value of the provided fields) in our GitHub repository. Submission XML The submission XML is used to validate, submit or update any number of other objects. The submission XML refers to other XMLs. New submissions use the ADD action to submit new objects. Object updates are done using the MODIFY action and objects can be validated using the VERIFY action. Descriptive submission XML example True values submission XML example Study XML The study XML is used to describe the study containing a title, a study type and abstract as it would appear in a publication. Descriptive study XML example True values study XML example Please use the following notation within the property "STUDY_LINKS" when including PubMed citations in the Study XML: <STUDY_LINKS> <STUDY_LINK> <XREF_LINK> <DB>PUBMED</DB> <ID>18987735</ID> </XREF_LINK> </STUDY_LINK> </STUDY_LINKS> Sample XML The sample XML is used to describe the samples used to obtain the data, whether they were sequenced, measured in any other way, or have an associated phenotype. The mandatory fields include information about the taxonomy of the sample, sex, subject ID and phenotype. For example, the mandatory attribute fields for each sample would look like these, within the array of "SAMPLE_ATTRIBUTES": <SAMPLE_ATTRIBUTES> <SAMPLE_ATTRIBUTE> <TAG>subject_id</TAG> <VALUE>free text!</VALUE> </SAMPLE_ATTRIBUTE> <SAMPLE_ATTRIBUTE> <TAG>sex</TAG> <VALUE>female/male/unknown</VALUE> </SAMPLE_ATTRIBUTE> <SAMPLE_ATTRIBUTE> <TAG>phenotype</TAG> <VALUE>Free text, EFO terms (e.g. EFO:0000574) are recommended</VALUE> </SAMPLE_ATTRIBUTE> </SAMPLE_ATTRIBUTES> Sample is one of the most important objects to be described biologically, it is highly recommended that “TAG-VALUE” pairs are generated as SAMPLE_ATTRIBUTES to describe the sample in as much detail as possible. For example, were we to give the population ancestry of the sample, we could add a new attribute to the array, in which, for example, we would indicate that the sample derives from an individual of "Mende in Sierra Leone" (MSL), with an african ancestry: <SAMPLE_ATTRIBUTE> <TAG>Population</TAG> <VALUE>MSL</VALUE> </SAMPLE_ATTRIBUTE> Given that VALUE and TAG are free text, the combinations are limitless in order to give you full flexibility on the information you want to provide. We recommend you use the Experimental Factor Ontology (EFO) to describe the phenotypes of your samples. You can provide more than one phenotype by adding more items to the array of SAMPLE_ATTRIBUTES. Phenotypes considered essential for understanding the data submission should be provided. Each phenotype described should be listed as a separate sample attribute <SAMPLE_ATTRIBUTE> </SAMPLE_ATTRIBUTE>. There is no limit to the number of phenotypes that can be submitted. If a suitable EFO accession cannot be found for your phenotype attribute, please consider using another controlled ontology database (e.g. HPO, MONDO, etc.) before using free text. Descriptive sample XML example True values sample XML example Experiment XML The experiment XML is used to describe the experimental setup, including instrument platform and model details, library preparation details, and any additional information required to correctly interpret the submitted data. Where any of these values differ between runs, a new experiment object must exist, since runs are grouped by experiments. Each experiment references a study and a sample by alias, or if previously-submitted, by accession. Pooled data must be demultiplexed by barcode for submission. Descriptive experiment ( Illumina paired read ) XML example True values experiment ( Illumina paired read ) XML example Run XML The run XML is used to associate data files with experiments and typically comprises a single data file (e.g. a FASTQ file). Please note that pooled samples should be de-multiplexed prior submission and submitted as different runs. Descriptive run XML example True values run XML example Analysis XML Given that an analysis can be used to submit any type of processed data to the EGA, we will list below an example of each of the three most common types of analysis XMLs submitted to the EGA: sequence alignments (e.g. BAM files); sequence variation (e.g. VCF files); and clinical metadata or phenotypes (e.g. phenopackets). Regardless of the type of processed data submitted in the analysis, the analysis must be associated with a Study and can reference multiple types of other objects, from samples to experiments, if they are available at the EGA. Just like with Runs, whenever a file is submitted to the EGA through an analysis object, the file MD5 checksums must be present, in order for the EGA to validate file integrity upon transfer. This also includes index files when applicable (e.g. .bai.md5 files). Ideally, any analysis that uses a reference sequence for some kind of alignment (e.g. BAM, CRAM or VCF files), would contain metadata about the alignment, such as INSDC reference assemblies and sequences, by either using accessions (e.g. CM000663.1) or common labels (e.g. GRCh37). Read alignment (BAM) Analysis XML The Analysis can be used to submit BAM alignments to EGA. Only one BAM file can be submitted in each analysis and the samples used within the BAM read groups must be associated with Samples. Descriptive bam alignments XML example True values bam alignments XML example Sequence variation (VCF) Analysis XML The Analysis can be used to submit VCF files to EGA. Only one VCF file can be submitted in each analysis and the samples used within the VCF files must be associated with Samples. Download analysis XML (VCF) Phenotype files The Analysis XML can be used to submit phenotype files to the EGA. Only one phenotype file can be submitted in each analysis and the samples used within the phenotype files must be associated with EGA Samples. Download analysis XML (Phenotype) DAC XML The DAC XML describes the Data Access Committee (DAC) affiliated to the data submission. The DAC may consist of a group or a single individual and is responsible for the data access decisions based on the application procedure described in the POLICY.XML. As with any other object, if it was already submitted to the EGA, there is no need to submit it again: you can reference an existing object within the EGA. Hence, A DAC XML does not need to be provided if your submission is affiliated to an existing EGA DAC.. Further information on DACs can be found here, and you can always contact our Helpdesk team if you have further inquiries. Descriptive dac XML example True values dac XML example Policy XML The Policy XML describes the Data Access Agreement (DAA) to be affiliated to the named Data Access Committee. Descriptive policy XML example True values study XML example Dataset XML The dataset XML describes the data files, defined by the Run.XML and Analysis.XML, that make up the dataset and links the collection of data files to a specified Policy. The dataset xml is commonly the last metadata object to be submitted, since it references multiple other entities. Please consider the number of datasets that your submission consists of. For example, a case-control study is likely to consist of at least two datasets. In addition, we suggest that multiple datasets should be described for studies using the same samples but different sequence technologies. Descriptive dataset XML example True values dataset XML example Validating and submitting your EGA Validating EGA's XMLs through Webin After you have ensured that the XMLs are properly formatted and contain all the required information. You can proceed to validate and submit your data. Use the curl command to validate your XML file: Once you have prepared your XML file and asserted you have access to Webin, you can validate your XML file programmatically against EGA's schemas using the curl command. There are multiple ways in which you can validate your XMLs. This variety has to do with the fact that: (1) there are 2 instances of Webin (test and production); and (2) that validation is a default step during submission. In other words, any time that you submit your data through Webin, it will be validated automatically before being accepted. This allows for 4 possible routes of validation, all having the same validation result: validating or submitting to either the production service or the test service of Webin. For example, directly validating a "study" object XML in the testing service (wwwdev…) would look like the following: curl -u <USERNAME>:<PASSWORD> -F "ACTION=VALIDATE" "https://wwwdev.ebi.ac.uk/ena/submit/drop-box/submit/" -F "STUDY=@study.xml" In this command, you would need to replace <USERNAME> and <PASSWORD> with your EGA account username and password, respectively. You would also replace <INPUT_FILE> with the path to your XML file. A mock example would look like the following: curl -u ega-test-data@ebi.ac.uk:egarocks -F "ACTION=VALIDATE" "https://wwwdev.ebi.ac.uk/ena/submit/drop-box/submit/" -F "STUDY=@study.xml" The validation attempt can have different results depending on the given arguments: If your XML file is valid according to EGA's schemas, you will see a message indicating that your XML file is compliant. For example, see below for our mock example, where the "success" was "true" (i.e. no validation errors found). Nevertheless, notice how the "<STUDY accession=" is empty: it is because we were simply validating, so the study did not get an accession or ID. <?xml version="1.0" encoding="UTF-8"?> <?xml-stylesheet type="text/xsl" href="receipt.xsl"?> <RECEIPT receiptDate="2023-04-11T15:19:28.850+01:00" submissionFile="submission-EBI-TEST_1681222768850.xml" success="true"> <STUDY accession="" alias="Mock example" status="PRIVATE"/> <SUBMISSION accession="" alias="SUBMISSION-11-04-2023-15:19:28:840"/> <MESSAGES> <INFO>VALIDATE action has been specified.</INFO> <INFO>Submission has been rolled back.</INFO> <INFO>This submission is a TEST submission and will be discarded within 24 hours</INFO> </MESSAGES> <ACTIONS>VALIDATE</ACTIONS> <ACTIONS>PROTECT</ACTIONS> If there are any errors or warnings, the tool will display them, allowing you to correct them before submitting your data to EGA. For example, in the following response, it is said that the object we were trying to submit was already existing, and therefore the "success" was "false". <?xml version="1.0" encoding="UTF-8"?> <?xml-stylesheet type="text/xsl" href="receipt.xsl"?> <RECEIPT receiptDate="2023-04-11T15:12:35.609+01:00" submissionFile="submission-EBI-TEST_1681222355609.xml" success="false"> <STUDY alias="Example!_Human Microbiome Project SP56J" status="PRIVATE" holdUntilDate="2023-03-11Z"/> <SUBMISSION alias="SUBMISSION-11-04-2023-15:12:35:576"/> <MESSAGES> <ERROR>In study, alias: "Example!_Human Microbiome Project SP56J". The object being added already exists in the submission account with accession: "ERP127584".</ERROR> <INFO>VALIDATE action has been specified.</INFO> <INFO>Submission has been rolled back.</INFO> <INFO>This submission is a TEST submission and will be discarded within 24 hours</INFO> </MESSAGES> <ACTIONS>VALIDATE</ACTIONS> <ACTIONS>PROTECT</ACTIONS> If the curl command retrieves no response at all, please double check if your username and password are correctly provided. Also notice the "ACTION=..." argument passed to the Curl command. This specifies the action to take during the call to Webin, so we do not need a "Submission" XML just for a validation attempt. See more at submission actions without submission XML. Furthermore, validation of multiple files or objects (e.g. sample, experiment, study…) can be done in a single command by adding more arguments (i.e. '-F'). For example: curl -u <USERNAME>:<PASSWORD> -F "ACTION=VALIDATE" "https://wwwdev.ebi.ac.uk/ena/submit/drop-box/submit/" -F "STUDY=@study.xml" -F "SAMPLE=@sample.xml" -F "DATASET=@dataset.xml" As mentioned above, beside "validate" action in the test environment, you can also validate your metadata by three other methods: "Validate" in the production server. From our example above, you simply need to take the "dev" away from the URL. curl -u <USERNAME>:<PASSWORD> -F "ACTION=VALIDATE" "https://www.ebi.ac.uk/ena/submit/drop-box/submit/" -F "STUDY=@study.xml" "Add" in the development server. From our example above, you would simply need to replace the action: from "validate" to "add". Whatever is submitted to this service will be discarded in 24h, so whether something gets submitted or not would not matter in the long run. curl -u <USERNAME>:<PASSWORD> -F "ACTION=ADD" "https://wwwdev.ebi.ac.uk/ena/submit/drop-box/submit/" -F "STUDY=@study.xml" "Add" in the productionserver. A combination of the previous two methods, which would render this attempt into a submission. This path is just to be taken when you are sure your metadata is compliant and what you want to submit. curl -u <USERNAME>:<PASSWORD> -F "ACTION=ADD" "https://www.ebi.ac.uk/ena/submit/drop-box/submit/" -F "STUDY=@study.xml" What happens after the submission of a dataset XML? Once you have completed the registration of your dataset/s please contact our Helpdesk Team to provide a release date for your study. Please note that all datasets affiliated to unreleased studies are automatically placed on hold until the authorised submitter or DAC contact contact the EGA Helpdesk for the study to be released. We strongly advise you not to delete your data until EGA Helpdesk confirms that your data has been successfully archived.

  Documentation submission/metadata/submission/programmatic-submission-xml

• Genome-Wide Predictors of Treatment-Related Toxicities in SWOG S0221 Trial

  When undergoing treatment for breast cancer, many women experience severe side effects, some of which result in treatment-related death and some that can persist for years. Little is understood regarding factors that may predict drug toxicities. Pharmacogenetics, the investigation of variants in candidate genes in drug metabolism pathways, has been used to determine susceptibility to treatment-related toxicities, as well as to cancer recurrence. Although there have been some strong and important findings using this approach, such as identification of single nucleotide polymorphisms (SNPs) that predispose to side effects associated with thiopurines and irinotecan, there has been less progress in assessment of genetic variants that predispose to toxicities resulting from the multi-drug regimen commonly used to treat breast cancer, anthracyclines (A), cyclophosphamide (C), and taxanes (T). These difficulties in identification of key gene variants may be due to the complex metabolic pathways of these drugs, the lack of rate limiting enzymes in the processes, or the limitations of single SNP analysis, rather than capturing all of the variability across the genes. In addition to drug metabolism pathways, however, there may be a number of constitutional factors or other processes that affect damage to normal tissues in the course of chemotherapy, some known or hypothesized, such as DNA repair and oxidative stress pathways, and others not yet discovered. However, there have been no clear candidate genes that account for a large part of the variation in drug or treatment response, and there are likely important genes that influence sensitivity of cells to chemotherapy through unknown pathways which have not yet been identified or hypothesized. The present technological capabilities to screen the entire genome for variants that discriminate populations allows the opportunity to identify these as yet unknown pathways, and open the doors to exciting new avenues of research into mechanisms that had not been previously considered. We conducted a genome-wide scan (GWAS) in a clinical trial (S0221), in which women with high risk breast cancer were treated with different dosing schedules of C, A and T. Blood specimens were collected and banked, and DNA extracted for genotyping on the Illumina OMNI 1M platform. The GWAS data were used to examine genetic variants significantly associated with grades 3 and 4 toxicities, including peripheral neuropathy recorded during the T segment. In S0221, toxicities were graded according to the NCI Common Toxicity Criteria for Adverse Events (CTCAE). The neurotoxicity is predominantly a distal sensory neuropathy, which is characterized by pain, numbness, tingling, and reduced functional capacity in the extremities. Other symptoms include parasthesias, ataxia, impaired vibration and joint position sense, and loss of tendon reflexes. By using a GWAS approach, it is likely that important pathways not previously considered can be revealed as important in susceptibility to treatment-related toxicities, identifying those at greatest risk for alternate drugs or dose reduction, and opening new areas of research for prevention of taxanes-related neuropathy among patients receiving chemotherapy for breast cancer.

  Study phs001428

• NHLBI TOPMed: My Life Our Future (MLOF) Research Repository of Patients with Hemophilia A (Factor VIII Deficiency) or Hemophilia B (Factor IX Deficiency)

  Hemophilia A and B are X-linked bleeding disorders resulting from a deficiency in coagulation factor VIII (FVIII) or factor IX (FIX), respectively. Hemophilia affects approximately 1/5000 male births worldwide, and results in premature death and disability due to bleeding if coagulation factor replacement therapy is not used effectively. Hemophilia is clinically categorized by coagulation factor activity levels and ranges in severity from mild (6% to 30%) to moderate (1-5%) to severe (&lt;1%). Many female "carriers" of hemophilia also have decreased factor activity and morbidity from bleeding. Hemophilia A and B are almost always caused by identifiable mutations in the F8 and F9 genes, respectively, and these mutations are found throughout the structural genes. Although the hemophilias are monogenic disorders, there are wide variations in disease severity and therapeutic outcomes which are not readily explained by the disease causing mutations alone. The My Life Our Future (MLOF) project (www.mylifeourfuture.org) is a national resource developed by a partnership of BloodworksNW (BWNW, formerly the Puget Sound Blood Center), the American Thrombosis and Hemostasis Network (ATHN), the National Hemophilia Foundation (NHF) and Bioverativ, to provide free F8 and F9 gene variant analysis to patients with hemophilia A or B, and to establish a research repository of DNA sequence, DNA, RNA, buffy coat, serum and plasma. The sequence analysis and serum samples are linked to a phenotypic database hosted by ATHN, with samples submitted and clinical data entered at ~100 hemophilia treatment centers (HTCs) nationwide. (See ATHN Research Report Brief in the resource center at www.athn.org). MLOF has become the largest hemophilia genetic project worldwide. The roles of the MLOF partners are: BWNW, to serve as the central laboratory for the project and house the research repository; ATHN, to support and provide the administrative link with HTCs, to facilitate the collection of accurate phenotypic data, to conduct research review and approval for use of the repository and with BWNW to provide samples and data for research projects; NHF, to provide consumer education and facilitate consumer input into the project; and Bioverativ, to provide financial support and scientific input. The project is governed by a Steering Committee consisting of one representative from each organization. Subject samples chosen from the MLOF parent study for TOPMed and WGS were drawn from those who gave (or parents gave) informed consent for the Research Repository and included patients of all severities and type, but with an emphasis on those with severe hemophilia and others at increased risk of neutralizing antibody (inhibitor) formation and who had samples in the Research Repository (plasma, serum, RNA) for potential additional -omic studies. Also included were samples from subjects where a likely causative variant for hemophilia was not found in the F8 or F9 coding region, intron-exon boundaries or immediate upstream and downstream regions. Since hemophilia is an X-linked disorder, the majority of subjects are male. Racial distribution is similar to the overall population distribution.

  Study phs001515

• Understanding the genetic risk underlying racial disparities in uterine fibroids

  Fibroids affect 77% of women by onset of menopause in the U.S. and account for $2.1 billion in healthcare costs each year. Fibroids negatively impact reproductive health causing heavy and painful menses, pelvic pain and pressure, pregnancy complications, and interventions including myomectomy and hysterectomy. Until recently, tumor tissue and cell culture studies investigating fibroid growth have been the primary sources for understanding fibroid pathophysiology. Genetic analysis can provide a powerful and cost effective tool to identify etiological and causal factors, especially since a genetic predisposition to fibroids has already been documented from twin studies. As much as 69% of risk is explained by genetic factors. Racial disparities also support a role for genetics with fibroid risk. African American women have earlier age of onset, more numerous and larger fibroids with a greater lifetime incidence compared to Caucasians. We propose to identify genetic markers for risk of fibroids through a genome-wide association study (GWAS) of African American and Caucasian participants, leveraging ancestral differences to narrow down genomic regions for targeted follow- up analyses. To accomplish this we will take advantage of a unique Vanderbilt resource, the BioVU DNA databank. BioVU currently has over 122,470 adults linked to electronic medical records. From BioVU we have already identified 2,902 African American and Caucasian subjects who meet our stringent inclusion criteria to conduct a GWAS of fibroids, including pelvic imaging. Available imaging is critical, because many women with fibroids are asymptomatic and without imaging, studies may misclassify as many as 51% of women. We have also defined definitive controls who reached menopause without fibroids. We have a strong group of nationally known fibroid researchers who will provide over 10,000 samples for replication. Our first Specific Aim is to conduct a GWAS for association between common single nucleotide polymorphisms (SNPs) and fibroid risk. Using a case-control design we will perform a GWAS in 2,902 (1,451 fibroid cases and 1,451 controls) women from BioVU stratified by African American and Caucasian race. Secondary admixture mapping (AM) analyses will also be performed to identify chromosomal regions of interest to prioritize for replication. Our second Aim is to resequence chromosome regions identified from GWAS and AM to discover rare variants. Finally, in Aim 3 we will replicate SNPs selected from Aim 1 and 2 in independent samples of at least 3,230 fibroid cases and 7,097 controls. We propose an efficient and cost-effective approach to identify genetic risk factors for fibroids, by taking advantage of imaging information and DNA available through BioVU. This study represents the largest GWAS of uterine fibroids and the first among African Americans leveraging emerging technologies and new statistical approaches to conduct this study. Our proposed study will fundamentally change knowledge about fibroids and lay the ground work for breakthroughs in understanding mechanisms of fibroid formation and in identifying novel therapeutic approaches.

  Study phs001409

• Resuscitation Outcomes Consortium (ROC) Controlled Study of the Clinical Effectiveness of Automated Real-Time Feedback on CPR Process Conducted at a Subset of ROC Sites (CPR) (ROC-CPR-BioLINCC)

  Data Access NOTE: Please refer to the "Authorized Access" section below for information about how access to the data from this accession differs from many other dbGaP accessions.Objectives: A substudy of the ROC PRIMED trial, the ROC CPR trial sought to investigate whether real-time audio and visual feedback during cardiopulmonary resuscitation (CPR) outside a hospital increases the proportion of participants who achieved prehospital return of spontaneous circulation.Background: Cardiopulmonary resuscitation is an essential link in the chain of survival for treating cardiac arrest. However, performance of CPR is highly variable both outside hospital and in hospital. Interruptions in chest compression, inadequate depth of chest compression, and high rates of ventilation adversely affect blood flow during chest compressions and can hinder resuscitation. Suboptimal CPR, particularly time spent without chest compressions (low chest compression fraction), can reduce survival of cardiac arrest patients.Current technology incorporated into a monitor-defibrillator can assess core components of CPR through the use of an accelerometer and impedance changes across the defibrillation electrodes. This technology can also provide real-time audiovisual feedback so that the rescuer is prompted to perform according to guideline specifications. Use of such feedback increases the likelihood of performing CPR in accordance with guidelines during training and simulation. Participants: There were 1586 participants: 771 treated without feedback and 815 with feedback.Design: CPR feedback was provided through proprietary Q-CPR software operating in the Philips MRx monitor-defibrillator. The feedback feature of the defibrillator includes audible voice prompts and visual messages on the monitor screen that are triggered when measured chest compressions or ventilation deviate from guidelines or are interrupted.The study was conducted in 21 emergency medical service (EMS) agencies at three ROC regions in the U.S. and Canada. Randomized treatment clusters, which ranged from individual emergency medical vehicles to groups of emergency agencies, were assigned to feedback-on or feedback-off treatments. Each cluster remained in its assigned mode for two to seven months, after which it switched to the opposite treatment arm. At the end of those two treatment periods, each cluster was again randomly assigned to feedback-on or feedback-off. This cycle continued for the duration of the study. Each cluster switched treatment arms at least once, and up to four times, during the study. Conclusions: Real-time visual and audible feedback during CPR altered performance to more closely conform with CPR guidelines. Clusters assigned to feedback were associated with increased proportion of time in which chest compressions were provided, increased compression depth, and decreased proportion of compressions with incomplete release. However, frequency of prehospital return of spontaneous circulation did not differ according to feedback status, nor did the presence of a pulse at hospital arrival, survival to discharge, or awake at hospital discharge (Hostler, et al., 2011, PMID: 21296838).

  Study phs003818

• Immunophenotyping in a COVID-19 Cohort (IMPACC) Transcriptomics and Genotyping Assays

  IMPACC (IMmunoPhenotyping Assessment in a COVID-19 Cohort) is a prospective longitudinal cohort study (NCT04378777) launched in May 2020 in response to the worldwide pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was funded by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institute of Health (NIH). Patient enrollment and sample analysis involved 20 hospitals associated with 15 U.S. biomedical research centers and 11 centralized Core immunoassay laboratories.The study aimed to enable the identification of potential biomarkers and inform future therapeutic interventions using a longitudinal approach encompassing the whole disease course for a comprehensive understanding of the contributions of the pathogen and host immune response in modulating the manifestations, severity, and post-acute sequelae of the infection. IMPACC enrolled close to 1200 adult symptomatic, molecularly confirmed hospitalized COVID-19 patients in the study within 48 hours of their hospital admission. Clinical data and biological samples (blood, mid-turbinate nasal swabs, and esophageal aspirant) were collected according to minimal risk guidelines at enrollment and on days 4, 7, 14, 21, and 28. Biological samples were collected at 3-month intervals up to 12 months after hospital discharge to assess functional and immunologic recovery measures. Sample collection, processing, and storage procedures were standardized across sites, and samples were transported to centralized assay-specific core laboratories (Core Labs) in batches for testing and analysis. The description of outcome severity was not limited to survival versus death but encompassed a clinical trajectory approach using 5 groups leveraging longitudinal data based on time in the hospital, disease severity by ordinal scale based on the degree of respiratory illness, and presence or absence of limitations at discharge. Disease severity was assessed based on the degree of respiratory illness using a 7-point ordinal scale adapted from the World Health Organization COVID-19 and NIAID disease ordinal severity scales. DNA for genetic analyses was collected from whole blood at a single time point. To identify any genomic determinants of severe COVID-19 disease, single-nucleotide polymorphism (SNP) genotyping and exome sequencing were conducted to assess genetic variants associated with individual susceptibility to severe disease. In addition, IMPACC included bulk transcriptomic analysis of upper airway (nasal swaps) samples, lower airway (esophageal aspirant) samples, and peripheral blood mononuclear cells (PBMCs) to evaluate dynamic changes in cellular composition and cellular response during the course of the disease. Reads were aligned to the GRCh38 human reference genome. Additional information for the IMPACC study has been submitted to The Immunology Database and Analysis Portal (ImmPort) under study accession SDY1760. Further information and requests for resources and reagents should be directed to and will be fulfilled by the Lead Contact, Dr. Steven Kleinstein (steven.kleinstein@yale.edu).

  Study phs002686

• A Prospective Natural History Study of Diagnosis, Treatment and Outcomes of Children with SCID Disorders

  Individuals with a recent or new diagnosis of severe combined immune deficiency (including infants who were identified by newborn screening) may be eligible to be enrolled on the PIDTC research study 6901. Speak to your doctor to determine if you or your child may be eligible. Protocol 6901 follows patients with SCID prospectively, meaning the 6901 study enrolls participants where there is a plan to receive a blood and marrow transplant, enzyme therapy, or gene therapy in the future. Patients are then followed according to a schedule set out by the study protocol after the procedure. The times the study requests follow up will be the same as when your doctor would want to be seeing you or your child as part of their regular ongoing medical care. Patients with &#34;leaky SCID&#34;, reticular dysgenesis, and Omenn syndrome may also be eligible to participate in 6901. The 6901 research study does NOT dictate how your or your child&#39;s doctors should treat you or your child, as the PIDTC recognizes that there are many complex factors that go into this decision. The decision about how you or your child with SCID will be treated is made by your doctor. The 6901 study simply follows how you or your child do over time. There are no experimental therapies on this study. The 6901 study has been open since August 2010, and continues to be open and enrolling patients to the present day. The study plans to enroll approximately 250 patients with SCID. By studying new patients undergoing treatment for SCID, the goal is to learn more about: (1) outcomes from the treatment of SCID in the modern era of medicine, (2) what factors lead to the best long-term outcomes, such as best donor, conditioning regimen, timing of transplant, etc. and (3) what impact newborn screening and the early diagnosis of SCID has had on the long-term outcomes following BMT or gene therapy. A significant amount of information is also being gathered on how and when the immune system recovers after BMT, quality of life for long-term survivors, and about whether children develop normally after treatment. The 6901 study is the largest coordinated prospective study of patients with SCID ever performed. Information that we will learn, both now and in the future, will help doctors and other health professionals to better treat children with SCID. All hospitals within the PIDTC are enrolling patients with SCID on 6901, ensuring that the outcomes are reflective of what happens in the &#34;real world&#34; as opposed to at just one or two large centers.

  Study phs001392

• Metagenomic Epidemiology of Antibiotic Resistance in Infectious Diarrhea

  The study of antimicrobial resistance (AMR) in infectious diarrhea has generally been limited to cultivation, antimicrobial susceptibility testing and targeted PCR assays. When individual strains of significance are identified, whole genome shotgun (WGS) sequencing of important clones and clades is performed. Genes that encode resistance to antibiotics have been detected in environmental, insect, human and animal metagenomes and are known as &#34;resistomes&#34;. While metagenomic datasets have been mined to characterize the healthy human gut resistome in the Human Microbiome Project and MetaHIT and in a Yanomani Amerindian cohort, directed metagenomic sequencing has not been used to examine the epidemiology of AMR. Especially in developing countries where sanitation is poor, diarrhea and enteric pathogens likely serve to disseminate antibiotic resistance elements of clinical significance. Unregulated use of antibiotics further exacerbates the problem by selection for acquisition of resistance. This is exemplified by recent reports of multiple antibiotic resistance in Shigella strains in India, in Escherichia coli in India and Pakistan, and in nontyphoidal Salmonella (NTS) in South-East Asia. We propose to use deep metagenomic sequencing and genome level assembly to study the epidemiology of AMR in stools of children suffering from diarrhea. Here the epidemiology component will be surveillance and analysis of the microbial composition (to the bacterial species/strain level where possible) and its constituent antimicrobial resistance genetic elements (such as plasmids, integrons, transposons and other mobile genetic elements, or MGEs) in samples from a cohort where diarrhea is prevalent and antibiotic exposure is endemic. The goal will be to assess whether consortia of specific mobile antimicrobial resistance elements associate with species/strains and whether their presence is enhanced or amplified in diarrheal microbiomes and in the presence of antibiotic exposure. This work could potentially identify clonal complexes of organisms and MGEs with enhanced resistance and the potential to transfer this resistance to other enteric pathogens. We have performed WGS, metagenomic assembly and gene/protein mapping to examine and characterize the types of AMR genes and transfer elements (transposons, integrons, bacteriophage, plasmids) and their distribution in bacterial species and strains assembled from DNA isolated from diarrheal and non-diarrheal stools. The samples were acquired from a cohort of pediatric patients and controls from Colombia, South America where antibiotic use is prevalent. As a control, the distribution and abundance of AMR genes can be compared to published studies where resistome gene lists from healthy cohort sequences were compiled. Our approach is more epidemiologic in nature, as we plan to identify and catalogue antimicrobial elements on MGEs capable of spread through a local population and further we will, where possible, link mobile antimicrobial resistance elements with specific strains within the population.

  Study phs001260

• PanCuRx Translational Research Initiative

  The goal of the PanCuRx TRI is to seek solutions to the high fatality rate of pancreatic adenocarcinoma (PDAC), the most common type of pancreatic cancer, by generating new knowledge about the genetics and biology of the disease, mechanisms of how tumours grow and tailored treatment options. PDAC is the fourth leading cause of cancer death in Canada and is expected to become the second-leading cause of cancer death within the next decade. The current five-year survival rate of eight per cent is the lowest of all epithelial cancers. There are major clinical challenges to treating the disease, including the fact that PDAC spreads to other parts of the body early so surgical removal of the tumour benefits few patients, that PDAC has proven relatively resistant to systemic therapies such as chemotherapy and that there has been limited benefit from the use of newer molecular targeted agents. The PanCuRx team has created the world’s first resource of tumour-purified PDAC whole genomes; more than 500 PDAC samples, with combined clinical annotation, have been successfully sequenced and analyzed at the Ontario Institute for Cancer research in Toronto. The resulting clinical genomic resource created from this data has led to multiple new findings that have established a framework to better understand PDAC biology and lays the foundation for new genomic approaches to better understanding the disease. The team also launched a clinical trial called COMPASS (Comprehensive Molecular Characterization of Advanced Ductal Pancreas Adenocarcinoma for Better Treatment Selection: A Prospective Study), which is recruiting patients with advanced PDAC (both locally advanced and metastatic) at The Princess Margaret Cancer Centre (PM) in Toronto. The study uses the molecular results from individual patient tumours to guide selection of better second line treatment on a case-by-case basis. The primary objective of the initial study was to assess the feasibility of collecting tumour materials from patients with advanced PDAC and delivering results within 56 days of biopsy. Having achieved this objective, the trial has expanded to other cancer centres across Canada. Pancreatic cancer is one of the most deadly forms of cancer and outcomes have not improved in four decades. The PanCuRx initiative is providing a better understanding of the disease and actively applying new knowledge to cancer patients through clinical trials. This knowledge will help to improve quality of life and prolong survival for pancreatic cancer patients worldwide.

  Study EGAS00001002543

• Assessing Neural Mechanisms of Injury in Inborn Errors of Urea Metabolism Using Structural MRI, Functional MRI, and Magnetic Resonance Spectroscopy

  Urea cycle disorders represent a group of rare inborn errors of metabolism that lead to accumulation of ammonia, a toxic product of protein metabolism. Individuals with urea cycle disorders cannot metabolize the ammonia that accumulates due to enzyme deficiency. The symptoms of these disorders may present at birth, childhood or adulthood (milder deficiencies). There are currently eight enzyme deficiencies that constitute the range of inborn errors of ureagenesis. This project will focus on the most common enzyme disorder of the urea cycle, ornithine transcarbamylase deficiency, inherited as an X-linked trait. This project will study cognitive and motor dysfunction in patients who are female carriers of ornithine transcarbamylase deficiency (OTCD) or are males with late onset presentation of OTCD, utilizing state of the art MRI (magnetic resonance imaging), a non -invasive technique. This project seeks to improve our understanding of the underlying neural mechanisms that contribute to metabolic, cognitive, sensory and motor abnormalities in urea cycle disorders, which although individually rare, collectively constitute a major cause of neonatal encephalopathy, leading to significant morbidity and mortality. As a result of this study, a greater understanding of the anatomic, cognitive, motor, and biochemical underpinnings of neurologic damage attributable to this metabolic disorder will be gained. Experimental approaches will combine sensory, cognitive and motor testing with structural, functional and molecular magnetic resonance imaging to study symptomatic and asymptomatic heterozygous female carriers of X-linked ornithine transcarbamylase deficiency (OTCD), and late onset hemizygous males. Participants to be included in the studies will range from ages 18-60 years and will be compared to an age-matched typically developed (TD) comparison group. For our research, we use anatomic MRI, functional Magnetic Resonance Imaging (fMRI), and magnetic resonance spectroscopy (MRS) to monitor brain activity. The technique of fMRI provides detailed maps of the brain areas underlying human mental activities. By using fMRI, we are able to observe how the brain is functioning while a person is performing a specific task, such as reading. We can not only observe differences in the structure of the brain, but can also measure differences in brain function and activity as well. This information will ultimately be used to provide a basis for designing more effective interventions and methods for early identification of learning disabilities in patients with OTCD and related disorders. We will also use MRS to study various brain chemicals such as glutamine using the non-invasive MRI imaging techniques.

  Study phs001108

• National Heart Lung and Blood Institute (NHLBI) GO-ESP: Heart Cohorts Component of the Exome Sequencing Project (ARIC)

  The NHLBI "Grand Opportunity" Exome Sequencing Project (GO-ESP), a signature project of the NHLBI Recovery Act investment, was designed to identify genetic variants in coding regions (exons) of the human genome (the "exome") that are associated with heart, lung and blood diseases. These and related diseases that are of high impact to public health and individuals from diverse racial and ethnic groups will be studied. These data may help researchers understand the causes of disease, contributing to better ways to prevent, diagnose, and treat diseases, as well as determine whether to tailor prevention and treatments to specific populations. This could lead to more effective treatments and reduce the likelihood of side effects. GO-ESP is comprised of five collaborative components: 3 cohort consortia - HeartGO, LungGO, and WHISP - and 2 sequencing centers - BroadGO and SeattleGO. HeartGO is a consortium of six well-phenotyped NHLBI cohorts: Atherosclerosis Risk in Communities (ARIC) study, the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Cardiovascular Health Study, the Framingham Heart Study, the Jackson Heart Study, and the Multi-Ethnic Study of Atherosclerosis. Together, these cohorts have provided DNA and phenotype datasets from a diverse cohort of individuals of African-American, Caucasian, Asian, and Hispanic ancestry to be made available for use by qualified investigators in dbGaP. HeartGO investigators will conduct genotype-phenotype analyses for phenotypes related not only to heart disease but with other variables that will be contributed to dbGaP. The HeartGO dataset provides investigators with genotype-phenotype analytic opportunities for traits not only related to heart disease but also associated with ancillary variables that will be contributed to dbGaP, including disease endpoints, risk factors, biomarkers, and subclinical disease measures. The phenotypes planned for investigation as part of the GO-ESP HeartGO project include early-onset myocardial infarction (EOMI), low density lipoprotein (LDL) cholesterol, body mass index/type 2 diabetes (BMI/T2D), blood pressure and ischemic stroke. Results of the proposed analyses as well as relevant replication/follow-up analyses will be reported in peer-reviewed journals. This study phs000398 contains the Atherosclerosis Risk in Communities (ARIC) subset of GO-ESP/Heart-GO. Additional GO-ESP data is also available via dbGaP.

  Study phs000398

• Cooperative Study of Sickle Cell Disease (CSSCD)

  The Cooperative Study of Sickle Cell Disease was initiated in 1977 to determine the natural history of sickle cell disease (SCD) from birth to death in order to identify those factors contributing to the morbidity and mortality of the disease. Specific objectives included: 1) to study the effect of sickle cell disease on growth and development from birth through adolescence 2) to study the conditions or events that may be related to the onset of painful crises 3) to obtain data on the nature, duration, and outcome of major complications of SCD 4) determine the nature, prevalence, and age- related incidence of organ damage due to SCD, and 5) study the role of SCD and its interaction with selected health events.Phases 2 and 3 of the study involved followup of the infant cohort. A total of 709 infants (age less than 6 months) were enrolled during Phase 1 of the Cooperative Study of Sickle Cell Disease (CSSCD), and Phases 2 and 3 of the CSSCD was designed to follow these children for an additional 10 years. The study objectives included: 1) define prospectively the natural history of sickle cell disease; 2) determine the relationships between cognitive and academic functioning and brain status as determined by MRI; 3) determine the cognitive or behavioral markers of silent infarct; 4) determine the relationship of family functioning on the Family Environment Scale (FES) to brain status, cognitive functioning, and social and demographic factors; 5) continue studies that will enhance the state of knowledge on the influence of sickle cell disease on the psychosocial adjustment of children and adolescents. Phase 2A of the study sought to examine the progression of organ damage in the heart, lung, kidney, and liver in adult cohort patients (born before 1/1/56) enrolled in phase 1 of the study between 3/79 and 5/81. A total of 620 patients from 11 centers were eligible for phase 2A.Instructions for requesting individual-level data are available on BioData Catalyst at https://biodatacatalyst.nhlbi.nih.gov/resources/data/. Apply for data access in dbGaP. Upon approval, users may begin accessing requested data in BioData Catalyst. For questions about availability, you may contact the BioData Catalyst team at https://biodatacatalyst.nhlbi.nih.gov/contact.

  Study phs002362

• Genetic Modifiers of Huntington's Disease

  Huntington&#39;s disease (HD) is a neurodegenerative disorder typically diagnosed in mid-life that is caused by expansion of an otherwise polymorphic CAG trinucleotide repeat. The mutation causes a gain-of-function of the huntingtin protein to trigger a pathogenic process that produces detectable phenotypic differences many years before the traditional diagnosis, which is based upon characteristic motor symptoms. The prediagnosis phase of pathogenesis is now the subject of intense scrutiny by an NINDS-funded longitudinal study, PREDICT-HD, in which undiagnosed gene carriers are followed longitudinally and subjected to detailed phenotyping (PREDICT-HD Huntington Disease Study -- dbGaP Study Accession: phs000222). This powerful approach, which offers the potential for moving the focus of therapeutic development to the decades prior to neurological disease diagnosis, is enabled by the fact that all individuals with HD have the same type of mutation, which can be determined at any time in life by a single HD CAG repeat PCR amplification assay. The precise length of the HD CAG repeat differs between individuals. There is a strong negative correlation between the number of CAG repeats and the age at onset of diagnostic neurological abnormalities in HD, such that the CAG repeat accounts for ~50% of the variation in age at diagnosis. Analysis of the remaining variance not explained by the length of the CAG repeat has shown that it is highly heritable, being due to genetic variation, elsewhere in the genome. The intent of the Genetic Modifiers of Huntington&#39;s Disease study is to identify genetic modifiers of HD pathogenesis by using genomewide association techniques in diagnosed HD individuals to identify genetic factors associated with the residual variance in age at onset not explained by the CAG repeat, and to extend these analyses to pre-diagnosis phenotypes, for example, those defined in the PREDICT-HD study. Identification of modifier genes is a top priority for HD research (and an example of an approach that can be applied in other late-onset genetic disorders), as it could provide clues to developing rational treatments that delay or prevent the pathogenic process from causing the ravages of the disease that ensue in the ~15 years of inexorable decline to ultimate death that now follows clinical diagnosis. To further that goal, the release of study version 2 makes available whole exome sequencing data of n=221 study participants.

  Study phs000371

• National Heart Lung and Blood Institute (NHLBI) GO-ESP: Heart Cohorts Component of the Exome Sequencing Project (FHS)

  The NHLBI "Grand Opportunity" Exome Sequencing Project (GO-ESP), a signature project of the NHLBI Recovery Act investment, was designed to identify genetic variants in coding regions (exons) of the human genome (the "exome") that are associated with heart, lung and blood diseases. These and related diseases that are of high impact to public health and individuals from diverse racial and ethnic groups will be studied. These data may help researchers understand the causes of disease, contributing to better ways to prevent, diagnose, and treat diseases, as well as determine whether to tailor prevention and treatments to specific populations. This could lead to more effective treatments and reduce the likelihood of side effects. GO-ESP is comprised of five collaborative components: 3 cohort consortia - HeartGO, LungGO, and WHISP - and 2 sequencing centers - BroadGO and SeattleGO. HeartGO is a consortium of six well-phenotyped NHLBI cohorts: Atherosclerosis Risk in Communities (ARIC) study, the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Cardiovascular Health Study, the Framingham Heart Study, the Jackson Heart Study, and the Multi-Ethnic Study of Atherosclerosis. Together, these cohorts have provided DNA and phenotype datasets from a diverse cohort of individuals of African-American, Caucasian, Asian, and Hispanic ancestry to be made available for use by qualified investigators in dbGaP. HeartGO investigators will conduct genotype-phenotype analyses for phenotypes related not only to heart disease but with other variables that will be contributed to dbGaP. The HeartGO dataset provides investigators with genotype-phenotype analytic opportunities for traits not only related to heart disease but also associated with ancillary variables that will be contributed to dbGaP, including disease endpoints, risk factors, biomarkers, and subclinical disease measures. The phenotypes planned for investigation as part of the GO-ESP HeartGO project include early-onset myocardial infarction (EOMI), low density lipoprotein (LDL) cholesterol, body mass index/type 2 diabetes (BMI/T2D), blood pressure and ischemic stroke. Results of the proposed analyses as well as relevant replication/follow-up analyses will be reported in peer-reviewed journals. This study phs000401 contains the Framingham Heart Study (FHS) subset of GO-ESP/Heart-GO. Additional GO-ESP data is also available via dbGaP.

  Study phs000401

• National Heart Lung and Blood Institute (NHLBI) GO-ESP: Heart Cohorts Component of the Exome Sequencing Project (JHS)

  The NHLBI "Grand Opportunity" Exome Sequencing Project (GO-ESP), a signature project of the NHLBI Recovery Act investment, was designed to identify genetic variants in coding regions (exons) of the human genome (the "exome") that are associated with heart, lung and blood diseases. These and related diseases that are of high impact to public health and individuals from diverse racial and ethnic groups will be studied. These data may help researchers understand the causes of disease, contributing to better ways to prevent, diagnose, and treat diseases, as well as determine whether to tailor prevention and treatments to specific populations. This could lead to more effective treatments and reduce the likelihood of side effects. GO-ESP is comprised of five collaborative components: 3 cohort consortia - HeartGO, LungGO, and WHISP - and 2 sequencing centers - BroadGO and SeattleGO. HeartGO is a consortium of six well-phenotyped NHLBI cohorts: Atherosclerosis Risk in Communities (ARIC) study, the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Cardiovascular Health Study, the Framingham Heart Study, the Jackson Heart Study, and the Multi-Ethnic Study of Atherosclerosis. Together, these cohorts have provided DNA and phenotype datasets from a diverse cohort of individuals of African-American, Caucasian, Asian, and Hispanic ancestry to be made available for use by qualified investigators in dbGaP. HeartGO investigators will conduct genotype-phenotype analyses for phenotypes related not only to heart disease but with other variables that will be contributed to dbGaP. The HeartGO dataset provides investigators with genotype-phenotype analytic opportunities for traits not only related to heart disease but also associated with ancillary variables that will be contributed to dbGaP, including disease endpoints, risk factors, biomarkers, and subclinical disease measures. The phenotypes planned for investigation as part of the GO-ESP HeartGO project include early-onset myocardial infarction (EOMI), low density lipoprotein (LDL) cholesterol, body mass index/type 2 diabetes (BMI/T2D), blood pressure and ischemic stroke. Results of the proposed analyses as well as relevant replication/follow-up analyses will be reported in peer-reviewed journals. This study phs000402 contains the Jackson Heart Study (JHS) subset of GO-ESP/Heart-GO. Additional GO-ESP data is also available via dbGaP.

  Study phs000402

• National Heart Lung and Blood Institute (NHLBI) GO-ESP: Heart Cohorts Component of the Exome Sequencing Project (CHS)

  The NHLBI "Grand Opportunity" Exome Sequencing Project (GO-ESP), a signature project of the NHLBI Recovery Act investment, was designed to identify genetic variants in coding regions (exons) of the human genome (the "exome") that are associated with heart, lung and blood diseases. These and related diseases that are of high impact to public health and individuals from diverse racial and ethnic groups will be studied. These data may help researchers understand the causes of disease, contributing to better ways to prevent, diagnose, and treat diseases, as well as determine whether to tailor prevention and treatments to specific populations. This could lead to more effective treatments and reduce the likelihood of side effects. GO-ESP is comprised of five collaborative components: 3 cohort consortia - HeartGO, LungGO, and WHISP - and 2 sequencing centers - BroadGO and SeattleGO. HeartGO is a consortium of six well-phenotyped NHLBI cohorts: Atherosclerosis Risk in Communities (ARIC) study, the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Cardiovascular Health Study, the Framingham Heart Study, the Jackson Heart Study, and the Multi-Ethnic Study of Atherosclerosis. Together, these cohorts have provided DNA and phenotype datasets from a diverse cohort of individuals of African-American, Caucasian, Asian, and Hispanic ancestry to be made available for use by qualified investigators in dbGaP. HeartGO investigators will conduct genotype-phenotype analyses for phenotypes related not only to heart disease but with other variables that will be contributed to dbGaP. The HeartGO dataset provides investigators with genotype-phenotype analytic opportunities for traits not only related to heart disease but also associated with ancillary variables that will be contributed to dbGaP, including disease endpoints, risk factors, biomarkers, and subclinical disease measures. The phenotypes planned for investigation as part of the GO-ESP HeartGO project include early-onset myocardial infarction (EOMI), low density lipoprotein (LDL) cholesterol, body mass index/type 2 diabetes (BMI/T2D), blood pressure and ischemic stroke. Results of the proposed analyses as well as relevant replication/follow-up analyses will be reported in peer-reviewed journals. This study phs000400 contains the Cardiovascular Health Study (CHS) subset of GO-ESP/Heart-GO. Additional GO-ESP data is also available via dbGaP.

  Study phs000400

• Proteomic Biomarkers of Progressive Fibrosing Interstitial Lung Disease: a Multicentre Cohort Analysis (PF-ILD Proteomics-BioLINCC)

  Data Access NOTE: Please refer to the &#8220;Authorized Access&#8221; section below for information about how access to the data from this accession differs from many other dbGaP accessions. Objectives: To identify novel plasma biomarkers of progressive fibrosing interstitial lung disease and develop a proteomic signature to predict this phenotype. Background: Progressive fibrosing interstitial lung disease (ILD) is a devastating condition characterized by parenchymal scar formation, leading to deteriorating lung function and early death. Whereas almost all patients with idiopathic pulmonary fibrosis (IPF) progress, a variable proportion of patients with other common ILDs, including connective tissue disease associated ILD, chronic hypersensitivity pneumonitis, and unclassifiable ILD, develop progressive fibrosing ILD. There are criteria that effectively identify those experiencing ILD progression. However, the criteria do not allow patients who are at risk to be identified before progression occurs. Several blood-based biomarkers have been linked to differential progression in patients with IPF and other fibrosing ILDs. Inflammatory signaling also appears to have a prominent role in fibrotic-predominant ILDs. As such, cytokines, interleukins, and other immune mediators might serve as useful biomarkers of progressive fibrosing ILD. The PF-ILD Proteomics study was a targeted investigation of inflammation-related proteins to identify and validate novel biomarkers of progressive fibrosing ILD in patients with fibrotic connective tissue disease-associated ILD, chronic hypersensitivity pneumonitis, and unclassifiable ILD. Participants: There were 589 participants. The discovery cohort comprised 385 participants and the validation cohort comprised 204 participants. Design: PF-ILD Proteomics was a multicenter cohort analysis study. Peripheral blood was collected from consenting patients and plasma was isolated according to center-specific protocols. Relative plasma concentrations for 368 biomarkers were determined with use of a semi-quantitative, targeted proteomic platform. Patients from UC Davis and UCSF comprised the discovery cohort and those from UTSW comprised the validation cohort. Participants who were alive with less than 10% relative decline in forced vital capacity (FVC) at 12 months-after blood draw were considered to have non-progressive ILD. Participants who died of any cause, underwent lung transplant, or experienced 10% or greater relative FVC decline within 12 months of blood draw were deemed to have progressive fibrosing ILD. Conclusions: 17 plasma biomarkers of progressive fibrosing interstitial lung disease were identified and showed consistent associations across ILD subtypes.

  Study phs003954

• Lung Health Study (LHS-BioLINCC)

  Data Access NOTE: Please refer to the &#8220;Authorized Access&#8221; section below for information about how access to the data from this accession differs from many other dbGaP accessions. Objectives: To determine the effects of Special Care, compared to Usual Care, on rate of decline in pulmonary function in a group of cigarette smokers identified as having mild abnormalities in pulmonary function. In addition, the study sought to determine if participants with chronic obstructive pulmonary disease, who were assigned to inhaled corticosteroids had a lower rate of decline in lung function and lower incidence of respiratory morbidity compared to participants assigned to placebo. Also, the study sought to determine the long-term effects of smoking cessation and continued smoking, on cardiopulmonary morbidity, mortality, and the rate of decline in the one second forced expiratory volume in men and women with early chronic obstructive lung disease who have been followed prospectively for 12 to 15 years.Participants: A total of 5887 participants were enrolled.Conclusions: Participants in the two smoking intervention groups showed significantly smaller declines in Forced Expiratory Volume 1 (FEV1) than did those in the control group. Most of this difference occurred during the first year following entry into the study and was attributable to smoking cessation, with those who achieved sustained smoking cessation experiencing the largest benefit. The small noncumulative benefit associated with use of the active bronchodilator vanished after the bronchodilator was discontinued at the end of the study. The authors concluded that an aggressive smoking intervention program significantly reduced the age-related decline in FEV1 in middle-aged smokers with mild airways obstruction. Use of an inhaled anticholinergic bronchodilator resulted in a relatively small improvement in FEV1 that appeared to be reversed after the drug was discontinued. Use of the bronchodilator did not influence the long-term decline of FEV1. Additionally, the study showed that lung function decline in the participants treated with the inhaled corticosteroid was statistically no different from that in the placebo group. Corticosteroid use did, however, result in 25 percent fewer respiratory symptoms and nearly 50 percent fewer outpatient visits for respiratory problems. However, after three years, bone density in the hip and back was lower in the corticosteroid group.

  Study phs004013

• Genome_Diversity_in_Africa_Project___GemCode_libraries

  Globally, human populations show structured genetic diversity as a result of geographical dispersion, selection and drift. Understanding this genetic variation can provide insights into the evolutionary processes that shape both human adaptation and variation in disease. Populations from Africa have the highest levels of genetic diversity. This characteristic, in addition to historical genetic admixture, can lead to complexities in the design of studies assessing the genetic determinants of disease and human variation. However, such studies of African populations are also likely to provide new opportunities to discover novel disease susceptibility loci and variants and refine gene–disease association signals. A systematic assessment of genetic diversity within Africa would facilitate genomic epidemiological studies in the region.The Genome Diversity in Africa Project (GDAP) will extend and expand the African Genome Variation (AGV) project, an international collaboration aimed to produce a comprehensive catalogue of human genetic variation in Sub-Saharan Africa (SSA). Using a sequencing-based approach, GDA project aims to capture human genetic variation in Africa, including single nucleotide polymorphisms (SNPs), structural variants, and haplotypes. This resource will make a substantial contribution to understanding patterns of genetic diversity within and among populations in Africa, as well as providing a global resource to help design, implement and interpret genomic studies in African populations and studies comprising globally diverse populations, complementing existing genomic resources. Specifically, we plan to carry out whole genome sequencing at high depth (30x) of up to 1000 individuals across Africa (25 individuals from each ethnolinguistic group). We have already completed sequencing from 5 ethno-linguistic groups and we are now adding others.Our scientific objectives are to: 1) develop a resource that provides a comprehensive catalogue of genetic variation in populations from Africa accessible to the global scientific community; 2) characterise population genetic diversity, structure, gene flow and admixture across Africa; 3) develop a cost-efficient, next-generation genotype array for diverse populations across Africa; and 4) facilitate whole genome-sequencing association studies of complex traits and diseases by developing a reference panel for imputation and resource for enhancing fine-mapping disease susceptibility loci. These scientific objectives will be supported by cross-cutting operational activities, including network and management of the consortium, research ethics, and research capacity building in statistical genetics and bioinformatics.

  Study EGAS00001001589

• GeneSTAR (Genetic Study of Atherosclerosis Risk) NextGen Consortium: Functional Genomics of Platelet Aggregation Using iPS and Derived Megakaryocytes

  The causal mechanisms of common diseases and their therapies have been only marginally illuminated by genetic variants identified in genome wide association studies (GWAS) utilizing single nucleotide polymorphism (SNPs). Platelet activation pathways reflecting hemostasis and thrombosis are the underlying substrate for many cardiovascular diseases and related acute events. To overcome GWAS limitations, genomic studies are needed that integrate molecular surrogates for platelet-related phenotypes assayed in cell-based models derived from individuals of known genotypes and phenotypes. In our GWAS study of native platelet aggregation phenotypes and aggregation in response to low dose aspirin in 2200 subjects (GeneSTAR, Genetic Study of Aspirin Responsiveness), important genome wide "signals" (p&lt;5x10-8) associated with native platelet aggregation and important "signals" associated with platelet responsiveness to aspirin were identified and replicated. Although we are currently performing functional genomics studies to elucidate our most promising findings in known genes (PEAR1, MET, PIKC3G), most "signals" occurred in intergenic regions or in introns. Mechanistic interpretation is limited by uncertainty as to which gene(s) are up- or down-regulated in the presence of most SNP modifications. In this 3 phase proposal, we will (1) create pluripotent stem cells (iPS) from peripheral blood mononuclear cells, and then differentiate these stem cells into megakaryocytes (2) develop an efficient strategy to produce iPS and megakaryocytes using a novel pooling method, and (3) produce iPS and megakaryocytes from 250 subjects in GeneSTAR (European Americans and African Americans), selected based on specific hypotheses derived from GWAS signals in native and post aspirin platelet function; characterize genetic mRNA transcripts using a comprehensive Affymetrix array; measure protein expression for transcripts of interest using mass spectrometry; examine mRNA and protein expression patterns for each GWAS signal to determine the functional pathway(s) involved in native platelet phenotypes; and examine the functional genomics of variations in responsiveness to aspirin using our prior genotyped and phenotyped population. Precise information about the exact functional processes in megakaryocytes and platelets may lead to innovative and tailored approaches to risk assessment and novel therapeutic targets to prevent first and recurrent cardiovascular and related thrombotic events.

  Study phs001074

• ALS Compute

  Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disorder characterized by the progressive loss of brain and spinal cord motor neurons. Half of ALS patients display cognitive symptoms of frontotemporal dementia (FTD); reciprocally, about 40% of FTD patients show motor neuron deficits, and approximately 15% develop overt ALS. The clinical overlap between ALS and FTD means that the two conditions are thought to represent a disease spectrum (ALS/FTD). In recent years, the identification of several genetic causes of ALS/FTD has contributed significantly to our understanding of disease pathogenesis. Unfortunately, one-third of the underlying genetic causes of familial cases and ~90% of sporadic cases of ALS/FTD remain unexplained. As such, there is a dire need to identify additional genetic factors contributing to ALS/FTD. Such studies require huge cohorts of harmonized whole genome sequencing (WGS) data sets from cases and controls. Currently, there are several major ongoing sequencing efforts for ALS patients. Numerous centers lead to inefficiency, especially in terms of overall costs. At a minimum, this includes the cost of high-performance computing, the storage of large data files, and the duplication of effort between groups. This lack of data harmonization between groups precludes sharing of genetic information and weakens collaborative efforts. The cost and logistics are also a barrier to attracting talented investigators to the ALS/FTD field. To overcome this unmet need, we have founded the ALS Compute project. We are centralizing the storage of ALS/FTD WGS data from every significant sequencing effort in the United States and beyond within a single Cloud environment. This approach will facilitate data harmonization and improve accessibility to the data. To accomplish this, we have made the data and the computational infrastructure available via the Terra platform hosted by NHGRI's Genomic Data Science Analysis, Visualization, and Informatics Lab-Space (AnVIL). This will allow researchers worldwide to access this wealth of data, develop new theories of the disease, and yield breakthroughs in our understanding of ALS/FTD.

  Study phs003184

• Northwestern NUgene Project: Type 2 Diabetes

  The ability to correlate genetic variation with disease susceptibility and response to drug therapy depends on genotype or sequence analysis of large numbers of richly characterized DNA samples. Eight years agoWe are a part of NHGRI&#39;s electronic Medical Records and Genomics (eMERGE) Network, whose goal is to conduct genome-wide association studies in thousands of individuals using EMR-derived phenotypes and DNA from linked biorepositories. For eMERGE, Northwestern University (NU) is studying type 2 diabetes as a phenotype. In addition, in order to explore race differences in the prevalence of type 2 diabetes, NU collaborated with Vanderbilt University to study a mix of both Caucasian and African-Americans. Northwestern University: In 2002, Northwestern committed to the development of a DNA repository to serve as a platform for the identification and validation of genotype-phenotype associations that will impact healthcare. The NUgene Project is a repository with longitudinal medical information from participating patients at affiliated hospitals and outpatient clinics from the Northwestern University Medical Center. Participants&#39; DNA samples are coupled with data from a questionnaire (2 versions were used, 1 before and 1 after February 2006, both are included) and continuously updated data from our Electronic Medical Record (EMR) representing actual clinical care events. Northwestern has a state-of-the art, comprehensive inpatient and outpatient EMR system of over 2 million patients. NUgene has broad access to participant data for all outpatient visits as well as inpatient data via a consolidated data warehouse. NUgene participants consent to distribution and use of their coded DNA samples and data for a broad range of genetic research by third-party investigators. Vanderbilt University: BioVU, Vanderbilt&#39;s DNA databank, is an enabling resource for exploration of the relationships among genetic variation, disease susceptibility, and variable drug responses, and represents a key first step in moving the emerging sciences of genomics and pharmacogenomics from research tools to clinical practice. BioVU acquires DNA from discarded blood samples collected from routine patient care. The biobank is linked to de-identified clinical data extracted from Vanderbilt&#39;s EMR, which forms the basis for phenotype definitions used in genotype-phenotype correlations.

  Study phs000237

• Exceptional Responders Initiative

  The Exceptional Responders Initiative is a pilot study to investigate the underlying molecular factors driving exceptional treatment responses of cancer patients to drug therapies. Study researchers will examine molecular profiles of tumors from patients either enrolled in a clinical trial for an investigational drug(s) and who achieved an exceptional response relative to other trial participants, or who achieved an exceptional response to a non-investigational chemotherapy. An exceptional response is defined as achievement of either a complete response or a partial response for at least 6 months duration in a trial or treatment where the overall response rate is &#60; 10%. The hope is to discover underlying molecular features that can be further investigated and may eventually predict benefit from a given drug or class of drugs for a particular patient. This pilot project will successfully characterize approximately 100 cases of tumor tissue and, when available, case-matched germline DNA. All samples will undergo whole exome sequencing, and cases with sufficient nucleic acids will undergo additional analyses (e.g. whole genome sequencing, mRNA-sequencing, mi RNA sequencing, promoter methylation analysis, SNP etc). Each case will be annotated with demographic and clinical information, along with follow-up information minimally sufficient to correlate molecular profiles with response. Both retrospective and prospective collections will be considered. The project will also accept sequencing data and clinical data from patients who have had sequencing performed outside of this project. All data will be de-identified and placed in a controlled access database so other investigators may use them for additional insights. Clinically annotated tissue specimens meeting the criteria will be provided by groups participating in the Exceptional Cases Initiative to a Biospecimen Core Resource (BCR), which will perform quality control on the tissues, and will use a standard operating procedure to isolate nucleic acids. The nucleic acids will be shipped to a sequencing center to perform whole exome sequencing and analysis. These findings will be made available to the broader cancer research community in a controlled access database.

  Study phs001145