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Objectives To assess whether implementation of the Strengthen Opioid Misuse Prevention (STOP) Act was associated with an increase in the percentage of opioid prescriptions written for 7 days or fewer among patients with acute or postsurgical musculoskeletal conditions. Design An interrupted time-series study was conducted to determine the change in duration of opioid prescriptions associated with the STOP Act. Setting Data were extracted from the electronic health record of a large health care system in North Carolina. Subjects Patients presenting from 2016 to 2020 with an acute musculoskeletal injury and the clinicians treating them were included in an interrupted time-series study (n  = 12 839). Methods Trends were assessed over time, including the change in trend associated with implementation of the STOP Act, for the percentage of prescriptions written for ≤7 days. Results Among patients with acute musculoskeletal injury, less than 30% of prescriptions were written for ≤7 days in January of 2016; by December of 2020, almost 90% of prescriptions were written for ≤7 days. Prescriptions written for ≤7 days increased 17.7% after the STOP Act was implemented (P  < .001), after adjustment for the existing trend. Conclusions These results demonstrate significant potential for legislation to influence opioid prescribing behavior. [ABSTRACT FROM AUTHOR]

Objectives The objective of this study is to explore the characteristics of the subset of patients with hematologic malignancies (HMs) who had little to no change in SARS-CoV-2 spike antibody index value levels after a third mRNA vaccine dose (3V) and to compare the cohort of patients who did and did not seroconvert post-3V to get a better understanding of the demographics and potential drivers of serostatus. Study design This retrospective cohort study analyzed SARS-CoV-2 spike IgG antibody index values pre and post the 3V data on 625 patients diagnosed with HM across a large Midwestern United States healthcare system between 31 October 2019 and 31 January 2022. Methods To assess the association between individual characteristics and seroconversion status, patients were placed into two groups based on IgG antibody status pre and post the 3V dose, (−/+) and (−/−). Odds ratios were used as measures of association for all categorical variables. Logistic regressions were used to measure the association between HM condition and seroconversion. Results HM diagnosis was significantly associated with seroconversion status (P = 0.0003) with patients non-Hodgkin lymphoma six times the odds of not seroconverting compared with multiple myeloma patients (P = 0.0010). Among the participants who were seronegative prior to 3V, 149 (55.6%) seroconverted after the 3V dose and 119 (44.4%) did not. Conclusion This study focuses on an important subset of patients with HM who are not seroconverting after the COVID mRNA 3V. This gain in scientific knowledge is needed for clinicians to target and counsel these vulnerable patients. [ABSTRACT FROM AUTHOR]

Background Bisulfite sequencing is commonly used to measure DNA methylation. Processing bisulfite sequencing data is often challenging owing to the computational demands of mapping a low-complexity, asymmetrical library and the lack of a unified processing toolset to produce an analysis-ready methylation matrix from read alignments. To address these shortcomings, we have developed BiSulfite Bolt (BSBolt), a fast and scalable bisulfite sequencing analysis platform. BSBolt performs a pre-alignment sequencing read assessment step to improve efficiency when handling asymmetrical bisulfite sequencing libraries. Findings We evaluated BSBolt against simulated and real bisulfite sequencing libraries. We found that BSBolt provides accurate and fast bisulfite sequencing alignments and methylation calls. We also compared BSBolt to several existing bisulfite alignment tools and found BSBolt outperforms Bismark, BSSeeker2, BISCUIT, and BWA-Meth based on alignment accuracy and methylation calling accuracy. Conclusion BSBolt offers streamlined processing of bisulfite sequencing data through an integrated toolset that offers support for simulation, alignment, methylation calling, and data aggregation. BSBolt is implemented as a Python package and command line utility for flexibility when building informatics pipelines. BSBolt is available at https://github.com/NuttyLogic/BSBolt under an MIT license. [ABSTRACT FROM AUTHOR]

Why is postnatal parental provisioning so rare in ectothermic vertebrates while prolonged parental care is almost ubiquitous in endotherms? We argue that the scarcity of postnatal parental care is a result of ectothermy itself. While almost all endothermic young require prolonged postnatal care due to thermal constraints, ectothermic physiology does not pose the same constraint. Most ectothermic young are thus independent from birth. Ectothermic mothers are better off investing in future reprod [ABSTRACT FROM AUTHOR]

Foraging mode (ambush vs. active) profoundly affects many aspects of organismal biology, including metabolic rates and their relationship with food intake. Previous studies on snakes suggest that ambushers tend to have lower standard metabolic rates (SMR) and higher energetic costs of digestion and assimilation of prey (specific dynamic action, or SDA) than do active foragers. However, phylogenetic considerations may be at least partly responsible for such patterns, as foraging mode is strongly conserved evolutionarily and most SDA studies have focused on species from only two lineages of ambush foragers (pythonid and viperid snakes) and one lineage of active foragers (colubrid snakes). We sought to deconfound the effects of phylogeny and foraging mode, investigating SMR and SDA in two closely related pygopodid lizards, the common scaly-foot Pygopus lepidopodus (active forager) and Burton's legless lizard Lialis burtonis (ambush forager). Consistent with the pattern seen in snakes, L. burtonis exhibits a significantly lower SMR and a higher SDA than does P. lepidopodus. The magnitude of SDA in L. burtonis is comparable to that of some pythons and vipers, providing yet more evidence for the remarkable convergence between this species and ambush-foraging snakes. [ABSTRACT FROM AUTHOR]

Aims Members of the growth factor family of neurotrophins [NTs; e.g. brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT3)] and their high-affinity receptors (tropomyosin-related kinase; Trk) and low-affinity receptors p75 neurotrophin receptor (p75NTR) have been localized to pulmonary artery (PA) in humans. However, their role is unclear. Based on previous findings of NTs and their receptors within the pulmonary endothelium, we tested the hypothesis that NTs induce nitric oxide (NO) production in pulmonary endothelial cells (ECs), thus contributing to vasodilation. Methods and results In human pulmonary artery ECs loaded with the NO-sensitive fluorescent dye diaminofluorescein-2, both BDNF and NT3 (100 pM, 1 nM, and 10 nM) acutely (<10 min) and substantially increased fluorescence levels in a concentration-dependent fashion (to levels comparable to that induced by 1 μM acetylcholine). NT-induced elevation of NO levels was blunted by the tyrosine kinase inhibitor K252a, the nitric oxide synthase (NOS) inhibitor NG–nitro–L–arginine methyl ester, the Ca2+ chelator 1,2-bis(o-aminophenoxy)ethane-N,N,N′,N′-tetraacetic acid, and the NO scavenger 2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide. Suppression of TrkB or TrkC expression via siRNA as well as functional blockade of p75NTR prevented NT-induced NO elevation. Both BDNF and NT3 increased phosphorylation of Akt and endothelial NO synthase (eNOS). In endothelium-intact porcine PA rings, NTs increased cGMP and induced vasodilation in pre-contracted arteries. Conclusion These results indicate that NTs acutely modulate pulmonary endothelial NO production and contribute to relaxation of the pulmonary vasculature. [ABSTRACT FROM AUTHOR]

The Arabidopsis (Arabidopsis thaliana) genome encodes 51 proteins annotated as serine carboxypeptidase-like (SCPL) enzymes. Nineteen of these SCPL proteins are highly similar to one another, and represent a clade that appears to be unique to plants. Two of the most divergent proteins within this group have been characterized to date, sinapoyl-glucose (Glc):malate sinapoyltransferase and sinapoyl-Glc:choline sinapoyltransferase. The fact that two of the least related proteins within this clade are acyltransferases rather than true serine carboxypeptidases suggests that some or all of the remaining members of this group may have similar activities. The gene that encodes sinapoyl-Glc:malate sinapoyltransferase (sinapoyl-Glc accumulatorl [SNG1]: At2g22990) is one of five SCPL genes arranged in a cluster on chromosome 2. In this study, an analysis of deletion mutant lines lacking one or more genes in this SCPL gene cluster reveals that three of these genes also encode sinapoyl-Glc-dependent acyltransferases. At2g23000 encodes sinapoyl-Glc:anthocyanin acyltransferase, an enzyme that is required for the synthesis of the sinapoylated anthocyanins in Arabidopsis. At2g23010 encodes an enzyme capable of synthesizing 1,2-disinapoyl-Glc from two molecules of sinapoyl-Glc, an activity shared by SNG1 and At2g22980. Sequence analysis of these SCPL proteins reveals pairwise percent identities that range from 71% to 78%, suggesting that their differing specificities for acyl acceptor substrates are due to changes in a relatively small subset of amino acids. The study of these SCPL proteins provides an opportunity to examine enzyme structure-function relationships and may shed light on the role of evolution of hydroxycinnamate ester metabolism and the SCPL gene family in Arabidopsis and other flowering plants. [ABSTRACT FROM AUTHOR]

The article focuses on the statistical analysis of laboratories engaged in the study of genetically modified organisms in Great Britain. One of the principal methods of checking laboratories is the proficiency test. Using the proficiency test method, the interpretation of data is based on the distributed test materials to participating laboratories. The laboratories analyze the test material blindly and report the result to the provider who later assesses them by usually calculating a z-score.

Background The emergence of Klebsiella pneumoniae Carbapenemase-producing Enterobacteriaceae (KPC-E) has created a major public health concern. In clinical practice, rapid identification of KPC-KP has important implications for clinical management and infection control. In some settings matrix-assisted laser desorption ionization time of flight (MALDI-TOF) software has been used for rapid detection of KPC producing K. pneumoniae with high sensitivity and specificity. Genomic sequencing has determined that the 11.09 m/z peak is related to protein expression from the P109 gene found mostly in Tna4401a isoform among KPC-E. In our study, we evaluated the use of MALDI-TOF automated detection software to evaluate for KPC detection among a diverse group of KPC-E isolates. Methods We tested 52 KPC-E isolates from various hospitals in Connecticut and the Centers for Disease Control and Prevention (CDC) Antibiotic Resistance (AR) Bank. All specimens were verified as KPC-producing strains by detection of the blaKPCgene through polymerase chain reaction. Protein extraction using the standard extraction method was performed on sub-cultured isolates. Each isolate was tested three times on MALDI-TOF MS with the incorporated bio-subtype KPC module. An organism confidence or log score value of 2 or higher was considered valid. Results Among 52 tested KPC- K. pneumoniae isolates, 44 (85%) were from various hospitals in Connecticut, eight (15%) came from the AR Bank. Only 15 (25.1%) of the isolates were detected as KPC-producing using the MALDI-TOF KPC module. Further investigation by peak analysis confirmed all 15 isolates detected positive demonstrated a peak at 11.09 m/z. The 11.09 m/z peak was not found in the 37 specimens that were not detected. Conclusion The results from our study suggest low sensitivity using this software and contradicts results seen in previous European studies. The Tna4401a isoform is often seen in KPC-2 strains, which may be less prevalent in our sample of isolates, explaining the poor sensitivity of MALDI-TOF. Further study is needed to explore this finding and potential opportunities for MALDI-TOF for rapid identification of KPC-KP. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

The region of the second ionization of helium in the Sun is a narrow layer near the surface. Ionization induces a local change in the adiabatic exponent Γ1, which produces a characteristic signature in the frequencies of p modes. By adapting the method developed by Monteiro, Christensen-Dalsgaard & Thompson, we propose a methodology for determining the properties of this region by studying such a signature in the frequencies of oscillation. Using solar data we illustrate how the signal from the helium ionization zone can be isolated. Using solar models which each use different physics – the theory of convection, equation of state and low-temperature opacities – we establish how the characteristics of the signal depend on the various physical processes contributing to the structure in the ionization layer. We further discuss how the method can be used to measure the solar helium abundance in the envelope and to constrain the physics affecting this region of the Sun. The potential usefulness of the method we propose is shown. It may complement other inversion methods developed to study the solar structure and to determine the envelope helium abundance. [ABSTRACT FROM AUTHOR]

Studies the role played by hypothalamic growth hormone-releasing hormones (GHRH) in the development of bone pathology. Occurrence of bone loss and decreased bone strength in aging rats and humans; Similarities between bone changes encountered and those taking place in aging.

The article discusses the results of a study that compares the Horwitz function with the characteristic function as a descriptor of the precision of individual analytical methods. A significant difference between the two functions is the ability to accommodate a detection limit by the characteristic function. The Horwitz function's additional role as a fitness-for-purpose criterion in the form of the Horwitz ratio (HorRat) is discussed.

Examines the surgical management of bile duct stones. Use of endoscopic retrograde cholangiopancreatography for ductal stones; Efficacy of endoscopic sphincterotomy for infirm patients; Adoption of non-invasive approach for uncertain findings.

Yvonne P ElsworthandMichael J Thompsonexamine the theory and practice of asteroseismology, the study of the oscillations of Sun-like stars. Seismology has become a powerful tool for analysis of the interior of the Sun; it has great potential for the study of oscillations in solar-like stars. Asteroseimology could provide direct information about detailed properties of stellar interiors, bringing the potential for testing theories of stellar evolution and structure. Current stellar models are simple with few direct observational constraints; consequences such as age estimates are uncertain to a factor of two. A recent attempt at asteroseismology on Procyon, a likely candidate star, found no detectable oscillations. In this paper we discuss the asteroseismology of solar-like stars in the context of studies of the Sun and then indicate possible reasons for the Procyon results. [ABSTRACT FROM AUTHOR]

Michael J Thompson gets under the skin of the Sun using waves on its surface. Helioseismology is the study of the solar interior using observations of waves on the Sun's surface. It has done much to improve our understanding of the interior of the Sun, testing the physical inputs used to model stellar interiors and providing a detailed map of the Sun's structure and internal rotation. This in turn has greatly influenced theories of the solar magnetic dynamo. These interior studies thus make a valuable bridge between solar physics and studies of the structure and evolution of other stars. Recent developments include new local techniques for unprecedented studies of subsurface structures and flows in emerging active regions, under sunspots, and even of active regions on the far side of the Sun. These developments hold the possibility of a real understanding of how the interior links to solar magnetic activity in the corona and heliosphere. Finally, studies such as those of the deep solar interior are on the verge of becoming possible for other stars exhibiting similar multimode oscillations. [ABSTRACT FROM AUTHOR]

An effective visual signal elicits a strong receiver response. The visual receptors of most insects are sensitive to ultraviolet (UV), blue and green light. The decorations of certain orb web spiders may be described as a type of visual signal, a sensory trap, as they exploit visual biases in insects. We filtered UV and blue light from the decorations of Argiope keyserlingi, under field conditions, using plastic sheets to test if the UV and blue light reflected affects the type of prey caught. We found that houseflies, blowflies, stingless bees, honeybees and vespid wasps were caught more frequently in webs with decorations than webs without, while ichneumonid wasps were caught less frequently. Blowflies, stingless bees, honeybees and vespid wasps were caught more often in unfiltered decorated webs. These insects also have receptor sensitivities in the blue and UV. We showed that exploiting visual sensory biases plays an integral role in attracting insects to orb web decorations. Whether UV light, blue light, or both, are the most important cue, however, requires further study. © 2008 The Linnean Society of London, Biological Journal of the Linnean Society, 2008, 94, 221–229. [ABSTRACT FROM AUTHOR]

Northern sand lance (Ammodytes dubius) and Atlantic herring (Clupea harengus) represent the dominant lipid-rich forage fish species throughout the Northeast US shelf and are critical prey for numerous top predators. However, unlike Atlantic herring, there is little research on sand lance or information about drivers of their abundance. We use intra-annual measurements of sand lance diet, growth, and condition to explain annual variability in sand lance abundance on the Northeast US Shelf. Our observations indicate that northern sand lance feed, grow, and accumulate lipids in the late winter through summer, predominantly consuming the copepod Calanus finmarchicus. Sand lance then cease feeding, utilize lipids, and begin gonad development in the fall. We show that the abundance of C. finmarchicus influences sand lance parental condition and recruitment. Atlantic herring can mute this effect through intra-guild predation. Hydrography further impacts sand lance abundance as increases in warm slope water decrease overwinter survival of reproductive adults. The predicted changes to these drivers indicate that sand lance will no longer be able to fill the role of lipid-rich forage during times of low Atlantic herring abundance—changing the Northeast US shelf forage fish complex by the end of the century. [ABSTRACT FROM AUTHOR]

Background Recommendations on screening HIV-infected (+) patients for bone disease exist. We sought to characterize awareness of and adherence to HIV-specific recommendations and assess risk factors for fracture in this population. Methods Primary care provider (PCP) and ID specialist awareness of screening recommendations was assessed using an anonymous electronic survey. We conducted interviews of 45 HIV+ patients and chart review. We calculated risk using the fracture risk assessment tool (FRAX). Email notifications were sent if an indication dual-energy x-ray absorptiometry (DXA) scans was identified. Chart review was repeated 12 months later to assess response. Statistical methods included chi-square and Fisher's exact test for categorical data, and t -tests or Wilcoxon rank-sum tests for continuous data. A multivariate logistic regression examined the relationship between adult fragility fractures and covariates. Results No immunologic or virologic factors or exposure to specific antiretroviral therapies (ART) were associated with FFX (Table 1). FRAX score (hip, major osteoporotic fracture) successfully predicted FFX history (P = 0.002, P = 0.001, respectively). Overall, 35 (78%) patients qualified for DXA; 23 (66%) were men, only 8 (23%) had a previous DXA. Following provider notification, an additional 5 patients had DXA ordered. DXA was recommended for all patients with FFX, compared with 68% without a fracture (P = 0.02). In logistic regression modeling, increasing age, male sex, and months of ART therapy were associated with FFX (Table 2). Twenty-seven providers responded to the pre-intervention survey, of whom only 35% were aware of screening recommendations for HIV+ patients. Of the 18 providers who responded post-intervention, 63% were aware of these recommendations (Table 3). Conclusion A brief educational intervention resulted in increased awareness of HIV-specific screening recommendations, but this translated into adherence to a lesser extent. HIV+ men were more likely to have a history of fragility fracture compared with females. No specific ART or immunologic marker predicted fracture risk or history. Fostering a greater understanding of unique characteristics and risks in this population is crucial to ensure appropriate preventive care. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Viviparity has evolved from oviparity at least 150 independent times in vertebrates. More than 80% of these transitions have occurred in squamate reptiles, where both reproductive modes are rarely seen in different populations of the same species. This condition (bimodal reproduction) is ideal for studying the physiological and morphological changes underpinning the evolution of reproductive mode, and their genetic determinants. Here we analysed the genomes of Zootoca vivipara populations with either oviparous or viviparous reproduction using a RAD sequencing approach. No signature of interbreeding between oviparous and viviparous individuals was found. We conservatively identified 22 annotated coding sequences in genes potentially associated with parity mode differences. Six of these genes are transcription regulators that are also expressed in reproductive tissues of mammals and reptiles, suggesting that changes in gene expression are important for the evolution of viviparity. Using a more inclusive approach based on contigs mapping in either coding or non-coding regions, 45 genes were identified. Twelve of these candidate genes are transcription regulators and four encode protease enzymes. We propose that the evolution of proteases may support morphological changes to the uterus during pregnancy. This study provides the foundation for further experimental studies of the genetic basis of parity mode in Z. vivipara. [ABSTRACT FROM AUTHOR]

The evolution of new organs is difficult to study because most vertebrate organs evolved only once, more than 500 million years ago. An ideal model for understanding complex organ evolution is the placenta, a structure that is present in live bearing reptiles and mammals (amniotes), which has evolved independently more than 115 times. Using transcriptomics, we characterized the uterine gene expression patterns through the reproductive cycle of a viviparous skink lizard, Pseudemoia entrecasteauxii. Then we compare these patterns with the patterns of gene expression from two oviparous skinks Lampropholis guichenoti and Lerista bougainvillii. While thousands of genes are differentially expressed between pregnant and non-pregnant uterine tissue in the viviparous skink, few differentially expressed genes were identified between gravid and non-gravid oviparous skinks. This finding suggests that in P. entrecasteauxii, a pregnant-specific gene expression profile has evolved, allowing for the evolution of pregnancy-specific innovations in the uterus. We find substantial gene expression differences between the uterus of the chorioallantoic and the yolk sac placenta in P. entrecasteauxii, suggesting these placental regions are specialized for different placental functions. In particular, the chorioallantoic placenta is likely a major site of nutrient transport by membrane-bound transport proteins, while the yolk sac placenta also likely transports nutrients but via apocrine secretions. We discuss how the evolution of transcription factor networks is likely to underpin the evolution of the new transcriptional states in the uterine tissue of viviparous reptiles. [ABSTRACT FROM AUTHOR]

Invasive species are considered one of the greatest threats to native ecosystems, second only to habitat loss and fragmentation. Despite this, the temporal dynamics of invasions are poorly understood, with most studies focusing on a single time point, providing us with only a snapshot of the biology and genetics of the invader. We investigated the invasion of Lord Howe Island by the delicate skink Lampropholis delicata and assessed the introduction history and genetic structure of this species over a 5-year period. Using genetic data taken from 2007, and again in 2011/12, we examined changes in the population genetic structure (whether new haplotypes had been introduced to the island, and shifts in haplotype frequencies) of the species on the island between these two time points. No new haplotypes were introduced to the island between 2007 and 2011/12; however, significant shifts in haplotype frequencies across the island were detected. We conclude that the delicate skink is expanding its range into the southern regions of the island and that the haplotype frequencies on Lord Howe Island are still in a state of highly dynamic flux. Our study highlights the importance of considering invasions as dynamic and studying them in such a way that enable us to better manage their impacts. [ABSTRACT FROM AUTHOR]

Although the morphological and physiological changes involved in pregnancy in live-bearing reptiles are well studied, the genetic mechanisms that underlie these changes are not known. We used the viviparous African Ocellated Skink, Chalcides ocellatus, as a model to identify a near complete gene expression profile associated with pregnancy using RNA-Seq analyses of uterine transcriptomes. Pregnancy in C. ocellatus is associated with upregulation of uterine genes involved with metabolism, cell proliferation and death, and cellular transport. Moreover, there are clear parallels between the genetic processes associated with pregnancy in mammals and Chalcides in expression of genes related to tissue remodeling, angiogenesis, immune system regulation, and nutrient provisioning to the embryo. In particular, the pregnant uterine transcriptome is dominated by expression of proteolytic enzymes that we speculate are involved both with remodeling the chorioallantoic placenta and histotrophy in the omphaloplacenta. Elements of the maternal innate immune system are downregulated in the pregnant uterus, indicating a potential mechanism to avoid rejection of the embryo. We found a downregulation of major histocompatability complex loci and estrogen and progesterone receptors in the pregnant uterus. This pattern is similar to mammals but cannot be explained by the mammalian model. The latter finding provides evidence that pregnancy is controlled by different endocrinological mechanisms in mammals and reptiles. Finally, 88% of the identified genes are expressed in both the pregnant and the nonpregnant uterus, and thus, morphological and physiological changes associated with C. ocellatus pregnancy are likely a result of regulation of genes continually expressed in the uterus rather than the initiation of expression of unique genes. [ABSTRACT FROM AUTHOR]

Although the morphological and physiological changes involved in pregnancy in live-bearing reptiles are well studied, the genetic mechanisms that underlie these changes are not known. We used the viviparous African Ocellated Skink, Chalcides ocellatus, as a model to identify a near complete gene expression profile associated with pregnancy using RNA-Seq analyses of uterine transcriptomes. Pregnancy in C. ocellatus is associated with upregulation of uterine genes involved with metabolism, cell proliferation and death, and cellular transport. Moreover, there are clear parallels between the genetic processes associated with pregnancy in mammals and Chalcides in expression of genes related to tissue remodeling, angiogenesis, immune system regulation, and nutrient provisioning to the embryo. In particular, the pregnant uterine transcriptome is dominated by expression of proteolytic enzymes that we speculate are involved both with remodeling the chorioallantoic placenta and histotrophy in the omphaloplacenta. Elements of the maternal innate immune system are downregulated in the pregnant uterus, indicating a potential mechanism to avoid rejection of the embryo. We found a downregulation of major histocompatability complex loci and estrogen and progesterone receptors in the pregnant uterus. This pattern is similar to mammals but cannot be explained by the mammalian model. The latter finding provides evidence that pregnancy is controlled by different endocrinological mechanisms in mammals and reptiles. Finally, 88% of the identified genes are expressed in both the pregnant and the nonpregnant uterus, and thus, morphological and physiological changes associated with C. ocellatus pregnancy are likely a result of regulation of genes continually expressed in the uterus rather than the initiation of expression of unique genes. [ABSTRACT FROM AUTHOR]

Background: Newly published guidelines from the American Society of Hematology and College of American Pathologists (ASH/CAP) optimize laboratory testing in patients with newly diagnosed (ND) leukemia. We profiled recent testing patterns in patients with ND acute myeloid leukemia (AML) from academic and community clinical practices to determine antecedent conformity with these guidelines. Methods: Patients with ND AML (n = 259; ≥55 years) were identified from the CONNECT Myelodysplastic Syndrome (MDS)/AML Disease Registry (NCT01688011), a US prospective, observational cohort with ongoing enrollment. Testing patterns up to December 8, 2016, were compared to the ASH/CAP guidelines. Results: Of 27 ASH/CAP guidelines, 18 were relevant to AML and included recommendations on morphologic evaluation, immunophenotyping, karyotyping, and molecular genetic testing. Guideline-recommended morphologic evaluations were performed using bone marrow aspirates in 98.8% of patients and reported for cellularity (92% of patients); fibrosis (44%); ring sideroblasts (51%); Auer rods (39%); and granulocytic (27%), megakaryocytic (36%), and erythroid dysplasia (40%). Recommended cytogenetic, molecular, and fluorescence in situ hybridization (FISH) analyses were reported in 92.7%, 66.8%, and 79.5% of patients, respectively. Molecular or FISH testing, without karyotyping, occurred in only 5.4% of patients. When molecular analyses were performed (n = 173), guideline conformance varied with only 75.7% of patients tested for FLT3-ITD, 21.4% for IDH1, 20.2% for IDH2, and 12.7% for TP53. Only 8.7% of patients were tested for all recommended mutations. Molecular analyses performed in seven of 11 (63.3%) patients with core-binding factor (CBF) AML included KIT testing in four of seven (57.1%) patients. When AML was not associated with CBF or myelodysplasia-related changes (124/259 [47.9%]), recommended tests for NPM1, CEBPA, and RUNX1 were performed in 75.8%, 50.8%, and 15.3% of patients, respectively. Conclusions: Current laboratory testing for ND AML do not conform to the new ASH/CAP guidelines. The CONNECT, MDS/AML registry is uniquely positioned to document evolving conformity after guideline publication. [ABSTRACT FROM AUTHOR]