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BACKGROUNDCellular stressors influence the development of clonal hematopoiesis (CH). We hypothesized that environmental, inflammatory, and genotoxic stresses drive the emergence of CH in lung transplant recipients. METHODSWe performed a cross-sectional cohort study of 85 lung transplant recipients to characterize CH prevalence. We evaluated somatic variants using duplex error-corrected sequencing and germline variants using whole exome sequencing. We evaluated CH frequency and burden using χ2 and Poisson regression, and we evaluated associations with clinical and demographic variables and clinical outcomes using χ2, logistic regression, and Cox regression. RESULTSCH in DNA damage response (DDR) genes TP53, PPM1D, and ATM was increased in transplant recipients compared with a control group of older adults (28% versus 0%, adjusted OR [aOR], 12.9 [1.7-100.3], P = 0.0002). Age (OR, 1.13 [1.03-1.25], P = 0.014) and smoking history (OR 4.25 [1.02-17.82], P = 0.048) were associated with DDR CH. Germline variants predisposing to idiopathic pulmonary fibrosis were identified but not associated with CH. DDR CH was associated with increased cytomegalovirus viremia versus patients with no (OR, 7.23 [1.95-26.8], P = 0.018) or non-DDR CH (OR, 7.64 [1.77-32.89], P = 0.024) and mycophenolate discontinuation (aOR, 3.8 [1.3-12.9], P = 0.031). CONCLUSIONCH in DDR genes is prevalent in lung transplant recipients and is associated with posttransplant outcomes including cytomegalovirus activation and mycophenolate intolerance. FUNDINGNIH/NHLBI K01HL155231 (LKT), R25HL105400 (LKT), Foundation for Barnes-Jewish Hospital (LKT), Evans MDS Center at Washington University (KAO, MJW), ASH Scholar Award (KAO), NIH K12CA167540 (KAO), NIH P01AI116501 (AEG, DK), NIH R01HL094601 (AEG), and NIH P01CA101937 (DCL).

Uttarakhand State of India suffered a widespread devastation in June 2013 due to floods caused by excessive rain in the upper reaches of the Himalaya, glacial lake outburst flood (GLOF) and landslides. Restoration process in this mountainous State calls for scientifically sound planning so that the vulnerabilities and risks to such natural hazards are minimised and developmental processes are sustainable in long run. Towards this, an understanding of the patterns and major controls of damage of the recent disaster is a key requirement which can be achieved only if the primary data on locations and types of damage along with other local site conditions are available. Considering widespread damage, tough nature of terrain and the need for collecting the primary data on damage in shortest possible time, crowdsourcing approach was considered to be the most viable solution. Accordingly, a multiinstitutional initiative called \"Map the Neighbourhood in Uttarakhand\" (MANU) was conceptualised with the main objective of collecting primary data on damage through participation of local people (mainly students) using state-of-art tools and technologies of data collection and a mechanism to integrate the same with Bhuvan geo-portal (www.bhuvan.nrsc.gov.in) in near real-time. Geospatial analysis of crowd-sourced points with different themes has been carried out subsequently for providing inputs to restoration planning and for future developmental activities. The present paper highlights the capacity building aspect in enabling the data collection process using crowdsourcing technology.