Deflation versus maintained inflation of gastric band in pregnancy:A national cohort study

BACKGROUND: With no evidence to guide management of the gastric band in pregnancy, we aim to compare outcomes according to band management. METHODS: Data were collected on all women pregnant (November 2011-October 2012) following gastric banding, using the UK Obstetric Surveillance System surveillance system. We compared outcomes between band management groups and with national data. RESULTS: Band management was variable; deflation 43.4%, inflation maintained 56.6%. The deflation group had lower risk of small for gestational age infants (no cases vs. 11.3%; risk ratio = 0.14, p = 0.05). There was greater gestational weight gain (deflation 15.4 kg, inflation 7.6 kg; adjusted p = 0.05), and perhaps higher risk of gestational hypertension (deflation 10.5%, inflation no cases; p = 0.08) in the deflation group. Other maternal outcomes were similar between management groups but overall worse than national data. CONCLUSIONS: Deflation is associated with better outcomes for babies but worse outcomes for mothers than maintained inflation

Integrated Molecular Characterization of Uterine Carcinosarcoma

SummaryWe performed genomic, epigenomic, transcriptomic, and proteomic characterizations of uterine carcinosarcomas (UCSs). Cohort samples had extensive copy-number alterations and highly recurrent somatic mutations. Frequent mutations were found in TP53, PTEN, PIK3CA, PPP2R1A, FBXW7, and KRAS, similar to endometrioid and serous uterine carcinomas. Transcriptome sequencing identified a strong epithelial-to-mesenchymal transition (EMT) gene signature in a subset of cases that was attributable to epigenetic alterations at microRNA promoters. The range of EMT scores in UCS was the largest among all tumor types studied via The Cancer Genome Atlas. UCSs shared proteomic features with gynecologic carcinomas and sarcomas with intermediate EMT features. Multiple somatic mutations and copy-number alterations in genes that are therapeutic targets were identified

Integrated genomic characterization of pancreatic ductal adenocarcinoma

We performed integrated genomic, transcriptomic, and proteomic profiling of 150 pancreatic ductal adenocarcinoma (PDAC) specimens, including samples with characteristic low neoplastic cellularity. Deep whole-exome sequencing revealed recurrent somatic mutations in KRAS, TP53, CDKN2A, SMAD4, RNF43, ARID1A, TGFβR2, GNAS, RREB1, and PBRM1. KRAS wild-type tumors harbored alterations in other oncogenic drivers, including GNAS, BRAF, CTNNB1, and additional RAS pathway genes. A subset of tumors harbored multiple KRAS mutations, with some showing evidence of biallelic mutations. Protein profiling identified a favorable prognosis subset with low epithelial-mesenchymal transition and high MTOR pathway scores. Associations of non-coding RNAs with tumor-specific mRNA subtypes were also identified. Our integrated multi-platform analysis reveals a complex molecular landscape of PDAC and provides a roadmap for precision medicine

The Somatic Genomic Landscape of Chromophobe Renal Cell Carcinoma

We describe the landscape of somatic genomic alterations of 66 chromophobe renal cell carcinomas (ChRCCs) based on multidimensional and comprehensive characterization, including mitochondrial DNA (mtDNA) and whole genome sequencing. The result is consistent that ChRCC originates from the distal nephron compared to other kidney cancers with more proximal origins. Combined mtDNA and gene expression analysis implicates changes in mitochondrial function as a component of the disease biology, while suggesting alternative roles for mtDNA mutations in cancers relying on oxidative phosphorylation. Genomic rearrangements lead to recurrent structural breakpoints within TERT promoter region, which correlates with highly elevated TERT expression and manifestation of kataegis, representing a mechanism of TERT up-regulation in cancer distinct from previously-observed amplifications and point mutations

Acceptability and feasibility of telehealth as a training modality for trainee psychologist placements: a COVID-19 response study

Objective This study examined the extent to which telehealth placements are feasible for developing perceived competence as a psychologist and are an acceptable training modality for provisional psychologists. Method Fifteen provisional psychologists who undertook a postgraduate placement using telehealth completed an online survey. Acceptability and attitudes towards future telehealth service provision were assessed via Likert scales and open-ended questions. Feasibility was assessed via comparison using Wilcoxon Rank Signed tests of pre- and post-placement self-efficacy using the Psychology Counsellor Self-Efficacy Scale. Open-ended questions were analysed using content analysis. Results Participants reported high satisfaction with the telehealth placement. Perceived self-efficacy improved between pre- and post-placement on all competencies except for research. Students reported that a telehealth placement enabled them to improve in all areas, with particular benefits including rapport building, therapeutic questioning, and management of safety and ethical concerns. Challenges of a telehealth placement included assessing mental status, isolation from peers, and technical difficulties. Students reported positive attitudes towards future use of telehealth. Conclusions Telehealth appears to offer an acceptable, feasible and valuable training experience for developing competence for provisional psychologists. Undertaking a telehealth placement may help prepare clinicians for future use of telehealth, especially in relation to ethics and risk management

The Somatic Genomic Landscape of Chromophobe Renal Cell Carcinoma

We describe the landscape of somatic genomic alterations of 66 chromophobe renal cell carcinomas (ChRCCs) on the basis of multidimensional and comprehensive characterization, including mtDNA and whole-genome sequencing. The result is consistent that ChRCC originates from the distal nephron compared with other kidney cancers with more proximal origins. Combined mtDNA and gene expression analysis implicates changes in mitochondrial function as a component of the disease biology, while suggesting alternative roles for mtDNA mutations in cancers relying on oxidative phosphorylation. Genomic rearrangements lead to recurrent structural breakpoints within TERT promoter region, which correlates with highly elevated TERT expression and manifestation of kataegis, representing a mechanism of TERT upregulation in cancer distinct from previously observed amplifications and point mutationsclose5