An integrated genomic analysis of anaplastic meningioma identifies prognostic molecular signatures

Anaplastic meningioma is a rare and aggressive brain tumor characterised by intractable recurrences and dismal outcomes. Here, we present an integrated analysis of the whole genome, transcriptome and methylation profiles of primary and recurrent anaplastic meningioma. A key finding was the delineation of distinct molecular subgroups that were associated with diametrically opposed survival outcomes. Relative to lower grade meningiomas, anaplastic tumors harbored frequent driver mutations in SWI/SNF complex genes, which were confined to the poor prognosis subgroup. Aggressive disease was further characterised by transcriptional evidence of increased PRC2 activity, stemness and epithelial-to-mesenchymal transition. Our analyses discern biologically distinct variants of anaplastic meningioma with prognostic and therapeutic significance

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Integrating logistical and technical criteria into a multiteam, competitive watershed model ranking procedure

A systematic and holistic watershed model comparison and selection process, integrating a full range of relevant criteria, is illustrated here. The process consists of screening for a set of candidate models on the basis of prerequisite model attributes; assessing hydrologic simulation performance using various conventional statistical metrics; assessing operational logistics performance, reflecting somewhat subjective but centrally important issues around relative feasibility and suitability of candidate models in the intended context of use; and integrating the hydrologic and operational performance results, which are each evaluated using a weighted-matrix approach, into a single coherent and comprehensive ranking system. The process was applied to evaluation of watershed models for operational hydroelectric inflow forecasting in British Columbia, Canada. An important feature of the study was its horse-race project management approach, involving a supervised competition between expert teams using different models but the same data sets. Four models passed the prescreening phase, and these were evaluated for three test basins representing contrasting geophysical regimes. The model selection process presented here is believed to be potentially very broadly useful. \ua9 2013 American Society of Civil Engineers.Peer reviewed: YesNRC publication: Ye