Geospatial immune variability illuminates differential evolution of lung adenocarcinoma

Remarkable progress in molecular analyses has improved our understanding of the evolution of cancer cells toward immune escape. However, the spatial configurations of immune and stromal cells, which may shed light on the evolution of immune escape across tumor geographical locations, remain unaddressed. We integrated multiregion exome and RNA-sequencing (RNA-seq) data with spatial histology mapped by deep learning in 100 patients with non-small cell lung cancer from the TRACERx cohort. Cancer subclones derived from immune cold regions were more closely related in mutation space, diversifying more recently than subclones from immune hot regions. In TRACERx and in an independent multisample cohort of 970 patients with lung adenocarcinoma, tumors with more than one immune cold region had a higher risk of relapse, independently of tumor size, stage and number of samples per patient. In lung adenocarcinoma, but not lung squamous cell carcinoma, geometrical irregularity and complexity of the cancer–stromal cell interface significantly increased in tumor regions without disruption of antigen presentation. Decreased lymphocyte accumulation in adjacent stroma was observed in tumors with low clonal neoantigen burden. Collectively, immune geospatial variability elucidates tumor ecological constraints that may shape the emergence of immune-evading subclones and aggressive clinical phenotypes

Laparoscopic gastrostomy: towards the ideal technique

BackgroundLaparoscopic gastrostomy is the best option for long-term gastric intubation when percutaneous endoscopic gastrostomy is not possible. The ideal technique is yet to be defined.MethodsA technique of suturing the gastric wall to the posterior rectus sheath under direct vision has been developed. The method is simple and avoids the difficulties and potential complications described with other techniques.ResultsThe technique has been used in three cases with excellent results and no complications.ConclusionThe described technique is a further advance in defining the 'ideal' technique of laparoscopic gastrostomy.Andrew Luck and Peter Hewet

Global ATM security Management - D2.3 - Risk Treatment Report

This document is the deliverable D2.3 – Security Risk Treatment Report, providing the last step of the risk analysis. As defined by ISO 27005 the risk analysis starts with the context establishment (D2.1), risk identification (D2.1), risk evaluation (D2.1), security objectives and security need definition (D2.2) and ends with the risk treatment (D2.3)

Global ATM security Management - D2.2 - Security objective report

This document is the deliverable D2.2 – Security objective report of GAMMA WP2 “ATM threat assessment model”, providing a list of security objectives for the ATM system. It is based on the risk assessment made in D2.1 with the context and scope, threat scenarios and risks identified on the ATM system, in order to provide a list of security objectives

Global ATM security Management - D2.1 - Threat analysis & evaluation report

This deliverable, D2.1 – Threat analysis and evaluation report of GAMMA WP2 “ATM threat assessment model”, is defined in the GAMMA project as an assessment of the full set of security threats and vulnerabilities possibly affecting the global ATM current system and future evolutions prepared in the frame of SESAR