No abstract

BackgroundFor children with cancer, the clinical integration of precision medicine to enable predictive biomarker–based therapeutic stratification is urgently needed.MethodsWe have developed a hybrid-capture next-generation sequencing (NGS) panel, specifically designed to detect genetic alterations in paediatric solid tumours, which gives reliable results from as little as 50 ng of DNA extracted from formalin-fixed paraffin-embedded (FFPE) tissue. In this study, we offered an NGS panel, with clinical reporting via a molecular tumour board for children with solid tumours. Furthermore, for a cohort of 12 patients, we used a circulating tumour DNA (ctDNA)–specific panel to sequence ctDNA from matched plasma samples and compared plasma and tumour findings.ResultsA total of 255 samples were submitted from 223 patients for the NGS panel. Using FFPE tissue, 82% of all submitted samples passed quality control for clinical reporting. At least one genetic alteration was detected in 70% of sequenced samples. The overall detection rate of clinically actionable alterations, defined by modified OncoKB criteria, for all sequenced samples was 51%. A total of 8 patients were sequenced at different stages of treatment. In 6 of these, there were differences in the genetic alterations detected between time points. Sequencing of matched ctDNA in a cohort of extracranial paediatric solid tumours also identified a high detection rate of somatic alterations in plasma.ConclusionWe demonstrate that tailored clinical molecular profiling of both tumour DNA and plasma-derived ctDNA is feasible for children with solid tumours. Furthermore, we show that a targeted NGS panel–based approach can identify actionable genetic alterations in a high proportion of patients.

BackgroundThe aim of our study was twofold. The first was to investigate the optimum position of the elbow while measuring grip endurance. The second was to investigate the optimum position of the elbow while measuring peak grip strength. The American Society of Hand Therapists advocate estimation of grip strength with the elbow flexed at 90° with the subject in the sitting position . As far as we are aware, there have been no reports in English literature regarding studies done to evaluate the position of the elbow while measuring grip endurance. Materials and methodsA total of 45 healthy adults (16 males, 29 females) participated in this study. A computerised handgrip analyser was used to measure the peak strength in the non-dominant hand, followed by measurement of the grip endurance. These measurements were conducted in 90° of flexion and full extension of the elbow for each participant.ResultsMean endurance in flexion was 71.0 N (SD 22.9) and in extension was 68.7 N (SD 27.4). Mean peak grip strength in flexion was 262.8 N (SD 73.1) and in extension was 264.1 N (SD 82.0). T test analysis showed no statistical significance for elbow positions for grip endurance (P = 0.67) and peak gip strength (P = 0.93).ConclusionPractical implications from this study are that grip endurance training can be undertaken with the elbow in 90° of flexion or full extension.

No abstract