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This is the first report of a NACC2‐NTRK2 fusion in a histological glioblastoma. Oncogenomic analysis revealed this actionable fusion oncogene in a pediatric cerebellar glioblastoma, which would not have been identified through routine diagnostics, demonstrating the value of clinical genome profiling in cancer care.

Integrated smartly controlled energy networks have the potential to deliver significant reductions in carbon emissions, improve air quality and reduce energy costs for end-users across the world. This paper introduces a novel methodology for the development of integrated thermal, power and mobility 5th generation (5G) smart energy networks. The proposed 5G concept builds on state of the art by connecting flexible electricity demands such as heat pumps, and electric vehicles to intermittent, renewable and secondary energy sources and storage using artificial intelligence to facilitate optimal control and to maximise revenue and carbon savings. The proposed innovative method is being applied in central London through the development of two independent 5G smart energy schemes. The proposed schemes will incorporate a range of different renewables and secondary energy sources, for example, waste heat from local data centres and the London Underground that will supply a large proportion of the energy demand of the overall district network capacity. Both networks will operate at close to ambient temperature, approximately 15–25 °C as a so-called ‘ambient loop’ system, with individual heat pumps for each end-user or building connected to the network. The system also integrates thermal and electrical storage to create additional flexibility for the network and smart control for demand-side management. A smart management system flexibly controls individual assets such as heat pumps and electric vehicles in response to price signals reflecting the intermittency of renewable energy sources on the electricity grid. The ambient district thermal loop will distribute low carbon energy to a range of end users. Results presented in this paper provide an understanding of capital costs associated with integrated smart energy systems and the relative performance of individual technologies in a complex system using a techno-economic modelling approach. Overall, this paper demonstrates that the implementation of the 5G concept results in lower energy costs to consumers while at the same time transforming a large existing urban area to a near zero-carbon energy system in terms of heating, cooling, electricity and transport.

Clinical detection of sequence and structural variants in known cancer genes points to viable treatment options for a minority of children with cancer.1 To increase the number of children who benefit from genomic profiling, gene expression information must be considered alongside mutations.2,3 Although high expression has been used to nominate drug targets for pediatric cancers,4,5 its utility has not been evaluated in a systematic way.6 We describe a child with a rare sarcoma that was profiled with whole-genome and RNA sequencing (RNA-Seq) techniques. Although the tumor did not harbor DNA mutations targetable by available therapies, incorporation of gene expression information derived from RNA-Seq analysis led to a therapy that produced a significant clinical response. We use this case to describe a framework for inclusion of gene expression into the clinical genomic evaluation of pediatric tumors.

Some investigators have suggested that medulloblastomas can be distinguished from other cerebellar neoplasms by demonstrating "restricted diffusion" on the Apparent Diffusion Coefficient (ADC) map obtained from diffusion-weighted imaging (DWI) sequences on magnetic resonance imaging. Previous authors have postulated that this observed restricted diffusion is a reflection of very high cell density. There has been a tendency to assert that pediatric medulloblastoma uniformly demonstrates restricted diffusion on DWI. However, our clinical observation has been that there are pediatric medulloblastomas that exhibit normal or even increased diffusion on DWI. The current study was undertaken primarily to determine whether restricted diffusion is uniformly present in pediatric medulloblastoma and secondly to look for pathological features that might distinguish medulloblastomas with and without restricted diffusion.The DWI characteristics of pathologically confirmed medulloblastomas diagnosed at our institution were retrospectively reviewed. The ADC was obtained in two non-overlapping, solid, non-hemorrhagic, non-necrotic regions of tumor and averaged. An ADC below 1 × 10(-3) mm(2)/s was considered to represent restricted diffusion. A detailed pathologic review of each tumor was conducted.Ten cases of medulloblastoma were reviewed, of which two demonstrated average ADCs above 1 × 10(-3) mm(2)/s (1.223 and 1.169 × 10(-3) mm(2)/s, respectively), indicating no restricted diffusion. Pathologic review revealed that both of these non-restricting cases displayed a lack of reticulin deposition by light microscopy.DWI does not appear to be an entirely reliable means of distinguishing medulloblastomas from other cerebellar neoplasms. Histologically, restricted diffusion in medulloblastomas may be related to reticulin deposition.