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Many adolescents and young adults (AYAs; 15-39 years) with cancer receive high intensity (HI) care at the end of life (EOL). Palliative care (PC) involvement in this population is associated with lower risk of HI-EOL care. Whether this association differs by specialized versus generalist PC (SPC, GPC) is unknown.(1) To evaluate whether SPC had an impact on the intensity of EOL care received by AYAs with cancer; (2) to determine which subpopulations are at highest risk for reduced access to SPC.A decedent cohort of AYAs with cancer who died between 2000-2017 in Ontario, Canada was identified using registry and population-based data. The primary composite measure of HI-EOL care included any of: intravenous chemotherapy14 days from death; more than one ED visit, more than one hospitalization or any ICU admission30 days from death. Physician's billing codes were used to define SPC and GPC involvement.Of 7,122 AYA decedents, 2,140 (30%) received SPC and 943 (13%) received GPC. AYAs who died in earlier years, those with hematologic malignancies, males and rural AYAs were least likely to receive SPC. No PC involvement was associated with higher odds of receiving HI-EOL care (odds ratio (OR) 1.5; p0.0001). However, SPC was associated with the lowest risk of HI-EOL care (OR SPC versus GPC 0.8; p=0.007) and decreased odds of ICU admission (OR 0.7; p=0.006).SPC involvement was associated with the lowest risk of HI-EOL care in AYAs with cancer. However, access to SPC remains a challenge.

Objective: To find out the prevalence of sexually transmitted diseases (STDS) among the patients attending the tertiary care center through microscopic screening. Methods: This Cross Sectional study was conducted from April 2018 to December 2019 wherein 500 samples were collected from patients attending the STD clinic of Skin and VD-OPD, and integrated counseling and testing center (ICTC), having cervical or urethral discharge along with signs and symptoms of sexually transmitted infections (STI) and were screened microscopically for the same. Results: This study reported only 2 cases suggestive of N. gonorrhoeae on microscopy, wherein the Gram-stained smear showed the presence of a particular arrangement of Gram-negative coffee bean shape cocci, both intracellular and extracellular, and plenty of pus cells. In Direct Microscopy findings, 49.2% of samples showed normal flora, 20.4% Gram-positive cocci, 15.8% Gram-negative cocci, 4% Clue cells, 13.8% with mixed flora, 3% Budding yeast-like cells and 0.4% showed Gram-negative cocci. Conclusion: Such studies involving the laboratory and demographic data should be conducted regularly, which can help in estimating the disease burden, strengthening the diagnostic capacity, and formulating the requisite strategy for tackling this problem through a syndromic approach.

Adolescents and young adults (AYA, ages 15-39 years) affected by cancer have unique treatment, survivorship, and palliation concerns. Current oncology training does not focus on the distinctive needs of this demographic. Amid this recognition, the Canadian National AYA Cancer Task Force and Canadian Partnership Against Cancer have advocated the need for clinicians with formalized AYA experience. To address this need and standardize training, a national task force developed criteria for structured academic programs in AYA Oncology in Canada.Workshops were organized to identify and establish the fundamentals of practice in AYA Oncology through consensus. These workshops followed the pre-existing rigorous process established by the Royal College of Physicians and Surgeons of Canada (Royal College) for new program development. The process includes: (i) developing the tasks associated with the discipline's practice, (ii) identifying the evidence trainees must provide to demonstrate tasks can be performed independently (the competence portfolio), (iii) developing training requirements and summarizing the knowledge, skills and attitudes required to perform these tasks, and (iv) identifying specific experiences essential to acquiring skills and demonstrating competent performance.AYA Oncology is a recognized an Area of Focused Competence (AFC) by the Royal College.The AFC designation in AYA Oncology provides a standardized curriculum, training experience and accreditation process to attract oncologists, promote expertise and advance AYA oncology care.

Inflammatory myofibroblastic tumor (IMT) is a neoplasm that typically occurs in children. The genetic landscape of this tumor is incompletely understood and therapeutic options are limited. Although 50% of IMTs harbor anaplastic lymphoma kinase (ALK) rearrangements, no therapeutic targets have been identified in ALK-negative tumors. We report for the first time that IMTs harbor other actionable targets, including ROS1 and PDGFRβ fusions. We detail the case of an 8-year-old boy with treatment-refractory ALK-negative IMT. Molecular tumor profiling revealed a ROS1 fusion, and he had a dramatic response to the ROS1 inhibitor crizotinib. This case prompted assessment of a larger series of IMTs. Next-generation sequencing revealed that 85% of cases evaluated harbored kinase fusions involving ALK, ROS1, or PDGFRβ. Our study represents the most comprehensive genetic analysis of IMTs to date and also provides a rationale for routine molecular profiling of these tumors to detect therapeutically actionable kinase fusions.Significance: Our study describes the most comprehensive genomics-based evaluation of IMT to date. Because there is no “standard-of-care” therapy for IMT, the identification of actionable genomic alterations, in addition to ALK, is expected to redefine management strategies for patients with this disease. Cancer Discov; 4(8); 889–95. ©2014 AACR.See related commentary by Le and Doebele, p. 870This article is highlighted in the In This Issue feature, p. 855

PDF file - 106KB, Schematic representation of the study design. 37 IMT tumor samples from 33 patients were collected under IRB approved protocols. ALK immunohistochemistry (IHC) was performed on each of the 37 cases as standard of clinical care. Targeted next-generation sequencing (NGS) using the FoundationOne was completed in each case. 22/26 ALK IHC+ and 11/11 ALK IHC- samples were evaluable. ALK kinase fusions were detected in 20/22 (91%) of the ALK IHC+ cases. In the ALK IHC- cases, 2/11 (18%) harbored ALK fusions, 2/11 (18%) harbored PDGFRβ fusions, and 4/11 (36%) harbored ROS1 fusions. Overall, therapeutically actionable kinase fusions were detected in 28/33 (85%) of cases.

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PDF file - 59KB, Schematic representation of the index patient's treatment history. A timeline detailing the index patient's diagnosis and subsequent systemic therapies is depicted. Time in months is shown below the arrow. The timeline starts at the patient's initial diagnosis.

PDF file - 137KB, Summary of genomic coordinates for the kinase fusions identified in this study. The sample number is depicted in the far left column. For tumor samples in which a kinase fusion was identified, the genomic coordinates for of each of the fusion genes is indicated. There were no other recurrent alterations. *The FN1-ALK fusion was detected with RNA sequencing. #Sufficient material was available to verify these kinase fusions with RNA sequencing.

PDF file - 53KB, FoundationOne panel. This targeted next generation sequencing platform evaluates for 3769 exons of 236 cancer genes and 47 introns of 19 commonly rearranged genes, including 8 tyrosine kinases.

PDF file - 87KB, Changes in the indicated laboratory parameters after 3 cycles of crizotinib. HgB: hemoglobin, Hct: hematocrit, MCV: mean corpuscular volume, ESR: erythrocyte sedimentation rate, LDH: lactate dehydrogenase.

Objectives: The objectives of the study were to find out the prevalence and spectrum of intestinal parasitic infestations among the patients attending the associated hospital with complaints of abdominal pain and diarrhea. Methods: A total of 117 stool samples were collected and screened for intestinal parasitic infection. Plastic containers with identification numbers were given to the patients, and information regarding name, age, sex, ward, and findings of stool routine microscopy were recorded. All samples were examined macroscopically for appearance, color, and the presence of blood and mucus then analyzed using direct microscopy for the presence of intestinal parasites. Results: It was found that intestinal parasitic infections were mainly attributed to Entamoeba histolytica, Ascaris lumbricoides, and Giardia lamblia which are pretty prevalent in the region of the study. Conclusion: It was found that intestinal parasitic infections were mainly attributed to E. histolytica, A. lumbricoides, and G. lamblia which are pretty prevalent in the region of the study.

Osteosarcoma is the most common pediatric malignant bone tumor. Concomitant osteoporosis has typically been attributed to oncologic therapy. The present case series is aimed to describe 3 patients who presented with osteoporosis or osteopenia before, or early in, their oncology treatment. In our patients, bone health and its complications had significant impacts including pain, reduced mobility, prolonged admission, and delays in recovery. Our patients experienced improvement with resection of their primary tumor and with bisphosphonate infusion. Future studies are required to determine the prevalence osteoporosis at presentation of osteosarcoma and the role of bisphosphonates.

Purpose This study aimed to evaluate the impact of the COVID-19 pandemic on adolescent and young adult (AYA) cancer survivors. Methods We conducted a cross-sectional survey of AYAs aged 18–49 with cancer in Canada between January and February 2021. Data from survivors, defined as AYAs more than one year off cancer treatment, were analysed. Multiple logistic regression was used to identify factors associated with psychological distress, loneliness and insomnia. Results The analysis included 384 survivors. Moderate-to-severe psychological distress was reported by 257 (68.9%) survivors and was associated with an income ≥ $60,000 (adjusted odds ratio [AOR] 2.15, 95% CI 1.11–4.17) and the presence of a pre-existing chronic physical health condition (AOR 2.05, 95% CI 1.18–3.56). Loneliness was reported by 204 (54.0%) survivors and was associated with being unemployed (AOR 2.26 95%CI 1.18–4.31), pandemic causing finances to be worse (AOR 1.82, 95%CI 1.08–3.06) and the presence of a pre-pandemic mental health condition (AOR 1.88, 95% CI 1.03–3.42). Clinical insomnia was reported by 74 (19.5%) survivors and was associated with employment status as a student (AOR 3.00, 95% CI 1.08–8.29) or unemployed (AOR 3.97, 95% CI 1.46–10.83), earning $60,000 or more in the year 2020 (AOR 4.36, 95% CI 1.43–13.32), having haematologic cancer (AOR 2.21, 95% CI 1.05–4.70) and being single (AOR 2.52, 95% CI 1.08–5.91). Pandemic negatively affected employment, finances, physical activity, cancer care and substance use for 73.9%, 66.5%, 32.5%, 21.8% and 19.2% of survivors, respectively. Worries about finances, contracting COVID-19, cancer treatment increasing the risk of COVID-19 infection, and having poor health outcomes from contracting COVID-19 were reported by 46.0%, 45.6%, 55.0% and 47.3% of survivors, respectively. Conclusions The COVID-19 pandemic has had a significant impact on AYA cancer survivors, and these individuals report high levels of psychological distress, insomnia and loneliness. Implications for Cancer Survivors. Cancer survivors are at risk for worsening mental and physical health outcomes during the COVID-19 pandemic. Targeted interventions and support programs are urgently needed to support the mental health of AYA cancer survivors and optimize their health outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01158-9.

Parents of adolescents with cancer (AWC) provide critical support throughout the cancer journey and could offer key insights into support needs. This prospective study aimed to obtain parent perspectives on peer support needs of AWC. Ten individual parents (9 mothers and 1 father) completed a survey and a semistructured interview. Four themes were identified: cancer journey challenges; emotions, reactions, and coping; personal support preferences; and AWC's support needs. Parents recognized that AWC require various support, but lacked insight into their specific peer support desires. Next step interventions should focus on peer support for AWC, while also incorporating peer support for parents.

In today’s scenario, investors’ preferences towards different investment avenues depend upon their risk tolerance level and return associated with investment plan. The tolerance level of investors for risk is influenced by many demographic and psychological factors. Personality traits (PTs) are one of the important factors that impact the tolerance levels of investors for risk. Thus, the existing study focuses on whether (a) the direct effect of Big Five PTs on financial risk tolerance (FRT) or (b) PTs as a second-order (higher-order) factor leads to FRT. Data are cross-sectional in nature, which were collected from 599 investors who invested through Angel Broking Co. (Securities co.) in Delhi and the National Capital Region (NCR) by using online structured questionnaire. To examine the strength of the relationship between variables’ correlation and regression tests were applied using the structural equation modelling approach. The study found that among Big Five personality dimensions, only agreeableness, conscientiousness and openness are significantly associated with FRT, whereas PTs as a second-order (higher-order) factor have a strong association with FRT of investors. Thus, the PT as a second order is the preferred model. JEL Code: G02

Background: Leprosy (Hansen’s disease) still continues to be an important public health problem. The present study was carried to correlate histological diagnosis of skin biopsies of untreated leprosy cases with clinical diagnosis using Ridley- Jopling classification. Material and Methods: 124 skin biopsies of untreated leprosy cases over a period of 6 years were included. Paraffin sections of biopsies were stained with Haematoxylin & Eosin, Ziehl- Neelsen’s & Fite stains examined and classified histopathologically according to Ridley- Jopling scale and then correlated with clinical diagnosis. Results: Prevalence rate of leprosy in Ajmer district is 0.16 per 10,000 population per annum. Among the 124 biopsies, most cases were of indeterminate type (39.51%), followed by LL type (17.74%), TT type (16.93%), BT type (10.48%), BL type (07.25%), BB type (05.64%), histioid type (2.41%). Most commonly the patients were affected in 4th decade of life. Male and female ratio was 2.26:1. Most common clinical presentation was anesthesia. Conclusion: Correlation of clinical and histopathological features along with bacteriological index appears more useful for accurate typing of leprosy than considering any of the single parameters alone. This helps the clinician for better care and management of the patients.

Background: There is a lack of self-management tools for adolescents with cancer (AWC). This study evaluated the feasibility of Teens Taking Charge Cancer, a web-based self-management program. Methods: A pilot randomized control trial (RCT) was conducted across 4 pediatric oncology clinics. AWC (12–18 years) and their caregivers were randomized to either the intervention or control group. All were asked to complete 12 website modules over 12 weeks (at their own pace) and received monthly calls from health coaches. The intervention website was based on cognitive behavioral principals, designed as an interactive self-guided online program, while the control consisted of education and included links to 12 general cancer websites. Outcome assessments occurred at enrollment and 12 weeks post-intervention. The primary outcomes included rate of accrual and retention, adherence to the protocol, acceptability and satisfaction with intervention using questionnaire and semi-structured interviews, adverse events and engagement with the intervention. Results: Eighty-one teen-caregiver dyads were enrolled with a retention rate of 33%. In the intervention group 46% ( n = 18) logged in at least once over the 12-week period. A mean of 2.4 of 12 modules ( SD 3.0) were completed; and no one completed the program. Thirty-three percent of caregivers in the intervention logged into the website at least once and none completed the full program. Discussion: The results from this pilot study suggest that the current design of the Teens Taking Charge Cancer RCT lacks feasiblity. Future web-based interventions for this group should include additional features to promote uptake and engagement with the program.

BACKGROUND: There has been an alarming increase in the prevalence of Coronary Artery Disease (CAD) worldwide and is a leading cause of mortality in India. Yoga is emerging as a signicant tool in managing the disease. OBJECTIVES:The study was conducted to nd out the effect of yogic lifestyle modication on anginal episodes in CAD patients. METHODS: This prospective, controlled study included the CAD patients between the ages 30 to 70 years who were randomised to yoga group (group A, n=51) and control group (group B, n=51). They were assessed clinically on the basis of number of anginal episodes per week. The yoga group patients were prescribed a family based yoga programme in addition to the conventional drug treatment for CAD. The control group received conventional drug therapy alone. The patients were assessed at baseline and thereafter, at the end of 6 months. RESULTS: The number of anginal episodes per week reduced signicantly by 25.40% in the yoga group vis-à-vis the control group at the end of six months (independent t-test p-value0.05), the difference became signicant at the end of six months (independent t-test p-value

This study investigates, through a mixed method design, the effectiveness of a professional development program on teacher knowledge and student learning in order to systematically improve student achievement in elementary literacy. A large urban school district partnered with a local university to provide intervention in a Title 1, low-performing elementary school. Measures included teacher knowledge and practices based on surveys, classroom observation, and student achievement data. Teachers self-reported their perspectives on school-based teacher training in terms of its significance, requirements, challenges, and possible solutions to teacher training. Schools were selected based on their Adequate Yearly Progress (AYP) in reading/ language arts’ status. Adequate Yearly Progress (AYP) is a measurement defined by the United States federal No Child Left Behind Act that allows the U.S. Department of Education to determine how every public school and school district in the country is performing academically according to results on standardized tests. The collaboration effort involved supporting the school’s goal of enhancing reading, language arts, and math achievement of students by providing interventions targeted towards grades 4 and 5.

Purpose The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival. Patients and methods Retrospective review at 25 international sarcoma centers identified patients ≥18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplan–Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed. Results 370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%–62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26–0.80], p = 0.01). Conclusion Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS.

The role of CD4 T regulatory cells is well established in peripheral tolerance and the pathogenesis of the murine model and human autoimmune diseases. CD4 T regulatory cells (CD4 Tregs) have been investigated in common variable immunodeficiency (CVID). Recently, additional members have been added to the club of regulatory lymphocytes. These include CD8 T regulatory (CD8 Tregs), B regulatory (Bregs), and T follicular helper regulatory (TFR) cells. There are accumulating data to suggest their roles in both human and experimental models of autoimmune disease. Their phenotypic characterization and mechanisms of immunoregulation are evolving. Patients with CVID may present or are associated with an increased frequency of autoimmunity and autoimmune diseases. In this review, we have primarily focused on the characteristics of CD4 Tregs and new players of the regulatory club and their changes in patients with CVID in relation to autoimmunity and emphasized the complexity of interplay among various regulatory lymphocytes. We suggest future careful investigations of phenotypic and functional regulatory lymphocytes in a large cohort of phenotypic and genotypically defined CVID patients to define their role in the pathogenesis of CVID and autoimmunity associated with CVID.

Despite excellent properties of aluminium silicon (Al-Si) alloys in several aircraft and automotive applications, its usage is limited because near net shape casting of Al-Si alloys may cause several defects like surface pinholes and grooves. Fabrication of components and then welding them via fusion-based welding processes imposes issues like porosity and slag inclusions which may severely degrades its properties. Thus in present study, friction stir welding (FSW) was employed for welding of hypereutectic Al-Si cast alloy. The nugget zone (NZ) of welded alloy and its as-cast counterparts were characterized for their performance in terms of mechanical and tribological behaviour. The results depicted fragmentation of α-Al dendrites, refinement and redistribution of acicular Si particles as a result of stirring with high strain rate, and improvement in mechanical properties such as ultimate tensile strength, yield strength, ductility, hardness and wear resistance as compared to as-cast alloy. It is also shown that disparate wear mechanisms occured in friction stir welded (FSWed) and as-cast alloys. A sizeable amount of adhesion with plastic deformation and delamination pits were observed for as-cast alloy, while the dominant mechanism in FSWed alloy was peeling with little adhesion.

The article addresses diversity issues related to language, gender, and culture. Topics include fundamental areas of research essential to the discussion on language diversity in the context of education with respect to equity, poverty, stereotype threat, Pygmalion Effect, non-sexist language, and Matthews Effect. The discussion on diversity and equity creates a space to think about issues of access, opportunity, voice, and equal participation within society and educational settings. Diversity among humans requires thoughtful considerations, accommodations, and differentiations in educational treatment, yet providing equal opportunities for growth and learning for all.

Background: Location of cancer care (LOC: pediatric versus adult center) impacts outcomes in adolescents and young adults (AYA) with some cancer types. Data on impact of LOC on survival in AYA with osteogenic sarcoma (OGS) and Ewing sarcoma (EWS) are limited. Objectives: To compare differences in demographics, disease/treatment characteristics, and survival in a population-based cohort of AYA with OGS or EWS treated at pediatric versus adult centers Methods: The IMPACT Cohort captured demographic, disease, and treatment data for all AYA (15-21 years old) diagnosed with OGS and EWS in Ontario, Canada between 1992-2012. Patients were linked to provincial administrative healthcare databases. Outcomes were compared between patients treated in pediatric versus adult centers using appropriate statistical methods. Results: 137 AYA were diagnosed with OGS (LOC: 47 pediatric, 90 adult) and 84 with EWS (LOC: 38 pediatric, 46 adult). AYA treated at pediatric centers were more likely to be enrolled in a clinical trial (OGS 55% vs 1%, [p

Introduction: In neonates, septicaemia is one of leading cause of morbidity and mortality. Therefore, timely diagnosis is important to prevent fatal outcome. C-reactive protein is an important biomarker that aids in the timely diagnosis of neonatal septicaemia. Aim: The present study was carried out to compare the accuracy of CRP in the diagnosis of neonatal septicaemia with blood culture. Materials and Methods: 148 neonates diagnosed with neonatal sepsis were included in the study over a period of 6 months. Blood culture and semi-qualitative assessment of CRP was done for all the patients. Results: Of the 148 neonates studied, 53 were blood culture positive while 101 were CRP positive. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of CRP were 86.7%, 43%, 45.5%, 85% and 69% respectively. Conclusion: The specificity and sensitivity of CRP against blood culture strengthen the use of this acute phase protein in the diagnosis of neonatal sepsis. Keywords: Osteomyelitis, Gastroenteritis, Pyelonephritis, Endocarditis.

The purpose of this paper is to analyze the role of information support system and organizational culture on knowledge management (KM) attitude of the organization which in turn leads to innovativeness among the employees and improve their job performance. The study uses the sample of 200 employees of the IT organizations and performs Structural Equation Modeling to assess the links between IT support, Organizational Culture (OC), KM Attitude, Innovativeness and Job Performance. Meditation ofKM attitude of employees is assessed using PROCESS Macro. The study finds a significant relationship between presence of information technology support system available in the organization along with culture of the organization and level of knowledge sharing attitude among the employees of organization. Secondly, knowledge management attitude is directlyrelated with innovation and performance of the employees. The study also establishes the mediating role of knowledge management attitude between technological support, OC with innovative competence and job performance of the employees.

In this work, an effective numerical approach based on the isogeometric analysis (IGA) employing first-order shear deformation theory (FSDT) is proposed and implemented for the static and transient...

Objectives: Sarcomas are mesodermal cancers of bone and soft tissue of which there are >60 malignant varieties, many of which can be difficult to diagnose or subtype using traditional histopathology. A universal molecular definition of sarcoma types would therefore be an invaluable tool to the diagnostic pathologist. RNA has the potential to offer a complimentary perspective to cytogenetic- and methylation-based diagnostics, as it represents the active state of the disease at sampling and better reveals its phenotype. Recognizing the potential for RNA-based classification, we set out to create a first-generation transcriptional atlas of sarcoma. Methods: To develop transcriptional definitions of cancers with the potential to further subclassify tumor types, we designed a self-optimizing and scale-adaptive unsupervised method (RACCOON), which groups samples into hierarchically organized clusters. We used this approach on the UCSC Treehouse Childhood Cancer Compendium, a set of 2,178 pediatric and 9,400 adult tumors, 1,130 of which are sarcomas, as well as 1,735 non-neoplastic samples. We then trained an ensemble of convolutional neural networks to classify tumors to these transcriptional clusters. We have now added 624 more sarcoma samples from Toronto centers and international collaborators to better represent the breadth of sarcoma. We are actively sequencing 500 additional samples in partnership with the Gabriella Miller Kids First Research Program to yield an expanded cohort of >2,200 uniformly processed and analyzed sarcomas. Results: Sarcomas organize into two clusters at the highest hierarchical level: one characterized by entities which occur primarily in adults and resemble mature tissue, the other by primarily pediatric entities which exhibit high stemness and resemble embryonic tissue. Several included entities are not bona fide sarcomas but originate from the mesoderm (e.g., Wilms Tumor) signifying a common transcriptional identity for mesodermal neoplasms. Additionally, we demonstrate the first transcriptional subtypes of central osteosarcoma reflecting its major histotypes and representing divergent clinical courses. We also determine Ewing Sarcoma (ES) to be a distinct entity which clusters separately from all other cancers, raising questions of its origin and affinity to sarcoma. When classifying ongoing patients to the atlas, we correctly classified >85% of tumors and corrected the diagnosis of 7%. We find 14% of ES in our dataset were likely misdiagnosed CIC- or BCOR-driven sarcomas. Critically, assigned subtypes are consistent between primary and relapse pairs. Conclusion: RNA-seq is a promising tool for both subtype discovery and classifying sarcoma in ongoing patients. We have already included this tool in tumor boards to help inform patient care. Our method reveals the overarching organization of sarcoma for the first time and specifies its underlying biology. This atlas is ever-growing and is open to the community to contribute. Citation Format: Joshua O. Nash, Federico Comitani, Rose Chami, Sarah Cohen-Gogo, Astra Chang-Schwertschkow, Yael Babichev, Jodi Lees, Noa Alon, Nalan Gokgoz, Stephen Man Yu, Kyoko Yuki, Miranda Lorenti, Zhanqin Liu, Alaina McGoey, Famida Spatare, Bernarld Castro, Kim Tsoi, Hagit Peretz Soroka, Jack Brzezinski, Anita Villani, Albiruni Razak, Abha Gupta, Elizabeth Demicco, Gino Somers, Brendan C. Dickson, Jay S. Wunder, Irene L. Andrulis, David Malkin, Rebecca A. Gladdy, Adam Shlien. The development of a multiscale transcriptional atlas of sarcoma [abstract]. In: Proceedings of the AACR Special Conference: Sarcomas; 2022 May 9-12; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2022;28(18_Suppl):Abstract nr B027.