Erratum to: FoundationOne CDx testing accurately determines whole arm 1p19q codeletion status in gliomas.

[This corrects the article DOI: 10.1093/noajnl/vdab017.].

FoundationOne CDx testing accurately determines whole arm 1p19q codeletion status in gliomas.

BACKGROUND: Molecular profiling of gliomas is vital to ensure diagnostic accuracy, inform prognosis, and identify clinical trial options for primary and recurrent tumors. This study aimed to determine the accuracy of reporting the whole arm 1p19q codeletion status from the FoundationOne platform. METHODS: Testing was performed on glioma samples as part of clinical care and analyzed up to 395 cancer-associated genes (including IDH1/2). The whole arm 1p19q codeletion status was predicted from the same assay using a custom research-use only algorithm, which was validated using 463 glioma samples with available fluorescence in-situ hybridization (FISH) data. For 519 patients with available outcomes data, progression-free and overall survival were assessed based on whole arm 1p19q codeletion status derived from sequencing data. RESULTS: Concordance between 1p19q status based on FISH and our algorithm was 96.7% (449/463) with a positive predictive value (PPV) of 100% and a positive percent agreement (PPA) of 91.0%. All discordant samples were positive for codeletion by FISH and harbored genomic alterations inconsistent with oligodendrogliomas. Median overall survival was 168 months for the IDH1/2 mutant, codeleted group, and 122 months for IDH1/2 mutant-only (hazard ratio (HR): 0.42; P < .05). CONCLUSIONS: 1p19q codeletion status derived from FoundationOne testing is highly concordant with FISH results. Genomic profiling may be a reliable substitute for traditional FISH testing while also providing IDH1/2 status.

Medical practice in rural Saskatchewan: factors in physician recruitment and retention.

INTRODUCTION: The recruitment and retention of physicians in rural communities is a challenge throughout Canada and across the globe. In 1976, a group of medical students profiled rural communities with medical practices and produced a summary report entitled Medical Practice in Saskatchewan. Our objective was to repeat the 1976 study and to identify factors that motivate physicians to select rural locations for practice. METHODS: Physicians practising in rural Saskatchewan were interviewed in 2011 and 2012. Through qualitative, inductive analysis, we identified themes that drove the recruitment and retention of physicians. RESULTS: Sixty-two physicians were interviewed and 105 communities profiled. Of the physicians interviewed, 21 noted that the ability to practise full-scope family medicine and having the freedom to practise as they desire was important for recruitment, and 43 reported that these factors influenced their decision to remain in a community. Attraction to a rural lifestyle (cited by 17 physicians), having a rural background (13) and having ties to a specific community (12) were important for recruitment. Feeling appreciated by patients (45), one's spouse and/or family enjoying the community (41), and integration into the community (38) were important factors for retention. CONCLUSION: The decision to practise in a rural location correlates with a desire for a broad and varied scope of practice, being attracted to a rural lifestyle and having rural roots. Once physicians establish a rural practice, they are more likely to stay if they can continue a broad scope of practice, if they feel appreciated by their patients, and if their spouses and family are happy in the community.

INTRODUCTION: Le recrutement et la fidélisation des médecins dans les communautés rurales présentent un défi partout au Canada et ailleurs dans le monde. En 1976, un groupe d'étudiants en médecine a dressé un profil des communautés rurales dotées de pratiques médicales et produit un rapport sommaire intitulé Medical Practice in Saskatchewan. Notre objectif est de répéter l'étude de 1976 et de relever les facteurs qui motivent les médecins à choisir de pratiquer en région rurale. MÉTHODES: Nous avons interrogé des médecins exerçant en milieu rural en Saskatchewan en 2011 et en 2012. Par analyse inductive qualitative, nous avons recensé les facteurs qui ont favorisé leur recrutement et leur fidélisation. RÉSULTATS: Soixante-deux médecins ont été interrogés et le profil de 105 communautés a été dressé. Parmi les médecins interrogés, 21 ont mentionné que la capacité d'exercer pleinement dans toute l'envergure de la médecine familiale et la liberté de pratiquer comme ils le souhaitaient avaient joué un rôle important dans leur recrutement et 43 ont mentionné que ces facteurs avaient influé sur leur décision de demeurer dans une communauté. Les facteurs suivants ont aussi été jugés importants pour le recrutement : l'attrait du mode de vie rural (mentionné par 17 médecins), provenir d'un milieu rural (13) et les liens avec une communauté en particulier (12). En ce qui concerne les facteurs de fidélisation, le sentiment d'être apprécié par les patients (45), le fait que les conjoints et(ou) les proches apprécient la vie dans la communauté (41) et l'intégration dans la communauté (38). CONCLUSION: La décision d'exercer en milieu rural est en corrélation avec le désir d'avoir une pratique dont l'envergure est vaste et variée, l'attirance pour un mode de vie rural et des racines rurales. Une fois que les médecins s'établissent en milieu rural, ils sont plus susceptibles d'y rester s'ils peuvent continuer d'avoir une pratique diversifiée, s'ils se sentent appréciés par leurs patients et si les conjoints et les familles se plaisent dans la communauté.

Desensitizing a pilot with a phobic response to required helicopter underwater escape training.

INTRODUCTION: A systematic desensitization program designed to help aircrew who have a phobic anxiety of the Helicopter Underwater Escape Training (HUET) has been developed. CASE PRESENTATION: A student pilot presented with a severe phobic anxiety of the HUET course--a result of a being trapped underwater on a marine survival training course. A treatment team was assembled and concluded his phobia could be treated by a systematic desensitization method. An exposure matrix of graded difficulty of in/underwater escapes was performed over 2 d. The student reported that his confidence increased and anxiety reduced as he became accustomed to being strapped into a seat in the escape trainer while wearing increasingly difficult levels of equipment which increased the difficulty of escape, such as taking away nasal protection and goggles. At the end of Day 1, he was able to jettison the exit door/hatch while inverted underwater with a facemask and dressed in a simple coverall. At the end of Day 2, without nasal protection, inverted underwater, wearing full military equipment, he was able to cross the cabin, jettison the exit door, and successfully escape. DISCUSSION: A systematic desensitization treatment program can be used to successfully treat aircrew for phobia of the helicopter underwater escape trainer.