Tram-track cycling injuries: a significant public health issue.

AIM: Many cycling collisions occur due to human error, cycling ability, distraction or infrastructure. One such infrastructural issue for cyclists sharing the road with tram lines is where the wheel of the bicycle gets caught in the rail track itself or in a gap between the rail and the road margin resulting in a sudden stall of the bicycle and potentially significant injury. This study aims to describe the crash characteristics of tram-track cycling collisions and their associated injuries. METHODS: A retrospective chart review was conducted over 2 years, looking at cyclists that presented to St James's Emergency Department (ED) following injuries sustained due to a bicycle wheel catching in the on-road tram tracks. RESULTS: Forty-eight patients were identified over a 2-year period. Sixty per cent of cyclists sustained limb fractures with 14% requiring orthopaedic surgery. Fifty per cent of patients were not wearing a helmet at the time of the incident and 54% of the collisions occurred around Dublin city centre during rush hour. CONCLUSION: Further prospective multi-centre studies are required to properly describe the magnitude cycling accidents around the Luas tracks and inform future public health measures in this area.

Counteracting lineage-specific transcription factor network finely tunes lung adeno-to-squamous transdifferentiation through remodeling tumor immune microenvironment.

Human lung adenosquamous cell carcinoma (LUAS), containing both adenomatous and squamous pathologies, harbors strong plasticity and is significantly associated with poor prognosis. We established an up-to-date comprehensive genomic and transcriptomic landscape of LUAS in 109 Chinese specimens and demonstrated LUAS development via adeno-to-squamous transdifferentiation. Unsupervised transcriptomic clustering and dynamic network biomarker analysis identified an inflammatory subtype as the critical transition stage during LUAS development. Dynamic dysregulation of the counteracting lineage-specific transcription factors (TFs), containing adenomatous TFs NKX2-1 and FOXA2, and squamous TFs TP63 and SOX2, finely tuned the lineage transition via promoting CXCL3/5-mediated neutrophil infiltration. Genomic clustering identified the most malignant subtype featured with STK11-inactivation, and targeting LSD1 through genetic deletion or pharmacological inhibition almost eradicated STK11-deficient lung tumors. These data collectively uncover the comprehensive molecular landscape, oncogenic driver spectrum and therapeutic vulnerability of Chinese LUAS.