Specific genomic alterations have been found in primary breast cancer involving driver mutations that result in tumorigenesis. Metastatic breast cancer, which is uncommon at the time of disease onset, variably impacts patients throughout the course of their disease. Both the molecular profiles and diverse genomic pathways vary in the development and progression of metastatic breast cancer. From the most common metastatic site (bone), to the rare sites such as orbital, gynecologic, or pancreatic metastases, different levels of gene expression indicate the potential involvement of numerous genes in the development and spread of breast cancer. Knowledge of these alterations can, not only help predict future disease, but also lead to advancement in breast cancer treatments. This review discusses the somatic landscape of breast primary and metastatic tumors.

Thromboelastography (TEG) and rotational thromboelastometry are emerging technologies that are gaining increasing acceptance in the medical field to evaluate the coagulation status of patients on an individual level by assessing dynamic clot formation. TEG has been proven to reduce blood product use as well as improve patient outcomes in a variety of medical settings, including trauma and surgery due to the expediated nature of the test as well as the ability to determine specific deficiencies present in whole blood that are otherwise undetectable with traditional coagulation studies. Currently, no guidelines or recommendations are in place for the utilization of TEG in interventional or diagnostic radiology although access to TEG has become increasingly common in recent years. This manuscript presents a review of prior literature on the technical aspects of TEG as well as its use in various fields and explains the normal TEG-tracing parameters. Common hemodynamic abnormalities and their effect on the TEG tracing are illustrated, and the appropriate treatments for each abnormality are briefly mentioned. TEG has the potential to be a useful tool for determining the hemodynamic state of patients in both interventional and diagnostic radiology, and further research is needed to determine the value of these tests in the periprocedural setting.

The quality of Internet access for mobile users may suffer from highly variable communication characteristics (packet loss, delay, throughput) and from temporary disconnections. The former occur as a result of changing radio properties, handovers, or variable system load, the latter whenever wireless coverage is insufficient. While quite some research has tackled improving radio coverage to keep users always best connected and numerous approaches pursue improving wireless performance and robustness, these often assume a greenfield deployment or a tight integration with operators. We present the mobility support system architecture developed in the CHIANTI project. While building on related work in various technical respects, the CHIANTI architecture is specifically designed to be instantly and incrementally deployable in today's Internet landscape, considering real-world legal and deployment constraints, and supports roles of different (independent) players. We also report on our proof-of-concept implementation.

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Background: Emergency department (ED)-initiated medications for opioid use disorder (MOUD) have emerged as an effective strategy against the opioid epidemic. Opioid use disorder (OUD) patients engaged in ED-initiated MOUD programs have higher retention in treatment programs and improved outcomes with regard to overdose rates and mortality. It is unclear however, how engagement in ED-initiated MOUD programs might affect quality of life (QoL). We sought to describe demographic characteristics and QoL factors reported by patients engaged in ED-initiated MOUD and referral services. Methods: An ED MOUD-initiation program was launched in July 2019, with subsequent referral to definitive services. Enrolled patients were interviewed at intake, 3-months, and 6-months to ascertain QoL indices via the Government Performance and Results Act (GPRA) measures. Descriptive statistics and Fisher’s Exact were utilized to assess the data. Results: Through 12/2020, 89 participants were enrolled. The majority were white (85.4%), male (61.8%), and between the ages of 25-44 (75.3%). To-date, 31 participants (43.7% eligible) have completed 3-month follow-up and 28 (45.2% eligible) have competed 6-month follow-up. With regards to assessed QoL factors, over half demonstrated significant improvement, including 5 of 7 psychosocial factors, to include satisfaction with personal relationships, QoL self-rating, satisfaction with personal health, energy for everyday life, and satisfaction with self (p <.05). Financial needs met was the only objective QoL factor to demonstrate significant improvement during the follow-up time period. While not significant, homelessness also decreased, specifically 14 (15.7%) identified as homeless at intake as compared to one (3.7%) at 6-month follow-up. Additional trends toward decreased violence exposure and increased employment rates were also noted.Conclusions: In addition to decreasing illicit opioid drug use, maintenance of ED-initiated MOUD may positively impact broad QoL measures.