Baseline characteristics and outcomes of children with cancer in the English-speaking Caribbean: A multinational retrospective cohort.

BACKGROUND: English-speaking Caribbean (ESC) childhood cancer outcomes are unknown. PROCEDURE: Through the SickKids-Caribbean Initiative (SCI), we established a multicenter childhood cancer database across seven centers in six ESC countries. Data managers entered patient demographics, disease, treatment, and outcome data. Data collection commenced in 2013, with retrospective collection to 2011 and subsequent prospective collection. RESULTS: A total of 367 children were diagnosed between 2011 and 2015 with a median age of 5.7 years (interquartile range 2.9-10.6 years). One hundred thirty (35.4%) patients were diagnosed with leukemia, 30 (8.2%) with lymphoma, and 149 (40.6%) with solid tumors. A relative paucity of children with brain tumors was seen (N = 58, 15.8%). Two-year event-free survival (EFS) for the cohort was 48.5% ± 3.2%; 2-year overall survival (OS) was 55.1% ± 3.1%. Children with acute lymphoblastic leukemia (ALL) and Wilms tumor (WT) experienced better 2-year EFS (62.1% ± 6.4% and 66.7% ± 10.1%), while dismal outcomes were seen in children with acute myeloid leukemia (AML; 22.7 ± 9.6%), rhabdomyosarcoma (21.0% ± 17.0%), and medulloblastoma (21.4% ± 17.8%). Of 108 deaths with known cause, 58 (53.7%) were attributed to disease and 50 (46.3%) to treatment complications. Death within 60 days of diagnosis was relatively common in acute leukemia [13/98 (13.3%) ALL, 8/26 (30.8%) AML]. Despite this, traditional prognosticators adversely impacted outcome in ALL, including higher age, higher white blood cell count, and T-cell lineage. CONCLUSIONS: ESC childhood cancer outcomes are significantly inferior to high-income country outcomes. Based on these data, interventions for improving supportive care and modifying treatment protocols are under way. Continued data collection will allow evaluation of interventions and ensure maximal outcome improvements.

Transient metabolic modeling of Escherichia coli MG1655 and MG1655 DeltaackA-pta, DeltapoxB Deltapppc ppc-p37 for recombinant beta-galactosidase production.

Escherichia coli is one of the most widely used hosts for the production of recombinant proteins, among other reasons because its genetics are far better characterized than those of any other microorganism. To improve the understanding of recombinant protein synthesis in E. coli, the production of a model recombinant protein, beta-galactosidase, was studied in response to the constitutive overexpression of the anaplerotic reaction afforded by PEP carboxylase. To this end, an IPTG wash-in experiment was performed starting from a well-defined steady-state condition for both the wild-type E. coli and a mutant with a defective acetate pathway and a constitutively overexpressed ppc. In order to compare the dynamics of the fluxes over time during the wash-in experiment, a method referred to as transient metabolic flux analysis, which is based on steady-state metabolic flux analysis, was used. This allowed us to track the intracellular changes/fluxes in both strains. It was observed that the flux towards fermentation products was 3.6 times lower in the ppc overexpression mutant compared to the wild-type E. coli. In the former on the other hand, the PPC flux is in general higher. In addition, the flux towards beta-galactosidase was higher (12.4 times), resulting in five times more protein activity. These results indicate that by constitutively overexpressing the anaplerotic ppc gene in E. coli, the TCA cycle intermediates are increasingly replenished. The additional supply of these protein precursors has a positive result on recombinant protein production.

Symmetry breaking of ionic semiconductors under pressure: the case of InAs.

The NaCl-to-Cmcm phase transition and the Cmcm structure of InAs under high pressure are studied by x-ray diffraction. The lattice parameters and fractional coordinates are given as a function of pressure. We propose a mechanism responsible for this type of symmetry breaking under pressure. We show that the ppσ interactions do not play a major role in the stabilization of the NaCl structure. Consequently the NaCl-to-Cmcm transition occurs only in compounds with a large charge transfer. General conclusions on the behavior of III-V semiconductors under pressure are drawn.

Comparison of protein quantification and extraction methods suitable for E. coli cultures.

Many different extraction and analysis methods exist to determine the protein fraction of microbial cells. For metabolic engineering purposes it is important to have precise and accurate measurements. Therefore six different protein extraction protocols and seven protein quantification methods were tested and compared. Comparison was based on the reliability of the methods and boxplots of the normalized residuals. Some extraction techniques (SDS/chloroform and toluene) should never be used: the measurements are neither precise nor accurate. Bugbuster extraction combined with UV280 quantification gives the best results, followed by the combinations Sonication-UV280 and EasyLyse-UV280. However, if one does not want to use the quantification method UV280, one can opt to use Bugbuster, EasyLyse or sonication extraction combined with any quantification method with exception of the EasyLyse-BCA_P and Sonication-BCA_P combinations.

New phase transition of solid bromine under high pressure.

Solid bromine has been studied by x-ray absorption spectroscopy experiments up to a maximum pressure of 75 GPa. The data analysis of the extended fine structure reveals that the intramolecular distance first increases, reaching its maximum value at 25+/-5 GPa. From this value the intramolecular distance abruptly begins to decrease evidencing a nonpreviously observed phase transformation taking place at 25+/-5 GPa. A maximum variation of 0.08 A is observed at 65+/-5 GPa where again a phase transition occurs. This last transformation could correspond with the recently observed change to an incommensurate modulated phase. We discuss the possible generalization of the observed new phase transition at 25+/-5 GPa to the case of the other halogens.

Comparison of different strategies to reduce acetate formation in Escherichia coli.

E. coli cells produce acetate as an extracellular coproduct of aerobic cultures. Acetate is undesirable because it retards growth and inhibits protein formation. Most process designs or genetic modifications to minimize acetate formation aim at balancing growth rate and oxygen consumption. In this research, three genetic approaches to reduce acetate formation were investigated: (1) direct reduction of the carbon flow to acetate (ackA-pta, poxB knock-out); (2) anticipation on the underlying metabolic and regulatory mechanisms that lead to acetate (constitutive ppc expression mutant); and (3) both (1) and (2). Initially, these mutants were compared to the wild-type E. coli via batch cultures under aerobic conditions. Subsequently, these mutants were further characterized using metabolic flux analysis on continuous cultures. It is concluded that a combination of directly reducing the carbon flow to acetate and anticipating on the underlying metabolic and regulatory mechanism that lead to acetate, is the most promising approach to overcome acetate formation and improve recombinant protein production. These genetic modifications have no significant influence on the metabolism when growing the micro-organisms under steady state at relatively low dilution rates (less than 0.4 h(-1)).

Construction and model-based analysis of a promoter library for E. coli: an indispensable tool for metabolic engineering.

BACKGROUND: Nowadays, the focus in metabolic engineering research is shifting from massive overexpression and inactivation of genes towards the model-based fine tuning of gene expression. In this context, the construction of a library of synthetic promoters of Escherichia coli as a useful tool for fine tuning gene expression is discussed here. RESULTS: A degenerated oligonucleotide sequence that encodes consensus sequences for E. coli promoters separated by spacers of random sequences has been designed and synthesized. This 57 bp long sequence contains 24 conserved, 13 semi-conserved (W, R and D) and 20 random nucleotides. This mixture of DNA fragments was cloned into a promoter probing vector (pVIK165). The ligation mixtures were transformed into competent E. coli MA8 and the resulting clones were screened for GFP activity by measuring the relative fluorescence units; some clones produced high fluorescence intensity, others weak fluorescence intensity. The clones cover a range of promoter activities from 21.79 RFU/OD600 ml to 7606.83 RFU/OD600 ml. 57 promoters were sequenced and used for promoter analysis. The present results conclusively show that the postulates, which link promoter strength to anomalies in the -10 box and/or -35 box, and to the length of the spacer, are not generally valid. However, by applying Partial Least Squares regression, a model describing the promoter strength was built and validated. CONCLUSION: For Escherichia coli, the promoter strength can not been linked to anomalies in the -10 box and/or -35 box, and to the length of the spacer. Also a probabilistic approach to relate the promoter sequence to its strength has some drawbacks. However, by applying Partial Least Squares regression, a good correlation was found between promoter sequence and promoter strength. This PLS model can be a useful tool to rationally design a suitable promoter in order to fine tune gene expression.

A retrotracheal right subclavian artery in association with a vertebral artery and thyroidea ima.

The retro-oesophageal right subclavian artery is an anatomical abnormality encountered by anatomists and pathologists and, more recently, interventional cardiologists and thoracic surgeons with an incidence of 0.2-2% in the population. We report a case of a retrotracheal right subclavian artery which originated distally along the left aortic arch and coursed between the trachea and the oesophagus. Additionally, the aortic arch gave rise to a common trunk, which subsequently bifurcated to yield to a right vertebral artery and a left thyroidea ima, replacing the left inferior thyroid artery. Consequently the right and the left recurrent laryngeal nerves were found to recur normally. The possible embryonic development of these branching patterns and their clinical significance is discussed.

Nucleation and growth of single-walled nanotubes: the role of metallic catalysts.

We present a review of experimental and theoretical results on the nucleation and growth of single-walled nanotubes, with particular emphasis on the growth of nanotube bundles emerging from catalyst particles obtained from evaporation-based elaboration techniques. General results are first discussed. Experiments strongly suggest a root-growth process in which carbon, dissolved at high temperatures in catalytic particles, segregates at the surface at lower temperatures to form tube embryos and finally nanotubes through a nucleation and growth process. A theoretical analysis of the reasons carbon does not always form graphene sheets to wrap the particles suggests analogies with other surface or interface instabilities, in particular, with those found in epitaxial growth. In the second part, detailed experimental results for nickel-rare earth metal catalysts are presented. By using various electron microscopy techniques, it is shown that carbon and the rare earth metal co-segregate at the surface of the particle and form carbide platelets, providing nucleation sites for nanotubes growing in directions perpendicular to the surface. A simple theoretical model is then presented in which the role of the rare earth metal is just to transfer electrons from metal to carbon. The graphene sheet is shown to become unstable; pentagons and heptagons are favored, which can explain the occurrence of local curvatures and of tube embryos. Finally, a brief discussion of some recent atomistic models is given.

[Normative aspects of sources]. / Aspects normatifs des sources.

The human body is more and more exposed to the electromagnetic phenomena generated by all domestic and professional electric appliances. This problem "EMF and health" is devoted to the possible effects known as "biological" and the possibilities of disturbances of the medical implants. Although many studies still did not give conclusions on these long-term effects, international standardisation is in progress and could lead to a difficult use of electricity such that it currently exists. The modelling of the phenomena in the human body can contribute to a better knowledge of the interactions field-man and to the development of more realistic standards.

Regulation of vascular endothelial growth factor by the Wnt and K-ras pathways in colonic neoplasia.

Angiogenesis is not restricted to advanced stages of tumor development but is also observed in benign precursor lesions. Vascular endothelial growth factor (VEGF) is a key regulator of tumor angiogenesis, but the genetic mechanisms controlling its expression in premalignant lesions are poorly described. The Wnt signaling pathway, which is commonly mutated in benign colonic adenomas, was found to strongly up-regulate VEGF. A T-cell factor-4-binding element at -805 bp in the VEGF promoter is an important mediator of this effect. Signaling through the K-ras oncogene, also frequently mutated in benign colonic polyps, up-regulated VEGF in a phosphatidylinositol 3-kinase-dependent manner. Furthermore, K-ras activation appeared to enhance Wnt signaling, which suggests a unique interaction between these two pathways. These studies thus identify VEGF as a novel target of the Wnt pathway in early colonic neoplasia and serve to underscore the importance of angiogenesis in premalignant disease.

Hyponatremia due to enalapril in an elderly patient. A case report.

Angiotensin-converting enzyme (ACE) inhibitors are of value in the treatment of hypertension and congestive heart failure. The combination of proven effectiveness with a favorable side-effect profile makes ACE inhibitors, such as enalapril maleate, reasonable first choices in the treatment of hypertension in the elderly.

Meloidogyne incognita Survival in Soil Infested with Paecilomyces lilacinus and Verticillium chlamydosporium.

Meloidogyne incognita-infected tomato seedlings were transplanted into sterilized soil or unsterilized soil collected from 20 California tomato fields to measure suppression caused by Paecilomyces lilacinus, Verticillium chlamydosporium, and other naturally occurring antagonists. Unsterilized soils Q, A, and H contained 35, 39, and 55% fewer M. incognita second-stage juveniles (J2) than did sterilized soil 1 month after infected tomato seedlings were transplanted to these soils and placed in a greenhouse. Three months after infected seedlings were transplanted to unsterilized or sterilized soil, unsterilized soils K, L, and Q had 97, 62, and 86% fewer J2 than the corresponding sterilized soils. Unsterilized soils of M. incognita-infected seedlings that were maintained 1 month in a greenhouse followed by 1 or 2 months of post-harvest incubation contained J2 numbers equal to, or greater than, numbers in the corresponding sterilized soil. The most suppressive of the unsterilized soils, K and Q, were not infested with V. chlamydosporium. Paecilomyces lilacinus and V. chlamydosporium increased in colony forming units in unsterilized soil of all bioassays, but they were not associated with lower numbers of J2.

Overwintering Stages of Meloidogyne incognita in Vitis vinifera.

The overwintering of Meloidogyne incognita in and around Vitis vinifera cv. French Colombard roots was studied in a naturally infested vineyard at the Kearney Agricultural Center, in a growth chamber, in inoculated vines in microplots at the University of California, Davis, and in a greenhouse. Infected roots were sampled at intervals from onset of vine dormancy until plants accumulated about 800 degree days (DD - base 10 C). Embryogenesis within eggs, classified as less than or more than 16 cells and fully differentiated, and numbers of juveniles (second to fourth stage) and preovipositional and mature (egg-laying) adult stages in roots were determined. All stages were present at the onset of dormancy. Juveniles and immature females were not recovered during the dormant period. Mature females and eggs were always present in roots, although the number of mature females generally decreased with time after onset of dormancy. In contrast, in a greenhouse experiment that accumulated comparable DD without the host plant going through dormancy, the number of mature females increased. After bud break, the number of eggs per female increased and all nematode stages were found in host roots. Eggs in all stages of embryogenesis were observed at all times of sampling, indicating that females overwinter and are capable of laying eggs when conditions improve in the spring and need to be considered in nematode management decisions.

Density-dependent parasitism of the soil-borne nematodeCriconemella xenoplax by the nematophagous fungusHirsutella rhossiliensis.

Spatial sampling was used to investigate temporal density-dependent parasitism of the plant-parasitic nematodeCriconemella xenoplax byHirsutella rhossiliensis in three peach orchards on eight sample dates. The patches of soil in which the nematode and fungus interacted were assumed to possess similar density-dependent dynamics and to be small, independent, and asynchronous. Furthermore, sampling of separate patches was assumed to provide similar information with respect to density dependence as would temporal (repeated) sampling of the same patch. Percent parasitism was dependent on the number ofC. xenoplax/100 cm(3) soil (P=0.0001). The slope was unaffected by orchard or date but ranged from 0.0001 to 0.0043 depending on distance from the irrigation furrow. The relative shallowness of the slope and the large variation in percent parasitism not explained by nematode density suggest thatH. rhossiliensis is a weak regulator ofC. xenoplax population density.

A comparative trial of digoxin and digitoxin in the treatment of congestive heart failure.

A randomized, crossover, single-blind study compared the efficacy and dosing accuracy of digoxin and digitoxin in 15 ambulatory patients wth congestive heart failure. Loading doses and maintenance doses were calculated according to published equations that adjust for sex, height, and lean body weight (for digitoxin), plus estimated creatinine clearance (for digoxin). At each 2-week visit, serum drug concentrations were measured and compliance with the prescribed regimen was assessed by tablet count. At the end of each study period, a congestive heart failure (CHF) score was determined in a blinded fashion by the same physician. Patient compliance was unusually high (greater than or equal to 80%) at every visit. Therapeutic concentrations were achieved with digoxin and digitoxin in 5 and 14 patients, respectively (p less than 0.05). During digitoxin therapy, CHF scores were lower than pretreatment values (p less than 0.05). The difference between CHF scores during the digoxin and digitoxin periods did not achieve significance (0.05 less than p less than 0.06). Therapeutic serum concentrations can be achieved more easily and frequently with digitoxin than digoxin without compromising the patient's CHF status.