Outcomes for children with recurrent/refractory atypical teratoid rhabdoid tumor: A single-institution study with molecular correlation.

BACKGROUND: Survival data for recurrent pediatric atypical teratoid rhabdoid tumor (ATRT) and its association to molecular groups are extremely limited. METHODS: Single-institution retrospective study of 64 children less than 21 years old with recurrent or treatment-refractory (progressive disease [PD]) ATRT treated at St. Jude Hospital from January 2000 to December 2020. Demographic, clinicopathologic, treatment, molecular grouping (SHH, TYR, and MYC) and germline data were collected. Progression-free survival (PFS2: time from PD to subsequent first progression) and overall survival (OSpostPD: time from PD to death/last follow-up) were estimated by Kaplan-Meier analysis. RESULTS: Median age at and time from initial diagnosis to PD were 2.1 years (range: 0.5-17.9 years) and 5.4 months (range: 0.5-125.6 months), respectively. Only five of 64 children (7.8%) are alive at median follow-up of 10.9 (range: 4.2-18.1) years from PD. The 2/5-year PFS2 and OSpostPD were 3.1% (±1.8%)/1.6% (±1.1%) and 20.3% (±4.8%)/7.3% (±3.5%), respectively. Children with TYR group (n = 10) had a better OSpostPD compared to those with MYC (n = 11) (2-year survival estimates: 60.0% ± 14.3% vs. 18.2% ± 9.5%; p = .019), or those with SHH (n = 21; 4.8% ± 3.3%; p = .014). In univariate analyses, OSpostPD was better with older age at diagnosis (p = .037), female gender (p = .008), and metastatic site of PD compared to local or combined sites of PD (p < .001). Two-year OSpostPD for patients receiving any salvage therapy (n = 39) post PD was 33.3% ± 7.3%. CONCLUSIONS: Children with recurrent/refractory ATRT have dismal outcomes. Older age at diagnosis, female gender, TYR group, and metastatic site of PD were associated with relatively longer survival in our study.

Constitutional balanced translocations involving SMARCB1: A rare cause of rhabdoid tumor predisposition syndrome.

Rhabdoid Tumor Predisposition Syndrome 1 (RTPS1) confers an increased risk of developing rhabdoid tumors and is caused by germline mutations in SMARCB1. RTPS1 should be evaluated in all individuals with rhabdoid tumor and is more likely in those with a young age at presentation (occasionally congenital presentation), multiple primary tumors, or a family history of rhabdoid tumor or RTPS1. Proband genetic testing is the standard method for diagnosing RTPS1. Most known RTPS1-related SMARCB1 gene mutations are copy number variants (CNVs) or single nucleotide variants/indels, but structural variant analysis (SVA) is not usually included in the molecular evaluation. Here, we report two children with RTPS1 presenting with atypical teratoid/rhabdoid tumor (ATRT) who had constitutional testing showing balanced chromosome translocations involving SMARCB1. Patient 1 is a 23-year-old female diagnosed with pineal region ATRT at 7 months who was found to have a de novo, constitutional t(16;22)(p13.3;q11.2). Patient 2 is a 24-month-old male diagnosed with a posterior fossa ATRT at 14 months, with subsequent testing showing a constitutional t(5;22)(q14.1;q11.23). These structural rearrangements have not been previously reported in RTPS1. While rare, these cases suggest that structural variants should be considered in the evaluation of children with rhabdoid tumors to provide more accurate genetic counseling on the risks of developing tumors, the need for surveillance, and the risks of passing the disorder on to future children. Further research is needed to understand the prevalence, clinical features, and tumor risks associated with RTPS1-related constitutional balanced translocations.

Cascading events during the 1650 tsunamigenic eruption of Kolumbo volcano.

Volcanic eruptions can trigger tsunamis, which may cause significant damage to coastal communities and infrastructure. Tsunami generation during volcanic eruptions is complex and often due to a combination of processes. The 1650 eruption of the Kolumbo submarine volcano triggered a tsunami causing major destruction on surrounding islands in the Aegean Sea. However, the source mechanisms behind the tsunami have been disputed due to difficulties in sampling and imaging submarine volcanoes. Here we show, based on three-dimensional seismic data, that ~1.2 km³ of Kolumbo's northwestern flank moved 500-1000 m downslope along a basal detachment surface. This movement is consistent with depressurization of the magma feeding system, causing a catastrophic explosion. Numerical tsunami simulations indicate that only the combination of flank movement followed by an explosive eruption can explain historical eyewitness accounts. This cascading sequence of natural hazards suggests that assessing submarine flank movements is critical for early warning of volcanogenic tsunamis.

Revised Minoan eruption volume as benchmark for large volcanic eruptions.

Despite their global societal importance, the volumes of large-scale volcanic eruptions remain poorly constrained. Here, we integrate seismic reflection and P-wave tomography datasets with computed tomography-derived sedimentological analyses to estimate the volume of the iconic Minoan eruption. Our results reveal a total dense-rock equivalent eruption volume of 34.5 ± 6.8 km³, which encompasses 21.4 ± 3.6 km³ of tephra fall deposits, 6.9 ± 2 km³ of ignimbrites, and 6.1 ± 1.2 km³ of intra-caldera deposits. 2.8 ± 1.5 km³ of the total material consists of lithics. These volume estimates are in agreement with an independent caldera collapse reconstruction (33.1 ± 1.2 km³). Our results show that the Plinian phase contributed most to the distal tephra fall, and that the pyroclastic flow volume is significantly smaller than previously assumed. This benchmark reconstruction demonstrates that complementary geophysical and sedimentological datasets are required for reliable eruption volume estimates, which are necessary for regional and global volcanic hazard assessments.

Evaluating pediatric spinal low-grade gliomas: a 30-year retrospective analysis.

PURPOSE: Most pediatric spinal tumors are low-grade gliomas (LGGs). Characterization of these tumors has been difficult given their heterogeneity and rare incidence. The objective was to characterize such tumors diagnosed at our institution. METHODS: Spinal tumors diagnosed in our pediatric patients between 1984 and 2014 were reviewed retrospectively. Demographics, presentation, pathology, imaging, management, and sequelae were examined. RESULTS: Forty patients had spinal LGG tumors, 24 (62%) of which were pilocytic astrocytomas. The most common initial presentations were pain (n = 15), partial extremity paralysis (n = 13), and ataxia (n = 11), with the diagnosis frequently delayed by months (median = 5.9 months, range 4 days-6.2 years). Twenty-nine patients had some tumor resection, and 8 required adjuvant therapy with chemotherapy (n = 4) or radiation (n = 4) post-resection. Ten other patients received only biopsy for histologic diagnosis, who were treated with chemotherapy (n = 4) or radiation (n = 5) post biopsy. Tumor progression was noted in 16 patients (2 after gross-total resection; 10, partial resection; and 4, biopsy). During the evaluation period, 3 patients died secondary to tumor progression. BRAF status could have shortened progression-free survival: patients with BRAFV600E mutations (n = 3) all experienced progression within 10 months. Long-term sequelae of the disease/treatment were mostly residual neurologic deficits (paresthesia, paralysis), chemotherapy-induced hearing loss, and scoliosis. CONCLUSIONS: Spinal LGG is a rare entity with significant long-term effects. Although surgery is the most common initial treatment option, more in-depth analysis of molecular biomarkers may improve stratification and prognostication.

Modelling of the tsunami from the December 22, 2018 lateral collapse of Anak Krakatau volcano in the Sunda Straits, Indonesia.

On Dec. 22, 2018, at approximately 20:55-57 local time, Anak Krakatau volcano, located in the Sunda Straits of Indonesia, experienced a major lateral collapse during a period of eruptive activity that began in June. The collapse discharged volcaniclastic material into the 250 m deep caldera southwest of the volcano, which generated a tsunami with runups of up to 13 m on the adjacent coasts of Sumatra and Java. The tsunami caused at least 437 fatalities, the greatest number from a volcanically-induced tsunami since the catastrophic explosive eruption of Krakatau in 1883 and the sector collapse of Ritter Island in 1888. For the first time in over 100 years, the 2018 Anak Krakatau event provides an opportunity to study a major volcanically-generated tsunami that caused widespread loss of life and significant damage. Here, we present numerical simulations of the tsunami, with state-of the-art numerical models, based on a combined landslide-source and bathymetric dataset. We constrain the geometry and magnitude of the landslide source through analyses of pre- and post-event satellite images and aerial photography, which demonstrate that the primary landslide scar bisected the Anak Krakatau volcano, cutting behind the central vent and removing 50% of its subaerial extent. Estimated submarine collapse geometries result in a primary landslide volume range of 0.22-0.30 km3, which is used to initialize a tsunami generation and propagation model with two different landslide rheologies (granular and fluid). Observations of a single tsunami, with no subsequent waves, are consistent with our interpretation of landslide failure in a rapid, single phase of movement rather than a more piecemeal process, generating a tsunami which reached nearby coastlines within ~30 minutes. Both modelled rheologies successfully reproduce observed tsunami characteristics from post-event field survey results, tide gauge records, and eyewitness reports, suggesting our estimated landslide volume range is appropriate. This event highlights the significant hazard posed by relatively small-scale lateral volcanic collapses, which can occur en-masse, without any precursory signals, and are an efficient and unpredictable tsunami source. Our successful simulations demonstrate that current numerical models can accurately forecast tsunami hazards from these events. In cases such as Anak Krakatau's, the absence of precursory warning signals together with the short travel time following tsunami initiation present a major challenge for mitigating tsunami coastal impact.

Correlates of a general psychopathology factor in a clinical sample of childhood sexual abuse survivors.

BACKGROUND: Childhood sexual abuse (CSA) increases risk for most psychiatric disorders. There is evidence that the structure of psychopathology can be explained by a number of latent dimensions of psychopathology including a 'General Psychopathology' (P) factor. The objective of the current study was to provide the first assessment as to whether P is identifiable, and what its correlates might be in a clinical sample. METHODS: An adult, clinical sample of Danish CSA survivors (N = 420) was assessed using the Millon Clinical Multiaxial Inventory-III. Confirmatory factory analysis (CFA) was used to assess the latent structure of nine psychiatric disorders, and structural equation modelling (SEM) was used to determine correlates of the best-fitting dimensional model. RESULTS: CFA results favoured a bifactor model including three specific dimensions of psychopathology, "Internalizing", "Externalizing", and "Thought Disorder", and a bi-factor "P". A SEM model that included ten predictors was a good fit to the data and explained 55% of variance in 'P'. The 'P' factor was significantly associated with emotional coping, negative self-worth, traumatic life events, and anxious attachments. LIMITATIONS: Psychiatric disorders were assessed using self-report measures, and the sample was predominately female. CONCLUSIONS: Results provide initial evidence of P in a clinical sample and several unique correlates of this factor were identified.

A distinct source and differentiation history for Kolumbo submarine volcano, Santorini volcanic field, Aegean arc.

This study reports the first detailed geochemical characterization of Kolumbo submarine volcano in order to investigate the role of source heterogeneity in controlling geochemical variability within the Santorini volcanic field in the central Aegean arc. Kolumbo, situated 15 km to the northeast of Santorini, last erupted in 1650 AD and is thus closely associated with the Santorini volcanic system in space and time. Samples taken by remotely-operated vehicle that were analyzed for major element, trace element and Sr-Nd-Hf-Pb isotope composition include the 1650 AD and underlying K2 rhyolitic, enclave-bearing pumices that are nearly identical in composition (73 wt.% SiO2, 4.2 wt.% K2O). Lava bodies exposed in the crater and enclaves are basalts to andesites (52-60 wt.% SiO2). Biotite and amphibole are common phenocryst phases, in contrast with the typically anhydrous mineral assemblages of Santorini. The strong geochemical signature of amphibole fractionation and the assimilation of lower crustal basement in the petrogenesis of the Kolumbo magmas indicates that Kolumbo and Santorini underwent different crustal differentiation histories and that their crustal magmatic systems are unrelated. Moreover, the Kolumbo samples are derived from a distinct, more enriched mantle source that is characterized by high Nb/Yb (>3) and low 206Pb/204Pb (<18.82) that has not been recognized in the Santorini volcanic products. The strong dissimilarity in both petrogenesis and inferred mantle sources between Kolumbo and Santorini suggests that pronounced source variations can be manifested in arc magmas that are closely associated in space and time within a single volcanic field.

Metagenomic investigation of the geologically unique Hellenic Volcanic Arc reveals a distinctive ecosystem with unexpected physiology.

Hydrothermal vents represent a deep, hot, aphotic biosphere where chemosynthetic primary producers, fuelled by chemicals from Earth's subsurface, form the basis of life. In this study, we examined microbial mats from two distinct volcanic sites within the Hellenic Volcanic Arc (HVA). The HVA is geologically and ecologically unique, with reported emissions of CO2 -saturated fluids at temperatures up to 220°C and a notable absence of macrofauna. Metagenomic data reveals highly complex prokaryotic communities composed of chemolithoautotrophs, some methanotrophs, and to our surprise, heterotrophs capable of anaerobic degradation of aromatic hydrocarbons. Our data suggest that aromatic hydrocarbons may indeed be a significant source of carbon in these sites, and instigate additional research into the nature and origin of these compounds in the HVA. Novel physiology was assigned to several uncultured prokaryotic lineages; most notably, a SAR406 representative is attributed with a role in anaerobic hydrocarbon degradation. This dataset, the largest to date from submarine volcanic ecosystems, constitutes a significant resource of novel genes and pathways with potential biotechnological applications.

New insights into hydrothermal vent processes in the unique shallow-submarine arc-volcano, Kolumbo (Santorini), Greece.

We report on integrated geomorphological, mineralogical, geochemical and biological investigations of the hydrothermal vent field located on the floor of the density-stratified acidic (pH ~ 5) crater of the Kolumbo shallow-submarine arc-volcano, near Santorini. Kolumbo features rare geodynamic setting at convergent boundaries, where arc-volcanism and seafloor hydrothermal activity are occurring in thinned continental crust. Special focus is given to unique enrichments of polymetallic spires in Sb and Tl (±Hg, As, Au, Ag, Zn) indicating a new hybrid seafloor analogue of epithermal-to-volcanic-hosted-massive-sulphide deposits. Iron microbial-mat analyses reveal dominating ferrihydrite-type phases, and high-proportion of microbial sequences akin to "Nitrosopumilus maritimus", a mesophilic Thaumarchaeota strain capable of chemoautotrophic growth on hydrothermal ammonia and CO2. Our findings highlight that acidic shallow-submarine hydrothermal vents nourish marine ecosystems in which nitrifying Archaea are important and suggest ferrihydrite-type Fe(3+)-(hydrated)-oxyhydroxides in associated low-temperature iron mats are formed by anaerobic Fe(2+)-oxidation, dependent on microbially produced nitrate.

Characterization, treatment, and outcome of intracranial neoplasms in the first 120 days of life.

Little is known about brain tumors in early infancy. Investigators reviewed the records of 27 patients (12 boys and 15 girls) diagnosed within 120 days of birth. The median age was 66 days (range, 0-110 days) at diagnosis. All patients underwent surgery; 18 received adjuvant chemotherapy, and 3 received adjuvant chemotherapy and radiation therapy. The median follow-up was 2.1 years (range, 0.2-21.6 years). At last encounter, 15 patients were alive, and 11 had no evidence of disease. Ten patients died of progressive disease, and 2 died of treatment-related complications. All survivors experienced late effects, including endocrine, neurologic, and cognitive deficits. Of the 13 patients who completed neurocognitive assessments, 7 had an IQ score less than 70. Children in whom brain tumors arise during early infancy can be cured with conventional therapy; however, contemporary approaches can adversely affect long-term function, and families need to be aware of these effects when making therapeutic decisions.

NM23-H2 may play an indirect role in transcriptional activation of c-myc gene expression but does not cleave the nuclease hypersensitive element III(1).

The formation of G-quadruplex structures within the nuclease hypersensitive element (NHE) III(1) region of the c-myc promoter and the ability of these structures to repress c-myc transcription have been well established. However, just how these extremely stable DNA secondary structures are transformed to activate c-myc transcription is still unknown. NM23-H2/nucleoside diphosphate kinase B has been recognized as an activator of c-myc transcription via interactions with the NHE III(1) region of the c-myc gene promoter. Through the use of RNA interference, we confirmed the transcriptional regulatory role of NM23-H2. In addition, we find that further purification of NM23-H2 results in loss of the previously identified DNA strand cleavage activity, but retention of its DNA binding activity. NM23-H2 binds to both single-stranded guanine- and cytosine-rich strands of the c-myc NHE III(1) and, to a lesser extent, to a random single-stranded DNA template. However, it does not bind to or cleave the NHE III(1) in duplex form. Significantly, potassium ions and compounds that stabilize the G-quadruplex and i-motif structures have an inhibitory effect on NM23-H2 DNA-binding activity. Mutation of Arg(88) to Ala(88) (R88A) reduced both DNA and nucleotide binding but had minimal effect on the NM23-H2 crystal structure. On the basis of these data and molecular modeling studies, we have proposed a stepwise trapping-out of the NHE III(1) region in a single-stranded form, thus allowing single-stranded transcription factors to bind and activate c-myc transcription. Furthermore, this model provides a rationale for how the stabilization of the G-quadruplex or i-motif structures formed within the c-myc gene promoter region can inhibit NM23-H2 from activating c-myc gene expression.

Psorospermin structural requirements for P-glycoprotein resistance reversal.

Resistance to chemotherapy reduces its effectiveness, resulting in increased mortality. Psorospermin, a natural product, is a topoisomerase II-directed DNA alkylating agent active against multidrug-resistant (MDR) cell lines, including multiple myeloma. In this study, the mechanism of the P-glycoprotein (P-gp) modulation activity of psorospermin and that of its associated pharmacophore were examined. Flow cytometry shows that doxorubicin-resistant multiple myeloma cells (8226/D40) pretreated with psorospermin enhance intracellular retention of doxorubicin compared with control (75% versus 38%). Because the overexpression of P-gp is the primary cause of drug resistance in the 8226/D40 cells, psorospermin-induced sensitization was likely due to mdr1/P-gp expressional or functional inhibition. As shown by PCR and Western blot, neither transcription of mdr1 nor translation of P-gp was down-regulated by psorospermin treatment. Therefore, the mechanism of psorospermin-induced resistance reversal is most likely through a direct interaction between psorospermin and P-gp. Furthermore, because only the (2'R,3'R) isomer of psorospermin showed any resistance reversal activity, the side chain of psorospermin is apparently a crucial moiety for resistance reversal. By understanding the mechanism of psorospermin-induced MDR modulation, psorospermin and similar compounds can be combined with other chemotherapies to treat resistant cancers.

Hsf1 is required for the nuclear translocation of p53 tumor suppressor.

Although the p53 tumor suppressor is most frequently inactivated by genetic mutations, exclusion from the nucleus is also seen in human tumors. We have begun to examine p53 nuclear importation by isolating a series of mutant cells in which the temperature-sensitive murine p53(Val135) mutant is sequestered in the cytoplasm. We previously showed that that three of them (ALTR12, ALTR19, and ALTR25) constituted a single complementation group. Here, we found that ALTR12 cells are more sensitive to heat stress than either ALTR19 or ALTR25 and that there was a complete lack of induction of Hsp70 in response to heat shock. Western blot analysis showed no expression of the Hsf1 transcription factor, and neither heat shock nor azetidine could induce p53 nuclear localization in ALTR12 cells but did in parental A1-5 cells. Suppression of Hsf1 in A1-5 cells with quercetin or an Hsf1 siRNA reduced p53 nuclear importation and inhibited p53-mediated activation of a p21 reporter. Most convincingly, p53 nuclear importation could be restored in ALTR12 cells by introducing an exogenous Hsf1 gene. Collectively, our result suggests that Hsf1 is required for p53 nuclear importation and activation and implies that heat shock factors play a role in the regulation of p53.

Time and dose-dependent radiosensitization of the glioblastoma multiforme U251 cells by the EGF receptor tyrosine kinase inhibitor ZD1839 ('Iressa').

Hyperactive epidermal growth factor receptor (EGFR) signaling, which promotes unregulated cell growth and inhibits apoptosis, is believed to contribute to clinical radiation resistance of glioblastoma multiforme (GBM). Blockage of the EGFR signalling pathways may offer an attractive therapeutic target to increase the cytotoxic effects of radiotherapy. We report the effects of ZD1839 ('Iressa'), a selective EGFR tyrosine kinase inhibitor on the radiation sensitivity of the U251 GBM cell line, which expresses high levels of EGFR. In radiation survival experiments, 5 microM of ZD1839 had a significant radiosensitizing effect and increased cell death was observed at doses of 5Gy in the presence of ZD1839. Dose and schedule of drug administration in combination with radiation appeared to be a crucial element to obtain radiosensitization of the cells. These studies suggest novel therapeutic strategies in the treatment of GBM.

Volcanic disasters in Latin America and the 13th november 1985 eruption of Nevado del Ruiz volcano in Colombia

Volcanic eruptions in Latin America have claimed about 61,000 lives since 1600 A.D. and the region's volcanoes are responsible for about a quarter of the world's fatalities from this type of hazard. Nearly all loss of life from volcanism in Latin America is due to pyroclastic surges, pyroclastic flows and lahars or volcanic mudflows. Lahars generated during the 13th November, 1985 eruption of Nevado del Ruiz in Colombia claimed 25,000 lives, underscoring the great hazard from lahars, which can be generated from the fifty-six, active, ice-capped Central and South American volcanoes during even very small eruptions. The probability of specific prediction of the timing of such events is currently low, whereas the probability of a general prediction of volcanic eruption is high, giving sufficient time to install telemetered lahar alarm systems, which could largely avoid the loss of life.(AU)