SELNET clinical practice guidelines for bone sarcoma

Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context

The Cyst-Dividing Bacterium Ramlibacter tataouinensis TTB310 Genome Reveals a Well-Stocked Toolbox for Adaptation to a Desert Environment

Ramlibacter tataouinensis TTB310T (strain TTB310), a betaproteobacterium isolated from a semi-arid region of South Tunisia (Tataouine), is characterized by the presence of both spherical and rod-shaped cells in pure culture. Cell division of strain TTB310 occurs by the binary fission of spherical “cyst-like” cells (“cyst-cyst” division). The rod-shaped cells formed at the periphery of a colony (consisting mainly of cysts) are highly motile and colonize a new environment, where they form a new colony by reversion to cyst-like cells. This unique cell cycle of strain TTB310, with desiccation tolerant cyst-like cells capable of division and desiccation sensitive motile rods capable of dissemination, appears to be a novel adaptation for life in a hot and dry desert environment. In order to gain insights into strain TTB310's underlying genetic repertoire and possible mechanisms responsible for its unusual lifestyle, the genome of strain TTB310 was completely sequenced and subsequently annotated. The complete genome consists of a single circular chromosome of 4,070,194 bp with an average G+C content of 70.0%, the highest among the Betaproteobacteria sequenced to date, with total of 3,899 predicted coding sequences covering 92% of the genome. We found that strain TTB310 has developed a highly complex network of two-component systems, which may utilize responses to light and perhaps a rudimentary circadian hourglass to anticipate water availability at the dew time in the middle/end of the desert winter nights and thus direct the growth window to cyclic water availability times. Other interesting features of the strain TTB310 genome that appear to be important for desiccation tolerance, including intermediary metabolism compounds such as trehalose or polyhydroxyalkanoate, and signal transduction pathways, are presented and discussed

Engineered Models of Metastasis with Application to Study Cancer Biomechanics

Three-dimensional complex biomechanical interactions occur from the initial steps of tumor formation to the later phases of cancer metastasis. Conventional monolayer cultures cannot recapitulate the complex microenvironment and chemical and mechanical cues that tumor cells experience during their metastatic journey, nor the complexity of their interactions with other, noncancerous cells. As alternative approaches, various engineered models have been developed to recapitulate specific features of each step of metastasis with tunable microenvironments to test a variety of mechanistic hypotheses. Here the main recent advances in the technologies that provide deeper insight into the process of cancer dissemination are discussed, with an emphasis on three-dimensional and mechanical factors as well as interactions between multiple cell types

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Métodos y técnicas de monitoreo y predicción temprana en los escenarios de riesgos socionaturales

Esta obra concentra los métodos y las técnicas fundamentales para el seguimiento y monitoreo de las dinámicas de los escenarios de riesgos socionaturales (geológicos e hidrometeorológicos) y tiene como objetivo general orientar, apoyar y acompañar a los directivos y operativos de protección civil en aterrizar las acciones y políticas públicas enfocadas a la gestión del riesgo local de desastre

The role of the kai operon genes in Legionella pneumophila

Legionella pneumophila est un pathogène opportuniste avec un cycle de vie intracellulaire obligatoire, ils arrivent à se répliquer dans leurs cellules hôtes comme des protozoaires, en exploitant les protéines et les voies de signalisation de l’organisme infecté pour échapper à sa réponse immunitaire. L. pneumophila est décrite comme un organisme sans oscillations circadiennes, pourtant elle possède des gènes homologues aux gènes circadiennes kaiBC de cyanobactéries. En appliquant un système d’infections in vitro et in vivo ainsi qu’une approche de génomique comparative et fonctionnelle sur l’ organisme modèle Legionella pneumophila mon projet a pour objectif de caractériser le rôle des gènes kaiBC de L. pneumophila. Les protéines KaiABC de cyanobactéries encodent un oscillateur circadien permettant la coordination et l’optimisation temporelle de divers processus biologiques ainsi que l’adaptation aux fluctuations quotidiennes (comme la production d’oxygène via la photosynthèse pendant le jour et la fixation d’azote dans l’obscurité). Notre étude montre que kaiC, kaiB, avec le lpp1114 (codant pour une protéine à plusieurs domaines), l’ensemble constitue une unité transcriptionnelle sous la commande du facteur sigma RpoS. Les souches mutantes de l'opéron kai affichent une haute sensibilité sous conditions de stress par le paraquat ou le sel en comparaison avec la souche sauvage. En effect, nos données provenant d’une expérience utilisant des systèmes de double hybride suggèrent que les proteines KaiC et KaiB de L. pneumophila n’interagissent pas comme ceux de cyanobactéries. Cependant, une version étendue de L. pneumophila KaiB contenant des résidus de C-terminal de T. elongatus est capable d’interagir avec KaiC. Nous démontrons aussi que la structure cristalline de KaiB de L. pneumophila révèle un pliage pareil a ceux de thiorédoxine (protéine d'oxydoréduction) mais manque les résidus de l'extrémité C-terminale important pour l'interaction avec KaiC. En revanche, L. pneumophila KaiC conserve l'activité d'autophosphorylation, mais KaiB ne declénche pas la phosphorylation de KaiC comme chez les cyanobacteries. L'analyse phylogénétique des protéines de Kai indique qu'elles ont été transférés à L. pneumophila et ont évolué de Synechosystis KaiC2B2 et pas du copie circadienne KaiB1C1. Il semble que les protéines Kai de L. pneumophila améliorent son adaptation à des conditions stressantes et aux changements environnementaux.Legionella pneumophila is an opportunistic pathogen with an intracellular life cycle that uses aquatic protozoa as replication niche and protection from harsh environments. Although L. pneumophila is not known to have a circadian clock, it encodes homologues of the KaiBC proteins of Cyanobacteria that regulate circadian gene expression. By using a wide range of in vitro, in vivo and in silico approaches I characterized the KaiB and KaiC proteins of L. pneumophila The proteins KaiABC of cyanobacteria coordinate a circadian oscillator that regulates many physiological functions in the cells according to the day and the night time induce by the rotation of the Earth (e.g. they do photosynthesis during the day and nitrogen fixation during the night). We show that L. pneumophila kaiB, kaiC and the downstream gene lpp1114, are transcribed as a unit under the control of the stress sigma factor RpoS. Mutant analyses revealed that the kai operon-encoded proteins increase fitness of L. pneumophila in competitive environments, and confer higher resistance to oxidative and sodium stress. Indeed, KaiC and KaiB of L. pneumophila do not interact as evidenced by yeast and bacterial two- hybrid analyses. Fusion of the C-terminal residues of cyanobacterial KaiB to Legionella KaiB restores their interaction. The crystal structure of L. pneumophila KaiB suggests that it is an oxidoreductase-like protein with a typical thioredoxin fold. In contrast, KaiC of L. pneumophila conserved autophosphorylation activity, but KaiB does not trigger the dephosphorylation of KaiC like in Cyanobacteria. The phylogenetic analysis indicates that L. pneumophila KaiBC resemble Synechosystis KaiC2B2 and not the circadian KaiB1C1 copy. Thus, the L. pneumophila Kai proteins do not encode a circadian clock, but enhance stress resistance and adaption to changes in the environments

The role of the kai operon genes in Legionella pneumophila

Legionella pneumophila est un pathogène opportuniste avec un cycle de vie intracellulaire obligatoire, ils arrivent à se répliquer dans leurs cellules hôtes comme des protozoaires, en exploitant les protéines et les voies de signalisation de l organisme infecté pour échapper à sa réponse immunitaire. L. pneumophila est décrite comme un organisme sans oscillations circadiennes, pourtant elle possède des gènes homologues aux gènes circadiennes kaiBC de cyanobactéries. En appliquant un système d infections in vitro et in vivo ainsi qu une approche de génomique comparative et fonctionnelle sur l organisme modèle Legionella pneumophila mon projet a pour objectif de caractériser le rôle des gènes kaiBC de L. pneumophila. Les protéines KaiABC de cyanobactéries encodent un oscillateur circadien permettant la coordination et l optimisation temporelle de divers processus biologiques ainsi que l adaptation aux fluctuations quotidiennes (comme la production d oxygène via la photosynthèse pendant le jour et la fixation d azote dans l obscurité). Notre étude montre que kaiC, kaiB, avec le lpp1114 (codant pour une protéine à plusieurs domaines), l ensemble constitue une unité transcriptionnelle sous la commande du facteur sigma RpoS. Les souches mutantes de l'opéron kai affichent une haute sensibilité sous conditions de stress par le paraquat ou le sel en comparaison avec la souche sauvage. En effect, nos données provenant d une expérience utilisant des systèmes de double hybride suggèrent que les proteines KaiC et KaiB de L. pneumophila n interagissent pas comme ceux de cyanobactéries. Cependant, une version étendue de L. pneumophila KaiB contenant des résidus de C-terminal de T. elongatus est capable d interagir avec KaiC. Nous démontrons aussi que la structure cristalline de KaiB de L. pneumophila révèle un pliage pareil a ceux de thiorédoxine (protéine d'oxydoréduction) mais manque les résidus de l'extrémité C-terminale important pour l'interaction avec KaiC. En revanche, L. pneumophila KaiC conserve l'activité d'autophosphorylation, mais KaiB ne declénche pas la phosphorylation de KaiC comme chez les cyanobacteries. L'analyse phylogénétique des protéines de Kai indique qu'elles ont été transférés à L. pneumophila et ont évolué de Synechosystis KaiC2B2 et pas du copie circadienne KaiB1C1. Il semble que les protéines Kai de L. pneumophila améliorent son adaptation à des conditions stressantes et aux changements environnementaux.Legionella pneumophila is an opportunistic pathogen with an intracellular life cycle that uses aquatic protozoa as replication niche and protection from harsh environments. Although L. pneumophila is not known to have a circadian clock, it encodes homologues of the KaiBC proteins of Cyanobacteria that regulate circadian gene expression. By using a wide range of in vitro, in vivo and in silico approaches I characterized the KaiB and KaiC proteins of L. pneumophila The proteins KaiABC of cyanobacteria coordinate a circadian oscillator that regulates many physiological functions in the cells according to the day and the night time induce by the rotation of the Earth (e.g. they do photosynthesis during the day and nitrogen fixation during the night). We show that L. pneumophila kaiB, kaiC and the downstream gene lpp1114, are transcribed as a unit under the control of the stress sigma factor RpoS. Mutant analyses revealed that the kai operon-encoded proteins increase fitness of L. pneumophila in competitive environments, and confer higher resistance to oxidative and sodium stress. Indeed, KaiC and KaiB of L. pneumophila do not interact as evidenced by yeast and bacterial two- hybrid analyses. Fusion of the C-terminal residues of cyanobacterial KaiB to Legionella KaiB restores their interaction. The crystal structure of L. pneumophila KaiB suggests that it is an oxidoreductase-like protein with a typical thioredoxin fold. In contrast, KaiC of L. pneumophila conserved autophosphorylation activity, but KaiB does not trigger the dephosphorylation of KaiC like in Cyanobacteria. The phylogenetic analysis indicates that L. pneumophila KaiBC resemble Synechosystis KaiC2B2 and not the circadian KaiB1C1 copy. Thus, the L. pneumophila Kai proteins do not encode a circadian clock, but enhance stress resistance and adaption to changes in the environments.PARIS5-Bibliotheque electronique (751069902) / SudocSudocFranceF