Decolonizing Botany: Indonesia, UNESCO, and the Making of a Global Science.

Decolonization created new opportunities for international scientific research collaboration. In Indonesia this began in the late 1940s, as Indonesian scientists and officials sought to remake the formerly colonial botanical gardens in the city of Bogor into an international research center. Indonesia sponsored the Flora Malesiana project, a flora of all of island Southeast Asia. This project was formally centered in Bogor, Indonesia, with participation from tropical botanists from around the world. The international orientation of Indonesian science led to the establishment of one of UNESCO's Field Science Co-operation Offices in Jakarta, and to a period of close collaboration between Indonesian botanists and UNESCO. This paper examines the importance of UNESCO's Humid Tropics research program, which initially provided further opportunities for Indonesian botanists to participate in international scientific networks. The paper concludes by showing that the Humid Tropics program led to the slow erosion of Indonesian agency and authority over tropical botany, and the assertion of Western control and management over tropical botany research.

Retinoblastoma protein expression and its predictors in triple-negative breast cancer.

Retinoblastoma protein (Rb) is a product of the RB tumor suppressor gene. Its expression is highly prevalent in luminal breast cancers and is critical to the success of cyclin-dependent kinase (CDK) 4/6 inhibitor therapy. Expression of Rb in triple-negative breast cancer (TNBC), tumors generally associated with basal biology, is not well known. However, heterogeneity among TNBC and presence of subtypes with luminal features are well described. The purpose of this study was to determine prevalence and predictors of Rb protein expression in BRCA1-associated and sporadic TNBCs. We studied 180 TNBC patients (70 BRCA1-associated and 110 sporadic). The clinical and pathologic features of these cases were previously assessed and reported. For this study, immunohistochemical stains for Rb were performed on tissue microarray sections. Details of treatment and outcome were abstracted from medical records. Fifty-one percent of TNBC were Rb positive (≥10% nuclei staining), and 85% of these cases had ≥50% nuclei staining. Rb expression was significantly associated with sporadic TNBC (71.4% vs 49.4%; p < 0.001), androgen receptor (AR) expression (16.5% vs 3.4%; p = 0.007), histologic grade 1 or 2 (9.9% vs 2.2%; p = 0.04), and first recurrence in bone (8.8% vs 1.1%; p = 0.03). Expression of p53 was not associated with Rb expression. Expression of Rb in TNBC was significantly associated with sporadic TNBC, AR expression, lower histologic grade, and metastasis to bone. These observations characterize a TNBC subtype with features suggestive of luminal-like biology and the potential to benefit from CDK 4/6 inhibition.

TBCRC 031: Randomized Phase II Study of Neoadjuvant Cisplatin Versus Doxorubicin-Cyclophosphamide in Germline BRCA Carriers With HER2-Negative Breast Cancer (the INFORM trial).

PURPOSE: Platinum compounds have activity in triple-negative breast cancer (TNBC) in germline BRCA mutation carriers (BRCA carriers). Limited data exist for estrogen receptor (ER)-positive (+) breast cancer among BRCA carriers. INFORM is a randomized, multicenter, phase II trial comparing pathologic complete response (pCR) rates (ypT0/is, N0) after neoadjuvant single-agent cisplatin (CDDP) versus doxorubicin-cyclophosphamide (AC) in BRCA carriers with stage I-III human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Secondary objectives included residual cancer burden scores (RCB) of 0 or 1 (combined) and toxicity. The goal was to determine whether pCR was ≥ 20% higher with CDDP than AC. PATIENTS AND METHODS: BRCA carriers with cT1-3 (≥ 1.5 cm), cN0-3 HER2-negative breast cancer were randomly assigned to preoperative CDDP (75 mg/m2 every 3 weeks × 4 doses) or AC (doxorubicin 60 mg/m2; cyclophosphamide 600 mg/m2 every 2-3 weeks × 4 doses) followed by surgery. Pathologic responses were confirmed by central review. RESULTS: A total of 118 patients were randomly assigned; 117 were included in outcome analyses. Mean age was 42 years (range, 24-73 years); 69% were BRCA1+, 30% were BRCA2+, and 2% had both mutations. Clinical stage was I for 19%, II for 63%, and III for 18%; 45% had nodal involvement at baseline. Seventy percent had TNBC. Clinical and tumor characteristics were well matched between treatment arms. The pCR rate was 18% with CDDP and 26% with AC, yielding a risk ratio (RR) of 0.70 (90% CI, 0.39 to 1.2). The risk of RCB 0 or 1 (RCB 0/1) was 33% with CDDP and 46% with AC (RR, 0.73; 90% CI, 0.50 to 1.1). Both regimens were generally well tolerated without unexpected toxicities. CONCLUSION: pCR or RCB 0/1 is not significantly higher with CDDP than with AC in BRCA carriers with stage I-III HER2-negative breast cancer for both TNBC and ER+/HER2-negative disease.

Building the world's supply of quinine: Dutch colonialism and the origins of a global pharmaceutical industry.

Quinine, a naturally occurring alkaloid from the Cinchona tree, was one of the first drugs produced and sold by a global pharmaceutical industry during the nineteenth century. Factories in Europe and North America dominated the manufacturing industry, and between 1890 and 1940, Cinchona plantations on Java supplied most of the bark for the quinine pharmaceutical business. At the end of the nineteenth century, the Dutch colonial state kept a hands-off approach to the Cinchona enterprises, in keeping with its liberal orientation. But the persistent low-price for bark, which led to the near ruin of the Cinchona planters, eventually pushed the colonial state to actively protect the Cinchona plantations. Colonial officials sought to stabilize the colonial Cinchona export-business by encouraging the integration of the quinine industry on a global scale. Most important was the colonial state's sponsorship in 1913 of the Quinine Agreement, establishing a set price for Cinchona bark, which created the world's first pharmaceutical cartel. In the interwar period, an alliance of Dutch government officials, planters, scientists, doctors and drug-makers, working in both the motherland and the colony, actively promoted the expansion of quinine consumption, as well as the merit of the Quinine Agreement, which they argued supplied guaranteed a steady supply of quinine, all for the wellbeing of global humanity.

Skiing and snowboarding head injuries in 2 areas of the United States.

OBJECTIVE: To explore the use of helmets in skiers and snowboarders injured at ski runs and terrain parks in Colorado and the northeast United States and to examine differences in head injury severity in terrain parks as compared to ski runs. METHODS: This was a retrospective cohort study. We reviewed emergency department medical records of injured skiers at 9 medical facilities in Colorado, New York, and Vermont to examine the frequency of helmet use, type of terrain on which injuries occurred, and effect of injury event type and helmet use on change in mental status. Injuries that occurred from July 2002 to July 2004 were included. Eligible patients were skiers and snowboarders who sustained a head injury as defined by International Classification of Diseases-9 codes for acute head injuries. Data elements included event location, mechanism of injury, helmet use, loss of consciousness, neurologic findings, Glasgow Coma Scale score, and initial outcome. Data were entered into SPSS for analysis. RESULTS: Of 1013 patients, 52.6% were skiing, 46.7% were snowboarding, and the remainder engaged in other activities such as sledding or using a sit ski. Most (78.7%) were using a ski run, whereas 19.1% were at a terrain park when their injuries occurred, and 37.1% were wearing helmets. Most injuries (74.1%) occurred when the victim hit his/her head on the snow; 10.0% and 13.1% occurred in collisions with other skiers and fixed objects, respectively. There were significantly fewer instances of loss of consciousness in fall events in the Colorado group (chi(2): 4.127; P < .05), a significantly lower incidence of loss of consciousness in helmet users who struck a fixed object (chi(2): 5.800; P < .05), and a significantly higher incidence of skiers colliding with fixed objects in the Northeast (chi(2): 14.05; P < .005). There were significantly more documented head injuries in terrain parks, even when controlling for helmet use (chi(2): 5.800; P < .05). CONCLUSION: There is an increased risk of head injury, regardless of helmet use, at terrain parks as compared to ski runs, and helmets were notably protective in collisions with fixed objects. Regional differences in injury events were noted in that there were more fall-related head injuries and a higher incidence of collisions with fixed objects in the Northeast compared to Colorado.