Differences in Prevalence of Histologic Gastric Cancer Subtypes Between Mestizo and Mayan Populations in Guatemala.

PURPOSE: Although the intestinal subtype of gastric cancer (GC) is most prevalent around the world, a relatively high prevalence of the diffuse subtype has been reported in some populations of Central American countries, including Guatemala. This study aimed to investigate whether differences exist in the prevalence of the two GC subtypes in the two main ethnic groups in Guatemala, namely Mayan and Mestizo (known as Ladino in Guatemala), between whom significant socioeconomic disparities exist, and to determine whether there is an association with Helicobacter pylori/CagA seropositivity. MATERIALS AND METHODS: Participants included 65 patients with GC and 135 age-/sex-matched controls. Data on ethnicity, H. pylori and CagA seropositivity status, as well as tumor subtype (diffuse or intestinal) were collected. Logistic regression models were fitted to examine the relationship between predictor variables (age, sex, ethnicity, H. pylori, and CagA) and the binary response variable (tumor type). Model selection was based on the Akaike information criterion. RESULTS: The prevalence of diffuse GC was found to be significantly higher in the Mayan compared with the Mestizo population in Guatemala. Although seropositivity for CagA was significantly higher in patients with GC, there were no significant differences between the two GC subtypes. CONCLUSION: This study suggests that there are differences in the prevalence of intestinal and diffuse GC histologic subtypes between the two main ethnic groups in Guatemala. Further studies are warranted, given the potential higher prevalence of the more severe GC subtype in the most vulnerable population.

A Bayesian nonparametric approach to marginal structural models for point treatments and a continuous or survival outcome.

Marginal structural models (MSMs) are a general class of causal models for specifying the average effect of treatment on an outcome. These models can accommodate discrete or continuous treatments, as well as treatment effect heterogeneity (causal effect modification). The literature on estimation of MSM parameters has been dominated by semiparametric estimation methods, such as inverse probability of treatment weighted (IPTW). Likelihood-based methods have received little development, probably in part due to the need to integrate out confounders from the likelihood and due to reluctance to make parametric modeling assumptions. In this article we develop a fully Bayesian MSM for continuous and survival outcomes. In particular, we take a Bayesian nonparametric (BNP) approach, using a combination of a dependent Dirichlet process and Gaussian process to model the observed data. The BNP approach, like semiparametric methods such as IPTW, does not require specifying a parametric outcome distribution. Moreover, by using a likelihood-based method, there are potential gains in efficiency over semiparametric methods. An additional advantage of taking a fully Bayesian approach is the ability to account for uncertainty in our (uncheckable) identifying assumption. To this end, we propose informative prior distributions that can be used to capture uncertainty about the identifying "no unmeasured confounders" assumption. Thus, posterior inference about the causal effect parameters can reflect the degree of uncertainty about this assumption. The performance of the methodology is evaluated in several simulation studies. The results show substantial efficiency gains over semiparametric methods, and very little efficiency loss over correctly specified maximum likelihood estimates. The method is also applied to data from a study on neurocognitive performance in HIV-infected women and a study of the comparative effectiveness of antihypertensive drug classes.

Biosynthesis of a substituted cellulose from a mutant strain of Xanthomonas campestris.

In Xanthomonas campestris the genes involved in polysaccharide (xanthan) biosynthesis are located in a gene cluster (gum) of 16 kb. A Tn5 insertion mutant with a reduced slimy phenotype has been characterized. This mutant failed to produce the pentasaccharide repeating-unit of xanthan. Only three sugars were transferred to the prenyl phosphate intermediate. Several lines of evidence suggested that the lipid-associated saccharide was the trisaccharide reducing end of the pentasaccharide from the wild-type strain. This trisaccharide was built up from UDP-Glc and GDP-Man, and a glucose residue was at the reducing end, linked to an allylic prenol through a diphosphate bridge. Results from one- or two-stage reactions showed that the trisaccharide-P-P-polyprenol was the precursor of the polymer. This new polymer, a polytrisaccharide, was detected also in vivo. The transposon responsible for the mutation was located within gumK gene. Therefore, this gene encodes for the glycosyltransferase IV, which catalyses the transfer of glucuronic acid to the lipid-linked beta-D-Manp-(1-->3)-beta-D-Glcp-(1-->4)-beta-D-Glcp trisaccharide. A recombinant plasmid with the whole gum cluster restored the wild type phenotype.

Evidence for a role for the gumB and gumC gene products in the formation of xanthan from its pentasaccharide repeating unit by Xanthomonas campestris.

The biosynthesis of the extracellular polysaccharide xanthan in Xanthomonas campestris pv. campestris is directed by a cluster of 12 genes, gumB-gumM. Several xanthan-deficient mutants of the wild-type strain 8004 have previously been described which carry Tn5 insertions in this region of the chromosome. Here it is shown that the transposon insertion in one of these mutants, strain 8397, is located 15 bp upstream of the translational start site of the gumB gene. EDTA-treated cells of strain 8397 were able to synthesize the lipid-linked pentasaccharide repeating unit of xanthan from the three nucleotide sugar donors (UDP-glucose, GDP-mannose and UDP-glucuronic acid) but were unable to polymerize the pentasaccharide into mature xanthan. A subclone of the gum gene cluster carrying gumB and gumC restored xanthan production to strain 8397 to levels approximately 28% of the wild-type. In contrast, subclones carrying gumB or gumC alone were not effective. These results are discussed with reference to previous speculations, based on computer analysis, that gumB and gumC are both involved in the translocation of xanthan across the bacterial membranes.