bluuebunny/crossref_metadata_2025 huggingface dataset:
An Aggressive Primary Cutaneous Follicle Center Lymphoma With c-MYC Translocation and CDKN2A (9p21) Deletion: A Case Report and Review of the Literature
Authors: Tsang Hamilton C. , Mathew Susan , Magro Cynthia M.
Published: October 2016

Diffuse large cell B-cell lymphoma of the skin is most commonly represented by diffuse large cell variants of primary cutaneous follicle center lymphoma and the leg-type lymphoma. In a minority of cases, the infiltrates are an expression of stage 4 disease of established extracutaneous B-cell lymphoma. We describe 1 female patient 85 years of age with an aggressive form of primary cutaneous B-cell lymphoma manifesting in multiple firm erythematous indurated solid nodules 1–2 cm each symmetrically on the face periorbitally and on the upper extremities bilaterally. The tumor was a de novo presentation of this aggressive form of lymphoma. The disease demonstrated an aggressive course with only transient improvement of skin lesions after chemotherapy. Punch biopsy taken from a left arm skin lesion showed a diffuse and nodular large cell lymphocytic infiltrate in the 15–20 μm range exhibiting round to oval nuclei and prominent eosinophilic nucleoli. Phenotypically, the tumor cells were CD10, Bcl-2, Bcl-6, and CD43 positive with a residuum of a follicular dendritic cell network revealed by CD21 staining. There was c-MYC rearrangement and CDKN2A deletion in this sample. The importance in reporting this case is to emphasize that in the context of primary cutaneous B-cell lymphoma, the 9p21 deletion while characteristic of the leg-type lymphoma is not a unique signature of the leg-type lymphoma and is not exclusionary to lymphomas falling under the designation of follicle center lymphoma. As with the leg-type lymphoma, however, this cytogenetic abnormality is a critical determinant to a more aggressive clinical course.
Anogenital Mammary-Like Glands: A Study of Their Normal Histology With Emphasis on Glandular Depth, Presence of Columnar Epithelial Cells, and Distribution of Elastic Fibers
Authors: Konstantinova Anastasia M. , Kyrpychova Liubov , Belousova Irena E. , Spagnolo Dominic V. , Kacerovska Denisa , Michal Michal , Kerl Katrin , Kazakov Dmitry V.
Published: October 2016

The normal histology of anogenital mammary-like glands (AGMLG) has been studied previously, but some aspects, including glandular depth, presence of columnar epithelium resembling columnar cell change/hyperplasia as defined in mammary pathology, and distribution of elastic fibers, have not been previously investigated. To address these issues, we studied 148 AGMLG identified in 133 paraffin blocks sampled from 64 vulvar wide excision or vulvectomy specimens (64 patients, various indications for surgery). The depth of AGMLG ranged from 0.64 to 3.9 mm. Epithelial columnar cell change was noted in 33.1% of all AGMLG, whereas columnar cell hyperplasia was detected in 10.1%. Occasionally, combinations of cuboidal epithelium and columnar cell change were seen within 1 histological section. Of 22 specimens stained for elastic fibers, in only 6 (27.3%) cases were elastic fibers found around glands. Periductal elastic fibers were demonstrated around 3 of the only 5 ducts, which were available for analysis in slides stained for elastic fibers. The depth of AGMLG should be taken into account when planning topical and surgical therapies for lesions derived or evolving from AGMLG. Alterations identical to columnar cell change may represent a normal variation of AGMLG.
Occlusive Nonvasculitic Vasculopathy
Authors: Llamas-Velasco Mar , Alegría Victoria , Santos-Briz Ángel , Cerroni Lorenzo , Kutzner Heinz , Requena Luis
Published: October 2016

We review the most characteristic clinical and histopathologic findings of the cutaneous manifestations of the occlusive nonvasculitic vasculopathic disorders. Clinically, most of these conditions are characterized by retiform purpura. Histopathologic findings consist of occlusion of the vessel lumina with no vasculitis. Different disorders may produce nonvasculitic occlusive vasculopathy in cutaneous blood and lymphatic vessels, including embolization due to cholesterol and oxalate emboli, cutaneous intravascular metastasis from visceral malignancies, atrial myxomas, intravascular angiosarcoma, intralymphatic histiocytosis, intravascular lymphomas, endocarditis, crystal globulin vasculopathy, hypereosinophilic syndrome, and foreign material. Other times, the occlusive disorder is due to platelet pugging, including heparin necrosis, thrombocytosis secondary to myeloproliferative disorders, paroxysmal nocturnal hemoglobinuria, and thrombotic thrombocytopenic purpura. Occlusive vasculopathy may also appear in cold-related gelling agglutination, like that occurring in cryofibrinogenemia, cryoglobulinemia, cold agglutinin syndrome, and crystalglobulinemia. Microorganisms may also occlude the vessels lumina and this is especially frequent in ecthyma gangrenosum, opportunistic fungi as aspergillosis or fusariosis, Lucio phenomenon of lepromatous leprosy and disseminated strongyloidiasis. Systemic coagulopathies due to defects of C and S proteins, coumarin/warfarin-induced skin necrosis, disseminated intravascular coagulation, and antiphospholipid antibody/lupus anticoagulant syndrome may also result in occlusive nonvasculitic vasculopathy. Finally, vascular coagulopathies such as Sneddon syndrome, livedoid vasculopathy, and atrophic papulosis may also cause occlusion of the vessels of the dermis and/or subcutis. Histopathologic study of occlusive vasculopathic lesions is the first step to achieve an accurate diagnosis, and they should be correlated with clinical history, physical examination, and laboratory findings to reach a final diagnosis.
p53 Is a Helpful Marker in Distinguishing Langerhans Cell Histiocytosis From Langerhans Cell Hyperplasia
Authors: Grace Shane A. , Sutton Angela M. , Armbrecht Eric S. , Vidal Claudia I. , Rosman Ilana S. , Hurley Maria Y.
Published: October 2016

Langerhans cell histiocytosis (LCH) is a proliferative disorder of Langerhans cells that can be challenging to distinguish histologically from Langerhans cell (LC) hyperplasia, seen in a variety of inflammatory dermatoses. Lesional cells in both entities demonstrate positive staining for CD1a and S100. Previous studies have demonstrated positive staining of fascin, CD31, and p53 in cases of LCH, but currently, no studies have compared the staining profiles of these markers between LCH and LC hyperplasia. The authors compared immunohistochemical staining profiles of LCH (n = 15) and various inflammatory dermatoses with LC hyperplasia (n = 15) using fascin, CD31, and p53. Fascin, CD31, and p53 were graded as a percentage of CD1a staining cells in the epidermis and dermis of each specimen. Fascin showed no significant differences in staining between the 2 entities. CD31 was positive in the dermal infiltrate in 40% of cases of LCH and negative in all cases of LC hyperplasia. p53 was positive in the epidermal infiltrate in 50% of cases of LCH, and positive in the dermal infiltrate in 93% of cases of LCH, whereas negative in all cases of LC hyperplasia. Fascin was not a helpful marker in distinguishing LCH from LC hyperplasia. CD31, if positive in the dermal infiltrate, is suggestive of a diagnosis of LCH, but exhibits a relatively low sensitivity for this purpose. p53 proved to be a helpful and accurate diagnostic immunohistochemical stain when distinguishing between LCH and LC hyperplasia.
A Case of Plasma Cell Granuloma Located on the Gingiva
Authors: Akdoğan Neslihan , Yalçın Başak , Gür Aksoy Güneş , Tuna Elvan Evrim , Ünal Devrim Tuba
Published: October 2016

Plasma cell granuloma (PCG) is an uncommon benign tumor of unknown etiology, primarily located in the lungs. We report a case of PCG on the gingiva mimicking benign and malignant tumors in a 56-year-old woman. Histopathological examination revealed a relatively sharp circumscribed inflammatory cell infiltration under the mucosa-containing plasma cells, predominantly those including Russell bodies. Plasma cells are stained by CD138 immunohistochemistry. Polyclonal status of the lesion was confirmed by kappa and lambda light chaining. The typical histopathological and immunohistochemical findings in combination with the clinical features were consistent with PCG, about which the literature reports very few cases.
OUTCOMES OF AN INTRAVITREAL INJECTION CLINIC
Authors: Atchison Elizabeth A. , Omar Ahmed F. , Iezzi Raymond , Barkmeier Andrew J. , Bakri Sophie J.
Published: October 2016

Purpose:

To examine the safety outcomes of an intravitreal injection-only clinic where patients needing long-term anti-vascular endothelial growth factor therapy are treated with injections at a predetermined interval for a set number of injections without an accompanying clinic visit.

Methods:

This is a retrospective chart review of all patients with exudative macular degeneration treated in an intravitreal injection clinic over a 4-year period. Data on the outcome measures of interest were gathered from electronic medical records.

Results:

There were 556 patients who received 4,386 injections in the injection-only clinic in a total of 1,524 injection cycles. One hundred six cycles were interrupted. The most common causes for interruption were decreased vision in the injected eye (32), decreased vision in the fellow eye (23), flashing lights (6), pain (5), and irritation in the noninjected eye (2). Of patients who had interruption of the cycle, 32 had a new diagnosis (6 corneal abrasions, 6 exudative age-related macular degeneration in fellow eye). There were six instances of conversion to exudative age-related macular degeneration found in the other eye at a routine follow-up visit following the injection clinic.

Conclusion:

An injection-only clinic may provide a reasonable approach to streamline retina practices to ensure that patients receive timely injections.
TREATMENT OF MACULAR FOLDS COMPLICATING RETINAL DETACHMENT SURGERY USING AIR FOR RETINAL UNFOLDING
Authors: Barale Pierre-Olivier , Mora Paolo , Errera Marie-Hélène , Ores Raphaëlle , Pâques Michel , Sahel José-Alain
Published: October 2016

Purpose:

We discuss a modified surgical procedure for the treatment of macular folds complicating retinal reattachment surgery.

Methods:

To facilitate the completion of the macular redetachment and the subsequent unrolling of the fold, we propose the subretinal injection, in addition to the conventional balanced salt solution, of filtered air as an original approach. In the presence of a subretinal air bubble, the action of gravity on the perfluorocarbon liquid in the vitreous cavity combined with an active globe manipulation proved to be very effective for flattening the central retina. Short-term tamponade with gas was successful at stabilizing the result.

Results:

This technique has been used to treat symptomatic macular fold after surgery for rhegmatogenous retinal detachment in 3 consecutive eyes since 2014. Flattening of the macula with progressive visual recovery was achieved in all cases by the end of follow-up.

Conclusion:

Direct injection of air into the macular fold may represent an effective strategy to enhance the surgical management of such a vision-threatening complication. Air also minimizes the risks related to the forceful injection of fluid under the macula. An overview of recently reported surgical techniques is included, along with a brief discussion.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY SHOWS INNER CHOROIDAL ISCHEMIA IN ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY
Authors: Dolz-Marco Rosa , Sarraf David , Giovinazzo Vincent , Freund K. Bailey
Published: October 2016

Purpose:

To describe multimodal imaging findings of an evolving case of acute posterior multifocal placoid pigment epitheliopathy occurring in a young healthy male.

Methods:

Case report of a patient with acute posterior multifocal placoid pigment epitheliopathy including comprehensive systemic and ocular examinations. Ultra-widefield autofluorescence, fluorescein angiography, indocyanine green angiography, and serial optical coherence tomography angiography were performed.

Results:

A 34-year-old male presented with acute vision loss in his left eye for 2 weeks. His best-corrected visual acuity was 20/20 in his right eye and 20/200 in his left eye. Dilated funduscopic examination revealed multiple creamy white deep retinal lesions showing macular involvement of the left eye with a diffuse area of pigmentary changes. The presence of multiple areas of hypoperfusion of the inner choroid were demonstrated with fluorescein and indocyanine green angiography. Serial optical coherence tomography angiography showed multiple evolving areas of decreased flow at the level of the inner choroid.

Conclusion:

Although the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy remains unknown, there is growing evidence of a primary choroidal involvement with secondary damage to the overlying retinal pigment epithelium and the outer retinal layers. Optical coherence tomography angiography may provide valuable information for the diagnosis and follow-up of this condition avoiding invasive angiographic procedures.
The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain
Authors: MacPherson H. , Vertosick E.A. , Foster N.E. , Lewith G. , Linde K. , Sherman K.J. , Witt C.M. , Vickers A.J. ,   On behalf of the Acupuncture Trialists' Collaboration
Published: October 2016

There is uncertainty regarding how long the effects of acupuncture treatment persist after a course of treatment. We aimed to determine the trajectory of pain scores over time after acupuncture, using a large individual patient data set from high-quality randomized trials of acupuncture for chronic pain. The available individual patient data set included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck, and shoulder), osteoarthritis of the knee, and headache/migraine. We used meta-analytic techniques to determine the trajectory of posttreatment pain scores. Data on longer term follow-up were available for 20 trials, including 6376 patients. In trials comparing acupuncture to no acupuncture control (wait-list, usual care, etc), effect sizes diminished by a nonsignificant 0.011 SD per 3 months (95% confidence interval: −0.014 to 0.037, P = 0.4) after treatment ended. The central estimate suggests that approximately 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, we observed a reduction in effect size of 0.025 SD per 3 months (95% confidence interval: 0.000-0.050, P = 0.050), suggesting approximately a 50% diminution at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not seem to decrease importantly over 12 months. Patients can generally be reassured that treatment effects persist. Studies of the cost-effectiveness of acupuncture should take our findings into account when considering the time horizon of acupuncture effects. Further research should measure longer term outcomes of acupuncture.
Can Down-gaze During Near Work Cause Peripheral Deprivation in Asian Eyes?
Authors: Xu Renfeng , Wang Huachun , Jiang Feng , Xue Chunyan , Huang Zhenping , Bradley Arthur
Published: October 2016

Purpose

We hypothesize that the typically narrower palpebral apertures of East Asian eyes in combination with the narrowing of this aperture during down-gaze combine to reduce light levels and image contrast in the inferior retina during near work, thus creating peripheral deprivation in these eyes that could generate deprivation myopia in children culturally encouraged to perform near work.

Methods

We photographed the right eyes of 53 Chinese children during down-gaze (from 10 to 40 degrees) from the fixation point and the primary gaze position. From these images, we determined the size and shape of the effective foveal and superior field entrance pupil at different down-gaze angles. By using an eye model with typical levels of off-axis higher-order aberrations, we quantified the impact of eyelid and eyelash vignetting of the pupil on both retinal illuminance and image quality using Visual Strehl Ratio (VSOTF), and the non-visually weighted Strehl Ratio (SROTF).

Results

The effective aperture for the superior visual field is vignetted during down-gaze by lids and lashes, producing reductions in retinal illuminance of 30% and >60% at 20 and 40 degrees, respectively. However, the aperture vignetting effect on peripheral image modulation is small, with neural and aberration changes dominating image quality in the superior field during down-gaze.

Conclusions

Occlusion of the pupil by eyelid and eyelashes during down-gaze is unlikely to produce significant superior field deprivation in East Asian eyes.
Cerebral Air Embolism
Authors: Roquero Leonardo Pacheco , Camelo-Piragua Sandra , Schmidt Carl
Published: October 2016

Cerebral air embolism is a recognized life-threatening complication, sometimes iatrogenic. Its timely diagnosis is essential because it can result in neurologic deficits or death. We report a case of a 58-year-old man who died from cerebral air embolism diagnosed by nonenhanced computed tomography scan of the head after a cardiac bypass surgery with Biventricular Assist Device and multiple vascular line placements. Autopsy revealed extensive subcutaneous emphysema, intravascular and perivascular air bubbles in the central nervous system and associated cerebral and cerebellar hemorrhagic infarction. The autopsy was helpful in documenting the extent of the air embolism and its appearance in soft tissue and central nervous system.
Effectiveness of a High-Fidelity Simulation-Based Training Program in Managing Cardiac Arrhythmias in Children
Authors: Bragard Isabelle , Farhat Nesrine , Seghaye Marie-Christine , Karam Oliver , Neuschwander Arthur , Shayan Yasaman , Schumacher Katharina
Published: October 2016

Objectives

Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias.

Methods

Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval. Questionnaires assessed self-reported changes in self-efficacy, stress, and satisfaction about skills. Blinded evaluators assessed changes in leaders' TSs and NTSs during the simulations and the time to initiate cardiopulmonary resuscitation.

Results

After training, stress decreased and satisfaction about skills increased in the EG, whereas it remained the same in the CG (P = 0.014 and P < 0.001, respectively). There was no significant change in self-efficacy. Analyses of video-recorded skills showed significant improvements in TSs and NTSs of the EG leaders after training, but not of the CG leaders (P = 0.026, P = 0.038, respectively). The comparison of the evolution of the 2 groups concerning time to initiate cardiopulmonary resuscitation was not significantly different between the first and last simulation sessions.

Conclusions

A simulation-based training with debriefing had positive effects on stress and satisfaction about skills of pediatric residents and nurses and on observed TSs and NTSs of the leaders during simulation sessions. A future study should assess the effectiveness of this training in a larger sample and its impact on skills during actual emergencies.
Scout-Based Automated Tube Potential Selection Technique (kV Assist) in Enhanced Chest Computed Tomography: Effects on Radiation Exposure and Image Quality
Authors: Li Meng , Feng Shichao , Wu Ning , Zhang Li
Published: October 2016

Objective

The aim of our study was to assess radiation dose reduction and image quality for enhanced chest CT examinations with a scout-based automated tube potential selection technique (kV Assist) compared with a standard 120-kV protocol.

Methods

Prospective study of enhanced chest CT examinations was performed in 100 consecutive patients with kV Assist and in 100 consecutive patients with conventional 120-kV protocol on a multislice CT (Discovery CT750 HD). The body mass index, CT dose index volume, and dose length product were recorded from the examination protocol. Image noise and CT value was measured on region of interest, signal-to-noise ratio, and contrast-to-noise ratio was calculated. The subjective image quality was assessed by two radiologists blinded to the respective protocol with the use of a 3-grade scale (3, superior quality; 2, moderate quality; 1, inferior quality).

Results

With kV Assist, the percentages of patients being scanned using 80, 100, and 120 kV were 12.0%, 80.0%, and 8.0%, respectively. The kilovolt setting was related with body mass index (r = 0.565, P = 0.000). Compared with the conventional 120 kV protocol, kV Assist allowed for an overall average decrease of 30.6% in CT dose index volume (kV Assist, 11.05 ± 4.78 mGy; 120 kV, 15.92 ± 6.89 mGy) (P < 0.001) and 32.3% in dose length product (kV Assist, 386.41 ± 184.02 mGy cm−1; 120 kV, 571.14 ± 286.68 mGy cm−1) (P < 0.001). In the kV Assist, mean attenuation of regions of interest inside the aorta was significantly higher than that in 120-kV protocols (kV Assist, 310.27 ± 73.70 HU; 120 kV, 239.44 ± 47.65 HU) (P < 0.001), resulting in increased contrast-to-noise ratio (kV Assist, 26.69 ± 7.78; 120 kV, 21.38 ± 6.05) (P < 0.001). There was no significant difference in subjective image quality scores between the 2 groups.

Conclusions

The use of attenuation-based kV Assist technique enables significant dose reduction in enhanced chest CT scan while improving arterial enhancement and preserving image quality at adequate levels.
Abdominal Multidetector Computed Tomography for Suspected Small-Bowel Obstruction: Multireader Study Comparing Radiologist Performance for Predicting Surgical Outcomes
Authors: Scrima Andrew , Lubner Meghan G. , King Scott , Kennedy Gregory , Pickhardt Perry J.
Published: October 2016

Objective

To compare performance of junior (JR)/senior (SR) abdominal radiologists using multidetector computed tomography (MDCT) to predict surgical intervention, bowel resection, and presence of bowel ischemia in patients with suspected small-bowel obstruction (SBO).

Methods

Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, blinded, independent review of MDCT studies for suspected SBO in 179 adults (mean age, 55.8 years; 86 men/93 women) was performed by 12 board-certified radiologists (6 JR, 6 SR). Readers rated likelihood of need for surgery, bowel ischemia, and resection. Correlation with clinical outcomes/pathology was performed.

Results

Pooled receiver operating characteristic area under the curve for surgery, ischemia, and resection were 0.802, 0.736, and 0.824 and 0.773, 0.851, and 0.751 JR/SR, respectively. Sensitivity/specificity for predicting surgery was 86.7%/65.4% and 79.6%/64.4%. No differences existed between JR/SR performance overall (P = 0.451); highest/lowest performing readers between groups (P < 0.001) and within groups (P = 0.008) varied.

Conclusions

Junior radiologists performed as well as SR in predicting surgical outcomes on MDCT in patients with suspected SBO.
Escitalopram-Associated Acute Urinary Retention in Elderly Men With Known or Latent Benign Prostatic Hyperplasia: A Case Series
Authors: Ferentinos Panagiotis , Margaritis Dimitrios , Douzenis Athanasios
Published: October 2016

Lower urinary tract outflow dysfunction is frequent in older men and a potential cause of serious complications such as acute urinary retention (AUR). Drug-induced AUR has only rarely been reported with selective serotonin reuptake inhibitors including escitalopram; reported cases had no history of urinary outflow dysfunction. We herein report the development of AUR after the introduction of escitalopram at a standard dose in 3 male patients with previously diagnosed or unknown/latent and nonsymptomatic benign prostatic hyperplasia. Urinary retention receded after escitalopram discontinuation in 2 cases but led to emergent prostatectomy in the third. This case series highlights escitalopram's potential association with AUR in elderly men with known or latent benign prostatic hyperplasia. Further studies are warranted to investigate whether compromised or marginal urinary outflow should be considered a contraindication for treatment with escitalopram.
Evaluation of Cognitive Function When Hearing One's Own Name in Patients With Brain Injuries in Early Developmental Stages
Authors: Tamura Kaori , Mizuba Takaaki , Okamoto Tsuyoshi , Matsufuji Mayumi , Takashima Sachio , Iramina Keiji
Published: October 2016

Purpose:

The level of residual cognitive function in patients with early brain injury is a key factor limiting rehabilitation and the quality of life. Although understanding residual function is necessary for appropriate rehabilitation, the extent of its effects on cognitive improvement remains unknown. This study evaluated cognitive function in patients with severe motor and intellectual disabilities after early brain injuries due to cerebral hemorrhage or periventricular leukomalacia. We focused on neural responses to hearing the subject's own name (SON). According to previous studies, differences in response to SON are associated with several types of cognitive dysfunction.

Methods:

We examined healthy subjects (aged 21.4 ± 1.10 years; control) and patients with a previous brain injury (aged 13–27 years at the time of our analysis) resulting in periventricular leukomalacia or a cerebral hemorrhage during the perinatal period or childhood. We recorded EEG responses to the SON and to other Japanese words, obtaining EEG-evoked potentials with wavelet transformations.

Results:

Compared with healthy controls, beta power (not alpha power) revealed differences in response to SON by patients with brain injury, especially those with cerebral hemorrhage.

Conclusions:

We suggest that alpha and beta power differences reflect different cognitive functions and that the SON response reveals more than one process. Beta powers may reflect the intellectual disability of cognitive function in response to self-relevant stimuli, especially in patients with cerebral hemorrhage. Meanwhile, alpha powers did not differ from those of the healthy controls, suggesting that the patients perhaps paid attention to their own names.
Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults
Authors: Yoo Ji Yeoun , Marcuse Lara V. , Fields Madeline C. , Rosengard Jillian L. , Traversa Maria Vittoria , Gaspard Nicolas , Hirsch Lawrence J.
Published: October 2016

Introduction:

Brief potentially ictal rhythmic discharges (B(I)RDs) have been described in neonates and critically ill adults, and their association with seizures has been demonstrated. Their significance in noncritically ill adults remains unclear. We aimed to investigate their prevalence, electrographic characteristics, and clinical significance.

Methods:

We identified adult patients with B(I)RDs who received long-term EEG recordings either in the epilepsy monitoring unit or in the ambulatory setting. Patients with acute findings on imaging or status epilepticus were excluded. B(I)RDs were defined as very brief (<10 seconds) runs of focal or generalized sharply contoured rhythmic activity greater than 4 Hz, with or without evolution, that were not consistent with any known normal or benign pattern. The clinical history, EEG, and imaging results were retrieved. Each patient with B(I)RDs was matched by age and etiology to a control group with epileptiform discharges but without B(I)RDs in a 1:2 ratio.

Results:

We identified B(I)RDs in 15 patients of 1,230 EEGs (1.2%). The pattern typically consisted of 0.5 to 4 second runs of sharply contoured alpha activity without evolution. All patients with B(I)RDs had epilepsy, and, when compared with controls with epilepsy but without BIRDs, were more likely to be medically refractory (10 of 15 [67%] vs. 5 of 30 [17%]; P < 0.01). All seizure onsets colocalized to the B(I)RDs, and most were morphologically similar.

Conclusions:

In noncritically ill patients, B(I)RDs are associated with refractory epilepsy and their location is correlated with the seizure onset area.
Androgens predict parasitism in female meerkats: a new perspective on a classic trade-off
Authors: Smyth Kendra N. , Greene Lydia K. , Clutton-Brock Tim , Drea Christine M.
Published: October 2016

The immunocompetence handicap hypothesis posits that androgens in males can be a ‘double-edged sword’, actively promoting reproductive success, while also negatively impacting health. Because there can be both substantial androgen concentrations in females and significant androgenic variation among them, particularly in species portraying female social dominance over males or intense female–female competition, androgens might also play a role in mediating female health and fitness. We examined this hypothesis in the meerkat (Suricata suricatta), a cooperatively breeding, social carnivoran characterized by aggressively mediated female social dominance and extreme rank-related reproductive skew. Dominant females also have greater androgen concentrations and harbour greater parasite loads than their subordinate counterparts, but the relationship between concurrent androgen concentrations and parasite burdens is unknown. We found that a female's faecal androgen concentrations reliably predicted her concurrent state of endoparasitism irrespective of her social status: parasite species richness and infection by Spirurida nematodes,Oxynema suricattae,Pseudandrya suricattaeand coccidia were greater with greater androgen concentrations. Based on gastrointestinal parasite burdens, females appear to experience the same trade-off in the costs and benefits of raised androgens as do the males of many species. This trade-off presumably represents a health cost of sexual selection operating in females.
Disease implication of hyper-Hippo signalling
Authors: Wang Shu-Ping , Wang Lan-Hsin
Published: October 2016

The Hippo signalling pathway regulates cellular proliferation, apoptosis and differentiation, thus exerting profound effects on cellular homeostasis. Inhibition of Hippo signalling has been frequently implicated in human cancers, indicating a well-known tumour suppressor function of the Hippo pathway. However, it is less certain whether and how hyperactivation of the Hippo pathway affects biological outcome in living cells. This review describes current knowledge of the regulatory mechanisms of the Hippo pathway, mainly focusing on hyperactivation of the Hippo signalling nexus. The disease implications of hyperactivated Hippo signalling have also been discussed, including arrhythmogenic cardiomyopathy, Sveinsson's chorioretinal atrophy, Alzheimer's disease, amyotrophic lateral sclerosis and diabetes. By highlighting the significance of disease-relevant Hippo signalling activation, this review can offer exciting prospects to address the onset and potential reversal of Hippo-related disorders.
Tomographic docking suggests the mechanism of auxin receptor TIR1 selectivity
Authors: Uzunova Veselina V. , Quareshy Mussa , del Genio Charo I. , Napier Richard M.
Published: October 2016

We study the binding of plant hormone IAA on its receptor TIR1, introducing a novel computational method that we calltomographic dockingand that accounts for interactions occurring along the depth of the binding pocket. Our results suggest that selectivity is related to constraints that potential ligands encounter on their way from the surface of the protein to their final position at the pocket bottom. Tomographic docking helps develop specific hypotheses about ligand binding, distinguishing binders from non-binders, and suggests that binding is a three-step mechanism, consisting of engagement with a niche in the back wall of the pocket, interaction with a molecular filter which allows or precludes further descent of ligands, and binding on the pocket base. Only molecules that are able to descend the pocket and bind at its base allow the co-receptor IAA7 to bind on the complex, thus behaving as active auxins. Analysing the interactions at different depths, our new method helps in identifying critical residues that constitute preferred future study targets and in the quest for safe and effective herbicides. Also, it has the potential to extend the utility of docking from ligand searches to the study of processes contributing to selectivity.
Using network analysis to study behavioural phenotypes: an example using domestic dogs
Authors: Goold Conor , Vas Judit , Olsen Christine , Newberry Ruth C.
Published: October 2016

Phenotypic integration describes the complex interrelationships between organismal traits, traditionally focusing on morphology. Recently, research has sought to represent behavioural phenotypes as composed of quasi-independent latent traits. Concurrently, psychologists have opposed latent variable interpretations of human behaviour, proposing instead a network perspective envisaging interrelationships between behaviours as emerging from causal dependencies. Network analysis could also be applied to understand integrated behavioural phenotypes in animals. Here, we assimilate this cross-disciplinary progression of ideas by demonstrating the use of network analysis on survey data collected on behavioural and motivational characteristics of police patrol and detection dogs (Canis lupus familiaris). Networks of conditional independence relationships illustrated a number of functional connections between descriptors, which varied between dog types. The most central descriptors denoted desirable characteristics in both patrol and detection dog networks, with ‘Playful’ being widely correlated and possessing mediating relationships between descriptors. Bootstrap analyses revealed the stability of network results. We discuss the results in relation to previous research on dog personality, and benefits of using network analysis to study behavioural phenotypes. We conclude that a network perspective offers widespread opportunities for advancing the understanding of phenotypic integration in animal behaviour.
The role of three heat shock protein genes in the immune response to
Aeromonas hydrophila
challenge in marbled eel,
Anguilla marmorata
Authors: Liang Fenfei , Zhang Guosong , Yin Shaowu , Wang Li
Published: October 2016

Heat shock proteins (HSPs) are highly conserved molecular chaperones that play critical roles in both innate and adaptive immunity. However, little information about HSPs from marbled eel
Anguilla marmorata
is known. In this study, the full-length
Amhsp90
(2527 bp),
Amhsp70
(2443 bp) and
Amhsc70
(2247 bp) were first cloned from
A. marmorata
, using rapid amplification of cDNA ends, containing open reading frames of 2181, 1932 and 1950 bp in length, and encoding proteins with 726, 643 and 649 amino acids, respectively. The deduced amino acid sequences of three
Amhsps
shared a high homology similarity with other migratory fish. Real-time fluorescent quantitative polymerase chain reaction was used to evaluate tissue-specific distribution and mRNA expression levels of three
Amhsps
subjected to infection with
Aeromonas hydrophila
. The mRNA expression of three
Amhsps
in eight tested tissues, namely liver, heart, muscle, gill, spleen, kidney, brain and intestine, of juvenile
A. marmorata
was evaluated to reveal the major expression distribution in liver, intestine, muscle and heart. After pathogen challenge treatments, mRNA transcriptions of three
Amhsps
revealed a significant regulation at various time points in the same tissue. All these findings suggest that
Amhsps
may be involved in the immune response in
A. marmorata
.
Maternal effects and
Symbiodinium
community composition drive differential patterns in juvenile survival in the coral
Acropora tenuis
Authors: Quigley Kate M. , Willis Bette L. , Bay Line K.
Published: October 2016

Coral endosymbionts in the dinoflagellate genus
Symbiodinium
are known to impact host physiology and have led to the evolution of reef-building, but less is known about how symbiotic communities in early life-history stages and their interactions with host parental identity shape the structure of coral communities on reefs. Differentiating the roles of environmental and biological factors driving variation in population demographic processes, particularly larval settlement, early juvenile survival and the onset of symbiosis is key to understanding how coral communities are structured and to predicting how they are likely to respond to climate change. We show that maternal effects (that here include genetic and/or effects related to the maternal environment) can explain nearly 24% of variation in larval settlement success and 5–17% of variation in juvenile survival in an experimental study of the reef-building scleractinian coral,
Acropora tenuis
. After 25 days on the reef,
Symbiodinium
communities associated with juvenile corals differed significantly between high mortality and low mortality families based on estimates of taxonomic richness, composition and relative abundance of taxa. Our results highlight that maternal and familial effects significantly explain variation in juvenile survival and symbiont communities in a broadcast-spawning coral, with
Symbiodinium
type A3 possibly a critical symbiotic partner during this early life stage.
Zebrafish response to a robotic replica in three dimensions
Authors: Ruberto Tommaso , Mwaffo Violet , Singh Sukhgewanpreet , Neri Daniele , Porfiri Maurizio
Published: October 2016

As zebrafish emerge as a species of choice for the investigation of biological processes, a number of experimental protocols are being developed to study their social behaviour. While live stimuli may elicit varying response in focal subjects owing to idiosyncrasies, tiredness and circadian rhythms, video stimuli suffer from the absence of physical input and rely only on two-dimensional projections. Robotics has been recently proposed as an alternative approach to generate physical, customizable, effective and consistent stimuli for behavioural phenotyping. Here, we contribute to this field of investigation through a novel four-degree-of-freedom robotics-based platform to manoeuvre a biologically inspired three-dimensionally printed replica. The platform enables three-dimensional motions as well as body oscillations to mimic zebrafish locomotion. In a series of experiments, we demonstrate the differential role of the visual stimuli associated with the biologically inspired replica and its three-dimensional motion. Three-dimensional tracking and information-theoretic tools are complemented to quantify the interaction between zebrafish and the robotic stimulus. Live subjects displayed a robust attraction towards the moving replica, and such attraction was lost when controlling for its visual appearance or motion. This effort is expected to aid zebrafish behavioural phenotyping, by offering a novel approach to generate physical stimuli moving in three dimensions.
Does the kinorhynch have a hydrophobic body surface? Measurement of the wettability of a meiobenthic metazoan
Authors: Ishii Daisuke , Yamasaki Hiroshi , Uozumi Ryosuke , Hirose Euichi
Published: October 2016

The body surface of aquatic invertebrates is generally thought to be hydrophilic to prevent the attachment of air bubbles. In contrast, some interstitial invertebrates, such as kinorhynchs and some crustaceans, have a hydrophobic body surface: they are often trapped at the water surface when the sediment in which they reside is mixed with air and water. Here, we directly measured the wettability of the body surface of the kinorhynch
Echinoderes komatsui
, using a microscopic contact angle meter. The intact body surface of live specimens was not hydrophobic, but the anterior part was less hydrophilic. Furthermore, washing with seawater significantly decreased the wettability of the body surface, but a hydrophilic surface was recovered after a 1 h incubation in seawater. We believe that the hydrophobic cuticle of the kinorhynch has a hydrophilic coat that is readily exfoliated by disturbance. Ultrastructural observations supported the presence of a mucus-like coating on the cuticle. Regulation of wettability is crucial to survival in shallow, fluctuating habitats for microscopic organisms and may also contribute to expansion of the dispersal range of these animals.
Mothers may shape the variations in social organization among gorillas
Authors: Robbins Andrew M. , Gray Maryke , Breuer Thomas , Manguette Marie , Stokes Emma J. , Uwingeli Prosper , Mburanumwe Innocent , Kagoda Edwin , Robbins Martha M.
Published: October 2016

When mothers continue to support their offspring beyond infancy, they can influence the fitness of those offspring, the strength of social relationships within their groups, and the life-history traits of their species. Using up to 30 years of demographic data from 58 groups of gorillas in two study sites, this study extends such findings by showing that mothers may also contribute to differences in social organization between closely related species. Female mountain gorillas remained with their sons for significantly longer than western gorillas, which may explain why male philopatry and multimale groups are more common among mountain gorillas. The presence of the putative father and other familiar males did not vary significantly between species, and we found only limited support for the socio-ecological theory that the distribution of adult males is influenced by the distribution of females. Within each gorilla species, variations in those distributions may also reflect the different stages in the typical life cycle of a group. Collectively, our results highlight the potentially far-reaching consequences of maternal support that extends beyond infancy, and they illustrate the opportunity to incorporate additional factors into phylogenetic analyses of variations in social organization, including studies of human evolution.
Chemical communication is not sufficient to explain reproductive inhibition in the bumblebee
Bombus impatiens
Authors: Padilla Mario , Amsalem Etya , Altman Naomi , Hefetz Abraham , Grozinger Christina M.
Published: October 2016

Reproductive division of labour is a hallmark of eusociality, but disentangling the underlying proximate mechanisms can be challenging. In bumblebees, workers isolated from the queen can activate their ovaries and lay haploid, male eggs. We investigated if volatile, contact, visual or behavioural cues produced by the queen or brood mediate reproductive dominance in
Bombus impatiens.
Exposure to queen-produced volatiles, brood-produced volatiles and direct contact with pupae did not reduce worker ovary activation; only direct contact with the queen could reduce ovary activation. We evaluated behaviour, physiology and gene expression patterns in workers that were reared in chambers with all stages of brood and a free queen, caged queen (where workers could contact the queen, but the queen was unable to initiate interactions) or no queen. Workers housed with a caged queen or no queen fully activated their ovaries, whereas ovary activation in workers housed with a free queen was completely inhibited. The caged queen marginally reduced worker aggression and expression of an aggression-associated gene relative to queenless workers. Thus, queen-initiated behavioural interactions appear necessary to establish reproductive dominance. Queen-produced chemical cues may function secondarily in a context-specific manner to augment behavioural cues, as reliable or honest signal.
Computational models for the determination of depth-dependent mechanical properties of skin with a soft, flexible measurement device
Authors: Yuan Jianghong , Dagdeviren Canan , Shi Yan , Ma Yinji , Feng Xue , Rogers John A. , Huang Yonggang
Published: October 2016

Conformal modulus sensors (CMS) incorporate PZT nanoribbons as mechanical actuators and sensors to achieve reversible conformal contact with the human skin for non-invasive,
in vivo
measurements of skin modulus. An analytic model presented in this paper yields expressions that connect the sensor output voltage to the Young moduli of the epidermis and dermis, the thickness of the epidermis, as well as the material and geometrical parameters of the CMS device itself and its encapsulation layer. Results from the model agree well with
in vitro
experiments on bilayer structures of poly(dimethylsiloxane). These results provide a means to determine the skin moduli (epidermis and dermis) and the thickness of the epidermis from
in vivo
measurements of human skin.
Mutation rate analysis via parent–progeny sequencing of the perennial peach. I. A low rate in woody perennials and a higher mutagenicity in hybrids
Authors: Xie Zhengqing , Wang Long , Wang Lirong , Wang Zhiqiang , Lu Zhenhua , Tian Dacheng , Yang Sihai , Hurst Laurence D.
Published: October 2016

Mutation rates vary between species, between strains within species and between regions within a genome. What are the determinants of these forms of variation? Here, via parent–offspring sequencing of the peach we ask whether (i) woody perennials tend to have lower per unit time mutation rates compared to annuals, and (ii) hybrid strains have high mutation rates. Between a leaf from a low heterozygosity individual, derived from an intraspecific cross, to a leaf of its selfed progeny, the mutation rate is 7.77 × 10−9point mutations per bp per generation, similar toArabidopsis thaliana(7.0–7.4 × 10−9point mutations per bp per generation). This suggests a low per unit time mutation rate as the generation time is much longer in peach. This is supported by our estimate of 9.48 × 10−9point mutations per bp per generation from a 200-year-old low heterozygosity peach to its progeny. From a more highly heterozygous individual derived from an interspecific cross to its selfed progeny, the mutation rate is 1.38 × 10−8mutations per site per generation, consistent with raised rates in hybrids. Our data thus suggest that (i) peach has an approximately order of magnitude lower mutation rate per unit time thanArabidopsis, consistent with reports of low evolutionary rates in woody perennials, and (ii) hybridization may, indeed, be associated with increased mutation rates as considered over a century ago.
A bottom-up perspective on ecosystem change in Mesozoic oceans
Authors: Knoll Andrew H. , Follows Michael J.
Published: October 2016

Mesozoic and Early Cenozoic marine animals across multiple phyla record secular trends in morphology, environmental distribution, and inferred behaviour that are parsimoniously explained in terms of increased selection pressure from durophagous predators. Another systemic change in Mesozoic marine ecosystems, less widely appreciated than the first, may help to explain the observed animal record. Fossils, biomarker molecules, and molecular clocks indicate a major shift in phytoplankton composition, as mixotrophic dinoflagellates, coccolithophorids and, later, diatoms radiated across shelves. Models originally developed to probe the ecology and biogeography of modern phytoplankton enable us to evaluate the ecosystem consequences of these phytoplankton radiations. In particular, our models suggest that the radiation of mixotrophic dinoflagellates and the subsequent diversification of marine diatoms would have accelerated the transfer of primary production upward into larger size classes and higher trophic levels. Thus, phytoplankton evolution provides a mechanism capable of facilitating the observed evolutionary shift in Mesozoic marine animals.