Patchy Pattern Research Articles

Syntaxonomy and biogeography of the Irano‐Turanian mires and springs

AbstractAimsTo develop the first comprehensive syntaxonomic classification for patchy montane mire and spring vegetation across the Irano‐Turanian phytogeographical region in Iran, Tajikistan and Kyrgyzstan and to explore the effects of the main environmental and geographic gradients on their distribution.LocationAlborz Mountain range (Iran), Pamir‐Alai Mountains (Tajikistan) and Tian Shan Mountains (Kyrgyzstan); total area about 3,000,000 km2.MethodsA database of 1,015 vegetation relevés including a total of 675 vascular and bryophyte taxa was established, covering the large mountains ranges of the Irano‐Turanian regions in Iran, Tajikistan and Kyrgyzstan, at altitudes ranging from 1,300 to 4,505 m a.s.l. A semi‐supervisedk‐means analysis was performed. Additional analyses were carried out to show differences among predefined vegetation groups in terms of phytogeographical, climatic and compositional factors.ResultsTwo large groups of mire communities, referable to mires and springs were identified. Twenty associations, one subassociation and four alliances of these wetlands, belonging to three orders and three classes, were defined. Among them, ten associations, one subassociation and two alliances were formally described as new syntaxa. Moreover, a new orderCaricetalia orbicularis, that comprises phytogeographically unique vegetation of the Irano‐Turanian mires, is proposed.ConclusionsBased on our results and comparison between the Irano‐Turanian and other phytogeographical regions, we propose a first comprehensive syntaxonomic synopsis for the Irano‐Turanian mires and springs. Despite some identical character species and their vicariant nature, the Irano‐Turanian, Euro‐Siberian and Mediterranean mires and springs show considerable compositional differences. Irano‐Turanian wetlands contain a large and distinct set of endemic plant species, which are mixed with Euro‐Siberian species in the west and north, but predominate in the eastern locations. They have a patchy pattern and scattered distribution and serve as inland hotspots of wetland vegetation in the vast dry landscape of southwest and Central Asia.

Superficial Cryotherapy, Does It Work In Alopecia Areata?

Abstract:Alopecia areata is a common cause of nonscarring alopecia, with patchy, confluent or diffuse patterns, involving mainly the scalp and other hairy areas of the body. It's considered a therapeutic challenge due to prognosis, unpredictable course and variable efficacy of available therapies. Several studies have evaluated the efficacy of cryotherapy in the treatment of alopecia areata with varying success rates.Superficial cryotherapy using liquid nitrogen mainly was used in several studies for treating alopecia areata with various subtypes including mild, moderate and recalcitrant alopecia areata, and alopecia totalis with variable rates of therapeutically accepted terminal hair regrowth. Its main mechanisms of efficacy in alopecia areata are vascular changes and immunomodulation. Superficial cryotherapy was effective and safe in treating alopecia areata of the eyebrows. It was nearly as effective as topical steroids and topical PUVA therapy, and was combined with topical immunotherapy and topical steroid with increased efficacy. It's well-tolerated, convenient and simple office-based procedure, especially in children who are susceptible to side effects of other conventional therapeutic options.The reported side effects of superficial cryotherapy included vesiculation, erosion, crust formation, transient pigmentary alteration and partial leukotrichia, however they were transient. Key words: alopecia, cryotherapy, liquid nitrogen

Clinical Implication of Patchy Pattern Corneal Staining in Dry Eye Disease.

Corneal fluorescein staining in a form that is commonly called a “patchy pattern (PP)” is sometimes seen with or without superficial punctate keratopathy (SPK) in dry-eye diseases (DEDs). Here, we investigated the differences in the clinical features of DED patients with and without PP corneal staining (PPCS). This study involved 35 DEDs with PPCS (PPCS group) and 30 DEDs with SPK and without PPCS (non-PPCS group). The tear meniscus radius (TMR, mm), spread grade (SG) of the tear-film lipid layer (i.e., SG 1–5, 1 being best), noninvasive breakup time (NIBUT, seconds), fluorescein breakup time (FBUT, seconds), corneal epithelial damage (CED, 15 points maximum), conjunctival epithelial damage (CjED, six points maximum), the Schirmer’s 1 test (ST1, mm), and the prevalence of Sjögren’s syndrome (SS) were examined, and then compared between the two groups. Our findings revealed that between the groups (PPCS vs. non-PPCS), there was a statistically significant difference (p < 0.05) in CjED (3.1 ± 1.9 vs. 1.3 ± 1.6), ST1 (5.6 ± 7.4 vs. 14.8 ± 11.4), and the prevalence of SS (60.0% vs. 16.7%). Our findings suggest that DEDs and dry-eye patients with PPCS may indicate not only SS itself, but also the ophthalmological characteristics compatible with SS.

On the Consequences of Using Moving Window Segmentation to Analyze the Structural Stand Heterogeneity and Debatable Patchiness of Old-Growth Temperate Forests

(1) Background: Early research in natural forests on decennia implanted conviction concerning the patchy patterns of their structural heterogeneity. Due to the variety of methodological approaches applied, verification of this fundamental assumption remains open. The aim of this study was to discuss the methodological limitations associated with the use of moving windows with overlap for the delineation of homogeneous patch mosaics in forest ecosystems. (2) Methods: The “patchiness” hypothesis was tested in six old-growth forests formed by Abies alba Mill., Fagus sylvatica L., and Picea abies (L.) H. Karst. localized in Bosnia and Herzegovina and southern Poland. In each stand, the tree diameter at breast height (dbh) was recorded on circular sample plots of 154 m2 regularly distributed in a 20 × 20 m lattice over an area of 10 ha. (3) Results: Computer simulations showed that patch classification based on overlapping windows results in apparent patchiness, even for completely randomized tree distributions. Analyses carried out on the empirical data indicated prevalent random patterns of structural heterogeneity. (4) Conclusions: Patchiness is not a universal feature of the investigated forest communities. The size of the moving window and the noise-smoothing procedure exert strong effects on the biasedness of patch classification, the frequency of structural types, and the mean patch size.

Describing the heterotopic gastric mucosa (inlet patch) located in the esophagus with cases

Aim: The inlet patch, also called as the heterotopic gastric mucosa, is often located in proximal esophagus and is generally asymptomatic. These lesions are rarely polypoid and mostly have a patchy pattern. In the literature, there are only few cases of inlet patches that show a malignant progression following a metaplasia- dysplasia- adenocarcinoma sequence. In our study, we aimed to present the endoscopic and morphological features of our case series. Methods: The study, which was conducted in two clinics, included the inlet patch cases diagnosed in esophagus biopsy materials between 2016 and 2019. The slides and the demographic data of the cases were re-analyzed. Results: Among 4190 cases whose esophageal biopsies were examined, 63 inlet patches (1.5%) were diagnosed. Thirty four cases were male and 29 were female. Age range was 16-82 years. The cases were mostly located in proximal esophagus and the size of the lesions ranged between 0.2-3.5 cm. One of the four cases with polypoid appearance was microscopically diagnosed as a hyperplastic polyp. The most common gastric type epithelium was the oxyntic type. Helicobacter pylori was observed in four cases, and intestinal metaplasia and low-grade dysplasia were observed in one. No malignancy was diagnosed in our series. Conclusion: Although benign, the inlet patch is significant due to its risk of progression to malignancy. Thus, obtaining biopsies from each lesion endoscopically considered as inlet patch is recommended. This will help determine the precise incidence of the inlet patch and more importantly, identify neoplasia earlier.

Chaotic genetic structure and past demographic expansion of the invasive gastropod Tritia neritea in its native range, the Mediterranean Sea

To better predict population evolution of invasive species in introduced areas it is critical to identify and understand the mechanisms driving genetic diversity and structure in their native range. Here, we combined analyses of the mitochondrial COI gene and 11 microsatellite markers to investigate both past demographic history and contemporaneous genetic structure in the native area of the gastropod Tritia neritea, using Bayesian skyline plots (BSP), multivariate analyses and Bayesian clustering. The BSP framework revealed population expansions, dated after the last glacial maximum. The haplotype network revealed a strong geographic clustering. Multivariate analyses and Bayesian clustering highlighted the strong genetic structure at all scales, between the Black Sea and the Adriatic Sea, but also within basins. Within basins, a random pattern of genetic patchiness was observed, suggesting a superimposition of processes involving natural biological effects (no larval phase and thus limited larval dispersal) and putative anthropogenic transport of specimens. Contrary to the introduced area, no isolation-by-distance patterns were recovered in the Mediterranean or the Black Seas, highlighting different mechanisms at play on both native and introduced areas, triggering unknown consequences for species’ evolutionary trajectories. These results of Tritia neritea populations on its native range highlight a mixture of ancient and recent processes, with the effects of paleoclimates and life history traits likely tangled with the effects of human-mediated dispersal.

PD-L1 expression patterns in oral cancer as an integrated approach for further prognostic classification.

Despite the well-known role of programmed cell death ligand 1 (PD-L1) in promoting immune resistance in oral squamous cell carcinoma (OSCC), its potential utility as a prognostic biomarker is undetermined. We evaluated PD-L1 expression as predictor of survival in patients with OSCC and explored PD-L1 expression patterns. We conducted a retrospective cohort study that assessed PD-L1 expression through immunohistochemistry in 123 surgical specimens of OSCC. A first approach evaluated tumor proportion scores (TPS) and combined proportion scores (CPS). Next, expression patterns were examined by evaluating PD-L1 localization in tumor nests, as well as the interfaces of tumor cells (TC) and immune cells (IC) in the tumor microenvironment. High-level PD-L1 expression determined by TPS and CPS using variable cutoffs was not associated with survival. Immunohistochemistry revealed that TC expressed PD-L1 in either patchy or diffuse patterns. The patchy pattern was an independent risk factor for overall survival. Furthermore, expression patterns in the tumor immune microenvironment showed that most cases expressed PD-L1 on both TC and IC, while PD-L1 non-expressors had the lowest overall survival. PD-L1 expression patterns in the context of localization in tumor nests and TC-IC interactions represent antitumor immune responses better than either TPS or CPS. Our suggested classification system may have important implications for the characterization of OSCC and for the use of PD-L1 as a prognostic biomarker.

Segmental longitudinal strain as the most accurate predictor of the patchy pattern late gadolinium enhancement in hypertrophic cardiomyopathy

BackgroundThe prognostic value of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM) has been well-established. Although cardiac magnetic resonance (CMR) is the method of choice in its revealing as the presence of late gadolinium enhancement (LGE), this technique still has limited availability in daily clinical practice. Two-dimensional speckle tracking echocardiography (2D STE) seems to be helpful in verification which HCM patient has the highest probability of LGE presence and hence needs to be qualified to CMR. While the majority of HCM patients have a patchy pattern of myocardial fibrosis, the aim of this study was to evaluate whether segmental rather than global longitudinal strain is more accurate in the identification of the presence of LGE. MethodsForty-six HCM patients had transthoracic echocardiography and CMR imaging performed. Each patient had global longitudinal strain and rotation parameters calculated, as well as segmental analyses for wall thickness, longitudinal strain, and LGE presence based on 736 segments of the left ventricle (LV). The presence of LGE in CMR was confirmed on a per-segment basis, which was similar to LV segments in the echocardiographic examination. All patients were divided into two groups according to the CMR result: LGE (+) and LGE (−). ResultsReceiver-operating characteristic analyses identified peak global longitudinal strain and peak twisting velocity with the cut-off values −14.4% and 116°/s respectively as the accurate predictors of LGE presence in CMR, whereas segmental longitudinal strain of −12.5% cut-off value had the highest area under the curve value (87.4%, confidence interval 84.5–90.3%), with 93.7% sensitivity, 86.5% negative predictive value, and 55% specificity. ConclusionsSegmental longitudinal strain with the cut-off value of −12.5% has the highest discriminatory power for LGE presence and seems to be more adequate than global speckle tracking parameters in identification of HCM patients with strong indications for CMR for more accurate risk stratification.

Utilization of cardiac MRI for the assessment of suspected rejection with negative biopsy in heart transplant recipients

Abstract Background Heart transplant (HTx) patients can develop graft dysfunction (GD) without biopsy evidence of cell or antibody mediated rejection. Cardiac MRI (CMR) can detect inflammatory or infiltrative causes of cardiomyopathy however CMR findings in HTx recipients with GD have not been previously described. Purpose We sought to identify CMR characteristics of HTx patients with GD, and evaluate its additive value in its diagnosis and prognosis. Methods CMR has been performed routinely to evaluate GD at our institutions. There were 37 HTx recipients who presented with acute decline in left ventricular ejection fraction (LVEF) of &amp;lt;50% and &amp;gt;10% from baseline, with no biopsy evidence of rejection between 2007 and 2018. Coronary angiogram with IVUS was done to rule out allograft vasculopathy. Treatment of GD was per discretion of the treating clinician. Responders were defined as those with LVEF improvement &amp;gt;10% at 180 days or greater post-presentation. LV and RV indices, the presence and pattern of late gadolinium enhancement (LGE) were determined by CMR. Results There were 34% females and mean age at transplant was 49±13 years. Median time from HTx to GD was 1.2 years. Presenting symptoms were heart failure (n=25), cardiogenic shock (n=1) and 11 patients were asymptomatic. Mean LVEF at presentation was 37±12% and donor specific antibodies were detected in 38% patients. Most patients were treated with steroid bolus (n=29), and/or plasmapheresis (n=23). There were no major changes made in immunosuppression in 6 patients. Delayed enhancement MRI was performed with standard inversion-recovery (IR) gradient echo sequences, between 5 and 20 minutes after institutional-standard protocol administration of IV gadolinium contrast. Biventricular LGE was present in 18/37 (49%) patients with GD and was more prevalent in responders (57%, 13 of 23) than non-responders (35%, 5 of 14), although not statistically significant (p=0.21). There were two patterns of LGE noted: 1) Diffuse epicardial (10 patients out which 9 were responders) and 2) Patchy pattern with non-specific distribution (8 patients out of which 4 were responders). Myocardial edema by triple IR sequencing was seen in 6 patients, all having diffuse epicardial pattern of enhancement matching the delayed enhancement pattern. When comparing different treatment groups, among those treated for GD (n=31), 12 of 21 (57%) responders had LGE and 4 of 10 (40%) non-responders had LGE (p=0.37), a pattern similar to the broader population. Among those not treated for GD (n=6), 1 of 2 responders had LGE and 1 of 4 non-responders had LGE (p=0.5). Conclusion CMR identified inflammation as a potential cause of GD in approximately 50% of HTx patients. There are 2 distinct patterns of LGE observed in GD, diffuse epicardial (56%) and patchy (44%). Although the presence of LGE in itself is not associated with myocardial recovery, 90% of patients with a diffuse epicardial pattern have recovery of GD. Funding Acknowledgement Type of funding source: None

Patterns of Cytokeratin 7 Expression in Cervical Squamous Intraepithelial Lesions

Abstract Introduction/Objective It has been suggested that cervical high-grade squamous intraepithelial lesions (HSIL/CIN2-3) arise from squamocolumnar junction cells that express cytokeratin 7 (CK7). Significant CK7 expression (gradation or full-thickness) has been proposed as a marker of progression of low-grade squamous intraepithelial lesions (LSIL/CIN1) to HSIL and of persistence of HSIL/CIN2. The goal of the study is to survey patterns of CK 7 expression in the different grades of squamous intraepithelial lesions (SILs). Methods 65 cervical specimens (biopsies and excisions) containing 95 lesions of different grades were assessed by immunohistochemical analysis (IHC) for CK7 expression. 26 cases contained more one lesion grade. The diagnosis of HSIL (CIN2-3) was confirmed by p16 IHC. CK7 expression was scored negative, patchy, gradation (i.e., top-down), or full-thickness pattern. In cases with heterogeneous staining, the strongest pattern was used for analysis. Results There was significant variation in patterns within morphologically contiguous lesional foci; staining heterogeneity was noted in 42% of cases. All patterns of expression were encountered in all lesion grades. LSIL/CIN1 (n=47), either alone (n=27) or in combination with HSIL (n=20), often lacked CK7 expression (53%) or were patchy (17%). The frequency of significant (gradation or full-thickness) CK7 expression in LSIL with concomitant HSIL was greater than LSIL occurring alone (40% vs. 22%, respectively). HSIL/CIN3 (n=19) was dominated by full-thickness expression (57%). HSIL/CIN2 (n=29) had a very heterogeneous spectrum of expression with 34% of cases lacking expression. Conclusion CK7 expression is variable across all grades of SILs. LSIL with concomitant HSIL was associated with significant CK7 expression more frequently than LSIL alone. Significant proportion of HSIL, particularly CIN2, lacks CK7 expression. Given this variability, caution is advised regarding the use of CK7 expression as a marker of progression.

PATHOLOGY OF ALL ASPECTS OF END-STAGE PULMONARY SARCOIDOSIS: A RETROSPECTIVE ANALYSIS OF LUNG EXPLANTS FROM A HIGH-VOLUME LUNG TRANSPLANTATION CENTER

SESSION TITLE: Late-breaking Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Sarcoidosis is a multisystem disease of unknown etiology with variable prognosis; 10-30% of patients develop advanced fibrosis progressing to end stage pulmonary sarcoidosis (ESPS). ESPS carries a poor prognosis and lung transplantation becomes the last resort for some of these patients. Sarcoidosis can involve all parts of the respiratory system. Explanted lungs provide a unique opportunity to examine the underlying pathophysiology and patterns of fibrosis and other architectural involvement in ESPS. METHODS: We retrospectively evaluated histologic sections from twenty-four explants from patients transplanted for ESPS diagnosed clinically or by biopsy. Explants were evaluated for all components, including lung parenchyma, airways, vasculature, lymph nodes and pleura. The extent of fibrosis was scored categorized as: 1 = 1% to 25%; 2 = 26% to 50%; 3 = 51% to 75%; 4 = 76% to 100% of lung parenchyma. RESULTS: Twenty-four patients underwent lung transplantation at our institution between March 2012 to January 2020. All explants had extensive fibrosis with the majority (70.1%) found in a patchy pattern along a central and peribronchovascular distribution; twelve explants had a fibrosis score of 3 or 4. Presence of architectural distortion in the form of honeycombing was identified in four patients, two of which showed upper lobe predominant changes. Rare fibroblast foci were present in seven patients with an average of 1/10 high power fields. Parenchymal granulomas were present in all but five patients. Airway examination showed granulomatous involvement in eight patients. All explants had histologic signs consistent with a clinical impression of pulmonary hypertension including five with granulomas in vasculature; none had definitive findings of pulmonary veno-occlusive disease. Three explants had granulomatous involvement of pleura while fourteen had evidence of chronic pleuritis. Lymph nodes were evaluated in twenty-one explants; eight of which had granulomatous involvement. CONCLUSIONS: In this large analysis of lung explants from patients with ESPS, all parts of the respiratory system were examined to assess the extensive involvement in sarcoidosis. We indeed found a widespread but variable involvement of these with granulomatous inflammation and fibrosis. This might be one of the contributory factors in the variability of patient presentation and prognosis in pulmonary sarcoidosis. These will be correlated with clinical, radiological, physiological and hemodynamic features as well as outcomes. CLINICAL IMPLICATIONS: Understanding the underlying histologic pattern(s) is important to target therapy for not only patients with ESPS but also hopefully advance the field towards preventing end stage disease in patients with pulmonary sarcoidosis. DISCLOSURES: No relevant relationships by Amandeep Aneja, source=Web Response No relevant relationships by Francis Cordova, source=Web Response no disclosure on file for Gerard Criner; Human Factors Study Participant relationship with Nuvaira Inc Please note: $1001 - $5000 Added 07/29/2020 by Andrew Gangemi, source=Web Response, value=Honoraria No relevant relationships by Rohit Gupta, source=Web Response No relevant relationships by Nirag Jhala, source=Web Response no disclosure on file for A. Mamary; no disclosure on file for Kriti Mittal; No relevant relationships by Catherine Myers, source=Web Response No relevant relationships by Stephanie Tittaferrante, source=Web Response No relevant relationships by Matthew Zheng, source=Web Response

S2513 Giant Cell Hepatitis Due to Drug-Induced Autoimmune Hepatitis from Dupilumab

INTRODUCTION: Giant cell hepatitis (GCH) is a pathologic diagnosis characterized by liver inflammation and large multinucleated hepatocytes. GCH is a common pathologic entity in infants but is exceedingly rare in adults. It is typically in response to drugs, autoimmune hepatitis (AIH), viruses and malignancy. We present a case of drug-induced autoimmune hepatitis causing giant cell transformation. CASE DESCRIPTION/METHODS: A 24-year-old male with eosinophilic asthma, chronic eosinophilia, primary sclerosing cholangitis (PSC) and Crohn’s disease presented with right upper quadrant pain, jaundice, anorexia, lymphadenopathy and weight loss. Labs on admission were AST 973 (u/L), ALT 801 (u/L), AP 225 (u/L), total bilirubin 16.6 (mg/dL), direct bilirubin 11.2 (mg/dL), INR 2.4, absolute eosinophil count 20.4 (k/uL). Extensive serologic work up of acute liver injury was unrevealing with the exception of a total IgG of 5291 (mg/dL). An MRI abdomen demonstrated hepatomegaly, non-specific hepatitis and findings consistent with his known PSC. Workup for infectious, autoimmune and malignant causes of hypereosinophilia was negative. Three months prior to admission, he was started on dupilumab for his eosinophilic asthma. A liver biopsy was pursued. H&E Staining (Figure 1) noted prominent giant cell hepatocellular transformation and hepatocyte ballooning degeneration. There were plasma cell, lymphocyte and eosinophil portal infiltrates present. Trichrome staining (Figure 2) showed fibrosis in a periportal and patchy sinusoidal pattern. The pathologic analysis was most consistent with giant cell hepatitis. His clinical and pathologic diagnosis was consistent with GCH due to drug-induced AIH from dupilumab. Management included discontinuation of dupilumab and IV methylprednisolone which was transitioned to a prolonged prednisone taper at discharge. After 6 months, his liver function tests have nearly normalized. DISCUSSION: GCH is a common pathologic entity in infants but is rare in adults. Fewer than 100 reported adult cases are present in the literature. AIH followed by drug-induced and viral hepatitis are most frequently causative of GCH. Our patient’s negative serologic workup, biopsy findings, and timing of dupilumab initiation to acute hepatitis makes drug-induced autoimmune hepatitis the most likely etiology. There have been no previous reports that dupilumab has been implicated in drug-induced liver injury, drug-induced AIH or has been responsible for the pathologic diagnosis of Giant Cell Hepatitis.Figure 1.: Liver biopsy (H&E stained slide, 200x): This portal tract demonstrates a mixed inflammatory infiltrate composed of lymphocytes, plasma cells, and eosinophils without vasculitis or ductulitis. The portal tract is surrounded by the prominent multinucleated, syncytial giant hepatocytes and ballooning degeneration.Figure 2.: Liver biopsy (Massons's Trichrome stain, 200x): The trichrome staining demonstrates increased periportal fibrosis and patchy perisinusoidal fibrosis.

Landscape evolution, post-LGM surface denudation and soil weathering processes from Dickinson Park mire, Wind River Range, Wyoming (USA)

At mid-latitudes, the transition from the Pleistocene to the Holocene was characterised by distinct and partially abrupt climatic changes. Also during the Holocene, climatic perturbations, with sometimes cold-dry conditions, have occurred. How land surfaces and soil development processes in high-mountains respond to these climatic oscillations is so far only poorly known. We traced the responses of surfaces in the alpine settings of the Wind River Range (Wyoming, US) by using a large mire as natural archive. This enabled us to reconstruct environmental conditions and ecosystem changes during the Holocene in this montane area. Although adjacent moraine deposits display 10Be exposure ages from the Last Glacial Maximum up to MIS16 or even older, the accessible sediment deposits covered only the Holocene (via radiocarbon dating). By applying a geoforensic approach and deriving sedimentation rates, major climatic signals were detected. A higher deposition (and consequently erosion) rate and thus a higher rate of geomorphic activity was measured for the known cold periods 9.4–10.2 ka BP, 4.2 ka BP and 2.5 ka BP. During the LIA, especially rapid aggradation of organic matter organic matter took place here. Rates of chemical weathering and soil formation seem to have been relatively low until about 5–6 ka BP but have since increased during the Late Holocene. This would fit previous observations of increasing moisture conditions after the mid-Holocene aridity period. In contrast to several other studies, no clear signs of major disturbances (erosion, weathering) during the 8.2 ka event could be observed. Together with the low levels of chemical weathering found here, we do not see any evidence that the climate was more humid during this period. Compared to previous findings, more humid conditions seemed to have returned earlier, i.e. about 5 kyr BP. In general, this landscape displayed a patchy pattern of reaction to environmental changes, as all events were not recorded in each mire profile.

Integrative taxonomy reveals a cryptic species of the nudibranch genus Polycera (Polyceridae) in European waters

AbstractThis work aimed to test whether the colour variability featured by the European nudibranch Polycera quadrilineata is consistent with the concept of a single polychromatic species or may hide multiple lineages. Samples from across the geographic range of P. quadrilineata together with representatives from worldwide species with a focus on Atlantic diversity, were gathered and studied using an integrative taxonomic approach. Morpho-anatomical characters were investigated by light and scanning electron microscopy. Bayesian molecular phylogenetics using MrBayes, the Automatic Barcode Gap Discovery species delimitation method, and haplotype network analysis using the PopArt software were employed to help delimit species using the mitochondrial gene cytochrome c oxidase subunit I (COI). The results supported the existence of a second species, here described and named Polycera norvegica sp. nov., only known from Norway where it is sympatric with P. quadrilineata. The COI uncorrected p-genetic distance between the two species was estimated at 9.6–12.4%. Polycera norvegica sp. nov. differs by exhibiting a black dotted or patchy dotted pattern occasionally with more or less defined orange/brown patches, but never black continuous or dashed stripes as in P. quadrilineata. The two species share a common colouration with a whitish base and yellow/orange tubercles. Anatomically, P. norvegica sp. nov. has a weaker labial cuticle, a smaller radula with fewer rows, and only four marginal teeth, a reproductive system with a single lobed bursa copulatrix, shorter reproductive ducts, and a penis armed with two kinds of spines: needle-like and hook-shaped penile spines.

Cathodoluminescence visualisation of local thickness variations of GaAs/AlGaAs quantum-well tubes on nanowires

We present spatially and spectrally resolved emission from nanowires with a thin radial layer of GaAs embedded in AlGaAs barriers, grown radially around taper-free GaAs cores. The GaAs layers are thin enough to show quantization, and are quantum wells. Due to their shape, they are referred to as quantum well tubes (QWTs). We have investigated three different nominal QWT thicknesses: 1.5, 2.0, and 6.0 nm. They all show average emission spectra from the QWT with an energy spread corresponding to a thickness variation of ±30%. We observe no thickness gradient along the length of the nanowires. Individual NWs show a number of peaks, corresponding to different QW thicknesses. Apart from the thinnest QWT, the integrated emission from the QWTs shows homogeneous emission intensity along the NW. The thinnest QWTs show patchy emission patterns due to the incomplete coverage of the QWT. We observe a few NWs with larger diameters. The QWTs in these NWs show spatially resolved variations across the NW. An increase in the local thickness of the QWT at the corners blocks the diffusion of carriers from facet to facet, thereby enabling us to visualise the thickness variations of the radial quantum wells.

Carboxypeptidase A1 and regenerating islet-derived 1α as new markers for pancreatic acinar cell carcinoma

Acinar cell carcinoma (ACC) is a rare tumor that differentiates towardpancreatic acinar cells and shows evidence of pancreatic enzyme production. Mixed acinar-neuroendocrine carcinoma (MANC) is defined as having more than 30% of both acinar and neuroendocrine cell types as per immunohistochemistry analysis. Trypsin is currently the most commonly used stain for acinar differentiation. In this study, we investigate the utility of two novel markers, carboxypeptidase A1 (CPA1) and regenerating islet-derived 1α (REG1a), in diagnosing ACC/MANC. Immunohistochemical staining for CPA1 and REG1a was performed on 14 cases of ACC and 5 cases of MANCas well as on 80 other pancreatic tumors including 20 cases each ofductal adenocarcinoma, well-differentiated neuroendocrine tumor, mucinous cystic neoplasm, and solid pseudopapillary tumor. All ACCs and MANCs were positive for CPA1 (all diffuse) and REG1a (12 diffuse, 4 patchy, and 3 focal). A diffuse or patchy staining pattern was significantly more common in ACC/MANC cases (100% diffuse/patchy for CPA1 and 84% for REG1a) than in other pancreatic tumors (5% diffuse/patchy for CPA1 and 7.5% for REG1a), with a P-value of <0.0001 for both CPA1 and REG1a. The sensitivity and specificity of diffuse/patchy staining for CPA1 and REG1a in diagnosing pancreatic ACC/MANC were 100% and 95% for CPA1 and 84% and 93% for REG1a, respectively. In conclusion, CPA1 and REG1a are sensitive markers for ACC that can be used as additional acinar cell differentiation markers to help in the diagnosis of pancreatic ACC and MANC. A negative result for CPA1 virtually excludes ACC/MANC.

Dermoscopy of plaque psoriasis differs with plaque location, its duration, and patient's sex.

Literature data on dermoscopic features of psoriasis vulgaris are inconsistent. The aim of the study was to evaluate whether dermoscopic features of psoriatic plaques differ with anatomic location or any clinical characteristics. Clinical evaluation and videodermoscopy of psoriatic plaques located on the face, chest, abdomen, forearms, lower legs, back, and scalp were performed in 50 patients with psoriasis vulgaris. A total of 306 plaques were evaluated. Videodermoscopy with a 20-fold magnification revealed red dots and globules in 306/306 (100%) plaques, arranged in diffuse (170/306, 56%), patchy (117/306, 38%), or polygonal (19/306, 6%) pattern. A 70 fold magnification of these vessels revealed the presence of bushy vessels (213/306, 70%) and twisted loops (107/306, 35%), with the latter occurring more commonly on the scalp and face (P<.001). In lesions lasting less or equal 5weeks on forearms and scalp, patchy distribution of the scale predominated, whereas in older lesions-diffuse type (forearm P=.005, scalp P=.017). Diffuse distribution of the scale in lesions located on the face was more common in women, than men (P=.003). Videodermoscopic picture of psoriatic plaques may differ with the anatomic location and duration of the psoriatic plaque and with patient's sex.

Dermoscopic clues of palmoplantar hyperkeratotic eczema and palmoplantar psoriasis: A prospective, comparative study of 90 patients.

Diagnosis can be difficult in isolated palmar and plantar lesions in patients with psoriasis and eczema. The purpose of our study is to compare the dermoscopic findings in patients with palmoplantar psoriasis and palmoplantar hyperkeratotic eczema. This prospective, comparative study included 90 patients histopathologically diagnosed with eczema or psoriasis (35 psoriasis and 55 eczema). The age range was 18-75years. The most common vessel type was dot vessel in psoriasis. Red globular ring vessels were seen in five patients with psoriasis, but not in any with eczema (P=0.007). The most common vascular distribution pattern was regular in psoriasis (40%). Patchy vascular pattern was significant in eczema. The most common background color was light red in psoriasis (48.6%) (P<0.001). Brownish-orange globules were observed in 25.7% of patients with eczema and 5.7% in patients with psoriasis (P=0.02). There is only one study in the published work about dermoscopy of palmoplantar psoriasis and eczema. In our study, yellow crusts, patchy scale distribution, patchy vascular pattern, yellow scale color, dull red background color and brownish-orange globules were significant in patients with palmoplantar eczema. On the other hand, patients with psoriasis had light red background color, regular vascular distribution pattern and white scale color. We observed globule structures with a pale center and dark peripheral rim only in patients with eczema, which was not identified in previous studies. This globule structure may be a new finding in eczema.

Proteus syndrome of the foot: A case report and literature review.

Proteus syndrome (PS) is an extremely rare and sporadic disorder characterized by asymmetric and/or disproportionate overgrowth of limbs, hamartomas, and vascular malformations. The onset of overgrowth usually involves the skin, bone, fat, and other connective tissues in a patchy or mosaic pattern. Partial gigantism of the affected limb or digit is a pathognomonic sign of PS. Thus far, only a few cases of PS have been recorded in the literature. In the present report, a case of PS in a 35-year old woman with classic cerebriform plantar hyperplasia and macrodactyly of the left foot was documented. The clinical and molecular characteristics and differential diagnosis of PS are also discussed in this report.

Kecenderungan Naiknya Suhu Permukaan Laut dan Resiliensi Karang Setelah Kejadian Pemutihan Karang 2010 dan 2016 di Taman Wisata Perairan (TWP) Pulau Pieh, Padang, Sumatra Barat

&lt;strong&gt;Trend of Sea Surface Temperature Increase and Coral Resilience After Bleaching Events of 2010 and 2016 in The Marine Tourism Park (TWP) of Pieh Island, Padang, West Sumatra&lt;/strong&gt;. The coral bleaching event has hit almost all of Indonesia's waters at least 4 times (in the last 34 years), which the last two events (2010 and 2016) have been discussed rather deeply. However, detailed studies in a specific location, such as in Marine Tourism Park (TWP) of Pieh Island, Padang waters, West Sumatra Province that influenced by the water mass of Indian Ocean have not yet been studied. The aim of this paper is to examine the trend of sea surface temperatures (SST)’s increase in the TWP of Pieh Island in 2010 and 2016 coral bleaching, and the coral resilience after the events. In this study, the long-term SST data acquired from the Aqua MODIS satellite images were used intensively. Results show that the highest mean monthly SST called MMM that corals can be tolerated in the TWP of Pieh is 29.6 &lt;sup&gt;o&lt;/sup&gt;C, higher than in all Indonesian waters (29.1 &lt;sup&gt;o&lt;/sup&gt;C).The differences between the anomaly SST and the normal SST (MMM) or called Hot Spot (HS) has exceeded the average MMM in the 2010 bleaching event around 0.4-0.5 &lt;sup&gt;o&lt;/sup&gt;C with its peak in April, and with alert-1 severity (Degree Heating Weeks (DHW) &amp;lt; 8 &lt;sup&gt;o&lt;/sup&gt;C-weeks; which means that the coral has partial bleaching with patchy pattern).In 2016, the HS increased by an average of 0.5 ~ 1.0 &lt;sup&gt;o&lt;/sup&gt;C with peaks in January-February and May-June and with the severity of Alert-2 (DHW ≥ 8 &lt;sup&gt;o&lt;/sup&gt;C-weeks, which means corals experienced severe bleaching, over wider areas, and some of corals are died). One year earlier (2015), higher HS with an average value of 0.3-0.8 &lt;sup&gt;o&lt;/sup&gt;C and DHW ~ 4 &lt;sup&gt;o&lt;/sup&gt;C-weeks were also observed. This indicates that coral bleaching events in the TWP of Pieh Island is repeated and occurs for long periods.The trend of increasing SST in this TWP is 0.23&lt;sup&gt;o&lt;/sup&gt;C/decade, lower than in the all Indonesian waters (0.36 &lt;sup&gt;o&lt;/sup&gt;C/decade). This trend shows that coral reefs in Indonesian waters including this TWP have a high resilience to recover themselves from bleaching, since the trend of increasing SST &amp;lt; 1.0 &lt;sup&gt;o&lt;/sup&gt;C/decade of the 11 coral resilience key factors, positive factors that support high coral resilience are low pollution/nutrients, low sedimentation (high water transparency), and low unfriendly of human activities, while the most negative one is the explosion of crown-of-thorns starfish, Acanthaster planci population as well as coral disease.