Epithelioid variant of pleomorphic liposarcoma as potential mimic of metastatic carcinoma

We report a case of epithelioid variant of pleomorphic liposarcoma (EPL) found in the the infrapatellar fat pad of Hoffa of a 31-year old male. Histologically, the predominant population was formed by epithelioid cells with eosinophilic or clear cytoplasm admixed with rare pleomorphic lipoblasts. The immunohistochemical panel was not helpful in the diagnosis. FISH analysis using the locus-specific indicator CHOP (12q13) dual color break apart was applied to representative formalin-fixed, paraffin-embedded tissue sections. The result of FISH indicated a rearranged CHOP (DDIT3) gene and confirmed the diagnosis of EPL. The EPL should be differentiated from a metastatic carcinoma or other type of sarcoma. In these cases a clinicopathological correlation and an exhaustive sampling of the specimen for demonstration of lipogenic areas or pleomorphic lipoblasts is always necessary. FISH with demonstration of CHOP gene rearrangement is useful in providing specific ancillary information for the difficult differential diagnosis of this case

Relative Stability of Core Groups in Pollination Networks in a Biodiversity Hotspot over Four Years

Plants and their pollinators form pollination networks integral to the evolution and persistence of species in communities. Previous studies suggest that pollination network structure remains nested while network composition is highly dynamic. However, little is known about temporal variation in the structure and function of plant-pollinator networks, especially in species-rich communities where the strength of pollinator competition is predicted to be high. Here we quantify temporal variation of pollination networks over four consecutive years in an alpine meadow in the Hengduan Mountains biodiversity hotspot in China. We found that ranked positions and idiosyncratic temperatures of both plants and pollinators were more conservative between consecutive years than in non-consecutive years. Although network compositions exhibited high turnover, generalized core groups – decomposed by a k-core algorithm – were much more stable than peripheral groups. Given the high rate of turnover observed, we suggest that identical plants and pollinators that persist for at least two successive years sustain pollination services at the community level. Our data do not support theoretical predictions of a high proportion of specialized links within species-rich communities. Plants were relatively specialized, exhibiting less variability in pollinator composition at pollinator functional group level than at the species level. Both specialized and generalized plants experienced narrow variation in functional pollinator groups. The dynamic nature of pollination networks in the alpine meadow demonstrates the potential for networks to mitigate the effects of fluctuations in species composition in a high biodiversity area

Fluid challenges in intensive care: the FENICE study A global inception cohort study

Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC.This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC.2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500-1000). The median time was 24 min (40-60 min), and the median rate of FC was 1000 [500-1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57-61 %). In 43 % (CI 41-45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34-37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20-24 %). No safety variable for the FC was used in 72 % (CI 70-74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response.The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account

The bacterial dicarboxylate transporter VcINDY uses a two-domain elevator-type mechanism

Secondary transporters use alternating-access mechanisms to couple uphill substrate movement to downhill ion flux. Most known transporters use a 'rocking bundle' motion, wherein the protein moves around an immobile substrate-binding site. However, the glutamate-transporter homolog GltPh translocates its substrate-binding site vertically across the membrane, through an 'elevator' mechanism. Here, we used the 'repeat swap' approach to computationally predict the outward-facing state of the Na(+)/succinate transporter VcINDY, from Vibrio cholerae. Our model predicts a substantial elevator-like movement of VcINDY's substrate-binding site, with a vertical translation of ~15 Å and a rotation of ~43°. Our observation that multiple disulfide cross-links completely inhibit transport provides experimental confirmation of the model and demonstrates that such movement is essential. In contrast, cross-links across the VcINDY dimer interface preserve transport, thus revealing an absence of large-scale coupling between protomers

Reliability of hip muscle strength measured in principal and intermediate planes of movement

Background. Muscle strength testing is widely used in clinical and athletic populations. Commercially available dynamometers are designed to assess strength in three principal planes (sagittal, transverse, frontal). However, the anatomy of the hip suggests muscles may only be recruited submaximally during tasks performed in these principal planes. Objective. To evaluate the inter-session reliability of maximal isometric hip strength in the principal planes and three intermediate planes. Methods. Twenty participants (26.1 ± 2.7 years, 50% female) attended two testing sessions 6.2 ± 1.8 days apart. Participants completed 3-5 maximal voluntary isometric contractions for hip abduction, adduction, flexion, extension, and internal and external rotation measured using a fixed uniaxial load cell (custom rig) and commercial dynamometer (Biodex). Three intermediate hip actions were also tested using the custom rig: Extension with abduction, extension with external rotation, and extension with both abduction and external rotation. Results. Moderate-to-excellent intraclass correlation coefficients were observed for all principal and intermediate muscle actions using the custom rig (0.72-0.95) and the Biodex (0.85-0.95). The minimum detectable change was also similar between devices (custom rig D 11-31%; Biodex = 9-20%). Bland-Altman analysis revealed poor agreement between devices (range between upper and lower limits of agreement = 77-131%). Conclusions. Although the custom rig and Biodex showed similar reliability, both devices may lack the sensitivity to detect small changes in hip strength commonly observed following intervention.Full Tex

Electromyography measurements of the deep hip muscles do not improve estimates of hip contact force

The deep hip muscles are often omitted in studies investigating hip contact forces using neuromusculoskeletal modelling methods. However, recent evidence indicates the deep hip muscles have potential to change the direction of hip contact force and could have relevance for hip contact loading estimates. Further, it is not known whether deep hip muscle excitation patterns can be accurately estimated using neuromusculoskeletal modelling or require measurement (through invasive and time-consuming methods) to inform models used to estimate hip contact forces. We calculated hip contact forces during walking, squatting, and squat-jumping for 17 participants using electromyography (EMG)-informed neuromusculoskeletal modelling with (informed) and without (synthesized) intramuscular EMG for the deep hip muscles (piriformis, obturator internus, quadratus femoris). Hip contact force magnitude and direction, calculated as the angle between hip contact force and vector from femoral head to acetabular center, were compared between configurations using a paired t-test deployed through statistical parametric mapping (P < 0.05). Additionally, root mean square error, correlation coefficients (R2), and timing accuracy between measured and modelled deep hip muscle excitation patterns were computed. No significant between-configuration differences in hip contact force magnitude or direction were found for any task. However, the synthesized method poorly predicted (R2-range 0.02–0.3) deep hip muscle excitation patterns for all tasks. Consequently, intramuscular EMG of the deep hip muscles may be unnecessary when estimating hip contact force magnitude or direction using EMG-informed neuromusculoskeletal modelling, though is likely essential for investigations of deep hip muscle function.No Full Tex