S100A6 preferentially labels type C nevus cells and nevic corpuscles: additional support for Schwannian differentiation of intradermal nevi

Melanocytic nevi typically show a morphologic sequence of maturation from epithelioid “type A” cells to fusiform, Schwann cell-like “type C” cells with dermal descent. Nevi may also produce Wagner-Meissner-like structures (nevic corpuscles). Previous studies have shown that this maturation of intradermal nevi recapitulates intermediate stages in Schwann cell development. In intradermal nevi, we have evaluated the pattern of S100A6 protein, a form of S100 found in Schwann cells. Methods: Formalin-fixed, paraffin-embedded archival tissues were evaluated by immunohistochemistry using antibodies specific for S100A6 and S100B in 38 intradermal nevi (IDN). Ten neurofibromas (NF), 3 Schwannomas (SCH), 2 palisaded and encapsulated neuromas (PEN), and 2 granular cell tumors (GCT) were included as positive controls since these lesions have large numbers of Schwann cells. Results: Melanocytic nevi demonstrated preferential anti-S100A6 staining of “type C” cells (36/38; 28 strong, 8 weak) and nevic corpuscles (25/38; 19 strong, 6 weak) compared to “type A” cells (17/38; 17 weak) and “type B” cells (17/38; 4 strong, 13 weak). All NF, SCH, and PEN stained strongly with anti-S100A6. Both GCT were negative with anti-S100A6 but positive with anti-S100B. Conclusions: The pattern of S100A6 expression in intradermal nevi further supports the hypothesis that maturation in these lesions recapitulates features of Schwann cell differentiation. The lack of S100A6 expression by both GCT suggests that these lesions have lost this feature of Schwann cells, which may play a role in their peculiar phenotypic appearance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75660/1/j.1600-0560.2001.028008393.x.pd

Linking floral biodiversity with nitrogen and carbon translocations in semi-natural grasslands in Lithuania

© 2015 The Authors. Published by Walter de Gruyter/Sciendo. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1515/eko-2015-0014The aim of the present study is to evaluate the long-term effects of long-term piggery effluent application on semi-natural grassland ecotop-phytotop changes (above- and below-ground phytomass production, and carbon and nitrogen allocation in grassland communities) in relation to changes (or variability) in topsoil properties. Analysis of phytomass distribution in piggery effluent irrigated grassland communities showed that dry biomass yield varied from 1.7-5.3 t ha-1. Variability in soil and plant cover created a unique and highly unpredictable site specific system, where long-term anthropogenic influences established successor communities with specific characteristics of above- and below-ground biomass distribution. These characteristics depend more on grassland communities than on soil chemical properties. Families of grasses (Poaceae) dominated the surveyed communities and accumulated most carbon and least nitrogen, while legumes accumulated most nitrogen and lignin and least carbon. Carbon concentrations in above-ground biomass had minor variations, while accumulation of nitrogen was strongly influenced by species diversity (r = 0.94, n = 10, p <0.001) and production of above-ground biomass.Published versio

CD34‐positive superficial myxofibrosarcoma: a potential diagnostic pitfall

Background Myxofibrosarcoma (MFS) arises most commonly in the proximal extremities of the elderly, where it may involve subcutaneous and dermal tissues and masquerade as benign entities in limited biopsy samples. We encountered such a case, in which positivity for CD34 and morphologic features were initially wrongly interpreted as a ‘low‐fat/fat‐free’ spindle cell/pleomorphic lipoma. Case series have not assessed prevalence of CD34 reactivity among cutaneous examples of MFS. Methods We performed a systematic review of our institution's experience, selecting from among unequivocal MFS resection specimens those superficial cases in which a limited biopsy sample might prove difficult to interpret. These cases were immunostained for CD34 and tabulated for clinicopathologic characteristics. Results After review of all MFS diagnoses over 5 years (n = 56), we identified a study group of superficial MFS for comparison to the index case (total n = 8). Of these, the index and three additional cases (4 of 8, 50%; 2 low, 2 high grade) demonstrated positive staining for CD34 , with diffuse staining of spindled cells including cellular processes. Four additional cases showed no or equivocal/rare staining. Conclusions CD34 positivity should be recognized as prevalent among such cases and should not be inappropriately construed as inveighing against a diagnosis of MFS in favor of benign entities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98187/1/cup12158.pd

Connecting With Clients in Later Life: The Use of Telebehavioral Health to Address Older Adults’ Mental Health Needs

Telebehavioral health offers a unique opportunity to expand access to mental health services for older clients by addressing systemic barriers that often render mental health care inaccessible in later life. Although health interventions facilitated by technology, including telebehavioral health approaches, proliferated at the start of the COVID-19 pandemic, little guidance exists for counselors seeking to provide such services to clients in later life. In this manuscript, we describe challenges accessing mental health services, how telebehavioral health services can address these barriers, and practical consideration for delivering telebehavioral health approaches for counselors who work with older clients

Comprehensive histopathological comparison of epidermotropic/dermal metastatic melanoma and primary nodular melanoma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141829/1/his13384.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141829/2/his13384_am.pd

The application of proximal visible and near-infrared spectroscopy to estimate soil organic matter on the Triffa Plain of Morocco

© 2020 Soil organic matter (SOM) is a fundamental soil constituent. The estimation of this parameter in the laboratory using the classical method is complex time-consuming and requires the use of chemical reagents. The objectives of this study were to assess the accuracy of two laboratory measurement setups of the VIS-NIR spectroscopy in estimating SOM content and determine the important spectral bands in the SOM estimation model. A total of 115 soil samples were collected from the non-root zone (0–20 cm) of soil in the study area of the Triffa Plain and then analysed for SOM in the laboratory by the Walkley–Black method. The reflectance spectra of soil samples were measured by two protocols, Contact Probe (CP) and Pistol Grip (PG)) of the ASD spectroradiometer (350–2500 nm) in the laboratory. Partial least squares regression (PLSR) was used to develop the prediction models. The results of coefficient of determination (R2) and the root mean square error (RMSE) showed that the pistol grip offers reasonable accuracy with an R2 = 0.93 and RMSE = 0.13 compared to the contact probe protocol with an R2 = 0.85 and RMSE = 0.19. The near-Infrared range were more accurate than those in the visible range for predicting SOM using the both setups (CP and PG). The significant wavelengths contributing to the prediction of SOM for (PG) setup were at: 424, 597, 1432, 1484, 1830,1920, 2200, 2357 and 2430 nm, while were at 433, 587, 1380, 1431, 1929, 2200 and 2345 nm for (CP) setup

The application of proximal visible and near-infrared spectroscopy to estimate soil organic matter on the Triffa Plain of Morocco

© 2020 The Authors. Published by Elsevier. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1016/j.iswcr.2020.04.005Soil organic matter (SOM) is a fundamental soil constituent. The estimation of this parameter in the laboratory using the classical method is complex time-consuming and requires the use of chemical reagents. The objectives of this study were to assess the accuracy of two laboratory measurement setups of the VIS-NIR spectroscopy in estimating SOM content and determine the important spectral bands in the SOM estimation model. A total of 115 soil samples were collected from the non-root zone (0–20 cm) of soil in the study area of the Triffa Plain and then analysed for SOM in the laboratory by the Walkley–Black method. The reflectance spectra of soil samples were measured by two protocols, Contact Probe (CP) and Pistol Grip (PG)) of the ASD spectroradiometer (350–2500 nm) in the laboratory. Partial least squares regression (PLSR) was used to develop the prediction models. The results of coefficient of determination (R2) and the root mean square error (RMSE) showed that the pistol grip offers reasonable accuracy with an R2 = 0.93 and RMSE = 0.13 compared to the contact probe protocol with an R2 = 0.85 and RMSE = 0.19. The near-Infrared range were more accurate than those in the visible range for predicting SOM using the both setups (CP and PG). The significant wavelengths contributing to the prediction of SOM for (PG) setup were at: 424, 597, 1432, 1484, 1830,1920, 2200, 2357 and 2430 nm, while were at 433, 587, 1380, 1431, 1929, 2200 and 2345 nm for (CP) setup.The authors acknowledge the facilities and financial supports provided by the Mohammed First University and the National Institute of Agronomic Research (INRA) of Oujda.Published versio

Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework

Background: The Theoretical Domains Framework (TDF) was developed to investigate determinants of specific clinical behaviors and inform the design of interventions to change professional behavior. This framework was used to explore the beliefs of chiropractors in an American Provider Network and two Canadian provinces about their adherence to evidence-based recommendations for spine radiography for uncomplicated back pain. The primary objective of the study was to identify chiropractors’ beliefs about managing uncomplicated back pain without xrays and to explore barriers and facilitators to implementing evidence-based recommendations on lumbar spine xrays. A secondary objective was to compare chiropractors in the United States and Canada on their beliefs regarding the use of spine x-rays. Methods: Six focus groups exploring beliefs about managing back pain without x-rays were conducted with a purposive sample. The interview guide was based upon the TDF. Focus groups were digitally recorded, transcribed verbatim, and analyzed by two independent assessors using thematic content analysis based on the TDF. Results: Five domains were identified as likely relevant. Key beliefs within these domains included the following: conflicting comments about the potential consequences of not ordering x-rays (risk of missing a pathology, avoiding adverse treatment effects, risks of litigation, determining the treatment plan, and using x-ray-driven techniques contrasted with perceived benefits of minimizing patient radiation exposure and reducing costs; beliefs about consequences); beliefs regarding professional autonomy, professional credibility, lack of standardization, and agreement with guidelines widely varied (social/professional role & identity); the influence of formal training, colleagues, and patients also appeared to be important factors (social influences); conflicting comments regarding levels of confidence and comfort in managing patients without x-rays (belief about capabilities); and guideline awareness and agreements (knowledge). Conclusions: Chiropractors’ use of diagnostic imaging appears to be influenced by a number of factors. Five key domains may be important considering the presence of conflicting beliefs, evidence of strong beliefs likely to impact the behavior of interest, and high frequency of beliefs. The results will inform the development of a theorybased survey to help identify potential targets for behavioral-change strategies

Using theory to improve low back pain care in Australian Aboriginal primary care: a mixed method single cohort pilot study

Background: Low back pain (LBP) care is frequently discordant with research evidence. This pilot study evaluated changes in LBP care following a systematic, theory informed intervention in a rural Australian Aboriginal Health Service. We aimed to improve three aspects of care; reduce inappropriate LBP radiological imaging referrals, increase psychosocial oriented patient assessment and, increase the provision of LBP self-management information to patients. Methods: Three interventions to improve care were developed using a four-step systematic implementation approach. A mixed methods pre/post cohort design evaluated changes in the three behaviours using a clinical audit of LBP care in a six month period prior to the intervention and then following implementation. In-depth interviews elicited the perspectives of involved General Practitioners (GPs). Qualitative analysis was guided by the theoretical domains framework. Results: The proportion of patients who received guideline inconsistent imaging referrals (GICI) improved from 4.1 GICI per 10 patients to 0.4 (95 % CI for decrease in rate: 1.6 to 5.6) amongst GPs involved in the intervention. Amongst non-participating GPs (locum/part-time GPs who commenced post-interventions) the rate of GICI increased from 1.5 to 4.4 GICI per 10 patients (95 % CI for increase in rate: .5 to 5.3). There was a modest increase in the number of patients who received LBP self-management information from participating GPs and no substantial changes to psychosocial oriented patient assessments by any participants; however GPs qualitatively reported that their behaviours had changed. Knowledge and beliefs about consequences were important behavioural domains related to changes. Environmental and resource factors including protocols for locum staff and clinical tools embedded in patient management software were future strategies identified. Conclusions: A systematic intervention model resulted in partial improvements in LBP care. Determinants of practice change amongst GPs were increased knowledge of clinical guidelines, education delivered by someone considered a trusted source of information, and awareness of the negative consequences of inappropriate practices, especially radiological imaging on patient outcomes. Inconsistent and non-evidence based practices amongst locum GPs was an issue that emerged and will be a significant future challenge. The systematic approach utilised is applicable to other services interested in improving LBP care