Cutaneous metastasis from colorectal cancer: Making light on an unusual and misdiagnosed event

Cutaneous metastasis from solid tumors is a rare event and usually represents a late occurrence in the natural history of an advanced visceral malignancy. Rarely, cutaneous metastasis has been described in colorectal cancer patients. The most frequent cutaneous site of colorectal metastasis is the surgical scar in the abdomen following the removal of the primary malignancy, followed by the extremities, perineum, head, neck, and penis. Metastases to the thigh and back of the trunk are anecdotical. Dermatological diagnosis of cutaneous metastasis can be quite complex, especially in unusual sites, such as in the facial skin or thorax and in cases of single cutaneous lesions since metastasis from colorectal cancer is not usually the first clinical hypothesis, leading to misdiagnosis. To date, due to the rarity of cutaneous metastasis from colorectal cancer, little evidence, most of which is based on case reports and very small case series, is currently available. Therefore, a better understanding of the clinic-pathological characteristics of this unusual metastatic site represents an unmet clinical need. We present a large series of 29 cutaneous metastases from colorectal cancer with particular concerns regarding anatomic localization and the time of onset with respect to primitive colorectal cancer and visceral metastases

axl has a prognostic role in metastatic colorectal cancer mcrc and is a predictive biomarker of lack of efficacy of chemotherapy ct cetuximab in ras wild type wt patients pts

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Poor correlation between large-scale environmental flow violations and freshwater biodiversity: implications for water resource management and the freshwater planetary boundary

The freshwater ecosystems around the world are degrading, such that maintaining environmental flow1 (EF) in river networks is critical to their preservation. The relationship between streamflow alterations (subsequent EF violations2) and the freshwater biodiversity response is well established at the scale of stream reaches or small basins (∼&lt;100 km2). However, it is unclear if this relationship is robust at larger scales, even though there are large-scale initiatives to legalize the EF requirement. Moreover, EFs have been used in assessing a planetary boundary3 for freshwater. Therefore, this study intends to conduct an exploratory evaluation of the relationship between EF violation and freshwater biodiversity at globally aggregated scales and for freshwater ecoregions. Four EF violation indices (severity, frequency, probability of shifting to a violated state, and probability of staying violated) and seven independent freshwater biodiversity indicators (calculated from observed biota data) were used for correlation analysis. No statistically significant negative relationship between EF violation and freshwater biodiversity was found at global or ecoregion scales. These findings imply the need for a holistic bio-geo-hydro-physical approach in determining the environmental flows. While our results thus suggest that streamflow and EF may not be the only determinant of freshwater biodiversity at large scales, they do not preclude the existence of relationships at smaller scales or with more holistic EF methods (e.g., including water temperature, water quality, intermittency, connectivity, etc.) or with other biodiversity data or metrics.</p

A model of direction selectivity in the starburst amacrine cell network

Displaced starburst amacrine cells (SACs) are retinal interneurons that exhibit GABAA receptor-mediated and Cl− cotransporter-mediated, directionally selective (DS) light responses in the rabbit retina. They depolarize to stimuli that move centrifugally through the receptive field surround and hyperpolarize to stimuli that move centripetally through the surround (Gavrikov et al, PNAS 100(26):16047–16052, 2003, PNAS 103(49):18793–18798, 2006). They also play a key role in the activity of DS ganglion cells (DS GC; Amthor et al, Vis Neurosci 19:495–509 2002; Euler et al, Nature 418:845–852, 2002; Fried et al, Nature 420:411– 414, 2002; Gavrikov et al, PNAS 100(26):16047–16052, 2003, PNAS 103(49):18793–18798, 2006; Lee and Zhou, Neuron 51:787–799 2006; Yoshida et al, Neuron 30:771–780, 2001). In this paper we present a model of strong DS behavior of SACs which relies on the GABA-mediated communication within a tightly interconnected network of these cells and on the glutamate signal that the SACs receive from bipolar cells (a presynaptic cell that receives input from cones). We describe how a moving light stimulus can produce a large, sustained depolarization of the SAC dendritic tips that point in the direction that the stimulus moves (i.e., centrifugal motion), but produce a minimal depolarization of the dendritic tips that point in the opposite direction (i.e., centripetal motion). This DS behavior, which is quantified based on the relative size and duration of the depolarizations evoked by stimulus motion at dendritic tips pointing in opposite directions, is robust to changes of many different parameter values and consistent with experimental data. In addition, the DS behavior is strengthened under the assumptions that the Cl− cotransporters Na + -K + -Cl − and K + -Cl − are located in different regions of the SAC dendritic tree (Gavrikov et al, PNAS 103(49):18793–18798, 2006) and that GABA evokes a long-lasting response (Gavrikov et al, PNAS 100(26):16047–16052, 2003, PNAS 103(49):18793–18798, 2006; Lee and Zhou, Neuron 51:787–799, 2006). A possible mechanism is discussed based on the generation of waves of local glutamate and GABA secretion, and their postsynaptic interplay as the waves travel between cell compartments

Managed Aquifer Recharge as a Tool to Enhance Sustainable Groundwater Management in California

A growing population and an increased demand for water resources have resulted in a global trend of groundwater depletion. Arid and semi-arid climates are particularly susceptible, often relying on groundwater to support large population centers or irrigated agriculture in the absence of sufficient surface water resources. In an effort to increase the security of groundwater resources, managed aquifer recharge (MAR) programs have been developed and implemented globally. MAR is the approach of intentionally harvesting and infiltrating water to recharge depleted aquifer storage. California is a prime example of this growing problem, with three cities that have over a million residents and an agricultural industry that was valued at 47 billion dollars in 2015. The present-day groundwater overdraft of over 100 km3 (since 1962) indicates a clear disparity between surface water supply and water demand within the state. In the face of groundwater overdraft and the anticipated effects of climate change, many new MAR projects are being constructed or investigated throughout California, adding to those that have existed for decades. Some common MAR types utilized in California include injection wells, infiltration basins (also known as spreading basins, percolation basins, or recharge basins), and low-impact development. An emerging MAR type that is actively being investigated is the winter flooding of agricultural fields using existing irrigation infrastructure and excess surface water resources, known as agricultural MAR. California therefore provides an excellent case study to look at the historical use and performance of MAR, ongoing and emerging challenges, novel MAR applications, and the potential for expansion of MAR. Effective MAR projects are an essential tool for increasing groundwater security, both in California and on a global scale. This chapter aims to provide an overview of the most common MAR types and applications within the State of California and neighboring semi-arid regions

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Fate of water pumped from underground and contributions to sea-level rise

The contributions from terrestrial water sources to sea-level rise, other than ice caps and glaciers, are highly uncertain and heavily debated.. Recent assessments indicate that groundwater depletion (GWD) may become the most important positive terrestrial contribution over the next 50 years, probably equal in magnitude to the current contributions from glaciers and ice caps6. However, the existing estimates assume that nearly 100% of groundwater extracted eventually ends up in the oceans. Owing to limited knowledge of the pathways and mechanisms governing the ultimate fate of pumped groundwater, the relative fraction of global GWD that contributes to sea-level rise remains unknown. Here, using a coupled climate–hydrological model simulation, we show that only 80% of GWD ends up in the ocean. An increase in runoff to the ocean accounts for roughly two-thirds, whereas the remainder results from the enhanced net flux of precipitation minus evaporation over the ocean, due to increased atmospheric vapour transport from the land to the ocean. The contribution of GWD to global sea-level rise amounted to 0.02 (±0.004) mm yr−1 in 1900 and increased to 0.27 (±0.04) mm yr−1 in 2000. This indicates that existing studies have substantially overestimated the contribution of GWD to global sea-level rise by a cumulative amount of at least 10 mm during the twentieth century and early twenty-first century. With other terrestrial water contributions included, we estimate the net terrestrial water contribution during the period 1993–2010 to be +0.12 (±0.04) mm yr−1, suggesting that the net terrestrial water contribution reported in the IPCC Fifth Assessment Report report is probably overestimated by a factor of three