Vegetation history and climatic fluctuations on a transect along the Dead Sea west shore and impact on past societies over the last 3500 years.

This study represents the vegetation history of the last 3500 years and conducts an analysis of the climatic fluctuations on a 75 km long transect on the western Dead Sea shore. Palynological and sedimentological data are available from six cores near Mount Sedom, Ein Boqueq, and Ein Gedi and from outcrops near Ze'elim and Ein Feshkha. The comparison of the pollen data with the lake levels shows synchronous trends. During the Middle Bronze Age, Iron Age and Hellenistic to Byzantine Period the high lake level of the Dead Sea signals an increase in precipitation. Contemporaneously, values of cultivated plants indicate an increase in agriculture. Lake level is low during the Late Bronze Age, within the Iron Age and at the end of the Byzantine period, indicating dry periods when all pds show a decrease of cultivated plants. Forest regeneration led by drought-resistant pines is observed in all pollen diagrams (pds) following the agricultural decline in the Byzantine period and, in the pds near Ein Boqeq, Ze'elim and Ein Feshkha, during the late Iron Age. The modern vegetation gradient is reflected in the palaeo-records: a stronger expansion of Mediterranean vegetation and cultivated plants in the northern sites is recognisable

Using palynology to re-assess the Dead Sea laminated sediments – indeed varves?

Lacustrine laminated sediments are often varves representing annual rhythmic deposition. The Dead Sea high-stand laminated sections consist of mm-scale alternating detrital and authigenic aragonite laminae. Previous studies assumed these laminae were varves deposited seasonally. However, this assumption has never been robustly validated. Here we report an examination of the seasonal deposition of detrital-aragonite couplets from two well-known Late Holocene laminated sections at the Ze’elim fan-delta using palynology and grain-size distribution analyses. These analyses are complemented by the study of contemporary flash-flood samples and multivariate statistical analysis. Because transport affects the pollen preservation state, well–preserved (mostly) air-borne transported pollen was analysed separately from badly-preserved pollen and fungal spores, which are more indicative of water transport and reworking from soils. Our results indicate that (i) both detrital and aragonite laminae were deposited during the rainy season; (ii) aragonite laminae have significantly lower reworked and fungal spore concentrations than detrital and flash-flood samples; and (iii) detrital laminae are composed of recycling of local and distal sources, with coarser particles that were initially deposited in the Dead Sea watershed and later transported via run-off to the lake. This is in line with previous carbon balance studies that showed that aragonite precipitation occurs after the massive input of TCO2 associated with run-off episodes. Consequently, at least for the Holocene Ze’elim Formation, laminated sediments cannot be considered as varves. Older Quaternary laminated sequences should be re-evaluated

Interpreting Soft Sediment Deformation and Mass Transport Deposits as Seismites in the Dead Sea Depocenter

Peer reviewedPublisher PD

Congenital Midline Nodules on the Chin and Sternum

History: A 5-day old black male full-term neonate born via vacuum-assisted delivery for non-reassuring fetal heart rate presented with congenital presentation of two asymptomatic midline lesions which appeared asymptomatic. There was no history of seizures, ophthalmologic findings, abnormalities in head circumference, height, weight or limb size. Newborn screening examination was unremarkable. Examination: On the midline submental chin there was a soft, brown dome-shaped plaque measuring 0.8-centimeters with a circumferential ring of light brown pigmentation; on the midline upper chest there was a light brown 2-millimeter dome-shaped papule. Course and Therapy: Ultrasound of the submental chin lesion revealed a 0.5 x 0.8 x 0.4-centimeter heterogeneously hypoechoic structure with a peripheral soft tissue rind. Punch biopsies of the submental chin and the midline upper chest revealed haphazardly arranged striated muscle fibers in the dermis, some of which inserted directly into the epidermis. The muscle fibers were highlighted by Masson’s trichrome and myogenin. Alcian blue revealed increased dermal mucin. Discussion: Striated muscle hamartomas (SMH) are rare, benign congenital skin tumors characterized by haphazard arrangement of mature striated skeletal muscle, collagen, nerve bundles, and adipose tissue in the dermal and subcutaneous tissue. Although a rare entity, it is important to recognize this benign hamartoma as a congenital midline defect. Conservative management with clinical monitoring is recommended if cosmetically acceptable, as spontaneous regression over a period of years has been reported. Surgical excision may be pursued; however, the hamartoma may recur.https://scholarlycommons.henryford.com/merf2020caserpt/1133/thumbnail.jp

Targeted high-throughput sequencing for genetic diagnostics of hemophagocytic lymphohistiocytosis

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rapid-onset, potentially fatal hyperinflammatory syndrome. A prompt molecular diagnosis is crucial for appropriate clinical management. Here, we validated and prospectively evaluated a targeted high-throughput sequencing approach for HLH diagnostics. Methods: A high-throughput sequencing strategy of 12 genes linked to HLH was validated in 13 patients with previously identified HLH-associated mutations and prospectively evaluated in 58 HLH patients. Moreover, 2504 healthy individuals from the 1000 Genomes project were analyzed in silico for variants in the same genes. Results: Analyses revealed a mutation detection sensitivity of 97.3 %, an average coverage per gene of 98.0 %, and adequate coverage over 98.6 % of sites previously reported as mutated in these genes. In the prospective cohort, we achieved a diagnosis in 22 out of 58 patients (38 %). Genetically undiagnosed HLH patients had a later age at onset and manifested higher frequencies of known secondary HLH triggers. Rare, putatively pathogenic monoallelic variants were identified in nine patients. However, such monoallelic variants were not enriched compared with healthy individuals. Conclusions: We have established a comprehensive high-throughput platform for genetic screening of patients with HLH. Almost all cases with reduced natural killer cell function received a diagnosis, but the majority of the prospective cases remain genetically unexplained, highlighting genetic heterogeneity and environmental impact within HLH. Moreover, in silico analyses of the genetic variation affecting HLH-related genes in the general population suggest caution with respect to interpreting causality between monoallelic mutations and HLH. A complete understanding of the genetic susceptibility to HLH thus requires further in-depth investigations, including genome sequencing and detailed immunological characterization.Peer reviewe

US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017.Comment: 102 pages + reference

No impact of early intervention on late outcome after minimal, mild and moderate head injury

<p>Abstract</p> <p>Objectives</p> <p>To evaluate the effect of an educational intervention on outcome after minimal, mild and moderate head injury.</p> <p>Methods</p> <p>Three hundred and twenty six patients underwent stratified randomization to an intervention group (n = 163) or a control group (n = 163). Every second patient was allocated to the intervention group. Participants in this group were offered a cognitive oriented consultation two weeks after the injury, while subjects allocated to the control group were not. Both groups were invited to follow up 3 and 12 months after injury.</p> <p>Results</p> <p>A total of 50 (15%) patients completed the study (intervention group n = 22 (13%), control group n = 28 (17%), not significant). There were no statistically significant differences between the intervention group and the control group.</p> <p>Conclusions</p> <p>There was no effect on outcomes from an early educational intervention two weeks after head injury.</p

26856 Proliferative nodule resembling angiomatoid Spitz with pronounced degenerative atypia arising within a giant congenital nevus

Proliferative nodules arising within congenital melanocytic nevi present a diagnostic challenge for dematopathologists given their close resemblance to melanoma. In difficult cases, ancillary molecular tests can be used to better exclude the possibility of malignancy. We report case of a biopsy and subsequent excision of an unusual proliferative nodule with overlapping features of angiomatoid Spitz tumor and ancient melanocytic nevus which demonstrated normal findings on both chromosomal microarray and a gene expression profiling assay. Our case is noteworthy given its striking resemblance to what has been reported for an angiomatoid Spitz tumor. To our knowledge, this particular morphologic subset of Spitz has been described primarily in the context of spontaneous melanocytic tumors arising de novo outside the context of a congenital lesion. The pathology showed bizarre cytological features along with a myxoid and highly vascularized stroma which is thought to represent degenerative atypia characteristic of an “ancient nevus.” The lesions described as ancient nevi have some overlapping stromal features with angiomatoid Spitz tumors. A low proliferation index and paucity of mitotic figures is characteristic of these neoplasms. We hypothesize that continued host response to the lesion may be responsible for inducing the observed cytological and stromal derangement. Interestingly, these changes increased from the time of biopsy to the excision. Future studies should aim to define the genetic and immunologic signature of these lesions to help predict prognosis. The relationship between angiomatoid Spitz tumor, ancient change, and regressing nevi should also be investigated

An observational study of compliance with the Scandinavian guidelines for management of minimal, mild and moderate head injury

<p>Abstract</p> <p>Background</p> <p>The Scandinavian guidelines for management of minimal, mild and moderate head injuries were developed to provide safe and cost effective assessment of head injured patients. In a previous study conducted one year after publication and implementation of the guidelines (2003), we showed low compliance, involving over-triage with computed tomography (CT) and hospital admissions. The aim of the present study was to investigate guideline compliance after an educational intervention.</p> <p>Methods</p> <p>We evaluated guideline compliance in the management of head injured patients referred to the University Hospital of Stavanger, Norway. The findings from the previous study in 2003 were communicated to the hospitals physicians, and a feed-back loop training program for guideline implementation was conducted. All patients managed during the months January through June in the years 2005, 2007 and 2009 were then identified with an electronic search in the hospitals patient administrative database, and the patient files were reviewed. Patients were classified according to the Head Injury Severity Scale, and the management was classified as compliant or not with the guideline.</p> <p>Results</p> <p>The 1 180 patients were 759 (64%) males and 421 (36%) females with a mean age of 31.5 (range 0-97) years. Over all, 738 (63%) patients were managed in accordance with the guidelines and 442 (37%) were not. Compliance was not significantly different between minimal (56%) and mild (59%) injuries, while most moderate (93%) injuries were managed in accordance with the guidelines (p < 0.05). Noncompliance was caused by overtriage in 362 cases (30%) and undertriage in 80 (7%). Guideline compliance was 54% in 2005, 71% in 2007, and 64% in 2009.</p> <p>Conclusions</p> <p>This study shows higher guideline compliance after an educational intervention involving feed-back on performance. A substantial number of patients are exposed to over-triage, involving unnecessary radiation from CT examinations, and unnecessary costs from hospital admissions.</p