[Indications and technique for transconjunctival optic nerve sheath fenestration : Video article]

BACKGROUND

Placement of a ventricular shunt is the primary surgical procedure for lowering intracranial pressure in pseudotumor cerebri syndrome; however, if ophthalmological symptoms prevail over neurological symptoms or if there are no neurological symptoms at all, optic nerve sheath fenestration may be a valuable option for relief of pressure on the retrobulbar optic nerve when papilledema caused by pseudotumor cerebri syndrome threatens vision despite previous conservative measures.

METHODS

This review covers the indications, technique and results of optic nerve sheath fenestration compared to competing procedures based on a systematic literature search, analysis of own cases and a documentation of the surgical technique.

SURGICAL TECHNIQUE

After performing a medial transconjunctival orbitotomy the medial rectus muscle tendon is temporarily detached and the eye abducted by traction sutures. Using confocal illumination under a surgical microscope, the optic nerve can be visualized using orbital spatulas and the sheath can be punctured with a microscalpel. A video of this operation is available online.

CONCLUSION

Transconjunctival optic nerve sheath fenestration is a relatively safe method to reduce the rate of visual loss in pseudotumor cerebri syndrome. In selected cases it can be a useful alternative to ventriculoperitoneal/atrial shunts or venous stents.

Testing the environmental filtering concept in global drylands

1. The environmental filtering hypothesis predicts that the abiotic environment selects species with similar trait values within communities. Testing this hypothesis along multiple - and interacting - gradients of climate and soil variables constitutes a great opportunity to better understand and predict the responses of plant communities to ongoing environmental changes. 2. Based on two key plant traits, maximum plant height and specific leaf area (SLA), we assessed the filtering effects of climate (mean annual temperature and precipitation, precipitation seasonality), soil characteristics (soil pH, sand content and total phosphorus) and all potential interactions on the functional structure and diversity of 124 dryland communities spread over the globe. The functional structure and diversity of dryland communities were quantified using the mean, variance, skewness and kurtosis of plant trait distributions. 3. The models accurately explained the observed variations in functional trait diversity across the 124 communities studied. All models included interactions among factors, i.e. climate - climate (9% of explanatory power), climate - soil (24% of explanatory power) and soil - soil interactions (5% of explanatory power). Precipitation seasonality was the main driver of maximum plant height, and interacted with mean annual temperature and precipitation. Soil pH mediated the filtering effects of climate and sand content on SLA. Our results also revealed that communities characterized by a low variance can also exhibit low kurtosis values, indicating that functionally contrasting species can co-occur even in communities with narrow ranges of trait values. 4. Synthesis We identified the particular set of conditions under which the environmental filtering hypothesis operates in drylands worldwide. Our findings also indicate that species with functionally contrasting strategies can still co-occur locally, even under prevailing environmental filtering. Interactions between sources of environmental stress should be therefore included in global trait-based studies, as this will help to further anticipate where the effects of environmental filtering will impact plant trait diversity under climate change.

Functional trait diversity maximizes ecosystem multifunctionality

Understanding the relationship between biodiversity and ecosystem functioning has been a core ecological research topic over the last decades. Although a key hypothesis is that the diversity of functional traits determines ecosystem functioning, we do not know how much trait diversity is needed to maintain multiple ecosystem functions simultaneously (multifunctionality). Here, we uncovered a scaling relationship between the abundance distribution of two key plant functional traits (specific leaf area, maximum plant height) and multifunctionality in 124 dryland plant communities spread over all continents except Antarctica. For each trait, we found a strong empirical relationship between the skewness and the kurtosis of the trait distributions that cannot be explained by chance. This relationship predicted a strikingly high trait diversity within dryland plant communities, which was associated with a local maximization of multifunctionality. Skewness and kurtosis had a much stronger impact on multifunctionality than other important multifunctionality drivers such as species richness and aridity. The scaling relationship identified here quantifies how much trait diversity is required to maximize multifunctionality locally. Trait distributions can be used to predict the functional consequences of biodiversity loss in terrestrial ecosystems.

Overexpression of PIK3CA in murine head and neck epithelium drives tumor invasion and metastasis through PDK1 and enhanced TGFβ signaling

Head and neck squamous cell carcinoma (HNSCC) patients have a poor prognosis, with invasion and metastasis as major causes of mortality. The phosphatidylinositol 3-kinase (PI3K) pathway regulates a wide range of cellular processes crucial for tumorigenesis, and PIK3CA amplification and mutation are among the most common genetic alterations in human HNSCC. Compared to the well-documented roles of the PI3K pathway in cell growth and survival, the roles of the PI3K pathway in tumor invasion and metastasis have not been well delineated. We generated a PIK3CA-genetically engineered mouse model (PIK3CA-GEMM) in which wildtype PIK3CA is overexpressed in head and neck epithelium. Although PIK3CA overexpression alone was not sufficient to initiate HNSCC formation, it significantly increased tumor susceptibility in an oral-carcinogenesis mouse model. PIK3CA overexpression in mouse oral epithelium increased tumor invasiveness and metastasis by increasing epithelial-mesenchymal transition and by enriching a cancer stem cell phenotype in tumor epithelial cells. In addition to these epithelial alterations, we also observed marked inflammation in tumor stroma. AKT is a central signaling mediator of the PI3K pathway. However, molecular analysis suggested that progression of PIK3CA-driven HNSCC is facilitated by PDK1 and enhanced TGFβ signaling rather than by AKT. Examination of human HNSCC clinical samples revealed that both PIK3CA and PDK1 protein levels correlated with tumor progression, highlighting the significance of this pathway. In summary, our results offer significant insight into how PIK3CA-overexpression drives HNSCC invasion and metastasis, providing a rationale for targeting PI3K/PDK1 and TGFβ signaling in advanced HNSCC patients with PIK3CA amplification.

Functional trait diversity across trophic levels determines herbivore impact on plant community biomass

Understanding the consequences of trophic interactions for ecosystem functioning is challenging, as contrasting effects of species and functional diversity can be expected across trophic levels. We experimentally manipulated functional identity and diversity of grassland insect herbivores and tested their impact on plant community biomass. Herbivore resource acquisition traits, i.e. mandible strength and the diversity of mandibular traits, had more important effects on plant biomass than body size. Higher herbivore functional diversity increased overall impact on plant biomass due to feeding niche complementarity. Higher plant functional diversity limited biomass pre-emption by herbivores. The functional diversity within and across trophic levels therefore regulates the impact of functionally contrasting consumers on primary producers. By experimentally manipulating the functional diversity across trophic levels, our study illustrates how trait-based approaches constitute a promising way to tackle existing links between trophic interactions and ecosystem functioning.

A global meta-analysis of the relative extent of intraspecific trait variation in plant communities

Recent studies have shown that accounting for intraspecific trait variation (ITV) may better address major questions in community ecology. However, a general picture of the relative extent of ITV compared to interspecific trait variation in plant communities is still missing. Here, we conducted a meta-analysis of the relative extent of ITV within and among plant communities worldwide, using a data set encompassing 629 communities (plots) and 36 functional traits. Overall, ITV accounted for 25% of the total trait variation within communities and 32% of the total trait variation among communities on average. The relative extent of ITV tended to be greater for whole-plant (e.g. plant height) vs. organ-level traits and for leaf chemical (e.g. leaf N and P concentration) vs. leaf morphological (e.g. leaf area and thickness) traits. The relative amount of ITV decreased with increasing species richness and spatial extent, but did not vary with plant growth form or climate. These results highlight global patterns in the relative importance of ITV in plant communities, providing practical guidelines for when researchers should include ITV in trait-based community and ecosystem studies.

[Technique and Results for the Transconjunctival Removal of Orbital Haemangiomas]

BACKGROUND

The cavernous haemangioma (cavernoma) is the most common orbital tumour in adults. Various surgical approaches have been described so far. We prefer a transconjunctival approach and analyse herein how our outcomes compare with those of transcutaneous or transosseous approaches.

METHODS

A retrospective series of 10 cases was analysed with regard to surgical success and complications.

RESULTS

The tumour could be completely removed in all cases. In one case, preoperative diplopia disappeared after surgery. Another case suffered from postoperative diplopia, which resolved within two months. Two cases developed a long-lasting partial tonic pupil.

CONCLUSION

A retrobulbar cavernoma can be safely removed via a transconjunctival approach through shrinkage by coagulation and subsequent cryoextraction.

Functional equivalence, competitive hierarchy and facilitation determine species coexistence in highly invaded grasslands

Alien and native plant species often differ in functional traits. Trait differences could lead to niche differences that minimize competitive interactions and stabilize coexistence. However, trait differences could also translate into average fitness differences, leading to a competitive hierarchy that prevents coexistence. We tested whether trait differences between alien and native species translated into average fitness or stabilizing niche differences, and whether competition could explain observed coexistence within invaded grassland communities (New Zealand). Trait differences reflected marked competitive hierarchy, suggesting average fitness differences. Species coexistence was determined by a trade-off between species susceptibility to herbivory vs competitive hierarchy and facilitation. Importantly, although aliens and natives differed in their trait values, they did not differ in their competitive response, highlighting the importance of equalizing mechanisms in structuring invaded communities. Only a few alien species with a particular set of traits were able to jeopardize species coexistence when grazing was ceased. Our study explains why some alien species coexist with natives, whereas others have strong impacts on native communities. It highlights that trait differences can underlie several coexistence processes and that the demonstration of trait differences between aliens and natives is only a first step to understanding the role of biotic interactions in structuring invaded communities.

Functional diversity enhances the resistance of ecosystem multifunctionality to aridity in Mediterranean drylands

We used a functional trait-based approach to assess the impacts of aridity and shrub encroachment on the functional structure of Mediterranean dryland communities (functional diversity (FD) and community-weighted mean trait values (CWM)), and to evaluate how these functional attributes ultimately affect multifunctionality (i.e. the provision of several ecosystem functions simultaneously). Shrub encroachment (the increase in the abundance/cover of shrubs) is a major land cover change that is taking place in grasslands worldwide. Studies conducted on drylands have reported positive or negative impacts of shrub encroachment depending on the functions and the traits of the sprouting or nonsprouting shrub species considered. FD and CWM were equally important as drivers of multifunctionality responses to both aridity and shrub encroachment. Size traits (e.g. vegetative height or lateral spread) and leaf traits (e.g. specific leaf area and leaf dry matter content) captured the effect of shrub encroachment on multifunctionality with a relative high accuracy (r(2)  = 0.63). FD also improved the resistance of multifunctionality along the aridity gradient studied. Maintaining and enhancing FD in plant communities may help to buffer negative effects of ongoing global environmental change on dryland multifunctionality.

Influence of segmental chromosome abnormalities on survival in children over the age of 12 months with unresectable localised peripheral neuroblastic tumours without MYCN amplification

Background:

The prognostic impact of segmental chromosome alterations (SCAs) in children older than 1 year, diagnosed with localised unresectable neuroblastoma (NB) without MYCN amplification enrolled in the European Unresectable Neuroblastoma (EUNB) protocol is still to be clarified, while, for other group of patients, the presence of SCAs is associated with poor prognosis.

Methods:

To understand the role of SCAs we performed multilocus/pangenomic analysis of 98 tumour samples from patients enrolled in the EUNB protocol.

Results:

Age at diagnosis was categorised into two groups using 18 months as the age cutoff. Significant difference in the presence of SCAs was seen in tumours of patients between 12 and 18 months and over 18 months of age at diagnosis, respectively (P=0.04). A significant correlation (P=0.03) was observed between number of SCAs per tumour and age. Event-free (EFS) and overall survival (OS) were calculated in both age groups, according to both the presence and number of SCAs. In older patients, a poorer survival was associated with the presence of SCAs (EFS=46% vs 75%, P=0.023; OS=66.8% vs 100%, P=0.003). Moreover, OS of older patients inversely correlated with number of SCAs (P=0.002). Finally, SCAs provided additional prognostic information beyond histoprognosis, as their presence was associated with poorer OS in patients over 18 months with unfavourable International Neuroblastoma Pathology Classification (INPC) histopathology (P=0.018).

Conclusions:

The presence of SCAs is a negative prognostic marker that impairs outcome of patients over the age of 18 months with localised unresectable NB without MYCN amplification, especially when more than one SCA is present. Moreover, in older patients with unfavourable INPC tumour histoprognosis, the presence of SCAs significantly affects OS.

Disentangling coordination among functional traits using an individual-centred model: impact on plant performance at intra- and inter-specific levels

Background

Plant functional traits co-vary along strategy spectra, thereby defining trade-offs for resource acquisition and utilization amongst other processes. A main objective of plant ecology is to quantify the correlations among traits and ask why some of them are sufficiently closely coordinated to form a single axis of functional specialization. However, due to trait co-variations in nature, it is difficult to propose a mechanistic and causal explanation for the origin of trade-offs among traits observed at both intra- and inter-specific level.

Methodology/Principal Findings

Using the Gemini individual-centered model which coordinates physiological and morphological processes, we investigated with 12 grass species the consequences of deliberately decoupling variation of leaf traits (specific leaf area, leaf lifespan) and plant stature (height and tiller number) on plant growth and phenotypic variability. For all species under both high and low N supplies, simulated trait values maximizing plant growth in monocultures matched observed trait values. Moreover, at the intraspecific level, plastic trait responses to N addition predicted by the model were in close agreement with observed trait responses. In a 4D trait space, our modeling approach highlighted that the unique trait combination maximizing plant growth under a given environmental condition was determined by a coordination of leaf, root and whole plant processes that tended to co-limit the acquisition and use of carbon and of nitrogen.

Conclusion/Significance

Our study provides a mechanistic explanation for the origin of trade-offs between plant functional traits and further predicts plasticity in plant traits in response to environmental changes. In a multidimensional trait space, regions occupied by current plant species can therefore be viewed as adaptive corridors where trait combinations minimize allometric and physiological constraints from the organ to the whole plant levels. The regions outside this corridor are empty because of inferior plant performance.

RNA interference screening identifies a novel role for autocrine fibroblast growth factor signaling in neuroblastoma chemoresistance

Chemotherapeutic drug resistance is one of the major causes for treatment failure in high-risk neuroblastoma (NB), the most common extra cranial solid tumor in children. Poor prognosis is typically associated with MYCN amplification. Here, we utilized a loss-of-function kinome-wide RNA interference screen to identify genes that cause cisplatin sensitization. We identified fibroblast growth factor receptor 2 (FGFR2) as an important determinant of cisplatin resistance. Pharmacological inhibition of FGFR2 confirmed the importance of this kinase in NB chemoresistance. Silencing of FGFR2 sensitized NB cells to cisplatin-induced apoptosis, which was regulated by the downregulation of the anti-apoptotic proteins BCL2 and BCLXL. Mechanistically, FGFR2 was shown to activate protein kinase C-δ to induce BCL2 expression. FGFR2, as well as the ligand fibroblast growth factor-2, were consistently expressed in primary NB and NB cell lines, indicating the presence of an autocrine loop. Expression analysis revealed that FGFR2 correlates with MYCN amplification and with advanced stage disease, demonstrating the clinical relevance of FGFR2 in NB. These findings suggest a novel role for FGFR2 in chemoresistance and provide a rational to combine pharmacological inhibitors against FGFR2 with chemotherapeutic agents for the treatment of NB.

Habitat filtering and niche differentiation jointly explain species relative abundance within grassland communities along fertility and disturbance gradients

Deterministic niche-based processes have been proposed to explain species relative abundance within communities but lead to different predictions: habitat filtering (HF) predicts dominant species to exhibit similar traits while niche differentiation (ND) requires that species have dissimilar traits to coexist. Using a multiple trait-based approach, we evaluated the relative roles of HF and ND in determining species abundances in productive grasslands. Four dimensions of the functional niche of 12 co-occurring grass species were identified using 28 plant functional traits. Using this description of the species niche, we investigated patterns of functional similarity and dissimilarity and linked them to abundance in randomly assembled six-species communities subjected to fertilization/disturbance treatments. Our results suggest that HF and ND jointly determined species abundance by acting on contrasting niche dimensions. The effect of HF decreased relative to ND with increasing disturbance and decreasing fertilization. Dominant species exhibited similar traits in communities whereas dissimilarity favored the coexistence of rare species with dominants by decreasing inter-specific competition. This stabilizing effect on diversity was suggested by a negative relationship between species over-yielding and relative abundance. We discuss the importance of considering independent dimensions of functional niche to better understand species abundance and coexistence within communities.