Targeted worker removal reveals a lack of flexibility in brood transport specialisation with no compensatory gain in efficiency.

Division of labour is widely thought to increase the task efficiency of eusocial insects. Workers can switch their task to compensate for sudden changes in demand, providing flexible task allocation. In combination with automated tracking technology, we developed a robotic system to precisely control and spatiotemporally manipulate floor temperature over days, which allowed us to predictably drive brood transport behaviour in colonies of the ant Camponotus floridanus. Our results indicate that a small number of workers, usually minors belonging to the nurse social group, are highly specialised for brood transport. There was no difference in the speed at which workers transported brood, suggesting that specialisation does not correlate with efficiency. Workers often started to transport the brood only after having identified a better location. There was no evidence that workers shared information about the presence of a better location. Notably, once brood transporters had been removed, none of the remaining workers performed this task, and the brood transport completely stopped. When brood transporters were returned to their colony, brood transport was immediately restored. Taken together, our study reveals that brood transport is an inflexible task, achieved through the synchronous actions of a few privately informed specialist workers.

Social network position is a major predictor of ant behavior, microbiota composition, and brain gene expression.

The physiology and behavior of social organisms correlate with their social environments. However, because social environments are typically confounded by age and physical environments (i.e., spatial location and associated abiotic factors), these correlations are usually difficult to interpret. For example, associations between an individual's social environment and its gene expression patterns may result from both factors being driven by age or behavior. Simultaneous measurement of pertinent variables and quantification of the correlations between these variables can indicate whether relationships are direct (and possibly causal) or indirect. Here, we combine demographic and automated behavioral tracking with a multiomic approach to dissect the correlation structure among the social and physical environment, age, behavior, brain gene expression, and microbiota composition in the carpenter ant Camponotus fellah. Variations in physiology and behavior were most strongly correlated with the social environment. Moreover, seemingly strong correlations between brain gene expression and microbiota composition, physical environment, age, and behavior became weak when controlling for the social environment. Consistent with this, a machine learning analysis revealed that from brain gene expression data, an individual's social environment can be more accurately predicted than any other behavioral metric. These results indicate that social environment is a key regulator of behavior and physiology.

Ant behavioral maturation is mediated by a stochastic transition between two fundamental states.

The remarkable ecological success of social insects is often attributed to their advanced division of labor, which is closely associated with temporal polyethism in which workers transition between different tasks as they age. Young nurses are typically found deep within the nest where they tend to the queen and the brood, whereas older foragers are found near the entrance and outside the nest.1-3 However, the individual-level maturation dynamics remain poorly understood because following individuals over relevant timescales is difficult; hence, previous experimental studies used same-age cohort designs.4-15 To address this, we used an automated tracking system to follow >500 individuals over >100 days and constructed networks of physical contacts to provide a continuous measure of worker social maturity. These analyses revealed that most workers occupied one of two steady states, namely a low-maturity nurse state and a high-maturity forager state, with the remaining workers rapidly transitioning between these states. There was considerable variation in the age at transition, and, surprisingly, the transition probability was age independent. This suggests that the transition is largely stochastic rather than a hard-wired age-dependent physiological change. Despite the variation in timing, the transition dynamics were highly stereotyped. Transitioning workers moved from the nurse to the forager state according to an S-shaped trajectory, and only began foraging after completing the transition. Stochastic switching, which occurs in many other biological systems, may provide ant colonies with robustness to extrinsic perturbations by allowing the colony to decouple its division of labor from its demography.

Update on Current Treatment Recommendations for Primary Cutaneous Melanoma.

Primary cutaneous melanoma describes any primary melanoma lesion of the skin that does not have evidence of metastatic disease. This article reviews the current workup, treatment, and follow-up recommendations for primary cutaneous melanoma (stages 0, I, and II). Specific attention is focused on recent updates with regard to staging, sentinel lymph node biopsy, and surgical modalities.

Oxytocin/vasopressin-like peptide inotocin regulates cuticular hydrocarbon synthesis and water balancing in ants.

Oxytocin/vasopressin-like peptides are important regulators of physiology and social behavior in vertebrates. However, the function of inotocin, the homologous peptide in arthropods, remains largely unknown. Here, we show that the level of expression of inotocin and inotocin receptor are correlated with task allocation in the ant Camponotus fellah Both genes are up-regulated when workers age and switch tasks from nursing to foraging. in situ hybridization revealed that inotocin receptor is specifically expressed in oenocytes, which are specialized cells synthesizing cuticular hydrocarbons which function as desiccation barriers in insects and for social recognition in ants. dsRNA injection targeting inotocin receptor, together with pharmacological treatments using three identified antagonists blocking inotocin signaling, revealed that inotocin signaling regulates the expression of cytochrome P450 4G1 (CYP4G1) and the synthesis of cuticular hydrocarbons, which play an important role in desiccation resistance once workers initiate foraging.

Treatment of Facial Telangiectases With Glycerin Sclerotherapy.

BACKGROUND: Sclerotherapy is used to treat varicosities and telangiectases. Glycerin is a sclerosing agent that has been used off-label for years with a favorable adverse effect profile. However, the treatment of facial telangiectases with sclerotherapy is controversial given the potential for necrosis and embolization in relation to the complex vascular anatomy of the face. OBJECTIVE: To determine the safety and efficacy of glycerin sclerotherapy for the treatment of facial telangiectases. MATERIALS AND METHODS: The authors report a series of 8 patients with facial telangiectases treated with glycerin sclerotherapy. Glycerin mixed with lidocaine and epinephrine was used. The telangiectases were measured and identified as targets for treatment. RESULTS: The patients ranged in age from 45 to 88 years. Between 0.5 and 1 mL was used to treat telangiectases of the nose and malar cheek area per session. Five of the patients achieved satisfactory results after 1 treatment, whereas patients with more extensive telangiectases required up to 3 sessions with 4-week intervals between each session. Injection site pain was the only reported adverse effect, and no evidence of necrosis or blindness was observed. CONCLUSION: Glycerin sclerotherapy seems to be a safe and effective modality for the treatment of facial telangiectases.

Assessment of Provider Utilization Through Skin Biopsy Rates.

BACKGROUND: There have been recent claims of overdiagnosis and unnecessary treatment in dermatology. One potential manifestation of overutilization would be providers who perform numerous biopsies per patient. OBJECTIVE: To identify the frequency of skin biopsy rate outliers. MATERIALS AND METHODS: Data on biopsy rates at the individual provider level were obtained from Medicare Provider Utilization and Payment Data Public Use Files. The total number of biopsies for each provider was obtained by summing the number of claimed biopsy services for each unique National Provider Identifier. The visit count for each provider was obtained by summing all evaluation and management services claimed. Provider biopsy rates were calculated by dividing the total number of biopsies associated with each National Provider Identifier by the corresponding visit count. RESULTS: The mean provider biopsy rate was 0.31 services per visit, or approximately 1 biopsy every 3 visits. Defining outliers as providers who averaged 3 or more biopsies per visit, there were 38 outliers out of 18,260 providers. Physicians had a lower mean biopsy rate than nonphysician clinicians (p = 1.70E-28). CONCLUSION: Contrary to claims, the authors' results do not indicate widespread overutilization of skin biopsy services.

A case of gemcitabine-related acute lipodermatosclerosis.

INTRODUCTION: Gemcitabine is a chemotherapeutic agent used to treat several solid organ malignancies. The most common cutaneous toxicities are a mild erythematous rash and pruritus, which are often attributed to infectious etiologies. However, certain clinical characteristics may favor a drug-related reaction. Clinicians should recognize these phenomena to avoid potentially unnecessary antibiotic treatment or withdrawal of chemotherapeutic agents. OBJECTIVE: We aim to report a case of gemcitabine-related acute lipodermatosclerosis-like eruption, add to the evolving classification of this condition, and highlight developing literature on gemcitabine that may explain this toxicity. CASE: Dermatology was consulted for presumed cellulitis in a 62-year-old female with pancreatic carcinoma. The patient presented to the emergency department five days after her first dose of gemcitabine with erythema in both lower extremities. A diagnosis of gemcitabine-related acute lipodermatosclerosis was made and the patient was started on topical triamcinolone. CONCLUSION: It is important to recognize gemcitabine-related acute lipodermatosclerosis in order to avoid unnecessary antibiotic use and disruptions in chemotherapy.

Flexible foraging strategies in Pipistrellus pygmaeus in response to abundant but ephemeral prey.

There is growing recognition that with sympathetic management, plantation forests may contain more biodiversity than previously thought. However, the extent to which they may support bat populations is contentious. Many studies have demonstrated active avoidance of coniferous plantations and attributed this to the lack of available roost sites and low invertebrate density. In contrast, other work, carried out in plantation dominated landscapes have shown that certain bat species are able to exploit these areas. However, the extent to which bats use plantations for roosting and foraging, or simply move through the plantation matrix to access more favourable sites is unclear. We radio tracked female Pipistrellus pygmaeus over two summers to establish the extent to which individual bats use Sitka Spruce plantations in southern Scotland for foraging and roosting and assess the implications for felling operations on bats. Maternity roosts identified (n = 17) were in all in buildings and most were large (> 500 individuals). We found no evidence of bats roosting in mature Sitka Spruce crop trees, although several bats used roosts in old or dead beech and oak trees as an alternative to their main maternity roost. Home ranges were much larger (mean 9.6 ± 3.12 km2) than those reported from other studies (0.6-1.6 km2), and it is likely that roost availability rather than food abundance constrains P. pygmaeus use of Sitka Spruce plantations. At the landscape scale, most individuals selected coniferous habitats over other habitat types, covering large distances to access plantation areas, whilst at a local scale bats used forest tracks to access water, felled stands or patches of broadleaf cover within the plantation. Sitka Spruce plantations support a high abundance of Culicoides impuctatus, the Highland midge which may act as a reliable and plentiful food source for females during lactation, an energetically expensive period. The use of felled stands for foraging by bats has implications for forest management as wind turbines, following small-scale felling operations, are increasingly being installed in plantations; wind turbines have been associated with high bat mortality in some countries. Decisions about siting wind turbines in upland plantations should consider the likelihood of increased bat activity post felling.

Cicatricial Alopecia in Identical Twin Lumbee Native American Women.

Central centrifugal cicatricial alopecia (CCCA) has become a well-known entity occurring mainly in African-American women, but is rarely encountered in other populations. This report describes a set of identical twin Lumbee Indian women, both developing cicatricial alopecia, with one sister diagnosed with CCCA overlap with lichen planopilaris and the other with CCCA. The Lumbee Tribe is a federally recognized group of Native Americans who reside in North Carolina. Lumbee Indians have shown an increased incidence of several metabolic and neurologic diseases but cicatricial alopecia has never been an identified associated disease of the Lumbee. Thus far, no published studies have shown cicatricial alopecia as occurring in identical twins or in Native Americans. This case report discusses the issues of haircare practices and genetics in contributing to cicatricial alopecia.

A Review of the Current Modalities for the Treatment of Papulopustular Rosacea.

Papulopustular rosacea is characterized by papules and pustules in the central facial region. We review the literature surrounding the treatment of papulopustular rosacea. PubMed, EMBASE, and Cochrane (Central) databases searches of articles published from 1980 to 2015 were performed using the MeSH terms or keywords "rosacea" and "clinical trial." Additional searches were performed to include rosacea and each treatment modality used. Topical metronidazole, azelaic acid, ivermectin, and oral doxycycline have the most robust data to support their use. Variation in assessment tools and a lack of clinical trial standardization makes comparison of therapeutic options difficult.

Medical Management of Facial Redness in Rosacea.

Persistent centrofacial erythema is a predominant component of rosacea. The authors review the topical and systemic treatments for rosacea-related erythema and flushing to aid in treatment decision making in clinical practice. Databases were searched for literature pertaining to treatment options for erythema related to rosacea. The paucity of large-scale clinical trials in patients with the erythematotelangiectatic rosacea subtype makes it difficult to draw firm conclusions regarding treatment. Although certain topical and oral treatments appear to have modest benefit in reducing erythema, there is a need for high-quality, well-designed, and rigorously reported studies for the treatments for rosacea.

Treatment of Atopic Dermatitis in the United States: Analysis of Data from the National Ambulatory Medical Care Survey.

Introduction: Atopic dermatitis (AD) affects both adult and pediatric patients, and multiple practitioners encounter and manage AD. However, differences with regard to the treatment of AD between specialties are not well characterized. OBJECTIVE: The primary objective of this study was to determine if there is a difference between dermatologists and non-dermatology specialties with regard to treatment strategies for AD and to describe those differences. METHODS: Data from the 1993-2010 National Ambulatory Medical Care (NAMCS) and National Hospital Ambulatory Care (NHAMCS) Surveys were used to characterize outpatient visits made for AD. Differences in demographic, geographic and seasonal characteristics were obtained and compared. Additionally, the frequency of medications prescribed at dermatologist visits were compared to other specialties. PRIMARY OUTCOME MEASURES: Frequency of modalities used in the treatment of atopic dermatitis between dermatologists and non-dermatology specialties. RESULTS: An estimated 3.7 million visits for AD were made to outpatient offices and hospital departments from 1993 to 2010. The rates per capita of visits for atopic dermatitis were similar when evaluated by gender and season. However, Caucasians were almost 50% less likely than African Americans or individuals of other minority races to have visits for AD. Topical corticosteroids (TCS) were mentioned at 52% of visits, and dermatologists were more likely than non-dermatologists to prescribe TCS, emollients, and topical calcineurin inhibitors. CONCLUSIONS: Dermatologists were more likely to recommend TCS, emollients, and topical calciuneurin inhibitors for the treatment of AD. Dermatologists were also more likely to prescribe higher potency TCS in comparison to non-dermatology specialties, and these differences may ultimately affect patient care. As a result, there remains a disparity between dermatologists and non-dermatology specialties with regard to evidence-based approaches to the treatment of AD.

J Drugs Dermatol. 2017;16(3):250-255.

Superficial Radiation Therapy for the Treatment of Nonmelanoma Skin Cancers.

Superficial radiation therapy has become more widely available to dermatologists. With the advent of more portable machines, it has become more convenient for dermatology practices to employ in an office-based setting. The goal of this paper is to provide a deeper insight into the role of superficial radiation therapy in dermatology practice and to review the current literature surrounding its use in the treatment of both basal and squamous cell carcinomas.

Dupilumab for the treatment of atopic dermatitis: A clinical trial review.

INTRODUCTION: Current treatment options for moderate-to-severe atopic dermatitis (AD) are limited and have potentially dangerous side effects. Dupilumab is a novel monoclonal antibody that was recently studied in adult patients with moderate-to-severe AD. Dupilumab inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling and was previously found to be effective in asthma. Considering that both AD and asthma are Th2 cell-mediated inflammatory processes, it is reasonable to suspect that dupilumab would be beneficial in AD.` AREAS COVERED: This article is a review of the one major clinical trial that assessed the efficacy of dupilumab in patients with AD. Its goal is to provide a comparison to the current modalities for the treatment of AD and expert insight regarding future studies. EXPERT OPINION: The results of this study are a significant therapeutic advancement. Dupilumab was shown to provide a mean percent change in Eczema Area and Severity Index score of -74% ± 3.6, in addition to, statistically and clinically significant reductions the severity, symptomatology, and morbidity associated with AD. However, the small sample size makes it difficult to assess the magnitude of this effect. As a result, dupilumab will likely be reserved for cases of severe AD unresponsive to traditional modalities.