Learning Curve for Ultrasound Assessment of Myometrial Infiltration in Endometrial Cancer Visualizing Videoclips: Potential Implications for Training

Background: Diagnostic accuracy for estimating myometrial infiltration by ultrasound in endometrial cancer requires experience. The objective of this study is to determine the learning curve (LC) for assessing myometrial infiltration in cases of endometrial cancer using transvaginal ultrasound (TVS). Methods: Five trainees (one staff radiologist and four fourth-year OB/GYN residents) participated in this study. All trainees had experience in performing TVS, but none of them had specific training on the assessment of myometrial infiltration. Trainees were given one specific lecture about the topic, and then they observed videoclips from 10 cases explained by the trainer. After this, all trainees visualized 45 videoclips of uterine ultrasound scans of endometrial cancer cases. The assessment of myometrial infiltration was based on the subjective impression. Definitive histology was used as a reference standard. Trainees stated whether myometrial infiltration was ≥50% or <50%. LC-CUSUM and standard CUSUM graphics were plotted to determine how many cases were needed to reach competence, allowing a mistake rate of 15%. Results: All trainees completed the study. LC-CUSUM graphics showed that three trainees reached competence at the 33rd, 35th and 36th case, respectively. All three of them kept the process under control after reaching competence. One trainee reached competence but did not maintain it in the cumulative analysis. One trainee did not reach competence. Conclusion: Our study suggests that 30-40 cases would be needed to be trained for assessing myometrial infiltration by TVS by visual interpretation of videoclips by most trainees

The genetic diversity of Mesodinium and associated cryptophytes

Ciliates from the genus Mesodinium are globally distributed in marine and freshwater ecosystems and may possess either heterotrophic or mixotrophic nutritional modes. Members of the Mesodinium major/rubrum species complex photosynthesize by sequestering and maintaining organelles from cryptophyte prey, and under certain conditions form periodic or recurrent blooms (= red tides). Here, we present an analysis of the genetic diversity of Mesodinium and cryptophyte populations from 10 environmental samples (eight globally dispersed habitats including five Mesodinium blooms), using group-specific primers for Mesodinium partial 18S, ITS, and partial 28S rRNA genes as well as cryptophyte large subunit RuBisCO genes (rbcL). In addition, 22 new cryptophyte and four new M, rubrum cultures were used to extract DNA and sequence rbcL and 18S-ITS-28S genes, respectively, in order to provide a stronger phylogenetic context for our environmental sequences. Bloom samples were analyzed from coastal Brazil, Chile, two Northeastern locations in the United States, and the Pribilof Islands within the Bering Sea. Additionally, samples were also analyzed from the Baltic and Barents Seas and coastal California under non-bloom conditions. Most blooms were dominated by a single Mesodinium genotype, with coastal Brazil and Chile blooms composed of M. major and the Eastern USA blooms dominated by M. rubrum variant B. Sequences from all four blooms were dominated by Teleaulax amphioxeia-like cryptophytes. Non bloom communities revealed more diverse assemblages of Mesodiniurn spp., including heterotrophic species and the mixotrophic Mesodinium Chamaeleon. Similarly, cryptophyte diversity was also higher in non-bloom samples. Our results confirm that Mesodinium blooms may be caused by M. major, as well as multiple variants of M, rubrum, and further implicate I amphioxeia as the key cryptophyte species linked to these phenomena in temperate and subtropical regions.Peer reviewe

The New Carotenoid Pigment Moraxanthin Is Associated with Toxic Microalgae

The new pigment “moraxanthin” was found in natural samples from a fish mortality site in the Inland Bays of Delaware, USA. Pure cultures of the species, tentatively named Chattonella cf. verruculosa, and natural samples contained this pigment as a dominant carotenoid. The pigment, obtained from a 10 L culture of C. cf. verruculosa, was isolated and harvested by HPLC and its structure determined from MS and 1D- and 2D-NMR. The data identified this pigment as a new acylated form of vaucheriaxanthin called moraxanthin after the berry like algal cell. Its presence in pure cultures and in natural bloom samples indicates that moraxanthin is specific to C. cf. verruculosa and can be used as a marker of its presence when HPLC is used to analyze natural blooms samples

Unraveling the Genetic Basis of Asthma and Allergic Diseases

Asthma and allergic diseases are believed to be complex genetic diseases which may result from the interaction of multiple genetic factors and environmental stimuli. In past decades, great efforts have been exerted in unraveling their genetic basis. The strategies in discovering genes and genetic variants, confirming their importance in pathogenesis of asthma and allergic diseases, as well as their strengths and limitations are summarized comprehensively and concisely. The current consensus about the genetic basis of asthma and allergic diseases is briefly described as well

Phylogeography of Ostreopsis along West Pacific Coast, with Special Reference to a Novel Clade from Japan

BACKGROUND: A dinoflagellate genus Ostreopsis is known as a potential producer of Palytoxin derivatives. Palytoxin is the most potent non-proteinaceous compound reported so far. There has been a growing number of reports on palytoxin-like poisonings in southern areas of Japan; however, the distribution of Ostreopsis has not been investigated so far. Morphological plasticity of Ostreopsis makes reliable microscopic identification difficult so the employment of molecular tools was desirable. METHODS/PRINCIPAL FINDING: In total 223 clones were examined from samples mainly collected from southern areas of Japan. The D8-D10 region of the nuclear large subunit rDNA (D8-D10) was selected as a genetic marker and phylogenetic analyses were conducted. Although most of the clones were unable to be identified, there potentially 8 putative species established during this study. Among them, Ostreopsis sp. 1-5 did not belong to any known clade, and each of them formed its own clade. The dominant species was Ostreopsis sp. 1, which accounted for more than half of the clones and which was highly toxic and only distributed along the Japanese coast. Comparisons between the D8-D10 and the Internal Transcribed Spacer (ITS) region of the nuclear rDNA, which has widely been used for phylogenetic/phylogeographic studies in Ostreopsis, revealed that the D8-D10 was less variable than the ITS, making consistent and reliable phylogenetic reconstruction possible. CONCLUSIONS/SIGNIFICANCE: This study unveiled a surprisingly diverse and widespread distribution of Japanese Ostreopsis. Further study will be required to better understand the phylogeography of the genus. Our results posed the urgent need for the development of the early detection/warning systems for Ostreopsis, particularly for the widely distributed and strongly toxic Ostreopsis sp. 1. The D8-D10 marker will be suitable for these purposes

Inhomogeneity detection in phytoplankton time series using multivariate analyses

Phytoplankton communities have long been used as water quality indicators within environmental policies. This has fostered the development of national and international phytoplankton monitoring programs, but these networks are subject to sources of uncertainty due to laboratory issues. Nevertheless, studies regarding the interference associated with these aspects are not well-documented. Hence, a long time series (2003–2015) from the Basque continental shelf (southeastern Bay of Biscay) was analyzed to evaluate the uncertainty given by laboratory strategies when studying phytoplankton variability. Variability in phytoplankton communities was explained not only by environmental conditions but also by changes in fixatives (glutaraldehyde and acidic Lugol's solution) and laboratory staff. Based on Bray-Curtis distances, phytoplankton assemblages were found to be significantly dissimilar according to the effect of changes in the specialist handling the sample and the employed fixative. The pair-wise permutational multivariate analysis of variance (PERMANOVA) showed significant differences between the two fixatives utilized and also between the three taxonomists involved. Thus, laboratory-related effects should be considered in the study of phytoplankton time series

Origin of cryptophyte plastids in Dinophysis from Galician waters: results from field and culture experiments

Photosynthetic species of the dinoflagellate genus Dinophysis retain cryptophyte plastids from the Teleaulax/Plagioselmis/Geminigera group via their ciliate prey Mesodinium rubrum, but other cryptophyte and algal sources have occasionally been found. Identifying the specific prey of ciliates fed upon by mixotrophic Dinophysis species is a requisite to improve predictive capabilities of their bloom formation. Here we examined the origin of Dinophysis plastids from Galician waters and their transfer in cross-feeding experiments in the laboratory. Plastid 23S rDNA sequences were obtained from 60 Dinophysis specimens from the Galician Rías Baixas and shelf waters. Most sequences in Dinophysis cells were identical to Teleaulax amphioxeia. Galician shelf samples also yielded T. amphioxeia-type sequences, although one of these was closer to a freshwater cryptophyte, and a few others were related with other taxa (diatoms, red algae and proteobacteria). Mesodinium cf. major, an alternative prey to M. rubrum, was identified. Cross-feeding tests in the laboratory showed that T. amphioxeia, T. minuta, T. gracilis, and Plagioselmis prolonga sustained growth of M. rubrum. D. acuminata cultivated on a M. rubrum–T. amphioxeia system was transferred to M. rubrum fed upon T. minuta, T. gracilis and P. prolonga. After >2 mo of acclimation, T. amphioxeia plastid 23S rDNA and psbA gene sequences from D. acuminata were replaced by those of secondary cryptophytes. Here we confirm 2 cryptophytes, T. minuta and P. prolonga, as suitable prey for M. rubrum. Nevertheless, field and laboratory results show that, at least for D. acuminata, T. amphioxeia represents the main source of plastids.Versión del edito

Learning Curve for Ultrasound Assessment of Myometrial Infiltration in Endometrial Cancer Visualizing Videoclips: Potential Implications for Training

Background: Diagnostic accuracy for estimating myometrial infiltration by ultrasound in endometrial cancer requires experience. The objective of this study is to determine the learning curve (LC) for assessing myometrial infiltration in cases of endometrial cancer using transvaginal ultrasound (TVS). Methods: Five trainees (one staff radiologist and four fourth-year OB/GYN residents) participated in this study. All trainees had experience in performing TVS, but none of them had specific training on the assessment of myometrial infiltration. Trainees were given one specific lecture about the topic, and then they observed videoclips from 10 cases explained by the trainer. After this, all trainees visualized 45 videoclips of uterine ultrasound scans of endometrial cancer cases. The assessment of myometrial infiltration was based on the subjective impression. Definitive histology was used as a reference standard. Trainees stated whether myometrial infiltration was ≥50% or <50%. LC-CUSUM and standard CUSUM graphics were plotted to determine how many cases were needed to reach competence, allowing a mistake rate of 15%. Results: All trainees completed the study. LC-CUSUM graphics showed that three trainees reached competence at the 33rd, 35th and 36th case, respectively. All three of them kept the process under control after reaching competence. One trainee reached competence but did not maintain it in the cumulative analysis. One trainee did not reach competence. Conclusion: Our study suggests that 30–40 cases would be needed to be trained for assessing myometrial infiltration by TVS by visual interpretation of videoclips by most trainees