Draft Genome Sequence of Environmental Bacterium Vibrio vulnificus CladeA-yb158

We report the genome sequence of the environmental Vibrio vulnificus biotype 1_cladeA. This draft genome of the CladeA-yb158 strain, isolated in Israel, represents this newly emerged clonal group that contains both clinical and environmental strains

Genome-Wide SNP-genotyping array to study the evolution of the human pathogen Vibrio vulnificus Biotype 3

Vibrio vulnificus is an aquatic bacterium and an important human pathogen. Strains Of V. vulnificus are classified into three different biotypes. The newly emerged biotype 3 has been found to be clonal and restricted to Israel. In the family Vibrionaceae , horizontal gene transfer is the main mechanism responsible for the emergence of new pathogen groups. To better understand the evolution of the bacterium, and in particular to trace the evolution of biotype 3, we performed genome-wide SNP genotyping of 254 clinical and environmental V. vulnificus isolates with worldwide distribution recovered over a 30-year period, representing all phylogeny groups. A custom single-nucleotide polymorphism (SNP) array implemented on the Illumina GoldenGate platform was developed based on 570 SNPs randomly distributed throughout the genome. In general, the genotyping results divided the V. vulnificus species into three main phylogenetic lineages and an additional subgroup, clade B, consisting of environmental and clinical isolates from Israel. Data analysis suggested that 69% of biotype 3 SNPs are similar to SNPs from clade B, indicating that biotype 3 and clade B have a common ancestor. The rest of the biotype 3 SNPs were scattered along the biotype 3 genome, probably representing multiple chromosomal segments that may have been horizontally inserted into the clade B recipient core genome from other phylogroups or bacterial species sharing the same ecological niche. Results emphasize the continuous evolution of V. vulnificus and support the emergence of new pathogenic groups within this species as a recurrent phenomenon. Our findings contribute to a broader understanding of the evolution of this human pathogen

Psychosocial outcomes of sharing a diagnosis of cancer with a pediatric patient

Purpose: This innovative pilot study was designed to provide research-based evidence on the variables to consider informing a child of his/her cancer diagnosis, so as to minimize the negative psychosocial effects of the cancer experience on survivors. The hypotheses of the study were that 'good information' about cancer, will allow the child a better understanding way to cope with treatment and improve socio-psychological outcomes at adulthood.Methods: Ninety-one adult childhood cancer survivors got the questionnaires while waiting to their routine checkup at a grate childhood cancer medical center in center Israel. Results: To our surprise and not according to the hypothesis, there was a difference between children diagnosed up to 12 years of age and those diagnosed during adolescence. (Participants were divided into two groups according to their age at diagnosis: from birth to 12-years-old and from age 12 to 18). In the group diagnosed at a younger age, those who had received good information were found to have better quality of life, lower mental pain and higher mental pain tolerance than did those in the same group (diagnosed at a younger age) who received not good information. By contrast, in the group diagnosed during adolescence, those who had received not good information scored higher on these measures than did their counterparts who had received good information.Conclusions: Given that information conveyed to children diagnosed with cancer can have a significant impact on survivors' quality of life, further research is needed to determine the precise information to be divulged to children at the time of diagnosis. In the meantime, extreme caution, sensitivity, and careful judgement are required. Clinical Relevance: Findings the current study and of future studies can be used to formulate clear guidelines for assessing a child's readiness and the information to be divulged, so as to improve the quality of life of childhood cancer survivors. Keywords: childhood cancer, information, childhood cancer survivors, quality of life, mental pain, meaning

Environmental monitoring of Vibrio cholerae using chironomids in India

Environmental Vibrio cholerae strains belonging to the non-O1/non-O139 serogroups are natural inhabitants of freshwater including estuarine environments. Recent findings indicated that chironomids (Diptera: Chironomidae), the most widely distributed insects in freshwater, serve as a natural reservoir of these bacteria. Here we study the role of chironomids, particularly exuviae as carriers and as a monitoring tool for the distribution of V. cholerae in the environment. During a survey conducted in India (June 2006), 326 V. cholerae non-O1/non-O139 isolates were isolated from chironomid egg masses, larvae and exuviae. In addition, a heat-stable enterotoxin (nag-st) positive strain was isolated from exuviae during the local cholera outbreak. We identified 62 different strains in a subset of 102 isolates by analysis of variable number of tandem repeats (VNTR), demonstrating a high variation of V. cholerae on hosting chironomids. Our results show that chironomids can both maintain and distribute this overwhelming diversity of environmental V. cholerae strains, including toxigenic ones. Exuviae proved to be an efficient tool for the monitoring of environmental V. cholerae, offering simple, direct and practical access for on-shore collection. Finally, finding toxigenic V. cholerae on chironomids in endemic areas, together with molecular typing, may potentially improve monitoring of cholera in the future

See-and-treat in-office hysteroscopy versus operative hysteroscopy for the treatment of retained products of conception: A retrospective study

AIM: To compare the efficacy and safety of in-office hysteroscopy with a see-and-treat approach with that of operative hysteroscopy for the treatment of retained products of conception (RPOC). METHODS: We retrospectively identified all consecutive patients who underwent hysteroscopic treatment of RPOC between 2015 and 2019. We excluded patients with RPOC larger than 2 cm at preoperative transvaginal ultrasounds. Between 2015 and 2017, all hysteroscopic removals of RPOC were performed by operative hysteroscopy. Between 2018 and 2019, all cases of RPOC less than 2 cm in size were hysteroscopically removed by the see-and-treat approach in the office setting. Sociodemographic, clinical, and procedure characteristics along with complications were retrieved from medical records. RESULTS: Between 2015 and 2019, 119 women underwent hysteroscopic removal of RPOC equal to or smaller than 2 cm: 53 patients by in-office hysteroscopy, and 66 by operative hysteroscopy. The two groups were similar in preoperative characteristics. Although the time required to complete the RPOC removal was similar, the total procedure and assistant time were significantly higher in the operative hysteroscopy group (p < 0.001). Moreover, operative hysteroscopy was associated with a higher proportion of cases complicated by excessive bleeding, cervical tear, or uterine perforation (p = 0.016). Failure to complete the procedure was similarly reported in the two groups (p = 0.58). CONCLUSIONS: In-office hysteroscopy with the see-and-treat approach for RPOC equal to or smaller than 2 cm appears as effective as operative hysteroscopy, but safer. In-office hysteroscopy may be considered the first choice for treating RPOC equal to or smaller than 2 cm

MUM-1 immunohistochemistry has high accuracy and reliability in the diagnosis of chronic endometritis: a multi-centre comparative study with CD-138 immunostaining

Purpose The current gold standard for chronic endometritis (CE) diagnosis is immunohistochemistry (IHC) for CD-138. However, IHC for CD-138 is not exempt from diagnostic limitations. The aim of our study was to evaluate the reliability and accuracy of MUM-1 IHC, as compared with CD-138. Methods This is a multi-centre, retrospective, observational study, which included three tertiary hysteroscopic centres in university teaching hospitals. One hundred ninety-three consecutive women of reproductive age were referred to our hysteroscopy services due to infertility, recurrent miscarriage, abnormal uterine bleeding, endometrial polyps or myomas. All women underwent hysteroscopy plus endometrial biopsy. Endometrial samples were analysed through histology, CD138 and MUM-1 IHC. The primary outcome was to evaluate the diagnostic accuracy of MUM-1 IHC for CE, as compared with CD-138 IHC. Results Sensitivity and specificity of CD-138 and MUM-1 IHC were respectively 89.13%, 79.59% versus 93.48% and 85.03%. The overall diagnostic accuracy of MUM-1 and CD-138 IHC were similar (AUC = 0.893 vs AUC = 0.844). The intercorrelation coefficient for single measurements was high between the two techniques (ICC = 0.831, 0.761-0.881 95%CI). However, among CE positive women, MUM-1 allowed the identification of higher number of plasma cells/hpf than CD-138 (6.50 [SD 4.80] vs 5.05 [SD 3.37]; p = 0.017). Additionally, MUM-1 showed a higher inter-observer agreement as compared to CD-138. Conclusion IHC for MUM-1 and CD-138 showed a similar accuracy for detecting endometrial stromal plasma cells. Notably, MUM-1 showed higher reliability in the paired comparison of the individual samples than CD-138. Thus, MUM-1 may represent a novel, promising add-on technique for the diagnosis of CE

PCA of genotyping data of Israeli biotype_1 strains processed in relation to synthetic biotype_3 haplotype.

<p>Principal component analysis (PCA) was carried out on datasets containing 530 SNPs. The scatter diagram of a cluster analysis performed with PCA is shown; the strains (dots) are classified into two or three groups with the following color code: LI – light blue, azure, LIII – black, LI-clade-B – dark blue. Together, components PC1 and PC2 explain 50% of the variance (38 and 12%, respectively); 95% confidence ellipses around each group are indicated.</p

Phylogenetic relationships among 254 <i>V. vulnificus</i> isolates based on variation data at 570 SNP loci.

<p>(A) Parametric analysis: the evolutionary history was inferred using the neighbor-joining method and the evolutionary distances were computed using the Kimura two-parameter method with bootstrap analysis of 1,000 replicates. (B) Nonparametric analysis: genetic relationships among strains were inferred using the Jaccard similarity coefficient, and the distance matrix was generated with PAST software (version 1.94b). The phylogenetic tree was constructed by using the minimum evolution (ME) cluster analysis.</p

The group origin map of the biotype 3 haplotype in comparison to the synthetic haplotype.

<p>Data are arranged in three rows representing the 530 SNPs along the <i>V. vulnificus</i> chromosomes (genome). (1) The group origin map based on PCA results (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0114576#pone-0114576-g004" target="_blank">Fig. 4</a>). Blue – SNPs originated in LI-clade-B, light blue – SNPs originated in LI, black – SNPs originated in LIII; SNPs that were not found in any of the 59 tested biotype 1 strains were not colored. (2) The synthetic haplotype of biotype 3. The different alleles are color coded as follows: allele 1 – orange, allele 2 – green, and “no product” allele – yellow.</p

Phylogenetic relationships among 30 <i>V. vulnificus</i> strains inferred from GoldenGate genotyping results compared to sequencing.

<p>Results were based on Illuminus-P genotype calls obtained by the GoldenGate assay at 31 SNPs compared to sequencing analysis of the same 12 intergenic loci analyzed as sequence types. These loci served for array quality control. A nonparametric analysis of allelic variation was used to calculate the Nei coefficient of association and to generate the corresponding matrix with SAS 8.02, followed by minimum-evolution (ME) cluster analysis using MEGA5.</p