Genomics reveals the role of admixture in the evolution of structure among sperm whale populations within the Mediterranean Sea

In oceanic ecosystems, the nature of barriers to gene flow and the processes by which populations may become isolated are different from the terrestrial environment, and less well understood. In this study we investigate a highly mobile species (the sperm whale, Physeter macrocephalus) that is genetically differentiated between an open North Atlantic population and the populations in the Mediterranean Sea. We apply high-resolution single nucleotide polymorphism (SNP) analysis to study the nature of barriers to gene flow in this system, assessing the putative boundary into the Mediterranean (Strait of Gibraltar and Alboran Sea region), and including novel analyses on structuring among sperm whale populations within the Mediterranean basin. Our data support a recent founding of the Mediterranean population, around the time of the last glacial maximum, and show concerted historical demographic profiles in both the Atlantic and the Mediterranean. In each region there is evidence for a population decline around the time of the founder event. The largest decline was seen within the Mediterranean Sea where effective population size is substantially lower (especially in the eastern basin). While differentiation is strongest at the Atlantic/Mediterranean boundary, there is also weaker but significant differentiation between the eastern and western basins of the Mediterranean Sea. We propose, however, that the mechanisms are different. While post-founding gene flow was reduced between the Mediterranean and Atlantic populations, within the Mediterranean an important factor differentiating the basins is probably a greater degree of admixture between the western basin and the North Atlantic and some level of isolation between the western and eastern Mediterranean basins. Subdivision within the Mediterranean Sea exacerbates conservation concerns and will require consideration of what distinct impacts may affect populations in the two basins.

Artificial Intelligence DENTOMO: Opportunities and Prospects for Interpretation of Cone Beam CT in Dentistry

The model of artificial intelligence DENTOMO, which allows automated deciphering the CT in maxillofacial area, was developed and implemented in practical dentistry. The presented model is based on two convolutional neural networks, includes a database and knowledge base, harmonized with SNOMED Clinical Terms is a systematically organized computer processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. The developed model automatically decodes cone beam CT images, identifies and classifies the anatomical structures of the human dental system, and reveals the pathological processes and their dynamics in dentistry system. This model generates the medical reports automatically. Testing of DENTOMO model demonstrated a reasonable effectiveness in deciphering the CT of dental system. The developed technology allows computerizing and objectifying interpretation of CT of the dental system.

Retrospective Study of Traumatic Intra-Interspecific Interactions in Stranded Cetaceans, Canary Islands

Aggressive encounters involving cetacean species are widely described in the literature. However, detailed pathological studies regarding lesions produced by these encounters are scarce. From January 2000 to December 2017, 540 cetaceans stranded and were necropsied in the Canary Islands, Spain. Of them, 24 cases of eight species presented social traumatic lesions produced by cetaceans of the same or different species. All the cases presented severe multifocal vascular changes, 50% (12/24) presented fractures affecting mainly the thoracic region, 41.7% (10/24) acute tooth-rake marks, 37.5% (9/24) undigested food in the stomach, 33.3% (8/24) tracheal edema, and 12.5% (3/24) pulmonary perforation. In 10 cases with tooth-rake marks, the distance between the teeth, allowed us to further identify the aggressor species: four cases were compatible with killer whales (Orcinus orca) affecting three species [pigmy sperm whale (Kogia breviceps), Cuvier's beaked whale (Ziphius cavirostris), and short-finned pilot whale (Globicephala macrorhynchus)] and four cases compatible with common bottlenose dolphins (Tursiops truncatus) affecting two species [short-beaked common dolphin (Delphinus delphis) and Atlantic spotted dolphin (Stenella frontalis)]. We also described two cases of intraspecific interaction in stripped dolphin (Stenella coeruleoalba). Microscopically, 70.8% (17/24) of the cases presented acute degenerative myonecrosis, 66.7% (14/21) presented vacuoles in the myocardiocytes, 36.8% (7/19) pigmentary tubulonephrosis, 31.6% (6/19) cytoplasmic eosinophilic globules within hepatocytes, 21.4% (3/14) hemorrhages in the adrenal gland, and 17.3% (4/23) bronchiolar sphincter contraction. The statistical analysis revealed that deep divers, in good body condition and nearby La Gomera and Tenerife were more prone to these fatal interactions. Additionally, in this period, three animals died due to an accident during predation: a false killer whale (Pseudorca crassidens) died because of a fatal attempt of predation on a stingray, and two Risso's dolphins (Grampus griseus) died as a consequence of struggling while predating on large squids.

Advances in research on the impacts of anti-submarine sonar on beaked whales

Mass stranding events (MSEs) of beaked whales (BWs) were extremely rare prior to the 1960s but increased markedly after the development of naval mid-frequency active sonar (MFAS). The temporal and spatial associations between atypical BW MSEs and naval exercises were first observed in the Canary Islands, Spain, in the mid-1980s. Further research on BWs stranded in association with naval exercises demonstrated pathological findings consistent with decompression sickness (DCS). A 2004 ban on MFASs around the Canary Islands successfully prevented additional BW MSEs in the region, but atypical MSEs have continued in other places of the world, especially in the Mediterranean Sea, with examined individuals showing DCS. A workshop held in Fuerteventura, Canary Islands, in September 2017 reviewed current knowledge on BW atypical MSEs associated with MFAS. Our review suggests that the effects of MFAS on BWs vary among individuals or populations, and predisposing factors may contribute to individual outcomes. Spatial management specific to BW habitat, such as the MFAS ban in the Canary Islands, has proven to be an effective mitigation tool and mitigation measures should be established in other areas taking into consideration known population-level information.

Contamination status by persistent organic pollutants of the Atlantic spotted dolphin (Stenella frontalis) at the metapopulation level

The Atlantic spotted dolphin (Stenella frontalis) is an endemic species of the tropical-temperate Atlantic Ocean with widespread distribution. Although this species has been the subject of a large number of studies throughout its range, it remains in the "data deficient" category of the International Union for Conservation of Nature (IUCN). Chemical pollution by persistent organic pollutants (POPs) has been listed as one of the major threats to this species, however, there is no information on a wide scale. Thus, the aim of the present study was to investigate the contamination status of spotted dolphins on the metapopulation level as well as determine spatial and temporal variations in POP concentrations and bio-accumulation. A total of 115 blubber samples collected from a large part of the Atlantic basin were analysed for PCBs, DDTs, PBDEs, chlordanes, HCB and mirex. Although PCBs and DDTs were the predominant compounds in all areas, inter-location differences in POP concentrations were observed. Dolphins found at São Paulo, southeastern coast of Brazil, had the highest PCB concentrations (median: 10.5 μg/g lw) and Canary Islands dolphins had the highest DDT concentrations (median: 5.13 μg/g lw). Differences in PCB patterns among locations were also observed. Dolphins from the Azores and São Paulo demonstrated a similar pattern, with relatively highly contributions of tetra- (6.8 and 5.2%, respectively) and penta-CBs (25.6 and 23.8%, respectively) and lower contributions of hepta-CBs (20.8 and 23.5%, respectively) in comparison to other areas. Moreover, the sex of the animals and the year in which sampling or capture occurred exerted an important influence on the majority of the POPs analysed. Comparisons with toxicity thresholds available in the literature reveal that the São Paulo and Canary Island dolphins are the most vulnerable populations and should be considered in future conservation and management programs for the Atlantic spotted dolphin.

True's beaked whale (Mesoplodon mirus) in Macaronesia

The True’s beaked whale (Mesoplodon mirus, True 1913) is a poorly known member of the Ziphiidae family. Its distribution in the northern hemisphere is thought to be restricted to the temperate or warm temperate waters of the North Atlantic, while a few stranding records from the southern hemisphere suggest a wider and antitropical distribution, extending to waters from the Atlantic coast of Brazil to South Africa, Mozambique, Australia and the Tasman Sea coast of New Zealand. This paper (i) reports the first molecular confirmation of the occurrence of the True’s beaked whale at the southern limit of its distribution recorded in the northeast Atlantic: the Azores and Canary Islands (macaronesian ecoregion); (ii) describes a new colouration for this species using evidence from a whale with molecular species confirmation; and (iii) contributes to the sparse worldwide database of live sightings, including the first underwater video recording of this species and close images of a calf. Species identification was confirmed in two cases using mitochondrial DNA control region and cytochrome b gene markers: a subadult male True’s beaked whale that stranded in El Hierro, Canary Islands, in November 2012, and a subadult male found floating dead near Faial, the Azores, in July 2004. The whale that stranded in the Canary Islands had a clearly delimited white area on its head, extending posteriorly from the tip of the beak to cover the blowhole dorsally and the gular grooves ventrally. This colouration contrasts with previous descriptions for the species and it may be rare, but it exemplifies the variability of the colouration of True’s beaked whales in the North Atlantic, further confirmed here by live sightings data. The recording of several observations of this species in deep but relatively coastal waters off the Azores and the Canary Islands suggests that these archipelagos may be unique locations to study the behaviour of the enigmatic True’s beaked whale.

Levels and profiles of POPs (organochlorine pesticides, PCBs, and PAHs) in free-ranging common bottlenose dolphins of the Canary Islands, Spain

The effect of anthropogenic pollution in marine mammals worldwide has become an important issue due to the high concentrations found in many areas. The present study represents the first report of pollutants in free-ranging cetaceans from the Canary Islands, where there are 12 marine Special Areas of Conservation (SACs), because of the presence of bottlenose dolphins (Tursiops truncatus). We selected this resident population of dolphins as a bioindicator to gain knowledge concerning the toxicological status of the cetaceans of this protected area. In 64 biopsy samples of live free-ranging animals sampled from 2003 to 2011, we determined the concentrations of 18 polychlorinated biphenyls (PCBs), 23 organochlorine pesticides (OCPs) and 16 polycyclic aromatic hydrocarbons (PAHs). We found high levels of many of these pollutants, and some of them were detectable in 100% of the samples. The median value for ∑OCPs was 57,104 ng g(-1) lipid weight (lw), and the dichlorodiphenyldichloroethylene (p,p'-DDE) accounted for 70% of this amount. Among PCBs, congeners 180, 153 and 138 were predominant (82% of ∑PCBs; median = 30,783 ng g(-1) lw). Concerning the analyzed PAHs, the total median burden was 13,598 ng g(-1) lw, and phenanthrene was the compound measured at the highest concentration followed by pyrene and by naphthalene. Surprisingly, we have found that organohalogen pollutants exhibit an upward trend in recent years of sampling. Thus, according to the guidelines outlined in the EU's Marine Strategy Framework Directive, further monitoring studies in Canary Islands are required to contribute to the conservation of the resident populations of marine mammals in this region.

Clinical, molecular and biochemical characterization of nine Spanish families with Conradi-Hünermann-Happle syndrome: new insights into X-linked dominant chondrodysplasia punctata with a comprehensive review of the literature

BACKGROUND

Conradi-Hünermann-Happle syndrome (CDPX2, OMIM 302960) is an inherited X-linked dominant variant of chondrodysplasia punctata which primarily affects the skin, bones and eyes. CDPX2 results from mutations in EBP (emopamil binding protein), and presents with increased levels of sterol precursors 8(9)-cholesterol and 8-dehydrocholesterol.

OBJECTIVES

To expand the understanding of CDPX2, clinically, biochemically and genetically.

METHODS

We present one of the largest series reported to date, including 13 female patients belonging to nine Spanish families. Patients were studied biochemically using gas chromatography-mass spectrometry, genetically using polymerase chain reaction and in their methylation status using the HUMARA assay.

RESULTS

In our cases, there was a clear relationship between abnormal sterol profile and the EBP gene mutation. We describe three novel mutations in the EBP gene. EBP mutations were inherited in three out of nine families and were sporadic in the remaining cases.

CONCLUSIONS

No clear genotype-phenotype correlation was found. Patients' biochemical profiles did not reveal a relationship between sterol profiles and severity of disease. A skewed X-chromosome inactivation may explain the clinical phenotype in CDPX2 in some familial cases.

[Quality and accreditation of emergency departments]

The concept of quality has been linked to the health care world since the remote past and is one of the strategic elements on which the transformation and improvement of modern health systems is based. Study of quality in health care involves different approaches given that it holds different meanings for patients, professionals and managers. In recent years formal systems of quality management have been progressively introduced, such as certification according to the ISO-9000 Norms, the system of accreditation of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the European Model of Excellence (EFQM). Management by processes is another tool directed towards achieving the aims of total quality in the care process and tackling health problems centred on the patient. Quality health care involves evidence based clinical practice; based on current scientific knowledge, following clinical practice guidelines based on evidence, with the least risk for patients and relatives, involving greater efficiency and greater satisfaction for users and health personnel. The accreditation of health care centres and services is, without doubt, the most widely accepted method for guaranteeing quality. It can be defined as the process of external evaluation to which a health organisation is subjected, based on a review of certain accepted criteria and standards, whose fulfillment demonstrates that that centre is developing its functions within parameters of quality that at least approach excellence.

The EORTC QLQ-C30 (version 3.0) Quality of Life questionnaire: validation study for Spain with head and neck cancer patients

The EORTC Quality of Life Study Group has developed a questionnaire for evaluating Quality of Life in international clinical trials: QLQ-C30. The purpose of the present work is to validate the third version of this questionnaire (3.0) for use in Spain. Two hundred and one head and neck cancer patients completed the QLQ-C30 at one or two time points during the treatment and follow-up periods, and a subsample completed the questionnaire on three occasions. Psychometric evaluation of the structure, reliability and validity of the questionnaire was undertaken. The data support the structure and the reliability of the scales. Validity was confirmed in three ways: the interscale correlations are statistically significant and moderate, several scales and items discriminate among groups of patients with different scores on the clinical variables, and some scales reflect significant changes during treatment and the follow-up period. The EORTC QLQ-C30 (version 3.0) is a reliable and valid questionnaire when applied to a sample of Spanish head and neck cancer patients. These results are in line with previous studies.

Hyperfractionated radiotherapy concomitant with cisplatin and granulocyte colony-stimulating factor (filgrastim) for laryngeal carcinoma

An open-label, non-randomized study evaluated the feasibility and efficacy of filgrastim (recombinant methionyl human granulocyte colony-stimulating factor, r-metHuG-CSF) to prevent mucositis induced by accelerated hyperfractionated radiotherapy (1.6 Gy b.i.d., total dose 67.2 Gy in six weeks with a two-week split) and concomitant chemotherapy (cisplatin, 20 mg/m2/day, days 1-5 by continuous intravenous infusion) in patients with laryngeal carcinoma. Filgrastim 300 microg/day was administered on days 1, 3, and 5 in weeks 2-6 of radiotherapy, after the second fraction. Twenty patients (three stage II, six stage III, and eleven stage IV, according to AJCC) were enrolled in the trial. Oral mucosal toxicity was grade 2 in nine patients (45%), grade 3 in eight (40%), and grade 4 in three (15%). Severe hematological toxicity (WHO criteria) was uncommon. Nineteen patients (95%) completed the treatment in the planned time. Overall survival was 55% at three years. The administration of filgrastim with this regimen was feasible, and it appeared to reduce the severity and duration of mucositis induced by the combined treatment.

Radical chemoradiotherapy for elderly patients with bladder carcinoma invading muscle

BACKGROUND

Chemoradiotherapy is becoming an alternative to radical cystectomy among patients with bladder carcinoma invading muscle. In 1988, the authors began a protocol with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC regimen) and radiotherapy for these patients. Traditionally, age has been considered a determinant factor thereby excluding the older patients from the oncologic protocols that are considered to be more aggressive. The authors analyzed 20 patients (age > 70 years) who were treated during this period with the same protocol as the authors' other patients.

METHODS

The study included 20 patients (age range, 70-78 years; median age, 74 years) including 4 patients with T2 disease, 9 with T3 disease, and 7 with T4 disease. All patients had a Karnofsky performance status of > 60. Treatment protocol included cytoreductive transurethral resection, 2 cycles of M-VAC chemotherapy, and radiotherapy (45 grays [Gy] on pelvic volume) with concurrent cisplatin (20 mg/m2 on Days 1-5. Response was determined by cystoscopic evaluation. If there was a complete response, radiotherapy continued until a total dose of 65 Gy; if there was not a complete response, cystectomy was performed.

RESULTS

Tumor response after a dose of 45 Gy included 11 complete responses (55%), 5 partial responses (25%), and 4 nonresponses (20%). Overall survival was 75%, 34%, and 27% in the 2nd, 3rd, and 5th years of follow-up, respectively. Cause specific survival was 79%, 54%, and 38%, respectively. Survival for patients with complete response was 100%, 60%, and 48%, respectively. Severe toxicity was uncommon, with the most frequent toxicities being leukopenia and cystitis. No treatment-related death occurred with either treatment protocol.

CONCLUSIONS

The age of the individual must not become a strict exclusion criterion for the radical treatment of old patients with invasive bladder carcinoma.

Split hyperfractionated accelerated radiation therapy and concomitant cisplatin for locally advanced head and neck carcinomas: a preliminary report

PURPOSE

The feasibility and activity of an intensive chemoradiotherapeutic scheme for patients with locally advanced squamous cell head and neck cancers were tested in a single institution Phase II pilot study.

METHODS AND MATERIALS

Between January 1990 and February 1992, 40 patients were entered into this trial. The treatment protocol consisted of split hyperfractionated accelerated radiation therapy (SHART), 1.6 Gy per fraction given twice per day to a total dose of 64-67.2 Gy for a total of 6 weeks with a 2-week gap, and cisplatin (20 mg/sqm/Days 1 to 5, in continuous perfusion) concomitantly.

RESULTS

All of the 40 patients are evaluable for response and survival. Toxicity was significant, but tolerable. A complete tumor response to this treatment was achieved by 37 patients (92.5%). With a minimal follow-up of 22 months (median 30 months) there have been 16 local relapses and 19 patients have died, 2 without tumor. The projected 2- and 3-year overall survival rates are 64% (confidence interval (CI) 95%, 49-79%) and 47%, respectively. The 2-year local control probability has been 56% (CI 95%, 39-73%).

CONCLUSION

This treatment obtains a high rate of complete responses with increased acute toxicity but tolerable late effects. Preliminary results are encouraging for laryngeal neoplasms. A longer follow-up is needed to evaluate the impact of this treatment on patient survival.

Mitomycin, cisplatin, and vindesine followed by radiotherapy combined with cisplatin in stage III nonsmall cell lung cancer: long-term results

PURPOSE

To assess the tolerance, response rate, pattern of failure, and long-term survival of patients with unresectable nonsmall cell lung cancer treated with one cycle of induction chemotherapy followed by concurrent cisplatin and radiotherapy.

METHODS AND MATERIALS

From 1986 to 1988, 45 patients with histologically proven nonsmall cell lung cancer clinical Stage III (29 IIIA and 16 IIIB) were included in this study. Patients received one cycle of Mitomycin C 10 mg/m2 day 1, Cisplatin 120 mg/m2 day 1, and Vindesine 3 mg/m2 days 1, 8, 15, and 22, by i.v. bolus injection. Radiotherapy was started within 4-6 weeks after completion of chemotherapy, with a total tumor dose of 60 Gy, at 2 Gy/day. Cisplatin, 20 mg/m2/day by i.v. continuous infusion was administered for days 1-5 of radiation treatment.

RESULTS

The main toxic acute effects were nausea-vomiting grade 1-3 in 38 patients (85%). Ten patients (22%) developed esophagitis grade 3. Leukopenia grade 1-2 was observed in 18 patients (40%), grade 3 in 12 (27%), and grade 4 in 4 (9%). Three patients (6.6%) died by granulocytopenia and sepsis. A bronchoscopic proven complete response was achieved in 9 patients (21.5%) and partial response in 28 patients (67%). With a minimum follow-up of 65 months, overall median survival was 13 months, 2-year survival was 21%, and 5-year survival was 7%, with no statistical difference between Stage IIIA and IIIB. Median survival of patients with complete response was 23.2 months, and 5-year survival was 33%.

CONCLUSION

This treatment scheme produced a severe toxicity and in spite of a high response rate, long-term survival is poor, similar to previous studies with radiotherapy alone.

Neoadjuvant chemotherapy and radiotherapy in locally advanced esophagus carcinoma: long-term results

PURPOSE

A prospective study with neoadjuvant chemotherapy and radiotherapy in patients with locally advanced esophagus carcinoma for evaluating: toxicity, response rate, pattern of recurrence, and survival after a long follow-up.

METHODS AND MATERIALS

Between 1983-1988, 40 patients with locally advanced squamous cell carcinoma of the thoracic esophagus were entered into a prospective trial of neoadjuvant chemotherapy and radiotherapy. Eight patients (20%) were Stage II and 32 patients (80%) were Stage III, according to American Joint Committee staging criteria. Neoadjuvant chemotherapy consisted of two cycles with cisplatin (120 mg/m2 day 1), vindesine (3 mg/m2 days 1, 8, 15, and 22) and bleomycin (10 mg/m2 days 3 to 6). Second cycle was initiated on day 29. Radiation therapy was administered 2-4 weeks after completion of chemotherapy, with a total dose on tumor of 60 Gy.

RESULTS

Two patients died from treatment-related toxicity. Complete response was observed in 20 patients (53%) and symptomatic improvement in 31 patients (82%). The median survival was 11 months, with an actuarial survival at 1 year of 45%, 3 year 20%, and 5 years 15%. Significantly (p < 0.05) longer survival was observed in patients with Stage II (median survival 18 months) vs. Stage III (median survival 10 months). The pattern of failure was predominantly local/regional (62%).

CONCLUSION

This treatment scheme is an effective and tolerable regimen but long-term survival was poor.

Induction chemotherapy with carboplatin and ftorafur in advanced head and neck cancer. A randomized study

From 1987 to 1989, 42 patients with locally advanced squamous cell carcinoma of the head and neck (Stages III-IV, Mo) were randomized to receive radiotherapy (Group A) or three courses of induction chemotherapy followed by radiotherapy (Group B). There were 36 evaluable patients, 17 in Group A and 19 in Group B. The radiotherapy regimen was the same for both groups, 66-74 Gy total tumor doses with standard fractionation scheme of 2 Gy/day. The chemotherapy regimen was a combination of carboplatin 400 mg/m2 by intravenous bolus injection on day 1, and Ftorafur 1,000 mg/m2 orally once a day for 14 days. Cycles were given every 4 weeks. The complete response rate in Group A was 65%; in group B it was 31.5% after induction chemotherapy and 84% after radiotherapy. The 42-month actuarial overall survival rates were 34% for Group A and 47% for Group B (P = NS). Patients from both groups with a complete response had a significantly longer survival time than those with a partial response (P less than 0.001). No significant differences in disease-free survival were found between the two treated groups. The chemotherapy regimen was well tolerated, with moderate hematologic and gastrointestinal toxicity. Increased in radiation toxicity by chemotherapy was not observed.

Modulation of cell growth and differentiation induced by prostaglandin D2 in the glioma cell line C6

Prostaglandins are produced mainly from arachidonic in various normal and neoplastic tissues and are well-known to be involved in the regulation of tumor cell proliferation, differentiation and metastasis. Prostaglandin D2 is cytotoxic to several human tumor cell lines, has antitumoral activity in vitro and is reported to be antimetastatic. However, the effects of prostaglandin D2 on tumoral cell differentiation have not been clarified. This paper studies the effects of prostaglandin D2 on C6 rat glioma cell differentiation and proliferation. Prostaglandin D2 administration in the culture medium is observed to alter cell morphology and cytoskeleton filament patterns. These alterations suggest a cell maturation, and correlate with a drop in proliferating capacity. The antitumoral activity of prostaglandin D2 involves a biomodulation of cell parameters which would affect neoplastic processes.

Potentiation of radiation toxicity in C-6 glioma cells by prostaglandin D2

The effects of prostaglandin D2 (PG D2) and X-ray radiation on the growth and cell survival of C-6 rat glioma cells were evaluated. Exponentially growing monolayer cultures of C-6 glioma cells were incubated with various concentrations of PG D2 for 24 hours prior to X-ray irradiation. PG D2 exposure was associated with an inhibition of cell growth and a reduction in cell survival (IC50 = 5.2 micrograms/ml). The combination of PG D2 and X-ray radiation significantly increased cell killing in comparison with either PG D2 or X-alone. The enhancing factor measured at a survival level of 10% was determined. PG D2 potentiation of radiation toxicity could be related to a blockage of a G1 phase of the cell cycle.