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Background: According to the European Society for Medical Oncology/ European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology (ESMO/ESGO/ESTRO) Consensus Conference, the role of preoperative risk groups (RGs) in endometrial cancer (EC) is to direct surgical nodal staging. We compared diagnostic accuracy and economic impact of three work-up strategies to identify RGs., Methods: A retrospective multicentre study including patients with early-stage EC. The three different work-up strategies were as follows:-Mondovì Hospital: transvaginal ultrasonography, pelvic magnetic resonance imaging (MRI); frozen section examination of the uterus in case of imaging discordance. High-risk patients underwent abdominal computed tomography.-Gemelli Hospital: transvaginal ultrasonography, MRI, One-Step Nucleic Acid Amplification (OSNA) of sentinel lymph node (SLN); frozen section examination of the uterus in case of imaging discordance.-Negrar Hospital: positron emission tomography (PET), frozen section examination of the uterus and of SLN. For statistical purposes patients were assigned, preoperatively and postoperatively, to two groups: group A (high-risk) and group B (not high-risk)., Results: Three hundred eighty-five patients were included (93 Mondovì, 215 Gemelli, 77 Negrar). Endometrial biopsy errors led to 47.3% misclassifications. Test accuracy of Mondovì, Gemelli and Negrar strategies was 0.83 (95%CI 0.734-0.901), 0.95 (95%CI 0.909-0.975) and 0.94 (95%CI 0.866-0.985), respectively. Preoperative work-up mean cost per patient in group A was €514.5 at Mondovì, €868.5 at Gemelli, and €1212.8 at Negrar hospital (p-value < 0.001), while in group B was €378.8 at Mondovì, €941.2 at Gemelli, and €1848.4 at Negrar hospital (p-value < 0.001)., Conclusions: In our study, work-up strategies with more relevant economic impact showed a better diagnostic accuracy. Upcoming guidelines should specify recommendations about the gold standard work-up strategy, including the role of SLN., Competing Interests: Conflict of Interest statement: none of the authors declare conflicts of interest., (Copyright © 2020 Facts, Views & Vision.)

Marine and coastal quality assessment, based on test batteries involving a wide array of endpoints, organisms and test matrices, needs for setting up toxicity indices that integrate multiple toxicological measures for decision-making processes and that classify the continuous toxicity response into discrete categories according to the European Water Framework Directive. Two toxicity indices were developed for the lagoon environment such as the Venice Lagoon. Stepwise procedure included: the construction of a database that identified test-matrix pairs (indicators); the selection of a minimum number of ecotoxicological indicators, called toxicological core metrics (CMs-tox) on the basis of specific criteria; the development of toxicity scores for each CM-tox; the integration of the CMs-tox into two indices, the Toxicity Effect Index (TEI), based on the transformation of Toxic Unit (TU) data that were integrated as logarithmic sum, and the Weighted Average Toxicity Index (WATI), starting from toxicity classes integrated as weighted mean. Results from the indices are compared; advantages and drawbacks of both approaches are discussed., (Copyright © 2010. Published by Elsevier Ltd.)

Porewater plays an important role in sediment toxicity assessment using bioassays, but the most reliable extracting method and the potential contribution of confounding factors to the real toxicity need to be studied. The applicability of bioassays with the early life stages of Paracentrotus lividus, Mytilus galloprovincialis and Crassostrea gigas on porewaters extracted by centrifugation from the Venice Lagoon (Italy) is evaluated and demonstrated: toxicity tests can discriminate the toxicity of porewaters from sites with different kinds and levels of pollution and, using toxicity scores, data are classified in five toxicity classes. Sulphides do not represent a confounding factor in porewater toxicity; in contrast ammonia exhibited some concentrations above the toxicity threshold for sea urchin embryos.

Bioassays are routinely employed for sediment quality assessment. In order to be able to effectively use Bioassays responses in regulatory and management frameworks, toxicity scores, which rank toxicity data in defined classes that are continuous and difficult to interpret, should be reliable and suitable tools to support decisions about the presence or absence of toxicity in tested samples and on how toxic a sample is. A statistical approach is needed to define thresholds for toxicity scores. The Minimum Significance Difference (MSD) criterion allowed the evaluation of toxicity thresholds for each test-matrix and organism pair, based on large sets of experimental data. The MSD values were normalized with respect to the control, ranked in ascending order, and the 90th percentile was identified; the Toxicity Threshold (TT) was calculated by subtracting the 90th percentile from 100 and the Toxicity Limit (TL) was estimated as the percentage of control response multiplied by TT. Taking into account sample responses normalized with respect to control (S), when S > TL, the sample is considered nontoxic; when S

This work reports some considerations on the possible contribution of sulfide and ammonia to the toxicity of elutriate samples of sediments from the Venice lagoon, tested with a battery of bioassays using early life stages of the sea urchin Paracentrotus lividus and the oyster Crassostrea gigas. A comparison of ammonia or sulfide concentration in the test matrix, matrix toxicity, and the sensitivity limit of bioassays for ammonia or sulfide were used in evaluating toxicity data. Results highlighted that sperm cell and embryo toxicity of elutriates were not affected by sulfides. Neither was any direct relationship shown between elutriate toxicity and ammonia concentration. Most elutriates had ammonia concentrations below the sensitivity limit of acute test methods, while the more sensitive subchronic toxicity tests were affected by ammonia interference in some samples.

Methodological research was carried out to evaluate the discriminatory capability of three toxicity bioassays toward different elutriation ratios (1:4, 1:20, 1:50, and 1:200 sediment:water ratios). Samples from six sampling stations of the Lagoon of Venice have been investigated. The toxicity bioassay results (sea urchin Paracentrotus lividus Lmk sperm cell and embryo toxicity bioassays and bivalve mollusk Crassostrea gigas Thunberg embryo toxicity bioassays) have shown that elutriates generated from the widely used 1:4 ratio were less toxic than those from intermediate ratios (1:20 and 1:50).

Sperm cell and embryo toxicity tests using the Mediterranean sea urchin Paracentrotus lividus Lmk were performed to assess the toxicity of As3+, Cd2+, Cr3+, Ni2+, Pb2+, Cu2+, Zn2+, and Hg2+. The aim of this study was to improve information about the comparative sensitivity of sea urchin bioassays to the heavy metals, which are an important cause of contamination in the ecosystem of the Lagoon of Venice. Considering the data in mM/L, the order of toxicity is Hg2+ > Cu2+ > Zn2+ > As3+ > or = Cr3+ > or = Cd2+ > or = Pb2+ > or = Ni2+ for the sperm cell test and Hg2+ > or = Pb2+ > Cu2+ > Zn2+ > Cd2+ > Ni2+ > As3+ > or = Cr3+ for the embryo test. New toxicity data for metals expressed as median effective concentration (EC50) and no-observed-effect concentration (NOEC) are reported for the Mediterranean species. Accurate observations of embryotoxic effects at increasing metal concentrations were done, detecting some different behaviors in metal toxicity. Toxicity data compared with water column and pore-water concentrations recorded in the Lagoon of Venice (Italy) demonstrate the potential ability of bioassays using sea urchin to detect important contaminants in this ecosystem.

Sperm cell and embryo toxicity tests using the Mediterranean sea urchin Paracentrotus lividus were performed to assess the toxicity of tributyltin chloride, bis(tributyltin)oxide, triphenyltin acetate, and triphenyltin hydroxide. Toxicity values (mean effective concentration [EC50]) ranged from 2.97 to 18.5 microg/L for sperm cells and from 1.11 to 2.62 microg/L for embryos. For sperm cells, the toxicity of the two tributyl compounds was significantly greater than that of two triphenyl compounds; for embryos, the triphenyl compounds appeared to be more toxic. Study of embryotoxic effects highlighted closely concentration-dependent damages, the most sensitive stages corresponding to the crucial phases of differentiation (gastrula and prisma). Both EC50 and no-observed-effect concentration values for the four organotin compounds are similar to those reported in the literature for early life stages of other marine organisms.

A reliable sperm cell toxicity test procedure has been developed for the Mediterranean sea urchin Paracentrotus lividus. The sensitivity and discriminatory ability of the test were investigated with regard to surfactants and their biotransformation products. Aromatic and aliphatic surfactants of anionic (linear alkylbenzene sulfonates [LAS]) and nonionic (alcohol polyethoxylates [AE] and nonylphenol polyethoxylates [NPE]) types and their aerobic biodegradation products, i.e., sulfophenylcarboxylates (SPC), polyethylene glycols (PEG), carboxylated polyethylene glycols (PEGC), carboxylated AE (AEC), and nonylphenol (NP), were examined in order to elucidate the influence of their molecular structure on toxicity. Experimental results reveal that the sperm cell test showed good discriminatory ability among all tested compounds, median effective concentration (EC50) values differing by about four orders of magnitude. The toxicity of anionic surfactants depends on the length of the alkyl chain and that of nonionic surfactants is due to their length and branching. Much lower toxicity was shown by aerobic biodegradation products in comparison with that of their parent compounds, with the exception of NP. The obtained EC50s were comparable with available literature data and constitute new toxicity data regarding surfactants for sea urchins.