bluuebunny/crossref_metadata_2025 huggingface dataset:
CARDIOPULMONARY SUPPORT WITH EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) DURING CATHETER ABLATION OF VENTRICULAR FIBRILLATION: A CASE REPORT
Authors: Perniciaro V , Troisi F , Katsouras G , Quadrini F , Di Monaco A , Grimaldi M
Published: May 2024

The clinical case deals with a 46–year–old man, severely obese and suffering from type II diabetes mellitus and arterial hypertension, a smoker. He was admitted to our department for iterative ventricular fibrillation (VF) following a recent acute myocardial infarction with ST–segment elevation treated with percutaneous coronary angioplasty (PTCA) and implantation of drug–eluting stents on the anterior interventricular. Control coronary angiography showed good results of previous PTCA. On the echocardiogram, left ventricular pump function moderately reduced (EF 45%) with district alterations of the kinetics and aneurysmal dilatation of the ascending aorta. During hospitalization, iterative episodes of VF despite maximal antiarrhythmic therapy, promptly treated with DC shock. Continuous telemetry monitoring showed frequent early premature ventricular complex (PVC) triggering VF episodes. A 12–lead Holter ECG was performed to better identify the morphology of these PVC, documenting PVC of morphology compatible with origin from Purkinjie fibres. An electrophysiological study and mapping of the left ventricle were performed with extracorporeal membrane oxygenation (ECMO) support. During mapping of the middle left interventricular septum, VF occurred several times and was promptly treated with DC shock. In this area have been documented Purkinje fibers and low voltage and multifragmented areas; ablation was then performed by delivering radiofrequency in this area until the all potentials were completely eliminated. After ablation, no more ventricular arrhythmias were induced. Cardiac magnetic resonance imaging was performed which showed large areas of late gadolinium enhancement. The patient underwent automatic defibrillator implantation. Ventricular arrhythmias were no longer documented during telemetric monitoring. In this complex case of significant arrhythmic instability in ischemic heart disease with moderate left ventricular pump dysfunction, ECMO assistance allowed us to effectively and safely perform the ablation of the arrhythmic substrate triggering the iterative episodes of VF.
NOT JUST A SIMPLE FEVER: DIAGNOSIS OF COMPLICATED INFECTIVE ENDOCARDITIS ON BICUSPID AORTIC VALVE IN A YOUNG MAN
Authors: Caprio M , Verrengia E , Corazzini A , D‘Alleva A , Gallina S , Di Marco M
Published: May 2024

Bicuspid aortic valve is the most common form of congenital heart disease (prevalence of 0.5 to 2.0%). These patients develop infective endocarditis at significantly higher rates than the general population; furthermore, they are at increased risk of developing infective endocarditis at a younger age owing to intrinsic factors of the aortic valve, but demonstrate better long–term survival after surgical treatment. This case report concerns a 33–year–old caucasian man who presented to the emergency department for persistent fever. He had no significant past medical history, except for a known bicuspid aortic (type 0) valve. The laboratory test demonstrated an active infection and blood cultures were positive, so we performed a transthoracic echocardiogram showing a mobile mass on the aortic valve, associated to a severe aortic regurgitation. Hence, we decided to perform a transesophageal echocardiogram that documented a bicuspid aortic valve with an extensive endocarditic vegetation on anterior leaflet, cusp prolapse and a non–homogenous peri–valvular area, involving the mitral–aortic junction, compatible with abscess. Perivalvular extension of infective endocarditis is the most frequent cause of uncontrolled infection and is associated with a poor prognosis so, as suggested by ESC Guidelines, this clinical case represented an indication for early surgery. The patient was transferred to cardiac surgery department where he underwent surgery. Extensive debridement of the endocarditic lesion was performed; the mitral–aortic junction was reconstructed by suturing a double patch of heterologous pericardium. The defect resulting from the debridement beneath the left coronary ostium was also reconstructed using an additional sutured pericardial patch; then, an Inspiris Resilia size 23 prosthesis was implanted. Transesophageal echocardiography revealed good functioning of the aortic valve prosthesis with mild mitral insufficiency. Meanwhile, blood cultures resulted positive for Staphylococcus Aureus coagulase–negative, so specific antibiotic therapy was started.
WELLENS SYNDROME OR PNEUMONIA?
Authors: Massara M , Lanari A , Zappelli L , Pergolini M , Giovagnoli A , Refi G , Di Noto G
Published: May 2024

Background

Wellens syndrome, also known as "left anterior descending coronary syndrome," is characterized by the appearance of T–wave changes recorded on the ECG and it is an ECG manifestation of critical proximal left anterior descending artery stenosis.

Case Report

A 65–year–old man from Bangladesh with a history of chronic ischemic heart disease and trivessel coronary artery disease following surgical revascularization (CABG 2007). Recent admission for NSTEMI (June 2022) with unchanged coronary angiography compared to the previous one. Comorbidities include peripheral arterial disease, type II diabetes with organ damage, and COPD with recent exacerbations. Last myocardial scintigraphy (2021) was positive for inducible myocardial ischemia in the posterolateral region. Admission due to fever, productive cough, and severe chest pain. Initial instrumental assessments revealed ST–segment alterations in inferior leads and V1–V2 with negative/isodiphasic T–waves, not present in previous ECG tracings. A slight troponin elevation with ischemic curve (101 → 303 → 277 → 155 pg/dl, normal range < 50 pg/dl) led to the diagnosis of NSTEMI. Echocardiogram showed concentric remodeling of the left ventricle with normal global systolic function and hypokinesia of the mid–basal inferior wall (noted). Additionally, chest CT revealed pulmonary consolidations in the right middle lobe and upper left lobe, prompting antibiotic therapy and bronchodilator inhalation. Arterial blood gas analysis: pH 7.45, pO2 83, Lactate 0.8, HCO3– 24, P/F 360. Coronary angiography showed an unchanged picture compared to the previous one (patent AMIS and AMID, good run–off in native branches, no distal stenosis at the anastomosis). Clinical symptoms, inflammatory indices, and myocardial damage markers clinically improved during hospitalization. Discharged after optimization of anti–ischemic therapy with DAPT and diagnosis of NSTEMI. However, ECG abnormalities persisted at discharge (negative T–waves in DI–aVL–V1–V2). Post–discharge cardiac MRI was requested.

Conclusions

Diagnostic hypotheses include, primarily, a possible type II myocardial infarction due to an ongoing pneumonia (although hypoxia/hypovolemia/hypotension sufficient to cause MI was never documented during hospitalization), MINOCA, or microcirculatory disease (functional tests such as iFR/FFR, ACh, IMR were not performed during coronary angiography), or a possible myocarditic outcome (pending MRI).
A NEGLECTED RARE DISORDER: IGG4 RELATED DISEASE
Authors: Prenna E , Maffè S , Paffoni P , Facchini E , Ariotti S , Bergamasco L , Franchetti Pardo N , Paino A , Ticozzi S , Dellavesa P
Published: May 2024

IgG4–related disease (IgG4–RD) is an autoimmune disorder characterized by infiltration of plasma cells with IgG4. Almost any organ could be affected. Common presentations include lung manifestation, autoimmune pancreatitis, retroperitoneal fibrosis and tubulointerstitial nephritis. Cardiovascular involvement is less frequent. Corticosteroids are first line therapy, with or without anti–rheumatic drugs. Long–term prognosis of IgG4–RLD remains unknown. We present the case of a 65–years old woman, with a previuos diagnosis of IgG4–RD with mediastinal involvement. In the meantime she was recovered for pyelonephritis with high fever and positive blood coltures (S. hominis). We were called to perform a transthoracic echocardiogram to rule out infective endocarditis. The exam showed normal size of cardiac chambers, normal biventricular systolic function, absence of relevant valvular disease. In apical view we noticed a hyperechogenic ovalar imagine in the right atrium, not visible in all the projections. A first differential diagnosis included a mass with site of implantation at the top of the right atrium or something external but contiguous to heart structures. To clear this doubt the patient performed a thoracic CT with stunning results. The CT highlighted parietal encasement of chardiac structures and, particularly, of the superior vena cava at the confluence in right atrium, explaining the image we saw with transthoracic echo. The exam also showed encasement of ascending aorta, aortic arch and descending aorta with maximum thickness of 18 mm. CT also reported encasement of right pulmonary arthery. The CT highlighted a progression of the disease with indication to more aggressive therapy. In fact IgG4–RD of the cardiovascular system results in serious complications that need to be recognized and treated. Aortic involvement in IgG4–RD is extremely rare and tipically affects the infrarenal abdominal aorta. Cardiovascular IgG4–RD could also lead to aortitis, medium–vessel arteritis, pulmonary vascular disease, phlebitis, valvulopathy, pericarditis and myocardial disease. These forms of Igg4–RD are often underdiagnosed as clinical presentations is similar to cardiovascular disease due to more common aetiologies. Regarding our case the patient began methotrexate based on the results of the CT. This was a really interesting case for our working group to deepen this little–known disease. “The eyes see only what the mind is prepared to comprehend”.
THE APEX TALKS…CARDIAC METASTASIS MIMICKING ST SEGMENT ELEVATION MYOCARDIAL INFARCTION
Authors: Maurizi K , Lofiego C , Vagnarelli F , Capodaglio I , Patani F , Tofoni P , Brugiatelli L , Pietrucci F , Dottori M , Schicchi N , Fogante M , Esposto Pirani P , Dello Russo A , Perna G
Published: May 2024

A 78–year–old man with a recent diagnosis of lung squamous cell carcinoma was referred to our cardiology department for marked ECG abnormalities (ST segment elevation in V2–V4 and T waves inversion in the antero–lateral leads, Fig.1) in the absence of ischemic symptoms and for the detection of an intramyocardial mass at the apical segments on the CT scan. He had no significant previous cardiovascular history. A transthoracic echocardiogram (TTE) was performed and showed an isoechoic mass at the LV apical segments measuring 3 x 4 cm apparently incorporating the myocardial wall without a clear cleavage plane (Fig.2a). The EF was normal. No pericardial effusion present. The contrast echocardiography with Sonovue revealed a late uptake of the contrast (Fig.2b). Cardiac magnetic resonance (CMR) showed an ovular image in the para–apical area of 40 x 23 cm consistent with a secondary lesion (Fig.3). Unfortunately, the exam was interrupted early due to a patient’s claustrophobic crisis, without having acquired the post–contrast images. Due to infiltrative appearance of the mass and the oncology history, this formation was highly suspicious for metastasis. No complicated ventricular arrhythmias were detected on ECG monitoring. No symptoms of heart failure were reported. Due to the marked EKG repolarization abnormalities the patient underwent coronary angiography which excluded significant stenosis. FDG PET/CT showed areas of increased metabolism also at liver and adrenal left gland. Finally, the patient was transferred to the oncology department for specific management. Cardiac metastases are more common than primary cardiac malignancy and are more frequently related to primary lung cancer, followed by breast cancer and hematologic malignancies. Typical presentation includes arrhythmias or conduction disturbances. The imaging findings of cardiac metastases are non–specific but mostly infiltrative, heterogeneous, and multiple masses may be present. Echocardiography is the initial imaging test for the detection of cardiac metastasis, although CMR, CT and PET/CT may be helpful. Herein we described a case of cardiac metastasis with EKG mimicking acute coronary syndrome. This finding is not uncommon among these patients. EKG findings of myocardial ischemia or injury, particularly localized and prolonged ST elevation, in the absence of ischemic symptoms have been reported in previous studies as high specificity for cardiac metastasis in patients with malignancy.
ANOMALY OF ORIGIN AND COURSE OF THE CIRCUMFLEX ARTERY: AN ECHOCARDIOGRAPHIC DIAGNOSIS
Authors: Marino G , Di Fusco S , Cianfrocca C , Colivicchi F
Published: May 2024

Coronary artery anomalies are often incidental findings. Most anomalies are benign, but some can cause sudden death. It is important to identify them especially before invasive procedures and cardiac surgery. The echocardiogram, as in this case report, provides a high diagnostic accuracy. We describe three typical echocardiographic signs that we find when the circumflex artery originates from the right coronary cusp and has a retroaortic course. A 42–year–old man presented to the emergency department with oppressive chest pain at rest lasting 1 h. In his medical history, the patient reported the following cardiovascular risk factors: smoking, family history of coronary heart disease, hypertension, type 2 diabetes mellitus for 10 years and hypercholesterolemia. Electrocardiogram showed sinus rhythm at 70 bpm without signs of myocardial ischemia. Troponin, D–dimer, C–reactive protein were normal in consecutive blood samples. The echocardiogram documented a left ventricle with normal size and wall thickness, preserved systolic function and absence of significant valvular disease and pericardial effusion. Apical 4–chamber view showed a tubular structure on the atrial side of the mitral valve (Figure 1A, RAC sign). The same structure was identified in parasternal short–axis view just below the noncoronary aortic cusp (Figure 1B, crossed aorta). The tubular shape suggested a vascular structure in an anomalous position. In the parasternal long–axis view, a transverse section of this vessel was visible near aortic valve (Figure 1C, bleb sign). Patient underwent coronary angiography due to persistence of symptoms. Angiography did not reveal significant coronary stenoses, but documented anomalies in the origin and course of the coronary arteries. The circumflex artery shared its origin from the right coronary cusp with the right coronary artery and had a retroaortic course while the only anterior descending artery originated from the left coronary cusp. Anomalies of origin and/or course of the coronary arteries can be detected in 1.3% of the population undergoing coronary angiography. On echocardiogram “RAC sign”, “crossed aorta” and “bleb sign” are often misdiagnosed as artefacts, calcifications or catheter. In case of suspected coronary anomalies, CT is the reference diagnostic test. The abnormal origin and course found in our patient are considered benign and not associated with an increased risk of sudden death and myocardial ischemia.
ACUTE CORONARY SYNDROME IN A PATIENT WITH LEFT SUBCLAVIAN OCCLUSION AND ANTEROLATERAL CORONARY STEAL
Authors: Biancofiore A , Filippi F , Pieraccini M , De Angelis F , Belcastro M , Landini R , Picchi A , Limbruno U
Published: May 2024

This is a 57–year–old male patient suffering from multiple cardiovascular risk factors: obesity, arterial hypertension, dyslipidemia, type 2 diabetes mellitus, active smoker. Chronic obstructive pulmonary disease. Stage 2 chronic kidney disease. Peripheral vascular disease with previous bilateral thromboendarterectomy and percutaneous revascularization of the lower limbs. Stable angina for which three years ago he underwent Coronary Artery Bypass Graft: left internal mammary artery (LIMA) to left anterior descending artery combined with saphenous vein grafts to the main obtuse marginal branch. The patient presented with Acute Coronary Syndrome non ST–segment elevation myocardial infarction (N–STEMI), intermittent episodes of chest pain due to mild exertion in the previous days. Antero–lateral ST depression and inverted T waves, associated with a mild reduction in left ventricular systolic function due to hypokinesia of the antero–lateral walls and increased troponin values were present. Coronary angiography documented patency of the LIMA graft without evidence of any culprit lesions on the coronary branches. However, selective angiography documented a sub–occlusion of the proximal left subclavian artery (Figure 1). A computed tomography scan confirmed a hyperdense calcified plaque occluding 95% of the origin of the left subclavian artery. The patient then underwent angioplasty with stenting of the left subclavian artery (Figure 2). Subclavian coronary steal syndrome usually presents with exertional angina, but rarely can cause Acute Coronary Syndrome. During coronary angiography performed for Acute Coronary Syndrome and in the absence of detection of clear coronary culprit lesions, selective angiography of the subclavian artery may confirm the suspicion of coronary steal syndrome.
AN UNCOMMON CASE OF MINOCA
Authors: Scordato F , Giunta N , Smecca I , Longo R , Cirrincione G , Vicari C
Published: May 2024

We report the case of a 51 year old male, smoker of about 20 cigarettes/day and with history of uninvestigated headache. In March 2023 he arrived in the Emergency Department for oppressive retrosternal chest pain radiating to the left arm; the electrocardiogram (ECG) showed sinus rhythm, no acute ST segment changes; HS troponin T was elevated. Transthoracic echocardiogram showed 55% EF, no kinesis defects, no major valvulopathy, neither pericardial effusion. The patient was admitted to the ICU with a diagnosis of NSTE myocardial infarction. Despite on admission HS troponin T HS was further increased and ECG evolved with inferior and lateral subepicardial ischemia, coronary angiogram showed normal coronary arteries, with an area of haziness in the right coronary artery. To investigate the etiology of myocardial damage the patient underwent cardiac MRI, that showed a left ventricle with normal size and mildly reduced systolic function; inferior apical and septal segment were akinetic; right ventricle was normal with preserved systolic function; edema and fibrosis with ischemic pattern was seen in the inferior apical and septal segment. Then we looked for embolic sources: continuous ECG monitoring excluded supraventricular arrhythmias. We performed echocardiogram that raised suspicion of a patent foramen ovale (PFO) confirmed on transesophageal contrast echocardiogram. Brain MRI showed no obvious changes compatible with recent ischemic lesions; few millimeters focal hyperintense areas in T2 and FLAIR, of gliotic nonspecific significance were reported in the frontal subcortical white matter bilaterally, left parietal and in the right corona radiata. We concluded for diagnosis of paradoxical coronary embolism and the patient was treated with percutaneous closure of PFO: by right femoral vein route and under intracardiac ultrasound guidance, closure of PFO was performed with Amplatzer No. 25 with excellent fluoroscopic and final ultrasound result. The broad spectrum of the possible cause of myocardial injury in MINOCA makes defining the extact underlying etiology challenging, but correctly knowing the culprit mechanism improves therapies and outcome; paradoxical coronary embolism due to a patent foramen ovale is rarely diagnosed; in our clinical case integrated multimodality imaging diagnostic work up, proved highly effective in identifying the cause of the myocardial damage and allowed the appropriate treatment.
STENT FRAME DECOUPLING FOLLOWING SELF–EXPANDABLE TAVR
Authors: Lentini E , Moscarelli M , Sollami G , Fattouch K
Published: May 2024

Introduction

Transcatheter heart valve (THV) deformation may affect leaflet kinematics and coaptation, with potential formation of hypoattenuated leaflet thickening (HALT). The flexible nitinol frame of the self–expandable THV, conforms to the native annulus shape while maintaining the prosthesis in a higher position. This arrangement is called stent–frame ‘decoupling’ and should minimize the impact of ellipticity at the valve level post–deployment.

Methods

We analysed multi detector computer tomography scan and 2D transthoracic echocardiography from 50 patients. Prosthesis eccentricity was computed at 6 levels: i) frame inflow; ii) native annulus; iii) leaflets inflow; iv) prosthesis waist; v) leaflets outflow; vi) frame outflow). Implantation depth and canting, leaflets expansion and alignment and residual anatomic sinus area ratio were also calculated. Frame inflow and native annulus eccentricity were compared to the valvular eccentricity to assess ‘decoupling’.

Results

Highest eccentricity was observed at the native annulus (0.540.12) and progressively decreases toward the outflow level (0.230.11). Subvalvular eccentricity was significantly higher as compared with valvular components (0.500.13 vs. 0.370.09, p<0.001). Similar results were observed in the subgroup analysis of 23, 26, 29 and 34 size. At 12 months follow–up, HALT with mild to severe restricted movement was detected in 8 individuals (16%). There was no correlation between implantation depth and prothesis eccentricity (r= –0.08, p=0.128).

Conclusions

Stent frame decoupling can be frequently detected after (THV) replacement with Evolut R. The effect on valve performance and clinical implications remains uncertain.
Activity-based protein profiling of serine hydrolases and penicillin-binding proteins in Enterococcus faecium
Authors: Grunnvåg Jeanette S , Hegstad Kristin , Lentz Christian S
Published: May 2024

Enterococcus faecium is a gut commensal bacterium which is gaining increasing relevance as an opportunistic, nosocomial pathogen. Its high level of intrinsic and acquired antimicrobial resistance is causing a lack of treatment options, particularly for infections with vancomycin-resistant strains, and prioritizes the identification and functional validation of novel druggable targets. Here, we use activity-based protein profiling (ABPP), a chemoproteomics approach using functionalized covalent inhibitors, to detect active serine hydrolases across 11 E. faecium and Enterococcus lactis strains. Serine hydrolases are a big and diverse enzyme family, that includes known drug targets such as penicillin-binding proteins (PBPs), whereas other subfamilies are underexplored. Comparative gel-based ABPP using Bocillin-FL revealed strain- and growth condition-dependent variations in PBP activities. Profiling with the broadly serine hydrolase-reactive fluorescent probe fluorophosphonate-TMR showed a high similarity across E. faecium clade A1 strains, but higher variation across A2 and E. lactis strains. To identify these serine hydrolases, we used a biotinylated probe analog allowing for enrichment and identification via liquid chromatography–mass spectrometry. We identified 11 largely uncharacterized targets (α,β-hydrolases, SGNH-hydrolases, phospholipases, and amidases, peptidases) that are druggable and accessible in live vancomycin-resistant E. faecium E745 and may possess vital functions that are to be characterized in future studies.
The Rapid Evolution of De Novo Proteins in Structure and Complex
Authors: Chen Jianhai , Li Qingrong , Xia Shengqian , Arsala Deanna , Sosa Dylan , Wang Dong , Long Manyuan
Published: May 2024

Recent studies in the rice genome-wide have established that de novo genes, evolving from noncoding sequences, enhance protein diversity through a stepwise process. However, the pattern and rate of their evolution in protein structure over time remain unclear. Here, we addressed these issues within a surprisingly short evolutionary timescale (<1 million years for 97% of Oryza de novo genes) with comparative approaches to gene duplicates. We found that de novo genes evolve faster than gene duplicates in the intrinsically disordered regions (such as random coils), secondary structure elements (such as α helix and β strand), hydrophobicity, and molecular recognition features. In de novo proteins, specifically, we observed an 8% to 14% decay in random coils and intrinsically disordered region lengths and a 2.3% to 6.5% increase in structured elements, hydrophobicity, and molecular recognition features, per million years on average. These patterns of structural evolution align with changes in amino acid composition over time as well. We also revealed higher positive charges but smaller molecular weights for de novo proteins than duplicates. Tertiary structure predictions showed that most de novo proteins, though not typically well folded on their own, readily form low-energy and compact complexes with other proteins facilitated by extensive residue contacts and conformational flexibility, suggesting a faster-binding scenario in de novo proteins to promote interaction. These analyses illuminate a rapid evolution of protein structure in de novo genes in rice genomes, originating from noncoding sequences, highlighting their quick transformation into active, protein complex-forming components within a remarkably short evolutionary timeframe.
Experimental investigation of using the evaporative air cooling technique to enhance the performance of the photovoltaic module
Authors: Jaffar Malik F , Mohammad Abdulrahman Th , Ahmed Ahmed Qasim , Al-Shohani Wisam A M
Published: May 2024

In this experimental study, two techniques of photovoltaic thermal (PVT) collector with active cooling were used to enhance the performance of the photovoltaic (PV) module. The first technique was prepared by integrating the PV module with a forced air duct (PVTFC). At the same time, the second technique was the PV module integrated with a forced air duct including a direct evaporative cooling unit (PVTDEC). In these two techniques, the air was forced by an electrical centrifugal fan with variable speeds (1.5, 2.5 and 3.5 m/s) placed at the end of the duct. The output electrical characteristics of the PVTFC and PVTDEC modules were compared with the reference PV module. The obtained results showed a significant decrease in the temperature of the PV module, where the reduction in the temperature of the PV module was achieved between 5°C and 16°C and 21°C and 25°C in PVTFC and PVTDEC techniques, respectively. Accordingly, the voltage was dropped to 15.1 and 15.8 V in PVTFC and PVTDEC, respectively, as compared with the sharp decline of voltage for the reference PV module, which recorded 14.2 V at a maximum PV module temperature of 69°C. In addition, the maximum enhancement percentage of PV efficiency was achieved at a maximum airflow rate of 0.22 kg/s, where it was recorded between 3.5% and 6.2% in the case of PVTFC and 7% and 9.3% in the case of PVTDEC.
Genomic diversity and antimicrobial resistance in clinical Klebsiella pneumoniae isolates from tertiary hospitals in Southern Ghana
Authors: Mills Richael O , Dadzie Isaac , Le-Viet Thanh , Baker David J , Addy Humphrey P K , Akwetey Samuel A , Donkoh Irene E , Quansah Elvis , Semanshia Prince S , Morgan Jennifer , Mensah Abraham , Adade Nana E , Ampah Emmanuel O , Owusu Emmanuel , Mwintige Philimon , Amoako Eric O , Spadar Anton , Holt Kathryn E , Foster-Nyarko Ebenezer
Published: May 2024

Objectives

Comprehensive data on the genomic epidemiology of hospital-associated Klebsiella pneumoniae in Ghana are scarce. This study investigated the genomic diversity, antimicrobial resistance patterns, and clonal relationships of 103 clinical K. pneumoniae isolates from five tertiary hospitals in Southern Ghana—predominantly from paediatric patients aged under 5 years (67/103; 65%), with the majority collected from urine (32/103; 31%) and blood (25/103; 24%) cultures.

Methods

We generated hybrid Nanopore–Illumina assemblies and employed Pathogenwatch for genotyping via Kaptive [capsular (K) locus and lipopolysaccharide (O) antigens] and Kleborate (antimicrobial resistance and hypervirulence) and determined clonal relationships using core-genome MLST (cgMLST).

Results

Of 44 distinct STs detected, ST133 was the most common, comprising 23% of isolates (n = 23/103). KL116 (28/103; 27%) and O1 (66/103; 64%) were the most prevalent K-locus and O-antigen types. Single-linkage clustering highlighted the global spread of MDR clones such as ST15, ST307, ST17, ST11, ST101 and ST48, with minimal allele differences (1–5) from publicly available genomes worldwide. Conversely, 17 isolates constituted novel clonal groups and lacked close relatives among publicly available genomes, displaying unique genetic diversity within our study population. A significant proportion of isolates (88/103; 85%) carried resistance genes for ≥3 antibiotic classes, with the blaCTX-M-15 gene present in 78% (n = 80/103). Carbapenem resistance, predominantly due to blaOXA-181 and blaNDM-1 genes, was found in 10% (n = 10/103) of the isolates.

Conclusions

Our findings reveal a complex genomic landscape of K. pneumoniae in Southern Ghana, underscoring the critical need for ongoing genomic surveillance to manage the substantial burden of antimicrobial resistance.
Retrospective Data Analysis Reveals Unusual Metabolism Pattern of Ethanol in Pediatrics as Compared to Adult and Geriatric Populations
Authors: Baryeh Kwaku , Zhou Roy , Brown Erin , McMillin Gwendolyn A , Krasowski Matthew D , Johnson-Davis Kamisha L
Published: May 2024

Background

About 95% of consumed ethanol is metabolized by oxidative pathways. Less than 1% is metabolized via nonoxidative pathways: glucuronidation, sulfation, and the formation of fatty acid esters of ethanol. In neonates, the glucuronidation pathway has been reported to be underdeveloped but matures with age. This work compared the test results of patients’ random urine samples submitted to our facility for ethyl glucuronide (EtG) and ethyl sulfate (EtS) measurements across pediatric and adult populations.

Methods

Test results (n = 63 498) from urine samples tested for EtG and EtS by quantitative liquid chromatography-tandem mass spectrometry at our facility were utilized for this study. EtG and EtS concentrations were compared across the age partitions 0 to 17 years (pediatric), 18 to 80 years (adult), and 81 to 100 years (geriatric). Eight pediatric patients from a tertiary academic hospital contributed clinical context via abstracted clinical information.

Results

Across the individual age partitions, 60% to 65% of patients had both EtG and EtS present in urine. Approximately 5% to 10% of patients had only EtG, and 25% to 35% had neither metabolite present. The lowest percentages (<1.5%) had EtS present in the absence of EtG. Markedly, no pediatric patients had only EtS present; compared to the adult population, this was statistically significant (Fisher exact test, P = 0.025).

Conclusions

From the data presented in this work, EtG is more prevalent relative to EtS in urine samples of patients assessed for ethanol exposure.
How Do Physical Disability Cues Influence Assumptions about Consumer Tastes? Unpacking the Disability Preference Stereotype
Authors: van der Sluis Helen , Samper Adriana , Kristofferson Kirk , Hlava Terri
Published: May 2024

Across 10 experimental studies, this research identifies and provides evidence of a disability preference stereotype whereby observers infer that disabled consumers prefer utilitarian products more than nondisabled consumers and prefer hedonic products less than nondisabled consumers. We show that this stereotype occurs because of societal associations between physical disability and pity. Pity elicits a multidimensional response such that considering the interests of a disabled person increases feelings of personal discomfort, driving both an inclination to help (help-giving orientation) and a tendency to assess the perceived misfortune (misfortune appraisal) in parallel. Thus, when considering the preferences of disabled individuals, the help-giving orientation increases focus on functional (utilitarian) goods, while the misfortune appraisal decreases focus on pleasurable (hedonic) goods. Importantly, this stereotype can be mitigated through increased disability representation. Representation of empowered disabled individuals in media can dampen the help-giving orientation, reducing inferred utilitarian preferences, while representation of disabled people partaking in daily pleasures through increased accessibility can reduce misfortune perceptions, increasing inferred hedonic preferences. This work addresses the paucity of disability-related consumer research, identifies how aspects unique to consumption can limit consumers with disabilities, and highlights opportunities to minimize ableist stereotypes by expanding representation and increasing marketplace inclusion.
Potential use of pinenes to improve localized insecticide injections targeting the western drywood termite (Blattodea: Kalotermitidae)
Authors: Poulos Nicholas A , Lee Chow-Yang , Rust Michael K , Choe Dong-Hwan
Published: May 2024

The western drywood termite, Incisitermes minor (Hagen), causes significant economic damage to wood structures in the United States of America, especially California. When infestation is not widespread, localized insecticide injections may be useful for remedial control. However, the extensive gallery structure of drywood termites and their tendency to aggregate at specific parts of the galleries can impact the efficacy of localized insecticide injection. Chemicals that attract termites from a distance may improve the localized insecticide injection by increasing the number of termites contacting the insecticide residues. Two volatile terpenes, α-pinene and β-pinene, commonly found in many coniferous timber trees, were applied to artificial termite galleries to determine if termites were attracted from their original aggregation site. Furthermore, we examined if adding these pinenes would improve the overall efficacy of some insecticide products for drywood termite control. Behavioral assay results showed that the treatment with pinenes increased the likelihood that drywood termites would leave their original aggregation site and contact the treated part of the gallery. When tested with the pesticide products applied in a small area away from the termite aggregation, β-pinene significantly accelerated the time course of mortality for the aqueous fipronil. The efficacy of disodium octaborate tetrahydrate dust was not influenced by the addition of pinenes. Implications for drywood termite management and future research directions are discussed.
The role of satellite DNAs in the chromosomal rearrangements and the evolution of the rare XY1Y2 sex system in Harttia (Siluriformes: Loricariidae)
Authors: Deon Geize Aparecida , dos Santos Rodrigo Zeni , Sassi Francisco de Menezes Cavalcante , Moreira-Filho Orlando , Vicari Marcelo Ricardo , Porto-Foresti Fábio , Utsunomia Ricardo , Cioffi Marcelo de Bello
Published: May 2024

The underlying processes behind the formation, evolution, and long-term maintenance of multiple sex chromosomes have been largely neglected. Among vertebrates, fishes represent the group with the highest diversity of multiple sex chromosome systems and, with six instances, the Neotropical fish genus Harttia stands out by presenting the most remarkable diversity. However, although the origin mechanism of their sex chromosome systems is well discussed, little is known about the importance of some repetitive DNA classes in the differentiation of multiple systems. In this work, by employing a combination of cytogenetic and genomic procedures, we evaluated the satellite DNA composition of H. carvalhoi with a focus on their role in the evolution, structure, and differentiation process of the rare XY1Y2 multiple-sex chromosome system. The genome of H. carvalhoi contains a total of 28 satellite DNA families, with the A + T content ranging between 38.1% and 68.1% and the predominant presence of long satellites. The in situ hybridization experiments detected 15 satellite DNAs with positive hybridization signals mainly on centromeric and pericentromeric regions of almost all chromosomes or clustered on a few pairs. Five of them presented clusters on X, Y1, and/or Y2 sex chromosomes which were therefore selected for comparative hybridization in the other three congeneric species. We found several conserved satellites accumulated on sex chromosomes and also in regions that were involved in chromosomal rearrangements. Our results provide a new contribution of satellitome studies in multiple sex chromosome systems in fishes and represent the first satellitome study for a Siluriformes species.
Tidal disruption events from three-body scatterings and eccentricity pumping in the discs of active galactic nuclei
Authors: Prasad Chaitanya , Wang Yihan , Perna Rosalba , Ford K E Saavik , McKernan Barry
Published: May 2024

Tidal disruption events (TDEs) are routinely observed in quiescent galaxies, as stars from the nuclear star cluster are scattered into the loss cone of the central supermassive black hole (SMBH). TDEs are also expected to occur in active galactic nuclei (AGNs), due to scattering or orbital eccentricity pumping of stars embedded in the innermost regions of the AGN accretion disc. Encounters with embedded stellar-mass black holes (BH) can result in AGN μTDEs. AGN TDEs and μTDEs could therefore account for a fraction of observed AGN variability. Here, by performing scattering experiments with the few-body code SpaceHub, we compute the probability of AGN TDEs and μTDEs as a result of 3-body interactions between stars and binary BHs. We find that AGN TDEs are more probable during the early life of the AGNs, when rates are $\sim (6\times 10^{-5}-5 \times 10^{-2}) (f_\bullet /0.01)\, \rm {AGN}^{-1}$ yr−1 (where f• is the ratio between the number density of BHs and stars), generally higher than in quiescent galactic nuclei. By contrast, μTDEs should occur throughout the AGN lifetime at a rate of $\sim (1\times 10^{-4} - 4\times 10^{-2})(f_\bullet /0.01)\, \rm {AGN}^{-1}$ yr−1. Detection and characterization of AGN TDEs and μAGN TDEs with future surveys using Rubin and Roman will help constrain the populations of stars and compact objects embedded in AGN discs, a key input for the LVK AGN channel.
EPOCHS Paper – VIII. An insight into MIRI-selected galaxies in SMACS-0723 and the benefits of deep MIRI photometry in revealing AGN and the dusty universe
Authors: Li Qiong , Conselice Christopher J , Adams Nathan , Trussler James A A , Austin Duncan , Harvey Thomas , Ferreira Leonardo , Caruana Joseph , Ormerod Katherine , Juodžbalis Ignas
Published: May 2024

We present the analysis of the stellar population and star formation history of 181 MIRI selected galaxies at z = 0 − 3.5 in the massive galaxy cluster field SMACS J0723.3–7327, commonly referred to as SMACS0723, using the JWST Mid-Infrared Instrument (MIRI). We combine the data with the JWST Near Infrared Camera (NIRCam) catalogue, in conjunction with the Hubble Space Telescope (HST) WFC3/IR and ACS imaging. We find that the MIRI bands capture PAH features and dust emission, significantly enhancing the accuracy of photometric redshift and measurements of the physical properties of these galaxies. The median photo-z’s of galaxies with MIRI data are found to have a small 0.1 per cent difference from spectroscopic redshifts and reducing the error by 20 per cent. With MIRI data included in SED fits, we find that the measured stellar masses are unchanged, while the star formation rate is slightly lower by 0.1 dex. We also fit the median SED of active galactic nuclei (AGNs) and star-forming galaxies (SFG) separately. MIRI data provides tighter constraints on the AGN contribution, reducing the typical AGN contributions by ∼15 per cent. In addition, we also compare the median SED obtained with and without MIRI, and we find that including MIRI data yields steeper optical and UV slopes, indicating bluer colours, lower dust attenuation, and younger stellar populations. In the future, MIRI/MRS will enhance our understanding by providing more detailed spectral information and allowing for the study of specific emission features and diagnostics associated with AGN.
Incongruent active head rotations increase visual motion detection thresholds
Authors: Pickard Kate , Davidson Matthew J , Kim Sujin , Alais David
Published: May 2024

Attributing a visual motion signal to its correct source—be that external object motion, self-motion, or some combination of both—seems effortless, and yet often involves disentangling a complex web of motion signals. Existing literature focuses on either translational motion (heading) or eye movements, leaving much to be learnt about the influence of a wider range of self-motions, such as active head rotations, on visual motion perception. This study investigated how active head rotations affect visual motion detection thresholds, comparing conditions where visual motion and head-turn direction were either congruent or incongruent. Participants judged the direction of a visual motion stimulus while rotating their head or remaining stationary, using a fixation-locked Virtual Reality display with integrated head-movement recordings. Thresholds to perceive visual motion were higher in both active-head rotation conditions compared to stationary, though no differences were found between congruent or incongruent conditions. Participants also showed a significant bias to report seeing visual motion travelling in the same direction as the head rotation. Together, these results demonstrate active head rotations increase visual motion perceptual thresholds, particularly in cases of incongruent visual and active vestibular stimulation.
Multiomics analyses provide insights into the genomic basis of differentiation among four sweet osmanthus groups
Authors: Li Yong , Zhao Heng , Xia He-Xiao , Huang Jinling , Ma Nan , Guo Peng , Liu Yan-Pei , Liu Hong-Li , Wang Yi-Han , Lin Nan , Shang Fu-De
Published: May 2024

Sweet osmanthus (Osmanthus fragrans) is famous in China for its flowers and contains four groups: Albus, Luteus, Aurantiacus, and Asiaticus. Understanding the relationships among these groups and the genetic mechanisms of flower color and aroma biosynthesis are of tremendous interest. In this study, we sequenced representative varieties from two of the four sweet osmanthus groups. Multiomics and phylogenetic analyses of varieties from each of the four groups showed that Asiaticus split first within the species, followed by Aurantiacus and the sister groups Albus and Luteus. We show that the difference in flower color between Aurantiacus and the other three groups was caused by a 4-bp deletion in the promoter region of carotenoid cleavage dioxygenase 4 (OfCCD4) that leads to expression decrease. In addition, we identified 44 gene pairs exhibiting significant structural differences between the multiseasonal flowering variety “Rixianggui” in the Asiaticus group and other autumn-flowering varieties. Through correlation analysis between intermediate products of aromatic components and gene expression, we identified eight genes associated with the linalool and α- and β-ionone biosynthesis pathways. Overall, our study offers valuable genetic resources for sweet osmanthus, while also providing genetic clues for improving the flower color and multiseasonal flowering of osmanthus and other flowers.
ELONGATED HYPOCOTYL 5 interacts with HISTONE DEACETYLASE 9 to suppress glucosinolate biosynthesis in Arabidopsis
Authors: Choi Dasom , Kim Seong-Hyeon , Choi Da-Min , Moon Heewon , Kim Jeong-Il , Huq Enamul , Kim Dong-Hwan
Published: May 2024

Glucosinolates (GSLs) are defensive secondary metabolites produced by Brassicaceae species in response to abiotic and biotic stresses. The biosynthesis of GSL compounds and the expression of GSL-related genes are highly modulated by endogenous signals (i.e. circadian clocks) and environmental cues, such as temperature, light, and pathogens. However, the detailed mechanism by which light signaling influences GSL metabolism remains poorly understood. In this study, we found that a light-signaling factor, ELONGATED HYPOCOTYL 5 (HY5), was involved in the regulation of GSL content under light conditions in Arabidopsis (Arabidopsis thaliana). In hy5-215 mutants, the transcript levels of GSL pathway genes were substantially upregulated compared with those in wild-type (WT) plants. The content of GSL compounds was also substantially increased in hy5-215 mutants, whereas 35S::HY5-GFP/hy5-215 transgenic lines exhibited comparable levels of GSL-related transcripts and GSL content to those in WT plants. HY5 physically interacts with HISTONE DEACETYLASE9 and binds to the proximal promoter region of MYB29 and IMD1 to suppress aliphatic GSL biosynthetic processes. These results demonstrate that HY5 suppresses GSL accumulation during the daytime, thus properly modulating GSL content daily in Arabidopsis plants.
Improving the efficiency of research proposals evaluation: A two-stage procedure
Authors: Seeber Marco , Svege Ida , Hesselberg Jan Ole
Published: May 2024

An important share of research funding is allocated via competitive programs, which entail considerable direct and indirect costs, such as to develop and evaluate the proposals. The goal of this article is to explore whether adopting a two-stage evaluation procedure could improve the efficiency of the process. For this purpose, we study the evaluation system designed by the Foundation Dam (Stiftelsen Dam), one of the largest foundations in Norway supporting health research. In 2020, Foundation Dam adopted a new evaluation procedure consisting in a short proposal for a first stage of selection and, for those selected, a second-stage evaluation of a long proposal. We explore whether such a procedure reduces the evaluation costs and how the evaluation procedures compare in terms of reliability. Survey responses from 94 of the 594 applicants in the one-stage procedure (2018–19) and all the 668 applicants in the two-stage procedure (2020–21) show that the two-stage procedure reduced the average time that applicants spent in drafting the proposal(s) by 38%. According to the reviewers’ estimate, the two-stage procedure also reduced by 28% the time they spent on average to evaluate an applicant’s proposal(s). The analysis of the evaluation data of 594 long proposals in the one-stage procedure and 668 short proposals in the two-stage procedure shows that reviewers’ scores of short proposals display greater reliability and agreement than the reviewers’ scores of long proposals in the old one-stage procedure. Our findings suggest that a two-stage procedure can substantially improve the efficiency of grant writing and review, without harming the reliability of the evaluation.