Oral bacteria in infective endocarditis requiring surgery: a retrospective analysis of 134 patients.

OBJECTIVES It has been reported that bacteria associated with infective endocarditis originate from the oral cavity in 26-45% of cases. However, little is known on the counts and species of periodontal microbiota in infected heart valves. The aim of this study was to identify these aspects of periodontal microbiota in infective endocarditis and to potentially initiate a dental extraction concept for periodontally compromised teeth concerning patients requiring heart valve surgery. MATERIALS AND METHODS The retrospective study group consisted of tissue samples from infected heart valves of 683 patients who had undergone heart valve surgery. Before patients had undergone cardiac surgery, the following laboratory tests confirmed the occurrence of endocarditis in all patients: blood cultures, echocardiography, electrocardiography, chest X-ray, and electrophoresis of the serum proteins. The specimens were aseptically obtained and deep frozen immediately following surgery. Microbiological diagnosis included proof of germs (dichotomous), species of germs, and source of germs (oral versus other). RESULTS Microbiota was detected in 134 (31.2%) out of 430 enrolled patients. Oral cavity was supposed to be the source in 10.4% of cases, whereas microbiota of the skin (57.5%) and gastrointestinal tract (GIT, 24.6%) were detected considerably more frequently. Moreover, periodontal bacteria belonged mostly to the Streptococci species and the yellow complex. None of the detected bacteria belonged to the red complex. CONCLUSION Most frequently, the skin and GIT represented the site of origin of the microbiota. Nevertheless, the oral cavity represented the source of IE in up to 10%. Consequently, it needs to be emphasized that a good level of oral hygiene is strongly recommended in all patients undergoing heart valve surgery in order to reduce the bacterial load in the oral cavity, thereby minimizing the hematogenous spread of oral microbiota. The prerequisites for conservative dental treatment versus radical tooth extraction must always be based on the patient's cooperation, and the clinical intraoral status on a sense of proportion in view of the overall clinical situation due to the underlying cardiac disease. CLINICAL RELEVANCE The oral cavity is a source of oral microbiota on infected heart valves. Patients requiring heart valve surgery should always undergo a critical evaluation of dental treatment affecting periodontally compromised teeth, favoring a systematic, conservative-leaning recall

A systems perspective on the interactions between urban green infrastructure and the built environment

This research addresses the intricate dynamics between urban green infrastructure (UGI) and the built environment, focusing on the effects of urban heat islands, building energy demand, and human health. Following the idea of the Socio-Ecological-Technological Systems framework, we investigate key indicators related to green and grey infrastructure and their interactions at the urban scale. We construct a comprehensive causal-loop diagram through an iterative approach involving literature analysis and expert consultation. The outcomes highlight the significance of urban form and green infrastructure in connecting indoor and outdoor spaces. This research enhances the understanding of systemic behavior in the urban fabric and offers insights into the complex interactions between UGI and the built environment. The approach underscores the value of iterative modeling, fostering collaborative efforts and providing a foundation for further system modeling. Future research should focus on quantitative validation of the identified connections. Additionally, connection strengths and spatial elements would be valuable extensions of the presented system model

Nuclear pores as versatile reference standards for quantitative superresolution microscopy

Quantitative fluorescence and superresolution microscopy are often limited by insufficient data quality or artifacts. In this context, it is essential to have biologically relevant control samples to benchmark and optimize the quality of microscopes, labels and imaging conditions. Here, we exploit the stereotypic arrangement of proteins in the nuclear pore complex as in situ reference structures to characterize the performance of a variety of microscopy modalities. We created four genome edited cell lines in which we endogenously labeled the nucleoporin Nup96 with mEGFP, SNAP-tag, HaloTag or the photoconvertible fluorescent protein mMaple. We demonstrate their use (1) as three-dimensional resolution standards for calibration and quality control, (2) to quantify absolute labeling efficiencies and (3) as precise reference standards for molecular counting. These cell lines will enable the broader community to assess the quality of their microscopes and labels, and to perform quantitative, absolute measurements

Gamma-ray follow-up studies on Eta Carinae

Observations of high energy gamma rays recently revealed a persistent source in spatial coincidence with the binary system Eta Carinae. Since modulation of the observed gamma-ray flux on orbital time scales has not been reported so far, an unambiguous identification was hitherto not possible. Particularly the observations made by the Fermi Large Area Telescope (LAT) posed additional questions regarding the actual emission scenario owing to the existence of two energetically distinct components in the gamma-ray spectrum of this source, best described by an exponentially cutoff power-law function (CPL) at energies below 10 GeV and a power-law (PL) component dominant at higher energies. The increased exposure in conjunction with the improved instrumental response functions of the LAT now allow us to perform a more detailed investigation of location, spectral shape, and flux time history of the observed gamma-ray emission. For the first time, we are able to report a weak but regular flux decrease over time. This can be understood and interpreted in a colliding-wind binary scenario for orbital modulation of the gamma-ray emission. We find the spectral shape of the gamma-ray signal in agreement with a single emitting particle population in combination with significant absorption by gamma-gamma pair production. Studying the correlation of the flux decrease with the orbital separation of the binary components allows us to predict the behaviour up to the next periastron passage in 2014.Comment: 11 pages, 9 figure

The 2.35 year itch of Cygnus OB2 #9: III. X-ray and radio emission analysis based on 3D hydrodynamical modelling

Context. The wind-wind collision in a massive star binary system leads to the generation of high temperature shocks that emit at X-ray wavelengths and, if particle acceleration is effective, may exhibit non-thermal radio emission. Cyg OB2 is one of a small number of massive star binary systems in this class. Aims. X-ray and radio data recently acquired as part of a project to study Cyg OB2 are used to constrain physical models of the binary system, providing in-depth knowledge about the wind-wind collision and the thermal, and non-thermal, emission arising from the shocks. Methods. We use a 3D, adaptive mesh refinement simulation (including wind acceleration, radiative cooling, and the orbital motion of the stars) to model the gas dynamics of the wind-wind collision. The simulation output is used as the basis for radiative transfer calculations considering the thermal X-ray emission and the thermal/non-thermal radio emission. Results. The flow dynamics in the simulation show that wind acceleration (between the stars) is inhibited at all orbital phases by the opposing star's radiation field, reducing pre-shock velocities below terminal velocities. To obtain good agreement with the X-ray observations, our initial mass-loss rate estimates require a down-shift by a factor of ∼7.7 to 6.5 × 10-7 M yr-1 and 7.5 × 10-7 M yr-1 for the primary and secondary star, respectively. Furthermore, the low gas densities and high shock velocities in Cyg OB2 are suggestive of unequal electron and ion temperatures, and the X-ray analysis indicates that an immediately post-shock electron-ion temperature ratio of 0.1 is also required. The radio emission is dominated by non-thermal synchrotron emission. A parameter space exploration provides evidence against models assuming equipartition between magnetic and relativistic energy densities. However, fits of comparable quality can be attained with models having stark contrasts in the ratio of magnetic-to-relativistic energy densities. Both X-ray and radio lightcurves are largely insensitive to viewing angle. The variations in X-ray emission with orbital phase can be traced back to an inverse relation with binary separation and pre-shock velocity. The radio emission also scales with pre-shock velocity and binary separation, but to positive powers (i.e. not inversely). The radio models also reveal a subtle effect whereby inverse Compton cooling leads to an increase in emissivity as a result of the synchrotron characteristic frequency being significantly reduced. Finally, using the results of the radio analysis, we estimate the surface magnetic field strengths to be 0.3-52G

Variable millimetre radiation from the colliding-wind binary Cygnus OB2 #8A

Context. Massive binaries have stellar winds that collide. In the colliding-wind region, various physically interesting processes occur, leading to enhanced X-ray emission, non-thermal radio emission, as well as non-thermal X-rays and gamma-rays. Non-thermal radio emission (due to synchrotron radiation) has so far been observed at centimetre wavelengths. At millimetre wavelengths, the stellar winds and the colliding-wind region emit more thermal free-free radiation, and it is expected that any non-thermal contribution will be difficult or impossible to detect. Aims. We aim to determine if the material in the colliding-wind region contributes substantially to the observed millimetre fluxes of a colliding-wind binary. We also try to distinguish the synchrotron emission from the free-free emission. Methods. We monitored the massive binary Cyg OB2 #8A at 3 mm with the NOrthern Extended Millimeter Array (NOEMA) interferometer of the Institut de Radioastronomie Millimétrique (IRAM). The data were collected in 14 separate observing runs (in 2014 and 2016), and provide good coverage of the orbital period. Results. The observed millimetre fluxes range between 1.1 and 2.3 mJy, and show phase-locked variability, clearly indicating that a large part of the emission is due to the colliding-wind region. A simple synchrotron model gives fluxes with the correct order of magnitude, but with a maximum that is phase-shifted with respect to the observations. Qualitatively this phase shift can be explained by our neglect of orbital motion on the shape of the colliding-wind region. A model using only free-free emission results in only a slightly worse explanation of the observations. Additionally, on the map of our observations we also detect the O6.5 III star Cyg OB2 #8B, for which we determine a 3 mm flux of 0.21 ± 0.033 mJy. Conclusions. The question of whether synchrotron radiation or free-free emission dominates the millimetre fluxes of Cyg OB2 #8A remains open. More detailed modelling of this system, based on solving the hydrodynamical equations, is required to give a definite answer

Resistance to mesenchymal reprogramming sustains clonal propagation in metastatic breast cancer

The acquisition of mesenchymal traits is considered a hallmark of breast cancer progression. However, the functional relevance of epithelial-to-mesenchymal transition (EMT) remains controversial and context dependent. Here, we isolate epithelial and mesenchymal populations from human breast cancer metastatic biopsies and assess their functional potential in vivo. Strikingly, progressively decreasing epithelial cell adhesion molecule (EPCAM) levels correlate with declining disease propagation. Mechanistically, we find that persistent EPCAM expression marks epithelial clones that resist EMT induction and propagate competitively. In contrast, loss of EPCAM defines clones arrested in a mesenchymal state, with concomitant suppression of tumorigenicity and metastatic potential. This dichotomy results from distinct clonal trajectories impacting global epigenetic programs that are determined by the interplay between human ZEB1 and its target GRHL2. Collectively, our results indicate that susceptibility to irreversible EMT restrains clonal propagation, whereas resistance to mesenchymal reprogramming sustains disease spread in multiple models of human metastatic breast cancer, including patient-derived cells in vivo