The arrhythmogenic cardiomyopathy phenotype associated with PKP2 c.1211dup variant

Background: The arrhythmogenic cardiomyopathy (ACM) phenotype, with life-threatening ventricular arrhythmias and heart failure, varies according to genetic aetiology. We aimed to characterise the phenotype associated with the variant c.1211dup (p.Val406Serfs*4) in the plakophilin‑2 gene (PKP2) and compare it with previously reported Dutch PKP2 founder variants. Methods: Clinical data were collected retrospectively from medical records of 106 PKP2 c.1211dup heterozygous carriers. Using data from the Netherlands ACM Registry, c.1211dup was compared with 3 other truncating PKP2 variants (c.235C &gt; T (p.Arg79*), c.397C &gt; T (p.Gln133*) and c.2489+1G &gt; A (p.?)). Results: Of the 106 carriers, 47 (44%) were diagnosed with ACM, at a mean age of 41 years. By the end of follow-up, 29 (27%) had experienced sustained ventricular arrhythmias and 12 (11%) had developed heart failure, with male carriers showing significantly higher risks than females on these endpoints (p &lt; 0.05). Based on available cardiac magnetic resonance imaging and echocardiographic data, 46% of the carriers showed either right ventricular dilatation and/or dysfunction, whereas a substantial minority (37%) had some form of left ventricular involvement. Both geographical distribution of carriers and haplotype analysis suggested PKP2 c.1211dup to be a founder variant originating from the South-Western coast of the Netherlands. Finally, a Cox proportional hazards model suggested significant differences in ventricular arrhythmia–free survival between 4 PKP2 founder variants, including c.1211dup. Conclusions: The PKP2 c.1211dup variant is a Dutch founder variant associated with a typical right-dominant ACM phenotype, but also left ventricular involvement, and a possibly more severe phenotype than other Dutch PKP2 founder variants.</p

A SPectroscopic Survey of Biased Halos in the Reionization Era (ASPIRE): A First Look at the Rest-frame Optical Spectra of z > 6.5 Quasars Using JWST

© 2023. The Author(s). Published by the American Astronomical Society. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/Studies of rest-frame optical emission in quasars at z > 6 have historically been limited by the wavelengths accessible by ground-based telescopes. The James Webb Space Telescope (JWST) now offers the opportunity to probe this emission deep into the reionization epoch. We report the observations of eight quasars at z > 6.5 using the JWST/NIRCam Wide Field Slitless Spectroscopy as a part of the “A SPectroscopic survey of biased halos In the Reionization Era (ASPIRE)” program. Our JWST spectra cover the quasars’ emission between rest frame ∼4100 and 5100 Å. The profiles of these quasars’ broad Hβ emission lines span a full width at half maximum from 3000 to 6000 km s−1. The Hβ-based virial black hole (BH) masses, ranging from 0.6 to 2.1 billion solar masses, are generally consistent with their Mg ii-based BH masses. The new measurements based on the more reliable Hβ tracer thus confirm the existence of a billion solar-mass BHs in the reionization epoch. In the observed [O iii] λ λ 4960,5008 doublets of these luminous quasars, broad components are more common than narrow core components (≤ 1200 km s−1), and only one quasar shows stronger narrow components than broad. Two quasars exhibit significantly broad and blueshifted [O iii] emission, thought to trace galactic-scale outflows, with median velocities of −610 and −1430 km s−1 relative to the [C ii] 158 μm line. All eight quasars show strong optical Fe ii emission and follow the eigenvector 1 relations defined by low-redshift quasars. The entire ASPIRE program will eventually cover 25 quasars and provide a statistical sample for the studies of the BHs and quasar spectral properties.Peer reviewe

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Fusarium wilt (Foc Race 1) in relation to soil properties in smallholder’s farms with ‘gros Michel’ banana (Musa AAA) in Costa Rica

The aim of the study was to understand the relationship between soil properties and Fusarium wilt (FW) by Foc Race 1 in banana cv. ‘Gros Michel’. The experimentation was based on soils from the Turrialba region in Costa Rica. A first analysis took place under greenhouse conditions with Foc Race 1 inoculated plants and grown in two representative soil types from the region. The disease expression in relation with two soil pH levels (lower than 5.0 and higher than 6.0) and three weekly N doses (low: 0.00 g plant-1, medium: 0.08 g plant-1 and high: 0.25 g plant-1) applied with an ammonium nitrate solution in water. Soil type, pH and their interactions significantly affected the disease, where plants grown in the lower pH showed a higher FW expressed as a lower biomass. A second analysis used information at 20 farms in the region, where 49 fields were studied. FW expressed as a Severity Index (SI) was measured. Besides, agroecological variables such as altitude, slope, annual rainfall, average temperature, and soil fertility were determined. In addition, management variables as plant density and soil cover were gathered. A higher SI of FW was linked with a lower organic matter (SOM), and a higher acidity, calcium, and magnesium concentration in the soil. Other agroecological and management evaluated variables were not linked with the SI of FW. Given the fact that soil properties were highly correlated, it is difficult to attribute differences in SI of FW to individual soil properties. Each case should be considered as independent; however, results provide new insights into the relationship Soil-FW in banana. Practices of soil management such as liming, SOM founds application, and an adequate nutrient package are important options to alleviate the impact of the disease in the midterm in banana regions with Foc infested soils

The in‐vitro biocompatibility of ureido‐pyrimidinone compounds and polymer degradation products

Supramolecular biomaterials based on ureido-pyrimidinone (UPy) moieties are versatile polymer materials as their function can be tailored to the application. These UPy-materials can be designed into polymer coatings, self-healing polymers, hydrogels and elastomers. The biocompatibility of UPy-based materials and their degradation products is a long-term success requirement for many regenerative medicine and biomedical applications. Earlier research has shown that UPy-based materials and polymers display no immediate toxic effects, but in-depth in-vitro studies on potential UPy-polymer degradation products have not been executed. Owing to their resemblance to naturally occurring purines and pyrimidines, UPy-compounds and their degradation products could potentially initiate an immune response or be mutagenic. Accordingly, 11 selected UPy-compounds were synthesized, and their effect on cell viability, wound healing, and their immunogenicity and potential mutagenic potential, were studied. We showed that low molecular weight degradation products of UPy-based biomaterials do not affect cell viability, nor do these interfere with several aspects of endothelial function including proliferation, angiogenic sprouting and cellular migration even in levels exceeding plausibly attainable concentrations. Furthermore, the compounds are neither immunogenic nor mutagenic, showing that UPy-biomaterials exhibit good biocompatibility in vitro, and could in principle be used in humans

The in-vitro biocompatibility of ureido-pyrimidinone compounds and polymer degradation products

Supramolecular biomaterials based on ureido-pyrimidinone (UPy) moieties are versatile polymer materials as their function can be tailored to the application. These UPy-materials can be designed into polymer coatings, self-healing polymers, hydrogels and elastomers. The biocompatibility of UPy-based materials and their degradation products is a long-term success requirement for many regenerative medicine and biomedical applications. Earlier research has shown that UPy-based materials and polymers display no immediate toxic effects, but in-depth in-vitro studies on potential UPy-polymer degradation products have not been executed. Owing to their resemblance to naturally occurring purines and pyrimidines, UPy-compounds and their degradation products could potentially initiate an immune response or be mutagenic. Accordingly, 11 selected UPy-compounds were synthesized, and their effect on cell viability, wound healing, and their immunogenicity and potential mutagenic potential, were studied. We showed that low molecular weight degradation products of UPy-based biomaterials do not affect cell viability, nor do these interfere with several aspects of endothelial function including proliferation, angiogenic sprouting and cellular migration even in levels exceeding plausibly attainable concentrations. Furthermore, the compounds are neither immunogenic nor mutagenic, showing that UPy-biomaterials exhibit good biocompatibility in vitro, and could in principle be used in humans

Streamflow droughts aggravated by human activities despite management

Human activities both aggravate and alleviate streamflow drought. Here we show that aggravation is dominant in contrasting cases around the world analysed with a consistent methodology. Our 28 cases included different combinations of human-water interactions. We found that water abstraction aggravated all drought characteristics, with increases of 20%-305% in total time in drought found across the case studies, and increases in total deficit of up to almost 3000%. Water transfers reduced drought time and deficit by up to 97%. In cases with both abstraction and water transfers into the catchment or augmenting streamflow from groundwater, the water inputs could not compensate for the aggravation of droughts due to abstraction and only shift the effects in space or time. Reservoir releases for downstream water use alleviated droughts in the dry season, but also led to deficits in the wet season by changing flow seasonality. This led to minor changes in average drought duration (-26 to +38%) and moderate changes in average drought deficit (-86 to +369%). Land use showed a smaller impact on streamflow drought, also with both increases and decreases observed (-48 to +98%). Sewage return flows and pipe leakage possibly counteracted the effects of increased imperviousness in urban areas; however, untangling the effects of land use change on streamflow drought is challenging. This synthesis of diverse global cases highlights the complexity of the human influence on streamflow drought and the added value of empirical comparative studies. Results indicate both intended and unintended consequences of water management and infrastructure on downstream society and ecosystems. Water Resource