Efficient CRISPR genome editing and integrative genomic analyses reveal the mosaicism of Cas-induced mutations and pleiotropic effects of scarlet gene in an emerging model system.

Despite the revolutionary impacts of CRISPR-Cas gene editing systems, the effective and widespread use of CRISPR technologies in emerging model organisms still faces significant challenges. These include the inefficiency in generating heritable mutations at the organismal level, limited knowledge about the genomic consequences of gene editing, and an inadequate understanding of the inheritance patterns of CRISPR-Cas-induced mutations. This study addresses these issues by 1) developing an efficient microinjection delivery method for CRISPR editing in the microcrustacean Daphnia pulex; 2) assessing the editing efficiency of Cas9 and Cas12a nucleases, examining mutation inheritance patterns, and analyzing the local and global mutation spectrum in the scarlet mutants; and 3) investigating the transcriptomes of scarlet mutants to understand the pleiotropic effects of scarlet underlying their swimming behavior changes. Our reengineered CRISPR microinjection method results in efficient biallelic editing with both nucleases. While indels are dominant in Cas-induced mutations, a few on-site large deletions (>1kb) are observed, most likely caused by microhomology-mediated end joining repair. Knock-in of a stop codon cassette to the scarlet locus was successful, despite complex induced mutations surrounding the target site. Moreover, extensive germline mosaicism exists in some mutants, which unexpectedly produce different phenotypes/genotypes in their asexual progenies. Lastly, our transcriptomic analyses unveil significant gene expression changes associated with scarlet knock-out and altered swimming behavior in mutants, including several genes (e.g., NMDA1, ABAT, CNTNAP2) involved in human neurodegenerative diseases. This study expands our understanding of the dynamics of gene editing in the tractable model organism Daphnia and highlights its promising potential as a neurological disease model.

Generation of Human Isogenic Induced Pluripotent Stem Cell Lines with CRISPR Prime Editing.

We developed an efficient CRISPR prime editing protocol and generated isogenic-induced pluripotent stem cell (iPSC) lines carrying heterozygous or homozygous alleles for putatively causal single nucleotide variants at six type 2 diabetes loci (ABCC8, MTNR1B, TCF7L2, HNF4A, CAMK1D, and GCK). Our two-step sequence-based approach to first identify transfected cell pools with the highest fraction of edited cells significantly reduced the downstream efforts to isolate single clones of edited cells. We found that prime editing can make targeted genetic changes in iPSC and optimization of system components and guide RNA designs that were critical to achieve acceptable efficiency. Systems utilizing PEmax, epegRNA modifications, and MLH1dn provided significant benefit, producing editing efficiencies of 36-73%. Editing success and pegRNA design optimization required for each variant differed depending on the sequence at the target site. With attention to design, prime editing is a promising approach to generate isogenic iPSC lines, enabling the study of specific genetic changes in a common genetic background.

MXene nanosheet-derived N, S-codoped graphene quantum dots for ultrasensitive and selective detection of 3-nitro-l-tyrosine in human serum.

3-Nitro-l-tyrosine (3NT) is an oxidative stress metabolite associated with neurodegenerative diseases such as Parkinson's disease and rheumatoid arthritis. In this study, the N, S-co-doped graphene quantum dots (NSGQDs) derived from nitrogen-doped Ti3C2Tx MXene nanosheet via the hydrothermal method in the presence of mercaptosuccinic acid was synthesized as an optical sensing probe to detect 3NT in human serum. Tetramethyl ammonium hydroxide, the nitrogen source and delamination agent, was used to prepare nitrogen-doped MXene nanosheets via one step at room temperature. The as-prepared NSGQDs are uniform with an average size of 1.2 ± 0.6 nm, and can be stable in aqueous solution for at least 90 d to serve as the fluorescence probe. The N atoms in N-MXene reduce the restacking and aggregation of MXene nanosheets, while the sulfur dopant in NSGQDs increases the quantum yield from 6.2 to 12.1 % as well as enhances the selectivity of 3NT over the other 12 interferences via coordination interaction with nitro group in 3NT. A linear range of 0.02-150 µM in PBS and 0.05-200 µM in human serum with a recovery of 97-108 % for 3NT detection is observed. Moreover, the limit of detection can be lowered to 4.2 and 7 nM in PBS and 1 × diluted human serum, respectively. Results obtained clearly indicate the potential application of the N-Ti3C2Tx derived NSGQD for effective detection of 3NT, which can open a window for the synthesis of doped GQDs via 2D MXene materials for ultrasensitive and selective detection of other biometabolites and biomarkers of neurodegenerative diseases in biological fluids.

Weld Line Strength of Polyamide Fiberglass Composite at Different Processing Parameters in Injection Molding Technique.

This study examines the impact of injection parameters on the weld line strength of the polyamide 6 and 30% fiberglass (PA6 + 30% FG) composite samples. The effects of filling time, packing time, packing pressure, melt temperature, and mold temperature on the ultimate tensile strength (UTS) and the elongation value of the weld line are investigated. The results reveal that the filling time factor has the lowest influence rate. On the contrary, the packing pressure has the most considerable value of UTS standard deviation, indicating that this factor has a high impact rate. The melt temperature factor has the highest elongation standard deviation, pointing out the strong impact of melt temperature on the elongation value. In reverse, the filling time factor has the lowest elongation standard deviation, showing the low impact of this factor on the elongation value. Increasing the mold temperature enhances the elongation value greatly because a higher temperature generates a better connection in the weld line area. Although the UTS value improves modestly when the mold temperature control system is used, the elongation result from the mold temperature parameter is better than expected. The UTS result from all parameters presents a minor deviation; therefore, it is lower than expected. The optimal strength result from artificial neural networks with genetic algorithm optimization is 85.1 MPa, which is higher than the best experiment result of 76.8 MPa. Scanning electron microscopy (SEM) results show that the interface between the fiberglass and the PA matrix has high adherence. The fracture surface is smooth, indicating that the PA6 + 30% FG composite sample has a high fragility level. The findings could help to increase the injection sample's weld line strength by optimizing the injection molding conditions.

Applying artificial intelligence and digital health technologies, Viet Nam.

Problem: Direct application of digital health technologies from high-income settings to low- and middle-income countries may be inappropriate due to challenges around data availability, implementation and regulation. Hence different approaches are needed. Approach: Within the Viet Nam ICU Translational Applications Laboratory project, since 2018 we have been developing a wearable device for individual patient monitoring and a clinical assessment tool to improve dengue disease management. Working closely with local staff at the Hospital for Tropical Diseases, Ho Chi Minh City, we developed and tested a prototype of the wearable device. We obtained perspectives on design and use of the sensor from patients. To develop the assessment tool, we used existing research data sets, mapped workflows and clinical priorities, interviewed stakeholders and held workshops with hospital staff. Local setting: In Viet Nam, a lower middle-income country, the health-care system is in the nascent stage of implementing digital health technologies. Relevant changes: Based on patient feedback, we are altering the design of the wearable sensor to increase comfort. We built the user interface of the assessment tool based on the core functionalities selected by workshop attendees. The interface was subsequently tested for usability in an iterative manner by the clinical staff members. Lessons learnt: The development and implementation of digital health technologies need an interoperable and appropriate plan for data management including collection, sharing and integration. Engagements and implementation studies should be conceptualized and conducted alongside the digital health technology development. The priorities of end-users, and understanding context and regulatory landscape are crucial for success.

The Transcriptomic Signature of Cyclical Parthenogenesis.

Cyclical parthenogenesis, where females can engage in sexual or asexual reproduction depending on environmental conditions, represents a novel reproductive phenotype that emerged during eukaryotic evolution. The fact that environmental conditions can trigger cyclical parthenogens to engage in distinct reproductive modes strongly suggests that gene expression plays a key role in the origin of cyclical parthenogenesis. However, the genetic basis underlying cyclical parthenogenesis remains understudied. In this study, we characterize the female transcriptomic signature of sexual versus asexual reproduction in the cyclically parthenogenetic microcrustacean Daphnia pulex and Daphnia pulicaria. Our analyses of differentially expressed genes (DEGs), pathway enrichment, and gene ontology (GO) term enrichment clearly show that compared with sexual reproduction, the asexual reproductive stage is characterized by both the underregulation of meiosis and cell cycle genes and the upregulation of metabolic genes. The consensus set of DEGs that this study identifies within the meiotic, cell cycle, and metabolic pathways serves as candidate genes for future studies investigating how the two reproductive cycles in cyclical parthenogenesis are mediated at a molecular level. Furthermore, our analyses identify some cases of divergent expression among gene family members (e.g., doublesex and NOTCH2) associated with asexual or sexual reproductive stage, suggesting potential functional divergence among gene family members.

Influences of TPU Content on the Weld Line Characteristics of PP and ABS Blends.

This study aims to explore the effects of Thermoplastic Polyurethane (TPU) content on the weld line properties of Polypropylene (PP) and Acrylonitrile Butadiene Styrene (ABS) blends. In PP/TPU blends, increasing the TPU content results in a significant decrease in the PP/TPU composite's ultimate tensile strength (UTS) and elongation values. Blends with 10 wt%, 15 wt%, and 20 wt% TPU and pure PP outperform blends with 10 wt%, 15 wt%, and 20 wt% TPU and recycled PP in terms of UTS value. The blend with 10 wt% TPU and pure PP achieves the highest UTS value of 21.85 MPa. However, the blend's elongation decreases due to the poor bonding in the weld line area. According to Taguchi's analysis, the TPU factor has a more significant overall influence on the mechanical properties of PP/TPU blends than the recycled PP factor. Scanning electron microscope (SEM) results show that the TPU area has a dimple shape on the fracture surface due to its significantly higher elongation value. The 15 wt% TPU sample achieves the highest UTS value of 35.7 MPa in ABS/TPU blends, which is considerably higher than other cases, indicating good compatibility between ABS and TPU. The sample containing 20 wt% TPU has the lowest UTS value of 21.2 MPa. Furthermore, the elongation-changing pattern corresponds to the UTS value. Interestingly, SEM results present that the fracture surface of this blend is flatter than the PP/TPU blend due to a higher compatibility rate. The 30 wt% TPU sample has a higher rate of dimple area than the 10 wt% TPU sample. Moreover, ABS/TPU blends gain a higher UTS value than PP/TPU blends. Increasing the TPU ratio mainly reduces the elastic modulus of both ABS/TPU blends and PP/TPU blends. This study reveals the advantages and disadvantages of mixing TPU with PP or ABS to ensure that it meets the requirements of the intended applications.

Postural orthostatic tachycardia syndrome-like symptoms following COVID-19 vaccination: An overview of clinical literature.

BACKGROUND: Postural Orthostatic Tachycardia Syndrome (POTS) is a common condition affecting more than 170 people per 100,000 population. However, POTS following COVID-19 vaccination remains a rare reporting in the medical literature. OBJECTIVE: We, herein, summarize and highlight the evidence that has been reported regarding POTS-like symptoms following COVID-19 vaccination. METHODS: We conducted a literature search and summarized the findings in the form of a narrative commentary. All types of publications (case reports/series, original articles, letters to editors, brief communications etc.) in English language were included. RESULTS: Whilst the exact pathogenetic mechanism behind POTS is yet to elucidated, there has been increasing evidence pointing towards an autoimmune dysfunction. Females were found to be predominantly affected (72%) with age range from 17 years to 52 years. Additionally, it seems that POTS-like symptoms could be triggered after immunization with Pfizer- BioNTech, Moderna, and Oxford-AstraZeneca COVID-19 vaccines. The symptoms typically appear within the first week, depending upon previous exposure to the virus and presence of other systemic conditions. In some patients, the condition is self-resolving. However, in others, non-pharmacological interventions coupled with negative ionotropic medications can be used for symptomatic management of the patients. CONCLUSIONS: Timely diagnosis and proper treatment are quintessential for ensuring early alleviation (and in some cases complete resolution) of symptoms. Furthermore, there may be episodes of relapse. Overall prognosis of the new-onset POTS-like symptoms is difficult to predict based on current literature.

Learning meaningful latent space representations for patient risk stratification: Model development and validation for dengue and other acute febrile illness.

Background: Increased data availability has prompted the creation of clinical decision support systems. These systems utilise clinical information to enhance health care provision, both to predict the likelihood of specific clinical outcomes or evaluate the risk of further complications. However, their adoption remains low due to concerns regarding the quality of recommendations, and a lack of clarity on how results are best obtained and presented. Methods: We used autoencoders capable of reducing the dimensionality of complex datasets in order to produce a 2D representation denoted as latent space to support understanding of complex clinical data. In this output, meaningful representations of individual patient profiles are spatially mapped in an unsupervised manner according to their input clinical parameters. This technique was then applied to a large real-world clinical dataset of over 12,000 patients with an illness compatible with dengue infection in Ho Chi Minh City, Vietnam between 1999 and 2021. Dengue is a systemic viral disease which exerts significant health and economic burden worldwide, and up to 5% of hospitalised patients develop life-threatening complications. Results: The latent space produced by the selected autoencoder aligns with established clinical characteristics exhibited by patients with dengue infection, as well as features of disease progression. Similar clinical phenotypes are represented close to each other in the latent space and clustered according to outcomes broadly described by the World Health Organisation dengue guidelines. Balancing distance metrics and density metrics produced results covering most of the latent space, and improved visualisation whilst preserving utility, with similar patients grouped closer together. In this case, this balance is achieved by using the sigmoid activation function and one hidden layer with three neurons, in addition to the latent dimension layer, which produces the output (Pearson, 0.840; Spearman, 0.830; Procrustes, 0.301; GMM 0.321). Conclusion: This study demonstrates that when adequately configured, autoencoders can produce two-dimensional representations of a complex dataset that conserve the distance relationship between points. The output visualisation groups patients with clinically relevant features closely together and inherently supports user interpretability. Work is underway to incorporate these findings into an electronic clinical decision support system to guide individual patient management.

A proposed scenario to improve the Ncut algorithm in segmentation.

In image segmentation, there are many methods to accomplish the result of segmenting an image into k clusters. However, the number of clusters k is always defined before running the process. It is defined by some observation or knowledge based on the application. In this paper, we propose a new scenario in order to define the value k clusters automatically using histogram information. This scenario is applied to Ncut algorithm and speeds up the running time by using CUDA language to parallel computing in GPU. The Ncut is improved in four steps: determination of number of clusters in segmentation, computing the similarity matrix W, computing the similarity matrix's eigenvalues, and grouping on the Fuzzy C-Means (FCM) clustering algorithm. Some experimental results are shown to prove that our scenario is 20 times faster than the Ncut algorithm while keeping the same accuracy.

Unique Genomic Epidemiology of COVID-19 in the White Mountain Apache Tribe, April to August 2020, Arizona.

The first case of coronavirus disease 2019 (COVID-19) within the White Mountain Apache Tribe (WMAT) in Arizona was diagnosed almost 1 month after community transmission was recognized in the state. Aggressive contact tracing allowed for robust genomic epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and subsequent phylogenetic analyses implicated only two virus introductions, which resulted in the spread of two unique viral lineages on the reservation. The phylogenies of these lineages reflect the nature of the introductions, the remoteness of the community, and the extraordinarily high attack rates. The timing and space-limited nature of the outbreaks validate the public health tracing efforts involved, which were illustrated by multiple short transmission chains over a period of several weeks, eventually resulting in extinction of the lineages. Comprehensive sampling and successful infection control efforts are illustrated in both the effective population size analyses and the limited mortality outcomes. The rapid spread and high attack rates of the two lineages may be due to a combination of sociological determinants of the WMAT and a seemingly enhanced transmissibility. The SARS-CoV-2 genomic epidemiology of the WMAT demonstrates a unique local history of the pandemic and highlights the extraordinary and successful efforts of their public health response. IMPORTANCE This article discusses the introduction and spread of two unique viral lineages of SARS-CoV-2 within the White Mountain Apache Tribe in Arizona. Both genomic sequencing and traditional epidemiological strategies (e.g., contract tracing) were used to understand the nature of the spread of both lineages. Beyond providing a robust genomic analysis of the epidemiology of the outbreaks, this work also highlights the successful efforts of the local public health response.

A modified Sequential Organ Failure Assessment score for dengue: development, evaluation and proposal for use in clinical trials.

BACKGROUND: Dengue is a neglected tropical disease, for which no therapeutic agents have shown clinical efficacy to date. Clinical trials have used strikingly variable clinical endpoints, which hampers reproducibility and comparability of findings. We investigated a delta modified Sequential Organ Failure Assessment (delta mSOFA) score as a uniform composite clinical endpoint for use in clinical trials investigating therapeutics for moderate and severe dengue. METHODS: We developed a modified SOFA score for dengue, measured and evaluated its performance at baseline and 48 h after enrolment in a prospective observational cohort of 124 adults admitted to a tertiary referral hospital in Vietnam with dengue shock. The modified SOFA score included pulse pressure in the cardiovascular component. Binary logistic regression, cox proportional hazard and linear regression models were used to estimate association between mSOFA, delta mSOFA and clinical outcomes. RESULTS: The analysis included 124 adults with dengue shock. 29 (23.4%) patients required ICU admission for organ support or due to persistent haemodynamic instability: 9/124 (7.3%) required mechanical ventilation, 8/124 (6.5%) required vasopressors, 6/124 (4.8%) required haemofiltration and 5/124 (4.0%) patients died. In univariate analyses, higher baseline and delta (48 h) mSOFA score for dengue were associated with admission to ICU, requirement for organ support and mortality, duration of ICU and hospital admission and IV fluid use. CONCLUSIONS: The baseline and delta mSOFA scores for dengue performed well to discriminate patients with dengue shock by clinical outcomes, including duration of ICU and hospital admission, requirement for organ support and death. We plan to use delta mSOFA as the primary endpoint in an upcoming host-directed therapeutic trial and investigate the performance of this score in other phenotypes of severe dengue in adults and children.

Frailty and Associated Factors among the Elderly in Vietnam: A Cross-Sectional Study.

BACKGROUND: Frailty syndrome is common among older people and can lead to various adverse consequences such as falls, cognitive decline, disability, dependent living, increased mortality, excessive drug use, and prolonged hospital stays. OBJECTIVES: This research determined the prevalence of frailty and associated factors among older adults in Vietnam. METHODS: A cross-sectional study was conducted on 584 older adults across five Ho Chi Minh City wards from November 2020 to January 2021. Based on the modified Fried frailty scale, the participants were divided into three categories: robust, pre-frail, and frail. A chi-square test (or Fisher's test) examined the relationship between frailty categories and other variables. Multivariable logistic regression used variates with a cut-off of p ≤ 0.05 in the univariate analysis. RESULTS: The prevalence rates of frailty and pre-frailty were 19% and 64%, respectively. The most common frailty component was weak grip strength (63.9%), followed by slowness (36.1%), weight loss (21.6%), low physical activity (19.5%), and exhaustion (18.5%). In addition, the prevalence of frailty was significantly associated with age, BMI levels, living alone, and sarcopenia. CONCLUSION: The community's prevalence of frailty among older adults is high. Frailty can lead to many adverse consequences for the elderly. As there were some modifiable factors associated with frailty, it should be assessed in older people through community-based healthcare programs for early diagnosis and management.

Erbium-Doped GQD-Embedded Coffee-Ground-Derived Porous Biochar for Highly Efficient Asymmetric Supercapacitor.

A nanocomposite with erbium-doped graphene quantum dots embedded in highly porous coffee-ground-derived biochar (Er-GQD/HPB) was synthesized as a promising electrode material for a highly efficient supercapacitor. The HPB showed high porosity, with a large surface area of 1295 m2 g-1 and an average pore size of 2.8 nm. The 2-8-nanometer Er-GQD nanoparticles were uniformly decorated on the HPB, subsequently increasing its specific surface area and thermal stability. Furthermore, the intimate contact between the Er-GQDs and HPB significantly reduced the charge-transfer resistance and diffusion path, leading to the rapid migration of ions/electrons in the mesoporous channels of the HPB. By adding Er-GQDs, the specific capacitance was dramatically increased from 337 F g-1 for the pure HPB to 699 F g-1 for the Er-GQD/HPB at 1 A g-1. The Ragone plot of the Er-GQD/HPB exhibited an ultrahigh energy density of 94.5 Wh kg-1 and a power density of 1.3 kW kg-1 at 1 A g-1. Furthermore, the Er-GQD/HPB electrode displayed excellent cycling stability, and 81% of the initial capacitance remained after 5000 cycles. Our results provide further insights into a promising supercapacitance material that offers the benefits of both fast ion transport from highly porous carbons and electrocatalytic improvement due to the embedment of Er-doped GQDs to enhance energy density relative to conventional materials.

Contamination of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in sediment of the Cau River, Vietnam.

Perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) are recognized as emerging environmental pollutants because of their high persistence in various environmental matrices and toxic effects on humans and animals. In Vietnam, PFOA and PFOS have been detected in surface water and sediment in recent studies. The objectives of this study were to evaluate the spatial and vertical distribution, determine the factors affecting the sorption onto sediment, and assess the environmental risk of PFOS and PFOA in the sediment of the Cau River. The average concentrations of PFOS and PFOA in the surface sediment were 2.66 ng/g and 0.84 ng/g, respectively. The highest concentrations were recorded in the areas receiving wastewater from domestic and industrial activities. According to the depth, the contents of target chemicals in the surface sediments (0-5 cm) were lower than those in the second layer (5-10 cm). The remaining layers have decreasing concentration as the depth of the sediment increases. The water-sediment distribution coefficient was relatively different for PFOS and PFOA with log Kd values ranging from 1.31 to 1.86 and from 0.08 to 1.31, respectively. This study also demonstrated that the level of PFOS and PFOA in sediment is significantly correlated with total organic carbon content of sediment. No apparent relation was found between PFOS, PFOA concentration in sediment, and particle size distribution. Risk quotients of the two compounds were below 0.01, indicating that the environmental risk in the sediment is negligible at present. The results of this study provide an overview of PFOS and PFOA contamination in sediment in the Cau River, Vietnam.

The compensatory reserve index predicts recurrent shock in patients with severe dengue.

BACKGROUND: Dengue shock syndrome (DSS) is one of the major clinical phenotypes of severe dengue. It is defined by significant plasma leak, leading to intravascular volume depletion and eventually cardiovascular collapse. The compensatory reserve Index (CRI) is a new physiological parameter, derived from feature analysis of the pulse arterial waveform that tracks real-time changes in central volume. We investigated the utility of CRI to predict recurrent shock in severe dengue patients admitted to the ICU. METHODS: We performed a prospective observational study in the pediatric and adult intensive care units at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. Patients were monitored with hourly clinical parameters and vital signs, in addition to continuous recording of the arterial waveform using pulse oximetry. The waveform data was wirelessly transmitted to a laptop where it was synchronized with the patient's clinical data. RESULTS: One hundred three patients with suspected severe dengue were recruited to this study. Sixty-three patients had the minimum required dataset for analysis. Median age was 11 years (IQR 8-14 years). CRI had a negative correlation with heart rate and moderate negative association with blood pressure. CRI was found to predict recurrent shock within 12 h of being measured (OR 2.24, 95% CI 1.54-3.26), P < 0.001). The median duration from CRI measurement to the first recurrent shock was 5.4 h (IQR 2.9-6.8). A CRI cutoff of 0.4 provided the best combination of sensitivity and specificity for predicting recurrent shock (0.66 [95% CI 0.47-0.85] and 0.86 [95% CI 0.80-0.92] respectively). CONCLUSION: CRI is a useful non-invasive method for monitoring intravascular volume status in patients with severe dengue.

The transcriptomic signature of obligate parthenogenesis.

Investigating the origin of parthenogenesis through interspecific hybridization can provide insight into how meiosis may be altered by genetic incompatibilities, which is fundamental for our understanding of the formation of reproductive barriers. Yet the genetic mechanisms giving rise to obligate parthenogenesis in eukaryotes remain understudied. In the microcrustacean Daphnia pulex species complex, obligately parthenogenetic (OP) isolates emerged as backcrosses of two cyclically parthenogenetic (CP) parental species, D. pulex and D. pulicaria, two closely related but ecologically distinct species. We examine the genome-wide expression in OP females at the early resting egg production stage, a life-history stage distinguishing OP and CP reproductive strategies, in comparison to CP females of the same stage from the two parental species. Our analyses of the expression data reveal that underdominant and overdominant genes are abundant in OP isolates, suggesting widespread regulatory incompatibilities between the parental species. More importantly, underdominant genes (i.e., genes with expression lower than both parentals) in the OP isolates are enriched in meiosis and cell-cycle pathways, indicating an important role of underdominance in the origin of obligate parthenogenesis. Furthermore, metabolic and biosynthesis pathways enriched with overdominant genes (i.e., expression higher than both parentals) are another genomic signature of OP isolates.

Novel Clinical Monitoring Approaches for Reemergence of Diphtheria Myocarditis, Vietnam.

Diphtheria is a life-threatening, vaccine-preventable disease caused by toxigenic Corynebacterium bacterial species that continues to cause substantial disease and death worldwide, particularly in vulnerable populations. Further outbreaks of vaccine-preventable diseases are forecast because of health service disruptions caused by the coronavirus disease pandemic. Diphtheria causes a spectrum of clinical disease, ranging from cutaneous forms to severe respiratory infections with systemic complications, including cardiac and neurologic. In this synopsis, we describe a case of oropharyngeal diphtheria in a 7-year-old boy in Vietnam who experienced severe myocarditis complications. We also review the cardiac complications of diphtheria and discuss how noninvasive bedside imaging technologies to monitor myocardial function and hemodynamic parameters can help improve the management of this neglected infectious disease.