A massive galaxy that formed its stars at z ≈ 11

The formation of galaxies by gradual hierarchical co-assembly of baryons and cold dark matter halos is a fundamental paradigm underpinning modern astrophysics1,2 and predicts a strong decline in the number of massive galaxies at early cosmic times3-5. Extremely massive quiescent galaxies (stellar masses of more than 1011 M⊙) have now been observed as early as 1-2 billion years after the Big Bang6-13. These galaxies are extremely constraining on theoretical models, as they had formed 300-500 Myr earlier, and only some models can form massive galaxies this early12,14. Here we report on the spectroscopic observations with the JWST of a massive quiescent galaxy ZF-UDS-7329 at redshift 3.205 ± 0.005. It has eluded deep ground-based spectroscopy8, it is significantly redder than is typical and its spectrum reveals features typical of much older stellar populations. Detailed modelling shows that its stellar population formed around 1.5 billion years earlier in time (z ≈ 11) at an epoch when dark matter halos of sufficient hosting mass had not yet assembled in the standard scenario4,5. This observation may indicate the presence of undetected populations of early galaxies and the possibility of significant gaps in our understanding of early stellar populations, galaxy formation and the nature of dark matter.

A high black-hole-to-host mass ratio in a lensed AGN in the early Universe

Early JWST observations have uncovered a population of red sources that might represent a previously overlooked phase of supermassive black hole growth1-3. One of the most intriguing examples is an extremely red, point-like object that was found to be triply imaged by the strong lensing cluster Abell 2744 (ref. 4). Here we present deep JWST/NIRSpec observations of this object, Abell2744-QSO1. The spectroscopy confirms that the three images are of the same object, and that it is a highly reddened (AV ≃ 3) broad emission line active galactic nucleus at a redshift of zspec = 7.0451 ± 0.0005. From the width of Hβ (full width at half-maximum = 2,800 ± 250 km s-1), we derive a black hole mass ofM BH = 4 - 1 + 2 × 1 0 7 M ⊙ . We infer a very high ratio of black-hole-to-galaxy mass of at least 3%, an order of magnitude more than that seen in local galaxies5 and possibly as high as 100%. The lack of strong metal lines in the spectrum together with the high bolometric luminosity (Lbol = (1.1 ± 0.3) × 1045 erg s-1) indicate that we are seeing the black hole in a phase of rapid growth, accreting at 30% of the Eddington limit. The rapid growth and high black-hole-to-galaxy mass ratio of Abell2744-QSO1 suggest that it may represent the missing link between black hole seeds6 and one of the first luminous quasars7.

A population of faint, old, and massive quiescent galaxies at [Formula: see text] revealed by JWST NIRSpec Spectroscopy

Here we present a sample of 12 massive quiescent galaxy candidates at [Formula: see text] observed with the James Webb Space Telescope (JWST) Near Infrared Spectrograph (NIRSpec). These galaxies were pre-selected from the Hubble Space Telescope imaging and 10 of our sources were unable to be spectroscopically confirmed by ground based spectroscopy. By combining spectroscopic data from NIRSpec with multi-wavelength imaging data from the JWST Near Infrared Camera (NIRCam), we analyse their stellar populations and their formation histories. We find that all of our galaxies classify as quiescent based on the reconstruction of their star formation histories but show a variety of quenching timescales and ages. All our galaxies are massive ([Formula: see text] M[Formula: see text]), with masses comparable to massive galaxies in the local Universe. We find that the oldest galaxy in our sample formed [Formula: see text] M[Formula: see text] of mass within the first few hundred million years of the Universe and has been quenched for more than a billion years by the time of observation at [Formula: see text] ([Formula: see text] billion years after the Big Bang). Our results point to very early formation of massive galaxies requiring a high conversion rate of baryons to stars in the early Universe.

Allergic acute coronary syndrome: a case report with a concise review

Occurrence of chest pain during an allergic reaction is a typical manifestation of the Kounis syndrome, defined in 1991 by Nicholas Kounis and George Zavras as an "allergic angina", whose clinical course can range from a simple coronary spasm without troponin elevation to an acute myocardial infarction with all the possible complications, including sudden cardiac death. The full pathogenetic mechanisms are still not fully understood, and this is one of the reasons why it is underestimated in the emergency practice; on the other hand, an immediate identification and an appropriate treatment could prevent the occurrence of the most serious consequences. In this article we report the case study of a patient with Kounis syndrome and we review the literature on this uncommon disease; it is fundamental to consider Kounis syndrome as a possible cause of chest pain in patients admitted in the emergency department with an ongoing allergic reaction.

Beware of the dog - Capnocytophga Canimorsus septic shock: a case report

Capnocytophaga canimorsus is a Gram-negative rods frequently isolated as commensal in the saliva of pets that can be transmitted to humans. We report a case of septic shock caused by this pathogen. A 78-year-old man affected by diabetes and hypertension was admitted for fever in our Emergency Department. He reported fever (37.7°C) with normal values of blood pressure, heart rate and saturation of oxygen. Laboratory studies showed increased values of procalcitonin and normal white-cell level. Blood cultures were collected and an empirical antibiotic therapy was started. He reported six days earlier a bite of a dog at the right hand. During the following days the patient presented a deterioration of clinical conditions with fever, asthenia and comparison of petechial lesions. C. canimorsus was isolated from blood cultures. He was treated with fluids and appropriate antibiotic therapy with a full recovery. Dog wounds are frequent minor injuries with an underestimated worldwide incidence because only few patients develop complications. C. canimorsus could be an emerging cause of sepsis, also in immunocompetent patients. The current understanding of risk factors for C. canimorsus associated sepsis and a prompt approach to anamnesis and treatment of early stage injuries, could have a considerable medical outcome.

Two-year treatment of Alzheimer's disease with eptastigmine. The Eptastigmine Study Group

The effectiveness of long-term treatment of Alzheimer's disease with cholinesterase inhibitors is a matter of controversy. We evaluated the effects of prolonged treatment with eptastigmine in 176 patients with mild to moderate Alzheimer's disease participating in the open-label extension phase of a 25-week double-blind, placebo-controlled trial of eptastigmine. The effects of eptastigmine on cognition and daily functioning were evaluated with the cognitive portion of the Alzheimer's Disease Assessment Scale (ADAS-Cog) and the Instrumental Activities of Daily Living (IADL) scale, respectively. Safety was monitored by physical examination, laboratory tests, vital functions and electrocardiogram measurements and by the assessment of adverse events. One hundred and fifty-three patients (87%) completed 1 year of treatment, 77 patients (44%) 18 months and 33 patients (19%) 2 years of treatment. Patients treated for 2 years showed an improvement of mean ADAS-Cog scores compared to baseline for 31 weeks and mean IADL scores remained close to baseline for 25 weeks. Cognitive and functional scores then worsened as expected in this progressive disease. After 2 years, patients deteriorated compared to baseline by 13.4 points on the ADAS-Cog and 6.1 points on IADL. Historical untreated controls with identical disease severity are expected to have an annual worsening of approximately 10.9 points on ADAS-Cog and 4.9 points on IADL. Thus patients treated with eptastigmine for 2 years had a benefit of 8.5 points on ADAS-Cog and 3.8 points on IADL. These benefits translate to about 9 months difference between eptastigmine-treated patients and untreated historical patients. The drug was generally well tolerated with 14 patients (7.9%) withdrawing due to adverse events. Adverse events, not necessarily drug-related, were recorded in 66 patients (37.5%) and were transient and generally mild in severity. This study indicates that prolonged treatment with eptastigmine is safe and produced a clinically long-term benefit in patients with Alzheimer's disease.

Preliminary chemical, biochemical, and pharmacological characterization of a low molecular weight dermatan sulphate

The aim of this study was to set up a depolymerization process which resulted in the formation of a low molecular weight dermatan sulphate (LMWDS), retaining the chemical properties possessed by native dermatan sulphate (DS), fundamental for the expression of its specific biological activity. The depolymerization of DS by a beta elimination process led to the production of oligosaccharide chains having a 4,5 unsaturated uronic acid at the nonreducing end. The chemical evaluation has shown that the most important parameters (degree of sulphation, sulphate to carboxyl ratio, and specific rotation) have not undergone any particular modification compared to native DS. The biochemical results demonstrate that the LMWDS obtained retains most, if not all, of the specific biological activity. The reduction in molecular weight significantly enhanced the bioavailability of the product after subcutaneous administration.

Analysis of the HLA-restricted influenza-specific cytotoxic T lymphocyte response in transgenic mice carrying a chimeric human-mouse class I major histocompatibility complex

Transgenic murine lines have been constructed that express a chimeric class I molecule composed of the alpha 1 and alpha 2 domains of HLA-A2.1 and the alpha 3, transmembrane, and cytoplasmic domains of H-2Kb. Upon immunization with influenza virus, transgenic mice developed a strong A2.1Kb-restricted cytotoxic T lymphocyte (CTL) response specific for the same matrix protein epitope that serves as the dominant A2.1-restricted determinant in the equivalent human response. Fine specificity analysis of CTL clones using truncated peptides revealed strong similarity between the response repertoire of transgenic mice and that previously reported using influenza-specific A2.1-restricted CTL clones from humans. This suggests that even when considering T cell responses by different species, the alpha 1 and alpha 2 domains of the restriction element play a dominant role in determining the CTL specific repertoire. Thus, substituting the alpha 3 domain of A2.1 with a murine counterpart has permitted development of a transgenic strain that should serve as an excellent model system in studies of HLA-restricted responses.

Dietetic treatment of essential mixed cryoglobulinemia

On the basis of a functional model of the system removing immune complexes from blood (SRIC), we may consider essential mixed cryoglobulinemia (EMC) as a condition of SRIC insufficiency due to an excessive input of immune complexes. Thus, we tried to lower the global input to SRIC in 10 symptomatic EMC patients by giving them a hypoantigenic diet for 2-3 weeks, with a gradual return on free diet in the subsequent 12 weeks. After 10-60 days from the beginning of diet, all patients experienced significant reductions of symptoms' intensity (p = 0.005), of cryoprecipitate protein content (p = 0.025) and of circulating immune complex-like material (p = 0.035). A reduction of the prednisone dosage (p less than 0.005) in the 7 patients on continuous treatment was made possible. After the return on free diet, 6 patients had a relapse. Although preliminary, our results show that a hypoantigenic diet is able to lower circulating cryoglobulin levels and to clinically improve the EMC, probably by making the SRIC more functionally efficient.