Human Autosomal Recessive DNA Polymerase Delta 3 Deficiency Presenting as Omenn Syndrome

The DNA polymerase δ complex (PolD), comprising catalytic subunit POLD1 and accessory subunits POLD2, POLD3, and POLD4, is essential for DNA synthesis and is central to genome integrity. We identified, by whole exome sequencing, a homozygous missense mutation (c.1118A > C; p.K373T) in POLD3 in a patient with Omenn syndrome. The patient exhibited severely decreased numbers of naïve T cells associated with a restricted T-cell receptor repertoire and a defect in the early stages of TCR recombination. The patient received hematopoietic stem cell transplantation at age 6 months. He manifested progressive neurological regression and ultimately died at age 4 years. We performed molecular and functional analysis of the mutant POLD3 and assessed cell cycle progression as well as replication-associated DNA damage. Patient fibroblasts showed a marked defect in S-phase entry and an enhanced number of double-stranded DNA break-associated foci despite normal expression levels of PolD components. The cell cycle defect was rescued by transduction with WT POLD3. This study validates autosomal recessive POLD3 deficiency as a novel cause of profound T-cell deficiency and Omenn syndrome.

A Narrative Review of the Neurological Manifestations of Human Adenosine Deaminase 2 Deficiency

Deficiency of human adenosine deaminase type 2 (DADA2) is a complex systemic autoinflammatory disorder characterized by vasculopathy, immune dysregulation, and hematologic abnormalities. The most notable neurological manifestations of DADA2 are strokes that can manifest with various neurological symptoms and are potentially fatal. However, neurological presentations can be diverse. We here present a review of the neurological manifestations of DADA2 to increase clinical awareness of DADA2 as the underlying diagnosis. We reviewed all published cases of DADA2 from 1 January 2014 until 19 July 2022 found via PubMed. A total of 129 articles describing the clinical features of DADA2 were included in the analysis. Six hundred twenty-eight patients diagnosed with DADA2 were included in the review. 50.3% of patients had at least signs of one reported neurological event, which was the initial or sole manifestation in 5.7% and 0.6%, respectively. 77.5% of patients with neurological manifestations had at least signs of one cerebrovascular accident, with lacunar strokes being the most common and 35.9% of them having multiple stroke episodes. There is a remarkable predilection for the brain stem and deep gray matter, with 37.3% and 41.6% of ischemic strokes, respectively. Other neurological involvement included neuropathies, focal neurological deficits, ophthalmological findings, convulsions, and headaches. In summary, neurological manifestations affect a significant proportion of patients with DADA2, and the phenotype is broad. Neurological manifestations can be the first and single manifestation of DADA2. Therefore, stroke, encephalitis, posterior reversible encephalopathy syndrome, mononeuropathy and polyneuropathy, and Behçet's disease-like presentations should prompt the neurologist to exclude DADA2, especially but not only in childhood.

[Reconstruction after facial trauma with dento-alveolar injury]

While abroad, a healthy 36-year-old woman slammed head-on into a rock wall at high speed, resulting in significant facial trauma. The initial trauma care and first aid took place abroad. In the Netherlands, the woman was referred to the Department of Oral and Maxillofacial Surgery (OMFS) for reconstruction of her face and alveolar processes, gingiva and dentition. In view of the seriousness of the injuries, a 3D treatment plan was drawn up in a multidisciplinary collaboration with an OMF surgeon, an implantologist, dentist and dental technician. By making a digital setup of both the top and bottom front in advance, it was possible to work predictably. The first step consisted of bone augmentation by means of an iliac crest graft to reconstruct the major bone defects of the superior and inferior alveolar processes. Implants were then placed in the upper and lower jaws in the ideal position for the suprastructure by means of drill jigs. Within 10 months after the trauma, the implant bridges could be placed on individual zirconia frameworks to optimally restore oral function and aesthetics, completing the reconstruction.

Bose-Einstein Condensation of Efimovian Triples in the Unitary Bose Gas

In an atomic Bose-Einstein condensate quenched to the unitary regime, we predict the sequential formation of a significant fraction of condensed pairs and triples. At short distances, we demonstrate the two-body and Efimovian character of the condensed pairs and triples, respectively. As the system evolves, their size becomes comparable to the interparticle distance, such that many-body effects become significant. The structure of the condensed triples depends on the size of Efimov states compared with density scales. Unexpectedly, we find universal condensed triples in the limit where these scales are well separated. Our findings provide a new framework for understanding dynamics in the unitary regime as the Bose-Einstein condensation of few-body composites.

Lattice Boltzmann simulations of drying suspensions of soft particles

The ordering of particles in the drying process of a colloidal suspension is crucial in determining the properties of the resulting film. For example, microscopic inhomogeneities can lead to the formation of cracks and defects that can deteriorate the quality of the film considerably. This type of problem is inherently multiscale and here we study it numerically, using our recently developed method for the simulation of soft polymeric capsules in multicomponent fluids. We focus on the effect of the particle softness on the film microstructure during the drying phase and how it relates to the formation of defects. We quantify the order of the particles by measuring both the Voronoi entropy and the isotropic order parameter. Surprisingly, both observables exhibit a non-monotonic behaviour when the softness of the particles is increased. We further investigate the correlation between the interparticle interaction and the change in the microstructure during the evaporation phase. We observe that the rigid particles form chain-like structures that tend to scatter into small clusters when the particle softness is increased. This article is part of the theme issue 'Progress in mesoscale methods for fluid dynamics simulation'.

INPP4B overexpression and c-KIT downregulation in human achalasia

BACKGROUND

Achalasia is a rare motility disorder characterized by myenteric neuron and interstitial cells of Cajal (ICC) abnormalities leading to deranged/absent peristalsis and lack of relaxation of the lower esophageal sphincter. The mechanisms contributing to neuronal and ICC changes in achalasia are only partially understood. Our goal was to identify novel molecular features occurring in patients with primary achalasia.

METHODS

Esophageal full-thickness biopsies from 42 (22 females; age range: 16-82 years) clinically, radiologically, and manometrically characterized patients with primary achalasia were examined and compared to those obtained from 10 subjects (controls) undergoing surgery for uncomplicated esophageal cancer (or upper stomach disorders). Tissue RNA extracted from biopsies of cases and controls was used for library preparation and sequencing. Data analysis was performed with the "edgeR" option of R-Bioconductor. Data were validated by real-time RT-PCR, western blotting and immunohistochemistry.

KEY RESULTS

Quantitative transcriptome evaluation and cluster analysis revealed 111 differentially expressed genes, with a P ≤ 10^-3 . Nine genes with a P ≤ 10^-4 were further validated. CYR61, CTGF, c-KIT, DUSP5, EGR1 were downregulated, whereas AKAP6 and INPP4B were upregulated in patients vs controls. Compared to controls, immunohistochemical analysis revealed a clear increase in INPP4B, whereas c-KIT immunolabeling resulted downregulated. As INPP4B regulates Akt pathway, we used western blot to show that phospho-Akt was significantly reduced in achalasia patients vs controls.

CONCLUSIONS & INFERENCES

The identification of altered gene expression, including INPP4B, a regulator of the Akt pathway, highlights novel signaling pathways involved in the neuronal and ICC changes underlying primary achalasia.

Penrose-Onsager criterion validation in a one-dimensional polariton condensate

We perform quantum tomography on one-dimensional polariton condensates, spontaneously occurring in linear disorder valleys in a CdTe planar microcavity sample. By the use of optical interferometric techniques, we determine the first-order coherence function and the amplitude and phase of the order parameter of the condensate, providing a full reconstruction of the single particle density matrix for the polariton system. The experimental data are used as input to theoretically test the consistency of the Penrose-Onsager criterion for Bose-Einstein condensation in the framework of nonequilibrium polariton condensates. The results confirm the pertinence and validity of the criterion for a nonequilibrium condensed gas.

PP095. Guideline-based development of quality indicators for hypertensive diseases in pregnancy

INTRODUCTION

Hypertensive disorders in pregnancy are one of the main causes of maternal morbidity and mortality. Internationally, several organizations have developed clinical guidelines to assist professionals and to supply patients with the best possible care. To improve the care for this group of patients, insight into the application of clinical guidelines in daily practice is needed. Valid quality indicators are necessary to estimate actual guideline adherence. In this study, we developed a set of valid guidelines based quality indicators for hypertensive diseases in pregnancy.

OBJECTIVES

None.

METHODS

A systematic RAND-modified Delphi method was used to develop a set of quality indicators based on evidence-based guidelines and the literature, about hypertension and pregnancy. Experts' opinions were used to select the indicators regarding specific criteria such as efficacy, level of health gain and potential for care improvement.

RESULTS

A representative set of 14 quality indicators was selected from 48 initial guideline recommendations. Indicators concerned both professional performance and organisation of care for patients with hypertension in pregnancy.

CONCLUSION

This study describes the systematic, stepwise method used to develop quality indicators that can be used to monitor care for hypertensive diseases in pregnancy.

From single particle to superfluid excitations in a dissipative polariton gas

Using an angle-resolved heterodyne four-wave-mixing technique, we probe the low momentum excitation spectrum of a coherent polariton gas. The experimental results are well captured by the Bogoliubov transformation which describes the transition from single particle excitations of a normal fluid to soundlike excitations of a superfluid. In a dense coherent polariton gas, we find all the characteristics of a Bogoliubov transformation, i.e., the positive and negative energy branch with respect to the polariton gas energy at rest, soundlike shapes for the excitations dispersion, intensity, and linewidth ratio between the two branches in agreement with the theory. The influence of the nonequilibrium character of the polariton gas is shown by a careful analysis of its dispersion.

Polariton condensation in a one-dimensional disordered potential

We study the coherence and density modulation of a nonequilibrium exciton-polariton condensate in a one-dimensional valley with disorder. By means of interferometric measurements we evidence a modulation of the first-order coherence function and we relate it to a disorder-induced modulation of the condensate density, that increases as the pump power is increased. The nonmonotonic spatial coherence function is found to be the result of the strong nonequilibrium character of the one-dimensional system, in the presence of disorder.

Probing the dynamics of spontaneous quantum vortices in polariton superfluids

The experimental investigation of spontaneously created vortices is of utmost importance for the understanding of quantum phase transitions towards a superfluid phase, especially for two-dimensional systems that are expected to be governed by the Berezinski-Kosterlitz-Thouless physics. By means of time-resolved near-field interferometry we track the path of such vortices, created at random locations in an exciton-polariton condensate under pulsed nonresonant excitation, to their final pinning positions imposed by the stationary disorder. We formulate a theoretical model that successfully reproduces the experimental observations.

Coherent oscillations in an exciton-polariton Josephson junction

We report on the observation of spontaneous coherent oscillations in a microcavity polariton bosonic Josephson junction. Condensation of exciton polaritons here takes place under incoherent excitation in a double potential well naturally formed in the disorder. Coherent oscillations set on at an excitation power well above the condensation threshold. The time resolved population and phase dynamics reveal the analogy with the ac Josephson effect. A theoretical two-mode model describes the observed effects, explaining how the different realizations of the pulsed experiment can be in phase.

Polariton condensation in dynamic acoustic lattices

We demonstrate that the tunable potential introduced by a surface acoustic wave on a homogeneous polariton condensate leads to fragmentation of the condensate into an array of wires which move with the acoustic velocity. Reduction of the spatial coherence of the condensate emission along the surface acoustic wave direction is attributed to the suppression of coupling between the spatially modulated condensates. Interparticle interactions observed at high polariton densities screen the acoustic potential, partially reversing its effect on spatial coherence.

Multistability of a coherent spin ensemble in a semiconductor microcavity

Coherent manipulation of spin ensembles is a key issue in the development of spintronics. In particular, multivalued spin switching may lead to new schemes of logic gating and memories. This phenomenon has been studied with atom vapours 30 years ago, but is still awaited in the solid state. Here, we demonstrate spin multistability with microcavity polaritons in a trap. Owing to the spinor nature of these light-matter quasiparticles and to the anisotropy of their interactions, we can optically control the spin state of a single confined level by tuning the excitation power, frequency and polarization. First, we realize high-efficiency power-dependent polarization switching. Then, at constant excitation power, we evidence polarization hysteresis and determine the conditions for realizing multivalued spin switching. Finally, we demonstrate an unexpected regime, where our system behaves as a high-contrast spin trigger. These results open new pathways to the development of advanced spintronics devices and to the realization of multivalued logic circuits.

Dynamics of long-range ordering in an exciton-polariton condensate

We report on time-resolved measurements of the first order spatial coherence in an exciton-polariton Bose-Einstein condensate. Long-range spatial coherence is found to set in right at the onset of stimulated scattering, on a picosecond time scale. The coherence reaches its maximum value after the population and decays slowly, staying up to a few hundred picoseconds. This behavior can be qualitatively reproduced, using a stochastic classical field model describing interaction between the polariton condensate and the exciton reservoir within a disordered potential.

Observation of long-lived polariton states in semiconductor microcavities across the parametric threshold

The excitation spectrum around the pump-only stationary state of a polariton optical parametric oscillator in semiconductor microcavities is investigated by time-resolved photoluminescence. The response to a weak pulsed perturbation in the vicinity of the idler mode is directly related to the lifetime of the elementary excitations. A dramatic increase of the lifetime is observed for a pump intensity approaching and exceeding the optical parametric oscillator threshold. The observations can be explained in terms of a critical slowing down of the dynamics upon approaching the threshold and the following appearance of a soft Goldstone mode in the spectrum.