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Background/Objectives: Randomized studies of patients with unprotected left main coronary artery (ULMCA) disease involve highly selected populations. Therefore, we sought to investigate the 60-month event-free survival of consecutive patients undergoing ULMCA percutaneous coronary intervention (PCI) and determine the best risk score system and independent predictors of event-free survival. Methods: All patients who underwent ULMCA PCI at our center between 1 January 2007 and 31 December 2014 were included. The primary endpoint was the time to cardiac death, target lesion myocardial infarction, or target lesion revascularization (whichever came first) with a follow-up of 60 months. Results: A total of 513 patients (mean age 68 ± 12 years, 64% male, 157 elective, 356 acute) underwent ULMCA PCI. The 60-month incidence of events was 16.8% and 38.0% in elective and acute patients, respectively. There were significantly more events in the acute group during the first 6.5 months. Of the risk scores, the ACEF (AUC = 0.786) and SYNTAX II (AUC = 0.716) scores had the best predictive power in elective and acute patients, respectively. The SYNTAX score proved to be the least predictive in both groups (AUC = 0.638 and 0.614 in the elective and acute groups, respectively). Left ventricular function (hazard ratio (HR) for +10% 0.53 [95% CI, 0.38–0.75] and 0.81 [95% CI, 0.71–0.92] in elective and acute patients, respectively) and, in acute patients, access site (femoral vs. radial HR 1.76 [95% CI, 1.11–2.80]), hyperlipidemia (HR 0.58 [95% CI, 0.39–0.86]), and renal function (HR for +10 mL/min/1.73 m2 higher GFR: 0.87 [95% CI, 0.78–0.97]) were independent predictors of event-free survival. Conclusions: Acute ULMCA PCI patients have worse prognosis than elective patients, having more events during the first 6.5 months. Besides anatomical complexity, clinical and procedural parameters determine the prognosis.

A Reflection on the PastMurdoch and her Jewish TeachersIn the present dissertation, I will provide a comparative analysis of the impact of the German exile literature on Iris Murdoch’s early novels. In this work, I will explain how the issues of trauma, memory, displacement and power in Murdoch’s fiction were informed by her intellectual encounters with three German-speaking exiled authors, Elias Canetti, Franz Baermann Steiner and H.G. Adler. Concentrating on five novels from Murdoch’s early period, Under the Net (1954), The Flight from the Enchanter (1956), A Severed Head (1961), The Italian Girl (1964), The Nice and the Good(1968), I will explore how the post-war trauma and the questions of displacement, power and making sense of the past had become central to her. What makes these works curious to discuss is that, in them, she sets up the diagnosis of post-war societies, which are suffering between two totalitarian powers, where exile is a symbol of the modern state of being that is characterized by rootlessness and alienation. Considering the theoretical aspects where the memories of the war, the trauma of the Holocaust and the problem of exile are represented by her refugee characters, many of whom were inspired by Canetti, Steiner and Adler, I will explain how the sense of rootlessness and identity search depicted in these novels can be compared with the theories and the lived experiences of the three authors discussed.Iris Murdoch was one of the most prolific and significant English writers and philosophers in the 20thcentury. She was born in Dublin in 1919 of Anglo-Irish parents. From 1932 to 1938, she was a boarding student at Badminton School in Bristol. From 1938 to 1942, she studied philosophy at Somerville College, Oxford. During the war she went to work as an Assistant Principal at HM Treasury, and then worked for the United Nations Relief and Rehabilitation Administration (U.N.R.R.A.) in the refugee camps in the refugee camps in Brussels and Innsbruck between 1945 and 1946. From 1947 to 1948, she had a postgraduate studentship in philosophy at Newnham College, Cambridge. In 1948, she returned to Oxford, where she became a fellow of St Anne’s College. She lived with her husband, the professor and literary critic John Bayley, from 1956 until her death in 1999.From her debut with Under the Net, Iris Murdoch was regarded as one of the most remarkable post-war women writers starting their careers in the mid-twentieth century, now called intermodernism, whose vivid description of sexuality and morals has influenced such novelists of the later generation as Margaret Drabble, A.S. Byatt, Alan Hollinghurst, or Sarah Waters. In her career as a novelist, spanning for more than four decades, she wrote 26 twenty-six novels, a short story (Something Special, 1957), six plays, two volumes of poetry, and four books on philosophy, including two Platonic dialogues. Her novels enjoyed a wide readership and were hailed by her contemporaries, winning several literary awards, among the Booker Prize for The Sea, the Sea (1978), the James Tait Black Memorial Prize for The Black Prince (1973) and the Whitbread Prize for The Sacred and Profane Love Machine(1974).

In this study 308 ticks (Ixodes ariadnae: 26 larvae, 14 nymphs, five females; I. vespertilionis: 89 larvae, 27 nymphs, eight females; I. simplex: 80 larvae, 50 nymphs, nine females) have been collected from 200 individuals of 17 bat species in two countries, Hungary and Romania. After DNA extraction these ticks were molecularly analysed for the presence of piroplasm DNA. In Hungary I. ariadnae was most frequently identified from bat species in the family Vespertilionidae, whereas I. vespertilionis was associated with Rhinolophidae. Ixodes ariadnae was not found in Romania. Four, four and one new bat host species of I. ariadnae, I. vespertilionis and I. simplex were identified, respectively. DNA sequences of piroplasms were detected in 20 bat ticks (15 larvae, four nymphs and one female). I. simplex carried piroplasm DNA sequences significantly more frequently than I. vespertilionis. In I. ariadnae only Babesia vesperuginis DNA was detected, whereas in I. vespertilionis sequences of both B. vesperuginis and B. crassa. From I. simplex the DNA of B. canis, Theileria capreoli, T. orientalis and Theileria sp. OT3 were amplified, as well as a shorter sequence of the zoonotic B. venatorum. Bat ticks are not known to infest dogs or ruminants, i.e. typical hosts and reservoirs of piroplasms molecularly identified in I. vespertilionis and I. simplex. Therefore, DNA sequences of piroplasms detected in these bat ticks most likely originated from the blood of their respective bat hosts. This may indicate either that bats are susceptible to a broader range of piroplasms than previously thought, or at least the DNA of piroplasms may pass through the gut barrier of bats during digestion of relevant arthropod vectors. In light of these findings, the role of bats in the epidemiology of piroplasmoses deserves further investigation.

Background Despite the increasingly recognized eco-epidemiological significance of bats, data from molecular analyses of vector-borne bacteria in bat ectoparasites are lacking from several regions of the Old and New Worlds. Methods During this study, six species of ticks (630 specimens) were collected from bats in Hungary, Romania, Italy, Kenya, South Africa, China, Vietnam and Mexico. DNA was extracted from these ticks and analyzed for vector-borne bacteria with real-time PCRs (screening), as well as conventional PCRs and sequencing (for pathogen identification), based on the amplification of various genetic markers. Results In the screening assays, Rickettsia DNA was only detected in bat soft ticks, whereas Anaplasma phagocytophilum and haemoplasma DNA were present exclusively in hard ticks. Bartonella DNA was significantly more frequently amplified from hard ticks than from soft ticks of bats. In addition to Rickettsia helvetica detected by a species-specific PCR, sequencing identified four Rickettsia species in soft ticks, including a Rickettsia africae -like genotype (in association with a bat species, which is not known to migrate to Africa), three haemotropic Mycoplasma genotypes in Ixodes simplex , and Bartonella genotypes in I. ariadnae and I. vespertilionis . Conclusions Rickettsiae (from both the spotted fever and the R. felis groups) appear to be associated with soft rather than hard ticks of bats, as opposed to bartonellae. Two tick-borne zoonotic pathogens ( R. helvetica and A. phagocytophilum ) have been detected for the first time in bat ticks. The present findings add Asia (China) to the geographical range of R. lusitaniae , as well as indicate the occurrence of R. hoogstraalii in South Africa. This is also the first molecular evidence for the autochthonous occurrence of a R. africae -like genotype in Europe. Bat haemoplasmas, which are closely related to haemoplasmas previously identified in bats in Spain and to “ Candidatus Mycoplasma haemohominis”, are reported here for the first time from Central Europe and from any bat tick.

Antimicrobial resistance (AMR) is a global health challenge requiring cross-sector action, with research largely focused on chickens, leaving ducks underexplored. This study examines AMR dynamics in Ross 308 broilers and Cherry Valley ducks over 15 months and 15 stocking periods under consistent rearing conditions. A total of 96 pooled samples were collected: 50 from broiler farms (26 biological, 24 environmental) and 46 from duck farms (24 biological, 22 environmental). Using next-generation shotgun sequencing, 3,665 distinct AMR types were identified: 1,918 in broilers and 1,747 in ducks. Host-specific AMRs comprised 25.3% in broilers and 18% in ducks, while 56.7% were shared. AMR diversity declined across production phases, with broilers losing 641 types and ducks losing 308, yet AMR frequencies increased significantly by the finisher phase ( p  < 0.0001). Based on in silico data, prophylactic antibiotic use significantly reduced the prevalence of multidrug-resistant bacteria in both poultry species ( p  < 0.05). Hospital-acquired infection-associated AMRs were higher in broilers than in ducks at the start of production but declined significantly by the end of the rearing period ( p  < 0.0001). Above-average resistance markers accounted for approximately 10% of all detected resistance determinants. Tetracycline and phenicol resistances emerged as the most prevalent. 13 high-resistance carrier (HRC) species were shared between both hosts. Broiler-specific HRCs exhibited significantly higher abundances (relative frequency: 0.08) than duck-specific HRCs (relative frequency: 0.003, p  = 0.035). The grower phase emerged as a critical intervention point. In farm environments 15 broiler-specific and 9 duck-specific biomarker species were identified, each strongly correlated with poultry-core HRCs (correlation coefficient > 0.7). Broiler exhibited higher abundances of key resistance genes, with tetracycline resistance predominantly associated with Bacteroides coprosuis , Pasteurella multocida , and Acinetobacter baumannii . Despite its limitations, this research provides key insights into AMR trends in two major poultry types, guiding targeted interventions and sustainable management strategies.

Antimicrobial resistance (AMR) is a global crisis, posing a critical challenge to healthcare systems, particularly in intensive care units (ICUs), where multidrug-resistant organisms (MDROs) threaten patient survival. This study offers a unique, real-world perspective on AMR dynamics by analyzing 96 metagenomic samples from three key sources: oropharyngeal and rectal swabs of deceased ICU patients (both postadmission and antemortem), healthcare workers, and high-touch ICU surfaces. Findings revealed the ICU environment as a major AMR reservoir, with oropharyngeal swabs carrying the highest AMR burden. While healthcare staff facilitated MDRO spread, they were not primary sources. Staff microbiomes’ MDRO pattern closely resembled environmental samples. Key AMR species included B. fragilis , E. coli , S. pneumoniae , S. aureus , with P. aeruginosa persisting on high-touch surfaces. Tetracycline resistance was the most prevalent, with common resistances comprising 36.1% of all detected AMR markers. Staff microbial community exhibited higher resistance to macrolides, fluoroquinolones, lincosamides, and cephamycins. A 10-day survival threshold distinguished early (EM) and late mortality (LM) groups. EM patients exhibited unique AMR species in the oropharynx, suggesting respiratory-driven infections, while LM patients showed greater gut-associated resistance. Higher rectal AMR counts correlated with prolonged survival. Notably, four key MDROs ( L. monocytogenes , M. tuberculosis , S. haemolyticus , and S. agalactiae ) were enriched in sepsis patients, suggesting early risk markers. Fewer new resistances emerged in rectal than oropharyngeal swabs, likely due to antibiotic selection pressure. Vancomycin and levofloxacin, frequently co-administered, exerted stronger selective pressure in the oropharynx, possibly explaining the high MRSA prevalence in patient and environmental samples.

Background Parasites may actively seek for hosts and may use a number of adaptive strategies to promote their reproductive success and host colonization. These strategies will necessarily influence their host specificity and seasonality. Ticks are important ectoparasites of vertebrates, which (in addition to directly affecting their hosts) may transmit a number of pathogens. In Europe, three hard tick species (Ixodidae: Ixodes ariadnae , I. simplex and I. vespertilionis ) and at least two soft tick species (Argasidae: Argas transgariepinus and A. vespertilionis ) are specialized for bats. Methods Here we report data on the host range of these ticks and the seasonality of tick infestation on wild caught bats in south-east Europe. We collected 1803 ticks from 30 species of bats living in underground shelters (caves and mines) from Romania and Bulgaria. On the basis of tick–host associations, we tested several hypotheses on host–parasite evolutionary adaptations regulating host specificity, seasonality and sympatric speciation. Results We observed significant differences in host specificity and seasonality of abundance between the morphologically different bat specialist ticks ( I. simplex and I. vespertilionis ) likely caused by their host choice and their respective host-seeking behavior. The two highly generalist, but morphologically similar tick species ( I. ariadnae and I. vespertilionis ) showed temporal differences in occurrence and activity, thus exploiting significantly different host communities while occurring in geographical sympatry. Conclusions We conclude that bat-specialist ticks show a wide range of adaptations to their hosts, with differences in specificity, seasonality of occurrence, the prevalence and intensity of infestation and all these contribute to a successful division of temporal niches of ticks sharing morphologically similar hosts occurring in geographical sympatry.

Background From a veterinary-medical point of view, the stable fly, Stomoxys calcitrans , is perhaps the economically most important blood-sucking muscoid fly species (Diptera: Muscidae), owing to its worldwide occurrence, frequently high local abundance, direct harm caused to livestock, pet animals and humans, as well as its vector role. Considering the latter in the context of protozoan parasites, the stable fly is a mechanical vector of trypanosomes and Besnoitia besnoiti . However, its role as a vector of piroplasms appears to be seldom studied, despite old data suggesting mechanical transmission of babesiae by dipteran flies. Methods In this study 395 stable flies (and one Haematobia stimulans ) were collected at a cattle farm with known history of bovine theileriosis, and at further nine, randomly chosen locations in Hungary. These flies were separated according to sex (30 of them also cut into two parts: the head with mouthparts and the thorax-abdomen), followed by individual DNA extraction, then screening for piroplasms by PCR and sequencing. Results In stable flies, Theileria orientalis  and T. capreoli were identified at the cattle farm and T. equi was identified in three other locations. At the cattle farm, significantly more male stable flies carried piroplasm DNA than females. There was no significant difference between the ratio of PCR-positive flies between the stable (void of cattle for at least two hours) and the pen on the pasture with cattle at the time of sampling. Among dissected flies (29 S. calcitrans and 1 H. stimulans ), exclusively the thoracic-abdominal parts were PCR-positive, whereas the head and mouthparts remained negative. Conclusions Theileria DNA is detectable in stable flies, in the case of T. orientalis at least for two hours after blood-feeding, and in the case of T. capreoli also in the absence of infected hosts (i.e. roe deer). Male flies rather than females, and thoracic-abdominal (most likely crop) contents rather than mouthparts may pose a risk of mechanical transmission. These data suggest that it is worth to study further the vector role of stable flies in the epidemiology of theilerioses, in which not the immediate, but rather the delayed type transmission seems possible.

Background Bats are regarded as the primary (ancestral) hosts of bugs of the family Cimicidae. The historically and economically most important species in the family is the common bedbug ( Cimex lectularius ), because of its worldwide occurrence and association with humans. This molecular-phylogenetic study was initiated in order to expand the knowledge on the phylogeny of cimicid bugs of bats, by investigating samples from Hungary, Romania (representing central-eastern Europe) and two further countries (South Africa and Vietnam). Results Altogether 216 cimicid bugs were collected (73  Ci. lectularius , 133  Ci. pipistrelli , nine Cacodmus ignotus and one Ca. sparsilis ). Members of the Cimex lectularius species group were found both in the environment of bats (only Myotis emarginatus , which is a cave/attic-dwelling species) and on three crevice-dwelling bat species (two pipistrelloid bats and M. bechsteinii ). On the other hand, Ci. pipistrelli always occurred off-host (near M. myotis/blythii , which are cave/attic-dwelling species). In addition, two Cacodmus spp. were collected from Pipistrellus hesperidus . The morphological characters of these specimens are illustrated with high resolution pictures. Analysis of cytochrome c oxidase subunit 1 ( cox 1) sequences generated from 38 samples indicated relative genetic homogeneity of Ci. pipistrelli , while the Ci. lectularius group had two haplotypes (collected from pipistrelloid bats in Hungary and Vietnam) highly divergent from other members of this species group. These results were confirmed with molecular and phylogenetic analyses based on the internal transcribed spacer 2 (ITS2). Bat-associated bugs morphologically identified as Ca. ignotus and Ca. sparsilis were different in their cox 1, but identical in their ITS2 sequences. Conclusions Molecular evidence is provided here on the existence of two new genotypes, most likely new species, within the Ci. lectularius species group. The relevant specimens (unlike the others) were collected from pipistrelloid bats, therefore the association of Ci. lectularius with different bat host species (pipistrelloid vs myotine bats) should be evaluated further as a possible background factor of this genetic divergence. In addition, Ca. ignotus is reported for the first time in South Africa.