Catecholaminergic polymorphic ventricular tachycardia patients with multiple genetic variants in the PACES CPVT Registry.

BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is often a life-threatening arrhythmia disorder with variable penetrance and expressivity. Little is known about the incidence or outcomes of CPVT patients with ≥2 variants. METHODS: The phenotypes, genotypes and outcomes of patients in the Pediatric and Congenital Electrophysiology Society CPVT Registry with ≥2 variants in genes linked to CPVT were ascertained. The American College of Medical Genetics & Genomics (ACMG) criteria and structural mapping were used to predict the pathogenicity of variants (3D model of pig RyR2 in open-state). RESULTS: Among 237 CPVT subjects, 193 (81%) had genetic testing. Fifteen patients (8%) with a median age of 9 years (IQR 5-12) had ≥2 variants. Sudden cardiac arrest occurred in 11 children (73%), although none died during a median follow-up of 4.3 years (IQR 2.5-6.1). Thirteen patients (80%) had at least two RYR2 variants, while the remaining two patients had RYR2 variants plus variants in other CPVT-linked genes. Among all variants identified, re-classification of the commercial laboratory interpretation using ACMG criteria led to the upgrade from variant of unknown significance (VUS) to pathogenic/likely pathogenic (P/LP) for 5 variants, and downgrade from P/LP to VUS for 6 variants. For RYR2 variants, 3D mapping using the RyR2 model suggested that 2 VUS by ACMG criteria were P/LP, while 2 variants were downgraded to likely benign. CONCLUSIONS: This severely affected cohort demonstrates that a minority of CPVT cases are related to ≥2 variants, which may have implications on family-based genetic counselling. While multi-variant CPVT patients were at high-risk for sudden cardiac arrest, there are insufficient data to conclude that this genetic phenomenon has prognostic implications at present. Further research is needed to determine the significance and generalizability of this observation. This study also shows that a rigorous approach to variant re-classification using the ACMG criteria and 3D mapping is important in reaching an accurate diagnosis, especially in the multi-variant population

Early Last Interglacial ocean warming drove substantial ice mass loss from Antarctica

The future response of the Antarctic ice sheet to rising temperatures remains highly uncertain. A useful period for assessing the sensitivity of Antarctica to warming is the Last Interglacial (LIG) (129 to 116 ky), which experienced warmer polar temperatures and higher global mean sea level (GMSL) (+6 to 9 m) relative to present day. LIG sea level cannot be fully explained by Greenland Ice Sheet melt (∼2 m), ocean thermal expansion, and melting mountain glaciers (∼1 m), suggesting substantial Antarctic mass loss was initiated by warming of Southern Ocean waters, resulting from a weakening Atlantic meridional overturning circulation in response to North Atlantic surface freshening. Here, we report a blue-ice record of ice sheet and environmental change from the Weddell Sea Embayment at the periphery of the marine-based West Antarctic Ice Sheet (WAIS), which is underlain by major methane hydrate reserves. Constrained by a widespread volcanic horizon and supported by ancient microbial DNA analyses, we provide evidence for substantial mass loss across the Weddell Sea embayment during the LIG, most likely driven by ocean warming and associated with destabilization of subglacial hydrates. Ice sheet modeling supports this interpretation and suggests that millennial-scale warming of the Southern Ocean could have triggered a multimeter rise in global sea levels. Our data indicate that Antarctica is highly vulnerable to projected increases in ocean temperatures and may drive ice–climate feedbacks that further amplify warming

Transcriptomic links to muscle mass loss and declines in cumulative muscle protein synthesis during short-term disuse in healthy younger humans

Muscle disuse leads to a rapid decline in muscle mass, with reduced muscle protein synthesis (MPS) considered the primary physiological mechanism. Here, we employed a systems biology approach to uncover molecular networks and key molecular candidates that quantitatively link to the degree of muscle atrophy and/or extent of decline in MPS during short-term disuse in humans. After consuming a bolus dose of deuterium oxide (D2O; 3 mL.kg−1), eight healthy males (22 ± 2 years) underwent 4 days of unilateral lower-limb immobilization. Bilateral muscle biopsies were obtained post-intervention for RNA sequencing and D2O-derived measurement of MPS, with thigh lean mass quantified using dual-energy X-ray absorptiometry. Application of weighted gene co-expression network analysis identified 15 distinct gene clusters (“modules”) with an expression profile regulated by disuse and/or quantitatively connected to disuse-induced muscle mass or MPS changes. Module scans for candidate targets established an experimentally tractable set of candidate regulatory molecules (242 hub genes, 31 transcriptional regulators) associated with disuse-induced maladaptation, many themselves potently tied to disuse-induced reductions in muscle mass and/or MPS and, therefore, strong physiologically relevant candidates. Notably, we implicate a putative role for muscle protein breakdown-related molecular networks in impairing MPS during short-term disuse, and further establish DEPTOR (a potent mTOR inhibitor) as a critical mechanistic candidate of disuse driven MPS suppression in humans. Overall, these findings offer a strong benchmark for accelerating mechanistic understanding of short-term muscle disuse atrophy that may help expedite development of therapeutic interventions

Atmospheric histories and emissions of chlorofluorocarbons CFC-13 (CClF3), ΣCFC-114 (C2Cl2F4), and CFC-115 (C2ClF5)

Based on observations of the chlorofluorocarbons CFC-13 (chlorotrifluoromethane), ΣCFC-114 (combined measurement of both isomers of dichlorotetrafluoroethane), and CFC-115 (chloropentafluoroethane) in atmospheric and firn samples, we reconstruct records of their tropospheric histories spanning nearly 8 decades. These compounds were measured in polar firn air samples, in ambient air archived in canisters, and in situ at the AGAGE (Advanced Global Atmospheric Gases Experiment) network and affiliated sites. Global emissions to the atmosphere are derived from these observations using an inversion based on a 12-box atmospheric transport model. For CFC-13, we provide the first comprehensive global analysis. This compound increased monotonically from its first appearance in the atmosphere in the late 1950s to a mean global abundance of 3.18 ppt (dry-air mole fraction in parts per trillion, pmol mol1) in 2016. Its growth rate has decreased since the mid-1980s but has remained at a surprisingly high mean level of 0.02 ppt yr⁻¹ since 2000, resulting in a continuing growth of CFC-13 in the atmosphere. ΣCFC-114 increased from its appearance in the 1950s to a maximum of 16.6 ppt in the early 2000s and has since slightly declined to 16.3 ppt in 2016. CFC-115 increased monotonically from its first appearance in the 1960s and reached a global mean mole fraction of 8.49 ppt in 2016. Growth rates of all three compounds over the past years are significantly larger than would be expected from zero emissions. Under the assumption of unchanging lifetimes and atmospheric transport patterns, we derive global emissions from our measurements, which have remained unexpectedly high in recent years: mean yearly emissions for the last decade (2007–2016) of CFC-13 are at 0.48 ± 0.15 kt yr⁻¹ (> 15 % of past peak emissions), of ΣCFC-114 at 1.90 ± 0.84 kt yr⁻¹ (∼ 10 % of peak emissions), and of CFC-115 at 0.80 ± 0.50 kt yr⁻¹(> 5 % of peak emissions). Mean yearly emissions of CFC-115 for 2015–2016 are 1.14 ± 0.50 kt yr⁻¹ and have doubled compared to the 2007–2010 minimum. We find CFC-13 emissions from aluminum smelters but if extrapolated to global emissions, they cannot account for the lingering global emissions determined from the atmospheric observations. We find impurities of CFC-115 in the refrigerant HFC-125 (CHF₂CF₃) but if extrapolated to global emissions, they can neither account for the lingering global CFC-115 emissions determined from the atmospheric observations nor for their recent increases. We also conduct regional inversions for the years 2012–2016 for the northeastern Asian area using observations from the Korean AGAGE site at Gosan and find significant emissions for ΣCFC-114 and CFC-115, suggesting that a large fraction of their global emissions currently occur in northeastern Asia and more specifically on the Chinese mainland

Perfluorocyclobutane (PFC-318, <i>c</i>-C<sub>4</sub>F<sub>8</sub>) in the global atmosphere

We reconstruct atmospheric abundances of the potent greenhouse gas span classCombining double low line inline-formula span classCombining double low line inline-formula perfluorocyclobutane, perfluorocarbon PFC-318) from measurements of in situ, archived, firn, and aircraft air samples with precisions of span classCombining double low line inline-formula reported on the SIO-14 gravimetric calibration scale. Combined with inverse methods, we found near-zero atmospheric abundances from the early 1900s to the early 1960s, after which they rose sharply, reaching 1.66ppt (parts per trillion dry-air mole fraction) in 2017. Global span classCombining double low line inline-formula span classCombining double low line inline-formula emissions rose from near zero in the 1960s to span classCombining double low line inline-formula (1span classCombining double low line inline-formula gyrspan classCombining double low line inline-formula in the late 1970s to late 1980s, then declined to span classCombining double low line inline-formula classCombining double low line inline-formula in the mid-1990s to early 2000s, followed by a rise since the early 2000s to span classCombining double low line inline-formula 2.20±0.05 Ggyrspan classCombining double low line inline-formula in 2017. These emissions are significantly larger than inventory-based emission estimates. Estimated emissions from eastern Asia rose from 0.36Ggyrspan classCombining double low line inline-formula in 2010 to 0.73Ggyrspan classCombining double low line inline-formula in 2016 and 2017, 31% of global emissions, mostly from eastern China. We estimate emissions of 0.14Ggyrspan classCombining double low line inline-formula from northern and central India in 2016 and find evidence for significant emissions from Russia. In contrast, recent emissions from northwestern Europe and Australia are estimated to be small (span classCombining double low line inline-formula % each). We suggest that emissions from China, India, andspan idCombining double low line page10336 Russia are likely related to production of polytetrafluoroethylene (PTFE, Teflon ) and other fluoropolymers and fluorochemicals that are based on the pyrolysis of hydrochlorofluorocarbon HCFC-22 (span classCombining double low line inline-formula) in which span classCombining double low line inline-formula classCombining double low line inline-formula is a known by-product. The semiconductor sector, where span classCombining double low line inline-formula span classCombining double low line inline-formula is used, is estimated to be a small source, at least in South Korea, Japan, Taiwan, and Europe. Without an obvious correlation with population density, incineration of waste-containing fluoropolymers is probably a minor source, and we find no evidence of emissions from electrolytic production of aluminum in Australia. While many possible emissive uses of span classCombining double low line inline-formula span classCombining double low line inline-formula are known and though we cannot categorically exclude unknown sources, the start of significant emissions may well be related to the advent of commercial PTFE production in 1947. Process controls or abatement to reduce the span classCombining double low line inline-formula span classCombining double low line inline-formula by-product were probably not in place in the early decades, explaining the increase in emissions in the 1960s and 1970s. With the advent of by-product reporting requirements to the United Nations Framework Convention on Climate Change (UNFCCC) in the 1990s, concern about climate change and product stewardship, abatement, and perhaps the collection of span classCombining double low line inline-formula span classCombining double low line inline-formula by-product for use in the semiconductor industry where it can be easily abated, it is conceivable that emissions in developed countries were stabilized and then reduced, explaining the observed emission reduction in the 1980s and 1990s. Concurrently, production of PTFE in China began to increase rapidly. Without emission reduction requirements, it is plausible that global emissions today are dominated by China and other developing countries. We predict that span classCombining double low line inline-formula span classCombining double low line inline-formula emissions will continue to rise and that span classCombining double low line inline-formula span classCombining double low line inline-formula will become the second most important emitted PFC in terms of span classCombining double low line inline-formula equivalent emissions within a year or two. The 2017 radiative forcing of span classCombining double low line inline-formula span classCombining double low line inline-formula 0.52mWmspan classCombining double low line inline-formula) is small but emissions of span classCombining double low line inline-formula span classCombining double low line inline-formula and other PFCs, due to their very long atmospheric lifetimes, essentially permanently alter Earth's radiative budget and should be reduced. Significant emissions inferred outside of the investigated regions clearly show that observational capabilities and reporting requirements need to be improved to understand global and country-scale emissions of PFCs and other synthetic greenhouse gases and ozone-depleting substances.United States. National Aeronautics and Space Administration (Grant NNX07AE89G)United States. National Aeronautics and Space Administration (Grant NNX07AF09G)United States. National Aeronautics and Space Administration (Grant NNX07AE87G)Great Britain. Department for Business, Energy & Industrial Strategy (Grant 1028/06/2015)United States. National Oceanic and Atmospheric Administration (Grant RA-133-R15-CN-0008)National Natural Science Foundation of China (Grant 41575114)National Science Foundation (U.S.) (Grant ARC-1203779)National Science Foundation (U.S.) (Grant ARC-1204084)Natural Environment Research Council (Great Britain) (Grant NE/I027282/1

Channeling contrast analysis of lattice images: Conditions for probe-insensitive STEM

Quantitative analysis of lattice resolved images generated by scanning transmission electron microscopy (STEM) requires specification of probe characteristics, such as defocus, aberration and source distribution. In this paper we show that knowledge of such characteristics is unnecessary for quantitative interpretation, if the signal is integrated over a unit cell. Such a condition, whether the result of experimental setup or post-processing of lattice resolved images, reduces the intensity distribution to that of channelling contrast, where the signal for plane wave incidence is averaged over the angular range of the probe, and the result is independent of the probe characteristics. We use a Bloch wave model to show analytically how this applies to all forms of STEM imaging, such as that formed by annular dark field or backscatter detection, as well as characteristic X-ray fluorescence or electron energy loss. As a specific example, we consider how the signal from an annular dark field detector can be used to determine specimen thickness via a transfer curve for the zone axis and scattering geometries employed. This method has advantages over matching lattice images with calculations since these are sensitive to probe coherence and aberration, and saturation of the on-column intensity is approached more rapidly

The origin of basin-scale syn-extesnional synclines on the southern margin of the Northern Carnarvon Basin

Fault geometry exerts a dominant structural control on the deformation of hanging wall sequences during extension and contraction. Numerical, kinematic and sandbox modelling studies have demonstrated that characteristic anticline–syncline pairs are produced during the extension of ramp-flat faults. These features are commonly recognized in smaller fault-scale structures, but remain underappreciated in larger, basin-scale settings. The Lewis Trough, situated within the Northern Carnarvon Basin, Western Australia, is a basin-scale, largely unfaulted syncline with an associated anticline along its western flank, rather than the fault-related graben typical of the region. We present kinematic models demonstrating that a SE-dipping, ramp-flat fault geometry can produce relative highs and lows in Jurassic strata as well as honouring the asymmetrical onlap pattern within the Lewis Trough. This study indicates that the Lewis Trough formed during the Early Jurassic, a period typically associated with high rates of extension and not during the Late Triassic Fitzroy Compression Event. This study also highlights the importance of the Locker Shale in partitioning deformation of the Permian and Mesozoic fault systems and as a diffuse zone that variably partitions displacement between stacked Permian and Mesozoic fault systems

AQA GCSE English language and literature. Teacher's resource book. Higher and foundation

Recurso para el profesor con directrices detalladas y consejos prácticos para los estudiantes que preparan el General Certificate of Secondary Education (GCSE) AQA de lengua y literatura inglesas. Estructurado en diecisiete unidades, las siete primeras preparan los exámenes y las restantes incluyen unidades con evaluaciones controladas.SCBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]