Severe Coarctation of the Aorta: A Delayed Diagnosis

INTRODUCTION: Coarctation of the aorta (CoA) is a congenital heart disease characterized by narrowing of the aorta near the aortic isthmus. The incidence of CoA is 4 out of every 10,000 births, accounting for 6–8% of all congenital heart disease. It is common for CoA to be accompanied by other cardiovascular abnormalities, such as bicuspid aortic valve, ventricular septal defects, and mitral valve stenosis. Early diagnosis and treatment of CoA is crucial to improving morbidity and mortality associated with this disease as the mean age of death in untreated coarctation is 34 years. CASE DESCRIPTION: A 10 year old male presented to the outpatient pediatric clinic for an acute illness. On examination, he was found to be hypertensive with a blood pressure of 126/69 accompanied by a systolic heart murmur. Medical history included the diagnosis of a heart murmur at a 2 year well child examination before the patient was lost to follow-up until age 9. Upon re-establishment he was noted to have a II/VI systolic heart murmur. He was seen multiple times during year 10 of life where this murmur was consistently documented. Referral to cardiology for further evaluation was made. At presentation to the cardiologist, patient was found to be well appearing with clear lung sounds and a III/VI systolic murmur heard best at the left upper sternal boarder with radiation throughout the chest. During examination absent femoral and lower extremity pulses with pale lower extremity nail beds were also noted. Echocardiogram demonstrated severe CoA, bicuspid aortic valve, and aortic root dilatation. He was started on metoprolol for aortic root dilatation. Referral for heart catheterization was made for planned stenting to relieve the coarctation. DISCUSSION: Heart murmurs are a common finding on pediatric exams. The primary care provider typically determines which heart murmurs are pathologic and require follow-up. In the setting of a heart murmur there are clinical signs that indicate when further follow-up with cardiology is needed, including absent distal pulses, hypertension, radiation of the murmur throughout the chest, and discrepancy between upper and lower extremity blood pressure. Early referral to cardiology is imperative for any murmur that is not innocent to prevent delayed diagnosis of pathologic lesions. This case demonstrates the importance of checking blood pressure and lower extremity pulses in the setting of an asymptomatic patient with a heart murmur.N

The Encoding of Temporally Irregular and Regular Visual Patterns in the Human Brain

In the work reported here, we set out to study the neural systems that detect predictable temporal patterns and departures from them. We used functional magnetic resonance imaging (fMRI) to locate activity in the brains of subjects when they viewed temporally regular and irregular patterns produced by letters, numbers, colors and luminance. Activity induced by irregular sequences was located within dorsolateral prefrontal cortex, including an area that was responsive to irregular patterns regardless of the type of visual stimuli producing them. Conversely, temporally regular arrangements resulted in activity in the right frontal lobe (medial frontal gyrus), in the left orbito-frontal cortex and in the left pallidum. The results show that there is an abstractive system in the brain for detecting temporal irregularity, regardless of the source producing it

Research is needed to inform environmental management of hydrothermally inactive and extinct polymetallic sulfide (PMS) deposits

Polymetallic sulfide (PMS) deposits produced at hydrothermal vents in the deep sea are of potential interest to miners. Hydrothermally active sulfide ecosystems are valued for the extraordinary chemosynthetic communities that they support. Many countries, including Canada, Portugal, and the United States, protect vent ecosystems in their Exclusive Economic Zones. When hydrothermal activity ceases temporarily (dormancy) or permanently (extinction), the habitat and associated ecosystem change dramatically. Until recently, so-called "inactive sulfide" habitats, either dormant or extinct, received little attention from biologists. However, the need for environmental management of deep-sea mining places new imperatives for building scientific understanding of the structure and function of inactive PMS deposits. This paper calls for actions of the scientific community and the emergent seabed mining industry to i) undertake fundamental ecological descriptions and study of ecosystem functions and services associated with hydrothermally inactive PMS deposits, ii) evaluate potential environmental risks to ecosystems of inactive PMS deposits through research, and iii) identify environmental management needs that may enable mining of inactive PMS deposits. Mining of some extinct PMS deposits may have reduced environmental risk compared to other seabed mining activities, but this must be validated through scientific research on a case-by-case basis.FCT: IF/00029/2014/CP1230/CT0002/ UID/05634/2020/ CEECIND005262017/ UID/MAR/00350/2019; Direcao-Geral de Politica do Mar (DGPM) Mining2/2017/005/ Mining2/2017/001info:eu-repo/semantics/publishedVersio

Nitrate postdeposition processes in Svalbard surface snow

The snowpack acts as a sink for atmospheric reactive nitrogen, but several postdeposition pathways have been reported to alter the concentration and isotopic composition of snow nitrate with implications for atmospheric boundary layer chemistry, ice core records, and terrestrial ecology following snow melt. Careful daily sampling of surface snow during winter (11–15 February 2010) and springtime (9 April to 5 May 2010) near Ny‐Ålesund, Svalbard reveals a complex pattern of processes within the snowpack. Dry deposition was found to dominate over postdeposition losses, with a net nitrate deposition rate of (0.6 ± 0.2) µmol m−2 d−1 to homogeneous surface snow. At Ny‐Ålesund, such surface dry deposition can either solely result from long‐range atmospheric transport of oxidized nitrogen or include the redeposition of photolytic/bacterial emission originating from deeper snow layers. Our data further confirm that polar basin air masses bring 15N‐depleted nitrate to Svalbard, while high nitrate δ(18O) values only occur in connection with ozone‐depleted air, and show that these signatures are reflected in the deposited nitrate. Such ozone‐depleted air is attributed to active halogen chemistry in the air masses advected to the site. However, here the Ny‐Ålesund surface snow was shown to have an active role in the halogen dynamics for this region, as indicated by declining bromide concentrations and increasing nitrate δ(18O), during high BrO (low‐ozone) events. The data also indicate that the snowpack BrO‐NOx cycling continued in postevent periods, when ambient ozone and BrO levels recovered

From Sea to Sea: Canada's Three Oceans of Biodiversity

Evaluating and understanding biodiversity in marine ecosystems are both necessary and challenging for conservation. This paper compiles and summarizes current knowledge of the diversity of marine taxa in Canada's three oceans while recognizing that this compilation is incomplete and will change in the future. That Canada has the longest coastline in the world and incorporates distinctly different biogeographic provinces and ecoregions (e.g., temperate through ice-covered areas) constrains this analysis. The taxonomic groups presented here include microbes, phytoplankton, macroalgae, zooplankton, benthic infauna, fishes, and marine mammals. The minimum number of species or taxa compiled here is 15,988 for the three Canadian oceans. However, this number clearly underestimates in several ways the total number of taxa present. First, there are significant gaps in the published literature. Second, the diversity of many habitats has not been compiled for all taxonomic groups (e.g., intertidal rocky shores, deep sea), and data compilations are based on short-term, directed research programs or longer-term monitoring activities with limited spatial resolution. Third, the biodiversity of large organisms is well known, but this is not true of smaller organisms. Finally, the greatest constraint on this summary is the willingness and capacity of those who collected the data to make it available to those interested in biodiversity meta-analyses. Confirmation of identities and intercomparison of studies are also constrained by the disturbing rate of decline in the number of taxonomists and systematists specializing on marine taxa in Canada. This decline is mostly the result of retirements of current specialists and to a lack of training and employment opportunities for new ones. Considering the difficulties encountered in compiling an overview of biogeographic data and the diversity of species or taxa in Canada's three oceans, this synthesis is intended to serve as a biodiversity baseline for a new program on marine biodiversity, the Canadian Healthy Ocean Network. A major effort needs to be undertaken to establish a complete baseline of Canadian marine biodiversity of all taxonomic groups, especially if we are to understand and conserve this part of Canada's natural heritage

TRIF Modulates TLR5-dependent Responses by Inducing Proteolytic Degradation of TLR5*

Proteolytic modification of pattern recognition receptors and their signaling adaptor molecules has recently emerged as an essential cellular event to regulate immune and inflammatory responses. Here we show that the TIR domain containing adaptor-inducing interferon-β (TRIF), an adaptor molecule mediating TLR3 signaling and MyD88-independent signaling of TLR4, plays an inhibitory role in TLR5-elicited responses by inducing proteolytic degradation of TLR5. TRIF overexpression in human embryonic kidney (HEK293) and human colonic epithelial (NCM460) cells abolishes the cellular protein level of TLR5, whereas it does not alter TLR5 mRNA level. Thus, TRIF overexpression dramatically suppresses flagellin/TLR5-deriven NFκB activation in NCM460 cells. TRIF-induced TLR5 protein degradation is completely inhibited in the presence of pan-caspase inhibitor (benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone), whereas several specific inhibitors against cathepsin B, reactive oxygen species, or ubiquitin-mediated proteasome activity fail to suppress this degradation. These results indicate that TRIF-induced caspase activity causes TLR5 protein degradation. In addition, we identify that the C terminus of TRIF and extracellular domain of TLR5 are required for TRIF-induced TLR5 degradation. Furthermore, TRIF-induced proteolytic degradation is extended to TLR3, TLR6, TLR7, TLR8, TLR9, and TLR10, whereas the cellular level of TLR1, TLR2, and TLR4 is not affected by TRIF overexpression. These results suggest that, in addition to mediating TLR3- or TLR4-induced signaling as an adaptor molecule, TRIF can participate in proteolytic modification of certain members of TLRs to modulate the functionality of TLRs at post-translational level. Collectively, our findings propose a potential inhibitory role of TRIF at least in regulating host-microbial communication via TLR5 in colonic epithelial cells