An International Multi-Center Evaluation of Type 5 Long QT Syndrome: A Low Penetrant Primary Arrhythmic Condition.

Background: Insight into type 5 long QT syndrome (LQT5) has been limited to case reports and small family series. Improved understanding of the clinical phenotype and genetic features associated with rare KCNE1 variants implicated in LQT5 was sought through an international multi-center collaboration. Methods: Patients with either presumed autosomal dominant LQT5 (N = 229) or the recessive Type 2 Jervell and Lange-Nielsen syndrome (JLNS2, N = 19) were enrolled from 22 genetic arrhythmia clinics and 4 registries from 9 countries. KCNE1 variants were evaluated for ECG penetrance (defined as QTc > 460ms on presenting ECG) and genotype-phenotype segregation. Multivariable Cox regression was used to compare the associations between clinical and genetic variables with a composite primary outcome of definite arrhythmic events, including appropriate implantable cardioverter-defibrillator shocks, aborted cardiac arrest, and sudden cardiac death. Results: A total of 32 distinct KCNE1 rare variants were identified in 89 probands and 140 genotype positive family members with presumed LQT5 and an additional 19 JLNS2 patients. Among presumed LQT5 patients, the mean QTc on presenting ECG was significantly longer in probands (476.9 ± 38.6ms) compared to genotype positive family members (441.8 ± 30.9ms, p<0.001). ECG penetrance for heterozygous genotype positive family members was 20.7% (29/140). A definite arrhythmic event was experienced in 16.9% (15/89) of heterozygous probands in comparison with 1.4% (2/140) of family members (adjusted hazard ratio [HR]: 11.6, 95% confidence interval [CI]: 2.6-52.2; p=0.001). Event incidence did not differ significantly for JLNS2 patients relative to the overall heterozygous cohort (10.5% [2/19]; HR: 1.7, 95% CI: 0.3-10.8, p=0.590). The cumulative prevalence of the 32 KCNE1 variants in the Genome Aggregation Database (gnomAD), which is a human database of exome and genome sequencing data from now over 140,000 individuals, was 238-fold greater than the anticipated prevalence of all LQT5 combined (0.238% vs. 0.001%). Conclusions: The present study suggests that putative/confirmed loss-of-function KCNE1 variants predispose to QT-prolongation, however the low ECG penetrance observed suggests they do not manifest clinically in the majority of individuals, aligning with the mild phenotype observed for JLNS2 patients

Contribution of topographically-generated submesoscale turbulence to Southern Ocean overturning

The ocean’s global overturning circulation regulates the transport and storage of heat, carbon and nutrients. Upwelling across the Southern Ocean’s Antarctic Circumpolar Current and into the mixed layer, coupled to water mass modification by surface buoyancy forcing, has been highlighted as a key process in the closure of the overturning circulation. Here, using twelve high-resolution hydrographic sections in southern Drake Passage, collected with autonomous ocean gliders, we show that Circumpolar Deep Water originating from the North Atlantic, known as Lower Circumpolar Deep Water, intersects sloping topography in narrow and strong boundary currents. Observations of strong lateral buoyancy gradients, enhanced bottom turbulence, thick bottom mixed layers and modified water masses are consistent with growing evidence that topographically generated submesoscale flows over continental slopes enhance near-bottom mixing, and that cross-density upwelling occurs preferentially over sloping topography. Interactions between narrow frontal currents and topography occur elsewhere along the path of the Antarctic Circumpolar Current, which leads us to propose that such interactions contribute significantly to the closure of the overturning in the Southern Ocean

To eat or not to eat? The diet of the endangered iberian wolf (Canis lupus signatus) in a human- dominated landscape in central Portugal

Livestock predation by large carnivores and their persecution by local communities are major conservation concerns. In order to prevent speculations and reduce conflicts, it is crucial to get detailed and accurate data on predators’ dietary ecology, which is particularly important in human dominated landscapes where livestock densities are high. This is the case of the endangered Iberian wolf in Portugal, an endemic subspecies of the Iberian Peninsula, which has seen its population distribution and abundance decline throughout the 20th century. Accordingly, the diet of the Iberian wolf was analyzed, using scat analysis, in a humanized landscape in central Portugal. From 2011 to 2014, a total of 295 wolf scats were collected from transects distributed throughout the study area, prospected on a monthly basis. Scat analysis indicated a high dependence of Iberian wolf on livestock. Domestic goat predominated the diet (62% of the scats), followed by cow (20%) and sheep (13%); the only wild ungulate present in the scat analysis was the wild boar (4% of the scats). Our results show that even though livestock constitute most part of wolves diet, different livestock species may represent different predation opportunities. We conclude that the high levels of livestock consumption may be a result of low diversity and density of wild ungulates that settles livestock as the only abundant prey for wolves. Our findings help on the understanding of the Iberian wolf feeding ecology and have implications for conflict management strategies. Finally, management implications are discussed and solutions are recommended

Getting to the bottom of the ocean

International audienc

Loss-of-Function KCNE2 Variants: True Monogenic Culprits of Long-QT Syndrome or Proarrhythmic Variants Requiring Secondary Provocation?

BACKGROUND: Insight into type 6 long-QT syndrome (LQT6), stemming from mutations in the KCNE2-encoded voltage-gated channel β-subunit, is limited. We sought to further characterize its clinical phenotype. METHODS AND RESULTS: Individuals with reported pathogenic KCNE2 mutations identified during arrhythmia evaluation were collected from inherited arrhythmia clinics and the Rochester long-QT syndrome (LQTS) registry. Previously reported LQT6 cases were identified through a search of the MEDLINE database. Clinical features were assessed, while reported KCNE2 mutations were evaluated for genotype-phenotype segregation and classified according to the contemporary American College of Medical Genetics guidelines. Twenty-seven probands possessed reported pathogenic KCNE2 mutations, while a MEDLINE search identified 17 additional LQT6 cases providing clinical and genetic data. Sixteen probands had normal resting QTc values and only developed QT prolongation and malignant arrhythmias after exposure to QT-prolonging stressors, 10 had other LQTS pathogenic mutations, and 10 did not have an LQTS phenotype. Although the remaining 8 subjects had an LQTS phenotype, evidence suggested that the KCNE2 variant was not the underlying culprit. The collective frequency of KCNE2 variants implicated in LQT6 in the Exome Aggregation Consortium database was 1.4%, in comparison with a 0.0005% estimated clinical prevalence for LQT6. CONCLUSIONS: On the basis of clinical phenotype, the high allelic frequencies of LQT6 mutations in the Exome Aggregation Consortium database, and absence of previous documentation of genotype-phenotype segregation, our findings suggest that many KCNE2 variants, and perhaps all, have been erroneously designated as LQTS-causative mutations. Instead, KCNE2 variants may confer proarrhythmic susceptibility when provoked by additional environmental/acquired or genetic factors, or both