PUF60-related developmental disorder: A case series and phenotypic analysis of 10 additional patients with monoallelic PUF60 variants.

PUF60-related developmental disorder (also referred to as Verheij syndrome), resulting from haploinsufficiency of PUF60, is associated with multiple congenital anomalies affecting a wide range of body systems. These anomalies include ophthalmic coloboma, and congenital anomalies of the heart, kidney, and musculoskeletal system. Behavioral and intellectual difficulties are also observed. While less common than other features associated with PUF60-related developmental disorder, for instance hearing impairment and short stature, identification of specific anomalies such as ophthalmic coloboma can aid with diagnostic identification given the limited spectrum of genes linked with this feature. We describe 10 patients with PUF60 gene variants, bringing the total number reported in the literature, to varying levels of details, to 56 patients. Patients were recruited both via locally based exome sequencing from international sites and from the DDD study in the United Kingdom. Eight of the variants reported were novel PUF60 variants. The addition of a further patient with a reported c449-457del variant to the existing literature highlights this as a recurrent variant. One variant was inherited from an affected parent. This is the first example in the literature of an inherited variant resulting in PUF60-related developmental disorder. Two patients (20%) were reported to have a renal anomaly consistent with 22% of cases in previously reported literature. Two patients received specialist endocrine treatment. More commonly observed were clinical features such as: cardiac anomalies (40%), ocular abnormalities (70%), intellectual disability (60%), and skeletal abnormalities (80%). Facial features did not demonstrate a recognizable gestalt. Of note, but remaining of unclear causality, we describe a single pediatric patient with pineoblastoma. We recommend that stature and pubertal progress should be monitored in PUF60-related developmental disorder with a low threshold for endocrine investigations as hormone therapy may be indicated. Our study reports an inherited case with PUF60-related developmental disorder which has important genetic counseling implications for families.

Origin of the complex main and satellite features in Fe 2p XPS of Fe2O3.

Although the origin and assignment of the complex XPS features of the cations in ionic compounds has been the subject of extensive theoretical work, agreement with experimental observations remains insufficient for unambiguous interpretation. This paper presents a rigorous ab initio treatment of the main and satellite features in the Fe 2p XPS of Fe2O3. This has been possible using a unique methodology for the selection of orbitals that are used to form the ionic wavefunctions. This orbital selection makes it possible to treat both the angular momentum coupling of the open shell core and valence electrons as well the shake excitations from the closed shell orbitals associated with the O ligands into the valence open shell orbitals associated with the Fe 3d shell. This allows the character of the ionic states in terms of the occupations of the open shell core and valence orbitals and of the contributions of 2p1/2 and 2p3/2 ionization to the XPS intensities to be determined. Our analysis gives strong evidence that many body effects are essential for a correct description of the ionic states and, in general the states cannot be described by a single configuration over the open shell orbitals. An important consequence is that the Fe 2p XPS intensity in most of the features arises from small contributions from the ionization to many, tens to hundreds, of often unresolved ionic states. While the usual understanding of the lower binding energy main and satellite features as being dominantly from 2p3/2 ionization is confirmed, this is not the case for the higher binding energy features where 2p1/2 and 2p3/2 ionization and shake excitations in the valence space mix strongly. Furthermore, we have been able to show that a very large fraction, 88%, of the total Fe 2p XPS intensity is contained in a relatively small binding energy range of ∼35 eV. This is relevant if one wants to extract the stoichiometry of Fe2O3 from Fe 2p/O 1s intensity ratios. Similar considerations about the importance of many-body effects are likely to be relevant for other ionic compounds as well.

Combined multiplet theory and experiment for the Fe 2p and 3p XPS of FeO and Fe2O3.

The Al K alpha, 1486.6 eV, based x-ray photoelectron spectroscopy (XPS) of Fe 2p and Fe 3p for Fe(III) in Fe2O3 and Fe(II) in FeO is compared with theoretical predictions based on ab initio wavefunctions that accurately treat the final, core-hole, multiplets. The principal objectives of this comparison are to understand the multiplet structure and to evaluate the use of both the 2p and 3p spectra in determining oxidation states. In order to properly interpret the features of these spectra and to use the XPS to provide atomistic insights as well as atomic composition, it is necessary to understand the origin of the multiplet energies and intensities. The theoretical treatment takes into account the ligand field and spin-orbit splittings, the covalent mixing of ligand and Fe 3d orbitals, and the angular momentum coupling of the open shell electrons. These effects lead to the distribution of XPS intensity into a large number of final, ionic, states that are only partly resolved with energies spread over a wide range of binding energies. For this reason, it is necessary to record the Fe 2p and 3p XPS spectra over a wide energy range, which includes all the multiplets in the theoretical treatment as well as additional shake satellites. We also evaluate the effects of differing assumptions concerning the extrinsic background subtraction, to make sure our experimental spectrum may be fairly compared to the theory. We conclude that the Fe 3p XPS provides an additional means for distinguishing Fe(III) and Fe(II) oxidation states beyond just using the Fe 2p spectrum. In particular, with the use of the Fe 3p XPS, the depth of the material probed is about 1.5 times greater than for the Fe 2p XPS. In addition, a new type of atomic many-body effect that involves excitations into orbitals that have Fe f,ℓ = 3, symmetry has been shown to be important for the Fe 3p XPS.

Covalency in Fe2O3 and FeO: Consequences for XPS satellite intensity.

The covalent character of the interaction between the metal cation and the oxygen ligands has been examined for two Fe oxides with different nominal oxidation states, Fe(II)O, and Fe(III)2O3. The covalent character is examined for the initial, ground state configuration and for the ionic states involving the removal of a shallow core, Fe 3p, and a deep core, Fe 2p, electron. The covalency is assessed based on novel theoretical analyses of wave functions for the various cases. It is found that the covalency is considerably different for different oxidation states and for different ionized and non-ionized configurations. The changes in covalency for the ions are shown to be responsible for important changes in relaxation energies for X-Ray Photoelectron Spectroscopy (XPS) spectra and in the intensity lost from main XPS peaks to shake satellites. While these consequences are not observables themselves, they are important for the interpretation of the XPS spectra, in particular, for efforts to extract stoichiometries of these iron oxides from XPS data. This is a finding likely applicable across various 3d transition metal oxide materials.

Analysis of the Fe 2p XPS for hematite α Fe2O3: Consequences of covalent bonding and orbital splittings on multiplet splittings.

The origins of the complex Fe 2p X-Ray Photoelectron Spectra (XPS) of hematite (α-Fe2O3) are analyzed and related to the character of the bonding in this compound. This analysis provides a new and novel view of the reasons for XPS binding energies (BEs) and BE shifts, which deepens the current understanding and interpretation of the physical and chemical significance of the XPS. In particular, many-body effects are considered for the initial and the final, 2p-hole configuration wavefunctions. It is shown that a one-body or one-configuration analysis is not sufficient and that the many-body, many-determinantal, and many-configurational character of the wavefunctions must be taken into account to describe and understand why the XPS intensity is spread over an extremely large number of final 2p-hole multiplets. The focus is on the consequences of angular momentum coupling of the core and valence open shell electrons, the ligand field splittings of the valence shell orbitals, and the degree of covalent mixing of the Fe(3d) electrons with the O(2p) electrons. Novel theoretical methods are used to estimate the importance of these various terms. An important consequence of covalency is a reduction in the energy separation of the multiplets. Although shake satellites are not considered explicitly, the total losses of intensity from the angular momentum multiplets to shake satellites is determined and related to the covalent character of the Fe-O interaction. The losses are found to be the same for Fe 2p1/2 and 2p3/2 ionization.

Linkage of recessive Robinow syndrome to a 4 cM interval on chromosome 9q22.

Autosomal recessive Robinow syndrome is a form of mesomelic dwarfism with multiple rib and vertebral anomalies. Using autozygosity mapping we have identified a genetic locus (RBNW1) for this syndrome at chromosome 9q22 in seven consanguineous families from Oman. Our results indicate that the gene lies within a 4 cM region between markers D9S1836 and D9S1803 (maximum multipoint LOD score 12.3). In addition, we have analysed two non-Omani families with autosomal recessive Robinow and found no genetic heterogeneity.

The prognostic value of a normal Tc-99m sestamibi SPECT study in suspected coronary artery disease.

BACKGROUND: Myocardial perfusion is widely used for risk stratification of patients with suspected or known coronary artery disease (CAD). Recent years have seen an increasing demand for screening of such patients. The value of a normal stress thallium-201 scanning is well established. The advent of technetium 99m-sestamibi single photon emission computed tomography (SPECT) has enhanced the profile of nuclear cardiology even further as a reliable test for screening. However, in spite of previous reports, there is paucity of large-scale data regarding the prognostic value of a normal Tc 99m-sestamibi scanning result. METHODS: The aim of our study was to assess the incidence of cardiac death and non-fatal myocardial infarction in patients with an intermediate probability of coronary artery disease (CAD). A total of 473 patients with normal stress Tc-99m-sestamibi SPECT were monitored for 30+/-16 (6 to 56) months to assess serious cardiac events. There were 272 men and 201 women, with a mean age of 56+/-2 years, of whom 89% had symptoms suggestive of CAD, 65% had an abnormal exercise electrocardiography, 6% had known CAD, and 5% had a high risk of CAD. The average workload was 9.14 metabolic equivalents, peak exercise heart rate was 93%+/-13% of the age predicted target. RESULTS: The annualized mortality rate was 0.2% (95%CI 0.02% to 0.7%) and no infarctions occurred in this group. CONCLUSIONS: A normal stress Tc-99m-sestamibi is highly predictive of a benign outcome, even in patients with intermediate probability of CAD.