Unprecedented Fe delivery from the Congo River margin to the South Atlantic Gyre.

Rivers are a major supplier of particulate and dissolved material to the ocean, but their role as sources of bio-essential dissolved iron (dFe) is thought to be limited due to rapid, efficient Fe removal during estuarine mixing. Here, we use trace element and radium isotope data to show that the influence of the Congo River margin on surface Fe concentrations is evident over 1000 km from the Congo outflow. Due to an unusual combination of high Fe input into the Congo-shelf-zone and rapid lateral transport, the Congo plume constitutes an exceptionally large offshore dFe flux of 6.8 ± 2.3 × 108 mol year-1. This corresponds to 40 ± 15% of atmospheric dFe input into the South Atlantic Ocean and makes a higher contribution to offshore Fe availability than any other river globally. The Congo River therefore contributes significantly to relieving Fe limitation of phytoplankton growth across much of the South Atlantic.

Poor-fit indexes of Kupperman index: a psychometric analysis based on item response theory.

OBJECTIVE: This study aims to test the construct validity of the 11 items of the Kupperman index (KI), which has been pioneering in its attempt to quantify climacteric symptoms. METHODS: Unidimensional confirmatory factor analysis of the 11 graded items (hot flashes, paresthesia, insomnia, nervousness, melancholia, vertigo, weakness, arthralgia or myalgia, headache, palpitations, and formication), using a four-point scale (0, none; 4, severe), was used to evaluate the KI in a sample consisting of 84 women with a mean (SD) age of 54.34 (4.00) years who have been in menopause for a mean (SD) of 4.36 (2.53) years. RESULTS: The KI returned poor results on unidimensional model testing (root-mean-square error adjustment, 0.109; 90% CI, 0.075-0.142; comparative fit index, 0.871; Tucker Lewis index, 0.838; weighted root-mean-square residual, 0.971; χ(2)(44) = 87.599; P < 0.001), indicating that the set of items does not properly evaluate the underlying phenomena (climacteric symptoms). CONCLUSIONS: Our study verifies the poor fit of the KI and provides psychometric evidence that KI items warrant revision and/or that the concept underlying climacteric symptoms should be revisited.

Insuficiência cardíaca neonatal e síndrome de Marfan / Neonatal heart failure and Marfan syndrome

We report the case of a neonate admitted to the hospital in the 4th day of life in severe heart failure due to aortic and mitral regurgitation with a largely dilated aortic root. The associated skeletal features involving the superior and inferior limbs as well as the thorax, and joint hypermobility, allowed the clinical diagnosis of Marfan syndrome. Despite favorable initial response to medical therapy, sudden deterioration led to death two weeks after birth. Typical necroscopic findings were confirmed and the case is considered the most severe clinical manifestation possible to be found in this syndrome

É relatado caso de um neonato internado no 4º dia de vida com insuficiência cardíaca grave, secundária à insuficiência aórtica e mitral, com dilatação acentuada da aorta ascendente. Alterações ósseas características em membros e tórax com hipermobilidade articular permitiram o diagnóstico da síndrome de Marfan. Apesar da evolução inicial favorável com tratamento clínico convencional, súbita piora levou ao óbito no 13º dia de vida. Achados necroscópicos característicos foram encontrados, sendo o caso considerado como a manifestação mais grave possível de ser encontrada nessa síndrome