Arterial Hypertension Refractory to Renal Denervation, Abdominal Pain and Claudication: Any Coral’ations?

Coral reef aorta is a rare form of calcifying atherosclerosis typically involving the supra and juxtarenal aorta. P atients classically present with refractory hypertension, intermittent claudication and abdominal angina. The treatment is either surgical via transaortic endarterectomy or through transferal endovascular stentgraft placement. Here we describe the case of a 45yearold female patient infected with human immuno deficiency virus, with resistant hypertension, lower limb and abdominal claudication, who was successfully treated with endovascular stent placement. We f urther provide a brief overview of the disease characteristics and treatment options.

Earth system commitments due to delayed mitigation

As long as global CO₂ emissions continue to increase annually, long-term committed Earth system changes grow much faster than current observations. A novel metric linking this future growth to policy decisions today is the mitigation delay sensitivity (MDS), but MDS estimates for Earth system variables other than peak temperature (ΔT max) are missing. Using an Earth System Model of Intermediate Complexity, we show that the current emission increase rate causes a ΔT max increase roughly 3–7.5 times as fast as observed warming, and a millenial steric sea level rise (SSLR) 7–25 times as fast as observed SSLR, depending on the achievable rate of emission reductions after the peak of emissions. These ranges are only slightly affected by the uncertainty range in equilibrium climate sensitivity, which is included in the above values. The extent of ocean acidification at the end of the century is also strongly dependent on the starting time and rate of emission reductions. The preservable surface ocean area with sufficient aragonite supersaturation for coral reef growth is diminished globally at an MDS of roughly 25%–80% per decade. A near-complete loss of this area becomes unavoidable if mitigation is delayed for a few years to decades. Also with respect to aragonite, 12%–18% of the Southern Ocean surface become undersaturated per decade, if emission reductions are delayed beyond 2015–2040. We conclude that the consequences of delaying global emission reductions are much better captured if the MDS of relevant Earth system variables is communicated in addition to current trends and total projected future changes.

Potential Future Coral Habitats Around Japan Depend Strongly on Anthropogenic CO2 Emissions

Using the results from the NCAR CSM1.4-coupled global carbon cycle– climate model under the Intergovernmental Panel on Climate Change (IPCC) emission scenarios SRES A2 and B1, we estimated the effects of both global warming and ocean acidification on the future habitats of corals in the seas around Japan during this century. As shown by Yara et al. (Biogeosciences 9:4955–4968,2012), under the high-CO₂-emission scenario (SRES A2), coral habitats will be sandwiched and narrowed between the northern region, where the saturation state of the carbonate mineral aragonite (Ωarag) decreases, and the southern region, where coral bleaching occurs. We found that under the low-emission scenario SRES B1, the coral habitats will also shrink in the northern region by the reduced Ωarag but to a lesser extent than under SRES A2, and in contrast to SRES A2, no bleaching will occur in the southern region. Therefore, coral habitats in the southern region are expected to be largely unaffected by ocean acidification or surface warming under the low-emission scenario. Our results show that potential future coral habitats depend strongly on CO₂ emissions and emphasize the importance of reducing CO₂ emissions to prevent negative impacts on coral habitats.