The regional variability in tundra and boreal carbon dioxide (CO2) fluxes can be high, complicating efforts to quantify sink‐source patterns across the entire region. Statistical models are ...increasingly used to predict (i.e., upscale) CO2 fluxes across large spatial domains, but the reliability of different modeling techniques, each with different specifications and assumptions, has not been assessed in detail. Here, we compile eddy covariance and chamber measurements of annual and growing season CO2 fluxes of gross primary productivity (GPP), ecosystem respiration (ER), and net ecosystem exchange (NEE) during 1990–2015 from 148 terrestrial high‐latitude (i.e., tundra and boreal) sites to analyze the spatial patterns and drivers of CO2 fluxes and test the accuracy and uncertainty of different statistical models. CO2 fluxes were upscaled at relatively high spatial resolution (1 km2) across the high‐latitude region using five commonly used statistical models and their ensemble, that is, the median of all five models, using climatic, vegetation, and soil predictors. We found the performance of machine learning and ensemble predictions to outperform traditional regression methods. We also found the predictive performance of NEE‐focused models to be low, relative to models predicting GPP and ER. Our data compilation and ensemble predictions showed that CO2 sink strength was larger in the boreal biome (observed and predicted average annual NEE −46 and −29 g C m−2 yr−1, respectively) compared to tundra (average annual NEE +10 and −2 g C m−2 yr−1). This pattern was associated with large spatial variability, reflecting local heterogeneity in soil organic carbon stocks, climate, and vegetation productivity. The terrestrial ecosystem CO2 budget, estimated using the annual NEE ensemble prediction, suggests the high‐latitude region was on average an annual CO2 sink during 1990–2015, although uncertainty remains high.
We synthesized eddy covariance and chamber measurements of annual and growing season carbon dioxide (CO2) fluxes from 148 terrestrial high‐latitude (i.e., tundra and boreal) sites. We used statistical models to predict terrestrial ecosystem CO2 fluxes across the region over 1990–2015. Average annual net ecosystem CO2 sink strength was generally strong in the boreal biome but decreased with increasing latitude towards the tundra which was nearly neutral. Uncertainties remained high, but our results suggest that the high‐latitude region was on average an annual terrestrial ecosystem CO2 sink.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background
Whether the remote myocardium of reperfused ST‐segment elevation myocardial infarction (STEMI) patients plays a part in adverse left ventricular (LV) remodeling remains unclear. We aimed ...to use automated extracellular volume fraction (ECV) mapping to investigate whether changes in the ECV of the remote (ECVRemote) and infarcted myocardium (ECVInfarct) impacted LV remodeling.
Methods and Results
Forty‐eight of 50 prospectively recruited reperfused STEMI patients completed a cardiovascular magnetic resonance at 4±2 days and 40 had a follow‐up scan at 5±2 months. Twenty healthy volunteers served as controls. Mean segmental values for native T1, T2, and ECV were obtained. Adverse LV remodeling was defined as ≥20% increase in LV end‐diastolic volume. ECVRemote was higher on the acute scan when compared to control (27.9±2.1% vs 26.4±2.1%; P=0.01). Eight patients developed adverse LV remodeling and had higher ECVRemote acutely (29.5±1.4% vs 27.4±2.0%; P=0.01) and remained higher at follow‐up (28.6±1.5% vs 26.6±2.1%; P=0.02) compared to those without. Patients with a higher ECVRemote and a lower myocardial salvage index (MSI) acutely were significantly associated with adverse LV remodeling, independent of T1Remote, T1Core and microvascular obstruction, whereas a higher ECVInfarct was significantly associated with worse wall motion recovery.
Conclusions
ECVRemote was increased acutely in reperfused STEMI patients. Those with adverse LV remodeling had higher ECVRemote acutely, and this remained higher at follow‐up than those without adverse LV remodeling. A higher ECVRemote and a lower MSI acutely were significantly associated with adverse LV remodeling whereas segments with higher ECVInfarct were less likely to recover wall motion.
Abstract
The origins of Lyman continuum (LyC) photons responsible for the reionization of the universe are as of yet unknown and highly contested. Detecting LyC photons from the Epoch of Reionization ...is not possible due to absorption by the intergalactic medium, which has prompted the development of several indirect diagnostics to infer the rate at which galaxies contribute LyC photons to reionize the universe by studying lower-redshift analogs. We present the Low-redshift Lyman Continuum Survey (LzLCS) comprising measurements made with the Hubble Space Telescope Cosmic Origins Spectrograph for a
z
= 0.2–0.4 sample of 66 galaxies. After careful processing of the far-UV spectra, we obtain a total of 35 Lyman continuum emitters (LCEs) detected with 97.725% confidence, nearly tripling the number of known local LCEs. We estimate escape fractions from the detected LyC flux and upper limits on the undetected LyC flux, finding a range of LyC escape fractions up to 50%. Of the 35 LzLCS LCEs, 12 have LyC escape fractions greater than 5%, more than doubling the number of known local LCEs with cosmologically relevant LyC escape.
Gray mold, a disease of strawberry (Fragaria × ananassa) caused by the ubiquitous necrotroph Botrytis cinerea, renders fruit unmarketable and causes economic losses in the postharvest supply chain. ...To explore the feasibility of selecting for increased resistance to gray mold, we undertook genetic and genomic prediction studies in strawberry populations segregating for fruit quality and shelf life traits hypothesized to pleiotropically affect susceptibility. As predicted, resistance to gray mold was heritable but quantitative and genetically complex. While every individual was susceptible, the speed of symptom progression and severity differed. Narrow-sense heritability ranged from 0.38 to 0.71 for lesion diameter (LD) and 0.39 to 0.44 for speed of emergence of external mycelium (EM). Even though significant additive genetic variation was observed for LD and EM, the phenotypic ranges were comparatively narrow and genome-wide analyses did not identify any large-effect loci. Genomic selection (GS) accuracy ranged from 0.28 to 0.59 for LD and 0.37 to 0.47 for EM. Additive genetic correlations between fruit quality and gray mold resistance traits were consistent with prevailing hypotheses: LD decreased as titratable acidity increased, whereas EM increased as soluble solid content decreased and firmness increased. We concluded that phenotypic and GS could be effective for reducing LD and increasing EM, especially in long shelf life populations, but that a significant fraction of the genetic variation for resistance to gray mold was caused by the pleiotropic effects of fruit quality traits that differ among market and shelf life classes.
Discharge plasmas can be ignited by direct current (DC), low to mid-frequency alternating current (AC), radio-frequency (RF), and microwave power sources. In addition to these continuous excitation ...sources, pulsed excitation, e.g. by bipolar or unipolar DC pulses is also possible. Plasmas in devices which contain insulating (dielectric) surfaces can generally not be sustained by DC power because of the buildup of charges that eventually will cause arcing. Plasma generation using pulsed DC power has emerged as a particularly attractive technique because of the high level of control and versatility afforded by the independent variation of pulse amplitude, pulsing frequency, and duty cycle. In this thesis, we used time-resolved electrical probe measurements and optical diagnostics techniques (emission spectroscopy and imaging) to study the temporal behavior of two plasmas excited by pulsed DC power, low-pressure magnetron plasmas for reactive sputter deposition and high-pressure dielectric barrier discharge plasmas for the generation of ultraviolet (UV) light and reactive radicals. An attempt was made to correlate the macroscopic plasma parameters with the basic collisional and radiative processes in these plasmas.
To update the Assessment of SpondyloArthritis international Society (ASAS)-EULAR recommendations for the management of axial spondyloarthritis (axSpA).
Following the EULAR Standardised Operating ...Procedures, two systematic literature reviews were conducted on non-pharmacological and pharmacological treatment of axSpA. In a task force meeting, the evidence was presented, discussed, and overarching principles and recommendations were updated, followed by voting.
Five overarching principles and 15 recommendations with a focus on personalised medicine were agreed: eight remained unchanged from the previous recommendations; three with minor edits on nomenclature; two with relevant updates (#9, 12); two newly formulated (#10, 11). The first five recommendations focus on treatment target and monitoring, non-pharmacological management and non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice pharmacological treatment. Recommendations 6-8 deal with analgesics and discourage long-term glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for pure axial involvement. Recommendation 9 describes the indication of biological DMARDs (bDMARDs, that is, tumour necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i)) and targeted synthetic DMARDs (tsDMARDs, ie, Janus kinase inhibitors) for patients who have Ankylosing Spondylitis Disease Activity Score ≥2.1 and failed ≥2 NSAIDs and also have either elevated C reactive protein, MRI inflammation of sacroiliac joints or radiographic sacroiliitis. Current practice is to start a TNFi or IL-17i. Recommendation 10 addresses extramusculoskeletal manifestations with TNF monoclonal antibodies preferred for recurrent uveitis or inflammatory bowel disease, and IL-17i for significant psoriasis. Treatment failure should prompt re-evaluation of the diagnosis and consideration of the presence of comorbidities (#11). If active axSpA is confirmed, switching to another b/tsDMARD is recommended (#12). Tapering, rather than immediate discontinuation of a bDMARD, can be considered in patients in sustained remission (#13). The last recommendations (#14, 15) deal with surgery and spinal fractures.
The 2022 ASAS-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.
Vascular targeted photodynamic therapy with TOOKAD® is a new therapeutic option for localized prostate cancer management. The objectives of this study were to assess the feasibility of radical ...prostatectomy after vascular targeted photodynamic therapy and describe functional and oncologic outcomes.
We retrospectively included in study 45 patients who underwent salvage radical prostatectomy after vascular targeted photodynamic therapy for recurrent prostate cancer at a total of 14 surgical centers in Europe between October 2008 and March 2017. Of the 42 radical prostatectomies performed 16 were robot-assisted, 6 were laparoscopic and 20 were open surgery. Primary end points were morbidity and technical difficulties. Secondary end points were early and intermediate postoperative functional and oncologic outcomes.
Median operative time was 180 minutes (IQR 150-223). Median blood loss was 200 ml (IQR 155-363). According to the surgeons the surgery was easy in 29 patients (69%) and difficult in 13 (31%). Nerve sparing was feasible in 14 patients (33%). Five postoperative complications (12%) were found, including 2 Clavien I, 2 Clavien II and 1 Clavien IIIB complications. Of the cases 13 (31%) were pT3 and 21 (50%) were pT2c. Surgical margins were positive in 13 patients (31%). Prostate specific antigen was undetectable at 6 to 12 months in 37 patients (88%). Nine patients underwent complementary radiotherapy. Four patients had final prostate specific antigen greater than 0.2 ng/ml at a median followup of 23 months (IQR 12-36). At 1 year 27 patients (64%) were completely continent (no pads) and 10 (24%) had low incontinence (1 pad). Four patients (11%) recovered potency without treatment and 23 (64%) recovered potency with appropriate treatment.
Salvage radical prostatectomy after vascular targeted photodynamic therapy treatment was feasible and safe without difficulty for most of the surgeons.
The International Union for Conservation of Nature (IUCN) Red List of Threatened Species is central in biodiversity conservation, but insufficient resources hamper its long-term growth, updating, and ...consistency. Models or automated calculations can alleviate those challenges by providing standardised estimates required for assessments, or prioritising species for (re-)assessments. However, while numerous scientific papers have proposed such methods, few have been integrated into assessment practice, highlighting a critical research–implementation gap. We believe this gap can be bridged by fostering communication and collaboration between academic researchers and Red List practitioners, and by developing and maintaining user-friendly platforms to automate application of the methods. We propose that developing methods better encompassing Red List criteria, systems, and drivers is the next priority to support the Red List.
The IUCN Red List of Threatened Species plays a central role in monitoring biodiversity and informing conservation actions.To best inform conservation, the Red List must be frequently updated, become more taxonomically and geographically representative, and be consistent within and among taxonomic groups, but this is hampered by limited resources.A variety of models and automated calculations has been proposed in the literature to support Red List assessments, for instance using citizen science or remote-sensing data to predict extinction risk.We highlight a major research–implementation gap in the application of these methods, which could be bridged by providing assessors with easy access to the most relevant tools, hands-on training, and strengthening communication.Further efforts are needed to develop relevant methods to prioritise assessments or better predict extinction risk.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To evaluate the impact of the recent changes to the urology residency application process on the criteria utilized by residency program directors (PDs) for interview invitations and their ...perspectives concerning these changes.
One hundred thirty-seven urology residency PDs were invited to participate in an anonymous survey to explore interview selection criteria and the impact of the increase in preference signals (PS) per applicant.
Fifty-eight PDs (42.8%) completed the survey. The highest-ranked criteria were letters of recommendation (LoR) and successful sub-internship (sub-I) at the PD’s institution, without statistically significant differences between these 2. Gender, ethnicity, and medical school prestige were the lowest rated criteria, without significant differences between these 3. Compared to before the increase in the number of PS per applicant, 80.7% of PDs reported that not receiving a PS from an applicant this cycle would more negatively impact the chances of offering an interview to that applicant. Moreover, 12.2% stated they would not interview any applicants who did not send a PS. Finally, 62.1% of PDs believed recent changes worsened the process.
Recent changes impacted PDs applicant evaluation, with the highest ranked criteria being LoRs and sub-I. Paradoxically, the increase in the number of PS per applicant has increased their importance as applicants are much less likely to receive interview offers from programs they have not signaled. Lastly, most PDs believe changes have worsened the evaluation process.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
BACKGROUND AND PURPOSE—Intra-arterial therapy (IAT) promotes recanalization of large artery occlusions in acute ischemic stroke. Despite high recanalization rates, poor clinical outcomes are common. ...We attempted to optimize a score that combines clinical and imaging variables to more accurately predict poor outcome after IAT in anterior circulation occlusions.
METHODS—Patients with acute ischemic stroke undergoing IAT at University of Texas (UT) Houston for large artery occlusions (middle cerebral artery or internal carotid artery) were reviewed. Independent predictors of poor outcome (modified Rankin Scale, 4–6) were studied. External validation was performed on IAT-treated patients at Emory University.
RESULTS—A total of 163 patients were identified at UT Houston. Independent predictors of poor outcome (P≤0.2) were identified as score variables using sensitivity analysis and logistic regression. Houston Intra-Arterial Therapy 2 (HIAT2) score ranges 0 to 10age (≤59=0, 60–79=2, ≥80 years=4), glucose (<150=0, ≥150=1), National Institute Health Stroke Scale (≤10=0, 11–20=1, ≥21=2), the Alberta Stroke Program Early CT Score (8–10=0, ≤7=3). Patients with HIAT2≥5 were more likely to have poor outcomes at discharge (odds ratio, 6.43; 95% confidence interval, 2.75–15.02; P<0.001). After adjusting for reperfusion (Thrombolysis in Cerebral Infarction score ≥2b) and time from symptom onset to recanalization, HIAT2≥5 remained an independent predictor of poor outcome (odds ratio, 5.88; 95% confidence interval, 1.96–17.64; P=0.02). Results from the cohort of Emory (198 patients) were consistent; patients with HIAT2 score ≥5 had 6× greater odds of poor outcome at discharge and at 90 days. HIAT2 outperformed other previously published predictive scores.
CONCLUSIONS—The HIAT2 score, which combines clinical and imaging variables, performed better than all previous scores in predicting poor outcome after IAT for anterior circulation large artery occlusions.
PDF
