We use a global aerosol microphysics model in combination with an offline radiative transfer model to quantify the radiative effect of biogenic secondary organic aerosol (SOA) in the present-day ...atmosphere. Through its role in particle growth and ageing, the presence of biogenic SOA increases the global annual mean concentration of cloud condensation nuclei (CCN; at 0.2% supersaturation) by 3.6-21.1%, depending upon the yield of SOA production from biogenic volatile organic compounds (BVOCs), and the nature and treatment of concurrent primary carbonaceous emissions. This increase in CCN causes a rise in global annual mean cloud droplet number concentration (CDNC) of 1.9-5.2%, and a global mean first aerosol indirect effect (AIE) of between +0.01 W m-2 and -0.12 W m-2. The radiative impact of biogenic SOA is far greater when biogenic oxidation products also contribute to the very early stages of new particle formation; using two organically mediated mechanisms for new particle formation, we simulate global annual mean first AIEs of -0.22 W m-2 and -0.77 W m-2. The inclusion of biogenic SOA substantially improves the simulated seasonal cycle in the concentration of CCN-sized particles observed at three forested sites. The best correlation is found when the organically mediated nucleation mechanisms are applied, suggesting that the first AIE of biogenic SOA could be as large as -0.77 W m-2. The radiative impact of SOA is sensitive to the presence of anthropogenic emissions. Lower background aerosol concentrations simulated with anthropogenic emissions from 1750 give rise to a greater fractional CCN increase and a more substantial first AIE from biogenic SOA. Consequently, the anthropogenic indirect radiative forcing between 1750 and the present day is sensitive to assumptions about the amount and role of biogenic SOA. We also calculate an annual global mean direct radiative effect of between -0.08 W m-2 and -0.78 W m-2 in the present day, with uncertainty in the amount of SOA produced from the oxidation of BVOCs accounting for most of this range.
Epstein–Barr virus (EBV) is a ubiquitous gamma‐herpesvirus that establishes a lifelong persistent infection in the oral cavity and is intermittently shed in the saliva. EBV exhibits a biphasic life ...cycle, supported by its dual tropism for B lymphocytes and epithelial cells, which allows the virus to be transmitted within oral lymphoid tissues. While infection is often benign, EBV is associated with a number of lymphomas and carcinomas that arise in the oral cavity and at other anatomical sites. Incomplete association of EBV in cancer has questioned if EBV is merely a passenger or a driver of the tumorigenic process. However, the ability of EBV to immortalize B cells and its prevalence in a subset of cancers has implicated EBV as a carcinogenic cofactor in cellular contexts where the viral life cycle is altered. In many cases, EBV likely acts as an agent of tumor progression rather than tumor initiation, conferring malignant phenotypes observed in EBV‐positive cancers. Given that the oral cavity serves as the main site of EBV residence and transmission, here we review the prevalence of EBV in oral malignancies and the mechanisms by which EBV acts as an agent of tumor progression.
In patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. ...More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes.
In this phase 3, placebo-controlled trial, we randomly assigned 4744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either dapagliflozin (at a dose of 10 mg once daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of worsening heart failure (hospitalization or an urgent visit resulting in intravenous therapy for heart failure) or cardiovascular death.
Over a median of 18.2 months, the primary outcome occurred in 386 of 2373 patients (16.3%) in the dapagliflozin group and in 502 of 2371 patients (21.2%) in the placebo group (hazard ratio, 0.74; 95% confidence interval CI, 0.65 to 0.85; P<0.001). A first worsening heart failure event occurred in 237 patients (10.0%) in the dapagliflozin group and in 326 patients (13.7%) in the placebo group (hazard ratio, 0.70; 95% CI, 0.59 to 0.83). Death from cardiovascular causes occurred in 227 patients (9.6%) in the dapagliflozin group and in 273 patients (11.5%) in the placebo group (hazard ratio, 0.82; 95% CI, 0.69 to 0.98); 276 patients (11.6%) and 329 patients (13.9%), respectively, died from any cause (hazard ratio, 0.83; 95% CI, 0.71 to 0.97). Findings in patients with diabetes were similar to those in patients without diabetes. The frequency of adverse events related to volume depletion, renal dysfunction, and hypoglycemia did not differ between treatment groups.
Among patients with heart failure and a reduced ejection fraction, the risk of worsening heart failure or death from cardiovascular causes was lower among those who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes. (Funded by AstraZeneca; DAPA-HF ClinicalTrials.gov number, NCT03036124.).
The relationship between rooting depth and above‐ground hydraulic traits can potentially define drought resistance strategies that are important in determining species distribution and coexistence in ...seasonal tropical forests, and understanding this is important for predicting the effects of future climate change in these ecosystems.
We assessed the rooting depth of 12 dominant tree species (representing c. 42% of the forest basal area) in a seasonal Amazon forest using the stable isotope ratios (δ18O and δ2H) of water collected from tree xylem and soils from a range of depths. We took advantage of a major ENSO‐related drought in 2015/2016 that caused substantial evaporative isotope enrichment in the soil and revealed water use strategies of each species under extreme conditions. We measured the minimum dry season leaf water potential both in a normal year (2014; Ψnon‐ENSO) and in an extreme drought year (2015; ΨENSO). Furthermore, we measured xylem hydraulic traits that indicate water potential thresholds trees tolerate without risking hydraulic failure (P50 and P88).
We demonstrate that coexisting trees are largely segregated along a single hydrological niche axis defined by root depth differences, access to light and tolerance of low water potential. These differences in rooting depth were strongly related to tree size; diameter at breast height (DBH) explained 72% of the variation in the δ18Oxylem. Additionally, δ18Oxylem explained 49% of the variation in P50 and 70% of P88, with shallow‐rooted species more tolerant of low water potentials, while δ18O of xylem water explained 47% and 77% of the variation of minimum Ψnon‐ENSO and ΨENSO.
We propose a new formulation to estimate an effective functional rooting depth, i.e. the likely soil depth from which roots can sustain water uptake for physiological functions, using DBH as predictor of root depth at this site. Based on these estimates, we conclude that rooting depth varies systematically across the most abundant families, genera and species at the Tapajós forest, and that understorey species in particular are limited to shallow rooting depths.
Our results support the theory of hydrological niche segregation and its underlying trade‐off related to drought resistance, which also affect the dominance structure of trees in this seasonal eastern Amazon forest.
Synthesis. Our results support the theory of hydrological niche segregation and demonstrate its underlying trade‐off related to drought resistance (access to deep water vs. tolerance of very low water potentials). We found that the single hydrological axis defining water use traits was strongly related to tree size, and infer that periodic extreme droughts influence community composition and the dominance structure of trees in this seasonal eastern Amazon forest.
Our results support the theory of hydrological niche segregation and demonstrate its underlying trade‐off related to drought resistance (access to deep water vs. tolerance of very low water potentials). We found that the single hydrological axis defining water use traits was strongly related to tree size, and infer that periodic extreme droughts influence community composition and the dominance structure of trees in this seasonal eastern Amazon forest.
We report the discovery and characterization of two transiting planets around the bright M1 V star LP 961-53 (TOI-776,
J
= 8.5 mag,
M
= 0.54 ± 0.03
M
⊙
) detected during Sector 10 observations of the ...Transiting Exoplanet Survey Satellite (TESS). Combining the TESS photometry with HARPS radial velocities, as well as ground-based follow-up transit observations from the MEarth and LCOGT telescopes, for the inner planet, TOI-776 b, we measured a period of
P
b
= 8.25 d, a radius of
R
b
= 1.85 ± 0.13
R
⊕
, and a mass of
M
b
= 4.0 ± 0.9
M
⊕
; and for the outer planet, TOI-776 c, a period of
P
c
= 15.66 d, a radius of
R
c
= 2.02 ± 0.14
R
⊕
, and a mass of
M
c
= 5.3 ± 1.8
M
⊕
. The Doppler data shows one additional signal, with a period of ~34 d, associated with the rotational period of the star. The analysis of fifteen years of ground-based photometric monitoring data and the inspection of different spectral line indicators confirm this assumption. The bulk densities of TOI-776 b and c allow for a wide range of possible interior and atmospheric compositions. However, both planets have retained a significant atmosphere, with slightly different envelope mass fractions. Thanks to their location near the radius gap for M dwarfs, we can start to explore the mechanism(s) responsible for the radius valley emergence around low-mass stars as compared to solar-like stars. While a larger sample of well-characterized planets in this parameter space is still needed to draw firm conclusions, we tentatively estimate that the stellar mass below which thermally-driven mass loss is no longer the main formation pathway for sculpting the radius valley is between 0.63 and 0.54
M
⊙
. Due to the brightness of the star, the TOI-776 system is also an excellent target for the
James Webb
Space Telescope, providing a remarkable laboratory in which to break the degeneracy in planetary interior models and to test formation and evolution theories of small planets around low-mass stars.
Little is known about employment following total knee arthroplasty (TKA). This study aims to identify factors which predict return to work following TKA in patients of working age in the United ...Kingdom.
We prospectively assessed 289 patients (289 TKAs) aged ≤ 65 years who underwent TKA between 2010 and 2013. There were 148 women. The following were recorded pre-operatively: age, gender, body mass index, social deprivation, comorbidities, indication for surgery, work status and nature of employment, activity level as assessed by the University of California, Los Angeles (UCLA) activity score and Oxford Knee Score (OKS). The intention of patients to return to work or to retire was not assessed pre-operatively. At a mean of 3.4 years (2 to 4) post-operatively, the return to work status, OKS, the EuroQol-5 dimensions (EQ-5D) score, UCLA activity score and Work, Osteoarthritis and joint-Replacement (WORQ) score were obtained. Univariate and multivariate analyses were performed.
Of 261 patients (90%) who were working before TKA, 105 (40%) returned to any job, including 89 (34%) who returned to the same job at a mean of 13.5 weeks (2 to 104) post-operatively. A total of 108 (41%) retired following TKA and 18 remained on welfare. Patients not working before the operation did not return to work. Median UCLA scores improved in 125 patients (58%) from 4 (mild activity) to 6 (moderate activity) (p < 0.001). Significant (p < 0.05) factors which were predictive of return to any work included age, heavy or moderate manual work, better post-operative UCLA, OKS and EQ-5D general health scores. Significant predictive factors of return to the same work included age, heavy or moderate manual work and post-operative OKS. Multivariate analysis confirmed heavy or moderate manual work and age to independently predict a return to either any or the same work. All patients aged < 50 years who were working pre-operatively returned to any work as did 60% of those aged between 50 and 54 years, 50% of those aged between 55 and 59 years and 24% those aged between 60 and 65 years.
If working pre-operatively, patients aged < 50 years invariably returned to work following TKA, but only half of those aged between 50 to 60 years returned. High post-operative activity levels and patient reported outcome measures do not predict return to work following TKA. Cite this article:
2017;99-B:1037-46.
Objective
To evaluate the association between marijuana use and a composite adverse pregnancy outcome using biological sampling.
Design
Retrospective cohort study.
Setting
Single tertiary center.
...Population
Young women (13–22 years old) with singleton, non‐anomalous pregnancies delivered from September 2011 to May 2017.
Methods
Exposure was defined as marijuana detected on universal urine toxicology testing or by self‐report. Multivariable logistic regression modelling was used to estimate the effect of any marijuana use on the primary composite outcome. The effect of marijuana exposure was also estimated for self‐reported use, toxicology‐detected use, and multiple use detected by toxicology.
Main outcome measure
The primary composite outcome included spontaneous preterm birth, hypertensive disorders of pregnancy, stillbirth, or small for gestational age.
Results
Of 1206 pregnant young women, 17.5% (n = 211) used marijuana. Among the women who used marijuana, 8.5% (n = 18) were identified by self‐report alone, 63% (n = 133) by urine toxicology alone, and 28.4% (n = 60) by both. Urine toxicology testing results were available for 1092 (90.5%) births. The composite outcome occurred more frequently in pregnancies exposed to marijuana (46 versus 34%, P < 0.001). This remained significant after adjusting for race/ethnicity and tobacco in the multivariable model (adjusted OR 1.50, 95% CI 1.09–2.05). When marijuana exposure was defined by self‐report only, the association with adverse pregnancy outcome became non‐significant (adjusted OR 1.01, 95% CI 0.62–1.64).
Conclusion
In a population of young women with nearly universal biological sampling, marijuana exposure was associated with adverse pregnancy outcomes. The heterogeneity of findings in existing studies evaluating the impact of marijuana on mothers and neonates may result from the incomplete ascertainment of exposure.
Tweetable
Marijuana use, as detected by universal urine testing, was associated with a composite adverse pregnancy outcome among young mothers.
Tweetable
Marijuana use, as detected by universal urine testing, was associated with a composite adverse pregnancy outcome among young mothers.
This report offers a consensus opinion on the diagnosis of spontaneous canine hyperadrenocorticism. The possibility that a patient has hyperadrenocorticism is based on the history and physical ...examination. Endocrine tests should be performed only when clinical signs consistent with HAC are present. None of the biochemical screening or differentiating tests for hyperadrenocorticism are perfect. Imaging can also play a role. Awareness of hyperadrenocorticism has heightened over time. Thus, case presentation is more subtle. Due to the changes in manifestations as well as test technology the Panel believes that references ranges should be reestablished. The role of cortisol precursors and sex hormones in causing a syndrome of occult hyperadrenocorticism remains unclear.
Constraining the thermal and compositional state of the mantle is crucial for deciphering the formation and evolution of Mars. Mineral physics predicts that Mars’ deep mantle is demarcated by a ...seismic discontinuity arising from the pressure-induced phase transformation of the mineral olivine to its higher-pressure polymorphs, making the depth of this boundary sensitive to both mantle temperature and composition. Here, we report on the seismic detection of a midmantle discontinuity using the data collected by NASA’s InSight Mission to Mars that matches the expected depth and sharpness of the postolivine transition. In five teleseismic events, we observed triplicated P and S waves and constrained the depth of this discontinuity to be 1,006
±
40 km by modeling the triplicated waveforms. From this depth range, we infer a mantle potential temperature of 1,605
±
100 K, a result consistent with a crust that is 10 to 15 times more enriched in heat-producing elements than the underlying mantle. Our waveform fits to the data indicate a broad gradient across the boundary, implying that the Martian mantle is more enriched in iron compared to Earth. Through modeling of thermochemical evolution of Mars, we observe that only two out of the five proposed composition models are compatible with the observed boundary depth. Our geodynamic simulations suggest that the Martian mantle was relatively cold 4.5 Gyr ago (1,720 to 1,860 K) and are consistent with a present-day surface heat flow of 21 to 24 mW/m
2
.
Reducing uncertainties in the response of tropical forests to global change requires understanding how intra- and interannual climatic variability selects for different species, community functional ...composition and ecosystem functioning, so that the response to climatic events of differing frequency and severity can be predicted.
Here we present an extensive dataset of hydraulic traits of dominant species in two tropical Amazon forests with contrasting precipitation regimes – low seasonality forest (LSF) and high seasonality forest (HSF) – and relate them to community and ecosystem response to the El Niño–Southern Oscillation (ENSO) of 2015.
Hydraulic traits indicated higher drought tolerance in the HSF than in the LSF. Despite more intense drought and lower plant water potentials in HSF during the 2015-ENSO, greater xylem embolism resistance maintained similar hydraulic safety margin as in LSF. This likely explains how ecosystem-scale whole-forest canopy conductance at HSF maintained a similar response to atmospheric drought as at LSF, despite their water transport systems operating at different water potentials.
Our results indicate that contrasting precipitation regimes (at seasonal and interannual time scales) select for assemblies of hydraulic traits and taxa at the community level, which may have a significant role in modulating forest drought response at ecosystem scales.
PDF
