RESUMO
Some forage legumes synthesize phytoestrogens. We conducted a glasshouse study to investigate how water stress (drought and waterlogging) influences phytoestrogen accumulation in red clover and kura clover. Compared to the red clover control, the 20 day drought resulted in an over 100% increase in the phytoestrogens formononetin and biochanin A, which together accounted for 91-96% of the total phytoestrogens measured. Waterlogging resulted in elevated concentrations of daidzein, genistein, and prunetin but not formononetin or biochanin A. Concentrations of phytoestrogens in kura clover were low or undetectable, regardless of water stress treatment. Leaf water potential was the most explanatory single-predictor of the variation in concentrations of formononetin, biochanin A, and total phytoestrogens in red clover. These results suggest that drought-stressed red clover may have higher potential to lead to estrogenic effects in ruminant livestock and that kura clover is a promising alternative low- or no-phytoestrogen perennial forage legume.
Assuntos
Fitoestrógenos , Trifolium , Trifolium/metabolismo , Trifolium/química , Trifolium/crescimento & desenvolvimento , Fitoestrógenos/metabolismo , Fitoestrógenos/análise , Água/metabolismo , Água/análise , Isoflavonas/metabolismo , Isoflavonas/análise , Secas , Genisteína/análise , Genisteína/metabolismoRESUMO
Transgenic, dicamba-resistant soybean and cotton were developed to enable farmers to combat weeds that had evolved resistance to the herbicide glyphosate. The dramatic increases in dicamba use these crops facilitated have led to serious problems, including the evolution of dicamba-resistant weeds and widespread damage to susceptible crops and farming communities. Disturbingly, this pattern of dicamba use has unfolded while the total herbicide applied to soybean has nearly doubled since 2006. Without substantive changes to agricultural policy and decision making, the next 'silver-bullet' agrotechnology will likely be no more than another step on the transgene-facilitated herbicide treadmill. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Assuntos
Glycine max , Glifosato , Resistência a Herbicidas , Herbicidas , Plantas Daninhas , Plantas Geneticamente Modificadas , Herbicidas/farmacologia , Resistência a Herbicidas/genética , Plantas Geneticamente Modificadas/genética , Glycine max/genética , Glycine max/efeitos dos fármacos , Plantas Daninhas/efeitos dos fármacos , Plantas Daninhas/genética , Transgenes , Dicamba/farmacologia , Controle de Plantas Daninhas/métodos , Gossypium/genética , Glicina/análogos & derivados , Glicina/farmacologia , Produtos Agrícolas/genéticaRESUMO
Cover crops are plants grown to provide regulating, supporting, and cultural ecosystem services in managed environments. In agricultural systems, weed suppression services from cover crops can be an important tool to promote sustainability as reliance on herbicides and tillage for weed management has caused pollution, biodiversity loss, and human health issues. However, to effectively use weed suppression services from cover crops, farmers must carefully select species that fit within their rotations and suppress their problematic weeds. Understanding how the relatedness between cover crops and weeds affects their interactions will help farmers select cover crops for targeted weed management. The phylogenetic distance between species reflects their relatedness and was studied through a series of field experiments that compared weed suppression in winter and summer cover crops with tilled controls. This study demonstrates that cover crops can reduce up to 99% of weed biomass and alter weed community structure by suppressing phylogenetically related weed species. Results also suggest that cover crop planting season can influence weed community structure since only overwintering treatments affected the phylogenetic distance of weed communities. In an applied context, these results help develop cover crop-based weed management systems, demonstrating that problematic weeds can be managed by selecting phylogenetically related cover crop species. More broadly, this study provides a framework for evaluating weed communities through a phylogenetic perspective, which provides new insight into plant interactions in agriculture.
Assuntos
Ecossistema , Herbicidas , Humanos , Filogenia , Agricultura/métodos , Plantas Daninhas , Herbicidas/farmacologia , Produtos Agrícolas , Controle de Plantas Daninhas/métodosRESUMO
Predicting and mitigating changes in soil carbon (C) stocks under global change requires a coherent understanding of the factors regulating soil organic matter (SOM) formation and persistence, including knowledge of the direct sources of SOM (plants vs. microbes). In recent years, conceptual models of SOM formation have emphasized the primacy of microbial-derived organic matter inputs, proposing that microbial physiological traits (e.g., growth efficiency) are dominant controls on SOM quantity. However, recent quantitative studies have challenged this view, suggesting that plants make larger direct contributions to SOM than is currently recognized by this paradigm. In this review, we attempt to reconcile these perspectives by highlighting that variation across estimates of plant- versus microbial-derived SOM may arise in part from methodological limitations. We show that all major methods used to estimate plant versus microbial contributions to SOM have substantial shortcomings, highlighting the uncertainty in our current quantitative estimates. We demonstrate that there is significant overlap in the chemical signatures of compounds produced by microbes, plant roots, and through the extracellular decomposition of plant litter, which introduces uncertainty into the use of common biomarkers for parsing plant- and microbial-derived SOM, especially in the mineral-associated organic matter (MAOM) fraction. Although the studies that we review have contributed to a deeper understanding of microbial contributions to SOM, limitations with current methods constrain quantitative estimates. In light of recent advances, we suggest that now is a critical time to re-evaluate long-standing methods, clearly define their limitations, and develop a strategic plan for improving the quantification of plant- and microbial-derived SOM. From our synthesis, we outline key questions and challenges for future research on the mechanisms of SOM formation and stabilization from plant and microbial pathways.
Assuntos
Carbono , Solo , Solo/química , Carbono/metabolismo , Microbiologia do Solo , Plantas/metabolismo , Minerais/químicaRESUMO
Growing evidence suggests that conservation agricultural practices, like no-till and cover crops, help protect annual crops from insect pests by supporting populations of resident arthropod predators. While adoption of conservation practices is growing, most field crop producers are also using more insecticides, including neonicotinoid seed coatings, as insurance against early-season insect pests. This tactic may disrupt benefits associated with conservation practices by reducing arthropods that contribute to biological control. We investigated the interaction between preventive pest management (PPM) and the conservation practice of cover cropping. We also investigated an alternative pest management approach, integrated pest management (IPM), which responds to insect pest risk, rather than using insecticides prophylactically. In a 3-year corn (Zea mays mays L.)-soy (Glycine max L.) rotation, we measured the response of invertebrate pests and predators to PPM and IPM with and without a cover crop. Using any insecticide provided some small reduction to plant damage in soy, but no yield benefit. In corn, vegetative cover early in the season was key to reducing pest density and damage, likely by increasing the abundance of arthropod predators. Further, PPM in year 1 decreased predation compared to a no-pest-management control. Contrary to our expectation, the IPM strategy, which required just one insecticide application, was more disruptive to the predator community than PPM, likely because the applied pyrethroid was more acutely toxic to a wider range of arthropods than neonicotinoids. Promoting early-season cover was more effective at reducing pest density and damage than either intervention-based strategy. Our results suggest that the best pest management outcomes may occur when biological control is encouraged by planting cover crops and avoiding broad-spectrum insecticides as much as possible. As part of a conservation-based approach to farming, cover crops can promote natural-enemy populations that can help provide biological effective control of insect pest populations.
Assuntos
Artrópodes , Inseticidas , Animais , Produtos Agrícolas , Controle de Insetos , Insetos , Neonicotinoides , Controle de Pragas , Controle Biológico de Vetores/métodos , Estações do Ano , Glycine max , Zea maysRESUMO
Globalization's need for global cities with highly concentrated financial districts is discussed to explain how the Covid-19 pandemic will paradoxically only serve to make the world's leading global cities more essential, valuable, and demanding of skyscrapers than ever before. Financial and corporate service firms cannot only be digitally based because they also require face-to-face interaction, collaboration, and joint-production within themselves, and between one another, in the most connected global cities to effectively function as competitive businesses. However, after Covid-19 advanced service firms will only not practice remote working where and when they must; so that in-place face-to-face interactions with colleagues and clients will be overwhelmingly only concentrated in the skyscraper-laden financial districts of the world's leading global cities. The future of commercial and luxury residential skyscrapers in the world's leading global cities can be said to be secure because the impact of Covid-19 on enhancing the centrality of these few highly connected and super-wealthy cities in globalization is both understandable and predictable; skyscrapers elsewhere in the Global North or South will struggle to remain viable as firms increasingly decentralise the work of their staff away from city centre offices.
RESUMO
Neonicotinoids from insecticidal seed coatings can contaminate soil in treated fields and adjacent areas, posing a potential risk to nontarget organisms and ecological function. To determine if cover crops can mitigate neonicotinoid contamination in treated and adjacent areas, we measured neonicotinoid concentrations for three years in no-till corn-soybean rotations, planted with or without neonicotinoid seed coatings, and with or without small grain cover crops. Although neonicotinoids were detected in cover crops, high early season dissipation provided little opportunity for winter-planted cover crops to absorb significant neonicotinoid residues; small grain cover crops failed to mitigated neonicotinoid contamination in either treated or untreated plots. As the majority of neonicotinoids from seed coatings dissipated shortly after planting, residues did not accumulate in soil, but persisted at concentrations below 5 ppb. Persistent residues could be attributed to historic neonicotinoid use and recent, nearby neonicotinoid use. Tracking neonicotinoid concentrations over time revealed a large amount of local interplot movement of neonicotinoids; in untreated plots, contamination was higher when plots were less isolated from treated plots.
Assuntos
Produtos Agrícolas , Inseticidas , Inseticidas/análise , Neonicotinoides , Sementes/química , SoloRESUMO
Zero tillage (ZT) is widely promoted throughout India's Eastern Indo-Gangetic Plains (IGP) because of its potential to increase wheat productivity and resilience to abiotic stresses. Weeds remain a major barrier to ZT adoption, yet it remains unclear how ZT will influence weed communities in the Eastern-IGP. The primary objective of this study was to characterise the composition of the germinable weed seedbank sampled just prior to the wheat phase of rice-wheat farms in Bihar and Eastern Uttar Pradesh, and examine whether adoption of ZT wheat has shifted weed community composition compared to conventional tillage (CT). Additionally, we examined whether edaphic properties and topography (upland vs. lowland) explain variation in germinable weed seedbank communities. In December 2014, we evaluated the germinable seedbank from 72 fields differing in their historic (>=3 year) tillage practices (ZT vs. CT) in three regions: Samastipur-Vaishali-Muzaffarpur (SVM), Ara-Buxar and Maharajgunj-Kushinagar. Weed community composition and species richness varied by region and topography. ZT adoption was associated with lower relative density of Chenopodium album in the germinable seedbank and lower emergence of Phalaris minor seedlings within farmers' fields. In upland topographies of the SVM region, ZT adoption was also associated with greater relative abundance of Solanum nigrum in the weed seedbank. However, differences between tillage systems in individual species were not large enough to result in detection of differences at the whole-community level. Variation in edaphic properties, most notably soil texture and pH, explained 51% of the variation in the weed seedbank community. Our work suggests several frequent but poorly understood species (e.g. Mazus pumilus and Grangea maderaspatana) in Eastern IGP for which future research should quantify their effects on crop yields. Finally, future work surveying weed species abundance at harvest could further determine the dominant problematic species in these regions.
RESUMO
Researchers have developed precursor functional analyses to provide an alternative, and presumably safer, format for functional analysis of severe problem behavior. When researchers use functional analysis contingencies for precursor behaviors, it is possible to infer functional characteristics about severe problem behaviors based on patterns of less severe precursor behaviors, permitting practitioners to complete the assessment with less risk to clients, practitioners, or others. The current paper discusses recent advances in the development and validation of precursor identification, and offers suggestions and future directions for investigating and implementing precursor functional analyses. We propose a decision-making model, in which practitioners integrate procedures to identify precursors into the functional-analysis process, to expedite the analysis of severe problem behaviors.
Assuntos
Comportamento Problema/psicologia , Sintomas Prodrômicos , Reforço Psicológico , Humanos , Modelos PsicológicosRESUMO
Maintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients. This retrospective review of MCS patients with subtherapeutic INRs compared an intravenous unfractionated heparin (UFH) strategy with a subcutaneous enoxaparin or fondaparinux strategy. Native thromboelastography (n-TEG) was used to evaluate anticoagulant effect with coagulation index (CI) as the primary outcome measure. Enoxaparin 0.5 mg/kg subcutaneously (SC) every 12 hours or fondaparinux 2.5-5 mg SC daily were compared with an initial UFH rate of 5 units/kg/hr and titrated to stated n-TEG goal range. The anticoagulant groups UFH, enoxaparin, and fondaparinux were found to be statistically similar with regard to frequency in n-TEG goal range, above range (hypercoagulability), or below range (hypocoagulability). Clinical outcomes were similar among groups with three gastrointestinal bleeds in UFH, one in enoxaparin, and one in fondaparinux groups. Device thrombosis occurred in one UFH patient, while UFH and fondaparinux groups had one ischemic cerebrovascular accident event each. These strategies provided comparable n-TEG results and clinical outcomes when compared with intravenous UFH. Low-dose enoxaparin or fondaparinux may provide an alternative anticoagulant bridging option in MCS patients presenting with subtherapeutic INR.
Assuntos
Anticoagulantes/uso terapêutico , Coração Auxiliar/efeitos adversos , Trombose/prevenção & controle , Enoxaparina/uso terapêutico , Feminino , Fondaparinux/uso terapêutico , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Trombose/etiologiaRESUMO
Climate models predict increasing weather variability, with negative consequences for crop production. Conservation agriculture (CA) may enhance climate resilience by generating certain soil improvements. However, the rate at which these improvements accrue is unclear, and some evidence suggests CA can lower yields relative to conventional systems unless all three CA elements are implemented: reduced tillage, sustained soil cover, and crop rotational diversity. These cost-benefit issues are important considerations for potential adopters of CA. Given that CA can be implemented across a wide variety of regions and cropping systems, more detailed and mechanistic understanding is required on whether and how regionally-adapted CA can improve soil properties while minimizing potential negative crop yield impacts. Across four US states, we assessed short-term impacts of regionally-adapted CA systems on soil properties and explored linkages with maize and soybean yield stability. Structural equation modeling revealed increases in soil organic matter generated by cover cropping increased soil cation exchange capacity, which improved soybean yield stability. Cover cropping also enhanced maize minimum yield potential. Our results demonstrate individual CA elements can deliver rapid improvements in soil properties associated with crop yield stability, suggesting that regionally-adapted CA may play an important role in developing high-yielding, climate-resilient agricultural systems.
Assuntos
Produtos Agrícolas , Solo/química , Mudança Climática , Ecossistema , Glycine max/crescimento & desenvolvimentoRESUMO
BACKGROUND: We sought to better understand the patient population who receive a temporary total artificial heart (TAH) as bridge to transplant or as bridge to decision by evaluating data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database. METHODS: We examined data related to survival, adverse events, and competing outcomes from patients who received TAHs between June 2006 and April 2017 and used hazard function analysis to explore risk factors for mortality. RESULTS: Data from 450 patients (87% men; mean age, 50 years) were available in the INTERMACS database. The 2 most common diagnoses were dilated cardiomyopathy (50%) and ischemic cardiomyopathy (20%). Risk factors for right heart failure were present in 82% of patients. Most patients were INTERMACS Profile 1 (43%) or 2 (37%) at implantation. There were 266 patients who eventually underwent transplantation, and 162 died. Overall 3-, 6-, and 12-month actuarial survival rates were 73%, 62%, and 53%, respectively. Risk factors for death included older age (p = 0.001), need for pre-implantation dialysis (p = 0.006), higher creatinine (p = 0.008) and lower albumin (p < 0.001) levels, and implantation at a low-volume center (≤10 TAHs; p < 0.001). Competing-outcomes analysis showed 71% of patients in high-volume centers were alive on the device or had undergone transplantation at 12 months after TAH implantation vs 57% in low-volume centers (p = 0.003). CONCLUSIONS: Patients receiving TAHs have rapidly declining cardiac function and require prompt intervention. Experienced centers have better outcomes, likely related to patient selection, timing of implantation, patient care, and device management. Organized transfer of knowledge to low-volume centers could improve outcomes.
Assuntos
Coração Artificial , Sistema de Registros/estatística & dados numéricos , Fatores Etários , Cardiomiopatia Dilatada/mortalidade , Cardiomiopatia Dilatada/cirurgia , Feminino , Transplante de Coração , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/mortalidade , Isquemia Miocárdica/cirurgia , Complicações Pós-Operatórias/mortalidade , Fatores de Risco , Taxa de Sobrevida , Resultado do TratamentoRESUMO
With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use.
Assuntos
Simulação por Computador , Insuficiência Cardíaca/fisiopatologia , Coração Artificial , Coração/fisiopatologia , Hemodinâmica , Modelos Cardiovasculares , Pressão Atrial , Desenho de Equipamento , Coração Auxiliar , Humanos , Função Ventricular EsquerdaRESUMO
Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs.
Assuntos
Insuficiência Cardíaca/cirurgia , Coração Artificial , Implantação de Prótese/métodos , Adulto , Feminino , Humanos , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: Right ventricular failure is a serious complication after left ventricular assist device placement. CASE PRESENTATION: A 70-year-old male in decompensated heart failure with right ventricular failure after the placement of a left ventricular assist device. A single dual-lumen PROTEKDuo cannula was inserted percutaneously via the internal jugular vein to draw blood from the right atrium and return into the pulmonary artery using the CentriMag system, by passing the failing ventricle. The patient was successfully weaned from right ventricular assist device. CONCLUSIONS: In comparison to two-cannula conventional procedures, this right ventrivular assist device system improves patient rehabilitation and minimizes blood loss and risk of infection, while shortening procedure time and improving clinical outcomes in right ventricular failure.
Assuntos
Insuficiência Cardíaca/cirurgia , Coração Auxiliar , Implantação de Prótese/instrumentação , Disfunção Ventricular Direita/cirurgia , Idoso , Cânula , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos RetrospectivosRESUMO
Yield stability is fundamental to global food security in the face of climate change, and better strategies are needed for buffering crop yields against increased weather variability. Regional- scale analyses of yield stability can support robust inferences about buffering strategies for widely-grown staple crops, but have not been accomplished. We present a novel analytical approach, synthesizing 2000-2014 data on weather and soil factors to quantify their impact on county-level maize yield stability in four US states that vary widely in these factors (Illinois, Michigan, Minnesota and Pennsylvania). Yield stability is quantified as both 'downside risk' (minimum yield potential, MYP) and 'volatility' (temporal yield variability). We show that excessive heat and drought decreased mean yields and yield stability, while higher precipitation increased stability. Soil water holding capacity strongly affected yield volatility in all four states, either directly (Minnesota and Pennsylvania) or indirectly, via its effects on MYP (Illinois and Michigan). We infer that factors contributing to soil water holding capacity can help buffer maize yields against variable weather. Given that soil water holding capacity responds (within limits) to agronomic management, our analysis highlights broadly relevant management strategies for buffering crop yields against climate variability, and informs region-specific strategies.
Assuntos
Produtos Agrícolas/crescimento & desenvolvimento , Solo/química , Zea mays/crescimento & desenvolvimento , Agricultura/métodos , Clima , Mudança Climática , Secas , Illinois , Modelos Lineares , Michigan , Minnesota , Pennsylvania , Estações do Ano , Temperatura , Água , Tempo (Meteorologia)RESUMO
There is increasing global demand for food, bioenergy feedstocks and a wide variety of bio-based products. In response, agriculture has advanced production, but is increasingly depleting soil regulating and supporting ecosystem services. New production systems have emerged, such as no-tillage, that can enhance soil services but may limit yields. Moving forward, agricultural systems must reduce trade-offs between production and soil services. Soil functional zone management (SFZM) is a novel strategy for developing sustainable production systems that attempts to integrate the benefits of conventional, intensive agriculture, and no-tillage. SFZM creates distinct functional zones within crop row and inter-row spaces. By incorporating decimeter-scale spatial and temporal heterogeneity, SFZM attempts to foster greater soil biodiversity and integrate complementary soil processes at the sub-field level. Such integration maximizes soil services by creating zones of 'active turnover', optimized for crop growth and yield (provisioning services); and adjacent zones of 'soil building', that promote soil structure development, carbon storage, and moisture regulation (regulating and supporting services). These zones allow SFZM to secure existing agricultural productivity while avoiding or minimizing trade-offs with soil ecosystem services. Moreover, the specific properties of SFZM may enable sustainable increases in provisioning services via temporal intensification (expanding the portion of the year during which harvestable crops are grown). We present a conceptual model of 'virtuous cycles', illustrating how increases in crop yields within SFZM systems could create self-reinforcing feedback processes with desirable effects, including mitigation of trade-offs between yield maximization and soil ecosystem services. Through the creation of functionally distinct but interacting zones, SFZM may provide a vehicle for optimizing the delivery of multiple goods and services in agricultural systems, allowing sustainable temporal intensification while protecting and enhancing soil functioning.
RESUMO
Shortly after SynCardia total artificial heart (TAH) implant, venovenous extracorporeal membrane oxygenation (ECMO) via a 31 Fr Avalon cannula was used for profound hypoxic lung dysfunction. Immediately after starting ECMO, TAH flow increased by 1.5-2.0 L/min, presumably because of augmented TAH filling by the ECMO jet.
Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Coração Artificial , Adulto , Humanos , MasculinoRESUMO
The 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.