The xylem of anisohydric Quercus alba L. is more vulnerable to embolism than isohydric codominants.

The coordination of plant leaf water potential (ΨL ) regulation and xylem vulnerability to embolism is fundamental for understanding the tradeoffs between carbon uptake and risk of hydraulic damage. There is a general consensus that trees with vulnerable xylem more conservatively regulate ΨL than plants with resistant xylem. We evaluated if this paradigm applied to three important eastern US temperate tree species, Quercus alba L., Acer saccharum Marsh. and Liriodendron tulipifera L., by synthesizing 1600 ΨL observations, 122 xylem embolism curves and xylem anatomical measurements across 10 forests spanning pronounced hydroclimatological gradients and ages. We found that, unexpectedly, the species with the most vulnerable xylem (Q. alba) regulated ΨL less strictly than the other species. This relationship was found across all sites, such that coordination among traits was largely unaffected by climate and stand age. Quercus species are perceived to be among the most drought tolerant temperate US forest species; however, our results suggest their relatively loose ΨL regulation in response to hydrologic stress occurs with a substantial hydraulic cost that may expose them to novel risks in a more drought-prone future.

Reforestation and surface cooling in temperate zones: Mechanisms and implications.

Land-use/cover change (LUCC) is an important driver of environmental change, occurring at the same time as, and often interacting with, global climate change. Reforestation and deforestation have been critical aspects of LUCC over the past two centuries and are widely studied for their potential to perturb the global carbon cycle. More recently, there has been keen interest in understanding the extent to which reforestation affects terrestrial energy cycling and thus surface temperature directly by altering surface physical properties (e.g., albedo and emissivity) and land-atmosphere energy exchange. The impacts of reforestation on land surface temperature and their mechanisms are relatively well understood in tropical and boreal climates, but the effects of reforestation on warming and/or cooling in temperate zones are less certain. This study is designed to elucidate the biophysical mechanisms that link land cover and surface temperature in temperate ecosystems. To achieve this goal, we used data from six paired eddy-covariance towers over co-located forests and grasslands in the temperate eastern United States, where radiation components, latent and sensible heat fluxes, and meteorological conditions were measured. The results show that, at the annual time scale, the surface of the forests is 1-2°C cooler than grasslands, indicating a substantial cooling effect of reforestation. The enhanced latent and sensible heat fluxes of forests have an average cooling effect of -2.5°C, which offsets the net warming effect (+1.5°C) of albedo warming (+2.3°C) and emissivity cooling effect (-0.8°C) associated with surface properties. Additional daytime cooling over forests is driven by local feedbacks to incoming radiation. We further show that the forest cooling effect is most pronounced when land surface temperature is higher, often exceeding -5°C. Our results contribute important observational evidence that reforestation in the temperate zone offers opportunities for local climate mitigation and adaptation.

Strain Imaging: An Everyday Tool for the Perioperative Echocardiographer.

Strain analysis allows for global and regional analysis of myocardial function and has been shown to be an independent predictor of outcomes after cardiac surgery. Strain imaging offers advantages over traditional EF measurements in that it is relatively angle independent, it is less dependent upon loading conditions, it is reproducible, it does not rely on geometric assumptions, and it can detect subclinical systolic dysfunction. Limitations of strain analysis include high temporal resolution requirements, a strong dependence on image quality, and inter-vendor variability. In addition, there is a paucity of data on the intraoperative applications of strain. The ASE has defined a global longitudinal strain of -20% measured by transthoracic echocardiography to be considered normal, with less negative values considered abnormal. Presently, there are no published guidelines on the normal values of strain with transesophageal echocardiography (TEE). However, multiple studies have shown that a reduction in intraoperative strain assessed with TEE has been shown to be an independent predictor of complications during cardiac surgery. Accordingly, further incorporation of intraoperative strain analysis with TEE could aid in prognostication for patients undergoing cardiac surgery. As perioperative strain analysis continues to advance, an understanding of these concepts is imperative for perioperative echocardiographers. It is the authors' goal to show that strain imaging can provide a reliable and objective measure that can be performed in real time to aid in decision-making and perioperative risk stratification.

Amniotic fluid embolism mortality rate.

AIM: The objective of this study was to determine the mortality rate of amniotic fluid embolism (AFE) using population-based studies and case series. METHODS: A literature search was conducted using the two key words: 'amniotic fluid embolism (AFE)' AND 'mortality rate'. Thirteen population-based studies were evaluated, as well as 36 case series including at least two patients. RESULTS: The mortality rate from population-based studies varied from 11% to 44%. When nine population-based studies with over 17 000 000 live births were aggregated, the maternal mortality rate was 20.4%. In contrast, the mortality rate of AFE in case series varies from 0% to 100% with numerous rates in between. CONCLUSION: The AFE mortality rate in population-based studies varied from 11% to 44% with the best available evidence supporting an overall mortality rate of 20.4%. Data from case series should no longer be used as a basis for describing the lethality of AFE.

Obstetric Hemorrhage Education in the United States Survey of Current Efforts and Policy Options.

OBJECTIVE: To characterize efforts to improve obstetric hemorrhage education by state health departments and to evaluate them for guiding public policy. STUDY DESIGN: A survey with questions about maternal mortality/hemorrhage assessments and hemorrhage education for health professionals was emailed to public health officials in all 50 states. Follow-up phone calls and emails were sent over 5 months to maximize participation. A nationwide initiative for educating health professionals in treating chest pain was also examined. RESULTS: Responses were received from 34 states; 31 had legislative or regulatory requirements for identification and/or investigation of maternal deaths. Obstetric hemorrhage education among states is voluntary with the exception of Illinois, which had a regulatory require- ment. In contrast, a nationwide voluntary accreditation program for chest pain had over 1,000 accredited centers in the 10 years or so since being established. CONCLUSION: Only a few states had. voluntary efforts in place for obstetric hemorrhage education. A sin- gle state, Illinois, has a. mandatory education require- ment. A voluntary niodel of accreditation based on the example of Chest Pain Centers might serve as a faster way to provide education to large numbers of health pro- fessionals.

Intimate Partner Violence and Subsequent Depression: Examining the Roles of Neighborhood Supportive Mechanisms.

This study examines the direct effects of neighborhood supportive mechanisms (e.g., collective efficacy, social cohesion, social networks) on depressive symptoms among females as well as their moderating effects on the impact of IPV on subsequent depressive symptoms. A multilevel, multivariate Rasch model was used with data from the Project on Human Development in Chicago Neighborhoods to assess the existence of IPV and later susceptibility of depressive symptoms among 2959 adult females in 80 neighborhoods. Results indicate that neighborhood collective efficacy, social cohesion, social interactions, and the number of friends and family in the neighborhood reduce the likelihood that females experience depressive symptoms. However, living in areas with high proportions of friends and relatives exacerbates the impact of IPV on females' subsequent depressive symptoms. The findings indicate that neighborhood supportive mechanisms impact interpersonal outcomes in both direct and moderating ways, although direct effects were more pronounced for depression than moderating effects. Future research should continue to examine the positive and potentially mitigating influences of neighborhoods in order to better understand for whom and under which circumstances violent relationships and mental health are influenced by contextual factors.

Acetabular cartilage assessment in patients with femoroacetabular impingement by using T2* mapping with arthroscopic verification.

PURPOSE: To evaluate the ability of T2* mapping to help differentiate damaged from normal acetabular cartilage in patients with femoroacetabular impingement (FAI). MATERIALS AND METHODS: The institutional review board approved this retrospective study, and the requirement to obtain informed consent was waived. The study complied with HIPAA guidelines. The authors reviewed T2* relaxation time maps of 28 hips from 26 consecutive patients (mean patient age, 28.2 years; range, 12-53 years; eight male patients (nine hips) with a mean age of 26.7 years [range, 16-53 years]; 18 female patients (19 hips) with a mean age of 28.9 years [range, 12-46 years]). Conventional diagnostic 3.0-T magnetic resonance (MR) arthrography was augmented by including a multiecho gradient-recalled echo sequence for T2* mapping. After imaging, acetabular and femoral data were separated and acetabular regions of interest were identified. Arthroscopic cartilage assessment with use of a modified Beck scale for acetabular cartilage damage was performed by an orthopedic surgeon who was blinded to the results of T2* mapping. A patient-specific acetabular projection with a T2* overlay was developed to anatomically correlate imaging data with those from surgery (the standard of reference). Results were analyzed by using receiver operating characteristic (ROC) curves. RESULTS: The patient-specific acetabular projection enabled co-localization between the MR imaging and arthroscopic findings. T2* relaxation times for normal cartilage (Beck score 1, 35.3 msec ± 7.0) were significantly higher than those for cartilage with early changes (Beck score 2, 20.7 msec ± 6.0) and cartilage with more advanced degeneration (Beck scores 3-6, ≤19.8 msec ± 5.6) (P < .001). At ROC curve analysis, a T2* value of 28 msec was identified as the threshold for damaged cartilage, with a 91% true-positive and 13% false-positive rate for differentiating Beck score 1 cartilage (normal) from all other cartilages. CONCLUSION: The patient-specific acetabular projection with a T2* mapping overlay enabled good anatomic localization of cartilage damage defined with a T2* threshold of 28 msec and less.

Susceptibility weighted imaging of cartilage canals in porcine epiphyseal growth cartilage ex vivo and in vivo.

PURPOSE: High-resolution visualization of cartilage canals has been restricted to histological methods and contrast-enhanced imaging. In this study, the feasibility of non-contrast-enhanced susceptibility weighted imaging (SWI) for visualization of the cartilage canals was investigated ex vivo at 9.4 T, further explored at 7 and 3 T and demonstrated in vivo at 7 T, using a porcine animal model. METHODS: SWI scans of specimens of distal femur and humerus from 1 to 8 week-old piglets were conducted at 9.4 T using 3D-GRE sequence and SWI post-processing. The stifle joints of a 2-week old piglet were scanned ex vivo at 7 and 3 T. Finally, the same sites of a 3-week-old piglet were scanned, in vivo, at 7 T under general anesthesia using the vendor-provided sequences. RESULTS: High-contrast visualization of the cartilage canals was obtained ex vivo, especially at higher field strengths; the results were confirmed histologically. In vivo feasibility was demonstrated at 7 T and comparison of ex vivo scans at 3 and 7 T indicated feasibility of using SWI at 3 T. CONCLUSIONS: High-resolution 3D visualization of cartilage canals was demonstrated using SWI. This demonstration of fully noninvasive visualization opens new avenues to explore skeletal maturation and the role of vascular supply for diseases such as osteochondrosis.

Generation of gas-phase zirconium fluoroanions by electrospray of an ionic liquid.

RATIONALE: New approaches for forming anions are sought that have strong abundance and no isobaric overlap, attributes that are compatible with the measurement of isotope ratios. Fluoroanions are particularly attractive because fluorine is monoisotopic, and thus will not have overlapping isobars with the isotope of interest. Since many elements do not have positive electron affinity values, they do not form stable negative atomic ions, and hence are not compatible with isotope ratio measurement using high sensitivity isotope ratio mass spectrometers such as accelerator mass spectrometers. METHODS: Zirconium fluoroanions were prepared using the fluorinating ionic liquid (IL) 1-ethyl-3-methylimidazolium fluorohydrogenate, which was used to generate abundant [ZrF5](-) ions using electrospray ionization. The IL was dissolved in acetonitrile, combined with a dilute solution of either Zr(4+) or ZrO(2+), and then electrosprayed. Mass analysis and collision-induced dissociation experiments were conducted using a time-of-flight mass spectrometer. Cluster structures were predicted using density functional theory calculations. RESULTS: The fluorohydrogenate IL solutions generated abundant [ZrF5](-) ions starting from solutions of both Zr(4+) and ZrO(2+). The mass spectra also contained IL-bearing cluster ions, whose compositions indicated the presence of [ZrF6](2-) in solution, a conclusion supported by the structural calculations. Rinsing out the zirconium-IL solution with acetonitrile decreased the IL clusters, but enhanced [ZrF5](-), which was sorbed by the polymeric electrospray supply capillary, and then released upon rinsing. This reduced the ion background in the mass spectrum. CONCLUSIONS: The fluorohydrogenate-IL solutions are a facile way to form zirconium fluoroanions in the gas phase using electrospray. The approach has potential as a source of fluoroanions for isotope ratio measurements, which would enable high-sensitivity measurement of minor zirconium isotopes without overlapping isobars caused by the charge carrier (i.e., the monoisotopic fluorine atoms).

Expression and function of scalloped during Drosophila development.

BACKGROUND: The scalloped (sd) and vestigial (vg) genes function together in Drosophila wing development. Little is known about sd protein (SD) expression during development, or whether sd and vg interact in other developing tissues. To begin to address these questions, we generated an anti-SD antibody. RESULTS: During embryogenesis, SD is expressed in both central and peripheral nervous systems, and the musculature. SD is also expressed in developing flight appendages. Despite SD expression herein, the peripheral nervous system, musculature, and dorsal limb primordia appeared generally normal in the absence of sd function. SD is also expressed in subsets of ventral nerve cord cells, including neuroblast 1-2 descendants and ventral unpaired median motor neurons (mVUMs). While sd function is not required to specify these neurons, it is necessary for the correct innervation of somatic muscles by the mVUMs. We also show that SD and vg protein (VG) are co-expressed in overlapping and distinctive subsets of cells in embryonic and larval tissues. CONCLUSIONS: We describe the full breadth of SD expression during Drosophila embryogenesis, and identify a requirement for sd function in a subset of motor neurons. This work provides the necessary foundation for functional studies regarding the roles of sd during Drosophila development.

Plasma: indications, controversies, and opportunities.

Plasma is overused as a blood product worldwide; however, data supporting appropriate use of plasma is scant. Its most common utilization is for treatment of coagulopathy in actively bleeding patients; it is also used for coagulation optimization prior to procedures with specific coagulation profile targets. A baseline literature review in PUBMED and Google Scholar was done (1 January 2000 to 1 June 2023), utilizing the following search terms: plasma, fresh frozen plasma, lyophilized plasma, indications, massive transfusion protocol, liver disease, warfarin reversal, cardiothoracic surgery, INR < 2. An initial review of the titles and abstracts excluded all articles that were not focused on transfusional medicine. Additional references were obtained from citations within the retrieved articles. This narrative review discusses the main indications for appropriate plasma use, mainly coagulation factor replacement, major hemorrhage protocol, coagulopathy in liver disease, bleeding in the setting of vitamin K antagonists, among others. The correlation between concentration of coagulation factors and INR, as well as the proper plasma dosing with its volume being weight-based, is also discussed. A high value approach to plasma utilization is supported with a review of the clinical situations where plasma is overutilized or unnecessary. Finally, a discussion of novel plasma products is presented for enhanced awareness.

Design considerations regarding ellipsoidal mirror based reflectometers.

Hemi-ellipsoidal mirrors are used in reflection-based measurements due to their ability to collect light scattered from one focal point at the other. In this paper, a radiometric model of this energy transfer is derived for arbitrary mirror and detector geometries. This model is used to examine the imaging characteristics of the mirror away from focus for both diffuse and specular light. The radiometric model is applied to several detector geometries for measuring the Directional Hemispherical Reflectance for both diffuse and specular samples. The angular absorption characteristics of the detector are then applied to the measurement to address measurement accuracy for diffuse and specular samples. Examining different detector configurations shows the effectiveness of flat detectors at angles ranging from normal to 50°, and that multifaceted detectors can function from normal incidence to grazing angles.

Fluorohydrogenate cluster ions in the gas phase: electrospray ionization mass spectrometry of the [1-ethyl-3-methylimidazolium(+)][F(HF)2.3(-)] ionic liquid.

Electrospray ionization of the fluorohydrogenate ionic liquid [1-ethyl-3-methylimidazolium][F(HF)2.3] ionic liquid was conducted to understand the nature of the anionic species as they exist in the gas phase. Abundant fluorohydrogenate clusters were produced; however, the dominant anion in the clusters was [FHF(-)], and not the fluoride-bound HF dimers or trimers that are seen in solution. Density functional theory (DFT) calculations suggest that HF molecules are bound to the clusters by about 30 kcal/mol. The DFT-calculated structures of the [FHF(-)]-bearing clusters show that the favored interactions of the anions are with the methynic and acetylenic hydrogen atoms on the imidazolium cation, forming planar structures similar to those observed in the solid state. A second series of abundant negative ions was also formed that contained [SiF5(-)] together with the imidazolium cation and the fluorohydrogenate anions that originate from reaction of the spray solution with silicate surfaces.

Accuracy of routine fat-suppressed FLAIR and diffusion-weighted images in detecting clinically evident acute optic neuritis.

BACKGROUND: Contrast-enhanced, fat-suppressed T1-weighted imaging (CET1WI) magnetic resonance imaging (MRI) is quite sensitive in detecting acute optic neuritis (ON), but ON remains a clinical diagnosis. MRI is indicated to evaluate demyelinating brain lesions rather than the optic nerves, while "routine" brain protocols typically include axial FLAIR and DWI. PURPOSE: To evaluate the accuracy of axial, fat-suppressed FLAIR and DWI sequences used for our routine brain imaging in detecting acute ON, as compared to CET1WI and the clinical diagnosis. MATERIAL AND METHODS: The clinical data and MRI examinations were retrospectively reviewed of 60 patients presenting to a neuro-ophthalmologist for various visual symptoms. Each patient underwent dedicated neuro-ophthalmologic examination, with axial 5 mm fat-suppressed FLAIR and DWI (part of "routine" brain MRI protocol), as well as 3 mm axial and coronal fat-suppressed CET1WI (part of dedicated orbit MRI protocol). Two neuroradiologists independently evaluated FLAIR and DWI, while CET1WI was reviewed by consensus. RESULTS: Thirty-one patients were clinically positive, 29 negative for ON (total = 34 positive and 86 negative nerves). The sensitivities of FLAIR, DWI, and CET1WI for ON were 75.7-77.3%, 77.3%, and 89.5%, respectively; the specificities were 90.5-93.5%, 80.4-82.7%, and 86.0%, respectively; the accuracies were 85.7-88.2%, 79.5-81.1%, and 87.0%, respectively. Inter-observer kappa was 0.783 for FLAIR, and 0.605 for DWI; intra-observer kappa was 0.746-0.816 for FLAIR, and 0.674-0.699 for DWI (each P < 0.0001). CONCLUSION: Being more specific, but not as sensitive, as dedicated CET1WI in acute ON, axial fat-suppressed FLAIR likely has additional value in evaluating for acute ON in "routine" brain MR protocols evaluating for demyelinating disease, while DWI may be hampered by artifacts.

Illuminating practitioner challenges in energy transitions.

Sustainable development (SD) is a concept that can be used to address complex challenges, including energy transitions. SD offers diverse strategies that provide useful direction in navigating tensions, trade-offs and synergies in energy transitions. The purpose of this research was to identify the challenges that energy practitioners are faced with in energy transitions and explore potential solutions. To achieve this purpose, we identified and explored the challenges faced by energy practitioners in Canada. Specifically, we conducted a survey of 34 energy practitioners from across Canada, as well as in-depth interviews with the Energy Futures Lab design team (which is a civil society initiative actively working on the energy transition in Canada). We identified the following challenges faced by energy practitioners in Canada: there is no simple, single solution for energy transitions; energy transitions have potentially conflicting considerations; energy systems have potentially conflicting goals; energy practitioners have different levels of trust and competencies in key actors; energy practitioners need to work across the political spectrum; and the costs and benefits of energy transitions are unevenly distributed. We discuss how the three strategies of SD (i.e., economic choice, political choice, social choice) could be applied to manage the intended and unintended tensions and trade-offs inherent in energy transitions. We conclude that the three SD strategies are not always equally valued by energy practitioners, but they have the potential to be useful in different energy transitions scenarios.

Stimulation of Pro-inflammatory Cytokines in Mixed Cultures of Peripheral Blood Mononuclear Cells and Anaerobic Bacteria.

In the last couple of decades, much progress has been made in studying bacteria living in humans. However, there is much more to learn about bacteria immune cell interactions. Here, we show that anaerobic bacteria do not grow when cultured overnight with human cells under atmospheric air. Air contains about 18% oxygen, which inhibits the growth of these bacteria while supporting the cultivation of human cells. The bacteria cultured with human peripheral blood mononuclear cells (PBMCs) inflamed with phytohemagglutinin (PHA) greatly increased the production of proinflammatory cytokines like tumor necrosis factor-alpha (TNFα) while inhibiting the production of monocyte chemoattractant protein-1 (MCP-1), an important chemokine.

Current concepts of immunology and diagnosis in amniotic fluid embolism.

Amniotic fluid embolism (AFE) is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylaxis appears to be doubtful while the available evidence supports a role for complement activation. With the mechanism remaining to be elucidated, AFE remains a clinical diagnosis. It is diagnosed based on one or more of four key signs/symptoms: cardiovascular collapse, respiratory distress, coagulopathy, and/or coma/seizures. The only laboratory test that reliably supports the diagnosis is the finding of fetal material in the maternal pulmonary circulation at autopsy. Perhaps the most compelling mystery surrounding AFE is not why one in 20,000 parturients are afflicted, but rather how the vast majority of women can tolerate the foreign antigenic presence of their fetus both within their uterus and circulation?

Uterine intravascular fetal material and coagulopathy at peripartum hysterectomy.

BACKGROUND/AIMS: To test the hypothesis that obstetrical disseminated intravascular coagulopathy results from an excessive leakage of fetal material into the maternal circulation. METHODS: All peripartum hysterectomy cases for hemorrhage at two suburban Illinois hospitals over 10 years were included. Intravascular presence of fetal material was determined by two pathologists blinded to each other and to any clinical information. For a given diagnosis, the percentage of intravascular fetal material in those patients with the diagnosis was compared with those without that diagnosis using Fisher's exact test. RESULTS: Seven diagnoses were attributed to the etiology of the hemorrhage: uterine rupture, abruption, uterine atony, placenta previa, accreta, coagulopathy, and retained placenta. Each of these diagnostic categories had fetal material present--ranging from 20 to 33%, but there were no statically significant differences. Secondary outcome measures of morbidity demonstrated that blood transfusion and intraoperative bladder injury were the chief comorbidities of peripartum hysterectomy. CONCLUSION: Maternal intravascular fetal material at the time of peripartum hysterectomy is present in up to one third of patients and does not invariably result in disseminated intravascular coagulopathy.

Investigation of uranyl nitrate ion pairs complexed with amide ligands using electrospray ionization ion trap mass spectrometry and density functional theory.

Ion populations formed from electrospray of uranyl nitrate solutions containing different amides vary depending on ligand nucleophilicity and steric crowding at the metal center. The most abundant species were ion pair complexes having the general formula [UO(2)(NO(3))(amide)(n=2,3)](+); however, singly charged complexes containing the amide conjugate base and reduced uranyl UO(2)(+) were also formed as were several doubly charged species. The formamide experiment produced the greatest diversity of species resulting from weaker amide binding, leading to dissociation and subsequent solvent coordination or metal reduction. Experiments using methyl formamide, dimethyl formamide, acetamide, and methyl acetamide produced ion pair and doubly charged complexes that were more abundant and less abundant complexes containing solvent or reduced uranyl. This pattern is reversed in the dimethylacetamide experiment, which displayed lower abundance doubly charged complexes, but augmented reduced uranyl complexes. DFT investigations of the tris-amide ion pair complexes showed that interligand repulsion distorts the amide ligands out of the uranyl equatorial plane and that complex stabilities do not increase with increasing amide nucleophilicity. Elimination of an amide ligand largely relieves the interligand repulsion, and the remaining amide ligands become closely aligned with the equatorial plane in the structures of the bis-amide ligands. The studies show that the phenomenological distribution of coordination complexes in a metal-ligand electrospray experiment is a function of both ligand nucleophilicity and interligand repulsion and that the latter factor begins exerting influence even in the case of relatively small ligands like the substituted methyl-formamide and methyl-acetamide ligands.