Response to Comment on "Tropical forests are a net carbon source based on aboveground measurements of gain and loss".

The Hansen et al critique centers on the lack of spatial agreement between two very different datasets. Nonetheless, properly constructed comparisons designed to reconcile the two datasets yield up to 90% agreement (e.g., in South America).

A Global Deal For Nature: Guiding principles, milestones, and targets.

The Global Deal for Nature (GDN) is a time-bound, science-driven plan to save the diversity and abundance of life on Earth. Pairing the GDN and the Paris Climate Agreement would avoid catastrophic climate change, conserve species, and secure essential ecosystem services. New findings give urgency to this union: Less than half of the terrestrial realm is intact, yet conserving all native ecosystems-coupled with energy transition measures-will be required to remain below a 1.5°C rise in average global temperature. The GDN targets 30% of Earth to be formally protected and an additional 20% designated as climate stabilization areas, by 2030, to stay below 1.5°C. We highlight the 67% of terrestrial ecoregions that can meet 30% protection, thereby reducing extinction threats and carbon emissions from natural reservoirs. Freshwater and marine targets included here extend the GDN to all realms and provide a pathway to ensuring a more livable biosphere.

Tropical forests are a net carbon source based on aboveground measurements of gain and loss.

The carbon balance of tropical ecosystems remains uncertain, with top-down atmospheric studies suggesting an overall sink and bottom-up ecological approaches indicating a modest net source. Here we use 12 years (2003 to 2014) of MODIS pantropical satellite data to quantify net annual changes in the aboveground carbon density of tropical woody live vegetation, providing direct, measurement-based evidence that the world's tropical forests are a net carbon source of 425.2 ± 92.0 teragrams of carbon per year (Tg C year-1). This net release of carbon consists of losses of 861.7 ± 80.2 Tg C year-1 and gains of 436.5 ± 31.0 Tg C year-1 Gains result from forest growth; losses result from deforestation and from reductions in carbon density within standing forests (degradation or disturbance), with the latter accounting for 68.9% of overall losses.

Iron lung treatment of subjects with COPD in acute respiratory failure. Evaluation of short- and long-term prognosis.

We evaluated retrospectively the short-term and the long-term prognosis of 105 patients with COPD and prolonged respiratory insufficiency admitted to our respiratory intensive care unit from 1976 to 1980 for acute respiratory failure. All subjects underwent intermittent negative pressure ventilation by means of an iron lung to overcome the acute episode. Twelve patients died during hospitalization, six were lost after discharge, while 87 were successfully weaned and were included in a follow-up lasting five years. All relapses of ARF were treated by INPV. The survival rates after one and five years were 82 percent and 37 percent, respectively and were significantly influenced by factors such as age, chronic cor pulmonale, FEV1/VC, PaCO2 on admission. The survival rate observed in our patients was better than that reported previously by other authors in COPD patients with ARF submitted to mechanical ventilation after intubation. These results suggest that INPV can improve survival in this category of patients, but a controlled clinical trial will be needed to address this issue.

Practice of opportunistic PSA screening in the Florence District.

The widespread use of the prostate-specific antigen (PSA) test had a great impact on the rise of incidence of prostate cancer. The magnitude of opportunistic screening by PSA varies across countries, being highest in the US, and considerably lower in Europe. To estimate the opportunistic use of PSA over the period of one year (2000) in the District of Florence, we analysed the Regional Database of diagnostic exams. According to the Regional Database, subjects having at least one PSA test during the year 2000 ranged from 5.8 to 6.7%, 8.8-10.8%, 11.7-15.0%, 16.5-22.3%, 18.0-24.3%, 17.0-23.8% and 14.1-18.3% in the 50-54, 55-59, 60-64, 65-69, 70-74, 75-79 and >79 years age groups, respectively. Minimum and maximum values are reported according to exclusion or inclusion of PSA determinations with incomplete subject identification data. Such a high use of PSA should deserve special attention from both the medical and health care provider community. The aim of the present study was to evaluate the frequency of opportunistic screening by PSA in the District of Florence in the general population.

Respiratory impedance and bronchodilator response in healthy Italian preschool children.

OBJECTIVE: To define normal values for respiratory resistance (R(rs)) and reactance (X(rs)) and bronchodilator response (BDR) in a population of healthy Italian preschool children using a commercially available forced oscillation device. METHODS: R(rs) and X(rs) were measured in kindergartens in Viterbo, Italy. Regression analysis was performed taking into account height, weight, age, gender, and reference equations calculated. The coefficient of repeatability (CR) between two tests performed 15 min apart was calculated in a subset of children. BDR was assessed by repeating the measurements 15 min after the administration of 200 µg of inhaled salbutamol and calculated as an absolute change in R(rs) and X(rs) at 8 Hz, as a percent change in baseline, and as a change in Z-score calculated from the reference equations. RESULTS: Lung function was attempted in 175 healthy children and successful in 163 (81 male, median age 4.8, range 2.9-6.1 years). R(rs) and X(rs) at 6, 8, and 10 Hz were related to height but not other variables. The CR was 1.53 hPa s L(-1) for R(rs8) and 0.91 hPa s L(-1) for X(rs8). The 5th percentile for absolute R(rs8) BDR was -3.16 hPa s L(-1), whereas the 95th percentile for absolute X(rs8) BDR was 2.25 hPa s L(-1). These cut-off values corresponded to a change in the Z-score of -1.88 and 2.48, respectively. CONCLUSIONS: We have established reference equations for R(rs) and X(rs) in healthy Italian preschool children using forced oscillations. We recommend a change in Z-score of -1.88 for R(rs8) and 2.48 for X(rs8) as cut-off values for a positive BDR.

Clustering time-series gene expression data using smoothing spline derivatives.

Microarray data acquired during time-course experiments allow the temporal variations in gene expression to be monitored. An original postprandial fasting experiment was conducted in the mouse and the expression of 200 genes was monitored with a dedicated macroarray at 11 time points between 0 and 72 hours of fasting. The aim of this study was to provide a relevant clustering of gene expression temporal profiles. This was achieved by focusing on the shapes of the curves rather than on the absolute level of expression. Actually, we combined spline smoothing and first derivative computation with hierarchical and partitioning clustering. A heuristic approach was proposed to tune the spline smoothing parameter using both statistical and biological considerations. Clusters are illustrated a posteriori through principal component analysis and heatmap visualization. Most results were found to be in agreement with the literature on the effects of fasting on the mouse liver and provide promising directions for future biological investigations.

Respiratory muscle insufficiency in acute respiratory failure of subjects with severe COPD: treatment with intermittent negative pressure ventilation.

Nine subjects with severe chronic obstructive pulmonary disease (COPD) in acute respiratory failure (ARF) and with marked weakness of the respiratory muscles (Group A) underwent intermittent negative pressure ventilation by means of an iron lung (8 h daily for 7 days). Seven subjects with COPD in stabilized chronic respiratory failure (Group B) were studied as controls and submitted to the same medical therapy without ventilator treatment. Functional respiratory tests were performed before and after 7 days of treatment. After ventilatory treatment, Group A showed an increase of maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax), vital capacity (VC), arterial oxygen tension (PaO2), pH and a decrease of residual volume (RV), total lung capacity of (TLC) and arterial carbon dioxide tension (PaCO2) (all statistically significant). No improvement was ascertained in the functional parameters of Group B. The expiratory muscles seem to play a determining role in ARF. We conclude that the iron lung is a useful therapeutic defence in removing muscular fatigue and in restoring a good level of respiratory compensation of ARF in severe COPD.