Transcriptomic responses of Mediterranean sponges upon encounter with symbiont microbial consortia.

BACKGROUND: Sponges (phylum Porifera) constantly interact with microbes. They graze on microbes from the water column by filter-feeding and they harbor symbiotic partners within their bodies. In experimental setups, sponges take up symbionts at lower rates compared with seawater microbes. This suggests that sponges have the capacity to differentiate between microbes and preferentially graze in non-symbiotic microbes, although the underlying mechanisms of discrimination are still poorly understood. Genomic studies showed that, compared to other animal groups, sponges present an extended repertoire of immune receptors, in particular NLRs, SRCRs, and GPCRs, and a handful of experiments showed that sponges regulate the expression of these receptors upon encounter with microbial elicitors. We hypothesize that sponges may rely on differential expression of their diverse repertoire of poriferan immune receptors to sense different microbial consortia while filter-feeding. To test this, we characterized the transcriptomic response of two sponge species, Aplysina aerophoba and Dysidea avara, upon incubation with microbial consortia extracted from A. aerophoba in comparison with incubation with seawater microbes. The sponges were sampled after 1 h, 3 h, and 5 h for RNA-Seq differential gene expression analysis. RESULTS: D. avara incubated with A. aerophoba-symbionts regulated the expression of genes related to immunity, ubiquitination, and signaling. Within the set of differentially-expressed immune genes we identified different families of Nucleotide Oligomerization Domain (NOD)-Like Receptors (NLRs). These results represent the first experimental evidence that different types of NLRs are involved in microbial discrimination in a sponge. In contrast, the transcriptomic response of A. aerophoba to its own symbionts involved comparatively fewer genes and lacked genes encoding for immune receptors. CONCLUSION: Our work suggests that: (i) the transcriptomic response of sponges upon microbial exposure may imply "fine-tuning" of baseline gene expression as a result of their interaction with microbes, (ii) the differential response of sponges to microbial encounters varied between the species, probably due to species-specific characteristics or related to host's traits, and (iii) immune receptors belonging to different families of NLR-like genes played a role in the differential response to microbes, whether symbionts or food bacteria. The regulation of these receptors in sponges provides further evidence of the potential role of NLRs in invertebrate host-microbe interactions. The study of sponge responses to microbes exemplifies how investigating different animal groups broadens our knowledge of the evolution of immune specificity and symbiosis.

Genetic analysis of late-maturity α-amylase in twelve wheat populations.

MAIN CONCLUSION: Genetic loci, particularly those with an effect in the independent panel, could be utilised to further reduce LMA expression when used with favourable combinations of genes known to affect LMA. Late maturity α-amylase (LMA) is a grain quality defect involving elevated α-amylase within the aleurone of wheat (Triticum aestivum L.) grains. The genes known to affect expression are the reduced height genes Rht-B1 (chromosome 4B) and Rht-D1 (chromosome 4D), and an ent-copalyl diphosphate synthase gene (LMA-1) on chromosome 7B. Other minor effect loci have been reported, but these are poorly characterised and further genetic understanding is needed. In this study, twelve F4-derived populations were created through single seed descent, genotyped and evaluated for LMA. LMA-1 haplotype C and the Rht-D1b allele substantially reduced LMA expression. The alternative dwarfing genes Rht13 and Rht18 had no significant effect on LMA expression. Additional quantitative trait loci (QTL) were mapped at 16 positions in the wheat genome. Effects on LMA expression were detected for four of these QTL in a large independent panel of Australian wheat lines. The QTL detected in mapping populations and confirmed in the large independent panel provide further opportunity for selection against LMA, especially if combined with Rht-D1b and/or favourable haplotypes of LMA-1.

Comparison of the LMA BlockBuster and intubating LMA as a conduit to blind tracheal intubation.

Background and Aims: Primary aim of the study was to evaluate the performance of Intubating LMA (ILMA) and blockbuster LMA in terms of first pass success rate, ease and duration taken for blind tracheal intubation. Material and Methods: The present prospective randomised study was conducted on 70 patients of either sex aged 18-60 years belonging to ASA physical status I or II. Patients were randomly allocated to either, group I and group B of n = 35 each. In group I and B patients were intubated using ILMA and LMA BlockBuster respectively. Insertion time and ease of placement of supraglottic device, total time taken for successful intubation, number of attempts for endotracheal tube (ETT) placement, and ease of placement of ETT, were recorded. Results: In both groups, the supraglottic device was placed on the first attempt in 88.6% patients. The first-attempt success rate for ETT placement was 71.4% in group I versus 94.3% in group B, (P = 0.01) with an overall success rate of 88.5% in group I and 100% in group. More failure rate was observed in group I (11.4%) compared to group B (0%). The total time taken for successful intubation in group I was 11.53 ± 6.410 sec and 9.17 ± 2.749 sec in group B (P = 0.04). Conclusion: We conclude that the modifications in the design of LMA Blockbuster (>95° angle, availability of the parker flex tube 27-30°angle of the emergence of airway tube) make it a more convenient, effective, simpler, and faster intubating device than ILMA.

Comparative evaluation of self-pressurized Air-Q® and Proseal™ LMA® in patients undergoing elective surgery under general anaesthesia: A randomized clinical trial.

Background and Aims: Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. Material and Methods: The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. Results: All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Conclusions: Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.

Comparison of insertion characteristics of LMA ProSeal from the front and head-end of the patient: A randomized pilot study.

Background and Aims: LMA ProSeal (PLMA) is a commonly used airway maintenance device in elective procedures and is routinely inserted from the head-end of the patient. It is also used in pre-hospital emergencies where it may not always be possible to access the head-end. This study aims to compare the insertion characteristics of PLMA when inserted while standing, either at the head-end or from the front. Material and Methods: After institutional ethics committee approval, 60 consenting patients of either sex, between 18 and 60 years, ASA class I/II, and scheduled to undergo elective surgeries were randomly allocated to either group H (head-end insertion) or group F (front-end insertion). Patients with anticipated difficult airway, chronic respiratory disease, obesity, and who were pregnant were excluded. Insertion time, ease of insertion, fiber optic view, ease of drain tube insertion, number of attempts and success rate were noted. Normally distributed quantitative variables were compared using t-test, and qualitative variables were compared using Chi-squared test. A P < 0.05 was considered significant. Results: Insertion time in group H (23.76 ± 4.48 s) was lesser than in group F (30.53 ± 6.23s) (P = 0.027). Ease of insertion (P = 0.052), fiber optic view, ease of drain tube placement (P = 1.000), and number of attempts (P = 1.000) were comparable among the groups. Conclusion: Although the insertion time from the front is longer than from the head-end, the other insertion characteristics of PLMA including ease of its insertion, placement and success rate of placement are similar when it is inserted from the front or from the head-end. It is an appropriate airway device for securing the airway when the head-end is inaccessible.

Multiple loci with cumulative effects on late maturity α-amylase (LMA) in wheat.

MAIN CONCLUSION: The cumulative action of combinations of alleles at several loci on the wheat genome is associated with different levels of resistance to late maturity α-amylase in bread wheat. Resistance to late maturity α-amylase (LMA) in bread wheat (Triticum aestivum L.) involves a complex interaction between the genotype and the environment. Unfortunately, the incidence and severity of LMA expression is difficult to predict and once the trait has been triggered an unacceptably low falling number, high grain α-amylase may be the inevitable consequence. Wheat varieties with different levels of resistance to LMA have been identified but whilst some genetic loci have been reported, the mechanisms involved in resistance and the interaction between resistance loci requires further research. This investigation was focused on mapping resistance loci in populations derived by inter-crossing resistant wheat varieties or crossing resistant lines with a very susceptible line and then mapping quantitative trait loci. In addition to the previously reported locus on chromosome 7B for which a candidate gene has been proposed, loci were mapped on chromosomes 1B, 2A, 2B, 3A, 3B, 4A, 6A and 7D. These loci have limited effects on their own but have a cumulative effect in combination with each other. Further research will be required to determine the nature of the causal genes at these loci, to develop diagnostic markers and determine how the genes fit into the pathway that leads to the induction of α-AMY1 transcription in the aleurone of developing wheat grains. Depending on the target environmental conditions, different combinations of alleles may be required to achieve a low risk of LMA expression.

The ratio of electron transport to assimilation (ETR/AN): underutilized but essential for assessing both equipment's proper performance and plant status.

MAIN CONCLUSION: ETR/AN ratios should be in the range 7.5-10.5 for non-stressed C3 plants. Ratios extremely out of this range can be reflecting both uncontrolled plant status and technical mistakes during measurements. We urge users to explicitly refer to this ratio in future studies as a proof for internal data quality control. For the last few decades, the use of infra-red gas-exchange analysers (IRGAs) coupled with chlorophyll fluorometers that allow for measurements of net CO2 assimilation rate and estimates of electron transport rate over the same leaf area has been popularized. The evaluation of data from both instruments in an integrative manner can result in additional valuable information, such as the estimation of the light respiration, mesophyll conductance and the partitioning of the flux of electrons into carboxylation, oxygenation and alternative processes, among others. In this review, an additional and more 'straight' use of the combination of chlorophyll fluorescence and gas exchange-derived parameters is presented, namely using the direct ratio between two fully independently estimated parameters, electron transport rate (ETR)-determined by the fluorometer-and net CO2 assimilation rate (AN)-determined by the IRGA, i.e., the ETR/AN ratio, as a tool for fast detection of incongruencies in the data and potential technical problems associated with them, while checking for the study plant's status. To illustrate this application, a compilation of 75 studies that reported both parameters for a total of 178 species under varying physiological status is presented. Values of ETR/AN between 7.5 and 10.5 were most frequently found for non-stressed C3 plants. C4 species showed an average ETR/AN ratio of 4.7. The observed ratios were larger for species with high leaf mass per area and for plants subjected to stressful factors like drought or nutritional deficit. Knowing the expected ETR/AN ratio projects this ratio as a routinary and rapid check point for guaranteeing both the correct performance of equipment and the optimal/stress status of studied plants. All known errors associated with the under- or overestimation of ETR or AN are summarized in a checklist that aims to be routinely used by any IRGA/fluorometer user to strength the validity of their data.

Diversity and structure of bacterial and archaeal communities associated with the vulnerable sponge Halichondria cebimarensis.

Sponges are essential components of the marine benthos and well known for their complex and abundant associated microbial communities. There are five endemic species of the genus Halichondria on the Brazilian coast and H. cebimarensis is one of the least studied. This sponge has a very limited geographic distribution and is classified as vulnerable. In order to understand the bacterial and archaeal communities associated with this sponge, samples of H. cebimarensis were collected from the southwestern Atlantic coast (Brazil, São Paulo state). Choanosome samples were separated and processed to be (i) inoculated in three different culture media; (ii) investigated by transmission electron microscopy; (iii) submitted to 16S rRNA metabarcoding. Forty isolates were obtained and 12 were identified as belonging to the Bacilli class. The culture-dependent approaches allowed us to access unique members of the microbial community. Our analyses revealed that this animal belongs to the Low Microbial Abundance group of sponges. Culture-independent approaches showed that the H. cebimarensis microbiome is dominated by the heterotrophic Gammaproteobacteria AqS2 ("Ca. Amphirhobacter heronislandensis"). This is the first study to reveal details of the microbiome of this vulnerable sponge and is an important step in understanding how this sponge functions, its biotechnological potential and a contribution to conservation efforts.

Gastrointestinal endoscopy procedures under intravenous sedation in the prone position: keep LMA gastro handy!

Gastrointestinal endoscopies are often done in the prone position and anesthesiologists are needed to provide sedation. Airway access is limited in the prone position and may make timely airway management difficult in case of airway obstruction during sedation. Specialized laryngeal mask airway devices customized for endoscopy procedures like LMA® Gastro™ can be inserted in the prone position and may help anesthesiologists tide over such crisis situations while simultaneously allowing the endoscopy procedures through the dedicated conduit available for inserting the endoscopes. We have described one such case managed successfully by inserting LMA® Gastro™ in the prone position.

The plastid-nucleus localized DNA-binding protein WHIRLY1 is required for acclimation of barley leaves to high light.

MAIN CONCLUSION: In accordance with a key role of WHIRLY1 in light-acclimation mechanisms, typical features of acclimation to high light, including photosynthesis and leaf morphology, are compromised in WHIRLY1 deficient plants. Acclimation to the environment requires efficient communication between chloroplasts and the nucleus. Previous studies indicated that the plastid-nucleus located WHIRLY1 protein is required for the communication between plastids and the nucleus in situations of high light exposure. To investigate the consequences of WHIRLY1 deficiency on the light acclimation of photosynthesis and leaf anatomy, transgenic barley plants with an RNAi-mediated knockdown of HvWHIRLY1 were compared to wild-type plants when growing at low and high irradiance. While wild-type plants showed the typical light acclimation responses, i.e. higher photosynthetic capacity and thicker leaves, the WHIRLY1 deficient plants were not able to respond to differences in irradiance. The results revealed a systemic role of WHIRLY1 in light acclimation by coordinating responses at the level of the chloroplast and the level of leaf morphology.

Spatial and environmental variables structure sponge symbiont communities.

Understanding the maintenance and origin of beta diversity is a central topic in ecology. However, the factors that drive diversity patterns and underlying processes remain unclear, particularly for host-prokaryotic associations. Here, beta diversity patterns were studied in five prokaryotic biotopes, namely, two high microbial abundance (HMA) sponge taxa (Xestospongia spp. and Hyrtios erectus), one low microbial abundance (LMA) sponge taxon (Stylissa carteri), sediment and seawater sampled across thousands of kilometres. Using multiple regression on distance matrices (MRM), spatial (geographic distance) and environmental (sea surface temperature and chlorophyll α concentrations) variables proved significant predictors of beta diversity in all five biotopes and together explained from 54% to 82% of variation in dissimilarity of both HMA species, 27% to 43% of variation in sediment and seawater, but only 20% of variation of the LMA S. carteri. Variance partitioning was subsequently used to partition the variation into purely spatial, purely environmental and spatially-structured environmental components. The amount of variation in dissimilarity explained by the purely spatial component was lowest for S. carteri at 11% and highest for H. erectus at 55%. The purely environmental component, in turn, only explained from 0.15% to 2.83% of variation in all biotopes. In addition to spatial and environmental variables, a matrix of genetic differences between pairs of sponge individuals also proved a significant predictor of variation in prokaryotic dissimilarity of the Xestospongia species complex. We discuss the implications of these results for the HMA-LMA dichotomy and compare the MRM results with results obtained using constrained ordination and zeta diversity.

Testing unified theories for ozone response in C4 species.

There is tremendous interspecific variability in O3  sensitivity among C3  species, but variation among C4  species has been less clearly documented. It is also unclear whether stomatal conductance and leaf structure such as leaf mass per area (LMA) determine the variation in sensitivity to O3 across species. In this study, we investigated leaf morphological, chemical, and photosynthetic responses of 22 genotypes of four C4 bioenergy species (switchgrass, sorghum, maize, and miscanthus) to elevated O3 in side-by-side field experiments using free-air O3 concentration enrichment (FACE). The C4  species varied largely in leaf morphology, physiology, and nutrient composition. Elevated O3 did not alter leaf morphology, nutrient content, stomatal conductance, chlorophyll fluorescence, and respiration in most genotypes but reduced net CO2 assimilation in maize and photosynthetic capacity in sorghum and maize. Species with lower LMA and higher stomatal conductance tended to show greater losses in photosynthetic rate and capacity in elevated O3 compared with species with higher LMA and lower stomatal conductance. Stomatal conductance was the strongest determinant of leaf photosynthetic rate and capacity. The response of both area- and mass-based leaf photosynthetic rate and capacity to elevated O3 were not affected by LMA directly but negatively influenced by LMA indirectly through stomatal conductance. These results demonstrate that there is significant variation in O3  sensitivity among C4  species with maize and sorghum showing greater sensitivity of photosynthesis to O3 than switchgrass and miscanthus. Interspecific variation in O3  sensitivity was determined by direct effects of stomatal conductance and indirect effects of LMA. This is the first study to provide a test of unifying theories explaining variation in O3  sensitivity in C4 bioenergy grasses. These findings advance understanding of O3 tolerance in C4  grasses and could aid in optimal placement of diverse C4 bioenergy feedstock across a polluted landscape.

Comparison of the third-generation streamlined liner of the pharynx airway (SLIPA-3G) with the laryngeal mask airway supreme for laparoscopic cholecystectomy: a randomized prospective study.

BACKGROUND: The third-generation streamlined liner of the pharynx airway (SLIPA-3G) is a new-generation supraglottic airway device (SAD) that is non-cuffed and disposable, with a sealing pressure that varies dynamically with the airway pressure. This study compared the SLIPA-3G with the laryngeal mask airway supreme (LMAS) in patients undergoing laparoscopic cholecystectomy. METHODS: Two hundred and twenty patients scheduled for laparoscopic cholecystectomy were randomly allocated to either the SLIPA-3G group or the LMAS group. Data were collected on the patients' hemodynamic parameters at different time points, ease of insertion, fiberoptic view, oropharyngeal leak pressure (OLP) at different time points and SAD-related complications. RESULTS: The mean OLP immediately after device placement in the LMAS group was significantly higher than that of the SLIPA-3G group (31.34 ± 6.99 cmH2O vs.28.94 ± 6.01 cmH2O, P = 0.008, 95% CI 0.62-4.17). The OLPs of the two groups were not significantly different after the induction of a pneumoperitoneum until the end of surgery. The OLP increased gradually through the course of the operation in the SLIPA-3G group (P value = 0.035) but not in the LMAS group (P value = 0.945). There was no significant difference between the two groups in hemodynamic parameters, insertion time and success rate, fiberoptic view and complication rate. CONCLUSIONS: The SLIPA-3G and LMAS were associated with comparable OLPs, hemodynamic parameters, ease of insertion, fiberoptic views and complication rates when used during laparoscopic cholecystectomy. The SLIPA-3G can be used as an effective alternative to the LMAS in patients undergoing laparoscopic surgeries.

THE HENNEPIN DOUBLE-TUBE TECHNIQUE: A MORE EFFICIENT METHOD OF TRACHEAL INTUBATION THROUGH THE LMA FASTRACH.

BACKGROUND: The LMA Fastrach (LMA North America, Inc; hereafter termed the intubating laryngeal mask airway [ILMA]) is an extraglottic device designed to facilitate endotracheal intubation. After the endotracheal tube is placed through the lumen of the ILMA into the trachea, the ILMA is removed, using a proprietary stabilizer rod to hold the tube in place. DISCUSSION: The traditional method of ILMA removal is not optimized for the critically ill patient. It requires the use of unfamiliar equipment, exposes the patient to a significant period without ventilation, and risks tube dislodgement. We designed a simple technique with a double-endotracheal tube setup that addresses these problems using common equipment, allowing for continuous ventilation, and minimizing the risk of tube dislodgement. CONCLUSIONS: The traditional method of ILMA removal around an endotracheal tube is not designed for critically ill patients or the physicians taking care of them. This novel technique is designed to improve the usability of the ILMA for physicians and improve airway outcomes for patients.

To compare clinical versus ultrasound assessment of correct placement of ProSeal Laryngeal mask airway (PLMA): a prospective randomized study.

Extraglottic airway devices (EAD) have revolutionized the perioperative airway management. The accuracy of clinical tests to identify malposition has been questioned by recent studies where fibreoptic evaluation identified various malpositions that were undiagnosed by a clinical test. Ultrasound (USG) has evolved to guide various airway interventions. However, USG is under-evaluated in the assessment of the EADs position. Our study aimed to compare clinical versus USG assessment of optimal placement of ProSeal laryngeal mask airway (PLMA). This randomized control trial was done in 212 consenting patients undergoing onco-surgery with PLMA as an airway device. Patients were randomized in Group CL (n-107) and US (n-105). Following primary assessment-using clinical tests and USG evaluation using a scoring system, fibreoptic evaluation of the placement of PLMA was done and then assessed for optimal position. The accuracy of each technique for optimal placement was compared statistically. We found that the sensitivity and specificity of the clinical evaluation were 98.77% and 34.62% with a diagnostic accuracy of 83.18% when compared with fibreoptic evaluation. While USG evaluation using the scoring system has sensitivity and specificity of 95.45% and 29.41% with a diagnostic accuracy of 84.76%. It was noted that USG assessment has a higher positive predictive value (87.5%) as compared to clinical assessment (82.47%). The incidence of rotation was higher in the clinical group. There was no difference in airway related morbidity. USG is comparable to clinical tests for evaluation of the optimal placement of PLMA. However, USG has various advantages over clinical assessment as it is quick and identifies the unacceptable placement of PLMA where the tip of PLMA may not lie over the tip of the esophagus, thereby, avoiding unnecessary mucosal injury during forceful or repeated attempts for gastric drainage tube insertion.Trial registration: Clinical Trials Registry (CTRI/2017/11/010359) dated 3rd November 2017.

A randomized comparative study of three supraglottic airway devices for controlled ventilation in anesthetized patients.

Background and Aims: The LMA® ProSeal™, LMA® Supreme™ and Ambu® AuraGain™ are second-generation supraglottic airway devices (SADs) with integrated gastric access. In this study, we compared the clinical performance of these three devices in adults for controlled ventilation in anesthetized paralysed patients. Material and Methods: Two hundred and seventy adults, American Society of Anesthesiologists (ASA) Physical Status I-III, undergoing elective surgical procedures, were randomized into three groups with 90 patients in each: Group 1: LMA® ProSeal™, Group 2: LMA® Supreme™ and Group 3: Ambu® AuraGain™. All the three devices were evaluated for oropharyngeal seal pressure (OSP) and other parameters: ease and the number of attempts at device placement, fibreoptic laryngeal view and intraoperative and postoperative complications. Results: In the present study, the mean OSP was 38.9 ± 3.050 cm H2O in the LMA ProSeal™ group, 37.41 ± 4.097 cm H2O in LMA® Supreme™ group and 37.32 ± 3.740 cm H2O in Ambu® AuraGain™ group. The difference was found to be statistically significant (P = 0.006). The three groups were comparable for the ease of device insertion, number of attempts at device placement, fibreoptic laryngeal view, intraoperative and postoperative complications. Conclusion: In this study, we found that the LMA® ProSeal™ provided the highest OSP in comparison to the other two devices, even though this difference is not clinically relevant. The use of Ambu® AuraGain™ was associated with difficult and lowest first-time insertion success rate (P < 0.001) along with an increased incidence of airway trauma as compared to the other two SADs.

A best-practice guide to predicting plant traits from leaf-level hyperspectral data using partial least squares regression.

Partial least squares regression (PLSR) modelling is a statistical technique for correlating datasets, and involves the fitting of a linear regression between two matrices. One application of PLSR enables leaf traits to be estimated from hyperspectral optical reflectance data, facilitating rapid, high-throughput, non-destructive plant phenotyping. This technique is of interest and importance in a wide range of contexts including crop breeding and ecosystem monitoring. The lack of a consensus in the literature on how to perform PLSR means that interpreting model results can be challenging, applying existing models to novel datasets can be impossible, and unknown or undisclosed assumptions can lead to incorrect or spurious predictions. We address this lack of consensus by proposing best practices for using PLSR to predict plant traits from leaf-level hyperspectral data, including a discussion of when PLSR is applicable, and recommendations for data collection. We provide a tutorial to demonstrate how to develop a PLSR model, in the form of an R script accompanying this manuscript. This practical guide will assist all those interpreting and using PLSR models to predict leaf traits from spectral data, and advocates for a unified approach to using PLSR for predicting traits from spectra in the plant sciences.

Brief Research Report: Prehospital Rapid Sequence Airway.

BACKGROUND: Rapid Sequence Airway (RSA) describes the administration of an induction agent and paralytic followed by the intended primary placement of an extraglottic airway device rather than an endotracheal tube. The purpose of this study was to determine the success rates for prehospital RSA. The secondary goal was to determine aspiration rates among patients managed with RSA. METHODS: Adult and pediatric prehospital RSA cases between 2005 and 2017 reported to an airway quality assurance registry from one ground and one air agency were reviewed. Success was defined as the ability to adequately ventilate patients after extraglottic device placement. Aspiration was defined as radiologic evidence (chest x-ray or CT scan) within 48 hours of hospital presentation. RESULTS: 68 patients underwent RSA with a King LTS-D (n = 24), LMA-Supreme (n = 28), Combitube (n = 2), LMA-Unique (n = 8) and iGel (n = 6). Age ranged from 1 year to 73 years with 10 patients less than 18. RSA was successful in 64 (94%) cases; 56 (88%) were successful on first pass and 63 (98%) within 2 attempts. The RSA procedure occurred in an aircraft in 14 (21%) of cases and 71% of patients were in cervical precautions. Duration of EGD insertion prior to hospital arrival ranged from 5 to 102 minutes with an average of 34.5 minutes. Aspiration data was available for 46 patients of whom 4 (8.7%) were found to have evidence of aspiration. CONCLUSION: Overall and first pass RSA success rates were high and aspiration rates were low in this quality assurance registry despite predictors of airway difficulty. RSA may be a reasonable alternative to RSI for prehospital airway management that merits further research.

A comparison of laryngeal mask airway-supreme and endotracheal tube use with respect to airway protection in patients undergoing septoplasty: a randomized, single-blind, controlled clinical trial.

BACKGROUND: There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airway protection against blood leakage through the fiberoptic bronchoscopy, oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events. METHODS: The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia. RESULTS: In the fiberoptic evaluation of the airway postoperatively, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not different between the two groups. CONCLUSION: The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases. TRIAL REGISTRATION: This trial is registered at the US National Institutes of Health ( ClinicalTrials.gov ) # NCT03903679 on April 5, 2019.

Long-term effects of 7-year warming experiment in the field on leaf hydraulic and economic traits of subtropical tree species.

Rising temperature associated with climate change may have substantial impacts on forest tree functions. We conducted a 7-year warming experiment in subtropical China by translocating important native forest tree species (Machilas breviflora, Syzygium rehderianum, Schima superba and Itea chinensis) from cooler high-elevation sites (600 m) to 1-2°C warmer low-elevation sites (300 and 30 m) to investigate warming effects on leaf hydraulic and economic traits. Here, we report data from the last 3 years (Years 5-7) of the experiment. Warming increased leaf hydraulic conductance of S. superba to meet the higher evaporative demand. M. breviflora (300 m), S. rehderianum, S. superba and I. chinensis (300 and 30 m) exhibited higher area-based and mass-based maximum photosynthetic rates (Aa and Am , respectively) related to increasing stomatal conductance (gs ) and stomatal density in the wet season, which led to rapid growth; however, we observed decreased growth of M. breviflora at 30 m due to lower stomatal density and decreased Aa in the wet season. Warming increased photosynthetic nitrogen-use efficiency and photosynthetic phosphorus-use efficiency, but reduced leaf dry mass per unit area due to lower leaf thickness, suggesting that these tree species allocated more resources into upregulating photosynthesis rather than into structural investment. Our findings highlight that there was trait variation in the capacity of trees to acclimate to warmer temperatures such that I. chinensis may benefit from warming, but S. superba may be negatively influenced by warming in future climates.