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Soil is the largest terrestrial carbon (C) reservoir and a large potential source or sink of atmospheric CO₂. Soil C models have usually focused on refining representations of microbe‐mediated C turnover, whereas lateral hydrologic C fluxes have largely been ignored at regional and global scales. Here, we provide large‐scale estimates of hydrologic export of soil organic carbon (SOC) and its effects on bulk soil C turnover rates. Hydrologic export of SOC ranged from nearly 0 to 12 g C m−2yr−1 amongst catchments across the conterminous United States, and total export across this region was 14 (95% CI 4‐41) Tg C/yr. The proportion of soil C turnover attributed to hydrologic export ranged from <1% to 20%, and averaged 0.97% (weighted by catchment area; 95% CI 0.3%–2.6%), with the lowest values in arid catchments. Ignoring hydrologic export in C cycle models might lead to overestimation of SOC stocks by 0.3–2.6 Pg C for the conterminous United States. High uncertainty in hydrologic C export fluxes and potentially substantial effects on soil C turnover illustrate the need for research aimed at improving our mechanistic understanding of the processes regulating hydrologic C export. Key Points: The rate of hydrologic export was estimated at 14 Tg C per yearHydrologic export can account for 0.5–20 percent of soil carbon turnover across conterminous U.S. watershedsOmitting hydrologic export from carbon cycle models can result in overestimation of soil carbon stocks by 0.3–2.6 Pg C [ABSTRACT FROM AUTHOR]

In lakes, the production and emission of methane (CH4) have been linked to lake trophic status. However, few studies have quantified the temporal response of lake CH4 dynamics to primary productivity at the ecosystem scale or considered how the response may vary across lakes. Here, we investigate relationships between lake CH4 dynamics and ecosystem primary productivity across both space and time using data from five lakes in northern Wisconsin, USA. From 2014 to 2019, we estimated hypolimnetic CH4 storage rates for each lake using timeseries of hypolimnetic CH4 concentration through the summer season. Across all lakes and years, hypolimnetic CH4 storage ranged from <0.001 to 7.6 mmol CH4 m−2 d−1 and was positively related to the mean summer rate of gross primary productivity (GPP). However, within‐lake temporal responses to GPP diverged from the spatial relationship, and GPP was not a significant predictor of interannual variability in CH4 storage at the lake scale. Using these data, we consider how and why temporal responses may differ from spatial patterns and demonstrate how extrapolating cross‐lake relationships for prediction at the lake scale may substantially overestimate the rate of change of CH4 dynamics in response to lake primary productivity. We conclude that future predictions of lake‐mediated climate feedbacks in response to a shifting distribution of trophic status should incorporate both varying lake responses and the temporal scale of change. Plain Language Summary: Many lakes produce substantial amounts of methane, a potent greenhouse gas. Previous research has found that more methane is produced from lakes with high algal biomass. However, little is known about how methane dynamics from a single lake respond to annual changes in algal biomass. By examining lake methane dynamics and metrics of algal biomass from five lakes across 5 years, we find that within‐lake responses of methane dynamics do not align with the across‐lake patterns we see when comparing different lakes. Within‐lake methane responses were different between lakes and were undetectable in some lakes. Understanding the temporal scale of how lakes respond to changes in algal biomas is important for predicting the role of lakes for producing methane under future environmental change scenarios. Key Points: Hypolimnetic methane storage was positively related to the mean summer rate of gross primary productivity across five lakes and 24 lake‐yearsYet within each lake, there was no relationship between hypolimnetic methane storage and mean summer gross primary productivityPredictions of lake methane responses to shifting trophic status should incorporate varying lake responses and the temporal scale of change [ABSTRACT FROM AUTHOR]

Introduction: For individuals with haemophilia A, prophylaxis with factor VIII (FVIII) is typically directed towards trough activity >1 IU/dL; however, some patients still experience spontaneous bleeding events (sBEs). Aim: Aims were to evaluate relationships of endogenous thrombin potential (ETP) and FVIII:C with occurrence of clinical bleeding. Methods: GENA‐21 was a prospective, open‐label, phase IIIb study investigating the safety and efficacy of Nuwiq® (human‐cl rhFVIII) in previously treated adults with severe haemophilia A. The study included a 72‐hour pharmacokinetic (PK) evaluation phase and a 6‐month personalized prophylaxis phase in which treatment was guided by PK parameters. This subanalysis assessed FVIII:C by one‐stage assay and ETP by thrombin generation assay in blood samples. Results: Baseline mean ETP was lower in the 7 patients who experienced sBEs during personalized prophylaxis versus 25 who did not (n = 32 with data from PK phase and prophylaxis phase; P = .0002). During personalized prophylaxis (n = 49), only patients with lower median trough ETP experienced sBEs (8/49 patients; ROC AUC = 0.9421; P < .0001); there was no significant relationship for FVIII:C in predicting sBEs (ROC AUC = 0.5838; P = .4750). Directly following infusion of human‐cl rhFVIII, ETP was lower in patients who experienced sBEs versus those who did not (P = .0002), whereas FVIII:C did not differ significantly between these groups. Conclusions: In adults with severe haemophilia A and reduced thrombin generation, increased frequency of spontaneous bleeding was observed irrespective of trough FVIII levels. Thus, personalized prophylaxis should take into account variables other than FVIII:C. Large prospective trials are needed to verify ETP as a marker for spontaneous bleeding. [ABSTRACT FROM AUTHOR]

SUMMARY An efficient heterogeneous flow model that combines incompressible viscous flow and potential flow(PF)(both) with free-surface boundaries for fluid-structure interaction(FSI) problems was developed and solved numerically. In the model, the near field(viscous) fluid subdomain of the FSI simulation is described by the Navier-Stokes equations(NSE), whereas the far field(inviscid) subdomain is described by PF. This method is particularly suitable for modeling a large fluid domain while avoid solving the NSE at the far field, where the inviscid flow assumption is appropriate and adopting a simplified(e.g., PF) flow description reduces computing cost. Numerically, the NSE are solved using a FEM, and the PF is solved using a BEM. Free surface tracking is achieved through a hybrid level set method for the NSE and the mixed Eulerian-Lagrangian method for the PF. The coupling is based on a non-overlapping DD method similar to the Dirichlet-Neumann method. At the interface between the two flow model subdomains, velocity and pressure are matched to ensure continuity of the corresponding variables at the common boundary. In this framework of the heterogeneous DD method, an explicit scheme is developed and implemented. The relation between this scheme and the classical Dirichlet-Neumann method for a homogeneous problem is revealed. Numerical examples demonstrating the capability of the method to model nonlinear wave phenomena and FSI problems with flexible structures are presented. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Summary 1. The introduction of invasive species is one of the main threats to global biodiversity, ecosystem structure and ecosystem processes. In freshwaters, invasive crayfish alter macroinvertebrate community structure and destroy macrophyte beds. There is limited knowledge on how such invasive species-driven changes affect consumers at higher trophic levels. 2. In this study, we explore how the invasive rusty crayfish Orconectes rusticus, a benthic omnivore, affects benthic macroinvertebrates, as well as the broader consequences for ecosystem-level trophic flows in terms of fish benthivory and trophic position (TP). We expected crayfish to decrease abundance of benthic macroinvertebrates, making most fish species less reliant on benthic resources. We expected crayfish specialists (e.g. Lepomis sp. and Micropterus sp.) to increase their benthic dependence. 3. In 10 northern Wisconsin lakes, we measured rusty crayfish relative abundance (catch per unit effort, CPUE), macroinvertebrate abundance, and C and N stable isotope ratios of 11 littoral fish species. We used stable isotope data and mixing models to characterise the trophic pathways supporting each fish species, and related trophic structure to crayfish relative abundance, fish body size and abiotic predictors using hierarchical Bayesian models. 4. Benthic invertebrate abundance was negatively correlated with rusty crayfish relative abundance. Fish benthivory increased with crayfish CPUE for all 11 fish species; posterior probabilities of a positive effect were >95%. TP also increased slightly with crayfish CPUE for some species, particularly smallmouth bass, largemouth bass, rock bass and Johnny darter. Moreover, both fish body size and lake abiotic variables explained variation in TP, while their effects on benthivory were small. 5. Rusty crayfish abundance explained relatively little of the overall variation in fish benthivory and TP. Although rusty crayfish appear to have strong effects on abundances of benthic macroinvertebrates, energy flow pathways and trophic niches of lentic fishes were not strongly influenced by invasive rusty crayfish. [ABSTRACT FROM AUTHOR]

Finite element (FE) modeling techniques were developed to isolate the different contributions of corrosion damage to structural response of experimental reinforced concrete beams with shear-dominated behavior. Corrosion-damage parameters included concrete cover spalling due to the expansion of corrosion products; uniform stirrup cross-sectional loss from corrosion; localized stirrup cross-sectional loss due to pitting; debonding of corrosion-damaged stirrups from the concrete. FE analyses were performed including both individual and combined damages. The FE results matched experimental results well and quantitatively estimated capacity reduction of the experimental specimens. [ABSTRACT FROM AUTHOR]

A process-based simulation model was used to examine the nature and intensity of food-web interactions that allow Osmerus mordax to dominate invaded lakes. The model simulates food-web interactions among linked populations of O. mordax, Coregonus artedi and Sander vitreus. Simulations indicated that O. mordax dominate where: (1) adult O. mordax prey on young-of-the-year (YOY) C. artedi, (2) YOY O. mordax negatively affect YOY S. vitreus through competition and (3) adult S. vitreus experience moderate fishing mortality. Osmerus mordax dominated simulations across a broad range of variable values that regulated competition and predation, and displayed threshold responses to increasing angler harvest. Consequently, angler harvest should be carefully managed in lakes susceptible to O. mordax invasions because the alternative could lead to fishery collapse. [ABSTRACT FROM AUTHOR]

Goal-directed coagulation therapy is essential in the management of trauma patients with severe bleeding. Due to the complex nature of coagulation disorders in trauma, a quick and reliable diagnostic tool is essential. We report a severely injured multiple trauma patient who received haemostatic therapy with coagulation factor concentrates, guided by rotational thromboelastometry (ROTEM®). Initial therapy consisted of fibrinogen concentrate (Haemocomplettan® P), as maximum clot firmness in the ROTEM analyses was low, whereas clotting time was normal. Later on, prothrombin complex concentrate was given to optimise thrombin generation. This approach enabled extended emergency hemihepatectomy to be performed without using fresh frozen plasma. As the EXTEM maximum clot firmness showed good clot quality, no platelets were transfused despite low platelet counts. This case shows the potential success of treatment using both fibrinogen concentrate and prothrombin complex concentrate, not only in restoring haemostasis but also in minimising requirement for transfusion of allogeneic blood products. [ABSTRACT FROM AUTHOR]

Bronchoscopy and bronchial suctioning during intra-operative artificial ventilation often causes leakage from the ventilation circuit with a decrease in ventilatory parameters and possible workplace contamination with anaesthetic gases. Different connectors have been developed to reduce gas leakage. We evaluated the following connectors : VBM 2 mm, 3 mm and 5 mm, Bodai Suction-Safe, Bodai Bronch-Safe and Bodai Trach-Safe, as well as the BE 105-7, BE 105-8 and SH 7-45. Invasive bronchial instruments (catheters, bronchoscopes and bronchial blockers) with 1.67–7.33 mm diameter were used. Pressure-controlled ventilation was performed on a test lung using a ventilator. Sevoflurane concentration in the room was measured 0.2 and 1.5 m from the connector using a photo-acoustic infrared-spectroscope. The VBM connectors caused the least gas leak and ensured stability of ventilation parameters even at peak pressures when combined with smaller instruments. With instruments > 6 mm, BE 105-7, BE 105-8 and SH 7-45 connectors performed best. The Bodai connectors showed a reduced ability to prevent leakage and to keep ventilatory parameters stable. All connectors, excluding the Bodai Trach-Safe, prevented exposure to anaesthetic gases beyond the current safety recommendations when combined with the fitting instruments. The connectors showed different ranges of tightness, equivalent to different ranges of compatibility with the instruments used. [ABSTRACT FROM AUTHOR]

Background: Platelet dysfunction contributes to the pathophysiology of bleeding complications during and after cardiac surgery. In most surgical institutions, no peri-operative point-of-care monitoring of platelet function is used. We evaluated the usefulness of the Multiplate® platelet function analyser based on impedance aggregometry for identifying groups of patients at a high risk of transfusion of platelet concentrates (PC). Methods: Platelet function parameters were determined in 60 patients before and after routine cardiac surgery. Impedance aggregometry measurements were performed on Multiplate® using ADP (ADPtest), collagen (COLtest) and thrombin receptor activating peptide (TRAPtest) as platelet activators. The correlations between the aggregometry results and the transfusion of PC were calculated. The results of the aggregation tests were also divided into tertiles and the differences in PC transfusion between the low and the high tertile were assessed. Results: Low aggregometry delimited groups of patients with significantly higher PC transfusion. In the receiver operating characteristic curve, low pre-operative aggregation in the ADPtest identified patients with high total transfusion of PC (area under the curve 0.74, P=0.001), while the ADPtest performed at the end of the operation identified patients with high PC transfusion on the intensive care unit (ICU) (area under the curve 0.76, P=0.002). Conclusions: Near-patient platelet aggregation may allow the identification of patients with enhanced risk of PC transfusion, both pre-operatively and upon arrival on the ICU. [ABSTRACT FROM AUTHOR]

Three-dimensional finite element (FE) models are developed to simulate the behavior of full-scale reinforced concrete beams strengthened with glass and carbon fiber-reinforced polymer sheets (an unstrengthened control beam, a flexural-strengthened beam, a shear-strengthened beam, and a beam with both shear and flexural strengthening). FE models use eight-node isoparametric elements with a smeared cracking approach for the concrete and three-dimensional layered elements to model the FRP composites. Analysis results are compared with data obtained from full-scale beam tests through the linear and nonlinear ranges up to failure. It was found that the FE models could identify qualitatively trends observed in the structural behavior of the full-scale beams. Predicted crack initiation patterns resemble the failure modes observed for the full-scale beam tests. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine whether high levels of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) are associated with prevalent cardiovascular disease (CVD) and to evaluate factors most influencing Lp-PLA(2) levels in a community-based cohort of older adults. DESIGN: Cross-sectional. SETTING: The Cardiovascular Health Study (CHS), a population-based cohort study of men and women aged 65 and older. PARTICIPANTS: Five thousand five hundred thirty-one CHS participants. MEASUREMENTS: Levels of Lp-PLA(2) activity were determined using stored blood samples from the baseline examination. RESULTS: Mean Lp-PLA(2) was higher in participants with electrocardiographically determined ventricular conduction defect and major Q-wave abnormality and was positively correlated with left ventricular (LV) mass. It was high in those with echocardiographically determined abnormal LV ejection fraction, which persisted after adjustment. Mean Lp-PLA(2) was also higher in participants with mild renal insufficiency and kidney disease. After multivariable adjustment, there was a modest but significant 27% greater risk of prevalent CHF per standard deviation increment of Lp-PLA(2) and a modest but significant 12% greater risk of prevalent myocardial infarction. Lp-PLA(2) was weakly but mainly most strongly correlated with cholesterol and lipoproteins, but those correlations were not especially strong. Lp-PLA(2) was weakly positively correlated with soluble intercellular adhesion molecule-1 but not interleukin-6. In total, all factors considered could explain only 29% of Lp-PLA(2) activity. CONCLUSION: Novel findings in the study are the associations, in those aged 65 and older, between Lp-PLA(2) activity and LV dysfunction, CHF, and renal disease. CVD risk factors only minimally explain levels of Lp-PLA(2). [ABSTRACT FROM AUTHOR]

Our objective was to examine prospectively the associations between fasting plasma proinsulin and the proinsulin/insulin ratio and the incidence of Type 2 diabetes in women. We designed a nested case-control study within the Nurses’ Health Study, a cohort of 121 700 US women aged 30–55 years at study inception in 1976. Fasting plasma proinsulin, specific insulin and C-peptide levels were determined in 183 women with a new diagnosis of diabetes made after blood sampling between 1989 and 1990, and 369 control subjects without diabetes. After adjustment for age, body mass index, family history of diabetes and other potential confounders, including HbA1c, the odds ratios for diabetes associated with increasing quartiles of proinsulin were 1.00, 0.85, 2.49 and 5.73 ( P for trend: < 0.001). Proinsulin remained significantly associated with diabetes risk after adjusting for C-peptide and specific insulin (multivariate odds ratios for quartiles: 1.00, 0.78, 1.94, 3.69; P for trend = 0.001). In addition, the proinsulin/insulin ratio was significantly associated with diabetes risk, controlling in multivariate analysis for C-peptide (odds ratios for extreme quartiles: 2.48; 95% CI: 1.14–5.41; P for trend = 0.005). These data suggest that proinsulin and the proinsulin/insulin ratio are strong independent predictors of diabetes risk, after adjustment for obesity and other potential confounders. Diabet. Med. (2005) [ABSTRACT FROM AUTHOR]

This article presents information on the study related to personality disorders. Borderline Personality Disorder (BPD) is a diagnostic entity still in a stage of formulation. While there appears to be some feeling that the BPD is a nosological entity, the ability, until relatively recently, to identify diagnostic criteria reliably has been fraught with inconsistencies. Researchers in their review found multiple problems in methodology and difficulties with the acquisition of samples. Researchers found multiple sets of descriptive criteria for the diagnosis. Their concern was that despite expanding literature in the borderline area, little consensus was found on diagnostic criteria.

Examines the functioning of toddlers with physical anomalies in comparison to premature toddlers and to normal toddlers. Performance of both premature and handicapped toddlers in measures of social initiative, focused play, language production and intelligence quotient; Manifestation of increased distractability, decreased compliance and reluctance to separate from their mothers.

In response to criticisms of a study conducted by Shaffran and Décarie, the author underscores the need for objective, accurate peer evaluation. Several serious errors and misinterpretations in the critical article are reported and corrected. [ABSTRACT FROM AUTHOR]

Aim: The precise role of the influenza virus in the morbidity of hospitalised paediatric pneumonia cases is unknown. We identified how many cases hospitalised during the 2009 pandemic had influenza-associated pneumonia and assessed their severity., Methods: Children admitted to three Israeli medical centres during the 2009 influenza pandemic with radiologically confirmed pneumonia were prospectively screened for influenza. We compared the clinical, laboratory and radiologic findings for positive and negative cases., Results: The pandemic H1N1 virus was detected in 89 (30%) of the 297 patients hospitalised for pneumonia and 55% of the Paediatric Intensive Care Unit admissions for pneumonia. There were no significant differences in the rates of underlying disease between the two groups. Logistic regression analysis revealed that children with pandemic H1N1 virus-associated pneumonia had significantly increased disease severity than those without, with a higher incidence of hypoxemia (41.6% versus 24%) with a relative risk (RR) of 2.2, higher rate of paediatric intensive care unit admission (16.9% versus 5.8%, RR of 2.7) and higher rate of mechanical ventilation (10.1% versus 2.4%, RR:4.4)., Conclusion: During the 2009 influenza pandemic, 30% of children hospitalised for pneumonia had the influenza infection and these children displayed increased disease severity., (©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Aims: To examine the influence of traditional tobacco use on smoking cessation among American Indian adult smokers., Design, Setting and Participants: A cross-sectional survey of self-identified American Indians was conducted from 2008 to 2009. A total of 998 American Indian adults (18 years and older) from the Midwest participated in the study., Measurements: Traditional tobacco use and method of traditional use were both assessed. Commercial tobacco use (current smoking) was obtained through self-reported information as well as the length of their most recent quit attempt. We also assessed knowledge and awareness of pharmacotherapy for current smokers., Findings: Among participants in our study, 33.3% were current smokers and they reported smoking an average of 10 cigarettes per day. American Indian current smokers who used traditional tobacco reported a greater number of days abstinent during their last quit attempt compared to those who do not use traditional tobacco (P = 0.01). However, it appears that this protective effect of traditional tobacco use is diminished if the person smokes traditional tobacco. Finally, very few (fewer than 20% of current smokers) were aware of more recent forms of pharmacotherapy such as Chantix or bupropion., Conclusions: American Indians appear to show low levels of awareness of effective pharmacotherapies to aid smoking cessation, but those who use 'traditional tobacco' report somewhat longer periods of abstinence from past quit attempts., (© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.)

The cardiopulmonary bypass (CPB) used in heart surgery has a deleterious effect on hemostasis. The aim of our study was to assess by means of standard laboratory and point-of-care methods changes induced by CPB in coagulation parameters, particularly in platelet function, and to determine whether these changes differ depending on the type of heart-lung machine (HLM) used: minimal extracorporeal circulation system (MECC) and standard HLM. The study enrolled 88 patients scheduled for coronary artery bypass surgery performed on pump. Forty-four interventions were performed with MECC and 44 with standard HLM. Blood was sampled preoperatively, after 30 min on CPB, after weaning from CPB, and 24 h postoperatively. Coagulation and platelet function were assessed using multiple electrode aggregometry (MEA), rotation thromboelastometry, as well as standard laboratory tests. Rotation thromboelastometry and standard laboratory reflected significantly impaired hemostasis after weaning from CPB but no significant differences between the two groups at different time points. Aggregation decreased significantly in both groups as early as 30 min after the institution of CPB (P < 0.05, Mann-Whitney U-test) and recovered within the first 24 h postoperatively, without reaching the preoperative level. Intraoperatively, aggregometry values reflected a significantly more severe reduction of platelet function in standard HLM group than in the MECC group (P < 0.01, ProcMixed test). Our findings suggest that MEA and thromboelastometry reflect impairment of coagulation in cardiac surgery performed on different types of HLM and that platelet function is less affected by MECC than by standard HLM.