Extreme events driving year-to-year differences in gross primary productivity across the US

Solar-Induced chlorophyll Fluorescence (SIF) has previously been shown to strongly correlate with gross primary productivity (GPP), however this relationship has not yet been quantified for the recently launched TROPOspheric Monitoring Instrument (TROPOMI). Here we use a Gaussian mixture model to develop a parsimonious relationship between SIF from TROPOMI and GPP from flux towers across the conterminous United States (CONUS). The mixture model indicates the SIF-GPP relationship can be characterized by a linear model with two terms. We then estimate GPP across CONUS at 500-m spatial resolution over a 16-day moving window. We find that CONUS GPP varies by less than 4% between 2018 and 2019. However, we observe four extreme precipitation events that induce regional GPP anomalies: drought in west Texas, flooding in the midwestern US, drought in South Dakota, and drought in California. Taken together, these events account for 28% of the year-to-year GPP differences across CONUS

A double peak in the seasonality of California's photosynthesis as observed from space

Solar-induced chlorophyll fluorescence (SIF) has been shown to be a powerful proxy for photosynthesis and gross primary productivity (GPP). The recently launched TROPOspheric Monitoring Instrument (TROPOMI) features the required spectral resolution and signal-to-noise ratio to retrieve SIF from space. Here, we present a downscaling method to obtain 500 m spatial resolution SIF over California. We report daily values based on a 14 d window. TROPOMI SIF data show a strong correspondence with daily GPP estimates at AmeriFlux sites across multiple ecosystems in California. We find a linear relationship between SIF and GPP that is largely invariant across ecosystems with an intercept that is not significantly different from zero. Measurements of SIF from TROPOMI agree with MODerate Resolution Imaging Spectroradiometer (MODIS) vegetation indices – the normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and near-infrared reflectance of vegetation index (NIR_v) – at annual timescales but indicate different temporal dynamics at monthly and daily timescales. TROPOMI SIF data show a double peak in the seasonality of photosynthesis, a feature that is not present in the MODIS vegetation indices. The different seasonality in the vegetation indices may be due to a clear-sky bias in the vegetation indices, whereas previous work has shown SIF to have a low sensitivity to clouds and to detect the downregulation of photosynthesis even when plants appear green. We further decompose the spatiotemporal patterns in the SIF data based on land cover. The double peak in the seasonality of California's photosynthesis is due to two processes that are out of phase: grasses, chaparral, and oak savanna ecosystems show an April maximum, while evergreen forests peak in June. An empirical orthogonal function (EOF) analysis corroborates the phase offset and spatial patterns driving the double peak. The EOF analysis further indicates that two spatiotemporal patterns explain 84 % of the variability in the SIF data. Results shown here are promising for obtaining global GPP at sub-kilometer spatial scales and identifying the processes driving carbon uptake

Extreme events driving year-to-year differences in gross primary productivity across the US

Solar-Induced chlorophyll Fluorescence (SIF) has previously been shown to strongly correlate with gross primary productivity (GPP), however this relationship has not yet been quantified for the recently launched TROPOspheric Monitoring Instrument (TROPOMI). Here we use a Gaussian mixture model to develop a parsimonious relationship between SIF from TROPOMI and GPP from flux towers across the conterminous United States (CONUS). The mixture model indicates the SIF-GPP relationship can be characterized by a linear model with two terms. We then estimate GPP across CONUS at 500-m spatial resolution over a 16-day moving window. We find that CONUS GPP varies by less than 4% between 2018 and 2019. However, we observe four extreme precipitation events that induce regional GPP anomalies: drought in west Texas, flooding in the midwestern US, drought in South Dakota, and drought in California. Taken together, these events account for 28% of the year-to-year GPP differences across CONUS

Teen, Parent, and Clinician Expectations About Obesity and Related Conditions During the Annual Well-Child Visit

Purpose: This study aimed to examine family (patient, parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Methods: Four focus groups with teen patients (n = 16), four focus groups with parents (n = 15) and one focus group with providers (n = 12) were conducted using a structured moderator guide tailored to each population. Eligible patients had a well-child visit during the past 12 months and a diagnosis of overweight, obesity, hyperlipidemia or elevated blood pressure. Parents who attended their child’s well-child visit and whose child met the diagnostic criteria were eligible. Teen focus groups were divided by gender (male/female) and age (14–15/16–17 years). Focus group transcripts were coded for concepts and themes using qualitative data and thematic analysis. Analysis was performed across groups to determine common themes and domains of intersect. Results: Teens and parents expect weight to be discussed at well-child visits and prefer discussions to come from a trusted clinician who uses serious, consistent language. Teens did not recognize the health implications from excess weight, and both parents and teens express the need for more information on strategies to change behavior. Providers recognize several challenges and barriers to discussing weight management in the well-child visit. Conclusions: A clinician-teen-family relationship built on trust, longevity, teamwork, support and encouragement can create a positive atmosphere and may improve understanding for weight-related messages for teens and families during a well-child visit

Planet Hunters X: Searching for Nearby Neighbors of 75 Planet and Eclipsing Binary Candidates from the K2 Kepler Extended Mission

We present high-resolution observations of a sample of 75 K2 targets from Campaigns 1-3 using speckle interferometry on the Southern Astrophysical Research (SOAR) telescope and adaptive optics (AO) imaging at the Keck II telescope. The median SOAR $I$-band and Keck $K_s$-band detection limits at 1" were $\Delta m_{I}=4.4$~mag and $\Delta m_{K_s}=6.1$~mag, respectively. This sample includes 37 stars likely to host planets, 32 targets likely to be eclipsing binaries (EBs), and 6 other targets previously labeled as likely planetary false positives. We find nine likely physically bound companion stars within 3" of three candidate transiting exoplanet host stars and six likely EBs. Six of the nine detected companions are new discoveries; one of the six, EPIC 206061524, is associated with a planet candidate. Among the EB candidates, companions were only found near the shortest period ones ($P<3$ days), which is in line with previous results showing high multiplicity near short-period binary stars. This high-resolution data, including both the detected companions and the limits on potential unseen companions, will be useful in future planet vetting and stellar multiplicity rate studies for planets and binaries.Comment: Accepted in A

Extracorporeal Membrane Oxygenation in Patients With COVID-19:An International Multicenter Cohort Study

BACKGROUND: To report and compare the characteristics and outcomes of COVID-19 patients on extracorporeal membrane oxygenation (ECMO) to non-COVID-19 acute respiratory distress syndrome (ARDS) patients on ECMO. METHODS: We performed an international retrospective study of COVID-19 patients on ECMO from 13 intensive care units from March 1 to April 30, 2020. Demographic data, ECMO characteristics and clinical outcomes were collected. The primary outcome was to assess the complication rate and 28-day mortality; the secondary outcome was to compare patient and ECMO characteristics between COVID-19 patients on ECMO and non-COVID-19 related ARDS patients on ECMO (non-COVID-19; January 1, 2018 until July 31, 2019). RESULTS: During the study period 71 COVID-19 patients received ECMO, mostly veno-venous, for a median duration of 13 days (IQR 7-20). ECMO was initiated at 5 days (IQR 3-10) following invasive mechanical ventilation. Median PaO(2)/FiO(2) ratio prior to initiation of ECMO was similar in COVID-19 patients (58 mmHg [IQR 46-76]) and non-COVID-19 patients (53 mmHg [IQR 44-66]), the latter consisting of 48 patients. 28-day mortality was 37% in COVID-19 patients and 27% in non-COVID-19 patients. However, Kaplan-Meier curves showed that after a 100-day follow-up this non-significant difference resolves. Non-surviving COVID-19 patients were more acidotic prior to initiation ECMO, had a shorter ECMO run and fewer received muscle paralysis compared to survivors. CONCLUSIONS: No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19

Lessons from Toxicology: Developing a 21st‑Century Paradigm for Medical Research

Biomedical developments in the 21st century provide an unprecedented opportunity to gain a dynamic systems-level and human-specific understanding of the causes and pathophysiologies of disease. This understanding is a vital need, in view of continuing failures in health research, drug discovery, and clinical translation. The full potential of advanced approaches may not be achieved within a 20th-century conceptual framework dominated by animal models. Novel technologies are being integrated into environmental health research and are also applicable to disease research, but these advances need a new medical research and drug discovery paradigm to gain maximal benefits. We suggest a new conceptual framework that repurposes the 21st-century transition underway in toxicology. Human disease should be conceived as resulting from integrated extrinsic and intrinsic causes, with research focused on modern human-specific models to understand disease pathways at multiple biological levels that are analogous to adverse outcome pathways in toxicology. Systems biology tools should be used to integrate and interpret data about disease causation and pathophysiology. Such an approach promises progress in overcoming the current roadblocks to understanding human disease and successful drug discovery and translation. A discourse should begin now to identify and consider the many challenges and questions that need to be solved

The Effect of Volitional Preemptive Abdominal Contraction on Biomechanical Measures During A Front Versus Back Loaded Barbell Squat

# Background Weightlifting is growing in popularity among recreational and competitive athletes. The barbell back squat (BackS) is commonly included in these training programs, while the barbell front squat (FrontS) is commonly performed as a component of other lifts such as the power clean or clean and jerk, it is less commonly practiced in isolation. # Hypothesis/Purpose The purpose of this study was to examine the effects of VPAC performance on trunk muscle and LE biomechanical responses during loaded BackS versus FrontS in healthy subjects. # Study Design Controlled Laboratory Study # Methods Healthy male subjects with the ability to perform a sub-maximal loaded barbell squat lift were recruited. Subjects completed informed consent, demographic/medical history questionnaires and an instructional video. Subjects practiced VPAC and received feedback. Surface electromyography (sEMG) electrodes and kinematic markers were applied. Muscles included were the internal oblique (IO), external oblique (EO), rectus abdominis, iliocostalis lumborum (ICL), superficial multifidi, rectus femoris, vastus lateralis, biceps femoris, and gluteus maximus. Maximal voluntary isometric contractions established reference sEMG values. A squat one-rep-max (1RM) was predicted by researchers using a three to five repetition maximum (3RM, 5RM) load protocol. Subjects performed BackS trials at 75% 1RM while FrontS trials were performed at 75% BackS weight, both with and without VPAC. Subjects performed three repetitions of each condition with feet positioned on two adjacent force plates. Significant interactions and main effects were tested using a 2(VPAC strategy) x 2(squat variation) and 2(VPAC strategy) x 2(direction) within-subject repeated measures ANOVAs. Tukey's Post-Hoc tests identified the location of significant differences. # Results Trunk muscle activity was significantly higher during FrontS versus BackS regardless of VPAC condition. (IO: p=0.018, EO: p\<0.001, ICL: p\<0.001) VPAC increased performance time for both squat variations (p=.0011), which may be associated with decreased detrimental force potential on the lumbar spine and knees. VPAC led to improved ability to maintain a neutral lumbar spine during both squat variations. This finding is associated with decreased detrimental force potential on the lumbar spine. # Conclusions Findings could help guide practitioners and coaches to choose squat variations and incorporate VPAC strategies during their treatments and/or training programs. # Level of Evidence Level 3 ©The Author(s