Insensitivity of alkenone carbon isotopes to atmospheric CO₂ at low to moderate CO₂ levels

Atmospheric pCO2 is a critical component of the global carbon system and is considered to be the major control of Earth’s past, present and future climate. Accurate and precise reconstructions of its concentration through geological time are, therefore, crucial to our understanding of the Earth system. Ice core records document pCO2 for the past 800 kyrs, but at no point during this interval were CO2 levels higher than today. Interpretation of older pCO2 has been hampered by discrepancies during some time intervals between two of the main ocean-based proxy methods used to reconstruct pCO2: the carbon isotope fractionation that occurs during photosynthesis as recorded by haptophyte biomarkers (alkenones) and the boron isotope composition (δ11B) of foraminifer shells. Here we present alkenone and δ11B-based pCO2 reconstructions generated from the same samples from the Plio-Pleistocene at ODP Site 999 across a glacial-interglacial cycle. We find a muted response to pCO2 in the alkenone record compared to contemporaneous ice core and δ11B records, suggesting caution in the interpretation of alkenone-based records at low pCO2 levels. This is possibly caused by the physiology of CO2 uptake in the haptophytes. Our new understanding resolves some of the inconsistencies between the proxies and highlights that caution may be required when interpreting alkenone-based reconstructions of pCO2

INFLUENCE OF PHOSPHATE SOURCE ON VESICULAR-ARBUSCULAR MYCORRHIZAE OF \u3ci\u3eBOUTELOUA GRACILIS\u3c/i\u3e

Non-mycorrhizal and vesicular-arbuscular mycorrhizal Bouteloua gracilis infected with Glomus fasciculatus were grown in defined media containing different phosphate sources and compared with respect to phosphate content and form, biomass, chlorophyll concentration, and root phosphatase activity. The phosphate sources were sodium monobasic phosphate, a mixture of sodium monobasic phosphate and calcium phytate, and calcium phytate. Inositol and inositol plus calcium were added to the sodium phosphate medium as additional treatments. Mycorrhizal infection was highest in roots of plants grown in the presence of phytate (75%). Lower root infection levels were noted in plants from the sodium phosphate (19%) and mixed phosphate (22%) media. No penetration by fungi occurred in plants from the sodium phosphate plus inositol or inositol and calcium media. Dry wts of non-mycorrhizal plants were highest when grown in media containing phytate and sodium phosphate plus inositol and calcium followed in decreasing order by sodium phosphate plus inositol, mixed phosphates, and sodium phosphate. Mycorrhizal infection increased leaf dry wt in plants from the sodium phosphate medium and root dry wt from the phytate medium. Phosphate concentrations in the plants were highest when grown in mixed phosphate medium followed by sodium phosphate and phytate. Mycorrhizal infection always increased significantly leaf phosphate concentrations but increased root phosphate concentrations only in the phytate medium. Phosphates were found predominantly as organicallybound compounds in leaves of mycorrhizal plants whereas in leaves of non-mycorrhizal plants, most of the phosphate was inorganic. Chlorophyll concentrations increased significantly with mycorrhizal infection with no change in a/b ratios. Mycorrhizal plants grown in the phytate medium had substantially higher alkaline phosphatase activity than did non-mycorrhizal plants; acid phosphatase activity was not affected by mycorrhizal condition. These results suggest that form of the phosphate in the root environment influences naycorrhizal establishment and effect of mycorrhizae on plant growth

INFLUENCE OF PHOSPHATE SOURCE ON VESICULAR-ARBUSCULAR MYCORRHIZAE OF \u3ci\u3eBOUTELOUA GRACILIS\u3c/i\u3e

Non-mycorrhizal and vesicular-arbuscular mycorrhizal Bouteloua gracilis infected with Glomus fasciculatus were grown in defined media containing different phosphate sources and compared with respect to phosphate content and form, biomass, chlorophyll concentration, and root phosphatase activity. The phosphate sources were sodium monobasic phosphate, a mixture of sodium monobasic phosphate and calcium phytate, and calcium phytate. Inositol and inositol plus calcium were added to the sodium phosphate medium as additional treatments. Mycorrhizal infection was highest in roots of plants grown in the presence of phytate (75%). Lower root infection levels were noted in plants from the sodium phosphate (19%) and mixed phosphate (22%) media. No penetration by fungi occurred in plants from the sodium phosphate plus inositol or inositol and calcium media. Dry wts of non-mycorrhizal plants were highest when grown in media containing phytate and sodium phosphate plus inositol and calcium followed in decreasing order by sodium phosphate plus inositol, mixed phosphates, and sodium phosphate. Mycorrhizal infection increased leaf dry wt in plants from the sodium phosphate medium and root dry wt from the phytate medium. Phosphate concentrations in the plants were highest when grown in mixed phosphate medium followed by sodium phosphate and phytate. Mycorrhizal infection always increased significantly leaf phosphate concentrations but increased root phosphate concentrations only in the phytate medium. Phosphates were found predominantly as organicallybound compounds in leaves of mycorrhizal plants whereas in leaves of non-mycorrhizal plants, most of the phosphate was inorganic. Chlorophyll concentrations increased significantly with mycorrhizal infection with no change in a/b ratios. Mycorrhizal plants grown in the phytate medium had substantially higher alkaline phosphatase activity than did non-mycorrhizal plants; acid phosphatase activity was not affected by mycorrhizal condition. These results suggest that form of the phosphate in the root environment influences naycorrhizal establishment and effect of mycorrhizae on plant growth

Measuring Hospital Performance Using Mortality Rates: An Alternative to the RAMR

Background The risk-adjusted mortality rate (RAMR) is used widely by healthcare agencies to evaluate hospital performance. The RAMR is insensitive to case volume and requires a confidence interval for proper interpretation, which results in a hypothesis testing framework. Unfamiliarity with hypothesis testing can lead to erroneous interpretations by the public and other stakeholders. We argue that screening, rather than hypothesis testing, is more defensible. We propose an alternative to the RAMR that is based on sound statistical methodology, easier to understand and can be used in large-scale screening with no additional data requirements. Methods We use an upper-tail probability to screen for hospitals performing poorly and a lower-tail probability to screen for hospitals performing well. Confidence intervals and hypothesis tests are not needed to compute or interpret our measures. Moreover, unlike the RAMR, our measures are sensitive to the number of cases treated. Results To demonstrate our proposed methodology, we obtained data from the New York State Department of Health for 10 Inpatient Quality Indicators (IQIs) for the years 2009-2013. We find strong agreement between the upper tail probability (UTP) and the RAMR, supporting our contention that the UTP is a viable alternative to the RAMR. Conclusion We show that our method is simpler to implement than the RAMR and, with no need for a confidence interval, it is easier to interpret. Moreover, it will be available for all hospitals and all diseases/conditions regardless of patient volum

Interdisciplinary communication in the intensive care unit

Background. Patient safety research has shown poor communication among intensive care unit (ICU) nurses and doctors to be a common causal factor underlying critical incidents in intensive care. This study examines whether ICU doctors and nurses have a shared perception of interdisciplinary communication in the UK ICU. Methods. Cross-sectional survey of ICU nurses and doctors in four UK hospitals using a previously established measure of ICU interdisciplinary collaboration. Results. A sample of 48 doctors and 136 nurses (47% response rate) from four ICUs responded to the survey. Nurses and doctors were found to have differing perceptions of interdisciplinary communication, with nurses reporting lower levels of communication openness between nurses and doctors. Compared with senior doctors, trainee doctors also reported lower levels of communication openness between doctors. A regression path analysis revealed that communication openness among ICU team members predicted the degree to which individuals reported understanding their patient care goals (adjR2 = 0.17). It also showed that perceptions of the quality of unit leadership predicted open communication. Conclusions. Members of ICU teams have divergent perceptions of their communication with one another. Communication openness among team members is also associated with the degree to which they understand patient care goals. It is necessary to create an atmosphere where team members feel they can communicate openly without fear of reprisal or embarrassment

The effect of executive walk rounds on nurse safety climate attitudes: A randomized trial of clinical units

BACKGROUND: Executive walk rounds (EWRs) are a widely used but unstudied activity designed to improve safety culture in hospitals. Therefore, we measured the impact of EWRs on one important part of safety culture – provider attitudes about the safety climate in the institution. METHODS: Randomized study of EWRs for 23 clinical units in a tertiary care teaching hospital. All providers except physicians participated. EWRs were conducted at each unit by one of six hospital executives once every four weeks for three visits. Providers were asked about their concerns regarding patient safety and what could be done to improve patient safety. Suggestions were tabulated and when possible, changes were made. Provider attitudes about safety climate measured by the Safety Climate Survey before and after EWRs. We report mean scores, percent positive scores (percentage of providers who responded four or higher on a five point scale (agree slightly or agree strongly), and the odds of EWR participants agreeing with individual survey items when compared to non-participants. RESULTS: Before EWRs the mean safety climate scores for nurses were similar in the control units and EWR units (78.97 and 76.78, P = 0.458) as were percent positive scores (64.6% positive and 61.1% positive). After EWRs the mean safety climate scores were not significantly different for all providers nor for nurses in the control units and EWR units (77.93 and 78.33, P = 0.854) and (56.5% positive and 62.7% positive). However, when analyzed by exposure to EWRs, nurses in the control group who did not participate in EWRs (n = 198) had lower safety climate scores than nurses in the intervention group who did participate in an EWR session (n = 85) (74.88 versus 81.01, P = 0.02; 52.5% positive versus 72.9% positive). Compared to nurses who did not participate, nurses in the experimental group who reported participating in EWRs also responded more favorably to a majority of items on the survey. CONCLUSION: EWRs have a positive effect on the safety climate attitudes of nurses who participate in the walk rounds sessions. EWRs are a promising tool to improve safety climate and the broader construct of safety culture