Thermal sensitivity across forest vertical profiles: patterns, mechanisms, and ecological implications

Rising temperatures are influencing forests on many scales, with potentially strong variation vertically across forest strata. Using published research and new analyses, we evaluate how microclimate and leaf temperatures, traits, and gas exchange vary vertically in forests, shaping tree, and ecosystem ecology. In closed-canopy forests, upper canopy leaves are exposed to the highest solar radiation and evaporative demand, which can elevate leaf temperature (T_leaf ), particularly when transpirational cooling is curtailed by limited stomatal conductance. However, foliar traits also vary across height or light gradients, partially mitigating and protecting against the elevation of upper canopy T_leaf . Leaf metabolism generally increases with height across the vertical gradient, yet differences in thermal sensitivity across the gradient appear modest. Scaling from leaves to trees, canopy trees have higher absolute metabolic capacity and growth, yet are more vulnerable to drought and damaging T_leaf than their smaller counterparts, particularly under climate change. By contrast, understory trees experience fewer extreme high T_leaf 's but have fewer cooling mechanisms and thus may be strongly impacted by warming under some conditions, particularly when exposed to a harsher microenvironment through canopy disturbance. As the climate changes, integrating the patterns and mechanisms reviewed here into models will be critical to forecasting forest-climate feedback.

Long-term Outcome of Lupus Nephritis: A Single Center Study

Introduction

There is paucity of data on long-term outcome of lupus nephritis (LN) from south India. Our study looks at long term outcomes in patients with biopsy proven LN with terms of response to therapy, flare, mortality, treatment-related complications, outcome and post flare analysis. We also analyzed the factors which predicted the outcome.

Methods

A retrospective observational study was conducted from 2005 to 2012 at St. John's Medical college and hospital, Bangalore. Patients received treatment as per NIH protocol. Patients of LN who regularly visited OPD were included. Statistical analysis was done by using SPSS 19 software.

Results

At end of 84 ± 6 months (N = 59), 38 subjects showed complete remission (CR), 6 partial remission (PR), 3 developed chronic kidney disease, 2 developed end-stage kidney disease (ESKD), and 10 died. In outcome of flare (N = 15), 7 had nephrotic flare, 3 had refractory flare, 3 showed nephritic flare with 2 developing ESKD. Change of LN class was 3 subjects had changed to class II from class IV, 1 to class II from class V, 7 to class III from class IV, 2 to class IV from class V, and 2 to class IV from class VI. Factors predicting poor outcomes were serum creatinine, hypertension at presentation, and failure to achieve remission in 1 year. 7 subjects conceived, of which 4 of them were treated with azathioprine (AZA) and 3 of them who were on mycophenolate mofetil and was changed to AZA. 4 subjects had successful pregnancy outcome, 2 had preeclampsia, and 1 subject had missed abortion.

Conclusion

At end of 84 ± 6 months, patient survival rate was 84%.

Management of incidentally detected gallbladder carcinomas in a high prevalence area of gallbladder cancer

BACKGROUND

There is an increasing incidence of advanced unresectable gallbladder cancer even in patients who undergo re-exploration and these cases are marked by poor survival even after undergoing curative resection and adjuvant chemotherapy. Lack of suspicion during primary surgery, unavailability of frozen section facilities and delayed referrals are believed to contribute to this high incidence.

AIM

Our aim was to evaluate the results of re-surgery in incidental gallbladder cancers detected after open or laparoscopic cholecystectomy and to assess the outcome in patients who underwent complete radical cholecystectomy and adjuvant therapy.

METHOD

We retrospectively analyzed the data from a prospectively maintained computerized database of all patients with incidentally detected gallbladder cancers operated in the Department of Surgical Oncology, from June 2006 to January 2013.

RESULTS

Forty-two patients with incidental gallbladder cancer were re-explored. The median time of re-exploration after initial surgery was 65 days. Eighteen (43%) patients were found inoperable due to locally advanced unresectable or metastatic disease. Among the 24 (57%) patients who underwent completion radical cholecystectomy, 11 developed recurrence over a median time of 11 months.

CONCLUSION

Despite the dismal prognosis, more than half of the incidentally detected gallbladder carcinoma patients could receive curative treatment. Identification of patients with incidentally discovered gallbladder cancer and early referral to an oncology center may ensure these patients receive curative resection thereby increasing their chances for long-term disease free survival.

Pattern of breakdown of laminar flow into turbulent spots

The breakdown into turbulent spots is the least understood stage of the laminar-turbulent transition process. With cellular-automaton stochastic simulations and stability analysis, we show that the pattern of breakdown in boundary-layer flow bears a connection to laminar instability and may be reconstructed using macroscopic properties of the transition zone, such as persistence times and transitional intermittency. We propose experimental tests of our ideas.