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In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
Methods:
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
Results:
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
Conclusion:
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
Mrs. Wilson’s case exemplifies one kind of disagreement about treatment near the end of life that occurs frequently in hospitals and often prompts a request for ethics consultation. There are several reasons for the frequent resort to ethics consultation in these situations. The values at stake, including freedom from suffering and disability and prolongation of life, are significant. In addition, treatment choices are often complex, offering uncertain benefits and burdens. Finally, as the long, public, and bitter legal battle over the care of Terri Schiavo made clear, Americans hold strong and divergent views about which life-sustaining treatments should, and should not, be pursued (Gostin, 2005). In this chapter, we explain that advance care planning and attention to goals of care can prevent or ameliorate much uncertainty and conflict over treatment decisions near the end of life.
Tree-rings representing annual dates from live and deadwood Pinus flexilis at ten sites across the central Great Basin (~38°N) yielded a cumulative record across 4002 years (1983 BC–AD 2019). Individual site chronologies ranged in length from 861–4002 years; all were continuous over their sample depths. Correlations of growth with climate were positive for water relations and mostly negative for summer temperatures. Growth was generally correlated across sites, with the central Nevada stands most distinct. Although growth was low during the Late Holocene Dry Period, variability marked this interval, suggesting that it was not pervasively dry. All sites had low growth during the first half of the Medieval Climate Anomaly, high growth during the mid-interval pluvial, and low growth subsequently. Little synchrony occurred across sites for the early Little Ice Age. After AD 1650, growth was depressed until the early twentieth century. Growth at all sites declined markedly ca. AD 1985, was similar to the lowest growth period of the full records, and indicative of recent severe droughts. A small rebound in growth occurred after ca. AD 2010. A strong signal for Atlantic Multidecadal Oscillation (AMO) occurred in growth response at most sites. The persistence of all stands despite climate variability indicates high resilience of this species.
Annually dated tree-rings of 509 live and deadwood limber pine (Pinus flexilis) samples from the semi-arid Wassuk Range, Nevada, yielded a 3996-yr record extending from 1983 BC to AD 2013. Correlations of radial growth with climate were positive for water relations and negative for summer temperatures. Long-term trends of ring-width corresponded to climate variability documented from other proxies, including low growth during the Late Holocene Dry Period and Medieval Climate Anomaly (MCA) and elevated growth during cool, wet periods of the Neoglacial and Little Ice Age. Spline fit of the data indicated that growth decrease in the last 20 years was second lowest on record, surpassed by lowest growth at 20 BC—AD 150. Demographics of limber pine by aspect and elevation were not strongly related to long-term climate dynamics, except in the case of extirpations on all but north aspects at the end of the MCA. Pines occurred persistently on north aspects, where a continuous record existed to present. Elevation shifts were not obvious on any aspect, and no evidence existed for migration above current treeline. Non-climatic factors appear to interact with climate to make north slopes refugial for upland pines in semi-arid regions across four millennia.
In the more than two hundred years since his death, Cook's reputation has been much discussed, opinion ranging from celebration of his achievement to more subjective assessments of the long-term implications of his voyages in those countries of the Pacific which he visited. The thirteen essays in this book, grouped in four sections, continue the debate. 'The Years in England' cover Cook's Whitby background and the part played by the Royal Society in the Pacific ventures of the period. 'The Pacific Voyages' investigates the clash between the Endeavour's crew and the Aborigines on the banks of the Endeavour River, the process by which Cook and his crews became 'Polynesianised', Cook's visit to the Hawaiian Islands, and his call at Nootka Sound, both on his final voyage. 'Captain Cook and his Contemporaries' views other European explorers in the Pacific, and concludes with an analysis of Russian attitudes towards Cook. 'The Legacy of Captain Cook' compares Cook's death on Hawaii with the later killing of a missionary on Eromanga, examines fluctuations in Cook's reputation, and describes life on board the replica of the Endeavour. GLYNDWR WILLIAMS is Emeritus Professor of History, Queen Mary & Westfield College, University of London. His many books include an edition of Captain Cook's Voyages, 1768-79, from the official accounts derived from Cook's journals.
We present 1 and 100 MHz ground-based radar data from the onset region of Rutford Ice Stream, West Antarctica, which indicate the form and internal structure of isochrones. In the flow-parallel lines, modelled isochrone patterns reproduce the gross pattern of the imaged near-surface layers, assuming steady-state flow velocity from GPS records and the current accumulation rate for the last 200 years. We interpret this as indicating overall stability in flow in the onset region of Rutford Ice Stream throughout this period. However, in the cross-flow lines some local variability in accumulation is seen in areas close to the ice-stream margin where a number of tributaries converge towards the ice-stream onset zone. Episodic surface lowering events are observed followed by rapid fill episodes. The fill events indicate deposition towards the northwest, most likely generated by storm winds, which blow at an oblique angle to ice flow. More problematic is explaining the generation of episodic surface lowering in this area. We speculate this may be due to: changing ice-flow direction in the complex tributary area of the onset zone; a change in basal sediments or sedimentary landforms; a change in basal melt rates or water supply; or episodic lake drainage events in the fjord systems of the Ellsworth Subglacial Highlands. The study highlights the difficulty of assessing flow stability in the complex onset regions of West Antarctic ice streams.
It has been an underlying assumption in many studies that near-surface layers imaged by ground-penetrating radar (GPR) can be interpreted as depositional markers or isochrones. It has been shown that GPR layers can be approximately reproduced from the measured electrical properties of ice, but these material layers are generally narrower and more closely spaced than can be resolved by typical GPR systems operating in the range 50−400 MHz. Thus GPR layers should be interpreted as interference patterns produced from closely spaced and potentially discontinuous material layers, and should not be assumed to be interpretable as precise markers of isochrones. We present 100 MHz GPR data from Lyddan Ice Rise, Antarctica, in which near-surface (<50 m deep) layers are clearly imaged. The growth of the undulations in these layers with depth is approximately linear, implying that, rather than resulting from a pattern of vertical strain rate, they do correspond to some pattern of snowfall variation. Furthermore, comparison of the GPR layers with snow-stake measurements suggests that around 80% of the rms variability in mean annual accumulation is present in the GPR layers. The observations suggest that, at least in this case, the GPR layers do approximate isochrones, and that patterns of snow accumulation over Lyddan Ice Rise are dominated by extremely persistent spatial variations with only a small residual spatial variability. If this condition is shown to be widely applicable it may reduce the period required for measurements of surface elevation change to be taken as significant indications of mass imbalance.
We present seismic and radar data from the onset region of Rutford Ice Stream, West Antarctica, which show the form and internal structure of a variety of bed forms beneath an active ice stream. The ice flow in the area of our survey accelerates from 72 to >200 m a–1, the ice is 2200–3200 m thick, and the bed of the ice stream lies up to 2000 m below present sea level. We have imaged the internal structure of the bed forms with seismic reflection techniques and also observed radar reflections from below the bed in some circumstances. We observed a transverse moraine 2 km wide and 1.5 km long beneath the slower-flowing part of the ice stream, which we interpret to be composed of unconsolidated sediment undergoing active deformation near the ice–sediment interface. We observed drumlins of classical form with elongation ratios of between 1:1.5 and 1:4.0 where the surface flow speed exceeded 95 m a–1. The conformity of the internal structure of the bed forms with the ice base suggests that the bed forms are active depositional features in congruence with the observation of a contemporary drumlin-forming episode in the distal part of the same ice stream. These observations provide the first direct evidence of the association between ice-stream flow speed and bed-form shape.
Growth chamber studies and field trials were conducted to evaluate the toxicity of glyphosate [N-(phosphonomethyl)glycine] and certain other herbicides to wild garlic (Allium vineale L.). Toxicity to wild garlic increased with increasing rates up to 6 kg/ha. Glyphosate was more toxic to wild garlic when applied in spray volumes of 125 to 500 L/ha than in greater volumes. Addition of surfactant did not increase toxicity or absorption rates of 3 kg/ha of glyphosate, but did increase the advantage of 2 kg/ha of glyphosate over 2,4-D [(2,4-dichlorophenoxy)acetic acid]. When glyphosate was sprayed on wild garlic plants at 3 kg/ha, then washed off after 2, 4, 8, 16, and 32 h, absorption of a biologically significant amount of glyphosate required 8 h, and toxicity increased through the 32-h exposure. Injury, which increased as mowing was delayed up to 12 days after application, indicated that significant quantities of glyphosate were translocated between 3 to 12 days after treatment in a field test. Glyphosate; 2,4-D; 2,4-D + mecoprop {2-[(4-chloro-o-tolyl)oxy] propionic acid} + dicamba (3,6-dichloro-o-anisic acid); and VEL-4207 [N-phenyldiethanolamine-bis-(2-methoxy-3,6-dichlorobenzoate)], applied in a sequence of either spring-fall-spring or fall-spring, were compared for wild garlic control. All herbicides tested controlled wild garlic, but glyphosate was more effective than 2,4-D after spring-fall-spring applications. All spring-fall-spring treatments except 2,4-D + mecoprop + dicamba significantly reduced the number and weight of hardshell bulbs present 8 weeks after the last treatment. The initial treatment in the spring-fall-spring sequence was necessary to reduce hardshell bulb populations the second spring. One year after treatment wild garlic reinfested all plots.
Deadwood tree stems scattered above treeline on tephra-covered slopes of Whitewing Mtn (3051 m) and San Joaquin Ridge (3122 m) show evidence of being killed in an eruption from adjacent Glass Creek Vent, Inyo Craters. Using tree-ring methods, we dated deadwood to AD 815–1350 and infer from death dates that the eruption occurred in late summer AD 1350. Based on wood anatomy, we identified deadwood species as Pinus albicaulis, P. monticola, P. lambertiana, P. contorta, P. jeffreyi, and Tsuga mertensiana. Only P. albicaulis grows at these elevations currently; P. lambertiana is not locally native. Using contemporary distributions of the species, we modeled paleoclimate during the time of sympatry to be significantly warmer (+3.2°C annual minimum temperature) and slightly drier (−24 mm annual precipitation) than present, resembling values projected for California in the next 70–100 yr.
Hand-held hyperspectral reflectance data were collected in the summers of 2002, 2003, and 2004 to differentiate unique spectral characteristics of common turfgrass and weed species. Turfgrass species evaluated were: bermudagrass, ‘Tifway 419’; zoysiagrass, ‘Meyer’; St. Augustinegrass, ‘Raleigh’; common centipedegrass; and creeping bentgrass, ‘Crenshaw’. Weed species evaluated were: dallisgrass, southern crabgrass, eclipta, and Virginia buttonweed. Reflectance data were collected from greenhouse and field locations. An overall classification accuracy of 85% was achieved for all species in the field. A total of 21 spectral bands between 378 and 1,000 nm that were consistent over the three data collection periods were used for analysis. Only centipedegrass, zoysiagrass, and dallisgrass were correctly classified less than 80% of the time. An overall classification accuracy of 69% was achieved for the greenhouse species. Spectral bands used in this analysis ranged from 353 to 799 nm. Creeping bentgrass and Virginia buttonweed were classified correctly at 96 and 92%, respectively.
The Kulshan caldera formed at ∼1.15 Ma on the present-day site of Mt. Baker, Washington State, northwest USA and erupted a compositionally zoned (dacite-rhyolite) magma and a correlative eruptive, the Lake Tapps tephra. This tephra has previously been described, but only from the Puget Lowland of NW Washington. Here an occurrence of a Kulshan caldera correlative tephra is described from the Quaternary Palouse loess at the Washtucna site (WA-3). Site WA-3 is located in east-central Washington, ∼340 km southeast of the Kulshan caldera and ∼300 km east-southeast of the Lake Tapps occurrence in the Puget Lowland. Major- and trace element chemistry and location of the deposit at Washtucna within reversed polarity sediments indicates that it is not correlative with the Mesa Falls, Rockland, Bishop Ash, Lava Creek B or Huckleberry Ridge tephras. Instead the Washtucna deposit is related to the Lake Tapps tephra by fractional crystallisation, but is chemically distinct, a consequence of its eruption from a compositionally zoned magma chamber. The correlation of the Washtucna occurrence to the Kulshan caldera-forming eruption indicates that it had an eruptive volume exceeding 100 km3, and that its tephra could provide a valuable early-Pleistocene chronostratigraphic marker in the Pacific Northwest.
The collective response of electrons in an ultrathin foil target irradiated by an ultraintense (${\sim}6\times 10^{20}~\text{W}~\text{cm}^{-2}$) laser pulse is investigated experimentally and via 3D particle-in-cell simulations. It is shown that if the target is sufficiently thin that the laser induces significant radiation pressure, but not thin enough to become relativistically transparent to the laser light, the resulting relativistic electron beam is elliptical, with the major axis of the ellipse directed along the laser polarization axis. When the target thickness is decreased such that it becomes relativistically transparent early in the interaction with the laser pulse, diffraction of the transmitted laser light occurs through a so called ‘relativistic plasma aperture’, inducing structure in the spatial-intensity profile of the beam of energetic electrons. It is shown that the electron beam profile can be modified by variation of the target thickness and degree of ellipticity in the laser polarization.
Before Shackleton arrived at South Georgia aboard Endurance on 5 November 1914 he was aware that the vessel might meet bad pack-ice in the Weddell Sea. This had been forecast on the basis of climate analysis by Robert Mossman, the meteorologist on the Scottish National Antarctic Expedition (1902–1904), who was currently working at the Argentine Meteorological Office. Mossman was interested in teleconnections linking meteorological and oceanic conditions in widely separated places and had studied the links between the Weddell Sea and South America. Mossman's Antarctic data were mainly records from the Orcadas station in the South Orkneys which had operated continuously from 1903. He found a correlation between extensive pack-ice in the Weddell Sea and plentiful rain in a belt across South America that included Buenos Aires. The experiences of Endurance supported this. Modern studies of the El Niño-Southern Oscillation (ENSO) broadly confirm Mossman's conclusions.