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Abstract We aimed to determine the prognostic role of ileal resection on postoperative complications and the final oncological results of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) treatment in patients with peritoneal metastasis (PM). Patients with PM who underwent CRS and HIPEC between 2007 and 2020 were analyzed retrospectively. Ileal resection was defined as the resection of the ileum at 100 cm or below. Patients were divided into ileal-resection and non-ileal resection groups. Besides clinico-pathological variables, peritoneal cancer index (PCI), completeness of cytoreduction (CC-0-1-2), (neo)adjuvant chemotherapy, operative time, need for surgical intensive care unit, and usage of blood products were all evaluated. The data of 664 patients was analyzed. Ileal resection was performed in 346(52.1%) patients. The median follow-up period was 27 months. The ileal resection group had significantly lower 3-and 5-year survival rates (55% and 43% vs. 69% and 52, p = .005, respectively). High PCI score (p

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The Etoliko Lagoon in western Greece has experienced extensive human modification since the 20th century, both on the surrounding land and in the aquatic environment. To examine human impacts and disentangle climatic from anthropogenic changes, we present a suite of biomarker records that span the past two centuries (∼1790-2011). Specifically, we use terrigenous (n-alkanes, polycyclic aromatic hydrocarbons (PAHs), and phytosterols) and aquatic (dinosterol, brassicasterol, cholesterol, and stigmasterol) biomarkers to document changes in nutrient inputs, combustion, and algal productivity. During most of the 19th and 20th centuries, aquatic communities respond to temperature, forced mainly by solar irradiance and volcanic activity, and precipitation, controlled largely by summer and winter North Atlantic Oscillation (NAO) patterns that determine freshwater runoff. PAHs illustrate the acceleration of coal combustion during the 1800s, and declining concentrations since the 1950s correspond to the implementation of emission controls and reductions in rainfall that likely inhibited PAH transport. As human pressures increased in the late 1900s and water column anoxia grew, the absence of a clear human waste and eutrophication signal suggests that other factors also contributed to limited oxygen availability. Overall, environmental degradation of the late 20th and early 21st centuries is clear and can be attributed to a combination of especially arid conditions and human interferences that altered lagoon hydrography, trophic state, and aquatic community composition., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Audrey Taylor reports financial support was provided by National Science Foundation. Audrey Taylor reports financial support was provided by Clare Booth Luce. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Prior to ~1 million years ago (Ma), variations in global ice volume were dominated by changes in obliquity; however, the role of precession remains unresolved. Using a record of North Atlantic ice rafting spanning the past 1.7 million years, we find that the onset of ice rafting within a given glacial cycle (reflecting ice sheet expansion) consistently occurred during times of decreasing obliquity whereas mass ice wasting (ablation) events were consistently tied to minima in precession. Furthermore, our results suggest that the ubiquitous association between precession-driven mass wasting events and glacial termination is a distinct feature of the mid to late Pleistocene. Before then (increasing), obliquity alone was sufficient to end a glacial cycle, before losing its dominant grip on deglaciation with the southward extension of Northern Hemisphere ice sheets since ~1 Ma.

Both increases in temperature and changes in precipitation may limit future tree growth, but rising atmospheric CO 2 could offset some of these stressors through increased plant Water Use Efficiency (WUE). The net balance between the negative impacts of climate change and positive effects of CO 2 on tree growth is crucial for ecotones, where increased climate stress could drive mortality and shifts in range. Here, we quantify the effects of climate, stand structure, and rising CO 2 on both annual tree-ring growth increment and intrinsic WUE (iWUE) at a savanna-forest boundary in the Upper Midwest United States. Taking a Bayesian hierarchical modelling approach, we find that plant iWUE increased by ~ 16-23% over the course of the twentieth century, but on average, tree-ring growth increments do not significantly increase. Consistent with higher iWUE under increased CO 2 and recent wetting, we observe a decrease in sensitivity of tree growth to annual precipitation, leading to ~ 35-41% higher growth under dry conditions compared to trees of similar size in the past. However, an emerging interaction between summer maximum temperatures and annual precipitation diminishes the water-savings benefit under hot and dry conditions. This decrease in precipitation sensitivity, and the interaction between temperature and precipitation are strongest in open canopy microclimates, suggesting that stand structure may modulate response to future changes. Overall, while higher iWUE may provide some water savings benefits to growth under normal drought conditions, near-term future temperature increases combined with drought events could drive growth declines of about 50%., (© 2021. The Author(s).)

The dominant feature of large-scale mass transfer in the modern ocean is the Atlantic meridional overturning circulation (AMOC). The geometry and vigour of this circulation influences global climate on various timescales. Palaeoceanographic evidence suggests that during glacial periods of the past 1.5 million years the AMOC had markedly different features from today 1 ; in the Atlantic basin, deep waters of Southern Ocean origin increased in volume while above them the core of the North Atlantic Deep Water (NADW) shoaled 2 . An absence of evidence on the origin of this phenomenon means that the sequence of events leading to global glacial conditions remains unclear. Here we present multi-proxy evidence showing that northward shifts in Antarctic iceberg melt in the Indian-Atlantic Southern Ocean (0-50° E) systematically preceded deep-water mass reorganizations by one to two thousand years during Pleistocene-era glaciations. With the aid of iceberg-trajectory model experiments, we demonstrate that such a shift in iceberg trajectories during glacial periods can result in a considerable redistribution of freshwater in the Southern Ocean. We suggest that this, in concert with increased sea-ice cover, enabled positive buoyancy anomalies to 'escape' into the upper limb of the AMOC, providing a teleconnection between surface Southern Ocean conditions and the formation of NADW. The magnitude and pacing of this mechanism evolved substantially across the mid-Pleistocene transition, and the coeval increase in magnitude of the 'southern escape' and deep circulation perturbations implicate this mechanism as a key feedback in the transition to the '100-kyr world', in which glacial-interglacial cycles occur at roughly 100,000-year periods.

The use of hydrogen isotope ratios (δ(2)H) of sedimentary n-alkanes from leaf waxes has become an important tool for reconstructing paleoenvironmental and ancient hydrologic conditions. Studies of modern plant waxes can elucidate driving ecological mechanisms behind geologic deposits. Here, we used a transect across the North American Monsoon region of the western USA from Tucson, Arizona to Salt Lake City, Utah to study variations in leaf wax δ(2)H among co-occurring plants. Three co-occurring life forms were selected: perennial shrub (rabbit brush, Chrysothamnus nauseosus; sagebrush, Artemisia tridentata); tree (Gambel's oak tree, Quercus gambelii); and annual (sunflower, Helianthus annuus). Our results showed that the distributions and abundances of n-alkanes in perennial plants were similar across all sites and generally did not vary with environmental conditions (e.g., precipitation and temperature). In contrast, variations in n-alkane δ(2)H were significantly correlated with the fraction of the annual precipitation coming during the summer monsoon period. We use a modified Craig-Gordon model to speculate on the possible drivers of the δ(2)H values of leaf wax n-alkanes of plants across the region. The model results suggest that the most likely explanation for variation in wax δ(2)H values was a combination of seasonal source water usage and subsequent environmental conditions.

The extent to which both water source and atmospheric humidity affect δ(2)H values of terrestrial plant leaf waxes will affect the interpretations of δ(2)H variation of leaf waxes as a proxy for hydrological conditions. To elucidate the effects of these parameters, we conducted a long-term experiment in which we grew two tree species, Populus fremontii and Betula occidentalis, hydroponically under combinations of six isotopically distinct waters and two different atmospheric humidities. We observed that leaf n-alkane δ(2)H values of both species were linearly related to source water δ(2)H values, but with slope differences associated with differing humidities. When a modified version of the Craig-Gordon model incorporating plant factors was used to predict the δ(2)H values of leaf water, all modelled leaf water values fit the same linear relationship with n-alkane δ(2)H values. These observations suggested a relatively constant biosynthetic fractionation factor between leaf water and n-alkanes. However, our calculations indicated a small difference in the biosynthetic fractionation factor between the two species, consistent with small differences calculated for species in other studies. At present, it remains unclear if these apparent interspecies differences in biosynthetic fractionation reflect species-specific biochemistry or a common biosynthetic fractionation factor with insufficient model parameterization., (© 2014 John Wiley & Sons Ltd.)

Leaf-wax n-alkanes (2)H/(1)H ratios are widely used as a proxy in climate reconstruction. Although the broad nature of the relationship between n-alkanes δ(2)H values and climate is appreciated, the quantitative details of the proxy remain elusive. To examine these details under natural environmental conditions, we studied a riparian broadleaf angiosperm species, Populus angustifolia, growing on water with a constant δ(2)H value and monitored the δ(2)H values of leaf-wax n-alkanes and of stem, leaf, stream, and atmospheric waters throughout the entire growing season. Here we found the δ(2)H values of leaf-wax n-alkanes recorded only a 2-wk period during leaf flush and did not vary for the 19 weeks thereafter when leaves remained active. We found δ(2)H values of leaf-wax n-alkanes of P. angustifolia record conditions earlier in the season rather than fully integrating the entire growing season. Using these data, we modeled precipitation δ(2)H values during the time of wax synthesis. We observed that the isotope ratios of this precipitation generally were (2)H-enriched compared with mean annual precipitation. This model provides a mechanistic basis of the often-observed (2)H-enrichment from the expected fractionation values in studies of broadleaf angiosperm leaf-wax δ(2)H. In addition, these findings may have implications for the spatial and temporal uses of n-alkane δ(2)H values in paleoapplications; when both plant community and growth form are known, this study allows the isolation of the precipitation dynamics of individual periods of the growing season.

The potential for increased drought frequency and severity linked to anthropogenic climate change in the semi-arid regions of the southwestern United States (US) is a serious concern. Multi-year droughts during the instrumental period and decadal-length droughts of the past two millennia were shorter and climatically different from the future permanent, 'dust-bowl-like' megadrought conditions, lasting decades to a century, that are predicted as a consequence of warming. So far, it has been unclear whether or not such megadroughts occurred in the southwestern US, and, if so, with what regularity and intensity. Here we show that periods of aridity lasting centuries to millennia occurred in the southwestern US during mid-Pleistocene interglacials. Using molecular palaeotemperature proxies to reconstruct the mean annual temperature (MAT) in mid-Pleistocene lacustrine sediment from the Valles Caldera, New Mexico, we found that the driest conditions occurred during the warmest phases of interglacials, when the MAT was comparable to or higher than the modern MAT. A collapse of drought-tolerant C(4) plant communities during these warm, dry intervals indicates a significant reduction in summer precipitation, possibly in response to a poleward migration of the subtropical dry zone. Three MAT cycles ∼2 °C in amplitude occurred within Marine Isotope Stage (MIS) 11 and seem to correspond to the muted precessional cycles within this interglacial. In comparison with MIS 11, MIS 13 experienced higher precessional-cycle amplitudes, larger variations in MAT (4-6 °C) and a longer period of extended warmth, suggesting that local insolation variations were important to interglacial climatic variability in the southwestern US. Comparison of the early MIS 11 climate record with the Holocene record shows many similarities and implies that, in the absence of anthropogenic forcing, the region should be entering a cooler and wetter phase.