Comparative assessment of leaf photosynthetic capacity datasets for estimating terrestrial gross primary productivity

The maximum Rubisco carboxylation rate normalized to 25 °C (Vcmax25) is a key parameter in terrestrial biosphere models for simulating carbon cycling. Recently, global distributions of Vcmax25 have been derived through various methods and different data, including field measurements, ecological optimality theory (EOT), leaf chlorophyll content (LCC), and solar-induced chlorophyll fluorescence (SIF). However, direct validation poses challenges due to high uncertainty arising from limited ground-based observations. This study conducted an indirect evaluation of four Vcmax25 datasets by assessing the accuracy of gross primary productivity (GPP) simulated using the Biosphere-atmosphere Exchange Process Simulator (BEPS) at both site and global scales. Results indicate that, compared to utilizing Vcmax25 fixed by plant functional types (PFT) derived from field measurements, incorporating Vcmax25 derived from SIF and LCC (SIF + LCC), or solely LCC, into BEPS significantly reduces simulated errors in the annual total GPP, with a 23.2 %-25.1 % decrease in the average absolute bias across 196 FLUXNET2015 sites. Daily GPP for evergreen needleleaf forests, deciduous broadleaf forests, shrublands, grasslands, and croplands shows a 7.8 %-27.6 % decrease in absolute bias, primarily attributed to reduced simulation errors during off-peak seasons of vegetation growth. Conversely, the annual total GPP error simulated using EOT-derived Vcmax25 increases slightly (2.2 %) compared to that simulated using PFT-fixed Vcmax25. This is primarily due to a significant overestimation in evergreen broadleaf forests and underestimation in croplands, despite slight increased accuracy for other PFTs. The global annual GPP simulated using Vcmax25 with seasonal variations (i.e., LCC Vcmax25 and SIF + LCC Vcmax25) yields a 4.3 %-7.3 % decrease compared to that simulated using PFT-fixed Vcmax25. Compared to FLUXCOM and GOSIF GPP products, the GPP simulated based on SIF + LCC Vcmax25 and LCC Vcmax25 demonstrates better consistency (R2 = 0.91-0.93, RMSE = 314.2-376.6 g C m-2 yr-1). This study underscores the importance of accurately characterizing the spatiotemporal variations in Vcmax25 for the accurate simulation of global vegetation productivity.

A novel hybrid modelling framework for GPP estimation: Integrating a multispectral surface reflectance based Vcmax25 simulator into the process-based model

Terrestrial gross primary productivity (GPP) is the key element in the carbon cycle process. Accurate GPP estimation hinges on the maximum carboxylation rate (Vcmax,025). The high uncertainty in deriving ecosystem-level Vcmax,025 has long hampered efforts toward the performance of the GPP model. Recently studies suggest the strong relationship between spectral reflectance and Vcmax,025. We proposed the multispectral surface reflectance-driven Vcmax,025 simulator using the fully connected deep neural network and built the hybrid modelling framework for GPP estimation by integrating the data-driven Vcmax,025 simulator in the process-based model. The performance of hybrid GPP model was evaluated at 95 flux sites. The result shows that the multispectral surface reflectance-driven Vcmax,025 simulator acquires the satisfactory estimation, with correlation coefficient (R), root mean square error (RMSE) and median absolute percentage error (MdAPE) ranging from 0.34 to 0.80, 14 to 43 μmol m-2 s-1 and 21 % to 66 % across different land cover types, respectively. The hybrid framework generates good GPP estimates with R, RMSE and MdAPE varying from 0.76 to 0.89, 1.79 to 6.16 μmol m-2 s-1 and 27 % to 90 %, respectively. Compared with EVI-driven method, the multispectral surface reflectance significantly improves the Vcmax,025 and GPP estimates, with MdAPE declining by 0.6 %-18 % and 1 % to 21 %, respectively. The Shapley value analysis reveals that red (620-670 nm), near-infrared (841-876 nm) and shortwave infrared (1628-1652 nm and 2105-2155 nm) are the key bands for Vcmax,025 estimation. This study highlights the potential of multispectral surface reflectance for quantifying ecosystem-level Vcmax,025. The new hybrid framework fully extracts the information of all available spectral bands using deep learning to reduce parameter uncertainty while maintains the description of photosynthetic process to ensure its physical reasonability. It can serve as a powerful tool for accurate global GPP estimation.

Therapeutic Potential of Spesolimab-Sbzo in the Management of Generalized Pustular Psoriasis Flares in Adults: Evidence to Date

Generalized pustular psoriasis (GPP) is a rare, chronic, and severe skin disorder characterized by the eruption of non-infectious pustules on an erythematous background often associated with systemic symptoms. It may appear in association with plaque psoriasis or occur in previously healthy individuals. It differs from psoriasis vulgaris in clinical presentation, immunopathogenesis, histology, and therapeutic strategies. Overexpression of interleukin 36 (IL-36) or a loss-of-function mutation of IL-36 receptor antagonist (IL-36RA) are thought to play a pivotal role in the pathogenesis of this disease. There are currently no globally approved guidelines for the treatment of GPP, and the therapies used so far, with variable results, have given unsatisfactory results. Spesolimab, a selective humanized antibody against the IL-36 receptor that blocks its activation, is the first biologic drug approved in Europe in December 2022 for the treatment of GPP flares. It represents a promising therapy, demonstrating efficacy in reducing disease severity and improving patient outcomes. In our review, we have analyzed the latest advancements and findings regarding the efficacy and safety of spesolimab in the context of GPP management.

Carbon cycle responses to climate change across China's terrestrial ecosystem: Sensitivity and driving process

Investigations into the carbon cycle and how it responds to climate change at the national scale are important for a comprehensive understanding of terrestrial carbon cycle and global change issues. Contributions of carbon fluxes to the terrestrial sink and the effects on climate change are still not fully understood. In this study, we aimed to explore the relationship between ecosystem production (GPP/SIF/NDVI) and net ecosystem carbon exchange (NEE) and to investigate the sensitivity of carbon fluxes to climate change at different spatio-temporal scales. Furthermore, we sought to delve into the carbon cycle processes driven by climate stress in China since the beginning of the 21st century. To achieve these objectives, we employed correlation and sensitivity analysis techniques, utilizing a wide range of data sources including ground-based observations, remote sensing observations, atmospheric inversions, machine learning, and model simulations. Our findings indicate that NEE in most arid regions of China is primarily driven by ecosystem production. Climate variations have a greater influence on ecosystem production than respiration. Warming has negatively impacted ecosystem production in Northeast China, as well as in subtropical and tropical regions. Conversely, increased precipitation has strengthened the terrestrial carbon sink, particularly in the northern cool and dry areas. We also found that ecosystem respiration exhibits heightened sensitivity to warming in southern China. Moreover, our analysis revealed that the control of terrestrial carbon cycle by ecosystem production gradually weakens from cold/arid areas to warm/humid areas. We identified distinct temperature thresholds (ranging from 10.5 to 13.7 °C) and precipitation thresholds (approximately 1400 mm yr-1) for the transition from production-dominated to respiration-dominated processes. Our study provides valuable insights into the complex relationship between climate change and carbon cycle in China.

Asymmetric response of vegetation GPP to impervious surface expansion: Case studies in the Yellow and Yangtze River Basins

Terrestrial gross primary production (GPP) changes due to impervious surfaces significantly impact ecosystem services in watersheds. Understanding the asymmetric response of vegetation GPP to impervious surface expansion is essential for regional development planning and ecosystem management. However, the asymmetric response of vegetation GPP to the impacts of impervious surface expansion is unknown in different watersheds. This paper selected the Yellow River and Yangtze River basins as case studies. We characterized the overall change in GPP based on changes in impervious surface ratio (ISR), determined impervious surface expansion's direct and indirect impacts on GPP in the two watersheds, and further analyzed the asymmetric response of the compensatory effects of indirect influences on the impervious surface expansion in different watersheds. The results showed that: (1) The vegetation GPP decreased with increasing ISR in the Yangtze River Basin, while that in the Yellow River Basin first increased and then reduced. (2) The direct impacts of increased ISR reduced vegetation GPP, while the indirect impacts both had a growth-compensating effect. Growth compensation stabilized at approximately 0.40 and 0.30 in the Yellow and Yangtze River Basins. (3) When the ISR was 0.34-0.56, the growth compensation could offset the reduction of GPP due to direct impact and ensure that the background vegetation GPP was not damaged in the Yellow River Basin. In contrast, the background vegetation GPP was inevitably impaired with increased ISR in the Yangtze River Basin. Therefore, this study suggests that the ISR should be ensured to be between 0.34 and 0.56 to maximize the impervious surface of the Yellow River Basin without compromising the background vegetation GPP. While pursuing impervious surface expansion in the Yangtze River Basin, other programs should be sought to compensate for the loss to GPP.

Diverse responses of gross primary production and leaf area index to drought on the Mongolian Plateau

Drought is a crucial factor regulating vegetation growth on the Mongolian Plateau (MP). Previous studies of drought effects on the MP have mainly concentrated on drought characterization, while the response of vegetation to drought remains unclear. To close this knowledge gap, we examined the response of MP vegetation to drought in terms of gross primary production (GPP) and leaf area index (LAI) from 1982 to 2018. Our findings show that intra-seasonally the frequency of drought occurrence in autumn had a greater impact on GPP (relative importance over 70 %), while the intensity of drought was more influential for LAI (relative importance approximately 60 %). Inter-seasonally, summer droughts had the most pronounced effect on vegetation (with median standardized anomalies of -0.72 for GPP and -0.4 for LAI, respectively). Additionally, we found that meteorological drought was more consistent with atmospheric aridity (high vapor pressure deficit) than soil drought (low soil moisture). This study advances knowledge of vegetation's susceptibility to climate extremes and improves the precision of predicting ecosystem response to climate change.

The role of the interleukin-36 axis in generalized pustular psoriasis: a review of the mechanism of action of spesolimab

Generalized pustular psoriasis (GPP) is a rare, chronic, inflammatory skin disorder characterized by recurrent flares associated with skin erythema, desquamation, and widespread superficial sterile pustules, which may be severe ("lakes of pus"). Systemic symptoms are often present, including malaise, fever, and skin pain. In GPP, innate immune responses are driven by abnormal activation of the interleukin (IL)-36-chemokine-neutrophil axis and excessive neutrophil infiltration. This review highlights the IL-36 pathway in the context of the IL-1 superfamily and describes how unopposed IL-36 signaling can lead to the development of GPP. Targeted inhibition of the IL-36 receptor (IL-36R) is an attractive therapeutic strategy in the treatment of GPP, including flare prevention and sustained disease control. Spesolimab is a first-in-class, humanized, monoclonal antibody that binds specifically to the IL-36R and antagonizes IL-36 signaling. Spesolimab was approved by the US Food and Drug Administration in September 2022 to treat GPP flares in adults and was subsequently approved for GPP flare treatment in other countries across the world. Anti-IL-36R therapy, such as spesolimab, can mitigate flares and address flare prevention in GPP, presumably through rebalancing IL-36 signaling and modulating the pro-inflammatory response of the downstream effectors.

Exploring the Quality-of-Life Impact, Disease Burden, and Management Challenges of GPP: The Provider and Patient Perspective [Podcast]

Generalized pustular psoriasis (GPP) is a rare, chronic, and debilitating disease characterized by flares of widespread erythema, desquamation, and pustule formation. GPP flares can be accompanied by systemic symptoms including fever, fatigue, malaise, and skin pain; severe cases may be fatal if untreated. Although GPP may occur concurrently with plaque psoriasis, they represent two distinct inflammatory conditions. Patients with GPP experience a substantial burden of disease, and the impact of GPP on an individual's mental health and quality-of-life (QoL) goes far beyond skin pain and discomfort. The rarity of GPP may result in a misdiagnosis, as the sudden onset of skin pustules may be mistaken for a primary infection. Misdiagnosis with a subsequent delay in treatment has tremendous negative consequences for the affected patient. In September 2022, spesolimab became the first FDA-approved medication in the US for the treatment of GPP flares in adults. Spesolimab has since been approved by regulatory agencies in numerous countries, including Japan, Mainland China, and the EU. Prior to spesolimab, the clinical management of GPP relied on the off-label use of systemic or biologic therapies approved for plaque psoriasis or other inflammatory conditions. There is a need for increased education among healthcare providers regarding the clinical diagnosis, risk stratification, and therapeutic management of this rare disease, including the other novel GPP-specific therapies in development. In this podcast, two dermatologists and a patient who has plaque psoriasis and GPP discuss the clinical presentation, symptoms, disease burden, QoL impacts, diagnostic challenges, and therapeutic strategies for the management of GPP.

Assessment of Forest Ecosystem Variations in the Lancang-Mekong Region by Remote Sensing from 2010 to 2020

Five countries in the Lancang-Mekong region, including Myanmar, Laos, Thailand, Cambodia, and Vietnam, are facing the threat of deforestation, despite having a high level of forest coverage. Quantitatively assessing the forest ecosystem status and its variations based on remote sensing products for vegetation parameters is a crucial prerequisite for the ongoing phase of our future project. In this study, we analyzed forest health in the year 2020 using four vegetation indicators: forest coverage index (FCI), leaf area index (LAI), fraction of green vegetation cover (FVC), and gross primary productivity (GPP). Additionally, we introduced an ecosystem quality index (EQI) to assess the quality of forest health. To understand the long-term trends in the vegetation indicators and EQI, we also performed a linear regression analysis from 2010 to 2020. The results revealed that Laos ranked as the top-performing country for forest ecosystem status in the Lancang-Mekong region in 2020. However, the long-term trend analysis results showed that Cambodia experienced the most significant decline across all indicators, while Vietnam and Thailand demonstrated varying degrees of improvement. This study provides a quality assessment of forest health and its variations in the Lancang-Mekong region, which is crucial for implementing effective conservation strategies.

Dryness limits vegetation pace to cope with temperature change in warm regions

Climate change leads to increasing temperature and more extreme hot and drought events. Ecosystem capability to cope with climate warming depends on vegetation's adjusting pace with temperature change. How environmental stresses impair such a vegetation pace has not been carefully investigated. Here we show that dryness substantially dampens vegetation pace in warm regions to adjust the optimal temperature of gross primary production (GPP) (T opt GPP ) in response to change in temperature over space and time.T opt GPP spatially converges to an increase of 1.01°C (95% CI: 0.97, 1.05) per 1°C increase in the yearly maximum temperature (Tmax ) across humid or cold sites worldwide (37o S-79o N) but only 0.59°C (95% CI: 0.46, 0.74) per 1°C increase in Tmax across dry and warm sites.T opt GPP temporally changes by 0.81°C (95% CI: 0.75, 0.87) per 1°C interannual variation in Tmax at humid or cold sites and 0.42°C (95% CI: 0.17, 0.66) at dry and warm sites. Regardless of the water limitation, the maximum GPP (GPPmax ) similarly increases by 0.23 g C m-2 day-1 per 1°C increase inT opt GPP in either humid or dry areas. Our results indicate that the future climate warming likely stimulates vegetation productivity more substantially in humid than water-limited regions.

Current management of generalized pustular psoriasis

Generalized pustular psoriasis (GPP) is a rare subset of psoriasis involving episodes of sterile pustules accompanied by inflammation and, often, systemic involvement. The inflammatory nature of GPP has potential for severe multisystem complications including high-output cardiac failure, infections, digestive system issues, and disfiguring or lethal acute flare episodes. The disease tends to have higher prevalence in females and Asians. The IL-1/IL-36 inflammatory pathway is a critical facet of GPP's pathology. Genetic mutations that are associated with GPP include modifications of Interleukin 36 Receptor Antagonist (IL36RN), Caspase Recruitment Domain Family Member 14 (CARD14), Adaptor Related Protein Complex 1 Subunit Sigma 3 (AP1S3), Myeloperoxidase (MPO) and Serpin Peptidase Inhibitor Clade A Member 3 (SERPINA3) genes. Treatment guidelines for GPP are not well-entrenched. Currently, only one GPP-specific treatment, the interleukin-36 receptor antagonist (IL-36Ra) spesolimab, has been approved for use in the United States. Additional anti-IL-36 pathway therapies are currently being developed. Other treatment options include other biologic therapies such as IL-17 inhibitors, IL-23 inhibitors and TNFα inhibitors. Non-biologic therapeutic options include retinoids, cyclosporine and methotrexate. Treatment options differ throughout the world; most countries utilize retinoids, cyclosporine and methotrexate as first-line non-biologic options. China and United Kingdom have no GPP-specific biologic therapies approved for use, while several biologic therapies are approved for use in Japan. This review aims to serve as an update on the current global management of GPP while also including relevant aspects of disease pathogenesis, diagnosis, clinical presentation, histopathology, aetiology and epidemiology.

Rapid and sustained improvements in Generalized Pustular Psoriasis Physician Global Assessment scores with spesolimab for treatment of generalized pustular psoriasis flares in the randomized, placebo-controlled Effisayil 1 study

BACKGROUND

Effisayil 1 was a randomized, placebo-controlled study of spesolimab, which is an anti-IL-36 receptor antibody, in patients presenting with a generalized pustular psoriasis flare.

OBJECTIVE

To assess the effects of spesolimab over the 12-week study.

METHODS

The primary endpoint of the study was Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) pustulation subscore of 0 at week 1. Patients (N = 53) were randomized (2:1) to receive a single intravenous dose of 900 mg spesolimab or placebo on day 1. Patients could receive open-label spesolimab for persistent flare symptoms on day 8.

RESULTS

Most patients receiving spesolimab achieved a GPPGA pustulation subscore of 0 (60.0%) and GPPGA total score of 0 or 1 (60.0%) by week 12. In patients randomized to placebo who received open-label spesolimab on day 8, the proportion with GPPGA pustulation subscore of 0 increased from 5.6% at day 8 to 83.3% at week 2. No factors predictive of spesolimab response were identified in patient demographics or clinical characteristics.

LIMITATIONS

The effect of initial randomization was not determined conventionally beyond week 1 due to patients receiving open-label spesolimab.

CONCLUSION

Rapid control of generalized pustular psoriasis flare symptoms with spesolimab was sustained over 12 weeks, further supporting its potential use as a therapeutic option for patients.

Synchronous Changes of GPP and Solar-Induced Chlorophyll Fluorescence in a Subtropical Evergreen Coniferous Forest

Using in situ near-surface observations of solar-induced chlorophyll fluorescence (SIF) and gross primary productivity (GPP) of a subtropical evergreen coniferous forest in southern China, this study analyzed the dynamics of SIF, GPP and their environmental responses, and explored the potential of SIF in characterizing the variation of GPP. The results showed that SIF and GPP have similar diurnal and seasonal variation and both reach the highest value in summer, indicating that the SIF can be applied to indicate the seasonal variation of GPP for the subtropical evergreen co-niferous. With the increase in temporal scale, the correlation between SIF and GPP becomes more linear. The diurnal variations of both SIF and GPP were characterized by photosynthetically active radiation (PAR), the seasonal variations of SIF and GPP were influenced by air temperature (Ta) and PAR. Probably due to the absent of drought stress during the study period, no significant correlation was detected between soil water content (SWC) and either SIF or GPP. With the in-crease in Ta, PAR or SWC, the linear correlation between the SIF and GPP gradually decreased, and when Ta or PAR was relatively higher, the correlation between SIF and GPP become weakly. Further research is still needed to illustrate the relationship between SIF and GPP under drought condition which occurred frequently in this region based on longer observation.

A cytosolic bifunctional geranyl/farnesyl diphosphate synthase provides MVA-derived GPP for geraniol biosynthesis in rose flowers

Geraniol derived from essential oils of various plant species is widely used in the cosmetic and perfume industries. It is also an essential trait of the pleasant smell of rose flowers. In contrast to other monoterpenes which are produced in plastids via the methyl erythritol phosphate pathway, geraniol biosynthesis in roses relies on cytosolic NUDX1 hydrolase which dephosphorylates geranyl diphosphate (GPP). However, the metabolic origin of cytosolic GPP remains unknown. By feeding Rosa chinensis "Old Blush" flowers with pathway-specific precursors and inhibitors, combined with metabolic profiling and functional characterization of enzymes in vitro and in planta, we show that geraniol is synthesized through the cytosolic mevalonate (MVA) pathway by a bifunctional geranyl/farnesyl diphosphate synthase, RcG/FPPS1, producing both GPP and farnesyl diphosphate (FPP). The downregulation and overexpression of RcG/FPPS1 in rose petals affected not only geraniol and germacrene D emissions but also dihydro-β-ionol, the latter due to metabolic cross talk of RcG/FPPS1-dependent isoprenoid intermediates trafficking from the cytosol to plastids. Phylogenetic analysis together with functional characterization of G/FPPS orthologs revealed that the G/FPPS activity is conserved among Rosaceae species. Site-directed mutagenesis and molecular dynamic simulations enabled to identify two conserved amino acids that evolved from ancestral FPPSs and contribute to GPP/FPP product specificity. Overall, this study elucidates the origin of the cytosolic GPP for NUDX1-dependent geraniol production, provides insights into the emergence of the RcG/FPPS1 GPPS activity from the ancestral FPPSs, and shows that RcG/FPPS1 plays a key role in the biosynthesis of volatile terpenoid compounds in rose flowers.

The magnitude and pace of photosynthetic recovery after wildfire in California ecosystems

Wildfire modifies the short- and long-term exchange of carbon between terrestrial ecosystems and the atmosphere, with impacts on ecosystem services such as carbon uptake. Dry western US forests historically experienced low-intensity, frequent fires, with patches across the landscape occupying different points in the fire-recovery trajectory. Contemporary perturbations, such as recent severe fires in California, could shift the historic stand-age distribution and impact the legacy of carbon uptake on the landscape. Here, we combine flux measurements of gross primary production (GPP) and chronosequence analysis using satellite remote sensing to investigate how the last century of fires in California impacted the dynamics of ecosystem carbon uptake on the fire-affected landscape. A GPP recovery trajectory curve of more than five thousand fires in forest ecosystems since 1919 indicated that fire reduced GPP by [Formula: see text] g C m[Formula: see text] y[Formula: see text]([Formula: see text]) in the first year after fire, with average recovery to prefire conditions after [Formula: see text] y. The largest fires in forested ecosystems reduced GPP by [Formula: see text] g C m[Formula: see text] y[Formula: see text] (n = 401) and took more than two decades to recover. Recent increases in fire severity and recovery time have led to nearly [Formula: see text] MMT CO[Formula: see text] (3-y rolling mean) in cumulative forgone carbon uptake due to the legacy of fires on the landscape, complicating the challenge of maintaining California's natural and working lands as a net carbon sink. Understanding these changes is paramount to weighing the costs and benefits associated with fuels management and ecosystem management for climate change mitigation.

Restored vegetation is more resistant to extreme drought events than natural vegetation in Southwest China

Large scale Ecosystem restoration projects (ERPs) have been implemented to restore vegetation and increase carbon stocks across China. However, whether restored vegetation is strongly resistant to Extreme drought events (EDEs) remains unclear, especially when compared to natural vegetation. Therefore, we used the standardized anomaly of 3-month Standard Precipitation-Evapotranspiration Index (SPEI) to characterize the spatial-temporal trends of EDEs, and figured out the capacity of restored vegetation to withstand the strongest EDE in Southwest China by analyzing their changes of Gross Primary Productivity (GPP) and Water Use Efficiency (WUE). The results showed that Southwest China had experienced six typical EDEs with increasing frequency and severity from 1982 to 2017, particularly the EDE during 2009-2010 (EDE 2009/2010) which had the longest duration and strongest severity. Overall, the EDE 2009/2010 substantially suppressed the vegetation GPP and ecosystem WUE in both restored and natural vegetation area. Compared with natural vegetation, the GPP and WUE of restored vegetation was relative higher and moreover, their GPP decreased more slowly during the EDE 2009/2010 and increased more quickly during the recovery period. This indicates that restored vegetation had a higher drought resistance to the EDE than natural vegetation. Additionally, karst landforms have a stronger negative impact on vegetation GPP and WUE during the EDE. Furthermore, the reduction in the afforestation areas was more obviously observed than that in natural forest areas. Therefore, we suggest that vegetation suitable for regional characteristics should be selected during vegetation restoration, such as afforestation in the non-karst areas.

Efficacy and safety of spesolimab in Asian patients with a generalized pustular psoriasis flare: Results from the randomized, double-blind, placebo-controlled Effisayil™ 1 study

Generalized pustular psoriasis is a potentially life-threatening neutrophilic skin disease characterized by recurrent flares of widespread erythema and eruption of sterile pustules. In the Effisayil™ 1 study (NCT03782792), 53 patients with a generalized pustular psoriasis flare were treated with placebo or spesolimab, a humanized anti-interleukin-36 receptor monoclonal antibody, the first targeted treatment to be studied in a randomized clinical trial. Spesolimab treatment resulted in rapid pustular and skin clearance, with an acceptable safety profile. Here, we evaluate the efficacy and safety of spesolimab in 29 Asian patients in the Effisayil™ 1 study. The primary endpoint, a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) pustulation subscore of 0 (no visible pustules) at Week 1, was achieved by 10 patients (62.5%) randomized to spesolimab and one patient (7.7%) randomized to placebo (risk difference 54.8, 95% confidence interval [CI] 17.3-79.8). The key secondary endpoint, a GPPGA total score of 0 or 1 (clear or almost clear skin) at Week 1, was achieved by eight (50.0%) and two (15.4%) patients, respectively (risk difference 34.6, 95% CI -3.1-64.7). This was similar to previously published data in the overall population in whom the primary and key secondary endpoints were achieved by 54% versus 6% and 43% versus 11% of patients, respectively. The percentages of Asian patients randomized to spesolimab with a GPPGA pustulation subscore of 0 and GPPGA total score of 0 or 1 were sustained above 60% for up to 12 weeks. In these patients, patient-reported outcomes also improved and markers of systemic inflammation were normalized. Eleven (68.8%) and eight (61.5%) of spesolimab- and placebo-treated patients, respectively, experienced at least one adverse event. In conclusion, spesolimab improved outcomes in Asian patients compared with placebo, supporting its use in the treatment of generalized pustular psoriasis flares.

Real-world data on the use of secukinumab and acitretin in pediatric generalized pustular psoriasis

To evaluate the outcomes of secukinumab and acitretin use in children with generalized pustular psoriasis (GPP), we compared the efficacy and adverse events of secukinumab in 20 children and acitretin in 16 children with GPP from January 1, 2019, to January 30, 2022. Among the 20 patients treated with secukinumab, the average time for pustules to fade, temperature to normalize, and C-reactive protein (CRP) to normalize was 3.83, 2.46, and 3.91 days, respectively. All patients recovered (Japanese Dermatological Association severity index score: 0/1) in 3 weeks. The adverse events were abnormal liver enzyme (10%), atopic dermatitis-like lesions (10%), herpes simplex (5%), and neutropenia (10%). For the patients treated with acitretin, the average time for pustules to fade, temperature to normalize, and CRP to normalize was 6, 6.14, and 8.73 days, respectively. The adverse events included mucocutaneous dryness (75%), dyslipidemia (37.5%), and abnormal liver enzyme (25%). These findings demonstrate that secukinumab has more favorable outcomes than acitretin, and secukinumab was well tolerated by the pediatric patients with GPP.

A homozygous loss-of-function variant in the MPO gene is associated with generalized pustular psoriasis

Generalized pustular psoriasis (GPP) is a rare form of psoriasis, which is characterized by sudden onset of repeated erythema and pustule formation with generalized inflammation. Recent advances in molecular genetics have led to the identification of several genes associated with GPP, including IL36RN, CARD14, AP1S3, SERPINA3, and MPO. Of these, only limited cases of GPP have been reported to carry mutations in the AP1S3, SERPINA3, or MPO to date. In the present study, we investigated a Japanese patient with GPP and found a homozygous missense mutation c.1769G>T (p.Arg590Leu) in the MPO gene. Structural analysis predicted that the mutant MPO protein would abolish its ability to bind with heme protein. In vitro studies using cultured cells revealed that the mutant MPO was stably expressed, but completely lost its myeloperoxidase activity. Immunohistochemistry (IHC) using an anti-MPO antibody showed markedly reduced expression of MPO protein in the patient's skin, suggesting that the mutation would lead to an instability of the MPO protein in vivo. Finally, IHC with an anti-citrullinated Histone H3 antibody demonstrated a sparse formation of neutrophil extracellular traps within a Kogoj's spongiform pustule of the patient's skin. Collectively, we conclude that the c.1769G>T (p.Arg590Leu) in the MPO is a complete loss-of-function mutation associated with GPP in the patient. Our data further underscore critical roles of the MPO gene in the pathogenesis of GPP.

Case report: Successful treatment of acute generalized pustular psoriasis of puerperium with secukinumab

Generalized pustular psoriasis (GPP) is a rare and severe form of psoriasis presenting with erythematous, aseptic pustules. Common systemic symptoms include fever and myalgias. The presentation of GPP resembles acute generalized exanthematous pustulosis (AGEP). However, the treatment of these two pathologies differs. While AGEP is self-limiting and treated with topical corticosteroids and constrain of systemic steroids. GPP treatment avoids corticosteroid, choosing acitretin, methotrexate, and cyclosporine as first-line agents. In this case report, a 27-year-old female with a medical history of AGEP presented to the hospital with extensive erythema and pustules. Complete blood count acute phase reactant analysis revealed an elevated white blood cell count and C-reactive protein (CRP). Two histopathological examinations revealed psoriatic hyperplasia of the epidermis with keratosis, along with Kogoj and Munro micro abscesses above the spina layer. Lymphocytic and neutrophilic infiltrate was present in the superficial derma layer along with vasodilation. The patient was diagnosed with GPP according to pathological and clinical criteria. Treatment was initiated with secukinumab because of the patient's failure to respond to systemic treatment with Acitretin, methotrexate, and cyclosporin. Following 2 weeks of therapy with 300 mg of secukinumab, the pustular lesions had resolved. This study indicates the potential efficacy of secukinumab as an effective therapy that can rapidly improve the clinical symptoms of GPP.

Landscape determinants of pelagic and benthic primary production in northern lakes

Global change affects gross primary production (GPP) in benthic and pelagic habitats of northern lakes by influencing catchment characteristics and lake water biogeochemistry. However, how changes in key environmental drivers manifest and impact total (i.e., benthic + pelagic) GPP and the partitioning of total GPP between habitats represented by the benthic share (autotrophic structuring) is unclear. Using a dataset from 26 shallow lakes located across Arctic, subarctic, and boreal northern Sweden, we investigate how catchment properties (air temperature, land cover, hydrology) affect lake physico-chemistry and patterns of total GPP and autotrophic structuring. We find that total GPP was mostly light limited, due to high dissolved organic carbon (DOC) concentrations originating from catchment soils with coniferous vegetation and wetlands, which is further promoted by high catchment runoff. In contrast, autotrophic structuring related mostly to the relative size of the benthic habitat, and was potentially modified by CO₂ fertilization in the subarctic, resulting in significantly higher total GPP relative to the other biomes. Across Arctic and subarctic sites, DIC and CO₂ were unrelated to DOC, indicating that external inputs of inorganic carbon can influence lake productivity patterns independent of terrestrial DOC supply. By comparison, DOC and CO₂ were correlated across boreal lakes, suggesting that DOC mineralization acts as an important CO₂ source for these sites. Our results underline that GPP as a resource is regulated by landscape properties, and is sensitive to large-scale global changes (warming, hydrological intensification, recovery of acidification) that promote changes in catchment characteristics and aquatic physico-chemistry. Our findings aid in predicting global change impacts on autotrophic structuring, and thus community structure and resource use of aquatic consumers in general. Given the similarities of global changes across the Northern hemisphere, our findings are likely relevant for northern lakes globally.

Spatiotemporal variations and relationships of absorbing aerosol-radiation-gross primary productivity over China

High-load carbonaceous and dust aerosols can significantly reduce direct radiation (DIRR), which would affect photosynthesis in terrestrial ecosystems, thereby further affecting the productivity of vegetation. Based on this, a variety of remote sensing data were used to study the spatiotemporal distributions and changing tendencies of the absorbing aerosols, CO, DIRR, and gross primary productivity (GPP) in China during 2005-2019; then, the relationships were analyzed between different types of absorbing aerosols and DIRR as well as GPP. The results showed that the annual mean absorbing aerosols index (AAI) in China during 2005-2019 was 0.39, with a slow growth rate of 0.02 year^-1, and the emission of CO showed a decreasing trend with each passing year, especially in North China Plain and Sichuan Basin. Carbonaceous and dust aerosols were predominantly bounded by Hu line. The east of Hu line was the dominant area of carbonaceous aerosols, and the west of Hu line was the topographical region of dust aerosols. Near the Hu line was the dominant area of carbonaceous-dust aerosols. However, the Karamay-Urumqi-Hami area and Northeast China Plain were exceptional. During the vegetation growing season, different types of absorbing aerosols significantly negatively affected GPP. From a perspective of regional scale variation pattern, the negative effect of absorbing aerosols on vegetation productivity was the most significant in Northeast China; from the perspective of the effects of different vegetation types, the negative effect of absorbing aerosols on grasslands was greater than that of woodlands; from the perspective of the composition characteristics of aerosols, the negative effect of dust aerosols on GPP was greater than that of carbonaceous aerosols.

Disentangling effects of natural and anthropogenic drivers on forest net ecosystem production

Net Ecosystem Production (NEP) of forests is the net carbon dioxide (CO₂) fluxes between land and the atmosphere due to forests' biogeochemical processes. NEP varies with natural drivers such as precipitation, air temperature, solar radiation, plant functional type (PFT), and soil texture, which affect the gross primary production and ecosystem respiration, and thus the net C sequestration. It is also known that deposition of sulphur and nitrogen influences NEP in forest ecosystems. These drivers' respective, unique effects on NEP, however, are often difficult to be individually identified by conventional bivariate analysis. Here we show that by analyzing 22 forest sites with 231 site-year data acquired from FLUXNET database across Europe for the years 2000-2014, the individual, unique effects of these drivers on annual forest CO₂ fluxes can be disentangled using Generalized Additive Models (GAM) for nonlinear regression analysis. We show that S and N deposition have substantial impacts on NEP, where S deposition above 5 kg S ha^-1 yr^-1 can significantly reduce NEP, and N deposition around 22 kg N ha^-1 yr^-1 has the highest positive effect on NEP. Our results suggest that air quality management of S and N is crucial for maintaining healthy biogeochemical functions of forests to mitigate climate change. Furthermore, the empirical models we developed for estimating NEP of forests can serve as a forest management tool in the context of climate change mitigation. Potential applications include the assessment of forest carbon fluxes in the REDD+ framework of the UNFCCC.

Assessment of vegetation change on the Mongolian Plateau over three decades using different remote sensing products

As a major component of temperate steppes in the Eurasian continent, the Mongolian Plateau (MP) plays a pivotal role in the East Asian and global carbon cycles. This paper describes the use of five remote sensing indices derived from satellite data to characterize vegetation cover on MP, namely: gross primary production (GPP), net primary production (NPP), normalized difference vegetation index (NDVI), leaf area index (LAI) and fractional vegetation cover (FVC). It is found that GPP, NPP, and NDVI exhibit increasing trends, whereas LAI and FVC present decreasing trends on the MP since 1982. The different indices highlight discrepancies in the spatial pattern of vegetation growth, with the greatest increase in the southeast of MP. Only 3.4% of the total land area of MP exhibited consistent trends in the indices (0.1% degradation and 3.3% growth, P < 0.01), with the synchronous change of both LAI and NPP exhibiting higher consistency than that of raw NDVI and NPP. Understanding of the characteristics and status of vegetation change on the MP has far-reaching implications for its ecological protection management, and climate change mitigation.

The role of terrestrial productivity and hydrology in regulating aquatic dissolved organic carbon concentrations in boreal catchments

The past decades have witnessed an increase in dissolved organic carbon (DOC) concentrations in the catchments of the Northern Hemisphere. Increasing terrestrial productivity and changing hydrology may be reasons for the increases in DOC concentration. The aim of this study is to investigate the impacts of increased terrestrial productivity and changed hydrology following climate change on DOC concentrations. We tested and quantified the effects of gross primary production (GPP), ecosystem respiration (RE) and discharge on DOC concentrations in boreal catchments over 3 years. As catchment characteristics can regulate the extent of rising DOC concentrations caused by the regional or global environmental changes, we selected four catchments with different sizes (small, medium and large) and landscapes (forest, mire and forest-mire mixed). We applied multiple models: Wavelet coherence analysis detected the delay-effects of terrestrial productivity and discharge on aquatic DOC variations of boreal catchments; thereafter, the distributed-lag linear models quantified the contributions of each factor on DOC variations. Our results showed that the combined impacts of terrestrial productivity and discharge explained 62% of aquatic DOC variations on average across all sites, whereas discharge, gross primary production (GPP) and RE accounted for 26%, 22% and 3%, respectively. The impact of GPP and discharge on DOC changes was directly related to catchment size: GPP dominated DOC fluctuations in small catchments (<1 km² ), whereas discharge controlled DOC variations in big catchments (>1 km² ). The direction of the relation between GPP and discharge on DOC varied. Increasing RE always made a positive contribution to DOC concentration. This study reveals that climate change-induced terrestrial greening and shifting hydrology change the DOC export from terrestrial to aquatic ecosystems. The work improves our mechanistic understanding of surface water DOC regulation in boreal catchments and confirms the importance of DOC fluxes in regulating ecosystem C budgets.

CO2 fertilization of terrestrial photosynthesis inferred from site to global scales

The magnitude of the CO₂ fertilization effect on terrestrial photosynthesis is uncertain because it is not directly observed and is subject to confounding effects of climatic variability. We apply three well-established eco-evolutionary optimality theories of gas exchange and photosynthesis, constraining the main processes of CO₂ fertilization using measurable variables. Using this framework, we provide robust observationally inferred evidence that a strong CO₂ fertilization effect is detectable in globally distributed eddy covariance networks. Applying our method to upscale photosynthesis globally, we find that the magnitude of the CO₂ fertilization effect is comparable to its in situ counterpart but highlight the potential for substantial underestimation of this effect in tropical forests for many reflectance-based satellite photosynthesis products.

Global photosynthesis is increasing with elevated atmospheric CO₂ concentrations, a response known as the CO₂ fertilization effect (CFE), but the key processes of CFE are not constrained and therefore remain uncertain. Here, we quantify CFE by combining observations from a globally distributed network of eddy covariance measurements with an analytical framework based on three well-established photosynthetic optimization theories. We report a strong enhancement of photosynthesis across the observational network (9.1 gC m⁻² year⁻²) and show that the CFE is responsible for 44% of the gross primary production (GPP) enhancement since the 2000s, with additional contributions primarily from warming (28%). Soil moisture and specific humidity are the two largest contributors to GPP interannual variation through their influences on plant hydraulics. Applying our framework to satellite observations and meteorological reanalysis data, we diagnose a global CO₂-induced GPP trend of 4.4 gC m⁻² year⁻², which is at least one-third stronger than the median trends of 13 dynamic global vegetation models and eight satellite-derived GPP products, mainly because of their differences in the magnitude of CFE in evergreen broadleaf forests. These results highlight the critical role that CFE has played in the global carbon cycle in recent decades.

Ecosystem Service Values in the Dongting Lake Eco-Economic Zone and the Synergistic Impact of Its Driving Factors

Ecosystem service values (ESVs) are crucial to ecological conservation and restoration, urban and rural planning, and sustainable development of land. Therefore, it is important to study ESVs and their driving factors in the Dongting Lake Eco-Economic Zone (Dongting Lake). This paper quantifies the changes in ESVs in the Dongting Lake using land use data from 2000, 2005, 2010 and 2018. The eXtreme Gradient Boosting (XGBoost) model is used to study the effects of individual driving factors and the synergistic effects of these driving factors on ESVs. Our analysis suggests that: (1) From 2000 to 2018, the largest dynamic degree values in the Dongting Lake are in unused land types, followed by construction lands and wetlands. The ESVs of the Dongting Lake show an increasing trend, with those of forestlands being the highest, accounting for approximately 44.65% of the total value. Among the ESVs functions, water containment, waste treatment, soil formation and protection, biodiversity conservation and climate regulation contribute the most to ESVs, with a combined contribution of 76.64% to 76.99%; (2) The integrated intensity of anthropogenic disturbance shows a U-shaped spatial distribution, decreasing from U1 to U3. The driving factors in descending order of importance are the human impact index, total primary productivity (GPP), slope, elevation, population, temperature, gross domestic product, precipitation and PM2.5; (3) When the GPP is low (GPP < 900), the SHAP (SHapley Additive exPlanation) value of the high human impact index is greater than zero, indicating that an increase in GPP increases the ESVs in the Dongting Lake. This study can provide technical support and a theoretical basis for ecological environmental protection and ecosystem management in the Dongting Lake.

Reducing model uncertainty of climate change impacts on high latitude carbon assimilation

The Arctic-Boreal Region (ABR) has a large impact on global vegetation-atmosphere interactions and is experiencing markedly greater warming than the rest of the planet, a trend that is projected to continue with anticipated future emissions of CO₂ . The ABR is a significant source of uncertainty in estimates of carbon uptake in terrestrial biosphere models such that reducing this uncertainty is critical for more accurately estimating global carbon cycling and understanding the response of the region to global change. Process representation and parameterization associated with gross primary productivity (GPP) drives a large amount of this model uncertainty, particularly within the next 50 years, where the response of existing vegetation to climate change will dominate estimates of GPP for the region. Here we review our current understanding and model representation of GPP in northern latitudes, focusing on vegetation composition, phenology, and physiology, and consider how climate change alters these three components. We highlight challenges in the ABR for predicting GPP, but also focus on the unique opportunities for advancing knowledge and model representation, particularly through the combination of remote sensing and traditional boots-on-the-ground science.

Environmental factors modulate the diffuse fertilization effect on gross primary productivity across Chinese ecosystems

Diffuse radiation allocated by cloud cover and aerosols can promote vegetation photosynthesis, which is known as the diffuse fertilization effect (DFE). As an important uncertain factor regulating the DFE, understanding the role of environmental conditions in the response of terrestrial ecosystems to diffuse radiation is vital for quantitative and intensive studies. By using a light use efficiency model and statistical methods with satellite data and ChinaFLUX observation data, the optimal environmental range of DFE was estimated, the indirect role of vapor pressure deficit (VPD) and air temperature (T_a) on DFE was explored, and the relative contribution of diffuse photosynthetically active radiation (PAR_dif) on gross primary productivity (GPP) was analyzed across Chinese ecosystems under different sky conditions. The results showed that the DFE increased with leaf area index (LAI), but distributed a unimodal curve along with VPD and T_a, both of which had an optimum range that was lower in the forest (or cropland) and higher in the grass (or desert) ecosystem. When considering the co-effect of VPD and T_a, the strongest positive effect of DFE was found at 0-5 h Pa and 20-25 °C. Based on path analysis, PAR_dif promoted GPP and served as the main controlling factor in forest ecosystems predominantly through a direct pathway from half-hourly to the daily scale, while T_a and VPD occupied the dominant position at single-canopy ecosystem sites. When the aerosol optical depth (AOD) increased, the relative contribution of PAR_dif increased in multiple-canopy ecosystems and decreased in single-canopy ecosystems; when the sky conditions changed from sunny to cloudy, the relative contribution of PAR_dif was higher in the forest ecosystem and increased significantly in the grass ecosystem. These findings offer a more comprehensive understanding of the environmental effects of regulating DFE on GPP across ecosystems.

Pustular psoriasis: Molecular pathways and effects of spesolimab in generalized pustular psoriasis

BACKGROUND

The IL-36 pathway plays a key role in the pathogenesis of generalized pustular psoriasis (GPP). In a proof-of-concept clinical trial, treatment with spesolimab, an anti-IL-36 receptor antibody, resulted in rapid skin and pustular clearance in patients presenting with GPP flares.

OBJECTIVE

We sought to compare the molecular profiles of lesional and nonlesional skin from patients with GPP or palmoplantar pustulosis (PPP) with skin from healthy volunteers, and to investigate the molecular changes after spesolimab treatment in the skin and blood of patients with GPP flares.

METHODS

Pre- and post-treatment skin and blood samples were collected from patients with GPP who participated in a single-arm, phase I study (n = 7). Skin biopsies from patients with PPP (n = 8) and healthy volunteers (n = 16) were obtained for comparison at baseline. Biomarkers were assessed by RNA-sequencing, histopathology, and immunohistochemistry.

RESULTS

In GPP and PPP lesions, 1287 transcripts were commonly upregulated or downregulated. Selected transcripts from the IL-36 signaling pathway were upregulated in untreated GPP and PPP lesions. In patients with GPP, IL-36 pathway-related signatures, T_H1/T_H17 and innate inflammation signaling, neutrophilic mediators, and keratinocyte-driven inflammation pathways were downregulated by spesolimab as early as week 1. Spesolimab also decreased related serum biomarkers and cell populations in the skin lesions from patients with GPP, including CD3⁺ T, CD11c⁺, and IL-36γ⁺ cells and lipocalin-2-expressing cells.

CONCLUSIONS

In patients with GPP, spesolimab showed rapid modulation of commonly dysregulated molecular pathways in GPP and PPP, which may be associated with improved clinical outcomes.

Exploring new strategies for ozone-risk assessment: A dynamic-threshold case study

Tropospheric ozone is a dangerous atmospheric pollutant for forest ecosystems when it penetrates stomata. Thresholds for ozone-risk assessment are based on accumulated stomatal ozone fluxes such as the Phytotoxic Ozone Dose (POD). In order to identify the effect of ozone on a Holm oak forest in central Italy, four flux-based ozone impact response functions were implemented and tested in a multi-layer canopy model AIRTREE and evaluated against Gross Primary Productivity (GPP) obtained from observations of Eddy Covariance fluxes of CO₂. To evaluate if a clear phytotoxic threshold exists and if it changes during the year, six different detoxifying thresholds ranging between 0 and 5 nmol O₃ m^-2 s^-1 were tested. The use of species-specific rather than more general response functions based on plant functional types (PFT) increased model accuracy (RMSE reduced by up to 8.5%). In the case of linear response functions, a threshold of 1 nmol m^-2 s^-2 produced the best results for simulations of the whole year, although the tolerance to ozone changed seasonally, with higher tolerance (5 nmol m^-2 s^-1 or no ozone impact) for Winter and Spring and lower thresholds in Summer and Fall (0-1 nmol m^-2 s^-1). A "dynamic threshold" obtained by extracting the best daily threshold values from a range of different simulations helped reduce model overestimation of GPP by 213 g C m^-2 y^-1 and reduce RMSE up to 7.7%. Finally, a nonlinear ozone correction based on manipulative experiments produced the best results when no detoxifying threshold was applied (0 nmol O₃ m^-2 s^-1), suggesting that nonlinear functions fully account for ozone detoxification. The evidence of seasonal changes in ozone tolerance points to the need for seasonal thresholds to predict ozone damage and highlights the importance of performing more species-specific manipulative experiments to derive response functions for a broad range of plant species.

Impact of rising temperatures on the biomass of humid old-growth forests of the world

BACKGROUND

Understanding how warming influence above-ground biomass in the world's forests is necessary for quantifying future global carbon budgets. A climate-driven decrease in future carbon stocks could dangerously strengthen climate change. Empirical methods for studying the temperature response of forests have important limitations, and modelling is needed to provide another perspective. Here we evaluate the impact of rising air temperature on the future above-ground biomass of old-growth forests using a model that explains well the observed current variation in the above-ground biomass over the humid lowland areas of the world based on monthly air temperature.

RESULTS

Applying this model to the monthly air temperature data for 1970-2000 and monthly air temperature projections for 2081-2100, we found that the above-ground biomass of old-growth forests is expected to decrease everywhere in the humid lowland areas except boreal regions. The temperature-driven decrease is estimated at 41% in the tropics and at 29% globally.

CONCLUSIONS

Our findings suggest that rising temperatures impact the above-ground biomass of old-growth forests dramatically. However, this impact could be mitigated by fertilization effects of increasing carbon dioxide concentration in the atmosphere and nitrogen deposition.

Prevalence of Dental Anomalies in Patients With Unilateral Cleft Lip and Alveolus Treated With Gingivoperiosteoplasty

OBJECTIVE

To compare the prevalence of dental malformations and agenesis in patients who received or did not receive gingivoperiosteoplasty (GPP).

DESIGN

Retrospective cohort study.

PATIENTS

Review of patients born January 1, 2000, to December 31, 2007, with unilateral cleft lip and alveolus, with or without clefting of the secondary palate, who received GPP and/or secondary alveolar bone grafting (ABG). Patients were included if they had clinical images and dental radiographs available at ages 5 to 9 and 10 to 12 years. Ninety-four patients met the inclusion criteria; 46 treated with GPP, and 48 who did not receive GPP.

OUTCOME MEASURES

Records were assessed for supernumerary, missing, and malformed teeth by a blinded examiner, and prevalence compared between groups using χ² tests.

RESULTS

Cleft side lateral incisors were absent in 54% of GPP patients, compared to 50% in the no-GPP group. Two patients in the GPP group and 1 in the no-GPP group had supernumerary lateral incisors. Most lateral incisors were undersized or peg shaped in both the no-GPP (83.3%) and GPP (71.4%) groups. In the GPP group, 5 (10.9%) patients exhibited central incisor agenesis, and 3 had significant hypoplasia. In the no-GPP group, 4 (8.3%) patients exhibited central incisor agenesis, and 5 (10.5%) significant hypoplasia. These differences were not statistically significant.

CONCLUSIONS

Gingivoperiosteoplasty was not associated with increased prevalence of dental malformation or agenesis. When performed appropriately, GPP is a safe treatment technique that does not increase the risk of dental anomalies.

Water use efficiency in terrestrial ecosystem over East Asia: Effects of climate regimes and land cover types

Water use efficiency (WUE) is an environmental factor to account for the metabolism of terrestrial ecosystems using various climate systems and vegetation types. It is estimated by the ratio of gross primary productivity (GPP) to evapotranspiration (ET), the largest carbon and water fluxes with respect to plant respiration. In this study, the WUE was calculated using GPP and ET from the community land model version 4.0 (CLM4.0), inclusive of the prognostic carbon-nitrogen model in the community earth system model (CESM). The estimated WUE in East Asia was analyzed for climate zones, land cover types, and water- and energy-limited zones, with aridity index (AI). Spatial variations from 2001 to 2015 in annual WUE gradually increased as latitude decreased, though small year-to-year differences appeared between monthly GPP and ET. Monthly WUE was lower in summer than fall because the water loss rate in summer was higher than the carbon assimilation increase. The WUE under arid conditions (AI<0.5) was lower than under humid conditions. The GPP, ET, and WUE were higher in the forest, savannas, cropland, and permanent wetland with dense vegetation or abundant water resources than in other land cover types. The WUE was lower in water-limited zones than in energy-limited zones due to the low amount of water to use for the physical processes of GPP and ET. Based on this study, we identified general spatial and temporal variations of carbon fluxes in East Asia with various climate zones and land cover types.

Treatments and outcomes of generalized pustular psoriasis: A cohort of 1516 patients in a nationwide inpatient database in Japan

BACKGROUND

Because generalized pustular psoriasis (GPP) is rare, there are few studies reporting treatments and outcomes for large numbers of patients.

OBJECTIVE

To report treatments and outcomes in a large cohort of patients hospitalized with GPP.

METHODS

Using a Japanese national inpatient database, we identified 1516 patients with GPP who required hospitalization between July 2010 and March 2019. We categorized patients into 3 medication groups: biologics (294 patients), oral agents without biologics (948 patients), and systemic corticosteroids only (274 patients). We investigated their characteristics, treatments, and outcomes.

RESULTS

Mean age was 66 years (interquartile range: 52-77 years). Fifty patients (3.3%) were admitted to the intensive care unit, 125 (8.2%) required blood pressure support, and 63 (4.2%) died. Patients who received biologics were younger and had fewer comorbidities. In-hospital mortality was lower in the biologics group (1.0% [biologics group] vs 3.7% [oral-agents group] vs 9.1% [corticosteroids-only group]; P < .001) as was morbidity (5.4% vs 8.2% vs 12%, respectively; P = .02). Among those who received biologics, IL-17 inhibitor use increased over time, with in-hospital mortality and morbidity comparable to those of tumor necrosis factor inhibitors.

LIMITATIONS

Retrospective study design. Some patients received multiple medications.

CONCLUSION

Biologic treatments showed favorable outcomes compared with other treatments.

Monitoring Crop Status in the Continental United States Using the SMAP Level-4 Carbon Product

Accurate monitoring of crop condition is critical to detect anomalies that may threaten the economic viability of agriculture and to understand how crops respond to climatic variability. Retrievals of soil moisture and vegetation information from satellite-based remote-sensing products offer an opportunity for continuous and affordable crop condition monitoring. This study compared weekly anomalies in accumulated gross primary production (GPP) from the SMAP Level-4 Carbon (L4C) product to anomalies calculated from a state-scale weekly crop condition index (CCI) and also to crop yield anomalies calculated from county-level yield data reported at the end of the season. We focused on barley, spring wheat, corn, and soybeans cultivated in the continental United States from 2000 to 2018. We found that consistencies between SMAP L4C GPP anomalies and both crop condition and yield anomalies increased as crops developed from the emergence stage (r: 0.4–0.7) and matured (r: 0.6–0.9) and that the agreement was better in drier regions (r: 0.4–0.9) than in wetter regions (r: −0.8–0.4). The L4C provides weekly GPP estimates at a 1-km scale, permitting the evaluation and tracking of anomalies in crop status at higher spatial detail than metrics based on the state-level CCI or county-level crop yields. We demonstrate that the L4C GPP product can be used operationally to monitor crop condition with the potential to become an important tool to inform decision-making and research.

Gross primary production of dwarf bamboo, Sasa senanensis, in a mature beech forest with a substantial gap-mosaic structure

Forest understory plays an important role in the gross primary production (GPP) of some forest ecosystems. However, differences in understory GPP caused by obviously different overstory canopy structure have not been taken into consideration in previous studies, thus potentially over- or underestimating understory GPP. To estimate the understory GPP more accurately, we separated a forest into "canopy area", with closed-overstory canopy, and "gap area", with open-overstory canopy. The study was conducted in a mature deciduous forest dominated by beech and with an understory dominated by dwarf bamboo, Sasa senanensis. We measured S. senanensis GPP at the community scale (GPP_{Sasa-community}) using a static chamber system that covered the aboveground part of the plants and then upscaled it to the ecosystem scale (GPP_{Sasa-ecosystem}) by considering the proportions of canopy and gap areas within the forest. GPP_{Sasa-community} was 192 g C m^-2 year^-1 in the canopy area and 699 g C m^-2 year^-1 in the gap area. The large difference likely occurred because the photosynthetic ability and biomass of the S. senanensis community differed strongly between the two areas. The seasonal dynamics of GPP_{Sasa-community} also differed between the areas. The 10-day cumulative GPP_{Sasa-community} peaked from July to August in the gap area, whereas there was no clear peak of GPP_{Sasa-community} in the canopy area. Multiple linear regressions showed that light intensity and biomass were significant predictors of GPP_{Sasa-community} in the canopy area, whereas air temperature and biomass were significant predictors of GPP_{Sasa-community} in the gap area. GPP_{Sasa-ecosystem} during growing season in 2019 was 3.74 t C ha^-1 year^-1, which contributed between 16.37 and 19.85% of the entire forest ecosystem GPP. This study highlights the need to consider differences in overstory structure for the accurate estimation of understory GPP.

Drug survival in the treatment of generalized pustular psoriasis: A retrospective multicenter study

Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening inflammatory skin disease. Our aim was to assess patient and disease characteristics and analyze drug survival rates in the treatment of GPP in a real-life setting. In this retrospective study, 201 treatment series of 86 patients with GPP treated at five University Medical Centers were analyzed. Overall, excellent response was reached in 41.3% of all treatment courses, partial response in 31.4%, and nonresponse in 27.3%. Biological treatment was significantly more effective than non-biological therapies (excellent response: 47.4% vs 35.9%; P = .02). Overall, the median drug survival was 14.0 months (biologicals: 36.0 months vs nonbiologicals: 6.0 months; P < .001). The crude probability of survival was highest for secukinumab (hazard ratio [HR] of drug discontinuation compared with acitretin: 0.22), followed by ixekizumab and ustekinumab (HR: 0.38 each), adalimumab (HR: 0.59), etanercept (HR: 0.62), infliximab (HR: 0.69), cyclosporine (HR: 1.00), acitretin (reference for HR), fumaric acid esters (HR: 1.06), methotrexate (HR: 1.26), and apremilast (HR: 3.44); no drug discontinuation with guselkumab. Our results reveal high efficacy and drug survival, particularly for IL-17 and IL-(12)/23 antagonists. Thus, these biologics may be considered early in the therapeutic algorithm of GPP.

Seasonal variation in photosynthetic rates and satellite-based GPP estimation over mangrove forest

In view of increasing anthropogenic influences and global changes, quantification of carbon assimilation through photosynthesis has gained tremendous significance. Precise estimation of Gross Primary Productivity (GPP) is essential for several ecosystem models and is typically done using coarser scale satellite data. The mangrove ecosystem, which offers significant protection to the coastal environment, is one of the critical habitats from a global change point of view. Light use efficiency (LUE) was measured using diurnal in situ photosynthetic rate observations for 13 dominant mangrove species for 3 seasons at each of the three mangrove dominant test-sites situated along the east and west coast of India. Variations in photosynthetic rates among these species were studied for 3 seasons that indicated varying responses of mangrove ecosystem at each site. Among all species, Rhizophora mucronata and Sonneratia apetala indicated higher values at two of the test-sites. IRS Resourcesat-2 LISS-IV datasets were used for the estimation of GPP. Mean GPP for all the sites varied from 1.2 to 7.7 g C m^-2 day^-1 with maximum value of 14.4 g C m^-2 day^-1. Mean values of GPP varied across the sites, based on its maximum LUE values and available photosynthetically active radiation (PAR). The results provide GPP values at much better spatial resolution for a threatened habitat like mangroves that typically survive in a narrow habitat along the coasts.

Asymmetric responses of ecosystem productivity to rainfall anomalies vary inversely with mean annual rainfall over the conterminous United States

The CONterminous United States (CONUS) presents a large range of climate conditions and biomes where terrestrial primary productivity and its inter-annual variability are controlled regionally by rainfall and/or temperature. Here, the response of ecosystem productivity to those climate variables was investigated across different biomes from 2010 to 2018 using three climate datasets of precipitation, air temperature or drought severity, combined with several proxies of ecosystem productivity: a remote sensing product of aboveground biomass, an net primary productivity (NPP) remote sensing product, an NPP model-based product and four gross primary productivity products. We used an asymmetry index (AI) where positive AI indicates a greater increase of ecosystem productivity in wet years compared to the decline in dry years, and negative AI indicates a greater decline of ecosystem productivity in dry years compared to the increase in wet years. We found consistent spatial patterns of AI across the CONUS for the different products, with negative asymmetries over the Great Plains and positive asymmetries over the southwestern CONUS. Shrubs and, to a lesser extent, evergreen forests show a persistent positive asymmetry, whilst (natural) grasslands appear to have transitioned from positive to negative anomalies during the last decade. The general tendency of dominant negative asymmetry response for ecosystem productivity across the CONUS appears to be influenced by the negative asymmetry of precipitation anomalies. AI was found to be a function of mean rainfall: more positive AIs were found in dry areas where plants are adapted to drought and take advantage of rainfall pulses, and more negative AIs were found in wet areas, with a threshold delineating the two regimes corresponding to a mean annual rainfall of 200-400 mm/year.

Spatiotemporal variations and relationships of aerosol-radiation-ecosystem productivity over China during 2001-2014

Several air pollution episodes occurred in China in the past decade, and high levels of aerosols load also caused the changes of radiation, which could further influence the gross primary productivity (GPP) in the terrestrial ecosystem. This paper focuses on the spatiotemporal variations and relationship of aerosol-radiation-GPP in China during a heavy pollution period (2001-2014). For this purpose, the Fu-Liou radiation transfer mechanism model was used to estimate total radiation (TR) and diffuse radiation (DIFR) at the spatial resolution of 1° × 1° based on the satellite aerosol optical depth (AOD) and other auxiliary data. This model shows excellent performance with an R² of 0.88 and 0.79 for TR and DIFR, respectively. A significant increasing trend (0.23 W m^-2 year^-1) in TR was found in China in this phase, and it was mainly attributed to DIFR. Furthermore, a scenario without aerosols (AOD = 0) was simulated as a comparison to quantify the aerosol radiative forcing, which indicated that aerosols play a catalytic role in DIFR, increasing it by approximately 19.55%. Despite all this, aerosols have weakened the brightening of China due to the negative forcing on direct radiation. Meanwhile, 0.65-4.20 kgC m^-2 year^-1 increase of GPP was also captured in seven regions of China during this phase.However, the significant negative response of GPP to aerosol was found in most ecosystems in the growing season of vegetation, and the highest correlation of -0.76 (p < .01) existed in the central China forest regions. It suggests although aerosol causes a diffuse fertilization effect, GPP is still lost due to high levels of aerosol load in most areas of China during growing season of vegetation. This paper aims to determine the relationship among the aerosol-radiation-ecosystem productivity in different regions of China, which could provide a reference for the divisional strategy formulation and classification management in different ecosystems.

Loss-of-Function Myeloperoxidase Mutations Are Associated with Increased Neutrophil Counts and Pustular Skin Disease

The identification of disease alleles underlying human autoinflammatory diseases can provide important insights into the mechanisms that maintain neutrophil homeostasis. Here, we focused our attention on generalized pustular psoriasis (GPP), a potentially life-threatening disorder presenting with cutaneous and systemic neutrophilia. Following the whole-exome sequencing of 19 unrelated affected individuals, we identified a subject harboring a homozygous splice-site mutation (c.2031-2A>C) in MPO. This encodes myeloperoxidase, an essential component of neutrophil azurophil granules. MPO screening in conditions phenotypically related to GPP uncovered further disease alleles in one subject with acral pustular psoriasis (c.2031-2A>C;c.2031-2A>C) and in two individuals with acute generalized exanthematous pustulosis (c.1705C>T;c.2031-2A>C and c.1552_1565del;c.1552_1565del). A subsequent analysis of UK Biobank data demonstrated that the c.2031-2A>C and c.1705C>T (p.Arg569Trp) disease alleles were also associated with increased neutrophil abundance in the general population (p = 5.1 × 10^-6 and p = 3.6 × 10^-5, respectively). The same applied to three further deleterious variants that had been genotyped in the cohort, with two alleles (c.995C>T [p.Ala332Val] and c.752T>C [p.Met251Thr]) yielding p values < 10^-10. Finally, treatment of healthy neutrophils with an MPO inhibitor (4-Aminobenzoic acid hydrazide) increased cell viability and delayed apoptosis, highlighting a mechanism whereby MPO mutations affect granulocyte numbers. These findings identify MPO as a genetic determinant of pustular skin disease and neutrophil abundance. Given the recent interest in the development of MPO antagonists for the treatment of neurodegenerative disease, our results also suggest that the pro-inflammatory effects of these agents should be closely monitored.

Myeloperoxidase Modulates Inflammation in Generalized Pustular Psoriasis and Additional Rare Pustular Skin Diseases

Generalized pustular psoriasis (GPP) is a severe multi-systemic inflammatory disease characterized by neutrophilic pustulosis and triggered by pro-inflammatory IL-36 cytokines in skin. While 19%–41% of affected individuals harbor bi-allelic mutations in IL36RN, the genetic cause is not known in most cases. To identify and characterize new pathways involved in the pathogenesis of GPP, we performed whole-exome sequencing in 31 individuals with GPP and demonstrated effects of mutations in MPO encoding the neutrophilic enzyme myeloperoxidase (MPO). We discovered eight MPO mutations resulting in MPO -deficiency in neutrophils and monocytes. MPO mutations, primarily those resulting in complete MPO deficiency, cumulatively associated with GPP (p = 1.85E−08; OR = 6.47). The number of mutant MPO alleles significantly differed between 82 affected individuals and >4,900 control subjects (p = 1.04E−09); this effect was stronger when including IL36RN mutations (1.48E−13) and correlated with a younger age of onset (p = 0.0018). The activity of four proteases, previously implicated as activating enzymes of IL-36 precursors, correlated with MPO deficiency. Phorbol-myristate-acetate-induced formation of neutrophil extracellular traps (NETs) was reduced in affected cells (p = 0.015), and phagocytosis assays in MPO-deficient mice and human cells revealed altered neutrophil function and impaired clearance of neutrophils by monocytes (efferocytosis) allowing prolonged neutrophil persistence in inflammatory skin. MPO mutations contribute significantly to GPP’s pathogenesis. We implicate MPO as an inflammatory modulator in humans that regulates protease activity and NET formation and modifies efferocytosis. Our findings indicate possible implications for the application of MPO inhibitors in cardiovascular diseases. MPO and affected pathways represent attractive targets for inducing resolution of inflammation in neutrophil-mediated skin diseases.

Effects of low flow and co-occurring stressors on structural and functional characteristics of the benthic biofilm in small streams

Low flow and co-occurring stress is a more and more frequent phenomenon these years in small agricultural streams as a consequence of climate change. In the present study we explored short and longer term structural responses of the stream benthic algae community and biofilm metabolism to multiple stress in small streams applying a semi-experimental approach. We hypothesized that i) a reduction in flow in combination with secondary stress (nutrients and sediments) have immediate effects on the benthic algae community in terms of biomass (chlorophyll a, biovolume), taxonomic and trait (lifeform and size distribution) compositions as well as on metabolism (GPP and CR), and ii) that changes in the benthic algae community persist due to altered environmental settings but that functional redundancy among benthic algae species provides a high level of resilience in metabolism (GPP and CR). Overall, we found that stress imposed by nutrients was less pronounced than stress imposed by fine sediments under low flow, and that nutrient enrichment to some extent mitigated effects of fine sediments. Fine sediment deposition mediated a decline in the fraction of erect algae and/or algae with mucilage stalks but this did not happen under co-occurring stress from both sediments and nutrients. Additionally, fine sediment deposition mediated a decline in GPP of the biofilm, but again this did not happen under co-occurring stress from nutrients. We conclude that 1) the benthic algae community and biofilm metabolism displayed similar resilience to stress imposed by low flow and co-occurring stress from nutrients and sediments on a short and longer time scale and 2) as structure-function adaptations may occur at several trophic levels in the biofilm, more research is needed to explore mechanisms underlying mitigating effects of nutrients in response to sediment deposition under low flow.

CO2 effluxes from an urban tidal river flowing through two of the most populated and polluted cities of India

Urbanized rivers flowing through polluted megacities receive substantial amount of carbon from domestic sewage and industrial effluents which can significantly alter the air-water CO₂ flux rates. In this regard, we quantified the partial pressure of CO₂ in the surface water (pCO₂(water)), air-water CO₂ fluxes, and associated biogeochemical parameters in the Hooghly River, India, flowing through two of the most polluted cities of the country, Kolkata and Howrah, over a complete annual cycle during spring tidal phase (SP) and neap tidal phase (NP). This urbanized part of Hooghly River was always supersaturated with CO₂ having an annual mean pCO₂(water) and air-water CO₂ flux of ~ 3800 μatm and ~ 49 mol C m^-2 year^-1, respectively. Significant seasonal variability was observed for both pCO₂(water) and air-water CO₂ flux (pre-monsoon, 3038 ± 539 μatm and 5049 ± 964 μmol m^-2 h^-1; monsoon, 4609 ± 711 μatm and 7918 ± 1400 μmol m^-2 h^-1; post-monsoon, 2558 ± 258 μatm and 4048 ± 759 μmol m^-2 h^-1, respectively). Monthly mean pH and total alkalinity varied from 7.482 to 8.099 and from 2437 to 4136 μmol kg^-1, respectively, over the annual cycle. pCO₂(water) showed significant positive correlation with turbidity and negative correlation with electrical conductivity and gross primary productivity (GPP). High water discharge could have facilitated high turbidity, especially during the monsoon season, which led to depletion in GPP and enhancement in pCO₂(water) which in turn led to very high CO₂ effluxes. The CO₂ efflux rate in this urbanized riverine stretch was substantially higher than that observed in previous studies carried out in the less urbanized estuarine stretch of Hooghly. This indicates that the presence of highly urbanized and polluted metropolis potentially enhanced the pCO₂(water) and CO₂ effluxes of this river. Similar observations were made recently in some Asian and Australian urban rivers.

Acitretin inhibits IL-17A-induced IL-36 expression in keratinocytes by down-regulating IκBζ

BACKGROUND

IL-36 plays a critical role in aggravating psoriatic inflammation, which is significantly elevated in generalized pustular psoriasis (GPP) compared to psoriasis vulgaris. It is well known that acitretin brings about a rapid and significant effect on the treatment of GPP but not psoriasis vulgaris, whereas the quick therapeutic mechanism of acitretin in GPP has not been fully clarified.

OBJECTIVES

We conducted this study to investigate whether acitretin interferes IL-36 expression in keratinocytes.

METHOD

We used 100 ng/mL IL-17A and/or various doses of acitretin (0, 0.1, 1, 10 μmol/L) to treat cultured HaCaT cells. We performed Real-time quantitative PCR and ELISA to detect gene and protein expression of IL-36 cytokines, real-time quantitative PCR and Western blot to examine IκBζ. Imiquimod (IMQ)-induced psoriasis-like mouse model was established to evaluate effect of gastrointestinal administrated acitretin. Immunohistochemistry was conducted for effect assessment.

RESULTS

Acitretin significantly down-regulated expression of IL-36β and IL-36γ induced by IL-17A stimulation at both gene and protein levels in HaCaT cells. Acitretin alone had no obvious effect on IL-36 expression in keratinocytes. In IMQ + acitretin group, the skin lesion severity was slightly relieved, however, immunohistochemistry showed IL-36β and IL-36γ expression in keratinocytes significantly declined in comparison with IMQ group. IL-17A stimulation induced significantly IκBζ expression in HaCaT cells, which could be inhibited by acitretin.

CONCLUSION

Acitretin inhibits IL-36 expression induced by IL-17A stimulation in keratinocytes by down-regulating IκBζ, and acitretin significantly inhibits keratinocytes-expressed IL-36β and IL-36γ in psoriasis-like mouse model, which reveals a new possible mechanism of the notable and quick therapeutic action of acitretin on GPP.

Ozone and particle fluxes in a Mediterranean forest predicted by the AIRTREE model

Mediterranean forests are among the most threatened ecosystems by the concurrent effects of climate change and atmospheric pollution. In this work we parameterized the AIRTREE multi-layer model to predict CO₂, water, ozone, and fine particles exchanges between leaves and the atmosphere. AIRTREE consists of four different modules: (1) a canopy environmental module determines the leaf temperature and radiative fluxes at different levels from above to the bottom of the canopy; (2) a hydrological module predicts soil water flow and water availability to the plant's photosynthetic apparatus; (3) a photosynthesis module estimates the net photosynthesis and stomatal conductance, and (4) a deposition module estimates ozone and PM deposition sinks as a function of the resistances to gas diffusion in the atmosphere, and within the canopy and leaf boundary layer. We describe the AIRTREE model framework, accuracy and sensitivity by comparing modeling results against long-term continuous Eddy Covariance measurements of ozone, water, and CO₂ fluxes in a Mediterranean Holm oak forest, and we discuss potential application of AIRTREE for ozone-risk assessment in view of availability of a large observational database from ecosystems distributed worldwide.