Patients with pulmonary arterial hypertension (PAH) may develop large pulmonary artery aneurysms (PAA) which may be complicated by rupture, dissection or intravascular thrombus formation. These patients were traditionally considered for heart-lung transplantation but more recently, there have been reports of successful lung transplantation with reconstruction of the pulmonary artery (PA). We present two patients who underwent successful transplantation for PAH with giant PAA. One patient had end stage PAH and right pulmonary artery atresia complicated by a giant main PAA. This patient underwent bilateral sequential lung transplantation with concurrent pulmonary artery reconstruction. Another patient had end stage PAH with giant PAA on a background of D-transposition of the great arteries who had a Mustard repair at 9 months of age. This patient underwent heart-lung transplantation. Both heart-lung transplantation and lung transplantation with reconstruction of the pulmonary should be considered as a treatment option for patients with PAH with PAA.

Concerning the various effects of climate change on intensifying extreme weather phenomena all around the world, studying its possible consequences in the following years has attracted the attention of researchers. As the drought characteristics identified by drought indices are highly significant in investigating the possible future drought, the Copula function is employed in many studies. In this study, the two- and three-variable Copula functions were employed for calculating the return period of drought events for the historical, the near future, and the far future periods. The results of considering the two- and three-variable Copula functions were separately compared with the results of the calculated Due to the high correlation between drought characteristics, bivariate and trivariate of Copula functions were applied to evaluate the return periods of the drought. The most severe historical drought was selected as the benchmark, and the drought zoning map for the GCM models was drawn. The results showed that severe droughts can be experienced, especially in the upper area of the basin where the primary water resource is located. Also, the nature of the drought duration plays a decisive role in the results of calculating the return periods of drought events.

Irrigation activities are a major control on water movement and storage in irrigated river valleys in the Intermountain West, USA. Particularly in dry years, surface water diversions can deplete streams over the summer irrigation season, leading to more variable stream temperatures and increased risk for resident aquatic species. Cooler lateral inflows derived from irrigation activities can mitigate the impacts of depletion by buffering main channel stream temperatures. Given the increasing susceptibility of depleted streams to climate and land use changes, understanding stream temperature patterns and controls in these systems is critical. We used intensive field monitoring over three summers and thermal aerial imagery to characterize stream temperature patterns and irrigation influences in a 2.5 km reach of a small agricultural stream in northern Utah. Considering variable hydrology, weather, channel morphology, diversions, and lateral inflows we found stream temperatures to be relatively insensitive to flow depletion or lateral inflows in a wet year but very sensitive in drier years. Irrigation-related lateral inflows reduced longitudinal warming and diel variability during drier years and at times prevented temperatures from reaching stressful or lethal limits. Reaches with substantial lateral inflow contributions also had a greater areal proportion of low temperatures and spatial temperature diversity. These trends were enhanced by differences in channel morphology, with greater spatial and temporal variability in multi-thread than single-thread reaches. Study results highlight critical flow and weather conditions driving increased temperature variability that will likely become more extreme with additional climate change related reductions in baseflow. Regardless of the cause, this study highlights that decreased instream flows increase the importance of identifying, quantifying, and maintaining lateral inflows to maintain instream temperatures and preservation of these inflows should be considered in future water management decisions.

In this research study, fuzzy fractional differential equations in presence of the Atangana-Baleanu-Caputo differential operators are analytically and numerically treated using extended reproducing Kernel Hilbert space technique. With the utilization of a fuzzy strongly generalized differentiability form, a new fuzzy characterization theorem beside two fuzzy fractional solutions is constructed and computed. To besetment the attitude of fuzzy fractional numerical solutions; analysis of convergence and conduct of error beyond the reproducing kernel theory are explored and debated. In this tendency, three computational algorithms and modern trends in terms of analytic and numerical solutions are propagated. Meanwhile, the dynamical characteristics and mechanical features of these fuzzy fractional solutions are demonstrated and studied during two applications via three-dimensional graphs and tabulated numerical values. In the end, highlights and future suggested research work are eluded.

An Italian male with no link to China SARS-CoV-2 epidemic presented at Emergency Room with severe respiratory impairment. The RT-PCR on 20th February, 2020, nasopharyngeal swab revealed SARS-CoV-2 infection, confirmed with viral culture and sequencing. This was the first identified autochthonous SARS-CoV-2 transmission in Italy, that unveiled global pathogen diffusion.

Background: Allergic diseases are the most prevalent chronic childhood diseases resulting in a massive societal and economic burden for the community and a significant reduction of health-related quality of life (HRQoL) for affected families. The project CHAMP (CHildhood Allergy and tolerance: bioMarkers and Predictors) was funded in 2017 by the German Federal Ministry for Education and Research. Methods: CHAMP investigates the determinants of different allergic diseases from birth to adolescence to identify clinically relevant biomarkers predicting onset, progression, remission and severity. Data on HRQoL and patient’s needs and requirements were collected, supported by the German Asthma and Allergy Association (DAAB). Using validated questionnaires and outpatient visits, eight subprojects analysed allergic diseases in epidemiological or clinical cohorts (more than 2500 children/adolescents), sampling numerous biomaterials to assess omics on several levels. Murine models disentangled underlying mechanisms of early tolerance, translating findings from the cohorts to models and vice versa. Results: The DAAB survey, including 851 participants, showed that 83% were interested in prediction of the course of different current allergic diseases and future manifestation. 86% of participants considered doctor’s specialized training and their education as highly important, over 70% chose research for allergy understanding and prevention as critical. CHAMP addresses these needs. Common SOPs have been established and recruitment is ongoing. Conclusion: The DAAB patient survey confirmed the critical need for translational allergy research. CHAMP envisions to predict onset, tolerance and remission of allergic diseases and to identify disease sub-phenotypes for future development of preventive strategies and novel avenues for therapeutic options.

Rash is frequently seen in patients with leukemia either as a sequence of thrombocytopenia, or as result of infection or allergic drug rash, however sometimes rash is pointing towards fatal complications of underlying drug therapy or underlying disease , not being aware of these alarming signs can have fatal consequences.

Abstract Objective: We aimed to further assess the evolution of pulmonary function and bronchodilator response in the Chinese case series with post-infectious bronchiolitis obliterans (PIBO). Methods: Twelve children with PIBO, aged 59-110 months, were retrospectively studied between 2011 and 2019. According to the ATS/ERS recommendations, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and maximal midexpiratory flow velocity 25%-75% (MMEF25%-75%) were collected at each pulmonary function tests (PFTs), as well as bronchodilator responses were evaluated. Spirometric parameters were monitored over time, and generalized linear mixed models were used to analyze longitudinal panel data. Results: The median baseline PFT values for FVC, FEV1, FEV1/FVC ratio and MMEF25% -75% were 41.6%, 39.75%, 90.7% and 22.2% respectively. At the initial PFTs, 10 (83.3%) patients demonstrated a significant bronchodilator response. FVC and FEV1 increased by a mean of 8.212%/year and 5.007%/year, and FEV1/FVC ratio with an average decrease of 3.537%/year. MMEF25-75% showed an average increase of 1.583% per year. Over all, FEV1 and MMEF25%-75% showed different degrees of improvement after inhaled bronchodilators at each PFT sessions for ten patients, and FEV1 was with significant (>12%) β2-bronchodilation in 53% of PFT sessions. Conclusions: Pediatric patients with PIBO showed an obstructive defect of pulmonary function. The FVC, FEV1 and MMEF25%-75% improved as they grew old, while FEV1/FVC ratio decreased. It may be due to the development of lung parenchyma more than airway growth. Airway obstruction of some patients improved with the use of β2 agonists.

Understanding how stem cells adapt to space flight conditions is fundamental for human space missions and extraterrestrial settlement. We analyzed gene expression in boundary cap neural crest stem cells (bNCSCs), which are attractive for regenerative medicine by their ability to promote proliferation and survival of co-cultured and co-implanted cells. bNCSCs were launched to space (Space cells), onboard Sounding rocket as free-floating neurospheres or in bioprinted scaffold. For comparison, bNCSCs were placed in random positioning machine to simulate microgravity (Microgravity cells) or cultured under Earth conditions. Using Next-Generation RNA sequencing and data post-processing, a list of genes that were at least two-fold changed between control cells and Space cells were selected for further analysis. Functional clusters of enriched genes were obtained by gene ontology bioinformatics, using the DAVID program, and Ingenuity Pathway Analysis was used to predict functional implications of the identified gene expressions. Space cells upregulated genes related to proliferation and survival, whereas Microgravity cells upregulated genes associated with differentiation and inflammation. Thus, i) space flight provides unique conditions with distinctly different effects on the properties of bNCSCs compared to Earth controls, and ii) may induce post-flight properties that reinforce the utility of bNCSCs for regenerative medicine and tissue engineering.

Background. Query a single institution computed tomography (CT) database to assess the prevalence of aortic arch anomalies in general adult population and their potential association with thoracic aortopathies. Methods. CT chest scan reports of patients aged 50-85 years old performed for any indication at a single health system between 2013 and 2016 were included in the analysis. Characteristics of patients with and without aortic arch anomalies were compared by t-test and Fisher exact tests. Logistic regression analysis was performed to assess for independent risk factors of thoracic aortic aneurysm. Results. Of 21,336 CT scans, 603 (2.8%) described arch anomalies. Bovine arch (n=354, 58.7%) was the most common diagnosis. Patients with arch anomalies were more likely to be female (p<0.001), non-Caucasian(p<0.001), and hypertensive (p<0.001). Prevalence of thoracic aortic aneurysm in arch anomalies group was 10.8% (n=65) compared to 4.1% (n=844) in the non-arch anomaly cohort (p<0.001). The highest prevalence of thoracic aneurysm was associated with right-sided arch combined with aberrant left subclavian configuration (33%), followed by bovine arch (13%), and aberrant right subclavian artery (8.2%). On binary logistic regression, arch anomaly (OR=2.85 [2.16-3.75]), aortic valve pathology (OR 2.93 [2.31-3.73]), male sex (OR 2.38 [2.01-2.80]), and hypertension (OR 1.47 [1.25-1.73]) were significantly associated with increased risk of thoracic aneurysm disease. Conclusions. Reported prevalence of aortic arch anomalies by CT imaging in the older adult population is ~3%, with high association of thoracic aortic aneurysm (OR=2.85) incidence in this subgroup. This may warrant a more tailored surveillance strategy for aneurysm disease in this subpopulation.

Primary microcephaly (PM) is defined as a significant reduction in occipito-frontal circumference (OFC) of prenatal onset. Clinical and genetic heterogeneity of PM represents a diagnostic challenge. We performed detailed phenotypic and genomic analyses in a large cohort (n=169) of patients referred for PM, and could establish a molecular diagnosis in 38 patients. Pathogenic variants in ASPM and WDR62 were the most frequent causes in non-consanguineous patients in our cohort. In consanguineous patients, microarray and targeted gene panel analyses reached a diagnostic yield of 67%, which contrasts with a much lower rate in outbred patients (9%). Our series includes 15 previously unreported families and 11 novel pathogenic variants, and we identify novel candidate genes including IGF2BP3, DNAH2, and TSR1. We confirm progression of microcephaly over time in affected children. Epilepsy was an important associated feature in our PM cohort, affecting 34% of patients, with various degrees of severity and seizure types. Our findings will help to prioritize genomic investigations, accelerate molecular diagnoses and improve management of PM patients.

Bivalent ions such as Ca2+ and Mg2+ are known to affect the structural and mechanical properties of biofilms. In order to reveal the impact of Fe2+ ions within the cultivation medium on biofilm development, structure and stability, Bacillus subtilis biofilms were cultivated in mini-fluidic flow cells. Two different Fe2+ inflow concentrations (0.25 and 2.5 mg/L, respectively) and wall shear stress levels (0.05 and 0.27 Pa, respectively) were tested. Biofilm structure was determined daily in situ and non-invasively by means of optical coherence tomography. A set of ten structural parameters was used to quantify biofilm structure, its development and change. Moreover, for each experiment ten replicates were cultivated and analyzed allowing for valid conclusions. Fe2+ addition influenced biofilm development (e.g., biofilm accumulation) and structure markedly. Experiments revealed the accumulation of FeO(OH) within the biofilm matrix and a positive correlation of Fe2+ inflow concentration and biofilm accumulation. Even at elevated shear stress levels this correlation was valid. In more detail, independent of the wall shear stress applied during cultivation over ten days biofilms grew approximately four times thicker at 2.5 mg Fe2+/L compared to low Fe2+ inflow concentrations of 0.25 mg/L. This finding hints on a higher stability of Bacillus subtilis biofilms against detachment when growing at elevated Fe2+ concentrations.

Comprising more than 1400 species, bats possess adaptations unique among mammals including powered flight, unexpected longevity given small body size, and extraordinary immunity. Some of the molecular mechanisms underlying these unique adaptations includes DNA repair, metabolism and immunity. However, analyses have been limited to a few divergent lineages, reducing the scope of inferences on gene family evolution across the Order Chiroptera. We conducted an exhaustive comparative genomic study of 37 bat species encompassing a large number of lineages, with a particular emphasis on multi-gene family evolution across immune system and metabolic genes. In agreement with previous analyses, we found lineage-specific expansions of the APOBEC3 and MHC-I gene families, and loss of the proinflammatory PYHIN gene family. We inferred more than 1,000 gene losses unique to bats, including genes involved in the regulation of inflammasome pathways such as epithelial defense receptors, the natural killer gene complex and the interferon-gamma induced pathway. Gene set enrichment analyses revealed genes lost in bats are involved in defense response against pathogen-associated molecular patterns and damage-associated molecular patterns. Gene family evolution and selection analyses indicate bats have evolved fundamental functional differences compared to other mammals in both innate and adaptive immune system, with the potential to enhance anti-viral immune response while dampening inflammatory signaling. In addition, metabolic genes have experienced repeated expansions related to convergent shifts to plant-based diets. Our analyses support the hypothesis that, in tandem with flight, ancestral bats had evolved a unique set of immune adaptations whose functional implications remain to be explored.

Objectives. Sarcoidosis is a multisystemic inflammatory disease with extrathoracic manifestations, most commonly affecting the young and middle-aged, female and black populations. Diagnosis usually requires evidence of non-caseating granulomata and, when treated, prognosis is usually favourable. We aim to establish the incidence, clinical features and optimal treatment of ENT manifestations of this disease. Design. We performed a review of the literature to determine the evidence-base supporting this. Results. ENT manifestations are present in 10-15% of patients with sarcoidosis, often as a presenting feature, and require vigilance for swift recognition and coordinated additional treatment specific to the organ. Laryngeal sarcoidosis presents with difficulty in breathing, dysphonia and cough, and may be treated by Speech and Language Therapy (SLT) or intralesional injection, dilatation or tissue reduction. Nasal disease presents with crusting, rhinitis, nasal obstruction and anosmia, usually without sinus involvement. It is treated by topical nasal or intralesional treatments but may also require endoscopic sinus surgery, laser treatment or even nasal reconstruction. Otological disease is uncommon but includes audiovestibular symptoms, both sensorineural and conductive hearing loss, and skin lesions. Conclusions. The consequences of ENT manifestations of sarcoidosis can be uncomfortable, disabling and even life threatening. Effective management strategies require good diagnostic skills and use of specific therapies combined with established treatments such as corticosteroids. Comparisons of treatment outcomes are needed to establish best practice in this area.

Purpose: To evaluate transfusion practices in pediatric oncology and hematopoietic stem cell transplant (HSCT) patients. Methods: This is a multicenter retrospective study of children with oncologic diagnoses treated from 2013-2016 at hospitals that participated in the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). Transfusion practices were evaluated by diagnosis code and pre-transfusion laboratory values. Results: A total of 4766 inpatient encounters of oncology and HSCT patients were evaluated, with 39.3% (95% CI 37.9-40.7%) involving a transfusion. Red blood cells (RBCs) were the most commonly transfused component (32.4%; 95% CI 31.1-33.8%), followed by platelets (22.7%; 95% CI 21.5-23.9%). Patients in the 1 to <6-year old age range were most likely to be transfused and HSCT, acute myelogenous leukemia, and aplastic anemia were the diagnoses most often associated with transfusion. The median hemoglobin (Hb) prior to RBC transfusion was 7.5 g/dL (10-90th percentile: 6.4-8.8 g/dL), with 45.7% of transfusions being given at 7-<8 g/dL. The median platelet count prior to platelet transfusion was 20x109/L (10-90th percentile: 8-51x109/L), and 37.9% of transfusions were given at platelet count of >20-50x109/L. The median international normalized ratio (INR) prior to plasma transfusion was 1.7 (10-90th percentile: 1.3-2.7), and 36.3% of plasma transfusions were given at an INR between >1.4-1.7. Conclusion: Transfusion of blood components is common in hospitalized children with cancer. Relatively high pre-transfusion Hb and platelet values and relatively low INR values prior to transfusion across the studied diagnoses highlight the need for evidence- based practice in this population.

Aim In critically ill mechanically ventilated children, midazolam is used first line for sedation, however its sedative effects have been difficult to quantify for which novel quantification methods are still required. In this analysis, we use parametric time-to-event (PTTE) analysis to quantify the effects of midazolam in critically ill children. Methods For the PTTE analysis, data was analyzed from a published sedation interruption study in mechanically ventilated critically ill children. In this study, blinded midazolam or placebo infusions were administered during the sedation interruption phase until, based on COMFORT-B and NISS scores, patients became undersedated and unblinded midazolam was restarted. Using NONMEM® v.7.4.3.,the restart of unblinded midazolam was analysed as a clinical event, followed by internal and external validation. Results Data contained 138 events from 79 individuals (37 blinded midazolam; 42 blinded placebo). In the PTTE model, a constant function best described the baseline hazard. The use of midazolam reduced the hazard for restart of unblinded midazolam due to undersedation by 51%. In the blinded midazolam group, time to midazolam restart was 26 h versus 58 h in patients with low versus high disease severity upon admission (PRISM II <10 versus > 21), respectively. For blinded placebo these times were 14 h and 33 h, respectively. The model performed well in an external validation with 42 individuals. Conclusion The PTTE analysis effectively quantified the effect of midazolam and the influence of disease severity on sedation in mechanically ventilated critically ill children and provides a valuable tool to quantify sedative efficacy

Studies focused on the drivers of change in species composition often fail to integrate several aspects of beta diversity and scale. Here, we assess the impact of species pool, environmental gradients, geographic distance, and spatial scale on the diversity of epiphytic bryophytes. We identify biogeographic modules of co-occurring species using network analyses. For each biogeographic unit we study the effects of environment, abundance structure of the community and geographic distance on beta diversity. We analyse two aspects of beta diversity related to different scales of analysis: between-forests dissimilarity in species composition and within-forests heterogeneity in species composition. We show that the structuring of the communities is a by-product of niche-related and stochastic processes. The balance of these processes changes with biogeographic region and scale, neutral stochastic effects are more significant in the most favourable regions and for small-scale within-forest heterogeneity

The biopharmaceutical industry is transitioning from currently deployed batch-mode bioprocessing to a highly efficient and agile next generation bioprocessing with the adaptation of continuous bioprocessing, which reduces the capital investment and operational costs. Continuous bioprocessing, aligned with FDA’s quality-by-design (QbD) platform, is designed to develop robust processes to deliver safe and effective drugs. With the deployment of knowledge based operations, product quality can be built into the process to achieve desired critical quality attributes (CQAs) with reduced variability. To facilitate next generation continuous bio-processing, it is essential to embrace a fundamental shift-in-paradigm from “quality-by-testing” to “quality-by-design”, which requires the deployment of process analytical technologies (PAT). With the adaptation of PAT, a systematic approach of process and product understanding and timely process control are feasible. Deployment of PAT tools for real-time monitoring of CQAs and feedback control is critical for continuous bioprocessing. Given the current deficiency in PAT tools to support continuous bioprocessing, we have integrated Agilent 2D-LC with a post-flow-splitter in conjunction with the SegFlow automated sampler to the bioreactors. With this integrated system, we have established a platform for online measurements of titer and CQAs of monoclonal antibodies (mAbs) as well as amino acid concentrations of bioreactor cell culture.

Peptides that bind to and are presented on the cell surface by Human Leukocyte Antigens (HLA) molecules play a critical role in adaptive immunity. For a long time, it was believed all of the HLA bound peptides were generated through simple proteolysis of linear sequences of cellular proteins, and therefore, are templated in the genome and proteome. However, evidence for untemplated peptide ligands of HLA molecules has accumulated over the last two decades, with a recent global analysis of HLA-bound peptides suggesting that a considerable proportion of HLA bound peptides are potentially generated through splicing/fusion of discontinuous peptide segments from one or two distinct proteins. In this review, we will review recent discoveries and debates on the contribution of spliced peptides to the HLA class I immunopeptidome, consider biochemical rules for splicing, and the potential role of these spliced peptides in immune recognition.

Background: Although atopic dermatitis (AD) is associated with certain gene variants, the rapidly increasing incidence of AD suggests that environmental factors contribute to disease development. In this study, we investigated the association of AD incidence and phenotype with antibiotic exposure within 6 months of age, considering the dose administered and genetic risk. Methods: This study included 1,637 children from the COCOA birth cohort. Pediatric allergists assessed the presence of AD at each visit and obtained information about antibiotic exposure for more than 3 days. IL-13 (rs20541) polymorphism was genotyped by the TaqMan method. We stratified the AD phenotypes into 4 groups and used multinomial logistic regression models for analysis. Results: Antibiotic exposure within 6 months of age was found to increase the risk of AD within 3 years of life (aOR=1.40, 95%, CI 1.09–1.81) in dose-dependent manner. Antibiotic exposure more than twice increased the risk of the early-persistent AD phenotype (aOR=2.50, 95% CI 1.35–4.63). There was a weak interaction between genetic polymorphisms and environmental factors on the development of AD (p for interaction=0.06). Children with the IL-13 (rs20541) GA+ AA genotype have a higher risk of the early-persistent AD phenotype when exposed to antibiotics more than twice than those with the IL-13 (rs20541) GG genotype and without exposure to antibiotics (aOR=4.73, 2.01–11.14). Conclusion: Antibiotic exposure within 6 months was related to the incidence of early-persistent AD and a dose-dependent increase in the incidence of AD in childhood, whose effect was modified by the IL-13 (rs20541) genotype.

In this paper, we consider a nonlinear p .x/Laplacian equation with delay of time and variable exponents. Firstly, we prove the blow up of solutions. Then, by applying an integral inequality due to Komornik, we obtain the decay result. These results improve and extend earlier results in the literature.

Phenotypic plasticity can mask population genetic differentiation, reducing the predictability of trait-environment relationships. In short-lived plants, reproductive traits may be more genetically determined due to their direct impact on fitness, whereas vegetative traits may show higher plasticity to buffer short-term perturbations. Combining a multi-treatment greenhouse experiment with global field observations for the short-lived Plantago lanceolata, we 1) disentangled the genetic and plastic responses of functional traits to a set of environmental drivers and 2) assessed the utility of trait-environment relationshisps inferred from observational data for predicting genetic differentiation. Reproductive traits showed distinct genetic differentiation that was highly predictable from observational data, but only when correcting traits for differences in their (labile) biomass component. Vegetative traits showed higher plasticity and contrasting genetic and plastic responses, leading to unpredictable trait patterns. Our study suggests that genetic differentiation may be inferred from observational data only for the traits most closely related with fitness.

Since its inception in 2009, the cryptocurrency market has grown considerably. Several authors have proposed models to explain the price movements of assets in this new emerging market. However, only few researches have been done using the dynamical approach. This paper proposes a robust time fractional spectral method for studying a three dimensional fractional differential equation that models cryptocurrency asset flow obtained by utilizing the concept of liquidity price. The method relies on fractional spectral integration matrix operator approach. Numerical simulations are conducted to show efficiency of the numerical method on the fractional cryptocurrency model compared to existing methods.

Despite the importance of headwater catchments for western United States’ water supply, these regions are often poorly understood, particularly with respect to quantitative understanding of evapotranspiration (ET) fluxes. Heterogeneity of land cover, physiography, and atmospheric patterns in these high-elevation regions lead to difficulty in developing spatially-distributed characterization of ET. As the largest terrestrial water flux behind precipitation, ET represents a significant fraction of the water budget for any watershed. Likewise, groundwater is the largest available freshwater store and has been shown to play a large role in the water balance, even in headwater systems. Using an eddy covariance tower in the East River Catchment, a Colorado River headwaters basin, this study estimates water and energy fluxes in high-elevation, complex systems to better constrain ET estimates and calculate overall water and energy budgets, including losses from groundwater. The eddy covariance method is used to estimate ET from years 2017 through 2019 at a saturated, riparian end-member site. Owing to complexities in near surface atmospheric structure such as stable boundary layers over snowpack and shallow terrain driven flow from surrounding landscape features, energy flux and ET estimates were limited to the warm season when energy closure residuals from the eddy-covariance system were reliably less than 30 %, a threshold commonly used in eddy covariance energy flux estimation. The resulting ET estimations are useful for constraining water budget estimates at this energy-limited site, which uses groundwater for up to 84 % of ET in the summer months. We also compared East River ET magnitudes and seasonality to two other flux towers (Niwot Ridge, CO and Valles Caldera, NM), located in the Rocky Mountains. This data is useful for constraining ET estimates in similar end-member locations across the East River Catchment. Our results show that groundwater-fed ET is a significant component of the water balance and groundwater may supply riparian ET even during low-snow years.