Although adolescents’ emotional lives are thought to be more turbulent than those of adults, it is unknown whether this difference is attributable to developmental changes in emotional reactivity or emotion regulation. Study 1 addressed this question by presenting healthy individuals aged 10–23 with negative and neutral pictures and asking them to respond naturally or use cognitive reappraisal to down-regulate their responses on a trial-by-trial basis. Results indicated that age exerted both linear and quadratic effects on regulation success but was unrelated to emotional reactivity. Study 2 replicated and extended these findings using a different reappraisal task and further showed that situational (i.e., social vs. nonsocial stimuli) and dispositional (i.e., level of rejection sensitivity) social factors interacted with age to predict regulation success: young adolescents were less successful at regulating responses to social than to nonsocial stimuli, particularly if the adolescents were high in rejection sensitivity. Taken together, these results have important implications for the inclusion of emotion regulation in models of emotional and cognitive development.

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hospital will ultimately develop chronic lung dysfunction related to post-COVID-19 pulmonary fibrosis. 9 Although none of the reported transplants has been done in that scenario, with time and more experience of the longerterm effects of COVID-19, a population of patients who have developed fibrosis might require transplantation.In summary, with ECMO support, patients with severe, life-threatening lung failure secondary to ARDS can be treated for remarkably long periods and return to meaningful and active lives. SARS-CoV-2 has caused a worldwide pandemic of unprecedented magnitude, with COVID-19 leading to ARDS in many patients. The underlying mechanism of COVID-19-induced lung injury, its associated systemic comorbidities, and its recoverability are still incompletely understood at this time. As such, lung transplantation should be considered only in a very select group of patients with COVID-19-related ARDS. The ultimate effect and results of offering this life-saving therapy in this population remain unknown.We declare no competing interests.

Red blood cell (RBC) transfusion is common in critically ill, postsurgical, and posttrauma patients in whom both systemic inflammation and immune suppression are associated with adverse outcomes. RBC products contain a multitude of immunomodulatory mediators that interact with and alter immune cell function. These interactions can lead to both proinflammatory and immunosuppressive effects. Defining clinical outcomes related to immunomodulatory effects of RBCs in transfused patients remains a challenge, likely due to complex interactions between individual blood product characteristics and patient-specific risk factors. Unpacking these complexities requires an in-depth understanding of the mechanisms of immunomodulatory effects of RBC products. In this review, we outline and classify potential mediators of RBC transfusion-related immunomodulation and provide suggestions for future research directions.

• Washing older blood before transfusion reduces plasma iron, improving outcomes from established infection in canines.• In contrast, washing fresh blood before transfusion increases in vivo plasma CFH release, worsening outcomes.In a randomized controlled blinded trial, 2-year-old purpose-bred beagles (n 5 24), with Staphylococcus aureus pneumonia, were exchanged-transfused with either 7-or 42-dayold washed or unwashed canine universal donor blood (80 mL/kg in 4 divided doses). Washing red cells (RBC) before transfusion had a significantly different effect on canine survival, multiple organ injury, plasma iron, and cell-free hemoglobin (CFH) levels depending on the age of stored blood (all, P < .05 for interactions). Washing older units of blood improved survival rates, shock score, lung injury, cardiac performance and liver function, and reduced levels of non-transferrin bound iron and plasma labile iron. In contrast, washing fresh blood worsened all these same clinical parameters and increased CFH levels. Our data indicate that transfusion of fresh blood, which results in less hemolysis, CFH, and iron release, is less toxic than transfusion of older blood in critically ill infected subjects. However, washing older blood prevented elevations in plasma circulating iron and improved survival and multiple organ injury in animals with an established pulmonary infection. Our data suggest that fresh blood should not be washed routinely because, in a setting of established infection, washed RBC are prone to release CFH and result in worsened clinical outcomes. (Blood. 2014;123(9):1403-1411 IntroductionTransfusion of older stored canine universal donor blood in a canine model of experimental Staphylococcus aureus pneumonia results in markedly increased lung injury and mortality rates.1 Transfusion with older blood is also associated with increased levels of cell-free hemoglobin (CFH), transferrin bound iron (TBI), non-TBI (NTBI) and plasma labile iron (PLI). NTBI represents iron excess bound to proteins that do not normally handle circulating iron, and PLI is the toxic iron moiety in plasma. Whereas increased nitric oxide scavenging by CFH causing vasoconstriction and vascular injury and increased available iron promoting bacterial growth represent 2 candidate mechanisms of injury, multiple other biological changes have been documented with increasing blood storage interval.2,3 Some of these changes involve the release into the plasma of biologically active proteins, microvesicles, potassium, acid, and plasticizer, all of which can be reduced by means of standard red cell (RBC) washing procedures. [4][5][6][7][8][9][10] The clinical effect(s) of washing on the RBC storage lesion has not been studied.RBC washing has long been performed to reduce potassium levels in stored blood transfused to neonates, debris from RBCs recovered during surgery, cryoprotectant glycerol from cryopreserved RBCs, and plasma proteins from blood intended for patients who have been sensitized to those proteins.11-13 Automated cell washers cap...