bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Small Focal Liver Lesions Using Real‐time Contrast‐Enhanced Sonography
Authors: Xu Hui-Xiong , Liu Guang-Jian , Lu Ming-De , Xie Xiao-Yan , Xu Zuo-Feng , Zheng Yan-Ling , Liang Jin-Yu
Published: January 2017

Objective. The purpose of this study was to assess the diagnostic performance of real‐time contrast‐enhanced sonography in characterization of small focal liver lesions (FLLs; ≤3.0 cm in diameter). Methods. Two hundred small FLLs in 200 patients were examined by contrast‐enhanced sonography using a contrast‐specific mode of contrast pulse sequencing and a sulfur hexafluoride–filled microbubble contrast agent. The sonographic images were reviewed by 2 independent readers. A 5‐point confidence level was used to discriminate malignant from benign FLLs, and specific diagnoses were recorded. The diagnostic performances were evaluated by receiver operating characteristic (ROC) analysis, and the interobserver agreement was analyzed by weighted κ statistics. Results. After review of contrast‐enhanced sonography, ROC analysis revealed significant improvement in differentiating between malignant and benign small FLLs that the areas under the ROC curve were 0.856 at baseline sonography versus 0.954 at contrast‐enhanced sonography for reader 1 (P < .001) and 0.857 versus 0.954 for reader 2 (P = .003). The sensitivity, negative predictive value, and accuracy for both readers also improved significantly after contrast agent administration (all P < .001). A better result of specific diagnosis was obtained (38.5% [77/200] at baseline sonography versus 80.5% [161/200] at contrast‐enhanced sonography for reader 1 and 34.5% [69/200] versus 80.5% [161/200] for reader 2; both P < .001) after contrast agent administration, and a better interobserver agreement was achieved (κ = 0.425 at baseline sonography versus 0.716 at contrast‐enhanced sonography). Conclusions. Real‐time contrast‐enhanced sonography improves the diagnostic performance in small FLLs compared with baseline sonography.
Diagnostic Performance of a Random Versus Lesion‐Directed Biopsy of the Prostate From Transrectal Ultrasound
Authors: Lan Shih-Kai , Tsai Yuh-Shyan , Lin Yi-Hsiang , Tzai Tzong-Shin
Published: January 2017

Objectives

The purpose of this study was to compare cancer detection rates of sonographically suspicious lesion‐directed biopsies and random biopsies through transverse examination of prostate halves in 518 patients over 5 years.

Methods

From 1998 to 2002, 518 patients were referred for prostate biopsies because of either elevated prostate‐specific antigen (PSA) levels or abnormal digital rectal examination findings. On the basis of transverse examination of prostate halves by transrectal ultrasound, we performed lesion‐directed biopsy of 3 to 5 cores if morphologically suspicious lesions existed on sonography or random biopsy of 3 cores if no obvious suspicious lesions existed. Biopsy specimens were put into 2 labeled containers. Pathologic results were correlated with random and lesion‐directed guided locations.

Results

Nine‐hundred fifty‐nine results were obtained from 439 random and 520 lesion‐directed biopsies in 518 patients. Cancer was detected in 207 patients (40.7%). Patients with cancer who had PSA levels of 10.0 ng/mL or greater had higher proportions of bilateral cancer lesions than those with PSA levels of less than 10 ng/mL (P = 0.03). One hundred ten (25.1%) of 439 normal‐appearing halves taken by random biopsy were tumor‐positive compared with 200 (38.5 %) of 520 biopsies from halves with sonographically suspicious lesions. Regardless of having random or lesion‐directed biopsies, patients with PSA levels of 10 ng/mL or greater had higher positive malignancy rates than those with PSA levels of less than 10.0 ng/mL (P < .001). In about 40 patients, a diagnosis was made by random biopsy from halves that were morphologically normal on sonography, not by lesion‐directed biopsy from tumor‐suspicious contralateral halves.

Conclusions

Cancer detection rates of lesion‐directed biopsies are superior to those of random biopsies regardless of PSA level.
Correlation of Prenatal Sonographic Diagnosis and Morphologic Findings of Fetal Autopsy in Fetuses With Trisomy 21
Authors: Szigeti Zsanett , Csaba Ákos , Pete Barbara , Hajdú Júlia , Papp Zoltán , Papp Csaba
Published: January 2017

Objectives

The purpose of this study was to compare the prenatal sonographic and postmortem pathologic findings of fetuses with trisomy 21.

Methods

Among 22,150 fetal chromosome analyses, trisomy 21 was diagnosed in 207 fetuses between 1990 and 2004. Findings of second‐trimester sonography and fetal autopsy were compared by organ system, and their correlation was assigned to 1 of 3 categories.

Results

In total, 83.1% of the 184 fetuses that constituted the final study group had 1 or more abnormal structural findings at postabortion pathologic examination, whereas in 16.9% of the cases, fetal pathologic examination did not reveal any defects in fetal anatomy. Among major structural defects, the agreement between sonographic and autopsy findings was greater than 60% of all abnormalities of these systems: central nervous system (65.4%), heart (67.4%), fetal hydrops (100%), and cystic hygroma (93.3%), whereas the concordance rate was lower in these organ systems: abdominal abnormalities (46.2%), renal anomalies (50%), facial abnormalities (1.2%), and extremities (4.4%). The rate of additional major findings at autopsy was 34.2%. These mainly involved 3 organ systems: heart, head, and abdominal anomalies. Some sonographic findings (n = 16) were not verified at autopsy. The concordances between sonographic and autopsy findings regarding soft markers were considerably high in these markers: increased nuchal fold thickness (72%), short femur/humerus (75%), and pyelectasis (51.9%).

Conclusions

Examining the correlation between sonography and pathologic findings may indicate possible directions of further development in sonographic screening for trisomy 21. In addition to obstetricians, pediatricians, and geneticists, specialized perinatal pathologists have an important role in the multidisciplinary management of prenatally diagnosed fetal malformations.
An Increased Thermal Index Can Be Achieved When Performing Doppler Studies in Obstetric Sonography
Authors: Sheiner Eyal , Shoham-Vardi Ilana , Pombar Xavier , Hussey Michael J. , Strassner Howard T. , Abramowicz Jacques S.
Published: January 2017

Objectives

The present study was aimed at evaluating acoustic outputs during clinical ultrasound examinations, as expressed by the thermal index (TI) and the mechanical index (MI), during the second half of pregnancy and comparing acoustic outputs between B‐mode and Doppler examinations.

Methods

Patients with suspected fetal growth problems undergoing Doppler studies of the fetal circulation in addition to B‐mode sonography were selected. Examinations took place between 21 and 40 weeks' gestation. An obstetrician collected data prospectively. Sonographers were unaware of the data being sought. The analysis of variance test was applied for differences in continuous variables.

Results

A total of 63 examinations were evaluated. The mean gestational age ± SD was 31.6 ± 5.1 weeks. The mean duration of the total examinations was 17.6 ± 8.6 minutes, whereas the Doppler studies lasted 0.9 ± 0.8 minutes. The TI was significantly higher in the pulsed wave Doppler studies (mean, 1.5 ± 0.5; range, 0.9–2.8) and color flow imaging studies (mean, 0.8 ± 0.1; range, 0.6–1.2) compared with B‐mode sonography (mean, 0.3 ± 0.1; range, 0.1–0.7; P < .01). During the examination, 190 B‐mode MI variations were recorded (mean, 1.1 ± 0.1), which were comparable with those of the 31 color flow Doppler studies (mean, 1.0 ± 0.1; P = .09) but higher than the 190 pulsed wave Doppler MI variations (mean 0.9 ± 0.2; P < .001).

Conclusions

Increased acoustic output levels, as expressed by TI levels, are reached during obstetric Doppler studies. In particular, TI levels may reach 1.5 and higher. Doppler procedures should be performed with caution and be as brief as possible during obstetric sonography.
Interobserver Reproducibility of Transabdominal 3‐Dimensional Sonography of the Fetal Brain
Authors: Fratelli Nicola , Taddei Fabrizio , Prefumo Federico , Franceschetti Laura , Farina Giuliano , Frusca Tiziana
Published: January 2017

Objective. The purpose of this study was to assess the interobserver reproducibility of transabdominal 3‐dimensional (3D) fetal neurosonography. Methods. This was a prospective observational study. We studied 23 consecutive singleton pregnancies between 18 and 23 weeks' gestation. All cases had normal fetal neurosonographic examination findings, which were confirmed after birth. A 3D sonographic volume of the fetal head was acquired transabdominally by a single operator using an axial approach. Fetal brain anatomy was later analyzed offline by 2 different operators. Axial, sagittal, and coronal views of the fetal brain were obtained to perform a detailed evaluation of the fetal brain. Each operator defined the scanning planes obtained as adequate or inadequate. Results were evaluated with 2 × 2 tables and the Cohen κ coefficient to assess interobserver agreement. Results. Good‐quality multiplanar images were obtained in 23 of 23 cases. The rate of adequate visualization was 100% for all of the axial planes, with κ values of 1.00. For sagittal and coronal planes, the rate of visualization ranged between 78% and 91%, with κ values ranging between 0.61 and 0.83. Conclusions. Transabdominal 3D sonography of the fetal brain at 18 to 23 weeks' gestation has an acceptable degree of interobserver reproducibility.
Diagnosis of Fetal Limb Abnormalities Before 15 Weeks
Authors: Rice Katherine J. , Ballas Jerasimos , Lai Edgar , Hartney Caitlin , Jones Marilyn C. , Pretorius Dolores H.
Published: January 2017

Objectives

The purposes of this study were (1) to identify cases of limb abnormalities identified before 15 weeks and correlate with outcomes and (2) to assess first‐trimester nuchal translucency examinations to determine how frequently the upper and lower limbs were identified.

Methods

A retrospective review was conducted of sonographic studies up to 15 weeks' gestational age from 2003 to 2010 at our high‐risk fetal center. Data were collected regarding fetal gestational age, limb abnormalities, associated anatomic abnormalities, pregnancy outcomes, karyotypes, autopsy results, and the utility of transabdominal sonography, transvaginal sonography, and 3‐dimensional sonography. A retrospective analysis of 100 consecutive first‐trimester examinations was also conducted to assess the sensitivity of transabdominal sonography in visualization of limb buds.

Results

A total of 15 cases were identified with a mean gestational age of 12 weeks 6 days. Club hand was the most common abnormality seen (8 cases), followed by absence of long bones (5 cases), a missing limb (5 cases), club foot (5 cases), shortening of long bones (2 cases), abnormal hands (2 cases), clenched hands (2 cases), and overlapping digits (1 case). Trisomy 18 was present in 9 cases. Transabdominal sonography allowed for detection of all limb buds in 100 consecutive nuchal translucency examinations and 9 of 15 cases of limb abnormalities. Four of the cases resulted in fetal death, and the remaining 11 cases were terminated.

Conclusions

Fetal limb abnormalities can be detected on sonography before 15 weeks' gestational age and are often associated with serious congenital conditions, especially trisomy 18. Transabdominal sonography alone can show most of these abnormalities, although transvaginal and 3‐dimensional sonography can provide additional information. Targeted evaluation of fetal limbs during sonography before 15 weeks should be considered in high‐risk populations.
Fetal Polydactyly
Authors: Filges Isabel , Kang Anjeung , Hench Jürgen , Wenzel Friedel , Bruder Elisabeth , Miny Peter , Tercanli Sevgi
Published: January 2017

Records of 24 pregnancies with fetal polydactyly were reviewed for the type of polydactyly, family history, associated sonographic findings, genetic testing, and postnatal/postmortem examination findings. The importance of fetal polydactyly can be mainly elucidated by the family history and absent or associated anomalies on a specialized malformation scan. Fetal karyotyping diagnoses frequent chromosomal anomalies in about half of cases with additional malformations, and array comparative genomic hybridization may be a future means of detecting cryptic chromosomal aberrations. Syndromic disorders of monogenic origin demand a careful interdisciplinary clinical assessment for establishing a clinical diagnosis and prognosis for the outcome of the child.
Differentiating Benign From Malignant Thyroid Nodules
Authors: Jang Mijung , Kim Sun Mi , Lyou Chae Yeon , Choi Byung Se , Choi Sang Il , Kim Jae Hyoung
Published: January 2017

Objectives

To compare the diagnostic performance of radiologists and to determine interobserver and intraobserver variability with regard to differentiation of benign and malignant thyroid nodules using prospectively obtained 2‐dimensional (2D) and 3‐dimensional (3D) sonograms.

Methods

This study had Institutional Review Board approval, and the requirement for patient informed consent was waived. Conventional 2D and 3D sonograms were obtained from 82 patients (age range, 20–77 years; mean age, 51 years) with 91 thyroid nodules (15 cancers, 13 indeterminate, and 63 benign lesions) before diagnostic fine‐needle aspiration. Three radiologists reviewed stored 2D and 3D images for internal content, shape, margin, echogenicity, echo texture, and the presence of calcification and estimated the level of suspicion as to the probability of malignancy according to known sonographic criteria. The diagnostic performance of 2D images was compared with that of 3D images.

Results

For all readers, interpretation using 3D images was more sensitive and specific than that using 2D images for diagnosis of malignant thyroid nodules, with the exception of specificity for reader 1. However, differences were not statistically significant (P > .05). Area under the receiver operating characteristic curve values were 0.83 for 2D images and 0.92 for 3D images for reader 1; 0.78 for 2D images and 0.89 for 3D images for reader 2; and 0.89 for 2D images and 0.93 for 3D images for reader 3. Interobserver agreement between the 3 radiologists for differentiation of benign and malignant thyroid nodules was better for 3D images (κ = 0.49) than for 2D images (κ = 0.15). Intraobserver variability for nodule descriptions and assessments using 3D and 2D images was fair to moderate.

Conclusion

The performance of radiologists and interobserver and intraobserver agreement for characterization of thyroid nodules were better when 3D sonograms were used than when 2D sonograms were used.
Maternal Hydration Therapy Improves the Quantity of Amniotic Fluid and the Pregnancy Outcome in Third‐Trimester Isolated Oligohydramnios
Authors: Patrelli Tito Silvio , Gizzo Salvatore , Cosmi Erich , Carpano Maria Giovanna , Di Gangi Stefania , Pedrazzi Giuseppe , Piantelli Giovanni , Modena Alberto Bacchi
Published: January 2017

Objectives

Amniotic fluid is important for the maintenance of fetal well‐being; therefore, an amniotic fluid deficiency, ie, oligohydramnios, can have multiple impacts on the prognosis of the pregnancy. In some cases, there are no evident fetal or maternal causes, and the condition is called isolated oligohydramnios. The aim of our study was to validate maternal intravenous and oral hydration therapy as a means for improvement of isolated oligohydramnios in the third trimester of pregnancy.

Methods

We conducted a prospective randomized controlled study on pregnancies complicated by idiopathic oligohydramnios (group A, 66 women) with a control group of women with normal pregnancies without oligohydramnios (group B, 71 women). Oligohydramnios was diagnosed using the amniotic fluid index (AFI; <5 cm). Sonographic examinations were performed with a convex 3.5‐MHz probe. Group A underwent 6 days of intravenous infusion of 1500 mL of an isotonic solution per day. An AFI measurement, a nonstress test, and a fetal biophysical profile were performed at 0 and 7 days. Group A was randomized into subgroups A1 and A2. Subgroup A1 was prescribed home oral hydration therapy of 1500 mL/d and subgroup A2 2500 mL/d. We considered the AFI to compare the effectiveness of the therapy.

Results

General features did not reveal any significant differences between the two groups. In group A, the mean AFI ± SD at recruitment was 39.68 ± 11.11 mm; in group B, it was 126.92 ± 10.59 mm (P < .001). In group A, the mean AFI at 7 days was 77.70 ± 15.03 mm; in group B, it was unchanged. In subgroup A1, the mean AFI at birth was 86.21 ± 16.89 mm; in subgroup A2, it was 112.45 ± 14.92 mm (P < .001).

Conclusions

Our data show that in pregnancies complicated by isolated oligohydramnios, hydration therapy significantly improves the quantity of amniotic fluid.
Safety of Sulfur Hexafluoride Microbubbles in Sonography of Abdominal and Superficial Organs: Retrospective Analysis of 30,222 Cases
Authors: Tang Chunlin , Fang Kejing , Guo Yanli , Li Rui , Fan Xiaozhou , Chen Ping , Chen Zhaohui , Liu Qiangwei , Zou Ye
Published: January 2017

Objectives

The purpose of this study was to investigate the safety of the sulfur hexafluoride microbubble contrast agent SonoVue (Bracco SpA, Milan, Italy) and to implement precautions with the intent of further improving the safety of this contrast agent.

Methods

A total of 30,222 patients undergoing contrast‐enhanced sonography of abdominal and superficial organs in our hospital from January 2005 to December 2014 were retrospectively investigated. SonoVue was used as the ultrasound contrast agent. The symptoms and treatments of adverse reactions occurring during the contrast‐enhanced sonographic examinations were reviewed and analyzed.

Results

No patient died as a result of any adverse reaction. Six patients (0.020%) had adverse reactions of varying degrees, including 2 patients (0.007%) who had signs of early anaphylactic shock (chest tightness, palpitations, sweating, and rapid and weak pulse, followed by cyanosis, a disappearing pulse, and a drop in blood pressure) that improved after active rescue. The remaining 4 patients developed the following: redness and a rash on the arm above the injection site, nasal bleeding and nausea, nausea and vomiting, and back pain with numbness of the lips and limbs. Symptoms in these 4 patients self‐resolved after a period of rest.

Conclusions

Contrast‐enhanced sonography with sulfur hexafluoride microbubbles had good clinical safety, but rare adverse reactions were observed. A comprehensive emergency plan and rescue measures for adverse reactions should be prepared and made available to minimize the occurrence of negative clinical outcomes.
Effect of Cement Replacement with Carbide Waste on the Strength of Stabilized Clay Subgrade
Authors: Muntohar Agus Setyo , Hartono Edi , Diana Wilis , Rahmawati Anita
Published: January 2017

Cement is commonly used for soil stabilization and many other ground improvement techniques. Cement is believed to be very good to improve the compressive and split-tensile strength of clay subgrades. In some application cement could be partly or fully replaced with carbide waste. This research is to study the effectiveness of the cement replacement and to find the maximum carbide waste content to be allowed for a clay subgrade. The quantities of cement replaced with the carbide waste were 30, 50, 70, 90, and 100% by its mass. The results show that replacing the cement with carbide waste decreased both the compressive and split tensile strength. Replacing cement content with carbide waste reduced its ability for stabilization. The carbide waste content should be less than 70% of the cement to provide a sufficient stabilizing effect on a clay subgrade.
Avaliação da fragilidade em idosos participantes de um centro de convivência Evaluation of fragility in elderly participants of a community center
Authors: Vieira Gerlane Ângela Costa Moreira , Costa Eliene Pereira , Medeiros Ana Claudia Torres , Costa Marta Miriam Lopes , Rocha Fernanda Azevedo Teixeira
Published: January 2017

Objetivo: Avaliar a existência de fragilidade em idosos participantes de um Centro de Convivência na cidade de Campina Grande – PB. Método: Trata-se de uma pesquisa descritiva com delineamento transversal, realizada com 83 idosos com 60 anos ou mais. Utilizou-se um questionário semiestruturado e a avaliação de quatro dos cinco itens do fenótipo elaborado por Fried et al. Resultados: A presença da fragilidade foi verificada em 6% dos participantes e a pré-fragilidade em 71,1%. Observou-se também que 53,01% dos idosos apresentou sobrepeso. Apesar dos idosos se mostrarem ativos e inseridos em atividades que buscam melhorias para a sua qualidade de vida, observou-se que a maioria já se encontra em estado de pré-fragilidade. Conclusão: Há necessidade de se investigar os determinantes dessa condição e reforçam a importância de redirecionamento das atividades oferecidas a partir da necessidade de cada indivíduo a fim de que tragam benefícios à sua saúde física e mental.Descritores: Envelhecimento; Idoso Fragilizado; Saúde do Idoso.
Conhecimentos e condutas de biossegurança entre docentes de enfermagem Knowledge and practices of biosafety among nursing professors
Authors: Morais Roberta Laíse Gomes Leite , Tanan Manuella Serra , Oliveira Juliana da Silva , Macedo Maiara Pimentel , Nery Adriana Alves , Matos Filho Silvio Arcanjo
Published: January 2017

Objetivos: Descrever o conhecimento dos docentes enfermeiros de um curso de enfermagem sobre Norma Regulamentadora 32 e as condutas pós-exposição a materiais biológicos e, identificar a situação vacinal destes docentes. Método: Estudo quantitativo descritivo de corte transversal. Os dados foram coletados, entre setembro e outubro de 2014, através de um questionário e analisados através do Software estatístico SPSS 21.0. Participaram da pesquisa 35 docentes enfermeiros. Resultados: 71,4% eram do sexo feminino; 100% afirmou ter conhecimento sobre biossegurança; 51,4% conheciam a Norma Regulamentadora 32; 71,4% estavam imunizados para hepatite B; 22,9% sofreram acidente envolvendo material biológico; apenas 14,3% citaram a lavagem com água e sabão do ferimento após a ocorrência de acidente. Conclusão: Evidenciou-se que existe uma fragilidade no conhecimento dos docentes relativo às ações de biossegurança.
Carga de trabalho de enfermagem em UTI neonatal: aplicação da ferramenta nursing activities score Nursing workload in neonatal ICU: application of the nursing activities score tool
Authors: Luna Aline Affonso , Branco Lenyza Lucas Winchello Vieira , Beleza Ludmylla de Oliveira
Published: January 2017

Objetivo: Identificar a real carga de trabalho de enfermagem, aplicando-se a ferramenta Nursing Activities Score (NAS), em uma unidade de neonatologia de um hospital referência para prematuridade e patologias cirúrgicas do Distrito Federal e propor o dimensionamento de profissionais adequado para a unidade de neonatologia. Métodos: Estudo exploratório quantitativo, amostra de 98 pacientes, critérios de inclusão todos os pacientes internados no setor, os dados foram coletados através de instrumento construído e pela ferramenta NAS, os dados foram tabulados no Excel® 2010 e realizada estatística descritiva no programa SPSS® versão 21, Comitê de Ética e Pesquisa da FEPECS, CAAE 37164714.5.0000.5553. Resultados: A média do NAS houve variação entre 48,5% a 50% com complexidade classificada como semi-intensiva. A ala azul foi a que apresentou maior índice de inadequação de profissionais, com média de 51%. Conclusão: Foi observado dissociação entre carga de trabalho e complexidade clínica do paciente.Descritores: Enfermagem Neonatal, Unidade de Terapia Intensiva Neonatal, Dimensionamento de Pessoal, Administração Hospitalar.
Caracterização de uma instituição de longa permanência para idosos Characteristics of a long-stay institution for the elderly
Authors: Do Nascimento Silva Nadjara Marciele , Azevedo Ana Karina Silva , Da Silva Farias Lívia Maria , Lima Jéssica de Medeiros
Published: January 2017

Objetivo: Caracterizar o funcionamento de uma Instituição de Longa Permenência para idosos (ILPI), visando à adequação da ILPI à legislação e melhoria da assistência. Métodos: Realizou-se um estudo de caso, de cunho exploratório-descritivo, qualitativo, em uma ILPI, no município de Currais Novos/RN. A observação participante da rotina, realização de entrevistas e acesso aos prontuários foram os métodos empregados para coleta de dados. Resultados: A instituição caracterizou-se como filantrópica, aproximando-se da modalidade assistencial tipo II. O confinamento dos idosos se dava principalmente em decorrência do abandono familiar. A composição da equipe de saúde apresentava-se incompleta e com carga horária aquém do preconizado, e a equipe de cuidados atuava sem a coordenação e supervisão do enfermeiro. Conclusão: Espera-se que a proposta de intervenção venha a contribuir para melhorias na ILPI, melhorando a qualidade da assistência prestada ao idoso.
Percepção de mulheres acerca da violência vivenciada The women’s perception on the violence experienced
Authors: Costa Leite Franciele Marabotti , Santos Dherik Fraga , Castro Denise Silveira , Netto Leonidas Albuquerque , Vasconcelos Moura Maria Aparecida , Lima Eliane de Fátima Almeida
Published: January 2017

Objetivo: analisar a percepção de mulheres acerca da violência vivenciada. Método: estudo qualitativo, os dados foram obtidos por meio de uma entrevista semiestruturada e analisados através da modalidade de Análise de Conteúdo. Resultado: a partir da análise dos relatos das 14 mulheres participantes do estudo foram identificadas 04 categorias temáticas. Sendo que 34,8% dos relatos se enquadram na categoria Percepção e sentimentos acerca da violência; 26,1% apresentaram relatos na categoria Percepção dos motivos da vivência da violência e na categoria Cessação da liberdade; e 13,0% na categoria Reflexo da violência sobre a saúde. Conclusão: emerge a necessidade de políticas e ações que apoiem e contribuem para que as mulheres se desvencilhem da violência, bem como o fortalecimento das redes de apoio intersetoriais, já que a violência acarreta inúmeros problemas não apenas de caráter socioeconômico, mas também gera danos à saúde de suas vítimas.
O cuidado à mulher no contexto da maternidade: caminhos e desafios para a humanização The care of women in the context of maternity: challenges and ways to humanize
Authors: Dodou Hilana Dayana , Rodrigues Dafne Paiva , Oriá Mônica Oliveira Batista
Published: January 2017

Objetivo: conhecer a percepção de puérperas acerca da atenção recebida durante a internação em uma maternidade pública. Método: Estudo descritivo, realizado em um hospital público de nível secundário de Fortaleza/Ceará. Os dados foram coletados mediante entrevista semiestruturada a 20 puérperas, e analisados a partir da técnica de análise de conteúdo. Resultados: As mulheres, em sua maioria, perceberam a atenção recebida como de qualidade, fácil acesso e humanizada, além de enfatizarem o acolhimento e o bom relacionamento com a equipe de saúde. Porém, dificuldades também foram evidenciadas, como a falta de acompanhamento da equipe de saúde durante o trabalho de parto, a ausência de informações e o comportamento indelicado e insensível de alguns profissionais. Conclusão: O estudo estimula reflexão e debate entre profissionais e gestores, aponta fragilidades e potencialidades e indica desafios a serem seguidos com vistas a melhorar a assistência à mulher nas maternidades.
Sofrimento psíquico no trabalhador de enfermagem: uma revisão integrativa Psychical distress in nursing worker: an integrative review
Authors: Soares Ferreira Dayana Kelly , De Medeiros Soraya Maria , De Carvalho Inaiane Marlisse
Published: January 2017

Objetivo: Analisar a produção sobre o sofrimento psíquico no trabalhador de enfermagem, a fim de identificar os fatores que o influenciam. Métodos: Realizou-se uma revisão integrativa com pesquisa na Biblioteca Virtual da Saúde (BVS) de janeiro a fevereiro de 2013, colhendo artigos entre 2005 a 2012 do banco de dados da LILACS, SciELO e BDENF. Utilizou-se os descritores sofrimento psíquico e trabalhador de enfermagem. Resultados: Obteve-se 17 artigos, onde foi possível perceber que boa parte dos estudos detectou certas características comuns no dia a dia dos profissionais, que condicionam a sobrecarga e o desgaste do trabalhador, desencadeando o adoecimento dos mesmos com consequente sofrimento psíquico. Conclusão: Pode ser visto que o tema tem sido muito pesquisado e os estudos bem abordam sobre muitos fatores inerentes ao ambiente de trabalho que são constatados como influenciadores do sofrimento psíquico no profissional de enfermagem. Descritores: Enfermagem, sofrimento psíquico, saúde do trabalhador.
Currículos de cursos de graduação em enfermagem: revisão integrativa de literatura Curriculum for undergraduate nursing courses: integrative literature review
Authors: Martini Jussara Gue , Massaroli Aline , Lazzari Daniele Delacanal , Luz Juliana Homem da
Published: January 2017

Objetivo: conhecer quais assuntos tem sido abordados e debatidos nas investigações sobre currículo nos cursos de graduação em enfermagem no Brasil, no período de 2000 a 2013. Método: utilizaram-se os pressupostos da revisão integrativa de literatura nas bases de dados LILACS, SCIELO, BDENF e ERIC. A análise dos dados foi organizada a partir da pré-análise, exploração do material e, tratamento e interpretação dos resultados. Resultados: foram selecionados 36 artigos, que possibilitaram a definição de três categorias: Pressupostos das reformas curriculares; Características da formação profissional de enfermeiros e Diretrizes Curriculares Nacionais dos cursos de graduação em Enfermagem e os currículos. Conclusão: verificou-se aderência dos estudos á legislação pertinente, e a ênfase na necessidade de formação profissional fundamentada nos princípios do Sistema Único de Saúde. Descritores: enfermagem; currículo; educação em enfermagem; educação.
Fatores agravantes e atenuantes à percepção de morte em UTI: a visão dos pacientes Aggravating and mitigating factors to death perception in the ICU: a vision of patients
Authors: Nogueira Jose Joeudes de Queiroz , Ferreira Jocelly de Araújo , Albuquerque Adriana Montenegro de , Agra Glenda
Published: January 2017

Objetivo: Identificar os fatores agravantes e atenuantes à percepção de morte dos pacientes em Unidade de Terapia Intensiva.Métodos: Estudo exploratório e descritivo com abordagem qualitativa, realizado com 07 pacientes internos em UTI, utilizando-se o critério saturação para delimitação da amostra. Os dados foram coletados através de entrevistas com roteiro semi estruturado, abordagem indireta ao sujeito, mediante assinatura de termos de consentimentos livre e esclarecido, e procedendo-se a analise dos dados sob a luz da literatura pertinente, após aprovação do Comitê de Ética e Pesquisa do Hospital Universitário Alcides Carneiro HUAC, sob o CAAE nº04818912.0.0000.5182.Resultados: Emergiram duas categorias temáticas, sendo uma apresentando os fatores agravantes à percepção de morte, e a segunda traz os fatores atenuantes a essa percepção.Conclusão: A existência de alguns fatores podem contribuir com o agravamento da percepção de morte dos pacientes, entretanto, outros atenuam essa percepção, muitas vezes favorecendo para a sua recuperação.
A família não é de ferro: ela cuida de pessoas com transtorno mental Family needs a break: it takes care of people with mental disorder
Authors: Nazaré Oliveira Eliany , Cordeiro Eloia Suzana Mara , Dos Santos Lima Danyela , Cordeiro Eloia Sara , Ferreira Linhares Amanda Mabel
Published: January 2017

Objetivo: Analisar a sobrecarga de cuidadores familiares de pessoas com transtorno mental assistidas por um Centro de Atenção Psicossocial no Norte do Ceará. Método: A amostra se constituiu por 120 familiares, utilizando-se a Escala de Avaliação da Sobrecarga dos Familiares para coleta de dados. Resultados: O perfil dos cuidadores caracterizou-se pelo gênero feminino, mãe, casada, com faixa etária entre 51 a 60 anos, ensino fundamental incompleto e encontrava-se desempregada ou do lar. A assistência prestada aos usuários em sua vida cotidiana foi o domínio que mais contribuiu para a sobrecarga objetiva destes cuidadores, enquanto preocupações com o paciente, peso dos gastos financeiros e supervisão dos comportamentos desconcertantes se constituíram os de maior sobrecarga subjetiva. Conclusão: A família se tornou parceira no tratamento e necessita dos profissionais e gestão da saúde uma atenção especial que vise prevenir o seu adoecimento físico e mental.
Discursos dos profissionais de saúde da família na ótica da assistência à saúde do idoso Speeches of family health professionals in optics of assistance to the elderly
Authors: Amthauer Camila , Falk João Werner
Published: January 2017

Objetivo: Identificar as práticas realizadas pelos profissionais da Estratégia de Saúde da Família (ESF) junto aos idosos atendidos em uma Unidade Básica de Saúde (UBS). Método: Trata-se de uma pesquisa qualitativa, desenvolvida junto aos profissionais da ESF. A pesquisa constituiu-se por meio de entrevistas semiestruturadas com 16 profissionais de saúde. Resultados: A partir da análise temática, proposta por Minayo, emergiram sete categorias: visita domiciliar, grupos de convivência, atividades físicas, escuta, vínculo, corresponsabilização do idoso e prevenção de agravos. Conclusão: Para pensar nos significados do envelhecimento devem-se considerar as relações dinâmicas que a sociedade remete ao processo de envelhecer. É papel do profissional da saúde assegurar o cuidado integral ao idoso. Refletir sobre suas práticas de cuidado garante ao usuário um atendimento digno e humanizado, compreendendo o idoso em sua totalidade.
Pacific‐Atlantic Ocean influence on wildfires in northeast China (1774 to 2010)
Authors: Yao Qichao , Brown Peter M. , Liu Shirong , Rocca Monique E. , Trouet Valerie , Zheng Ben , Chen Haonan , Li Yinchao , Liu Duanyang , Wang Xiaochun
Published: January 2017

Identification of effects that climate teleconnections, such as El Niño–Southern Oscillation (ENSO), Pacific Decadal Oscillation (PDO), and North Atlantic Oscillation (NAO), have on wildfires is difficult because of short and incomplete records in many areas of the world. We developed the first multicentury wildfire chronologies for northeast China from fire‐scarred trees. Regional wildfires occurred every 7 years from the 1700s to 1947, after which fire suppression policies were implemented. Regional wildfires occurred predominately during drought years and were associated with positive phases of ENSO and PDO and negative NAO. Twentieth century meteorological records show that this contingent combination of +ENSO/+PDO/−NAO is linked to low humidity, low precipitation, and high temperature during or before late spring fire seasons. Climate and wildfires in northeast China may be predictable based on teleconnection phases, although future wildfires may be more severe due to effects of climate change and the legacy of fire suppression.
Generation of Multiband Chorus in the Earth's Magnetosphere: 1‐D PIC Simulation
Authors: Gao Xinliang , Ke Yangguang , Lu Quanming , Chen Lunjin , Wang Shui
Published: January 2017

Multiband chorus waves, where the frequency of upper band chorus is about twice that of lower band chorus, have recently been reported based on THEMIS observations. The generation of multiband chorus waves is attributed to the mechanism of lower band cascade, where upper band chorus is excited via the nonlinear coupling process between lower band chorus and the associated density mode with the frequency equal to that of lower band chorus. In this letter, with a one‐dimensional (1‐D) particle‐in‐cell (PIC) simulation model, we have successfully reproduced multiband chorus waves. During the simulation, the significant density fluctuation is driven by the fluctuating electric field along the wave vector of the pump wave (lower band chorus), which can be directly observed in this self‐consistent plasma system. Then, the second harmonic of the pump whistler‐mode wave (upper band chorus) is generated. After quantitatively analyzing resonant conditions among wave numbers, we can confirm that the generation is caused due to the coupling between the pump wave and the density fluctuation along its wave vector. The third harmonic can also be excited through lower band cascade if the pump whistler‐mode wave has a sufficiently large amplitude. Our simulation results not only provide a theoretical support to the mechanism of lower band cascade to generate multiband chorus but also propose a new pattern of evolution for whistler‐mode waves in the Earth's magnetosphere.
Community production modulates coral reef pH and the sensitivity of ecosystem calcification to ocean acidification
Authors: DeCarlo Thomas M. , Cohen Anne L. , Wong George T. F. , Shiah Fuh‐Kwo , Lentz Steven J. , Davis Kristen A. , Shamberger Kathryn E. F. , Lohmann Pat
Published: January 2017

Coral reefs are built of calcium carbonate (CaCO3) produced biogenically by a diversity of calcifying plants, animals, and microbes. As the ocean warms and acidifies, there is mounting concern that declining calcification rates could shift coral reef CaCO3 budgets from net accretion to net dissolution. We quantified net ecosystem calcification (NEC) and production (NEP) on Dongsha Atoll, northern South China Sea, over a 2 week period that included a transient bleaching event. Peak daytime pH on the wide, shallow reef flat during the nonbleaching period was ∼8.5, significantly elevated above that of the surrounding open ocean (∼8.0–8.1) as a consequence of daytime NEP (up to 112 mmol C m−2 h−1). Diurnal‐averaged NEC was 390 ± 90 mmol CaCO3 m−2 d−1, higher than any other coral reef studied to date despite comparable calcifier cover (25%) and relatively high fleshy algal cover (19%). Coral bleaching linked to elevated temperatures significantly reduced daytime NEP by 29 mmol C m−2 h−1. pH on the reef flat declined by 0.2 units, causing a 40% reduction in NEC in the absence of pH changes in the surrounding open ocean. Our findings highlight the interactive relationship between carbonate chemistry of coral reef ecosystems and ecosystem production and calcification rates, which are in turn impacted by ocean warming. As open‐ocean waters bathing coral reefs warm and acidify over the 21st century, the health and composition of reef benthic communities will play a major role in determining on‐reef conditions that will in turn dictate the ecosystem response to climate change.
Contributions of wood smoke and vehicle emissions to ambient concentrations of volatile organic compounds and particulate matter during the Yakima wintertime nitrate study
Authors: VanderSchelden Graham , de Foy Benjamin , Herring Courtney , Kaspari Susan , VanReken Tim , Jobson Bertram
Published: January 2017

A multiple linear regression (MLR) chemical mass balance model was applied to data collected during an air quality field experiment in Yakima, WA, during January 2013 to determine the relative contribution of residential wood combustion (RWC) and vehicle emissions to ambient pollutant levels. Acetonitrile was used as a chemical tracer for wood burning and nitrogen oxides (NOx) as a chemical tracer for mobile sources. RWC was found to be a substantial source of gas phase air toxics in wintertime. The MLR model found RWC primarily responsible for emissions of formaldehyde (73%), acetaldehyde (69%), and black carbon (55%) and mobile sources primarily responsible for emissions of carbon monoxide (CO; 83%), toluene (81%), C2‐alkylbenzenes (81%), and benzene (64%). When compared with the Environmental Protection Agency's 2011 winter emission inventory, the MLR results suggest that the contribution of RWC to CO emissions was underestimated in the inventory by a factor of 2. Emission ratios to NOx from the MLR model agreed to within 25% with wintertime emission ratios predicted from the Motor Vehicle Emissions Simulator (MOVES) 2010b emission model for Yakima County for all pollutants modeled except for CO, C2‐alkylbenzenes, and black carbon. The MLR model results suggest that MOVES was overpredicting mobile source emissions of CO relative to NOx by a factor of 1.33 and black carbon relative to NOx by about a factor of 3.
Climate change and the Madden‐Julian Oscillation: A vertically resolved weak temperature gradient analysis
Authors: Wolding Brandon O. , Maloney Eric D. , Henderson Stephanie , Branson Mark
Published: January 2017

WTG balance is used to examine how changes in the moist thermodynamic structure of the tropics affect the MJO in two simulations of the Superparameterized Community Earth System Model (SP‐CESM), one at preindustrial (PI) levels of
and one where
levels have been quadrupled (4×CO2). While MJO convective variability increases considerably in the 4×CO2 simulation, the dynamical response to this convective variability decreases. Increased MJO convective variability is shown to be a robust response to the steepening vertical moisture gradient, consistent with the findings of previous studies. The steepened vertical moisture gradient allows MJO convective heating to drive stronger variations in large‐scale vertical moisture advection, supporting destabilization of the MJO. The decreased dynamical response to MJO convective variability is shown to be a consequence of increased static stability, which allows weaker variations in large‐scale vertical velocity to produce sufficient adiabatic cooling to balance variations in MJO convective heating. This weakened dynamical response results in a considerable reduction of the MJO's ability to influence the extratropics, which is closely tied to the strength of its associated divergence. A composite lifecycle of the MJO was used to show that northern hemisphere extratropical 525 hPa geopotential height anomalies decreased by 27% in the 4×CO2 simulation, despite a 22% increase in tropical convective heating associated with the MJO. Results of this study suggest that while MJO convective variability may increase in a warming climate, the MJO's role in “bridging weather and climate” in the extratropics may not.
On the role of the stratiform cloud scheme in the inter‐model spread of cloud feedback
Authors: Geoffroy O. , Sherwood S. C. , Fuchs D.
Published: January 2017

This study explores the role of the stratiform cloud scheme in the inter‐model spread of cloud feedback. Six diagnostic cloud schemes used in various CMIP (Coupled Model Intercomparison Experiment] climate models are implemented (at low and midlevels) into two testbed climate models, and the impacts on cloud feedback are investigated. Results suggest that the choice of stratiform cloud scheme may contribute up to roughly half of the intermodel spread of cloud radiative responses in stratocumulus (Sc) regions, and may determine or favor a given sign of the feedback there. Cloud schemes assuming a probability density function for total water content consistently predict a positive feedback in Sc regions in our experiments. A large negative feedback in Sc regions is obtained only with schemes that consider variables other than relative humidity (e.g., stability). The stratiform cloud scheme also significantly affects cloud feedback at the scale of the tropics and at global scale. Results are slightly less consistent for tropical means, likely indicating coupling with other boundary layer processes such as convective mixing.
Differences in behavior and distribution of permafrost‐related lakes in Central Yakutia and their response to climatic drivers
Authors: Ulrich M. , Matthes H. , Schirrmeister L. , Schütze J. , Park H. , Iijima Y. , Fedorov A. N.
Published: January 2017

The Central Yakutian permafrost landscape is rapidly being modified by land use and global warming, but small‐scale thermokarst process variability and hydrological conditions are poorly understood. We analyze lake‐area changes and thaw subsidence of young thermokarst lakes on ice‐complex deposits (yedoma lakes) in comparison to residual lakes in alas basins during the last 70 years for a local study site and we record regional lake size and distribution on different ice‐rich permafrost terraces using satellite and historical airborne imagery. Statistical analysis of climatic and ground‐temperature data identified driving factors of yedoma‐ and alas‐lake changes. Overall, lake area is larger today than in 1944 but alas‐lake levels have oscillated greatly over 70 years, with a mean alas‐lake‐radius change rate of 1.6 ± 3.0 m/yr. Anthropogenic disturbance and forest degradation initiated, and climate forced rapid, continuous yedoma‐lake growth. The mean yedoma lake‐radius change rate equals 1.2 ± 1.0 m/yr over the whole observation period. Mean thaw subsidence below yedoma lakes is 6.2 ± 1.4 cm/yr. Multiple regression analysis suggests that winter precipitation, winter temperature, and active‐layer properties are primary controllers of area changes in both lake types; summer weather and permafrost conditions additionally influence yedoma‐lake growth rates. The main controlling factors of alas‐lake changes are unclear due to larger catchment areas and subsurface hydrological conditions. Increasing thermokarst activity is currently linked to older terraces with higher ground‐ice contents, but thermokarst activity will likely stay high and wet conditions will persist within the near future in Central Yakutian alas basins.
The influence of injection velocity and relaxation time on the spreading of tracers in viscoelastic liquids agitated by submerged, recirculating jets with low reynolds numbers
Authors: Bhattacharjee Pradipto K. , Kennedy Stephen P. , Xu Qian , Eshtiaghi Nicky , Parthasarathy Rajarathinam
Published: January 2017

We provide experimental demonstration that the spread of tracer elements in a tank containing a viscoelastic liquid and agitated by a submerged jet pointing to the base of the tank can be influenced by the relaxation time of the liquid. We analyzed the temporal spreading of the boundary of a tracer‐front in two dimensions using flow visualization at early stages and found that for a given fluid, the evolution of the tracer‐front at various injection velocities follows a universal trajectory when considered on a normalized time scale of, where t is observation time,is injection velocity andis the effective diffusivity of the tracer elements in the medium. For a different fluid, at a given, the trajectory scales with the relaxation time of the fluid. The importance of relaxation time to the evolution of a tracer‐front is something previously unreported. © 2017 American Institute of Chemical EngineersAIChE J, 63: 3132–3140, 2017
A Two‐Dimensional Lamellar Membrane: MXene Nanosheet Stacks
Authors: Ding Li , Wei Yanying , Wang Yanjie , Chen Hongbin , Caro Jürgen , Wang Haihui
Published: January 2017

Two‐dimensional (2D) materials are promising candidates for advanced water purification membranes. A new kind of lamellar membrane is based on a stack of 2D MXene nanosheets. Starting from compact Ti3AlC2, delaminated nanosheets of the composition Ti3C2Tx with the functional groups T (O, OH, and/or F) can be produced by etching and ultrasonication and stapled on a porous support by vacuum filtration. The MXene membrane supported on anodic aluminum oxide (AAO) substrate shows excellent water permeance (more than 1000 L m−2 h−1 bar−1) and favorable rejection rate (over 90 %) for molecules with sizes larger than 2.5 nm. The water permeance through the MXene membrane is much higher than that of the most membranes with similar rejections. Long‐time operation also reveals the outstanding stability of the MXene membrane for water purification.