bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adoção de terapias nutricionais enteral e parenteral associada à redução da taxa de óbitos de pacientes neoplásicos
Authors: Abbade Eduardo Botti 
Published: August 2020

Modelo do estudo: Estudo descritivo transversal. Objetivo: Este estudo analisou a relação entre a adoção da nutrição enteral e parenteral adulta e o tempo de permanência médio, a taxa de óbitos e o custo das internações de pacientes neoplásicos em hospitais do Rio Grande do Sul. Método: Foram analisados os dados dissemináveis disponíveis no SIH/SUS de 2017 do Rio Grande do Sul específicos para internações realizadas sob o diagnóstico principal associado ao CID Cap. II (Neoplasmas). Os dados foram analisados por observação da média e teste de Kruskal Wallis. Resultados: Foi observada taxa de óbito significativamente inferior em pacientes neoplásicos que foram internados em UTI e que foram submetidos às terapias dietéticas enterais e/ou parenterais, em relação aos pacientes que não receberam tais suplementos, em casos de diagnóstico de neoplasias malignas no esôfago (C15), no intestino delgado (C17) e no pâncreas (C25). Já o tempo médio de permanência e valor total médio de internações de pacientes neoplásicos tendem a ser maior em pacientes que recebem terapias dietéticas enterais e/ou parenterais, possivelmente devido à gravidade do quadro clínico. Conclusão: A adoção de nutrição enteral e parenteral apresenta potencial significativo na redução da taxa de mortalidade de pacientes com câncer no sistema digestivo, principalmente dos casos mais graves que necessitam de internação em UTI.
Hematúria levando ao diagnóstico de duas condições singulares na prática clínica - síndrome de quebra-nozes e traço falcêmico
Authors: Gomes Orlando Vieira , Rodrigues Mateus de Sousa , Santana Leonardo Fernandes e , Souza Carlos Edmundo Oliveira , Damasceno Laíse Paulo , Vieira Rafael Valois 
Published: August 2020

A hematúria é definida como o achado de mais que duas hemácias por campo de aumento na análise microscópica de urina coletada por jato médio. Na sua forma macroscópica, caracteriza-se por sua coloração típica (avermelhada ou marrom), acompanhada pela presença de mais de 106 hemácias/ml na sedimentoscopia. É uma condição que necessita de investigação da causa e apresenta-se com prevalência incerta e definição às vezes imprecisa, mas com vasto diagnóstico diferencial. Dentre as possíveis causas, encontramos a presença do traço falciforme, aparentemente subdiagnosticado, e a síndrome de quebra-nozes, possibilidade mais rara. No caso relatado a seguir, foram diagnosticadas simultaneamente as duas causas acima citadas, descobertas após a investigação do primeiro episódio de hematúria macroscópica em uma mulher jovem previamente hígida. Com o objetivo de chamar a atenção para a concomitância de duas possíveis e incomuns causas de hematúria numa mesma paciente, relatamos o caso a seguir.
Bias-Corrected CMIP5-Derived Single-Forcing Future Wind-Wave Climate Projections toward the End of the Twenty-First Century
Authors: Lemos Gil , Semedo Alvaro , Dobrynin Mikhail , Menendez Melisa , Miranda Pedro M. A. 
Published: August 2020

AbstractA quantile-based bias-correction method is applied to a seven-member dynamic ensemble of global wave climate simulations with the aim of reducing the significant wave heightHS, mean wave periodTm, and mean wave direction (MWD) biases, in comparison with the ERA5 reanalysis. The corresponding projected changes toward the end of the twenty-first century are assessed. Seven CMIP5 EC-EARTH runs (single forcing) were used to force seven wave model (WAM) realizations (single model), following the RCP8.5 scenario (single scenario). The biases for the 1979–2005 reference period (present climate) are corrected using the empirical Gumbel quantile mapping and empirical quantile mapping methods. The same bias-correction parameters are applied to theHS,Tm(and wave energy fluxPw), and MWD future climate projections for the 2081–2100 period. The bias-corrected projected changes show increases in the annual meanHS(14%),Tm(6.5%), andPw(30%) in the Southern Hemisphere and decreases in the Northern Hemisphere (mainly in the North Atlantic Ocean) that are more pronounced during local winter. For the upper quantiles, the bias-corrected projected changes are more striking during local summer, up to 120%, forPw. After bias correction, the magnitude of theHS,Tm, andPworiginal projected changes has generally increased. These results, albeit consistent with recent studies, show the relevance of a quantile-based bias-correction method in the estimation of the future projected changes in swave climate that is able to deal with the misrepresentation of extreme phenomena, especially along the tropical and subtropical latitudes.
Entropy Production Rates of the Climate
Authors: Gibbins Goodwin , Haigh Joanna D. 
Published: August 2020

AbstractThere is ongoing interest in the global entropy production rate as a climate diagnostic and predictor, but progress has been limited by ambiguities in its definition; different conceptual boundaries of the climate system give rise to different internal production rates. Three viable options are described, estimated, and investigated here, two—the material and the total radiative (here “planetary”) entropy production rates—that are well established and a third that has only recently been considered but appears very promising. This new option is labeled the “transfer” entropy production rate and includes all irreversible processes that transfer heat within the climate, radiative, and material, but not those involved in the exchange of radiation with space. Estimates in three model climates put the material rate in the range 27–48 mW m−2 K−1, the transfer rate at 67–76 mW m−2 K−1, and the planetary rate at 1279–1312 mW m−2 K−1. The climate relevance of each rate is probed by calculating their responses to climate changes in a simple radiative–convective model. An increased greenhouse effect causes a significant increase in the material and transfer entropy production rates but has no direct impact on the planetary rate. When the same surface temperature increase is forced by changing the albedo instead, the material and transfer entropy production rates increase less dramatically and the planetary rate also registers an increase. This is pertinent to solar radiation management as it demonstrates the difficulty of reversing greenhouse gas–mediated climate changes by albedo alterations. It is argued that the transfer perspective has particular significance in the climate system and warrants increased prominence.
Air–Sea Interactions among Oceanic Low-Level Cloud, Sea Surface Temperature, and Atmospheric Circulation on an Intraseasonal Time Scale in the Summertime North Pacific Based on Satellite Data Analysis
Authors: Takahashi Naoya , Hayasaka Tadahiro 
Published: August 2020

AbstractLow-level cloud plays a key role in modulating air–sea interaction processes and sea surface temperature (SST) variability. The present study investigated the evolution process of oceanic low-level cloud cover (LCC) and related air–sea interaction processes on an intraseasonal time scale in the summertime (June–October) North Pacific (30°–40°N, 165°–175°E) based on satellite observational and reanalysis datasets from 2003 to 2016. The intraseasonal time scale (20–100 days) is dominant not only for the LCC, but also for LCC controlling factors, that is, SST, estimated inversion strength (EIS), and horizontal temperature advection (Tadv). To reveal the lead–lag relationship among these variables, we conducted phase composite analysis with a bandpass filter based on the intraseasonal variability (ISV) of LCC. It suggests that ISV of LCC leads to that of SST and that horizontal dry–cold advection from the poleward region leads to increasing LCC and decreasing SST. The increasing LCC corresponds to a positive relative humidity (RH) anomaly in the lower troposphere, which is due to adiabatic cooling with shallow convection, vertical moisture advection, and meridional RH advection associated with the anomalous cold Tadv. Heat budget analysis of the ocean mixed layer suggests the importance of anomalous dry–cold advection for cooling SST, not only via enhanced latent heat release but also via decreased downward shortwave radiation at the sea surface according to cloud radiative effect with a positive LCC anomaly. Determining the detailed lead–lag relationship between LCC and its controlling factor is a good approach to understand mechanisms of the local processes of both low-level cloud evolution and air–sea interaction.
Climate Response to Increasing Antarctic Iceberg and Ice Shelf Melt
Authors: Mackie Shona , Smith Inga J. , Ridley Jeff K. , Stevens David P. , Langhorne Patricia J. 
Published: August 2020

AbstractMass loss from the Antarctic continent is increasing; however, climate models either assume a constant mass loss rate or return snowfall over land to the ocean to maintain equilibrium. Numerous studies have investigated sea ice and ocean sensitivity to this assumption and reached different conclusions, possibly due to different representations of melt fluxes. The coupled atmosphere–land–ocean–sea ice model, HadGEM3-GC3.1, includes a realistic spatial distribution of coastal melt fluxes, a new ice shelf cavity parameterization, and explicit representation of icebergs. This configuration makes it appropriate to revisit how increasing melt fluxes influence ocean and sea ice and to assess whether responses to melt from ice shelves and icebergs are distinguishable. We present results from simulated scenarios of increasing meltwater fluxes and show that these drive sea ice increases and, for increasing ice shelf melt, a decline in Antarctic Bottom Water formation. In our experiments, the mixed layer around the Antarctic coast deepens in response to rising ice shelf meltwater and shallows in response to stratification driven by iceberg melt. We find similar surface temperature and salinity responses to increasing meltwater fluxes from ice shelves and icebergs, but midlayer waters warm to greater depths and farther north when ice shelf melt is present. We show that as meltwater fluxes increase, snowfall becomes more likely at lower latitudes and Antarctic Circumpolar Current transport declines. These insights are helpful for interpretation of climate simulations that assume constant mass loss rates and demonstrate the importance of representing increasing melt rates for both ice shelves and icebergs.
Saharan Dust Aerosols Change Deep Convective Cloud Prevalence, Possibly by Inhibiting Marine New Particle Formation
Authors: Zamora Lauren M. , Kahn Ralph A. 
Published: August 2020

AbstractDeep convective clouds (DCCs) are important to global climate, atmospheric chemistry, and precipitation. Dust, a dominant aerosol type over the tropical North Atlantic, has potentially large microphysical impacts on DCCs over this region. However, dust effects are difficult to identify, being confounded by covarying meteorology and other factors. Here, a method is developed to quantify DCC responses to dust and other aerosols at large spatial and temporal scales despite these uncertainties. Over 7 million tropical North Atlantic cloud, aerosol, and meteorological profiles from CloudSat satellite data and MERRA-2 reanalysis products are used to stratify cloud observations into meteorological regimes, objectively select a priori assumptions, and iteratively test uncertainty sensitivity. Dust is robustly associated with a 54% increase in DCC prevalence. However, marine aerosol proxy concentrations are 5 times more predictive of dust-associated increases in DCC prevalence than the dust itself, or any other aerosol or meteorological factor. Marine aerosols are also the most predictive factor for the even larger increases in DCC prevalence (61%–87%) associated with enhanced dimethyl sulfide and combustion and sulfate aerosols. Dust-associated increases in DCC prevalence are smaller at high dust concentrations than at low concentrations. These observations suggest that not only is dust a comparatively ineffective CCN source, but it may also act as a condensation/coagulation sink for chemical precursors to CCN, reducing total CCN availability over large spatial scales by inhibiting new particle formation from marine emissions. These observations represent the first time this process, previously predicted by models, has been supported and quantified by measurements.
Seasonal Variability and Dynamics of the Pacific North Equatorial Subsurface Current
Authors: Yang Ya , Li Xiang , Wang Jing , Yuan Dongliang 
Published: August 2020

AbstractThe North Equatorial Subsurface Current (NESC) is a subthermocline ocean current uncovered recently in the tropical Pacific Ocean, flowing westward below the North Equatorial Countercurrent. In this study, the dynamics of the seasonal cycle of this current are studied using historical shipboard acoustic Doppler current profiler measurements and Argo absolute geostrophic currents. Both data show a westward current at the depths of 200–1000 m between 4° and 6°N, with a typical core speed of about 5 and 2 cm s−1, respectively. The subsurface current originates in the eastern Pacific, with its core descending to deeper isopycnal surfaces and moving to the equator as it flows westward. The zonal velocity of the NESC shows pronounced seasonal variability, with the annual-cycle harmonics of vertical isothermal displacement and zonal velocity presenting characters of vertically propagating baroclinic Rossby waves. A simple analytical Rossby wave model is employed to simulate the propagation of the seasonal variations of the westward zonal currents successfully, which is the basis for exploring the wind forcing dynamics. The results suggest that the wind curl forcing in the central-eastern basin between 170° and 140°W associated with the meridional movement of the intertropical convergence zone dominates the NESC seasonal variability in the western Pacific, with the winds west of 170°W and east of 140°W playing a minor role in the forcing.
Trends in Hepatitis B Surveillance Among Pregnant Women in New York City, 1998-2015
Authors: Arciuolo Robert J. , Lazaroff Julie E. , Rosen Jennifer B. , Lim Sungwoo , Zucker Jane R. 
Published: August 2020

Objective Infants born to women with hepatitis B virus (HBV) infection are at high risk for chronic HBV infection and premature death. We examined epidemiologic trends among women with HBV infection who gave birth in New York City (NYC) to inform public health prevention activities. Methods We obtained data on HBV-infected women residing and giving birth in NYC during 1998-2015 from the NYC Perinatal HBV Prevention Program. We obtained citywide birth data from the NYC Office of Vital Statistics. We calculated the incidence of births to HBV-infected women per 100 000 live births and stratified by maternal race, birthplace, and age. We calculated annual percentage change (APC) in incidence of births to HBV-infected women by using joinpoint regression. Results Of 29 896 HBV-infected women included in the study, 28 195 (94.3%) were non–US-born, of whom 16 600 (58.9%) were born in China. Overall incidence of births to HBV-infected women per 100 000 live births increased from 1156 in 1998 to 1573 in 2006 (APC = 3.1%; P < .001) but declined to 1329 in 2015 (APC = –1.4%; P = .02). Incidence among US-born women declined from 1998 to 2015 (330 to 84; APC = –7.3%; P < .001) and among non–US-born women increased from 1998 to 2007 (1877 to 2864; APC = 3.6%; P < .001) but not thereafter. Incidence among women born in China increased from 1998 to 2006 (13 275 to 16 480; APC = 1.8%; P = .02) but decreased to 12 631 through 2015 (APC = –3.3%; P < .001). Conclusions The incidence of births to HBV-infected women in NYC declined significantly among US-born women but not among non–US-born women, highlighting the need for successful vaccination programs worldwide.
Effects of a Thermosensitive Antiadhesive Agent on Single-Row Arthroscopic Rotator Cuff Repair
Authors: Kim Jangwoo , Kim Yuna , Jung Whanik , Nam Ji Hoon , Kim Sae Hoon 
Published: August 2020

Background: Postoperative stiffness after rotator cuff repair is a common complication that can lead to poor outcomes and patient discomfort. The application of an antiadhesive agent at the time of repair recently became an option for clinicians, but little information is available on its effects. Purpose: To evaluate and compare retear rates, the incidence of postoperative stiffness, and the clinical outcomes of patients who underwent cuff repair with or without the application of an antiadhesive agent. Study Design: Cohort study; Level of evidence, 3. Methods: Among 296 patients who underwent arthroscopic rotator cuff repair surgery, we compared the outcomes of those injected with a thermosensitive gel antiadhesive agent into the subacromial space (112 cases) versus noninjected controls (184 cases). Retear rates in the 2 groups were determined by magnetic resonance imaging at 1 year after surgery. Shoulder joint range of motion and functional scores were evaluated serially. Results: The rate of retear was significantly lower in the injection group (20/112 cases; 17.9%) than the control group (53/184 cases; 28.8%) ( P = .034). Postoperative stiffness was not significantly different between the 2 groups ( P = .710). Among the data regarding range of motion, only forward flexion at 6 months after surgery showed superior results in the injection group. Functional scores showed conflicting results: The control group had better visual analog scale scores for pain (injection vs control: 2.17 vs 1.68 at 6 months; 1.82 vs 1.28 at 12 months), American Shoulder and Elbow Surgeons scores (79.89 vs 89.64 at 12 months), and simple shoulder test scores (8.70 vs 10.06 at 12 months), whereas the injection group had better Constant-Murley scores (injection vs control: 59.49 vs 55.60 at 3 months; 77.35 vs 71.98 at 6 months; 87.28 vs 81.56 at 12 months). Conclusion: The tendon healing rate was significantly higher in the group receiving an antiadhesive agent than in the control group. No intergroup difference was seen in the occurrence of postoperative stiffness. However, the pain-related functional score showed inferior results in the injection group at 12 months. The biological action of antiadhesive agents in rotator cuff repair should be further evaluated.
Radiographic and Clinical Outcomes of the Salto Talaris Total Ankle Arthroplasty
Authors: Day Jonathan , Kim Jaeyoung , O’Malley Martin J. , Demetracopoulos Constantine A. , Garfinkel Jonathan , Sanders Austin , Roney Andrew , Deland Jonathan T. , Levine David S. , Ellis Scott J. 
Published: August 2020

Background: The Salto Talaris is a fixed-bearing implant first approved in the US in 2006. While early surgical outcomes have been promising, mid- to long-term survivorship data are limited. The aim of this study was to present the survivorship and causes of failure of the Salto Talaris implant, with functional and radiographic outcomes. Methods: Eighty-seven prospectively followed patients who underwent total ankle arthroplasty with the Salto Talaris between 2007 and 2015 at our institution were retrospectively identified. Of these, 82 patients (85 ankles) had a minimum follow-up of 5 (mean, 7.1; range, 5-12) years. The mean age was 63.5 (range, 42-82) years and the mean body mass index was 28.1 (range, 17.9-41.2) kg/m2. Survivorship was determined by incidence of revision, defined as removal/exchange of a metal component. Preoperative, immediate, and minimum 5-year postoperative AP and lateral weightbearing radiographs were reviewed; tibiotalar alignment (TTA) and the medial distal tibial angle (MDTA) were measured to assess coronal talar and tibial alignment, respectively. The sagittal tibial angle (STA) was measured; the talar inclination angle (TIA) was measured to evaluate for radiographic subsidence of the implant, defined as a change in TIA of 5 degrees or more from the immediately to the latest postoperative lateral radiograph. The locations of periprosthetic cysts were documented. Preoperative and minimum 5-year postoperative Foot and Ankle Outcome Score (FAOS) subscales were compared. Results: Survivorship was 97.6% with 2 revisions. One patient underwent tibial and talar component revision for varus malalignment of the ankle; another underwent talar component revision for aseptic loosening and subsidence. The rate of other reoperations was 21.2% ( n = 18), with the main reoperation being exostectomy with debridement for ankle impingement ( n = 12). At final follow-up, the average TTA improved 4.4 (± 3.8) degrees, the average MDTA improved 3.4 (± 2.6) degrees, and the average STA improved 5.3 (± 4.5) degrees. Periprosthetic cysts were observed in 18 patients, and there was no radiographic subsidence. All FAOS subscales demonstrated significant improvement at final follow-up. Conclusions: We found the Salto Talaris implant to be durable, consistent with previous studies of shorter follow-up lengths. We observed significant improvement in radiographic alignment as well as patient-reported clinical outcomes at a minimum 5-year follow-up. Level of Evidence: Level IV, retrospective case series.
Fracture Epidemiology in Professional Baseball From 2011 to 2017
Authors: Rubenstein William J. , Allahabadi Sachin , Curriero Frank , Feeley Brian T. , Lansdown Drew A. 
Published: August 2020

Background: Fractures are a significant cause of missed time in Major League Baseball (MLB) and Minor League Baseball (MiLB). MLB and the MLB Players Association recently instituted rule changes to limit collisions at home plate and second base. Purpose: To evaluate the epidemiologic characteristics of fractures in professional baseball and to assess the change in acute fracture incidence secondary to traumatic collisions at home plate and second base after the recently instituted rule changes. Study Design: Descriptive epidemiology study. Methods: The MLB Health and Injury Tracking System (HITS) database was used to access injury information on MLB and MiLB players to analyze fracture data from 2011 to 2017. Injuries were included if the primary diagnosis was classified as a fracture in the HITS system in its International Classification of Diseases, Ninth Revision, codes; injuries were excluded if they were not work related, if they occurred in the offseason, or if they were sustained by a nonplayer. The proportion of fractures occurring due to contact with the ground or another person in the relevant area of the field—home plate or second base—in the years before rule implementation was compared with the years after. Results: A total of 1798 fractures were identified: 342 among MLB players and 1456 among MiLB players. Mean time missed per fracture was 56.6 ± 48.4 days, with significantly less time missed in MLB (46.8 ± 47.7 days) compared with MiLB (59.0 ± 48.3 days) ( P < .0001). A 1-way analysis of variance with post hoc Bonferroni correction demonstrated that starting pitchers missed significantly more time due to fractures per injury than all other position groups ( P < .0001). Acute fractures due to contact with the ground or with another athlete were significantly decreased after rule implementation at home plate in 2014 (22 [3.0%] vs 14 [1.3%]; P = .015) and at second base in 2016 (90 [7.0%] vs 23 [4.5%]; P = .045). Conclusion: The recently instituted rule changes to reduce collisions between players at home plate and at second base are associated with reductions in the proportion of acute fractures in those areas on the field.