bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in air pollutants and health impacts in three Swedish cities over the past three decades
Authors: Olstrup Henrik , Forsberg Bertil , Orru Hans , Spanne Mårten , Nguyen Hung , Molnár Peter , Johansson Christer 
Published: November 2018

Abstract. Air pollution concentrations have been decreasing in many cities in the
developed countries. We have estimated time trends and health effects
associated with exposure to NOx, NO2,
O3, and PM10 (particulate matter) in the Swedish cities Stockholm, Gothenburg, and
Malmö from the 1990s to 2015. Trend analyses of concentrations have been
performed by using the Mann–Kendall test and the Theil–Sen method. Measured
concentrations are from central monitoring stations representing urban
background levels, and they are assumed to indicate changes in long-term
exposure to the population. However, corrections for population exposure have
been performed for NOx, O3, and PM10 in
Stockholm, and for NOx in Gothenburg. For
NOx and PM10, the concentrations at the central
monitoring stations are shown to overestimate exposure when compared to
dispersion model calculations of spatially resolved, population-weighted
exposure concentrations, while the reverse applies to O3. The
trends are very different for the pollutants that are studied;
NOx and NO2 have been decreasing in all cities,
O3 exhibits an increasing trend in all cities, and for PM10,
there is a slowly decreasing trend in Stockholm, a slowly increasing trend in
Gothenburg, and no significant trend in Malmö. Trends associated with
NOxand NO2 are mainly attributed to local emission
reductions from traffic. Long-range transport and local emissions from road
traffic (non-exhaust PM emissions) and residential wood combustion are the
main sources of PM10. For O3, the trends are affected by
long-range transport, and there is a net removal of O3 in the
cities. The increasing trends are attributed to decreased net removal, as
NOx emissions have been reduced. Health effects in terms of changes in life expectancy are calculated based
on the trends in exposure to NOx, NO2, O3, and PM10 and
the relative risks associated with exposure to these pollutants. The
decreased levels of NOx are estimated to increase the life expectancy
by up to 11 months for Stockholm and 12 months for Gothenburg. This
corresponds to up to one-fifth of the total increase in life expectancy
(54–70 months) in the cities during the period of 1990–2015. Since the
increased concentrations in O3 have a relatively small impact on the
changes in life expectancy, the overall net effect is increased life
expectancies in the cities that have been studied.
High variability of particulate organic carbon export along the North Atlantic GEOTRACES section GA01 as deduced from 234Th fluxes
Authors: Lemaitre Nolwenn , Planchon Frédéric , Planquette Hélène , Dehairs Frank , Fonseca-Batista Debany , Roukaerts Arnout , Deman Florian , Tang Yi , Mariez Clarisse , Sarthou Géraldine 
Published: November 2018

Abstract. In this study we report particulate organic carbon (POC) export fluxes for
different biogeochemical basins in the North Atlantic as part of the
GEOTRACES GA01 expedition (GEOVIDE, May–June 2014). Surface POC export
fluxes were deduced by combining export fluxes of total Thorium-234
(234Th) with the ratio of POC to 234Th of sinking
particles at the depth of export. Particles were collected in two size
classes (>53 and 1–53 µm) using in situ pumps and the large
size fraction was considered representative of sinking material. Surface POC
export fluxes revealed latitudinal variations between provinces, ranging from
1.4 mmol m−2 d−1 in the Irminger basin, where the bloom was
close to its maximum, to 12 mmol m−2 d−1 near the Iberian
Margin, where the bloom had already declined. In addition to the state of
progress of the bloom, variations of the POC export fluxes were also related
to the phytoplankton size and community structure. In line with previous
studies, the presence of coccolithophorids and diatoms appeared to enhance
the POC export flux, while the dominance of picophytoplankton cells, such as
cyanobacteria, resulted in lower fluxes. The ratio of POC export to primary
production (PP) strongly varied regionally and was generally low (≤14 %), except at two stations located near the Iberian Margin (35 %)
and within the Labrador basin (38 %), which were characterized by unusual
low in situ PP. We thus conclude that during the GEOVIDE cruise, the North
Atlantic was not as efficient in exporting carbon from the surface, as
reported earlier by others. Finally, we also estimated the POC export at
100 m below the surface export depth to investigate the POC transfer
efficiencies. This parameter was also highly variable amongst regions, with
the highest transfer efficiency at sites where coccolithophorids dominated.
Effect of high dust amount on surface temperature during the Last Glacial Maximum: a modelling study using MIROC-ESM
Authors: Ohgaito Rumi , Abe-Ouchi Ayako , O'ishi Ryouta , Takemura Toshihiko , Ito Akinori , Hajima Tomohiro , Watanabe Shingo , Kawamiya Michio 
Published: November 2018

Abstract. The effect of aerosols is one of many uncertain factors in projections of
future climate. However, the behaviour of mineral dust aerosols (dust) can be
investigated within the context of past climate change. The Last Glacial
Maximum (LGM) is known to have had enhanced dust deposition in comparison
with the present, especially over polar regions. Using the Model for
Interdisciplinary Research on Climate Earth System Model (MIROC-ESM), we
conducted a standard LGM experiment following the protocol of the
Paleoclimate Modelling Intercomparison Project phase 3 and sensitivity
experiments. We imposed glaciogenic dust on the standard LGM experiment and
investigated the impacts of glaciogenic dust and non-glaciogenic dust
on the LGM climate. Global mean radiative perturbations by glaciogenic and
non-glaciogenic dust were both negative, consistent with previous studies.
However, glaciogenic dust behaved differently in specific regions; e.g. it
resulted in less cooling over the polar regions. One of the major reasons for
reduced cooling is the ageing of snow or ice, which results in albedo
reduction via high dust deposition, especially near sources of high
glaciogenic dust emission. Although the net radiative perturbations in the
lee of high glaciogenic dust provenances are negative, warming by the ageing of
snow overcomes this radiative perturbation in the Northern Hemisphere. In
contrast, the radiative perturbation due to high dust loading in the
troposphere acts to warm the surface in areas surrounding Antarctica,
primarily via the longwave aerosol–cloud interaction of dust, and it is
likely the result of the greenhouse effect attributable to the enhanced cloud
fraction in the upper troposphere. Although our analysis focused mainly on
the results of experiments using the atmospheric part of the MIROC-ESM, we
also conducted full MIROC-ESM experiments for an initial examination of the
effect of glaciogenic dust on the oceanic general circulation module. A
long-term trend of enhanced warming was observed in the Northern Hemisphere
with increased glaciogenic dust; however, the level of warming around
Antarctica remained almost unchanged, even after extended coupling with the
ocean.
Bayesian earthquake dating and seismic hazard assessment using chlorine-36 measurements (BED v1)
Authors: Beck Joakim , Wolfers Sören , Roberts Gerald P. 
Published: November 2018

Abstract. Over the past 20 years,
analyzing the abundance of the isotope chlorine-36 (36Cl) has emerged
as a popular tool for geologic dating. In particular, it has been observed
that 36Cl measurements along a fault plane can be used to study the
timings of past ground displacements during earthquakes, which in turn can be
used to improve existing seismic hazard assessment. This approach requires
accurate simulations of 36Cl accumulation for a set of fault-scarp
rock samples, which are progressively exhumed during earthquakes, in order to
infer displacement histories from 36Cl measurements. While the
physical models underlying such simulations have continuously been improved,
the inverse problem of recovering displacement histories from 36Cl
measurements is still mostly solved on an ad hoc basis. The current work
resolves this situation by providing a MATLAB implementation of a fast,
automatic, and flexible Bayesian Markov-chain Monte Carlo algorithm for the
inverse problem, and provides a validation of the 36Cl approach to
inference of earthquakes from the demise of the Last Glacial Maximum until
present. To demonstrate its performance, we apply our algorithm to a
synthetic case to verify identifiability, and to the Fiamignano and Frattura
faults in the Italian Apennines in order to infer their earthquake
displacement histories and to provide seismic hazard assessments. The results
suggest high variability in slip rates for both faults, and large
displacements on the Fiamignano fault at times when the Colosseum and other
ancient buildings in Rome were damaged.
Effect of deforestation and subsequent land use management on soil carbon stocks in the South American Chaco
Authors: Osinaga Natalia Andrea , Álvarez Carina Rosa , Taboada Miguel Angel 
Published: November 2018

Abstract. The subhumid Chaco region of Argentina, originally covered by dry
sclerophyll forest, has been subjected to clearing since the end of the 1970s
and replacement of the forest by no-till farming. Land use changes produced a
decrease in aboveground carbon (C) stored in forests, but little is known
about the impact on soil organic C stocks. The aim of this study was to
evaluate soil C stocks and C fractions up to 1 m depth in soils under
different land use: <10-year continuous cropping, >20-year continuous
cropping, warm-season grass pasture and native forest in 32 sites distributed
over the Chaco region. The organic C stock content up to 1 m depth expressed
as equivalent mass varied as follows: forest
(119.3 Mg ha−1) > pasture (87.9 Mg ha−1) > continuous
cropping (71.9 and 77.3 Mg ha−1), with no impact of the number of
years under cropping. The coarse particle fraction (2000–212 µm) at
0–5 and 5–20 cm depth layers was the most sensitive organic carbon
fraction to land use change. Resistant carbon (<53 µm) was the
main organic matter fraction in all sample categories except in the forest.
Organic C stock, its quality and its distribution in the profile were responsive
to land use change. The conversion of the Chaco forest to crops was
associated with a decrease of organic C stock up to 1 m depth and with the
decrease of the labile fraction. The permanent pastures of warm-season
grasses allowed higher C stocks to be sustained than cropping systems and so could
be considered a sustainable land use system in terms of soil C preservation.
As soil organic C losses were not restricted to the first few centimetres of the soil,
the development of models that would allow the estimation of soil organic C
changes in depth would be useful to evaluate the
impact of land use change on C stocks with greater precision.
Clinical Utility of Chromosome Genomic Array Testing for Unclassified and Advanced-Stage Renal Cell Carcinomas
Authors: Andeen Nicole K. , Qu Xiaoyu , Antic Tatjana , Tykodi Scott S. , Fang Min , Tretiakova Maria S. 
Published: November 2018

Context.—Cytogenomic analysis provides a useful adjunct to traditional pathology in the categorization of renal cell carcinomas (RCCs), particularly in morphologically ambiguous cases, but it has disadvantages, including cost.Objective.—To define the clinical scenarios in which this technology has direct clinical applications.Design.—DNA was isolated from paraffin-embedded tissue from 40 selected cases of RCC. Chromosome genomic array testing was performed using the OncoScan.Results.—Of 23 cases of unclassified renal tumors, 19 (83%) were reclassified with incorporation of cytogenetic and histologic features, including 10 as clear cell RCC, 2 as collecting duct carcinoma, 2 as papillary RCC, and 1 as novel TFEB-amplified tumor lacking TFEB translocation. Of 5 tumors with “hybrid” oncocytic features, 3 were reclassified as an eosinophilic variant of chromophobe RCC and 1 as oncocytoma. Appropriate staging in 2 patients was determined by identifying distinct, nonshared cytogenetic profiles. Of 11 cases of metastatic clear cell RCC, 7 (63%) had cytogenetic features associated with a poor prognosis.Conclusions.—We identified 5 scenarios in which chromosome genomic array testing has direct clinical utility: (1) to investigate unclassified RCCs, (2) to understand tumors with “hybrid” features and “collision” tumors, (3) to determine appropriate staging in questions of bilateral tumors and/or metastases, (4) to identify chromosomal aberrations in metastatic clear cell RCCs associated with a worse prognosis, and (5) to identify new entities. This has practical value in our institution, where a molecular profile diagnostically separating morphologically difficult to classify clear cell, papillary, chromophobe, and unclassified RCC influences treatment recommendations and clinical trial eligibility.
Assessing the Understanding of Pediatric-Oriented Medication Education Materials Versus Standard Available Education Materials
Authors: Biggs Jessica M. , Glasgow Nicole E. , Pradel Francoise , Morgan Jill A. 
Published: November 2018

OBJECTIVES The objective of this study was to determine if education material targeting children would improve understanding of medication indication, administration, and common side effects in pediatric subjects.METHODS This cross-sectional pilot study included students 7 to 11 years old from a suburban elementary school. Study participants were read either the US Food and Drug Administration–approved adult medication leaflet or a pediatric medication leaflet created at a first-grade reading level for levetiracetam (Keppra, UCB, Inc, Atlanta, GA). Students were asked a set of standardized survey questions to evaluate comprehension of side effects, medication indication, dosing frequency, administration, and overall impression of the leaflet.RESULTS Fifty-eight children were included. Fifty percent of the children were male, 79% were Caucasian, and the average age was 9 years. There was no statistical difference for demographics in the adult leaflet versus the pediatric leaflet group. Children correctly stated the indication for the medication in 30% of participants (9/30) in the adult leaflet group and 79% of participants (22/28) in the pediatric leaflet group, p = 0.002. The administration frequency question was answered correctly in 93% of the pediatric leaflet group (26/28) as compared to 73% in the adult leaflet group (22/30), p = 0.05. For questions about side effects and how to administer the medication, there was no difference between the groups. The responses regarding readability and understanding of the leaflets were significantly different in the pediatric leaflet group compared to the adult leaflet group, p = 0.001 and p = 0.001, respectively.CONCLUSIONS Leaflets designed for pediatric patients resulted in an improvement in the understanding of the indication for levetiracetam.
Poractant Alfa Versus Beractant for Neonatal Respiratory Distress Syndrome: A Retrospective Cost Analysis
Authors: Brown Sara , Hurren Jeff , Sartori Heidi 
Published: November 2018

OBJECTIVES The objectives of this study were to determine the average medication cost per patient of poractant alfa and beractant, and to compare the outcomes of treatment with these agents.
METHODS We conducted a retrospective, observational, cohort study of patients who received surfactant, before and after an institutional formulary change from beractant to poractant alfa. The primary outcome was the average medication cost per case. Secondary measures were clinical outcomes, including duration of respiratory support, length of hospital stay, and the occurrence of complications.
RESULTS A total of 114 patients were enrolled; 38 were treated with poractant alfa and 76 patients were treated with beractant. Baseline characteristics were similar between groups. The average medication cost per patient was $1756.44 ± $1030.06 and $1329.78 ± $705.64 for poractant alfa and beractant, respectively (p = 0.011). Patients treated with poractant alfa had a shorter length of stay (45.0 ± 30.5 days) than patients treated with beractant (65.1 ± 37.1 days) (p = 0.010). Rates of pneumothoraces, pulmonary hemorrhage, necrotizing enterocolitis, intraventricular hemorrhage, and mortality did not differ significantly between groups.
CONCLUSIONS We found an unanticipated increase in drug cost with poractant alfa compared to beractant.
Relationship of Pulmonary Outcomes, Microbiology, and Serum Antibiotic Concentrations in Cystic Fibrosis Patients
Authors: Hahn Andrea , Jensen Caroline , Fanous Hani , Chaney Hollis , Sami Iman , Perez Geovanny F. , Louie Stan , Koumbourlis Anastassios C. , Bost James E. , van den Anker John N. 
Published: November 2018

OBJECTIVES To determine the frequency of subtherapeutic exposure to intravenously administered β-lactam antibiotics in a cohort of cystic fibrosis (CF) patients who were treated for a pulmonary exacerbation, and its impact on pulmonary function.
METHODS Nineteen CF patients between the ages of 5 and 21 years treated at Children's National Health System for a pulmonary exacerbation were followed between March 2015 and August 2016 in a prospective, longitudinal study. Pharmacokinetic modeling and minimum inhibitory concentrations (MICs) of the involved pathogens were used to determine therapeutic or subtherapeutic β-lactam antibiotic exposure based on the time the antibiotic concentration was above the MIC. Clinical outcomes were measured by spirometry values.
RESULTS The 19 participants were treated with a total of 29 courses of antibiotics. The most common β-lactam antibiotics used in a treatment course were ceftazidime (62%) and meropenem (45%). There was no difference in age, CF genotype, or creatinine clearance between the 9 participants (47%) who reached therapeutic concentrations versus the 10 (53%) who did not. Those who achieved sufficiently high antibiotic exposure had more significant improvement of their pulmonary function tests.
CONCLUSIONS We found that sufficient antibiotic exposure during treatment of CF pulmonary exacerbations was associated with improved pulmonary function. Moreover, it was impossible to predict, solely from the dosing regimen used, which patients were going to reach therapeutic β-lactam antibiotic serum concentrations. This suggests that CF patients may benefit from closer monitoring of their β-lactam exposure and bacterial MIC for optimal clinical outcomes.
Azithromycin Induces Migrating Motor Complexes in Pediatric Patients Undergoing Antroduodenal Motility Studies
Authors: Shakir Asiya K , Altaf Muhammad Adnan 
Published: November 2018

OBJECTIVE Erythromycin (ERY) is used in the treatment of gastroparesis; however, this medication is associated with serious side effects, such as cardiac arrhythmias and consequent cardiorespiratory arrest. Azithromycin (AZM) has been suggested as an alternative to ERY as a result of its improved safety profile. Intravenous ERY (1 mg/kg) is administered during antroduodenal motility studies to induce migrating motor complexes (MMCs), the presence or absence of which helps diagnose motility disorders like gastroparesis and gastrointestinal dysmotility. However, there are no pediatric studies comparing the effects of AZM and ERY on antroduodenal pressure profiles. The goal of this study is to determine if AZM is comparable in inducing MMCs in pediatric patients undergoing antroduodenal motility studies.
METHODS We performed a retrospective chart analysis of gastric and small bowel manometric data in 2 adolescent patients, both age 15 years, who were given AZM (1 mg/kg) during antroduodenal motility studies. The pressure profiles obtained during motility studies were compared to those of patients of similar age and symptomology who were given the standard intravenous ERY dose during motility studies. We then compared the total duration of effect, mean amplitude of contractions, number of cycles per minute, and duration of highest antral and duodenal contractions.
RESULTS Intravenous AZM induces migrating motor contractions in the stomach followed by contractions in the small intestine. The mean amplitude of the stomach contractions was 259 mm Hg in patients who received AZM vs 241 mm Hg in patients who received ERY. The mean amplitude of small intestinal MMCs was 68 mm Hg in patients who received AZI and 72 mm Hg in patients who received ERY. Additionally, the frequency and duration of stomach and small intestinal contractions were also similar in the 2 groups.
CONCLUSIONS Intravenous AZM has similar prokinetic effects to intravenous ERY. Our study suggests that AZM is a suitable alternative to ERY in inducing MMCs without the concerning side effects related to ERY and may potentially be used in the management of gastroparesis and other small bowel motility disorders. However, larger prospective studies are required to better understand the long-term efficacy of AZM.
Use of Intravenous Acetaminophen in Children for Analgesia After Spinal Fusion Surgery: A Randomized Clinical Trial
Authors: Rizkalla Nicole , Zane Nicole R. , Prodell Janice L. , Elci Okan U. , Maxwell Lynne G. , DiLiberto Mary Ann , Zuppa Athena F. 
Published: November 2018

OBJECTIVES Opioid pharmacotherapy is the cornerstone of postoperative analgesia. Despite its effectiveness, it has a variety of potential adverse effects. Therefore, a multimodal approach with non-opioid analgesics would be optimal. The aim of this study was to determine if intravenous (IV) acetaminophen would reduce opioid requirements and improve clinical outcomes in children after surgery.
METHODS A single-center, randomized, double-blind study was conducted in 57 children (10–18 years old) undergoing posterior spine fusion surgery between July 2011 to May 2014. All subjects received either acetaminophen or placebo at the end of surgery, followed by repeated doses every 6 hours for a total of 8 doses.
RESULTS In the first 24 postoperative hours, the average opioid consumption was lower for the active group compared with the placebo group (p = 0.02). The total unadjusted time to patient controlled analgesia (PCA) discontinuation was also longer in the placebo group than the active group (90 hours vs. 73 hours, p = 0.02); however, this was not statistically significant after normalizing for body weight. Additionally, time to first solid intake was longer without the use of acetaminophen (69 hours vs. 49 hours, p = 0.01).
CONCLUSIONS Postoperative use of IV acetaminophen was associated with earlier time to diet advancement and discontinuation of IV analgesics and may result in lower opioid consumption.