High resolution climate change observations and projections for the evaluation of heat-related extremes.

The Climate Hazards Center Coupled Model Intercomparison Project Phase 6 climate projection dataset (CHC-CMIP6) was developed to support the analysis of climate-related hazards, including extreme humid heat and drought conditions, over the recent past and in the near-future. Global daily high resolution (0.05°) grids of the Climate Hazards InfraRed Temperature with Stations temperature product, the Climate Hazards InfraRed Precipitation with Stations precipitation product, and ERA5-derived relative humidity form the basis of the 1983-2016 historical record, from which daily Vapor Pressure Deficits (VPD) and maximum Wet Bulb Globe Temperatures (WBGTmax) were derived. Large CMIP6 ensembles from the Shared Socioeconomic Pathway 2-4.5 and SSP 5-8.5 scenarios were then used to develop high resolution daily 2030 and 2050 'delta' fields. These deltas were used to perturb the historical observations, thereby generating 0.05° 2030 and 2050 projections of daily precipitation, temperature, relative humidity, and derived VPD and WBGTmax. Finally, monthly counts of frequency of extremes for each variable were derived for each time period.

Gastropleural Fistula Presenting as a Complication of Gastric Sleeve Surgery: A Case Report.

A rare complication of sleeve gastrectomy surgery is gastropleural fistulas (GPF), where a fistula develops between the stomach and the pleural cavity. This complication can be debilitating and present with many nonspecific symptoms making it hard to diagnose. This is a case report of a 45-year-old female who underwent robotic-assisted gastric sleeve revision after developing a GPF as a complication of her gastric sleeve six years later. This led to the development of a recurrent subdiaphragmatic abscess in the left upper quadrant. Before presenting to us, she underwent multiple hospitalizations and received numerous endoscopic stent treatments. However, the abscess continued to recur. Given her recurrent abscess, she consented to gastric sleeve revision. GPFs are amongst the rarest complications, with only 76 reported cases. Since this complication can cause shock, early diagnosis and treatment are necessary to improve patient outcomes and reduce morbidity.

Advancing early warning capabilities with CHIRPS-compatible NCEP GEFS precipitation forecasts.

CHIRPS-GEFS is an operational data set that provides daily bias-corrected forecasts for next 1-day to ~15-day precipitation totals and anomalies at a quasi-global 50-deg N to 50-deg S extent and 0.05-degree resolution. These are based on National Centers for Environmental Prediction (NCEP) Global Ensemble Forecast System version 12 (GEFS v12) precipitation forecasts. CHIRPS-GEFS forecasts are compatible with Climate Hazards center InfraRed Precipitation with Stations (CHIRPS) data, which is actively used for drought monitoring, early warning, and near real-time impact assessments. A rank-based quantile matching procedure is used to transform GEFS v12 "reforecast" and "real-time" forecast ensemble means to CHIRPS spatial-temporal characteristics. Matching distributions to CHIRPS makes forecasts better reflect local climatology at finer spatial resolution and reduces moderate-to-large forecast errors. As shown in this study, having a CHIRPS-compatible version of the latest generation of NCEP GEFS forecasts enables rapid assessment of current forecasts and local historical context. CHIRPS-GEFS effectively bridges the gap between observations and weather predictions, increasing the value of both by connecting monitoring resources (CHIRPS) with interoperable forecasts.

Global urban population exposure to extreme heat.

Increased exposure to extreme heat from both climate change and the urban heat island effect-total urban warming-threatens the sustainability of rapidly growing urban settlements worldwide. Extreme heat exposure is highly unequal and severely impacts the urban poor. While previous studies have quantified global exposure to extreme heat, the lack of a globally accurate, fine-resolution temporal analysis of urban exposure crucially limits our ability to deploy adaptations. Here, we estimate daily urban population exposure to extreme heat for 13,115 urban settlements from 1983 to 2016. We harmonize global, fine-resolution (0.05°), daily temperature maxima and relative humidity estimates with geolocated and longitudinal global urban population data. We measure the average annual rate of increase in exposure (person-days/year-1) at the global, regional, national, and municipality levels, separating the contribution to exposure trajectories from urban population growth versus total urban warming. Using a daily maximum wet bulb globe temperature threshold of 30 °C, global exposure increased nearly 200% from 1983 to 2016. Total urban warming elevated the annual increase in exposure by 52% compared to urban population growth alone. Exposure trajectories increased for 46% of urban settlements, which together in 2016 comprised 23% of the planet's population (1.7 billion people). However, how total urban warming and population growth drove exposure trajectories is spatially heterogeneous. This study reinforces the importance of employing multiple extreme heat exposure metrics to identify local patterns and compare exposure trends across geographies. Our results suggest that previous research underestimates extreme heat exposure, highlighting the urgency for targeted adaptations and early warning systems to reduce harm from urban extreme heat exposure.

Carcinosarcoma of the Uterus: A Study From the Surveillance Epidemiology and End Result (SEER) Database.

BACKGROUND: Uterine cancer (UC) is one of the leading gynecologic neoplastic disorders in the United States (US), of which over 80% are endometrioid adenocarcinomas (EA). In contrast to EA, carcinosarcoma (CS) of the uterus is a sporadic and highly malignant tumor, phylogenetically containing both epithelial and mesenchymal histologic elements. This study sought to analyze demographic, pathological retrospectively, and survival characteristics of a large cohort of CS patients compared to EA patients to identify prognostic factors and treatment approaches that may improve the current clinical management of CS patients. METHODS: Demographic and clinical data were abstracted from 88,530 patients diagnosed with uterine malignancy from the Surveillance, Epidemiology, and End Results (SEER) database for 38 years (1973-2010). Extracted variables were analyzed using the Chi-square test, paired t-test, and multivariate analysis, while Kaplan-Meier functions were used to compare survival between groups. Statistical analyses were performed with IBM Statistical Product and Service Solutions (SPSS©), version 20.2 (IBM Corp., Armonk, NY). RESULTS: A total of 3,706 cases of CS comprised 38.2% of uterine sarcomas (n=9,702), and 4.1% of uterine cancers overall (n=88,530). EA made up 88.6% (n=78,481) of all uterine cancers. CS patients presented later in life (68.3±11.5 years) than EA (61.9±12.5 years). 65.2% of CS and 77.8% of EA occurred in Caucasians. The incidence (per million) of EA was higher in Caucasians compared to African-Americans (AA) (41% vs. 26.8%), while the incidence of CS was higher among AA than Caucasians (4% vs. 1.9%, p<0.001). 33.4% of CS was poorly differentiated at presentation, compared to 13.1% of EA. 27.8% of CS patients presented with a distant disease compared to only 4.7% of EA patients. 29.9% of AA patients with CS presented with metastatic disease, compared to 28.2% of Caucasian patients (p<0.001). Mean survival for CS patients (6.6±0.2 years) was significantly lower than that of EA patients (17.7±0.7 years, p<0.001), and AA CS patients had significantly lower survival than Caucasians CS patients (4.5±0.4 years vs. 7.1±0.3 years, p<0.001). CS patients treated with combined surgery and radiotherapy had the highest survival (9.4±0.5 years, p<0.001), while EA patients treated with surgery alone had the highest survival (20.4±1.2 years, p<0.001). Survival among AA CS patients treated with combination therapy was significantly inferior compared to Caucasians (6.5±0.6 years vs. 9.8±0.5 years, p<0.001). Multivariate analysis identified CS histology (odds ratio [OR] 1.9, CI=1.7-2.1), AA race (OR 1.3, CI=1.2-1.4), age over 40 (OR 3.4, CI=2.9-4.1), undifferentiated grade (OR 3.0, CI=2.6-3.4), and distant metastases (OR 6.2, CI=5.8-6.8) as independently associated with increased mortality (p<0.005). The use of radiotherapy in CS patients was independently associated with decreased mortality (OR 0.1, CI=0.02-0.6, p<0.005). CONCLUSIONS: Uterine CS is a highly malignant tumor with a significantly worse prognosis than EA. AA has a considerably higher CS incidence compared to EA. Moreover, AA CS had higher tumor grades, higher rates of metastatic disease, and experienced significantly lower overall survival compared to Caucasians despite receiving similar therapy. Primary radiotherapy or combination radiotherapy confers a survival advantage to AA uterine CS patients.

Development and validation of the CHIRTS-daily quasi-global high-resolution daily temperature data set.

We present a high-resolution daily temperature data set, CHIRTS-daily, which is derived by merging the monthly Climate Hazards center InfraRed Temperature with Stations climate record with daily temperatures from version 5 of the European Centre for Medium-Range Weather Forecasts Re-Analysis. We demonstrate that remotely sensed temperature estimates may more closely represent true conditions than those that rely on interpolation, especially in regions with sparse in situ data. By leveraging remotely sensed infrared temperature observations, CHIRTS-daily provides estimates of 2-meter air temperature for 1983-2016 with a footprint covering 60°S-70°N. We describe this data set and perform a series of validations using station observations from two prominent climate data sources. The validations indicate high levels of accuracy, with CHIRTS-daily correlations with observations ranging from 0.7 to 0.9, and very good representation of heat wave trends.

Corrigendum: The Centennial Trends Greater Horn of Africa precipitation dataset.

This corrects the article DOI: 10.1038/sdata.2015.50.

A land data assimilation system for sub-Saharan Africa food and water security applications.

Seasonal agricultural drought monitoring systems, which rely on satellite remote sensing and land surface models (LSMs), are important for disaster risk reduction and famine early warning. These systems require the best available weather inputs, as well as a long-term historical record to contextualize current observations. This article introduces the Famine Early Warning Systems Network (FEWS NET) Land Data Assimilation System (FLDAS), a custom instance of the NASA Land Information System (LIS) framework. The FLDAS is routinely used to produce multi-model and multi-forcing estimates of hydro-climate states and fluxes over semi-arid, food insecure regions of Africa. These modeled data and derived products, like soil moisture percentiles and water availability, were designed and are currently used to complement FEWS NET's operational remotely sensed rainfall, evapotranspiration, and vegetation observations. The 30+ years of monthly outputs from the FLDAS simulations are publicly available from the NASA Goddard Earth Science Data and Information Services Center (GES DISC) and recommended for use in hydroclimate studies, early warning applications, and by agro-meteorological scientists in Eastern, Southern, and Western Africa.

The climate hazards infrared precipitation with stations--a new environmental record for monitoring extremes.

The Climate Hazards group Infrared Precipitation with Stations (CHIRPS) dataset builds on previous approaches to 'smart' interpolation techniques and high resolution, long period of record precipitation estimates based on infrared Cold Cloud Duration (CCD) observations. The algorithm i) is built around a 0.05° climatology that incorporates satellite information to represent sparsely gauged locations, ii) incorporates daily, pentadal, and monthly 1981-present 0.05° CCD-based precipitation estimates, iii) blends station data to produce a preliminary information product with a latency of about 2 days and a final product with an average latency of about 3 weeks, and iv) uses a novel blending procedure incorporating the spatial correlation structure of CCD-estimates to assign interpolation weights. We present the CHIRPS algorithm, global and regional validation results, and show how CHIRPS can be used to quantify the hydrologic impacts of decreasing precipitation and rising air temperatures in the Greater Horn of Africa. Using the Variable Infiltration Capacity model, we show that CHIRPS can support effective hydrologic forecasts and trend analyses in southeastern Ethiopia.

The Centennial Trends Greater Horn of Africa precipitation dataset.

East Africa is a drought prone, food and water insecure region with a highly variable climate. This complexity makes rainfall estimation challenging, and this challenge is compounded by low rain gauge densities and inhomogeneous monitoring networks. The dearth of observations is particularly problematic over the past decade, since the number of records in globally accessible archives has fallen precipitously. This lack of data coincides with an increasing scientific and humanitarian need to place recent seasonal and multi-annual East African precipitation extremes in a deep historic context. To serve this need, scientists from the UC Santa Barbara Climate Hazards Group and Florida State University have pooled their station archives and expertise to produce a high quality gridded 'Centennial Trends' precipitation dataset. Additional observations have been acquired from the national meteorological agencies and augmented with data provided by other universities. Extensive quality control of the data was carried out and seasonal anomalies interpolated using kriging. This paper documents the CenTrends methodology and data.