bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Low-Level, Terrain-Induced Jets in Rainfall Variability in Tigris–Euphrates Headwaters
Authors: Dezfuli Amin K. , Zaitchik Benjamin F. , Badr Hamada S. , Evans Jason , Peters-Lidard Christa D. 
Published: January 2017

Abstract
Rainfall variability in the Tigris–Euphrates headwaters is a result of interaction between topography and meteorological features at a range of spatial scales. Here, the Weather Research and Forecasting (WRF) Model, driven by the NCEP–DOE AMIP-II reanalysis (R-2), has been implemented to better understand these interactions. Simulations were performed over a domain covering most of the Middle East. The extended simulation period (1983–2013) enables us to study seasonality, interannual variability, spatial variability, and extreme events of rainfall. Results showed that the annual cycle of precipitation produced by WRF agrees much more closely with observations than does R-2. This was particularly evident during the transition months of April and October, which were further examined to study the underlying physical mechanisms. In both months, WRF improves representation of interannual variability relative to R-2, with a substantially larger benefit in April. This improvement results primarily from WRF’s ability to resolve two low-level, terrain-induced flows in the region that are either absent or weak in R-2: one parallel to the western edge of the Zagros Mountains, and one along the east Turkish highlands. The first shows a complete reversal in its direction during wet and dry days: when flowing southeasterly it transports moisture from the Persian Gulf to the region, and when flowing northwesterly it blocks moisture and transports it away from the region. The second is more directly related to synoptic-scale systems and carries moist, warm air from the Mediterranean and Red Seas toward the region. The combined contribution of these flows explains about 50% of interannual variability in both WRF and observations for April and October precipitation.
The Impact of Ocean Surface Currents on Sverdrup Transport in the Midlatitude North Pacific via the Wind Stress Formulation
Authors: Yu Zhitao , Metzger E. Joseph , Fan Yalin 
Published: January 2017

AbstractA more complete wind stress τn formulation takes into account the ocean surface currents Vo, while the conventional wind stress τc popularly used in ocean circulation models is only a function of 10-m winds V10. An analytical solution is derived for the difference of Sverdrup transport induced by using τn instead of τc. A scaling analysis of the analytical solution indicates a 6% reduction of the Sverdrup transport in the North Pacific (i.e., the Kuroshio transport in the East China Sea) when Ekman velocity dominates the ocean surface currents. Because of the quadratic nature of wind stress, four nonlinear terms contribute equally to this difference: two vorticity torque terms and two speed gradient torque terms. A pair of 12.5-yr (July 2002–14) Hybrid Coordinate Ocean Model simulations that only differ in the wind stress formulation are used to test the analytical solution. The model results (2004–14) confirm that using τn instead of τc reduces the Sverdrup transport in the North Pacific by 8%–17% between 23° and 32°N. The reduction rate of the simulated 11-yr mean Kuroshio transport through the East Taiwan Channel and Tokara Strait is 8.0% (−2.5 Sv; 1 Sv ≡ 106 m3 s−1) and 12.8% (−4.8 Sv), respectively, in good agreement with the Sverdrup transport reduction rate, which is 7.4% (−2.6 Sv) and 15.4% (−6.3 Sv) at the corresponding latitude. The local effect of changing wind stress/wind work and Ekman transport due to the inclusion of Vo in the wind stress formulation is negligible compared to the Kuroshio volume transport change estimated in this study.
Novel Method for Laryngotracheal Reconstruction: Combining Single- and Double-Stage Techniques
Authors: Setlur Jennifer , Maturo Stephen , Hartnick Christopher J. 
Published: January 2017

Objectives: Traditional open techniques for laryngotracheal reconstruction are either single- or double-stage procedures. Some patients may benefit from the presence of a long, single-tube stent, such as an endotracheal tube, but their predicted need for a 2-stage procedure and a persistent tracheostomy is high. We describe a novel technique for airway reconstruction that combines the methods of both single- and double-stage procedures. Methods: We present a retrospective review of 4 patients. All patients underwent laryngotracheal reconstruction by a single surgeon. After the operation, the airway was stented with nasotracheal intubation. A small stent, fashioned from an endotracheal tube, was placed in the tracheostoma to keep it patent. The patients subsequently underwent extubation and replacement of the tracheostomy tube. Results: The study included 1 patient with grade 4 subglottic stenosis, 2 patients with grade 3 subglottic stenosis, and 1 patient with a posterior glottic scar. All were tracheostomy tube-dependent. Serial bronchoscopy was used to follow the patients for a minimum of 9 months after the operation. All 4 patients have since met the criteria for decannulation. Conclusions: This hybrid reconstruction merges the advantages of both the single- and double-stage procedures. It adds versatility to the surgical toolbox for airway reconstruction.
Bureaucrats, Cattle, and Public Policy
Authors: Picard Louis A. 
Published: January 2017

The formulation of a policy on land use offers a clear example of the relationship between a bureaucracy and policy formulation. In much of the Third World, and particularly in many African countries, national and local government employees are to all intents and purposes the dominant socioeconomic elite in the country. This would suggest that those who are formulating and implementing a new policy such as that on land use may have the most to gain from the policy which is under examination. Using data from the Southern African country of Botswana, this article examines the relationship between the socioeconomic status of the bureaucracy and the type of land tenure policy which is likely to result. Since the movement from communal to individual tenure of both grazing land and farm land is occurring throughout the African continent, the relationship between bureaucratic interests and public policy is of general interest beyond this specific case study.
The Role of the Medical Examiner in the Euthanasia Notification Procedure in the Netherlands
Authors: Cuperus-Bosma Jacqueline M , Van Der Wal Gerrit , Kostense Piet J , Van Der Maas Paul J 
Published: January 2017

The objective of the study was to provide an insight into the role of the medical examiner in the euthanasia notification procedure in The Netherlands. At the beginning of 1996 a representative group of 116 medical examiners was interviewed. The study found that there was a considerable variation in the way in which the medical examiners fulfilled their tasks. In all cases, after the physician-assisted death had taken place, the medical examiner investigated whether the attending physician had met the requirements for prudent practice, and in approximately 75% of the cases he reported his findings to the Public Prosecutor. In 78% of cases the attending physician was well known to the medical examiners, who were general practitioners, and in a third of the cases this influenced their assessment. Seventy-six per cent of the medical examiners, 61% of the members of the public prosecution and 47% of the physicians thought that it is the task of the medical examiner to review whether the requirements for prudent practice have been met by the attending physician. In conclusion, further specification of the task of the medical examiner would appear to be beneficial to increase uniformity in the procedure. In particular, it should be determined whether it is the medical examiner's responsibility to review whether the requirements for prudent practice have been met. It should also be taken into consideration whether the position of the general practitioner medical examiner is sufficiently independent to make an objective report.
2. A Fatal Nail Gun Injury — An Unusual Ricochet?
Authors: Nadesan Kasinathan 
Published: January 2017

An 18-year-old construction worker suddenly collapsed while handling a power-actuated nail gun and died shortly after. A neat, almost circular puncture wound was found on the front of his left chest. No fire-arm residues were detected on the surrounding skin. The police stated that it was an accidental injury, at a construction site, where a nail fired from a nail gun by the deceased had deflected off the wall and struck him on the front of the chest. Since the entry wound appeared to be a neat hole, and that too on the front of the left chest overlying the heart area, there was reluctance on the part of the pathologist to accept it as an accidental injury due to a ricochet. A visit to the scene, interrogation of witnesses, examination of the alleged tool and post-mortem X-ray of the deceased were undertaken prior to autopsy. A bent nail was found in the heart. The scene visit and the subsequent autopsy revealed that the nail took a roughly circular flightpath after it had struck the wall, all the while travelling with its pointed end directed forward. Within the body too, the nail maintained the same path. Various medicolegal issues are discussed pertaining to nail-gun injuries. The importance of a visit to the scene, examination of the alleged tool, interrogation of witnesses and the X-ray of the body, all prior to autopsy, are emphasized. The conclusion was: accidental death due to the unusual ricochet of a nail.
A Controlled Trial of Iron Therapy in Sideropenia
Authors: Morrow J. J. , Dagg J. H. , Goldberg A. 
Published: January 2017

It has been shown that there is a high incidence of latent iron deficiency (sideropenia) in the female population. To assess the role of this deficiency as a cause of symptoms a double blind trial of iron and placebo therapy was carried out on 20 sideropenic women presenting with symptoms. The incidence of all the symptoms studied fell and there was no significant difference between iron and placebo in producing improvement. A significant rise in haemoglobin level occurred only in response to iron therapy and this was reversed on cessation of iron. No significant changes in haemoglobin occurred in response to the placebo. It has been concluded that while iron has no specific effect on the symptoms associated with sideropenia, it will produce a significant rise in haemoglobin level, reverse biochemical defects and, in a minority, prevent development of iron deficiency anaemia.
The Influence of Predominant Cell Type on the Management and Prognosis of Bronchial Carcinoma
Authors: Le Roux B. T. 
Published: January 2017

Of 4,000 patients with bronchial carcinoma, the histology of the tumour was known in all but 5.8 per cent; nearly 48 per cent of tumours were squamous; 40 per cent were undifferentiated; 5 per cent were adenocarcinomata; in 17 patients the tumour was an alveolar cell carcinoma; in 56 patients submitted to exploratory thoracotomy the histology of the tumour was mixed. More than half the patients with adenocarcimoa and alveolar cell carcinoma were surgically managed. Mediastinal glandular metastases from squamous or undifferentiated carcinoma demonstrated after pulmonary resection, did not preclude long survival. Operative mortality after pneumonectomy was relatively highest in those with an adenocarcinoma. There was evidence at necropsy of distant spread in more than 80 per cent of patients who died in the early post-operative period after pneumonectomy. One in every 3 patients who died from metastases in the first 2 years after pneumonectomy died with cerebral metastases. Lobectomy in 65 per cent of patients was for squamous carcinoma, and was only slightly more common for undifferentiated carcinoma (18%) than for adenocarcinoma (15%). Long survival after lobectomy for squamous or undifferentiated carcinoma with glandular metastases was not uncommon. Bronchial carcinoma in patients who presented without symptoms and with an abnormal routine chest radiograph was most often squamous, peripheral in type, and small. In this group the rate of resectability and of long survival were high and operative mortality was small. A third of the patients with bronchial carcinoma, who denied ever having smoked, had squamous tumours. The incidence of adenocarcinoma in women, and those with hypertrophic pulmonary osteoarthropathy, was significantly higher. The incidence of resectability with long survival in a small group of patients with alveolar cell carcinoma was surprisingly high.
Physiological Responses and Thermal, Humidity, and Comfort Sensations in Wear Trials with Cotton and Polypropylene Vests
Authors: Vokac Z. , Køpke V. , Keül P. 
Published: January 2017

Relations were studied between skin temperature of the back as well as temperature and humidity inside clothing, and subjective estimates of thermal, humidity, and comfort sensations in 5 subjects wearing cross-country ski dress. The 2-h wear trials were performed in a climatic chamber at −2°C and simulated the actual circumstances under which such a dress is worn by alternating periods of intensive walking (20 min) on a treadmill with periods of resting (5–10 min). Each subject participated in 4 trials wearing alternately one of the 4 experimental, double-layer vests (double-cotton, cotton-polypropylene with cotton layer next to skin, same combination with polypropylene layer next to skin, double-polypropylene). Skin temperature of the back was during the experiments systematically lower ( P<0.05) by about 1°C with the double-layer cotton vest than with the double-layer polypropylene vest. Since the physical parameters of the two fabrics were not identical, the findings cannot be definitely attributed to the inherently different properties of the fibers. No significant differences were found in the 4 experimental series either in other objective measurements (temperature and humidity of the microclimate, energy output, total amount of sweat, amount of sweat trapped in the vests) or in subjective estimates of thermal, humidity, and comfort sensations. Gradual increase of skin temperature as well as of temperature and humidity (sweating) of the microclimate was recorded during walking periods. When walking was interrupted by a pause, both the temperature and humidity rose steeply, due to the cessation of bellows ventilation of the clothing, and fell again when walking was resumed. The thermal and humidity sensations on the back reported after the turning-points of the intermittent activity showed opposite direction of changes than those of the recorded parameters— i.e., decrease during pauses and increase after walking was resumed. It is possible that the perception of local sensations was affected by superimposed, central perception of changes in the amount of heat delivered from muscles to the brain receptors. The sensations of comfort seemed to be affected mostly by perception of “warmth” when walking and “cold” when resting.
Slow Improvement of Clinically-Diagnosed Dengue Haemorrhagic Fever Case Fatality Rates
Authors: Magpusao Nelma S , Monteclar Alan , Deen Jacqueline L 
Published: January 2017

Dengue haemorrhagic fever (DHF) is recognized as a leading cause of hospitalization and death among children in many Southeast Asian countries. This study reviews the case fatality rates of DHF cases admitted to a referral hospital in Cebu (Philippines) over the past 5 years. Information on patients 14 years old or younger admitted from 1 January 1997 to 31 December 2001 with the final clinical diagnosis of DHF was collated and analysed. Case fatality rates were compared before and after a standardized management protocol was implemented by the healthcare staff and after introduction of revisions to that protocol. The case fatality rate during the 2-year periods prior and after introduction of the management protocol decreased significantly from 197/2644 (7.45%) to 39/1182 (3.30%) ( P<0.01). Following the introduction of revisions to the protocol, the case fatality was reduced even further to 52/1697 (3.06%) ( P=0.7). In this government hospital the introduction of a standardized management protocol for DHF was associated with a significant improvement in the case fatality rate of hospitalized children with clinically diagnosed DHF. However, compared with reports from hospitals in other dengue-endemic countries, the improvement has been slow. Possible ways to decrease fatality rates further have been identified.
Morbidity and Mortality following Induced Abortion in Nnewi, Nigeria
Authors: Ikechebelu J I , Okoli C C 
Published: January 2017

We present a study of the maternal morbidity and mortality among 76 patients treated at the Nnamdi Azikiwe University Teaching Hospital, Nnewi for complications of induced abortion from January 1996 to December 2000. The total number of maternal admissions over this period was 5750, and illegal induced abortion was responsible for 1.3% of the admissions, with a mortality rate of 5.3% ( n=4) for induced abortion. This accounted for 21.1% of the total maternal deaths ( n=19) for the period. The mean age of the women was 20.6 years (range 15–34 years), 94.7% ( n=72) were unmarried, 93.5% ( n=71) were nulliparous and 76.5% ( n=58) were unemployed, 67.1% ( n=51) had had a mid-trimester termination at > 13 weeks gestational age. It is significant that 55.3% of the patients were teenagers and 45.1% of the mid-trimester abortions occurred in this group. Genital sepsis, haemorrhage, pelvic infection with peritonitis and abscess formation, uterine perforation, and gut injury were the major complications encountered. This study demonstrates that induced abortion is still a major cause of maternal mortality in Nigeria. Integrated family health education, planned parenthood and contraceptive education, a mass literacy campaign and improvement of the existing national health services are recommended in order to ameliorate the problems of illegally induced abortion in Nigeria.
Use of Cholera Beds in the Delivery Room: A Simple and Appropriate Method for Direct Measurement of Postpartum Bleeding
Authors: Strand Roland T , da Silva Florinda , Bergström Staffan 
Published: January 2017

Abundant obstetric bleeding is a predominant cause of maternal death, with the immediate postpartum period being the most critical time. Visual estimation of postpartum haemorrhage (PPH) often leads to severe underestimation and delay in treatment. Various methods have been developed in order to measure blood loss accurately, but none has proved appropriate in poor settings. The aim of this study was to present a method which is appropriate for measuring postpartum blood loss in a setting with limited resources. Parturient women ( n=814) with active management of third stage of labour in Luanda, Angola were studied. Vaginal bleeding immediately after birth and during the first 2 hours postpartum was collected using a combination of a plastic sheet and a bucket below a cholera bed, in which the women rested during postpartum observation. Monitoring postpartum blood loss in the same way as cholera patients are monitored for loss of stool fluid was found to be a useful and practical way of measuring haemorrhage of parturient women after childbirth. The method described here is simple and appropriate, which makes it a good alternative to more costly methods in detecting and quantifying PPH.
Value of Fibreoptic Oesophago-Gastro-Duodenoscopy: Experience with 4000 Procedures at Kilimanjaro Christian Medical Centre, Moshi, Tanzania
Authors: Missalek W , Jones F , Mmuni K , Cutinha P 
Published: January 2017

The paper presents the results of a retrospective study and the experiences with 4000 fibreoptic oesophago-gastro-duodenoscopies (EGD), which were performed at Kilimanjaro Christian Medical Centre (KCMC) between 1985 and 1989 in an open access service. Seventy per cent of all patients examined had abnormal findings with duodenal ulcer as the most frequent diagnosis (22%). Pyloric stenosis was seen in 6%, gastric ulcer in 5% and esophageal varices in 4% of all patients. High figures were found for carcinoma of the esophagus (4%) and malignancy of the stomach (5%). Gastritis was diagnosed in 11%. We consider fibreoptic EGD a cost effective and appropriate technology. Because of its high diagnostic yield, we advocate its use in certain centres in developing countries.
Complications of Methods of Fracture Treatment used by Traditional Healers: A Report of Three Cases Necessitating Amputation at Ihiala, Nigeria
Authors: Ofiaeli R O 
Published: January 2017

Three fracture cases treated by immobilization with bamboo sticks by traditional bone setters ended up with amputation in a rural hospital, two for gangrene and the third for diaphyseal sequestration. Venous occlusion, followed by interruption of arterial blood supply and immobilization in a dependent position are responsible for the gangrene. Overwhelming sepsis accounted for diaphyseal sequestration in the third patient. These cases illustrate the need for more emphasis to be placed on primary surgical care, centred on rural hospitals, in the developing world.
What Lies Beneath: An Examination of the Underpinnings of Dietary Supplement Safety Regulation
Authors: Ziker Dana 
Published: January 2017

In response to the increasing attention to the link between health and nutrition, a wealth of information—and misinformation—is becoming available, especially via the Internet. Consumers are advised to carefully assess the reliability of information they use to determine whether a product is safe. Meanwhile, regulators are sorting out the facts themselves, but despite the ever-increasing availability of scientific research, our evolving understanding of nutrition is still supplemented by our perceptions about risk.The primary framework for the regulation of dietary supplements is the Dietary Supplement Health and Education Act of 1994 (“DSHEA”). Underlying DSHEA is the congressional intent to support two goals: “(1) to facilitate consumer access to dietary supplements, given that many dietary supplements are used by consumers to help them maintain and improve their health; and (2) to give the Food and Drug Administration (“FDA”) the authority to step in where safety problems arise and to ensure proper labeling.”
Functional Foods: What are They? How are They Regulated? What Claims Can Be Made?
Authors: Hahn Martin 
Published: January 2017

Scientific studies continue to establish a strong relationship between constituents in foods and dietary supplements and certain diseases. The general population is inundated on a seemingly daily basis by media reports of new studies showing that a food or dietary supplement is useful in treating particular diseases or reducing the likelihood that a consumer will develop particular diseases. With increasing frequency, consumers are looking for foods and supplements to help manage and prevent the onset of disease.Not surprisingly, the food and dietary supplement industries are responding by developing new products and repositioning old products efforts to help consumers manage their health. For example, yogurt used to be positioned only as a delicious component of a meal but now is also promoted for use in weight loss programs after a study showed that the calcium in dairy products is effective in weight loss.