bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodel Ensemble Sea Level Forecasts for Tropical Pacific Islands
Authors: Widlansky Matthew J. , Marra John J. , Chowdhury Md. Rashed , Stephens Scott A. , Miles Elaine R. , Fauchereau Nicolas , Spillman Claire M. , Smith Grant , Beard Grant , Wells Judith 
Published: January 2017

AbstractSea level anomaly extremes impact tropical Pacific Ocean islands, often with too little warning to mitigate risks. With El Niño, such as the strong 2015/16 event, comes weaker trade winds and mean sea level drops exceeding 30 cm in the western Pacific that expose shallow-water ecosystems at low tides. Nearly opposite climate conditions accompany La Niña events, which cause sea level high stands (10–20 cm) and result in more frequent tide- and storm-related inundations that threaten coastlines. In the past, these effects have been exacerbated by decadal sea level variability, as well as continuing global sea level rise. Climate models, which are increasingly better able to simulate past and future evolutions of phenomena responsible for these extremes (i.e., El Niño–Southern Oscillation, Pacific decadal oscillation, and greenhouse warming), are also able to describe, or even directly simulate, associated sea level fluctuations. By compiling monthly sea level anomaly predictions from multiple statistical and dynamical (coupled ocean–atmosphere) models, which are typically skillful out to at least six months in the tropical Pacific, improved future outlooks are achieved. From this multimodel ensemble comes forecasts that are less prone to individual model errors and also uncertainty measurements achieved by comparing retrospective forecasts with the observed sea level. This framework delivers online a new real-time forecasting product of monthly mean sea level anomalies and will provide to the Pacific island community information that can be used to reduce impacts associated with sea level extremes.
Oceanic Origins of Historical Southwest Asia Precipitation During the Boreal Cold Season
Authors: Hoell Andrew , Barlow Mathew , Cannon Forest , Xu Taiyi 
Published: January 2017

While a strong influence on cold season southwest Asia precipitation by Pacific sea surface temperatures (SSTs) has been previously established, the scarcity of southwest Asia precipitation observations prior to 1960 renders the region’s long-term precipitation history largely unknown. Here a large ensemble of atmospheric model simulations forced by observed time-varying boundary conditions for 1901–2012 is used to examine the long-term sensitivity of November–April southwest Asia precipitation to Pacific SSTs. It is first established that the models are able to reproduce the key features of regional variability during the best-observed 1960–2005 period and then the pre-1960 variability is investigated using the model simulations. During the 1960–2005 period, both the mean precipitation and the two leading modes of precipitation variability during November–April are reasonably simulated by the atmospheric models, which include the previously identified relationships with El Niño–Southern Oscillation (ENSO) and the multidecadal warming of Indo-Pacific SSTs. Over the full 1901–2012 period, there are notable variations in precipitation and in the strength of the SST influence. A long-term drying of the region is associated with the Indo-Pacific warming, with a nearly 10% reduction in westernmost southwest Asia precipitation during 1938–2012. The influence of ENSO on southwest Asia precipitation varied in strength throughout the period: strong prior to the 1950s, weak between 1950 and 1980, and strongest after the 1980s. These variations were not antisymmetric between ENSO phases. El Niño was persistently related with anomalously wet conditions throughout 1901–2012, whereas La Niña was not closely linked to precipitation anomalies prior to the 1970s but has been associated with exceptionally dry conditions thereafter.
Correction of Dual-PRF Doppler Velocity Outliers in the Presence of Aliasing
Authors: Altube Patricia , Bech Joan , Argemí Oriol , Rigo Tomeu , Pineda Nicolau , Collis Scott , Helmus Jonathan 
Published: January 2017

AbstractIn Doppler weather radars, the presence of unfolding errors or outliers is a well-known quality issue for radial velocity fields estimated using the dual–pulse repetition frequency (PRF) technique. Postprocessing methods have been developed to correct dual-PRF outliers, but these need prior application of a dealiasing algorithm for an adequate correction. This paper presents an alternative procedure based on circular statistics that corrects dual-PRF errors in the presence of extended Nyquist aliasing. The correction potential of the proposed method is quantitatively tested by means of velocity field simulations and is exemplified in the application to real cases, including severe storm events. The comparison with two other existing correction methods indicates an improved performance in the correction of clustered outliers. The technique proposed is well suited for real-time applications requiring high-quality Doppler radar velocity fields, such as wind shear and mesocyclone detection algorithms, or assimilation in numerical weather prediction models.
“It’s Not Balancing out Like It Should Be”: Perceptions of Local Climate Variability in Native Oklahoma
Authors: Peppler Randy A. 
Published: January 2017

Abstract
Fieldwork was conducted in 2009–11 with Native American agriculturalists and traditionalists in southwestern Oklahoma on the form and use of their weather and climate knowledge: how it is constituted, how it is used in agricultural decision-making, and the extent to which their own weather knowledge is valued in light of other forms of weather information available. Conversations rekindled memories of knowledge imparted and stories told by previous generations and illuminated observational signs some still rely upon. Conversations also revealed that while the agriculturalists and traditionalists are acculturated into contemporary society, they still hold tightly to culturally important ways of knowing about and being in the world and are keen observers of their local environments. Given the contemporary relevance of climate change and its impacts on Indigenous peoples, this paper focuses on their observations and thoughts about climate variability: Have you noticed changes? What impacts do these changes have on you, including both on your agricultural activities and your trusted observational signs? What do you think about the public discourse on climate change? According to most, a changing climate is a real phenomenon perceived at the local scale and is impacting their ability to observe relied-upon indicators, and has caused them to make changes in their agricultural endeavors. The knowledge professed by those in this study can be placed within the larger context of Indigenous environmental knowledge formation, as it follows closely with that discovered through archival research and that described by other inquiries from around the world.
Syndromes of Water and Electrolyte Depletion of Intestinal Origin
Authors: Shields R. 
Published: January 2017

Because of the important part played by the intestine in maintaining the constancy of the internal environment, any disturbance in the orderly sequence of secretion and reabsorption of water and electrolytes can quickly lead to severe fluid depletion. Malabsorption of water and electrolytes may occur in diseases of the intestinal mucosa or following massive resection of bowel or as a result of disordered intestinal motility. The handling of fluids by the bowel may be altered by the action of hormones or of bacterial toxins, or in the presence of neoplasms. Electrolyte disorders may result from the introduction of abnormal solutions into the intestinal lumen. Management of the clinical problems requires a clear understanding of the abnormal mechanisms and urgent attention to the re-institution of water and salt balance, restoration of acid-base status and replacement of lost potassium.
The Effect of Acute Alcohol Withdrawal on the Serum Potassium and Total Body Potassium in Heavy Drinkers
Authors: Watson W S. , Lawson P. McN. , Beattie A. D. 
Published: January 2017

In a group of 20 patients with heavy alcohol intake a relation was found between withdrawal symptoms and fall in serum potassium. Total body potassium (TBK) was measured in all subjects and was lower in the group of subjects who displayed symptoms than in the group who did not. The subgroup of the four most severe reactors had a mean TBK value significantly less than the ‘non-reactor’ group. The minimum serum potassium levels observed for all subjects in the four day period following alcohol withdrawal correlated with their TBK values. We suggest that the mechanism for the serum potassium fall might be overactivity of the Na-K pump caused by ethanol consumption. There was also an association between withdrawal reaction and abnormal liver function and a transient rise in serum phosphate in the more severely reacting subjects.
An Analysis of Cases Incorrectly Coded as Inflammatory Bowel Disease in Scottish Hospital In-Patient Statistics (Ships)
Authors: Murchison J. , Barton J.R. , Ferguson A. 
Published: January 2017

As part of a large clinical and epidemiological study of inflammatory bowel disease (IBD), we examined the hospital case records of a sample (255) of the 1257 patients aged 0–20 years, recorded in Scottish Hospital In-Patient Statistics (SHIPS) for 1968–1983 as Crohn's disease (CD) or ulcerative colitis (UC). The coded diagnosis was incorrect at the time of coding in 47 instances (18.4% of the sample), for the following reasons: clinical diagnosis wrong (24 cases); IBD correctly diagnosed but wrongly coded as CD for UC or UC for CD (seven cases): various other clerical or computer errors (15 cases). One case that did not meet standard diagnostic criteria for CD at the time of coding was shown to be correctly labelled when confirmatory pathological information became available. In view of the influence of such statistics on the social and clinical management of chronic illnesses such as IBD, and in view of the impact of analysis of these data on the provision of services and allocation of resources, it is suggested that some indication of the degree of confidence in the clinical diagnosis (possible, probable, definite) should be incorporated in the information submitted for coding and should be reflected in the derived data.
Management of Hypertensive Crises
Authors: Isles C.G. 
Published: January 2017

Hypertensive crises are now uncommon in developed countries, and few doctors will have experience in their management. A review of the drugs used by clinicians in Scotland suggests considerable diversity in approach but broadly follows the best advice that is available in the literature. For emergencies such as hypertensive encephalopathy and hypertension associated with aortic dissection in which irreversible damage would occur within hours if left untreated, patients should probably be admitted to Intensive Care Units and be given nitroprusside. Similarly nitroprusside or nitroglycerin would be appropriate choices for hypertension that is complicated by acute left ventricular failure. By contrast if the risk to the patient is measured in days rather than hours then oral therapy will be quite sufficient. Atenolol or nifedipine retard can safely be given as initial treatment for uncomplicated malignant hypertension, and nifedipine retard can be used for the milder cases of encephalopathy or heart failure. The use of sublingual drugs in the management of hypertensive emergencies and urgencies cannot be recommended as the fall in blood pressure is both unpredictable and uncontrolled with the consequent and unacceptable risk of organ ischaemia.
Home Nebuliser Use in Children with Asthma in Two Scottish Health Board Areas
Authors: Madge P.J. , Nisbet L. , McColl J.H. , Vallance A. , Paton J.Y. , Beattie J.O. 
Published: January 2017

Objective: To audit the use of home nebulisers in children with asthma. Design: Postal questionnaire. Setting: Two Health Board Areas in Central Scotland-one large industrialised city, one mixed urban and rural. Subjects: 297 children with asthma. Measures evaluated: Initial supply and technical support for the compressor. Education: Pattern of drug usage. Symptom control: Monitoring and treatment of acute attacks. Results: The full burden of the home nebulised therapy is not being met by the NHS. Supply and servicing arrangements for home nebuliser therapy were poorly organised. Chronic asthma symptoms did not appear to be optimally controlled on present medication, with 61% reporting sleep disturbance in the previous three months. About 20% of parents admitted that they would give nebulised bronchodilator therapy more frequently than the recommended 3 to 4 hourly. Conclusion: Re-organisation of resources and arrangements could improve the service and bring it in line with recognised standards of care.
The Management of First Seizures in Adults in a District General Hospital
Authors: Morrison A.D. , McAlpine C.H. 
Published: January 2017

This study considered the management of first seizures in adults in Stirling Royal Infirmary over a six month period. Thirty-four patients presented of whom 19 were admitted to medical wards. Alcohol was implicated in 35% of cases. Blood tests were done in many but provided little useful information. CT Scan was performed in 53% and was abnormal in 15% (five patients). EEG was requested for 21% and failed to influence management in any. Six patients (18%) were started on anticonvulsant therapy. It was recorded in only three cases that advice on driving had been given. The literature concerning single seizures is complex, especially with regards to recurrence risk and treatment benefits. We await with interest the publication of the SIGN (Scottish Intercollegiate Guidelines Network) guidelines for seizure investigation and treatment in Scotland.
Silver Spoons and Golden Genes: Genetic Engineering and the Egalitarian Ethos
Authors: Fox Dov 
Published: January 2017

What mother or father does not want to give his or her child the best chance of leading a happy and successful life? Infertile couples today enlist assisted reproductive technologies (ARTs) such as in vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD) to handpick from among available gamete donors or embryo arrays to implant for gestation. As advances in genetic science permit increasing prenatal control over offspring traits, even fertile couples may choose to relocate procreation from the bedroom into the laboratory.The development of safe genetic therapies capable of curing debilitating conditions in embryos or fetuses would be unequivocal cause for celebration. Less straightforwardly worthy of embrace would be techniques that make it possible to choose offspring genes for non-health related characteristics, such as strength, intelligence, and memory. At present, neither state nor federal law regulates ARTs.
Can We Handle the Truth? Legal Fictions in the Determination of Death
Authors: Shah Seema K. , Miller Franklin G. 
Published: January 2017

AbstractAdvances in life-saving technologies in the past few decades have challenged our traditional understandings of death. People can be maintained on life-support even after permanently losing the ability to breathe spontaneously and remaining unconscious and unable to interact meaningfully with others. In part because this group of people could help fulfill the growing need for organ donation, there has been a great deal of pressure on the way we determine death. The determination of death has been modified from the old way of understanding death as occurring when a person stops breathing, her heart stops beating, and she is cold to the touch. Today, physicians determine death by relying on a diagnosis of total brain failure or by waiting a short while after circulation stops. Evidence has emerged that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from our biological and common-sense understandings of death.We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. However, the considerable debate over the determination of death in the medical and scientific literature has not informed the public of the fact that our current determinations of death do not adequately establish that a person has died. It seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution of acknowledging the legal fictions involved in determining death. This move in the direction of greater transparency may someday result in allowing us to face squarely these issues and effect the legal changes necessary to permit ethically appropriate vital organ transplantation. Finally, this paper also provides the beginnings of a taxonomy of legal fictions, concluding that a more systematic theoretical treatment of legal fictions is warranted to understand their advantages and disadvantages across a variety of legal domains.
Patient Data: Property, Privacy & the Public Interest
Authors: Rodwin Marc A. 
Published: January 2017

Changes in technology sometimes raise important public policy choices and require that we clarify key values and reexamine legal concepts. Such is the case with the development of electronic medical records (EMRs), which facilitate obtaining patient data from provider and insurer records. EMRs expand our ability to tap patient data and thereby create great potential benefits as well as risks. This new technology requires that we clarify the ambiguous property interests in patient data. How the law defines ownership of patient data will shape whether its benefits can be developed and also affects patient confidentiality.EMRs make it feasible to collect aggregate patient data that can be used to vastly improve medical knowledge, patient safety and public health. Researchers have long used patient data from clinical trials to evaluate the benefits and risks of drugs and medical therapy, compare their relative effectiveness, and analyze health care cost and quality.
Prometheus and Bilski: Pushing the Bounds of Patentable Subject Matter in Medical Diagnostic Techniques with the Machine-or-Transformation Test
Authors: Pessagno Stephen 
Published: January 2017

AbstractIf nature has made any one thing less susceptible than all others of exclusive property, it is the action of the thinking power called an idea, which an individual may exclusively possess as long as he keeps it to himself; but the moment it is divulged, it forces itself into the possession of every one, and the receiver cannot dispossess himself of it.
Protecting Scientific Integrity: The Commercial Speech Doctrine Applied to Industry Publications
Authors: Sax Joanna K. 
Published: January 2017

The pharmaceutical industry is a competitive business. Companies spend billions of dollars researching and developing new drugs. Many drugs never make it to market. For the limited drugs that make it through the experimental, regulatory, and clinical rigors of drug development, companies recoup their lost expenditures for the drugs that previously failed.Pharmaceutical companies face increasing pressure to bring new treatments to market in order to survive. The economic reality of survival and profits may distort a company's decision-making process regarding full disclosure on a particular new drug. An example of this type of conflict was seen in the silicone breast implant fiasco in the 1970s, 1980s, and 1990s. Dow Corning, the manufacturer of the implants, withheld important data from long-term animal models that demonstrated adverse effects from the breast implants. Further, Dow failed to conduct long-term studies on breast implants, even when armed with data indicating that such studies were necessary to ensure the continued health of the patients.
Commercial Speech and Off-Label Drug Uses: What Role for Wide Acceptance, General Recognition and Research Incentives?
Authors: Gilhooley Margaret 
Published: January 2017

This article provides an overview of how the constitutional protections for commercial speech affect the Food and Drug Administration's (FDA) regulation of drugs, and the emerging issues about the scope of these protections. A federal district court has already found that commercial speech allows manufacturers to distribute reprints of medical articles about a new off-label use of a drug as long as it contains disclosures to prevent deception and to inform readers about the lack of FDA review. This paper summarizes the current agency guidance that accepts the manufacturer's distribution of reprints with disclosures.Allergan, the maker of Botox, recently maintained in a lawsuit that the First Amendment permits drug companies to provide “truthful information” to doctors about “widely accepted” off-label uses of a drug. While the case was settled as part of a fraud and abuse case on other grounds, extending constitutional protections generally to “widely accepted” uses is not warranted, especially if it covers the use of a drug for a new purpose that needs more proof of efficacy, and that can involve substantial risks.A health law academic pointed out in an article examining a fraud and abuse case that off-label use of drugs is common, and that practitioners may lack adequate dosage information about the off-label uses. Drug companies may obtain approval of a drug for a narrow use, such as for a specific type of pain, but practitioners use the drug for similar uses based on their experience. The writer maintained that a controlled study may not be necessary to establish efficacy for an expanded use of a drug for pain. Even if this is the case, as discussed below in this paper, added safety risks may exist if the expansion covers a longer period of time and use by a wider number of patients. The protections for commercial speech should not be extended to allow manufacturers to distribute information about practitioner use with a disclosure about the lack of FDA approval. Distributions of information about unapproved uses should not be acceptable unless experts consider the expanded use to be generally recognized as safe and effective based on adequate studies.The last part of this paper considers the need to develop better research incentives to encourage more testing and post-market risk surveillance by drug makers on off-label uses of their drugs. Violations of the Federal Food Drug and Cosmetic Act (FFDCA) can be considered violations of the False Claims Act, which opens the way to fraud and abuse suits. The scale of penalties involved in these suits may lead to more examination of the scope of FDA regulation and commercial speech protections. Thus this symposium's consideration of these issues is timely and important.