bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-Resolution Hail Observations: Implications for NWS Warning Operations
Authors: Blair Scott F. , Laflin Jennifer M. , Cavanaugh Dennis E. , Sanders Kristopher J. , Currens Scott R. , Pullin Justin I. , Cooper Dylan T. , Deroche Derek R. , Leighton Jared W. , Fritchie Robert V. , Mezeul II Mike J. , Goudeau Barrett T. , Kreller Stephen J. , Bosco John J. , Kelly Charley M. , Mallinson Holly M. 
Published: April 2017

Abstract
A field research campaign, the Hail Spatial and Temporal Observing Network Effort (HailSTONE), was designed to obtain physical high-resolution hail measurements at the ground associated with convective storms to help address several operational challenges that remain unsatisfied through public storm reports. Field phases occurred over a 5-yr period, yielding hail measurements from 73 severe thunderstorms [hail diameter ≥ 1.00 in. (2.54 cm)]. These data provide unprecedented insight into the hailfall character of each storm and afford a baseline to explore the representativeness of the climatological hail database and hail forecasts in NWS warning products. Based upon the full analysis of HailSTONE observations, hail sizes recorded in Storm Data as well as hail size forecasts in NWS warnings frequently underestimated the maximum diameter hailfall occurring at the surface. NWS hail forecasts were generally conservative in size and at least partially calibrated to incoming hail reports. Storm mode played a notable role in determining the potential range of maximum hail size during the life span of each storm. Supercells overwhelmingly produced the largest hail diameters, with smaller maximum hail sizes observed as convection became progressively less organized. Warning forecasters may employ a storm-mode hail size forecast philosophy, in conjunction with other radar-based hail detection techniques, to better anticipate and forecast hail sizes during convective warning episodes.
Somatic symptoms are sensitive in predicting interstitial cystitis/bladder pain syndrome
Authors: Chen I-Chun , Lee MingHuei , Wu Shang-Liang , Lin Hsuan-Hung , Chang Kun-Min , Lin HsiuYing 
Published: April 2017

Objectives Somatic symptoms are somatic complaints accompanied by disproportionate thoughts, feelings, and behaviors related to such symptoms. The study investigated five International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses hallmarked by somatic symptoms. The study hypothesized an increased risk of interstitial cystitis/bladder pain syndrome in patients with somatic symptoms. Methods The raw data were obtained from a nationwide health insurance reimbursement database over a 12-year period from 2002 to 2013. The study followed a somatic symptoms cohort ( n = 34,393) and non-somatic symptoms cohort ( n = 637,999) for interstitial cystitis/bladder pain syndrome. Both cohorts were stratified into three subgroups based on propensity scores calculated by sex, age, and 17 comorbidities of interstitial cystitis/bladder pain syndrome. Results The incidence density of interstitial cystitis/bladder pain syndrome between the somatic symptoms cohort and non-somatic symptoms cohort was significantly different in the three subgroups (relative ratio [95% confidence interval], 2.14 [1.01, 4.53], 1.52 [1.47, 1.57], and 1.59 [1.28, 1.98], respectively). The adjusted hazard ratio for interstitial cystitis/bladder pain syndrome was significantly greater in the female-dominant and older age subgroups—subgroup 2 and subgroup 3 (adjusted hazard ratios, 1.47 [1.07, 2.01] and 1.72 [1.38, 2.16], respectively). Conclusion The longitudinal investigation identified a subsequent risk of interstitial cystitis/bladder pain syndrome in patients with somatic symptoms. Somatic symptoms might be linked to biological pathways that might increase the risk of interstitial cystitis/bladder pain syndrome, much like more traditional psychosocial factors.
Facial presentations of primary headache disorders
Authors: Sharav Yair , Katsarava Zaza , Charles Andrew 
Published: April 2017

Background Many patients with mid-face or lower face craniofacial pain are diagnosed, based on accompanying signs and symptoms and features other than location, as either atypical migraines or atypical TACs. Distinguishing features of headache disorders as a cause of facial pain include the temporal pattern of pain, associated symptoms including light and sound sensitivity and nausea, cranial autonomic symptoms, and the lack of local triggering among others. Results An intraoral neurovascular pain has been observed, and was termed neurovascular orofacial pain (NVOP). Due to its location, and signs imitating dental pulpitis, it has great diagnostic and therapeutic importance for differentiating NVOP from dental pathology. The hypothesized mechanism is neurogenic inflammatory activation within the space confined by dentine around the dental pulp, expressed in strong paroxysmal pain and typical allodynia to cold foods. Conclusion Facial manifestations of headache disorders and primary facial pain disorders share common trigeminal nerve input, yet they are highly distinct disorders. Somatotopic segregation may occur at the level of the trigeminal nucleus, thalamus, and somatosensory cortex, and distinct ionic or neurochemical signaling pathways may be involved. Further investigation of facial presentations of headache disorders has the potential to provide new insight into the interface between headache and facial pain.
Conscience, conscientious objection, and nursing: A concept analysis
Authors: Lamb Christina , Evans Marilyn , Babenko-Mould Yolanda , Wong Carol A , Kirkwood Ken W 
Published: April 2017

Background: Ethical nursing practice is increasingly challenging, and strategies for addressing ethical dilemmas are needed to support nurses’ ethical care provision. Conscientious objection is one such strategy for addressing nurses’ personal, ethical conflicts, at times associated with conscience. Exploring both conscience and conscientious objection provides understanding regarding their implications for ethical nursing practice, research, and education. Research aim: To analyze the concepts of conscience and conscientious objection in the context of nurses. Design: Concept analysis using the method by Walker and Avant. Research context: Data were retrieved from Philosopher’s Index, PubMed, and CINAHL with no date restrictions. Ethical consideration: This analysis was carried out per established, scientific guidelines. Findings: Ethical concepts are integral to nursing ethics, yet little is known about conscientious objection in relation to conscience for nurses. Of note, both concepts are well established in ethics literature, addressed in various nursing codes of ethics and regulatory bodies, but the meaning they hold for nurses and the impact they have on nursing education and practice remain unclear. Discussion and conclusion: This article discusses the relevance of conscience and conscientious objection to ethical nursing practice and proposes a model case to show how they can be appreciated in the context of nurses. Conscientious objection is an option for ethical transparency for nurses but is situated in contentious discussions over its use and has yet to be fully understood for nursing practice. Conscience is an element in need of more exploration in the context of conscientious objection. Further research is warranted to understand how nurses respond to conscience concerns in morally, pluralistic nursing contexts.
Long-term Outcomes Following Syme’s Amputation
Authors: Finkler Elissa S. , Marchwiany Daniel A. , Schiff Adam P. , Pinzur Michael S. 
Published: April 2017

Background: The metabolic cost of walking after Syme’s ankle disarticulation amputation is minimally more than that for nonamputation. The ability to end weightbearing makes prosthetic fitting relatively simple, and very few patients require extensive rehabilitation or placement in a skilled nursing or rehabilitation facility. In spite of these potential benefits, there is a paucity of objective information on the actual long-term outcomes. Methods: Fifty-one patients were identified who underwent single-stage Syme’s ankle disarticulation amputation with excision of the lateral and medial malleoli by a single surgeon during a 23-year period. None of these patients had sufficient tissue to allow amputation at the transmetatarsal or tarsometatarsal levels. Thirty-three underwent amputation due to a diabetic forefoot infection, 11 secondary to a crush injury, 3 for a nondiabetic infection, 3 for a noncorrectable acquired deformity, and 1 for neoplasm. The average age at surgery for the diabetic patients was 62.1 years (range, 36-81 years), with an average follow-up of 6.8 years (range, 4.0-11.6 years). The nondiabetic patients had an average age of 37.8 years (range, 21-65 years), with an average follow-up of 9.3 years (range, 2.2-25.0 years). Patients who were alive and could be contacted were invited to complete the Short Musculoskeletal Function Assessment (SMFA) questionnaire that was scored for functional, mobility, and bothersome indices. Results: Seventeen of the 33 diabetic patients died. Four (12.1%) were converted to transtibial amputation. One of the nondiabetic patients died, and 1 (5.5%) was converted to transtibial amputation. Eleven of the 33 patients who were contacted completed the SMFA. All of these patients demonstrated favorable outcome scores in the mobility, functional, and bothersome indices (average mobility index of 17.2, functional index of 14.7, and bothersome index of 16.7 for nondiabetic patients compared to 34.7, 29.9, and 30.6 for diabetic patients, respectively). Conclusion: The objective information derived from this investigation supports the opinion that patients who underwent Syme’s ankle disarticulation amputation appear to fare better than similar patients with transtibial amputation. These data also refute the notion of high complication rates and difficulties with prosthetic fitting. These patients required less rehabilitation and achieved improved levels of functional independence as demonstrated by favorable functional, mobility, and bothersome indices. Level of Evidence: Therapeutic Level IV, retrospective series.
Organizational Inertia and Vulnerability – Alcoholics Anonymous in the Swedish Welfare State
Authors: Bergmark Karin Helmersson 
Published: April 2017

The first stable AA group in Sweden was founded in 1953. For many years Swedish AA lived in the shadow of a successful dissident movement, the Links. Thereby thousands of alcoholics got acquainted with the disease concept and with other parts of the AA ideology. The introduction of the Minnesota Model for alcohol treatment in the 1980s coincided with a general transition towards a market economy and the demands for professionalism in treatment. The impact of these changes on the Swedish AA should not be underestimated. The development had a turbo effect on it. This time the changes outside of AA worked in favour of the movement. Instead of vanishing in the shadow of the Links, AA was triumphantly revived by way of the Minnesota Model for treatment. The peculiar organizational characteristics of AA are central to the discussion in this article. It suggests that the organizational form of AA (the cell structure) and the genetic code (the Traditions) imply that AA will always be vulnerable to external circumstances. AA cannot act to protect itself. That is to say, the organizational form of AA inhibited, in Sweden, its defence against the growth of hybrid movements such as the Links. The mere existence of the Links delayed the development of AA in such a way that Swedish AA became closely connected to the professional 12-step treatment, a fact which in itself might have strongly influenced the character of the Swedish AA movement.
Nordic, Italian, and German Drinking Habits: A Comparison between Surveys Made since the 1980s
Authors: Hanhinen Sari 
Published: April 2017

This article compares Nordic drinking habit surveys and their results — a comparison previously done in 1988. It includes all the main surveys regarding drinking habits of the adult population in the Nordic countries since 1988. In addition the analysis takes in Italy and Germany. Drinking habits are described and compared on four dimensions: the share of abstainers and drinkers, overall drinking frequency, the volume of alcohol consumption, and heavy drinking and drinking for intoxication. The study highlights the difficulties inherent in the international comparison of drinking habits. The results indicate that even though the changes in beverage preferences imply a homogenization of drinking patterns, the homogenization hypothesis proves to be wrong when comparing the results concerning the shares of abstainers, drinking frequencies or distribution of alcohol consumption between women and men. Denmark still differs from the rest of the Nordic countries in these respects, being closer to central European countries like Germany. In the other Nordic countries traditional drinking patterns seem to persist despite the changes in beverage preferences. Closest to Denmark and central European countries stands Finland, where drinking frequency has been rising and where more alcohol is consumed than in Sweden, Norway and Iceland. Looking at the previous comparison of Nordic drinking habits, it can be concluded that drinking habits are very open to changes.
The EU challenge: New Organization and Culture around Psychotropic Prescription Drugs in the Nordic Count
Authors: Jensen Thor øivind , Berner David 
Published: April 2017

The complicated balance, including the formal system, that regulates patterns of psychotropic drug usage in the Nordic countries is under rapid change. The European Union is the main agent of change. The general public, the politicians, the administrators and health professionals all seem to agree that consumption is too high and the awareness of this problem has been rising in recent years. This coincides with the European integration process. It is suggested in the article that the Nordic tendencies to have a paternalistic “health” regulatory system will be replaced by a “market” organized system, emphasizing free competition, consumer rigths, legal decisions and industry interests. One result will be a larger and unpredictable assortment; another probable result is higher and more complicated structured usage patterns. The old system of national health authorities as the main regulatory actor will be seriously weakened. The challenge of solving the problem of managing and reducing consumption of addictive drugs is difficult, and social regulation must rely on new tools. Local and regional authorities and organizations will have a central role, as well as patient organizations and public and professional debate. The final outcome is unpredictable, but one thing is clear, it will be a significantly different structure.
Travellers' Imports of Alcohol into Finland: Changes Caused by Finnish EU Membership
Authors: Österberg Esa , Pehkonen Juhani 
Published: April 2017

The article examines the development in travellers' imports of alcoholic beverages into Finland from 1994 to 1995, the year that Finland became a member of EU. The membership, beginning January 1st 1995, included provisions for increased allowances in travellers' tax-free import of alcoholic beverages and lifted time-limits restricting imports. These provisions have clearly increased the imported volumes, most sharply for beer, from 3.5 million litres in 1994 to around 30 million litres in 1995. The import of spirits increased from 3 million litres in 1994 to 7 million litres in 1995. It is estimated that the import of wines increased from 3.5 million litres in 1994 to 9 million litres in 1995. In 1994 travellers' imports added 6 % and in 1995 17 % to the recorded consumption of alcohol. There were no significant changes in the frequency of air travel or of trips between Finland and Sweden. In contrast, tourism to Russia and Estonia increased dramatically. The relaxed import restrictions were an important factor in this development. Most of the increase in beer imports and the bulk of the increase in wine and spirits imports derive from tourism to these two countries. The article also discusses different ways of estimating travellers' alcohol imports, and proposes how this issue should be studied in the future.
The effect of PDE5 inhibitors on bone and oxidative damage in ovariectomy-induced osteoporosis
Authors: Alp Hamit H , Huyut Zübeyir , Yildirim Serkan , Başbugan Yıldıray , Ediz Levent , Şekeroğlu Mehmet R 
Published: April 2017

Osteoporosis is a major public health problem associated with many factors, and it affects more than 50% of women over 50 years old. In the current study, our purpose was to investigate the effects of phosphodiestarase-5 inhibitors on osteoporosis via the nitric oxide/3′,5′-cyclic guanosine monophosphate/protein kinase G signalling pathway. A total of 50 female albino Wistar rats were separated into five groups. The first group was appointed as the healthy control group with no ovariectomy. All animals in the other groups underwent a bilateral ovariectomy. Six months after the ovariectomy, vardenafil, udenafil and tadalafil were given to the third, fourth and fifth groups, respectively, but were not administered to the positive control group (10 mg/kg per day for two months). The bone mineral density values were determined using a densitometry apparatus for all groups pre- and post-ovariectomy as well as after treatment. The levels of nitric oxide, endothelial nitric oxidesynthase, asymmetric dimethylarginine, 3′,5′-cyclic guanosine monophosphate, protein kinase G, phosphodiestarase-5, pyridinoline, deoxypyridinoline, carboxyterminal telopeptide fragments and plasma carboxy terminal propeptide of type I collagen were determined using an enzyme linked immunosorbent assay. The levels of malondialdehyde, 8-hydroxy-2-deoxy guanosine, deoxyguanosine and coenzyme Q10 were determined by a high-performance liquid chromatography assay. Additionally, the right femoral trabecular bone density and the epiphyseal plate were measured in all groups. Angiogenesis was histologically observed in the bone tissue. In addition, we determined that the inhibitors may have caused a positive impact on the increased bone mass density and reduction of bone resorption markers. We also observed the positive effects of these inhibitors on oxidative stress. In conclusion, these phosphodiestarase-5 inhibitors increase angiogenesis in bone tissue and improve the re-formation rate of bone in rats with osteoporosis. Chemical compounds studied in this article Udenafil (PubChem CID: 6918523); Tadalafil (PubChem CID: 110635); Vardanafil (PubCham CID: 110634). Impact statement The results in our study appear to establish the osteoporosis model and provide evidence of the positive effects of three separate PDE5 inhibitors (vardenafil, udenafil, and tadalafil). The positive effects of these PDE5 inhibitors are investigated and demonstrated by the bone mass density and bone resorption markers. These effects are associated with significant demonstrated antioxidant activities. Osteoporosis is a significant major public health problem especially in more aged populations. Advances in identifying and understanding new potential therapeutic modalities for this disease are significant. This study provides such an advance.
Effectiveness of Manual Therapy and Stretching for Baseball Players With Shoulder Range of Motion Deficits
Authors: Bailey Lane B. , Thigpen Charles A. , Hawkins Richard J. , Beattie Paul F. , Shanley Ellen 
Published: April 2017

Background: Baseball players displaying deficits in shoulder range of motion (ROM) are at increased risk of arm injury. Currently, there is a lack of consensus regarding the best available treatment options to restore shoulder ROM. Hypothesis: Instrumented manual therapy with self-stretching will result in clinically significant deficit reductions when compared with self-stretching alone. Study Design: Controlled laboratory study. Methods: Shoulder ROM and humeral torsion were assessed in 60 active baseball players (mean age, 19 ± 2 years) with ROM deficits (nondominant − dominant, ≥15°). Athletes were randomly assigned to receive a single treatment of instrumented manual therapy plus self-stretching (n = 30) or self-stretching only (n = 30). Deficits in internal rotation, horizontal adduction, and total arc of motion were compared between groups immediately before and after a single treatment session. Treatment effectiveness was determined by mean comparison data, and a number-needed-to-treat (NNT) analysis was used for assessing the presence of ROM risk factors. Results: Prior to intervention, players displayed significant ( P < 0.001) dominant-sided deficits in internal rotation (−26°), total arc of motion (−18°), and horizontal adduction (−17°). After the intervention, both groups displayed significant improvements in ROM, with the instrumented manual therapy plus self-stretching group displaying greater increases in internal rotation (+5°, P = 0.010), total arc of motion (+6°, P = 0.010), and horizontal adduction (+7°, P = 0.004) compared with self-stretching alone. For horizontal adduction deficits, the added use of instrumented manual therapy with self-stretching decreased the NNT to 2.2 (95% CI, 2.1-2.4; P = 0.010). Conclusion: Instrumented manual therapy with self-stretching significantly reduces ROM risk factors in baseball players with motion deficits when compared with stretching alone. Clinical Relevance: The added benefits of manual therapy may help to reduce ROM deficits in clinical scenarios where stretching alone is ineffective.
Creating a New System of Supports: The Vermont Self-Determination Project
Authors: Aichroth Sue , Carpenter Jeremy , Daniels Kim , Grassette Patty , Kelly Darlene , Murray Amie , Rice Joanne , Rivard Bob , Smith Cindy , Smith Phil , Topper Karen 
Published: April 2017

The Vermont Self-Determination Project is a model program for enhancing the self-determination of people with developmental disabilities in a rural state. Definitions of self-determination differ in a larger political perspective from those used in systems of supports and for people with disabilities. A brief historical overview demonstrates individualized funding and self-managed supports in Canada and the United States. Rural Vermont's developmental services system enhances opportunities for self-determination through the unique program qualities of the Self-Determination Project. These qualities include circles of support, facilitating self-advocacy, system-wide change, and a triad team approach, in addition to approaches to self-determination that include self-management and self-direction. Significant project outcomes point to areas for future exploration by rural as well as urban researchers and practicioners.