bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why Has the Summertime Central U.S. Warming Hole Not Disappeared?
Authors: Eischeid J. K. , Hoerling M. P. , Quan X.-W. , Kumar A. , Barsugli J. , Labe Z. M. , Kunkel K. E. , Schreck C. J. , Easterling D. R. , Zhang T. , Uehling J. , Zhang X. 
Published: July 2023

Abstract
A cooling trend in summer (May–August) daytime temperatures since the mid-twentieth century over the central United States contrasts with strong warming of the western and eastern United States. Prior studies based on data through 1999 suggested that this so-called warming hole arose mainly from internal climate variability and thus would likely disappear. Yet it has prevailed for two more decades, despite accelerating global warming, compelling reexamination of causes that in addition to natural variability could include anthropogenic aerosol–induced cooling, hydrologic cycle intensification by greenhouse gas increases, and land use change impacts. Here we present evidence for the critical importance of hydrologic cycle change resulting from ocean–atmosphere drivers. Observational analysis reveals that the warming hole’s persistence is consistent with unusually high summertime rainfall over the region during the first decades of the twenty-first century. Comparative analysis of large ensembles from four different climate models demonstrates that rainfall trends since the mid-twentieth century as large as observed can arise (although with low probability) via internal atmospheric variability alone, which induce warming-hole-like patterns over the central United States. In addition, atmosphere-only model experiments reveal that observed sea surface temperature changes since the mid-twentieth century have also favored central U.S cool/wet conditions during the early twenty-first century. We argue that this latter effect is symptomatic of external radiative forcing influences, which, via constraints on ocean warming patterns, have likewise contributed to persistence of the U.S. warming hole in roughly equal proportion to contributions by internal variability. These results have important ramifications for attribution of extreme events and predicting risks of record-breaking heat waves in the region.

Significance Statement
Our paper makes a significant contribution to analysis of a cooling trend in summer (May–August) daytime temperatures since the mid-twentieth century over the central United States, contrasting with strong warming over the remainder of the United States and having important ramifications for assigning cause to and predicting record-breaking heat waves in the region. Observations and model simulations reveal the critical importance of hydrologic cycle change resulting from ocean–atmosphere impacts. Precipitation has increased substantially over the region as a result of atmospheric circulation trends consisting of generally lower pressure and cooler air advection into the region. The persistence of this pattern of increased rainfall/lower temperatures is likely due to near-equal contributions of external forcing (climate change) and internal climate variability.
A slow-burning crisis: Executive relations and the normalisation of distrust in Northern Ireland's ‘cash for ash’ fiasco
Authors: Rice Charis , Connaughton Bernadette , Ratcliffe Jenny , Somerville Ian 
Published: July 2023

This paper explores relationships between ministers, special advisers and civil servants through the lens of a high-profile government crisis in Northern Ireland (NI). Although political–administrative relationships are a mainstay of public administration research, we still have limited understanding of how these relationships feature and function within the ‘Westminster family’ of governance when operating within devolved institutions or post-conflict societies, nor of their role in crisis. We use Scott’s institutional pillars as an analytical framework and conduct a documentary analysis of public inquiry witness statements to explore the Renewable Heat Incentive crisis which led to the collapse of the NI legislature. Utilising a novel application of existing theory, we demonstrate that the implementation of the devolved, consociational power-sharing model incubated new governance norms, that prioritised and legitimised the agendas and actions of political actors (ministers and special advisers), over civil servants. Specifically, in understanding how relational norms – particularly distrust – feed public policy failure and institutional crisis, our findings contribute to this research area and to the broader public administration field. Government institutional crisis negatively impacts upon public service delivery and the wider health of democracy. Understanding such crises is an important first step in their amelioration. Points for practitioners Structural, systemic and day-to-day behavioural layering of distrust adversely impacts government professionals’ ability to recognise, communicate and respond to risk; this can create policy problems, which can escalate, unchecked, until they have become full-blown crises. In order to proactively mitigate crises in other public policy contexts, managers and teams should build in awareness raising, reflection and management processes to individual and operational performance reviews to improve relational norms, and prevent the normalisation of distrust.
AI, Concepts of Intelligence, and Chatbots: The “Figure of Man,” the Rise of Emotion, and Future Visions of Education
Authors: Baker Bernadette , Mills Kathy A. , McDonald Peter , Wang Liang 
Published: July 2023

Background: Artificial intelligence (AI) applications have been implemented across all levels of education, with the rapid developments of chatbots and AI language models, like ChatGPT, demonstrating the urgent need to conceptualize the key debates and their implications for a new era of learning and assessment. This adoption occurs in a context where AI is dramatically remapping “the human,” the purposes of schooling, and pedagogy. Focus of Study: The paper examines how different formulations of “human” became interwoven with the sliding signifier of “intelligence” through a series of violent exclusions, and how the shifting contour of “intelligence” produces uneven and unjust ontological scales undergirding both education and AI fields. Its purpose is to engage the education research community in dialogue about biases, the nature of ethics, and decision-making concerning AI in education. Research Design: This paper adapts a historical-philosophical method. It traces the effects of colonialism and racialization within humanism’s emergence through Sylvia Wynter’s historiography of “figure of Man,” especially via the invention of “intelligence,” which has linked education and computer science. It also investigates themes central to modern education such as justice, equity, and in/exclusion through a philosophical examination of the ontological scales of “human.” Conclusions: After outlining how “intelligence” has shifted from reason-as-morality to concepts of natural intelligence, we argue that current examples of AI in Education (AIEd), like classroom chatbots and social agents, constitute an intermediary point in the arc toward a new computational superintelligence—the emergence of man3—illustrating the opportunities, risks, and ethical issues in pedagogical applications based on emotion. We outline three differing visions of AIEd’s future, concluding with a series of provocations (onto-epistemological, practice-based, and purposes of schooling) that exceed such models and that, given rapid innovations in machine learning, require urgent consideration from multiple stakeholders.
“You want them to be partners in therapy, but that's tricky when they’re not there”: A qualitative study exploring caregiver involvement across the continuum of care during the early COVID pandemic
Authors: Wasilewski Marina B , Szigeti Zara , Sheppard Christine L , Minezes Jacqueline , Hitzig Sander L , Mayo Amanda L , Robinson Lawrence R , Lung Maria , Simpson Robert 
Published: July 2023

Objective Widespread visitor restrictions were implemented during the COVID-19 pandemic at acute and inpatient rehabilitation hospitals. Family caregivers were physically isolated from their loved ones, which challenged engagement in patient care and readiness for their role. Thus, we aimed to explore the involvement of family caregivers in COVID-19 patients as they journeyed across the care continuum during the early phase of the COVID-19 pandemic. Design We employed a qualitative descriptive approach. Participants We conducted interviews with family caregivers, COVID-19 patients, and healthcare providers between August 2020 and February 2021. Setting Participants were recruited from a single hospital network in Toronto, Ontario, Canada. Interviews were recorded and transcribed. Data were analyzed thematically. Results A total of 27 participants were interviewed—12 healthcare providers, 10 patients, and 5 family caregivers. Four themes were identified: (a) Caregivers were shut out in acute COVID care, (b) Patient discharge from inpatient rehabilitation was turbulent for caregivers, (c) Caregivers were unprepared to support loved ones in the community, and (d) Patient discharge to home was heavily dependent on caregiver availability. Conclusions Visitor restrictions prevent family caregivers from being physically present at patients’ bedside, leading to complex and detrimental impacts such as caregivers feeling that they were not engaged in their loved one's care planning until they were discharged. In turn, discharge to the community was met with several challenges including caregivers feeling underprepared and unsupported to meet their loved one's unique care requirements. This was exacerbated by a lack of community-based resources due to ongoing pandemic restrictions.
Immune checkpoints as potential theragnostic biomarkers for epithelial ovarian cancer
Authors: Habel Azza , Weili Xu , Hadj Ahmed Mariem , Stayoussef Mouna , Bouaziz Hanen , Ayadi Mouna , Mezlini Amel , Larbi Anis , Yaacoubi-Loueslati Basma 
Published: July 2023

Background Epithelial ovarian cancer (EOC) is the leading cause of death associated with gynecologic tumors. EOC is asymptomatic in early stages, so most patients are not diagnosed until late stages, highlighting the need to develop new diagnostic biomarkers. Mediators of the tumoral microenvironment may influence EOC progression and resistance to treatment. Aim To analyze immune checkpoints to evaluate them as theranostic biomarkers for EOC. Patients and methods Serum levels of 16 immune checkpoints were determined in EOC patients and healthy controls using the MILLIPLEX MAP® Human Immuno-Oncology Checkpoint Protein Magnetic Bead Panel. Results Seven receptors: BTLA, CD40, CD80/B7-1, GITRL, LAG-3, TIM-3, TLR-2 are differentially expressed between EOC and healthy controls. Serum levels of immune checkpoints in EOC patients are positively significantly correlated with levels of their ligands, with a higher significant correlation between CD80 and CTLA4 than between CD28 and CD80. Four receptors, CD40, HVEM, PD-1, and PD-L1, are positively associated with the development of resistance to Taxol-platinum-based chemotherapy. All of them have an acceptable area under the curve (>0.7). Conclusion This study has yielded a first panel of seven immune checkpoints (BTLA, CD40, CD80/B7-1, GITRL, LAG-3, TIM-3, TLR-2) associated with a higher risk of EOC and a second panel of four immune checkpoints (CD40, HVEM, PD-1, PD-L1) that may help physicians to identify EOC patients who are at high risk of developing resistance to EOC chemotherapy.
Relationship Between Resilience, Community Participation, and Successful Aging Among Older Adults in South Korea: Mediating Role of Community Participation
Authors: Kim Jung-Ran , Park Sangmi , Lee Chang Dae 
Published: July 2023

A high level of resilience is positively related to successful aging. However, interventions to increase resilience in older adults are not yet available. This study aimed to examine the mediating role of community participation in the relationship between resilience and successful aging. Data from 284 individuals aged 60 years and above were analyzed in this cross-sectional study. The pathways among resilience, community participation, and successful aging were statistically significant after controlling for sociodemographic characteristics, depression, disability, and chronic disease. The analysis revealed a partial mediating effect of community participation (unstandardized estimate = .01, p < .01), explaining 16.4% of the total effect of resilience on successful aging. Promoting community participation may be beneficial for enhancing successful aging in community-dwelling older adults. Further studies to examine the causal relationship between community participation and successful aging and to develop community services are recommended to use community resources as means to support successful aging.
Residents’ experiences of paternalism in nursing homes
Authors: Mortensen Anne Helene , Nåden Dagfinn , Karterud Dag , Lohne Vibeke 
Published: July 2023

Background Interest in strengthening residents’ autonomy in nursing homes is intensifying and professional caregivers’ experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in nursing homes and how being subject to paternalism affects residents’ dignity. Research question/aim This study explored how residents experience paternalism in nursing homes. Research design This study involved a qualitative interpretive design with participant observations and semi-structured interviews. The interpretations were informed by Gadamer’s hermeneutics. Participants and research context Eleven residents were interviewed after a period of participant observation in two nursing homes. Ethical considerations The study was performed in accordance with the Helsinki declaration. The Regional Ethics Committee (REK) permitted the researcher to perform participant observation in the nursing homes. The use of audio recordings of interviews was registered and supervised by Sikt - Norwegian Agency for Shared Services in Education and Research. The resident’s consent was assessed continuously. Three interviews were terminated for ethical reasons. Findings The resident interviews revealed that residents found it obvious for caregivers to possess the decision-making authority in nursing homes. When residents explained their views, three main themes emerged: (1) To be included even though caregivers make the decisions, (2) Surrender to dependency, and (3) Adherence to nursing home norms. Conclusions Residents submit to their caregivers and give caregivers the responsibility and function as leaders. Paternalism was experienced as dignifying in situations where it contributed to residents being able to live according to second order desires and values, and when it implied respect and appraisal of residents’ capabilities. Paternalism was experienced as debasing when residents felt left out, and when residents felt that their capabilities were underestimated. This also included their capability to withstand paternalistic influence.
Bibliometric Review of Research on Misinformation: Reflective Analysis on the Future of Communication
Authors: Pandey Swetabh , Ghosh Munmun 
Published: July 2023

The communication channels driving misinformation often carry the misinformation to elicit responses, which can turn into big threats. Users’ extensive availability and convenience in creating and facilitating user-provided content in online social media enable people with common interests, worldviews and narratives to come together and spread information/misinformation. This research aims to create an intellectual structure through reflective analysis that will help us identify the existing communication pattern that led to misinformation during recent times, also considering the pandemic times. This study analyses and reviews the emerging literature on misinformation using a bibliometric analysis approach. A total of 1,363 papers published from January 2008 to June 2022 from the Scopus database were extracted for analysis in VOS viewer, revealing 10 clusters derived from the keyword, finally coming under four broad themes. The findings revealed that the earlier studies in this area were more expressive and theoretical, and there is a need to provide simple and scientific solutions to counter the misinformation. Considering all possible adversities, this article draws concrete conclusions by offering directions and propositions to create more comprehensive systems and policies to drive a conclusive future.
A Real-World Disproportionality Analysis of Drug-Induced Immune Hemolytic Anemia in the FDA Adverse Event Reporting System
Authors: Tang Linlin , Ding Chuanhua , Li Hongying , Zhou Xueheng , Yin Guoqiang 
Published: July 2023

Background: Drug-induced immune hemolytic anemia (DIIHA) is a rare but potentially life-threatening pharmacogenic hematological adverse effect. Updating the risk of DIIHA among the currently available drugs based on spontaneously reported adverse event data is of great significance. Objective: This study aimed to identify the top 50 drugs associated with immune hemolytic anemia in adults as well as common drugs that could cause immune hemolytic anemia in children based on the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: We extracted adverse events (AE) in the FAERS database from Q1 2004 to Q3 2022 using Open vigil2.1. We use the high-level term “anaemias haemolytic immune” according to the Medical Dictionary for Regulatory Activities (MedDRA) Dictionary (version 24.0). The reported correlation between drugs and DIIHA risk was identified by reported odds ratio (ROR) and proportional reporting ratio (PRR). Results: There were 10500309 AEs in FAERS from 2004Q1 to 2022Q3, of which 2326 (0.02%) were DIIHA cases. The incidence of DIIHA is comparable between males and females. The most common drugs associated with DIIHA in adults and children are summarized according to the number of AE reports. The top 3 categories in terms of quantity of drugs are antineoplastic agents, immunosuppressants, and antibiotics for systemic use. The top 5 drugs in terms of ROR and PRR are alemtuzumab, daclizumab, fludarabine, busulfan, and bendamustine in adults, with entecavir, treosulfan, vinorelbine, pegademase, and alemtuzumab for children. Conclusions: Our study identified the most common drugs that could induce DIIHA in adults and children, as well as the respective ROR and PRR value to discover new drug signals. This study provides references to clinicians for the management of rare DIIHA.
Evaluation of glycopeptide prescription in high-risk febrile neutropenia: A monocentric study of North Africa
Authors: Boufrikha Wiem , Rakez Rim , Laabidi Baraa , Laatiri Mohamed Adnene 
Published: July 2023

Introduction High-risk febrile neutropenia (FN) is one of the main causes of morbidity and mortality in onco-hematology. The initiation of empirical antibiotic therapy is an emergency that can change the prognosis of some patients. Given the emergence of increasingly resistant Gram-positive bacteremia, glycopeptides, as an empirical treatment, have an important place in the management of high-risk FN. The aim of this study is to evaluate the appropriateness of glycopeptide prescription in high-risk FN patients. Methods This study was conducted in the Hematology Department of Fattouma Bourguiba University Hospital of Monastir, Tunisia. Patients with high-risk FN were enrolled during the period between January 1 and December 31, 2020. Results Of the 29 patients included in this study, 88 FN episodes were noted of which 39 episodes treated with glycopeptides were evaluated. Twenty-four febrile episodes were empirically treated with glycopeptides (27.3%) of which 17 prescriptions (70.8%) were appropriate according to the European Conference on Infection in Leukemia and the Infectious Diseases Society of America recommendations. A therapeutic escalation using glycopeptides was noted in 17% of cases and appropriately opted in 6 FN episodes (40%). Conclusion Prescriptions of glycopeptides were appropriate according to the international recommendations in 71% of the empirical prescriptions and in 40% of the therapeutic escalation using glycopeptides. In high-risk FN episodes, glycopeptides prescriptions should be rationalized and limited to the indications detailed in the international guidelines to control the emergence of multidrug-resistant bacteria.
Enablers and Barriers to the Scaling Up of Pneumococcal Conjugate Vaccine in India During the COVID-19 Pandemic: A Qualitative Study
Authors: Hora Rhythm , Ray Arindam , Mehra Rashmi , Priya Tanwi , Koshal Seema Singh , Agrawal Pankaj , Kaur Amanjot , Quadri Syed F , Deb Roy Arup 
Published: July 2023

Background: Pneumonia is one of the leading causes of death in under-5 children in India. This led the Ministry of Health & Family Welfare (MoHFW) in India to decide for the nationwide roll-out of the Pneumococcal Conjugate Vaccine (PCV). However, the introduction of PCV became more complex in the face of unprecedented challenges set forth by the COVID-19 pandemic. The study aims to assess enablers and barriers to the introduction of PCV in India during the pandemic. Methodology: Qualitative research approach involving key-informant interviews from John Snow India (JSI), the lead technical agency that supported MoHFW in the PCV expansion was employed to delineate the enablers and barriers. Principle of saturation was employed to derive the sample size. Thematic analysis using inductive approach was based on the modified World Health Organization (WHO) framework for new vaccine introduction impact on the Immunization and Health Systems, using NVIVO 12 qualitative data analysis software. Results: A total of 11 key informants (4 national-level program managers and 7 state technical officers) were telephonically interviewed. The study found social acceptance, lower cost of the vaccine, and intensive communication activities as potential enablers. Other enablers for PCV introduction included a robust vaccine supply-chain system, ample cold-chain space availability, and strong political commitment, despite the ongoing second wave. Further, the identified barriers included poor physical access, insufficient social mobilization, and limited advocacy along with a stretched workforce. Conclusion: The study delineated several enablers and barriers to introducing PCV in the country during the pandemic. The existing barriers in the PCV roll-out prompted the need to address these gaps, making key program-based recommendations to improve future new vaccine introductions during the pandemic.