bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced Interannual Variability in Temperature during the Last Glacial Maximum
Authors: Shi Jiawen , Jiang Dabang , Tian Zhiping , Lang Xianmei 
Published: May 2022

Abstract
Using all relevant climate experiments archived in phases 3 and 4 of the Paleoclimate Modeling Intercomparison Project (PMIP3/4), we examine the interannual variability change in global-scale surface air temperature and associated physical mechanisms during the Last Glacial Maximum (LGM). The results show that relative to the preindustrial period, the LGM interannual temperature variability increased by 20% globally, which was mainly attributed to the large-scale increase in the meridional temperature gradient, especially at midlatitudes. Larger magnitudes of change occurred in areas where the underlying surface properties, such as the surface altitude, land–sea distribution, and ice sheet extent, differed from those in the preindustrial period. In addition, the relationship between changes in the meridional temperature gradient and the interannual temperature variability became closer in the winter hemisphere. In the tropical land regions, changes in interannual temperature variability are mainly related to the adjustment of latent and sensible heat fluxes during the LGM.
Future Changes in African Heatwaves and Their Drivers at the Convective Scale
Authors: Birch C. E. , Jackson L. S. , Finney D. L. , Marsham J. M. , Stratton R. A. , Tucker S. , Chapman S. , Senior C. A. , Keane R. J. , Guichard F. , Kendon E. J. 
Published: May 2022

Abstract
The future change in dry and humid heatwaves is assessed in 10-yr pan-African convective-scale (4.5 km) and parameterized convection (25 km) climate model simulations. Compared to reanalysis, the convective-scale simulation is better able to represent humid heatwaves than the parameterized simulation. Model performance for dry heatwaves is much more similar. Both model configurations simulate large increases in the intensity, duration, and frequency of heatwaves by 2100 under RCP8.5. Present-day conditions that occur on 3–6 heatwave days per year will be normal by 2100, occurring on 150–180 days per year. The future change in dry heatwaves is similar in both climate model configurations, whereas the future change in humid heatwaves is 56% higher in intensity and 20% higher in frequency in the convective-scale model. Dry heatwaves are associated with low rainfall, reduced cloud, increased surface shortwave heating, and increased sensible heat flux. In contrast, humid heatwaves are predominately controlled by increased humidity, rainfall, cloud, longwave heating, and evaporation, with dry-bulb temperature gaining more significance in the most humid regions. Approximately one-third (32%) of humid heatwaves commence on wet days. Moist processes are known to be better represented in convective-scale models. Climate models with parameterized convection, such as those in CMIP, may underestimate the future change in humid heatwaves, which heightens the need for mitigation and adaptation strategies and indicates there may be less time available to implement them to avoid future catastrophic heat stress conditions than previously thought.

Significance Statement
Temperatures are higher in dry heatwaves, but humid heatwaves can be more dangerous, as the ability to cool by sweating is limited. We found that dry heatwaves are caused by decreased cloud, allowing the sun to heat the surface, whereas humid heatwaves are caused by increased cloud, rainfall, and evaporation from the surface. We found that a state-of-the-art very high-resolution climate model predicts a larger future change in humid heatwaves compared to a more traditional global climate model. Previous estimates of the prevalence of humid heatwaves in the future may therefore be underestimated. If we do not cut emissions of greenhouse gases, present-day African heatwave conditions could be experienced on up to half of all days of the year by 2100.
The Arctic Surface Heating Efficiency of Tropospheric Energy Flux Events
Authors: Cardinale Christopher J. , Rose Brian E. J. 
Published: May 2022

Abstract
This paper examines the processes that drive Arctic anomalous surface warming and sea ice loss during winter-season tropospheric energy flux events, synoptic periods of increased tropospheric energy flux convergence (Ftrop), using the NASA MERRA-2 reanalysis. During an event, a poleward anomaly in Ftrop initially increases the sensible and latent energy of the Arctic troposphere; as the warm and moist troposphere loses heat, the anomalous energy source is balanced by a flux upward across the tropopause and a downward net surface flux. A new metric for the Arctic surface heating efficiency (Etrop) is defined, which measures the fraction of the energy source that reaches the surface. Composites of high-, medium-, and low-efficiency events help identify key physical factors, including the vertical structure of Ftrop and Arctic surface preconditioning. In high-efficiency events (Etrop ≥ 0.63), a bottom-heavy poleward Ftrop occurs in the presence of an anomalously warm and unstratified Arctic—a consequence of decreased sea ice—resulting in increased vertical mixing, enhanced near-surface warming and moistening, and further sea ice loss. Smaller Etrop, and thus weaker surface impacts, are found in events with anomalously large initial sea ice extent and more vertically uniform Ftrop. These differences in Etrop are manifested primarily through turbulent heat fluxes rather than downward longwave radiation. The frequency of high-efficiency events has increased from the period 1980–99 to the period 2000–19, contributing to Arctic surface warming and sea ice decline.
Sea Surface Salinity Changes in Response to El Niño–like SST Warming and Relevant Ocean Dynamics in the Tropical Pacific under the CMIP6 Abrupt-4XCO2 Scenario
Authors: Sun Qiwei , Du Yan 
Published: May 2022

Abstract
Based on the abrupt-4XCO2 scenario in phase 6 of the Coupled Model Intercomparison Project (CMIP6), this study investigates the response of the rainfall changes to El Niño–like SST warming and the role of ocean dynamical processes in the salinity changes in the tropical Pacific. The results show that the Walker circulation weakening and eastward shift, related to El Niño–like SST warming, dominates the zonal precipitation change. Precipitation decreases (increases) in the Maritime Continent (the equatorial Pacific), partly offsetting the effect of specific humidity. At the same time, the El Niño–like warming triggers convergence of meridional winds, which leads to a precipitation increase in the equatorial Pacific and a decrease in the intertropical convergence zone and the South Pacific convergence zone, following the “warmer-get-wetter” mechanism. Unlike the spatial pattern of precipitation changes, the sea surface salinity changes become fresher in the tropical western Pacific, related to the precipitation and the mean horizontal advection. The precipitation increase leads to negative salinity anomalies in the equatorial central Pacific. The westward climatological zonal currents transport the negative salinity anomalies westward. The meridional currents advect the salinity anomalies to both sides of the equator, partly offsetting the contribution of the freshwater flux on the salinity change. In addition, shallower mixed layer depth and weakening upwelling bring less high-salinity water to the surface and impact salinity redistribution through the vertical process in the equatorial regions.
The moral foundations of restraint: Partisanship, military training, and norms of civilian protection
Authors: Bell Andrew M , Gift Thomas , Monten Jonathan 
Published: May 2022

How does partisan identification shape the attitudes of US military officers toward the protection of civilians in war? Drawing on unique cross-cohort surveys of soon-to-be commissioned officers in 12 Army Reserve Officers’ Training Corps (ROTC) training battalions, we find that Democratic-leaning cadets generally prioritize norms of civilian protection more than Republican-leaning cadets when confronted with competing values of military advantage and force protection as part of a ‘combatant’s trilemma’. This gap remains partially resilient after sustained exposure to military training and socialization, including in the norms of restraint embodied by principles of combat ethics and the law of war. We attribute these partisan differences to insights from Moral Foundations Theory (MFT), which suggests that the moral values of Democrats and Republicans guide their views toward the individual use of force in combat. Our findings have important implications for comprehending the impact of political ideology and military training and socialization on attitudes regarding restraint toward civilians in war. Given the widely recognized conservative composition of the US military’s membership, these findings may help to further inform understanding of US military operations and the underlying causes of US adherence to – or violation of – the laws of armed conflict.
Combined Use of Glucose-Specific Model Identification and Alarm Strategy Based on Prediction-Funnel to Improve Online Forecasting of Hypoglycemic Events
Authors: Faccioli Simone , Prendin Francesco , Facchinetti Andrea , Sparacino Giovanni , Del Favero Simone 
Published: May 2022

Background: Advanced decision support systems for type 1 diabetes (T1D) management often embed prediction modules, which allow T1D people to take preventive actions to avoid critical episodes like hypoglycemia. Real-time prediction of blood glucose (BG) concentration relies on a subject-specific model of glucose-insulin dynamics. Model parameter identification is usually based on the mean square error (MSE) cost function, and the model is usually used to predict BG at a single prediction horizon (PH). Finally, a hypo-alarm is raised if the predicted BG crosses a threshold. This work aims to show that real-time hypoglycemia forecasting can be improved by leveraging: a glucose-specific mean square error (gMSE) cost function in model’s parameters identification, and a “prediction-funnel,” that is, confidence intervals (CIs) for multiple PHs, within the hypo-alarm-raising strategy. Methods: Autoregressive integrated moving average with exogenous input (ARIMAX) models are selected to illustrate the proposed solution (use of gMSE and prediction-funnel) and its assessment against the conventional approach (MSE and single PH). The gMSE penalizes the model misfit in unsafe BG ranges (e.g., hypoglycemia), and the prediction-funnel allows raising an alarm by monitoring if the CIs cross a suitable threshold. The algorithms were evaluated by measuring precision ( P), recall ( R), F1-score ( F1), false positive per day (FP/day), and time gain (TG) on a real dataset collected in 11 T1D individuals. Results: The best performance is achieved exploiting both the gMSE and the prediction-funnel: P = 65%, R = 88%, F1 = 75%, FP/day = 0.29, and mean TG = 15 minutes. Conclusions: The combined use of a glucose-specific metric and an alarm-raising strategy based on the prediction-funnel allows achieving a more effective and reliable hypoglycemia prediction algorithm.
Oblique Cutting Based Mechanical Model for Insertion Torque of Dental Implant
Authors: Li Luli , Zhang Song , Li Quhao , Bian Cuirong , Zhang Airong 
Published: May 2022

AbstractThe insertion torque of a dental implant is an important indicator for the primary stability of dental implants. Thus, the preoperative prediction for the insertion torque is crucial to improve the success rate of implantation surgery. In this present research, an alternative method for prediction of implant torque was proposed. First, the mechanical model for the insertion torque was established based on an oblique cutting process. In the proposed mechanical model, three factors, including bone quality, implant geometry and surgical methods were considered in terms of bone-quality coefficients, chip load and insertion speeds, respectively. Then, the defined bone-quality coefficients for cancellous bone with the computed tomography (CT) value of 235–245, 345–355 and 415–425 Hu were obtained by a series of insertion experiments of IS and ITI implants. Finally, the insertion experiments of DIO implants were carried out to verify the accuracy of developed model. The predicted insertion torques calculated by the mechanical model were compared with those acquired by insertion experiments, with good agreement, the relative error being less than 15%. This method allows the insertion torque for different implant types to be quickly established and enhances prediction accuracy by considering the effects of implants’ geometries and surgical methods.
In-vitro and in-silico antibacterial activity of Azadirachta indica (Neem), methanolic extract, and identification of Beta.d-Mannofuranoside as a promising antibacterial agent
Authors: Altayb Hisham N. , Yassin Nijood F. , Hosawi Salman , Kazmi Imran 
Published: May 2022

Abstract
Background
Antimicrobial resistance became the leading cause of death globally, resulting in an urgent need for the discovery of new, safe, and efficient antibacterial agents. Compounds derived from plants can provide an essential source of new types of antibiotics. A. indica (neem) plant is rich in antimicrobial phytoconstituents. Here, we used the sensitive and reliable gas chromatography-mass spectrometry (GC–MS) approach, for the quantitative and quantitative determination of bioactive constituents in methanolic extract of neem leaves grown in Sudan. Subsequently, antibacterial activity, pharmacokinetic and toxicological properties were utilized using in silico tools.

Results
The methanolic extract of neem leaves was found to have antibacterial activity against all pathogenic and reference strains. The lowest concentration reported with bacterial activity was 3.125%, which showed zones of inhibition of more than 10 mm on P. aeruginosa, K. pneumoniae, Citrobacter spp., and E. coli, and 8 mm on Proteus spp., E. faecalis, S. epidermidis, and the pathogenic S. aureus. GC–MS analysis revealed the presence of 30 chemical compounds, including fatty acids (11), hydrocarbons (9), pyridine derivatives (2), aldehydes (2), phenol group (1), aromatic substances (1), coumarins (1), and monoterpenes (1). In silico and in vitro tools revealed that.beta.d-Mannofuranoside, O-geranyl was the most active compound on different bacterial proteins. It showed the best docking energy (-8 kcal/mol) and best stability with different bacterial essential proteins during molecular dynamic (MD) simulation. It also had a good minimum inhibitory concentration (MIC) (32 μg/ml and 64 μg/ml) against S. aureus (ATCC 25,923) and E. coli (ATCC 25,922) respectively.

Conclusion
The methanolic extract of A. indica leaves possessed strong antibacterial activity against different types of bacteria. Beta.d-Mannofuranoside, O-geranyl was the most active compound and it passed 5 rules of drug-likeness properties. It could therefore be further processed for animal testing and clinical trials for its possible use as an antibacterial agent with commercial values.
Elevated effluent potassium concentrations predict the development of postreperfusion hyperkalemia in deceased liver transplantation: a retrospective cohort study
Authors: Zhang Liang , Xue Fu-Shan , Tian Ming , Zhu Zhi-Jun 
Published: May 2022

Abstract
Background
Postreperfusion hyperkalemia (PRHK) has garnered increasing attention in regard to deceased liver transplantation (LT), especially for LT using the expanded criteria donor grafts. However, the impact of the effluent potassium (eK+) concentration on PRHK has been largely overlooked. We evaluated whether elevated eK+ concentrations are associated with PRHK in deceased LT.

Methods
In this single-institution, retrospective cohort study, we included all adults who underwent deceased LT with intraoperative eK+ concentration monitoring between November 2016 and December 2018. The eK+ concentrations were obtained from the effluent samples collected following a standard portal vein flush. PRHK was defined as any serum potassium (sK+) level of > 5.5 mmol/L following reperfusion. Logistic regression was performed to identify predictors for PRHK, and linear regression was used to examine predictors of the maximum percentage increase in the sK+ level following reperfusion.

Results
Of the 86 patients who met the inclusion criteria, 54 (62.8%) developed PRHK. Independent predictors for PRHK included greater graft weight (OR 1.283 [95% CI 1.029–1.599] per 100 g, P = 0.027), an elevated eK+ concentration (OR 1.291 [95% CI 1.068–1.561] per mol/L, P = 0.008), and a higher sK+ level before reperfusion (OR 4.459 [95% CI 1.543–12.884] per mol/L, P = 0.006). An eK+ concentration of more than 6.9 mmol/L had a sensitivity of 59.26% and a specificity of 78.12% for predicting PRHK (area under the receiver operating characteristic curve, 0.694). Multiple linear regression analyses indicated that the eK+ and sK+ levels before reperfusion were significant predictors of the maximum percentage increase in the sK+ level following reperfusion. In addition, PRHK was associated with an increased risk of postreperfusion significant arrhythmias, severe postreperfusion syndrome, and postoperative early allograft dysfunction.

Conclusions
This study shows that the eK+ concentration could predict the risk of PRHK in deceased LT. Further prospective studies are warranted to clarify these associations.
Relationship between risk, cumulative burden of exacerbations and mortality in patients with COPD: modelling analysis using data from the ETHOS study
Authors: Rhodes Kirsty , Jenkins Martin , de Nigris Enrico , Aurivillius Magnus , Ouwens Mario 
Published: May 2022

Abstract
Background
The major drivers of cost-effectiveness for chronic obstructive pulmonary disease (COPD) therapies are the occurrence of exacerbations and deaths. Exacerbations, including acute and long-term events, can cause worsening of COPD and lead to an increased risk of further exacerbations, and ultimately may elevate the risk of death. In contrast to this, health economic models are based on COPD severity progression. In this post hoc analysis of the ETHOS study, we focus on the progression of COPD due to exacerbations and deaths.

Methods
We fitted semi-parametric and fully parametric multi-state Markov models with the following five progressive states: State 1, no exacerbation; State 2, 1 moderate exacerbation; State 3, ≥ 2 moderate exacerbations; State 4, ≥ 1 severe exacerbations; State 5, death. The models only allowed a patient to transition to a worsened health state, and transitions did not necessarily have to be to the next adjacent state. We used the multi-state models to analyse data from ETHOS, a phase III, 52-week study assessing the efficacy and safety of triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate in moderate-to-very severe COPD.

Results
The Weibull multi-state Markov model showed good fit of the data. In line with clinical evidence, we found a higher mortality risk after a severe exacerbation (11.4-fold relative ratio increase [95% CI, 7.7–17.0], 6.4-fold increase [95% CI, 3.8–10.8] and 5.4-fold increase [95% CI, 2.9–10.3] relative to no exacerbations, 1 moderate exacerbation or ≥ 2 moderate exacerbations, respectively). One moderate exacerbation increased mortality risk 1.8-fold (95% CI, 1.1–2.9) vs no exacerbations. We also found a higher risk of severe exacerbation and mortality following ≥ 2 moderate exacerbations.

Conclusion
Multi-state modelling of patients with COPD in ETHOS found an acute and chronic effect of severe exacerbations on mortality risk. Risk was also increased after a moderate exacerbation. Clinical management with effective pharmacotherapies should be optimised to avoid even moderate exacerbations. Modelling with exacerbations could be an alternative to current COPD models focused on disease progression.

Trial registration
NCT02465567
Multi-dimensional vulnerability analysis on catastrophic health expenditure among middle-aged and older adults with chronic diseases in China
Authors: Miao Wenqing , Zhang Xiyu , Shi Baoguo , Tian Wanxin , Wu Bing , Lai Yongqiang , Li Yuze , Huang Zhipeng , Xia Qi , Yang Huiqi , Ding Fan , Shan Linghan , Xin Ling , Miao Jingying , Zhang Chenxi , Li Ye , Li Xiaodong , Wu Qunhong 
Published: May 2022

Abstract
Objective
Middle-aged and older adults are more likely to suffer from chronic diseases because of their particular health characteristics, which lead to a high incidence of catastrophic health expenditure (CHE). This study plans to analyse the different factors affecting CHE in middle-aged and older adults with chronic diseases, target the vulnerable characteristics, and suggest groups that medical insurance policies should pay more attention to.

Methods
The data used in this study came from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database. The method of calculating the CHE was adopted from the World Health Organization (WHO). The logistic regression was used to determine the family characteristics of chronic disease in middle-aged and older adults with a high probability of incurring CHE.

Results
The incidence of CHE in middle-aged and older adults with chronic disease was highest in sub-poverty level families (26.20%) was lowest in wealthier level families (20.07%). Households with malignant tumours had the highest CHE incidence under any circumstances, especially if the householder had been using inpatient service in the past year. Among the comparison of CHE incidence in different types of medical insurance, the Urban and Rural Residents’ Basic Medical Insurance (URRBMI) was the highest (27.46%). The incidence of CHE was 2.73 times (95% CI 2.30–3.24) and 2.16 times (95% CI 1.81–2.57) higher among people who had used inpatient services in the past year or outpatient services in the past month than those who had not used them.

Conclusions
Relatively wealthy economic conditions cannot significantly reduce the financial burden of chronic diseases in middle-aged and older adults. For this particular group with multiple vulnerabilities, such as physical and social vulnerability, the high demand and utilization of health services are the main reasons for the high incidence of CHE. After achieving the goal of lowering the threshold of universal access to health services, the medical insurance system in the next stage should focus on multiple vulnerable groups and strengthen the financial protection for middle-aged and older adults with chronic diseases, especially for patients with malignant tumours.