bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robust Polar Amplification in Ice-Free Climates Relies on Ocean Heat Transport and Cloud Radiative Effects
Authors: England Mark R. , Feldl Nicole 
Published: January 2024

Abstract
A fundamental divide exists between previous studies that conclude that polar amplification does not occur without sea ice and studies that find that polar amplification is an inherent feature of the atmosphere independent of sea ice. We hypothesize that a representation of climatological ocean heat transport is key for simulating polar amplification in ice-free climates. To investigate this, we run a suite of targeted experiments in the slab ocean aquaplanet configuration of CESM2-CAM6 with different profiles of prescribed ocean heat transport, which are invariant under CO2 quadrupling. In simulations without climatological ocean heat transport, polar amplification does not occur. In contrast, in simulations with climatological ocean heat transport, robust polar amplification occurs in all seasons. What is causing this dependence of polar amplification on ocean heat transport? Energy-balance model theory is incapable of explaining our results and in fact would predict that introducing ocean heat transport leads to less polar amplification. We instead demonstrate that shortwave cloud radiative feedbacks can explain the divergent polar climate responses simulated by CESM2-CAM6. Targeted cloud locking experiments in the zero ocean heat transport simulations are able to reproduce the polar amplification of the climatological ocean heat transport simulations, solely by prescribing high-latitude cloud radiative feedbacks. We conclude that polar amplification in ice-free climates is underpinned by ocean–atmosphere coupling, through a less negative high latitude shortwave cloud radiative feedback that facilitates enhanced polar warming. In addition to reconciling previous disparities, these results have important implications for interpreting past equable climates and climate projections under high-emissions scenarios.

Significance Statement
Polar amplification is a robust feature of climate change in the modern-day climate. However, previous climate modeling studies fundamentally do not agree on whether polar amplification occurs in ice-free climates. In this study, we find in a state-of-the-art climate model that, if ocean heat transport is neglected, the response to an increase in CO2 is not polar amplified, whereas robust polar amplification occurs if ocean heat transport is included. Using targeted model experiments, we diagnose cloud radiative effects as the driver of this divergent behavior. We conclude that polar amplification is a robust feature of the atmosphere–ocean system. Our results have important implications for interpreting past warm climates and future projections under high-emissions scenarios.
Impact of the North Pacific Meridional Mode on the Tropical Pacific Modulated by the Interdecadal Pacific Oscillation
Authors: Liu Bowen , Gan Bolan , Jia Fan , Wu Lixin 
Published: January 2024

Abstract
The North Pacific meridional mode (NPMM) peaking in boreal spring influences El Niño–Southern Oscillation (ENSO) properties in the ensuing winter. Whether the precursory impact of NPMM on the spatial diversity of ENSO has decadal variation remains unknown. Using long-term reanalysis datasets, we find that the interdecadal Pacific oscillation (IPO) significantly modulates the NPMM forcing on two types of ENSO. During the positive IPO (+IPO) phase, a strengthened background Aleutian low and southward-shifted storm track, in comparison to the negative IPO (−IPO) phase, produce stronger basin-scale negative geopotential height tendency anomalies over the North Pacific through synoptic-scale eddy–mean flow interaction. Such strong background negative tendency facilitates an Aleutian low–like pressure monopole rather than a North Pacific Oscillation (NPO)-like pressure dipole in boreal spring, leading to a weak NPMM that cannot effectively promote development of either a central Pacific (CP) or an eastern Pacific (EP) ENSO. By contrast, the NPO-like dipole enhances in boreal spring during −IPO, corresponding to stronger and more frequently occurring NPMM events that induce a robust CP-ENSO-like response in boreal winter. Moreover, the −IPO-related tropical Pacific mean states and the associated positive feedbacks cause a strong decrease in mixed layer temperature variance in the equatorial eastern Pacific, but a slight increase in the central Pacific, thus further contributing to the enhanced correlation between NPMM and CP-ENSO. Therefore, −IPO has played a role in the stronger impact of NPMM on CP-ENSO since the 1990s, and the modulation effects of IPO should be considered in understanding the extratropical–tropical climatic connection and ENSO spatial diversity.
Limited Width of Tropical Cyclone–Induced Baroclinic Geostrophic Response
Authors: Lu Zhumin , Shang Xiaodong 
Published: January 2024

Abstract
Despite the large radius (R17) of gale-force wind of a tropical cyclone (TC), the observed TC-induced effects on mesoscale and large-scale ocean via the baroclinic geostrophic response are found to have a limited cross-track width; this strange but important phenomenon is interpreted here. Driven by the wind stress curl (WSC), the TC-induced geostrophic response is in fact regulated by along-track integration of the WSC (AIWSC). Constrained by atmospheric TC dynamics, the violent winds outside the radius (Rmax) of maximum wind of any TC must have nearly zero WSC. Consequently, the AIWSC function can be fit as a boxcar function with an extraordinarily large positive value between ±Rmax about the track. Based on this boxcar function, the theoretical estimate of the cross-track length scale of the baroclinic geostrophic response, Ld + Rmax, is presented, where Ld is the first-mode baroclinic Rossby deformation radius. Further, this scale is validated by numerical experiments to well explain the width of the altimetry-observed geostrophic response induced by any TC. Evidently, Ld + Rmax is far smaller than R17 and thus the baroclinic geostrophic response generally has a limited width. This study implies that, although for a TC the violent winds outside Rmax are generally ∼90% of all winds, in an open ocean these winds may be useless to perturb the ocean interior due to the nearly zero WSC.

Significance Statement
Despite the large radius of gale-force wind of a tropical cyclone, the effects of a tropical cyclone on mesoscale and large-scale ocean are confined in a limited cross-track width; this strange but important phenomenon is interpreted here. In essence, the effects are exerted by the wind stress curl rather than by the wind stress. However, constrained by atmospheric dynamics, a tropical cyclone has most of the positive wind stress curl in the inner core and nearly zero wind stress curl far away from the inner core. Consequently, albeit violent, the winds outside the inner core cannot make an appreciable contribution to the physical processes below the mixed layer.
Impact of Precipitation on Ocean Responses during a Tropical Cyclone
Authors: Liu Fu , Toumi Ralf , Zhang Han , Chen Dake 
Published: January 2024

Abstract
Precipitation plays a crucial role in modulating upper-ocean salinity and the formation of the barrier layer, which affects the development of tropical cyclones (TCs). This study performed idealized simulations to investigate the influence of precipitation on the upper ocean. Precipitation acts to suppress the wind-induced sea surface reduction and generates an asymmetric warming response with a rightward bias. There is substantial vertical change with a cooling anomaly in the subsurface, which is about 3 times larger than the surface warming. The mean tropical cyclone heat potential is locally increased, but the net effect across the cyclone footprint is small. The impact of precipitation on the ocean tends to saturate for extreme precipitation, suggesting a nonlinear feedback. A prevailing driver of the model behavior is that the freshwater flux from precipitation strengthens the stratification and increases current shear in the upper ocean, trapping more kinetic energy in the surface layer and subsequently weakening near-inertial waves in the deep ocean. This study highlights the competing roles of TC precipitation and wind. Because the TC category is weaker than category 3, the warming anomaly is caused by reduced vertical mixing, whereas for stronger storms, the advection process is most important.
Effects of In-Vehicle Touchscreen Location on Driver Task Performance, Eye Gaze Behavior, and Workload During Conditionally Automated Driving: Nondriving-Related Task and Take-Over
Authors: Ban Gayoung , Park Woojin 
Published: January 2024

Objective This study investigated the effects of nondriving-related task (NDRT) touchscreen location and NDRT difficulty level on the driver task performance, eye gaze behavior, and workload during SAE Level 3 conditionally automated driving. Two driver tasks were considered: a visuomanual NDRT and a take-over task. Background Touchscreens are expected to play important roles inside automated vehicles. However, few studies have investigated the driver-touchscreen interaction during automated driving. Method A driving simulator experiment was conducted. The experimental task consisted of two successive subtasks: an NDRT followed by a take-over task. NDRT touchscreen location (Upper Left, Upper Right, and Lower Right) and NDRT difficulty level (Easy and Hard) were the independent variables. A set of driver task performance, eye gaze behavior, and perceived workload measures were employed for each subtask as the dependent variables. Results NDRT touchscreen location significantly affected both the NDRT and the take-over task performance. Lower Right was superior to Upper Right in the NDRT performance but was inferior in the take-over task performance. NDRT touchscreen location affected the perceived physical workload of the NDRT. NDRT difficulty level affected the perceived workload of the take-over task. Conclusion The research findings enhance our understanding of how NDRT touchscreen location and NDRT difficulty level impact the driver task performance during conditionally automated driving, and, further provide useful design implications and knowledge. Application The study results would inform the NDRT touchscreen interface design and the NDRT design for conditionally automated vehicles.
The Effectiveness of Adolescent-Focused Therapy and Family-Based Therapy for Anorexia Nervosa
Authors: Stewart Marni P. , Baumann Oliver 
Published: January 2024

Anorexia Nervosa is the most deadly mental illness due to the high mortality and relapse rates after reaching remission. The systematic review investigated the effectiveness of two empirically validated interventions (Family-Based Therapy [FBT] and Adolescent-Focused Therapy [AFT]) for an adolescent or young adult living with Anorexia Nervosa to reach partial or full remission and expected weight ratios. Twelve studies published between 1994 and 2015 were evaluated and indicated that FBT resulted in significant weight gain and higher partial and full remission rates than AFT, demonstrating its superiority in treating AN in adolescents and young adult samples, in one instance, at least up to 4 years. Despite FBT and AFT delivery, a significant proportion of participants did not achieve their target weight or full remission, indicating that both treatments may not be effective in all circumstances.
An Evaluation of Messages to Promote Parental Intent to Vaccinate Children Aged <12 Years Against COVID-19
Authors: Chan Isabella L. , Schwarz Kelsey , Weinstein Nicole , Mansergh Gordon , Nahhas Ramzi W. , Gelaude Deborah , Alexander Robert , Rodriguez Leslie , Strauss Warren , Repetski Torey , Sullivan Nancy , Long Everett , Evener Steve L. , Garbarino Adrienne , Kollar Laura M. Mercer 
Published: January 2024

Objectives: Effective health communication can increase intent to vaccinate. We compared 8 messages that may influence parents’ intent to vaccinate their children against COVID-19. Methods: In a cross-sectional survey of adults in the United States administered online in August 2021, 1837 parents and legal guardians were exposed to 8 messages (individual choice, gain/practical benefits, nonexpert, health care provider recommendation, altruism/community good, safety/effectiveness, safety, and effectiveness) to determine message reception and influence on intent to vaccinate their children. Parents responded to 10 questions using a Likert scale. We computed odds ratios (ORs) for each message, with an OR >1.0 indicating greater observed odds of participant agreement with the follow-up statement as compared with a reference message. We compared outcomes individually across messages with ordinal logistic regression fit using generalized estimating equations. Results: The individual choice message had the highest odds of agreement for understanding intent (OR = 2.10; 95% CI, 1.94-2.27), followed by the health care provider recommendation message (OR = 1.58; 95% CI, 1.46-1.71). The individual choice message had the highest odds of memorability, relatability, and trustworthiness. The altruism/community good message was at or near second best. The altruism/community good message had the highest or near-highest odds of increasing parents’ intent to vaccinate their children, asking friends and family for their thoughts, and searching for additional information. The message that most motivated parents to vaccinate their children depended on parental intent to vaccinate prior to being exposed to the tested messages. Conclusions: Messages with themes of individual choice, health care provider recommendation, and altruism/community good may be used in future message campaigns. Further research is needed to refine message concepts related to altruism/community good.
Can the General Public Be a Proxy for an “At-Risk” Group in a Patient Preference Study? A Disease Prevention Example in Rheumatoid Arthritis
Authors: DiSantostefano R. L. , Simons G. , Englbrecht M. , Humphreys Jennifer H. , Bruce Ian N. , Bywall K. Schölin , Radawski C. , Raza K. , Falahee M. , Veldwijk J. 
Published: January 2024

Background When selecting samples for patient preference studies, it may be difficult or impractical to recruit participants who are eligible for a particular treatment decision. However, a general public sample may not be an appropriate proxy. Objective This study compares preferences for rheumatoid arthritis (RA) preventive treatments between members of the general public and first-degree relatives (FDRs) of confirmed RA patients to assess whether a sample of the general public can be used as a proxy for FDRs. Methods Participants were asked to imagine they were experiencing arthralgia and had screening tests indicating a 60% chance of developing RA within 2 yrs. Using a discrete choice experiment, participants were offered a series of choices between no treatment and 2 unlabeled hypothetical treatments to reduce the risk of RA. To assess data quality, time to complete survey sections and comprehension questions were assessed. A random parameter logit model was used to obtain attribute-level estimates, which were used to calculate relative importance, maximum acceptable risk (MAR), and market shares of hypothetical preventive treatments. Results The FDR sample ( n = 298) spent more time completing the survey and performed better on comprehension questions compared with the general public sample ( n = 982). The relative importance ranking was similar between the general public and FDR participant samples; however, other relative preference measures involving weights including MARs and market share differed between groups, with FDRs having numerically higher MARs. Conclusion In the context of RA prevention, the general public (average risk) may be a reasonable proxy for a more at-risk sample (FDRs) for overall relative importance ranking but not weights. The rationale for a proxy sample should be clearly justified. Highlights Participants from the general public were compared to first-degree relatives on their preferences for rheumatoid arthritis (RA) preventive treatments using a discrete choice experiment. Preferences were similar between groups in terms of the most important and least important attributes of preventive treatments, with effectiveness being the most important attribute. However, relative weights differed. Attention to the survey and predicted market shares of hypothetical RA preventive treatments differed between the general public and first-degree relatives. The general public may be a reasonable proxy for an at-risk group for patient preferences ranks but not weights in the disease prevention context; however, care should be taken in sample selection for patient preference studies when choosing nonpatients.
Modified Posterior Triple Scoring as a Refinement Technique in Creating Aesthetic Antihelical Fold in Otoplasty
Authors: Brito Kenneth , Zacharia Michael 
Published: January 2024

Objective: To develop a precise and reliable technique in addressing underdevelopment of antihelical fold in patients with prominent ears. Background: Prominent ears remain to be a common presentation in aesthetic surgery. Multiple otoplasty techniques addressing the antihelical fold have been developed, but no standard technique is globally adopted. Creating a uniformly even, defined and smooth-edged antihelical fold without retropulsion of helix can be at times challenging and difficult to achieve. This study describes a modified way of refining a desirable antihelical fold by posterior triple scoring technique. Methods: A posterior approach was developed to access the posterior surface of antihelix and apply strategic triple linear scoring in conjunction with conchal repositioning. Ten patients underwent this procedure and followed up in 1-month and 1-year periods. Results: All patients were satisfied with the procedure. None of the patients developed complication or require secondary otoplasty. Conclusion: This novel technique provides a simple yet reliable and precise technique in conjunction with conchal setback or as a standalone procedure in selected patients to achieve the aesthetic curves of the external ear. We suggest this technique as an option to address the underdevelopment of antihelical fold in patients with prominent ears.
The Type 1 & 2 systemic lupus erythematosus model: Perspectives of people living with systemic lupus erythematosus
Authors: Eudy Amanda M , Clowse Megan EB , Corneli Amy , McKenna Kevin , Pisetsky David S , Maheswaranathan Mithu , Burshell Dana , Doss Jayanth , Sun Kai , Sadun Rebecca E , Criscione-Schreiber Lisa G , Rogers Jennifer L 
Published: January 2024

Objective In the new Type 1 & 2 model for systemic lupus erythematosus (SLE), Type 1 SLE represents classic inflammatory manifestations, such as arthritis, while Type 2 SLE encompasses symptoms such as pain and fatigue where the relationship to inflammation is less clear. The objective of this study was to interview individuals living with SLE to determine the content and face validity of the Type 1 & 2 SLE model. Methods We conducted a qualitative study using semi-structured interviews with a purposeful sample of participants who met classification criteria for SLE. Participants were asked to describe their experiences with Type 1 & 2 SLE symptoms and treatments, and they indicated if and how their personal experiences aligned with the Type 1 & 2 SLE model. All interviews were audio-recorded and transcribed; applied thematic analysis identified the most frequent and salient themes. Results We interviewed 42 participants with SLE. Type 2 SLE symptoms, such as pain and fatigue, were very common, with almost all participants experiencing some Type 2 symptoms at some point during their disease course. Participants described Type 1 SLE symptoms as being acute flares and life-threatening and Type 2 SLE symptoms as “everyday lupus” that affected their daily lives and were a dominant part of their SLE disease experience. Most participants stated they want their rheumatologists to discuss Type 2 symptoms during clinical appointments in order to address their full symptom experience. Conclusion We demonstrated content and face validity of the Type 1 & 2 SLE model with people living with SLE. Participants in our study largely understood the model and felt it accurately reflected their experience living with SLE. Type 2 SLE symptoms are very common in individuals with SLE and impact patients’ quality of life. Using the model to address Type 2 SLE symptoms allows the rheumatologist to incorporate the patient’s perspective and provide patient-centered care.
Validity of the Cleft Aesthetic Rating Scale Does Not Improve with Inclusion of Fixed Scores for Atypical Outcomes
Authors: Vroom Y. , Kornmann N. S. S. , Mosmuller D. G. M. , Niessen F. B. , Don Griot J. P. W. 
Published: January 2024

Objective The Cleft Aesthetic Rating Scale (CARS) is a valid tool to assess the aesthetic outcome after unilateral cleft lip and palate (UCLP) repair. The goal of this study was to investigate whether the reliability of CARS increases by including fixed rates for atypical outcomes such as a smaller nostril, lower vermillion border or whistling deformity. Design 197 patients with UCLP who underwent cleft repair were included. Three cleft experts rated the post-operative photos using the original CARS, followed by a second assessment employing the modified CARS. Setting Medisch Centrum Leeuwarden, Universitair Medisch Centrum Groningen, Radboud Universitair Medisch Centrum and Amsterdam University Medical Center. Patients Photographs of 16- to 25-year-old patients with repaired UCLP. Interventions Two separate assessments using the original and modified CARS. Main outcome measures The Intraclass Correlation Coefficient (ICC) was used to test inter-rater reliability of the original and modified version of the CARS. Results The reported ICC for the nose scored by means of the original and modified CARS were 0.68 (95% CI 0.62-0.74) and 0.66 (95% CI 0.59-0.72) respectively. The reported ICC for the lip assessed with the original and modified CARS were 0.53 (95% CI 0.33-0.67) and 0.57 (95% CI 0.34-0.72) respectively. Conclusions No significant difference was found between the original and modified ICC of the nose and lip. The implementation of the fixed rates did not result in an increased reliability of the CARS. Therefore, we recommend the utilization of the original CARS.