bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Stirring Tropics: Theory of Moisture Mode–Hadley Cell Interactions
Authors: Adames Corraliza Ángel F. , Mayta Víctor C. 
Published: December 2023

Abstract
Interactions between large-scale waves and the Hadley cell are examined using a linear two-layer model on an f plane. A linear meridional moisture gradient determines the strength of the idealized Hadley cell. The trade winds are in thermal wind balance with a weak temperature gradient (WTG). The mean meridional moisture gradient is unstable to synoptic-scale (horizontal scale of ∼1000 km) moisture modes that are advected westward by the trade winds, reminiscent of oceanic tropical depression–like waves. Meridional moisture advection causes the moisture modes to grow from “moisture-vortex instability” (MVI), resulting in a poleward eddy moisture flux that flattens the zonal-mean meridional moisture gradient, thereby weakening the Hadley cell. The amplification of waves at the expense of the zonal-mean meridional moisture gradient implies a downscale latent energy cascade. The eddy moisture flux is opposed by a regeneration of the meridional moisture gradient by the Hadley cell. These Hadley cell–moisture mode interactions are reminiscent of quasigeostrophic interactions, except that wave activity is due to column moisture variance rather than potential vorticity variance. The interactions can result in predator–prey cycles in moisture mode activity and Hadley cell strength that are akin to ITCZ breakdown. It is proposed that moisture modes are the tropical analog to midlatitude baroclinic waves. MVI is analogous to baroclinic instability, stirring latent energy in the same way that dry baroclinic eddies stir sensible heat. These results indicate that moisture modes stabilize the Hadley cell and may be as important as the latter in global energy transport.

Significance Statement
The tropics are characterized by steady circulations such as the Hadley cell as well as a menagerie of tropical weather systems. Despite progress in our understanding of both, little is known about how the mean circulations and the weather systems interact with one another. Here we show that tropical waves can grow by extracting moisture from the Hadley cell, thereby weakening it. They also transport moisture to higher latitudes. Our results challenge the notion that the Hadley cell is the sole transporter of energy out of the tropics and instead favor a view where tropical waves are also essential for the global energy balance. They dry the humid regions and moisten the drier regions via stirring.
Different Configurations of Cross-Equatorial Flows over the Indian Ocean–Western Maritime Continent and Their Implications for Improving Regional Climate Predictability
Authors: Wang Xudong , Jin Dachao , Guan Zhaoyong , Zhang Yu , Han Qiuchang 
Published: December 2023

Abstract
Low-level cross-equatorial flows (CEFs) over the Indian Ocean–western Maritime Continent (IO-wMC) play a crucial role in transporting energy, mass, and water vapor into the Northern Hemisphere during the Asian summer monsoon season (May–September). Utilizing ECMWF reanalysis data (ERA5), we investigate three CEFs over the IO-wMC: the Somali-CEF, Bay of Bengal CEF (BoB-CEF), and South China Sea CEF (SCS-CEF). The statistical independence of the Somali-CEF and BoB-CEF implies distinct formation processes on the interannual time scale. To examine the interannual variability of CEFs, we perform an empirical orthogonal function (EOF) analysis of vertically integrated meridional winds from surface pressure to 850 hPa over the equatorial IO-wMC. The first EOF mode reveals a weakening of the Somali-CEF and strengthening of the BoB-CEF and SCS-CEF, which is associated with the concurrent summer Indian Ocean dipole and quasi-biennial phase transition of El Niño events. The second EOF is related to the Indo-western Pacific Ocean capacitor (IPOC) mode that often emerges in post–El Niño summers. Despite the IPOC’s influence on meridional winds over the tropical southwestern Indian Ocean, three CEFs are uncorrelated with the EOF2. On the other hand, the Somali-CEF and BoB-CEF are significantly weakened in the EOF3. The EOF3 is an ENSO-unrelated internal IPOC mode. We further use a multilinear regression model based on preceding sea surface temperature (SST) over the Indo-Pacific and EOF3 to predict regional climate anomalies and compare the prediction skill with the SST-based models. Our results suggest that adding EOF2- and EOF3-related variability to the prediction model can improve Asian summer monsoon predictability.

Significance Statement
This study examines the interannual variability of low-level cross-equatorial flows (CEFs) over the Indian Ocean and western Maritime Continent, crucial components of the Asian summer monsoon. We identify three CEFs and investigate their relationships with interannual sea surface temperature modes in the Indo-Pacific region. The leading empirical orthogonal function (EOF) modes of equatorial meridional wind reveal diverse CEF configurations and post–El Niño summer wind variability. Also, the EOFs distinguishes between El Niño and El Niño–unrelated equatorial meridional wind variability. Utilizing a multilinear regression model based on both preceding Indo-Pacific SST modes and configurations of CEFs, we demonstrate the potential to enhance regional climate predictions, contributing to a more comprehensive understanding and forecasting of the Asian summer monsoon and its associated climate impacts.
The Pacific Northwest Heat Wave of 25–30 June 2021: Synoptic/Mesoscale Conditions and Climate Perspective
Authors: Mass Clifford , Ovens David , Christy John , Conrick Robert 
Published: December 2023

Abstract
An unprecedented heat wave occurred over the Pacific Northwest and southwest Canada on 25–30 June 2021, resulting in all-time temperature records that greatly exceeded previous record maximum temperatures. The impacts were substantial, including several hundred deaths, thousands of hospitalizations, a major wildfire in Lytton, British Columbia, Canada, and severe damage to regional vegetation. Several factors came together to produce this extreme event: a record-breaking midtropospheric ridge over British Columbia in the optimal location, record-breaking midtropospheric temperatures, strong subsidence in the lower atmosphere, low-level easterly flow that produced downslope warming on regional terrain and the removal of cooler marine air, an approaching low-level trough that enhanced downslope flow, the occurrence at a time of maximum insolation, and drier-than-normal soil moisture. It is shown that all-time-record temperatures have not become more frequent and that annual high temperatures only increased at the rate of baseline global warming. Although anthropogenic warming may have contributed as much as 1°C to the event, there is little evidence of further amplification from increasing greenhouse gases. Weather forecasts were excellent for this event, with highly accurate predictions of the extreme temperatures.

Significance Statement
This paper describes the atmospheric evolution that produced an extreme heat wave over the Pacific Northwest during June 2021 and puts this event into historical perspective.
Radiographic Assessment of Cleft Alveolar Bone Defects: A Preliminary Comparison of Periapical and Cone Beam Computed Tomography Images
Authors: Guo Yiou , Woodyard De Brito Kiersten C. , Gosnell Elizabeth S. , Sun Qin , Wang Jue 
Published: December 2023

Background & Purpose Accurate radiographic assessment of secondary alveolar bone grafting (SABG) is critical in evaluating SABG outcomes in patients with cleft lip and palate. This study compared Periapical (PA) and Cone beam computed tomography (CBCT) grading of SABG outcomes and conducted an analysis of agreement rate between the two imaging modalities. Methods A retrospective chart review was performed of patients who underwent secondary alveolar bone grafting at a single institution. Bone quality of the alveolar cleft site was assessed at three root levels of the adjacent teeth on PA and CBCT images. Results 48 patients had pre- or post-operative images with both CBCT and PA that were appropriate for comparison. A total of 174 alveolar bone sections (three root levels of adjacent teeth in 58 pairs) were graded on CBCT and PA images. Agreement of CBCT grading with PA grading was 41.3% (72/174) overall. CBCT assessments rated bone quality lower than PA grading in 51.2% (89/174) of sections. CBCT had higher grading than PA image grading in 7.5% (13/174) of sections. The weighted Cohen Kappa value for comparison of CBCT and PA readings was 0.17, indicating a low rate of agreement. Wilcoxon signed rank test demonstrated that the difference between grading on CBCT and PA assessments was statistically significant ( P < .001). Conclusions CBCT and PA readings demonstrated an overall low rate of agreement in the assessment of cleft alveolar bone. This investigation suggests that PA radiographs have lower sensitivity in detecting poor bone grafting outcomes.
Anophthalmic socket in retinoblastoma: Exploring complications and risk factors in a tertiary centre in Malaysia
Authors: Ng Lay Hui , Chan Li Yen , Mohamad Nor Fadhilah , Rahmat Jamalia Bt 
Published: December 2023

Purpose To evaluate the complications of anophthalmic socket in retinoblastoma patients at a tertiary centre in Malaysia. Design Retrospective study Methods Patients who underwent enucleation for retinoblastoma were reviewed from 2004–2020. Details were recorded, including demographics, diagnosis, surgical techniques, implant types, additional therapies, and complications. Results Of 250 patients with retinoblastoma managed over the period, the anophthalmic sockets of 160 eyes who underwent enucleation were analysed. The mean age at enucleation was 2.03 years (26 days to 9.18 years). The follow-up periods after enucleation range from 5 days to 16.83 years. Porous polyethylene (Medpor) implants were used in 135 patients (84.4%), as were Bioceramic in 9, glass balls in 7, acrylic in 7, dermis fat grafts in 1, and silicone implants (Aurosphere) in 1. The overall complications in our study were 28.8%. Complications seen in the study included implant exposure (12.5%), shallow inferior fornix (10.6%), granuloma formation (3.1%), discharge (2.5%), implant migration (1.9%), ptosis (0.6%), and orbital dystopia (0.6%). Implant exposure is solely found in Medpor, more common in those with donor sclera caps, and exposure times range from 28 days to 11.42 years. The suturing of the Tenon and conjunctiva in separate layers significantly reduced the rate of implant exposure. Six out of seven radiation patients had shallow inferior fornixes. Conclusions Long-term post-enucleation complications were not uncommon. Luckily, most had good outcomes, with a few needing surgical intervention. Meticulous suturing technique on the Tenon and conjunctival layer is essential to prevent implant exposure.
Feasibility and Efficacy of the Cogmed Working Memory Training in Forensic Mental Health Inpatients With Schizophrenia Spectrum Disorders: A Pilot Study
Authors: Keller Suzie , Hii Quang , Branjerdporn Grace , Gillespie Kerri M. 
Published: December 2023

Introduction Schizophrenia spectrum disorders are characterised by notable deficits in executive function, working memory, attention and social cognition. Previous studies in cognitive remediation therapies, of various dose and duration, have shown behavioural and neurobiological improvements. The current pilot study will be the first to test the Cogmed Working Memory Training (CWMT) program in schizophrenia spectrum disorder. Methods This pilot study was conducted using purposive sampling of consumers with schizophrenia spectrum disorders from a forensic mental health inpatient unit in Australia was used. Eleven participants completed 30 sessions of CWMT over a 2-month period. One participant completed 28 sessions. The primary outcome measure was the CogState Schizophrenia Battery (CSB). Secondary measures included the Brock Adaptive Functioning Questionnaire (BAFQ) and the Allen Cognitive Level Screen (ACLS). Measures were taken before and after the intervention, and at 6-months follow-up to detect maintenance of improvements. Results Significant improvements were seen in social cognition and emotionality. Trends toward improvement in executive function and working memory were observed in younger participants, but were not significant. Conclusion Findings indicate that the CWMT may be a beneficial tool for improving social cognition in patients with schizophrenia. CWMT interventions of longer than 2 months may be required to see measurable improvements in other cognitive functions. Age-related cognitive impairment should be controlled for in future studies. Larger studies should be conducted to confirm these findings.
The gut-lung axis in critical illness: microbiome composition as a predictor of mortality at day 28 in mechanically ventilated patients
Authors: Zhou Piaopiao , Zou Zhiqiang , Wu Wenwei , Zhang Hui , Wang Shuling , Tu Xiaoyan , Huang Weibin , Chen Cunrong , Zhu Shuaijun , Weng Qinyong , Zheng Shixiang 
Published: December 2023

Abstract
Background
Microbial communities are of critical importance in the human host. The lung and gut microbial communities represent the most essential microbiota within the human body, collectively referred to as the gut-lung axis. However, the differentiation between these communities and their influence on clinical outcomes in critically ill patients remains uncertain.

Methods
An observational cohort study was obtained in the intensive care unit (ICU) of an affiliated university hospital. Sequential samples were procured from two distinct anatomical sites, namely the respiratory and intestinal tracts, at two precisely defined time intervals: within 48 h and on day 7 following intubation. Subsequently, these samples underwent a comprehensive analysis to characterize microbial communities using 16S ribosomal RNA (rRNA) gene sequencing and to quantify concentrations of fecal short-chain fatty acids (SCFAs). The primary predictors in this investigation included lung and gut microbial diversity, along with indicator species. The primary outcome of interest was the survival status at 28 days following mechanical ventilation.

Results
Sixty-two mechanically ventilated critically ill patients were included in this study. Compared to the survivors, the diversity of microorganisms was significantly lower in the deceased, with a significant contribution from the gut-originated fraction of lung microorganisms. Lower concentrations of fecal SCFAs were detected in the deceased. Multivariate Cox regression analysis revealed that not only lung microbial diversity but also the abundance of Enterococcaceae from the gut were correlated with day 28 mortality.

Conclusion
Critically ill patients exhibited lung and gut microbial dysbiosis after mechanical ventilation, as evidenced by a significant decrease in lung microbial diversity and the proliferation of Enterococcaceae in the gut. Levels of fecal SCFAs in the deceased served as a marker of imbalance between commensal and pathogenic flora in the gut. These findings emphasize the clinical significance of microbial profiling in predicting the prognosis of ICU patients.
Exercise combined with postbiotics treatment results in synergistic improvement of mitochondrial function in the brain of male transgenic mice for Alzheimer’s disease
Authors: Kolonics Attila , Bori Zoltán , Torma Ferenc , Abraham Dora , Fehér János , Radak Zsolt 
Published: December 2023

Abstract
Background
It has been suggested that exercise training and postbiotic supplement could decelerate the progress of functional and biochemical deterioration in double transgenic mice overexpresses mutated forms of the genes for human amyloid precursor protein (APPsw) and presenilin 1 (m146L) (APP/PS1TG). Our earlier published data indicated that the mice performed better than controls on the Morris Maze Test parallel with decreased occurrence of amyloid-β plaques in the hippocampus. We investigated the neuroprotective and therapeutic effects of high-intensity training and postbiotic supplementation.

Methods
Thirty-two adult APP/PS1TG mice were randomly divided into four groups: (1) control, (2) high-intensity training (3) postbiotic, (4) combined (training and postbiotic) treatment for 20 weeks. In this study, the whole hemibrain without hippocampus was used to find molecular traits explaining improved brain function. We applied qualitative RT-PCR for gene expression, Western blot for protein level, and Zymography for LONP1 activity. Disaggregation analysis of Aβ-40 was performed in the presence of Lactobacillus acidophilus and Bifidobacterium longum lysate.

Results
We found that exercise training decreased Alzheimer’s Disease (AD)-related gene expression (NF-kB) that was not affected by postbiotic treatment. The preparation used for postbiotic treatment is composed of tyndallized Bifidobacterium longum and Lactobacillus acidophilus. Both of the postbiotics effectively disaggregated amyloid-β/Aβ-40 aggregates by chelating Zn2+ and Cu2+ ions. The postbiotic treatment decreased endogenous human APPTG protein expression and mouse APP gene expression in the hemibrains. In addition, the postbiotic treatment elevated mitochondrial LONP1 activity as well.

Conclusion
Our findings revealed distinct mechanisms behind improved memory performance in the whole brain: while exercise training modulates NF-kB signaling pathway regulating immune response until postbiotic diminishes APP gene expression, disaggregates pre-existing amyloid-β plaques and activates mitochondrial protein quality control in the region of brain out of hippocampus. Using the above treatments complements and efficiently slows down the development of AD.
The first Chinese with Hb Chile leading to chronic anemia and methemoglobinemia: a case report
Authors: Gong Yao , Zheng Qinxin , Long Sili , Chen Hongying , Liu Wenjun , Li Cheng 
Published: December 2023

Abstract
Background
Hemoglobin (Hb) Chile [β28(B10) Leu > Met; HBB: c.85 C > A] is a rare hemoglobin variant caused by a missense mutation in the HBB gene. Only one case of Hb Chile has been reported worldwide so far. It is an unstable hemoglobin, characterized by cyanosis associated with chronic methemoglobinemia and hemolytic anemia induced by sulfonamides or methylene blue.

Case presentation
A 9-year-3-month-old girl had mild anemia of unknown etiology for more than 6 years. She had a slight pallor without other symptoms or signs. The complete blood count revealed normocytic normochromic anemia with a sometimes-elevated reticulocyte count, and the bone marrow cytology showed marked erythroid hyperplasia, but the tests related to hemolysis were normal. Therefore, the whole exome sequencing was performed and showed a heterozygous mutation for HBB: c.85 C > A. With asymptomatic methemoglobinemia confirmed later, she was eventually diagnosed with Hb Chile.

Conclusions
This is the first report of Hb Chile in China and the second worldwide. This case shows that Hb Chile is clinically heterogeneous and difficult to diagnose and expands our understanding on the clinical and hematological traits of the disease.
Cardiovascular health and life expectancy with and without cardiovascular disease in the middle-aged and elderly Chinese population
Authors: Xia Xue , Chen Shuohua , Tian Xue , Xu Qin , Zhang Yijun , Zhang Xiaoli , Wang Penglian , Wu Shouling , Lin Liming , Wang Anxin 
Published: December 2023

Abstract
Background
High cardiovascular health (CVH) was associated with lower risk of cardiovascular disease (CVD) and longer life expectancy. However, whether life years lived without CVD could increase faster than or at least at the same pace as total lifespan remains unknown. We aimed to explore the associations of CVH status with total life expectancy and life years lived with and without CVD among middle-aged and elderly men and women.

Methods
We included 65,587 participants aged ≥ 45 years from Kailuan study, who were recruited during June 2006 to October 2007. CVH was scored and classified (low [0–49 points], moderate [50–79 points] and high [80–100 points]) with Life’s Essential 8, incorporating evaluations of health behaviors and factors. All-cause mortality and incident non-fatal CVD were recorded from baseline to December 31, 2020. The multi-state life table was adopted to explore the associations of CVH status with total life expectancy and life years lived with and without CVD.

Results
Six thousand fifty eight cases of incident non-fatal CVD and 10,580 cases of deaths were identified. Men aged 45 years with low, moderate, and high CVH had a life expectancy of 33.0, 36.5 and 38.5 years, of which 7.8 (23.6%), 6.0 (16.3%) and 3.7 years (9.6%) were spent with CVD. For women, the corresponding life expectancy was 36.6, 43.6 and 48.6 years, and the remaining life years lived with CVD were 7.8 (21.3%), 6.0 (13.7%) and 4.5 years (9.3%), respectively. The benefits of high CVH were persistent across lifespan from age 45 to 85 years and consistent when CVH was evaluated with health behaviors and factors alone.

Conclusions
High CVH compared with low CVH was associated with longer total life expectancy and fewer years spent with CVD, indicating that promoting CVH is of great importance for CVD prevention and healthy ageing in China.
Healthcare disparities: patients’ perspectives on barriers to joint replacement
Authors: Goodman Susan M. , Mannstadt Insa , Gibbons J. Alex B. , Rajan Mangala , Bass Anne , Russell Linda , Mehta Bella , Figgie Mark , Parks Michael L. , Venkatachalam Shilpa , Nowell W. Benjamin , Brantner Collin , Lui Geyanne , Card Andrea , Leung Peggy , Tischler Henry , Young Sarah R. , Navarro-Millán Iris 
Published: December 2023

Abstract
Objective
Racial and ethnic disparities in arthroplasty utilization are evident, but the reasons are not known. We aimed to identify concerns that may contribute to barriers to arthroplasty from the patient’s perspective.

Methods
We identified patients’ concerns about arthroplasty by performing a mixed methods study. Themes identified during semi-structured interviews with Black and Hispanic patients with advanced symptomatic hip or knee arthritis were used to develop a questionnaire to quantify and prioritize their concerns. Multiple linear and logistic regression analyses were conducted to determine the association between race/ethnicity and the importance of each theme. Models were adjusted for sex, insurance, education, HOOS, JR/KOOS, JR, and discussion of joint replacement with a doctor.

Results
Interviews with eight participants reached saturation and provided five themes used to develop a survey answered by 738 (24%) participants; 75.5% White, 10.3% Black, 8.7% Hispanic, 3.9% Asian/Other. Responses were significantly different between groups (p < 0.05). Themes identified were “Trust in the surgeon” “Recovery”, “Cost/Insurance”, “Surgical outcome”, and “Personal suitability/timing”. Compared to Whites, Blacks were two-fold, Hispanics four-fold more likely to rate “Trust in the surgeon” as very/extremely important. Blacks were almost three times and Hispanics over six times more likely to rate “Recovery” as very/extremely important.

Conclusion
We identified factors of importance to patients that may contribute to barriers to arthroplasty, with marked differences between Blacks, Hispanics, and Whites.