bluuebunny/crossref_metadata_2025_split huggingface dataset:
New trends in personalized treatment of depression
Authors: Sampogna Gaia , Toni Claudia , Catapano Pierluigi , Rocca Bianca Della , Di Vincenzo Matteo , Luciano Mario , Fiorillo Andrea 
Published: October 2023

Purpose of review
Major depressive disorder (MDD) is a common and burdensome severe mental disorder, which is expected to become the leading cause of disease burden worldwide. Most patients with MDD remain untreated/undertreated. For many decades “a trial and error” approach has been adopted for selecting the best treatment plan for each individual patient, but more recently a personalized treatment approach has been proposed, by taking into account several individual and clinical factors (e.g., clinical stage, comorbidity, duration of illness). Therefore, the aim of this study is to address the most relevant innovations in the personalized treatment plan for patients with MDD.

Recent findings
In recent years, several pharmacological and nonpharmacological innovations have been introduced in the treatment of patients with MDD. As regards pharmacological treatments, the newly developed drugs have an innovative mechanism of action, targeting the glutamatergic systems. These drugs are highly effective in improving depressive symptoms, with a good level of safety and tolerability. As regards nonpharmacological interventions, innovations include both new strategies targeting different domains (e.g., lifestyle interventions aiming to improve the physical symptoms of depression or virtual reality) and classical interventions provided through innovative mechanisms (e.g., web-based psychotherapies and use of digital approaches). Patients globally report a good level of acceptability of these interventions.

Summary
Depression is a heterogeneous, complex and multidimensional disorder, representing one of the leading causes of disability worldwide. The final aim of the management of patients is functional recovery, which can be achieved by using personalized, integrated and recovery-oriented interventions. Several innovative pharmacological and nonpharmacological treatments are now available; interventions should be selected on the basis of the patient's needs and preferences in order to tailor the treatment, according to a shared decision-making approach.
Buoyancy forcing and the subpolar Atlantic meridional overturning circulation
Authors: Buckley Martha W. , Lozier M. Susan , Desbruyères Damien , Evans Dafydd Gwyn 
Published: October 2023

The North Atlantic meridional overturning circulation and its variability are examined in terms of the overturning in density space and diapycnal water mass transformation. The magnitude of the mean overturning is similar to the surface water mass transformation, but the density and properties of these waters are modified by diapycnal mixing. Surface waters are progressively densified while circulating cyclonically around the subpolar gyre, with the densest waters and deepest convection occurring in the Labrador Sea and Nordic Seas. The eddy-driven interaction between the convective interior and boundary currents is a key to the export of dense waters from marginal seas. Due to the multitude of pathways of dense waters within the subpolar gyre, as well as mixing with older waters, waters exiting the subpolar gyre have a wide range of ages, with a mean age on the order of a decade. As a result, interannual changes in water mass transformation are mostly balanced locally and do not result in changes in export to the subtropics. Only persistent changes in water mass transformation result in changes in export to the subtropics. The dilution of signals from upstream water mass transformation suggests that variability in export of dense waters to the subtropics may be controlled by other processes, including interaction of dense waters with the energetic upper ocean.This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Observed mechanisms activating the recent subpolar North Atlantic Warming since 2016
Authors: Chafik Léon , Penny Holliday N. , Bacon Sheldon , Baker Jonathan A. , Desbruyères Damien , Frajka-Williams Eleanor , Jackson Laura C. 
Published: October 2023

The overturning circulation of the subpolar North Atlantic (SPNA) plays a fundamental role in Earth’s climate variability and change. Here, we show from observations that the recent warming period since about 2016 in the eastern SPNA involves increased western boundary density at the intergyre boundary, likely due to enhanced buoyancy forcing as a response to the strong increase in the North Atlantic Oscillation since the early 2010s. As these deep positive density anomalies spread southward along the western boundary, they enhance the North Atlantic Current and associated meridional heat transport at the intergyre region, leading to increased influx of subtropical heat into the eastern SPNA. Based on the timing of this chain of events, we conclude that this recent warming phase since about 2016 is primarily associated with this observed mechanism of changes in deep western boundary density, an essential element in these interactions.
This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Arctic freshwater impact on the Atlantic Meridional Overturning Circulation: status and prospects
Authors: Haine Thomas W. N. , Siddiqui Ali H. , Jiang Wenrui 
Published: October 2023

Arguably, the most conspicuous evidence for anthropogenic climate change lies in the Arctic Ocean. For example, the summer-time Arctic sea ice extent has declined over the last 40 years and the Arctic Ocean freshwater storage has increased over the last 30 years. Coupled climate models project that this extra freshwater will pass Greenland to enter the sub-polar North Atlantic Ocean (SPNA) in the coming decades. Coupled climate models also project that the Atlantic Meridional Overturning Circulation (AMOC) will weaken in the twenty-first century, associated with SPNA buoyancy increases. Yet, it remains unclear when the Arctic anthropogenic freshening signal will be detected in the SPNA, or what form the signal will take. Therefore, this article reviews and synthesizes the state of knowledge on Arctic Ocean and SPNA salinity variations and their causes. This article focuses on the export processes in data-constrained ocean circulation model hindcasts. One challenge is to quantify and understand the relative importance of different competing processes. This article also discusses the prospects to detect the emergence of Arctic anthropogenic freshening and the likely impacts on the AMOC. For this issue, the challenge is to distinguish anthropogenic signals from natural variability.This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Challenges simulating the AMOC in climate models
Authors: Jackson Laura C. , Hewitt Helene T. , Bruciaferri Diego , Calvert Daley , Graham Tim , Guiavarc’h Catherine , Menary Matthew B. , New Adrian L. , Roberts Malcolm , Storkey David 
Published: October 2023

The latest assessment report from the Intergovernmental Panel on Climate Change concluded that the Atlantic Meridional Overturning Circulation (AMOC) was very likely to decline over the twenty-first century under all emissions scenarios; however, there was low confidence in the magnitude of the decline. Recent research has highlighted that model biases in the mean climate state can affect the AMOC in its mean state, variability and its response to climate change. Hence, understanding and reducing these model biases is critical for reducing uncertainty in the future changes of the AMOC and in its impacts on the wider climate. We discuss how model biases, in particular salinity biases, influence the AMOC and deep convection. We then focus on biases in the UK HadGEM3-GC3-1 climate model and how these biases change with resolution. We also discuss ongoing model development activities that affect these biases, and highlight priorities for improved representation of processes, such as the position of the North Atlantic Current, transports in narrow boundary current, resolution (or improved parameterization) of eddies and spurious numerical mixing in overflows.This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Towards two decades of Atlantic Ocean mass and heat transports at 26.5° N
Authors: Johns William E. , Elipot Shane , Smeed David A. , Moat Ben , King Brian , Volkov Denis L. , Smith Ryan H. 
Published: October 2023

Continuous measurements of the Atlantic meridional overturning circulation (AMOC) and meridional ocean heat transport at 26.5° N began in April 2004 and are currently available through December 2020. Approximately 90% of the total meridional heat transport (MHT) at 26.5° N is carried by the zonally averaged overturning circulation, and an even larger fraction of the heat transport variability (approx. 95%) is explained by the variability of the zonally averaged overturning. A physically based separation of the heat transport into large-scale AMOC, gyre and shallow wind-driven overturning components remains challenging and requires new investigations and approaches. We review the major interannual changes in the AMOC and MHT that have occurred over the nearly two decades of available observations and their documented impacts on North Atlantic heat content. Changes in the flow-weighted temperature of the Florida Current (Gulf Stream) over the past two decades are now taken into account in the estimates of MHT, and have led to an increased heat transport relative to the AMOC strength in recent years. Estimates of the MHT at 26.5° N from coupled models and various surface flux datasets still tend to show low biases relative to the observations, but indirect estimates based on residual methods (top of atmosphere net radiative flux minus atmospheric energy divergence) have shown recent promise in reproducing the heat transport and its interannual variability.
This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Labrador sea water spreading and the Atlantic meridional overturning circulation
Authors: Le Bras Isabela Alexander-Astiz 
Published: October 2023

In 1982, Talley and McCartney used the low potential vorticity signature of Labrador Sea Water (LSW) to make the first North Atlantic maps of its properties. Forty years later, our understanding of LSW variability, spreading time scales and importance has deepened. In this review and synthesis article, I showcase recent observational advances in our understanding of how LSW spreads from its formation regions into the Deep Western Boundary Current and southward into the subtropical North Atlantic. I reconcile the fact that decadal variability in LSW formation is reflected in the Deep Western Boundary Current with the fact that LSW formation does not control subpolar overturning strength and discuss hypothesized connections between LSW spreading and decadal Atlantic Meridional Overturning Circulation variability. Ultimately, LSW spreading is of fundamental interest because it is a significant pathway for dissolved gasses such as oxygen and carbon dioxide into the deep ocean. We should hence prioritize adding dissolved gas measurements to standard hydrographic and circulation observations, particularly at targeted western boundary locations.
This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Overturning in the subpolar North Atlantic: a review
Authors: Lozier M. Susan 
Published: October 2023

The Overturning in the Subpolar North Atlantic Program (OSNAP) was initiated in the spring of 2010 through a collaborative effort involving the USA, the UK, Germany, the Netherlands and Canada. A key feature of OSNAP is a trans-basin observing system deployed in the summer of 2014 for the continuous measure of volume, heat and freshwater fluxes in the subpolar North Atlantic. This review focuses on advancements made possible by the collective OSNAP observations. Chief among those advancements is the quantification of the dominant role of the eastern subpolar North Atlantic in the production of dense waters that reside in the lower limb of the overturning: the Irminger and Iceland basins contributed approximately three times as much dense water compared with the Labrador Sea over the observational period. Other advancements include elucidation of the relationship between convective activity in the basin interior and boundary current anomalies; the spread of overflow waters in the subpolar region; the seasonality of the meridional volume, heat and freshwater fluxes; and the challenges involved in designing a simpler, less costly observing system. Collectively, OSNAP measurements are laying a framework on which to assess the overturning circulation's vulnerability to continued warming and freshening as climate change continues apace.
This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
From theory to RAPID AMOC observations: a personal voyage of discovery
Authors: Marotzke Jochem 
Published: October 2023

I review the history of ideas that have led to the establishment of the RAPID monitoring system for the Atlantic Meridional Overturning Circulation (AMOC) at 26.5° N. This history is closely connected to important events in my personal career. Starting from early and largely unsuccessful attempts at formulating a dynamically consistent force balance for the AMOC, I made theoretical progress by separately predicting the density at the eastern and western boundaries and by invoking exact geostrophic balance throughout, including the western boundary current. A remarkable confluence of individuals and ideas then enabled the establishment of the RAPID array, at its core based on monitoring boundary densities and on geostrophy. The RAPID results, such as the surprisingly large sub-seasonal variability, have encouraged AMOC monitoring approaches at other latitudes. I finish by pointing at two theoretical concepts—first, acknowledging the difference between convective mixing and sinking and, second, considering the advective rather than wave propagation of density perturbations in the deep western boundary current—that, together with continued observations and newly available global coupled simulations at very high resolution, should substantially improve our understanding of the causes of AMOC variability.
This article is part of a discussion meeting issue 'Atlantic overturning: new observations and challenges'.
Can we trust projections of AMOC weakening based on climate models that cannot reproduce the past?
Authors: McCarthy Gerard D. , Caesar Levke 
Published: October 2023

The Atlantic Meridional Overturning Circulation (AMOC), a crucial element of the Earth's climate system, is projected to weaken over the course of the twenty-first century which could have far reaching consequences for the occurrence of extreme weather events, regional sea level rise, monsoon regions and the marine ecosystem. The latest IPCC report puts the likelihood of such a weakening as ‘very likely’. As our confidence in future climate projections depends largely on the ability to model the past climate, we take an in-depth look at the difference in the twentieth century evolution of the AMOC based on observational data (including direct observations and various proxy data) and model data from climate model ensembles. We show that both the magnitude of the trend in the AMOC over different time periods and often even the sign of the trend differs between observations and climate model ensemble mean, with the magnitude of the trend difference becoming even greater when looking at the CMIP6 ensemble compared to CMIP5. We discuss possible reasons for this observation-model discrepancy and question what it means to have higher confidence in future projections than historical reproductions.
This article is part of a discussion meeting issue 'Atlantic overturning: new observations and challenges'.
Contrasting internally and externally generated Atlantic Multidecadal Variability and the role for AMOC in CMIP6 historical simulations
Authors: Robson Jon , Sutton Rowan , Menary Matthew B. , Lai Michael W. K. 
Published: October 2023

Atlantic multidecadal variability (AMV) has long been thought to be an expression of low-frequency variability in the Atlantic Meridional Overturning Circulation (AMOC). However, alternative hypotheses have been forwarded, including that AMV is primarily externally forced. Here, we review the current state of play by assessing historical simulations made for the sixth coupled model intercomparison project (CMIP6). Overall, the importance of external forcing is sensitive to the type of AMV index used, due to the importance of globally coherent externally forced signals in the models. There are also significant contrasts between the processes that drive internally and externally forced AMV, but these processes can be isolated by exploring the multivariate expression of AMV. Specifically, internal variability in CMIP6 models is consistent with an important role of ocean circulation and AMOC and the externally forced AMV is largely a surface-flux forced mechanism with little role for the ocean. Overall, the internal multivariate fingerprint of AMV is similar to the observed, but the externally forced fingerprint appears inconsistent with observations. Therefore, climate models still suggest a key role for ocean dynamics, and specifically AMOC, in observed AMV. Nevertheless, models remain deficient in a number of areas, and a stronger role for externally forced dynamical changes cannot be ruled out.
This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
Should AMOC observations continue: how and why?
Authors: Frajka-Williams E. , Foukal N. , Danabasoglu G. 
Published: October 2023

The Atlantic meridional overturning circulation (AMOC) is a large-scale circulation pattern responsible for northward heat transport in the Atlantic and is associated with climate variations on a wide range of time scales. Observing the time-varying AMOC has fundamentally changed our understanding of the large-scale ocean circulation and its interaction with the climate system, as well as identified shortcomings in numerical simulations. With a wide range of gains already achieved, some now ask whether AMOC observations should continue. A measured approach is required for a future observing system that addresses identified gaps in understanding, accounts for shortcomings in observing methods and maximizes the potential to guide improvements in ocean and climate models. Here, we outline a perspective on future AMOC observing and steps that the community should consider to move forward.This article is part of a discussion meeting issue ‘Atlantic overturning: new observations and challenges’.
FHIR-GPT Enhances Health Interoperability with Large Language Models
Authors: Li Yikuan , Wang Hanyin , Yerebakan Halid Z. , Shinagawa Yoshihisa , Luo Yuan 
Published: October 2023

AbstractAdvancing health interoperability can significantly benefit health research, including phenotyping, clinical trial support, and public health surveillance. Federal agencies, including ONC, CDC, and CMS, have been collectively collaborating to promote interoperability by adopting Fast Healthcare Interoperability Resources (FHIR). However, the heterogeneous structures and formats of health data present challenges when transforming Electronic Health Record (EHR) data into FHIR resources. This challenge becomes more significant when critical health information is embedded in unstructured data rather than well-organized structured formats. Previous studies relied on multiple separate rule-based or deep learning-based NLP tools to complete the FHIR resource transformation, which demands substantial development costs, extensive training data, and meticulous integration of multiple individual NLP tools. In this study, we assessed the ability of large language models (LLMs) to transform clinical narratives into HL7 FHIR resources. We developed FHIR-GPT specifically for the transformation of clinical texts into FHIR medication statement resources. In our experiments using 3,671 snippets of clinical texts, FHIR-GPT demonstrated an exceptional exact match rate of over 90%, surpassing the performance of existing methods. FHIR-GPT improved the exact match rates of existing NLP pipelines by 3% for routes, 12% for dose quantities, 35% for reasons, 42% for forms, and over 50% for timing schedules. Our findings provide the foundations for leveraging LLMs to enhance health data interoperability. Future studies will aim to build upon these successes by extending the generation to additional FHIR resources.
Potential targets for the treatment of MI: GRP75-mediated Ca2+transfer in MAM
Authors: Zhang Chenyan , Liu Bowen , Sheng Jiaxing , Wang Jia , Zhu Weijie , Xie Chen , Zhou Xuan , Zhang Yuxin , Meng Qinghai , Li Yu 
Published: October 2023

AbstractBackgroundAfter myocardial infarction (MI), there is a notable disruption in cellular calcium ion homeostasis and mitochondrial function. These alterations are believed to be linked to endoplasmic reticulum (ER) stress, though the specific mechanisms are not fully understood. This research endeavors to elucidate the involvement of glucose regulated protein 75 (GRP75) in post-MI calcium ion homeostasis and mitochondrial function.ResultsExcessive oxidative stress was activated in humans’ post-myocardial infarction, with most differentially expressed genes being enriched in metabolic pathways, especially the calcium signaling pathway. In MI rats, symptoms of myocardial injury were accompanied by an increase in the activation of PERK, ATF6, and IRE1, as well as elevated Binding immunoglobulin protein (Bip) expression. Moreover, in oxygen-glucose deprivation (OGD)-induced cardiomyocytes, it was confirmed that inhibiting PERK exacerbated intracellular Ca2+disruption and cell apoptosis. More importantly, in cardiomyocytes undergoing Tunicamycin-induced ER stress, Ca2+accumulated in both the ER and mitochondria. Concurrently, the co-localization of GRP75 with IP3R and VDAC1 increased under ER stress in cardiomyocytes. In OGD-induced cardiomyocytes, knockdown of GRP75 not only reduced the Ca2+levels in both the ER and mitochondria and improved the ultrastructure of cardiomyocytes, but it also increased the number of contact points between ER and mitochondria, reducing MAM formation, and decreased cell apoptosis. Significantly, knockdown of GRP75 did not affect the protein expression of PERK and hypoxia-inducible factor 1α (HIF-1α). Transcriptome analysis of cardiomyocytes revealed that knockdown of GRP75 mainly influenced the molecular functions of sialyltransferase and IP3R, as well as the biosynthesis of glycosphingolipids and lactate metabolism. In OGD-induced cardiomyocytes, the knockdown of GRP75 lowered the protein expression levels of glucose transporter-1 (Glut1), pyruvate kinase M2 (PKM2), and lactate dehydrogenase A (LDHA), and decreased the metabolic products of glycolysis.ConclusionThe complex interaction between the ER and mitochondria, driven by the GRP75 and its associated IP3R1-GRP75-VDAC1 complex, is crucial for calcium homeostasis and cardiomyocyte’s adaptive response to ER stress. Modulating GRP75 could offer a strategy to regulate calcium dynamics, diminish glycolysis, and thereby mitigate cardiomyocyte apoptosis.