Uncertainties of ENSO-related Regional Hadley Circulation Anomalies within Eight Reanalysis Datasets

El Nino-Southern Oscillation(ENSO),the leading mode of global interannual variability,usually intensifies the Hadley Circulation(HC),and meanwhile constrains its meridional extension,leading to an equatorward movement of the jet system.Previous studies have investigated the response of HC to ENSO events using different reanalysis datasets and evaluated their capability in capturing the main features of ENSO-associated HC anomalies.However,these studies mainly focused on the global HC,represented by a zonal-mean mass stream function(MSF).Comparatively fewer studies have evaluated HC responses from a regional perspective,partly due to the prerequisite of the Stokes MSF,which prevents us from integrating a regional HC.In this study,we adopt a recently developed technique to construct the three-dimensional structure of HC and evaluate the capability of eight state-of-the-art reanalyses in reproducing the regional HC response to ENSO events.Results show that all eight reanalyses reproduce the spatial structure of HC responses well,with an intensified HC around the central-eastern Pacific but weakened circulations around the Indo-Pacific warm pool and tropical Atlantic.The spatial correlation coefficient of the three-dimensional HC anomalies among the different datasets is always larger than 0.93.However,these datasets may not capture the amplitudes of the HC responses well.This uncertainty is especially large for ENSO-associated equatorially asymmetric HC anomalies,with the maximum amplitude in Climate Forecast System Reanalysis(CFSR)being about 2.7 times the minimum value in the Twentieth Century Reanalysis(20CR).One should be careful when using reanalysis data to evaluate the intensity of ENSO-associated HC anomalies.

Fracture sealing performance of granular lost circulation materials at elevated temperature:A theoretical and coupled CFD-DEM simulation study

Lost circulation is a common downhole problem of drilling in geothermal and high-temperature,high-pressure(HTHP)formations.Lost circulation material(LCM)is a regular preventive and remedial measure for lost circulation.However,conventional LCMs seem ineffective in high-temperature formations.This may be due to the changes in the mechanical properties of LCMs and their sealing performance under high-temperature conditions.To understand how high temperature affects the fracture sealing performance of LCMs,we developed a coupled computational fluid dynamics-discrete element method(CFD-DEM)model to simulate the behavior of granular LCMs in fractures.We summarized the literature on the effects of high temperature on the mechanical properties of LCMs and the rheological properties of drilling fluid.We conducted sensitivity analyses to investigate how changing LCM slurry properties affected the fracture sealing efficiency at increasing temperatures.The results show that high temperature reduces the size,strength,and friction coefficient of LCMs as well as the drilling fluid viscosity.Smaller,softer,and less frictional LCM particles have lower bridging probability and slower bridging initiation.Smaller particles tend to form dual-particle bridges rather than single-particle bridges.These result in a deeper,tighter,but unstable sealing zone.Reduced drilling fluid viscosity leads to faster and shallower sealing zones.

Arterial Duct Stenting Versus Modified Blalock-Taussig Shunt in Patient with Ductal-Dependent Pulmonary Circulation: Systematic Review & Meta-Analysis

Objective:Patients with ductal-dependent pulmonary circulation require alternative bloodflow to provide and maintain adequate oxygenation.Modified Blalock-Taussig Shunt(MBTS)has been the standard for providing such a result.Currently,less invasive methods such as Arterial Duct(AD)stenting have been performed as alter-natives.This study aims to compare the outcome of AD stenting and MBTS.Method:Systematic research was performed in online databases using the PRISMA protocol.The outcomes measured were 30-day mortality,com-plication,unplanned intervention,oxygen saturation,duration of hospital,and ICU length of stay.Any compara-tive study provided with full text is included.The outcome of each study was analyzed using a trandom effects model with relative risk and mean difference as the effect size.Bias risk assessment was conducted using the New-castle-Ottawa Scale.All analyses were performed using Review Manager 5.4.1.Result:A total of 11 studies with 3154 samples included in this study.There is no significant difference in 30-day mortality between the two groups(p-value=0.10).However,there is significantly less complication(RR 0.53[0.35,0.82];p-value=0.004)and unplanned intervention(RR 0.59[0.38,0.92];p-value=0.02)in the AD stent group.Comparison of the Nakata index showed no significant difference(p-value=0.88).Post-operative oxygen saturation was measured signifi-cantly higher in the AD stenting(MD 1.80[0.85,2.74];p-value=0.0002).However,AD stent group shows sig-nificantly lower long-term oxygen saturation(MD-8.43[-14.38,-2.48];p-value=0.005).Both hospital and ICU length of stay was significantly shorter in the AD stent group(MD-8.30[-11.13,-5.48];p-value<0.00001;MD-5.09[-7.79,-2.38];p-value=0.0002).Conclusion:AD stenting provides comparable outcomes relative to MBTS as it provides less complication and unplanned intervention and higher post-procedural O2 saturation.However,MBTS proved its superiority in maintaining higher long-term oxygen saturation and still became the preferred option to manage complex cases where stenting is either challenging or unsuccessful.

A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study

BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.

Application Effect of External Diaphragm Pacemaker Combined with Active Respiratory Circulation Technology in Pulmonary Rehabilitation of Perioperative Lung Cancer Patients

Aim: To explore the application effect of external diaphragm pacemaker combined with active respiratory circulation technology in pulmonary rehabilitation of perioperative lung cancer patients. Methods: A total of 98 lung cancer patients admitted to our hospital from April 2020 to November 2021 were selected as the observation objects, and then divided into a control group and an observation group using the random number table method, with 49 cases in each group. The control group received routine admission guidance and active respiratory circulation training, while the observation group was supplemented with external diaphragm pacemaker on the basis of the control group. The intervention effect was evaluated by blood gas indicators, pulmonary function indicators, diaphragm function indicators, sputum comfort degree, and activity tolerance indicators before and after intervention. Results: Before intervention, there were no significant differences in blood gas analysis indicators, pulmonary function indicators, diaphragm function indicators, sputum comfort degree, and activity tolerance indicators between the two groups (P > 0.05). After intervention, the improvement degree of the above indicators in the observation group was higher than that in the control group (P < 0.05). Conclusions: The application of external diaphragm pacemaker combined with active respiratory circulation technology in pulmonary rehabilitation of perioperative lung cancer patients is significant, which can effectively improve the pulmonary function, blood gas function, and diaphragm function of lung cancer patients after surgery, and improve the activities of daily living and quality of life of patients.

Numerical simulations of Atlantic meridional overturning circulation(AMOC)from OMIP experiments and its sensitivity to surface forcing

Atlantic meridional overturning circulation(AMOC)plays an important role in transporting heat meridionally in the Earth’s climate system and is also a key metrical tool to verify oceanic general circulation models.Two OMIP(Ocean Model Intercomparison Project phase 1 and 2)simulations with LICOM3(version 3 of the LASG/IAP Climate System Ocean Model)developed at the State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics(LASG),Institute of Atmospheric Physics(IAP),are compared in this study.Both simulations well reproduce the fundamental characteristics of the AMOC,but the OMIP1 simulation shows a significantly stronger AMOC than the OMIP2 simulation.Because the LICOM3 configurations are identical between these two experiments,any differences between them must be attributed to the surface forcing data.Further analysis suggests that sea surface salinity(SSS)differences should be mainly responsible for the enhanced AMOC in the OMIP1 simulation,but sea surface temperature(SST)also play an unignorable role in modulating AMOC.In the North Atlantic,where deep convection occurs,the SSS in OMIP1 is more saline than that in OMIP1.We find that in the major region of deep convection,the change of SSS has more significant effect on density than the change of SST.As a result,the SSS was more saline than that in OMIP2,leading to stronger deep convection and subsequently intensify the AMOC.We conduct a series of numerical experiments with LICOM3,and the results confirmed that the changes in SSS have more significant effect on the strength of AMOC than the changes in SST.

Correction:Establishment of a prediction model for prehospital return of spontaneous circulation in out-of-hospital patients with cardiac arrest

This is an erratum to an already published paper named“Establishment of a prediction model for prehospital return of spontaneous circulation in out-ofhospital patients with cardiac arrest”.We found errors in the affiliated institution of the authors.We apologize for our unintentional mistake.Please note,these changes do not affect our results.

Comparative Analysis of Energy Characteristics of Two Southwest Vortices in Sichuan Under Similar Circulation Backgrounds

Based on ERA5 reanalysis data,the present study analyzed the thermal energy development mechanism and kinetic energy conversion characteristics of two extreme rainstorm processes in relation to the shallow southwest vortex in the warm-sector during a“rain-generated vortex”process and the deep southwest vortex in a“vortex-generated rain”process.The findings were as follows:(1)During the extreme rainstorm on August 11,2020(hereinafter referred to as the“8·11”process),intense surface heating and a high-energy unstable environment were observed.The mesoscale convergence system triggered convection to produce heavy rainfall,and the release of latent condensation heat generated by the rainfall promoted the formation of a southwest vortex.The significant increase(decrease)in atmospheric diabatic heating and kinetic energy preceded the increase(decrease)in vorticity.By contrast,the extreme rainstorm on August 16,2020(hereinafter referred to as the“8·16”process)involved the generation of southwest vortex in a low-energy and highhumidity environment.The dynamic uplift of the southwest vortex triggered rainfall,and the release of condensation latent heat from rainfall further strengthened the development of the southwest vortex.The significant increase(decrease)in atmospheric diabatic heating and kinetic energy exhibited a delayed progression compared to the increase(decrease)in vorticity.(2)The heating effect around the southwest vortex region was non-uniform,and the heating intensity varied in different stages.In the“8·11”process,the heating effect was the strongest in the initial stage,but weakened during the vortex's development.On the contrary,the heating effect was initially weak in the“8·16”process,and intensified during the development stage.(3)The available potential energy of the“8·11”process significantly increased in kinetic energy converted from rotational and divergent winds through baroclinic action,and the divergent wind energy continued to convert into rotational wind energy.By contrast,the“8·16”process involved the conversion of rotational wind energy into divergent wind energy,which in turn converted kinetic energy back into available potential energy,thereby impeding the further development and maintenance of the southwest vortex.

Circulation Pattern Controls of Summer Temperature Anomalies in Southern Africa

This study investigates the relationship between circulation patterns and austral summer temperature anomalies in southern Africa. The results show that the formation of continental lows tends to increase the thickness of the lower atmosphere. Further, the distinct variabilities of high and low pressure under the circulation types, influence air mass advection from the adjacent oceans, as well as atmospheric stability over land. Stronger anticyclonic circulation at the western branch of the Mascarene high-pressure system enhances the low-level cold air advection by southeast winds,decreases the thickness, and lowers the temperature over a majority of the land in southern Africa. Conversely, a weaker Mascarene High, coupled with enhanced cyclonic activity in the southwest Indian Ocean increases low-level warm air advection and increases temperature anomalies over vast regions in southern Africa. The ridging of a closed South Atlantic anticyclone at the southern coast of southern Africa results in colder temperatures near the tip of southern Africa due to enhanced low-level cold air advection by southeast winds. However, when the ridge is weak and westerly winds dominate the southern coast of southern Africa, these areas experience temperature increases. The northward track of the Southern Hemisphere mid-latitude cyclone, which can be linked to the negative Southern Annular Mode, reduces the temperature in the southwestern part of southern Africa. Also, during the analysis period, El Ni?o was associated with temperature increases over the central parts of southern Africa;while the positive Indian Ocean dipole was linked to a temperature increase over the northeastern, northwestern, and southwestern parts of southern Africa.

Spatio-temporal Variation Characteristics of Extreme Climate Events and Their Teleconnections to Large-scale Ocean-atmospheric Circulation Patterns in Huaihe River Basin,China During 1959–2019

Huaihe River Basin(HRB) is located in China’s north-south climatic transition zone,which is very sensitive to global climate change.Based on the daily maximum temperature,minimum temperature,and precipitation data of 40 meteorological stations and nine monthly large-scale ocean-atmospheric circulation indices data during 1959–2019,we present an assessment of the spatial and temporal variations of extreme temperature and precipitation events in the HRB using nine extreme climate indices,and analyze the teleconnection relationship between extreme climate indices and large-scale ocean-atmospheric circulation indices.The results show that warm extreme indices show a significant(P < 0.05) increasing trend,while cold extreme indices(except for cold spell duration) and diurnal temperature range(DTR) show a significant decreasing trend.Furthermore,all extreme temperature indices show significant mutations during 1959-2019.Spatially,a stronger warming trend occurs in eastern HRB than western HRB,while maximum 5-d precipitation(Rx5day) and rainstorm days(R25) show an increasing trend in the southern,central,and northwestern regions of HRB.Arctic oscillation(AO),Atlantic multidecadal oscillation(AMO),and East Atlantic/Western Russia(EA/WR) have a stronger correlation with extreme climate indices compared to other circulation indices.AO and AMO(EA/WR) exhibit a significant(P < 0.05) negative(positive)correlation with frost days and diurnal temperature range.Extreme warm events are strongly correlated with the variability of AMO and EA/WR in most parts of HRB,while extreme cold events are closely related to the variability of AO and AMO in eastern HRB.In contrast,AMO,AO,and EA/WR show limited impacts on extreme precipitation events in most parts of HRB.

Evaluation of the Mechanisms Acting on the Atlantic Meridional Overturning Circulation in CESM2 for the 1pctCO_(2) Experiment

The Atlantic Meridional Overturning Circulation(AMOC)is a crucial component of the Earth’s climate system due to its fundamental role in heat distribution,carbon and oxygen transport,and the weather.Other climate components,such as the atmosphere and sea ice,influence the AMOC.Evaluating the physical mechanisms of those interactions is paramount to increasing knowledge about AMOC’s functioning.In this study,the authors used outputs from the Community Earth System Model version 2 and observational data to investigate changes in theAMOC and the associated physical processes.Two DECK experiments were evaluated:piControl and 1pctCO_(2),with an annual increase of 1%of atmospheric CO_(2).The analysis revealed a significant decrease in the AMOC,associated with changes in mixed layer depth and buoyancy in high latitudes of the North Atlantic,resulting in the shutdown of deep convection and potentially affecting the formation of North Atlantic Deep Water and Antarctic Bottom Water.A vital aspect observed in this study is the association between increased runoff and reduced water evaporation,giving rise to a positive feedback process.Consequently,the rates of freshwater spreading have intensified during this period,which could lead to an accelerated disruption of the AMOC beyond the projections of existing models.

Westward extension of summer atmospheric circulation over the North Pacific after the 1990s

本文研究了20世纪90年代前后夏季北太平洋大气环流(NPcirculation)向西扩展,并探讨了其可能的原因.结果表明,在1961-1983年期间NP中心主要位于东北太平洋,而在1994-2016年期间NP中心发生西移,至北太平洋中部进一步分析指出,90年代以后NP活动中心的西移和春季中纬度北太平洋海温(SST_NP)与NP关系的加强有关.春季SST_NP异常通过引起后期夏季北太平洋中部地表热通量(即感热通量和潜热通量)和垂直运动异常,有利于NP活动中心向西移动,此外,20世纪90年代以后,北太平洋中部海平面气压的年际变率增加,这可能是NP向西扩展的另一原因。

Unprecedented Heatwave in Western North America during Late June of 2021: Roles of Atmospheric Circulation and Global Warming

An extraordinary and unprecedented heatwave swept across western North America(i.e.,the Pacific Northwest)in late June of 2021,resulting in hundreds of deaths,a massive die-off of sea creatures off the coast,and horrific wildfires.Here,we use observational data to find the atmospheric circulation variabilities of the North Pacific and Arctic-Pacific-Canada patterns that co-occurred with the development and mature phases of the heatwave,as well as the North America pattern,which coincided with the decaying and eastward movement of the heatwave.Climate models from the Coupled Model Intercomparison Project(Phase 6)are not designed to simulate a particular heatwave event like this one.Still,models show that greenhouse gases are the main reason for the long-term increase of average daily maximum temperature in western North America in the past and future.

Circulation Patterns Linked to the Positive Sub-Tropical Indian Ocean Dipole

The positive phase of the subtropical Indian Ocean dipole(SIOD)is one of the climatic modes in the subtropical southern Indian Ocean that influences the austral summer inter-annual rainfall variability in parts of southern Africa.This paper examines austral summer rain-bearing circulation types(CTs)in Africa south of the equator that are related to the positive SIOD and the dynamics through which specific rainfall regions in southern Africa can be influenced by this relationship.Four austral summer rain-bearing CTs were obtained.Among the four CTs,the CT that featured(i)enhanced cyclonic activity in the southwest Indian Ocean;(ii)positive widespread rainfall anomaly in the southwest Indian Ocean;and(iii)low-level convergence of moisture fluxes from the tropical South Atlantic Ocean,tropical Indian Ocean,and the southwest Indian Ocean,over the south-central landmass of Africa,was found to be related to the positive SIOD climatic mode.The relationship also implies that positive SIOD can be expected to increase the amplitude and frequency of occurrence of the aforementioned CT.The linkage between the CT related to the positive SIOD and austral summer homogeneous regions of rainfall anomalies in Africa south of the equator showed that it is the principal CT that is related to the inter-annual rainfall variability of the south-central regions of Africa,where the SIOD is already known to significantly influence its rainfall variability.Hence,through the large-scale patterns of atmospheric circulation associated with the CT,the SIOD can influence the spatial distribution and intensity of rainfall over the preferred landmass through enhanced moisture convergence.

Establishment of a prediction model for prehospital return of spontaneous circulation in out-of-hospital patients with cardiac arrest

BACKGROUND Out-of-hospital cardiac arrest(OHCA)is a leading cause of death worldwide.AIM To explore factors influencing prehospital return of spontaneous circulation(P-ROSC)in patients with OHCA and develop a nomogram prediction model.METHODS Clinical data of patients with OHCA in Shenzhen,China,from January 2012 to December 2019 were retrospectively analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate logistic regression were applied to select the optimal factors predicting P-ROSC in patients with OHCA.A nomogram prediction model was established based on these influencing factors.Discrimination and calibration were assessed using receiver operating charac-teristic(ROC)and calibration curves.Decision curve analysis(DCA)was used to evaluate the model’s clinical utility.RESULTS Among the included 2685 patients with OHCA,the P-ROSC incidence was 5.8%.LASSO and multivariate logistic regression analyses showed that age,bystander cardiopulmonary resuscitation(CPR),initial rhythm,CPR duration,ventilation mode,and pathogenesis were independent factors influencing P-ROSC in these patients.The area under the ROC was 0.963.The calibration plot demonstrated that the predicted P-ROSC model was concordant with the actual P-ROSC.The good clinical usability of the prediction model was confirmed using DCA.CONCLUSION The nomogram prediction model could effectively predict the probability of P-ROSC in patients with OHCA.

Machine Learning for Predicting the Development of Postoperative Acute Kidney Injury After Coronary Artery Bypass Grafting Without Extracorporeal Circulation

Background:Cardiac surgery-associated acute kidney injury(CSA-AKI)is a major complication that increases morbidity and mortality after cardiac surgery.Most established predictive models are limited to the analysis of nonlinear relationships and do not adequately consider intraoperative variables and early postoperative variables.Nonextracorporeal circulation coronary artery bypass grafting(off-pump CABG)remains the procedure of choice for most coronary surgeries,and refined CSA-AKI predictive models for off-pump CABG are notably lacking.Therefore,this study used an artificial intelligence-based machine learning approach to predict CSA-AKI from comprehensive perioperative data.Methods:In total,293 variables were analysed in the clinical data of patients undergoing off-pump CABG in the Department of Cardiac Surgery at the First Affiliated Hospital of Guangxi Medical University between 2012 and 2021.According to the KDIGO criteria,postoperative AKI was defined by an elevation of at least 50%within 7 days,or 0.3 mg/dL within 48 hours,with respect to the reference serum creatinine level.Five machine learning algorithms—a simple decision tree,random forest,support vector machine,extreme gradient boosting and gradient boosting decision tree(GBDT)—were used to construct the CSA-AKI predictive model.The performance of these models was evaluated with the area under the receiver operating characteristic curve(AUC).Shapley additive explanation(SHAP)values were used to explain the predictive model.Results:The three most influential features in the importance matrix plot were 1-day postoperative serum potassium concentration,1-day postoperative serum magnesium ion concentration,and 1-day postoperative serum creatine phos-phokinase concentration.Conclusion:GBDT exhibited the largest AUC(0.87)and can be used to predict the risk of AKI development after surgery,thus enabling clinicians to optimise treatment strategies and minimise postoperative complications.

An internal circulation iron-carbon micro-electrolysis reactor for aniline wastewater treatment:Parameter optimization,degradation pathways and mechanism

Aniline is a vital industrial raw material.However,highly-toxic aniline wastewater usually deteriorated effluent quality,posed a threat to human health and ecosystem safety.Therefore,this study reported a novel internal circulation iron-carbon micro-electrolysis(ICE)reactor to treat aniline wastewater.The effects of reaction time,pH,aeration rate and iron-carbon(Fe/C)ratio on the removal rate of aniline and the chemical oxygen demand were investigated using single-factor experiments.This process exhibited high aniline degradation performance of approximately 99.86% under optimal operating conditions(reaction time=20 min,pH=3,aeration rate=0.5 m3·h^(-1),and Fe/C=1:2).Based on the experimental results,the response surface method was applied to optimize the aniline removal rate.The Box–Behnken method was used to obtain the interaction effects of three main factors.The result showed that the reaction time had a dominant effect on the removal rate of aniline.The highest aniline removal rate was obtained at pH of 2,aeration rate of 0.5 m^(3)·h^(-1)and reaction time of 30 min.Under optional experimental conditions,the aniline content of effluent was reduced to 3 mg·L^(-1)and the removal rate was as high as 98.24%,within the 95% confidence interval(97.84%-99.32%)of the predicted values.The solution was treated and the reaction intermediates were identified by high-performance liquid chromatography,ultraviolet-visible spectroscopy,Fourier-transform infrared spectroscopy,gas chromatography-mass spectrometry,and ion chromatography.The main intermediates were phenol,benzoquinone,and carboxylic acid.These were used to propose the potential mechanism of aniline degradation in the ICE reactor.The results obtained in this study provide optimized conditions for the treatment of industrial wastewater containing aniline and can strengthen the understanding of the degradation mechanism of iron-carbon micro-electrolysis.

The internal circulations on internal mass transfer rate of a single drop in nonlinear uniaxial extensional flow

The internal flow of a droplet in the nonlinear extensional flow field will exhibit more than two internal circulations with the variation of nonlinear intensity(E).In this paper,the effect of positions and sizes of internal circulations on internal mass transfer rate of a single spherical droplet in a nonlinear extensional flow field is studied and compared with that in a linear extensional flow field.The simulation results show that when E≥0,there are two symmetrical internal circulations in the droplet,which is the same with that in a linear extensional flow.The limit value of mass transfer rate Sh is 15,which is equal to that in a linear extensional flow,no matter how large E is.When E≤-3/7,the number of internal flow circulation of a droplet increase to four and the transfer rate Sh increases.When E=-1,the maximum internal transfer rate Sh equals 30 which is twice of that in a linear extensional flow.The generation of new flow circulations in droplets and the circulation positions will enhance mass transfer when E≤-3/7,which provides a new idea for enhancing the internal mass transfer rate of droplets.

Arctic summertime anticyclonic circulation mode and its influence on substantial sea ice depletion:a review

The summertime anticyclonic circulation mode(SACM)is related to recent substantial loss of sea ice in the Arctic.This review outlines the potential causes of the SACM and considers its influence on sea ice depletion.Local triggers(i.e.,sea ice loss and sea surface temperature(SST)variation)and spatiotemporal teleconnections(i.e.,extratropical cyclone intrusion,tropical and mid-latitude SST anomalies,and winter atmospheric circulation preconditions)are discussed.The influence of the SACM on the dramatic loss of sea ice is emphasized through inspection of relevant dynamic(i.e.,Ekman drift and export)and thermodynamic(i.e.,moisture content,cloudiness,and associated changes in radiation)mechanisms.Moreover,the motivation for investigation of the underlying physical mechanisms of the SACM in response to the recent substantial sea ice depletionis also clarified through an attempt to better understand the shifting ice-atmosphere interaction in the Arctic during summer.Therecord low extent of sea ice in September 2012 could be reset in the near future if the SACM-like scenario continues to exist during summer in the Arctic troposphere.

Hemodynamic Profiling Using a Cardiac Index–Systemic Vascular Resistance Plot in Patients with Fontan Circulation

Background: Elevated Fontan pressure (FP) alone cannot fully predict clinical outcomes. We hypothesized thathemodynamic profiling using a cardiac index (CI)-systemic vascular resistance (SVR) plot could characterize clinicalfeatures and predict the prognosis of post-Fontan patients. Methods: We included post-Fontan patients whounderwent cardiac catheterization at age < 10 years. Patients were classified into four categories: A, CI ≥ 3, SVRindex (SVRI) ≥ 20;B, CI < 3, SVRI ≥ 20;C, CI ≥ 3, SVRI < 20;and D, CI < 3, SVRI < 20. The primary outcome wasfreedom from the combined endpoint: new onset of protein-losing enteropathy or plastic bronchitis, heart transplant,and death. Clinical and hemodynamic variables and freedom from the endpoint were compared betweenthe hemodynamic categories and outcome predictors were evaluated. Results: Eighty-three patients wereincluded. Median follow-up was 5.3 years. Category A/B/C/D consisted of 4/15/53/11 patients, respectively. Allthe patients in category A were New York Heart Association I/II and had a significantly lower pulmonary vascularresistance index (PVRI). Patients in category C had lower pulmonary/systemic blood flow. Patients in category Dhad a higher PVRI and had the poorest freedom from the endpoint (44% at 5 years). Elevated FP and category Dwere outcome predictors. Conclusions: CI-SVR plots was a novel adjunctive method for Fontan hemodynamicprofiling.