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Tides in the Adriatic Sea are anomalously strong in comparison with most of other parts of the Mediterranean Sea. Consequently, tides play a fundamental role in the hydrodynamics of this sea and in the formation of destructive floods in its northernmost part. The resonant character of the Adriatic tides is evident, but the exact mechanism of their formation has never been thoroughly examined. In the present study, we used multidecadal tide gauge data from 10 stations located along the basin's coastline to examine the spectral properties of the Adriatic Sea and to provide high‐resolution tidal analysis. Our results demonstrate that both diurnal and semidiurnal tidal harmonics are resonantly amplified due to the proximity of tidal periods to the periods of the fundamental (21.5 hr) and first (10.9 hr) Adriatic eigen modes, respectively. The constructed resonance models were found to closely describe specific features of the observed tides in the Adriatic Sea, including both major and minor harmonics, and therefore help to explain the dominant physical mechanism driving the floods in the northernmost part of the basin, including the Venice Lagoon.

Objective: The objective of this study was to provide guidance on the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to determine certainty in estimates of association between prognostic factors and future outcomes. Study Design and Setting: We developed our guidance through an iterative process that involved review of published systematic reviews and meta-analyses of prognostic factors, consultation with members, feedback, presentation, and discussion at the GRADE Working Group meetings. Results: For questions of prognosis, a body of observational evidence (potentially including patients enrolled in randomized controlled trials) begins as high certainty in the evidence. The five domains of GRADE for rating down certainty in the evidence, that is, risk of bias, imprecision, inconsistency, indirectness, and publication bias, as well as the domains for rating up, also apply to estimates of associations between prognostic factors and outcomes. One should determine if their ratings do not consider (noncontextualized) or consider (contextualized) the clinical context as this will may result in variable judgments on certainty of the evidence. Conclusions: The same principles GRADE proposed for bodies of evidence addressing treatment and overall prognosis work well in assessing individual prognostic factors, both in noncontextualized and contextualized settings. (C) 2020 Elsevier Inc. All rights reserved.

Air and sea interact on a wide range of scales, shaping climate and influencing weather. The direct effect of sea surface temperature (SST) structures on the extratropical atmosphere at the daily time-scale is generally masked by the large variability associated with atmospheric dynamics. With 25 years of daily SST and surface wind observational products, obtained with data from buoys, satellite and atmospheric analysis in the Mediterranean, we show that strong surface wind convergence preferentially occurs when the air encounters a cold SST front. The mechanism responsible for the influence of ocean fronts on surface winds is rooted in the thermal disequilibrium that emerges at the air–sea interface, where cold water enhances the stability of the boundary layer, decoupling surface winds from the stronger winds aloft. Surface convergence drives upward motion which, under appropriate conditions, favours cloud formation. Thus, these results suggest that weather forecast models need to properly represent the small-scale ocean thermal structures, which could affect rainfall. © 2020 Royal Meteorological Society

Based on the data release of the Large Sky Area Multi-Object Fiber Spectroscopic Telescope survey (LAMOST DR5) and the Gaia Early Data Release 3 (Gaia EDR3), we construct a sample containing 46,109 giant (log g ≤ 3.5 dex) stars with heliocentric distance d ≤ 4 kpc, and the sample is further divided into two groups of the inner (R GC < 8.34 kpc) and outer region (R GC > 8.34 kpc). The L Z distributions of our program stars in the panels with different [Fe/H] and [α/Fe] suggest that the thick-disk consists of two distinct components with different chemical compositions and kinematic properties. For the inner region, the metal-weak thick disk (MWTD) significantly contributes when [α/Fe] > +0.2 dex and [Fe/H] < −0.8 dex, while the canonical thick-disk (TD) dominates when [Fe/H] > −0.8 dex. However, MWTD clearly appears only when [α/Fe] > +0.2 dex and [Fe/H] < −1.2 dex for the outer region, and its proportion is lower than that of the inner region within the same metallicity. Similar results can be obtained from the V ϕ distribution. The higher fraction of MWTD in the inner region than that in the outer region implies that MWTD may form in the inner disk, and is observational evidence about the inside-out disk formation scenario.

Benefiting from the pollution controls implemented by the Chinese government, the concentrations of PM2.5, SO2, NO2 and CO showed a significant decrease in Beijing during 2013–2017. In this study, an observation-based method was employed to estimate the relative contributions of regional transport (MaxRTC) and local emissions (MinLEC) to air pollutant levels during 2013–2017 in Beijing. The results showed that the MaxRTC to SO2 and PM2.5 increased significantly over the five years, while those to CO and NO2 changed little. Furthermore, the difference in the emissions control efficiency ( ΔECE ) between Beijing (receptor region) and Shijiazhuang (source region), which refers to the concentration changes corresponding to unit emission changes of a certain air pollutant between the two regions, was introduced to verify the estimated variation in MaxRTC and MinLEC over 2013–2017. The negative value of Δ ECE found for PM2.5 and SO2 supports the conclusion of an increasing effect of regional transport. This implies that local emissions control alone is not adequate for mitigating Beijing's air pollution, especially with the demand for continuously improving air quality. Joint prevention and control with regard to air quality on a regional scale is more important and urgent in the next Five-Year Plan.

International audience; Magnetic flux ropes of various scale sizes have been observed at the Earth's magnetopause for four decades. These multiple structures resulting from reconnection have complex internal field and plasma signatures, and evolve as they propagate along the dayside magnetopause. Here plasma and magnetic field observations from the Magnetospheric Multiscale (MMS) mission are used to describe a different type of large-scale multiple reconnection, magnetic flux rope-like structure at the Earth's magnetopause. These observations show at least two X lines separated by many Earth radii. Unlike smaller-scale flux ropes or flux transfer events, these multiple X lines are stationary and consist of primary and secondary X lines. The secondary X line is either transient in time or does not reconnect all of the magnetic flux that reconnects at the primary X line. Several examples of these large-scale reconnection structures are tabulated. These examples indicate that this type of structure may be common at the magnetopause at least for a narrow range of interplanetary magnetic field clock angles.

Although long predicted on theoretical grounds, prior to the 1990s there was no observational evidence of worlds orbiting distant stars; however, the development of new technologies has enabled the...

Ancient globular clusters contain multiple stellar populations identified by variations in light elements (e.g., C, N, O, Na). Although many scenarios have been suggested to explain this phenomenon, all are faced with challenges when compared with all the observational evidence. In this Letter, we propose a new scenario in which light element variations originate from nucleosynthesis in accretion discs around black holes. Since the black holes form after a few $Myrs$, the cluster is expected to still be embedded in a gas rich environment. Through a simplified accretion model, we show that the correct light element anti-correlations can be produced. Assuming a Kroupa stellar initial mass function (IMF), each black hole would only have to process ${\approx}300M_{\odot}$ of material in order to explain multiple populations; over a period of $3Myr$ this corresponds to $ \sim10^{-4} M_{\odot}yr^{-1}$ (similar to the estimated accretion rate for the X-ray binary SS 433)., Comment: Accepted for publication in MNRAS letters, heavily revised version of original preprint

Background Deterioration of hand motor function is a possible risk factor of cognitive impairment in older adults. Despite a growing body of research, a lack of clarity exists regarding the relationships. This review offers a synthesis of existing observational studies evaluating the associations of handgrip strength and hand dexterity with cognitive performance in community-dwelling older adults. Methods PubMed, PsycINFO, and ScienceDirect were systematically searched (search dates: 1990-2016), and relevant articles were cross-checked for related and relevant publications. Results Twenty-two observational studies assessed the association of handgrip strength or hand dexterity with cognitive performance; none evaluated handgrip strength and hand dexterity together. Handgrip strength was associated with global cognition, mostly assessed using the Mini-Mental State Examination, cross-sectionally and longitudinally. Also, one cross-sectional and three longitudinal studies found an association with cognitive domains, such as language, memory, visuospatial ability, working memory, and processing speed. Hand dexterity was only assessed cross-sectionally in four studies. These studies found an association with cognitive domains, such as executive function. Conclusions Although handgrip strength was associated with cognitive performance, it is unclear which variable at baseline affects the other in the long-term. Cross-sectional studies indicate an association between hand dexterity and cognitive performance, yet longitudinal studies are needed to elucidate this association. The interaction effects of both decreased grip strength and hand dexterity on cognitive performance is still unclear; therefore, future studies will need to consider the interaction of the three variables cross-sectionally and longitudinally.

The Arctic has warmed more than twice as fast as the global average since the late twentieth century, a phenomenon known as Arctic amplification (AA). Recently, there have been considerable advances in understanding the physical contributions to AA, and progress has been made in understanding the mechanisms that link it to midlatitude weather variability. Observational studies overwhelmingly support that AA is contributing to winter continental cooling. Although some model experiments support the observational evidence, most modelling results show little connection between AA and severe midlatitude weather or suggest the export of excess heating from the Arctic to lower latitudes. Divergent conclusions between model and observational studies, and even intramodel studies, continue to obfuscate a clear understanding of how AA is influencing midlatitude weather.

In recent papers (Alfonso et al., 2013; Alfonso and Raga, 2017) the sol–gel transition was proposed as a mechanism for the formation of large droplets required to trigger warm rain development in cumulus clouds. In the context of cloud physics, gelation can be interpreted as the formation of the “lucky droplet” that grows by accretion of smaller droplets at a much faster rate than the rest of the population and becomes the embryo for raindrops. However, all the results in this area have been theoretical or simulation studies. The aim of this paper is to find some observational evidence of gel formation in clouds by analyzing the distribution of the largest droplet at an early stage of cloud formation and to show that the mass of the gel (largest drop) is a mixture of a Gaussian distribution and a Gumbel distribution, in accordance with the pseudo-critical clustering scenario described in Gruyer et al. (2013) for nuclear multi-fragmentation.

Background The ART (Arterial Revascularization Trial) showed no difference in survival at 10 years between patients assigned to the single versus bilateral internal thoracic artery grafting strategies. This finding is in contrast with the results of most observational studies, where the use of 2 internal thoracic arteries has been associated with improved survival. Methods and Results We selected propensity‐matched studies from the most comprehensive observational meta‐analysis on the long‐term outcomes of patients receiving 1 versus 2 internal thoracic arteries. Individual participant survival data from each study and the ART were reconstructed using an iterative algorithm that was applied to solve the Kaplan‐Meier equations. The reconstructed individual participant survival data were aggregated to obtain combined survival curves and Cox regression hazard ratios with 95% CIs. Individual participant survival data were obtained from 14 matched observational studies (24 123 patients) and the ART. The 10‐year survival of the control group of ART was significantly higher than that of the matched observational studies (hazard ratio, 0.86; 95% CI, 0.80–0.93). The 10‐year survival of the experimental group of ART was significantly lower than that of the bilateral internal thoracic artery group of the observational studies (hazard ratio, 1.11; 95% CI, 1.03–1.20). Conclusions Both the improved outcome of the control arm and the lower beneficial effect of the intervention had played a role in the difference between observational evidence and ART.

An analysis of observational data shows that, in most cases,Wolf–Rayet (WR) stars in known WR+ OB binary systems were formed as a result of mass transfer in initial OB + OB systems, rather than through radial mass loss by the more massive OB star via its stellar wind.

Understanding the structural and dynamical drivers of network flow is an important goal for our complete understanding of complex systems. Particularly challenging is the determination of the routes used by items when flowing through a network. The study of vehicular traffic flow in cities offers a unique opportunity to test theoretical models about network flows and traffic routes using experimental data. Here, we found observational evidence that there is higher vehicular traffic flow through the communicability shortest paths, which assume an ‘all-routes’ flow, than through the shortest paths in four cities of different sizes, populations and geographical locations. The communicability function is derived here from a coarse-grained theory of traffic on networks accounting for an auxiliary vehicular propagation speed. Finally, we study the vehicular ‘all-routes’ flow in cities as the perceptual problem of drivers seeing the shortest paths as ‘too central to be empty’. Akbarzadeh and Estrada mathematically characterize the properties of traffic flow and find that, in four different cities, there is more traffic not through the shortest paths, but through the communicability shortest paths, which assume an ‘all-routes’ flow.

Within the variety of objects populating stellar clusters, blue straggler stars (BSSs) are among the most puzzling ones. BSSs are commonly found in globular clusters, but they are also known to populate open clusters of the Milky Way. Two main theoretical scenarios (collisions and mass transfer) have been suggested to explain their formation, although finding observational evidence in support of either scenario represents a challenging task. Among the APOGEE observations of the old open cluster M67, we found 8 BSS candidates known from the literature and two known evolved BSSs. We carried out a chemical analysis of 3 BSS candidates and of the 2 evolved BSSs out of the sample and found that the BSS candidates have surface abundances similar to those of stars on the main-sequence turn-off of M67. Especially the absence of any anomaly in their carbon abundances seems to support a collisional formation scenario for these stars. Furthermore, we note that the abundances of the evolved BSSs S1040 and S1237 are consistent with the abundances of the red clump stars of M67. In particular, they show a depletion in carbon by $\sim0.25$ dex, which could be either interpreted as the signature of mass transfer or as the product of stellar evolutionary processes. Finally, we summarise the properties of the individual BSS stars observed by APOGEE, as derived from their APOGEE spectra and/or from information available in the literature., 16 pages, 11 figures, accepted by MNRAS

Clarification of whether suspension-feeding infaunal bivalves are able to utilize benthic diatoms as food is essential for understanding coastal food webs. Although many benthic diatoms possess hard thickly siliceous cell walls (frustules), no study has examined if bivalves can effectively break their frustules to digest and assimilate the cell contents. In the present study, feeding rates and digestion efficiencies of the Manila clam fed on three benthic and a planktonic diatom species with different mechanical strengths (hardness) of frustules were compared to determine if the clam can efficiently break benthic diatoms with relatively hard frustules. Fragments of diatom frustules in the gut were observed using a scanning electron microscope . Although digestion efficiencies of the Manila clam were significantly different among the diatom species, the efficiencies were all above 90% for all four diatom species indicating that the Manila clam can efficiently crush hard diatom frustules of benthic species. The mechanism for crushing diatom cells in the gut appears to rely on the density of diatom cells ingested into the clam's stomach. By the rotation of the crystalline style, densely packed diatom cells in the stomach are agitated leading to attrition with each other, and subsequently the frustules are ruptured. The results of the present study indicate that when benthic diatoms are suspended in the water column the Manila clam can effectively utilize benthic diatoms as a major food source irrespective of the hardness of the diatom's frustules.

Understanding the origins and maintenance of biodiversity remains one of biology's grand challenges. From theory and observational evidence, we know that variability in environmental conditions through time is likely critical to the coexistence of competing species. Nevertheless, experimental tests of fluctuation-driven coexistence are rare and have typically focused on just one of two potential mechanisms, the temporal storage effect, to the neglect of the theoretically equally plausible mechanism known as relative nonlinearity of competition. We combined experiments and simulations in a system of nectar yeasts to quantify the relative contribution of the two mechanisms to coexistence. Resource competition models parameterized from single-species assays predicted the outcomes of mixed-culture competition experiments with 83% accuracy. Model simulations revealed that both mechanisms have measurable effects on coexistence and that relative nonlinearity can be equal or greater in magnitude to the temporal storage effect. In addition, we show that their effect on coexistence can be both antagonistic and complementary. These results falsify the common assumption that relative nonlinearity is of negligible importance, and in doing so reveal the importance of testing coexistence mechanisms in combination.

For nearly a century, the study of atmospheric dynamics in the midlatitudes has presented dichotomic perspectives on one of its focal points: the birth and life cycle of cyclones. In particular, the role of fronts has driven much of the historical discourse on cyclogenesis. In the 1910s–20s, the Bergen School of Meteorology postulated that cyclogenesis occurs on a preexisting front. This concept was later replaced by the baroclinic instability paradigm, which describes the development of a surface front as a consequence of the growing cyclone rather than its cause. However, there is ample observational evidence for cyclogenesis on well-marked fronts (frontal-wave cyclones) as well as for cyclogenesis in the absence of fronts in broader baroclinic zones. Thus, after a century of research on the link between extratropical cyclones and fronts, this study has the objective of climatologically quantifying their relationship. By combining identification schemes for cyclones and fronts, the fraction of cyclones with attendant fronts is quantified at all times during the cyclones’ life cycle. The storm-track regions over the North Atlantic are dominated by cyclones that form on preexisting fronts. Over the North Pacific, the result more strongly depends on the front definition. Cyclones that acquire their fronts during the life cycle dominate over the continents and in the Mediterranean. Further, cyclones that develop attendant fronts during their life cycle typically do so around the time they attain maximum intensity. At the time of cyclolysis, at least 40% of all cyclones are still associated with a front. The number of occluded fronts at lysis has not been considered.

The existence intermediate mass black holes (IMBH, MBH ≲ 106M⊙) at the centers low-mass galaxies with stellar masses between (1–10)×10M⊙ are key to constraining the origin of black hole (BH) seeds and understanding the physics deriving the co-evolution of central BHs and their host galaxies. However, finding and weighing IMBH is challenging. Here, we present the first observational evidence for such IMBHs at the centers of the five nearest early-type galaxies (D < 3.5 Mpc, ETGs) revealed by adaptive optics kinematics from Gemini and VLT and high-resolution HST spectroscopy. We find that all five galaxies appear to host IMBHs with four of the five having masses below 1 million M⊙ and the lowest mass BH being only ∼7,000 M⊙. This work provides a first glimpse of the demographics of IMBHs in this galaxy mass range and at velocity dispersions < 70 km/s, and thus provides an important extension to the bulge mass and galaxy dispersion scaling relations. The ubiquity of central BHs in these galaxies provides a unique constraint on BH seed formation scenarios, favoring a formation mechanism that produces an abundance of low-mass seed BHs.

Valid evidence does not support universal influenza vaccination for pregnant women, the LTE objections are unfounded. The observational evidence is less valid than that from RCTs: important safety signals in all the RCTs require high consideration. In RCTs, influenza vaccinated women have mostly local adverse effects, while their offspring shows a nonsignificant excess of deaths, and a significant excess of serious presumed/neonatal infections in the larger RCT. Several Authors have financial relationships with vaccine producers, several conclusions omit the safety signals. A cited systematic review has methodological problems and excluded important published RCTs. Waiting for new independent RCTs, the precautionary principle suggests avoiding to promote pregnant women vaccination. Health services could offer it highlighting existing uncertainties, with balanced informations allowing informed choices.

The large-scale impact of magnetic fields on galaxy clusters has been unclear. Images from the MeerKAT radio telescope suggest that such fields can bend jets of particles ejected from massive black holes in galaxy clusters. Observational evidence of cosmic magnetic fields in a galaxy cluster.

Origin of enhanced abundance of heavy elements observed in the surface chemical composition of carbon-enhanced metal-poor (CEMP) stars still remain poorly understood. Here, we present detailed abundance analysis of seven CEMP stars based on high resolution (R${\sim}$ 50\,000) spectra that reveal enough evidence of Asymptotic Giant Branch (AGB) stars being possible progenitors for these objects. For the objects HE0110$-$0406, HE1425$-$2052 and HE1428$-$1950, we present for the first time a detailed abundance analysis. Our sample is found to consists of one metal-poor ([Fe/H]$, Comment: Accepted for publication in Astrophysical Journal (ApJ)

Background Toxicological studies have raised concerns regarding the neurotoxic effects of per- and polyfluoroalkyl substances (PFAS). However, observational evidence from human studies investigating the association between childhood PFAS and neurobehavior is limited and remains unclear. Objectives To examine whether childhood PFAS concentrations are associated with neurobehavior in children at age 8 years and whether child sex modifies this relationship. Methods We used data from 208 mother-child dyads in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort (Cincinnati, OH, USA). We quantified PFAS in child serum at 3 and 8 years. We assessed neurobehavioral domains using the Behavior Assessment System for Children-2 at 8 years. We used multiple informant models to estimate score changes per ln-increase in repeated PFAS concentrations. Results Childhood PFAS were not associated with Externalizing or Internalizing Problems at 8 years. However, we noted effect measure modification by sex, with higher scores in Externalizing Problems among males per ln-unit increase in perfluorononanoate (PFNA) at 3 years (β = 4.3 points, 95% CI: 1.0, 7.7) while females had lower scores (β = −2.8 points, 95% CI: −4.7, −1.0). More Internalizing Problems were observed among males per ln-unit increase in concurrent PFNA concentrations (β = 3.7 points, 95% CI: 0.7, 6.8), but not in females (β = −1.7 points, 95% CI: −4.6, 1.2). Childhood PFNA concentrations were associated with lower scores for attention problems and activity of daily living. Conclusion While findings do not consistently support an association between childhood PFAS serum concentrations and neurobehavior, child sex may play a role in this relationship.

This paper presents the results of a systematic review of temperature and precipitation extremes over the Iberian Peninsula, focusing on observed changes in temperature and precipitation during the past years and what are the projected changes by the end of the 21st century. The purpose of this review is to assess the current literature about extreme events and their change under global warming. Observational and climate modeling studies from the past decade were considered in this review. Based on observational evidence and in climate modeling experiments, mean and maximum temperatures are projected to increase about 2 °C around the mid-century and up to 4 °C by the end of the century. The more pronounced warming is expected in summer for the central-south region of IP, with temperatures reaching 6 °C to 8 °C around 2100. Days with maximum temperature exceeding 30 °C and 40 °C will become more common (20 to 50 days/year), and the heatwaves will be 7 to 10 times more frequent. Significative reduction in events related to cold extremes. The climate change signal for precipitation in IP shows a considerable decline in precipitation (10–15%) for all seasons except winter. It is predicted that heavy precipitation will increase by 7% to 15%. Extreme precipitation will increase slightly (5%) by mid-century, then decline to 0% by 2100. Significant reduction in wet days (40% to 60%) followed by a dryness trend more pronounced by the end of the century.

There is a growing interest in the factors that influence research quality and into research culture more generally. Reform must be evidence based, but experimental studies in real-world settings can be challenging. Observational evidence, even if imperfect, can be a valuable and efficient starting point to help identify the most fruitful avenues for meta-research investment., There is growing interest in the factors that influence research quality, and into research culture more generally. Reform must be evidence-based, but experimental studies in real-world settings can be challenging. This Perspective article argues that observational evidence, even if imperfect, can be a valuable and efficient starting point to help identify the most fruitful avenues for meta-research investment.

In the last few years, alternative gravity theories have seen increased interest due to the lack of observational evidence of dark matter. Further, new empirical patterns found in rotation curve data such as the Radial Acceleration Rule (RAR) have given new testable features for gravitational theories. In this paper, we revisit two popular surveys of galaxies (Randriamampandry et al 2013 and Bottema et al 2015) which when published were shown to be problematic for alternative gravity. Here, we apply the most recent observational parameters to the surveys and provide fits of Conformal Gravity, MOND as well as the RAR rotation curve formalism and show how these theories can apply to the new findings. We also provide the fits to the RAR and Tully-Fisher relation for each theory and discuss how the RAR may allow for some confining of parameters in the fitting procedure.

The Mid-Pleistocene Transition (MPT), where the Pleistocene glacial cycles changed from 41 to ∼100 kyr periodicity, is one of the most intriguing unsolved issues in the field of paleoclimatology. Over the course of over four decades of research, several different physical mechanisms have been proposed to explain the MPT, involving non-linear feedbacks between ice sheets and the global climate, the solid Earth, ocean circulation, and the carbon cycle. Here, we review these different mechanisms, comparing how each of them relates to the others, and to the currently available observational evidence. Based on this discussion, we identify the most important gaps in our current understanding of the MPT. We discuss how new model experiments, which focus on the quantitative differences between the different physical mechanisms, could help fill these gaps. The results of those experiments could help interpret available proxy evidence, as well as new evidence that is expected to become available.

Various types of slow earthquakes (e.g., tectonic tremors and slow slip events) have been reported in tectonic zones, especially in the subduction zone. The tidal response of a tremor is considered to be strongly related to the weak friction state of the plate interface, and many studies have reported observational evidence of such correlation between tides and deep tremor activity. Here, we used the modified frequency scanning method at a single station to detect micro tectonic tremors that have not been previously reported in southern Kyushu. In the early stage of the tremor activity, tremors are mostly modulated by slow slip events. In contrast, we found a seismic response to ocean tides during the later stage in the shallower part of the subduction zone. This might indicate that the tremors are triggered by tidal changes caused by fault weakening due to slow slip events as same as deeper condition.

In the past decade, the National Network of Libraries of Medicine (NNLM) and the Medical Library Association recognized an important trend of health sciences librarian involvement in electronic health records (EHR). This trend continues as librarians seek to help solve information challenges in health care settings. In 2016, two regions of the NNLM sponsored a forum focusing on the use of EHR data. Attended by 77 librarians, clinicians and bioinformaticians, the forum confirmed that there are opportunities for librarians to develop roles related to use and analysis of EHR data as evidence for patient care, patient safety and quality improvement.

Oncoplastic breast conserving surgery is increasingly used to treat patients with breast cancer. In the absence of randomized data, a large body of observational evidence consistently indicates low rates of recurrence and high rates of survival, but points to a higher rate of complications compared to conventional breast conserving surgery. Established goals of oncoplastic breast conserving surgery are to broaden the indication for breast conservation towards larger tumors, and to improve esthetic outcomes. The benefit from the patient's perspective, however, remains largely to be confirmed. There is a growing demand to standardize various aspects of oncoplastic breast conserving surgery for implementation in clinical research and practice. Several classification systems and outcomes measurement tools have been proposed, but to the present day, none of them has achieved international acceptance.

A four-step adaptive ozone trend estimation scheme is proposed by integrating multivariate linear regression (MLR) and ensemble empirical mode decomposition (EEMD) to analyze the long-term variability of total column ozone from a set of four observational and reanalysis total ozone data sets, including the rarely explored ERA-Interim total ozone reanalysis, from 1979 to 2009. Consistency among the four data sets was first assessed, indicating a mean relative difference of 1% and root-mean-square error around 2% on average, with respect to collocated ground-based total ozone observations. Nevertheless, large drifts with significant spatiotemporal inhomogeneity were diagnosed in ERA-Interim after 1995. To emphasize long-term trends, natural ozone variations associated with the solar cycle, quasi-biennial oscillation, volcanic aerosols, and El Nino–Southern Oscillation were modeled with MLR and then removed from each total ozone record, respectively, before performing EEMD analyses. The resulting rates of change estimated from the proposed scheme captured the long-term ozone variability well, with an inflection time of 2000 clearly detected. The positive rates of change after 2000 suggest that the ozone layer seems to be on a healing path, but the results are still inadequate to conclude an actual recovery of the ozone layer, and more observational evidence is needed. Further investigations suggest that biases embedded in total ozone records may significantly impact ozone trend estimations by resulting in large uncertainty or even negative rates of change after 2000.

Clouds are a key regulator of Earth’s surface energy balance. The presence or absence of clouds, along with their macroscale and microscale characteristics, is the primary factor modulating the amount of radiation incident on the surface. Recent observational studies in the Arctic highlight the ubiquity of supercooled liquid-containing clouds (LCCs) and their disproportionately large impact on surface melt. Global climate models (GCMs) do not simulate enough Arctic LCCs compared to observations, and thus fail to represent the surface energy balance correctly. This work utilizes spaceborne observations from NASA’s A-Train satellite constellation to explore physical processes behind LCCs and surface energy biases in the Community Earth System Model Large Ensemble (CESM-LE) project output. On average CESM-LE underestimates LCC frequency by ~18% over the Arctic, resulting in a ~20 W m−2 bias in downwelling longwave radiation (DLR) over the ~18 × 106 km2 area examined. Collocated observations of falling snow and LCCs indicate that Arctic LCCs produce precipitation ~13% of the time. Conversely, CESM-LE generates snow in ~70% of LCCs. This result indicates that the Wegener–Bergeron–Findeisen (WBF) process—the growth of ice at the expense of supercooled liquid—may be too strong in the model, causing ice to scavenge polar supercooled cloud liquid too efficiently. Ground-based observations from Summit Station, Greenland, provide further evidence of these biases on a more local scale, suggesting that CESM-LE overestimates snow frequency in LCCs by ~52% at the center of the ice sheet leading to ~21% too few LCCs and ~24 W m−2 too little DLR.

Understanding the relationship between gradually varying soil moisture (SM) conditions and monsoon rainfall anomalies is crucial for seasonal prediction. Though it is an important issue, very few studies in the past attempted to diagnose the linkages between the antecedent SM and Indian summer monsoon rainfall. This study examined the relationship between spring (April–May) SM and June rainfall using observed data during the period 1979–2010. The Empirical Orthogonal Function (EOF) analyses showed that the spring SM plays a significant role in June rainfall over the Central India (CI), South India (SI), and North East India (NEI) regions. The composite anomaly of the spring SM and June rainfall showed that excess (deficit) June rainfall over the CI was preceded by wet (dry) spring SM. The anomalies in surface-specific humidity, air temperature, and surface radiation fluxes also supported the existence of a positive SM-precipitation feedback over the CI. On the contrary, excess (deficit) June rainfall over the SI and NEI region were preceded by dry (wet) spring SM. The abnormal wet (dry) SM over the SI and NEI decreased (increased) the 2-m air temperature and increased (decreased) the surface pressure compared to the surrounding oceans which resulted in less (more) moisture transport from oceans to land (negative SM-precipitation feedback over the Indian monsoon region).

The impact of ozone-depleting substances on global lower-stratospheric temperature trends is widely recognized. In the tropics, however, understanding lower-stratospheric temperature trends has proven more challenging. While the tropical lower-stratospheric cooling observed from 1979 to 1997 has been linked to tropical ozone decreases, those ozone trends cannot be of chemical origin, as active chlorine is not abundant in the tropical lower stratosphere. The 1979–97 tropical ozone trends are believed to originate from enhanced upwelling, which, it is often stated, would be driven by increasing concentrations of well-mixed greenhouse gases. This study, using simple arguments based on observational evidence after 1997, combined with model integrations with incrementally added single forcings, argues that trends in ozone-depleting substances, not well-mixed greenhouse gases, have been the primary driver of temperature and ozone trends in the tropical lower stratosphere until 1997, and this has occurred because ozone-depleting substances are key drivers of tropical upwelling and, more generally, of the entire Brewer–Dobson circulation.

We examine cases of a regional elevated mixed layer (EML) observed during the Hudson Valley Ambient Meteorology Study (HVAMS) conducted in New York State, USA in 2003. Previously observed EMLs referred to topographic domains on scales of 10 $$^{5}$$ –10 $$^{6}$$ km $$^{2}$$ . Here, we present observational evidence of the mechanisms responsible for the development and maintenance of regional EMLs overlying a valley-based convective boundary layer (CBL) on much smaller spatial scales (

At the turn of the twenty-first century, an important pair of studies established that greater female representation in government is associated with lower levels of perceived corruption in that government. But recent research finds that this relationship is not universal and questions why it exists. This article presents a new theory explaining why women’s representation is only sometimes related to lower corruption levels and provides evidence in support of that theory. The study finds that the women’s representation–corruption link is strongest when the risk of corruption being detected and punished by voters is high – in other words, when officials can be held electorally accountable. Two primary mechanisms underlie this theory: prior evidence shows that (1) women are more risk-averse than men and (2) voters hold women to a higher standard at the polls. This suggests that gender differences in corrupt behavior are proportional to the strength of electoral accountability. Consequently, the hypotheses predict that the empirical relationship between greater women’s representation and lower perceived corruption will be strongest in democracies with high electoral accountability, specifically: (1) where corruption is not the norm, (2) where press freedom is respected, (3) in parliamentary systems and (4) under personalistic electoral rules. The article presents observational evidence that electoral accountability moderates the link between women’s representation and corruption in a time-series, cross-sectional dataset of seventy-six democratic-leaning countries.

Accumulated snow amounts are a key climate change indicator. It combines the competing effects of climate change-driven changes in precipitation and stronger snowmelt related to increasing temperatures. Here we provide observational evidence from a pan-European in situ data set that mean snow depth generally decreases stronger than extreme snow depth. Widespread decreases in maximum and mean snow depth were found over Europe, except in the coldest climates, with an average decrease of −12.2%/decade for mean snow depth and −11.4%/decade for maximum snow depth since 1951. These trends accelerated after the 1980s. This has strong implications for the availability of freshwater in spring, while extremes in snow depth, usually very disruptive to society, are decreasing at a slower pace.

Isentropic mixing across and above the subtropical jet in the presence of a double tropopause may be a significant mechanism for moistening the lowermost stratosphere. We present an analysis of high spatial resolution two-dimensional measurements of the water vapour distribution that were obtained using the Spatial Heterodyne Observations of Water instrument during a demonstration flight from NASA’s high altitude ER-2 airplane. We focus on a set of measurements from 37° to 44° North, obtained on July 21, 2017 during a flight off the West coast of North America, where the instrument sampled the region above and poleward of the subtropical jet. Analysis of these measurements reveals poleward mixing of moist filaments in the region of a double tropopause. These moist filaments are examined in the context of the meteorological fields in the ECMWF (ERA-interim) model output. It is shown that the observed moist filaments are consistent with isentropic mixing across and above the sub-tropical jet. These new observations provide further evidence that the tropospheric intrusion associated with the double tropopause contributes to moistening of the lowermost stratosphere

We numerically construct images of thin accretion disks in rotating wormhole backgrounds, for the Kerr-like and the Teo class of wormholes. Our construction is illustrated by two methods, a semi-analytic scheme where separated null geodesic equations obtained by analytically integrating the second order equations once are used, as well as by a numerical ray-tracing method utilizing a fourth order Runge-Kutta algorithm. Our result shows dramatic differences between accretion disk images in wormhole backgrounds, compared to black hole ones, specifically because a wormhole can in principle have accretion disks on both sides of its throat. We establish the nature of the images if the observer and the disk are on two opposite sides of the throat, and show that these can provide conclusive observational evidence of wormhole geometries., 24 pages, 4 figures, new references added

In isolated solar active regions, we find that the waiting times between flares correlate with flare magnitudes as determined by the GOES soft X-ray fluxes. A "build-up and release" scenario (BUR) for magnetic energy storage in the solar corona suggests the existence of such a relationship, relating the slowly varying subphotospheric energy sources to the sudden coronal energy releases of flares and CMEs. Substantial amounts of research effort had not previously found any obvious observational evidence for such a BUR process. This has posed a puzzle since coronal magnetic energy storage represents the consensus view of the basic flare mechanism. We have revisited the GOES soft X-ray flare statistics for any evidence of correlations, using two isolated active regions, and have found significant evidence for a "saturation" correlation. Rather than a "reset" form of this relaxation, in which the time \textit{before} a flare correlates with its magnitude, the "saturation" relationship results in the time \textit{after} the flare showing the correlation. The observed correlation competes with the effect of reduced GOES sensitivity, in which weaker events can be under-reported systematically. This complicates the observed correlation, and we discuss several approaches to remedy this., Comment: v.2 of a submission to MNRAS

Scholars of social influence can benefit from attending to symbolic boundaries. A common and influential way to understand symbolic boundaries is as widely shared understandings of what types of behaviors, tastes, and opinions are appropriate for different kinds of people. Scholars following this understanding have mostly focused on how people judge others and how symbolic boundaries align with and thus reproduce social differences. Although this work has been impressive, I argue that it might miss important ways in which symbolic boundaries become effective in everyday social life. I therefore develop an understanding of how symbolic boundaries affect people’s ideas and decisions about themselves and their own behavior. Based on this, I argue that focusing on boundary violations—that is, what happens if people express opinions or enact behavior that contravenes what is considered (in)appropriate for people like them—might offer an important way to understand how symbolic boundaries initiate and shape cultural and social change. Using data from Add Health, I demonstrate the utility of this line of argument and show that boundary violations play an important role in channeling social influence. Conservative/Evangelical Protestants and to a lesser degree Catholics, but not Mainline Protestants are highly influenced by the drinking of co-religionists. I consider the implications for cultural sociology.

Various unification schemes interpret the complex phenomenology of quasars and luminous active galactic nuclei (AGN) in terms of a simple picture involving a central black hole, an accretion disc and an associated outflow. Here, we continue our tests of this paradigm by comparing quasar spectra to synthetic spectra of biconical disc wind models, produced with our state-of-the-art Monte Carlo radiative transfer code. Previously, we have shown that we could produce synthetic spectra resembling those of observed broad absorption line (BAL) quasars, but only if the X-ray luminosity was limited to $10^{43}$ erg s$^{-1}$. Here, we introduce a simple treatment of clumping, and find that a filling factor of $\sim0.01$ moderates the ionization state sufficiently for BAL features to form in the rest-frame UV at more realistic X-ray luminosities. Our fiducial model shows good agreement with AGN X-ray properties and the wind produces strong line emission in, e.g., Ly \alpha\ and CIV 1550\AA\ at low inclinations. At high inclinations, the spectra possess prominent LoBAL features. Despite these successes, we cannot reproduce all emission lines seen in quasar spectra with the correct equivalent-width ratios, and we find an angular dependence of emission-line equivalent width despite the similarities in the observed emission line properties of BAL and non-BAL quasars. Overall, our work suggests that biconical winds can reproduce much of the qualitative behaviour expected from a unified model, but we cannot yet provide quantitative matches with quasar properties at all viewing angles. Whether disc winds can successfully unify quasars is therefore still an open question., Comment: Accepted for publication in MNRAS. 14 pages, 8 figures. Comments welcome. Simulation grid output spectra available online at http://jhmatthews.github.io/quasar-wind-grid/

The purpose of this paper is to introduce the main scientific results made by the one-meter New Vacuum Solar Telescope (NVST), which was put into commission on 2010. NVST is one of the large aperture solar telescopes in the world, located on the shore of Fuxian lake of Yunnan province in China, aiming at serving solar physicists by providing them with high resolution photospheric and chromospheric observational data. Based on the data from NVST and complementary observations from space (e.g., Hinode, SDO and IRIS, etc), dozens of scientific papers have been published with a wide range of topics concentrating mainly on dynamics and activities of fine-scale magnetic structures and their roles in the eruptions of active-region filaments and flares. The achievements include dynamic characteristics of photospheric bright points, umbral dots, penumbral waves, and sunspot/light bridge oscillation, observational evidence of small-scale magnetic reconnection, and fine-scale dynamic structure of prominences. All these new results will shed light on the better understanding of solar eruptive activities. Data release, observation proposals, and future research subjects are introduced and discussed., 49 pages,17 figures, Accepted for publication in SCIENCE CHINA Technological Sciences, Note that the last 5 figures were not submitted due to the size limitation