Explainable El Niño predictability from climate mode interactions.

The El Niño-Southern Oscillation (ENSO) provides most of the global seasonal climate forecast skill1-3, yet, quantifying the sources of skilful predictions is a long-standing challenge4-7. Different sources of predictability affect ENSO evolution, leading to distinct global effects. Artificial intelligence forecasts offer promising advancements but linking their skill to specific physical processes is not yet possible8-10, limiting our understanding of the dynamics underpinning the advancements. Here we show that an extended nonlinear recharge oscillator (XRO) model shows skilful ENSO forecasts at lead times up to 16-18 months, better than global climate models and comparable to the most skilful artificial intelligence forecasts. The XRO parsimoniously incorporates the core ENSO dynamics and ENSO's seasonally modulated interactions with other modes of variability in the global oceans. The intrinsic enhancement of ENSO's long-range forecast skill is traceable to the initial conditions of other climate modes by means of their memory and interactions with ENSO and is quantifiable in terms of these modes' contributions to ENSO amplitude. Reforecasts using the XRO trained on climate model output show that reduced biases in both model ENSO dynamics and in climate mode interactions can lead to more skilful ENSO forecasts. The XRO framework's holistic treatment of ENSO's global multi-timescale interactions highlights promising targets for improving ENSO simulations and forecasts.

Author Correction: El Niño-Southern Oscillation complexity.

In this Review, the middle initial of author Kim M. Cobb was omitted. The original Review has been corrected online.

El Niño-Southern Oscillation complexity.

El Niño events are characterized by surface warming of the tropical Pacific Ocean and weakening of equatorial trade winds that occur every few years. Such conditions are accompanied by changes in atmospheric and oceanic circulation, affecting global climate, marine and terrestrial ecosystems, fisheries and human activities. The alternation of warm El Niño and cold La Niña conditions, referred to as the El Niño-Southern Oscillation (ENSO), represents the strongest year-to-year fluctuation of the global climate system. Here we provide a synopsis of our current understanding of the spatio-temporal complexity of this important climate mode and its influence on the Earth system.

On the influence of ENSO complexity on Pan-Pacific coastal wave extremes.

Wind-generated waves are dominant drivers of coastal dynamics and vulnerability, which have considerable impacts on littoral ecosystems and socioeconomic activities. It is therefore paramount to improve coastal hazards predictions through the better understanding of connections between wave activity and climate variability. In the Pacific, the dominant climate mode is El Niño Southern Oscillation (ENSO), which has known a renaissance of scientific interest leading to great theoretical advances in the past decade. Yet studies on ENSO's coastal impacts still rely on the oversimplified picture of the canonical dipole across the Pacific. Here, we consider the full ENSO variety to delineate its essential teleconnection pathways to tropical and extratropical storminess. These robust seasonally modulated relationships allow us to develop a mathematical model of coastal wave modulation essentially driven by ENSO's complex temporal and spatial behavior. Accounting for this nonlinear climate control on Pan-Pacific wave activity leads to a much better characterization of waves' seasonal to interannual variability (+25% in explained variance) and intensity of extremes (+60% for strong ENSO events), therefore paving the way for significantly more accurate forecasts than formerly possible with the previous baseline understanding of ENSO's influence on coastal hazards.

Summertime stationary waves integrate tropical and extratropical impacts on tropical cyclone activity.

Tropical cyclones (TC) are one of the most severe storm systems on Earth and cause significant loss of life and property upon landfall in coastal areas. A better understanding of their variability mechanisms will help improve the TC seasonal prediction skill and mitigate the destructive impacts of the storms. Early studies focused primarily on tropical processes in regulating the variability of TC activity, while recent studies suggest also some long-range impacts of extratropical processes, such as lateral transport of dry air and potential vorticity by large-scale waves. Here we show that stationary waves in the Northern Hemisphere integrate tropical and extratropical impacts on TC activity in July through October. In particular, tropical upper-tropospheric troughs (TUTTs), as part of the summertime stationary waves, are associated with the variability of large-scale environmental conditions in the tropical North Atlantic and North Pacific and significantly correlated to the variability of TC activity in these basins. TUTTs are subject to the modulation of diabatic heating in various regions and are the preferred locations for extratropical Rossby wave breaking (RWB). A strong TUTT in a basin is associated with enhanced RWB and tropical-extratropical stirring in that basin, and the resultant changes in the tropical atmospheric conditions modulate TC activity. In addition, the anticorrelation of TUTTs between the North Atlantic and North Pacific makes the TC activity indices over the two basins compensate each other, rendering the global TC activity less variable than otherwise would be the case if TUTTs were independent.

Evaluation of the clinical application effect of eSource record tools for clinical research.

BACKGROUND: Electronic sources (eSources) can improve data quality and reduce clinical trial costs. Our team has developed an innovative eSource record (ESR) system in China. This study aims to evaluate the efficiency, quality, and system performance of the ESR system in data collection and data transcription. METHODS: The study used time efficiency and data transcription accuracy indicators to compare the eSource and non-eSource data collection workflows in a real-world study (RWS). The two processes are traditional data collection and manual transcription (the non-eSource method) and the ESR-based source data collection and electronic transmission (the eSource method). Through the system usability scale (SUS) and other characteristic evaluation scales (system security, system compatibility, record quality), the participants' experience of using ESR was evaluated. RESULTS: In terms of the source data collection (the total time required for writing electronic medical records (EMRs)), the ESR system can reduce the time required by 39% on average compared to the EMR system. In terms of data transcription (electronic case report form (eCRF) filling and verification), the ESR can reduce the time required by 80% compared to the non-eSource method (difference: 223 ± 21 s). The ESR accuracy in filling the eCRF field is 96.92%. The SUS score of ESR is 66.9 ± 16.7, which is at the D level and thus very close to the acceptable margin, indicating that optimization work is needed. CONCLUSIONS: This preliminary evaluation shows that in the clinical medical environment, the ESR-based eSource method can improve the efficiency of source data collection and reduce the workload required to complete data transcription.

Consensus-Based Linguistic Distribution Large-Scale Group Decision Making Using Statistical Inference and Regret Theory.

Large-scale group decision-making (LSGDM) deals with complex decision- making problems which involve a large number of decision makers (DMs). Such a complex scenario leads to uncertain contexts in which DMs elicit their knowledge using linguistic information that can be modelled using different representations. However, current processes for solving LSGDM problems commonly neglect a key concept in many real-world decision-making problems, such as DMs' regret aversion psychological behavior. Therefore, this paper introduces a novel consensus based linguistic distribution LSGDM (CLDLSGDM) approach based on a statistical inference principle that considers DMs' regret aversion psychological characteristics using regret theory and which aims at obtaining agreed solutions. Specifically, the CLDLSGDM approach applies the statistical inference principle to the consensual information obtained in the consensus process, in order to derive the weights of DMs and attributes using the consensus matrix and adjusted decision-making matrices to solve the decision-making problem. Afterwards, by using regret theory, the comprehensive perceived utility values of alternatives are derived and their ranking determined. Finally, a performance evaluation of public hospitals in China is given as an example in order to illustrate the implementation of the designed method. The stability and advantages of the designed method are analyzed by a sensitivity and a comparative analysis.

Pellicle development of Shewanella oneidensis is an aerotaxis-piloted and energy-dependent process.

Pellicles are biofilms found at the air-liquid interface and are widely distributed in natural environments. In this study, a simple pellicle detection method was established, and using this new method, the pellicle formation activities of Shewanella oneidensis MR-1 and its 42 cytochrome c mutants were analysed. The results showed that the pellicle was initiated at very early stages of incubation. Aerotaxis was the major external factor, while energy acquirement was the main internal factor for pellicle initiation. Among the 42 cytochrome c mutants, 17 mutants, including those deficient in aerobic respiration, sulfur or sulfite/sulfate respiration, nitrite respiration, metal respiration, DMSO respiration and fumarate respiration, exhibited delayed pellicle initiation. The results suggest that S. oneidensis utilizes the electron acceptors simultaneously under anoxic conditions and that the disruption of any of these anaerobic respiration routes would retard pellicle initiation.

Late-twentieth-century emergence of the El Niño propagation asymmetry and future projections.

The El Niño/Southern Oscillation (ENSO) is the Earth's most prominent source of interannual climate variability, exerting profound worldwide effects. Despite decades of research, its behaviour continues to challenge scientists. In the eastern equatorial Pacific Ocean, the anomalously cool sea surface temperatures (SSTs) found during La Niña events and the warm waters of modest El Niño events both propagate westwards, as in the seasonal cycle. In contrast, SST anomalies propagate eastwards during extreme El Niño events, prominently in the post-1976 period, spurring unusual weather events worldwide with costly consequences. The cause of this propagation asymmetry is currently unknown. Here we trace the cause of the asymmetry to the variations in upper ocean currents in the equatorial Pacific, whereby the westward-flowing currents are enhanced during La Niña events but reversed during extreme El Niño events. Our results highlight that propagation asymmetry is favoured when the westward mean equatorial currents weaken, as is projected to be the case under global warming. By analysing past and future climate simulations of an ensemble of models with more realistic propagation, we find a doubling in the occurrences of El Niño events that feature prominent eastward propagation characteristics in a warmer world. Our analysis thus suggests that more frequent emergence of propagation asymmetry will be an indication of the Earth's warming climate.

Beta-ionone-inhibited proliferation of breast cancer cells by inhibited COX-2 activity.

As one of the isoprenoids and widely derived from many fruits and vegetables, ß-ionone (BI) has a potent inhibitory proliferation of cancer cells in vitro and in vivo. However, its exact mechanism is still uncompleted understood and needs to be further verified. Cyclooxygenase-2 (COX-2), as a potential target of cancer chemoprevention, has been played pivotal roles in proliferation of tumor cells and carcinogenesis. Thus, the objective of present study was to determine that BI inhibited the activity of COX-2 in breast cancer and related to cancer cell models. Cell proliferation, DNA synthesis, the distribution of cell cycle, apoptosis induction and the expression of P38-MAPK protein were determined in MCF-7 cells by methylene blue, 3H-thymidine (TdR) incorporation, flow cytometry, TUNEL and Western blotting assays. Quinone reductase (QR) activity was determined in murine hepatoma Hepa1c1c7 cells by enzyme-linked immunosorbent assay (ELISA). The expression of COX-2 in a phorbol-12-myristate-13-acetate (PMA)-induced cell model and mammary tumor tissues was examined by Western blotting and immunohistochemistry. The results showed that BI significantly inhibited cell proliferation and DNA synthesis, arrested the distribution of cell cycle at the S phase or decreased proteins related to cell cycle such as cyclin D1 and CDK4, induced apoptosis and increased the expression of p-P38 in MCF-7 cells. BI at low doses (< 50 µmol/L) significantly increased QR activity, decreased the expression of COX-2 protein and prostaglandin E2 (PEG2) release in cell models. In addition, BI also significantly decreased the expression of COX-2 protein in rat mammary tumor tissues. Therefore, our findings indicate that BI possesses inhibitory proliferation of breast cancer cells through down-regulation of COX-2 activity.

El Niño-Southern Oscillation frequency cascade.

The El Niño-Southern Oscillation (ENSO) phenomenon, the most pronounced feature of internally generated climate variability, occurs on interannual timescales and impacts the global climate system through an interaction with the annual cycle. The tight coupling between ENSO and the annual cycle is particularly pronounced over the tropical Western Pacific. Here we show that this nonlinear interaction results in a frequency cascade in the atmospheric circulation, which is characterized by deterministic high-frequency variability on near-annual and subannual timescales. Through climate model experiments and observational analysis, it is documented that a substantial fraction of the anomalous Northwest Pacific anticyclone variability, which is the main atmospheric link between ENSO and the East Asian Monsoon system, can be explained by these interactions and is thus deterministic and potentially predictable.

El Niño in a changing climate.

El Niño events, characterized by anomalous warming in the eastern equatorial Pacific Ocean, have global climatic teleconnections and are the most dominant feature of cyclic climate variability on subdecadal timescales. Understanding changes in the frequency or characteristics of El Niño events in a changing climate is therefore of broad scientific and socioeconomic interest. Recent studies show that the canonical El Niño has become less frequent and that a different kind of El Niño has become more common during the late twentieth century, in which warm sea surface temperatures (SSTs) in the central Pacific are flanked on the east and west by cooler SSTs. This type of El Niño, termed the central Pacific El Niño (CP-El Niño; also termed the dateline El Niño, El Niño Modoki or warm pool El Niño), differs from the canonical eastern Pacific El Niño (EP-El Niño) in both the location of maximum SST anomalies and tropical-midlatitude teleconnections. Here we show changes in the ratio of CP-El Niño to EP-El Niño under projected global warming scenarios from the Coupled Model Intercomparison Project phase 3 multi-model data set. Using calculations based on historical El Niño indices, we find that projections of anthropogenic climate change are associated with an increased frequency of the CP-El Niño compared to the EP-El Niño. When restricted to the six climate models with the best representation of the twentieth-century ratio of CP-El Niño to EP-El Niño, the occurrence ratio of CP-El Niño/EP-El Niño is projected to increase as much as five times under global warming. The change is related to a flattening of the thermocline in the equatorial Pacific.

Northwestern Pacific Oceanic circulation shaped by ENSO.

The intricate currents of the Northwest Pacific Ocean, with strong manifestations along the westside rim, connect tropical and subtropical gyres and significantly influence East Asian and global climates. The El Niño/Southern Oscillation (ENSO) originates in the tropical Pacific Ocean and disrupts this ocean circulation system. However, the spatiotemporal dependence of the impact of ENSO events has yet to be elucidated because of the complexities of both ENSO events and circulation systems, as well as the increased availability of observational data. We thus combined altimeter and drifter observations to demonstrate the distinct tropical and subtropical influences of the circulation system on ENSO diversity. During El Niño years, the North Equatorial Current, North Equatorial Countercurrent, Mindanao Current, Indonesian Throughflow, and the subtropical Kuroshio Current and its Extension region exhibit strengthening, while the tropical Kuroshio Current weakens. The tropical impact is characterized by sea level changes in the warm pool, whereas the subtropical influence is driven by variations in the wind stress curl. The tropical and subtropical influences are amplified during the Centra Pacific El Niño years compared to the Eastern Pacific El Niño years. As the globe warms, these impacts are anticipated to intensify. Thus, strengthening observation systems and refining climate models are essential for understanding and projecting the enhancing influences of ENSO on the Northwest Pacific Oceanic circulation.

[Expression of MicroRNA-3162-3p in Different Clinical Stages of Children with Primary Immune Thrombocytopenia and Its Significance].

OBJECTIVE: To explore the expression of microRNA-3162-3p in different clinical stages of childhood primary immune thrombocytopenia (ITP) and its significance. METHODS: Ninety-six children with ITP were enrolled and divided into new diagnosis group (n=40), persistent group (n=30) and chronic group (n=26) according to the course of disease. 80 healthy children were selected as the control group. Peripheral blood mononuclear cells (PBMNC) of ITP children and healthy children were isolated and cultured, and the expression of microRNA-3162-3p in PBMNC of subjects was detected by real-time fluorescence quantitative PCR. The contents of IL-17, IL-23, IL-10 and TGF-ß in PBMNC of subjects were determined by ELISA. The correlation between microRNA-3162-3p and platelet count, IL-17, IL-23, IL-10 and TGF-ß was analyzed. RESULTS: Compared with the control group, the expression of microRNA-3162-3p and IL-10 in PBMNC and platelet count of ITP children were significantly decreased（P < 0.05）, while IL-17, IL-23 and TGF-ß were significantly increased (P < 0.05). With the prolongation of the disease course, the expressions of microRNA-3162-3p and IL-10 in PBMNC and platelet count were significantly decreased（P < 0.05）, while the expressions of IL-17, IL-23 and TGF-ß were significantly increased (P < 0.05). The expression of microRNA-3162-3p in PBMNC was positively correlated with platelet count and IL-10 (r =0.716, 0.667), and negatively correlated with IL-17, IL-23, and TGF-ß (r =-0.540, -0.641, -0.560). CONCLUSION: MicroRNA-3162-3p expression is significantly reduced in PBMNC of children with ITP, and is involved in the regulation of Th17/Treg imbalance, which can be used as a potential therapeutic target of ITP.

Ocean internal tides suppress tropical cyclones in the South China Sea.

Tropical Cyclones (TCs) are devastating natural disasters. Analyzing four decades of global TC data, here we find that among all global TC-active basins, the South China Sea (SCS) stands out as particularly difficult ocean for TCs to intensify, despite favorable atmosphere and ocean conditions. Over the SCS, TC intensification rate and its probability for a rapid intensification (intensification by ≥ 15.4 m s-1 day-1) are only 1/2 and 1/3, respectively, of those for the rest of the world ocean. Originating from complex interplays between astronomic tides and the SCS topography, gigantic ocean internal tides interact with TC-generated oceanic near-inertial waves and induce a strong ocean cooling effect, suppressing the TC intensification. Inclusion of this interaction between internal tides and TC in operational weather prediction systems is expected to improve forecast of TC intensity in the SCS and in other regions where strong internal tides are present.

Challenges and Solutions in Implementing eSource Technology for Real-World Studies in China: Qualitative Study Among Different Stakeholders.

BACKGROUND: eSources consist of data that were initially documented in an electronic structure. Typically, an eSource encompasses the direct acquisition, compilation, and retention of electronic information (such as electronic health records [EHRs] or wearable devices), which serves to streamline clinical research. eSources have the potential to enhance the accuracy of data, promote patient safety, and minimize expenses associated with clinical trials. An opinion study published in September 2020 by TransCelerate outlined a road map for the future application of eSource technology and identified 5 key areas of challenges. The background of this study concerns the use of eSource technology in clinical research. OBJECTIVE: The aim of this study was to present challenges and possible solutions for the implementation of eSource technology in real-world studies by summarizing team experiences and lessons learned from an eSource record (ESR) project. METHODS: After initially developing a simple prototype of the ESR software that can be demonstrated systematically, the researchers conducted in-depth interviews and interacted with different stakeholders to obtain guidance and suggestions. The researchers selected 5 different roles for interviewees: regulatory authorities, pharmaceutical company representatives, hospital information department employees, medical system providers, and clinicians. RESULTS: After screening all consultants, the researchers concluded that there were 25 representative consultants. The hospital information department needs to implement many demands from various stakeholders, which makes the existing EHR system unable to meet all the demands of eSources. The emergence of an ESR is intended to divert the burden of the hospital information department from the enormous functional requirements of the outdated EHR system. The entire research process emphasizes multidisciplinary and multibackground expert opinions and considers the complexity of the knowledge backgrounds of personnel involved in the chain of clinical source data collection, processing, quality control, and application in real-world scenarios. To increase the readability of the results, the researchers classified the main results in accordance with the paragraph titles in "Use of Electronic Health Record Data in Clinical Investigations," a guide released by the US Food and Drug Administration. CONCLUSIONS: This study introduces the requirement dependencies of different stakeholders and the challenges and recommendations for designing ESR software when implementing eSource technology in China. Experiences based on ESR projects will provide new insights into the disciplines that advance the eSource research field. Future studies should engage patients directly to understand their experiences, concerns, and preferences regarding the implementation of eSource technology. Moreover, involving additional stakeholders, including community health care providers and social workers, will provide valuable insights into the challenges and potential solutions across various health care settings.

Epidemiology and the economic burden of traumatic fractures in China: A population-based study.

Objectives: National data on the admission rate, distribution, in-hospital mortality, and economic burden of traumatic fractures in China is unclear. We aimed to conduct a cross-sectional population-based study to determine such above data at the national level in China. Methods: A national administrative database was used to review all traumatic fracture hospitalizations in China during 2020, from which a total of 2,025,169 inpatients with traumatic fractures was retrieved. Admission rates and in-hospital mortality rates stratified by age, sex, and region were calculated. The causes of traumatic fracture and economic burden were described. Results: The admission rate of traumatic fractures of all China population in 2020 was 1.437‰. The admission rate increased with age and varied with genders and causes of injuries. Falls are the leading cause of traumatic fracture hospitalization, followed by road traffic injuries. The most common diagnoses were femoral neck fractures, with a number of 138,377. The in-hospital mortality was 1.209‰. Road traffic injuries led to the highest in-hospital mortality. The median length of stay was 10 days, with the median hospitalization cost of ¥20,900 (about $3,056). Conclusion: Traumatic fractures are concerning conditions with a high admission rate and in-hospital mortality in China, which are mainly caused by falls and road traffic injuries. The government should implement more public health policies to enhance the health of the elderly and improve transportation safety to prevent traumatic fractures.

Hysteresis of the El Niño-Southern Oscillation to CO2 forcing.

El Niño-Southern Oscillation (ENSO) is the strongest interannual climate variability with far-reaching socioeconomic consequences. Many studies have investigated ENSO-projected changes under future greenhouse warming, but its responses to plausible mitigation behaviors remain unknown. We show that ENSO sea surface temperature (SST) variability and associated global teleconnection patterns exhibit strong hysteretic responses to carbon dioxide (CO2) reduction based on the 28-member ensemble simulations of the CESM1.2 model under an idealized CO2 ramp-up and ramp-down scenario. There is a substantial increase in the ensemble-averaged eastern Pacific SST anomaly variance during the ramp-down period compared to the ramp-up period. Such ENSO hysteresis is mainly attributed to the hysteretic response of the tropical Pacific Intertropical Convergence Zone meridional position to CO2 removal and is further supported by several selected single-member Coupled Model Intercomparison Project Phase 6 (CMIP6) model simulations. The presence of ENSO hysteresis leads to its amplified and prolonged impact in a warming climate, depending on the details of future mitigation pathways.

Influence of El Niño on the variability of global shoreline position.

Coastal zones are fragile and complex dynamical systems that are increasingly under threat from the combined effects of anthropogenic pressure and climate change. Using global satellite derived shoreline positions from 1993 to 2019 and a variety of reanalysis products, here we show that shorelines are under the influence of three main drivers: sea-level, ocean waves and river discharge. While sea level directly affects coastal mobility, waves affect both erosion/accretion and total water levels, and rivers affect coastal sediment budgets and salinity-induced water levels. By deriving a conceptual global model that accounts for the influence of dominant modes of climate variability on these drivers, we show that interannual shoreline changes are largely driven by different ENSO regimes and their complex inter-basin teleconnections. Our results provide a new framework for understanding and predicting climate-induced coastal hazards.

Electronic Source Data Transcription for Electronic Case Report Forms in China: Validation of the Electronic Source Record Tool in a Real-world Ophthalmology Study.

BACKGROUND: As researchers are increasingly interested in real-world studies (RWSs), improving data collection efficiency and data quality has become an important challenge. An electronic source (eSource) generally includes direct capture, collection, and storage of electronic data to simplify clinical research. It can improve data quality and patient safety and reduce clinical trial costs. Although there are already large projects on eSource technology, there is a lack of experience in using eSource technology to implement RWSs. Our team designed and developed an eSource record (ESR) system in China. In a preliminary prospective study, we selected a cosmetic medical device project to evaluate ESR software's effect on data collection and transcription. As the previous case verification was simple, we plan to choose more complicated ophthalmology projects to further evaluate the ESR. OBJECTIVE: We aimed to evaluate the data transcription efficiency and quality of ESR software in retrospective studies to verify the feasibility of using eSource as an alternative to traditional manual transcription of data in RWS projects. METHODS: The approved ophthalmic femtosecond laser project was used for ESR case validation. This study compared the efficiency and quality of data transcription between the eSource method using ESR software and the traditional clinical research model of manually transcribing the data. Usability refers to the quality of a user's experience when interacting with products or systems including websites, software, devices, or applications. To evaluate the system availability of ESR, we used the System Usability Scale (SUS). The questionnaire consisted of the following 2 parts: participant information and SUS evaluation of the electronic medical record (EMR), electronic data capture (EDC), and ESR systems. By accessing log data from the EDC system previously used by the research project, all the time spent from the beginning to the end of the study could be counted. RESULTS: In terms of transcription time cost per field, the eSource method can reduce the time cost by 81.8% (11.2/13.7). Compared with traditional manual data transcription, the eSource method has higher data transcription quality (correct entry rate of 2356/2400, 98.17% vs 47,991/51,424, 93.32%). A total of 15 questionnaires were received with a response rate of 100%. In terms of usability, the average overall SUS scores of the EMR, EDC, and ESR systems were 50.3 (SD 21.9), 51.5 (SD 14.2), and 63.0 (SD 11.3; contract research organization experts: 69.5, SD 11.5; clinicians: 59.8, SD 10.2), respectively. The Cronbach α for the SUS items of the EMR, EDC, and ESR systems were 0.591 (95% CI -0.012 to 0.903), 0.588 (95% CI -0.288 to 0.951), and 0.785 (95% CI 0.576-0.916), respectively. CONCLUSIONS: In real-world ophthalmology studies, the eSource approach based on the ESR system can replace the traditional clinical research model that relies on the manual transcription of data.