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  • 1
    Online Resource
    Online Resource
    An Outbreak of Fungal Endophthalmitis After Cataract Surgery in South Korea
    American Medical Association (AMA) ; 2023
    In:  JAMA Ophthalmology Vol. 141, No. 3 ( 2023-03-01), p. 226-
    Details
    In: JAMA Ophthalmology, American Medical Association (AMA), Vol. 141, No. 3 ( 2023-03-01), p. 226-
    Abstract: Fungal endophthalmitis caused by contaminated medical products is extremely rare; it follows an intractable clinical course with a poor visual prognosis. Objective To report the epidemiologic and clinical features and treatment outcomes of a nationwide fungal endophthalmitis outbreak after cataract surgery as a result of contaminated viscoelastic agents in South Korea. Design, Setting, and Participants This was a retrospective case series analysis of clinical data from multiple institutions in South Korea conducted from September 1, 2020, to October 31, 2021. Data were collected through nationwide surveys in May and October 2021 from the 100 members of the Korean Retinal Society. Patients were diagnosed with fungal endophthalmitis resulting from the use of the viscoelastic material sodium hyaluronate (Unial [Unimed Pharmaceutical Inc]). Data were analyzed from November 1, 2021, to May 30, 2022. Main Outcomes and Measures The clinical features and causative species were identified, and treatment outcomes were analyzed for patients who underwent 6 months of follow-up. Results The fungal endophthalmitis outbreak developed between September 1, 2020, and June 30, 2021, and peaked in November 2020. An official investigation by the Korea Disease Control and Prevention Agency confirmed contamination of viscoelastic material. All 281 eyes of 265 patients (mean [SD] age, 65.4 [10.8] years; 153 female individuals [57.7%]) were diagnosed with fungal endophthalmitis, based on clinical examinations and supportive culture results. The mean (SD) time period between cataract surgery and diagnosis was 24.7 (17.3) days. Patients exhibited characteristic clinical features of fungal endophthalmitis, including vitreous opacity (212 of 281 [75.4%] ), infiltration into the intraocular lens (143 of 281 [50.9%]), and ciliary infiltration (55 of 281 [19.6%] ). Cultures were performed in 260 eyes, and fungal presence was confirmed in 103 eyes (39.6%). Among them, Fusarium species were identified in 89 eyes (86.4%). Among the 228 eyes included in the treatment outcome analysis, the mean (SD) best-corrected visual acuity improved from 0.78 (0.74) logMAR (Snellen equivalent, 20/120 [7.3 lines]) to 0.36 (0.49) logMAR (Snellen equivalent, 20/45 [4.9 lines] ) at 6 months. Furthermore, disease remission with no signs of fungal endophthalmitis (or cells in the anterior chamber milder than grade 1) was noted in 214 eyes (93.9%). Conclusions and Relevance This was a retrospectively reviewed case series of a fungal endophthalmitis outbreak resulting from contaminated viscoelastic material. Findings of this case series study support the potential benefit of prompt, aggressive surgical intervention that may reduce treatment burden and improve prognosis of fungal endophthalmitis caused by contaminated medical products.
    Type of Medium: Online Resource
    ISSN: 2168-6165
    URL: Article
    DOI: 10.1001/jamaophthalmol.2022.5927
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2023
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  • 2
    Online Resource
    Online Resource
    Genetic Diversity, Structure, and Core Collection of Korean Apple Germplasm Using Simple Sequence Repeat Markers
    Japanese Society for Horticultural Science ; 2019
    In:  The Horticulture Journal Vol. 88, No. 3 ( 2019), p. 329-337
    Details
    In: The Horticulture Journal, Japanese Society for Horticultural Science, Vol. 88, No. 3 ( 2019), p. 329-337
    Type of Medium: Online Resource
    ISSN: 2189-0102 , 2189-0110
    URL: Article
    DOI: 10.2503/hortj.UTD-041
    Language: English
    Publisher: Japanese Society for Horticultural Science
    Publication Date: 2019
    detail.hit.zdb_id: 2857293-2
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  • 3
    Online Resource
    Online Resource
    Understanding ENSO Regime Behavior upon an Increase in the Warm-Pool Temperature Using a Simple ENSO Model
    American Meteorological Society ; 2011
    In:  Journal of Climate Vol. 24, No. 5 ( 2011-03-01), p. 1438-1450
    Details
    In: Journal of Climate, American Meteorological Society, Vol. 24, No. 5 ( 2011-03-01), p. 1438-1450
    Abstract: The regime behavior of the low-order El Niño–Southern Oscillation (ENSO) model, according to an increase in the radiative–convective equilibrium sea surface temperature (SST; Tr), is studied to provide a possible explanation for the observed increase in ENSO irregularity characterized by decadal modulation. During recent decades, a clear increasing trend of the warm-pool SST has been observed. In this study, the increase in the warm-pool maximum SST is interpreted as an increase in Tr following previous studies. A bifurcation analysis with Tr as a control parameter is conducted to reveal that the degree of ENSO irregularity in the model is effectively controlled by the equilibrium states of the model. At a critical value of Tr, bifurcation analysis reveals that period-doubling bifurcation occurs and an amplitude-modulated ENSO emerges. At this point, a subcycle appears within the preexisting ENSO cycle, which initiates decadal modulation of ENSO. As Tr increases further, nested oscillations are successively generated, illustrating clear decadal modulation of ENSO. The qualitative regime changes revealed in this study are supported by the observation of regime shifts in the 1970s. With increasing Tr, the mean zonal SST gradient increases, and the model adjusts toward a “La Niña–like” mean state. Further constraint with shoaling of the mean thermocline depth and increasing stratification causes ENSO to exhibit stronger amplitude modulation. Furthermore, the timing of the period-doubling bifurcation advances with these two effects.
    Type of Medium: Online Resource
    ISSN: 1520-0442 , 0894-8755
    URL: Article
    DOI: 10.1175/2010JCLI3635.1
    RVK:
    UA 4548
    Language: English
    Publisher: American Meteorological Society
    Publication Date: 2011
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 4
    Online Resource
    Online Resource
    Sensitivity of ENSO to Stratification in a Recharge–Discharge Conceptual Model
    American Meteorological Society ; 2011
    In:  Journal of Climate Vol. 24, No. 16 ( 2011-08-15), p. 4332-4349
    Details
    In: Journal of Climate, American Meteorological Society, Vol. 24, No. 16 ( 2011-08-15), p. 4332-4349
    Abstract: El Niño–Southern Oscillation (ENSO) is driven by large-scale ocean–atmosphere interactions in the equatorial Pacific and is sensitive to change in the mean state. Whereas conceptual models of ENSO usually consider the depth of the thermocline to be influential on the stability of ENSO, the observed changes in the depth of the 20°C isotherm are rather weak, on the order of approximately 5 m over the last decades. Conversely, change in stratification that affects both the intensity and sharpness of the thermocline can be pronounced. Here, the two-strip conceptual model of An and Jin is extended to include three parameters (i.e., the contribution of the first three baroclinic modes) that account for the main characteristics of the mean thermocline vertical structure. A stability analysis of the model is carried out that indicates that the model sustains a lower ENSO mode when the high-order baroclinic modes (M2 and M3) are considered. The sensitivity of the model solution to the coupling efficiency further indicates that, in the weak coupling regime, the model allows for several ocean basin modes at low frequency. The latter can eventually merge into a low-frequency and unstable mode representative of ENSO as the coupling efficiency increases. Also, higher baroclinic modes project more energy onto the ocean dynamics for the same input of wind forcing. Therefore, in this study’s model, a shallower, yet more intense mean thermocline may still sustain a strong (i.e., unstable) and low-frequency ENSO mode. Sensitivity tests to the strength of the two dominant feedbacks (thermocline vs zonal advection) indicate that the presence of high-order baroclinic modes favors the bifurcation from a low-frequency regime to a higher-frequency regime when the zonal advective feedback is enhanced. It is suggested that the proposed formalism can be used to interpret and measure the sensitivity of coupled general circulation models to climate change.
    Type of Medium: Online Resource
    ISSN: 0894-8755 , 1520-0442
    URL: Article
    DOI: 10.1175/2011JCLI4148.1
    RVK:
    UA 4548
    Language: English
    Publisher: American Meteorological Society
    Publication Date: 2011
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 5
    Online Resource
    Online Resource
    Impact of North Atlantic Freshwater Forcing on the Pacific Meridional Overturning Circulation under Glacial and Interglacial Conditions
    American Meteorological Society ; 2019
    In:  Journal of Climate Vol. 32, No. 15 ( 2019-08-01), p. 4641-4659
    Details
    In: Journal of Climate, American Meteorological Society, Vol. 32, No. 15 ( 2019-08-01), p. 4641-4659
    Abstract: The Pacific meridional overturning circulation (PMOC) is not well known compared to the Atlantic meridional overturning circulation (AMOC), due to its absence today. However, considering PMOC development under different climate conditions shown by proxy and modeling studies, a better understanding of PMOC is appropriate to properly assess the past and future climate change associated with global ocean circulation. Here, the PMOC response to freshwater forcing in the North Atlantic (NA) is investigated using an Earth system model of intermediate complexity under glacial (i.e., Last Glacial Maximum) and interglacial [i.e., preindustrial with/without inflow through Bering Strait (BS)] conditions. The water hosing over NA led to the shutdown of the AMOC, which accompanied an active PMOC except for the preindustrial condition with the opening BS, indicating that the emergence of the PMOC is constrained by the freshwater inflow through the BS, which hinders its destabilization through enhancing ocean stratification. However, the closure of the BS itself could not explain how the sinking motion is maintained in the North Pacific. Here we found that various atmospheric and oceanic processes are involved to sustain the active PMOC. First, an atmospheric teleconnection associated with the collapsed AMOC encouraged the evaporation in the sinking region, causing buoyancy loss at the surface of the North Pacific. Second, the strengthened subpolar gyre transported saltier water northward, enhancing dense water formation. Finally, the vigorous upwelling in the Southern Ocean enabled a consistent mass supply to the sinking region, with the aid of enhanced westerlies.
    Type of Medium: Online Resource
    ISSN: 0894-8755 , 1520-0442
    URL: Article
    DOI: 10.1175/JCLI-D-19-0065.1
    RVK:
    UA 4548
    Language: English
    Publisher: American Meteorological Society
    Publication Date: 2019
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 6
    Online Resource
    Online Resource
    Characteristics of the North Pacific Oscillation in CMIP5 Models in Relation to Atmospheric Mean States
    American Meteorological Society ; 2020
    In:  Journal of Climate Vol. 33, No. 9 ( 2020-05-01), p. 3809-3825
    Details
    In: Journal of Climate, American Meteorological Society, Vol. 33, No. 9 ( 2020-05-01), p. 3809-3825
    Abstract: The North Pacific Oscillation (NPO), the second leading atmospheric mode in the North Pacific Ocean, is known to be responsible for climate variability and extremes in adjacent regions. The reproducibility of the NPO in climate models is thus a topic of interest for the more accurate prediction of climate extremes. By investigating the spatial characteristics of the NPO in models from phase 5 of the Coupled Model Intercomparison Project (CMIP5), this study reveals the intimate relationship between the NPO structure and the atmospheric mean states over the North Pacific. The majority of the models reasonably capture the meridional contrast of pressure anomalies, but the detailed horizontal characteristics of the NPO are found to differ among the models. Diagnostic analysis of 30 climate models and long-term observations suggest that systematic bias in the mean atmospheric baroclinicity over the North Pacific crucially affects the horizontal shape and zonal position of the NPO. In the models in which the climatological continental trough over the western North Pacific extends farther to the east, the NPO tends to be simulated farther to the east, strengthening its impact on the downstream climate. In contrast, when the climatological continental trough is reduced in size toward the west, the growth of the NPO is limited to the west, and its influence is weakened downstream. This relationship can be understood via the altered available potential and kinetic energy conversions that feed the total energy of the NPO, primarily stemming from the difference in the mean horizontal temperature gradient and stretching deformation of the mean horizontal wind.
    Type of Medium: Online Resource
    ISSN: 0894-8755 , 1520-0442
    URL: Article
    DOI: 10.1175/JCLI-D-19-0446.1
    RVK:
    UA 4548
    Language: Unknown
    Publisher: American Meteorological Society
    Publication Date: 2020
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 7
    Online Resource
    Online Resource
    El Niño–La Niña Asymmetry in the Coupled Model Intercomparison Project Simulations*
    American Meteorological Society ; 2005
    In:  Journal of Climate Vol. 18, No. 14 ( 2005-07-15), p. 2617-2627
    Details
    In: Journal of Climate, American Meteorological Society, Vol. 18, No. 14 ( 2005-07-15), p. 2617-2627
    Abstract: The El Niño–La Niña asymmetry was estimated in the 10 different models participating in the Coupled Model Intercomparison Project (CMIP). Large differences in the “asymmetricity” (a variance-weighted skewness) of SST anomalies are found between models and observations. Most of the coupled models underestimate the nonlinearity and only a few exhibit the positively skewed SST anomalies over the tropical eastern Pacific as seen in the observation. A significant association between the nonlinear dynamical heating (NDH) and asymmetricity in the model–ENSO indices is found, inferring that asymmetricity is caused mainly by NDH. Among the 10 models, one coupled GCM simulates the asymmetricity of the tropical SST realistically, and its simulation manifests a strong relationship between the intensity and the propagating feature of ENSO—the strong ENSO events moving eastward and the weak ENSO events moving westward—which is consistent with the observation. Interestingly, the coupled general circulation models, of which the ocean model is based on the one used by Bryan and Cox, commonly showed the reasonably positive skewed ENSO. The decadal changes in the skewness, variance, and NDH of the model-simulated ENSO are also observed. These three quantities over the tropical eastern Pacific are significantly correlated to each other, indicating that the decadal change in ENSO variability is closely related to the nonlinear process of ENSO. It is also found that these decadal changes in ENSO variability are related to the decadal variation in the tropical Pacific SST, implying that the decadal change in the El Niño–La Niña asymmetry could manifest itself as a rectified change in the background state.
    Type of Medium: Online Resource
    ISSN: 1520-0442 , 0894-8755
    URL: Article
    DOI: 10.1175/JCLI3433.1
    RVK:
    UA 4548
    Language: English
    Publisher: American Meteorological Society
    Publication Date: 2005
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 8
    Online Resource
    Online Resource
    Seesawing of Winter Temperature Extremes between East Asia and North America
    American Meteorological Society ; 2021
    In:  Journal of Climate Vol. 34, No. 11 ( 2021-06), p. 4423-4434
    Details
    In: Journal of Climate, American Meteorological Society, Vol. 34, No. 11 ( 2021-06), p. 4423-4434
    Abstract: In recent winters, there have been repeated observations of extreme warm and cold spells in the midlatitude countries. This has evoked questions regarding how winter temperature extremes are induced. In this study, we demonstrate that abnormally warm winter weather in East Asia can drive the onset of extremely cold weather in North America approximately one week forward. These seesawing extremes across the basin are mediated by the North Pacific Oscillation (NPO), one of the recurrent atmospheric patterns over the North Pacific. Budget analysis of the quasigeostrophic geopotential tendency equation shows that intense thermal advection over East Asia is able to trigger the growth of the NPO. Vorticity fluxes associated with the upper-level stationary trough then strengthen and maintain the NPO against thermal damping following the onset of the NPO. Differential diabatic heating accompanied by changes in circulation also positively contribute to the growth and maintenance of the NPO. These results imply that recurrent cold extremes, seemingly contrary to global warming, may be an inherent feature resulting from strengthening warm extremes.
    Type of Medium: Online Resource
    ISSN: 0894-8755 , 1520-0442
    URL: Article
    DOI: 10.1175/JCLI-D-20-0789.1
    RVK:
    UA 4548
    Language: Unknown
    Publisher: American Meteorological Society
    Publication Date: 2021
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 9
    Online Resource
    Online Resource
    Seasonal Gap Theory for ENSO Phase Locking
    American Meteorological Society ; 2021
    In:  Journal of Climate ( 2021-04-12), p. 1-44
    Details
    In: Journal of Climate, American Meteorological Society, ( 2021-04-12), p. 1-44
    Abstract: The life cycle of El Niño-Southern Oscillation (ENSO) typically follows a seasonal march, onset in spring, developing during summer, maturing in boreal winter, and decaying over the following spring. This feature is referred to as ENSO phase locking. Recent studies have noted that seasonal modulation of the ENSO growth rate is essential for this process. This study investigates the fundamental effect of a seasonally varying growth rate on ENSO phase locking using a modified seasonally-dependent recharge oscillator model. There are two phase locking regimes associated with the strength of the seasonal modulation of growth rate: (1) a weak regime in which only a single peak occurs; and (2) a strong regime in which two types of events occur either with a single peak or double peak. Notably, there is a seasonal gap in the strong regime, during which the ENSO peak cannot occur because of large-scale ocean-atmosphere coupled processes. We also retrieve a simple analytical solution of the seasonal variance of ENSO, revealing that the variance is governed by the time-integral of seasonally varying growth rate. Based on this formulation, we propose a seasonal energy index (SEI) that allows explaining the seasonal gap, and provides an intuitive explanation for ENSO phase locking, potentially applicable to global climate model ENSO diagnostics.
    Type of Medium: Online Resource
    ISSN: 0894-8755 , 1520-0442
    URL: Article
    DOI: 10.1175/JCLI-D-20-0495.1
    RVK:
    UA 4548
    Language: Unknown
    Publisher: American Meteorological Society
    Publication Date: 2021
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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  • 10
    Online Resource
    Online Resource
    The Role of Background Meridional Moisture Gradient on the Propagation of the MJO over the Maritime Continent
    American Meteorological Society ; 2021
    In:  Journal of Climate ( 2021-05-18), p. 1-54
    Details
    In: Journal of Climate, American Meteorological Society, ( 2021-05-18), p. 1-54
    Abstract: This study investigates the role of the background meridional moisture gradient (MMG) on the propagation of the Madden–Julian Oscillation (MJO) across the Maritime Continent (MC) region. It is found that the interannual variability of the seasonal mean MMG over the southern MC area is associated with the meridional expansion and contraction of the moist area in the vicinity of the MC. Sea surface temperature anomalies associated with relatively high and low seasonal mean MMG exhibit patterns that resemble those of the El Niño–Southern Oscillation. By contrasting the years with anomalously low and high MMG, we show that MJO propagation through the MC is enhanced (suppressed) in years with higher (lower) seasonal mean MMG, though the effect is less robust when MMG anomalies are weak. Column-integrated moisture budget analysis further shows that sufficiently large MMG anomalies affects MJO activity by modulating the meridional advection of the mean moisture via MJO wind anomalies. Our results suggest that the background moisture distribution has a strong control over the propagation characteristics of the MJO in the MC region.
    Type of Medium: Online Resource
    ISSN: 0894-8755 , 1520-0442
    URL: Article
    URL: Article
    DOI: 10.1175/JCLI-D-20-0085.1
    DOI: 10.1175/JCLI-D-20-0085.s1
    RVK:
    UA 4548
    Language: Unknown
    Publisher: American Meteorological Society
    Publication Date: 2021
    detail.hit.zdb_id: 246750-1
    detail.hit.zdb_id: 2021723-7
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