Lateropulsion and visual vertical tilt after supra- and infratentorial stroke: a longitudinal study.

Abstract Oceanic mesoscale eddies are often asymmetric, exhibiting horizontal deformation and vertical tilt, yet the implications of these structural asymmetries for finer‐scale dynamics remain poorly understood. Based on a series of high‐resolution numerical experiments, we found that asymmetric anticyclones act as potent catalysts for submesoscale motions compared to symmetric counterparts. This catalysis follows a clear dynamical pathway. Initial asymmetries in elliptical and vertically tilting anticyclones rapidly develop vortex Rossby waves (VRWs) of azimuthal wavenumber‐2 and wavenumber‐1, respectively, through axisymmetrization. The breakdown of these VRWs generates small‐scale filaments, fronts and vortices along the periphery of the anticyclone, accompanied by strong strain and frontogenesis. Submesoscale instabilities, including mixed barotropical/baroclinic and symmetric instability then appear, driving vigorous submesoscale motions. Frontogenetic tendency analysis reveals that this frontogenesis is primarily driven by two ageostrophic processes, horizontal advection and vertical straining. Our findings elucidate a potential mechanism in idealized simulations whereby mesoscale eddy asymmetries catalyze submesoscale motions.

Abstract We present a systematic, year-round classification of Arctic cyclones (ACs) based on their intensification mechanisms and identify three distinct types. Type I is characterized by weak diabatic heating, weak low-level baroclinicity, and weak upper-level forcing. Type II exhibits strong upper-level forcing and strong diabatic heating, combining the features of type-B and type-C midlatitude cyclones. Type III is characterized by strong low-level baroclinicity. The three AC types differ in intensity evolution and structural characteristics. Type I has the weakest mean intensity and intensification rate, whereas type II shows the strongest. Both type II and type III display a westward vertical tilt and a low-level dominant vorticity structure during early intensification but evolve into a more upright, upper-level dominant structure later. Although type III shares strong baroclinicity with type-A midlatitude cyclones, its vertical tilt evolves over time, in contrast to the vertical phase locking associated with the baroclinic modal growth of type-A midlatitude cyclones. Type I represents a unique subset resembling isolated, barotropic monopole vortices with an upper-level dominant vorticity structure throughout development. The three AC types also exhibit distinct spatial distributions. Type II tends to intensify over the southern Nordic seas with a high atmospheric river occurrence. Type III primarily strengthens over the northern Nordic seas and along the Arctic frontal zone, while type I preferentially intensifies over the central Arctic. These distributions suggest that AC intensification mechanisms are closely tied to local environmental conditions. Additionally, our analyses indicate that some tropopause polar vortices are an integral part of an intensifying AC, while some are generated by a decaying, cold-core AC. Significance Statement Arctic cyclones are the primary storm systems in the Arctic. This study identifies three types of Arctic cyclones based on their development mechanisms. Type II is characterized by strong upper-level forcing and strong diabatic heating (including latent heating from condensation and freezing). Type III is characterized by a strong temperature gradient near the surface. In contrast, all three development mechanisms are weak in type I. The three types of Arctic cyclones (ACs) are characterized by different intensity and structural evolutions and have different geographic distributions. Type II tends to intensify over the southern Nordic seas, type III preferentially strengthens over the northern Nordic seas and coastal Siberia, whereas type I primarily intensifies over the central Arctic Ocean. The classification provides a conceptual framework for understanding the development mechanisms and evolutionary processes of Arctic cyclones.

Purpose To report the results of Yamane technique for scleral fixation of intraocular lenses (IOL) in children with lens subluxation or insufficient capsular support. Methods A prospective observational study was conducted on 56 eyes of 38 children <18 years with insufficient capsular support. A Sensar AR40e or a Tecnis ZA9003 IOL was used for scleral fixation. Haptics were externalized using Yamane technique. Postoperative refractive error, visual acuity, and intraocular pressure were recorded for 6 months after surgery. Degree of IOL tilt and decentration were measured using ultrasound biomicroscopy. Results Mean age was 6.5 ± 3.6 years. Intraoperative haptic breakage occurred in 4 cases. Postoperative haptic slippage occurred in 2 eyes. Revision for IOL decentration was needed in 2 patients. Mean improvement in logMAR lines at 6 months after surgery was 5.2 ± 4.8 lines. Mean angle of vertical and horizontal tilts were 5.4 ± 4.4° (range, 0–18°) and 4.4 ± 4.7° (range, 0–18.6°), respectively. Mean absolute amounts of vertical and horizontal decentration were 0.58 ± 0.42 mm and 0.58 ± 0.41 mm, respectively. Significant IOL tilt >7 degrees and decentration > 1 mm occurred in 10 and 5 cases, respectively. Haptic complications and IOL tilt/decentration were associated with ocular comorbidities and early parts of the learning curve. IOL tilt and decentration were not associated with significant effect on BCVA, spherical equivalent, or cylindrical error Conclusions While Yamane technique is an option for the management of children with insufficient capsular support, it requires a steep learning curve and is still associated with a relatively high rate of complications.

To evaluate refractive outcomes and intraocular lens (IOL) tilt following secondary implantation using the Yamane technique and to assess the relationship between tilt and refractive predictability compared with standard phacoemulsification. This retrospective comparative study included 19 eyes (16 patients) treated with the Yamane technique and 18 eyes (16 patients) undergoing uncomplicated phacoemulsification between 2022 and 2024. Pre- and postoperative best-corrected visual acuity (BCVA) were recorded. Refractive prediction error (RPE), mean absolute error (MAE), and median absolute error (MedAE) were analyzed. IOL tilt was assessed using anterior segment optical coherence tomography (AS-OCT) at least six weeks postoperatively. The mean best-corrected visual acuity (BCVA, logMAR) improved significantly in both groups-from 0.61 ± 0.39 to 0.10 ± 0.10 in the Yamane group (p < 0.0001) and from 0.81 ± 0.91 to 0.13 ± 0.32 in the control group. The mean refractive prediction error (RPE) was 0.81 ± 0.97 D in the Yamane group and 0.01 ± 1.08 D in the control group. Corresponding mean absolute error (MAE) values were 1.05 ± 0.69 D and 0.69 ± 0.82 D, with median absolute errors (MedAE) of 0.86 D and 0.56 D, respectively. The average intraocular lens (IOL) tilt was greater in the Yamane group (3.79°) than in the control group (0.69°). In the Yamane group, the highest tilt was observed at the 60° meridian (4.70°), and the lowest at the horizontal meridian (2.36°). In contrast, in the control group, the greatest tilt occurred at the 90° meridian (0.81°) and the smallest at the horizontal meridian (0.62°). A significant positive correlation was found between vertical IOL tilt (90°) and RPE in the Yamane group (ρ = 0.41, p < 0.05). No significant correlations were observed between tilt at other meridians and BCVA, MAE, or RPE. The Yamane technique provides excellent postoperative visual outcomes despite greater IOL tilt compared with standard pseudophakia. Only vertical tilt correlated with refractive prediction error, suggesting a mild hyperopic trend. The method represents a safe and effective alternative for posterior chamber IOL fixation in eyes lacking capsular support.

Abstract In September 2022, NASA conducted the Convective Processes Experiment-Cabo Verde (CPEX-CV) campaign over the data-sparse eastern Atlantic. Over this region, CPEX-CV collected a suite of dense observations to aid in the study of convective systems. Tropical Storm (TS) Hermine formed in late September and had an unusual northward trajectory. Hermine was sampled by two consecutive research flights prior to becoming a TS, which provided an opportunity to improve Hermine’s forecast via data assimilation and verify model forecasts. With an improved forecast after assimilating CPEX-CV observations, model data is used to study the processes controlling Hermine’s evolution more accurately. Two experiments were conducted. One experiment assimilated CPEX-CV observations (WCPEX) while the other did not (WoCPEX). Compared to WoCPEX, the assimilation of CPEX-CV observations in the WCPEX analysis produced a stronger Saharan air layer, more intense dry-air intrusion, more easterly wind bias corrections, and a stronger mid-level circulation within pre-Hermine. Forecasts show that the strengthening of pre-Hermine into a TS in WoCPEX was delayed by 12 hours due to the large vertical tilt of the vortex and weak mid-level vorticity; it also had a westward track bias. Compared to WoCPEX, in WCPEX, while convection near pre-Hermine was weaker at early forecast times due to a more intense dry-air intrusion, stronger, more organized mid-level vorticity and better vertical alignment of the vortex improved the intensity and track forecast. Additional sensitivity tests revealed that assimilating only CPEX-CV remote sensing observations improved Hermine’s forecast nearly as much as assimilating all CPEX-CV observations.

Introduction:Radiographic markers including the crossover sign (COS), ischial spine sign (ISS), and posterior wall sign (PWS) are commonly used to assess acetabular morphology. The aim of this study was to determine the vertical tilt or horizontal rotation needed to elicit sign changes on anterior-posterior (AP) digitally reconstructed radiographs (DRRs).Methods:CT scans of the pelvis were retrospectively collected and imported into three-dimensional (3D) imaging software to create 3D AP digitally reconstructed radiographs (DRRs). Rendered pelvises were standardized to 0° of tilt and rotation and assessed for positive or negative findings of COS, ISS, and PWS. Then, the DRR was manipulated at 1° intervals (from 0° to 20° in each direction), progressively inducing pelvic tilt in the vertical axis, and the process was then repeated in the horizontal axis. The degree at which the sign changed from positive to negative or vice versa in each hip was recorded.Results:A total of 20 hips were assessed (five men, five women). On the standardized AP pelvis radiographs, positive COS, ISS, and PWS were 45%, 25%, and 75% respectively. The mean rotation required to change COS, ISS, and PWS from positive to negative or vice versa was 7.92° ± 4.25°, 5.55° ± 2.63°, and 6.37° ± 3.89°, respectively. The mean tilt required to flip COS, ISS, and PWS was 8.80° ± 5.73°, 7.73° ± 3.65°, and 9.55° ± 4.98°.Conclusion:Close consideration should be given to pelvic position when assessing positive findings of COS, ISS, and PWS because all signs were noted to flip with small degrees of rotation and tilt.

Abstract This study compares the vertical tilt and potential vorticity structure of average and extreme extra‐tropical cyclones (ETCs) in the Northern Hemisphere during the cold season (October–March) in ERA5 reanalysis. Vertical tilt is quantified using a novel two‐component (directional and lateral, aligned with and across cyclone motion) horizontal offset between the near‐surface and upper‐level ETC centers. Compared to average ETCs, extreme ETCs exhibit an amplified tilt magnitude during the intensification phase and a change in the sign of the lateral tilt prior to maximum intensity. Accounting for the tilted vertical structure, this study shows that average ETCs are associated with an upper‐level positive anomaly, which is constant through the ETC lifecycle, while the intensifies from the bottom up. In contrast, extreme ETCs are characterized by a growing magnitude of upper‐level anomaly, and a simultaneous intensification throughout the lower levels.

To evaluate the characteristics and treatment outcomes for presumed unilateral congenital superior oblique palsy (SOP) in adults. Retrospective medical records of adult patients diagnosed with presumed unilateral congenital SOP were included. Presumed unilateral congenital SOP was defined as manifesting vertical diplopia and/or head tilt with an insidious or subacute onset or duration of over one year, vertical misalignment greater than 10 prism diopters (PD) and a positive Bielschowsky head tilt test, and/or underaction of the superior oblique (SO) muscle or overaction of its antagonistic inferior oblique muscle on the affected side. The clinical manifestations and surgical treatment outcomes of presumed congenital SOP in adults were evaluated. Among adult patients initially diagnosed with unilateral SOP, 41% were classified as presumed congenital SOP. Patients exhibited various clinical manifestations beyond the typical over-elevation or under-depression during adduction, with the greatest deviation in the field of action of the SO muscle observed in only 6.9% of cases. Orbital imaging revealed SO asymmetry due to the SO hypoplasia in 58.5% of patients. Among various factors, combined horizontal strabismus was more common in those with symmetric SO, with no significant differences in clinical presentation or surgical outcomes based on SO volume. The overall surgical outcome for presumed congenital SOP was generally favorable, with an 85% success rate. No factors including the presence of SO hypoplasia influenced the surgical result. In adults with presumed congenital SOP, diverse clinical manifestations were observed. The angle of deviation, duction and version patterns, and treatment outcomes were not associated with the presence of SO hypoplasia on MRI. Despite the diversity in clinical features, treatment outcomes remained favorable. Retrospectively registered.

Balanced Evolution of the Vertical Tilt of Simulated Tropical Cyclone Vortices in a Sheared Environment

High variability in pelvic orientation in the lateral decubitus position negatively affects acetabular component placement.

To evaluate the intraocular lens (IOL) position after scleral suture fixation using ultrasound biomicroscopy (UBM), assess the value of the technique, and recommend ways of improving outcomes. This observational, cross-sectional study was conducted at a university eye hospital in Fudan, China from 2023 to 2025. UBM examinations were performed on patients undergoing scleral-sutured IOL fixation for IOL dislocation, aphakia, or crystalline lens dislocation. In each eye, central crossing scans and additional scans in eight directions were obtained and analysed. Image analysis focused on IOL haptic positioning (4-grade classification system), ciliary sulcus visibility, anterior segment parameters and overall IOL positioning (IOL tilt/decentration, Image-Pro Plus software). Nonparametric statistics analysed outcome correlations (SPSS v20.0, P < 0.05 significance). UBM examinations were performed on 65 eyes from 64 patients. High-quality images of the anterior segments were acquired in all eyes, clearly visualising the optics/haptics of the IOL, peripheral anterior synechiae, residual membrane proliferation and adhesion, and iris concavity. The analysis showed that 57.69% of the haptics were positioned within the ciliary sulcus, and in 520 images of 65 eyes, the sulcus was found in 303 images (58.27%). The haptic was asymmetrically placed in 33 eyes (50.77%). Multiple linear regression showed that haptic location discrepancy was associated with increased IOL vertical tilt (β = 1.72; 95% CI 0.65-2.79; P = 0.002), while axial length correlated with horizontal decentration (r = 0.37, P = 0.011). UBM is a valuable tool for assessing anterior segment conditions following IOL scleral fixation. Asymmetric haptic placement significantly increases IOL tilt, while longer axial length predicts horizontal decentration. These quantifiable parameters should inform both surgical technique selection and postoperative monitoring protocols.

Purpose:To compare the tilt and decentration between secondary sulcus-implanted versus optic-captured intraocular lens (IOL) in pediatric aphakia using ultrasound bio-microscopy (UBM).Design:Prospective, comparative study at “Cairo University” pediatric ophthalmology and strabismus unit.Methods:Forty-four eyes of 25 aphakics were scheduled for secondary implantation. Patients were randomly divided into two equal groups: Group A underwent sulcus implantation, while Group B underwent optic capture. UBM was performed preoperatively, 3 months and 6 months after surgery to evaluate the anterior chamber depth (ACD), angle width in the four quadrants, horizontal and vertical tilt, and decentration.Results:Preoperative demographic data, ACD, and angle width did not differ between the groups. Six months after surgery, ACD was significantly higher in the capture group (mean 3.6 mm ± 0.59 [2.25−4.45]) than the sulcus group (mean 3.01 mm ± 0.25 [2.55−3.33]) with a mean difference of 0.59 mm (P = 0.000). The anterior chamber angle (ACA) showed larger values in all four quadrants in the capture group, highly statistically significant in the temporal (47.09° versus 42.23° P = 0.001) and superior (46.38° versus 42.47° P = 0.009) quadrants. Although there was no difference in the horizontal (0.22 versus 0.31 mm) and vertical (0.28 versus 0.30 mm) decentration between both groups, the capture group showed statistically significant more horizontal (1.8 versus 0.83°) and vertical tilt (2.16 versus 0.89°) compared to the sulcus group. This tilt did not affect the target refraction or cylinder and was, therefore, considered clinically insignificant.Conclusion:Secondary IOL implantation with the capture technique appears to provide a deeper AC and a wider angle than sulcus implantation but could result in greater IOL tilt. UBM discloses changes in IOL position that are not clinically detected during follow-up.

Biceps involvement and degree of motor deficit at diagnosis are independently predictive of timing of postoperative C5 palsy recovery.

Retrospective matched cohort study. To evaluate and compare the predictive value of different preoperative imaging measurements and modalities for postoperative C5P. C5 palsy (C5P) is a debilitating complication following cervical spine surgery with unpredictable but typically favorable recovery. While research has explored preoperative radiographic measurements in predicting C5P development, their findings remain inconclusive. Adult patients who underwent anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF) from 2010-2023 with available preoperative imaging (MRI or radiographs) and subsequently developed a C5P were matched 1:3 to control patients without C5P. Demographic/surgical/outcome data were collected. Preoperative radiographic measurements included C2-7 cobb angle, sagittal vertical axis, C2 tilt, C2 and T1 slope, and Pavlov-Torg ratio/stenosis. MRI measurements included anteroposterior canal diameter, bilateral foraminal diameter, bilateral cord-lamina angle, bilateral nerve root diameter, cord/canal cross-sectional area, and stenosis based on Kim grading system. Statistical analysis was conducted with alpha set at 0.05. 63 patients with postoperative C5P and accessible preoperative radiographs were matched with 189 controls. Amongst the 63 patients with C5P, 42 patients with accessible MRI images were matched to an additional 126 controls. Both cohorts demonstrated similar demographic/surgical variables between C5P and control patients. Amongst the radiograph cohort, C5P patients had a greater preoperative C2-7 cobb angle (11.4° vs. 6.39; P =0.001). All other measurements were similar between patients with C5P and no C5P. Amongst the MRI cohort, C5P patients had similar measurements as controls. Both MRI and radiographs demonstrated poor predictive power with the highest area under the curve being 0.636 (C2-7 Cobb angle). Neither preoperative radiographic nor MRI measurements demonstrated predictive power for postoperative C5P in this study thereby highlighting the need for additional strategies to preoperatively identify patients at risk for C5P.

Overlap joining is one of the most adopted configurations to combine metals and polymers, mostly due to technological limitations of mechanical fastening, conventional welding, and adhesive bonding. Nonetheless, the misalignment of the neutral lines between base materials leads to the development of secondary bending moment that generates a bending stress component, limiting the admissible load. This work investigates the feasibility of friction stir joining AA6082‐T6 aluminum alloy and a glass fiber–reinforced polymer (Noryl GFN2) in buttstrap configuration, aimed at mitigating secondary bending effects. Exploratory trials were performed to simultaneously weld two aluminum plates that overlap a third polymeric plate, varying travel and rotational speeds while maintaining constant vertical position and tilt angle. Nine buttstrap joints were successfully produced, achieving ultimate tensile strengths between 80.3 and 138.9 MPa, corresponding to joints’ efficiencies ranging from 27.7 and 47.9% of the aluminum alloy's strength. The microstructural analysis unveiled that all joints exhibited an interfacial defect among the three plates with characteristics of i) unwelded root defect, typically observed in butt joints, and ii) hook‐shaped defects, mainly associated with overlap joints. The size of the defect significantly affected the effective joining thickness between aluminum plates and, consequently, the associated mechanical performance.

Abstract The Madden‐Julian Oscillation (MJO) is the dominant weather system in the tropics on week‐to‐week time scales. Here, we exploit almost two decades of Argo float observations, assimilated into an ocean reanalysis, to examine the deep ocean response to the MJO. A coherent MJO signal in potential density and zonal velocity anomalies is observed down to at least 2,000 m (the typical maximum depth of Argo observations) in the Pacific and Indian Ocean basins, but not in the Atlantic. The signal is consistent with equatorial Kelvin wave structures. Below the thermocline, the anomalies are characterized by a vertical tilt, downward and to the east. Two theoretical frameworks are used to interpret the signal. The vertical mode framework is reasonably successful in representing the eastward propagation of equatorial Kelvin waves in the thermocline. The first internal mode is efficiently forced by the MJO surface winds, and energy is transferred to the second, third, and higher internal modes through nonlinear processes. However, these vertical modes are not useful for interpreting the deeper structure. Instead, ray paths are constructed using a vertically propagating wave framework. Rays forced by the low‐frequency component of the MJO (with periods near 60 days) are consistent with the vertical tilt of the observed response. These ray paths explain the observed “shadow zones,” where no coherent signal is found within 6,000 km of the western boundary of each ocean basin at 2,000 m depth.

Research in Lewa District, East Sumba Regency, Indonesia, aimed to identify mineral potential and clarify subsurface geological structures through gravity gradient analysis and 3D inversion modeling. This approach addresses the limitations of field gravity data in the study area. The gravity gradient method was chosen to delineate geological structure boundaries (such as formation contacts and faults) compared to conventional gravity methods and for processing global satellite data (GGMplus and EGM2008 derivatives of ERTM 2160) with limited measured data. Gravity gradient analysis, including vertical, horizontal gradient, and tilt angle, was applied to Complete Bouguer Anomaly data using 2D Fourier transformation. Gravity field correction in Lewa showed positive anomalies from volcanic basement rocks. The gradient analysis sharpened boundaries of anomalies linked to geological structures. Zero contours of vertical gradient and tilt angle defined structural boundaries, while peaks of horizontal gradient and tilt angle indicated metallic mineral sources. 3D gravity inversion modeling (density 2.22–2.97 g/cm³) showed rock intrusions at 215 meters depth, interpreted as key to mineralization formation. The 2D sections (A-A', B-B', C-C') contain Masu Formation volcanic rocks, with fault zones filled by Waikabubak Formation sedimentary rocks and silicified rocks from magma intrusion alteration. Fault systems were identified through vertical gradient extremes, representing contact formation. Highly positive contour values on the tilt angle map confirm the influence of the volcanic basement rock. Metal mineralization is closely related to tectonic activity and alteration from massive igneous intrusion. The integration of gravity gradient analysis and 3D inversion modeling has proven to be effective in mapping geological structures and identifying mineral prospects using limited data. These findings provide insights into the subsurface geology of Lewa and provide a basis for further mineral exploration in East Sumba.

Abstract Previous studies have indicated that diabatic heating plays a crucial role in aligning the vortices of tropical cyclones (TCs) at various altitudes within a sheared environment. However, the influence of diabatic heating associated with convective asymmetries on the continuous tilt reduction, one pathway toward vortex alignment, remains insufficiently understood. In this study, idealized experiments under a full range of easterly moderate vertical wind shear (VWS) are conducted to investigate the continuous tilt reduction of the simulated TCs. The onset of TC intensification relies on achieving a vertically aligned TC structure, while the evolution of the vortex tilt varies nonmonotonically with shear magnitude. We demonstrate that the convective asymmetry, mainly enhanced on the downtilt side in the simulated TCs, plays a dominant role in the continuous tilt evolution. On the one hand, the direct influence of diabatic heating associated with the asymmetric convection facilitates the reduction of vortex tilt. On the other hand, the convective asymmetry generates a pair of counterrotating gyres over the inner-core region, with cyclonic (anticyclonic) vorticity located downstream of heating (cooling) regions. This convectively induced asymmetric flow impedes the vertical coupling of TC vortices. The evolution of the vertical tilt is primarily governed by the approximate balance between these two processes. This study highlights the critical importance of understanding convective evolution in TC intensification prediction.

External windows and shading systems significantly influence solar radiation control and natural daylighting in building spaces. This study focuses on west-facing dormitory rooms in universities in Kunming, China—spaces particularly prone to solar overexposure—and proposes a fixed external shading design method optimized for solar heat control and daylighting performance. A parametric modeling and simulation approach was adopted, and Pareto-optimal solutions were generated using the Non-dominated Sorting Genetic Algorithm II (NSGA-II). Results indicate that a shading configuration with a panel depth of 0.35 m, spacing of 0.27 m, and an upward horizontal tilt of 7° effectively minimizes seasonal fluctuations in solar heat gain while achieving a reasonable trade-off with daylighting. The Technique for Order Preference by Similarity to the Ideal Solution (TOPSIS) was further applied to evaluate and rank the multi-objective solutions. Under equal-weight evaluation, a configuration with a depth of 0.4 m, spacing of 0.57 m, and a 3° vertical tilt facing north ranked highest, indicating a strong balance between thermal control and daylight performance.This study focuses on optimizing the geometric parameters of passive fixed shading components, without addressing adjustable or dynamic systems. The findings offer practical design references and parametric guidance for external shading strategies in west-facing dormitories in Kunming and other regions with similar climatic conditions.