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In the Weather Research and Forecasting (WRF) community, a standard model setup at a grid size smaller than 5 km excludes cumulus parameterization (CP), although it is unclear how to determine a cutoff grid size where convection permitting can be assumed adequate. Also, efforts to improve high-resolution precipitation forecasts in the range of 1–10 km (the so-called gray zone for parameterized precipitation physics) have recently been made. In this study, we attempt to statistically evaluate the skill of a gray-zone CP with a focus on the quantitative precipitation forecast (QPF) in the summertime. A WRF Model simulation with the gray-zone simplified Arakawa–Schubert (GSAS) CP at 3-km spatial resolution over East Asia is evaluated for the summer of 2013 and compared with the results from a conventional setup without CP. A statistical evaluation of the 3-month simulations shows that the GSAS demonstrates a typical distribution of the QPF skill, with high (low) scores and bias in the light (heavy) precipitation category. The WRF without CP seriously suppresses light precipitation events, but its skill for heavier categories is better. Meanwhile, a new set of precipitation data, which is simply averaged precipitation from the two simulations, demonstrates the best skill in all precipitation categories. Bearing in mind that high-resolution QPF requires essential challenges in model components, along with complexity in precipitating convection mechanisms over geographically different regions, this proposed method can serve as an alternative for improving the QPF for practical usage.

The effects of a nonlocal planetary boundary layer (PBL) scheme that considers scale dependency in the parameterized turbulent vertical transport are investigated for a case of wintertime lake-effect precipitation over Korea at gray-zone resolutions using a mesoscale model. An experiment using the scale-aware PBL scheme is compared with that using a conventional PBL scheme, which shows that the simulated precipitation amount at a resolution of less than 1 km is smaller with the scale-aware PBL scheme. The role of turbulent processes in simulating lake-effect precipitation is understood through interaction with microphysical processes. When the scale-aware PBL scheme is used, liquid water content is increased while ice water content is reduced. The higher cloud water content is because of enhanced condensation with stronger updrafts, attributed to the suppression of parameterized turbulent mixing. This results in higher rainwater content by enhancing autoconversion and accretion from cloud water to rainwater. The cloud ice content is reduced mainly because of the suppressed deposition and enhanced sublimation centered near the PBL top, and the snow content is reduced mainly because of the enhanced sublimation below and near the PBL top and suppressed growth of cloud ice to snow. The lower ice water content is mainly due to the drier PBL, attributed to the enhanced resolved (suppressed parameterized) turbulent moisture transport and enhanced condensation. The melting of a smaller amount of snow under dominant cold rain processes is responsible for the reduced surface precipitation with the scale-aware PBL scheme.

The Korea Institute of Atmospheric Prediction Systems (KIAPS) has developed a new global numerical weather prediction model, named the Korean Integrated Model (KIM). This paper presents the cumulus parameterization scheme (CPS) used in KIM, which originates from the simplified Arakawa–Schubert (SAS) convection scheme in the National Centers for Environmental Prediction (NCEP) Global Forecast System (GFS) and has undergone numerous modifications in an effort to improve the medium-range forecast skill for precipitation and large-scale fields. The modifications include the following: 1) the threshold of the trigger condition is updated to consider the dependency on the environmental relative humidity (RH) averaged over the subcloud layer in order to suppress the trigger of convection in dry low-level environments; 2) the entrainment rate is modified to increase the sensitivity to environmental humidity, so that enhanced entrainment under lower RH conditions leads to a greater decrease in the strength of the convection that develops in drier environments; 3) the autoconversion parameter from cloud condensate to convective precipitation is changed to have a temperature dependency above the freezing level; 4) the closure is modified to consider rapidly varying boundary layer forcing; 5) the effect of the convection-induced pressure gradient force in convective momentum transport is enhanced in the upper part of the convective updrafts; and 6) scale awareness that enables a mass-flux CPS to work seamlessly at various grid sizes across gray-zone resolutions is addressed. The evaluation of medium-range forecasts with the KIM CPS reveals higher forecast skill, especially over the tropics, in comparison with its original version.

Eastern North America receives elevated atmospheric mercury deposition from a combination of local, regional, and global sources. Anthropogenic emissions originate largely from electric utilities, incinerators, and industrial processes. The mercury species in these emissions have variable atmospheric residence times, which influence their atmospheric transport and deposition patterns. Forested regions with a prevalence of wetlands and of unproductive surface waters promote high concentrations of mercury in freshwater biota and thus are particularly sensitive to mercury deposition. Through fish consumption, humans and wildlife are exposed to methylmercury, which markedly bioaccumulates up the freshwater food chain. Average mercury concentrations in yellow perch fillets exceed the Environmental Protection Agency's human health criterion across the region, and mercury concentrations are high enough in piscivorous wildlife to cause adverse behavioral, physiological, and reproductive effects. Initiatives are under way to decrease mercury emissions from electric utilities in the United States by roughly 70%.

The post-extraction socket of a periodontally compromised tooth/implant is oftentimes accompanied by a very wide-deep alveolar ridge defect. The commonly utilized treatment is ridge preservation followed by delayed implant placement 4 to 6 months after extraction. In the four cases presented in this study, a novel technique of utilizing a bone block obtained from the lateral wall of the maxillary sinus is introduced. Due to the severe localized vertical ridge deficiency, an intraoral autogenous bone block was obtained from the ipsilateral sinus bony window. After the obtained bone block was properly trimmed, it was fixed in the form of a bridge over the vertical defect by the press-fit method. In two cases, the gap between the autogenous bone and defect was filled with a particulate synthetic bone graft, and in another two cases, the gap was left without grafting. All cases were covered with a resorbable collagen membrane. At the time of re-entry after 5 to 6 months, the bone bridge was well incorporated beside the adjacent native bone and helped by the implant placement. Uncovering was performed after 3 to 6 months, and prostheses were delivered after 2 months. Oral function was maintained without any change in the marginal bone level even after the 1- to 7-year post-prosthesis delivery. This case series showed that the bone bridge technique performed using an ipsilateral sinus bony window for a localized vertical deficiency of a post-extraction socket can be used for successful vertical ridge augmentation (VRA).

Peri-implant soft tissue deficiency (PSTD) is a significant factor impacting aesthetics, particularly in the anterior zone, where labial bone resorption and thin peri-implant phenotypes are common. The occurrence of a gray color around the implant fixture due to PSTD can be aesthetically concerning in the esthetic zone. In cases involving natural teeth, autogenous soft tissue grafts such as subepithelial connective tissue grafts (SCTGs), free gingival grafts (FGGs), and coronally advanced flaps (CAFs) are commonly utilized. However, there are limited reports of using bone grafts in conjunction with these techniques for modifying the gingival phenotype around both teeth and implants. In the presented cases where PSTD resulted in visible gray coloration of the implant fixture in the esthetic zone, mechanical and chemical decontamination of the exposed implant surface was performed using a titanium brush and tetracycline (Tc) HCl. Subsequently, to enhance peri-implant mucosa thickness and mask the titanium color, simultaneous SCTG and bone grafting procedures were conducted. Within the limitations of these case reports, successful esthetic outcomes were achieved and maintained without recurrence for 3–6 years following the simultaneous subepithelial connective tissue graft and bone graft procedures. These findings suggest the potential efficacy of this combined approach in addressing PSTD and enhancing aesthetic results around dental implants, though further studies are needed to validate these outcomes.

The aim of this study was to retrospectively determine the effects of applying different treatment methods to the bony access window on the healing outcomes in lateral sinus floor elevation (SFE). Lateral SFE with implant placement was performed in 131 sinuses of 105 patients. The following three treatment methods were applied to the bony access window: application of a collagen barrier (group CB), repositioning the bone fragment (group RW) and untreated (group UT). Radiographic healing in the window area, augmented bone height changes and marginal bone level changes were examined. Mixed logistic and mixed linear models were analyzed. Over 4.3 ± 1.4 years of follow-up, the implant survival rate was 100% in groups CB and UT, and 96.9% in group RW. The treatment applied to the window did not significantly influence the radiographic healing in the window area, augmented bone height changes or marginal bone level changes ( p  > 0.05). The healed window areas had generally flat morphologies and were fully corticalized. The mean changes in the augmented bone were less than 1.5 mm in all groups. Marginal bone level changes were minimal. In conclusion, Healing outcomes were not different among three different methods to treat the bony access window in lateral SFE.

Complications that occur after maxillary sinus floor augmentation (MSA) can be divided into early and late complications. Early complication is a side effect that occurs during the MSA procedure or during the initial healing period. Usually, late complication refers to a side effect that occurs after 3 weeks of MSA. However, in the longer term, there are cases that occur during the follow-up period after the prosthesis is delivered, and most of them present with peri-implantitis. In the present two cases, sinus graft complications occurred 1–2 years after prosthesis delivery but were independent of peri-implantitis and had atypical features showing asymptomatic results. Although the route of the infection source is unclear, the lesions were presumed to be caused by slow and delayed inflammation of oral bacteria infiltrating the bone graft area of the maxillary sinus. Within the limitations of present case reports, bone defects were successfully managed with a guided bone regeneration (GBR) procedure that included thorough defect degranulation, surface decontamination of exposed implant, and regrafting. Periodic monitoring of radiographic images is required for the detection of unusual sinus graft complications in sinus-augmented sites.

Among the complications of orthodontic treatment, mucogingival problems with gingival recession in the mandibular anterior teeth are challenging for clinicians. Mucogingival problems can lead to esthetic deficits, thermal hypersensitivity, tooth brushing pain, and complicated plaque control. Herein, we present a case of a 16-year-old female with gingival recession in the left mandibular central incisor after orthodontic treatment. The preoperative clinical findings showed a thin soft tissue biotype with root prominence in the mandibular anterior area. The interdental area was relatively depressed. After reflection of the full-thickness flap, root coverage using a bone graft substitute and subepithelial connective tissue graft obtained from the palatal mucosa was performed. The 6-month and 5-year postoperative clinical findings showed improved soft tissue phenotype. The cross-sectional CBCT scans 5 years after surgery showed a well-maintained labial bone plate in the mandibular incisors. Within the limitations of this case report, for patients with gingival recession in the mandibular incisors after orthodontic treatment, a successful biotype modification can be achieved with a combined procedure using subepithelial connective tissue graft with bone graft substitutes.

One common complication with dental implants placed in the atrophic posterior maxilla, especially with simultaneous transcrestal sinus augmentation, is the implant protruding into the sinus without apical bone support. Frequently, apically exposed implants contribute to various sinus pathologies that may lead to implant failure. Treatment options include (1) managing asymptomatic sinus pathology; (2) regrafting the apically exposed portion of the implant(s); and (3) removing the implant and placing a new implant with simultaneous grafting. The purpose of this case report is to present 4 clinical cases of apically exposed implants in the maxillary sinus. The report will cover: (1) exposed implants with asymptomatic sinus pathologies and (2) show successful management of protruding implants and pathologies using maxillary sinus floor augmentation. Various methods of implant surface detoxification, mechanical and chemical, are described for predictable bone remodeling around existing implants as well as newly installed implants. After 6 months of healing, osseointegration was well achieved for all implants and sinonasal complications were not observed. Clinical photographs and 3-dimensional imaging of surgical sites were used to validate clinical assessments.