Speleothem oxygen isotope records over East Asia reveal apparently large and rapid paleoclimate changes over the last several hundred thousand years. However, what the isotopic variation actually represent in terms of the regional climate and circulation is debated. We present an answer that emerges from an analysis of the interannual variation in amount-weighted annual δ18O of precipitation over East Asia as simulated by an isotope-enabled model constrained by large-scale atmospheric reanalysis fields. 18O-enriched years have reduced summer seasonality both in terms of precipitation isotopes and in the large-scale circulation. Changes occur between June and October, where the δ18O of precipitation (δ18Op) transitions from the isotopically heavier winter to the lighter summer regime. For 18O-enriched years, this transition is less pronounced. Variations in precipitation amount alone are insufficient to explain the amount-weighted annual δ18Op between 18O-enriched and 18O-depleted years. Reduced summer seasonality is also expressed in the low-level monsoonal southerlies and upper-level westerlies; for the latter, the northward migration across the Tibetan Plateau in the summer is less pronounced. Our result thus implicates the westerlies across the plateau as the proximate cause of East Asian paleomonsoon changes, manifested as a modulation of its summer peak.

Increased atmospheric moisture content and changing land-ocean thermal contrasts are usually implicated in the East Asian summer rainfall response to global warming. We highlight an additional influence whereby increased meridional stationary eddy circulation downstream of the Tibetan Plateau drives a stronger moisture flux convergence over southeastern China, intensifying the early summer rainband. This effect occurs robustly across the Community Earth System Model large ensemble Representative Control Pathway 8.5 simulations, and only for its pre-Meiyu stage (mid-May through late June). The westerly jet impinging on the Plateau is also enhanced, suggesting an orographic influence on the westerlies as the root cause. The increased westerlies result from warmer tropical tropospheric temperatures that enhance the meridional temperature gradient at the latitudes of the Plateau. Our results highlight the potential role of the westerlies in altering the East Asian early summer monsoon rainfall in the late 21st century.

Speleothem oxygen isotope records over East Asia reveal apparently large and rapid paleoclimate changes over the last several hundred thousand years. However, what the isotopic variation actually represent in terms of the regional climate and circulation is debated. We present an answer that emerges from an analysis of the interannual variation in amount-weighted annual δ¹⁸O of precipitation over East Asia as simulated by an isotope-enabled model constrained by large-scale atmospheric reanalysis fields. ¹⁸O-enriched years have reduced summer seasonality both in terms of precipitation isotopes and in the large-scale circulation. Changes occur between June and October, where the δ¹⁸O of precipitation (δ¹⁸O_p) transitions from the isotopically heavier winter to the lighter summer regime. For ¹⁸O-enriched years, this transition is less pronounced. Variations in precipitation amount alone are insufficient to explain the amount-weighted annual δ¹⁸O_p between ¹⁸O-enriched and ¹⁸O-depleted years. Reduced summer seasonality is also expressed in the low-level monsoonal southerlies and upper-level westerlies; for the latter, the northward migration across the Tibetan Plateau in the summer is less pronounced. Our result thus implicates the westerlies across the plateau as the proximate cause of East Asian paleomonsoon changes, manifested as a modulation of its summer peak.

The incidence and biochemical consequences of rare tumor subtypes are often hard to study. Fibrolamellar liver cancer (FLC) is a rare malignancy affecting adolescents and young adults. To better characterize the incidence and biochemical consequences of this disease, we combined a comprehensive analysis of the electronic medical record and national payer data and found that FLC incidence is likely five to eight times higher than previous estimates. By employing unsupervised learning on clinical laboratory data from patients with hyperammonemia, we find that FLC-associated hyperammonemia mirrors metabolic dysregulation in urea cycle disorders. Our findings demonstrate that advanced computational analysis of rich clinical datasets can provide key clinical and biochemical insights into rare cancers.