Search

The incidence of deep vein thrombosis (DVT) is increasing with aging, which needs a screening and monitoring biomarker. This study focused on the significance of aging- and angiogenesis-related lncRNA RAMP2-AS1 (RAMP2-AS1) aiming to identify a promising biomarker for the incidence of DVT. Serum samples were collected from 63 healthy individuals and 98 patients with DVT. The serum RAMP2-AS1 level was analyzed by PCR and its significance in DVT detection and development prediction was evaluated by ROC and multivariate Cox regression analysis. The regulatory effect of RAMP2-AS1 on endothelial progenitor cells (EPCs) was evaluated by CCK8 and transwell assays. RAMP2-AS1 was significantly downregulated in patients with DVT, which could discriminate patients with DVT from healthy individuals with relatively high sensitivity and specificity. The downregulation of RAMP2-AS1 could predict poor outcomes and was associated with activities of daily living (ADL), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and monocyte to high-density lipoprotein cholesterol ratio (MHR) of patients with DVT. RAMP2-AS1 was identified as an independent prognostic factor of DVT by Cox regression analysis. In EPCs, overexpressing RAMP2-AS1 significantly suppressed cell proliferation, migration, and invasion. Downregulated serum RAMP2-AS1 could predict the incidence and progression of DVT. RAMP2-AS1 inhibited EPCs growth and motility, which provides a target for thrombolytic therapy. RAMP2-AS1 level could be included in the risk assessment model of DVT. [ABSTRACT FROM AUTHOR]

The study investigates variabilities and trends in the onset, peak, and retreat of Intertropical Discontinuity (ITD) annual migrations over West Africa between 1979 and 2020, using reanalysis data of the daily mean surface location of ITD of longitudes 15°W to 15°E. The ITD migration peaks are determined from its migration pentad graphs, while its migration onsets and retreats are detected using the ogive. ITD attains peak from August 4 to 28 at latitudes 17°N to 23°N. The percentage cumulative migrations of ITD perfectly exhibit the ogive/sigmoid curve that reflects changes in ITD's migration speed and direction. A new precision method is developed for the determination of the onsets and retreats on the ogive. The ITD periods of onset are between April 26 and May 5 in the west and April 21 and 25 in the east while their corresponding periods of retreats are between October 27 and November 1 and October 18 and 22. The locations of ITD at the onset and retreat periods increase from approximately 11°N and 12°N to 17°N and 20°N in the east and west, respectively. The peak period exhibits the highest variability (5.5–8.6% Coefficient of Variation (CV) and 45–85 days ranges), followed by the onset (4.9–7.2% CV and 20–35 days ranges) and the retreat (1.8–2.9% CV and 20–40 days ranges). However, the latitudinal location of the onset shows the highest variability (9.4–19.7% CV and 8.3–13° latitudinal ranges), followed by the retreat (9.0-15.3% CV and 4.7–11.8° latitudinal ranges) and lastly, the peak (1.6–7.8% CV and 1.4–7.9° latitudinal ranges). There are significant upward trends in the ITD's latitudinal location at the onset, peak and retreat along longitudes 5°E, 0°-15°E, and 10°E, respectively. The trends are attributed to the deepening of the Sahara Heat Low, which in turn is due to its enhanced heating in association with climate change. Direct relationships are observed between the pairs of ITD onset, peak and retreat periods. The ITD migration speed increases from the beginning of the year to the end and displays a gradual advance but rapid retreat. [ABSTRACT FROM AUTHOR]

Asphaltene precipitation in oil reservoirs, well equipment, and pipelines reduces production, causing pore blockage, wettability changes, and decreased efficiency. Asphaltenes, with their unique chemical structure, self-assemble via acid–base interactions and hydrogen bonding. Nano-inhibitors prevent asphaltene aggregation at the nanoscale under reservoir conditions. This study investigates the effect of two surface-modified nanoparticles, silica, and calcium carbonate, as asphaltene inhibitors and oil production agents. The impacts of these nano-inhibitors on asphaltene content, onset point, wettability, surface tension, and oil recovery factor were determined to understand their mechanism on asphaltene precipitation and oil production. Results demonstrate that these nano-inhibitors can significantly postpone the onset point of asphaltene precipitation, with varying performance. Calcium carbonate nano-inhibitor exhibits better efficiency at low concentrations, suspending asphaltene molecules in crude oil. In contrast, silica nano-inhibitor performs better at high concentrations. Wettability alteration and IFT reduction tests reveal that each nano-inhibitor performs optimally at specific concentrations. Silica nano-inhibitors exhibit better colloidal stability and improve oil recovery more than calcium carbonate nano-inhibitors, with maximum oil recovery factors of 33% at 0.1 wt.% for silica and 25% at 0.01 wt.% for calcium carbonate nano-inhibitors. [ABSTRACT FROM AUTHOR]

Introduction: Primary Sjögren's is a multi-system autoimmune disease affecting patients' physical, mental, and emotional wellbeing. The epidemiology of Sjögren's is not well understood, and up-to-date epidemiological evidence is needed to improve knowledge and awareness of Sjögren's among patients and healthcare professionals, and to ascertain the global burden of disease. The objective of this research was to conduct a de novo systematic literature review (SLR) to identify and synthesise evidence on global epidemiology of primary Sjögren's. Methods: This SLR was conducted in May 2021 by searching MEDLINE and Embase databases, relevant conference proceedings, websites of registries, and health technology assessment agencies and databases. Publications were systematically screened for English language articles reporting on the incidence, prevalence, age at symptom onset, and age at diagnosis for people with primary Sjögren's. Results: Of 3510 records identified, 68 publications were included, representing 62 unique studies. Studies reported on age at symptom onset (16/62; 25.8%) and age at diagnosis (43/62; 69.4%) more frequently than incidence (7/62; 11.3%) and prevalence (9/62; 14.5%). Primary Sjögren's was found to have the highest incidence and prevalence in females and in older age groups (incidence: ≥65 years; prevalence: ≥75 years). Average age at onset and diagnosis of primary Sjögren's ranged between 34–57 years and 40–67 years, respectively. Conclusions: This SLR identified a paucity of incidence and prevalence data for primary Sjögren's, highlighting a need for further epidemiological studies. The global Sjögren's community must work together to follow the defined classification criteria of primary Sjögren's and reporting guidelines for incidence and prevalence data to allow for meaningful epidemiological comparisons across studies, settings, and countries. [ABSTRACT FROM AUTHOR]

Better understanding on the phases of Indian summer monsoon i.e., onset, progress and withdrawal helps in the decision making and proper management. In this paper, date of onset of monsoon (DOM) and date of withdrawal of monsoon (DWM) is estimated using the long-term daily rainfall data observed by the India Meteorological Department (IMD) and cumulative rainfall anomaly concept, as the onset/withdrawal represents a signature of rainfall transition. The results are promising with a better match between the estimated DOM and IMD announced DOM over Kerala. The length of monsoon season variability is also analysed. The concept of onset at grid point (OGP) in India is also evaluated and progress of monsoon is monitored by considering the latitudinal variation, persistent & strength of rainfall in the continental India. The zonal classification of the spread of monsoon in terms of the intensity and time (duration) is presented. Zone wise pentad analysis of onset clearly signifies the progress of monsoon and its dependency on various physical factors like SST, OLR, TTG, ITCZ, Energy budget and wind circulation. The impact of ENSO on the OGP is brought out, which clearly shows that DOM, DWM and progress is almost influenced by the largescale processes. The intensity–duration–frequency analysis quantified the actual ISM length, seasonal rainfall and rainy days at all locations in India. This study will help modellers in better understanding of onset and progress of monsoon dynamics in India and can be integrated with NWP for the accurate and advance prediction of DOM and the progress. [ABSTRACT FROM AUTHOR]

Sepsis is a life-threatening condition whose early recognition is key to improving outcomes for patients in intensive care units (ICUs). Artificial intelligence can play a crucial role in mining and exploiting health data for sepsis prediction. However, progress in this field has been impeded by a lack of comparability across studies. Some studies do not provide code, and each study independently processes a dataset with large numbers of missing values. Here, we present a comparative analysis of early sepsis prediction in the ICU by using machine learning (ML) algorithms and provide open-source code to the community to support future work. We reviewed the literature and conducted two phases of experiments. In the first phase, we analyzed five imputation strategies for handling missing data in a clinical dataset (which is often sampled irregularly and requires hand-crafted preprocessing steps). We used the MIMIC-III dataset, which includes more than 5,800 ICU hospital admissions from 2001 to 2012. In the second phase, we conducted an extensive experimental study using five ML methods and five popular deep learning models. We evaluated the performance of the methods by using the area under the precision-recall curve, a standard metric for clinical contexts. The deep learning methods (TCN and LSTM) outperformed the other methods, particularly in early detection tasks more than 4 hours before sepsis onset. The motivation for this work was to provide a benchmark framework for future research, thus enabling advancements in this field. [ABSTRACT FROM AUTHOR]

Despite extensive research on the impact of smoking on health, there remains an inadequate understanding of the temporal relationship between smoking, education levels, and racial/ethnic groups. This study aims to clarify the influence of smoking initiation and cessation on the changing trends of educational disparities in smoking prevalence among women from diverse racial/ethnic backgrounds across varying birth cohorts. Using a sample of 336,732 women from the U.S. National Health Interview Survey (1997–2018), we employ Cox proportional hazards models to analyze the relative risks of smoking initiation and cessation across birth cohorts by race/ethnicity and education. Our investigation reveals that the education gap in smoking prevalence has experienced the most notable increase across cohorts among White women, followed by Black and Hispanic women. Particularly pronounced is the widening of the education gap in smoking initiation rates among White women in successive cohorts. This is primarily driven by a decline in smoking initiation among college-educated women and a marked surge in smoking initiation among those without a college degree. Conversely, among Black and Hispanic women, the rate of smoking initiation has declined in recent cohorts, with a more substantial decrease among those with a college degree. In contrast, smoking cessation rates have consistently risen across cohorts within each racial group, regardless of their education level. Hence, the expanding education gap in smoking prevalence across birth cohorts predominantly arises from the increasing disparity in smoking initiation rates. Given that smoking initiation typically occurs before college education is completed, this may underscore a growing trend of smokers being selected into cohorts without a college degree. We discuss the implications of this phenomenon within the context of selection based on family socioeconomic status and individual traits. [ABSTRACT FROM AUTHOR]

It has been proposed that the onset of Acquired Thrombotic Thrombocytopenic Purpura (iTTP) is more severe than subsequent relapses; however, existing studies have limitations. We conducted a retrospective observational study to compare analytical and clinical severity of onset and relapse aTTP cases between 2012 and 2023. A total of 370 episodes of aTTP were analyzed, comprising 272 at initial diagnosis and 98 relapses. At onset, analytical parameters indicative of severity (low hemoglobin, low platelet count, and increased LDH) were significantly worse; patients had severe neurological symptoms (p<0.001) and ≥ 3 points in the TMA mortality score (p<0.001). In conclusion, the onset of aTTP is associated with worse analytical parameters and severe neurological involvement. [ABSTRACT FROM AUTHOR]

Introduction: Eptinezumab is a humanized IgG1 immunoglobulin monoclonal antibody administered intravenously as a preventative migraine treatment. Previously conducted randomized, double-blind, placebo-controlled trials exhibited significant reductions in monthly migraine frequency among adults experiencing episodic and chronic migraine. The present study seeks to expand upon the current findings and to evaluate eptinezumab's efficacy as a preventative treatment for chronic and episodic migraine patients in the United Arab Emirates. This study is intended to represent the first real-world evidence and will hopefully serve as a valuable complement to the existing literature on the subject. Methods: This was a retrospective exploratory study. The participants included within the study were adult (≥ 18 years) patients diagnosed with either episodic or chronic migraine. Patients were categorized according to their history of previous preventative treatment failure. For the final assessment of treatment efficacy, we included only patients with a minimum of 6 months of clinical follow-up data. Patients were assessed at baseline for their monthly migraine frequency and assessed again at months 3 and 6. The primary objective was to evaluate the efficacy of eptinezumab in reducing migraine frequency among chronic and episodic migraine patients. Results: A total of 100 participants were identified, of whom 53 completed the study protocol at month 6. Of the total, 40 (75.47%) were female, 46 (86.79%) were Emirati locals, and 16 (30.19%) were pharmaceutically naïve, having never tried any prior preventative therapy. Additionally, 25 (47.17%) patients met the criteria for chronic migraine (CM), whereas the remaining 28 (52.83%) were diagnosed with episodic migraine (EM). The baseline monthly migraine frequency (MMD) was 12.23 (4.97) days across all participants, 15.56 (3.97) for CM patients, and 9.25 (3.76) for EM patients; by month 6, these frequencies reduced to 3.66 (4.21), 4.76 (5.32), and 2.68 (2.61), respectively. Overall, 58.49% of those enrolled experienced > 75% reduction in MMD frequency by month 6. Conclusion: Patients enrolled in this trial experienced clinically significant reductions in MMD by month 6. Eptinezumab was well tolerated and with one AE of significance that led to discontinuation from the study. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) usually has an early onset, however, also onset in the mid-40 s may occur. Recently, the threshold of 28 years to distinguish patients with early and late onset has been proposed. The objective of our study was to compare the quality of life (QoL) and psychological distress in early- and late-onset HS patients. In this cross-sectional, observational study, consecutive patients diagnosed with HS aged ≥ 16 years were recruited. Dermatology-specific QoL was evaluated using the Skindex-17 questionnaire, and psychological distress using the 12-item General Health Questionnaire (GHQ-12). Patients were categorized into "early onset" (< 28 years) and "late onset" (≥ 28 years). Data were collected on 467 patients. Mean age at diagnosis was 21.6 years, with 22.0% of patients presenting with late disease onset. Patients with late onset reported worse psychosocial QoL and higher psychological distress compared to early onset. No differences between the two groups were observed for clinical severity. In the final multivariate model lower diagnostic delay, higher number of fistulae, higher BMI, ex-smoker, no localization on axillae, no localization on mammary region, presence of psoriasis, and higher scores on the psychosocial scale of Skindex-17 were statistically significantly associated with late onset. In conclusion, the psychosocial impact of HS is higher in patients with late onset compared to those with early onset. Differences between these two groups should be further investigated. [ABSTRACT FROM AUTHOR]

The effect of soil moisture (SM) on the onset of East Asian subtropical summer monsoon (EASSM) is investigated based on multiple sets of reanalysis data in the period of 1981–2010. It is found that the EASSM is characterized by persistent 2-m s−1 southerly winds for about 3 months in spring at 850 hPa over the subtropical region of East Asia. Considering this feature of the meridional winds, we define the EASSM onset date, and obtain that the climatological onset date is pentad 17.7, around 26 March. On the interannual timescale, the onset date of EASSM exhibits statistically significant correlation with the SM in southeastern China in the month preceding the onset, with wetter (drier) conditions being associated with later (earlier) onset. The physical process by which the preceding SM affects the EASSM onset is further explored by examining the surface energy balance as well as its impacts. Positive (negative) SM anomalies in southeastern China in the month before onset may induce negative (positive) surface temperature anomalies. The decreased (increased) surface temperature in southeastern China before the EASSM onset weakens (strengthens) the zonal sea-land thermal contrast in the surface and low-level atmosphere in the subtropical East Asia. The zonal sea-land thermal contrast in wetter (drier) years induces anomalous northerly (southerly) winds over southeastern China, which tends to delay (advance) the zonal thermal seasonal transition in spring and is conducive to a later (earlier) onset of EASSM. These results are helpful for understanding and prediction of the variability of EASSM and the EASSM onset. [ABSTRACT FROM AUTHOR]

Knowledge of subseasonal-to-seasonal (S2S) rainfall characteristics such as onset, duration, and demise of the rainfall cycle, and characteristics of dry periods that are between rainfall seasons, can provide important insight for the agriculture, health, disaster, and energy industries. Several methods have attempted to calculate temporal characteristics of rainfall and few have worked with intermittent dry periods and calculate intermittent dry period characteristics. Issues arise when applying these methods for complex rainfall regimes, or regions that have one or more of the following: (1) multiple rainfall seasons in a given year, (2) a relatively wet dry season, (3) unclear transitions between wet and dry seasons. This study develops a new and comprehensive method for calculating S2S rainfall characteristics, especially for regions that have complex annual rainfall cycles. The method consists of three steps: (1) create the annual cycle climatology of rainfall and classify its modality by the presence or absence of intermittent dry period(s), (2) identify seasonal windows of the rainfall cycle based on its climatological modality, (3) calculate yearly intermittent dry period characteristics and calculate temporal rainfall characteristics for each year using information on daily rainfall amount and the concurrent rate of change. Application and results of the method are given for the Caribbean, which exhibits the properties of a region with complex rainfall regimes. The method can be utilized under a meteorological or agronomical lens and is able to delineate false meteorological and agronomical onsets and demises. Meteorological onsets and demises that are calculated via each year's Early-Rainy Season (ERS) and Late-Rainy Season (LRS) mean thresholds effectively characterize the seasonal evolution of mean onsets and demises in the Caribbean. The year-to-year variability of Mid-Summer Drought (MSD) characteristics, and onsets and demises that are calculated by climatological ERS and LRS mean thresholds resemble the variability of seasonal rainfall totals in the Caribbean and are statistically significantly correlated with the identified dynamical processes that impact each seasonal component of the rainfall cycle. The method has important implications for prediction, modeling capabilities, and understanding the variability of rainfall across timescales. [ABSTRACT FROM AUTHOR]

By using multiple data sources and numerical simulation results from the atmospheric general circulation model (AGCM) of CAM4.0 (Community Atmosphere Model, version 4), we investigated the effect of thermal forcing over the Tibetan Plateau (TP) on the onset of the summer monsoon in the Arabian Sea (AS) and India. Results indicate that the spatial distribution of diabatic heating over the TP in May is a southeastern–northwestern inverse pattern. This diabatic heating shows a robust negative relationship with the onset date of the summer monsoon over the AS and India. A positive diabatic heating seesaw pattern can enhance the ascending (descending) motion over the southeastern (northwestern) TP, corresponding to above (below) normal in- situ precipitation. Temperature budget diagnosis reveals that the adiabatic heating due to anomalous vertical motion and relevant horizontal advection of temperature in the mid-upper troposphere are responsible for the warming over the TP. Consequently, the reversal of the meridional temperature gradient from winter to summer over South Asian regions occurs earlier than the climate-mean state. Furthermore, the diabatic heating over the TP induces an enhanced and westward-extended South Asian High (SAH), which together with the easterly along the southern flank of the SAH superimpose on the low-level westerly flow over the AS and India, results in intensive upper-level divergence-pumping and upward motion. This anomalous circulation configuration in lower and upper levels further facilitates an earlier onset of the summer monsoon in AS and India. These findings are corroborated in the sensitivity runs based on CAM4.0. [ABSTRACT FROM AUTHOR]

There exists substantial heterogeneity in the developmental trajectories of ADHD symptoms, with distinctions often made between persistent versus remittent, and early- versus late-onset. However, how these trajectories relate to late adolescent functioning and whether, in particular, later onset trajectories mark a milder subtype remains unclear. Building on earlier work that has examined early life predictors of ADHD symptom trajectories up to age 14, we applied latent class growth analysis to data from the UK Millennium Cohort Study (N = 10,262) to evaluate whether developmental trajectories of ADHD symptoms up to age 17 (from age 3) were similar to those identified up to age 14 and associated with differing levels of impairment in peer victimisation, mental health, substance use, and delinquency outcomes at age 17. Our optimal model included five trajectory groups, labelled unaffected (37.6%), mildly affected (34.8%), subclinical remitting (14.4%), adolescent onset (7.6%), and stable high (5.6%). Adolescent onset and stable high trajectories were similarly impaired across all outcomes, other than substance use. Subclinical remitting individuals were impaired on self-esteem and well-being compared to unaffected individuals. By the end of mid-adolescence, those with a later onset have similar impairments to those following an early onset/persistent trajectory. Residual impairment may remain for those on a remitting trajectory. [ABSTRACT FROM AUTHOR]

Objectives: This retrospective study aims to investigate the evolution and clinical course of psychotic disorders from three large international cohorts of individuals with 22q11.2 deletion syndrome (22q11.2DS) (Tel Aviv, Philadelphia, and Geneva).We followed 118 individuals with 22q11.2DS from several years before the onset to several years after the onset of psychotic disorders. Data from structured baseline assessment of psychiatric disorders, symptoms of prodrome, indicators and types of psychotic disorders were collected. Additionally, cognitive evaluation was conducted using the age-appropriate Wechsler Intelligence Scale. Electronic medical records were reviewed for medication usage, occupational status, living situation, and psychiatric hospitalizations.At baseline evaluation, the most common psychiatric disorders were anxiety disorder (80%) and attention/deficit hyperactivity disorder (50%). The age of onset of prodromal symptoms and conversion to psychotic disorders were 18.6 ± 6.8 and 20.3 ± 7.2, respectively. The most common prodromal symptoms were exacerbation of anxiety symptoms and social isolation. Of the psychotic disorders, schizophrenia was the most common, occurring in 49% of cases. History of at least one psychiatric hospitalization was present in 43% of participants, and the number of psychiatric hospitalizations was 2.1 ± 1.4. Compared to the normalized chart, IQ scores in our cohort were lower after vs. before conversion to psychosis. Following conversion there was a decrease in the use of stimulants and antidepressants and an increase in antipsychotics use, and most individuals with 22q11.2DS were unemployed and lived with their parents.Our results indicate that 22q11.2DS psychosis is like non-22q11.2DS in its course, symptoms, and cognitive and functional impairments.Methods: This retrospective study aims to investigate the evolution and clinical course of psychotic disorders from three large international cohorts of individuals with 22q11.2 deletion syndrome (22q11.2DS) (Tel Aviv, Philadelphia, and Geneva).We followed 118 individuals with 22q11.2DS from several years before the onset to several years after the onset of psychotic disorders. Data from structured baseline assessment of psychiatric disorders, symptoms of prodrome, indicators and types of psychotic disorders were collected. Additionally, cognitive evaluation was conducted using the age-appropriate Wechsler Intelligence Scale. Electronic medical records were reviewed for medication usage, occupational status, living situation, and psychiatric hospitalizations.At baseline evaluation, the most common psychiatric disorders were anxiety disorder (80%) and attention/deficit hyperactivity disorder (50%). The age of onset of prodromal symptoms and conversion to psychotic disorders were 18.6 ± 6.8 and 20.3 ± 7.2, respectively. The most common prodromal symptoms were exacerbation of anxiety symptoms and social isolation. Of the psychotic disorders, schizophrenia was the most common, occurring in 49% of cases. History of at least one psychiatric hospitalization was present in 43% of participants, and the number of psychiatric hospitalizations was 2.1 ± 1.4. Compared to the normalized chart, IQ scores in our cohort were lower after vs. before conversion to psychosis. Following conversion there was a decrease in the use of stimulants and antidepressants and an increase in antipsychotics use, and most individuals with 22q11.2DS were unemployed and lived with their parents.Our results indicate that 22q11.2DS psychosis is like non-22q11.2DS in its course, symptoms, and cognitive and functional impairments.Results: This retrospective study aims to investigate the evolution and clinical course of psychotic disorders from three large international cohorts of individuals with 22q11.2 deletion syndrome (22q11.2DS) (Tel Aviv, Philadelphia, and Geneva).We followed 118 individuals with 22q11.2DS from several years before the onset to several years after the onset of psychotic disorders. Data from structured baseline assessment of psychiatric disorders, symptoms of prodrome, indicators and types of psychotic disorders were collected. Additionally, cognitive evaluation was conducted using the age-appropriate Wechsler Intelligence Scale. Electronic medical records were reviewed for medication usage, occupational status, living situation, and psychiatric hospitalizations.At baseline evaluation, the most common psychiatric disorders were anxiety disorder (80%) and attention/deficit hyperactivity disorder (50%). The age of onset of prodromal symptoms and conversion to psychotic disorders were 18.6 ± 6.8 and 20.3 ± 7.2, respectively. The most common prodromal symptoms were exacerbation of anxiety symptoms and social isolation. Of the psychotic disorders, schizophrenia was the most common, occurring in 49% of cases. History of at least one psychiatric hospitalization was present in 43% of participants, and the number of psychiatric hospitalizations was 2.1 ± 1.4. Compared to the normalized chart, IQ scores in our cohort were lower after vs. before conversion to psychosis. Following conversion there was a decrease in the use of stimulants and antidepressants and an increase in antipsychotics use, and most individuals with 22q11.2DS were unemployed and lived with their parents.Our results indicate that 22q11.2DS psychosis is like non-22q11.2DS in its course, symptoms, and cognitive and functional impairments.Conclusions: This retrospective study aims to investigate the evolution and clinical course of psychotic disorders from three large international cohorts of individuals with 22q11.2 deletion syndrome (22q11.2DS) (Tel Aviv, Philadelphia, and Geneva).We followed 118 individuals with 22q11.2DS from several years before the onset to several years after the onset of psychotic disorders. Data from structured baseline assessment of psychiatric disorders, symptoms of prodrome, indicators and types of psychotic disorders were collected. Additionally, cognitive evaluation was conducted using the age-appropriate Wechsler Intelligence Scale. Electronic medical records were reviewed for medication usage, occupational status, living situation, and psychiatric hospitalizations.At baseline evaluation, the most common psychiatric disorders were anxiety disorder (80%) and attention/deficit hyperactivity disorder (50%). The age of onset of prodromal symptoms and conversion to psychotic disorders were 18.6 ± 6.8 and 20.3 ± 7.2, respectively. The most common prodromal symptoms were exacerbation of anxiety symptoms and social isolation. Of the psychotic disorders, schizophrenia was the most common, occurring in 49% of cases. History of at least one psychiatric hospitalization was present in 43% of participants, and the number of psychiatric hospitalizations was 2.1 ± 1.4. Compared to the normalized chart, IQ scores in our cohort were lower after vs. before conversion to psychosis. Following conversion there was a decrease in the use of stimulants and antidepressants and an increase in antipsychotics use, and most individuals with 22q11.2DS were unemployed and lived with their parents.Our results indicate that 22q11.2DS psychosis is like non-22q11.2DS in its course, symptoms, and cognitive and functional impairments. [ABSTRACT FROM AUTHOR]

This paper investigates farmer perceptions of climate variability and change in rural North-west Ghana and compares with analyses of daily rainfall data (from 1960–2016) and monthly minimum and maximum temperature (1988–2014). Specifically, this study attempts to understand the following: (i) what does climatic data say about the nature of the past and current climate of North-west Ghana? (ii) what are farmer's perceptions of climate variability and change? and (iii) how do analyses from climatic data match or and mismatch farmers' perception of the climate? Statistical analyses and modelling of rainfall and temperature were performed, and the results compared with data collected through semi-structured questionnaire and qualitative interviews. The results from the farmer perceptions and analysis of climatic data largely disagreed. The only exception being agreement on increasing temperature. Specifically, farmers observed a shift in the start and end of the rainy season from March to June, and November to October respectively. However, the results from the climatic analyses showed variability in the start, end, and the length of the rainy season from 1960–2016. Even though farmers perceived changes in climate and climatic analysis showed variability, it is worth recognising that the two are problematic for farmers' decision making. Therefore, to increase farmers′ resilience to climate variability and change, this paper suggests the following: (i) climate-smart agricultural practices such as high yielding and improved varieties of seeds must be made available to farmers at affordable prices- however, this paper argues that, the cultural aspects of the uses of crops must be considered in the provision of crops that are suitable to the prevailing climatic conditions, and (ii) the capacity of agricultural extension workers should be enhanced on climate variability and change, for example equipping them on analysis, interpretation, and application of climatic events so they can engage with farmers in a participatory pathway to deal with climate variability and change impacts. [ABSTRACT FROM AUTHOR]

Introduction: Galcanezumab, a humanized monoclonal antibody that binds to calcitonin gene-related peptide, is approved for the preventive treatment of migraine in adults. It is self-administered once monthly as a subcutaneous injection. This paper describes the time course of effect of galcanezumab in patients with episodic and chronic migraine. Methods: Data were based on three double-blind, placebo-controlled, phase 3 studies. Patients (1773 episodic and 1113 chronic) were randomized (2:1:1) to monthly doses of placebo, galcanezumab 120 mg with a 240 mg loading dose, or galcanezumab 240 mg (January 2016–March 2017). Onset of effect was determined using a sequential analysis approach based on earliest time point at which galcanezumab achieved and subsequently maintained statistical superiority to placebo. Maintenance of effect was a comparison of the percentages of galcanezumab- and placebo-treated patients with maintenance of at least 50% response at the individual patient level. Cessation of effect was determined during a 4-month post-treatment period on the basis of change from baseline in monthly migraine headache days. Results: Galcanezumab led to a lower percentage of patients who had a migraine headache on the first day after injection, provided maintenance of effect throughout the duration of the double-blind treatment period, and gradually lost effect without signs of rebound headache throughout the post-treatment period in most patients with episodic and chronic migraine. Conclusion: Galcanezumab is a novel preventive therapeutic option for adult patients with migraine that has early onset of action, maintenance of effect, and gradual reduction of effect upon treatment cessation. Trial Registration: ClinicalTrials.gov: NCT02614183 (EVOLVE-1); NCT02614196 (EVOLVE-2); NCT02614261 (REGAIN). [ABSTRACT FROM AUTHOR]

The onset of thermal convection in two-dimensional porous cavities heated from below is studied theoretically. An open (constant-pressure) boundary is assumed, with zero perturbation temperature (thermally conducting). The resulting eigenvalue problem is a full fourth-order problem without degeneracies. Numerical results are presented for rectangular and elliptical cavities, with the circle as a special case. The analytical solution for an upright rectangle confirms the numerical results. Streamlines penetrating the open cavities are plotted, together with the isotherms for the associated closed thermal cells. Isobars forming pressure cells are depicted for the perturbation pressure. The critical Rayleigh number is calculated as a function of geometric parameters, including the tilt angle of the rectangle and ellipse. An improved physical scaling of the Darcy–Bénard problem is suggested. Its significance is indicated by the ratio of maximal vertical velocity to maximal temperature perturbation. [ABSTRACT FROM AUTHOR]

The need for an effective method of prediction of the onset and cessation dates of the rainy season cannot be overstressed. It becomes more imperative considering that the mainstay of the economy of the tropical Guinea Savanna region and the country at large is agriculture that is still rain-fed. Thus, an effective prediction of the onset dates of the rainy season is the first step to ensure food security. Two efficient methods were developed—the hybrid and the modified Anyadike's methods for the prediction of the onset dates of the rainy season and tested for the Guinea Savanna region of the country. Three stations were chosen: Lokoja, Bida and Jos. The methods proved to perform better than the earlier known and well-used method in the region—the Walter method. While the Walter method had about 12 false starts in Lokoja and 7 in Jos, the modified Anyadike had 5 and 3, respectively. However, the hybrid method had 1 and 2, respectively. The bias method also showed the hybrid method followed by the modified Anyadike's methods outperformed the Walter and Anyadike's methods. This is due to the overestimation associated with the Walter method and the underestimation by the Anyadike's method. Therefore, the two developed methods are recommended for use in the agricultural planning for the Guinea savanna region of Nigeria and any other region with a similar climate. Thus, it is recommended to be applied to other tropical Guinea savanna regions. [ABSTRACT FROM AUTHOR]

While there is evidence of morbidity compression in many countries, temporal patterns of non-communicable diseases (NCDs) in developing countries, such as India, are less clear. Age at onset of disease offers insights to understanding epidemiologic trends and is a key input for public health programs. Changes in age at onset and duration of major NCDs were estimated for 2004 (n = 38,044) and 2018 (n = 43,239) using health surveys from the India National Sample Survey (NSS). Survival regression models were used to compare trends by sociodemographic characteristics. Comparing 2004 to 2018, there were reductions in age at onset and increases in duration for overall and cause-specific NCDs. Median age at onset decreased for NCDs overall (57 to 53 years) and for diabetes, hypertension, heart disease, asthma, mental diseases, eye disease, and bone disease in the range of 2–7 years and increased for cancer, neurological disorders, some genitourinary disorders, and injuries/accidents in the range of 2–14 years. Hazards of NCDs were higher among females for cancers (HR 1.51, 95% CI 1.19–1.90) and neurological disorders (HR 1.18, 95% CI 1.06–1.32) but lower for heart diseases (HR 0.88, 95% CI 0.79–0.97) and injuries/accidents (HR 0.87, 95% CI 0.77–0.99). Hazards were greater among those with lower educational attainment at younger ages and higher educational attainment later in life. Unlike many countries, chronic disease morbidity may be expanding in India for many chronic diseases, indicating excess strain on the health system. Public health programs should focus on early diagnosis and prevention of NCDs. [ABSTRACT FROM AUTHOR]

This is the first study reporting a full three-dimensional (3D) non-normal-mode onset of convection in a porous medium. In this paper, the onset of thermal convection in a vertical porous cylinder is investigated theoretically. In particular, the contribution includes the following novelties. The homogeneous cylinder has a circular cross section. The eigenvalue problem is non-separable in space because of a constant heat flux condition at the upper boundary. In addition, a partly conducting cylinder wall is represented by a Robin parameter a. All boundaries are impermeable. The eigenvalue problem is solved numerically in the COMSOL Multiphysics environment. The critical Rayleigh number for the lowest onset modes is reported as a function of the ratio of the cylinder radius and its height. The only mode number, m, represents azimuthal dependency. The axisymmetric mode m = 0 corresponds to the preferred mode of convection for a small-cylinder radii. The numerical onset criterion is validated with the well-known analytical limit case, a → ∞ . Finally, we performed a visual comparison of the thermo-mechanical eigenfunctions against an established problem, where the only difference is the thermal condition at the upper boundary. The present 3D analysis is a step toward a full adequate modeling of experimental reality for convection onset, beyond the standard constraints of mathematical convenience. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to analyse the clinical and laboratory characteristics of different pathologic classifications of lupus nephritis (LN) patients in terms of age at systemic lupus erythematosus (SLE) diagnosis and nephritis onset. Method: Clinical, laboratory, and pathological data of 710 LN patients diagnosed by renal biopsy at our institution between 2000 and 2018 were retrospectively analysed. Patients were divided into the different pathological classification groups; childhood-, adult- and elderly-onset SLE groups and early- and late-onset LN groups. Results: Class IV occurred most frequently and had the lowest complement C3 level. There was an obvious increase in active index in class IV and class V + IV. Patients with class VI showed some clinical characteristics similar to end-stage renal disease. Patients with proliferative nephritis were younger at SLE diagnosis and had higher blood pressure, higher frequency of proteinuria and urinary erythrocyte and lower haemoglobin and complement C3. Pathologic classification between childhood-, adult- and elderly-onset SLE patients or between early- and late-onset LN patients was not significantly different. Elderly-onset SLE patients had the highest chronic index (CI), IgA, IgG and Sjögren's syndrome A antibodies and Sjögren's syndrome B antibodies rates, whereas late-onset LN patients showed significantly higher CI, haemoglobin, complement C3 and C4 but lower uric acid, IgM and IgG. Conclusions: LN patients present with different clinical and laboratory characteristics according to pathological classification, age at SLE diagnosis and nephritis onset. These results might be valuable for estimating the pathology and guiding treatment and prognosis. Key Points • Patients with proliferative nephritis have more severe immune disorders, worse renal function and stronger inflammatory state. • The elderly-onset SLE patients showed a poorer condition. • The late-onset LN patients might have a more stable status. [ABSTRACT FROM AUTHOR]

Detection of word boundaries in continuous speech is a tedious process due to the absence of a definite pause or silence in the word boundary position. Thus, continuous speech recognition is a very challenging task. However, the prosodic word boundaries, unlike the written word boundaries, can be predicted using the prosodic parameters of continuous speech. This paper proposes a method for detecting such prosodic word boundaries from Bengali continuous speech. Bengali is a bound-stress language, where stress is observed on the first syllable of a prosodic word. Empirical Mode Decomposition is applied to the logarithm of fundamental frequency (F0) contour of continuous speech to detect prosodic word boundaries. 200 Bengali readout sentences, read by ten speakers, are analyzed for the present work. An overall prosodic boundary detection accuracy of 88.05% is achieved, whereas precision and recall values are 90.73% and 88.31%, respectively, with f-score as 89.5. A prosodic word dictionary comprising 5031 prosodic words has been developed by analyzing 1526 Bengali sentences with the proposed prosodic word boundary detection method. [ABSTRACT FROM AUTHOR]

The onset of Darcy–Bénard convection in an unlimited horizontal porous layer is studied theoretically. The thermomechanical boundary conditions of Dirichlet or Neumann type at the lower and upper plane are switched from one type to another, at certain values of the horizontal x-coordinate. A semi-infinite portion of the lower boundary is defined as thermally conducting and impermeable, while the remaining boundary is open and with given heat flux. At the upper boundary, the same thermomechanical conditions are applied, but with a relative spatial displacement L and in the opposite spatial order. A domain of local destabilization around the origin is generated between the lines of discontinuity x = ± L / 2 . The marginal state of convection is triggered centrally, while it is penetrative in the domains exterior to the central domain. The onset problem is solved numerically, with a general 3D mode of disturbance, but 2D disturbances are preferred in most cases. The critical Rayleigh number is given as a function of the dimensionless gap width L and the wavenumber k in the y direction along the lines of discontinuity in the boundary conditions. An asymptotic formula for 2D penetrative eigenfunctions is shown to be in agreement with the numerical results. [ABSTRACT FROM AUTHOR]

Purpose: Whether an unfavorable lifestyle not only affects breast cancer risk, but also influences age at onset of breast cancer and survival, is under debate. Methods: In a population-based cohort, the Energy Balance and Breast Cancer Aspects throughout life (EBBA-Life) study, a total of 17,145 women were included. During follow-up, 574 women developed invasive breast cancer. Breast cancer cases were followed for an additional 9.1 years. Detailed medical records were obtained. Cox's proportional hazard regression models were used to study the association between pre-diagnostic lifestyle factors (weight, physical activity, alcohol use, smoking, and hypertension), breast cancer risk, age at diagnosis, and survival. Results: At study entry, 34.3% of the participating women were overweight and 30.7% were physically inactive. Mean age at breast cancer diagnosis was 58.0 years, and 78.9% of the tumors were estrogen receptor positive. Among menopausal women who did not use hormone therapy and had an unfavorable lifestyle (3–5 unfavorable factors), compared with women who had a favorable lifestyle, we observed a twofold higher risk for postmenopausal breast cancer (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.23–3.69), and they were 3.4 years younger at diagnosis (64.8 versus 68.2 years, P = 0.032). Breast cancer patients with an unfavorable lifestyle, compared with patients with a favorable lifestyle, had almost a two times higher overall mortality risk (HR 1.96, 95% CI 1.01–3.80). Conclusions: Our study supports a healthy lifestyle improving breast cancer prevention, postponing onset of disease, and extending life expectancy among breast cancer patients. [ABSTRACT FROM AUTHOR]

The analytical theory on Darcy–Bénard convection is dominated by normal-mode approaches, which essentially reduce the spatial order from four to two. This paper goes beyond the normal-mode paradigm of convection onset in a porous rectangle. A handpicked case where all four corners of the rectangle are non-analytical is therefore investigated. The marginal state is oscillatory with one-way horizontal wave propagation. The time-periodic convection pattern has no spatial periodicity and requires heavy numerical computation by the finite element method. The critical Rayleigh number at convection onset is computed, with its associated frequency of oscillation. Snapshots of the 2D eigenfunctions for the flow field and temperature field are plotted. Detailed local gradient analyses near two corners indicate that they hide logarithmic singularities, where the displayed eigenfunctions may represent outer solutions in matched asymptotic expansions. The results are validated with respect to the asymptotic limit of Nield (Water Resour Res 11:553–560, 1968). [ABSTRACT FROM AUTHOR]

The 4th order Darcy–Bénard eigenvalue problem for the onset of thermal convection in a 3D rectangular porous box is investigated. We start from a recent 2D model Tyvand et al. (Transp Porous Med 128:633–651, 2019) for a rectangle with handpicked boundary conditions defying separation of variables so that the eigenfunctions are of non-normal mode type. In this paper, the previous 2D model (Tyvand et al. 2019) is extended to 3D by a Fourier component with wave number k in the horizontal y direction, due to insulating and impermeable sidewalls. As a result, the eigenvalue problem is 2D in the vertical xz-plane, with k as a parameter. The transition from a preferred 2D mode to 3D mode of convection onset is studied with a 2D non-normal mode eigenfunction. We study the 2D eigenfunctions for a unit width in the lateral y direction to compare the four lowest modes k m = m π (m = 0 , 1 , 2 , 3) , to see whether the 2D mode (m = 0) or a 3D mode (m ≥ 1) is preferred. Further, a continuous spectrum is allowed for the lateral wave number k, searching for the global minimum Rayleigh number at k = k c and the transition between 2D and 3D flow at k = k ∗ . Finally, these wave numbers k c and k ∗ are studied as functions of the aspect ratio. [ABSTRACT FROM AUTHOR]

The rainfall during Indian summer monsoon (ISM) is very important for the population living in the Indian sub-continent. The recent Paris climate agreement determined to keep the global mean temperature rise well below 2 °C and pursue efforts to limit it within 1.5 °C. This global temperature rise would influence the ISM mechanism over the Indian sub-continent. This study examines the possible changes in the ISM characteristics at 1.5 and 2 °C specific warming levels (SWLs) with respect to the historical period. This analysis uses a set of 12 regional climate simulations under Coordinated Regional Climate Downscaling Experiments-South Asia (CORDEX-SA). The land as well as the oceans shows a warming signature due to the effect of anthropogenic forcings with much higher warming over land. The increase of global temperature to 1.5 °C (2 °C) SWL leads to an earlier onset of ISM over India by 7 (11) days in the model ensemble. The increasing land-sea temperature contrast gradually increases the strength of the Findlater jet (by 0.5–0.9 m/s), which transports more moisture towards land and causes higher rainfall (increase by 2–10%) over India. The study reveals that under a higher SWL of 2 °C the mean rainfall is augmented as compared to that under 1.5 °C. However, there exists uncertainty in the findings due to inter-model differences especially for the duration of ISM activity and the spatial distribution of rainfall at different SWLs. [ABSTRACT FROM AUTHOR]

Food security in Malawi relies on rainfall amount and timing. Because agricultural production is the main source of income for most rural communities, increased frequency of extreme events will increase the risk of production failure—a major threat to food security. Evidence of changing rainfall is reported by farmers and by recent analysis of gauge measurements, but these studies are limited due to small sample size, type of tests, or both. The main goal of this study is to test both statistically significant and robust but less significant changes in rainfall and rainy season for 1981–2018 using a high-resolution gridded dataset (0.05°). We analyzed different indices including onset, length, and cessation of rainy season, number of dry days, and number of extreme events during the rainy season. Our results show that roughly one-third of Malawi has experienced at least one type of significant change in rainfall indices during the study period. For instance, Northern Malawi had ~ 2 fewer extreme event days/decade and an end of season ~ 5 days/decade earlier as well as ~ 5 fewer dry days/decade. For the entire time period, delayed onset varies spatially from 18 to 35 days, number of dry days has decreased 21.6 days, the rainy season has ended 28.8 days earlier in the north and 36 days earlier in the south, and the number of extreme events has decreased 5 to 7 days in many places. The results are heterogeneous spatially and suggest that broad scale forcings are not driving them. [ABSTRACT FROM AUTHOR]

A special case of the fourth-order Darcy–Bénard problem in a two-dimensional (2D) rectangular porous box is investigated. The present eigenfunctions are of non-normal-mode type in the horizontal and vertical directions. They compose a time-periodic wave with one-way propagation out of the porous rectangle. Asymmetry in the horizontal direction generates an oscillatory time dependence of the marginal state, similar to Rees and Tyvand (Phys Fluids 16:3706–3714, 2004a). No analytical method is known for this non-degenerate eigenvalue problem. Therefore, the problem was solved numerically by the finite element method (FEM). Three boundaries of the rectangle are impermeable. The right-hand wall is fully penetrative. The lower boundary and the left-hand wall are heat conductors. The upper boundary has a given heat flux. The right-hand wall is thermally insulating. As a result, the computed eigenfunctions show complicated periodic time dependence. Finally, the critical Rayleigh number and the associated angular frequency are calculated as functions of the aspect ratio and compared against the case of normal modes in the vertical direction. [ABSTRACT FROM AUTHOR]

Sudden sensorineural hearing loss is a dire medical emergency which must be treated at the earliest to get better long term hearing results. Our study aims to determine the efficacy of intratympanic steroid (Methylprednisolone) on auditory outcomes in patients of sudden sensorineural hearing loss and study the relation between time of onset of hearing loss to start of therapy and frequency-wise recovery of hearing loss. A prospective cohort clinical study with 33 patients with sudden hearing loss of 30 dB or more were treated with the intratympanic injection of methylprednisolone and the effect of the drug was observed. In this study, 33 patients with sudden onset (unilateral or bilateral) of hearing loss were treated with intratympanic methylprednisolone. The duration at which the drug was administered and the age of the participants was taken into consideration. Main outcome measures included audiometry results at low, medium and high hearing loss frequencies. The specific frequency at which the hearing improvement took place was tabulated. It was observed that hearing improved significantly if the steroid is injected within the first 4 days of onset (p < 0.05) at all the frequencies. A gain of 15 dB or more was achieved in more than 78% patients after injecting methylprednisolone intratympanically. A statistically significant association was found between recovery rate and frequency of hearing loss with patients showing greater improvement at low hearing loss frequency in comparison to mid and high frequencies (p < 0.05). The drug efficacy does not change with the age of the patient. [ABSTRACT FROM AUTHOR]

Oil industry suffers from flow assurance problems that occur both in upstream and downstream operations. One of the common flow assurance issues arises from precipitation and deposition of asphaltenes in various locations along the oil production path including near wellbore region in the reservoir, production tubing, flowlines and separation unit at the surface. Asphaltene particles precipitate out of oil continuum due to changes in temperature, pressure or composition. Such changes in operating conditions occur during different recovery processes (natural depletion, gas injection, chemical injection, etc.) as well as production and blending of different oils during transportation. There are different experimental methodologies documented in the literature that describe how to determine onset of asphaltene precipitation. In this paper, a comprehensive review is performed on all the available procedures to measure onset of asphaltene precipitation. The advantages and limitations associated with all these methods are also documented. [ABSTRACT FROM AUTHOR]

The fourth-order Darcy–Bénard eigenvalue problem for onset of thermal convection in a 2D rectangular porous box is investigated. The conventional type of solution has normal-mode dependency in at least one of the two spatial directions. The present eigenfunctions are of non-normal-mode type in both the horizontal and the vertical direction. A numerical solution is found by the finite element method, since no analytical method is known for this non-degenerate fourth-order eigenvalue problem. All four boundaries of the rectangle are impermeable. The thermal conditions are handpicked to be incompatible with normal modes: The lower boundary and the right-hand wall are heat conductors. The upper boundary has given heat flux. The left-hand wall is thermally insulating. The computed eigenfunctions have novel types of complicated cell structures, with intricate internal cell walls. [ABSTRACT FROM AUTHOR]

We consider convection in a horizontal porous layer of uniform thickness which is heated from below and which is composed of two anisotropic sublayers with principal axes lying in the three coordinate directions. The aim is to determine criteria for the onset of convection by finding the critical Rayleigh number, wavenumber and roll orientation relative to the coordinate axes. The full set of nondimensional parameters has at least six members even when the sublayers are considered to be thermally isotropic, and therefore, we select some special cases in order to illuminate the type of qualitative behaviour which may be expected. One such case is where the anisotropic sublayers are identical except that one sublayer is rotated by an angle of 90 ∘ to the other. In this situation, the most unstable roll is found to lie at an angle of ± 45 ∘ to the principal axes. It is also found that fluid particles exhibit a mean longitudinal flow as they circulate about the vortex axis. This drift along the vortex is balanced by an equal and opposite drift in the two neighbouring vortices. Convection in each sublayer is shown to be two dimensional even though the full flow field is three dimensional. [ABSTRACT FROM AUTHOR]

The influence of trigonometric sine, square and triangular wave-types of time-periodic gravity-aligned oscillations on Rayleigh–Bénard convection in Newtonian liquids and in Newtonian nanoliquids is studied in the paper using the generalized Buongiorno two-phase model. The five-mode Lorenz model is derived under the assumptions of Boussinesq approximation, small-scale convective motion and some slip mechanisms. Using the method of multiscales, the Lorenz model is transformed to a Ginzburg–Landau equation the solution of which helps in quantifying the heat transport through the Nusselt number. Enhancement of heat transport in Newtonian liquids due to the presence of nanoparticles/nanotubes is clearly explained. The study reveals that all the three wave types of gravity modulation delay the onset of convection and thereby to a diminishment of heat transport. It is also found that in the case of trigonometric sine type of gravity modulation heat transport is intermediate to that of the cases of triangular and square types. The paper is the first such work that attempts to theoretically explain the effect of three different wave-types of gravity modulation on onset of convection and heat transport in the presence/absence of nanoparticles/nanotubes. Comparing the heat transport by the single-phase and by the generalized two-phase models, the conclusion is that the single-phase model under-predicts heat transport in nanoliquids irrespective of the type of gravity modulation being effected on the system. The results of the present study reiterate the findings of related experimental and numerical studies. [ABSTRACT FROM AUTHOR]

Purpose The articles in this special section examine opportunities for early intervention that is intended to retain the jobs of workers who have medical conditions that could put them at risk of prolonged work disability. Methods The first three articles examine options for analyzing various types of disability claims data for targeting early intervention; the fourth article provides new information from 50 case studies on how employers decide to invest in the retention of individual workers. Results Together, the four articles demonstrate that there may be an opportunity to positively affect longer-term outcomes for workers with medical conditions. This would be accomplished by building and expanding on existing systems in order to efficiently identify, and provide timely support to, workers with medical conditions in a critical period during which the decisions and actions of various stakeholders, including the workers themselves, may have a major influence on these outcomes. Conclusions Forthcoming opportunities to develop, implement, and test evidence-based interventions to promote job retention can provide further insight into the value of the options described in the articles. [ABSTRACT FROM AUTHOR]

Indian monsoon is the most prominent of the world’s monsoon systems which primarily affects synoptic patterns of India and adjacent countries such as Iran in interaction with large-scale weather systems. In this article, the relationship between the withdrawal date of the Indian monsoon and the onset of fall precipitation in Iran has been studied. Data included annual time series of withdrawal dates of the Indian monsoon prepared by the Indian Institute for Tropical Meteorology, and time series of the first date of 25 mm accumulated precipitation over Iran’s synoptic weather stations in a 10-day period which is the basis for the cultivation date. Both time series were considered in Julian calendar with the starting date on August 1. The studied period is 1960-2014 which covers 55 years of data from 36 meteorological stations in Iran. By classifying the withdrawal dates of the Indian monsoon in three stages of late, normal, and early withdrawals, its relation with the onset of fall precipitation in western, southwestern, southern, eastern, central, and northern regions of Iran was studied. Results demonstrated that in four out of the six mentioned regions, the late withdrawal of the Indian monsoon postpones the onset of fall precipitation over Iran. No significant relation was found between the onset of fall precipitation in central region of Iran and the monsoon’s withdrawal date. In the western, southwestern, southern, and eastern regions of Iran, the late monsoon delays the onset of fall’s precipitation; while in the south Caspian Sea coastal area, it causes the early onset of autumnal precipitation. The lag in onset of fall precipitation in Iran which is coordinated with the late withdrawal of monsoon is accompanied with prolonged subtropical high settling over Iran’s plateau that prevents the southward movement of polar jet frontal systems. Such conditions enhance northerly wind currents over the Caspian Sea which, in turn, increase the precipitation in Caspian coastal provinces, which has a different behavior from the overall response of Iran’s climate to the late withdrawal of monsoon. In the phase of early monsoon withdrawal, the subtropical jet is located at the 200 hPa level in 32.5° north latitude; compared with the late withdrawal date, it shows a 2° southward movement. Additionally, the 500 hPa trough is also located in the Eastern Mediterranean, and the MSL pressure anomaly is between − 4 to − 7 hPa. The Mediterranean trough in the late withdrawal phase is located in its central zones. It seems that the lack of significant correlation between late withdrawal date of Indian monsoon and late fall’s precipitation onset in the central region of Iran depends on three reasons:1. Lack of adequate weather stations in central region of Iran.2. Precipitation standard deviations over arid and warm regions are high.3. Central flat region of Iran without any source of humidity is located to the lee side of Zagros mountain range. So intensification or development of frontal systems is almost prohibited over there. [ABSTRACT FROM AUTHOR]

Adolescents and young adults represent the high-risk group for first onset of both DSM-IV mental disorders and lifetime suicide attempt (SA). Yet few studies have evaluated the temporal association of prior mental disorders and subsequent first SA in a young community sample. We examined (a) such associations using a broad range of specific DSM-IV mental disorders, (b) the risk of experiencing the outcome due to prior comorbidity, and (c) the proportion of SAs that could be attributed to prior disorders. During a 10-year prospective study, data were gathered from 3021 community subjects, 14-24 years of age at baseline. DSM-IV disorders and SA were assessed with the Munich-Composite International Diagnostic Interview. Cox models with time-dependent covariates were used to estimate the temporal associations of prior mental disorders with subsequent first SA. Most prior mental disorders showed elevated risk for subsequent first SA. Highest risks were associated with posttraumatic stress disorder (PTSD), dysthymia, and nicotine dependence. Comorbidity elevated the risk for subsequent first SA, and the more disorders a subject had, the higher the risk for first SA. More than 90% of SAs in the exposed group could be attributed to PTSD, and over 30% of SAs in the total sample could be attributed to specific phobia. Several DSM-IV disorders increase the risk for first SA in adolescents and young adults. Several promising early intervention targets were observed, e.g., specific phobia, nicotine dependence, dysthymia, and whether a young person is burdened with comorbid mental disorders. [ABSTRACT FROM AUTHOR]

The objective of the study is to determine the importance of the mode of onset as prognostic factor in systemic sclerosis (SSc). Data were collected from the Spanish Scleroderma Registry (RESCLE), a nationwide retrospective multicenter database created in 2006. As first symptom, we included Raynaud’s phenomenon (RP), cutaneous sclerosis, arthralgia/arthritis, puffy hands, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), and digestive hypomotility. A total of 1625 patients were recruited. One thousand three hundred forty-two patients (83%) presented with RP as first symptom and 283 patients (17%) did not. Survival from first symptom in those patients with RP mode of onset was higher at any time than those with onset as non-Raynaud’s phenomenon: 97 vs. 90% at 5 years, 93 vs. 82% at 10 years, 83 vs. 62% at 20 years, and 71 vs. 50% at 30 years (p < 0.001). In multivariate analysis, factors related to mortality were older age at onset, male gender, dcSSc subset, ILD, PAH, scleroderma renal crisis (SRC), heart involvement, and the mode of onset with non-Raynaud’s phenomenon, especially in the form of puffy hands or pulmonary involvement. The mode of onset should be considered an independent prognostic factor in systemic sclerosis and, in particular, patients who initially present with non-Raynaud’s phenomenon may be considered of poor prognosis. [ABSTRACT FROM AUTHOR]

Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body's appearance from an external observer's perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women's (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined. [ABSTRACT FROM AUTHOR]

The spatial coherence of interannual variations of sub-seasonal to seasonal anomalies in Indian summer monsoon rainfall is investigated at 0.25° spatial resolution using various metrics, including estimates of the number of degrees of freedom, the spatial scale of daily wet 'patches', as well as relationships between local and regional-scale rainfall anomalies and the monsoon circulation. Spatial coherence of interannual rainfall variations is generally found to peak near monsoon onset, in late May-June over Monsoonal India, and again during the withdrawal stage in September-October. However, the spatial coherence and correlations between local rainfall and the regional-scale monsoon circulation decrease during the core phase of the monsoon between early July and late August, when the interannual variability of local-scale amounts tend to be more tightly related to mean daily intensity rather than to the frequency of wet days. The drop in spatial coherence during the core phase is related to increases in the number and intensity of wet 'patches' of daily rainfall while their mean spatial extent remains similar throughout the monsoon season. The core phase, with large values of precipitable water, is characterized by very variable daily rainfall amounts across gridpoints, as a consequence of the near exponential distribution of daily rainfall. The interannual variations of sub-seasonal amounts are then dominated by very wet days, which tend to be rather randomly distributed. This contrasts with the onset and withdrawal phases where the mean of the exponential is smaller, and where interannual variations in the timing of regional-scale onset and end of the monsoon predominate. The early and late phases may thus be more potentially predictable than the core of the monsoon season. [ABSTRACT FROM AUTHOR]

The Ganges-Brahmaputra-Meghna (GBM) River Basin presents a spatially diverse hydrological regime due to it's complex topography and escalating demand for freshwater resources. This presents a big challenge in applying the current state-of-the-art regional climate models (RCMs) for climate change impact studies in the GBM River Basin. In this study, several RCM simulations generated by RegCM4.4 and PRECIS are assessed for their seasonal and interannual variations, onset/withdrawal of the Indian monsoon, and long-term trends in precipitation and temperature from 1982 to 2012. The results indicate that in general, RegCM4.4 and PRECIS simulations appear to reasonably reproduce the mean seasonal distribution of precipitation and temperature across the GBM River Basin, although the two RCMs are integrated over a different domain size. On average, the RegCM4.4 simulations overestimate monsoon precipitation by $${\sim }26$$ and $${\sim }5\%$$ in the Ganges and Brahmaputra-Meghna River Basin, respectively, while PRECIS simulations underestimate (overestimate) the same by $${\sim }7\%$$ ( $${\sim }16\%$$ ). Both RegCM4.4 and PRECIS simulations indicate an intense cold bias (up to $$10\,^\circ \hbox {C}$$ ) in the Himalayas, and are generally stronger in the RegCM4.4 simulations. Additionally, they tend to produce high precipitation between April and May in the Ganges (RegCM4.4 simulations) and Brahmaputra-Meghna (PRECIS simulations) River Basins, resulting in early onset of the Indian monsoon in the Ganges River Basin. PRECIS simulations exhibit a delayed monsoon withdrawal in the Brahmaputra-Meghna River Basin. Despite large spatial variations in onset and withdrawal periods across the GBM River Basin, the basin-averaged results agree reasonably well with the observed periods. Although global climate model (GCM) driven simulations are generally poor in representing the interannual variability of precipitation and winter temperature variations, they tend to agree well with observed precipitation anomalies when driven by perfect boundary conditions. It is also seen that all GCM driven simulations feature significant positive surface temperature trends consistent with the observed datasets. [ABSTRACT FROM AUTHOR]

We investigated whether lupus nephritis (LN) patients could be distinguished based on the time of disease onset and, if so, whether the groups differed in their clinical and laboratory features and long-term prognosis in ethnically homogeneous Korean patients. We enrolled 117 systemic lupus erythematosus patients with available clinical data at the time of renal biopsy of LN. Sociodemographic, clinical, and laboratory data and concomitant diseases were evaluated at the time of renal biopsy. We divided LN patients, according to age at LN diagnosis, into three groups: juvenile-onset LN (JLN, diagnosed at ≤18 years), adult-onset LN (ALN, diagnosed at 18-50 years), and late-onset LN (LLN, diagnosed at >50 years) and compared demographic, clinical, histological, and laboratory findings. We also compared treatment and long-term prognosis of LN. Of the 117 LN patients, 20 (17.8%), 84 (71.3%), and 13 (10.9%) were JLN, ALN, and LLN patients, respectively. LLN patients showed higher white blood cell counts and lower estimated glomerular filtration rate than ALN or LLN patients. LLN patients had higher chronicity indices and scores. Anti-Ro antibodies were found more frequently in ALN patients, and lower complement levels were more common in JLN patients. During a mean follow-up of 76.5 months, development of chronic kidney disease and death were higher in LLN patients than in JLN and ALN patients. LLN patients showed higher chronicity indices and deterioration of kidney function and death in long-term follow-up compared with JLN and ALN patients. Therefore, LLN patients should be carefully monitored to avoid poor outcomes. [ABSTRACT FROM AUTHOR]

The study evaluated for the first time the ability of meteorological models of TIGGE to forecast the main features of the West African monsoon rainfall. Seven numerical models were retained over the 2008-2012 period and compared to satellite rainfall estimates. We focused on the seasonal cycle and in particular on the onset of the rainy season and on the intra-seasonal variability that are both of high importance for agriculture, water management and health sectors. We found that the seasonal latitudinal shift of the ITCZ is rather well predicted in terms of amplitude and timing by the different models although there is a systematic northward drift in the ITCZ latitude from the lead-times 1- to 10-day. Although the onset date of rainfall varies a lot according to the different definition in the literature, we also found good performance of TIGGE forecasts in predicting the onset date of the monsoon. The analysis of intra-seasonal variability revealed that the skill of TIGGE forecasts is decreasing with the lead-time from 1- to 15-day and the performance of the ensemble mean of all models overcomes the one of any individual models. Overall criteria used in this study (intra-seasonal fluctuations, onset and seasonal cycles), the skill of UKMO and ECMWF models is better than any other model. Based on such analysis it is likely than an ensemble mean based only on these two models would be more skillful than the ensemble mean based on the seven models. TIGGE forecasts represent a promising step towards the delivery of useful climate information to end-users of key sectors such as agriculture, water management, health and public safety. [ABSTRACT FROM AUTHOR]

The literature on top-down contingent capture is concerned with the question of what constitutes a search set. Is it restricted to single stimulus properties such as color or onsets, or can such sets be more complex? In nine experiments ( N = 140), we tested whether cueing effects during search for onset targets were affected by cue color. According to the classic theory of contingent capture (Folk, Remington, & Johnston, Journal of Experimental Psychology: Human Perception and Performance, 18, 1030-1044, ), during search for onset targets, cues capture attention on the basis of a match between the cue's onset and top-down control settings directed to the target onsets. However, such cueing effects were based on cues of a color similar to the target color. Therefore, matches of the cue color to the target color could have contributed to the effects. Indeed, here we found cueing effects when the cues and targets were of the same color, but not when they were of different colors (Exps. 1a, 1b, 4a, and 4b). In addition, same-color cueing effects were stronger than different-color cueing effects (Exps. 2a, 2b, 3a, 3b, and the white-target conditions of Exp. 5). In Experiment 5, we also identified efficient search for only one target color as a critical prerequisite for the differences between cueing by color-similar and -dissimilar onset cues. We conclude with a discussion of the contributions of cue-to-set color matches, deallocation of attention, and intertrial priming to what appear to be top-down contingent-capture effects based on abrupt onsets. [ABSTRACT FROM AUTHOR]

Phenology is an important indicator of ecological response to climate change. Yet, phenological responses are highly variable among species and biogeographic regions. Recent monitoring initiatives have generated large phenological datasets comprised of observations from both professionals and volunteers. Because the observation frequency is often variable, there is uncertainty associated with estimating the timing of phenological activity. 'Status monitoring' is an approach that focuses on recording observations throughout the full development of life cycle stages rather than only first dates in order to quantify uncertainty in generating phenological metrics, such as onset dates or duration. However, methods for using status data and calculating phenological metrics are not standardized. To understand how data selection criteria affect onset estimates of springtime leaf-out, we used status-based monitoring data curated by the USA National Phenology Network for 11 deciduous tree species in the eastern USA between 2009 and 2013. We asked, (1) How are estimates of the date of leaf-out onset, at the site and regional levels, influenced by different data selection criteria and methods for calculating onset, and (2) at the regional level, how does the timing of leaf-out relate to springtime minimum temperatures across latitudes and species? Results indicate that, to answer research questions at site to landscape levels, data users may need to apply more restrictive data selection criteria to increase confidence in calculating phenological metrics. However, when answering questions at the regional level, such as when investigating spatiotemporal patterns across a latitudinal gradient, there is low risk of acquiring erroneous results by maximizing sample size when using status-derived phenological data. [ABSTRACT FROM AUTHOR]

Huntington disease (HD) is a neurodegenerative disorder characterized by motor dysfunction, cognitive deterioration, and psychiatric symptoms, with progressive motor impairments being a prominent feature. The primary objectives of this study are to delineate the disease course of motor function in HD, to provide estimates of the onset of motor impairments and motor diagnosis, and to examine the effects of genetic and demographic variables on the progression of motor impairments. Data from an international multisite, longitudinal observational study of 905 prodromal HD participants with cytosine-adenine-guanine (CAG) repeats of at least 36 and with at least two visits during the followup period from 2001 to 2012 was examined for changes in the diagnostic confidence level from the Unified Huntington's Disease Rating Scale. HD progression from unimpaired to impaired motor function, as well as the progression from motor impairment to diagnosis, was associated with the linear effect of age and CAG repeat length. Specifically, for every 1-year increase in age, the risk of transition in diagnostic confidence level increased by 11 % (95 % CI 7-15 %) and for one repeat length increase in CAG, the risk of transition in diagnostic confidence level increased by 47 % (95 % CI 27-69 %). Findings show that CAG repeat length and age increased the likelihood of the first onset of motor impairment as well as the age at diagnosis. Results suggest that more accurate estimates of HD onset age can be obtained by incorporating the current status of diagnostic confidence level into predictive models. [ABSTRACT FROM AUTHOR]

Purpose: Childhood adversity (variously defined) is a robust risk factor for psychosis, yet the mitigating effects of social support in adulthood have not yet been explored. This study aimed to investigate the relationships between childhood sexual and physical abuse and adult psychosis, and gender differences in levels of perceived social support.Methods: A sample of 202 individuals presenting for the first time to mental health services with psychosis and 266 population-based controls from south-east London and Nottingham, UK, was utilised. The Childhood Experience of Care and Abuse Questionnaire was used to elicit retrospective reports of exposure to childhood adversity, and the Significant Others Questionnaire was completed to collect information on the current size of social networks and perceptions of emotional and practical support.Results: There was evidence of an interaction between severe physical abuse and levels of support (namely, number of significant others; likelihood ratio test χ(2) = 3.90, p = 0.048). When stratified by gender, there were no clear associations between childhood physical or sexual abuse, current social support and odds of psychosis in men. In contrast, for women, the highest odds of psychosis were generally found in those who reported severe abuse and low levels of social support in adulthood. However, tests for interaction by gender did not reach conventional levels of statistical significance.Conclusions: These findings highlight the importance of investigating the potential benefits of social support as a buffer against the development of adult psychosis amongst those, particularly women, with a history of early life stress. [ABSTRACT FROM AUTHOR]

The reproducibility and future changes of the onset of the Asian summer monsoon were analyzed based on the simulations and projections under the Representative Concentration Pathways (RCP) scenario in which anthropogenic emissions continue to rise throughout the 21st century (i.e. RCP8.5) by all realizations from four Chinese models that participated in the Coupled Model Intercomparison Project Phase 5 (CMIP5). Delayed onset of the monsoon over the Arabian Sea was evident in all simulations for present-day climate, which was associated with a too weak simulation of the low-level Somali jet in May. A consistent advanced onset of the monsoon was found only over the Arabian Sea in the projections, where the advanced onset of the monsoon was accompanied by an increase of rainfall and an anomalous anticyclone over the northern Indian Ocean. In all the models except FGOALS-g2, the enhanced low-level Somali jet transported more water vapor to the Arabian Sea, whereas in FGOALS-g2 the enhanced rainfall was determined more by the increased wind convergence. Furthermore, and again in all models except FGOALS-g2, the equatorial SST warming, with maximum increase over the eastern Pacific, enhanced convection in the central West Pacific and reduced convection over the eastern Indian Ocean and Maritime Continent region, which drove the anomalous anticyclonic circulation over the western Indian Ocean. In contrast, in FGOALS-g2, there was minimal (near-zero) warming of projected SST in the central equatorial Pacific, with decreased convection in the central West Pacific and enhanced convection over the Maritime Continent. The broader-scale differences among the models across the Pacific were related to both the differences in the projected SST pattern and in the present-day simulations. [ABSTRACT FROM AUTHOR]

Background: Although the Oxford classification of IgA nephropathy appears valid, we found crescents were significantly related to renal outcome in our cohort, whereas segmental glomerulosclerosis (S) was not. The timing of renal biopsy may significantly affect the variables in the Oxford classification. Method: The relationship between biopsy timing and pathological variables (mesangial hypercellularity score [M], endocapillary hypercellularity [E], S, tubular atrophy/interstitial fibrosis [T], crescents, and global glomerulosclerosis [G]) was analyzed retrospectively in 250 children with IgA nephropathy. Results: The median time from disease onset to renal biopsy was 5.1 months (interquartile range, 2.7-15.4). M (ρ = −0.26, P < 0.0001), E (ρ = −0.34, P < 0.0001), and crescents (ρ = −0.14, P = 0.023) showed significant negative correlations, and S (ρ = 0.15, P = 0.018) and G (ρ = 0.25, P < 0.0001) showed significant positive correlations with time to biopsy (Spearman test). M, E, and crescents differed significantly in renal biopsies obtained before and after 3 years from onset (Wilcoxon test). Most crescents (92.9 %) were cellular/fibrocellular and were acute lesions. As crescents formed early after disease onset and decreased over time, they may be prognostic for acute phase, but not for chronic phase disease. Conclusions: Renal biopsy timing may alter the significance of variables used in the Oxford classification. [ABSTRACT FROM AUTHOR]