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Purpose Methods Results Conclusions Glaucoma incidence in patients with endogenous Cushing's syndrome (CS) has never been established. We aim to assess the risk for glaucoma among CS patients compared to controls and determine the age of disease onset.A nationwide retrospective matched‐cohort study of patients with endogenous CS diagnosed between 2000 and 2023. Patients with CS were matched in a 1:5 ratio, with a control group individually matched for age, sex, socioeconomic status and body mass index. Main outcomes were the incidence of glaucoma and disease onset.A total of 609 patients [396 women (65%); mean age 48.1 ± 17 years] were included in the CS group and 3018 controls. Follow‐up duration was 14.6 years (IQR 9.8–20.2) for the study group. The aetiology of hypercortisolism was divided into pituitary (259, 42.6%), adrenal (206, 33.8%) and unconfirmed aetiology (144, 23.6%) patients. At baseline, 44 (7.2%) CS patients had a diagnosis of glaucoma, compared with 151 (5%) controls. The overall risk for glaucoma was 74% higher in patients with CS compared with matched controls (hazard ratio = 1.74, p = 0.002). Patients with CS who developed glaucoma were younger (mean age of 62 ± 14.7 years) than controls (mean ± SD age, 62 ± 14.7 years), (p = 0.02). The overall risk for glaucoma in CS was high for both patients in remission and patients with persistent hypercortisolism (p = 0.048). Patients with active hypercortisolism experienced an earlier glaucoma onset (82.1 ± 88.0 months).Endogenous CS is associated with increased risk for glaucoma regardless of remission status and develops at a younger age compared with the general population. [ABSTRACT FROM AUTHOR]

Suicidal thoughts and behaviors often emerge in a predictable sequence, with suicidal ideation (SI) preceding planning, and planning preceding actions. Few studies, however, have considered the timing and duration of non-suicidal self-injury (NSSI) in these transitions. Accordingly, this study examined: 1) the developmental sequencing of NSSI, SI and suicide attempts, and 2) whether age of onset or duration predict transitions from NSSI to other SITB, and from SI to NSSI. 704 first-year students from a mid-sized Canadian university (Sample 1) and 2095 adults from an online research volunteer panel (Sample 2) completed the Self-Injurious Thoughts and Behaviors Interview self-report, which assessed the presence, age of onset, and recency of SITB. NSSI and SI typically onset before age 15, while suicide planning and attempt usually began at or after age 15. Transition from NSSI to SI was likeliest in the first year after NSSI onset. Transition from NSSI to suicide attempt was likeliest in the second and third year after NSSI onset in Sample 1, and up to four years after NSSI onset in Sample 2. Early (before age 13) and late (after age 16) onsets of NSSI predicted higher odds of transitioning from NSSI to SI or attempt. Transition from SI to NSSI was likeliest in the first two years after SI onset and when SI began before age 13. The first year after NSSI or SI onset are critical for transitions to other SITB. Targeted prevention and monitoring should be considered for people who recently initiated NSSI. • NSSI and suicidal ideation (SI) typically begin within 1–2 years of each other • Transition from NSSI to SI was likeliest in the first year after NSSI onset • Transition risk from NSSI to attempt persisted for 3+ years after NSSI onset • NSSI onset before age 13 or after 16 predicted transitioning to SI or attempt • Onset of SI before age 13 predicted transition to NSSI [ABSTRACT FROM AUTHOR]

Acknowledging the prolonged duration of the rainy season in Northeast India (NEI) compared to Central India, the official onset of the Indian summer monsoon over NEI is traditionally marked around 5 June, with May rainfall categorized as 'pre‐monsoon'. However, our study reveals that May rainfall in NEI occurs in active/break spells driven by persistent synoptic‐scale systems, contributing to a significant monsoon heat source during this period. Through an objective analysis, we determine that the climatological 'onset' in NEI actually occurs around 18 May, with withdrawal around 14 October, resulting in an extended rainy season of approximately 150 days. The enigma of the May onset, while the Intertropical Convergence Zone remains proximate to the equator, is addressed by identifying a conducive climate in May. This climate is characterized by low‐level cyclonic vorticity over the region, influenced by the interannual strengthening (weakening) by the Atlantic Niño (El Niño). The introduction of potential vorticity from extratropical transient Rossby waves in May significantly amplifies low‐level cyclonic vorticity by 3–4 times, acting as a catalyst for the monsoon onset in NEI. Furthermore, a 5–6 times intensification of northward moisture transport from the Bay of Bengal sustains the monsoon heat source post onset. The May onset is made feasible by the uplifting of low‐level cyclonic winds, facilitated by the horseshoe‐shaped orography around the Brahmaputra valley. This process is complemented by an increased local moisture content resulting from evapotranspiration. Our findings challenge conventional notions by demonstrating that a component of Indian summer monsoon rainfall in NEI is not directly related to the Intertropical Convergence Zone. This challenges the fundamental definition of the South Asian Monsoon and calls for a reassessment of the prevalent belief that the Indian monsoon season is confined to June–September in NEI. [ABSTRACT FROM AUTHOR]

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]

Background: A latent period of variable length elapses between multiple sclerosis (MS) biological onset and the occurrence of the first clinical episode reflecting a central nervous system (CNS) demyelinating event. Factors affecting the duration of such interval are unknown. Objective: To explore whether brain reserve, which moderates the impact of structural damage along MS course, could also affect the timing of MS clinical onset. Methods: We conducted a time-to-event analysis in 326 relapsing-onset multiple sclerosis patients to ascertain the effect of brain reserve, that is, larger maximal lifetime brain growth (MLBG) estimated as intracranial volume, on the risk of an earlier disease onset. For this purpose, we carried out a Cox proportional hazards regression model stratified by sex and adjusted by site and pre-morbid MS risk factors. All patients reached the event (i.e. the disease onset) with no censored case; the age (years) at disease onset was set as the main time variable. Results: We identified a protective effect of brain reserve on the time to disease onset (HR = 0.11, 95% CI = 0.02–0.83, p = 0.032), unchanged when accounting for MS risk factors. Conclusion: Brain reserve might counteract the pathological mechanisms ongoing after biological initiation, thus delaying the disease overt clinical manifestation. [ABSTRACT FROM AUTHOR]

INTRODUCTION: It is unknown whether concomitant esophageal involvement or anatomic location of eosinophilic infiltration affects the natural history of eosinophilic gastrointestinal disease (EGID). METHODS: A retrospective cohort study was performed using the University of North Carolina EGID Clinicopathologic Database. Patients were adults and children with a prior EGID diagnosis based on clinicopathologic features. Demographics, clinical characteristics, treatment information, and procedural data were extracted from medical records. Clinical course and flare history were characterized. RESULTS: Among 97 patients, 43% had EGID + esophageal involvement and 57% had EGID only. Patients with esophageal involvement had a longer diagnostic delay preceding diagnosis (36.6 vs 11.6 months, P = 0.001), more dysphagia (50% vs 18%; P = 0.001), required more chronic therapy (77% vs 52%, P = 0.016), and exhibited more progressive disease (25% vs 6%, P = 0.027). A continuous disease course was most common in eosinophilic gastritis (78%) while patients with eosinophilic gastritis + eosinophilic enteritis (29%) and eosinophilic enteritis + eosinophilic colitis (50%) had the highest proportion of progressive and relapsing disease, respectively (P = 0.045). A continuous disease course occurred more frequently in children (71%, P = 0.03) and those with single organ involvement (65%), whereas adults had more relapsing (39%) or progressive disease (18%). DISCUSSION: EGIDs with and without esophageal involvement display many similarities, although patients with esophageal involvement more frequently had dysphagia, had progressive disease courses, and required more chronic therapy. Location of involvement and age of onset affected the natural history with higher proportions of relapsing or progressive disease seen in adults and patients with small bowel or multiorgan involvement while a continuous disease course was more common in children and patients with gastric-only involvement. [ABSTRACT FROM AUTHOR]

Background & Methods: The aim of the study is to Comparison of onset of motor and sensory block between levobupivacaine and levobupivacaine with dexmedetomidine in infraumbilical surgeries under spinal anaesthesia. In the operating room, appropriate equipment for airway management and emergency drugs were kept ready. The horizontal position of the operating table was checked. Patients were shifted to the operating room and positioned. Results: We found 56% Male in Group L whereas 68% in Group LD, 44% Female in Group L & 32% Group LD. ASA Grade 1 72% in Group L & 60% in Group LD with P (0.021). We found maximum side effect in Hypotension 32% whereas 24% in Bradycardia in Group LD with P (0.037). Conclusion: We concluded that the supplementation of Dexmedetomidine as an adjuvant to 0.5% levobupivacaine in infraumbilical surgeries under spinal anaesthesia produces longer duration of sensory and motor block but takes slightly more time to attain complete motor block as compared to Buprenorphine. Dexmedetomidine also provides an additional benefit of providing conscious sedation with fewer side effects. [ABSTRACT FROM AUTHOR]

Introduction: Although the prevalence of Alzheimer’s disease (AD) is higher in older people compared to younger people, dementia has also been documented in younger adults. Although early-onset dementia and late-onset dementia had been considered a single disease in pathological investigations, many studies revealed differences in cognitive and neuroimaging changes between them. We evaluated differences in cognitive and neuroimaging changes among the following groups: individuals with early-onset AD (EOAD), late-onset AD (LOAD), early-onset mild cognitive impairment (EOMCI), or late-onset MCI (LOMCI), and healthy controls (HCs). Methods: Patients underwent both a 1.5 Tesla magnetic resonance imaging scan and the Mini-Mental State Examination (MMSE). Differences in regional gray matter volumes and MMSE subscales were investigated among the five diagnostic groups. Results: Compared to the EOAD group, the LOAD group had significantly higher scores on orientation in place. Compared to the LOMCI patients, the EOMCI patients achieved significantly higher recall scores. The LOAD and LOMC groups showed significant volume reductions in bilateral medial temporal regions compared to the HCs. The EOAD and EOMCI groups did not show significant atrophy of the medial temporal region compared to the HC group. Conclusions: The hippocampal volume and memory were preserved in the patients with EOMCI or EOAD compared to those with LOMCI or LOAD. These findings may indicate that the distinct and differing patterns of neuropsychological changes between EOAD and LOAD are also common in MCI, which is intermediate between normal cognition and AD.

Depression is a common mental disorder, yet it shows low remission rates. The available evidence on personality traits as factors associated with the course of depression has common methodological limitations. Identifying personality traits linked with depression can improve understanding of the course of illness. Therefore, we aimed to investigate personality traits that are associated with the course of depression over 18 months. longitudinal data of 2366 Adult Psychiatric Morbidity Survey respondents were analysed. Assessments were applied at two-time points (baseline) and follow-up (about 18 months later). We assessed the total score on the screening questionnaire from the Structured Clinical Interview (SCID-II) for the dependent, obsessive-compulsive, and borderline personalities. Depression was measured using the revised Clinical Interview Schedule (CIS-R) version. An increase of one score on the borderline personality scale at baseline increased the odds of experiencing persistent depression by 1.50 times (OR = 1.50, 95 % CI [1.22–1.86]), depression onset by 1.30 times (OR = 1.30, 95 % CI [1.14–1.50]), and recovery by 1.52 times (OR = 1.52, 95 % CI [1.35–1.70]), comparing to no depression group. Elevated scores of dependent personality traits significantly predicted depression persistence (OR = 1.95, 95 % CI [1.52–2.49]). An increase of one score on the obsessive-compulsive personality scale increases the odds of depression onset by 1.21 times (OR = 1.21, 95 % CI [1.04–1.39]). The APMS survey defined depression statuses in a limited sense, which may affect the generalisability of these results. The present study confirms previous findings and contributes evidence suggesting that personality dysfunctions worsen depression outcomes. • Depression is a highly recurrent disorder affecting around 25.8 million people worldwide. • Personality traits could be a potentially critical factor in understanding the course of depression. • Borderline personality was the most robust predictor of the change in depression status over 18 months. • Elevated scores of dependent personality traits were found to be associated with persistent depression, whereas high scores of obsessive-compulsive personality traits were associated with the onset of depression. • The present study confirms previous findings suggesting personality dysfunctions worsen depression outcomes. [ABSTRACT FROM AUTHOR]

Abstract 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.

Exacerbations and new onset of immune-mediated inflammatory diseases, such as psoriasis and hidradenitis suppurativa, have been reported following COVID-19 vaccination. In patients with hidradenitis suppurativa, recent studies have shown that those who received mRNA vaccines were 3.5 times as likely to develop flares following vaccination compared to patients who received non-mRNA vaccines, indicating that mRNA COVID-19 vaccines are associated with hidradenitis suppurativa flares. Similar findings have been found in other studies evaluating the association between COVID-19 vaccines and other immune-mediated inflammatory diseases such as psoriasis, atopic dermatitis, lichen planus, and alopecia areata. However, further research is warranted in larger populations to validate these findings. [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]

Over the East Africa region forecasts of the onset of the rainy seasons have the potential to support decision‐making, especially in the largely rain‐fed agricultural sector. However, the understanding of key features of onset remains limited. Here, we analyse the variability of onset and associated drivers at interannual and subseasonal timescales, using several onset definitions. Results show that the onset date is especially variable from year to year in some of the high‐potential agricultural areas (standard deviation >20 days), which has implications for agricultural risk management. The choice of onset definition metric matters; agronomic definitions have limited applicability at the regional scale and are also highly sensitive to the spatial scale of analysis and to the choice of rainfall data. Onset information provided at coarse scales should be used with caution for decision‐making at the local scale; the "hit rate" of coarse‐scale tercile onset information at the local scale is less than 40% on average. To varying degrees, onset is related to total seasonal rainfall and thus to dominant interannual drivers of rainfall, including the Indian Ocean Dipole and ENSO modes in October–December and the western Pacific "V‐gradient" pattern in March–May. However, by analysing the dominant proportion of onset variance unrelated to total rainfall during the climatological season we show a substantial influence of subseasonal drivers, notably the Madden–Julian Oscillation. As such, there is an opportunity for rainfall onset information to be provided across seasonal and subseasonal timescales. Our work reinforces the need for enhanced co‐production of such onset information with stakeholders, especially regarding the choice of metric, alignment of forecasts with livelihood calendars, interpretation of the credibility of information content for local‐level decision‐making, as well as appropriate strategies for staggered risk management interventions informed by forecasts over "seamless" lead times. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed to investigate the clinical course and characteristics of late toxicity over time following the completion of definitive radiotherapy (RT) in patients with cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 60 patients with cervical cancer who underwent pelvic external beam radiotherapy followed by intracavitary brachytherapy. Late toxicity was assessed for the lower gastrointestinal (GI) tract and bladder organ at 6, 12, 24, 36, and >36 months post-RT. We examined the onset and prevalence of late toxicity at each time point. Clinical remission and interventions for managing late toxicity were also investigated. Results: The peak onset of lower GI toxicity occurred 12 months after RT completion, with a median symptom duration of 9.9 months (range, 0.1–26.3 months), and exhibited its highest prevalence rate of 15.5% at 24 months post-RT. Most GI toxicities developed and resolved within three years post-RT, with a prevalence rate of 8.1% at three years, followed by a decreasing trend. Bladder toxicity first peaked at 24 months post-RT and continued to occur beyond 36 months, showing the re-increasing pattern in the prevalence rate after 36 months (23.5%). In terms of clinical remission, 66.7% of lower GI toxicities (12 of 18 patients) and 60% of bladder toxicities (9 of 15 patients) achieved complete remission by the last follow-up date. Conclusions: Late toxicities of the GI and bladder following definitive RT in cervical cancer are partially reversible and exhibit distinct patterns of onset and prevalence over time. A systematic follow-up strategy should be established for the early detection and timely intervention of late toxicity by understanding these clinical courses. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most common mental health disorders in the middle aged and older population. Because older individuals are more likely to have multiple comorbidities or increased frailty, the impact of anxiety disorders on their overall well-being is exacerbated. Early identification of anxiety disorders using machine learning (ML) can potentially mitigate the adverse consequences associated with these disorders. We applied ML to the data from the Canadian Longitudinal Study on Aging (CLSA) to predict the onset of anxiety disorders approximately three years in the future. We used Shapley value-based methods to determine the top factor for prediction. We also investigated whether anxiety onset can be predicted by baseline depression-related predictors alone. Our model was able to predict anxiety onset accurately (Area under the Receiver Operating Characteristic Curve or AUC = 0.814 ± 0.016 (mean ± standard deviation), balanced accuracy = 0.741 ± 0.016, sensitivity = 0.743 ± 0.033, and specificity = 0.738 ± 0.010). The top predictive factors included prior depression or mood disorder diagnosis, high frailty, anxious personality, and low emotional stability. Depression and mood disorders are well known comorbidity of anxiety; however a prior depression or mood disorder diagnosis could not predict anxiety onset without other factors. While our findings underscore the importance of a prior depression diagnosis in predicting anxiety, they also highlight that it alone is inadequate, signifying the necessity to incorporate additional predictors for improved prediction accuracy. Our study showcases promising prospects for using machine learning to develop personalized prediction models for anxiety onset in middle-aged and older adults using easy-to-access survey data. • Machine learning predicts anxiety onset with an AUC of 0.814 ± 0.016. • Top predictors for anxiety onset include prior depression and/or mood disorder diagnosis, high frailty, anxious personality, and low emotional stability. • Baseline depression and/or mood disorder alone is not sufficient to predict anxiety onset. [ABSTRACT FROM AUTHOR]

Introduction: In this paper, we wish to elucidate alterations of basic existential and intersubjective configurations in schizophrenia spectrum disorders (SSD) through the phenomenon of Anderssein (“feeling different”). Anderssein is an important yet neglected notion from German psychiatry, referring to a specific sense of feeling profoundly different from others occurring in SSD. Although phenomenological-psychopathological research mentions it as an aspect of the core disturbance of SSD (namely, “self-disorders”), the phenomenon has not yet been explored in empirical or theoretical detail. Method: We present material from a phenomenological-empirical study on the mode and onset of psychosis based on qualitative interviews with 25 patients with SSD. Results: Most of the participants in our study report having felt fundamentally and often ineffably different since childhood and articulate it as a sense of existing “outside” of the shared reality. Intersubjective reality appears progressively unreal or inauthentic, and simultaneously, the patient’s intimate, subjective sphere is permeated by an alien otherness. Importantly, this outside position should be understood carefully as it is often accompanied by the sense of being invaded by social rules, other people’s thoughts, or emotions. Incipient psychosis is described as a gradual extension of precedent alterations of the structures of (inter)subjectivity. Conclusion: We conceptualize the ontological feature of Anderssein as an altered “being in-between” – that is, some sort of halting of the dynamic movement between particularity and intersubjectivity. Finally, we discuss the critical implications of these results for research into the “onset” of schizophrenia. [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]

The present research is aimed at evaluating the climate coupled models with respect to the observational datasets for the investigation of the characteristics of the Indian summer monsoon (ISM). The monthly averaged historical simulations from 12 coupled climate models that participated in Coupled Model Intercomparison Project Phase 6 (CMIP6) are compared with the ground based observational data, satellite and reanalysis datasets for the study period of 1980–2014. This study uses these high‐resolution models to investigate monsoon features, onset and withdrawal dates, primarily focusing on individual model performances rather than highly documented multi‐model mean performance. Performance evaluation of the models suggests that sea surface temperature (SST) simulations by the models are in better agreement for the Arabian Sea than the Bay of Bengal with respect to the ERA5 reanalysis data sets. Further, inter‐model differences amongst the CMIP6 models in estimating the spatial distribution of various monsoon system variables during pre‐monsoon and monsoon seasons are noted which may be attributed to the different model components and varying physics configuration, nonetheless, models like NESM3 and INM‐CN5 are able to reproduce ISM pattern reasonably well. The annual precipitation cycle demonstrates a good agreement between most climate models and IMD data. Evolution of tropospheric temperature gradient (ΔTT) estimated from the CMIP6 models mimics the temporal pattern of the annual rainfall and therefore, is used to estimate the onset and withdrawal dates from CMIP6 models; however, high variability is noted amongst the CMIP6 models in retrieving the onset and withdrawal dates when compared with the IMD observations. Most of the models show a shorter rainy season except NorESM2‐MM. Overall our results suggest that the CMIP6 models can be used for the seasonal mean evaluation of monsoon system parameters and process‐based studies to improve our present understanding of the ISM system. [ABSTRACT FROM AUTHOR]

To develop harmful sexual behavior (HSB) early intervention strategies it is essential to understand how children come to engage in HSB. Through the lens of a pathways theory, this paper reports a scoping review of the literature in answer to the research question: What are the pathways to HSB onset for children and young people? Eight bibliographic databases were searched over the time period January 2000 to May 2022 using the following terms (and derivatives): harmful sexual behavior AND children and young people AND pathways. Forty-three papers were included and 10 pathways to onset identified through synthesis: Child sexual abuse victimization; Physical and emotional abuse; Living with domestic and family violence; Disrupted attachments; Sexual arousal; "Antisociality;" Pornography use; Inadequate sexual boundaries; Sexual attraction to children; and Hypermasculinity. The pathways are discussed in terms of opportunities for early intervention. [ABSTRACT FROM AUTHOR]

Harmful sexual behaviour (HSB) carried out by children and young people can include sexual abuse of younger children or adults, or sexual assault in dating or peer relationships. The aim of this paper is to capture the "practice wisdom" of practitioners and applied researchers about clusters of risk factors associated with HSB onset, as well as possibilities for earlier intervention. Participants included practitioners and applied researchers in the HSB field. Data was collected in 2020 through individual interviews with eight key expert informants, and two group interviews – the first with two applied researchers and the second with three practitioners. Data analysis revealed risk factor clusterings around five key childhood experiences: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. These clusters are discussed in relation to early intervention. PRACTICE IMPACT STATEMENT Harmful sexual behaviour (HSB) is preventable but the early intervention agenda is underdeveloped. In this paper, five risk clusters are identified: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. The identification of these risk clusters present opportunities for early intervention that could enhance the prevention agenda to address HSB in Australia and internationally. [ABSTRACT FROM AUTHOR]

Knowledge of drought onset and its relationship with drought severity (deficit volume) is crucial for providing timely information for reservoir operations, irrigation scheduling, devising cropping choices and patterns and managing surface and groundwater water resources. An analysis of the relationship between drought onset timing and deficit volume can help in drought hazard assessments and associated risks. Despite its importance, little attention has been paid to understand the drought onset timing and its potential linkage with deficit volume for effective drought monitoring and its impact assessment. Further, only a few studies have explored the role of environmental controls, encompassing the interaction between climate, catchment and land‐surface processes in influencing streamflow droughts and associated characteristics such as onset time and severity. This study leverages quality‐controlled streamflow observations from 1965 to 2018 to unveil regional patterns of streamflow drought onset, at‐site trends in deficit volume and detect non‐linear relationships between onset timing and deficit volume across 82 rain‐fed catchments in peninsular India (8°–24° N, 72°–87° E). We show that around 12% of catchments show an earlier onset of streamflow droughts in conjunction with a decreasing trend in deficit volume. Further, approximately one‐third of the catchments show a significant non‐linear dependency between drought deficit volume and onset time. Among catchment controls, such as soil and topographic properties, we found soil organic carbon stock and stock as dominant drivers controlling the streamflow drought onset time. Likewise, sand content and vertical distance to channel network control the streamflow deficit volume. Finally, the linkages between inferred dominant low‐flow generation mechanisms and the specific combinations of environmental controls are synthesized in a conceptual diagram that might assist in developing appropriate models for low‐flow simulations and predictions, especially across ungauged sites. The new insights add value to understanding the chain of physical processes linking climatic and physiographic controls on streamflow droughts, which can support drought forecasting and climate impact assessment efforts. [ABSTRACT FROM AUTHOR]

Aim: To examine whether polygenic risk scores (PRS) for neuroticism, depression, bipolar disorder and schizophrenia are higher in individuals manifesting trans‐diagnostic risk factors for the development of major mental disorders and whether PRS enhance prediction of early onset full‐threshold disorders. Methods: Using data from the Brisbane Longitudinal Twin Study, we examined individual PRS for neuroticism, depression, bipolar disorder and schizophrenia, recorded evidence of subthreshold syndromes and family history of mood and/or psychotic disorders and noted progression to trans‐diagnostic clinical caseness (onset of major mental disorders) at follow‐up. We undertook multivariate, receiver operating curve and logistic regression analyses that were adjusted for known variables of influence (age, twin status, and so on). Results: Of 1473 eligible participants (female = 866, 59%; mean age 26.3 years), 28% (n = 409) met caseness criteria for a mood and/or psychotic disorder. All PRS were higher in cases versus non‐cases but associations with different levels of risk were inconsistent. The prediction of caseness (reported as area under the curve with 95% confidence intervals [CI]) improved from 0.68 (95% CI: 0.65, 0.71) when estimated using clinical risk factors alone up to 0.71 (95% CI: 0.69, 0.73) when PRS were added to the model. Logistic regression identified five variables that optimally classified individuals according to caseness: age, sex, individual risk characteristics, PRS for depression and mental health case status of cotwins or siblings. Conclusions: The findings need replication. However, this exploratory study suggests that combining PRS with other risk factors has the potential to improve outcome prediction in youth. [ABSTRACT FROM AUTHOR]

The age of drinking onset is a central concept for both policy and prevention of alcohol-related harm, yet evidence on the predictive value of the age of onset is lacking. This study compares alcohol outcomes of adolescents who started to drink early with those who started later, and tests if associations are moderated by other explanatory factors. Data from a two-wave longitudinal prospective cohort survey with a Swedish nationwide sample of 4,018 adolescents aged 15/16 years at baseline (T1) and 17/18 years at follow-up (T2) were used. Outcome variables at T2 were Alcohol Use Disorders Identification Test (AUDIT)–C, risky drinking, and binge drinking monthly or more often. A vast number of explanatory factors at T1 were controlled for. Early drinking onset predicted later higher AUDIT-C scores (β = 0.57, p value <.001), and higher probability of risky drinking (odds ratio = 1.95, 95% confidence interval = 1.56–2.44), and binge drinking (odds ratio = 1.38, confidence interval = 1.06–1.81), controlled for other explanatory factors. If binge drinking frequency at T1 was included, the associations remained for AUDIT-C and risky drinking, but not for binge drinking at T2. No significant interactions between early drinking onset and the explanatory factors were found. Early drinking onset predicts subsequent higher alcohol consumption in late adolescence. Adolescents who had an early drinking onset drank more after 2 years than their peers who started later. The age of drinking onset is an independent predictor of alcohol use outcomes, beyond the effect of age of binge drinking onset. [ABSTRACT FROM AUTHOR]

Background. Wide awake local anesthesia no tourniquet (WALANT) is an increasingly popular anesthetic technique used in hand surgery which uses local anesthetic and epinephrine, achieves adequate anesthesia, and eliminates the need for a tourniquet. Objective. This study compares the onset and duration of the three most commonly used concentrations of lidocaine and epinephrine for WALANT. Methodology. This was a randomized double-blind comparative study of 78 middle fingers subjected to either 1% lidocaine with 1:100,000 epinephrine, 0.5% lidocaine with 1:200,000 epinephrine or 0.25% lidocaine with 1:400,000 epinephrine. The pinprick test was used to measure onset time and anesthetic duration for the local effect and as a digital nerve block. Results. The contents of each treatment arm were as follows: Arm A: 0.25% lidocaine with 1:400,000 epinephrine, Arm B: 1% lidocaine with 1:100,000 epinephrine, and Arm C: 0.5% lidocaine with 1:200,000 epinephrine. Arm B had the shortest onset time (30.77 ± 10.39 seconds for local, 2.78 ± 0.69 minutes for digital block) followed by Arm C (38 ± 17.17 seconds for local, 4.30 ± 1.62 minutes for digital block) and Arm A (55.38 ± 18.48 seconds for local, 5.18 ± 1.46 minutes for digital block, p

In Music Information Retrieval (MIR), a general goal is to recognize times of novelty within music recordings. This includes estimating structural boundaries through the detection of changes in harmony, tempo, or instrumentation and identifying onsets of note and sound events by capturing changes in the music signal’s energy or spectral content. These tasks leverage novelty functions, which are one-dimensional, time-dependent functions characterized by sharp local maxima that indicate significant musical and acoustical changes. From a given music recording, novelty functions can be derived using a variety of methods, ranging from traditional signal-processing techniques to modern data-driven approaches, where they are often termed “activation functions.” In this tutorial, we explore the concept of novelty functions and some of their essential properties. We discuss methods to enhance these functions and improve their distinctive peak-like structures. These improvements are crucial for simplifying the identification of specific musical events using post-processing methods, from basic peak picking to more sophisticated approaches like periodicity analysis. We also assess novelty functions through commonly used metrics such as precision, recall, and F-measure but with an emphasis on error tolerance. Aimed at Bachelor’s degree and beginning Master’s degree students with basic knowledge of signal processing and mathematics, this tutorial uses illustrative figures to clarify key concepts, thereby broadening its accessibility to a wider MIR audience and enriching their comprehension of this significant subject. Furthermore, Jupyter notebooks, including Python source code for the core algorithms and audio examples that allow for reproducing the tutorial’s figures, are provided at https://github.com/groupmm/edu_novfct.

Abstract Background Sarcopenic obesity, a clinical and functional condition characterized by the coexistence of obesity and sarcopenia, has not been investigated in relation to dementia risk and its onset. Methods We included 208,867 participants from UK biobank, who aged 60 to 69 years at baseline. Dementia diagnoses were identified using hospital records and death register data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to evaluate the associations of obesity, sarcopenia, and sarcopenic obesity with dementia risk, stratified by sex. Stratified analyses were performed across dementia-related polygenic risk score (PRS). Restricted mean survival time models were established to estimate the difference and 95%CIs of dementia onset across different status. Additionally, linear regression models were employed to estimate associations of different status with brain imaging parameters. The mediation effects of chronic diseases were also examined. Results Obese women with high PRS had a decreased risk (HR = 0.855 [0.761–0.961]), but obese men with low PRS had an increased risk (HR = 1.223 [1.045–1.431]). Additionally, sarcopenia was associated with elevated dementia risk (HRwomen = 1.323 [1.064–1.644]; HRmen = 2.144 [1.753–2.621]) in those with low PRS. Among those with high PRS, however, the association was only significant in early-life (HRwomen = 1.679 [1.355–2.081]; HRmen = 2.069 [1.656–2.585]). Of note, sarcopenic obesity was associated with higher dementia risk (HRwomen = 1.424 [1.227–1.653]; HRmen = 1.989 [1.702–2.323]), and results remained similar stratified by PRS. Considering dementia onset, obesity was associated with dementia by 1.114 years delayed in women, however, 0.170 years advanced in men. Sarcopenia (women: 0.080 years; men: 0.192 years) and sarcopenic obesity (women: 0.109 years; men: 0.511 years) respectively advanced dementia onset. Obesity, sarcopenia, and sarcopenic obesity were respectively related to alterations in different brain regions. Association between sarcopenic obesity and dementia was mediated by chronic diseases. Conclusions Sarcopenic obesity and sarcopenia were respectively associated with increased dementia risk and advanced dementia onset to vary degree. The role of obesity in dementia may differ by sex and genetic background.

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, which is based on inflammatory demyelination and neurodegeneration. Over the course of the COVID-19 pandemic, there has been a perception that the virus has an effect on the course of immune processes. The questions of whether the frequency of autoimmune diseases, including the nervous system, and their course has changed have been discussed. Aim of the study was to assess the clinical and epidemiological characteristics of MS during the COVID-19 pandemic from 01.01.2020 to 01.01.2023 in Novosibirsk. In the course of our work, we studied the incidence of MS and the features of the clinical picture of the debut of MS associated with COVID-19 infection. Material and methods. The study included 628 patients with MS living in Novosibirsk with the onset of the disease in the period before the pandemic from 01.01.2017 to 12/31/2019 (341 patients) and during the pandemic from 01.01.2020 to 01.1.2023 (287 patients). Results. The incidence rates of MS in Novosibirsk were calculated, it was 7.1 7.6 6.4 7.38 6.92 and 3.2 per 100 thousand population in 2017, 2018, 2019, 2020, 2021 and 2020, respectively. The average incidence of MS in the study period before the pandemic was 7.03 per 100 thousand population, during the pandemic – 5.83 per 100 thousand population (critical value of the Student’s t-test = 1.972, with a significance level of a = 0.05). When analyzing the association of clinical manifestations of the onset of MS with COVID-19, it was found that coordination disorders were observed in patients with moderate infection more often than in patients with mild infection (p < 0.05; odds ratio 0.410, 95% confidence interval 0.162–1.035). No statistically significant correlation of clinical manifestations with the severity of infection was shown for patients with primary progressive MS, however, the predominance of the multi-focal nature of disease after a more severe course of COVID-19 was noted (40 %). After the first clinical demyelinating episode in the group of patients with relapsing-remitting MS, the chances of complete recovery in patients with mild infection are 2.8 times higher than in patients with moderate infection (p < 0.05). Conclusions. Thus, as a result of the conducted study, the effect of COVID-19 on the change in the incidence of MS was not revealed. In the process of analyzing the clinical features of MS during the pandemic, it was found that COVID-19 infection can contribute to an unfavorable course of MS with worse recovery of neurological deficits after episodes of exacerbations, which leads to the accumulation of disability of patients.

ABSTRACTInflammatory bowel disease (IBD) is a chronic and debilitating condition of relapsing and remitting inflammation in the gastrointestinal tract. Conventional therapeutic approaches for IBD have shown limited efficacy and detrimental side effects, leading to the quest for novel and effective treatment options for the disease. Bacterial membrane vesicles (MVs) are nanosized lipid particles secreted by lysis or blebbing processes from both Gram-negative and Gram-positive bacteria. These vesicles, known to carry bioactive components, are facsimiles of the parent bacterium and have been implicated in the onset and progression, as well as in the amelioration of IBD. This review discusses the overview of MVs and their impact in the pathogenesis, diagnosis, and treatment of IBD. We further discuss the technical challenges facing this research area and possible research questions addressing these challenges. We summarize recent advances in the diverse relationship between IBD and MVs, and the application of this knowledge as a viable and potent therapeutic strategy for IBD.

Objective and Background Method Results Conclusions The personality trait of agreeableness is linked to a number of core tendencies (e.g., empathy, warmth) that operate in a feeling‐based manner. Following considerations of this type, it is proposed that the motivations and characteristics of agreeable individuals, relative to disagreeable individuals, should render them more receptive to emotional events and more responsive to them for this reason.Potential links between agreeableness and emotional reactivity were assessed in two studies involving four samples (total N = 517) in which participants continuously rated their feeling states in response to a variety of affective images.Agreeableness did not predict the speed with which emotional reactions began, but agreeable individuals exhibited higher‐magnitude peak intensities, regardless of whether stimuli were appetitive (pleasant) or aversive (unpleasant) in nature.The findings provide novel insights into the personality trait of agreeableness, emotional reactivity phenomena, and the dynamic processes that link agreeableness to emotion. [ABSTRACT FROM AUTHOR]

Insulin is known to be a key hormone in the regulation of peripheral glucose homeostasis, but beyond that, its effects on the brain are now undisputed. Impairments in insulin signaling in the brain, including changes in insulin levels, are thought to contribute significantly to declines in cognitive performance, especially during aging. As one of the most widely studied experimental interventions, dietary restriction (DR) is considered to delay the neurodegenerative processes associated with aging. Recently, however, data began to suggest that the onset and duration of a restrictive diet play a critical role in the putative beneficial outcome. Because the effects of DR on insulin signaling in the brain have been poorly studied, we decided to examine the effects of DR that differed in onset and duration: long‐term DR (LTDR), medium‐term DR (MTDR), and short‐term DR (STDR) on the expression of proteins involved in insulin signaling in the hippocampus of 18‐ and 24‐month‐old male Wistar rats. We found that DR‐induced changes in insulin levels in the brain may be independent of what happens in the periphery after restricted feeding. Significantly changed insulin content in the hippocampus, together with altered insulin signaling were found under the influence of DR, but the outcome was highly dependent on the onset and duration of DR. [ABSTRACT FROM AUTHOR]

The purpose of this study is to take a life course perspective to explore how experiences at different life course stages of substance users and contextual factors influence their drug use behaviors. Using the life history narrative approach to interview 31 persons who were taking part in rehabilitation treatment in Hong Kong, this study maps out substance use trajectory into four stages (onset, persistence, escalation, and desistance) addressing three interrelated themes: (1) substance use behavior characteristics, (2) critical life events, (3) and social and structural factors. The results showed an interaction between substance use behaviors and their experience in different life stages. Because substance use has become more hidden in the stage of persistence and escalation, particularly in dense cities like Hong Kong, early social support is advocated to be provided in prevention and rehabilitation, such as offering better vocational training support and follow-up service to rebuild relationships with families. [ABSTRACT FROM AUTHOR]

Background: Sarcopenic obesity, a clinical and functional condition characterized by the coexistence of obesity and sarcopenia, has not been investigated in relation to dementia risk and its onset. Methods: We included 208,867 participants from UK biobank, who aged 60 to 69 years at baseline. Dementia diagnoses were identified using hospital records and death register data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to evaluate the associations of obesity, sarcopenia, and sarcopenic obesity with dementia risk, stratified by sex. Stratified analyses were performed across dementia-related polygenic risk score (PRS). Restricted mean survival time models were established to estimate the difference and 95%CIs of dementia onset across different status. Additionally, linear regression models were employed to estimate associations of different status with brain imaging parameters. The mediation effects of chronic diseases were also examined. Results: Obese women with high PRS had a decreased risk (HR = 0.855 [0.761–0.961]), but obese men with low PRS had an increased risk (HR = 1.223 [1.045–1.431]). Additionally, sarcopenia was associated with elevated dementia risk (HRwomen = 1.323 [1.064–1.644]; HRmen = 2.144 [1.753–2.621]) in those with low PRS. Among those with high PRS, however, the association was only significant in early-life (HRwomen = 1.679 [1.355–2.081]; HRmen = 2.069 [1.656–2.585]). Of note, sarcopenic obesity was associated with higher dementia risk (HRwomen = 1.424 [1.227–1.653]; HRmen = 1.989 [1.702–2.323]), and results remained similar stratified by PRS. Considering dementia onset, obesity was associated with dementia by 1.114 years delayed in women, however, 0.170 years advanced in men. Sarcopenia (women: 0.080 years; men: 0.192 years) and sarcopenic obesity (women: 0.109 years; men: 0.511 years) respectively advanced dementia onset. Obesity, sarcopenia, and sarcopenic obesity were respectively related to alterations in different brain regions. Association between sarcopenic obesity and dementia was mediated by chronic diseases. Conclusions: Sarcopenic obesity and sarcopenia were respectively associated with increased dementia risk and advanced dementia onset to vary degree. The role of obesity in dementia may differ by sex and genetic background. [ABSTRACT FROM AUTHOR]

This study explores the spatiotemporal variability of the onset, end, and duration of the rainy season in Senegal. These phenological parameters, crucial for agricultural planning in West Africa, exhibit high interannual and spatial variability linked to precipitation. The objective is to detect and spatially classify these indices across Senegal using different approaches. Daily precipitation data and ERA5 reanalyses from 1981 to 2018 were utilized. The employed method enables the detection of key dates. Subsequently, the Kohonen algorithm spatially classifies these indices on topological maps. The results indicate a meridional gradient of the onset, progressively later from the southeast to the northwest, whereas the end follows a north–south gradient. The duration varies from 45 days in the north to 150 days in the south. The use of self-organizing maps allows for classifying the onset, end, and duration of the season into four zones for the onset and end, and three zones for the duration of the season. They highlight the interannual irregularity of transitions, with both early and late years. The dynamic analysis underscores the complex influence of atmospheric circulation fields, notably emphasizing the importance of low-level monsoon flux. These findings have tangible implications for improving seasonal forecasts and agricultural activity planning in Senegal. They provide information on the onset, end, and duration classes for each specific zone, which can be valuable for planning crops adapted to each region. [ABSTRACT FROM AUTHOR]

Objective: To provide additional information about clinical features associated with adult ADHD in patients diagnosed in childhood compared to those first diagnosed in adulthood. Method: We stratified a sample of adults with ADHD into patients diagnosed in childhood versus adulthood and compared demographic and clinical characteristics. Results: We found similar clinical features in adults diagnosed in childhood and adults diagnosed in adulthood. Among those diagnosed in adulthood, 95% reported symptom onset in youth. Our results do not support the hypothesis that ADHD diagnosed in adulthood is due to misinterpreting symptoms of other disorders as ADHD. They also suggest incorporating behavioral signs of executive dysfunction into diagnostic criteria for ADHD in adults may increase diagnostic sensitivity. Conclusion: These results support the validity of ADHD diagnoses in adulthood, as these adults show similar clinical profiles to those diagnosed in youth. Our results also suggest that if adult-onset ADHD exists, it is rare. [ABSTRACT FROM AUTHOR]

The accurate prediction of the onset and withdrawal of the southwest monsoon (SWM) is crucial to the economic and social well-being of the local community whose livelihoods depend strongly on monsoon rains. To date however, there has been a paucity of research into the prediction of SWM timing in east coast Peninsular Malaysia (ECPM) as compared to other monsoon regions. Thus, this study attempts to identify the variability of SWM dates in ECPM and analyze the influence of ENSO on the timing of SWM. Composites of daily 850 hPa zonal winds and outgoing long-wave radiation (OLR) during 2000-2020 were analyzed. The SWM onset is identified by the sudden acceleration of southerly winds in mid-May, while the retreating SWM wind is recognized by the steady decrease of westerly winds through September until October. The average date of SWM onset and withdrawal over ECPM was found to be May 23rd and September 27th, respectively. ENSO has a greater influence on the SWM onset than the SWM withdrawal. The study adds to our understanding of the inter-annual variability of SWM start and retreat dates, laying the groundwork for future research into the impact of climate change on the monsoon timing variability in the study area.

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]

Alopecia areata (AA) is a non‐scarring autoimmune hair loss of the scalp or body. While an early onset is considered a primary factor for poor prognosis, children with early‐onset AA show varied responses to treatment. This study aimed to describe the clinical characteristics and assess the prognostic factors of early‐onset AA in children. We performed a retrospective study of AA patients aged <10 years who visited our dermatologic clinic between January 2013 and December 2020, with a follow‐up period >12 months. A clinical review of medical records, photographs, and telephonic interviews was performed. Treatment efficacy was assessed based on the degree of hair regrowth at a 12‐month follow‐up. Of 162 patients treated with topical corticosteroids, alone or in combination with other modalities, 57.4% showed >50% hair regrowth. On comparing the good and poor treatment response groups, no significant differences were observed in the presence of known prognostic factors, except for personal atopic history. In addition, patients aged <4 years at onset responded significantly better than older patients (p = 0.0127). There is a possibility that the patients with early‐onset AA, especially those aged <4 years, demonstrate good treatment response. Further studies on long‐term prognosis are required. [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]

The onset of substance use is a strong predictor of substance use disorders and related problems. This study examined the differences between early- and late-onset substance use in personality and substance use characteristics, traumatic experiences, and social support with a sample of 100 Turkish adults with substance use disorders. Early onset (<18 years) was associated with more traumatic experiences, increased risk of developing posttraumatic stress disorder (PTSD), and higher levels of depressive symptoms compared to late onset (≥18 years). Also, depressive symptoms, living, and working status were predictors of substance use onset. The study addresses the groups at risk of initiating substance use. [ABSTRACT FROM AUTHOR]

Intentional binding refers to the apparent compression of the temporal interval between voluntary actions and sensory outcomes. Recent studies have shown that the binding effect differs according to the type of action, namely pressing and releasing. In this study, we examined whether the influence of the type of action can be explained by a sensory association between action and outcome. We manipulated the type of visual outcome (stimulus appearance and disappearance) in addition to the type of action (pressing and releasing) and measured the binding effect using the interval estimation task. The results showed that both the action and outcome types influenced interval estimations: intervals were estimated to be shorter for pressing action than for releasing action, and they were estimated to be shorter when the stimulus appeared than when it disappeared. However, no interaction effect was observed between these factors. Bayesian analysis also supported the model without interaction more than the model with interaction. Our findings suggest that the action and outcome types independently contribute to intentional binding. [ABSTRACT FROM AUTHOR]

Introduction: The externalizing disorders of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are common in adolescence and are strong predictors of adult psychopathology. While treatable, substantial diagnostic overlap complicates intervention planning. Understanding which factors predict the onset of each disorder and disambiguating their different predictors is of substantial translational interest. Materials and methods: We analyzed 5,777 multimodal candidate predictors from children aged 9-10 years and their parents in the ABCD cohort to predict the future onset of ADHD, ODD, and CD at 2-year follow-up. We used deep learning optimized with an innovative AI algorithm to jointly optimize model training, perform automated feature selection, and construct individual-level predictions of illness onset and all prevailing cases at 11-12 years and examined relative predictive performance when candidate predictors were restricted to only neural metrics. Results: Multimodal models achieved ~86-97% accuracy, 0.919-0.996 AUROC, and ~82-97% precision and recall in testing in held-out, unseen data. In neural-only models, predictive performance dropped substantially but nonetheless achieved accuracy and AUROC of ~80%. Parent aggressive and externalizing traits uniquely differentiated the onset of ODD, while structural MRI metrics in the limbic system were specific to CD. Psychosocial measures of sleep disorders, parent mental health and behavioral traits, and school performance proved valuable across all disorders. In neural-only models, structural and functionalMRImetrics in subcortical regions and cortical-subcortical connectivity were emphasized. Overall, we identified a strong correlation between accuracy and final predictor importance. Conclusion: Deep learning optimized with AI can generate highly accurate individual-level predictions of the onset of early adolescent externalizing disorders usingmultimodal features. While externalizing disorders are frequently co-morbid in adolescents, certain predictors were specific to the onset of ODD or CD vs. ADHD. To our knowledge, this is the first machine learning study to predict the onset of all three major adolescent externalizing disorders with the same design and participant cohort to enable direct comparisons, analyze >200 multimodal features, and includemany types of neuroimagingmetrics. Future study to test our observations in external validation data will help further test the generalizability of these findings. [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]

Smoking is associated with an increased risk of multiple sclerosis (MS), and smoking and early menopause are related to poor outcomes in MS. Smoking is also associated with early menopause. To explore this intricate relationship between smoking status, age at menopause and disease course in MS, 137 women with MS and 396 age-matched controls were included in this case– control study. Age at menopause (median 49.0 vs. 50.0 years; p=0.79) and smoking status (40.3% vs. 47.6%; p=0.15) were similar among MS and control women. Relapsing MS onset was earlier in ever-smoker women with early menopause compared to the rest of the women (median 30.4 vs. 37.0years; p=0.02) and also compared to ever-smoker women with normal age at menopause (median 30.4 vs. 41.0years; p=0.008) and never-smoker women with early menopause (median 30.4 vs. 41.5years; p=0.004). Progressive MS onset was also earlier in ever-smoker women with early menopause compared to ever-smoker women with normal age at menopause (median 41.1 vs. 49.4years; p=0.05) and never-smoker women with early menopause (median 41.1 vs. 50.1years; p=0.12). Our results suggest that smoking and menopause associate with MS disease course, including the onset of relapsing and progressive MS in women. [ABSTRACT FROM AUTHOR]

Risk factors for violent behaviour may differ depending on whether this begins before (VBO) or after (VAO) the onset of schizophrenia spectrum disorder. However, previous studies have been limited by selective samples of forensic patients and crude outcome measures. The sample consisted of 1013 patients with schizophrenia spectrum disorders recruited from various treatment settings across the Netherlands. Putative risk factors and outcomes were measured with standardised instruments. We used logistic regression models to compare patients with VBO (n = 48), patients with VAO (n = 130) and nonviolent (NV) patients (n = 708) on each risk factor, adjusting for sex and age. Patients with VBO more often lived in a socially disorganised neighbourhood than NV patients (adjusted odds ratio [aOR] 3.3, 95 % confidence interval [CI] 1.3–8.0) and patients with VAO (aOR 3.3, 95 % CI 1.1–9.6). Clinical risk factors were more prevalent in patients with VAO than in NV patients, with substance misuse (aOR 1.5, 95 % CI 1.0–2.3), impairments in executive functions (aOR 1.6, 95 % CI 1.0–2.4), poor impulse control (aOR 2.4, 9 % CI 1.5–3.6), delusions (aOR 1.5, 95 % CI 1.1–2.3) and lack of illness insight (aOR 1.5, 95 % CI 1.0–2.2) reaching statistical significance. Patients with VBO were also more likely to have poor impulse control than NV patients (aOR 2.6, 95 % CI 1.3–5.1). Strategies to predict and prevent violence in schizophrenia spectrum disorders should distinguish between VBO and VAO. [ABSTRACT FROM AUTHOR]