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Background: Hyperacute ischemic stroke is a type of ischemic stroke that occurs rapidly and suddenly due to blockage of blood flow to the brain, with onset within 0–24 h. The recommended treatment for hyperacute ischemic stroke patients is a recombinant tissue plasminogen activator (rtPA) according to the guidelines of the American Heart Association/American Stroke Association (AHA/ASA) and the European Stroke Organization (ESO). In Indonesia, there is still limited adoption of intravenous thrombolysis, and the researchers hope that hospitals in Indonesia will adopt this treatment for managing hyperacute ischemic stroke patients. Objective: This study aims to describe the clinical characteristics of hyperacute ischemic stroke patients treated with intravenous thrombolysis. Methods: This descriptive cross-sectional study was conducted at Dr. Hasan Sadikin Hospital in Bandung, which serves as the referral hospital for West Java for stroke cases treated with intravenous thrombolysis. The study employed total sampling from January 2021 to March 2024. Results: From 23 patients, we found that most hyperacute ischemic stroke patients treated with intravenous thrombolysis were in the late elderly age group, 56–65 years old (43.5%), with onset within ≤ 4.5 h. Of the total sample, 91.3% of patients did not experience complications and approximately 50% of patients have good clinical and functional outcomes (based on NIHSS score). Conclusion: This demonstrates the effectiveness of intravenous thrombolysis in managing hyperacute ischemic stroke patients. Future research should continue to explore optimal patient selection criteria and refine treatment protocols to further improve outcomes in stroke management. [ABSTRACT FROM AUTHOR]

Due to the depletion of heavy oil reservoirs, novel approaches such as microwave technology and the integration of nanoparticles have expanded significantly. In this study, Fe3O4 nanoparticles, along with Fe3O4-SiO2 and Fe3O4-NiO nanohybrids, were synthesized via a co-precipitation method and characterized using various tests. Furthermore, to enhance the effect of the nanoparticles, MW irradiation was employed, modifying the static properties of crude oil. The optimal conditions, identified using the Taguchi design of experiment approach, revealed Fe3O4-NiO to be the best option at a concentration of 0.5 wt.%, with 400 watts of power under 9 min of irradiation period. Under these conditions, a 42% reduction in viscosity, a 4.47° API gravity increase attributed to the breakdown of heavy molecules like asphaltenes. Also, it was revealed that this hybridizing approach leads to the stabilization of asphaltene particles, which was assessed by measuring the onset of asphaltene precipitation. The onset, evaluated with and without MW treatment, revealed a significant shift from 10 Vol.% to 26 Vol.% of n-heptane volume under optimal conditions. Furthermore, asphaltene content in the oil sample decreased by 22.6%, and sulfur content in asphaltenes dropped by 52.6%. These investigations, along with the conducted structural analysis tests provide novel evidence supporting our hypothesis regarding the stability of asphaltene particles in the presence of nanoparticles and MW energy, a methodology that has not been previously explored in the literature. [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]

This short article highlights unsolved problems of magnetic reconnection in collisionless plasma. Advanced in-situ plasma measurements and simulations have enabled scientists to gain a novel understanding of magnetic reconnection. Nevertheless, outstanding questions remain concerning the complex dynamics and structures in the diffusion region, cross-scale and regional couplings, the onset of magnetic reconnection, and the details of particle energization. We discuss future directions for magnetic reconnection research, including new observations, new simulations, and interdisciplinary approaches. [ABSTRACT FROM AUTHOR]

Background Preeclampsia (PE) is a gestational disease associated with developing hypertension and proteinuria. Aim This study investigated the effects of AKT1 polymorphisms, a key enzyme in cellular signal transmission that regulates various cellular processes associated with PE. Methods The PCR-RFLP method was employed to genotype AKT1 rs2494732, rs1130233, and rs1130214 polymorphisms. In silico analysis was conducted using SpliceAid2, RNAsnp, and STRING tools. Results The AKT1 rs1130233 variant was associated with an increased risk of PE in log-additive and allelic models. A significant relationship was also observed between the rs1130214 variant and PE risk in several genetic models. Results from the SpliceAid2 server indicated that the rs2494732 A to G substitution creates a new binding site for the SRP-40 protein. Several key protein binding sites were lost for rs1130214 (C-to-A) and rs1130233 (C-to-T) mutations. However, RNAsnp analysis did not show significant changes in secondary structure. Conclusion In conclusion, the AKT1 rs1130233 and rs1130214 polymorphisms were found to be associated with an increased risk of PE [ABSTRACT FROM AUTHOR]

Background/Objectives: Owing to the growing use of immune checkpoint inhibitors (ICIs) in the treatment of cancer, a wide spectrum of toxicity has arisen among cancer patients. Yet, limited ICI toxicity-related research is currently conducted in our region. Methods: This is a retrospective observational study conducted on adult cancer patients who received at least one cycle of ICI single therapy. Toxicity profiles of different ICI monotherapies were described and compared, and their association with different risk factors was assessed. SPSS version 28 was used for statistical analyses, and p < 0.05 was considered statistically significant. Results: A total of 428 patients were treated with anti-PD1 (nivolumab [n = 221, 51.6%] and pembrolizumab [n = 126, 29.5%]) or anti-PD-L1 (atezolizumab [n = 78, 18.2%] and durvalumab [n = 3, 0.7%]). Pneumonia was the most common complication (10%), followed by acute kidney injury (AKI; 8.2%) and hepatitis (7.9%). The proportion of hepatitis cases was significantly higher among atezolizumab compared to nivolumab-, pembrolizumab-, and durvalumab-treated patients (17.95% vs. 7.7% vs. 2.4% vs. 0.0%, respectively; p < 0.001). Gastrointestinal complication (colitis) was detected in 3.3% of patients with a significant difference between treatment groups (4.5%, 1.6%, 1.3%, and 33.3% in nivolumab, pembrolizumab, atezolizumab, and durvalumab, respectively; p = 0.008). Cardiac complications occurred in 1.2% of patients with a significant difference between treatment groups (0.5% in the nivolumab, 3.8% in the atezolizumab, 33.3% in the durvalumab, and none in the pembrolizumab groups (p < 0.001)). Musculoskeletal side effects, including both arthralgia and fatigue, were the most-reported side effects by 39.5% of patients, with significantly higher arthralgia complainers only in nivolumab (7.7%) compared to other treatment groups (0%, 2.6%, and 0% in pembrolizumab, atezolizumab, and durvalumab, respectively, p = 0.007). Hepatic, cardiovascular, hematological, respiratory, renal, gastrointestinal complications, thyroid complications, and dermatological side effects were found to occur on weeks 6, 7.5, 8, 8, 10, 10, 10.5, and 12 after treatment initiation, respectively, with no significant difference between treatment groups. Despite that, hepatitis and AKI tended to occur earlier with atezolizumab (week 2, p = 0.084) and pembrolizumab (week 2, p = 0.062), respectively, compared to their comparators. The female gender and a history of hepatitis were found to increase the odds of hepatic complication with anti-PD1 or anti-PD-L1 use [OR = 2.71; 95% CI 1.07–6.85, OR = 11.14; 95% CI 3.46–35.88, respectively]. Previous exposure to cancer therapy only was found to increase the odds of developing pneumonia among the treated patients [OR = 3.08; 95% CI 1.12–8.85]. Having hematological malignancy influenced the odds of hematological complications positively (either neutropenia or thrombocytopenia) compared to solid malignancies when patients were treated with anti-PD1 or anti-PD-L1 [OR = 17.18; 95% CI 4.06–72.71]. Finally, the female gender was found to positively associate with the odds of nausea/vomiting and fatigue secondary to anti-PD1 or anti-PD-L1 administration [OR = 2.08; 95% CI 1.34–3.21, OR = 1.65; 95% CI 1.09–2.51, respectively]. On the other hand, previous exposure to cancer therapy was found to reduce the risk of having arthralgia with anti-PD1 or anti-PD-L1 administration [OR = 0.344; 95% CI 0.121–0.974]. Conclusions: Treatment with anti-PD1 or anti-PD-L1 was associated with a spectrum of complications and side effects. Several risk factors have been identified to impact their occurrence. ICI toxicities and risk factors influencing their odds should be recognized and considered in clinical practice, as this could help in individualizing therapeutics regimens and avoiding treatment interruption. [ABSTRACT FROM AUTHOR]

Darkness is often used as an effective measure to induce leaf senescence. Although many senescence-related genes in rice have been reported, the genome-wide genetic architecture underlying leaf senescence remains poorly understood. In our study, indica and japonica rice showed contrasting responses to dark-induced leaf senescence (DILS). Genome-wide association studies (GWAS) combined with transcriptomic analyses revealed 57, 97, and 48 loci involved in the regulation of the onset, progression, and ending of DILS, respectively. Haplotype analyses showed that the senescence-related loci differentially accumulated in indica and japonica accessions and functioned additively to regulate DILS. A total of 357 candidate genes were identified that are involved in various senescence-related processes such as lipid and amino acid catabolism, photosynthesis, response to reactive oxygen species, and regulation of defence response. In addition, functional analyses of candidate genes revealed that OsMYB21 positively regulates the onset of DILS, while OsSUB1B negatively regulates its progression. Thus, our results provide new insights into the genetic regulation of DILS in rice. [ABSTRACT FROM AUTHOR]

Changes in patterns of accumulated rainfall, as well as the rainy season onset, cessation and duration, can impact the availability of water resources and sectors such as agriculture, affecting the livelihoods of the population. The knowledge of these changes is crucial for regions driven by strong precipitation variability such as the Andean countries. Therefore, the aim of this work is to determine the present and future spatio‐temporal patterns of the onset, cessation and duration of the rainy season in Peru. For this purpose, we analysed in a first step the present variability and trends in 11 homogeneous regions using data from 377 ground stations for the period 1981–2019. The results showed significant trends (1981–2019) of earlier onset and increased duration only in the Southern Peruvian Amazon (Madre de Dios River basin). Furthermore, the accumulated rainfall has significant trends of increases in North East Andes, Northern and Southern Amazon. In a second step, we assessed future changes of the rainy season from an ensemble of statistically downscaled CMIP6 climate scenarios. A two‐tailed Student t‐test was used to evaluate the significance of changes. Two future time slices (2031–2060 and 2071–2100) relative to the reference period (1981–2010) were analysed. Future changes of the rainy season showed significant delays in the onset for the Central East Andes, South West Andes and Amazon regions in the period 2071–2100. Likewise, the rainy season duration presents future significant reductions in regions of the central and southern Andes under the SSP2‐4.5 scenario. Moreover, the accumulated precipitation is projected to increase significantly in the Pacific slope and Andes regions, mainly under the SSP5‐8.5 scenario. These findings are particularly important for sectors like agriculture, energy and water resources management. [ABSTRACT FROM AUTHOR]

Abstract Background Hyperacute ischemic stroke is a type of ischemic stroke that occurs rapidly and suddenly due to blockage of blood flow to the brain, with onset within 0–24 h. The recommended treatment for hyperacute ischemic stroke patients is a recombinant tissue plasminogen activator (rtPA) according to the guidelines of the American Heart Association/American Stroke Association (AHA/ASA) and the European Stroke Organization (ESO). In Indonesia, there is still limited adoption of intravenous thrombolysis, and the researchers hope that hospitals in Indonesia will adopt this treatment for managing hyperacute ischemic stroke patients. Objective This study aims to describe the clinical characteristics of hyperacute ischemic stroke patients treated with intravenous thrombolysis. Methods This descriptive cross-sectional study was conducted at Dr. Hasan Sadikin Hospital in Bandung, which serves as the referral hospital for West Java for stroke cases treated with intravenous thrombolysis. The study employed total sampling from January 2021 to March 2024. Results From 23 patients, we found that most hyperacute ischemic stroke patients treated with intravenous thrombolysis were in the late elderly age group, 56–65 years old (43.5%), with onset within ≤ 4.5 h. Of the total sample, 91.3% of patients did not experience complications and approximately 50% of patients have good clinical and functional outcomes (based on NIHSS score). Conclusion This demonstrates the effectiveness of intravenous thrombolysis in managing hyperacute ischemic stroke patients. Future research should continue to explore optimal patient selection criteria and refine treatment protocols to further improve outcomes in stroke management.

Introduction: Strabismus is an eye disorder characterized by misalignment of the eyes, which can occur in individuals of any age. This study explored the surgical outcomes of horizontal strabismus correction in patients, aiming to provide insights into the factors influencing success. Methods: A prospective study was conducted with 17 patients (n=17) who underwent surgery at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Preoperative factors, including age, duration of misalignment, and preoperative angle of strabismus, were analyzed for their impact on surgical success. The International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) for Macintosh version 27.0 was used for data analysis. Results: This study reviewed the medical records of 17 research samples (n=17). A significant change in the median angle of deviation prism diopters (PD) preoperatively was indicated by the median Postoperative Deviation (PD) (p

Abstract Introduction The emergence of First-line Antiretroviral Therapy (ART) regimens fails; it necessitates the use of more costly and less tolerable second-line medications. Therefore, it is crucial to identify and address factors that increase the likelihood of first-line ART regimen failure in children. Although numerous primary studies have examined the incidence of first-line ART failure among HIV-infected children in Ethiopia, national-level data on the onset and predictors remain inconsistent. Hence, this study was conducted to fill the gaps in determining the onset of first-line ART failure and its predictors among HIV-infected children in Ethiopia. Methods Articles related to our topic of interest were searched using a systematic approach in national and international electronic databases. The retrospective follow-up cohort studies published in English up to 2022 were included. The data were extracted using a Microsoft Excel spread sheet and exported into Stata™ Version 17.0 for further management and analysis. The level of heterogeneity was quantified using I2 test together with a 95% confidence interval (CI). The incidence of the primary estimates was estimated using a random effects model in the Dersimonian-Lairedmethod. Subgroup analysis, Meta regression, and sensitivity analysis were computed to identify the source of heterogeneity but not explained. The predictors of first-line ART failure were explained using relative risk (RR) with 95% confidence interval (CI). Results Ten studies having a total of 5446 children were included. The pooled onset of first-line ART failure was 3.18 (95% CI: 1.91, 4.44) per 100 child-years of observations. Those study participants who began ART at an advanced WHO clinical stage at ART initiation had a 3.05 (95% CI: 1.47, 6.36), having poor ART adherence had a 2.19 (95% CI: 1.29, 3.70), and having TB-HIV coinfection at ART initiation had a 1.43 (95% CI: 1.06, 1.94) times higher chance of experiencing first-line ART failure than their corresponding counterparts. Conclusion The onset of first-line ART failure was high to achieve the 2030 UNAIDS target of ending the AIDS epidemic. Advanced WHO clinical stage, poor first-line ART adherence, and having TB-HIV coinfection were identified predictors. Hence, community HIV screening should continue to strengthen early ART initiation, and the attention of ART adherence should be kept to achieve ending the AIDS epidemic. The baseline tests and diagnosis, like TB diagnosis should be maintained for HIV-infected children while they begin ART.

Introduction: The emergence of First-line Antiretroviral Therapy (ART) regimens fails; it necessitates the use of more costly and less tolerable second-line medications. Therefore, it is crucial to identify and address factors that increase the likelihood of first-line ART regimen failure in children. Although numerous primary studies have examined the incidence of first-line ART failure among HIV-infected children in Ethiopia, national-level data on the onset and predictors remain inconsistent. Hence, this study was conducted to fill the gaps in determining the onset of first-line ART failure and its predictors among HIV-infected children in Ethiopia. Methods: Articles related to our topic of interest were searched using a systematic approach in national and international electronic databases. The retrospective follow-up cohort studies published in English up to 2022 were included. The data were extracted using a Microsoft Excel spread sheet and exported into Stata™ Version 17.0 for further management and analysis. The level of heterogeneity was quantified using I2 test together with a 95% confidence interval (CI). The incidence of the primary estimates was estimated using a random effects model in the Dersimonian-Lairedmethod. Subgroup analysis, Meta regression, and sensitivity analysis were computed to identify the source of heterogeneity but not explained. The predictors of first-line ART failure were explained using relative risk (RR) with 95% confidence interval (CI). Results: Ten studies having a total of 5446 children were included. The pooled onset of first-line ART failure was 3.18 (95% CI: 1.91, 4.44) per 100 child-years of observations. Those study participants who began ART at an advanced WHO clinical stage at ART initiation had a 3.05 (95% CI: 1.47, 6.36), having poor ART adherence had a 2.19 (95% CI: 1.29, 3.70), and having TB-HIV coinfection at ART initiation had a 1.43 (95% CI: 1.06, 1.94) times higher chance of experiencing first-line ART failure than their corresponding counterparts. Conclusion: The onset of first-line ART failure was high to achieve the 2030 UNAIDS target of ending the AIDS epidemic. Advanced WHO clinical stage, poor first-line ART adherence, and having TB-HIV coinfection were identified predictors. Hence, community HIV screening should continue to strengthen early ART initiation, and the attention of ART adherence should be kept to achieve ending the AIDS epidemic. The baseline tests and diagnosis, like TB diagnosis should be maintained for HIV-infected children while they begin ART. [ABSTRACT FROM AUTHOR]

Skilful monsoon onset forecasts are highly sought after in West Africa, due to the importance of monsoon onset for supporting agriculture, disease prevalence and energy provision. With the sub-seasonal timescale bridging the gap between weather and seasonal forecasts, sub-seasonal forecasts have the potential to provide useful decision-making information about the onset of the monsoon rainfall. This study explores sub-seasonal monsoon onset forecasts over Ghana using the European Centre for Medium Range Weather Forecasting (ECMWF) operational ensemble prediction systems. Three commonly used methods for defining monsoon onset are compared, and the benefits, challenges, and potential of real-time, sub-seasonal onset forecasting using these methods are examined. Monsoon onset forecasting at sub-seasonal timescales, and associated decision-making with shorter-term information can be challenging due to the typically single occurrence of rainfall onset within a season. Sub-seasonal forecasts of monsoon onset are shown to be particularly useful for confirming onset occurrence, at least 1–2 weeks earlier than when observations are used. Earlier confirmation of monsoon onset provided by sub-seasonal forecasts, has the potential for earlier decision-making and action that would positively impact sectors such as agriculture. [ABSTRACT FROM AUTHOR]

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]

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). Methods: 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. Results: 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. Conclusions: Our results indicate that 22q11.2DS psychosis is like non-22q11.2DS in its course, symptoms, and cognitive and functional impairments. [ABSTRACT FROM AUTHOR]

To identify factors in adolescence that predict the onset of sexual violence in adolescence and young adulthood. Data were analyzed from six survey waves of the longitudinal Growing up with Media Study (2008–2018) conducted in the USA. Participants were 778 youth 13–18 years old at baseline, who completed online surveys assessing sexual violence behaviors and predictors. Sexual violence perpetration behaviors included sexual assault, rape, attempted rape, and coercive sex. Only 2% of females and 3% of males reported their first sexual violence perpetration by age 14. In contrast, by age 18, 6% of females and 12% of males had perpetrated their first sexual violence. For both males and females, the rate of the onset seems to plateau by age 22. Predictors of the onset of sexually violent behavior for those who began perpetrating when they were 14–17 years old were largely similar to those who began perpetrating when they were 18–25 years old. Alcohol plus other substance use, aggressive and delinquent behavior, caregiver monitoring, behavior problems at school, externalizing peers, exposure to community violence, and exposure to violent media were all implicated. Early prevention—well before college and perhaps even before high school—is needed to have an impact on the onset of sexual violence perpetration, as most perpetrators of sexual violence will have acted for the first time by age 23. Several modifiable risk factors observed in adolescence could signal the opportunity for targeted prevention to reduce the odds of onset of sexual violence. [ABSTRACT FROM AUTHOR]

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]

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]

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]

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.

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.

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: 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]

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]

A systematic investigation on accelerative characteristics of syngas laminar premixed flames is conducted using the visual experimental platform of constant volume combustion chamber. The decoupling control of self‑instability is realized by adjusting the equivalence ratio and oxygen‑nitrogen ratio of gas mixture, allowing for an analysis of flame acceleration stages, onsets, and acceleration exponents. Three distinct stages of laminar flame propagation outwardly are identified, namely quasi‑steady, transitional acceleration, and saturated acceleration. The order of four onsets is as follows： crack branching≈transitional acceleration

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]

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]

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]

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]

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]

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]

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]

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]

Skilful monsoon onset forecasts are highly sought after in West Africa, due to the importance of monsoon onset for supporting agriculture, disease prevalence and energy provision. With the sub-seasonal timescale bridging the gap between weather and seasonal forecasts, sub-seasonal forecasts have the potential to provide useful decision-making information about the onset of the monsoon rainfall. This study explores sub-seasonal monsoon onset forecasts over Ghana using the European Centre for Medium Range Weather Forecasting (ECMWF) operational ensemble prediction systems. Three commonly used methods for defining monsoon onset are compared, and the benefits, challenges, and potential of real-time, sub-seasonal onset forecasting using these methods are examined. Monsoon onset forecasting at sub-seasonal timescales, and associated decision-making with shorter-term information can be challenging due to the typically single occurrence of rainfall onset within a season. Sub-seasonal forecasts of monsoon onset are shown to be particularly useful for confirming onset occurrence, at least 1–2 weeks earlier than when observations are used. Earlier confirmation of monsoon onset provided by sub-seasonal forecasts, has the potential for earlier decision-making and action that would positively impact sectors such as agriculture.

Objective: The aim of this study was to examine whether the age of e-cigarette use onset predicts subsequent use of e-cigarettes. Methods: We used the National Youth Tobacco Survey (NYTS) from 2022. Our sample consisted of 4537 US high school students who had ever used e-cigarettes. Age of first e-cigarette use was assessed by a categorical variable (≤12 years, 13 years, 14 years, 15 years, 16 years, and ≥17 years). We also constructed a binary variable of early onset use (

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.

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