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Irrigated agriculture in South Asia depends on meltwater, monsoon rains and groundwater. Climate change alters the hydrology and causes shifts in the timing, composition and magnitude of these sources of water supply. Simultaneously, socio-economic growth increases water demand. Here we use a high-resolution cryosphere–hydrology–crop model forced with an ensemble of climate and socio-economic projections to assess how the sources of irrigation water supply may shift during the twenty-first century. We find increases in the importance of meltwater and groundwater for irrigated agriculture. An earlier melt peak increases meltwater withdrawal at the onset of the cropping season in May and June in the Indus, whereas increasing peak irrigation water demand during July and August aggravates non-renewable groundwater pumping in the Indus and Ganges despite runoff increases. Increasing inter-annual variability in rainfall runoff increases the need for meltwater and groundwater to complement rainfall runoff during future dry years.South Asian agriculture depends on water from rains, meltwater and groundwater, but climate change impacts the timing of these water sources’ availability. Projections indicate that meltwater and groundwater will become more important and will need to offset reduced rainfall during drier years.

Mountains are the water towers of the world, supplying a substantial part of both natural and anthropogenic water demands 1 , 2 . They are highly sensitive and prone to climate change 3 , 4 , yet their importance and vulnerability have not been quantified at the global scale. Here we present a global water tower index (WTI), which ranks all water towers in terms of their water-supplying role and the downstream dependence of ecosystems and society. For each water tower, we assess its vulnerability related to water stress, governance, hydropolitical tension and future climatic and socio-economic changes. We conclude that the most important (highest WTI) water towers are also among the most vulnerable, and that climatic and socio-economic changes will affect them profoundly. This could negatively impact 1.9 billion people living in (0.3 billion) or directly downstream of (1.6 billion) mountainous areas. Immediate action is required to safeguard the future of the world’s most important and vulnerable water towers. The worldwide distribution and water supply of water towers (snowy or glacierized mountain ranges) is indexed, showing that the most important water towers are also the most vulnerable to socio-economic and climate-change stresses, with huge potential negative impacts on populations downstream.

IntroductionInternet use has become integral part of daily living in current world; at the same time its misuse is likely to cause addiction and negative impact in mental health. Internet addiction is similar to other substance addiction and has been associated with different psychiatric comorbidities.ObjectivesTo study prevalence of internet use disorder in youth patients,to find the association of psychiatric comorbidities with pattern of internet use and to study socio-demographic variables.MethodsAn institutional based cross-sectionalstudy was carried out in psychiatric out-patientdepartment of tertiary hospital. A total of 146 youth patients (15-24 years) who consented for the study were enrolled. Psychiatric diagnosis was made by the consultant psychiatrist using ICD-10/DSR criteria.ResultsOut of total 146 patients with mean age 19.99 years, internet use was found in 89.7% of youth patients out of which 63.7% used in single device and 26.3% in multiple devices. Internet addiction was found in 67.8% youth patients and internet gaming in 33.6% patients. Higher level of internet addiction was found in adolescent (15-19 years) than adult (20-24 years) with statistically significant p value 0.014; patients from middle and higher socio-economic condition than low socio-economic conditionwith statistically significant p value 0.024; patients from uran region compared to semi-urban and rural with statistically significant p value 0.000; and patient using internet gaming with statistically significant p vallue 0.000. Among psychiatric diagnosis, ANxiety, depression and subtance use disorders were associated with internet use disorder however were statistically insignificant.ConclusionsInternet addiction is high in youth patients; adolescent (15-19 years) compared to adults (20-24 years). Anxiety, Depression and substance use disorders had higher association with internet use disorder.Disclosure of InterestNone Declared

A trail study was conducted in the Sagarmatha (Mt. Everest) National Park, Nepal, during 1997-1998. Based on that study, this paper examines the spatial variability of trail conditions and analyzes factors that influence trail conditions. Logistic regression (multinomial logit model) is applied to examine the influence of use and environmental factors on trail conditions. The assessment of trail conditions is based on a four-class rating system: (class I, very little damaged; class II, moderately damaged, class III, heavily damaged; and class IV, severely damaged). Wald statistics and a model classification table have been used for data interpretation. Results indicate that altitude, trail gradient, hazard potential, and vegetation type are positively associated with trail condition. Trails are more degraded at higher altitude, on steep gradients, in areas with natural hazard potential, and within shrub/grassland zones. Strong correlations between high levels of trail degradation and higher frequencies of visitors and lodges were found. A detailed analysis of environmental and use factors could provide valuable information to park managers in their decisions about trail design, layout and maintenance, and efficient and effective visitor management strategies. Comparable studies on high alpine environments are needed to predict precisely the effects of topographic and climatic extremes. More refined approaches and experimental methods are necessary to control the effects of environmental factors.

People with serious mental illness (SMI) have significant unmet mental health needs. Development and testing of digital interventions that can alleviate the suffering of people with SMI is a public health priority. The aim of this study is to conduct a fully remote randomized waitlist-controlled trial of CORE, a smartphone intervention that comprises daily exercises designed to promote reassessment of dysfunctional beliefs in multiple domains. Individuals were recruited via the web using Google and Facebook advertisements. Enrolled participants were randomized into either active intervention or waitlist control groups. Participants completed the Beck Depression Inventory-Second Edition (BDI-II), Generalized Anxiety Disorder-7 (GAD-7), Hamilton Program for Schizophrenia Voices, Green Paranoid Thought Scale, Recovery Assessment Scale (RAS), Rosenberg Self-Esteem Scale (RSES), Friendship Scale, and Sheehan Disability Scale (SDS) at baseline (T1), 30-day (T2), and 60-day (T3) assessment points. Participants in the active group used CORE from T1 to T2, and participants in the waitlist group used CORE from T2 to T3. Both groups completed usability and accessibility measures after they concluded their intervention periods. Overall, 315 individuals from 45 states participated in this study. The sample comprised individuals with self-reported bipolar disorder (111/315, 35.2%), major depressive disorder (136/315, 43.2%), and schizophrenia or schizoaffective disorder (68/315, 21.6%) who displayed moderate to severe symptoms and disability levels at baseline. Participants rated CORE as highly usable and acceptable. Intent-to-treat analyses showed significant treatment×time interactions for the BDI-II (F =13.38; P<.001), GAD-7 (F =5.87; P=.01), RAS (F =23.42; P<.001), RSES (F =19.28; P<.001), and SDS (F =10.73; P=.001). Large effects were observed for the BDI-II (d=0.58), RAS (d=0.61), and RSES (d=0.64); a moderate effect size was observed for the SDS (d=0.44), and a small effect size was observed for the GAD-7 (d=0.20). Similar changes in outcome measures were later observed in the waitlist control group participants following crossover after they received CORE (T2 to T3). Approximately 41.5% (64/154) of participants in the active group and 60.2% (97/161) of participants in the waitlist group were retained at T2, and 33.1% (51/154) of participants in the active group and 40.3% (65/161) of participants in the waitlist group were retained at T3. We successfully recruited, screened, randomized, treated, and assessed a geographically dispersed sample of participants with SMI entirely via the web, demonstrating that fully remote clinical trials are feasible in this population; however, study retention remains challenging. CORE showed promise as a usable, acceptable, and effective tool for reducing the severity of psychiatric symptoms and disability while improving recovery and self-esteem. Rapid adoption and real-world dissemination of evidence-based mobile health interventions such as CORE are needed if we are to shorten the science-to-service gap and address the significant unmet mental health needs of people with SMI during the COVID-19 pandemic and beyond. ClinicalTrials.gov NCT04068467; https://clinicaltrials.gov/ct2/show/NCT04068467.

The UCNA experiment was designed to measure the neutron β-asymmetry parameter A0 using polarized ultracold neutrons (UCN). UCN produced via downscattering in solid deuterium were polarized via transport through a 7 T magnetic field, and then directed to a 1 T solenoidal electron spectrometer, where the decay electrons were detected in electron detector packages located on the two ends of the spectrometer. A value for A0 was then extracted from the asymmetry in the numbers of counts in the two detector packages. We summarize all of the results from the UCNA experiment, obtained during run periods in 2007, 2008–2009, 2010, and 2011–2013, which ultimately culminated in a 0.67% precision result for A0.

In January, 2018, Fornal and Grinstein proposed that a previously unobserved neutron decay branch to a dark matter particle (χ) could account for the discrepancy in the neutron lifetime observed in two different types of experiments. One of the possible final states discussed includes a single χ along with an e + e − pair. We use data from the UCNA (Ultracold Neutron Asymmetry) experiment to set limits on this decay channel. Coincident electron-like events are detected with ∼ 4π acceptance using a pair of detectors that observe a volume of stored Ultracold Neutrons (UCNs). We use the timing information of coincidence events to select candidate dark sector particle decays by applying a timing calibration and selecting events within a physically-forbidden timing region for conventional n → p + e - + ν̅ e decays. The summed kinetic energy ( E e + e − ) from such events is reconstructed and used to set limits, as a function of the χ mass, on the branching fraction for this decay channel.

Despite over two decades of efforts towards involving indigenous and traditional peoples in protected area management, there are few successful examples. Several international principles and guidelines on indigenous peoples' involvement in protected areas exist. However, because of the lack of evaluation of whether or not these principles and guidelines have been put into practice, there is hardly any information that indicates the actual involvement of indigenous peoples in protected areas. This paper attempts to compare efforts in partnership between indigenous peoples and protected area authority in three Asian countries: Nepal, Thailand, and China. It shows that the involvement of indigenous peoples is more successful where park planning is participatory and where political and socioeconomic reforms are underway. Indigenous peoples are in conflict with park authorities where park management is centralized and nonparticipatory. Unless concrete efforts are made to address livelihood issues of indigenous peoples living in and around protected areas, park management aimed to protect wildlife will rarely succeed. Participatory park management that involves indigenous peoples and that addresses livelihood issues of indigenous communities will ultimately succeed in its efforts toward wildlife conservation.

Soil water is a major requirement for biomass production and, therefore, one of the most important factors for agriculture productivity. As agricultural droughts are related to declining soil moisture, this paper examines soil moisture drought in the transboundary Koshi River basin (KRB) in the central Himalayan region. By applying the J2000 hydrological model, daily spatially distributed soil moisture is derived for the entire basin over a 28-year period (1980–2007). A multi-site and multi-variable approach – streamflow data at one station and evapotranspiration data at three stations – was used for the calibration and validation of the J2000 model. In order to identify drought conditions based on the simulated soil moisture, the soil moisture deficit index (SMDI) was then calculated, considering the derivation of actual soil moisture from long-term soil moisture on a weekly timescale. To spatially subdivide the variations in soil moisture, the river basin is partitioned into three distinct geographical regions, namely trans-Himalaya, the mountains, and the plains. Further, the SMDI is aggregated temporally to four seasons – winter, pre-monsoon, monsoon, and post-monsoon – based on wetness and dryness patterns observed in the study area. This has enabled us to look at the magnitude, extent, and duration of soil moisture drought. The results indicated that the J2000 model can simulate the hydrological processes of the basin with good accuracy. Considerable variation in soil moisture was observed in the three physiographic regions and across the four seasons due to high variation in precipitation and temperature conditions. The year 1992 was the driest year and 1998 was the wettest at the basin scale in both magnitude and duration. Similarly, the year 1992 also has the highest number of weeks under drought. Comparing the SMDI with the standardised precipitation index (SPI) suggested that SMDI can reflect a higher variation in drought conditions than SPI. Our results suggested that both the occurrence and severity of droughts have increased in the Koshi River basin over the last 3 decades, especially in the winter and pre-monsoon seasons. The insights provided into the frequency, spatial coverage, and severity of drought conditions can provide valuable contributions towards an improved management of water resources and greater agricultural productivity in the region.

IntroductionStaples and subcuticular suture are commonly used wound closure techniques after total knee arthroplasty (TKA). To date, only a few studies have investigated the differences between these two wound closure methods in TKA. Accordingly, this study aimed to compare cosmetic outcome and patient satisfaction between staples and subcuticular suture for post-TKA wound closure.Materials and methodsThis prospective randomized controlled trial included patients scheduled to undergo TKA at the Department of Orthopaedic Surgery of Siriraj Hospital (Bangkok, Thailand) during June 2018–March 2019. Patients were randomized into the staples or subcuticular suture groups. Hollander Wound Evaluation Scale (HWES), cosmetic-visual analogue scale (VAS), and patient satisfaction-VAS were evaluated at the 6-week and 3-month follow-ups. Functional outcome by the modified Knee Society Knee Scoring System and wound complications were also assessed.ResultsSixty-two patients (31 per group) were included. There were no significant differences in the HWES, cosmetic-VAS, patient satisfaction-VAS, or wound complication rate between groups at the 6-week or 3-month follow-ups. Wound closure time was significantly shorter in the staples group (p < 0.001), but the total operative time was not significantly different between groups. Modified knee score was significantly better in the suture group at 6 weeks (p = 0.024), but there was no significant difference between groups at 3 months. Significant association was observed between patient satisfaction-VAS and cosmetic-VAS at the 6-week (p = 0.03) and 3-month (p = 0.021) follow-ups.ConclusionSubcuticular suture and staples were found to be comparable wound-closure options after TKA relative to cosmetic outcome, patient satisfaction, functional outcome, and wound complication rate at 3-months post-operation.