Trend Change Point Research Articles

How likely are Eastern European and central Asian countries to achieve global NCD targets: multi-country analysis

BackgroundIn Europe, mortality rates from noncommunicable diseases (NCDs) among persons 30–69 years of age (“NCD premature mortality rates”) have declined significantly, except in twelve countries of Eastern Europe and Central Asia, namely Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Data on long-term trends in NCD mortality in these countries are limited. We analyzed NCD premature mortality rates, identified change points in NCD mortality trends and forecasted how likely countries are to achieve the global NCD targets, stratified by gender and NCD type.MethodsWe used the 1990–2019 Global Burden of Disease database to analyze NCD trends and identified country-specific change points by using piecewise linear regression. We assessed the likelihood of achieving the global targets for reducing NCD premature mortality rates among persons 30–69 years of age from four NCDs: cancers, diabetes, cardiovascular and chronic respiratory diseases. The global NCD targets are 25% reduction in mortality from 2010 to 2025 (WHO 25X25 target) and 33%—from 2015 to 2030 (SDG 3.4.1). We applied the analysis to both genders and four NCDs.ResultsOnly Kazakhstan and Russia are likely to achieve the global NCD targets. For Kazakhstan, WHO 25X25 and SDG 3.4.1 global targets for mortality rates were 494.3 and 374.8 per 100,000 population respectively; the corresponding predicted values (PVs) were 360.6 [CI 260.1–461.1] and 245.1 [CI 113.4–376.8]. For Russia, WHO 25X25 and SDG 3.4.1 global targets were 560.5 and 442.8 per 100,000 population respectively; the corresponding PVs were 427.7 [CI 270.3–585.1] and 311.0 [CI 102.8–519.1]. Achieving NCD global targets is less likely for Kyrgyzstan, while it is unlikely for the rest of countries. Most countries had higher mortality rates and slower progress among men compared with women. The likelihood of achieving overall global NCD targets was mainly explained by reduction in cardiovascular mortality.ConclusionsIn most Eastern Europe and Central Asia countries, progress towards achieving NCD global targets is slow, or there’s a reverse trend. Further quantitative and qualitative research is needed to understand the underlying reasons. Separate indicators are needed to monitor trends for cancers, diabetes and chronic respiratory diseases.

Analysing Micro-Level Rainfall Trends: Implications for Water Conservation in Paravanar River Basin

High-intensity, short-duration rainfall resulting in flood hazards is one of the significant challenges now. On the other hand, this basin is affected by drought in the subsequent years because of the lack of conservation of floodwater and high elevation difference. Rainfall analysis is the preliminary study for suggesting the type of water conservation measures. This study analyzes the trend and change point at a micro-scale with its village boundaries for the Paravanar River basin. One hundred forty-eight villages under six blocks have increasing trends, 28 towns in the summer season using rain gauge dataset show decreasing trends which are considered negligible, and the rest of the villages have no trends. It is identified that; trend analysis works well with the extended data record. 1991 is the trend change point for gridded data, and 1995 is for the rain gauge data. The main aim of this study is to analyze the rainfall trends and their change point at a micro level and suggest mitigation measures with the indigenous facilities.

Trend Analysis and Change Point Detection of Climatic Parameters in Ambedkar Nagar District of Uttar Pradesh, India

Climate change is one of the most serious challenges confronting humanity today, and its effects can be seen all over the world. The assessment of changes in the long-term weather trend is critical for developing water resource management strategies under climate change scenarios. Long-term trends for annual, monsoon, non-monsoon rainfall, rainy days, maximum temperature, and minimum temperature of Akbarpur, Allapur, Bhiti, Jalalpur, and Tanda stations in Uttar Pradesh's Ambedkar Nagar district were examined in this study. The Mann-Kendall test revealed a non-significant decreasing trend for annual and monsoon rainfall at Akbarpur, Bhiti, and Jalalpur stations with an average rate of 1.64 mm/year whereas, it shows a non-significant increasing trend for annual and monsoon rainfall at the Allapur and Tanda stations with an average rate of 3.168 mm/year. Non-monsoon rainfall showed an in-significant decreasing trend at Allapur and Jalalpur stations with an average rate of 0.415 mm/year, whereas a non-significant increasing trend was shown at Akbarpur, Bhiti, and Tanda stations with an average rate of 0.197 mm/year. Annual rainy days shows non-significant decreasing trend for all stations of Akbarpur district with an average rate of 0.117 day/year (one day decrease with in nine year). It indicates seasonal shift and increased possibility of high intensity rainfall. The impact of extreme events of rainfall on the trend was evaluated on the whole and partial series before and after the break point and it was observed that there was no significant climate change in Ambedkar Nagar district and non-significant changing year of precipitation data series was found in 1995. A significant increasing trend in maximum temperature was observed for all stations in the months of August and December, with an average rate of 0.02 0C per year, while Allapur station also shows a significant increasing trend in maximum temperature in September, with a rate of 0.012 0C per year. However, a significant decreasing trend was observed in minimum temperature in the month of May at Akbarpur, Allapur, Jalalpur, Tanda station with an average rate of 0.027 0C per year. Rainfall and temperature are a principal climatic parameter which regulates the environmental condition of a particular region by directly influencing the agricultural productivity and water resources.

Food Insecurity across Age Groups in the United States during the COVID-19 Pandemic.

Food insecurity increased during the COVID-19 pandemic, but the impact varied across different age groups during the prolonged public health emergency. This study sought to describe national food insecurity prevalence by adult age group at multiple stages of the pandemic and explore differences by demographic characteristics. Data were from the nationally representative US Census Bureau's Household Pulse Survey from April 2020 to May 2023 (N = 4,153,462). Locally weighted scatterplot smoothing (LOESS) regression analysis identified change points in food insecurity trends, segmenting the timeline into three periods: (1) April 2020-March 2021, (2) April 2021-May 2022, and (3) June 2022-May 2023. Logistic regression models examined associations between age, time period, and self-reported household food insecurity; covariates included demographics, socioeconomic status, household structure, and food support program usage. Overall, 9.3% of respondents experienced food insecurity, ranging from 3.5% among those aged ≥75 to 12.2% for ages 35-44 years. Significant interaction between age group and time period indicated inconsistency in the age-food insecurity association during the pandemic (p < 0.001). From Period 1 to 3, the proportion of food-insecure adults aged ≥65 rose from 9.2% to 13.9%. Across all age groups, higher odds of food insecurity were found among Black, Hispanic/Latino, or Other/Multiracial respondents; those with less than a Bachelor's degree; those with incomes below USD 35,000; those unemployed for reasons other than retirement; and non-homeowners (p < 0.001). The results show that trends and characteristics associated with food insecurity varied across age groups and time periods. Continuous monitoring of food insecurity during emergencies is critical to identify vulnerable populations and timely interventions.

20-year trends in Australian methamphetamine-related deaths, 2001–2020

BackgroundOver the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes. MethodsDescriptive analyses were conducted on Australian methamphetamine-related deaths (2001–2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded). ResultsUnintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001–2006 – annual percentage change (APC) = 15.4 %; 2009–2016 – APC 25.5 %), and two where they decreased (2006–2009 – APC = –11.8 %; 2017–2020 – APC = –2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases. ConclusionCause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine.

Temporal Patterns of Vegetation Greenness for the Main Forest-Forming Tree Species in the European Temperate Zone

In light of recently accelerating global warming, the changes in vegetation trends are vital for the monitoring of the dynamics of both whole ecosystems and individual species. Detecting changes within the time series of specific forest ecosystems or species is very important in the context of assessing their vulnerability to climate change and other negative phenomena. Hence, the aim of this paper was to identify the trend change points and periods of greening and browning in multi-annual time series of the normalised difference vegetation index (NDVI) and enhanced vegetation index (EVI) of four main forest-forming tree species in the temperate zone: pine, spruce, oak and beech. The research was conducted over the last two decades (2002–2022), and was based on vegetation indices data derived from the Moderate Resolution Imaging Spectroradiometer (MODIS). To this end, several research approaches, including calculating the linear trends in the moving periods and BEAST algorithm, were adapted. A pattern of browning then greening then constant was detected for coniferous species, mostly pine. In turn, for broadleaved species, namely oak and beech, a pattern of greening then constant was identified, without the initial phase of browning. The main trend change points seem to be ca. 2006 and ca. 2015 for coniferous species and solely around 2015 for deciduous ones.

Changes in South American surface ozone trends: exploring the influences of precursors and extreme events

Abstract. In this study, trends of 21st-century ground-level ozone and ozone precursors were examined across South America, a less-studied region where trend estimates have rarely been comprehensively addressed. Therefore, we provided an updated regional analysis based on validated surface observations. We tested the hypothesis that the recent increasing ozone trends, mostly in urban environments, resulted from intense wildfires driven by extreme meteorological events impacting cities where preexisting volatile organic compound (VOC)-limited regimes dominate. We applied the quantile regression method based on monthly anomalies to estimate trends, quantify their uncertainties and detect trend change points. Additionally, the maximum daily 8 h average (MDA8) and peak-season metrics were used to assess short- and long-term exposure levels, respectively, for the present day (2017–2021). Our results showed lower levels in tropical cities (Bogotá and Quito), varying between 39 and 43 nmol mol−1 for short-term exposure and between 26 and 27 nmol mol−1 for long-term exposure. In contrast, ozone mixing ratios were higher in extratropical cities (Santiago and São Paulo), with a short-term exposure level of 61 nmol mol−1 and long-term exposure levels varying between 40 and 41 nmol mol−1. Santiago (since 2017) and São Paulo (since 2008) exhibited positive trends of 0.6 and 0.3 nmol mol−1 yr−1, respectively, with very high certainty. We attributed these upward trends, or no evidence of variation, such as in Bogotá and Quito, to a well-established VOC-limited regime. However, we attributed the greater increase in the extreme percentile trends (≥ 90th) to heat waves and, in the case of southwestern South America, to wildfires associated with extreme meteorological events.

Statistical Analysis for the Detection of Change Points and the Evaluation of Monthly Mean Temperature Trends of the Moulouya Basin (Morocco)

This study examines the spatiotemporal variability of mean monthly temperature in the Moulouya watershed of northeastern Morocco, highlighting associated trends. To this end, statistical methods widely recommended by climate researchers were adopted. We used monthly mean temperature data for the period 1980–2020 from 9 measuring stations belonging to the Moulouya Watershed Agency (ABHM). These stations were rigorously selected, taking into account their reliability, the length of their records, and their geographical position in the basin. In addition, a quality test and homogenization of the temperature series were carried out using the Climatol tool. The results obtained show a significant upward trend in mean monthly temperature, mainly pronounced during the summer months, in the Moulouya watershed. In fact, Z values generally exceeded the 0.05 significance level at all stations during April, May, June, July, August, and October. According to the results of Sen’s slope test, mean monthly temperatures show an annual increase ranging from 0 to 0.13°C. The maximum magnitude of warming is recorded in July, specifically at Oujda Station. On an overall watershed scale, May, August, and July show a rapid warming trend, with average rates of 0.093, 0.086, and 0.08°C per year, respectively. By contrast, the series for the other months show no significant trend. Significant trend change points were also identified at watershed and station scales, mainly around 2000, primarily for accelerated warming of the summer months.

Performance evaluation of a magnetic NDE technique to assess residual fatigue life of the retired hydraulic cylinders

Metal magnetic memory (MMM) method is a novel and potential nondestructive evaluation (NDE) technique to assess residual fatigue life of the ferromagnetic structure, such as hydraulic cylinder. In this paper, an evaluation framework was proposed. Firstly, the MMM signals under different fatigue cycles were recorded in the tensile-tensile experiment. A representative signal characteristic Hpp was defined as an evaluation index. The monotonic change trend and abrupt change point was investigated. Statistical results show that Hpp can be used to predict residual fatigue life. Except for a few specimens, almost all specimens produced an abrupt change at the normalized fatigue life coefficient k = 0.91. This can be used to distinguish different stages of fatigue life. The sensitivity, specificity, and diagnostic performance were analyzed using Receiver Operating Characteristic (ROC) curves. The statistical results show that when the coefficient k = 0.91, the diagnostic performance is relatively best with an area under the curve (AUC) is about 0.85, and Jorden's index is about 0.75.

Inequalities in access to prenatal care during the COVID-19 pandemic: Analysis of a population-based cohort.

Before the COVID-19 pandemic, access to prenatal care was lower among some socio-demographic groups. This pandemic caused disruptions to routine preventative care, which could have increased inequalities. To investigate if the COVID-19 pandemic increased inequalities in access to prenatal care among those who are younger, live in rural areas, have a lower socio-economic situation (SES) and are recent immigrants. We used linked administrative datasets from ICES to identify a population-based cohort of 455,245 deliveries in Ontario from January 2018 to December 2021. Our outcomes were first-trimester prenatal visits, first-trimester ultrasound and adequacy of prenatal care. We used joinpoint analysis to examine outcome time trends and identify trend change points. We stratified analyses by age, rural residence, SES and recent immigration, and examined risk differences (RD) with 95% confidence intervals (CI) between groups at the beginning and end of the study period. For all outcomes, we noted disruptions to care beginning in March or April 2020 and returning to previous trends by November 2020. Inequalities were stable across groups, except recent immigrants. In July 2017, 65.0% and 69.8% of recent immigrants and non-immigrants, respectively, received ultrasounds in the first trimester (RD -4.8%, 95% CI -8.0, -1.5). By October 2020, this had increased to 75.4%, with no difference with non-immigrants (RD 0.4%, 95% CI -2.4, 3.2). Adequacy of prenatal care showed more intensive care as of November 2020, reflecting a higher number of visits. We found no evidence that inequalities between socio-economic groups that existed prior to the pandemic worsened after March 2020. The pandemic may be associated with increased access to care for recent immigrants. The introduction of virtual visits may have resulted in a higher number of prenatal care visits.

Trend detection and change point analysis of inflows in Karuppanadhi and Gundar dams of Chittar River Basin, Tamil Nadu, India

Abstract Gaining insights into the patterns of hydroclimatic elements such as inflows to dams is essential to adeptly strategize and oversee water resource planning. For this study, we focused on Karuppanadhi and Gundar dams within the Chittar River Basin in Tamil Nadu. We employed various time series trend assessment methods – Mann–Kendall (MK), modified Mann–Kendall (MMK), Sen slope estimator, and innovative trend analysis (ITA). Furthermore, we conducted change point detection analysis using homogeneity tests, namely Pettitt's test, standard normal homogeneity test (SNHT), and Buishand test. The analysis was carried out across three-time scales: monthly, seasonal, and annual for 30 years (1991–2020) span. Results revealed declining trends significantly across all three timescales for the Karuppanadhi dam. Whereas for the Gundar dam, notable trends included increased patterns in January, March, December, and the winter season, while other months/seasons showed statistically decreasing trends. ITA exhibited greater sensitivity in identifying trends at monthly and seasonal scales, indicating its superior trend detection over MK and MMK methods. Change point analysis of trends identified a rising trend in August post-2017 for both dams. Other change points indicated decreasing inflow trends thereafter. Analysing trends and change points in dam inflows aid decisions on water resources management.

Winter Rice Trend Analysis and Change Point Detection in Assam’s North Bank Plains Zone (NBPZ): A Non-Parametric Approach

Winter Rice Trend Analysis and Change Point Detection in Assam’s North Bank Plains Zone (NBPZ): A Non-Parametric Approach

Temporal trends in percutaneous coronary intervention in Australia: A retrospective analysis from 2000–2021

ObjectiveThe aim of this study was to describe the trend in percutaneous coronary intervention (PCI) with insertion of a stent in Australia from 2000/01 to 2020/21 and investigate trends in same-day versus non-same-day discharge following PCI. A secondary aim was to compare the rate of coronary artery bypass grafting (CABG) with PCI procedures, while a third aim was to compare marked PCI trend changes with the PCI guidelines during the study period. BackgroundPCI with stent deployment is the most common form of interventional treatment for coronary artery disease, and its use has been expanding since 2000. However, there is a lack of descriptive studies of the national trend in Australia. MethodsAll procedures for PCI and CABG were extracted across 21 years (2000/01 to 2020/21) from the Australian Institute of Health and Welfare data. Age-standardized rates were calculated using the Australian standard population as of June 2001. The ratio of PCI to CABG procedures was also calculated. Trends for PCI were stratified by age, gender, and same-day or overnight discharge episodes. Linear regression analysis was done to compare the age-standardized rates across different age categories. Segmented regression analysis was performed to ascertain the change in the age-standardized rates of PCI during the study period. Whether the changepoints in the trend were matched with guideline updates was also assessed. ResultsThere were 751 728 PCI procedures in persons aged 30 years and above between 2000/01 and 2020/21. The age-standardized rate for the study period showed that persons aged 60-74 years had a higher rate of procedures (102.7) compared to persons aged 30-59 years (81.3) and 75 years and older (61.8) (P < 0.001). There were two statistically significant changepoints in the overall trend; 2005/06 and 2013/14, matched with the change in PCI guidelines. Despite the lower number of procedures for same-day discharge episodes, there has been an increasing trend since 2014/15. More than two-thirds of all stenting procedures were the insertion of a single stent. PCI to CABG procedure ratio increased from 0.6 in 2000/01 to 1.8 in 2020/21. ConclusionsThere was a varying trend in the age-standardized rate of PCI with a peak in 2005/06. The trend appears to be stabilizing in the later part of the study period, but the rate for same-day discharge episodes showed an increasing trend after 2014/15. There is consistency with changepoints in the trend and updated PCI guideline recommendations. The ratio of PCI with insertion of a stent to CABG procedure increased substantially across the study period.

Trend assessment of rainfall, temperature and relative humidity using non-parametric tests in the national capital region, Delhi

Understanding rainfall and temperature’s spatio-temporal variations at the local, regional, and global scale is vital for planning soil and water conservation structures and making irrigation decisions. The present investigation attempts to observe the rainfall and temperature variability and trend over 31 years (1990-2020) in the National Capital Region (NCR), Delhi, India, obtained from IARI meteorological station, Pusa, New Delhi. The statistical trend analyses Mann-Kendall (MK) test followed by Theil Sen slope estimator test was used for annual and monthly analysis to assess the trend direction and magnitude of the change over time. Pettitt's test detected the inflection point in the variable time series. The annual Tmax, Tmin, and rainfall showed no trend in the time series data. However, Tmax indicated a statistically significant decreasing trend in January and December. This implies a dip in the temperature during the winter months of January and December. Similarly, Tmin revealed a statistically significant decreasing trend in January and December. But a statistically increasing trend for Tmin was observed in April, which may cause a harsh environment for cultivating the Zaid season crops due to increased warming. The Pettitt test showed no change point in the time series trend in the annual Tmax and Tmin data series. For January Tmax data, the trend change point occurred in 1998. However, it was observed that Tmin in April showed a change point in the time series trend in 1999. The change point in the annual average rainfall data was marked in 2012. A didactic implication of these changes on hydrologic design and crop irrigation decisions was discussed in this paper.

Revealing the trend and change point in Hargreaves equation based on potential evapotranspiration values with various statistical approaches.

Hotter and drier weather conditions due to climate change negatively affect water resources and agricultural production. For this reason, it is vital to analyze the change in potential evapotranspiration (PET) values, which is one of the most important parameters related to plant growth and agricultural irrigation planning. This study analyses the trends and changes in monthly and annual PET values between 1965 and 2018 at Erzincan, Bayburt and Gümüşhane meteorological stations in Turkey. For this purpose, monotonic trends in PET values were determined by Spearman's rho (SR), Mann-Kendall (MK), Şen slope (SS), and innovative trend analysis (ITA) tests and change points were analyzed with the sequential MK (SQMK) test. The Hargreaves equation was used to calculate the PET values. As a result of the study, according to MK and SR tests, while increasing trends at 95% and 99% significance levels were dominant at Erzincan and Bayburt stations, no statistically significant trends were found at Gümüşhane station except in February. ITA generally detected more than 5% increasing trends in PET data's low, medium, and high values. According to ITA slope analysis, there are significant increase trends in PET values at all periods, trend 1% significance level. According to the SQMK test, it was revealed that the trend started in PET values, especially in 1995, 2005, and 2010. The findings emphasized the importance of taking measures against decreased agricultural production and managing water resources effectively.

Assessment of Climate Change Induced Trend, Magnitude, and Change Point Date in 24-Hourly Annual Maximum Series Rainfall Data for Port Harcourt Metropolis in Nigeria

The study determined the effect of changing climate on rainfall 24-hourly annual maximum series (AMS) downscaled data found to be statistically insignificant in trend for the Port Harcourt metropolis. The measured rainfall data for this study were collected for 35 years (1971-2005) from the Nigeria Meteorological Agency (NIMET). The 24-hourly (AMS) rainfall data extracted were further downscaled into shorter-duration rainfall using Indian Meteorological Department (IMD) and the Modified Chowdhury Indian Meteorological Department (MCIMD) method. The result of the slope obtained showed decreasing positive values of 0.5250 (at 0.25 hour) to 0.0249 mm/hr/year (at 24 hours) and 0.7625 (at 0.25 hour) to 0.0250 mm/hr/year (at 24 hours) for IMD and MCIMD models, respectively. The variable rate of change obtained showed 0.6 mm/year or 6.00 mm/decade at 24 hours. Relatively, the trend test for the 24-hourly monthly maximum series (MMS) also showed a p-value of 0.2289 which is greater than the alpha value at a 5% significant level with a slope value of 0.0006 to confirm the positive mild trend status of the 24-hourly AMS sample data. The trend change point date was obtained in 1988 by plotting the distribution-free cumulative (CUSUM) test, while the sequential MK (SQMK) test gave another year of change point date as 1994, further intensifying the positive trend change in the Port Harcourt metropolis. Therefore, proving the existence of mild and positive changing climatic conditions in the time series measured rainfall data for the study area.

OA09 Trends for opioid prescriptions and the impact of the COVID-19 pandemic among patients with rheumatic and musculoskeletal diseases between 2006 and 2021

Abstract Background/Aims Rheumatic and musculoskeletal diseases (RMDs) are some of the most common indications for prescribed opioids. It is unclear how opioid prescribing has changed in the UK for RMDs, especially during the COVID-19 pandemic with limited healthcare access and cancelled elective-surgical interventions, which could impact prescribing in either direction. We aimed to investigate trends in opioid prescribing in RMDs and assess the impact of the pandemic in the UK. Methods Adult patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (AxSpA), systemic lupus erythematosus (SLE), osteoarthritis (OA) and fibromyalgia with opioid prescriptions between 01/Jan/2006–31/Aug/2021 without prior cancer in the UK Clinical Practice Research Datalink (CPRD) were included. We calculated age- and gender-standardised yearly rates of people with opioid prescriptions between 2006–2021, and identified change points in trends by checking whether the rate of change of standardised rates crossed zero. For people with opioid prescriptions, monthly measures of mean morphine milligram equivalents (MME)/day were calculated between 2006–2021. To assess the impact of the pandemic, we fitted regression models to the monthly number of people with opioid prescriptions between Jan/2015–Aug/2021. The time coefficient reflects the trend pre-pandemic and the interaction term coefficient represents the change in the trend during the pandemic. Results We included 1,313,519 patients: 36,932 with RA, 12,649 with PsA, 6,811 with AxSpA, 6,423 with SLE, 1,255,999 with OA, and 66,944 with fibromyalgia. People with opioid prescriptions increased from 2006 to 2018 for OA, to 2019 for RA, AxSpA and SLE, to 2020 for PsA, and to 2021 for fibromyalgia, and all plateaued/decreased afterwards. OA patients on opioids increased from 466.8/10,000 persons in 2006 to a peak of 703.0 in 2018, followed by a decline to 575.3 in 2021. From 2006 to 2021, there was a 4.5-fold increase in fibromyalgia opioid users (17.7 vs.78.5/10,000 persons). In this period, MME/day increased for all RMDs, with the highest for fibromyalgia (≥35). During COVID-19 lockdowns, RA, PsA and fibromyalgia showed significant changes in the trend of people with opioid prescriptions. With a decreasing trend for RA (-0.001,95%CI=-0.002,-0.001) and a decreasing-to-flat curve for PsA (0.0010,95%CI=0.0006,0.0015) pre-pandemic until Feb/2020, the trends changed by -0.005 (95%CI=-0.008,-0.002) for RA and -0.003 (95%CI=-0.006,-0.0003) for PsA, leading to steeper decreasing trends during the pandemic (Mar/2020–Aug/2021). Fibromyalgia, conversely, had an increasing trend (0.009,95%CI=0.008,0.009) pre-pandemic, and this trend started decreasing by -0.009 (95%CI=-0.011,-0.006) during the pandemic. Conclusion The plateauing/decreasing trend of people with opioid prescriptions in RMDs after 2018 may reflect the efforts to tackle the rising opioid prescribing in UK primary care. Of all RMDs, fibromyalgia patients had the highest MME/day throughout the study period. COVID-19 lockdowns contribute to fewer people on opioids for most RMDs, reassuring there was no sudden increase in opioid prescribing during the pandemic. Disclosure Y. Huang: None. D.A. Jenkins: None. B.B. Yimer: None. J. Benitez-Aurioles: None. N. Peek: None. M. Lunt: None. W.G. Dixon: Consultancies; WGD has received consultancy fees from Google unrelated to this work. M. Jani: None.

Establishing Climatic Change on Rainfall Trend, Variation and Change Point Pattern in Benin City, Nigeria

This study examined the effect of changing climate for thirty-six years (1982-2017) on 24-hourly annual maximum time series (AMS) rainfall data for Benin City. The results show the existence of a trend, variation in magnitude, and change point dates. Trend analysis was performed using Mann-Kendall (MK) test and Sen’s slope estimator (SSE) applied to obtain the trend magnitude. A statistically significant trend was found for Benin City at a 5% level of significance. The MK |Z| statistic varied from 2.0710 to 2.1550 for IMD and 2.0844 to 2.0995 for MCIMD downscaling models, which were both greater than the critical Z-value of 1.96. The SSE gave the magnitude of the trend variation rate due to climate change at 24-hour duration as 1.008 mm/year (10.08 mm/decade) and 1.1376 mm/year (11.376 mm/decade) for the IMD and MCIMD models, respectively. Also, the trend change point analysis was conducted using the distribution-free cumulative sum test (CUSUM) and the sequential Mann-Kendall test (SQMK) which has rainfall pattern definite change point date for Benin City as 2005 from where continued a positive trend which intensified through the year 2015. Thus, proving the existence of increasing changing climatic condition for the study area.

Spatiotemporal Rainfall Variability and Trend Analysis of Shimsha River Basin, India.

Karnataka state has the second highest rainfed agricultural land in India, where agricultural output relies heavily on rainfall. The Shimsha basin, a sub-basin of Cauvery in the state, comes under a semi-arid region and predominantly consists of rainfed agricultural land. Rainfall patterns have changed dramatically with time resulting in frequent floods and droughts. Understanding the spatiotemporal distribution of rainfall and its change patterns in the area would benefit sustainable agriculture planning and water resources management practices. The current study aims to determine the variability and trend in rainfall. The daily rainfall data of the Shimsha basin from 1989 to 2018 is collected, and the annual, seasonal, and monthly rainfall totals and the number of rainy days are derived. All the time series are subjected to statistical methods to examine rainfall variability and trend. The mean, standard deviation, coefficient of variation (CV), and Standardized Anomaly Index are used for the preliminary and variability analysis, while the coefficient of skewness and kurtosis are used to understand the rainfall distribution characteristics. The homogenous and serially independent series are identified by homogeneity and serial correlation tests. The trend in the homogenous and serially independent series is identified by Mann-Kendall and Spearman's rank correlation tests, while the magnitude of the trend is quantified using the Sen's slope technique, and the trend change point is evaluated using the sequential Mann-Kendall test. Based on the study, the average rainfall in the study area is 801.86mm, with CV ranging from 43.3 to 22.27%. The southwest monsoon (SWM) season brings the greatest rain to the basin, followed by the post-monsoon (PM), summer, and winter seasons. In the annual time frame, except one station, all other stations have shown significant or insignificant increasing trends. The seasonal rainfall has shown insignificant rising trends during the summer and winter seasons while insignificant increasing and decreasing trends during the PM season. The SWM season has indicated significant increasing trends, insignificant increasing and decreasing trends. Overall, the study area has noticed an increased annual and seasonal rainfall except for the post-monsoon season, during which the rainfall showed a considerable decline. The findings of the study are helpful in water resource management, agricultural planning, and socioeconomic development in the study area.

Analysis of Long-Term Trend of Stream Flow and Interaction Effect of Land Use and Land Cover on Water Yield by SWAT Model and Statistical Learning in Part of Urmia Lake Basin, Northwest of Iran

The water yield produced at the outlet of a sub-basin is the combination of multiple interacting land uses. In the majority of previous research, while accounting for the effect of land use and land cover (LULC) on water yield, the hydrologic components of a watershed have been attributed to the dominant land use class within that sub-basin. We adopted an approach to investigate the interaction effect of LULC on water yield (WYLD) using the Johnson–Neyman (JN) method. The soil and water assessment tool (SWAT) model was employed in the Urmia Lake Basin (ULB) to estimate the WYLD following successful calibration and validation of the model by stream flow. It was found that in each sub-basin, the effect of the soil class on the WYLD was statistically significant only when the area of rangeland was less than 717 ha and when the area of agricultural lands was less than 633 ha. On the other hand, the trend of stream flow was assessed over 70 years at two stations in the Urmia Lake Basin (ULB) using the Bayesian Estimator of Abrupt change, Seasonal change, and Trend (BEAST). The year 1991 turned out to be the most likely change point in both stations. A significant decrease in Urmia Lake’s water level started in 1995, which indicated that part of this shrinkage was most likely caused by water inflow reduction over a 4-year time delay. Besides identifying the most probable seasonal and trend change points, this method has the additional capability to analyze the uncertainty of estimated points, which was lacking in earlier methods.