Important Role Research Articles

Comprehensive analyses reveal molecular and clinical characteristics of RNA modification writers across 32 cancer types

<p class="MsoNormal" style="text-align: justify;"><span lang="EN-US" style="font-size: 12pt; font-family: Nunito;">Adenosine alterations to RNA, which are largely determined by RNA modification writers (RMWs), are critical for cancer growth and progression. These RMWs can catalyze different types of adenosine modifications, such as N6-methyladenosine (m6A), N1-methyladenosine (m1A), alternative polyadenylation (APA), and adenosine-to-inosine (A-to-I) RNA editing. These modifications have profound effects on gene expression and function, such as immune response, cell development. Despite this, the clinical effects of RMW interactive genes on these cancers remain largely unclear. A comprehensive analysis of the clinical impact of these epigenetic regulators in pan-cancer requires further comprehensive exploration. Here, we systematically profiled the molecular and clinical characteristics of 26 RMWs across 33 cancer types using multi-omics datasets and validated the expression level of some RMWs in various cancer lines. Our findings indicated that a majority of RMWs exhibited high expression in diverse cancer types, and this expression was found to be significantly associated with poor patient outcomes. In the genetic alterations, the amplification and mutation of RMWs were the dominant alteration events. Consequently, the RNA Modification Writer Score (RMW score) was established as a means to assess the risk of RMWs in pan-cancer. We found that 27 of 33 cancers had significantly higher scores compared with normal tissues, and it was significantly correlated with prognosis. We also evaluated their impact on the tumor microenvironment and the response to immunotherapy and targeted therapy. These findings verified the important role of RMWs in different aspects of cancer biology, and provided biomarkers and personalized therapeutic targets for cancer.</span></p>

Organic Chemistry and its Important Role in the Creation of Type: Novel Functional Materials

Organic Chemistry and its Important Role in the Creation of Type: Novel Functional Materials

Nutraceuticals: New Perspective and Approach to Prevent Dysmenorrhea

Background: The words "nutrition" and "pharmaceutical" are combined to form the phrase "nutraceutical." Nutraceuticals are foods or dietary components that have an important role in regulating and sustaining normal physiological function in humans. For the treatment of dysmenorrhoea, a variety of pharmacological medications are available, however, they all have significant side effects. Dietary supplements and lifestyle management, on the other hand, were found to have a major influence on the occurrence and control of dysmenorrhea. Objective: The objective of this paper is to study a comprehensive review of the dietary and nutritional supplements with special emphasis on dysmenorrhea. This paper focuses on understanding and interpreting the details of menstrual pain and its effective nutritional diet that can be used as a treatment for avoiding menstrual discomfort. Methods: The selection of data has been done by studying a combination of various research and review papers from different databases like PubMed, NCBI, Science Direct, WHO, Cochrane Library, and Web of Science from the year 2000-2022. Results: Based on various papers and literature reviews, we have concluded about various dietary supplements and herbs that can be used to avoid pain during mensuration followed by its all-daily requirement of nutrition on different age groups and efficacy of treatments. Conclusion: According to current evidence, young women should be instructed in the proper use of dietary supplements, nutrition, and vitamins, as well as the inclusion of effective diet and lifestyle changes such as exercise and a well-balanced diet with adequate nutrition, as these are likely to reduce the negative effects of dysmenorrhea.

Review of global burden of disease studies: trends, challenges, and future directions

Global burden of disease (GBD) studies plays an important role in assessing the variability of risk factors, injuries, and diseases worldwide, providing essential evidence for policy-making and healthcare planning. This study presents a review of current literature on GBD studies, aiming to analyze the trends, challenges, and future directions in this field. We conducted a review of published GBD studies from inception to date, utilizing major scientific databases and relevant sources. Our findings reveal several noteworthy trends in GBD studies. Over the years, GBD studies have expanded to cover a wider range of diseases and risk factors, providing a more comprehensive understanding of global health. Advances in data availability, technology, and modeling techniques have improved the accuracy of disease burden estimates. The inclusion of disability-adjusted life years (DALYs) has enabled comparisons as well as prioritization of interventions. However, challenges remain, such as limited data in middle and low-income countries and methodological complexities. The COVID-19 pandemic has emphasized the need for responsive methodologies. Future directions include strengthening data collection, utilizing machine learning, big data analytics, ethical use of artificial intelligence and promoting collaboration for consistent GBD studies.

Impact of Precision Nutrition on Microbiota and Obesity

Abstract: The human body is colonized by trillions of microbes, that contribute to our health and well-being. Many factors influence the composition and functions of the intestinal microbiota, including the host's eating habits, which seem to have a significant effect. A healthy intestinal microbiota is essential for proper metabolic function and homeostasis. Alterations in microbial composition could dramatically cause obesity and diabetes, modifying and influencing host metabolism, homeostasis, and central appetite mechanism. Brain reward signaling is mediated by the dopaminergic mesolimbic system and plays an important role in the development of obesity. Dysregulation of the energy balance causes obesity. Obesity is a serious health problem. The composition of the intestinal microbiota influences various aspects of energy metabolism: digestion, food intake from ingested foods, food components, and accumulation of excess fat. Therefore, the microbial community can contribute significantly to the progression of obesity and its complications. A "tailored nutritional approach" and more feasible and sustainable personalized nutritional strategies must be developed to optimize the gut microbiome and improve host response.

Analysis of potential Circular RNAs in regulating imatinib resistance of Gastrointestinal stromal tumor.

Recent studies have found that circular RNA is an abundant RNA species that belongs to part of the competing endogenous RNA network(ceRNA), which was proven to play an important role in the development, diagnosis and progress of diseases. However, the function of circRNAs in imatinib resistance in Gastrointestinal stromal tumor (GIST) are poorly understood so for. The present study aimed to screen and predict the potential circRNAs in imatinib resistance of GIST using microarray analysis. We determined the expression of circular RNAs in paired normal gastric tissues(N), primary GIST (gastrointestinal stromal tumor) tissues (YC) and imatinib mesylate secondary resistance GIST tissues(C) with microarray and predicted 8677 dysregulated circular RNAs. Compared with the YC group, we identified 15 circRNAs that were up-regulated and 8 circRNAs that were down-regulated in the C group. Gene ontology (GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis indicated that these host linear transcripts that differentially express circular RNAs are involved in many key biological pathways, predicting the potential tumor-genesis and drug resistance mechanismrelated to HIF-1 pathway, later we draw the cirRNA-miRNA-mRNA network involved in the HIF-1 pathway and found several dysregulated circRNAs and the relationship between circRNA-miRNAs-mRNA, such as circRNA_06551, circRNA_14668, circRNA_04497, circRNA_08683, circRNA_09923(Green, down-regulation) and circRNA_23636, circRNA_15734(Red, up-regulation). Taken together, we identified a panel of dysregulated circRNAs that may be potential biomarkers even therapy relevant to the GIST, especially imatinib secondary resistance GIST.

A Specificity Protein 1 assists the progression of the papillary thyroid cell line by initiating NECTIN4.

Papillary thyroid cancer (PTC) is one of the subtypes of thyroid cancer with increasing incidence worldwide, but the molecular mechanism is still unclear. Papillary thyroid cancer (PTC) is one of the subtypes of thyroid cancer with increasing incidence worldwide, but the molecular mechanism is still unclear. Studies have indicated that nectin cell adhesion molecule 4 (NECTIN4) was an oncogene and played an important role in the development and progression of PTC. Meanwhile, specificity protein 1 (SP1) expresses many important oncogenes and tumor suppressor genes. However, the relationship between NECTIN4 and SP1 in regulating PTC growth is unclear. In the present study, reverse transcription PCR was utilized to detect the mRNA expression of NECTIN4 and SP1 in thyroid cancer cell lines and normal thyroid cell lines. Chromatin immunoprecipitation assays and luciferase reporter assays were used to study whether SP1 could bind to the promoter region of NECTIN4 and activate its transcription. The biological functions of SP1 correlated with NECTIN4 were also performed in TPC-1 and KTC1 cell lines. The study revealed that the mRNA expression level of SP1 and NECTIN-4 showed a positive correlation and were upregulated in PTC cell lines. Moreover, the results of ChIP and luciferase reporter assays showed that SP1 could bind to the NECTIN4 promoter regions and activate the transcriptional level of NECTIN4. The experiments in vitro showed that SP1 could promote cell proliferation, colony formation, migration, and invasion by regulating NECTIN4 in PTC cells. In conclusion, our study, for the first time, demonstrated that SP1 could control the transcriptional regulation of NECTIN4 and accelerate the growth of PTC, which may provide a new potential therapeutic target for PTC patients.

Synthesis and In Silico Studies of Quinazolinones as PARP-1 Inhibitors.

Cancer is a leading threat to humankind, accounting for nearly one million deaths in 2018, and the expected number of cancer-related deaths in 2040 is more than 16 million. The most common causes of cancer deaths are lung, colorectal, stomach, liver and breast cancer, while the highest number of new cancer cases belong to lung, breast, colorectal, prostate, stomach and liver cancer. PARP-1 is an enzyme that plays an important role in DNA repair, cell propagation/survival and death due to its influence on numerous biological processes. Quinazolinones represent an important scaffold in medicinal chemistry and have a broad spectrum of biological activities. In this study, we have synthesized quinazolinones by reaction of 2-aminobenzamide and substituted aldehydes. Molecular docking studies of synthesized compounds were performed for their PARP-1 binding affinities using Schrodinger 2016 software. In silico ADME studies were also performed for the synthesized compounds using the QikProp tool of Schrodinger software. Results of molecular docking studies indicated that synthesized quinazolinones had a good affinity towards active site of PARP-1 and compound 4 had the best docking score (-10.343). Results of ADME studies indicated the drug-like properties of synthesized compounds, which make them suitable drug candidates. All the synthesized compounds have a better docking score than niraparib (-9.05). Further, the synthesized compounds have a favorable ADME profile. Therefore, they may serve as important leads in discovering PARP-1 inhibitors.

Centralized climate clubs and decentralized governance: A model of global CO2 mitigation

AbstractThis paper extends the climate literature by examining the feasibility of integrating sub‐national governance into global club governance for mitigating CO2 emissions. Global climate clubs become an argument for having separate bundles of emission targets and incentive mechanisms in the form of opportunities for climate finance and technology sharing among the club members. An exploratory analysis is important to examine the role of import and export taxes and other channels, such as the clean development mechanism, in meeting the objective of nonmember countries to join the club. The crux, however, is how, after determining national‐level quotas, the mitigation responsibilities are shared with subnational entities. We propose a design of a carbon entry tax at the subnational level, namely states, districts, and municipalities. The carbon entry tax uses the nighttime luminosity data published by NASA as a measure of carbon, which constitutes the tax base. The carbon entry tax serves as a fiscal instrument of decarbonization in a decentralized framework.

Global semiconductor supply chain resilience challenges and mitigation strategies: A novel integrated decomposed fuzzy set Delphi, WINGS and QFD model

The recent COVID-19 pandemic, Ukrainian-Russian conflict, China-US trade war, and current environmental concerns regarding carbon emissions have all made the semiconductor supply chain (SCSC) more vulnerable. In addition, the uncertainty of global SCSC is increasingly obscured owing to several resilience challenges within the exiting supply chain network. Thus, supply chain resilience issues are becoming popular among researchers and policymakers. Unfortunately, there is a lack of systematic research on evaluation of resilience challenges and mitigation strategies for the global SCSC. Additionally, existing models are incompetent to capture the optimistic and pessimistic views of experts during interaction assessment and mitigation strategy evaluation in an uncertain environment. Hence, this research, for the first time, develops a novel integrated Decomposed Fuzzy Set (DFS)-based Delphi, Weighted Influence Non-linear Gauge System (WINGS), and Quality Function Deployment (QFD) model to identify and assess strength-interaction relationship between resilience challenges and mitigation strategies. The findings demonstrated that out of thirteen resilience challenges, seven were identified as causal group resilience challenges while the remaining six were classified as result group resilience challenges indicating that addressing the causal group resilience challenges may directly influence the mitigation of the result group resilience challenges. According to findings of DFS-WINGS analysis, the resilience challenges “Geopolitical tensions” and “Natural disasters” are the two most priority causal group resilience challenges that can significantly influence the result group system components. Furthermore, the DSF-QFD analysis confirmed that the mitigation strategies “Investing in semiconductor R&D and developing regional semiconductor manufacturing facilities” and “Diversification of key components suppliers and promoting domestic manufacturing” received the highest correlation among the mitigation strategies to address the current resilience issues faced by global SCSC. The study findings make a significant contribution to policymaking. The roles of resilience challenges and importance of mitigation strategies both can be used as benchmarks for the SCSC to make the global SCSC more resilient and sustainable.

Evaluation of children's oral diagnosis and treatment using imaging examination using AI based Internet of Things.

Although cone beam computed tomography (CBCT) plays an important role in the diagnosis and treatment of oral diseases, its image segmentation method needs to be further improved, and there are still objections about the clinical application effect of general anesthesia (GA) on children's dental fear (CDF). This study aimed to investigate the application value of CBCT based on intelligent computer segmentation model in oral diagnosis and treatment of children in the context of biomedical signals, and to analyze the alleviating effect of GA on CDF. Based on the regional level set (CV) algorithm, the local binary fitting (LBF) model was introduced to optimize it, and the tooth CBCT image segmentation model CV-LBF was established to compare the segmentation accuracy (SA), maximum symmetric surface distance (MSSD), average symmetric surface distance (ASSD), over segmentation rate (OR), and under segmentation rate (UR) between these model and other algorithms. 82 children with CDF were divided into general anesthesia group (GAG) (n= 38) and controls (n= 44) according to the voluntary principle of their families. Children in GAG were treated with GA and controls with protective fixed intervention. Children's fear survey schedule-dental subscale (CFSS-DS) and Venham scores were counted before intervention in the two groups. CFSS-DS scores were recorded at 2 hours after intervention and after recovery in children in GAG. CFSS-DS and Venham scores were performed in all children 1 week after surgery. The results showed that the S⁢A value of CV-LBF algorithm was higher than that of region growing algorithm (P< 0.05). OR, UR, MSSD, and ASSD values of CV-LBF algorithm were evidently lower than those of other algorithms (P< 0.05). CFSS-DS scores were lower in GAG than in controls 2 hours after intervention and at return visits after 1 week of intervention (P< 0.001), and Venham scores were lower in GAG than in controls after intervention (P< 0.001). After intervention, the proportion of children with Venham grade 0, 1, 2, and 3 was obviously higher in GAG than in controls (P< 0.001), while the proportion of children with Venham grade 4 and 5 was clearly higher in controls than in GAG (P< 0.001). The results revealed that the computer intelligent segmentation model CV-LBF has potential application value in CBCT image segmentation of children's teeth, and GA can effectively alleviate anxiety of children with CDF and can be used as biomedical signals.

A NAGYSZEBENI JOGAKADÉMIA TANÁRAI (1844–1887) REKONSTRUKCIÓS KÍSÉRLET

An Experiment to Reconstruction. In the 19th and early 20th centuries, the law academies in Hungary and Transylvania played an important role in the training of the intellectuals of the multi-ethnic Carpathian Basin, especially in the training of officials. Perhaps the most unusual of these institutions was the History of the Academy of Law in Sibiu. To the best of our knowledge, the following data archive is the first attempt to reconstruct the composition of the teaching staff of the Academy of Law in Sibiu over the slightly more than four decades of its existence. The compilation is based on available printed and archival sources.

LAJOS FEKETE, HUNGARIAN ROYAL MINISTER COUNCELLAR, DIRECTOR OF THE HUNGARIAN ROYAL ACADEMY OF MINING AND FORESTRY

Lajos Fekete, Hungarian Royal Minister Counsellor, Forestry Academy professor is a leading figure in higher forestry education, who achieved indefeasible results in creating Hungarian language education and the Hungarian forestry language. Between 1872 and 1891, he headed the Department of Phytology and Silviculture at the Royal Hungarian Academy of Mining and Forestry in Selmecbánya, and from 1891 until his retirement he headed the Department of Forest Management. He played an important role in the organisation of the Academy campus, the construction of new educational buildings and the development and furnishing of the botanical gardens, as well as in the compilation and development of collections related to the subjects he taught (zoology, entomology, botany, climatology and soil science). Hungarian experiments in forestry began to take institutional form in 1897/98, and Lajos Fekete was responsible for this, as well as for the idea of establishing forestry education on a secondary level. Although he had already exceeded the possible age of retirement in 1894, his tireless work ethic kept him in the Academy. He enjoyed the confidence of the Academy's teaching staff and served as vice-principal in the academic year 1892/93, then as director in the academic years 1897/98, 1898/1899 and 1899/1900, and was also head of the forestry department. At the age of 69, on 1 October 1906, he was retired at his own request, because of his failing eyesight towards the end of his life. Thus, the last serving teacher of the first faculty of the Forestry Academy left the academy chair. On this occasion, he was awarded the title of Minister Counsellor in recognition of his services. In 1910, six years before his death, he received the highest recognition for his work, being accepted as a corresponding member of the Hungarian Academy of Sciences. There is no branch of forestry science in which his work has not left a lasting mark. Despite this extremely productive and diversified career, which produced outstanding achievements in all fields, posterity has treated and still treats Lajos Fekete, whose work and human behaviour can stand as an example to us all, rather cruel.

Interpersonal mattering and the experience of meaning in life

ABSTRACT Recent research in positive psychology has proposed that the experience of meaning in life (MIL) is multidimensional and consists of three components: mattering, purpose, and coherence. In this model, mattering has been operationalized as the extent to which people feel like they matter on the scale of the universe. The current research suggests this ‘cosmic mattering’ is only part of the picture and explored the relationships between the tripartite components of MIL and one well-established but previously unintegrated context of mattering: interpersonal mattering. Studies 1 and 2 found evidence that interpersonal mattering plays an important role in MIL even while accounting for cosmic mattering, purpose, and coherence. Study 3 experimentally demonstrated that increasing people’s feelings of interpersonal importance increases their sense of MIL. Together, these studies support the idea that interpersonal mattering is a context of existential mattering that contributes to MIL at least as much as cosmic mattering.

Stories and Data: Australian Musicians Navigating the Spotify for Artists Platform

ABSTRACT Spotify offers users powerful algorithmic recommendations and hybrid “algo-torial” curation at scale. In this paper we argue that juxtaposed within this data-driven platform, is the power of human stories and networking. We investigate the experiences of 10 Australian musicians through semi-structured interviews, asking how they navigate the Spotify for Artists interface. By attending to the experiences of the artists themselves, and their use of the Spotify for Artists platform, we explore the human stories that flow within this socio-technical music streaming network, arguing that stories, like data, have an important role and value in this context.

Theorizing data analysis platforms – digital refractions and reconfigurations of pasts, presents and futures

ABSTRACT Digital platforms are a pervasive force in the transformation of business, organization and social order, but also an evolving phenomenon in need of further conceptualization and detailed analysis. This article offers a theorization and analytical framework for the study of a sub-type of digital platforms that we may think of as data analysis platforms, and which play an increasingly important role in organizations, business, and society more broadly. Starting from a theoretical focus on how data, algorithms and technological systems work as ‘digital prisms’ that refract and reconfigure social phenomena, the article articulates how data integration and data-driven prediction can be seen as forms of knowledge production that allow for new dynamics of seeing, knowing and governing. On this backdrop, the article highlights five analytical dimensions of data analysis platforms (domains, datasets, models, humans and temporality) and offers a conceptualization of three different types and uses of data analysis platforms (data merging platforms, data prognosis platforms and data projection platforms). Taken together, this analytical framework may guide conceptual and empirical investigations and pave the way for more nuanced understandings of the shape, workings and societal ramifications of data analysis platforms. The article contributes to emergent research seeking to articulate the shapes and workings of digital platforms. The conceptualization of digital platforms may help us understand as the digitalization and datafication of knowledge production, work and organization, the reliance on platforms, as well as broader questions about how data, algorithms and digital systems are used in attempts to grasp and shape futures.

The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report

Blunt abdominal trauma is an event that can cause massive internal bleeding and can be life-threatening. Splenectomy is often performed to treat organ injuries in patients with blunt abdominal trauma. However, splenectomy can cause hemostasis problems, which can cause more bleeding and risk complications such as Acute Kidney Injury (AKI).&#x0D; This case report aims to discuss the role of prothrombin complex concentrate (PCC) in treating bleeding and preventing AKI in blunt abdominal trauma patients after splenectomy at Fatmawati Hospital, Jakarta, Indonesia.&#x0D; A 15-year-old woman experienced blunt abdominal trauma due to a sports accident and sustained internal bleeding. After a thorough evaluation, she underwent an emergency splenectomy to stop the bleeding. However, patients developed hemostasis problem which made the control of postoperative bleeding difficult. To overcome this problem, patient was administered PCC intravenously, which resulted in significant improvement in controlling postoperative bleeding. The hematocrit level and red blood cell count steadily increased, indicating the effectiveness of PCC in improving the patient's hemostasis.&#x0D; PCC can play an important role in treating post-splenectomy bleeding in patients with blunt abdominal trauma. Apart from that, the use of PCC can also help prevent AKI, which is a serious and life-threatening complication. Further research and clinical trials are needed to confirm the benefits of using PCC in a broader patient population with similar conditions.&#x0D; Abbreviations: AKI- Acute Kidney Injury; PCC- Prothrombin Complex Concentrate&#x0D; Keywords: Acute Kidney Injury; Bleeding; Blunt Abdominal Trauma; Prothrombin Complex Concentrate; Splenectomy&#x0D; Citation: Laksana AP, Manggala SK, Irawany V. The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report. Anaesth. pain intensive care 2024;28(1):177−181; DOI: 10.35975/apic.v28i1.2289&#x0D; Received: September 13, 2023; Reviewed: October 29, 2023; Accepted: December 19, 2023

One-pot multicomponent reaction: An efficient synthesis of 4-(HET)Aryl-substituted pyrazolo-quinolinones.

Pyrazolo-quinolinones (PQs) are a versatile class of Organic chemistry and it was found that they have very advanced functionally promising as selective compounds due to their scaffold and demonstrated low toxicity and considerable clinical promise. Moreover, these compounds have an important role in different applications such as analytical reagents, technical, pharmaceutical development, and biological markers. So, we aimed to synthesize and characterize new 4-(Het)aryl-substituted Pyrazole-quinolinones. Synthesis of One-Pot Multicomponent Reaction was carried out with the reaction of 5-amino-3-methyl-1H-pyrazole 1a, and 5-amino-3-phenyl-1H-pyrazole 1b and dimedone 2 with some (het)aryl aldehydes 3 using ethanol. Characterizations such as the linear structures and the regiospecificity of the reactions were determined by using NMR, GC-MS, IR, and UV measurements. This research will be very useful for all methods and procedures using multi-one-point reactions which are very popular in the synthesis of heterocyclic systems for pyrazole- quinoline skeleton synthesis.

Assessing Tidal Models in the Ryukyu Islands Region Using the ENOPF Method

Abstract Satellite remote sensing can monitor sea level changes at temporal and spatial scales, plays an important role in the study of tides, and is widely used in numerical tidal models. However, these tidal models are usually computationally expensive. The equidistant nodes orthogonal polynomial fitting (ENOPF) method may overcome that drawback. This study evaluates the accuracy of the ENOPF method in fitting the major tidal constituents in the region near the Ryukyu Islands, where the water depth on either side of the islands varies significantly. The results show that the ENOPF method can accurately fit the major tidal constituents in the presence of complex topography. Furthermore, this approach can also be used to generate reasonable cotidal charts and provide valuable tidal information for hydrodynamic model simulations in the East China Sea. For the high-resolution hydrodynamic model of the East China Sea in particular, reasonable open boundary conditions can be provided by the ENOPF method.

Tropical Atmospheric Intraseasonal Oscillations Leading to Sea Level Extremes in Coastal Indonesia during Recent Decades

Abstract Coastal flooding induced by sea surface high extreme (HEX) events is an increasing risk to human society and infrastructure as both urban growth in coastal areas and anthropogenic sea level rise continue, especially for island nations like Indonesia. This paper investigates the role of atmospheric intraseasonal oscillations (ISOs), which are dominated by the Madden–Julian oscillation (MJO), in forcing HEXs on the coasts of Indonesia bordering the Indian Ocean. We use satellite altimetry data from 1993 to 2021 and tide gauge observations to detect HEXs, and modeling experiments using both the Regional Ocean Modeling System and a Bayesian dynamic linear model to understand the forcing and processes. We find that HEXs exhibit strong seasonality, with most events occurring during boreal winter (December–February) and spring (March–May) that are dominated by seasonal-to-decadal and intraseasonal variability respectively. In 32% of the 56 HEX events detected, the amplitude of ISO-induced sea level anomalies (SLAs) exceeds that of seasonal-to-decadal SLAs. Surface wind stress associated with atmospheric ISOs is the major forcing for intraseasonal SLAs, and both the remote westerly wind stress from the Indian Ocean equator and northwesterly longshore wind stress at the Indonesian coasts play important roles in driving the HEXs. The MJO is the dominant cause of ISO-dominated HEXs and its impact shows strong seasonal differences. Spring MJOs are associated with stronger convective anomalies over the eastern Indian Ocean equator that drive stronger zonal winds across the equatorial basin that lead to more HEX events compared to winter MJOs when the convection is shifted southward.