Ajuste fino de un modelo de producción vocal para estimar el estrés de impacto utilizando un método metaheurístico

Introducción: En modelos de producción vocal que emplean estructuras de resorte-masa-amortiguador, la precisión en la determinación de coeficientes de amortiguamiento que se asemejen a las características fisiológicas de las cuerdas vocales es crucial, teniendo en cuenta posibles variaciones en la representación de la viscoelasticidad. Objetivo: Este estudio tiene como objetivo realizar un ajuste paramétrico de un modelo de producción vocal basado en un sistema de resorte-masa-amortiguador que incorpora interacción con la presión subglótica, con el fin de modelar de manera precisa las fuerzas de colisión ejercidas por las cuerdas vocales durante la fonación. Método: Se utilizó un algoritmo de búsqueda metaheurística para la síntesis paramétrica. El algoritmo se aplicó a los coeficientes de elasticidad c1 y c2, así como a los coeficientes de amortiguamiento ε1 y ε2, que se correlacionan directamente con las matrices de masa del modelo. Esto facilita el ajuste de la composición de las cuerdas para lograr un comportamiento fisiológico deseado. Resultados: El comportamiento del sistema vocal para cada ciclo de simulación se comparó con un estándar predefinido en condiciones normales. El algoritmo determinó el punto final de la simulación evaluando las discrepancias entre características clave de las señales obtenidas y las deseadas. Conclusión: El ajuste paramétrico permitió la aproximación del comportamiento fisiológico de la producción vocal, proporcionando estimaciones de las fuerzas de impacto experimentadas por las cuerdas vocales durante la fonación.

Introduction: In vocal production models employing spring-mass-damper frameworks, precision in determining damping coefficients that align with physiological vocal fold characteristics is crucial, accounting for potential variations in the representation of viscosity-elasticity properties. Objective: This study aims to conduct a parametric fitting of a vocal production model based on a mass-spring-damper system incorporating subglottic pressure interaction, with the purpose of accurately modeling the collision forces exerted by vocal folds during phonation. Method: A metaheuristic search algorithm was employed for parametric synthesis. The algorithm was applied to elasticity coefficients c1 and c2, as well as damping coefficients ε1 and ε2, which directly correlate with the mass matrices of the model. This facilitates the adjustment of fold composition to achieve desired physiological behavior. Results: The vocal system's behavior for each simulation cycle was compared to a predefined standard under normal conditions. The algorithm determined the simulation endpoint by evaluating discrepancies between key features of the obtained signals and the desired ones. Conclusion: Parametric fitting enabled the approximation of physiological vocal production behavior, providing estimates of the impact forces experienced by vocal folds during phonation.

Impact of Prosigna test on adjuvant treatment decision in lymph node-negative early breast cancer-a prospective national multicentre study (EMIT-1).

BACKGROUND: EMIT-1 is a national, observational, single-arm trial designed to assess the value of the Prosigna, Prediction Analysis of Microarray using the 50 gene classifier (PAM50)/Risk of Recurrence (ROR), test as a routine diagnostic tool, examining its impact on adjuvant treatment decisions, clinical outcomes, side-effects and cost-effectiveness. Here we present the impact on treatment decisions. PATIENTS AND METHODS: Patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative pT1-pT2 lymph node-negative early breast cancer (EBC) were included. The Prosigna test and standard histopathology assessments were carried out. Clinicians' treatment decisions were recorded before (pre-Prosigna) and after (post-Prosigna) the Prosigna test results were disclosed. RESULTS: Of 2217 patients included, 2178 had conclusive Prosigna results. The pre-Prosigna treatment decisions were: no systemic treatment (NT) in 27% of patients, endocrine treatment alone (ET) in 38% and chemotherapy (CT) followed by ET (CT + ET) in 35%. Post-Prosigna treatment decisions were 25% NT, 51% ET and 24% CT + ET, respectively. Adjuvant treatment changed in 28% of patients, including 21% change in CT use. Among patients assigned to CT + ET pre-Prosigna, 45% were de-escalated to ET post-Prosigna. Of patients assigned to ET, 12% were escalated to CT + ET and 8% were de-escalated to NT; of those assigned to NT, 18% were escalated to ET/CT + ET. CT was more frequently recommended for patients aged ≤50 years. In the subgroup with pT1c-pT2 G2 and intermediate Ki67 (0.5-1.5× local laboratory median Ki67 score), the pre-Prosigna CT treatment decision varied widely across hospitals (3%-51%). Post-Prosigna, the variability of CT use was markedly reduced (8%-24%). The correlation between Ki67 and ROR score within this subgroup was poor (r = 0.25-0.39). The median ROR score increased by increasing histological grade, but the ROR score ranges were wide (for G1 0-79, G2 0-90, G3 16-94). CONCLUSION: The Prosigna test result changed adjuvant treatment decisions in all EBC clinical risk groups, markedly decreased the CT use for patients categorized as higher clinical risk pre-Prosigna and reduced treatment decision discrepancies between hospitals.

Impact of seasonal malaria chemoprevention based on the number of medicines doses received on malaria burden among children aged 3-59 months in Nigeria: A propensity score-matched analysis.

BACKGROUND: Seasonal malaria chemoprevention using sulfadoxine-pyrimethamine plus amodiaquine (sulfadoxine-pyrimethamine plus amodiaquine on Day 1 and amodiaquine on both Day 2 and Day 3) is delivered to children aged 3-59 months in areas of highly season malaria transmission. While the overall population-level impact of seasonal malaria chemoprevention on malaria control has been documented in various countries and time periods, there is no clear evidence regarding seasonal malaria chemoprevention impact based on the number of medicine doses children receive in one cycle in routine programmatic conditions. METHODS: Data were extracted from Nigeria's routinely collected seasonal malaria chemoprevention end-of-round coverage surveys (2021, 2022). We matched seasonal malaria chemoprevention-targeted children who received specific numbers of seasonal malaria chemoprevention medicines with those who did not receive any doses of seasonal malaria chemoprevention medicines (non-sulfadoxine-pyrimethamine plus amodiaquine) using multiple sets of propensity score matches. We performed multilevel logistic regression for each matched group to evaluate the association between the number of doses of seasonal malaria chemoprevention medicines and monthly confirmed malaria cases (caregiver-reported malaria infection diagnosed by rapid diagnostic test at a health facility following the penultimate cycle of seasonal malaria chemoprevention). RESULTS: Among 21,621 SMC-targeted children, 9.7% received non-sulfadoxine-pyrimethamine plus amodiaquine, 0.5% received only Day 1 sulfadoxine-pyrimethamine plus amodiaquine, 1.0% received Day 1 sulfadoxine-pyrimethamine plus amodiaquine and either Day 2 amodiaquine or Day 3 amodiaquine (sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine), and 88.8% received Day 1 sulfadoxine-pyrimethamine plus amodiaquine and both Day 2 and Day 3 amodiaquine (sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine + amodiaquine). Children receiving only Day 1 sulfadoxine-pyrimethamine plus amodiaquine did not have significant lower odds of rapid diagnostic tests-confirmed malaria than those receiving non-sulfadoxine-pyrimethamine plus amodiaquine (OR 0.77, 0.42-1.42). However, children receiving sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine had significantly lower odds of rapid diagnostic tests-confirmed malaria than those receiving non-sulfadoxine-pyrimethamine plus amodiaquine (OR 0.42, 95% CI 0.28-0.63). Similarly, children receiving sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine + amodiaquine also had significantly lower odds of rapid diagnostic test-confirmed malaria than those receiving non-sulfadoxine-pyrimethamine plus amodiaquine (OR 0.54, 95% CI 0.47-0.62). CONCLUSION: Adherence to at least one daily dose of amodiaquine administration following receipt of Day 1 sulfadoxine-pyrimethamine plus amodiaquine by eligible children is crucial to ensure the effectiveness of seasonal malaria chemoprevention. This demonstrates the importance of enhancing caregiver awareness regarding the importance of amodiaquine and identifying barriers toward amodiaquine administration at the community level.

Deep-Sea Benthic Response to the Deepwater Horizon Oil Spill: Harpacticoid Families as Sentinels of Impact Through Space and Time.

The Deepwater Horizon (DWH) oil spill in the northern Gulf of Mexico, occurred in 2010 at 1525 meters depth, releasing approximately 507 million liters of oil. Research cruises in 2010 and 2011 were conducted to assess the initial and subsequent effects of the oil spill on deep-sea infauna. The spatial-temporal response of the deep-sea meiofaunal harpacticoid community composition to the DWH oil spill was investigated at 34 stations ranging from <1 km to nearly 200 km from the wellhead in 2010 and 2011. The pattern of reduced harpacticoid diversity in impacted zones compared to non-impacted zones in 2010 persisted in 2011. However, an increase in Hill's diversity index (N1) and the family richness across the two years in some of the impacted stations could suggest a first signal of a tentative recovery and an improvement of environmental conditions. The multivariate analysis of harpacticoid family composition revealed the persistence of an impact in 2011 with moderately high values of turnover diversity in the harpacticoid communities through time (37%) and space (38% - 39%). The consistent presence in all years and stations of long-term tolerant families (e.g., Ameiridae), the sharp decrease of fast responding opportunistic families (e.g., Tisbidae), and the increase of more sensitive ones (e.g., Ectinosomatidae, Canthocamptidae, Cletopsyllidae, and Laophontidae) lead to the preliminary conclusion that some initial signals of recovery are evident. However, as impacts were still evident in 2011, and because recruitment and succession rates can be extremely slow in the deep sea, full community recovery had not yet occurred one year after the DWH disaster. This study confirmed that harpacticoid copepod family diversity can offer an accurate assessment of oil-spill impacts on deep-sea benthic communities over space and time as well as a better understanding of the recovery mode of the system after an oil spill event.

Exploring the impact of Choroideremia on women with phenotypic and/or genotypic evidence of disease: insights from a global survey.

INTRODUCTION: Choroideremia (CHM) is an X-linked inherited retinal disease mostly affecting males. However, women with phenotypic and/or genotypic evidence of CHM may develop degenerative visual disability with advancing age. Our objective was to determine the visual impacts of phenotypic and/or genotypic evidence of CHM in women and its associated psychosocial burden and influence on activities of daily living (ADLs). METHODS: We conducted an international cross-sectional survey from April to December 2022 using an e-questionnaire distributed through not-for-profit stakeholder organizations and social media plat-forms. RESULTS: With a total of 55 respondents (n = 55), most women with phenotypic and/or genotypic evidence of CHM (76%) reported a change in their visual acuity. When assessing its impact on ADLs, Pearson's correlation coefficient showed a negative correlation between driving (p = 0.046) and mobility capabil-ities (0.046) with the respondent's age. More than half of women reported being afraid, anxious, and stressed, with women below the age of 50 years old reporting a significantly higher level of distress and hopelessness (p = 0.003), anxiety (p = 0.00007), issues with relaxing (p = 0.025), and negative personal thoughts (p = 0.042). CONCLUSION: Overall, this survey outlines both physical and psychological burden of being a woman with phenotypic and/or genotypic evidence of CHM. Given the limited clinical research in females affected by CHM, this patient-centered survey is a crucial advocacy tool for these individuals.

The impacts associated with having ADHD: an umbrella review.

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) affects up to 5% of the population and is characterised by symptoms of impulsivity, hyperactivity and inattention. These symptoms are significantly impairing and carry additional risks for children and adults with ADHD, including negative mental health (e.g. depression), physical health (e.g. obesity) and societal outcomes (e.g. imprisonment, divorce). Very few studies have attempted to synthesise these risks in one publication due to the breadth of evidence published on the adverse outcomes of ADHD. Methods: An umbrella review was performed to identify reviews (systematic, meta-analysis and narrative) that investigate the risks arising from having ADHD. We conducted a narrative synthesis of the findings and conducted a quality review of the included publications. Results: Upon searching five databases, 16,675 records were identified. Of these, 125 reviews met the criteria for inclusion. A narrative synthesis of these findings highlighted three key domains of risks associated with ADHD: mental health, physical health, social and lifestyle. Most reviews were of good and moderate quality. Discussion: This review highlights the many risks associated with having ADHD, beyond its three key symptom domains and the impact of the condition on daily functioning. Registration: International Prospective Register of Systematic Reviews (PROSPERO CRD42023404073).

The carbon footprint of a Dutch academic hospital-using a hybrid assessment method to identify driving activities and departments.

Background: The healthcare sector is responsible for 7% of greenhouse gas (GHG) emissions in the Netherlands. However, this is not well understood on an organizational level. This research aimed to assess the carbon footprint of the Erasmus University Medical Center to identify the driving activities and sources. Methods: A hybrid approach was used, combining a life cycle impact assessment and expenditure-based method, to quantify the hospital's carbon footprint for 2021, according to scope 1 (direct emissions), 2 (indirect emissions from purchased energy), and 3 (rest of indirect emissions) of the GHG Protocol. Results were disaggregated by categories of purchased goods and services, medicines, specific product groups, and hospital departments. Results: The hospital emitted 209.5 kilotons of CO2-equivalent, with scope 3 (72.1%) as largest contributor, followed by scope 2 (23.1%) and scope 1 (4.8%). Scope 1 was primarily determined by stationary combustion and scope 2 by purchased electricity. Scope 3 was driven by purchased goods and services, of which medicines accounted for 41.6%. Other important categories were medical products, lab materials, prostheses and implants, and construction investment. Primary contributing departments were Pediatrics, Real Estate, Neurology, Hematology, and Information & Technology. Conclusion: This is the first hybrid analysis of the environmental impact of an academic hospital across all its activities and departments. It became evident that the footprint is mainly determined by the upstream effects in external supply chains. This research underlines the importance of carbon footprinting on an organizational level, to guide future sustainability strategies.

Roentgenoscopy of laser-induced projectile impact testing.

Laser-induced projectile impact testing (LIPIT) based on synchrotron imaging is proposed and validated. This emerging high-velocity, high-strain microscale dynamic loading technique offers a unique perspective on the strain and energy dissipation behavior of materials subjected to high-speed microscale single-particle impacts. When combined with synchrotron radiation imaging techniques, LIPIT allows for in situ observation of particle infiltration. Two validation experiments were carried out, demonstrating the potential of LIPIT in the roentgenoscopy of the dynamic properties of various materials. With a spatial resolution of 10 µm and a temporal resolution of 33.4 µs, the system was successfully realized at the Beijing Synchrotron Radiation Facility 3W1 beamline. This innovative approach opens up new avenues for studying the dynamic properties of materials in situ.

Potential distribution and ecological impacts of Acmella radicans (Jacquin) R.K. Jansen (a new Yunnan invasive species record) in China.

BACKGROUND ACMELLA RADICANS: (Jacquin) R.K. Jansen is a new invasive species record for Yunnan Province, China. Native to Central America, it has also been recently recorded invading other parts of Asia. To prevent this weed from becoming a serious issue, an assessment of its ecological impacts and potential distribution is needed. We predicted the potential distribution of A. radicans in China using the MaxEnt model and its ecological impacts on local plant communities and soil nutrients were explored. RESULTS: Simulated training using model parameters produced an area under curve value of 0.974, providing a high degree of confidence in model predictions. Environmental variables with the greatest predictive power were precipitation of wettest month, isothermality, topsoil TEB (total exchangeable bases), and precipitation seasonality, with a cumulative contribution of more than 72.70% and a cumulative permutation importance of more than 69.20%. The predicted potential suitable area of A. radicans in China is concentrated in the southern region. Projected areas of A. radicans ranked as high and moderately suitable comprised 5425 and 26,338 km2, accounting for 0.06 and 0.27% of the Chinese mainland area, respectively. Over the 5 years of monitoring, the population density of A. radicans increased while at the same time the population density and importance values of most other plant species declined markedly. Community species richness, diversity, and evenness values significantly declined. Soil organic matter, total N, total P, available N, and available P concentrations decreased significantly with increasing plant cover of A. radicans, whereas pH, total K and available K increased. CONCLUSION: Our study was the first to show that A. radicans is predicted to expand its range in China and may profoundly affect plant communities, species diversity, and the soil environment. Early warning and monitoring of A. radicans must be pursued with greater vigilance in southern China to prevent its further spread.

Effects of ambient air pollution from shipping on mortality: A systematic review.

BACKGROUND: Shipping contributes to air pollution causing adverse health effects. We conducted for the first time a systematic review on the health and economic impacts of ambient air pollution from shipping emissions. METHODS: We performed a systematic search in PubMed, Web of Science, EBSCO (Medline), and Scopus of all time up to December 2023. We then inter-compared semi-quantitatively the results of the included eligible studies. RESULTS: We identified 23 eligible studies, 22 applying health impact assessment, and 1 using epidemiological methods. These studies used different methods for the evaluation of emissions, dispersion, and exposure, and for the exposure-mortality risk functions for exposure to shipping emissions for 1-2 years. The estimated excess global all-cause mortality from six studies ranged between 1 and 5 deaths per 100,000 person-years. However, the heterogeneity of the methods and critical gaps in the reporting seriously limited the synthesis of the evidence on health and economic effects of shipping emissions. Sufficient spatial and temporal resolutions in both dispersion and exposure modeling, as well as presentation of uncertainties is needed. Health impact assessment should present the results with all the main risk functions and population attributable risks, and the magnitude of the effect should be expressed in excess number per a given person-time or per population size. Economic effects should also cover work productivity, mental well-being, and cognitive functions. CONCLUSIONS: We recommend that future studies should properly evaluate and report the uncertainty ranges and the confidence limits of the results. Rigorous studies are needed on multipollutant exposures, exposures from various source categories, and exposures attributed to various particulate matter measures. Studies should report the health impact measures in a format that facilitates straightforward inter-study comparisons. Further research should also specifically report the used grid spacings and resolutions and evaluate whether these are optimal for the task.

[A longitudinal study of subjective olfactory function post-operatively in chronic rhinosinusitis patients with asthma and analysis of influencing factors].

Objective:To evaluate the subjective olfactory function in chronic sinusitis（CRS）patients with asthma after nasal endoscopic surgery and associated factors that may affect olfactory function. Methods：The study included 90 CRS patients with asthma from January 2008 to December 2020，and all of them underwent endoscopic sinus surgery（ESS）. VAS score of olfactory function before and after surgery were collected，and the data at baseline，3 months，6 months，1 year，3 years，5 years，8 years and 10 years after surgery were compared. Factors affecting olfactory function were analyzed in a generalized mixed linear model，which including age，surgical procedure，allergic rhinitis and so on.Results： The olfactory VAS scores were significantly lower at 3 months，6 months，1 year，3 years，and 5 years postoperatively compared with baseline，and the difference was statistically significant（P<0.05）.Olfactory VAS scores at 8 and 10 years postoperatively were not statistically different from baseline（P>0.05）.Age（≥60 years），aspirin intolerance syndrome，Lund-Kennedy score，modified sinus CT olfactory cleft score，and follow-up time were risk factors, and radical sinus surgery is a protective factor.Conclusion：Subjective olfactory scores in CRS patients with asthma after ESS remain relatively stable for 5 years postoperatively.Prior history of surgery did not affect postoperative subjective olfactory scores. Age，aspirin intolerance syndrome, Lund-Kennedy score，modified sinus CT olfactory cleft score, follow-up time，and surgical approach were strongly associated with subjective olfactory scores in CRS patients with asthma，and radical surgery had a protective effect on olfaction.

Systematic hand-held echocardiography in patients hospitalised with acute coronary syndrome.

AIMS: Transthoracic echocardiography is recommended in all patients with acute coronary syndrome but is time-consuming and lacks an evidence base. We aimed to assess the feasibility, diagnostic accuracy and time-efficiency of hand-held echocardiography in patients with acute coronary syndrome and describe the impact of echocardiography on clinical management in this setting. METHODS AND RESULTS: Patients with acute coronary syndrome underwent both hand-held and transthoracic echocardiography with agreement between key imaging parameters assessed using kappa statistics. The immediate clinical impact of hand-held echocardiography in this population was systematically evaluated.Overall, 262 patients (65±12 years, 71% male) participated. Agreement between hand-held and transthoracic echocardiography was good-to-excellent (kappa 0.60-1.00) with hand-held echocardiography having an overall negative predictive value of 95%. Hand-held echocardiography was performed rapidly (7.7±1.6 min) and completed a median of 5 [interquartile range 3-20] hours earlier than transthoracic echocardiography. Systematic hand-held echocardiography in all patients with acute coronary syndrome identified an important cardiac abnormality in 50% and the clinical management plan was changed by echocardiography in 42%. In 85% of cases, hand-held echocardiography was sufficient for patient decision-making and transthoracic echocardiography was no longer deemed necessary. CONCLUSIONS: In patients with acute coronary syndrome, hand-held echocardiography provides comparable results to transthoracic echocardiography, can be more rapidly applied and gives sufficient imaging information for decision-making in the vast majority of patients. Systematic echocardiography has clinical impact in half of patients, supporting the clinical utility of echocardiography in this population, and providing an evidence-base for current guidelines.

Can China's carbon generalized system of preferences reduce urban residents' carbon emissions? Evidence from a quasi-natural experiment.

The carbon generalized system of preferences (CGSP) is an innovative incentive mechanism implemented by the Chinese government, which has also become an important part of carbon emission reduction at the living end, and it is of great significance to study whether the Pilot Policy can reduce the carbon emissions of residents. This study firstly accounts for the total carbon emissions and per capita carbon emissions of the residents of 284 cities in China, and on this basis, adopts the SCM method to quantitatively study and analyze the overall and local implementation effects of CGSP in China by taking the first batch of CGSP pilots in China as an example, and further applies the mediation effect model to test the pathways of the role of CGSP. The main findings of the study are as follows: (1) During the period of 2010-2020, the total carbon emissions from urban residents' living in China showed a yearly growth trend, from 36,623.98 ×10-2Mt in 2010-85,241.20 ×10-2Mt in 2020, an increase of 8.83%. Total carbon emissions present a structural difference of "electricity consumption > central heating > private transport > gas (oil, natural gas) consumption". (2) Overall, the implementation of the CGSP had a robust positive impact on the overall carbon emission reduction in the pilot cities, with an average annual emission reduction effect value of 36.53 ×10-2Mt. Locally, the annual net policy effect values of Dongguan, Zhongshan, Heyuan, and Guangzhou are 6169.79 ×10-2, 26,600.17 ×10-2, 17,081.34 ×10-2 and 9393.36 ×10-2Mt respectively. (3) CGSP has a good carbon emission reduction effect by suppressing the impact on residents' carbon emissions through enhancing the city's innovation capacity and promoting electricity saving and consumption reduction, while the mediating effect played by the promotion of green and low-carbon travel in the pilot policy is not significant. Finally, based on the research findings, relevant suggestions are targeted.

Cost-Effectiveness and Budget Impact Analyses of Selective Internal Radiation Therapy versus Atezolizumab Plus Bevacizumab from a German Statutory Health Insurance Perspective.

Purpose: To compare personalized dosimetry with yttrium-90 (90Y)-loaded glass microspheres (SIRT) vs atezolizumab and bevacizumab (A+B) in hepatocellular carcinoma (HCC) treatment in terms of cost-effectiveness and budget impact from a German statutory health insurance (SHI) perspective. Patients and Methods: Cost-effectiveness analysis (CEA) and budget impact analysis (BIA) models were developed in MS Excel. The available key studies (IMbrave150 and DOSISPHERE-01) suggest that both strategies are comparable in terms of progression-free survival and overall survival in HCC, but a difference in severe adverse events (SAE) in favor of SIRT was observed. Accordingly, the CEA model investigates the endpoints "cost per SAE avoided" and "cost per quality-adjusted life year (QALY) gained", whereas the BIA simulates the impact of a stepwise re-allocation of current market share to the option which emerges as more cost-effective from the CEA. Results: The model suite estimated a mean annual total per-patient costs of € 29,984 for SIRT, compared to € 75,725 for A+B. SIRT was associated with a lower number of SAE and a higher number of QALYs compared to A+B. Switching additionally 25% of the eligible patients (≈500) from systemic therapy to SIRT could generate annual savings of approximately € 22.6 million Euros to the SHI. Conclusion: SIRT was identified as dominant treatment strategy. SIRT use not only saves SHI expenditure compared to systemic immunotherapy but also yields extra QALYs. This positions SIRT as the dominant and more cost-effective treatment strategy for patients with HCC. The savings to the SHI system, derived from the BIA conducted, become increasingly significant with rising adoption rates of SIRT.

The Psychological Impact and Behavioral Changes Among the Medical Students of Islamabad and Rawalpindi Due to the COVID-19 Pandemic.

Introduction The onset of the COVID-19 pandemic necessitated a shift in global lifestyles as individuals sought to safeguard themselves and their loved ones from the virus. This adaptation involved embracing a distinct way of life marked by social distancing, reduced outdoor engagements, and home confinement. Consequently, this period of quarantine led to diminished social interactions, challenges in accessing essential resources such as food, heightened unemployment rates, and increased burden on healthcare systems. Understandably, these circumstances gave rise to heightened emotions including fear, depression, and anxiety. In response to these dynamics, our research aimed to explore the psychological and behavioral shifts among medical students residing in Islamabad and Rawalpindi (the twin cities of Pakistan) during the year 2020 amidst the COVID-19 pandemic. Methods A structured, self-administered questionnaire was constructed, based on previously conducted surveys, assessing the psychological impact and behavioral changes due to the COVID-19 pandemic. The questionnaire was made available online through Google Forms and was provided to students of the various medical colleges of the twin cities of Pakistan. The results were further stratified based on gender. Results Categorical data were collected from 400 medical students studying in Rawalpindi and Islamabad. The negative psychological impact was shown by increased stress, 260 (65%), feeling of less energy, 211 (52.8%), and increased anxiety with upper respiratory symptoms, 202 (50.5%). Behavioral changes were also a reflection of the psychological changes depicted by an increased use of disinfectants, 256 (64%), increased desire to clean surfaces, 262 (65.6%), increased use of soaps and detergents, 300 (75%), reduced number of times one left their house 281, (70.3%), and decreased consumption of food products from outside, 226 (56.5%). When compared between the two genders, females had significantly increased stress levels (p=0.034), decreased food consumption from outside (p=0.026), and increased avoidance of people not wearing masks (p=0.001). Conclusion Through our study, we identified the various psychological and behavioral changes among our population due to the COVID-19 pandemic. Our study not only highlights these changes but also discusses the various ways to address them. This study would help relevant organizations to understand the broader aspect of how this pandemic has affected individual lives and will also give them ideas regarding how to cater to these changes in a positive way.

Assessment of patterns and related factors in using social media platforms to access health and oral health information among Sri Lankan adults, with special emphasis on promoting oral health awareness.

BACKGROUND: Social media has evolved beyond its conventional purpose of communication and information sharing to become a potent tool for disseminating health and oral health awareness. This study seeks to assess the patterns and related factors of using social media platforms to access health and oral health information among Sri Lankan adults, with special emphasis to promotion of oral health awareness. METHODS: In March 2023, individuals aged ≥ 18 years residing in Sri Lanka, who are users of social media participated in this electronic questionnaire-based survey. Statistical analyses of the collected data were done using the SPSS version 21 software, with a p-value of < 0.05 set to determine the level of statistical significance. RESULTS: A total of 421 persons participated in this survey. Majority (68.4%) belonged to the age category of 18 to 30 years, and 55.5% were females. WhatsApp (96.8%) was the most frequently used social media platform across all age groups and both genders. Statistically significant differences were identified between genders in the usage of Telegram, Twitter, and Viber within the 18-30 years age category, with a higher percentage of males using these platforms (p ≤ 0.05). Similar significant differences were observed in the 31-40 years age group for WhatsApp and Telegram (p ≤ 0.05). Among 95.4% of online health information seekers, YouTube (74.9%) was the most popular platform. One-quarter of the respondents preferred social media platforms, and 22.3% preferred websites for obtaining oral health information. Furthermore, 74.9% had positive opinions on obtaining oral health information via social media, while only 17% reported pleasant experiences with social media platforms for oral health promotion. In assessing the reliability of oral health information on social media, 48% relied on the quality of the information. The most preferred source of oral health information was short videos from professionals (43.1%). Additionally, 69.5% reported changes in their oral health behaviours after accessing information through social media. CONCLUSION: Social media is a viable platform for promoting public oral health awareness in Sri Lankan; hence, workable strategies need to be employed, to further ensure its effective and wider use in a culturally and socioeconomically diverse country like Sri Lanka.

Identifying the criteria for community-centred Life Cycle Sustainability Assessment of estate regeneration schemes.

Identifying the overall environmental, and socioeconomic impacts of different estate regeneration scenarios can contribute to the overall sustainability of such schemes. Life Cycle Sustainability Assessment (LCSA) is an appropriate tool for assessing holistic sustainability. To achieve resilient societies, the interests of communities should be considered in decision making. This paper proposes a method for incorporating community needs in identifying sustainability metrics for the sustainability assessment of estate regeneration schemes. A literature review in the field of sustainability assessment of buildings is conducted followed by a mixed methods empirical research. Collection of data has been through surveys, an interview, and an evaluation questionnaire. Data has been analysed through statistical and thematic analysis and triangulation of the results. The findings have consistently yielded the limitations of the scope of the current sustainability assessment methodologies, especially for lack of attention to societal impacts of regeneration. The results have justified the need for this research to employ participatory approaches for identifying a relevant set of sustainability indicators and criteria for assessing the lifetime impacts of estate regeneration schemes. Issues related to community involvement in decision making, maintenance and management, community facilities, refurbishment, and disruption have been identified as the stakeholders' top priorities. Mental Health and Socioeconomic Values have been introduced as new criteria. The findings confirm the need for an in-depth approach towards identifying the regeneration priorities of the communities for the scope of LCSA studies. The identified list of criteria can apply to other studies of this context for an equitable approach for selecting the indicators across different criteria and for communicating the LCSA results with different stakeholders.

Linking patient-reported oral and general health-related quality of life.

Background: The relationship between oral and overall health is of interest to health care professionals and patients alike. This study investigated the correlation between oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL) in a general adult population. Methods: This cross-sectional study used a convenience sample of adult participants (N = 607) attending the 2022 Minnesota County and State fairs in USA, the 5-item Oral Health Impact Profile (OHIP-5) assessed OHRQoL, and the 10-item PROMIS v.1.2 Global Health Instrument assessed HRQoL. Spearman and Pearson correlations were used to summarize the bivariable relationship between OHRQoL and HRQoL (both physical and mental health dimensions). A structural equation model determined OHRQoL-HRQoL correlations (r). Correlations' magnitude was interpreted according to Cohen's guidelines (r = 0.10, 0.30, and 0.50 to demarcate "small," "medium," and "large" effects, respectively). Results: OHRQoL and HRQoL correlated with r = 0.52 (95% confidence interval, CI: [0.50-0.55]), indicating that the two constructs shared 27% of their information. According to Cohen, this was a "large" effect. OHRQoL, and the physical and mental HRQoL dimensions correlated with r = 0.55 (95% CI: [0.50-0.59]) and r = 0.43 (95% CI: [0.40-0.46]), respectively, indicating a "large" and a "medium" effect. OHRQoL and HRQoL were substantially correlated in an adult population. Conclusion: Using OHIP-5 to assess their dental patients' oral health impact allows dental professionals to gain insights into patients' overall health-related wellbeing.

Investigating the effects of underwater noise from two vessels on the behaviour of short-finned pilot whales.

Multiple whale-watching vessels may operate around cetaceans at any one time, and targeted animals may experience underwater noise effects. We hypothesised that the cumulative noise of two vessels with low source levels (SLs) will elicit lower behavioural disturbance in short-finned pilot whales (Globicephala macrorhynchus) compared to a single vessel with a higher SL. We measured the behaviour of whales during 26 controls (stationary vessel >300 m) and 44 treatments off Tenerife (Canary Islands, Spain). Treatments consisted of vessel approaches mimicking whale-watch scenarios (distance ∼60 m, speed 1.5 kn). Approaches with two simultaneous vessels, with maximum cumulative mid and low-frequency (0.2-110 kHz) weighted source levels (SLsMF-LF) 137-143 dB, did not affect mother-calf pairs' resting, nursing, diving, respiration rate or inter-breath interval. However, a louder single vessel approach with twin petrol engines at SLsMF-LF 139-151 dB significantly decreased the proportion of time resting for the mother. The results suggest that if a single or two vessels are present, if the cumulative SL is < 143 dB, the behavioural disturbance on the whales will be negligible. By examining noise effects from multiple vessels on the behaviour of pilot whales, the importance of incorporating a noise threshold into whale-watching guidelines was emphasised.

Gas flaring: technicalities, challenges, and the economic potentials.

Gas flaring has been identified as a major contributor to global warming and climate change. It is used either as a safety measure or as a means of disposal for technical or economic reasons. Over 250 toxins have been directly/indirectly associated with gas flaring and its associated emissions. Most of these toxins have been known to have significant inimical impacts on humans' health, plant biodiversity, and the environment. With the recent rise in global energy insecurity, several EU countries have either returned to coal power generation or extended the lifetime of their coal-fired plants thereby increasing anthropogenic carbon emissions. This increase in carbon emission has necessitated the re-evaluate of gas flare practices vis-à-vis the environmental challenges and the financial potentials. This paper presents a holistic review of gas flaring, its types, composition, systems design, estimation methods, social and environmental challenges, the abatement measures, and the re-utilization strategies. It identified the potential to save a minimum of US$10.4 billion globally if more stringent gas flare abatement measures were pursued. Furthermore, the paper highlights the recent trends in flare gas re-utilization technologies such as the production of bioproducts which has been reported to hold a potential for an annual production of about 148 million bbl of biocrude and 67 million metrics of algae protein from 140 bcm of globally flared gas. Finally, it explored the possible way forward and stringent measures that can be pursued to disincentivize gas flare and also increase investments in gas processing technologies.