General Tool Research Articles

Towards a general tool chain integration platform for multi-disciplinary analysis and optimization in wind energy

To enable easier uptake and flexible usage for the wind energy community, a general tool chain integration platform for multi-disciplinary analysis and optimization, TopDesign, is proposed and developed. This work describes its concept and the initial implementation. The platform is written in Python and provided as an open source framework. The design of this platform puts emphasis on flexibility, usability and extensibility. General model classes with standard interfaces, which can wrap custom tools/models in different formats based on different programming languages, will be provided together with examples that are easy to understand and modify. Coupling tools/models into a system thus becomes an easy task of connecting models by inputs and outputs and defining workflow with a directed graph. To demonstrate the usage of the proposed platform, we implement a wind farm evaluation system by coupling the PyWake model, the FLORIS model and self-written constraint models in the platform and apply it in solving wind farm layout optimization problems with two algorithms, as implemented in an in-house optimization Python library. A case study for a wind farm composed of 9 turbines shows the potential of the proposed platform and methodology.

Diabetic Foot Ulcers: Impact on Quality of Life and Instruments for Its Measurement

Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, significantly impacting patients' quality of life (QoL) due to the heightened risk of infection and amputation. Pharmacists play a crucial role in managing diabetes and its complications, and assessing QoL can be a valuable tool for monitoring treatment success and medication effectiveness. This review explores instruments used to measure QoL in patients with DFUs, encompassing both general and disease-specific tools. We examine the impact of DFUs on QoL and discuss various theoretical frameworks used to understand this complex relationship.

Barbed Pharyngoplasty simulation using a 3D-printed model: design and validation study.

Learning how to use barbed sutures and perform Barbed Pharyngoplasty (BP) is challenging due to limited surgical training opportunities. This work aims to design, develop, and validate a new 3D surgical simulator to train ENT residents and specialists in performing BP. The Barbed Pharyngoplasty Simulator (BPS) was designed using diagnostic images of the facial mass and testing different materials to replicate the mucosal and bony tissues. ENT specialists with experience in BP and ENT residents were included in the validation study and were asked to perform the Alianza BP. After the simulation, they compiled the Face and Content Validity Questionnaires. The BPS consists of a reusable cranial structure that contains the disposable palatopharyngeal structure, replicating the palatal structures and the tongue. Fifteen experienced ENT specialists and nine residents were included in the study. Findings demonstrated that the BPS faithfully replicated the muscular and fibrous-bony palatopharyngeal structures, with only 11% of residents having a negative opinion of the mucosal tissue. All the participants positively rated the sensation of using surgical instruments on the simulator. Also, ENT residents rated all aspects of the content validity test from normal to excellent, while specialists rated the BPS as a general training tool from normal to excellent; for lateral pharyngoplasty, BP, and Alianza, only 6.7% of participants disagreed with its usefulness, and 13.3% disagreed with it for anterior pharyngoplasty. The BPS proposed in this preliminary study can potentially be a valuable tool in BP surgical training for residents and young otolaryngologists.

Spatial analysis of aerial remote sensing responses in the hotspot of terrorist attacks in Nigeria

ABSTRACT Ensuring a peaceful society has been the focus of different countries of the world. This has been jeopardized by the constant attacks from different terrorist groups, which has made some areas become the hotspot of terrorist attacks. Various techniques including remote sensing technology have been applied in curbing the attacks. However, an understanding of the spatial pattern of remote sensing responses to terrorist attacks especially in the hotspot areas will enhance the decision-makers and stakeholders’ better planning against terrorists. We present that the spatial analysis of the trend and pattern of terrorist attacks and aerial remote sensing responses in the hotspot of Nigeria using the Getis-Ord General tool in ArcGIS 10.8. We conclude that aerial remote sensing responses against terrorist attacks can be more effective if the spatial pattern of attacks and responses can be constantly considered in security monitoring and surveillance for both pro-active and counter-attack operations.

#1030 Addressing the unmet need of patient reported outcomes in ANCA associated vasculitis, in routine clinical practice

Abstract Background and Aims ANCA associated vasculitis (AAV) is associated with increased morbidity. Recent years has seen improvement in clinical outcomes yet little work has been done to better understand the patient's role within this condition. Patient reported outcome measures (PROMs) are increasingly standard in clinical research outcomes, as well as an overall indicator for good quality patient care. With the exception of Robson et al AAV-PRO [1], little research has been done to develop validated disease specific tools for patients living with AAV. We aim to develop a disease specific tool that can be used in clinical practice to aid patients and clinicians in understanding and track changes in health-related quality of life (HRQoL) over time. Method AAV patients from a single centre were invited to take part in focus groups conducted using a semi-structured topic guide. Participants were asked to discuss topics relating to four broad areas; 1) the effects of AAV on everyday life and living, 2) the effects of treatment on everyday life and living, 3) the role of patients in health management and the patient experience 4) a review of existing generic and disease specific PROM tools (SF-36 and AAV-PRO). Audio transcript of each focus group was transcribed verbatim and data was analysed using a combination of inductive and deductive framework analysis [2]. Results Twenty-eight patients with AAV were invited to participate, 19 attended one of three, 2.5 hour focus groups, 2 patients failed to attend, 4 declined and 3 were unavailable. The mean age of participants was 66.6 +9.4 years and there was a near equal male to female split (10:9). The median time from diagnosis as 7.4 years. Three participants had active or newly diagnosed AAV with BVAS scores of >10. Five participants had previously required dialysis with 1 receiving a renal transplant. All participants received glucocorticoid and immunosuppressive therapy (cyclophosphamide and or Rituximab), 15 (78.9%) were still receiving immunotherapy. Full analysis of the qualitative data is being undertaken. Preliminary findings outlined what was most important to participants when considering HRQoL. Areas acknowledged included; self-identity, social roles e.g. fulfilling caring responsibilities, fears of relapse and disease and treatment burden. Fifty-six deductive and inductive codes were identified which have been further categorised. Participants felt existing tools lacked consideration of some key issues. Scoring systems were considered to be negativity worded e.g. mild, moderate, severe, with the term ‘none’ being the only positive option. Participants reported that existing tools overlooked positive factors which impact HRQoL, such as symptom validation, close clinician monitoring and improvement with treatment. Limitations were noted when trying to address transient or inconsistent symptoms and difficulty separating vasculitis from other health conditions when answering questions. Participants expressed a preference for using a PROM as part of their clinical care and felt that completing it prior to clinic would be most helpful and facilitate discussions with healthcare professionals. The use of an electronic-PROM was widely supported and would support clinicians and patients to monitor changes over time. Conclusion The AAV-PRO represents a significant advancement over generic tools such as the SF-36, however, existing PROMs are not without limitations and are primarily used in research practices. Our study revealed that patients desire active participation in HRQoL discussions and further work to incorporate this into the clinic setting is needed. We are continuing to develop a PROM tool that can be used to assess patients HRQoL in relation to their AAV in the outpatient setting. We believe this will allow a deeper understanding of the disease burden and could support a comprehensive, patient-centred approach to decision-making, offering new insights and identifying the need for supportive care. On a broader scale, these insights can be utilized to compare treatments, shed light on inequalities and facilitate enhancements in services.

Seismic moment tensor solutions and geophysical settings in the Philippine Sea basin mapped by GMT

The study is focused on mapping geophysical settings on the margins of the Philippine Sea Plate (PSP). Active volcanism and seismic situation along the margins of the Philippine Sea Basin (PSB) shows earthquake events demonstrating high seismicity of the region caused by tectonic plate subduction. The aim was to perform cartographic mapping of the earthquake events using Generic Mapping Tools (GMT) modules, to analyze seismic situation through visualization of the geophysical datasets. The data was processed by GMT using multi-source data: GEBCO, CMT and ISC seismic data. Technically, a set of GMT modules was used ('psmeca', 'psvelo', 'grdtrack', 'grdimage') for data modelling and mapping. An application of GMT functionality is presented by selected code snippets with selected code snippets for 'psmeca' and 'psvelo', 'img2grd', 'img2grd' modules. Current paper presents a report on the cartographic techniques applied for geophysical mapping. Centroid moment tensor solutions are visualized for shallow depth earthquakes of Mw <10 along the PSB margins from 1976 to 2010. Earthquakes along the tectonic plate subduction zone are shown by GMT. Data from Global Centroid-Moment-Tensor (CMT) Project. Presented and explained GMT code snippets contribute to the development of methods in geological mapping using GMT scripting toolset, for visualizing focal mechanisms.

SVDF: enhancing structural variation detect from long-read sequencing via automatic filtering strategies.

Structural variation (SV) is an important form of genomic variation that influences gene function and expression by altering the structure of the genome. Although long-read data have been proven to better characterize SVs, SVs detected from noisy long-read data still include a considerable portion of false-positive calls. To accurately detect SVs in long-read data, we present SVDF, a method that employs a learning-based noise filtering strategy and an SV signature-adaptive clustering algorithm, for effectively reducing the likelihood of false-positive events. Benchmarking results from multiple orthogonal experiments demonstrate that, across different sequencing platforms and depths, SVDF achieves higher calling accuracy for each sample compared to several existing general SV calling tools. We believe that, with its meticulous and sensitive SV detection capability, SVDF can bring new opportunities and advancements to cutting-edge genomic research.

Systems and Methods for Continuous Evolution of Enzymes.

Directed evolution generates novel biomolecules with desired functions by iteratively diversifying the genetic sequence of wildtype biomolecules, relaying the genetic information to the molecule with function, and selecting the variants that progresses towards the properties of interest. While traditional directed evolution consumes significant labor and time for each step, continuous evolution seeks to automate all steps so directed evolution can proceed with minimum human intervention and dramatically shortened time. A major application of continuous evolution is the generation of novel enzymes, which catalyze reactions under conditions that are not favorable to their wildtype counterparts, or on altered substrates. The challenge to continuously evolve enzymes lies in automating sufficient, unbiased gene diversification, providing selection for a wide array of reaction types, and linking the genetic information to the phenotypic function. Over years of development, continuous evolution has accumulated versatile strategies to address these challenges, enabling its use as a general tool for enzyme engineering. As the capability of continuous evolution continues to expand, its impact will increase across various industries. In this review, we summarize the working mechanisms of recently developed continuous evolution strategies, discuss examples of their applications focusing on enzyme evolution, and point out their limitations and future directions.

Vesicle and reaction-diffusion hybrid modeling with STEPS

Vesicles carry out many essential functions within cells through the processes of endocytosis, exocytosis, and passive and active transport. This includes transporting and delivering molecules between different parts of the cell, and storing and releasing neurotransmitters in neurons. To date, computational simulation of these key biological players has been rather limited and has not advanced at the same pace as other aspects of cell modeling, restricting the realism of computational models. We describe a general vesicle modeling tool that has been designed for wide application to a variety of cell models, implemented within our software STochastic Engine for Pathway Simulation (STEPS), a stochastic reaction-diffusion simulator that supports realistic reconstructions of cell tissue in tetrahedral meshes. The implementation is validated in an extensive test suite, parallel performance is demonstrated in a realistic synaptic bouton model, and example models are visualized in a Blender extension module.

Time-Domain Self-Clustering-Based Diagnosis Applied on Open Cathode Fuel Cell

The ability of a diagnosis tool to observe an abnormal state of a system remains a major issue for health monitoring. For that purpose, several diagnosis tools have been proposed in the literature. Most of them are developed for specific system characterization, and the genericity of the approaches is not considered. Indeed, most approaches proposed in the literature are based on an expert offline consideration that makes it hard to apply the strategy to other systems. It is therefore important to develop a diagnostic tool that takes as little as possible expert knowledge to reduce the dependency between the tool and the system. This paper, therefore, focuses on the application of a generic diagnosis tool on an open cathode fuel cell. The goal is to feed the diagnosis algorithm with a voltage measurement and let it proceed to a self-clustering of the signal components. Each cluster’s interpretation remains to be established by the expert point of view that is then involved downstream of the diagnosis tool.

A space marching method for sonic boom near field predictions

The conventional sonic boom propagation prediction method widely adopted in supersonic aircraft design involves a two-step procedure. In the first step, a compressible viscous or inviscid Computational Fluid Dynamics analysis is applied to the aircraft geometry at flight conditions to produce a flow field solution near the aircraft. Then in the second step, a one dimensional nonlinear Burgers’ equation model is used to propagate sonic boom signature traces from the near field solution at flight altitude to the ground along a ray path. For an accurate ground signature prediction the near field signature must be accurately modeled at a sufficient distance from the aircraft flight path in order to minimize errors in the one dimensional propagation model. This is a very challenging task for general purpose CFD tools in a design environment because the cost of maintaining highly accurate off-body solutions increases dramatically as the radial distance is enlarged in the computational domain. It is also particularly difficult to apply these tools for wave propagation because the algorithms are normally lower order and numerically dissipative and dispersive. In this work a space marching procedure based on an optimized higher order finite difference method is developed and applied in conjunction with a CFD solution concentrated in the close vicinity of the aircraft. This new approach is much more efficient, compared to previous methods, in providing highly accurate near field signatures for full carpet ground predictions. Results indicate that near field signatures retain more waveform shape information farther from the aircraft geometry while reducing the CFD cost significantly. The predicted ground signature is also shown to converge in shape as the radial distance of the near field signature grows, which is indicative of a more ideal initial condition being supplied to the one dimensional wave propagation to ground. This feature is very difficult to replicate in a tractable manner with common CFD approaches used in design.

Transformative Impact of Technology in Landscape Architecture on Landscape Research: Trends, Concepts and Roles

The role of technology in landscape architecture (TLA) has significantly evolved since the 19th century, increasingly integrating with digital tools and technologies in the 21st century. Despite its growing importance, there is a notable deficiency in the scholarly literature regarding the progression of TLA trends and their interplay with the core domains and research themes within landscape research. The influence of TLA on landscape research remains ambiguous, especially concerning its ability to generate new knowledge and impact design and sustainability practices. Furthermore, there is a critical need to delineate how TLA differs from allied general digital technology tools and to identify specific specializations that are emerging within the TLA field. To explore the above gaps, this study utilized a mixed methods approach involving secondary data from peer-reviewed publications, primary data from the archival research of winning projects, and expert interviews based on the two major research types of “Research through Design (RTD)” and “Research for Design (RFD)” to explore the TLA’s contribution. This research is significant as it: (1) identified the trend of TLA; (2) conceptualized the TLA, and (3) identified its role in relation to the core domains and research themes of landscape research.

Exploring the Link Between Sensory Processing and Psychopathology in a Community Sample of Young Adults: Bayesian Network Analyses

AbstractSensory processing is a fundamental aspect of human experience, and varies significantly between individuals, potentially affecting individual functioning, behaviour, and mental health. This study investigated the associations between sensory processing and psychopathology in a sample of the general population. Participants responded to a general psychiatric screening tool (DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult) and to the Adolescent/Adult Sensory Profile (AASP) questionnaire. The sample comprised 1108 young adults (77.25% females, mean age 22.6). Data were analysed using item response theory and Bayesian network analyses, revealing specific associations between sensory profiles and psychopathological dimensions. Specifically, we detected associations between the low registration sensory profile and the dimensions of psychosis, substance use, and mania. Sensation seeking was associated with mania. Sensory sensitivity was related to depression and mania, while sensation avoiding was inversely correlated with mania. These findings suggest that reduced external sensory awareness may be linked to a predisposition to psychosis, while a multifaceted sensory processing pattern may indicate vulnerability to mood disorders. Assessing sensory processing could yield crucial insights into individual susceptibilities to mental disorders and help identify targeted preventive and therapeutic strategies

Singular stress field induced two-dimensional topological polar structures in SrTiO3: Topological number manipulation via loading modes

Topological structures in condensed matter attract much attention of the scientific community due to their unique and significant properties. In contrast to the well-explored topological spin structures such as meron, and skyrmion in ferromagnetic materials, ferroelectrics face challenges in forming topological polar structures due to the absence of a spontaneous driving force. Nevertheless, the coupling effect between polarization and strain (gradient), e.g. piezoelectricity and flexoelectricity, provides a mechanical approach to induce topological polar structures that reflect the intricate features of the strain (gradient) field. This study demonstrates the creation of a topological polar structure through a mode II crack-induced singular stress field in SrTiO3 by using phase-field simulations. Furthermore, under mixed-mode loading of mode I and mode II, alterations in the mode ratio induce a variety of topological structures, including a novel structure (winding number nv=4) that is absent under the single-mode loading. Our study demonstrates that topological strain field can be a general and effective tool to generate and control topological polar structures.

Design of 3D-Printed Heterogeneous Reactor Systems To Overcome Incompatibility Hurdles when Combining Metal and Enzyme Catalysis in a One-Pot Process.

Combining chemo- and biocatalysis enables the design of novel economic and sustainable one-pot processes for the preparation of industrial chemicals, preferably proceeding in water. While a range of proofs-of-concept for the compatibility of such catalysts from these two different "worlds of catalysis" have recently been demonstrated, merging noncompatible chemo- and biocatalysts for joint applications within one reactor remained a challenge. A conceptual solution is compartmentalization of the catalytic moieties by heterogenization of critical catalyst components, thus "shielding" them from the complementary noncompatible catalyst, substrate or reagent. Exemplified for a one-pot process consisting of a metal-catalyzed Wacker oxidation and enzymatic reduction as noncompatible individual reactions steps, we demonstrate that making use of 3D printing of heterogeneous materials containing Cu as a critical metal component can overcome such incompatibility hurdles. The application of a 3D-printed Cu-ceramic device as metal catalyst component allows an efficient combination with the enzyme and the desired two-step transformation of styrene into the chiral alcohol product with high overall conversion and excellent enantioselectivity. This compartmentalization concept based on 3D printing of heterogenized metal catalysts represents a scalable methodology and opens up numerous perspectives to be used as a general tool also for other related chemoenzymatic research challenges.

Design von 3D‐gedruckten heterogenen Reaktorsystemen zur Überwindung von Inkompatibilitätshürden bei der Kombination von Metall‐ und Enzym‐Katalyse in einem Eintopf‐Prozess

AbstractDie Kombination von Chemo‐ und Biokatalyse ermöglicht die Entwicklung neuartiger ökonomischer und nachhaltiger Eintopfverfahren für die Herstellung von Industriechemikalien, welche vorzugsweise in Wasser ablaufen. Während kürzlich anhand einer Reihe von Beispielen der Nachweis für die Kompatibilität solcher Katalysatoren aus diesen beiden unterschiedlichen “Welten der Katalyse” aufgezeigt wurde, blieb die Zusammenführung nicht kompatibler Chemo‐ und Biokatalysatoren für gemeinsame Anwendungen in einem Reaktor eine Herausforderung. Eine konzeptionelle Lösung besteht in der Kompartimentierung der katalytischen Einheiten durch Heterogenisierung kritischer Katalysatorkomponenten, wodurch diese von dem komplementären, nicht kompatiblen Katalysator, Substrat oder Reagenz “abgeschirmt” werden. Am Beispiel eines Eintopfverfahrens, das aus einer Metall‐katalysierten Wacker‐Oxidation und einer enzymatischen Reduktion als nicht‐kompatible Einzelreaktionsschritte besteht, zeigen wir, dass durch den Einsatz des 3D‐Drucks von heterogenen, die kritische Metallkomponente Kupfer enthaltenden Materialien solche Hürden der Inkompatibilität überwinden werden können. Der Einsatz eines 3D‐gedruckten Cu‐Keramikgerüsts als Metallkatalysator‐Komponente ermöglicht eine effiziente Kombination mit dem Enzym und die gewünschte zweistufige Umwandlung von Styrol in das chirale Alkoholprodukt mit hohem Gesamtumsatz und exzellenter Enantioselektivität. Dieses auf 3D‐Druck heterogenisierter Metallkatalysatoren basierende Konzept zur Kompartimentierung stellt eine skalierbare Methodik dar und eröffnet zahlreiche Perspektiven im Hinblick auf dessen Nutzung als allgemeiner Lösungsansatz auch für weitere verwandte chemoenzymatische Forschungsherausforderungen.

DNA-AuNP encoders array Integrating a multi-modal coupled analysis approach for noninvasive precision screening of myocardial function injury disease in children

Limited-species serum biomarkers could only partially reflect the information on myocardial function injury disease in children, leading to some important information being inevitably lost, which affects the judgment of the whole information, resulting in a high rate of false positives and negatives. There is a critical unmet need for noninvasive precision screening for myocardial function injury disease in children. Here, we introduced a multi-modal coupled analysis of the DNA-AuNP encoders to achieve this goal. The DNA-AuNP encoders react with the serum specimen from myocardial function injury disease in children to generate the multi-modal response signals, such as the fluorescence spectrum, size distribution, and surface ζ-potential distribution. Interestingly, we used dark-field microscopy to observe the interface changes between the DNA-AuNP encoder and serum at the microscopic level. Different machine learning algorithms analyze the correlation of a clinical outcome with multi-modal response signals from a target disease. As the number of modal response signals increases, our approach monotonically increases screening performance. The three-modal coupled analysis provided an average accuracy of up to 91.7% using 37 serum specimens in children from myocarditis, myocardial injury, and health. This study provides a highly generic tool for noninvasive screening using a drop of serum.

Experimental Virtual Distillation of Entanglement and Coherence.

Noise is, in general, inevitable and detrimental to practical and useful quantum communication and computation. Under the resource theory framework, resource distillation serves as a generic tool to overcome the effect of noise. Yet, conventional resource distillation protocols generally require operations on multiple copies of resource states, and strong limitations exist that restrict their practical utilities. Recently, by relaxing the setting of resource distillation to only approximating the measurement statistics instead of the quantum state, a resource-frugal protocol, "virtual resource distillation," is proposed, which allows more effective distillation of noisy resources. Here, we report its experimental implementation on a photonic quantum system for the distillation of quantum coherence (up to dimension four) and bipartite entanglement. We show the virtual distillation of the maximal superposed state of dimension four from the state of dimension two, an impossible task in conventional coherence distillation. Furthermore, we demonstrate the virtual distillation of entanglement with operations acting only on a single copy of the noisy Einstein-Podolsky-Rosen (EPR) pair and showcase the quantum teleportation task using the virtually distilled EPR pair with a significantly improved fidelity of the teleported state. These results illustrate the feasibility of the virtual resource distillation method and pave the way for accurate manipulation of quantum resources with noisy quantum hardware.

THE USE OF CULTURAL AND ENVIRONMENTAL HERITAGE IN EDUCATIONAL CONTEXTS BETWEEN SPACES, IDENTITIES, ATTITUDES, AND COGNITIVE WELL-BEING

The paper explores some links between educational research, the use of cultural and environmental heritage and education, where it is possible to combine knowledge, disciplines, and skills to strengthen the cultural profile of the school population, but also to bring about important changes in attitudes and behavior. The world's cultural and environmental heritage, which collects the traces of extraordinary but also tragic events in human history, can act as a unifying force for peaceful coexistence for the whole of humanity, enabling future citizens to participate in democratic debate and make informed choices about the social challenges they face. It therefore contributes not only to the development of knowledge, but also to the ability of children, young people, and adults to understand contemporary problems by placing them in human, social, environmental, historical, and cultural contexts that help them to live. For cultural heritage to contribute to the recovery of knowledge, researchers, teachers, and operators must be able to share a solid research background that allows them to address the various issues relating to the quality of the experiences of use carried out in school contexts, with the aim of improving the learning processes of users. In fact, the cultural and environmental resources of the territory can only be a real methodological resource for improving cognitive well-being and the overall quality of education at all levels if they are seen as useful tools for different types of learning (cognitive, social, etc.) and not as general educational tools. The paper therefore questions the use of cultural and environmental heritage in education and its adequacy with respect to learning conditions, pausing to consider also the role played by attitudes to fruition, highlighting those elements and dimensions that can contribute to redefining the relationship between education, goods, and environment, in the idea of strengthening interpretative repertoires in educational contexts.

A longitudinal study examining the relationship between prioritization scores and changes in impact on life scores in elective surgery patients.

Healthcare systems globally face the issue of resource constraints and need for prioritization of elective surgery. Inclusive, explicit prioritization tools are important in improving consistency and equity of access to surgery across health systems. The General Surgical Prioritization Tool developed by New Zealand's Ministry of Health scores patients for elective non-cancer surgery based on surgeon's clinical judgement and patient derived Impact on Life (IoL) scores. This study aims to measure the changes in patient derived IoL scores after common general surgical procedures to enable direct comparison and inform future prioritization. This longitudinal observational study enrolled 322 participants who had undergone elective general surgical procedures. Participants were contacted 3 to 9 months after their procedures and requested to complete the IoL questionnaire. The primary endpoint was the change in IoL scores after surgery among the different procedures. Overall, 229/304 (75%) participants responded to the questionnaire and there were no significant baseline differences between responders and non-responders. Patients in the gallbladder treatment group had the greatest improvement in IoL scores. Patients across all ethnic groups had similar changes in IoL scores. Multivariate analysis showed that gallbladder surgery (relative to hernia surgery) and pre-surgery IoL scores significantly predicted improvement. The patient reported IoL score recorded at prioritization for surgery all reduced, albeit to varying amounts, after common general surgical procedures. This, combined with the fact that IoL scores predicted post-operative improvement support their inclusion in prioritization tools in addition to surgeon derived components.