High Negative Impact Research Articles

What Is the Relationship Between Forest Footprint and Export of Forest Products? Evidence from Method of Moments Quantile Regression

This study investigates the long-run relationship between forest footprint, which shows the amount of forest area needed for pulp, industrial wood, firewood and timber, and forest products as an environmental indicator. Forest footprint, forest product exports, forest product production, forest areas, biomass consumption, and urbanization variables are used in the analyses with annual data for the period 2000–2017 for selected European Union (EU) countries. As a result of the cointegration analyses, there is a long-run relationship between the variables. According to the results of coefficient estimation, it is concluded that forest product exports and urbanization have a decreasing effect on forest ecological footprint, while forest area, forest product production, and biomass consumption have an increasing effect. According to the Method of Moments Quantile Regression (MMQR) estimation results, it is concluded that forest product exports have a decreasing effect on forest footprint in all quantiles in the analysis period. The production of forest products is determined as the variable with the highest negative impact on the forest’s ecological footprint. The effect of urbanization is calculated as positive, but it is the variable with the lowest impact together with forest area. Biomass consumption is found to significantly reduce the forest footprint. In view of the aforementioned findings, it is recommended that efforts be made to promote high-value added, sustainable, and environmentally friendly production processes in forest products exports. This is considered to be a key strategy to reducing the ecological footprint of forests.

Farnese palace in Caprarola, Italy: Towards a people-centred brand image in a cultural tourism market

The valorization of cultural identity-centered brand icons has become a requested action nowadays, promoting the marketing statement of local heritage sites that aren’t designated as UNESCO World Heritage. Thus, these sites might compete to enhance and safeguard cultural heritage and authentic cultural knowledge. Moreover, lessening the high negative impact of the customization approach on the conservation statement of the cultural asset, the research adopts a people-centered approach developing the interlinkages between cultural tourism marketing and conservative management to enhance the rapport between the community and the palace in a community-based cultural tourism manner. Therefore, this empirical study reviews the cultural significance of the Farnese Palace in Caprarola and its reflection on its marketing statement, developing its brand image. It applies an integrated method that combines quantitative and qualitative analysis. It mainly assesses 165 online questionnaires with the public audience. The findings of this study draw a proposal for generating a people-centered heritage branding image (logo and slogan) of the Farnese Palace in Caprarola that seeks to generate a lifelong learning memory for the community and a long-term brand image for the visitors’ mentality.

Welfare Implications of Low-Dose Atipamezole Reversal of Tiletamine/Zolazepam/Xylazine Anaesthesia in Pigs.

Anaesthesia is sometimes required for the effective restraint of laboratory pigs for sample collection. Yet, anaesthesia can initiate a range of physiological disruptions that can increase variability in study data and lead to poorer animal welfare. Judicious use of anaesthesia can mitigate experimental, human safety, and animal welfare concerns, but it does not eliminate the potential for adverse effects. The use of reversal agents can shorten recovery time and reduce the physiological impacts of anaesthesia but can also cause additional side effects. We, therefore, trialled the use of low-dose atipamezole (0.12 mg/kg) for the antagonism of xylazine in laboratory pigs anaesthetised using a combination of xylazine and zolazepam/tiletamine. We measured time to recovery, selected clinical variables, recovery characteristics, and behaviours to investigate if a low dose of antagonist decreased recovery time and reduced the physiological impacts of anaesthesia whilst avoiding adverse negative side effects. We categorised side effects and behaviours as having either a low or high negative welfare impact based on the potential risk of injury and whether behaviours were displayed before or after return to consciousness. Collectively, our results indicated that while the use of low-dose atipamezole decreased recovery time and improved thermoregulation in most pigs, it introduced and exacerbated adverse side effects and behaviours that can lead to poorer welfare outcomes for laboratory pigs.

Creating a Risk Score for Prolonged Length of Stay Following Pediatric Lung Transplants.

Pediatric lung transplant (LT) outcomes correlate with prolonged length of stay (pLOS), yet a paucity of research exists predicting pLOS in this population. We aim to identify factors associated with pLOS following pediatric LT, and to create a risk score identifying individual patients at increased risk of pLOS. Using the OPTN database, we analyzed 733 pediatric patients who received an LT between January 2000-July 2022. We used LASSO regularization to identify factors predicting pLOS. A risk score was calculated using odds ratios for each variable in the model. LASSO was run on 51 factors and identified 13 to be included in the model. The variables with the highest negative impact on LOS were recipient ethnicity (Asian, Native American, Pacific Islanders, or Mixed Race) (OR = 3.187), recipient requiring life support (OR = 2.354), and recipient age 2-10 years old (OR = 2.203). In contrast, low cold ischemia time (OR = 0.562), time on waitlist 21-60 days (OR = 0.284), and diagnosis of primary pulmonary hypertension (OR = 0.307) had protective effects on LOS. Using the risk score, we stratified patients into three equal groups: low (mean LOS = 20.60 days), medium (mean LOS = 22.53 days), and high risk (mean LOS = 36.72 days) of pLOS. The c-statistic for the model was 0.7931 and 0.7757 for the risk score. Using this model and risk score, physicians and healthcare systems could identify patients at risk of pLOS and could intervene on preventable variables before transplantation.

Traumatic dental injuries and oral health-related quality of life in children and adolescents with special health care needs in Eastern India: A case-control study.

This matched case-control study aimed to investigate the prevalence of traumatic dental injuries (TDI) and its impact on oral health-related quality of life (OHRQoL) in hearing and/or visually impaired children attending government special schools in Eastern India. A two-step cluster analysis was performed to define cases and controls based on the Parental-Caregivers Perceptions Questionnaire (PCP-Q) scores from the 228 parent/guardian responses. The cases included children with a higher negative impact on OHRQoL (89 subjects), whereas the controls were those with a lower negative impact on OHRQoL (139 subjects). Groups were matched for age and gender and researchers were blinded to case/control status. Binary logistic regression was performed. The prevalence of TDI among the study subjects was 24.12%. Compared to subjects in the control group (16.5%), a significantly higher proportion of cases (36%) reported a history of TDI. Children with TDI had considerably higher OHRQoL scores across all P-CPQ sub-scales. Falls were the most common cause of TDI, primarily at home or school and none received treatment. TDI significantly impacts OHRQoL in these children. Lack of treatment highlights the need for caregiver awareness and improved dental access for children with special needs. Further research with larger samples and specialized OHRQoL tools is recommended.

Bibliographic update about hypertensive disorders of pregnancy intervention studies and their importance

Introduction: cardiovascular diseases represent one of the main causes of death and disability in women, in turn, multicausal hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, preeclampsia/eclampsia, and chronic hypertension with overlapping preeclampsia/eclampsia. The objective was to describe the importance of the intervention studies about hypertensive disorders of pregnancy. Methods: a bibliographic review of 28 articles in Spanish and English, related to the subject, from databases such as SciELO, Pubmed, Scopus, Springer, where more than 60% are from the last 6 years, was carried out.Results: epidemiological data show the high negative impact on obstetric and neonatal health in these entities, emerging as a problem that has continued to affect the good health results in the sector. Added to the neglect of prenatal care, the lack of preparation/skills for the detection and treatment of these pathologies in health personnel, and the lack of knowledge of the pathologies by patients negatively influences the diagnosis. Education is an important means to address reproductive health problems; the proper understanding of a disorder contributes to its prevention, control and management.Conclusions: hypertensive disorders of pregnancy constitute a diverse group of diseases that cause maternal and fetal death. Health education through population-based interventions contributes to reproductive health care and the early detection and treatment of hypertensive disorders

Amazon severe drought in 2023 triggered surface water loss

Abstract The Amazon underwent a severe austral springtime drought attributed to the onset of El Niño in 2023 and the warmer North Atlantic, Indian, and North Pacific Oceans. The Amazon rivers, lakes, small streams, wetlands, and reservoirs quickly lowered their water level below historical records due to decreased rainfall and warmth in the region. Based on satellite imagery, this study presents the first estimate of the water loss extent in the 4.2 million km2 of the Brazilian Amazon biome (∼62% of the Amazon total biome) in 2023. We estimated the loss of 3.3 million hectares of surface water relative to 2022, with an overall accuracy of 92%. The surface water losses were concentrated in the states of Amazonas (59.4%) and Pará (25.5), adding up to 2.8 million hectares. The warmer and drier climate in the region affected the main rivers in the Amazon. Among them, the Solimões, Negro, Purus, Acre, and Branco suffered extreme drops in their levels in some regions, resulting in a high negative impact on the aquatic biodiversity, yet estimated only in local areas. A total of 1.14 million hectares of surface water loss (i.e. 35%) was detected within protected areas territories, affecting extractivist, indegenous, African-Brazilian, and fishing and traditional communities. Proximity analysis revealed that 75% of the 2023 surface water loss was within 25 km of small towns, 48% and 65.8% at 50 km from indigenous villages and urban areas, respectively. Our results reinforce people’s vulnerability to climate change, anticipating a plausible adverse impact scenario in the Amazon region and urging solutions to adaptation and mitigation. Therefore, an integrated monitoring system based on climate and water dynamics from satellite and ground stations is necessary to improve understanding of the problem for timing response of climatic change negative impacts.

Optimizing the Activation of WWTP Wet-Weather Operation Using Radar-Based Flow and Volume Forecasting with the Relative Economic Value (REV) Approach

Wastewater treatment plants (WWTPs) connected to combined sewer systems must cope with high flows during wet-weather conditions, often leading to bypass and thus pollution of water bodies. Radar rainfall forecasts coupled with a rainfall-runoff model provides flow and volume forecasts that can be used for deciding when to switch from normal to wet-weather operation, which temporarily allows for higher inflow. However, forecasts are by definition uncertain and may lead to potential mismanagement, e.g., false alarms and misses. Our study focused on two years of operational data from the Damhuså sewer catchment and WWTP. We used the Relative Economic Value (REV) framework to optimize the control parameters of a baseline control strategy (thresholds on flow measurements and radar flow prognosis) and to test new control strategies based on volume instead of flow thresholds. We investigated two situations with different objective functions, considering higher negative impact from misses than false alarms and vice versa, and obtained in both cases a reduction of the rate of false alarms, higher flow thresholds and lower bypass compared to the baseline control. We also assess a new control strategy that employs thresholds of predicted accumulated volume instead of predicted flow and achieved even better results.

Decoding Socio-Economic Demographic Trends: The Power of Spatial Econometrics and Geographic Analysis

Greece is experiencing a steady population decline caused by the declining migratory and natural balance. This research investigates the spatial impact of socio-economic and demographic factors on the natural population balance in Greece for the spatial zoning of municipal administrative units. Using geographically weighted regression (GWR) on data from the 2011 Greek census, the research explores the local impacts of factors like housing repair permits, vacant housing, employment rates, population inflows, distance from regional centers, aging, gender ratios, and education levels. An initial ordinary least squares (OLS) regression was conducted, revealing significant spatial variation and emphasizing the necessity of spatial econometric methods. The GWR model proved to be more effective in accounting for the variance in the data, removing spatial autocorrelation and revealing high local variation. Results show the high negative impact of the aging index in Western Greece and the Ionian islands, the counterintuitive positive effect of the gender ratio in urban areas, and the positive influence of population inflows in high-migration regions like Northern Greece and Crete. The results of this study underline the need to utilize spatial econometric methods for a precise and detailed understanding of demographic trends and provide valuable insights for localized strategies to address demographic challenges.

The Relationship of Pain Intensity, Perceived Injustice, and Pain Catastrophizing to Heart Rate Variability In Naturally Occurring Acute Pain.

Behavioral factors of pain catastrophizing and perceived injustice are associated with pain intensity in chronic pain. Diminished heart rate variability (HRV) is also strongly associated with chronic pain. These factors have been less explored earlier in the pain experience and it is unclear whether they play a role in the transition from acute to chronic pain. The aim of this study was to determine the relationship between pain catastrophizing, perceived injustice, pain intensity, and HRV in naturally occurring acute pain. Ninety-seven patients were recruited from local outpatient physical therapy clinics. Seated HRV was captured on 94 patients via Polar chest strap while patients were taking a survey via iPad. In addition to sociodemographic data, the survey included the Pain Catastrophizing Scale (PCS), Injustice Experience Questionnaire (IEQ), and Numeric Pain Rating Scale (NPRS). The natural log of high-frequency power (lnHFP) HRV was used in the statistical analysis. Multiple linear regression modeling revealed that lower pain catastrophizing, higher perceived injustice, and lower pain intensity were associated with lower HRV, and accounted for 11.4% of the variance in HRV. While greater chronic pain intensity is associated with lower HRV, the relationship is reversed in the setting of acute pain. These findings highlight the need to better understand the unique factors that contribute to lower HRV in the acute phase.

Impacts of commercial and subsistence fishing on marine and cultural ecosystem services important to the wellbeing of an Indigenous community in Hawai'i

Marine ecosystems provide essential services to coastal residents, particularly for indigenous fishing communities that have strong ties to the environment and obtain multiple benefits from their use and management of ocean spaces. However, understanding of how these are impacted by fisheries, external pressures, and ocean management, remains limited due to a focus on economic valuation and aggregated metrics. This study explores the importance of select marine ecosystem services to the wellbeing of an indigenous community in West Hawaiˈi and the observed impacts on these ecosystem services by commercial and subsistence fishing. We used a mixed-methods approach that combined a workshop with an online survey of community perceptions regarding community important marine resources and cultural values. We find that both fish and non-fish species are important to all four well-being categories, including food security, culture, mental wellbeing, and income, though the least importance was given to the economic value. This study also found that commercial fishing is perceived to have a higher negative impact on marine resources and cultural values than subsistence fishing, but a generally lower impact on non-fish than fish species. The lack of community input into legislation development and a lack of enforcement capacity were perceived to aggravate these further, whereas the integration of place-based knowledge, values and rules of the environment was seen as beneficial to both marine and cultural ecosystem services. Overall, this study shows that non-economic and disaggregated valuation approaches are critical for revealing the variable ecosystem services that marine environments provide to local communities and the importance of more inclusive resource management approaches to manage impacts on these services.

Improving Okra Production by Poultry Manure Application in Highland Acid Oxisols of Dschang, Western Cameroon

Problem Statement: Low yields of crops in Sub-saharan Africa are often associated with low soil fertility. However, due to high cost and negative environmental impact of chemical fertilizers, using cheap and readily available organic manures such as poultry manure (PM) has become indispensable. Aim: To evaluate the effect of different rates of PM on soil fertility and the performance of Okra (Abelmoschus esculentus) in the Cameroon Western Highlands. Methodology: The study was carried out in the field and in the laboratory. The experimental plot (191.25 m2) in the field was designed in a randomized complete block design with six treatments and three replications: 0 t ha-1 of PM (To), 3 t ha-1 of PM (T1), 6 t ha-1 of PM (T2), 9 t ha-1 of PM (T3), 12 t ha-1 of PM (T4), and 250 kg of NPK 12-14-19 (T5). Soil samples were analyzed in the laboratory by standard procedures before and after treatment. Results: Treatment T0 had a clay loam texture, acidic pH (5.4), relatively high organic carbon content (1.92%), moderate total nitrogen (0.33%) and moderate available phosphorus (36.07 mg kg-1). The exchangeable complex revealed high K+ (1.02 cmol kg-1), low Ca2+ (2.60 cmol kg-1) and Mg2+ (1.04 cmol kg-1), average Na+ (0.33 cmol kg-1). After treatment, soil pHH2O, available phosphorus and exchangeable K, Ca, and Mg increased after harvest whereas Na decreased for all the treatments. The effect of the treatments on growth parameters was such that T3>T4>T1>T5>T2>T0. The global trend of yield parameters was such that T3>T4>T5>T1>T0>T2. Economically, treatments T3, T4, and T5 were profitable and recommendable for popularization, with a benefit-to-cost-ratio (BCR) >2. The most economically viable treatment was T3 with a profit rate (PR) of 601.66% and a BCR value of 7.02, while T2 was the least economically viable treatment with a negative PR of -32.14% and a BCR of -33.67. Conclusion: Farmers in Western highlands can produce okra profitably and sustainably using PM at a rate of 9 tha-1f.

Health-Related Quality of Life and Satisfaction in Atrial Fibrillation Patients on Anticoagulant Therapy: Differences between Vitamin K Antagonists and Direct Oral Anticoagulants; Results from the Multicentre REGUEIFA Registry.

Background: Oral anticoagulation (OAC) is pivotal in the clinical management of atrial fibrillation (AF) patients. Vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) prevent thromboembolic events, but information about the quality of life (QoL) and patient satisfaction in relation with the anticoagulant treatment is limited. Methods: REGUEIFA is a prospective, observational, and multicentre study that included patients with AF treated by cardiologists. We included patients treated with VKAs or DOACs. The EuroQol-5D (EQ-5D) questionnaire evaluated QoL, and the Anti-Clot Treatment Scale (ACTS) questionnaire investigated patient satisfaction with OAC. Results: A total of 904 patients were included (532 on VKA and 372 on DOACs). A total of 846 patients completed the EQ-5D questionnaire, with results significantly worse in patients on VKAs than on DOACs: more mobility limitations (37.6% vs. 24.2%, p < 0.001), more restriction in usual activities (24.7% vs. 18.3%, p = 0.026), more pain/discomfort (31.8% vs. 24.2%, p = 0.015), a lower visual analogue scale (VAS) score (66.4 ± 16.21 vs. 70.8 ± 15.6), and a lower EQ-D5 index (0.79 ± 0.21 vs. 0.85 ± 0.2, p < 0.001). After adjusting for baseline characteristics, VKA treatment was not an independent factor towards worse EQ-5D results. Also, 738 patients completed the ACTS questionnaire, and burden and profit scores were lower in patients on VKAs than for DOACs (52.1 ± 8.4 vs. 55.5 ± 6.8, p < 0.001 and 11.1 ± 2.4 vs. 11.8 ± 2.6, p < 0.001, respectively). The negative impact score was higher for VKAs than for DOACs (1.8 ± 1.02 vs. 1.6 ± 0.99, p < 0.001), with a general positive impact score lower for VKAs than for DOACs (3.6 ± 0.96 vs. 3.8 ± 1.02, p < 0.001). Conclusions: Patients on VKA have more comorbidity and worse EQ-5D and VAS scores than those on DOACs. VKA has a greater burden and higher negative impact on the patient's life than DOACs.

PRODUÇÃO DE SILAGEM COM RESIDUO UMIDO DE CERVEJARIA PARA ALIMENTAÇÃO DE VACAS LEITEIRAS.

Dairy farming in the State of Amazonas only exists on an industrial scale because of the high cost and lack of availability of cattle feed imported into the State. There is a concrete difficulty in establishing quality forage plantations due to the inadequate climate and soils, causing livestock farming to cause environmental degradation and being considered an activity with a high negative impact due to fires to obtain new pasture areas. At the same time, waste from the local brewery industry is discarded when it could be used to feed dairy cows. The aim was to develop a simple way to use waste from a brewery located in the city of Manaus as an alternative to the high-cost feed used in industrial dairy farming and, possibly, to make family farming (Carvalho et al., 2021) viable through a methodology that defines the specific conditions for sun drying and proper storing of the wet waste, ensuring an increase in the product’s shelf life and enabling its river distribution to the inland of the state (Salman, 2020).

Predictors of perceived caregiver strain in carers of patients living with heart failure: data from a collectivist society

Abstract Background Informal caregivers are individuals voluntarily caring for someone facing a disease, disability, or any condition requiring particular attention.1 They provide around 90% of in-home care and play a key role in supporting the wellbeing and care of people living with chronic illnesses.2 Such diagnoses alter roles within the family unit and cause feelings of uncertainty, anxiety, depression, resentment, among others. This is true in caregivers of patients living with Heart Failure [HF]. High care dependency and lack of formal support for caregiving have increased the prevalence of caregiver strain. Purpose To describe caregiver strain and identify its determinants among caregivers of patients living with HF. Methods This was a cross-sectional correlational study. Caregivers were assessed for caregiver strain (Modified Caregiver Strain Index [MCSI]), social support (Carers of Older People in Europe Index [COPE]), and quality of life (QOL; Short Form 12). MCSI scores were compared across dyadic variables and then used as the outcome variables to create the regression model. Results 108 patients (age 63.54 ± 10.52 years, 70.4% males, 81.55% married) and caregivers (age 49.37 ± 13.69 years, 14.8% males, 82.2% married) were included. More than 80% of the dyads lived in the same household. Caregivers have been assuming this role for an average of 8.53 years and a mean of 37.73 hours per week. Almost 50% of the caregivers reported providing minimal care for their patient while 35% reported providing full care. An alarming 67.6% of the dyads were considered discordant and did not agree on how and by who the care is performed. Caregiver strain was average in this sample with a mean of 11.32 ± 6.94. Caregivers who provided full care had significantly higher caregiver strain (13.75 ± 6.16 versus 9.82 ± 7.16; F (2,76) = 3.329, p = 0.041). Poor caregiver perceived quality of the dyad was significantly associated with higher caregiver strain (16.07 ± 6 versus 10.71 ± 6.9; p &amp;lt; 0.001). Caregivers of symptomatic patients had lower caregiver strain than caregivers of asymptomatic patients (9.90 ± 7.43 versus 12.69 ± 6.21; p = 0.019). Being stressed in caregiving was significantly associated with higher caregiver strain (r = 0.774; p &amp;lt; 0.001). Having lower physical and/or mental QOL were associated with higher strain (r = -0.291 and -0.536 respectively; p &amp;lt; 0.001). Finally, a higher negative impact from caregiving, a lower mental and physical QOL, and a lower relationship quality explained about 63% of the variance in Caregiver Strain (F = 44.001; p &amp;lt; 0.001). Conclusion Knowledge from this study will help place caregivers’ health at the core of caregiving processes. HF nurses and physicians should start giving special attention to caregivers of HF patients who show signs if high caregiver strain. Interventions to reduce strain should be designed to address caregivers’ appraisal of dyad relationship quality, instrumental social support, and QOL.

Technical debt in AI-enabled systems: On the prevalence, severity, impact, and management strategies for code and architecture

Context:Artificial Intelligence (AI) is pervasive in several application domains and promises to be even more diffused in the next decades. Developing high-quality AI-enabled systems — software systems embedding one or multiple AI components, algorithms, and models — could introduce critical challenges for mitigating specific risks related to the systems’ quality. Such development alone is insufficient to fully address socio-technical consequences and the need for rapid adaptation to evolutionary changes. Recent work proposed the concept of AI technical debt, a potential liability concerned with developing AI-enabled systems whose impact can affect the overall systems’ quality. While the problem of AI technical debt is rapidly gaining the attention of the software engineering research community, scientific knowledge that contributes to understanding and managing the matter is still limited. Objective:In this paper, we leverage the expertise of practitioners to offer useful insights to the research community, aiming to enhance researchers’ awareness about the detection and mitigation of AI technical debt. Our ultimate goal is to empower practitioners by providing them with tools and methods. Additionally, our study sheds light on novel aspects that practitioners might not be fully acquainted with, contributing to a deeper understanding of the subject. Method:We develop a survey study featuring 53 AI practitioners, in which we collect information on the practical prevalence, severity, and impact of AI technical debt issues affecting the code and the architecture other than the strategies applied by practitioners to identify and mitigate them. Results:The key findings of the study reveal the multiple impacts that AI technical debt issues may have on the quality of AI-enabled systems (e.g., the high negative impact that Undeclared consumers has on security, whereas Jumbled Model Architecture can induce the code to be hard to maintain) and the little support practitioners have to deal with them, limited to apply manual effort for identification and refactoring. Conclusion:We conclude the article by distilling lessons learned and actionable insights for researchers.

Parents' perception of treatment-related toxicity in children treated according to the NOPHO ALL2008 protocol for acute lymphoblastic leukemia.

This study aimed to assess how parents perceived treatment-related side effects during acute lymphoblastic leukemia (ALL) treatment. Parents of children 1-17.9 years at diagnosis in Sweden, Finland, and Denmark who were alive and in first remission ≥6 months after end of ALL treatment were asked to respond on specific items regarding how their child was affected by side effects related to vincristine (VCR), corticosteroids, peg-asparaginase (ASP), and maintenance therapy, as well as overall impact of these treatments, complications in general, and their perception of impact on their child in comparison with other children with ALL. Parents of 307 children responded. More than a third reported that their child had been affected to a high extent by VCR (39.7%) and corticosteroids (35.8%), with walking difficulties, muscular weakness, pain, changes in appetite, and mood swings as the most common and severe symptoms. Reporting of these toxicities was lacking from the NOPHO ALL2008 database, except for peripheral paralysis (12.1%). For distinct toxicities reported in the NOPHO ALL2008 database, for example, thrombosis and pancreatitis, parent reports were similar to the database. Although a high overall negative impact during treatment was reported, parents generally rated the impact on their child as less, or similar, to other children with ALL. Parents perceived VCR and corticosteroid therapy, in particular, to have a negative impact on their child during ALL treatment, which was not captured in the NOPHO ALL2008 toxicity reporting. Our results highlight the importance of including patient/parent-reported outcomes in toxicity reporting.

Associations of ethylene oxide exposure with depression in American adults

Ethylene oxide (EO) is an organic compound known for its high reactivity and negative impact on human health, but its adverse effects on depression remain poorly understood. A cross-sectional study was conducted among 2884 participants from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2016. Participants were classified into four groups according to quartiles of log10-transformed hemoglobin adducts of EO (HbEO) levels. A logistic regression model was used to estimate the association between EO exposure and the risk of depression. Finally, we evaluated whether the association was mediated by inflammatory factors. Individuals with depression exhibited higher levels of hemoglobin adducts of ethylene oxide (HbEO) compared to those without depression. After adjusting for all covariates, patients in the highest quartile of HbEO (Q4 group) had a higher risk of depression, using the lowest quartile (Q1 group) as the reference group [odds ratio (OR) = 2.21, 95% confidence interval (95% CI): (1.47, 3.40)]. Additionally, the relationship between EO levels and the prevalence of depression followed a non-linear U-shaped pattern. Furthermore, inflammatory cells showed a positive correlation with EO levels. Moreover, white blood cells and neutrophils significantly mediated the relationship between HbEO and the risk of depression with mediated proportions of 14.70 and 12.55%, respectively. Exposure to ethylene oxide increases the risk of depression. Inflammatory factors partially mediated the observed association between EO exposure and depression.

(039) DIVERSITY OF CAUSES OF DYSPAREUNIA IN REAL CLINICAL PRACTICE IN THE OUTPATIENT GYNECOLOGY DEPARTMENT

Abstract Introduction Dyspareunia is a women's sexual health problem that still often goes undiagnosed, despite its high prevalence and negative impact on sexual, marital and psychological well-being. Genito-pelvic pain/penetration disorder (GPPPD) refers to significant pain and difficulty with penetrative sex that lasts for at least six months and might be caused by various diseases alone and their combinations. Objective Thus, the purpose of this study is to determine the contribution of different conditions to the total number of patients who applied for a primary appointment for GPPPD. Methods Women who agreed to participate in the study were presenting complaints on painful intercourse or inability to have intercourse for more than 6 months. Patients underwent a gynecological examination consisted of inspection, Q-tip testing, pelvic floor muscle testing and bimanual palpation in the lithotomy position (if it was possible). Diagnoses were documented according to the International Classification of Diseases Tenth Revision World Health Organization guidelines. Pain was assessed via the McGill Pain Questionnaire and a visual analogue scale. Assessment of pelvic floor muscle dysfunction was based on an International Continence Society report on the terminology for pelvic floor muscle assessment. Vulvar pain conditions were classified based on the consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women's Sexual Health, and International Pelvic Pain Society. Statistical analyses were performed by SPSS Statistics. Results The average age of the examined women was 30,63±0,69 years. As a cause of GPPPD vaginismus and dyspareunia were diagnosed in 19.31 and 80.69 % respectively. Predominant cause of dyspareunia was pelvic floor muscles dysfunction (66,19%) which was combined with other pathologies (scar deformity of the perineum, endometriosis and chronic pelvic pain, candidiasis, etc.) in 20 cases. The percentage of women diagnosed with endometriosis without the formation of central pain mechanisms was 11.36%. The overlapping chronic pain conditions such as migraine, interstitial cystitis/bladder pain syndrome, irritable bowel syndrome, endometriosis and vulvodynia were diagnosed in 21.13% patients with dyspareunia. Dyspareunia due to vaginal atrophy associated with lactation, combined oral contraception use and menopause was diagnosed in 4 patients (2.82%, 1.41% and 1.41%, respectively). Scar changes of the perineum due to traumatic delivery or episiotomy amounted to 4.23%. Lichen planus was diagnosed in one patient (1.41%). Vulvodynia was diagnosed in 8 patients with dyspareunia (11.26%) and was associated with pelvic floor tension myalgia and pelvic floor myofascial pain syndrome in 75% of cases. Conclusions GPPPD can be caused by various conditions with significant involvement of the pelvic floor muscles in the process of pain formation. Taking into account the risk of overlapping chronic pain conditions, a multidisciplinary approach is required in the treatment of this group of patients. Disclosure No.

Comparative Life Cycle Assessment of Electric and Internal Combustion Engine Vehicles

This article is devoted to the ecological comparison of electric and internal combustion engine vehicles throughout their entire life cycle, from mining to recycling. A scientifically based approach to a comprehensive environmental assessment of the impact of vehicles on the environment has been developed. To analyze the impact on the environmental situation, aspects such as the consumption of natural resources, waste generation, electricity consumption, emission of harmful substances into the atmosphere, water consumption, and greenhouse gas emissions are taken into consideration. As a result of comparing the environmental impacts of vehicles, it was found that natural resources consumption and production of industrial waste from electric vehicles (EV) is 6 times higher than from internal combustion engine vehicles (ICEV). Harmful substance emissions and greenhouse gas emissions from EV production are 1.65 and 1.5 times higher, respectively. The EV total electricity consumption is 1.4 times higher than that of ICEVs. At the same time, it was revealed that during operation, EVs have higher energy consumption and emit more harmful substances into the atmosphere, but EVs produce less greenhouse gas emissions. It means that at different life cycle stages, EVs have a much higher negative impact on the environment compared to gasoline engine vehicles.