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Software effort estimation is a significant part of software development and project management. The accuracy of effort estimation and scheduling results determines whether a project succeeds or fails. Many studies have focused on improving the accuracy of predicted results, yet accurate estimation of effort has proven to be a challenging task for researchers and practitioners, particularly when it comes to projects that use agile approaches. This work investigates the application of the adaptive neuro-fuzzy inference system (ANFIS) along with the novel Energy-Efficient BAT (EEBAT) technique for effort prediction in the Scrum environment. The proposed ANFIS-EEBAT approach is evaluated using real agile datasets. It provides the best results in all the evaluation criteria used. The proposed approach is also statistically validated using nonparametric tests, and it is found that ANFIS-EEBAT worked best as compared to various state-of-the-art meta-heuristic and machine learning (ML) algorithms such as fireworks, ant lion optimizer (ALO), bat, particle swarm optimization (PSO), and genetic algorithm (GA).

Particulate air pollution is becoming a serious public health concern in urban cities of China. Association of disability-adjusted life years (DALYs) and economic loss with air pollution-related health effects demand quantitative analysis for correctional measures in air quality. This study applies an epidemiology-based exposure–response function to obtain the quantitative estimate of health impact of particulate matter PM 2.5 and PM 10 across 190 cities of China during years 2014–2015. The annual average concentration of PM 2.5 and PM 10 is 57 ± 18 μg/m 3 (ranging from 18 to 119 μg/m 3 ) and 97.7 ± 34.2 μg/m 3 (ranging from 33.5 to 252.8 μg/m 3 ), respectively. Based on the present study, the total estimated annual premature mortality due to PM 2.5 is 722,370 [95% confidence interval (CI) = 322,716–987,519], 79% of which accounts for adult cerebrovascular disease (stroke) and ischemic heart disease (IHD). The premature mortality in megacities is very high, such as Chongqing (25,162/year), Beijing (19,702/year), Shanghai (19,617/year), Tianjin (13,726/year), and Chengdu (12,356/year). PM 10 pollution has caused 1,491,774 (95% CI = 972,770–1,960,303) premature deaths (age >30) in China. Further, 3,614,064 cases of chronic bronchitis (CB); 13,759,894 cases of asthma attack among all ages; 191,709 COPD-related hospital admission (HA) cases; 499,048 respiratory-related HA; 357,816 cerebrovascular HA; and 308,129 cardiovascular-related HA due to PM 10 pollution have been estimated during 2014–2015. Chongqing, Beijing, Baoding, Tianjin, and Shijiazhuang are the top five contributors to pollution-related mortality, accounting for 3.10, 2.71, 2.49, 2.20, and 2.02%, respectively, of the total deaths caused by PM 10 pollution. The total DALYs associated with PM 2.5 and PM 10 pollution in China is 7.2 and 20.66 million in 2014–2015, and mortality and chronic bronchitis shared about 93.3% of the total DALYs for PM 10 . During this period, the economic cost of health impact due to PM 10 is approximately US$304,122 million, which accounts for about 2.94% of China’s gross domestic product (GDP). Megacities are expected to contribute relatively more to the total costs. The present methodology could be used as a tool to help policy makers and pollution control board authorities, to further analyze costs and benefits of air pollution management programs in China.

Emergency Departments (EDs) are high-pressure environments that place significant psychological and physiological stress on both patients and healthcare staff. Despite increasing awareness of stress-related impacts, proactive stress management interventions have limited uptake in healthcare. This proof-of-concept study will evaluate WeCare: a 6-week, wearable-integrated, self-guided program grounded in a “Learn–Track–Act” framework to support stress regulation, resilience, and wellbeing. The study will examine four key aspects of implementing the program: (1) feasibility, (2) acceptability and usability, (3) preliminary clinical effectiveness (self-report and physiological outcomes), and (4) preliminary economic impacts. Using a mixed-methods, multiple-baseline N-of-1 design, the program will be trialled with up to 32 participants across four ED-exposed groups: patients with non-severe or severe injuries, patients with acute medical presentations, and ED staff. The intervention includes digital psychoeducation, continuous biofeedback via a smart ring, personalised guidance, and evidence-based self-regulation strategies. Assessments will include standardised questionnaires combined with continuous physiological monitoring via a smartwatch, and interviews. Quantitative outcomes include heart rate variability, sleep patterns, perceived stress, wellbeing, healthcare use, and time off work. Qualitative interviews will explore user experience, usability, and perceived barriers. The findings will inform the refinement of the intervention and co-design of a larger-scale trial, contributing valuable evidence to support low-cost, wearable-enabled proactive mental healthcare in high-stress healthcare environments.

The aim of this article is to study inclusion and recognition experienced amongst people with a Spinal Cord Injury (SCI) in Norway, The Netherlands, and Australia. This is approached both from the perspectives of an interest in the impact of mobility limitations versus social attitudes, and from a consideration of differences between societies. The data derive from the core questionnaire of International Spinal Cord Injury Community Survey with extended national modules on the attitudes and values of respondents from Norway, The Netherlands, and Australia. The data gathered in 2017-18 include 2,450 participants aged 18 years or older. The data are analysed and presented with descriptive statistics and OLS regression analyses. In order to explore our main questions, we run regression controlling for country effects in addition exploring within country effects. Mobility limitations are a substantially weaker predictor of self-perceived inclusion and recognition than experiences of negative attitudes towards disabled people. Stereotypical attitudes and norms in society are shown to have various impacts on inclusion in the three countries. The Norwegian respondents report overall better results on inclusion and recognition than respondents in Australia and The Netherlands, illustrating the importance of national contexts. Challenges associated with inclusion, recognition, and respect after SCI need to be defined in a language broader than mobility limitations and stereotypical attitudes towards people with an SCI. The main road to both inclusion and recognition in society is primarily linked to job and educational status, in addition to family and friends. The results are of particular interest as measures to support reintegration into society, including a strengthening of labour market integration programs.

The number of systematic reviews on the effects of exercise on aerobic fitness and muscle strength in people with spinal cord injury (SCI) has recently increased. However, the results of some of these reviews are inconclusive or inconsistent. To strengthen recommendations, this overview was undertaken to assimilate evidence about the effectiveness of different types of physical activities, exercises, and therapeutic interventions for improving aerobic fitness and muscle strength in people with SCI. Cochrane Overview of reviews methods were adopted to undertake this overview. An online search was conducted in August 2018 on eight databases based on predefined search criteria. Potential systematic reviews were screened, selected, and assessed on methodological quality by two independent authors, and discussed and resolved with a third author, when necessary. Only systematic reviews published in the English language were included. The protocol was registered on PROSPERO. Overall, 16 systematic reviews were included (aerobic fitness, n = 10; muscle strength, n = 15). For all 16 reviews, the quality of evidence was rated as “critically low.” Despite low evidence, this overview strengthens the existing guidelines for people with SCI, providing specific advice on exercise domains (types, intensities, frequency, and duration) for improving aerobic fitness and muscle strength. The evidence from this overview suggests that ergometry training with/without additional therapeutic interventions (20 min, moderate to vigorous intensity, twice weekly for 6 weeks) may improve aerobic fitness; similarly, resistance training with/without additional therapeutic interventions (three sets of 8–10 repetitions, moderate to vigorous intensity, twice weekly for 6 weeks) may improve muscle strength.

Study Design:Self-reported cross-sectional data for the Australian cohort participating in the International Spinal Cord Injury Community survey.Objectives:To contextualise post-injury employment for people with spinal cord injury (SCI) in Australia, including work participation rates, time to resuming work, underemployment and pre- and post-SCI employment changes.Setting:Australian survey data from four state-wide SCI services, one government insurance agency and three not-for-profit consumer organisations across New South Wales, Queensland, South Australia and Victoria.Methods:Data were analysed from 1579 participants with SCI who are at least 1-year post discharge from an inpatient facility. Survey measures included 16-items dedicated to employment. Pre- and post-injury job titles were based on the International Standard Classification of Occupations (ISCO-08) major classification. A mix of chi-squared, t-test and negative binomial regression were used to analyse data.Results:The absolute post-injury employment rate was 49.9%, with one-third of the sample currently working. Pre-injury employment and engagement with vocational rehabilitation resulted in higher employment rates. Individuals who were unable to return immediately following inpatient rehabilitation took mean 28 months (SD, 35.9) to return. Time to employment was significantly lengthier for those without pre-injury jobs, at 59.7 months [SD, 43.8] (p < 0.001). Engagement in less manual roles increased post-injury, accounting for three quarters of post-SCI jobs. Underemployment was identified by 16.6% of those currently working.Conclusions:While there are current services and programmes in place in Australia that support post-injury employment, findings indicate a need for more comprehensive early intervention focused services targeted towards employers and individuals.

Background To investigate the cumulative health burden and complex challenges to adjustment following road traffic injuries (RTIs), this study examined multiple environmental, personal, and health-related factors and outcomes over 12 months in a comprehensive and holistic way, comparing these outcomes between injured and non-injured controls. Methods A longitudinal controlled cohort study was conducted with two groups: adults with mild to moderate RTIs and non-injured controls. Assessments occurred at 1, 3, 6, and 12 months post-injury. The study involved 120 RTI participants and 112 controls. Data on physiological, psychological, cognitive, and social factors were collected and analyzed using the World Health Organization International Classification of Functioning, Disability, and Health (ICF) framework. The ICF Components—Impairments in Body Functions and Structures, Limitations in Activity, Restrictions to Participation, Environmental and Personal Contextual Factors—were used to link and categorize data and compare outcomes, allowing comprehensive evaluation of RTI-related burden and adjustment challenges. Results The RTI group exhibited significantly worse outcomes across all measured ICF Components, including higher pain, fatigue, psychological distress, and cognitive impairment. Despite some improvements over time, the RTI group continued to experience elevated symptoms, functional limitations, and restricted participation compared to controls at 12 months. Conclusions RTIs lead to sustained, multidimensional challenges to adjustment, emphasizing the need for early, comprehensive, and ongoing interventions for at least 1-year post-injury. These findings highlight the importance of evaluating multiple biopsychosocial factors and adopting a holistic framework to fully understand recovery patterns. Addressing these factors simultaneously across multiple systems is essential to improve recovery outcomes. Trial registration ACTRN12616001445460.

The sexual blood stage of the human malaria parasite Plasmodium falciparum undergoes remarkable biophysical changes as it prepares for transmission to mosquitoes. During maturation, midstage gametocytes show low deformability and sequester in the bone marrow and spleen cords, thus avoiding clearance during passage through splenic sinuses. Mature gametocytes exhibit increased deformability and reappear in the peripheral circulation, allowing uptake by mosquitoes. Here we define the reversible changes in erythrocyte membrane organization that underpin this biomechanical transformation. Atomic force microscopy reveals that the length of the spectrin cross-members and the size of the skeletal meshwork increase in developing gametocytes, then decrease in mature-stage gametocytes. These changes are accompanied by relocation of actin from the erythrocyte membrane to the Maurer’s clefts. Fluorescence recovery after photobleaching reveals reversible changes in the level of coupling between the membrane skeleton and the plasma membrane. Treatment of midstage gametocytes with cytochalasin D decreases the vertical coupling and increases their filterability. A computationally efficient coarse-grained model of the erythrocyte membrane reveals that restructuring and constraining the spectrin meshwork can fully account for the observed changes in deformability.

The construction industry is rapidly changing to meet growing demand and reduce its environmental impact. These objectives can be met, in part, through improved selection of construction materials. However, the material properties including embodied carbon (EC) of emerging construction materials are less well documented in material property databases compared to conventional ones, providing barriers to their utilisation and correct perception of their decarbonisation potentials. This study provides material property data for emerging structural materials through a comprehensive literature review, visualises the results on material property charts, and analyses these data comparing to conventional materials. Only 18% (37 out of 204) of the emerging structural materials reviewed had EC values; less (11%) had embodied energy values. Analysis of the data demonstrates that using alternative and emerging materials for structural beams and columns can substantially reduce EC. For example, in the beam case study presented and using cradle-to-gate EC data (excluding stored carbon in wood), engineered wood products (glulam, cross-laminated timber) and reused steel achieve 3-5% of the EC of primary steel. Therefore, we highlight the benefits of collecting material property and environmental impact data for emerging materials and their potential for greater adoption to achieve lower carbon construction.

Background Inequality in health is a prevalent and growing concern among countries where people with disabilities are disproportionately affected. Unmet healthcare needs explain a large part of the observed inequalities between and within countries; however, there are other causes, many non-modifiable, that also play a role. Aim This article explores the difference in health across income levels in populations with spinal cord injury (SCI). SCI is of special interest in the study of health systems, as it is an irreversible, long-term health condition that combines a high level of impairment with subsequent comorbidities. Methods We estimated the importance of modifiable and non-modifiable factors that explain health inequalities through a direct regression approach. We used two health outcomes: years living with the injury and a comorbidity index. Data come from the International Spinal Cord Injury Survey (InSCI), which has individual data on people with SCI in 22 countries around the world. Due to the heterogeneity of the data, the results were estimated country by country. Results On average, the results exhibit a prevalence of pro-rich inequalities, i.e., better health outcomes are more likely observed among high-income groups. For the years living with the injury, the inequality is mostly explained by non-modifiable factors, like the age at the time of the injury. In contrast, for the comorbidity index, inequality is mostly explained by unmet healthcare needs and the cause of the injury, which are modifiable factors. Conclusions A significant portion of health inequalities is explained by modifiable factors like unmet healthcare needs or the type of accident. This result is prevalent in low, middle, and high-income countries, with pervasive effects for vulnerable populations like people with SCI, who, at the same time are highly dependent on the health system. To reduce inequity, it is important not only to address problems from public health but from inequalities of opportunities, risks, and income in the population. Highlights • Better health status is evident among high-income groups, which is reflected in pro-rich inequalities. • Age at the time of the injury is the most important factor to explain inequalities in years living with the injury. • Unmet health care needs are the most important factor to explain inequalities in comorbidities. • The inequality in health varies by country dependent upon socioeconomic factors.