Drought events threaten freshwater reservoirs and agricultural productivity, particularly in semi-arid regions characterized by erratic rainfall. This study evaluates a novel technique for assessing the impact of drought on LULC variations in the context of climate change from 2018 to 2022. Various data sources were harnessed, encompassing Sentinel-2 satellite imagery for LULC classification, climate data from the CHIRPS and AgERA5 databases, geomorphological data from JAXA\'s ALOS satellite, and a drought indicator (Vegetation Health Index (VHI)) derived from MODIS data. Two classifier models, namely gradient tree boost (GTB) and random forest (RF), were trained and assessed for LULC classification, with performance evaluated by overall accuracy (OA) and kappa coefficient (K). Notably, the GTB model exhibited superior performance, with OA > 90% and a K > 0.9. Over the period from 2018 to 2022, Fez experienced LULC changes of 19.92% expansion in built-up areas, a 34.86% increase in bare land, a 17.86% reduction in water bodies, and a 37.30% decrease in agricultural land. Positive correlations of 0.81 and 0.89 were observed between changes in agricultural LULC, rainfall, and VHI. Furthermore, mild drought conditions were identified in the years 2020 and 2022. This study emphasizes the importance of AI and remote sensing techniques in assessing drought and environmental changes, with potential applications for improving existing drought monitoring systems.

OBJECTIVE: Arytenoid adduction as an addition to medialisation thyroplasty is highly advocated by some surgeons in selected cases but deemed less necessary by others in patients with unilateral vocal fold paralysis. This study aims to evaluate the additional benefits on voice outcome of arytenoid adduction in patients with unilateral vocal fold paralysis undergoing medialisation thyroplasty using intra-operative voice measurements.
METHODS: A prospective study was conducted. Voice audio recordings were obtained at 4 moments; 1. direct prior to the start of surgery, 2. during surgery after medialisation thyroplasty, 3. during surgery after medialisation and arytenoid adduction, 3 months postoperative. At these same timepoints patients rated their own voice on a numeric rating scale between 0 and 10. The blinded recordings were rated by consensus in a team of experienced listeners, using the Grade of the GRBAS scale. Furthermore, the Voice Handicap Index was administered before and at 3 months after surgery.
RESULTS: Ten patients who underwent medialisation and arytenoid adduction at our tertiary referral hospital between 2021 and 2022, were included. One patient was excluded after surgery. The intraoperative measurements showed a Grade score of 1.4 preoperatively, improving to 1.2 after medialisation, 1.2 after medialisation and arytenoid adduction, and further improving to 0.4 at 3 months postoperative, which was a not statistically significant improvement (p = 0.2). The intraoperative subjective numeric rating scale showed a statistically significant improvement from 3.9 preoperatively, to 6.1 after medialisation, 7.1 after medialisation and arytenoid adduction and a 7.6 at 3 months postoperative (p = 0.001). The Voice Handicap Index total score showed a statistically significant improvement from 71 points before surgery to 13 at 3 months after surgery (p = 0.008).
CONCLUSIONS: Our study using intraoperative voice measurements indicate that the addition of arytenoid adduction to medialisation thyroplasty is a benefit in selected patients although more studies are needed due to the many limitations inherent to this field of investigation.

The association of voice disorders in laryngeal cancers has been studied extensively; however Dysphonia associated with chemo-radiation in non laryngeal Head and Neck cancer (HNC) is a new area of practice in voice clinics. This study thus aimed to evaluate the efficacy of voice rehabilitation among non-laryngeal HNC survivors who were treated with curative RadioTherapy (RT)/Chemoradiotherapy (CRT) in adjunct with or without surgery. This tertiary institutional assessor blinded quasi experimental study after inclusion and exclusion criteria consisted of a study cohort of 128 patients who within 1-3 months of completion of treatment for HNC reported to the laryngology clinic for voice complaints and throat discomfort. All patients underwent documentation of laryngeal endoscopic imaging, acoustics assessment, Aronson\'s Laryngeal Palpatory Method (LPM) and Voice Handicap Index (VHI). Thereafter they were subjected to Vocal Rehabilitation Therapy (VRT) which constituted of Manual circumlaryngeal therapy, SOVTE, and vocal hygiene program. Re-evaluation of the vocal parameters was done at 6 weeks and 3 months from the start of the VRT. All parameters were significantly altered at 6 weeks and 3 months follow-up. Post VRT the videolaryngoscopic findings showed reduction in abnormal supraglottic MTPs with subsequent good approximation of true cords and reduction of involvement of supralaryngeal activities. The Dysphonia Severity Index (DSI) impairment levels and VHI scores showed significant improvement from the baseline to both at 6 weeks and 3 months of VRT (p < 0.001). DSI and VHI scores even showed significant improvement between 6 weeks to 3 months of therapy. There was highly significant correlation of VRT with/without surgery, with CRT and in non-smokers at 6 weeks and 3 months of VRT. In non-laryngeal head and neck malignancies, VRT offered as early as within 1-3 months of completion of treatment of HNC ameliorates surgical and chemo-radiation induced Muscle Tension Dysphonia.

OBJECTIVE: To analyze the internal consistency of the Voice Handicap Index (VHI) for evaluating the vocal handicap of individuals with dysphonia.
METHODS: This is a systematic review. Studies with a cross-sectional design and including a population of individuals with dysphonia, which validated the VHI and analyzed its internal consistency, were included. The following electronic databases were searched: Cochrane Library, EMBASE, LILACS, and PubMed, including Medline, Scopus, and Web of Science. A manual search was performed in gray literature through the Biblioteca Digital Brasileira de Teses e Dissertações and ProQuest Dissertation & Theses. In addition, the list of references of studies selected in the electronic search was mapped, and an expert in the area was consulted. Two reviewers blindly and independently conducted the selection, data extraction, and analysis of the risk of bias, the certainty of the evidence, and good psychometric measures. A meta-analysis was performed with a random effects model using the JAMOVI 2.3.2 software.
RESULTS: Forty-nine studies were analyzed. In risk of bias assessment, the studies were classified as having inadequate structural validity and very good internal consistency. The analysis of good psychometric properties indicated indeterminate structural validity and insufficient internal consistency. The overall value of Cronbach\'s alpha was estimated at 0.94, thus suggesting a very good internal consistency. However, there was high heterogeneity. The level of certainty of the evidence was too low for internal consistency.
CONCLUSIONS: The VHI proved to be a consistent and reliable patient-reported outcome measure to evaluate voice handicap in individuals with dysphonia; however, studies are heterogeneous, and the certainty of evidence is very low.

OBJECTIVE: Laryngeal framework surgery, including medialization laryngoplasty and arytenoid adduction (AA), is expected to have a lasting or permanent effect in patients with unilateral vocal fold paralysis (UVFP); however, there are few reports about the long-term outcomes of AA. This study aimed to evaluate the long-term postoperative effects of AA surgery and examine its stability and reliability.
METHODS: This study collected the voice handicap index (VHI) questionnaire from patients with UVFP who underwent AA more than 2 years previously. The VHI values preoperatively and 3 months postoperatively (early postoperative evaluation) were retrospectively calculated, and VHI values more than 2 years after surgery (late postoperative evaluation) were collected by mailing a sheet to the patients and asking to fill and return it. Possible influenced subscales such as age, sex, causes of UVFP, affected side, and surgeons were also analyzed.
RESULTS: A total of 77 patients with UVFP who underwent AA had significantly lower early and late postoperative evaluations than preoperative evaluations. In 38 patients with no missing values, there were no significant differences between early and late postoperative evaluations, measured at a median of approximately 5 years. There were also no significant differences between early and late postoperative evaluations in any of the subscale groups.
CONCLUSIONS: Patients with UVFP who underwent AA surgery achieved stable voice improvement in the long term after surgery.

OBJECTIVE: Vocal fatigue is an important complaint that may indicate a voice disorder or a risk thereof. There is a need for a reliable tool to detect and quantify vocal fatigue and distinguish dysphonic and vocally healthy speakers. The Vocal Fatigue Index (VFI) questionnaire has been found valid and reliable among speakers of different languages. This study aims to validate it for speakers of Finnish.
METHODS: Experimental comparative study.
METHODS: The VFI questionnaire was translated from English to Finnish according to the WHO recommendations. Next, it was subjected to the validation procedure. In total, 160 Finnish speakers volunteered to participate in the study. Hundred-and-eight were voice patients (83 males, 25 females) and 52 were vocally healthy controls (37 females, 15 males). As a comparison, the Voice Handicap Index (VHI) questionnaire was completed and voice samples were recorded to enable Acoustic Voice Quality Index (AVQI03.01FIN) analysis.
RESULTS: Results from the first and second completions of the VFI(F) questionnaire correlated strongly (Spearman\'s rho 0.901, P = 0.01). Answers to the individual questions the VFI(F) also correlated strongly, showing high internal consistency. Factor 1 (Tiredness of voice and avoidance of voice use) of the VFI correlated strongly with the VHI, and the two other factors (Physical discomfort associated with voicing and Improvement of symptoms) correlated moderately with the VHI. Factor one of the VFI(F) correlated moderately with AVQI03.01FIN and its sub-parameters, CPPS, HNR, and shimmer. The VFI(F) showed good construct validity, differentiating voice patients and controls at cut-off 13.5, with sensitivity of 0.963 and specificity of 0.885. Discriminatory power was strong for all factors: F1 AROC = 0.985, F2 AROC = 0.864, and F3 AROC = 0.821.
CONCLUSIONS: The VFI(F) correlates with the VHI and with AVQI01.01FIN and it is a valid and reliable tool for detecting vocal fatigue in Finnish speakers.

Background and Objectives: This study examined the utility of local estrogen therapy for improving urinary symptoms in women diagnosed with Overactive Bladder allied to the time of onset of urinary symptoms whether pre- or post-menopausal. Materials and Methods: Subject to informed consent, menopausal women diagnosed with Overactive Bladder (OAB) and Genitourinary Syndrome of Menopause (GSM) were enrolled at three urogynecological units. OAB symptoms were scored using the Global Pelvic Floor Symptoms Bother Questionnaire (GPFSBQ), with explicit attention to question number 3 that specifically addresses the presence or absence of urgency and the Patient Perception of Intensity of Urgency Scale (PPIUS). The Vaginal Health Index (VHI) was used to assess the vaginal mucosa trophism. Exclusion criteria included: Pelvic organ prolapse (POP) ≥ stage II, urinary tract infection or disease, diabetes, inflammatory diseases, use of diuretics, alcohol or drug addictions, neurological and/or psychiatric disorders, and other precluding conditions. Women were treated with local estrogens for 3 months and re-evaluated. Results: Forty-three post-menopausal women were enrolled. Of these, ten women developed OAB symptoms before menopause (Group I) and 33 developed symptoms after menopause (Group II). Following local estrogen therapy, based on the Global Pelvic Floor Symptoms Bother Questionnaire, improvement of OAB symptoms was reported by 20% of patients in Group I (p = 0.414) and 64% of patients in Group II, (p = 0.002). Based on the PPIUS scale, diminution in urinary urgency was experienced by 20% of patients in Group I (p = 0.68) and 66% of patients in Group II (p = 0.036). Improved VHI scores were graded statisticaly significant in both groups (Group I in 100% of women, p = 0.005 vs. 76% in Group II, p = 0.004). Conclusions: Our results indicate that local estrogen therapy is more effective in women who develop OAB after menopause.

Critical applications of satellite data products include monitoring vegetation dynamics and assessing vegetation health conditions. Some indicators like normalized difference vegetation index (NDVI) and land surface temperature (LST) are used to assess the status of vegetation growth and health. But one of the major problems with passive remote sensing satellite data products is cloud and shadow cover that leads to data gaps in the images. The present study proposes temporal aggregation of images over a short time span and developing short span harmonic analysis of time series (SS-HANTS) and pixel-wise multiple linear regression (PMLR) algorithms for retrieving cloud contaminated NDVI and LST information from Landsat-8 (L8) data products, respectively. The developed algorithms were applied in the northeastern part of Thailand to recover the missing NDVI and LST values from time series L8 images acquired in 2018. The predicted NDVI and LST values at artificially clouded locations were compared with the corresponding clear pixel values. Additionally, the model predicted LST and NDVI values were also compared with MODIS LST and NDVI datasets. The calculated root mean square (RMSE) values were ranging from 0.03 to 0.11 and 1.50 to 2.98 °C for NDVI and LST variables, respectively. The validation statistics show that these models can be satisfactorily applied to retrieve NDVI and LST values from cloud-contaminated pixels of L8 images. Furthermore, a vegetation health index (VHI) computed from cloud retrieved continuous NDVI and LST images at province level shows that most of the western provinces have healthy vegetation condition than other provinces in the northeast of Thailand.

We sought to explore the frequency of stress among OPD attending Kashmiri public diagnosed as muscle tension dysphonia (MTD) and determine the subjective consequences of voice therapy in management of muscle tension dysphonia. 72 subjects that attended to ENT and HNS OPD with change of voice were prospectively evaluated and also underwent an extensive otolaryngological examination. Patients identified as MTD were provided a questionnaire which was split into 3 parts: First part dealt with the identification of the subject (age, geography, gender, profession) and also provided evaluation of perceived anxiety using Perceived Stress Scale-10. In the next part the individuals needed to assess their vocal quality based on parameters of GRBAS 4-point score scale before and also after the treatment. In the final component the subjects also needed to answer the VHI-10 (Voice Handicap Index) and also the outcome was compared with those acquired at the assessment before the beginning of the treatment. The mean age of the cohort was 30.31 ± 07.43 (age range, 12-71) and every subject was an indigenous Kashmiri. As expected, vast majority of subjects were females (43 patients). In the pooled information set, women had numerically higher PSS-10 scores than males. For women, the typical stress score was M = 18.6 and for men the average stress score was M = 16.65. In a healthy population, the typical PSS stress score is described to be 13.7 (SD = 6.6) for women and 12.1 (SD = 5.9) for men. At the Wilcoxon test for paired data, we observed a significant difference between the VHI pretreatment (mean = 19.7) and VHI post-treatment, that\'s at time of the research (mean = 9.73; P = 0.017). The grade (G) was assessed in terms of improvement of the vocal quality as opposed with before treatment and also the individuals demonstrated a high level of satisfaction (mean = 0.65). When looking at roughness (R) as well as breathiness (B), the individuals remember that their speech is seldom rough (mean = 0.62) and also less breathy (median = 0.44). Patients likewise noted improvement in other variables of GRBAS scale. Stress is persistent, pervasive and nearly unavoidable in contemporary life. The decades old perplexing and mind baffling pandemonium hovering around the Kashmiri population has had a tremendous impression on the psychological development of people in this region. A careful conclusion is the fact that emotional stress might play a major role in the upkeep of MTD. MTD has to be approached in a multidisciplinary environment in which closer cooperation between a laryngologist, a speech language pathologist and also a psychologist is likely.

Teachers are the backbone of any civilized society as they are the keepers of knowledge, wisdom and values. Lack of infrastructure, manpower and resources makes voice the most important tool for a teacher. Teachers need to speak loudly for long periods often under unfavourable circumstances. Increased vocal effort and incorrect phonation techniques can lead to vocal fold tissue damage and vocal fold pathologies and hence voice problems producing adverse effects on teaching performance. To study the prevalence of voice disorders in Indian female secondary school teacher population. To identify the risk factors for the development of voice disorders. A multicentric, cross-sectional observational study of 200 teachers were conducted in 4 schools over a period of 2 years. Female teachers who gave consent and were willing for follow up were included in the study. Details were collected using a structured questionnaire. Subjective analysis by VHI, perceptual analysis by GRABS score, acoustic analysis and direct visualization using Hopkins 70° rigid laryngoscope were done.The prevalence of voice disorders was 18.5%. Risk factors identified were age group 41-60 years, repeated respiratory allergies, comorbidities, constitutional symptoms, increased number of years of teaching and number of lecture hours per week. VHI, GRABS, Acoustic analysis findings were consistent with Rigid Laryngoscopic finding making them effective tools in the assessment of voice.