Comfort Ratings Research Articles

Numerical modeling and optimization of annual thermal characteristics of an office room with PCM active–passive coupling system

Herein a numerical study was conducted on a PCM coupling room integrated with a PCM active–passive coupling system to optimize it annual thermal characteristics. In detail, four kinds of inorganic composite PCMs were simultaneously introduced into the wall, ventilation cavity and double-layer radiant floor to construct a PCM active–passive coupling system. The numerical model constructed by EnergyPlus was validated based on the experimental result. The simulation results shown that, compared with the room with common radiant floor, the PCM coupling room exhibited a lower annual energy consumption and a higher indoor thermal comfort rate, which was increased by 16.58%. Based on the thermal comfort evaluated by PMV-PPD method and annual energy consumption, a parameter optimization of the double-layer PCM radiant floor was performed, including the PCM thickness, the thermal conductivity and the location of the heat source. It was found that appropriately increasing the total thickness of the PCM layer could effectively enhance its heat storage capacity to improve the indoor temperature control effect. Specially, the total thickness and the thickness of the upper and lower PCM layers had optimal values. Furthermore, when the thermal conductivity of the upper PCM layer was fixed, increasing that of the lower PCM layer could improve the heat storage /release efficiency of the floor, while its enhancement effect gradually decreased. In addition, moving up or down the heat source would reduce the utilization rate of the PCMs. The radiant floor exhibited the optimal overall thermal performance when the heat source was placed between the two PCM layers. Finally, after parameter optimization, the PCM coupling room performed an indoor thermal comfort rate as high as 81.58%, while saving 20% of the electricity cost by utilizing the price difference between peak and valley electricity.

Assessment of passenger long-term vibration discomfort: a field study in high-speed train environments

This study revealed the mechanism of long-term passenger vibration discomfort in high-speed trains and proposed a novel evaluation model to assess it, while the most popular international standard ISO 2631-1 is unsuitable. Here, a field test was conducted to investigate the long-term passenger vibration comfort in high-speed trains under different operation environments by the measurement of the whole-body vibration (WBV) and the subjective ratings of passenger comfort. During the whole sitting period of high-speed train passengers, the phenomena ‘compensatory degradation’ and ‘discomfort accumulation’ were found, which meant that the brief termination of vibration cannot fundamentally alleviate passenger vibration comfort. And the vibration comfort can be evaluated by the product of exposure time and the novel vibration acceleration index we proposed. Meanwhile, high-speed trains with higher velocities or running in tunnel environments have higher frequency-weighted WBV amplitude than open-air and lower velocities, which caused more vibration discomfort of passengers. Practitioner Summary: This field study provided data support for ensuring the occupational health of train drivers whose work routes involve a large number of tunnels and improving passenger vibration comfort. Meanwhile, a novel idea was provided for evaluating the vibration comfort of passengers who prolonged exposure to low-amplitude environments.

Effects of Half-Time Cooling Using a Fan with Skin Wetting on Thermal Response During Intermittent Cycling Exercise in the Heat.

The present study investigated the effects of half-time (HT) break cooling using a fan and damp sponge on physiological and perceptual responses during the 2 nd half of a repeated-sprint exercise in a hot environment. Eight physically active men performed a familiarization trial and two experimental trials of a 2×30-min intermittent cycling exercise protocol with a 15-min HT break in hot conditions (35°C, 50% relative humidity). Two experimental trials were conducted in random order: skin wetting with a fan (FAN wet ) and no cooling (CON). During the 2 nd half, a repeated-sprint cycling exercise was performed: i. e., 5 s of maximal pedaling (body weight×0.075 kp) every minute, separated by 25 s of unloaded pedaling (80 rpm) and 30 s of rest. Rectal temperature, skin temperature (chest, forearm, thigh, and calf), heart rate, physiological strain index, rating of perceived exertion, thermal sensation, and comfort were significantly improved in the FAN wet condition (P<0.05). There was no significant difference in the repeated-sprint cycling exercise performance between conditions. The results suggest that skin wetting with a fan during the HT break is a practical and effective cooling strategy for mitigating physiological and perceptual strain during the 2 nd half in hot conditions.

Analisis Faktor yang Berhubungan dengan Pelaksanaan Manajemen Nyeri Non Farmakologis Oleh Perawat Pelaksana di Irna Non Bedah RSUP Dr M Djamil Padang Tahun 2015

The comfort rate of patients or patients free from pain is one indicator of the quality of health services in inpatient rooms. One of the nurse's efforts to improve the quality rate is non-pharmacological pain management. Non-surgical Irna has a fairly high pain rate, but the number of pain management performed by nurses is still low. The purpose of this study was to analyze the factors associated with the implementation of non-pharmacological pain management by nurses at Irna Non-Surgical. This study uses an analytical design with a Cross Sectional approach. The sample of this study was 89 people who were taken purposively. This research instrument was made by researchers who have been tested for validity and reliability. The results showed that more than half (59.6%) of nurses were not good at implementing non-pharmacological pain management. Based on the Chi-square statistical test, there is a significant relationship between training, knowledge, attitudes and motivation towards the implementation of non-pharmacological pain management with each P-value (0.001; 0.007; 0.001; 0.001). The factor that has the greatest contribution to the implementation of non-pharmacological pain management is training. Therefore, it is expected that service institutions can create sustainable training programs on non-pharmacological pain management.

Creating the Illusion of Sportiness: Evaluating Modified Throttle Mapping and Artificial Engine Sound for Electric Vehicles

Modern computerized vehicles offer the possibility of changing vehicle parameters with the aim of creating a novel driving experience, such as an increased feeling of sportiness. For example, electric vehicles can be designed to provide an artificial sound, and the throttle mapping can be adjusted to give drivers the illusion that they are driving a sports vehicle (i.e., without altering the vehicle’s performance envelope). However, a fundamental safety-related question is how drivers perceive and respond to vehicle parameter adjustments. As of today, human-subject research on throttle mapping is unavailable, whereas research on sound enhancement is mostly conducted in listening rooms, which provides no insight into how drivers respond to the auditory cues. This study investigated how perceived sportiness and driving behavior are affected by adjustments in vehicle sound and throttle mapping. Through a within-subject simulator-based experiment, we investigated (1) Modified Throttle Mapping (MTM), (2) Artificial Engine Sound (AES) via a virtually elevated rpm, and (3) MTM and AES combined, relative to (4) a Baseline condition and (5) a Sports car that offered increased engine power. Results showed that, compared to Baseline, AES and MTM-AES increased perceived sportiness and yielded a lower speed variability in curves. Furthermore, MTM and MTM-AES caused higher vehicle acceleration than Baseline during the first second of driving away from a standstill. Mean speed and comfort ratings were unaffected by MTM and AES. The highest sportiness ratings and fastest driving speeds were obtained for the Sports car. In conclusion, the sound enhancement not only increased the perception of sportiness but also improved drivers’ speed control performance, suggesting that sound is used by drivers as functional feedback. The fact that MTM did not affect the mean driving speed indicates that drivers adapted their “gain” to the new throttle mapping and were not susceptible to risk compensation.

Clinical Comparison of a Silicone Hydrogel and a Conventional Hydrogel Daily Disposable Contact Lens.

PurposeTo compare the subjective performances of verofilcon A daily disposable silicone hydrogel contact lenses (CLs) and etafilcon A hydrogel CLs.MethodsSuccessful wearers of spherical soft CLs for distance correction were prospectively randomized to wear verofilcon A or etafilcon A lenses for 1 week and crossed over to the alternative lenses. The primary study objective was a comparison of distance visual acuity (VA). Exploratory endpoints included subjective overall lens preference (5-point scale) and subjective ratings (10-point scales) of end-of-day (EOD) vision, overall handling, insertion comfort, EOD comfort, overall quality of vision, overall comfort, vision throughout the day, lens handling at insertion, and lens handling at removal.ResultsOf 92 subjects (184 eyes), 46 each were randomized to verofilcon A or etafilcon A lenses and subsequently crossed over to the other lenses. Evaluation of distance VA showed that verofilcon A lenses were noninferior to etafilcon A lenses. Comparison of lens preference showed that 68 (73.9%) subjects somewhat or strongly preferred verofilcon A lenses, whereas 21 (22.9%) somewhat or strongly preferred etafilcon A lenses (p<0.0001). Mean ± SD ratings of EOD vision (8.6±1.5 vs 7.7±1.9), overall handling (8.7±1.5 vs 6.9±2.3), insertion comfort (9.2±1.0 vs 7.7±1.9), and EOD comfort (8.0±1.9 vs 7.0±2.2) were all significantly (p≤0.0001 each) higher for verofilcon A than for etafilcon A lenses. Mean ± SD ratings of overall quality of vision (8.9±1.2 vs 8.2±1.8), overall comfort (8.6±1.5 vs 7.4±1.8), vision throughout the day (8.9±1.3 vs 8.1±1.8), lens handling at insertion (9.0±1.4 vs 6.9±2.5), and lens handling at removal (8.3±2.1 vs 7.7±2.2) were also significantly higher for verofilcon A lenses. No subject experienced any ocular adverse events.ConclusionAfter 1 week of wear, the study population reported that ratings for subjective endpoints were significantly higher for verofilcon A lenses than for etafilcon A lenses.

Increasing medical student confidence in gender and sexual health through a student-initiated lecture series.

Introduction: Medical students self-report insufficient training in topics of gender and sexuality in medicine, which may ultimately lead to negative health outcomes in patients for whom they will provide care. This study aims to identify whether a student-initiated lecture series on topics related to gender and sexual health leads to greater student comfort with discussing topics related to diverse sexual content.Methods: Medical students matriculated during two consecutive academic years were invited to participate in the lecture series. Investigators administered anonymous pre- and post-series surveys (n=152 and 105 respondents, respectively) using google forms. Respondents rated their comfort levels discussing relevant topics and provided narrative feedback concerning strengths and areas for improvement of the lecture series. Overlaps between the 95% confidence intervals around pre- and post-series percentage of students comfortable/very comfortable discussing each topic were examined to compare pre- vs post-series comfort ratings. Narrative comments were reviewed for thematic feedback.Results: 105 medical students completed the lecture series, with 80% identifying as female. Self-assessed comfort levels across all seminar topics were greater in post- versus pre-lecture series surveys with the following topics showing the biggest differences (percentage of students “somewhat” or “very” comfortable [95% confidence intervals]: discussing sexuality with gender (68%[59-77] vs. 29%[22-36]) and sexual minority patients (84%[77-91] vs. 49%[41-57]), HIV prevention counseling (70%[61-78] vs. 20% [20-34]), identifying female genital cutting (44% [34-53] vs. 11%[6-16]), and discussing intimate partner violence (65%[55-74] vs. 33%[25-40]). Qualitative analysis indicated respondents found the lectures to be effective and believed they should be integrated into the required medical school curriculum.Conclusion: Our student-initiated lecture series was associated with greater student comfort discussing topics related to gender and sexuality with patients. This framework represents a useful method to address gaps in medical education and has the potential to improve health outcomes in multiple populations.

The Road to Reopening Educational Institutes through Utilizing Machine Learning

The coronavirus transcended from epidemic to a pandemic in March 2020. Due to this many countries across the world went into lockdown, affecting daily activities and thereby severely hampering educational activities, specifically in rural areas and in particular in under-developed countries. This paper describes a supervised machine learning algorithm in detail, which provides a comfort rating by accounting the student demographics, available mode of transport, etc., across a given region, to help educational institutes across the world to come up with a suitable plan to restart their activities risk free amidst the pandemic.

Application of Peppermint Water Spray Combined With Cucumber Slice External Application or Lip Balm and Conventional Dipping in ICU Dry Mouth Patients

to analyze the effect of peppermint water spray combined with external application of cucumber slice or lip balm and conventional dipping in patients with dry mouth in intensive care unit (ICU). Methods: 120 patients with secondary xerostomia in our hospital from January 2018 to December 2019 were selected as the subjects. According to the different treatment methods, the patients were divided into A group (Peppermint water spray combined with cucumber slices for external application), group B (Peppermint water spray combined with lip gloss smear), group C (cotton swab dipped in normal saline), 40 cases in each group, and the saliva secretion and dry mouth before and after intervention in three groups were compared between the three groups. The degree of self-evaluation score and the evaluation of throat comfort and satisfaction after intervention. Results: after the intervention, the self-evaluation scores of salivary secretion and dry mouth degree of patients in group A and B were significantly higher than those before the intervention (P &lt; 0.01), the self-evaluation scores of salivary secretion and dry mouth degree of patients in group A were significantly higher than those in group B and C (P &lt; 0.01), and the self-evaluation scores of salivary secretion and dry mouth degree of patients in group B were significantly higher than those in group C (P &lt; 0.01). After intervention, the total effective rate of improvement of throat comfort in group A was 87.50%, which was significantly higher than 40.00% in group B and 0.00% in group C (P &lt; 0.01). The total effective rate of improvement of throat comfort in group B was significantly higher than that in group C (P &lt; 0.01). 97.50% of the patients in group A were significantly higher than 72.50% in group B and 2.50% in group C (P &lt; 0.01), and the patients in group B were significantly higher than those in group C (P &lt; 0.01). Conclusion: homemade peppermint water spray combined with external application of cucumber spray can effectively improve the symptoms of dry mouth and throat discomfort in patients with ICU, improve their satisfaction with treatment, and is conducive to the recovery of patients’ diseases, which is worthy of clinical promotion and application.

Effectiveness of a New 3D-Printed Dynamic Hand-Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients.

Spasticity, a common stroke complication, can result in impairments and limitations in the performance of activities and participation. In this study, we investigated the effectiveness of a new dynamic splint on wrist and finger flexor muscle spasticity in chronic stroke survivors, using a randomized controlled trial. Thirty chronic stroke survivors were recruited and randomly allocated to either an experimental or control group; 25 completed the 6-week intervention program. The participants in the experimental group were asked to wear the dynamic splint at least 6 h/day at home, for the entire intervention. The participants in the control group did not wear any splint. All the participants were evaluated 1 week before, immediately, and after 3 and 6 weeks of splint use, with the modified Ashworth scale and the Fugl−Meyer assessment for upper extremity. User experience was evaluated by a self-reported questionnaire after the 6-week intervention. The timed within-group assessments showed a significant reduction in spasticity and improvements in functional movements in the experimental group. We found differences, in favor of the experimental group, between the groups after the intervention. The splint users indicated a very good satisfaction rating for muscle tone reduction, comfort, and ease of use. Therefore, this new splint can be used for at-home rehabilitation in chronic stroke patients with hemiparesis.

Modified Breast Band Improving the Postoperative Breast Augmentation and Reconstructive Experience

Background: Superior displacement of implants is a common complication in the early postoperative period following breast augmentation surgery. Postoperative breast bands are used during the first 4 weeks to optimize breast implant position following breast augmentation and reconstructive procedures. Although currently available breast bands are effective in maintaining implants in an inferior position, they have been observed to irritate the armpit region. We hypothesized that a modified breast band geometry with cut outs to accommodate the armpit region would provide equal maintenance of desired implant position while providing improved postoperative comfort. Methods: Forty patients who underwent breast augmentation and/or reconstruction were randomly assigned to receive either the traditional breast band or the modified cut out designed breast band following surgery for 4 weeks. Patients rated their breast bands on a 1 to 10 scale regarding (1) comfort, (2) appearance, and (3) overall satisfaction at their routine postoperative visits at 1, 2, and 4 weeks following surgery. Results: The modified breast band scored higher for all factors at 1, 2, and 4 weeks following surgery. The traditional band demonstrated decreasing scores for comfort and overall satisfaction when compared at 4 weeks versus 1 week. There was no change in the modified breast band scores for comfort, appearance, nor overall satisfaction over the same time period. Discussion: This study of 40 patients found that the modified band provides equally effective maintenance of implants in a desired position without compromising comfort and appearance. Patients who used the modified band had a better experience with the band comfort, appearance, and overall satisfaction in comparison to the traditional band. The higher ratings for the cut out band for comfort, appearance, and overall satisfaction were consistent from week 1 to 4. Conclusion: In contrast, the traditional band not only scored lower in comfort, appearance, and overall satisfaction compared to the modified band but also demonstrated significant decrease in the patients’ ratings for comfort and overall satisfaction for the traditional band from week 1 to 4. This study supports the conclusion that a modified cut out breast band design provides an equally effective maintenance of implants in a desired position without compromising comfort, appearance, and overall satisfaction when compared to the traditional band.

Perceived Risk of Infection Linked to Changes in Comfort in Social Situations From Before to During the COVID-19 Pandemic.

Background: Social lives have significantly changed since social distancing measures have been implemented to prevent the spread of the coronavirus disease 2019 (COVID-19). This study aimed to investigate how our appraisal of social situations changed during the pandemic.Methods: In two online surveys, conducted in October 2019 and April 2020, 58 participants rated their personal level of comfort for sketches depicting social situations. Situations were separately categorized according to the risk of a possible COVID-19 infection and changes in ratings were analyzed by using a repeated measures ANOVA. Moreover, potential influencing factors on the change in ratings such as perceived infection risk and social factors like regular frequency and liking of social interactions were examined.Results: There was a significant interaction (p < 0.001) between time of measurement and risk category. Comfort ratings of depicted situations with low and medium infection risk were higher during the second compared to the first survey period. Ratings of high-risk situations did not change significantly, although there was a tendency toward lower ratings during the pandemic. Multiple regression analyses showed that perceived probability of short-term infection could explain variance in the change of ratings of social situations with low- and medium risk, but not perceived probability of long-term infection or social factors.Conclusion: The results suggest that the change of participant's appraisal of the social situations during the COVID-19 pandemic relates to perceived infection risk. Both, the risk associated with the specific scenario as well as the general belief of short-term infection risk were associated with change. This change predominantly manifested in greater thought of comfort during low and medium risk situations, which might give a sense of safety during the pandemic. The finding that high-risk social situations were not rated as uncomfortable as expected must be considered with regard to the young sample and may not be generalizable to other individuals. Further research is necessary to evaluate long-term effects on social interactions caused by global pandemics such as the COVID-19 pandemic.

The effect of various pressure of pneumatic uterine bracket by using saccule sterine external stent on incidence of supine hypotensive syndrome

The saccule uterine external stent with a pneumatic uterine bracket reportedly prevents the incidence of supine hypotension syndrome (SHS) during cesarean section under combined spinal - epidural anesthesia (CSEA). However, the preventive effect is affected by the pressure within pneumatic uterine bracket. This study aims to explore the optimal pressure. One hundred forty-eight pregnant women were selected and randomly divided into three groups: Group A (the control group, n = 49), Group B (n = 49), and Group C (n = 50). The pressure within pneumatic uterine bracket was set at 240 mmHg, 260mmHg, and 280mmHg, respectively, during cesarean section under CSEA for participants in groups A, B and C. The intraoperative comfort rate and incidence of SHS were recorded. No significant difference in the anesthetic efficacy was observed among the three groups (p > 0.05). However, there was a significant difference in the occurrence of SHS, with a reduction of 30 mmHg in blood pressure. The incidence of SHS belong the three groups showed significant differences (36.73% in Group A, 18.37% in Group B and 18.00% in Group C, p < 0.05). In addition, significant differences (p < 0.05) in the intraoperative comfort rate were also found among the three groups, with the comfort rate of 69.39% in group A, 91.84% in group B and 90.00% in Group C. The optimal pressure within pneumatic uterine bracket for preventing SHS hypotension is about 260 mmHg. These findings might contribute to the prevention of SHS.

Auricular Point Acupressure Combined with Compound Lidocaine Cream to Manage Arteriovenous Fistula Puncture Pain: A Multicenter Randomized Controlled Trial.

Background Arteriovenous fistula (AVF) puncture pain is an inevitable problem for maintenance hemodialysis (MHD) patients and may seriously endanger the physical and mental health of patients with MHD. Studies have shown that drug or nondrug measures can reduce AVF puncture pain, but much improvement is needed. When combined with compound lidocaine cream (CLC) in the treatment of AVF puncture pain, auricular point acupressure (APA)—a therapeutic method in which specific points on the auricle of the outer ear are stimulated to treat various disorders of the body—and the therapeutic value and synergistic effects of auriculotherapy merit further investigation. Methods 120 MHD patients were recruited at blood purification centers in three hospitals between January 2016 and April 2019. After completion of the baseline survey, all patients were randomly divided by the envelope method into a control group, APA group, CLC group, and APA combined with CLC, with 30 subjects per group. The numerical rating scale (NRS) of pain was used to measure the pain before intervention and 1, 4, and 8 weeks after intervention. The State-Trait Anxiety Inventory (STAI), General Comfort Questionnaire (GCQ), blood pressure, and heart rates were obtained before and after the intervention. Results Pain, anxiety, comfort, blood pressure (BP), and heart rates (HR) of the three groups were better than those of the control group; the difference was statistically significant (P < 0.05). In addition, the APA combined with CLC group was better than the APA group and CLC group, respectively, in those outcomes (P < 0.05). Conclusion Both APA and CLC can effectively relieve AVF puncture pain, and the combined application has more outstanding effects.

Effects of the COVID-19 lockdown on musculoskeletal pain, physical activity, and work environment in Estonian office workers transitioning to working from home.

COVID-19 lockdown caused a sudden change in the work culture and environment. The aim of this study was to evaluate the impact of COVID-19 lockdown caused changes in musculoskeletal pain (MSP), physical activity (PA), workplace properties, and their in-between relationships among office workers. A total of 161 office workers (64.6%female) with a mean age of 38.2±9.5 years participated. The study was conducted as an online form. Baecke Physical Activity Questionnaire, NORDIC Questionnaire, and questions about the work environment were used. The participants were asked to describe the current situation and retrospectively the situation 3 months before. We found no significant differences in the prevalence of MSP or between the mean number of body regions suffering from MSP before and during the lockdown. During the lockdown, a significant (p < 0.001) reduction in total PA and sport-related PA and a significant (p < 0.001) increase in work-related PA was noted. A significant drop in both workplace comfort rating (p < 0.05) and workplace ergonomics rating (p < 0.001) was suggested during the lockdown. Our data also suggested several individual factors influencing the MSP among office workers during the lockdown. Maintaining habitual physical activity level and preparing a more comfortable and ergonomic workspace can play a role in a healthier transition to working from home.

Perception of Thermal Comfort during Skin Cooling and Heating.

Due to the static and dynamic activity of the skin temperature sensors, the cutaneous thermal afferent information is dependent on the rate and direction of the temperature change, which would suggest different perceptions of temperature and of thermal comfort during skin heating and cooling. This hypothesis was tested in the present study. Subjects (N = 12; 6 females and 6 males) donned a water-perfused suit (WPS) in which the temperature was varied in a saw-tooth manner in the range from 27 to 42 °C. The rate of change of temperature of the water perfusing the suit (TWPS) was 1.2 °C min−1 during both the heating and cooling phases. The trial was repeated thrice, with subjects reporting their perception of the temperature and thermal comfort at each 3 °C change in TWPS. In addition, subjects were instructed to report when they perceived TWPS uncomfortably cool and warm during cooling and heating, respectively. Subjects reproducibly identified the boundaries of their Thermal Comfort Zone (TCZ), defined as the lower (Tlow) and upper (Thigh) temperatures at which subjects reported slight thermal discomfort. During the heating phase, Tlow and Thigh were 30.0 ± 1.5 °C and 35.1 ± 2.9 °C, respectively. During the cooling phase, the boundary temperatures of Tlow and Thigh were 35.4 ± 1.9 °C and 38.7 ± 2.3 °C, respectively. The direction of the change in the cutaneous temperature stimulus affects the boundaries of the TCZ, such that they are higher during cooling and lower during heating. These findings are explained on the basis of the neurophysiology of thermal perception. From an applied perspective, the most important observation of the present study was the strong correlation between the perception of thermal comfort and the behavioral regulation of thermal comfort. Although it is not surprising that the action of regulating thermal comfort is aligned with its perception, this link has not been proven for humans in previous studies. The results therefore provide a sound basis to consider ratings of thermal comfort as reflecting behavioral actions to achieve the sensation of thermal neutrality.

Assessment of Pediatric Resident Knowledge and Comfort in Addressing Childhood Obesity in Clinical Practice

Background: Recent data estimate the prevalence of pediatric obesity at 19.3%. Emphasis on primary prevention and early identification is needed to avoid development of serious medical and psychosocial sequelae. The objective of this initiative is to assess baseline knowledge and comfort among trainees at an inner-city pediatric residency program in identifying children with overweight/obesity, evaluating associated risk factors and comorbidities, and providing effective counseling. Methods: Key topics from 2 major guidelines on pediatric obesity assessment, prevention, and treatment were incorporated into the development of a resident questionnaire, which consisted of 12 knowledge-based questions and a Likert scale evaluating self-perceived knowledge and comfort on 7 skills. Results: Forty-six percent of eligible residents completed the questionnaire (n = 28). The mean score on the objective knowledge-based section was 44% ± 13%, with no differences by training year. The percentage of residents with correct responses by topic ranged from 14% to 79%. The mean self-perceived knowledge rating was 3.56 ± 0.86. The mean self-perceived comfort rating was 3.53 ± 0.89. Neither the self-perceived knowledge nor comfort rating was a significant predictor of performance on the objective knowledge-based section when controlling for postgraduate year status. Conclusions: Significant gaps in knowledge were discovered among pediatric residents with regard to appropriate screening, assessment, and counseling practices related to pediatric overweight/obesity. These deficits were not consistently reflected in residents' self-perceived knowledge and comfort ratings. The results of this initiative highlight the need for incorporation of standardized curricula on childhood overweight/obesity into pediatric resident education.

Thermal Comfort in an Office Room Using Square Diffuser

The office is an important part of our daily life, people spend most of their time doing works inside of the office and therefore the quality of the indoor environment is a significant factor affecting the productivity and happiness of office users. Many factors ınfluence the pattern of airflow: indoor air quality, thermal comfort and energy saving in an office room. In this study, the effects of the square diffusers on thermal comfort investigated numerically for an office room. Numerical research was subsequently carried out using the validated CFD model. This model solved the continuity, energy conservation and momentum equations in addition to k–ε model equation for turbulence modelling. Predicted Percentage of Dissatisfied (PPD) is a frequently used tool for assessing human comfort rating. A PPD based control HVAC (Heating, Ventilating and Air Conditioning) system has the potential to provide enhanced thermal comfort inside a location by taking into consideration all main thermal comfort variables. The CFD results revealed that thermal conditions occurred according to ASHRAE standards in the model office room with a square diffuser.

Fast versus gradual adaptation of soft monthly contact lenses in neophyte wearers

AimTo determine if a gradual adaptation period is necessary for neophytes when fitted with modern hydrogel or silicone hydrogel reusable disposable contact lenses. MethodAcross four sites, 74 neophytes (18–28 years) were randomly assigned to a reusable lens cleaned nightly with Opti-Free® Puremoist® multi-purpose contact lens solution: Proclear® (hydrogel) or Biofinity® (silicone hydrogel) and an adaptation schedule: fast (10 h wear from the first day) or gradual (4 h on the first day, increasing their wear time by 2 h on each subsequent day until they had reached 10 h). Masked investigators graded ocular surface physiology and non-invasive tear breakup time (NIBUT) and a range of comfort, vision and lens handling subjective ratings (0–100 visual analogue scales) were recorded at the baseline visit and after 10 h of lens wear, 4–6 days and 12–14 days after lens fitting. Subjective scores were also repeated after 7 days. ResultsThere was no difference (p > 0.05) in ocular surface physiology or NIBUT between fast and gradual adaptation groups at any time point in either lens type with the exception of increased corneal staining (p = 0.019) in the silicone hydrogel fast adaptation group after 4–6 days, but was similar by 12–14 days. Subjective scores were also similar across the visits and lens types with the exception of ‘lens awareness’ (p = 0.019) which was less in the gradual versus the fast adaptation silicone hydrogel lens group at 12–14 days. ConclusionThere seems to be no clinical benefit for recommending a gradual adaptation period in new wearers fitted with modern soft reusable disposable contact lenses. The findings of this work add to a growing body of evidence suggesting that such advice is unnecessary in regular soft contact lens wear, which has important ramifications for the initial clinical management of these patients.

Acute effects of spaced cathodal transcranial direct current stimulation in drug resistant focal epilepsies

ObjectiveTo evaluate the safety and temporal dynamic of the antiepileptic effect of spaced transcranial direct current stimulation (tDCS) in different focal epilepsies. MethodsCathodal tDCS with individual electrode placement was performed in 15 adults with drug resistant focal epilepsy. An amplitude of 2 mA was applied twice for 9 minutes, with an interstimulation interval of 20 minutes. Tolerability was assessed via the Comfort Rating Questionnaire and the frequency of interictal epileptiform discharges (IEDs) was sequentially compared between the 24 hours before and after tDCS. ResultsTDCS led to a significant reduction in the total number of IEDs/24 h by up to 68% (mean ± SD: −30.4 ± 21.1%, p = 0.001) as well as in seizure frequency (p = 0.041). The maximum IED reduction was observed between the 3rd and 21st hour after stimulation. Favorable clinical response was associated with structural etiology and clearly circumscribed epileptogenic foci but did not differ between frontal and temporal epilepsies. Overall, the tDCS treatment was well tolerated and did not lead to severe adverse events. ConclusionsThe spaced stimulation approach proved to be safe and well-tolerated in patients with drug-resistant unifocal epilepsies, leading to sustained IED and seizure frequency reduction. SignificanceSpaced tDCS induces mediate antiepileptic effects with promising therapeutic potential.