Discomfort Scale Research Articles

The efficacy of a food supplement in the treatment of tinnitus with comorbid headache: A Statistical and Machine Learning analysis with a literature review.

Introduction Tinnitus, the perception of sound without an external auditory stimulus, affects approximately 10% to 15% of the population and is often associated with significant comorbidities such as headaches. These conditions can severely impact the quality of life. The aim of this study was to evaluate the efficacy of a food supplement in reducing the symptoms of both tinnitus and headache in patients experiencing these conditions concurrently. Methods This prospective study included 32 patients (21 males and 11 females) aged between 23 and 68 years (mean age 49.38 years) who were experiencing both tinnitus and headache. The study assessed the impact of a food supplement on tinnitus and headache over a 90-day treatment period using three main instruments: the Tinnitus Handicap Inventory (THI), the Headache Impact Test (HIT-6), and a Visual Analog Scale (VAS) for discomfort. Statistical analyses, including paired t-tests, were conducted to compare pre- and post-treatment scores. In the same dataset, Ridge Regression, a linear regression model with L2 regularization, was used to predict post-treatment scores (THI90, HIT90, VAS90). Results The results indicated a statistically significant reduction in all three measures after 90 days of treatment. The mean THI score decreased from 29.81 to 27.06 (p = 0.011), the mean HIT-6 score decreased from 50.41 to 48.75 (p = 0.019), and the mean VAS score for discomfort decreased from 7.63 to 7.13 (p = 0.033). The optimal Ridge Regression model was found with an `alpha` value of approximately 3.73. The performance metrics on the test set were as follows: Mean Squared Error (MSE) of 13.91 and an R-squared score of 0.61, indicating that the model explains approximately 61% of the variance in the post-treatment scores. These results indicate that pre-treatment scores are significant predictors of post-treatment outcomes, and gender plays a notable role in predicting HIT and VAS scores post-treatment. Conclusion This study demonstrates that a food supplement is effective in reducing the symptoms of tinnitus and headache in patients suffering from both conditions. The significant improvements in THI, HIT-6, and VAS scores indicate a positive impact on patient quality of life. Further research with larger sample sizes and more detailed subgroup analyses is recommended to fully understand the differential impacts of treatment across various demographics.

Microneedling With RF-Assisted Skin Penetration Improves the Hard-to-Treat Periorbital Wrinkles: Nonrandomized Clinical Trial.

This prospective study evaluates the efficacy and safety of minimally invasive radiofrequency microneedling (RFMN) for the correction of periorbital wrinkles. This study aimed to address the challenges posed by the periorbital region's unique anatomy and the limitations of existing non-surgical treatments. Twenty-four subjects, ranging from 34 to 54 years old with Fitzpatrick skin types II-V, underwent a series of treatments using the Voluderm RF microneedling device. Participants were divided into two groups based on the severity of their wrinkles and treated with customized protocols over four sessions, with a 3-month follow-up to assess outcomes. Efficacy was determined through comparisons of pre-treatment and post-treatment wrinkle severity, using the Lemperle Classification of Facial Wrinkles (LFW) and the Global Aesthetic Improvement Scale, evaluated by both the investigators and the patients. Safety and tolerability were assessed through adverse event reporting and a Visual Analog Scale for treatment discomfort. The results demonstrated a statistically significant reduction in periorbital wrinkle severity, with an average 49% decrease of LFW score and improvements noted across all skin types in both groups. The aggregated facial LFW score decreased from baseline mean 13.00 ± 4.75 to 6.09 ± 3.90 (p < 0.05). The treatment was well tolerated without anesthetics, with minimal downtime and few adverse events, which were transient and resolved without intervention. The efficacy of Voluderm RF microneedling in improving periorbital wrinkles of variable severity was demonstrated in patients with diverse skin types. The unique RF-assisted mechanism of the skin penetration granted a high tolerability of the treatments, negligible downtime, and minimum number of adverse events with self-resolution.

Development of a new scale for self-reported procedural patient comfort during endovascular therapy for acute stroke.

In stroke patients with acute large vessel occlusion, endovascular therapy (EVT) may be performed with or without sedation. Our aim is to describe self-reported intraprocedural comfort in patients undergoing EVT depending on sedation type. We performed a prospective observational single-center study of patients undergoing EVT. Patients were systematically interviewed on the day following intervention using a structured questionnaire addressing five domains (nausea/vomiting, pain of any kind, physical discomfort, emotional discomfort, and medical team interaction). Each domain scored 0 to 2 points for a maximum total of 10 points (a higher score indicating greater discomfort). In addition, satisfaction with procedural comfort was rated on a visual analog scale (VAS), and patients reported whether they would have preferred more, less, or the same amount of sedation. Patients who underwent EVT without sedation (local anesthesia, LA) were compared to those who received procedural sedation (conscious sedation, CS). Seventy-seven questionnaires were completed: 37 (48%) patients underwent EVT with CS while 40 (52%) were treated under LA. Median scores on the self-reported discomfort scale (1[0-2] vs 1[0-2], p = 0.70) and mean scores on VAS (76 ± 25 vs 81 ± 24, p = 0.37) were similar between the CS and the LA group. The proportion of patients who were satisfied with the adopted sedation strategy was similar between groups. EVT without prior sedation seems to be well tolerated. Systematic self-evaluation of patient comfort appears feasible and may become integrated into routine clinical care. Patient-oriented outcomes should be included in future trials of sedation during thrombectomy.

Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders.

Research on temporomandibular disorder (TMD) responsiveness is scarce and limited regarding patients' representativeness. This study aimed to estimate minimum clinically important difference (MCID) and substantial clinical benefit (SCB) among a large and diverse patient population regarding sex and age. In this study, 162 patients participated from five hospitals. MCID and SCB in pain, functional disability and quality of life were examined with anchor-based methods. Patients' global impression of change was used as the anchor. Area under the curve (AUC) values were determined for testing accuracy. Changes from baseline and coefficient of variation by responsiveness status were calculated to explain the results of accuracy. SCB was estimated to be 2.18 for the numeric rating scale (NRS) for pain (AUC: 0.80 [95% CI: 0.72-0.88]) in all patients and 2.50 in women (AUC: 0.81 [95% CI: 0.71-0.89]). The estimated SCB of NRS for discomfort (1.50) and Jaw Functional Limitation Scale for mastication (1.35) had wide CIs for AUCs. Likewise, the estimated MCIDs of NRS for pain (0.80) and NRS for discomfort (1.50) had wide CIs for AUCs. Among non-responders who did not achieve the MCID of NRS for pain, the coefficient of variation was very high for all outcomes other than the NRS for pain. This study investigated the responsiveness of patients with TMD using a large and diverse patient sample. SCB in pain decrease can be used to assess the responsiveness of patients with TMD. Composite outcomes should be developed to estimate MCID.

Validity and Reliability of the German Vocal Fatigue Index in Adults With Voice Disorders.

Vocal fatigue-related symptoms, frequent in patients with voice disorders, are reliably quantifiable with the Vocal Fatigue Index (VFI) in several languages. The main aim of this work was to investigate the content and construct validity of the German Vocal Fatigue Index (VFI-D) by comparison with the German Voice Handicap Index 9 international (VHI9i) and the Vocal Tract Discomfort Scale (VTD). Moreover, the scale and retest reliability were investigated. In a prospective cohort study at two tertiary care hospitals, 93 adults with all types of voice complaints filled out the VFI-D, the VHI-9i, and the VTD. Eighty-one adults (Mage = 53.5 years, SD = 15.7) completed them one time, and additional 12 patients (Mage = 53.8 years, SD = 15.6) did a test-retest, completed them twice at an interval of 1 week. The validity was assessed by Spearman's rho and Mokken scaling and the reliability by a factor analysis and a two-tailed t test. Mokken scaling has proven the VFI-D as one-dimensional questionnaire (one cluster, r = .95). All VFI-D items could be assigned to one of three factors according to principal component and principal axis factor analysis. Although Factor 1 related best to the VHI9i (∅ rs = .76) and Factor 2 to the VTD (∅ rs = .74), Factor 3 correlated moderately with the VHI9i (rs = .34) and weakly with the VTD (rs = .25). Results from the first and second VFI-D completion agreed strongly (t = -1.78, p = .10). In this study, the content and construct validity of the VFI-D were confirmed. Also, both scale reliability with identical factors as those in the original study and retest reliability were verified. The VHI9i and VTD were highly indicative of VFI-D Factors 1 and 2, respectively. No correlation between Factor 3 and the other questionnaires was determined. Future research should evaluate which characteristics are specific to vocal fatigue versus general voice disorder-related symptoms.

Non-invasive quantitative assessment of induced component displacement can safely and accurately diagnose tibial component loosening in patients: A prospective diagnostic study.

Aseptic loosening often requires major, expensiveand invasive revision surgery. Current diagnostic modalities merely show indirect signs of loosening. A recent proof of concept study proposed a non-invasive technique for the quantitative and visual assessment of implant movement as a diagnostic aid for tibial component loosening. The primary research question addressed is whether this novel diagnostic modality can safely and effectively aid the diagnosis of aseptic loosening. This clinical study included patients suspected of aseptic total knee arthroplasty (TKA) loosening listed for revision surgery and asymptomatic patients. Safety was evaluated using a numerical rating scale (NRS) for discomfort and by registration of adverse events. Feasibility was assessed by recording the duration and ease of the procedure. Intra- and interrater reliability were evaluated. In symptomatic patients, diagnostic accuracy metrics were evaluated with intra-operative assessment as a reference test. In total, 34 symptomatic and 38 asymptomatic knees with a TKA were analysed. The medianNRSfor discomfort during loading was 6 (interquartile range [IQR]: 3.75-7.00) in symptomatic patients and 2 (IQR: 1.00-3.00) in asymptomatic patients. No adverse events were reported. The majority of users found the use of the loading device easy. The median time spent in the computed tomography roomwas 9 min(IQR: 8.00-11.00). Excellent to good intra- and interrater reliabilities were achieved. Diagnostic accuracy analysis resulted in a sensitivity of 0.91 (95% confidence interval [CI]: 0.72-0.97) and a specificity of 0.72 (95% CI: 0.43-0.90). The proposed diagnostic method is safe, feasible, reliableand accurate in aiding the diagnosis of aseptic tibial component loosening. Level II.

Parental Expectations and Student’s Morality Mediating Role of Frustration Intolerance

This study aimed to examine how student morality was affected by parents’ expectations and the emphasis was on moral disengagement and academic dishonesty. The study further demonstrated the mediating role of frustration intolerance between parental expectations and students’ morality. A sample of students was chosen from various educational institutions (colleges and universities) in the Attock and Wah Cantt districts. For data collection, the researchers used four reliable scales namely, Living up Parental Expectations Inventory (LPEI), Frustration Discomfort Scale (FDS), Moral Disengagement Scale (MDS) and Academic Dishonesty Scale (ADQ). The findings from the research showed that students striving to live according to their parent’s expectations, students frequently indulge in moral disengagement and academic dishonesty. The findings additionally indicated that male students exhibited a greater degree of moral disengagement and academic dishonesty than female students furthermore frustration intolerance partially mediates the relationship between parents’ expectations and the moral behaviour of learners. The study findings suggest that to promote and fortify ethical actions in students, parents' desire needs to be handled effectively. By considering the impact of the pressure of parental expectations on moral disengagement and academic dishonesty, parents and educationists can organise collective efforts to create a supportive atmosphere to encourage integrity and honesty among students in academic settings.

Measuring pain or discomfort during routine nursing care in lightly sedated mechanically ventilated intensive care patients: A prospective preliminary cohort study

BackgroundPain is routinely measured on mechanically ventilated ICU patients. However, the tools used are not designed to discriminate between pain and non-pain discomfort, a distinction with therapeutic implications. ObjectivesTo evaluate whether clinical measurement tools can discern both pain and non-pain discomfort. MethodsA prospective observational cohort study was conducted in a General ICU at a tertiary Medical Center in Israel. The Behavior Pain Scale (BPS) and Visual Analog Scale (VAS) of Discomfort were simultaneously assessed by a researcher and bedside nurse on thirteen lightly sedated patients during 71 routine nursing interventions in lightly sedated, mechanically ventilated, adult patients. Patients were asked whether they were in pain due to these interventions. ResultsStatistically significant increases from baseline during interventions were observed [median change: 1.00 (-1–5), 1.5(-4–8.5), p < 0.001] as measured by BPS and VAS Discomfort Scale, respectively. BPS scores ranged between 4 and 6 when the majority (53 %) of the patients replied that they had no pain but were interpreted by the clinicians as discomfort. Endotracheal suctioning caused the greatest increase in BPS and VAS, with no statistically significant differences in BPS and VAS Discomfort Scale scores whether patients reported or did not report pain. A BPS>6 had a higher sensitivity and specificity to reported pain (accuracy of 76 %) compared to a BPS of 4–6. ConclusionsStandard assessments are sensitive to pain caused by routine nursing care interventions. However, this study presents evidence that among lightly sedated ICU patients, moderate BPS scores could also measure non-pain discomfort. ICU nurses should be aware that signs of unpleasantness measured by a pain scale could reflect non-pain discomfort.

Population characteristics and self-assessment of speaking and singing voice in Polish contemporary commercial music singers-an exploratory, cross-sectional study.

The domination of the Contemporary Commercial Music (CCM) industry in music markets has led to a significant increase in the number of CCM performers. Performing in a wide variety of singing styles involves exposing CCM singers to specific risk factors potentially leading to voice problems. This, in turn, necessitates the consideration of this particular group of voice users in the Occupational Health framework. The aim of the present research was threefold. First, it sought to profile the group of Polish CCM singers. Second, it was designed to explore the prevalence of self-reported voice problems and voice quality in this population, in both speech and singing. Third, it aimed to explore the relationships between voice problems and lifetime singing involvement, occupational voice use, smoking, alcohol consumption, vocal training, and microphone use, as potential voice risk factors. The study was conducted in Poland from January 2020 to April 2023. An online survey included socio-demographic information, singing involvement characteristics, and singers' voice self-assessment. The prevalence of voice problems was assessed by the Polish versions of the Vocal Tract Discomfort Scale (VTDS) and the Singing Voice Handicap Index (SVHI). Also, a self-reported dysphonia symptoms protocol was applied. The perceived overall voice quality was assessed by a Visual Analogue Scale (VAS) of 100 mm. 412 singers, 310 women and 102 men, completed the survey. Nearly half of the studied population declared lifetime singing experience over 10 years with an average daily singing time of 1 or 2 h. 283 participants received vocal training. For 11.4% of respondents, singing was the primary income source, and 42% defined their career goals as voice-related. The median scores of the VTDS were 11.00 (0-44) and 12.00 (0-40) for the Frequency and Severity subscales, respectively. The median SVHI score of 33 (0-139) was significantly higher than the normative values determined in a systematic review and meta-analysis (2018). Strong positive correlations were observed between SVHI and both VTD subscales: Frequency (r = 0.632, p < 0.001) and Severity (r = 0.611, p < 0.001). The relationships between most of the other variables studied were weak or negligible. The examined CCM singers exhibited substantial diversity with regard to musical genre preferences, aspirations pertaining to singing endeavors, career affiliations, and source of income. Singing voice assessment revealed a greater degree of voice problems in the examined cohort than so far reported in the literature, based on the SVH and VTDS.

Self-Perceived Vocal Symptoms and Discomfort in Amateur Church Singers

PurposeTo analyze self-perceived vocal symptoms and discomfort in amateur church singers and compare them between genders and church types. MethodsIt was a quantitative cross-sectional study involving 99 amateur church singers aged between 18 and 59 years. Data collection was carried out through the completion of a socio-demographic questionnaire, the Voice Symptom Scale (VoiSS), and the Vocal Tract Discomfort Scale (VTDS). The Mann-Whitney test was used for comparisons, and Spearman's correlation test was used for analyzing correlations between scale scores. The adopted significance level was 5% (p <0.05). ResultsThere was a prevalence of females (71.7%), amateur singers from Protestant churches (73.7%), with a mean age of 27.5 years. The average VoiSS total score was 22.6 points, the "limitation" domain was 12.3, the "emotional" domain was 2.55, and the "physical" domain was 7.7. The most self-perceived sensations in the VTDS were "dryness," "sore throat," and "itchiness" with mild to moderate intensity. There was a statistically significant difference between genders (p<0.05) and a positive correlation from weak (r=0.212) to strong magnitude (r=0.660) between vocal symptoms and vocal tract discomfort. There was no statistically significant difference between types of churches. ConclusionAmateur singers self-report high levels of vocal symptoms, which impact limitation, emotional, and physical domains. Furthermore, they experience vocal tract discomfort sensations, with dryness being the most frequently reported, followed by sore throat and itching. No significant differences were found between the scale scores and church types. However, females reported a greater frequency and intensity of vocal tract discomfort sensations. The greater the self-reported vocal symptoms in this population, the higher their self-reported frequency and intensity of vocal tract discomfort sensations. These findings underscore the importance of addressing vocal health issues in amateur singers to enhance their overall well-being.

Assessment of the musculoskeletal discomfort scale for upper limb among workers in inner Brazil.

Work-related musculoskeletal disorders for upper limbs (UL-WMSDs) form a complex of occupational diseases common to many professions worldwide. UL-WMSDs are manifested in most cases by pain, resulting in musculoskeletal discomfort. This research aimed to evaluate the perception of musculoskeletal discomfort in workers from the interior of the Brazilian states of Alagoas and Bahia through the construction of a scale to assess musculoskeletal discomfort for upper limb. The discomfort assessment scale was constructed from self-reported pain symptoms by 420 workers from the inner regions of the Brazilian states of Alagoas and Bahia. The reliability and dimensionality of the collected data were analyzed by McDonald's Omega and exploratory factor analysis, respectively. Item Response Theory (IRT) was used to create parameters for the discomfort scale. The musculoskeletal discomfort metric was constructed from the workers' response with six levels (varying from minimum discomfort to maximum discomfort). At the lowest level of the scale, workers indicated symptoms in the shoulders and wrists were rare. At the highest level of the scale, daily pain symptoms are reported in all regions of the upper limbs. The shoulders are the last region to develop extreme pain symptoms. The metric was created to present satisfactory psychometric properties and capable measurement of the workers' level of musculoskeletal discomfort based on self-reported pain symptoms. Therefore, the metric can support measuring discomfort, contributing to decisions that improve a healthier occupational environment for the worker.

Vocal Tract Discomfort Scale-Brazil (VTDS-BR): Validation Based on Internal Consistency, Reliability, and Accuracy

ObjectiveTo validate the Vocal Tract Discomfort Scale for the Brazilian Portuguese (VTDS-BR), based on internal consistency, reliability and accuracy. MethodsThe participants were 431 adults of both sexes, divided in two groups: dysphonia (DG) and vocally healthy (VHG). We built a digital database with personal, professional information and the item-by-item VTDS-BR responses of the participants. We applied Cronbach's alpha, exploratory factor analysis (EFA); confirmatory factor analysis (CFA); Item Response Theory (IRT) using the Samejima model; and ROC curve analysis to obtain the VTDS-BR cut-off point. ResultsThe VTDS-BR has an eight-item structure and two factors: vocal hyperfunction without phonotraumatic injury and with phonotraumatic injury. Each item is evaluated based on two facets related to frequency and intensity, with a Likert scale response key. There are four possible answers: never, sometimes, often, and always for frequency and none, mild, moderate, and intense for intensity. We applied an IRT model, which allowed the identification of which items are more related to dysphonia, based on higher values in the parameters discrimination (a) and difficulty (b), which contributed to the calculation of each participant's aptitude for the development of voice problems, by means of a score. The cut-off value was determined using the ROC curve, in which values greater than -1.432 indicate a higher probability of voice alterations. ConclusionVTDS-BR went through the stages of validation of internal consistency, reliability and accuracy. It presents an 8-item, two-factor, and two-facet structure to assess frequency and intensity of vocal tract discomfort symptoms. VTDS-BR is suitable for clinical use or in screening activities, as it is quick to apply and its interpretation is indicative of people with and without phonotraumatic injury.

Validation of Korean Version of the Anger Discomfort Scale

This article reports on the validation of the Korean version of the Anger Discomfort Scale (ADS-K) in samples comprising college students and community-based adults living in South Korea (n = 765). The Anger Discomfort Scale (ADS) is a 15-item scale designed to assess levels of discomfort associated with both the experience and expression of anger in interpersonal contexts. For psychometric property testing, survey data were analyzed with advanced multivariate methods, focusing on aspects of validity and reliability. The properties of the total scores are examined by descriptive statistics. The results of exploratory factor analysis and confirmatory factor analysis identified the structure of the ADS-K as a well-defined bi-factor model. Correlational analyses indicated that anger discomfort was positively associated with anger suppression, anger expression, trait anxiety, and constructs related to anxiety in interpersonal relationships (e.g., fear of evaluation by others and expectations of negative interpersonal results). Implications for the use of the ADS-K and future directions are suggested.

Pain and Health-Related Quality of Life in Autosomal Dominant Polycystic Kidney Disease: Results from a National Patient-Powered Registry

Rationale and ObjectiveADPKD impacts health-related quality of life (HRQoL) including pain, discomfort, fatigue, emotional distress, and impaired mobility. Stakeholders prioritized kidney cyst-related pain as an important core outcome domain in clinical trials, leading to development of disease-specific assessment tools. Study DesignThe ADPKD Registry is hosted online with multiple disease-specific patient reported outcomes modules to characterize the patient experience in the United States. Setting and ParticipantsThe ADPKD Registry allows consented participants access to a Core Questionnaire which includes demographics, comorbid conditions, current symptoms, and kidney function. Participants complete subsequent modules on a 3-month schedule, including two validated HRQoL tools, the ADPKD Pain and Discomfort Scale (ADPKD-PDS), the ADPKD Impact Scale (ADPKD-IS) and a Healthcare Access and Utilization module. ExposuresPatient-reported latest eGFR or creatinine used to calculate stage of chronic kidney disease. OutcomesHealth-related quality of life, measured using validated ADPKD-specific tools; access to PKD-specific healthcare. Analytical ApproachFor the two HRQoL tools, scores were calculated for physical, emotional, and fatigue domains, pain severity, and pain interference (based on the licensed user manuals). Associations to health care access were also assessed. ResultsBy July 2022, 1,086 individuals with ADPKD completed at least one of the HRQoL modules, 319 completed four over a year. Participants were an average age of 53, 71% women and 91% white, with all CKD stages represented. 2.5% reported being on dialysis and 23% had a kidney transplant. CKD Stage 4/5 participants reported the most dull kidney pain, while sharp kidney pain was evenly distributed across early CKD stages. Dull kidney pain had an impact on sleep regardless of CKD stage. There was a strong positive correlation between the ADPKD-PDS and ADPKD-IS. Patients with a neutral or positive HRQoL were less likely to have been denied access to imaging or other care. LimitationsCurrently all the information collected is patient-reported without health record validation of clinical variables. ConclusionsUse of the HRQoL tools in the ADPKD Registry provided a broad cross-sectional assessment in the U.S. and provided granular information on the burden of pain across the CKD spectrum in ADPKD. The ADPKD Registry allowed assessment of ADPKD impact in a community that experiences decline in health and kidney function over decades.

The Relationship Between Physical and Psychological Discomfort on the Quality of Life of Pregnant Women

Pregnancy is a period when a pregnant woman needs to adapt with the physical and psychological change. During the pregnancy, the mother who cannot adapt with that change will experience discomfort and impact the life quality. This research aimed to find out the correlation between the physical and psychological discomfort and life quality of the pregnant women in the work area of Umban Sari Community Health Center. This research used descriptive correlational design by employing cross sectional approach. The research samples were 92 respondents that were selected by using purposive sampling technique. This research used Maternal Physical Discomfort Scale (MPDS), Depression Anxiety Stres Scale (DASS-21), and World Health Organization Quality Of Life-BREF (WHOQOL-BREF). The analysis used was bivariate analysis by using chi-square test. The research results showed that there was a significant correlation between the physical discomfort and the life quality of pregnant women and the research results also showed that there was a significant correlation between the life quality of pregnant women.

Frustration tolerance among computer-science-related novice university students

ABSTRACT Among students and lecturers of Computer Science (CS)-related subjects, there is often anecdotal talk that Frustration Tolerance (FT) is a requirement for success in CS studies or that students would learn it during their studies. In order to relate the anecdotal perception and the psychological concept of FT and to explore the anecdotal narratives, the Frustration Discomfort Scale (FDS) and self-assessment among other factors were conducted with students from a university CS1 course at two times. There seems to be no effect from one semester of CS on FT and no actual differences in prerequisites, although further studies will be needed. Students with extensive prior knowledge, male students and students in low CS-related majors rate their FT as higher than the opposite groups at the beginning of the course. Lecturers should reconsider the use of the term as it may support negative feelings related to Imposter Syndrome.

The effects of head mounted weight on comfort for helmets and headsets, with a definition of "comfortable wear time".

There are difficult tradeoffs when designing head-mounted equipment such as helmets, lights, cameras, or virtual or augmented reality displays. Increased functionality and battery life adds weight, which in turn reduces comfort. A successful product must balance both comfort and functionality to achieve its product engagement goals. This study defines "comfortable wear time" as a new metric, and applies it to the domain of headsets in determining the relationship between headset weight and comfort. Sixteen study participants wore four otherwise identical headsets weighted between 500g-600 g for up to two hours each in an office environment. If participants experienced more than "mild discomfort" (>3 on an NRS-11 discomfort scale), the trial ended early, and the comfortable wear time was recorded. Intensity and location of discomfort was rated at trial conclusion, and qualitative feedback collected. Higher weights were associated with shorter comfortable wear times. Not everyone could wear even the lightest headset (500 g) for the full two hours. Qualitatively, discomfort took many forms beyond the expected neck fatigue or contact pressure and included symptoms commonly associated with motion sickness, such as headache and dizziness. Finally, there were pronounced gender differences with females experiencing more severe discomfort with earlier onset. Heavier headsets were less comfortable for the lower quartile of participants -yielding an average of 11 fewer minutes of comfortable wear time per 33 g of weight added. Understanding the discomfort costs from adding weight empowers product teams to find the correct balance to meet their product engagement targets.

Transperineal Versus Transrectal Magnetic Resonance Imaging–targeted and Systematic Prostate Biopsy to Prevent Infectious Complications: The PREVENT Randomized Trial

Background and objectiveThe transrectal biopsy approach is traditionally used to detect prostate cancer. An alternative transperineal approach is historically performed under general anesthesia, but recent advances enable transperineal biopsy to be performed under local anesthesia. We sought to compare infectious complications of transperineal biopsy without antibiotic prophylaxis versus transrectal biopsy with targeted prophylaxis. MethodsWe assigned biopsy-naïve participants to undergo transperineal biopsy without antibiotic prophylaxis versus transrectal biopsy with targeted prophylaxis (rectal culture screening for fluoroquinolone-resistant bacteria and antibiotic targeting to culture and sensitivity results) through a multicenter, randomized trial. The primary outcome was post-biopsy infection captured by a prospective medical review and patient report on a 7-d survey. The secondary outcomes included cancer detection, noninfectious complications, and a numerical rating scale (0–10) for biopsy-related pain and discomfort during and 7-d after biopsy. Key findings and limitationsA total of 658 participants were randomized, with zero transperineal versus four (1.4%) transrectal biopsy infections (difference –1.4%; 95% confidence interval [CI] –3.2%, 0.3%; p = 0.059). The rates of other complications were very low and similar. Importantly, detection of clinically significant cancer was similar (53% transperineal vs 50% transrectal, adjusted difference 2.0%; 95% CI –6.0, 10). Participants in the transperineal arm experienced worse periprocedural pain (0.6 adjusted difference [0–10 scale], 95% CI 0.2, 0.9), but the effect was small and resolved by 7-d. Conclusions and clinical implicationsOffice-based transperineal biopsy is tolerable, does not compromise cancer detection, and did not result in infectious complications. Transrectal biopsy with targeted prophylaxis achieved similar infection rates, but requires rectal cultures and careful attention to antibiotic selection and administration. Consideration of these factors and antibiotic stewardship should guide clinical decision-making. Patient summaryIn this multicenter randomized trial, we compare prostate biopsy infectious complications for the transperineal versus transrectal approach. The absence of infectious complications with transperineal biopsy without the use of preventative antibiotics is noteworthy, but not significantly different from transrectal biopsy with targeted antibiotic prophylaxis.

The Relation Between Endoscopic and Subjective Laryngopharyngeal Reflux Signs, Vocal Tract Discomfort, Voice Handicap, and Voice Disorder Type: Same Yet Different?

ObjectivesThis study aimed to investigate the relation between subjective voice-related symptoms and endoscopic findings in patients with different etiology of voice disorder and vocally healthy subjects with and without laryngopharyngeal reflux (LPR). Study designretrospective cross-sectional study MethodsThe study involved 149 participants (106 female, 43 male) including 125 with various voice disorders (functional, structural and neurogenic) and 24 vocally healthy individuals. For self-rating the German versions of the Voice Handicap Index (VHI), Vocal Tract Discomfort (VTD) Scale, and Reflux Symptom Index (RSI) were applied, while endoscopic evaluations utilized the Reflux Finding Score (RFS) and Reflux Sign Assessment (RSA).Statistical analyses incorporated ANOVA with Bonferroni post-hoc tests to identify group variations. Correlations between VTD Scale, VHI, RSI, RFS and RSA were evaluated using Pearson’s correlation coefficient. To examine test sensitivity and specificity for the VTD Scale and RSA, we performed a ROC analysis. Youden’s-Index was applied to determine the cut-off-value with best discriminatory abilities. The diagnosis of LPR was assumed when the criteria of RFS > 7 AND RSI > 13 was met. ResultsSignificant differences for all voice diagnosis groups and vocally healthy individuals for RFS and all three self-rating questionnaires were found. Moreover, there was significant correlation between VTD Scale and VHI and RSI as well as RSI and RFS, which was moderate, negative in the group of persons with LPR. However, there was no significant difference for RSA results between the vocally healthy or any diagnosis group. ConclusionThus, the RFS may be more suitable to predict reflux and voice related symptoms. The VTD Scale is a useful instrument in screening voice disorders but also LPR and can therefore be used as a tool for decision making when transferring to a specialist.

Higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance in women with unsuccessful weight loss

Background/Aim. Obesity is a chronic and relapsing condition, and since recently, it has been considered a global epidemic. Current guidelines for tripartite treatment of obesity emphasize a program of lifestyle modifications such as medical nutrition therapy, aerobic exercise, and behavioral intervention. The aim of the study was to evaluate whether specific psychological factors (general attitudes and beliefs and frustration tolerance) could be predictors of successful weight loss, i.e., factors that can be further addressed as part of the integrated therapy approach. Methods. A total of 84 consecutive overweight and obese female participants who were apparently healthy and homogeneous in age, level of education, and marital or employment status were prescribed the same medical nutrition therapy protocol as a single six-month therapeutic intervention. Prior to starting the therapy, the General Attitude and Belief Scale (GABS) and the Frustration Discomfort Scale (FDS) were administered. The participants were divided into two groups: successful (group A) and unsuccessful (group B). Group A, or the successful group [with the mean body mass index (BMI) ? standard deviation (SD) of 24.1 ? 5.81 kg/m2], consisted of 40 participants who have reached the corresponding loss, i.e., they lost ? 10% of the starting body weight (BW). Group B, or the unsuccessful group (with the mean BMI ? SD of 28.51 ? 2.74 kg/m2), consisted of 44 participants who have not reached the corresponding loss, i.e., they lost &lt; 10% of the starting BW. Results. Participants in group B had significantly higher scores (p &lt; 0.05) on the GABS subscales for the Need for Approval, Need for Comfort, and Other Downing. A statistically significant difference between groups (p &lt; 0.05) was shown for FDS subscales of Emotional Intolerance, Entitlement, and Achievement Frustration. Conclusion. Results of our study showed that participants who were unsuccessful in medical nutrition therapy had a higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance when compared to successful participants. The recommendation, based on our results, would be to include psychotherapeutic techniques in the integrative obesity treatment, aimed at cognitive changes and increasing frustration tolerance.