Objective Quality Measures Research Articles

Poor Subjective Sleep Quality Predicts Symptoms in Irritable Bowel Syndrome Using the Experience Sampling Method.

Sleep quality may affect symptom experience in irritable bowel syndrome (IBS). Our aim was to investigate the relationship between sleep quality and gastrointestinal (GI) symptoms using actigraphy and the experience sampling method. Patients with IBS were recruited from a tertiary Neurogastroenterology clinic and the community. GI symptoms and mood were recorded on a smartphone application, 10 times per day, over 7 consecutive days. Subjective sleep quality was recorded every morning to reflect the night before. Objective measures of sleep quality were estimated from wrist-worn actigraphy. Cross-lagged structural equation models were built to assess the directionality of sleep-symptom relationships over time. Eighty patients with IBS completed the study (mean age: 37 years [range 20-68], 89% female, 78% community). Approximately 66% had a Pittsburgh Sleep Quality Index score ≥ 8, indicating a clinically significant sleep disturbance. Approximately 82% (95% CI: 72-90) screened positive for a sleep disorder, most commonly insomnia. In cross-lagged analysis, poor subjective sleep quality predicted next-day abdominal pain (0.036 < P < 0.040) and lower GI symptoms (0.030 < P < 0.032), but not vice versa. No significant relationship with GI symptoms was found for any objective sleep measure using actigraphy. Poor subjective sleep quality was associated with higher next-day lower GI symptom levels, but not vice versa. Objective sleep measures did not predict next-day abdominal symptoms, potentially supporting the conclusion that it is the perception of sleep quality that is most influential. This study may be used to guide future research into the effect of sleep interventions on GI symptoms.

Adaptation and validation of the PAC-19QoL-specific quality of life questionnaire for the Spanish population with long COVID

Introduction The post-acute (long) COVID-19 Quality of Life instrument is the only specific instrument designed to assess the quality of life in long COVID patients. The present study aims to make a transcultural adaptation and validation into Spanish of the disease-specific (long COVID) quality of life instrument, post-acute (long) COVID-19 Quality of Life, to have a tool for objective measurement of quality of life in this population. Methods A descriptive cross-sectional study was divided into two phases. In phase one, the translation and cultural adaptation of the questionnaire was performed, while in phase two, the questionnaire was validated. The Spanish version of the questionnaire was used with a sample of 206 people, 40 males (19.4%) and 166 females (80.6%), with an age range between 21 and 70 years old. Participants completed the questionnaire through an online platform. Internal consistency, construct validity, convergent validity, test-retest reliability, and ceiling and floor effects of the Spanish version were analyzed. Results The Spanish version of the post-acute (long) COVID-19 Quality of Life instrument showed high internal consistency, with Cronbach's alpha= 0.922 and an intraclass correlation coefficient of 0.936. Mean scores obtained in the PAC-19QoL and SF-12 questionnaires showed that those who had a worse quality of life in the SF-12 tool also a had worse quality of life in the PAC-19QoL tool. Conclusions This study shows that the Spanish version of the post-acute (long) COVID-19 Quality of Life instrument is an appropriate and valid tool for assessing the quality of life of long COVID patients.

Perception Matters: Perceived vs. Objective Air Quality Measures and Asthma Diagnosis among Urban Adults.

Urban air pollution is consistently linked to poorer respiratory health, particularly in communities of lower socioeconomic position (SEP), disproportionately located near highways and industrial areas and often with elevated exposures to chronic psychosocial stressors. Fewer studies, however, have considered air pollution itself as a psychosocial stressor and whether pollution may be impacting health through both direct physiologic and psychosocial pathways. We examined data on perceived air pollution exposures from a spatially representative survey of New York City adults through summer and winter 2012 (n = 1183) using residence-specific ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure estimates. We used logistic regression to compare associations for perceived and objective air quality on self-reported asthma and general health, adjusting for sociodemographics and mental health. In models including all exposure metrics, we found small but significant associations for perceived air quality (OR = 1.12, 95% CI: 1.04-1.22) but not for NO2 or PM2.5. Neither perceived nor objective pollution was significantly associated with self-reported general health. Results suggest that perceived air quality may be significantly associated with adult asthma, more so than objective air pollution and after adjusting for mental health-associations not observed for self-reported general health.

Impact of low oxygen storage on post-storage quality of pasteurized walnut (Juglans regia L.) kernels

Walnut (Juglans regia) kernels were obtained from two facilities, each using a different method for pasteurization to achieve a log 4 and log 5 reduction in the bacterial load on the kernel surface. Continuous pasteurization utilized high temperature steam applied for a short period, and batch pasteurization utilized lower temperature steam applied in a pressurized chamber for a longer period. Log 4 and 5 walnut kernels from both treatment methods were stored at 20 °C in air or sealed in bags with a low oxygen transmission rate, and an oxygen absorbing sachet was inserted to reduce internal oxygen concentrations to < 0.5 %. After pasteurization and packaging, walnuts were stored and evaluated periodically for peroxide value, hexanal, free-fatty acids, and total tocopherols. These objective quality measures were compared to descriptive sensory analyses of walnut taste, texture, and aroma conducted by a trained sensory panel. Continuous pasteurization of walnuts increased the rate of oil oxidation and loss of total tocopherols, but storage of walnuts in low oxygen atmospheres mitigated some of the negative quality impacts. Continuous pasteurization resulted in an immediate decreased in total tocopherols prior to storage under low oxygen atmospheres; however, low oxygen storage reduced subsequent losses in tocopherols. Batch pasteurization did not enhance quality degradation as compared to unpasteurized controls, but storage under low oxygen reduced oil oxidation and slowed the degradation of total tocopherols, as typically observed during walnut storage.

Towards an objective measurement of sleep quality in non-human animals; using the horse as a model species for the creation of sleep quality indices.

Sleep disturbance is observed across species, resulting in neurocognitive dysfunction and poor impulse control/regulation of negative emotion. Understanding animal sleep disturbance is thus important to understand how environmental factors influence animal sleep and day-to-day welfare. Self-reporting tools for sleep disturbance are commonly used in human research to determine sleep quality, that cannot be transferred to non-verbal animal species research. Human research has, however, successfully used frequency of awakenings to create an objective measurement of sleep quality. The aim of this study was to utilise a novel sleep quality scoring system for a non-human mammalian species. Five separate sleep quality indices calculations were developed using frequency of awakenings and total sleep time/total time spent in different sleep states. These indices were applied to a pre-existing data set of equine sleep behaviour taken from a study investigating the effects of environmental change (lighting and bedding) on the duration of time in different sleep states. Significant treatment effects for index scores both differed and aligned to the original sleep quantity results, thus sleep quality may be a useful alternative measurement of sleep disturbance that could be used to investigate impactful (emotional, cognitive) effects on the animal.

Ecologically recorded sleep patterns, stress, and lifestyle behaviors in college students prior to and during the COVID-19 pandemic

Objective: Beginning in the spring of 2020, college students adapted to a myriad of COVID-19 pandemic-related stressors including personal and family health concerns, social isolation and future uncertainty that affect sleep behavior. We investigated how the pandemic affected ecologically recorded sleep patterns, self-reported stress and lifestyle behaviors in three semester-differentiated cohorts of college students enrolled in a psychology of sleep course. Methods: Students (N = 117) used the SleepScore biomotion sensor system to track sleep patterns and responded to behavior questions during the spring 2018, fall 2020, and spring 2022 semesters. Results: When compared to students in the spring 2018 pre-pandemic semester, students who underwent remote/hybrid learning in the fall 2020 semester displayed improved objective measures of sleep quality that were accompanied by increased deep sleep, fewer disruptions, and decreased time awake during the night, while self-reported stress ratings were unchanged. During pandemic semesters, students also reported decreased time studying, increased napping and screen use and higher ratings of bedroom comfort. Conclusions: Pandemic initiated remote learning and social restrictions may have allowed for healthier sleeping environments that likely contributed to better sleep health and stress resiliency in college students.

Subjective Quality Assessment of V-PCC-Compressed Dynamic Point Clouds Degraded by Packet Losses.

This article describes an empirical exploration on the effect of information loss affecting compressed representations of dynamic point clouds on the subjective quality of the reconstructed point clouds. The study involved compressing a set of test dynamic point clouds using the MPEG V-PCC (Video-based Point Cloud Compression) codec at 5 different levels of compression and applying simulated packet losses with three packet loss rates (0.5%, 1% and 2%) to the V-PCC sub-bitstreams prior to decoding and reconstructing the dynamic point clouds. The recovered dynamic point clouds qualities were then assessed by human observers in experiments conducted at two research laboratories in Croatia and Portugal, to collect MOS (Mean Opinion Score) values. These scores were subject to a set of statistical analyses to measure the degree of correlation of the data from the two laboratories, as well as the degree of correlation between the MOS values and a selection of objective quality measures, while taking into account compression level and packet loss rates. The subjective quality measures considered, all of the full-reference type, included point cloud specific measures, as well as others adapted from image and video quality measures. In the case of image-based quality measures, FSIM (Feature Similarity index), MSE (Mean Squared Error), and SSIM (Structural Similarity index) yielded the highest correlation with subjective scores in both laboratories, while PCQM (Point Cloud Quality Metric) showed the highest correlation among all point cloud-specific objective measures. The study showed that even 0.5% packet loss rates reduce the decoded point clouds subjective quality by more than 1 to 1.5 MOS scale units, pointing out the need to adequately protect the bitstreams against losses. The results also showed that the degradations in V-PCC occupancy and geometry sub-bitstreams have significantly higher (negative) impact on decoded point cloud subjective quality than degradations of the attribute sub-bitstream.

Compressive speech enhancement using semi-soft thresholding and improved threshold estimation

&lt;span lang="EN-US"&gt;Compressive speech enhancement is based on the compressive sensing (CS) sampling theory and utilizes the sparsity of the signal for its enhancement. To improve the performance of the discrete wavelet transform (DWT) basis-function based compressive speech enhancement algorithm, this study presents a semi-soft thresholding approach suggesting improved threshold estimation and threshold rescaling parameters. The semi-soft thresholding approach utilizes two thresholds, one threshold value is an improved universal threshold and the other is calculated based on the initial-silence-region of the signal. This study suggests that thresholding should be applied to both detail coefficients and approximation coefficients to remove noise effectively. The performances of the hard, soft, garrote and semi-soft thresholding approaches are compared based on objective quality and speech intelligibility measures. The normalized covariance measure is introduced as an effective intelligibility measure as it has a strong correlation with the intelligibility of the speech signal. A visual inspection of the output signal is used to verify the results. Experiments were conducted on the noisy speech corpus (NOIZEUS) speech database. The experimental results indicate that the proposed method of semi-soft thresholding using improved threshold estimation provides better enhancement compared to the other thresholding approaches.&lt;/span&gt;

0958 Use of a Hybrid Mattress Improves Objective and Perceived Sleep Outcomes

Abstract Introduction Previous research has shown that comfort, including comfort of the sleep surface, is essential to sleep quality. In addition to comfort, the structure and firmness of a mattress may also play a role when it comes to sleep quality. More empirical research is needed to establish the impact of particular mattresses on both objective and self-reported measures of sleep quality. This study compared sleep on a hybrid mattress to participants’ prior sleep on their original mattress. Methods Healthy adults (81% female, ages 25-67) who reported sleeping hot participated in a 10-week field study, using a pre-post intervention design. During the 4-week baseline period, participants used their regular mattress at home. During the 4-week intervention period, which occurred following a 2-week adjustment period, they used a Serta iSeries mattress at home. This hybrid mattress includes materials designed to help the user feel cool. Sleep was measured objectively using SleepScore Max every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance. Results There were over 1,400 nights of tracked sleep across 39 participants. Objective sleep measurements showed increased time in bed (+10 minutes, p=.001) and total sleep time (+14 minutes, p=.002), as well as increased REM, both in duration (+6 minutes, p=.004) and proportion of the night (p=.023). Improvements also were observed in two objective sleep quality measures: SleepScore (p=.002) and MindScore (p=002). Self-report measures revealed that the hybrid mattress felt cooler (p&amp;lt;.001) and more comfortable (p&amp;lt;.001). Improvements also were found for a variety of perceived sleep outcomes, including time to fall asleep, waking less often, spending less time awake, longer sleep duration, better sleep quality, and feeling more rested in the morning (ps&amp;lt;.05). Conclusion Objectively-measured sleep and self-reported sleep improved when using the hybrid mattress compared to healthy adults’ original mattresses. Furthermore, qualitative and quantitative self-report results suggested that the intervention was perceived as comfortable and felt cool. These perceptions likely are what led to more time in bed, which in turn led to the key sleep improvements. Support (if any) Mattress Firm INC

Behavioral Health Provider Burnout and Mental Health Care in the Veterans Health Administration.

Although many studies assess predictors of provider burnout, few analyses provide high-quality, consistent evidence on the impact of provider burnout on patient outcomes exist, particularly among behavioral health providers (BHPs). To assess the impact of burnout among psychiatrists, psychologists, and social workers on access-related quality measures in the Veterans Health Administration (VHA). This study used burnout in VA All Employee Survey (AES) and Mental Health Provider Survey (MHPS) data to predict metrics assessed by the Strategic Analytics for Improvement and Learning Value, Mental Health Domain (MH-SAIL), VHA's quality monitoring system. The study used prior year (2014-2018) facility-level burnout proportion among BHPs to predict subsequent year (2015-2019) facility-level MH-SAIL domain scores. Analyses used multiple regression models, adjusting for facility characteristics, including BHP staffing and productivity. Psychologists, psychiatrists, and social workers who responded to the AES and MHPS at 127 VHA facilities. Four compositive outcomes included two objective measures (population coverage, continuity of care), one subjective measure (experience of care), and one composite measure of the former three measures (mental health domain quality). Adjusted analyses showed prior year burnout generally had no impact on population coverage, continuity of care, and patient experiences of care but had a negative impact on provider experiences of care consistently across 5years (p < 0.001). Pooled across years, a 5% higher facility-level burnout in AES and MHPS had a 0.05 and 0.09 standard deviation worse facility experiences of care from the prior year, respectively. Burnout had a significant negative impact on provider-reported experiential outcome measures. This analysis showed that burnout had a negative effect on subjective but not on objective quality measures of Veteran access to care, which could inform future policies and interventions regarding provider burnout.

Measuring Wine Quality and Typicity

Wine quality and typicity are complex concepts that can be hard to define. Wine is a product destined to not only be consumed and appreciated but also marketed, and its distinctiveness, quality and typicity are important characteristics that describe a wine’s sensory profile and, ultimately, add value to the finished product. Even though both quality and typicity are mostly assessed using a sensory evaluation, many studies have examined the feasibility of using chemical analysis methods in order to increase the objectivity of assessments. Today, the use of chemometrics facilitates the handling of big data, and outcomes from various analytical techniques can be integrated to produce more accurate results. This study discusses the existing sensory and analytical approaches, implications and future prospects for an objective measurement of quality and typicity as well as methods for the selection of appropriate data for predictive model development.

A matter of agreement: The effect of the technique and evaluator on the analysis of morphologic defects in stallion sperm.

Analysis of sperm morphology is an important part of the stallion breeding soundness evaluation since it provides an objective measure of a stallion's sperm quality and is one of many factors that estimate a stallion's fertility potential. To describe the effect of sperm quality level on the technique (Differential Interference Contrast - DIC; Phase-contrast - PH; Dip-Quick staining - DQ; and eosin-nigrosin staining - EN; semen samples fixed in buffered-formal saline) and evaluator (three evaluators; using only DIC), stallions were categorized based on sperm quality into three categories: High: >57% normal sperm, Moderate: 23-56% normal sperm, or Low: <23% normal sperm (four stallions per category). The data were analyzed using three different statistical methods: Analysis of Variance (ANOVA), correlative analysis, and Bland-Altman method (agreement). A higher level of agreement among techniques was observed between DIC and PH for morphologically normal sperm. The agreement between the alternative methods (EN, DQ, or PH) and the standard method (DIC) varied, depending on the sperm quality level (High, Moderate, or Low). Some morphological defects (e.g., AH, AMP) were constantly underestimated with the staining methods (DQ, EN) compared to DIC and PH, particularly in ejaculates with low sperm morphology. Underestimation of some abnormalities, due to the technique or the evaluator, has the potential to alter the clinical interpretation of stallion fertility.

Assessment of Perioperative Sleep Characteristics Using Subjective and Objective Methods: A Secondary Analysis of Prospective Cohort Study.

Perioperative sleep disturbances may impact healing and negatively affect the patient's perception of well-being. Therefore, accurately assessing postoperative sleep characteristics is necessary to treat sleep disturbances. This study is a secondary data analysis of research investigating the association between sleep and cognition in a perioperative setting. This study compares sleep characteristics between the St. Mary's Hospital Sleep Questionnaire and WatchPAT, a portable sleep apnea testing device. The goal of this study is to compare an objective measurement of sleep quality (WatchPAT) with a traditional questionnaire. One hundred and one patients who underwent elective, noncardiac surgical procedures wore a WatchPAT and completed the St. Mary's Hospital Sleep Questionnaire for three nights: two preoperative and one postoperative night. In the preoperative period, a Bland-Altman analysis showed an agreement Watch PAT and the St Mary's hospital sleep questionnaire except for sleep fragmentation. A good to fair correlation during the preoperative period was observed with both sleep latency and total sleep time. In the postoperative period, no correlation was observed between the St. Mary's Hospital Sleep Questionnaire data and WatchPAT data. Our study indicates that some potential factors affecting sleep and cognition such as admission type, depression, anesthesia type, and sleep apnea may limit patients' ability to report their sleep characteristics after surgery. Therefore, relying solely on one sleep assessment method is not advisable.

Plants Alkaloids Based Compound as Therapeutic Potential for Neurodegenerative

Although while getting a restful night's sleep is essential for your mental and physical health, insomnia is very prevalent. More people are turning to complementary and alternative therapies to treat or prevent sleeplessness. For hundreds of years, herbal treatments like valerian, passionflower, lemon balm, lavender, and California poppy have been utilized successfully. After using these herbal medicines, sleep latency was reduced and subjective and objective measures of sleep quality improved. Their sedative and sleep-inducing effects are caused by interactions with several neurotransmitter systems in the brain, according to molecular research. The plant species can be divided into 76 different genera and 32 different families, with the Asteraceae (24.2%) and Lamiaceae (21.1%) being the most prevalent subgroups. Leaves (29%) and flowers (27%), respectively, are used to make the majority of infusions (70%) and decoctions (25%). Just the most well-known taxa—out of the 106 known—are treated here (A. arvensis L., C. nepeta L., C. monogyna Jacq., H. lupulus L., L. nobilis L., L. angustifolia Mill., M. sylvestris L., M. chamomilla L., M. officinalis L., O. basilicum L., P. rhoeas L., P. somniferum L., R. officinalis L., T. platyphyllus Scop., and V. officinalis L.). Further study is required to confirm the therapeutic potential of these substitutes and define the mechanism of action of bioactive compounds because only seven of the fifteen species chosen have been investigated for pharmacological activity as hypnotic-sedatives.

Contemporary use of wearable activity monitors in prostate cancer survivors: A scoping review.

127 Background: Remote monitoring of daily activity using wearable activity monitors (“wearables”) (e.g., Fitbits) provides an unintrusive method to obtain continuous, objective physical activity (PA) and sleep data outside the clinical setting. Despite their potential for improving PA assessment for cancer survivors, there is currently limited information on how wearables are being used in PCa survivors. Thus, we reviewed the literature to understand how wearables are being integrated into research and interventional studies conducted in PCa survivors. Methods: We searched PubMed, CENTRAL, and Clinicaltrials.gov for randomized controlled trials (RCTs) and observational studies that involve commercially available wearables in PCa survivors, published between 2012 and 2022. Upon screening and full-text review by two independent reviewers, data were extracted from eligible studies, including study and patient characteristics, details on study interventions and outcomes, and purpose of device use. Baseline PA data were abstracted from articles with available quantitative data, including step counts, time spent in moderate-to-vigorous physical activity (MVPA), and sleep duration, and included in a quantitative analysis. Results: Eighty studies were screened and 17 studies met eligibility criteria and were included in this review (8 RCTs; 9 observational), with a total sample size of 1,148 PCa survivors (median age 66 years, range 39-84). Wearables used included: Fitbit: (47%), pedometer (18%), smartphone (6%), Jawbone (6%), and heart rate monitor (6%). Most studies (71%) involved individual or group-based exercise interventions that were either gym-based supervised by an exercise physiologist or home-based (online web-based delivery or written recommendations), as well as remotely delivered behavioral interventions. One study compared objective (actigraphy) and subjective sleep quality measures and one was a validation study comparing Fitbit to the ActiGraph accelerometer. Study durations ranged from 1-48 weeks with median reported adherence to wearing the device of 79.5% (range 63-100%). PA data, as measured with wearables, were available in 13 studies and summarized. Conclusions: Wearables are increasingly being used to assess daily activity and monitor adherence to exercise interventions in PCa survivors. Findings suggest wearables are feasible for use in this population with high levels of adherence. Wearables can provide added value to PA and functional assessment, although more research is needed to understand how wearables can be integrated into routine patient care or used as means to track or deliver tailored interventions for PCa survivors. [Table: see text]

Subjective and Objective Measurement of Sleep Quality and Activity in Glaucoma.

Glaucoma patients exhibit worse indices of sleep function by both objective and subjective metrics compared with controls. The purpose of this study is to characterize the sleep parameters and physical activity levels of glaucoma patients compared with controls. A total of 102 patients with a diagnosis of glaucoma in at least 1 eye and 31 control subjects were enrolled in the study. Participants completed the Pittsburgh Sleep Quality Index (PSQI) during enrollment and then wore wrist actigraphs for 7 consecutive days to characterize circadian rhythm, sleep quality, and physical activity. The primary outcomes of the study were subjective and objective metrics of sleep quality using the PSQI and actigraphy devices, respectively. The secondary outcome was physical activity, measured by the actigraphy device. From the PSQI survey, glaucoma patients had higher (worse) scores compared with controls for sleep latency, sleep duration, and subjective sleep quality, whereas scores for sleep efficiency were lower (better), suggesting more time spent in bed asleep. By actigraphy, time in bed was significantly higher in glaucoma patients as was time awake after sleep onset. Interdaily stability, quantifying the synchronization to the 24-hour light-dark cycle, was lower in glaucoma patients. There were no other significant differences between glaucoma and control patients with regard to rest-activity rhythms or physical activity metrics. In contrast to the survey data, findings from the actigraphy demonstrated that there were no significant associations between the study group and controls regarding sleep efficiency, onset latency, or total sleep time. In this study, patients with glaucoma demonstrated several subjective and objective differences in sleep function when compared with controls, whereas physical activity metrics were similar.

Multispectral Image Fusion using Deep Neural Network A Novel Approach

Polychromatic imaging is widely used in various fields including remote sensing, medical imaging, and industrial inspection. However, due to the limitations of imaging sensors, polychromatic images often suffer from low geospatial definition and poor optical fidelity. To address these issues, we propose a novel method for polychromatic image fusion based on deep neuronal system (DNN). Our method involves building a training set of high-definition and low-definition image blocks, utilizing an improved sparse denoising self-encoding encoder learning training neuronal system model for pre-training, and finely adjusting the frameworks of the DNN model. The proposed method is capable of preserving both the high geospatial definition and optical information of the polychromatic image. Experimental results demonstrate that our method outperforms state-of-the-art methods in terms of both objective and subjective quality measures.

Smart algorithm in wireless networks for video streaming based on adaptive quantization

SummaryNowadays, smart multimedia network services have become crucial in the healthcare system. The network parameters of Quality of Service (QoS) are widely affecting the efficiency and accuracy of multimedia streaming in wireless environments. This paper proposes an adaptation framework model, which makes a relation between the QP (quantization parameter) in H.264 and H.265 codecs and the QoS of 5G wireless technology. Besides, the effect of QP and packet loss have been studied because of their impact on video streaming. Packet loss of 5G wireless network characteristic is emulated to determine the impact of QP on the received video quality using objective and subjective quality metrics such as PSNR (peak signal to noise ratio), SSIM (structure similarity), and DMOS (differential mean opinion score). In this research, a Testbed is implemented to stream the encoded video from the server to the end users. The application model framework has automatically evaluated the QoE (Quality of Experience). Accordingly, the model detects the defect of network packet loss and selects the optimum QP value to enhance the QoE by the end‐users. The application has been tested on low and high video motions with full high definition (HD) resolution (1920 × 1080) which were taken from ( https://www.xiph.org/downloads/). Test results based on the objective and subjective quality measurements indicate that an optimal QP = 35 and QP = 30 have been chosen for low and high motion respectively to satisfy user QoE requirements.

Age-dependent treatment effect of vocal fold steroid injection for benign vocal fold lesions.

Benign vocal fold lesions (BVFLs) cause voice disorders and impair social life. Recently, office-based vocal fold steroid injection (VFSI) has gained attention as a minimally invasive treatment for BVFLs. This study aimed to analyze the age-dependent treatment effect of VFSI and to clarify the indications for treatment. In this retrospective cohort study, a total of 83 patients with BVFLs were treated with a similar regimen of VFSI. Three or four months after the injection, age-dependent phonological functions were evaluated. The differences between pre- and post-treatment findings were analyzed using the Wilcoxon matched-pair signed-rank test, and the correlation between patient age and improvement rates were determined by Pearson's correlation coefficient. Improvement in voice handicap index (VHI), which was the primary endpoint, was observed. Subjective and objective voice quality measurements also showed significant improvements. Subgroup analyses revealed that there was no age-related difference in the improvement of voice quality and that there was no improvement in aerodynamic effect in patients over 45 years of age. This study clarified the age-dependent treatment effect of VFSI and provided the important suggestion of establishing indication criteria for BVFLs. The study results provided clarity on the indication criteria of VFSI and served as an important indicator for tailoring treatment to patients' needs. 4.

Objective Sleep Quality Measurement based on Fuzzy Logic and Wearable Device

Sleep is the natural state of relaxation for human being. Sleep quality is an essential yet frequently neglected aspect of sleep in general. Sleep quality is essential because it allows the body to restore itself and prepare for the next day. The standard method for evaluating sleep quality was subjective evaluation. Actigraphy devices, which can measure the sleep cycle, are now widely available. This study developed a method using Fuzzy Logic and an actigraphy device to measure and classify sleep quality. The fuzzy logic method was developed in several stages, which are determining the sleep quality measurement parameters, constructing the fuzzy set for each input variable, and developing the fuzzy rules. To evaluate the proposed fuzzy model, five individuals were invited to participate in the experiment and required to complete the PSQI subjective sleep questionnaire. The evaluation result shows that our proposed Fuzzy model achieves lower error compared to the existing method.