Comfort Ratings Research Articles

Living in Western Australia induces some physiological adaptations of seasonal acclimatisation in the surgical burns team

ABSTRACT Seasonal acclimatization is known to result in adaptations that can improve heat tolerance. Staff who operate on burn injuries are exposed to thermally stressful conditions and seasonal acclimatization may improve their thermoeffector responses during surgery. Therefore, the aim of this study was to assess the physiological and perceptual responses of staff who operate on burn injuries during summer and winter, to determine whether they become acclimatized to the heated operating theater. Eight staff members had physiological and perceptual responses compared during burn surgeries conducted in thermoneutral (CON: 24.1 ± 1.2°C, 45 ± 7% relative humidity [RH]) and heated (HOT: 31.3 ± 1.6°C, 44 ± 7% RH) operating theaters, in summer and winter. Physiological parameters that were assessed included core temperature, heart rate, total sweat loss, sweat rate, and urinary specific gravity. Perceptual responses included ratings of thermal sensation and comfort. In summer, CON compared to winter CON, baseline (85 ± 15 bpm VS 94 ± 18 bpm), mean (84 ± 16 bpm VS 93 ± 18 bpm), and peak HR (94 ± 17 bpm VS 105 ± 19 bpm) were lower (p < 0.05), whereas core temperature was not different between seasons in either condition (p > 0.05). In HOT, ratings of discomfort were higher in summer (15 ± 3) than winter (13 ± 3; p > 0.05), but ratings of thermal sensation and sweat rate were similar between seasons (p > 0.05). The surgical team in burns in Western Australia can obtain some of the physiological adaptations that result from seasonal acclimatization, but not all. That is most likely due to a lower than required amount of outdoor heat exposure in summer, to induce all physiological and perceptual adaptations.

Application of high flow nasal canula in patients with pulmonary edema caused by seawater drowning

To investigate the therapeutic effect of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NPPV) on patients with pulmonary edema caused by seawater drowning. A retrospective analysis method was used. Based on the Utstein database of emergency drowning in the First Hospital of Qinhuangdao, the clinical data of patients with seawater drowning pulmonary edema admitted to the emergency medicine department of the First Hospital of Qinhuangdao from January 1, 2019 to December 31, 2022 were collected. The patients were divided into NPPV group and HFNC group according to different ventilation methods. The general data, endotracheal intubation rate in 7 days, arterial blood gas analysis indexes [arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial oxygen saturation (SaO2)] and hemodynamic indexes (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, blood lactic acid) before and after treatment, length of stay in intensive care unit (ICU), oxygen therapy comfort of the two groups were compared. A total of 54 patients were enrolled, including 21 patients in the NPPV group and 33 patients in the HFNC group. There were no significant differences in gender, age, state of consciousness and other general information between the two groups. Compared with NPPV group, the rate of endotracheal intubation in HFNC group within 7 days was significantly lower [24.2% (8/33) vs. 33.3% (7/21), P < 0.05]. Before treatment, there were no significant differences in arterial blood gas analysis and hemodynamics between the two groups. After treatment, the above indexes in both groups were significantly improved compared with those before treatment, and PaO2, SaO2, systolic blood pressure, diastolic blood pressure and mean arterial pressure in HFNC group were significantly higher than those in NPPV group [PaO2 (mmHg, 1 mmHg≈0.133kPa): 93.56±6.37 vs. 82.14±6.25, SaO2: 1.02±0.09 vs. 0.95±0.11, systolic blood pressure (mmHg): 117.37±8.43 vs. 110.42±8.38, diastolic blood pressure (mmHg): 79.43±7.61 vs. 72.21±4.32, mean arterial pressure (mmHg): 92.34±6.32 vs. 85.12±5.38], PaCO2, heart rate and blood lactic acid were significantly lower than those in NPPV group [PaCO2 (mmHg) : 34.26±5.63 vs. 37.24±6.22, heart rate (times/min): 73.38±7.56 vs. 86.25±5.41, blood lactic acid (mmol/L): 1.38±0.36 vs. 2.25±1.14], and the differences were statistically significant (all P < 0.05). In addition, the length of ICU stay in HFNC group was significantly shorter than that in NPPV group (days: 13.30±2.38 vs. 16.27±4.26), and the comfort rate of oxygen therapy was significantly higher than that in NPPV group [66.7% (22/33) vs. 42.8% (9/21)], with statistical significance (all P < 0.05). HFNC can improve the oxygenation of patients with pulmonary edema caused by seawater drowning, improve hemodynamics, reduce the rate of tracheal intubation, shorten the length of ICU stay, and improve the comfort of oxygen therapy, which has certain clinical application value.

Trypophobia, skin disease, and the visual discomfort of natural textures

In the last decade, the behavioral sciences have described the phenomenon of trypophobia, which is the discomfort felt by some individuals when viewing images containing clusters of bumps or holes. One evolutionary hypothesis for this phenomenon is that this visual discomfort represents an adaptation which helps organisms avoid skin disease and/or ectoparasites. Even though trypophobic imagery and disease imagery are both examples of visual textures, to date there has been no comparison of the visual discomfort elicited by these two specific kinds of textures within the larger context of the visual comfort elicited by natural texture imagery more generally. In the present study, we administered the Trypophobia Questionnaire (TQ) and recorded the visual comfort ratings elicited by a large set of standard natural texture images, including several trypophobic and skin disease images. In two independent samples, we found that while all observers find skin diseases uncomfortable to view, only those scoring high on the TQ rated trypophobic imagery equally uncomfortable. Comparable effects were observed using both standard ANOVA procedures as well as linear mixed effects modeling. Comparing the ratings of both high-TQ and low-TQ participants to the standard textures, we find remarkably consistent rank-order preferences, with the most unpleasant textures (as rated by both groups) exhibiting qualitative similarities to trypophobic imagery. However, we also find that low-level image statistics which have been previously shown to affect visual comfort are poor predictors of the visual comfort elicited by natural textures, including trypophobic and disease imagery. Our results suggest that a full understanding of the visual comfort elicited by natural textures, including those arising from skin disease, will ultimately depend upon a better understanding of cortical areas specialized for the perception of surface and material properties, and how these visual regions interact with emotional brain areas to evoke appropriate behavioral responses, like disgust.

Comparative feasibility study of physiological signals from wristband-type wearable sensors to assess occupants' thermal comfort

This study compares the feasibility of physiological signals acquired from wearable sensors to assess building occupants' thermal comfort. Field experiments were conducted to acquire electrodermal activity (EDA), heart rate (HR), skin temperature (SKT), and thermal comfort ratings from 18 subjects in actual office settings using wristband-type wearable biosensors based on thermal preference votes. Multilevel modeling outcomes indicate that (1) there are significant differences in electrodermal level (EDL) and SKT between the “Want Warmer” and “No Change” and between the “No Change” and “Want Cooler” states across subjects; (2) while the thermal comfort significantly affects subjects' EDLs, the effects are not significant on SKT after associations with other physiological signals are accounted for. Given the diversity of building occupants and environmental conditions, findings from the comparative analysis are expected to provide a foundation for the development of a general thermal comfort model using physiological signals.

The association between participant-reported ratings of comfort, dryness and vision quality in soft contact lens wearers.

Previous literature has indicated an association between participant-reported perceptions (e.g., ratings) of comfort, dryness and vision quality during soft contact lens wear. However, these reports do not account for participant- and lens-specific factors which may impact the interpretation of these results. The purpose of this project was to quantify the association between these participant-reported ratings while accounting for both participant- and lens-specific factors. Participant-reported ratings (scale 0-100) of comfort, dryness and quality of vision for 675 soft contact lens wearers (1207 eyes) were aggregated across 31 studies completed at Indiana University. Linear mixed-effects regression modelling was performed on each outcome rating individually. Covariate-adjusted models incorporated both participant- (e.g., age, sex) and lens-related (e.g., lens material, edge and optics) factors. The models were statistically adjusted for the duration of lens wear in hours and cumulative days of exposure. Consistent with estimates from covariate-adjusted regression models, pairwise Spearman correlations [95% CI] between dryness and comfort (rs = 0.71,[0.69, 0.74]), vision quality and comfort (rs = 0.53, [0.49, 0.57]) and vision quality and dryness (rs = 0.49, [0.42, 0.54]) were all positive and had p < 0.001. Average participant-reported ratings of comfort, dryness and vision quality decreased by (bs [95% CI]) = -0.81 [-1.15, -0.46] -0.34 [-0.67, 0.0005] and -0.90 [-1.19, -0.60] rating units, respectively, for each hour of lens wear. Significant positive associations were found between participant-reported measures of comfort, dryness and vision quality during soft contact lens wear. The associations between these ratings and the participant- and lens-related factors that drive them should be considered by clinicians and manufacturers when fitting and designing soft contact lenses.

Control design of vibrotactile stimulation on weighted vest for deep pressure therapy

Introduction: This study presents a novel weighted vest integrated with vibrotactile stimulation for deep pressure therapy. Following the principles of Morrison's research, we assessed its effectiveness in calming users with four distinct vibration patterns. Method: Ten male participants without ASD history, aged 19-25 and weighing 48-73 kg, provided subjective evaluations using the Comfort Rating Scale (CRS). Result: Results showed that participants reported increased calmness after using the device, as evidenced by the overall ratings of the "calming" term, with the "down" pattern receiving the highest ratings. The study advocates for future work involving physiological sensors to measure the device's effectiveness objectively. While promising, this innovation has limitations, such as fixed vibration frequency and reliance on an adapter for power. Future iterations could address these issues to enhance the device's portability and customizable vibration frequencies. Conclusion: This research contributes to deep pressure therapy and vibration therapy by focusing on responsive patterns and subjective evaluations, opening doors for future developments.

Working Toward Recommended Terminology in the Canadian Preschool Speech-Language Pathology Context.

This quality improvement project aimed to address the inconsistent use of clinical labels across a preschool speech and language program in Ontario, Canada. The study investigated whether a multicomponent knowledge translation (KT) intervention could increase speech-language pathologists' (SLPs') knowledge about the recommended clinical labels, motivate their intentions to use the labels, and facilitate practice change during a 3-month pilot period. The diffusion of innovations theory was utilized to identify and address known and suspected barriers and facilitators that could influence the adoption of consistent terminology. The intervention was evaluated using a pre-experimental study design (with pre, post, and follow-up testing) and included two phases: Phase 1 involved the pretraining survey, KT intervention, and posttraining survey, and Phase 2 included an exit survey after a 3-month pilot period. Five hundred twenty-nine SLPs in Phase 1 and 387 SLPs in Phase 2 participated. Following the web-based intervention, SLPs demonstrated improved knowledge about the recommended labels with most indicating intentions to communicate the labels going forward. SLPs also reported increased comfort using labels and positive views on their importance and value. After the 3-month pilot period, SLPs' reported use of most recommended labels decreased, as did ratings of comfort, value, and importance. However, most SLPs reported intentions to use the labels going forward. Despite having intentions to adopt the recommended labels, the lack of implementation by SLPs suggests the presence of additional barriers impacting their use of the recommended clinical labels in practice. Future work should investigate clinician-identified barriers to inform future implementation efforts. https://doi.org/10.23641/asha.25254940.

Thermal preference effects on physiological responses and bedding system insulation selection during good quality sleep in the transitional season

Studies have proven that thermal preference significantly affects physiological parameters and thermal sensation. However, most of these studies were performed in the waking state and only a few were conducted in the sleeping state. In addition, skin temperature differed between the good and poor quality sleep. This study analysed the effects of thermal preference on physiological responses (skin temperature, human-bed interface temperature, bed microenvironment temperature, and heart rate) and bedding system insulation selection during good quality sleep at moderate temperatures in the transitional season. The results showed that the warm-preference subjects had higher skin temperature, human-bed interface temperature, bed microenvironment temperature, and bedding system insulation, but lower heart rate than the cold-preference subjects. Meanwhile, gender differences were apparent between subjects who had the same preference (warm/neutral/cold): the skin temperature, human-bed interface temperature, and bed microenvironment temperature of females were higher than those of males. Furthermore, the effects of body geometry parameters (height, weight, body mass index, body surface area, and specific surface area) on thermal preferences were not statistically significant. These results can provide research guidelines for designing thermal environments and personalised cooling/heating system for sleeping based on thermal preference difference, which can help improve the satisfaction rate of sleep thermal comfort and optimise building energy use strategies.

The order of running shoes and how it influences the perception of effort and comfort

Introduction High performance modern shoes reduce energy expenditure and improve performance, however, these gains may also stem from differences in perceived effort. Humans tend to weigh negative information more heavily than positive information, which could influence perception of effort when different shoes are tested sequentially. This study aimed to determine the existence of negativity bias on different measures of perception when alternating running shoes. Methods Eleven well-trained male athletes [age: 28 ± 6 years, weight: 68 ± 5 kg, height: 179 ± 5 cm, peak oxygen consumption: 65 ± 4 ml O2･kg-1･min-1] performed three lab visits: a familiarization day with an incremental test followed by two experimental days (track and treadmill, in balanced order). On each day, participants performed four sets of two 5-min runs at 16km･h-1 (5-min breaks in-between) alternating between On Cloudrunner (entry-level, EL) and Cloudboom Echo 3 (high-performance, HP). The order of the shoes was changed every set (i.e, EL-HP or HP-EL). After each run, participants reported their perception of effort (both on a 100-mm Visual Analog Scale [VAS] and on a 1-10 Borg Scale) and shoe comfort (VAS). Heart rate and gas exchange were monitored using a chest sensor and a metabolic cart. Differences in ratings between EL-HP and HP-EL were compared using paired t-tests. Results In combined data of track and treadmill, the physiological response and perception of effort were significantly lower while perception of comfort was significantly higher with HP compared to EL. On the treadmill, the absolute value of the change in perceived effort (VAS) was lower for EL-HP compared with HP-EL (0.6 ± 0.5 mm vs. 1.0 ± 0.7 mm, p = 0.013), but not on the track (EL-HP 0.5 ± 0.5 mm vs. HP-EL 0.6 ± 0.3 mm, p = 0.602). Absolute changes of effort (Borg) were neither affected by shoe order on the treadmill (EL-HP 0.7 ± 0.4 pts vs. HP-EL 0.8 ± 0.7 pts, p = 0.699) nor on the track (EL-HP 0.5 ± 0.4 pts vs. HP-EL 0.7 ± 0.6 pts, p = 0.452). Similarly, ratings of shoe comfort were neither affected by shoe order on the treadmill (EL-HP 1.8 ± 1.1 mm vs. HP-EL 1.4 ± 1.0 mm, p = 0.086) nor on the track (EL-HP 1.5 ± 1.1 mm vs. HP-EL 1.6 ± 1.0 mm, p = 0.674). Discussion/Conclusion Changes in perceived effort (VAS) assessed during treadmill running were nearly two times larger when switching from EL to HP than vice-versa, supporting the presence of a negativity bias in this specific condition, which could be related to the higher resolution of VAS scales compared with Borg. Possibly, the lack of negativity bias on the track resulted from an overall reduced rating of effort compared with treadmill, which left less room for differences. These findings suggest that it would be beneficial to include a control shoe worn before and between the tested shoes of interest to mitigate any potential negativity bias in tests when determining perceived effort on a treadmill with different shoes.

APPLYING DESIGN ALTERNATIVE APPROACH TO OPTIMIZE COMFORT, SAFETY, AND COST-EFFECTIVENESS IN THE REDESIGN OF ACCOMMODATION ROOMS ON THE SHIP KM TAREX 2

In late December 2021, the ship KM Tarex 2, owned by PT. Pelayaran Mandala Sejahtera Abadi, underwent its annual docking at PT. Tambangan Permai Raya. During this time, the ship was found to be in a state of disrepair, including its accommodation rooms. The ship's current condition, feedback from stakeholders, and financial considerations served as the catalyst for a comprehensive interior redesign, with a primary focus on enhancing comfort, safety, and economy. The interior redesign of the accommodation spaces on the ship KM Tarex 2 involved the exploration of two alternative design concepts. These concepts centered around the Owner's Room, Crew's Room, Messroom and Life Jacket Storage. Alternative Design 1 adopted a Contemporary Concept, while Alternative Design 2 embraced a Modern Minimalist concept. The selection process for these designs involved soliciting feedback from a panel of 18 individuals, consisting of 12 representatives from PT. Pelayaran Mandala Sejahtera Abadi, 3 individuals from PT. Tambangan Permai Raya, and 3 crew members of the ship KM Tarex 2. Ultimately, Alternative Design 1 garnered an average approval rating of 67% across all rooms, surpassing Alternative Design 2 in preference. The selected design alternatives were evaluated for compliance with regulatory standards, achieving a 100% compliance rate for each room and an average comfort rating of 40%. Additionally, the chosen materials, as determined through a Google Form questionnaire, included ALUMETAL brand ACP Materials for room lining and ceiling, along with Henan Fortovan brand LVT for ship deck covering. These materials received an average approval rating of 61%. Economically, the analysis of material costs demonstrated that the project could be undertaken without exceeding the ship's annual income, ensuring financial feasibility.

Exploratory evaluation of spinal cord stimulation with dynamic pulse patterns: a promising approach to improve stimulation sensation, coverage of pain areas, and expected pain relief.

The societal burden of chronic pain and the contribution-in-part to the opioid crisis, is a strong motivation to improve and expand non-addictive treatments, including spinal cord stimulation (SCS). For several decades standard SCS has consisted in delivery of tonic pulses with static parameter settings in frequency, pulse width, and amplitude. These static parameters have limited ability to personalize the quality of paresthesia, the dermatomal coverage, and thus may affect SCS efficacy. Further, static settings may contribute to the build-up of tolerance or loss of efficacy of the therapy over time in some patients. We conducted an acute exploratory study to evaluate the effects of SCS using time-dynamic pulses as compared to time-static (conventional tonic) stimulation pulses, with the hypotheses that dynamic pulse SCS may enable beneficial tailoring of the sensation and the patient's expectation for better pain relief with SCS. During a single clinic visit, consented subjects undergoing a standard SCS trial had their implanted leads temporarily connected to an investigational external stimulator capable of delivering time-static and six categories of time-dynamic pulse sequences, each characterized by continuously varying a stimulation parameter. Study subjects provided several assessments while blinded to the stimulation pattern, including: drawing of paresthesia maps, descriptions of sensation, and ratings for comfort and helpfulness to pain relief. Even without optimization of the field location, a majority of subjects rated sensations from dynamic stimulation as better or equal to that of static stimulation for comfortableness and for helpfulness to pain relief. The initial data showed a gender and/or pain dermatomal location related preference to a stimulation pattern. In particular, female subjects and subjects with pain at higher dermatomes tended to rank the sensation from dynamic stimulation better. Dynamic stimulation produced greater pain coverage without optimization; in 70% (9/13) of subjects, maximal pain coverage was achieved with a dynamic stimulation pattern. There was also greater variety in the words used by patients to describe stimulation sensation in the free text and free form verbal descriptions associated with dynamic stimulation. With the same electrode configuration and comparable parameter settings, acute SCS using dynamic pulses produced more positive ratings, expanded paresthesia coverage, and greater variation in sensation as compared to SCS using static pulses, suggesting that dynamic stimulation has the potential to improve capabilities of SCS for the treatment of chronic pain. Further study is warranted. This study was registered at ClinicalTrials.gov under ID NCT02988713, November 2016 (URL: https://clinicaltrials.gov/ct2/show/NCT02988713).

Lichttherapiebrillen während der Nachtschicht: eine Feldstudie

Abstract Background Night shift work leads to severe short- and long-term side effects, posing a risk to personal and occupational safety. Objective This study aimed to test the effects of blue-enriched light-emitting glasses on sleepiness, alertness, and sustained attention during the early morning hours of night shift work. Methods To remedy the risks of reduced alertness, sustained attention, and increased sleepiness in a single-blind study design, Luminette® 3 (Lucimed SA, Wavre, Belgium) glasses emitting blue-enriched light (BL) were tested from 05:00 to 05:30 during night shift work in 21 participants at a sleep laboratory, and the effects were compared with those of glasses emitting sham dim red light (DRL). Sleepiness was rated hourly from 21:00 to 07:30 using the Karolinska Sleepiness Scale, while alertness was assessed using the PC Psychomotor Vigilance Task before and after the intervention. At the end of the night shift, sustained attention (using the computerized Mackworth Clock Test), comfort ratings, and fatigue were measured. Statistical analyses were conducted using the Friedman and Wilcoxon signed-rank tests. Results Sleepiness increased significantly throughout the night and was not significantly reduced after the intervention, with a more prolonged reduction using BL. Compared with using DRL, using BL revealed no clear benefit in terms of alertness or sustained attention, yet comfort ratings were slightly better, without any negative side effects. Conclusion In the current study, BL glasses were not clearly superior to DRL glasses in ameliorating the negative side effects of night shift work. Despite some limitations, however, this field study showed high ecological validity and demonstrated the convenient use of an intervention that is easy to implement in a realistic workplace setting.

A Survey of Patient Experience During Molecular Breast Imaging.

Molecular breast imaging (MBI) is one of several options available to patients seeking supplemental screening due to mammographically dense breasts. Patient experience during MBI may influence willingness to undergo the test but has yet to be formally assessed. We aimed to assess patient comfort level during MBI, to compare MBI comfort with mammography comfort, to identify factors associated with MBI discomfort, and to evaluate patients' willingness to return for future MBI. Methods: A 10-question survey was sent by e-mail to patients undergoing MBI between August and December 2022 to obtain quantitative assessments and qualitative opinions about MBI. Results: Of 561 invited patients, 209 (37%) completed the survey and provided study consent. Their average age was 60.1 y (range, 40-81 y). Of the 209 responders, 202 (97%) were presenting for screening MBI, 195 (94%) had dense breasts, and 46 (22%) had a personal history of breast cancer. The average rating of MBI comfort was 2.9 (SD, 1.5; median, 3.0) on a 7-point scale (1 indicating extremely comfortable and 7 indicating extremely uncomfortable). The rating distribution was as follows: 140 (67%) comfortable (rating, 1-3); 24 (12%) neither comfortable nor uncomfortable (rating, 4); and 45 (22%) uncomfortable (rating, 5 or 6). No responders gave a 7 rating. The most frequently mentioned sources of discomfort included breast compression (n = 16), back or neck discomfort (n = 14), and maintaining position during the examination (n = 14). MBI comfort was associated with responder age (74% ≥55 y old were comfortable, versus 53% <55 y old [P = 0.003]) and history of MBI (71% with prior MBI were comfortable, versus 61% having a first MBI [P = 0.006]). Of 208 responders with a prior mammogram, 148 (71%) said MBI is more comfortable than mammography (a significant majority [P < 0.001]). Of 202 responders to the question of whether they were willing to return for a future MBI, 196 (97%) were willing. A notable factor in positive patient experience was interaction with the MBI nuclear medicine technologist. Conclusion: Most responders thought MBI to be a comfortable examination and more comfortable than mammography. Patient experience during MBI may be improved by ensuring back support and soliciting patient feedback at the time of positioning and throughout the examination. Methods under study to reduce imaging time may be most important for improving patient experience.

Microclimate-Adaptive Morphological Parametric Design of Streets and Alleys in Traditional Villages

Microclimate is a reflection of the climatic conditions within the scope of human daily activities, so it is closely related to human activities. This paper uses Qingshui Village in Hancheng as the research object and the purpose of this paper was to study the influence mechanism of the traditional street spatial form on microclimate and thermal comfort, emphasizing the use of parameterized design platforms in technical methods to construct performance simulations and obtain relatively optimal solutions that are suitable for the spatial form of rural streets and alleys in the region. We select the Universal Thermal Climate Evaluation Index (UTCI) as the evaluation index for microclimate comfort and construct a performance-driven automatic optimization method for street and alley spaces. The results showed that: (1) When the street is in the northeast-southwest direction, the width is taken in the range of 6.5 m–7.3 m, the height of the building on the north side of the street is about 6.0 m, and the height of the building on the south side of the street is about 5.7 m, the comfort rate can reach up to 33.8%. (2) As for street and alley intersections, the focus remains on retaining their original forms while primarily controlling the scale changes. Within streets, the height of the building in the east-west direction is controlled at 5.6 m–6.1 m, the building in the north-south direction is controlled at 7 m–7.4 m, and street widths are controlled between 5.4 m and 6.3 m, resulting in a comfort level of 32.0%; (3) In alleys, east-west building heights are kept between 4.2 m and 5.5 m, and north-south building heights range from 4.5 m to 5.3 m, with widths at around 4.5 m, resulting in a similar comfort level of 32.0%. The research outcomes offer a scientific foundation for the design, creation, and enhancement of the physical environment of local village streets and alleys.

Safety-Net Primary Care and Endocrinology Clinicians’ Knowledge and Perspectives on Screening for Nonalcoholic Fatty Liver Disease: A Mixed-Methods Evaluation

ObjectiveClinical guidelines have expanded the indications for nonalcoholic fatty liver disease (NAFLD) screening to type 2 diabetes mellitus and obesity, which are conditions common in populations who receive care in urban safety-net settings. This study aimed to evaluate safety-net primary care and endocrinology clinicians’ knowledge of NAFLD, determine barriers and facilitators to screening, and examine perspectives on the use of electronic health record tools for risk assessment. MethodsSequential explanatory mixed methods using survey and qualitative interviews with primary care, primary care subspecialty, and endocrinology clinicians in an urban safety-net health care system. ResultsA total of 109 participants completed the survey (36.5% response rate), and 13 participated in interviews. Most respondents underestimated or did not know the prevalence of NAFLD (68%), did not use the recommended noninvasive tests for risk stratification (65%), and few were comfortable with screening for (27%) or managing (17%) NAFLD. Endocrinologists had greater knowledge of risk factors but lower rates of comfort and more often felt that screening was not their responsibility. The qualitative themes included the following: (1) lack of knowledge about screening, (2) concern for underdiagnosing NAFLD, (3) perception of severity impacts beliefs about screening, (4) screening should occur in primary care but is not normative practice, (5) concerns exist about benefit, (6) competing demands with a complex population hinder screening, and (7) a need for easier ways to integrate screening into practice. ConclusionKnowledge gaps may hamper uptake of new guidelines for NAFLD screening in primary care and endocrinology clinics in an urban safety-net health care system. Implementation strategies focused on training and educating clinicians and informed by behavioral economics may increase screening.

Life Cycle Analysis of Biodegradable Plastics using Cradle-to-Grave Assessment

This research examines the impact of ergonomic adjustments on production settings, focusing specifically on the concept of biodegradable plastic. The study used a mixed-methods approach, combining quantitative and qualitative analyses derived from the collected data. The Life cycle assessment data reveal a department-specific improvement of 28.57% in the Degradable department, demonstrating the efficacy of the implemented ergonomic solutions. Research on biodegradable plastic in workstations uncovers inconsistencies and advocates for the standardization of features to provide uniform ergonomic comfort. The Productivity and Comfort Survey demonstrates a significant correlation between perceived comfort and productivity. Based on the survey findings, there is a direct correlation between a 10% increase in productivity and a one-point increase in comfort ratings. Analysis of Training and Feedback data reveals that the introduction of training initiatives resulted in a 20% improvement in outcomes linked to attention. The analysis of this information necessitates the integration of ergonomic interventions as a fundamental aspect of Life cycle industrial practices. This integration has the potential to enhance both workplace comfort and productivity, as well as job satisfaction.

Simulation of the effect of horizontal airflow channel on natural ventilation in apartments

Natural ventilation has an important impact on people's work and life. Reasonable use of natural ventilation can effectively improve indoor air quality and thermal comfort, reduce the use of air conditioning and reduce energy consumption. With the continuous development of urbanization, many apartments cannot effectively use natural ventilation. This paper uses CFD simulation to analyze the improvement effect of indoor ventilation after the installation of airflow channel in residential public transportation. The results show that the horizontal airflow channel can improve the indoor air environment and effectively reduce the dissatisfaction rate of indoor thermal comfort and indoor air age.

A study on eye movement test and visuospatial optimization of wayfinding perception in large-scale comprehensive transportation hubs

Abstract The integration of rail transit stations and the surrounding underground space presents volume scale and functional complexity, and it has gradually formed a complex integrated transportation hub. Wayfinding inside its space is also more difficult, and the behavioral phenomena of passengers stopping, wandering, and getting lost are common. This paper uses station A of a large transportation hub as an example. It combines target detection technology and the optical flow method, designs the traffic space guidance system, tests how well passengers can find their way by moving their eyes, and then looks at how the visual space can be improved in terms of color, comfort, and subjective comfort after getting feedback. The data from the passenger eye-movement test reveals that during the sub-processes of information perception and elevator path selection, the logo is the primary focus, with attention ratios of 72.35% and 61.28%. Orange, yellow, and green were the three colors that received the highest ratings for subjective spatial comfort from passengers, with ratings of 0.58, 0.55, and 0.35, respectively, which are data-supported for visuospatial optimization.

Magnetic resonance imaging respirators: a randomized crossover trial to assess respiratory protection, usability, and comfort.

Many available facepiece filtering respirators contain ferromagnetic components, which may cause significant problems in the magnetic resonance imaging (MRI) environment. We conducted a randomized crossover trial to assess the effectiveness, usability, and comfort of 3 types of respirators, judged to be "conditionally MRI safe" with an aluminum nosepiece (Halyard 46727 duckbill-type respirators and Care Essentials MSK-002 bifold cup-type respirators) or "MRI safe" completely metal free (Eagle AG2200 semirigid cup-type respirators). We recruited 120 participants to undergo a quantitative fit test (QNFT) on each of the 3 respirators in a randomized order. Participants then completed a usability and comfort assessment of each respirator. There were significant differences in the QNFT pass rates (51% for Halyard 46727, 73% for Care Essentials MSK-002, and 86% for Eagle AG2200, P < .001). The first-time fit test pass rate and overall fit factor were significantly higher for Eagle AG2200 compared with the other 2 respirators. Eagle AG2200 scored the lowest ratings in the ease of use and overall comfort. There were no significant differences in other modalities, including the seal rating, breathability, firmness, and overall assessment. Our study supports the utility of the Eagle AG2200 and Care Essentials MSK-002 respirators for healthcare professionals working in an MRI environment, based on their high QNFT pass rates and reasonably good overall usability and comfort scores. Eagle AG2200 is unique because of its metal-free construction. However, its comparatively lower usability and comfort ratings raise questions about practicality, which may be improved by greater user training.

How effective is automated vehicle education? – A Kentucky case study revealing the dynamic nature of education effectiveness

This study is motivated by the need to quantitatively understand the dynamic nature of Automated Vehicle (AV) education's effectiveness, given the fact that existing research has identified factors that associated with the change of AV acceptance between before and after education. To address this research gap, an online state-wide survey study was conducted in Kentucky, USA, offering the opportunity to receive AV education via watching a video and assessing survey respondents' AV acceptance before and after education. By employing a Structural Equation Modeling (SEM) approach with multi-layer endogenous variables included, what makes AV education effective and the underlying reasons were identified and quantitatively revealed with focusing on respondents' socio-demographics, affordability, travel needs, built environment, and exposure level to AV knowledge. As a result, significant factors that impact the probability of “AV acceptance being increased after education” were identified from the aforementioned perspectives. Overall, older generations are less likely to increase their AV acceptance after education for two particular reasons: (a) concerning the comfortableness of Level 5 (full) automation and (b) living in the rural setting, which leads to fewer chances of experiencing automated driving. From a gender perspective, women are more likely to be affected by AV education because they are less familiar with AV technology than men. Also, our results suggest that Level 5 comfort rating plays the most influential role in determining the likelihood of increasing AV acceptance after education. The likelihood is improved by 33% if there is a one-unit increase in the Level 5 comfort rating. As such, the research informs AV policymakers of identities that make AV education effective for future AV education considerations.