Subjective Discomfort Research Articles

Visual quality following FS-LASIK with Q-value-guided optimized monovision in patients with myopia and presbyopia: Custom-Q in treating myopia and presbyopia

PurposeTo evaluate the objective and subjective visual quality 3 months after femtosecond laser‐assisted laser in situ keratomileusis (FS-LASIK) performed with Q-value–guided optimized monovision scheme (Custom-Q) for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency. DesignProspective before-and-after study. MethodsPatients who had Custom-Q FS-LASIK for myopia with age-related accommodation deficiency were included in this prospective study. Distance, intermediate, and near visual acuities; refraction; Q value; corneal higher-order aberrations (HOAs); accommodative and binocular function measurements; defocus curve; contrast sensitivity and a subjective questionnaire assessing near visual ability and visual discomforts were evaluated before and after surgery. ResultsClinical data of 48 cases were analyzed. The mean age was 42.73 ± 2.67 years (40 to 50 years). At the 3-month follow-up, there were 100% (48/48), 92% (44/48), and 56% (27/48) patients who achieved a binocular uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA) not less than 20/20 separately. Defocus curves revealed better results postoperatively at – 1.00 D and – 1.50 D. The Q value in the dominant eyes was more positive postoperatively (P<0.001), and in the non-dominant eyes, the Q value and corneal spherical aberration (SA) became more negative (P<0.05). The accommodative amplitude (AA) and relative accommodation improved binocularly (P<0.001). The questionnaire demonstrated high patient satisfaction with near vision, and patients’ perceptions of visual discomforts had no significantly difference compare with preoperative. ConclusionFor myopic patients with age-related accommodation deficiency, the Custom-Q ablation could improve near vision without compromising distance vision. It also led to minimal changes in objective optical quality, coordination of accommodative and binocular functions, contrast sensitivity, and subjective visual discomforts perceptions.

Simple Epithelial Transplantation for Ocular Surface Reconstruction After Severe Ocular Burn Injury.

To manage ocular surface complications and recover conjunctival and corneal epithelia after unilateral severe chemical burn. We performed simple conjunctival epithelial transplantation (SCET) to obtain renewal of fornix and bulbar-tarsal conjunctiva epithelium, followed by simple limbal epithelial transplantation (SLET) to recover limbal function and epithelial corneal surface. Slit-lamp examination, fluorescein staining, in vivo confocal microscopy, Kheirkhah grading system for symblepharon severity, Wong-Baker FACES Pain Rating Scale, and best-corrected visual acuity were assessed before surgery, at 1 to 3 months after SCET and SLET, and thereafter at 6 to 12 to 36 months. Two patients with unilateral burn injuries underwent surgery. Eye mobility and fornix reconstruction were promptly achieved, and conjunctival epithelium with goblet cells was observed on the bulbar and tarsal conjunctiva 3 months after SCET. After SLET, corneal epithelium and cornea-conjunctiva transition zone were observed at 3 and 6 months, respectively. From before surgery to 6 months after SLET, symblepharon improved from grade IVa2 and IIIb2 to Ic0 and Ib0, the Wong-Baker FACES Pain Rating Scale changed from grade 6 and 4 to 0, and best-corrected visual acuity upgraded from 1.40 and 1.10 logarithm of the minimum angle of resolution to 0.5 logarithm of the minimum angle of resolution, in patient 1 and 2, respectively. After 3 years, results remained stable. SCET effectively healed the bare conjunctival area relieving subjective symptoms and discomfort. Sequential SCET and SLET showed to be feasible in restoring a normal ocular surface with long-lasting results suggesting the aim in patients with severe ocular burn is not merely corneal epithelium renewal but also the regeneration of ocular surface homeostasis.

Influences of mechanical decompression using different forces on knee joint space, range of motion, and hamstring flexibility in asymptomatic subjects

INTRODUCTION: Knee joint decompression is one of the promising methods for the treatment of osteoarthritis. Yet, the most appropriate decompression force is not conclusive. OBJECTIVES: To compare the effect of different distraction force magnitudes on knee joint space, active range of motion (ROM), hamstring flexibility, and self-reported discomfort in asymptomatic subjects. METHODS AND MATERIALS: Twenty-five asymptomatic participants were recruited in this study. The dominant knee was distracted for 30 minutes in a 30° flexion position using three force magnitudes (10%, 20%, and 30% body weight (BW)). The traction forces were randomized with one week in between knee distractions. Joint space, range of motion (ROM), and hamstring flexibility were assessed before, immediately after, and 30 minutes after the distraction. The self-reported discomfort was assessed immediately after the distraction only. RESULTS: Medial joint space, ROM, and discomfort showed a significant difference between different force magnitudes post-distraction. The 20% and 30% BW force magnitudes significantly, but equally, increased joint space and ROM post distraction. The discomfort level was directly related to distraction force magnitude and the least comforting was the 30% BW force. Follow-up data was not significantly different than that for post-distraction. Hamstring muscle flexibility showed a significant. Yet, small increase after the 30% BW distraction force. CONCLUSION: Continued mechanical distraction of the knee joint using force magnitudes of 20% and 30% of body weight was effective in increasing medial joint space, active knee ROM, and hamstring flexibility in asymptomatic individuals. 20% force magnitude was more comfortable than the 30% percent.

A Case Report of Chest Discomfort Accompanying Insomnia in a Taeeumin Improved with Korean Medicine Treatment Focused on Gami Cheongsim-tang

Objectives: The purpose of this study was to report the case of a patient with chest discomfort and insomnia.Methods: The patient in this case was hospitalized for 11 days and improved after the administration of Korean medicine, mainly Gami Cheongsim-tang. The Beck Anxiety Inventory and Beck Depression Inventory were taken, and the insomnia severity index was measured on the first day and last day of the hospitalization. The patient’s subjective discomfort level was also evaluated daily.Results: Chest discomfort was reduced, mental breakdown symptoms such as depression and anxiety were greatly improved, and the quality of sleep was also enhanced after the Korean medicine treatment.Conclusion: This study suggests that Korean medicine might be effective in chest discomfort with anxiety and sleep disorder in a patient exhibiting Taeeumin-type personality.

Relationship between the intraindividual interplay of negative and positive exam-related emotions and the behavioral-emotional dimensions of academic procrastination

Although achievement situations trigger multiple emotions and learners experience both negative and positive emotions simultaneously, procrastination research typically examines isolated relationships between specific emotions and procrastination. The potential interplay of negative and positive emotions regarding procrastination is often overlooked, although this perspective can shed light on their dynamic relationships. Moreover, past studies primarily address the behavioral aspect of procrastination (delay) while overlooking its emotional facet (subjective discomfort), albeit this differentiation could enhance understanding of procrastination and its correlates. The present study explores the understudied interplay of the two most frequently experienced negative (anxiety) and positive (hope) exam-related emotions regarding students’ procrastination tendencies with differentiated behavioral and emotional dimensions. The study analyzes cross-sectional data from two independent studies (Nstudy1 = 266, Nstudy2 = 468) conducted in Germany among university students. Latent profile analyses (LPA) reveal three similar profiles across both studies—High Anxiety–Low Hope, Low Anxiety–High Hope and Moderate Anxiety–Moderate Hope— and two study-specific profiles namely, Low Anxiety–Moderate Hope (Study 1) and High Anxiety–Moderate Hope (Study 2). Females compared to males are more likely to belong to the anxiety-dominated profiles. Overall, students in anxiety-dominated profiles report higher scores whereas students in hope-dominated profiles report lower scores on both behavioral and emotional dimensions of academic procrastination. This study advances an integrated approach that incorporates the combined effects of both negative and positive emotions concerning procrastination. Findings further inform research efforts towards identifying risk and protective emotional factors to develop tailored intervention against academic procrastination.

Discomfort in pedestrian-electric scooter interactions during frontal approaches

BackgroundAs urban landscapes rapidly integrate e-scooters into their transportation ecosystems, understanding pedestrian-e-scooter interactions becomes paramount for safety and planning. This study investigates pedestrian discomfort levels and avoidance strategies when encountering an e-scooter approaching from the front. Methods25 participants were exposed to e-scooters approaching at three different speeds and lateral distances. Avoidance paths were plotted, and subjective discomfort levels were recorded and analysed. ResultsOur findings underscored two key behaviours: 1) As the speed of the e-scooter increased, participants initiated avoidance manoeuvres from a further distance ahead, suggesting a heightened perception of risk. 2) Regardless of the e-scooter's speed, the lateral distance maintained during passing remained fairly constant. However, when the e-scooter's initial lateral position was closer to participants, both the initiation distance for avoidance and the reported discomfort level increased noticeably. ConclusionThe findings underscore the critical influence of lateral distance and e-scooter speed on pedestrian comfort and avoidance behaviour. These insights can guide urban planners and policymakers in designing safer and more efficient shared spaces.

Early oral hydration on demand in postanesthesia care unit effectively relieves postoperative thirst in patients after gynecological laparoscopy: a prospective randomized controlled trial

BackgroundPostoperative thirst is one of the most intense, common and easily ignored subjective discomforts in patients after gynecological surgery. This study aimed to investigate whether early oral hydration on demand in the postanesthesia care unit (PACU) after gynecological laparoscopy under general anesthesia can appease postoperative thirst and increase patient comfort.MethodsParticipants were randomized into the intervention and control groups. Patients in the intervention group were allowed to achieve early oral hydration on demand in the PACU if they were evaluated as fully conscious, with stable vital signs, grade 5 muscle strength, and well-recovered cough and swallowing reflex. However, the total amount of water intake throughout the entire study should not exceed 0.5mL/kg. During the study, the frequency of water intake, the total amount of water intake and adverse events were accurately recorded. The control group was managed according to the routine procedures and began to drink water 2 h after anesthesia. The intensity of thirst and subjective comfort in patients were assessed using the visual analog scale (VAS) when they entered and left the PACU.ResultsNo statistically significant differences were identified in age, height, weight, body mass index, pre-operative fasting time, duration of surgery, intraoperative fluid intake, intraoperative blood loss, intraoperative urine volume, and thirst intensity and subjective comfort scores between the groups before intervention (P > 0.05). After intervention, the VAS score for thirst intensity in the intervention group significantly decreased (P < 0.05), and the VAS score for subjective comfort in the intervention group significantly increased (P < 0.05). No adverse events were detected in both groups during the entire study.ConclusionEarly oral hydration on demand in the PACU can safely and effectively relieve postoperative thirst in patients, and improve patient comfort after gynecological laparoscopy.Trial registrationThis single-center, prospective, randomized controlled trial was registered at the Chinese Clinical Trial Center on April 27, 2023. The registration number of this study is ChiCTR2300070985.

Human-Robot Collaboration With a Corrective Shared Controlled Robot in a Sanding Task.

Physical and cognitive workloads and performance were studied for a corrective shared control (CSC) human-robot collaborative (HRC) sanding task. Manual sanding is physically demanding. Collaborative robots (cobots) can potentially reduce physical stress, but fully autonomous implementation has been particularly challenging due to skill, task variability, and robot limitations. CSC is an HRC method where the robot operates semi-autonomously while the human provides real-time corrections. Twenty laboratory participants removed paint using an orbital sander, both manually and with a CSC robot. A fully automated robot was also tested. The CSC robot improved subjective discomfort compared to manual sanding in the upper arm by 29.5%, lower arm by 32%, hand by 36.5%, front of the shoulder by 24%, and back of the shoulder by 17.5%. Muscle fatigue measured using EMG, was observed in the medial deltoid and flexor carpi radialis for the manual condition. The composite cognitive workload on the NASA-TLX increased by 14.3% for manual sanding due to high physical demand and effort, while mental demand was 14% greater for the CSC robot. Digital imaging showed that the CSC robot outperformed the automated condition by 7.16% for uniformity, 4.96% for quantity, and 6.06% in total. In this example, we found that human skills and techniques were integral to sanding and can be successfully incorporated into HRC systems. Humans performed the task using the CSC robot with less fatigue and discomfort. The results can influence implementation of future HRC systems in manufacturing environments.

Ultrasonic Scalpel vs. Polymeric Clip Laparoscopic Varicocelectomy in Adolescents with Symptomatic Varicocele.

Background: The aim of this study was to investigate treatment outcomes in adolescents who underwent laparoscopic surgery with an ultrasonic scalpel for symptomatic varicocele compared with adolescents who underwent surgery with a polymer clip. Methods: A total of 270 adolescents with a median age of 16 (interquartile range, IQR 13-17) years were included in the study. Taking into account the laparoscopic varicocelectomy technique used, the patients were divided into two groups. In the first group (n = 151), a polymer clip was used, while in the second group (n = 119), an ultrasonic scalpel was used to resect the spermatic vessels. The primary outcome measure was the effect of the laparoscopic technique used on treatment outcomes (postoperative complications and recurrence rates). Secondary outcomes were the duration of surgery and anesthesia and the length of hospital stay. Results: The duration of the surgical procedure (12 min (IQR 11, 15) versus 15 min (12, 19), p = 0.029) and anesthesia (21.5 min (16, 29.5) versus 28 min (23, 34), p = 0.003) was shorter in the group of adolescents in whom laparoscopic varicocelectomy was performed with an ultrasonic scalpel than in the group in which a polymer clip was used. No statistically significant difference was found between the groups studied in terms of length of hospital stay, recurrence rate (p >0.999), and complications (p = 0.703). There were no cases of testicular atrophy in either group. In the group of patients who underwent laparoscopic varicocelectomy with an ultrasonic scalpel, a slightly higher incidence of hydroceles was found (n = 4, 3.4%) than in the group in which a polymer clip was used (n = 2, 1.3%) (p = 0.410). At six-month follow-up, it was found that the majority of patients showed moderate or significant improvement in the spermogram after laparoscopic varicocelectomy (n = 85, 89.5%). In addition, the subjective discomfort or pain disappeared in the majority of patients (n = 71, 93.4%). The testicular volume increased significantly in 132 adolescents (89.8%). Conclusions: Laparoscopic varicocelectomy with a polymer clip or ultrasonic scalpel is safe and effective in adolescents with symptomatic varicocele. Treatment outcomes after laparoscopic varicocelectomy are the same regardless of whether a polymer clip or an ultrasonic scalpel is used to resect the spermatic vessels. The use of an ultrasonic scalpel for resection of the spermatic vessels shortens the overall duration of surgery and anesthesia.

Effect of age-related extended high frequency hearing loss on the subjective impressions of dental drill noise

Fear and anxiety among patients are sometimes evoked in dental clinics due to the sound of dental drills. This study aimed to explore the impact of age-related hearing loss in the extended high frequency (EHF) range above 8 kHz on individuals' subjective discomfort towards dental drill noise. After measuring pure-tone audiometric thresholds at both conventional and extended high frequencies, we used a psychoacoustic approach to evaluate subjective impressions of four dental drill sound stimuli, which featured varying frequency components, in 62 participants (aged 12–67 years). We found a significant decrease in hearing sensitivity within the EHF range as age increased, with notable differences in hearing thresholds at 14 kHz between teenage and older adults exceeding 65 dB. Furthermore, significant differences were observed between younger and older (above 40 years) participants in the subjective impressions of dental drill noise, emphasizing age as a critical factor in the perception of high frequency components. Consequently, age may influence the unpleasantness of dental drilling noise. Compared to older individuals, young participants may exhibit increased fear of dental procedures owing to physiological factors. These results underscore the need for age-appropriate noise control strategies in dental clinics to mitigate anxiety and improve patient comfort.

A comparative analysis of older patients with chewing difficulties due to temporomandibular disorders and tooth loss

Background/purposeChewing difficulty can contribute to psychological stress, which reduces the quality of life for older adults. The purpose of this study was to investigate and analyze the severity of masticatory discomfort, stress response, and sleep disturbance in older patients experiencing masticatory discomfort due to tooth loss or temporomandibular disorders (TMD), to find the further treatment direction for these patients. Materials and methodsA total of 392 patients aged 50 years and older with mastication difficulties were analyzed. Two group of patients, those seeking prosthetic treatment due to tooth loss (n = 193) and those who were referred due to TMD-related pain discomfort (n = 199), were identified. Numeric rating scale (NRS), stress response inventory (SRI), and insomnia severity index (ISI) were used as tools to measure patients’ subjective chewing discomfort, stress response, and sleep status. ResultsChewing discomfort and age were found to be much higher in the prosthetic group than in the TMD group. The TMD group had significantly higher scores in five SRI parameters (tension, anger, depression, fatigue, and frustration) as well as total score and a higher percentage of clinical insomnia compared to prosthetic patients. ConclusionSince the number of remaining teeth has a significant impact on the masticatory discomfort severity, restoring the occlusion through prosthodontic treatment is important to improve masticatory function. In patients with TMD, it is necessary to assess stress response and sleep quality, and a multidisciplinary treatment approach may be necessary to effectively address masticatory discomfort.

Randomized clinical trial comparing customized corneal crosslinking: epi-on in high oxygen and epi-off in room air for keratoconus.

To compare clinical outcomes of customized transepithelial (epi-on) corneal crosslinking (CXL) in high oxygen and customized CXL with epithelial removal (epi-off) in room air for keratoconus (KC). Umeå University Hospital, Umeå, Sweden. Prospective, randomized, single-masked, intraindividually comparing study. 32 participants with bilateral progressive KC were treated with bilateral customized topography-guided CXL, 30 mW/cm 2 ; 7.2 to 15 J/cm 2 and were randomized to epi-on in one eye (32 eyes) and epi-off in the fellow eye (32 eyes). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), maximal keratometry (Kmax), subjective ocular discomfort, low-contrast visual acuities (LCVAs) at 10% and 2.5% contrast, ocular and anterior corneal wavefront aberrations, manifest refractive spherical equivalent, endothelial cell count (ECC), and adverse events were assessed through 24 months. Both treatments showed improvements at 24 months in UDVA; -0.16 ± 0.24 ( P < .001) and -0.13 ± 0.20 logMAR ( P = .006), respectively, CDVA; -0.10 ± 0.11 ( P < .001) and -0.10 ± 0.12 ( P = .001), Kmax; -1.74 ± 1.31 ( P < .001) and -1.72 ± 1.36 D ( P < .001). LCVA 10% improved for both protocols ( P < .001), but LCVA 2.5% improved for epi-on CXL only ( P = .001). ECC was unaltered, and no adverse events occurred. The epi-on eyes had significantly less discomfort symptoms during the whole first week posttreatment ( P < .05). High-oxygen customized epi-on CXL is a viable alternative to room air customized epi-off CXL, with faster improvements in CDVA and LCVA and less early ocular discomfort.

성인 여성의 음주 및 흡연이 현존 치아 수 및 주관적 구강불편에 미치는 영향 요인 조사

Objectives: The purpose of this study was to determine the relationship between alcohol consumption and smoking on the existing dental index and subjective oral discomfort of Korean women. Methods: The subjects of this study were women aged 19 to 64. The collected data were analyzed using IBM SPSS Statistics ver. 21.0 (IBM Co. Armonk, NY, USA). The significance level of the statistical tests was set to 0.05. Results: Drinking (p &lt; 0.001) and smoking (p = 0.011) had a statistically significant influence on the number of existing teeth, and drinking(p = 0.009) and smoking (p = 0.009) had a statistically significant influence on the discomfort of chewing. Conclusions: Programs that can provide women who are otherwise unable to obtain access smoking cessation clinics should be expanded.

Associations Among Hypersensitivity, Vagal Tone, and Mood State in Adults.

Although many previous studies have reported the relationship between hypersensitivity and vagal function in children, the relationship in adults is unclear. This study investigates the relationship between hypersensitivity and vagal function, discomfort to sensory stimuli, and daily mood states in healthy adults. Using a questionnaire, 39 healthy adults were divided into hypersensitivity and control groups. We compared the baseline respiratory sinus arrhythmia (RSA), reflecting vagal tone and reactivity, subjective discomfort to sensory stimuli, and daily mood status between groups. Those in the hypersensitivity group had significantly lower baseline RSA and were more likely to experience greater RSA variability and discomfort during exposure to sensory stimuli than the control group. We found no significant difference between groups in daily mood status. These findings suggest that vagal function is an important marker of hypersensitivity in healthy adults.

Orbicularis oculi muscle activity during computer reading under different degrees of artificially-induced aniseikonia.

Aniseikonia is a binocular vision disorder that has been associated with asthenopic symptoms. However, asthenopia has been evaluated with subjective tests that make difficult to determine the level of aniseikonia. This study aims to objectively evaluate the impact of induced aniseikonia at different levels on visual fatigue by measuring the orbicularis oculi muscle activity in the dominant and non-dominant eyes while performing a reading task. Twenty-four collegiate students (24.00 ± 3.86 years) participated in this study. Participants read a passage for 7 minutes under four degrees of aniseikonia (0%, 3%, 5% and 10%) at 50 cm. Orbicularis oculi muscle activity of the dominant and non-dominant eye was recorded by surface electromyography. In addition, visual discomfort was assessed after each task by completing a questionnaire. Orbicularis oculi muscle activity increased under induced aniseikonia (i.e., greater values for the 10% condition in comparison to 0%, and 3% conditions (p=0.034 and p=0.023, respectively)). No statistically significant differences were observed in orbicularis oculi muscle activity for the time on task and between the dominant and non-dominant eyes. Additionally, higher levels of subjective visual discomfort were observed for lower degrees of induced aniseikonia. Induced aniseikonia increases visual fatigue at high aniseikonia degrees as measured by the orbicularis oculi muscle activity, and at low degrees as measured with subjective questionnaires. These findings may be of relevance to better understand the visual symptomatology of aniseikonia.

Dry eye syndrome associated with traumatic keratitis

Dry eye syndrome (DES) is an urgent problem in healthcare practice worldwide. Various diseases of the eye are of particular importance for the development of this syndrome. A special place among the diseases leading to symptomatic DES with ocular surface lesion belongs to corneal injuries of traumatic origin. The frequency of post-traumatic complications of the eye, especially the cornea, remains high due to its anatomical location. And often these patients are at risk of secondary DES. For the pathogenesis of DES after ke­ratitis, ultrastructural changes in the cells of different corneal layers and the toxic effect on the tear film layers of preservative-containing drugs used in the treatment of keratitis are important. The purpose of the study was to assess the severity of secondary DES in patients after traumatic keratitis and the effectiveness of hyaluronic acid combined with antioxidants in the treatment of this pathology. An ophthalmological examination, functional tests were made, and the Ocular Surface Disease Index was used to evaluate the symptoms and severity of the disease. The criteria for the effectiveness of the therapy with hyaluronic acid in combination with vitamins A and E four times a day were: reduction of corneal syndrome, increase in the tear film break-up time, a decrease in subjective discomfort. Clinical observation of patients with DES after traumatic keratitis showed that the use of hyaluronic acid can result in a significant reduction or complete disappearance of subjective symptoms of the disease, sustained improvement in vision and increased stability of the tear film. The use of these eye drops makes it possible to reach compliance and shorten the treatment period.

Effectiveness of EScoop® lenses on a Select Group of Veterans

Purpose: The purpose of this study was to perform a retrospective chart review to see if the use of EScoop® lenses improved the referred veterans' contrast acuity and subjective visual discomfort of glare, photophobia, or difficulty with night driving. Methods: We retrospectively reviewed examinations of 23 veterans aged 36 to 91 who chose EScoop ® for their spectacle prescription. The EScoop ® set available in our clinic included two shades, yellow or orange, two center lens thicknesses (LT), 6 or 9 mm, and with or without 4 prism diopters yoked base up (BU) prism. Results: The largest diagnostic group tested was with traumatic brain injury (12 of 23), and they preferred the orange-tinted lens (10 of 12). The orange 9 mm LT with 4 prism diopters BU was the most commonly chosen EScoop® lens overall (5 of 23). Pre and post lens visual acuity testing with Sloan EDTRS LogMAR Low Contrast Chart at 25% contrast was available for 13 of the 23 patients. A small but statistically significant improvement of 0.11 decimal mean acuity (about one-line Snellen) under a low contrast condition was noted while wearing the preferred EScoop ® lenses (Wilcoxon Signed Rank P=0.015). Conclusion: Our retrospective study reviewed visually impaired patients with varied clinical conditions, including traumatic brain injury, age-related macular degeneration, glaucoma, and optic atrophy. Upon informal questioning, the patients reported improvements in glare, photophobia, and night glare symptoms. Objectively, we measured approximately one line of improvement in contrast Snellen acuity, which was statistically significant. Further research is needed to discern the actual effectiveness of this lens.

Effectiveness of EScoop® lenses on a Select Group of Veterans

Purpose: The purpose of this study was to perform a retrospective chart review to see if the use of EScoop® lenses improved the referred veterans' contrast acuity and subjective visual discomfort of glare, photophobia, or difficulty with night driving. Methods: We retrospectively reviewed examinations of 23 veterans aged 36 to 91 who chose EScoop ® for their spectacle prescription. The EScoop ® set available in our clinic included two shades, yellow or orange, two center lens thicknesses (LT), 6 or 9 mm, and with or without 4 prism diopters yoked base up (BU) prism. Results: The largest diagnostic group tested was with traumatic brain injury (12 of 23), and they preferred the orange-tinted lens (10 of 12). The orange 9 mm LT with 4 prism diopters BU was the most commonly chosen EScoop® lens overall (5 of 23). Pre and post lens visual acuity testing with Sloan EDTRS LogMAR Low Contrast Chart at 25% contrast was available for 13 of the 23 patients. A small but statistically significant improvement of 0.11 decimal mean acuity (about one-line Snellen) under a low contrast condition was noted while wearing the preferred EScoop ® lenses (Wilcoxon Signed Rank P=0.015). Conclusion: Our retrospective study reviewed visually impaired patients with varied clinical conditions, including traumatic brain injury, age-related macular degeneration, glaucoma, and optic atrophy. Upon informal questioning, the patients reported improvements in glare, photophobia, and night glare symptoms. Objectively, we measured approximately one line of improvement in contrast Snellen acuity, which was statistically significant. Further research is needed to discern the actual effectiveness of this lens.

Effects of Short-Term Hand Tractor Operation on Upper Limb Responses of Users

ABSTRACT Objectives Continuous exposure to hand-arm vibration integrated with poor posture and forceful movements are known causes of musculoskeletal disorders (MSD). In most related studies, force and vibration levels in experimental research is controlled. This study aims to determine how actual hand tractor field operation can affect the upper limb of users. It intends to characterize upper limb muscle activation applied during actual hand tractor usage. Lastly, it determines the immediate impacts on hand strength and perceived upper limb discomfort after the operation. Methods We recruited 15 farm operators with a mean working experience of 20.1 ± 12.2 years. They were asked to operate a hand tractor on paddy fields for at most 8 minutes. Handle vibration was measured using a tri-axial accelerometer. The total unweighted vibration acceleration was computed and used to represent the handle vibration magnitude. Muscle activation was measured using surface electromyography (sEMG). Six sEMG sensors were attached to the dominant and non-dominant side of the extensor carpi radialis (ECR), bicep, and deltoid. Pre- and post-task hand strength and subjective discomfort rating were also taken. Results The total unweighted handle vibration acceleration is 17.45 ± 7.53 m/s2. This exceeds the allowable safe value. Meanwhile, the percentage of maximum voluntary contraction (% MVC) of the muscles ranged from 6% to 14% with the ECR having a significantly higher activation (p < .05) than the bicep and deltoid. The post-task grip strength of the dominant hand was lower than its pre-task value (p < .01) while that of the non-dominant side did not vary significantly. There is a modest trend of higher hand discomfort of the non-dominant side on post-task than pre-task rating (p < .10). Although, overall, the perceived discomfort ranged from none to mild discomfort. Conclusion In conclusion, the study showed an indication that the effects of vibration on humans are evident even at mild muscle exertion, with the exertion predominantly concentrated on the distal arm area clearly affecting grip strength and hand discomfort. In such cases, future recommendations can revolve around the improvement of the hand tractor handle grip to impose grip comfort and ease.

Subjective discomfort and lack of volitional drive with neuroleptic pharmacotherapy - a phenomenological case study

IntroductionIn comparison to extrapyramidal and metabolic side effects, the subjective aspects of neuroleptic treatment have been less extensively researched. Nevertheless, they are equally significant given their potential to influence adherence and functional outcome. Historically, terms such as “neuroleptic dysphoria,” “neuroleptic-induced psychic indifference,” and “neuroleptic-induced deficit syndrome” were used to characterize a range of unpleasant mood states on the one hand and a documented and observable motivational deficit on the other. The latter aligns with the findings from preclinical neuroscientific studies and animal models highlighting the significant involvement of mesolimbic dopamine in motivational processes. Despite an abundance of anecdotal data these adverse effects are often undetectable in large-scale clinical studies that utilize standardized assessment measures.ObjectivesTo present adverse subjective changes in arousal, mood and volitional drive resulting from neuroleptic intake from a patient’s perspective.MethodsThe subject is a patient, with no reported negative symptoms or lasting functional impairment described, who underwent a gradual 6-month discontinuation of risperidone in an outpatient setting following a complete recovery after a single psychotic episode. A semi-structured interview modelled after The Clinical Assessment Interview for Negative Symptoms (CAINS) was conducted. We aimed to elicit descriptions of the subjective experience while ensuring our approach remained non-suggestive.ResultsIn addition to describing potential akathisia and lethargy at higher doses, the subject reported a significant lack of motivation and a notably reduced willingness to exert effort towards achieving specific goals or engaging in activities that he still found rewarding or pleasurable. Furthermore, he consistently noted gradual improvements across various psycho-social aspects following the discontinuation of the medication. These adverse and unpleasant experiences were presented as the primary reason for wanting to discontinue pharmacological treatment.ConclusionsCertain adverse effects of antipsychotic medications can only be elucidated by the clinician through the examination of the patient’s subjective experiences. Medication induced dysphoria and volitional deficits have the potential to profoundly impact treatment adherence, leading to unrecommended discontinuation of neuroleptics, and can cause important functional impairment.Disclosure of InterestNone Declared