Descriptive Scale Research Articles

Impact of autologous HSCT on the quality of life and fatigue in patients with relapsing multiple sclerosis

In this study, we aimed to assess the quality of life, fatigue, anxiety, and depression after Autologous haematopoietic stem cell transplantation (AHSCT) and to investigate its impact of on separate domains of health status and fatigue in patients with multiple sclerosis (MS). Overall, 18 patients with highly active relapsing MS (mean age 36.3 years, 83.3% female) underwent the AHSCT in Vilnius Multiple Sclerosis center, and we prospectively collected Short Form 36, Health Survey Questionnaire, Fatigue Descriptive Scale, and Hospital Anxiety and Depression Scale beforeand Month3, 12, and 24 after AHSCT. The median score of Expanded Disability Status Scale at Month3 after transplant improved in 14 patients (77.8%). A significant improvement in physical functioning, vitality, and pain was found at Month3 after AHSCT (p < 0.05), which was sustained until Month12 and 24. The improvement in fatigue score was found at Month12 after AHSCT, which was sustained until Month24. Decrease in EDSS score had a positive impact on the better HRQoL outcomes, especially physical and social outcomes. Thus, AHSCT improved quality of life and reduced symptoms of fatigue in patients with highly active relapsing MS. The improvement was determined earlier in the domains of QoL than in the fatigue.

Development of the Auburn Induction Scale for evaluating induction quality in dogs

ObjectiveTo develop and begin establishing evidence for validity of an instrument to assess the quality of induction in dogs. Study designCross-sectional survey and video scoring. Animals and populationA total of 51 veterinary anesthesia personnel, four board-certified anesthesiologists and videos of induction of anesthesia in 18 dogs. MethodsIn Part 1, an online survey was sent to veterinary anesthesia personnel to solicit expressions and words that they associate with induction of anesthesia. These expressions were evaluated by four anesthesiologists to create a composite scale (Auburn Induction Scale). In Part 2, 18 videos were reviewed by the same four anesthesiologists on two separate occasions. The videos were scored using the Auburn Induction Scale, a simple descriptive scale (SDS) and a visual analog scale (VAS). Intra-rater and inter-rater reliability was measured using an intraclass correlation coefficient (ICC). Significance was set at p < 0.05. ResultsThe survey yielded 51 responses that were condensed into 133 expressions. The four anesthesiologists created 18 items incorporating the 133 expressions. The mean ± standard deviation intra-rater reliability ICC was 0.81 ± 0.08 for the Auburn Induction Scale, 0.71 ± 0.02 for the SDS and 0.71 ± 0.08 for the VAS for all raters. The mean ± standard deviation inter-rater reliability ICC was 0.69 ± 0.04 for the Auburn Induction Scale, 0.61 ± 0.05 for the SDS and 0.60 ± 0.06 for the VAS. Conclusions and clinical relevanceIn a research setting, widespread use of this scale may be helpful in increasing the accuracy of data and improving agreement between studies assessing induction of anesthesia in dogs. The results of this study have yielded a composite scale that is more reliable between and among raters than a unidimensional scale.

Nutrition Education Preferences Of High Level Athletes Living In New Zealand And Australia

PURPOSE: Nutrition education (NE) may help athletes optimize nutrition self-efficacy and dietary intake. We aimed to investigate athletes’ preferences for NE. METHODS: Athletes competing at a national or international level from 18 sports, and living in New Zealand (n = 88, 84.6%) and Australia (n = 12, 11.5%) participated in an online survey developed by the researchers (n = 104, median (IQR) = 22 (8) years, female 50.5%). Responses (from descriptive Likert scales, ranking of preferences) were analyzed using descriptive statistics. RESULTS: Athletes were very (47.6%) or extremely interested (40.0%) in NE. General nutrition topics considered an essential priority for NE were energy requirements (54.8% of athletes), hydration (52.9%), and nutrient deficiencies (43.3%). Performance topics considered essential were recovery (56.7%), pre-exercise nutrition (51.0%) and energy requirements for training (49.0%). Adapting meals for training requirements (36.5% of athletes) and behavior change techniques (26.9%) were considered essential nutrition-related life skills. Credible content was important (92.3%), and most participants wanted some repetition of topics (69.2%). Athletes’ top-ranked setting preferences were ‘one-on-one’, followed by ‘in person group’ and a ‘mixture of in person one-on-one and group’ sessions. For both online and in person group sessions, most athletes wanted NE with athletes of the same sporting caliber (60.6%) and with 6-10 others (38.0%). Preferred session duration was 31-60 minutes (61.5%) and held monthly (39.4%). A performance dietitian or nutritionist was the top-ranked facilitator, followed by sports/exercise physiologist, and an experienced athlete in the sport. Preferred facilitator traits were credibility (74.0%), experience in sports nutrition (77.9%) and knowledge of the sport (84.6%). CONCLUSIONS: Athletes were interested in and preferred ‘in person’ NE. Content preferences covered general, performance and skill-based nutrition, such as adapting meals for sporting requirements. Credibility of the facilitator was important, as well as experience in sports nutrition and knowledge of the athlete’s sport. Further research is needed with athletes at different levels and across all sports to further tailor athlete’s preferences for NE.

Characteristics and prevalence of orofacial pain as an initial symptom of oral and oropharyngeal cancer and its impact on the patient's functionality and quality of life

To evaluate the prevalence and characteristics of orofacial pain in oral and oropharyngeal cancer (OOC), at diagnosis. a) Study group (SG; n = 74) patients with cancer were divided into 2 subgroups: oral cancer (OC) and oropharyngeal cancer (OPC); b) control group (CG; n = 74) patients within dental care. An Orofacial Pain Assessment, verbal descriptive scale, Helkimo dysfunction index, Quality of Life questionnaire, and Karnofsky performance status (KPS) was used for evaluation. The mean age was 58.46 years (79.7% male) in SG, 58.61 years (20.3% male) in CG. The pain within the SG was indicated by the following: prevalence = 91.9% (21.6% in stages 0, I, or II; 70.3% in III or IV); reason for seeking care = 50.1%; main complaint = 55.4%; most important issue in the past 7 days = 74.3%; breakthrough-like pain = 64.9%; main features: chewing or swallowing as triggering factors, wake up patient, variable duration, independent of daytime, multiple descriptors, and earache. The following indexes were worse within the SG: clinical dysfunction, quality of life, and KPS. In addition, the OC subgroup reported toothache-like pain and burning; whereas the OPC subgroup reported heavy swallowing as triggering factor, throat as location, and a bilateral earache. At diagnosis, orofacial pain, including breakthrough-like pain, was prevalent in patients with OOC, and the pattern was heterogeneous. Predominantly, the pain was moderate to severe, related to stage of cancer, and already compromising the patients' quality of life and functionality.

Effect of lamaze breathing and psychosomatic relaxation techniques on labour pains and its outcome

Background: Labour is an emotional experience and involves both physiological and psychological mechanisms. Even if a woman is thrilled about being pregnant, a new baby adds emotional stress to life. Childbirth has always been associated with pain. The study's objectives are to assess the level of pain during labour and the effectiveness of Lamaze Breathing relaxation techniques on the outcome of labour. Methods: The quantitative research approach was used by implementing the Post-test control group research design. About 50 samples were selected by executing the purposive sampling technique. Independent variables were the Lamaze breathing relaxation techniques, while dependent variables were the labour pains and Outcome of Labour. Data from the participants were obtained by administering the observational techniques. A visual descriptor scale was used to assess the level of pain. Result: About 72% of the women in the control group had moderate labor pain, while 44% of the women in the experimental group had moderate pain. About 44% of them had severe labour pain, and the p values were 0.032, which indicates a significant effect of Lamaze breathing relaxation techniques in reducing the labour pain.

Evaluation of Clinical and Genetic Determinants of Treatment OutCome In EGFR Mutation Positive Advanced Lung Adenocarcinoma.

BackgroundThe aim of this research was to evaluate clinical and low-cost genetic determinants of treatment outcome in EGFR mutation positive advanced lung adenocarcinoma patients.Material and MethodsEGFR mutation testing and EGFR 181946C>T genotyping were performed in 101 advanced lung adenocarcinoma patients using qRT-PCR and PCR-RFLP, respectively. Progression-free survival was defined as the time from the start of TKI therapy to date of progression, and overall survival as the time from diagnosis to death from any cause. Pain level was evaluated using a Numerical Rating Scale and the Verbal Descriptor Scale. Statistical significance was considered for P < .05.ResultsPatients were treated with EGFR-TKIs for a period of 1–39months (median 9), with a median PFS of 12.0 months (10.4-13.6, CI 95%), and a median OS of 19.0 months (15.1-22.7, CI 95%). The presence of pain was significantly correlated with the existence of bone (P < .001) and adrenal glands metastases (P = .029). Genetic factors did not have a direct impact on pain management but had a significant effect on the response to TKIs leading to pain alleviation.ConclusionsEGFR mutation subtype and the EGFR 181946 C>T SNP had a significant effect on the response to TKI inducing an indirect anti-dolorous effect.

Attitudes to noise in young adults and associated factors: adaptation of the youth attitude to noise scale into Spanish using item response theory analysis

Objective This study aimed to identify the attitudes to noise in young adults and the possible effects of gender, age, and a positive history of auditory symptoms related to recreational noise exposure on the attitudes to noise in this population. Design The Youth Attitude to Noise (YANS) and the hearing symptom description (HSD) scales were adapted into Spanish to be used with young adults. The validity was determined using factor analyses and Item Response Theory (IRT) models. Linear regression models were used to determine whether the YANS scores were associated with gender, age, and auditory symptoms. Study sample Both instruments were given to a sample of 728 Chilean young adults. Data obtained from this sample was used to determine the YANS and HSD scales' validity and to assess the effects of gender, age, and auditory symptoms on attitudes. Results Our results showed that the YANS and HSD scales had adequate validity and reliability. Differences in the items' capacity to discriminate attitudes to noise were noted using the IRT model. Auditory symptoms were significantly associated with the YANS scores. Conclusions The attitudes to noise in Chilean young adults are influenced by self-perception of auditory symptoms, age, and gender.

Assessing Frailty Risk in Clinical Practice

Assessing Frailty Risk in Clinical Practice

Application of complex medical rehabilitation in patients in the late recovery period after acute cerebrovascular accident

Many observations have shown a close relationship between post-stroke spasticity and pain syndrome due to stroke; with regard to that, in 72% of patients, spasticity was accompanied by pain and only 1,5% of patients experienced pain in the absence of spasticity.Purpose of the study: to substantiate the inclusion of combined physiotherapy methods, i. e. low-frequency electrostatic massage and broadband modulation currents, and multimodal physiotherapy methods from the Alpha LED Oxy Light — Spa™ device, in the standard complex of medical rehabilitation to relieve pain and reduce spasticity in the late recovery period in patients who have undergone acute cerebrovascular accident. Material and methods: the paper presents the data on the inclusion of various physiotherapy methods in the rehabilitation program in the late recovery period in 120 patients with spasticity of the upper limb who underwent acute cerebrovascular accident. The dynamics of pain syndrome intensity were assessed according to the Numerical Pain Rating Scale and the Verbal Descriptor Scale, and the severity of spasticity in the upper limb was evaluated according to the Modified Ashworth Spasticity Scale. All patients were divided into 3 groups comparable in terms of clinical and functional characteristics: group 1 (40 patients), who, in addition to the standard treatment complex (exercise therapy, medical massage, mechanotherapy), were prescribed massage with a pulsed low-frequency electrostatic field from the HIVAMAT device and broadband modulation currents; group 2 (40 patients), whose therapy included physiotherapy methods from the Alpha LED Oxy Light — Spa™ device, against the background of standard therapy and medical rehabilitation; group 3 — 40 patients who received standard drug therapy and medical rehabilitation. Results. Inclusion of pulsed low-frequency electrostatic massage and broadband modulation currents in medical rehabilitation of patients with spasticity of the upper limb who have undergone acute cerebrovascular accident in the late recovery period contributes to the formation of analgesic and antispasmodic effects to a greater extent, compared to the Alpha LED Oxy Light — Spa™ multimodal effects, which is manifested in a significant reduction in pain and a decrease in spasticity.

Assessing verbal interaction: towards European harmonization. Insights from the co-operation between Spanish and French language exams for Higher Education (CertAcles/CLES)

Abstract Verbal interaction has been the subject of a growing interest among language professionals in Europe since the CEFR was published in 2001; in linguistics, verbal interaction has long been studied. In the Bakhtinian approach, it is even considered “the fundamental reality of language”. All types of interaction share the fact that they are dynamically co-constructed by participants. How then can we assess or certify interactional competence on an individual basis when dynamic instability prevails? What criteria can be defined in order to deconstruct interactional competence into specific operational criteria, if interaction is intrinsically multidimensional? These are the questions that we address in this paper. To do so, this paper presents the insights gained as a result of the co-operation between two certification systems: CertAcles (Spain) and CLES (France), both belonging to NULTE (Network of University Language Testers in Europe). These certification systems have agreed to collaborate extensively, sharing their constructs and assessment routines. As a result, CertAcles is shifting towards more contextualized tasks and CLES is considering adopting descriptive assessment scales for interaction (C1 level). We hope to demonstrate that the materialization of scientific collaboration of this kind can help improve individual systems.

Scaling of entropy production under coarse graining in active disordered media.

Entropy production plays a fundamental role in the study of nonequilibrium systems by offering a quantitative handle on the degree of time-reversal symmetry breaking. It depends crucially on the degree of freedom considered as well as on the scale of description. How the entropy production at one resolution of the degrees of freedom is related to the entropy production at another resolution is a fundamental question which has recently attracted interest. This relationship is of particular relevance to coarse-grained and continuum descriptions of a given phenomenon. In this work, we derive the scaling of the entropy production under iterative coarse graining on the basis of the correlations of the underlying microscopic transition rates for noninteracting particles in active disordered media. Our approach unveils a natural criterion to distinguish equilibrium-like and genuinely nonequilibrium macroscopic phenomena based on the sign of the scaling exponent of the entropy production per mesostate.

Padded Dressing with Lidocaine HCL for Reducing Pain during Intravenous Cannulation in Adult Patients: A Randomized Controlled Clinical Trial.

Objective In this study, we aimed to evaluate the effect of administering lidocaine as a local anesthetic at the puncture site prior cannulation on reduction of pain during intravenous cannulation (IVC). Methods A total of 77 patients were divided into two groups as the patients who received a local anesthetic prior IVC procedure (n = 40) and the control group (n = 37). Patients' demographic data, including age, gender, height, weight and body mass index, IV gauge, IV site, heart rate (HR), and oxygen saturation (SpO2) were recorded and analyzed. Patients in both groups scored the pain they felt during IVC through the visual analog scale (VAS) and the verbal descriptor scale (VDS). Results No statistically significant difference was found between the two groups in terms of the demographic features. There was no significant difference between the two groups in terms of the cannula gauges and site of IVC. The mean post-IVC HR value was statistically significantly higher compared to pre-IVC in the control group (p = 0.032), while no difference was found between the mean pre- and postprocedure HR in the lidocaine group. The mean VAS score was significantly lower in the lidocaine group compared to the control group (p < 0.001). There was a significant difference between the groups in terms of the current VDSs. The rate of the patients reporting mild pain was statistically significantly higher in the lidocaine group compared to the control subjects (p < 0.001). Conclusion According to the results of this study, lidocaine HCL-impregnated padded dressing prior IV cannulation significantly reduced pain sensation during IVC.

Challenges encountered by peri-urban women in landed property ownership in Minna

Peri-urban areas are areas around the cities, known to possess vast area of land for agricultural activities and other uses. This study investigates the extent of land and property ownership among women in the peri-urban areas of Minna, Nigeria, and more importantly the challenges they encountered as a result of ownership. By utilizing purposive sampling method, women within marriageable age of 18 years and above were sampled across 12 randomly selected peri-urban areas in the study area. Based on the questionnaire survey conducted between 8th June and 10th June, 2019, a total number of 622 respondents were interviewed. The data for the study entailed general information on land and property ownership and socio-demographic characteristics of the respondents. The data were analysed using descriptive statistics (simple frequency and proportion method) and 4-point likert scale. The study observed that only 52.27% of the respondents owned land/property and revealed that 61.26% of the women did not experience any major threat from owning such asset. The most outstanding challenge experienced as revealed by the study is envy from other women within their society; 62.47% of the respondents attested to this fact. The current study contributes to the extant literature by recommending the formation of social capital network among the women as a panacea to curb the major challenge of envy identified. This could help create good social relationship, social cohesion, collective action and trust among the women. It can also help create economic empowerment which would give women better opportunities to own land and property.

Vestibuloplasty using an apically-shifted flap in patients with edentulous mandibles

BACKGROUND: One of the most common problems of the dental system in the residential and senile age is the complete absence of teeth. This pathology affects up to 35% of patients aged 5570 years, and at the age of 75 years and older, more than 50% of patients have toothless jaws. A small vestibule of the oral cavity due to atrophy of the alveolar process on the lower jaw is an important reason for unsatisfactory fixation of a complete removable prosthesis, and therefore prosthetics of this group of patients is a complex clinical problem.&#x0D; AIM: Study: to optimize the surgical stage of treatment during the operation of deepening the vestibule of the mouth by the method of apically displaced flap in the complete absence of teeth on the lower jaw by using the gel preparation Emalan (Zelenaya dubrava, Russia) based on collagen.&#x0D; MATERIAL AND METHODS: The results of the study of 28 patients aged 67 to 76 years with complete absence of teeth in the lower jaw, whose treatment was carried out on the basis of the dental clinic Prime Dentistry of Ryazan, were analyzed. The study included elderly and senile patients, according to the WHO age classification. Patients were not assigned by gender. All patients were equally divided into 2 groups.&#x0D; Clinical evaluation of the early postoperative period was carried out for 10 days after surgery on the 2nd, 5th and 10th days. A verbal descriptive pain scale was used to assess the intensity of pain.&#x0D; In order to control the presence of an inflammatory reaction in the postoperative period, local thermometry was performed locally using an infrared scanner.&#x0D; RESULTS: Examination on the 2nd day showed that patients of both the main and comparison groups had slightly pronounced edema of the surrounding soft tissues. No increase in body temperature was recorded in both groups. Assessing the postoperative wound, on the 2nd day, all patients of the comparison group had marked hyperemia and swelling of the mucous membrane in the area of the surgical wound, and in patients of the main group such changes were detected less frequently. On the 5th day, no mucosal edema was observed in patients of the main group, and hyperemia was noted twice. In the comparison group, swelling and hyperemia of the mucous membrane in the wound area were recorded in almost half of the group. Examination of the wound defect on the 10th day showed that in the main group in all patients the wound was epithelized, whereas in the comparison group the signs of epithelization were weakly expressed. When studying the dynamics of local thermal symmetry using an IR scanner, carried out three times: on the eve of the operation, on the 2nd and 5th days after the intervention, a difference in indicators was noted between the main group and the comparison group. Patients assessment of the intensity of pain in the postoperative period using a verbal descriptive pain scale showed the following results. After complete cessation of anesthesia, most patients of the main group had slight discomfort in the wound area. Patients of the comparison group mainly complained of severe pain. On the 2nd day and on the 5th day after surgical intervention, some patients of the comparison group had complaints of mild pain in the wound, all other patients, including patients of the main group, had no pain.&#x0D; CONCLUSION: The use of collagen-based gel preparation Emalan to close wound postoperative defects with open methods of deepening the vestibule of the mouth gives positive results in the healing process of the wound defect in the form of absence or significant reduction of pain syndrome, reduction of inflammatory reaction in the wound and acceleration of epithelization.

Algorithm-based pain management for people with dementia in nursing homes.

Algorithm-based pain management for people with dementia in nursing homes.

Prevalence of iatrogenic heart murmurs in a population of apparently healthy cats.

To determine the prevalence of iatrogenic heart murmurs in a population of apparently healthy cats and to investigate factors that may predispose cats to iatrogenic murmurs. Apparently healthy cats presenting for routine examinations were prospectively enrolled. Following a physical examination to confirm there were no abnormalities, a cardiac examination was performed before and during a provocative manoeuvre performed independently by two clinicians. The provocative manoeuvre was performed on the right side of the chest wall by applying gentle pressure with a stethoscope to ascertain whether a murmur became audible, graded using a modified descriptive scale (soft/moderate). The cat's heart rate before and during the provocative manoeuvre and their age, sex, body condition score and bodyweight were recorded. One hundred and six cats were prospectively enrolled. The average prevalence of iatrogenic murmurs was 28.2% with good interobserver agreement recorded on both the presence (kappa 0.67 and 0.62) and grade of the murmur (kappa 0.6 and 0.53). A significant association was noted between age and body condition score, with iatrogenic murmurs more likely in cats with increasing age and decreasing body condition score. There was no association between heart rate and the presence of an iatrogenic murmur. Iatrogenic murmurs are a common finding in cats with increasing prevalence noted in older and lean cats. Iatrogenic murmurs should therefore be considered as a differential diagnosis in a cat when an audible soft systolic right-sided murmur occurs with gentle pressure application to the chest wall during auscultation.

Individual symptom visual analogue scale severity scores for determining EPOS guideline-based chronic rhinosinusitis disease control.

The goal of this study was to determine how to translate visual analogue scale (VAS) symptom scores to the binary, descriptive symptom scales used in the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) criteria for chronic rhinosinusitis (CRS) disease control. 309 CRS patients were recruited. All patients rated their burden of 5 symptoms (nasal blockage, rhinorrhea/postnasal drip, facial pain/pressure, smell loss, sleep disturbance or fatigue) using the binary EPOS descriptive symptom scales and a VAS (on a scale of 0 to 10). In addition, participants completed a 22-item Sinonasal Outcome Test (SNOT-22) and rated their overall CRS disease control as "controlled", "partly controlled" or "uncontrolled" Results: Symptom burdens measured by VAS, binary descriptive EPOS scale and SNOT-22 were associated with worsening CRS disease control reported by participants. Each symptom had a distinct VAS score cut-off that strongly predicted the uncontrolled option on the corresponding binary descriptive EPOS symptom scale. However, the predictive ability of VAS for rhinorrhea/ postnasal drip was disparately worse than the other 4 symptoms. When considering all symptom data simultaneously, a VAS score higher than 3.5 strongly predicted the uncontrolled option on the corresponding binary descriptive EPOS symptom scale for all 5 symptoms. A VAS symptom score of higher than 3.5 translates to the uncontrolled option in the binary, descriptive symptom scale of the EPOS control criteria. The rhinorrhea/postnasal drip descriptive symptom scale translates disparately worse to VAS scores and may be considered for revision in future criteria.

Comparative Evaluation of the Sedative and Analgesic Effects of Caudal Epidural Administration of Lidocaine Alone or in Combination With Xylazine, Detomidine, Medetomidine, and Dexmedetomidine in Mediterranean Miniature Donkeys

The present study aimed to compare the sedative and analgesic effects of caudal epidural administration of lidocaine alone or in combination with four different α2-adrenergic agonists in Mediterranean miniature donkeys. A total of ten clinically healthy (five males and five females) Mediterranean miniature donkeys with an age of 5 ± 1 years, a weight of 100 ± 2 kg and a height at the withers of 0.8 ± 0.06 m (mean ± standard deviation) were used in experimental, crossover (Latin square), randomized, and blinded study. Animals were assigned to five treatment groups including lidocaine alone (0.22 mg kg−1), or associated with one among xylazine (0.17 mg kg−1), detomidine (30 μg kg−1), medetomidine (15 μg kg−1), dexmedetomidine (5 μg kg−1) with a minimum washout period of 8 days between treatments. The degree of sedation was investigated using a simple descriptive scale of 0–3. Sedation scores were compared at each time using nonparametric (Kruskal–Wallis and Mann–Whitney U) tests. Analgesia was assessed by pinprick test. Sedation was greater in lidocaine and/or α2-adrenergic agonist groups than in lidocaine group at 45–75 minutes after drug administration (P < .05). There were no significant differences among groups in time to onset of analgesia and ataxia and also in number of animals with complete perineal analgesia and ataxia. Duration of analgesia and ataxia were longer in lidocaine and/or α2-adrenergic agonist groups than in lidocaine (P < .05). There were no significant differences among lidocaine and/or α2-adrenergic agonist groups in sedation score and duration of analgesia and ataxia. No significant differences were observed in heart and respiratory rate and also rectal temperature at any time points between groups and within groups. Caudal epidural administration of α2- adrenergic agonists associated with lidocaine resulted in sedative effects on Mediterranean miniature donkeys, while lidocaine alone did not induce sedation. These drugs associations should be considered when superior analgesia is advocated.

Dynamic primitives of brain network interaction

What dynamic processes underly functional brain networks? Functional connectivity (FC) and functional connectivity dynamics (FCD) are used to represent the patterns and dynamics of functional brain networks. FC(D) is related to the synchrony of brain activity: when brain areas oscillate in a coordinated manner this yields a high correlation between their signal time series. To explain the processes underlying FC(D) we review how synchronized oscillations emerge from coupled neural populations in brain network models (BNMs). From detailed spiking networks to more abstract population models, there is strong support for the idea that the brain operates near critical instabilities that give rise to multistable or metastable dynamics that in turn lead to the intermittently synchronized slow oscillations underlying FC(D). We explore further consequences from these fundamental mechanisms and how they fit with reality. We conclude by highlighting the need for integrative brain models that connect separate mechanisms across levels of description and spatiotemporal scales and link them with cognitive function.

Assessment of postoperative pain intensity after laparoscopic cholecystectomy: Comparative analysis of three rating scales in terms of scores and patient preferences

Objective: To compare three rating scales in assessment of postoperative pain intensity after laparoscopic cholecystectomy Methods: A total 102 patients who underwent elective laparoscopic cholecystectomy surgery were participated on a voluntary basis in this cross-sectional questionnaire survey. The questionnaire form elicited items on sociodemographic characteristics of patients, pain characteristics and the pain intensity assessment via three scales including Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Descriptor Scale (VDS). Results: Mean(SD) VAS, VDS and NRS scores were 4.7(1.3), 2.8(0.7) and 4.5(1.2), respectively. VDS (67.6%) was the most commonly preferred scale by patients, as followed by VAS (23.5%) and NRS (8.8%). Positive significant correlations were noted between each scale (r: ranged from 0.809 between VAS and VDS to 0.865 between VDS and NRS, p&lt;0.001 for each). There was a high level of inter-scale concordance overall (Cronbach's alpha: 0.910), including VAS x VDS (Cronbach's alpha: 0.820), VAS x NRS (Cronbach’s alpha=0.906) and VDS x NRS (Cronbach’s alpha=0.868). Conclusion: In conclusion, our findings demonstrate that all three scales (VAS, NRS, VDS) provide reliable and valid data with strong correlations and a high level of inter-scale concordance in assessing postoperative pain intensity in laparoscopic cholecystectomy patients. However, VDS appears to be the best scale in assessing pain intensity after laparoscopic cholecystectomy surgery with respect to patient preference rates as well as its strong correlation with other scales, particularly the NRS.