Medically Unexplained Oropharyngeal Dysphagia at the University Hospital ENT Outpatient Clinic for Dysphagia: A Cross-Sectional Cohort Study

Medically unexplained oropharyngeal dysphagia (MUNOD) is a rare condition. It presents without demonstrable abnormalities in the anatomy of the upper aero-digestive tract and/or swallowing physiology. This study investigates whether MUNOD is related to affective or other psychiatric conditions. The study included patients with dysphagic complaints who had no detectible structural or physiological abnormalities upon swallowing examination. Patients with any underlying disease or disorder that could explain the oropharyngeal dysphagia were excluded. All patients underwent a standardized examination protocol, with FEES examination, the Hospital Anxiety and Depression Scale (HADS), and the Dysphagia Severity Scale (DSS). Two blinded judges scored five different FEES variables. None of the 14 patients included in this study showed any structural or physiological abnormalities during FEES examination. However, the majority did show abnormal piecemeal deglutition, which could be a symptom of MUNOD. Six patients (42.8%) had clinically relevant symptoms of anxiety and/or depression. The DSS scores did not differ significantly between patients with and without affective symptoms. Affective symptoms are common in patients with MUNOD, and their psychiatric conditions could possibly be related to their swallowing problems

Introducing the DizzyQuest: an app-based diary for vestibular disorders

BACKGROUND Most questionnaires currently used for assessing symptomatology of vestibular disorders are retrospective, inducing recall bias and lowering ecological validity. An app-based diary, administered multiple times in daily life, could increase the accuracy and ecological validity of symptom measurement. The objective of this study was to introduce a new experience sampling method (ESM) based vestibular diary app (DizzyQuest), evaluate response rates, and to provide examples of DizzyQuest outcome measures which can be used in future research. METHODS Sixty-three patients diagnosed with a vestibular disorder were included. The DizzyQuest consisted of four questionnaires. The morning- and evening-questionnaires were administered once each day, the within-day-questionnaire 10 times a day using a semi-random time schedule, and the attack questionnaire could be completed after the occurrence of a vertigo or dizziness attack. Data were collected for 4~weeks. Response rates and loss-to-follow-up were determined. Reported symptoms in the within-day-questionnaire were compared within and between patients and subgroups of patients with different vestibular disorders. RESULTS Fifty-one patients completed the study period. Average response rates were significantly higher than the desired response rate of \textgreater 50% (p \textless 0.001). The attack-questionnaire was used 159 times. A variety of neuro-otological symptoms and different disease profiles were demonstrated between patients and subgroups of patients with different vestibular disorders. CONCLUSION The DizzyQuest is able to capture vestibular symptoms within their psychosocial context in daily life, with little recall bias and high ecological validity. The DizzyQuest reached the desired response rates and showed different disease profiles between subgroups of patients with different vestibular disorders. This is the first time ESM was used to assess daily symptoms and quality of life in vestibular disorders, showing that it might be a useful tool in this population

Ice nucleation activity of agricultural soil dust aerosols from Mongolia, Argentina, and Germany

Soil dust particles emitted from agricultural areas contain considerable mass fractions of organic material. Also, soil dust particles may act as carriers for potentially ice-active biological particles. In this work, we present ice nucleation experiments conducted in the Aerosol Interaction and Dynamics in the Atmosphere (AIDA) cloud chamber. We investigated the ice nucleation efficiency of four types of soil dust from different regions of the world. The results are expressed as ice nucleation active surface site (INAS) densities and presented for the immersion freezing and the deposition nucleation mode. For immersion freezing occurring at 254 K, samples from Argentina, China, and Germany show ice nucleation efficiencies which are by a factor of 10 higher than desert dusts. On average, the difference in ice nucleation efficiencies between agricultural and desert dusts becomes significantly smaller at temperatures below 247 K. In the deposition mode the soil dusts showed higher ice nucleation activity than Arizona Test Dust over a temperature range between 232 and 248 K and humidities RHice up to 125%. INAS densities varied between 109 and 1011m-2 for these thermodynamic conditions. For one soil dust sample (Argentinian Soil), the effect of treatments with heat was investigated. Heat treatments (383 K) did not affect the ice nucleation efficiency observed at 249 K. This finding presumably excludes proteinaceous ice-nucleating entities as the only source of the increased ice nucleation efficiency.Fil: Steinke, I.. Karlsruhe Institute of Technology; AlemaniaFil: Funk, R.. Leibniz Centre for Agricultural Landscape Research; AlemaniaFil: Busse, J.. Leibniz Centre for Agricultural Landscape Research; AlemaniaFil: Iturri, Laura Antonela. Universidad Nacional de La Pampa; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Ciencias de la Tierra y Ambientales de La Pampa. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales. Instituto de Ciencias de la Tierra y Ambientales de La Pampa; ArgentinaFil: Kirchen, S.. Karlsruhe Institute of Technology; AlemaniaFil: Leue, M.. Leibniz Centre for Agricultural Landscape Research; AlemaniaFil: Möhler, O.. Karlsruhe Institute of Technology; AlemaniaFil: Schwartz, T.. Universidad Nacional de La Pampa; ArgentinaFil: Schnaiter, M.. Karlsruhe Institute of Technology; AlemaniaFil: Sierau, B.. Institute for Atmospheric and Climate Science; SuizaFil: Toprak, E.. Karlsruhe Institute of Technology; AlemaniaFil: Ullrich, R.. Karlsruhe Institute of Technology; AlemaniaFil: Ulrich, A.. Leibniz Centre for Agricultural Landscape Research; AlemaniaFil: Hoose, C.. Karlsruhe Institute of Technology; AlemaniaFil: Leisner, T.. Karlsruhe Institute of Technology; Alemania. Heidelberg University; Alemani

Psychometric evaluation of an experience sampling method–based patient-reported outcome measure in functional dyspepsia

Background: Due to important biases, conventional end-of-day and end-of-week assessment methods of gastrointestinal symptoms in functional dyspepsia (FD) are considered suboptimal. Real-time symptom assessment based on the experience sampling method (ESM) could be a more accurate measurement method. This study aimed to evaluate validity and reliability of an ESM-based patient-reported outcome measure (PROM) for symptom assessment in FD. Methods: Thirty-five patients with FD (25 female, mean age 44.7 years) completed the ESM-based PROM (a maximum of 10 random moments per day) and an end-of-day symptom diary for 7 consecutive days. On day 7, end-of-week questionnaires were completed including the Nepean Dyspepsia Index (NDI) and Patient Assessment of Gastrointestinal Symptom Severity Index (PAGI-SYM). Key Results: Experience sampling method and corresponding end-of-day scores for gastrointestinal symptoms were significantly associated (ICCs range 0.770–0.917). However, end-of-day scores were significantly higher (Δ0.329–1.031) than mean ESM scores (p < 0.05). Comparing ESM with NDI and PAGI-SYM scores, correlations were weaker (Pearson's r range 0.467–0.846). Cronbach's α coefficient was good for upper gastrointestinal symptoms (α = 0.842). First half-week and second half-week scores showed very good consistency (ICCs range 0.913–0.975). Conclusion and Inferences: Good validity and reliability of a novel ESM-based PROM for assessing gastrointestinal symptoms in FD patients was demonstrated. Moreover, this novel PROM allows to evaluate individual symptom patterns and can evaluate interactions between symptoms and environmental/contextual factors. ESM has the potential to increase patients' disease insight, provide tools for self-management, and improve shared decision making. Hence, this novel tool may aid in the transition toward personalized health care for FD patients

Embodiment of Wearable Augmented Reality Technology in Tourism Experiences

The increasing use of wearable devices for tourism purposes sets the stage for a critical discussion on technological mediation in tourism experience. This paper provides a theoretical reflection on the phenomenon of embodiment relation in technological mediation and then assesses the embodiment of wearable augmented reality technology in a tourism attraction. The findings suggest that technology embodiment is a multidimensional construct consisting of ownership, location, and agency. These support the concept of technology withdrawal, where technology disappears as it becomes part of human actions, and contest the interplay of subjectivity and intentionality between humans and technology in situated experiences such as tourism. It was also found that technology embodiment affects enjoyment and enhances experience with tourism attractions

A modern network approach to revisiting the positive and negative affective schedule (PANAS) construct validity

Introduction: The factor structure of the Positive and Negative Affective Schedule (PANAS) is still a topic of debate. There are several reasons why using Exploratory Graph Analysis (EGA) for scale validation is advantageous and can help understand and resolve conflicting results in the factor analytic literature. Objective: The main objective of the present study was to advance the knowledge regarding the factor structure underlying the PANAS scores by utilizing the different functionalities of the EGA method. EGA was used to (1) estimate the dimensionality of the PANAS scores, (2) establish the stability of the dimensionality estimate and of the item assignments into the dimensions, and (3) assess the impact of potential redundancies across item pairs on the dimensionality and structure of the PANAS scores. Method: This assessment was carried out across two studies that included two large samples of participants. Results and Conclusion: In sum, the results are consistent with a two-factor oblique structure.Fil: Flores Kanter, Pablo Ezequiel. Universidad Empresarial Siglo XXI; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Garrido, Luis Eduardo. Pontificia Universidad Católica Madre y Maestra; República DominicanaFil: Moretti, Luciana Sofía. Universidad Empresarial Siglo XXI; Argentina. Pontificia Universidad Católica Madre y Maestra; República Dominicana. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Medrano, Leonardo. Universidad Empresarial Siglo XXI; Argentina. Pontificia Universidad Católica Madre y Maestra; República Dominicana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

A Theoretical Model of Augmented Reality Acceptance in Urban Cultural Heritage Tourism

Latest mobile technologies have revolutionised the way people experience their environment. Recent research explored the opportunities of using augmented reality (AR) in order to enhance the user experience however, there is only limited research on users’ acceptance of AR in the tourism context. The technology acceptance model is the predominant theory for researching technology acceptance. Previous researchers used the approach of proposing external dimensions based on secondary literature; however missed the opportunity to integrate context specific dimensions. This paper therefore aims to propose an AR acceptance model in the context of urban heritage tourism. Five focus groups, with young British female tourists visiting Dublin and experiencing a mobile AR application, were conducted. The data were analysed using thematic analysis and revealed seven dimensions that should be incorporated into AR acceptance research including information quality, system quality, costs of use, recommendations, personal innovativeness and risk as well as facilitating conditions