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PurposeThis study aimed to investigate the immediate effects of texting and listening to music with headphones, both separately and in combination, on the static and dynamic balance of young adults.MethodA cross-sectional study was conducted on 35 healthy young adults. The FreeMed-Baropodometric platform was used to assess static balance outcomes, including sway length, sway velocity, and displacement of the center of pressure in the mediolateral (DeltaX) and anteroposterior (DeltaY) directions, and dynamic balance outcomes, including initial contact, loading response, midstance, and terminal stance times. The participants underwent four conditions: standing still without any additional tasks, standing while texting, standing while music listening with headphones, and standing while both texting and listening to music with headphones. Additional measurements included forward head posture analysis, and New York Posture Rating Scale. Data were analyzed using Friedman and Wilcoxon tests with Bonferroni correction for multiple comparisons.ResultsTexting compared to listening to music with headphones or standing significantly affected static balance outcomes, including sway length, velocity, and Delta X and Delta Y, particularly in monopodalic conditions (p < .001). In contrast, listening to music with headphones with or without texting did not significantly impact static or dynamic balance outcomes (p > .05).ConclusionsTexting can adversely affect static balance, whereas listening to music with headphones does not significantly impact static or dynamic balance in young-healthy individuals. These findings suggest that individuals should consider stopping and sitting when texting to maintain balance and safety.

This study investigates the impact of Mozart's music on the reliability of visual field testing among healthy Thai individuals, using a large sample population. Automated perimetry was conducted on the right eyes of 163 perimetry-naive participants using a Humphrey Field Analyzer III (SITA standard 24-2 program). Participants were randomly assigned to one of three groups: control (no auditory input), headphones (noise-canceling headphones without music), and Mozart (headphones with Mozart's Sonata for Two Pianos in D Major, K. 448). Each group received a 10&#x2009;min pretest intervention according to their group assignment. Key perimetric indices, including fixation loss (FL), false positives (FP), false negatives (FN), test duration, mean deviation (MD), pattern standard deviation (PSD), and sensitivity depression in total and pattern deviation (TD and PD) plots, were collected and analyzed across groups using the Kruskal-Wallis test. The mean percentages of FL were 14.3% (95% CI 9.2%-19.4%) in the control group, 13.4% (95% CI 7.8%-19%) in the headphones group, and 6.4% (95% CI 4%-8.8%) in the Mozart group. An improvement in FL was observed between the control and Mozart groups (p = 0.03). However, no significant differences were found among the groups with respect to FP, FN, or test duration. Additionally, the values for MD, PSD, TD, and PD remained within normal ranges across all groups, with no significant differences. Mozart's music may facilitate enhanced concentration and spatial reasoning among individuals undergoing visual field testing with automated perimetry. Consequently, its application in clinical settings has the potential to improve the FL, a reliability index of visual field assessment.

Many commercially available hearing protector fit testing (HPFT) systems are able to measure personal attenuation rating (PAR) values for earplugs, but only a few are capable of measuring PAR with over-the-ear protectors and even fewer are able to estimate PAR values with double hearing protection. One approach that could potentially be used with any type of hearing protection is to modify the real-ear attenuation at threshold method to use an occluded threshold that is measured with circumaural headphones worn around the neck rather than over the ears. However, this method would only be valid if the neck-to-ear transfer function of the headphones is stable across a variety of headphone fittings. This study evaluated the validity of a neck-based HPFT approach by (1) measuring the transfer function from headphones worn around the neck to the ear across a variety of headphone positions and head and ear geometries; and (2) using an acoustic test fixture to compare PAR values measured with a neck-based sound source to those obtained with more conventional HPFT approaches. The results indicate that the neck-based HPFT system has a relatively consistent neck-to-ear transfer function and produced PAR values comparable to those obtained with other HPFT systems.

Postoperative delirium (POD) is a common and clinically significant complication among older adults undergoing major surgery under general anesthesia. Gamma-frequency (40-Hz) auditory stimulation has demonstrated potential neuroprotective and cognition-enhancing effects, suggesting a plausible role in perioperative delirium prevention. However, direct clinical evidence supporting intraoperative 40-Hz auditory stimulation in reducing POD remains limited, warranting rigorous evaluation in a randomized trial. This prospective, parallel-group, randomized controlled trial will enroll 550 older adults scheduled for major noncardiac, nonneurosurgical surgery under general anesthesia. Participants will be randomized in a 1:1 ratio to either the active stimulation group, receiving intraoperative 40-Hz gamma-frequency auditory stimulation delivered via headphones for 2&#x2009;h following successful anesthesia induction, or the sham stimulation group, wearing headphones without active auditory output. The primary outcome is the incidence of POD on postoperative day 1 though 3, assessed using the Confusion Assessment Method (CAM) or the CAM for the ICU (CAM-ICU). Secondary outcomes include POD severity, sleep quality, pain scores, analgesic consumption, the incidence of postoperative nausea and vomiting (PONV), rescue antiemetic use, duration of post-anesthesia care unit (PACU) stay, length of hospital stay, quality of postoperative recovery, incidence of perioperative adverse events; postoperative morbidity, health-related quality of life, and all-cause 30-day mortality. This trial will determine whether intraoperative 40-Hz gamma-frequency auditory stimulation reduces the incidence of POD among older adults undergoing major surgery under general anesthesia. If efficacious, this noninvasive intervention could constitute a feasible perioperative strategy to mitigate delirium risk and enhance postoperative recovery. Chinese Clinical Trial Registry (ChiCTR2500115156).

Music can enhance exercise performance, but its potential has not been well explored in pulmonary rehabilitation (PR). The aim was to explore the current music-related behaviours among PR service users with chronic respiratory diseases (CRDs) to inform future PR service interventions and explore the potential for music to facilitate exercise adherence in this context. The cross-sectional survey was distributed among PR attendees at the University Hospitals of Leicester (UHL) NHS Trust in the United Kingdom, between November 2023 and August 2024. Participants completed a 25-item survey exploring (i) relevant technology ownership and music-related behaviours, (ii) preferred music genres and songs and (iii) anticipated benefits/concerns of exercising to music. Quantitative data were analysed descriptively. Free-text data were analysed using qualitative counting. We surveyed 109 people living with CRDs (51% male, 56% aged &#x2265;70 year, 76% chronic obstructive pulmonary disease, 82% owned a smartphone). More than half had no prior experience of exercising to music (n=59, 54%). Despite this, almost half of participants listened to music at least once/day (n=54, 49%), primarily via the radio (n=83, 76%) and/or online music platforms (n=76, 70%). Pop (n=39, 36%) and Country (n=38, 35%) were the most popular music genres listened to, with the majority listening to music without headphones (n=64, 59%). The main concern about wearing headphones while exercising was that it might reduce their awareness of the surroundings (n=67, 61%). The perceived benefits of listening to music during exercise were to boost their mood (n=39, 36%) or help maintain their walking pace (n=19, 17%). There is potential to use music as a tool to support exercise in PR. However, lack of prior experience exercising to music, diverse music preferences, safety considerations and the need to increase knowledge of the potential benefits of exercising to music are key challenges. These findings may help future PR services to implement music into their programmes and develop personalised music-based interventions to optimise exercise performance.

Music listening with headphones and at high sound levels is common among young people. Risky music listening may be influenced by behavioral factors, and investigating these could have implications for more effective prevention. The aim is to describe participants' hearing health and music listening habits and explore associations between attitudes to noise and measured sound pressure levels (SPLs) from participants' headphones and between perceived auditory symptoms with hearing and SPL measurements. This is a cross-sectional study including audiometry (0.125-16 kHz), distortion product otoacoustic emissions (DPOAEs), SPL measurements, and a questionnaire. The participants were 10-20 years old. Out of 71 respondents to the questionnaire, 53 also participated in the hearing and SPL measurements. Positive attitudes to noise were significantly associated with higher measured SPLs. Participants &#x2265; 15 years old had more positive attitudes, higher measured SPLs, and reported longer durations of headphone music listening. Most auditory symptoms were significantly correlated with self-reported music listening habits but not with measured SPLs, audiometry, or DPOAEs. Participants experiencing a greater need for auditory recovery had higher variation in DPOAE amplitude for both ears. Attitudes to noise may play a role in shaping risky music listening behaviors. Perceived auditory symptoms may occur before detectable audiometric threshold shifts. Addressing these aspects could promote safer music listening behaviors. https://doi.org/10.23641/asha.30781904.

Binaural audio rendering aims to reconstruct virtual sound images at a listener's ears using headphones or loudspeakers. While headphones can deliver stereo sound separately to each ear, loudspeakers-based binaural audio systems suffer from intrinsic crosstalk, which necessitates crosstalk cancellation (CTC) as a preprocessing technique. Traditional two-channel CTC methods experience performance degradation near ill-conditioned frequencies that are determined by physical system configuration. The optimal source distribution approach overcomes this problem by varying the loudspeaker pair's positions with frequency; however, its application is constrained by the requirement for a large number of loudspeakers. As an alternative approach, this paper proposes an optimal control point distribution (OCPD) method that minimizes the condition number of the transfer matrix by dynamically adjusting control point positions instead of the loudspeaker positions. By selecting appropriate control point locations, the proposed OCPD method effectively mitigates the performance deterioration of traditional two-channel loudspeaker systems at the ill-conditioned frequencies without increasing the number of loudspeakers. Theoretical analysis and simulation results demonstrate that the proposed OCPD method outperforms conventional two-channel CTC systems and, using only two loudspeakers, achieves performance comparable to the discrete optimal source distribution method with five loudspeaker pairs. Experiments conducted in an anechoic chamber validate the theoretical findings and further confirm the effectiveness of the proposed approach.

Orthopedic surgeries are commonly associated with significant postoperative pain and physiological stress, which can be objectively identified through alterations in vital signs, such as blood pressure and heart rate. During postoperative bedside care, procedures that involve patient handling and mobilization may intensify pain-related physiological responses, highlighting the need for interventions capable of modulating both pain perception and vital signs in this clinical context. To evaluate the effect of music as an intervention on pain and vital signs during bedside care in postoperative orthopedic patients DESIGN: This randomized, single-blind clinical trial evaluated the effect of music as an intervention therapy during bed baths in patients on the first and second postoperative days after orthopedic surgery. One hundred adults were randomized into a control group and an intervention group. Pain intensity was assessed using the visual analog scale and the McGill Pain Questionnaire. Physiological assessment was performed by measuring vital signs, including blood pressure and heart rate. Pressure pain threshold was objectively measured using digital pressure algometry, with controlled application of pressure until the participant first reported the sensation of pain (pressure pain threshold). Participants in the control group wore headphones without music throughout the procedure, whereas participants in the intervention group underwent the same procedure while listening to preselected classical music through headphones. Music exposure significantly reduced systolic blood pressure (p = .002) and heart rate (p = .001), and decreased pain perception assessed by the McGill Pain Questionnaire (p < .001), except for the "miscellaneous" dimension (p = .066). Furthermore, pain measured by the visual analog scale decreased (p < .001), and pressure pain threshold measured by algometry increased (p < .001). This study demonstrated that music as a complementary intervention was associated with reduced pain intensity and lower systolic blood pressure and heart rate when assessed before and after a bedside care procedure in postoperative orthopedic patients.

Music serves as an ergogenic and affective aid in land-based exercise, yet its real&#x2010;time impact during swimming remains underexplored. Prior work has focused on pre&#x2010;performance arousal or post&#x2010;exercise recovery, leaving a gap in understanding how music tempo affects swimmers&#x2019; psychophysiological and emotional responses. This study examined the effects of no music (Beats Per Minute [BPM]), slow&#x2010;tempo (65 BPM), and fast&#x2010;tempo (120 BPM) music on affect (via the Exercise&#x2010;Induced Feeling Inventory [EFI] and Physical Activity Enjoyment Scale [PACES]), Rating of Perceived Exertion (RPE), and stroke mechanics during an 800&#xa0;m self&#x2010;paced freestyle swim. In a single&#x2010;blind, randomized crossover trial, 24 university swimmers (18 male, 6 female) with&#x2009;&#x2265;&#x2009;1&#xa0;year of experience and neutral music preference completed three 800&#xa0;m trials under randomized auditory conditions using bone&#x2010;conduction headphones. After each trial, participants rated affective valence (EFI), enjoyment (PACES), and exertion (RPE). Stroke rate, stroke length, performance time, and heart rate were monitored continuously. Music tempo significantly influenced affective measures but not physical or exertional outcomes. Fast&#x2010;tempo music increased EFI Positive Engagement compared to no music (p&#x2009;=&#x2009;.013), with no changes in Revitalization, Tranquility, or Physical Exhaustion (ps&#x2009;>&#x2009;.05). Both slow&#x2010; and fast&#x2010;tempo conditions elevated PACES scores versus no music (p&#x2009;<&#x2009;.01). No significant effects emerged for stroke rate, stroke length, swim time, RPE, or heart rate (all ps&#x2009;>&#x2009;.05). While music tempo did not alter performance or perceived effort during self&#x2010;paced swimming, it meaningfully enhanced positive engagement and enjoyment. These findings suggest that tempo&#x2010;congruent music may be a practical strategy to enrich emotional experiences, potentially improving adherence and motivation in aquatic exercise settings. Trial registration: This trial was not prospectively registered. The study was conducted in compliance with relevant national and institutional regulations. Due to local regulatory and institutional constraints applicable to this type of educational/exercise research in our setting, prospective registration on a public trial registry was not completed and retrospective registration is not permitted under those constraints. To maximise transparency, we provide the full study protocol (version and date), the pre-specified statistical analysis plan, ethics approval documentation (including approval number and dates), de-identified participant-level data and analysis code as Supplementary Materials (see Supplementary Files in system). We acknowledge that prospective registration is best practice and we will prospectively register future trials. The online version contains supplementary material available at 10.1038/s41598-026-39356-z.

Deficits in basic auditory processing (BAP) are features of schizophrenia (SCZ), contributing to cognitive and psychosocial dysfunction. While pitch discrimination tasks are widely used to assess BAP, conventional tasks conflate auditory processing deficits with impairments in echoic memory. We designed a novel Simultaneous Binaural Pitch Discrimination (SBPD) task to focus more on BAP by eliminating temporal separation between stimuli. We administered the SBPD task to 42 patients with SCZ and 42 demographically matched healthy controls (HC). Pure tone pairs were presented simultaneously binaurally by dichotic headphones, requiring participants to judge pitch identity/differences without echoic memory involvement. Accuracy and reaction time were examined and analyzed. Relationships between clinical variables (age at diagnosis, illness duration and antipsychotic dosage) and task performance were assessed. Patients exhibited significantly lower accuracy than controls (57.87&#xa0;% vs. 74.33&#xa0;%, t&#xa0;=&#xa0;-3.688, p&#xa0;<&#xa0;0.001; Cohen's d&#xa0;=&#xa0;-0.62) and longer reaction times (2111.61&#xa0;&#xb1;&#xa0;447.18 ms vs. 1906.04&#xa0;&#xb1;&#xa0;413.88 ms, t&#xa0;=&#xa0;2.414, P&#xa0;=&#xa0;0.020, d&#xa0;=&#xa0;0.40). We employed a newly designed task and found basic auditory processing deficits in patients compared to healthy individuals. Future studies should investigate the stability and neural mechanisms of binaural integration deficits, particularly brainstem dysfunction implicated in abnormal auditory brainstem responses (ABRs) in SCZ.

To evaluate the effects of music therapy and virtual reality on physiological parameters, pain and anxiety levels in critically ill patients undergoing nursing interventions in the intensive care unit. Randomized controlled trail. The study was conducted in the adult intensive care unit of a tertiary care hospital in Turkey. A total of 90 intensive care unit patients were enrolled and randomly assigned to one of three groups: Music Therapy (n&#x202f;=&#x202f;30), Virtual Reality (n&#x202f;=&#x202f;30), and control group receiving standard nursing care (n&#x202f;=&#x202f;30). Inclusion criteria included adult patients with stable vital signs and the ability to provide informed consent. Patients with hearing or vision impairments, cognitive disorders, or under sedation were excluded. The music therapy group received music therapy using calming instrumental tracks through headphones for 20&#x202f;min during nursing interventions. The virtual reality group experienced relaxing nature scenes using a virtual reality headset for the same duration. The control group received no additional interventions beyond routine care. Physiological parameters (heart rate, blood pressure, respiratory rate, oxygen saturation), pain and anxiety levels (using validated intensive care unit scales) measured pre- and post-intervention. Both music therapy and virtual reality groups showed statistically significant improvements in physiological parameters and anxiety levels compared to the control group (p&#x202f;<&#x202f;0.05). Music therapy was more effective in reducing anxiety scores, with a mean reduction of 5.6&#x202f;&#xb1;&#x202f;1.2 points on the State Anxiety Inventory, and improving oxygen saturation levels, with a mean increase of 2.1&#x202f;&#xb1;&#x202f;0.5% compared to virtual reality. In contrast, the virtual reality group demonstrated greater reductions in perceived pain levels, with a mean decrease of 4.8&#x202f;&#xb1;&#x202f;1.1 points measured using the Visual Analog Scale, compared to music therapy (4.1&#x202f;&#xb1;&#x202f;1.3). Pulse rate, respiratory rate, and blood pressure values improved in both intervention groups post-intervention, while minimal changes were observed in the control group. No adverse effects were reported during or after interventions. The study demonstrates that both music therapy and virtual reality are effective non-pharmacological interventions for reducing anxiety and stabilizing physiological parameters in ICU patients during nursing procedures. Music therapy may be preferred when the goal is anxiety reduction and oxygenation improvement, whereas virtual reality may be more suitable for managing procedural pain. Integrating such interventions into routine intensive care unit nursing practice can enhance patient comfort and psychological well-being during critical care.

Cast removal can be an anxiety-provoking medical procedure for children. Distraction emerges as the safest and most effective intervention to reduce anxiety. Although various distractions have been studied, none of them have proven simple and inexpensive enough to meet the needs of orthopaedic clinics. The present study aims to evaluate whether multimodal distraction incorporating music, drawings in a mirror, and finger puppets, can decrease children's anxiety during cast removal compared with standard of care. A before and after quasi-experimental design was implemented with children aged 3 to 12 years old. The control group received standard care during cast removal, while the intervention group was offered distractions, including noise-cancelling headphones for music, finger puppets, and a mirror for drawing or observing the reflection of their healthy limb. Anxiety levels before, during, and after cast removal were assessed using the Children's Fear Scale (CFS) and the Faces, Legs, Activity, Cry and Consolability (FLACC) Scale. Parent and cast technician satisfaction was evaluated through homemade questionnaires and the Short Assessment of Patient Satisfaction (SAPS). One hundred two children participated in this study, with the first 51 assigned to the control group and the subsequent 51 to the intervention group. On the FLACC Scale, the median anxiety level was at 0 points in both groups at all 3 time points. On the CFS, the median anxiety level during cast removal was at 0.5 points for the intervention group and 1 point for the control group ( P = 0.71). The level of anxiety was very low for both groups. Finally, 77% of parents indicated they would like their children to use distraction again. The multimodal distraction presented in this study did not demonstrate a reduction in anxiety levels during cast removal in children compared with standard care provided at the institution. However, it provides a potentially more positive experience for children and is well accepted by the orthopaedic clinical team. Level II-prospective comparative study.

To facilitate the implementation of France's 2018 '100% sant&#xe9;' reform, requiring speech-in-noise (SPIN) audiometry for all ages, and building upon existing adult test reviews, this study surveyed pediatric tests for potential French adaptation. A systematic literature review of PubMed, Acoustical Society of America, and ScienceDirect databases used keywords related to speech, audiometry, children, and noise. Articles were screened, and data extracted via a reading grid, detailing test criteria: age, materials, conditions, SNR, administration, scoring, duration, translations, references, and evidence level. Tests were then scored for clinical use. From 4605 articles, 27 tests were identified, with 6 available in French for a pediatric population (FRA-SIMAT, VRB, DTT, HINT-C, SSI-ICM, and TMB). For screening, VRB, FRA-SIMAT, DTT, TMB and SSI-ICM offer accessible options for children aged five and above. For hearing aid applications, VRB and HINT-C were deemed most comprehensive. Developing French pediatric speech-in-noise audiometry standards, considering age-related effects, is crucial. Out of the 6 pediatric SPIN tests (available in French) found in this review, the DTT (headphones) is optimal for screening, and HINT-C (free field) for hearing aid use. In France, the VRB could be a promising solution for both screening and for auditory rehabilitation.

Exposure to loud noise can cause hearing loss and tinnitus. Few adolescents and young adults do, however, engage in hearing protective behaviours (HPBs) to reduce noise exposure. To enable the development of behavioural interventions, the present study aimed to identify influential, modifiable, psychological factors of HPB. An online survey measured predefined psychological factors and three HPBs (i.e. earplug use, safe listening, hearing protection at work). Psychological factors' univariate distributions and their associations with the HPBs were assessed to identify their potential as intervention target. Persons 12 to 25&#x2009;years of age living in the Netherlands (N&#x2009;=&#x2009;1637, mean age = 18.6, 67.6% female). Less than one in three participants wore earplugs at music venues, and less than one in two kept a safe level of sound exposure during use of headphones and speakers. Anticipated regret, awareness, experiential attitude, capacity and social norms were the psychological factors most strongly associated with HPBs (r &#x2248; 0.45 to r &#x2248; 0.65, and d&#x2009;&#x2248;&#x2009;0.9 to d&#x2009;&#x2248;&#x2009;1.5) that simultaneously, had univariate distributions indicating room for improvement. Anticipated regret, awareness, experiential attitude, capacity and social norms are potentially promising intervention targets to increase HPBs in young persons.