Why Is Tinnitus a Problem? A Qualitative Analysis of Problems Reported by Tinnitus Patients.

Tinnitus is a prevalent complaint, and people with bothersome tinnitus can report any number of associated problems. Yet, to date, only a few studies, with different populations and relatively modest sample sizes, have qualitatively evaluated what those problems are. Our primary objective was to determine domains of tinnitus problem according to a large clinical data set. This was a retrospective analysis of anonymized clinical data from patients who attended a U.K. Tinnitus Treatment Center between 1989 and 2014. Content analysis was used to code and collate the responses of 678 patients to the clinical interview question "Why is tinnitus a problem?" into categories of problems (domains). We identified 18 distinct domains of tinnitus-associated problems. Reduced quality of life, tinnitus-related fear, and constant awareness were notably common problems. Clinicians need to be mindful of the numerous problem domains that might affect their tinnitus patients. Current questionnaires, as well as being measures of severity, are useful clinical tools for identifying problem domains that need further discussion and possibly measurement with additional questionnaires. The domains identified in this work should inform clinical assessment and the development of future clinical tinnitus questionnaire.

High environmental stress yields greater tocotrienol content while changing vitamin e profiles of wild emmer wheat seeds.

Vitamin E is an essential human nutrient that was first isolated from wheat. Emmer wheat, the cereal of Old World agriculture and a precursor to durum wheat, grows wild in the Fertile Crescent. Evolution Canyon, Israel, provides a microsite that models effects of contrasting environments. The north-facing and south-facing slopes exhibit low and high stress environments, respectively. Wild emmer wheat seeds were collected from both slopes and seed tocochromanol contents measured to test the hypothesis that high stress alters emmer wheat seed tocol-omics. Seeds from high stress areas contained more total vitamin E (108±15 nmol/g) than seeds from low stress environments (80±17 nmol/g, P=.0004). Vitamin E profiles within samples from these different environments revealed significant differences in isoform concentrations. Within each region, ß- plus γ-tocotrienols represented the highest concentration of wheat tocotrienols (high stress, P<.0001; low stress, P<.0001), while α-tocopherol represented the highest concentration of the tocopherols (high stress, P=.0002; low stress, P<.0001). Percentages of both δ-tocotrienol and δ-tocopherol increased in high stress conditions. Changes under higher stress apparently are due to increased pathway flux toward more tocotrienol production. The production of more δ-isoforms suggests increased flow through a divergent path controlled by the VTE1 gene. Hence, stress conditions alter plant responses such that vitamin E profiles are changed, likely an attempt to provide additional antioxidant activity to promote seed viability and longevity.