Contribution and safety of the side‐to‐end hypoglossal‐to‐facial transfer in multidisciplinary facial reanimation

alexandrossfakianakis shared this article with you from Inoreader Contribution and safety of the side‐to‐end hypoglossal‐to‐facial transfer in multidisciplinary facial reanimation Via Head & Neck Abstract Background This study evaluates facial and tongue function in patients undergoing side-to-end hypoglossal-to-facial transfer (HFT) with additional techniques. Methods Thirty-seven patients underwent a side-to-end HFT. Twelve had additional cross-face grafts, and 9 had an additional masseter-to-facial transfer. Facial was assessed with House–Brackmann (HB), Sunnybrook Facial Grading Scale (SFGS), and eFACE. Martins scale and the Oral-Pharyngeal Disability Index (OPDI) were used to assess tongue function. Results Ninety-four percent of cases reached HB grades III–IV. Mean total SFGS score improved from 16 ± 15 to 59 ± 11, while total eFACE score from 52 ± 13 to 80 ± 5. Dual nerve transfers were a predictor for a better eFACE total score p = 0.034, β = 2.350 [95% CI, 0.184–4.516]), as well as for a higher SFGS total score (p = 0.036, β = 5.412 [95% CI, 0.375–10.449]). All patients had Martin's grade I. Mean postoperative OPDI scores were 84 ± 17 (local physical), 69 ± 16 (simple and sensory motor components), 82 ± 14 (complex functions), and 73 ± 22 (psychosocial). Conclusions The side-to-end HFT offers predictable facial function outcome and preserves tongue function in nearly all cases. Dual nerve transfers appear to improve the final outcome. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bad, mad, or glad? Exploring the relationship between leaders’ appraisals or attributions of their use of abusive supervision and emotional reactions

alexandrossfakianakis shared this article with you from Inoreader Bad, mad, or glad? Exploring the relationship between leaders' appraisals or attributions of their use of abusive supervision and emotional reactions Via Applied Psychology Abstract A large body of research has documented the ill effects of abusive supervision. However, this begs the question of why these behaviors continue to occur. To address this question, we contend that scholars need to understand how leaders – the perpetrators of these actions – make sense of abusive supervision. Specifically, drawing upon theories of appraisal and attribution, this paper examines leaders' cognitions of who is accountable for incidents of abusive supervision (i.e., the leader or the subordinate) and their future expectations (i.e., are individuals likely to engage in the same behaviors subsequently or capable of change) and how these appraisals interact to shape emotional reactions. We conducted three complementary studies: a pilot study to identify relevant emotions, an event-based experience sampling study (Study 1), and a retrospective recall study (Study 2). Accountability appraisals were associated with emotions, such that appraisals that oneself (vs. one's subordinate) was more responsible for the incident were linked to higher levels of guilt and shame. Although growth mindset moderated associations between accountability appraisals and emotions, it did so for different emotions across the two studies (i.e., hostility in Study 1 and shame in Study 2). Implications for theory and practice are discussed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Longer length of stay, days between discharge/first readmission, and pulmonary involvement ≥50% increase prevalence of admissions in ICU in unplanned readmissions after COVID‐19 hospitalizations

alexandrossfakianakis shared this article with you from Inoreader Longer length of stay, days between discharge/first readmission, and pulmonary involvement ≥50% increase prevalence of admissions in ICU in unplanned readmissions after COVID‐19 hospitalizations Via Journal of Medical Virology Abstract Hospital readmissions due to COVID-19 are one of the main concerns for the health system due to risks to the patient's life and increased use of health resources. Studies focusing on this issue are important to understand the risk factors and create strategies to avoid readmissions. We evaluated the readmission of patients with confirmed COVID-19 in a private hospital in southern Brazil, between March 2020 and 2021. Also, the characteristics and clinical outcomes of patients admitted to the intensive care unit (ICU) and nonadmitted were compared. Poisson regression models with prevalence ratio (PR) with 95% confidence intervals (95% CIs) were applied to confirm the association between variables and ICU admission. Of the 2084 hospitalized patients with COVID-19, 1806 were discharged alive. Among them, 106 were readmitted for unplanned reasons during one year. Early hospital readmission (≤30 days) occurred in 52.8% of the cases. The main reasons were respiratory, gastroe nterological, kidney, and cardiac disease. The median age was 73.0 years old and women correspond to 52.8%. The presence of at least one comorbidity was detected in 87.7% of patients. Hypertension, diabetes, cardiac, and lung disease were more frequent. The ICU admitted patients (n = 43; 40.5%) mostly had 4–5 comorbidities, pulmonary involvement ≥50%, length of stay (LOS), and days between discharge and first readmission. Longer LOS (PR: 3.46; 95% CI: 1.24–5.67), days between discharge/first readmission (PR: 2.21; 95% CI: 1.15–5.88), and pulmonary involvement (≥50%; PR: 1.59; 95% CI: 1.11–3.54) were independently associated with ICU admission. Longer LOS, longer days between discharge/first readmission, and pulmonary involvement (≥50%) were associated with ICU admission in readmitted patients. Readmissions evaluation is pivotal and may help in ensuring safe care transition and postdischarge follow-up. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessing the risks associated with the emergence of Florona and possible preventive measures

alexandrossfakianakis shared this article with you from Inoreader Message: Κορωνοϊός: Τι είναι η Delmicron και η Florona REUTERS / MAY JAMES Το στέλεχος Όμικρον του SARS-CoV-2 κυριαρχεί πλέον στην Ευρώπη και οδηγεί σε κατακόρυφη αύξηση των νέων κρουσμάτων COVID-19. Πρόσφατα, δύο νέοι όροι έχουν έρθει στο προσκήνιο. Ο λόγος για τους όρους Delmicron και Florona. Οι Ιατροί της Θεραπευτικής Κλινικής της Ιατρικής Σχολής του Εθνικού και Καποδιστριακού Πανεπιστημίου Αθηνών Θεοδώρα Ψαλτοπούλου, Γιάννης Ντάνασης, Πάνος Μαλανδράκης και Θάνος Δημόπουλος (Πρύτανης ΕΚΠΑ) συνοψίζουν τα νεότερα σχετικά με τα Delmicron και Florona. Αρχικά πρέπει να σημειωθεί ότι και οι δύο όροι δεν αναφέρονται σε κάποιο νέο στέλεχος του SARS-CoV-2, αλλά σε συνύπαρξη του στελέχους Όμικρον είτε με το στέλεχος Δέλτα (Delmicron) είτε με την εποχική γρίπη (Florona). Σύμφωνα με τον Παγκόσμιο Οργανισμό Υγείας (ΠΟΥ), η επικράτηση του στελέχους Όμικρον δεν θα πρέπει να μας κάνει να λησμονήσουμε άλλες πολύ συχνές ιογενείς λοιμώξεις που συνυπάρχουν στην κοινότητα και μπορεί να εμφανιστούν παράλληλα σε ευάλωτα άτομα. Γι' αυτό το λόγο, τονίζεται η ανάγκη πλήρους εμβολιασμού με όλες τις απαραίτητες αναμνηστικές δόσεις τόσο έναντι του SARS-CoV-2 όσο και έναντι της εποχικής γρίπης, παράλληλα με την τήρηση των κανόνων σωματικής απομάκρυνσης για την πρόληψη της μετάδοσης και των δύο λοιμώξεων. Τι είναι η Delmicron: Ποια τα συμπτώματα Τα άτομα με εξασθενημένο ανοσοποιητικό σύστημα, τα άτομα μεγαλύτερης ηλικίας και με συνυπάρχουσες παθήσεις παρουσιάζουν αυξημένο κίνδυνο COVID-19 και μάλιστα είναι πιθανό να νοσήσουν ταυτόχρονα και από δύο επικρατούντα στελέχη του SARS-CoV-2, δηλαδή το Όμικρον και το Δέλτα. Η συλλοίμωξη με τα δύο στελέχη (Delmicron) μπορεί επίσης να παρατηρηθεί σε περιοχές με χαμηλή εμβολιαστική κάλυψη του πληθυσμού. Και αυτό ισχύει γιατί μπορεί το στέλεχος Όμικρον να είναι το κυρίαρχο, ωστόσο το στέλεχος Δέλτα δεν έχει εκλείψει. Στο γενικό πληθυσμό η πιθανότητα της ταυτόχρονης λοίμωξης με δύο στελέχη SARS-CoV-2 είναι χαμηλή, ωστόσο σε περιπτώσεις συνωστισμού μπορεί να συνυπάρχουν κρούσματα τόσο Δέλτα όσο και Όμικρον. Εάν τα άτομα που έχουν εξασθενημένο ανοσοποιητικό βρεθούν στο πλήθος, θα εκτεθούν πιθανότατα και στα δύο στελέχη και μπορεί να εμφανίσουν κλινική νόσο και από τα δύο στελέχη. Τα συμπτώματα είναι ουσιαστικά ο συνδυασμός των συμπτωμάτων από τα δύο στελέχη και περιλαμβάνουν εμπύρετο, βήχα, ανοσμία, αγευσία, πονοκέφαλο, καταρροή και πονόλαιμο. Τι είναι η Florona: Τα συμπτώματα και οι επιπλοκές Πολύ πρόσφατα αναφέρθηκε στο Ισραήλ η περίπτωση μιας εγκύου που προσήλθε στο νοσοκομείο για τοκετό και διαγνώσθηκε με παράλληλη λοίμωξη COVID-19 και γρίπης (Florona). Η ασθενής δεν είχε εμβολιαστεί για κανέναν από τους δύο ιούς. Παρόλο που ο όρος Florona μπορεί να προέκυψε πρόσφατα, η συλλοίμωξη δεν αποτελεί κάτι καινούργιο για την ιατρική κοινότητα. Ο ιός SARS-CoV-2 και ο ιός της γρίπης μεταδίδονται με παρόμοιο τρόπο, δηλαδή με την κοντινή επαφή σε απόσταση μικρότερη των 2 μέτρων μέσω αναπνευστικών σταγονιδίων ή/και αερολύματος κατά τη διάρκεια της ομιλίας, του βήχα και του πτερνίσματος. Οι δύο λοιμώξεις έχουν κοινά συμπτώματα όπως βήχας, πυρετό και καταρροή. Διαφορετικές δοκιμασίες PCR για τον ιό της γρίπης και για τον SARS-CoV-2 μπορεί να αποσαφηνίσουν σε κάθε περίπτωση την αιτιολογία των συμπτωμάτων. Και οι δύο λοιμώξεις μπορεί να έχουν σοβαρές επιπλοκές όπως πνευμονία, οξεία αναπνευστική ανεπάρκεια, πολυ-οργανική ανεπάρκεια, καρδιακά συμβάματα, εγκεφαλίτιδα, μυοκαρδίτιδα, ισχαιμικό εγκεφαλικό επεισόδιο και θάνατο. Unlike some of the claims made by fake news posts of social media, Florona is not a new Covid-19 variant. The last Covid-19 variant that was detected was Omicron and no further variants have since been identified by the World Health Organisation. The WHO does, however, confirm that co-infection with both Covid-19 (any variant) and the flu virus is indeed possible and added that the best way to avoid such a condition is to get vaccinated against both Covid-19 and Influenza. What are the symptoms of Florona? While both Covid-19 and influenza affect the respiratory system, there are some differences between the way flu and Covid-19 impacts health and manifests themselves. Symptoms of "Florona" include high fever, consistent chest pain or constriction, shortness of breath and loss of appetite. It can also lead to states of confusion and anxiety. According to the WHO, mild symptoms of a double Covid-19 and flu infection can be treated at home itself without requiring any hospitalisation. In severe cases, symptoms of Florona may also include pneumonia, myocarditis and inflammation in heart muscles. Is Florona a matter of concern? Both Covid-19 and flu are viruses that affect the respiratory tract and can cause severe illness and even death. While the symptoms and means of transmission for both viruses are the same, both have different treatments and different vaccines. Double infection with both viruses can cause complications the body and stress out the immune system. While "Florona" is not a new variant, the occurrence might be indicative of a weakened immune system under attack from two virus infections, Dr Nahla Abdel Wahab, Cairo University Hospital doctor, was quoted by Israeli media following the emergence of the disease. Amid the ongoing winter months, otherwise known as "flu season", season influenza breakouts are not uncommon in several countries. With Covid-19 cases also peaking across the world following the emergence of Omicron, fear of "Florona" cases spiking may not be unfounded. (Credit: Pixabay) How to prevent Florona? Following social distancing protocols, wearing masks and getting vaccinated against both Covid-19 and influenza is the only way to prevent Florona. Flu vaccines have been used since 1949, especially among vulnerable groups such as senior citizens. Meanwhile, a majority of countries have rolled out vaccination plans for their adult populations. Assessing the risks associated with the emergence of Florona and possible preventive measures Via Journal of Medical Virology Abstract The emergence of novel variants of SARS-CoV-2, especially the VOCs (variants of concern), has been considered a severe threat amid the mighty efforts of various nations to contain the negative repercussions of the COVID-19 pandemic caused by SARS-CoV-2. This article is protected by copyright. All rights reserved. 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Memory impairment and concentration problems in COVID‐19 survivors eight weeks after non‐ICU hospitalization: a retrospective cohort study

alexandrossfakianakis shared this article with you from Inoreader Memory impairment and concentration problems in COVID‐19 survivors eight weeks after non‐ICU hospitalization: a retrospective cohort study Via Journal of Medical Virology Abstract Background Studies on the SARS-CoV-1 have shown long term effects on health, rehabilitation and quality of life in patients. Objective To evaluate effects on recovery and mental health in COVID-19 survivors Methods A single centre, retrospective cohort study in (non ICU admitted) adult patients with COVID-19 infection was conducted. Next to baseline characteristics during hospital admission, data on remaining symptoms and radiographic abnormalities were extracted at the 8-week follow-up at the outpatient clinic. The HADS (Hospital Anxiety and Depression Scale) was used to detect anxiety and depression. Results 211 patients were included, median age 63 years, 61% male, with overweight (average BMI 28.6 kg/m2). At the outpatient clinic 13% of the patients were symptom free, whereas 25% reported more than three symptoms. Persisting physical symptoms were mainly fatigue 68%, dyspnea 56% and cough 26%. Most patients had norma lisation of chest X-ray (61.1%) and oxygen saturation (89.9%). Interestingly, 33% reported memory impairment and concentration problems 28%. 7.8% scored for anxiety and 7.1% for depression on the HADS. Correlations were found between the number of physical symptoms and scores on the HADS. Conclusion Only 13% had symptom free recovery after 8 weeks. Besides physical symptoms memory problems were frequently seen. The number of mental and physical symptoms were correlated. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two conserved amino acids differentiate the biology of high‐risk and low‐risk HPV E5 proteins.

alexandrossfakianakis shared this article with you from Inoreader Two conserved amino acids differentiate the biology of high‐risk and low‐risk HPV E5 proteins. Via Journal of Medical Virology Abstract The high-risk alpha human papillomaviruses (HPVs) are responsible for 99% of cervical cancers. While the biological functions of the HPV E6 and E7 oncoproteins are well-characterized, the function of E5 has remained elusive. Here, we examined gene expression changes induced by E5 proteins from high-risk HPV-16 and low-risk HPV-6b in multiple pools of primary human keratinocytes. Surprisingly, microarray analysis revealed that over 700 genes were significantly regulated by HPV-6b E5, while only 25 genes were consistently and significantly regulated by HPV-16 E5 in three biological replicates. However, we observed that more than thousand genes were altered in individual sample compared to vector. The gene expression profile induced by 16E5 in primary genital keratinocytes was very different from what has been previously published using immortalized HaCaT cells. Genes altered by HPV-16 E5 were unaffected by HPV-6b E5. Our data demonstrate that E5 proteins from the high- and low-risk HPVs have different functions in the HPV-host cell. Interestingly, conversion of two amino acids in HPV-16 E5 to the low-risk HPV-6b sequence eliminated the induction of high-risk related cellular genes. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study Via Journal of Human Nutrition and Dietetics Abstract Background Disease-related-malnutrition predicts poor clinical outcomes in elderly patients, and screening is pivotal to identify patients at nutritional risk. This study aimed to investigate nutrition screening rates in electronic patient records, and validate the scores given. Secondary was to investigate whether the proportion of patients at risk differed between patients where screening was documented and those where no screening was documented. Methods This cross-sectional observational study was conducted in a Danish university hospital during November 2020. Patients aged 65 years or more admitted to a medical department were included. The Nutrition Risk Screening (NRS-2002) tool was used to identify patients at nutritional risk, both in routine clinical care, where data were collected retrospectively, and during a validation process in a random patient sample, where data were collected prospectively. Results In total, 817 patients were ad mitted for more than 24 hours. Of these, an NRS-2002 score was documented in 294 (36%), among whom 177 (60%) were at nutritional risk. In 146 patients where no score was documented, 88 (60%) were at risk. Validation was possible in 91 patients where a record-based score and a validated score were documented. The specificity of the record-based score was 100%, while the sensitivity was 75%, indicating that routine screening underestimated nutritional risk (p<0.001, proportion difference 19%(95%CI 10;28%)). Conclusions: Electronic documentation does not solve issues about compliance with nutritional risk screening. In patients where screening was not documented, the occurrence of nutritional risk was similar, indicating that omission of screening is not related to the score. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Examining the role of brooding, distress, and negative urgency in dysregulated behaviors: A cross‐sectional study in treatment‐seeking young people

alexandrossfakianakis shared this article with you from Inoreader Examining the role of brooding, distress, and negative urgency in dysregulated behaviors: A cross‐sectional study in treatment‐seeking young people Via Journal of Clinical Psychology Abstract Objective Dysregulated behaviors including substance use, disordered eating, and nonsuicidal self-injury (NSSI) have significant negative implications for individuals and health systems. It is therefore paramount to understand factors influencing behavioral dysregulation, to inform prevention and treatment approaches. The literature suggests that distress and rumination (brooding) prompt individuals to engage in behavioral dysregulation for distraction (Emotional Cascade Model), although these concepts have limited investigation in clinical, treatment-seeking samples, particularly alongside negative urgency. This cross-sectional study sought to examine the relationships of brooding, distress, and negative urgency with behavioral dysregulation, as well as the moderating effect of negative urgency between brooding and behavioral dysregulation, in treatment-seeking young people. Method A total of 385 treatment-seeking young people completed cross-sectional, self-report measures of distress, rumination, negative urgency, and engagement in dysregulated behaviors (NSSI, alcohol use, drug use, binge eating, and purging) over the past 1−3 months. Results Structural equation modeling revealed that only negative urgency, and not brooding or distress, had a significant positive relationship with behavioral dysregulation. Negative urgency did not significantly moderate the relationship between brooding and behavioral dysregulation. Conclusions These findings reinforce the importance of considering negative urgency in the conceptualization, prevention, and treatment of behavioral dysregulation, and contribute to the knowledge of the relationship between brooding and various dysregulated behaviors within a treatment-seeking sample. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of posttraumatic stress symptom severity and meaning made in treatment‐seeking veterans

alexandrossfakianakis shared this article with you from Inoreader Predictors of posttraumatic stress symptom severity and meaning made in treatment‐seeking veterans Via Journal of Clinical Psychology Abstract Objective Combat-exposed veterans risk encountering events that disrupt beliefs. To facilitate reduced discrepancy between prior beliefs and current trauma appraisals, veterans may engage in a process of meaning-making. Meaning-making can lead to positive outcomes, such as integrating the traumatic event into one's life narrative or adapting global meaning (meaning made) or elicit distress. Given these potentially different outcomes, this study examined potential correlates of posttraumatic stress symptom (PTSS) severity and meaning made, including relationship attachment dimensions of anxiety and avoidance, and difficulties with emotion regulation, while controlling for combat exposure. Method Veterans receiving mental health services at a Veterans Affairs (VA) Medical Center and a VA community-based outpatient clinic (N = 130) completed measures through a paper-and-pencil survey. Almost all participants (92%) were male, with a mean age of 55.92 years. Results In terms of meaning made, lower levels of attachment anxiety and emotional clarity (an aspect of emotion regulation) predicted higher meaning made. In terms of PTSS severity, higher attachment avoidance, attachment anxiety, and difficulties engaging in goal-directed behavior (an aspect of emotion regulation) significantly predicted higher PTSS severity. Conclusion Aspects of both attachment style and emotion regulation difficulties affect meaning made and PTSS severity. These constructs may be especially relevant for clinicians working with veterans to help PTSS and support meaning made postcombat. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Spinal Cord Stimulation System with a Battery‐Free Micro Implantable Pulse Generator

alexandrossfakianakis shared this article with you from Inoreader A Novel Spinal Cord Stimulation System with a Battery‐Free Micro Implantable Pulse Generator Via Pain Practice Abstract Spinal cord stimulation (SCS) is effective for the treatment of chronic intractable pain of the trunk and limbs. The mechanism of action may be based, at least in part, upon the gate control theory; however, new waveforms may suggest other mechanisms. Although benefits of the SCS technology generally outweigh the complications associated with SCS, some complications such as infection and skin erosion over the implant can result in device removal. Additional reasons for device removal, such as pocket pain and battery depletion, have driven technological innovations including battery-free implants and device miniaturization. The neurostimulation system described here was specifically designed to address complications commonly associated with implantable batteries and/or larger implantable devices. The benefits of the small size are further augmented by a minimally invasive implant procedure. Usability data show that patients found this novel neurostimulation system to be easy to use and comfortable to wear. What is more, clinical data demonstrate that the use of this system provides statistically significant reduction in pain scores with responder rates (defined as ≥ 50% reduction in pain) of 78% in the low back and 83% in the leg(s). Advances in miniaturization technology arose from the considerable shrinkage of the integrated circuit, with an increase in performance, according to Moore's law (1965). However, commensurate improvements in battery technology have not maintained a similar pace. This has prompted some manufacturers to place the battery outside, against the skin, thereby allowing a massive reduction in the implant volume, with the hopes of fewer device-related complications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

In Silico Finite Element Analysis of Implant‐Supported CAD‐CAM Resin Composite Crowns

alexandrossfakianakis shared this article with you from Inoreader In Silico Finite Element Analysis of Implant‐Supported CAD‐CAM Resin Composite Crowns Via Journal of Prosthodontics Abstract Purpose The aim of this study was to evaluate the mechanical behavior of an implant-supported crown made using computer-aided design and computer aided manufacturing (CAD-CAM) resin composite (RC) blocks in the posterior region. Material and methods Four commercially available CAD-CAM RC blocks were used in this study: Cerasmart 300 (CS300; GC, Tokyo, Japan), Katana Avencia P Block (KAP; Kuraray Noritake Dental, Niigata, Japan); KZR HR3 Gamma Theta (HR3; Yamakin, Osaka, Japan), and Estelite P block (ESP; Tokuyama Dental, Tokyo, Japan). Katana Zirconia STML (ST; Kuraray Noritake Dental) was used as the control group. The elastic moduli of each material were determined by a three-point bending test. After the CAD models were designed, two different loading scenarios (oblique, vertical) were created. 3D finite element analysis was conducted with the prepared models. Results The elastic modulus of the material utilized for the implant restorations did not cause any change in the stresses transmitted to the implant or peripheral bone. An important difference was detected in the abutment–crown junction area. The minimum von Mises value at the abutment-crown interface was obtained in ST, which has the closest elastic modulus to the titanium abutment. Conclusions The 3D finite element model designed in this study was used to demonstrate that implant-supported crowns fabricated with four different CAD-CAM RCs showed no critical stress concentrations in the bone or implant under all loading conditions. These results suggest that CAD-CAM RC blocks could be used as an alternative material for implant-supported restorations in the posterior region in terms of stress distribution. This article is protected by copyright. All rights reserved View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.