Πέμπτη 5 Μαΐου 2022

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

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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.

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

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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.

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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

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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.

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Memory impairment and concentration problems in COVID‐19 survivors eight weeks after non‐ICU hospitalization: a retrospective cohort study

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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.

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

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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.

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The moderating role of sexual minority status in the associations of the experience and tolerance of shame‐related emotions to suicide risk

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

This study examined the associations of the experience and tolerance of shame-related emotions to suicide risk, as well as the moderating role of sexual minority status.

Methods

Community adults (N = 360) were recruited via MTurk and completed self-report questionnaires. Hierarchical regression analyses examined the main and interactive associations of sexual minority status and shame-related variables to suicide risk.

Results

Results revealed significant positive associations between self-disgust and suicide risk for sexual minority and heterosexual participants, although the magnitude was greater for sexual minority participants. Additionally, tolerance of shame was significantly negatively related to suicide risk only among sexual minority participants. Finally, exploratory analyses examining the three-way interaction of self-disgust, shame tolerance, and sexual minority status revealed a significant negative association between shame tolerance and suicide risk only among sexual minority participants with high levels of self-disgust.

Conclusion

Results highlight the relevance of shame-related experiences to suicide risk among sexual minorities.

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

alexandrossfakianakis shared this article with you from Inoreader

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.

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

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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.

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

alexandrossfakianakis shared this article with you from Inoreader

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.

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Digital Determination and Recording of Edentulous Maxillomandibular Relationship Using A Jaw Movement Tracking System

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Abstract

Purpose

To establish a direct digital method for determining and recording edentulous maxillomandibular relationship using a custom-made jaw movement tracking system and evaluate its accuracy.

Materials and methods

A novel jaw tracking system was used to record the trajectory of habitual opening-closing jaw movement, and mandibular rest position (MRP) in 10 edentulous patients. 3D surface scanning was performed on the conventional maxillomandibular impressions and facial structures of patients in MRP. The multi-source data were registered using a custom-made recording tool. A plane parallel to the ala-tragus and horizontal lines was constructed 2 mm above the MRP, and its vertical position was used to determine the vertical relationship. The intersections of the trajectory passing through the plane were located, and their density distributions were analyzed. The coordinates of highest density, which presented the highest repeatability of jaw movement, were used to construct the digital maxillomandibular relationship (test group). The maxillomandibular relationship of the new complete dentures with artificial teeth in the intercuspal position was defined as the control group. The displacement s of the anterior reference point and 3D deviations of the entire mandibular arch were measured and compared between the test and control groups using a Wilcoxon signed-ranks test and a one-sample t-test, respectively.

Results

With reference to the centric relationship position, the maximum displacements of the anterior reference points were in the horizontal anteroposterior direction for both groups, and there were no significant differences. Compared to the control group, the 3D deviations of the entire mandibular arch in the test group were significant (95% confidence interval: 0.76 mm to 1.35 mm, P < 0.001).

Conclusions

By analyzing the individual trajectory features obtained by the in-house developed jaw tracking system, a digital method for determining and recording edentulous maxillomandibular relationships was established; however, the accuracy needs to be further improved.

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Tooth as graft material: Histologic study

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Abstract

Background

An effective regenerative protocol is key to reestablish and maintain the hard and soft tissue dimensions over time. The choice of the graft material and its properties also could have an impact on the results. To prevent alveolar ridge dimensional changes, since numerous graft materials have been suggested and in the past years, a growing interest in teeth material has been observed as a valuable alternative to synthetic biomaterials.

Aim

The aim of the study was to explore the histomorphometric outcomes of tooth derivative materials as used as bone substitute material in socket preservation procedure.

Methods

After alveolar socket preservation (ASP) procedures using autologous demineralized tooth as graft material prepared by means of an innovative device, was evaluated. A total of 101 histological samples, from 96 subjects, were analyzed by evaluating the total amount of bone (BV), residual tooth material (residual graft, TT), and vital bone (VB). The section from each sample was then split in nine subsections, resulting in 909 subsections, to allow statistical comparison between the different areas.

Results

It was not noticed a statistically significant difference between maxillary and mandibular sites, being the amount of VB in upper jaw sites 37.9 ± 21.9% and 38.0 ± 22.0% in lower jaw sites and the amount of TT was 7.7 ± 12.2% in maxilla and 7.0 ± 11.1% in mandibles. None of the other considered parameters, including defect type and section position, were statistically correlated to the results of the histomorphometric analysis.

Conclusions

ASP procedure using demineralized autologous tooth-derived biomaterial may be a predictable procedure to produce new vital bone potentially capable to support dental implant rehabilitation.

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First-line therapy in non-small cell lung cancer patients with EGFR activating mutations: a consideration of the clinical position of osimertinib based on the subset of Japanese patients in the FLAURA study

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Abstract
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been established as the standard first-line treatment for patients with previously untreated advanced non-small cell lung cancer (NSCLC) with an EGFR activating mutation. In the FLAURA study, osimertinib, third-generation EGFR-TKI, resulted in significantly longer progression-free survival and overall survival (OS) than first-generation EGFR-TKIs (gefitinib or erlotinib) in patients with previously untreated advanced NSCLC with an EGFR activating mutation. Osimertinib is now widely used as first-line therapy for those patients. In Japanese subset analysis of the FLAURA study, the median progression-free survival was prolonged by osimertinib (19.1 months) relative to gefitinib (13.8 months). However, there was no apparent OS benefit, albeit at the level of an exploratory post-hoc analysis. Although the safety profile in the Japanese subset was generally consistent with the overall population, the incidence of liver enzyme increases in the gefitinib group and that of interstitial lung disease/pneumonitis in the osimertinib group was higher among Japanese patients. There is now an increasing number of first-line treatment options for NSCLC with EGFR mutations, including EGFR-TKIs in combination with platinum-doublet chemotherapy or anti-angiogenic drugs. These combinations show progression-free survival benefits similar to osimertinib regardless of the mutation type. Therefore, a first-line combination regimen followed by osimertinib remains an attractive strategy. We review data from the randomized clinical trials of first-line EGFR-TKIs including a subset of Japanese patients and discuss first-line therapies for patients with NSCLC harbouring EGFR mutations.
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