Multidisciplinary Care of Patients with Facial Palsy: Treatment of 1220 Patients in a German Facial Nerve Center

To determine treatment and outcome in a tertiary multidisciplinary facial nerve center, a retrospective observational study was performed of all patients referred between 2007 and 2018. Facial grading with the Stennert index, the Facial Clinimetric Evaluation (FaCE) scale, and the Facial Disability Index (FDI) were used for outcome evaluation; 1220 patients (58.4% female, median age: 50 years; chronic palsy: 42.8%) were included. Patients with acute and chronic facial palsy were treated in the center for a median of 3.6 months and 10.8 months, respectively. Dominant treatment in the acute phase was glucocorticoids ± acyclovir (47.2%), followed by a significant improvement of all outcome measures (p < 0.001). Facial EMG biofeedback training (21.3%) and botulinum toxin injections (11%) dominated the treatment in the chronic phase, all leading to highly significant improvements according to facial grading, FDI, and FaCE (p < 0.001). Upper eyelid weight (3.8%) and hypoglossal–facial-nerve jump suture (2.5%) were the leading surgical methods, followed by improvement of facial motor function (p < 0.001) and facial-specific quality of life (FDI, FaCE; p < 0.05). A standardized multidisciplinary team approach in a facial nerve center leads to improved facial and emotional function in patients with acute or chronic facial palsy.

Children’s self-reported discomfort of restorative treatments for deep caries lesions in primary teeth: Results from a randomized clinical trial

The aim of this study was to evaluate the impact of different restorative techniques to treat deep caries lesions of primary molars on children’s self-reported discomfort. A randomized clinical trial with two parallel arms (1:1) was conducted in São Paulo, Brazil. 4-8 years-old children with at least one occlusal or occlusoproximal deep caries lesion in primary molars were selected. Molars were randomly allocated into two groups: (1) restoration performed with calcium hydroxide cement followed by high-viscosity Glass Ionomer Cement (CHC+HVGIC), and (2) HVGIC restoration. Immediately after the intervention, children reported the experienced discomfort during restoration to an external examiner using a Wong-Baker face-scale. Children’s self-reported discomfort was analyzed using Poisson regression comparing both groups and assessing other variables’ influence (α=5%). One hundred and eight children fulfilled the eligibility criteria and were randomized in the two groups (n=54). Most of the children who received CHC+HVGIC restorations reported none or minimal discomfort (83.3%). Similar scores (92.6%) were reported for those treated with HVGIC (p=0.758). The mean reported discomfort in children with CHC+HVGIC restorations was 0.37(1.01), and 0.41(1.01) for those with HVGIC restorations. Children’s self-reported discomfort was associated with age, sex, children’s cooperation, and intervention duration. We can conclude that CHC+HVGIC or HVGIC restorations result in none or minimal discomfort in the management of deep caries lesions, being considered a reliable option.

A Non-Randomized Controlled Trial for the Effectiveness of the ‘Aibo’ Intervention Program for Distraction in Childhood Vaccination

Procedures and actions such as injections and immobilization cause pain and distress to children. In the pediatric field, there is a need for interventions and support to alleviate the pain and distress caused by such medical procedures. In recent years, the introduction of robots as a means of distraction has begun to be attempted. In this study, we conducted a non-randomized controlled trial to examine the effect of intervention using ‘aibo’, a dog-like robot which has artificial intelligence (AI), to promote distraction in children after vaccination. As a result, 57 children (32 in the intervention group) participated in the study. Results of a t-test with the control group showed that the intervention group using aibo had significantly less pain following the post-vaccination intervention than the control group using stuffed dog (Face Scale, t(55) = 2.582, p = .0125; Behavioral Observation Scale, t(55) = 2.772, p = .00759). The results support the hypothesis that the aibo intervention group will be less distressed and able to calm down more quickly after vaccination than the control group. Conclusion : AI-powered aibo interventions that allow for interactive interaction can be an effective distraction method during painful procedures such as vaccinations.

A Prospective Study to Examine Responsiveness and Minimally Important Differences (MIDs) for the CLEFT-Q Scales Following Three Cleft-Specific Operations

The aim of this study was to examine internal responsiveness and estimate minimally important differences (MIDs) for CLEFT-Q scales. In this prospective cohort study, participants completed the CLEFT-Q appearance and health-related quality of life (HRQL) scales before and six months after cleft-related surgery. Seven cleft centres in Canada, USA and UK participated. Patients were ages 8–29 years with CL/P. Patients underwent rhinoplasty, orthognathic or cleft lip scar revision surgery. Internal responsiveness was examined using Cohen's d effect sizes (ESs) based on the following interpretation: 0.20–0.49 small, 0.50–0.79 moderate and ≥ 0.80 large. MIDs were estimated using two distribution-based approaches. Participants had a rhinoplasty (n = 31), orthognathic (n = 21) or cleft lip scar revision (n = 18) surgery. Most participants were males (56%) and aged 8–11 years (41%). Following rhinoplasty, ESs were larger for the nose (0.92, p = 0.001) and nostrils (0.94, p < 0.001) scales than for the face scale (0.51, p = 0.003). MIDs ranged between 6.2–10.4. For orthognathic surgery, larger ES was observed for the jaws scale (1.80, p < 0.001) compared with the teeth (1.16, p < 0.001), face (1.15, p = 0.001) and lips (0.94, p < 0.001) scales. MIDs ranged between 5.9–14.4. In the cleft lip scar revision sample, the largest ES was observed for the nose scale (0.76, p = 0.03), followed by lips (0.58, p = 0.009) and cleft lip scar (0.50, p = 0.043) scales. MIDs ranged between 6.4–12.3. CLEFT-Q detected change in key outcomes for three cleft-specific surgeries, providing evidence of its responsiveness. Estimated MIDs will aid in interpreting this PROM.

Effective Face Detector Based on YOLOv5 and Superresolution Reconstruction

The application of face detection and recognition technology in security monitoring systems has made a huge contribution to public security. Face detection is an essential first step in many face analysis systems. In complex scenes, the accuracy of face detection would be limited because of the missing and false detection of small faces, due to image quality, face scale, light, and other factors. In this paper, a two-level face detection model called SR-YOLOv5 is proposed to address some problems of dense small faces in actual scenarios. The research first optimized the backbone and loss function of YOLOv5, which is aimed at achieving better performance in terms of mean average precision (mAP) and speed. Then, to improve face detection in blurred scenes or low-resolution situations, we integrated image superresolution technology on the detection head. In addition, some representative deep-learning algorithm based on face detection is discussed by grouping them into a few major categories, and the popular face detection benchmarks are enumerated in detail. Finally, the wider face dataset is used to train and test the SR-YOLOv5 model. Compared with multitask convolutional neural network (MTCNN), Contextual Multi-Scale Region-based CNN (CMS-RCNN), Finding Tiny Faces (HR), Single Shot Scale-invariant Face Detector (S3FD), and TinaFace algorithms, it is verified that the proposed model has higher detection precision, which is 0.7%, 0.6%, and 2.9% higher than the top one. SR-YOLOv5 can effectively use face information to accurately detect hard-to-detect face targets in complex scenes.

Development and Validation of a Simplified Chinese Version and a Face-Scale Version of the Oxford Shoulder Score: A 2-Center Prospective Study

Background: There has not yet been a pictorial version of a patient-reported outcome measure for shoulder pain. Purpose: To translate the English version of the Oxford Shoulder Score (OSS) to a simplified Chinese version (SC-OSS) and to validate a new face-scale version of the OSS (FS-OSS), while investigating cross-cultural adaptation, validation, and reproducibility of both versions in patients with shoulder pain. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The translation and cross-cultural adaptation of the SC-OSS was performed using a forward-backward translation method. The FS-OSS was developed on the basis of the SC-OSS, using the Wong-Baker FACES Pain Rating Scale for reference. Participants were asked to complete the SC-OSS, FS-OSS, Simple Shoulder Test (SST), Constant-Murley score (CMS), and 36-Item Short Form Health Survey (SF-36). Validation and reproducibility were tested by calculating Cronbach α values for internal consistency as well as by intraclass correlation coefficients. Time needed to complete the scores was used to test cross-cultural adaption. Results: A total of 312 respondents participated in the research and completed all outcome measures. The internal consistency was strong, with a Cronbach α of .94 and .91 for the FS-OSS and SC-OSS, respectively. High intraclass correlation coefficient values for the FS-OSS score (0.95) and SC-OSS (0.92) were obtained, which indicated excellent test-retest reliability. The Pearson correlation coefficients of the SC-OSS and FS-OSS with the SST ( r = 0.67 and 0.65, respectively), CMS ( r = 0.62 and 0.66, respectively), and SF-36 ( r = 0.52 and 0.57, respectively) indicated good construct validity. The time needed to complete the FS-OSS was less than that needed for the SC-OSS and SST. Conclusion: The FS-OSS and SC-OSS were validated as reliable instruments for patients with shoulder pain. For Chinese patients, the face-scale version was easier to understand than the cross-cultural text version.

Massage Counterpressure, Massage Effleurage dan Murothal Efektif Menurunkan Nyeri Persalinan Primigravida Kala 1 Fase Aktif

Introduction: Labor pain is a physiological condition experienced by the mother during the birth process. The impact of labor pain if left untreated will cause fear and anxiety then it will cause stress and the delivery time will be long. Counterpressure massage, effleurage and murottal are non-pharmacological measures to reduce labor pain. Objectives: The purpose of this study was to determine whether there is an effectiveness of Counterpressure Massage, Massage Effleurage, Murohlah Against the Reduction of Primigravida Stage 1 Labor at BPM “M”.Method: This research method is quantitative using a quasi- experimental research design. The population in this study were all primigravida mothers in the first phase of labor in the active phase of the Midwife M BPM, amounting to 30 respondents. sample in this study were 30 . The sampling technique uses total sampling because the number of population is relatively small, 30. The instrument used is a face scale sheet. Data processing using computerized, with univariate and bivariate data analysis.Result: T-dependent massage counterpressure test results obtained p- value = 0,000 <0.05, massage effect p-value 0.001 <0.05, and for murothal p-value 0.010 <0.05. Based on the results of the study it can be concluded that the counterpressure, effleurage and murothal at BPM Midwife M affect labor pain. With this research, it is expected that BPM will further increase efforts to reduce the level of pain with this research.Conclution: It is expected that in midwives M midwives will perform counterpressure massage treatments for each delivery patient so as to improve the quality of service.

Hypersensitivity in Molar Incisor Hypomineralization: Superficial Infiltration Treatment

To date, there are no standardized protocols available in the literature for hypersensitivity treatment in molar incisor hypomineralization (MIH) patients. The aim of this study was to evaluate the efficacy of erosion–infiltration treatments with resin in children with a strong hypersensitivity and also to develop a minimally invasive diagnostic–therapeutic pathway for young MIH patients. Patients with clinical signs of MIH were enrolled according to international guidelines. A total of 42 patients (8–14 years old) with sensitivity of at least one molar and patients with post eruptive enamel fractures, but without dentin involvement or cavitated carious lesions were selected. A single superficial infiltration treatment with ICON (DMG, Germany) was performed with a modified etching technique. Sensitivity was tested with the Schiff Scale and Wong Baker Face Scale and was repeated at 12 months follow-up. All patients reported lower sensitivity values at the end of the treatment. Significant differences of sensitivity according to the Schiff scale were reported between T0 and all subsequent follow-ups, p < 0.05. The treatment of erosion infiltration with ICON resin is a minimally invasive preventive treatment that significantly improves the problem of hypersensitivity in permanent molars with MIH.

Experience of using Neurouridine® in various types of peripheral neuropathy

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.