To explore factors influencing adolescents and young adults’ (AYAs) risk perception of COVID-19 and adherence to public health measures, we conducted a cross-sectional online survey of AYAs (14–22 years old) from Quebec (Canada) recruited through school and community partners in April 2020 during the first wave of the COVID-19 pandemic. The study included 3037 participants (mean age = 17.7 years, 74.6% female). AYAs had higher mean (standard deviation (SD)) risk perception of COVID-19 for their relatives (8.2 (1.9)) than for themselves (5.6 (2.6)) (p < 0.001). Factors associated with higher risk perception included higher disease knowledge (adjusted odds ratio (aOR) 1.06, 95% CI 1.01–1.11), presence of chronic disease (aOR 2.31, 95%CI 1.82–2.93) and use of immunosuppressants (aOR 2.53, 95%CI 1.67–3.87). AYAs with a higher risk perception (aOR 1.06, 95%CI 1.02–1.10) those wishing to help flatten the disease curve (aOR 1.18, 95%CI 1.12–1.25) or to protect their family/friends (aOR 1.14, 95%CI 1.05–1.24) were more likely to engage in preventive behaviors. Self-perceived risk and desire to protect others were significantly associated with adherence to preventive measures among youth. These findings may help inform public health messaging to AYAs in the current and future pandemics.

Objective A systematic review and meta-analysis were performed to evaluate the prevalence and prognosis of otorhinolaryngological symptoms in patients with the diagnosed coronavirus disease 2019 . Methods A systematic search of PubMed, Embase, Web of Science, and Google Scholar databases was performed up to August 19, 2020.We included studies that reported infections with COVID-19 and symptoms of otolaryngology. The retrieved data from the respective studies were evaluated and summarized. The study's immediate result was to assess the combined prevalence of otorhinolaryngological symptoms in patients with COVID-19. However, the secondary result was to determine the exacerbation of COVID-19 infection in patients with otorhinolaryngological symptoms. Results Fifty-four studies with 16,478 patients were included. Olfactory dysfunction, sneezing and sputum production were the 3 most prevalent otorhinolaryngological symptoms in patients with COVID-19. The pooled prevalence amongst the prevalent symptoms was 47% (95% CI 29-65; range 0-98; I 2 = 99.58%), 27% (95% CI 11-48; range 12-40; I 2 = 93.34%), and 22% (95% CI 16-30; range 2-56; I 2 = 97.60%), respectively. The proportion of severely ill patients with sputum production and shortness of breath was significantly higher among patients with COVID-19 infections (OR 1.66 [95% CI 1.08-2.54]; P = 0.02, I 2 = 51% and 3.29 [95% CI 1.57-6.90]; P = 0.002, I 2 = 49%, respectively). Subgroup analysis showed no statistically significant differences between the incidence of otolaryngology symptoms in severely ill patients and non-severely ill patients (OR 1.43 [95% CI 1.12-1.82]; P = 0.07 I 2 = 53.1%). In contrast, the incidence of shortness of breath in severely ill patients was significantly increased (3.29 [1.57-6.90]; P = 0.002, I 2 = 49%). Conclusion Our research shows that otorhinolaryngology symptoms in patients with COVID-19 are not uncommon, which should attract otorhinolaryngologists' attention.

Objective: To analyze the factors influencing the diagnosis and treatment of tracheobronchial foreign bodies (TFBs) in children. Methods: The clinical data of 300 consecutive children with suspected TFBs who were admitted to our department between January 2016 and December 2019 were retrospectively collected, including demographics, diagnosis, history of foreign body inhalation, preoperative chest computed tomography (CT) findings, duration of foreign body retention, time from admission to operation, operation duration, duration of hospitalization, and complications. Results: Among the 300 cases, the male:female ratio was 193:107, and the age range was 6 months to 12 years (median age: 19 months). A total of 291 cases (97.0%) involved TFBs confirmed by rigid bronchoscopy, while the other 9 cases (3.0%) involved bronchopneumonia. The diagnostic accuracy, sensitivity, and specificity of a history of foreign body inhalation and chest CT were 96.0%, 98.6%, and 11.1% and 97.7%, 97.6%, and 100%, respectively. The duration of hospitalization, time from admission to operation, and operation duration were all related to bronchopneumonia ( P < .05). Conclusions: A detailed history, adequate physical examination, and preoperative imaging examination help improve the diagnostic accuracy. Preoperative bronchopneumonia in children with TFBs will increase the surgical risks and treatment costs, prolonging the duration of hospitalization.

Background: The aim of this study was to evaluate psychological distress among orthodontic patients and its relationship to orthodontic emergencies related to different appliances during the COVID-19 lockdown. Methods: This was a cross-sectional online questionnaire survey involving orthodontic patients in Shanghai, China. Data collection occurred from May 15 to June 1 2022. The demographic information and orthodontic emergencies were collected, while the peritraumatic distress symptoms were assessed by the COVID-19 Peritraumatic Distress Index (CPDI). Data analysis was performed by SPSS software. Results: A total of 480 patients were examined, including 331 fixed appliance patients, 131 clear aligner patients and 18 removable appliance patients. Patients who encountered emergencies and suffered from temporomandibular joint (TMJ) pain reported significantly higher CPDI scores in each group (p<0.01). Multivariate linear analysis showed that patients aged above 18 years old (p<0.01), emergencies in fixed appliance patients (p<0.05), emergencies among clear aligner patients (p<0.01), and higher TMJ-pain scores were significantly associated with increasing CPDI scores. Conclusions: Orthodontic patients encountered emergencies, especially those who suffered from TMJ pain and were at higher risk of psychological distress related to COVID-19; thus, targeted intervention and self-management guidelines should be designed to relieve anxiety and strengthen coping capacity for orthodontic patients during the pandemic.

Background: Individual cognitive stimulation therapy (ICST) can benefit cognition and quality of life for people with dementia, but the evidence for nurses-led individual cognitive stimulation interventions is limited.Objectives: The current study aimed to develop the process of planning and implementing ICST, and evaluate the effect of ICST on cognitive function and therapeutic effect in patients with mild Alzheimer’s disease (AD). Methods: It was a randomized controlled trial lasting for a half year. 38 patients with mild AD were recruited. The control group was given the “Individual Cognitive Stimulation Therapy Manual for AD” to deliver the sessions at home. The intervention group was given 90 minutes ‘cognitive stimulation sessions, completed up to three times weekly over 24 weeks. The outcomes were measured at baseline and 24weeks by the scales widely used in AD evaluation (MMSE, MoCA and ADL).Results: There were statistical significance between the two groups, especially the scores of memory, delayed memory in MMSE and scores of memory, delayed memory, immediate memory, attention in MoCA were significantly improved in the intervention group compared with control group. ICST show positive effects that may help preserve memory in mild AD.Conclusions: The ICST can improve the memory and attention cognitive domains in patients with mild AD. And the feedback from patient and caregiver in ICST was favorable.

Penetrating carotid artery traumas are rare yet fatal injuries with a high rate of mortality, and survivors may live with neurological sequelae. Of all the types of penetrating carotid artery traumas, the total transection of the common carotid artery (CCA) may be the most serious, can lead to death quickly, and has few reports of survivors. We described two cases of patients with complete CCA transections who survived without any neurological sequelae. The penetrating neck traumas of both patients were confirmed as complete CCA severance by CT and surgical exploration. Case 1 received the insertion of an interposition polytetrafluoroethylene graft to reconstruct the CCA, with postoperative ultrasound and CT angiography (CTA) verifying the total occlusion. Case 2 underwent nonoperative management under close observation and did not develop delayed active bleeding or neurological symptoms. Both patients recovered well, and no nervous system sequelae appeared during the follow-up period. A carotid artery injury cannot be ruled out in an asymptomatic penetrating neck injury. If CTA is feasible given the patient's hemodynamic condition, then it should be used as a routine examination to evaluate cervical vascular injury in patients with penetrating neck trauma. Management for hemodynamically stable carotid artery injuries remains controversial. These two cases of transverse carotid artery injury have caused us to further consider the principles of this kind of case management.

The aim of this study was to evaluate the usefulness of the motor unit number index (MUNIX) technique in Kennedy disease (KD) and test the correlation between the MUNIX and other clinical parameters. The MUNIX values of the bilateral deltoid, abductor digiti minimi (ADM), quadriceps femoris (QF), and tibialis anterior (TA) were determined and compared with the course of the disease. The MUNIX sum score was calculated by adding the MUNIX values of these 8 muscles. Disability was evaluated using the spinal and bulbar muscular atrophy functional rating scale (SBMAFRS). The MUNIX scores of patients with KD were negatively correlated with the course of the disease (p &lt; 0.05), whereas their motor unit size index (MUSIX) scores were positively correlated with the course the of disease (p &lt; 0.05). MUNIX sum scores were correlated with SBMAFRS scores (r = 0.714, p &lt; 0.05). MUNIX was more sensitive than compound muscle action potentials or muscle strength as an indicator of neuron loss and axonal collateral reinnervation. The MUNIX sum score is an objective and a reliable indicator of disease progression, and it is a potential choice for therapeutic clinical trials. The MUNIX can assess the functional loss of motor axons and is correlated with disability. The MUNIX sum score may be especially suitable as an objective parameter.

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