“Read That Article”: Exploring synergies between gaze and speech interaction

Gaze information has the potential to benefit Human-Computer Interaction (HCI) tasks, particularly when combined with speech. Gaze can improve our understanding of the user intention, as a secondary input modality, or it can be used as the main input modality by users with some level of permanent or temporary impairments. In this paper we describe a multimodal HCI system prototype which supports speech, gaze and the combination of both. The system has been developed for Active Assisted Living scenarios.info:eu-repo/semantics/acceptedVersio

Impairments in psychological functioning in refugees and asylum seekers

© 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Refugees are at increased risk for developing psychological impairments due to stressors in the pre-, peri- and post-migration periods. There is limited knowledge on how everyday functioning is affected by migration experience. In a secondary analysis of a study in a sample of refugees and asylum seekers, it was examined how aspects of psychological functioning were differentially affected. 1,101 eligible refugees and asylum seekers in Europe and Türkiye were included in a cross-sectional analysis. Gender, age, education, number of relatives and children living nearby, as well as indicators for depressive and posttraumatic symptoms, quality of life, psychological well-being and functioning, and lifetime potentially traumatic events were assessed. Correlations and multiple regression models with World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item version’s total and six subdomains’ scores (‘mobility’, ‘life activities’, ‘cognition’, ‘participation’, ‘self-care’, ‘getting along’) as dependent variables were calculated. Tests for multicollinearity and Bonferroni correction were applied. Participants reported highest levels of impairment in ‘mobility’ and ‘participation’, followed by ‘life activities’ and ‘cognition’. Depression and posttraumatic symptoms were independently associated with overall psychological functioning and all subdomains. History of violence and abuse seemed to predict higher impairment in ‘participation’, while past events of being close to death were associated with fewer issues with ‘self-care’. Impairment in psychological functioning in asylum seekers and refugees was related to current psychological symptoms. Mobility and participation issues may explain difficulties arising after resettlement in integration and exchange with host communities in new contexts.Peer reviewe

IDEST: International Database of Emotional Short Texts

We introduce a database (IDEST) of 250 short stories rated for valence, arousal, and comprehensibility in two languages. The texts, with a narrative structure telling a story in the first person and controlled for length, were originally written in six different languages (Finnish, French, German, Portuguese, Spanish, and Turkish), and rated for arousal, valence, and comprehensibility in the original language. The stories were translated into English, and the same ratings for the English translations were collected via an internet survey tool (N = 573). In addition to the rating data, we also report readability indexes for the original and English texts. The texts have been categorized into different story types based on their emotional arc. The texts score high on comprehensibility and represent a wide range of emotional valence and arousal levels. The comparative analysis of the ratings of the original texts and English translations showed that valence ratings were very similar across languages, whereas correlations between the two pairs of language versions for arousal and comprehensibility were modest. Comprehensibility ratings correlated with only some of the readability indexes. The database is published in osf.io/9tga3, and it is freely available for academic research.</p

Long-term effectiveness of Self-Help Plus in refugees and asylum seekers resettled in Western Europe: 12-month outcomes of a randomised controlled trial

AimsAs refugees and asylum seekers are at high risk of developing mental disorders, we assessed the effectiveness of Self-Help Plus (SH + ), a psychological intervention developed by the World Health Organization, in reducing the risk of developing any mental disorders at 12-month follow-up in refugees and asylum seekers resettled in Western Europe.MethodsRefugees and asylum seekers with psychological distress (General Health Questionnaire-12 ⩾ 3) but without a mental disorder according to the Mini International Neuropsychiatric Interview (M.I.N.I.) were randomised to either SH + or enhanced treatment as usual (ETAU). The frequency of mental disorders at 12 months was measured with the M.I.N.I., while secondary outcomes included self-identified problems, psychological symptoms and other outcomes.ResultsOf 459 participants randomly assigned to SH + or ETAU, 246 accepted to be interviewed at 12 months. No difference in the frequency of any mental disorders was found (relative risk [RR] = 0.841; 95% confidence interval [CI] 0.389–1.819; p-value = 0.659). In the per protocol (PP) population, that is in participants attending at least three group-based sessions, SH + almost halved the frequency of mental disorders at 12 months compared to ETAU, however so few participants and events contributed to this analysis that it yielded a non-significant result (RR = 0.528; 95% CI 0.180–1.544; p-value = 0.230). SH + was associated with improvements at 12 months in psychological distress (p-value = 0.004), depressive symptoms (p-value = 0.011) and wellbeing (p-value = 0.001).ConclusionsThe present study failed to show any long-term preventative effect of SH + in refugees and asylum seekers resettled in Western European countries. Analysis of the PP population and of secondary outcomes provided signals of a potential effect of SH + in the long-term, which would suggest the value of exploring the effects of booster sessions and strategies to increase SH + adherence.</p

Trajectories of psychosocial symptoms and wellbeing in asylum seekers and refugees exposed to traumatic events and resettled in Western Europe, Turkey, and Uganda

Background: Longitudinal studies examining mental health trajectories in refugees and asylum seekers are scarce.Objectives: To investigate trajectories of psychological symptoms and wellbeing in refugees and asylum seekers, and identify factors associated with these trajectories. Method: 912 asylum seekers and refugees from the control arm of three trials in Europe (n = 229), Turkey (n = 320), and Uganda (n = 363) were included. We described trajectories of psychological symptoms and wellbeing, and used trauma exposure, age, marital status, education, and individual trial as predictors. Then, we assessed the bidirectional interactions between wellbeing and psychological symptoms, and the effect of each predictor on each outcome controlling for baseline values.Results: Symptom improvement was identified in all trials, and for wellbeing in 64.7% of participants in Europe and Turkey, versus 31.5% in Uganda. In Europe and Turkey domestic violence predicted increased symptoms at post-intervention (ß = 1.36, 95% CI 0.17-2.56), whilst murder of family members at 6-month follow-up (ß = 1.23, 95% CI 0.27-2.19). Lower wellbeing was predicted by murder of family member (ß = -1.69, 95% CI -3.06 to -0.32), having been kidnapped (ß = -1.67, 95% CI -3.19 to -0.15), close to death (ß = -1.38, 95% CI -2.70 to -0.06), and being in the host country >= 2 years (ß = -1.60, 95% CI -3.05 to -0.14). In Uganda at post-intervention, having been kidnapped predicted increased symptoms (ß = 2.11, 95% CI 0.58-3.65), and lack of shelter (ß = -2.51, 95% CI -4.44 to -0.58) and domestic violence predicted lower wellbeing (ß = -1.36, 95% CI -2.67 to -0.05). Conclusion: Many participants adapt to adversity, but contextual factors play a critical role in determining mental health trajectories.</p

The free radial forearm flap for closure of large defects of upper lip and adjacent cheek tissue

Four cases with large defects of the upper lip and adjacent cheek, reconstructed with radial forearm free flaps, are presented. The defects were secondary to tumor excision, three recurrent and one primary. Because of the extensive infiltration of the tumor into the adjacent tissues, the excisions were extensive. There were also large mucosal defects. Free radial forearm flaps were chosen to repair these defects instead of local cheek or lip flaps. The free flap was easily folded to repair skin and mucosa simultaneously. Although the patients had partial loss of orbicularis oris muscle, they did not completely lose upper lip function. Drooling was controlled, and there was no microstomia. This is the free flap of choice to repair a large defect of the upper lip and adjacent cheek tissue in selected cases. © 1989 Springer-Verlag

Reconstruction of the wide palate defects with temporal osteocutaneous island flaps

The temporal osteocutaneous island (TOCI) flap was first performed in reconstruction of palatal defects by Furnas [8]. It consists of temporoparietal fascia, galea, pericranium and the cortical layer of parietal bone covered with pericranium. In this study, we present five patients with wide palatal defects treated by TOCI flaps. The causation of the wide palatal defects were gun-shot wounds in two patients and unsuccessful reconstruction of congenital cleft palate during early childhood in three patients. All patients were adult. TOCI flaps were performed in two stages. At first, the TOCI flap was elevated and covered with a split thickness skin graft. In the second stage (approximately 1.5 months later), the flap was elevated based on the superficial temporal artery as an island flap. It was then transferred to the palatal defect via a cheek tunnel and sutured to the edges of the defect. There was no need for bone fixation. The length of the pedicle of the flap was sufficient in size to easily reach the anterior part of the palate. No serious complications were seen. One minor oronasal fistula occurred; this was repaired by local flaps. The TOCI flaps improved speech only partially. In conclusion, we believe this procedure is a good method for reconstruction in wide palatal defects which need three layer closure. This procedure is not a satisfactory solution for complete correction of speech defects. © 1994 Springer-Verlag

Orbital apex syndrome associated with fractures of the zygoma and orbital floor

The orbital apex syndrome can be caused by trauma. The patient presented was hit by an elbow in the right periorbital area with resulting fractures to the right zygoma and orbital floor. Examination revealed visual loss, total ophthalmoplegia, and ptosis of the right upper eyelid with hypoesthesia in the ophthalmic division of the trigeminal nerve. After a week of supportive therapy and observation, the orbital floor fracture was repaired by reducing the bone fragments, and the zygomatic fracture was reduced through a Gillies incision. Over the next six months, there was complete resolution of the ophthalmoplegia, the ptosis, the loss of sensation in the ophthalmic division of the trigeminal nerve, and the vision. © 1993 Springer-Verlag

Use of cross-leg latissimus dorsi free flap for repair of extensive lower leg electrical injury in a child

PubMedID: 16621306Extensive electrical injury to the distal part of the lower extremity presents a difficult reconstruction problem to the plastic surgeon. The amputation rate of the lower extremity in patients with high-voltage electrical injuries is reported as 40% [1]. Providing vascularized tissue to the injured area has been advocated as a method to improve outcome in electrical injuries [1]. The usefulness and reliability of muscle flaps diminish in the distal third of the leg. Early reconstruction with microvascular tissue transfers became the method of choice especially for large soft tissue defects due to condition of patient, microsurgical skill of surgeon and availability of suitable recipient vessels in defect area. Microvascular surgery in children is safe and carries a high success rate which was reported by Parry et al. [2]. Cross-leg free flaps have been described for reconstruction of leg defects in cases of trauma with no suitable recipient vessels in the vicinity of the defect. Vascular pedicle of the free flap can be temporarily anastomised to the recipient vessels in the contralateral leg and then divided after adequate neovascularisation of the flap occurs from the recipient bed. We present a 7-year-old child who sustained a high voltage burn to his right upper extremity and bilateral lower extremities. A pedicled latissimus dorsi flap was used to converge the stump of upper extremity; the other lattisimus dorsi muscle flap was used to as a cross-leg free flap procedure for salvaging of the distal lower leg. Case report: A 7-year-old child sustained a high voltage electrical burn to his right upper extremity and bilateral lower extremity. He was initially treated in another hospital where fasciotomy was performed on his right forearm. He was referred to our burn unit 2 days later. Total extensive destruction at right arm without pulse and bilateral lower extremity revealed deep full thickness burns and tissue necrosis especially at distal 1/3 of the right lower extremity and above the supramalleolar region of the left lower extremity. The injury covered 12% of the body surface area. The flexion contracture and complete muscle necrosis was observed at the fasciotomy site of the right arm. Doppler ultrasonic investigation demonstrated non-pulsatile arteries in the right arm. Occlusion of the anterior tibial vessels of the right leg was noted although the left lower extremity vessels were intact. Three days later, surgical treatment was started. The right upper limb was amputated. Non-viable tissues over the shoulder and the distal part of the humerus were excised. Immediate coverage of the shoulder was achieved by a right pedicled latissimus dorsi muscle flap for the formation of the stump. At the same time, The third, fourth and fifth toes of the left foot were also amputated with debridement of right lower extremity. After the first operation physical examination revealed a circular large defect of the right leg. The exposed tendons and bones were measured 16 cm × 10 cm (Fig. 1). Proper local tissues was absent to cover the defect. Three weeks after injury, a left free latissimus dorsi muscle flap; 20 cm × 10 cm, was harvested using an oblique posterior axillary incision. The muscle was carried to the right lower extremity wound, and an end-to-end anastomosis was performed to the cross-leg peroneal artery and its vena comitans using 9-0 microstruture temporarily at the left lower extremity (Fig. 2). The vascular pedicle of the flap was buried into the recipient area with proximal part of the free muscle flap so the protection of anastomosis by preventing the stress on the pedicle was achieved. In addition to this, fixing the two legs together with an external fixator was done to prevent accidental avulsion of the vessels during the period of neovascularisation (Fig. 3). A meshed split thickness skin graft was applied over the free muscle flap. Donor area was closed without tension. No complications were seen after surgery and the patient tolerated the operation and postoperative period well. Postoperatively, neovascularisation of the microvascular transfer was checked by temporary ligation of the pedicle. Cyanosis due to the problem of venous return was noted at 21st day. The muscle flap pedicle was divided at 25th day completely without any arterial and venous problem. The patient was able to walk well during early postoperative period (Fig. 4) and he was followed up for 3 years without any complications. Discussion: Guidelines for the surgical management of children differ from adults in anatomic, physiologic, and rehabilitative ways. Hudson et al. [3] and Smith et al. [4] reported that the cross-leg flap is a safe and reliable alternative to free tissue transfer in pediatric lower limb trauma. Morris et al. [5] stated the 94% success rate and the long-term results in his series of 165 flaps confirm that the cross-leg flap is a reliable procedure for resurfacing defects of the lower leg and foot. Mooney et al. [6] stated the cross extremity flaps in a severe pediatric foot defect in which free tissue transfer was not be optimal. The success of free flap reconstruction depends on many factors such as adequate calibration of the healthy recipient vessels as well as surgical skills for microvascular anastomosis. The development of free tissue transfers by microvascular anastomosis are increasing day by day. Devaraj et al. [7] reported that free flap reconstruction in children is safe and carries a high success rate. Microvascular free tissue transfer in children with 96% success rate have been reported also by Parry et al. [2]. The investigation of recipient arteries or defect are important. We prefer Doppler ultrasonic investigation, which is a non-invasive technique and gives enough information about vessels. Also, digital substraction arteriogram can be used in vascular injuries and for child who suffered an electrical injury [8]. The free latissimus dorsi myocutaneous flap was harvested in this case because of no reliable local muscle flaps for reconstructive option in the same extremity and inadequate cross-leg flap size to cover the large defect. The latissimus dorsi myocutaneous flap has many advantages. The most important is that it has a long pedicle with very little anatomic variation and free flap reconstruction can be done even in very small children [9]. Among our other criteria for using the latissimus dorsi myocutaneous flap for our patient were: the desire to reconstruct the lower extremity defect with salvaging of extremity; easy harvesting of the flap with better coverage of the large soft tissue defect; the presence of free muscle tissue which plays an important role in neovascularisation; and the prevention of possible osteomyelitis formation at exposed bony tissue with muscle flap which provides the best condition for angiogenesis. We think that the anastomosis of free flap must be done to the cross-leg in this case for two reason: first, the possibility of jeopardizing of distal blood flow due to possible occlusion of the posterior tibial vessels which were the only intact vessels at the same extremity even end-to-side anastomosis and second, avoid from using vein grafts. The vein grafts were needed between vessels to make anastomosis away from the zone of trauma in this case, which increases number of the anastomosis and also the risk of the failure of flap. An arterial jump graft from the ipsilateral popliteal artery is another alternative option for the reconstruction of this defect at the same extremity. We do not prefer this approach due to the (1) possibility of the kinking of the grafts, (2) stenosis of distal anastomosis [10], The increased incidence of the formation of the thrombus due to intima damage of the vessels during reconstruction of the early electrical injury, especially near the defect area, and increased number of anastomosis are the other disadvantages. Temporarily anastomosis to the recipient vessels in the contralateral leg was first described in 1979 by Taylor et al. [11]. They used contralateral leg vessels as recipient vessels in leg reconstruction using a free circumflex iliac artery flap. Cross-leg free flap procedure were applied successfully and reported at the lower leg traumas as a salvaging procedure [12,13]. To date, use of cross-leg free flap for defects in the burned lower extremity has been previously reported by Lai et al. [14] for 20-year-old male patient. Our case report is the first report that free cross-leg latissimus dorsi flap operation has been successfully applied as a salvage procedure for a 7-year-old child who was sustained high voltage electrically trauma. Some points are especially important because of the age of the patient: decision to recipient vessels; coverage of the vascular pedicle; protection of the pedicle by external fixator; and division time of the pedicle. We believe that if we performed this operation in the same leg we had to use the end-to-side or end-to-end anastomosis between posterior tibial artery or peroneal artery with donor vessels. This may be ended with three ways such as (1) loss of flap, (2) trombus formation at the anastomosis area or the main arterial trunks or (3) decrease of the distal blood flow due to sacrifice of the one of the remaining artery. The cross-leg peroneal vessels were prepared as the recipients away from the zone of injury due to occlusion of tibialis anterior artery at the same extremity and occlusion of dorsalis pedis artery at the contralateral leg. End-to-end vascular anastomosis was done between vessels. Yu et al. [13] reported that end-to-end vascular anastomosis is necessary in the cross-bridge procedure as sacrifice of the donor vessels is inevitable. In this case, we secured the vessels under the proximal part of the flap into the cross-leg area by suturing. Taylor et al. [11] recommend suturing a portion of the free skin flap to the hinged flap on the other leg