Nevin Manimala

Psychol Res. 2024 Dec 23;89(1):38. doi: 10.1007/s00426-024-02067-z.

ABSTRACT

Previous research highlights impairments in the recognition of facial expression of emotion in individuals diagnosed with Autism Spectrum Disorder (ASD). Relatives of people with ASD may exhibit similar, albeit subtler, impairments, referred to as the Broad Autism Phenotype (BAP). Recently, the Differential outcomes procedure (DOP) has been shown to enhance this ability in young adults using dynamic stimuli, with fewer intensity levels required to identify fear and surprise. The present study aimed to extend these findings to adults diagnosed with ASD (ASD group), and relatives of people diagnosed with ASD (BAP group). A Bayesian Generalized Linear Model was employed for statistical inference. The results indicated that the ASD DOP group performed worse than the BAP DOP group in fear trials. The social dimension of autism negatively impacted performance in some conditions, while positive relationships were found between the repetitive behavior dimension and performance for the ASD group. The opposite pattern was observed in the BAP group. These results suggest the importance of considering different dimensions of autism when conducting research on its relationship with other variables. Finally, participants in both ASD and BAP groups required less intensity to identify certain emotions when the DOP was applied, highlighting its potential utility for improving dynamic facial emotion recognition.

PMID:39710715 | DOI:10.1007/s00426-024-02067-z

BMC Psychiatry. 2024 Dec 23;24(1):938. doi: 10.1186/s12888-024-06409-4.

ABSTRACT

BACKGROUND: In observational studies, frailty has been strongly associated with mental disorders. However, the mechanisms underlying the association between frailty and mental disorders remain unclear.

METHODS: We conducted a two-sample Mendelian randomization (MR) study to assess the causal relationship between frailty, as measured by the frailty index (FI), and ten common mental disorders. The datasets involved European ancestry individuals and included measurements of the FI (N = 175,226), schizophrenia (SCZ; N = 320,404), major depressive disorder (MDD; N = 143,265), bipolar disorder (N = 337,199), insomnia (N = 462,341), obsessive-compulsive disorder (N = 33,925), anxiety disorders (N = 463,010), autism spectrum disorder (N = 46,351), anorexia nervosa (N = 14,477), opioid-related mental and behavioral disorders (N = 215,650), and mental and behavioral disorders due to use of other stimulants including caffeine (N = 215,570).

RESULTS: Two-sample MR analyses were performed using inverse variance weighting followed by various sensitivity and validation analyses. Genetically predicted SCZ (odds ratio [OR] = 1.019, 95% confidence interval [CI] 1.005-1.033) and MDD (OR = 1.211, 95% CI 1.092-1.343) had significant causal effects on FI. In the reverse MR analysis, we discovered that MDD was significantly and causally affected by FI (OR = 1.290, 95% CI 1.133-1.469). No causal links were identified between the FI and the other eight common mental disorders. In the Multivariable MR, the estimated MDD effect on FI is comparable to the univariate IVW estimate (OR = 1.298; 95% CI, 1.175 to 1.435), while the estimated SCZ effect on FI fails to be significant compared to the univariate estimate. The results of the sensitivity and validation analyses confirmed stabilization.

CONCLUSIONS: Our study found evidence of a causal relationship between SCZ, MDD, and frailty and explored the underlying mechanisms.

PMID:39710650 | DOI:10.1186/s12888-024-06409-4

BMC Surg. 2024 Dec 23;24(1):411. doi: 10.1186/s12893-024-02692-w.

ABSTRACT

PURPOSE: This study aims to investigate the risk factors for postoperative complications following Femoral Neck System (FNS) fixation in young patients with femoral neck fractures (FNFs).

METHODS: We retrospective analyzed 133 patients with FNFs who underwent FNS fixation between May 2021 and October 2023. Potential risk factors that may affect the results included age, gender, body mass index (BMI), Pauwels classification, Garden classification, fracture anatomical classification, reduction method, reduction quality, coronal plane position of the FNS bolt. Postoperative complication data, including femoral head necrosis, nonunion, shortening of the femoral neck, fracture displacement, and screw cut-out, were collected. Multivariate logistic regression analysis was used to analyze different influencing factors.

RESULTS: A total of 133 FNFs patients were divided into a healing group (108 patients) and a failure group (25 patients). 25 patients (18.79%) had postoperative complications, including 8 cases of femoral head necrosis, 3 cases of nonunion, 3 cases of significant shortening of the femoral neck, and 7 cases of fracture displacement, 4 cases of screw cut-out; the remaining patients’ fractures all healed. There were no statistical differences between the two groups in age (P = 0.746), gender (P = 0.992), BMI (P = 0.361), Pauwels classification (P = 0.231), fracture anatomical classification (P = 0.459), reduction method (P = 0.383). Garden classification significantly influenced postoperative complications, with the proportion of Garden type IV being significantly higher in the failure group than in the healing group (64% vs. 39.8%, P = 0.01). Multivariate logistic regression analysis showed that coronal position of the FNS bolt and reduction quality were risk factors for postoperative complications. Subgroup analysis using logistic regression showed a positive correlation between coronal plane position of the FNS bolt and reduction quality with the occurrence of postoperative complications, with FNS positioned in the upper 1/3 and negative support being significant risk factors (P < 0.01; P < 0.01).

CONCLUSIONS: FNS is an effective method for treating FNFs in young adults, but there is still a certain risk of failure. The Garden classification is an important evaluation indicator for postoperative complications, with a higher failure rate observed in type IV fractures. Coronal plane position of the FNS bolt and reduction quality are significant risk factors for failure after FNS surgery for FNFs.

PMID:39710644 | DOI:10.1186/s12893-024-02692-w

Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Dec 6;58(12):1885-1893. doi: 10.3760/cma.j.cn112150-20240708-00545.

ABSTRACT

Objective: To investigate the distribution characteristics and analyze the clinical significance of dermatophagoides pteronyssinus allergen components in children with allergic rhinitis and asthma in Shenzhen. Methods: This study was a cross-sectional study. The clinical data of children with allergic rhinitis and asthma induced by dust mites admitted to the allergy clinic of Shenzhen Children’s Hospital from 2021 to 2024 were collected and the serum sIgE levels of dermatophagoides pteronyssinus, dermatophagoides farinae (Der p, Der f) and dermatophagoides pteronyssinus components (Der p 1, Der p 2, Der p 10, Der p 23) were detected by magnetic bead chemiluminescence method. The correlation between dermatophagoides pteronyssinus allergen components and clinical data of children was analyzed. According to the diagnosis, the children were divided into allergic rhinitis (AR) group and AR with asthma (ARAS) group. According to the age, the children were divided into preschool age (5 years ≤age<7 years), school age (7 years ≤age<10 years) and adolescence (10 years ≤age≤15 years). The expression differences of dermatophagoides pteronyssinus components among AR group and ARAS group and different age groups were compared. Results: A total of 314 children with allergic rhinitis and asthma caused by dust mites were included in the study, of whom 112 were male and 202 were female. There were 188 cases of AR and 126 cases of ARAS, aged 5-15 years, with a median age of 7.54 years and an average age of (8.02±2.24) years. BMI was 13.89-31.76 kg/m²,the median BMI was 15.87 kg/m² and average BMI was (16.55±3.05) kg/m². There was not statistically significant difference in gender, age, BMI, blood eosinophils, blood basophils, FeNO, FVC and FEV1 between the AR group and the ARAS group (P>0.05). There was significant difference in FEV1/FVC and small airway function indexes MMEF, MEF75%, MEF50% and MEF25% between the AR group and the ARAS group (P<0.05). In the 314 children, the dermatophagoides pteronyssinus allergen components sensitization rates were in the order of Der p 1 (97.1%), Der p 2 (89.8%), Der p 23 (55.1%), Der p 10 (8.6%), and the difference in the positive rate was statistically significant (χ²=658.31, P<0.001). There was not significant difference in Der p 1, Der p 2 and Der p 10 among children of different ages (P>0.05). There was significant difference in Der p 23 among children of different ages (χ²=7.29, P=0.03). A correlation analysis showed that Der p, Der f, Der p 1 and Der p 2 had a high positive correlation (P<0.001). Eosinophils are positively correlated with Der p, Der f, Der p 1, Der p 2, Der p 10 and Der p 23 (P<0.001). FeNO is positively correlated with Der p, Der f, and Der p 23 (P<0.05). Small airway function indicators MMEF, MEF50% and MEF25% are negatively correlated with Der p, Der f and Der p 1 (P<0.05). The sIgE levels of Der p, Der f, Der p 1, Der p 2 and Der p 10 in the AR group were significantly lower than those in the ARAS group (P<0.05). In the ARAS group, 120 cases (95.24%) showed positive results for at least 2 dermatophagoides pteronyssinus components, while 71 cases (56.35%) showed positive results for at least 3 dermatophagoides pteronyssinus components. In the AR group, 171 cases (90.96%) showed positive results for at least 2 dermatophagoides pteronyssinus components, while 94 cases (50.00%) showed positive results for at least 3 dermatophagoides pteronyssinus components. Conclusion: Der p 1, Der p 2 and Der p 23 may be the main dermatophagoides pteronyssinus allergen components that induce allergic rhinitis and asthma in Shenzhen City. The elevation of sIgE levels in the dermatophagoides pteronyssinus components can aggravate the severity of lower airway eosinophilic inflammation and airway obstruction. Attention should be paid to the detection of dermatophagoides pteronyssinus components in children with poor response to dust mite-allergen specific immunotherapy.

PMID:39710466 | DOI:10.3760/cma.j.cn112150-20240708-00545

J Oral Maxillofac Surg. 2024 Dec 4:S0278-2391(24)00977-7. doi: 10.1016/j.joms.2024.12.001. Online ahead of print.

ABSTRACT

BACKGROUND: Fibrous dysplasia/McCune-Albright syndrome (FD/MAS) is a genetic disorder, marked by bone lesions, often affecting the craniofacial skeleton. Pain is a prevalent yet heterogeneous symptom reported by patients with craniofacial FD. Effective treatments are currently lacking, posing a significant clinical challenge to patient care.

PURPOSE: This preliminary study examined pain profiles in craniofacial FD and aimed to identify subtypes of patients based on pain phenotypes and emotional health.

STUDY DESIGN, SETTING, SAMPLE: A prospective, cross-sectional study involving 15 patients with FD/MAS, conducted at Boston Children’s Hospital and Massachusetts General Brigham’s Hospitals.

PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: Headache frequency, craniofacial pain severity, neuropathic pain quality, pain interference, allodynia, photophobia, depression, and anxiety were assessed using clinical questionnaires.

MAIN OUTCOME VARIABLE(S): The primary outcome variable was the symptom profile derived from standardized clinical questionnaires and analyzed using principal component analysis and K-means clustering.

COVARIATES: Covariates included demographic data, diagnosis, and lesion location(s).

ANALYSES: Principal component analysis and K-means clustering of patient-reported measures of pain and emotional health were performed. Analysis of variance was conducted to determine significant differences among patient subtypes. Statistical significance was set at (P < .05).

RESULTS: The study included 15 subjects with FD/MAS, with a mean age of 36.2 (13.9) years, including 1 male. Clustering analysis identified 3 subtypes of patients with distinct symptom profiles. Cluster 1 (n = 2) averaged 70 (28.3) headache days in a 90-day period, pain level of 7.5 (0.7) on a 0-10 scale, and severe anxiety, depression, allodynia, photophobia, and pain interference. Cluster 2 (n = 7) patients reported an average of 5.4 (7.5) headache days, an average pain level of 2.7 (2.6), mild or no anxiety, depression, allodynia, photophobia, and pain interference. Cluster 3 (n = 6) patients displayed a mixed symptom profile with an average of 47.3 (36.4) headache days and a pain level of 5.25 (1.4). Notably, patients with temporal and skull base lesions were predominantly found in Clusters 1 and 3, which exhibited the most severe symptomatology.

CONCLUSIONS AND RELEVANCE: This study establishes a basis for future longitudinal research aimed at understanding underlying pain mechanisms and evaluating the response to personalized pain management strategies in subtypes of patients with craniofacial FD.

PMID:39710366 | DOI:10.1016/j.joms.2024.12.001

J Oral Maxillofac Surg. 2024 Dec 9:S0278-2391(24)00979-0. doi: 10.1016/j.joms.2024.11.016. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with cleft lip and palate (CLP) often exhibit unique anatomical variations in the pterygoid plates, which can influence fracture patterns at the pterygomaxillary junction (PMJ) during Le Fort I osteotomy. These differences may increase the risk of unfavorable fractures, complicating surgery and recovery.

PURPOSE: The study purpose was to measure the association between the osteotomy level with the PMJ fracture patterns in CLP patients undergoing Le Fort I osteotomy.

STUDY DESIGN, SETTING, AND SAMPLE: This retrospective cohort study included 100 patients with CLP, representing 200 tomographic views of the right and left pterygomaxillary regions. Preoperative tomographic scans were analyzed to measure morphometric features of the pterygomaxillary suture in the axial and sagittal planes.

PREDICTOR VARIABLE: The primary predictor was osteotomy level: at the level or above of the PMJ.

MAIN OUTCOME VARIABLE: The main outcome was the pterygomaxillary fracture pattern, categorized as favorable or unfavorable.

COVARIATES: The covariates included age, sex, side of the mandible, pterygomaxillary suture thickness, pterygomaxillary suture width, distance between the greater palatine canal and the pterygoid suture, length of the medial plate, length of the lateral plate, insertion of the pterygomaxillary suture in the posterior part of the maxilla, and the length and height of the tuber.

ANALYSIS: Statistical analyses included t-tests for mean differences (P < .05) and χ² tests for associations. Relative risk was calculated for osteotomy levels to assess the significance of associations with fracture patterns.

RESULTS: The study comprised 100 participants (47 men, 53 women), with a mean age of 23 years (SD = 2.31). In total, 110 (55%) fractures were classified as favorable. The frequency of unfavorable fractures was significantly higher when the osteotomy was performed above the PMJ (P < .005). The relative risk for unfavorable fractures was 23.06 on the right side (95% confidence interval = [5.94, 89.53], P < .001) and 65.00 on the left side (95% confidence interval = [9.30, 454.52], P < .001).

CONCLUSION: The study findings suggest that in cleft surgery the osteotomy should be performed at the level of the PMJ to reduce the risk of inadvertent pterygomaxillary fractures.

PMID:39710365 | DOI:10.1016/j.joms.2024.11.016

Chest. 2024 Dec 20:S0012-3692(24)05717-9. doi: 10.1016/j.chest.2024.12.015. Online ahead of print.

ABSTRACT

BACKGROUND: A large number of symptomatic individuals with central sleep apnea (CSA) in clinical practice have an indication for adaptive servo-ventilation (ASV) therapy.

RESEARCH QUESTION: What are the effects of ASV therapy on sleep quality and PROMs in patients with CSA across a range of devices and indications.

METHODS: This prospective, multicenter, observational cohort study was conducted in France and enrolled participants from June 2017 to February 2020. Adults with predominant CSA at diagnosis or obstructive sleep apnea with central events not controlled with continuous positive airway pressure who had an indication for ASV were eligible. Participants attended clinic visits at baseline, and after 1, 3, 6 and 12 months of follow-up. The primary endpoint was the change in Pittsburgh Sleep Quality Index (PSQI) score from baseline to 6-month follow-up (evaluated using a Wilcoxon signed rank test on paired data).

RESULTS: We included 526 individuals (median age 69 years, 88.2% male). The indication for ASV included CSA with cardiovascular/neurologic etiology (38.4%), treatment-emergent CSA (36.1%), idiopathic CSA (14.1%) or drug-induced CSA (11.4%). At 6-month follow-up, study participants were using ASV for a median of 6.1 h/night. The median [interquartile range] change in the PSQI score from baseline to 6 months in the overall study population was -1 [-3; 0] (p<0.001), with significant results across all indications for ASV except for drug-induced CSA, where the median change was similar to the overall result but did not achieve statistical significance (-1 [-2; 1]; p=0.0866). Overall, 65% of participants had a ≥1-point improvement in the PSQI.

INTERPRETATION: Individuals with a clinical indication for ASV therapy experienced improved sleep quality during real-world treatment, irrespective of which ASV device was used.

PMID:39710250 | DOI:10.1016/j.chest.2024.12.015

World Neurosurg. 2024 Dec 20:123593. doi: 10.1016/j.wneu.2024.123593. Online ahead of print.

ABSTRACT

This paper reviews the historical progression of ventriculoperitoneal shunt valve designs with the goal of providing an understanding of their functionality and failure mechanisms. While shunting is the predominant treatment for hydrocephalus, the statistics of overall shunt failure remain high, and valve failure is responsible for a significant percentage of revision surgeries. Therefore, this review spans valve evolution from an engineering perspective with an emphasis on discussing potential failure mechanisms and patient specific valve selection. Information is provided on the importance of valves in hydrocephalus treatment with discussion on each class of valves and their advantages and shortcomings. Substantial development over decades has significantly improved valve functionality, and ongoing research continues to provide more robust valves and shunt systems for hydrocephalus management.

PMID:39710199 | DOI:10.1016/j.wneu.2024.123593

World Neurosurg. 2024 Dec 20:123586. doi: 10.1016/j.wneu.2024.123586. Online ahead of print.

ABSTRACT

BACKGROUND: While studies have examined the relationship between sex and outcomes after lumbar fusion surgery, few have strictly controlled for other patient-level variables. In this study, we use coarsened exact matching to determine the effect of patient-reported sex on spinal fusion outcomes.

METHODS: Outcomes across 4680 consecutive adult single-level, posterior-only lumbar fusions at a multihospital academic medical center were retrospectively assessed. First, univariate analyses were performed to broadly examine the effect of sex on surgical outcomes, uncontrolled for other patient factors. Next, the population was split by sex (male vs. female) and matched 1:1 on demographic and medical factors known to influence outcomes (including age, race, smoking status, and past surgical history) using coarsened exact matching (CEM). CEM effectively controls for confounding variable bias by creating pairs of matched samples and preserving the fidelity of each covariate through binning. Primary outcomes included 30- and 90-day readmissions, Emergency Department visits, reoperations, and mortality. Secondary outcomes included discharge disposition and length of hospital stay.

RESULTS: Between otherwise exactly matched male-female pairs, females were less likely to be discharged home (OR 1.70, p<0.001) and had a longer length of stay (mean: 95.7 vs 87 hr, p<0.001). No differences in readmissions or reoperations were observed between matched cohorts.

CONCLUSION: Female patients encountered longer hospital stays and higher odds of non-home discharge after single-level lumbar fusion compared to otherwise exactly matched male patients.

PMID:39710198 | DOI:10.1016/j.wneu.2024.123586

World Neurosurg. 2024 Dec 20:123585. doi: 10.1016/j.wneu.2024.123585. Online ahead of print.

ABSTRACT

OBJECTIVE: Cervical medial branch blocks (CMBB) are frequently used for the treatment of facet arthropathy. The present study compares the effectiveness of lidocaine and prilocaine in CMBB procedures.

METHODS: Patients with facet arthropathy scheduled for CMBB were randomly divided into two groups who were administered a combination of 2 mg dexamethasone and either 1% lidocaine or 1% prilocaine with a total volume of 1 mL per level. All patients were assessed prior to the procedure (baseline), and at 1 hour, 1 week and 1 month after the procedure using the Numeric Rating Scale-11 (NRS-11), Neck Disability Index (NDI), and patient satisfaction was evaluated at 1 hour, 1 week and 1 month after the procedure.

RESULTS: A total of 97 patients were included in the study (n = 49 in the lidocaine group and n = 48 in the prilocaine group). A significant decrease was noted in the NRS-11 and NDI scores recorded during all follow-up assessments in both groups (p<0.001), while the NRS-11, NDI scores and patient satisfaction did not statistically differ between groups at 1 hour, 1 week and 1 month following the procedure (p˃0.05).

CONCLUSION: CMMB achieved with either lidocaine or prilocaine decreased the recorded pain severity and disability scores to a similar degree. The selection of either lidocaine or prilocaine for CMBB is thus at the clinician’s discretion.

PMID:39710195 | DOI:10.1016/j.wneu.2024.123585