Identify Group Differences Research Articles

Impaired Sleep-Dependent Memory Consolidation in Pediatric Narcolepsy Type 1.

Disrupted nighttime sleep (DNS) is common in pediatric Narcolepsy type 1, yet its cognitive impact is unknown. As N2 sleep spindles are necessary for sleep-dependent memory consolidation, we hypothesized that Narcolepsy Type 1 impairs memory consolidation via N2 sleep fragmentation and N2 sleep spindle alterations. We trained 28 pediatric Narcolepsy Type 1 participants and 27 healthy controls (HC) on a spatial declarative memory task before a nocturnal in-lab polysomnogram and then gave them a cued recall test upon awakening in the morning. We extracted wake and sleep stage bout numbers and N2 spindle characteristics from the polysomnogram and conducted mixed model analysis of sleep-dependent memory consolidation to identify group differences. Narcolepsy Type 1 participants had shorter N2 bout durations and associated shorter N2 spindles vs. HC, but other N2 spindle features were similar. Narcolepsy Type 1 participants had worse memory performance post-sleep than HCs after adjusting for age and gender (mean memory consolidation HC: -3.1% ± 18.7, NT1: -15.6 ± 24.8, main effect group x time of testing F=5.3, p=0.03). We did not find significant relationships between sleep-dependent memory consolidation and N2 spindle characteristics. Notably, increased N1% was associated with worse sleep-dependent memory consolidation with results driven by the Narcolepsy Type 1 group. Sleep-dependent memory consolidation is mildly impaired in youth with Narcolepsy Type 1 and findings may be attributed to increases in N1 sleep. Further studies are needed to determine if these findings are generalizable and reversible with sleep-based therapies.

Comorbid Diabetes Is Associated with Dyspnea Severity and Cardiometabolic Biomarkers in Black Adults with Heart Failure.

Comorbidities such as type 2 diabetes mellitus significantly and adversely influence heart failure outcomes, especially in Black adult populations. Likewise, heart failure has a negative effect on diabetes and cardiometabolic outcomes. Dyspnea, a common symptom of heart failure, often correlates with disease severity and prognosis. However, the relationship between comorbid diabetes, dyspnea severity, and cardiometabolic biomarkers in Black adults with heart failure remains understudied. The purpose of this pilot study was to examine differences in the distressing heart failure symptom of dyspnea and in cardiometabolic and inflammatory biomarkers in Black adults living with heart failure with and without diabetes. Black adults with heart failure were enrolled in this cross-sectional pilot study. Cardiometabolic and inflammatory biomarkers were measured via multiplex immunoassay. Univariate general liner models were used to identify group differences between persons with heart failure with comorbid diabetes and those without, controlling for age, sex, and comorbid burden. Participants were mostly female with a mean age of 55 years and mean left ventricular ejection fraction of 33%. Participants with diabetes exhibited higher dyspnea scores compared to those without diabetes, indicating greater symptom burden. Moreover, individuals with comorbid diabetes demonstrated higher levels of cardiometabolic and inflammatory markers. Comorbid diabetes was associated with higher dyspnea severity and adverse cardiometabolic profiles in Black adults with heart failure. These findings underscore the importance of targeted interventions addressing diabetes management and cardiometabolic risk factors to improve symptom control and outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and develop tailored therapeutic strategies for managing comorbidities in persons with heart failure, particularly in minoritized communities.

Structural alterations in a rumination-related network in patients with major depressive disorder

Rumination is a common symptom in major depressive disorder (MDD). Previous work has connected individual differences in rumination to structural properties in various brain regions. Some of these, such as the dorsolateral prefrontal cortex (dlPFC), have also been highlighted as being altered in MDD, suggesting a connection between structural changes and ruminative symptoms. Although informative, such localised relations have limitations in the context of a network view of the brain. To further investigate rumination-related structural changes in depression, and to situate these within potential functional networks, we acquired T1-weighted structural MRI data from patients with MDD (n=32) and controls (n=69). Rumination was measured with the Rumination Response Scale. Surface-based, whole-brain analysis of cortical grey-matter identified group differences in the dlPFC that were, however, not related to rumination. Instead, rumination was correlated with grey-matter properties in the right precuneus. Using normative functional connectivity analysis on an independent sample (n = 100), we show these two regions to be interconnected. Further developing a network-based perspective, it was shown that the rumination-related precuneus region is connected with networks associated with processes such as executive function, autobiographical memory, and visual perception. Notably, these processes have been connected to rumination. These results suggest that rumination in depression may be linked to focal structural changes. The effects of these focal changes on rumination may then be connected to their influence on distributed functional networks.

Contribution of resting-state functional connectivity of the subgenual anterior cingulate to prediction of antidepressant efficacy in patients with major depressive disorder

This study investigated how resting-state functional connectivity (rsFC) of the subgenual anterior cingulate cortex (sgACC) predicts antidepressant response in patients with major depressive disorder (MDD). Eighty-seven medication-free MDD patients underwent baseline resting-state functional MRI scans. After 12 weeks of escitalopram treatment, patients were classified into remission depression (RD, n = 42) and nonremission depression (NRD, n = 45) groups. We conducted two analyses: a voxel-wise rsFC analysis using sgACC as a seed to identify group differences, and a prediction model based on the sgACC rsFC map to predict treatment efficacy. Haufe transformation was used to interpret the predictive rsFC features. The RD group showed significantly higher rsFC between the sgACC and regions in the fronto-parietal network (FPN), including the bilateral dorsolateral prefrontal cortex (DLPFC) and bilateral inferior parietal lobule (IPL), compared to the NRD group. These sgACC rsFC measures correlated positively with symptom improvement. Baseline sgACC rsFC also significantly predicted treatment response after 12 weeks, with a mean accuracy of 72.64% (p < 0.001), mean area under the curve of 0.74 (p < 0.001), mean specificity of 0.82, and mean sensitivity of 0.70 in 10-fold cross-validation. The predictive voxels were mainly within the FPN. The rsFC between the sgACC and FPN is a valuable predictor of antidepressant response in MDD patients. These findings enhance our understanding of the neurobiological mechanisms underlying treatment response and could help inform personalized treatment strategies for MDD.

Characteristics of locus coeruleus functional connectivity network in patients with comorbid migraine and insomnia

BackgroundMigraine and insomnia are prevalent conditions that often co-occur, each exacerbating the other and substantially impacting the quality of life. The locus coeruleus (LC), a brainstem region responsible for norepinephrine synthesis, participates in pain modulation, sleep/wake cycles, and emotional regulation, rendering it a potential nexus in the comorbidity of migraine and insomnia. Disruptions in the LC-noradrenergic system have been hypothesized to contribute to the comorbidities of migraine and insomnia, although neuroimaging evidence in humans remains scarce. In this study, we aimed to investigate the intrinsic functional connectivity (FC) network of the LC in patients with comorbid migraine and subjective chronic insomnia and patients with migraine with no insomnia (MnI) using resting-state functional magnetic resonance imaging (rs-fMRI) and seed-based FC analyses.MethodsIn this cross-sectional study, 30 patients with comorbid migraine and chronic insomnia (MI), 30 patients with MnI, and 30 healthy controls (HCs) were enrolled. Participants underwent neuropsychological testing and rs-fMRI. The LC-FC network was constructed using seed-based voxel-wise FC analysis. To identify group differences in LC-FC networks, voxel-wise covariance analysis was conducted with sex and age as covariates. Subsequently, a partial correlation analysis was conducted to probe the clinical relevance of aberrant LC-FC in patients with MI and MnI.ResultsExcept for the insomnia score, no other significant difference was detected in demographic characteristics and behavioral performance between the MI and MnI groups. Compared with HCs, patients with MI exhibited altered LC-FC in several brain regions, including the dorsomedial prefrontal cortex (DMPFC), anterior cerebellum, dorsolateral prefrontal cortex (DLPFC), thalamus, and parahippocampal gyrus (PHG). Lower FC between the LC and DLPFC was associated with greater insomnia severity, whereas higher FC between the LC and DMPFC was linked to longer migraine attack duration in the MI group.ConclusionOur findings reveal the presence of aberrant LC-FC networks in patients with MI, providing neuroimaging evidence of the interplay between these conditions. The identified LC-FC alterations may serve as potential targets for therapeutic interventions and highlight the importance of considering the LC-noradrenergic system in the management of MI.

A - 129 Healthcare Disparity between Dominant English Versus Spanish-Speaking Deep Brain Stimulation Candidates with Parkinson’s Disease

Abstract Objective The existence of healthcare disparities is well documented, although data regarding mental health disparities in pre-surgical deep brain stimulation surgery (DBS) patients with Parkinson’s disease (PD) remains emergent. In this study, we compare mood, apathy, and quality of life (QoL) in dominant English and Spanish-speaking PD-DBS candidates. We hypothesized that presurgical PD-DBS Spanish-speakers would have greater disease burden and lower mood and QoL compared to native English-speakers. Method Demographic and disease specific characteristics including disease duration and severity (Unified Parkinsons Disease Rating Scale (MDS-UPDRS)), mood (Beck Depression Inventory-II (BDI-II), Starkstein Apathy Scale (SAS)), and QoL (Parkinson’s Disease Questionnaire-39 (PDQ-39)) were compared. Data were analyzed using independent t-tests and chi-square tests to identify group differences based on language dominance (English (n = 20), Spanish (n = 20)). Results Spanish-speakers had higher disease burden (MDS-UPDRS “on”: p = 0.018; “off”: p = 0.023), but no other statistical significance in demographic or clinical motor characteristics. There were significant group differences in mood (BDI-II: p = 0.046), PDQ-39 Total and subdomain scores (Total: p = 0.017; ADL: p = 0.005; Mobility: p = 0.007; Emotional Wellbeing: p = 0.029; and Bodily Discomfort: p = 0.007) with Spanish-speakers reporting poorer QoL. No significant group differences were found regarding apathy. Conclusion(s) Spanish-speakers demonstrated greater disease burden and endorsed significantly lower QoL and depression symptoms compared to English speakers. These data add to our understanding of healthcare disparities among presurgical PD-DBS candidates and suggest that underrepresented groups, such as dominant Spanish-speakers, may have less access to early intervention, missed PD symptomology, and/or cultural apprehension about seeking medical care, thus increasing disease burden and impacting QoL over time.

Transdiagnostic failure to adapt interoceptive precision estimates across affective, substance use, and eating disorders: A replication and extension of previous results

Recent Bayesian theories of interoception suggest that perception of bodily states rests upon a precision-weighted integration of afferent signals and prior beliefs. In a previous study, we fit a computational model of perception to behavior on a heartbeat tapping task to test whether aberrant precision-weighting could explain misestimation of cardiac states in psychopathology. We found that, during an interoceptive perturbation designed to amplify afferent signal precision (inspiratory breath-holding), healthy individuals increased the precision-weighting assigned to ascending cardiac signals (relative to resting conditions), while individuals with anxiety, depression, substance use disorders, and/or eating disorders did not. In this pre-registered study, we aimed to replicate and extend our prior findings in a new transdiagnostic patient sample (N = 285) similar to the one in the original study. As expected, patients in this new sample were also unable to adjust beliefs about the precision of cardiac signals – preventing the ability to accurately perceive changes in their cardiac state. Follow-up analyses combining samples from the previous and current study (N = 719) also afforded power to identify group differences between narrower diagnostic categories, and to examine predictive accuracy when logistic regression models were trained on one sample and tested on the other. With this confirmatory evidence in place, future studies should examine the utility of interoceptive precision measures in predicting treatment outcomes and test whether these computational mechanisms might represent novel therapeutic targets.

Career identity among children leaving out-of-home care: Implications on Self-Esteem and Self-Efficacy

ObjectiveThis study explores the career identity and self-concept (self-esteem and self-efficacy) of adolescents leaving out-of-home care and also examines how these two constructs are associated. MethodData were from the 2021 Independent Living Settlement Compulsory Education for Adolescents Leaving Residential Out-of-Home Care Survey. The sample included 220 children living across Gyeonggi Province, South Korea. We used latent profile analysis (LPA) for profile classification, ANOVA for identifying group differences on career identity and self-concept, and multiple regression analysis to predict self-esteem and self-efficacy with different types of career identity. ResultsAdolescents with moderate to high career identity accounted for 76.4% of the sample and they were more likely to have higher levels of self-esteem and self-efficacy compared to those with lower career identity. For Self-Doubt group, it seemed that children had mixed feelings of self-doubt and some confidence although they reported quite reasonable levels of career exploration and preparation. In addition, adolescents with higher scores of good mental health were more likely to have higher levels of self-esteem and self-efficacy. ConclusionsAdolescents with higher levels of career identity tend to have better self-concept, such as high self-esteem and self-efficacy. An integrated intervention approach is essential for adolescents leaving out-of-home care building confidence in themselves as well as having a clear career path.

The Effects of Language Background and Parental Education on Measures of Cognitive Ability: An Analysis of the WPPSI-IV Cognitive Profiles of Monolingual, Simultaneous Bilingual, and Sequential Bilingual German Children Aged 4 to 7 Years.

The present study investigated the possible effects of language background (monolinguals, simultaneous bilinguals, and sequential bilinguals) and parental education (no/low, medium, high, and highest parental education) on measures of cognitive ability provided by the Wechsler Primary and Preschool Scale-Fourth Edition (WPPSI-IV). Statistical analyses were based on a sample of 290 children (130 females, 160 males). Three multivariate variance analyses were conducted to identify possible effects. In cases of statistically significant main effects, post hoc analyses were additionally performed to identify group differences. The results indicated that simultaneous bilinguals performed more similarly to monolinguals than sequential bilinguals. On average, sequential bilinguals achieved significantly lower scores on the Verbal Comprehension Index (VCI), the Vocabulary Acquisition Index (VAI), and the associated subtests than monolinguals and simultaneous bilinguals. Significantly lower average scores on VAI and the associated subtests were found for simultaneous bilinguals compared to monolinguals. Children with parents having no, a lower, or a medium educational level achieved significantly lower scores on VCI, VAI, and the FSIQ than children with parents having a high or highest educational level on average. The present findings suggest that the WPPSI-IV represents a suitable and reliable test battery for the assessment of cognitive skills in children with different language backgrounds and parental educational levels.

One size does not fit all: notable individual variation in brain activity correlates of antidepressant treatment response.

To date, no robust electroencephalography (EEG) markers of antidepressant treatment response have been identified. Variable findings may arise from the use of group analyses, which neglect individual variation. Using a combination of group and single-participant analyses, we explored individual variability in EEG characteristics of treatment response. Resting-state EEG data and Montgomery-Åsberg Depression Rating Scale (MADRS) symptom scores were collected from 43 patients with depression before, at 1 and 12 weeks of pharmacotherapy. Partial least squares (PLS) was used to: 1) identify group differences in EEG connectivity (weighted phase lag index) and complexity (multiscale entropy) between eventual medication responders and non-responders, and 2) determine whether group patterns could be identified in individual patients. Responders showed decreased alpha and increased beta connectivity, and early, widespread decreases in complexity over treatment. Non-responders showed an opposite connectivity pattern, and later, spatially confined decreases in complexity. Thus, as in previous studies, our group analyses identified significant differences between groups of patients with different treatment outcomes. These group-level EEG characteristics were only identified in ~40-60% of individual patients, as assessed quantitatively by correlating the spatiotemporal brain patterns between groups and individual results, and by independent raters through visualization. Our single-participant analyses suggest that substantial individual variation exists, and needs to be considered when investigating characteristics of antidepressant treatment response for potential clinical applicability. https://clinicaltrials.gov, identifier NCT00519428.

Nano-curcumin in the decrease of proteinuria in white rats (Rattus norvegicus) with preeclampsia

HIGHLIGHTS The size of curcumin was modified to nano scale in order to enhance its bioavailability and facilitate its absorption in the body. As a herbal medicine, nano-curcumin has the ability to reduce proteinuria and serve as a preventive measure against preeclampsia. ABSTRACT Objective: Since preeclampsia is one of the most serious hypertensive disorders in pregnancy, as it occurs in 5-7% of all pregnancies, and causes around 70,000 maternal deaths and 500,000 fetal deaths worldwide each year, this study aimed to determine the effect of nano-curcumin on proteinuria in pregnant white rats (Rattus norvegicus) with preeclampsia. Materials and Methods: In this study, 24 white rats (Rattus norvegicus) were randomly selected and divided into six groups. Inclusion criteria included healthy rats aged 8 weeks or older, with normal blood pressure and weight, while exclusion criteria included sick, deceased, or prematurely birthing rats, and those with high blood pressure. Treatment, administered over six days from gestational days 13-18, involved L-NAME and nano-curcumin injections. Groups included K- (no treatment) and K+, P1, P2, P3, and P4 (treated with L-NAME and varying nano-curcumin doses). Blood pressure and proteinuria were evaluated on gestation days 12, 15, and 19 to confirm the preeclampsia model and assess nano-curcumin's effect on proteinuria. Urine collected over 24 hours in metabolic cages preceded rat termination. Data analysis utilized IBM SPSS version 23, including the Shapiro-Wilk test, parametric independent sample t-tests, One-Way ANOVA tests, and LSD post-hoc tests to identify group differences. Results: The results of this study showed that nano-curcumin had the effect of reducing proteinuria in white rats with preeclampsia. The significant results of the One-Way Anova test was p=0.001 &lt;0.05 and the LSD post-hoc test revealed that an effective dose was 25 mg/ml. It was found that higher nano-curcumin dose had a higher average of proteinuria. Conclusion: Nano-curcumin can affect proteinuria in preeclampsia. The most effective dose is 25 mg/ml.

Affective norms for 501 Chinese words from three emotional dimensions rated by depressive disorder patients.

Emotional words are often used as stimulus material to explore the cognitive and emotional characteristics of individuals with depressive disorder, while normal individuals mostly rate the scores of affective words. Given that individuals with depressive disorder exhibit a negative cognitive bias, it is possible that their depressive state could influence the ratings of affective words. To enhance the validity of the stimulus material, we specifically recruited patients with depression to provide these ratings. This study provided subjective ratings for 501 Chinese affective norms, incorporating 167 negative words selected from depressive disorder patients' Sino Weibo blogs, and 167 neutral words and 167 positive words selected from the Chinese Affective Word System. The norms are based on the assessments made by 91 patients with depressive disorder and 92 normal individuals, by using the paper-and-pencil quiz on a 9-point scale. Regardless of the group, the results show high reliability and validity. We identified group differences in three dimensions: valence, arousal, and self-relevance: the depression group rated negative words higher, but positive and neutral words lower than the normal control group. The emotional perception affected the individual's perception of words, to some extent, this database expanded the ratings and provided a reference for exploring norms for individuals with different emotional states.

Surgical Force: Initial Study and Clinical Implications in the Assessment of Ureteral Access Sheath Induced Injury.

Purpose: Ureteral access sheaths (UAS) pose the risk of severe ureteral injury. Our prior studies revealed forces ≤6 Newtons (N) prevent ureteral injury. Accordingly, we sought to define the force urologists and residents in training typically use when placing a UAS. Materials and Methods: Among urologists and urology residents attending two annual urological conferences in 2022, 121 individuals were recruited for the study. Participants inserted 12F, 14F, and 16F UAS into a male genitourinary model containing a concealed force sensor; they also provided demographic information. Analysis was completed using t-tests and Chi-square tests to identify group differences when passing a 16F sheath UAS. Participant traits associated with surpassing or remaining below a minimal force threshold were also explored through polychotomous logistic regression. Results: Participant force distributions were as follows: ≤4N (29%), >6N (45%), and >8N (32%). More years of practice were significantly associated with exerting >6N relative to forces between 4N and 6N; results for >8N relative to 4N and 8N were similar. Compared to high-volume ureteroscopists (those performing >20 ureteroscopies/month), physicians performing ≤20 ureteroscopies/month were significantly less likely to exert forces ≤4N (p = 0.017 and p = 0.041). Of those surpassing 6N and 8N, 15% and 18%, respectively, were high-volume ureteroscopists. Conclusions: Despite years of practice or volume of monthly ureteroscopic cases performed, most urologists failed to pass 16F access sheaths within the ideal range of 4N to 6N (74% of participants) or within a predefined safe range of 4N to 8N (61% of participants).

Kinematic Sequence Differences Between Trained Baseball Players and Untrained Adolescent Individuals.

An overhead throwing motion is a common gross motor skill often taught in early childhood to improve physical activity participation. Yet, research investigating motor efficiency in overhead throws often focuses on improving performance in trained individuals. This project compares kinematic sequencing between trained and untrained youth. After a brief warm-up, untrained high school students (N = 9) and trained high school and college students (N = 10) threw a weighted tennis ball for accuracy (N = 10 throws). Upper extremity angular velocities were collected using 3-dimensional inertial sensor motion capture. Kinematic sequencing of joints and segments (pelvis, trunk, shoulder, elbow, and wrist) was assessed using Kruskal-Wallis test; Friedman and Wilcoxon tests identified group differences between sequences. Seven independent kinematic sequences were identified (N = 2 unique trained; N = 3 unique untrained; N = 2 shared). The rankings for the trained group maintained a mostly consistent pattern with only elbow and wrist joints producing similar rankings. The untrained group lacked that consistency with similar rankings of elbow versus wrist and shoulder versus elbow. Trained individuals threw with a more efficient proximal-to-distal sequencing pattern than the untrained participants, specifically at the trunk and shoulder. Continuous training of gross motor skills beyond initial skill development is necessary to maintain motor proficiency.

Exploring the Utility of Narrative Comprehension and Production Tasks to Identify Vocabulary Delay Using Eye-Tracker

Objectives: The purpose of this study was to identify group differences in various aspects of narrative tasks performance (comprehension, production, and eye-tracking variables) and finally to explore whether narrative tasks can be used to detect vocabulary delay.Methods: Children in the 1st and 2nd grades (TD= 101, VD= 22) of elementary school participated in this study. All children participated in story comprehension and production tasks, and eye-tracking variables were extracted from two reading conditions (‘listening+reading’, and ‘reading’) in the story comprehension task.Results: There was a significant difference between the two groups in the ‘listening+reading’ condition in the story comprehension task, the ‘construction’ condition in the story production task, and the ‘total fixation duration (TFD)’ in the eye-tracking variables. We examined the ability of the story performances to discriminate vocabulary delays, and found that a total of 79.6% of the original cases based on the standardized vocabulary test could be correctly classified by the story performance variables. The ROC curve also showed that 84.6% of the children could be validly identified by a combination of narrative comprehension scores in the ‘listening+reading’ condition, narrative production scores in the ‘structure’ condition, and TFD in the ‘listening+reading’ condition of comprehension task.Conclusion: The significance of this study is that it explored the possibility of using narrative tasks as a useful tool for identifying micro-level vocabulary delays.

Morphosyntactic profiles among preschoolers with and without speech sound disorders

ABSTRACT The aim of the current study was to identify whether certain morphosyntactic constructs are more difficult for children with speech sound disorder than children with typical speech development. In this post-hoc study, we used chi-square analyses to identify group differences on individual questions on a standardised test of expressive morphosyntax. Participants included 80 preschool-age children, 40 with typical speech and language development (TD), and 40 with speech sound disorder and typical language development (SSD). A chi-square analysis revealed group (TD vs. SSD) differences in usage of subject pronouns, irregular past tense verbs, and yes/no interrogative formation. Ordinal logistic regression revealed that phonological awareness was related to irregular past tense verb use. Children with SSD may present with subclinical morphosyntax difficulties. Speech-language pathologists should consider incorporating morphosyntax assessment into test batteries for children with SSD.

Comparison of Attitude and Insight Toward Illness Between in Patients with Bipolar I Disorder Manic Episode and Major Depressive Disorder.

Studies comparing insight toward illness in patients with bipolar I disorder manic episode and in patients with major depressive disorder are scarce. The aim of this study was to investigate the attitudes and insight of patients with bipolar I disorder in manic episode and in patients with major depressive disorder. In total, 86 patients were recruited, including 52 inpatients with bipolar I disorder in manic episodes and 34 inpatients with major depressive disorder. Attitudes toward illness were evaluated using the Self-Appraisal of Illness Questionnaire. Higher Self-Appraisal of Illness Questionnaire scores indicate better awareness and positive attitudes toward one's illness. Insights were assessed using the Insight Scale for Affective Disorders. Higher scores indicate poorer insight. To identify group differences, we used Mann-Whitney U test for statistical analysis. In the Self-Appraisal of Illness Questionnaire, items 1, 2, 3, 4, 6, 7, 10, 15, and 17 showed significantly lower scores in patients with bipolar I disorder than those with major depressive disorder (P < .05). All 3 subscales (presence/outcome of illness, need for treatment, and worry) of the Self-Appraisal of Illness Questionnaire revealed significantly lower scores in the bipolar I disorder group (P < .05). In the Insight Scale for Affective Disorders, items 3, 4, 12, and 16 showed significantly higher scores in the bipolar I disorder group (P < .05). Patients with major depressive disorder had significantly more positive attitudes and greater insight than those with bipolar I disorder. Patients with bipolar I disorder are less aware of their symptoms, including changes in mood, speed of mental functioning, and social relationships. The clinicians may integrate the findings into treatment plans for mood disorders.

Differential effect of heteronymous feedback from femoral nerve and quadriceps muscle stimulation onto soleus H-reflex.

Excitatory feedback from muscle spindles, and inhibitory feedback from Golgi tendon organs and recurrent inhibitory circuits are widely distributed within the spinal cord to modulate activity between human lower limb muscles. Heteronymous feedback is most commonly studied in humans by stimulating peripheral nerves, but the unique effect of non-spindle heteronymous feedback is difficult to determine due to the lower threshold of excitatory spindle axons. A few studies suggest stimulation of the muscle belly preferentially elicits non-spindle heteronymous feedback. However, there remains a lack of consensus on the differential effect of nerve and muscle stimulation onto the H-reflex, and the relation of the heteronymous effects onto H-reflex compared to that onto ongoing EMG has not been determined. In this cross-sectional study, we compared excitatory and inhibitory effects from femoral nerve and quadriceps muscle belly stimulation onto soleus H-reflex size in 15 able-bodied participants and in a subset also compared heteronymous effects onto ongoing soleus EMG at 10% and 20% max. Femoral nerve stimulation elicited greater excitation of the H-reflex compared to quadriceps stimulation. The differential effect was also observed onto ongoing soleus EMG at 20% max but not 10%. Femoral nerve and quadriceps stimulation elicited similar inhibition of the soleus H-reflexes, and these results were better associated with soleus EMG at 20%. The results support surface quadriceps muscles stimulation as a method to preferentially study heteronymous inhibition at least in healthy adults. The primary benefit of using muscle stimulation is expected to be in persons with abnormal, prolonged heteronymous excitation. These data further suggest heteronymous feedback should be evaluated with H-reflex or onto ongoing EMG of at least 20% max to identify group differences or modulation of heteronymous feedback in response to treatment or task.

Is it possible to decrease the occurrence of dental implant failures through the use of preventative antibiotics?

The research was a randomized placebo-controlled clinical trial evaluating the use of clindamycin as a preoperative medication to prevent the dental implant. The purpose of the study was to assess if giving a single dose of 600 mg oral clindamycin 1 h before a conventional dental implant procedure could reduce the risk of early implant failure and post-surgical complications in healthy adults. A clinical trial was conducted with ethical standards, utilizing a randomized, double-blind, placebo-controlled approach. Healthy adults who required a single oral implant and had no previous surgical site infection or need for bone grafting were enrolled. Before surgery, participants were given either oral clindamycin or placebo at random. A single surgeon performed all operations, and patients were observed by a trained professional on multiple postoperative days. The study considered early dental implant failure as the loss or removal of an implant. Clinical, radiological, and surgical data were analyzed statistically to identify group differences. The number of subjects needed to treat, or harm, was calculated. The research involved two groups of 31 patients each: the control group and the clindamycin group. Two patients in the clindamycin group experienced implant failures (NNH = 15, p = 0.246). Three patients in the study had postoperative infections; two of them were from the placebo group, while one from the clindamycin group had an unsuccessful treatment outcome. The relative risk was 0.5, with a CI of 0.05-5.23 and an absolute risk reduction of 0.03. The confidence interval was -0.07-0.13, and the NNT was 31, with a CI of 7.2-∞ and p = 0.5. In addition, only one patient treated with clindamycin reported gastrointestinal disturbances and diarrhea. There is no conclusive evidence to suggest that administering clindamycin prior to oral implant surgery in healthy adults reduces the risk of implant failure or post-surgical complications.

Poster 343: How Does the Literature on Minimum Clinically Important Difference (MCID) Apply to the Patient Population from a Single Center: The Challenge of MCID in Anterior Cruciate Ligament Reconstruction

Objectives: The field of orthopaedic surgery continues to transition towards using patient-reported outcome measures (PROMs) to measure treatment success. Metrics such as the minimum clinically important difference (MCID) can help define treatment success, but there is no clear consensus on the methodology or application of scores in clinical medicine. MCID calculations can vary significantly based on cohort size, methodology (e.g. anchor-based versus distribution-based methods), follow-up time point, and patient-specific factors. Anterior cruciate ligament reconstruction (ACLR) is a highly prevalent procedure that provides high patient satisfaction according to PROMs such as the Knee Injury &amp; Osteoarthritis Outcome Score (KOOS) and the Single Assessment Numerical Evaluation (SANE). Both scales have MCID values reported in the ACLR literature. The purpose of this study was to identify patients that reached the literature-reported MCID values for KOOS and SANE. The secondary aim was to identify if there were any differences in demographic, injury, and treatment characteristics among patients that reach MCID for KOOS and/or SANE and those that do not. Methods: The PROM database of a single ambulatory surgical center was queried for ACLR procedures from 2009-2016. Revision procedures, concomitant ligament repairs/reconstructions, and patients without outcome data at baseline and two-year follow-up were excluded from the study. Demographic, injury, and surgical characteristics were extracted via chart review. Demographics included age, sex, and diagnosis of anxiety and/or depression. Injury characteristics included acuity of injury (≥6 months considered chronic) and presence of meniscal injuries. Surgical characteristics included body mass index (BMI), operative time, American Society of Anesthesiologists (ASA) Score, graft type, implant type, and concomitant meniscal procedures. Outcomes evaluated were KOOS and SANE after two years of ACLR. Patients were grouped according to whether they did or did not meet literature-reported MCIDs for KOOS and/or SANE. One-way analysis of variance and chi-square tests were conducted to identify group differences, with p=0.05 set as the threshold for significance. Results: A total of 322 patients were included. Most were female (62.1%) and had an average age of 28. Average BMI and operative time were 25.3 and 108.3 minutes, respectively. Most patients had an ASA score of 1 (84.1%). A total of 20.5% of patients had a mental health diagnosis of anxiety and/or depression. Most patients received a bone-tendon-bone autograft (49.1%). Only 6.8% of patients presented with a chronic injury. The proportion of patients that achieved MCID at two years for KOOS and SANE were 73.6% and 45.7%, respectively (p&lt;0.00001). The majority of patients achieving SANE MCID achieved KOOS MCID (89.8%), while just 55.7% of patients achieving KOOS MCID achieved SANE MCID. 41.0% of patients achieved MCID for both KOOS and SANE, while 21.7% of patients did not achieve MCID for any scale. Compared to patients that achieved MCID in at least one PROM, there was a significantly higher proportion of patients that underwent ACLR for chronic injuries among those that did not meet MCID (11.4% vs 5.6%, p=0.004). Surgical technique did not statistically differ among patients that achieved MCID and those that did not. Conclusions: The rates of achieving literature-reported MCID values for KOOS and SANE were significantly different within the same cohort of ACLR patients (73.6% for KOOS vs 45.7% for SANE). Only 41.0% of patients achieved MCID for both PROMs. A higher percentage of patients that did not meet MCID had chronic injuries compared to those that met at least one MCID. Treatment success in ACLR as determined by PROMs is thus a function of the tool employed and the injury/patient undergoing treatment rather than the surgery performed. This study particularly found that the timing from injury to presentation was associated with likelihood of achieving MCID. As orthopaedics continues to incorporate PROM data to determine treatment success as well as prior authorization and reimbursement policies, it is important to refine these PROMs and tailor them to patient-specific factors in order to adequately capture a successful treatment. [Table: see text][Table: see text]