Lower Total Scores Research Articles

A comparative study of dynamic versus static rehabilitation protocols after acute Achilles tendon rupture repair with channel assisted minimally invasive repair technique

To explore the difference in effectiveness between a dynamic rehabilitation protocol and a traditional static rehabilitation protocol after the treatment of acute Achilles tendon rupture with channel assisted minimally invasive repair (CAMIR) technique through a prospective comparative trial, aiming to provide a reference for clinically selecting a feasible treatment regimen. Patients with acute Achilles tendon rupture admitted between June 2021 and June 2022 were included in the study, with 60 patients meeting the selection criteria. They were randomly divided into a dynamic rehabilitation group ( n=30) and a static rehabilitation group ( n=30) using a computer-generated random number method. There was no significant difference in baseline data such as gender, age, body mass index, smoking history, injured side, cause of injury, and disease duration between the two groups ( P>0.05). After Achilles tendon anastomosis by using CAMIR technique, the dynamic rehabilitation group implemented early partial weight-bearing training with the assistance of an Achilles heel boot and controlled ankle joint exercises for 6 weeks, while the static rehabilitation group maintained a non-weight-bearing status during this period. Complications in both groups were recorded. At 3 and 6 months after operation, the Achilles tendon total rupture score (ATRS) was used to evaluate the degree of functional limitation of the Achilles tendon in the affected limb, and the 12-Item Short Form Health Survey (SF-12 scale) was used to assess the patients' quality of life, including physical component summary (PCS) and mental component summary (MCS) scores. No sural nerve injury occurred during operation in both groups. All patients were followed up 12-18 months (mean, 14 months). The dynamic rehabilitation group had significantly higher ATRS scores at 3 and 6 months after operation compared to the static rehabilitation group ( P<0.05). At 3 months after operation, the dynamic rehabilitation group had significantly lower PCS, MCS, and SF-12 total scores compared to the static rehabilitation group ( P<0.05). At 6 months, all quality of life scores in the two groups were similar ( P>0.05). Two cases (6.6%) in the dynamic rehabilitation group and 5 cases (16.7%) in the static rehabilitation group developed complications, with no significant difference in incidence of complications ( P>0.05). For acute Achilles tendon rupture, the dynamic rehabilitation protocol after Achilles tendon anastomosis by using CAMIR technique can improve early functional recovery and maintains comparable safety and effectiveness compared to static rehabilitation.

Surgeon Age, Years in Practice, and Location of Training Are Associated With Patient Satisfaction.

Patient satisfaction is associated with communication-related measures, empathy, and meeting expectations. However, it is not clear what surgeon characteristics are associated with patient satisfaction. As such, the purpose of this study was to investigate the surgeon sociodemographic, training, and practice parameters that may be associated with patient satisfaction. A retrospective study of patient satisfaction scores was conducted from 7,856 patients who rated 62 orthopaedic surgeons in 2021 within a single hospital system. Three questions from the National Research Corporation survey were used to assess patient satisfaction. Bivariate analyses and multiple linear regression analyses were performed. For chi-square analyses, patient satisfaction scores were recoded into either above the mean or below/equal to the mean score. Overall, 57 male (91.9%) and five female orthopaedic surgeons (8.1%) participated. Mean age was 49.3 ± 9.9 years. Median years in practice was 14 years (range, 1 to 38 years). More years in practice was associated with lower patient satisfaction scores for careful listening (P = 0.048), likelihood to recommend the provider (P = 0.021), and total score (P = 0.029). Older surgeon age was associated with lower total scores (P = 0.039). Surgeons with 30 or more years of practice were more likely to be recommended (P = 0.030). Surgeons who trained in the Northeast for fellowship and/or residency were more likely to be recommended. Older surgeon age and training in the Northeast were associated with higher patient satisfaction. Older surgeon age and fellowship and/or residency training in the Northeast were associated with higher patient satisfaction, whereas 30 or more years of practice was associated with lower patient satisfaction. In bivariate analysis, female surgeons and foot and ankle training were associated with higher patient satisfaction, whereas spine surgeons had lower patient satisfaction scores. These findings suggest that patient-centered communication, patient-surgeon concordance, and appropriate help may improve patient satisfaction. Level IV.

Amplitude-integrated electroencephalography showed alterations in cerebral activity in monochorionic twins with twin-to-twin transfusion syndrome.

Monochorionic twins are at higher risk of perinatal mortality and morbidity, primarily due to pregnancy-related complications, such as twin-to-twin transfusion syndrome (TTTS). We aimed to investigate whether amplitude-integrated electroencephalography (aEEG) signals are different between monochorionic twins with and without TTTS. This was a retrospective single-centre study conducted at Innsbruck Medical University Hospital, Austria. Preterm infants born before 32 weeks of gestation between 6 November 2010 and 6 December 2022 were eligible. The aEEG was analysed for the total maturation score, its component scores and the number of sleep-wake cycles per hour. We enrolled 79 monochorionic twin infants (48% male) and 157 dichorionic (62% male) twin infants. We found no differences between these two groups of preterm infants regarding the total maturation and component scores, or the number of sleep wake cycles. Monochorionic twins with TTTS showed significantly lower total maturation scores and individual component scores compared to monochorionic twins without TTTS. Preterm infants with TTTS showed differences in neonatal aEEG signals. Whether these differences are caused by prematurity-related or TTTS-related factors, such as hemodynamic and metabolic changes due to placental anastomoses, should be investigated in future prospective studies, to gain more insight into this important topic.

Clinical features and quality of life in patients with Fabry disease

To explore the clinical characteristics of patients with Fabry disease (FD) and the potential influencing factors, as well as to analyze the main factors affecting the quality of life (QOL) of FD patients. The clinical data of 21 adult FD patients who were hospitalized and treated at the University of Hong Kong-Shenzhen Hospital from January 2022 to December 2023 were retrospectively analyzed, including questionnaire data from 17 of these patients. The total score of the Short Form 36 Health Survey (SF-36) was used to determine the QOL. The patient's average age was (42±9) years, including 13 males (61.9%). All patients belonged to 17 families and had a total of 14 gene mutation types. The c.640-801G>A mutation was the most common type, found in 4 patients (19.0%), with cardiac damage as the primary manifestation. The c.901C>T mutation led to lesions in the heart, brain, and kidneys, and early onset and severe phenotypes were detected in female patients. Male patients had lower total SF-36 scores than females (P<0.05). Patients with proteinuria, stroke, hypohidrosis/anhidrosis, and cardiac insufficiency had lower total SF-36 scores compared with those without these symptoms (all P<0.05). The current study indicates that the clinical phenotypes of patients with FD are influenced by a combination of gender, genotype, and non-genetic factors, and gender and clinical symptoms serve as the primary factors affecting patient's QOL.

Ginkgo biloba for Tardive Dyskinesia and Plasma MnSOD Activity: Association with MnSOD Ala-9Val Variant: A Randomized, Double-blind Trial.

Excessive free radicals are implicated in the pathophysiology of tardive dyskinesia (TD), and Ginkgo biloba extract (EGb761) scavenges free radicals, thereby enhancing antioxidant enzymes such as mitochondrial manganese superoxide dismutase (MnSOD). This study examined whether EGb761 treatment would improve TD symptoms and increase MnSOD activity, particularly in TD patients with specific MnSOD Val-9Ala genotype. An EGb761 (240 mg/day) 12-week double-blind clinical trial with 157 TD patients was randomized. The severity of TD was measured by the Abnormal Involuntary Movement Scale (AIMS) and plasma MnSOD activity was assayed before and after 12 weeks of treatment. Further, in an expanded sample, we compared MnSOD activity in 159 TD, 227 non-TD and 280 healthy controls, as well as the allele frequencies and genotypes for the MnSOD Ala-9Val polymorphism in 352 TD, 486 non-TD and 1150 healthy controls. EGb761 significantly reduced TD symptoms and increased MnSOD activity in TD patients compared to placebo (both p < 0.01). Moreover, we found an interaction between genotype and treatment response (p < 0.001). Furthermore, in the EGb761 group, patients carrying the Ala allele displayed a significantly lower AIMS total score than patients with the Val/Val genotype. In addition, MnSOD activity was significantly lower at baseline in TD patients compared with healthy controls or non-TD patients. EGb761 treatment enhanced low MnSOD activity in TD patients and produced greater improvement in TD symptoms in patients with the Ala allele of the MnSOD Ala-9Val polymorphism.

Characteristics of subjective olfactory dysfunction and imaging features in patients with traumatic olfactory disorders: a retrospective case-control study.

Olfactory dysfunction caused by head trauma poses significant challenges in clinical diagnosis and treatment. The primary difficulty arises from direct injuries to olfactory-related brain tissues. Although imaging provides the most direct method to evaluate such injuries, there is no standardized international diagnostic criterion for olfactory dysfunction based on imaging. We designed this study to compare the subjective olfactory function differences and brain gray-matter (GM) and white-matter (WM) volume differences between patients with traumatic olfactory dysfunction and those with other types of olfactory dysfunction and to determine the characteristics of subjective olfactory dysfunction and imaging features in patients with traumatic olfactory disorders. The findings of this study can provide a theoretical basis for the diagnosis of traumatic olfactory disorders. This ethics committee-approved, retrospective case-control study included 56 patients with traumatic olfactory dysfunction (trauma group) and 45 patients with other types of olfactory dysfunction (e.g., postinfection, nasal inflammation, idiopathic disease). The "Sniffin' Sticks" olfactory function test was used to analyze the subjective olfactory function differences between the two groups, and voxel-based morphometry (VBM) was used to compare the GM volume (GMV) and WM volume (WMV) of brain regions between the two groups. (I) There was no statistical difference in age distribution between the trauma group (41.55±11.77 years) and the control group (38.87±14.37 years; P>0.05). (II) The trauma group had significantly lower total scores and subtest scores on the Sniffin' Sticks olfactory test compared to the control group [odor threshold test (OT): 1.04±0.33 vs. 1.67±1.42; odor discrimination test (OD): 2.93±2.25 vs. 5.42±3.66; odor identification test (OI): 2.77±1.94 vs. 6.71±3.55; total scores: 6.74±3.91 vs. 13.81±7.63; all P values <0.05]. (III) Compared with the control group, the trauma group had significantly reduced GMV and WMV in the bilateral orbitofrontal cortex, bilateral anterior cingulate gyrus, bilateral cingulate gyrus, bilateral rectus gyrus, bilateral olfactory cortex, right superior frontal gyrus, bilateral insula, bilateral caudate nucleus, and bilateral thalamus [Pfamily-wise error (FWE)<0.05]. (IV) There was a significant positive correlation between the odor identification function scores and GMV in certain brain regions (PFWE<0.05), and the GMV in these regions was reduced in the trauma group compared to the control group. Compared to patients with other types of olfactory dysfunction, patients with traumatic olfactory dysfunction have poorer subjective olfactory functions and more severe damage to olfactory-related brain regions, including the bilateral orbitofrontal cortex, anterior cingulate gyrus, cingulate gyrus, rectus gyrus, insula, and olfactory cortex. The olfactory nerve damage in these brain regions can be used as a basis for the diagnosis of traumatic olfactory disorders.

Post-earthquake spiritual well-being and depression levels of postpartum women in Turkey

ABSTRACT This study was carried out to examine the spiritual well-being and depression levels of postpartum women following the two major earthquakes that occurred in 2023 with the epicenter Kahramanmaraş in Turkey. This cross-sectional analytical study was conducted with the participation of 345 postpartum women admitted to the maternity ward of a medical faculty hospital in the provincial center of Kahramanmaraş in Turkey between June and September 2023. Data were collected using the Spiritual Well-Being Scale (SWBS) and the Edinburgh Postnatal Depression Scale (EPDS). Independent-samples t-tests, Pearson’s correlation tests, and simple linear regression analysis were used in the analyses. It was determined that 48.7% of the participants were at risk of postpartum depression. The participants whose relatives were lost/injured in the earthquakes and those who experienced financial losses had significantly lower total SWBS scores and significantly higher total EPDS scores (p < 0.05). A negative and statistically significant relationship was found between the total SWBS and total EPDS scores of the participants (p < 0.001). In this study, it was determined that after the Kahramanmaraş earthquakes in 2023, almost one in every two postpartum women was at risk of depression, and their earthquake experience affected their mental health and spiritual well-being negatively. Moreover, as the spiritual well-being of the postpartum women increased, their risk of postpartum depression decreased.

Impact of gestational diabetes mellitus on women’s sexual function: a systematic review and meta-analysis

BackgroundGestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap.MethodsThis systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis.ResultsThe systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD − 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD − 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD − 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD − 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function.ConclusionCompared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs.

Characteristics of cerebellar cognitive affective syndrome in patients with acute cerebellar stroke and its impact on outcome

Purpose To evaluate the cerebellar cognitive affective syndrome scale (CCAS-S) in patients with acute cerebellar stroke (ACS) and examine its relationship with the discharge destination. Methods Patients with first-time ACS admitted to our hospital between April 2021 and April 2023 were included. The CCAS-S, Mini-Mental State Examination (MMSE), and Scale for the Assessment and Rating of Ataxia (SARA) were evaluated 1 week after stroke onset, and Functional Independence Measure (FIM)/Barthel Index (BI) at discharge, duration of hospitalization, and discharge destination were evaluated. The Mann–Whitney U test was used to compare CCAS-S and variables. Results Thirteen consecutive patients with ACS and age-matched comparison groups were included. The MMSE was within the normal range in all patients; however, patients with stroke had a lower total CCAS-S score (median 72, IQR 66–80) and a higher number of failed tests (median 4, IQR 3–5) than comparison. Significant deficits were observed in semantic fluency (p = 0.008), category switching (p = 0001), and similarity (p = 009). Definite CCAS were diagnosed 10 patients, respectively. Patients discharged home showed better SARA and FIM/BI but similar CCAS-S compared to those discharged to rehabilitation hospitals. Conclusion In patients with ACS, it is the impairment of motor function, not CCAS, that affects discharge destination.

Health-related quality of life in young adults with perinatal HIV after transfer to adult health care in the Netherlands.

Health-related quality of life (HRQoL) in adult people with HIV is lower than that of the general population. Previously, no differences were detected in HRQoL of Dutch children with perinatal HIV (PHIV) compared to norm groups. In this study we compared HRQoL of PHIV young adults (PHIV-YA, aged 18-30) to two norm groups; the healthy Dutch YA population and YA with various chronic conditions. Participants received questionnaires on HRQoL, adherence and demographics. Additional social and healthcare-related variables were collected from patients' medical files. We explored correlations between HRQoL and demographic characteristics. Effect sizes (ES, Hedges' g with confidence intervals) were calculated to quantify the difference between PHIV-YA and norm groups. Of 81 participants, 53 filled out the questionnaires. Compared with the healthy Dutch YA population, PHIV-YA 18-30 had significantly lower HRQoL scores in the school/work subscale. PHIV-YA aged 26-30 had significantly lower total, physical and psychosocial HRQoL scores as well. Participants in the older age category had lower HRQoL scores throughout all subcategories as compared to the younger age group.For PHIV-YA aged 18-25 lower scores on the school/work subscale were correlated with substance use and being born outside the Netherlands. PHIV-YA had low HRQoL scores in school/work functioning compared with the healthy Dutch YA population. The circumstances driving these outcomes are likely to be multi-dimensional, including HIV infection, social background and challenges in growing up with a chronic condition.

Introduction and preliminary psychometric evaluation of the assessment of functional capacity interview for older adults

Measures of complex functional decision-making capacity can greatly aid in assessing mild cognitive impairment (MCI) and facilitating early intervention in dementia care. We examined the ability of the Assessment of Functional Capacity Interview (AFCI) to detect functional differences among older adults who were cognitively unimpaired (CU), or who presented with subjective cognitive decline (SCD) or MCI. A sample of 97 older adults (CU; n = 30, Mage = 74.64 ± 7.42 years; SCD; n = 34, Mage = 72.56 ± 6.43 years; MCI; n = 33, Mage = 78.28 ± 7.55 years) underwent neuropsychological testing and responded to the Financial Capacity Instrument (FCI-SF). Informants completed the Assessment of Functional Capacity (AFCI), an instrument of functional decision-making capacity, and responded to the Social Vulnerability Scale (SVS15) and Amsterdam Instrumental Activity of Daily Living (A-IADL-Q-SV), a measure of functional status, for comparison. According to informant-reported responses, the CU group had significantly lower AFCI total (and domain) scores, H(2) = 27.59, p<.001, relative to MCI. Additionally, the CU group had significantly lower AFCI scores in the Home and Personal Safety domain relative to the SCD group, H(2) = 14.06, p<.05. In the overall sample, AFCI total scores were associated with FCI-SF, SVS15, and A-IADL-Q-SV scores and cognitive measures. Our results demonstrate that the AFCI is sensitive to impairment in safety, social, financial, and medical functioning in MCI and is associated with measures of cognitive functioning and social vulnerability in older adults. Incorporating this instrument as a supplement to cognitive screening instruments may aid in the prevention of hazardous decision-making in older adults.

Evaluation of two scoring systems assessing the epiphyseal union at shoulder joint as predictors of chronological age among a sample of Egyptians

Age estimation has extensive medicolegal implications in civil and criminal identification. Despite the surge in adopting radiological investigations to assess developmental bony changes, the shoulder joint is understudied. A cross-sectional study was conducted, enrolling 283 shoulder radiographs of Egyptians, investigating the reliability of two previously established scores as predictors of chronological age using the epiphyseal maturation of proximal humerus and acromion process. Epiphyseal union of proximal humerus commenced at age of 16.1–17 and completed around 21, while complete acromial union was observed around the age of 20.8. Females significantly preceded males and showed lower mean total Scores A and B at different maturation stages. There was a significant strong positive correlation between the chronological age and the epiphyseal maturation of humerus, acromion and total shoulder scores with correlation coefficients between 0.84 and 0.9. The receiver operating characteristic curves showed significant discriminating power of the total shoulder Scores A and B as predictors of the ages of 14 and 16, with area under curves above 0.9, minimal accuracy of 96.5 % and p values of 0.001. Six proposed models were established where the model “age = 0.318 + (0.388) total shoulder Score A + (2.842) total shoulder Score B + 1.931 (sex)” showed the best significant prediction power of radiographic evaluation of epiphyseal maturation in the proximal humerus and acromion in estimating the ages between 8 and around 20 years (R2 of 0.812). Applying this model to assess the chronological age, especially if the results from the hand and teeth are inconclusive, is promising.

The protective effect of vitamin B12 on neuropsychiatric symptoms in dementia-free older adults in a multi-ethnic population

Vitamin B12 deficiency has been associated with neuropsychiatric symptoms (NPS), but the relationship between vitamin B12 and NPS remains unclear prior to the onset of dementia. The study aims to examine the association between vitamin B12 and NPS in dementia-free Asian older adults. This is a cross-sectional population-based study where multi-ethnic community-dwelling Asian participants (i.e. Chinese, Malay, Indian) aged ≥60 years underwent comprehensive neuropsychological and clinical assessments including the examination of clinical history and the collection of blood samples. NPS and subsyndromes were evaluated using the Neuropsychiatric Inventory (NPI). Serum vitamin B12 and homocysteine (Hcy) concentration were measured by competitive immunoassays. To analyse the relationship between vitamin B12 and NPS, hierarchical linear regression, multinomial regression and moderation analyses were performed. A total of 798 dementia-free individuals (age=69.7±6.5 years old, F=408 (51.1%)) were included in the current study. There were 80 (10%) individuals with clinically relevant NPS (i.e. NPI scores ≥4). Higher vitamin B12 was associated with lower NPI total scores (p=0.030) and apathy (p=0.005), after controlling for age, sex, ethnicity, cognitive functioning, socioeconomic status and Hcy concentration. Participants with higher vitamin B12 was also less likely to have clinically relevant apathy (p=0.007). The moderation effect of Hcy and cognitive functioning on the inverse association between vitamin B12 and NPS was observed. A protective effect of vitamin B12 on NPS and subsyndromes was observed in a multi-ethnic Asian cohort of dementia-free individuals. Future longitudinal studies are required to further elucidate the pathophysiological mechanisms between vitamin B12 and NPS in diverse ethnic groups.

Depression is associated with lower diet quality in both pre- and postmenopausal U.S. women: NHANES 2007-2018

Depression has been associated with adverse diet-related outcomes and women are particularly vulnerable to depression around the menopause transition. Therefore, we hypothesized that depression and post-menopausal status would be associated with lower diet quality, and that depression would be associated with lower diet quality in both pre- and post-menopausal women, but that the association would be stronger in postmenopausal women. Data from 5,634 non-pregnant women age > 20 years from the National Health and Nutrition Examination Survey from 2007-2018 were analyzed. Diet quality was determined using the Healthy Eating Index 2020 (HEI-2020). Multivariable linear regression was used to examine the association between depression and diet quality, menopause and diet quality, and depression and diet quality by menopause status, adjusting for covariates. Mean age was 49.6 ± 0.4; 12% of women were classified as depressed and 46% as postmenopausal. In multivariable-adjusted models, depression was associated with lower HEI-2020 total (β = -3.33, p < 0.001) and adequacy scores (β = -2.41, p < 0.0001) but not moderation scores. Postmenopausal women had higher HEI-2020 total (β = 2.48, p < 0.0001), moderation (β = 1.19, p < 0.0001), and adequacy (β = 0.81, p < 0.01) scores than premenopausal women. In a nationally representative sample of U.S. women, depression was associated with lower diet quality across all women and in both pre- and postmenopause. Further research is needed to better understand the relationship between depression and diet quality throughout the menopause transition, when hormonal changes could make women more vulnerable to depression.

Depressive symptoms and quality of life in patients with benign essential blepharospasm under long-term therapy with botulinum toxin.

Regular and long-term injections of botulinum toxin (BoNT) are considered the first line therapy for essential blepharospasm (BEB), but no data exists on the long-term effect of this therapy on depressive symptoms and quality of life. This study aims to prospectively evaluate the long-term effects of BoNT therapy on depressive symptoms as well as on daily activities, emotional well-being and quality of life using validated questionnaires (BEB-scale, Beck`s Depression Inventory (BDI)). 86 patients diagnosed with BEB were followed up for a median of 4 years. Clinical symptoms improved significantly after BoNT-injections. Everyday activities and subjective assessment of the overall situation improved gradually under long-term BoNT therapy. Significant correlations (p < 0.0001; r-values between 0.498 and 0.706) were found between the BDI and items of the BEB-scale. No significant antidepressive effect of long-term BoNT therapy was found with a low median BDI total score (5/max. 63), but up to 31.3% of BEB patients had a BDI score ≥ 11, indicating clinically relevant depressive symptoms. Of these, 65.4% had no known history of depression. Although, several studies reported an antidepressant effect of botulinum toxin injections in patients with major depression, this effect does not seem to be present in patients with BEB despite clinical improvement of symptoms. A high prevalence of previously undetected depressive symptoms was found in BEB patients. As this may influence BoNT therapy success, identifying potential depressive symptoms at the time of BEB diagnosis and initiating appropriate treatment seems important.

Basic self-disturbance in adolescents at risk of psychosis: temporal stability investigated by the experience sampling method in a mixed method study.

Basic self-disturbance (BSD), also called anomalous self-experiences (ASEs), are core phenotypic markers for schizophrenia spectrum disorders and a prepsychotic vulnerability marker considered to be temporally stable (trait-phenomenon). Studies of BSD in children and adolescents are lacking. To be clinically useful, we need to know more about the characteristics and temporal development of BSD in prepsychotic phases. This study used a smartphone application measuring the occurrence and subjective intensity of ASEs in the daily life of 27 help-seeking adolescents (12-18 years) repeatedly over a period of 6 months. A total of 5223 unique application-reports based on individually selected and verbatim descriptions of personal core ASEs were analysed by mixed methods. The intensity of ASEs, within subjects and between subjects and irrespective of time intervals or baseline scores obtained by the Examination of Anomalous Self-Experience (EASE) were relatively stable with a mean variability of 1.25 (0.4) SD. Participants with low EASE total scores at baseline had a significantly lower score on ASE intensity than those with high baseline EASE total scores at baseline (mean 2.42 vs 3.42, p=0.046). In this study, ASEs were not reported as essentially fluctuating experiences but as almost constantly present, demonstrating BSD as a mainly trait phenomenon in prepsychotic phases in persons under the age of 18. Considering the continuous experience of BSD and its predictive value for psychosis development, ASEs should be targeted and monitored to the same extent as other prepsychotic features.

Non-classical monocyte levels correlate negatively with HIV-associated cerebral small vessel disease and cognitive performance.

Despite antiretroviral treatment (cART), aging people living with HIV (PWH) are more susceptible to neurocognitive impairment (NCI) probably due to synergistic/additive contribution of traditional cerebrovascular risk factors. Specifically, transmigration of inflammatory CD16+ monocytes through the altered blood brain barrier (BBB) may exacerbate cerebral small vessel disease (CSVD), a known cause of vascular cognitive impairment. PWH on cART (n=108) and age, sex, and Reynold's cardiovascular risk score-matched uninfected individuals (PWoH, n=111) were enrolled. This is a longitudinal observational study but only cross-sectional data from entry visit are reported. Neuropsychological testing and brain magnetic resonance imaging (MRI) were performed. CSVD was diagnosed by Fazekas score ≥1. Flow cytometric analyses of fresh whole blood were conducted to evaluate circulating levels of monocyte subsets (classical, intermediate, and non-classical) and markers of monocyte activation (CCR2, CD40, PSGL-1, TNFR2 and tissue factor). ELISAs were used to measure sCD14, ICAM, and Osteoprotegerin. Two-way analysis of variance (ANOVA), and linear regression models were performed to study the effects of HIV status, CSVD status, and their interaction to outcome variables such as cognitive score. Two-sample t-tests and correlation analyses were performed between and within PWoH with CSVD and PWH with CSVD participants. PWH with CSVD (n=81) had significantly lower total cognitive scores, higher levels of NCMs and soluble CD14 and intracellular adhesion molecule 1 (ICAM-1) as compared to PWoH with CSVD group (n=68). sCD14 and ICAM1 were positively correlated with each other indicating that monocyte and endothelial activation are associated with each other. Cognition was negatively correlated with NCMs, especially in the PWH with CSVD group. Among other blood biomarkers measured, osteoprotegerin levels showed mild negative correlation with cognitive performance in individuals with CSVD irrespective of HIV status. Elevated levels of NCMs may contribute to neuroinflammation, CSVD and subsequent cognitive impairment. This finding is of particular relevance in aging PWH as both HIV and aging are associated with increased levels of NCMs. NCMs may serve as a potential biomarker to address these comorbidities. Further longitudinal studies are needed to evaluate whether changes in NCM levels are associated with changes in CSVD burden and cognitive impairment.

Investigation of Body Perception, Alexithymic Characteristics, and Self-Esteem in Patients Underwent Septorhinoplasty.

Objective: This study evaluated patients' body perception, self-esteem, and personality traits during the preoperative and postoperative periods of septorhinoplasty. Based on these evaluations, we may provide patient selection recommendations for septorhinoplasty applicants. Methods: In this cross-sectional questionnaire study, 86 patients who underwent primary septorhinoplasty in the Department of Otolaryngology at Bilecik Training and Research Hospital were included between March 2023 and 2024. The same surgeon performed all operations. The preoperative Rhinoplasty Outcome Evaluation (ROE) Questionnaire, Rosenberg Self-Esteem Scale (RSES), Body Perception Scale (BPS), Toronto Alexithymia Scale (TAS), and TEMPS-A Temperament Scale in the preoperative period and ROE, RSES, and BPS in the postoperative period were applied. Results: Fifty-four female and 32 male patients participated in our study. The mean age was 24.0 ± 0.6 years. While there was no significant difference in the BPS and RSES scores between the preoperative and postoperative periods, the total ROE score was significantly higher in the postoperative than in the preoperative period. Postoperative ROE scores were positively correlated with RSES and hyperthymic temperament. In contrast, it was negatively correlated with depressive temperament, cyclothymic temperament, anxious temperament, BPS total score, TAS total score, and TAS emotion recognition and expression subscale scores. In the group with alexithymia features separated according to the TAS cutoff score, preoperative and postoperative ROE results were significantly lower, whereas depressive, cyclothymic, irritable, and anxious personality traits and total BPS scores were higher. However, the postoperative RSBE scores were lower in this group. Conclusion: This is the first study to evaluate self-esteem, body image, alexithymia, and personality traits in septorhinoplasty patients. Appropriate patient selection is essential for success and patient satisfaction in aesthetic operations such as septorhinoplasty. Performing BPS, TEMPS-A, and TAS may help evaluate psychological factors.

Effects of decision making and impulsivity on the addictive features of non-suicidal self-injury behaviors in adolescents with depressive disorder

BackgroundNon-suicidal self-injury (NSSI) behaviors pose a significant threat to the physical and psychological well-being of adolescents. Recent research suggests that persistent, uncontrollable and repetitive NSSI can be conceptualized as a behavioral addiction. The addictive feature of NSSI behavior can be assessed using Ottawa self-injury inventory (OSI), the higher addiction score indicates the more serious NSSI behavior. This study aims to explore the relationship of impulsivity and decision-making on the addictive features of NSSI in adolescents with depressive disorder, to explore the influencing factors of behavioral addictive features of NSSI and to predict the addictive features of NSSI.MethodsUsing a cross-sectional design, a total of 126 adolescent outpatients and inpatients with a mean age of 15.49 years old (M = 15.49, SD = 1.56), male students (n = 28, 22.2%) and female students (n = 98, 77.8%) diagnosed with depressive disorders were recruited according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and clinical interviews were completed by two psychiatrists. NSSI addictive features according to the OSI’s addictive features items. The final group was categorized into three groups: depression without NSSI (n = 42), depression with NSSI without addictive features (n = 44), and depression with NSSI and addictive features (n = 40). The present study employed the Hamilton Depression Scale (HAMD-24), Chinese Revised Barratt Impulsiveness Scale Version 11 (BIS-11), OSI, and the Adolescent Non-Suicidal Self-Injury Questionnaire (ANSSIQ). Cognitive decision-making abilities were assessed using the Iowa Gambling Task (IGT).ResultsThe depression with NSSI addictive features group had significantly lower total net scores and net scores of block3, block4, and block5 in the IGT than the depression without NSSI group, whereas there was no statistically significant difference between the two in net scores of block1 and block2. Lower scores mean more unfavorable decisions and strategy adjustments. The addictive features of NSSI behaviors were significantly and positively correlated with the severity of NSSI behaviors, depression, and cognitive impulsiveness, and significantly and negatively correlated with the total net score of the IGT. The severity of NSSI behaviors, severity of depression, cognitive impulsiveness positively predicts the addictive features of NSSI behaviors, the total net score of the IGT negatively predicted the addictive features of NSSI behaviors.ConclusionAdolescents with depressive disorders with NSSI behavioral addictive features had higher severity of depression, exhibited higher cognitive impulsivity, and made more unfavorable decisions when making choices.

Predisposing factors to pattern change in cervical dystonia.

Cervical dystonia (CD) patterns may change with Botulinum toxin (BoNT) treatment. To evaluate the time within those changes usually occur, the most predisposed phenotypes and predisposing factors. We divided idiopathic CD patients into two groups- change YES and NO, collecting general clinical and demographic variables. We also evaluated duration of BoNT treatment, Tsui total scores and subscores - assessed at T0 - before BoNT start - and at T1- time to chenge in the YES group or last visit in the NO group. The risk of pattern change was assessed by Kaplan Meyer curves and Cox regression analysis. Finally, Multivariate linear regressions were employed to assess if Tsui severity correlated with the change. Among 100 patients (60 women), 37 experienced a phenotype switch, mostly in the first five years of BoNT treatment, YES and NO groups were comparable. Multivariate Cox Regression revealed the presence of laterocollis or rotatocollis at T0 as predictors of switch (respectively P = 0.01, HR = 3.5; P = 0.03, HR = 1.5). Multivariate linear regressions revealed that high Tsui subscores for the tilt and low Tsui total scores were risk factors for the change of pattern (respectively P = 0.002, OR = 6; P = 0.03, OR = 0.8). Latero and Rotatocollis are the CD phenotypes most predisposed to change. CD characterized by neck tilt are more likely to change phenotype following treatment. Dystonias with a low degree of severity are more predisposed to switch. Both, the different degree of muscle activation and BoNT mechanism of action, may impact on that phenomenon.