Complexity analysis of head movements in autistic toddlers

alexandrossfakianakis shared this article with you from Inoreader Complexity analysis of head movements in autistic toddlers via Journal of Child Psychology and Psychiatry Background Early differences in sensorimotor functioning have been documented in young autistic children and infants who are later diagnosed with autism. Previous research has demonstrated that autistic toddlers exhibit more frequent head movement when viewing dynamic audiovisual stimuli, compared to neurotypical toddlers. To further explore this behavioral characteristic, in this study, computer vision (CV) analysis was used to measure several aspects of head movement dynamics of autistic and neurotypical toddlers while they watched a set of brief movies with social and nonsocial content presented on a tablet. Methods Data were collected from 457 toddlers, 17–36 months old, during their well-child visit to four pediatric primary care clinics. Forty-one toddlers were subsequently diagnosed with autism. An application (app) displayed several brief movies on a tablet, and the toddlers watched these movies while sitting on their caregiver's lap. The front-facing camera in the tablet recorded the toddlers' behavioral responses. CV was used to measure the participants' head movement rate, movement acceleration, and complexity using multiscale entropy. Results Autistic toddlers exhibited significantly higher rate, acceleration, and complexity in their head movements while watching the movies compared to neurotypical toddlers, regardless of the type of movie content (social vs. nonsocial). The combined features of head movement acceleration and complexity reliably distinguished the autistic and neurotypical toddlers. Conclusions Autistic toddlers exhibit differences in their head movement dynamics when viewing audiovisual stimuli. Higher complexity of their head movements suggests that their movements were less predictable and less stable compared to neurotypical toddlers. CV offers a scalable means of detecting subtle differences in head movement dynamics, which may be helpful in identifying early behaviors associated with autism and providing insight into the nature of sensorimotor differences associated with autism. View on Web

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Lack of complete response pretransplant is not associated with inferior overall survival for stage 4a metastatic retinoblastoma

alexandrossfakianakis shared this article with you from Inoreader Lack of complete response pretransplant is not associated with inferior overall survival for stage 4a metastatic retinoblastoma via Pediatric Blood & Cancer Abstract Background Stage 4a metastatic retinoblastoma (RB) is curable with intensive multimodality therapy including myeloablative chemotherapy with autologous stem cell transplant (HDC-ASCT) and involved field radiation therapy (IFRT). To our knowledge, no data exist on the impact of (a) pre-ASCT disease status, and (b) IFRT to sites of metastatic disease post ASCT on survival. Procedure We retrospectively reviewed patients with stage 4a metastatic RB who underwent induction chemotherapy followed by HDC-ASCT, with or without IFRT, to residual tumor sites at Memorial Sloan Kettering Cancer Center (MSKCC) (n = 24). Results The degree of postinduction response prior to ASCT did not affect outcome, with 5-year overall survival (OS) of 68% and 86% in patients who achieved complete response (CR) and very good partial response (VGPR)/partial response (PR) prior to ASCT, respectively. IFRT administered post ASCT in patients with possible residual bony metastatic disease increases the likelihood of developing osteosarcoma in the radiation field. Conclusion OS for patients with stage 4a metastatic RB treated with ASCT with VGPR or PR to pretransplant chemotherapy was not significantly different from patients with CR. In addition, IFRT does not seem to be required for bony disease control and increased the likelihood of developing osteosarcoma. View on Web

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ELANE neutropenia and solid tumors: Four cases from the French severe chronic neutropenia registry

alexandrossfakianakis shared this article with you from Inoreader ELANE neutropenia and solid tumors: Four cases from the French severe chronic neutropenia registry via Pediatric Blood & Cancer Abstract Neutropenia related to ELANE gene mutations predisposes patients to infection and leukemia/myelodysplasia, but little is known about the predisposition to cancer. Among a cohort of 147 patients, we identified four with malignant solid tumors (papillary thyroid cancer, anal squamous cell cancer, papillary renal cell carcinoma, and adrenocortical carcinoma), all aged 25–50 years. Three occurred with cyclic neutropenia, and one occurred with severe chronic neutropenia. Previous radiotherapy was identified as a risk factor in one patient. No genetic predisposition was identified in the three other patients. View on Web

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Effect of periodontal treatment on glycated hemoglobin and metabolic syndrome parameters: a randomized clinical trial.

alexandrossfakianakis shared this article with you from Inoreader Effect of periodontal treatment on glycated hemoglobin and metabolic syndrome parameters: a randomized clinical trial. via Journal of Clinical Periodontology Abstract Aim to assess the effect of periodontal treatment on HbA1c and diagnostic parameters of patients with Metabolic Syndrome (MetS). Material and Methods A hundred and fifty-eight patients with MetS, and moderate and severe periodontitis were included. They were randomized into a test group (n=79), which received non-surgical periodontal treatment, and a control group (n=79), which received no treatment. Medical treatment was delivered to both groups. Clinical periodontal, anthropometric, and serological parameters were assessed at baseline, 3 and 6 months. The main outcome was glycated hemoglobin (HbA1c) levels, and the secondary outcomes were changes in the MetS parameters, C-reactive protein and HOMA indexes. Results Significant reductions in all the periodontal parameters were observed in the test group, compared with the control group, at 3 and 6 months (p<0.001). HbA1c levels, MetS parameters, C-reactive protein and HOMA indexes showed no significant differences between the test group and the control group at 3 and 6 months. Conclusion(s) periodontal treatment led to a substantial reduction in periodontal inflammation, although there was no significant effect on the parameters used for MetS diagnosis in patients with early-diagnosed and well-controlled MetS. Registration number NCT02012842, www.clinicaltrials.gov. This article is protected by copyright. All rights reserved. View on Web

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Middle Fossa Decompression for Recurrent Facial Palsy: Prevalence and Surgical Outcomes

alexandrossfakianakis shared this article with you from Inoreader Middle Fossa Decompression for Recurrent Facial Palsy: Prevalence and Surgical Outcomes via The Laryngoscope Our study examined the facial nerve and audiometric outcomes of patients undergoing middle fossa decompression for recurrent facial nerve paresis. We found that facial nerve decompression for patients with incomplete functional recovery may be an effective treatment for decreasing the frequency and severity of facial palsy episodes. Objective To investigate the surgical outcomes in patients treated for recurrent facial nerve palsy (RFP) at a quaternary facial nerve referral center. Methods A retrospective chart review was performed on 132 patients with RFP who presented to our institution's facial nerve clinic from 2001 to 2021. Records were analyzed for etiology of palsy, facial nerve function, and recurrence rates. Pre- and post-operative audiometric outcomes were also assessed in surgically managed patients. Results 6.8% of RFP patients underwent surgical decompression. For patients who did not undergo surgery, the House-Brackmann (HB) score was 2.9 ± 1.3 (SD) at the initial clinic visit, and 2.4 ± 1.3 (SD) at the last clinic visit. This difference was significantly different (p = 0.01, t-test). For surgical patients, the pre-operative HB score was 2.9 ± 0.9 (SD) and post-operative HB score was 1.8 ± 0.6 (SD), which were significantly different (p = 0.01, t-test). The number of facial palsy episodes also decreased pre- and post-operatively from 3.5 ± 0.8 (SD) to 0.2 ± 0.4 (SD) episodes, which were significantly different (p < 0,001, t-test). Audiometric outcomes were not significantly different pre- and post-surgery (p = 0.31, t-test for PTA; p = 0.34, t-test for WRS). Conclusion Facial nerve decompression for RFP patients with incomplete functional recovery may be an effective treatment for decreasing the frequency and severity of facial palsy episodes. Level of Evidence 4 Laryngoscope, 2022 View on Web

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Mental health considerations in patients undergoing complex head and neck reconstruction

alexandrossfakianakis shared this article with you from Inoreader Mental health considerations in patients undergoing complex head and neck reconstruction via Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print Purpose of review To summarize recent advances in the psycho-oncology literature, with a focus on findings relevant to the head and neck cancer patient. Recent findings Patients with cancer are at an increased risk of suicide and self-harm. Head and neck cancer patients are among the highest risk compared with other cancer patients. Unique challenges pertaining to disfigurement and voicelessness may, in part, explain these observations. Patient-reported outcome measures can be used to help identify high-risk patients. Summary Psychosocial support needs are highest for head and neck cancer patients. Patient-reported outcome measures should be integrated within clinical workflows to identify high-risk patients. View on Web

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Mortality After Pediatric Tonsillectomy

alexandrossfakianakis shared this article with you from Inoreader Mortality After Pediatric Tonsillectomy via JAMA Otolaryngology–Head & Neck Surgery Current Issue Tonsillectomy is one of the most common surgeries performed in children. In recent years, sleep-disordered breathing has replaced chronic tonsillitis as the most common indication for tonsillectomy in children. While tonsil surgery is safe and effective at relieving upper airway obstruction in most children, it can result in serious complications such as posttonsillectomy hemorrhage and respiratory compromise. Rarely, mortality can occur. Rates of mortality related to pediatric tonsillectomy, reported at 1 in 55 000, have been estimated from various sources including physician survey, malpractice claims, and database reviews. In the study published in JAMA, "Association of Patient Characteristics With Postoperative Mortality in Children Undergoing Tonsillectomy in 5 US States," Edmonson et al aimed to identify clinical predictors o f posttonsillectomy mortality from the Healthcare Cost and Utilization Project for patients younger than 21 years in 5 US states from 2005 to 2017. The authors report the overall mortality at 7 deaths per 100 000 tonsillectomies, which—while rare—is over twice the reported aggregate mortality for the 10 most common pediatric surgeries. View on Web

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Risk of Stroke After Definitive Radiotherapy—Cause for Concern or Modest Risk?

alexandrossfakianakis shared this article with you from Inoreader Risk of Stroke After Definitive Radiotherapy—Cause for Concern or Modest Risk? via JAMA Otolaryngology–Head & Neck Surgery Current Issue With the rapidly increasing prevalence of oropharyngeal squamous cell carcinoma (OPSCC), largely driven by the human papillomavirus (HPV) epidemic, and with relative equipoise between radiation-based and surgery-based treatment protocols, there has been renewed interest in describing differences in functional outcomes between the 2 treatment modalities. Radiation is theoretically related to stroke risk due to carotid artery intimal injury, which could lead to the development of atherosclerosis. Both carotid artery stenosis and carotid intima-medial thickness have been shown to be associated with radiation therapy providing a biologic basis for the findings. A retrospective population-based cohort study of veterans with OPSCC authored by Sun et al reported a 12.5% imputed stroke risk within 10 years after treatment. The major finding of t his study is that there was an observed 23% relative risk reduction of stroke in patients treated with definitive surgery as compared with those treated with definitive radiotherapy. Although there were notable differences between the groups at baseline, in particular higher T- and N-stage as well as worse ECOG performance status and Charlson Comorbidity Index in the nonsurgical group, the authors conducted propensity score–based analyses to account for these imbalances. Interestingly, there was no increase in stroke risk among surgical patients treated with adjuvant radiation as compared with those treated with surgery alone. (Other population-based studies have observed the same.) View on Web

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Sudden Sensorineural Hearing Loss and COVID-19 Vaccination Revisited

alexandrossfakianakis shared this article with you from Inoreader Sudden Sensorineural Hearing Loss and COVID-19 Vaccination Revisited via JAMA Otolaryngology–Head & Neck Surgery Current Issue To the Editor Widespread vaccination against SARS-CoV-2 is critical in turning the tide on the COVID-19 pandemic, but achieving widespread acceptance has proven elusive. Fear of adverse effects has been a recurring theme in surveys of the public vaccination hesitancy. Therefore, studies investigating the incidence of sudden sensorineural hearing loss (SSNHL) after COVID-19 vaccination garner intense interest. Whereas Formeister and colleagues find no association between COVID-19 vaccination and incidence of hearing loss in their cross-sectional analysis, Yanir et al identify a possible association but with very small effect size and without consistent demographic groups. Ulrich and colleagues conclude that the benefits of COVID-19 vaccination exceed the possible cost of rare instances of SSNHL. Analyses involving large data sets often un cover statistically significant differences that are not necessarily clinically meaningful, and spurious associations can arise owing to chance or bias. View on Web

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Stimulation Rate and Voice Pitch Perception in Cochlear Implants

alexandrossfakianakis shared this article with you from Inoreader Stimulation Rate and Voice Pitch Perception in Cochlear Implants via JARO - Journal of the Association for Research in Otolaryngology via MedWorm.com We describe two experiments with 16 Nu cleus® CI users, where we controlled modulation characteristics and carrier rate using Spectral and Temporal Enhanced Processing (STEP), a novel experimental multichannel sound coder. We used a fixed set of threshold and comfortable stimulation levels for each subject, obtained from clinical MAPs. In the first experiment, we determined equivalence for voice pitch ranking and voice gender categorization between the Advanced Combination Encoder (ACE), a widely used clinical strategy in Nucleus® recipients, and STEP for fundamental frequencies (F0) 120–250 Hz. In the second experiment, loudn ess was determined as a function of the input amplitude of speech samples for carrier rates of 1000, 500, and 250 pps per channel. Then, using equally loud soun... View on Web

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