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Although oxytocin is generally thought to exert anxiolytic, prosocial and antistress effects, reports of anxiogenic effects in humans have recently emerged. Here the authors show that oxytocin receptors in the lateral septum mediate the stress-induced enhancement of fear conditioning in mice in a process involving MAPK-ERK signaling. The nonapeptide oxytocin is considered beneficial to mental health due to its anxiolytic, prosocial and antistress effects, but evidence for anxiogenic actions of oxytocin in humans has recently emerged. Using region-specific manipulations of the mouse oxytocin receptor (Oxtr) gene ( Oxtr ), we identified the lateral septum as the brain region mediating fear-enhancing effects of Oxtr. These effects emerge after social defeat and require Oxtr specifically coupled to the extracellular signal–regulated protein kinase pathway.

The basal septal hypertrophy(BSH) is an often under-recognized morphological change in the left ventricle. This is a common echocardiographic finding with a prevalence of approximately 7-20%, which may indicate early structural and functional remodeling of the left ventricle in certain pathologies. It also poses a risk of severe left ventricular outflow tract obstruction and is a significant cause of postoperative complications in patients undergoing transcatheter aortic valve implantation (TAVI). Compared to traditional algorithms, machine learning algorithms are more effective at capturing nonlinear relationships and developing more accurate diagnostic and predictive models. However, no predictive models for BSH have been developed using machine learning algorithms. To evaluate the effectiveness of five machine learning algorithms in predicting thickening of the basal segment of the interventricular septum and to develop a simple, yet efficient, prediction model for BSH. Echocardiographic and clinical data from 902 patients were collected from the First Central Hospital of Baoding City, including 91 BSH patients and 811 non-BSH patients. The data were divided into training and test sets in a 7:3 ratio. Five machine learning algorithms -XGBoost, Random Forest(RF), Dicision tree(DT), K-Nearest Neighbor classification(KNN), and Naive Bayes(NB) were applied to construct the models, combined with logistic regression (LR) based on Lasso regression. The performance of each model was evaluated using Receiver Operating Characteristic curve (ROC),calibration curves and Decision Curve Analysis (DCA)curve, with the model demonstrating the best performance being selected. The shapley additive explanation (SHAP) method was employed to interpret the XBoost and RF models. The logistic regression (LR) of the Lasso regression model showed that IVS-AO Angle, Left Ventricular Mass Index (LVMI), Diastolic Left Ventricular Internal Diameter Index (LVIDdI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Distance from mitral valve closure point to basal segment of interventricular septum (MVCP-Sd), GLU, and Mitral Valve peak A (MV-A) were associated with BSH, with odds ratios (OR) of 0.86 (0.831-0.888), 1.034 (1.018-1.052), 0.104 (0.023-0.403), 1.041 (1.021-1.064), 0.964 (0.93-0.998), 0.852 (0.764-0.949), 1.146 (1.023-1.281), and 0.967 (0.947-0.987), respectively. The area under the ROC curve (AUC) for Model-relevant variable IVS-AO Angle, MVCP_Sd,LVMI, GLU, LVIDdI, SBP,DBP,LVIDdI,MV_A were 0.87,0.68,0.66,0.55,0.56,0.67,0.75,0.75. The AUC for the algorithms (XGBoost, RF, DT, KNN, NB) in the test set were 0.92, 0.91, 0.85, 0.84, and 0.88, respectively. The SHAP method identified eight predictor variables for BSH based on importance rankings, with the top four being IVS-AO Angle, LVMI, LVIDdI, and SBP, with IVS-AO Angle emerging as the most important predictor. The external validation of the RF model yielded an AUC of 0.86. Machine learning can effectively predict BSH, with IVS-AO Angle identified as an independent predictor. The RF model, being simple to operate, can be applied to the risk management of BSH patients.

We intended to investigate the deviation of septal swell body, perpendicular plate, septal spur and vomer in patients with and without nasal obstruction. We compared the deviation of these septal areas in computed tomography scans of patients scheduled for nasal surgical procedures (cases) and of patients without clinically relevant nasal obstruction (controls). Septal swell body was similarly deviated between 56 cases (median value: 6.5 mm) and 56 controls (6.4 mm; > 0.2). Septal spur was more deviated in cases (5.6 mm) than in controls (4.7 mm; < 0.001). The deviation of perpendicular plate (found in 28/112 subjects) did not differ significantly between cases (3.0 mm) and controls (2.2 mm; > 0.2). The deviation of vomer (found in 71/112 subjects) was larger in cases (7.1 mm) than in controls (4.3 mm; = 0.001). Septal spur, vomer and perpendicular plate were more frequent causes of nasal obstruction compared to septal swell body.

Septoplasty (surgical correction of the deviated nasal septum) is the most frequently performed ear, nose, and throat operation in adults, but no randomised controlled trials or non-randomised comparative studies on the effectiveness of septoplasty have been published. Consequently, health-care providers, health insurance companies, and policy makers are concerned about the effectiveness of the procedure. We aimed to assess the effectiveness of septoplasty for nasal obstruction in adults with a deviated septum. We did this open, multicentre, pragmatic, randomised controlled trial in 16 secondary and two tertiary referral hospitals in the Netherlands. Adults (aged ≥18 years) with nasal obstruction, a deviated septum, and an indication to have septoplasty done were randomly allocated (1:1) to receive either septoplasty with or without concurrent turbinate surgery or non-surgical management. Patients were stratified by sex, age (<35 years or ≥35 years), and deviation severity (mild, moderate, or severe). The primary outcome was health-related quality of life, measured with the validated Glasgow Health Status Inventory at 12 months. Analyses were done on an intention-to-treat basis. The trial is registered with the Netherlands Trial Register, number NTR3868. Between Sept 2, 2013, and Dec 12, 2016, we randomly assigned 203 participants to receive either septoplasty with or without concurrent turbinate surgery (n=102) or non-surgical management (n=101). 189 participants were analysed at 12 months. At 12 months, mean score on the Glasgow Health Status Inventory of patients assigned to septoplasty was 72·2 (SD 12·2) and for those assigned to non-surgical management was 63·9 (SD 14·5, mean difference 8·3 [95% CI 4·5–12·1], favouring septoplasty). Septal abscess occurred in one surgical patient and septal perforation in two surgical patients. No side-effects of nasal medication were reported. Septoplasty is more effective than non-surgical management for nasal obstruction in adults with a deviated septum. This effect was sustained up to 24 months of follow-up. The Netherlands Organisation for Health Research and Development (ZonMw).

Background We aimed to comparatively analyze nasal projection and rotation changes in patients that underwent secondary cleft rhinoplasty with a columellar strut graft (CSG) or septal extension graft (SEG). Methods Thirty-three patients were randomly divided into two groups. Preoperative, intraoperative (immediate postoperative), postoperative 1-, 6- and 12-month profile view pictures were analyzed. The nasion (N), alar base-cheek junction (A), tip defining point (T), columella (C), and lips (L) were marked. The AT/AN ratio, NAT angle, Goode ratio, and columellar-labial angle (CLA) were measured. Results Regarding tip projection, the AT/AN ratio was lower in CSG group compared to SEG group postoperatively. In CSG group, there was a significant progressive decrease in the AT/AN ratio, whereas in SEG group, it decreased until postoperative 6 month. Regarding tip rotation, the NAT angle was higher in CSG group postoperatively and increased progressively. In SEG group, the NAT angle was lower intraoperatively compared to the postoperative period, whereas it did not differ significantly in-between follow-ups. The Goode ratio was significantly lower in CSG group compared to SEG group postoperatively. In SEG group, the Goode ratio was significantly higher intraoperatively compared to the postoperative period, but it did not differ significantly in-between follow-ups. In CSG group, the Goode ratio decreased progressively. The CLA decreased in both groups, but there was no statistically significant difference between the groups. Conclusion Secondary cleft lip rhinoplasty is a distinct subgroup of rhinoplasty that necessitates stable and strong tip support. SEG provides more reliable and predictable long-term results in secondary cleft lip rhinoplasty than CSG. Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Multilevel anatomic obstruction is often present in snoring and obstructive sleep apnoea (OSA). As the nose is the first anatomical boundary of the upper airway, nasal obstruction may contribute to sleep-disordered breathing (SDB). A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in SDB. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex and the role of nitric oxide (NO). Clinically, a number of case–control studies have shown that nasal obstruction is associated with snoring and mild SDB. However, there is not a linear correlation between the degree of nasal obstruction and the severity of SDB, while nasal obstruction is not the main contributing factor in the majority of patients with moderate to severe OSA. Randomised controlled studies have shown that in patients with allergic rhinitis or non-allergic rhinitis and sleep disturbance, nasal steroids could improve the subjective quality of sleep, and may be useful for patients with mild OSA, however, they are not by themselves an adequate treatment for most OSA patients. Similarly, nasal surgery may improve quality of life and snoring in a subgroup of patients with mild SDB and septal deviation, but it is not an effective treatment for OSA as such. On the other hand, in patients who do not tolerate continuous positive airway pressure (CPAP) well, if upper airway evaluation demonstrates an obstructive nasal passage, nasal airway surgery can improve CPAP compliance and adherence.

Background Septoplasty (surgery to straighten a deviation in the nasal septum) is a frequently performed operation worldwide, with approximately 250,000 performed annually in the US and 22,000 in the UK. Most septoplasties aim to improve diurnal and nocturnal nasal obstruction. The evidence base for septoplasty clinical effectiveness is hitherto very limited. Aims To establish, and inform guidance for, the best management strategy for individuals with nasal obstruction associated with a deviated septum. Methods/design A multicentre, mixed-methods, open label, randomised controlled trial of septoplasty versus medical management for adults with a deviated septum and a reduced nasal airway. Eligible patients will have septal deflection visible at nasendoscopy and a nasal symptom score ≥ 30 on the NOSE questionnaire. Surgical treatment comprises septoplasty with or without reduction of the inferior nasal turbinate on the anatomically wider side of the nose. Medical management comprises a nasal saline spray followed by a fluorinated steroid spray daily for six months. The recruitment target is 378 patients, recruited from up to 17 sites across Scotland, England and Wales. Randomisation will be on a 1:1 basis, stratified by gender and severity (NOSE score). Participants will be followed up for 12 months post randomisation. The primary outcome measure is the total SNOT-22 score at 6 months. Clinical and economic outcomes will be modelled against baseline severity (NOSE scale) to inform clinical decision-making. The study includes a recruitment enhancement process, and an economic evaluation. Discussion The NAIROS trial will evaluate the clinical effectiveness and cost-effectiveness of septoplasty versus medical management for adults with a deviated septum and symptoms of nasal blockage. Identifying those individuals most likely to benefit from surgery should enable more efficient and effective clinical decision-making, and avoid unnecessary operations where there is low likelihood of patient benefit. Trial registration EudraCT: 2017–000893-12, ISRCTN: 16168569 . Registered on 24 March 2017.

Background The value of endoscopic septoplasty for patients with deviated nasal septum and allergic rhinitis has not been systematically summarized. This study aims to assess the impact of surgical intervention on quality of life through a meta-analysis. Methods We conducted a comprehensive search of PubMed, CNKI, EMBASE, and the Cochrane Library for studies on the treatment of patients with deviated nasal septum and allergic rhinitis up to 2024. Studies that were duplicates, lacked full text, had incomplete data, or involved animal experiments, commentaries, or systematic reviews were excluded. Meta-analysis was performed using STATA 16.0. Results The total nasal symptom score (TNSS) in patients who received endoscopic surgery was considerably reduced compared to those treated with spray therapy alone, indicating a significant improvement (SMD = -21.29, 95% CI: -26.26, -116.33). Classic symptoms of allergic rhinitis, including rhinorrhea (SMD=-9.97, 95% CI: -16.97, -2.98), nasal obstruction (SMD=-27.25, 95% CI: -41.12, -13.38), nasal itching (SMD=-10.32, 95% CI: -13.16, -7.48), and sneezing (SMD=-12.66, 95% CI: -14.99, -10.34), showed significant improvement. There was no significant difference in the incidence of complications between the two treatments (OR = 1.01, 95% CI: 0.49, 2.10). Conclusion Patients with a deviated nasal septum and allergic rhinitis benefit more from septoplasty. However, the procedure should be performed cautiously by experienced clinicians, taking into account the specific condition of the nasal septum.

The interatrial septum morphology, shaped by the septum primum and secundum fusion, results in the formation of the fossa ovalis (FO) and its limbus. Incomplete fusion can lead to a patent foramen ovale (PFO), while complete fusion may produce septal ridges and pouches (SPs), with SPs in humans linked to ischemic stroke and atrial arrhythmias. In horses, atrial tachycardia and fibrillation often originate near the FO. This study examines adult equine interatrial septum morphology to enhance understanding the region and guide electrophysiological interventions for equine cardiac arrhythmias. Post-mortem examinations of 62 adult equine hearts, assessed the interatrial septum morphology from both right and left sides, measuring the dimensions of the FO and the craniocaudal length, and dorsoventral height of the SPs. Histological analysis at selected septal locations evaluated the wall’s thickness and composition. Significant morphological variations were observed, particularly the consistent presence of right-sided SP. The septum wall comprises three layers, with the central layer containing cardiomyocytes in varied orientations, interspersed with fibroadipose tissue, features potentially contributing to atrial arrhythmias. Understanding the equine interatrial septum morphology is important for optimizing transseptal puncture outcomes, by facilitating accurate intracardiac echocardiography interpretation, guiding precise puncture site selection and improving procedural safety and efficacy.

Background Mesiodens is the most prevalent type of supernumerary tooth and frequently interferes with the eruption of maxillary incisors. While its dental implications are well described, its potential impact on maxillofacial structures—such as nasal septum deviation (NSD) and transverse skeletal development—has not been thoroughly investigated. This study aimed to evaluate these effects in pediatric patients using cone-beam computed tomography (CBCT). Methods A total of 102 pediatric patients with mesiodens and 102 age- and sex-matched controls were retrospectively evaluated. Maxillofacial parameters, including nasal base width, maxillary and mandibular transverse widths, and the presence of NSD, were assessed using CBCT. Statistical analyses involved independent t-tests, chi-square tests, and one-way ANOVA with post hoc comparisons ( p  < .05). Results The presence of mesiodens was significantly associated with a narrower nasal base width ( p  < .001) and a higher prevalence of NSD ( p  = .009). No significant differences were observed between groups regarding maxillary ( p  = .260) or mandibular width ( p  = .078). Conclusions These findings suggest that mesiodens may influence not only dental eruption but also broader craniofacial development. Early detection and comprehensive radiographic evaluation may help mitigate potential maxillofacial complications associated with this anomaly.