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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.

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 .

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.

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 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.

Introduction The nasal septum plays a pivotal role in craniofacial growth and development, and nasal septum deviation (NSD) is a common finding in clinical practice. This study aims to investigate the morphological relationship between the NSD and craniofacial transversal asymmetry. Materials and methods Cone-beam computed tomography (CBCT) scans from 114 patients were collected and analyzed to examine the association between NSD parameters and transverse metrics of the maxilla, dentoalveolus, and cranium. Additionally, craniofacial transverse parameters were compared across subgroups stratified by NSD variables, including Septal Deviation Angle (SDA), Deviated Septal Width (DSW), and Deviated Septal Curve Angle (DSCA), to evaluate their efficacy in predicting transverse asymmetry. Results NSD variables (SDA, DSW, and DSCA) were significantly associated with transverse asymmetry of the maxilla, dentoalveolus, and cranial base. Specifically, maxillary parameters reflecting transverse asymmetry of the maxillary sinus lateral wall around the palatal plane level and dentoalveolar parameters reflecting transverse asymmetry of the alveolar bone and dental arch exhibited significant differences across subgroups with varying NSD severity, as classified by SDA, DSW, and DSCA. Conclusions Our findings confirm a robust relationship between NSD and transverse asymmetry of multiple craniofacial structures. SDA and DSW demonstrate higher sensitivity, while DSCA shows greater specificity in identifying craniofacial asymmetry. Collectively, these parameters play key roles in the development of transverse asymmetry within the nasomaxillary skeleton.

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.

Background Nasal septum deviation (NSD) plays a vital role in paranasal sinus development, influencing sinonasal structures and maxillary sinus volume (MSV). This study aims to identify the NSD types and ascertain their impact on sinonasal variants, MSV, and morphometry of the infundibulum using three-dimensional (3D) computed tomography (CT) scans. Methods CT images of 300 patients (150 females and 150 males), aged between 18 and 70 years, were retrospectively analyzed. The prevalences of NSD types, NS pneumatization (NSP), middle concha bullosa (MCB), paradoxical middle turbinate (PMT), MS mucosal thickening (MSMT), accessory maxillary ostium (AMO), uncinate process (UP) variants, and inferior turbinate hypertrophy (ITH) were evaluated. Also, MSV, MO width (MOW), infundibulum length (IL) and angle (IA) were measured. Statistical analyses of data was done taking into account gender, laterality, and age. Results The greater the degree of NSD, the greater the likelihood of MCB, PMT and ITH occurring on the opposite side. Conversely, AMO, hypoplastic MS, MSMT, and hook-shaped UP were more prevalent on the same side of the deviation. The strongest associations with ipsilateral hyperplastic MS and being a young male were exhibited by PMT and MCB. Moderate and severe NSD, AMO, hook-shaped UP, hypoplastic MS and MSMT were more prevalent in older subjects, while younger subjects had more NSP, extensive MCB, PMT with a significant difference. The mean MSV, MOW and IL were found to be lower in MS on the same side of NSD, while the largest IA was observed in MS with severe NSD, as well as larger IA on the ipsilateral side of deviation, with a significant difference. However, we found that, as the degree of NSDA increased, the mean IL decreased and the mean MOW increased. The mean MOW and IL values indicated a positive correlation with ageing, whereas the MSV and IA values decreased with increasing age. Conclusions Despite their significance, our understanding of how sinonasal structures, MSV, and infundibulum morphometry vary and covary with NSD remains limited, a crucial aspect in the planning of dental implantology and endoscopic sinus surgery.