Consensus statement on the orofacial myofunctional assessment and therapy in patients with OSA: proposal of an international Delphi Method process

La rééducation myofonctionnelle orofaciale a été montrée efficace dans la prise en charge multidisciplinaire du syndrome d’apnées obstructives du sommeil chez l’enfant, l’adolescent et l’adulte, et elle est prescrite à plusieurs étapes de ces prises en charge. Cependant, compte tenu du manque d’homogénéité des protocoles de traitement et de mesures des résultats, du manque de recherches sur le type, la fréquence et la durée des exercices myofonctionnels et sur les phénotypes spécifiques qui peuvent en bénéficier, il apparait nécessaire de définir des recommandations de bonne pratique. Un consensus de recommandations Delphi consacré à l’évaluation et au traitement myofonctionnel orofacial pour les patients atteints de SAOS, a été mis en oeuvre à l’initiative de Marc Richard Moeller. Les deux premières étapes du consensus de recommandations Delphi sont achevées. La troisième étape, consacrée à l’élaboration du questionnaire aura lieu lors de la réunion conjointe de la World Sleep Society et de l’Academy of Applied Myofunctional Sciences, en mars 2022 à Rome. Les conclusions du consensus de recommandations Delphi seront publiées l’année suivante et largement diffusées.info:eu-repo/semantics/publishedVersio

Seeing Emotion with Your Ears: Emotional Prosody Implicitly Guides Visual Attention to Faces

Interpersonal communication involves the processing of multimodal emotional cues, particularly facial expressions (visual modality) and emotional speech prosody (auditory modality) which can interact during information processing. Here, we investigated whether the implicit processing of emotional prosody systematically influences gaze behavior to facial expressions of emotion. We analyzed the eye movements of 31 participants as they scanned a visual array of four emotional faces portraying fear, anger, happiness, and neutrality, while listening to an emotionally-inflected pseudo-utterance (Someone migged the pazing) uttered in a congruent or incongruent tone. Participants heard the emotional utterance during the first 1250 milliseconds of a five-second visual array and then performed an immediate recall decision about the face they had just seen. The frequency and duration of first saccades and of total looks in three temporal windows ([0–1250 ms], [1250–2500 ms], [2500–5000 ms]) were analyzed according to the emotional content of faces and voices. Results showed that participants looked longer and more frequently at faces that matched the prosody in all three time windows (emotion congruency effect), although this effect was often emotion-specific (with greatest effects for fear). Effects of prosody on visual attention to faces persisted over time and could be detected long after the auditory information was no longer present. These data imply that emotional prosody is processed automatically during communication and that these cues play a critical role in how humans respond to related visual cues in the environment, such as facial expressions

Decreased pool of mesenchymal stem cells is associated with altered chemokines serum levels in atrophic nonunion fractures

Nonunion fractures can cause severe dysfunction and are often difficult to treat mainly due to a poor understanding of their physiopathology. Although many aspects of impaired fracture healing have been extensively studied, little is known about the cellular and molecular mechanisms leading to atrophic nonunion. Therefore, the aim of the present study was to assess the pools and biological functions of bone marrow-derived mesenchymal stem cells (hMSCs) and circulating endothelial progenitor cells (EPCs) in atrophic nonunion patients compared to healthy subjects, and the systemic levels of growth factors involved in the recruitment, proliferation and differentiation of these cells. In nonunions, the pool of hMSCs was decreased and their proliferation delayed. However, once committed, hMSCs from nonunions were able to proliferate, differentiate into osteoblastic cells and mineralize in vitro as efficiently as hMSCs from healthy subjects. In parallel, we found altered serum levels of chemokines and growth factors involved in the chemotaxis and proliferation of hMSCs such as leptin, interleukin-6 (IL-6) and its soluble receptor, platelet-derived growth factor-BB (PDGF-BB), stem cell factor (SCF) and insulin-like growth factor-1 (IGF-1). Moreover, we showed that the number of EPCs and their regulating growth factors were not affected in nonunion patients. If nonunion is generally attributed to a vascular defect, our results also support a role for a systemic mesenchymal and osteogenic cell pool defect that might be related to alterations in systemic levels of factors implicated in their chemotaxis and proliferation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The Concept of Contexts in Pain: Generalization of Contextual Pain-Related Fear Within a de Novo Category of Unique Contexts

The experience of unpredictable pain fluctuations can trigger anticipatory pain-related fear. When discrete predictors for pain are lacking, fear typically accrues to the broader environmental context: a phenomenon referred to as contextual pain-related fear. We examined whether conceptual similarity between discrete contexts facilitates pain-related fear generalization; this mechanism is known as category-level fear generalization. Using a voluntary joystick movement paradigm, pain-free participants performed movements in 2 contexts (within-subjects design); context was manipulated by varying background color screens. In the predictable context, one movement predicted pain and another did not. In the unpredictable context, 2 other movements never predicted pain but pain was unpredictably delivered during the context. Participants subsequently learned to categorize novel background colors (ie, generalization contexts) as being similar to either the unpredictable or predictable pain context. Then we tested fear generalization to these novel contexts. We measured self-reported pain-related fear, expectancy, and eyeblink startle. Results indicated higher pain-related fear reports, but no elevated startle responses, for generalization contexts that were trained to be similar to the original unpredictable context rather than the predictable pain context. This highlights a potential pathway through which neutral contexts can elicit pain-related fear and motivate avoidance behavior associated with chronic pain disability. PERSPECTIVE: Self-reported pain-related fear and expectancy of painful outcome in response to a context associated with unpredictable pain generalizes to perceptually distinct contexts that are trained to be conceptually similar to the unpredictable pain context. Category-level generalization may be a pathway contributing to spreading of fear and avoidance in chronic pain