Cheiloscopy patterns in individuals with and without parafunctional oral habits: A cross-sectional observation pilot study.

PURPOSE: Lip prints are unique and have potential for use as a human identifier. The purpose of this study was to observe possible cheiloscopy differences of individuals with and without parafunctional oral habits such as smoking, vaping, playing a wind instrument or using an asthma inhaler. METHODS: This IRB approved blinded cross-sectional observation pilot study collected lip prints from 66 individuals, three of which were excluded. Participants cleansed their lips, then lipstick was applied to the vermillion zones of the upper and lower lips. Adhesive tape was applied to the lips and prints were transferred to white bond paper for viewing purposes. Each set of included lip prints was divided into quadrants and dichotomized into a group of those with an oral parafunctional habit or with no such habits. Each quadrant sample was then manually analysed and classed according to the gold standard Suzuki and Tsuchihashi system. RESULTS: A total of 252 dichotomized lip print quadrants (with habits n = 76, 30.2%, and without habits n = 176, 69.8%) were analysed. Type II patterns were the most common for examined quadrant samples; however, no statistically significant differences (Pearson's chi-squared test, p = 0.366) were observed between pattern classifications of samples with and without parafunctional oral habits. CONCLUSIONS: There is no statistically significant difference of lip print patterns between individuals with and without parafunctional oral habits. Further research on populational variations is needed for cheiloscopy to aid in human identifications.

Neonatal Outcomes in a Medicaid Population With Opioid Dependence.

Confounding may account for the apparently improved infant outcomes after prenatal exposure to buprenorphine versus methadone. We used Massachusetts Medicaid Analytic eXtract (MAX) data to identify a cohort of opioid-dependent mother-infant pairs (2006-2011), supplemented with confounder data from an external Boston, Massachusetts, cohort (2015-2016). Associations between prenatal buprenorphine exposure versus methadone exposure and infant outcomes in the MAX cohort were adjusted for measured MAX confounders and were additionally adjusted for unmeasured confounders with bias analysis using external cohort data. A total of 477 women in MAX were treated with methadone and 543 with buprenorphine. More buprenorphine users than methadone users were white and used psychotropic medications. After adjustment for MAX confounders, risk ratios among infants exposed to buprenorphine versus those exposed to methadone were 0.45 (95% confidence interval (CI): 0.34, 0.61) for preterm birth (birth at <37 weeks) and 0.75 (95% CI: 0.51, 1.11) for low birth weight for gestational age. The mean difference in infant hospitalization was -7.35 days (95% CI: -9.16, -5.55). After further adjustment with bias analysis, the risk ratios were 0.53 (95% CI: 0.39, 0.71) for preterm birth and 1.14 (95% CI: 0.77, 1.69) for low birth weight for gestational age, and the mean difference in infant hospitalization was -3.66 days (95% CI: -5.46, -1.87). External confounder data can be used to adjust for unmeasured confounding in studies of prenatal outcomes among women on opioid agonist therapy based on administrative databases.

Populational Variations of Cheiloscopy Patterns: A cross-sectional observation pilot study.

Purpose Lip prints are unique and have potential for use as a human identifier. The purpose of this study was to observe possible cheiloscopy differences of individuals with and without parafunctional oral habits such as smoking, vaping, playing a wind instrument or using an asthma inhaler.Methods This IRB approved blinded cross-sectional observation pilot study collected lip prints from sixty-six individuals, three of which were excluded. Participants cleansed their lips, then lipstick was applied to the vermillion zones of the upper and lower lips. Adhesive tape was applied to the lips and prints were transferred to white bond paper for viewing purposes. Each set of included lip prints was divided into quadrants and dichotomized into a group of those with an oral parafunctional habit or with no such habits. Each quadrant sample was then manually analyzed and classed according to the gold standard Suzuki and Tsuchihashi system.Results A total of 252 dichotomized lip print quadrants (with habits n=76, 30.2%, and without habits n=176, 69.8%) were analyzed. Type II patterns were the most common for examined quadrant samples; however, no statistically significant differences (Pearson's chi-squared test, p=0.366) were observed between pattern classifications of samples with and without parafunctional oral habits.Conclusion There is no statistically significant difference of lip print patterns between individuals with and without parafunctional oral habits. Further research on populational variations is needed for cheiloscopy to aid in human identifications.

Prenatal Treatment and Outcomes of Women With Opioid Use Disorder.

OBJECTIVE: To describe the characteristics, treatment, and outcomes of pregnant women with opioid use disorder. METHODS: Women attending an obstetric and addiction recovery clinic in Boston from 2015 to 2016 were enrolled in a prospective cohort study and followed through delivery (N=113). Buprenorphine or methadone was initiated clinically. The Addiction Severity Index was administered at enrollment. Prenatal and delivery data were systematically abstracted from medical charts. RESULTS: Most women in the cohort were non-Hispanic white (80.5%) with a mean age of 28 years. Few women were married (8.9%). More than half of the cohort had been incarcerated, 29.2% had current legal involvement, and 15.0% generally had unstable housing. A majority (70.8%) were infected with hepatitis C and histories of sexual (56.6%) and physical (65.5%) abuse were prevalent. Regular substance used included heroin (92.0%), injection heroin (83.2%), other opioids (69.0%), marijuana (73.5%), alcohol (56.6%), and cocaine (62.8%). Fifty-nine women (52.2%) were treated initially with prenatal buprenorphine and 54 (47.8%) with methadone; 49.6% also were taking concomitant psychotropic medications. Employment (0.766±0.289) and psychologic (0.375±0.187) Addiction Severity Index scores were the highest, indicating the most severe problems in these areas. Opioid use relapse did not differ by treatment (44.7% overall). Thirteen (22.5%) of 59 women treated with buprenorphine transitioned to methadone mainly because of positive opioid screens. Overall, 23.0% (n=26) of the cohort discontinued clinical care. The number of pregnancy losses was small (three therapeutic abortions, four miscarriages, one stillbirth), with an overall live birth rate of 90.8% (95% CI 82.7-95.9). CONCLUSION: These data on the social circumstances, substance use, treatment, and treatment outcomes of pregnant women with opioid use disorder may help clinicians to understand and treat this clinically complex population.

Abnormal striatal resting-state functional connectivity in adolescents with obsessive-compulsive disorder.

Neuroimaging research has implicated abnormalities in cortico-striatal-thalamic-cortical (CSTC) circuitry in pediatric obsessive-compulsive disorder (OCD). In this study, resting-state functional magnetic resonance imaging (R-fMRI) was used to investigate functional connectivity in the CSTC circuitry in adolescents with OCD. Imaging was obtained with the Human Connectome Project (HCP) scanner using newly developed pulse sequences which allow for higher spatial and temporal resolution. Fifteen adolescents with OCD and 13 age- and gender-matched healthy controls (ages 12-19) underwent R-fMRI on the 3T HCP scanner. Twenty-four minutes of resting-state scans (two consecutive 12-min scans) were acquired. We investigated functional connectivity of the striatum using a seed-based, whole brain approach with anatomically-defined seeds placed in the bilateral caudate, putamen, and nucleus accumbens. Adolescents with OCD compared with controls exhibited significantly lower functional connectivity between the left putamen and a single cluster of right-sided cortical areas including parts of the orbitofrontal cortex, inferior frontal gyrus, insula, and operculum. Preliminary findings suggest that impaired striatal connectivity in adolescents with OCD in part falls within the predicted CSTC network, and also involves impaired connections between a key CSTC network region (i.e., putamen) and key regions in the salience network (i.e., insula/operculum). The relevance of impaired putamen-insula/operculum connectivity in OCD is discussed.