Morphological characteristics of facial scars: A retrospective analysis according to scar location, onset, age, and cause

The morphology of facial scars shows a wide variation in terms of texture and colour. To date, there are no reliable predictors of aberrant scarring. We conducted a retrospective analysis to identify factors associated with specific scar features and types. Photographs and medical records of 428 patients with facial scars were retrospectively reviewed. Patients with keloids were excluded. The mean age of the patients was 45.43 ± 23.13 years with a male-to-female ratio of 1:1.36. Atrophic scars were the most common (42.8%), followed by flat scars (38.7%) and hypertrophic scars (18.5%). Scars on the forehead were more likely to be atrophic, whereas scars on the chin/jaw and around the mouth were more likely to be hypertrophic. Hypopigmentation was significantly more common in scars located on the forehead. Redness (erythema) was significantly more common in scars located on the chin/jaw. Old scars were less likely to be erythematous, and hypertrophic. Atrophic scars were more common in younger patients. Scars caused by dermatologic conditions, such as acne, were more likely to be atrophic, whereas surgical scars had the lowest risk of being atrophic or hypertrophic. In conclusion, the location, onset, and cause of facial scars were associated with specific features of scars.

Characterization of orofacial features in sclerodermatous chronic graft-versus-host disease

BACKGROUND

Chronic graft-versus-host disease (cGVHD) is a leading cause of morbidity and mortality following allogeneic hematopoietic cell transplantation (alloHCT). The sclerodermatous form of cGVHD can be particularly debilitating; however, orofacial sclerodermatous involvement remains poorly described.

OBJECTIVE

To characterize orofacial features of sclerodermatous cGVHD in a single center cohort of patients who underwent alloHCT.

STUDY DESIGN

Retrospective data were collected from electronic medical records and analyzed descriptively.

RESULTS

There were 39 patients who received alloHCT between 1993 and 2017 and developed orofacial sclerodermatous cGVHD. Concomitant cutaneous sclerodermatous cGVHD was common (n = 20, 51%). Orofacial sclerodermatous cGVHD features included fibrous bands of the buccal mucosa (n = 23, 59%), limited mouth opening (n = 19, 54%), perioral fibrosis (n = 8, 21%), and focal gingival recession (n = 4, 10%). Oral mucosal fibrosis was observed at the site of active or resolved chronic lichenoid inflammation in 30 patients, with all but two also presenting with a history of ulcerations. Management included jaw stretching exercises (n = 10; 6 stable/improved), surgery (n = 3; 2 improved), and intralesional corticosteroid injections (n = 2; 2 improved).

CONCLUSIONS

Orofacial involvement with sclerodermatous cGVHD can present with multiple manifestations including fibrous banding, limited mouth opening, perioral fibrosis, and focal gingival recession. Surgical and non-surgical management strategies may improve clinical function and reduce morbidity.

Individual differences in human gaze behavior generalize from faces to objects

Individuals differ in where they fixate on a face, with some looking closer to the eyes while others prefer the mouth region. These individual biases are highly robust, generalize from the lab to the outside world, and have been associated with social cognition and associated disorders. However, it is unclear, whether these biases are specific to faces or influenced by domain-general mechanisms of vision. Here, we juxtaposed these hypotheses by testing whether individual face fixation biases generalize to inanimate objects. We analyzed >1.8 million fixations toward faces and objects in complex natural scenes from 405 participants tested in multiple labs. Consistent interindividual differences in fixation positions were highly inter-correlated across faces and objects in all samples. Observers who fixated closer to the eye region also fixated higher on inanimate objects and vice versa. Furthermore, the inter-individual spread of fixation positions scaled with target size in precisely the same, non-linear manner for faces and objects. These findings contradict a purely domain-specific account of individual face gaze. Instead, they suggest significant domain-general contributions to the individual way we look at faces, a finding with potential relevance for basic vision, face perception, social cognition, and associated clinical conditions.

Adverse Effects of Natural Products in the Oral Mucosa and Face: A Scoping Review

Objective: This scoping review aimed to map the adverse reactions in the oral mucosa and face caused by the use of natural products. Methodology: This review was performed according to the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with a protocol registered in the Open Science Framework (DOI 10.17605/OSF.IO/R57D8). The search was carried out systematically using PubMed, Scopus, Web of Science, Embase, LILACS, and LIVIVO databases, as well as gray literature through Google Scholar and OpenGrey. Reports of clinical cases on the adverse effects of natural products on the oral mucosa or perioral region of the face resulted from inappropriate use or self-medication were included. Data from the included studies were described in a narrative form. Results: Seven hundred and six studies were identified, and after removing duplicates and applying the eligibility criteria, 28 studies were included. The year of publication ranged from 1976 to 2022. The studies were conducted in 19 countries. Fifty patients were mentioned in the included studies and 34 were female (68%). The natural products most related to adverse reactions were propolis (n = 17), with manifestations such as perioral eczema, edema, erosions, erythema, allergic contact dermatitis, and garlic (n = 9), with manifestations such as chemical burn, burning sensation, vesicles and blisters, crusts, and ulcerations. Conclusion: Propolis and garlic were the natural products with the most reported adverse effects on the oral mucosa and perioral region.

Prevalence of dental, oral, and maxillofacial traumatic injuries among domestic violence victims: A systematic review and meta-analysis

BACKGROUND/AIMS

Domestic violence (DV) encompasses a series of abusive behaviors, perpetrated in a family environment, against individuals of all ages and genders. Injuries to the head, neck, and face are frequent findings among victims of abuse, negatively impacting their quality of life. Although oral and maxillofacial injuries (OMFI) and traumatic dental injuries (TDI) are commonly diagnosed among DV victims, their prevalence is still unknown. This systematic review was aimed to assess the prevalence of OMFI and TDI among victims of DV.

METHODS

The protocol of the review was registered in PROSPERO (CRD42023424235). Literature searches were performed in eight electronic databases, up to August 7th, 2023. Observational studies published in the Latin-roman alphabet and reporting the prevalence of OMFI and/or TDI were included. The Joanna Briggs Institute's critical appraisal tool, checklist for prevalence studies, was used for quality assessment. Results were presented as qualitative and quantitative syntheses.

RESULTS

Seventeen studies, totaling 12,375 victims of domestic violence, were included. Meta-analyses showed an overall prevalence of 29% (95% CI: 15%-48%, I2  = 99%) and 4% (95% CI: 1%-10%, I2  = 98%) for OMFI and TDI, respectively. Higher pooled prevalence for OMFI (41%, 95% CI: 13%-46%, I2  = 99%) was demonstrated in samples with only women. OMFI was less prevalent (20%) among DV victims under 18, while TDI was lower among adults (1%). Hospital samples presented higher pooled prevalence of OMFI (32%), and forensic data from fatal victims presented higher prevalence of TDI (8%).

CONCLUSION

The overall prevalence of OMFI and TDI in DV victims was 29% and 4%, respectively. Women victims of DV presented higher rates of OFMI (41%) and TDI (6%).

The role of dental professionals in identifying, reporting, and supporting domestic violence victims

Domestic violence is a pervasive social issue affecting individuals across all demographics and has severe consequences for both the victims and society. Domestic violence is commonly defined as the exertion of power by one individual over another within a relationship, aiming to establish a sense of fear, control, and authority. The connection between domestic violence and oral health is established, with common oral health issues associated with domestic violence, such as dental trauma, head and neck bruises and injuries as well as facial fractures. Dental professionals play a crucial role in detecting signs of domestic violence by closely examining the head and neck region and the oral cavity during routine examinations. The significance of approaching patients suspected of experiencing domestic violence with sensitivity and empathy is of utmost importance. Recommendations include establishing trust, maintaining confidentiality, using open-ended questions, and providing information about local resources. Legal and ethical considerations are paramount, highlighting the obligations of dental professionals in cases of suspected domestic violence, including mandatory reporting laws and the balance between patient autonomy and safety. Challenges faced by dental professionals in reporting and intervening are discussed as well in this narrative review, emphasizing the importance of collaboration with other healthcare professionals and support services. This review underscores the vital role of dental care providers in recognizing signs of domestic violence, promoting intervention and support, and contributing to the well-being and safety of individuals impacted by domestic violence.

Dental and maxillofacial injuries associated with domestic violence against women in Israel: A report for 2011-2021

BACKGROUND/AIM

The WHO, in its 2002 report, indicated the dramatic worldwide increase in the incidence of intentional injuries affecting people of all ages and both sexes, but especially children, women, and the elderly. The aim of this study was to analyze dental and maxillofacial injuries associated with domestic violence against women in Israel between the years 2011-2021.

METHODS

This was a retrospective cohort study based on data from the Israeli National Trauma Registry (INTR). The INTR provides comprehensive data on hospitalized patients from all six Level I trauma centers (TC) and 15 of the 20 Level II TCs in Israel. Women, ages 14 and older, injured and hospitalized due to domestic violence between 2011 and 2021 were identified.

RESULTS

Between 2011 and 2021, there were 1818 cases of women ages 14 + that were hospitalized due to violence, excluding terror, occupational trauma, and attempted suicide. Out of these injuries, 753 cases were attributed to domestic violence, 537 were defined as non-domestic violence and 528 were a result of a brawl/fight. Of the domestic violence cases, 5% (38) exhibited maxillofacial injuries compared to the non-domestic violence cases where 6.2% (33) exhibited maxillofacial injuries and the brawl group where 5.7% (30) exhibited maxillofacial injuries. The most injured areas in domestic violence cases were the maxilla followed by the zygomatic bone and the mandible. Almost half of the domestic violence cases (47.7%) required surgical intervention during their hospitalization. The spouse was the perpetrator responsible for the domestic violence in the majority of the cases.

CONCLUSIONS

Dental professionals might be able, in some cases, to identify and report domestic violence signs and thus, better understanding of the specific characteristics of domestic violence related to traumatic injuries is important.

An integration protocol for aligning intraoral scans to facial scans using the nasal geometry reference in a fully dentate patient

Advanced digital technologies have rapidly been integrated into prosthodontics to improve the digital workflow for prosthetic rehabilitation. The integration of 3D datasets acquired from various imaging sources such as intraoral scanners and facial optical scanners allows the creation of virtual patients to perform presurgical simulation and prosthetic rehabilitation. The presented technique introduced a straightforward protocol for aligning intraoral scans (Trios 4, 3Shape) to optical face scans (Face Hunter, Zirkonzahn) using a global best-fit algorithm of 3D evaluation software (GOM Inspect). Nasal geometry data were used as the matching reference to produce virtual dental patients. This integration protocol ensured that the intraoral scanner (Trios 4, 3Shape) was used not only to scan dental arches but also used effectively to scan the nose. These scans along with professional facial scans can be successfully aligned to produce virtual dental patients. As only a single fully dentate patient case with an alignment deviation of 243.6 µm was used, further research to evaluate the accuracy of this protocol is needed.

Facial Analysis of Patients with Unilateral or Bilateral Cleft Lip and Palate Using 3D Stereophotogrammetry

OBJECTIVES

To evaluate the quantitative values of linear and angular facial anthropometrics in patients with unilateral cleft lip and palate (UCLP) and compare them with those of patients with bilateral cleft lip and palate (BCLP) using three-dimensional (3D) facial imaging.

DESIGN

Retrospective, observational, and cross-sectional study.

SETTING

Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP).

PATIENTS/ PARTICIPANTS

In total, 61 non-syndromic patients with CLP who underwent multidisciplinary treatment and rehabilitated with a prosthesis were enrolled and divided into those with UCLP (G1; n = 31) and those with BCLP (G2; n = 30).

INTERVENTION

Facial images were captured using a 3D camera after landmarks were marked on each patient's face. The software evaluated linear and angular parameters. Statistical tests were applied. Significance was determined as P < 0.05.

MAIN OUTCOME MEASUREMENTS

Overall, 22 linear and 13 angular measurements were evaluated.

RESULTS

The nasal length (P = 0.08), middle third of the face (P = 0.06), base nose width (P < 0.001), nasal root width (P < 0.001), nasal tip angle (P = 0.018), philtrum width (P < 0.001), lower face width (P = 0.039) and midfacial depth (P = 0.040) were significantly higher in G2; the upper cutaneous lip height was significantly higher in G1. Sexual dimorphism was observed except for linear measurements (linear distance between the labiale superius and labiale inferius landmarks, nasal root width, and upper cutaneous lip length) and angular measurements.

CONCLUSIONS

G2 had a greater length and width of nose and nasal root, nasal tip angle, philtrum width, and lower face width, midfacial depth, and midface third than G1. These findings also revealed the presence of sexual dimorphism.

Using AI Text-to-Image Generation to Create Novel Illustrations for Medical Education: Current Limitations as Illustrated by Hypothyroidism and Horner Syndrome

Our research letter investigates the potential, as well as the current limitations, of widely available text-to-image tools in generating images for medical education. We focused on illustrations of important physical signs in the face (for which confidentiality issues in conventional patient photograph use may be a particular concern) that medics should know about, and we used facial images of hypothyroidism and Horner syndrome as examples.

Atrophic Postacne Scar Treatment: Narrative Review

Acne scarring is a frequent complication of acne. Scars negatively impact psychosocial and physical well-being. Optimal treatments significantly improve the appearance, quality of life, and self-esteem of people with scarring. A wide range of interventions have been proposed for acne scars. This narrative review aimed to focus on facial atrophic scarring interventions. The management of acne scarring includes various types of resurfacing (chemical peels, lasers, and dermabrasion); the use of injectable fillers; and surgical methods, such as needling, punch excision, punch elevation, or subcision. Since the scarred tissue has impaired regeneration abilities, the future implementation of stem or progenitor regenerative medical techniques is likely to add considerable value. There are limited randomized controlled trials that aimed to determine which treatment options should be considered the gold standard. Combining interventions would likely produce more benefit compared to the implementation of a single method.

Neuronal Population Encoding of Identity in Primate Prefrontal Cortex

The ventrolateral prefrontal cortex (VLPFC) shows robust activation during the perception of faces and voices. However, little is known about what categorical features of social stimuli drive neural activity in this region. Since perception of identity and expression are critical social functions, we examined whether neural responses to naturalistic stimuli were driven by these two categorical features in the prefrontal cortex. We recorded single neurons in the VLPFC, while two male rhesus macaques (Macaca mulatta) viewed short audiovisual videos of unfamiliar conspecifics making expressions of aggressive, affiliative, and neutral valence. Of the 285 neurons responsive to the audiovisual stimuli, 111 neurons had a main effect (two-way ANOVA) of identity, expression, or their interaction in their stimulus-related firing rates; however, decoding of expression and identity using single-unit firing rates rendered poor accuracy. Interestingly, when decoding from pseudo-populations of recorded neurons, the accuracy for both expression and identity increased with population size, suggesting that the population transmitted information relevant to both variables. Principal components analysis of mean population activity across time revealed that population responses to the same identity followed similar trajectories in the response space, facilitating segregation from other identities. Our results suggest that identity is a critical feature of social stimuli that dictates the structure of population activity in the VLPFC, during the perception of vocalizations and their corresponding facial expressions. These findings enhance our understanding of the role of the VLPFC in social behavior.

A Case of Pan-TRK Positive Dermatofibrosarcoma Protuberans Located on the Nose

Dermatofibrosarcoma protuberans (DFSP) is a rare and infiltrative soft tissue tumor. Our report details a distinctive case of DFSP with pan-TRK positivity in the right nasal dorsum of a 46-year-old female. Histological analysis identified NTRK fusion gene involvement in this patient, detectable through pan-TRK immunostaining. The case underscores the significance of comprehensive management for pan-TRK-positive DFSP in challenging facial locations, indicating the potential efficacy of TRK inhibitors.

A Split-face Study on Rejuvenation Efficacy According to Monopolar Radiofrequency Tip Size

Monopolar radiofrequency (RF) non-invasively tightens and rejuvenates the skin by stimulating collagen fiber production. Since the introduction of the monopolar RF device in the early 2000's, RF devices have advanced and they can rejuvenate of periorbital and forehead wrinkles, as well as skin laxity of the lower face and neck. We compared the differences in the treatment effects based on the tip size. This randomized split-face study comprised 31 participants aged 29 to 75 years old (three males and 28 females) who underwent one session of monopolar RF; one side of the face was treated with a 3cm2 tip and the other with a 4cm2 tip. Facial wrinkle scores were measured on the upper face and the lower face before and after treatment for up to three months. Significant improvement was observed in the periorbital area (p<0.001), forehead (p=0.72), and glabellar (p=0.63) treated with a smaller tip. However, nasolabial folds (p=0.8) and marionette lines (p=0.13) showed better improvement when treated with a larger tip.

Masks and Faces in the Setting at the Time of Coronavirus

The "health emergency" forced analysts to seek new ways of continuing with analysis. The article focuses, in particular, on the changes brought about in the setting by the presence of the sanitary mask, following a line that begins with the theme of the "mask" in the collective uses of human cultures, and develops through the Jungian concept of persona, as opposed to the "face" that may convey an authentic image of oneself. A clinical vignette illustrates the issues that the mask raises in the setting by obstructing the communication of emotions. When there is no transformative processing of concrete data, "unmasking" can also lead to an uncanny encounter and to moments of darkness and confusion in analysis, when the analyst experiences the kind of "unconscious identity" between therapist and patient that Jung defined as nigredo. The article is intended as a contribution to the analytic community's current reflections on the new and unforeseen challenges encountered in analysis at the time of the Coronavirus. It is possible to learn from these experiences with a view to integrating new elements and thus modify one's own internal setting, the compass with which each analyst orientates himself.

DNA-guided transcription factor cooperativity shapes face and limb mesenchyme

Transcription factors (TFs) can define distinct cellular identities despite nearly identical DNA-binding specificities. One mechanism for achieving regulatory specificity is DNA-guided TF cooperativity. Although in vitro studies suggest that it may be common, examples of such cooperativity remain scarce in cellular contexts. Here, we demonstrate how "Coordinator," a long DNA motif composed of common motifs bound by many basic helix-loop-helix (bHLH) and homeodomain (HD) TFs, uniquely defines the regulatory regions of embryonic face and limb mesenchyme. Coordinator guides cooperative and selective binding between the bHLH family mesenchymal regulator TWIST1 and a collective of HD factors associated with regional identities in the face and limb. TWIST1 is required for HD binding and open chromatin at Coordinator sites, whereas HD factors stabilize TWIST1 occupancy at Coordinator and titrate it away from HD-independent sites. This cooperativity results in the shared regulation of genes involved in cell-type and positional identities and ultimately shapes facial morphology and evolution.

Characteristic Dermatoscopic Features of Hyperpigmented Macules on the Faces of Young Children

The aim was to describe the characteristic dermatoscopic features of hyperpigmented macules on the faces of young children. Sixteen patients with typical clinical presentations of hyperpigmented macules on the faces of young children were included in this study. The lesions were evaluated using a dermatoscope. The clinical and dermatoscopic features were analyzed and summarized. There were 12 boys and 4 girls enrolled in the study. The hyperpigmented macules had an age of onset ranging from 1 to 18 months (mean, 6.12 months). The hyperpigmentation was distributed on the forehead and/or temple, as follows: forehead (n = 8 [50%]); temple (n = 3 [18.8%]); and both sites (n = 5 [31.2%]). Fifteen patients (93.7%) had pseudoreticular pigmentation, 1 patient (6.3%) had reticular pigment with pseudoreticular pigment, and 100% had erythema and linear/branching vessels. Light brown pseudoreticular pigment and linear vessels were shown to be the 2 major dermatoscopic manifestations of hyperpigmented macules on the faces of young children.

Customized planning of the visible maxillary arch width in harmony with interparopia width and smile width for female facial aesthetics

BACKGROUND

The visible maxillary arch width (VAW) is an important aesthetic-determining feature. To date, there is no well-established methodology to determine the aesthetically optimal VAW in customized treatment planning.

METHODS

In this study, the common traits of the dentofacial configuration were investigated in most attractive Asian and Caucasian female smiles. The smiling photo of a subject was digitally modified based on combined variations of VAW, smile width (SW), transverse facial dimensions (TFD), and vertical facial dimensions. These modified photos were assessed for aesthetics. The aesthetically essential parameters were identified, and their mathematic correlations and reference ranges were determined for different vertical facial patterns. Using the obtained results, a mathematic guidance was constructed for customized smile designing. The applicability of this guidance was tested in Asian females.

RESULTS

The most attractive Asian and Caucasian female smiles have intraracial and interracial commonalities in the VAW-to-TFD ratios. The interparopia width (IPD) predominated over facial widths in determining well-matched VAW and SW. For optimal smile aesthetics, the VAW and SW were correlated as simulated by the formula 1.92 IPD ≤ VAW + 2.3 SW ≤ 2.17 IPD, plus the VAW-to-IPD ratio within 0.54 to 0.62 and the SW-to-IPD ratio within 0.61 to 0.71, ranges tailored to vertical facial patterns. This constitutes a mathematic guidance for customized planning of the aesthetically optimal VAW. This guidance was preliminarily validated to be applicable to Asian females.

CONCLUSIONS

The VAW-to-TFD ratios were essential for Caucasian and Asian female smile aesthetics. The mathematic guidance could serve as a reference for customized smile designs for Asian females.

Comparison of face-based and voice-based first impressions in a Chinese sample

People often form first impressions of others based on face and/or voice cues. This study aimed to compare the first impressions formed under these two cues. First, we compared free descriptions based on face and voice cues and found differences in the content and frequency of the personality words. We then compiled three wordlists used for face-based and voice-based first impression evaluations separately or simultaneously. Second, using these wordlists, we compared face-based and voice-based first impression ratings and found that both had significant intra-rater and inter-rater reliability. However, using the mean of the actors' self-rating and their acquaintance rating as the validity criterion, only the ratings of 'ingenuous' and 'mature' traits in the face-based first impression evaluation were significantly correlated with the validity criterion. Factor analysis revealed that face-based first impression had the dimensions of capability and approachability, while voice-based first impression had capability, approachability and reliability. The findings indicate that stable first impressions can be formed by either face or voice cues. However, the specific composition of impressions will vary between the cues. These results also provide a foundation for studying first impressions formed by an integrated perception of voice and face cues.

Health Care Professional-Supported Co-Design of a Mime Therapy-Based Serious Game for Facial Rehabilitation

This research letter presents the co-design process for RG4Face, a mime therapy-based serious game that uses computer vision for human facial movement recognition and estimation to help health care professionals and patients in the facial rehabilitation process.

Balancing beauty and science: a review of facial implant materials in craniofacial surgery

Facial reconstruction and augmentation, integral in facial plastic surgery, address defects related to trauma, tumors infections, and congenital skeletal deficiencies. Aesthetic considerations, including age-related facial changes, involve volume loss and diminished projection, often associated with predictable changes in the facial skeleton. Autologous, allogeneic, and alloplastic implants are used to address these concerns. Autologous materials such as bone, cartilage, and fat, while longstanding options, have limitations, including unpredictability and resorption rates. Alloplastic materials, including metals, polymers, and ceramics, offer alternatives. Metals like titanium are biocompatible and used primarily in fracture fixation. Polymers, such as silicone and polyethylene, are widely used, with silicone presenting migration, bony resorption, and visibility issues. Polyethylene, particularly porous polyethylene (MedPor), was reported to have one of the lowest infection rates while it becomes incorporated into the host. Polyether-ether-ketone (PEEK) exhibits mechanical strength and compatibility with imaging modalities, with custom PEEK implants providing stable results. Acrylic materials, like poly-methylmethacrylate (PMMA), offer strength and is thus mostly used in the case of cranioplasty. Bioceramics, notably hydroxyapatite (HaP), offer osteoconductive and inductive properties, and HaP granules demonstrate stable volume retention in facial aesthetic augmentation. Combining HaP with other materials, such as PLA, may enhance mechanical stability. 3D bioprinting with HaP-based bioinks presents a promising avenue for customizable and biocompatible implants. In conclusion, various materials have been used for craniofacial augmentation, but none have definitively demonstrated superiority. Larger randomized controlled trials are essential to evaluate short- and long-term complications comprehensively, potentially revolutionizing facial balancing surgery.

Neural mechanisms of face familiarity and learning in the human amygdala and hippocampus

Recognizing familiar faces and learning new faces play an important role in social cognition. However, the underlying neural computational mechanisms remain unclear. Here, we record from single neurons in the human amygdala and hippocampus and find a greater neuronal representational distance between pairs of familiar faces than unfamiliar faces, suggesting that neural representations for familiar faces are more distinct. Representational distance increases with exposures to the same identity, suggesting that neural face representations are sharpened with learning and familiarization. Furthermore, representational distance is positively correlated with visual dissimilarity between faces, and exposure to visually similar faces increases representational distance, thus sharpening neural representations. Finally, we construct a computational model that demonstrates an increase in the representational distance of artificial units with training. Together, our results suggest that the neuronal population geometry, quantified by the representational distance, encodes face familiarity, similarity, and learning, forming the basis of face recognition and memory.

The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson's Disease

Facial movements are crucial for social and emotional interaction and well-being. Reduced facial expressions (i.e., hypomimia) is a common feature in patients with Parkinson's disease (PD) and previous studies linked this manifestation to both motor symptoms of the disease and altered emotion recognition and processing. Nevertheless, research on facial motor impairment in PD has been rather scarce and only a limited number of clinical evaluation tools are available, often suffering from poor validation processes and high inter- and intra-rater variability. In recent years, the availability of technology-enhanced quantification methods of facial movements, such as automated video analysis and machine learning application, led to increasing interest in studying hypomimia in PD. In this narrative review, we summarize the current knowledge on pathophysiological hypotheses at the basis of hypomimia in PD, with particular focus on the association between reduced facial expressions and emotional processing and analyze the current evaluation tools and management strategies for this symptom, as well as future research perspectives.

Clinical outcomes of scalp or face angiosarcoma treatment with intensity-modulated radiotherapy: a multicenter study

Combined modality therapy, including radiotherapy (RT), is a common treatment for scalp or face angiosarcoma. Although intensity-modulated radiotherapy (IMRT) can deliver homogeneous doses to the scalp or face, clinical data are limited. This multicenter study aimed to evaluate scalp or face angiosarcoma treated with definitive or post-operative IMRT. We retrospectively analyzed data from patients who received IMRT for scalp or face angiosarcoma at three institutions between January 2015 and March 2020. Local control (LC) rate, overall survival (OS), progression-free survival (PFS), recurrence patterns and toxicity were evaluated. Fifteen patients underwent IMRT during the study period. Definitive RT was performed on 10 patients and post-operative RT was performed on 5 patients. The 1-year LC rate was 85.7% (95% confidence interval [CI], 53.9-96.2%). The 1-year OS and PFS rates were 66.7% (95% CI, 37.5-84.6%) and 53.3% (95% CI, 26.3%-74.4%), respectively. Univariate analysis revealed that a clinical target volume over 500 cm3 was associated with poor LC. Distant metastasis was the most common recurrence pattern. All patients experienced Grade 2 or 3 radiation dermatitis, and five patients experienced grade ≥ 3 skin ulceration. One patient who underwent maintenance therapy with pazopanib developed Grade 5 skin ulceration. Fisher's exact test showed that post-operative RT was significantly associated with an increased risk of skin ulceration of grade ≥ 3. These results demonstrate that IMRT is a feasible and effective treatment for scalp or face angiosarcoma, although skin ulceration of grade ≥ 3 is a common adverse event in patients who receive post-operative RT.

Children's Visual Perception of Facial Scarring and Cleft Lip Deformity Using Eye Tracking Data

OBJECTIVE

The purpose of this study is to determine children's perception of secondary cleft lip deformity (SCLD) using objective eye tracking technology and subjective responses on a survey to understand pediatric perceptions of facial scarring.

DESIGN

Cross-sectional study of participants aged 5-17 years old.

METHODS

Participants viewed images of children's faces with an eye tracking device. Sixteen images were displayed, 12 with unilateral SCLD and four with no facial scarring. Eye tracking data were obtained. Gaze samples were analyzed for areas of interest (AOIs). Immediately after viewing each image, participants answered two survey questions relating to facial asymmetry attitude toward the child pictured. For analysis, participants were divided into age groups.

RESULTS

A total of 259 participants were enrolled (42.5% female). Mean age was 10.5 years and 78% identified as White. In all age groups, total fixation time was greater for SCLD compared to control images. Early elementary age children spent significantly less time assessing the nose AOI compared to other groups, and also spent the least total fixation time and had the lowest visit count on all AOIs. Subjective survey questions showed similar trends with elementary age not noticing facial asymmetry compared to older age groups.

CONCLUSION

This study demonstrates the successful use of eye tracking technology in children as young as 5 years old. This study suggests that SCLD is perceived as less noticeable in elementary age children and becomes more noticeable to older groups. Understanding peer perception on SCLD from this study may impact decision on revision surgery for SCLD.

LEVEL OF EVIDENCE

IV Laryngoscope, 2024.

A multi-study analysis enables identification of potential microbial features associated with skin aging signs

Introduction: During adulthood, the skin microbiota can be relatively stable if environmental conditions are also stable, yet physiological changes of the skin with age may affect the skin microbiome and its function. The microbiome is an important factor to consider in aging since it constitutes most of the genes that are expressed on the human body. However, severity of specific aging signs (one of the parameters used to measure "apparent" age) and skin surface quality (e.g., texture, hydration, pH, sebum, etc.) may not be indicative of chronological age. For example, older individuals can have young looking skin (young apparent age) and young individuals can be of older apparent age. Methods: Here we aim to identify microbial taxa of interest associated to skin quality/aging signs using a multi-study analysis of 13 microbiome datasets consisting of 16S rRNA amplicon sequence data and paired skin clinical data from the face. Results: We show that there is a negative relationship between microbiome diversity and transepidermal water loss, and a positive association between microbiome diversity and age. Aligned with a tight link between age and wrinkles, we report a global positive association between microbiome diversity and Crow's feet wrinkles, but with this relationship varying significantly by sub-study. Finally, we identify taxa potentially associated with wrinkles, TEWL and corneometer measures. Discussion: These findings represent a key step towards understanding the implication of the skin microbiota in skin aging signs.

The Critical Photographic Variables Contributing to Skull-Face Superimposition Methods to Assist Forensic Identification of Skeletons: A Review

When an unidentified skeleton is discovered, a video superimposition (VS) of the skull and a facial photograph may be undertaken to assist identification. In the first instance, the method is fundamentally a photographic one, requiring the overlay of two 2D photographic images at transparency for comparison. Presently, mathematical and anatomical techniques used to compare skull/face anatomy dominate superimposition discussions, however, little attention has been paid to the equally fundamental photographic prerequisites that underpin these methods. This predisposes error, as the optical parameters of the two comparison photographs are (presently) rarely matched prior to, or for, comparison. In this paper, we: (1) review the basic but critical photographic prerequisites that apply to VS; (2) propose a replacement for the current anatomy-centric searches for the correct 'skull pose' with a photographic-centric camera vantage point search; and (3) demarcate superimposition as a clear two-stage phased procedure that depends first on photographic parameter matching, as a prerequisite to undertaking any anatomical comparison(s).

Exploring the Multifaceted Impact of Acne on Quality of Life and Well-Being

A suitable portion of the total population still suffers through acne vulgaris, a widespread dermatological illness that mostly affects teens and young adults. Although acne is typically considered to be a cosmetic problem, recent research has concluded that certainly it has a significant role on impacting many physiological aspects of human health. This thorough investigation attempts to examine the intricate effects of acne on human physiology, taking into consideration both systemic and local effects. The study synthesizes research from a number of scientific disciplines, including dermatology, endocrinology, immunology, and psychoneuroimmunology. It investigates the complex interrelationships between several factors, such as sebum production, follicular hyperkeratinization, hormone imbalance, and Propionibacterium acnes colonisation, that lead to the development of acne. The study also sheds information on the intricate physiological mechanisms, oxidative stress, and immune response that contribute to the aetiology of acne. Along with it, the review investigates the relationship between endocrine problems and acne, emphasizing hormonal anomalies and their possible role in acne severity. The psychological effects of acne are also discussed, including the psychological problems, concerns with self-esteem, and decreased quality of life that acne sufferers encounter. On comprehensively examining the diverse physiological aspects affected by acne, this review provides a foundation for future research endeavours and informs the development of targeted therapeutic interventions. Ultimately, the integration of multidisciplinary approaches will enable healthcare professionals to address the physiological complexities of acne and improve the overall well-being of individuals affected by this common skin condition.

Perifollicular linear projections: A dermatoscopic criterion for the diagnosis of lentigo maligna on the face

BACKGROUND

Lentigo maligna (LM) can mimic benign, flat, pigmented lesions and can be challenging to diagnose.

OBJECTIVE

To describe a new dermatoscopic feature termed "perifollicular linear projections (PLP)" as a diagnostic criterion for LM on the face.

METHODS

Retrospective study on reflectance confocal microscopy and dermatoscopy images of flat facial pigmented lesions originating from 2 databases. PLP were defined as short, linear, pigmented projections emanating from hair follicles. Dermatoscopy readers were blinded to the final histopathologic diagnosis.

RESULTS

From 83 consecutive LMs, 21/83 (25.3%) displayed "bulging of hair follicles" on reflectance confocal microscopy and 18 of these 21 (85.7%), displayed PLP on dermatoscopy. From a database of 2873 consecutively imaged and biopsied lesions, 252 flat-pigmented facial lesions were included. PLP was seen in 47/76 melanomas (61.8%), compared with 7/176 lesions (3.9%) with other diagnosis (P < .001). The sensitivity was 61.8% (95% CI, 49.9%-72.7%), specificity 96.0% (95% CI, 92.9%-98.4%). PLP was independently associated with LM diagnosis on multivariate analysis (OR 26.1 [95% CI, 9.6%-71.0]).

LIMITATIONS

Retrospective study.

CONCLUSION

PLP is a newly described dermatoscopic criterion that may add specificity and sensitivity to the early diagnosis of LM located on the face. We postulate that PLP constitutes an intermediary step in the LM progression model.

Facial growth and development trajectories based on three-dimensional images: geometric morphometrics with a deformation perspective

Developmental changes of facial shape are commonly investigated through geometric morphometrics. A limitation with this approach is the inability to investigate patterns of morphological changes at local scale. This could be addressed through quantifying the deformation required to deform one shape to another. This study aimed to investigate changes in mean, rate and variance of facial shape at local scale using geometric morphometrics through deformation perspective. A total of 2112 Europeans 3 to 40 years old from the three-dimensional Facial Norms project were included. Shape and rate trajectories from partial least-squares regressions revealed that the developmentally protrusive nasal bridge was due to local expansion in surrounding tissues as opposed to shape changes in nasal bridge per se. Local expansion of the supraorbital region, in particular the medial part in males, resulted in the sloping forehead and deep-situated eyes with development. Facial shape variation increased nonlinearly with age (p < 0.05), with features having larger rate of change becoming more developmentally diversified. In summary, our deformation perspective facilitates unravelling morphogenetic processes underlying shape changes. Our extended analytical scope inspires novel measures worthy of consideration while establishing facial growth charts. The analytical framework in this study is broadly applicable for analysis of shape changes in general.

Face-like pareidolia images are more difficult to detect than real faces in children with autism spectrum disorder

BACKGROUND

Research on the diagnosis, treatment and pathophysiology of neurodevelopmental disorders is multifaceted, requiring the use of genetics, imaging, psychology, and artificial intelligence (AI). Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a limited ability to communicate and a limited interest in social environments. Facial recognition is really important in daily life. Seeing faces in unusual objects, e.g., a face in a cloud, is called face pareidolia.

OBJECTIVES

Although more evidence points to a greater role of genetic factors in ASD, neuropsychological tests have an important role in diagnosing ASD. The aim of the study was to investigate how face perception is processed in children with autism using a new digital test that consists of faces and pareidolia images.

MATERIAL AND METHODS

Twenty typically developing (TD) children (8 male, 12 female) between 6 and 16 years of age and 21 children with ASD (14 male, 7 female) between 6 and 14 years of age were included in the study. A new neuropsychological test called the digital pareidolia test was administered to the participants. The study consisted of 2 stages: a face condition and a pareidolia condition.

RESULTS

Our results showed that children with autism (n = 21) were less successful in identifying both face and pareidolia images, and were slower to react in both conditions than children from the TD group. Both children with ASD and the TD group reacted faster to face images than pareidolia images.

CONCLUSIONS

The findings in this study are in agreement with atypical and different face perceptions in autism which cause social difficulties. We demonstrated that the digital face and pareidolia test has considerable potential for use as a neuropsychological test that can specify the diagnosis and progression of autism in subclinical areas. Pareidolia faces and real faces are processed in a common way.

On the persistence of race: Unique skulls and average tissue depths in the practice of forensic craniofacial depiction

The (re-)surfacing of race in forensic practices has received plenty of attention from STS scholars, especially in connection with modern forensic genetic technologies. In this article, I describe the making of facial depictions based on the skulls of unknown deceased individuals. Based on ethnographic research in the field of craniofacial identification and forensic art, I present a material-semiotic analysis of how race comes to matter in the face-making process. The analysis sheds light on how race as a translation device enables oscillation between the individual skull and population data, and allows for slippage between categories that otherwise do not neatly map on to one another. The subsuming logic of race is ingrained - in that it sits at the bases of standard choices and tools - in methods and technologies. However, the skull does not easily let itself be reduced to a racial type. Moreover, the careful efforts of practitioners to articulate the individual characteristics of each skull provide clues for how similarities and differences can be done without the effect of producing race. Such methods value the skull itself as an object of interest, rather than treat it as a vehicle for practicing race science. I argue that efforts to undo the persistence of race in forensic anthropology should focus critical attention on the socio-material configuration of methods and technologies, including data practices and reference standards.

The politics of face and the trouble with race: Exploring relations at the interface between the individual and the collective in forensic practice

This special issue interrogates race through the lens of face. Its central faces are those in forensic settings. Promising immediate legibility and access to the individual suspect, forensic faces nevertheless mobilize a variety of collectives. We offer conceptual and methodological tools to examine the face as both an individual and a collective phenomenon, and demonstrate through detailed cases how the face thus allows us to address the absent presence of race. Given its long and convoluted history in physical anthropology, as a marker of racial typology, the face forces us to reckon with colonial histories of ordering human difference. But the face also allows us to question a regime of visuality that congeals around the face in Western culture. In this introduction to The Politics of Face and the Trouble with Race we elaborate these concerns and introduce the contributions to this volume.

A multimodal intervention

This article problematizes vision in practices of identification. It draws on the metaphor of the 'interface' to emphasize that vision emerges 'in between' eyes, faces, bodies, objects and ideas of belonging and otherness. As such, vision can be a material and political technology that enacts certain people as racial others. To attend to the materiality and politics of vision and its messy relationship with race, I bring together three European stories in which faces are drawn, seen or identified, while race hides or surfaces in intriguing ways. Through these stories we learn that race is saturated with affect and is recalled in objects and bodies. In addition, this article offers a novel methodological approach. It employs the eyes of the reader not only to read but also to watch. Vision itself becomes a technology, this time not to produce or reinforce, but to disturb and perhaps even undo ideas of racial otherness. Through the use of experimental montage, I attend to the complexities and incongruities of seeing faces and race without settling on a single narrative. I actively engage the eyes of the viewer to argue that vision is always relational and partial and therefore, it can also be harnessed to undo racial otherness by fragmenting, multiplying and affecting.

Face-to-face live eye-tracking in toddlers with autism: Feasibility and impact of familiarity and face covering

Studies utilizing eye-tracking methods have potential to promptly capture real-world dynamics of one of the core areas of vulnerability in autism spectrum disorders (ASD), selective social attention. So far, no studies have successfully reported utilizing the method to examine social attention in toddlers with neurodevelopmental vulnerabilities in real world and challenging settings such as an interactive face-to-face. This study examined the feasibility and validity of live eye-tracking method in response to live interaction occurring in several contexts in toddlers with and without ASD. Forty-seven toddlers with ASD, with atypical development (ATYP), or typically developing (TD), underwent a 30-s live eye-tracking procedure during a face-to-face interaction with a masked stranger using child-directed-speech (16 ASD, 14 ATYP, 17 TD; Mage  = 23.44 months, SD = 6.02). Out of this group of toddlers, 29 (10 ASD, 8 ATYP, 11 TD, Mage  = 21.97 months, SD = 5.76) underwent the same procedure with one of their maskless parent. Task completion rate, calibration accuracy, and affective response (feasibility measures) as well as attention to the task and the social partner (validity measures) were examined. Task completion rate and calibration accuracy were excellent. Despite the challenging context of face-to-face interaction, the toddlers exhibited a neutral affect, and high attention to the task and the speaker. As anticipated, toddlers with ASD looked less at the social partner compared with control groups. However, attention was comparable between the Stranger and Parent conditions, indicating that the effect was consistent regardless of presence of face covering or the familiarity of the interactive partner. The study demonstrates the high feasibility and validity of a live eye-tracking task involving face-to-face interaction in neurodiverse toddlers with social vulnerabilities. The effect of diminished attention to social partners in toddlers with autism is robust and present when interacting with an unfamiliar person and parent. The results suggest that a brief live eye-tracking method constitutes a promising ecologically valid candidate biomarker and potential intervention outcome in autism.

Evaluating the Impact of a Cream Containing Horse Placental Extract on Eye Corner Wrinkles in Healthy Women: Single-Blind Comparative Study

BACKGROUND

Placental extract has been mostly used in skin care for cosmetic purposes. However, the use of various placental extracts has been limited due to the lack of established and effective application methods.

OBJECTIVE

In this study, we investigated the antiwrinkle effect of a cream formulation-LNC wrinkle eye cream (LNC-EC)-containing horse placental extract as the main ingredient.

METHODS

A total of 24 healthy women, aged 37-54 years, with wrinkle grades 1-3, were treated with LNC-EC for 2 weeks. The cream was applied on one-half of the participants' faces, and the results were compared with the untreated half of the face.

RESULTS

Visual inspection, using the wrinkle grade standard, showed that the area treated with LNC-EC had a significantly lower wrinkle grade than the untreated area when comparing before and after the application of LNC-EC. In addition, replica analysis showed a significant reduction in both the maximum wrinkle width and the number of wrinkles in the LNC-EC-treated area in comparison to the untreated area before and after the application. These results suggest that LNC-EC has an antiwrinkle effect on the corners of the eyes based on parameters like the maximum wrinkle width and the number of wrinkles.

CONCLUSIONS

LNC-EC, with horse placental extract as its main ingredient, was shown to be effective in improving wrinkles at the eye corners, presumably due to a reduction in the maximum wrinkle width and the number of wrinkles. Interpretation of the results is limited because this study was conducted only in the intervention group. A randomized controlled trial with a placebo control group is necessary to verify the antiwrinkle effects of horse placental extract.

The complete anatomy of the transverse facial artery: a computed tomography angiography analysis

BACKGROUND

The transverse facial artery (TFA) provides blood supply to various structures of the lateral face, including the parotid gland, parotid duct, masseter muscle, and facial skin. Knowledge about its anatomy is of utmost importance in various plastic and reconstructive procedures.

MATERIALS AND METHODS

The results of 55 (110 hemifaces) consecutive patients who underwent head and neck computed tomography angiography (CTA) in the Department of Radiology of the Jagiellonian University Medical College, Cracow, Poland, were evaluated in July 2022.

RESULTS

TFA was found to originate from STA in 84 of the cases (95.5%), whereas from ECA only in 4 of the cases (4.5%). Median length of the TFA was found to be 43.39 mm (LQ = 38.53 ; UQ = 46.37). The median TFA diameter, at its origin, was established at 2.26 mm (LQ = 1.93 ; UQ = 2.54). Median TFA cross-sectional area, at its origin, was set to be 2.54 mm (LQ = 1.67 ; UQ = 3.10).

CONCLUSIONS

The TFA has an important role in the arterial blood supply to the face, and the present study has demonstrated its stable prevalence in the lateral face region. The most frequent origin of the artery was from the STA; however, it also originated from the ECA in some cases. Moreover, the topographic relationships between the TFA and nearby arteries and anatomical landmarks were measured and analyzed.

Periaqueductal/periventricular gray deep brain stimulation for the treatment of neuropathic facial pain

Background

The Periaqueductal gray (PAG) and the periventricular gray (PVG) are the anatomical targets for deep brain stimulation (DBS) to treat severe, refractory neuropathic pain.

Methods

Seven (four female and three male) patients were qualified for PAG/PVG DBS because of neuropathic facial pain. Frame-based unilateral implantations of DBS were conducted according to indirect planning of the PAG/PVG, contralateral to reported pain (3389, Activa SC 37603, Medtronic). The efficacy of PAG/PVG DBS on pain was measured with Numeric Pain Rating Scale (NRS) and Neuropathic Pain Symptom Inventory (NPSI) before surgery and 3, 12, and 24 months after surgery.

Results

The mean age of the group at the implantation was 43.7 years (range: 28-62; SD: 12.13). The mean duration of pain varied from 2 to 12 years (mean: 7.3; SD: 4.11). Five patients suffered from left-sided facial pain and two suffered right-sided facial pain. The etiology of pain among four patients was connected to ischemic brain stroke and in one patient to cerebral hemorrhagic stroke. Patients did not suffer from any other chronic medical condition The beginnings of ailments among two patients were related to craniofacial injury. NRS decreased by 54% at the 3 months follow-up. The efficacy of the treatment measured with mean NRS decreased at one-year follow-up to 48% and to 45% at 24 months follow-up. The efficacy of the treatment measured with NPSI decreased from 0.27 to 0.17 at 2 years follow-up (mean reduction by 38%). The most significant improvement was recorded in the first section of NPSI (Q1: burning- reduced by 53%). The records of the last section (number five) of the NPSI (paresthesia/dysesthesia- Q11/Q12) have shown aggravation of those symptoms by 10% at the two-years follow-up. No surgery- or hardware-related complications were reported in the group. Transient adverse effects related to the stimulation were eliminated during the programming sessions.

Conclusion

PAG/PVG DBS is an effective and safe method of treatment of medically refractory neuropathic facial pain. The effectiveness of the treatment tends to decrease at 2 years follow-up. The clinical symptoms which tend to respond the best is burning pain. Symptoms like paresthesia and dysesthesia might increase after DBS treatment, even without active stimulation.

Distinct patterns of neural response to faces from different races in humans and deep networks

Social categories such as the race or ethnicity of an individual are typically conveyed by the visual appearance of the face. The aim of this study was to explore how these differences in facial appearance are represented in human and artificial neural networks. First, we compared the similarity of faces from different races using a neural network trained to discriminate identity. We found that the differences between races were most evident in the fully connected layers of the network. Although these layers were also able to predict behavioural judgements of face identity from human participants, performance was biased toward White faces. Next, we measured the neural response in face-selective regions of the human brain to faces from different races in Asian and White participants. We found distinct patterns of response to faces from different races in face-selective regions. We also found that the spatial pattern of response was more consistent across participants for own-race compared to other-race faces. Together, these findings show that faces from different races elicit different patterns of response in human and artificial neural networks. These differences may underlie the ability to make categorical judgements and explain the behavioural advantage for the recognition of own-race faces.

Improving Monocular Facial Presentation-Attack-Detection Robustness with Synthetic Noise Augmentations

We present a synthetic augmentation approach towards improving monocular face presentation-attack-detection (PAD) robustness to real-world noise additions. Face PAD algorithms secure authentication systems against spoofing attacks, such as pictures, videos, and 2D-inspired masks. Best-in-class PAD methods typically use 3D imagery, but these can be expensive. To reduce application cost, there is a growing field investigating monocular algorithms that detect facial artifacts. These approaches work well in laboratory conditions, but can be sensitive to the imaging environment (e.g., sensor noise, dynamic lighting, etc.). The ideal solution for noise robustness is training under all expected conditions; however, this is time consuming and expensive. Instead, we propose that physics-informed noise-augmentations can pragmatically achieve robustness. Our toolbox contains twelve sensor and lighting effect generators. We demonstrate that our toolbox generates more robust PAD features than popular augmentation methods in noisy test-evaluations. We also observe that the toolbox improves accuracy on clean test data, suggesting that it inherently helps discern spoof artifacts from imaging artifacts. We validate this hypothesis through an ablation study, where we remove liveliness pairs (e.g., live or spoof imagery only for participants) to identify how much real data can be replaced with synthetic augmentations. We demonstrate that using these noise augmentations allows us to achieve better test accuracy while only requiring 30% of participants to be fully imaged under all conditions. These findings indicate that synthetic noise augmentations are a great way to improve PAD, addressing noise robustness while simplifying data collection.

Development of the mirror-image sensitivity for different object categories-Evidence from the mirror costs of object images in children and adults

Object recognition relies on a multitude of factors, including size, orientation, and so on. Mirrored orientation, particularly due to children's mirror confusion in reading, holds special significance among various object orientations. Brain imaging studies suggest that the visual ventral and dorsal streams exhibit distinct orientation sensitivity across diverse object categories. Yet, it remains unclear whether mirror orientation sensitivity also varies among these categories during development at the behavioral level. Here, we explored the mirror sensitivity of children and adults across five distinct categories, which encompass tools that activate both the visual ventral stream for function information and the dorsal stream for manipulation information, and animals and faces that mainly activate the ventral stream. Two types of symbols, letters and Chinese characters, were also included. Mirror sensitivity was assessed through mirror costs-that is, the additional reaction time or error rate in the mirrored versus the same orientation condition when judging the identity of object pairs. The mirror costs in reaction times and error rates consistently revealed that children exhibited null mirror costs for tools, and the mirror costs for tools in adults were minimal, if any, and were smaller than those for letters and characters. The mirror costs reflected in absolute reaction time and error rate were similar across adults and children, but when the overall difference in reaction times was considered, adults showed a larger mirror cost than children. Overall, our investigation unveils categorical distinctions and development in mirror sensitivity of object recognition across the ventral and dorsal streams.

Characterization of craniofacial-based clinical phenotypes in children with suspected obstructive sleep apnea

STUDY OBJECTIVES

We conducted this study to identify phenotypes of obstructive sleep apnea (OSA) in children based on lifestyle, sleep habits, age, obesity, sex, soft tissue facial features, and specific craniofacial abnormalities.

METHODS

Seventy-three children with symptoms of pediatric OSA who underwent overnight observed polysomnography participated in this study. Soft tissue facial features were assessed using a 3-dimensional stereophotogrammetric system. Craniofacial abnormalities were evaluated based on the most common facial features associated with orthodontic treatment needs. Data regarding lifestyle, sleep habits, age, obesity, and sex were also collected. To identify phenotypes of OSA, a sequential analysis was then performed on categories of variables using fuzzy clustering with medoids.

RESULTS

Craniofacial abnormalities and soft tissue facial features defined clusters. Three clusters were identified. Cluster 1 comprised a group of younger children (5.9 ± 3.8 years) without obesity, without craniofacial abnormalities, and with smaller soft tissue facial features dimensions. Cluster 2 comprised a group of older children (9.6 ± 3.9 years) without obesity and with larger mandibular dimensions and mildly arched palates (71.4%). Cluster 3 comprised a group of older children (9.2 ± 3.9 years) with obesity and a history of health issues (68.4%), excessive lower facial height (63.2%), and midface deficiency (73.7%). No differences were observed across clusters regarding sleep features. A moderate severity of obstructive and mixed respiratory events was observed in all 3 clusters.

CONCLUSIONS

The study results did not identify distinct phenotypes of pediatric OSA based on soft tissue facial features or craniofacial abnormalities alone. Age and body mass index likely modify the effect of soft tissue facial features and craniofacial abnormalities as risk factors for OSA in children.

CITATION

Fernandes Fagundes NC, Loliencar P, MacLean JE, Flores-Mir C, Heo G. Characterization of craniofacial-based clinical phenotypes in children with suspected obstructive sleep apnea. J Clin Sleep Med. 2023;19(11):1857-1865.

Postnatal growth and spatial conformity of the cranium, brain, eyeballs and masseter muscles in the macaque (Macaca mulatta)

Spatial growth constraints in the head region can lead to coordinated patterns of morphological variation that pleiotropically modify genetically defined phenotypes as the tissues compete for space. Here we test for such architectural modifications during rhesus macaque (Macaca mulatta) postnatal ontogeny. We captured cranium and brain shape from 153 MRI datasets spanning 13 to 1090 postnatal days and tested for patterns of covariation with measurements of relative brain, eyeball, and masseter muscle size as well as callosal tract length. We find that the shape of the infant (<365 days) macaque cranium was most closely aligned to masseter muscle and brain size measured relative to face size. Infant brain and juvenile (365-1090 days) cranium shape were more closely linked with brain size relative to basicranium and face size. Meanwhile, the juvenile macaque brain shape was dominated by the size of the brain relative to that of the basicranium. Associations with relative eyeball size and commissural tract lengths were weaker. Our results are consistent with a spatial-packing regime operating during postnatal macaque ontogeny, in which relative growth of the masseter, face and basicranium have a greater influence than brain growth on the overall shape of the cranium and brain.

Does Platelet-Rich Plasma Promote Facial Rejuvenation? Revising the Latest Evidence in a Narrative Review

Facial aging is characterized by progressive macroscopic, histological, and molecular changes. Due to its regenerative and rejuvenating properties, the use of platelet-rich plasma (PRP) as a facial antiaging agent has gained popularity over the last decade. In order to gather and evaluate the latest evidence focusing on the effect of PRP on facial skin rejuvenating, a search through MEDLINE (PubMed) using relevant keywords, inclusion, and exclusion criteria was performed. A total of 539 articles were initially retrieved, and from those, 16 were included in the review. Treatment protocols comprised the use of PRP both in monotherapy and in combination with other substances and by means of direct injection or topical application following skin permeation. The selected studies presented high variability regarding PRP preparation methods, administration protocols, and results assessment. In most studies, PRP seemed to improve to some degree the signs of facial aging, such has wrinkles, skin quality, and pigmentation, accompanied by significant histological and molecular responses. Optimizing treatment protocols should be the next step in assessing the full potential of PRP.

Mammalian facial muscles contain muscle spindles

Muscle spindles are sensory receptors in skeletal muscle that provide information on muscle length and velocity of contraction. Previous studies noted that facial muscles lack muscle spindles, but recent reports indicate that the human platysma muscle and "buccal" muscles contain spindles. Mammalian facial muscles are active in social communication, vibrissa movement, and vocalizations, including human speech. Given these functions, we hypothesized that facial muscles contain muscle spindles, and we predicted that humans would have the greatest number, given the role our lips play in speech. We examined previously sectioned and stained (with H&E and trichrome stains) orbicularis oris (upper fibers) and zygomaticus (major) muscles across a broad phylogenetic range of mammalian species, spanning a wide distribution of body size and ecological niche, to assess the presence of muscle spindles. We also stained several sections with Sirius red to highlight the muscle spindle capsule. Our results indicate that mammalian facial muscles contain muscle spindles, supporting our hypothesis. Contrary to our prediction, though, humans (and other primates) had the lowest number of muscle spindles. We instead found that the carnivoran sample and the horse sample had the greatest number of spindles. Larger body size and nocturnality were also associated with a greater number of spindles. These results must be viewed with caution, though, as our sample size was small and there are critical mammalian taxa missing. Future work should use an expanded phylogenetic range of mammalian species to ascertain the role that phylogeny plays in muscle spindle presence and count.

Episodic memory and recognition are influenced by cues' sensory modality: comparing odours, music and faces using virtual reality

Most everyday experiences are multisensory, and all senses can trigger the conscious re-experience of unique personal events embedded in their specific spatio-temporal context. Yet, little is known about how a cue's sensory modality influences episodic memory, and which step of this process is impacted. This study investigated recognition and episodic memory across olfactory, auditory and visual sensory modalities in a laboratory-ecological task using a non-immersive virtual reality device. At encoding, participants freely and actively explored unique and rich episodes in a three-room house where boxes delivered odours, musical pieces and pictures of face. At retrieval, participants were presented with modality-specific memory cues and were told to 1) recognise encoded cues among distractors and, 2) go to the room and select the box in which they encountered them at encoding. Memory performance and response times revealed that music and faces outperformed odours in recognition memory, but that odours and faces outperformed music in evoking encoding context. Interestingly, correct recognition of music and faces was accompanied by more profound inspirations than correct rejection. By directly comparing memory performance across sensory modalities, our study demonstrated that despite limited recognition, odours are powerful cues to evoke specific episodic memory retrieval.

Real-time imaging as visual biofeedback in active second stage of labor among nulliparas: a randomized controlled trial

BACKGROUND

A prolonged second stage of labor increases the risk of severe perineal laceration, postpartum hemorrhage, operative delivery, and poor Apgar score. The second stage is longer in nulliparas. Maternal pushing during the second stage of labor is an important contributor to the involuntary expulsive force developed by uterine contraction to deliver the fetus. Preliminary data indicate that visual biofeedback during the active second stage hastens birth.

OBJECTIVE

This study aimed to evaluate if visual feedback focusing on the perineum reduced the length of the active second stage of labor in comparison with the control.

STUDY DESIGN

A randomized controlled trial was conducted in the University Malaya Medical Centre from December 2021 to August 2022. Nulliparous women about to commence the active second stage, at term, with singleton gestation, reassuring fetal status, and no contraindication for vaginal delivery were randomized to live viewing of the maternal introitus (intervention) or maternal face (sham/placebo control) as visual biofeedback during their pushing. A video camera Bluetooth-linked to a tablet computer display screen was used; in the intervention arm, the camera was focused on the introitus, and in the control arm, on the maternal face. Participants were instructed to watch the display screen during their pushing. The primary outcomes were the intervention-to-delivery interval and maternal satisfaction with the pushing experience assessed using a 0-to-10 visual numerical rating scale. Secondary outcomes included mode of delivery, perineal injury, delivery blood loss, birthweight, umbilical cord arterial blood pH and base excess at birth, Apgar score at 1 and 5 minutes, and neonatal intensive care unit admission. Data were analyzed with the t test, Mann-Whitney U test, chi-square test, and Fisher exact test, as appropriate.

RESULTS

A total of 230 women were randomized (115 to intervention and 115 to control arm). The active second stage duration (intervention-to-delivery interval) was a median (interquartile range) of 16 (11-23) and 17 (12-31) minutes (P=.289), and maternal satisfaction with the pushing experience was 9 (8-10) and 7 (6-7) (P<.001) for the intervention and control arm, respectively. Women randomized to the intervention arm were more likely to agree to recommend their management to a friend (88/115 [76.5%] vs 39/115 [33.9%]; relative risk, 2.26 [95% confidence interval, 1.72-2.97]; P<.001) and more likely to have less severe perineal injury (P=.018).

CONCLUSION

Real-time viewing of the maternal introitus as visual biofeedback during pushing resulted in higher maternal satisfaction compared with the sham control of viewing the maternal face; however, the time to delivery was not significantly shortened.

Immunoactivation Affects Perceived Body Odor and Facial but Not Vocal Attractiveness

Several previous studies have shown that in mammals, the health status of conspecifics can be assessed based on perceptual cues. Olfactory, visual, or acoustic cues may lead to avoidant behavior, thus reducing the risk of contagion by close contact with infected individuals. We tested whether immune system activation after immunization leads to perceptible changes in body odor and facial and vocal attractiveness in humans. We have experimentally activated the immune system of male participants using vaccination against hepatitis A/B and meningococcus. Their body odor, facial photographs, and vocal recordings were collected before and 14 days after vaccination. Subsequently, the body odor samples, facial photographs, and vocal recordings were assessed by female raters for their attractiveness and healthiness. We have also measured skin coloration (from facial photographs and in vivo using a spectrophotometer), vocal parameters, and C-reactive protein (CRP) levels as a marker of inflammation. We found an increase in perceived body odor attractiveness, a decrease in facial attractiveness and healthiness, and no change in vocal attractiveness 14 days after vaccination compared to the prevaccination condition. Moreover, there was no change in facial coloration or vocal parameters between the prevaccination and postvaccination conditions. Prevaccination CRP levels were negatively associated with body odor and facial attractiveness and positively associated with body odor intensity. Overall, our results suggest that perceived body odor as well as facial but not vocal attractiveness may provide cues to activation of the immune response and that each modality may carry specific information about the individual's condition.