Search results for: facial surgery

Authors: Sadhana Deshmukh

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Objective: Men represent only a fraction of the medical aesthetic practice. They are increasingly becoming more cosmetically-inclined. The primary objective is to harmonize facial proportion by prioritizing and focusing on forehead nose, cheek and chin complex. Introduction: Despite tremendous variability, diverse population of the Indian subcontinent, the male skull is unique in its overall larger size, and shape. Men tend to have a large forehead with prominent supraorbital ridges, wide glabella, square orbit, and a prominent protruding mandible. Men have increased skeletal muscle mass, with less facial subcutaneous fat. Facial aesthetics is evolving rapidly. Commonly published canons of facial proportions usually represent feminine standards and are not applicable to males. Strict adherence to these norms is therefore not necessary to obtain satisfying results in male patients. Materials and Methods: Male patients age group 30-60 years have been enrolled. Botulinum toxin and hyaluronic acid fillers were used to update consensus recommendations for facial rejuvenation using these two types of products alone and in combination. Results: There are specific recommendations by facial area, focusing on relaxing musculature, restoring volume, recontouring using toxin and dermal fillers alone and in combination. For upper face, though botulinum toxin remains the cornerstone of treatment, temples and forehead fillers are recommended for optimal results. In Mid face, these fillers are placed more laterally to maintain the masculine look. Botulinum toxin and fillers in combination can improve outcomes in the lower face. Chin augmentation remains the center point for lower face. Conclusions: Males are more likely to have shorter doctor visits, less likely to ask questions, have a lower attention to bodily changes. The physician must patiently gauge male patients’ aging and cosmetic goals. Clinicians can also benefit from ongoing guidance on products, tailoring treatments, treating multiple facial areas, and using combinations of products. An appreciation that rejuvenation is 3-dimensional process involving muscle control, volume restoration and recontouring helps.

Keywords: male aesthetics, botulinum toxin, hyaluronic acid dermal fillers, Asian patients

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Authors: Catia Correia Caeiro, Kun Guo, Daniel Mills

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Despite its growing interest, emotions are still an understudied cognitive process and their origins are currently the focus of much debate among the scientific community. The use of facial expressions as traditional hallmarks of discrete and holistic emotions created a circular reasoning due to a priori assumptions of meaning and its associated appearance-biases. Ekman and colleagues solved this problem and laid the foundations for the quantitative and systematic study of facial expressions in humans by developing an anatomically-based system (independent from meaning) to measure facial behaviour, the Facial Action Coding System (FACS). One way of investigating emotion cognition processes is by applying comparative psychology methodologies and looking at either closely-related species (e.g. chimpanzees) or phylogenetically distant species sharing similar present adaptation problems (analogy). In this study, the domestic dog was used as a comparative animal model to look at facial expressions in social interactions in parallel with human facial expressions. The orofacial musculature seems to be relatively well conserved across mammal species and the same holds true for the domestic dog. Furthermore, the dog is unique in having shared the same social environment as humans for more than 10,000 years, facing similar challenges and acquiring a unique set of socio-cognitive skills in the process. In this study, the spontaneous facial movements of humans and dogs were compared when interacting with hetero- and conspecifics as well as in solitary contexts. In total, 200 participants were examined with FACS and DogFACS (The Dog Facial Action Coding System): coding tools across four different emotionally-driven contexts: a) Happiness (play and reunion), b) anticipation (of positive reward), c) fear (object or situation triggered), and d) frustration (negation of a resource). A neutral control was added for both species. All four contexts are commonly encountered by humans and dogs, are comparable between species and seem to give rise to emotions from homologous brain systems. The videos used in the study were extracted from public databases (e.g. Youtube) or published scientific databases (e.g. AM-FED). The results obtained allowed us to delineate clear similarities and differences on the flexibility of the facial musculature in the two species. More importantly, they shed light on what common facial movements are a product of the emotion linked contexts (the ones appearing in both species) and which are characteristic of the species, revealing an important clue for the debate on the origin of emotions. Additionally, we were able to examine movements that might have emerged for interspecific communication. Finally, our results are discussed from an evolutionary perspective adding to the recent line of work that supports an ancient shared origin of emotions in a mammal ancestor and defining emotions as mechanisms with a clear adaptive purpose essential on numerous situations, ranging from maintenance of social bonds to fitness and survival modulators.

Keywords: comparative and evolutionary psychology, emotion, facial expressions, FACS

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Authors: McClain Thiel

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Object detection and localization has historically required two or more sensors due to the loss of information from 3D to 2D space, however, most surveillance systems currently in use in the real world only have one sensor per location. Generally, this consists of a single low-resolution camera positioned above the area under observation (mall, jewelry store, traffic camera). This is not sufficient for robust 3D tracking for applications such as security or more recent relevance, contract tracing. This paper proposes a lightweight system for 3D person tracking that requires no additional hardware, based on compressed object detection convolutional-nets, facial landmark detection, and projective geometry. This approach involves classifying the target into a demographic category and then making assumptions about the relative locations of facial landmarks from the demographic information, and from there using simple projective geometry and known constants to find the target's location in 3D space. Preliminary testing, although severely lacking, suggests reasonable success in 3D tracking under ideal conditions.

Keywords: monocular distancing, computer vision, facial analysis, 3D localization

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Authors: Samuel Mwangi, Josephine K. Mule

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Access control as a security technique regulates who or what can access resources. It is a fundamental concept in security that minimizes risks to the institutions that use access control. Regulating access to institutions of higher learning is key to ensure only authorized personnel and students are allowed into the institutions. The use of biometrics has been criticized due to the setup and maintenance costs, hygiene concerns, and trepidations regarding data privacy, among other apprehensions. Facial recognition is arguably a fast and accurate way of validating identity in order to guard protected areas. It guarantees that only authorized individuals gain access to secure locations while requiring far less personal information whilst providing an additional layer of security beyond keys, fobs, or identity cards. This exploratory study sought to investigate the use of facial recognition in controlling access in institutions of higher learning in Kenya. The sample population was drawn from both private and public higher learning institutions. The data is based on responses from staff and students. Questionnaires were used for data collection and follow up interviews conducted to understand responses from the questionnaires. 80% of the sampled population indicated that there were many security breaches by unauthorized people, with some resulting in terror attacks. These security breaches were attributed to stolen identity cases, where staff or student identity cards were stolen and used by criminals to access the institutions. These unauthorized accesses have resulted in losses to the institutions, including reputational damages. The findings indicate that security breaches are a major problem in institutions of higher learning in Kenya. Consequently, access control would be beneficial if employed to curb security breaches. We suggest the use of facial recognition technology, given its uniqueness in identifying users and its non-repudiation capabilities.

Keywords: facial recognition, access control, technology, learning

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Authors: Saw Thiha, Jay Rajasekera

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A boom in video conferencing generated millions of hours of video data daily to be analyzed. However, such enormous data pose certain scalability issues to be analyzed efficiently, let alone do it in real-time, as online conferences can involve hundreds of people and can last for hours. This paper proposes an efficient online proctoring solution that can analyze the online conferences real-time on edge devices such as Android, iOS, and desktops. Since the computation can be done upfront on the devices where online conferences take place, it can scale well without requiring intensive resources such as GPU servers and complex cloud infrastructure. According to the linear models, face orientation does indeed impact the perceived eye openness. Also, the proposed z score facial landmark standardization was proven to be functional in detecting face orientation and contributed to classifying eye blinks with single eyelid distance computation while achieving a better f1 score and accuracy than the Eye Aspect Ratio (EAR) threshold method. Last but not least, the authors implemented the solution natively in the MediaPipe framework and open-sourced it along with the reproducible experimental results on GitHub. The solution provides face orientation, eye blink, facial activity, and translation detections out of the box and is highly customizable and extensible.

Keywords: android, desktop, edge computing, blink, face orientation, facial activity and translation, MediaPipe, open source, real-time, video conference, web, iOS, Z score facial landmark standardization

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Authors: Babak Masoomian, Masoud Khorrami Nejad, Hamid Riazi Esfahani

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Purpose: To report the result of strabismus surgery in eye-salvaged retinoblastoma (Rb) patients. Methods: A retrospective case series including 18 patients with Rb and strabismus who underwent strabismus surgery after completing tumor treatment by a single pediatric ophthalmologist. Results: A total of 18 patients (10 females and 8 males) were included with a mean age of 13.3 ± 3.0 (range, 2-39) months at the time tumor presentation and 6.0 ± 1.5 (range, 4-9) years at the time of strabismus surgery. Ten (56%) patients had unilateral, and 8(44%) had bilateral involvement, and the most common worse eye tumor’s group was D (n=11), C (n=4), B (n=2) and E (n=1). Macula was involved by the tumors in 12 (67%) patients. The tumors were managed by intravenous chemotherapy (n=8, 47%), intra-arterial chemotherapy (n=7, 41%) and both (n=3, 17%). After complete treatment, the average time to strabismus surgery was 29.9 ± 20.5 (range, 12-84) months. Except for one, visual acuity was equal or less than 1.0 logMAR (≤ 20/200) in the affected eye. Seven (39%) patients had exotropia, 11(61%) had esotropia (P=0.346) and vertical deviation was found in 8 (48%) cases. The angle of deviation was 42.0 ± 10.4 (range, 30-60) prism diopter (PD) for esotropic and 35.7± 7.9 (range, 25-50) PD for exotropic patients (P=0.32) that after surgery significantly decreased to 8.5 ± 5.3 PD in esotropic cases and 5.9±6.7 PD in exotropic cases (P<0.001). The mean follow-up after surgery was 15.2 ± 2.0 (range, 10-24) months, in which 3 (17%) patients needed a second surgery. Conclusion: Strabismus surgery in treated Rb is safe, and results of the surgeries are acceptable and close to the general population. There was not associated with tumor recurrence or metastasis.

Keywords: retinoblastoma, strabismus, chemotherapy, surgery

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Authors: Noha El Toukhy

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The ‘beauty is good” stereotype suggests that people perceive attractive people as having several positive characteristics. Likewise, an “anomalous-is-bad” stereotype is hypothesized to facilitate biases against people with anomalous or less attractive faces. Researchers integrated both into a stereotype content model, which is one of the frameworks used in this study to assess how facial anomalies influence people’s social attitudes and, specifically, people’s ratings of warmth and competence. The mind perception theory, as well as the assessment of animalistic and mechanistic dehumanization against facially anomalous people, are two further frameworks that we are using in this study. This study will test the hypothesis that people have negative attitudes towards people with facial anomalies. We also hypothesize that people have negative biases toward faces with visible differences compared to faces without such differences regardless of the specific type of anomaly, as well as that individual differences in psychological dispositions bear on the expression of the anomalous-is-bad stereotype. Using highly controlled and some never-before-used face stimuli, this pre-registered study examines whether moral character influences perceptions of attractiveness, warmth, and competence for facial anomalies.

Keywords: adolescents, attractiveness, competence, social attitudes, warmth

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Authors: Kriddikorn Kaewwongsri, Nikom Suvonvorn

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In the deep south of Thailand, checkpoints for people verification are necessary for the security management of risk zones, such as official buildings in the conflict area. In this paper, we propose an automatic checkpoint system that verifies persons using information from ID cards and facial features. The methods for a person’s information abstraction and verification are introduced based on useful information such as ID number and name, extracted from official cards, and facial images from videos. The proposed system shows promising results and has a real impact on the local society.

Keywords: face comparison, card recognition, OCR, checkpoint system, authentication

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Authors: Hyun June Kim, Tailong Shi, Seden Akdagli, Sam Most, Yuling Yan

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Quantitative analysis of mouse whisker movement can be used to study functional recovery and regeneration of facial nerve after an injury. However, it is challenging to accurately track mouse whisker movements, and most whisker tracking methods require manual intervention, e.g. fixing the head of the mouse during a study. Here we describe a semi-automated image processing method that is applied to high-speed video recordings of free-moving mice to track whisker movements. We first track the head movement of a mouse by delineating the lower head contour frame-by-frame to locate and determine the orientation of its head. Then, a region of interest is identified for each frame, with subsequent application of the Hough transform to track individual whisker movements on each side of the head. Our approach is used to examine the functional recovery of damaged facial nerves in mice over a course of 21 days.

Keywords: mystacial macrovibrissae, whisker tracking, head tracking, facial nerve recovery

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Authors: A. S. Bouchikhi, A. Megueni, S. Habibi

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One major problem when using bonded Fiber Reinforced Polymer is the presence of high inter facial stresses near the end of the composite laminate which might govern the failure of the strengthening schedule. It is known that the decrease of FRP plate thickness and the fitness of adhesive reduce the stress concentration at plate ends. Another way is to use a plate with a non uniform section or tapered ends and softer adhesive at the edges. In this paper, a comprehensive finite element (FE) study has been conducted to investigate the effect of mixed adhesive joints (MAJ) and tapering plate on the inter facial stress distribution in the adhesive layer, this paper presents the results of a study of application of two adhesives with different stiffnesses (bi-adhesive) along the joint strength length between the CFRP-strengthened steel beam for tapered and untapered plate on the distribution of inter facial stresses. A stiff adhesive was applied in the middle portion of the joint strength, while a low modulus adhesive was applied towards the edges prone to stress concentrations.

Keywords: FRP, mixed adhesive joints, stresses, tapered plate, retrofitted beams bonded

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Authors: Lilah Inzelberg, David Rand, Stanislav Steinberg, Moshe David Pur, Yael Hanein

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Human facial expressions carry important psychological and neurological information. Facial expressions involve the co-activation of diverse muscles. They depend strongly on personal affective interpretation and on social context and vary between spontaneous and voluntary activations. Smiling, as a special case, is among the most complex facial emotional expressions, involving no fewer than 7 different unilateral muscles. Despite their ubiquitous nature, smiles remain an elusive and debated topic. Smiles are associated with happiness and greeting on one hand and anger or disgust-masking on the other. Accordingly, while high-resolution recording of muscle activation patterns, in a non-interfering setting, offers exciting opportunities, it remains an unmet challenge, as contemporary surface facial electromyography (EMG) methodologies are cumbersome, restricted to the laboratory settings, and are limited in time and resolution. Here we present a wearable and non-invasive method for objective mapping of facial muscle activation and demonstrate its application in a natural setting. The technology is based on a recently developed dry and soft electrode array, specially designed for surface facial EMG technique. Eighteen healthy volunteers (31.58 ± 3.41 years, 13 females), participated in the study. Surface EMG arrays were adhered to participant left and right cheeks. Participants were instructed to imitate three facial expressions: closing the eyes, wrinkling the nose and smiling voluntary and to watch a funny video while their EMG signal is recorded. We focused on muscles associated with 'enjoyment', 'social' and 'masked' smiles; three categories with distinct social meanings. We developed a customized independent component analysis algorithm to construct the desired facial musculature mapping. First, identification of the Orbicularis oculi and the Levator labii superioris muscles was demonstrated from voluntary expressions. Second, recordings of voluntary and spontaneous smiles were used to locate the Zygomaticus major muscle activated in Duchenne and non-Duchenne smiles. Finally, recording with a wireless device in an unmodified natural work setting revealed expressions of neutral, positive and negative emotions in face-to-face interaction. The algorithm outlined here identifies the activation sources in a subject-specific manner, insensitive to electrode placement and anatomical diversity. Our high-resolution and cross-talk free mapping performances, along with excellent user convenience, open new opportunities for affective processing and objective evaluation of facial expressivity, objective psychological and neurological assessment as well as gaming, virtual reality, bio-feedback and brain-machine interface applications.

Keywords: affective expressions, affective processing, facial EMG, high-resolution electromyography, independent component analysis, wireless electrodes

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Authors: S. Shujan, A. T. Rupasinghe, N. L. Gunawardena

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Numerous studies have determined that there is a direct correlation between the successful interviewee and the nonverbal behavioral patterns of that person during the interview. In this study, we focus on formations of interview questions in such a way that, it gets an opportunity for assessing interviewee through the answers using the nonverbal behavioral cues. From all the nonverbal behavioral factors we have identified, in this study priority is given to the ‘facial expression variations’ with the assistance of facial expression analytics tool; this research proposes a novel approach in question formation for the assessment of interviewees in ‘Software Industry’.

Keywords: assessments, hirability, interviews, non-verbal behaviour patterns, question formation

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Authors: Minna Salim, James Brady

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Postoperative nausea and pain (PONV) are adverse effects following surgical procedures. It is especially pronounced in patients undergoing orthognathic surgery, as their mouth is closed postoperatively using wires or rubber bands. Postoperative mouth closure increases the discomfort and risk of complications associated with nausea and vomiting. Many surgeons and institutions apply gastric decompression in hopes of aspirating stomach contents and, therefore, decreasing PONV incidence. This review observed that PONV incidence was not affected by gastric decompression overall. However, the effect of gastric decompression on PONV in orthognathic surgery was variable. This paper aims to summarize the findings of gastric decompression on PONV and to determine the need for it in orthognathic surgery.

Keywords: gastric decompression, nasogastric tube, orthognathic surgery, postoperative nausea, vomiting

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Authors: H. G. C. P. Dinesh, G. Tharshini, M. P. B. Ekanayake, G. M. R. I. Godaliyadda

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This paper presents a new spatial feature extraction method based on principle component analysis (PCA) and Fisher Discernment Analysis (FDA) for facial expression recognition. It not only extracts reliable features for classification, but also reduces the feature space dimensions of pattern samples. In this method, first each gray scale image is considered in its entirety as the measurement matrix. Then, principle components (PCs) of row vectors of this matrix and variance of these row vectors along PCs are estimated. Therefore, this method would ensure the preservation of spatial information of the facial image. Afterwards, by incorporating the spectral information of the eigen-filters derived from the PCs, a feature vector was constructed, for a given image. Finally, FDA was used to define a set of basis in a reduced dimension subspace such that the optimal clustering is achieved. The method of FDA defines an inter-class scatter matrix and intra-class scatter matrix to enhance the compactness of each cluster while maximizing the distance between cluster marginal points. In order to matching the test image with the training set, a cosine similarity based Bayesian classification was used. The proposed method was tested on the Cohn-Kanade database and JAFFE database. It was observed that the proposed method which incorporates spatial information to construct an optimal feature space outperforms the standard PCA and FDA based methods.

Keywords: facial expression recognition, principle component analysis (PCA), fisher discernment analysis (FDA), eigen-filter, cosine similarity, bayesian classifier, f-measure

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Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi

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The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.

Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)

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Authors: R. Litt, A. Kana, K. House

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The primary aim of this patient-related experience questionnaire was to gain a better understanding of our patients' experience as inpatients when they undergo orthognathic surgery. The secondary aim of this study was to identify ways in which we can improve the orthognathic inpatient experience and to share this with other units. All patients who received orthognathic surgery at an NHS hospital - Bristol Royal Infirmary, England, over the course of 6 months were asked to complete a questionnaire regarding their care. This data was then analysed and compared to the same questionnaire given to patients treated in a private hospital where orthognathic surgery was completed. All treatment was completed by the same surgeon. The design of the questions took into account NICE (National Institute for Health and Care Excellence) guidance on improving the experience of patient care. Particularly taking into account patients' essential requirements of care, for example, assessing and managing pain, ensuring adequate and appropriate nutrition, and ensuring the patients' personal needs are regularly reviewed and addressed. Overall the patient-related experience after orthognathic surgery was comparable in both the NHS and private hospitals. However, the questionnaire highlighted aspects of inpatient care after orthognathic surgery that can easily be improved in order to provide our patients with the best possible care.

Keywords: orthognathic surgery, patient feedback, jaw surgery, inpatient experience

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Authors: Amin Derakhshan, Mohammad Mikaili, Mohammad Ali Khalilzadeh, Amin Mohammadian

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This paper proposes a stress recognition system from multi-modal bio-potential signals. For stress recognition, Support Vector Machines (SVM) and LDA are applied to design the stress classifiers and its characteristics are investigated. Using gathered data under psychological polygraph experiments, the classifiers are trained and tested. The pattern recognition method classifies stressful from non-stressful subjects based on labels which come from polygraph data. The successful classification rate is 96% for 12 subjects. It means that facial thermal imaging due to its non-contact advantage could be a remarkable alternative for psycho-physiological methods.

Keywords: stress, thermal imaging, face, SVM, polygraph

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Authors: Sangram A. Sathe, Neha A. Madgulkar, Shruti S. Raut, S. P. Wadkar

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Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.

Keywords: TLIF, spondylolisthesis, spine, instruments

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Authors: Rosemarie Basile, Maria Loizos, John Pallarino, Karen Gibbs

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Given that complications can be significant following bariatric surgery and with rates of long-term success measured in excess weight loss varying as low as 33% after five years, an understanding of the psychological factors that may mitigate findings and increase success and result in better screening and supports prior to surgery are critical. An internally oriented locus of control (LOC) has been identified as a predictor for success in obesity therapy, but has not been investigated within the context of bariatric surgery. It is hypothesized that making behavioral changes prior to surgery which mirror those that are required post-surgery may ultimately predict long-term success. 122 subjects participated in a clinical interview and completed self-report measures including the Multidimensional Health Locus of Control Scale, Overeating Questionnaire (OQ), and Lifestyle Questionnaire (LQ). Pearson correlations were computed between locus of control orientation and likelihood to make behavior changes prior to surgery. Pearson correlations revealed a positive correlation between locus of control and likelihood to make behavior changes r = 0.23, p < .05. As hypothesized, there was a significant correlation between internal locus of control and likelihood to make behavior changes. Participants with a higher LOC believe that they are able to make decisions about their own health. Future research will focus on whether this positive correlation is a predictor for future bariatric surgery success.

Keywords: bariatric surgery, behavior modification, health locus of control, overeating questionnaire

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Authors: Xiaoyuan Suo

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3D object reconstruction is a broad research area within the computer vision field involving many stages and still open problems. One of the existing challenges in this field lies with micromotion, such as the facial expressions on the appearance of the human or animal face. Similar literatures in this field focuses on 3D reconstruction in stable conditions such as an existing image or photos taken in a rather static environment, while the purpose of this work is to discuss a flexible scan system using multiple cameras that can correctly reconstruct 3D stable and moving objects -- human face with expression in particular. Further, a mathematical model is proposed at the end of this literature to automate the 3D object reconstruction process. The reconstruction process takes several stages. Firstly, a set of simple 2D lines would be projected onto the object and hence a set of uneven curvy lines can be obtained, which represents the 3D numerical data of the surface. The lines and their shapes will help to identify object’s 3D construction in pixels. With the two-recorded angles and their distance from the camera, a simple mathematical calculation would give the resulting coordinate of each projected line in an absolute 3D space. This proposed research will benefit many practical areas, including but not limited to biometric identification, authentications, cybersecurity, preservation of cultural heritage, drama acting especially those with rapid and complex facial gestures, and many others. Specifically, this will (I) provide a brief survey of comparable techniques existing in this field. (II) discuss a set of specialized methodologies or algorithms for effective reconstruction of 3D objects. (III)implement, and testing the developed methodologies. (IV) verify findings with data collected from experiments. (V) conclude with lessons learned and final thoughts.

Keywords: 3D photogrammetry, 3D object reconstruction, facial expression recognition, facial recognition

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Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

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The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

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Authors: Avyarthana Dey, Naren P. Rao, Arpitha Jacob, Chaitra V. Hiremath, Shivarama Varambally, Ganesan Venkatasubramanian, Rose Dawn Bharath, Bangalore N. Gangadhar

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Objective: Impaired facial emotion recognition is widely reported in schizophrenia. Neuropeptide oxytocin is known to modulate brain regions involved in facial emotion recognition, namely amygdala, in healthy volunteers. However, its effect on facial emotion recognition deficits seen in schizophrenia is not well explored. In this study, we examined the effect of intranasal OXT on processing facial emotions and its neural correlates in patients with schizophrenia. Method: 12 male patients (age= 31.08±7.61 years, education= 14.50±2.20 years) participated in this single-blind, counterbalanced functional magnetic resonance imaging (fMRI) study. All participants underwent three fMRI scans; one at baseline, one each after single dose 24IU intranasal OXT and intranasal placebo. The order of administration of OXT and placebo were counterbalanced and subject was blind to the drug administered. Participants performed a facial emotion recognition task presented in a block design with six alternating blocks of faces and shapes. The faces depicted happy, angry or fearful emotions. The images were preprocessed and analyzed using SPM 12. First level contrasts comparing recognition of emotions and shapes were modelled at individual subject level. A group level analysis was performed using the contrasts generated at the first level to compare the effects of intranasal OXT and placebo. The results were thresholded at uncorrected p < 0.001 with a cluster size of 6 voxels. Neuropeptide oxytocin is known to modulate brain regions involved in facial emotion recognition, namely amygdala, in healthy volunteers. Results: Compared to placebo, intranasal OXT attenuated activity in inferior temporal, fusiform and parahippocampal gyri (BA 20), premotor cortex (BA 6), middle frontal gyrus (BA 10) and anterior cingulate gyrus (BA 24) and enhanced activity in the middle occipital gyrus (BA 18), inferior occipital gyrus (BA 19), and superior temporal gyrus (BA 22). There were no significant differences between the conditions on the accuracy scores of emotion recognition between baseline (77.3±18.38), oxytocin (82.63 ± 10.92) or Placebo (76.62 ± 22.67). Conclusion: Our results provide further evidence to the modulatory effect of oxytocin in patients with schizophrenia. Single dose oxytocin resulted in significant changes in activity of brain regions involved in emotion processing. Future studies need to examine the effectiveness of long-term treatment with OXT for emotion recognition deficits in patients with schizophrenia.

Keywords: recognition, functional connectivity, oxytocin, schizophrenia, social cognition

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Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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Authors: Isa Moazen, Ali Nahvi

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Driver drowsiness is a major cause of vehicle accidents, and facial images are highly valuable to detect drowsiness. In this paper, we perform our research via a thermal camera to record drivers' facial images on a driving simulator. A robust real-time algorithm extracts the features using horizontal and vertical integration projection, contours, contour orientations, and cropping tools. The features are included four target areas on the cheeks and forehead. Qt compiler and OpenCV are used with two cameras with different resolutions. A high-resolution thermal camera is used for fifteen subjects, and a low-resolution one is used for a person. The results are investigated by four temperature plots and evaluated by observer rating of drowsiness.

Keywords: advanced driver assistance systems, thermal imaging, driver drowsiness detection, feature extraction

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Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam

Abstract:

This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.

Keywords: laceration, suture, trauma, trial

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Authors: Azadeh Mottaghi, Reyhaneh Yousefi, Saeed Safari

Abstract:

Background: Bariatric surgery is widely proposed as the most effective approach to mitigate the growing pace of morbid obesity. As bariatric surgery candidates suffer from pre-existing nutritional deficiencies, it is of great importance to assess nutritional status of candidates before surgery in order to establish appropriate nutritional interventions. Objectives: The present study assessed and represented baseline data according to the nutritional status among candidates for bariatric surgery. Methods: A cross-sectional analysis of pre-surgery data was collected on 170 morbidly obese patients undergoing bariatric surgery between October 2017 and February 2018. Dietary intake data (evaluated through 147-item food frequency questionnaire), anthropometric measures and biochemical parameters were assessed. Results: Participants included 145 females (25 males) with average age of 37.3 ± 10.2 years, BMI of 45.7 ± 6.4 kg/m² and reported to have a total of 72.3 ± 22.2 kg excess body weight. The most common nutritional deficiencies referred to iron, ferritin, transferrin, albumin, vitamin B12, and vitamin D, the prevalence of which in the study population were as followed; 6.5, 6.5, 3, 2, 17.6 and 66%, respectively. Mean energy, protein, fat, and carbohydrate intake were 3887.3 ± 1748.32 kcal/day, 121.6 ± 57.1, 144.1 ± 83.05, and 552.4 ± 240.5 gr/day, respectively. The study population consumed lower levels of iron, calcium, folic acid, and vitamin B12 compared to the Dietary Reference Intake (DRI) recommendations (2, 26, 2.5, and 13%, respectively). Conclusion: According to the poor dietary quality of bariatric surgery candidates, leading to nutritional deficiencies pre-operatively, close monitoring and tailored supplementation pre- and post-bariatric surgery are required.

Keywords: bariatric surgery, food frequency questionnaire, obesity, nutritional status

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Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

Abstract:

Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

Abstract:

Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

Procedia PDF Downloads 413

Authors: H. Abas Nejad, A. R. Teymoori

Abstract:

Facial expression recognition is one of the open problems in computer vision. Robust neutral face recognition in real time is a major challenge for various supervised learning based facial expression recognition methods. This is due to the fact that supervised methods cannot accommodate all appearance variability across the faces with respect to race, pose, lighting, facial biases, etc. in the limited amount of training data. Moreover, processing each and every frame to classify emotions is not required, as the user stays neutral for the majority of the time in usual applications like video chat or photo album/web browsing. Detecting neutral state at an early stage, thereby bypassing those frames from emotion classification would save the computational power. In this work, we propose a light-weight neutral vs. emotion classification engine, which acts as a preprocessor to the traditional supervised emotion classification approaches. It dynamically learns neutral appearance at Key Emotion (KE) points using a textural statistical model, constructed by a set of reference neutral frames for each user. The proposed method is made robust to various types of user head motions by accounting for affine distortions based on a textural statistical model. Robustness to dynamic shift of KE points is achieved by evaluating the similarities on a subset of neighborhood patches around each KE point using the prior information regarding the directionality of specific facial action units acting on the respective KE point. The proposed method, as a result, improves ER accuracy and simultaneously reduces the computational complexity of ER system, as validated on multiple databases.

Keywords: neutral vs. emotion classification, Constrained Local Model, procrustes analysis, Local Binary Pattern Histogram, statistical model

Procedia PDF Downloads 320