Face Region Research Articles

New anatomical findings in the mandibular body region: Two parts that make up bucco-mandibular space.

Soft tissue spaces not only enable gliding by contraction of the facial muscles, but they also cause drooping of the superficial fat due to gravity in the upright position. This study was performed to clarify the structures around the bucco-mandibular space (BMS) and to apply this anatomical knowledge to clinical practice. Four sides of the face were dissected using a conventional gross anatomical dissection technique, and 10 sides (5 horizontal and 5 frontal sections) of the removed semi-facial soft tissue were dissected using the stretched tissue dissection (STD) method. Histological examination of the mandible was performed on two sides to confirm the findings of conventional gross anatomical dissection and STD. In all cases, both gross dissection and STD revealed that the BMS was composed of two parts. The superficial part was filled with adipose tissue containing nerves and vessels, including the marginal mandibular branch of the facial nerve, facial artery, facial vein, and mental nerve. We named this part the adipo-neuromandibular part. By contrast, the deep part was separated from the adipo-neurovascular part by facial deep fascia and composed of loose connective tissue. We named this deep part the loose connective tissue part. The STD method enabled us to obtain detailed anatomical findings of the mandibular region and elucidate two parts of the BMS in which the neurovasculature is distributed. We believe that these findings provide new insights into facial anatomy by resolving existing anatomical uncertainties and will contribute to safer surgical treatment in the facial region.

Wrestling injuries during the 2016 Rio and 2020 Tokyo Olympic Games

ObjectivesTo evaluate and compare the injuries of Olympic wrestlers during the 2016 Rio and 2020 Tokyo Olympic Games held in August 2021 due to the COVID-19 pandemic.MethodsIn this descriptive epidemiological...

Ultrasound rejuvenation for upper facial skin: A randomized blinded prospective study.

Growing demand for facial rejuvenation drives advancements in these therapies, including laser, radiofrequency, and focused ultrasound, alongside thermal stimulation adjuncts. These methods, known for stimulating collagen regeneration, skin tightening, and lifting, have gained popularity due to their minimal side effects, low trauma, and high safety, demonstrating favorable outcomes in clinical practice. We sought to assess the efficacy of ultrasound skin tightening for brow lift within the scope of a procedure addressing facial sagging across the entire face. Our aim was to explore a noninvasive method capable of effectively enhancing mild to moderate brow ptosis by tightening and lifting the skin in the upper facial region. This was a rater-blinded, prospective cohort study. The upper facial region of the participants was treated with the new device, micro-focused ultrasound (MFU), in model D3.0/D2.0/M3.0. Outcomes of brow lift were measured in comparison of pretreatment and posttreatment photographs and three-dimensional (3D) vector analysis. A total of 42 participants (37 females) were enrolled, with 2 participants withdrawing from the trial, resulting in 40 subjects who completed 180-day-follow-up and evaluation. 35 (87.5%) were deemed to have clinically significant brow elevation by two blinded assessors (experienced clinicians) at 180-day posttreatment (p < 0.01). The mean change in brow height after 90-day was 2.16 ± 0.63 mm at the frontal position (straight-ahead gaze) (p < 0.01). The 3D vector analysis reveals varying magnitudes of vector displacement in the upward and outward directions of the skin on the frontal region above the eyebrows. Focused ultrasound appears to be a safe and effective method for upper facial skin rejuvenation. A single focused ultrasound treatment on the forehead and temple areas resulted in an average brow elevation of 2.1 mm.

Neuromodulators in Men.

Botulinum toxin treatment is gaining popularity among men for cosmetic purposes driven by workplace competition and a desire for confidence and youthfulness. Because of the unique features of male facial anatomy, careful consideration is necessary during assessment and treatment execution. The peer-reviewed literature on male facial anatomy in relation to neuromodulator treatment was analyzed with a particular emphasis on studies involving male subjects and the use of botulinum toxin type A. Anatomic differences in muscle mass and contraction patterns between men and women help guide treatment. Men appear to require higher doses for effective treatment of facial wrinkles and, in the case of glabellar lines, often require double the standard dose for women. Treatment of the frontalis muscle in men, responsible for forehead creases, requires precise dosage and placement to avoid brow ptosis. The lateral canthal wrinkles are often the first area that men seek consultation for. Although FDA approval for lower face regions is lacking, off-label use can still be considered. Successful botulinum toxin treatment in men necessitates understanding facial anatomy, customized treatment plans, and appropriate dosing. Further research is warranted to refine protocols and enhance outcomes for male patients.

Adverse events related to botulinum toxin type A, reported in Brazil between 2019 and 2022

The International Society of Aesthetic Plastic Surgery estimates that 18,857,311 non-invasive aesthetic procedures were carried out worldwide in 2022. This represents an increase of 7.2% compared to 2021 and 57.8% compared to 2018. Brazil is the second country in the world, just behind the United States, in the number of aesthetic procedures, with 3,020,552. Of these, 971,294 were non-invasive, with the administration of botulinum toxin, at 433,263, being the most frequent procedure. In aesthetics, it is used for the treatment of facial asymmetries, expression lines, hyperhidrosis in the hands, feet, armpits, face, and inguinal region, and in the treatment of gummy smile, attenuation of forehead wrinkles, perioral wrinkles, mental creases, glabellar lines, periorbital wrinkles, nasal wrinkles, wrinkles found on the décolletage, nasal tip stabilization, drooping lips, eyebrow lifting, and platysma bands. The most common adverse reactions associated with the use of botulinum toxin are burning, pain, swelling, irritation at the application sites, hypersensitivity, anaphylaxis in extreme cases, blurred vision, dry mouth, rarely respiratory failure, and muscle weakness. The objective of the study was to describe the adverse events (AEs) reported in the Vigimed system between 2019 and 2022. In the period analyzed, only 50 possible AEs were reported, with the female gender and the age group of 18 to 44 years being the most frequent. The pharmaceutical industry was responsible for 82% of the notifications analyzed, however, when evaluating the reporting professional, it was observed that pharmacists reported in only 8% of the cases. When evaluating the most reported AEs, swelling and pain were the most frequent, at 30% and 24% respectively. The underreporting of these events and the need for public and private incentives to raise awareness among health professionals and users about the need for identification and reporting of AEs is clear.

Delta waves as a sign of cortical plasticity after full-face transplantation

This study focused on detecting the reflections of healing and change in cortex activation in full-face transplantation and lesions patients on EEG activity. Face transplant patients have facial lesions before transplantation and, to identify pre-face transplant patients' brain activity in the absence of pre-transplant recordings, we used data obtained from pre-transplant facial lesion patients. Ten healthy, four facial lesion and three full-face transplant patients participated in this study. EEG data recorded for four different sensory stimuli (brush from the right face, right hand, left face, and left-hand regions) were analyzed using wavelet packet transform method. EEG waves were analyzed for standard bands. Our findings indicate significant change in the 2–4 Hz frequency range which may be a result of ongoing or previous cortical reorganization for face lesion and transplant patients. Alterations of the delta wave seen in patients with facial lesion and face transplant can also be explained by the intense central plasticity. Our findings show that the delta band differences might be used as a marker in the evaluation of post-transplant cortical plasticity in the future.

Rare Histologic Imitator Central Mucoepidermoid Carcinoma Arising from Glandular Odontogenic Cyst of the Mandible: Case Report with Updated Review of Literature.

Central mucoepidermoid carcinoma is a relatively rare salivary gland tumour of the jawbone. Glandular odontogenic cyst is another unique odontogenic developmental cyst characterised by glandular differentiation. Both entities share several histological characteristics, and a pre-existing Glandular odontogenic cyst can evolve into Central mucoepidermoid carcinoma. Case 1: A 56-year-old male presented with chief complaint of swelling in lower left facial region since 1 year. Histopathology revealed multicystic compartments resembling mucoepidermoid carcinoma, but strong positive expression of Cytokeratin 13 upon immunohistochemistry helped us in rendering the final diagnosis as Glandular odontogenic cyst Case 2: A 34-year-old female presented with a lesion on right side of face. Histologically, the biopsy specimen revealed both typical findings of a Glandular odontogenic cyst component and a recognizable component of Mucoepidermoid carcinoma. The results from cytokeratin profiling demonstrated that, while both Mucoepidermoid carcinoma and Glandular odontogenic cyst expressed Cyokeratins 7, 18, and 19. Cytokeratin 13 was interestingly exclusively expressed in Glandular odontogenic cyst. Present case findings showed that central mucoepidermoid carcinoma and Glandular odontogenic cyst may be part of the same disease spectrum. However, because the expression profile of Cytokeratin13 in mucoepidermoid carcinoma and Glandular odontogenic cyst was so diverse, it can be used to differentiate both.

Deep Visual Computing of Behavioral Characteristics in Complex Scenarios and Embedded Object Recognition Applications.

By leveraging artificial intelligence and big data to analyze and assess classroom conditions, we can significantly enhance teaching quality. Nevertheless, numerous existing studies primarily concentrate on evaluating classroom conditions for student groups, often neglecting the need for personalized instructional support for individual students. To address this gap and provide a more focused analysis of individual students in the classroom environment, we implemented an embedded application design using face recognition technology and target detection algorithms. The Insightface face recognition algorithm was employed to identify students by constructing a classroom face dataset and training it; simultaneously, classroom behavioral data were collected and trained, utilizing the YOLOv5 algorithm to detect students' body regions and correlate them with their facial regions to identify students accurately. Subsequently, these modeling algorithms were deployed onto an embedded device, the Atlas 200 DK, for application development, enabling the recording of both overall classroom conditions and individual student behaviors. Test results show that the detection precision for various types of behaviors is above 0.67. The average false detection rate for face recognition is 41.5%. The developed embedded application can reliably detect student behavior in a classroom setting, identify students, and capture image sequences of body regions associated with negative behavior for better management. These data empower teachers to gain a deeper understanding of their students, which is crucial for enhancing teaching quality and addressing the individual needs of students.

ОСОБЕННОСТИ СТРОЕНИЯ СКЕЛЕТА ГОЛОВЫ АЗИАТСКОГО (БЕЛОХВОСТОГО) ДИКОБРАЗА (HYSTRICIDAE LEVICURA)

The purpose of research is to study the structural features of the head skeleton of the Asian (white-tailed) porcupine. The object of the study is the skeleton of the head of an Asian (white-tailed) porcupine at the age of 12 years. To make the porcupine skeleton, a biological method of processing the material was used. The study of the bones was accompanied by measuring their length and width using an electronic caliper with an accuracy of 0.1 mm, describing and photographing. The head skeleton of the Asian (white-tailed) porcupine is divided into cerebral and facial sections, the size of which is related to the size of the brain and the development of the masticatory apparatus. The brain region is represented by unpaired (occipital, sphenoid, interparietal, ethmoid) and paired (temporal, frontal, parietal, alar) bones. The facial region is represented by the maxillary, incisive, palatine, zygomatic, lacrimal and nasal bones. The rostral edge of the orbit serves as the boundary between the facial and brain regions. The facial section reaches the greatest development, occupying 59.8 % of the length of the brain. The configuration of the skull and the presence of a large number of processes make it possible to attach well-developed masticatory muscles to it. The caudal part of the skull is represented by the occipital bone, and the cranial part by the ethmoid bones. The body of the occipital bone is connected to the sphenoid bone, which participates in the formation of the foramen lacerum. The body of the sphenoid bone is trapezoidal in shape, from which the orbital and temporal wings branch. There are six foramina on the orbital wing: optic, orbital fissure, round, caudal alar, oval and carotid. The temporal wing is involved in the formation of the foramen lacerum with the oval, spinous and carotid notches. On the facial surface of the maxillary bone there is a facial ridge; between its facial and nasal surfaces there is an extensive maxillary sinus. The mandibular bone is paired, represented by two bones connected to each other by a ligament. The massive, triangular-shaped lower jaw has two processes: the condylar and the coronoid. The condylar process is convex, oval-elongated. The coronoid process is low with a bifurcated apex. The pterygoid and chewing fossae are deep and triangular in shape.

Stereophotometric facial changes in edentulous older adults after rehabilitation with complete dentures.

To evaluate the facial characteristics of edentulous older adults who underwent rehabilitation using complete dentures, and to compare them with dentate individuals. Edentulism rehabilitation with complete dentures aims to restore occlusion and facial aesthetics. The study included 102 edentulous participants needing prosthodontic rehabilitation with complete dentures and 30 with a natural dentition (aged >65). The 3D facial scans were performed using an Artec optical scanner. Superficial facial landmarks were identified, and 16 parameters were calculated. Regional analysis with the superimposition of two scans was used to calculate the average distances and percentage of non-matching surfaces in the 11 regions. Paired and independent t-tests (α = .05) were used to test for group differences, as appropriate. After rehabilitation with complete dentures, facial changes were most noticeable in the perioral region: wider rima oris, longer upper lip, wider upper vermilion, and more protruded profile. The comparison of facial regions without and with dentures showed fuller and curvier cheeks, with no direct influence of dentures. The edentulous faces with dentures appeared shorter and more retruded than those of dentate individuals. A narrower lower vermilion, retruded upper lip, and more flattened facial profile were observed in females with dentures than in their dentate peers. Besides the expected positive influence of rehabilitation with complete dentures on facial appearance in the perioral region, there are some unexpected changes, such as fuller cheeks, but there is still deficiency in vertical facial dimensions and a more flattened facial profile.

Exploring Progression and Differences in Facial Asymmetry for Hemifacial Microsomia and Isolated Microtia: Insights from Extensive 3D Analysis.

Aiming to measure and compare asymmetry of facial hard and soft tissues in patients with HFM and isolated microtia, examining how it evolves. This cross-sectional study assessed facial asymmetry in male East Asian patients aged 5-12 diagnosed with unilateral hemifacial microsomia (Pruzansky-Kaban types I and IIA) or isolated microtia. Using 3D imaging of computed tomography scans, it measured root-mean-square (RMS) values for surface deviations across facial regions. Statistical analyses explored differences between conditions and the relationship of age with facial asymmetry. A total of 120 patients were categorized into four groups by condition (HFM or isolated microtia) and age (5-7 and 8-12 years). Patients with HFM exhibited the greatest asymmetry in the lower cheek, while those with isolated microtia showed primarily upper face asymmetry. Significant differences, except in the forehead and nasal soft tissue, were noted between the groups across age categories. Notable distinctions in hard tissue were found between age groups in the nasal and mid-cheek areas for patients with HFM (median RMS (mm) 0.9 vs. 1.1, P = 0.02; 1.5 vs. 1.7, P = 0.03) and in the nasal and upper lip areas for patients with isolated microtia (median RMS (mm) 0.8 vs. 0.9, P =0.002; 0.8 vs. 1.0, P = 0.002). Besides these areas for HFM, no significant age-asymmetry correlation was detected. Significant differences in facial asymmetry were observed between HFM and isolated microtia, with the asymmetry in specific area evolving over time. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Familiarity enhances functional connectivity between visual and nonvisual regions of the brain during natural viewing.

We explored the neural correlates of familiarity with people and places using a naturalistic viewing paradigm. Neural responses were measured using functional magnetic resonance imaging, while participants viewed a movie taken from Game of Thrones. We compared inter-subject correlations and functional connectivity in participants who were either familiar or unfamiliar with the TV series. Higher inter-subject correlations were found between familiar participants in regions, beyond the visual brain, that are typically associated with the processing of semantic, episodic, and affective information. However, familiarity also increased functional connectivity between face and scene regions in the visual brain and the nonvisual regions of the familiarity network. To determine whether these regions play an important role in face recognition, we measured responses in participants with developmental prosopagnosia (DP). Consistent with a deficit in face recognition, the effect of familiarity was significantly attenuated across the familiarity network in DP. The effect of familiarity on functional connectivity between face regions and the familiarity network was also attenuated in DP. These results show that the neural response to familiarity involves an extended network of brain regions and that functional connectivity between visual and nonvisual regions of the brain plays an important role in the recognition of people and places during natural viewing.

Emergency Management Patient with Multiple Mid-Lower Face Fracture and Tissue Avulsion of 1/3 Mid Face : A Case Report

Introduction : Facial trauma can be defined as bone and or soft tissue damage in the face region. Severe facial trauma might cause life threatening and permanent damage such as vision loss, unable to speak, swallows and chews because there are many bones, blood vessels, nerves, muscles and sensory organs at the face region. The facial damage could be a facial bone fracture with severe avulsion of facial tissue so two-dimensional and three-dimensional measurement of the wound is taken to assess the size of tissue to be covered. The aim of this case report was to give an explanation regarding the emergency management patient with multiple mid-lower face fracture and tissue avulsion of 1/3 mid face. Case Report : A 46 years old male traffic accident patient came to Emergency Department Hasan Sadikin General Hospital with facial fracture and had a severe avulsion of facial tissue. He also had an active bleeding from his face and based on immediate examination the airway was not clear. The patient has been diagnosed with Le Fort I, right orbital rim inferior aspect, nasal, right zygoma and parasymphisis of mandible bone fracture and Tissue loss at upper lip, nasolabial, left nose, left buccal and Multiple lacerated wound at facial region. He was treated with tracheostomy to clear the airway continued with open reduction internal fixation at right orbital rim inferior aspect, nasal, right zygoma, bilateral maxilla bone and parasymphisis of mandible bone with wound closing using rotational and sliding loco regional flap technique. Conclusion : Emergency treatment on multiple facial fracture with severe avulsion of facial tissue must be done to prevent life threatening condition, permanent damage and also to support the secondary reconstruction. Keywords : Severe avulsion of facial tissue, Mid lower face fracture, Open reduction internal fixation, Rotational flap, Sliding loco regional flap

Thermal comfort prediction in multi-occupant spaces based on facial temperature and human attributes identification

Research on thermal comfort prediction has garnered significant attention, with numerous studies focusing on predicting individual thermal comfort through various physiological indicators. However, these methods often lack reliability in long-distance, multi-occupant spaces and fail to utilize RGB image information fully. To address these limitations, this study introduces a new method for predicting thermal comfort in multi-occupant spaces by integrating individual attributes and facial temperature features. The research extracts human body attributes from RGB images and temperature features from different facial regions using image registration and deep learning algorithms. Results show that specific facial regions (cheeks, nose, eyes) combined with human attributes effectively predict thermal comfort. In contrast, the forehead, mouth, and chin are less reliable due to their sensitivity to external influences. Among various models, the LightGBM model achieves the highest accuracy at 90.04 ± 4.46%, demonstrating the effectiveness of the model this study proposed. This study offers a novel perspective for thermal comfort prediction in various settings, such as classrooms and lecture halls.

Fully Deformable Network for Multiview Face Image Synthesis.

Photorealistic multiview face synthesis from a single image is a challenging problem. Existing works mainly learn a texture mapping model from the source to the target faces. However, they rarely consider the geometric constraints on the internal deformation arising from pose variations, which causes a high level of uncertainty in face pose modeling, and hence, produces inferior results for large pose variations. Moreover, current methods typically suffer from undesired facial details loss due to the adoption of the de-facto standard encoder-decoder architecture without any skip connections (SCs). In this article, we directly learn and exploit geometric constraints and propose a fully deformable network to simultaneously model the deformations of both landmarks and faces for face synthesis. Specifically, our model consists of two parts: a deformable landmark learning network (DLLN) and a gated deformable face synthesis network (GDFSN). The DLLN converts an initial reference landmark to an individual-specific target landmark as delicate pose guidance for face rotation. The GDFSN adopts a dual-stream structure, with one stream estimating the deformation of two views in the form of convolution offsets according to the source pose and the converted target pose, and the other leveraging the predicted deformation offsets to create the target face. In this way, individual-aware pose changes are explicitly modeled in the face generator to cope with geometric transformation, by adaptively focusing on pertinent regions of the source face. To compensate for offset estimation errors, we introduce a soft-gating mechanism for adaptive fusion between deformable features and primitive features. Additionally, a pose-aligned SC (PASC) is tailored to propagate low-level input features to the appropriate positions in the output features for further enhancing the facial details and identity preservation. Extensive experiments on six benchmarks show that our approach performs favorably against the state-of-the-arts, especially with large pose changes. Code is available at https://github.com/cschengxu/FDFace.

Sacred Buildings of Kramatorshchyna in the Conditions of Russian Aggression of 2022–2024: Losses and Ways of Recovery

The state of the sacred buildings in the Kramatorsk district of Donetsk region, on the eve and during the full-scale Russian military aggression of 2022–2024 is investigated in the article. The main aspects of the history of temples’ building in Kramatorshchyna during the late 20th – early 21st centuries are described. In particular, it is emphasized that during the specified period, the active revival of the Holy Mountains Lavra of the Holy Dormition has taken place; its churches of St. Nicholas, St. Dormition, and St. Pokrovsky, etc. have been restored. At the same time, the famous Lavra sketes are renewed: in the villages of Adamivka, Bohorodychne, Dolyna, Tetianivka and the city of Sviatohirsk. The active process of building churches has continued in the other villages and towns of the district. It is noted that, on the eve of the Russian invasion on February 24, 2022 into Ukraine, the sacred architecture of Kramatorshchyna has been related primarily to the Holy Mountains Lavra. It has been the core of its cultural and touristic potential. The data on damaged and destroyed churches for the period of 2022–2024 is collected and systematized in the article. It is found out, in particular, that 43 religious objects have been damaged during this time. Most of them belong to the Orthodox-Christian jurisdiction, although we also have destruction of Protestant and Islamic religious architecture, etc. It is ascertained that the main part of the shrines damaged in the spring of 2022, mainly in May, is situated on the territory of Sviatohirsk and Lyman communities. It is emphasized that this phenomenon is connected with active hostilities for the localities of Lyman, Sviatohirsk and the Siverskyi Donets river. It should be mentioned, that not only sacred buildings of Sviatohirshchyna and Lymanshchyna are affected, but also of Kostiantynivska, Kramatorska, Slovianska, Mykolaivska, Oleksandrivska and Druzhkivska communities. In general, it is stated that the full-scale war has caused irreparable losses to the religious buildings of the Kramatorsk district. It is noted also in the article, that the restoration of destroyed churches depends entirely on the further nature and development of hostilities. On the other hand, measures aimed at eliminating their consequences have already been carried out in the vast majority of temples those received light and are medium damaged. Finally, the issue of taking into account objects of sacred architecture that have historical and cultural value is raised. It is emphasized that the local authorities of Donetsk region and other oblasts of Ukraine now face the urgent task of identifying and registering objects of cultural heritage. The identified problem has prospects for further research on materials from other raions of Donechchyna and the regions of Ukraine.

Multi-task network with inter-task consistency learning for face parsing and facial expression recognition at real-time speed

In recent years, face parsing and facial expression recognition have attracted increasing interest. Even though there are relevant results about face parsing and face representation, these approaches seek accuracy at the expense of speed. In this paper, we design a novel multi-task learning network for face parsing and facial expression recognition (MPENet). Specifically, MPENet consists of shared encoders and three downstream branches. In the edge perceiving branch, we use category edge and binary edge to extract face boundary information and improve localization of face boundaries. In the segmentation branch, we use graph learning to fuse edge and semantic information of the image, analyze the relations between different feature regions, and capture more contextual relationships. Finally, we design a consistent learning loss function, forcing different branches to learn the same predictions. We have carried out experiments on face datasets, and found that it shows high precision and fast inference speed. Specifically, MPENet achieves F1 scores of 85.9 on the CelebAMask-HQ dataset and 92.9 on the Lapa dataset, with an inference speed of 92.9 FPS. Moreover, MPENet precisely delineates the semantic boundaries of facial regions and, through consistent multi-task learning, effectively facilitates synergy among various tasks.

Enhanced Hybrid Vision Transformer with Multi-Scale Feature Integration and Patch Dropping for Facial Expression Recognition.

Convolutional neural networks (CNNs) have made significant progress in the field of facial expression recognition (FER). However, due to challenges such as occlusion, lighting variations, and changes in head pose, facial expression recognition in real-world environments remains highly challenging. At the same time, methods solely based on CNN heavily rely on local spatial features, lack global information, and struggle to balance the relationship between computational complexity and recognition accuracy. Consequently, the CNN-based models still fall short in their ability to address FER adequately. To address these issues, we propose a lightweight facial expression recognition method based on a hybrid vision transformer. This method captures multi-scale facial features through an improved attention module, achieving richer feature integration, enhancing the network's perception of key facial expression regions, and improving feature extraction capabilities. Additionally, to further enhance the model's performance, we have designed the patch dropping (PD) module. This module aims to emulate the attention allocation mechanism of the human visual system for local features, guiding the network to focus on the most discriminative features, reducing the influence of irrelevant features, and intuitively lowering computational costs. Extensive experiments demonstrate that our approach significantly outperforms other methods, achieving an accuracy of 86.51% on RAF-DB and nearly 70% on FER2013, with a model size of only 3.64 MB. These results demonstrate that our method provides a new perspective for the field of facial expression recognition.

The location of pain in cluster headache: Data from the International Cluster Headache Questionnaire.

To identify the most common locations of cluster headache pain from an international, non-clinic-based survey of participants with cluster headache, and to compare these locations to other cluster headache features as well as to somatotopic maps of peripheral, brainstem, thalamic, and cortical areas. Official criteria for cluster headache state pain in the orbital, supraorbital, and/or temporal areas, yet studies have noted pain extending beyond these locations, and the occipital nerve appears relevant, given the effectiveness of suboccipital corticosteroid injections and occipital nerve stimulation. Furthermore, cranial autonomic features vary between patients, and it is not clear if the trigeminovascular reflex is dermatome specific (e.g., do patients with maxillary or V2 division pain have more rhinorrhea?). Finally, functional imaging studies show early activation of the posterior hypothalamus in a cluster headache attack. However, the first somatosensory area to be sensitized is unclear; the first area can be hypothesized based on the complete map of pain locations. The International Cluster Headache Questionnaire was an internet-based cross-sectional survey that included a clickable pain map of the face. These data were compared to several other datasets: (1) a meta-analysis of 22 previous publications of pain location in cluster headache (consisting of 6074 patients); (2) four cephalic dermatome maps; (3) participants' survey responses for demographics, autonomic features, and effective medications; and (4) previously published somatotopic maps of the brainstem, thalamus, primary somatosensory cortex, and higher order somatosensory cortex. One thousand five hundred eighty-nine participants completed the pain map portion of the survey, and the primary locations of pain across all respondents was the orbital, periorbital, and temporal areas with a secondary location in the lower occiput; these primary and secondary locations were consistent with our meta-analysis of 22 previous publications. Of the four cephalic dermatomes (V1, V2, V3, and a combination of C2-3), our study found that most respondents had pain in two or more dermatomes (range 85.7% to 88.7%, or 1361-1410 of 1589 respondents, across the four dermatome maps). Dermatomes did not correlate with their respective autonomic features or with medication effectiveness. The first area to be sensitized in the canonical somatosensory pathway is either a subcortical (brainstem or thalamus) or higher order somatosensory area (parietal ventral or secondary somatosensory cortices) because the primary somatosensory cortex (area 3b) and somatosensory area 1 have discontinuous face and occipital regions. The primary pain locations in cluster headache are the orbital, supraorbital, and temporal areas, consistent with the official International Classification of Headache Disorders criteria. However, activation of the occiput in many participants suggests a role for the occipital nerve, and the pain locations suggest that somatosensory sensitization does not start in the primary somatosensory cortex.

The efficacy of hyaluronic acid fragments with amino acid in combating facial skin aging: an ultrasound and histological study

BackgroundVarious techniques have been employed in aesthetic medicine to combat skin aging, in particular that of the facial region. Hyaluronic acid is utilized to enhance moisture levels and extracellular matrix molecules. This study aims to histologically assess the effects of low molecular weight hyaluronic acid fragments combined with amino acids (HAAM) on facial skin rejuvenation through intradermal microinjections.MethodsA total of twenty women, with an average age of 45 and ranging from 35 to 64 years old, participated in the study, including 8 in menopause and 12 in the childbearing age group. Mesotherapy was used to administer HAAM to the patients. Prior to and three months after the treatment, each patient underwent small circular punch biopsies. Ultrasound examinations were conducted using B-mode, capturing 2D images in longitudinal or transverse orientations with frequencies ranging from 5 to 13 Mega-hertz (MY LAB X8, ESAOTE, Genova, Italy). A total of 60 ultrasound examinations were taken, with 30 collected before treatment and 30 after treatment.ResultsThe histological analysis demonstrates an increase in fibroblast activity resulting in the production of Type III reticular collagen, as well as an increased number of blood vessels and epidermal thickness. However, the analysis of ultrasound data before and after treatment showed no statistical difference in skin thickness in malar area, chin and mandibular angle.ConclusionsHistological assessments indicate that subcutaneous infiltration of HAAM has a substantial impact on the dermis of facial skin.