Social Losses Research Articles

Subjective well-being across the life course among non-industrialized populations.

Subjective well-being (SWB) is often described as being U-shaped over adulthood, declining to a midlife slump and then improving thereafter. Improved SWB in later adulthood has been considered a paradox given age-related declines in health and social losses. While SWB has mostly been studied in high-income countries, it remains largely unexplored in rural subsistence populations lacking formal institutions that reliably promote social welfare. Here, we evaluate the age profile of SWB among three small-scale subsistence societies (n = 468; study 1), forest users from 23 low-income countries (n = 6987; study 2), and Tsimane' horticulturalists (n = 1872; study 3). Across multiple specifications, we find variability in SWB age profiles. In some cases, we find no age-related differences in SWB or even inverted U-shapes. Adjusting for confounders reduces observed age effects. Our findings highlight variability in average well-being trajectories over the life course. Ensuring successful aging will require a greater focus on cultural and socioecological determinants of individual trajectories.

W poszukiwaniu przyczyn wyrażania niechęci wobec dzieci w internecie

The article aims to highlight the phenomenon of adults expressing resentment towards children and to try to reach its causes. The subject of the study consists of the statements of internet users perceived through the prism of linguistic discourse analysis. The author distinguishes three groups of causes: cultural (individualism, freedom in way of life, egocentrism), social (child-centrism vs. loss of social contact with the child) and psychological (individual). Cultural reasons relate to the fact that people nowadays value freedom and don’t want to make sacrifices for children who they consider a disturbance to their orderly, ideal way of life and individualistic mindset. Social causes come in the form of two seemingly opposing ideas. The first is about protest against pressure to have and to like children, alongside the priority given to families with children. The second is about the loss of social contact with the child, caused by the change in the family model and the privatization of motherhood. Psychological causes are of an individual nature; they may be related to trauma and various hypersensitivities and often manifest in expressions of disgust towards children. The author draws attention to the normalization of rude language behavior and the escalation of expressed resentment, which raises questions about the possibility of age discrimination.

Evaluation of the Relationship between Sociodemographic Factors, COVID-19 Fear Levels and Vaccination Status in Patients Applying to Family Medicine Outpatient Clinics in a University Hospital

ABSTRACT Objective: This study has aimed to examine the relationship between sociodemographic factors and COVID-19 fear levels in patients aged 18-65 years and their COVID-19 vaccination status. Methods: The study sample consists of 866 patients aged between 18-65 who applied to the Family Medicine Polyclinics of a university hospital between 01.03.2022 and 01.06.2022. Personal Information Form and Fear of COVID-19 Scale were used to collect data. As the score obtained from the scale increases, the level of fear of COVID-19 increases. The analyzes of the study were done in SPSS 21.0 package program. Kruskal Wallis test and Mann Whitney U test were used for comparisons. Results: 52.3% of the participants in the study were women and the mean age was 36.59±12.32 years. Compared to men, women's fear of coronavirus was statistically significantly higher. The coronavirus fear levels of those who received at least one dose of vaccine compared to those who did not get vaccinated at all, and those who received more doses of vaccines compared to those who received only one dose were found to be statistically significantly higher. Conclusion: As the level of fear of COVID-19 increased, it was determined that the vaccination behavior of individuals was positively affected. COVID-19 is a vaccine preventable disease. With vaccination in all healthcare institutions, it will be possible to prevent morbidity and mortality, as well as economic and social losses that may be caused by the COVID-19 pandemic.

Analysis, Quantification and Identification of Pesticides from Lettuce in Ouagadougou City (Burkina Faso)

In Burkina Faso, chemical inputs are used massively in market gardening to increase the yields. The misuse of these chemicals is responsible of contamination of market garden products, leading to the rapid rotting of vegetables. The objective of this study was to determine the pesticides in chemical inputs applied on vegetables produced in Ouagadougou City. To do this, lettuce has been sampled from producers in three sites (Tanghin, Boulmiougou and Kossodo) and pesticides amounts have been analyzed using Gas Chromatography coupled with mass spectrometry. Chemical analyses have carried out on three lettuce samples and the extraction of chemical input residues was done according to QuEChERS (Quick Easy Cheap Effective Rugged and Safe) method. Results revealed the presence of six (06) pesticide molecules (chlordimeform, quintozene, lindane, cypermethrin, α-cypermethrin, δ-deltamethrin) in Boulmiougou sample, four (04) molecules (methomyl, cypermethrin, α-cypermethrin, δ-deltamethrin) in Kossodo sample and three (03) molecules (cypermethrin, α-cypermethrin, δ-deltamethrin) in Tanghin sample. In this regard, analysis of pesticide amount revealed that the quantity of molecules was acceptable for the consumer, but these pesticides could contribute to the rapid rotting of our vegetables which generates economic and social losses for the country.

Selecting facility location of Gendarmerie Search and Rescue (GSR) Units; An analysis of efficiency in disaster response

Disasters, referred to as events that result in physical, economic, and social losses for individuals and disrupt the daily activities of human communities, necessitate ongoing preparedness due to their unpredictable nature. Swift response during and after a disaster is crucial for preserving human life. Hence, it is imperative to initiate planning immediately following a disaster to ensure readiness for various tasks. Given these factors, search and rescue units must carefully select a base location that enables them to promptly reach affected areas.Disasters exhibit unique characteristics across different regions of Türkiye. While some regions are prone to earthquakes, others face the risks of landslides, avalanches, or floods. Consequently, the required measures for disaster management vary from region to region. Nevertheless, when the term “disaster” is mentioned in Türkiye, earthquakes often come to mind due to their frequent occurrence and significant impact. The Gendarmerie Search and Rescue (GSR) units have been actively responding to these earthquakes, renowned for their exemplary institutional discipline and working methods. This study aims to examine the operations and deployment locations of GSR units, which play a crucial role in mitigating the impact of frequent earthquakes in Türkiye, utilizing a SWOT analysis. Additionally, a Multi-Criteria Decision Making-based mathematical model will be employed to optimize task activities and to select the most suitable facility locations for GSR units. The use of mathematical modeling in this context ensures that GSR units are strategically positioned to maximize their operational effectiveness and minimize response times. The results will be evaluated through sensitivity analysis.

Would carbon tax policy promote real estate prices?

Real estate plays a pivotal role in carbon emissions. Carbon tax policy is a crucial measure for mitigating enterprises' carbon emissions. However, imposing a carbon tax on productive enterprises in the real estate industry to reduce emissions may increase their production costs, which could easily be passed on to buyers, thus inflating real estate prices and impeding policy effectiveness. To examine the impact and negative consequences of carbon tax policy applied to the real estate industry, we develop a dynamic stochastic general equilibrium model encompassing building materials manufacturers, real estate firms, and the environmental regulatory government. Findings indicate that implementing the carbon tax policy significantly reduces carbon emissions in the real estate industry. However, the existence of a price transmission mechanism makes carbon tax policies susceptible to driving up real estate prices. Further welfare analysis shows that increasing carbon tax rates will result in social welfare losses, allowing the government to modify and refine its policy objectives.

A Semi-Detailed Survey of Soils in the City of Jaboatão dos Guararapes – PE

The economic development of the city of Jaboatão dos Guararapes was generated spontaneously without considering the land use capacity or its position in the landscape. Due to the occupation and intensive disordered use of the city pedological coverage, there have been mass movements that have caused economic and social losses. These can be resized based on the understanding of the pedological aspects inherent to the city. The objective of the present paper was to map the soils of the city area at a semi-detailed level. For this purpose, different toposequences were used, with soil examinations at a rate of 1 for every 2.75 km², totaling 94 points. The mapping and taxonomic classification of soils were made in accordance with standards, procedures and criteria adopted by Embrapa Soils. Based on the morphological data, locations were defined for soil description and sampling, totaling 14 soil profiles. 15 soil classes were identified, and 23 mapping units were defined, which highlighted the notable role of the source material in the distribution of the city's pedological properties. The mapping units that require greater care for use are: a) in hill environments - PAdr1, PVAd1 and PVd; and b) in the fluvial-marine plains – EKu1, EKu2 and GXbd2. The expansion of urban areas must consider the type of soil and the behavior of the material, especially during the rainy season, in order to minimize risks and adverse losses.

Fault Location Method of Distribution Network Based on VGAE-GraphSAGE

The distribution network is the main component of the power system, which undertakes the important function of power transmission and distribution. Fast and accurate distribution network fault location is one of the important means to ensure the safe and stable operation of the power system and is helpful in guiding troubleshooting, shortening the power outage time, reducing the workload of manual inspection, and reducing the social and economic losses caused by faults. Due to the development of the new distribution network, the comprehensive influence of many factors has put forward new challenges to the traditional distribution network fault location methods. In this paper, a distribution network fault location method based on the graph neural network is proposed. Firstly, the distribution network is treated as non-Euclidean graph data; secondly, variational graph auto-encoders (VGAE) are used to mine the underlying information of nodes and improve the overall anti-noise performance of the fault location method. Then the GraphSAGE model is used to aggregate the neighbor information of nodes, fully consider the influence of the surrounding lines on the target lines, and improve the output of the model to locate the distribution network line where the fault occurred. The experimental example analysis based on OpenDSS simulation software (version 9.8) proves that the proposed method has high accuracy and anti-interference, and the accuracy reached 97.81%. Moreover, the positioning result is still good in the new intelligent distribution network scenario with distributed power access, with an accuracy of 95.07% in the hybrid power generation scenario.

Adult stakeholders' perspectives on supporting or undermining the mental health of sexual and gender minoritised adolescents.

To explore adult stakeholders' perspectives on what supports or undermines the mental health of sexual and gender minoritised adolescents (SGMA) in everyday life in order to better understand how to foster supportive psychosocial environments for SGMA. Descriptive qualitative study design, using framework analysis. Semi-structured interviews were conducted remotely with 16 UK-based adult stakeholders which included parents of SGMA, health and social care professionals, community-based professionals, and professionals who commission services related to adolescent health and well-being. Nine themes were identified that represented barriers and enablers of fostering psychosocial environments that are supportive of SGMA mental health. Example barrier themes include SGMA 'facing chronic and acute safety threats and stress', 'psychological responses to social connection losses and navigating alienation', 'digital exposure and online risk and vulnerability' and 'conflicting messages, resulting divisions and adult distancing'. Example enablers include 'exploring, owning, and changing (personal) identities', 'advocating alongside adolescents whilst containing oneself as the adult in the situation' and 'personally fostering adolescents' psychological safety and inclusion'. Adult stakeholders report that SGMA are often exposed to environments hostile to key aspects of their identity which then by extension undermines their mental health. These experiences can threaten their sense of safety and evolving identity. Practitioners in particular should be aware of the stressors relating to SGMA identity and minoritisation experiences in order to develop the psychological safety and sense of inclusion needed for SGMA to trust in the relationship and the support offered.

8446 Thermoneutral Housing has Limited Effects on Social Isolation-Induced Bone Loss in Male C57BL/6J Mice

8446 Thermoneutral Housing has Limited Effects on Social Isolation-Induced Bone Loss in Male C57BL/6J Mice

Child sexual abuse and social identity loss: A qualitative analysis of survivors' public accounts.

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma-related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families.

A method for assessing the resilience of urban interdependent systems integrating physical damage and social loss

As systems in urban areas become increasingly interdependent, the effects of disasters extend beyond facilities damage, precipitating casualties, and public service disruptions. Establishing a holistic resilience assessment method is crucial for urban sustainability planning. Existing resilience assessment methods often focus on the physical damage; however, few studies examine the social loss. This study proposes a resilience assessment method that integrates physical damage and social loss. A multilayer network model of physical-social systems is first developed based on their interdependency. Then, the evolution of disaster damage within and between systems process, and the multi-task parallel restoration process are quantified. Resilience is assessed by measuring dynamic changes in service supply and demand throughout these processes. The method considers social loss as a combination of population harm and service interruption caused by physical damage. The proposed method was applied to an urban area in Southern China. The results reveal the impact of seismic events on infrastructure, buildings, and populations. Furthermore, they demonstrate the coupling impacts of supply and transportation on emergency and healthcare systems’ resilience. This comprehensive method could facilitate the development of efficient strategies to improve urban resilience to disasters.

Procrastination as a social problem

Procrastination, or the unwillingness to get things done on time, is one of the most widespread problems in modern society. Every year more and more people experience this phenomenon, leading to serious consequences for both individuals and society as a whole. Procrastination can lead to poor mental health, reduced productivity and quality of work, as well as social and economic losses. In our information society, where access to various forms of entertainment and distractions is unprecedented, it is no wonder that procrastination has become such a widespread problem. Social media, video games and other entertainment formats easily capture our attention and take away time that should be devoted to work or study. As a result, we often find ourselves tangled in a hopeless situation: aware of our reluctance to start work or perform responsible tasks, but unable to control our behaviour. However, procrastination is not only a personal problem for each individual. Its negative impact extends to the entire social structure of society. For example, employees prone to procrastination can cause delays in the completion of collective projects or reduced team performance. Procrastination, or the unwillingness to get things done on time, is one of the most widespread problems in modern society. Every year more and more people experience this phenomenon, leading to serious consequences for both individuals and society as a whole. Procrastination can lead to poor mental health, reduced productivity and quality of work, as well as social and economic losses. In our information society, where access to various forms of entertainment and distractions is unprecedented, it is no wonder that procrastination has become such a widespread problem. Social media, video games and other entertainment formats easily capture our attention and take away time that should be devoted to work or study. As a result, we often find ourselves tangled in a hopeless situation: aware of our reluctance to start work or perform responsible tasks, but unable to control our behaviour. However, procrastination is not only a personal problem for each individual. Its negative impact extends to the entire social structure of society. For example, employees prone to procrastination can cause delays in the completion of collective projects or reduced team performance.

Immigrant Ghosts and Haunted Heritages in Rani Manicka’s The Rice Mother

ABSTRACT In Malaysia, even the ghosts are transnational. Rani Manicka’s 2002 debut novel The Rice Mother follows the intergenerational narratives of a diasporic Ceylonese family in Malaysia. As they reflect on the atrocities of the Second World War and Japanese Occupation – notably the abduction and presumed murder of the eldest daughter, Mohini, by Japanese soldiers – each family member shares their haunted relationship with Mohini’s ghost. While Avery Gordon and Kathleen Brogan have examined how hauntings can characterize social or ethnic loss, Mohini’s hauntings are unique to the Ceylonese diaspora in Malaysia. In addition to the family members encountering her ghost through dreams – significant connections to the spiritual world in Hindu mythology – Mohini’s character is inspired by the mohini pey, a legendary ghost from Southern India and Sri Lanka. However, the discrepancy between mohini the ghost and Mohini the character interrogates the malleability of memory across generations. How might hauntings – manifestations of the traumatic past – change as generations evolve and reaffiliate cultural memory over time? Drawing on Marianne Hirsch’s concept of postmemory, this paper examines the family’s evolving relationship with Mohini’s ghost and argues that the residual power of diasporic heritage inherited through storytelling provides a path for generational healing in a new homeland.

The Impact of Error in Persona : Lilability of Police Investigators in Wrongful Arrest Cases

Wrongful arrest in Indonesia is a serious problem in law enforcement that often results in physical suffering, psychological, and social losses for victims. One form of error that often occurs is “error in persona,” which is a misidentification that results in the arrest of an innocent person. This research uses normative juridical method with literature study and qualitative analysis to analyze the responsibility of investigators in cases of wrongful arrest. The purpose of this study is to understand the factors that cause errors in persona and their impact on victims and the legal system. The results show that misidentification often occurs due to inaccuracies in evidence collection, pressure to quickly resolve cases, and the use of inadequate investigative methods. In addition, the importance of fulfilling the legal procedures stipulated in the Criminal Procedure Code (KUHAP) is crucial to prevent these errors. Reforms in the investigation process, increased capacity of investigators, and the use of modern technology are necessary to minimize the risk of errors and ensure justice and the protection of human rights.

A novel extended social force model for studying the impact of the heterogeneity of pedestrian physical fitness on emergency evacuation efficiency

Emergencies in public places, particularly confined crowded areas, will disrupt the stability of dense crowds and consequently lead to accidents. To promote public emergency safety, there is a pressing need for efficient modeling methods to investigate the evacuation mechanism in these places and improve the social public safety. This study proposes a Physical Fitness Heterogeneity based Social Force Model (PFH-SFM) that takes into account the heterogeneous desired evacuation velocity caused by the heterogeneity of pedestrian physical fitness, by means of developing the normalized desired velocity ratio. Then, we use PFH-SFM to investigate the relationships between the escape rate and the desired velocity, and between the evacuation duration and the desired velocity in terms of various group sizes with heterogeneous physical fitness, the relationship between the percentage of reduction in evacuation duration and desired velocity when including weak pedestrians, the pedestrian distribution in the evacuation process, the relationship between the total evacuation duration and the desired velocity in terms of various proportions of weak pedestrians and the relationship between the evacuation duration and the desired velocity in terms of various normalized starting and ending velocity ratios by considering various group sizes, respectively. The findings of this study show that the existence of a certain small proportion of pedestrians with weak physical fitness can promote global evacuation dynamics, especially in the case of high crowded density, and can reduce evacuation duration by up to 20% in our experiments. Additionally, when the percentage of pedestrians with weak physical fitness is relatively high, they tend to have a detrimental effect on the evacuation efficiency. Furthermore, there exists a moderate normalized desired starting velocity ratio that maximizes the overall evacuation efficiency; on the other hand, the lower the normalized desired ending velocity ratio is, the more efficient the evacuation is. To the best of the authors’ knowledge, this study is the first time to introduce the concepts of normalized desired starting and ending velocity ratios and innovatively analyzes the impact of the continuously changing desired velocity of pedestrians on the evacuation efficiency in multi-exit scenarios. The results offer valuable insights for relevant stakeholders to formulate effective evacuation plans, so as to enhance urban emergency capacity and minimize social and economic losses.

Assessing South Indian Ocean tropical cyclone characteristics in HighResMIP simulations

AbstractSeveral damaging tropical cyclones (TCs) have occurred recently over the South Indian Ocean (SIO) region, causing enormous social and economic losses. Yet, while many studies have examined SIO TC characteristics using observations and reanalysis, only a few have assessed these characteristics specifically for this region in climate models, and fewer have investigated their projections under climate change. Here we do this for a historical (1980–2010) and future (2020–2050) period, using multimodel simulations from the High Resolution Model Intercomparison Project, as well as examine biases in the historical period relative to a reanalysis (ERA5). The models have horizontal resolutions of 25–50 km, which has enabled an improved ability to represent tropical cyclones globally in previous studies. TempestExtremes software is employed to detect tropical storm and cyclone tracks. In cases where TempestExtremes cannot be applied due to a lack of requisite variables in a dataset, we instead examine extreme wind speeds in that dataset. For the historical period, we find considerable variation in model biases compared to ERA5, which itself exhibits realistic spatial patterns of tracks and their monthly distribution. Models do at least agree on positive biases in track frequency east of Madagascar and somewhat in the Mozambique Channel. However, the models and ERA5 only produce Category 3 tropical cyclones at best. Wind speeds for 25 km resolution models have much larger positive biases than for 50 km ones, suggesting the former can simulate even higher‐category tropical cyclones. Considerable intermodel variation is also found in track changes between the future and historical periods. No systematic intercategory pattern of change exists, and low signal‐to‐noise may obscure any such patterns in the limited timespan of available data. Thus, no meaningful conclusions can be drawn regarding changes in track intensity. Nevertheless, track frequency broadly decreases across models for the region, as does accumulated cyclone energy. An east‐to‐west shift in track location from east of Madagascar toward the Mozambique Channel is also implied by track frequency and wind speed changes. Our findings provide information to potentially improve storm resiliency in this vulnerable region.

Forecasting the outcomes of construction contract disputes using machine learning techniques

PurposeThis study aims to develop a predictive model using machine learning techniques to forecast construction dispute outcomes, thereby minimizing economic and social losses and promoting amicable settlements between parties.Design/methodology/approachThis study develops a novel conceptual model incorporating project characteristics, root causes, and underlying causes to predict construction dispute outcomes. Utilizing a dataset of arbitration cases in Türkiye, the model was tested using five machine learning algorithms namely Logistic Regression, Support Vector Machines, Decision Trees, K-Nearest Neighbors, and Random Forest in a Python environment. The performance of each algorithm was evaluated to identify the most accurate predictive model.FindingsThe analysis revealed that the Support Vector Machine algorithm achieved the highest prediction accuracy at 71.65%. Twelve significant variables were identified for the best model namely, work type, root causes, delays from a contractor, extension of time, different site conditions, poorly written contracts, unit price determination, penalties, price adjustment, acceptances, delay of schedule, and extra payment claims. The study’s results surpass some existing models in the literature, highlighting the model’s robustness and practical applicability in forecasting construction dispute outcomes.Originality/valueThis study is unique in its consideration of various contract, dispute, and project attributes to predict construction dispute outcomes using machine learning techniques. It uses a fact-based dataset of arbitration cases from Türkiye, providing a robust and practical predictive model applicable across different regions and project types. It advances the literature by comparing multiple machine learning algorithms to achieve the highest prediction accuracy and offering a comprehensive tool for proactive dispute management.

Advances, challenges, and prospects of electroencephalography-based biomarkers for psychiatric disorders: a narrative review.

Owing to a lack of appropriate biomarkers for accurate diagnosis and treatment, psychiatric disorders cause significant distress and functional impairment, leading to social and economic losses. Biomarkers are essential for diagnosing, predicting, treating, and monitoring various diseases. However, their absence in psychiatry is linked to the complex structure of the brain and the lack of direct monitoring modalities. This review examines the potential of electroencephalography (EEG) as a neurophysiological tool for identifying psychiatric biomarkers. EEG noninvasively measures brain electrophysiological activity and is used to diagnose neurological disorders, such as depression, bipolar disorder (BD), and schizophrenia, and identify psychiatric biomarkers. Despite extensive research, EEG-based biomarkers have not been clinically utilized owing to measurement and analysis constraints. EEG studies have revealed spectral and complexity measures for depression, brainwave abnormalities in BD, and power spectral abnormalities in schizophrenia. However, no EEG-based biomarkers are currently used clinically for the treatment of psychiatric disorders. The advantages of EEG include real-time data acquisition, noninvasiveness, cost-effectiveness, and high temporal resolution. Challenges such as low spatial resolution, susceptibility to interference, and complexity of data interpretation limit its clinical application. Integrating EEG with other neuroimaging techniques, advanced signal processing, and standardized protocols is essential to overcome these limitations. Artificial intelligence may enhance EEG analysis and biomarker discovery, potentially transforming psychiatric care by providing early diagnosis, personalized treatment, and improved disease progression monitoring.

Long-Term Outcome of Surgery for Grade 4 Gynecomastia: A Single-Center Experience

Abstract Background Gynecomastia results in a feminine appearance of the male chest, leading to social embarrassment and loss of self-esteem in the afflicted males. Grade 4 gynecomastia is expected to have less than perfect results with liposuction and gland excision alone. This study was done to assess the long-term outcome of this surgery for grade 4 gynecomastia. Materials and Methods From January 2021 to December 2022, 81 patients with grade 4 gynecomastia were treated by us. All the patients underwent vibration amplification of sound energy at resonance (VASER) and suction-assisted liposuction of the chest and side rolls with excision of the gland with crescentic lift in the cases with ptosis. A retrospective study was done to analyze the long-term surgical outcomes in these patients by review of clinical records. Results Symmetry was achieved in 37/39 patients with grade 4a gynecomastia but only in 33/42 patients with grade 4b gynecomastia. The inframammary fold disappeared in 35/39 patients with grade 4a gynecomastia but only in 25/42 of grade 4b gynecomastia patients. Ptosis was corrected in 35/42 grade 4b gynecomastia patients. The mean follow-up was 15 months (range: 12–24 months). Only seven patients desired a second stage to correct the remaining deformity. Conclusion Liposuction with gland removal alone in grade 4a gynecomastia and with liposuction with crescentic nipple–areola complex (NAC) lift in patients of grade 4b gynecomastia give satisfactory results in patients with massively enlarged breasts. While grade 4a gynecomastia has overall better results and lesser complications as compared with grade 4b gynecomastia, the latter also has acceptable outcomes. Realistic prognosis needs to be explained to the patient preoperatively.