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PubMed2003

Neandertal faces were not long; modern human faces are short.

Neandertal faces have been described as being derived with respect to their overall length or degree of anterior projection. A comparison of cranial and mandibular indicators of lower facial projection across archaic and modern Homo indicates that Neandertal facial lengths on average are similar to those of preceding archaic Homo and principally contrast with those of recent humans. Neandertal facial length is not derived. The shortness of recent human facial skeletons is the evolutionarily derived condition.

Animals↗
PubMed2001

Decision aids for people facing health treatment or screening decisions.

BACKGROUND: Decision aids are interventions designed to help people make specific and deliberative choices among options (including status quo) by providing (at a minimum) information on the options and outcomes relevant to a person's health status. A systematic review is needed to summarize what is known about their efficacy. OBJECTIVES: 1. To create an inventory of existing decision aids. 2. To conduct a systematic review of randomized controlled trials of decision aids aimed at improving people's decision making and outcomes. SEARCH STRATEGY: The following electronic databases were searched: MEDLINE, EMBASE, PsycINFO, CINAHL, Aidsline, Cancerlit, the Cochrane Controlled Trials Register. In addition, individuals known to be active in the field of decision support were contacted. SELECTION CRITERIA: We screened titles and abstracts for all interventions providing structured, detailed, and specific information on treatment or screening options and outcomes to aid decision making. Information about the decision aids was compiled in an inventory and those evaluated in a randomized controlled trial were reviewed in detail. DATA COLLECTION AND ANALYSIS: Using Cochrane review methods, two reviewers independently screened and extracted data on several evaluation criteria. Results of randomized trials were pooled using weighted mean differences and relative risks with all data analysed using a random effects model. MAIN RESULTS: Eighty-seven decision aids were identified. Twenty-three of them had been evaluated in 24 randomized controlled trials. Among the trials comparing decision aids to usual care interventions, decision aids performed better in terms of: a) greater knowledge of options in seven of seven studies (weighted mean difference (WMD = 19 out of 100, 95% confidence interval (CI): 13,25); b) more realistic expectations in two of three studies (RR=1.48 95%CI 1.02, 2.14); c) lower decisional conflict related to feeling informed in three of three studies (WMD = -9.0 of 100 95%CI: -15, -3); d) reducing the proportion of people who were passive in decision making in three of four studies (RR = 0.63, 95% CI: 0.5, 0.8). When simpler decision aids were compared to more detailed ones, the relative improvement was significant in: a) improved knowledge in two of seven studies (WMD = 4 out of 100, 95% CI: 2, 5); b) realistic expectations in two of two studies (relative risk (RR ranged from 1.5 95%CI: 1.3,1.8); and c) decisional conflict in one of two studies (WMD= -4 95% CI -8,-0.2). There was a consistent trend for decision aids to do no better than comparison interventions in affecting: satisfaction with the decision in five of six studies, satisfaction with the decision making process in four of five studies, and anxiety in four of five studies. Decision aids had a variable effect on which screening or treatment options were selected. Exposure to decision aids relative to controls resulted in a consistent non-significant trend toward reduced preference for major surgery over conservative options by 21 to 42 per cent in five of five studies; however, they had no impact on circumcision in two of two studies. For colon and prostate cancer screening choices, the results were inconsistent. Two studies have shown no impact on persistence with chosen option and few studies have shown significant benefits on general health outcomes (two of three studies), or disease-specific health outcomes (one of four studies). REVIEWER'S CONCLUSIONS: The number of decision aids is expanding, but there is considerable overlap in some areas leaving gaps in others. Trials of decision aids indicate that they are superior to usual care interventions in improving knowledge and realistic expectations of the benefits and harms of options; reducing passivity in decision making; and lowering decisional conflict stemming from feeling uninformed. When simpler versions of decision aids are compared to more detailed aids, the differences in knowledge are marginal but there are other benefits in terms of creating realistic expectations and in reducing decisional conflict. To date, decision aids have had little effect on anxiety or satisfaction with the decision making process or satisfaction with the decision. Their effects on choices vary with the decision. The effects on persistence with chosen therapies and health outcomes require further evaluation. The essential elements in decision aids for different groups and different types of decisions need to be established. Consensus needs to be reached regarding standards for developing and evaluating decision aids.

Decision Support Techniques↗
PubMed2006

Face-to-face seated positioning for phacoemulsification in patients unable to lie flat for cataract surgery.

PURPOSE: To describe a technique of phacoemulsification for patients unable to lie flat. DESIGN: Prospective interventional case report. METHODS: Two patients unable to lie flat during phacoemulsification underwent this technique in a University Ophthalmology Department in the United Kingdom. Each patient was positioned erect or semirecumbent in a standard reclining cataract surgical chair. The ceiling-mounted microscope was rotated 60 degrees from the vertical to point toward the patient. The surgeon sat beside the patient, and while facing him or her, operated at nearly arm's length. RESULTS: The intraoperative and postoperative periods were uneventful in both patients, with good visual outcomes after surgery. CONCLUSIONS: This technique is valuable for situations where the patient or the eye requires upright positioning because of the inability to recline flat, and should be considered for cases where standard surgical positioning is not possible.

Aged↗
PubMed2004

Face to face: visual scanpath evidence for abnormal processing of facial expressions in social phobia.

Cognitive models of social phobia propose that cognitive biases and fears regarding negative evaluation by others result in preferential attention to interpersonal sources of threat. These fears may account for the hypervigilance and avoidance of eye contact commonly reported by clinicians. This study provides the first objective examination of threat-related processing in social phobia. It was predicted that hyperscanning (hypervigilance) and eye avoidance would be most apparent in social phobia for overt expressions of threat. An infrared corneal reflection technique was used to record visual scanpaths in response to angry, sad, and happy vs. neutral facial expressions. Twenty-two subjects with social phobia were compared with age- and sex-matched normal controls. As predicted, social phobia subjects displayed hyperscanning, (increased scanpath length) and avoidance (reduced foveal fixations) of the eyes, particularly evident for angry faces. The results could not be explained by either medication or co-morbid depression. These findings are consistent with theories emphasising the role of information processing biases in social phobia, and show promise in the application to treatment evaluation in this disorder.

Adult↗
PubMed1985

Right brain, left brain; left face, right face: hemisphericity and the expression of facial emotion.

Research on the asymmetry of facial expressions is reviewed in terms of neuroanatomy, qualitative and quantitative measures of asymmetrical expression, method of expression elicitation (spontaneous, posed, imagery-based), type of expression (happy, sad, etc.), and expression rating procedures. Neuroanatomical evidence indicated that contralateral control of facial musculature exists only for the lower face and that different motor pathways are responsible for spontaneous versus posed expressions. Empirical research on the differential assignment of qualitative trait attributes to facial regions was judged to be meagre and data on quantitative differences in the asymmetry of facial expressions was inconclusive because of the wide variability in methodology across past investigations. Specific suggestions for future investigations in this area are offered and alternative conceptualizations of hemisphericity and facial asymmetry proposed.

Adolescent↗
PubMed1993

Growth allometry of the human face: analysis of the osseous component of the mid and lower face in Brazilian fetuses.

Growth of facial bones was studied in 30 human fetuses ranging from 14 to 35 weeks of gestation (both sexes together), investigating both bivariate and multivariate allometry with principal components analysis (PCA). Weight of the mandible, maxillae, zygomatic, palatine, vomer and both lateral masses of the ethmoid bones was measured and correlated with fetal weight. The relative order of growth rates was similar for bivariate and multivariate results. These results indicate that the growth rate of the lower face is greater than growth rates of the vomer and palatine bones, and is less than growth rates of the maxillae, zygomatic and ethmoid bones. Bivariate and multivariate results present only one significant difference: the mandible grows with positive allometry in bivariate study and with negative allometry in multivariate analysis. The analysis performed in this study provides an approximation of the biological phenomenon of growth which may be useful in the interpretation of facial growth.

Analysis of Variance↗
PubMed2002

Four heads are better than one: combining face composites yields improvements in face likeness.

Four participants constructed face composites, of familiar and unfamiliar targets, using Pro-Fit, with reference images present or from memory. The "mean" of all 4 composites, created by morphing (4-morph) was rated as a better likeness than individual composites on average and was as good as the best individual likeness. When participants attempted to identify targets from line-ups, 4-morphs again performed as well as the best individual composite. In a second experiment, participants familiar with target women attempted to identify composites, and the trend showed better recognition from multiple composites, whether combined or shown together. In a line-up task with unfamiliar participants, 4-morphs produced most correct choices and fewest false positives from target-absent or target-present arrays. These results have practical implications for the way evidence from different witnesses is used in police investigations.

Adolescent↗
PubMed1999

I see a face-a happy face.

Information analysis shows that face-selective neurons in inferior temporal cortex encode different stimulus attributes early and late in their response to the same image.

Facial Expression↗
PubMed2004

Anterior face-lift for correction of middle face aging utilizing a minimally invasive technique.

OBJECTIVE: A minimally invasive face-lifting approach aimed at rejuvenation of the midface was examined, for patients with concerns limited to midfacial aging. METHODS: An incision in the preauricular area and then minor undermining to lift superfical musculo apponeurotic system (SMAS), followed by SMAS plication and removal of skin laxity in the midface, results in excellent superolateral reversal of inferomedial displacement of the aging vector. RESULTS AND CONCLUSION: A minimally invasive procedure was performed easily under local anesthesia in an office/ambulatory surgery center setting.

Adult↗
PubMedDate not supplied

Face to face with Sturge-Weber syndrome.

ISSUES AND PURPOSE: Chronic illness is a way of life for parents of children with Sturge-Weber syndrome (SWS), a rare progressive congenital disease that has as its defining feature a port wine stain. This case study describes the experience of one family living with a child with SWS. CONCLUSIONS: This family's struggle with a devastating syndrome and the ways in which they coped and maintained hope inform all those who care for families living with a chronically ill, disabled child. PRACTICE IMPLICATIONS: Social support is critical for families facing overwhelming care needs. Families also need anticipatory guidance about child rearing, developmental milestones, decision making, and coping strategies. Additionally, families may need help in mobilizing professional and family resources and in effectively using available services.

Adaptation, Psychological↗
PubMed2004

Cobalamin-independent methionine synthase (MetE): a face-to-face double barrel that evolved by gene duplication.

Cobalamin-independent methionine synthase (MetE) catalyzes the transfer of a methyl group from methyltetrahydrofolate to L-homocysteine (Hcy) without using an intermediate methyl carrier. Although MetE displays no detectable sequence homology with cobalamin-dependent methionine synthase (MetH), both enzymes require zinc for activation and binding of Hcy. Crystallographic analyses of MetE from T. maritima reveal an unusual dual-barrel structure in which the active site lies between the tops of the two (betaalpha)(8) barrels. The fold of the N-terminal barrel confirms that it has evolved from the C-terminal polypeptide by gene duplication; comparisons of the barrels provide an intriguing example of homologous domain evolution in which binding sites are obliterated. The C-terminal barrel incorporates the zinc ion that binds and activates Hcy. The zinc-binding site in MetE is distinguished from the (Cys)(3)Zn site in the related enzymes, MetH and betaine-homocysteine methyltransferase, by its position in the barrel and by the metal ligands, which are histidine, cysteine, glutamate, and cysteine in the resting form of MetE. Hcy associates at the face of the metal opposite glutamate, which moves away from the zinc in the binary E.Hcy complex. The folate substrate is not intimately associated with the N-terminal barrel; instead, elements from both barrels contribute binding determinants in a binary complex in which the folate substrate is incorrectly oriented for methyl transfer. Atypical locations of the Hcy and folate sites in the C-terminal barrel presumably permit direct interaction of the substrates in a ternary complex. Structures of the binary substrate complexes imply that rearrangement of folate, perhaps accompanied by domain rearrangement, must occur before formation of a ternary complex that is competent for methyl transfer.

Amino Acid Sequence↗
PubMed1992

Adult tactile stimulation during face-to-face interactions modulates five-month-olds' affect and attention.

3 studies were designed to investigate infant responses to tactile stimulation during brief adult-infant interaction using a modified still-face (SF) procedure. When adults pose a neutral SF expression, infants decrease gazing and smiling at the adults, and some increase grimacing, relative to normal interaction periods. This SF effect was substantially reduced in Study 1 when mothers or strangers continued to touch infants during the SF period. In Studies 2 and 3, tactile versus visual and active versus passive aspects of adult touch were isolated during different SF periods. Visible, active adult hands unaccompanied by touch elicited infant attention, but not smiling, during the SF period. By contrast, active, not passive, adult touch substantially reduced the SF effect, even when the adult's hands were invisible. In the latter condition, infants continued to gaze and smile at the adult's SF. Thus, adult facial expressions are not the only modulator of infant affect and attention during social exchanges; adult touch appears to play an active role.

Adult↗
PubMed1988

The fourth dimension of the face: a preliminary report of growth potential in the face of the Chinese population of Singapore.

Age-related changes were studied in 32 linear measurements from the faces of 180 healthy Chinese subjects of Singapore, aged 6, 12 and 18 years, with equal representation of the sexes. In addition, the differences in 10 inclinations and 6 angles of the facial profile between thirty 6-year-olds and thirty 18-year-olds of each sex were determined. The total absolute and relative growth between 6 and 18 years was established and, in the linear measurements, the relative increments were separately calculated for the 6- to 12-year-old and 12- to 18-year-old periods.

Adolescent↗