The non-surgical rhinoplasty is presented as safe by majority of authors, with very rare risk of vision loss and skin necrosis. Publications explain that by injecting with cannulas against the bone and cartilage, complications are really reduced, compared with the use of needles. The description of a deep fat plane below the nasal subcutaneous muscular aponeurotic system (smas) could explain the safety of it's injections. Thanks to a good knowledge of the surgical anatomy of the nose and that if you know how to manage the complications, it's a reliable and safe procedure. On the other hand, an update on blindness from filler published in Aesthetic Surg J in 2024 report 48 cases in 3 years from 2015 and 365 new cases in the following 3 years from 2019. This dramatic increase in the number of cases of vision loss prove our current safety procedures are flawed. A publication by the Department of Plastic and Reconstructive Surgery Shanghai Ninth People's Hospital shows that 90% of cases of extensive necrosis and loss of vision following hyaluronic acid injections occur when cannulas are used. This can be explained by the fact that the nasal smas in which the vessels are located is attached to bone and cartilage. Consequently the universal advice to inject against bone and cartilage may be not the best way to avoid too frequent acute vascular obstruction. We propose another technique, the dermal medical rhinoplasty (D.M. R.). The skin must be pinched and disjoined from the smas. The injection must be very superficial, in the upper dermis or lower dermis to be sure of not creating a vascular obstruction. Upper dermis injections used the interpores technique to help create for instance lines of light thanks to sharp elevation of the tip of a 34 G needle, beveled angle turned upward and visible through the skin. The effect of the volume injected is instantly visible. Lower dermis injections used the vacuum technique to help creating volume on a precise spot above the smas, in the dead space created by a sharp elevation of the tip of a 27 G needle, beveled angle turned downward and then injecting the required volume The effect is instantly visible and under control. One advantage of the superficial nature of these injections is the precise modelling of the shape of the nose, with less volume of filler than after a deep injection. With 206 cases in 2 years of D. M. R. using these 2 techniques, there have been no complications of vascular obstruction or skin necrosis. This nonsurgical rhinoplasty is a really safe and effective alternative or complement to traditional augmentation rhinoplasty.

Axenfeld-Rieger syndrome/anomaly (ARS) is a rare genetic disorder with an autosomal dominant inheritance pattern, characterized by dysgenesis of the anterior segment of the eye. It may present with systemic anomalies (Axenfeld-Rieger syndrome) or without (Axenfeld anomaly) and may sometimes be associated with multiple congenital malformations. The estimated prevalence ranges from 1 in 50,000 to 1 in 200,000 live births, with an approximate rate of 1 in 100,000, but no epidemiological studies have been conducted to date. A clinical diagnosis of Axenfeld-Rieger syndrome requires the presence of both Axenfeld and Rieger ocular anomalies, accompanied by extraocular systemic features. Ocular manifestations include iris abnormalities, posterior embryotoxon, juvenile-onset glaucoma (a common complication), and dysgenesis of the iridocorneal angle with iridocorneal adhesions. The most commonly observed systemic anomalies include: umbilical defects; craniofacial dysmorphism; dentofacial abnormalities, such as Class III malocclusion due to maxillary hypoplasia, oligodontia, dental malformations (taurodontism, root dysplasia), microdontia, hypodontia, and anodontia; hearing impairment (partial or complete sensorineural hearing loss); and cardiac anomalies, including non-congenital heart disease and mitral valve insufficiency. Additional anomalies may include hypospadias in males, anal stenosis, endocrine disorders (notably growth retardation) secondary to pituitary dysfunction, psychomotor delay, and various neurological malformations such as Dandy-Walker malformation, mega cisterna magna, posterior fossa cysts, cerebellar vermis hypoplasia, ventriculomegaly, aprosencephaly, cerebral atrophy, microcephaly, arteriovenous malformations (AVM), and digital anomalies such as camptodactyly. Diagnosis is typically made in infancy, based on iris anomalies such as corectopia (displacement of the pupil), polycoria (multiple pupils), and iris hypoplasia. Posterior embryotoxon is frequently observed upon slit-lamp examination. Given the clinical variability, a comprehensive pediatric assessment is essential to identify systemic anomalies and distinguish Axenfeld-Rieger syndrome from the isolated Axenfeld anomaly.

Two recent studies suggested that the APOE ε4 haplotype was associated with increased α-synuclein pathology in cell and mouse models. Genetic variants in the SNCA region have strong association with Parkinson's disease (PD), dementia with Lewy bodies (DLB) and idiopathic REM sleep behaviour disorder (iRBD), while APOE is a genetic risk determinant for only DLB. To determine if genetic-level interactions between SNCA and APOE exists that can explain the protein-level association, we investigated the genotypic interaction of APOE and SNCA in cohorts of PD, DLB and iRBD. We analysed genome-wide association study (GWAS) data from 5229 PD patients and 5480 controls, 2610 DLB patients and 1920 controls, and 1055 iRBD patients and 3667 controls. We used logistic regression interaction models across all three cohorts independently between the (i) top GWAS signals of SNCA single nucleotide polymorphisms (SNPs) and APOE haplotypes and (ii) SNP×SNP and three-way SNP interaction across the entire coding region plus 200 kb flanking each gene. No significant interactions were found to be associated with any of the synucleinopathies after correction for multiple testing. Our results do not support a role for genetic interactions between APOE and SNCA across PD, DLB and iRBD. Since the tested genetic variants affect the expression and function of these proteins, it is likely that any interactions between them do not affect the risk of PD, DLB and iRBD.

Conjugated nanohoops have attracted much attention in recent years due to their unique optoelectronic properties. A more complex geometry, in which two nanohoops are covalently linked to form a so-called double nanohoop, can have a significant influence on the morphology, (chir)optical properties and supramolecular interactions compared to a single nanohoop. Herein, we present the systematic design, synthesis, structural and chiroptical analysis of a novel series of three chiral double nanohoops together with their single hoop reference compounds. They each incorporate a tetrahydroindeno[2,1-a]indene-5,10-diol unit as an asymmetric bridge with central chirality. Notably, they display high photoluminescence quantum yields of 79-95%, along with distinct trends in absorption, emission, and energy transfer dynamics. Enantiomers of the double and reference single nanohoops were successfully separated by HPLC using a chiral stationary phase, and their chiroptical properties were investigated through electronic circular dichroism (ECD) and circularly polarized luminescence (CPL) spectroscopy revealing increased asymmetry factors (gabs) compared to their reference compounds. Our study provides a systematic exploration of how size, geometry, and asymmetry impact the optoelectronic behavior of chiral double nanohoops and offers valuable insight for the development of high-performance chiroptical materials.

Current international and national urolithiasis guidelines still base surgical management on maximum stone diameter (MSD), despite its limitations in assessing stone burden. For stones >20mm, MSD has a major limitation in predicting stone-free status which stem from the reduced sphericity of stones >10mm compared with smaller calculi. Two stones with the same MSD can have vastly different volumes, impacting treatment decisions. Stone volume provides a more accurate evaluation, particularly for complex cases, and has been suggested by French urolithiasis guidelines since 2022. Automated segmentation software, including AI-based tools, offers precise and reproducible stone volume measurements. Stone volume (SV) is a better predictor of stone-free rates (SFR) than MSD, especially for ureteroscopy (URS). However, its clinical adoption remains limited due to accessibility. Automation through AI will improve both accessibility and precision, enabling standardized volumetric assessment to optimize stone management and, in particular, surgical outcomes. Consequently, stones with similar MSD may present substantially different volumes, potentially influencing the choice and success of surgical management. Stone volume (SV) offers a more accurate representation of stone burden and has been endorsed by the French urolithiasis guidelines since 2022.

Total nasal reconstruction represents a complex challenge, requiring restoration of all three anatomical planes while preserving respiratory function. This procedure has significant therapeutic, aesthetic, social and professional implications for patients. We share our academic experience of reconstruction using a folded microanastomosed radial forearm flap (FRFF) combined with a paramedian forehead flap, using the technique of F.J. Menick. We detail the technical aspects of this surgical approach, as well as the aesthetic results observed at the donor sites. In our single-center retrospective study, we analyzed 6 cases of total nasal reconstruction performed between January 2017 and January 2024. We assessed the typology of substance loss, types of reconstruction, and aesthetic results via the NAFEQ score at 6 months postoperatively. Among the cases, necrosis was observed (16%), occurring on the fourth day following thrombosis. Mean loss of substance was 5.5cm, with a mean NAFEQ functional score of 82% and aesthetic score of 88%. The FRFF reconstruction technique combined with LFP is optimal for total nose reconstructions, offering adequate cartilage projection and good nostril conformation.

Background: First permanent molars (FPM) are highly susceptible to decay before the age of 15. When they are severely affected, the decision between conservation and extraction arises, particularly considering the potential for the second permanent molar (SPM) to replace the FPM. This cohort study aimed to evaluate clinical practices regarding FPM pulp necrosis treatment in children aged eight to twelve in two hospital departments in the Paris region. A second objective was to evaluate the one-year outcomes of the two therapies. Methods: A retrospective analysis was conducted using computerized billing software to identify patients aged eight to twelve who underwent either extraction or root canal treatment (RCT). Data collected included sex, age, arch involved, number of decayed surfaces, presence of Molar Incisor Hypomineralization (MIH), presence of infection, and treatment type. Results: A total of 66 patients were included, representing 61 extracted teeth and 23 RCT. Three main decision criteria were identified: presence of MIH (p < 0.005), extent of decay (p < 0.05), and SPM Nolla's stage. A total of 48% of the patients were seen at one year. A total of 16 of the 32 extractions and five of the nine RCTs had favorable evolution (p = 1). Conclusions: The question of whether to perform RCT or extraction of necrotic FPM in children aged eight to twelve is difficult to assess. It appears that five criteria need to be considered before the decision: possibility of long-term sealed coronal reconstruction, SPM Nolla's stage, follow-up possibilities, arch concerned, and presence of third permanent molar.

The representations and beliefs of both patient and practitioner influence the relationship that develops between them. We developed an innovative, interactive teaching tool in two stages (1- interviews with the patient or healthcare practitioner and 2- a session with sharing of the patient's and practitioner's perspective) whose objectives are to recognize the basic characteristics of PPR and identify how it can be influenced by expectations, beliefs and emotions. This pedagogical device was particularly appreciated by the students, as it enabled them to identify the importance of the patient's point of view and to reflect on their future professional identity.

Background: The risk of conversion to open surgery is inevitably present during any minimally invasive colorectal surgical procedure. Conversions have been associated with adverse postoperative and oncologic outcomes. No previous study has evaluated the specific causes and consequences of conversion during a minimally invasive right colectomy (MIS-RC). Materials and Methods: We analyzed the Minimally invasivE surgery for oncologic Right ColectomY (MERCY) study database including patients who underwent laparoscopic or robotic RC because of colon cancer between 2014 and 2020. Descriptive analyses were performed to determine the different reasons for conversion. Uni- and multivariate logistic regressions were run to identify potential variables associated with this outcome. Cox regression analyses were used to evaluate the impact of conversion on tumor recurrence. Results: Over a total of 1574 MIS-RC, 120 (7.6%) were converted to open surgery. The main reasons for conversion were procedural difficulties related to adherences from previous abdominal surgical procedures (39.2%), or owing to large tumor size or infiltration of adjacent structures (26.7%). Only 16.7% of the conversions were caused by intraoperative medical or surgical complications. Converted patients required longer operative times and developed more postoperative complications, both overall (39.2% versus 27.5%; P = .006) and severe ones (13.3% versus 8.3%; P = .061). Male gender (odds ratio [OR] = 1.89 [95% confidence interval: 1.31-2.71]), obesity (OR = 1.99 [1.4-2.83]), prior abdominal surgery (OR = 1.68 [1.19-2.37]), and pT4 cancers (OR = 4.04 [2.86-5.69]) were independently associated with conversion. Conversion to open surgery was not significantly associated with tumor recurrence (hazard ratios = 1.395 [0.724-2.687]). Conclusions: Although conversion to open surgery during MIS-RC for cancer is associated with worsened postoperative outcomes, it seems not to impact on the oncologic prognosis.