Various surgical approaches have been developed to address brow ptosis. The direct brow lift allows a precise correction of brow ptosis by targeting the head, body and/or tail of the brow. The aim of this study was to evaluate the clinical efficacy, long-term positional stability, aesthetic satisfaction and scar-related outcomes of the direct brow lift procedure. This prospective monocentric study included 41 patients who underwent direct brow lift surgery with the Castanares technique between September 2020 and April 2024. In 35 patients, upper blepharoplasty was performed concurrently. Objective morphometric assessments of brow position were performed at preoperative (T0), 1-month (T1) and 12-month (T12) post-operative evaluating standardized photographic images with ImageJ software. Patient satisfaction was measured through the FACE-Q questionnaire (“Satisfaction with Forehead and Eyebrows”), while scar perception was assessed using the SCAR-Q. Data were analysed using ANOVA for repeated measures. A statistically significant post-operative increase in the distance from point A (brow’s tail) and point C (brow’s head) to the interpupillary line was observed at one month, with only a slight decrease at 12 months, indicating long-term surgical stability. In contrast, the brow’s body (point B) exhibited minimal variation overall. In terms of patient satisfaction, FACE-Q scores improved at all time points and across all patient groups. The overall SCAR-Q scores reflected improved patient perception of the scar with time. The direct brow lift is a reliable and effective technique for achieving stable, long-term correction of brow ptosis. It demonstrates high patient satisfaction and acceptable scar perception 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 .
Chronic hypoparathyroidism (HypoPT) is characterized by sustained parathyroid hormone (PTH) deficiency, leading to reduced bone turnover, increased bone mineral density (BMD), and altered skeletal microarchitecture. Despite preserved or elevated BMD, fracture risk in HypoPT remains controversial. We conducted a systematic review and meta-analysis to assess site-specific fracture risk and the influence of disease duration in patients with chronic HypoPT. Fifteen observational studies, including 13,563 HypoPT subjects and 137,245 controls, were analyzed. HypoPT subjects had a significantly higher risk of vertebral fractures (VFs) than controls (OR 1.88, 95
Rehabilitative therapies play a crucial role in upper limb motor recovery, as upper limbs are the most active parts in executing the activities of daily living. Because of a huge number of people with motor disorders and a shortage of therapists, the integration of data-driven AI methodologies and robots for rehabilitation could be helpful in creating personalized and challenging therapies, leading to a myriad of benefits for both patients and therapists. AI methods can be implemented in different functional modules of the robotic platform, such as user intention recognition, robot motion planning, robot interaction control, and system adaptation through different learning paradigms. This article presents a systematic literature review on the use of data-driven learning methods applied in upper limb robot-aided rehabilitation. The analysis is structured around the learning paradigms adopted, namely, supervised, unsupervised, and reinforcement learning, as well as the corresponding task types (e.g., classification, regression, and control tasks) and model types, distinguishing between machine learning and deep learning approaches. The review reveals that most studies employ supervised learning to address classification tasks, and that deep learning models are the most frequently adopted.
Accurate prognosis of Non-Small Cell Lung Cancer (NSCLC) is crucial for enhancing patient care and treatment outcomes. Despite the advancements in deep learning, the task of overall survival prediction in NSCLC has not fully leveraged these techniques, yet. This study introduces a novel methodology for predicting 2-year overall survival (OS) in NSCLC patients using CT scans. Our approach integrates CT scan representations produced by EfficientNetB0 with a soft attention mechanism to identify the most relevant slices for survival risk prediction, which are then analyzed by a risk-assessment network. To validate our method and ensure reproducibility, we employed the public LUNG1 dataset and a smaller private dataset. Our approach was compared to benchmark 3D networks and two variants of our methodology: on the LUNG1 it outperformed the competitors achieving a mean C^td -index of 0.584 over tenfold cross-validation. On the LUNG1 we also demonstrated the adaptability of our method with 5 other 2D backbones replacing the EfficientNetB0, confirming that our mechanism of combining 2D slice representations to construct a 3D volume representation is more effective for OS prediction compared to a traditional 3D approach. Finally, we used transfer learning on the private dataset, showing that it can significantly enhance performance in limited data scenarios, increasing the C^td -index by 0.076 compared to model without transfer learning.
Aromatase inhibitors (AIs) are one of the adjuvant endocrine therapies of choice, for estrogen receptor-positive breast cancer in postmenopausal women and premenopausal women with ovarian suppression. However, treatment with AIs leads to accelerated bone loss, and an increased fracture risk. Denosumab or bisphosphonates are recommended to prevent bone loss and reduce fracture risk during AIs treatment. However, specific attention must be paid to the “rebound phenomenon” after denosumab discontinuation. This review focuses on the therapeutic benefits of denosumab for its antiresorptive and antifracture effect in women with early breast cancer treated with AIs, risks related to denosumab discontinuation after treatment with AIs, prevention, and potential interventions for its associated fracture risk. A narrative review of available literature was carried out by International Osteoporosis Foundation Committee of Scientific Advisors Working Group on Cancer-Induced Bone Disease. Papers were retrieved by means of a PubMed enquiry (from 2006 to August 2025). A total of 126 papers closely related to our topic were included. After denosumab withdrawal in women with breast cancer treated with AIs, bone turnover increases, and there is a risk of spontaneous rebound-associated vertebral fractures, even in the absence of other risk factors for bone fragility. Therefore, expert consensus suggests initiating bisphosphonate treatment after denosumab discontinuation, even though there is no an optimal bisphosphonate regimen. There are numerous open research questions which future prospective studies will have to answer in order to personalize the most appropriate antiresorptive therapy for each patient.
