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Thread lift boasts the advantage of minimal invasion for facial rejuvenation and has been increasingly used nowadays. The purpose of this study was to evaluate the outcomes and safety of elastic thread when it was used in the modified minimal access cranial suspension (MACS) lift for rejuvenation of the lower and middle third of the face. Forty-six patients with sagging and laxity of the lower face treated by the elastic thread modified MACS lift from December 2015 and December 2017 were enrolled in this study. A retrospective chart review was conducted. The degree of Wrinkle Severity Rating Scale (WSRS) score and satisfaction score were evaluated immediately, 6 months and 12 months after procedure. Complications during the study were also recorded. All the patients were female, with a mean age of 50.7 ± 6.4 years and a mean follow-up period of 15.4 ± 2.1 months. The mean operation time was 114 ± 13 minutes. For the left face, the mean WSRS score was 4.0 ± 0.8 preoperatively and 3.1 ± 0.8 on the 1-year follow-up; and 4.1 ± 0.9 and 3.1 ± 0.7 on the right face (P < .01). Thirty-nine (84.8%) patients considered the long-term results satisfactory. There were no major complications during the follow-up period. The elastic thread modified MACS lift is a minimally invasive, effective and safe method to improve lagging middle and lower third of the face without significant postoperative morbidity or complications.

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Background: Perforator flaps have revolutionized lower limb reconstruction by offering single-stage thin, pliable coverage with an excellent aesthetic match. Although anastomosis of the flap to a major artery remains the gold standard, perforator-to-perforator anastomosis has several advantages, including expedient recipient dissection and increased recipient options in vessel-depleted extremities. The aim of this study was to compare flap survival when a perforator or major artery was used as a recipient vessel. Methods: A retrospective cohort of free perforator flaps for lower limb reconstruction was reviewed. Demographics, comorbidities, vascular status, defect characteristics, operative details, and complications were recorded. Outcomes for perforator and major artery recipients were compared. Results: Four hundred twenty-three flaps were performed for various reasons using perforator flaps. The total limb salvage rate was 98.8 percent. Total and partial flap failure rates were 6.1 percent and 9.0 percent, respectively. Comparing perforator recipients [n = 109 (25.8 percent)] to major artery recipients [n = 314 (74.2 percent)], there was no significant difference in total (p = 0.746) or partial flap failure (p = 0.212). Significant factors between the groups included larger flap size with major artery recipients (p = 0.001) and shorter operative time when using a perforator recipient (p = 0.012) Conclusions: Perforator-to-perforator anastomosis is a reliable option that affords equivalent rates of flap success compared to major artery anastomosis in lower extremity reconstruction. The authors advocate using a major artery recipient in defects where the axial vessels are easily accessible. A perforator recipient is a viable alternative in defects where access to the axial vessels is inconvenient and in patients with limited recipient options. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Due to the inherent nonlinear nature of Electro-rheological (ER) fluid dampers, one of the challenging aspects for utilizing these devices to achieve high system performance is the development of accurate models and control algorithms that can take advantage of their unique characteristics. In this paper, the nonlinear damping force model is made to identify the properties of the ER damper using higher order spectrum. The higher order spectral analysis is used to investigate the nonlinear frequency coupling phenomena with the damping force signal according to the sinusoidal excitation of the damper.Also, this paper presents an inverse model of the ER damper, i.e., the model can predict the required voltage so that the ER damper can produce the desired force for the requirement of vibration control of vehicle suspension systems. The inverse model has been constructed by using piecewise linear damping force model.In this paper, the fuzzy logic control based on heuristic knowledge is combined with the skyhook control. And it is simulated for a quarter car model. The acceleration of the sprung mass is included in the premise part of the fuzzy rules to reduce the vertical acceleration RMS value of the sprung mass. Then scaling factors and membership functions are tuned using genetic algorithm to obtain optimal performance. J. S. Joh is with

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