The evolutionary origins of the Global Neuronal Workspace in vertebrates.

The Global Neuronal Workspace theory of consciousness offers an explicit functional architecture that relates consciousness to cognitive abilities such as perception, attention, memory, and evaluation. We show that the functional architecture of the Global Neuronal Workspace, which is based mainly on human studies, corresponds to the cognitive-affective architecture proposed by the Unlimited Associative Learning theory that describes minimal consciousness. However, we suggest that when applied to basal vertebrates, both models require important modifications to accommodate what has been learned about the evolution of the vertebrate brain.

Natural Shaping of Acellular Dermal Matrices for Implant-Based Breast Reconstruction via Expansile Kirigami.

To complete a successful and aesthetic breast reconstruction for breast cancer survivors, tissue reinforcing acellular dermal matrices (ADMs) are widely utilized to create slings/pockets to keep breast implants or autologous tissue transfer secured against the chest wall in the desired location. However, ADM sheets are 2D and cannot completely cover the entire implant without wrinkles. Here, guided by finite element modeling, a kirigami strategy is presented to cut the ADM sheets with locally and precisely controlled stretchability, curvature, and elasticity.

Numbers don't speak for themselves: strategies of using numbers in public policy discourse.

In mathematics education, there is general agreement regarding the significance of mathematical literacy (also quantitative literacy or numeracy) for informed citizenship, which often requires evaluating the use of numbers in public policy discourse. We hold that such an evaluation must accommodate the necessarily fragile relation between the information that numbers are taken to carry and the policy decisions they are meant to support. In doing so, attention needs to be paid to differences in that relation is formed.

Unlimited Associative Learning and the origins of consciousness: a primer and some predictions.

Over the past two decades, Ginsburg and Jablonka have developed a novel approach to studying the evolutionary origins of consciousness: the Unlimited Associative Learning (UAL) framework. The central idea is that there is a distinctive type of learning that can serve as a transition marker for the evolutionary transition from non-conscious to conscious life. The goal of this paper is to stimulate discussion of the framework by providing a primer on its key claims (Part I) and a clear statement of its main empirical predictions (Part II).

Evolutionary transitions in learning and cognition.

We define a cognitive system as a system that can learn, and adopt an evolutionary-transition-oriented framework for analysing different types of neural cognition. This enables us to classify types of cognition and point to the continuities and discontinuities among them. The framework we use for studying evolutionary transitions in learning capacities focuses on qualitative changes in the integration, storage and use of neurally processed information.

Improvements in Cleft Lip Aesthetics with the Fisher Repair Compared to the Mohler Repair.

Background: The extended Mohler rotation-advancement repair and the Fisher anatomic subunit repair are commonly used for the surgical correction of unilateral cleft lip. The rotation-advancement repair was the initial technique of choice by the senior surgeon. However, due to recurring suboptimal aesthetic results, the senior surgeon transitioned to the anatomic subunit repair.

Human Social Evolution: Self-Domestication or Self-Control?

The self-domestication hypothesis suggests that, like mammalian domesticates, humans have gone through a process of selection against aggression - a process that in the case of humans was self-induced. Here, we extend previous proposals and suggest that what underlies human social evolution is selection for socially mediated emotional control and plasticity. In the first part of the paper we highlight general features of human social evolution, which, we argue, is more similar to that of other social mammals than to that of mammalian domesticates and is therefore incompatible with the notion of human self-domestication.

Make Your Own Deep Inferior Epigastric Artery Perforator Flap: Perforator Delay Improves Deep Inferior Epigastric Artery Perforator Flap Reliability.

Unlabelled: Abdominal-based autologous breast reconstruction remains a conflict between blood supply and donor site complication. Optimizing esthetics and minimizing recovery and postoperative pain add further complexity. We present a 2-stage technique of deep inferior epigastric artery perforator flap reconstruction to (1) reliably harvest single-vessel flaps while minimizing fat necrosis, (2) decrease abdominal wall morbidity, and (3) improve breast and donor site esthetics.

Retrospective cohort-based comparison of intraoperative liposomal bupivacaine versus bupivacaine for donor site iliac crest analgesia during alveolar bone grafting.

Introduction: Bone grafting of alveolar clefts is routinely performed with cancellous bone harvested from the iliac crest. Graft site morbidity is frequently seen, with early postoperative pain being one of the most common complaints. Liposomal bupivacaine (LB) has been demonstrated to provide improvement in postoperative pain for patients undergoing bunionectomy or hemorrhoidectomy, which may translate to patients requiring iliac crest bone graft harvest.

A Simplified Cost-Utility Analysis of Inpatient Flap Monitoring after Microsurgical Breast Reconstruction and Implications for Hospital Length of Stay.

Background: The number of free flap take-backs and successful salvages following microsurgical breast reconstruction decreases as time from surgery increases. As a result, the cost of extended inpatient monitoring to achieve a successful flap salvage rises rapidly with each postoperative day. This study introduces a simplified cost-utility model of inpatient flap monitoring and identifies when cost-utility exceeds the thresholds established for other medical treatments.

Cognitive gadgets and genetic accommodation.

Heyes argues that human metacognitive strategies (cognitive gadgets) evolved through cultural rather than genetic evolution. Although we agree that increased plasticity is the hallmark of human metacognition, we suggest cognitive malleability required the genetic accommodation of gadget-specific processes that enhanced the overall cognitive flexibility of humans.

3-DIEPrinting: 3D-printed Models to Assist the Intramuscular Dissection in Abdominally Based Microsurgical Breast Reconstruction.

Harvest of the deep inferior epigastric vessels for microsurgical breast reconstruction can be complicated by an intricate and lengthy subfascial dissection. Although multiple preoperative imaging modalities exist to help visualize the vascular anatomy and assist in perforator selection, few can help clearly define the intramuscular course of these vessels. The authors introduce their early experience with 3D-printed anatomical modeling (to-scale) of the infraumbilical course of the deep inferior epigastric subfascial vascular tree to better assist in executing the intramuscular dissection.

Total penile reconstruction: A systematic review.

Background: Phalloplasty poses a unique challenge to the plastic and reconstructive surgeon. The development of advanced microsurgical techniques has greatly augmented the range of surgical approaches available.

Methods: A systematic review of the MEDLINE and Cochrane databases was performed to identify clinical studies of total penile reconstruction published within the last 10 years using the search algorithm: "(phallus or penis or penile) and (reconstruction or phalloplasty or transplant)".

Defining the Role of Free Flaps in Partial Breast Reconstruction.

Background:  Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer.

Methods:  A retrospective review was performed of all patients undergoing partial breast reconstruction at our center between February 2009 and October 2015.

The evolutionary implications of epigenetic inheritance.

The Modern Evolutionary Synthesis (MS) forged in the mid-twentieth century was built on a notion of heredity that excluded soft inheritance, the inheritance of the effects of developmental modifications. However, the discovery of molecular mechanisms that generate random and developmentally induced epigenetic variations is leading to a broadening of the notion of biological heredity that has consequences for ideas about evolution. After presenting some old challenges to the MS that were raised, among others, by Karl Popper, I discuss recent research on epigenetic inheritance, which provides experimental and theoretical support for these challenges.

Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction.

Background: Side effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge.

Methods: A retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade.

Why the missing heritability might not be in the DNA.

There are four major hypotheses (H1, H2, H3, and H4) as to the source of missing heritability. We propose that estimates obtained from GWAS underestimate heritability by not taking into account non-DNA (epigenetic) sources of heritability. Taking those factors into account (H4) should result in increased heritability estimates.

The Use of a Hyaluronic Acid-Carboxymethylcellulose Membrane as an Adhesion Barrier during Nipple Delay before Nipple-preserving Mastectomy.

The desire for nipple-preserving mastectomies has increased over the past decade as studies have proven that the procedure has comparable oncologic risk as a traditional mastectomy in both therapeutic and prophylactic cases. Partial or complete nipple necrosis is a well-known complication of this procedure with rates in the literature ranging between 1% and 9%. In high-risk patients, surgeons are performing a delay procedure before the mastectomy to help improve nipple vascularity and decrease necrosis rates.

The Transition to Minimal Consciousness through the Evolution of Associative Learning.

The minimal state of consciousness is sentience. This includes any phenomenal sensory experience - exteroceptive, such as vision and olfaction; interoceptive, such as pain and hunger; or proprioceptive, such as the sense of bodily position and movement. We propose (UAL) as the marker of the , its phylogenetically earliest sustainable manifestation and the driver of its evolution.

The Impact of Resident Participation in Outpatient Plastic Surgical Procedures.

Introduction: Ensuring patient safety along with a complete surgical experience for residents is of utmost importance in plastic surgical training. The effect of resident participation on the outcomes of outpatient plastic surgery procedures remains largely unknown. We assess the impact of resident participation on surgical outcomes using a prospective, validated, national database.

Risk Factors for Readmission and Adverse Outcomes in Abdominoplasty.

Background: In an era of outcomes-driven medicine, being able to benchmark complication rates of various procedures is of utmost importance. The rates of readmission, reoperation, and adverse outcomes in abdominoplasty have been previously reported, although risk factors for these adverse outcomes have not been thoroughly elucidated. This study aims to identify specific independent risk factors for readmission and other adverse outcomes of abdominoplasty.