James A Edwards1, David W Mathes21Department of Plastic and Reconstructive Surgery, Skagit Valley Hospital, Mount Vernon, WA, USA; 2Division of Plastic Surgery, University of Washington Medical Center, Seattle, WA, USA: The surgical history of transplantation in the modern era begins in 1956 with the successful transplantation of a kidney between identical twins. Since then the field of transplantation has seen remarkable advancements in both surgical techniques and our understanding and ability to manipulate the immune response. Composite (...) tissue allotransplantation involves the transplantation of any combination of vascularized skin, subcutaneous tissue, blood vessels, nerves, muscle, and bone. Orthotopic hand transplantation is considered the first clinical example of CTA and has seen success at many different centers worldwide. Facial allotransplantation is a recent development in the field of CTA and the first successful case was performed as recently as November 2005. Since then there have been a number of successful facial transplants. The purpose of this paper is to examine some of the issues surrounding facial transplantation including the complex ethical issues, the surgical and clinical issues, cost and administrative issues, and future directions for this new, exciting, and controversial field.Keywords: composite tissue allograft, facial transplantation. (shrink)

Animal blood -- Fabricating noses -- The face transplant -- The Manson effect -- Robles' disease -- Chagas' error.

This book supports the emerging field of vascularized composite allotransplantation for face and upper-limb transplants by providing a revised, ethically appropriate consent model which takes into account what is actually required of facial and upper extremity transplant recipients. In place of consent as permission-giving, waiver, or autonomous authorization, this book imagines consent as an ongoing mutual commitment, i.e. as covenant consent. The covenant consent model highlights the need for a durable personal relationship between the patient/subject and the care provider/researcher. (...) Such a relationship is crucial given the recovery period of 5 years or more for VCA recipients. The case for covenant consent is made by first examining the field of vascularized composite allotransplantation, the history and present understandings of consent in health care, and the history and use of the covenant concept from its origins through its applications to health care ethics today. This book explains how standard approaches to consent are inadequate in light of the particular features of facial and upper limb transplantation. In contrast, use of the covenant concept creates a consent model that is more appropriate ethically for these very complex surgeries and long-term recoveries. (shrink)

With the recent advent of facial transplant (FT) treatment, patients who live with facial disfigurement have a new hope of improved facial aesthetics and quality of life. However, FT has been the subject of intense ethical debate, and there are numerous important ethical considerations surrounding FT that require further in-depth exploration. In the present review, the numerous ethical issues surrounding FT are elucidated, especially the weighty psychosocial impacts of FT, issues surrounding patients’ consent, selection and donor matching, (...) and current challenges with postoperative complication management and the facial reconstruction of donors. These are discussed with a key focus on stakeholders’ perspectives including recipients, donors’ families, and the medical teams involved. This review found that a number of key ethical questions remain unanswered in the field of FT, and further consideration is needed for this novel surgical procedure to have the same evidence-based ethical backing as conventional surgical procedures. (shrink)

Abstract:Facial transplantation is emerging as a therapeutic option for self-inflicted gunshot wounds. The self-inflicted nature of this injury raises questions about the appropriate role of self-harm in determining patient eligibility. Potential candidates for facial transplantation undergo extensive psychosocial screening. The presence of a self-inflicted gunshot wound warrants special attention to ensure that a patient is prepared to undergo a demanding procedure that poses significant risk, as well as stringent lifelong management. Herein, we explore the ethics of (...) considering mechanism of injury in the patient selection process, referring to the precedent set forth in solid organ transplantation. We also consider the available evidence regarding outcomes of individuals transplanted for self-inflicted mechanisms of injury in both solid organ and facial transplantation. We conclude that while the presence of a self-inflicted gunshot wound is significant in the overall evaluation of the candidate, it does not on its own warrant exclusion from consideration for a facial transplantation. (shrink)

Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet (...) all the ethical requirements usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (shrink)

We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to (...) those in need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

The face embodies for the individual the sense of identity, that is to say, precisely the place where someone recognizes himself and where others recognize him. From the outset the face is meaning, translating in a living and enigmatic form the absoluteness yet minuteness of individual difference. Any alteration to the face puts at stake the sense of identity. Disfigurement destroys the sense of identity of an individual who can no longer recognize himself or be recognized by others. Disfigurement places (...) a mask on the face. The goal of a facial transplant consists of restoring an individual’s place in the world and reviving his taste for life, returning to him his ‘human shape’. Facial transplants raise essential anthropological questions such as ‘Who am I?’ and ‘To whom belongs this face that henceforth is mine?’. (shrink)

Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

Face transplantation—or, more properly, facial allograft transplantation —generates much public interest and academic debate. In this paper, we suggest that it is up to opponents of FAT to make the case for its impermissibility. We allow that there is a number of apparently strong arguments that might be deployed against FAT. However, all but one of these turn out not to be compelling after examination. The remaining argument is not so easily dismissed—but its central point is fairly (...) workaday and certainly does not tell us anything about FAT in particular. Therefore, qua argument about facial transplant surgery, it fails to hit its target. Overall, we conclude that a compelling case against FAT remains to be made. (shrink)

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal (...) identity. Recipients of facial allograft transplantation have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one “lives on”. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal (...) identity. Recipients of facial allograft transplantation have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one ‘‘lives on’’. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

The ethical discussion of facial allograft transplantation for severe facial deformity, popularly known as facial transplantation, has been one sided and sensationalistic. It is based on film and fiction rather than science and clinical experience. Based on our experience in developing the first IRB approved protocol for FAT, we critically discuss the problems with this discussion, which overlooks the plight of individuals with severe facial deformities. We discuss why FAT for facial deformity is (...) ethically and surgically justified despite its negative portrayal in the media. (shrink)

Two competing intuitions have dominated the debate over facial tissue transplantation. On one side are those who argue that relieving the suffering of those with severe facial disfigurement justifies the medical risks and possible loss of life associated with this experimental procedure. On the other are those who say that there is little evidence to show that such transplants would have longterm psychological benefits that couldn’t be achieved by other means and that without clear benefits, the risk (...) is simply too great. Ethicists on both sides have called for more analysis of the link between the face and personal identity in order to get a better grasp on potential gains and losses. This paper responds to that call by looking at contemporary philosophical analyses of the relation between organ transplants and personal identity and between the human face, human dignity, and human vulnerability. It is argued that the face matters not because it is the unique marker of our identity, but because of its role in the intersubjective constitution of moral identity and human dignity. (shrink)

Ethical lapses associated with the first facial transplant included breaches of confidentiality, bending of research rules, and film deals. However, discussions of the risk-benefit ratio for face transplantation are often deficient in that they ignore the needs, experience, and decision-making capability of potential recipients.

Automated facial recognition methods have become widely used as a way to ascertain the identity of individuals. Yet the methods by which facial recognition technologies (FRT) operate – the machinic performance of the perception of the human face – are often invisible to those under their gaze. This article investigates the machinic perception of the face through an FRT method known as eigenface, in order to both reveal and problematize the ways of seeing that underlie it. As part (...) of its algorithmic processes, eigenface produces an image. This image can be understood as a portrait of machine recognition, making visible the processes through which the algorithm performs recognition and ‘sees’ the human face. The eigenface portrait reveals a way of seeing that is based on statistical processes of pattern recognition. An analogue antecedent of this application of statistics to the recognition of facial images can be found in the composite portrait. Through a dialectical discussion of composite portraiture in multiple disciplinary fields ranging from sociology to philosophy and the visual arts, this article experiments with providing a cultural and social translation of machine processes of visual perception. The discussion shifts the focus of enquiry towards the aesthetics of the algorithmic process in order to provide an entry point for critique and a possible reimagination on algorithmic knowledge production. (shrink)

As innovations in the field of vascular composite allotransplantation (VCA) progress, whole-eye transplantation (WET) is poised to transition from non-human mammalian models to living human recipients. Present treatment options for vision loss are generally considered suboptimal, and attendant concerns ranging from aesthetics and prosthesis maintenance to social stigma may be mitigated by WET. Potential benefits to WET recipients may also include partial vision restoration, psychosocial benefits related to identity and social integration, improvements in physical comfort and function, and reduced (...) surgical risk associated with a biologic eye compared to a prosthesis. Perioperative and postoperative risks of WET are expected to be comparable to those of facial transplantation (FT), and may be similarly mitigated by immunosuppressive protocols, adequate psychosocial support, and a thorough selection process for both the recipient and donor. To minimize the risks associated with immunosuppressive medications, the first attempts in human recipients will likely be performed in conjunction with a FT. If first-in-human attempts at combined FT-WET prove successful and the biologic eye survives, this opens the door for further advancement in the field of vision restoration by means of a viable surgical option. This analysis integrates recent innovations in WET research with the existing discourse on the ethics of surgical innovation and offers preliminary guidance to VCA programs considering undertaking WET in human recipients. (shrink)

This article aims to determine to what extent photographic practices in psychology, psychiatry and physiology contributed to the definition of the external bodily signs of passions and emotions in the second half of the 19th century in France. Bridging the gap between recent research in the history of emotions and photographic history, the following analyses focus on the photographic production of scientists and photographers who made significant contributions to the study of expressions and gestures, namely Duchenne de Boulogne, (...) Charles Darwin, Paul Richer and Albert Londe. This article argues that photography became a key technology in their works due to the adequateness of the exposure time of different cameras to the duration of the bodily manifestations to be recorded, and that these uses constituted facial expressions and bodily gestures as particular objects for the scientific study. (shrink)

On being told that "translation is an impossible thing," Anatole France replied: "precisely, my friend; the recognition of that truth is a necessary preliminary to success in art." The task of Transplantings is to add flesh and bones to that familiar quip. Indeed, Daniel Weissbort notes that Viereck's study represented a sixty-five year long project. Now, it is finally being brought to print in its full form, with the completion of the final manuscript shortly before Viereck's death. If translation is (...) a special genre in its own right, the translation of poetry, especially from major foreign languages, is a special subset of that genre. What emerges in the imperfect act of translation is an aesthetic dimension that Viereck considers unique in its own right. Transplantings provides new insight into Viereck as a poet of substance, but more than that as a public intellectual. He is critical in probing the work of the major figures such as Stefan George and Georg Heym. To round out this monumental new look at German poetical history, Viereck reviews Goethe, Novalis, and Rilke among others. For Viereck, the difference between the poetical and the political is critical. The quality of poetry is not measured by politics, nor can the worth of political action be defined by commitment to the poetical. The experience of German thought, as well as French and Italian efforts, reveals a divide that can be narrowed but hardly bridged by rhetoric. Transplantings does not simplify the task of the reader. Rather it shows without doubt that the passion of great poetry is part of a national tradition. Efforts at translation indicate how such poetry becomes part of an international culture. This is a major work by one of the great thinkers of the twentieth century. It merits reading, and then, re-reading. "Peter Viereck was that rare scholar who captured the European experience with America, while fully realizing the American encounter with Europe. He did so with consciousness of and compassion for both sectors of Western Civilization" --Irving Louis Horowitz, Society Peter Viereck was a Pulitzer Prize-winning poet, critic, and historian. He held the Kenan Chair in History at Mount Holyoke College. He was known as one of America's conservatism's early leaders and was the recipient of Guggenheim Fellowships both in history and poetry. (shrink)

The options currently available to women with uterine infertility are adoption or surrogacy. Recently the option of uterine transplantation has been explored which would allow a woman to carry her own genetically related child. Although this type of transplant raises similar ethical considerations to other types of non-life-saving organ transplantation, such as facial tissue and limb, it also raises its own very unique considerations. In this paper, some of the considerations surrounding uterine transplantation, such as informed (...) consent and an individual's rights, and potential limit to reproductive autonomy are explored. (shrink)

It is hypothesized that human faces judged to be attractive by people possess two features—averageness and symmetry—that promoted adaptive mate selection in human evolutionary history by way of production of offspring with parasite resistance. Facial composites made by combining individual faces are judged to be attractive, and more attractive than the majority of individual faces. The composites possess both symmetry and averageness of features. Facial averageness may reflect high individual protein heterozygosity and thus an array of proteins (...) to which parasites must adapt. Heterozygosity may be an important defense of long-lived hosts against parasites when it occurs in portions of the genome that do not code for the essential features of complex adaptations. In this case heterozygosity can create a hostile microenvironment for parasites without disrupting adaptation. Facial bilateral symmetry is hypothesized to affect positive beauty judgments because symmetry is a certification of overall phenotypic quality and developmental health, which may be importantly influenced by parasites. Certain secondary sexual traits are influenced by testosterone, a hormone that reduces immunocompetence. Symmetry and size of the secondary sexual traits of the face (e.g., cheek bones) are expected to correlate positively and advertise immunocompetence honestly and therefore to affect positive beauty judgments. Facial attractiveness is predicted to correlate with attractive, nonfacial secondary sexual traits; other predictions from the view that parasite-driven selection led to the evolution of psychological adaptations of human beauty perception are discussed. The view that human physical attractiveness and judgments about human physical attractiveness evolved in the context of parasite-driven selection leads to the hypothesis that both adults and children have a species-typical adaptation to the problem of identifying and favoring healthy individuals and avoiding parasite-susceptible individuals. It is proposed that this adaptation guides human decisions about nepotism and reciprocity in relation to physical attractiveness. (shrink)

Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small and large artery elasticity in heart (...) transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy. (shrink)

Psychiatric genomics research protocols are increasingly incorporating tools of deep phenotyping to observe and examine phenotypic abnormalities among individuals with neurodevelopmental disorders. In particular, photography and the use of two-dimensional and three-dimensional facial analysis is thought to shed further light on the phenotypic expression of the genes underlying neurodevelopmental disorders, as well as provide potential diagnostic tools for clinicians. In this paper, I argue that the research use of photography to aid facial phenotyping raises deeply fraught issues from (...) an ethical point of view. First, the process of objectification through photographic imagery and facial analysis could potentially worsen the stigmatisation of persons with neurodevelopmental disorders. Second, the use of photography for facial phenotyping has worrying parallels with the historical misuse of photography to advance positive and negative eugenics around race, ethnicity and intellectual disability. The paper recommends ethical caution in the use of photography and facial phenotyping in psychiatric genomics studies exploring neurodevelopmental disorders, outlining certain necessary safeguards, such as a critical awareness of the history of anthropometric photography use among scientists, as well as the exploration of photographic methodologies that could potentially empower individuals with disabilities. (shrink)

ABSTRACT An American surgical team has announced its intention to perform the first human facial transplantation. The team has, however, invited further analysis of the ethical issues before it proceeds and in this paper we take up that challenge in seeking to frame the debate with a particular focus on the recipients of the transplant. We address seven related areas of concern and identify numerous questions that require answers or, perhaps, better answers. We start by examining the nature (...) of the procedure and its intended benefits, why the procedure is being developed, and whether or not this should be viewed as experimental. Having concluded that this is experimental in nature, we then consider the broad question, who is the patient? Here we perceive difficulties in terms of the autonomy of the recipient, the unpredictable effects of receiving the transplant, and the role and influence of society. We conclude by asking whether the question should be ‘whether or not?’ rather than ‘when?’, particularly while the risks of losing face appear to far outweigh the likelihood of gaining face. (shrink)

The face is the first thing that others notice and remember about a person. This is true for the severely facially burned patient, with disfigurement, impaired self-esteem and body image. They and others suffer from chronic devastating facial sequelae resulting from tumors, burns, or congenital malformations and trauma, e.g. ballistic injury to the face. Face transplantation is considered a way to restore eating, swallowing, and speech, and to reestablish esthetics.Alongside these vital bodily functions, the face plays a remarkable (...) role in a person’s identity. Societies place a high value on the face and this gives... (shrink)

Moodley and Rennie’s paper arguing against penile transplantation stated out of context arguments and wrongly quoted statements. The cost of penile transplantation is much less than portrayed. The burden of cases is much less than is communicated. The men on our penis transplantation programme represent the poorest of the poor and are one of the most discriminated against groups of humans on earth. The false hope said to be created by Moodley is indeed not false hope at (...) all as there is a real possibility that most patients on our waiting list may be transplanted. Moodley argues that government has, in the context of penile transplantation, no duty to cure those who lost a penis after ritual circumcision, but only an obligation to prevent this from happening. A ‘yuk’ reaction, similarly described in facial transplantation, may be present in colleagues arguing against penile transplantation. (shrink)

The technique of nuclear transplantation – popularly known as cloning – has been integrated into several different histories of twentieth century biology. Historians and science scholars have situated nuclear transplantation within narratives of scientific practice, biotechnology, bioethics, biomedicine, and changing views of life. However, nuclear transplantation has never been the focus of analysis. In this article, I examine the development of nuclear transplantation techniques, focusing on the people, motivations, and institutions associated with the first successful nuclear (...) transfer in metazoans in 1952. The conflict between embryologists and geneticists over the mechanisms of differentiation motivated Robert Briggs to pursue nuclear transplantation experiments as a way to resolve the debate. Briggs worked at the Lankenau Hospital Research Institute, a research facility devoted to the study of cancer. The goal of understanding cancer would play a role in the development of the technique, and the story of nuclear transplantation sheds light on the role that biomedical contexts play in biological research in the second half of the twentieth century. (shrink)

Viewing missionary Protestantism and non-governmental organizations (NGOs) as carriers of transnational institutional innovation, this article compares their successes and failures at creating self-sustaining institutions in distant societies. Missionary Protestantism and NGOs are similar in that they attempt to establish formal organizations outside kinship, lineage, and ethnic forms of solidarity. Focusing on institutions as ways to create collective capacities that organize social life, we trace the route whereby Protestant missionaries established congregational religion in Africa and identify social practices that made this (...) enterprise successful but are comparatively absent in current NGO attempts to transform organizational life. Largely ignored by sociologists interested in institutional transformation, the history of congregational religion offers valuable sociological lessons about the conditions for radical institutional innovation. Its success was rooted first, in colonial missionaries’ ability to enforce new ways of life on small exemplary communities; second, in local adaptations (African prophetic movements, Pentecostalism) that deepened and widened the social reach of congregational principles; and third in the incentives Protestantism created for propagating the congregational form. (shrink)

Although images of faces have long been employed in the scientific study of emotion, the objectives and assumptions motivating their use have shifted according to the various fields and research programs within which they have been put to use. This article traces these shifts through three such fields – the social psychology of interwar America, cross-cultural research of the 1970s, and the contemporary neurosciences of emotion – in order to assess the recent use of facial images as a means (...) of correlating particular emotions with particular locations in the brain. (shrink)

This article describes the exclusion of public expressions of religion from the history of bioethics during recent decades. It offers a proposal to include the public church for the purpose of gaining donations of vital organs for transplantation. I also include a brief discussion of theological support and practical suggestions for such a program.

Although scientific interest in facial attractiveness has developed substantially in recent years, few studies have contributed to our understanding of the ontogeny of facial preferences. In this study, attractiveness of 30 male faces was evaluated by four female groups: girls at puberty, nonpregnant and pregnant young women, and middle-aged women. The main findings are as follows: (1) Preference for sexy-looking faces was strongest in young, nonpregnant women. (2) Biologically more mature girls displayed more adultlike preferences. (3) The intragroup (...) consistency for postmenopausal women was relatively low. (4) In terms of the preference pattern, pregnant women were more similar to perimenopausal women than they were to their nonpregnant peers. (5) Preference for youthful appearance decreased with the age of the women. I argue that the life history of female preferences for male faces is, to a large extent, hormone-driven and underpinned by a set of evolutionary adaptations. (shrink)

Over the last two decades, facial symmetry has been intensively researched. The present article aims to summarize empirical research concerning relations between facial symmetry and health and facial symmetry and personality. A systematic review of the literature shows that facial symmetry is one of the most influential visual markers of attractiveness and health, important for mate selection, while asymmetry can be considered a consequence of an individual’s inability to resist environmental and genetic stressors during development of (...) the organism. However, in spite of evidence suggesting that preferences for facial symmetry are deeply rooted in our evolutionary history, a strong connection between facial symmetry and health is demonstrated only in studies measuring perceived health, while there is only scarce evidence corroborating the link between symmetry and actual health. The interconnections between facial symmetry and personality have not yet been extensively researched. Less than a dozen studies have addressed that issue and they have reached different conclusions. Some evidence suggests that facial symmetry signals personality attributes that indicate good psychological health, while other findings imply that pro-social personality traits negatively correlate with facial symmetry. (shrink)

Parkinson's disease (PD) is characterized by the loss of the dopaminergic nigrostriatal pathway which has led to the successful development of drug therapies that replace or stimulate this network pharmacologically. Although these drugs work well in the early stages of the disease, over time they produce side effects along with less consistent clinical benefits to the person with Parkinson's (PwP). As such there has been much interest in repairing this pathway using transplants of dopamine neurons. This work which began 50 (...) years ago this September is still ongoing and has now moved to first in human trials using human pluripotent stem cell‐derived dopaminergic neurons. The results of these trials are eagerly awaited although proof of principle data has already come from trials using human fetal midbrain dopamine cell transplants. This data has shown that developing dopamine cells when transplanted in the brain of a PwP can survive long term with clinical benefits lasting decades and with restoration of normal dopaminergic innervation in the grafted striatum. In this article, we discuss the history of this field and how this has now led us to the recent stem cell trials for PwP. (shrink)