Observation of female-male mounting in the carrion crow.

In the biological sciences, sexual behaviours in non-human animals are traditionally investigated in the context of reproduction and direct fitness benefits. While the evolutionary functions of non-conceptive sexual behaviours ('socio-sexual behaviours') remain less well explored, these interactions and displays have been suggested to be important for shaping and maintaining social relationships. Here, we report an observation of a captive female carrion crow, Corvus corone corone, mounting her co-housed male partner. We highlight the importance of more systematic research, reporting, and discussions of rarely observed behaviours in social evolution research, including considerations for behaviours that transcend binary or heteronormative frameworks, for a more comprehensive understanding of non-conceptive socio-sexual behaviours.

Molecular characterization of an avian rotavirus a strain detected from a large-billed crow (Corvus macrorhynchos) in Japan.

Avian rotaviruses A (RVAs) are occasionally transmitted to animals other than the original hosts across species barriers. Information on RVAs carried by various bird species is important for identifying the origin of such interspecies transmission. In this study, to facilitate an understanding of the ecology of RVAs from wild birds, we characterized all of the genes of an RVA strain, JC-105, that was detected in a fecal sample of a large-billed crow (Corvus macrorhynchos) in Japan. All of the genes of this strain except for the VP4 and VP7 genes, which were classified as novel genotypes (P[56] and G40, respectively), were closely related to those of the avian-like RVA strain detected from a raccoon, indicating the possibility that crows had been involved in the transmission of avian RVAs to raccoons. Our findings highlight the need for further viral investigations in wild birds and mammals to understand the mechanisms of avian-to-mammal RVA transmission.

West Nile virus surveillance using sentinel birds: results of eleven years of testing in corvids in a region of northern Italy.

The natural transmission cycle of West Nile virus (WNV) involves birds as primary hosts and mosquitoes as vectors, but this virus can spread to mammals, human beings included. Asymptomatic infected donors pose a risk to the safety of blood transfusions and organ transplants, as WNV can be transmitted through these medical procedures. Since 2009, the region of Emilia-Romagna in northern Italy has been implementing an integrated surveillance system in order to detect WNV circulation in the environment at an early stage. Here we report the results of the two components of the surveillance system, the active testing of corvids and humans, and demonstrate that bird surveillance alone improves a surveillance system based solely on human case detection. As WNV risk reduction measures are applied on a provincial basis, we assessed the ability of this surveillance system component to detect virus circulation prior to the notification of the first human case for each province. Overall, 99 epidemic seasons were evaluated as a result of 11 years (2013-2023) of surveillance in the nine provinces of the region. In this period, 22,314 corvids were tested for WNV and 642 (2.9%) were found to be infected. WNV was generally first detected in birds in July, with sample prevalence peaks occurring between August and September. During the same period, 469 autochthonous human cases were notified, about 60% of which were reported in August. WNV was detected 79 times out of the 99 seasons considered. The virus was notified in birds 73 times (92.4%) and 60 times (75.9%) in humans. WNV was first or only notified in birds in 57 seasons (72.1%), while it was first or only notified in humans in 22 seasons (27.8%). Active surveillance in corvids generally allows the detection of WNV before the onset of human cases. Failure of virus detection occurred mainly in seasons where the number of birds tested was low. Our results show that active testing of a minimum of 3.8 corvids per 100 km2 provides a satisfactory timeliness in the virus detection, but for early detection of WNV it is crucial to test birds between mid-June and mid-August.

Enterococcus faecalis provides protection during scavenging in carrion crow ( Corvus corone).

The gut microbiota significantly influences host physiology and provides essential ecosystem services. While diet can affect the composition of the gut microbiota, the gut microbiota can also help the host adapt to specific dietary habits. The carrion crow ( Corvus corone), an urban facultative scavenger bird, hosts an abundance of pathogens due to its scavenging behavior. Despite this, carrion crows infrequently exhibit illness, a phenomenon related to their unique physiological adaptability. At present, however, the role of the gut microbiota remains incompletely understood. In this study, we performed a comparative analysis using 16S rRNA amplicon sequencing technology to assess colonic content in carrion crows and 16 other bird species with different diets in Beijing, China. Our findings revealed that the dominant gut microbiota in carrion crows was primarily composed of Proteobacteria (75.51%) and Firmicutes (22.37%). Significant differences were observed in the relative abundance of Enterococcus faecalis among groups, highlighting its potential as a biomarker of facultative scavenging behavior in carrion crows. Subsequently, E. faecalis isolated from carrion crows was transplanted into model mice to explore the protective effects of this bacterial community against Salmonella enterica infection. Results showed that E. faecalis down-regulated the expression of pro-inflammatory cytokines tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), and interleukin 6 (IL-6), prevented S. enterica colonization, and regulated the composition of gut microbiota in mice, thereby modulating the host's immune regulatory capacity. Therefore, E. faecalis exerts immunoregulatory and anti-pathogenic functions in carrion crows engaged in scavenging behavior, offering a representative case of how the gut microbiota contributes to the protection of hosts with specialized diets.

A novel hybrid BonT-A and hyaluronic acid cannula-based technique for eyelid ptosis and periorbital rejuvenation.

BACKGROUND: Eyelid ptosis is characterized by an inferior displacement of the upper eyelid when the eye assumes its primary position. Besides its aesthetic implications, ptosis can also adversely affect visual acuity. OBJECTIVE: This study aimed to evaluate the simultaneous administration of IncobotulinumtoxinA (IncoBonTA) and hyaluronic acid effect in eyelid ptosis and ocular rejuvenation. METHODS: A novel, non-surgical technique for eyelid ptosis management involving IncoBonTA and hyaluronic acid the co-administration within a single syringe, and applied using a cannula. RESULTS: The dual action of IncoBonTA and hyaluronic acid in conjunction with the exact injection sites approaches improves overall aesthetic outcomes but also optimizes the restoration of eyelid functionality in palpebral ptosis. CONCLUSIONS: The functional balance achieved among the contributory muscles-primarily the orbicularis oculi (OO) and its antagonists, the frontal muscle and levator palpebrae superioris (LPS), yields to both, cosmetic and functional.

Efficacy and Safety of Skin Radiance Collagen on Skin and Hair Matrix: A Placebo-Controlled Clinical Trial in Healthy Human Subjects.

Purpose: Collagen supplements are rising in the market as collagen has been demonstrated to be an important protein in the human aging process. Also, it is safe and easily absorbed in the body. Hence the aim of this study was to examine the effectiveness and safety of a collagen and antioxidant-rich treatment compared to a placebo in relation to various skin and hair indicators in healthy adult human subjects. Patients and Methods: Forty healthy adult non-pregnant/non-lactating women (aged 38-50 years) provided their informed consent in writing before their participation. Skin Radiance Collagen (SRC) treatment and a placebo were assessed for efficacy before application on Day 1, and post-application on Days 28 and 56, to measure changes in skin elasticity, hydration, brightness, pigmentation; texture, wrinkles, dryness, smoothness, fine lines, changes in the crow's feet region; as well as hair strength and hair fall. Results: It was observed after 56 days that therapy with SRC, compared to placebo, produced a substantial effect on reduction of wrinkle depth and fine lines by 48.11% and 39%, respectively, with p-value <0.01 in the test group. There was a 15.69% improvement in skin hydration observed and 28% reduction in hair fall with p-value <0.01. Conclusion: SRC, a combination of collagen with hyaluronic acid (HA), biotin, and vitamins C and E, showed a significant improvement in skin and hair health, including improvements in skin elasticity, skin hydration, reduction in crow's feet area wrinkles and fine lines, hair fall, and decrease in roughness, leading to improved skin texture. Vitamin C in the formulation also acts as a collagen builder for the body and helps in preventing oxidative stress in the body. The test treatment SRC was found to be efficacious and safe in healthy human adult subjects.

Gaze tracking of large-billed crows (Corvus macrorhynchos) in a motion capture system.

Previous studies often inferred the focus of a bird's attention from its head movements because it provides important clues about their perception and cognition. However, it remains challenging to do so accurately, as the details of how they orient their visual field toward the visual targets remain largely unclear. We thus examined visual field configurations and the visual field use of large-billed crows (Corvus macrorhynchos Wagler 1827). We used an established ophthalmoscopic reflex technique to identify the visual field configuration, including the binocular width and optical axes, as well as the degree of eye movement. A newly established motion capture system was then used to track the head movements of freely moving crows to examine how they oriented their reconstructed visual fields toward attention-getting objects. When visual targets were moving, the crows frequently used their binocular visual fields, particularly around the projection of the beak-tip. When the visual targets stopped moving, crows frequently used non-binocular visual fields, particularly around the regions where their optical axes were found. On such occasions, the crows slightly preferred the right eye. Overall, the visual field use of crows is clearly predictable. Thus, while the untracked eye movements could introduce some level of uncertainty (typically within 15 deg), we demonstrated the feasibility of inferring a crow's attentional focus by 3D tracking of their heads. Our system represents a promising initial step towards establishing gaze tracking methods for studying corvid behavior and cognition.

Species and habitat specific changes in bird activity in an urban environment during Covid 19 lockdown.

Covid-19 lockdowns provided ecologists with a rare opportunity to examine how animals behave when humans are absent. Indeed many studies reported various effects of lockdowns on animal activity, especially in urban areas and other human-dominated habitats. We explored how Covid-19 lockdowns in Israel have influenced bird activity in an urban environment by using continuous acoustic recordings to monitor three common bird species that differ in their level of adaptation to the urban ecosystem: (1) the hooded crow, an urban exploiter, which depends heavily on anthropogenic resources; (2) the rose-ringed parakeet, an invasive alien species that has adapted to exploit human resources; and (3) the graceful prinia, an urban adapter, which is relatively shy of humans and can be found in urban habitats with shrubs and prairies. Acoustic recordings provided continuous monitoring of bird activity without an effect of the observer on the animal. We performed dense sampling of a 1.3 square km area in northern Tel-Aviv by placing 17 recorders for more than a month in different micro-habitats within this region including roads, residential areas and urban parks. We monitored both lockdown and no-lockdown periods. We portray a complex dynamic system where the activity of specific bird species depended on many environmental parameters and decreases or increases in a habitat-dependent manner during lockdown. Specifically, urban exploiter species decreased their activity in most urban habitats during lockdown, while human adapter species increased their activity during lockdown especially in parks where humans were absent. Our results also demonstrate the value of different habitats within urban environments for animal activity, specifically highlighting the importance of urban parks. These species- and habitat-specific changes in activity might explain the contradicting results reported by others who have not performed a habitat specific analysis.

Lockdowns due to the COVID-19 pandemic reduced human activity in early 2020, providing a rare opportunity to examine how wildlife behaves when humans are absent. While several studies reported increased abundance of animals in urban habitats, others cast doubt on these reports. Variation in study conclusions could be due to different species showing different levels of adaptation to human activity. Additionally, studies that rely on visually observing animals can impact their behavior and those based on public reporting may also have been influenced by changes in human activity. Therefore, it remained unclear whether COVID-19 lockdowns impacted wildlife and how this might differ among species. To quantify wildlife presence and activity during lockdown, Sun et al. placed recording devices in different urban environments, including roads, residential areas, and urban parks across Tel Aviv in Israel during early 2020. This allowed continuous monitoring of bird vocalizations during lockdown and non-lockdown periods and ensured the birds were not disturbed by human observers. Three common bird species, which each show different levels of adaptation to urban ecosystems, were monitored. The hooded crow, which depends heavily on human resources, and the rose-ringed parakeet, an invasive alien species which has adapted to exploit human resources, decreased their activity in most urban habitats during lockdowns. On the other hand, the graceful prinia, which has adapted to thrive in urban green spaces but is relatively shy of humans, showed increased activity, especially in parks where humans were absent. The findings of Sun et al. reveal that birds show species- and habitat-specific changes to their behavior as a result of decreased human activity. This might explain why previous studies ­ which did not perform habitat-specific analyses ­ gave conflicting reports of the impact of COVID-19 lockdowns on wildlife activity. The results also demonstrate the value of different habitats within urban environments for animal activity, specifically identifying the importance of urban parks. By highlighting the impact of human activity on urban wildlife, the findings provide a scientific basis for future conservation efforts.

The Symbolism in a Case of Hysterical Psychosis

The authors take inspiration from a case of hysterical psychosis to illustrate a typical condition of this evocative disease: the symbolic language of hysteria, conjurer of archetypical images. The authors encourage the clinician not to decode such aspects in rational analytical terms, rather to have a more wide-open approach that promotes the emergence of the individual unconscious, reconnecting with the collective imagination. This approach could help psychiatrists better understand a subject's inner experiences and interpersonal behavior. (AU)

Evaluating the Impact of a Cream Containing Horse Placental Extract on Eye Corner Wrinkles in Healthy Women: Single-Blind Comparative Study.

BACKGROUND: Placental extract has been mostly used in skin care for cosmetic purposes. However, the use of various placental extracts has been limited due to the lack of established and effective application methods. OBJECTIVE: In this study, we investigated the antiwrinkle effect of a cream formulation-LNC wrinkle eye cream (LNC-EC)-containing horse placental extract as the main ingredient. METHODS: A total of 24 healthy women, aged 37-54 years, with wrinkle grades 1-3, were treated with LNC-EC for 2 weeks. The cream was applied on one-half of the participants' faces, and the results were compared with the untreated half of the face. RESULTS: Visual inspection, using the wrinkle grade standard, showed that the area treated with LNC-EC had a significantly lower wrinkle grade than the untreated area when comparing before and after the application of LNC-EC. In addition, replica analysis showed a significant reduction in both the maximum wrinkle width and the number of wrinkles in the LNC-EC-treated area in comparison to the untreated area before and after the application. These results suggest that LNC-EC has an antiwrinkle effect on the corners of the eyes based on parameters like the maximum wrinkle width and the number of wrinkles. CONCLUSIONS: LNC-EC, with horse placental extract as its main ingredient, was shown to be effective in improving wrinkles at the eye corners, presumably due to a reduction in the maximum wrinkle width and the number of wrinkles. Interpretation of the results is limited because this study was conducted only in the intervention group. A randomized controlled trial with a placebo control group is necessary to verify the antiwrinkle effects of horse placental extract.

Efficacy, Safety, and Subject Satisfaction of PrabotulinumtoxinA for Moderate-to-Severe Crow's Feet: A Phase IV, Multicenter, Double-Blind, Randomized, Placebo-Controlled Trial.

PrabotulinumtoxinA has been identified as an effective agent against crow's feet. Our study, which included Korean patients with moderate to severe crow's feet, was undertaken to compare the efficacy and safety of PrabotulinumtoxinA and placebo treatments. Of the 90 study participants, 60 received prabotulinumtoxinA (24 U), whereas 30 received a placebo. The primary outcome assessment included facial wrinkle grading by investigators. At week 4, 69.64% of patients in the prabotulinumtoxinA group exhibited minimal crow's feet severity; in contrast, a 0% improvement was observed in the placebo group (p < 0.0001). At week 12, the improvement rates were 30.36% for prabotulinumtoxinA and 6.90% for the placebo, demonstrating a significant difference (p = 0.0152). Based on the independent review panel's assessment at week 4, the improvement rate was 39.29% in the prabotulinumtoxinA group and 3.45% in the placebo group during maximum smiling. Additionally, patient satisfaction was notably higher in the prabotulinumtoxinA group (32.14%) than in the placebo group (10.34%) at week 4 (p = 0.0289). Both treatments displayed comparable safety profiles, with only mild local reactions reported as ADRs for one patient from the prabotulinumtoxinA group. Thus, prabotulinumtoxinA demonstrates significant potential as a potent and safe remedy for crow's feet.

The evaluation of university management performance using the CS-RBM algorithm.

Amidst the ongoing higher education reforms in China, the escalated investments in colleges and universities underscore the need for an effective assessment of their performance to ensure sustainable development. However, traditional evaluation methods have proven time-consuming and labor-intensive. In response, a novel approach called CS-RBM (Crow Search Restricted Boltzmann Machine) prediction algorithm has been proposed for the educational management of these institutions. By integrating the CS algorithm and an enhanced RBM algorithm, this method facilitates the scoring of project performance indicators, bolstered by insights from user evaluation form reports. The comprehensive project performance is ultimately derived from this combination. Comparative analysis with the standard particle swarm optimization algorithm on public data sets demonstrates a remarkable 45.6% reduction in prediction errors and an impressive 34.7% increase in iteration speed using the CS-RBM algorithm. The accuracy of the tested data set surpasses 98%, validating the efficacy of the CS-RBM algorithm in achieving precise predictions and effective assessments. Consequently, this innovative approach exhibits promising potential for expediting and enhancing the performance evaluation of colleges and universities, contributing significantly to their sustainable development.

Birth in the U.S. Plantation South and Racial Differences in all-cause mortality in later life.

The American South has been characterized as a Stroke Belt due to high cardiovascular mortality. We examine whether mortality rates and race differences in rates reflect birthplace exposure to Jim Crow-era inequalities associated with the Plantation South. The plantation mode of agricultural production was widespread through the 1950s when older adults of today, if exposed, were children. We use proportional hazards models to estimate all-cause mortality in Non-Hispanic Black and White birth cohorts (1920-1954) in a sample (N = 21,941) drawn from REasons for Geographic and Racial Differences in Stroke (REGARDS), a national study designed to investigate Stroke Belt risk. We link REGARDS data to two U.S. Plantation Censuses (1916, 1948) to develop county-level measures that capture the geographic overlap between the Stroke Belt, two subregions of the Plantation South, and a non-Plantation South subregion. Additionally, we examine the life course timing of geographic exposure: at birth, adulthood (survey enrollment baseline), neither, or both portions of life. We find mortality hazard rates higher for Black compared to White participants, regardless of birthplace, and for the southern-born compared to those not southern-born, regardless of race. Race-specific models adjusting for adult Stroke Belt residence find birthplace-mortality associations fully attenuated among White-except in one of two Plantation South subregions-but not among Black participants. Mortality hazard rates are highest among Black and White participants born in this one Plantation South subregion. The Black-White mortality differential is largest in this birthplace subregion as well. In this subregion, the legacy of pre-Civil War plantation production under enslavement was followed by high-productivity plantation farming under the southern Sharecropping System.

Recurring Trans-Atlantic Incursion of Clade 2.3.4.4b H5N1 Viruses by Long Distance Migratory Birds from Northern Europe to Canada in 2022/2023.

In December 2022 and January 2023, we isolated clade 2.3.4.4b H5N1 high-pathogenicity avian influenza (HPAI) viruses from six American crows (Corvus brachyrhynchos) from Prince Edward Island and a red fox (Vulpes vulpes) from Newfoundland, Canada. Using full-genome sequencing and phylogenetic analysis, these viruses were found to fall into two distinct phylogenetic clusters: one group containing H5N1 viruses that had been circulating in North and South America since late 2021, and the other one containing European H5N1 viruses reported in late 2022. The transatlantic re-introduction for the second time by pelagic/Icelandic bird migration via the same route used during the 2021 incursion of Eurasian origin H5N1 viruses into North America demonstrates that migratory birds continue to be the driving force for transcontinental dissemination of the virus. This new detection further demonstrates the continual long-term threat of H5N1 viruses for poultry and mammals and the subsequent impact on various wild bird populations wherever these viruses emerge. The continual emergence of clade 2.3.4.4b H5Nx viruses requires vigilant surveillance in wild birds, particularly in areas of the Americas, which lie within the migratory corridors for long-distance migratory birds originating from Europe and Asia. Although H5Nx viruses have been detected at higher rates in North America since 2021, a bidirectional flow of H5Nx genes of American origin viruses to Europe has never been reported. In the future, coordinated and systematic surveillance programs for HPAI viruses need to be launched between European and North American agencies.

A Variable Step Crow Search Algorithm and Its Application in Function Problems.

Optimization algorithms are popular to solve different problems in many fields, and are inspired by natural principles, animal living habits, plant pollinations, chemistry principles, and physic principles. Optimization algorithm performances will directly impact on solving accuracy. The Crow Search Algorithm (CSA) is a simple and efficient algorithm inspired by the natural behaviors of crows. However, the flight length of CSA is a fixed value, which makes the algorithm fall into the local optimum, severely limiting the algorithm solving ability. To solve this problem, this paper proposes a Variable Step Crow Search Algorithm (VSCSA). The proposed algorithm uses the cosine function to enhance CSA searching abilities, which greatly improves both the solution quality of the population and the convergence speed. In the update phase, the VSCSA increases population diversities and enhances the global searching ability of the basic CSA. The experiment used 14 test functions,2017 CEC functions, and engineering application problems to compare VSCSA with different algorithms. The experiment results showed that VSCSA performs better in fitness values, iteration curves, box plots, searching paths, and the Wilcoxon test results, which indicates that VSCSA has strong competitiveness and sufficient superiority. The VSCSA has outstanding performances in various test functions and the searching accuracy has been greatly improved.

Costs and benefits of voluntary attention in crows.

Behavioural signatures of voluntary, endogenous selective attention have been found in both mammals and birds, but the relationship between performance benefits at attended and costs at unattended locations remains unclear. We trained two carrion crows (Corvus corone) on a Posner-like spatial cueing task with dissociated cue and target locations, using both highly predictive and neutral central cues to compare reaction time (RT) and detection accuracy for validly, invalidly and neutrally cued targets. We found robust RT effects of predictive cueing at varying stimulus-onset asynchronies (SOA) that resulted from both advantages at cued locations and costs at un-cued locations. Both crows showed cueing effects around 15-25 ms with an early onset at 100 ms SOA, comparable to macaques. Our results provide a direct assessment of costs and benefits of voluntary attention in a bird species. They show that crows are able to guide spatial attention using associative cues, and that the processing advantage at attended locations impairs performance at unattended locations.

West Nile Virus Lineage 2 in Free-Living Corvus cornix Birds in Poland.

The summer temperatures recorded in Poland in 2022 were among the highest in over 30 years and, combined with higher-than-expected rainfall, gave the impression of an almost tropical climate. Such climatic conditions were ideal for the transmission of vector-borne zoonotic diseases such as West Nile fever. In northeastern Poland, in the Mazowieckie region, the Polish event-based surveillance network reported increased fatalities of free-living hooded crows (Corvus corone cornix). West Nile virus (WNV) lineage 2 was identified for the first time as the etiological agent responsible for the death of the birds. WNV was detected in 17 out of the 99 (17.17%) free-living birds tested in this study. All the WNV-infected dead birds were collected in the same area and were diagnosed in September by the NVRI and confirmed by the EURL for equine diseases, ANSES, in October 2022. Unnaturally high temperatures recorded in Poland in 2022 likely favored the infection and spread of the virus in the avian population. A nationwide alert and awareness raising of blood transfusion centers and hospitals was carried out to prevent human infections by WNV.

Effect of Different Packaging Strategies on the Secondary Shelf Life of Young and Structured Red Wine.

When bottled wine is opened, a completely different scenario occurs that can accelerate the oxidation of the product. This is called the secondary shelf life (SSL), which is generally shorter and less predictable than the primary shelf life (PSL). In this context, the research aim was to evaluate the changes that occur in two types of red wine during two tests to evaluate the secondary shelf life as a function of the packaging systems. The variation of Total SO2 and Free SO2 and the other chemical parameters (polyphenols, anthocyanins, proanthocyanidins, color, and volatile acidity) were used to assess the oxidation rate of the packaging samples after opening during the SSL. In both tests and for the two types of stored red wine, the polymeric cap showed the best results. The other types of closure (screw cap, natural cork, crow cap, and Tetra Brik) showed a negative trend and a reduced SSL for both red wines. Finally, the sensory results confirmed that with the polymeric cap, the SSL increases considerably compared to other capping systems. These results may be due to the technical characteristics of polymeric materials, which tend to vary slightly in shape after repeated usage.

SAMCEP Society consensus on the treatment of upper facial lines with botulinum neurotoxin type A: A tailored approach.

BACKGROUND: The safety and efficacy of botulinum neurotoxin type A (BoNTA) treatments are well established, but injection techniques, target muscles, and toxin doses continue to evolve, with each refinement producing improvements in treatment outcomes. The recommendations in this consensus move away from standard templates and illustrate how to tailor treatments to individual patterns and strengths of muscle activity, and patient preferences. METHODS: Seventeen experts in the fields of plastic surgery, dermatology, ophthalmology, otorhinolaryngology, and neurology convened in 2022 to develop consensus-based recommendations for the use of botulinum toxin A for the treatment of horizontal forehead lines, glabellar frown lines, and crow's feet lines that reflect current clinical practice. The focus was on how to tailor injections to individual patients to optimize treatment outcomes. RESULTS: For each upper face indication, consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is presented for commonly observed patterns of dynamic lines. Units of Inco are defined and the precise location of injection points, illustrated with the use of anatomical images. CONCLUSION: This consensus provides up-to-date recommendations on the tailored treatment of upper facial lines based on the latest research and collective clinical experience of the expert injectors. Optimal outcomes require thorough patient evaluation, both at rest and during animation, using both visual and tactile cues; detailed understanding of facial muscular anatomy and how opposing muscles interact; and use of a BoNTA with high precision to target identified zones of excess muscle activity.

Double vision due to lateral rectus injury after cosmetic botulinum toxin injections.

Facial intramuscular injections of Botulinum toxin (BoNT) injections are among the most common cosmetic procedures in dermatology. Rarely, serious adverse reactions such as blepharoptosis, diplopia and periorbital hematoma may occur with improper administration technique. Here we report a case of painless diplopia 5 weeks post-BoNT injection for 'crow's feet' likely due to inadvertent BoNT diffusion into the lateral rectus muscle causing a temporary palsy. This case aims to raise awareness of proper cosmetic BoNT injection techniques in the periorbital area to avoid ophthalmic complications.