A systematic review of generative adversarial networks (GANs) in plastic surgery.

INTRODUCTION: Generative adversarial networks (GANs) are a form of deep learning architecture based on the zero-sum game theory, which uses real data to generate realistic fake data. GANs use two opposing neural networks working: a generator and a discriminator. They represent a powerful tool for generating realistic synthetic patient data sets and can potentially revolutionize research. This systematic literature review evaluated the scale and scope of GANs within plastic surgery, constructing a framework for its use and evaluation within subspecialties. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a systematic review was performed for applications of GANs in plastic surgery from 2014 to 2022. Three independent reviewers screened from databases: PubMed, Embase, PsychInfo, Scopus, and Google Scholar. RESULTS: A total of 70 studies were captured by the search, of which seven studies met our criteria. The most common subspecialty was craniofacial (n = 4). Proposed uses of GANs included facial recognition, burn estimation, scar prediction, and post-breast cancer reconstruction anomaly scoring. GANs were conditional, trained on data sets averaging 54,652 ± 112,180 samples, with some sourced publicly and others being primary. CONCLUSION: GANs hold promise for advancing plastic surgery, backed by diverse applications in the literature. Studies should follow a standardized reporting structure for consistency and transparency, as outlined, especially regarding the data sets used to ensure appropriate representation from an ethnic and cultural diversity perspective. Although GANs require specialist computational expertise to create, surgeons need to understand their development by leveraging the full potential of GANs within the emerging field of computational plastic surgery and beyond.

Perceptions, awareness and influences of medical students towards plastic surgery: A systematic review.

Introduction: Plastic, reconstructive and aesthetic surgery (PRAS) is a significant yet often overlooked specialty in medical school curricula. The impact of social media and unregulated information sources can distort the perceptions of medical specialties, including PRAS, leading to a decline in student interest, inappropriate referrals and strain on healthcare services. This systematic review aimed to understand the perceptions of medical students towards PRAS, identify influencing factors and explore strategies to address these influences. Methods: The review followed the PRISMA 2020 guidelines. Four databases were searched, and the inclusion and exclusion criteria were applied. Data from 17 relevant studies were analysed in Microsoft Excel using descriptive statistics. The risk of bias was assessed using a modified Newcastle-Ottawa Scale. Results: Medical students generally held positive perceptions about PRAS, particularly regarding career opportunities, specialised skills and the nature of the specialty. However, their awareness of the full scope of plastic surgery is limited, with a focus on cosmetic and aesthetic procedures. Social media and the internet significantly influenced the students' perceptions, whereas personal experiences had a minor impact. Education and training in plastic surgery positively affected the students' perceptions. Nevertheless, there is a need for improved representation of PRAS in medical school curricula and promotion of accurate information through reliable sources. Conclusion: Students exhibited a favourable attitude towards plastic surgery, but their knowledge of the specialty can be enhanced. Strengthening PRAS teaching in medical schools and ensuring accurate information dissemination can foster a deeper understanding and interest in this field. Large-scale studies with standardised protocols should be conducted in different countries to gain comprehensive insights tailored to specific educational contexts.

Online Provision of BRCA1 and BRCA2 Health Information: A Search Engine Driven Systematic Web-Based Analysis.

BRCA genetic testing is available for UK Jewish individuals but the provision of information online for BRCA is unknown. We aimed to evaluate online provision of BRCA information by UK organisations (UKO), UK Jewish community organisations (JCO), and genetic testing providers (GTP). Google searches for organisations offering BRCA information were performed using relevant sets of keywords. The first 100 website links were categorised into UKOs/JCOs/GTPs; additional JCOs were supplemented through community experts. Websites were reviewed using customised questionnaires for BRCA information. Information provision was assessed for five domains: accessibility, scope, depth, accuracy, and quality. These domains were combined to provide a composite score (maximum score = 5). Results were screened (n = 6856) and 45 UKOs, 16 JCOs, and 18 GTPs provided BRCA information. Accessibility was high (84%,66/79). Scope was lacking with 35% (28/79) addressing >50% items. Most (82%, 65/79) described BRCA-associated cancers: breast and/or ovarian cancer was mentioned by 78%(62/79), but only 34% (27/79) mentioned ≥1 pancreatic, prostate, melanoma. Few websites provided carrier frequencies in the general (24%,19/79) and Jewish populations (20%,16/79). Only 15% (12/79) had quality information with some/minimal shortcomings. Overall information provision was low-to-moderate: median scores UKO = 2.1 (IQR = 1), JCO = 1.6 (IQR = 0.9), and GTP = 2.3 (IQR = 1) (maximum-score = 5). There is a scarcity of high-quality BRCA information online. These findings have implications for UK Jewish BRCA programmes and those considering BRCA testing.