The Psychological Impact of Remote Communication on Body-Image Perception: Cosmetic Surgery on the Rise.

In recent times the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA) has increased. The correlation between this increase and the concept of "Zoom Boom" changing how we perceive our image is under speculation. However, this could also be linked to the psychological impact of the pandemic on patients' moods. This study investigated the correlation between the pandemic era and seeking cosmetic surgery while focusing on the psychological impact of the pandemic on body-image perception. An anonymous web-based poll was distributed through social networks in Italy and the UK to patients seeking cosmetic surgery. The questions gathered responses on: 1. patient demographics; 2. cosmetic procedures requested; 3. motivations; 4. delays to cosmetic surgery caused by the pandemic; 5. pandemic effects on mood; 6. influence of video conferencing on body-image perception. A total of 159 respondents completed the online poll. Patients were more inclined to undergo cosmetic surgery during the pandemic citing the wish to improve their "lockdown face" (61%) and also the benefits of home recovery during smart working (36%). Eighty-one percent of respondents stated that video conferencing had impacted on their body-image perception, 95% indicated lower mood due to backlogs and surgery delays, while 72% of participants noted declined body-image perception during the pandemic. Data suggest that although video conferencing appears to play a key role in rising requests for cosmetic surgery consultations, a patient's negative self-perception is also likely linked to the psychological impact of the pandemic on mood levels. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Accounting for attitudes and perceptions influencing users' willingness to purchase Electric Vehicles through a Hybrid Choice Modeling approach based on Analytic Hierarchy Process

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Breast Reconstruction and the Covid-19 Pandemic: Adapting Practice

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Budesonide increases TLR4 and TLR2 expression in Treg lymphocytes of allergic asthmatics

Background: Reduced innate immunity responses as well as reduced T regulatory activities characterise bronchial asthma. Objectives: In this study the effect of budesonide on the expression of TLR4 and TLR2 in T regulatory lymphocyte sub-population was assessed. Methods: TLR4 and TLR2 expression in total peripheral blood mononuclear cells (PBMC), in CD4+/CD25+ and in CD4+/CD25- was evaluated, by flow cytometric analysis, in mild intermittent asthmatics (n = 14) and in controls (n = 11). The in vitro effects of budesonide in modulating: TLR4 and TLR2 expression in controls and in asthmatics; IL-10 expression and cytokine release (IL-6 and TNF-\u3b1 selected by a multiplex assay) in asthmatics were also explored. Results: TLR4 and TLR2 were reduced in total PBMC from asthmatics in comparison to PBMC from controls. CD4+CD25+ cells expressed at higher extent TLR2 and TLR4 in comparison to CD4+CD25- cells. Budesonide was able to increase the expression of TLR4, TLR2 and IL-10 in CD4+/CD25highly+ cells from asthmatics. TLR4 ligand, LPS induced Foxp3 expression. Budesonide was also able to reduce the release of IL-6 and TNF-\u3b1 by PBMC of asthmatics. Conclusions: Budesonide potentiates the activity of Treg by increasing TLR4, TLR2 and IL-10 expression. This event is associated to the decreased release of IL-6 and TNF-\u3b1 in PBMC treated with budesonide. These findings shed light on new mechanisms by which corticosteroids, drugs widely used for the clinical management of bronchial asthma, control T lymphocyte activation

Formoterol Exerts Anti-Cancer Effects Modulating Oxidative Stress and Epithelial-Mesenchymal Transition Processes in Cigarette Smoke Extract Exposed Lung Adenocarcinoma Cells

Lung cancer frequently affects patients with Chronic Obstructive Pulmonary Disease (COPD). Cigarette smoke (CS) fosters cancer progression by increasing oxidative stress and by modulating epithelial-mesenchymal transition (EMT) processes in cancer cells. Formoterol (FO), a long-acting β2-agonist widely used for the treatment of COPD, exerts antioxidant activities. This study explored in a lung adenocarcinoma cell line (A549) whether FO counteracted the effects of cigarette smoke extract (CSE) relative to oxidative stress, inflammation, EMT processes, and cell migration and proliferation. A549 was stimulated with CSE and FO, ROS were evaluated by flow-cytometry and by nanostructured electrochemical sensor, EMT markers were evaluated by flow-cytometry and Real-Time PCR, IL-8 was evaluated by ELISA, cell migration was assessed by scratch and phalloidin test, and cell proliferation was assessed by clonogenic assay. CSE significantly increased the production of ROS, IL-8 release, cell migration and proliferation, and SNAIL1 expression but significantly decreased E-cadherin expression. FO reverted all these phenomena in CSE-stimulated A549 cells. The present study provides intriguing evidence that FO may exert anti-cancer effects by reverting oxidative stress, inflammation, and EMT markers induced by CS. These findings must be validated in future clinical studies to support FO as a valuable add-on treatment for lung cancer management

Cigarette smoke increases BLT2 receptor functions in bronchial epithelial cells: in vitro and ex vivo evidence

Leukotriene B4 (LTB4) is a neutrophil chemotactic molecule with important involvement in the inflammatory responses of chronic obstructive pulmonary disease (COPD). Airway epithelium is emerging as a regulator of innate immune responses to a variety of insults including cigarette smoke, the major risk factor for COPD. In this study we have explored whether cigarette smoke extracts (CSE) or soluble mediators present in distal lung fluid samples (mini-bronchoalveolar lavages) from smokers alter the expression of the LTB4 receptor 2 (BLT2) and peroxisome proliferator- activated receptor-a (PPAR-a) in bronchial epithelial cells. We also evaluated the effects of CSE on the expression of intercellular adhesion molecule 1 (ICAM-1) and on the binding of signal transducer and activator of transcription 1 (STAT-1) to ICAM-1 promoter as well as the adhesiveness of neutrophils to bronchial epithelial cells. CSE and minibronchoalveolar lavages from smokers increased BLT2 and ICAM-1 expression as well as the adhesiveness of neutrophils to bronchial epithelial cells and decreased PPAR-a expression. CSE induced the activation of STAT-1 and its binding to ICAM-1 promoter. These findings suggest that, in bronchial epithelial cells, CSE promote a prevalent induction of pro-inflammatory BLT2 receptors and activate mechanisms leading to increased neutrophil adhesion, a mechanism that contributes to airway neutrophilia and to tissue damage

The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator’s experience

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from “knife-to-skin” to insertion of the last stitch. Results: One hundred and twenty patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (P=0.73). However, patients in the CT-VC group had significantly shorter operations vs. WI (472 vs. 586 min, P<0.00001) and vs. VC alone (472 vs. 572 min, P=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs. VC: 100 vs. 89 min, P=0.0106; VC vs. CT-VC: 89 vs. 80 min, P=0.0307; WI vs. CT-VC: 100 vs. 80 min, P<0.00001). Conclusions: Combination of CTA and VC significantly reduced operative and ischaemic times for FFBR; this was predominantly due to use of CTA. CTA mitigates the surgical learning curve as demonstrated by shorter operating times via providing a vascular anatomy roadmap, thus facilitating flap harvest

Wearable Sensor for Real-time Monitoring of Hydrogen Peroxide in Simulated Exhaled Air

In this work, an innovative and cheap electrochemical sensor for hydrogen peroxide quantification in exhaled breath was developed. H2O2 is the most used biomarker among the Reactive Oxygen Species (ROS) for monitoring the level of oxidative stress in the respiratory system. This is due to its stability and ability to cross biological membranes and also because it is detectable in extracellular space. The electrochemical sensor was obtained using the silver layer of wasted compact discs (CDs). All three electrodes, working (WE), counter (CE), and pseudo-reference electrode (RE), were fabricated using a laser cutter. The working electrode was used directly, while an Ag/AgCl paste and a graphite paste were applied respectively on the RE and the CE. In addition, a chitosan layer was deposited by Electro-Phoretic Deposition (EPD) on the surface of the sensor. This biopolymer improves the wettability of the sensor in presence of a humid atmosphere such as that given by exhaled air. The sensor was tested in both liquid and nebulized solutions containing different concentrations of hydrogen peroxide. The detection of H2O2 was evaluated using Linear Sweep Voltammetry (LSV) as electrochemical technique. The results show that the peak current increases linearly with hydrogen peroxide concentration from 100 to 500 μM with a sensitivity of 0.068 µA µM−1 cm−2 and 0.108 µA µM−1 cm−2, a Limit Of Detection (LOD) of 60 μM and 30 μM respectively for liquid and nebulized solutions. Therefore, the use of the electrochemical sensor can allow the monitoring of hydrogen peroxide in real time with good results

Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: A Time and Cost Analysis

Background- Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a “hydraulic system technique” optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure. Methods- Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, “1-track,” and “2-tracks” systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat. Results- In 15 cases the standard system was used (mean treated fat 72 [30–100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the “1-track” system (mean treated fat 183.3 [120–280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the “2-tracks” one (mean treated fat 311[220–550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the “1-track” system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the “1-track” system and “2-tracks” system becomes statistically significant from 240 mL of fat in 15 minutes (“1-track”) versus 9.3 minutes for the “2-tracks” system. Conclusion- Data analysis would indicate the use of the standard system, “1-track,” and “2-tracks” to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively

Electrochemical sensors for worker safety in manufacturing industries

The National Institute for Occupational Safety and Health has attributed most occupational diseases of industrial workers to excessive exposure to dangerous substances. In particular, occupational lung diseases are caused by the inhalation of harmful substances such as dust particles and gases [1]. The use of DPI and periodic health checks for industrial workers certainly reduces risks, but a more effective prevention strategy should include real-time monitoring of physiological parameters [2]. In this context, recent academic and industrial research has focused on the development of smart wearable systems for continuous health monitoring. This has been possible mainly due to significant progress in micro- and nanotechnology and the miniaturization of devices [3]. In such regard, electrochemical sensors represent a promising alternative due to their speed of response, simplicity of operation, and lower cost than traditional methods of diagnosis [4]. This research activity involves the development of a smart mask based on an electrochemical sensor for the non-invasive detection of hydrogen peroxide in exhaled breath. In particular, a higher concentration of this biomarker indicates the onset of oxidative stress, a pathological condition that can lead to more serious diseases, such as asthma and COPD (Chronic Obstructive Pulmonary Disease) [5]. This sensor was fabricated through a sustainable production process, from the CDs at the end of life because their silver layer can be used for its good electrochemical properties. In particular, this layer was peeled off the CD and a three electrodes configuration was given using a laser cutter