SUMMARY:Thighplasty is a widely performed body contouring procedure, using various surgical techniques for thigh lifting, including medial scar positioning, vertical and horizontal procedures, and liposuction. Despite its popularity, thighplasty is associated with high complication rates and suboptimal postoperative outcomes. This article presents a novel technique: the J-medial thighplasty combined with helium plasma radiofrequency (HPRF) technology to address moderate skin and soft-tissue laxity and ptosis in the inner thighs. Between 2020 and 2023, 21 patients underwent this combined procedure. The surgical approach involved selective liposuction in targeted areas, skin resection, and preservation of deep tissue layers, coupled with the application of HPRF in the lower third of the medial thigh. Results demonstrated significant reductions in thigh laxity, correction of skin overhang, and fat reduction, yielding improved functional and aesthetic outcomes in the lower thigh region. By strategically avoiding lymphatic vessels in superficial areas, the risk of secondary lymphedema was minimized. Patient satisfaction was notably high, with both patients and surgeons reporting favorable results. In conclusion, the J-medial thighplasty combined with HPRF offers an effective and straightforward method for enhancing the lower thigh area with minimal complications. This innovative technique provides a promising solution for patients seeking improved thigh contouring while ensuring high levels of patient satisfaction. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

In this work, we present experimental data on the chemical solution deposition of superconducting YBa2Cu3O7-delta (YBCO) films by the low fluorine metal-organic decomposition technique. The growth of YBCO film on SrTiO3 (STO) single crystal has been studied with particular attention to the degree of crystal orientation, along either the a or c axes, by varying the crystallization temperature and water partial pressure. The experimental data have been interpreted using a model based on the thermodynamics and kinetics of YBCO nucleation at solid surfaces. In the present form, the model has been reformulated to be more versatile for describing kinetic data. In addition, the description of the experimental data through the model requires considering the composition of Barium oxyfluoride as a function of water partial pressure, the adhesion work of YBCO/STO interface, the crystallization temperature and the partial pressure of water. The present study shows that a deeper understanding of the nucleation mechanism can lead to the improvement not only of the YBCO superconducting properties but also of the process robustness and reproducibility.

Background/Objectives: Medial thighplasty is a widely performed body contouring procedure, particularly in patients with massive weight loss. Despite advancements in surgical techniques, complications remain a significant concern. The integration of liposuction into thigh lift procedures has shown promise in improving both aesthetic and functional outcomes while reducing risks. This review aims to assess the role of liposuction in medial thighplasty by evaluating its impact on surgical outcomes and complications. Methods: This systematic review was conducted following PRISMA guidelines. A comprehensive search was performed in the MEDLINE/PubMed database using predefined keywords. A total of 52 records were identified, of which 19 studies met the inclusion criteria, encompassing 1113 patients who underwent liposuction-assisted medial thighplasty. Two independent reviewers screened and selected the studies, resolving discrepancies through discussion or consultation with a third reviewer. Data on surgical techniques, complications, and outcomes were extracted and analyzed. Statistical comparisons were performed using the Chi-square test, with significance set at p < 0.05. Results: The incorporation of liposuction significantly reduced the overall complication rate (36.75% vs. 70.68%, p < 0.001). Specific complications, including infections (1.77% vs. 9.02%), hematomas (1.30% vs. 6.77%), and seromas (8.95% vs. 24.81%), were markedly lower in the liposuction group. Conclusions: Liposuction appears to reduce complication rates and improve surgical outcomes in medial thighplasty. Further standardization of techniques and additional research on advanced liposuction technologies are necessary to refine this surgical approach and optimize patient outcomes.

BackgroundOver the past two decades, liposuction techniques have significantly evolved, moving from basic fat removal to sophisticated methods aimed at improving safety, efficiency, and cosmetic outcomes. This study evaluates the efficacy and safety of a combined approach using ultrasound-assisted liposuction (UAL) and helium plasma radiofrequency (HPRF) technology to enhance skin tightening without the need for extensive surgical interventions.MethodsWe conducted a retrospective analysis of 639 patients who underwent the combined UAL and HPRF liposuction technique. The patient cohort had an average age of 31.5 years and a mean BMI of 27.9 kg/m2. The procedure predominantly targeted the abdomen, with an average of 2.4 body areas treated per patient. Surgical duration averaged 118 minutes, with a mean aspirate volume of 1698 mL.ResultsMinimal residual skin laxity was observed in 87% of patients, and 91% achieved excellent improvement in body contouring. The complication rates were low, with minor occurrences of seroma (5.6%) and a very low incidence of infection (0.3%). This combined technique demonstrated safety and efficacy, providing significant skin tightening and reducing recovery time compared to more invasive procedures.ConclusionsThe combined use of UAL and HPRF technology offers a safe and effective method for enhancing skin tightening and improving body contouring outcomes. Despite the promising results, this study acknowledges the limitations of its retrospective design. Future prospective, multicenter studies are recommended to further validate these findings. This technique represents a significant advancement in the field of cosmetic surgery, emphasizing minimally invasive solutions with substantial esthetic benefits.Level of Evidence IVThis 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.

Accurate measurement methods for the reliable characterization of the electrical transport properties of high-temperature superconducting materials are essential for the assessment of their performances and suitability for power applications. In this study, we correlate measurements of critical current J c in a dc external magnetic field with microwave contactless measurements of the so-called pinning constant k p . While J c requires patterning of the samples and/or high probe currents, microwave measurements can be performed in as-grown films or tapes, and thus are ideal for evaluating the performances without any further process. The parametric analysis of the correlation between J c and k p shows a clear correlation, and opens up the possibility of reliably using contactless k p measurements for the evaluation of J c in pristine samples of technological superconductors.

Pure-tungsten and tungsten-aluminium films deposited by high power impulse magnetron sputtering (HiPIMS) on copper-chromium-zirconium substrates were investigated as protective coatings against liquid tin corrosion, a critical issue for nuclear fusion applications. The growth of pure-tungsten coatings was controlled by using a negative substrate bias synchronized to the HiPIMS pulse onset, resulting in columnar films with various degree of compactness and crystallinity according to the set bias amplitude (0, 400 and 800 V). Differently, the cosputtering of W and Al favored the formation of an amorphous layer with a compact morphology. During liquid tin corrosion experiments at 400 degrees C for up to 600 min, all produced coatings were not dissolved, but different protective performances were observed after localized liquid tin interaction. Pure-W coated samples suffered from tin penetration after brittle failure of the protective layer. On the contrary, under the same experimental condition, W-Al coatings proved to be effective in limiting liquid tin attack.

REBCO tapes are currently being produced by various companies, each employing unique combinations of materials and deposition processes. To effectively design and optimize their use in power devices, it is crucial to ascertain their critical field characteristics and understand their flux pinning properties. In this work, we conducted a comprehensive investigation involving electrical transport and magnetization measurements on coated conductors (CCs) produced by Shanghai Superconductor Technology Co., Ltd. (SST). Our findings reveal that the flux pinning energy of these CCs exhibits a collective pinning behavior across the entire range of magnetic fields under consideration. Moreover, the behavior of these CCs in high magnetic fields suggests that their design is well-suited for low-temperature, high-power applications.

Caliber mismatch in microvascular anastomosis can significantly increase procedural difficulty and elevate the risk of thrombosis. A comprehensive literature search in PubMed, Scopus, Web of Science, and Google Scholar was conducted to identify articles addressing surgical techniques for overcoming caliber mismatch in microvascular anastomosis. Various techniques described in the literature were found: modifications of end-to-end anastomosis, the use of end-to-side anastomosis, the application of vessel grafts and the use of vessel couplers. In this review, we critically analyze these techniques and introduce additional technical variations. We discuss the options and express our preferred choice of methods based on specific clinical scenarios: if an alternative vessel (either new or isolated further away) is not found, the severity of the mismatch guides the choice. When less then 1/3 our choice is for vessel dilation and oblique cut of the smaller vessel end (if necessary with the adjunct of a titanium small Ligaclip in an oblique fashion to avoid a cul-de-sac). If caliber mismatch is around or over 1/3, we would prefer an end to side anastomosis

Gd-YBa2Cu3O7-delta (Gd-YBCO) thin films with 10 mol% and 20 mol% excess-Gd concentration with respect to Y were investigated at the Gd L3 and Y K core absorption edges by EXAFS spectroscopy with the aim of determining the local structure of the Gd dopant. To this purpose, EXAFS data were collected also on GdBa2Cu3O7-delta (GdBCO) and pristine YBCO films and on Gd2O3 and Y2O3 model compounds for comparison with the YBCO films with Gd excess. The EXAFS analysis was based on Y and Gd oxides as well as on a cluster obtained by Density Functional Theory (DFT) where Gd atoms were inserted substitutional to Y atoms. The EXAFS data clearly reveal the incorporation of Gd in the lattice as substitute of Y and no evidence of segregated Gd oxide was found within the film matrix.

Introduction: The choice of the most adequate surgical technique for upper limb defects remains challenging. The aim of this article is to discuss the main microsurgical (pedicled or free) reconstructive options for the post-oncological reconstruction of different anatomical areas of the upper extremity. Materials and methods: We reviewed different reconstructive methods reported in the literature needing microsurgical expertise and compared them to our clinical experience, in order to provide further guidance in the choice of different flaps for upper limb soft tissue reconstruction. Six clinical cases, one for each anatomical district, are presented as examples of possible solutions. Results: We report the options available in the literature for post-oncologic upper limb reconstruction, dividing them by anatomical area and type of flap: local flaps, regional flaps, free flaps, and distant pedicled flaps. Our examples of the reconstruction of each anatomical area of the upper limb include one reverse ulnar pedicled perforator flap, one free Antero-Lateral Thigh (ALT) flow-through flap, one perforator-based lateral arm flap, two myocutaneous latissimus dorsi pedicled flaps, and one parascapular perforator-plus flap. Conclusions: In oncological cases, it is important to consider reconstructive options that provide stable tissue and allow for the early healing of the donor and recipient site if the patient needs to undergo adjuvant radiotherapy or chemotherapy. A wider range of flap options is essential when choosing the proper technique according to the patient’s needs, surgeon’s preference, and logistical possibilities. Perforator flaps combine the advantages of other flaps, but they require microsurgical expertise. Free flap reconstruction remains the gold standard to obtain a better overall and cosmetic outcome in complex and wide defects, where no suitable local pedicled flap option exists. The pedicled latissimus dorsi flap should still be included among the reconstructive options for its strong vascularization, size, and arc of transposition.

The design of new tokamak machines relying on the use of high temperature superconductors (HTS) is promoting the study of HTS properties at the operating conditions required by fusion applications. In particular, the interest in the damage induced by neutron irradiation on RE Ba 2 Cu 3 O 7-δ ( RE BCO, RE = Y or lanthanide series), one of the most used family of HTS, has recently risen and several studies have been devoted to radiation hardness tests performed with ion irradiation or fission neutrons. In this work, the effect of neutron irradiation on YBCO films and commercial RE BCO tapes was investigated using, for the first time, neutrons produced by the D-T fusion reaction. The experiment was carried out at ENEA-Frascati Neutron Generator (FNG) where a deuteron beam is accelerated up to 300 keV and directed on a tritiated target to produce a nearly isotropic 14.1 MeV neutron field via the T(d,n)α fusion reaction. Different YBCO films deposited through metal-organic decomposition (MOD) route on single crystals (SrTiO 3 and LaAlO 3 ) and RE BCO commercial tapes, grown by pulsed laser deposition, were irradiated. Samples exposed to three fluences were compared with a maximum neutron fluence of 1.2·10 14 cm −2 . The properties of HTS materials were assessed before and after irradiation by means of different techniques. From these measurements, no significant effect on the considered properties was recognized indicating the robustness of films up to the explored irradiation fluences.

It was recently shown that the introduction of nanodiamond (ND) into a superconducting metal-organic deposited YBa2Cu3O7-δ (YBCO) film produces an increase in critical current density in self-field conditions (B = 0 T). Such improvement appears to be due to the formation of denser and smoother films than the samples deposited without ND. This paper presents the work done to understand the role of ND during YBCO nucleation and growth. A detailed study on YBCO+ND films quenched at different temperatures of the crystallization process was carried out. Results showed that the reaction responsible for YBCO production appeared effectively affected by ND. In particular, ND stabilizes one of the YBCO precursors, BaF2(1-x)Ox, whose conversion into YBCO requires a prolonged time. Therefore, the YBCO nucleation is slowed down by ND and begins when the experimental conditions favor both thermodynamically and kinetically the formation of YBCO along the c-axis. This effect has important implications because the growth of a highly epitaxial c-axis YBCO film enables excellent superconducting performance.

Objective: Systemic sclerosis is characterized by endothelial dysfunction, autoimmunity abnormalities, and fibrosis of the skin and internal organs. The pathogenetic mechanisms underlying systemic sclerosis vasculopathy are still not clarified. A complex cellular and extracellular network of interactions has been studied, but it is currently unclear what drives the activation of fibroblasts/myofibroblasts and the extracellular matrix deposition. Methods: Using RNA sequencing, the aim of the work was to identify potential functional pathways implied in systemic sclerosis pathogenesis and markers of endothelial dysfunction and fibrosis in systemic sclerosis patients. RNA-sequencing analysis was performed on RNA obtained from biopsies from three systemic sclerosis patients and three healthy controls enrolled in our University Hospital. RNA was used to generate sequencing libraries that were sequenced according to proper transcriptomic analyses. Subsequently, we performed gene set enrichment analysis of differentially expressed genes on the entire list of genes that compose the RNA-sequencing expression matrix. Results: Gene set enrichment analysis revealed that healthy controls were characterized by gene signatures related to stromal stem cells proliferation, cytokine–cytokine receptor interaction, macrophage-enriched metabolic network, whereas systemic sclerosis tissues were enriched in signatures associated with keratinization, cornification, retinoblastoma 1 and tumor suppressor 53 signaling. Conclusion: According to our data, RNA-sequencing and pathway analysis revealed that systemic sclerosis subjects display a discrete pattern of gene expression associated with keratinization, extracellular matrix generation, and negative regulation of angiogenesis and stromal stem cells proliferation. Further analysis on larger numbers of patients is needed; however, our findings provide an interesting framework for the development of biomarkers useful to explore potential future therapeutic approaches.

Background: The surgical plan to reconstruct the palate must be carefully prepared given the morphological peculiarity of the soft palate forming both the roof of the mouth and the floor of the nasal cavity. This article focuses on the use of folded radial forearm free flaps to manage isolated defects of the soft palate in the absence of tonsillar pillar involvement. Methods: Three patients affected by squamous cell carcinoma of the palate underwent resection of the soft palate and immediate reconstruction with a folded radial forearm free flap. Results: All three patients showed good short-term morphological-functional outcomes as far as swallowing, breathing, and phonation were concerned. Conclusions: The folded radial forearm free flap seems to be an efficacious way to manage localized defects of the soft palate, given the positive outcomes of the three patients treated, and in accordance with other authors. In general, the radial forearm free flap was confirmed to be a versatile solution for those intraoral defects of the soft tissue requiring a limited quantity of volume as in the case of the soft palate.

Treatment of organic fecal incontinence in children, typical of anorectal malformations, is most often conservative; however, when necessary, it can be surgical. Autologous fat grafting, or lipofilling, can be used to improve fecal incontinence. We present our experience with the echo-assisted anal-lipofilling and its effects on fecal incontinence in children and on the quality of life of the entire family. Under general anesthesia, fat tissue was harvested according to the traditional technique, and processed in a closed system Lipogems® set. Injection of the processed adipose tissue was guided by trans-anal ultrasound assistance. Ultrasound and manometry were also used for follow-up. From November 2018, we performed 12 anal-lipofilling procedures in six male patients (mean age 10.7 years). Five children had a stable improvement in bowel function with Krickenbeck's scale scores going from soiling grade 3 pre-treatment in 100% of children to grade 1 post-treatment in 75% of them. No major post-operative complications developed. An increase in thickness of the sphincteric apparatus was shown at ultrasound during follow-up. The quality of life of the entire family, evaluated with a questionnaire, improved after the surgical treatment of the children. Anal-lipofilling is a safe and effective procedure to reduce organic fecal incontinence thereby benefiting both the patients and their families.

BACKGROUND AND AIM:Androgenetic alopecia (AGA) is a common chronic, hereditary, cutaneous and androgen-dependent condition. Low self-esteem and negatively impact quality of life are often consequences of AGA. Clinical treatment of AGA using SVF (Stromal vascular fraction) has been effective. In fact, hair follicle is affected by various environment factors and one of the most important factors is the vascularity of the scalp which is itself affected bySVF.METHODS:During October 2022 we carried out a systematic review to identify all scientific publications discussing about hair loss treatment with stromal vascular fraction or adipose stem cell. We selected 140 articles. After screening process, we kept 9 articles complying with inclusion criteria.  Results: No serious adverse events were reported in all studies. Despite standardized protocol was not found, all studies reported a statistically significant increase in the number (density) of hair after SVF treatment. Two studies found a significant improvement at pull test. An increase of hair diameter was noticed after treatment. The combination between medical therapy and SVF proved to be advantageous.CONCLUSIONS:SVF is nowadays at the center of studies in the field of regenerative medicine due to its potential applications in many branches of medicine and surgery. The initial results are very promising but furthermore studies are necessary to establish a methodical and systematic research capable of demonstrating its real benefits and the creation of homogenous treatment protocols.

Microsurgical techniques are an important part of clinical and experimental research. In this paper, we present our survey of Italian microsurgery training and our experience of the importance of a free access microsurgical laboratory. A cross-sectional observational study was performed by administering a questionnaire regarding the current situation about microsurgical training in Italian Plastic, Reconstructive and Aesthetic Surgery residency programs. A case–control study was performed on 12 residents divided into four groups of attendance to the microlaboratory. Two hundred and seventy-six trainees replied to the questionnaire, representing 94.7