Feasibility and safety of Heavy Lifting Strength Training in Head and Neck Cancer survivors post-surgical neck dissection (the LIFTING trial).

BACKGROUND: Light-to-moderate intensity strength training (LMST) improves muscular strength, physical functioning, and some side effects in head and neck cancer survivors (HNCS). Heavy lifting strength training (HLST) may further improve these outcomes; however, it has not been studied in HNCS. The primary aim of the LIFTING trial was to examine the feasibility and safety of a HLST program in HNCS ≥1-year post-surgical neck dissection. METHODS: In this single-arm feasibility study, HNCS were asked to complete a twice weekly, 12-week, supervised HLST program, gradually progressing to lifting heavy loads of 80-90% of 1 repetition maximum (1RM) for barbell squat, bench press, and deadlift. The feasibility outcomes included recruitment rate, 1RM completion rate, program adherence, barriers, and motivation. The preliminary efficacy outcomes included changes in upper and lower body strength. RESULTS: Nine HNCS were recruited over an 8-month period during the COVID-19 pandemic. All 9 (100%) completed the 1RM tests and successfully progressed to heavy loads at approximately 5 weeks. The median attendance was 95.8% (range 71-100%), and few barriers were reported. Weight lifted increased for squat/leg press (median change: +34kg; 95% CI +25 to +47), bench press (median change: +6kg; 95% CI +2 to +10), and deadlift (median change: +12kg; 95% CI +7 to +24). No adverse events were reported and participants were motivated to continue HLST after the study. CONCLUSIONS: HLST appears feasible and safe for HNCS and may result in meaningful improvements in muscular strength. Future research should consider additional recruitment strategies and compare HLST to LMST in this understudied survivor population. TRIAL REGISTRATION: NCT04554667.

Assessing the Impact of COVID-19 on Facial Aesthetic Surgery Search Interest.

ABSTRACT: The global COVID-19 pandemic reshaped many components of modern health care practice. Before the pandemic, research was beginning to demonstrate the impact of self-facing cameras, selfie images, and webcams on patient interest in head and neck (H&N) aesthetic surgery. We sought to determine temporal changes in patient interest in aesthetic surgery of the H&N as compared with the rest of the body because of COVID-19, and the subsequent surge in Web-conferencing and telecommunication. The 2020 Plastic Surgery Trends Report produced by the American Society of Plastic Surgeons was used to identify the 5 most common aesthetic surgical procedures performed on the H&N and the rest of the body for 2019: blepharoplasty, face lift, rhinoplasty, neck lift, cheek implant, and breast lift, liposuction, tummy tuck, breast augmentation, and breast reduction, respectively. Google Trends filters, which provide relative search interest for greater than 85% of Internet searches, were applied to gauge interest from January 2019 to April 2022. Relative search interest and mean interest were plotted as a function of time for each term. Our findings demonstrate a sharp decline in online aesthetic surgery interest in March 2020, coinciding with the beginning of the COVID-19 pandemic for both the H&N and the rest of the body. Search interest increased shortly after March 2020 and reached values greater than those of the prepandemic year (2019) in 2021 for rest of the body procedures. After March 2020, there was a brief, sharp increase in search interest for rhinoplasty, neck lift, and facelift, whereas patient interest in blepharoplasty increased more gradually. There was no increase in search interest for H&N procedures as a result of COVID-19 when using the mean values of the included procedures, although current interest has returned to prepandemic levels. The COVID-19 pandemic caused a disruption of normal trends in aesthetic surgery interest, with a sharp decline in search interest in March 2020. Afterward, there was a sharp increase in rhinoplasty, face lift, neck lift, and blepharoplasty interest. Patient interest in blepharoplasty and neck lift has remained elevated compared with 2019. Interest in rest of the body procedures has returned to and even surpassed prepandemic levels.

Impact of Implementing and Lifting COVID-19 Lockdown on Study and Physical Activity Patterns Among Youths in China.

OBJECTIVE: The youths' study and physical activity (PA) patterns may have been affected by lockdown measures due to COVID-19. This study aimed to reveal how youths' study and PA patterns had changed after implementing and lifting COVID-19 lockdown in China. METHODS: The COVID-19 Impact on Lifestyle Change Survey (COINLICS) was used, where 10082 youth participants voluntarily reported their study and PA patterns in the 3 periods before, during, and after COVID-19 lockdown. PA was measured as the weekly frequency of engaging in active transport for commuting/errands, leisure-time walking, leisure-time moderate-/vigorous-intensity physical activity (MVPA), and moderate-/vigorous-intensity housework (MVH); study patterns were measured as the daily average study time and the major study modes. We assessed differences of these variables across educational levels, sex, and periods. RESULTS: The significant decreases were generally observed during lockdown in the frequency of active transport for commuting/ errands (1.3 to 0.2 days/ week), leisure-time walking (1.0 to 0.2 days/ week), leisure-time MVPA (0.7 to 0.3 days/ week), and MVH (2.3 to 2.0 days/ week), with heterogeneities existing between sexes and across educational levels, except for the increase in MVH engagement among graduate students, especially female (1.5 to 2.4 days/ week). Rebounds were observed in the frequency of all activities except MVH after lifting lockdown (2.0 to 1.9 days/ week). The average study time generally increased during lockdown, with more youths studying for 1 - 4 hours/ day and less studying for < 1 hour/ day, and further increased after lockdown. A main shift of study modes has been from in-class to online study after implementing lockdown. CONCLUSIONS: The youths' PA level have generally decreased, and study patterns significantly changed during and after lockdown in China. Our results would inform policymakers and educational administrators of the declined PA levels and changed study patterns among youths during COVID-19 lockdown for better policy making. In - class and/ or extracurricular PA programs could be designed to counteract those effects under cooperation of youths' parents.

Decline in reported measles cases in Italy in the COVID-19 era, January 2020 - July 2022: The need to prevent a resurgence upon lifting non-pharmaceutical pandemic measures.

From January 2020 to July 2022, 120 measles cases were reported to the Italian national surveillance system, of which 105 had symptom onset in 2020, nine in 2021 and six in the first seven months of 2022. This represents a sharp decline compared to the time period immediately preceding the COVID-19 pandemic, most likely due to the non-pharmaceutical interventions implemented to prevent SARS-CoV2 transmission. Of 105 cases reported in 2020, 103 acquired the infection before a national lockdown was instituted on 9 March 2020. Overall, one quarter of cases reported at least one complication. As non-pharmaceutical pandemic measures are being eased worldwide, and considering measles seasonality, infectiousness, and its potential severity, it is important that countries ensure high vaccination coverage and close immunity gaps, to avoid risk of future outbreaks.

Evaluation of the HeroWear Apex back-assist exosuit during multiple brief tasks.

Trunk exoskeletons are wearable devices that support humans during physically demanding tasks by reducing biomechanical loads on the back. While most trunk exoskeletons are rigid devices, more lightweight soft exoskeletons (exosuits) have recently been developed. One such exosuit is the HeroWear Apex, which achieved promising results in the developers' own work but has not been independently evaluated. This paper thus presents an evaluation of the Apex with 20 adult participants during multiple brief tasks: standing up from a stool with a symmetric or asymmetric load, lifting a unilateral or bilateral load from the floor to waist level, lifting the same bilateral load with a 90-degree turn to the right, lowering a bilateral load from waist level to floor, and walking while carrying a bilateral load. The tasks were performed in an ABA-style protocol: first with exosuit assistance disengaged, then with it engaged, then disengaged again. Four measurement types were taken: electromyography (of the erector spinae, rectus abdominis, and middle trapezius), trunk kinematics, self-report ratings, and heart rate. The exosuit decreased the erector spinae electromyogram by about 15% during object lifting and lowering tasks; furthermore, participants found the exosuit mildly to moderately helpful. No adverse effects on other muscles or during non-lifting tasks were noted, and a decrease in middle trapezius electromyogram was observed for one task. This confirms that the HeroWear Apex could reduce muscle demand and fatigue. The results may transfer to other exoskeletons with similar design principles, and may inform researchers working with other wearable devices.

Resumption of the treatment of non-COVID-19 gynecologic patients after lifting lockdown: Triage and infection prevention experiences from Wuhan.

AIM: To share our experiences of resuming the treatments for gynecologic patients after lifting the lockdown in a hotspot area for the Coronavirus Disease 2019 (COVID-19) pandemic. METHODS: The triage process used to resume medical activities for gynecologic patients at the Wuhan Union Hospital after a 76-day lockdown of the city is described, and its effectiveness in preventing COVID-19 nosocomial transmission is shown. RESULTS: Nonemergency patients were pretriaged based on their contact history and body temperature at an outpatient clinic, and negative COVID-19 screening test results were required for admission to the buffering rooms at the gynecologic department. The buffering lasted at least 3 days for symptom monitoring, and a second round of COVID-19 testing was required before patients could be transferred to the regular gynecologic wards. For patients who needed emergency surgery, the first screening was completed at the isolation wards after surgery, followed by buffering at the gynecologic department. We received 19 298 outpatient visits, admitted 326 patients, and performed 223 operations in the first 2 months after the lockdown was lifted. No COVID-19 cases occurred in the hospitalized patients, while the proportion of potentially high-risk patients with cancer and severe anemia was increased in comparison to that observed during the same period in 2019 and the first 2 months of 2020 before the lockdown. CONCLUSIONS: We provide an effective triage system with buffering at two levels to guarantee safe and timely treatment for non-COVID-19 gynecologic patients in the postlockdown phase.

High Superficial Musculoaponeurotic System Lamellar Facelift Under Local Anesthesia.

PURPOSE: Patients, nowadays, prefer easy, low-risk, day-case procedures under local anesthesia for facial rejuvenation. Therefore, they favor facelift operations applied under local anesthesia. MATERIALS AND METHODS: A total of 160 patients who underwent high superficial musculoaponeurotic system (SMAS) lamellar facelift under local anesthesia between 2010 and 2020 were included in this study. Patients operated under general anesthesia were excluded from this study. High SMAS lamellar facelift under local anesthesia was performed in all patients, consisting of 145 women and 15 men without any additional disease aged between 38 and 65 years. About 140 of these patients underwent primary facelift, whereas 20 of them had undergone SMAS plication more than 10 years ago. Lidocaine was used as a local anesthetic and the patients were not sedated. The duration of the operation was 80 minutes on average. The patients were left to rest for 1 hour after the operation and then sent home until their follow-up every other day for the first week. RESULTS: This study shows that high SMAS facelift operations for the mid-face can easily be performed under local anesthesia under operating room conditions without sedation. However, an important point to keep in mind is that although the results of this surgery satisfy the patients, the outcomes do not entirely match the expectations from total face and neck lift performed under general anesthesia. High SMAS facelift with local anesthesia should be considered as an alternative for patients who do not want to undergo general anesthesia or who are at risk of undergoing general anesthesia. Especially during the COVID-19 pandemic, local anesthesia was considered much safer for the patients.Level of evidence: Level V.

Oculofacial plastic surgery-related online search trends including the impact of the COVID-19 pandemic.

Purpose: The authors aim to characterize oculofacial plastic surgery-related online interest that may be useful in forecasting demand and in designing patient-directed online resources. Methods: The authors queried Google Trends for over 100 oculofacial plastic surgery terms. The main outcome measure was the top 50 oculofacial plastic surgery-related search terms from 2004 to 2020. Secondary outcomes were trends, including seasonality, and search volume changes during the COVID-19 lockdown (March-May 2020) compared to 2018-2019. Terms were analyzed individually and in thematic categories; controlled against generic search terms to account for general internet traffic. Results: Between 2004 and 2020, searches for oculofacial plastic surgery altogether increased, surpassing the rate of internet traffic growth. One thematic category - eyelid malpositions - decreased month-over-month. The top five terms were "face lift," "Bell's palsy," "puffy eyes," "dark circles under eyes," and "chalazion." Eyelid neoplasms searches peaked in summer (R2  = 0.880) whereas cosmetic (R2  = 0.862), symptoms (R 2 = 0.907), and surgeries (R 2 = 0.140) peaked in winter. Overall, oculofacial-related searches decreased during the COVID-19 lockdown, although thyroid eye disease interest increased compared to 2018 or 2019 (+68.6%; adj. p = .005). Oculofacial plastic surgery interest in 2020 was inversely correlated to "COVID-19" searches (r = -0.76, p < .001). Conclusions: Oculofacial plastic surgery searches increased since 2004 at a pace greater than that ascribed to internet traffic growth. The most searched terms were "face lift," "Bell's palsy," "puffy eyes," "dark circles under eyes," and "chalazion." Almost all oculofacial-related searches decreased during the COVID-19 lockdown.

Coronavirus Disease-19 and Rhinology/Facial Plastics.

This review summarizes the challenges and adaptations that have taken place in rhinology and facial plastics in response to the ongoing coronavirus disease-19 pandemic. In particular, the prolonged exposure and manipulation of the nasal and oral cavities portend a high risk of viral transmission. We discuss evidence-based recommendations to mitigate the risk of viral transmission through novel techniques and device implementation as well as increasing conservative management of certain pathologies.

A Google Trends Analysis of Facial Plastic Surgery Interest During the COVID-19 Pandemic.

The COVID-19 pandemic has had a multitude of effects on daily life. Aesthetic and cosmetic surgery practices have been significantly reduced in their working capacity or closed during this time. We used Google Trends to gauge the public's interest in facial plastic surgery during this pandemic, and how it has changed over the preceding months. As local shelter-in-place orders are being lifted, interest in facial plastic surgery is increasing even in the context of an ongoing national pandemic. LEVEL OF EVIDENCE V: Letter to the Editor.