Search Results (201,128)

The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE), with more than 700 members, represents one of the most relevant conference meetings in Europe relating to Aesthetic Plastic Surgery due to the number of participants and due to the faculty of invited speakers chosen for their renowned scientific value. The 13th meeting was held in Rome (Italy) from 10 to 12 April 2026. Key focus areas of the scientific program concerned breast (reduction, lifting supported or not by mesh, implant surfaces, augmentation), face and neck (lifting, blepharoplasty, malar implants, feminization), body (abdominoplasty and torsoplasty, post-partum and ex-obesity surgery, body and limb contouring, complication treatments) and nose surgery combined with medical innovations in energy devices, threads and aesthetic medicine procedures. Special attention was also given to the theme of the therapeutic role of aesthetic surgery, which is increasingly becoming an integral part of a clinical pathway useful for restoring the patient’s psycho-physical balance. Presented here is a report of the abstracts accepted due to their innovative or cutting-edge content that were selected to be given as oral presentations during the congress sessions. The 2nd edition of the Saccomanno memorial award for the best abstract presented by a young surgeon has been organized with the endorsement of Surgical Techniques Development by MDPI. Full article

Chronic limb-threatening ischemia (CLTI) in patients with no conventional targets for revascularization presents a formidable challenge in limb salvage. Deep venous arterialization (DVA) is an emerging endovascular approach that redirects arterial blood flow into the venous system to perfuse the ischemic foot. Despite early promising results, appropriate wound management of the ischemic foot following a DVA procedure has been described in the literature, albeit infrequently and with limited standardization. Here, we present a case of an 85-year-old male with multiple comorbidities, including peripheral artery disease and a prior right above-knee amputation (AKA), who underwent a successful left-sided DVA following an open transmetatarsal amputation (TMA) for infection. A staged wound care approach with guillotine amputation, delayed revision and skin grafting ultimately preserved his only remaining limb and allowed for ambulation. This case underscores the potential of DVA as a limb-saving option in complex “no-option” patients when paired with multidisciplinary care and tailored wound management. Full article

Despite the growing attention paid to sustainability education, limited quasi-experimental research has examined how metacognitive guidance can integrate cognitive, affective, and agency-oriented learning in food-related climate education. This classroom-based quasi-experimental study, complemented by student interviews, investigated a six-lesson metacognitive guidance-based unit designed to strengthen ninth-grade students’ sustainable food literacy (SFL), climate-change perceptions and attitudes, and constructive hope. Participants were 59 students from two intact classes in northern Israel; one class received the intervention, and the other received traditional instruction on the same content. Quantitative data were collected through a sustainable food and climate change knowledge test and a climate change literacy questionnaire and were analyzed using mixed-design repeated-measures ANOVA, t-tests, and multiple regression. Qualitative data were obtained from individual semi-structured interviews with students in the experimental group. Results indicated significant intervention-related gains in SFL knowledge, climate-change perceptions, climate-change attitudes, and constructive hope, with moderate-to-large time × group effects across the main outcomes (partial η² = 0.16–0.33). Climate-change perceptions emerged as the strongest post-intervention predictor of constructive hope (β = 0.92, p < 0.001). Interviews illustrated how reflective prompts, self-monitoring, discussion, and learning artifacts supported conceptual understanding, moral responsibility, perceived agency, and self-reported short-term intentions for sustainable food choices. The findings suggest that metacognitive guidance can support integrative, hope-oriented sustainability learning among adolescents. These findings should be interpreted cautiously given the small non-random sample, the use of two intact classes, the short six-lesson intervention, and the reliance on short-term self-reported outcomes. The study’s novelty lies in integrating sustainable food literacy, climate-change perceptions and attitudes, and constructive hope within a metacognitively guided food–climate unit in a culturally underrepresented Druze school context. Full article

Background: Strychnos madagascariensis Poir (Loganiaceae) is a drought-tolerant indigenous fruit tree of East and southern Africa, valued for its food, medicinal, and socio-economic contributions to rural communities. Despite its importance as a candidate food crop, intraspecific morphological and genetic diversity had not previously been characterized, and no simple sequence repeat (SSR) markers had been developed for this species, leaving breeders and conservation planners without the basic diversity baseline needed to prioritize material for domestication. Methods: This study assessed vegetative and reproductive trait variation, variance components, and broad-sense heritability, and SSR-based genetic diversity among 27 morphologically defined S. madagascariensis morphotypes at Bonamanzi Game Reserve, KwaZulu-Natal, South Africa. Three trees were measured per morphotype (81 trees total), over two growing seasons. Genetic diversity was characterized in one representative tree per morphotype using seventeen newly developed SSR loci, the first such markers reported for this species, and analyzed with population structure (STRUCTURE version 2.3.4), PCA, and Nei’s genetic distance. Results: Twenty-seven morphotypes were identified based on leaf colour, shape, hairiness and size, dominated by grey (41%), elongated (59%), less hairy (48%), and medium-sized (>50–90 mm) leaves. Fruit diameter and mass showed the highest inter-morphotype variation (r = 0.949) and also the highest broad-sense heritability (H² = 55.3% and 47.8%, respectively), indicating strong genetic control of these traits and their suitability as targets for selective breeding. Environmental variance exceeded genotypic variance for most traits. A total of 144 alleles were identified across 17 SSR loci (mean 4.24 alleles/locus; mean PIC = 0.31). Population structure gave a preliminary, tentative signal of two genetic clusters (K = 2) with substantial admixture, which we interpret cautiously, given the limited sampling depth. Conclusions: This is the first study to characterize intraspecific morphological variation in S. madagascariensis and the first to develop SSR markers for the species. The results provide a preliminary, single-site framework for conservation genetics and crop improvement that should be validated with larger, multi-site samples. Grey morphotypes GyEvH1, GyEvH2, GyEvH3, GyRlH1 and GyEH2 combined consistent fruiting performance with favourable fruit-trait values and are proposed as priority candidates for further evaluation in domestication and breeding programmes. Full article

Background/Objectives: Chronic primary pain (CPP) is a new diagnostic category including chronic pain conditions lacking clinical signs or a clear etiopathogenetic origin. These disorders may share a common neural mechanism known as central sensitization, where nociceptive neurons become hyper-responsive to standard or subthreshold pain stimuli, resulting in pain hyper-sensitivity. In this context, non-invasive brain stimulation (NIBS) appears to be a promising tool for improving CPP symptoms by targeting maladaptive brain activity and connectivity. To date, the effects of NIBS on CPP symptoms remain unexplored. To fill this gap, we conducted a meta-analysis, investigating the effect of NIBS in improving the three core symptoms of CPP, namely pain intensity, emotional distress, and functional disability. Methods: Following PRISMA guidelines, we screened four databases up to February 2025 for English-language, peer-reviewed randomized clinical trials that included CPP patients treated with NIBS and reported pre/post or follow-up scores on validated measures of at least one core symptom. Quality of life was examined as an additional outcome. Results: Fifty-four studies were included, with 1371 participants receiving real stimulation and 1103 sham. Findings highlighted that real stimulation improved CPP symptoms immediately after treatment and at one-month follow-up. Meta-regressions showed that longer CPP duration reduced short-term effects on emotional distress and diminished all outcomes at one-month follow-up. Conclusions: Further research is needed to establish standardized NIBS protocols for CPP management, to investigate the effectiveness at longer follow-up periods, and to test whether combining NIBS with other interventions enhances treatment effectiveness and durability. Full article

While individual determinants of students’ well-being are well established, less is known about the association with the institutional context. This study evaluates institutional-level factors associated with students’ mental health while controlling for individual characteristics. The cross-sectional analysis used data from 12 German institutions (n = 13,715) collected in the StudiBiFra survey on study conditions and student mental health. Individual-level variables included gender, age, study subject group, and four mental health variables (general well-being, depressiveness, cognitive stress, and exhaustion). Institution-level variables comprised institution type, excellence status, multi-campus structure, size, and satisfaction with the quality of health promotion services. Multilevel binary logistic regression models were applied to examine associations between institutional characteristics and mental health outcomes, adjusting for individual factors. Students enrolled at universities of applied sciences showed a lower likelihood of reporting depressiveness and exhaustion. Higher levels of depressiveness and cognitive stress were observed among students at medium-sized institutions compared to small ones. Students not enrolled at institutions with excellence status had lower risks of depressiveness, stress, and exhaustion. Additionally, higher satisfaction with institutional health promotion services was associated with reduced odds of depressiveness. Institutional factors are related to students’ mental health beyond individual characteristics, highlighting the need for a holistic, setting-based approach. Full article

Background: Physical activity is a key modifiable factor influencing healthy aging, yet data on activity patterns and their physiological correlates in older adults from Central Asia remain limited. Understanding these relationships is essential for informing region-specific health promotion strategies. Objectives: This study assessed physical activity levels among urban-dwelling older adults in Astana, Kazakhstan, and examined associations between activity level, body composition, visceral fat accumulation, metabolic indicators, and muscle strength. Methods: A cross-sectional study was conducted among 608 adults aged ≥60 years (median age: 68 years; 82.1% women). Physical activity was measured using the validated Physical Activity Scale for the Elderly (PASE). Anthropometric and body composition indicators, including BMI, total and visceral fat, skeletal muscle mass, and handgrip strength, were evaluated. Spearman correlation and linear regression analyses were applied. The analyses were exploratory and did not include adjustment for potential confounders such as sex, chronic disease burden, or socioeconomic status; therefore, the observed associations should be interpreted with caution. Results: The median PASE score was 55.55, with 61.8% of participants demonstrating moderate activity levels, primarily through walking and household tasks. In analyses without adjustment for potential confounding factors, PASE scores showed weak inverse associations with visceral fat (ρ = −0.214; p < 0.001) and waist-to-hip ratio (ρ = −0.154; p < 0.001), as well as weak positive associations with handgrip strength. Across the reported significant associations, correlation coefficients ranged from |ρ| = 0.103 to 0.235, and the explanatory capacity of the regression models was low, with R² values ranging from 0.6% to 8.2%. Conclusions: Higher habitual physical activity may be linked to selected bioelectrical impedance parameters, WHR, and handgrip strength among urban older adults. Given the cross-sectional design, causal interpretation should be approached with caution. These findings provide meaningful regional baseline evidence for future longitudinal and intervention studies on physical activity and healthy aging in Central Asia. Full article

Circulating ketone bodies (KBs), particularly β-hydroxybutyrate (β-HB), have emerged as metabolites with dual roles as both oxidative fuels and metabolic signaling molecules. Beyond serving as an alternative energy substrate, β-HB regulates diverse pathways involved in oxidative stress, inflammation, and mitochondrial function. However, the clinical implications of circulating KBs remain uncertain. This review summarizes current evidence regarding the potential role of KBs in glycemic progression and diabetic cardiomyopathy (DCM). Epidemiologic and experimental studies report conflicting associations between KB levels and the progression to hyperglycemia or type 2 diabetes, with some findings suggesting that elevated KB levels may reflect a metabolically favorable phenotype or a compensatory mechanism, whereas others indicate links to worsening glycemia. Similarly, studies in DCM have produced divergent results, with β-HB reported to improve mitochondrial function and cardiac performance in some models while contributing to metabolic inflexibility and adverse cardiac remodeling in others. We discuss potential mechanisms underlying these discrepancies and propose that the metabolic effects of β-HB are context-dependent, influenced by factors such as circulating concentration, the mode of ketosis induction, and the underlying metabolic or disease stage. Understanding these contextual determinants may help clarify whether β-HB represents an adaptive metabolic signal or a maladaptive substrate shift in cardiometabolic disease. Full article

Deep learning models for power quality (PQ) disturbance classification remain critically vulnerable to adversarial perturbations, with classification performance degrading severely under white-box attacks. Existing defenses address individual models in isolation and provide no mechanism for operators to assess whether the system is under attack or which classifier remains trustworthy. This paper proposes a two-stage framework that combines adversarial training with large language model (LLM) reasoning to improve both robustness and interpretability. In the first stage, four architecturally diverse classifiers, including a proposed Multi-Scale Temporal Attention Network (MSTAN), are evaluated under four adversarial attacks (FGSM, PGD, C&W, and UAP), and their failure patterns are recorded as structured vulnerability fingerprints. The ensemble is then retrained via adversarial training on mixed clean and perturbed signals. In the second stage, an LLM analyzes the ensemble predictions alongside the fingerprint knowledge base to perform attack detection, fingerprint-guided meta-classification, and operator-facing threat report generation. On a 17-class, 255,000-signal synthetic benchmark, adversarial training recovers FGSM and PGD accuracy from below 25% to the 53–78% range, with MSTAN achieving the highest post-training robustness (78.26% under FGSM, 65.41% under PGD). The LLM reasoning layer provides an additional 3.5–6.2 percentage point improvement over majority voting by selecting the most reliable ensemble member based on the inferred attack condition, and detects adversarial attacks with 87.6% overall accuracy. To our knowledge, this is the first integration of LLM-based ensemble reasoning into the PQ adversarial robustness pipeline and the first application of the C&W optimization attack to power quality signals. Full article

Plastic pollution in terrestrial and freshwater environments and its accumulation along food chains has been poorly studied in birds. In this paper we reported evidence of microplastic (MP) contamination in pellets collected in rural and urban sites for a set of species: common kestrel, Falco tinnunculus; great cormorant, Phalacrocorax carbo; barn owl, Tyto alba; little owl, Athene noctua; long-eared owl, Asio otus; Eurasian scops owl, Otus scops; European bee-eater, Merops apiaster; and little egret, Egretta garzetta. A total of 559 pellets were collected and analyzed; among them, 78 microplastics were found on 77 pellets (13.8% compared to the total number of pellets sampled). The following polymers were recorded: polyvinylchloride (PVC), polyethylene (PE), expanded polyester (EPS), polyethylene terephthalate (PET), polybutylene terephthalate (PBT), polyester (PES), polymethyl acrylate (PMA), rubber, and starch-based biopolymer. We found significantly higher MP frequency in the most anthropized site. Pellets with the highest number of microplastics were those produced by Falco tinnunculus, Asio otus, and Tyto alba, with 30.0%, 29.6%, and 27.1%, respectively. Of a total sample of 78 MP items, 59.0% are represented by fibers, 23.1% by fragments and 17.9% by films. Among the microplastics, fragments of balloons (in a remote area) and biopolymer shopping bags were found. Our results suggest that pellet analysis may represent a cost-effective method for monitoring MP contamination along food chains in terrestrial ecosystems. Full article

Background: The transition toward sustainable development models has increased the relevance of the circular economy (CE) as a strategy for improving resource efficiency and reducing environmental impacts. In this context, higher education may contribute to strengthening sustainability-oriented competencies and environmental awareness among university students. Methods: This study aimed to assess differences in knowledge of the circular economy, perceptions regarding higher education in circular economy education, and sustainability dimensions among university students in Peru, Colombia, and Mexico. A quantitative, non-experimental, cross-sectional design was adopted using a structured questionnaire administered to 702 university students. The analysis included descriptive statistics, the Kruskal–Wallis test, and Dunn’s post hoc comparisons. Results: The results showed significant differences among countries regarding knowledge of CE principles, sustainability initiatives, and perceptions associated with higher education in circular economy education. Peruvian students generally reported higher levels of knowledge and more positive perceptions across several indicators, whereas Mexican students presented comparatively lower scores. Differences were also identified across the environmental, social, and economic dimensions of sustainability, particularly in the economic dimension. Conclusions: Overall, the findings suggest that higher education may support the development of CE-related competencies and sustainability-oriented educational strategies within diverse Latin American contexts. Full article

This study compares environmental goal-setting and monitoring priorities of EMAS-registered and non-EMAS organizations in the European Union. Using a dataset of 847 organizations and exploratory factor analysis, it examines differences in the structure of environmental objectives and indicators. The results show that EMAS-registered organizations prioritize operational performance and continuous improvement, while non-EMAS organizations focus more on regulatory compliance, awareness-building, and external communication. EMAS participation is associated with a more integrated and strategic approach to environmental management, linking objectives with measurable performance indicators. In contrast, non-EMAS organizations often adopt more symbolic or externally oriented practices driven by legal and reputational concerns. To isolate the effects of formal verification and transparency, ISO 14001 certification is not treated separately; instead, EMAS organizations are compared with all non-EMAS entities. The findings provide new empirical evidence on how voluntary environmental schemes shape organizational behavior by improving alignment between goals and indicators. They also offer practical guidance for organizations preparing for the EU Corporate Sustainability Reporting Directive (CSRD) and European Sustainability Reporting Standards (ESRS), highlighting EMAS as a model for credible, performance-based environmental reporting. Full article

Background: Obesity among Saudi adolescents has risen sharply, yet whether school athletic participation is associated with students showing improved dietary habits and better anthropometric profiles compared to those of their non-athlete peers remains unclear. This study compared anthropometric indices and dietary habits between school athletes and non-athletes in Riyadh. Methods: A cross-sectional study was conducted with 124 male secondary school students (70 athletes and 54 non-athletes aged 16–17 years) in Riyadh, Saudi Arabia. Athletes were defined as students who reported engaging in vigorous-intensity sport for ≥3 days/week for ≥60 min/session. BMI, body weight, and waist circumference were measured objectively. Dietary habit frequencies across ten food categories were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used; effect sizes were calculated as Cohen’s d. A Bonferroni-corrected threshold (p < 0.005) was applied for multiple dietary comparisons. Results: Athletes had significantly lower BMI (23.64 ± 5.39 vs. 30.28 ± 7.25 kg/m²; p < 0.001, d = 1.06), body weight (p < 0.001, d = 0.93), and waist circumference (85.46 ± 12.61 vs. 95.50 ± 17.89 cm; p < 0.001, d = 0.66). Obesity prevalence was 15.7% among athletes versus 51.9% among non-athletes. Of ten dietary variables, only fresh fruit consumption showed a between-group difference (62.9% vs. 40.7% high-frequency; p = 0.010), which did not survive Bonferroni correction. Conclusions: School athletes demonstrated substantially better anthropometric profiles than their non-athlete peers, but dietary habit frequencies were largely similar across both groups. The high obesity prevalence among non-athletes underscores the need for school-based programs that combine structured physical activity with targeted nutrition education. Full article

The development of digital learning technologies has introduced innovative tools to enhance science and chemistry education, including PhET simulations. This study aims to evaluate the effectiveness of PhET simulations on students’ learning outcomes through a systematic literature review following the PRISMA 2020 guidelines. A systematic search of Scopus and Crossref databases was conducted (last search: January 2026) using predefined keywords. Eligible studies were empirical research published between 2020 and 2026 that investigated PhET simulations in science-related education and reported learning outcomes, while non-empirical studies and non-Scopus-indexed articles were excluded. Risk of bias was assessed using an adapted Joanna Briggs Institute critical appraisal tool. Due to heterogeneity in study designs and outcome measures, the results were synthesized using a narrative approach. A total of 14 studies across elementary to higher education levels were included. The findings indicate that PhET simulations consistently improve learning outcomes, particularly academic achievement and conceptual understanding, with effects generally favoring simulation-based instruction over traditional methods. However, higher-order skills and affective outcomes such as motivation and attitude remain less frequently investigated. The evidence is limited by variability in study designs, incomplete reporting of non-cognitive outcomes, and the absence of quantitative synthesis. Overall, PhET simulations demonstrate strong potential as an effective interactive learning medium, although their impact depends on instructional design, teacher facilitation, and technological accessibility. Full article

This work examines how well a Negative Derivative Feedback (NDF) controller suppresses vibration in a nonlinear electromechanical oscillator that is subjected to mixed excitations. Coupled nonlinear ordinary differential equations are used to model the system and show how mechanical and electrical components interact. The method of multiple scales (MMS) is used to develop analytical approximate solutions up to the second order, specifically for the primary resonance scenario. This study’s main contribution is a thorough bifurcation analysis and proof of the NDF controller’s high efficacy, which effectively lowers the first and second mode resonance amplitudes by roughly $99.8\%$ and $98\%$., respectively, with impressive reported effectiveness values of roughly 590 and 51.5. Additionally, the quantitative error analysis between the numerical simulation and the analytical approximation solution demonstrates a high degree of agreement, with a maximum error of less than ${10}^{-5}\%$ for the second mode and just $0.01\%$ for the first mode. Furthermore, we present the impact of parameters on FRCs. Frequency response curves (FRCs) are used in a thorough comparison analysis to assess the behavior of the system both before and after the controller is activated. A strong degree of connection between the analytical conclusions and numerical simulations carried out using the “fourth-order Runge–Kutta method” rigorously validates the accuracy of the perturbation analysis. Additionally, a performance benchmark between different control techniques, such as the NDF controller, Positive Position Feedback (PPF), and Linear Negative Position Feedback (LNPF), is shown in the paper. When compared to alternative approaches, the NDF controller shows the greatest reduction in oscillation amplitudes and higher robustness, as shown by transient response analysis (time history) at various time intervals. The outcomes validate the NDF approach’s dependability and efficiency in stabilizing intricate nonlinear electromechanical systems. The chaotic response and system periodicity were demonstrated through bifurcation diagrams and Poincaré maps. Full article