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In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements. A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements. Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08). This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.

Thanks to the identification of new copies of the Cancionero de Zaragoza (two of the edition of 1492 and one of 1495) it is now possible to establish the essential guidelines of its material and internal structure. The data now available contribute to a more careful bibliographical description, which in turn leads to a correct chronological distribution of the copies and a more accurate reconstruction of their historical development. On the basis of the materiality of these precious incunabula, it is possible to delve deeper into questions that cover not only the dimension of the copy as an individual element, as a specific object or piece of a specific collection, but also, through these material features, it is possible to approach the model of the edition as the product of a cultural design or plan, animated by a specific intention and aimed at a specific public. This process of analysis, which goes from the copy to the edition, allows us to reconstruct the ideal copy of of this songbook and to shed light on its organisation and the aims of this editorial project, which is an important piece in the history of Castilian literature at the end of the 15th century.

Thanks to the identification of new copies of the Cancionero de Zaragoza (two of the edition of 1492 and one of 1495) it is now possible to establish the essential guidelines of its material and internal structure. The data now available contribute to a more careful bibliographical description, which in turn leads to a correct chronological distribution of the copies and a more accurate reconstruction of their historical development. On the basis of the materiality of these precious incunabula, it is possible to delve deeper into questions that cover not only the dimension of the copy as an individual element, as a specific object or piece of a specific collection, but also, through these material features, it is possible to approach the model of the edition as the product of a cultural design or plan, animated by a specific intention and aimed at a specific public. This process of analysis, which goes from the copy to the edition, allows us to reconstruct the ideal copy of of this songbook and to shed light on its organisation and the aims of this editorial project, which is an important piece in the history of Castilian literature at the end of the 15th century. Gracias a la identificación de nuevos ejemplares del Cancionero de Zaragoza (dos de la edición de 1492 y uno de la de 1495) es hoy posible fijar de forma más concreta las pautas esenciales de su estructura material e interna. Los datos de los que hoy se dispone contribuyen a una descripción bibliográfica más cuidada, que a su vez comporta una correcta distribución cronológica de los ejemplares y una reconstrucción más exacta de sus avatares históricos. A partir de la materialidad de estos preciosos testimonios poéticos incunables, se puede profundizar en cuestiones que abarcan no solo la dimensión del ejemplar como elemento individual, como objeto o pieza concreta de una colección determinada, sino que, a través de esos rasgos materiales, es posible acercarse al modelo de la edición en cuanto producto de un diseño o plan cultural, animado por un intento específico y dirigido a un público concreto. Este proceso de análisis que va del ejemplar a la edición, permite reconstruir la copia ideal del Cancionero de Zaragoza y arrojar luz sobre su organización y las perspectivas de este proyecto editorial, que marca un hito en la historia de la literatura castellana de finales del siglo xv.

En este artículo se ofrece una edición crítica y anotada de las que se conocen como Coplas a Nuestro Señor (ID6942), poema anónimo que remata la traducción en coplas de arte menor de los Disticha Catonis al cuidado de Martín García Puyazuelo, publicada alrededor de 1490 en la imprenta zaragozana de los Hurus (90*DC). El estudio que precede la edición enmarca la obra en su contexto y ahonda en el tema de su autoría, que con fundamento puede atribuirse al propio traductor de la obra latina, que, con este texto liminar (o marginal, si se prefiere), quiso rematar su obra.

En este artículo se ofrece una edición crítica y anotada de las que se conocen como Coplas a Nuestro Señor (ID6942), poema anónimo que remata la traducción en coplas de arte menor de los Disticha Catonis al cuidado de Martín García Puyazuelo, publicada alrededor de 1490 en la imprenta zaragozana de los Hurus (90·DC). El estudio que precede la edición enmarca la obra en su contexto y ahonda en el tema de su autoría, que con fundamento puede atribuirse al propio traductor de la obra latina, que, con este texto liminar (o marginal, si se prefiere), quiso rematar su obra.

Se dan a conocer tres versiones de textos de Lope en dos Cancioneros españoles copiados en Roma a principios del xvii. Son testimonios poco conocidos, ambos guardados en el fondo Corsini de la Accademia dei Lincei de Roma: el Ms. Corsini 625, que es musical (textos 1 y 2), y el Ms. Corsini 970 (texto 3). Los poemas lopescos que nos transmiten son: 1) Esto que me abrasa el pecho (5 estrofas de 9 vv. que constituyen el canto de Olimpio en el Libro III de la Arcadia de 1598); 2) En esta larga ausencia (4 estrofas de 6 vv. que constan en otras fuentes musicales); 3) Aquel sangriento paño descogiendo (3 octavas de endecasílabos pertenecientes a la comedia El bastardo Mudarra, de 1612, que terminan todas con la cita del verso de Garcilaso, Ay dulces prendas por mi mal halladas). Se editan las tres versiones romanas y se estudia el texto que nos transmiten.

Introduction Ex-obese patients present with redundancy of abdominal skin and soft tissue due to massive weight loss (MWL). The plastic surgeon can restore the body shape through body contouring procedures. Hence the need to adequately direct patients to body contouring by identifying suitable candidates exists. Our work aims to retrospectively analyze the abdominoplasty complications in our case series to identify associated risk factors and evaluate the effect of combined procedures on abdominoplasty outcomes. Materials and Methods We retrospectively investigated predictive factors of abdominoplasty procedure complications on 213 MWL patients who received abdominoplasty with and without rectus sheath plication, abdominal liposuction, and other body contouring procedures. We identified risk and protective factors with univariate and multivariate regression analysis. Furthermore, we assessed the impact of additional procedures on the complication rates. Results The overall complication rate was 49.8% (26.8% minor complications; 23% major complications). The delayed wound healing rate was 27.7%, and the revision surgery rate was 25.8% (14.7% early revision; 14.2% late revision). These results were compared with literature reports. Several negative predictors emerged as non-modifiable (advanced age, diabetes mellitus, surgical mode of weight loss) or modifiable (preoperative obesity and body mass index (BMI); active smoking; preoperative anemia; use of fibrin glue or quilting sutures). Performing rectus sheath plication improved most of the outcomes. Liposuction of hypochondriac regions and flanks led to increased safety and reduced the risk of surgical dehiscence and delayed wound healing, in contrast to epimesogastric liposuction. The other combined body contouring procedures did not worsen the outcomes, except for poor scarring. Conclusion Our findings encourage us to continue associating rectus sheath plication, liposuction, and other body contouring surgeries with abdominoplasty. We emphasize the importance of proper patient selection, particularly with regard to anemia, before body contouring surgery in the interests of offering safe surgery and satisfactory results. Further studies are needed to investigate how the optimal BMI cut-off and abstinence from smoking (in terms of time) before surgery reduce postoperative complications. Level of Evidence IV 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 https://www.springer.com/journal/00266 .

BackgroundCapsular contracture (CC) represents one of the most common complications in breast reconstruction surgery, impairing final result and patients’ well-being. The role of acellular dermal matrixes (ADM) has been widely described for the treatment and prevention of contracture. The aim of the study was to evaluate the efficacy and safety of complete implant coverage with porcine-derived ADM in preventing CC limiting complications. In addition, patients’ reported outcomes were evaluated in order to define the role of ADM in improving sexual, physical and psychosocial well-being and satisfaction.Methods42 patients who underwent surgical treatment of 46 contracted reconstructed breasts from May 2018th to May 2019th were collected in the two groups (ADM group vs. Control group).ResultsThe ADM group showed lower rate of CC recurrence and a higher rate of implant losses and minor complications. A significant difference was observed in red breast syndrome (27.3% in the ADM group vs. absent in control the group) and skin ulceration rates (18.2% in the ADM group vs. 4.18% in the control group). As for patients’ perceived outcomes, the ADM group showed a statistically significant higher postoperative Satisfaction of Breast Scale score compared to the control group. In addition, a significant difference was observed in the improvement of Physical Well-Being of the Chest Scale and the Satisfaction of Breast Scale after surgery, in favor to the ADM group.ConclusionComplete implant coverage with ADM may reduce the risk of CC recurrence in breast reconstruction. An accurate patient selection allows minimizing complications improving patient well-being and satisfaction.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.

People experiencing homelessness suffer from a risk of mortality three to four times that of the general population, with drug-induced overdose replacing HIV as the emerging epidemic. This study assessed markers of mortality among people experiencing homelessness (N=157) in Orange County, CA during the Fall of 2016. We utilized the Vulnerability Index, an eight-question survey, to identify factors that may affect mortality risk among individuals experiencing homelessness and included two additional questions to identify potential risk of drug-induced overdose. Eighty-three percent of participants reported more than one heightened mortality risk marker and 64% may be at higher risk of drug-induced overdose. Given the state of the opioid epidemic, there is pressing need to couple public health interventions targeting people experiencing homelessness with harm reduction efforts including naloxone distribution (opioid-induced overdose reversal medication) and syringe exchange programs.

People experiencing homelessness suffer from a risk of mortality three to four times that of the general population, with drug-induced overdose replacing HIV as the emerging epidemic. This study assessed markers of mortality among people experiencing homelessness (N=157) in Orange County, CA during the Fall of 2016. We utilized the Vulnerability Index, an eight-question survey, to identify factors that may affect mortality risk among individuals experiencing homelessness and included two additional questions to identify potential risk of drug-induced overdose. Eighty-three percent of participants reported more than one heightened mortality risk marker and 64% may be at higher risk of drug-induced overdose. Given the state of the opioid epidemic, there is pressing need to couple public health interventions targeting people experiencing homelessness with harm reduction efforts including naloxone distribution (opioid-induced overdose reversal medication) and syringe exchange programs.