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Gut microbiota is an important modulator of human health and contributes to high inter-individual variation in response to food and pharmaceutical ingredients. The clinical outcomes of interventions with prebiotics, probiotics, and synbiotics have been mixed and often unpredictable, arguing for novel approaches for developing microbiome-targeted therapeutics. Here, we review how the gut microbiota determines the fate of and individual responses to dietary and xenobiotic compounds via its immense metabolic potential. We highlight that microbial metabolites play a crucial role as targetable mediators in the microbiota-host health relationship. With this in mind, we expand the concept of synbiotics beyond prebiotics' role in facilitating growth and engraftment of probiotics, by focusing on microbial metabolism as a vital mode of action thereof. Consequently, we discuss synbiotic compositions that enable the guided metabolism of dietary or co-formulated ingredients by specific microbes leading to target molecules with beneficial functions. A workflow to develop novel synbiotics is presented, including the selection of promising target metabolites (e.g. equol, urolithin A, spermidine, indole-3 derivatives), identification of suitable substrates and producer strains applying bioinformatic tools, gut models, and eventually human trials.In conclusion, we propose that discovering and enabling specific substrate-microbe interactions is a valuable strategy to rationally design synbiotics that could establish a new category of hybrid nutra-/pharmaceuticals.

Objective: Mental health is a fundamental aspect in ensuring the stable and successful professional life of future physicians. Depressive symptoms can negatively affect the work-life-balance and efficiency at work of medical students. To date, there have been very few studies involving medical students that examine the association between single sleep characteristics and the outcome of the Beck Depression Inventory-II score. Therefore, the aim of the present study is to investigate this possible association. A classroom survey using socio-demographic characteristics, the Beck Depression Inventory-II, and the Pittsburgh Sleep Quality Index was conducted amongst students at a German medical school from December 2017 to September 2018. Data analysis was performed with descriptive statistics and binary logistic regression., Results: Of the students surveyed, 19% showed depressive symptoms with a Beck Depression Inventory-II score over 13 and 42% of these cases were moderate or severe. The occurrence of relevant depressive symptoms was associated with lower sleep quality, higher sleep latency, and the consumption of sleeping pills. In general, female students and students from abroad had a higher risk of depressive symptoms. Addressing these relevant findings in medical school can increase awareness of mental health., (© 2022. The Author(s).)

Background: Elevated levels of depressive symptoms among medical students have been the subject of international and national research before, yet associated risk factors and protective factors are to be determined. This study aims to show the burdens of depression at different stages of academic medical education with a special emphasis on correlated risk factors and protective factors. Methods: A total number of n=1103 medical students of a middle-sized German university were sampled and surveyed regarding depressive symptoms and correlating factors. The assessment of potential depressive symptoms was based on the BDI-II. Correlating factors were surveyed through a self-designed questionnaire consisting of possible cofactors for depressive symptoms based on established scientific literature. Results: Survey response rate was 90.2% (1103/1223). The prevalence of depressive symptoms was 11% for mild, 5.6% for moderate and 2.4% for severe symptoms. The sample's most prevalent risk factors were feeling unable to confide one's own worries to someone else (88%); and experiencing a lack of time for partner, friends and family (77%) or hobbies (76%). Significant predictors for depressive symptoms were neuroticism above all, insufficient emotional support, eating irregular meals, use of medication or drugs to calm down, and mental overload. Factors associated with less depressive symptoms could be identified as: spending time with partner, friends, family, hobbies and exercise; and confiding worries to classmates. Conclusions: Every fifth medical student surveyed reported at least mild depressive symptoms. The majority of the surveyed medical students felt unable to confide their worries to someone else and lamented not having enough time for social interaction with peers, family and hobbies. Certain personality traits - such as neuroticism - and insufficient emotional support showed to play important roles in making medical students more prone to developing depressive symptoms. Based on this research, control of the surveyed cofactors associated with depressive symptoms and possible intervention programs targeted to these are proposed to be a key subject of further research., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Pukas et al.)

Depression is a serious and widespread mental illness that can occur among all ages and genders. This cross-sectional study investigates the previously disregarded state of mental health of German law students based on the Beck Depression Inventory-II. A sample consisting of N = 306 students was surveyed, showing an increased frequency of depressive symptoms. One-third of the participants reported having depression according to BDI-II scoring criteria. More specifically, in the whole sample there are 16.7% with mild, 11.1% with moderate, and 5.6% with severe depression. About 17.7% reported having suicidal thoughts in the last two weeks before the survey. Moreover, the study reports about the correlation between the BDI-II total score and certain risk factors, stress factors and resilience factors, which were assessed using self-report questionnaires and the NEO-FFI. The self-reported depressive symptoms were higher with every accumulation of risk or stress factors and lower with each accumulation of resilience factors. Finally, based on the test results, recommendations are offered to facilitate the burdened student's life., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The morphological and histological alterations were studied that appeared in the peridural space of a patient who was anesthetized for 114 days with a peridural catheter (Perifix-Catheter, Braun) because of intensive violent pain caused by an incurable carcinoma. No macroscopical or histological indication of inflammation could be observed in any of the peridural space and spinal canal. The only alterations detected were nonspecific foreign-body reactions, such as an increase in foreign-body gigant cells and single connective tissue adhesions. Peridural opiate analgesia combined with long-term local anesthesia (0.25% Bupivacain) provided the patient with a long period free of pain.

Two hundred sixty-nine patients suffering from malignant melanoma were sensitized with DNCB acetone solution. The intensity of the skin reaction was normally independent of both the current stage and the further progression of the disease.

Lead particles (1.4 mm2) were implanted into the vitreous body of rats (16 animals) for 10 days and the recovery rate of the ERG was measured over an observation time of 190 days. After extraction of the lead particles the a- and b-wave amplitudes show a recovery from about 60% to 87% in comparison to those of the intact fellow eyes between the 60th and 90th day of observation. In earlier experiments the mechanical damage was measured using glass splinters. The differences between these values and the above mentioned recovery rate after lead extraction correspond to the irreversible component of the metal intoxication. In another group of rats (16 animals) the lead particle was not removed before the end of the observation time of 190 days. Subtracting these ERG values from those of the first group of rats after lead extraction one gets small differences which correspond to the reversible component of the metal intoxication. The irreversible lead intoxication is much less than that of intravitreal iron particles as we found under the same conditions. The lead particles we used, are larger than those we have to handle in clinical cases taking the relation of surface area size of the particle to the total bulbus weight. The ophthalmoscopical findings are described.