Search

Abstract Introduction Depression and anxiety are pervasive mental health disorders with substantial global burdens. Probiotics, live microorganisms known for their health benefits, have emerged as a potential therapeutic intervention for these conditions. This systematic review and meta-analysis aim to evaluate the strain-specific effects of probiotics on relieving depressive and anxiety symptoms while elucidating underlying mechanisms. Methods EMBASE, Cochrane CENTRAL and PubMed/Medline were systematically queried to identify studies released until May 15, 2024. Randomized Controlled Trials (RCTs) that employed standardized assessment tools for depression and anxiety namely Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), Depression Anxiety Stress Scales (DASS), or Montgomery-Asberg Depression Rating Scale (MADRS) were included. Results 12 RCTs involving 707 participants were included. Seven RCTs utilizing the BDI questionnaire demonstrated a significant decrease in depressive symptoms favoring probiotics containing strains such as Lactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus casei, Lactobacillus plantarum, Lactobacillus salivarius, Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium breve, and Bifidobacterium longum (MD: -2.69, CI95%: -4.22/-1.16, p value: 0.00). Conversely, RCTs using HAMD showed a non-significant reduction in depressive symptoms (MD: -1.40, CI95%: -3.29/0.48, p value: 0.14). RCTs employing DASS and MADRS scales also showed no significant differences. Conclusion This meta-analysis offers valuable insights into the strain-specific effects of probiotics containing Lactobacillus and Bifidobacterium species on depressive and anxiety symptoms. While our findings suggest a significant reduction in depressive symptoms based on the BDI scale favoring probiotics, the lack of significant effects observed on the HAMD, DASS, and MADRS scales underscores the complexity inherent in these conditions. It is imperative to acknowledge the mixed results across different measurement scales, indicating the need for cautious interpretation. Therefore, we advocate for a nuanced understanding of probiotics’ impacts on various dimensions of mood, emphasizing the necessity for further research.

Accumulating literature suggests that the risk of perpetrating bullying is greater among those who have been bullied. The association between the transition from victim to bully and revenge aggression suggests the critical role of forgiveness. However, evidence on the mediating role of forgiveness on the victimisation-bullying association is still sparse. The aim of this study was to investigate the mediating effect of person's dispositional forgiveness (DF) on the relationship between cyber-victimisation (CV) and cyber-bullying (CB) and to explore the moderating effect of gender on this relationship. Four hundred eighty-one upper secondary students (n = 481, 47.8% females, mean age = 17.2, SD = 1.5) completed the Florence Cyber-Bullying -- Cyber-Victimisation Scales and the Heartland Forgiveness Scale. Statistical analysis reveals significant direct and indirect effects between CV, DF, and CB latent variables. CV has a negative influence on DF and positive influence on CB behaviour. Furthermore, there was an indirect influence of CV on CB behaviour following the path through DF only in females. The results suggest that DF seems to decrease CB behaviours by buffering the adverse outcomes of being CV, particularly among female victims. The findings underline the relevance of forgiveness within preventative interventions against bullying and cyberbullying.

Nail surgery, commonly performed to manage a wide range of nail disorders, is associated with potential complications that can affect patient’s recovery and outcomes. This review provides a detailed overview of these possible complications and strategies for their prevention. Surgical complications in nail procedures can be classified into specific and non-specific. Specific complications are associated with damage to particular structures of the nail unit, such as the matrix, nail bed, or hyponychium. Non-specific complications, such as hematoma, infection, and necrosis, may be a consequence of any surgical procedure and are not directly related to the anatomical structures involved in the operation. Recognizing factors that can contribute to these complications, such as the choice of surgical techniques, patient comorbidity management, and the implementation of postoperative care practices, is essential to reduce their incidence. This work reports the current evidence and best practices in order to reduce surgical risks and improve patient outcomes. Examining each complication and its prevention strategies in detail, this review is a practical resource for clinicians who manage nail surgery cases.

IntroductionThe envelope proteins syncytin-1 and pHERV-W from the Human Endogenous Retroviral family ‘W’ (HERV-W) have been identified as potential risk factors in multiple sclerosis (MS). This study aims to evaluate both humoral and cell-mediated immune response to antigenic peptides derived from these proteins across different clinical forms and inflammatory phases of MS.MethodsIndirect enzyme-linked immunosorbent assay (ELISA) was employed to measure immunoglobulin G (IgG) responses to syncytin-1env 486-500 and pHERV-Wenv 486-504 peptides in MS patients. Discriminant analysis was used to assess whether clinical course prediction could be enhanced by integrating clinical variables with humoral response data against other MS-associated viral factors. Additionally, peripheral blood mononuclear cells from MS patients and healthy controls (HC) were analyzed for inflammatory responses following stimulation with these peptides.ResultsMS patients exhibited significantly elevated antibody titers against -pHERV-Wenv 486-504 and syncytin-1env 486-500 compared to HCs, with the highest levels observed in progressive MS forms. Discriminant analysis accurately predicted the clinical course in 75.3% of the cases, with an 85% accuracy rate for progressive MS. In vitro, stimulation with pHERV-Wenv 486-504 led to a notable increase in pro-inflammatory cytokine production by CD4, CD8, and CD19 cells compared to syncytin-1env 486-500. A strong correlation was found between pHERV- Wenv 486-504 induced cytokine production and EBV and CMV titers in MS patients.DiscussionThese findings suggest that the pHERV-W envelope protein could be a valuable biomarker for monitoring peripheral inflammation in MS.

Introduction: Medical evacuation has historically been rooted in military contexts. It involves the systematic transfer of sick or injured individuals from the battlefield to designated medical facilities. Medical evacuation has found application in civilian settings: the Ebola outbreak and the COVID-19 pandemic. This paper examines the medical evacuation that occurred during the COVID-19 pandemic in Lombardy, Italy (Operation “MEDEVAC”), where overloaded hospitals required the transfer of patients to other regions and even internationally. Methods: MEDEVAC was implemented by the Regional Emergency and Urgency Agency (AREU). Data from MEDEVAC were analysed using the AREU register, detailing patient characteristics, transfer logistics, and outcomes. Results: From March to April 2020, 121 intensive care patients were transferred via MEDEVAC, primarily by air. 65 % of patients were moved to other Italian regions. The Federal Republic of Germany received 35 % of patients, all transported by air. Outcome and mortality rates among transferred patients were comparable to those within regional intensive care units. One life-threatening event was reported during transport. The return of patient to Lombardy showed a 100 % survival rate. Conclusion: This study emphasises the importance of standardised protocols, improved information exchange systems, and enhanced training for medical personnel involved in medical evacuation. MEDEVAC was found to be feasible and able to cope with demands that were excessive in relation to available resources. This study proposes the development of a shared protocol for air transport of patients and a model for international cooperation among emergency response agencies to optimise future medical evacuation activities in civil context.

The COVID-19 pandemic strongly transformed the healthcare system in the Lombardy region (Italy), forcing a rapid reorganization of hospital structures. The emergency medical service (EMS) system and emergency departments (EDs) were among the most affected departments. Several studies have shown a change in the epidemiology of time-dependent pathologies, such as stroke, during the pandemic’s peak. However, there is little scientific evidence regarding the interpandemic phase. The regional register for ED accesses (EUOL) was analyzed, taking into consideration all accesses for stroke and stroke-like syndromes during the years 2019, 2020, and 2021. The analysis shows a significant difference in the average number of diagnoses per month [2092 vs. 1815 vs. 2015, respectively (p < 0.05)] and an increase in the percentage of transports carried out by EMS vehicles to EDs [17% vs. 25% vs. 22%, respectively (p < 0.05)]. The length of stay (LOS) increased for both discharged patients (9.0 vs. 10.1 vs. 11.2 h, respectively; p < 0.005) and hospitalized patients (7.5 vs. 9.7 vs. 10.6 h, respectively; p < 0.005). During the COVID-19 pandemic, the overall number of stroke diagnoses decreased, while the percentage of patients transported to EDs by EMS vehicles increased. Furthermore, an increased processing time in EDs was highlighted.

Inter‐alpha‐trypsin inhibitor heavy chain 5 (ITIH5) has been identified as a metastasis suppressor gene in pancreatic cancer. Here, we analyzed ITIH5 promoter methylation and protein expression in The Cancer Genome Atlas (TCGA) dataset and three tissue microarray cohorts (n = 618), respectively. Cellular effects, including cell migration, focal adhesion formation and protein tyrosine kinase activity, induced by forced ITIH5 expression in pancreatic cancer cell lines were studied in stable transfectants. ITIH5 promoter hypermethylation was associated with unfavorable prognosis, while immunohistochemistry demonstrated loss of ITIH5 in the metastatic setting and worsened overall survival. Gain‐of‐function models showed a significant reduction in migration capacity, but no alteration in proliferation. Focal adhesions in cells re‐expressing ITIH5 exhibited a smaller and more rounded phenotype, typical for slow‐moving cells. An impressive increase of acetylated alpha‐tubulin was observed in ITIH5‐positive cells, indicating more stable microtubules. In addition, we found significantly decreased activities of kinases related to focal adhesion. Our results indicate that loss of ITIH5 in pancreatic cancer profoundly affects its molecular profile: ITIH5 potentially interferes with a variety of oncogenic signaling pathways, including the PI3K/AKT pathway. This may lead to altered cell migration and focal adhesion formation. These cellular alterations may contribute to the metastasis‐inhibiting properties of ITIH5 in pancreatic cancer.

Chiral organometallic compounds and metal complexes, and more recently metal clusters, have attracted great interest for applications in chemical, biological, medical, and material sciences. In these fields, liquid chromatography has been widely used for fast chiral analysis to determine the enantiomeric purity of metal-containing chiral compounds prepared by asymmetric synthesis, for quality control of commercial chiral metal catalysts, for accessing enantioenriched or pure enantiomers of metal complexes for various applications, and often as test probe analytes for screening the enantioseparation capability of newly developed chiral columns and chromatographic systems. With the aim to show what was done in this field as a useful guide for new applications, in this review the evolution of methods and approaches used to separate the enantiomers of chiral metal-containing compounds is described, showing how this field have been changed over time, from the 1970s until most recent studies. For this purpose, representative applications of enantioselective liquid chromatography for the enantioseparation of chiral organometallic compounds and metal complexes will be presented and discussed, indicating chiral columns, mobile phases, and chromatographic conditions which have been used to obtain successful enantioseparations in this field.

With the widespread use of plastic products and the increase in waste, microplastics and nanoplastics (MNPs) have become an important issue in global environmental pollution. In recent years, an increasing number of studies have shown that MNPs may have negative impacts on human health. This review aimed to explore the association between MNPs and cardiovascular disease and provide an outlook for future research. Research has shown that there may be a link between MNPs exposure and cardiovascular disease. Laboratory studies have shown that animals exposed to MNPs often exhibit abnormalities in the cardiovascular system, such as increased blood pressure, vascular inflammation, and myocardial damage. Epidemiological surveys have also revealed that people exposed to MNPs are more likely to suffer from cardiovascular diseases, such as hypertension and myocardial infarction. Although the specific impact mechanism is not fully understood, there are several possible pathways of action, including the effects of toxic substances on MNPs and interference with the endocrine system. In summary, MNPs exposure may have a negative impact on cardiovascular health, but further research is needed to confirm its specific mechanism and extent of impact to guide relevant public health and environmental policies.

The discovery of the role of Bruton’s Tyrosine Kinase (BTK) in inflammation and autoimmunity has recently led to the development of BTK inhibitors for the treatment of autoimmune diseases, including pemphigus vulgaris. We herein present the case of a patient affected by pemphigus vulgaris, refractory to conventional immunosuppressive therapies and to multiple courses of rituximab, who was treated with rilzabrutinib and achieved disease control, but whose immunological profile switched from pemphigus vulgaris to pemphigus foliaceus after drug discontinuation. Furthermore, we review the literature in order to better characterize the phenotypic transitions from pemphigus vulgaris to pemphigus foliaceus reported so far. The factors underlying this transition are largely unknown, although it has been postulated that immunosuppressive therapies may be more effective against anti-desmoglein 3 antibodies compared to anti-desmoglein 1. However, further studies are needed to better define the effect of rilzabrutinib (and immunosuppressive therapies in general) on anti-desmoglein 1 and anti-desmoglein 3 antibodies.

According to the European Directive 2007/60/CE, flood risk evaluation should include a cost–benefit analysis (CBA) on a long-term time horizon to evaluate the impact of mitigation measures. The standard CBA assumes to know in advance the events observed in the time horizon and a priori compares all mitigation measures by an economic metric. No change is supposed to be made to these measures throughout the time horizon. This modus operandi is not appropriate in the domain of flood risk management because several conditions are uncertain when the CBA is made (e.g., urban policies). This article faces these challenges by the integration of cost–benefit analysis and decision trees, to prescribe mitigation measures under uncertainty on the budget for mitigation actions because their funding can be modified after the conclusion of the CBA. The former integration is discussed in the real case of the lowland valley of the Coghinas River (Sardinia, Italy), for which the classical CBA compared five mitigation measures of infrastructural works. The integration into the decision tree also allows evaluation of mitigation measures with changes in infrastructural works and a lamination action. The outcomes advise decreasing the maximum storage level and increase the peak lamination. HIGHLIGHTS Integrates decision tree into a cost-benefit analysis to prescribe optimal decisions for the planning of flood risk mitigation.; Investigates the introduction of uncertainty on budget availability by the probability of funding each configuration in the time horizon.; Defines optimal decisions under uncertainty and provides the authorities with strategic information about the flood mitigation measures to be implemented.;

Increasing evidence indicates that human endogenous retroviruses (HERVs) are important to human health and are an underexplored component of many diseases. Certain HERV families show unique expression patterns and immune responses in autism spectrum disorder (ASD) patients compared to healthy controls, suggesting their potential as biomarkers. Despite these interesting findings, the role of HERVs in ASD needs to be further investigated. In this review, we discuss recent advances in genetic research on ASD, with a particular emphasis on the implications of HERVs on neurodevelopment and future genomic initiatives aimed at discovering ASD-related genes through Artificial Intelligence. Given their pro-inflammatory and autoimmune characteristics, the existing literature suggests that HERVs may contribute to the onset or worsening of ASD in individuals with a genetic predisposition. Therefore, we propose that investigating their fundamental properties could not only improve existing therapies but also pave the way for new therapeutic strategies.