On the lowest rung of the ladder:How social exclusion, perceived economic inequality and stigma increase homeless people's resignation

Despite the relevance of social exclusion and economic inequality for homelessness, empirical studies investigating how these issues relate to homeless people’s psychological well-being are scarce. We aimed to fill this gap by conducting two quasi-experimental studies on homeless and non-homeless groups. The first study (N=200) showed that homeless (vs. non-homeless) people presented higher levels of resignation, characterized by depression, alienation, helplessness, and unworthiness. The second study (N=183) replicated the findings from Study 1 and showed that perceived economic inequality could increase homeless people’s resignation by emphasizing perceptions of social exclusion. Additional analyses found that identification with the stigmatized homeless group could mediate the relationship between perceived inequality and social exclusion, increasing the resignation. Overall, the results showed that chronic social exclusion of homeless people is associated with higher levels of resignation. Moreover, they showed the role of perceived economic inequality and homeless group stigmatized identification as group-specific mechanisms favouring social exclusion and ultimately worsening psychological well-being

Deficits in naming pictures of objects are associated with glioma infiltration of the inferior longitudinal fasciculus: A study with diffusion MRI tractography, volumetric MRI, and neuropsychology

It has been suggested that the inferior longitudinal fasciculus (ILF) may play an important role in several aspects of language processing such as visual object recognition, visual memory, lexical retrieval, reading, and specifically, in naming visual stimuli. In particular, the ILF appears to convey visual information from the occipital lobe to the anterior temporal lobe (ATL). However, direct evidence proving the essential role of the ILF in language and semantics remains limited and controversial. The first aim of this study was to prove that patients with a brain glioma damaging the left ILF would be selectively impaired in picture naming of objects; the second aim was to prove that patients with glioma infiltrating the ATL would not be impaired due to functional reorganization of the lexical retrieval network elicited by the tumor. We evaluated 48 right-handed patients with neuropsychological testing and magnetic resonance imaging (MRI) before and after surgery for resection of a glioma infiltrating aspects of the left temporal, occipital, and/or parietal lobes; diffusion tensor imaging (DTI) was acquired preoperatively in all patients. Damage to the ILF, inferior frontal occipital fasciculus (IFOF), uncinate fasciculus (UF), arcuate fasciculus (AF), and associated cortical regions was assessed by means of preoperative tractography and pre-/pos-toperative MRI volumetry. The association of fascicles damage with patients' performance in picture naming and three additional cognitive tasks, namely, verbal fluency (two verbal non-visual tasks) and the Trail Making Test (a visual attentional task), was evaluated. Nine patients were impaired in the naming test before surgery. ILF damage was demonstrated with tractography in six (67%) of these patients. The odds of having an ILF damage was 6.35 (95% CI: 1.27-34.92) times higher among patients with naming deficit than among those without it. The ILF was the only fascicle to be significantly associated with naming deficit when all the fascicles were considered together, achieving an adjusted odds ratio of 15.73 (95% CI: 2.30-178.16, p = .010). Tumor infiltration of temporal and occipital cortices did not contribute to increase the odd of having a naming deficit. ILF damage was found to be selectively associated with picture naming deficit and not with lexical retrieval assessed by means of verbal fluency. Early after surgery, 29 patients were impaired in naming objects. The association of naming deficit with percentage of ILF resection (assessed by 3D-MRI) was confirmed (beta = -56.78 ± 20.34, p = .008) through a robust multiple linear regression model; no significant association was found with damage of IFOF, UF or AF. Crucially, postoperative neuropsychological evaluation showed that naming scores of patients with tumor infiltration of the anterior temporal cortex were not significantly associated with the percentage of ILF damage (rho = .180, p > .999), while such association was significant in patients without ATL infiltration (rho = -.556, p = .004). The ILF is selectively involved in picture naming of objects; however, the naming deficits are less severe in patients with glioma infiltration of the ATL probably due to release of an alternative route that may involve the posterior segment of the AF. The left ILF, connecting the extrastriatal visual cortex to the anterior region of the temporal lobe, is crucial for lexical retrieval on visual stimulus, such as in picture naming. However, when the ATL is also damaged, an alternative route is released and the performance improves

Tracking the immunopathological response to Pseudomonas aeruginosa during respiratory infections

Repeated cycles of infections, caused mainly by Pseudomonas aeruginosa, combined with a robust host immune response and tissue injury, determine the course and outcome of cystic fibrosis (CF) lung disease. As the disease progresses, P. aeruginosa adapts to the host modifying dramatically its phenotype; however, it remains unclear whether and how bacterial adaptive variants and their persistence influence the pathogenesis and disease development. Using in vitro and murine models of infection, we showed that P. aeruginosa CF-adaptive variants shaped the innate immune response favoring their persistence. Next, we refined a murine model of chronic pneumonia extending P. aeruginosa infection up to three months. In this model, including CFTR-deficient mice, we unveil that the P. aeruginosa persistence lead to CF hallmarks of airway remodelling and fibrosis, including epithelial hyperplasia and structure degeneration, goblet cell metaplasia, collagen deposition, elastin degradation and several additional markers of tissue damage. This murine model of P. aeruginosa chronic infection, reproducing CF lung pathology, will be instrumental to identify novel molecular targets and test newly tailored molecules inhibiting chronic inflammation and tissue damage processes in pre-clinical studies

IL-17A impairs host tolerance during airway chronic infection by Pseudomonas aeruginosa

Resistance and tolerance mechanisms participate to the interplay between host and pathogens. IL-17-mediated response has been shown to be crucial for host resistance to respiratory infections, whereas its role in host tolerance during chronic airway colonization is still unclear. Here, we investigated whether IL-17-mediated response modulates mechanisms of host tolerance during airways chronic infection by P. aeruginosa. First, we found that IL-17A levels were sustained in mice at both early and advanced stages of P. aeruginosa chronic infection and confirmed these observations in human respiratory samples from cystic fibrosis patients infected by P. aeruginosa. Using IL-17a(-/-) or IL-17ra(-/-) mice, we found that the deficiency of IL-17A/IL-17RA axis was associated with: i) increased incidence of chronic infection and bacterial burden, indicating its role in the host resistance to P. aeruginosa; ii) reduced cytokine levels (KC), tissue innate immune cells and markers of tissue damage (pro-MMP-9, elastin degradation, TGF-β1), proving alteration of host tolerance. Blockade of IL-17A activity by a monoclonal antibody, started when chronic infection is established, did not alter host resistance but increased tolerance. In conclusion, this study identifies IL-17-mediated response as a negative regulator of host tolerance during P. aeruginosa chronic airway infection

ACE2 expression is related to the interferon response in airway epithelial cells but is that functional for SARS-CoV-2 entry?

In vitro interferon (IFN)α treatment of primary human upper airway basal cells has been shown to drive ACE2 expression, the receptor of SARS-CoV-2. The protease furin is also involved in mediating SARS‐CoV‐2 and other viral infections, although its association with early IFN response has not been evaluated yet. In order to assess the in vivo relationship between ACE2 and furin expression and the IFN response in nasopharyngeal cells, we first examined ACE2 and furin levels and their correlation with the well-known marker of IFNs’ activation, ISG15, in children (n = 59) and adults (n = 48), during respiratory diseases not caused by SARS-CoV-2. A strong positive correlation was found between ACE2 expression, but not of furin, and ISG15 in all patients analyzed. In addition, type I and III IFN stimulation experiments were performed to examine the IFN-mediated activation of ACE2 isoforms (full-length and truncated) and furin in epithelial cell lines. Following all the IFNs treatments, only the truncated ACE2 levels, were upregulated significantly in the A549 and Calu3 cells, in particular by type I IFNs. If confirmed in vivo following IFNs’ activation, the induction of the truncated ACE2 isoform only would not enhance the risk of SARS‐CoV‐2 infection in the respiratory tract

Dante nelle letterature straniere

Il volume offre un incrocio di sguardi critici sulle rotte percorse dall’opera dantesca nelle letterature straniere. A settecento anni dalla sua morte, la voce di Dante continua a oltrepassare confini permeando immaginari lontani, in un incedere di evocazioni, traduzioni, interpretazioni e riscritture. I venti saggi qui presentati tratteggiano un itinerario di esplorazione delle tracce dantesche nelle tradizioni letterarie di Albania, Svezia, Francia, Cuba, Polonia, Stati Uniti, Germania, Argentina, Danimarca, Scozia, Inghilterra e Messico. Le diverse latitudini abbracciate si articolano in una raccolta di studi che dall’epoca moderna confluisce nell’estremo contemporaneo, calibrando nuovi orizzonti e prospettive nello sconfinato territorio della critica dantesca. Gli autori e le autrici illuminano storie di ricezione, riletture e dialoghi intertestuali nei quali la memoria della Commedia si riconfigura in un’inesauribile pluralità di scritture, di cui si intende consegnare in queste pagine uno sguardo di carattere esplorativo e non antologico. La parola di Dante attraversa lingue e universi letterarioculturali senza tradirsi ma conoscendo nuove fioriture: confermandosi una parola necessaria, profetica e viva

Cystic Fibrosis-Niche Adaptation of Pseudomonas aeruginosa Reduces Virulence in Multiple Infection Hosts

The opportunistic pathogen Pseudomonas aeruginosa is able to thrive in diverse ecological niches and to cause serious human infection. P. aeruginosa environmental strains are producing various virulence factors that are required for establishing acute infections in several host organisms; however, the P. aeruginosa phenotypic variants favour long-term persistence in the cystic fibrosis (CF) airways. Whether P. aeruginosa strains, which have adapted to the CF-niche, have lost their competitive fitness in the other environment remains to be investigated. In this paper, three P. aeruginosa clonal lineages, including early strains isolated at the onset of infection, and late strains, isolated after several years of chronic lung infection from patients with CF, were analysed in multi-host model systems of acute infection. P. aeruginosa early isolates caused lethality in the three non-mammalian hosts, namely Caenorhabditis elegans, Galleria mellonella, and Drosophila melanogaster, while late adapted clonal isolates were attenuated in acute virulence. When two different mouse genetic background strains, namely C57Bl/6NCrl and Balb/cAnNCrl, were used as acute infection models, early P. aeruginosa CF isolates were lethal, while late isolates exhibited reduced or abolished acute virulence. Severe histopathological lesions, including high leukocytes recruitment and bacterial load, were detected in the lungs of mice infected with P. aeruginosa CF early isolates, while late isolates were progressively cleared. In addition, systemic bacterial spread and invasion of epithelial cells, which were detected for P. aeruginosa CF early strains, were not observed with late strains. Our findings indicate that niche-specific selection in P. aeruginosa reduced its ability to cause acute infections across a broad range of hosts while maintaining the capacity for chronic infection in the CF host

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

ANÁLISE COMPARATIVA DO USO DE INIBIDORES DA BOMBA DE PRÓTONS E DE ANTAGONISTAS DOS RECEPTORES H2 NO TRATAMENTO DA GASTRITE

Considering the high prevalence of gastritis and its significant impact on patients' quality of life, this research was justified to understand and compare the efficacy and safety of the two main groups of drugs used in the treatment of gastritis: proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs). The objectives were to review and synthesize the existing scientific literature on the efficacy and safety of PPIs and H2RAs, compare their mechanisms of action, side effects, and clinical outcomes, identify best practices for the use of each therapeutic class in different clinical scenarios, and provide evidence-based recommendations to guide the choice of the most appropriate treatment for patients with gastritis. To this end, a qualitative bibliographic review was conducted, utilizing databases such as Scielo, Google Scholar, scientific journals, academic repositories, and virtual libraries, including materials published in multiple languages. Thus, it was observed that PPIs demonstrated greater efficacy in suppressing acid secretion and healing gastric lesions, but with a long-term safety profile that includes potential serious side effects. H2 receptor antagonists, although less potent, presented a relatively better safety profile. It was concluded that, although PPIs are generally preferred for severe acid hypersecretion conditions, the choice between PPIs and H2RAs should consider the individual risks and benefits for each patient, in addition to their specific clinical conditions.Considerando a alta prevalência da gastrite e seu impacto significativo na qualidade de vida dos pacientes, justificou-se a realização desta pesquisa para compreender e comparar a eficácia e segurança dos dois principais grupos de medicamentos utilizados no tratamento da gastrite: os inibidores da bomba de prótons (IBPs) e os antagonistas dos receptores H2. Objetivou-se revisar e sintetizar a literatura científica existente sobre a eficácia e segurança dos IBPs e dos antagonistas dos receptores H2, comparar seus mecanismos de ação, efeitos colaterais e desfechos clínicos, identificar as melhores práticas para a utilização de cada classe terapêutica em diferentes cenários clínicos, e fornecer recomendações baseadas em evidências para guiar a escolha do tratamento mais apropriado para pacientes com gastrite. Para tanto, procedeu-se a uma revisão bibliográfica qualitativa, utilizando bases de dados como Scielo, Google Acadêmico, revistas científicas, repositórios acadêmicos e bibliotecas virtuais, incluindo materiais publicados em múltiplos idiomas. Desse modo, observou-se que os IBPs demonstraram maior eficácia na supressão da secreção ácida e na cicatrização de lesões gástricas, porém com um perfil de segurança a longo prazo que inclui potenciais efeitos colaterais graves. Os antagonistas dos receptores H2, embora menos potentes, apresentaram um perfil de segurança relativamente melhor. Concluiu-se que, embora os IBPs sejam geralmente preferidos para condições graves de hipersecreção ácida, a escolha entre IBPs e antagonistas H2 deve considerar os riscos e benefícios individuais para cada paciente, além de suas condições clínicas específicas