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Post-tuberculosis lung disease: a guide for clinicians
No full textPost-tuberculosis lung disease (PTLD) is an increasingly recognized condition that significantly affects survivors’ quality of life, creating disability and incrementing the risk of mortality. PTLD includes a spectrum of structural and functional lung impairments such as obstructive, restrictive, and mixed patterns, bronchiectasis, and pulmonary fibrosis that persist beyond microbiological cure. Global prevalence data highlight a heavy burden of PTLD, especially in high-incidence regions, driven by late diagnosis and suboptimal treatment. Functional and radiological evaluation remains critical for timely diagnosis, with spirometry and imaging revealing lasting abnormalities in a large proportion of TB survivors. Multidisciplinary care is essential and includes bronchodilator therapy, infections/complications management and prevention, pulmonary rehabilitation, and, in selected cases, surgical intervention. Despite increasing recognition, standardized diagnostic and therapeutic pathways for PTLD are still lacking, and data on optimal follow-up, rehabilitation strategies, and preventive measures remain limited. Prospective studies, better stratification tools, and patient education initiatives are urgently needed to reduce PTLD morbidity and mortality. This narrative review synthesizes current evidence on PTLD epidemiology, clinical evaluation and management while offering practical suggestions for clinicians taking care of people with TB and addressing research needs
Beyond crisis and grief: Rethinking conservation narratives
No full textSince 1985, conservation science has been unquestioningly described as a crisis discipline. This narrative entails prioritizing immediate responses to threats despite limited knowledge. Although crisis interventions have grown significantly, biodiversity loss has continued unabated, and those working or living alongside declining ecosystems report increasing levels of emotional distress. Ecological grief is particularly on the rise and is claimed by some as a necessary process to fuel the urgent lifesaving changes. However, I argue that both narratives - the emerging ecological grief and the established crisis approach - can synergically reinforce a loop of resignation, where ecological decline is either passively accepted or inadvertently perpetuated. Such resignation ultimately leads to harmful adaptation to ongoing ecological degradation. Finally, I propose a shift toward a transformative conservation narrative, moving away from the primary focus on crisis thinking to embrace proactive futures. Reframing the underlying narratives is essential, because they can influence the broader conservation agenda
Molecular insights and emerging therapeutic perspectives of the lncRNA GAS5/miR-21 axis in cancer, fibrosis, cardiovascular, and immune disorders
No full textNon-coding RNAs (ncRNAs) have redefined the complexity of gene regulation, with the long non-coding (lncRNA) GAS5/miR-21 axis emerging as a critical determinant of cell fate across diverse pathological contexts. This review examines the molecular mechanisms by which GAS5 regulates miR-21 activity, thereby restoring tumor suppressor networks and controlling key pathways, including the PI3K/AKT, MAPK/ERK, and Wnt/β-catenin pathways. We detail how dysregulation of this axis fuels cancer progression, metastasis, therapy resistance, fibrosis, cardiovascular diseases, osteoporosis, osteoarthritis, and autoimmune conditions like systemic lupus erythematosus. Beyond its role as a master regulator of apoptosis, proliferation, and EMT, the GAS5/miR-21 interaction holds immense promise as a therapeutic target and a liquid biopsy biomarker. However, clinical translation demands solutions to major challenges, including RNA delivery barriers, context-dependent effects, and adaptive resistance. Leveraging multi-omics integration, gene-editing technologies, and personalized RNA therapeutics will be pivotal to overcoming these obstacles. By critically integrating current knowledge and outlining future directions, this review positions the GAS5/miR-21 axis at the forefront of next-generation ncRNA therapeutics. Harnessing its full potential could not only revolutionize treatment paradigms but also transform our understanding of RNA-driven disease networks
Long-Term Effectiveness and Safety of Rituximab in Neuromyelitis Optica Spectrum Disorder: A 5-Year Observational Study
No full textBackground: Neuromyelitis optica spectrum disorder (NMOSD) is a severely disabling autoimmune disease that predominantly impacts the optic nerves and spinal cord. It is often linked to immunoglobulin G (IgG) antibodies targeting the aquaporin-4 water channel (AQP4-IgG). Rituximab, which depletes CD20-positive B cells, is effective in reducing the frequency of NMOSD relapses. The objective of this retrospective, 5-year observational study was to evaluate the effectiveness and safety of rituximab in patients with AQP4-IgG-positive NMOSD. Methods: We conducted a multicenter, retrospective study using prospectively collected data from 23 multiple sclerosis (MS) and NMOSD centers (22 in Italy, 1 in Switzerland). The study cohort included patients with AQP4-IgG-positive NMOSD who had completed rituximab induction therapy, with data collected up to May 2024. Two maintenance strategies were used—fixed 6-monthly infusions or reinfusions guided by flow cytometry—on the basis of CD19+ or CD27+ memory B-cell repopulation thresholds. Clinical outcomes included annualized relapse rate (ARR), time to first relapse (TTFR), and Expanded Disability Status Scale (EDSS) worsening, which was assessed both overall and between relapses to indirectly evaluate the possibility of inter-attack disability progression. Safety outcomes encompassed infusion-related reactions and adverse events. Results: A total of 138 patients were analyzed. ARR significantly decreased from 1.54 (95% confidence interval (CI) 1.34–1.75) before rituximab to 0.15 (95% CI 0.12–0.19) over the 5-year follow-up. Approximately 33% of patients experienced at least one relapse during treatment, after a median time of 5.21 months. Higher pre-rituximab relapse rates were associated with shorter TTFR. Subtle increases of 0.5–1 points in EDSS between relapses were observed in one third of patients. Mild infections were common, and 21% of patients experienced infusion-related reactions. In addition, six patients developed malignancies. Conclusions: Over 5 years, rituximab consistently reduced the incidence of relapses in patients with NMOSD, though 33% of them still experienced a relapse during this period, generally within the first 6 months of treatment. No unexpected adverse events were identified. While safety monitoring remains crucial, further studies are needed to better understand rituximab’s impact on NMOSD management
Recovery and Resolution planning, Liquidity Management and Fragility
No full textWe study how regulation shapes the interaction between financial fragility and bank liquidity management, and propose a rationale for the complementarity between bank recovery and resolution planning. To this end, we analyze an economy in which a resolution authority arranges a bank resolution plan to suspend deposit withdrawals and create a “good bank” at a cost in the event of a depositors’ run. In such a framework, banks find it optimal to establish recovery plans in advance, specifying how to manage liquidity during runs. However, such plans are time inconsistent, and resolution authorities need powers to force their implementation at times of financial fragility
In Reference to Utilization of Artificial Intelligence in the Creation of Patient Information on Laryngology Topics
No full textAccuracy and Precision of Digital Impression with Reverse Scan Body Prototypes and All-on-4 Protocol: An In Vitro Research
No full textBackground/Objectives: Digital workflows for implant-supported full-arch restorations remain challenging. This study evaluated the accuracy and precision of digital impressions using reverse scan body (RSB) prototypes and intraoral scanners (IOSs) for rehabilitating fully edentulous patients following the All-on-4 protocol. Secondary objectives included comparing accuracy between expert clinicians and beginners, as well as desktop scanners and various RSB designs. Methods: An in vitro study was conducted using a fully edentulous mandible model with four Osstem TSIII implants. A final-year dental student and an expert clinician captured digital impressions using IOSs and desktop scanners. Four groups were analyzed: (A) original scan bodies with the IOS, (B) short RSBs with the IOS, (C) RSBs with desktop scanners (short sandblasted, long sandblasted, long coated), and (D) a control group using original scan bodies with a desktop scanner. Root mean square (RMS) values measured dimensional differences, with statistical analysis performed using the Wilcoxon signed-rank test and one-way ANOVA (α = 0.05). Results: A total of 42 scans were analyzed. No significant difference was found between expert and student for original scan bodies using the IOS (p = 0.220), while RSB prototypes showed significant differences (p = 0.008). No significant accuracy differences were noted between original scan bodies and RSBs with the IOS, but IOSs outperformed desktop scanners. Among RSBs scanned with desktop scanners, no significant differences were observed between designs. Conclusions: RSB prototypes are a viable alternative to original scan bodies for fully digital workflows in All-on-4 rehabilitations, with IOSs offering superior accuracy. However, proper training is crucial for optimizing RSB accuracy. Variations in height and coating did not impact overall accuracy
Non tutte le stagioni sono uguali per nascere e morire. Il primo anno di vita a Treppio, 1790-1909
No full textCombining biochar, plant growth-promoting rhizobacteria, and annual ryegrass for the recovery of a PTEs multi-contaminated soil
No full textPhytoremediation is a sustainable, environmentally friendly and low-cost technology for the restoration of soils contaminated with potentially toxic elements (PTEs). We hypothesized that the effectiveness of the recovery process can be improved by associating phytoremediation with the application to the soil of amendments and/or the inoculum of plant growth-promoting rhizobacteria (PGPR). The aim of this study was therefore to assess the suitability of combining a new microbial consortium with biochar for the remediation of a soil contaminated with Cd (22.6 mg·kg−1), Pb (4473 mg kg−1) and Zn (3147 mg kg−1) and cultivated with annual ryegrass (Lolium rigidum). In the biochar treated-soil, the amounts of exchangeable PTEs were reduced by 56, 60 and 81 % for Cd, Pb and Zn respectively, compared to the untreated soil. Dehydrogenase and urease activities increased in the amended soil compared to the control, while β-glucosidase decreased in the presence of biochar. Soils treated with PGPR alone or in combination with biochar showed the lowest bacterial and fungal diversity, showing that the microbial inoculum was the main factor influencing the structure of the soil microbiota. The highest biomass production of ryegrass was detected in plants grown in soil treated with biochar and inoculated with PGPR (+31 % vs. control), suggesting a synergistic effect of the treatments in improving plants growth. A reduced PTEs uptake was also recorded in plants grown in soil treated with biochar and inoculated with PGPR. These results highlighted that PGPR significantly increased the effectiveness of biochar in the assisted phytoremediation