In recent years the increasing presence of refugees and asylum seekers displaced from their country of origin, determined significant social, economic, humanitarian and public health implications in host nations. Advancing the knowledge on factors contributing to these implications, could foster the implementation of new public-health plans for these population. As a matter of fact, to date, the rates of mental disorders in these population are uncertain due to the high variability of methods used in the studies on topic, and of risk and protective factors analyzed. The most replicated finding is the high prevalence of Post-Traumatic Stress Disorder (PTSD) and depression in refugees and asylum seekers as compared to the population of host countries.The aim of the present study was to investigate the needs for mental health prevention, care and rehabilitation of adult refugees and asylum seekers in Italy, performing a multidisciplinary evaluation of migrants who were guests in two refugees’ centers in Campania .The Mini-International Neuropsychiatric Interview (MINI) was assessed in 303 migrants, in order to evaluate the presence or not of a psychiatric diagnosis. Analysis of variance (ANOVA) was used to investigate differences between migrants with a mental disorder vs migrants without a mental disorder in terms of cognitive functions, depressive and anxiety symptoms, traumatic events and pre-migration risk factors. Person’s correlation was performed to investigate relationships between the Hopkins Symptom Checklist-25 (HSCL-t25) psychopathological index with all the other above-mentioned variables. Logistic regression was used to evaluate factors associated to the presence of a current mental disorder.At least one mental disorder was found in 90 subjects (29.7% of the sample). Most prevalent diagnoses were major depressive disorder, lifetime panic disorder, PTSD, and generalized anxiety disorder. People with at least one psychiatric illness showed impaired global  and social  cognition, higher trauma levels  and more severe anxiety and depressive symptoms  compared to healthy migrants. Only trauma levels significantly correlated with HSCL-t25 psychopathological index. Trauma levels, global cognition, occupation, and migration status were associated to the presence of a current mental disorder.The results of the present study demonstrated that almost 1/3 of the guests of refugee centers in Campania have a mental disorder. The identification of risk factors associated to the onset of mental disorder and to severity of psychopathology in refugees and asylum seekers, may contribute to plan preventive and early psychiatric care in this population.None Declared


We present a rare case of slow-progressing neurocutaneous vasculopathy described as Sneddon syndrome. A child presented with global developmental delay, congenital livedo racemosa, unilateral vision loss, and a past history of focal neurological deficit. Our main objective is to make physicians aware of this nature of presentation in children. The presentation of neurological symptoms and widespread livedo racemosa raise clinical suspicion of Sneddon syndrome. The exact causative factor is unknown. The mode of inheritance is often sporadic but autosomal dominance with variable penetrance is seen in rare familial cases. It is considered to be part of the clinical spectrum of primary antiphospholipid syndrome. Women of age between 20 and 42 are predominantly affected .Apart from nervous system involvement, this syndrome also affects organs like the kidneys, heart, and eyes . The morAn eight-year-old girl presented with a history of congenital red-arborizing rash on the back and abdomen, gradually progressing to involve the rest of her body over five to six years Figure .The patient was born to second-degree consanguineous parents with uneventful antenatal and postnatal history. History was significant for delayed physical and mental development with no formal evaluation and work-up. Frequent episodes of headache, dizziness, weakness of the right side of the body, and loss of right eye vision at the age of seven were present. Over the course of one year, she had a retinal detachment in the right eye leading to phthisis bulbi, and the left eye showed changes of familial exudative vitreoretinopathy (FEVR), treated with laser photocoagulation. Cutaneous examination revealed an overlap of livedo racemosa and livedo reticularis, in the form of bluish to erythematous complete rings, closely arranged in a net-like pattern in a background of normal-looking skin all over the body including palms and soles with relatively sparing the central facial area. An isolated Nevus comedonicus was noticed over the left knee as multiple grouped keratotic follicular plugs Figure .The results of routine laboratory investigations, including complete blood count, comprehensive metabolic panel, and inflammatory markers, were within normal limits. Connective tissue disorders, including mixed connective tissue disorder, lupus, and Behcet's disease, were ruled out based on the negative anti-nuclear antibody, anti-U1 ribonucleoprotein, and anti-Sjogren's-syndrome-related antigen A autoantibody panel, and no association with human leukocyte antigen-B5. On neurological examination, the patient had decreased intelligence, loss of vision in the right eye, normal hearing and speech, sensory and motor functions, and normal tendon reflexes. A cerebral angiogram revealed bilateral internal carotid artery narrowing with collaterals from the external carotid artery and vertebral artery with bilateral segmental aneurysms suggesting vasculopathy. Magnetic resonance imaging of the brain showed gliosis representing vascular insults in the left frontoparietal and right frontal regions. Oral aspirin was initiated by the neurology team for stroke prophylaxis.Excisional skin biopsy from the central part of livedo racemosa was significant for thrombosis in medium and small-sized arteries and organizing hemorrhage at the junction of the dermis and subcutaneous tissue on histopathology, which translated to the clinical picture of the central pale area leading to the manifestation of a ringed net-like pattern Figure .With the cutaneous finding of livedo racemosa, histopathological features, thrombotic evidence in the computed tomography angiogram, and vasculopathy on magnetic resonance imaging, the patient was diagnosed to have Sneddon syndrome. This is one of the few cases reported of this syndrome manifesting in children at an early age.Sneddon syndrome is a rare non-inflammatory disorder involving small and medium-sized arteries characterized by cerebrovascular thrombotic episodes and a striking cutaneous component of livedo racemosa . The incLivedo racemosa is characterized by erythematous irregular, closely arranged rings and distributed most commonly over limbs, the trunk, buttocks, face, hands, and feet . In mostThe pattern of livedo racemosa is due to the stasis of blood in the superficial small to medium-sized arteries at the junction of the dermis and subcutaneous tissue either due to the hyperviscosity of the blood or due to the obstruction in the dermal arteries and capillaries ,6. The pExtracranial vascular events include deep venous thrombosis of the legs, pulmonary embolisms, and spontaneous abortions . CardiacThe management of Sneddon syndrome has no objective guidelines due to the rarity of the disease, which poses a challenge for clinical trials. The goal of the treatment is to prevent further ischemic insults in the skin, cerebral and extracerebral vasculature, and symptomatic control. Skin lesions associated with pain can be reduced by nifedipine . AntiplaSneddon syndrome preferentially involves cerebral and cutaneous small to medium-sized vasculature. Cutaneous findings of livedo racemosa in the setting of cerebral events, especially in younger females, warrant Sneddon syndrome in the list of differential diagnoses and as a diagnosis of exclusion. Optimal management remains unsolved. We would hereby emphasize considering Sneddon syndrome as a potential diagnosis in the presence of livedo racemosa and cerebral symptoms, irrespective of age, and the prompt initiation of antiplatelet and/or anticoagulative prophylaxis. The importance of follow-up in preventing irreversible complications and limiting disability due to neurological, cardiovascular, and ophthalmological complications cannot be overstated.


From Cobots to Human-Robot Synergy” delves into this fascinating dimension of human-machine collaboration, where robots and humans work together as a team to achieve common goals. Three distinct works shed light on various facets of this rapidly evolving topic, emphasizing the critical importance of adaptive autonomy, deliberative capabilities, and future-oriented support technologies in enhancing human-machine collaboration. Each paper contributes unique insights into the development of teaming frameworks promoting the role of robots from mere tools to efficient teammates able to learn from interactions, experiences and specific contexts and to adapt their behavior to suit the preferences and needs of their human partners.In recent years, technological advancements have paved the way for innovative solutions that integrate human operators with autonomous systems. The Research Topic “Hussein et al.) introduces the captivating world of swarms for urban search, rescue and cyber defense, with a keen focus on the critical coupling between humans and the swarm. The authors delve into five key aspects necessary for an adaptive agent to operate effectively, including mission objectives, interaction, mission complexity, automation levels, and human states. To ensure seamless interaction between humans and the swarm during missions, coordination is vital. Their approach employs an adaptive agent at the interface, skilfully monitoring and managing the system’s entities. This agent dynamically adjusts the level of autonomy based on mission states, using adaptive autonomy to strike the perfect balance between human workload and autonomous system performance. Furthermore, the research addresses the cognitive state of users in the human-swarm interaction. By assessing real-time human cognitive states like workload, fatigue, and attention, the system is enabled to make timely adjustments, ensuring safety and efficiency. Translating these cognitive states into meaningful guidance empowers the system to adapt effectively.The first article of this Research Topic (Avram et al. capitalizes on the teaming of humans and mobile robots by cultivating intelligent robot behaviors to alleviate stress factors and mitigate human exposure to hazardous tasks. The authors propose a deliberative framework for harsh working environments, aiming to proactively identify possible human errors and at-risk behaviors that could lead to accidents or compromise operational efficiency and reliability. The framework interprets these factors as primary behavioral cues affecting the robot’s decisional process and provides a well-organized integration of an extended set of robotic capabilities, including navigation, human activity perception, HRI, emotion recognition, deliberation, and planning and execution of tasks within MRO settings. The central goal is to trigger adapted behavioral responses that not only improve operational efficiency but also significantly enhance the occupational health and welfare of humans working in challenging environments. Exploring further the deliberative aspects, the framework relies upon three behavioral dimensions. First of all, it identifies potential hazards and safety issues in the current working situation involving the human. Next, it assesses the emotional state of the human, considering the impact of excessive psychological burden on task performance. Lastly, it proposes alternative routes to ease the difficulty of tasks, fostering a shared human-robot plan for optimal task execution.With an alternative approach accounting for the cognitive load and emotional states, Ott et al. discusses human-machine teaming dynamics from the perspective of direct-contact support technologies such as exoskeletons. The main motivation stems from the lack of scientific investigation and standardized tools to qualify exoskeletons as adaptable support technologies. Their framework aims at laying groundwork for the future-oriented qualification of exoskeletons and represents a novel and holistic approach to describing the support characteristics of these physical support technologies. Furthermore, it emphasizes the importance of user-individual and context-dependent adaptivity in exoskeletons’ interaction with operators. The need for adaptive systems arises from the ever-changing conditions and complexity of human beings and activities and the work carried out bridges this gap by enabling the description of existing support characteristics and defining future system behaviour. Exoskeletons, with their user-specific and context-dependent adaptivity, hold significant potential for providing targeted support in manual work processes.Unlike the first two frameworks which emphasize the potential of separate robotic teammates to complement and enhance the abilities of human teammates, All papers collectively highlight the vital aspects of adaptive autonomy, deliberative frameworks, and future-oriented support technologies in achieving effective and harmonious human-robot collaboration. From swarm systems to mobile robots and exoskeletons, the presented frameworks paint a compelling picture of how human-robot synergy can be harnessed to unleash the full potential of collaborative robotics. As researchers and practitioners delve deeper into these areas, the journey towards a future where humans and robots work hand in hand in perfect harmony continues to accelerate, promising a world of enhanced productivity, safety, and wellbeing.


In the climate of great uncertainty characterizing the COVID-19 pandemic, health communication played a significant role: several communicative strategies and channels were used to inform, educate and alert. Entropy-related risks were soon translated into the “infodemic”, a wide-spread phenomenon with psychosocial and cultural roots. Therefore, new challenges for public institutions occurred: public health communication, especially expressed through advertising and audiovisual spots, was engaged to offer key support in combatting the disease, mitigating its effects and supporting health and psychological wellbeing. This work aims to investigate how the Italian public institutions addressed those challenges by employing institutional spots. We tried to answer two main research questions: (a) in line with the literature concerning persuasive communication, what were the main variables that social advertising concerning health attitudes and behaviors relied on; and (b) how the different variables were combined to propose specific communicative pathways following both the different waves/phases of the COVID-19 pandemic and the elaboration likelihood model. To answer these questions, 34 Italian spots were analyzed by means of qualitative multimodal analysis . The results enabled us to individuate different communicative pathways, oriented by inclusivity, functionality and contamination, in line with different rounds as well as with the holistic configurations of cultural narratives, central and peripheral cues. The onset of the COVID-19 pandemic between the end of 2019 and the beginning of 2020 represented a phenomenon strongly correlated to a climate of great health uncertainty. After China, Italy was the second largest country with the most immediate and widespread diffusion of the SARS-CoV-2 virus. These data characterized it as having a privileged point of view and, in some respects, being a model of the various processes involved in the pandemic event. In Italy, as in other countries, the expansion of the virus, combined with the initial inability to provide adequate solutions for the treatment of the disease, immediately forced the national public health authorities to think of and plan a series of measures that could curb the spread of disease and the blocking of hospital systems. The resulting list of measures was accompanied by a significant communicative effort to seek the general population’s compliance and enable the established political and health strategies to be effective.Communication in the health field has therefore played an essential role in the management processes of the COVID-19 pandemic. However, it is well recognized that public health is a highly difficult field in which to intervene with massive communication campaigns to inform citizens about health risks and disease prevention , in lineThese processes and problems have manifested themselves in a climate previously characterized by a progressive erosion of trust in public institutions and by a general state of information crisis in the field of health and science . ConsequThrough these channels, institutional communication, following the evolution of the pandemic, has made effective use of public advertising, primarily through audiovisual spots, intending to represent the fundamental support in countering the SARS-CoV-2 infection, mitigating the effects of the disease and, in general, support the health and psychological well-being of the population. The present work is specifically focused on this short and strategically planned communication and analyzes the entire Italian institutional advertising campaign, broadcast during the COVID-19 emergency, through a qualitative investigation of their main characteristics.It is widely acknowledged that advertising acts as a “cultural operator” and through micro-stories of everyday life, “it deliberately turns abstract notions into specific situations by precisely delineating features, contexts, dialogues and social interactions”  (p. 3). Taking into account the colossal scale of the social, economic and political events related to COVID-19, the attention of social scientists and scholars should be focused not only for the scrutiny of the events themselves but also on how they are narratively reported: cultural narratives generated by advertising can account for new forms of awareness and sensibilities . Thus, aFor at least the past 60 years, social psychology widely acknowledged the importance of persuasive communication in trying to change peoples’ attitudes and behaviors, and these studies generated a consensus regarding the role of attitudes in affecting actions as well as concerning the existence of several variables moderating attitude–behavior relationships . These pAn integrative framework to analyze how different mechanisms in different situations can impact persuasion is the elaboration likelihood model . This mSince public health communication and campaigns aim, especially during a sanitary emergency, to obtain a massive adhesion to specific attitudes and behaviors, persuasive messages should be disseminated in the most conducive way. Consequently, the types of cues and the related levels of elaboration are of significant interest to the comprehension and improvement of the persuasive processes.This work aims to investigate how Italian public institutions focused on health communication by means of institutional spots during the different phases of the pandemic crisis. In this light, cultural issues and persuasive pathways were considered. Specifically, this work tried to answer the following research questions: (a) in line with the literature concerning persuasive communication, what were the main variables/factors that social advertising relied on when trying to affect health attitudes and behaviors, and (b) how the different variables were combined in order to propose specific communicative pathways following the different waves/phases of the COVID-19 pandemic. These research directions were explored in accordance with several variables, concerning: (i) the scopes of the spots; (ii) the major cultural narratives proposed by Italian institutional advertising; and (iii) in accordance with the elaboration likelihood model, the main types of central and peripheral cues.https://www.governo.it/it/node, accessed on 1 September 2022).We collected and analyzed 34 Italian spots , which were broadcasted during the first four COVID-19 waves through the institutional national TV channels (RAI channels), social media  and social networks . The whole corpus see  was avaiSpots were analyzed through qualitative multimodal content analysis. Based on the literature concerning institutional advertising during the pandemic and of the more general application of ELM to advertising ,17,28,30The coding activity was conducted in accordance with the following domains.(a)General (meta)data. In this domain, a categorization of the scopes of advertising was proposed, through bottom-up and top-down processes, as it enabled us to frame the main functions of spots.(b)Cultural narratives. We considered this variable essential since, through the scenarios and social interactions offered by the spots’ micro-stories, the representations of reality were transformed into cultural references, supporting how reality may be perceived and explained [xplained .(c)Central cues. As the favorite way for an accurate cognitive elaboration, the presence of information, the reference to morality and values and the type of argumentation were investigated.(d)Peripheral cues. The features of testimonials, images and soundtracks were considered significant but activated less elaborate reflections.These domains and variables were included in our analysis as they were able to explain the institutional and communicative efforts to activate both more general meaning-making processes and more contextualized pathways of content elaboration. The specific codifying variables are presented in In line with the broadcast date/time and with the main objects proposed by the audiovisual spots, three phases of the Italian institutional campaign concerning health communication during COVID-19 were identified.Facing lockdown. Spots from 1 to 12 (broadcast from 11 February 2020 to 23 April 2020) were included in this round. The main scopes of these spots concerned hygiene rules for virus prevention, the presentation of supporting services to facilitate the sanitary emergency, the promotion of virtuous behaviors and emotional messages of union/solidarity.(1) -call for collective responsibility and mutual protection (five spots);-macro social changes (four spots) ;-resilience and overcoming challenges (three spots);-feeling of togetherness (three spots);-sense of community (three spots);-space and social atmosphere (two spots);-gratitude (one spot) addressed to “our heroes” .As for the cultural narrative domain see , the mosLooking at the central cue domain see , five spAs for the peripheral cue domain see , five spLiving with COVID-19. Spots from 13 to 24 (broadcast from 5 May 2020 to 28 October 2020) were included in this round. Even if officially set during the first Italian lockdown, spots from 13 to 15 were included as well, since they appeared as “transitional” messages aimed to convey public recommendations for facing the last days of lockdown. The main scopes proposed by audiovisual spots concerned hygiene rules for virus prevention, supporting services for the health emergency and the promotion of virtuous behaviors.(2) -collective responsibility and mutual protection (nine times);-sense of community (two times);-having a resilient attitude (two times);-social spaces and atmosphere (two times);-macro social changes (one time) ;-the possibility of coming back (one time).As for the cultural narrative domain see , we founThe central cue domain see  was consAs for the peripheral cue domain see , five spThe vaccine challenge. Spots from 25 to 34 (broadcast from 17 January 2021 to 29 December 2021) were included in this round. The scope of the spots concerned the vaccine awareness campaign and, just in one case, the supporting services for the health emergency (but again related to the vaccine facilitation).(3) -collective responsibility and mutual protection (five times);-social spaces and atmosphere (eight times);-resilience and overcoming challenges (seven times);-togetherness (six times);-sense of community (four times);-the idea of coming back to past situations (three times);-macro social changes (two times), referring to the risks of vaccine-related fake news;-gratitude (one spot) addressed to members of the scientific field for their work with vaccines.As for the cultural narrative domain see , we obseLooking at the central cue domain see , all theAs for the peripheral cue domain see , spots fDuring the health emergency related to the COVID-19 pandemic, extraordinary interventions and measures were taken. Health communication had to be “resilient” to face the changing global community and meet citizens’ needs and expectations, trying to maintain responsible relationships with media and various strategic public institutions . InstituIn terms of the earliest and most critical phase, during lockdown, institutional advertising had to accompany the severe restrictions characterizing that period, facing uncertainties, informational needs and emotional turmoil. Two main directions were found in public spots. First, a wide variety of messages and cues, involving several cultural narratives and heterogeneous scopes, informative and conative aims and individual and collective values were evidenced. The well-blended narratives and the rather equally distributed central and peripheral cues, typical of this phase, appear oriented to emphasize the exceptionality of the situation. Second, the overall value of “inclusivity” was proposed, since: (i) scopes, narratives and contents were addressed to fragile populations , as also testified by the use of Italian Sign Language; (ii) morality was mostly other-oriented and values were focused on responsibility and national security, thus emphasizing self-transcending and conservative orientations . These fThe second phase, focusing on the need for co-existence with the pandemic, had a transitional nature: some cultural narratives and scopes typical of the initial stage  were overcome in favor of more functional messages and cues. In addition, certain features typical of the third phase began to appear. The configuration of narratives represented a first timid impulse toward the idea of a “normal” life. The scopes, mainly oriented to present hygiene rules, supporting services, and virtuous behaviors; contents, dealing with simplified and repeated behaviors and practices; morality, both self- and other-oriented; and values, again emphasizing self-transcending and conservative orientations, concurred to promote a clear and univocal attitude toward health practices. The types of arguments, mixed between one-sided and two-sided but involving a larger number of issues, implied a more functional communicative style. In addition, the fewer recurring peripheral cues, mainly images and soundtracks, outline a more rational approach. In this context, testimonials were either missing or non-popular; when celebrities were used, three comic actors generated an atmosphere of familiarity and reassurance; therefore, they could be identifiable as non-biased testimonials . The preThe third phase, essentially identified with the institutional pro-vaccine campaign, showed a more propositional aim and followed a new communicative scenario. The cultural narratives, again focused on responsibility and mutuality (representing the common thread of the whole campaign) were set in a changed context and appeared as future-oriented: the memory of social spaces and atmospheres, the emphasis on resilience and national security, the battle against the pandemic and the trust in science converged to create a general encouraging climate, promoting the opportunity to both come back and to overcome the challenges proposed by the pandemic. The main feature of the institutional campaign in this phase is “contamination”, which can be defined in the following forms: (1) the chronotope, since space and time, which were “suspended” in the previous stages, are proposed again, thus creating a connection between past practices, present care and future opportunities; (2) testimonials, with (i) both celebrity and non-celebrity figures appearing in the same spots and (ii) celebrities from all domains , as well as (iii) COVID-19-related non-celebrity figures; (3) central and peripheral pathways, involving values—not only highlighting self-transcendence and conservation but also openness and self-enhancement —and contThis work has some limitations, mainly related to the reduced and contextualized sample, even though it coincided with the Italian institutional advertising campaign. In addition, the variables, although they were selected from among the most representative in the recent international literature devoted to these matters and fit our sample well, were not exhaustive in terms of the central/peripheral cues in advertising. Most importantly, since pandemic communication was an important point for mitigating the crisis’ effects, an approach oriented to investigate the effectiveness of the applied communication and social advertising could fulfill the insights obtained from our results, mainly focused on the communicative features of the spots which the public institutions in Italy commissioned. This input represents an essential base for future investigation.Nonetheless, to the best of our knowledge, this is the first work matching the analysis of cultural narratives with the ELM framework and applying the ELM model to institutional advertising concerning the health emergency of COVID-19. In addition, some emerging results—e.g., the types of arguments and the reference to values, the importance of gestures, and the role of testimonials—offer innovative implications for health communication and literacy and new inputs for audiovisual institutional communication.Our study emphasized the importance of qualitative investigation as an opportunity to deepen the communicative efforts by institutions in the battle against the COVID-19 pandemic and the infodemic, in line with strategical advertising communication and against a broader socio-cultural background. Even if we propose a coding activity enabling us to compare the spots of each round referring to the incidences of cultural narratives and central and peripheral cues, we believe that the most interesting insights concern the way in which the included variables offer specific inputs and, at the same time, are set together as more holistic repertoires in different contexts. Therefore, similar narratives, as well as the preference for central/peripheric cues, can have different outcomes when they are differently blended, thus configuring communicative pathways regarding inclusivity (first round), functionality (second round) and contamination (third round).In addition, this study offers significant applicative opportunities in promoting overall and specific awareness about health communication. In particular, the comprehension of the configuration of the cultural narratives and of the persuasive  cues can (a) inform about the levels of elaboration and attitude creation, including epistemic self-defense skills and health literacy ; (b) imp


The chemosensory system is vital in maintaining homeostasis in humans and animals. However, the complex mechanisms behind the detection, transmission, and modulation of chemosensory cues by homeostasis are not fully understood. Chemosensory processing is postulated to involve a multifaceted flow of events, including nutrient sensing mechanisms in the brain and gut, learning, memory, and reward systems. Therefore, understanding the chemosensory receptor's ability to sense nutrients in response to metabolic changes can inform disease treatment and suggest directions for nutrition wellbeing.Tuluhong and Han, Kwon et al., Yeung, Zhang et al., and Briard et al. lies in their exploration of the complex interactions between chemosensory perception, food ingredients, micronutrients, stress, reward, functional sensory cues, and higher-level cognitive processing of food information, all of which contribute to our understanding of nutrition and health. Below are the key highlights from the papers published.This Research Topic focuses on the burgeoning interdisciplinary field seeking to understand the role of chemosensory perception in nutrition and health. In this special issue, we present a collection of five articles that explore various aspects of sensory nutrition association, including epidemiology, sensory psychophysics, physiology of chemical senses, and the impact of stress, emotion, reward, and mood on chemosensory perception, paving the way for nutritional tools to study chemosensory perceptions and their potentially broad role in human health and diet-related diseases. The commonality between these articles, including those by Tuluhong and Han investigated the relationship between chronic stress, food reward, and the perception of food and non-food odors among college students. The results showed that subjective perceived stress levels significantly correlated with the emotional and reward-based eating behaviors. In addition, the daily stressor exposure was associated with decreased liking for low-calorie sweet foods.Kwon et al. explored the impact of coffee intake on the sympathetic response to acetylcholine and the sudomotor function. This study revealed that high concentrations of caffeine intake could stimulate higher activation in axon reflexes and sweat responses, implying that caffeine may activate nicotinergic axon reflexes and muscarinergic acetylcholine signaling and supporting its further implications in the activation of the cholinergic and sudomotor functions as a clinical supplement.Yeung conducted a meta-analysis of fMRI studies examining the neural correlates of food labels  as stimuli. Results showed that food labels were generally processed in brain regions related to internal mentation of self-consciousness and nutritional evaluation, but the correlates of food brand and food nature labels were inconsistent across findings, highlighting the need for further research.Zhang et al. investigated the cross-sectional association between vitamin K intake and depressive symptoms in United States adults using a large dataset from the National Health and Nutrition Examination Survey (NHANES) 2013–2018. The study reported an inverse linear relationship between vitamin K intake and depressive symptoms in a sample of 11,687 adults, after adjustments of potential confounding variables. Such findings provide initial evidence that increased vitamin K intake may be associated with a reduced likelihood of depressive symptoms.Briard et al. examined the effects of supplementation with a sensory functional ingredient (flavor) on the behavioral and brain responses of juvenile pigs to acute stress. The study demonstrated that previous exposure to the functional ingredient modulated the brain activation in the brain areas involved in food pleasure and motivation, while alleviating the brain responses to acute stress in animals such as pigs. This study offers insights into the role of chemosensory signals (flavor) on stress adaptation.Using functional magnetic resonance imaging (fMRI), The research presented in this special issue emphasizes the significant progress made in understanding the role of sensory nutrition association in health and wellbeing management. These studies offer valuable insights into the complex interactions between chemosensory perception and environmental factors, including findings from brain imaging in animals. Moreover, the articles underscore the importance of continued investigation in this field to develop targeted or personalized sensory-nutritional interventions that could potentially be used to manage diet-related diseases and wellbeing. By addressing various aspects of this multifaceted field, the articles collectively contribute to the growing body of knowledge on sensory nutrition association, highlighting its potential connections with other aspects of human health and wellbeing. As such, the diverse Research Topics presented in this issue underscore the importance of a comprehensive understanding of chemosensory perception in human health and disease management, paving the way for continued investigation and critical analysis.Collectively, the articles included in this Research Topic demonstrate the findings from various techniques on the relationship between chemosensory perception and wellbeing. We sincerely hope you find this collection of articles interesting and inspiring. These studies contribute to the expanding knowledge base on sensory nutrition association and emphasize its potential impact on human health and wellbeing. By continuing to explore this fascinating area of research, we can develop a deeper understanding of the role chemosensory perception plays in nutrition, psychology, and brain health, ultimately leading to improved health outcomes and wellbeing management strategies.All authors wrote the first draft, made critical revision, and approved the final version of the manuscript.


The maintenance of redox homeostasis is associated with a healthy status while the disruption of this mechanism leads to the development of various pathological conditions. Bioactive molecules such as carbohydrates accessible to the microbiota (MACs), polyphenols, and polyunsaturated fatty acids (PUFAs) are food components best characterized for their beneficial effect on human health. In particular, increasing evidence suggests that their antioxidant ability is involved in the prevention of several human diseases. Some experimental data indicate that the activation of the nuclear factor 2-related erythroid 2 (Nrf2) pathway—the key mechanism in the maintenance of redox homeostasis—is involved in the beneficial effects exerted by the intake of PUFAs and polyphenols. However, it is known that the latter must be metabolized before becoming active and that the intestinal microbiota play a key role in the biotransformation of some ingested food components. In addition, recent studies, indicating the efficacy of the MACs, polyphenols, and PUFAs in increasing the microbial population with the ability to yield biologically active metabolites ), support the hypothesis that these factors are responsible for the antioxidant action on the physiology of the host. The underlying mechanisms through which MACs, polyphenols, and PUFAs might influence the redox status have not been fully elucidated, but based on the efficacy of SCFAs as Nrf2 activators, their contribution to the antioxidant efficacy of dietary bioactives cannot be excluded. In this review, we aimed to summarize the main mechanisms through which MACs, polyphenols, and PUFAs can modulate the host’s redox homeostasis through their ability to directly or indirectly activate the Nrf2 pathway. We discuss their probiotic effects and the role played by the alteration of the metabolism/composition of the gut microbiota in the generation of potential Nrf2-ligands  in the host’s redox homeostasis. Oxidative eustress represents the physiological exposure to low doses of endogenous oxidant species, produced by cells to address specific targets via the redox network to maintain cell homeostasis . The altFirmicutes and Bacteroides over potentially pathogenic ones such as Proteobacteria is called eubiosis, and it has been associated with a healthy status of the host organism. On the contrary, the perturbation or disruption of this composition, known as dysbiosis, has been associated with several metabolic or immune disorders [The intestine is an essential organ involved in human nutrition, and increasing evidence indicates that the interplay between gut commensal bacteria (microbiota)—the complex microbial community that colonizes the human gut—and its composition is influenced by the host’s genotype, environment, and diet. In particular, food nutrients play a key role in human metabolism and health via the modulation of multiple mechanisms, including energy metabolism, intestinal homeostasis, antioxidant homeostasis, and immune responses . In partisorders .The consensus on microbiota-mediated healthy effects on the host is based on the microbe-induced biotransformation of food components into bioactive metabolites. Bioactive molecules exhibit, in combination with food components, the ability to modulate the metabolic pathways of the host or to modify the composition and metabolism of the microbiota. Among them, non-digestible fibers, also known as microbiota-accessible carbohydrates (MACs), polyphenols, and PUFAs, are the best-characterized food components influencing the composition and metabolism of the microbiota .Analogously, the regulation/activation of the Nrf2 pathway can be exerted by endogenous ROS (Reactive Oxygen Species) or exogenous molecules, such as dietary bioactive molecules that may need to undergo structural transformations by the gut microbiota before performing their bioactivity. The link between Nrf2 and gut microbiota health may be hypothesized on the basis of the association of Nrf2 dysfunction with the alteration of the composition of the microbiota due to ageing or pathological conditions. Unfortunately, there is only one study that supports this connection  and, as In this review, we first discuss the role of microbial by-products, such as short-chain fatty acids (SCFAs), on Nrf2-mediated oxidoreductive homeostasis (redox status). Then, we provide a comprehensive and updated overview of the interplay of MACs, polyphenols, and PUFAs on the composition/metabolism of the gut microbiota and their direct action on specific molecular targets or their indirect action—via the modulation of the composition of the microbiota—which, downstream, modulates the host’s redox status via the production of SCFAs .Nrf2 is a redox-sensitive transcription factor, and it is the master regulator of oxidoreductive and immune homeostasis. In the cell cytoplasm, Nrf2 is associated with the inhibitory protein Kelch-such as ECH-associated Protein 1(Keap1), which, owing to the presence of specific cysteine residues, acts as a sensor of endogenous and exogenous prooxidants . In partAs for SCFAs, bioactive polyphenol metabolites can affect specific pathways determining the modulation of specific target genes. In particular, their antioxidant activity is achieved through the activation of the Nrf2 pathway . HoweverRoseburia, Oscillibacter, Faecalibaculum) in mice treated with several Nrf2 activators [This hypothesis is consistent with a recent result showing the positive correlation between Nrf2 activation in the brain with the levels of SCFA-producing bacteria , Firmicutes (30–52%), and Actinobacteria (1–13%) [14 cells, representing the largest number and highest concentration of microorganisms found in the human body [The gut microbiota comprise thousands of bacterial species, mainly those of  1–13%) ,13, whos% ,13, whman body . Recent man body .Firmicutes to Bacteroidetes ratio (F/B ratio) has been extensively examined in the human and mouse gut microbiota, and it has been demonstrated that the F/B ratio is associated with metabolic diseases [The homeostatic condition of the intestinal microbiota (eubiosis) mainly depends on the balanced diversity of these microbial populations and the controlled growth of potentially pathogenic bacteria. A reduction in the diversity of the intestinal population (dysbiosis) can directly affect the epithelial and mucosal functions, leading to an inflammatory environment in the gastrointestinal tract  as well diseases , inflammdiseases , neuropsdiseases ,22,23.The beneficial effects associated with the diversity of the microbial population arise from the metabolic activities of specific microbial populations. Under eubiotic conditions, the commensal relationship between the microbiota and the host mainly consists of the capacity of bacteria to generate bioactive metabolites, starting from the ingested food, which exhibits the ability to modulate different metabolic pathways of the host . For exaBacteroidetes and Firmicutes, mainly produce acetate/propionate and butyrate, respectively [Bacteroidetes and Firmicutes to produce butyrate and propionate [The growth of anaerobic SCFA-producing bacteria is favored by the low oxygen concentrations in the intestine where the two most abundant populations, namely, ectively . Interesopionate . This exThe homeostatic condition of the intestinal microbiota can be restored by the level of SCFAs, and many studies in vivo describe the link between gut dysbiosis and the production of SCFAs .2 consumption during butyrate uptake and its metabolism by the intestinal epithelium stabilizes the hypoxia-inducible factor (HIF)—a transcription factor that coordinates barrier protection—which promotes the creation of an anaerobic environment. This “physiological hypoxia” stimulates the growth of SCFA-producers (anaerobic bacteria) [Salmonella typhimurium [Clostridium difficile [It can be assumed that butyrate, being a fundamental nutrient for colonocytes, satisfies the metabolic demands of the colon epithelium , and it acteria) , indirecacteria) . In addihimurium  or Clostifficile .Acetate, propionate, and butyrate in the colon are present in the molar ratio 60:25:15, although proportions can vary depending on factors such as diet, microbiota composition, the site of fermentation, and the genotype of the host . These aAcetate, propionate, and butyrate reach the highest concentrations (70–140 mM) in the proximal colon  where thA study on a mouse model of induced colitis demonstrated that SCFAs preserve gut homeostasis by acting on the inflammasome pathway through the upregulation of interleukin (IL)-18 . AccordiConvincing evidence supports the idea that the beneficial effect of SCFAs extends beyond the colon. In fact, SCFAs participate in different physiological processes in the human body, being able to improve gut physiology, modulate the host’s glucose and lipid metabolism, and affect immune function ,64. In pThe detailed description of the mechanisms involved in the signalling activity of SCFAs does not fall within the scope of this work and, due to its complexity, only a synthetic presentation is reported herein. Besides the relevant role in intestinal health, SCFAs may play their signalling role via the activation of several biochemical pathways: G-protein-coupled receptors (GPCRs), histone deacetylases (HDACs), and Nrf2 ,72,73 F.2+ release and the activation of protein kinase C [In humans, there are at least six GPRs that are sensitive to SCFAs, but among them, only GPR41, GPR43, and GPR109A are involved in SCFA-mediated signaling. GPR41 and GPR43 are the best-studied SCFA receptors  and are kinase C .+ T cell IL-10 production [HDACs are a group of enzymes that affect gene transcription or alter protein activity by removing the acetyl group on the lysine ϵ-amino group of the target protein. The inhibition of HDACs is relevant for immune and inflammatory regulation by modulating either innate immunity through regulation of the Toll-Like Receptor (TLR) and Interferon (IFN) signaling pathways or by regulating antigen presentation and B and T lymphocytes to achieve adaptive immunity ,79. In poduction ,81.Clostridium butyricum pretreatment to increase the SCFA contents in the cecum of Enterotoxigenic Escherichia coli K88 (ETEC K88)-infected mice. In particular, the data indicated that such improvement was associated with the amelioration of the oxidative damage induced by ETEC K88 infection through the activation of the Nrf2 pathway [Interestingly, the functional link existing between this signaling pathway and gut microbiota homeostasis has been indicated by (a) the modulatory ability of SCFAs in the Nrf2 pathway , (b) the pathway . A summaFinally, the interplay existing between different SCFAs further strengthens the complexity of their mechanism of action ,86 Figu.Diet has a fundamental role in determining the composition of the gut microbiota. MACs, PUFAs, and polyphenols are the most well-characterized food components able to modulate the composition and metabolism of microbiota. All of these food components can exert prebiotic effects that result in the modulation of bacterial strains producing SCFAs. These compounds can affect specific molecular mechanisms that result directly in beneficial effects on the host’s health or indirectly allow the gut microbiota to produce active/antioxidant metabolites. A detailed description of the complex network involved in the SCFA-mediated signaling activity and its therapeutic relevance have been presented elsewhere by  and willNon-digestible polysaccharides such as resistant starch, inulin, cellulose, guar gum, and pectin—collectively known as MACs—are the main energetic source of gut bacteria. MACs exert a modulatory role in the gut microbial composition, maintaining gut homeostasis. An MAC-rich diet in humans is associated with an increased content of colonic and fecal SCFAs . On the After ingestion, intact MACs reach the colon where they are metabolized by microbial enzymes, i.e., glycoside hydrolases and polysaccharide lyases. These enzymes, degrading the glycosidic bonds, convert MACs into monosaccharides . The digPolyphenols are dietary bioactive compounds derived from plants and present in fruits and vegetables. These compounds are chemically characterized by the presence of at least one phenyl ring and one or more hydroxyl substituents. Dietary polyphenols are characterized by poor absorption and extensive metabolism .Most of the dietary-ingested polyphenols are present as glycosylated ester or polymer forms, and after ingestion, they are recognized as xenobiotics. Their structural complexity determines that they reach the large intestine without modifications. In the gut, polyphenols—through microbic metabolism—are converted into low-molecular-weight metabolites and then absorbed from epithelial cells to reach the plasma.Small polyphenols can be easily absorbed after de-glycosylation by bacterial enzymes. Then, they are converted into soluble metabolites through Phase I  and Phase II reactions (conjugation) . On the Polyphenols are present in low concentrations in foods, as compared to macronutrients, and their low bioavailability results in a lower amount absorbed by the body. The strong discrepancy between the biological activity of polyphenols and their concentration has led to the formulation of the low bioavailability/high bioactivity paradox ,103.The biotransformation of polyphenols by gut microbiota and the capacity of polyphenols to modulate gut microbiota have been reported ,105. ConFor example, resveratrol, widely distributed in grapes, berries, and peanuts, is transformed by the gut microbiota into different metabolites: dihydroresveratrol (DHR), which is partly absorbed and further metabolized to two conjugated forms: monosulfate (DHR) and monoglucuronide (DHR). An analysis of the bioavailability of these microbial metabolites indicates that upon daily intake of 500 mg of pure trans-resveratrol, the metabolite concentration in plasma increased from 3 to 13 μM .Curcuma longa (Linn.)), is converted into active metabolites in a two-step reaction: the first produces dihydro curcumin (DHC) from curcumin, and then DHC is converted into tetrahydro curcumin (THC). It has been reported that supplementation with 1 g of turmeric acid and curcumin was not detectable in plasma while the concentration of the active metabolites persisted in blood for at least 8 h, ranging from 2 to 47 nM [Curcumin, found in turmeric  PCA , and 3-OPAC (3-hydroxyphenyl acetic acid). These metabolites may exert their effect by directly modulating different signaling pathways , such asAs for SCFAs, bioactive polyphenol metabolites can affect specific pathways determining the modulation of specific target genes. For example, their antioxidant activity is achieved through the activation of the Nrf2 pathway. Several in vitro and in vivo studies demonstrated that polyphenols can activate the Nrf2 pathway ; howeverBacteroides, Enterococcus, and Eubacteria play a key role in determining the metabolic fate of polyphenols [Slackia equolifaciens and Adlercreutzia equolifaciens. Curcumin is converted into active metabolites mainly by Escherichia coli, but it can also be metabolized by Blautia sp. [Eubacterium ramulus, Clostridium orbiscindens, Eubacterium oxidoreducens, and Butyrovibrio spp. that can cleave the C-ring [Different microbial genera including yphenols . In addiutia sp. , and quee C-ring . The impe C-ring . Howevere C-ring . Individe C-ring . This caBifidobacteria and decreases the ratio of Firmicutes to Bacteroidetes. Polyphenols can alter the composition of the microbiota, thus determining changes in polyphenol metabolism and bioavailability, and bioactive metabolites can have beneficial effects on the host’s health  [Bifidobacteria) and limit that of LPS-producing bacteria (Proteobacteria) [Dietary lipids have been recognized to alter the gut microbiota composition by acting as substrates for bacterial metabolic processes or by modulating the growth of propionate- and butyrate-producing bacteria  . A recenseburia) . In partseburia) . Severalseburia) ,138. Othacteria) , whose pButyrivibrio, Roseburia, and Lactobacillus), leading to a significant increase in butyrate in the feces and in acetate in the plasma [Conjugated Linoleic Acid  is another PUFA that is attracting scientific interest due to its multiple beneficial effects, which, similarly to n-3 PUFAs, may be independent or dependent on the modulation of gut microbiota metabolism. The term CLA is the collective name generally used to indicate a further subclass of PUFAs without a methyl group between adjacent double bonds . In particular, this generally refers to geometric and positional isomers of LA mainly present in dairy products and meat from ruminants ; the concentration of the former isomer typically ranges from 3 to 7 mg/g of fat. Commercially available dietary CLA supplement (CLAmix) is composed of an equimolar mixture of these two isomers. Dietary supplementation with the trans10, cis12 isomer is associated with the modulation of lipid metabolism and glucose tolerance, while the cis9, trans11 isomer has preeminent anti-oxidant and anti-inflammatory effects. The intake of an equimolar mixture of the two CLA isomers was suggested to effectively activate many biological pathways owing to the combined action of its isomers . Moreovee plasma . In thise plasma . In addie plasma .In other studies, dietary LA may be indeed metabolized by several gut bacteria and converted into cis9, trans11 or some of its precursors  . These CIn this review, we summarized the antioxidant mechanisms underlying dietary MACs, polyphenols, and PUFAs. The literature data reported in the field suggest that these molecules can exert their modulatory activity on the human redox status by acting in two main different ways: direct or indirect.In particular, the antioxidant activity exhibited by PUFAs may be, at least in part, a consequence of their direct ability to target the Nrf2 pathway. In addition, based on the role of SCFAs as Nrf2 ligands, dietary MACs, polyphenols, and PUFAs may also have prebiotic activity, favoring the growth of SCFA-producing microbial populations, which are characteristic of eubiosis conditions.Polyphenols and PUFA metabolites also exhibit an indirect effect, in which their biological activities can contribute to or enhance the effects triggered by the parent ingested molecules.The key modulatory role played by SCFAs and polyphenol metabolites on the physiology of the host is mirrored by the network of molecular mechanisms underlying their direct activities, involving Nrf2 and HDAC signaling pathways and GPRs for SCFAs. Such complexity is further accentuated by the reciprocal interactions between these pathways.SCFA production also represents important crossroads of the biological activities exerted by polyphenols and PUFAs.The interplay among n-3 PUFA and CLA and gut microbiota is herein summarized for the first time, and the evidence of their direct and indirect actions on the physiology of the host likely contributes to expanding the nutritional and therapeutic importance of these dietary molecules.In conclusion, the shared molecular pathways activated by polyphenols, PUFAs, and SCFAs support the role of Nrf2, HDACs, and GPRs as pharmacological targets. Since the activation of these pathways triggers a downstream signaling cascade, this can explain why dietary bioactive molecules can exert antioxidant/beneficial effects even when present in a low plasma concentration. A better understanding of the mechanisms underlying the prebiotic effects of polyphenols and PUFAs is an issue to be further explored that will shed light on the knowledge of their beneficial effects on human health.


Background and Objectives: In the current literature, mandatory surgical exploration is a controversial topic, with some advocating for it and others against it, proposing a selective conservative management. This multidisciplinary therapeutic approach is based on clinical examination and serial paraclinical explorations associated with supportive drug treatment. Materials and Methods: The study group consisted of 103 patients with complex cervical trauma pathology produced by various mechanisms such as car or domestic accidents, aggression, ballistic trauma, self-inflicted attempts, hanging or strangulation hospitalized in the Ear, Nose and Throat (E.N.T.) Clinic, at “St. Spiridon” Iași Hospital, between 2012 and 2016. Results: The universal clinical indication for urgent surgical exploration of the patient with complex cervical trauma is the presence of the following symptoms: unstable vital signs, significant pulsatile bleeding, hematoma with a substantial increase in size, shock, airway obstruction, open airway wound, hematemesis, or hemoptysis. In this context, we considered it worthwhile to research the management of complex cervical trauma in a reference university medical center, alongside the analysis of the patient’s characteristics under different aspects . Conclusions: Complex cervical trauma has a variety of clinical aspects, with a variable evolution, which involves multidisciplinary therapeutic management. The increasing trauma rate is one of the main public health problems, requiring epidemiological studies, and the implementation of control strategies. The management of cervical trauma has been a topic of great interest and controversy over the years. The need for surgical exploration of all cervical wounds’ dates back to the time of the Second World War (WWII). However, the evolution of the emergency medical system and paraclinical investigations has contributed to the improvement of global statistics regarding the mortality and morbidity of this pathology.Currently, studies reported by various authors show similar mortality and morbidity regarding the approach of clinical surveillance and non-exploratory diagnosis in selected cases versus surgical management for all patients. The universal clinical indication for urgent surgical exploration of the patient with complex cervical trauma is the presence of the following symptoms: unstable vital signs, significant pulsatile bleeding, hematoma with a substantial increase in size, shock, airway obstruction, open airway wound, hematemesis or hemoptysis . ProponeOn the other hand, in the last five years, the current otolaryngology opinion issues the hypothesis, with already quite a few followers, in favor of selective surgical management. Paraclinical examinations are required, which include angiography, esophagography, panendoscopy, and computed tomography. Explorations are indicated only in hemodynamically and respiratory stable patients. This management strategy is preferably performed only in hospital facilities with appropriate logistics .We present a retrospective and prospective study of complex cervical trauma pathology secondary to various accidents or aggressions, which required surgical interventions. Our main objectives were to analyze the management of complex cervical trauma in a reference university medical center, and the analysis of the patient’s characteristics under different aspects .The study group was made up of 103 patients admitted to the Ear, Nose and Throat (E.N.T.) Clinic, “St. Spiridon”, Iasi, between 2012–2016, with complex cervical trauma pathology produced by various mechanisms, such as car accidents, domestic accidents, assaults, ballistic trauma, self-inflicted attempts, hanging or strangulation. However, this study was partially limited by the fact that information on particular patients was incomplete, due to the retrospective nature of the research and the lack of uniformity regarding the description of the operative technique, along with the results of the paraclinical investigations performed, as there was no existing standardized protocol; a situation that could bring some damage to the data identified on this study. The study was started in 2014 and it consisted of two parts. The patients included in the retrospective study were those admitted to the ENT clinic of “Saint Spiridon” Hospital, Iasi, in the period 2012–2014. Likewise, the patients included the prospective study were those patients admitted to the ENT Clinic in during 2014–2016. We defined the complex cervical trauma as the lesions that are penetrating platysma and involve at least the superior aero-digestive tract, vascular, neurologic, thyroidian or salivary gland structures.p < 2) method tests the normality of the series of values. In calculating the significant difference between the two means, the Student’s t-test considers the measurement of variability and the weight of the observations. F-test (ANOVA) was used to compare values with normal distributions in three or more groups. The Pearson correlation coefficient was used to establish the existence of correlations, and their intensity between various numerical variables studied. The type of correlation was expressed by the sign of the Pearson correlation coefficient, and the power of the link between the variables was represented by its value. Statistical significance was set at the p < 0.05 threshold for a 95% confidence interval. Univariate and multivariate analysis by logistic regression was used to determine the variables correlated with the presence or absence of the studied events, identifying statistically significant independent parameters.The data were centralized in an SPSS 18.0 database and processed with the statistical functions to which they lend themselves at the significance threshold of 95%. Using specific statistical methods, it was possible to calculate the mean value and the standard deviation (SD); quantitative variables were compared using the Student’s t-test, and the Chi-square test assessed quantitative parameters. The ANOVA test was used to evaluate descriptive statistical indicators: minimum, maximum, mean, median, standard deviation, standard error of the mean, and variance. The Skewness, Kurtosis . patients come more frequently from rural areas (56.6%), they are predominantly male (89.6%), under the age of 45 (55.7%); the lesional determining mechanism is noted more frequently through aggression (39.6%), followed by the self-inflicted mechanism (39.6%) and the accidental mechanism (22.6%).In the study group, made up of 103 patients hospitalized in the ENT clinic, the age varied between 17 and 78 years, the average age was 43 years (standard deviation = 15.67), registering a slightly higher average value in the male sex , fracture of the laryngeal cartilages with dilaceration of the epiglottis, vocal cords and pyriform sinuses (14 cases), dilacerations with retrocricoid hematomas (5 cases), sectioning of the cricothyroid membrane and interest partial or total cricoid cartilage (7 cases), sectioning of the crico-tracheal membrane and tracheal rings (7 cases), sectioning of the superficial jugular veins (31 cases), involvement of the internal jugular vein (6 cases), involvement of the thyroid gland (6 cases), involvement of the submandibular gland (5 cases), polytraumas due to traffic accidents or falls from a height with complex thoracic, abdominal, craniofacial and limb injuries (11 cases) .From the total number of vascular lesions of the anterior, external, and internal jugular veins, the following lesions were identified: contusions, adventitial lesions, and complete or partial sections, to which is added a case of penetrating wound involving the thoracic duct. These injuries required parietal reconstruction and vascular ligature to perform hemostasis, depending on the case, through specific techniques .Regarding the arterial lesions of the carotid system, adventitious contusion-type lesions of the common and external carotid arteries and pseudoaneurysm-type lesions at the level of the common carotid artery were identified in our study .As for the penetrating hypopharyngeal lesions, in the entire study group, penetrating lesions of the pharyngeal wall were identified only at the level of the piriform sinuses with the development of parapharyngeal hematomas that had a posterior prevertebral extension and determined compressive phenomena with the onset of acute upper respiratory insufficiency and dysphagia .The appearance of traumatic laryngeal lesions identified both clinically, paraclinical, and intraoperatively is very diverse, including lesions of the mucosa, vocal cords, laryngeal cartilages, thyrohyoid and cricothyroid membrane, as illustrated in p = 0.656), age group under 45 years  and with a rural background  , more frequently in males  .p = 0.05)  .p = 0.443), age group over 45 years  and the urban environment  , more frequently in females  .p = 0.117) (Tracheostomy was performed in 17 patients included in the study (16%) without significant differences between sexes, age groups, or place of residence . In addi= 0.117) .p = 0.961)  .Conservative therapeutic management, consisting of observation, serial clinical examination, paraclinical explorations, and supportive drug treatment, was carried out in 38 of the selected patients (35.8%) without significant differences between sexes, age groups, or the place of residence .p = 0.001)  .The need for the administration of supportive drug treatment was identified in 102 patients from the group (96.2%), without significant differences between sexes, age groups, or the place of residence .Postoperative complications were noted in 6 patients (5.7%), all male, five aged over 45 years, and five from rural areas. The postoperative complications identified were the following: partial dehiscence of the postoperative wound, parotid salivary fistula, postoperative wound infection with Enterobacter, stroke, pneumococcal pneumonia, post-traumatic left genial edema, dysphonia, and torticollis.The essential therapeutic attitude in complex cervical trauma is ensuring the airways’ safety through orotracheal intubation or emergency tracheostomy and hemostasis control, followed by clinical and paraclinical investigations, then exploration and reconstructive surgical treatment. In cases where the hemodynamically unstable patient could not be investigated paraclinical and presented traumatic injuries with a penetrating character, urgent surgical exploration is required. This exploration can be performed under general anesthesia with orotracheal intubation, tracheostomy, or local anesthesia.The importance of first aid, as well as emergency therapeutic measures in other health facilities, must include primary hemostasis and the proper support of cardio-respiratory parameters. Transport must be ensured in safe conditions and as soon as possible, considering the complications that can occur in the first hours after the trauma. In emergencies, the airway was secured , immobilizing the cervical spine, accessing the venous lines, and obtaining a correct anamnesis regarding the circumstances of the accident, the associated diseases, the state of consciousness. Intubation through the cervical area is indicated when there are injuries to the oral cavity, pharynx, or larynx. Orotracheal intubation can accentuate pharyngolaryngeal lesions, causing the extension of some lesions from the level of the piriform sinus to the mediastinum. In lesions with significant cervical tissue destruction, intubation was performed through the continuity solution at the level of the sectioned thyrohyoid membrane.According to the European Manual of Medicine, Otorhinolaryngology, Head and Neck Surgery, the standard of investigation and exploration procedures in the case of cervical traumatology is applied depending on the presence or not of the hemodynamic and neurological stability criteria. The unstable patient will be provided with an airway simultaneously with the treatment of shock and cervical surgical exploration; postoperative achievement of hemodynamic stability and neurological will allow additional endoscopic and imaging investigations to be performed. The symptomatically stable patient is subjected to endoscopic, imaging and interventional angiographic investigations to determine the lesion balance and establish subsequent to the therapeutic conduct.Depending on the symptomatology and clinical examination of the patients with cervical trauma selected for this study, the following methods of paraclinical exploration were used: cervical and thoracic X-ray, Doppler cervical and soft part ultrasound, craniocerebral, cervical and thoracic computed tomographic scan, computed tomographic angiography, naso-pharyngo-laryngeal and upper digestive endoscopic exploration.Cervical and chest X-rays identify cervical soft tissue emphysema, fractures, tracheal lacerations, foreign body retention, hemothorax, pneumothorax, mediastinal emphysema. Computed tomography, ultrasound of the cervical soft parts and Doppler, angiography, or pharyngoesophageal transit with contrast material are performed when complex lesions are suspected. Panendoscopic exploration  are used in the case of complex lesions of the aerodigestive axis. The use of the rigid endoscope is superior to the flexible one in upper esophageal lesions.For patients with aero-digestive lesions depending on the severity of the symptoms and the injury complexity, the therapeutic attitude involved a medical treatment associated with the surgical one. Patients with mild laryngeal and tracheal injuries, without respiratory changes or signs of laryngeal fractures, were hospitalized and kept under observation for at least 24–48 h . The treatment was conservative, with medicinal support, and consisted of administering antibiotic therapy, steroid anti-inflammatories, aerosols, oxygen therapy, and air humidification. During hospitalization, it is indicated to carry out serial evaluations clinically and through naso-pharyngo-laryngeal fiberoscopy.In the case of patients with variable respiratory disorders associated with laryngeal mucosa lesions, edema, and hematomas, the intervention was performed by performing a tracheotomy under local anesthesia and an endoscopic lesion assessment after the induction of general anesthesia. 3–5 days postoperatively, the tracheotomy was suppressed, during which the patient received supportive drug treatment. The presentation at admission with signs and different degrees of acute respiratory insufficiency associated with extensive laryngeal lesions of the mucosa, edema, and endolaryngeal hematomas, alteration of the mobility of the vocal cords or different degrees of comminution of cartilaginous fractures required the surgical therapeutic approach. This was performed in the following sequence: tracheotomy, endolarynx exploration through direct laryngoscopy, cervical wound exploration, and laryngeal approach through thyrotomy or the thyroid cartilage fracture path. Lesions of the laryngeal mucosa were repaired by sutures with absorbable 4-0 or 5-0 threads without exposing cartilaginous areas. Depending on each case’s lesion, the foot of the epiglottis, the ventricular band, or the vocal cords were reinserted, the aryepiglottic fold was restored, and the laryngeal fractures were reduced by suturing with non-absorbable threads. Anchorage of the superior and inferior retrocricoid ends was required. In cases with significant loss of substance, the larynx was restored with different muscles plasties. Anchorage of the hyoid with separate wires to the external laryngeal perichondrium was performed to achieve adequate laryngeal tightness and statics. Surgical therapeutic management was associated with antibiotic treatment, steroid anti-inflammatories, aerosols, and oxygen therapy. Suppression of the tracheal cannula was performed after 10–12 days.The most severe cases with poor prognosis were characterized by extensive destructive lesions, loss of soft and cartilaginous substance, vocal cord disinsertion, or crico-tracheal disjunction associated with severe acute respiratory failure. These required emergency surgical exploration, laryngeal reconstruction, and recalibration. Recalibration was performed by fitting and maintaining a Montgomery tube for two weeks. Again, appropriate laryngeal calibration is recommended, with scar management in major debridement and mucosal restoration to avoid stenoses.In cases with hypopharyngeal lesions of varying degrees of complexity, a careful clinical examination was performed, digestive rest was indicated with the application of a nasogastric tube, and depending on the severity of the lesion, surgical reconstruction as quickly as possible  associated with performing a tracheotomy. The suturing of the pharyngeal wall was performed in two planes, serous and mucous. Hypopharyngoesophageal injuries are severe and require immediate recognition and treatment. A muscle flap can be used as a sleeve and isolates the upper digestive tract to avoid the formation of pharyngo-cutaneous or eso-tracheal fistulas. Pharyngeal plastic surgery was performed with prevertebral aponeurosis and subhyoid muscles. They are ideal for preventing post-operative suppurative or stenotic complications. Significant is the prompt correction of metabolic and hydro-electrolytic imbalances in the pre-, intra-, and post-operative periods, such as the administration of correct broad-spectrum antibiotic therapy, anti-inflammatories, and proton pump and H2 receptor inhibitors to prevent regional complications and sequelae. Maintaining the nasogastric feeding tube is indicated in cases where pharyngeal sutures were performed and in the remission of fistulas for 3–4 weeks.Depending on the complexity of the traumatic aero-digestive injury, digestive rest through a nasogastric tube and respiratory rest through tracheotomy for 7–14 days are necessary conditions for resuming normal swallowing, breathing, and phonation. In addition, aspiration drainage is applied and maintained to avoid the formation of postoperative hematomas and seromas to smooth the tissue planes.Cervical wounds involving various tissues and the cervical visceral aerodigestive axis require an established protocol for a multidisciplinary team approach. This team consists of the otolaryngologist, anesthesia and intensive care physician, emergency physician, and other specialties depending on the injuries associated with different body segments.Vascular lesions in the zone I required collaboration with the thoracic surgery department, with the performance of mediastinotomy and thoracotomy to perform hemostasis. The identification following the radiological examination of hemothorax, pneumothorax, or pneumomediastinum required proper drainage of air and blood collections. In one case with plurivisceral involvement and basicervical venous vascular section, the thoracic duct was also involved, along with anterior mediastinal lesions in the left half. This case also involved collaboration with the thoracic surgeon. In zone III, the lesions required the performance of a median mandibulotomy to expose the parapharyngeal space to evacuate hematomas with an obstructive dyspneic character or to have access to the vasculo-nervous structures at the base of the skull. In the case of cases involving the submandibular gland, excision of the torn tissues, suturing of the glandular body, or total or partial excisions of it were necessary.Cervical venous injuries  were resolved by ligation and adventitial sutures except when both internal jugular veins were involved when an attempt was made to restore the continuity of one of them. In the case of the carotid artery injury, it was important to fix it by adventitial sutures, end-to-end anastomosis, or by applying a graft with the help of vascular surgery colleagues (two cases).In the case of complex cervical trauma produced by a closed or penetrating mechanism, which involved the thyroid, the following aspects were identified: expansive anterior cervical hematoma, compressive on the respiratory axis with phenomena of acute respiratory failure, which required its emergency drainage; cervical wounds with thyroid and laryngeal involvement with bleeding, which flood the respiratory tract, causing the exacerbation of respiratory failure phenomena and which required the performance of protective tracheotomy and the securing of the airway associated with the removal of crushed glandular tissues or different degrees of subtotal thyroidectomy. In addition, in 7 of the cases included in the study group, the glandular suture of the suture type with slow resorbable thread was performed.The postoperative occurrence of fever, tachycardia, chest pain, widening of the radiographic mediastinum, subcutaneous emphysema, bleeding wound, the onset of neurological deficits, or the development of a hematoma requires imaging and surgical re-exploration.All cervical aero-digestive traumas, regardless of complexity, were carefully recorded in terms of local examination, the evolution of symptoms and vital or biological constants, imaging and endoscopic examination, and exploratory and surgical reconstruction protocols.The clinical management of complex cervical trauma has changed over time towards a conservative approach. Even so, the need for surgical exploration in patients with traumatic penetrating injuries of the aerodigestive tract or great vessels should be based on clinical elements and reliable indicators for indicating an open exploration.The number of medical and medical-surgical specialties involved and the diagnostic assessment of patients with traumatic neck injuries requires developing and implementing a multidisciplinary institutional protocol with national applicability. In addition, it could support the ways of indicating paraclinical diagnostic procedures, such as flexible naso-pharyngo-laryngeal fiberoscopy, plain radiography, and esophagography, as well as computed tomography, but also the clear indications of surgical versus conservative treatment.Since Ambroise Pare ligated both carotid arteries and the jugular vein of a soldier with polytrauma of the neck in 1552, the therapeutic approach to complex penetrating cervical trauma has been one of the controversial topics in trauma surgery. There has not yet been a consensus on this. Surgical exploration of all neck injuries beyond the platysma muscle significantly reduced mortality during World War II , but 89%In the 1990s, two studies focused on clinical examination to identify severe signs of vascular involvement in zone II cervical trauma and the need for an indication for reparative surgical exploration ,9. In adSome studies even promote mandatory surgical exploration of all penetrating cervical wounds based on low morbidity and reduced hospital days. This approach has been described as cost-effective and characterized by higher accuracy than contrast-enhanced imaging studies .For patients with high suspicion of penetrating laryngotracheal injury, detailed clinical examination is mandatory. Trauma of the upper aerodigestive tract is suspected in face of dysphonia or stridor, subcutaneous emphysema appearance, or blowing wound presence, and the main objective is to ensure and maintain the upper airway patency. In a retrospective study including 748 patients with this type of injury, only 11% of cases required immediate airway control, raising questions about the importance of conservative measures [Metheny et al. believe that nasogastric tube placement and feeding is more effective than parenteral nutrition in most patients with critical aero-digestive traumatic injury because it preserves the integrity of the bowel and causes fewer infectious complications. However, nasogastric tube feeding has been associated with risks like other therapies. The most serious potential complication is the tracheobronchial aspiration of gastric contents, with the risk of developing a series of clinically silent microaspirations .As we emphasized before, starting with WWII, the main recommendation was to surgically explore the neck for any traumatic lesion that involves the platysma . Over thNowadays, the advantages of a selective nonoperative management for penetrating cervical trauma have been established, but there remain some circumstances when immediate operative exploration is mandatory, such as significant airway or major vascular injuries . In 2011In the case of our study, all cervical traumas beyond the platysma were surgically explored under general or local anesthesia with the identification and surgical reconstruction of the lesion. The indication of paraclinical imaging studies was influenced by the hemodynamic status and the need to secure the airway by orotracheal intubation or tracheostomy. In addition, complex aero-digestive lesions required digestive rest and the placement of a nasogastric tube, with the administration of food through this route or the association with the parenteral administration of the necessary nutrients. In cases of reduced complexity, conservative management and supportive drug treatment of traumatic and associated pathology were associated, as appropriate.Early recognition and management of the complications of penetrating cervical wounds are essential in reducing the mortality and morbidity of these injuries. Prevention of these complications depends on the initial therapeutic actions of securing the airway by intubation or tracheostomy, prompt control of bleeding, protection of the head and neck, accurate and rapid lesion diagnosis, and surgical treatment according to the indication . AdditioThe first evaluation of complex cervical trauma is part of the standard Advanced Trauma Life Support (ATLS) protocol, an essential element on which the vital prognosis depends: securing the airways by orotracheal intubation or tracheostomy. The prehospital period should not be prolonged by performing the ATLS protocol and involves simultaneously balancing vital signs. These elements can dramatically change the patient’s prognosis, transforming him from dying to savable. An unstable hemodynamic status and an airway, which requires emergency stabilization, determined the performance of the lesion balance by performing emergency surgical exploration and involves multidisciplinary therapeutic management, followed by reconstructive surgical treatment at the same operative time or a second time. Optimizing a multidisciplinary emergency medical system will lead to improving global statistics regarding this pathology’s mortality and morbidity.


The global demand for food security, sustainability, and international food trade are critical topics in food science and are strictly influenced by food safety. To ensure safe products for consumers, an integrated approach for controlling microbial contamination “from farm to fork” is recommended by government agencies worldwide. In this context, omics-based technologies  have revolutionized the diagnostics of microbial contamination of food, feed, and beverages  treatment, a cell viability dye. The authors observed that PMA was adequate for their experiment, but further studies are necessary, especially for applications on more complexes microbiomes.With the advent of high-throughput DNA sequencing-based methods, multiple studies for determining the microbial communities of various food matrices were conducted; however a few reported the issues associated with inaccuracies resulted from DNA of unviable microorganisms. Based on this approach, in silico metatranscriptomic approach, Almeida et al., studied biofilm-related effectors in metatranscriptomics datasets to understand the mechanisms for bacterial persistence in dairy environments. The authors observed genes involved with flagella, adhesion, and Quorum sensing/Quorum quenching, and demonstrated that the use of metatranscriptomic data is important to understand the regulatory mechanisms in dairy-related biofilms; therefore this tool can be successfully used to improve food safety.Using Wang et al. observed the production of beneficial metabolites during the co-fermentation of human milk-derived probiotic strains and Poria cocos, suggesting an important role of Poria cocos as a functional food. Another study, demonstrated that the fermentation of white ginseng (WG) with distinct probiotic strains led to different metabolite composition, which presented different biological activities and enhanced product quality . Additionally, Shang et al. studied the communities of Daqu and fermented grains for brewing Jiang-flavor Baijiu, a traditional Chinese food, this study was important to screen for indigenous bacteria to be used in this product and to understand the major fermentation steps of the product.In fermented food, omics technologies have been applied to aid the optimization of processes and the development of better products. Montso et al. assessed the caecal microbial communities and their metabolic pathways of broiler chickens after using non-conventional protein sources, such as marama, in the animals' diet. The results revealed that the diet based on marama bean meal could drastically improve caecal microbiota, and can be used to reduce the costs associated with feed and to enhance the broilers' health. Finally, transcriptome analysis was conducted to evaluate the mechanisms involved in the production of docosahexaenoic acid (DHA)-rich lipids by the microalgae Schizochytrium sp. The study demonstrated that the use of malate during fed-batch fermentation may enhance DHA production due to the upregulation of genes involved in acetyl-CoA and NADPH algae metabolism.In another context, This topic explored the multifaceted use of omics technologies, aiming to expand the associated knowledge to improve food quality, safety, and the processes involved in the production of functional foods. This collection of manuscripts delivered innovative results and demonstrated some unresolved challenges that need further investigation in food science.All authors listed have made equal contributions to the editorial and approved it for publication.


Continuous and unplanned urbanization, combined with negative alterations in land use land cover (LULC), leads to a deterioration of the urban thermal environment and results in various adverse ecological effects. The changes in LULC and thermal characteristics have significant implications for the economy, climate patterns, and environmental sustainability. This study focuses on the Province of Naples in Italy, examining LULC changes and the Urban Thermal Field Variance Index (UTFVI) from 1990 to 2022, predicting their distributions for 2030. The main objectives of this research are the investigation of the future seasonal thermal characteristics of the study area by characterizing land surface temperature (LST) through the UTFVI and analyzing LULC dynamics along with their correlation. To achieve this, Landsat 4-5 Thematic Mapper (TM) and Landsat 9 Operational Land Imager (OLI) imagery were utilized. LULC classification was performed using a supervised satellite image classification system, and the predictions were carried out using the cellular automata-artificial neural network (CA-ANN) algorithm. LST was calculated using the radiative transfer equation (RTE), and the same CA-ANN algorithm was employed to predict UTFVI for 2030. To investigate the multi-temporal correlation between LULC and UTFVI, a cross-tabulation technique was employed. The study’s findings indicate that between 2022 and 2030, there will be a 9.4% increase in built-up and bare-land areas at the expense of the vegetation class. The strongest UTFVI zone during summer is predicted to remain stable from 2022 to 2030, while winter UTFVI shows substantial fluctuations with a 4.62% decrease in the none UTFVI zone and a corresponding increase in the strongest UTFVI zone for the same period. The results of this study reveal a concerning trend of outward expansion in the built-up area of the Province of Naples, with central northern regions experiencing the highest growth rate, predominantly at the expense of vegetation cover. These predictions emphasize the urgent need for proactive measures to preserve and protect the diminishing vegetation cover, maintaining ecological balance, combating the urban heat island effect, and safeguarding biodiversity in the province. Cities play a crucial role in a country’s development, as they facilitate economic growth, employment opportunities, infrastructure development, innovation, and cultural diversity. They act as central hubs for transportation, telecommunications, energy, and water services. The increasing effects of global warming along with unplanned city infrastructure, including poorly designed and congested road networks, disorganized building layouts, and inadequate green spaces, contribute to environmental degradation, disasters , social inequality, and economic inefficiencies. Continuous unplanned urbanization and negative modifications in land use land cover (LULC) lead to a deteriorating urban thermal environment, resulting in various adverse ecological effects, such as increased air pollution  and highIn recent years, there has been increasing research focusing on thermal characteristics, their impacts, and contributing factors, particularly in mega-cities. Liu and Weng  investigRemote sensing techniques offer advanced support for monitoring spatio-temporal LULCC, ecological conditions, and thermal patterns at local, regional, and global scales . SatelliThe paper is structured as follows: The Province of Naples serves as the administrative hub for the Campania region and is the third-largest metropolitan area in Italy. The selection of the Province of Naples for this study is based on its status as one of the most densely populated area in Italy and the lack of previous investigations into its thermal features in relation to LULCCs. The left panel of LST was characterized by using the UTFVI due to its efficient capability to assess the thermal characteristics of urban areas . The UTFThe study utilized a total of eight Landsat satellite images, specifically Landsat Collections Level-1 products for thermal bands used in LST processing and Landsat Collections Level-2 products reflective bands for LULC processing. These images were captured at about 10-year intervals . The images were downloaded from the United States Geological Survey (USGS) Earth Explorer website , consideTo retrieve LST, the RTE approach was utilized since it is not dependent on average temperature and air humidity. Furthermore, according to Yu et al. , the RTEThe following procedure was applied to thermal bands to obtain LST. Firstly, using the radiometric rescaling coefficients contained in the metadata file, included within the Level-1 product, the thermal band from the Landsat 4-5 TM was scaled to top of atmosphere (TOA) spectral radiance using the following equation:Then, thermal band 6 from Landsat 4-5 TM and thermal band 10 from Landsat 9 OLI were converted to the TOA brightness temperature, using the following equation:It follows the calculation of the Normalized Difference Vegetation Index (NDVI) using the following formula:The next step is the calculation of the land surface emissivity to identify the portion of vegetation. The land surface emissivity  learning process. The prediction process involved the utilization of the Modules for Land Use Change Evaluation (MOLUSCE) plugin . QGIS veThe spatial distribution of seasonal UTFVI is presented in Summer and winter distributions of UTFVI classes over LULC categories are shown in In The ANN model used for LULC classification was validated for the year 2022. Additionally, the UTFVI model was validated for the year 2022 by comparing predicted and reference UTFVI maps. The validation parameters are listed in The predicted LULC map for year 2030 is presented in Left panel of The analysis of thermal characteristics offers valuable insights into the thermal patterns observed in the Province of Naples. By systematically analyzing satellite images, a comprehensive understanding of the thermal environment was achieved. Particularly, reflective and thermal bands from Landsat 4-5 TM and Landsat 9 OLI were employed. The findings of this study revealed a concerning trend of outward expansion in the built-up area of the Province of Naples, with central northern regions experiencing the highest growth rate, predominantly at the expense of vegetation cover. The Vesuvius area saw a notable transition to bare-land, possibly due to a significant forest fire event in 2017. Over the decades, the steady conversion of vegetation cover to bare-land in the Sorrento peninsula is evident. The CA-ANN model predictions highlight the amplification in built-up and bare-land areas and a significant decrease in vegetation cover by 2030. The expansion of built-up and bare-land areas between 1990 and 2022 led to notable changes in thermal attributes. During this period, the strongest UTFVI class expanded in all directions, especially towards the northern and eastern regions of the province, resulting in a more pronounced worst class in the ecological evaluation index. The prediction for 2030 confirms this trend, which is anticipated to have significant impacts on the quality of life in the study area. Addressing soil consumption through appropriate policies becomes crucial to prevent further deterioration in habitability. These predictions emphasize the urgent need for proactive measures to preserve and protect the diminishing vegetation cover to maintain ecological balance, combat the urban heat island effect, and safeguard biodiversity in the province. Additionally, the increased built-up and bare-land areas could exacerbate the vulnerability to floods, necessitating careful urban planning to prioritize the preservation of natural resources. By promoting sustainable development practices, such as the adoption of renewable energy sources, the creation of urban green spaces, and water-sensitive design, the province can mitigate the adverse thermal effects and enhance the quality of life for its residents. It is crucial for provincial authorities to take decisive actions now to secure a sustainable and resilient future for the region. Our findings revealed that the vegetation cover will diminish; thus, it could be interesting to carry out in-depth research about the corresponding changes in the carbon sequestration in the same area. The investigation of the relationship between concentrations of free and trapped carbon and LULC dynamics can further assist the development of efficient strategies to mitigate these effects.