Alzheimer’s disease (AD), the primary cause of dementia accounting for 60% to 70% of cases globally, results in a gradual decline in cognitive abilities, affecting memory, executive function, and daily activities. Recent research highlights the essential involvement of the microbiota-gut-brain axis in AD pathogenesis, characterized by complex bidirectional signaling that modulates neuroinflammation, neurogenesis, neurotransmission, and immune functions. This manuscript extends the discussion beyond the gut alone by emphasizing the significance of the oral-gut microbiota axis as a dynamic and relatively under-investigated factor in AD progression. Microbial populations in both the oral cavity and gastrointestinal tract produce key neurotransmitters, such as gamma-aminobutyric acid, noradrenaline, and dopamine, as well as neuroactive metabolites like short-chain fatty acids, which together impact brain physiology. Disturbances in gut and oral microbial balance can compromise barrier integrity, promoting systemic inflammation and neuroinflammation, and facilitating amyloid-β plaque formation and tau-related changes typical of AD. This review introduces a novel probiotic, prebiotics, synbiotics, and postbiotics (PPSP) therapeutic model designed to modulate both oral and gut microbiota, aiming to restore homeostasis, regulate neuroimmune interactions, and counteract cognitive impairment.We comprehensively assess emerging clinical and translational findings supporting the effectiveness of microbiota-targeted therapies in the scope of this dual-axis framework, addressing both their potential to alter disease course and recognized limitations.By underscoring the importance of the integrated oral-gut microbiota axis alongside targeted PPSP interventions, this manuscript puts forth a paradigm-shifting conceptual strategy that may redefine approaches to AD management and improve cognitive outcomes.

Background: In recent years, the rise of workplace racial discrimination and microaggressions has decreased the efficiency and productivity of organizations and institutions, and realization of organizational goals globally. Accordingly, it was decided to conduct a systematic review and meta-analysis in the present study with the aim of investigating the prevalence of microaggression and racial discrimination in the workplace. Methods: The PubMed, Scopus, Web of Science, ScienceDirect and Google Scholar databases were systematically searched for studies that had reported the effects of work stress among managers. The search did include a lower time limit and was conducted in June 2023. The heterogeneity of the studies was investigated using the I2 index, and accordingly random effects method was adopted for meta-analysis. Data analysis was conducted with the Comprehensive Meta-Analysis (v.2) software. Results: In the review of seven studies with a sample size of 2998 people, the overall prevalence of microaggression and racial discrimination in the workplace was found to be 73.6% and 18.8%, respectively. Publication bias within the selected studies was examined with the Egger's test, which indicated the absence of publication bias for the pooled prevalence of workplace microaggression (p: 0.264) and for the pooled prevalence of workplace racial discrimination (p: 0.061). Conclusion The results obtained from this report indicate the high impact of micro-aggression and racial discrimination in the workplace. Considering the negative effects of such behaviours, the findings from this study will be helpful to managers and health policymakers.

The authors regret that one of the coauthor's affiliation in this article was incorrectly printed.

PURPOSE: The purpose of this study was to clarify the meaning and the nature of empowerment concept in some Iranian old people suffering from chronic diseases. METHODS: Concept analysis was undertaken according to the hybrid model, which consists of three phases: an initial theoretical phase, a fieldwork phase and a final analytical phase. After an extensive review of the literature in order to describe the characteristics and definition of the concept, a fieldwork phase followed in order to empirically elucidate the empowerment concept in the Iranian old people with chronic diseases. In the third phase, attributes of empowerment were extracted from the first and second phases. Purposive sampling was done for 13 participants consisted of 7 old people with chronic diseases, 3 family caregivers of elderly adult with chronic disease and 3 health care providers with experience of care with elderly patients with chronic disease. RESULTS: The review of literature in theoretical phase determined the attributes of the concept, including "active participation", "informed change", "knowledge to problem solve", "self-care responsibility", "presence of client competency", and "control of health or life". Fieldwork phase determined attributes such as "awareness promotion", "sense of control", "the development of personal abilities", "autonomy", and "coping". In the final analytical phase, the critical attributes of old people with chronic diseases were investigated. They included "social participation", "informed change", "awareness promotion to problem solve", "presence of client competency", and "control of health or life", "autonomy", "coping" and "the development of personal abilities". CONCLUSION: The concept analysis of empowerment showed some of the required conditions for the empowerment of older people with chronic diseases in nursing care, which have not been mentioned in the literature.
*Adaptation, Psychological ; Aged/*psychology ; Aging/*psychology ; Attitude to Health ; Chronic Disease/*psychology ; Female ; Humans ; Iran ; Male ; *Models, Psychological ; *Power (Psychology)

PURPOSE: Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. RESULTS: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. CONCLUSIONS: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.
Anesthesia, General ; Coma ; Hemiplegia ; Humans ; Iran ; Medical Records ; Nephrostomy, Percutaneous ; Neurologic Manifestations ; Paraplegia ; Prone Position ; Retrospective Studies