Introduction: Obstructive sleep apnea (OSA) is a serious and prevalent medical condition with major consequences for health and safety. Excessive daytime sleepiness (EDS) is a common—but not universal—accompanying symptom. The purpose of this literature analysis is to understand whether the presence/absence of EDS is associated with different physiopathologic, prognostic, and therapeutic outcomes in OSA patients. Methods: Articles in English published in PubMed, Medline, and EMBASE between January 2000 and June 2017, focusing on no-EDS OSA patients, were critically reviewed. Results: A relevant percentage of OSA patients do not complain of EDS. EDS is a significant and independent predictor of incident cardiovascular disease (CVD) and is associated with all-cause mortality and an increased risk of metabolic syndrome and diabetes. Male gender, younger age, high body mass index, are predictors of EDS. The positive effects of nasal continuous positive airway pressure (CPAP) therapy on blood pressure, insulin resistance, fatal and non-fatal CVD, and endothelial dysfunction risk factors have been demonstrated in EDS-OSA patients, but results are inconsistent in no-EDS patients. The most sustainable cause of EDS is nocturnal hypoxemia and alterations of sleep architecture, including sleep fragmentation. These changes are less evident in no-EDS patients that seem less susceptible to the cortical effects of apneas. Conclusions: There is no consensus if we should consider OSA as a single disease with different phenotypes with or without EDS, or if there are different diseases with different genetic/epigenetic determinants, pathogenic mechanisms, prognosis, and treatment.The small number of studies focused on this issue indicates the need for further research in this area. Clinicians must carefully assess the presence or absence of EDS and decide accordingly the treatment. This approach could improve combination therapy targeted to a patient's specific pathology to enhance both efficacy and long-term adherence to OSA treatment and significantly reduce the social, economic, and health negative impact of OSA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1 is a 2019 novel coronavirus, which only in the European area has led to more than 300,000 cases with at least 21,000 deaths. This manuscript aims to speculate that the manipulation of the microbial patterns through the use of probiotics and dietary fibers consumption may contribute to reduce inflammation and strengthen the immune system response in COVID-19 infection. The reviews of this paper are available via the supplemental material section.

Background and Aim: Artificial intelligence (AI) is among the most promising innovations for transforming nursing education, making it more interactive, personalized, and competency-based. However, its integration also raises significant ethical and practical concerns. This scoping review aims to analyze and summarize key studies on the application of AI in university-level nursing education, focusing on its benefits, challenges, and future prospects. Methods: A scoping review was conducted using the Population, Concept, and Context (PCC) framework, targeting nursing students and educators in academic settings. A comprehensive search was carried out across the PubMed, Scopus, and Web of Science databases. Only peer-reviewed original studies published in English were included. Two researchers independently screened the studies, resolving any disagreements through team discussion. Data were synthesized narratively. Results: Of the 569 articles initially identified, 11 original studies met the inclusion criteria. The findings indicate that AI-based tools—such as virtual simulators and ChatGPT—can enhance students’ learning experiences, communication skills, and clinical preparedness. Nonetheless, several challenges were identified, including increased simulation-related anxiety, potential misuse, and ethical concerns related to data quality, privacy, and academic integrity. Conclusions: AI offers significant opportunities to enhance nursing education; however, its implementation must be approached with critical awareness and responsibility. It is essential that students develop both digital competencies and ethical sensitivity to fully leverage AI’s potential while ensuring high-quality education and responsible nursing practice.

Influence of the Lung Microbiota Dysbiosis in Chronic Obstructive Pulmonary Disease Exacerbations: The Controversial Use of Corticosteroid and Antibiotic Treatments and the Role of Eosinophils as a Disease Marker

L’apnea ostruttiva del sonno (OSAS) è una malattia cronica eccessivamente sotto-diagnosticata con un’alta prevalenza negli adulti. L’OSAS sta diventando un problema sociale significativo perché associata ad un peggioramento della qualità della vita ed un aumento della mortalità. Il rapporto costo-efficacia nella gestione diagnostica e terapeutica dell’OSAS è un problema strategico per contrastare la crescente domanda di test oggettivi. I pazienti OSAS che non presentano comorbilità clinicamente evidenti devono essere studiati utilizzando un sistema semplificato e poco costoso, come l’Home Sleep Testing (HST). Al contrario, la Sleep Laboratory Polisomnography (PSG) rimane il gold standard per la gestione dei pazienti con OSAS in presenza di comorbidità. Occorre sottolineare che l’uso di HST potrebbe portare ad una diagnosi errata in soggetti OSAS non ben selezionati. Questa breve rassegna si propone di offrire argomenti di riflessione sulla corretta diagnosi e trattamento dell’OSAS, in rapporto ai dati di prevalenza e alle ricadute sui costi/benefici sociali della malattia. Attualmente non può essere solo il rapporto costo/efficacia a definire il modello organizzativo adottato per la gestione dell’OSAS, in quanto si rendono necessari ulteriori studi prospettici a lungo termine, volti a validare in maniera definitiva tale rapporto nonché il confronto tra il trattamento con modelli di gestione ospedaliera versus l’assistenza domiciliare.

Background. The COVID-19 pandemic has transformed people’s lifestyles by imposing social, economic, and labor changes. Health professionals have been in the spotlight, occasionally even elevated to the status of “heroes”, as they have been at the forefront of the health emergency. Media exposure has undoubtedly played a pivotal role in the evolution and perception of the public’s image of nurses, especially within the Italian context. Currently, there is only one study conducted in Italy during the pandemic period. For this reason, we have opted to delve further into this subject during the post-pandemic period, with the ultimate goal of identifying this perceptual evolution. Methods. An online snowball sampling survey was conducted among the Italian population using social networks between August 2022 and January 2023. The survey utilized the Nursing Attitude Questionnaire (NAQ) to collect data. Results. The sample consisted of 564 individuals. Among the respondents, 63.8% (n = 360) were familiar with the nursing pathway, and the level of agreement regarding the training of nurses was 81.5% (n = 260). In terms of recognizing the professional role of nurses, variations emerged in certain domains of the NAQ. Specifically, professional values of nurses were more pronounced in northern and central Italy (M = 26.27). Moreover, stereotypes were more prevalent in the north (23.73 ± 3.538) and the center (23.13 ± 4.104) (p = 0.001). Conclusions. The sample acknowledged a unique competence inherent to nurses that cannot be replaced by other professionals. The study population perceives the nursing profession as pivotal within the IHS (Integrated Health System). However, the attractiveness of the profession remains exceedingly low. This study was not registered on a publicly available registry.