Background: Animal-assisted intervention (AAIs) represent an adequate expression of integrated medicine, according to the One Health approach. We argue that AAIs are interventions based on interspecific relationships between humans and animals. Although there are many studies on the effects of AAIs on animal and human health and wellbeing, research is still needed to give us more data. For example, information is still lacking on the aspects characterizing and influencing the interspecific relationships occurring in AAIs. The efficacy of an intervention based on interspecific relationships will be influenced by different factors, such as attachment styles and personalities of both the animal and the handler, an appropriate choice of animal species and their individuality, animal educational training techniques, the relationship between the handler and the animal, and relational reciprocity between animal, the patients, and members of the working team. Method: This article aims to contribute to the study of interspecific relationships in AAIs via theoretical considerations. An interspecific relationship determines the result of safe interventions, which directly influences the welfare of the animal. Results and considerations: AAIs should be evaluated systemically as a network within a process in which every component interacts with and influences other components. Standardized methods using appropriate tests and parameters are needed to better select appropriate animals (i.e., species and individual subjects) using interspecific relational competences as well as appropriate educational training methods and health protocols to assess potential risks.

Recently, animal-assisted interventions (AAIs), which are defined as psychological, educational, and rehabilitation support activities, have become widespread in different contexts. For many years, they have been a subject of interest in the international scientific community and are at the center of an important discussion regarding their effectiveness and the most appropriate practices for their realization. We carried out an umbrella review (UR) of systematic reviews (SRs), created for the purpose of exploring the literature and aimed at deepening the terminological and methodological aspects of AAIs. It is created by exploring the online databases PubMed, Google Scholar, and Cochrane Library. The SRs present in the high-impact indexed search engines Web of Sciences and Scopus are selected. After screening, we selected 15 SRs that met the inclusion criteria. All papers complained of the poor quality of AAIs; some considered articles containing interventions that did not always correspond to the terminology they have explored and whose operating practices were not always comparable. This stresses the need for the development and consequent diffusion of not only operational protocols, but also research protocols which provide for the homogeneous use of universally recognized terminologies, thus facilitating the study, deepening, and comparison between the numerous experiences described.

Background: Gene therapy cannot be yet considered a far perspective, but a tangible therapeutic option in the field of retinal diseases. Although still confined in experimental settings, the preliminary results are promising and provide an overall scenario suggesting that we are not so far from the application of gene therapy in clinical settings. The main aim of this review is to provide a complete and updated overview of the current state of the art and of the future perspectives of gene therapy applied on retinal diseases.Methods: We carefully revised the entire literature to report all the relevant findings related to the experimental procedures and the future scenarios of gene therapy applied in retinal diseases. A clinical background and a detailed description of the genetic features of each retinal disease included are also reported.Results: The current literature strongly support the hope of gene therapy options developed for retinal diseases. Although being considered in advanced stages of investigation for some retinal diseases, such as choroideremia (CHM), retinitis pigmentosa (RP), and Leber's congenital amaurosis (LCA), gene therapy is still quite far from a tangible application in clinical practice for other retinal diseases.Conclusions: Gene therapy is an extremely promising therapeutic tool for retinal diseases. The experimental data reported in this review offer a strong hope that gene therapy will be effectively available in clinical practice in the next years.

Recently, many efforts have been made to assess the effectiveness of non-pharmacological therapies as an alternative or supportive option to conventional approaches. Specifically, animal-assisted therapy (AAT) has recently raised a great interest and large research efforts. This work represents a retrospective study carried out over seven years (from 2012 to 2019) in 127 patients with mild-to-moderate Alzheimer’s disease. The patients were divided into three groups: an experimental group that received AAT interventions adapted to the formal reality orientation therapy (ROT), a group receiving a formal ROT, and a control group that did not perform any of the previous therapies. All sessions, for all patient groups, were held weekly for a total period of six months. The evaluation of cognitive function was performed through the Mini Mental State Examination (MMSE), while the Geriatric Depression Scale (GDS) assessed the depressive state. Test administration to all patients was performed before the start of the first session (T0) and after the last session (T1). The results obtained showed an improvement in the values in the GDS and MMSE tests. The variations between the average MMSE values between T1 and T0 were 0.94 ± 0.9 (SD), 0.15 ± 0.62, and −0.42 ± 0.45 in the AAT group, ROT group, and control (CTRL) group, respectively. The variations between the average GDS values between T1 and T0 were −1.12 ± 1.17 (SD), −0.42 ± 1.21, and 0.12 ± 0.66 in the AAT group, ROT group, and CTRL group, respectively. Based on our findings, we can therefore affirm how the study carried out confirms the potential of AAT performed by Federico II Model of Healthcare Zooanthropology, and particularly its efficacy in the treatment of cognitive deficits deriving from Alzheimer’s disease.

Purpose. To summarize the role of widefield optical coherence tomography angiography (WF-OCTA) in diabetic retinopathy (DR), extending from the acquisition strategies to the main clinical findings. Methods. A PubMed-based search was carried out using the terms “Diabetic retinopathy”, “optical coherence tomography angiography”, “widefield imaging”, and “ultra-widefield imaging”. All studies published in English up to August 2020 were reviewed. Results. WF-OCTA can be obtained with different approaches, offering advantages over traditional imaging in the study of nonperfusion areas (NPAs) and neovascularization (NV). Quantitative estimates and topographic distribution of NPA and NV are useful for treatment monitoring and artificial intelligence-based approaches. Curvature, segmentation, and motion artifacts should be assessed when using WF-OCTA. Conclusions. WF-OCTA harbors interesting potential in DR because of its noninvasiveness and capability of objective metrics of retinal vasculature. Further studies will facilitate the migration from traditional imaging to WF-OCTA in both the research and clinical practice fields.

The pathogenesis of diabetic macular edema (DME) is complex. Persistently high blood glucose activates multiple cellular pathways and induces inflammation, oxidation stress, and vascular dysfunction. Retinal ganglion cells, macroglial and microglial cells, endothelial cells, pericytes, and retinal pigment epithelium cells are involved. Neurodegeneration, characterized by dysfunction or apoptotic loss of retinal neurons, occurs early and independently from the vascular alterations. Despite the increasing knowledge on the pathways involved in DME, only limited therapeutic strategies are available. Besides antiangiogenic drugs and intravitreal corticosteroids, alternative therapeutic options tackling inflammation, oxidative stress, and neurodegeneration have been considered, but none of them has been currently approved.

Optical coherence tomography angiography (OCTA) provides several data regarding the status of retinal capillaries. This information can be further enlarged by employing quantitative metrics, such as vessel density (VD). A mandatory preliminary step of OCTA quantification is image binarization, a procedure used to highlight retinal capillaries on empty background. Although several binarization thresholds exist, no consensus is reached about the thresholding technique to be used. In this study, we tested thirteen binarization thresholds on a dataset made by thirty volunteers. The aim was to assess the impact of binarization techniques on: (I) detection of retinal capillaries, assessed by the calculation of overlapping percentages between binarized and original images; (II) quantitative OCTA metrics, including VD, vessel tortuosity (VT) and vessel dispersion (Vdisp); (III) foveal avascular zone (FAZ) detection. Our findings showed Huang, Li, Mean and Percentile as highly reliable binarization thresholds (p < 0.05), whereas the worst binarization thresholds were Intermodes, MaxEntropy, RenylEntropy and Yen (p < 0.05). All the thresholds variably underestimated VD metric and FAZ detection, with respect to the original OCTA images, whereas VT and Vdisp turned out to be more stable. The usage of a Fixed threshold resulted extremely useful to reduce VD and FAZ underestimations, although bound to operators’ experience.

Animal-assisted therapy (AAT) is a non-pharmacological therapy aimed at people with physical and/or mental disabilities. Therefore, it is necessary to carry out interventions that guarantee its benefits for patients while also avoiding the risk of zoonoses due to contact with the animals or their mucous membranes. The present study aimed to detect the occurrence of Pasteurella multocida in the oral cavity of dogs attending a “dog educational centre” and training for AAT interventions. In addition, some of the potential predictable factors of infection (i.e., age, sex, breed, and living conditions) were analyzed. In total, 25/200 dogs examined (12.5%; 95% confidence interval = 8.4–18.1%) were positive for P. multocida, as confirmed by PCR. Sex, breed, and living conditions were risk factors associated with P. multocida as revealed by the logistic regression analysis. Specifically, cross-bred female dogs living prevalently outdoors were significantly associated with the presence of P. multocida (p < 0.05). This study represents the first epidemiological survey of the prevalence of P. multocida in the oral cavity of dogs involved subsequently in AAT interventions, highlighting the potential risk of P. multocida infection in patients, often belonging to risk categories (e.g., children, the elderly, and immunocompromised individuals). Therefore, healthcare guidelines could be suggested to integrate the current literature related to the health check of dogs involved in AAT. In this way, it could be ensured that, even with bodily contact during AAT, the risk of pathogen transmission by the co-therapist dog can be avoided.