Translational control of E2f1 regulates the Drosophila cell cycle.

E2F transcription factors are master regulators of the eukaryotic cell cycle. In Drosophila, the sole activating E2F, E2F1, is both required for and sufficient to promote G1→S progression. E2F1 activity is regulated both by binding to RB Family repressors and by posttranscriptional control of E2F1 protein levels by the EGFR and TOR signaling pathways. Here, we investigate cis-regulatory elements in the E2f1 messenger RNA (mRNA) that enable E2f1 translation to respond to these signals and promote mitotic proliferation of wing imaginal disc and intestinal stem cells. We show that small upstream open reading frames (uORFs) in the 5' untranslated region (UTR) of the E2f1 mRNA limit its translation, impacting rates of cell proliferation. E2f1 transgenes lacking these 5'UTR uORFs caused TOR-independent expression and excess cell proliferation, suggesting that TOR activity can bypass uORF-mediated translational repression. EGFR signaling also enhanced translation but through a mechanism less dependent on 5'UTR uORFs. Further, we mapped a region in the E2f1 mRNA that contains a translational enhancer, which may also be targeted by TOR signaling. This study reveals translational control mechanisms through which growth signaling regulates cell cycle progression.

Independently paced Ca2+ oscillations in progenitor and differentiated cells in an ex vivo epithelial organ.

Cytosolic Ca2+ is a highly dynamic, tightly regulated and broadly conserved cellular signal. Ca2+ dynamics have been studied widely in cellular monocultures, yet organs in vivo comprise heterogeneous populations of stem and differentiated cells. Here, we examine Ca2+ dynamics in the adult Drosophila intestine, a self-renewing epithelial organ in which stem cells continuously produce daughters that differentiate into either enteroendocrine cells or enterocytes. Live imaging of whole organs ex vivo reveals that stem-cell daughters adopt strikingly distinct patterns of Ca2+ oscillations after differentiation: enteroendocrine cells exhibit single-cell Ca2+ oscillations, whereas enterocytes exhibit rhythmic, long-range Ca2+ waves. These multicellular waves do not propagate through immature progenitors (stem cells and enteroblasts), of which the oscillation frequency is approximately half that of enteroendocrine cells. Organ-scale inhibition of gap junctions eliminates Ca2+ oscillations in all cell types - even, intriguingly, in progenitor and enteroendocrine cells that are surrounded only by enterocytes. Our findings establish that cells adopt fate-specific modes of Ca2+ dynamics as they terminally differentiate and reveal that the oscillatory dynamics of different cell types in a single, coherent epithelium are paced independently.

Immunonutrients involved in the regulation of the inflammatory and oxidative processes: implication for gamete competence.

PURPOSE: The purpose of this umbrella review is to bring together the most recent reviews concerning the role of immunonutrients for male and female infertility. METHODS: Regarding immunonutrients and fertility, the authors have analyzed reviews, systematic reviews, and meta-analyses published between 2011 and June 2021. All reviews on animal or in vitro studies were excluded. Relevant keywords to term micronutrients were analyzed alone or in association with other terms such as "gamete competence," "male OR female fertility," "male OR female infertility," "fertile, "folliculogenesis," "spermatogenesis," "immunomodulation," "immune system," "oxidative stress." RESULTS: The primary research has included 108 results, and after screening by title, abstract. and not topic-related, 41 studies have been included by full texts. The results show the molecular mechanisms and the immunonutrients related impact on gamete formation, development. and competence. In particular, this review focused on arginine, glutamine, vitamin C, vitamin D, vitamin E, omega-3, selenium, and zinc. CONCLUSIONS: Inflammation and oxidative stress significantly impact human reproduction. For this reason, immunonutrients may play an important role in the treatment of infertile patients. However, due to the lack of consistent clinical trials, their application is limited. Therefore, the development of clinical trials is necessary to define the correct supplementation, in case of deficiency.

Role of vitamin K2 in bone-vascular crosstalk.

Vitamin K (VK) is a fat-soluble vitamin that is indispensable for the activation of vitamin K-dependent proteins (VKDPs). It has been shown to play an important role in the proper calcium deposit at the bone level, hindering that on the vascular walls. The deficiency of this vitamin in European populations is frequent and unknown. It is related to several factors, poor dietary intake, altered intestinal absorption or altered production by bacteria, indicating possible dysbiosis. For Vitamin K2 (VK2), there is currently no official reference daily intake (RDI). However, the effects of VK2 on the improvement of health in cardiovascular diseases, on bone metabolism, on chronic kidney diseases have been the subject of research in recent decades. The microbiota in the gastrointestinal tract plays an important role: Bacteroides are primarily capable of synthetizing very long chain forms of menaquinones and, in addition to the bacteria present in the intestinal flora, VK2 is also produced by bacteria used in food fermentation processes. This review provides an update on the current literature regarding the origin of VK2 and its implications in what is called the "calcium paradox", namely the lack of calcium in the bone and its storage in the wall of the vessel.

Maternal body mass index associates with blastocyst euploidy and live birth rates: the tip of an iceberg?

RESEARCH QUESTION: Does maternal preconceptional body mass index (BMI) associate with mean blastocyst euploidy rate (m-ER) per patient and live birth rate (LBR) after vitrified-warmed euploid single embryo transfer (SET)? DESIGN: Observational study conducted between April 2013 and March 2020 at a private IVF clinic, involving 1811 Caucasian women undergoing trophectoderm biopsy and comprehensive chromosome testing. The outcomes of 1125 first vitrified-warmed euploid SET were also analysed. Patients were clustered as normal weight (BMI 18.5-25; n = 1392 performing 859 SET), underweight (BMI <18.5; n = 160 performing 112 SET) and overweight (BMI >25; n = 259 performing 154 SET). m-ER per patient was the primary outcome. The secondary outcomes were all clinical outcomes per euploid SET. All data were adjusted for confounders through regression analyses. RESULTS: The m-ER per patient decreases as maternal BMI increases from 17 up to 22-23 before reaching a plateau. A linear regression adjusted for maternal age confirmed this moderate association (unstandardized coefficient B: -0.6%, 95% confidence interval [CI]: -1.1 to -0.1%, P = 0.02). All clinical outcomes were similar between normal weight and underweight women. Overweight women, instead, showed higher miscarriage rate per clinical pregnancy (n = 20/75, 26.7% versus n = 67/461, 14.5%; odds ratio [OR] adjusted for blastocyst quality and day of full blastulation: 2.0, 95% CI: 1.1-3.6, P = 0.01) and lower LBR per SET (n = 55/154, 35.7% versus n = 388/859, 45.2%; OR adjusted for blastocyst quality and day of full blastulation: 0.67, 95% CI: 0.46-0.96, P = 0.03). CONCLUSION: These data indicate a need for future research on more sensitive metrics to assess body fat mass and distribution, as well as on the mechanisms leading to lipotoxicity, thereby impairing embryo competence and/or endometrial receptivity. Overweight women should be informed of their higher risk for miscarriage and, whenever possible, encouraged to lose weight, especially before transfer.

The New Hyperspectral Satellite PRISMA: Imagery for Forest Types Discrimination.

Different forest types based on different tree species composition may have similar spectral signatures if observed with traditional multispectral satellite sensors. Hyperspectral imagery, with a more continuous representation of their spectral behavior may instead be used for their classification. The new hyperspectral Precursore IperSpettrale della Missione Applicativa (PRISMA) sensor, developed by the Italian Space Agency, is able to capture images in a continuum of 240 spectral bands ranging between 400 and 2500 nm, with a spectral resolution smaller than 12 nm. The new sensor can be employed for a large number of remote sensing applications, including forest types discrimination. In this study, we compared the capabilities of the new PRISMA sensor against the well-known Sentinel-2 Multi-Spectral Instrument (MSI) in recognition of different forest types through a pairwise separability analysis carried out in two study areas in Italy, using two different nomenclature systems and four separability metrics. The PRISMA hyperspectral sensor, compared to Sentinel-2 MSI, allowed for a better discrimination in all forest types, increasing the performance when the complexity of the nomenclature system also increased. PRISMA achieved an average improvement of 40% for the discrimination between two forest categories (coniferous vs. broadleaves) and of 102% in the discrimination between five forest types based on main tree species groups.

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students.

BACKGROUND: The amount of research about orthorexic attitudes and behaviours has increased in the last five years, but is still mainly based on descriptive and anecdotal data, yielding a variety of prevalence data and inconsistent results. The interplay between socio-cultural context and orthorexia has been poorly investigated and is still far from being understood. METHOD: Multicentre, cross-sectional study involving Italian (N = 216), Polish (N = 206) and Spanish (N = 242) university students, assessed through a protocol including informed consent, socio-demographic and anamnestic data sheet and self-administered questionnaires (ORTO-15, Eating Attitudes Test- 26 [EAT-26], Temperament and Character Inventory [TCI]). RESULTS: Higher prevalence of orthorexia (as described by the ORTO-15 cutoff) was found in Poland. Female gender, Body Mass Index (BMI), current Eating Disorder, dieting, EAT-26 score ≥ 20 and low/medium Persistence were associated with orthorexia in the whole sample. The cross-cultural comparison showed several differences among the three subgroups of students. CONCLUSIONS: The associations found between orthorexic attitudes, self-reported current eating disorder, BMI and adherence to a dieting need to be supported by further research. The differences among students from the three countries seem to suggest a possible rolve for cultural elements in the construct of orthorexia.

OpenMICE: an open spatial and temporal data set of small mammals in south-central Italy based on owl pellet data.

The use of database technologies as a tool for implementing data for quantitative ecological studies and biodiversity conservation planning has recently attracted the attention of the biological community. Despite the fact that the number of biodiversity data sets is quickly rising, online databases of small mammals are still scarce, especially for Mediterranean ecosystems. We implemented the first standardized and accessible georeferenced European database of small mammal occurrences, abundances, and functional traits. Data derived from owl pellets was obtained from different sources, including original field surveys, publications, gray literature, existing databases, and museum collections. The OpenMICE database covers the years 1972 to 2017 and includes nearly 50,000 individuals from 23 species (13 Rodentia and 10 Eulipotyphla) at 190 sites in south-central Italy. Our specific goals in compiling this data set were as follows: (1) to make data that is usually accessible to a restricted audience widely available; (2) to identify the gaps in knowledge about small mammal communities and guide future sampling and conservation efforts; and (3) to gain a first insight into small mammal diversity and abundance in the study area. The potential applications of our spatial relational database are many, from individual-based to community-based models as potential indicators of environmental changes at different geographical scales. Given the long-term support for data storage, the OpenMICE database could be further expanded to include other geographical contexts and implemented with new information and traits. We would appreciate that researchers cite this paper if using all or part of the data set. We also request that researchers and teachers inform us of how they are using the data. We intend to keep it up to date as novel studies become available (see Data Availability).

SHARING AND COLLECTING HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT REPORTS INTERNATIONALLY: IS AN EXTENSIVE PARTICIPATION OF STAKEHOLDERS REALISTIC?

OBJECTIVES: The emergence of new medical technologies and budget restrictions has led to a substantial increase in the use of hospital-based health technology assessment (HB-HTA). This qualitative study explores whether there is a possibility and interest to realize the collection and dissemination of HB-HTA reports on an international scale by exploring the opinions from HB-HTA experts. METHODS: A survey was designed and sent to an international group of experts knowledgeable in HB-HTA from eighteen different countries. The survey contained questions about their opinions on the collection and distribution of HB-HTA information, and about the meaningful dimensions, barriers and values about a database. The data obtained were analyzed through the method of content analysis. RESULTS: A total of thirty-six experts (response rate of 18.3 percent) responded to the survey. The obtained data shows that all respondents agree that the collection of HB-HTA reports is useful. Moreover, 41.7 percent of respondents that are in the position of sharing HB-HTA reports (n = 24) mentioned that full HB-HTA reports can be shared. Many other respondents reported that confidentiality (45.7 percent) and investment into a database (40.0 percent) are important barriers for the dissemination of HB-HTA reports. CONCLUSIONS: There seem to be enough demand and willingness to share all or most reports by a large community of HB-HTA producers. Therefore, there is a need for a well-designed database with regular maintenance and complete, comparable, and qualitative HB-HTA reports. The database of the AdHopHTA project could potentially facilitate this process.

TOWARD A CONTINGENCY MODEL FOR HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT: EVIDENCE FROM ADHOPHTA PROJECT.

OBJECTIVES: Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several similarities. The aims of this study were to explore, describe, interpret, and explain seven cases of the application of HB-HTA logic and to propose a classification for HB-HTA organizational models which may be beneficial for policy makers and HTA professionals. METHODS: The study was part of the AdHopHTA Project, granted under the European 7th Framework Research Programme. A case study methodology was applied to analyze seven HB-HTA initiatives in seven countries, with collection of qualitative and quantitative data. Cross-case analysis was performed within the framework of contingent organizational theory. RESULTS: Evidence showed that some organizational or "structural" variables, namely the level of procedure formalization/structuration and the level of integration with other HTA bodies at the national, regional, and provincial levels, predominantly shape the HB-HTA approach, determining a contingency model of HB-HTA. Crossing the two variables, four options have emerged: integrated specialized HTA unit, stand-alone HTA unit, integrated-essential HTA, independent group unit. CONCLUSIONS: No one-best-way approach can be used for HTA at the hospital level. Rather, the characteristics of HTA models depend on many contextual factors. Such conceptualization may aid the diffusion of HB-HTA to inform managerial decision making and clinical practice.

Seasonality and microhabitat selection in a forest-dwelling salamander.

Many small terrestrial vertebrates exhibit limited spatial movement and are considerably exposed to changes in local environmental variables. Among such vertebrates, amphibians at present experience a dramatic decline due to their limited resilience to environmental change. Since the local survival and abundance of amphibians is intrinsically related to the availability of shelters, conservation plans need to take microhabitat requirements into account. In order to gain insight into the terrestrial ecology of the spectacled salamander Salamandrina perspicillata and to identify appropriate forest management strategies, we investigated the salamander's seasonal variability in habitat use of trees as shelters in relation to tree features (size, buttresses, basal holes) and environmental variables in a beech forest in Italy. We used the occupancy approach to assess tree suitability on a non-conventional spatial scale. Our approach provides fine-grained parameters of microhabitat suitability and elucidates many aspects of the salamander's terrestrial ecology. Occupancy changed with the annual life cycle and was higher in autumn than in spring, when females were found closer to the stream in the study area. Salamanders showed a seasonal pattern regarding the trees they occupied and a clear preference for trees with a larger diameter and more burrows. With respect to forest management, we suggest maintaining a suitable number of trees with a trunk diameter exceeding 30 cm. A practice of selective logging along the banks of streams could help maintain an adequate quantity of the appropriate microhabitat. Furthermore, in areas with a presence of salamanders, a good forest management plan requires leaving an adequate buffer zone around streams, which should be wider in autumn than in spring.

Assessing habitat quality in relation to the spatial distribution of protected areas in Italy.

The conservation of species and habitats is increasingly threatened by anthropogenic impacts, particularly land use change, from local to global scales. Although many efforts have been carried out so far to halt or at least reduce the biodiversity loss (e.g., the establishment of protected areas' networks), there are still both knowledge and policy gaps slowing the conservation of species and habitats in complex environments, such as the Mediterranean region. In particular, the human-driven impacts and threats on biodiversity need more careful analysis. Accordingly, this paper aims to assess the habitat quality and degradation in Italy in relation with the spatial pattern of the current protected areas' network, mainly to identify priority areas of intervention, thus supporting large-scale conservation strategies. A survey of experts was conducted to identify the main threats for biodiversity from different land uses at the national scale. The InVEST software was then applied to assess and map habitat quality and degradation with a high spatial resolution (20 m). The relationship between habitat quality and degradation as well as their hotspots, and alternative PA categories were also explored. Results indicate that: (i) habitat quality and degradation depend on the location and intensity of the anthropogenic impacts and are sensitive to different protection levels; (ii) the combination of the survey of experts and the spatially-explicit assessment of habitat quality and degradation is useful to highlight variations of the current conditions of biodiversity and habitats; and (iii) the identification of hotspots allows one to identify priority areas for conservation. Accordingly, the proposed approach may be used to strengthen the conservation efforts in similar contexts, and thus support the implementation of the biodiversity-related policies over the long term.

Modeling the influence of alternative forest management scenarios on wood production and carbon storage: A case study in the Mediterranean region.

Forest ecosystems are fundamental for the terrestrial biosphere as they deliver multiple essential ecosystem services (ES). In environmental management, understanding ES distribution and interactions and assessing the economic value of forest ES represent future challenges. In this study, we developed a spatially explicit method based on a multi-scale approach (MiMoSe-Multiscale Mapping of ecoSystem services) to assess the current and future potential of a given forest area to provide ES. To do this we modified and improved the InVEST model in order to adapt input data and simulations to the context of Mediterranean forest ecosystems. Specifically, we integrated a GIS-based model, scenario model, and economic valuation to investigate two ES (wood production and carbon sequestration) and their trade-offs in a test area located in Molise region (Central Italy). Spatial information and trade-off analyses were used to assess the influence of alternative forest management scenarios on investigated services. Scenario A was designed to describe the current Business as Usual approach. Two alternative scenarios were designed to describe management approaches oriented towards nature protection (scenario B) or wood production (scenario C) and compared to scenario A. Management scenarios were simulated at the scale of forest management units over a 20-year time period. Our results show that forest management influenced ES provision and associated benefits at the regional scale. In the test area, the Total Ecosystem Services Value of the investigated ES increases 85% in scenario B and decreases 82% in scenario C, when compared to scenario A. Our study contributes to the ongoing debate about trade-offs and synergies between carbon sequestration and wood production benefits associated with socio-ecological systems. The MiMoSe approach can be replicated in other contexts with similar characteristics, thus providing a useful basis for the projection of benefits from forest ecosystems over the future.

CAPACITY BUILDING IN AGENCIES FOR EFFICIENT AND EFFECTIVE HEALTH TECHNOLOGY ASSESSMENT.

OBJECTIVES: Health technology assessment (HTA) yields information that can be ideally used to address deficiencies in health systems and to create a wider understanding of the impact of different policy considerations around technology reimbursement and use. The structure of HTA programs varies across different jurisdictions according to decision-maker needs. Moreover, conducting HTA requires specialized skills. Effective decision making should include multiple criteria (medical, economic, technical, ethical, social, legal, and cultural) and requires multi-disciplinary teams of experts working together to produce these assessments. A workshop explored the multi-disciplinary skills and competencies required to build an effective and efficient HTA team, with a focus on low- and middle-income settings. METHODS: This proceeding summarizes main points from a workshop on capacity building, drawing on presentations and group discussions among attendees including different points of view. RESULTS AND CONCLUSIONS: The workshop and thus this study would have benefited from a larger variety of stakeholders. Therefore, the conclusions arising from the workshop are not the opinion of a representative sample of HTA professionals. Nonetheless, organizations and speakers were carefully selected to provide a valuable approach to this theme. Thus, these proceedings highlight some of the gaps and needs in the education and training programs offered worldwide and calls for further investigation.

Surgical Management of Myofibroma of the Gengiva.

The purpose of this paper is to report a rare patient of oral myofibroma in a 12-year old patient and to describe its clinical, histopathologic, and immunohistochemical features to establish the correct diagnosis and surgical management.Pathological and immunohistochemical examination is a mandatory method for establishing a definitive diagnosis of this lesion avoiding unnecessary treatment. Surgical excision and careful postoperative observation should be a treatment option.

A systematic conservation planning approach to fire risk management in Natura 2000 sites.

A primary challenge in conservation biology is to preserve the most representative biodiversity while simultaneously optimizing the efforts associated with conservation. In Europe, the implementation of the Natura 2000 network requires protocols to recognize and map threats to biodiversity and to identify specific mitigation actions. We propose a systematic conservation planning approach to optimize management actions against specific threats based on two fundamental parameters: biodiversity values and threat pressure. We used the conservation planning software Marxan to optimize a fire management plan in a Natura 2000 coastal network in southern Italy. We address three primary questions: i) Which areas are at high fire risk? ii) Which areas are the most valuable for threatened biodiversity? iii) Which areas should receive priority risk-mitigation actions for the optimal effect?, iv) which fire-prevention actions are feasible in the management areas?. The biodiversity values for the Natura 2000 spatial units were derived from the distribution maps of 18 habitats and 89 vertebrate species of concern in Europe (Habitat Directive 92/43/EEC). The threat pressure map, defined as fire probability, was obtained from digital layers of fire risk and of fire frequency. Marxan settings were defined as follows: a) planning units of 40 × 40 m, b) conservation features defined as all habitats and vertebrate species of European concern occurring in the study area, c) conservation targets defined according with fire sensitivity and extinction risk of conservation features, and d) costs determined as the complement of fire probabilities. We identified 23 management areas in which to concentrate efforts for the optimal reduction of fire-induced effects. Because traditional fire prevention is not feasible for most of policy habitats included in the management areas, alternative prevention practices were identified that allows the conservation of the vegetation structure. The proposed approach has potential applications for multiple landscapes, threats and spatial scales and could be extended to other valuable natural areas, including protected areas.

Integration of land use and land cover inventories for landscape management and planning in Italy.

There are both semantic and technical differences between land use (LU) and land cover (LC) measurements. In cartographic approaches, these differences are often neglected, giving rise to a hybrid classification. The aim of this paper is to provide a better understanding and characterization of the two classification schemes using a comparison that allows maximization of the informative power of both. The analysis was carried out in the Molise region (Central Italy) using sample information from the Italian Land Use Inventory (IUTI). The sampling points were classified with a visual interpretation of aerial photographs for both LU and LC in order to estimate surfaces and assess the changes that occurred between 2000 and 2012. The results underscore the polarization of land use and land cover changes resulting from the following: (a) recolonization of natural surfaces, (b) strong dynamisms between the LC classes in the natural and semi-natural domain and (c) urban sprawl on the lower hills and plains. Most of the observed transitions are attributable to decreases in croplands, natural grasslands and pastures, owing to agricultural abandonment. The results demonstrate that a comparison between LU and LC estimates and their changes provides an understanding of the causes of misalignment between the two criteria. Such information may be useful for planning policies in both natural and semi-natural contexts as well as in urban areas.

GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS.

OBJECTIVES: Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. METHODS: A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units. RESULTS: Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project. CONCLUSIONS: Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.

Participation in a 9-month selected physical exercise programme enhances psychological well-being in a prison population.

BACKGROUND: There is general population evidence that physical exercise is effective in reducing the risk of depression and has positive effects on mood. Some prisons encourage exercise, but there is no evidence specific to this group on its benefits or the relative merits of different programmes. AIMS: To test the effect of physical exercise on the psychological well-being of prisoners and to determine which mental disorders are most affected by physical activity. METHODS: Sixty-four participants were randomly assigned across three groups: cardiovascular plus resistance training (CRT), high-intensity strength training (HIST) and no exercise. Before and after the 9-month experimental period, all participants completed the Symptom Checklist-90-Revised. RESULTS: Each form of exercise significantly reduced depression scale scores compared with those in the control group, in which average depression scale scores actually increased. The CRT group also showed a significant decrease in GSI scores on the Symptom Checklist-90 and on its interpersonal sensitivity scale, whereas the HIST group also significantly improved on the anxiety, phobic anxiety and hostility scale scores. CONCLUSIONS: Our evidence, taken together with general population studies, supports introduction of supervised, moderately intense exercise for at least 1 h per week for men in prison. They form a high risk group for mental disorders, and such exercise reduces depression and anxiety. Minimal special equipment is needed for CRT. Further research should replicate the study in a larger, multi-centre trial, and examine impact on shorter-term and longer-term prisoners, female prisoners and effects on recidivism.