Journal of Interdisciplinary Research Applied to Medicine

Occupational stress in dentistry, particularly during endodontic procedures, impacts practitioners’ health and performance. This study introduces a novel approach using real-time Heart Rate (HR) data from Apple Watch technology to assess physiological responses potentially indicative of occupational stress among endodontists. Materials and Methods: Twelve endodontists participated in this study, treating 119 patients. In a controlled clinical environment, HR was continuously monitored with the Apple Watch, and data were recorded via the Cardiogram app, capturing HR variations across treatment stages. Results: Significant HR fluctuations were observed during procedurally demanding stages such as local anesthesia and rubber dam placement. The endodontist’s HR, as a physiological proxy for stress, was significantly influenced by the treatment difficulty level, stage, and the patient’s age. Conclusions: Using Apple Watch technology, our study revealed significant HR variations during different endodontic treatment stages, suggesting fluctuating physiological responses that may reflect occupational stress. Elevated HR was noted during patient examination and rubber dam placement, particularly in complex cases. These preliminary findings suggest that HR monitoring via wearable technology may serve as a useful, albeit indirect, indicator of occupational stress during endodontic procedures. Future studies with larger samples and additional validated stress biomarkers are needed to confirm these observations. Full article

The development of precise quantitative metrics is essential for characterizing the response of biological systems to external perturbations, enabling a transition from qualitative observation to predictive modeling. In this context, mathematical frameworks can provide insight into the dynamic behavior of cell populations under external stimuli. In this study, a logistic-type growth model was employed to describe wound healing dynamics. A scratch assay protocol was applied to lung cancer cells, and a perturbation-based analytical framework was developed to quantify the influence of external factors. Novel metrics were introduced, including the percentage difference in wound closure at specific time points, the shift in inflection time, and the Average Difference in Wound Closure (ADWC). A pilot experimental study was conducted to evaluate the effect of Low-Level Laser Therapy (LLLT) on cell migration. The proposed model successfully captured the nonlinear dynamics of wound closure and enabled quantitative comparison between control and treated groups. The analysis demonstrated that LLLT enhances cellular activity, leading to a shift in the inflection time by approximately 7.6 h and an increase of 25.4% in wound closure at 24 h compared to the control group. The ADWC metric further confirmed a systematic difference in the overall healing dynamics between conditions. The presented perturbation-based framework provides a rigorous and interpretable tool for quantifying the effects of external stimuli on biological systems. These findings suggest a light-dependent modulation of tumor cell migration in an in vitro model, indicating that light exposure may influence cellular behavior under certain conditions. This observation may be relevant for clinical applications involving light, such as photodynamic therapy, particularly in cases of incomplete drug delivery. Full article

Background: In electronic health record (EHR) research, multimorbidity is commonly represented by summary indices that may oversimplify disease co-occurrence or by unsupervised cluster labels that may lack stability across samples. This study evaluated a leakage-safe framework for deterministic, overlapping multimorbidity phenotyping. Methods: Data from the All of Us Research Program were used to study 23,435 adults aged 50 years and older, anchored at their first SARS-CoV-2-positive test. Eleven pre-index Charlson component indicators were used as the binary baseline representation. Stable co-occurrence patterns were explored using association rule mining with bootstrap recurrence criteria. K-modes clustering was used as a discovery aid, while final phenotype membership was defined by deterministic rule functions. Results: The framework produced three overlapping phenotype flags and a transparent 8-state overlap structure. The analytic cohort included 1462 incident cognitive impairment cases. Two phenotype flags were associated with higher odds of incident cognitive impairment. However, adding the phenotype flags to baseline models yielded only marginal improvements in discrimination. Conclusions: The framework’s primary value lies in providing a reproducible, transparent, and overlap-aware representation of multimorbidity rather than in producing substantial predictive gains. This approach may support interpretable baseline phenotyping and leakage-safe modeling in real-world EHR studies. Full article

Accurate and efficient seizure detection remains a major challenge for portable EEG-based monitoring systems, where computational and power limitations restrict the use of deep learning approaches. We introduce a compact set of fourteen propagation-based EEG features that quantify spike directionality, propagation velocity, and spatial coherence across channels. These physiologically interpretable features were evaluated using a gradient-boosted XGBoost classifier on the TUH Seizure Corpus under a leave-one-subject-out cross-validation framework. The proposed model achieved 97.8% accuracy, 98.7% specificity, 93.6% sensitivity, and a weighted F1 score of 97.8% using 2 s epochs and eight electrodes. The framework remained robust across generalized, focal, and complex partial seizure types and maintained consistent short-window performance. The compact 14-feature representation enables efficient, accurate, and interpretable seizure detection with strong potential for real-time wearable EEG-based applications. The proposed gradient-boosting approach demonstrates that shallow, interpretable architectures can achieve performance comparable to deep learning methods while offering improved computational efficiency, making them promising for low-power embedded implementations. Full article

Ossification of the vascular pedicle following fibula free flap (FFF) reconstruction is an uncommon and typically asymptomatic complication. Symptomatic cases requiring intervention are rare. We report a 29-year-old man with anterior maxillary osteosarcoma who underwent tumor resection followed by reconstruction with an osteocutaneous FFF. Calcification within the surgical site region was noted on imaging at two months after fibular reconstruction. By five months, he developed progressive trismus and pain with mastication. Computed tomography demonstrated a calcified structure extending from the mandible to the reconstructed maxilla along the flap pedicle, raising concern for tumor recurrence. Surgical excision was performed, and histopathology revealed benign woven bone without evidence of malignancy. Postoperatively, trismus improved, and flap viability was preserved. Retained periosteum during FFF harvest maintains osteogenic potential and may result in pedicle ossification. In symptomatic patients, particularly when recurrence is suspected, surgical resection is both diagnostic and therapeutic. Full article

This paper introduces SNAP (Structure, Narrative, Activation, Process, Next), a multidimensional clinical reflection tool supporting psychotherapists in systematically attending to phenomenological, relational, and process-oriented dimensions. SNAP integrates Gestalt therapy, complex systems theory, and the Research Domain Criteria (RDoC) framework, comprising 73 items across five dimensions. A pilot acceptability and perceived utility study (N = 20 psychotherapists) used a retrospective pre-post design in which participants provided retrospective pre-exposure and post-exposure ratings for each item. Post-exposure ratings were higher overall than retrospective pre-exposure ratings (T2: M = 6.69, SD = 0.54 vs. T1: M = 6.02, SD = 0.70; mean difference +0.67; Hedges’ g = 0.28, Cohen’s d = 0.29; 15/73 items p < 0.05 uncorrected; 2/73 after Benjamini-Hochberg FDR correction). The largest descriptive contrasts were observed in phenomenological dimensions: Next (g = 0.61), Activation (g = 0.49), Narrative (g = 0.43), and Process-Therapist (g = 0.41). Structural bio-psycho-social dimensions showed minimal contrasts (d = −0.02 to 0.15). Absolute post-exposure ratings were high across items (89% rated 6/9 or above), supporting good acceptability and perceived usefulness within this sample. These preliminary findings support SNAP as a promising, positively perceived framework for clinical reflection. Larger-sample psychometric validation is warranted. Full article

Background: Generative artificial intelligence (AI) can produce realistic human faces that are shared on social media, from where younger generations often derive body image norms. Aesthetic bias in these systems may promote unrealistic standards of beauty. This study examines whether generative AI produces facial images that are perceived by humans as more attractive than real human faces. Thus, we examine AI-generated facial imagery as a contemporary site of consumer culture, where beauty may become biased, unrealistic, and commodified: generating an algorithmically optimized product circulating through social media and digital platforms without proper regulation. Methods: Fifty AI-generated female faces were prospectively compared with 50 photographs of female models from a model agency. Facial attractiveness was rated by plastic surgeons, using a Likert scale and Mann–Whitney U for analysis. Results: AI-generated images received higher mean aesthetic scores than real photographs (7.79 vs. 6.88, p < 0.05), despite prompts requesting unattractive features. Conclusions: The AI model showed a small but consistent bias toward enhanced facial attractiveness. As AI-generated imagery increasingly shapes visual culture, this bias may contribute to unrealistic beauty standards, highlighting the need for AI literacy, responsible use of AI, and ethical oversight, especially when shared on social media. Full article

Background: Conventional CT–dacryocystography (CT-DCG) requires canalicular cannulation and forced contrast injection, which may distort anatomy and cause discomfort. This study describes a non-cannulated CT-DCG protocol using dropwise iodixanol 320 instillation designed to simulate physiological tear drainage. Methods: We retrospectively reviewed 80 patients (25 males, 55 females; mean age 64.3 ± 8.9 years) with suspected nasolacrimal duct obstruction. Iodixanol 320 was instilled at 2 drops/min for 10 min without cannulation. Imaging was performed on a low-dose 128-slice CT system with multiplanar reconstructions. Lacrimal patency, obstruction site, and patient discomfort (10-point VAS) were evaluated by a blinded radiologist. Results: Adequate contrast opacification was achieved in all cases. Obstruction was detected in 70/80 (87.5%) patients. Mean patient discomfort was 2.1 ± 1.3 VAS scale, lower than the values reported in the literature for conventional CT-DCG. No adverse reactions occurred. Conclusions: Non-cannulated CT-DCG with dropwise iodixanol instillation is a feasible and well-tolerated imaging technique that provides high diagnostic yield while preserving physiological tear flow. Further prospective, comparative studies are warranted to validate these findings. Full article

Background: A training program for University Internship Supervisors in Dentistry (UISD) was created from scratch in 2022 at the Faculty of Dentistry in Tours. Designed to prepare practitioners for the role of UISD, it is structured into three distinct modules, each with specific educational objectives. The first module, dedicated to the supervision of students during observation internships, has been delivered for three years. Aim: To assess the experience of UISDs as trainers, to identify their perceptions of their role, and to assess their expectations regarding the future development of this training. The study also aimed to propose a knowledge and competency framework that could serve as a basis for this first module. Methods: A qualitative approach was used, based on semi-structured individual interviews with trained UISDs who had supervised students during observation internships. Interviews were coded and analyzed inductively. Results: A total of 19 UISDs participated in the study. The mean age was 49.4 years, with an average of 23.9 years of private practice experience. Providing high-quality supervision to students in their offices was considered a major priority. Based on these results, the UISD training program was revised to identify four structuring themes for a competency framework: the internship environment, required knowledge, interpersonal skills (soft skills), and practical skills (know-how). Conclusions: The UISD training program in dentistry, designed for observation internships, has been adapted to meet practitioners’ expectations and has evolved into an initial structured framework of competencies and knowledge for supervising students during observation internships. This framework will require ongoing refinement. Full article

In an advanced scientific and technological context, where it is now tangible the possibility of interfering indefinitely in the process of dying, it becomes necessary to disseminate knowledge about end of life that, for the great variety of areas that it invests, presents many controversial aspects. With the Law no. 219/2017, the right of self-determination and freedom of treatment of the patient is enshrined, aspects that to date still remain too little discussed. An online survey was conducted from December 2019 to February 2020, among the population residing in the provinces of Lecce and Brindisi, spread thanks to the collaboration of local authorities. A large part of the sample (82.4%, N=333) claims the right to self-determination, stating that therapeutic decisions are up to the patient who has signed his advance treatment dispositions, declared absolutely binding for 50% (N=205) of the sample. However, there is still a lack of information about how to draw up advance treatment agreements (AADs). 12.6% (N=51) of those interviewed stated that they knew nothing about it and only 32.9% (N=133) felt ready and adequately informed to make their own declarations. Another peculiar aspect is that topics such as euthanasia and assisted suicide seem to be considered at the margins of acceptability among End-of-Life instances. The results of the study show that knowledge on the subject has definitely improved over the years and that in most of the issues addressed, the population has an adequate degree of preparedness even though there is still some skepticism in dealing with issues such as assisted suicide and euthanasia. Future research could explore the possibility of identifying effective training tools and communication strategies that can be used by the widest possible segment of the population. Full article

For the last decades neuroscientists have grown interest in the analysis of the rhythmic activity of the brain syn- chronized at temporal and spatial level. These neural oscillations, grouped by their frequency, have been pro- posed to govern all cognitive processes. In the field of the neurobiology of language, considerable research has linked speech processing and language comprehension to neural oscillations. On one hand, neural rhythmic ac- tivity is thought to synchronize to relevant spectral information of speech on three-time scales – which physically reflect phoneme, syllable and phrase processing. On the other hand, syntactic and semantic processing is sub- served by faster oscillatory patterns not necessarily related to the acoustic properties of speech. For each linguistic process, this article summarizes the neural oscillations involved. Further evidence comes from studies on language-related pathologies. Full article

Cardiac amyloidosis (CA) is characterized by extracellular deposition of protein-derived fibrils and lead to heart failure. Gold standard for its etiological diagnosis is endomyocardial biopsy and laboratory tests, both high-cost and invasive procedures. Technetium- 99m hydroxymethylene diphosphonate (99mTc-HMDP) scintigraphy is important tool for defining CA, specifically transthyretin subtype (ATTR). From July 2020 to February 2021, we retrospectively analyzed 18 pts [14 males, 4 females; aged 32-86y] with suspected ATTR, underwent to scintigraphy 150 min after iv administration of 740 MBq 99mTc-HMDP.Myocardial uptake was assessed optically based on Perugini Score (0- 3). Biopsy confirmed diagnosis. Intense (Score 3) and moderate (Score 2) myocardial uptake verified in 8 patients by 99mTc-HDMP scintigraphy, was consistent with ATTR suspect. In 10 patient’s cardiac radiotracer uptake was absent (Score 0) avoiding biopsy. Our data indicate a 99mTc-HDMP scintigraphy key role in the early diagnosis but even more in the exclusion of patients with ATTR subtype, optimizing the management of pts who do not require high costs and invasive procedures. Full article

Adenoid cystic carcinoma of the Bartholin gland (BG-ACC) is a rare form of vulvar cancer. Literature reported approximately 350 cases of BG-ACC since 1864. Literature data and case reports suggested an aggressive nature with protracted clinical symptoms and a tendency for local recurrence despite adequate surgical excision with or without adjuvant radiotherapy. Survival rates of 71% and 59% are reported, respectively, at five and ten years. A comparative analysis of the immunohistochemical profile was performed with the homologous tumor of the salivary glands, and it was observed that the expression of various antigen in different morphological patterns of this neoplasia allowed some considerations about on its histogenesis that was hitherto never proposed. Full article

This study aims to compare polygraphic data in patients with OSA treated with Barbed Reposition Pharyn-goplasty (BRP) performed with a simplified technique compared to the standard method. Variations of tech-nique were performed and tested with the purpose of promoting tolerability and diffusion of this simplified technique. To evaluate the efficacy of the simplified BRP method, a sample of 99 patients was divided into two groups: Group A was treated with BRP (BRP group) and Group B was treated with simplified BRP (sBRP group). The results obtained on the two groups were compared with the two sample Bootstrap t-tests method, showing a substantial overlap in polygraphic results recorded 6 months after surgery. Full article

Successful communication is considered an essential component of the quality of care and safety of the patient with Amyotrophic Lateral Sclerosis (ALS). Recent technology has provided alternative communication systems, including the Eye-tracking technology, which enables interaction with others in the more advanced stages of the disease. The aim of the study is to investigate patients' difficulties in using the eye tracker, their problem in ob-taining the device and the clinical complications resulting from it. A “snowball sampling” method study was conducted from April to September 2020 until sample saturation. The results of the study demonstrate the countless difficulties in obtaining the eye- tracker, with long waiting times, which are not followed by adequate training in its correct use. Among the consequences linked to the use of this device, the most frequent were nys-tagmus (8.8%), onset of eyelid ptosis (16.2%) and the appearance of increased fatigue. 56.1% of the sample used the eye tracker to surf the Internet whereas 9.1% used it to write e-mails. Overall, the use of the eye tracker led to an improvement in overall quality of life (24%). In Conclusions, the Eye-tracking technology is a valuable de-vice for Alternative Augmentative Communication (AAC) in ALS patients and can be used with good perfor-mance, therefore the need for information, training and improvement on this topic is essential. Full article

The term "pharmacogenetics" refers to the study of individual genetic variations that give rise to different re-sponses to the intake of a drug. Recently, however, it has begun to think that an important role in this sense can also be played by our microbiota. The interaction between our gut microbial flora and drugs is actually bidirec-tional: evidence has accumulated that some drugs, in addition to classical antibiotics, have a strong impact on the composition of the microbiota. Full article

In addition to biochemical and molecular signals coming from the microenvironment, cells are able to sense and integrate mechanical stresses, additional fundamental regulators of cell behaviour. Emerging demonstrations in-dicate that mechanical cues go far beyond the plasma membrane and the cytoskeleton, since, exerting tension on the outside local microenvironment via adhesions, cells develop an equal cytoskeletal stress on the nucleus inside, leading to 3D nuclear modifications. In this context, dynamic changes in nuclear lamina and the surrounding cy-toskeleton modify mechanical properties of the nucleus affecting its structural arrangement, chromatin anchor-ing, 3D chromosome conformation and gene expression. Here we discuss findings supporting the role of the nucleus in cellular mechanosensing, ranging from how mechanical cues are transduced to the nucleus to how ge-nome organization is influenced by cell mechanics. Full article