Search Results (56)

Objectives: Digitalization has revolutionized dentistry, introducing advanced technological tools that improve diagnostic accuracy and access to healthcare. This study aims to examine the effects of integrating digital technologies into the dental field, analyzing the associated benefits and risks, with particular paid attention to the therapeutic relationship and decision-making autonomy. Materials and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, complemented by Google Scholar for non-indexed studies. The selection criteria included peer-reviewed studies published in English between 2014 and 2024, focusing on digital dentistry, artificial intelligence, and medical ethics. This is a narrative review. Elements of PRISMA guidelines were applied to enhance transparency in reporting. Results: The analysis highlighted that although digital technologies and AI offer significant benefits, such as more accurate diagnoses and personalized treatments, there are associated risks, including the loss of empathy in the dentist–patient relationship, the risk of overdiagnosis, and the possibility of bias in the data. Conclusions: The balance between technological innovation and the centrality of the dentist is crucial. A human and ethical approach to digital medicine is essential to ensure that technologies improve patient care without compromising the therapeutic relationship. To preserve the quality of dental care, it is necessary to integrate digital technologies in a way that supports, rather than replaces, the therapeutic relationship. Full article

Background: Handheld dynamometry (HHD) is widely utilized for assessing muscle strength, particularly in the wrist. However, variability in measurement reliability due to differences in testing protocols poses a challenge for clinical and research applications. Methods: The design of this study includes a scoping review of the literature, conducted following the PRISMA-ScR checklist methodology developed by the Joanna Briggs Institute. The databases most commonly cited in review articles were consulted: EBSCO, PEDro, PubMed, Scopus, and Cochrane Library. The following MeSH terms were used: “Handheld Dynamometer”, “Wrist”, “Forearm”, “Muscle”, and “Strength”. The search strings were built using combinations of these terms. Article screening was performed by three reviewers independently, blinded to each other’s selections. Results: The review indicates that HHD can provide reliable measurements when standardized protocols are used. Most studies reported high intra-examiner reliability with Intraclass Correlation Coefficients (ICCs) between 0.71 and 0.90. However, inter-examiner reliability showed more variability, particularly when more than two examiners were involved. The review also highlights the importance of precise dynamometer placement and consistent patient positioning in order to reduce measurement variability. Conclusions: While HHD is a valuable tool for wrist strength assessment, the effectiveness of its measurements largely depends on the testing procedure’s standardization. Implementing validated standardized protocols is essential in enhancing measurement reliability and ensuring their consistent application across clinical settings. Further research is needed to firmly implement these protocols and expand their application in clinical practice. Full article

This paper presents field experiments of mineral deposition on steel, induced by cathodic polarization in natural seawater, as a sustainable strategy for the life extension of marine steel structures. Although this approach is quite well known, the ability of the mineral deposit to both protect steel from corrosion in the absence of a cathodic current, thus operating as an inorganic coating, and provide an effective substrate for colonization by microorganisms still needs to be fully explained. To this end, two identical steel structure prototypes were installed at a depth of 20 m: one was submitted to cathodic polarization, while the other was left under free corrosion for comparison. After 6 months, the current supplied to the electrified structure was interrupted. A multidisciplinary approach was used to analyze the deposits on steel round bars installed in the prototypes over time, in the presence and in the absence of a cathodic current. Different investigation techniques were employed to provide the following information on the deposit: the composition in terms of elements, compounds and macro-biofouling; the morphology; the thickness and the degree of protection estimated by electrochemical impedance spectroscopy (EIS). The results showed that under cathodic polarization, the thickness of the deposit increased to 2.5 mm and then remained almost constant after the current was interrupted. Conversely, the surface impedance decreased from 3 kΩ cm² to about 1.5 kΩ cm² at the same time, and the aragonite–brucite ratio also decreased. This indicates a deterioration in the protection performance and soundness of the deposit, respectively. Considering the trends in thickness and impedance together, it can be concluded that the preformed mineral deposit does not undergo generalized deterioration after current interruption, which would result in a reduction in thickness, but rather localized degradation. This phenomenon was attributed to the burrowing action of marine organisms, which created porosities and/or capillary pathways through the deposit. Therefore, the corrosion protection offered by the mineral deposit without a cathodic current is insufficient because it loses its protective properties. However, the necessary current can be quite limited in the presence of the deposit, which in any case provides a suitable substrate for sustaining the colonization and growth of sessile marine organisms, thus promoting biodiversity. Full article

Gases emitted from active volcanic systems constitute a primary natural source of global atmospheric pollution. Atmospheric sulfur dioxide (SO₂) concentrations were monitored using a near-continuous network based on Scan-DOAS (Differential Optical Absorption Spectroscopy) technology. Complementary intermittent measurements were performed using a UV Thermo^® analyzer deployed at fixed locations and along predefined transects on the island. SO₂ flux data derived from the Scan-DOAS measurements, coupled with atmospheric dispersion maps generated using the AERMOD modeling software, enabled the estimation of SO₂ distribution across the volcanic crater region and inhabited areas of the island, including Vulcano Village and Vulcano Piano. The results of the estimation of SO₂ concentration in the atmosphere, integrated with the dispersion modeling, exhibited consistency with direct SO₂ concentration measurements obtained by the Thermo^® analyzer, demonstrating coherence between the two methodologies, although some overestimations of ambient SO₂ were noted. This study provided valuable insights into areas with anomalous SO₂ concentrations exceeding the threshold limits established by the World Health Organization (WHO) and the European Union (EU). These limits are generally exceeded in the crater zone and surrounding areas. The findings also highlighted the influence of prevailing winds and the temporal variations in volcanic degassing activity observed over the preceding 17 years, characterized by four periods of unrest degassing with SO₂ emission rates from the summit solfataric area reaching up to 250 tonnes per day (td⁻¹). Full article

Matcha, a finely powdered green tea, has been cherished in Japan for centuries, used in the traditional tea ceremony and nowadays also valued for its health-promoting properties. Cultivated under shaded conditions to enhance chlorophyll production, which gives the typical vibrant green color, matcha is rich in important bioactive compounds, including caffeine, catechins, and theanine. This study analyzes three matcha grades—ceremonial grade 1 (G1), grade 4 (G4), and food grade (FG)—to assess variations in their metabolite profiles. The Bligh–Dyer method was employed to extract polar and non-polar metabolites from organic and hydroalcoholic phases. High-performance thin-layer chromatography (HPTLC) was used for qualitative metabolite analysis, while nuclear magnetic resonance (NMR) spectroscopy was employed for both qualitative and quantitative analyses. Results reveal a decreasing gradient of amino acids and caffeine from grade 1 to food grade, while other metabolites, such as polyphenols, display an increasing trend. These findings suggest that factors such as harvesting time and leaf maturity significantly influence matcha’s chemical composition, providing a scientific basis for its quality differentiation and potential nutraceutical uses. Full article

Background: In response to the growing demand for the real-time, in-field characterization of odorous anthropogenic emissions, this study develops and uses a MEMS-based micropacked thermal desorption Gas Chromatography system coupled with a PhotoIonization Detector (GC/PID) for Hot Mix Asphalt (HMA) plant emissions. Methods: The innovative portable device, Pyxis GC, enables the high-sensitivity profiling of Volatile Organic Compounds (VOCs), particularly aldehydes and ketones, with sub-ppb detection limits using ambient air as the carrier gas. A comprehensive experimental design optimized the preconcentration parameters, resulting in an efficient, green analytical method evaluated via the Green Analytical Procedure Index (GAPI). Sorbent comparison showed quinoxaline-bridged cavitands outperform the conventional materials. Results and conclusions: The method was successfully deployed on site for source-specific sampling at an HMA plant, generating robust emission fingerprints. To assess environmental impact, a Generalized Additive Model (GAM) was developed, incorporating the process temperature and Sum of Odour Activity Values (SOAV) to predict odour concentrations. The model revealed a significant non-linear influence of temperature on emissions and validated its predictive capability despite the limited sample size. This integrated analytical–statistical approach demonstrates the utility of MEMS technology for real-time air quality assessment and odour dispersion modelling, offering a powerful tool for environmental monitoring and regulatory compliance. Full article

In this work, a preliminary screening of the bioactivities of an ethanolic extract obtained from the leaves of Wollemia nobilis W.G.Jones, K.D.Hill & J.M.Allen was carried out to explore its potential pharmaceutical applications. In particular, the radical scavenging, chelating, reducing antiglycative, antimicrobial and antifungal activities as well as the inhibitory effects on the production of aflatoxin B1 in Aspergillus flavus Link were evaluated. The extract demonstrated promising biological activities, although generally with lower potency compared to the positive control. To identify the metabolites potentially responsible for these effects, the extract was subjected to phytochemical analysis evidencing the presence of eight known compounds. Among them, 15-agathic acid methyl ester (1) and ladanein (5) were reported for the first time in this species. Furthermore methyl-(E)-communate (2), 7,4′,7″,4‴-tetra-O-methyl-robustaflavone (6), agathisflavone (7) and quinic acid (8) were detected for the first time in the leaf tissue of W. nobilis. Their presence and the presence of isocupressic acid (3) and acetyl-isocupressic acid (4) in this species highlights the taxonomic correlations within the Araucariaceae family and suggests a possible contribution of these compounds in the bioactivities of the extract. However, further studies are required to confirm these contributions and to elucidate their mechanisms of action. Full article

Background: An extensive use of transesophageal echocardiography (TEE) has recently been suggested for the diagnosis of infective endocarditis (IE). In this study, we investigated whether among patients with negative transthoracic echocardiography (TTE), subgroups can be identified among whom TEE can be avoided/delayed. Methods: We conducted a retrospective study of 637 consecutive patients who underwent TEE for suspected IE. We selected 375 patients with negative TTE. For each patient, we obtained age, sex, blood culture (BC), blood exams, evidence of embolism, presence of moderate/severe heart valve disease, valve prostheses, and intracardiac devices. Results: IE was eventually diagnosed in 56 patients. Variables independently associated with IE at multivariate analysis included positive BC (OR 3.45; p = 0.006), evidence of embolism (OR 13.0; p < 0.001), bioprosthetic heart valves (OR 4.31; p < 0.001) and platelet count < 150,000/mL (OR 2.47; p = 0.014). In patients without any of these predictors for IE (n = 81), only 1 had a diagnosis of IE and no in-hospital IE-related deaths occurred. Among patients with negative BC (n = 127), IE prevalence increased with the number of other predictors, but IE-related mortality was 0%. IE prevalence (10.8%) and IE related in-hospital mortality (2.7%) were also rather low in patients with a positive blood culture without any other independent predictors for IE but were 20% (IE-related mortality 3.8%) and 71% (IE-related mortality 28.6%) in those with only one or 2–3 other IE predictors, respectively. Conclusions: Our data suggest that, among patients with suspected IE and negative TTE, subgroups can be identified in whom TEE might be safely avoided or delayed. Full article

Background: Posterior cruciate ligament (PCL) injuries are relatively rare, with limited consensus on the optimal treatment for isolated acute cases. Conservative management and surgical reconstruction each offer potential benefits, but their comparative efficacy remains unclear. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) framework and PRISMA-ScR guidelines. A systematic search of MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science was completed on 23 December 2024. Studies comparing conservative treatment and surgical reconstruction for isolated acute PCL injuries were included. Outcomes such as functional recovery, stability, and long-term complications were extracted and synthesized qualitatively. Results: Six studies were included, comprising case series, prospective, retrospective, and review designs. Conservative treatment demonstrated significant improvements in functional recovery (IKDC scores: 67–90.3/100) but showed limited improvement in stability (STSD reduction: 0–3 mm). Surgical reconstruction yielded superior stability (STSD reduction: 8.2 to 2.7 mm) and lower rates of degenerative changes but was associated with a higher risk of complications. Functional outcomes were comparable between approaches in some studies, although surgical patients showed slightly better long-term stability. Conclusions: Both conservative and surgical treatments achieve satisfactory outcomes for isolated acute PCL injuries. Treatment selection should be tailored to patient-specific factors, considering functional demands and injury severity. Full article

Background: Cheiloscopy, a forensic technique based on the uniqueness of labial traces, has traditionally relied on analog methods. While simple, these methods present significant limitations in terms of precision and reproducibility. The introduction of 3D technology, specifically high-resolution optical scanners, represents a pivotal advancement in overcoming these challenges. Objective: This pilot study aimed to explore the feasibility and potential advantages of 3D cheiloscopy in forensic science by analyzing its precision and repeatability compared to traditional analog methods. Methods: Two participants were selected as a pilot sample, and their lip impressions were captured using both analog techniques and a high-resolution intraoral scanner (Medit i700). A total of 40 samples were collected, equally distributed among operators with varying levels of experience. Surface deviation analysis was performed to compare the methods. Results: The 3D models demonstrated greater uniformity and resolution compared to the analog impressions, which were more prone to errors caused by material quality or operator pressure. Surface deviation analysis showed an average similarity of 70%, with a standard deviation of 0.229 mm. The digital methods also significantly reduced operator-dependent variability. Conclusions: This pilot study highlights the potential of 3D cheiloscopy to improve precision and standardization in forensic applications. While the small sample size limits the generalizability of the findings, the results provide a foundation for further research with larger and more diverse datasets. Future studies should explore the capability of 3D cheiloscopy to accurately match individuals and further validate its applicability in forensic and clinical contexts. Full article

Background and Aims: Low back pain is a prevalent condition affecting 60–85% of individuals during their lifetime. Despite various proposed mechanisms, the etiology of low back pain remains unclear. This study aims to evaluate the effectiveness of combining ultrasound-guided infiltrations with early rehabilitation in reducing pain and improving functional limitations in patients with chronic nonspecific low back pain. Methods: A retrospective observational study was conducted, reviewing data from January to April 2024 involving 40 patients with chronic nonspecific low back pain. Each patient received two cycles of ultrasound-guided lidocaine and corticosteroid infiltrations at the level of the posterior lower iliac spine, followed by 10 rehabilitation sessions. Patients were assessed at baseline (T0), after the first treatment cycle (T1), and after the second cycle (T2) using the Oswestry Disability Index, Quebec Back Pain Disability Scale, Roland Disability Questionnaire, and Numeric Rating Scale. Results: Significant improvements were observed across all assessment scales. The ODI scores decreased from 33.5 at baseline to 3.5 after treatment (p < 0.001). Similar reductions were noted in the QBPDS (from 61.5 to 10.3), RDQ (from 18 to 3.4), and NRS (from 7.4 to 1.3). The combination of ultrasound-guided infiltrations and early rehabilitation resulted in a significant reduction in pain and disability, with the most notable improvements occurring after the second treatment cycle. Conclusions: The integration of ultrasound-guided infiltrations with early rehabilitation is highly effective in managing chronic nonspecific low back pain, significantly reducing both pain and functional limitations. Full article

In this work, for the first time, different parts of the Finger Lime (Citrus australasica F. Muell.), such as pulp, peel and seeds, were analyzed by HS-SPME-GC/MS, and NMR techniques in order to describe its volatile and non-volatile chemical profile. The results highlighted the presence of a high number of terpenes with limonene as principal component in all investigated parts (ranging from 40.4% to 62.6%) and molecules belonging to the classes of amino acids, organic acids, carbohydrates, fatty acids, phenols and miscellaneous compounds that followed a different trend between the investigated different parts. In this study, the inhibition of ChEs (AChE and BChE) was evaluated using the spectrophotometric method of Ellman. The results showed that only peel extract weakly inhibited AChE (14%). Based on these data, this extract was further investigated by GC/MS after derivatization. Furthermore, peel extract was chosen to evaluate the in vitro effects on two human glioblastoma cells lines (U87 and LN18). Flow cytometry results showed that citrus extract was more effective in down-regulating the expression of the adhesion molecule CD44. In fact, after 72 h with 400 µg/mL of citrus extract, CD44 expression levels were reduced in both U87 and LN18 glioblastoma cell lines. This was confirmed by immunofluorescence analysis, which also showed a modification of CD44 antigen localization in both U87 and LN18 cell lines. Moreover, wound assay data supported its ability to reduce glioblastoma cell’s motility. The migration ability of U87 cells decreased (85% control vs. 50% at 400 μg/mL), while it was even more pronounced in resistant LN18 cells (93% control vs. 15% at 400 μg/mL). The findings highlighted that citrus peel extract could have an anti-invasive activity for glioma management. Full article

Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. Consequently, treatment-related costs are a major burden to the healthcare system in developed and undeveloped countries. After the failure of conservative treatments or to avoid daily chronic drug intake, invasive treatments should be suggested. In a world where many patients reject surgery and prefer minimally invasive procedures, interventional radiology is pivotal in pain management and could represent a bridge between medical therapy and surgical treatment. We herein report the different image-guided procedures that can be used to manage degenerative spine-related low back pain. Particularly, we will focus on indications, different techniques, and treatment outcomes reported in the literature. This literature review focuses on the different minimally invasive percutaneous treatments currently available, underlining the central role of radiologists having the capability to use high-end imaging technology for diagnosis and subsequent treatment, allowing a global approach, reducing unnecessary surgeries and prolonged pain-reliever drug intake with their consequent related complications, improving patients’ quality of life, and reducing the economic burden. Full article

Background: Postoperative physical therapy emerges as a pivotal element of the rehabilitation process, aimed at enhancing functional recovery, managing pain, and mitigating the risk of further complications. The debate concerning the optimal timing of physical therapy intervention post-surgery remains unresolved; in particular, whether to initiate physical therapy immediately or to wait weeks is of particular interest. The aim of this study is to review the available literature regarding the optimal timing of physical therapy initiation and the outcomes obtained. Methods: This review was carried out in accordance with the Preferential Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. This search was carried out in February 2024. Only peer-reviewed articles were considered for inclusion. Results: Fourteen studies were included. The primary outcomes assessed in the included studies were the following: 12-week and 12-month low back pain, return to work, function and disability, psychological status, patient satisfaction, and complications associated with early physical therapy. A meta-analysis was performed concerning low back pain after lumbar discectomy at 12 weeks and 12 months and complications after early physical therapy after lumbar discectomy and lumbar interbody fusion. A significant difference was found between early and standard physical therapy in terms of low back pain at 12–18 months (p = 0.0062); no significant differences were found in terms of complications, both for discectomy and arthrodesis. Conclusions: This review indicates that employing early rehabilitation strategies for intervertebral disc disease could enhance results in terms of pain and disability without an enhanced risk of complications. Full article

Background: Diffuse large B-cell lymphoma (DLBCL) especially affects the older population. Old (≥60 years) and very old age (≥80 years) DLBCL patients often present high-risk molecular alterations, lower tolerability to conventional immunochemotherapy, and poor clinical outcomes. In this scenario, attenuated therapeutic strategies, such as the R-MiniCHOP and R-MiniCHOP of the elderly regimens, have emerged for this particularly fragile population. However, the responses, clinical outcomes, and toxicities of these regimens currently remain poorly understood, mainly because these individuals are not usually included in controlled clinical trials. Methods: This retrospective, observational, and single-center real-world study included 185 DLBCL, NOS patients older than 70 years treated at the largest oncology center in Latin America from 2009 to 2020. We aimed to assess the outcomes, determine survival predictors, and compare responses and toxicities between three different primary therapeutic strategies, including the conventional R-CHOP regimen and the attenuated R-MiniCHOP and R-MiniCHOP of the elderly protocols. Results: The median age at diagnosis was 75 years (70–97 years), and 58.9% were female. Comorbidities were prevalent, including 19.5% with immobility, 28.1% with malnutrition, and 24.8% with polypharmacy. Advanced clinical stage was observed in 72.4%, 48.6% had bulky disease ≥7 cm, 63.2% had B-symptoms, and 67.0% presented intermediate–high/high-risk IPI. With a median follow-up of 6.3 years, the estimated 5-year OS and PFS were 50.2% and 44.6%, respectively. The R-MiniCHOP of the elderly regimen had a lower ORR (p = 0.040); however, patients in this group had higher rates of unfavorable clinical and laboratory findings, including hypoalbuminemia (p = 0.001), IPI ≥ 3 (p = 0.013), and NCCN-IPI ≥ 3 (p = 0.002). Although associated with higher rates of severe neutropenia (p = 0.003), the R-CHOP regimen promoted increased OS (p = 0.003) and PFS (p = 0.005) in comparison to the attenuated protocols. Additionally, age ≥ 75 years, high levels of LDH, B-symptoms, advanced clinical stage (III/IV), neutrophilia, and low lymphocyte/monocyte ratio were identified as poor prognostic factors in this cohort. Conclusions: In this large and real-life Latin American cohort, we demonstrated that patients with DLBCL, NOS older than 70 years still do not have satisfactory clinical outcomes in 2024, with half of cases not reaching 5 years of life expectancy after diagnosis. Although the conventional R-CHOP offers response and survival advantages over attenuated regimens, its myelotoxicity is not negligible. Therefore, the outcomes reported and the prognostic factors here identified may assist clinicians in the appropriate selection of therapeutic strategies adapted to the risk for old and very old DLBCL patients. Full article