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Background: The surgery-first approach (SFA) in orthognathic surgery eliminates the need for pre-surgical orthodontic treatment, significantly reducing overall treatment time. However, reliance on a compromised occlusion introduces risks of condylar displacement and remodeling. This study employs artificial intelligence (AI) and deep learning to analyze condylar behavior, comparing the outcomes of SFA to the traditional surgery-late approach (SLA). Methods: A retrospective analysis was conducted on 77 patients (18 SFA and 59 SLA) treated at Perugia Hospital between 2016 and 2022. Preoperative (T0) and 12-month postoperative (T1) cone-beam computed tomography (CBCT) scans were analyzed using the 3D Slicer software and its Dental Segmentator extension, powered by a convolutional neural network (CNN). This automated approach reduced segmentation time from 7 h to 5 min. Pre- and postoperative 3D models were compared to assess linear and rotational deviations in condylar morphology, stratified via dentoskeletal classification and surgical techniques. Results: Both the SFA and SLA achieved high surgical accuracy (<2 mm linear deviation and <2° rotational deviation). The SFA and SLA exhibited similar rates of condylar surface remodeling, with minor differences in resorption and formation across dentoskeletal classifications. Mean surface changes were 0.41 mm (SFA) and 0.36 mm (SLA, p < 0.05). Conclusions: Deep learning enables rapid, precise CBCT analysis and shows promise for the early detection of condylar changes. The SFA does not increase adverse effects on condylar morphology compared to SLA, supporting its safety and efficacy when integrated with AI technologies.

Background: Temporomandibular disorders (TMDs) represent a prevalent multifactorial condition that impacts a significant portion of the global population. The objective of this study was to employ Fonseca’s questionnaire for an initial assessment of TMDs. Methods: A cross-sectional study was conducted on a sample of 250 undergraduates from the Dental School of the University of Perugia, Italy. The chi-square test, with a significance level set at p < 0.05, was used to evaluate a statistically significant relationship between TMDs and several variables such as gender, age, employed/unemployed, and physically active or not. Results: The data obtained through the questionnaire indicated that a considerable percentage of students (78%) exhibited signs consistent with TMDs. The most frequently reported signs and symptoms included psychological stress (49.6%), dental clenching and grinding (34%), joint clicking (33.6%), frequent headaches (15.2%), and neck pain (23.2%). Notably, when considering moderate to severe symptoms of TMDs, females were more significantly affected than males. Furthermore, factors such as age, employment status, and physical activity did not appear to influence the prevalence of TMDs. Conclusions: The high prevalence of TMDs identified within this young population (university students), as measured by this questionnaire (albeit warranting validation through more rigorous methodologies) underscores the necessity for the implementation of new preventive strategies that specifically address this demographic.

Background Free flap monitoring techniques still rely on gold standard methods such as skin color evaluation, temperature, and puncture tests that are time-consuming, discontinuous, and prone to human error. Near-Infrared Spectroscopy represents a continuous, non-invasive technique that aims to avoid subjective errors by detecting early stages of vascular compromise, providing enough time for successful salvage surgery. Methods This retrospective study includes 56 patients undergoing microvascular reconstruction and 24-h NIRS monitoring. All other patients without detailed MAP charts were excluded. The NIRS system used was the HemoSphere-ForeSight by Edwards Lifesciences; this platform enabled the detection of StO2 values and their integration with real-time intra-arterial catheter-detected MAP values. Data were recorded by an adhesive sensor, chosen according to the height and width of the flap. Results Forty-seven (83%) patients showed a positive correlation between MAP and StO2 data (ρs > 0.450, p  < 0.0001), validating the theory that MAP values positively correlate with flap perfusion, tissue oxygenation, and survival rate. Nine patients did not show a direct correlation between MAP and StO2 data; their values were influenced by vasopressors or psychophysical conditions during their admission to the Intensive Care Unit (ICU) after surgery. Conclusions Comparing MAP and StO2 values, their trend charts play a crucial role in flap monitoring, contributing to the best possible survival rate outcome and, if necessary, leading to micro-anastomosis checks and eventual flap salvage surgery. MAP data analysis should, indeed, be considered in future guidelines for free flap monitoring techniques. Level of Evidence: Level III, diagnostic study.

The actual contribution of migratory birds in spreading West Nile (WNV) and Usutu virus (USUV) across Europe and from Africa to old countries is still controversial. In this study, we reported the results of molecular and serological surveys on migrating birds sampled during peaks of spring and autumn migration at 11 Italian sites located along important flyways, from 2012 to 2014. A total of 1335 specimens made of individual or pooled sera, and organs from 275 dead birds were tested for WNV and USUV RNA by real time PCR (RT-PCR). Furthermore, sera were tested by serum neutralization assay for detecting WNV and USUV neutralizing antibodies. Molecular tests detected WNV lineage 2 RNA in a pool made of three Song Thrush (Turdus philomelos) sera sampled in autumn, and lineage 1 in kidneys of six trans-Saharan birds sampled in spring. Neutralizing antibodies against WNV and USUV were found in 5.80% (n = 72; 17 bird species) and 0.32% (n = 4; 4 bird species) of the tested sera, respectively. Our results do not exclude the role of migratory birds as potential spreaders of WNV and USUV from Africa and Central Europe to Mediterranean areas and highlight the importance of a more extensive active surveillance of zoonotic viruses.

This review aims to provide a comprehensive overview of photopolymers for additive manufacturing (AM) applications, with particular attention to the 3D printing (3DP) processes for thermosetting polymeric materials and the main mechanisms and reactions involved during their photopolymerization process. The introduction highlights the principles and significance of photopolymerization in AM. It is followed by an exploration of free-radical (FRP) and cationic photopolymerization (CP), the two main mechanisms underpinning these processes. The focus then shifts to the AM technologies suitable for photopolymer processing. Photopolymer-based AM technologies, such as vat photopolymerization (VPP) and ink-jet (IJ) photopolymerization, are examined in detail. VPP has been widely studied for its ability to produce 3D-printed components with highly complex geometries and good final resolution by selectively curing liquid resin in a vat through targeted light-activated polymerization reactions. Similarly, IJ, which involves depositing droplets of photocurable resins in a controlled manner and curing them with light, offers precise material deposition, enabling the creation of more detailed and intricate structures. Finally, the review addresses the shift from monomers derived from fossil-based sources to those coming from bio-sources. This transition is driven by the harmful effects of using polymers derived from non-renewable resources and the increasing emphasis on sustainable development. Research and development efforts aimed to use bio-based precursors are discussed in this context. The conclusions and outlook summarize the findings and offer perspectives on future research directions in photopolymerization for AM, emphasizing innovations in bio-based precursors and advancements in AM technologies. Graphical abstract

The present work aimed to prepare novel bio-based composites by adding fillers coming from agro-wastes to an acrylate epoxidized soybean oil (AESO) resin, using liquid crystal display (LCD) 3D printing. Different photocurable formulations were prepared by varying the reactive diluents, iso-bornyl methacrylate (IBOMA) and tetrahydrofurfuryl acrylate (THFA). Then, two fillers derived from different industrial wastes, corn (GTF) and wine (WPL-CF) by-products, were added to the AESO-based formulations to develop polymer composites with improved properties. The printability by LCD of the photocurable formulations was widely studied. Bio-based objects with different geometries were realized, showing printing accuracy, layer adhesion, and accurate details. The thermo-mechanical and mechanical properties of the 3D-printed composites were tested by TGA, DMA, and tensile tests. The results revealed that the agro-wastes’ addition led to a remarkable increase in the elastic modulus, tensile strength, and glass transition temperature in the glassy state for the systems containing IBOMA and for flexible structures in the rubbery region for systems containing THFA. AESO-based polymers demonstrated tunable properties, varying from rigid to flexible, in the presence of different diluents and biofillers. This finding paves the way for the use of this kind of composite in applications, such as biomedical for the realization of prostheses.

Aquaporin-4 (AQP4) is a channel protein that plays a fundamental role in glymphatic system, a newly described pathway for fluid exchange in the central nervous system, as well as a central figure in a fascinating new theory for the pathophysiology of neurodegenerative diseases such as Alzheimer’s disease (AD) and frontotemporal dementia (FTD). In this study, cerebrospinal fluid (CSF) concentration of AQP4, amyloid-β, total tau and P-tau were determined in 103 CSF samples from patients affected by neurodegenerative dementias (AD and FTD) or psychiatric diseases and 21 controls. Significantly higher levels of AQP4 were found in AD and FTD patients compared to subjects not affected by neurodegenerative diseases, and a significant, positive correlation between AQP4 and total tau levels was found. This evidence may pave the way for future studies focused on the role of this channel protein in the clinical assessment of the glymphatic function and degree of neurodegeneration.

Background: Curcumin is a polyphenolic compound present in turmeric (Curcuma longa). Curcumin, turmeric powder, and extracts are widely used in traditional Indian medicine and are active ingredients of dietary supplements and cosmeceutical products. The pharmacological properties of curcumin/turmeric as well as the studies performed in vitro, in animal models, and in volunteers have been the objects of a vast literature. Most of the clinical studies report on the effects of curcumin/turmeric administered orally, while only a few describe its topical applications. Summary: This review focuses on clinical studies in which curcumin/turmeric was applied topically to treat various skin conditions based on its antioxidant, anti-inflammatory, and antimicrobial properties. Key Messages: The clinical studies employing curcumin/turmeric as the only active ingredient allow us to appreciate its therapeutic potential without confounding contributions coming from additional pharmacologically active substances present in the same formulation. Curcumin/turmeric was regarded as an attractive alternative to conventional drugs, such as corticosteroids and antibiotics, thanks to its characteristics of a safe and well-tolerated natural substance.

Introduction The hyperinflammation phase of severe SARS-CoV-2 is characterised by complete blood count alterations. In this context, the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) can be used as prognostic factors. We studied NLR and PLR trends at different timepoints and computed optimal cutoffs to predict four outcomes: use of continuous positive airways pressure (CPAP), intensive care unit (ICU) admission, invasive ventilation and death. Methods We retrospectively included all adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia admitted from 23 January 2020 to 18 May 2021. Analyses included non-parametric tests to study the ability of NLR and PLR to distinguish the patients’ outcomes at each timepoint. Receiver operating characteristic (ROC) curves were built for NLR and PLR at each timepoint (minus discharge) to identify cutoffs to distinguish severe and non-severe disease. Their statistical significance was assessed with the chi-square test. Collection of data under the SMACORE database was approved with protocol number 20200046877. Results We included 2169 patients. NLR and PLR were higher in severe coronavirus disease 2019 (COVID-19). Both ratios were able to distinguish the outcomes at each timepoint. For NLR, the areas under the receiver operating characteristic curve (AUROC) ranged between 0.59 and 0.81, and for PLR between 0.53 and 0.67. From each ROC curve we computed an optimal cutoff value. Conclusion NLR and PLR cutoffs are able to distinguish severity grades and mortality at different timepoints during the course of disease, and, as such, they allow a tailored approach. Future prospects include validating our cutoffs in a prospective cohort and comparing their performance against other COVID-19 scores.