Accuracy and Completeness of ChatGPT-Generated Information on Interceptive Orthodontics: A Multicenter Collaborative Study.

Background: this study aims to investigate the accuracy and completeness of ChatGPT in answering questions and solving clinical scenarios of interceptive orthodontics. Materials and Methods: ten specialized orthodontists from ten Italian postgraduate orthodontics schools developed 21 clinical open-ended questions encompassing all of the subspecialities of interceptive orthodontics and 7 comprehensive clinical cases. Questions and scenarios were inputted into ChatGPT4, and the resulting answers were evaluated by the researchers using predefined accuracy (range 1-6) and completeness (range 1-3) Likert scales. Results: For the open-ended questions, the overall median score was 4.9/6 for the accuracy and 2.4/3 for completeness. In addition, the reviewers rated the accuracy of open-ended answers as entirely correct (score 6 on Likert scale) in 40.5% of cases and completeness as entirely correct (score 3 n Likert scale) in 50.5% of cases. As for the clinical cases, the overall median score was 4.9/6 for accuracy and 2.5/3 for completeness. Overall, the reviewers rated the accuracy of clinical case answers as entirely correct in 46% of cases and the completeness of clinical case answers as entirely correct in 54.3% of cases. Conclusions: The results showed a high level of accuracy and completeness in AI responses and a great ability to solve difficult clinical cases, but the answers were not 100% accurate and complete. ChatGPT is not yet sophisticated enough to replace the intellectual work of human beings.

Anti-Aggregative and Protective Effects of Vicenin-2 on Heat and Oxidative Stress-Induced Damage on Protein Structures.

Vicenin-2, a flavonoid categorized as a flavones subclass, exhibits a distinctive and uncommon C-glycosidic linkage. Emerging evidence challenges the notion that deglycosylation is not a prerequisite for the absorption of C-glycosyl flavonoid in the small intestine. Capitalizing on this experimental insight and considering its biological attributes, we conducted different assays to test the anti-aggregative and antioxidant capabilities of vicenin-2 on human serum albumin under stressful conditions. Within the concentration range of 0.1-25.0 µM, vicenin-2 effectively thwarted the heat-induced HSA fibrillation and aggregation of HSA. Furthermore, in this study, we have observed that vicenin-2 demonstrated protective effects against superoxide anion and hydroxyl radicals, but it did not provide defense against active chlorine. To elucidate the underlying mechanisms, behind this biological activity, various spectroscopy techniques were employed. UV-visible spectroscopy revealed an interaction between HSA and vicenin-2. This interaction involves the cinnamoyl system found in vicenin-2, with a peak of absorbance observed at around 338 nm. Further evidence of the interaction comes from circular dichroism spectrum, which shows that the formation of bimolecular complex causes a reduction in α-helix structures. Fluorescence and displacement investigations indicated modifications near Trp214, identifying Sudlow's site I, similarly to the primary binding site. Molecular modeling revealed that vicenin-2, in nonplanar conformation, generated hydrophobic interactions, Pi-pi stacking, and hydrogen bonds inside Sudlow's site I. These findings expand our understanding of how flavonoids bind to HSA, demonstrating the potential of the complex to counteract fibrillation and oxidative stress.

Ferroptosis: Emerging Role in Diseases and Potential Implication of Bioactive Compounds.

Ferroptosis is a form of cell death that is distinguished from other types of death for its peculiar characteristics of death regulated by iron accumulation, increase in ROS, and lipid peroxidation. In the past few years, experimental evidence has correlated ferroptosis with various pathological processes including neurodegenerative and cardiovascular diseases. Ferroptosis also is involved in several types of cancer because it has been shown to induce tumor cell death. In particular, the pharmacological induction of ferroptosis, contributing to the inhibition of the proliferative process, provides new ideas for the pharmacological treatment of cancer. Emerging evidence suggests that certain mechanisms including the Xc- system, GPx4, and iron chelators play a key role in the regulation of ferroptosis and can be used to block the progression of many diseases. This review summarizes current knowledge on the mechanism of ferroptosis and the latest advances in its multiple regulatory pathways, underlining ferroptosis' involvement in the diseases. Finally, we focused on several types of ferroptosis inducers and inhibitors, evaluating their impact on the cell death principal targets to provide new perspectives in the treatment of the diseases and a potential pharmacological development of new clinical therapies.

The Sleepiness-Depression Link in Obstructive Sleep Apnea: Preliminary Results on the Mediation of Impulsivity.

BACKGROUND: Emotional impulsivity has been found to be relevant in explaining the association between sleep problems and depressive symptoms, suggesting the potential role of impulsivity as a key underlying mechanism of this link. The objective of this study was to take a preliminary step in understanding the mediating role of impulsivity in the relation between excessive daytime sleepiness (EDS) and depression in patients with obstructive sleep apnea syndrome (OSAS) and to compare psychological and demographic characteristics between different levels of daytime sleepiness. METHODS: A total of 138 patients with OSAS underwent polygraphic cardiorespiratory monitoring and completed a series of questionnaires investigating perceived sleepiness, depression, impulsivity, and other psychological characteristics. A mediational model was tested in order to assess whether impulsivity mediated the relation between sleepiness and depressive symptoms while controlling for the effects of age, sex, BMI, and oxygen saturation parameters. RESULTS: the mediation model showed that there was a significant indirect effect of impulsivity in the sleepiness-depression link (αß = 0.084 [0.0243-0.1617]). CONCLUSIONS: The here-presented results showed that the sleepiness-depression link is not direct as previous studies asserted, but instead it may be better explained by impulsivity. Research and practical implications are discussed.

Upper Airway Characteristics and Morphological Changes by Different MADs in OSA Adult Subjects Assessed by CBCT 3D Imaging.

This study aimed to analyse the effectiveness of four different designs of the Mandibular Advancement Device (MAD) and the morphological changes on upper airway characteristics of Obstructive Sleep Apnea (OSA) patients inducted by each of them, detected by Cone Beam Computer Tomography (CBCT) 3D imaging. Twenty-two patients were recruited after an OSA diagnosis with PSG. Four different customised and titratable MADs were used and an initial CBCT scan was obtained for each patient. Six months after the end of the MAD titration phase, all the subjects performed a second PSG with the MAD in situ; the second PSG showed an Apnoea-Hypopnoea Index (AHI) of <5 or a decrease of 50% in AHI when compared with the initial AHI. Moreover, a second CBCT scan with the MAD in situ was performed. DICOM files were imported into the airway analysis software programme and the pharyngeal area around the oropharynx was highlighted. The area and volume of the oropharynx with and without the device was evaluated. A considerable improvement of the airway was observed (+33.76%), and a significant difference in the enlargement ratio between the posterior soft palate (+32.41%) and the posterior tongue (+36.96%) region was also found. The greatest increase in airway volume was achieved in patients treated with the MAD Forward and TAP (+42.77% and +41.63%, respectively). MAD therapy is effective to treat moderate to severe OSA with an increased upper airway volume. The design of the MAD can influence the effectiveness of the treatment.

Catechins and Proanthocyanidins Involvement in Metabolic Syndrome.

Recent studies on natural antioxidant compounds have highlighted their potentiality against various pathological conditions. The present review aims to selectively evaluate the benefits of catechins and their polymeric structure on metabolic syndrome, a common disorder characterized by a cluster of three main risk factors: obesity, hypertension, and hyperglycemia. Patients with metabolic syndrome suffer chronic low inflammation state and oxidative stress both conditions effectively countered by flavanols and their polymers. The mechanism behind the activity of these molecules has been highlighted and correlated with the characteristic features present on their basic flavonoidic skelethon, as well as the efficient doses needed to perform their activity in both in vitro and in vivo studies. The amount of evidence provided in this review offers a starting point for flavanol dietary supplementation as a potential strategy to counteract several metabolic targets associated with metabolic syndrome and suggests a key role of albumin as flavanol-delivery system to the different target of action inside the organism.

Tridimensional Changes in Mandibular Arch after Rapid Maxillary Expansion Therapy: A Clinical Study.

Aim: The upper jaw transverse deficit is certainly one of the most common clinical issues in the orthodontic field. It can be due to skeletal or dental factors, and its etiology may be both genetic and environmental. Rapid maxillary expanders (RMEs) are certainly the most effective appliance for upper transverse deficiency correction. The aim of this study was to evaluate the changes that occurred in the mandibular arch during treatment with RMEs in growing subjects by analyzing tridimensional lower digital casts. Materials and Methods: The study group (SG) consisted of 20 subjects (10 M, 10 F; mean age 9.4 ± 2.8 years old) randomly selected at the Department of Orthodontics at the University of Rome, "Tor Vergata". The inclusion criteria were negative posterior transverse interarch discrepancy ≥ 4 mm, mixed dentition phase with first permanent molars erupted, and prepubertal skeletal maturation stage (CS1-2), evaluated on a lateral radiograph through the Cervical Vertebral Maturation method. The SG was compared to an untreated control group (CG) of 20 subjects (10 M, 10 F, mean age 8.7 ± 2.3 years old) enrolled with the same inclusion criteria. The SG was treated by using RMEs. Dental casts of the lower arch were taken at two different times (T0-T1 = 6 months). All the dental casts were scanned with an OrthoXscan (Dentaurum 6mmbh E Co., Ispringen, Germany) and twenty points on the mandibular arch were digitized using Viewbox software. A Student t-test was used to compare the means of the quantitative variables associated with the effect of the device over time T0 and T1. Results: The results show a statistically significant increase (p < 0.05) in the intercanine and the intermolar diameters between the times T0 and T1 when compared to the CG. Conclusions: Rapid maxillary orthopedic expansion may achieve an increase in mandibular intercanine and intermolar diameter.

Dental anomalies in an Albanian orthodontic sample: a retrospective study.

BACKGROUND: To evaluate the prevalence and the distribution of dental anomalies in an Albanian orthodontic sample. METHODS: For this retrospective study, a sample of panoramic radiographs (PR) of n. 779 (456 F and 323 M, mean age of 15.1 ± 5.5 years) Albanian subjects with no genetic syndromes or craniofacial malformations (e.g., cleft lip/palate), history of extraction, trauma or previous orthodontic treatment drawn from the archives of the University Dental Clinic Our Lady of Good Counsel, was examined. The inclusion criteria were: subjects from 8 to 30 years of age, good quality of PRs in order to allow the assessment of crown and root development. For different dental anomalies, both the prevalence and the association were evaluated by using Chi-square test (p < 0.05). RESULTS: 24.4% of the sample had at least one dental anomaly and 4.6% had more than one. The following dental anomalies were most prevalent: hypodontia (9.8%), dental impaction (7.6%), and ectopic eruption (5.3%). No statistically significant correlation was found between males and females (p > 0.05). CONCLUSIONS: The most common anomalies in this group are found to be those of number and position, and only radiological investigations can reveal either of these anomalies. Early diagnosis of dental anomalies can contribute to prevent their complications and to establish the most suitable therapy to achieve a functional occlusion.

The Neuroprotective Potentiality of Flavonoids on Alzheimer's Disease.

Alzheimer's disease (AD), due to its spread, has become a global health priority, and is characterized by senile dementia and progressive disability. The main cause of AD and other neurodegenerations (Huntington, Parkinson, Amyotrophic Lateral Sclerosis) are aggregated protein accumulation and oxidative damage. Recent research on secondary metabolites of plants such as polyphenols demonstrated that they may slow the progression of AD. The flavonoids' mechanism of action in AD involved the inhibition of acetylcholinesterase, butyrylcholinesterase, Tau protein aggregation, ß-secretase, oxidative stress, inflammation, and apoptosis through modulation of signaling pathways which are implicated in cognitive and neuroprotective functions, such as ERK, PI3-kinase/Akt, NFKB, MAPKs, and endogenous antioxidant enzymatic systems. This review focuses on flavonoids and their role in AD, in terms of therapeutic potentiality for human health, antioxidant potential, and specific AD molecular targets.

Saliva Analysis of pH and Antioxidant Capacity in Adult Obstructive Sleep Apnea Patients.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) may be associated with and activates the stress response system, and variation in the physiological antioxidant capacity of body fluids. Our aim was to evaluate the variation of pH and antioxidant capacity on the saliva of obstructive sleep apnea subjects (OG) compared to a control group (CG). METHOD: Fifty subjects with moderate/severe OSAS were recruited in Tor Vergata Hospital and compared with 20 healthy subjects CG. The buffer and the antioxidant capacity of the samples were quantified measuring the pH and the percentage of total salivary antioxidant capacity (%TAC), which refers to the reduced glutathione salivary concentration (GSH). Moreover, the protein concentration and the gelatinolytic activity of metalloproteinases were quantified. RESULTS: The data showed that the pH value is slightly more alkaline in OSAS subjects; however, it is not directly related to the severity of OSAS. The %TAC was found to be significantly reduced by 86.2% in the OG. Proteins of saliva from the OG were found 1.5 times more concentrated than in the healthy sample. The gelatinolytic activity of metalloproteinases of healthy and OSA did not show statistically significant changes. CONCLUSIONS: The salivary samples from OSAS compared to CG show an alteration of the oxidative state, the pH buffering power, and protein concentrations, inducing conditions that can easily evolve chronic gingivitis. Further investigations are necessary to evaluate the feasibility of using salivary fluid for the early diagnosis of oral or systemic problems in OSAS subjects.

Pharmacology and toxicology of tannins.

Tannins are an interesting class of polyphenols, characterized, in almost all cases, by a different degree of polymerization, which, inevitably, markedly influences their bioavailability, as well as biochemical and pharmacological activities. They have been used for the process of tanning to transform hides into leather, from which their name derives. For several time, they have not been accurately evaluated, but now researchers have started to unravel their potential, highlighting anti-inflammatory, antimicrobial, antioxidant and anticancer activities, as well as their involvement in cardiovascular, neuroprotective and in general metabolic diseases prevention. The mechanisms underlying their activity are often complex, but the main targets of their action (such as key enzymes modulation, activation of metabolic pathways and changes in the metabolic fluxes) are highlighted in this review, without losing sight of their toxicity. This aspect still needs further and better-designed study to be thoroughly understood and allow a more conscious use of tannins for human health.

Implication of COVID-19 on Erythrocytes Functionality: Red Blood Cell Biochemical Implications and Morpho-Functional Aspects.

Several diseases (such as diabetes, cancer, and neurodegenerative disorders) affect the morpho-functional aspects of red blood cells, sometimes altering their normal metabolism. In this review, the hematological changes are evaluated, with particular focus on the morphology and metabolic aspects of erythrocytes. Changes in the functionality of such cells may, in fact, help provide important information about disease severity and progression. The viral infection causes significant damage to the blood cells that are altered in size, rigidity, and distribution width. Lower levels of hemoglobin and anemia have been reported in several studies, and an alteration in the concentration of antioxidant enzymes has been shown to promote a dangerous state of oxidative stress in red blood cells. Patients with severe COVID-19 showed an increase in hematological changes, indicating a progressive worsening as COVID-19 severity progressed. Therefore, monitored hematological alterations in patients with COVID-19 may play an important role in the management of the disease and prevent the risk of a severe course of the disease. Finally, monitored changes in erythrocytes and blood, in general, may be one of the causes of the condition known as Long COVID.

Molecular Basis of Interactions between the Antibiotic Nitrofurantoin and Human Serum Albumin: A Mechanism for the Rapid Drug Blood Transportation.

Nitrofurantoin is an antimicrobial agent obtained through the addition of a nitro group and a side chain containing hydantoin to a furan ring. The interactions of the antibiotic with human serum albumin (HSA) have been investigated by fluorescence, UV-VIS, Fourier transform infrared spectroscopy (FTIR) spectroscopy, and protein-ligand docking studies. The fluorescence studies indicate that the binding site of the additive involves modifications of the environment around Trp214 at the level of subdomain IIA. Fluorescence and UV-VIS spectroscopy, displacement studies, and FTIR experiments show the association mode of nitrofurantoin to HSA, suggesting that the primary binding site of the antibiotic is located in Sudlow's site I. Molecular modeling suggests that nitrofurantoin is involved in the formation of hydrogen bonds with Trp214, Arg218, and Ser454, and is located in the hydrophobic cavity of subdomain IIA. Moreover, the curve-fitting results of the infrared Amide I' band indicate that the binding of nitrofurantoin induces little change in the protein secondary structure. Overall, these data clarify the blood transportation process of nitrofurantoin and its rapid transfer to the kidney for its elimination, hence leading to a better understanding of its biological effects and being able to design other molecules, based on nitrofurantoin, with a higher biological potential.

Health Benefits Related to Tree Nut Consumption and Their Bioactive Compounds.

Long-term studies with regular tree nut consumption have indicated positive outcomes for multiple health benefits. Here, we review the beneficial effects of tree nuts, highlighting the impact on glucose modulation, body weight management, cardiovascular risk, inflammation, oxidative stress, cognitive performance, and gut microbiota. Nuts are important sources of nutrients and phytochemicals, which, together with a healthy lipid profile, could help prevent certain chronic diseases, protect against oxidative stress and inflammation, and improve cognitive performance, thus reducing the impact of aging and neurodegeneration.

Enamel interproximal reduction during treatment with clear aligners: digital planning versus OrthoCAD analysis.

BACKGROUND: The aim of the study was to compare the amount of interproximal enamel reduction (IPR) provided on ClinCheck software with the amount of IPR carried out by the orthodontist during treatment with clear aligners. METHODS: 30 subjects (14 males, 16 females; mean age of 24.53 ± 13.41 years) randomly recruited from the Invisalign account of the Department of Orthodontics at the University of Rome "Tor Vergata" from November 2018 to October 2019, were collected according to the following inclusion criteria: mild to moderate dento-alveolar discrepancy (1.5-6.5 mm); Class I canine and molar relationship; full permanent dentition (excluding third molars); both arches treated only using Comprehensive Package by Invisalign system; treatment plan including IPR. Pre- (T0) and post-treatment (T1) digital models (.stl files), created from an iTero scan, were collected from all selected patients. The OrthoCAD digital software was used to measure tooth mesiodistal width in upper and lower arches before (T0) and at the end of treatment (T1) before any refinement. The widest mesio-distal diameter was measured for each tooth excluding molars by "Diagnostic" OrthoCAD tool. The total amount of IPR performed during treatment was obtained comparing the sum of mesio-distal widths of all measured teeth at T0 and T1. Significant T1-T0 differences were tested with dependent sample t-test (P < 0.05). RESULTS: In the upper arch, IPR was digitally planned on average for 0.62 mm while in the lower arch was on average for 1.92 mm. As for the amount of enamel actually removed after IPR performing, it was on average 0.62 mm in the maxillary arch. In the mandibular arch, the mean of IPR carried out was 1.93 mm. The difference between planned IPR and performed IPR is described: this difference was on average 0.00 mm in the upper arch and 0.01 in the lower arch. CONCLUSIONS: The amount of enamel removed in vivo corresponded with the amount of IPR planned by the Orthodontist using ClinCheck software.

Obstructive Sleep Apnea, Palatal Morphology, and Aortic Dilatation in Marfan Syndrome Growing Subjects: A Retrospective Study.

The main cause of mortality in Marfan syndrome (MS) is aortic disease. Obstructive sleep apnea (OSA) is highly prevalent in MS, and it is also associated with cardiovascular risk and maxillary deformities. The aim of this research was to analyze the possible relations between OSA, palatal morphology, and aortic root diameters in growing subjects. A group of 15 growing subjects with MS and a control group of healthy peers was selected. All of them underwent nocturnal polygraphic monitoring, digital dental casts, and transthoracic echocardiography. The results showed that OSA indexes and aortic diameters were significantly higher in the study group. Transversal palatal dimension was smaller in MS patients. Moreover, OSA severity was not related with maxillary contraction severity in MS. No correlation between OSA severity and increased aortic diameters occurred. A high prevalence of OSA, increased aortic dimensions, and significant contraction of palatal dimensions were observed in MS compared with the control group. None of these single factors may directly be associated with aortic dilation, but together, they might contribute to the development and progression of aortic aneurysm from a young age.

Sleep Bruxism and SDB in Albanian Growing Subjects: A Cross-Sectional Study.

Background: The aim of this study was to evaluate a possible correlation between sleep bruxism and risk factors of developing obstructive sleep apnea syndrome (OSAS) in a sample of growing subjects and to assess parental awareness about sleep bruxism in their children. Methods: The sample was composed of 310 subjects (173 females and 137 males), with a mean age of 8.9 years, attending "Ndre Mjeda" school of Tirana (Albania). All parents of the children participating in the study were asked to fill in a questionnaire manually or via a digital version. The questionnaire was composed of three sections: personal data, sleep quality data, and OSAS risk factors, and it was filled out by both parents. Results: Of our samples, 41.3% presented with bruxism, and 16.5% of the parents ground their teeth. Oral breathing was reported in 11.9% of the subjects, and among these, 40% of the subjects were affected by bruxism (p > 0.05). Of the subjects, 18.7% snore overnight. Comparing it with sleep bruxism, the two phenomena are often related (p = 0.00). Conclusions: Heredity, night-sweating, nycturia, oral breathing, and snoring seem to have a significant correlation with bruxism.

Sleep Disordered Breathing: An Epidemiological Study among Albanian Children and Adolescents.

Sleep Disordered Breathing (SDB) comprises a group of diseases characterized by alterations in the frequency and/or depth of breathing during sleep. The aim of this study was to investigate the frequency of SDB in a group of Albanian children and adolescents and to describe its social, physiological, psychological, sleep-related, and anthropometric risk factors, in relation to the sociodemographic situation. A total of 6087 participants (mean age: 10.42 years, range: 6 to 15 years, 52.3% females and 47.7% males) attending public schools all over Albania took part in the cross-sectional study. On a sample of 6087 questionnaires distributed, 4702 (77.25% of the original sample) were returned and included in the study. High risk status for SDB was assessed using the Paediatric Sleep Questionnaire (PSQ). The prevalence of SDB was 7.9%. No statistically significant difference was found for gender at high risk for SBD. Compared to participants living in urban aeras (7.3%), participants living in rural areas (10.4%) reported significantly higher SDB prevalence rates. No other significant correlations were detected between the high-risk subjects and the age. The prevalence of the subjects at high risk of SBD obese participants (20.8%) was statistically higher than among nonobese ones (6.3%). SDB is highly prevalent in Albanian growing population and further prevalence studies are recommended.

Evaluation of Anthocyanin Profile, Antioxidant, Cytoprotective, and Anti-Angiogenic Properties of Callistemon citrinus Flowers.

Lemon bottlebrush (Callistemon citrinus (Curtis) Skeels) is one of the most common ornamental plants, diffused worldwide, and characterized by the presence of flowers with an intense red/purple coloration. There is increasing interest in the use and application of anthocyanins for their unique structural/chemical features in both food and pharmaceutical applications. RP-HPLC-DAD-ESI-MS/MS analysis of an enriched fraction of acidified methanolic extract of C. citrinus flowers allow the possibility of identifying, for the first time, the presence of four anthocyanins: cyanidin-3,5-O-diglucoside (cyanin), peonidin-3,5-O-diglucoside (peonin), cyanidin-3-O-glucoside, and cyanidin-coumaroylglucoside-pyruvic acid. Moreover, the evaluation of antioxidant and biological potential showed a remarkable activity of this fraction, able to actively scavenge DPPH, AAPH, and ABTS radicals, and to counteract the ß-carotene-bleaching. In addition, it protects human mononuclear cells from oxidative injuries and prevents angiogenesis (acting in the range of few µg/ml); furthermore, it does not show significant iron-chelating ability (up to 200 µg/mL). The easy way of cultivation, robustness, and adaptability to different environments make the flowers of this plant a useful source of anthocyanins, with remarkable health promoting properties.

Condylar long axis and articular eminence in MRI in patients with temporomandibular disorders.

OBJECTIVE: To compare morphologic findings in MRI and skeletal divergence of a group of patients with temporomandibular joint disorders (TMD) subdivided into condylar symmetric and asymmetric. METHODS: Fifty-nine adults (26.7 years old) with TMD were retrospectively recruited. Condylar height symmetry was evaluated by orthopantomography (Habets's method) and used to divide patients into Symmetric and Asymmetric groups; skeletal divergence was assessed on lateral cephalograms. MRI was used to evaluate the condylar long axis' angle, the glenoid fossa morphology, and the degree of disc displacement. RESULTS: Asymmetric subjects showed a hyperdivergent skeletal pattern (p = 0.036), asymmetric condylar long axis (p = 0.018), and deeper (p = 0.025) and asymmetric (p = 0.001) glenoid fossa compared to symmetric subjects. CONCLUSION: Patients with TMD and condylar asymmetry diagnosed with orthopantomography are more likely to show hyperdivergent skull in cephalometry, condylar asymmetry of both height and major axis, and a steeper glenoid fossa in MRI.