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Background: Chronic lateral epicondylitis (LE), also known as tennis elbow, affects 1–3% of the population, primarily those over 40 years old. Most cases resolve with conservative treatments, but some require more advanced interventions. Extracorporeal shockwave therapy (ESWT) has emerged as a non-surgical treatment option, utilizing either low- or high-energy levels to alleviate pain and improve function. Objective: This study aimed to compare the efficacy of low-energy versus high-energy ESWT in the treatment of chronic LE, focusing on pain relief and functional improvement. Methods: A retrospective observational study was conducted including patients treated for chronic LE between 2021 and 2024. Participants were divided into two groups: low-energy ESWT (0.10 mJ/mm2) and high-energy ESWT (0.20 mJ/mm2). Both groups received 2400 pulses at a frequency of 6 Hz once a week for three weeks. Pain and functional outcomes were measured using a visual analog scale (VAS) and the Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEE) at the baseline, three months (T1), and six months (T2) post-treatment. Results: Forty-six patients participated, with 24 in the low-energy group and 22 in the high-energy group. Baseline demographics and clinical characteristics were similar across groups. At T1 and T2, the low-energy group showed significantly greater reductions in the VAS scores (T1: 4.45 ± 0.8 vs. 3.6 ± 1.7, p = 0.04; T2: 3.2 ± 1.2 vs. 2.1 ± 1.1, p = 0.004) and PRTEE scores (T1: 34.3 ± 6.9 vs. 26.8 ± 11.9, p = 0.03; T2: 25.3 ± 6 vs. 17.6 ± 9, p = 0.005). Significant treatment–time interactions were observed for both the VAS and PRTEE scores, indicating sustained improvements in the low-energy group. Conclusions: Low-energy ESWT was more effective than high-energy ESWT in treating chronic LE, providing greater and longer-lasting pain relief and functional improvement. These findings suggest that low-energy ESWT should be preferred in clinical practice for managing this condition. Future research should focus on larger sample sizes and randomized controlled trials to confirm these results and explore the underlying mechanisms of differential efficacy between energy levels. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate changes in the concentration of N-terminal type I collagen extension pro-peptide (PINP), tartrate-resistant acid phosphatase (TRAcP), and parathyroid hormone-related protein (PTHrP) in saliva during orthodontic treatment in order to evaluate whether changes in bone turnover marker (BTM) concentration can help highlight the effects of orthodontic mechanical loading in the absence of clinical evidence of tooth movement in terms of tooth movement. Saliva samples from 25 apparently healthy young subjects (10 females and 15 males) were collected using Salivette® (Sarstedt) with cotton swabs and the concentrations of PTHrP, TRAcP 5b, and PINP were analyzed at time 0 (T1), 25 days (T2), and at 45 days (T3). Differences in the median value of biomarker levels between baseline T1 and follow-up of the different groups (T2 and T3) were assessed using the non-parametric Mann–Whitney U test. Trough concentrations of P1NP, PTHrP, and TRAcP were 0.80 µg/L, 0.21 ng/mL, and 0.90 U/L above the method LOD. The non-parametric Mann–Whitney U test confirmed a statistically significant difference in T1 versus concentrations of T2 and T3. All subjects evaluated had a statistically significant difference between T1 vs. T3. when compared with the specific critical difference (RCV) for the analyte The results obtained demonstrate that the evaluation of BTM changes in saliva can help the evaluation of orthodontic procedures and the monitoring of biomechanical therapy. [ABSTRACT FROM AUTHOR]

Rehabilitation after rotator cuff repair is crucial for functional recovery and for minimizing the risk of retear. There are two rehabilitation protocols (early and traditional) and the debate about which is the best is open. This umbrella review aimed to compare the effect of these rehabilitation protocols in terms of reduction in pain, functional recovery, and retear risk. We selected systematic reviews and meta-analyses published between 2012 and 2022 dealing with the aim. Nineteen systematic reviews were included. No significant differences were found between early and traditional protocols in terms of pain reduction. Early rehabilitation provided better short-term results regarding Range of Motion improvement, but long-term functional outcomes were similar. Retear risk remains a significant concern for the early protocol. We found major differences between the analyzed protocols. This review suggests that both protocols are useful to recover global shoulder function, but the standard protocol has a greater safety profile for larger tears. On the other hand, the early protocol may be preferable for smaller lesions, allowing a faster recovery and having less impact on medical costs. Further research is needed to identify optimal rehabilitation strategies tailored to the individual patient's needs and characteristics. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to evaluate the correlation between the mandibular arch shape and the vertical skeletal pattern in growing patients. Materials and Methods: A total of 73 Caucasian patients (33 males and 40 females; mean age 9.4) were retrospectively enrolled from a pool of patients treated in chronological order at the Department of Orthodontics, University of Foggia, Italy, from April 2018 to December 2021. Each patient received a laterolateral radiograph and a digital scan of the dental arch. Eight cephalometric parameters (lower gonial angle, intermaxillary angle, divergence angle, Wits index, Jarabak ratio, OP-MP angle, PP-OP angle, and ANB) and five dental measurements (posterior mandibular arch width, anterior mandibular arch width, mandibular occlusal angle, posterior width on distobuccal molar cusps, and molar angle) were analyzed and then compared. A Spearman's rho correlation test between the cephalometric measurements and the dental measurements was performed. Statistical significance was set at p < 0.05. Results: A negative statistically significant correlation was found between the Jarabak ratio and the intermolar angle; a statistically significant correlation was also observed between the Wits index, the posterior mandibular width, and the occlusal mandibular angle; the ANB angle and the occlusal mandibular angle; the intermaxillary angle (PP-PM) and the mandibular occlusal angle, posterior mandibular width on the disto-vestibular cusp, and the intermolar angle; and the OP-MP angle and mandibular occlusal angle and the posterior mandibular width on the disto-vestibular cusp. Conclusions: The mandibular arch form may be related to certain predisposing features in craniofacial morphology, such as jaw divergence, the Jarabak ratio, and the intermaxillary angle. [ABSTRACT FROM AUTHOR]

This case report presents an orthodontic treatment conducted on a 13-year-old girl with bilateral Class II malocclusion and a mandibular impacted canine. The presence of an impacted tooth necessitates careful consideration of the timing of orthodontic treatment, the appropriate surgical procedure to expose the tooth, the specific orthodontic mechanics involved, and the potential problems that may arise, all of which depend on the type and location of the canine impaction in the jaw. The treatment plan included a surgical procedure to expose the impacted tooth and orthodontic traction to guide it into position. Correction of the Class II Division 1 malocclusion utilized a specialized technique called the "reverse pin", reducing vertical side effects. The revised version maintains clarity and key information about the case report and treatment. [ABSTRACT FROM AUTHOR]

Levels of bone turnover markers (BTM) can be measured using saliva. The aim of the present study was to determine the Biological Variability of BTM in young subjects, on serial biological salivary samples. Saliva samples of 20 apparently healthy young subjects (9 females and 11 males) have been analyzed. Samples collected using salivette with cotton swabs were obtained three times every 15 days. PTHrP; TRAcP-5b and P1NP have been assayed. The ANOVA test was used to calculate intra and interindividual variance (CVI and CVG). The individuality index (II) and reference change value (RCV) were evaluated for the clinically significant variation between two results in the same individual. CVI was highest for PTHrP and lowest for P1NP while CVG was highest for TRAcP-5b. RCV was maximum for PTHrP and minimum for P1NP. The critical difference (RCV) is of particular interest in evaluating variations in the concentrations of BMT on the salivary matrix during oral pathologies and/or dental treatments The salivary dosage of BMT during dental treatments could be fundamental to establishing establish the timing of the treatment and, in the case of orthodontic treatments, to evaluate the effectiveness of the applied forces. [ABSTRACT FROM AUTHOR]

Leiomyosarcoma (LMS) is a rare type of mesenchymal tumor. Suspecting LMS before surgery is crucial for proper patient management. Ultrasound is the primary method for assessing myometrial lesions. The overlapping of clinical, laboratory, as well as ultrasound features between fibroids and LMS makes differential diagnosis difficult. We report our single-center experience in ultrasound imaging assessment of LMS patients, highlighting that misleading findings such as shadowing and absent or minimal vascularization may also occur in LMS. To avoid mistakes, a comprehensive evaluation of potentially overlapping ultrasound features is necessary in preoperative ultrasound evaluations of all myometrial tumors. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient's 1axilla-mandibular divergence. 3D maxillary models of 32 patients (7 males and 25 females; mean age 22.3 +/− 3.4 year) treated with clear aligners were analyzed. The angle (α) between a reference palatine plane and a maxillary occlusal plane was measured. Five angular cephalometric measurements (NSL/MP; PP-OP; OP-MP; PP-MP; PFH/AFH%) were performed and related to Δα. The subjects were further divided into three groups according to facial divergence. After aligner treatment, Δα increased in hyperdivergent patients and decreased in hypodivergent patients (p < 0.05). Δα showed a significant positive correlation with NSL/MP (rho = 0.44) and negative correlation with PFH/AFH% (rho = −0.53). Aligners treatment produced a counterlockwise rotation of the maxillary occlusal plane, even if this rotation occurs differently depending on divergence. [ABSTRACT FROM AUTHOR]

The aim of the present cohort study was to evaluate the possible occurrence of central sleep apnea (CSA) in patients with obstructive sleep apnea (OSA) after treatment with a mandibular advancement device (MAD). In this case, 56 patients with OSA treated with MAD were enrolled. Inclusion criteria were age over 20 years, body mass index (BMI) less than 34 kg/m2, diagnosis of OSA confirmed by polysomnography (PSG), and MAD therapy for OSA. Exclusion criteria were smoking, medications for neurological disorders or a history of cervical head injury, and comorbidities (arrhythmias, congenital heart disease, stroke, heart failure or lung disease). Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA) and Mixed Apnea were extracted from the PSGs before (T0) and after three months of treatment (T1). Paired-sample t-tests and the Wilcoxon Signature Rank test were performed to evaluate differences in PSG indices at T1 and T0. OSA, CSA, AHI, ODI showed a noticeable reduction after MAD therapy, but a limited number of patients showed a dramatic increase in TCSA. The presence of TECSA in the course of MAD treatment is a condition that should be taken into consideration when needing to treat an OSA patient. [ABSTRACT FROM AUTHOR]

The Punica granatum L. is an ancient fruit plant native to south-western Asia. It belongs to the Litraceae family and of its genus we have only one other Punica protopunic species. The fruit is rich in polyphenols, whose extract is consumed as a food and is considered safe. In medicine, it is used for its antioxidant properties; it has a rich component of tannic polyphenols among which the most bioactive are: punicalagin (flavonoids) and anthocyanins (delphinidin, cyanidin, pelargonidin), which are found mainly in the skins and in the pericarp; however, all the parts of the Punica granatum are used for therapeutic purposes as anti-inflammatories and analgesics and in diabetes and cardio-vascular disease. Punica granatum extracts also show interesting anticancer activities in influencing tumorgenesis and angiogenesis and cell transformation and proliferation. The purpose of this scoping review is to summarize all the scientific evidence on the possible applications of Punica granatum extracts in the treatment and prevention of oral cavity tumors to investigate the anticancer properties of the active ingredients extracted from Punica granatum. Methods: The scoping review was carried out following the PRISMA-ScR checklist; the search was performed on three databases (Scopus, Science direct and PubMed) and one registry (Cochrane library). Results: The search produced a number of bibliographic sources equal to 11,403; with the removal of duplicates, 670 potentially admissible articles were obtained, from 24 of which only 7 in vitro studies on OSCC cell lines were included. Conclusions: From the preliminary data on the cellular lines of OSCC, it emerges that for oral cancer there are conditions for which the extracts of Punic granatum are effective at least from a prevention perspective. [ABSTRACT FROM AUTHOR]

The study investigated the prevalence of temporomandibular disorders in 100 competitive athletes in contact sports, equally grouped by the practiced game: Soccer (SoG), Rugby (RG), American Football (AFG), Boxing (BoG), Basketball (BaG), compared to a randomly control group of 20 non-athletes (CG). Symptoms and signs were examined according to the standardized Diagnostic Criteria for Temporomandibular Disorders through a questionnaire and clinical evaluation. Arthralgia showed significant differences between RG and CG and between AFG and CG (p < 0.05). Study groups reported masticatory muscle pain during function, neck and shoulder pain more frequently than CG, except for BoG. Closing click was significantly more present in study groups than CG, while crepitation was significantly higher only in RG and AFG. The deviation was wider in SoG, RG and AFG compared to CG (p < 0.05). Tukey's multiple comparisons test showed a statistically significant reduction in right laterotrusion in RG vs. CG (p < 0.05); the comparison showed a decrease in right laterotrusion in RG vs. SoG and BoG (p < 0.05), a decrease in endfeel in RG vs. CG, BaG and AFG (p < 0.05). The data seem to support a relationship between the prevalence of TMD symptoms and signs in competitive athletes in contact sports, especially in RG and AFG compared to CG. [ABSTRACT FROM AUTHOR]

Congenital syngnathia is a very rare condition of unknown etiology with multiple clinical manifestations due to different combinations of bony or soft tissue adhesions between the mandible and maxilla. It shares possible association with other congenital anomalies in the head and neck region, or with other syndromes. The aims of the present work were: (1) to perform a literature review on bony syngnathia in order to obtain a general framework on epidemiology and management protocol; (2) to describe a case of a two-year-old boy with a left unilateral bony fusion treated with a distraction protocol of three months. Original articles were searched through PubMed, Cochrane Central database and Embase with a cut-off date of June 2022. In total, 94 articles were identified through database searching. After 39 exclusions, 55 articles were included in the review process. Eighty-seven cases of bony syngnathia have been reported from 1936 to 2022, and different classifications have been suggested in terms of location, extension, functional outcomes and management protocol. Complications may range from feeding difficulty to aspiration pneumonia and respiratory arrest. Early surgery is generally required to release the ankylosis and to establish good mandible function. [ABSTRACT FROM AUTHOR]

Parathyroid hormone-related peptide (PTHrP) is expressed at a wide range of sites in the body and performs different functions including vasodilation, relaxation of smooth muscle cells, and regulation of bone development. PTHrP also mediates hypercalcemia related to neoplastic diseases. However, reference ranges specific method and age were not evaluated. We establish PTHrP reference ranges in apparently healthy, normocalcemic, normophosphatemic pediatric individuals. In this observational prospective, study we measured PTHrP in serum from 178 samples (55.06% male 44.94% female) from apparently healthy pediatric subjects [median age 10 years (range 1–18)] subunit ELISA method The statistical analysis performed provided for the calculation of the 95% reference interval, right-sided, with a non-parametric percentile method (CLSI C28-A3). Upper reference limits (URL) for PTHrP was 2.89 ng/mL (2.60 to 3.18; 90% CI). No significant differences were found between the median PTHrP concentrations in males vs females and in the age range categories selected. Comprehensive normal values for PTHrP are indispensable to the assessment of calcium phosphorus dysfunction in children. Severe hypercalcemia is a rare, but clinically significant condition, in infancy and childhood. PTHrP values higher than the reference value may help to distinguish the hypercalcemic product of a malignancy, paraneoplastic syndromes mediated by PTHrP, from other causes. [ABSTRACT FROM AUTHOR]

Simple Summary: Head and neck squamous cell carcinoma (HNSCC) is the neoplasm with the highest incidence in the head and neck regions. More than 350,000 new cases of carcinoma are diagnosed worldwide every year, but the prognosis has not improved significantly in the past few decades. In addition to smoking and alcohol habits, which represent the main risk factors for HNSCC, deregulation of non-coding RNAs have been identified as negative prognostic survival factors. The expression of miR-155 appears to be altered in many neoplasms and its different expression in tumor tissues can represent a prognostic biomarker of survival. By carrying out a systematic review and meta-analysis of the data in the current international literature, we aim to provide the most up-to-date data on the different expression miR-155 and to correlate those data with the prognostic indices of survival in HNSCC. Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide; in fact, it is among the top six neoplasms, with an incidence of about 370,000 new cases per year. The 5-year survival rate, despite chemotherapy, radiotherapy, and surgery for stages 3 and 4 of the disease, is low. MicroRNAs (miRNAs) are a large group of small single-stranded non-coding endogenous RNAs, approximately 18–25 nucleotides in length, that play a significant role in the post-transcriptional regulation of genes. Recent studies investigated the tissue expression of miR-155 as a prognostic biomarker of survival in HNSCC. The purpose of this systematic review is, therefore, to investigate and summarize the current findings in the literature concerning the potential prognostic expression of tissue miR-155 in patients with HNSCC. The revision was performed according to PRISMA indications: three databases (PubMed, Scopus, and the Cochrane Register) were consulted through the use of keywords relevant to the revision topic. Totally, eight studies were included and meta-analyzed. The main results report for the aggregate HR values of 1.40 for OS, 1.36 for DFS, and 1.09 for DPS. Finally, a trial sequencing analysis was also conducted to test the robustness of the proposed meta-analysis. [ABSTRACT FROM AUTHOR]

COVID-19 (Coronavirus Disease 2019) is an emerging viral disease caused by the coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which leads to severe respiratory infections in humans. The first reports came in December 2019 from the city of Wuhan in the province of Hubei in China. It was immediately clear that children developed a milder disease than adults. The reasons for the milder course of the disease were attributed to several factors: innate immunity, difference in ACE2 (angiotensin-converting enzyme II) receptor expression, and previous infections with other common coronaviruses (CovH). This literature review aims to summarize aspects of innate immunity by focusing on the role of ACE2 expression and viral infections in children in modulating the antibody response to SARS-CoV-2 infection. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles deemed potentially eligible were considered, including those dealing with COVID-19 in children and providing more up-to-date and significant data in terms of epidemiology, prognosis, course, and symptoms, focusing on the etiopathogenesis of SARS-CoV-2 disease in children. The bibliographic search was conducted using the search engines PubMed and Scopus. The following search terms were entered in PubMed and Scopus: COVID-19 AND ACE2 AND Children; COVID-19 AND Immunity innate AND children. The search identified 857 records, and 18 studies were applicable based on inclusion and exclusion criteria that addressed the issues of COVID-19 concerning the role of ACE2 expression in children. The scientific literature agrees that children develop milder COVID-19 disease than adults. Milder symptomatology could be attributed to innate immunity or previous CovH virus infections, while it is not yet fully understood how the differential expression of ACE2 in children could contribute to milder disease. [ABSTRACT FROM AUTHOR]

Introduction: Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of the tooth, the surgical procedure selected, the extraoral time, the shape of the recipient socket, the vascularity of the recipient bed, and the vitality of the cells of the periodontal ligament. The aim of this scoping review was to provide the most up-to-date information and data on the clinical principles of the third-molar autograft and thus provide clinical considerations for its success. Materials and methods: This review was conducted based on PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). The research was conducted by searching for keywords in three databases--PubMed, Scopus and Google Scholar--by two independent reviewers following the PRISMA protocol, from which 599 records were identified. Conclusions: Third-molar autotransplantation is a valid solution to replace missing teeth. The key to the success of this technique is the surgical procedure, which must be as atraumatic as possible to preserve the periodontal ligament of the tooth to be transplanted. The success rate is also linked to the stage of development of the root, with a worse prognosis in the case of a complete root. [ABSTRACT FROM AUTHOR]

Current medical knowledge and research on patients’ management are still evolving, and several protocols on minimizing risk of infection by Candida spp. among the population have developed. The aim of this work is to review the epidemiological and biomolecular characteristics and the various histopathological carcinogenesis hypothesis mechanisms that can occur during Candida albicans infections. Current evidence from the literature on the role of C. albicans during potentially malignant oral disorders and oral cancer has been sought. Thus, these biomolecular processes can give or contribute to benign lesions, also in precancerous or cancerous situations. Alongside this, the physiological microorganism oral flora (microbiota) can play a crucial role in maintaining oral health during those infections and therefore avoid carcinogenesis. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is associated with a number of cardiovascular comorbidities, including hypertension, heart rate (HR) alterations, cardiac arrhythmias, endothelial dysfunction and atherosclerosis. HR, in particular, is an important sign correlated with cardiac stress and survival. Previous investigations on the effects of mandibular advancement device (MAD) therapy on HR resulted in contradictory findings. The aim of the present retrospective cohort study was to evaluate the effects of MAD therapy with a fully customizable appliance on respiratory and cardiovascular parameters. Fifty adult consecutive cases with mild to severe OSA underwent split-night polysomnography (SN-PSG) at baseline (T0) and after three months of MAD treatment (T1), after appropriate titration. The apnea/hypopnea index (AHI), 4% oxygen desaturation index (ODI) and HR (average, minimum and maximum) values are recorded at T0 and at T1 and statistically compared. The AHI and ODI values improved after three months of MAD treatment. The minimum HR increased after treatment, while the maximum HR decreased after treatment. MAD treatment with a fully customizable appliance was effective in improving breathing and cardiovascular parameters in adult patients with mild to severe OSA. [ABSTRACT FROM AUTHOR]

A national-scale study in Italy showed an incidence of cancer higher in the territories indicated as highly polluted compared to the regional average. One of them, the city of Taranto in Apulia (Italy), which is considered one of the most polluted cities in Europe, has numerous industrial activities that impact population health. We studied the epidemiological effects of a high level of pollution produced by the industrial area of Taranto in increasing the mortality rate for some specific cancer types in the city and towns of the two provinces located downwind. We analysed 10-year mortality rates for 15 major types of tumours reported among the residents of Taranto, of eight surrounding towns, randomly placed within an imaginary cone in the main wind direction from the vertex of the industrial zone of Taranto, and of the two related provinces (Bari and Taranto's metropolitan areas). Our results confirm our hypothesis that the mortality rate for some specific types of cancer is higher than the norm in the municipality of Taranto. We also found strong evidence that, for 12 out of 15 tumour types, mortality decreases with the distance of the other towns from Taranto's industrial site. However, we have reasons to believe that other local causes may be implicated in the excess of mortality in some specific municipalities besides the potential dispersal of pollutants from the industrial area of Taranto. The proximity to Taranto cannot, in fact, explain all the anomalies detected in some populations. It is likely that other site-specific sources of heavy pollution are playing a role in worsening the death toll of these towns and this must be taken into serious consideration by environmental policymakers and local authorities. [ABSTRACT FROM AUTHOR]

Although in strictly protected areas no forest management and logging activities should be evident, a preliminary study detected that, even in the 200 areas with the highest protection of Russia, more than 2 Mha of trees have been lost between 2001 and 2018. Nonetheless, a relevant percentage of the actual drivers of tree loss in Russian strictly protected areas was surrounded by uncertainties due to several factors. Here, in an attempt to "clarify the smokescreen of Russian protected areas", by validating previous remotely sensed data with new high-resolution satellite imagery and aerial images of land-use change, we shed more light on what has happened during the last 20 years. We used the same layer of tree loss from 2001 to 2020 but, instead of intersecting it with the MODIS data that could have been a source of underestimation of burned surfaces, we overlapped it to the layer of tree cover loss by dominant driver. We analysed the main drivers of tree loss in almost 200 strictly protected areas of Russia. We found that although fire is responsible for 75% of the loss in all strictly protected areas, forestry activities still account for 16%, and 9% is due to undefined causes. Therefore, uncontrolled wildfires (including those started before or after logging) and forestry activities are the main causes of 91% of the total tree loss. The combination of wildfires (often started intentionally) and forestry activities (illegally or barely legally put in place) caused a loss of an astonishing 3 million hectares. The fact that ≈10% of Russian tree cover was lost in two decades since 2001 only in strictly protected areas requires high attention by policymakers and important conservation actions to avoid losing other fundamental habitats and species during the next years when climate change and population growth can represent an additional trigger of an already dramatic situation. We call for an urgent response by national and local authorities that should start actively fighting wildfires, arsonists, and loggers even in inhabited remote areas and particularly in those included in strictly protected areas. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the levels of vitamin D (25OHD) and other bone biomarkers in patients with third molar impaction (TMI). Thirty males and 30 females with unilateral or bilateral impacted mandibular third molar, and 15 males and 15 females as a control group (CG) were recruited. Rx-OPT was used to evaluate dental position and Pederson index to measure the difficulty of the intervention. Bone biomarkers were measured through blood venous sample in TMI group and CG. Mann-Whitney test, Pearson's correlation coefficient, linear regression model were used to compare the different parameters in the two groups. 25OHD showed lower values in TMI group than in CG (p < 0.05) with values significantly lower in bilateral impaction (p < 0.05). Pearson's coefficient for 25OHD presented a negative correlation with the Pederson index (ρ = −0.75). Bone alkaline phosphatase (BALP) showed significantly lower dosage in TMI group than CG (p = 0.02), Pearson's coefficient for BALP presented a negative correlation with the Pederson index. Serum calcium, serum phosphorus, ionized calcium levels in TMI and CG groups were similar and Mann-Whitney test did not significantly differ between TMI and CG. TMI could be a sign of vitamin D deficiency and of low BALP levels that should be investigated. [ABSTRACT FROM AUTHOR]

This study is focused on the epidemiological characteristics and biomolecular mechanisms that lead to the development of precancerous and cancerous conditions of oral lesions related to Human Papilloma Virus (HPV) infections. Current evidence from the literature demonstrates the role of HPV in potentially malignant oral disorders. Therefore, the underlying biomolecular processes can give arise, or contribute to, benign lesions as well as to oral carcinogenesis. [ABSTRACT FROM AUTHOR]

Sterilization processes guarantee the sterility of dental instruments but can negatively affect instrument features by altering their physical and mechanical properties. The endodontic instrumentation can undergo a series of alterations, ranging from corrosion to variation in the cutting angle and then changes in the torsional properties and torsional fatigue resistance. This systematic literature review and meta-analysis aims to investigate alterations to the cutting efficiency of endodontic instruments that are induced by procedures for their disinfection and sterilization. Methodologies adopted for this investigation follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The following were used as search terms on PubMed and Scopus: "endodontic sterilization", "endodontic autoclave", "cyclic fatigue", "torsional", "cutting efficiency", "sterilization", "surface characteristics", and "corrosion". At the end of the selection process, 36 articles were identified, and seven of them are included in this systematic review. The results of a meta-analysis conducted for the use of 10 autoclaving cycles shows a standardized mean difference (SMD) of 0.80 with a p-value equal to 0.04 with respect to effect on cutting efficiency. The network meta-analysis, through direct and indirect comparison between the different autoclave cycles (0, 1, 5, 10, and 15 cycles), revealed that treatment involving 15 autoclave cycles produced the most robust results in terms of having the greatest effects in terms of altered cutting efficiency with a probability of 57.7% and a SUCRA (surface under the cumulative ranking) of 80%. The alterations in the effects on cutting efficiency appear to be triggered after five cycles of sterilization by heat (autoclave). In conclusion, the meta-analysis of the data indicates that the autoclave sterilization protocol must not be repeated more than five times to preserve cutting efficiency. Within the limitations of this review, we can therefore establish that sterilization by autoclaving alone results in steel and NiTi instruments becoming less efficient in cutting after five cycles, as measured by a reduction in cutting efficiency. [ABSTRACT FROM AUTHOR]

COVID-19 is a viral pandemic caused by the new coronavirus SARS-CoV-2, an enveloped positive stranded RNA virus. The mechanisms of innate immunity, considered as the first line of antiviral defense, is essential towards viruses. A significant role in host defense of the lung, nasal and oral cavities is played by Human epididymis secretory protein 4 (HE4) HE4 has been demonstrated to be serum inflammatory biomarker and to show a role in natural immunity at the level of oral cavity, nasopharynx and respiratory tract with both antimicrobial/antiviral and anti-inflammatory activity. Several biomarkers like IL-6, presepsin (PSP), procalcitonin (PCT), CRP, D-Dimer have showed a good function as predictor factors for the clinical evolution of COVID-19 patients (mild, severe and critical). The aim of this study was to correlate the blood levels of CRP, IL-6, PSP, PCT, D-Dimer with He4, to identify the predictive values of these biomarkers for the evolution of the disease and to evaluate the possible role of HE4 in the defense mechanisms of innate immunity at the level of oral cavity, nasopharynx and respiratory tract. Of 134 patients admitted at COVID hospital of Policlinico—University of Bari, 86 (58 men age 67.6 ± 12.4 and 28 women age 65.7 ± 15.4) fulfilled the inclusion criteria: in particular, 80 patients (93%) showed prodromal symptoms (smell and/or taste dysfunctions) and other typical clinical manifestations and 19 died (13 men age 73.4 ± 7.7 and 6 women age 74.8 ± 6.7). 48 patients were excluded because 13 finished chemotherapy and 6 radiotherapy recently, 5 presented suspected breast carcinoma, 5 suspected lung carcinoma, 6 suspected ovarian carcinoma or ovary cyst, 1 cystic fibrosis, 3 renal fibrosis and 9 were affected by autoimmune diseases in treatment with monoclonal antibodies. The venous sample was taken for each patient on the admission and during the hospital stay. For each patient, six measurements relating to considered parameters were performed. Significant correlations between He4 and IL-6 levels (r = 0.797), between He4 and PSP (r = 0.621), between He4 and PCT (r = 0.447), between He4 and D-Dimer (r = 0.367), between He4 and RCP (r = 0.327) have been found. ROC curves analysis showed an excellent accuracy for He4 (AUC = 0.92) and IL-6 (AUC = 0.91), a very good accuracy for PSP (AUC = 0.81), a good accuracy for PCT (AUC = 0.701) and D-Dimer (AUC = 0.721) and sufficient accuracy for RCP (AUC = 0.616). These results demonstrated the important correlation between He4, IL6 and PSP, an excellent accuracy of He4 and IL6 and showed a probable role of He4 in the innate immunity in particularly at the level of oral cavity, nasopharynx and respiratory tract. Besides He4 together with IL6 might be involved in the onset of smell and/or taste disorders and it might be used as innovative biomarker to monitor clinical evolution of COVID-19 because He4 could indicate a multi-organ involvement. [ABSTRACT FROM AUTHOR]

This study examined the impact of climate change on plant species diversity of a savanna ecosystem, through an assessment of climatic trends over a period of forty years (1974–2014) using Masvingo Province, Zimbabwe, as a case study. The normalised difference vegetation index (NDVI) was used as a proxy for plant species diversity to cover for the absence of long-term historical plant diversity data. Observed precipitation and temperature data collected over the review period were compared with the trends in NDVI to understand the impact of climate change on plant species diversity over time. The nonaligned block sampling design was used as the sampling framework, from which 198 sampling plots were identified. Data sources included satellite images, field measurements, and direct observations. Temperature and precipitation had significant (p < 0.05) trends over the period under study. However, the trend for seasonal total precipitation was not significant but declining. Significant correlations (p < 0.001) were identified between various climate variables and the Shannon index of diversity. NDVI was also significantly correlated to the Shannon index of diversity. The declining trend of plant species in savanna ecosystems is directly linked to the decreasing precipitation and increasing temperatures. [ABSTRACT FROM AUTHOR]