Eastman Dental Hospital

Bone regeneration focuses on the creation of functional tissue to repair bone defects. Creating a biodegradable scaffold hydrogel that combines a hemostatic agent with bioactive ceramics can afford the biological and mechanical benefits of both components. In the present study, we developed an injectable gelatin-alginate dual-composite hydrogel, loaded with two functional fillers: hydroxyapatite (HA) and the hemostatic agent montmorillonite (MMT). HA (microparticles and nanoparticles) was incorporated at concentrations of 10-30 mg/mL, with and without MMT at 20 mg/mL. The effects of functional fillers and their concentration on the microstructure and resulting physical and mechanical properties were studied, and a qualitative model summarising these effects was developed. All formulations exhibited clinically appropriate gelation times (5-29 s). n-HA significantly prolonged gelation time, reaching 29 ± 3 s at 30 mg/mL, while MMT reduced gelation time at all concentrations. The tensile strength of the unloaded hydrogel reached 20 kPa and increased to 57 kPa with 30 mg/mL of n-HA. The tensile strength even increased further with the addition of MMT (77 kPa). The results indicate that the combination of HA and MMT produced dual micro-composite hydrogels with moderate reinforcement, whereas the combination of n-HA and MMT generated dual nano-micro composites with combined reinforcing effects. The latter exhibited the highest strength and sealing ability while maintaining clinically relevant gelation times and controlled swelling behaviour. In conclusion, the combination of MMT with n-HA or HA enables the creation of functional hydrogels with controlled properties, tailored to specific applications in bone regeneration.

Oral health is an essential component of general health and wellbeing, but there are many potential challenges to the oral health of athletes, including nutrition and hydration, exercise-induced immune suppression, lack of awareness, negative health behaviours and lack of prioritisation. Oral diseases should be preventable, and there are simple interventions that have good evidence of efficacy. Screening that allows early recognition of disease is well-established in healthcare as the first step in prevention of disease and promotion of positive health behaviours. This paper aims to provide an overview of the oral health problems that can be screened for in sport.

This study aims to compare the evaluation of obstructive sleep apnea (OSA) by ten super-experts using responses from a 10-question survey answered by 3 different artificial intelligence chatbots, Chat GPT-3.5, Chat GPT-4.0, Gemini, and a panel of 100 otolaryngologists specialized in sleep medicine. A 10-question survey regarding OSA management was answered by Chat GPT-3.5, Chat GPT-4.0, Gemini, and a panel of 100 otolaryngologists. The responses were assessed by ten super-experts in sleep medicine for their agreement with expert consensus, using a Likert scale. Statistical analyses were performed to evaluate the level of agreement and significance. Expert consensus had the highest mean score (4.5 ± 0.9), significantly outperforming all AI models. ChatGPT-3.5 was the best among AI systems, with a score of 4.1 ± 1.2 (p=0.003), followed by ChatGPT-4 with 3.9 ± 1.4 (p<0.001) and Gemini with 3.6 ± 1.5 (p<0.001). Perfect agreement with expert consensus was achieved in specific scenarios, particularly regarding indications for bariatric surgery and lateral pharyngoplasty. However, there were significant differences in complex clinical scenarios that required integration of multiple factors, particularly in therapeutic management questions where the performance of AI models was significantly below that of expert consensus (p<0.01). Although AI models are promising in the management of OSA, especially for well-defined clinical scenarios, they at present serve best as complementary tools rather than replacements for expert clinical judgment. Most surprisingly, ChatGPT-3.5 outperformed its newer versions in many aspects, indicating that model updates with general capabilities may not always lead to better performance in specialized medical domains. These findings emphasize the potential of AI as a supportive resource while emphasizing the continuing need for human expertise in complex clinical decision-making.

To the EditorIn 2022, a group of clinician scientists working in the field of research in chronic rhinosinusitis with nasal polyps (CRSwNP), came together under the auspices of the European Academy of Allergy and Clinical Immunology (EAACI) to achieve

Nanoparticles (NPs) can exhibit unique properties distinct from their bulk counterparts. This has led to their utilization in many fields; most notably, they have been implemented in numerous biomedical applications. Given the significance of these applications, introducing students to nanoscience early can be highly beneficial. This paper outlines an outreach activity designed as an introduction to nanoscience for middle and early high school students, focusing on two of the most widely studied NPs in biomedicine: magnetic iron oxide nanoparticles (IONPs) and gold nanoparticles (Au NPs). The 2 h teaching session consists of four parts: two synthesis demonstrations and two interactive activities, using only nonspecialized apparatus and cost-effective materials. In the first demonstration, Au NPs are synthesized through chemical reduction of an Au salt, employing lemon juice as a reducing agent. The subsequent activity employs these NPs in an exhibition of colorimetric sensing. In the second demonstration, IONPs are synthesized through coprecipitation. Finally, the students employ ferrofluids to visualize the magnetic interactions that take place when IONPs come into proximity of a magnetic field. A series of learning goals are outlined, with assessment through in-session questions and a feedback session. The activity has been successfully implemented at an outreach event, where each section was well-received. Student responses to the questions and feedback showed strong engagement and indicated a clear understanding of basic nanoscience concepts, including NP properties, synthesis, and biomedical relevance, particularly for Au NPs and IONPs.

Background/objectives: Aging is associated with a decline in physiological and cognitive functions. Periodontitis, a disease affecting the periodontal tissues, increases in prevalence with age. Bacteria and inflammatory mediators resulting from periodontitis can trigger neuroinflammation and potentially accelerate the progression of neurodegenerative diseases. This study aimed to evaluate the association between periodontal status, salivary flow rate, salivary cortisol levels, and cytokine levels with cognitive status in elderly Indonesian subjects. Methods: This cross-sectional study involved 70 participants aged ≥ 60 years from several social institutions in Jakarta and the Dental Hospital, Faculty of Dentistry, Universitas Indonesia. All participants provided written informed consent before the examination. Periodontal parameters, including plaque score, calculus index, bleeding on probing, number of remaining teeth, and functional tooth units, were assessed. Unstimulated salivary flow was collected over five minutes, and salivary cortisol levels were measured. Gingival crevicular fluid samples from the deepest periodontal pockets were collected to measure cytokine levels (TNF-α and IL-1β). Both cortisol and cytokine levels were analyzed using ELISA. Cognitive function was evaluated using the Hopkins Verbal Learning Test. Results: Plaque score, calculus index, and bleeding on probing were moderately associated with cognitive scores (p < 0.05). In contrast, the number of remaining teeth, functional tooth units, periodontitis severity, salivary flow rate, salivary cortisol, and cytokine levels were not significantly associated with cognitive scores (p > 0.05). Conclusions: These findings suggest that elderly individuals with cognitive impairment tend to have poorer periodontal health than those with normal cognitive function.

There is an urgent need for effective prognostic biomarkers to better stratify patients with advanced hepatocellular carcinoma (HCC) undergoing systemic therapy. Shallow whole-genome sequencing (sWGS) of cell-free DNA (cfDNA) is a cost-effective approach for assessing circulating tumour DNA (ctDNA), genomic alterations, and fragmentomic patterns. This study aimed to evaluate sWGS-derived biomarkers as predictors of outcomes in advanced HCC patients receiving systemic treatment. Pretreatment plasma samples from 134 patients treated with either tyrosine kinase inhibitors (TKIs; n = 83) or immune checkpoint inhibitors (ICIs; n = 51) were analysed using sWGS. Tumour fraction (TF) and copy number alterations (CNAs) were derived using ichorCNA, while DNA fragmentation was assessed using the DELFI approach. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated. High TF was significantly associated with shorter median PFS (3.0 vs. 10.6 months; p<0.001) and OS (7.8 vs. 21.6 months; p=0.02). High fragmentation similarly correlated with reduced PFS (4.7 vs. 10.7 months; p<0.001) and OS (13.1 vs. 22.3 months; p<0.001). In multivariate analysis within the ICI subgroup, high fragmentation and BCLC stage independently predicted shorter PFS and OS. High AFP levels, advanced BCLC stage, and larger tumours correlated with elevated TF. Frequent CNA gains were observed in chromosomal arms 1q and 8q. High TF and high fragmentation levels are associated with worse clinical outcomes in advanced HCC patients treated with systemic therapy, making them promising prognostic biomarkers to consider for guiding treatment decisions.