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The field of misinformation studies has experienced a boom of scholarship in recent years. Buoyed by the emergence of information operations surrounding the 2016 election and the rise of so-called "fake news," researchers hailing from fields ranging from philosophy to computer science have taken up the challenge of detecting, analyzing, and theorizing false and misleading information online. In an attempt to understand the spread of misinformation online, researchers have adapted concepts from different disciplines. Concepts from epidemiology, for example, have opened doors to thinking about spread, contagion, and resistance. The life sciences offer concepts and theories to further extend what we know about how misinformation adapts; by viewing information as an organism within a complex ecosystem, we can better understand why some narratives succeed and others fail. Collaborations between misinformation researchers and life scientists to develop responsible adaptations of fitness models can bolster misinformation research.

Background: Augmented reality (AR) enhances sensory perception by adding extra information, improving anatomical localization and simplifying treatment views. In dentistry, digital planning on bidimensional screens lacks real-time feedback, leading to potential errors. However, it is not clear if AR can improve the clinical treatment precision. The aim of this research is to evaluate if the use of AR-based instruments could improve dental procedure precision. Methods: This review covered studies from January 2018 to June 2023, focusing on AR in dentistry. The PICO question was "Does AR increase the precision of dental interventions compared to non-AR techniques?". The systematic review was carried out on electronic databases, including Ovid MEDLINE, PubMed, and the Web of Science, with the following inclusion criteria: studies comparing the variation in the precision of interventions carried out with AR instruments and non-AR techniques. Results: Thirteen studies were included. Conclusions: The results of this systematic review demonstrate that AR enhances the precision of various dental procedures. The authors advise clinicians to use AR-based tools in order to improve the precision of their therapies.

Background: The use of 3D facial scans is becoming essential for dental practice. However, traditional scanners require labor-intensive procedures and are expensive, making them less accessible in routine clinical practice. In this context, high-performance smartphones and dedicated apps offer a more accessible alternative. This study aims to validate the accuracy of the EM3D app, which utilizes the iPhone's TrueDepth camera technology, by comparing it to Cone Beam Computed Tomography (CBCT). Methods: Thirty patients requiring CBCT scans were recruited for the study. Facial scans obtained with the TrueDepth camera of the iPhone 13 Pro in conjunction with EM3D app were automatically superimposed onto the 3D models derived from the CBCTs through the implementation of a deep learning methodology. The approach enabled the automatic identification of fifteen landmarks to perform linear and angular measurements for quantitative assessment. A color map was created to highlight discrepancies between the overlaid meshes, and the overall surface differences between the models were automatically quantified. Results: The overall surface difference between the CBCT and EM3D scans was highly accurate, with a mean discrepancy of 0.387 ± 0.361 mm. The mean discrepancies of most measurements were lower than 1 mm (five out of six; 83.33%) between the groups, with no significant differences ( p > 0.05). Conclusions: The combination of the iPhone's TrueDepth camera and the EM3D app exhibited high accuracy for 3D facial modeling. This makes it a cost-effective alternative to professional scanning systems.

Aging is frequently associated with a progressive increase in chronic low-grade inflammation, known as "inflammaging". Numerous studies have shown that inflammaging is closely linked to the development of several age-related diseases. However, the underlying mechanism and its causal role are still not fully understood despite this association. In the complex context of aging, mesenchymal stem cells (MSCs) undergo changes in behavior and functionality. This narrative topical review examines the recent advances in aging research, specifically focusing on the role of inflammaging and related mechanisms that contribute to age-related chronic diseases. The authors critically investigated whether and how inflammaging, epigenetic damage, mitochondrial changes, and macrophage alterations may influence stem cell behavior, highlighting the interplay between these factors and their potential therapeutic implications. By elucidating the mechanisms underlying these processes, we can gain valuable insights into the maintenance and regeneration of stem cell populations, providing the basis for novel therapeutic strategies targeting age-related decline and disease progression.

There is limited research about how groups solve collective action problems in uncertain environments, especially if groups are confronted with unknown unknowns. We aim to develop a more comprehensive view of the characteristics that allow both groups and individuals to navigate such issues more effectively. In this article, we present the results of a new online experiment where individuals make decisions of whether to contribute to the group or pursue self-interest in an environment with high uncertainty, including unknown unknowns. The behavioral game, Port of Mars is framed as a first-generation habitat on Mars where participants have to make decisions on how much to invest in the shared infrastructure to maintain system health and how much to invest in personal goals. Participants can chat during the game, and take surveys before and after the game in order to measure personality attributes and observations from the game. Initial results suggest that a higher average social value orientation and more communication are the key factors that explain why some groups are more successful than others in surviving Port of Mars. Neither other attributes of players nor the group's communication content explain the observed differences between groups., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Janssen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

An efficient enantioselective synthesis of chiral α-disubstituted β-homoprolines was developed, starting with the stereodivergent allylation of chiral N - tert -butanesulfinyl imines derived from 4-bromobutanal with indium or zinc and using well-established and reliable synthetic transformations. This methodology allows the easy introduction of different substituents at the α-position of the pyrrolidine scaffold and is characterized by the possibility of switching the absolute configuration of the newly formed stereocenter either by changing the configuration of the tert -butanesufinamide chiral auxiliary or by using a different stereodivergent allylation protocol with the same auxiliary.

Antibiotics have undoubtedly revolutionized medicine and the health and survival of patients with life-threatening infections, being nonetheless free from potential adverse effects, and the risk of intestinal dysbiosis, antimicrobial resistance, and the resulting consequences for the patient's health and the public purse. The present study narratively reviewed the epidemiological data on worldwide antibiotic consumption and administration in dental practice, patients' adherence to prescriptions, the antimicrobial resistance phenomenon in dentistry, and the evidence supporting and recommending appropriate antibiotic use in dental care. Eligible systematic reviews and original studies in humans published in the English language from January 2000 to 26 January 2023 were considered. A total of 78 studies, 47 on the epidemiology of antibiotic use and prescription in dentistry, 6 on antibiotic therapy in dentistry, 12 on antibiotic prophylaxis in dentistry, 0 on adherence of dental patients to antibiotic prescription, and 13 on antimicrobial resistance in dentistry, were presently considered. Retrieved evidence revealed that antibiotics are frequently overused and misused in dental practice, dental patients frequently do not adhere to prescriptions, and antimicrobial resistance in dentistry is a still rising phenomenon also secondary to improper oral antiseptics use. The present findings highlighted the need to establish more evidence-based and accurate antibiotic prescriptions to sensitize dentists and dental patients to minimize and rationalize the use of antibiotics only when it is indicated and necessary, improve patients' adherence, and enhance knowledge and awareness of the antimicrobial resistance in dentistry.

Aim: To enhance cleaning during retro-preparation in endodontic microsurgery., Materials and Methods: Forty mandibular premolars were instrumented, filled with a single cone technique, and then retro-preparation was performed and assigned to experiment A. In group A1, the cavity created by the retro preparation was cleansed with 2 mL of normal sterile saline. In group A2, the retro cavity was cleaned with 2 mL of sterile saline after the retro preparation. All the irrigation solutions mentioned above were delivered using an endodontic needle with a lateral vent and a gauge of 30. Subsequently, in group A2, 17% EDTA gel and 5.25% gel were inserted into the cavity and activated using ultrasonic tips. After the irrigation protocols, the specimens were decalcified for histological evaluation., Results: In the experiment, the amount of hard tissue debris was significantly greater in group A1 compared to group A2 ( p < 0.05)., Conclusions: The samples in group A2, where the new protocol was performed, showed statistically significant results.

The purpose of this paper is to analyse the perception of environmental attributes and food safety in Italy and Spain and how these different perceptions influence the importance of various attributes and certifications related to food. These two countries have a common root and some undeniable similarities, but there are two completely distinct individualities. Three main research questions have, thus, been identified: attention to food safety regarding Italian and Spanish consumers; the role of ecological certifications in the perception of health in the two countries; the role of the brand and the choice of organic products in the perception of food safety. To answer the research questions, a questionnaire was administered, face to face, to a sample of both Spanish consumers and Italian consumers. The analysis of the data collected through the questionnaires was administered using two logistic regressions to identify which variables influence issues concerning the health and safety of food products. A Spanish consumer interested in ecological certifications is also a consumer who is attentive to the safety and health of food consumption. Looking at Italian consumers, it is highly probable that a consumer who assesses ecological certifications positively is also a consumer concerned about food safety, but this probability increases the likelihood this consumer's choices are guided by brands and frequent consumption of organic products. This research has allowed us to highlight sharp differences in the approach to consumption in these two countries, which, despite similar cultures and the same sensitivity to environmental and food safety issues, exhibit marked differences in the selection of food products.

The Italian export of agri-food products has been increasingly threatened by the unfair use of misleading Italian symbols (such as the national flag or the green-white-red colors) by non-Italian producers. This research paper investigated what English and Spanish consumers know about "Made in Italy" food, and their attitude towards Italian appearance food products. Primary data were collected in Spain and England, and a probit model was used to identify the determinants of consumers' vulnerability to misleading Italian symbols. We found that merely having Italian symbols on the package might lead almost half of the consumers in the sample to consider food as Made in Italy, regardless of the actual origin. This result confirms the severity of the problem. The econometric model provides suggestions for public actions to mitigate the issue.

The main objective of this research paper is to understand consumer knowledge and perception of insects for food. Primary data was collected using a questionnaire conducted in Rome, and the data was analysed using a probit model in order to understand consumers' attitudes to include insects as a sustainable solution to meat consumption in their diet. We connected the participants with a willingness to consume insects with those that are critical, informed, and concerned about the environment. This study shows that insects' consumption and social acceptance is very low even for people who have a greater sensitivity to sustainable diets. Suggestions are included to improve the communication of this food type to raise awareness in the consumers' minds. This research continues the debate on sustainability and global food security.

This study aimed to analyze and predict interest in mental health-related queries created in Google Trends (GT) during the COVID-19 pandemic. The Google Trends tool collected data on the Google search engine interest and provided real-time surveillance. Five key phrases: "depression", "insomnia", "loneliness", "psychologist", and "psychiatrist", were studied for the period from 25 September 2016 to 19 September 2021. The predictions for the upcoming trend were carried out for the period from September 2021 to September 2023 and were estimated by a hybrid five-component model. The results show a decrease of interest in the search queries "depression" and "loneliness" by 15.3% and 7.2%, respectively. Compared to the period under review, an increase of 5.2% in "insomnia" expression and 8.4% in the "psychiatrist" phrase were predicted. The expression "psychologist" is expected to show an almost unchanged interest. The upcoming changes in the expressions connected with mental health might be explained by vaccination and the gradual removal of social distancing rules. Finally, the analysis of GT can provide a timely insight into the mental health interest of a population and give a forecast for a short period trend.

In this paper, we investigate the short-term and long-term effects of the COVID-19 emergency on consumers' decision of changing dietary habit. We used a certified dataset reporting information about 456 Italian consumers during the lockdown in the first wave of the pandemic emergency (April 2020). The survey collected data about changes in food purchases, respondents' mood during the lockdown, conspiracist beliefs, exposure to the virus, and planned food purchasing behavior after the lockdown. We used the data to construct measures of the psychological pressure exerted by the COVID-19 emergency on consumers. We use an endogenous selection regression model to assess the impact of psychological pressure on the decision of changing food purchased. The analysis identified two opposite approaches to change in food purchasing decisions: impulsive approach and reflective approach. The former is associated with a higher probability of changing food purchase but a lower probability to keep the changes in the long run than the latter. Our results suggest that COVID-19 psychological pressure was associated with impulsive approach to buy food. Consequently, food-purchasing behavior is expected to revert to pre-COVID 19 habits when the emergency is over., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Published by Elsevier Ltd.)

Background: The recent SARS-CoV-2 outbreak represents a global health emergency, and dialysis patients are a high-risk population. Patients with end-stage renal disease (ESRD) in hemodialysis facilities require specific protocols to be planned and promptly executed for the management of suspected/confirmed cases of COVID-19 with respect to prevention, protection, screening, and isolation., Materials and Methods: In order to prevent the spread of SARS-CoV-2 in our Hemodialysis Unit, we adopted individual protection measures accompanied by measures to minimize contacts among hemodialysis patients with suspicious symptoms as well as other patients and medical staff. We provided our patients detailed instructions to be followed in the event of their having symptoms compatible with SARS-CoV-2 infection or having contacts with SARS-CoV-2-positive subjects. Ultimately, four possible scenarios and care paths were developed and implemented in collaboration with the Infectious Diseases and Emergency Units at the Padua University Hospital., Results: The application of this strategy has resulted in the nearly 200 patients treated in our hemodialysis facilities while there were only 2 cases of COVID-19 (1% incidence rate) with no deaths., Conclusion: We attribute the low COVID-19 incidence noted so far for patients in our hemodialysis facilities to the early detection and prompt isolation of suspected patients per our specific plan along with the prompt application of preventive measures.

L-Carnitine is an amino acid derivative that plays a key role in the metabolism of fatty acids, including the shuttling of long-chain fatty acyl CoA to fuel mitochondrial β-oxidation. In addition, L-carnitine reduces oxidative damage and plays an essential role in the maintenance of cellular energy homeostasis. L-carnitine also plays an essential role in the control of cerebral functions, and the aberrant regulation of genes involved in carnitine biosynthesis and mitochondrial carnitine transport in Drosophila models has been linked to neurodegeneration. Drosophila models of neurodegenerative diseases provide a powerful platform to both unravel the molecular pathways that contribute to neurodegeneration and identify potential therapeutic targets. Drosophila can biosynthesize L-carnitine, and its carnitine transport system is similar to the human transport system; moreover, evidence from a defective Drosophila mutant for one of the carnitine shuttle genes supports the hypothesis of the occurrence of β-oxidation in glial cells. Hence, Drosophila models could advance the understanding of the links between L-carnitine and the development of neurodegenerative disorders. This review summarizes the current knowledge on L-carnitine in Drosophila and discusses the role of the L-carnitine pathway in fly models of neurodegeneration.

Methods: A systematic literature search was conducted in four electronic databases (Ovid via PubMed, Web of Science, Scopus, and CENTRAL) including all available randomised controlled trials published in the last 15 years comparing the use of dental amalgam with composite resins in humans with a follow-up period of at least one year. The primary outcome was the Hg concentration in biological fluids (urine, hair, blood, and saliva) with the aim of assessing their reliability as biomarkers of Hg exposure. The risk of bias was assessed through the Cochrane Collaboration tool and the overall quality of evidence through the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. The results of the meta-analysis were expressed using a random-effects model, and their power was assessed through the trial sequential analysis (TSA)., Results: From the initial 2555 results, only 6 publications were included in the review: five were considered as having high risk of bias, whereas one as having moderate risk. Only two articles were eligible for quantitative analysis. The meta-analysis gathered data from 859 patients but was nevertheless not significant ( p  = 0.12). The TSA confirmed this evidence revealing that it was due to a lack of statistical power since the required information size (RIS) threshold is not reached., Conclusions: The existing evidence revealed that there are not enough data to support the hypothesis that restorations with dental amalgam can cause nephrotoxicity when compared with composite resins restorations., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Romeo Patini et al.)

The lack of naturally occurring resistance to citrus psorosis virus (CPsV) necessitates a transgenic approach for the development of CPsV-resistant citrus. To evaluate the feasibility of conferring resistance to a non-transgenic scion, we have assembled citrus plants by grafting combining a non-transgenic Sweet Orange as scion, CPsV-resistant transgenic Sweet Orange lines expressing intron-hairpin (ihp) RNA derived from the viral coat protein (ihpCP) as interstock, and a non-transgenic citrus as rootstock. We demonstrated that ihpCP-transcripts translocate through the graft from interstock to scion, triggering the silencing of coat protein mRNA target. Two independent CPsV challenge assays showed that expression of ihpCP in the interstock provides resistance against CPsV in the interstock, and different levels of protection in the non-tg scion, depending of the virus delivery site. These results indicated that grafting is a promising biotechnological alternative to protect woody plants against virus infections in vegetative propagated plants.

Background: Migraine is the most common cause of primary headache in children leading to a decrease in the quality of life. During the last decade, pain catastrophizing construct became a major focus of interest in the study and treatment of pain. Aim of the study: To evaluate pain catastrophizing in episodic and chronic migraine children and adolescents selected in a tertiary headache Center.To test whether the children's pain catastrophizing might be associated (a) with the frequency of attacks and disability (b) with psychopathological aspects (c) with allodynia and total tenderness score as symptom of central sensitization.To test the best discriminating clinical variables and scores between episodic and chronic migraine, including pain catastrophizing. Methods: We conducted a cross sectional observational study on consecutive pediatric patients affected by migraine. We selected 190 headache patients who met the diagnostic criteria for Migraine without aura, Migraine with aura and Chronic migraine. We submitted all children to the Child version of the Pain Catastrophizing Scale (PCS-C), and to the disability scale for migraine (PedMIDAS), general quality of life estimated by children (PedsQL) and parents (PedsQL-P), anxiety and depression (SAFA-A; SAFA-D) scales. We also evaluated headache frequency and the presence and severity of allodynia and pericranial tenderness. Results: No difference was detected in Total Pain Catastrophizing score (PCS-C) between chronic and episodic migraine groups (ANOVA F = 0.59, p = 0.70); the PedMIDAS, the PedsQL-P for physical functioning and the Total Tenderness Score were discriminant variables between episodic and chronic migraine. The PCS-C was not correlated with migraine related disability as expressed by Ped MIDAS, but it was significantly correlated with general low quality of life, allodynia, pericranial tenderness, anxiety, and depression. Conclusion: Pain catastrophizing seems a mental characteristic of a clinical phenotype with psychopathological traits and enhanced expression of central sensitization symptoms. This clinical profile causes general decline in quality of life in the child judgment, with a probable parents' underestimation. In childhood age, it would not be a feature of chronic migraine, but the possibility that it could predict this evolution is consistent and worthy of further prospective evaluation.

Introduction: Numb chin syndrome (NCS) or mental neuropathy (MN) is a disorder characterized by sensory neuropathy on the distribution of the inferior alveolar nerve or mental nerve. The most frequent causes are of odontogenic origin (infections, wrong therapies). Other etiologies are related to primary tumor, metastasis, osteoradionecrosis and medication-related osteonecrosis of the jaw (MRONJ). The aim of this study is to highlight the clinical importance of NCS as one of the first symptoms of cancer or as consequence of drug therapy., Materials and Methods: The present study was conducted from 2010 to 2016 by recruiting patients who present NCS as one of the symptoms, having excluded those in which it depends on a clear odontogenic cause, on systemic degenerative diseases or metabolic disorders. Data collection included suspected diagnosis at the time of presentation of the symptom, final diagnosis, mandibular localization, treatment performed and diagnostic delay between the first medical examination and the definitive diagnosis., Results: This study included 29 patients in which NCS had not a clear odontogenic cause. NCS was the first symptom of malignancy in 11 cases and the clinical sign of metastasis in 4 cases. In a single patient, it was the first symptom of an immune-mediated disease. In the remaining 13 patients, NCS represented the symptom of MRONJ., Conclusion: NCS can be the first symptom of malignancy, especially in patients with a previous history of cancer, but also a prodromal sign of MRONJ. It should be recognized in order to require deeper examinations for early diagnosis of the disease., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Aim: The aim of this study was to evaluate the efficacy of the IG-file, a new instrument designed for apical diameter gauging., Materials and Methods: After shaping with F1 Universal Protaper, 60 roots were randomly divided into two groups and assigned to two operators, One Expert in Endodontics (EO) and One Unexpert (UO).In each sample, after canal curvatures have been detected, the apical diameters were measured with the IG-file and the K-NiTi. The results were compared with the reference value obtained by retrograde apical gauging. The data were statistically analyzed., Results: Among 60 samples, 10% of errors were recorded when the IG-files were used; in the K-NiTi group the incorrect measurements were 70%.In both groups (expert and unexpert) the IG-file measurements were more accurate than the K-NiTi (90 vs 33 and 90 vs 26,7). The differences were statistically significant.In curved canals, the difference between measurement rates performed with both instruments was statistically significant (85,7% IG-file vs 28,6% K-NiTi) as well as for the samples without curvatures (92,3% IG file vs 30,8% NiTi file).In root canals without curvatures overestimation errors in K-NiTi file group are more frequent than underestimation errors. This difference was statistically significant., Conclusion: A proper gauging of the apical diameter has a key role in endodontic therapy; an incorrect measurement can lead to clinical failures. This " in vitro " study highlights that IG-file improves measurement accuracy independently from clinician experience. Furthermore, in curved canals, the IG-file is more accurate than K-NiTi.

Background: Central sensitization is an important epiphenomenon of the adult migraine, clinically expressed by allodynia, pericranial tenderness and comorbidity for fibromyalgia in a relevant number of patients. This study aimed to evaluate the frequency and the clinical characteristics of allodynia, pericranial tenderness, and comorbidity for Juvenile Fibromialgia (JFM) in a cohort of migraine children selected in a tertiary headache center., Methods: This was an observational cross-sectional study on 8-15 years old migraine patients. Allodynia was assessed by a questionnaire. Pericranial tenderness and comorbidity for JFM as well as their possible association with poor quality of life and migraine related disability, and with other clinical symptoms as anxiety, depression, sleep disorders and pain catastrophizing, were also evaluated., Results: One hundred and fifty one patients were selected, including chronic migraine (n°47), migraine without aura (n° 92) and migraine with aura (n° 12) sufferers. Allodynia was reported in the 96,6% and pericranial tenderness was observed in the 68.8% of patients. Pericranial tenderness was more severe in patients with more frequent migraine and shorter sleep duration. Allodynia seemed associated with anxiety, pain catastrophizing and high disability scores. Comorbidity for JFM was present in the 0.03% ofpatients. These children presented with a severe depression and a significant reduction of quality of life as compared to the other patients., Conclusions: This study outlined a relevant presence of symptoms of central sensitization among children with migraine. Severe allodynia and comorbidity for JFM seemed to cause a general decline of quality of life, which would suggest the opportunity of a routine assessment of these clinical features.

Studies have failed to identify the molecular mechanisms that regulate the genotoxic and cytotoxic effects of methacrylate resins, which are important in the biocompatibility of dental materials. Interleukin (IL)-6 has a crucial role in the control of acute-phase protein response during inflammation. In humans, the synthesis and release of two major acute-phase proteins, C-reactive protein and serum amyloid A, are regulated by IL-6. This study focused on IL-6 and activation of its receptors gp80 and gp130 in human gingival fibroblasts in order to assess the effects of the commercial acid resins Jet Kit, Unifast, and Duralay on control of inflammation.

Understanding the mechanisms by which mesenchymal stromal cells (MSCs) interact with the physical properties (e.g. topography, charge, ζ-potential, and contact angle) of polymeric surfaces is essential to design new biomaterials capable of regulating stem cell behavior. The present study investigated the ability of two polymers (pHM1 and pHM3) with different positive surface charge densities to modulate the differentiation of MSCs into osteoblast-like phenotype via cell-cell ephrinB2/EphB4 signaling. Although pHM1 promoted the phosphorylation of EphB4, leading to cell differentiation, pHM3, characterized by a high positive surface charge density, had no significant effect on EphB4 activation or MSCs differentiation. When the MSCs were cultured on pHM1 in the presence of a forward signaling blocking peptide, the osteoblast differentiation was compromised. Our results demonstrated that the ephrinB2/EphB4 interaction was required for MSCs differentiation into an osteoblast-like phenotype and that the presence of a high positive surface charge density altered this interaction., (Copyright © 2016 Helmholtz Zentrum München. Published by Elsevier B.V. All rights reserved.)

Background: Given the epidemic proportions and economic costs associated with nutrition related diseases in Western countries, an empirical study was carried-out between September and December 2014 in Campania, the Italian region with the highest prevalence of obese children., Methods: The survey was conducted in a secondary school and involved 145 children, aged 11 to 14, and their parents, with the ultimate aim of studying the relationship between the behaviour of parents regarding the use of nutrition labels, the attention to product quality and the body weight of their children., Results: The results from our study showed that unhealthy diet concerned stems from the misguided food choices of their parents, who are responsible for their children's dietary habits, lifestyle and body weight., Conclusion: In order to incentivise adults and young people to change their food choices and eating behaviour in favour of healthy and sustainable lifestyles, some useful measures could involve the improvement of political marketing and advertising, labelling clarity and better information and awareness campaigns to do sport and eat healthily. Finally some recent patents related to healthy reformulated food products and communication strategies, with specific regard to healthy eating, have been reviewed.

Objectives: To evaluate temperature profiles developing in the root during warm compaction of gutta-percha with the heat sources System B and System MB Obtura (Analityc Technology, Redmond, WA, USA). Thirty extracted human incisor teeth were used. Root canals were cleaned and shaped by means of Protaper rotary files (Dentsply-Maillefer, Belgium), and imaging was performed by micro-CT (Skyscan 1072, Aartselaar, Belgium)., Methods: Teeth were instrumented with K-type thermocouples, and the roots were filled with thermoplastic gutta-percha. Vertical compaction was achieved through the heat sources System B and System MB, and temperature profiles were detect-ed by means of NI Dac Interface controlled by the LabView System. With both heat sources, higher temperature levels were recorded in the region of the root far from the apex. When the warm plugger tip was positioned at a distance of 3 mm from the root apex, temperature levels of about 180°C were used to soften gutta-percha, and no statistically significant differences were observed between peak temperatures developed by the two heating sources at the root apex. However, a temperature level higher than 40°C was maintained for a longer time with System MB., Results: Statistically significant differences were observed in peak temperature levels recorded far from the root apex. Thus, with a temperature of about 180°C and the warm plugger positioned at 3 mm from the root apex, both heating sources led to a temperature slightly higher than 40°C at the apex of the root, suggesting that the gutta-percha was properly softened., Significance: A temperature level higher than 40°C was maintained for a longer time with System MB, thus providing an ad-equate time for warm compaction of the gutta-percha.

A highly efficient TMSI-mediated deprotection and direct isolation method to obtain zwitterionic compounds from the corresponding N-Boc derivatives has been developed. This method has been demonstrated in the final deprotection/isolation of the β-lactamase inhibitor MK-7655 as a part of its manufacturing process. Further application of this process toward other zwitterionic compounds, such as dipeptides and tripeptides, has been successfully developed. Furthermore, a catalytic version of this transformation has been demonstrated in the presence of BSA or BSTFA.

The objective of this study is to understand the level of attention that the consumer awards to a balanced diet and to product ingredients, with a twofold purpose: to understand whether food product reformulation can generate a competitive advantage for companies that practice it and to evaluate the most appropriate policy interventions to promote a healthy diet. Reformulation strategy, in the absence of binding rules, could be generated by consumers. Results from qualitative research and from empirical analysis have shown that the question of health is a latent demand influenced by two main factors: a general lack of information, and the marketing strategies adopted by companies which bring about an increase in the information asymmetry between producers and consumers. In the absence of binding rules, it is therefore necessary that the government implement information campaigns (food education) aimed at increasing knowledge regarding the effects of unhealthy ingredients, in order to inform and improve consumer choice. It is only by means of widespread information campaigns that food product reformulation can become a strategic variable and allow companies to gain a competitive advantage. This may lead to virtuous results in terms of reducing the social costs related to an unhealthy diet., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Compound 1, a potent and irreversible inhibitor of β-lactamases, is in clinical trials with β-lactam antibiotics for the treatment of serious and antibiotic-resistant bacterial infections. A short, scalable, and cost-effective route for the production of this densely functionalized polycyclic molecule is described.

Endodontics is the branch of deciduous teeth pediatric dentistry that deals with the treatment of the root canal system. The goal of therapy is to maintain as long as possible the element in the dental arch to prevent alterations of orthognathodontic, infectious, and functional history and eruptive sequence. Although manual instrumentation has been widely used and still preferred by some practitioners, has limitations that affect the actual ability to clean the channel, the ability to create steps, perforations, dentinal plugs and fractures of the instrument. On the other hand, the disadvantages are the high cost of the instruments in nickel-titanium, which must be frequently replaced, and the risk of compromising the stability of the tooth due to an excessive consumption of dentinal tissue. The use of computed microtomography (μCT) of extracted elements has a considerable advantage in the study of dental hard tissues. The purpose of this study was to analyze the anatomy of the endodontic system of the elements deciduous.

Cleaning and shaping are important section for the root canal treatment. A number of different methodologies have been developed to overcome these problems, including the introduction of rotary instruments nickel-titanium (NiTi). In endodontics NiTi have been shown to significantly reduce procedural errors compared to manual techniques of instrumentation. The efficiency of files is related to many factor. Although previous investigations that have used µCT analysis were hampered by insufficient resolution or projection incorrect. The new generation of μCT performance best offer, as micron resolution and accurate measurement software for evaluating the accurate anatomy of the root canal. The aim the paper was to evaluate the efficiency of Reciproc files in root canal treatment, evaluated before and after instrumentation by using μ-CT analysis.

Aim: To evaluate the effects of repeated autoclave sterilization cycles on surface topography of conventional nickel-titanium ( NiTi ) and titanium nitride ( TiN )-coated rotary instruments., Methodology: A total of 60 NiTi rotary instruments, 30 ProTaper (Dentsply Maillefer) and 30 TiN -coated AlphaKite (Komet/Gebr. Brasseler), were analysed. Instruments were evaluated in the as-received condition and after 1, 5 and 10 sterilization cycles. After sterilization, the samples were observed using scanning electron microscope (SEM), and surface chemical analysis was performed on each instrument with energy dispersive X-ray spectroscopy (EDS). Moreover, the samples were analysed by atomic force microscopy (AFM), and roughness average (Ra) and the root mean square value (RMS) of the scanned surface profiles were recorded. Data were analysed by means of anova followed by Tukey's test., Result: Scanning electron microscope observations revealed the presence of pitting and deep milling marks in all instruments. EDS analysis confirmed that both types of instruments were composed mainly of nickel and titanium, whilst AlphaKite had additional nitride. After multiple autoclave sterilization cycles, SEM examinations revealed an increase in surface alterations, and EDS values indicated changes in chemical surface composition in all instruments. Ra and RMS values of ProTaper significantly increased after 5 (P = 0.006) and 10 cycles (P = 0.002) with respect to the as-received instruments, whilst AlphaKite showed significant differences compared with the controls after 10 cycles (P = 0.03)., Conclusions: Multiple autoclave sterilization cycles modified the surface topography and chemical composition of conventional and TiN -coated NiTi rotary instruments., (© 2012 International Endodontic Journal.)

Objective: Metal alloys used in dentistry and in other biomedical fields may release nickel ions in the oral environment. The release of nickel might influence the normal biological and physiological processes, including tissue wound healing, cell growth and proliferation. The aim of this study was to evaluate in vitro the effects of nickel ions on cell cycle, viability and proliferation., Materials and Methods: Human osteosarcoma cells (U2OS) and human keratinocytes (HaCat) were exposed to different nickel chloride (NiCl(2)) concentrations (0 - 5mM) for various periods exposure. The viability of cultured cells was estimated by flow cytometry using Annexin V-FITC and Propidium Iodide (PI). Cell proliferation was evaluated by using carboxyfluorescein diacetate succinimidyl ester (CFDA-SE) and flow cytometry. Finally, the effects of NiCl(2) on cell cycle were assessed and quantified by flow cytometry. Statistical analysis was performed by means of ANOVA followed by Tukey's test., Results: NiCl(2) induced a dose and time dependent decrease in cell viability. After 24h, 1mM NiCl(2) caused a similar and significant reduction of viability in U2OS and HaCat cells, while higher NiCl(2) concentrations and longer exposure times showed a reduced cytotoxic effect in HaCat as compared to U2OS cells. Exposure to NiCl(2) caused a dose- and time-dependent inhibition of cell proliferation in both cell lines tested, with a prominent effect on U2OS cells. Furthermore, both cell lines exposed to NiCl(2) exhibited significant changes in cell cycle distribution after 24h exposure 2mM NiCl2, as compared to untreated cells (p<0.05)., Conclusion: Our results indicate that release of nickel ions may affect cell proliferation. The inhibition of cell growth by NiCl2 is mediated by both cell cycle arrest and by induction of cell death.

Objective: Aim of the study was to determined by microcomputed tomography (µCT) the horizontal distance between the main (MB1) and the second mesiobuccal canal (MB2) orifices, the vertical distance between the MB1 and MB2 orifices planes, and the distance between the anatomic apex and major apical foramen (AF). Furthermore, we characterized the entire internal and external anatomy of the MB, distalbuccal (DB) and palatal (P) maxillary first molars roots., Materials and Methods: Twenty-two intact extracted first maxillary molars were scanned by X-ray computed transaxial µCT and then 2D and 3D images were processed and analyzed., Results: The results showed that 77.27% of the mesiobuccal (MB) roots presented a second MB canal, and 29.41% of the MB2 were independent from the MB1 canals. In 15 teeth, there were three root canal orifices on the chamber floor, and 10 of these teeth presented MB2 canals. The mean vertical distance between the MB1 and MB2 planes was 1.68 ± 0.83 mm. Seven teeth had four orifices. The mean horizontal interorificial distance between the MB1 and MB2 orifices was 1.21 ± 0.5 mm. Accessory canals were observed in 33.33% of the roots, loops in 6.06%, while isthmuses were found in 15 of the 22 MB roots. Of the total roots, 74.24% presented one foramen, while all of the roots showed a major apical foramen that was not coincident with the anatomic apex., Conclusions: Our µCT analysis provided interesting features on the horizontal and vertical distance between the MB1 and MB2 orifices and on the distance of AF and anatomic apex., Clinical Relevance: These results have an important clinical value because might support the endodontist in the recruitment, negotiation and obturation of maxillary first molar canal system.

Aim: To use atomic force microscopy (AFM) to evaluate the effects of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) on the surface characteristics of ProTaper rotary nickel-titanium instruments., Methodology: A total of twenty ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) instruments (S1, S2, F1, F2) were divided into five groups: no immersion, immersion in 5.25% NaOCl for 5 or 10min and immersion in 17% EDTA for 5 or 10min. Twenty surface areas along 3-mm sections at the tip of the files (perfect squares of 1x1μm) were analysed by AFM operating in contact mode under ambient conditions. Three-dimensional images (400x400 lines) were processed using Gwyddion software, and the roughness average (Ra) and the root mean square value (RMS) of the scanned surface profiles were recorded. Data were analysed by means of anova and paired samples t-test., Results: Three-dimensional AFM images of the surface of ProTaper instruments, including new and those immersed in NaOCl and EDTA solutions, revealed topographic irregularities at the nanometric scale. RMS and Ra values of instruments treated with NaOCl and EDTA solutions were statistically higher than that of the new ones (P<0.05)., Conclusions: Atomic force microscopy three-dimensional images and roughness values indicated that short-term contact between NaOCl and EDTA endodontic irrigants and ProTaper instruments caused alterations in the surface of instruments., (© 2010 International Endodontic Journal.)

Introduction: Mineral trioxide aggregate (MTA) is known to stimulate the hard tissue repair process. The purpose of this study was to evaluate the ability of MTA to support the adhesion, proliferation, and migration of human bone marrow-derived mesenchymal stem cells (hMSCs)., Methods: White ProRoot MTA and white Portland cement were mixed and left to set 24 hours. MSCs were cultured on the samples and observed after 24 hours by confocal laser scanning microscopy (CLSM) by using the cytoskeleton marker CellTracker. Cell proliferation was evaluated by means of alamar blue assay in the presence and absence of differentiation medium during a period of 28 days, and cells seeded on polystyrene culture wells were the control. To assess the effect on migratory ability of hMSCs, a transwell migration assay was performed for 18 hours, positioning MTA and Portland cement in 6-well plates and the cells in 8-μm pore inserts., Results: hMSCs observed under CLSM showed attachment and spread activity on the upper surface of the MTA. Cell proliferation was significantly higher on MTA than on Portland cement. A rate proliferation increase of the MTA group compared with the control was observed after 14 days in presence of basic medium, whereas the same effect was reached after 21 days in presence of differentiation medium. Moreover, MTA was able to enhance cell migration significantly more than Portland cement., Conclusions: Our findings suggest that MTA was able to assist hMSC adhesion, growth, and migration., (Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Biotechnologies such as high-throughput screening (HTS) enable evaluation of large compound libraries for their biological activity and toxic properties. In the field of drug development, embryonic stem (ES) cells have been instrumental in HTS for testing the effect of new compounds. We report an innovative method in one step to differentiate ES cells in neurons and glial cells. The four different neuronal subtypes, gamma-aminobutyric acid (GABA)-ergic, dopaminergic, serotonergic, and motor neurons, are formed in culture. This protocol is adaptable to small wells and is highly reproducible, as indicated by the Z-factor value. Moreover, by using either leukemia inhibitory factor (LIF) or recombinant Cripto protein in our culture conditions, we provide evidence that this protocol is suitable for testing the effect of different molecules on neuronal differentiation of ES cells. Finally, thanks to the simplicity in carrying out the experiment, this method provides the possibility of following the morphological evolution of the in vitro differentiating neuronal cells by timelapse videomicroscopy. Our experimental system provides a powerful tool for testing the effect of different substances on survival and/or differentiation of neuronal and glial cells in an HTS-based approach. Furthermore, using genetically modified ES cells, it would be possible to screen for drugs that have a therapeutic effect on specific neuronal pathologies or to follow, by time-lapse videomicroscopy, their ability to in vitro differentiate.

In this Letter, we present the first systematic report of shear-induced banding in microconfined biphasic liquid-liquid systems, i.e., formation of alternating regions of high and low volume fraction of dispersed-phase droplets in a parallel plate flow cell. Such a flow-driven, gap-dependent phenomenon is only observed at low values of the viscosity ratio between the dispersed and the continuous phase, and in a given range of the applied shear rate. Based on rheological measurements, band formation is found to be associated with a viscosity decrease as compared to the homogeneous, structureless case, thus showing that system microstructure is somehow evolving towards reduced viscous dissipation under shear flow.

Increases in NADPH oxidase activity, oxidative stress, and myocyte apoptosis coexist in failing hearts. In cardiac myocytes in vitro inhibition of NADPH oxidase reduces apoptosis. In this study, we tested the hypothesis that NADPH oxidase inhibition reduces myocyte apoptosis and improves cardiac function in heart failure after myocardial infarction (MI). Rabbits with heart failure induced by MI and sham-operated animals were randomized to orally receive apocynin, an inhibitor of NADPH oxidase (15 mg per day) or placebo for 4 weeks. Left ventricular (LV) dimension and function were assessed by echocardiography and hemodynamics. Myocardial NADPH oxidase activity was measured by superoxide dismutase-inhibitable cytochrome c reduction assay, NADPH oxidase subunit p47phox expression by Western blot and immunofluorescence analysis, myocardial oxidative stress evaluated by 8-hydroxydeoxyguanosine (8-OHdG) and 4-hydroxy-2-nonenal (4-HNE) using immunohistochemistry, and myocyte apoptosis by TUNEL assay. MI rabbits exhibited LV dilatation and systolic dysfunction measured by LV fractional shortening and the maximal rate of LV pressure rise (dP/dt). These changes were associated with increases in NADPH oxidase activity, p47phox protein expression, 8-OHdG expression, 4-HNE expression, myocyte apoptosis, and Bax protein and a decrease in Bcl-2 protein. Apocynin reduced NADPH oxidase activity, p47phox protein, oxidative stress, myocyte apoptosis, and Bax protein, increased Bcl-2 protein, and ameliorated LV dilatation and dysfunction after MI. The results suggest that inhibition of NADPH oxidase may represent an attractive therapeutic approach to treat heart failure.

The deformability of red blood cells flowing in microvessels is essential to maintain optimal blood circulation and to allow gas transfer between blood and tissues. Here, we report on an experimental methodology to investigate the deformability of RBCs flowing in microcapillaries having diameter close to the average cell size. The microcapillaries are placed in a rectangular flow cell, where a suspension of RBCs, properly diluted in albumin-additioned ACD, is fed through a syringe under the action of a liquid head in the physiological range. Video microscopy images of the flowing RBCs are acquired at high magnification and later processed by an automated image analysis macro. It was found that RBCs from healthy donors exhibit the classical parachute shape observed in vivo. Furthermore, all the data of healthy RBC velocity vs liquid head are well represented by the same linear regression, independently on the donor. Preliminary results on beta-thalassemia RBCs are also presented and show, on the average, a reduced velocity compared to healthy samples.

The deformation and breakup of a drop in an immiscible equiviscous liquid undergoing unbounded shear flow has been extensively investigated in the literature, starting from the pioneering work of Taylor. In this Letter, we address the case of microconfined shear flow, a problem which is relevant for microfluidics and emulsion processing applications. The main effects of confinement include complex oscillating transients and drop stabilization against breakup. In particular, very elongated drop shapes are observed, which would be unstable in the unbounded case and can be explained in terms of wall-induced distortion of the shear flow field. We show that wall effects can be exploited to obtain nearly monodisperse emulsions in microconfined shear flow.

Objectives: The purpose of this study was to simultaneously determine the impact of exposure times and incremental resin composite overlaying thickness on the cure kinetics of a light activated composite and a dentin adhesive at selected depths of a simulated restoration., Methods: Levels and kinetics of polymerization of a light activated resin composite (Z250, 3M-ESPE) and dentin adhesive (Excite, Ivoclar) cured with a halogen light unit (Demetron, Kerr, USA) operating at low/medium intensity (500 mW/cm2) for different exposure durations (20 and 60 s) were measured at selected depths (0.3, 0.6 and 1mm) using a modified calorimetric analyzer (DSC 25, METLLER-TOLEDO)., Results: Final polymerization levels of materials up to 1mm through the composite are not significantly different while the light shielding effect of incremental resin composite overlaying progressively reduces their reaction rates., Significance: Prolonged irradiation time at low/medium energies is effective for proper conversion of a resin composite and dentin adhesive; 60 s irradiation time provides the maximum obtainable conversion through the dental resin composite for thicknesses up to 1mm.

Objectives: To define the inlay shading effect on the polymerization levels and kinetics of a light activated bonding system for an indirect restoration technique., Materials and Methods: For the bonding system, an adhesive: Excite (Ivoclar-vivadent) and a composite: Z250 (3M-ESPE, St Paul Minnesota, USA) were investigated. A Demetron (Kerr USA) light curing unit was used. The composite inlay blocks of 2 mm thick were used for the experiment (Artglass A2 Heraeus, Kulzer, Dormagen, Germany). The bonding composite was photocured using a 2 mm composite inlay block as a shielding system while the adhesive was shielded by a 2.3 mm thick wafer, composed of the inlay material and the previously cured bonding composite. The kinetics and levels of polymerization were measured by a differential scanning calorimeter technique (DSC 25, Mettler, Orange, CA, Toledoh, küsnacht, switzerland)., Results: The inlay shielded dental composite reaches a significantly lower level of polymerization compared to the unshielded composite. Inlay shielded composite, has a slower polymerization kinetic compared to unshielded composite. The resin adhesive shielded by the inlay-composite wafer reaches polymerization values not significantly different from those of the unshielded adhesive., Significances: The degree of cure of the light-cured composite resins for use as a base for indirect composite restorations, may be severely reduced as a result of inlay shielding.

PRDX6 is a cytosolic member of the peroxiredoxin family of antioxidant proteins, which protect cells from oxidative damage by reducing cellular peroxides. Knockout studies and transgenic overexpression of Prdx6 in mice have demonstrated an important role for this protein in the defense against oxidative stress. Using Northern blotting with various Prdx6 probes, we have revealed the existence of multiple transcripts with distinct tissue distributions and regulation, including the major 1.4-kb transcript highly expressed in liver and lung, and two additional transcripts expressed primarily in liver. We hypothesized that these additional transcripts correspond either to alternative Prdx6 mRNAs or to highly related genes such as the intronless genes Aop2-rs1 and Aop2-rs2. A combination of Northern blotting, RACE, and EST and genomic sequence analysis has determined that all three liver transcripts are derived from the Prdx6 gene, as they are absent in Prdx6-null mice and differ in their 3' UTRs, suggesting the utilization of different transcription termination signal sequences which we have identified by sequence analysis. We found the Aop2-rs1 gene to be exclusively expressed in testis as a 1.2-kb transcript and have identified putative regulatory elements in its promoter. In contrast, Aop2-rs2 appears not to be expressed in any tissues, although we have evidence for the existence of other related genes that are expressed in a tissue-specific manner. Since the Prdx6 transcripts exhibit differential regulation in response to growth and oxidative stress, further investigation may reveal their distinct roles in the cell and mechanism of regulation.

In this work, we present an experimental methodology to investigate the dynamics under shear flow of a drop that is gelling as a consequence of a temperature quench. The experiments were carried out on the system water/gellan/kappa-carrageenan in the biphasic region of the phase diagram, the gellan-rich phase being used as the dispersed phase. Gelation was brought about by lowering the temperature during flow after steady state drop deformation had been reached. Simple shear flow was applied by using a parallel plate apparatus equipped with optical microscopy and image analysis, which made it possible to monitor drop shape evolution before, during, and after gelation. The onset of gelation trapped drop deformation, thus producing anisotropic particles. The fingerprint of gelation was the simultaneous tumbling of the drops, which rotated as rigid ellipsoids under the action of shear flow. Interfacial tension between the two equilibrium phases was determined at different times during the temperature quench by analyzing drop retraction upon cessation of flow. Up to gelation, no significant change was observed in the measured values.

Background: Invasion is an important early step of cancer metastasis that is not well understood. Developing therapeutics to limit metastasis requires the identification and validation of candidate proteins necessary for invasion and migration., Methods: We developed a functional proteomic screen to identify mediators of tumor cell invasion. This screen couples Fluorophore Assisted Light Inactivation (FALI) to a scFv antibody library to systematically inactivate surface proteins expressed by human fibrosarcoma cells followed by a high-throughput assessment of transwell invasion., Results: Using this screen, we have identified CD155 (the poliovirus receptor) as a mediator of tumor cell invasion through its role in migration. Knockdown of CD155 by FALI or by RNAi resulted in a significant decrease in transwell migration of HT1080 fibrosarcoma cells towards a serum chemoattractant. CD155 was found to be highly expressed in multiple cancer cell lines and primary tumors including glioblastoma (GBM). Knockdown of CD155 also decreased migration of U87MG GBM cells. CD155 is recruited to the leading edge of migrating cells where it colocalizes with actin and alphav-integrin, known mediators of motility and adhesion. Knockdown of CD155 also altered cellular morphology, resulting in cells that were larger and more elongated than controls when plated on a Matrigel substrate., Conclusion: These results implicate a role for CD155 in mediating tumor cell invasion and migration and suggest that CD155 may contribute to tumorigenesis.

This study was designed to determine the intra-operative incidence of right-sided ventricular ischaemia and any association with left ventricular ischaemia. In 60 patients, undergoing coronary artery bypass grafting surgery, a right-sided precordial lead V5R was used. ST segment deviation of more than 1 mm in V5R was considered significant for myocardial ischaemia. Right ventricular ischaemia occurred in 14 patients (23.3%) but was not associated with left ventricular inferior wall ischaemia. In 4 patients (6.6%) presenting with right ventricular ischaemia, ischaemia of the left inferior wall also developed but in all cases was transient and disappeared by the end of surgery. No myocardial infarction was detected in the post-operative period. The present study showed that the use of a right-sided lead may improve intra-operative electrocardiographic monitoring, by revealing ischaemia in those patients in whom ECG abnormalities were not detected by conventional leads. The transient right ventricular ischaemia recorded in this study was probably related to a reduced hypothermic protection of the right ventricle during aortic cross clamping.

The authors report a seven-month-old boy with severe hypotonia, poor spontaneous movements, breathing difficulties and recurrent respiratory infections, dysmorphisms and a peculiar movement disorder: minipolymyoclonus (MPM), previously reported only in spinal muscular atrophies. MPM is characterized by nonrhythmic myoclonic jerks associated with a rhythmic tremor of the extended fingers polygraphically detected. A muscle biopsy showed pathological changes typical of congenital nemaline myopathy (CNM). The relationship between MPM and CNM may be explained on the presumptive basis of the "neurogenic" nature of this congenital myopathy or by the non-specificity of this clinical sign.

We report the fourth case of partial status epilepticus (SE) in benign epilepsy of childhood with rolandic spikes (BECRS). The child suffered long-lasting attacks involving the mouth and pharynx, clinically manifest as speech arrest, sialorrhea, and drooling. Both clinical and electroencephalogram (EEG) data were compatible with the diagnosis of BECRS. Only during SE was the clinical picture similar to that observed in the operculum or Foix-Chavany-Marie syndrome. SE remission was obtained with the usual antiepileptic drug therapy (diazepam, clobazam, valproate). EEG records showed additional patterns of continuous spike-waves during slow sleep and specific inhibition and blocking of interictal centrotemporal spikes by mouth and/or tongue voluntary movements.