João Paulo Mardegan Issa

Background: Artificial intelligence (AI) is transforming medical education and clinical practice, requiring digital, critical, and ethical competencies. This study aimed to assess medical students’ attitudes toward AI, including perceived benefits, risks, and use in medical training. Methods: A mixed-methods, descriptive study used an electronic questionnaire comprising sociodemographic data and 13 items adapted from the authorized Artificial Intelligence Attitude Scale. Responses were recorded on a five-point Likert scale, with reverse-coding of negative items. Total and subscale scores for benefits, risks/threats, and use were calculated. Participants were medical students from the 1st to 6th years at the School of Medicine of Jundiaí (FMJ). Results: Among 436 students, attitudes toward AI were generally favorable. No significant gender difference was observed (p = 0.291), whereas scores differed significantly across training years (p = 0.025), with higher scores among advanced students. Despite recognizing AI’s benefits, students reported concerns regarding reliability, clinical autonomy, ethical implications, and gaps in practical knowledge. Conclusions: AI is positively perceived by medical students, particularly those in advanced years. These findings support structured AI integration into medical curricula to promote critical, ethical, and responsible use in medical education and future clinical practice.

Background: Additive manufacturing has emerged as a promising technology for the fabrication of patient-specific metallic implants with complex architectures for craniofacial reconstruction. Among metallic biomaterials, cobalt–chromium–molybdenum (Co–28Cr–6Mo) alloys exhibit excellent mechanical strength and corrosion resistance. Plasma anodization has been proposed as a surface engineering strategy to enhance the biological performance of metallic implants; how-ever, its ability to improve osseointegration and bone regeneration remains uncertain. This study investigated the biological response of plasma-anodized additively manufactured Co–28Cr–6Mo implants in a rat critical-size calvarial defect model. Methods: Forty-eight male Wistar rats were randomly assigned to eight experimental groups (n = 6 per group) receiving untreated Co–28Cr–6Mo implants, plasma-anodized Co–28Cr–6Mo implants, titanium-coated plas-ma-anodized Co–28Cr–6Mo implants, or empty defects (control). Animals were euthanized after 6 or 12 weeks. Biological performance was assessed by macroscopic and radiographic examina-tions, histological analyses (Stevens Blue and Von Kossa staining), and quantitative histomor-phometric evaluation of newly formed bone area. Results: All implant surfaces demonstrated excellent in vivo biocompatibility, with no evidence of chronic inflammation, implant rejection, corrosion, or postoperative complications throughout the experimental period. Histological analyses consistently revealed limited bone formation confined to the margins of the defects and the persistence of fibrous connective tissue between the implant surface and the host bone. Quan-titative histomorphometry showed a slight increase in newly formed bone after 12 weeks com-pared with 6 weeks; however, no statistically significant differences were observed among the Control, Co–28Cr–6Mo, Co–28Cr–6Mo PIII, and Co–28Cr–6Mo/Ti PIII groups (p > 0.05). Conclu-sions: Plasma anodization preserved the excellent biocompatibility of additively manufactured Co–28Cr–6Mo implants but did not significantly improve osseointegration or bone regeneration in a rat critical-size calvarial defect model. These findings indicate that plasma anodization alone is insufficient to enhance the regenerative performance of Co–Cr–Mo implants and suggest that additional bioactive surface functionalization strategies may be necessary to promote bone re-pair in critical-size craniofacial defects.

O progresso das tecnologias digitais tem alterado de maneira significativa a maneira como as nações organizam suas táticas de Defesa e Segurança Nacional. Neste contexto, o Big Data e a Inteligência Artificial (IA) desempenham uma função primordial ao viabilizar a análise extensiva de informações e a criação de competências preditivas que possibilitam a antecipação de ameaças e o suporte a decisões estratégicas em tempo real. Este artigo oferece uma análise acerca da função dessas tecnologias na Defesa Nacional, examinando casos internacionais e debatendo os desafios e as perspectivas para sua implementação no Brasil. Exploram-se aplicações como a supervisão de fronteiras, segurança cibernética, integração de dados entre múltiplas plataformas e apoio à decisão operacional. Além das vantagens, são abordadas as dificuldades pertinentes à infraestrutura tecnológica, à soberania digital, aos aspectos éticos e à formação de profissionais especializados. Por último, a pesquisa expõe visões para o futuro que englobam a implementação de centros nacionais de análise preditiva, a interconexão com tecnologias emergentes e o aperfeiçoamento de algoritmos de inteligência artificial explicáveis, enfatizando que a adoção estratégica dessas soluções é fundamental para consolidar a soberania e elevar a resiliência do Brasil diante de ameaças híbridas e cibernéticas.

Medical residency is a demanding stage of specialty training characterized by extensive clinical exposure, heavy workloads, and ongoing knowledge acquisition. Characterizing residents’ learning-style preferences may help residency programs refine their educational strategies and better address residents’ needs. This study assessed learning-style preferences using the Felder–Soloman Index of Learning Styles in 152 residents from clinical and surgical specialties in a Brazilian medical residency program. In the overall sample, the predominant preferences were sensing (90.79%), visual (73.68%), active (62.50%), and sequential (70.39%). Clinical and surgical residents differed significantly only in the understanding domain: sequential preference was more frequent among clinical than surgical residents (80.0% [95% CI: 68.7–87.9] vs. 63.2% [95% CI: 52.7–72.6]). The limited variation between groups suggests that most residents shared a broadly similar learning profile, although some cognitive-processing preferences may differ according to specialty-related demands. These findings may inform diversified educational strategies that combine visual resources, practical activities, and structured progression across clinical and surgical training contexts.

Medical residency is a demanding period of specialty training, marked by intense clinical exposure, heavy workload, and continuous knowledge development. Identifying how residents prefer to learn may help residency programs refine their educational strategies and better align teaching approaches with the needs of trainees. This study assessed learning-style preferences among medical residents using the Felder–Soloman Index of Learning Styles. A total of 152 residents from clinical and surgical specialties in a Brazil-ian medical residency program were included. In the overall sample, the predominant preferences were sensing (90.79%), visual (73.68%), active (62.50%), and sequential (70.39%). Comparisons between clinical and surgical specialties showed a significant dif-ference only in the understanding domain, with residents from clinical specialties being more frequently classified as sequential than those from surgical specialties (80.0% vs. 63.2%). The limited variation across groups suggests that most residents share a broadly similar learning profile, although some cognitive-processing preferences may differ ac-cording to specialty-related demands. These findings support the use of diversified educa-tional strategies in medical residency, combining visual resources, active learning meth-ods, and structured practical activities adapted to clinical and surgical training contexts.

Treating fractures involving complex bone defects remains a major challenge in regenerative medicine. Additive manufacturing enables the fabrication of patient-specific implants, while surface anodization may enhance osseointegration by improving cell adhesion at the bone–implant interface. This study evaluated the feasibility of porous Ti-6Al-4V implants produced by additive manufacturing and surface-modified by anodization for repairing critical-sized femoral defects. Eighty rats were assigned to four groups: control (no graft), non-anodized Ti-6Al-4V implants, nanoporous implants, and nanotubular implants. After six weeks, bone regeneration and mechanical performance were assessed. Newly formed bone volume was significantly higher in the implanted groups compared to control (24.62 ± 3.11%), reaching 47.25 ± 3.92% (non-anodized), 58.20 ± 5.39% (nanoporous), and 40.72 ± 2.22% (nanotubular). Bone strength was also greater in implanted groups (150.27 ± 2.94 N, 151.98 ± 10.37 N, and 156.59 ± 4.95 N, respectively) compared to control (128.16 ± 2.17 N), with no significant differences among treated groups. No signs of implant rejection or inflammation were observed, indicating good biocompatibility. Anodized surfaces demonstrated enhanced osteogenic performance, particularly in the nanoporous group. These findings indicate that anodized porous Ti-6Al-4V implants produced by additive manufacturing combine biological compatibility with mechanical stability, supporting their potential application in bone reconstruction therapies.

Hypertension and psychological stress are prevalent conditions that may adversely affect bone health, yet their combined impact on bone remodeling remains underexplored. This study aimed to investigate the effects of acute and chronic stress on bone structure and remodeling in normotensive and spontaneously hypertensive rats. Forty male rats (20 normotensive Hannover and 20 spontaneously hypertensive) were randomly assigned to control, acute stress, or chronic variable stress groups. Acute stress consisted of a single 2 h restraint session, while chronic variable stress involved five different stressors over 10 days. Bone remodeling was assessed using quantitative histology, immunohistochemistry for VEGF, bone sialoprotein (BSP), osteocalcin (OCN), and TRAP, as well as enzymatic activity analysis (MMP-2 and MMP-9). Results: Neither acute nor chronic stress significantly altered trabecular bone volume or collagen density within the study period. However, stress exposure reduced osteoblast activity (OCN, BSP), increased matrix remodeling enzymes (MMP-2, MMP-9), and promoted angiogenic signaling (VEGF). Notably, TRAP-positive osteoclasts were observed exclusively in stress-exposed animals, indicating elevated bone resorption. Importantly, hypertensive rats exhibited inherently higher basal levels of remodeling activity and MMP-2 expression compared to normotensive controls, and showed a more pronounced response to chronic stress, suggesting hypertension may predispose bone tissue to increased metabolic vulnerability. According to the results of corticosterone dosage, as well as histological and immunohistochemical analyses, it is provided that stress promotes changes in bone metabolism, corroborating the hypothesis that its effects occur early and precede detectable structural modifications. These findings indicate that both hypertension and psychological stress are relevant modulators of bone physiology, and that their interaction may amplify metabolic changes in bone remodeling, emphasizing the importance of monitoring bone health in hypertensive individuals exposed to stress.

Background/Objectives: This systematic review aimed to quantify the extent of wear of opposing posterior natural enamel in patients with single-unit ceramic crowns. Methods: A comprehensive search was conducted in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest through September 2025. A meta-analysis was performed using the inverse variance method. Results: Nine clinical studies (5 randomized controlled trials and 4 prospective studies) involving 203 patients (2015–2025) were included. All studies evaluated monolithic zirconia; two also assessed monolithic lithium disilicate, and three included metal-ceramic restorations with feldspathic veneering. Follow-up ranged from 6 to 24 months. Meta-analysis revealed significant enamel wear from zirconia (p < 0.05; MD: −1.32; 95% CI: −2.06 to −0.57; I² = 94%) and lithium disilicate (p < 0.05; MD: −0.45; 95% CI: −0.71 to −0.19; I² = 2%). Feldspathic ceramics did not show significant enamel wear (p = 0.06; MD: −2.77; 95% CI: −5.66 to 0.13; I² = 96%). Conclusions: Ceramic materials generally cause greater wear on opposing posterior natural enamel than enamel-to-enamel contact. Monolithic zirconia and lithium disilicate crowns produced higher antagonist wear, whereas metal-ceramic restorations with feldspathic veneering appeared more conservative for preserving posterior enamel.

Cannabidiol (CBD) is a non-psychotropic compound found in plants of the Cannabis genus, extensively studied for its therapeutic potential. Research has shown that CBD possesses anti-inflammatory, antioxidant, and regenerative properties, and may contribute to the recovery of neural and bone tissues. In light of the aging population and the resulting rise in neurodegenerative and osteodegenerative conditions, exploring novel therapeutic strategies that promote cellular regeneration is increasingly important. This review aims to compile and critically analyze key studies published in recent decades regarding the effects of CBD on the regeneration of the central and peripheral nervous systems, as well as bone tissue. Findings from in vivo studies indicate that CBD can attenuate inflammatory responses, inhibit oxidative stress, and modulate cellular pathways involved in tissue repair, thereby supporting neuronal and bone regeneration. Moreover, evidence suggests that CBD may protect cells from structural damage, enhancing the functional recovery of affected tissues. Despite scientific advances highlighting cannabidiol as a promising agent for bone and nerve regeneration, its therapeutic application still faces significant limitations. The primary challenge lies in the lack of robust clinical trials in humans, as most existing evidence is derived from in vitro and in vivo studies, making it difficult to confirm its efficacy and safety in clinical contexts. Additionally, CBD’s low bioavailability—due to first-pass hepatic metabolism—hinders dose standardization and reduces the predictability of therapeutic outcomes. Compounding these issues are regulatory constraints and the persistent social stigma surrounding cannabis-derived compounds, which further impede their integration and acceptance in regenerative medicine. Therefore, future research is essential to validate the therapeutic benefits of CBD and to establish its clinical applicability in treating neurological and bone disorders.

This review aims to provide an overview of the role of vitamin D in peri-implant and periodontal tissue. Electronic searches were carried out of the PubMed/Medline database. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was performed. Vitamin D plays a crucial role in bone balance and metabolism, contributing to reducing early implant failure and improving dental implant osseointegration. Vitamin D deficiency poses a challenge to clinical outcomes, and its supplementation can be an effective alternative to overcome this limitation. The results reported in this article show that vitamin D application on implants can improve the osseointegration, bone-to-implant contact, implant stability, and bone density. Moreover, vitamin D supplementation can increase RUNX2, ALP, OPN, and OCN expression, contributing to periodontal tissue health and its regeneration. Together, findings provide an overview of these topics and present future perspectives for clinical practice in dentistry.