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Are There Clinical Differences Between 3D-Printed and Milled Complete Dentures? A Systematic Review and Meta-analysis
No full textLimited studies assess clinical key factors in the success of digitally fabricated complete dentures between additive and subtractive methods. This study aimed to compare 2 determinants of clinical success-retention and patient satisfaction- in complete dentures fabricated using additive and subtractive approaches. PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar were searched up to August 2024. Records were screened by title, abstract, and full text against the eligibility criteria. The standardized mean difference (SMD) was calculated using the data extracted from each included study. A random effects model pooled the effect sizes, and heterogeneity was assessed with Cochran's Q test, I-squared, and Tau-squared indices; publication bias was evaluated using Begg's funnel plot and the Egger test, while sensitivity analyses checked result robustness. The risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. Of the initial 1098 records, a total of 4 articles were deemed eligible. Although mean denture retention was higher in the additive compared to the subtractive method, the difference was not statistically significant (SMD = 0.165 N, 95 CI = -0.176, 0.506, P = .343, I(2) = 58.72%). Similarly, mean satisfaction was lower in the additive compared to the subtractive method, but this difference was not statistically significant (SMD = -0.595, 95% CI = -1.579, 0.389, P = .236, I(2) = 85.94%). Considering the high heterogeneity and the small number of studies, it can be cautiously concluded that there is no significant difference between complete dentures fabricated by 3D printing and milling approaches
Proband-Only Exome Sequencing for Intellectual Disability in Iran: Diagnostic Yield and Genetic Insights
No full textIntellectual disability (ID) is a leading cause for referral to genetic services, with the most severe cases typically attributed to single genetic defects. This study aimed to evaluate the diagnostic yield of cost-effective proband-only exome sequencing for individuals diagnosed with ID within the Iranian population for the first time where a high rate of parental consanguinity exists. A total of 99 unrelated patients with ID were investigated by exome sequencing during 8 years. As a result, 43 pathogenic/likely pathogenic variants were identified in 40 patients, indicating a molecular diagnostic rate of 40.4 (40/99). The inclusion of five chromosomal copy number variations in the subsequent analysis increased the diagnostic rate of proband-only exome sequencing to 45.4 (45/99). Additionally, parental testing revealed five de novo variants. This contributed to a total diagnostic rate of 50.5 (50/99). In our study, proband-only exome sequencing achieved a remarkable diagnostic rate, identifying nearly half of the ID cases. This rate of diagnosis could be primarily attributed to prevalent consanguineous marriage in the Iranian population and the rare identification of de novo variants. With the ongoing advancements in neurogenetics, proband-only exome sequencing demonstrates significant potential as a future cost-effective diagnostic approach in Iran
Retrograde urethrography (RUG) combined with voiding cystourethrography (VCUG) versus surgical findings in assessment of urethral strictures length
No full textBACKGROUND AND OBJECTIVE: Retrograde urethrography (RUG) combined with voiding cystourethrography (VCUG) is the most common and preferred imaging modality for evaluating urethral strictures, despite its well-known limitations and disadvantages. In this study, we assessed the clinical relevance of RUG + VCUG, along with intraoperative assessment in measuring male urethral strictures. METHOD: This study was a single-center retrospective study involving 134 male patients diagnosed with urethral stricture disease. All participants underwent RUG + VCUG before the intervention, and the results were interpreted by a single radiologist. The location and length of urethral strictures were assessed. The accuracy of urethral stricture measurements obtained from combined VCUG and RUG imaging was compared to intraoperative measurements, which served as the reference standard. Urethral strictures were classified into three types: membranous and bulbomembranous, bulbar, and penile. RESULTS: A total of 130 patients were included (38.14 +/- 12.05 years) in the study. For patients with membranous and bulbar strictures, there were statistically significant differences in stricture length measurements between VCUG + RUG and surgical evaluation (p < 0.05). However, for patients with penile strictures, the differences in stricture length measurements between VCUG + RUG and surgical evaluation were not statistically significant (p = 0.448). CONCLUSION: This study suggests that RUG + VCUG may underestimate urethral stricture, particularly in the membranous and bulbar regions
Activation of muscle amine functional groups using eutectic mixture to enhance tissue adhesiveness of injectable, conductive and therapeutic granular hydrogel for diabetic ulcer regeneration
No full textHerein, Polydopamine-modified microgels and microgels incorporated with superficial epoxy groups were synthesized and applied as precursors for the fabrication of four granular hydrogels. To enhance the tissue adhesiveness, a ternary deep eutectic solvent was synthesized to activate the muscle amine functional groups facilitating the formation of robust NC bonds at ambient conditions. At a certain shear rate of 10 s(-1), hydrogel DMG displayed a viscosity of 9x10(3) Pa/s, representing the highest complex viscosity among the tested hydrogels primarily driven by quinone groups in PDA which enhanced reversible interactions, thereby increasing particle cohesion. Moreover, the intersection point escalating from about 4x10(3) to approximately 9x10(4) as the concentration of DMG increased from 0 (for MG) to 70 (7D3MG) by weight. There was a decrease in adhesion strength from 0.45 +/- 0.08 N in MG to 0.39 +/- 0.16 N, 0.35+/- 0.18 N, and 0.33 +/- 0.15 N for 3D7MG, 7D3MG, and DMG respectively, suggesting that MG was capable of forming numerous covalent bonds, thereby enhancing its adhesion to the substrate. The type of eutectic mixture affected the electrical conductivity and a very important point was the changes in resistance value with time. For MG catalyzed by DES(AZG), the resistance increased only by 1.3 % (from 3.37 to 3.81 kOmega) at day 3 and 37.09 % (from 3.37 to 4.62 kOmega) at day 5. The 3D7MG hydrogel exhibited superior therapeutic efficacy toward diabetic wound regeneration. The proliferation index value for 3D7MG-DES(AZG) and 3D7MG-DES(AG) were calculated 42.3 % and 58.6 %, respectively, while the control group exhibited a lower value of 37.8 %
Nested CNN architecture for three-dimensional dose distribution prediction in tomotherapy for prostate cancer
No full textBACKGROUND: The hypothesis of changing network layers to increase the accuracy of dose distribution prediction, instead of expanding their dimensions, which requires complex calculations, has been considered in our study. MATERIALS AND METHODS: A total of 137 prostate cancer patients treated with the tomotherapy technique were categorized as 80 training and validating as well as 20 testing for the nested UNet and UNet architectures. Mean absolute error (MAE) was used to measure the dosimetry indices of dose-volume histograms (DVHs), and geometry indices, including the structural similarity index measure (SSIM), dice similarity coefficient (DSC), and Jaccard similarity coefficient (JSC), were used to evaluate the isodose volume (IV) similarity prediction. To verify a statistically significant difference, the two-way statistical Wilcoxon test was used at a level of 0.05 (p < 0.05). RESULTS: Use of a nested UNet architecture reduced the predicted dose MAE in DVH indices. The MAE for planning target volume (PTV), bladder, rectum, and right and left femur were D(98) = 1.11 +/- 0.90; D(98) = 2.27 +/- 2.85, D(mean) = 0.84 +/- 0.62; D(98) = 1.47 +/- 12.02, D(mean) = 0.77 +/- 1.59; D(2) = 0.65 +/- 0.70, D(mean) = 0.96 +/- 2.82; and D(2) = 1.18 +/- 6.65, D(mean) = 0.44 +/- 1.13, respectively. Additionally, the greatest geometric similarity was observed in the mean SSIM for UNet and nested UNet (0.91 vs. 0.94, respectively). CONCLUSION: The nested UNet network can be considered a suitable network due to its ability to improve the accuracy of dose distribution prediction compared to the UNet network in an acceptable time
Simultaneous Increase of Mean Susceptibility and Mean Kurtosis in the Substantia Nigra as an MRI Neuroimaging Biomarker for Early-Stage Parkinson's Disease: A Systematic Review and Meta-Analysis
No full textBACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder. Early detection is crucial for treatment and slowing disease progression. HYPOTHESIS: Simultaneous alterations in mean susceptibility (MS) from quantitative susceptibility mapping (QSM) and mean kurtosis (MK) from diffusion kurtosis imaging (DKI) can serve as reliable neuroimaging biomarkers for early-stage PD (ESPD) in the basal ganglia nuclei, including the substantia nigra (SN), putamen (PUT), globus pallidus (GP), and caudate nucleus (CN). STUDY TYPE: Systematic review and meta-analysis. POPULATION: One hundred eleven patients diagnosed with ESPD and 81 healthy controls (HCs) were included from four studies that utilized both QSM and DKI in both subject groups. FIELD STRENGTH/SEQUENCE: Three-dimensional multi-echo gradient echo sequence for QSM and spin echo planar imaging sequence for DKI at 3 Tesla. ASSESSMENT: A systematic review and meta-analysis using PRISMA guidelines searched PubMed, Web of Science, and Scopus. STATISTICAL TESTS: Random-effects model, standardized mean difference (SMD) to compare MS and MK between ESPD patients and HCs, I(2) statistic for heterogeneity, Newcastle-Ottawa Scale (NOS) for risk of bias, and Egger's test for publication bias. A P-value <0.05 was considered significant. RESULTS: MS values were significantly higher in SN (SMD 0.72, 95 CI 0.31 to 1.12), PUT (SMD 0.68, 95 CI 0.29 to 1.07), and GP (SMD 0.53, 95 CI 0.19 to 0.87) in ESPD patients compared to HCs. CN did not show a significant difference in MS values (P = 0.15). MK values were significantly higher only in SN (SMD = 0.72, 95 CI 0.16 to 1.27). MK values were not significantly different in PUT (P = 1.00), GP (P = 0.97), and CN (P = 0.59). Studies had high quality (NOS 7-8) and no publication bias (P = 0.967). DATA CONCLUSION: Simultaneous use of MS and MK may be useful as an early neuroimaging biomarker for ESPD detection and its differentiation from HCs, with significant differences observed in the SN. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2
Insight into the cardioprotective effects of melatonin: shining a spotlight on intercellular Sirt signaling communication
No full textCardiovascular diseases (CVDs) are the leading causes of death and illness worldwide. While there have been advancements in the treatment of CVDs using medication and medical procedures, these conventional methods have limited effectiveness in halting the progression of heart diseases to complete heart failure. However, in recent years, the hormone melatonin has shown promise as a protective agent for the heart. Melatonin, which is secreted by the pineal gland and regulates our sleep-wake cycle, plays a role in various biological processes including oxidative stress, mitochondrial function, and cell death. The Sirtuin (Sirt) family of proteins has gained attention for their involvement in many cellular functions related to heart health. It has been well established that melatonin activates the Sirt signaling pathways, leading to several beneficial effects on the heart. These include preserving mitochondrial function, reducing oxidative stress, decreasing inflammation, preventing cell death, and regulating autophagy in cardiac cells. Therefore, melatonin could play crucial roles in ameliorating various cardiovascular pathologies, such as sepsis, drug toxicity-induced myocardial injury, myocardial ischemia-reperfusion injury, hypertension, heart failure, and diabetic cardiomyopathy. These effects may be partly attributed to the modulation of different Sirt family members by melatonin. This review summarizes the existing body of literature highlighting the cardioprotective effects of melatonin, specifically the ones including modulation of Sirt signaling pathways. Also, we discuss the potential use of melatonin-Sirt interactions as a forthcoming therapeutic target for managing and preventing CVDs
Serum 25-Hydroxyvitamin D Is Associated With Prediabetes, Type 2 Diabetes Mellitus, and Insulin Resistance in Children: A Systematic Review and Dose-Response Meta-analysis of Epidemiologic Studies
No full textCONTEXT: Although several investigations have been conducted on the association between serum vitamin D levels and prediabetes and type 2 diabetes mellitus (T2DM) in children and adolescents, their findings are inconsistent. OBJECTIVE: We conducted a systematic review and dose-response meta-analysis to summarize this subject. DATA SOURCES: The electronic databases of ISI Web of Science, Scopus, PubMed, and motor engineering of Google Scholar were comprehensively searched up to May 2023. DATA EXTRACTION: Epidemiologic studies that investigated the risk of hyperglycemia and insulin resistance in relation to serum 25-hydroxy vitamin D levels in children and adolescents were included. DATA ANALYSIS: Twenty-two investigations, with a total of 38 622 participants, were systematically reviewed. Meta-analysis of 15 studies (n = 32 720 participants) showed that participants with the highest serum vitamin D levels had 42 lower risk of hyperglycemia, compared with those in the lowest category of serum vitamin D levels (relative risk RR = 0.58; 95%CI, 0.48, 0.71). Moreover, pooling 8 studies (n = 10 465 participants) illustrated that highest serum vitamin D level was associated with a 44% lower risk of insulin resistance compared with the lowest serum vitamin D level (RR = 0.56; 95%CI, 0.37, 0.83). Based on linear dose-response analysis, each 10 nmol/L increment in serum 25-hydroxy vitamin D was associated with a 6% decreased risk of hyperglycemia and insulin resistance in children. Furthermore, nonlinear dose-response analysis revealed that increasing serum vitamin D concentration from 40 nmol/L to sufficient values (>50 nmol/L) was associated with a decreasing trend in risk of hyperglycemia and insulin resistance. CONCLUSION: This meta-analysis revealed inverse associations between serum vitamin D levels and hyperglycemia and insulin resistance in children and adolescents, in a dose-response manner. Increasing serum vitamin D concentration from 40 nmol/L to sufficient values (>50 nmol/L) was associated with a decreasing trend in hyperglycemia and insulin resistance risk. Systematic Review Registration: PROSPERO registration no. CRD42023458155
Association of the medication protocols and longitudinal change of COVID-19 symptoms: a hospital-based mixed-statistical methods study
No full textThe objective of this study was to identify the relationship between hospitalization treatment strategies leading to change in symptoms during 12-week follow-up among hospitalized patients during the COVID-19 outbreak. In this article, data from a prospective cohort study on COVID-19 patients admitted to Khorshid Hospital, Isfahan, Iran, from February 2020 to February 2021, were analyzed and reported. Patient characteristics, including socio-demographics, comorbidities, signs and symptoms, and treatments during hospitalization, were investigated. Also, to investigate the treatment effects adjusted by other confounding factors that lead to symptom change during follow-up, the binary classification trees, generalized linear mixed model, machine learning, and joint generalized estimating equation methods were applied. This research scrutinized the effects of various medications on COVID-19 patients in a prospective hospital-based cohort study, and found that heparin, methylprednisolone, ceftriaxone, and hydroxychloroquine were the most frequently prescribed medications. The results indicate that of patients under 65 years of age, 76 had a cough at the time of admission, while of patients with Cr levels of 1.1 or more, 80 had not lost weight at the time of admission. The results of fitted models showed that, during the follow-up, women are more likely to have shortness of breath (OR = 1.25; P-value: 0.039), fatigue (OR = 1.31; P-value: 0.013) and cough (OR = 1.29; P-value: 0.019) compared to men. Additionally, patients with symptoms of chest pain, fatigue and decreased appetite during admission are at a higher risk of experiencing fatigue during follow-up. Each day increase in the duration of ceftriaxone multiplies the odds of shortness of breath by 1.15 (P-value: 0.012). With each passing week, the odds of losing weight increase by 1.41 (P-value: 0.038), while the odds of shortness of breath and cough decrease by 0.84 (P-value: 0.005) and 0.56 (P-value: 0.000), respectively. In addition, each day increase in the duration of meropenem or methylprednisolone decreased the odds of weight loss at follow-up by 0.88 (P-value: 0.026) and 0.91 (P-value: 0.023), respectively (among those who took these medications). Identified prognostic factors can help clinicians and policymakers adapt management strategies for patients in any pandemic like COVID-19, which ultimately leads to better hospital decision-making and improved patient quality of life outcomes
The effects of MCC950 on NLRP3 inflammasome and inflammatory biomarkers: a systematic review and meta-analysis on animal studies
No full textIntroduction: The NLRP3 inflammasome plays a key role in the regulation of inflammation and has been implicated in various inflammatory diseases. The present study evaluated the impact of MCC950 on NLRP3 and inflammatory biomarkers in systematic review and meta-analysis. Methods: Searches were performed across databases including Medline (PubMed), Scopus, Web of Science, and Embase. The pooled effects of MCC950 on NLRP3, TNF-alpha, interleukin (IL)-16, IL-18, and IL-1β were analyzed using a random effects model. Results: Twenty animal studies met the inclusion criteria. MCC950 did not significantly reduce NLRP3 (SMD = -0.88; 95 CI: -1.79,0.03; P= 0.058) and TNF-alpha levels (SMD= -1.18; 95 CI: -2.45, 0.09; P= 0.069). A significant reduction was observed in IL-18 (SMD= -1.22; 95 CI: -2.44, -0.00; P= 0.049), IL-16 (SMD= -1.225; 95 CI: -2.779, 0.329; P= 0.122) and IL-1β (SMD = -1.38; 95 CI: -2.44 to -0.32; P= 0.011) concentrations after MCC950 treatment. Conclusion: MCC950 reduced serum levels of some inflammatory factors. However, NLRP3 did not change significantly. Further research is necessary to understand the function of pharmacological inhibition of NLRP3 activation. Registration: This study was conducted in accordance with the PRISMA checklist, and its protocol was registered on both the PROSPERO website (ID: CRD42024567477) and the Research Registry website (UIN: reviewregistry1887). Copyright © 2025 The Author(s