Nevin Manimala

Syst Rev. 2025 May 9;14(1):105. doi: 10.1186/s13643-025-02856-6.

ABSTRACT

BACKGROUND: Vaccination is a crucial public health intervention that has significantly reduced the incidence of infectious diseases. Vaccine-related interventions refer to strategies implemented to enhance vaccination uptake, coverage, and effectiveness, like modes of delivery, types or dosages. Despite extensive research on vaccine efficacy, a comprehensive analysis of the variability in vaccine effectiveness across different interventions, settings, and populations is limited. This study aims to systematically review and meta-analyze the impact of various Vaccine-Related Interventions (VRIs).

METHODS: This review included 139 randomized controlled trials, cohort, and case-control studies evaluating VRIs from January 2015 to December 2023. The risk of bias was assessed using the ROB-2 and ROBINS-E tools. Statistical analyses were conducted to evaluate overall effect sizes, infection rates, and heterogeneity and subgroup analysis.

RESULTS: Of the 139 studies reviewed, 97 were included in the meta-analysis, comprising approximately 1.4 million participants. Populations across various settings were analyzed, with median vaccinated population sizes for the 1st dose (4598, IQR = 15,749), 2nd dose (6214, IQR = 13,817), and 3rd dose (3508, IQR = 5546). The overall total vaccinated population had a median of 4370 and an IQR of 16,475. The interventions showed a significant positive effect on vaccine efficacy, with an estimated effect size of 0.6432 (95% CI 0.4049 to 0.8815). Heterogeneity was negligible, with Tau² = 0, I² = 0.00%, and H² = 1.00. The Galbraith plot suggested minimal variability. The study utilized ROB-2 and ROBINS-E tools to evaluate bias, with Egger’s test (t = – 0.9941, p = 0.3227) confirming no significant publication bias. The funnel plot indicated minimal bias in the included studies.

CONCLUSION: The study supports the effectiveness of vaccine-related interventions in enhancing vaccine efficacy. The negligible heterogeneity and consistent effect sizes across diverse populations and settings provide a robust basis for implementing public health strategies aimed at improving vaccination outcomes.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024543608.

PMID:40346627 | DOI:10.1186/s13643-025-02856-6

Reprod Biol Endocrinol. 2025 May 9;23(1):64. doi: 10.1186/s12958-025-01402-2.

ABSTRACT

BACKGROUND: The PPOS (Progestin Primed Ovarian Stimulation) protocol has been evaluated and has proved its effectiveness in preventing the LH (luteinizing hormone) surge. This protocol is often used for cryopreservation for social reasons because it is simpler and more cost-effective. The objective of our study was to evaluate the efficacy and the convenience of the PPOS protocol in the context of oocyte cryopreservation for social reasons.

METHODS: In this bicentric matched case‒control study, all PPOS cycles performed for nonmedical reasons between January 2021 and June 2023 were included. Each PPOS cycle was matched with 2 control cycles performed with the antagonist protocol on the basis of the antral follicle count (+/- 5), BMI (+/- 2 kg/cm²) and starting gonadotropin dose (+/- 75 UI). The primary endpoint was the number of mature oocytes. The secondary endpoints were other parameters and outcomes of COS. We evaluated the convenience of PPOS by analysing the frequency of monitoring sessions. Univariate analysis was performed via univariate conditional logistic regression. Multivariate analysis was performed via conditional multivariate logistic regression for significant parameters in the univariate analysis (p < 0.2).

RESULTS: The patient characteristics were comparable, except the median age, which was lower in the antagonist group (35.5 vs. 34.6 years, p < 0.001). Multivariate analysis revealed no statistically significant difference in the number of metaphase II (MII) oocytes between the groups (p = 0.91) or in the total number of COCs retrieved (0.94). There was no statistically significant difference between the groups in terms of the maturation rate or the OSI (p = 0.38 and p = 0.16). The number of monitoring sessions was significantly lower in the PPOS protocol group (p < 0.001).

CONCLUSION: The response to ovarian stimulation with the PPOS protocol for oocyte cryopreservation in patients with nonmedical indications does not differ statistically from that with the antagonist protocol in terms of the number of MII oocytes. This protocol offers the advantages of a more patient-friendly approach through oral administration, a significantly lower number of monitoring sessions with the same efficacy as the antagonist protocol and could be offered as a first line treatment.

CLINICAL TRIAL NUMBER: NA.

TRIAL REGISTRATION DATE: NA.

PMID:40346618 | DOI:10.1186/s12958-025-01402-2

BMC Oral Health. 2025 May 9;25(1):697. doi: 10.1186/s12903-025-05862-1.

ABSTRACT

BACKGROUND: Denture base fabrication techniques and hard relining resins play critical roles in the clinical durability of implant supported immediate provisional hybrid prostheses (IPHPs). This study aimed to investigate the effects of different denture base fabrication techniques and hard relining resins on the fixation of IPHPs to titanium cylinders using a push-out test, and observe the failure types.

METHODS: A total of 140 denture base acrylic resin specimens (diameter: 24 mm, height: 4 mm) were fabricated using four techniques: milling, 3D printing, injection molding, and conventional heat-polymerization. Holes in 10 mm diameter were drilled at the center of each specimen using an industrial drill. Then, titanium cylinders (Opus Implant) were fixed to the specimens using five hard relining resin materials: acrylic resin-based (Ufi Gel Hard)(UGH), heat-polymerized acrylic resin (Futura Basic Hot)(FBH), autopolymerizing composite resin (Quick Up)(QP), autopolymerizing denture repair resin based on diacrylate (Qu-resin)(QR), and autopolymerizing low shrinkage modelling acrylic resin (Pattern resin LS)(PR) (n = 7). Following 5000 thermal-cycles, a push-out test was performed using a universal testing machine (Test Control Systems). Data were statistically analyzed with two-way analysis of variance (ANOVA) and Tukey post-hoc test (SPSS26, p =.05).

RESULTS: Denture base fabrication techniques, hard relining resin materials, and their interactions had significant effects on the push-out forces (p <.001). Statistically significant differences among fabrication techniques were observed only in the QR group (p <.05), where heat-polymerization technique had the highest push-out forces. Among relining materials, PR exhibited the highest values for milling technique (p <.05). For 3D printing, PR (p =.007) and QR (p =.029) showed significantly higher values than UGH. For injection molding, PR was superior to QP (p =.012) and UGH (p =.001). For heat-polymerization technique, QR, PR and QP exhibited the higher values (p <.05). The most common failure type was adhesive failure between titanium cylinders and relining resins (ADHES-ti).

CONCLUSIONS: Denture base fabrication techniques and relining resin types had significant effects on the push-out force. Conventional heat-polymerization technique provided the most consistent performance, whereas milling and 3D printing required careful selection of relining materials. These results can inform clinical decisions to improve IPHP durability and reduce complications.

PMID:40346615 | DOI:10.1186/s12903-025-05862-1

BMC Oral Health. 2025 May 9;25(1):696. doi: 10.1186/s12903-025-05916-4.

ABSTRACT

BACKGROUND: This study evaluated the presence of preoperative apical periodontitis (AP) in endodontically treated teeth within a Turkish population, along with its causes, treatment methods, and the effectiveness of preventive and early intervention practices.

METHODS: A retrospective analysis was conducted on 1,440 teeth from 1,055 patients treated at Van Yüzüncü Yıl University between 2021 and 2023. Preoperative panoramic and periapical radiographs and postoperative periapical radiographs were examined. Data recorded included patient demographics, treated tooth location, presence of preoperative AP, coronal restorations, reasons for treatment, treatment methods, and number of missing and endodontically treated teeth. Statistical analyses were performed using Chi-Square, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests.

RESULTS: The overall incidence of AP was reported as 28.7%. It was more frequently observed in the mandible than in the maxilla and in incisors compared to other tooth groups (p < 0.001). Caries was the primary reason for treatment in molars (81.5%), while periodontal disease was more common in incisors (p < 0.001). As age increased, the number of endodontically treated and missing teeth also rose (p = 0.019; p < 0.001). Teeth with crowns had a lower AP rate, while retreatments due to periodontal disease or previous root canal failures showed higher AP rates (p < 0.001).

CONCLUSIONS: The high AP rate and the predominance of caries and periodontal disease as treatment causes indicate insufficient application of preventive and early treatments. AP prevalence varied by jaw location, tooth group, coronal restoration and treatment method. This study provides epidemiological data on endodontically treated teeth and their association with AP. These findings emphasize the importance of early diagnosis, preventive measures, and effective treatment planning in preserving tooth survival.

PMID:40346612 | DOI:10.1186/s12903-025-05916-4

Int J Retina Vitreous. 2025 May 9;11(1):56. doi: 10.1186/s40942-025-00679-0.

ABSTRACT

BACKGROUND: To assess macular anatomical and vascular parameters in individuals working in iron ore mines using Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) imaging to explore potential correlations between this occupational exposure and retinal changes.

METHODS: Individuals from the Sangan iron ore mine in Iran were included in a comparative cross-sectional observational study. An age-matched normal control group was selected from healthy participants employed at Mashhad University of Medical Sciences. Following thorough medical evaluations, participants underwent OCT and OCTA imaging. The macular thickness profile, vessel density (VD) of the superficial (SCP) and deep retinal capillary plexus (DCP), and the area of the foveal avascular zone (FAZ) were measured in our cases and compared with age-matched normal controls.

RESULTS: One hundred and one individuals, with an average age of 38.3 ± 5.59 years in the case group and 38.5 ± 5.59 years in the control group, were enrolled in the study. The difference in mean foveal thickness between cases (50.75 ± 9.13) and normal controls (50.38 ± 8.29) was not statistically significant (p = 0.758). Similarly, the mean VD in SCP and DCP for the case group (49.08 ± 2.20 and 49.32 ± 2.42, respectively) and the control group (49.45 ± 3.54 and 49.36 ± 3.97) did not show significant differences. Additionally, there were no significant changes (p-value > 0.05) in macular thickness and VD in other retinal regions when comparing the case and control groups.

CONCLUSION: The research did not establish a significant association between occupational exposure in an iron ore mine and retinal structural changes or alterations in macular VD.

PMID:40346601 | DOI:10.1186/s40942-025-00679-0

BMC Med. 2025 May 9;23(1):277. doi: 10.1186/s12916-025-04113-y.

ABSTRACT

BACKGROUND: Physical therapy is commonly recommended for treating meniscus tears and knee osteoarthritis (KOA). However, data from randomized trials that compare the effectiveness of this treatment with that of glucocorticoid injections are lacking.

METHODS: This randomized, single-blind, multicenter trial included 273 patients with KOA who were divided into either the physical therapy group (n = 133) or the glucocorticoid injection group (n = 140). The physical therapy included kinesiology tape, exercise protocols, and exercise training programs to increase core stability and periprosthetic muscle strength. The primary endpoint was the overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 1 year. Additionally, proprioception and safety were assessed. All analyses were performed with the use of the intention-to-treat approach. The data are reported as percentages (%) (n), and the threshold for statistical significance was p < 0.05.

RESULTS: There was no significant difference in the baseline characteristics between the two groups (p > 0.05). The average (± SD) WOMAC score at 1-year was 76.85 ± 2.50 in the physiotherapy group. And 99.55 ± 2.09 in the glucocorticoid injection group (mean difference = – 22.70; 95% confidence interval [95% CI] – 23.43 to – 21.96; p < 0.001). Compared with the glucocorticoid injection group, the physical therapy group exhibited superior performance in terms of proprioception, especially in the eyes-closed in situ stepping test (14.27 ± 0.75 versus 5.98 ± 0.74; mean difference = 8.29; 95% CI 8.09-8.50; p < 0.001). The incidence of serious adverse events at the 1-year follow-up was comparable between the two groups. Most of these events were determined to be complications arising from physical therapy and glucocorticoid injection.

CONCLUSIONS: The results revealed that pain, quality of life, and balance were greater in the physiotherapy group than in the glucocorticoid injection group within the 1-year study period. However, the long-term effects beyond this timeframe remain unknown, and future studies with extended follow-up times are needed to confirm the sustainability of these benefits.

TRIAL REGISTRATION: The protocol was approved by the local ethics committee of the ethical commission of the Hebei Sports Science Research Institute (SEC20200213019) and Ethics Committee of Sichuan Taikang Hospital (SCTK-IRB-032). The study was registered at the Chinese Clinical Trial Registry (ChiCTR2000032508).

PMID:40346599 | DOI:10.1186/s12916-025-04113-y

Clin Genitourin Cancer. 2025 Apr 11;23(4):102350. doi: 10.1016/j.clgc.2025.102350. Online ahead of print.

ABSTRACT

BACKGROUND: Acinar adenocarcinoma is the most common histological subtype of prostate cancer (PCa). However, 5% of cases present with unconventional histological subtypes (UHs), which have inconsistent clinical characteristics.

PATIENTS AND METHODS: 600 patients underwent a radical prostatectomy (RP) at our institution between 2003 and 2023. 50% had UHs, while other 50% age-matched patients (median age 63 years), with pure acinar adenocarcinoma served as comparison group. Collected parameters included age at diagnosis, PSA levels, imaging results, ISUP (International Society of Urological Pathology) Grade Group at biopsy and RP, TNM-stage and biochemical recurrence rates (BCR). Statistical analysis was conducted using SPSS and Excel, applying Mann-Whitney-U, Chi-Square tests, and Cox proportional hazards models to assess associations with recurrence-free survival.

RESULTS: All patients with UHs presented mixed histological forms (P < .001). Importantly, UHs were previously identified only in 9% of biopsy specimens (P < .001). Patients with UHs had more aggressive disease reflected by higher ISUP Grade Group (P < .001), higher prevalence of ≥pT3a tumors as well as higher rates of positive resection margins (P < .001) although fewer nerve-sparing procedures were performed (P < .001). Patients with UH had a higher risk of PSA persistence after RP (P = .04) and higher BCR rates (P < .001) after a median follow-up of 54.8 months. Notably, multivariate Cox regression analysis indicated that the presence of UHs is the most significant risk factor for BCR (HR 1.972, 95% CI 1.210-3.312).

CONCLUSION: Patients with UH exhibit more aggressive disease and have an increased risk of disease relapse following curative therapy.

PMID:40344715 | DOI:10.1016/j.clgc.2025.102350

Eur J Radiol. 2025 Apr 23;188:112132. doi: 10.1016/j.ejrad.2025.112132. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to investigate the impact of adaptive statistical iterative reconstruction-Veo (ASIR-V) and deep learning image reconstruction (DLIR) algorithms on the quantification of pericoronary adipose tissue (PCAT) and epicardial adipose tissue (EAT). Furthermore, we propose to explore the feasibility of correcting the effects through fat threshold adjustment.

METHODS: A retrospective analysis was conducted on the imaging data of 134 patients who underwent coronary CT angiography (CCTA) between December 2023 and January 2024. These data were reconstructed into seven datasets using filtered back projection (FBP), ASIR-V at three different intensities (ASIR-V 30%, ASIR-V 50%, ASIR-V 70%), and DLIR at three different intensities (DLIR-L, DLIR-M, DLIR-H). Repeated-measures ANOVA was used to compare differences in fat, PCAT and EAT attenuation values among the reconstruction algorithms, and Bland-Altman plots were used to analyze the agreement between ASIR-V or DLIR and FBP algorithms in PCAT attenuation values.

RESULTS: Compared to FBP, ASIR-V 30 %, ASIR-V 50 %, ASIR-V 70 %, DLIR-L, DLIR-M, and DLIR-H significantly increased fat attenuation values (-103.91 ± 12.99 HU, -102.53 ± 12.68 HU, -101.14 ± 12.78 HU, -101.81 ± 12.41 HU, -100.87 ± 12.25 HU, -99.08 ± 12.00 HU vs. -105.95 ± 13.01 HU, all p < 0.001). When the fat threshold was set at -190 to -30 HU, ASIR-V and DLIR algorithms significantly increased PCAT and EAT attenuation values compared to FBP algorithm (all p < 0.05), with these values increasing as the reconstruction intensity level increased. After correction with a fat threshold of -200 to -35 HU for ASIR-V 30 %, -200 to -40 HU for ASIR-V 50 % and DLIR-L, and -200 to -45 HU for ASIR-V 70 %, DLIR-M, and DLIR-H, the mean differences in PCAT attenuation values between ASIR-V or DLIR and FBP algorithms decreased (-0.03 to 1.68 HU vs. 2.35 to 8.69 HU), and no significant difference was found in PCAT attenuation values between FBP and ASIR-V 30 %, ASIR-V 50 %, ASIR-V 70 %, DLIR-L, and DLIR-M (all p > 0.05).

CONCLUSION: Compared to the FBP algorithm, ASIR-V and DLIR algorithms increase PCAT and EAT attenuation values. Adjusting the fat threshold can mitigate the impact of ASIR-V and DLIR algorithms on PCAT attenuation values.

PMID:40344712 | DOI:10.1016/j.ejrad.2025.112132

Int Orthod. 2025 May 8;23(4):101015. doi: 10.1016/j.ortho.2025.101015. Online ahead of print.

ABSTRACT

OBJECTIVES: To validate the accuracy of integration of intraoral scan to the facial scan acquired by the EM3D application, utilising the Blue Sky Plan 4 software, creating a digital model of an orthodontic patient, by comparing the same linear measurements on real photographs and images from the digital model of the patient.

MATERIAL AND METHODS: Thirty patients (20 females and 10 males; age range 12-30years) undergoing orthodontic treatment with fixed appliances were recruited in this prospective cross-sectional study from December 2024 to February 2025. Five facial landmarks were marked on each patient: Tragion right, Cheilion right and left, Subnasale and Pronasale. Intraoral scan and facial scan were performed at the same appointment. Facial scan was conducted using an iPhone 13 Pro with the EM3D face scanning application which utilizes the iPhone’s TrueDepth camera technology while the patient was smiling. The STL (Stereolithography) and OBG (Object) files (acquired from intraoral and facial scan respectively) were combined in a digital model using the Blue Sky Plan 4 software. Lateral and frontal photographs of the patient’s face, while smiling, were also acquired. Eight linear measurements (Tragion right – bracket #11, Tragion right – incisal #11, Cheilion right – #13, Cheilion left – #13, Subnasale – #11, Subnasale – #21, Pronasale – #11, Pronasale – #21) were digitally performed on the real and digital photographs of the patients using the facial landmarks and certain points on teeth and braces. Paired sample t-test and Wilcoxon signed-rank test were used for statistical analysis.

RESULTS: Significantly statistical difference was detected only in one (Cheilion right – #13) measurement (P=0.004).

CONCLUSION: Combining intraoral and facial scan using a special software provides a clinically useful digital model of an orthodontic patient for diagnosis, treatment planning and outcome assessment.

PMID:40344702 | DOI:10.1016/j.ortho.2025.101015

Int Orthod. 2025 May 8;23(4):101014. doi: 10.1016/j.ortho.2025.101014. Online ahead of print.

ABSTRACT

AIM: The study aimed to evaluate the impact of incorporating 2.5%, 5%, and 7% arginine on the hardness, roughness, and cytotoxicity of 3M™ Transbond™ XT.

MATERIAL AND METHODS: A total of 48 samples were divided into four groups (n=12): G1 – commercial resin 3M™ Transbond™ XT (TXT); G2 – TXT+2.5% arginine; G3 – TXT+5% arginine; and G4 – TXT+7% arginine. The hardness analysis was performed by a microhardness tester. The measurements of roughness were performed by a surface roughness measuring instrument. The surface morphology analysis was analyzed by digital images obtained with a scanning electron microscope (SEM). For the in vitro cytotoxicity test, dental pulp mesenchymal cells underwent a cell viability reduction assay. For statistical analysis, ANOVA (one-way/two-way) was used, followed by Tukey’s test post hoc (P<0.05).

RESULTS: There was a reduction in the hardness of experimental resins compared to 3M™ Transbond™ XT commercial resin (P < 0.05). There was no difference between concentrations of 2.5% and 5%, but there was the largest reduction in resin with 7% arginine (P < 0.05). Surface roughness analysis showed there was no statistical difference between the samples (P ≥ 0.05). SEM also did not demonstrate changes in the surface roughness of the resins. All groups exhibited good cell viability at each timepoint. After 48h, an increase was observed for groups contaning arginine (P < 0.05).

CONCLUSION: Surface hardness was modified with when arginine incorporation – to the Transbond™ XT resin formulation. No differences were observed for surface roughness. Due to the initial cytotoxicity of the resins, precautions regarding satisfactory photopolymerization and the distance of application in relation to the gingival tissues must be adopted.

PMID:40344701 | DOI:10.1016/j.ortho.2025.101014