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A comparison of progesterone via vaginal oil capsules versus pessaries for luteal phase support in assisted reproduction treatment: a multicentre cohort study of 42 291 cycles

Hum Reprod. 2025 Nov 21:deaf219. doi: 10.1093/humrep/deaf219. Online ahead of print.

ABSTRACT

STUDY QUESTION: What is the effect of progesterone administered via vaginal oil capsules versus pessaries, on clinical outcomes, when used for luteal phase support (LPS) in ART?

SUMMARY ANSWER: Our study findings indicate a higher live birth rate with vaginal oil capsules compared with pessaries, in both fresh and frozen cycles. In the frozen cycles, a lower miscarriage rate was observed with vaginal oil capsules compared with pessaries.

WHAT IS KNOWN ALREADY: Sufficient LPS, with exogenous progesterone, is essential during ART to improve implantation and pregnancy rates. Micronized vaginal progesterone (MVP) is the most commonly used form of luteal support worldwide. There are no head-to-head comparisons of vaginal oil capsules versus pessaries, with a focus on clinical efficacy, for LPS.

STUDY DESIGN, SIZE, DURATION: Retrospective cohort study of patients who completed ART cycles with either only vaginal oil capsules 600-800 mg/day or only pessaries 800 mg/day for LPS. Primary outcomes were live birth and miscarriage. Data for fresh IVF/ICSI cycles and frozen embryo transfer cycles with hormone replacement therapy (HRT-FET) were analysed separately. Multivariable regression analyses were performed with adjustment for female age, BMI, ethnicity, ovarian reserve, duration and cause of subfertility, stimulation protocol, number of previous cycles, number of oocytes, number of embryos transferred, previous live births, and previous miscarriages.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Our study population consisted of women undergoing treatment across 14 Care Fertility clinics in the UK, from January 2017 to December 2022. We included women with stimulated IVF/ICSI cycles with fresh embryo transfer and autologous HRT-FET cycles. A total of 42 291 cycles were analysed; vaginal oil capsules were exclusively used in 25 738 cycles and pessaries exclusively in 16 553 cycles.

MAIN RESULTS AND THE ROLE OF CHANCE: In the IVF/ICSI group, the live birth rate was higher in those taking vaginal oil capsules compared with pessaries: 34.3% vs 27.8%; adjusted risk ratio (aRR) 1.11 (95% CI 1.04-1.19; P < 0.001). In the HRT-FET group, the live birth rate was also higher in those taking vaginal oil capsules compared to pessaries: 36.7% vs 32.9% (aRR 1.09; 95% CI 1.04-1.14; P < 0.001). The miscarriage rate was lower in those taking vaginal oil capsules compared to pessaries for both IVF/ICSI (13.4% vs 14.5%, P < 0.05) and HRT-FET cycles (17.2% vs 19.7%, P < 0.001) in the crude analysis. The adjusted analysis for miscarriage found a statistically significant difference only for HRT-FET cycles (aRR 0.87; 95% CI 0.82-0.93).

LIMITATIONS, REASONS FOR CAUTION: This is a retrospective cohort study. Whilst we have extensively adjusted for confounding, there can still be residual confounding.

WIDER IMPLICATIONS OF THE FINDINGS: An appropriately powered randomized controlled trial directly comparing the two drugs, focusing on clinical efficacy, is required to determine if one is superior to the other.

STUDY FUNDING/COMPETING INTEREST(S): This study has been delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC). R.K.D.S. is in receipt of honoraria for lectures and presentations from Ferring Pharmaceuticals and Besins Healthcare UK. R.K.D.S. has received travel support from IBSA Pharma and Theramex UK and payment for participation on an advisory board for educational meetings for Ferring Pharmaceuticals and IBSA Pharma. A.C. has contributed to the scientific advisory boards of Ferring Pharmaceuticals, Theramax UK, Besins Healthcare UK, and Organon Pharma UK. M.K. has received travel support from Besins Healthcare UK and Merck. A.H.B. is on an advisory board and has received speaker fees from NovoNordisk Pharmaceuticals and is a shareholder at Care Fertility UK and Care Fertility Leeds. T.B. is in receipt of honoraria for lectures and presentations from Merck and Gedeon Richter. T.B. has received travel support from IBSA Pharma, Vitrolife, and Theramex and payment for participation on an advisory basis for IBSA Pharma and Conceivable Life Sciences. A.R. has received honoraria for lectures and presentations from Gedeon Richter. A.R. has received travel support from Gedeon Richter and payment for participation on an advisory board for educational meetings for Ferring Pharmaceuticals. V.S. has received travel support from IBSA Pharma and payment for educational meetings and participation in an advisory role for Theramex.

TRIAL REGISTRATION NUMBER: n/a.

PMID:41270285 | DOI:10.1093/humrep/deaf219

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Long-Term Efficacy and Safety of755-nm Alexandrite Laser for Axillary Hair Removal: ِA Comparative Analysis of Single vs. DualFlash lamp Systems

JMIR Dermatol. 2025 Nov 21;8:e76523. doi: 10.2196/76523.

ABSTRACT

BACKGROUND: Laser hair removal is a noninvasive cosmetic procedure that targets melanin in hair follicles through selective photothermolysis.

OBJECTIVE: This study aims to evaluate the long-term efficacy and safety of the 755-nm alexandrite laser for axillary hair removal by comparing single- and dual-flash lamp systems.

METHODS: In total, 40 women aged 20 to 35 years with Fitzpatrick skin types II and III participated in a study on laser hair removal for their axillae. Participants underwent 3 treatment sessions, each spaced 4 weeks apart, from January to April 2024. They were divided into 2 groups, both receiving treatments with an alexandrite laser (755 nm, 14 mm spot size). The first group was treated with a dose of 8 J/cm² using a single-flash lamp device operating at 5 Hz, with a pulse duration of 10 ms. The second group received doses between 9 and 11 J/cm² from a dual-flash lamp device operating at 2.5 Hz, with pulse durations ranging from 10 to 15 ms. Photographs and hair counts were taken at baseline and 1 month after the final session. A 2-tailed t test was used to assess statistical significance, and regression analysis evaluated treatment effects. Pain scores and side effects were assessed using a visual analog scale in a satisfaction questionnaire.

RESULTS: The dual-flash lamp laser achieved an overall hair reduction of 94%, while the single-flash lamp laser resulted in a 91% reduction in the axilla. The difference was not statistically significant (P=.14). No serious adverse effects were reported with either device, indicating effective safety features.

CONCLUSIONS: The outcomes show that both systems provide similar results in terms of efficacy and safety, with no reported side effects, and results were maintained even after 6 and 12 months of follow-up.

PMID:41270270 | DOI:10.2196/76523

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Adhesive Wear Assessment of the Prosthetic Abutment and Detorque Values of Conical Connection Implants with Different Conicities

Int J Oral Maxillofac Implants. 2025 Nov 21;0(0):1-18. doi: 10.11607/jomi.11600. Online ahead of print.

ABSTRACT

PURPOSE: Morse taper connection presents better functional load distribution than other types of connections. The angle and finishing surfaces are used to prevent components from loosening under direct axial load. The angulation of the connection walls for the Morse effect to exist should be from 6° to 16°. Therefore, there is a lack of consensus regarding the most appropriate conical connection from both biological and mechanical perspectives. This study aimed to evaluate the influence of different conicities (10°, 16°, 22°, and 24°) of implants with conical connections on the adhesive wear of the prosthetic abutment after the application of the tightening torque.

MATERIALS AND METHODS: Twenty implant sets, abutment with different conicities (10, 16, 22, and 24 degrees) were analyzed using five implants and five abutments, divided into four groups according to the taper angle: A-10° (Emfils, São Paulo Brazil); A-16° (SIN, Sao Paulo, Brazil); A-22° (Nobel Biocare, Zurich, Switzerland); and A-24° (Conexão Sistema de Prósteses, São Paulo, Brazil). The 20 implants were installed in specimens with a stability of 60N·cm, and their respective abutments were subjected to an installation torque of 32N·cm. After being subjected to the recommended torque, the abutments were subjected to detorque for scanning electron microscopy (SEM) analysis. The images obtained of the prosthetic abutments were delineated.

RESULTS: The adhesive wear areas outlined in the ImageJ and values of detorque were analyzed. After statistical analysis of the data, it was observed that group A-24° presented a higher detorque value compared to the other groups (p<0.05). In contrast, the others did not show significant differences among them (p>0.05). For the adhesive wear score, it was observed that group A-16° presented the highest adhesive wear scores, with a statistically significant difference compared to group A-10° (p<0.05). For the other conicities, no difference was observed (p>0.05).

CONCLUSION: It is possible to conclude that the conicity of 16° presented a higher adhesive wear score after tightening the torque of the prosthetic abutment.

PMID:41270268 | DOI:10.11607/jomi.11600

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Short/Long-term Clinical Evaluation of “Planned” Implant Overdentures: Retrospective Cohort Study

Int J Oral Maxillofac Implants. 2025 Nov 21;0(0):1-24. doi: 10.11607/jomi.11614. Online ahead of print.

ABSTRACT

PURPOSE: Implant overdenture rehabilitation has recently become a common treatment for patients. However, few papers present long-term observations (over 10 years) of IOD/IRPD. The purpose of this study was to investigate the clinical results of ‘planned’ IOD/IRPD provided at Tsurumi University Dental Hospital over approximately 20 years, as a retrospective cohort study.

MATERIALS AND METHODS: To investigate the clinical results of ‘planned’ IOD/IRPD, a survey was performed regarding patients who had received IOD/IRPD at our University Dental Hospital and underwent regular maintenance between August 2000 and August 2020. The data of ‘rescue’ overdentures, which have poor survival rates, were excluded in this study. Descriptive statistics show the age and gender ratio of the target patients, the length and diameter of the placed implants, implant position and number, denture designs, types of attachment, marginal bone loss (MBL) around implants, implant survival rate, prosthetic complications, and patient satisfaction. Kaplan-Meier curves were computed for IOD/IRPD survival analysis with implant failure as the endpoint, and log-rank tests were used to assess the IOD/IRPD rehabilitation.

RESULTS: The selected patients were 78 (32 males and 46 females). Eighty-six IODs/IRPDs were manufactured-Maxillary: 31 (IODs: 23, IRPDs: 23); and mandibular: 55 (IODs: 35, IRPD: 20). Regarding the survival rate of IOD/IRPDs, measured by the endpoint of implant failure, the survival rate of mandibular implants was significantly higher than that of maxillary implants (p<0.05). However, there was no significant difference between mandibular IOD and IRPD (p>0.05).

CONCLUSIONS: All ‘planned’ IODs/IRPDs were confirmed to maintain successful conditions for 5 years after the commencement of function. Many implant failures were observed in maxillary IODs/IRPDs with mandibular antagonist teeth. Even when biological and prosthetic complications occurred in IODs/IRPDs more than 5 years after function, higher.

PMID:41270267 | DOI:10.11607/jomi.11614

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Interpretation of Health-Smart Home Data and Implications for Clinical Decision-Making: Inductive Content Analysis

JMIR Nurs. 2025 Nov 21;8:e75234. doi: 10.2196/75234.

ABSTRACT

BACKGROUND: Health-smart home technologies offer real-time sensor-based monitoring of older adult activities of daily living, allowing for early detection of changes in health. The way clinicians interpret and use this data, particularly in visualized formats, such as bar, line, and pie graphs, remains underexplored.

OBJECTIVE: A qualitative descriptive study design with a quantitative component was used to explore how nurses interpret sensor-derived health data from health-smart homes in 3 cases.

METHODS: Using an inductive content analysis approach, we analyzed nurses’ qualitative interpretations of existing sensor-derived health data from health-smart homes from 3 older adults living with ambient whole-home sensing. Nurses provided structured written feedback on visualized trends in sensor-derived health data, including activity, sleep, and mobility patterns.

RESULTS: The findings highlight both opportunities and challenges of using sensor-derived health data in older adults’ care. Nurses identified key patterns in sleep, mobility, and home engagement, but interpretation difficulties, such as unclear sleep metrics and lack of clinical context, hindered decision-making. Nurses preferred bar and line graphs over pie charts for interpreting these data. Survey results show a statistically significant difference in how nurses rated different graph types (χ²2=17.1, P<.001), with pie charts rated significantly lower than both bar and line graphs (P<.001 and P=.008, respectively). These findings underscore the need for improved data visualization and integration to enhance the clinical utility of sensor-derived health data from health-smart homes.

CONCLUSIONS: Findings indicate that nurses were able to provide accurate interpretations of the sensor-derived health data from health-smart homes. However, there is a need for improved visualization techniques and clinician training to optimize health-smart home data for early intervention. Standardized approaches to data representation could enhance nurses’ ability to detect and act on subtle yet important information about older adults’ health changes occurring in home settings.

PMID:41270265 | DOI:10.2196/75234

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Additively Versus Subtractively Manufactured Endocrowns: Fit, Trueness, and Retention of Zirconia, Resin Composite, and Lithium Disilicate: An In Vitro Study

Int J Prosthodont. 2025 Nov 21;0(0):1-29. doi: 10.11607/ijp.9543. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated the marginal and internal adaptation, fabrication trueness, and retention of endocrowns made from additively manufactured (AM) glass-filler-reinforced resin composite and zirconia, and subtractively manufactured (SM) advanced lithium disilicate (ALD).

MATERIALS AND METHODS: A resin typodont model was scanned to design endocrowns. Sixty restorations (n=20/group) were fabricated using AM composite (Group C), AM zirconia (Group ZrO2), or SM lithium disilicate (Group ALD). All restorations were scanned with the same intraoral scanner; adaptation (marginal and internal gaps) was quantified with cross-sectional measurements, and trueness was analyzed as RMS deviations. Endocrowns were cemented on resin dies, thermomechanically aged, and tested for pull-out forces. One-way ANOVA (α = .05) was used for statistical analysis.

RESULTS: ALD showed the lowest marginal (30.81 ±2.45 μm) and internal (33.41 ±2.62 μm) discrepancies, followed by ZrO2 (40.45 ±2.80 μm; 46.23 ±2.20 μm), and C (63.92 ±4.30 μm; 60.34 ±3.30 μm). Significant differences were observed between C and ALD (p=.003; p=.009) and between C and ZrO2 (p=.007; p=.012), but not between ALD and ZrO2 (p=.386; p=.115). Trueness was highest in ALD (38.72 ±3.91 μm), followed by ZrO2 (43.55 ±4.16 μm) and C (51.08 ±4.84 μm), with significant differences between ALD and C (p<.001) and ZrO2 and C (p=.004). ZrO2 showed the highest retention (754 ±211 N), significantly greater than ALD (709 ±208 N; p=.014) and C (634 ± 363 N; p=.002).

CONCLUSIONS: ALD and ZrO2 endocrowns showed superior adaptation and trueness compared to AM composite. ZrO2 exhibited the highest retention. Within the study’s limitations, AM-zirconia appears to be a viable alternative to SM lithium disilicate for endocrown fabrication.

PMID:41270255 | DOI:10.11607/ijp.9543

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Influence of Prosthetic Emergence Profiles and Emergence Angles on Marginal Bone Loss Around Implants with and without Laser- Microtextured Collar Surface: A Retrospective Study

Int J Prosthodont. 2025 Nov 21;0(0):1-20. doi: 10.11607/ijp.9631. Online ahead of print.

ABSTRACT

The study was aimed to retrospectively evaluate differences in marginal bone loss (MBL) between bone level (BL) implants, with (LMS) and without (noLMS) laser-microtextured collar surface, restored with screwed single crowns with different emergence profiles (EP) and emergence angles (EA). Materials and methods: A retrospective evaluation of records and radiographs of 90 patients scheduled for single implant therapy at the molar region over a period of up to 10 years after prosthetic restoration was performed. The radiographic MBL and clinical parameters were measured over time and statistically analyzed. Results: LMS implants presented a statistically significant higher cumulative success rate (97.7 % vs. 91.1%. p<.05) and lower mean MBL compared to noLMS (0.8mm vs. 1.7 mm, p<.05). Around noLMS BL implants an EA.

PMID:41270253 | DOI:10.11607/ijp.9631

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Associations Between Cigarette Smoking and Poor Sleep Among Adults With a Lifetime Cancer Diagnosis

Cancer Rep (Hoboken). 2025 Nov;8(11):e70386. doi: 10.1002/cnr2.70386.

ABSTRACT

BACKGROUND: Poor sleep is associated with cigarette smoking and cancer diagnosis, but little is known about the contribution of smoking to poor sleep following a cancer diagnosis.

METHODS: Using the National Health and Nutrition Examination Survey (N = 6183), multivariable Poisson regression models estimated the associations between lifetime cancer diagnosis, cigarette smoking, and poor sleep, controlling for covariates and evaluating interactions between smoking and cancer diagnosis.

RESULTS: Among adults, 11.6% reported a lifetime cancer diagnosis, and 13.3% of those reported current cigarette smoking. Adults with a cancer diagnosis who smoked had a higher prevalence of inappropriate sleep duration (Adjusted Prevalence Ratio, APR: 2.29, 95% CI: 1.03, 5.13) and snorting/stop breathing (APR: 1.63, 95% CI: 1.10, 2.41) than those without a cancer diagnosis who don’t smoke.

CONCLUSION: Smoking among adults with a lifetime cancer diagnosis is correlated with poor sleep, highlighting the need for targeted smoking cessation interventions to improve sleep health in this population.

PMID:41270207 | DOI:10.1002/cnr2.70386

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Effect of negative pressure wound therapy with instillation and dwell time on health care utilization and costs in South Africa

Wounds. 2025 Oct;37(10):409-416.

ABSTRACT

BACKGROUND: Negative pressure wound therapy with instillation and dwell time (NPWTi-d) provides repeated wound cleansing plus the therapeutic benefits of traditional NPWT and has been elevated to a first-line therapy in some regions given evidence of its effectiveness.

OBJECTIVE: To examine the effect of NPWTi-d on health care utilization and costs in South Africa, where NPWTi-d may still be used as a therapy of last resort.

METHODS: This retrospective study was conducted utilizing a large, South African, private health insurance claims database. A matched cohort of 836 inpatients receiving NPWTi-d or NPWT for various wound types from 2018 through 2022 was created using propensity scoring. Differences in outcomes were compared between groups using t tests.

RESULTS: Despite matching, patients who received NPWTi-d were likely more complex than those who received NPWT, as indicated by a longer length of stay (18.5 days and 13.2 days, respectively; P < .001) and higher overall care costs during the index hospital admission. Readmission rates were similar between groups; however, patients who received NPWTi-d were less likely to have visits for wound-related subacute care or rehabilitation (20.1% vs 53.6%). The average cost of this care (in South African rand) was significantly lower for patients receiving NPWTi-d than for those receiving NPWT (R3 231 and R12 317, respectively; P < .001).

CONCLUSION: Although this study had limitations, including a potential selection bias, study data suggest that NPWTi-d may reduce wound-related health care utilization and costs for some patients through decreases in visits for subacute care. More studies are needed to fully assess how NPWTi-d affects wound care pathways, patient outcomes, and costs in South Africa.

PMID:41270202

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Protein drift-diffusion in membranes with non-equilibrium fluctuations arising from gradients in concentration or temperature

PLoS Comput Biol. 2025 Nov 21;21(11):e1013678. doi: 10.1371/journal.pcbi.1013678. Online ahead of print.

ABSTRACT

We investigate proteins within heterogeneous cell membranes where non-equilibrium phenomena arises from spatial variations in concentration and temperature. We develop simulation methods building on non-equilibrium statistical mechanics to obtain stochastic hybrid continuum-discrete descriptions which track individual protein dynamics, spatially varying concentration fluctuations, and thermal exchanges. We investigate biological mechanisms for protein positioning and patterning within membranes and factors in thermal gradient sensing. We also study the kinetics of Brownian motion of particles with temperature variations within energy landscapes arising from heterogeneous microstructures within membranes. The introduced approaches provide self-consistent models for studying biophysical mechanisms involving the drift-diffusion dynamics of individual proteins and energy exchanges and fluctuations between the thermal and mechanical parts of the system. The methods also can be used for studying related non-equilibrium effects in other biological systems and soft materials.

PMID:41270151 | DOI:10.1371/journal.pcbi.1013678