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Accurate volumetric assessment of intraosseous lesions is crucial in various fields, including bone defect evaluation, surgical outcome prediction, treatment monitoring, and 3D model design. High volumetric accuracy is essential for CBCT in digital dentistry applications. However, there is a notable lack of studies investigating the accuracy of volume determination using CBCT. In this study, we examined the factors affecting CBCT volumetric accuracy, namely voxel size, lesion location, and segmentation techniques, to improve diagnostic protocols and optimize the clinical applications of this imaging modality. 28 artificial bone defects were created in the dry rabbit mandible in two regions (Anterior and Posterior). CBCT imaging was performed with standardized positioning at two voxel sizes (0.1 and 0.2 mm). regarding micro-CT imaging as the gold standard. Images were analyzed in DICOM format using ImageJ after preprocessing, and semi-automatic segmentation was conducted via Otsu thresholding with a manually defined external defect border. In Avizo, a ResNet18-encoded U-Net architecture (Avizo’s Backboned U-Net implementation) was trained for the multiclass segmentation of the bone, background, and lesions. The volume calculations were based on the voxel counts. Volumetric measurements from CBCT showed no statistically significant difference from the micro-CT gold standard ( p  > 0.05). However, a significant underestimation of volume was observed when using a larger voxel size (0.2 mm) compared with a smaller voxel size (0.1 mm), irrespective of the segmentation software used ( p  < 0.05). The choice of software (ImageJ vs. Avizo’s deep learning-assisted tool) did not significantly affect the measurements of the porosity. The location of the defect (anterior vs. posterior) also had no significant impact on the accuracy. CBCT is a reliable tool for the volumetric assessment of mandibular bone defects and demonstrates strong agreement with micro-CT. Clinically, our findings suggest that selecting a smaller voxel size (0.1 mm) is paramount for maximizing measurement accuracy in applications requiring high precision, such as surgical planning and 3D model fabrication. The implementation of a deep learning-assisted segmentation model proved to be a viable and efficient alternative to conventional semi-automatic methods, highlighting its potential to streamline the digital workflow in dentistry without compromising accuracy.

Background Calretinin is a 29 kilodalton (KDa) calcium-binding protein that is expressed in normal and tumoral tissues. The expression of calretinin has been shown in the dental epithelium during odontogenesis and in different odontogenic cysts and tumors such as ameloblastoma. Since the epithelium of calcifying odontogenic cyst (COC) is similar to ameloblastoma and in both lesions, an arrangement of loose cells similar to stellate reticulum is seen, we aimed to investigate the comparative expression of calretinin in COC and ameloblastoma. Methods In this observational-analytical study, 11 paraffin blocks of each lesion were examined. The immunohistochemical expression of calretinin and its severity and distribution were evaluated. Data were evaluated using SPSS version 26 and P  < 0.05 was considered the level of significance. Results Out of 11 ameloblastoma samples, calretinin staining was positive in 6 samples in the stellate reticulum-like cells and also in the lining of microcysts and macrocysts in some cases. Ameloblast like cells did not show staining. In COC samples, epithelial cells were not stained, but in 8 samples, staining was seen in the area of ghost cells. There was no significant difference in staining between ameloblastoma and COC ( P  = 0.33), but the difference in staining in the stellate reticulum of ameloblastoma and COC was significant. ( P  = 0.012). Conclusions it is concluded that calretinin does not play a role in the pathogenesis and histogenesis of COC epithelium, but since ghost cells are caused by a degenerative process, the possibility of involving calretinin as an apoptotic factor in the formation of these cells is supported.

IntroductionHuman papillomavirus (HPV) is one of the most common sexually transmitted diseases and affects the quality of life (QoL) of individuals, necessitating interventions beyond physical treatments. The aim of this study is to determine the effectiveness of individual supportive counselling on the QoL in women with high-risk HPV.Methods and analysisThis randomised clinical trial will include 80 women with HPV who will be selected from 2025 to 2026 in Babol, Iran. Following selection based on inclusion criteria, samples will be randomly allocated to intervention and control groups. Then, they will complete demographic–social questionnaires, QoL in HPV patients and general health questionnaires. Individuals in the intervention group will receive 4 weekly online supportive counselling sessions in addition to routine care. The control group will receive routine care. Both groups will complete the questionnaires again at 6 weeks and 4 months postbaseline. Data will be analysed using SPSS V.26 software and statistical tests including χ², t-test and repeated measures analysis of variance, and regression models if necessary. A significance level of 5% will be used for the tests.Ethics and disseminationThis study was approved by the Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.HRI.REC.1404.082). The trial will adhere to the ethical principles of the Declaration of Helsinki. Findings will be disseminated through publication in peer-reviewed journals and presentation at scientific conferences.Trial registration numberIRCT20180218038783N11, 14 September 2025.

Background Sleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults. Methods In this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016–2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis. Results The mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P  < 0.0001), DSSI.Int (rho = -0.113, P  < 0.001), DSSI.Sat (rho = -0.160, P  < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P  < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P  < 0.0001), DSSI.Int ( P  < 0.0001, rho=-0.18), and DSSI.Sat ( P  < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI ( p  < 0.045, OR = 1.40), the use of hypnotic drugs ( p  < 0.0001, OR = 7.56), and occupation ( p <0.03, OR= 12.66). Conclusions The results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults.

Background Hearing loss was associated with age or presbycusis is the most common cause of hearing loss and has adverse effects on the quality of life, communication and social functioning of the older adults. So, the present study was conducted to investigate hearing loss and its associated factors in the older adults of Amirkola city. Methods This cross-sectional study is part of the third phase of the Amirkola Health and Ageing Cohort Project (AHAP), which was conducted in 2023–2024 on all people aged 60 years and older. The data collection tool included a demographic profile questionnaire and history of some chronic diseases. The data about hearing loss is self-reported and by asking the older adults, “Have you ever felt that you have hearing loss?” was obtained. Some chronic diseases such as diabetes and hypertension were diagnosed based on examinations and standard tests. After entering the SPSS22 software, the data were statistically analyzed using t-test, chi-square and multiple logistic regression. Results Among 1878 older adults studied, 834(50.2%) were men and 827 (49.8%) were women. Out of the total older adults studied, 755 (45.5%) had hearing loss. The prevalence of hearing loss in men was 55.3% and in women was 44.7% ( P  < 0.001). Hearing loss was also significantly higher among participants in the older age group ( P  < 0.0001), illiteracy ( P  < 0.002), unemployment ( P  = 0.002), those with more chronic diseases ( P  < 0.001), having multiple medications ( P  = 0.002), and those with lower body mass index (BMI) ( P  = 0.001). In the multiple logistic regression analysis, factors contributing to hearing loss in the older adults were age over 85 years and female gender, ( P  = 0.018), BMI ( P  = 0.020), inability to perform activities daily living (ADL) ( P  = 0.046) and number of chronic diseases P  < 0.001). Conclusion This study showed that hearing loss is highly prevalent in older adults in the city of Amirkola. Based on the finding of this study, it seems that an interdisciplinary and joint approach to the field of hearing loss screening and identification at the first level of health care services and referring patients to the second level is essential for the timely treatment of hearing loss.

While some biomolecules have been explored to identify potential biomarkers for the prognosis of COVID-19 patients, there is no reliable prognostic indicator of the disease progression and severity. We aimed to evaluate the ability of the C-reactive protein (CRP) to predict COVID-19 infection outcome. This retrospective study was conducted on 429 patients diagnosed with COVID-19 between March 30, 2020, and April 30, 2020. The study population was divided into severe (n = 175) and nonsevere cases (n = 254). Data on demographic characteristics, clinical features, and laboratory findings on admission were collected. The proportion of patients with increased CRP levels was significantly higher in severe cases than in nonsevere patients. Analysis of the receiver operating characteristic (ROC) curve found that CRP could be used as an independent factor in predicting the severity of COVID-19. Also, patients with CRP >64.75 mg/L were more likely to have severe complications. In conclusion, CRP serum levels can predict the severity and progression of illness in patients with COVID-19.

Background Extracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines. Methods This controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH). Results Five men and five women with a mean age of 57.30 ± 18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60% ± 3.94% and increased to 92.13% ± 3.28% after them ( p  < 0.001). Serum IL-6 showed a reduction from 139.70 ± 105.62 to 72.06 ± 65.87 pg/mL ( p  = 0.073); and c-reactive protein decreased from 136.25 ± 84.39 to 78.25 ± 38.67 mg/L ( P  = 0.016). Conclusions Extracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients. Trial registration The research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2 .

Objective The demand for esthetics has increased in today's world and most parents prefer to preserve their children's primary anterior teeth until their natural exfoliation. However, an intracanal post is required to provide retention for reconstruction of severely damaged anterior teeth due to caries or trauma. Various materials and methods may be used for the fabrication of intracanal posts. This study assessed the fracture strength and fracture mode of primary canine teeth reconstructed with prefabricated and customized polyethylene and glass fiber posts. Materials and Methods This in vitro study evaluated 60 extracted primary canine teeth in four groups (n = 15). After pulpectomy and post space preparation with 4 mm depth, composite resin post, prefabricated glass fiber post (Whitepost), customized glass fiber post (Interlig), or customized polyethylene fiber post (Ribbond) were placed in the root canals to provide retention, and the tooth crown was restored with bulk‐fill composite resin. The fracture strength was then measured in a universal testing machine. The fracture mode was also evaluated visually. Results The mean fracture strength was 22.45 ± 5.06, 33.10 ± 8.5, 30.20 ± 7.33, and 32.61 ± 5.73 N/mm2 in the composite resin post, Whitepost, Interlig, and Ribbond groups, respectively. The fracture strength was significantly lower in the composite group than in the remaining three groups (p = 0.000). No other significant differences were found (p > 0.05). Also, no significant difference was observed among the study groups in the fracture mode (p = 0.241). Conclusion The composite resin post yielded a significantly lower fracture strength than the prefabricated and customized glass and polyethylene fiber posts, but the fracture mode was not significantly different among the four groups.

Background and purpose The global incidence of breast cancer is the highest among all cancers and is the primary reason for cancer-related fatalities. Our study aimed to assess the predictors of quality of life (QOL) and mental health in breast cancer survivors in Northern Iran. Methods This cross-sectional study was done on 96 female breast cancer survivors between the ages of 20 and 65 and was based on convenience samples. We gathered information through demographic and fertility data, a QOL survey, and the Hospital Anxiety and Depression Scale (HADS). A significance level of P < 0.05 was set for the analysis. Results In this study, results showed that 11.5% of women had the optimal quality of life, 31.3% favorable quality of life, and 57.3% undesirable quality of life. The average HADS score was 20.14 ± 3.07, with anxiety scores of 10.21 ± 2.31 and depression scores of 9.93 ± 1.64. On multiple linear regression, marital relationship and the number of children were predictors of quality of life (β=-17.624, p = 0.023 and β=-7.427, p = 0.016, respectively), as well as the husband’s education and having no history of other cancers in the woman, were the most important predictors of HADS (β = 0.763, p = 0.039 and β=-0.528, p = 0.016, respectively). Conclusion It is crucial to provide exceptional care to breast cancer patients during treatment and post-recovery. Emotional and psychological support is a fundamental requirement for their well-being.

Background Considering the importance of tobacco use surveillance in different age-groups, this research was carried-out to investigate the prevalence of tobacco smoking and related predicting factors among older adults in northern Iran. Methods This observational study as part of the Amirkola Health and Ageing prospective cohort Project (AHAP) was conducted among older individuals (aged ≥ 60 years). Age, gender, occupation, level of education, marital status, living condition, any previous history of comorbidities as well as the self-reported smoking status was collected through a direct interview with the older adult. Also, the participant's cognitive function, and depressive symptoms were assessed with the Mini-Mental State Examination and Geriatric Depression Scale. Results A total of 1599 older people with mean age of 69.28 ± 7.33 years were included. Among women, only 8 persons (1.1%) had current or any previous history of smoking. Among 874 older men, 582 (66.6%) had no current or past smoking history, 181 (20.7%) had quit smoking, and 111 (12.7%) had current smoking. Logistic regression analysis revealed the significant effect of education (Adjusted OR: 0.48; 95% CI: 0.27–0.84; P  = 0.01), and depression (Adjusted OR: 1.63; 95% CI: 1.15–2.30; P  = 0.006) on tobacco smoking of older people. Conclusions Given higher prevalence of tobacco smoking among older men, in addition to the significant increasing effect of depression, and low level of education on smoking in old age, proper policies should be implemented in health-care package of older adults in northern Iran. Clinical trial number:  Not applicable.