In Vivo Biocompatibility of an Ionic Liquid-protected Silver Nanoparticle Solution as Root Canal Irrigant

Introduction: The aim of this study was to assess the biocompatibility of positively charged imidazolium-based ionic liquid-protected nanosilver solution (AgNPs) root canal irrigant. Methods and Materials: Eighteen male 4- to 5-month old Sprague-Dawley rats, weighing 200-300 gr were selected and randomly divided into 5 groups: Normal saline 0.9% (group 1), 5.25% NaOCl (group 2), 2.5% NaOCl (group 3), 2.0% chlorhexidine solution (group 4) and AgNPs at 5.7×10-8 M/L (group 5) were randomly injected in 5 sites of dorsal skin of each rat. Tissue inflammatory reaction were evaluated histopathologically after 2 h, 48 h and 14 days. Statistical analysis was done with SPSS version 21 and the Kruskal-Wallis H and Dunn tests were used to find statistically significant differences. The level of significance was set at 0.05. Result: All solutions irritated the highest tissue response after 48 h. Group 1 showed lower inflammatory response compared to groups 2 and 4 (P<0.05). Group 2 displayed higher inflammatory response in comparison with group 5 (P<0.05). Tissue reaction to group 5 was not more severe than the reaction to group 3 or 4. It also would irritate less inflammatory response compared to group 2 (P<0.05). Conclusion: Comparing with NaOCl and CHX, it is possible to label AgNPs as a tissue compatible agent. Keywords: Biocompatibility; Root Canal Irrigant; Silver Nanoparticl

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Governing the water conservation in the Urmia Lake Basin: addressing macro systems’ fit and micro users’ behavior

To change unadapted water governing systems, and water users’ traditional conducts in line with climate change, understanding of systems’ structures and users’ behaviors is necessary. To this aim, comprehensive and pragmatic research was designed and implemented in the Urmia Lake Basin where due to the severe droughts, and human-made influences, especially through the agricultural development, the lake has been shrunken drastically. To analyze the water governance and conservation issues in the basin, an innovative framework was developed based on mathematical physics concepts and pro-environmental behavior theories. Accordingly, in system level (macro/meso), the problem of fit of the early-shaped water governing system associating with the function of “political-security” and “political-economic” factors in the basin was identified through mean-field models. Furthermore, the effect of a “political-environmental” factor, the Urmia Lake Restoration Program (ULRP), on reforming the system structure and hence its fit was assessed. The analysis results revealed that by revising the provincial boundaries (horizontal alternation) for the entity of Kurdistan province to permit that interact with the headquarter of West Azerbaijan province for its water demand-supply initiatives, the system fit can increase. Also, the constitution of the ULRP (vertical arrangement) not only could increase the structural fit of the water governing system to the basin, but also significantly could enhance the system fit through its water-saving policy. Besides, in individual level (micro), the governing factors of water conservation behavior of the major users/farmers were identified through rational and moral socio-psychological models. In rational approach, incorporating PMT and TPB, the SEM results demonstrated that “Perceived Vulnerability”, “Self-Efficacy”, “Response Efficacy”, “Response Cost”, “Subjective Norms” and “Institutional Trust” significantly affect the water-saving intention/behavior. Likewise, NAM based analysis as a moral approach, uncovered the significant effects of “Awareness of Consequences”, “Appraisal of Responsibility”, “Personal Norms” as well as “Place Attachment” and “Emotions” on water-saving intention

Phonological abilities in Persian preschool children with stuttering and fluent peers

 ObjectivesSpeech sound production is poorer in stutterers than normally fluent peers. This study was performed to compare speech sound production abilities in Persian speaking children with developmental stuttering.Materials & MethodsOverall, 34 children with stuttering and 60 children without stuttering aged from 3 to 6 yr old were enrolled from Ahvaz City, Khuzestan Province, southern Iran in 2016. The phonetic information test was used to assess speech sound production in this study and 30-minute mother-child conversations were utilized for calculation of Percentage Consonant Correct. Phonological abilities of these two groups were compared against each other and a correlation between stuttering severity and speech sound articulation was calculated.ResultsThere was significant difference between children with stuttering and normal peers for articulation error total percentage but not significant difference was found for percentage consonant correct (P=0.16). Moreover, no significant correlation between stuttering severity and speech sound production in this population was found.ConclusionNo association seems to exist between stuttering severity and speech sound production abilities in this population. This study may lead to the notion that there was significant difference between the two groups in speech sound production assessment

The Effect of Elementary School Teachers’ Knowledge of Learning Disabilities on Referring Afflicted Students to Speech Therapy

Objectives: Learning disabilities can cause serious communication and socio-emotional disorders in students. Teachers, as specialists who are in direct contact with students on a daily basis, have an important role in identifying and referring students suspected of these disabilities. Therefore, this study investigated the role of primary school teachers’ awareness and attitude about the signs and symptoms of learning disabilities on the referral of students of Ahvaz City, Iran to speech therapy centers.  Methods: This case-control study was conducted on 165 elementary school teachers in Ahvaz in 2016-2017. The teacher’s awareness questionnaire was used to determine the teachers’ awareness level. A logistic regression test was used to explore the role of teachers’ attributes on the referral of students to speech therapies. Results: The mean total score of teachers’ awareness about students’ learning disabilities was significantly different in the case and control groups (P0.05). Discussion: Teaching experience, educational level, history of participation in educational workshops and the teachers’ awareness of learning disabilities are critical factors in referring students to speech therapy centers. It is recommended that teachers participate in workshops at regular intervals to update their knowledge on this topic

The Relationship between Perceived Sleep Quality, Polysomnographic Measures and Depressive Symptoms in Chemically-Injured Veterans: A Pilot Study.

Objective: Sleep complaints are common among Iranian chemically-injured veterans. The growing body of research has investigated (in) equalities between such subjective complaints and objective sleep records. Moreover, sleep complaints are associated with depressive symptoms. Depressive symptoms, also, have been frequently reported in chemically-injured veterans. Therefore, the purpose of this pilot study was to investigate the relationship between perceived sleep quality, polysomnographic measures and depressive symptoms in Iranian veterans with chemical injuries. Methods: In this pilot study, 35 Iranian veterans with chemical injuries complaining of a sleep problem were selected. Initially, participants were evaluated via all-night polysomnography, then, they completed the research questionnaires. Collected data were analyzed using Pearson correlation coefficients. Results: Data analyses showed that there was no significant correlation between many of self-reposted variables and polysomnogaphic recordings, h wever, remarkable relationships were found between the Pittsburgh Sleep Quality Index and the Beck Depression Inventory scores. Conclusion: The findings indicated that sleep complaints of chemically-injured veterans are not equivalent to objective sleep disturbances, however, these complaints are largely associated with level of depression. This study emphasizes the important role of mood in sleep evaluation. Further, the findings suggest using a combination of both subjective and objective measures for accurate assessment of sleep quality in Iranian veterans with chemical injuries (i.e., multimethod approach)

The relationship between occupational stresses with job burnout in pre-hospital emergency staff

Background & Objective: Job burnout is one of the inevitable consequences of occupational stress. Professional staff of social services are the first candidates of burnout, therefore this study was aimed to determine the relationship between occupational stresses with job burnout in pre-hospital emergency staff. Method: In this cross-sectional study, 206 employees, working in 44 pre-hospital emergency bases in Golestan province were enrolled in years 2011-12. Information was obtained by occupational stress questionnaire and Maslach Burnout and then using descriptive statistics, Pearson correlation coefficient test, ANOVA, T-Test and Tukey tests the data were analyzed in SPSS software. Results: 117 individuals (75.5 percent) had moderate to high stress. Organizational factors (21.62 ± 6.05) with a mean score from 100 (65.51) had the highest score in causing stress and physical factors (10.44 ± 3.43), occupational (37.12 ± 1.12) and group factors (10.54 ± 1.12) were second and third respectively. Among all the subjects, 76.6% had experienced moderate to high burnout. There was a significant statistical difference between job stress and age (P=0.02) , type of employment (P=0.048) and between burnout and education (P=0.028) in the overall level of job stress and burnout significant correlation was observed (r=0.335, P<0.001). Conclusion: Emergency staffs work in a stressful environment, which leads to burnout, thus identifying stressors and ways to overcome these factors, especially in the corporate (management) dimension can help reduce burnout

Correlation between components of tolerance caregivers in Jahrom hospitals using factor analysis

AbstractBackground and aim: Nurses have an important role in caring of clients. So, determine the component of burden, identifying structure of components and correlation between them can effective in determine the new component and identifying the effective factors of burden. The aim of current study is to determine the correlations between CBI components among nurses in Jahrom hospitols by using factor analysis.Materials and methods: In this research, 158 of nurses in Jahrom hospitals with stratified sampling enrolled to study. by using car-giver burden ills questionnaire, five burden’s components that involve "Time dependence burden", " Developmental burden", "Physical burden", " Social burden" and "Emotional burden" were assessed. Data were analyzed by Pierson correlation coefficient, regression models and factor analysis.Results: Time dependence burden, Developmental burden, Physical burden, Social burden and Emotional burden of women were significantly higher than men (p&lt;0.05). There was a significant difference between workplace and different burden components (p&lt;0.05). Time dependence burden of CCU nurses and triage nurses were in a high and low level, respectively. There was a significant correlation between Emotional burden and Social burden (P=0.000). Factor analysis showed that nurse's burden contains two main factors, that these two factors predicting 64% of total data variance. According to factor analysis physical burdens and Developmental burden and Physical burden were an independent factor, social burden and emotional burdens were another independent factor.Conclusion: There was a significant difference between gender and workplace with components of Burden. Women’s Burden in caring of patients was more than men which can related to physical and emotional characteristics of women.Key words: Time dependence burden, Developmental burden, Physical burden, Social burden, Emotional burden, Factor Analysi