Effectiveness of sodium bicarbonate combined with hydrogen peroxide and CPP-ACPF in whitening and microhardness of enamel

This study investigated the effects of sodium bicarbonate (NaHCO3) combined with 1.5% hydrogen peroxide (H2O2) and casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) on color and microhardness of enamel. Seventy-five bovine incisors were immersed in a tea solution for 7.5 days. The specimens were randomly divided into five groups according to the whitening agent applied: 1) 94% NaHCO3, 2) a blend of 94% NaHCO3 and CPP-ACPF, 3) a blend of 94% NaHCO3 and 1.5% H2O2, 4) a blend of 94% NaHCO3, 1.5% H2O2 and CPP-ACPF, 5) control. The whitening procedure was performed for 10 times over 10 days. At each day, the buccal surfaces were covered with whitening agents for 5 minutes and then brushed for 30 seconds. After the 10 days, the teeth were again immersed in a tea solution for 10 minutes. Color assessment was performed at baseline (T1), after the first staining process (T2), after the whitening procedure (T3), and after the second staining process (T4). Finally, the specimens were subjected to microhardness test. There was a statistically significant difference in the color change between T2 and T3 stages among the study groups (p<0.05), with the greatest improvement observed in group 4. Microhardness was significantly greater in groups 2 and 4, as compared to the other groups (p<0.05). The combination of 94% NaHCO3, 1.5% H2O2 and CPP-ACPF was effective in improving color and microhardness of teeth with extrinsic stains and could be recommended in the clinical situation

Effect of garlic (Allium sativum) on male fertility: a systematic review

Introduction: Fertility in men mainly depends on the number, quality, motility, and morphology of the sperms, and disruption of each of these factors leads to infertility. A large number of couples suffer from infertility problems. Among the various therapies, medicinal herbs are used in many countries to treat male infertility. Current systematic review was conducted to study the effects of garlic on male fertility. Methods: The information of this systematic review was collected by searching the key words: treatment, fertility, infertility, male, herbal medicine, garlic, Allium sativum, medicinal plant, sperm, sex hormones, testis and spermatogenesis in international databases such as: Web of Science (ISI), PubMed, Scopus and Embase until March 2018. This study was conducted in accordance with the PRISMA statement for systematic reviews and meta- analysis. and the SYRCLE risk of bias tool was used for qualitative assessment. Results: A total of 18 experimental studies were included in the study. Thirteen studies evaluated garlic and 5 studies compared garlic effect with adriamycin, titanium dioxide, furan, vitamin E, N-acetylcysteine and cadmium. All studies were conducted in in vivo condition. The results of the studies indicated the potential effect of garlic on enhancing fertility and spermatogenesis, increasing the level of testosterone and improving the testicular structure. Conclusion: Garlic can increase fertility probably due to its antioxidant properties. However, more clinical trials are recommended

The effect of cold application and lavender oil inhalation in cardiac surgery patients undergoing chest tube removal

Post-surgical chest tube removal (CTR) is associated with a significant pain and discomfort for patients. Current treatment strategies for reducing CTR-associated pain and anxiety are limited and partially efficacious. To determine the effects of cold application, inhalation of lavender essential oil, and their combination on pain and anxiety during CTR was investigated. This randomized controlled open-label trial was conducted with 80 p atients in the cardiac surgery intensive care unit who had a chest tube for duration of at least 24 hours after coronary artery bypass grafting (CABG). Patients were randomized (n=20 in each group) to receive cold application, aromatherapy with lavender oil, cold application in combination with lavender oil inhalation, or none of the above interventions (control group). The intensity and quality of pain and anxiety were evaluated using the visual analogue scale, short form and modified-McGill pain questionnaire (SFM-MPQ) and the Spielberger situational anxiety level inventory (STAII) scale, respectively. Patients in all treatment groups had significantly lower pain intensity and anxiety compared with the control group immediately, 5, 10 and 15 min after CTR. There was no statistically significant difference in the SFM-MPQ total scores between the intervention groups. With respect to anxiety score, there was a significantly reduced anxiety level immediately after CTR in the aromatherapy and cold-aromatherapy combination groups versus the cold application group. The present results suggested the efficacy of cold application and aromatherapy with lavender oil in reducing pain and anxiety associated with post-CABG CTR

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Effect of neurofeedback on sustaining attention in children with attention deficit-hyperactivity disorder

Purpose of current study was to investigate the effect of neurofeedback therapy on sustaining attention in children with attention deficit- hyperactivity disorder. In this study, 36 children (21 boys and 15 girls) were selected. For pretest and post-test, integrated visual and auditory continuous performance test was used. After 40 sessions of strengthening the sensory-motor rhythm 12-15 Hz and suppressing 1-8 Hz as well as 22-32 Hz frequency bands, the results of dependent t-test showed significant difference in sustaining attention (p<0.000) whereas there was no significant difference between girls and boys. On the whole, integrated visual and auditory continuous performance test was an effective way to measure sustaining attention in children attention deficit-hyperactivity disorder. Also, neurofeedback therapy as a non-medical intervention improved the continuous performances especially sustaining attention

Reliability of the Emergency Severity Index : Meta-analysis

Objectives: Although triage systems based on the Emergency Severity Index (ESI) have many advantages in terms of simplicity and clarity, previous research has questioned their reliability in practice. Therefore, the aim of this meta-analysis was to determine the reliability of ESI triage scales. Methods: This metaanalysis was performed in March 2014. Electronic research databases were searched and articles conforming to the Guidelines for Reporting Reliability and Agreement Studies were selected. Two researchers independently examined selected abstracts. Data were extracted in the following categories: version of scale (latest/older), participants (adult/paediatric), raters (nurse, physician or expert), method of reliability (intra/inter-rater), reliability statistics (weighted/unweighted kappa) and the origin and publication year of the study. The effect size was obtained by the Z-transformation of reliability coefficients. Data were pooled with random-effects models and a meta-regression was performed based on the method of moments estimator. Results: A total of 19 studies from six countries were included in the analysis. The pooled coefficient for the ESI triage scales was substantial at 0.791 (95% confidence interval: 0.787‒0.795). Agreement was higher with the latest and adult versions of the scale and among expert raters, compared to agreement with older and paediatric versions of the scales and with other groups of raters, respectively. Conclusion: ESI triage scales showed an acceptable level of overall reliability. However, ESI scales require more development in order to see full agreement from all rater groups. Further studies concentrating on other aspects of reliability assessment are needed

The effects of different carbohydrate-whey protein ratio on IL-6 and IL-10 cytokines after high intensity exercise in healthy young girls

Background: In previous studies, pro-inflammatory and anti-inflammatory cytokines were shown to increase after physical activity. The purpose of this study was to examine the effects of different carbohydrate-protein supplementation ratio on plasma levels of IL-6 and IL-10 after high-intensity exercise in healthy young females. Materials and Methods: Twenty seven volunteer females aged 20-25 year divided into three groups: 1-placebo, 2- carbohydrate-protein (3:1), and carbohydrate-protein (4:1). After 12 h fasting, subjects have standard breakfast and then completed anaerobic test at 10 AM. Subjects received one of supplementations pre-, post-, and 2 h after test. Blood samples were taken before, immediately and 2 h after exercise. Data were analyzed by MANOVA and repeated measure ANOVA. Statistical significance was accepted at the 0.05 level. Results: IL-6 and IL-10 increased significantly after test and then 2 hours after test IL-6 decreased and IL-10 remained high in all groups. IL-10 and IL-6 cytokines didn�t differ between groups. Although, IL-10 was higher and IL-6 was lower in carbohydrate-protein (4:1) group than placebo group at two hours after exercise but those were not statistically significant. Conclusion: carbohydrate-protein (4:1 ratio) supplementation resulted to some extent in improvements in cytokine responses at 2 hours after high-intensity exercise test

Presenting a Framework for Conceptualizing Knowledge Management Office

Designing an effective structure for knowledge management is one of the critical factors for its success in the organization. Structuring to KM and identifying the experts of this field in the structure of the organization is necessary to achieve the sustained and continuous benefits of knowledge management. This paper deals with the conceptualizing of knowledge management office as the organizational structure for effective management of knowledge. For this purpose, Meta-synthesize methodology was adopted. From 198 sources founded, 12 articles were consistent with accepted standards. As a result of combining the findings, concept of knowledge management office was figured with 54 codes, 12 concepts in the four themes including purpose (Strategic and Functional), structure (Centralized and Decentralized and Mixed), function (Strategies, Processes and Mechanisms) and role (KM Committee, CKO, knowledge manager, Knowledge Representative). Organizations can use the results of this study to establish an appropriate structure of knowledge management. According to research, any article was not found by the researchers that have has this integrity and methodology. So, this paper has innovation

The Effects of Ceftriaxone on Histology, Histomorphometry, and Histochemistry of Testis and Sperm Characteristics in Mice

Background and Objectives: Ceftriaxone is a third-generation cephalosporin antibiotic, which has a broad-spectrum activity against bacteria. Recently, its adverse effects on the reproductive system, was revealed. The aim of this study was to investigate the adverse effects of ceftriaxone on testicular tissue in adult male mice. Methods: A total of 40 adult male mice were randomly divided into 5 groups: Control group received normal saline; the first and second experimental groups, respectively, received ceftriaxone at doses of 20 and 50mg/kg bw for 7 days; and the third and fourth groups, respectively, received 20 and 50mg/kg bw of the drug for 45 days. After preparation of tissue sections, routine and specific staining was performed, and histological, histomorphometric, and histochemical studies were carried out. The data were analyzed by one-way ANOVA and Tukey&rsquo;s test. Significance level was considered as p<0.05.&nbsp; Results: The histological evaluations in experimental groups showed changes as atrophy of some seminiferous tubules, decrease in the spermatogenesis and sertoli as well as disruption and disintegration. Morphometric studies showed significant decreases (p0.05) in the interstitial tissue thickness in all the experimental groups compared to the control group. In the experimental groups, Sudan Black and alkaline phosphatase reactions were intense, while PAS reaction was weak. Conclusion: Ceftriaxone damages testicular structure, which includes loss of balance of the spermatogenic cell population and decrease in the spermatogenesis and spermiogenesis processes. &nbsp