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Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device. [ABSTRACT FROM AUTHOR]

Providing safe drinking water for the entire world's population is essential for ensuring sustainable development. The presence of harmful compounds in aquifers, majorly toxic elements, is a serious environmental concern around the globe. This research aimed to quantify for the initial period the amounts of toxic elements in freshwater in the Dehradun Industrial Region of Uttrakhand, India, as well as the associated health risks. The PTEs (potentially toxic elements) Fe, Cd, Mn, Cu, Cr and Pb, Zn, Ni is measured by AAS and compared to BIS and WHO requirements for drinking safety. The order of mean trace element values in all groundwater samples were determined as Fe > Zn > Cu > Ni > Co > Cd > Pb. HPI was discovered to be higher than high class during the research period (HPI > 30), but under the severe contamination criterion of 100. Iron's MI and PI values were consistently over the threshold limit during the research period, and certain toxic elements were discovered exceptionally near the threshold limit, indicating a severe future influence on groundwater quality. According to PCA (principal component analysis), CM (correlation matrix), and potential health hazard, maximum levels of toxic elements in groundwater in the Dehradun region are attributed to land use patterns, anthropogenic activity, industrial activity, fertilizer and pesticide leaching, and residential waste into the aquifer system. The findings of this study could aid local planners and policymakers in preventing health risks from contaminated aquifers through the deployment of suitable monitoring and mitigation measures. [ABSTRACT FROM AUTHOR]

Aim: An accurate working length (WL) estimation is fundamental to a successful endodontic therapy. The objective of this comparative in vitro research was to investigate the performance of iPex II and the Root ZX Mini electronic apex locators (EALs) in measuring root canal WL with different irrigant solutions and their relation to the electrical conductivity of irrigation solutions. Materials and Methods: Seventy sound permanent lower premolar teeth, each with a single root and developed apices, were used. Under an X15 stereomicroscope, the real working length was determined with the aid of a #10 file. After that, teeth were placed into an alginate model, and the iPex II and Root ZX Mini were used for the detection of electronic working length with various irrigants. Seventy teeth were randomly distributed into seven groups, 10 per each group (group I: dry canal; group II: distilled water; group III: ozonated water; group IV: 5% sodium hypochlorite (NaOCl); group V: 2% chlorhexidine, group VI: 17% ethylenediaminetetraacetic acid (EDTA) solution, and group VII: 17% EDTA gel). The difference in WL was calculated by deducting real working length from its electronic working length. The study also evaluates the electrical conductivity of the seven endodontic irrigant solutions. The two-way analysis of variance (ANOVA) test was used for statistical analysis. Results: Statistically, neither both types of EALs (P = 0.088) nor various irrigating solutions with varying electrical conductivities (P = 0.099) significantly affect the accuracy of EL estimation. Conclusions: There were no significant differences between the accuracy of the Root ZX Mini and the iPex II. The accuracy of both apex locators is unaffected in the presence of various irrigation solutions with varying electrical conductivities in this research. [ABSTRACT FROM AUTHOR]

The increasing frequency of zoonotic spillover events and viral mutations in low and middle-income countries presents a critical global health challenge. Contributing factors encompass cultural practices like bushmeat consumption, wildlife trade for traditional medicine, habitat disruption, and the encroachment of impoverished settlements onto natural habitats. The existing "vaccine gap" in many developing countries exacerbates the situation by allowing unchecked viral replication and the emergence of novel mutant viruses. Despite global health policies addressing the root causes of zoonotic disease emergence, there is a significant absence of concrete prevention-oriented initiatives, posing a potential risk to vulnerable populations. This article is targeted at policymakers, public health professionals, researchers, and global health stakeholders, particularly those engaged in zoonotic disease prevention and control in low and middle-income countries. The article underscores the importance of assessing potential zoonotic diseases at the animal-human interface and comprehending historical factors contributing to spillover events. To bridge policy gaps, comprehensive strategies are proposed that include education, collaborations, specialized task forces, environmental sampling, and the establishment of integrated diagnostic laboratories. These strategies advocate simplicity and unity, breaking down barriers, and placing humanity at the forefront of addressing global health challenges. Such a strategic and mental shift is crucial for constructing a more resilient and equitable world in the face of emerging zoonotic threats. [ABSTRACT FROM AUTHOR]

Nurses' household preparedness is critical if they are to avoid role conflict and report for duty during an emergency. To date, the alignment between nurses' perceived and actual household preparedness remains under examined. Investigating one of these variables in isolation fails to consider that perceived and actual household preparedness must be high and aligned. If misaligned, vulnerabilities could surface during emergencies, like concerns about family safety, potentially impacting a nurse's commitment to duty during a crisis, or nurses may lack the actual preparedness to continue working long hours during an emergency. An online questionnaire was distributed to registered nurses in Ireland. The questionnaire was informed by a review of the literature and captured nurses' perceived and actual household preparedness, attitudes towards and exposure to a range of emergencies, and pertinent demographic characteristics. The results showed a relationship between how nurses view their household preparedness and their actual preparedness. Regression analyses indicate that while there is an overlap, the factors associated with how prepared nurses think they are and how prepared they are can differ. This means that strategies to boost actual preparedness may differ from those needed to boost perceived preparedness. This finding underscores the importance of psychosocial preparedness. Feeling prepared is crucial as it can influence how one responds in an emergency. Considering both the perceived and actual aspects of household preparedness can lead to a more effective response during emergencies. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to evaluate the knowledge, attitude, and practice (KAP) of endodontists in India for working length measurements using Apex locators. Methods: This study is an online questionnaire-based survey consisting of 24 questions in total, divided into five parts. The first part consisted of questions related to demographic details, the second part inquires about the tools and technology used for working length determination, and the remaining questions evaluate the KAP regarding the use of apex locators to determine working length (five questions each). Participants in the study were either pursuing or completed postgraduation in endodontics. A total of 257 responses were recorded; however, six participants were excluded due to incomplete submission. Thus, 251 responses were analyzed as descriptive analyses. Correlation analysis and Chi-square tests were performed to find any association between demographic variables and years of experience in practice with KAP of using apex locators by endodontists. Results: In this study, it was observed that the knowledge of the majority of endodontic practitioners was fair, with a positive attitude and practice of using apex locators. Knowledge of the study participants was significantly (P ≤ 0.05) associated with the good attitude and practice of the study participants. Furthermore, years of experience in practice have a positive association with the KAP of endodontists. Conclusion: It can be concluded that endodontists have better clinical acceptance, as they show positive attitudes and practices for using apex locators for working length determination. [ABSTRACT FROM AUTHOR]

Global health security is an increasingly complex regime. The failures of global governance and norms of cooperation during the coronavirus disease 2019 (COVID-19) pandemic and the re-entrenchment to nationalist policy-making have created impetus for new governance arrangements, institutions and policy development. These changes include amendments to the International health regulations (IHR), development of a pandemic convention or accord, convening of the High- Level Meeting on Pandemic Preparedness and Response, establishment of the Pandemic Fund, and development of the medical countermeasures platform, among others. These various developments claim to be in synergy with each other, but understanding of regime complexes and forum shifting from international relations reveal the power dyna mics which underlie these processes. I use these concepts to demonstrate how states are transferring negotiations from one institutional location to another in search of more favourable outcomes, or are creating strategic uncertainty within negotiations to avoid future accountability. I further highlight three risks posed by these developments: (i) an increasingly complex landscape for global health security; (ii) erosion of the World Health Organization's authority in global health security; and (iii) dominance of high-income state positions within these negotiations. La securite sanitaire mondiale est un systeme de plus en plus complexe. Les echecs essuyes par la gouvernance mondiale et les normes en matiere de cooperation durant la pandemie de maladie a coronavirus 2019 (COVID-19), ainsi que le retour a une elaboration nationaliste des politiques, ont entraine la creation de mecanismes de gouvernance, destitutions et de programmes politiques inedits. Ces transformations se traduisent notamment par des amendements au Reglement sanitaire international (RSI), la mise au point d'une convention ou d'un accord face aux pandemies, l'organisation de la Reunion de haut niveau inedite sur la prevention, la preparation et la riposte face aux pandemies, l'etablissement du Fonds de lutte contre les pandemies, mais aussi l'instauration de la plateforme de contre-mesures medicales. Ces differents changements affirment reuvrer en synergie, mais la comprehension des complexites du systeme et revolution des debats, qui se detachent des relations internationales, revelent les dynamiques de pouvoir qui sous-tendent ces processus. J'utilise ces concepts pour montrer comment les Etats transferent les negociations d'un siege institutionnel a l'autre en quete de resultats plus favorables, ou creent une incertitude strategique dans le cadre des negociations pour se soustraire a de futures responsabilites. Je souligne egalement trois risques que comportent ces changements: (i) un paysage sans cesse plus complexe pour la securite sanitaire mondiale; (ii) l'erosion de l'autorite exercee par l'Organisation mondiale de la Sante en la matiere; et enfin, (iii) la position dominante des Etats a revenu eleve dans les negociations. La seguridad sanitaria mundial es un sistema cada vez mas complejo. Los fracasos de la gobernanza mundial y de las normas de cooperacion durante la pandemia de la enfermedad por coronavirus de 2019 (COVID-19) y el repliegue hacia la formulacion de politicas nacionalistas han impulsado nuevos acuerdos de gobernanza, instituciones y desarrollo de politicas. Estos cambios incluyen enmiendas al Reglamento Sanitario Internacional (RSI), el desarrollo de una convencion o acuerdo sobre pandemias, la convocatoria de la Reunion de Alto Nivel sobre Preparacion y Respuesta ante Pandemias, el establecimiento del Fondo para Pandemias y el desarrollo de la plataforma de contramedidas medicas, entre otros. Estos diversos desarrollos pretenden funcionar en sinergia, pero la comprension de las complejidades del sistema y la evolucion de los debates, al margen de las relaciones internacionales, revelan la dinamica de poder que subyace a estos procesos. Utilizo estos conceptos para demostrar como los Estados trasladan las negociaciones de un lugar institucional a otro en busca de resultados mas favorables o crean incertidumbre estrategica dentro de las negociaciones para evadir futuras responsabilidades. Ademas, destaco tres riesgos que plantean estos acontecimientos: (i) un panorama cada vez mas complejo para la seguridad sanitaria mundial; (ii) la perdida de autoridad de la Organizacion Mundial de la Salud en materia de seguridad sanitaria mundial; y (iii) el predominio de las posiciones de los Estados de ingresos altos en estas negociaciones., Introduction Global health security, defined by the World Health Organization (WHO) as 'the activities required, both proactive and reactive, to minimize the danger and impact of acute public health events [...]