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Background: The aim of this study was to investigate the effect of an immune-boosting beverage with Sambucus nigra (SAM), an energy beverage (ENE), an in-office bleaching agent with a novel composition, and a fine-grain professional dental prophylaxis (PDP) paste on the surface roughness (Ra) and microhardness (MH) of CAD/CAM restorative materials over time., Methods: Feldspathic ceramic (FC) and polymer infiltrated ceramic network (PICN) specimens were prepared (N = 126). Glazing, polishing, bleaching and immersion in beverages groups were formed. Bleaching gel containing 25% Hydrogen Peroxide Superior was applied to the specimens with a bleaching pen. Ra and MH were measured at five time points of baseline, days 1, 14, 28 and after PDP. Scanning electron microscopy (SEM) images were taken after PDP. Statistics were performed by ANOVA and Bonferroni tests (α = 0.05)., Results: Ra increased over time regardless of material type, polishing method, beverage type and bleaching (p < 0.0001). Glazed and polished FCs caused higher roughness than PICN, SAM and ENE than distilled water, and bleaching than no bleaching (p < 0.0001). For glazed or polished FCs, MH decreased slightly lower at all time points, but for PICN, MH increased until day 28, not changing after PDP. Beverages decreased the MH of ceramics at all time points, but PDP did not lead to a change for PICN (p < 0.0001). The MH decreased more in bleached specimens than in non-bleached specimens up to day 28 (p < 0.0001). According to the SEM images after PDP, the glazed FC had numerous crack marks, pores and detached particles. The polished FC had traces of mechanical polishing. The polymer part of the PICN had voids, but the ceramic part was better preserved., Conclusions: Both energy beverages and immune-boosting beverages can increase roughness on FCs compared to PICNs. There was no significant difference between glazing and polishing in terms of lower roughness in FCs. PDP tended to slightly increase the roughness for ceramics, while it tended not to change it for PICN. Beverages decreased the microhardness of ceramics. PDP further decreased the microhardness in glazed ceramics, but increased it in polished ones. In PICN the microhardness increased over time, but decreased slightly after PDP., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval is not applicable as this is an in vitro study in which humans and animals, including materials/data, are not used for experimental purposes. Consent for publication: As this article is an in vitro study not involving human use, consent for publication is not required. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Resin composite restorations are highly esthetic restorations, which should have and maintain high surface polish. However, esthetic restorations are subjected to different beverages at variable temperatures, which may affect their surface roughness. This study aimed to evaluate the surface roughness of single-shade (Omnichroma) and multi-shade (Filtek Z350XT) composite materials, following aging by immersion and thermocycling in different beverages, simulating one year of clinical service., Methods: Thirty specimens of each material were prepared and divided into 6 subgroups (n = 5). In each material, the grouping of the specimens was as follows: the first subgroup was the as-prepared specimens stored dry without immersion or thermocycling. The second, third, and fourth subgroups were immersed in saliva, tea, and red wine, respectively, for 12 days at 37 °C. The fifth and sixth subgroups were thermocycled for 10,000 cycles, in tea (the fifth between 37 and 57 °C) and in red wine (the sixth between 37 °C and12°C). The resultant surface roughness was measured by two different methods, stylus profilometer and atomic force microscopy (AFM). Intergroup comparison was performed using independent t test, while intragroup comparison was performed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test., Results: Intergroup comparison between both composites showed no statistically significant differences in all groups using the stylus profilometer roughness measurements (P>0.05), while the AFM measurements showed significant difference (P ≤ 0.05) within all storage media except the as-prepared control (P = 0.0645), where nanofilled Filtek Z350 XT showed lower nano-roughness. Intragroup comparison data were variable, depending on the material, aging conditions, and roughness assessment tool. However, the resultant average surface roughness (R a ) values in all groups did not exceed the threshold value of R a 0.2 μm., Conclusions: Both resin composites attained and retained a clinically acceptable surface finish after immersion and thermocycling in different beverages., (© 2023. The Author(s).)

Background: Currently, the demands for restorations have increased considerably; thus, improvements and modifications have been made in dental composite technologies especially using materials that have been claimed to improve color stability., Objective: This study aimed to determine the effect of various solutions on the color stability of different restorative materials in vitro study., Methods: This study used three types of esthetic restorative materials. The samples comprised 45 discs, including 15 micro-hybrids, 15 nano-hybrids, and 15 glass ionomers). These discs were immersed in various beverages an hour a day for one month at room temperature. The color stability was measured using a spectrophotometer before/after immersion (days 7 and 30)., Results: We realized a significant difference in color change with Coca-Cola and tea-milk solution after seven days and 30 days (p < 0.05). However, no significant difference was found in the samples immersed in DM after seven days and 30 days (p > 0.05). The highest value of lightness (∆L) and stainability (∆a) was seen in micro-hybrid after 30 days of immersion in tea-milk solution (- 12.16 ± 1.74 and 11.4 ± 3.82, respectively), while most samples had a positive ∆b value., Conclusion: After one month, the tea-milk solution affected the color stability of all used restorative materials. In addition, micro-hybrid had higher color stability than nano-hybrid and glass ionomer., (© 2023. The Author(s).)

Background: The increasing demand for childbirth care based on physiological principles has led official bodies to encourage health centers to provide evidence-based care aimed at promoting women's participation in informed decision-making and avoiding excessive medical intervention during childbirth. One of the goals is to reduce pain and find alternative measures to epidural anesthesia to enhance women's autonomy and well-being during childbirth. Currently, water immersion is used as a non-pharmacological method for pain relief. This review aimed to identify and synthesize evidence on women's and midwives' experiences, values, and preferences regarding water immersion during childbirth. Methods: A systematic review and thematic synthesis of qualitative evidence were conducted. Databases were searched and references were checked according to specific criteria. Studies that used qualitative data collection and analysis methods to examine the opinions of women or midwives in the hospital setting were included. Non-qualitative studies, mixed-methods studies that did not separately report qualitative results, and studies in languages other than English or Spanish were excluded. The Critical Appraisal Skills Program Qualitative Research Checklist was used to assess study quality, and results were synthesized using thematic synthesis. Results: Thirteen studies met the inclusion criteria and were included in this review. The qualitative studies yielded three key themes: 1) reasons identified by women and midwives for choosing a water birth, 2) benefits experienced in water births, and 3) barriers and facilitators of water immersion during childbirth. Conclusions: The evidence from qualitative studies indicates that women report benefits associated with water birth. From the perspective of midwives, ensuring safe water births requires adequate resources, midwives training, and rigorous standardized protocols to ensure that all pregnant women can safely opt for water immersion during childbirth with satisfactory results. [ABSTRACT FROM AUTHOR]

Background: This systematic review and network meta-analysis assessed via direct and indirect comparisons the recovery effects of hydrotherapy and cold therapy at different temperatures on exercise induced muscle damage. Methods: Five databases were searched in English and Chinese. The included studies included exercise interventions such as resistance training, high-intensity interval training, and ball games, which the authors were able to define as activities that induce the appearance of EIMD. The included RCTs were analyzed using the Cochrane Risk of Bias tool. Eligible studies were included and and two independent review authors extracted data. Frequentist network meta-analytical approaches were calculated based on standardized mean difference (SMD) using random effects models. The effectiveness of each intervention was ranked and the optimal intervention was determined using the surface under the cumulative ranking curve (SUCRA) indicator. Results: 57 studies with 1220 healthy participants were included, and four interventions were examined: Cold Water Immersion (CWI), Contrast Water Therapy (CWT), Thermoneutral or Hot Water Immersion (TWI/HWI), and Cryotherapy(CRYO). According to network meta-analysis, Contrast Water Immersion (SUCRA: 79.9%)is most effective in recovering the biochemical marker Creatine Kinase. Cryotherapy (SUCRA: 88.3%) works best to relieve Delayed Onset Muscle Soreness. In the recovery of Jump Ability, cryotherapy (SUCRA: 83.7%) still ranks the highest. Conclusion: We found that CWT was the best for recovering biochemical markers CK, and CRYO was best for muscle soreness and neuromuscular recovery. In clinical practice, we recommend the use of CWI and CRYO for reducing EIMD. Systematic Review Registration: [PROSPERO], identifier [CRD42023396067]. [ABSTRACT FROM AUTHOR]

Background: Because carbon dioxide (CO 2 )-enriched water causes cutaneous vasodilation, immersion in CO 2 -enriched water facilitates heat transfer from the body to the water or from the water to the body. Consequently, immersion in CO 2 -enriched water raises or reduces body temperature faster than immersion in fresh water. However, it takes time to dissolve CO 2 in tap water and because the dissolved CO 2 concentration decreases over time, the actual CO 2 concentration is likely lower than the stated target concentration. However, it is unclear whether water containing a lower CO 2 concentration would also cool the body faster than fresh water after body temperature had been increased., Methods: Ten healthy males (mean age = 20 ± 1 years) participated in the study. Participants were first immersed for 15 min in a tap water bath at 40 °C to raise body temperature. They then moved to a tap water or CO 2 -enriched water bath at 30 °C to reduce body temperature. The CO 2 concentration was set at 500 ppm. The present study measured cooling time and cooling rate (slope of the regression line relating auditory canal temperature (T ac ) to cooling time) to assess the cooling effect of CO 2 -enriched water immersion., Results: Immersion in 40 °C tap water caused T ac to rise 0.64 ± 0.25 °C in the tap water session and 0.62 ± 0.27 °C in the CO 2 -enriched water session (P > 0.05). During the 30 °C water immersion, T ac declined to the baseline within 13 ± 6 min in tap water and 10 ± 6 min in CO 2 -enriched water (P > 0.05). Cooling rates were 0.08 ± 0.06 °C/min in tap water and 0.08 ± 0.04 °C/min in CO 2 -enriched water (P > 0.05)., Conclusions: CO 2 -enriched water containing 500 ppm CO 2 did not cool faster than tap water immersion. This suggests that when the water temperature is 30 °C, a CO 2 concentration of 500 ppm is insufficient to obtain the advantageous cooling effect during water immersion after body temperature has been increased., (© 2021. The Author(s).)

Background: The purpose of this study evaluates and compares the effect of surface roughness (Ra) and color stability on computer-aided design/computer-aided manufacturing (CAD/CAM) hybrid resin (Vita Enamic), feldspathic (Vitablocs® Mark II), and lithium disilicate Zirconia (Vita Suprinity) glazed or polished ceramics immersed in hot Arabic Qahwa and cold coffee., Methods: A total of 96 standardized samples were prepared from CAD/CAM restorative materials. Half of the samples were polished as per the manufacturer's instructions using a porcelain polishing kit, and the other half were glazed. Samples were distributed and immersed in hot Arabian Qahwa and cold coffee followed by thermocycling. Ra measurements and color changes were conducted before and after immersion. SEM images were captured from each type of glazed or polished ceramic. One-way ANOVA paired Student's t-test, and Bonferroni test were conducted to detect significant difference between the groups. P > 0.05 was a significant level., Results: Of all the tested samples, Ra increased without any significant difference; however, mean color changes (ΔE*) showed significant differences. An increase in Ra was noted for all the glazed and polished samples after immersion and thermocycling. However, differences were significant only in VM II. In addition, ΔE* was significant only in Vita Suprinity (VS) samples. For immersion groups, significant Ra changes were noticed in glazed samples, only in Vita Enamic (VE) with no ΔE*. In polished samples, mean Ra changes were observed in VM II and VS samples. Significant differences were also noticed in polished VE and VS subgroups of ΔE*., Conclusions: Ra affects all the tested samples, providing higher values on the polished specimens. The ΔE* caused by hot Arabic Qahwa and cold coffee on glazed or polished CAD/CAM restorative materials were clinically acceptable., (© 2021. The Author(s).)

Background: Failure of surgical fixation in orthopaedic fractures occurs at a significantly higher rate in osteoporotic patients due to weakened osteoporotic bone. A therapy to acutely improve the mechanical properties of bone during fracture repair would have profound clinical impact. A previous study has demonstrated an increase in mechanical properties of acellular cortical canine bone after immersion in raloxifene. The goal of this study was to determine if similar treatment yields the same results in cancellous fetal bovine bone and whether this translates into a difference in screw pull-out strength in human cadaveric tissue., Methods: Cancellous bone from fetal bovine distal femora underwent quasi-static four-point bending tests after being immersed in either raloxifene (20 μM) or phosphate-buffered saline as a control for 7 days (n = 10). Separately, 5 matched pairs of human osteoporotic cadaveric humeral heads underwent the same procedure. Five 3.5 mm unicortical cancellous screws were then inserted at standard surgical fixation locations to a depth of 30 mm and quasi-static screw pull-out tests were performed., Results: In the four-point bending tests, there were no significant differences between the raloxifene and control groups for any of the mechanical properties - including stiffness (p = 0.333) and toughness (p = 0.546). In the screw pull-out tests, the raloxifene soaked samples and control samples had pullout strengths of 122 ± 74.3 N and 89.5 ± 63.8 N, respectively., Conclusions: Results from this study indicate that cancellous fetal bovine samples did not demonstrate an increase in toughness with raloxifene treatment, which is in contrast to previously published data that studied canine cortical bone. In vivo experiments are likely required to determine whether raloxifene will improve implant fixation.

Background: Water immersion during labour can provide benefits including reduced need for regional analgesia and a shorter labour. However, in the United Kingdom a minority of women use a pool for labour or birth, with pool use particularly uncommon in obstetric-led settings. Maternity unit culture has been identified as an important influence on pool use, but this and other possible factors have not been explored in-depth. Therefore, the aim of this study was to identify factors influencing pool use through qualitative case studies of three obstetric units and three midwifery units in the UK., Methods: Case study units with a range of waterbirth rates and representing geographically diverse locations were selected. Data collection methods comprised semi-structured interviews, collation of service documentation and public-facing information, and observations of the unit environment. There were 111 interview participants, purposively sampled to include midwives, postnatal women, obstetricians, neonatologists, midwifery support workers and doulas. A framework approach was used to analyse all case study data., Results: Obstetric unit culture was a key factor restricting pool use. We found substantial differences between obstetric and midwifery units in terms of equipment and resources, staff attitudes and confidence, senior staff support and women's awareness of water immersion. Generic factors influencing use of pools across all units included limited access to waterbirth training, sociodemographic differences in desire for pool use and issues using waterproof fetal monitoring equipment., Conclusions: Case study findings provide new insights into the influence of maternity unit culture on waterbirth rates. Access to pool use could be improved through midwives based in obstetric units having more experience of waterbirth, providing obstetricians and neonatologists with information on the practicalities of pool use and improving accessibility of antenatal information. In terms of resources, recommendations include increasing pool provision, ensuring birth room allocation maximises the use of unit resources, and providing pool room environments that are acceptable to midwives.

Background: There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic., Methods: This mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia. Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire. Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth. Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts., Results: The majority (85%; 29 of 34) of midwives surveyed returned a questionnaire. Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven. Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth. Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance. Phase two included two focus groups of seven and five midwives. Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth., Conclusions: This research contributes to the growing knowledge base examining midwives' education, knowledge and practice around immersion in water for labour or birth. It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are integral to sustaining waterbirth as an option for low risk women.

The purpose of this study was to investigate the effects of elevated core temperature by exposure to heat stress vs. heat exposure without elevated core temperature (mean skin temperature only) in addition to mental fatigue on aerobic exercise capacity in the heat. Seven highly trained athletes completed two experimental conditions: elevation in core and skin temperatures (hyperthermia: HYP), and skin temperatures (SKIN). Participants performed the AX-Continuous Performance Task and Stroop Task to induce mental fatigue during a warm water immersion at 40 °C (HYP) and a passive seated heat exposure in a climatic chamber at 35 °C and 60% relative humidity (SKIN) for 45 min before exercise. Thereafter, participants performed running trial at 80% maximal oxygen uptake until voluntary exhaustion in the same chamber as the SKIN. Exercise time to exhaustion was significantly shorter in the HYP trial (538 ± 200 s) than in the SKIN trial (757 ± 324 s). Rectal temperature at the end of tasks in the HYP trial increased by 0.86 ± 0.26℃ and was significantly higher (37.69 ± 0.18℃) than that of the SKIN trial (36.96 ± 0.13℃), albeit no significant differences in mean skin temperature. Self-reported mental fatigue using visual analog scale was significantly higher after tasks in both trials, but no significant difference between trials was found. Throughout the trial, salivary cortisol concentration and perceptual responses were not affected by hyperthermia. This study demonstrated that a combination of high core temperature and mean skin temperature, and mental fatigue limit aerobic exercise capacity in highly trained athletes in hot environments compared with heat exposure without an elevation of core temperature. [ABSTRACT FROM AUTHOR]

Background: Vinyl polyether silicone (VPES) is a novel impression biomaterial made of a combination of vinyl polysiloxane (VPS) and polyether (PE). Thus, it is significant to assess its properties and behaviour under varied disinfectant test conditions. This study aimed to assess the dimensional stability of novel VPES impression material after immersion in standard disinfectants for different time intervals. Methods: Elastomeric impression material used –medium body regular set (Monophase) [Exa'lence GC America]. A total of 84 Specimens were fabricated using stainless steel die and ring (ADA specification 19). These samples were distributed into a control group (n=12) and a test group (n=72). The test group was divided into 3 groups, based on the type of disinfectant used - Group-A- 2% Glutaraldehyde, Group-B- 0. 5% Sodium hypochlorite and Group-C- 2% Chlorhexidine each test group was further divided into 2 subgroups (n=12/subgroup) based on time intervals for which each sample was immersed in the disinfectants – subgroup-1- 10 mins and Subgroup 2- 30 mins. After the impression material was set, it was removed from the ring and then it was washed in water for 15 seconds. Control group measurements were made immediately on a stereomicroscope and other samples were immersed in the three disinfection solutions for 10 mins and 30 mins to check the dimensional stability by measuring the distance between the lines generated by the stainless steel die on the samples using a stereomicroscope at x40 magnification. Results: The distance measured in the control group was 4397.2078 µm and 4396.1571 µm; for the test group Group-A- 2% Glutaraldehyde was 4396.4075 µm and 4394.5992 µm; Group-B- 0. 5% Sodium hypochlorite was 4394.5453 µm and 4389.4711 µm Group-C- 2% Chlorhexidine was 4395.2953 µm and 4387.1703 µm respectively for 10 mins and 30 mins. Percentage dimensional change was in the range of 0.02 – 0.25 for all the groups for 10 mins and 30 mins. Conclusions: 2 % Glutaraldehyde is the most suitable disinfectant for VPES elastomeric impression material in terms of dimensional stability and shows minimum dimensional changes as compared to that of 2% Chlorhexidine and 0.5% Sodium hypochlorite. [ABSTRACT FROM AUTHOR]

Background: The temperature changes, chemical agents, and brushing activity that resin composite restorations are exposed to in the oral environment can cause changes in surface roughness. In this study, the aim was to investigate in vitro the clinical one-year surface roughness changes of different types of composites (flowable or conventional) from the same companies by subjecting them to immersion in solutions, brushing, and thermal cycling procedures to simulate intraoral conditions. Methods: Four different resin composite brands were included in the study using both their conventional (Charisma Smart, 3M Filtek Ultimate Universal, Omnichroma, Beautifil II) and flowable resin composites (Charisma Flow, 3M Filtek Ultimate Flowable, Omnichroma Flow, Beautifil Flow Plus F00), giving 4 groups with 2 types of resin composite in each. 40 samples were prepared for each group/resin type, for a total of 320 samples. After initial surface roughness measurements by a mechanical profilometer, the samples were divided into 4 subgroups (n = 10) and immersed in solutions (distilled water, tea, coffee, or wine) for 12 days. The samples were then subjected to 10,000 cycles of brushing simulation and 10,000 cycles of thermal aging. Surface roughness measurements were repeated after the procedures. For statistical analysis, the 3-way analysis of variance and the Tukey test were used (p < 0.05). Results: It was concluded that composite groups and types had an effect on surface roughness at time t0 (p < 0.001). At time t1, the highest surface roughness value was obtained in the Beautifil-conventional interaction. When the surface roughness values between time t0 and t1 were compared, an increase was observed in the Beautifil II and Beautifil Flow Plus F00, while a decrease was observed in the other composite groups. Conclusion: Composite groups, types, and solutions had an effect on the surface roughness of resin composites. After aging procedures, it was concluded that the Beautifil group could not maintain the surface structure as it exceeded the threshold value of 0.2 μm for bacterial adhesion. [ABSTRACT FROM AUTHOR]

Background: The degree of weightlessness during water immersion is usually estimated through percentage weight bearing (PWB). However, variations in PWB in different standing postures have not been documented. The study was designed to investigate the PWB of apparently healthy individuals in four standing postures at the anterior superior iliac spine level of immersion., Methods: One hundred and ninety-three consenting undergraduates were purposively enlisted in this study. Participants' body weight (BW) was measured on land as well as in Erect Standing (ES), Grasp-Inclined-Prone-Standing (GIPS), Half-Grasp-Inclined-Towards-Side Standing (HGITSS) and Inclined-Standing with Head Support (ISHS) postures in hydro pool, using a specially designed water-proof weighing scale. PWB was calculated by dividing BW in water by BW on land and multiplying by 100. Data were analyzed using mean, standard deviation and ANOVA at α = 0.05., Results: The mean age and BW (on land) of the participants were 22.4 years and 60.7 kg respectively. Participants' PWB were significantly different (p < 0.05) across the four standing postures. PWB was highest in ES and lowest in ISHS; PWB in ES (52.3 ± 5.8) being significantly higher (p < 0.001) than that observed in the derived standing postures. Further, PWB in GIPS (43.3 ± 5.6) and ISHS (43.2 ± 7.3) were significantly lower than in HGITSS (47.4 ± 5.2) posture while PWB in GIPS and ISHS postures were not significantly different (p > 0.05)., Conclusion: Changes in standing posture have significant effect on PWB in hydro pool. The finding has implication for partial weight bearing exercises in hydro pool.

Background: Water immersion during the first stage of labor can reduce the length of the first stage and epidural/spinal analgesia use; however, there is limited information regarding other outcomes. Our purpose was to compare maternal and neonatal outcomes of women who underwent water immersion during the first stage of labor with those who underwent conventional labor and delivery., Methods: Healthy primipara with singleton pregnancies and cephalic presentation were included in the study. Patients were allowed to choose water immersion during labor or conventional labor and delivery. For water immersion, the water temperature was maintained at 35-38°C and subjects left the tub on complete cervical dilatation. A visual analogue scale (VAS) was used to assess pain during labor. Other outcome measures included duration of labor, type of delivery, blood loss, pelvic floor dysfunction and symptoms of stress urinary incontinence (SUI) at 42 days after delivery, infant Apgar scores, and need for transfer of the infant to the neonatal intensive care unit., Results: Thirty eight subjects (mean age, 28.66 ± 3.08 y) received water immersion and 70 (mean age, 27.89 ± 2.99 y) underwent conventional labor and delivery. There were no differences in maternal height, weight, age, gestational age, gravidity, and newborn weight between the groups (all, p>0.05). VAS pain scores were significantly greater in the conventional labor group at 30 min and 60 min after a cervical dilatation of 3 cm (30 min: 10 [9, 10] vs. 6 [5, 8]; 60 min: 10 [10, 10] vs. 7 [6, 8], respectively, both, p<0.001). The duration of labor and postpartum bleeding were similar between the groups (all, p>0.05). The cesarean section rate was higher in the conventional labor group (32.9% vs. 13.2%, p=0.026). The 1-minute and 5-minute Apgar scores were similar between the groups. Maternal and neonatal culture results were similar between the groups. SUI symptoms at 42 days after delivery was significantly higher in the conventional labor group (25.5% vs. 6.1%, respectively, p=0.035)., Conclusions: Water immersion can reduce labor pain, and is associated with a lower rate of cesarean delivery and SUI symptoms at 42 days.

Background: Immersion in water during labour is an important non-pharmacological method to manage labour pain, particularly in midwifery-led care settings where pharmacological methods are limited. This study investigates the association between immersion for pain relief and transfer before birth and other maternal outcomes., Methods: A prospective cohort study of 16,577 low risk nulliparous women planning birth at home, in a freestanding midwifery unit (FMU) or in an alongside midwifery unit (AMU) in England between April 2008 and April 2010., Results: Immersion in water for pain relief was common; 50% in planned home births, 54% in FMUs and 38% in AMUs. Immersion in water was associated with a lower risk of transfer before birth for births planned at home (adjusted RR 0.88; 95% CI 0.79-0.99), in FMUs (adjusted RR 0.59; 95% CI 0.50-0.70) and in AMUs (adjusted RR 0.78; 95% CI 0.69-0.88). For births planned in FMUs, immersion in water was associated with a lower risk of intrapartum caesarean section (RR 0.61; 95% CI 0.44-0.84) and a higher chance of a straightforward vaginal birth (RR 1.09; 95% CI 1.04-1.15). These beneficial effects were not seen in births planned at home or AMUs., Conclusions: Immersion of water for pain relief was associated with a significant reduction in risk of transfer before birth for nulliparous women. Overall, immersion in water was associated with fewer interventions during labour. The effect varied across birth settings with least effect in planned home births and a larger effect observed for planned FMU births.

Objective: The aim of our study was to measure the color changes in one-shade composite resins when exposed to common drinks, such as tea, cola and coffee. Materials/Methods: In our study, Omnichroma, Vitrra APS Unique, GC A'chord and Charisma Diamond One composite resins were used. Composite resins were placed in stainless steel molds with depths of 2 mm and diameters of 5 mm. Ten specimens were immersed in tea, 10 specimens were immersed in coffee, 10 specimens were immersed in cola and 10 specimens were immersed in distilled water in an incubator at 37 °C for 14 days. Color measurements were performed at the beginning of the study and after 24 h and 14 days. Color values ​​were measured using a CIE L*a*b* system with a spectrophotometer device. Color and translucency changes were calculated and data analyzed using one-way ANOVA, two-way ANOVA, and post-hoc Tukey test (p < 0.05). Results: The greatest color changes occurred in the tea and coffee groups; the smallest color change occurred in the control group. After 14 days, the greatest color change was observed in the Charisma + Coffee group; the smallest color change was observed in the Omnichroma + Water group. The transparency and contrast ratios changed in all groups, and the smallest change occurred in the Omnichroma control group. Conclusion: Significant differences were found in the composite color changes after immersion in beverages. The color variations significantly differed depending on the beverage in which the specimens were immersed. The initial contrast ratio was markedly different from the examined materials. Clinical significance: The study emphasizes the significance of common beverages on the color stability of one-shade composite resins, underlining the need of appropriate material selection for long-term aesthetic effects in one-shade composite resin restorations. [ABSTRACT FROM AUTHOR]

Aims: To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives. Design: A systematic integrated mixed methods review was conducted. Data sources: MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches. Review methods: Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes. Results: Thirty seven articles (29 studies) were included—quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It's your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia. Conclusion: The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the "swing" within these factors directly affected whether birthing pool use was facilitated or inhibited. Plain English Summary: During childbirth, most women wish to use a pain management technique; some prefer to use medications and others prefer non-medication methods. Another option is to use a birthing pool, larger than a typical bath, that encourages buoyancy and the freedom to move. The warm water can also offer comfort, relaxation and pain relief. Extensive studies have demonstrated birthing pool use during childbirth is safe for mothers and babies. It is associated with reduced medical interventions (e.g. speeding up labour and cuts to the perineum), improved outcomes (e.g. satisfaction, less pain or excessive bleeding after birth). Given these positive outcomes, we wanted to explore any barriers or facilitators for birthing women and people accessing birthing pools so we could help improve access for those wishing to use one. We gathered and assessed the literature to explore these aspects. We included quantitative and qualitative studies exploring the perspectives of different maternity professionals and those of organisations. We reviewed 37 studies from 12 countries (from 2004 to 2020). We found that birthing pool use was a viable option when all maternity professional groups and their organisational guidelines or policies valued and supported its use. Conversely, in other organisations, multiple barriers prevented the use of birthing pools as an equally viable option to medication pain relief options. These barriers were influenced by the beliefs of different maternity professional groups, organisational guidelines or policies (where some were highly restrictive) whether midwives were supported to offer care in birthing pools or whether the midwives had the confidence to do so. [ABSTRACT FROM AUTHOR]

Background: Water immersion therapy is used to treat a variety of cardiovascular, respiratory, and orthopedic conditions. It can also benefit some neurological patients, although little is known about the effects of water immersion on neural activity, including somatosensory processing. To this end, we examined the effect of water immersion on short-latency somatosensory evoked potentials (SEPs) elicited by median nerve stimuli. Short-latency SEP recordings were obtained for ten healthy male volunteers at rest in or out of water at 30 °C. Recordings were obtained from nine scalp electrodes according to the 10-20 system. The right median nerve at the wrist was electrically stimulated with the stimulus duration of 0.2 ms at 3 Hz. The intensity of the stimulus was fixed at approximately three times the sensory threshold., Results: Water immersion significantly reduced the amplitudes of the short-latency SEP components P25 and P45 measured from electrodes over the parietal region and the P45 measured by central region., Conclusions: Water immersion reduced short-latency SEP components known to originate in several cortical areas. Attenuation of short-latency SEPs suggests that water immersion influences the cortical processing of somatosensory inputs. Modulation of cortical processing may contribute to the beneficial effects of aquatic therapy., Trial Registration: UMIN-CTR (UMIN000006492).