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INTRODUCTION: Climate change is a global phenomenon with far-reaching consequences, and its impact on human health is a growing concern. The intricate interplay of various factors makes it challenging to accurately predict and understand the implications of climate change on human well-being. Conventional methodologies have limitations in comprehensively addressing the complexity and nonlinearity inherent in the relationships between climate change and health outcomes. OBJECTIVES: The primary objective of this paper is to develop a robust theoretical framework that can effectively analyze and interpret the intricate web of variables influencing the human health impacts of climate change. By doing so, we aim to overcome the limitations of conventional approaches and provide a more nuanced understanding of the complex relationships involved. Furthermore, we seek to explore practical applications of this theoretical framework to enhance our ability to predict, mitigate, and adapt to the diverse health challenges posed by a changing climate. METHODS: Addressing the challenges outlined in the objectives, this study introduces the Complex Adaptive Systems (CAS) framework, acknowledging its significance in capturing the nuanced dynamics of health effects linked to climate change. The research utilizes a blend of field observations, expert interviews, key informant interviews, and an extensive literature review to shape the development of the CAS framework. RESULTS AND DISCUSSION: The proposed CAS framework categorizes findings into six key sub-systems: ecological services, extreme weather, infectious diseases, food security, disaster risk management, and clinical public health. The study employs agent-based modeling, using causal loop diagrams (CLDs) tailored for each CAS sub-system. A set of identified variables is incorporated into predictive modeling to enhance the understanding of health outcomes within the CAS framework. Through a combination of theoretical development and practical application, this paper aspires to contribute valuable insights to the interdisciplinary field of climate change and health. Integrating agent-based modeling and CLDs enhances the predictive capabilities required for effective health outcome analysis in the context of climate change. CONCLUSION: This paper serves as a valuable resource for policymakers, researchers, and public health professionals by employing a CAS framework to understand and assess the complex network of health impacts associated with climate change. It offers insights into effective strategies for safeguarding human health amidst current and future climate challenges.

This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics. [ABSTRACT FROM AUTHOR]

Abstract This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics.

Abstract Resettlement and relocation are among the most difficult policies to put into practice, but they may be the best ways to minimize future risks to settlements exposed to natural hazards both before and after disaster events. As climate-related disasters and forced migration become increasingly common worldwide, governments, humanitarian or development actors, and policymakers must now prioritize the implementation of a dignified and effective resettlement program as part of their planning and management responsibilities. Much of this effectiveness depends on the stakeholders and beneficiaries’ understanding and knowledge of the different resettlement phases, culture and customs of affected populations, activities, and the associated implementation challenges, costs, and benefits. Serious games are used in a variety of contexts to increase awareness, train and build capacity in stakeholders and beneficiaries. This article presents a serious game developed to educate practitioners, local agencies, students, and the public to understand the complexities and challenges involved in a successful resettlement. The game is based on a real proposed resettlement project initiated in the Chiradzulu District in southern Malawi after Cyclone Freddy in March 2023, which caused widespread flooding and landslides, forcing some villages to relocate permanently. The progression in the Road to Resettlement Game consists of six primary levels: land and site preparation, housing and livelihood, water, sanitation, and hygiene, health, education, and protection. These levels are meant to be completed in a sequence that adheres to the principles of resettlement. By engaging in the serious table-top board game, players gain an understanding of the resettlement activities, their sequence, and the associated practical (technical and social) and financial challenges.

Virtual reality (VR) is a promising new educational and training tool in the field of disaster and emergency management, especially for hazards that are not frequent or well known to the public and require spatial and situational understanding. The objective of this paper is to describe an educational VR simulation that was developed based on a landslide that really occurred in Southern Malawi during the March 2023 Cyclone Freddy. The cyclone induced several landslides that caused many casualties and significant damage. The VR simulation framework consisted of four critical steps using Unity3D for the creation of the simulation including data preparation, terrain and environmental modeling, landslide simulation development, and virtual reality interactions. The simulation scenarios were diversified to include three distinct landscapes that can help users learn how factors such as terrain can influence landslide impacts. The VR simulation offers users an intimate, firsthand experience of the landslide’s unfolding and allows users the ability to explore various facets of the landslide phenomena. This VR simulation aims to provide an educational tool to facilitate an in-depth understanding of and interaction with a real-word landslide to learn about the impacts of landslides and how different factors can influence these impacts.

Abstract Objective To assess the impact of self-medication on the transmission dynamics of COVID-19 across different age groups, examine the interplay of vaccination and self-medication in disease spread, and identify the age group most prone to self-medication. Methods We developed an age-structured compartmentalized epidemiological model to track the early dynamics of COVID-19. Age-structured data from the Government of Gauteng, encompassing the reported cumulative number of cases and daily confirmed cases, were used to calibrate the model through a Markov Chain Monte Carlo (MCMC) framework. Subsequently, uncertainty and sensitivity analyses were conducted on the model parameters. Results We found that self-medication is predominant among the age group 15-64 (74.52%), followed by the age group 0-14 (34.02%), and then the age group 65+ (11.41%). The mean values of the basic reproduction number, the size of the first epidemic peak (the highest magnitude of the disease), and the time of the first epidemic peak (when the first highest magnitude occurs) are 4.16499, 241,715 cases, and 190.376 days, respectively. Moreover, we observed that self-medication among individuals aged 15-64 results in the highest spreading rate of COVID-19 at the onset of the outbreak and has the greatest impact on the first epidemic peak and its timing. Conclusion Studies aiming to understand the dynamics of diseases in areas prone to self-medication should account for this practice. There is a need for a campaign against COVID-19-related self-medication, specifically targeting the active population (ages 15-64).

This case report highlights the successful management of a cystic apical lesion associated with root resorption through nonsurgical endodontic retreatment, utilizing calcium-enriched mixture (CEM) cement as an obturating biomaterial. A 35-year-old woman presented with mild discomfort in the mandibular right first molar (#46), with radiographic evidence of a well-defined radiolucent lesion at the apex of the mesial root. The tooth had a history of previous failed endodontic treatment with poor root canal obturation, indicating internal root resorption. Nonsurgical endodontic retreatment was performed, and the canals were filled/sealed with CEM cement. Follow-up radiographs showed a gradual reduction in the size of the cystic lesion. At 54 months, complete bone healing of the cystic apical lesion was evident. This case report provides clinical evidence supporting the potential efficacy of nonsurgical endodontic retreatment using CEM cement in managing certain cystic apical lesions, offering a promising alternative to traditional surgical enucleation, even in cases with inflammatory root resorption. Further research is needed to validate the long-term efficacy of this approach in larger patient populations.

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Climate change is global threat and the world is now facing its outcomes more than the last decades. Climate change has increased the frequency and intensity of flooding among other extreme weather events. The execution of knowledge management in different phases of disaster management can be effective in mitigating damages caused by floods to natural and human environments. The present study identified effective actions to implement the five stages of knowledge management in the stages before, during and after the flood event. For this purpose, a systematic review of sources and qualitative content analysis have been applied to evaluate the published research in four stages of items collection, descriptive analysis, selection and classification, and assessment. According to the findings, the pre-crisis stage requires 13 actions in knowledge creation, 20 actions in knowledge acquisition, 7 actions in knowledge organization and storage, 23 actions in knowledge sharing, and 20 actions in knowledge use and development. The crisis phase requires 12 actions in knowledge sharing and 10 actions in knowledge use. In the post-crisis stage, 5 actions in the knowledge sharing, 11 actions in the knowledge use, and 12 actions in the knowledge evaluation phases have been identified. To prevent and manage the flood crisis, knowledge improvement and management is an effective and necessary aspect that should be considered among the organizations and communities involved in emergency management.

Abstract Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving 1257 VPT-treated teeth, aiming to describe the demographic data and clinical characteristics of all failed cases and their management protocols. Clinical records/images of 105 failed cases treated by a single endodontist (2011–2022) were examined, including 10 extracted teeth. Asymptomatic cases with PDL widening received no intervention, while others underwent management protocols, including (selective) RCT and (tampon) re-VPT. These retreatments were assessed for success (defined as radiographic evidence of healing) and survival (characterized by the retention/function of the treated tooth) using Kaplan–Meier analysis. While 51.4% of all initial failures were diagnosed due to symptoms, 48.6% were symptom-free. Notably, failed cases with symptomatic irreversible pulpitis, and apical periodontitis/widened PDL before initial treatment significantly outnumbered asymptomatic cases and normal PDL, respectively (P = 0.001). Moreover, most of the initial failures were observed in teeth with composite resin rather than amalgam restorations (P = 0.002). The success and survival rates for the management protocols were 91.78% and 95.79%, respectively, over an average follow-up period of 36.94 (± 23.30) months. RCT and re-VPT procedures provide successful outcomes for managing unsuccessful VPTs.

BackgroundAccording to study on the under-estimation of COVID-19 cases in African countries, the average daily case reporting rate was only 5.37% in the initial phase of the outbreak when there was little or no control measures. In this work, we aimed to identify the determinants of the case reporting and classify the African countries using the case reporting rates and the significant determinants.MethodsWe used the COVID-19 daily case reporting rate estimated in the previous paper for 54 African countries as the response variable and 34 variables from demographics, socioeconomic, religion, education, and public health categories as the predictors. We adopted a generalized additive model with cubic spline for continuous predictors and linear relationship for categorical predictors to identify the significant covariates. In addition, we performed Hierarchical Clustering on Principal Components (HCPC) analysis on the reporting rates and significant continuous covariates of all countries.Results21 covariates were identified as significantly associated with COVID-19 case detection: total population, urban population, median age, life expectancy, GDP, democracy index, corruption, voice accountability, social media, internet filtering, air transport, human development index, literacy, Islam population, number of physicians, number of nurses, global health security, malaria incidence, diabetes incidence, lower respiratory and cardiovascular diseases prevalence. HCPC resulted in three major clusters for the 54 African countries: northern, southern and central essentially, with the northern having the best early case detection, followed by the southern and the central.ConclusionOverall, northern and southern Africa had better early COVID-19 case identification compared to the central. There are a number of demographics, socioeconomic, public health factors that exhibited significant association with the early case detection.

Abstract This cohort study evaluated the long-term success/survival of vital pulp therapies (VPTs) after carious pulp exposure in adult teeth. Additionally, factors influencing long-term success were identified. Teeth treated during 2011–2022 in a private clinic were studied with clinical/radiographic follow-ups. Data included patient demographics, tooth specifics, and treatment details. Outcomes were classified as success/failure based on clinical/radiographic findings, with tooth functionality determining the survival rate. Encompassing 1149 patients and 1257 VPT-treated teeth, the average monitoring period was 42.2 months. Overall VPTs’ survival and success rates were 99.1% and 91.6%, respectively. Success rates for 768 direct pulp cappings, 217 miniature pulpotomies, and 272 full pulpotomies were 91.9%, 92.6%, and 90.1%, respectively (P > 0.05). Influencing factors included symptomatic irreversible pulpitis (SIP; HR 1.974, 95% CI 1.242–3.137; P = 0.004), radiographic signs of apical periodontitis (AP; HR 2.983, 95% CI 1.961–4.540; P

Background and objectives: Inflammatory bowel disease (IBD) refers to idiopathic chronic and inflammatory bowel disorders such as ulcerative colitis. Considering the lack of definitive treatment and the side effects of existing drugs, finding efficient compounds is needed. Biochanin A has attracted the attention of researchers due to its wide range of medicinal activities. Until now, no study was conducted to evaluate its effects on colitis. Therefore, the aim of this study was to determine the effect of biochanin A on the nitrogen pathway in rats with acetic acid-induced colitis. Methods: Male rats were divided into five groups: normal group, negative control group, positive control group, and groups receiving biochanin A (10 and 20 mg/kg). Colitis was induced with 4% acetic acid. Next, the samples were evaluated at different macroscopic and microscopic levels, and biochemical test of superoxide dismutase (SOD) and nitric oxide activity was investigated. Results: Macroscopic and microscopic investigations showed that treatment with biochanin A decreased mucosal damage in rats with acetic acid-induced colitis. Biochanin A reduced neutrophil infiltration in the intestinal tissue. It also led to the reduction in nitric oxide and enhancement of SOD in rats. The optimal dose of biochanin A was 20 mg/kg, which had the best effect on reducing inflammation and mucosal lesions in rats. Conclusion: Biochanin A, due to its anti-inflammatory effects by reducing nitric oxide and enhancement of SOD and reducing mucosal damage in rats with acetic acid-induced colitis, can be a useful alternative drug for the prevention or treatment of IBD patients.

The changing and intensifying landscape of global, national, and local disaster risks, driven by socio-political, environmental, and technological shifts, underscores the critical need for risk assessment by international agencies and governments. The Risk Matrix, introduced in 1995, has been widely used for risk assessment in different contexts, lauded for its simplicity and effectiveness. This model relies on the core risk components of consequence and likelihood, making it a favored tool for risk managers. To enhance the precision of risk assessment, various adaptations and extensions of the risk matrix have emerged; while some indirectly address resilience aspects, none explicitly integrate resilience into the matrix. This paper explores the risk matrix and its extensions, advocating for the inclusion of resilience in risk assessment. It introduces an empirical approach to quantify resilience, through a survey targeting small and medium-sized businesses in Southern Ontario, Canada. By developing two types of risk matrices—one with resilience considerations and one without—our work demonstrates how resilience alters risk prioritization, highlighting the importance of preparedness. This research underscores the pivotal role of resilience in risk assessment and urges its explicit integration into risk matrices to enhance accuracy and efficacy. Through practical examples and empirical data, the paper builds a compelling case for the central role of resilience in modern risk assessment practices.

Invasive cervical root resorption (ICRR) is a rare and clinically complex condition marked by the progressive loss of dental hard tissues below the junctional epithelium. This case report outlines the management of a 32-year-old female patient presenting with ICRR class 3 affecting a maxillary incisor. Despite the absence of symptoms, the expansive nature of the defect warranted conservative surgical intervention. The procedure involved the surgical removal of inflamed tissues, followed by an ultraconservative modified pulpotomy utilizing calcium-enriched mixture (CEM) cement through a surgical window. The selected intervention is substantiated by its potential benefits, such as minimal removal of tooth structure and the inherent biocompatibility and sealing capabilities of CEM cement. A one-year follow-up revealed arrested resorption, reestablishment of periodontal attachment, and successful esthetic restoration, affirming the efficacy of vital pulp therapy in surgically addressing advanced ICRR. Accurate diagnosis, strategic treatment planning, and a patient-centered approach proved critical in achieving favorable outcomes. [ABSTRACT FROM AUTHOR]