Effect of various disinfectant solutions on the tensile strength of gutta-percha using the rapid sterilization technique.

Context: Gutta-percha (GP) gets contaminated during handling. It becomes imperative to ensure GP is sterile before placement in root canal space. Aims: The aim of the study was to evaluate and compare the tensile strength of GP treated with four different disinfectant solutions: 3% sodium hypochlorite (NaOCl), amla juice (AJ), Aloe vera (AV) juice, and pancha tulsi (PT). Settings and Design: The study design was an in vitro study. Materials and Methods: Fifty GP cones with a size of 30 were procured from sealed packages in five different groups. Experimental groups were disinfected for 1 min with 3% NaOCl, AJ, AV, and PT except the control group. Tensile and Brinell Testing Machine is used to measure the tensile strengths of GP. Statistical Analysis Used: Results were subjected to statistical analysis using the Kruskal-Wallis test followed by Dunn's post hoc test. Results: The mean tensile strength values for Groups A, B, C, D, and E are 9.49 Mpa, 13.33 Mpa, 12.58 Mpa, 12.69 MPa, and 13.56 MPa, respectively. In the herbal disinfectant group, such as AJ, AV, and PT, the tensile strength was not significantly altered, whereas in the 3% NaOCl group, it was reduced considerably. Conclusions: AJ, AV juice, and PT as a GP disinfectant do not alter the tensile strength of GP cones.

Amelioration of endothelial integrity by 3,5,4'-trihydroxy-trans-stilbene against high-fat-diet-induced obesity and -associated vasculopathy and myocardial infarction in rats, targeting TLR4/MyD88/NF-κB/iNOS signaling cascade.

Exacerbated expression of TLR4 protein (foremost pattern recognition receptor) during obesity could trigger NF-κB/iNOS signaling through linker protein (MyD88), predisposed to an indispensable inflammatory response. The induction of this detrimental cascade leads to myocardial and vascular abnormalities. Molecular docking was studied for protein-ligand interaction between these potential targets and resveratrol. The pre-treatment of resveratrol (20 mg/kg/p.o/per day for ten weeks) was given to investigate the therapeutic effect against HFD-induced obesity and associated vascular endothelial dysfunction (VED) and myocardial infarction (MI) in Wistar rats. In addition to accessing the levels of serum biomarkers for VED and MI, oxidative stress, inflammatory cytokines, and histopathology of these tissues were investigated. Lipopolysaccharide (for receptor activation) and protein expression analysis were introduced to explore the mechanistic involvement of TLR4/MyD88/NF-κB/iNOS signaling. Assessment of in-silico analysis showed significant interaction between protein and ligand. The involvement of this proposed signaling (TLR4/MyD88/NF-κB/iNOS) was further endorsed by the impact of lipopolysaccharide and protein expression analysis in obese and treated rats. Moreover, resveratrol pre-treated rats showed significantly lowered cardio and vascular damage measured by the distinct down expression of the TLR4/MyD88/NF-κB/iNOS pathway by resveratrol treatment endorses its ameliorative effect against VED and MI.

Dysbiosis versus diabesity: Pathological signaling and promising therapeutic strategies.

A healthy life depends on the inseparable relationship between a host and the gut microbiota. A healthy gut microbiota regulates intestinal integrity, whereas an unbalanced gut microbiota contributes to junctional remodeling and leads to dysbiosis. Bacterial infiltration and dysbiosis are reported to activate a series of pathological cascades that trigger metabolic abnormalities, including diabesity. Conversely, recent studies revealed that the incidence of dysbiosis itself is fuelled by diabesity. In this review, we highlight the molecular aspects of multifaceted pathological signaling between dysbiosis and diabetes that could pave the way for new drug discovery. Moreover, to reinstate the gut microbiota and restrict the epidemic of dysbiosis and diabesity, we also scrutinize a promising therapeutic strategy that can challenge the pathological interlink.

Strategies for ameliorating the photodegradation efficiency of Mn-doped CdAl2O4 nanoparticles for the toxic dyes under visible light illumination.

Worldwide environmental issues have been escalating with the growth of the global economy and become a vital problem. To solve the problems, we require an eco-friendly and sustainable binary catalyst for the degradation of Azo dye pollutants. In this work, magnetically reusable, multifunctional novel Mn-doped CdAl2O4 nanoparticles were effectively fabricated by the co-precipitation approach. It was utilized for the degradation of two Azo dyes, exhibiting 96 and 98% Mn (0.050 M)-doped CdAl2O4 removal rates under visible light illumination, and presenting improved photocatalytic capability than that of pure and other dopants. More notably, the Mn (0.050 M)-doped CdAl2O4 catalyst was recycled using centrifuges without major loss and displays almost similar photodegradation behaviors for six successive runs. According to the ESR measurements, outcome and quenching tests affirmed that .OH- and h+ radicals were better reactive species responsible for Azo dyes removal. A possible photodegradation reaction mechanism underlying the elimination of Azo dyes by Mn (0.050 M)-doped CdAl2O4 catalyst is also proposed. Elaborated analyzes by variable reaction parameters such as the role of reactive species and catalyst dosage, pH, COD and irradiation time in the degradation route was also discussed. We assume that our outcomes will provide novel insights into using a highly effectual Mn (0.050 M)-doped CdAl2O4 catalyst, with possible applications in the treatment of both industrial and domestic wastewater.

A critical review on recent research progress on microplastic pollutants in drinking water.

Plastic pollution is an emerging issue in recent days. Persistent plastic particles reach the atmosphere, land and water by multiple pathways. Research has confirmed that the existence of plastic particles is found surprisingly everywhere, from the Artic to the Antarctic region. The probability of ingestion of plastic by all living forms is quite natural, as the whole planet's environment is polluted with microplastic particles. The bioaccumulation of microplastics is a threat and the consequences for living beings are yet to be explored. Microplastics present in different drinking water sources like rivers, lakes, treatment units etc. are studied by several researchers, covering various aspects. Research carried out by various scientists on the microplastics in different drinking water sources is highlighted in this review. In view of the previous research carried out on various aspects of microplastic particles, the necessity of a uniform protocol for qualitative and quantitative analysis of microplastic is ascertained. Microplastic pollution is an ongoing environmental concern, it must be addressed and research should be expanded.

A synergistic consequence of catalyst dosage, pH solution and reactive species of Fe-doped CdAl2O4 nanoparticles on the degradation of toxic environmental pollutants.

Industrial wastewater treatment techniques are one of the biggest challenges of the scientific community that necessitate an increased consciousness to address water scarcity worldwide. Herein, an eco-friendly and cost-effective process was demonstrated to cope with tannery, textile and pharmaceutical dye wastes through the co-precipitation of highly reusable Fe-doped CdAl2O4 samples. The XRD studies exposed the space group R 3‾ with no secondary phase step being found for all samples. The outcomes of optical absorbance spectra demonstrate that Fe doping diminished the energy gap from 3.66 to 1.67 eV. HR-TEM images of existing spherical particles and some of the particles' rod-like structures with little agglomeration were found for Fe (0.075 M) doped CdAl2O4 nanoparticles. The PL emission outcomes show that Fe doping effectively prevented the charge carrier's recombination in CdAl2O4 during photocatalysis. All Fe-doped CdAl2O4 samples demonstrated higher photodegradation behaviors towards the effectual degradation of both dye solutions as compared to pure CdAl2O4 samples. Particularly, Fe (0.075 M)-doped CdAl2O4 samples exhibited improved photodegradation performance of 93 and 95% for both dye solutions. The amount of photodegradation was noticed to rely on dye pH, irradiation time, catalyst dosage, initial dye amount, and reactive species. The recyclability of the Fe (0.075 M) doped CdAl2O4 nanoparticles denotes that 78 and 82% of BB and BG were removed up to the 6th run of usage. The outcomes of trapping tests,.OH- and h+ radicals were the major Scavenging in the photodegradation reaction. COD studies affirmed the whole mineralization of BB and BG dye molecules. It is expected that our present examination could offer to improve various spinal oxide materials for the photodegradation activity of pharmaceutical contaminants and environmental issues and can also resolve energy storage applications.

Experimental investigation of the electrochemical detection of sulfamethoxazole using copper oxide-MoS2 modified glassy carbon electrodes.

An electrochemical sensor detection of sulfamethoxazole was performed using a copper oxide Molybdenum sulfide modified glassy carbon electrode using Molybdenum sulfide (CuO/MoS2) functionalization. As part of the characterization process, materials were characterized via cyclic voltammetry (CV), Square wave voltammetry (SWV), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD) and scanning electron microscopy (SEM). To optimize the performance of the experiment, parameters like the scan rate and pH, the electrolytes study, the stability, the comparative study and repeatability were optimized. In comparison to CuO, MoS2 and bare Glassy carbon electrode (GCE), an electrochemical sensor that incorporated CuO/MoS2 exhibited exceptional electrochemical performance. CuO/MoS2 modified electrodes showed a higher peak current for oxidation compared with bare, CuO and MoS2 modified electrodes, which demonstrated enhanced electrochemical conductivity for detection of SMX by minimizing oxidation potential from +0.18 V to +0.10 V. In the range of 100-800 µl SMX concentrations, the peak current linearly correlated with the concentration of SMX. In the calibration plot, the modified electrode showed linearity under ideal circumstances for SMX concentrations starting at 0.3 µM. This study investigated the presence of SMX with a detection limit of 0.34 Pg/L. CuO/MoS2 based electrochemical sensor, according to our analysis, are potentially useful in applications requiring the detection of trace amounts of SMX.

Exploring Australian high-performance athletes' perceptions and experiences of sport participation during pregnancy and post-pregnancy: Development and test-retest reliability of the Mum-Alete Survey.

OBJECTIVES: To develop and assess the test-retest reliability of a survey exploring high-performance athletes' perceptions and experiences during and post-pregnancy. DESIGN: Cross-sectional mixed-methods survey. METHODS: A three-phase approach was employed to develop the Mum-Alete survey. Relevant domains and questions were identified through a review of the literature and gap analysis (Phase 1). The face and content validity were assessed during Phase 2. The survey was modified, and the final survey included 113 questions. The test-retest reliability was assessed during Phase 3. Seven athletes aged ≥18 years who were currently pregnant and/or given birth since 1 July 2016 were recruited. The survey was administered via Qualtrics and completed on two occasions. Intraclass correlation coefficient (ICC) were determined to assess test-retest reliability (excellent, good, moderate, and poor). RESULTS: The average ICC of all items was 0.962 (95% CI 0.957-0.966) demonstrating excellent test-retest reliability. The test-retest reliability was excellent for the demographic and general questions domain (ICC = 0.967 95% CI 0.955-0.977) and good for the exercise (ICC 0.762 95% CI 0.707-0.811), physical health (ICC 0.841 95% CI 0.810-0.868) and well-being (ICC 0.827 95% CI 0.784-0.865) domains. CONCLUSIONS: The high test-retest reliability of the survey indicates excellent consistency of measures between the two time-points.

A recent advancement on the applications of nanomaterials in electrochemical sensors and biosensors.

Industrialization and globalization, both on an international and local scale, have caused large quantities of toxic chemicals to be released into the environment. Thus, developing an environmental pollutant sensor platform that is sensitive, reliable, and cost-effective is extremely important. In current years, considerable progress has been made in the expansion of electrochemical sensors and biosensors to monitor the environment using nanomaterials. A large number of emerging biomarkers are currently in existence in the biological fluids, clinical, pharmaceutical and bionanomaterial-based electrochemical biosensor platforms have drawn much attention. Electrochemical systems have been used to detect biomarkers rapidly, sensitively, and selectively using biomaterials such as biopolymers, nucleic acids, proteins etc. In this current review, several recent trends have been identified in the growth of electrochemical sensor platforms using nanotechnology such as carbon nanomaterials, metal oxide nanomaterials, metal nanoparticles, biomaterials and polymers. The integration strategies, applications, specific properties and future projections of nanostructured materials for emerging progressive sensor platforms are also observed. The objective of this review is to provide a comprehensive overview of nanoparticles in the field of electrochemical sensors and biosensors.

Assessment of physico-chemical parameters of surface waters of a tropical brackish water lake in South Asia.

Brackish lake systems and estuaries are unique aquatic systems that support diversified life forms and strongly influence a region's economy. Major chemical water quality parameters of India's second-largest brackish water lake, Pulicat were assessed. Physico-chemical parameters like pH, temperature, suspended solid concentrates, total dissolved solids, salinity, nitrogenous nutrients, phosphate, silicate, and chlorophyll a were analysed. The results obtained for different parameters were compared and interpreted with statistical software SPSS version 20 and images were plotted using the Arc GIS spatial analyst tool. During the summer months, the nitrogen to phosphorus ratio ranges from a minimum of 1.96 to a maximum of 16.64 (9.55 ± 4.01) while it ranges from a minimum of 7.98 to a maximum of 15.52 (12.47 ± 2) during the pre-monsoon. In the monsoon season, the nitrogen to phosphorus ratio of surface water suggests a range from a minimum of 8.64 to a maximum of 17.58 (13.87 ± 2.14). During the post-monsoon season, the nitrogen to phosphorus ratio ranges from 4.98 to 17.34 (11.77 ± 3.68). The average nitrogen to phosphorus ratios were 9.6, 12.5, 13.9 and 11.8 in summer, pre-monsoon, monsoon, and post-monsoon respectively. The nitrogen to phosphorus ratio was lower than the Redfield ratio for all the seasons. The average concentration of chlorophyll a was 14.9, 13.4, 12.8 and 11.8 in summer, pre-monsoon, monsoon, and post-monsoon respectively. As per the Pearson Correlation Coefficient, there was no significant correlation among nitrogen, phosphorus, and chlorophyll a. This suggests the influence of suspended solid concentrates, and nitrogen and phosphorus flux in the sediment-water interface might be interfering with the nutrient cycles and primary productivity.

The prevalence and socio-demographic risk factors of coexistence of stunting, wasting, and underweight among children under five years in Bangladesh: a cross-sectional study.

BACKGROUND: Childhood stunting, wasting and underweight are significant public health challenges. There is a gap in knowledge of the coexistence of stunting, wasting, and underweight among children under five years (under-5) in Bangladesh. This study aims to (i) describe the prevalence of the coexistence of stunting, wasting, and underweight and ii) examine the risk factors for the coexistence of stunting, wasting, and underweight among children under-5 in Bangladesh. METHODS: This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18, respectively. The associations between the coexistence of stunting, wasting, and underweight and independent variables were assessed using the Chi-square test of independence. The effects of associated independent variables were examined using negative binomial regression. RESULTS: The prevalence of coexistence of stunting, wasting, and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children born with low birth weight ((adjusted incidence rate ratios, aIRR) 2.31, 95% CI 1.64, 3.24)); children of age group 36-47 months (aIRR 2.26, 95% CI 1.67, 3.08); children from socio-economically poorest families (aIRR 2.02, 95% CI 1.36, 2.98); children of mothers with no formal education (aIRR 1.98, 95% CI 1.25, 3.15); and children of underweight mothers (aIRR 1.73, 95% CI 1.44, 2.08) were the most important risk factors. Further, lower incidence among children with the coexistence of stunting, wasting, and underweight was observed in the 2017-18 survey (aIRR 0.59, 95% CI 0.49, 0.70) compared to children in the 2014 survey. CONCLUSIONS: One out of thirty-five under-5 children was identified to have coexistence of stunting, wasting, and underweight in Bangladesh. The burden of coexistence of stunting, wasting, and underweight was disproportionate among children born with low birth weight, socio-economically poorest, a mother with no formal education, and underweight mothers, indicating the need for individual, household, and societal-level interventions to reduce the consequences of coexistence of stunting, wasting, and underweight.

Investigations of CNN for Medical Image Analysis for Illness Prediction.

When it comes to diabetic retinopathy, exudates are the most common sign; alarms for early screening and diagnosis are suggested. The images taken by cameras and high-definition ophthalmoscopes are riddled with flaws and noise. Overcoming noise difficulties and pursuing automated/computer-aided diagnosis is always a challenge. The major objective of this approach is to obtain a better prediction rate of diabetic retinopathy analysis. The accuracy, sensitivity, specificity, and prediction rate improvement are focused on the objective view. The images are separated into relevant patches of various sizes and stacked for use as inputs to CNN, which is then trained, tested, and validated. The article presents a mathematical approach to determine the prevalence, shape in precise, color, and density in the populations among image patches to operate and discover the fact the image collection consists of symptoms of exudates and methods to comprehend the diagnosis and suggest risks of early hospital treatment. The experimental result analysis of malignant quality shows the accuracy, sensitivity, specificity, and predictive value. Here, 78% of accuracy, 78.8% of sensitivity, and 78.3% of specificity are obtained, and both positive and negative predictive values are obtained.

Outcomes and Predictors of 28-Day Mortality in Patients With Solid Tumors and Septic Shock Defined by Third International Consensus Definitions for Sepsis and Septic Shock Criteria.

BACKGROUND: Data assessing outcomes of patients with solid tumors demonstrating septic shock using the Third International Consensus Definitions for Sepsis and Septic Shock are scarce. RESEARCH QUESTION: What are the independent predictors of 28-day mortality in critically ill adults with solid tumors and septic shock? STUDY DESIGN AND METHODS: Cohort of solid tumor patients admitted to the ICU with septic shock. Demographic and clinical characteristics were gathered from the electronic health records. We developed a reduced multivariate logistics regression model to identify independent predictors of 28-day mortality and used Kaplan-Meier plots to assess survival. RESULTS: A total of 271 patients were included. The median age was 62 years (range, 19-94 years); 57.2% were men and 53.5% were White. The most common underlying malignancies were lung (19.2%), breast (7.7%), pancreatic (7.7%), and colorectal (7.4%) cancers. Most patients (84.5%) harbored metastatic disease. Twenty-eight days after ICU admission, 188 patients (69.4%) had died. Nonsurvivors showed a higher rate of advanced cancer, longer hospital stays before ICU admission, and higher Sequential Organ Failure Assessment scores at admission and throughout the ICU stay (P < .001 for all). The multivariate analysis identified metastatic disease (OR, 3.17; 95% CI, 1.43-7.03), respiratory failure (OR, 2.34; 95% CI, 1.15-4.74), elevated lactate levels (OR, 3.19; 95% CI, 1.90-5.36), and Eastern Cooperative Oncology Group performance scores of 3 or 4 (OR, 2.72; 95% CI, 1.33-5.57) as independent predictors of 28-day mortality. Only 38 patients (14%) were discharged home without medical assistance. INTERPRETATION: The 28-day mortality rate of patients with solid tumors and septic shock was considerably high. Factors associated with worse survival included advanced oncologic disease, poor performance status, high lactate level, and concomitant acute respiratory failure. Early goals-of-care discussions should be considered for frail patients with septic shock and advanced metastatic disease without denying access to the appropriate level of care.

Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory tract disease. The most common clinical manifestation of severe COVID-19 is acute respiratory failure. Respiratory rehabilitation can be a crucial part of treatment, but data lack for patients with COVID-19. This study investigates the effects of short-term respiratory rehabilitation (i.e., breathing exercises) on respiratory recovery among non-ICU hospitalised patients with COVID-19. METHODS: This was a quasi-experimental, pre-and post-test study. The study recruited 173 patients hospitalised with moderate to severe COVID-19. All the patients received standardised care for COVID-19, and 94 patients in the intervention group also received the intervention of breathing exercises, which included breathing control, followed by diaphragmatic breathing, deep breathing, or thoracic expansion exercise, and huffing (forced expiratory technique) and coughing. Data on the mean values of peripheral oxygen saturation (SpO2), need for oxygen therapy (litre/min), respiratory rate (breaths/minute), and heart rate (beats/minute) and were collected at baseline, 4 days, and 7 days after the baseline assessment. Analysis of variance on repeated measures was applied to compare the mean value of outcome measures of all the time points. RESULTS: The mean (± SD) age of the intervention (69.6% men) and control group (62.1% men) were 50.1 (10.5) and 51.5 (10.4) years, respectively. At 4-day of follow-up, SpO2 (96.6% ± 1.9 vs. 90.7% ± 1.8, P < 0.001), need for oxygen therapy (0.8 ± 2.6 vs. 2.3 ± 2.9, P < 0.001), respiratory rate (20.5 ± 2.3 vs. 22.3 ± 2.5, P < 0.001), and heart rate (81.2 ± 9.5 vs. 89.2 ± 8.9, P < 0.001) improved in the intervention group compared to the control group. At 7-day follow-up, differences remained significant concerning the oxygen saturation and the need for oxygen therapy (P < 0.001) between the groups. CONCLUSIONS: Our results indicate that breathing exercise, even for a short period, effectively improves specific respiratory parameters in moderate to severe COVID-19 patients. As a non-invasive and cost-effective respiratory rehabilitation intervention, breathing exercise can be a valuable tool for a health care system overwhelmed by the COVID-19 pandemic. These results should be considered preliminary until they are replicated in larger samples in different settings.

Outcomes and Predictors of 28-Day Mortality in Patients With Hematologic Malignancies and Septic Shock Defined by Sepsis-3 Criteria.

BACKGROUND: To describe short-term outcomes and independent predictors of 28-dayx mortality in adult patients with hematologic malignancies and septic shock defined by the new Third International Consensus Definitions (Sepsis-3) criteria. METHODS: We performed a retrospective cohort study of patients admitted to the medical ICU with septic shock from April 2016 to March 2019. Demographic and clinical features and short-term outcomes were collected. We used descriptive statistics to summarize patient characteristics, logistic regression to identify predictors of 28-day mortality, and Kaplan-Meier plots to assess survival. RESULTS: Among the 459 hematologic patients with septic shock admitted to the ICU, 109 (23.7%) had received hematopoietic stem cell transplant. The median age was 63 years (range, 18-89 years), and 179 (39%) were women. Nonsurvivors had a higher Charlson comorbidity index (P=.007), longer length of stay before ICU admission (P=.01), and greater illness severity at diagnosis and throughout the hospital course (P<.001). The mortality rate at 28 days was 67.8% and increased with increasing sequential organ failure assessment score on admission (odds ratio [OR], 1.11; 95% CI, 1.03-1.20), respiratory failure (OR, 3.12; 95% CI, 1.49-6.51), and maximum lactate level (OR, 1.16; 95% CI, 1.10-1.22). Aminoglycosides administration (OR, 0.42; 95% CI, 0.26-0.69), serum albumin (OR, 0.51; 95% CI, 0.31-0.86), and granulocyte colony-stimulating factor (G-CSF) (OR, 0.40; 95% CI, 0.24-0.65) were associated with lower 28-day mortality. Life support limitations were present in 81.6% of patients at death. At 90 days, 19.4% of the patients were alive. CONCLUSIONS: Despite efforts to enhance survival, septic shock in patients with hematologic malignancies is still associated with high mortality rates and poor 90-day survival. These results demonstrate the need for an urgent call to action with higher awareness, including the further evaluation of interventions such as earlier ICU admission, aminoglycosides administration, and G-CSF treatment.

Despite maintaining a high daily training availability, a quarter of athletes start the season injured and three quarters experience injury in an Australian State Academy of Sport.

OBJECTIVES: To 1) investigate the incidence, prevalence, burden and characteristics of injuries; and 2) explore the frequency of physiotherapy and medical servicing for elite sports academy athletes over a 12-month season. DESIGN: Prospective cohort study. METHODS: Medical attention and time-loss injuries were prospectively recorded by Physiotherapy and Medical (Sports Physician) staff for 94 athletes (72.3% females). The number of linked physiotherapy and medical servicing appointments was also recorded. Injury incidence rates (IIR), point and period prevalence, and injury burden were calculated and compared by athlete gender, sport, and categorisation (performance level) using incidence rate ratios (IRR). RESULTS: The number of injuries reported was 193 in 71 (75.5%) athletes. The IIR was 2.1 (95%CI: 1.8 to 2.4) injuries per 365 days, with no gender difference observed (IRR: 1.1, 0.8 to 1.4). The injury burden was 43.5 (95%CI: 37.8 to 50.1) days absent per 365 days. More than one-quarter (point prevalence, 26.6%) of athletes commenced the season with an injury. In-season injury risk was 2.5 fold greater in athletes who started the season with an injury compared to athletes who started the season without an injury (IRR: 2.5, 1.9 to 3.4). The majority (81.2%) of the 1164 appointments recorded were physiotherapy, with an overall 4.3:1.0 physiotherapy to medical appointment ratio. CONCLUSIONS: One in four athletes began the elite pathway season with a pre-existing injury, while also demonstrating a 2.5 fold greater risk of subsequent injury in the scholarship period. Sports should not assume their athletes are uninjured at the beginning of their scholarship. Injury profiles, and physiotherapy and medical servicing varied across sports. To reduce health as a barrier in the successful transition of talented young athletes to elite athletes, injury management strategies at the commencement of recruitment and throughout the scholarship should be prioritised in the development pathway.

Physical activity and sedentary behaviour in current and former recreational and elite cricketers: a cross-sectional study.

OBJECTIVE: Former sports participants do not necessarily maintain high levels of physical activity (PA) across their lifespan. Considering physical inactivity in former athletes is associated with an increased susceptibility to inactivity-related chronic diseases, research into PA behaviours in cricketers of all playing-standards is needed. The objective was to (1) describe PA and sedentary behaviour in current and former cricketers, and (2) determine the odds of current, former, recreational and elite cricketers meeting PA guidelines and health-enhancing PA (HEPA) compared with the general population. STUDY DESIGN: Cross-sectional survey. SETTING: Questionnaire response, UK. PARTICIPANTS: 2267 current and former cricketers (age: 52±15 years, male: 97%, current: 59%, recreational: 45%) participated. Cricketers were recruited through the Cricket Health and Wellbeing Study and met eligibility requirements (aged ≥18 years; played ≥1 year of cricket). PRIMARY AND SECONDARY OUTCOMES: Age-matched and sex-matched data from Health Survey for England 2015 (n=3201) was used as the general population-based sample. The International Physical Activity Questionnaire Short-Form assessed PA. Logistic regression, adjusted for age, sex, body mass index, alcohol consumption, smoking, education and ethnicity were used to meet the second aim. RESULTS: 90% of current and 82% of former cricketers met UK PA guidelines. Current (OR 1.26, 95% CI 1.06 to 1.49)) and elite (OR 1.35, 95% CI 1.01 to 1.78) cricketers had greater odds of meeting UK PA guidelines, and elite cricketers had greater odds of HEPA (OR 1.19, 95% CI 1.02 to 1.42), compared with the general population. Former cricketers had reduced odds (OR 0.78, 95% CI 0.62 to 0.99) of meeting the UK PA guidelines compared with the general population. CONCLUSIONS: Elite cricketers had a greater odds of meeting the PA guidelines and HEPA, compared with the general population. Former cricketers demonstrated reduced odds of meeting the PA guidelines compared with the general population. Strategies are needed to transition cricketers to an active lifestyle after retirement, since former cricketers demonstrated reduced odds of meeting the PA guidelines compared with the general population.

Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh.

INTRODUCTION: Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. METHODS: This study extracted the children dataset from the 2017-18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. RESULTS: The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children's birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. CONCLUSION: Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Unusual presentation of rectal squamous cell carcinoma perforation-case report and literature review.

This is an unusual case of an obstructive rectal squamous cell carcinoma (SCC), causing perforation and a pelvic abscess, requiring source control and diverting colostomy. A 50-year-old female with chronic constipation presented with worsening right buttock pain for 1 month. On exam, the patient reported right hip tenderness. A computer tomography (CT) revealed rectal wall thickening with a presacral abscess. Due to the concern of rectal perforation with abscess she was taken to the operating room for proctoscopy with biopsy, colostomy diversion and drainage of the abscess over the right buttock. Pathology reported invasive rectal SCC. Rectal SCC presents similarly to rectal adenocarcinoma but its diagnosis must include special markers for cytokeratins. The treatment approach is controversial but adequately treated offers better survival than rectal ADC. Rectal SCC is rare and treated with chemoradiation however it must also be tailored to the variable acute presentations.

Effects of Herbal Mouthwashes on Plaque and Inflammation Control for Patients with Gingivitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

OBJECTIVE: The aim of this study was to evaluate the overall effects of herbal mouthwashes as supplements to daily oral hygiene on plaque and inflammation control compared with placebos and chlorhexidine (CHX) mouthwashes in the treatment of gingivitis. METHODS: PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and grey literature databases were searched. Only randomised controlled trials (RCTs) comparing herbal mouthwashes with placebos or CHX in the daily oral hygiene of patient with gingivitis were included to compare the effect of different mouthwashes on plaque and inflammation control. RESULTS: A total of 13 studies satisfied the eligibility criteria, and 11 studies were included in meta-analyses. Significant differences were observed in favour of herbal mouthwashes compared with placebos in both plaque- and inflammation-related indices (Quigley-Hein Plaque Index, QHPI: WMD = -0.61, 95% CI (-0.80, -0.42), P < 0.001; Gingival Index, GI: -0.28 (-0.51, -0.06), P=0.01; Modified Gingival Index, MGI: -0.59 (-1.08, -0.11), P=0.02; Gingival Bleeding Index, GBI: -0.06 (-0.09, -0.04), P < 0.001). No significant difference was found between herbal and CHX mouthwashes. CONCLUSIONS: Herbal mouthwashes have potential benefits in plaque and inflammation control as supplements to the daily oral hygiene of patients with gingivitis. Although no difference was observed between herbal and CHX mouthwashes in the selected studies, further high-quality RCTs are needed for more firm support before advising patients with gingivitis about whether they can use herbal mouthwashes to substitute for CHX mouthwashes or not (PROSPERO registration number: CRD42019122841).