"All citizens of the world can save a life" - The World Restart a Heart (WRAH) initiative starts in 2018.

"All citizens of the world can save a life". With these words, the International Liaison Committee on Resuscitation (ILCOR) is launching the first global initiative - World Restart a Heart (WRAH) - to increase public awareness and therefore the rates of bystander cardiopulmonary resuscitation (CPR) for victims of cardiac arrest. In most of the cases, it takes too long for the emergency services to arrive on scene after the victim's collapse. Thus, the most effective way to increase survival and favourable outcome in cardiac arrest by two- to fourfold is early CPR by lay bystanders and by "first responders". Lay bystander resuscitation rates, however, differ significantly across the world, ranging from 5 to 80%. If all countries could have high lay bystander resuscitation rates, this would help to save hundreds of thousands of lives every year. In order to achieve this goal, all seven ILCOR councils have agreed to participate in WRAH 2018. Besides schoolchildren education in CPR ("KIDS SAVE LIVES"), many other initiatives have already been developed in different parts of the world. ILCOR is keen for the WRAH initiative to be as inclusive as possible, and that it should happen every year on 16 October or as close to that day as possible. Besides recommending CPR training for children and adults, it is hoped that a unified global message will enable our policy makers to take action to address the inequalities in patient survival around the world.

Complex taxonomy of the 'brush tail' peregrine earthworm Pontoscolex corethrurus.

Pontoscolex corethrurus is the most widespread earthworm species in tropical and sub-tropical zones and one of the most studied in soil science. Although, ecological interactions of P. corethrurus with its environment are well documented, the taxonomic status of the species remains unclear. In this study, we investigated phylogenetic relationships within the genus Pontoscolex, in particular focusing on morphologically indistinguishable (i.e., cryptic) lineages. A total of 792 specimens collected from 25 different countries and islands all over the world were analyzed using two mitochondrial (COI and 16S rDNA) and two nuclear (internal transcribed spacers 2 and 28S rDNA) markers, and a total of 11 morphological characters both internal and external were investigated in all genetically characterized lineages. A large-scale multilocus sequence data matrix was also obtained for Pontoscolex spp. specimens using the Anchored Hybrid Enrichment (AHE) method. Multilocus phylogenetic and phylogenomic analyses, combined with species delimitation methods; including single locus (mPTP, ABGD) and multilocus (BPP) approaches, revealed congruent results. Four cryptic species were supported within the P. corethrurus species complex, and four potentially new species within the genus Pontoscolex. One widespread lineage (L1), within P. corethrurus complex was observed in the current population of Fritz Müller's garden where P. corethrurus was first described in 1856. Cryptic lineages were observed in sympatry at several localities. This, in combination with observed heteroplasmy in COI gene in one population raises an important question of reproductive isolation between these species.

Cervical collars and immobilisation: A South African best practice recommendation.

INTRODUCTION: The consequences of spinal injury as a result of trauma can be devastating. Spinal immobilisation using hard trauma boards and rigid cervical collars has traditionally been the standard response to suspected spinal injury patients even though the risk may be extremely low. Recently, adverse events due to the method of immobilisation have challenged the need for motion restriction in all trauma patients. International guidelines have been published for protection of the spine during transport and this article brings those guidelines into the South African context. RECOMMENDATIONS: Trauma patients need to be properly assessed using both an approved list of high and low risk factors, as well as a thorough examination. They should then be managed accordingly. Internationally validated assessment strategies have been developed, and should be used as part of the patient assessment. The method of motion restriction should be selected to suit the situation. The use of a vacuum mattress is the preferable technique, with the use of a trauma board being the least desirable. CONCLUSION: The need for motion restriction in suspected spinal injury should be properly evaluated and appropriate action taken. Not all trauma patients require spinal motion restriction.

INTRODUCTION: Les conséquences des lésions de la moelle épinière suite à un traumatisme peuvent être dévastatrices. L'immobilisation de la colonne vertébrale au moyen d'une planche dorsale rigide et de minerves rigides constituait par le passé la réponse standard aux patients que l'on suspectait de souffrir de lésions de la moelle épinière, même si le risque pouvait être extrêmement faible. Récemment, des événements indésirables qui se sont produits du fait de cette méthode d'immobilisation ont remis en question la nécessité de restreindre les mouvements chez tous les patients victimes de traumatisme. Des directives internationales ont été publiées sur la protection de la colonne vertébrale au cours du transport, et cet article adapte ces directives au contexte sud-africain. RECOMMANDATIONS: Les patients victimes de traumatisme doivent être adéquatement évalués en utilisant une liste approuvée de facteurs de risques faibles et élevés, et en procédant à un examen approfondi. Ils devraient être pris en charge en conséquence. Des stratégies d'évaluation validées au niveau international ont été développées, et devraient être utilisées dans le cadre de l'évaluation du patient. La méthode de restriction des mouvements devrait être sélectionnée en fonction de la situation. L'utilisation d'un matelas immobilisateur à dépression constitue la technique privilégiée, l'utilisation d'une planche dorsale étant la moins recommandée. CONCLUSION: La nécessité de restreindre les mouvements en cas de suspicion de lésions de la moelle épinière devrait être adéquatement évaluée et des mesures appropriées doivent être prises. Il n'est pas nécessaire de restreindre les mouvements de la colonne vertébrale chez tous les patients de traumatisme.

Effect of calcium phosphate addition to fluoride containing dental varnishes on enamel demineralization.

BACKGROUND: The aim of this study was to evaluate the ability of calcium phosphate and fluoride containing varnishes to inhibit enamel demineralization. METHODS: Six varnishes were selected for analysis: (1) Enamel Pro containing amorphous calcium phosphate; (2) Clinpro White containing functionalized tricalcium phosphate (fTCP); (3) MI Varnish containing casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP); (4) Duraphat (first no added calcium control); (5) Profluorid (second no added calcium control); and (6) placebo (no added calcium or fluoride control). Human enamel slabs (36) were each cut into half-slabs and covered with one of the six dental varnishes to create a window. The half-slabs were then individually immersed in a polyacrylate demineralization buffer pH 4.8 for four days at 37 °C with a change of solution each day. Mineral content was determined using transverse microradiography. RESULTS: All fluoride-containing varnishes significantly inhibited enamel demineralization when compared with the placebo varnish. However, out of the calcium phosphate and fluoride containing varnishes only MI Varnish, containing fluoride and CPP-ACP was superior to the fluoride-alone varnishes. MI Varnish also released the highest levels of calcium, phosphate and fluoride ions. CONCLUSIONS: MI Varnish containing fluoride and CPP-ACP was superior to the other varnishes in protecting against enamel demineralization.

Part 3: adult basic life support and automated external defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

This review comprises the most extensive literature search and evidence evaluation to date on the most important international BLS interventions, diagnostics, and prognostic factors for cardiac arrest victims. It reemphasizes that the critical lifesaving steps of BLS are (1) prevention, (2) immediate recognition and activation of the emergency response system, (3) early high-quality CPR, and (4) rapid defibrillation for shockable rhythms. Highlights in prevention indicate the rational and judicious deployment of search-and-rescue operations in drowning victims and the importance of education on opioid-associated emergencies. Other 2015 highlights in recognition and activation include the critical role of dispatcher recognition and dispatch-assisted chest compressions, which has been demonstrated in multiple international jurisdictions with consistent improvements in cardiac arrest survival. Similar to the 2010 ILCOR BLS treatment recommendations, the importance of high quality was reemphasized across all measures of CPR quality: rate, depth, recoil, and minimal chest compression pauses, with a universal understanding that we all should be providing chest compressions to all victims of cardiac arrest. This review continued to focus on the interface of BLS sequencing and ensuring high-quality CPR with other important BLS interventions, such as ventilation and defibrillation. In addition, this consensus statement highlights the importance of EMS systems, which employ bundles of care focusing on providing high-quality chest compressions while extricating the patient from the scene to the next level of care. Highlights in defibrillation indicate the global importance of increasing the number of sites with public-access defibrillation programs. Whereas the 2010 ILCOR Consensus on Science provided important direction for the "what" in resuscitation (ie, what to do), the 2015 consensus has begun with the GRADE methodology to provide direction for the quality of resuscitation. We hope that resuscitation councils and other stakeholders will be able to translate this body of knowledge of international consensus statements to build their own effective resuscitation guidelines.

The physical properties and ion release of CPP-ACP-modified calcium silicate-based cements.

BACKGROUND: This study investigated the physical properties and ion release of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-modified calcium silicate-based cements (CSCs) and compared the properties of a trial mineral trioxide aggregate (MTA) with two commercially available CSCs, Biodentine(™) and Angelus(®) MTA. METHODS: The setting time, solubility, compressive strength and Vickers surface microhardness of the three CSCs incorporated with 0%, 0.5%, 1.0%, 2.0% and 3.0% (w/w) CPP-ACP were investigated. Release of calcium (Ca(2+) ), phosphate ions (Pi ) and pH of the test cements were measured after 24, 72, 168 and 336 h of storage. RESULTS: The addition of up to 1.0% CPP-ACP into Biodentine(™) and 0.5% into the other cements did not adversely affect their physical properties except for the setting time. The addition of 0.5% CPP-ACP increased Ca(2+) released from Biodentine(™) (after 168 and 336 h), Angelus(®) MTA (after 168 h) and the trial MTA (after 72 h). The addition of 1.0-3.0% CPP-ACP increased Ca(2+) and Pi released from all the cements. Biodentine(™) released more Ca(2+) particularly in the early stages and showed shorter setting time and higher mechanical properties than the other cements. The mechanical properties of Angelus(®) MTA and the trial MTA were similar. All the cements produced highly alkaline storage solutions. CONCLUSIONS: Up to 1.0% CPP-ACP in Biodentine(™) improves Ca(2+) and Pi release and 0.5% CPP-ACP in Angelus(®) MTA and the trial MTA improves Ca(2+) release without altering the mechanical properties and solubility. The addition of CPP-ACP into CSCs prolonged the setting time.

Fluoride content of tank water in Australia.

BACKGROUND: The aims of this study were to: (1) analyse the fluoride content of tank water; (2) determine whether the method of water collection or storage influenced fluoride content; and (3) survey participant attitudes towards water fluoridation. METHODS: Plastic tubes and a questionnaire were distributed through dentists to households with water tanks in Victoria. A midstream tank water sample was collected and fluoride analysed in triplicate using ion chromatography RESULTS: All samples (n = 123) contained negligible amounts of fluoride, with a mean fluoride concentration of <0.01 ppm (range: <0.01-0.18 ppm). No statistically significant association was found between fluoride content and variables investigated such as tank material, tank age, roof material and gutter material. Most people did not know whether their tank water contained fluoride and 40.8% preferred to have access to fluoridated water. The majority thought fluoride was safe and more than half of the respondents supported fluoridation. Fluoride content of tank water was well below the optimal levels for caries prevention. CONCLUSIONS: People who rely solely on tank water for drinking may require additional exposure to fluoride for optimal caries prevention.

Antibacterial efficacy of casein-derived peptides against Enterococcus faecalis.

BACKGROUND: The aim of this study was to test a casein peptide in its glycosylated form (kappa-casein glycopeptide, KCGP) and its non-glycosylated form (kappa-casein peptide, KCP) for antibacterial efficacy against Enterococcus faecalis in planktonic and biofilm cultures. METHODS: E. faecalis strain JKD 15036 was exposed to different concentrations of KCGP and KCP in a 96-well culture plate. The effect of the peptides on the growth of E. faecalis in planktonic culture was monitored by measuring optical density over 7 hours. Biofilm formation was measured after 24 hours using a crystal violet assay. All experiments were performed in triplicate. RESULTS: KCGP and KCP inhibited growth of E. faecalis in planktonic culture with no significant difference in activity between the peptides. KCGP at 0.16% w/v was significantly better at inhibiting E. faecalis biofilm formation than KCP at the same concentration and significantly better than NaOCl at 1.0% w/v. CONCLUSIONS: KCGP effectively inhibited E. faecalis biofilm formation and may have potential to augment the efficacy of traditional antiseptic agents.

Acidogenic potential of soy and bovine milk beverages.

Soy beverages are water extracts of whole soybeans and are often promoted as a healthy alternative to bovine milk. Little analysis has been carried out to determine the effects of soy beverages on oral health, especially their potential acidogenicity. OBJECTIVES: The aim of this study was to determine the potential acidogenicity of a range of soy and bovine milk beverages. METHODS: In vitro acid production by Streptococcus mutans was measured in soy and milk beverages at a constant pH of 6.5 or 5.5, as was the fall in pH over a 10 min period. The acid buffering capacity and calcium and phosphate concentrations (total and soluble) of the beverages were also determined. RESULTS: The rate of acid production by S. mutans in the milk beverages was five to six times lower at pH 6.5 than in the soy beverages and three to five times lower at pH 5.5. Whilst the pH fall in the presence of S. mutans over 10 min was negligible in the milk beverages there was a significant decrease in pH in the soy beverages. This was also reflected in the lower buffering capacity of the soy beverages. The levels of soluble calcium in the soy beverages were lower than those in the milk beverages although total calcium contents were similar. CONCLUSIONS: Soy beverages have a higher potential acidogenicity than bovine milk beverages. CLINICAL SIGNIFICANCE STATEMENT: Patients consider soy beverages to be a healthy, low cariogenic alternative to other beverages, including bovine milk. This study shows that soy beverages have a higher potential acidogenicity than bovine milk and therefore may have a greater potential cariogenicity.

Formation of PbS materials from lead xanthate precursors.

Six lead xanthate adducts Pb(S(2)COR)(2).L [R = Et, (n)Bu, L = bipy, TMEDA (tetramethylethylenediamine), PMDETA (pentamethyldiethylenetriamine)] have been synthesised and the structures of all, save Pb(S(2)COBu(n))(2).TMEDA (4) which is an oil, determined. Pb(S(2)COEt)(2).TMEDA (3) is seven-coordinate at lead through three chelating ligands and one weak intermolecular Pb‥S interaction. Both Pb(S(2)COR)(2).bipy [R = Et (1), (n)Bu (2)] are dimers in which one xanthate is terminal and the other µ(2) bridging at each sulphur, generating an eight-coordinate lead when the bipy donor is included. Both Pb(S(2)COR)(2).PMDETA [R = Et (5), (n)Bu (6)] are seven-coordinate at lead by virtue of two bidentate chelating xanthate ligands and a tridentate PMDETA; there are no intermolecular interactions. Trends in the (207)Pb NMR chemical shifts mirror the changes in the intramolecular coordination number across the series. Pb(S(2)COEt)(2).TMEDA (3) has been used to deposit PbS films on glass, Mo-coated glass and Si by AACVD. Pb(S(2)COEt)(2) also generated PbS nanocubes when decomposed under an autogenerated pressure.

Predicting the anatomical position of the palatal root apex in maxillary first premolars during surgical endodontic treatment.

INTRODUCTION: Although many studies have reported on the morphology of maxillary first premolars, to our knowledge, there has never been an investigation reporting the anatomic position of the palatal (P) root tip relative to the B root tip in mesiodistal (MD), buccopalatal (BP), and apicocoronal (AC) dimensions. Such information could help clinicians more accurately locate root apices, reduce surgical morbidity, and improve the precision and prognosis of endodontic periradicular surgery for this tooth. METHODS: Fifty extracted, bifurcated, human maxillary first premolars were individually mounted and photographed under 10x magnification and oriented to simulate a clinical view. RESULTS: The P apex was superimposed by the B apex in 25 of 50 specimens, distal to the B apex in 24 of 50, and mesial to the B apex in only 1 instance. When not superimposed by or mesial to the B apex, the P apex was usually 1.4+/-0.7 mm distal to the B apex. In 98% of specimens, the P apex was positioned palatocoronal or palatocoronodistal to the B apex. CONCLUSIONS: This knowledge can be used to clinically minimize the size of osteotomies required to locate P root apices during endodontic surgery.

Clinical trial: a multicentre, randomized, double-blind, placebo-controlled, dose-finding, phase II study of subcutaneous interferon-beta-la in moderately active ulcerative colitis.

BACKGROUND: Ulcerative colitis (UC) pathophysiology is characterized by an imbalance between pro- and anti-inflammatory cytokines. Interferon (IFN)-beta-1a has potent immunoregulatory properties, including stimulation of host defence mechanisms and thus represents a potential treatment. AIM: To extend pilot data and identify a suitable dose of IFN-beta-1a to achieve endoscopically confirmed remission (ECR) in patients with moderately active UC and to evaluate safety. METHODS: In this multicentre, double-blind, placebo-controlled trial, adults with moderately active UC were randomized to IFN-beta-1a 44 or 66 microg, or placebo, subcutaneously three times weekly for 8 weeks, with a 4-week follow-up. RESULTS: Endoscopically-confirmed remission was observed in 23.4% [95% confidence interval (CI): 13.8-35.7] of placebo patients, 29.2% (95% CI: 18.6-41.8) of the IFN-beta-la 44 microg group and 20.0% (950% CI: 11.1-31.8) of the 66 microg group (P = 0.45). Improvements with IFN-beta-1a 44 microg were greater than with placebo for most secondary efficacy outcomes, although significance was not achieved. Placebo response rates were higher than expected from previous trials. Adverse events were similar to the known safety profile of IFN treatment. CONCLUSIONS: Interferon-beta-1a was generally well tolerated at the doses tested, but a significant therapeutic benefit in patients with UC was not observed.

Intrapallidal lipopolysaccharide injection increases iron and ferritin levels in glia of the rat substantia nigra and induces locomotor deficits.

Increasing evidence suggests that abnormal iron handling may be involved in the pathogenesis of Parkinson's disease. The present study investigates the role of iron and the iron-storage protein ferritin in inflammation-induced degeneration of dopaminergic neurons of the substantia nigra pars compacta. Injection of lipopolysaccharide into the globus pallidus of young and middle-aged rats substantially decreased tyrosine hydroxylase immunostaining in substantia nigra pars compacta four weeks after injection. Loss of tyrosine hydroxylase expression was accompanied by increased iron and ferritin levels in glial cells of the substantia nigra pars reticulata. Despite greater increases in nigral iron levels, ferritin induction was less pronounced in older rats, suggesting the regulation of ferritin was compromised with age. Automated movement tracking analyses showed that young rats recovered from LPS-induced locomotor deficits within four weeks, yet older rats failed to improve on measures of speed and total distance moved. Intrapallidal lipopolysaccharide injection also increased expression of alpha-synuclein and ubiquitin in tyrosine hydroxylase-positive neurons of the substantia nigra pars compacta. These results suggest that pallidal inflammation significantly increases stress on dopamine-containing neurons in the substantia nigra pars compacta. Alterations in nigral iron levels and protein handing may increase the vulnerability of nigral neurons to degenerative processes.

NMR studies of a novel calcium, phosphate and fluoride delivery vehicle-alpha(S1)-casein(59-79) by stabilized amorphous calcium fluoride phosphate nanocomplexes.

The repair of early tooth enamel lesions has been recently demonstrated by tryptic phosphopeptides derived from milk caseins that associate with amorphous calcium phosphate (ACP) forming stable complexes. These casein phosphopeptides (CPP), containing the cluster sequence-Ser(P)-Ser(P)-Ser(P)-Glu-Glu-, form calcium phosphate delivery vehicles that retard enamel demineralization and promote remineralization. Recently, we have shown that these peptides also stabilize calcium fluoride phosphate as soluble complexes. These complexes designated CPP-ACFP, have the potential to provide superior clinical efficacy in preventing dental caries and treating and repairing early stages of disease. In an approach to determine the ultrastructure of the casein phosphopeptide-amorphous calcium fluoride phosphate complexes, we have studied the structure of the predominant peptide alpha(S1)-CN(59-79) bound to ACFP using nuclear magnetic resonance (NMR) spectroscopy and X-ray diffraction. The alpha(S1)-CN(59-79) peptide stabilized calcium fluoride phosphate as amorphous nanocomplexes with a hydrodynamic radius of 2.12+/-0.26 nm. The nanocomplexes exhibited stoichiometry of one peptide to 15 calcium, nine phosphate and three fluoride ions. Sequence-specific resonance assignments were determined for the peptide alpha(S1)-CN(59-79) complexed to the ACFP. The secondary structure of the peptide alpha(S1)-CN(59-79) was characterized by sequential (i, i+1), medium-range (i, i+2) nOes and H alpha chemical shifts. The spectral data were compared with that of the peptide alpha(S1)-CN(59-79) bound to calcium ions, revealing that the structurally significant secondary NH and alpha-chemical shifts were similar.

Evaluation of bone thickness in the anterior hard palate relative to midsagittal orthodontic implants.

PURPOSE: The Straumann Orthosystem (Institut Straumann, Waldenburg, Switzerland) describes a technique that involves placement of titanium implants (4 or 6 mm long and 3.3 mm in diameter) into the midsagittal hard palate for orthodontic anchorage. The aim of this study was to determine the quantity of bone in the midline of the anterior hard palate, and specifically the thickness inferior to the incisive canal. MATERIALS AND METHODS: Twenty-five dry skulls were radiographed with a standardized cephalometric technique. The vertical thickness of the midsagittal palate was then measured to the nearest tenth of a millimeter. Next, gutta-percha was injected into the incisive canal, and the radiograph was repeated. The bone thicknesses were then measured from the inferior hard palate to the most Inferior part of the radiopaque canal. This is defined as the actual bone available for the implant without violating the canal. RESULTS: The measurements have shown that an average of 8.6 +/- 1.3 mm of bone is theoretically available for the implant. However, considering the canal (where only bone thickness inferior to it is utilized and measured), only 4.3 +/- 1.6 mm of bone exists. The canal itself averaged 2.5 +/- 0.6 mm in diameter. DISCUSSION: Prior studies have overestimated the amount of bone available for implants in the median hard palate. The main reason for this is that the incisive canal is not well visualized on cephalometric radiographs of live patients. CONCLUSION: This study supports the continued use of implants, as approximately 50% of skulls still had the requisite minimum 4 mm of bone inferior to the incisive canal for maximum osseointegration with the 4-mm implants. However, 6-mm implants should be used with caution.

Anatomical variations and clinical implications of the artery to the lingual nerve.

The pterygomandibular space is a critical anatomic area for the delivery of local anesthesia in the practice of dentistry. The neurovascular contents of this area are subject to trauma and its resultant local and systemic complications. This study of 202 cadaveric specimens reaffirms the literature as to the percent distributions of the superficial and deep routes of the maxillary artery and details for the first time the anatomic variations of the artery to the lingual nerve. This artery courses through the pterygomandibular space placing it at risk for injection trauma along with the other neurovascular contents. It has been uncommonly identified and referred to in the literature, yet it may be the first artery encountered when entering the space with a needle or during surgical intervention in the area.