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AbstractBackground: Chlorhexidine (CHX) 0.2% solution is still “the leading oral antiseptic” for controlling gingivitis. Side effects, however, limit the acceptability to users and the long‐term employment of a 0.2% CHX antiseptic in preventive dentistry. This stimulated the development of new formulations. The aim of the present study was to assess the effect on plaque inhibition and taste perception of two commercially available mouthrinses (0.12% CHX non‐alcohol base with 0.05% cetyl pyridinium chloride (Cpc) versus 0.2% CHX alcohol base).Methods: The study was designed as a single‐blind, randomized two group parallel experiment, to compare two different commercially available mouthrinses, during a 3‐day plaque accumulation model. Forty healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of the test period. Over a 72‐h experimental non‐brushing period, during which subjects abstained from all forms of mechanical oral hygiene, one group (test) used a 15 ml alcohol free 0.12% CHX (=18 mg) mouthrinse on a Cpc base (Perioaid®, CHX⊕Cpc), twice daily for 30 s. The other group (control) used a 10 ml 0.2% CHX (=20 mg) mouthrinse on an 11.8% ethanol alcohol base (Corsodyl®, CHX⊕Alc), twice daily for 60 s. After 72 h of plaque formation, the amount of plaque was evaluated. By the use of visual analogue scale, the subjects were asked for their appreciation of the taste of the mouthrinse they had used.Results: The mean plaque index for the CHX⊕Cpc group was 0.97 and for the CHX⊕Alc group 0.78. After 72 h of non‐brushing, there was no significant difference in plaque accumulation between the two groups. The answers to the questions (taste perception and after‐taste) showed a statistically significant difference between the two groups. The mean visual analogue scale (VAS) scores for taste appreciation on a scale from very bad to very good taste (0–10) were 5.92 for the CHX⊕Cpc group and 4.10 for the CHX⊕Alc group (p=0.02). The mean visual analogue scale (VAS) scores for the after‐taste on a scale from very short to very long (0–10) were 7.24 for the CHX⊕Cpc group and 5.38 for the CHX⊕Alc group.Conclusions: Within the limitations of the present study design, it can be concluded that rinsing with a 0.12% CHX mouthrinse on a non‐alcohol base with 0.05% Cpc (Perio‐Aid®) is not significantly different from rinsing with a 0.2% CHX mouthrinse on an alcohol base (Corsodyl®). It appears that the subjects appreciated the taste of the non‐alcohol CHX solution better but the after‐taste of the rinse remained longer in the mouth.

The COVID-19 pandemic has led to major disruptions in workflows across all industries. All sectors are trying to sustain operations during this extremely difficult time and the healthcare sector is the most important of them. It is unthinkable to stop the operations of the health system because it serves human life. Health institutions must supply the products such as masks, gloves, and ventilators subject to service on time for certain activities to continue indefinitely under all conditions. By adopting modern logistics activities and technologies, healthcare organizations can provide sustainable diagnosis and treatments to patients by automating their various operations. With the COVID-19 pandemic, how to select an appropriate sustainable supplier has become an important task in the era of Logistics 4.0. From this viewpoint, a sustainable supplier selection framework is implemented for a health institution under the effect of the pandemic. To determine the direct effects of the pandemic in the health sector, fuzzy Multi-Criteria Decision-Making (MCDM) methods are utilized in the application. After a thorough review of the literature and interviews with experts, the criteria are organized in a comprehensive hierarchical structure. The fuzzy Best-Worst Method (F-BWM) technique is employed to find the weights for the determined criteria. Consequently, the fuzzy Additive Ratio Assessment Method (F-ARAS) method was applied to rank the alternative suppliers. In addition, with a comprehensive sensitivity analysis, alternative situations are examined against possible breaks in the supply chain. Thus, from the perspective of Logistics 4.0 and sustainability, this study contributes to the literature with an analysis of the health system’s survival in difficult and fragile periods, such as COVID-19. Investigating the importance of SSS can be a road map for the policymakers and the decision-makers is beneficial since the impact of COVID-19 on SSS is studied from the perspective of Logistics 4.0.

Abstract Different assumptions and methodologies prompt divergent policy recommendationgs for combatting climate change. Although climate scientists would like to be as precise as possible, policymakers with different attitudes towards climate change will always choose the result that matches their own value judgments. This paper discusses the impact of climate change attitudes on optimal mitigation in 15 regions. The climate change attitude is refined by a meta-analysis of 27 climate damage estimations and distilled into five damage functions. The optimal mitigation is calculated using the non-cooperative scenario of the regional integrated model of climate economy (RICE). The results show that the optimal mitigation paths in developing countries are more sensitive to climate change attitudes than they are in developed countries. In 2100, the range of optimal emissions represents 20% of the average optimal emissions by developing countries, which is twice the value of average optimal emissions by developed countries. The average social carbon cost in developing countries is 20 times higher than that in developed countries. This large uncertainty may be the combined result of high shadow prices of capital and large quantities of future emissions in these developing countries.

Drug and alcohol dependence are global problems with substantial societal costs. There are few treatments for relapse prevention and therefore a pressing need for further study of brain mechanisms underpinning relapse circuitry. The Imperial College Cambridge Manchester (ICCAM) platform study is an experimental medicine approach to this problem: using functional magnetic resonance imaging (fMRI) techniques and selective pharmacological tools, it aims to explore the neuropharmacology of putative relapse pathways in cocaine, alcohol, opiate dependent, and healthy individuals to inform future drug development. Addiction studies typically involve small samples because of recruitment difficulties and attrition. We established the platform in three centres to assess the feasibility of a multisite approach to address these issues. Pharmacological modulation of reward, impulsivity and emotional reactivity were investigated in a monetary incentive delay task, an inhibitory control task, and an evocative images task, using selective antagonists for µ-opioid, dopamine D3 receptor (DRD3) and neurokinin 1 (NK1) receptors (naltrexone, GSK598809, vofopitant/aprepitant), in a placebo-controlled, randomised, crossover design. In two years, 609 scans were performed, with 155 individuals scanned at baseline. Attrition was low and the majority of individuals were sufficiently motivated to complete all five sessions ( n=87). We describe herein the study design, main aims, recruitment numbers, sample characteristics, and explain the test hypotheses and anticipated study outputs.

The majority of assessments of future heat-related health risk are based on projections of heat hazards superimposed solely on current socioeconomic conditions, thus neglecting the potential contribution of drivers of heat stress risk other than climate change. Partly to address this drawback, the climate change research community has developed a new scenario framework, made up of distinct sets of climate and socioeconomic scenarios. The few assessments of future heat-related health risk that have employed this new framework have focused on changes in population exposure but have often not accounted for future populations' vulnerability. In this paper, we combine European Shared Socioeconomic Pathways with Representative Concentration Pathways to provide spatially explicit European projections of heat-related health risk that account for multiple changes in both socioeconomic and climatic conditions. In doing so, we also address the challenge of accounting for projections of determinants of vulnerability under varying levels of socioeconomic development. Results reveal that the proportion of the European population at very high risk of heat stress will show a steady increase – from 0.4% currently to 20.3%, 32.6%, or 48.4% in 2050 depending on the scenario combination – unless substantial political changes occur rapidly and steadily shift the current socioeconomic development pathway towards sustainability. Ambitious mitigation policies associated with rapid technological progress to enhance human capital could also moderate future heat-related health challenges. Such challenges are unevenly spread across Europe, with the Mediterranean region and Scandinavia being respectively the most and the least impacted regions. Future heat-related health challenges are substantially influenced by varying levels of socioeconomic development, primarily through changes in vulnerability – changes in population exposure being only of secondary importance. The former may even have a more significant impact on future heat stress risk than climate change, particularly in the British Isles and in the Iberian Peninsula. Thus, there is an undeniable necessity to consider the future state of vulnerability – and its uncertainties under varying socioeconomic scenarios – when assessing future heat-related health challenges and designing health adaptation strategies.

Global supply chains power 80% of world trade, but also host widespread environmental, labor, and human rights abuses in developing countries. Most scholarship focuses on some form of sanction to motivate supply chain members, but we propose that the fundamental problem is not insufficient punishment, but a lack of trust. Fickle tastes, incessant demands for lower prices, and spot market indifference force suppliers into a constant struggle for economic survival. No trust can grow in such an environment, and few sustainability practices can take meaningful root. Responding to multiple calls for scholarship in the supply chain literature, we propose a trust-building process by which supply chains can evolve from indifference and hostility to a relational partnership that produces joint investments in sustainable practices. The result is a supply chain that is more efficient, more humane, and embeds sustainability in the supply chain for the long-term.

This thesis analyses how transport policy at different levels of governance is responding to sustainability challenges and how such policies can be strengthened, particularly for climate change mitigation in the ASEAN region. Its academic contribution comprises the application of transition studies and policy studies to low-carbon transport and sustainable development. The main conclusions are: 1) The Avoid – Shift – Improve approach needs to be expanded with Access, Lifestyle and Transition considerations in order to be an effective framework that does justice to the distributional, systemic and behavioural aspects of low-carbon transport policy; 2) The newer international climate instruments, such as NAMAs, NDCs and the GCF, show more potential than the Kyoto Protocol instruments to promote sustainable, low-carbon transport, as they are better aligned to national circumstances and better suited to address the barriers that developing country policymakers face; 3) ASEAN instruments around transport focus on policy cooperation and reflect ‘networked regionalism’. Sustainable transport has played a relatively small role in ASEAN cooperation but this role is growing, and a range of ‘soft’ measures can be used to further promote low-carbon transport in its member countries; 4) At the national level, transport policy objectives support international sustainable development and climate goals, however the instruments, mechanisms and calibrations need to be strengthened to reach those objectives. Climate change has, in a few cases, led to policy windows for modifying transport policy; 5) At the local level, Southeast Asian cities such as Bangkok and Manila increasingly recognise the potential and benefits of cycling, yet much remains to be done in policy and planning to move cycling beyond a niche activity. ________________________________________