Multidimensionality of oral health in dentate adults

OBJECTIVES: An understanding of the validity and usefulness of self-reported measures (as distinct from clinically determined measures) of oral health is emerging. These self-reported measures include self-rated oral health (SROH). Three objectives were to: (1) describe self-rated oral health in dentate adults, (2) quantify associations between self-rated oral health and other measures of oral health (oral disease and tissue damage, pain and discomfort, functional limitation, and disadvantage), and (3) assess the construct validity of a model of oral health proposed herein. METHODS: The Florida Dental Care Study is a longitudinal study of oral health, which included at baseline 873 subjects who had at least one tooth, were 45 years or older, and who participated for an interview and clinical examination. RESULTS: The prevalence of self-rated oral health decrements was substantial; approximately one fourth of subjects reported their oral health as only fair or poor. Bivariate and multivariate results provided consistent evidence of the construct validity of the proposed model of oral health. Additionally, the salience of one measure of dental appearance suggests that persons may use esthetic cues when rating their oral health. CONCLUSIONS: The proposed multidimensional model of oral health has construct validity. Self-rated oral health is affected by oral disease and tissue damage, oral pain and discomfort, oral functional limitation, and oral disadvantage. These self-reported measures and the proposed model should provide useful information for dental care effectiveness research. General health status has been disaggregated into the "physical" and the "mental;" an additional separation into the "oral" aspects of health seems warranted.     

Mast cells mediate acute inflammatory responses to implanted biomaterials

Implanted biomaterials trigger acute and chronic inflammatory responses. The mechanisms involved in such acute inflammatory responses can be arbitrarily divided into phagocyte transmigration, chemotaxis, and adhesion to implant surfaces. We earlier observed that two chemokines-macrophage inflammatory protein 1alpha/monocyte chemoattractant protein 1-and the phagocyte integrin Mac-1 (CD11b/CD18)/surface fibrinogen interaction are, respectively, required for phagocyte chemotaxis and adherence to biomaterial surfaces. However, it is still not clear how the initial transmigration of phagocytes through the endothelial barrier into the area of the implant is triggered. Because implanted biomaterials elicit histaminic responses in the surrounding tissue, and histamine release is known to promote rapid diapedesis of inflammatory cells, we evaluated the possible role of histamine and mast cells in the recruitment of phagocytes to biomaterial implants. Using i.p. and s. c. implantation of polyethylene terephthalate disks in mice we find: (i) Extensive degranulation of mast cells, accompanied by histamine release, occurs adjacent to short-term i.p. implants. (ii) Simultaneous administration of H1 and H2 histamine receptor antagonists (pyrilamine and famotidine, respectively) greatly diminishes recruitment and adhesion of both neutrophils (<20% of control) and monocytes/macrophages (<30% of control) to implants. (iii) Congenitally mast cell-deficient mice also exhibit markedly reduced accumulation of phagocytes on both i.p. and s.c implants. (iv) Finally, mast cell reconstitution of mast cell-deficient mice restores "normal" inflammatory responses to biomaterial implants. We conclude that mast cells and their granular products, especially histamine, are important in recruitment of inflammatory cells to biomaterial implants. Improved knowledge of such responses may permit purposeful modulation of both acute and chronic inflammation affecting implanted biomaterials.     

Glu227-->Lys substitution in the acidic loop of major histocompatibility complex class I alpha 3 domain distinguishes low avidity CD8 coreceptor and avidity-enhanced CD8 accessory functions

Cytotoxic T lymphocyte (CTL) activation requires specific T cell receptor (TCR)-class I major histocompatibility complex (MHC) antigen complex interactions as well as the participation of coreceptor or accessory molecules on the surface of CTL. CD8 can serve as a coreceptor in that it binds to the same MHC class I molecules as the TCR to facilitate efficient TCR signaling. In addition, CD8 can be "activated" by TCR stimulation to bind to class I molecules with high avidity, including class I not recognized by the TCR as antigenic complexes (non-antigen [Ag] class I), to augment CTL responses and thus serve an accessory molecule function. A Glu/Asp227-->Lys substitution in the class I alpha 3 domain acidic loop abrogates lysis of target cells expressing these mutant molecules by alloreactive CD8-dependent CTL. Lack of response is attributed to the destruction of the CD8 binding site in the alpha 3 domain which is likely to disrupt CD8 coreceptor function. The relative importance of the class I alpha 3 domain acidic loop Glu227 in coreceptor as opposed to accessory functions of CD8 is unclear. To address this issue, we examined CTL adhesion and degranulation in response to immobilized class I-peptide complexes formed in vitro from antigenic peptides and purified class I molecules containing wild-type or Glu227-->Lys substituted alpha 3 domains. The alpha 3 domain mutant class I-peptide complexes were bound by CTL and triggered degranulation, however to much lower levels than wild-type class I-peptide complexes. In further experiments, it is directly demonstrated that the alpha 3 domain mutant class I molecules, which lack the Glu227 CD8 binding site, still serve as TCR-activated, avidity-enhanced CD8 accessory ligands. However, mutant class I peptide Ag complexes failed to effectively serve as CD8 coreceptor ligands to initiate TCR-dependent signals required to induce avidity-enhanced CD8 binding to coimmobilized non-Ag class I molecules. Thus the Glu227-->Lys mutation effectively distinguishes CD8 coreceptor and avidity-enhanced CD8 accessory functions.     

“Those found responsible have been sacked”: some observations on the usefulness of error

Erik Hollnagel’s body of work in the past three decades has molded much of the current research approach to system safety, particularly notions of “error”. Hollnagel regards “error” as a dead-end and avoids using the term. This position is consistent with Rasmussen’s claim that there is no scientifically stable category of human performance that can be described as “error”. While this systems view is undoubtedly correct, “error” persists. Organizations, especially formal business, political, and regulatory structures, use “error” as if it were a stable category of human performance. They apply the term to performances associated with undesired outcomes, tabulate occurrences of “error”, and justify control and sanctions through “error”. Although a compelling argument can be made for Hollnagel’s view, it is clear that notions of “error” are socially and organizationally productive. The persistence of “error” in management and regulatory circles reflects its value as a means for social control.     

Reliability of seizure classification using a semistructured interview

Methods for standardized classification of epileptic seizures are important for both clinical practice and epidemiologic research. In this study, we developed a strategy for standardized classification using a semistructured telephone interview and operational diagnostic criteria. We interviewed 1,957 adults with epilepsy ascertained from voluntary organizations. To confirm and expand the seizure history, we also interviewed a first-degree relative for 67% of subjects and obtained medical records for 59%. Three lay reviewers used all available information to classify seizures. To assess reliability, each reviewer classified a sample of subjects assigned to the others. In addition, an expert physician classified a sample of subjects assigned to two of the reviewers. Agreement was "moderate-substantial" for generalized-onset seizures, both for the comparisons between pairs of lay reviewers and for the neurologist versus lay reviewers. Agreement was "substantial-almost perfect" for partial-onset seizures, both for pairs of lay reviewers and for the neurologist versus lay reviewers. These results suggest that seizures can be reliably classified by lay reviewers, using operational criteria applied to symptoms ascertained in a semistructured telephone interview.     

Relative effects of bacterial and protozoan predators on survival of Escherichia coli in estuarine water samples

The relative effect of protozoan and bacterial predators on the survival of Escherichia coli in estuarine water samples was examined. Predacious protozoa exerted their major influence on E. coli destruction during the first 2 days of a 10-day-decline period. Inhibition of protozoa after day 2 had little effect on E. coli survival. Bacterial predators also contributed to E. coli destruction but in natural estuarine water samples were maintained at lower levels due to "grazing" by predacious protozoa.     

Studies on the ultrastructure, histochemistry and cytochemistry of the uninfected digestive gland of Bithynia tentaculata (Mollusca: Gastropoda) and on the ultrastructure of this host organ in snails infected with larval digeneans

The structure and function of the digestive gland of the gastropod mollusc, Bithynia tentaculata, was investigated using ultrastructural, histochemical, and cytochemical techniques. The digestive gland was shown to be composed of two main cell types, the "digestive" cells and "secretory" cells. The digestive cells appeared to be concerned with the absorption and digestion of nutrients, while secretory cells produced digestive enzymes and calcareous concretions. Undifferentiated cells were scattered between these two main cell types. The pathological effects of larval digeneans on the digestive gland were also investigated, at the ultrastructural level. In such infected snails the digestive gland appeared to be degenerating. The significance of this tissue destruction was briefly discussed.     

PDF417二维条码肖像图片压缩编码的优化算法研究

针对PDF417二维条码存储空间有限的问题，提出了一种基于小波变换的有损图像压缩算法，通过这个算法，可以将静态图片信息加入PDF417条码中，并能够满足在指定字节数情况下保证高质量地压缩图像，该文在分析小波变换等算法理论的基础上，详细介绍了PDF417二维条码肖像图片压缩编码的优化算法及该算法的实验结果与美国Symbol公司的PC2VQ算法结果对比。     

Using cognitive artifacts to understand distributed cognition

Studies of patient safety have identified gaps in current work including the need for research about communication and information sharing among healthcare providers. They have also encouraged the use of decision support tools to improve human performance. Distributed cognition is the shared awareness of goals, plans, and details that no single individual grasps. Cognitive artifacts are objects such as: schedules, display boards, lists, and worksheets that form part of a distributed cognition. Cognitive artifacts that are related to operating room (OR) scheduling include: the availabilities sheet, master schedule, OR graph, and OR board. All provide a "way in" to understand how teams in the acute care setting dynamically plan and manage the balance between demand for care and the resources available to provide it. This work has import for the way that information technology supports the organization, management, and use of healthcare resources. Better computer-supported cognitive artifacts will benefit patient safety by making teamwork processes, planning, communications, and resource management more resilient.     

化学合成制药综合废水的处理

本文介绍了化学合成制药废水的处理工艺、原理和运行效果,该工艺处理后的污水完全达到国家规定的污水排放标准。