Care coordination among pediatricians and dentists: a cross-sectional study of opinions of North Carolina dentists

Abstract: Background: Care coordination between physicians and dentists remains a challenge. This study of dentists providing pediatric dental care examined their opinions about physicians’ role in oral health and identified factors associated with these opinions. Methods: North Carolina general and pediatric dentists were surveyed on their opinions of how physicians should proceed after caries risk assessment and evaluation of an 18-month-old, low risk child. We estimated two multinomial logistic regression models to examine dentists’ responses to the scenario under the circumstances of an adequate and a limited dental workforce. Results: Among 376 dentists, 52% of dentists indicated physicians should immediately refer this child to a dental home with an adequate dental workforce. With a limited workforce, 34% recommended immediate referral. Regression analysis indicated that with an adequate workforce guideline awareness was associated with a significantly lower relative risk of dentists’ recommending the child remain in the medical home than immediate referral. Conclusions: Dentists’ opinions and professional guidelines on how physicians should promote early childhood oral health differ and warrant strategies to address such inconsistencies. Without consistent guidelines and their application, there is a missed opportunity to influence provider opinions to improve access to dental care

Photometric Variability in the CSTAR Field: Results From the 2008 Data Set

The Chinese Small Telescope ARray (CSTAR) is the first telescope facility built at Dome A, Antarctica. During the 2008 observing season, the installation provided long-baseline and high-cadence photometric observations in the i-band for 18,145 targets within 20 deg2 CSTAR field around the South Celestial Pole for the purpose of monitoring the astronomical observing quality of Dome A and detecting various types of photometric variability. Using sensitive and robust detection methods, we discover 274 potential variables from this data set, 83 of which are new discoveries. We characterize most of them, providing the periods, amplitudes and classes of variability. The catalog of all these variables is presented along with the discussion of their statistical properties.Comment: 38 pages, 11 figures, 4 tables; Accepted for publication in ApJ

Photometry of Variable Stars from Dome A, Antarctica

Dome A on the Antarctic plateau is likely one of the best observing sites on Earth thanks to the excellent atmospheric conditions present at the site during the long polar winter night. We present high-cadence time-series aperture photometry of 10,000 stars with i<14.5 mag located in a 23 square-degree region centered on the south celestial pole. The photometry was obtained with one of the CSTAR telescopes during 128 days of the 2008 Antarctic winter. We used this photometric data set to derive site statistics for Dome A and to search for variable stars. Thanks to the nearly-uninterrupted synoptic coverage, we find 6 times as many variables as previous surveys with similar magnitude limits. We detected 157 variable stars, of which 55% are unclassified, 27% are likely binaries and 17% are likely pulsating stars. The latter category includes delta Scuti, gamma Doradus and RR Lyrae variables. One variable may be a transiting exoplanet.Comment: Accepted for publication in the Astronomical Journal. PDF version with high-resolution figures available at http://faculty.physics.tamu.edu/lmacri/papers/wang11.pd

Barriers to Pediatricians’ Adherence to American Academy of Pediatrics Oral Health Referral Guidelines: North Carolina General Dentists’ Opinions

Purpose—The purposes of this study were to: (1) assess knowledge, attitudes, and behaviors of North Carolina general dentists (GDs) regarding American Academy of Pediatrics (AAP) dental referral guidelines; and (2) determine factors that influence pediatricians’ ability to comply with AAP guidelines. Methods—One thousand GDs were surveyed to determine barriers toward acceptance of physician referrals of infants and toddlers. The primary outcome using ordered logistic regression was GDs’ acceptance of children described in five case scenarios, with different levels of risk and oral health status. Results—GDs believed pediatricians should refer patients at risk for caries to a dentist. While 61 to 75 percent of GDs were willing to accept low caries risk referrals of infants and toddlers, only 35 percent would accept referrals when caries was present. Predictors of referral acceptance were correct knowledge about AAP guidelines (OR=2.0, 95%CI=1.2-3.3), confidence in pro- viding preventive care to infants and toddlers (OR=2.6, 95%CI=1.3-4.9), and agreement that parents see importance in dental referrals (OR=2.1, 95% CI=1.2-3.6). Conclusions—This study identified factors influencing acceptance of pediatrician referrals for the age one dental visit among North Carolina GDs and highlighted challenges pediatricians face in referring young children for dental care

Eclipsing Binaries From the CSTAR Project at Dome A, Antarctica

The Chinese Small Telescope ARray (CSTAR) has observed an area around the Celestial South Pole at Dome A since 2008. About $20,000$ light curves in the i band were obtained lasting from March to July, 2008. The photometric precision achieves about 4 mmag at i = 7.5 and 20 mmag at i = 12 within a 30 s exposure time. These light curves are analyzed using Lomb--Scargle, Phase Dispersion Minimization, and Box Least Squares methods to search for periodic signals. False positives may appear as a variable signature caused by contaminating stars and the observation mode of CSTAR. Therefore the period and position of each variable candidate are checked to eliminate false positives. Eclipsing binaries are removed by visual inspection, frequency spectrum analysis and locally linear embedding technique. We identify 53 eclipsing binaries in the field of view of CSTAR, containing 24 detached binaries, 8 semi-detached binaries, 18 contact binaries, and 3 ellipsoidal variables. To derive the parameters of these binaries, we use the Eclipsing Binaries via Artificial Intelligence (EBAI) method. The primary and the secondary eclipse timing variations (ETVs) for semi-detached and contact systems are analyzed. Correlated primary and secondary ETVs confirmed by false alarm tests may indicate an unseen perturbing companion. Through ETV analysis, we identify two triple systems (CSTAR J084612.64-883342.9 and CSTAR J220502.55-895206.7). The orbital parameters of the third body in CSTAR J220502.55-895206.7 are derived using a simple dynamical model.Comment: 41 pages, 12 figures; published online in ApJ

Long-term spironolactone treatment reduces coronary TRPC expression, vasoconstriction, and atherosclerosis in metabolic syndrome pigs

Coronary transient receptor potential canonical (TRPC) channel expression is elevated in metabolic syndrome (MetS). However, differential contribution of TRPCs to coronary pathology in MetS is not fully elucidated. We investigated the roles of TRPC1 and TRPC6 isoforms in coronary arteries of MetS pigs and determined whether long-term treatment with a mineralocorticoid receptor inhibitor, spironolactone, attenuates coronary TRPC expression and associated dysfunctions. MetS coronary arteries exhibited significant atherosclerosis, endothelial dysfunction, and increased histamine-induced contractions. Immunohistochemical studies revealed that TRPC6 immunostaining was significantly greater in the medial layer of MetS pig coronary arteries compared to that in Lean pigs, whereas little TRPC6 immunostaining was found in atheromas. Conversely, TRPC1 immunostaining was weak in the medial layer but strong in MetS atheromas, where it was predominantly localized to macrophages. Spironolactone treatment significantly decreased coronary TRPC expression and dysfunctions in MetS pigs. In vivo targeted delivery of the dominant-negative (DN)-TRPC6 cDNA to the coronary wall reduced histamine-induced calcium transients in the MetS coronary artery medial layer, implying a role for TRPC6 in mediating calcium influx in MetS coronary smooth muscles. Monocyte adhesion was increased in Lean pig coronary arteries cultured in the presence of aldosterone; and spironolactone antagonized this effect, suggesting that coronary mineralocorticoid receptor activation may regulate macrophage infiltration. TRPC1 expression in atheroma macrophages was associated with advanced atherosclerosis, whereas medial TRPC6 upregulation correlated with increased histamine-induced calcium transients and coronary contractility. We propose that long-term spironolactone treatment may be a therapeutic strategy to decrease TRPC expression and coronary pathology associated with MetS

PHOTOMETRY OF VARIABLE STARS FROM DOME A, ANTARCTICA: RESULTS FROM THE 2010 OBSERVING SEASON

We present results from a season of observations with the Chinese Small Telescope ARray (CSTAR), obtained over 183 days of the 2010 Antarctic winter. We carried out high-cadence time-series aperture photometry of 20,000 stars with i<15.3 mag located in a 23 square-degree region centered on the south celestial pole. We identified 188 variable stars, including 67 new objects relative to our 2008 observations, thanks to broader synoptic coverage, a deeper magnitude limit and a larger field of view. We used the photometric data set to derive site statistics from Dome A. Based on two years of observations, we find that extinction due to clouds at this site is less than 0.1 and 0.4 mag during 45% and 75% of the dark time, respectively.Comment: Accepted for publication in the Astronomical Journal. Light curves and finding charts of all variable stars will be made available at http://casdc.china-vo.org/data/csta

STELLAR VARIABILITY AND FLARE RATES FROM DOME A, ANTARCTICA, USING 2009 AND 2010 CSTAR OBSERVATIONS

The Chinese Small Telescope ARray (CSTAR) carried out high-cadence time-series observations of 20.1 square degrees centered on the South Celestial Pole during the 2008, 2009 & 2010 winter seasons from Dome A in Antarctica. The nearly-continuous 6 months of dark conditions during each observing season allowed for >10^6 images to be collected through gri and clear filters, resulting in the detection of >10^4 sources over the course of 3 years of operation. The nearly space-like conditions in the Antarctic plateau are an ideal testbed for the suitability of very small-aperture (<20 cm) telescopes to detect transient events, variable stars and stellar flares. We present the results of a robust search for such objects using difference image analysis of the data obtained during the 2009 & 2010 winter seasons. While no transients were found, we detected 29 flaring events and find a normalized flaring rate of 5+\-4x10^-7 flare/hour for late-K dwarfs, 1+\-1x10^-6 flare/hour for M dwarfs and 7+\-1x10^-7 flare/hour for all other stars in our sample. We suggest future small-aperture telescopes planned for deployment at Dome A would benefit from a tracking mechanism, to help alleviate effects from ghosting, and a finer pixel scale, to increase the telescope's sensitivity to faint objects. We find that the light curves of non-transient sources have excellent photometric qualities once corrected for systematics, and are limited only by photon noise and atmospheric scintillation.Comment: Accepted for Publication in the Astronomical Journal, 14 pages, 12 figures and 2 table