Adopt-A-School in San Francisco’s Chinatown: Gordon J. Lau Elementary School 2018-2019

In present day, tooth decay is the most common chronic childhood disease which effects the overall health and development of the young individual. The U.S Department of Health and Human Services estimates that more than 51 million school hours are lost each year because of dental-related health problems, making it the primary reason for missing school. Dental caries is a preventable disease with routine and early dental visits but due to lack of oral health education in the public, the problem is more widespread. Here in San Francisco, 33% of kindergarteners have experienced dental caries. The number is higher for children in Chinatown as they are 2-3 times more likely to have dental caries compared to other areas within San Francisco. This is due to the lack of adequate access to dental care in addition to other barriers such has low income, language barrier, and cultural differences. The University o f the Pacific School of Dentistry’s Student Community Outreach for Public Education (SCOPE) strives to improve the oral health and awareness of the young population through providing education, screenings, and fluoride varnish. As the largest elementary school in the city of San Francisco, Gordon J. Lau Elementary School (GJL) presented an ideal opportunity to reach out to many children in the Chinatown neighborhood. SCOPE hopes to not only offer these services to the students of GJL on a regular basis but also to expand its outreach to more elementary schools throughout the San Francisco

Adopt-A-School in San Francisco’s Chinatown: Gordon J. Lau Elementary School 2018-2019

In present day, tooth decay is the most common chronic childhood disease which effects the overall health and development of the young individual. The U.S Department of Health and Human Services estimates that more than 51 million school hours are lost each year because of dental-related health problems, making it the primary reason for missing school. Dental caries is a preventable disease with routine and early dental visits but due to lack of oral health education in the public, the problem is more widespread. Here in San Francisco, 33% of kindergarteners have experienced dental caries. The number is higher for children in Chinatown as they are 2-3 times more likely to have dental caries compared to other areas within San Francisco. This is due to the lack of adequate access to dental care in addition to other barriers such has low income, language barrier, and cultural differences. The University o f the Pacific School of Dentistry’s Student Community Outreach for Public Education (SCOPE) strives to improve the oral health and awareness of the young population through providing education, screenings, and fluoride varnish. As the largest elementary school in the city of San Francisco, Gordon J. Lau Elementary School (GJL) presented an ideal opportunity to reach out to many children in the Chinatown neighborhood. SCOPE hopes to not only offer these services to the students of GJL on a regular basis but also to expand its outreach to more elementary schools throughout the San Francisco

A virtual community health field project during the COVID-19 pandemic

Problem: The Commission on Dental Accreditation mandates that dental graduates must be competent to treat patients from diverse backgrounds. Introducing dental students to oral health disparities in the community at an early stage helps them realize poor oral health for the public and dental patients results from multifaceted factors. Now, more than ever, COVID-19 disease and restrictions has highlighted how essential it is to understand the variety of barriers to access oral health care services. Strict public health regulations by city, county, and state orders made any extramural community health site visit by students impossible. Solution: The Community Health Field Project was converted to a virtual community experience using the flipped classroom technique. Students, in teams of 3, chose a community social agency or dental clinic site via google sheet posted in Canvas. Journal articles on public health and community dentistry with special focus on barriers to access and social determinants of health (SDOH) were provided as reference. Each team researched a new article and contrasted their new article with the provided journal as a critical thinking exercise. Prior to the workshop, the teams created a case presentation after conducting a virtual tour of their site. Per the rubric, students researched information on the mission statement, history of the agency, a description of the business model, and the community members served. Students briefly explained the process of how a person became eligible for services or as a patient at their agency or clinic. Also noted was the neighborhood, public transportation, and access and referral toother medical, dental, and counseling services, etc. (Figure 1). Each week, teams representing each of the 6 community clinic sites presented their case presentations to peers and faculty. The students individually submitted a reflection in canvas after their workshop using the 4Fs framework—Facts, Findings, Feelings, and Future—as a review of their virtual experience. They were asked about their assumptions on all aspects of community health, SDOH, and how the virtual experiences altered or confirmed their assumptions

Calibration of dentists for Caries Management by Risk Assessment Research in a Practice Based Research Network - CAMBRA PBRN.

BackgroundTo prove that Caries Management by Risk Assessment (CAMBRA) can be successfully implemented in dental practices outside of the university setting, dentists in the San Francisco Bay Area (CA) were approached to participate in a Practice Based Research Network (PBRN) study. The overall goal of the CAMBRA-PBRN study was to recruit 30 dentists to perform a two-year study involving approximately 900 patients. Goal of the calibration study was to standardize and calibrate dentists potentially participating in the CAMBRA-PBRN study.MethodsTo minimize inter-examiner variability in data collection, including classification of carious lesions and recording of existing restorations, participating dentists were trained and calibrated in accurate DMFS (decayed, missing, filled surfaces) charting. Dentists were also trained and calibrated to diagnose and differentiate between sound surfaces and non-cavitated caries lesions (International Caries Detection and Assessment - ICDAS scores 1 and 2) for posterior occlusal surfaces. Thirty dentists were calibrated to a single gold standard examiner (BJ) during 6 calibration sessions, between 2011 and 2014. Kappa statistics were used to determine inter-examiner reliability on 13 or more patients, aged 12-63 (average age 38 ± 15 years), per examiner during each session, resulting in 94 patient encounters over the course of all 6 sessions. To participate in the main study, examiners needed to achieve a minimum required kappa of 0.75. During the calibration process, examiners scored between 1036 and 2220 tooth surfaces.ResultsThe kappa values (unweighted kappa) of the participating dentists compared to the gold standard examiner ranged from 0.75 to 0.90, with an average kappa of 0.84 ± 0.03. 90% of the examiners achieved overall kappa values above 0.8. However, separate reliability for assessment of non-cavitated lesions, as in other studies, was lower (0.55 ± 0.15). Multiple subcategories were evaluated. All dentists reached sufficient reliability values to proceed into the study; nevertheless, one dentist discontinued with the study due to scheduling conflicts.ConclusionsThe high inter-examiner reliability results have shown that dentists who work in primarily non-research based practices can be effectively standardized and calibrated in data collection, based on specific guidelines created to anticipate potential research study scenarios

Calibration of dentists for Caries Management by Risk Assessment Research in a Practice Based Research Network - CAMBRA PBRN

Abstract Background To prove that Caries Management by Risk Assessment (CAMBRA) can be successfully implemented in dental practices outside of the university setting, dentists in the San Francisco Bay Area (CA) were approached to participate in a Practice Based Research Network (PBRN) study. The overall goal of the CAMBRA-PBRN study was to recruit 30 dentists to perform a two-year study involving approximately 900 patients. Goal of the calibration study was to standardize and calibrate dentists potentially participating in the CAMBRA-PBRN study. Methods To minimize inter-examiner variability in data collection, including classification of carious lesions and recording of existing restorations, participating dentists were trained and calibrated in accurate DMFS (decayed, missing, filled surfaces) charting. Dentists were also trained and calibrated to diagnose and differentiate between sound surfaces and non-cavitated caries lesions (International Caries Detection and Assessment - ICDAS scores 1 and 2) for posterior occlusal surfaces. Thirty dentists were calibrated to a single gold standard examiner (BJ) during 6 calibration sessions, between 2011 and 2014. Kappa statistics were used to determine inter-examiner reliability on 13 or more patients, aged 12–63 (average age 38 ± 15 years), per examiner during each session, resulting in 94 patient encounters over the course of all 6 sessions. To participate in the main study, examiners needed to achieve a minimum required kappa of 0.75. During the calibration process, examiners scored between 1036 and 2220 tooth surfaces. Results The kappa values (unweighted kappa) of the participating dentists compared to the gold standard examiner ranged from 0.75 to 0.90, with an average kappa of 0.84 ± 0.03. 90% of the examiners achieved overall kappa values above 0.8. However, separate reliability for assessment of non-cavitated lesions, as in other studies, was lower (0.55 ± 0.15). Multiple subcategories were evaluated. All dentists reached sufficient reliability values to proceed into the study; nevertheless, one dentist discontinued with the study due to scheduling conflicts. Conclusions The high inter-examiner reliability results have shown that dentists who work in primarily non-research based practices can be effectively standardized and calibrated in data collection, based on specific guidelines created to anticipate potential research study scenarios

Role of Dendritic Cells in Antibody-Dependent Enhancement of Dengue Virus Infection▿

Dengue viruses (DV), composed of four distinct serotypes (DV1 to DV4), cause 50 to 100 million infections annually. Durable homotypic immunity follows infection but may predispose to severe subsequent heterotypic infections, a risk conferred in part by the immune response itself. Antibody-dependent enhancement (ADE), a process best described in vitro, is epidemiologically linked to complicated DV infections, especially in Southeast Asia. Here we report for the first time the ADE phenomenon in primary human dendritic cells (DC), early targets of DV infection, and human cell lines bearing Fc receptors. We show that ADE is inversely correlated with surface expression of DC-SIGN (DC-specific intercellular adhesion molecule-3-grabbing nonintegrin) and requires Fc gamma receptor IIa (FcγRIIa). Mature DC exhibited ADE, whereas immature DC, expressing higher levels of DC-SIGN and similar FcγRIIa levels, did not undergo ADE. ADE results in increased intracellular de novo DV protein synthesis, increased viral RNA production and release, and increased infectivity of the supernatants in mature DC. Interestingly, tumor necrosis factor alpha and interleukin-6 (IL-6), but not IL-10 and gamma interferon, were released in the presence of dengue patient sera but generally only at enhancement titers, suggesting a signaling component of ADE. FcγRIIa inhibition with monoclonal antibodies abrogated ADE and associated downstream consequences. DV versatility in entry routes (FcγRIIa or DC-SIGN) in mature DC broadens target options and suggests additional ways for DC to contribute to the pathogenesis of severe DV infection. Studying the cellular targets of DV infection and their susceptibility to ADE will aid our understanding of complex disease and contribute to the field of vaccine development

Two-Dimensional Hierarchical Semiconductor with Addressable Surfaces

Surfaces play a key role in determining material properties, and their importance is further magnified in the two-dimensional (2D) limit. Though monolayers are entirely composed of surfaces, there is no chemical approach to covalently address them without breaking intralayer bond. Here, we describe a 2D semiconductor that offers two unique features among 2D materials: structural hierarchy within the monolayer and surface reactive sites that enable functionalization. The 2D semiconductor is composed of a single layer of strongly interconnected Re₆Se₈ clusters arranged in an oblique lattice capped by substitutionally labile Cl atoms. We show that a simple ligand substitution strategy borrowed from traditional coordination chemistry can be used to modify the surface of the 2D material while preserving its internal structure. The potential generality of this approach establishes a promising route toward multifunctional 2D materials with tunable physical and chemical properties and may also facilitate better electrical top contact to 2D semiconductors

The Kidney and Periodontal Disease (KAPD) study: A pilot randomized controlled trial testing the effect of non-surgical periodontal therapy on chronic kidney disease.

IntroductionChronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects minorities and the poor, despite intense efforts targeting traditional risk factors. Periodontal diseases are common bacterial plaque-induced inflammatory conditions that can respond to treatment and have been implicated as a CKD risk factor. However there is limited evidence that treatment of periodontal disease slows the progression of CKD.Methods/designWe describe the protocol of the Kidney and Periodontal Disease (KAPD) study, a 12-month un-blinded, randomized, controlled pilot trial with two intent-to-treat treatment arms: 1. immediate intensive non-surgical periodontal treatment or 2. rescue treatment with delayed intensive treatment. The goals of this pilot study are to test the feasibility of conducting a larger trial in an ethnically and racially diverse, underserved population (mostly poor and/or low literacy) with both CKD and significant periodontal disease to determine the effect of intensive periodontal treatment on renal and inflammatory biomarkers over a 12-month period.ResultsTo date, KAPD has identified 634 potentially eligible patients who were invited to in-person screening. Of the 83 (13.1%) of potentially eligible patients who attended in-person screening, 51 (61.4%) were eligible for participation and 46 enrolled in the study. The mean age of participants is 59.2years (range 34 to 73). Twenty of the participants (43.5%) are Black and 22 (47.8%) are Hispanic.DiscussionResults from the KAPD study will provide needed preliminary evidence of the effectiveness of non-surgical periodontal treatment to slow CKD progression and inform the design future clinical research trials