Promoting access to dental care in South London: adult patients' perspectives.

Objective: To evaluate patients' views on health service initiatives established to improve uptake of NHS primary dental care amongst adult patients in a socially deprived area, comparing practices with extended and regular contract capacity. Study design: Service evaluation and cross-sectional survey. Method: Questionnaire survey of patients attending a random sample of dental practices in three inner-metropolitan boroughs of south London following initiatives to improve access to dental care (across dental practices delivering regular and extended contracts for services) exploring attendance patterns and the influence and awareness of local initiatives to promote access. Results: Four hundred fifty adults across 12 dental practices completed questionnaires: 79% reported attending for routine and 21% for urgent care. Patients were most aware of banners outside practices, followed by dental advertisements in newspapers. Vouchers for free treatments were considered of the highest possible influence, followed by vouchers for reduced treatment costs and an emergency out-of-hours helpline. Awareness and influence were not aligned, and there was no evidence of difference by practice contract type whilst there were differences by age and type of attendance. Conclusion: The findings suggest that financial incentives and emergency services are considered the most influential initiatives for adult patients whose attendance patterns appear to be related to personal circumstances rather than merely being influenced by the provision of information

A Novel Ecdysone Receptor Mediates Steroid-Regulated Developmental Events during the Mid-Third Instar of Drosophila

The larval salivary gland of Drosophila melanogaster synthesizes and secretes glue glycoproteins that cement developing animals to a solid surface during metamorphosis. The steroid hormone 20-hydroxyecdysone (20E) is an essential signaling molecule that modulates most of the physiological functions of the larval gland. At the end of larval development, it is known that 20E—signaling through a nuclear receptor heterodimer consisting of EcR and USP—induces the early and late puffing cascade of the polytene chromosomes and causes the exocytosis of stored glue granules into the lumen of the gland. It has also been reported that an earlier pulse of hormone induces the temporally and spatially specific transcriptional activation of the glue genes; however, the receptor responsible for triggering this response has not been characterized. Here we show that the coordinated expression of the glue genes midway through the third instar is mediated by 20E acting to induce genes of the Broad Complex (BRC) through a receptor that is not an EcR/USP heterodimer. This result is novel because it demonstrates for the first time that at least some 20E-mediated, mid-larval, developmental responses are controlled by an uncharacterized receptor that does not contain an RXR-like component

Early infant HIV-1 diagnosis programs in resource-limited settings: opportunities for improved outcomes and more cost-effective interventions

Early infant diagnosis (EID) of HIV-1 infection confers substantial benefits to HIV-infected and HIV-uninfected infants, to their families, and to programs providing prevention of mother-to-child transmission (PMTCT) services, but has been challenging to implement in resource-limited settings. In order to correctly inform parents/caregivers of infant infection status and link HIV-infected infants to care and treatment, a 'cascade' of events must successfully occur. A frequently cited barrier to expansion of EID programs is the cost of the required laboratory assays. However, substantial implementation barriers, as well as personnel and infrastructure requirements, exist at each step in the cascade. In this update, we review challenges to uptake at each step in the EID cascade, highlighting that even with the highest reported levels of uptake, nearly half of HIV-infected infants may not complete the cascade successfully. We next synthesize the available literature about the costs and cost effectiveness of EID programs; identify areas for future research; and place these findings within the context of the benefits and challenges to EID implementation in resource-limited settings

Specific Humoral Immunity versus Polyclonal B Cell Activation in Trypanosoma cruzi Infection of Susceptible and Resistant Mice

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, affects 10–12 million people in Latin America. Patent parasitemia develops during acute disease. During this phase, polyclonal B cell activation has been reported to generate high levels of serum antibody with low parasite specificity, and delayed protective humoral immunity, which is necessary to prevent the host from succumbing to infection. In this manuscript, data show that relatively resistant mice have improved parasite-specific humoral immunity and decreased polyclonal B cell activation compared to susceptible mice. Parasite-specific humoral immunity was associated with differential expansion of B cell subsets and T cells in the spleen, as well as with increased Th1 and decreased Th2 cytokine production. These data suggest that host susceptibility/genetic biases impact the development of humoral responses to infection. Th2 cytokines are generally associated with improved antibody responses. In the context of T. cruzi infection of susceptible mice, Th2 cytokines were associated with increased total antibody production concomitant with delayed pathogen-specific humoral immunity. This study highlights the need to consider the effect of host biases when investigating humoral immunity to any pathogen that has reported polyclonal B cell activation during infection

A community-sourced glossary of open scholarship terms

Supplementary Information: This list of terms represents the ‘Open Scholarship Glossary 1.0’ (available at: https://forrt.org/glossary/. Glossary available under a CC BY NC SA 4.0 license at: https://static-content.springer.com/esm/art%3A10.1038%2Fs41562-021-01269-4/MediaObjects/41562_2021_1269_MOESM1_ESM.pdf).https://static-content.springer.com/esm/art%3A10.1038%2Fs41562-021-01269-4/MediaObjects/41562_2021_1269_MOESM1_ESM.pd