Providing Preventive Oral Health Care to Infants and Young Children in Women, Infants, and Children (WIC), Early Head Start, and Primary Care Settings

This report focuses on seven oral health programs that provide preventive oral health care to young children (infants, toddlers, and children up to 5 years old) in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Early Head Start (EHS), and primary care settings. All of the programs strive to increase access to preventive oral health care by integrating dental services into primary care settings, WIC clinics, or EHS centers. These programs also rely on primary care providers (physicians, nurses, medical assistants, etc.) or new types of dental hygienists who can practice in community settings to deliver preventive oral health services. Two additional reports in this series describe the remaining programs that provide care in non-dental settings and programs designed to specifically address socioeconomic, cultural, and geographic barriers to preventive oral health care.The findings from the EAs of these programs are synthesized to highlight diverse and innovative strategies that are utilized to provide preventive oral health care in primary care settings, WIC clinics, or EHS centers. These strategies have potential for rigorous evaluation and could emerge as best practices. If proven effective, these innovative program elements could then be disseminated and replicated to increase access for populations in need of preventive oral health care

Innovations that Address Socioeconomic, Cultural, and Geographic Barriers to Preventive Oral Health Care

This report focuses on nine oral health innovations that integrate service delivery and workforce models in order to reduce or eliminate socioeconomic, geographic, and cultural barriers to care. Two additional reports in this series describe the remaining programs that provide care in non-dental settings and care to young children. Although the programs are diverse in their approaches as well as in the specific characteristics of the communities they serve, a common factor among them is the implementation of multiple strategies to increase the number of children from low-income families who access preventive care, and also to engage families and communities in investing in and prioritizing oral health. For low-income children and their families, the barriers that must be addressed to increase access to preventive oral health care are numerous. For example, even children covered by public insurance programs face a shortage of dentists that accept Medicaid and who specialize in pediatric dentistry.(Guay, 2004).The effects of poverty intersect with other barriers such as living in remote geographic areas and community-wide history of poor access to dental care in populations such as recent immigrants . Overcoming these barriers requires creative strategies that address transportation barriers; establish welcoming environments for oral health care; and are linguistically and culturally relevant. Each of these nine programs is based on such strategies, including:-Expanding the dental workforce through training new types of providers or adding new providers to their workforce to increase reach and community presence;-Implementing new strategies to increase the cost-effectiveness of care so that more oral health care services are available and accessible;-Providing training and technical assistance that increase opportunities for and competence in delivering oral health education and care to children;-Developing creative service delivery models that address transportation and cultural barriers as well as the fear and stigma associated with dental care that may arise in communities with historically poor access.The findings from the EAs of these programs are synthesized to highlight diverse and innovative strategies for overcoming barriers to access that have potential for rigorous evaluation that could emerge as best practices. If proven effective, these innovative program elements could then be disseminated and replicated to increase access for populations in need of preventive oral health care

Dental Professionals in Non-Dental Settings

This report focuses on nine oral health innovations seeking to increase access to preventive oral health care in nondental settings. Two additional reports in this series describe the remaining programs that provide care in dental settings and care to young children. The nine innovations described here integrate service delivery and workforce models in order to reduce or eliminate socioeconomic, geographic, and cultural barriers to care. Although the programs are diverse in their approaches as well as in the specific characteristics of the communities they serve, a common factor among them is the implementation of multiple strategies to increase the number of children from low-income families who access preventive care, and also to engage families and communities in investing in and prioritizing oral health. For low-income children and their families, the barriers that must be addressed to increase access to preventive oral health care are numerous. For example, even children covered by public insurance programs face a shortage of dentists that accept Medicaid and who specialize in pediatric dentistry. The effects of poverty intersect with other barriers such as living in remote geographic areas and having a community-wide history of poor access to dental care in populations such as recent immigrants. Overcoming these barriers requires creative strategies that address transportation barriers, establish welcoming environments for oral health care, and are linguistically and culturally relevant. Each of these nine programs is based on such strategies, including:-Expanding the dental workforce through training new types of providers or adding new providers to the workforce toincrease reach and community presence;-Implementing new strategies to increase the cost-effectiveness of care so that more oral health care services are available and accessible;-Providing training and technical assistance that increase opportunities for and competence in delivering oral health education and care to children;-Offering oral health care services in existing, familiar community venues such as schools, Head Start programs and senior centers;-Developing creative service delivery models that address transportation and cultural barriers as well as the fear and stigma associated with dental care that may arise in communities with historically poor access.The findings from the EAs of these programs are synthesized to highlight diverse and innovative strategies for overcoming barriers to access. These strategies have potential for rigorous evaluation and could emerge as best practices. If proven effective, these innovative program elements could then be disseminated and replicated to increase access for populations in need of preventive oral health care

Improving and disaggregating N2O emission factors for ruminant excreta on temperate pasture soils

pre-printCattle excreta deposited on grazed grasslands are a major source of the greenhouse gas (GHG) nitrous oxide (N2O). Currently, many countries use the IPCC default emission factor (EF) of 2% to estimate excreta-derived N2O emissions. However, emissions can vary greatly depending on the type of excreta (dung or urine), soil type and timing of application. Therefore three experiments were conducted to quantify excreta-derived N2O emissions and their associated EFs, and to assess the effect of soil type, season of application and type of excreta on the magnitude of losses. Cattle dung, urine and artificial urine treatments were applied in spring, summer and autumn to three temperate grassland sites with varying soil and weather conditions. Nitrous oxide emissions were measured from the three experiments over 12 months to generate annual N2O emission factors. The EFs from urine treated soil was greater (0.30–4.81% for real urine and 0.13–3.82% for synthetic urine) when compared with dung (− 0.02–1.48%) treatments. Nitrous oxide emissions were driven by environmental conditions and could be predicted by rainfall and temperature before, and soil moisture deficit after application; highlighting the potential for a decision support tool to reduce N2O emissions by modifying grazing management based on these parameters. Emission factors varied seasonally with the highest EFs in autumn and were also dependent on soil type, with the lowest EFs observed from well-drained and the highest from imperfectly drained soil. The EFs averaged 0.31 and 1.18% for cattle dung and urine, respectively, both of which were considerably lower than the IPCC default value of 2%. These results support both lowering and disaggregating EFs by excreta type.This research was financially supported under the National Development Plan, through the Research Stimulus Fund, administered by the Department of Agriculture, Food and the Marine (Grant numbers RSF10/RD/SC/716 and 11S138)

SEREEGA: Simulating Event-Related EEG Activity

Abstract Electroencephalography (EEG) is a popular method to monitor brain activity, but it can be difficult to evaluate EEG-based analysis methods because no ground-truth brain activity is available for comparison. Therefore, in order to test and evaluate such methods, researchers often use simulated EEG data instead of actual EEG recordings, ensuring that it is known beforehand which e ects are present in the data. As such, simulated data can be used, among other things, to assess or compare signal processing and machine learn-ing algorithms, to model EEG variabilities, and to design source reconstruction methods. In this paper, we present SEREEGA, short for Simulating Event-Related EEG Activity . SEREEGA is a MATLAB-based open-source toolbox dedicated to the generation of sim-ulated epochs of EEG data. It is modular and extensible, at initial release supporting ve different publicly available head models and capable of simulating multiple different types of signals mimicking brain activity. This paper presents the architecture and general work ow of this toolbox, as well as a simulated data set demonstrating some of its functions. Highlights Simulated EEG data has a known ground truth, which can be used to validate methods. We present a general-purpose open-source toolbox to simulate EEG data. It provides a single framework to simulate many different types of EEG recordings. It is modular, extensible, and already includes a number of head models and signals. It supports noise, oscillations, event-related potentials, connectivity, and more

Alternative societal solutions to pharmaceuticals in the aquatic environment

Environmental contamination with pharmaceuticals is widespread, inducing risks to both human health and the environment. This paper explores potential societal solutions to human and veterinary pharmaceuticals in the aquatic environment. To this end, we adopt transition research’s multi-level perspective framework, which allows us to understand the dynamics underlying pharmaceutical emissions and to recognize social and technical factors triggering change. Our qualitative analysis is based on data collected through literature research and interviews with actors from pharmaceutical industry, the health and agricultural sector. The research aims at identifying potential future solutions including requirements for as well as barriers to pathways leading to these solutions and describing the role of key actors involved. The three alternative societal solutions identified are: 1) accepting pharmaceuticals in the environment - substantial changes to the system are not required; 2) reconfiguring the current system by implementing various innovations that reduce pharmaceutical emissions; 3) fundamentally changing the current system to (largely) avoid pharmaceutical emissions. The paper further elicits societal, financial, organizational, regulatory and technological requirements that can facilitate implementation of these solutions. This work is novel as it constitutes a systemic view on all stages of the pharmaceutical lifecycle, comprehensively synthesizing options and measures along the entire lifecycle into societal solutions that are framed as transition pathways. Deriving societal solutions from key actor’s perspectives is innovative and provides insights to reflect on choices societies are going to have to make regarding pharmaceuticals in the environment.The authors gratefully thank interviewees who allocated time to answer interview questions, shared valuable insights and expressed opinions. Thanks to G. Niebaum for feedback after a trial interview and to E. Aukes for methodological advice. Brugnach’s contribution was partially supported by the Spanish Government’s María de Maeztu excellence accreditation (Ref. MDM-2017-0714 ). The authors acknowledge funding by the European Regional Development fund of the European Union under the INTERREG project MEDUWA-Vecht(e) (project number 142118)

Patchy Amphiphilic Dendrimers Bind Adenovirus and Control Its Host Interactions and in Vivo Distribution

The surface of proteins is heterogeneous with sophisticated but precise hydrophobic and hydrophilic patches, which is essential for their diverse biological functions. To emulate such distinct surface patterns on macromolecules, we used rigid spherical synthetic dendrimers (polyphenylene dendrimers) to provide controlled amphiphilic surface patches with molecular precision. We identified an,. I optimal spatial arrangement of these patches on certain dendrimers that enabled their interaction with human adenovirus 5 (Ads). Patchy dendrimers bound to the surface of Ads formed a synthetic polymer corona that greatly altered various host interactions of Ads as well as in vivo distribution. The dendrimer corona (1) improved the ability of Ad5-derived gene transfer vectors to transduce cells deficient for the primary Ad5 cell membrane receptor and (2) modulated the binding of Ads to blood coagulation factor X, one of the most critical virus host interactions in the bloodstream. It significantly enhanced the transduction efficiency of Ad5 while also protecting it from neutralization by natural antibodies and the complement system in human whole blood. Ads with a synthetic dendrimer corona revealed profoundly altered in vivo distribution, improved transduction of heart, and dampened vector sequestration by liver and spleen. We propose the design of bioactive polymers that bind protein surfaces solely based on their amphiphilic surface patches and protect against a naturally occurring protein corona, which is highly attractive to improve Ad5-based in vivo gene therapy applications

Inverse modeling of GOSAT-retrieved ratios of total column CH4 and CO2 for 2009 and 2010

This study investigates the constraint provided by greenhouse gas measurements from space on surface fluxes. Imperfect knowledge of the light path through the atmosphere, arising from scattering by clouds and aerosols, can create biases in column measurements retrieved from space. To minimize the impact of such biases, ratios of total column retrieved CH4 and CO2 (Xratio) have been used. We apply the ratio inversion method described in Pandey et al. (2015) to retrievals from the Greenhouse Gases Observing SATellite (GOSAT). The ratio inversion method uses the measured Xratio as a weak constraint on CO2 fluxes. In contrast, the more common approach of inverting proxy CH4 retrievals (Frankenberg et al., 2005) prescribes atmospheric CO2 fields and optimizes only CH4 fluxes. The TM5–4DVAR (Tracer Transport Model version 5–variational data assimilation system) inverse modeling system is used to simultaneously optimize the fluxes of CH4 and CO2 for 2009 and 2010. The results are compared to proxy inversions using model-derived CO2 mixing ratios (XCO2model) from CarbonTracker and the Monitoring Atmospheric Composition and Climate (MACC) Reanalysis CO2 product. The performance of the inverse models is evaluated using measurements from three aircraft measurement projects. Xratio and XCO2model are compared with TCCON retrievals to quantify the relative importance of errors in these components of the proxy XCH4 retrieval (XCH4proxy). We find that the retrieval errors in Xratio (mean  =  0.61 %) are generally larger than the errors in XCO2model (mean  =  0.24 and 0.01 % for CarbonTracker and MACC, respectively). On the annual timescale, the CH4 fluxes from the different satellite inversions are generally in agreement with each other, suggesting that errors in XCO2model do not limit the overall accuracy of the CH4 flux estimates. On the seasonal timescale, however, larger differences are found due to uncertainties in XCO2model, particularly over Australia and in the tropics. The ratio method stays closer to the a priori CH4 flux in these regions, because it is capable of simultaneously adjusting the CO2 fluxes. Over tropical South America, comparison to independent measurements shows that CO2 fields derived from the ratio method are less realistic than those used in the proxy method. However, the CH4 fluxes are more realistic, because the impact of unaccounted systematic uncertainties is more evenly distributed between CO2 and CH4. The ratio inversion estimates an enhanced CO2 release from tropical South America during the dry season of 2010, which is in accordance with the findings of Gatti et al. (2014) and Van der Laan et al. (2015). The performance of the ratio method is encouraging, because despite the added nonlinearity due to the assimilation of Xratio and the significant increase in the degree of freedom by optimizing CO2 fluxes, still consistent results are obtained with respect to other CH4 inversions