The Role of Dental Hygienist in HPV Prevention and Education in Parents of Adolescents

Objectives/Aims: Today the Human Papillomavirus (HPV) infects nearly 14 million people each year in the United States alone. HPV is responsible for several cancers, including oropharyngeal, which is currently on the rise. Each year an estimated 53,000 cases of oropharyngeal cancers are diagnosed, with 70% of the cases related to HPV. The significance of educating dental providers and patients of the correlations between HPV and oropharyngeal cancers involves increased prevention strategies in dental practices. The aim is to begin offering multi-level education to adolescents’ parent’s in routine dental care visits, in order to provide an innovative approach to reduce HPV-related cancers. Methods: A sequence of MeSH terms were used to search the literature which included “HPV prevention strategies”, “Dental hygienist” and “HPV-related oropharyngeal cancer.” Results were refined to studies published within the last five years, excluding other countries outside the United States, and was centered to primary research sources. Results: The Human papillomavirus (HPV) has been shown to increase the rates of several cancers outside the cervical region, including cancers of the oropharynx. Evidence based research has discovered HPV vaccines that protect against strains of cervical cancer are likely to have the same effect in preventing HPV infections in the oropharynx. Researching the current data from The American Dental Education Association and PubMed Database, studies suggest that dental providers often feel uncomfortable providing HPV prevention with patients due to barriers: age, sexual orientation, and patient reactions. Dental providers should strongly consider implementing HPV prevention behaviors in dental practices to include HPV education, recommending the vaccine and referring patients for the vaccination. Conclusion: Compiling appropriate training along with refining dental providers self-efficacy to communicate HPV prevention strategies through continuing education. Along with expertise guided training in dental hygiene curricula could facilitate the process of reducing HPV-related cancers in the oral cavity.https://scholarscompass.vcu.edu/denh_student/1021/thumbnail.jp

The Internal-Collision-Induced Magnetic Reconnection and Turbulence (ICMART) Model of Gamma-Ray Bursts

The recent Fermi observation of GRB 080916C shows that the bright photosphere emission associated with a putative fireball is missing, which suggests a Poynting-flux-dominated outflow. We propose a model of gamma-ray burst (GRB) prompt emission in the Poynting-flux-dominated regime, namely, the Internal-Collision-induced MAgnetic Reconnection and Turbulence (ICMART) model. It is envisaged that the GRB central engine launches an intermittent, magnetically-dominated wind, and that in the GRB emission region, the ejecta is still moderately magnetized. Similar to the internal shock (IS) model, the mini-shells interact internally at the traditional internal shock radius. Most of these early collision have little energy dissipation, but serve to distort the ordered magnetic field lines. At a certain point, the distortion of magnetic field configuration reaches the critical condition to allow fast reconnection seeds to occur, which induce relativistic MHD turbulence in the interaction regions. The turbulence further distorts field lines easing additional magnetic reconnections, resulting in a runway release of the stored magnetic field energy (an ICMART event). Particles accelerated in the ICMART region radiate synchrotron photons that power the observed gamma-rays. Each ICMART event corresponds to a broad pulse in the GRB lightcurve, and a GRB is composed of multiple ICMART events. This model retains the merits of the IS and other models, but may overcome several difficulties/issues faced by the IS model (e.g. low efficiency, fast cooling, electron number excess, Amati/Yonetoku relation inconsistency, and missing bright photosphere). It predicts two-component variability time scales, and a decreasing Ep and polarization degree during each ICMART event. The model may be applied to most Fermi LAT GRBs that have time-resolved, featureless Band-function spectra (abridged).Comment: ApJ, in press (submitted on May 6, 2010). 27 emulateapj pages, 4 figures. Minor changes to match the published versio

Magnetic field structure of relativistic jets without current sheets

We present an analytical class of equilibrium solutions for the structure of relativistic sheared and rotating magnetized jets that contain no boundary current sheets. We demonstrate the overall dynamical stability of these solutions and, most importantly, a better numerical resistive stability than the commonly employed force-free structures which inevitably require the presence of dissipative surface currents. The jet is volumetrically confined by the external pressure, with no pressure gradient on the surface. We calculate the expected observed properties of such jets. Given the simplicity of these solution we suggest them as useful initial conditions for relativistic jet simulations.Comment: 13 pages, 13 figures, Accepted by MNRA

Open Questions in GRB Physics

Open questions in GRB physics are summarized as of 2011, including classification, progenitor, central engine, ejecta composition, energy dissipation and particle acceleration mechanism, radiation mechanism, long term engine activity, external shock afterglow physics, origin of high energy emission, and cosmological setting. Prospects of addressing some of these problems with the upcoming Chinese-French GRB mission, SVOM, are outlined.Comment: 27 pages. To appear in a special issue of Comptes Rendus Physique "GRB studies in the SVOM era", Eds. F. Daigne, G. Dubu

Spatio-temporal variation in progression rates of black band disease between Pramuka Island and Pari Island of the Seribu Islands, Indonesia

Black band disease (BBD) is one of the oldest recognized diseases of scleractinian corals. This disease is little known on the variation of progression rates across relatively small spatial scales and how local variations in the environment can impact prevalence and spread. The purpose of this study was to explore the progression of BBD on genus Montipora in relation to spatio-temporal environmental parameters in two islands of the Seribu Islands, North Jakarta, Indonesia during dry season and rainy season. Monthly underwater pictures were taken for determining the progress of disease level. Interestingly, the progression rate of the disease recorded at Pramuka Island was higher (8.10 cm2 day-1) than the one at Pari Island (3.79 cm2 day-1). In Pramuka Island, the infected corals had almost 89% of the dead surface, compared to only 68% at Pari Island. Similar to other studies in the region, we confirmed that the disease progressed faster during the dry season, where the environmental parameters, such as temperature, light intensity, and phosphate, were starting to increase, while total organic matter, current flow rates, and turbidity were lower. Progression of the disease was significantly different between seasons (p<0.001), but not between sites (p=0.118). Therefore, the progress of BBD has a higher impact at the more populated Pramuka island than at the less populated Pari Island, in addition to the influence of environmental parameters on coral vulnerability to diseases

Translating Glutamate: From Pathophysiology to Treatment

The neurotransmitter glutamate is the primary excitatory neurotransmitter in mammalian brain and is responsible for most corticocortical and corticofugal neurotransmission. Disturbances in glutamatergic function have been implicated in the pathophysiology of several neuropsychiatric disorders—including schizophrenia, drug abuse and addiction, autism, and depression—that were until recently poorly understood. Nevertheless, improvements in basic information regarding these disorders have yet to translate into Food and Drug Administration–approved treatments. Barriers to translation include the need not only for improved compounds but also for improved biomarkers sensitive to both structural and functional target engagement and for improved translational models. Overcoming these barriers will require unique collaborative arrangements between pharma, government, and academia. Here, we review a recent Institute of Medicine–sponsored meeting, highlighting advances in glutamatergic theories of neuropsychiatric illness as well as remaining barriers to treatment development.National Institute of Mental Health (U.S.) (grant R37MH49334)National Institute of Mental Health (U.S.) (Intramural Research Program)National Institute of Mental Health (U.S.) (R01DA03383)National Institute of Mental Health (U.S.) (P50MH086385)National Institutes of Health (U.S.)FRAXA Research FoundationHoward Hughes Medical InstituteSimons Foundatio

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Nuclear instrumentation and measurement: a review based on the ANIMMA conferences

The ANIMMA conferences offer a unique opportunity to discover research carried out in all fields of nuclear measurements and instrumentation with applications extending from fundamental physics to fission and fusion reactors, medical imaging, environmental protection and homeland security. After four successful editions of the Conference, it was decided to prepare a review based to a large extent but not exclusively on the papers presented during the first four editions of the conference. This review is organized according to the measurement methodologies: neutronic, photonic, thermal, acoustic and optical measurements, as well as medical imaging and specific challenges linked to data acquisition and electronic hardening. The paper describes the main challenges justifying research in these different areas, and summarizes the recent progress reported. It offers researchers and engineers a way to quickly and efficiently access knowledge in highly specialized areas

Contextualising complementary feeding in a broader framework for stunting prevention

An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels