Study on the Evaluation of the European Union Agency for Network and Information Security

The European Union Agency for Network and Information Security (ENISA) was established in 2004. The Agency provides advice and recommendations, data analysis, and supports awareness raising and cooperation by the EU bodies and Member States in the field of cybersecurity. ENISA uses its expertise to improve cooperation between Member States, and between actors from the public and private sectors, as well as to support capacity building. The present study involves the evaluation of ENISA over the 2013-2016 period, assessing the Agency’s performance, governance and organisational structure, and positioning with respect to other EU and national bodies. It assesses ENISA’s strengths, weaknesses, opportunities and threats (SWOTs) with regard to the new cybersecurity and digital privacy landscape. It also provides options to modify the mandate of the Agency to better respond to new, emerging needs and assesses their financial implications. The findings of the evaluation study show that ENISA has made some important achievements towards increasing NIS in the EU. However, a fragmented approach to cybersecurity across the EU and issues internal to the Agency, including limited financial resources, hinder ENISA’s ability to respond to the ever growing needs of stakeholders in a context of technological developments and evolving cybersecurity threats

Principles of Periodontology

Periodontal diseases are among the most common diseases affecting humans. Dental biofilm is a contributor to the etiology of most periodontal diseases. It is also widely accepted that immunological and inflammatory responses to biofilm components are manifested by signs and symptoms of periodontal disease. The outcome of such interaction is modulated by risk factors (modifiers), either inherent (genetic) or acquired (environmental), significantly affecting the initiation and progression of different periodontal disease phenotypes. While definitive genetic determinants responsible for either susceptibility or resistance to periodontal disease have yet to be identified, many factors affecting the pathogenesis have been described, including smoking, diabetes, obesity, medications, and nutrition. Currently, periodontal diseases are classified based upon clinical disease traits using radiographs and clinical examination. Advances in genomics, molecular biology, and personalized medicine may result in new guidelines for unambiguous disease definition and diagnosis in the future. Recent studies have implied relationships between periodontal diseases and systemic conditions. Answering critical questions regarding host‐parasite interactions in periodontal diseases may provide new insight in the pathogenesis of other biomedical disorders. Therapeutic efforts have focused on the microbial nature of the infection, as active treatment centers on biofilm disruption by non‐surgical mechanical debridement with antimicrobial and sometimes anti‐inflammatory adjuncts. The surgical treatment aims at gaining access to periodontal lesions and correcting unfavorable gingival/osseous contours to achieve a periodontal architecture that will provide for more effective oral hygiene and periodontal maintenance. In addition, advances in tissue engineering have provided innovative means to regenerate/repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors/biologic mediators. To maintain periodontal stability, these treatments need to be supplemented with long‐term maintenance (supportive periodontal therapy) programs

Interpain A, a Cysteine Proteinase from Prevotella intermedia, Inhibits Complement by Degrading Complement Factor C3

Periodontitis is an inflammatory disease of the supporting structures of the teeth caused by, among other pathogens, Prevotella intermedia. Many strains of P. intermedia are resistant to killing by the human complement system, which is present at up to 70% of serum concentration in gingival crevicular fluid. Incubation of human serum with recombinant cysteine protease of P. intermedia (interpain A) resulted in a drastic decrease in bactericidal activity of the serum. Furthermore, a clinical strain 59 expressing interpain A was more serum-resistant than another clinical strain 57, which did not express interpain A, as determined by Western blotting. Moreover, in the presence of the cysteine protease inhibitor E64, the killing of strain 59 by human serum was enhanced. Importantly, we found that the majority of P. intermedia strains isolated from chronic and aggressive periodontitis carry and express the interpain A gene. The protective effect of interpain A against serum bactericidal activity was found to be attributable to its ability to inhibit all three complement pathways through the efficient degradation of the α-chain of C3—the major complement factor common to all three pathways. P. intermedia has been known to co-aggregate with P. gingivalis, which produce gingipains to efficiently degrade complement factors. Here, interpain A was found to have a synergistic effect with gingipains on complement degradation. In addition, interpain A was able to activate the C1 complex in serum, causing deposition of C1q on inert and bacterial surfaces, which may be important at initial stages of infection when local inflammatory reaction may be beneficial for a pathogen. Taken together, the newly characterized interpain A proteinase appears to be an important virulence factor of P. intermedia

Acute periodontal lesions

This is a review and update on acute conditions affecting the gingival tissues, including abscesses in the periodontium, necrotizing periodontal diseases, and other acute conditions that cause gingival lesions with acute presentation, such as infectious process not associated with oral bacterial biofilms, muco-cutanenous disorders, and traumatic and allergic lesions. A periodontal abscess is clinically important since it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth, and because bacteria within the abscess have been identified, mainly by the type of etiology, and there are clear diffrences between those affecting a previously existing periodontal pocket ahd those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, with individual evaluation of the need for systemic antimicrobial therapy. the definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal disease (NPD) present three typical clinical features : papilla necrosis, gingival bleeding, and pain. Although the prevalence of these diseases is not high, their importance is clear, since they represent the most severe conditions associated with dental biofilm, with very rapid tissue destruction. In adittion to bacteria, the etiology of NPD includes numerous factors that alter the host response and predispose to these diseases, including HIV infection, malnutrition, stress, and tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine, and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in non-responding conditions and the best option is metronidazole.Once the acute disease is under control, definitive treatment should be provided, including the adequate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms , are infectious diseases, muco-cutaneous diseases and traumatic or allergic lesions. In most cases, the gingival envolvement is not severe, though they are common and may prompt a dental emergency visit. These conditions may the direct result of a trauma or the consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for an adequate management of the case

The Interactive Examination. A summative report of seven years of development and evaluation of an innovative assessment model in higher education.

The ability to self-assess one's competence is a crucial skill for all health professionals. The interactive examination is an assessment model aiming to evaluate not only students' clinical skills and competence, but also their ability to self-assess their proficiency. The methodology utilised students' own self-assessment, an answer to a written essay question and a group discussion. In five studies the role of Interactive Examination for learning and development of metacognitive skills in dental students was evaluated. Teachers and students' acceptance of the methodology was very positive. The Interactive Examination appeared to be a promising tool for providing a deeper insight in student s ability to self-assess and steer their learning. Exploration of the entire potential of the interactive examination would require full implementation of the method in a given curriculum

Mandibular growth estimated by four cephalometric measurements

Mandibular growth was estimated by four cephalometric measurements on three lateral cephalograms of 21 subjects. The estimates made by three standard cephalometric approaches were compared with that made by a "scientific" method. The scientific method was based on the change in position of the cephalometric landmark condylion on cephalograms orientated on two metal implants inserted in the mandible. 15The other three investigated "standard" cephalometric methods were each based on estimating the difference in length between two cephalometric landmarks: (1) pogonion-condylion, (2) pogonion-articulare, and (3) maximum mandibular length. In general, the individual estimates of the amount of mandibular growth by the scientific method and that estimated by each of the standard cephalometric methods were not proportional. Some factors affected the estimates of mandibular growth. For example, (1) the growth direction of the condyle, (2) the change in position of pogonion on the mandible during the growth, and (3) the apposition of bone on the chin in some cases. The amount of mandibular growth, which is estimated by the standard cephalometric methods, and growth velocity curves, which is based on such estimates, are therefore not valid. Accordingly, conventional cephalometric analyses are not as reliable at traditionally envisaged. © 1992 American Association of Orthodontists.link_to_subscribed_fulltex