Direction & Dilemma of Tropical Oral Health: a position paper

A number of tropical and communicable diseases are evident as oral manifestations. The tropical and communicable disease of oral health concern is an issue because, not only it is restricted to tropical countries, it is also affecting an underserved population of developed countries. Cross-border transmission of communicable diseases of tropical countries is an agenda where the number of tropical diseases, manifested with oral lesions, has not been taken into consideration by oral health care providers for timely identification and setting a goal for prevention and control of transmission at home and abroad. Moreover, every developed country has underserved populations that are prone to develop communicable oral diseases/TODs like tropical countries. The underserved population in developed countries are also experiencing higher incidence rate of communicable diseases which are not necessarily due to cross-border transmission, but related to their poor life-style and other prevailing factors of inequalities. However, the type of communicable diseases is dependent on the mode of transmission and progression; it may be contagious, vector borne or environmentally transmitted. Using TRIP (copy available at ICTOH*), I have searched and collated information anecdotally to understand the situation of the tropical oral diseases. First, we need to define what are tropical oral diseases? On this issue we had several discussions and interactions and reviewing of reports. We concluded that the tropical oral diseases largely cover communicable diseases which are mostly prevalent in the tropical countries. Also non-communicable diseases of life-threatening nature, those that are widely prevalent in the tropical countries, such as oral cancer and pre-cancer (in SE Asia), Noma (in Africa) could be taken into consideration to be identified as a category of tropical oral diseases (TODs). Moreover, till date, we are not able to rule out precisely, any possibility of mutational transmission of communicable disease(s) of oral health concern. Therefore, although all the communicable diseases have an infective nature, we cannot ignore the potential of inheritance factor which may exist irrespective of tropical and non-tropical locations, globally. To reduce the inequalities and improve prevention, including consistent clinical management (tertiary care), our oral health care providers may need to be adequately equipped to combat TODs. There are various oral diseases and conditions which fall into the category of ‘TODs,’ that need to be detected and managed by the general dental practitioners. They need to be able to ascertain when they should refer the critical TODs/cases to a specialist in oral medicine and/or surgery or a physician. Many of these disease (TODs) conditions are manifested with similar features and therefore it becomes almost impossible to identify these diseases clinically for definite diagnosis. In order to ensure that dental practitioners are able to tackle TODs appropriately and efficiently, development of appropriate measures to tackle TODs, in both clinical and community settings is necessary. The development of clinical databases and diagnostic test reports, carried out in the tropical countries is therefore highly recommended. The pooling of resources and clinical knowledge for early detection (required for early prevention and appropriate management of TODs) should therefore be an important point of consideration. I also strongly suggest developing a framework convention to recognize the TODs globally through a realistic strategic approach. Another very important component is development of research specifically in the areas of TODs. In the 1st International working group meeting we had discussed and taken resolution which had been published as a declaration from Poole, England. We have already started to develop a database in part of India, Bangladesh, Sudan, and Jordan. Therefore, it is our responsibility and commitment to put our efforts to pursuing need-based researches on the priority areas of TODs. The identification of the TOD priority research and the establishment of a research team with a lead will be a significant shot in the arm in the process of developing TOH and may generate the momentum which will ultimately lead to the further development of this area. Therefore, in this meeting I suggest the development of a research team(s) by a lead, and to work for securing grants-in –aids, nationally and internationally. We have started few projects with local support which will probably help act as pilot projects for the larger collaborative projects(s) to submitting for grants-in-aids in the near future. We would need to work on TODs, focusing on the aim of developing a few specific objectives, keeping in mind how beneficial it will be for the WHO International Clinical Trial Registry Platform. We may eventually propose a broad classification of TDOs as (i) Communicable and transmissible tropical oral diseases (TODs) includes Category 1 (Highly prevalent): AIDS/HIV infection, Malaria, TB, Kala-Azar, and Category 2 (Moderately prevalent): Mucocutaneous Leishmaniasis (MCL), Onchocerciasis, and Leprosy. (ii) Non-communicable diseases causing death and disability in the tropical countries. Oral Cancer, Noma (Cancrum Oris), PCM i.e. Marasmus (M), Kwashiorkor (K) including M&K and Diabetes. We do not have sufficient information on oral manifestation of WHO listed other tropical and communicable diseases which are mostly prevalent in African and Asian tropical countries, needs to be data-based. Moreover, we also need to identify the other systemic diseases of oral health concern in the tropical countries, (Proposed checklist draft protocol is available at ICTOH*).Some of those diseases is preceded with oral signs and/or coincided should be an important concern for oral health practitioners. However, I have identified the following constrains could be tackled through effective approaches for a realistic development of TODs, and that may help in a direction. Inadequate clinical data: Needs to be developed with an authentic database Inadequate training facilities for clinical diagnosis and management of TODs and conditions: A structured training programme for clinical diagnosis and management needs to be developed Lack of initiative for community education for the prevention and control: Oral health professionals of the tropical countries may need to participate, individually, and/or in a team (through an integrated approach) for the prevention and control of communicable diseases of oral health concern including TODs and general systemic diseases with oral manifestations (Preceded and/or coincided oral signs) Non-existence of categorization of Tropical Disease Research (TDR) [cf. WHO TDR value for tropical disease]: A specific TDR for TODs would be a good initiative Inadequate research: Priority-based systematic lab-based and epidemiological researches need to be developed, within the existing facilities Non existence of specific course contents: The syllabus and curriculums of the undergraduate and postgraduate courses need to be incorporated with the specific modules of TODs (especially in the tropical countries)

Is it necessary to stop HIV infected mothers breastfeeding? We need a clear-cut decision.

I refer to the timely article by Doherty et al. published in the February issue of the Bulletin of World health Organization (1). It has been seen in Southern India that out of 134 HIV-infected mothers, 81% are a potential source of vertical transmission of HIV and this devastating impact on families is alarming (2). We have no further information on this group of HIV-positive mothers, in particular how many infected mothers are giving birth the HIV-positive babies, and also what is the possibility of HIV transmission by breastfeeding in this group. We need a decision regarding the safety of children breastfeeding from a HIV positive mothers. Should those mothers stop feeding their babies to prevent transmission of HIV? Recent studies revealed that HIV type 1 (HIV-1) in breast milk may not necessarily infect a child through breastfeeding. Again, from a review of several recent publications, it has been reported that there is a possible risk to transmit HIV-1 by breastfeeding, but that the risk is not highly significant. The risk is there, of course, but may be cured with timely anti retroviral therapy treatment of the HIV-positive pregnant mother. The fact is that breastfeeding saves many children, mainly in resource-poor countries where the majority of people cannot afford formula milk or a good substitute to mother’s milk. Eventually, breastfeeding not only protects babies by increasing their immunity to infection, breast milk also prevents under-nutrition and starvation. Breastfeeding is still recommended where infectious diseases are a common cause of childhood death, despite the additional risk of HIV transmission. Unfortunately, there is an ambiguous recommendation “In countries where safe alternatives to breast milk exist, HIV-1 positive mothers should not breast feed their infants. On the other hand, in countries where infectious diseases cause considerable infant death, HIV-1 positive mothers should consider breastfeeding.” (3). We need a clear evidence-based opinion on HIV infected breastfeeding: is it safe or not? Chitta Ranjan Choudhury. REFERENCES: Tanya Doherty et al. Effect of the HIV epidemic on infant feeding in South Africa: "When they see me coming with the tins they laugh at me". Bull World Health Organ 2006;84:90-97 Mayer K et al. Marriage, monogamy and HIV: a profile of HIV-infected women in south India International Journal of STD & AIDS, Volume 11, Number 4, 1 April 2000, pp. 250-253(4) Dunn DT, Newell ML, Ades AE, Peckham CS. Risk of human immunodeficiency virus type 1 transmission through breastfeeding. Lancet: 1992 Sep 5;340(8819):585-8. Epidemiology and Biostatistics Unit, Institute of Child Health, London, UK. Professor Chitta Ranjan Choudhury, Coordinator, International Programme for Tropical Oral Health, Poole Hospital NHS and IHCS, Bournemouth University, Longfleet road, Poole, Dorset BH15 JB, England, UK; and Head, Department of Oral Biology, Centre for Oral Disease Prevention & Control, AB Shetty Memorial institute of Dental Sciences, Deralakatte, Mangalore, India (Email: [email protected])

Gender integration in aquaculture research and technology adoption processes: lessons learned in Bangladesh

This working paper is part of a review of aquaculture technologies and gender in Bangladesh in the period 1990 to 2014. It assesses how gender has been integrated within past aquaculture technology interventions, before exploring the gender dimensions associated with current approaches to transferring knowledge about homestead aquaculture technology. It draws out existing knowledge, identifies research gaps, and selects practices to build upon--as well as practices to move away from. The review examines the research and practice of WorldFish and other development partners in Bangladesh through consultations, a review of gray and published literature, and fieldwork. It aims to contribute to the development of aquaculture technology dissemination methodologies that strengthen and underpin women’s participation in aquaculture

Lepton flavor violation decays τ−→μ−P1P2\tau^-\to \mu^- P_1 P_2 in the topcolor-assisted technicolor model and the littlest Higgs model with TT parity

The new particles predicted by the topcolor-assisted technicolor ($TC2$) model and the littlest Higgs model with T-parity (called $LHT$ model) can induce the lepton flavor violation ($LFV$) couplings at tree level or one loop level, which might generate large contributions to some $LFV$ processes. Taking into account the constraints of the experimental data on the relevant free parameters, we calculate the branching ratios of the $LFV$ decay processes $\tau^-\to\mu^- P_1 P_2$ with $P_1 P_2$ = $\pi^+\pi^-$, $K^+K^-$ and $K^0\bar{K^0}$ in the context of these two kinds of new physics models. We find that the $TC2$ model and the $LHT$ model can indeed produce significant contributions to some of these $LFV$ decay processes.Comment: 24 pages, 7 figure

Higgs Boson Decay into Hadronic Jets

The remarkable agreement of electroweak data with standard model (SM) predictions motivates the study of extensions of the SM in which the Higgs boson is light and couples in a standard way to the weak gauge bosons. Postulated new light particles should have small couplings to the gauge bosons. Within this context it is natural to assume that the branching fractions of the light SM-like Higgs boson mimic those in the standard model. This assumption may be unwarranted, however, if there are non-standard light particles coupled weakly to the gauge bosons but strongly to the Higgs field. In particular, the Higgs boson may effectively decay into hadronic jets, possibly without important bottom or charm flavor content. As an example, we present a simple extension of the SM, in which the predominant decay of the Higgs boson occurs into a pair of light bottom squarks that, in turn, manifest themselves as hadronic jets. Discovery of the Higgs boson remains possible at an electron-positron linear collider, but prospects at hadron colliders are diminished substantially.Comment: 30 pages, 7 figure

Top-squark searches at the Tevatron in models of low-energy supersymmetry breaking

We study the production and decays of top squarks (stops) at the Tevatron collider in models of low-energy supersymmetry breaking. We consider the case where the lightest Standard Model (SM) superpartner is a light neutralino that predominantly decays into a photon and a light gravitino. Considering the lighter stop to be the next-to-lightest Standard Model superpartner, we analyze stop signatures associated with jets, photons and missing energy, which lead to signals naturally larger than the associated SM backgrounds. We consider both 2-body and 3-body decays of the top squarks and show that the reach of the Tevatron can be significantly larger than that expected within either the standard supergravity models or models of low-energy supersymmetry breaking in which the stop is the lightest SM superpartner. For a modest projection of the final Tevatron luminosity, L = 4 fb-1, stop masses of order 300 GeV are accessible at the Tevatron collider in both 2-body and 3-body decay modes. We also consider the production and decay of ten degenerate squarks that are the supersymmetric partners of the five light quarks. In this case we find that common squark masses up to 360 GeV are easily accessible at the Tevatron collider, and that the reach increases further if the gluino is light.Comment: 32 pages, 9 figures; references adde

CP violation in Bd,s→l+l−B_{d,s} \to l^+l^- in the model III 2HDM

We have calculated the Wilson coefficients $C_{10}, C_{Q_i}$ (i=1,2) in the $\bar{MS}$ renormalization scheme in the model III 2HDM. Using the obtained Wilson coefficients, we have analyzed the CP violation in decays $B^0_q\to l^+l^-$ (q=d,s) in the model. The CP asymmetry, $A_{CP}$, depends on the parameters of models and $A_{CP}$ in $B_d\to l^+l^-$ can be as large as 40% and 35% for $l=\tau$ and $l=\mu$ respectively. It can reach 4% for $B^0_s$ decays. Because in SM CP violation is smaller than or equal to O($10^{-3}$) which is unobservably small, an observation of CP asymmetry in the decays $B^0_q \to l^+l^- (q=d,s)$ would unambiguously signal the existence of new physics.Comment: revtex4, 16 pages, 7 figure

Electroweak Symmetry Breaking at the LHC

One of the major goals of the Large Hadron Collider is to probe the electroweak symmetry breaking mechanism and the generation of the masses of the elementary particles. We review the physics of the Higgs sector in the Standard Model and some of its extensions such as supersymmetric theories and models of extra dimensions. The prospects for discovering the Higgs particles at the LHC and the study of their fundamental properties are summarised.Comment: 27 pages, 45 figures, uses LaTeX (insa.sty). Invited review for volume on LHC physics to celebrate the Platinum Jubilee of the Indian National Science Academy, edited by Amitava Datta, Biswarup Mukhopadhyaya and Amitava Raychaudhuri. Expanded the acronym in the title in the annoncement. No other change in the text or reference

System Size and Energy Dependence of Jet-Induced Hadron Pair Correlation Shapes in Cu+Cu and Au+Au Collisions at sqrt(s_NN) = 200 and 62.4 GeV

We present azimuthal angle correlations of intermediate transverse momentum (1-4 GeV/c) hadrons from {dijets} in Cu+Cu and Au+Au collisions at sqrt(s_NN) = 62.4 and 200 GeV. The away-side dijet induced azimuthal correlation is broadened, non-Gaussian, and peaked away from \Delta\phi=\pi in central and semi-central collisions in all the systems. The broadening and peak location are found to depend upon the number of participants in the collision, but not on the collision energy or beam nuclei. These results are consistent with sound or shock wave models, but pose challenges to Cherenkov gluon radiation models.Comment: 464 authors from 60 institutions, 6 pages, 3 figures, 2 tables. Submitted to Physical Review Letters. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm