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Provision of orthodontic care to adolescents in South Australia: the type, the provider, and the place of treatment.

There are many pathways involving different providers and locations that individuals may take in obtaining, orthodontic services. The aim of this study was to document the provision of orthodontic services and establish the pathways taken toward fixed orthodontic treatment by adolescents in South Australia. Data were collected on the use of orthodontic services by a cohort of adolescents enrolled in the School Dental Service at age 13 years and again at age 15 years. By age 15 years, 83.2 per cent of the adolescents had received orthodontic consultations, 27.3 per cent had received fixed orthodontic treatment and 41.4 per cent had received other forms of orthodontic treatment (extractions, space retainers or removable appliances). The majority of fixed orthodontic treatment was supplied by orthodontists in the private sector, while extractions and removable appliances were provided mainly by public sector general dentists. Most individuals used services in both the public and private sectors and the most frequent pathway taken by the adolescents receiving fixed orthodontic treatment involved consultation in both the public and private sectors, non-fixed orthodontic treatment in the public sector and fixed orthodontic treatment in the private sector. The findings indicate wide access to orthodontic consultation and a high uptake of fixed orthodontic treatment once the adolescent sought private sector orthodontic consultation. Orthodontic care was seen to be an interactive process between public sector general dentists and private sector orthodontists.

Adolescent↗

Congruence of tissue expression profiles from Gene Expression Atlas, SAGEmap and TissueInfo databases.

BACKGROUND: Extracting biological knowledge from large amounts of gene expression information deposited in public databases is a major challenge of the postgenomic era. Additional insights may be derived by data integration and cross-platform comparisons of expression profiles. However, database meta-analysis is complicated by differences in experimental technologies, data post-processing, database formats, and inconsistent gene and sample annotation. RESULTS: We have analysed expression profiles from three public databases: Gene Expression Atlas, SAGEmap and TissueInfo. These are repositories of oligonucleotide microarray, Serial Analysis of Gene Expression and Expressed Sequence Tag human gene expression data respectively. We devised a method, Preferential Expression Measure, to identify genes that are significantly over- or under-expressed in any given tissue. We examined intra- and inter-database consistency of Preferential Expression Measures. There was good correlation between replicate experiments of oligonucleotide microarray data, but there was less coherence in expression profiles as measured by Serial Analysis of Gene Expression and Expressed Sequence Tag counts. We investigated inter-database correlations for six tissue categories, for which data were present in the three databases. Significant positive correlations were found for brain, prostate and vascular endothelium but not for ovary, kidney, and pancreas. CONCLUSION: We show that data from Gene Expression Atlas, SAGEmap and TissueInfo can be integrated using the UniGene gene index, and that expression profiles correlate relatively well when large numbers of tags are available or when tissue cellular composition is simple. Finally, in the case of brain, we demonstrate that when PEM values show good correlation, predictions of tissue-specific expression based on integrated data are very accurate.

Brain↗

High prevalence of overweight and short stature among Head Start children in Massachusetts.

The Head Start Program measures children's heights and weights to screen for growth problems such as obesity, wasting, and short stature. At present, little public health use is made of these data. In this paper, the authors present serial cross-sectional nutrition surveillance data from Massachusetts Head Start Programs. Nonrandom samples of local Head Start Programs provided annual screening data from 1988 to 1991 on an average of 2,664 children per year. Height and weight measurements were compared with National Center for Health Statistics (NCHS) reference populations. On average, 87 percent of the children were 36 to 59 months of age and 51 percent were white. From 7.3 to 8.8 percent of children were below the 5th percentile of height for age each year, and from 1.2 to 3.3 percent were underweight, with weight below the 5th percentile for height (P < 0.05 compared with NCHS population). In each year overweight (weight for height above the 95th percentile) was most prevalent, ranging from 9.6 percent to 13.3 percent (P < 0.05 compared with NCHS) and demonstrating a statistically significant upward trend over the 4 years of study (chi-square = 9.21, P < 0.01). The prevalence of overweight and short stature varied by race and ethnicity. A statistically significant upward trend in overweight was seen among Hispanic children (chi-square = 5.99, P < 0.05). Also, children who were 48 months of age or older were more likely than younger children to be overweight (P < 0.05). The prevalence of short stature did not vary significantly by year, sex, or age. The authors conclude that children attending Head Start Programs in Massachusetts are at risk for short stature and are at increasing risk of obesity. These risks vary by race and ethnicity. Further research is needed to determine the generalizability of these findings to other regions and to evaluate social and behavioral correlates of poor nutrition outcomes among Head Start children.

Age Factors↗

Evolution of a processing system in a large biomedical library.

The processing system used in the UCLA Biomedical Library is modest in size and still under development. Its origins date back to a batch mode serials control system begun in the mid-1960s. This was converted to an on-line system which currently has modules for check-in, updating and retrieval, claims, bindery preparation, and invoice information. Titles can be retrieved at the terminal by search of any word in the title, by subject heading, language, country of publication, and type of publication. The system is adaptable to network use and at present is shared with one other library. To the serials system has been added a computer-assisted cataloging and card production system. The latter utilizes serials nucleus software as well as design for data input and data storage. In-house listings and coding procedures overlap in a general way. Work is under way on further integration of the two processing subsystems and a feasibility study has been completed for addition of a subsystem for acquisitions which will combine and adapt features of the other two; for example, information retrieval characteristics from both, catalog coding and programs for acceptance of data, serials programs for claims, and other output programs. Cost benefits of the subsystems are described and discussed.

Cataloging↗

The use of operational modeling of HIV/AIDS in a systems approach to public health decision making.

Compartmental models of infectious diseases readily represent known biological and epidemiological processes, are easily understood in flow-chart form by administrators, are simple to adjust to new information, and lend themselves to routine statistical analysis such as parameter estimation and model fitting. Technical results are immediately interpretable in epidemiological and public health terms. Deterministic models are easily stochasticized where this is important for practical purposes. With HIV/AIDS, serial data on both HIV prevalence and AIDS morbidity have been available from San Francisco. Assuming the distribution of the incubation period to be biologically stable, statistical analysis is quite feasible in other regions, even those with no reliable HIV data. Transmission rates must be estimated locally. It is also often possible to estimate the effective size of a population subgroup at risk, from population data on AIDS morbidity only. Computer simulation provides estimates of the evolving pattern of both HIV prevalence and AIDS morbidity. Some public health questions can be answered only by appropriately formulated stochastic models.

Decision Making↗

The reference change value: a proposal to interpret laboratory reports in serial testing based on biological variation.

BACKGROUND: A proposal to calculate and use the reference change value (RCV) as an objective guide for interpreting the numerical results obtained in clinical laboratory serial testing is introduced in this study. METHODS: A database showing the results of a compilation of 191 publications on biological variation and including information on a number of analytes provided the standardized criterion based on biology for calculating the RCVs. RESULTS: For each of the 261 analytes included in the study, the RCV was determined using Harris's formula, replacing analytical imprecision with the desirable specification of analytical quality based on half the within-subject biological variation at 95% probability levels. The result is a guide for a common criterion to identify clinically significant changes in serial results. CONCLUSIONS: The RCV concept is an approach that can be offered by laboratories to assess changes in serial results. The RCV data in this study are presented as a point of departure for a widely applicable objective guide to interpret changes in serial results.

Algorithms↗

[Results of serial studies in basle children after 12 years of water fluoridation and 4 years of prophylaxis in nurseries and schools].

The public water supply of Basel has been fluoridated to a content of 1 ppm since May 1962. A distinct reduction of caries could be observed since. The last four years have shown a decrease of caries incidence too, and the merit for this should be given to the prophylaxis department. Particularly the youngest individuals have benefited from this prophylaxis, because it has been intensified and its scope widened.

Child↗

Genetic mutations driving ciprofloxacin resistance in laboratory-evolved Salmonella Typhimurium.

Ciprofloxacin resistance in Salmonella Typhimurium is a significant public health concern, and the mechanisms by which the resistance evolves are poorly defined. Here, by serial passaging under antibiotic selection, we isolated ciprofloxacin-resistant S. Typhimurium mutants and subjected them to whole-genome sequencing to reveal the major mutations associated with resistance. The Low CipR mutant acquired four chromosomal mutations in ramR, icdA, lipB, and gyrA, and the High CipR mutant gained additional mutations in gyrB, yaiC, and corA. Functional characterization determined that mutations in ramR resulted in efflux pump upregulation, while disruptions in the TCA cycle caused by mutations in icdA and lipB led to metabolic alterations. These changes indirectly enhanced resistance by increasing the expression of the global regulator MarA and reducing OmpF-dependent membrane permeability. Despite the observation of the G105A substitution in GyrA, enzymatic assays confirmed the failure to support resistance to ciprofloxacin, possibly because the structural alteration remained minimal. GyrB488-489dup was associated with maintained supercoiling under ciprofloxacin and enhanced fluoroquinolone resistance, suggesting a major role in resistance evolution. Other mutations in yaiC impaired biofilm and, in corA, intracellular accumulation of magnesium, possibly stabilizing the bacterial cell envelope under antibiotic pressure. The findings provide novel explanations for the multifaceted mechanisms leading to ciprofloxacin resistance in Salmonella and suggest targets to combat antimicrobial resistance.IMPORTANCEAntibiotic resistance in Salmonella Typhimurium is an increasing public health concern, yet the genetic changes that allow bacteria to become resistant are not fully understood. In this study, we evolved ciprofloxacin-resistant Salmonella in the laboratory and identified the mutations that arise during resistance development. We found that resistance does not result from a single change but from multiple adaptations affecting drug efflux, metabolism, and the antibiotic target. Some mutations increased the activity of pumps that remove antibiotics from the cell, while others altered bacterial metabolism and reduced membrane permeability, making it harder for the drug to enter. A duplication in the DNA gyrase subunit GyrB played a particularly important role in maintaining DNA function under antibiotic stress. Together, these results reveal how diverse genetic changes cooperate to generate ciprofloxacin resistance and provide insights that may help guide strategies to combat drug-resistant Salmonella infections.

DNA gyrase↗

Prognosis for gross motor function in cerebral palsy: creation of motor development curves.

CONTEXT: Lack of a valid classification of severity of cerebral palsy and the absence of longitudinal data on which to base an opinion have made it difficult to consider prognostic issues accurately. OBJECTIVE: To describe patterns of gross motor development of children with cerebral palsy by severity, using longitudinal observations, as a basis for prognostic counseling with parents and for planning clinical management. DESIGN: Longitudinal cohort study of children with cerebral palsy, stratified by age and severity of motor function and observed serially for up to 4 years during the period from 1996 to 2001. SETTING: Nineteen publicly funded regional children's ambulatory rehabilitation programs in Ontario. PARTICIPANTS: A total of 657 children aged 1 to 13 years at study onset, representing the full spectrum of clinical severity of motor impairment in children with cerebral palsy. MAIN OUTCOME MEASURES: Severity of cerebral palsy, classified with the 5-level Gross Motor Function Classification System; function, formally assessed with the Gross Motor Function Measure (GMFM). RESULTS: Based on a total of 2632 GMFM assessments, 5 distinct motor development curves were created; these describe important and significant differences in the rates and limits of gross motor development among children with cerebral palsy by severity. There is substantial within-stratum variation in gross motor development. CONCLUSIONS: Evidence-based prognostication about gross motor progress in children with cerebral palsy is now possible, providing parents and clinicians with a means to plan interventions and to judge progress over time. Further work is needed to describe motor function of adolescents with cerebral palsy.

Adolescent↗

Application of gene expression profiling to cardiovascular disease.

The number of cardiovascular publications featuring gene expression profiling technologies is growing rapidly. This article introduces four profiling techniques; serial analysis of gene expression, differential display, subtractive hybridisation and DNA microarrays. Illustrations of their application towards cardiovascular research are given and their potential for gene discovery and improving our understanding of gene function is discussed.

Animals↗

Isoimmunization in pregnancy to Gerbich antigen.

A case of hemolytic disease of the newborn due to Gerbich, a public antigen, is presented. The antibody which was IgG1 reacted in vitro with mononuclear phagocytes. Serial sonographic and amniotic fluid examinations were followed and a mildly jaundiced neonate was delivered. Further investigation may establish a relationship between severity of disease and IgG subclasses, a mononuclear phagocyte assay, and sonographic measurements. Sources of compatible blood for possible maternal, fetal, or neonatal transfusion include blood bank rare donor files, relatives, and autologous donation.

Adult↗

The White Bull effect: abusive coauthorship and publication parasitism.

Junior researchers can be abused and bullied by unscrupulous senior collaborators. This article describes the profile of a type of serial abuser, the White Bull, who uses his academic seniority to distort authorship credit and who disguises his parasitism with carefully premeditated deception. Further research into the personality traits of such perpetrators is warranted.

Aggression↗

Beta-blocker therapy in patients with heart failure in the urban setting: moving beyond clinical trials.

BACKGROUND: Despite their known benefits, beta-blockers (BBL) are not yet widely prescribed for heart failure, especially in the primary care setting. We wanted to identify patient characteristics that could guide primary care physicians in deciding whether they or a cardiologist should initiate BBL. A second objective was to determine the tolerability of BBL in clinical practice. METHODS: A retrospective chart review was conducted on a consecutive series of 551 patients with systolic dysfunction referred to a heart failure clinic in an urban public hospital. Patient responses to BBL were stratified into three categories: favorable (improvement of left ventricular ejection fraction by serial echocardiography), unfavorable (development of decompensated heart failure), or neither. Tolerability of BBL was assessed by the need to permanently discontinue BBL. RESULTS: Of 551 patients, 363 (66%) tolerated BBL. Among patients who had BBL initiated in the clinic, 48 had a favorable response, 34 had an unfavorable response, and 57 had neither a favorable or unfavorable response, as defined. A lower systolic blood pressure and higher diuretic dose were associated with development of decompensated heart failure as compared to improvement of ejection fraction. CONCLUSIONS: A majority of patients with heart failure in an urban public hospital can tolerate BBL. Easily measurable characteristics such as lower systolic blood pressure and higher diuretic dose may assist primary care physicians in triaging patients for referral to cardiologists for beta-blocker initiation.

Adrenergic beta-Antagonists↗

Starting from fins: parallelism in the evolution of limbs and genitalia. The fin-to-limb transition.

The March/April 2002 issue of Evolution and Development focused on three presentations made at the Starting from Fins: Parallelism in the Evolution of Limbs and Genitalia symposium held as part of the 2001 Chicago meeting of the Society of Integrative and Comparative Biology. The intention of the symposium and the publication of the presentations was to extend discussion of the potential and the limits of using serial homologues to understand developmental aspects of morphological evolution. The March/April 2002 issue concentrated on unpaired fin to genitalia transitions. This issue focuses on paired fins to limbs and highlights the need for developmental data to be integrated with data from fossil materal, phylogenetic analysis, and explicitly comparative studies. Coates et al. use phylogenetic methods to explore the limb/fin characters of taxa, but their analysis departs somewhat from the usual in that the reference group for organisms includes sister group taxa not usually considered true tetrapods. They state that including finned taxa from the stem group permits an attempt to distinguish the primitive condition of the characteristics demonstrated by the crown group, that is, "limbed tetrapods." In focusing on limb characters specifically and including aspects of the appendicular girdles, Coates et al. highlight morphological details and trends within a given phylogeny. They also demonstrate the degree of relevance of limb characters during the establishment of lineages and their branching patterns by using only limb characters to generate a tree and use a direct comparison of serial versus special homologies to explore the degree of evolutionary parallelism between fore-and hindlimbs. The preliminary conclusions indicate a high level of independence between the serially homologous fore-and hindlimb. Innes et al. present outcomes from the use of cutting edge molecular genetic approaches to understand developmental aspects of limb morphology. In a manner conceptually similar to Coates et al.'s use of fossil characters, Innes et al. use the serial analysis of gene expression to sort differences from similarities in the gene expression profiles of fore-and hindlimbs of the same embryos. Although these gene expression pattems are likely to reflect the serial homology of the paired limbs, they are silent in terms of our understanding both the profound and subtle differences between fore- and hindlimbs in any given species. Innes et al. point out the volume of data generated by SAGE far exceeds our ability to interpret its biological meaning. The studies presented here and in the March/April issue are excellent examples of the need to interpret complex data in light of collective knowledge of evolutionary history. We hope the insights gained from the symposium and papers contribute to a dialogue on how to integrate different approaches and assist in moving forward the field of Evolution and Development.

Animals↗

SAGEmap: a public gene expression resource.

We have constructed a public gene expression data repository and online data access and analysis, WWW and FTP sites for serial analysis of gene expression (SAGE) data. The WWW and FTP components of this resource, SAGEmap, are located at http://www.ncbi.nlm.nih. gov/sage and ftp://ncbi.nlm.nih.gov/pub/sage, respectively. We herein describe SAGE data submission procedures, the construction and characteristics of SAGE tags to gene assignments, the derivation and use of a novel statistical test designed specifically for differential-type analyses of SAGE data, and the organization and use of this resource.

Databases, Factual↗

Calculation of multi-segment rigid body joint dynamics using MATLAB.

A computational model of the human upper limb was developed utilizing a matrix calculation software package (MATLAB) and a public domain suite of subroutines [Robotics Toolbox (1)]. An easily configurable model of a rigid body, serially linked manipulator was established, avoiding the need for complex numerical equations to be formulated. A generalized model of the upper limb was used to study throwing action of individual subjects by incorporating body segment parameters and kinematic data. Estimates of joint moments were calculated for multiple time instances. This technique can be utilized and adapted for modelling any arbitrary serially linked manipulator system. Inverse and forward kinematics and kinetics can be calculated, enabling biomechanical simulations to be undertaken.

Biomechanical Phenomena↗

Reclassification and documentation in talog cards and a computer stored record.

A project to recatalog and reclassify the book collection of the Bowman Gray School of Medicine Library utilizing the Magnetic Tape/Selectric Typwriter system for simultaneous catalog card production and computer stored data acquisition marks the beginning of eventual computerization of all library operations. A keyboard optical display system will be added by late 1970. Major input operations requiring the creation of "hard copy" will continue via the MTST system. Updating, editing and retrieval operations as well as input without hard copy production will be done through the "on-line" keyboard optical display system. Once the library's first data bank, the book catalog, has been established the computer may be consulted directly for library holdings from any optical display terminal throughout the medical center. Three basic information retrieval operations may be carried out through "on-line" optical display terminals. Output options include the reproduction of part or all of a given document, or the generation of statistical data, which are derived from two Acquisition Code lines. The creation of a central bibliographic record of Bowman Gray Faculty publications patterned after the cataloging program is presently under way. The cataloging and computer storage of serial holdings records will begin after completion of the reclassification project. All acquisitions added to the collection since October 1967 are computer-stored and fully retrievable. Reclassification of older titles will be completed in early 1971.

Book Classification↗

A journal use study: checkouts and in-house use.

Journal use studies provide meaningful data to consider in shaping a library's journal collection. The University of California at Los Angeles (UCLA) Louise M. Darling Biomedical Library undertook such a study of 2,552 print subscription titles over one year, gathering data on circulation, in-house use, and interlibrary loan (ILL) use. Objectives focused on gathering practical data to support cancellation decisions and to determine whether reliable relationships of in-house to checkout use would emerge, upon which to base future decisions. Data were analyzed for all titles, for titles grouped by publication frequency, and for titles grouped by ten major subject headings. Results, to be interpreted within the limitations of this study and of use studies in general, showed in-house use to be higher than checkouts across all subjects and all publication frequencies-but in ratios too complex to be reduced to a single regression line. All use increases with increases in titles' frequency of publication. Even titles with few or no checkouts show some in-house use. Patterns of serial use differ among general subject disciplines.

Data Collection↗