Development of a US trust measure to assess and monitor parental confidence in the vaccine system

Objective

To develop a Vaccine Confidence Index (VCI) that is capable of detecting variations in parental confidence towards childhood immunizations centered on trust and concern issues that impact vaccine confidence.

Repair of DNA damage induced by the novel nucleoside analogue CNDAG through homologous recombination

We postulate that the deoxyguanosine analogue CNDAG [9-(2-C-cyano-2-deoxy-1-β-d-arabino-pentofuranosyl)guanine] likely causes a single-strand break after incorporation into DNA, similar to the action of its cytosine congener CNDAC, and that subsequent DNA replication across the unrepaired nick would generate a double-strand break. This study aimed at identifying cellular responses and repair mechanisms for CNDAG prodrugs, 2-amino-9-(2-C-cyano-2-deoxy-1-β-d-arabino-pentofuranosyl)-6-methoxy purine (6-OMe) and 9-(2-C-cyano-2-deoxy-1-β-d-arabino-pentofuranosyl)-2,6-diaminopurine (6-NH2). Each compound is a substrate for adenosine deaminase, the action of which generates CNDAG. Growth inhibition assay, clonogenic survival assay, immunoblotting, and cytogenetic analyses (chromosomal aberrations and sister chromatid exchanges) were used to investigate the impact of CNDAG on cell lines. The 6-NH2 derivative was selectively potent in T cell malignant cell lines. Both prodrugs caused increased phosphorylation of ATM and its downstream substrates Chk1, Chk2, SMC1, NBS1, and H2AX, indicating activation of ATM-dependent DNA damage response pathways. In contrast, there was no increase in phosphorylation of DNA-PKcs, which participates in repair of double-strand breaks by non-homologous end-joining. Deficiency in ATM, RAD51D, XRCC3, BRCA2, and XPF, but not DNA-PK or p53, conferred significant clonogenic sensitivity to CNDAG or the prodrugs. Moreover, hamster cells lacking XPF acquired remarkably more chromosomal aberrations after incubation for two cell cycle times with CNDAG 6-NH2, compared to the wild type. Furthermore, CNDAG 6-NH2 induced greater levels of sister chromatid exchanges in wild-type cells exposed for two cycles than those for one cycle, consistent with increased double-strand breaks after a second S phase. CNDAG-induced double-strand breaks are repaired mainly through homologous recombination.     

Alien limb phenomenon following posterior cerebral artery stroke: a distinct clinical entity

Journal of Neurology - Alien limb syndrome following stroke within the territory of the posterior cerebral artery is exceedingly rare. A right-handed female experienced left homonymous hemianopia,...     

Asbestos Exposure and Ovarian Cancer – a Gynaecological Occupational Disease. Background,Mandatory Notification,Practical Approach

In 2017, ovarian cancer due to asbestos exposure was designated a new, and thereby the first, gynaecological occupational disease in Germany. Asbestos is a naturally occurring mineral fibre with an annual usage in Germany of 160 000 – 180 000 metric tonnes in the 1960s and 1970s. The carcinogenicity of asbestos for the target organs lungs, larynx, pleura including pericardium, and peritoneum including tunica vaginalis testis has been clearly established for many years. Recent meta-analyses of data from cohort studies have demonstrated that the risk of ovarian cancer roughly doubles in women with occupational exposure to asbestos. Since the group of people with double the risk of developing lung cancer due to work-related asbestos exposure has a 2.25-fold increased risk of mortality from ovarian cancer on average, work-related ovarian cancer has been assigned the same recognition requirements as in occupational lung (and laryngeal) cancer. Thus, gynaecologists must obtain a thorough history of occupational exposure to asbestos, even if it may have taken place long in the past. The law mandates that suspected such cases must be reported to the Statutory Accident Insurance carrier or the State Occupational Safety and Health Agency.Key words: ovary, ovarian cancer, occupational disease, asbestos     

Patients with special health care needs in pediatric dental practices

PURPOSE: The objective of this study was to determine the involvement of pediatric dentists in practice in managing patients with special health care needs (SCHN) upon completion of training. METHODS: A questionnaire was developed, pilot tested, modified and sent to a randomly selected sample of 950 pediatric dentists in practice who were active and fellow members of the American Academy of Pediatric Dentistry. RESULTS: Fifty-one percent of the dentists responded. The majority were males between the ages of 41 and 50 years. Most practiced in communities with over 500,000 citizens. Most were trained in hospital-based programs, and 84% reported comprehensive didactic courses on SHCN patients during training. SCHN patients were routinely appointed in an integrated schedule in their practices. Seventy-one percent of responders continue to follow the patients after 21 years of age. Most had buildings and offices that were handicapped accessible. Patient profiles remained similar since initiating private practice with notable increases reported in the new and recall patients and patients with complicated medical histories categories. CONCLUSIONS: The results of this survey demonstrate the continuing involvement of pediatric dentists in private practice in scheduling and treating patients with special health care needs after the completion of training.     

Radiation doses of indirect and direct digital cephalometric radiography

AIM: The aim of this study was to measure organ doses and calculate the effective dose for indirect and direct digital cephalometric exposures. MATERIAL AND METHODS: Indirect digital cephalometric exposures were made of a Rando phantom head using a Cranex Tome multipurpose unit with storage phosphor plates from Agfa and the direct digital (Charge Coupled Device, CCD) exposures were made with a Proline Ceph CM unit. Exposure settings were 70 kV and 4 mAs for indirect digital exposures. Direct digital exposures were made with 70 kV, 10 mA and a total scanning time of 23 s. TLD700 dosemeters were used to measure organ doses, and the effective doses were calculated with (effective dose(sal)) and without inclusion of the salivary glands. A pilot study was carried out to compare diagnostic image quality of both imaging modalities. RESULTS: Effective doses were 1.7 microSv for direct digital and 1.6 microSv for indirect digital cephalometric imaging. When salivary glands were included in the calculation, effective doses(sal) were 3.4 microSv and 2.2 microSv respectively. Organ doses were higher for direct digital imaging, except for the thyroid gland, where the organ doses were comparable. Diagnostic image quality of indirect and direct digital cephalometric images seemed comparable. CONCLUSION: Effective dose and effective dose(sal) were higher for direct digital cephalometric exposure compared with indirect digital exposure. Organ doses were higher for direct digital cephalography. From preliminary data, it may be presumed that diagnostic image quality of indirect and direct digital cephalometric images are comparable.