Inequality in oral health‐related quality of life before and after a major subsidization reform

In Finland, a dental subsidization reform, implemented in 2001–2002, abolished age restrictions on subsidized dental care. We investigated income‐related inequality in oral health‐related quality of life (OHRQoL) and its determinants among adult Finns before and after the reform. Three cross‐sectional postal surveys, focusing on perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (n = 2,046), 2004 (n = 1,728), and 2007 (n = 1,560). Five measures, based on the Oral Health Impact Profile‐14, were used as indicators of OHRQoL. Income‐related inequality and associated factors were analysed using the concentration index and its decomposition. Prevalence, extent, and severity of oral health impacts were slightly lower in 2007 than in 2001. The oral health impacts were concentrated, at all study time points, among individuals with lower income. Most of the inequality was related to self‐perceived general health, tooth loss, and income. Contributions of time since the last dental visit and satisfaction with the last treatment period to the inequality decreased from 2001 to 2007. However, the contributions of these factors were already small (10–20%) in 2001. In general, OHRQoL improved slightly; however, no clear or dramatic change in inequality in OHRQoL was seen after the reform.     

Pinpointing the neural signatures of single-exposure visual recognition memory

Memories of the images that we have seen are thought to be reflected in the reduction of neural responses in high-level visual areas such as inferotemporal (IT) cortex, a phenomenon known as repetition suppression (RS). We challenged this hypothesis with a task that required rhesus monkeys to report whether images were novel or repeated while ignoring variations in contrast, a stimulus attribute that is also known to modulate the overall IT response. The monkeys’ behavior was largely contrast invariant, contrary to the predictions of an RS-inspired decoder, which could not distinguish responses to images that are repeated from those that are of lower contrast. However, the monkeys’ behavioral patterns were well predicted by a linearly decodable variant in which the total spike count was corrected for contrast modulation. These results suggest that the IT neural activity pattern that best aligns with single-exposure visual recognition memory behavior is not RS but rather sensory referenced suppression: reductions in IT population response magnitude, corrected for sensory modulation.

Under the right conditions, we are very good at remembering the images that we have seen: we can remember thousands of images after viewing each only once and only for a few seconds (1, 2). How our brains support this remarkable ability, often called “visual recognition memory” (3), is not well understood. The most prominent proposal to date suggests that memories about whether images have been encountered before are signaled in high-level visual brain areas such as inferotemporal cortex (IT) and perirhinal cortex via adaptation-like reductions of the population response to repeated as compared to novel stimuli, a phenomenon referred to as repetition suppression (RS) (4–9). Repetition suppression exhibits the primary attributes needed to account for the vast capacity of single-exposure visual memory behavior: response decrements in subsequent exposures are selective for image identity (even after viewing an extensive sequence of other images), and last for several minutes to hours (5, 6, 10). RS has also been shown to account for behavior in an image recognition memory task: a linear decoder with positive weights can predict single-exposure visual recognition memory behavior from neural responses in IT cortex (10).Despite the fact that the RS hypothesis is consistent with available evidence, it seems likely to be too simplistic an explanation for visual recognition memory encoding. In particular, it is well known that sensory neurons such as those of IT cortex are modulated not only by image memory, but also by stimulus properties such as image contrast (11). It is thus unclear whether and how these stimulus-induced effects interfere with judgments of whether images are novel or have been encountered before, and if they do not, how image memory can be decoded from neural responses in a way that disambiguates it from changes in these stimulus properties. To investigate this, we measured behavioral and neural responses of monkeys trained to report whether images were novel or repeated while disregarding image contrast (Fig. 1A).Open in a separate windowFig. 1.Visual memory behavior. (A) The contrast-invariant, single-exposure visual memory task. The monkeys viewed a sequence of images and reported whether they were novel (never seen before) or repeated (seen exactly once) while ignoring randomized changes in contrast. Monkeys were trained to saccade to one of two response targets to indicate their choice (red arrows). Images were repeated with a randomly chosen delay between the first and repeated presentation (“n-back”). (B) Images were displayed at one of two contrast levels, yielding two conditions for novel images, high (H) and low (L), and four conditions for repeated images: HH (repeated H preceded by novel H), LL (repeated L preceded by novel L), HL (repeated L preceded by novel H), and LH (repeated H preceded by novel L). The four repeated conditions were organized into same-contrast and mixed-contrast groups depending on whether the initial and repeated presentations were at the same or different contrasts, respectively. (C) Behavioral performance for the data pooled across monkeys in the task, where small black dots indicate average performance for an individual session and large colored dots indicate the average performance across sessions. A measure of contrast invariance, I, was computed as the ratio of the variance across contrast conditions and the variance with respect to the maximally contrast-modulated pattern after taking overall performance into account, subtracted from 1 (SI Appendix, SI Methods). Insets illustrate the expected behavioral pattern with minimal (I = 0) and maximal (I = 1) contrast invariance.     

Effects of dietary sodium on reactive oxygen species formation and endothelial dysfunction in low-density lipoprotein receptor-deficient mice on high-fat diet

Hypertension and high serum cholesterol level are important risk factors for atherosclerosis and coronary heart disease. In the present study we tested the hypothesis whether high sodium intake, when given in combination with Western type high-fat diet, induces endothelial dysfunction and promotes atherosclerosis. Furthermore, the role and enzyme sources of increased oxidative stress were examined. Low-density lipoprotein receptor-deficient mice (LDLR^−/−) and control C57Bl/6 mice received either high-fat, normal-sodium diet (fat 18% and cholesterol 0.5%; NaCl 0.7%; w/w) or high-fat, high-sodium diet (7% NaCl w/w) for 12 weeks. Superoxide formation was assessed by lucigenin enhanced chemiluminescence, endothelial functions were examined ex vivo, and atherosclerotic lesions from the aorta were assessed by light microscopy. High-fat, high-sodium diet increased systolic blood pressure in LDLR^−/− mice but not in C57Bl/6 mice, whereas it induced cardiac hypertrophy in both mouse strains. Dietary combination of fat and sodium induced endothelial dysfunction in LDLR^−/− mice. Preincubation with a superoxide scavenger Tiron normalized endothelial dysfunction, whereas the hydrogen peroxide scavenger catalase did not alter endothelial function. High sodium intake induced superoxide formation in LDLR^−/− mice on high-fat diet. Stimulation of muscarinic receptors in the endothelial cells by acetylcholine increased superoxide generation, whereas preincubation with the nitric oxide synthase (NOS) inhibitor L-arginine methyl ester or endothelium removal reduced superoxide production. Inhibition of nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase by apocynin decreased vascular superoxide formation whereas the xanthine oxidase inhibitor oxypurinol did not significantly affect oxidative stress in LDLR^−/− mice. In conclusion, the detrimental effects of dietary sodium on endothelial function and progression of atherosclerosis in LDLR^−/− mice on high-fat diet are mediated by increased ROS formation mainly through uncoupled NOS and NADPH oxidase. The present study also underscores the importance of superoxide and endothelial NOS uncoupling in the pathogenesis of endothelial dysfunction.     

Age‐time risk patterns of solid cancers in 60 901 non‐Hodgkin lymphoma survivors from Finland,Norway and Sweden

Survival after non‐Hodgkin lymphoma (NHL) has increased thanks to improved treatment but NHL survivors have an increased risk of second neoplasms. The assessment of cancer risk patterns after NHL may help to quantify the late side‐effects of therapy. Poisson regression was used to estimate relative risks (RRs) and absolute incidence rates for nine solid tumours based on a nationwide cohort of 60 901 NHL survivors from Finland, Norway and Sweden. Patients were diagnosed between 1980 and 2006 and developed 6815 s neoplasms. NHL patients showed an increased risk of each of the nine investigated cancer sites: prostate and pancreas (both RRs 1·28), breast (1·37), colorectum (1·48), urinary bladder (1·52), stomach and lung (both RRs 1·87), skin (melanoma 2·27) and kidney (2·56). The RRs showed a U‐shaped relationship with time after NHL for all nine‐second cancer types. NHL diagnosis early in life was a risk factor for the development of second cancers with the exception of melanoma, but a risk excess was even observed in patients diagnosed with NHL at age 80+ years. The present study provides accurate estimates on the adverse late effects of NHL therapy, which should guide the establishment of cancer prevention strategies in NHL survivors.     

Left ventricular hypertrophy persists after successful treatment for coarctation of the aorta

Objectives. To evaluate cardiac size and function in patients with coarctation of the aorta (CoA) before and after treatment. Design. Ventricular size and function were examined by 2- and 3-dimensional echocardiography, and concentrations of natriuretic peptides measured in 15 paediatric patients before repair, and one, 6, and 12 months thereafter. Controls comprised 15 children. Results. Before repair, mitral inflow velocities and left ventricular (LV) size and wall thickness were higher in patients. Thicknesses of interventricular septum and LV posterior wall decreased after repair but increased to initial level one year thereafter. The LV end-diastolic diameter remained larger than in controls despite successful repair. The size of right ventricle increased and levels of natriuretic peptides decreased during follow-up. Levels of natriuretic peptides correlated with the smallest diameter of CoA segment and diastolic indices of LV function. Conclusion. LV hypertrophy persists and LV size remains larger than in controls after successful repair even in normotensive patients with normal growth of CoA segment. This may be due to remodelling of ventricles and the aorta caused by CoA.     

Adenosine A2A receptors in secondary progressive multiple sclerosis: a [11C]TMSX brain PET study

In this study, positron emission tomography (PET) imaging with a radioligand to adenosine A2A receptors (A2AR)—a potent regulator of inflammation—was used to gain insight into the molecular alterations in normal-appearing white matter (NAWM) and gray matter (GM) in secondary progressive multiple sclerosis (SPMS). Normal-appearing white matter and GM, despite seeming normal in conventional mangnetic resonance imaging (MRI), are important loci of widespread inflammation, neuronal damage, and source of progressive disability in multiple sclerosis (MS). Dynamic PET imaging using A2AR-specific [¹¹C]TMSX and brain MRI with diffusion tensor imaging were performed to eight SPMS patients and seven healthy controls. Distribution volumes (V_T) of [¹¹C]TMSX were analyzed from 13 regions of interest using Logan plot with arterial plasma input. The SPMS patients had significantly increased [¹¹C]TMSX-V_T in NAWM compared with controls (mean (s.d.): 0.55 (±0.08) vs. 0.45 (±0.05); P=0.036). Both the increased V_T and the decreased fractional anisotropy (FA) in NAWM were associated with higher expanded disability status scale (EDSS) scores (P=0.030 and P=0.012, respectively), whereas the T2-lesion load of SPMS patients did not correlate with EDSS. This study shows, that A2ARs are increased in the brain of SPMS patients, and that [¹¹C]TMSX-PET provides a novel approach to learn about central nervous system pathology in SPMS in vivo.