The Eating Experience: Adaptive and Maladaptive Strategies of Older Adults with Tooth Loss.

OBJECTIVE: To explore the eating experience and eating-related quality of life (ERQOL) of community-dwelling older adults with tooth loss. METHOD: Nineteen older adults from the clinics of a northeast US dental school who met inclusion criteria (>65 y old, <20 teeth, and no dentures) composed the sample. For this mixed methods study, demographic characteristics, number and location of teeth, Mini Nutritional Assessment-Short Form score, and anthropometrics data were collected; semistructured interviews were conducted to collect in-depth information about the eating experience and ERQOL. Thematic analysis was completed with NVivo 12 software (QSR International). RESULTS: Participants' mean age was 71.3 y (SD = 5.2); 52.6% (n = 10) were women; 63.2% (n = 12) were Black or African American. The mean Mini Nutritional Assessment-Short Form score of 12.1 was reflective of normal nutrition status; 31.6% (n = 6) of patients were at risk for malnutrition or were malnourished. Fifteen percent (n = 3) were fully edentulous; 84.2% (n = 16) had 1 to 19 teeth (mean = 10.8, SD = 6.5). The 2 overarching themes identified were adaptive and maladaptive behavioral responses to tooth loss. Adaptive strategies included modification in food preparation and cooking methods, food texture selection, meal timing, and approaches to chewing. Maladaptive behaviors included food avoidance and limiting eating and smiling in front of others. Psychosocial factors, including finances, limited food choices and ERQOL, whereas the support of family and friends enhanced ERQOL according to participants. CONCLUSION: Older adults with tooth loss exhibit both adaptive and maladaptive behaviors that affect their eating experience, dietary intake, and ERQOL. While many expressed positive adaptive coping strategies, they also described maladaptive behaviors, including avoidance of healthy foods and limiting eating during social interactions, which may affect their nutritional status and overall health and well-being. Further research is needed to explore how duration and severity of tooth loss influence these behaviors and risk of malnutrition. Interprofessional approaches are needed to support positive adaptation and coping with tooth loss. KNOWLEDGE TRANSFER STATEMENT: The results of this study can be used by health professionals treating patients with tooth loss in an effort to improve their eating experience and eating-related quality of life. The findings provide data to support further studies and the need for evidence-based guidelines and educational materials to meet the unique needs of older adults with tooth loss.

Prediction of Shigellosis outcomes in Israel using machine learning classifiers.

Shigellosis causes significant morbidity and mortality in developing and developed countries, mostly among infants and young children. The World Health Organization estimates that more than one million people die from Shigellosis every year. In order to evaluate trends in Shigellosis in Israel in the years 2002-2015, we analysed national notifiable disease reporting data. Shigella sonnei was the most commonly identified Shigella species in Israel. Hospitalisation rates due to Shigella flexenri were higher in comparison with other Shigella species. Shigella morbidity was higher among infants and young children (age 0-5 years old). Incidence of Shigella species differed among various ethnic groups, with significantly high rates of S. flexenri among Muslims, in comparison with Jews, Druze and Christians. In order to improve the current Shigellosis clinical diagnosis, we developed machine learning algorithms to predict the Shigella species and whether a patient will be hospitalised or not, based on available demographic and clinical data. The algorithms' performances yielded an accuracy of 93.2% (Shigella species) and 94.9% (hospitalisation) and may consequently improve the diagnosis and treatment of the disease.

CBCT-based bone quality assessment: are Hounsfield units applicable?

CBCT is a widely applied imaging modality in dentistry. It enables the visualization of high-contrast structures of the oral region (bone, teeth, air cavities) at a high resolution. CBCT is now commonly used for the assessment of bone quality, primarily for pre-operative implant planning. Traditionally, bone quality parameters and classifications were primarily based on bone density, which could be estimated through the use of Hounsfield units derived from multidetector CT (MDCT) data sets. However, there are crucial differences between MDCT and CBCT, which complicates the use of quantitative gray values (GVs) for the latter. From experimental as well as clinical research, it can be seen that great variability of GVs can exist on CBCT images owing to various reasons that are inherently associated with this technique (i.e. the limited field size, relatively high amount of scattered radiation and limitations of currently applied reconstruction algorithms). Although attempts have been made to correct for GV variability, it can be postulated that the quantitative use of GVs in CBCT should be generally avoided at this time. In addition, recent research and clinical findings have shifted the paradigm of bone quality from a density-based analysis to a structural evaluation of the bone. The ever-improving image quality of CBCT allows it to display trabecular bone patterns, indicating that it may be possible to apply structural analysis methods that are commonly used in micro-CT and histology.

Insidious reintroduction of wild poliovirus into Israel, 2013.

Israel was certified as polio-free country in June 2002, along with the rest of the World Health Organization European Region. Some 11 years later, wild-type polio virus 1 (WPV1) was isolated initially from routine sewage samples collected between 7 and 13 April 2013 in two cities in the Southern district. WPV1-specific analysis of samples indicated WPV1 introduction into that area in early February 2013. National supplementary immunisation with oral polio vaccine has been ongoing since August 2013.

Apparent life-threatening events in infants and homeopathy: an alternative explanation.

BACKGROUND: A recent report showed increased frequency of apparent life-threatening events (ALTEs) in infants treated with the homeopathic medication GaliCol-Baby (GCB). The premise was that the ALTEs resulted from toxic effects of the drug's components. We examine an alternative explanation. METHOD: The toxicological literature was searched for known reactions to the various GCB components, noting doses and reported symptoms. Dosage quantities and severity of reaction to the GCB were ranked independently by two groups of physicians, and a dose-response curve was generated. Reported toxic doses and symptoms were compared with those of the GCB series. The homeopathic literature was searched as well to determine the propensity of the GCB components to cause ALTE symptoms, when given in homeopathic doses to healthy volunteers (proving). RESULTS: Doses ingested in the GCB series were 10-13 orders of magnitude smaller than those reported to cause toxic reactions in humans. There was poor correlation between symptoms with GCB and toxic profiles of the components. A nonsignificant, inverse relationship between dose and severity of reaction was observed. Conversely, four GCB components (in homeopathic doses) had a high propensity to produce at least one of five symptoms which define ALTE, two of which had intermediate to high propensity to produce three symptoms. CONCLUSIONS: It is unlikely that the ALTE following ingestion of GCB was a toxic reaction to any of the drug's component. Homeopathic theory may explain this linkage, though further research is needed to understand the pathogenic effects of highly diluted homeopathic compounds.

Petroleum: a series of 25 cases.

This study is based on 25 well documented reports of cases which responded well to treatment with Petroleum. Materia medica data were compared with results in contemporary clinical practice. Many patients had characteristic skin problems; children often had recurrent or chronic upper respiratory tract problems. The most prominent mental feature is a quiet, withdrawn or stubborn disposition. The mental symptoms may be difficult to recognise. Detailed documentation in daily practice can be helpful for preserving data of the effect of a medicine; confirmation of statements given in materia medica; improving understanding of homeopathic medicines and differentiating the indications for medicines.

Comparison of re-exposure rates of intraoral radiographs between dental students and trained dental assistants in an oral and maxillofacial radiology clinic.

OBJECTIVE: To compare the re-exposure rates of dental radiographs taken over a period of 1 year between dental students and trained dental assistants at a university-based oral and maxillofacial radiology clinic. METHODS: Detailed records of the number and type of intraoral radiographs taken by the students and staff members and the number of re-exposures that were required from July 2003 to July 2004 were used. Statistical analyses were performed on the data. RESULTS: A chi2 test showed that re-exposure rates of radiographic series between students and staff were statistically different. When comparing the students' re-exposure rates during each of the four quarters of their radiology rotation, one-way analysis of variance test showed that the results were not statistically significant for reduction in the number of re-exposures over the entire year. CONCLUSIONS: There were significant differences in the re-exposure rates between staff dental assistants and students. Film re-exposure rates for the students during the four quarters were expected to decrease with time. Instead, the consistency of the re-exposure rates of the students during the four quarters demonstrates the need to recognize why the students did not perform better as the year progressed. The percentage of films that needed to be re-exposed by either group (students or the staff dental assistants) was not extremely high.

The colour of the homeopathic improvement: the multidimensional nature of the response to homeopathic therapy.

Homeopathy differs from conventional medicine in many aspects. Little recognized to date is the unique, multidimensional nature of the response to homeopathic treatment. We discuss this 'colour' of the homeopathic response; altered temporal awareness, paucity of language, selective amnesia, lack of self-awareness, the holistic character of the improvement, and the development of acute illnesses, all in response to successful homeopathic treatment. We conclude that, beyond its biological effect, homeopathic treatment affects the awareness.

Simultaneous presentation of focal cemento-osseous dysplasia and simple bone cyst of the mandible masquerading as a multilocular radiolucency.

The fibro-osseous lesions represent a large group of disorders that have many common characteristics including clinical, radiographic and microscopic features. Although most are of unknown aetiology, some are believed to be neoplastic and others are related to metabolic imbalances. It is not unusual to see these lesions presenting with a range of radiographic appearances, causing considerable diagnostic confusion owing to their similar histology. This case report presents a histologically benign cemento-osseous lesion that is radiographically consistent with a focal cemento-osseous dysplasia, along with a concomitant simple (traumatic) bone cyst within the right mandibular alveolus, with the initial presentation as a multilocular radiolucency. Pertinent literature is reviewed.

A rare presentation of dens invaginatus in a mandibular lateral incisor occurring concurrently with bilateral maxillary dens invaginatus: case report and review of literature.

BACKGROUND: Dens Invaginatus (DI), commonly known as dens in dente, is a developmental malformation of tooth that most commonly affects permanent maxillary lateral incisor teeth. Deciduous teeth are infrequently affected. Presence of DI in mandibular permanent teeth is extremely rare. Further, the presence of DI bilaterally in the maxillary lateral incisors of the same patient is even more unusual. METHODS: In this article, an unusual case of DI affecting a mandibular lateral incisor tooth is described. This malformation was uncovered after a full mouth radiographic examination when the patient presented for dental treatment unrelated to this finding. In addition, the various radiographic appearances of DI as they present within the maxillary and mandibular teeth are described. Essential clinical considerations and treatment options are presented. A review of the pertinent literature is undertaken and a table summarizing previous published findings of mandibular DI is presented. RESULTS: A review of the literature indicates that DI in mandibular teeth is extremely rare with only 10 other cases involving 13 teeth reported previously. CONCLUSIONS: Although this is an extremely rare case, DI is an anomaly that should be familiar to all practising dentists due to the clinical implications of potential sequelae of pulpal involvement.

The structure of the Organon.

The Organon of Medicine is the seminal text of Homeopathy. However, its grammar and structure make it obtuse and remote to both new students and veterans. We propose a demarcation of the Organon into sections, exposing the didactic structure of the Organon, and display this demarcation in concise graphic form. It is hoped that this representation will improve accessibility and understanding of the Organon for readers at all levels.

Dens evaginatus and dens invaginatus in a maxillary lateral incisor: report of a rare occurrence and review of literature.

A case of dens evaginatus (DE) and dens invaginatus (DI) concurrently affecting the maxillary right permanent lateral incisor in a 25-year-old Hispanic male is reported. DE, referred to as Talon's cusp in the anterior teeth and Leong's premolar in the premolar teeth, is a relatively rare condition by itself. An association of DI with this rare anomaly within the same tooth has never been reported before although it has been known to occur within the same patient. Since it is known that DE may be composed of normal enamel and dentine, as well as varying amounts of pulpal tissue, care should be exercised while performing any aesthetic procedures to remove or recontour it.

The history of dental radiology.

Several events leading to discovery of the X-ray beam by Wilhelm Conrad Roentgen in November 1895 are traced. Some early dental radiologic advances are discussed.

Development states associated with the floral transition.

Floral initiation can be analyzed from a developmental perspective by focusing upon how developmental fates are imprinted, remembered, and expressed. This is not an altogether new perspective, since people studying flowering have been concerned for a long time with the commitment of meristems to form flowers and the morphological, cellular, and molecular changes associated with this commitment. What is novel is the emphasis on developmental states as opposed to physiological processes. This developmental focus indicates that there appear to be at least three major developmental states that are acquired and expressed in the process of a meristem initiating floral morphogenesis. The meristem cells must first become competent to respond to a developmental signal that evokes them into a florally determined state. The leaves are the usual source of this signal and a specific leaf may or may not have the capacity to be inductively active. When a leaf does develop the capacity for inductive activity, this capacity is usually correlated with the ontogeny of the leaf. Inductive activity, however, may be continually expressed as in some day-neutral plants or may be latent as in plants where the photoperiod is the external cue for activity. Competent shoot apical meristems respond to inductive leaf signal by being evoked into a florally determined state. Under permissive conditions this florally determined state is expressed as the initiation of floral morphogenesis. Many mechanisms have evolved to regulate entry into and expression of these developmental states. As we learn more about the developmental states associated with flowering and how they are acquired and expressed, we will understand better how the various patterns of flowering are related to one another as well as which developmental processes are common to all angiosperms.

Acquisition of competence for floral development in Nicotiana buds.

Grafting experiments were used to investigate the relative roles of strength of flowering signal(s) and competence of buds to respond to flowering signal(s) in the development of photoperiodic and day-neutral species of Nicotiana. At the time of commitment to floral development, a flowering signal (inhibitory or promotive) could reach a critical level or terminal buds could gain competence to perceive and-or respond to an existing signal. The latter hypothesis appears to be true for day-neutral N. tabacum L. cv. Wisconsin 38, while signal strength appears to be a more critical factor for long-day N. silvestris L. Nicotiana tabacum and N. silvestris differ in terms of signal intensity at anthesis of the terminal flower. Stocks of N. silvestris promote more rapid flowering in seedling scions of both genotypes. Terminal buds of seedlings of both genotypes have the same competence to respond to the signal affecting floral development. The competence of the terminal bud of both species to respond to this signal(s) changes as a function of age.

Determination for inflorescence development is a stable state, separable from determination for flower development in Pisum sativum L. buds.

Terminal meristems of Pisum sativum (garden pea) transit from vegetative to inflorescence development, and begin producing floral axillary meristems. Determination for inflorescence development was assessed by culturing excised buds and meristems. The first node of floral initiation (NFI) for bud expiants developing in culture and for adventitious shoots forming on cultured meristems was compared with the NFI of intact control buds. When terminal buds having eight leaf primordia were excised from plants of different ages (i.e., number of unfolded leaves) and cultured on 6-benzylaminopurine and kinetin-supplemented medium, the NFI was a function of the age of the source plant. By age 3, all terminal buds were determined for inflorescence development. Determination occurred at least eight nodes before the first axillary flower was initiated. Thus, the axillary meristems contributing to the inflorescence had not formed at the time the bud was explanted. Similar results were obtained for cultured axillary buds. In addition, meristems excised without leaf primordia from axillary buds three nodes above the cotyledons of age-3 plants gave rise to adventitious buds with an NFI of 8.3 ±0.3 nodes. In contrast seed-derived plants had an NFI of 16.5 ±0.2. Thus cells within the meristem were determined for inflorescence development. These findings indicate that determination for inflorescence development in P. sativum is a stable developmental state, separable from determination for flower development, and occurring prior to initiation of the inflorescence at the level of meristems.

Floral determination in internode tissues of day-neutral tobacco first occurs many nodes below the apex.

The temporal and spatial patterns of floral determination in cultured internode segments of Nicotiana tabacum L. cv. Wisconsin 38 were investigated. Segments from internodes, when cultured on hormone-free medium, either produced some de novo floral shoots or produced only vegetative shoots. Segments that produced some floral shoots were considered to contain florally determined tissues. The first internode tissues to exhibit floral determination were located 24 nodes (about 15 cm) below the terminal meristem on plants that had 21 leaves of length >/=3 cm (i.e., plants of age 21). Since the terminal meristem was morphologically vegetative at this age, floral determination in internode tissues did not result from a signal emanating from floral structures. As the plant continued growing, internode tissues progressively higher on the main axis gained the capacity to produce de novo floral shoots in culture. These data indicate that the inductive signal which elicited the state of floral determination in internode tissues was active in the upper half of the plant beginning at about age 21.

Selection of Glyphosate-Tolerant Tobacco Calli and the Expression of this Tolerance in Regenerated Plants.

From nonmutagenized haploid suspensions of Nicotiana tabacum L. cv Wisconsin 38 cells, 51 cell lines capable of growth in the presence of 1 millimolar glyphosate (N-phosphonomethyl glycine) were initially isolated at a frequency of 2.3 x 10(-8). Eighteen cell lines retained tolerance when grown on selective medium for 3 years. Tolerance persisted for at least 14 months in six cell lines cultured in the absence of glyphosate. Some plants regenerated from four glyphosate-tolerant cell lines were tolerant. Glyphosate-tolerant tissue was isolated from some sensitive as well as some tolerant regenerated plants. Six of the tolerant cell lines were also tolerant to the herbicide amitrole (3-amino-1,2,4-triazole). Five cell lines selected for amitrole tolerance were glyphosate tolerant. Some plants regenerated from three of these five cell lines were glyphosate tolerant and glyphosate-tolerant tissue was obtained from several of these regenerated plants. Amitrole uptake in suspension cultures of several variants was assessed in terms of influx rate constants. This parameter was not sufficiently different indicating that altered membrane properties could not account for the herbicide tolerance.