Smile microesthetics as perceived by dental professionals and laypersons.

OBJECTIVES: To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated. MATERIALS AND METHODS: A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model. RESULTS: The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P < .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons. CONCLUSIONS: The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.

Evaluation of radiation-induced compounds in irradiated raw or cooked chicken meat during storage.

The concentrations of hydrocarbons, 2-alkylcyclobutanones, and sulfur volatiles in irradiated (0 and 5 kGy) chicken meat samples (raw, precooked, and irradiated-cooked) were analyzed after 0 and 6 mo of frozen storage (-40°C) under oxygen-permeable packaging conditions. Two hydrocarbons [8-heptadecene (C(17:1)) and 6,9-heptadecadiene (C(17:2))], two 2-alkylcyclobutanones (2-dodecylcyclobutanone and 2-tetradecylcyclobutanone), and dimethyl disulfide were determined as radiation-induced detection markers in the irradiated raw and cooked chicken meats. Although irradiated-cooked samples produced fewer hydrocarbons and 2-alkylcyclobutanones than precooked irradiated samples, the number of individual hydrocarbons or 2-alkylcyclobutanones was still sufficient to detect radiation treatment even after 6 mo of storage at -40°C. Among sulfur volatiles, only dimethyl disulfide was found in meat after 6 mo of storage, indicating it has potential to be used an irradiation detection marker for frozen-stored meats under oxygen-permeable packaging conditions.

Risk factors for Nipah virus encephalitis in Bangladesh.

Nipah virus (NiV) is a paramyxovirus that causes severe encephalitis in humans. During January 2004, twelve patients with NiV encephalitis (NiVE) were identified in west-central Bangladesh. A case-control study was conducted to identify factors associated with NiV infection. NiVE patients from the outbreak were enrolled in a matched case-control study. Exact odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using a matched analysis. Climbing trees (83% of cases vs. 51% of controls, OR 8.2, 95% CI 1.25-infinity) and contact with another NiVE patient (67% of cases vs. 9% of controls, OR 21.4, 95% CI 2.78-966.1) were associated with infection. We did not identify an increased risk for NiV infection among persons who had contact with a potential intermediate host. Although we cannot rule out person-to-person transmission, case-patients were likely infected from contact with fruit bats or their secretions.

An innate defense peptide BPIFA1/SPLUNC1 restricts influenza A virus infection.

The airway epithelium secretes proteins that function in innate defense against infection. Bactericidal/permeability-increasing fold-containing family member A1 (BPIFA1) is secreted into airways and has a protective role during bacterial infections, but it is not known whether it also has an antiviral role. To determine a role in host defense against influenza A virus (IAV) infection and to find the underlying defense mechanism, we developed transgenic mouse models that are deficient in BPIFA1 and used these, in combination with in vitro three-dimensional mouse tracheal epithelial cell (mTEC) cultures, to investigate its antiviral properties. We show that BPIFA1 has a significant role in mucosal defense against IAV infection. BPIFA1 secretion was highly modulated after IAV infection. Mice deficient in BPIFA1 lost more weight after infection, supported a higher viral load and virus reached the peripheral lung earlier, indicative of a defect in the control of infection. Further analysis using mTEC cultures showed that BPIFA1-deficient cells bound more virus particles, displayed increased nuclear import of IAV ribonucleoprotein complexes, and supported higher levels of viral replication. Our results identify a critical role of BPIFA1 in the initial phase of infection by inhibiting the binding and entry of IAV into airway epithelial cells.

An innate defense peptide BPIFA1/SPLUNC1 restricts influenza A virus infection.

This corrects the article DOI: 10.1038/mi.2017.45.

Frequency and risk factors of severe hypoglycaemia in insulin-treated Type 2 diabetes: a cross-sectional survey.

AIMS: The reported risk of severe hypoglycaemia in insulin-treated Type 2 diabetes is highly variable and few studies have evaluated the influence of risk factors. We assessed the incidence and the influence of potential risk factors for severe hypoglycaemia in a questionnaire survey in subjects with insulin-treated Type 2 diabetes receiving currently recommended multifactorial intervention. METHODS: Consecutive patients with insulin-treated Type 2 diabetes (n = 401) completed a questionnaire about occurrence of hypoglycaemia in the past, hypoglycaemia awareness and socio-demographic factors. A zero-inflated negative binomial model was used to assess the influence of potential risk factors on the rate of severe hypoglycaemia. RESULTS: The overall incidence of severe hypoglycaemia in the preceding year was 0.44 episodes/person year. Sixty-six (16.5%) patients had experienced at least one event. The risk of any episode of severe hypoglycaemia positively correlated with impaired hypoglycaemia awareness, being married and long duration of diabetes. The risk of repeated episodes of severe hypoglycaemia positively correlated with the presence of peripheral neuropathy, while long duration of diabetes prior to insulin treatment and treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor antagonists (ARBs) were associated with reduced risk. C-peptide concentration and HbA1c were not associated with the risk of severe hypoglycaemia. CONCLUSIONS: In this cohort of insulin-treated Type 2 diabetic patients, the incidence of severe hypoglycaemia is higher than reported in most studies, corresponding to about one-third of that in Type 1 diabetes. Impaired hypoglycaemia awareness is the most important risk factor for severe hypoglycaemia.

A steep decline of death in a shigellosis epidemic in Bangladesh by a community--participated intervention.

The outcome of an intervention of a shigellosis epidemic during April-July 1985 at Dimla, northern Bangladesh is reported. People of the epidemic-affected community operated a makeshift hospital to provide early indoor treatment for 1,708 patients of blood dysentery, based on empirically selected antibiotic(s), oral rehydration of the patients and giving them high-protein diets. They raised funds and received technical and logistic assistance from the physicians and officials of the local government health centre and of the International Centre for Diarrhoeal Disease Research, Bangladesh. In comparison with the number of deaths recorded before intervention, there was a 187-fold reduction of case-fatality ratio from 11.2 to 0.06% (p less than 0.0001). Probable causes for this precipitious decline of mortality are discussed. It is concluded that such a community action in the intervention of a rural shigellosis epidemic in a developing country may avert death almost totally.

Determination of thickness, refractive index, and thickness irregularity for semiconductor thin films from transmission spectra.

A simplified theoretical model has been proposed to predict optical parameters such as thickness, thickness irregularity, refractive index, and extinction coefficient from transmission spectra. The proposed formula has been solved for thickness and thickness irregularity in the transparent region, and then the refractive index is calculated for the entire spectral region by use of the interference fringes order. The extinction coefficient is then calculated with the exact formula in the transparent region, and an appropriate model for the refractive index is used to solve for the extinction coefficient in the absorption region (where the interference fringes disappear). The proposed model is tested with the theoretical predicted data as well as experimental data. The calculation shows that the approximations used for solving a multiparameter nonlinear equation result in no significant errors.

Cholera epidemic and natural disasters; where is the link.

In May 1985, a cyclone and tidal surge devastated Sandwip, an island off the Southern Corner of Bangladesh. Within one week after this disaster a cholera epidemic broke out. It resulted in 12,194 registered cases and 51 deaths. The factors contributing to the occurrence of the epidemic are analyzed.

Emergence of a new epidemic strain of Vibrio cholerae in Bangladesh. An epidemiological study.

For decades, epidemic cholera in Bangladesh has produced contrasting pictures of appearance and disappearance of Vibrio cholerae, which until recently, remained confined to the biotypes and to serotypes of V. cholerae O1. The classical biotype continued to survive and coexisted with El Tor biotype in southern Bangladesh despite its disappearance from the rest of the world during the present pandemic. For the first time in history, during the cholera epidemic in 1993, both biotypes (classical and El Tor) of V. cholerae O1 have disappeared and have been replaced by a new strain of V. cholerae non-O1 (designated as O139 Bengal). Environmental changes occurring in the Bay of Bengal may have resulted in the emergence of the new epidemic strain of V. cholerae in Bangladesh.

Perception and practice of rest during pregnancy among mothers and family decision-makers.

The incidence of low birthweight (LBW) in Bangladesh is one of the highest in the world. Inadequate rest of the mothers during pregnancy is a contributing factor to LBW. To assess the perception and practice of rest during pregnancy, 136 mothers and family members who make important decisions on family matter (FDM) were studied in rural Bangladesh. Eighty per cent of mothers perceived the importance of rest during pregnancy, whereas only 29 per cent practised rest (p < 0.003). Of the mothers who lacked perception, none practised. Eighty-five per cent of FDM perceived rest as important, yet only 27 per cent practised rest. Mothers' education and socioeconomic status were significantly associated with perception (p < 0.028,p < 0.001) and practice (p < 0.008,p < 0.006) of rest. The mother's education was also significantly (p < 0.000) associated with the socioeconomic status of the family. Our study suggests that the inability to take rest was due to workload at home, illiteracy, low socioeconomic status and failure of family members to share the workload.

Vibrio cholerae O139: how great is the threat of a pandemic?

The emergence of the new strain Vibrio cholerae O139 and its rapid spread in Bangladesh and India together with its detection in several other countries, have raised the question whether this constitutes the beginning of the eighth pandemic of cholera, and if so, how large a threat it poses. In an attempt to answer this question, epidemic spread patterns of Vibrio cholerae O139 strain in Bangladesh were studied. Initially the epidemic moved quickly and affected the entire coastal and estuarine tidal plains of southern Bangladesh. In the flood plains of the northern regions it affected mostly the north-eastern and north-central areas, at a slower pace than in the southern areas. In the beginning the new strain totally displaced both biotypes (classic and El Tor) of Vibrio cholerae O1. Nearly 2 years after its initial detection, striking differences in the distribution of V. cholerae O139 and O1 were observed. In most northern areas, the new strain was replaced by V. cholerae O1, whereas in the southern coastal regions, the O139 strain continues to dominate epidemics. The study suggests that the O139 strain may become endemic in the coastal ecosystem. The threat of a pandemic, therefore, may not be as large as it first seemed.

Cholera epidemics in Bangladesh: 1985-1991.

In 1991, a major epidemic of diarrhoea broke out in Bangladesh. To estimate the extent of cholera during diarrhoea epidemics and to focus on the public health issues related to cholera in Bangladesh, we have used the government figures of the 1991 epidemic and data from our own experience of epidemic interventions in nearly 400 rural upazilas (sub-district) between 1985 and 1989 and in 1991. Our data showed that V. cholerae 01 was the most frequently (40%) isolated enteropathogen during the epidemics. The disease is widely distributed in the country. Only 24% of the total 1,648 laboratory confirmed cholera patients were below 5 years of age, and children below 2 years of age accounted for only 10% of the total. Access difficulty to medical care and absence of a reliable surveillance were thought to be the constraints to early detection and appropriate intervention, thus, there were more deaths during the epidemics. We have shown that a high proportion (59%) of cholera patients during their illness in the rural areas were not visited by the government surveillance staff and that most (80%) were treated at home. Access to treatment by qualified physicians was limited to 23% of the patients, whereas a large proportion of the patients were treated by the unqualified rural practitioners (68%), and the others (9%) had no access to any health care providers. Our experience also indicated a higher case fatality ratio (14%) prior to intervention by qualified physicians during epidemics and an overall fatality ratio of 4%, despite the significant reduction (less than 1%) achieved by the intervention. Cholera is highly epidemic in Bangladesh.(ABSTRACT TRUNCATED AT 250 WORDS)

Why treatment centres failed to prevent cholera deaths among Rwandan refugees in Goma, Zaire.

In July, 1994, in one of the worst cholera outbreaks in recent times, an estimated 12,000 Rwandan refugees died in Goma in eastern Zaire. The Vibrio cholerae strains were resistant to tetracycline and doxycycline, the commonly used drugs for cholera treatment. Despite the efforts of international organisations, which provided medical relief by establishing treatment centres in Goma, mortality from the disease was much higher than expected. In the area of Muganga camp, which had the largest concentration of refugees and where most of the medical aid organisations were active, the highest reported case-fatality ratio for a single day was 48%. The slow rate of rehydration, inadequate use of oral rehydration therapy, use of inappropriate intravenous fluids, and inadequate experience of health workers in management of severe cholera are thought to be some of the factors associated with the failure to prevent so many deaths during the epidemic. In one of the temporary treatment centres with the worst case-fatality record, our team showed that improvement of these factors could increase the odds of survival of cholera patients even in a disaster setting.