Dental Bite-Sized Bits: A Module for Teaching Common Oral Health Conditions to Multidisciplinary Students.

The Surgeon General's report in the year 2000 highlighted the association between chronic diseases and oral health infections. Current healthcare education programs, regrettably, report only 1 to 3 h of oral health instruction within curricula. In the years 2020-2022, as part of their respective oral health curricula, 278 first-year physician assistant and 12 pre-clinical second-year pharmacy students were invited to participate in a voluntary survey examining the effectiveness of animated succinct, online video-based oral health units. Among all student responses for the post-use survey, respondents "strongly agreed" or "agreed" that learning objectives of the unit(s) were achieved after reviewing the videos. Of the participants, 97% "strongly agreed" or "agreed" that the videos helped them understand information of which they had no prior knowledge. Similarly, 98% "strongly agreed" or "agreed" the information was appropriate for their level of knowledge. Most students, 93%, "strongly agreed" or "agreed" the exercise was a valuable learning experience. Regarding the importance of future interprofessional collaboration pertaining to a mutual patient's oral health, 95% of participants "strongly agreed" or "agreed" that they would be likely to collaborate. This study demonstrates the importance of oral health as a critical area of focus in healthcare education. The study also confirms the hypothesis that Dental Bite-Sized Bits units deliver engaging, valuable oral health education for preclinical healthcare learners, incorporating interprofessional perspectives from the disciplines of dental, pharmacy, and physician assistant.

Prevalence and dental professional awareness of antibiotic self-medication among older adults: Implications for dental education.

OBJECTIVE: Antibiotic stewardship has been recognized as an essential component of dental education. A notable threat to stewardship is the growing trend toward self-medication with nonprescribed antibiotics (SMNPA), particularly among older adults who may be at increased risk for adverse outcomes. This study aimed to assess the need to incorporate SMNPA into dental education by researching (1) professional awareness and (2) self-medication behaviors among older adults. METHODS: A SMNPA awareness survey was administered to dentists in Arizona with 148 respondents including general dentists, dental school faculty, and public health clinicians. A second survey was distributed to 410 households in an independent and assisted living facility. RESULTS: The dentists were aware of sources of SMNPA such as friends/family, leftover prescriptions, as well as sources outside of the United States; however, most (>80%) were not aware that ornamental fish antibiotics could be obtained online or in pet stores. The survey response rate for the older adults was 46.3%, of which 68.3% reported antibiotic use within the past 2 years (several for dental premedication) and 6.4% (n = 12) admitted to SMNPA for treating cold symptoms or pain. The main reason given for self-treatment was the belief that antibiotics had resolved similar symptoms in the past. One-third of the older adult respondents were unaware that antibiotics only treat bacterial infections. CONCLUSION: Approximately 1 in 16 older adults surveyed reported SMNPA. Dental professionals reported some knowledge of SMNPA but were unaware of all sources. This study highlights the need for SMNPA education, awareness, and implementation within dental curricula.

Problem Formulation for Off-Target Effects of Externally Applied Double-Stranded RNA-Based Products for Pest Control.

Externally applied dsRNA-based biocontrol products may lead to off-target degradation of messenger RNA in target and non-target organisms. For the purposes of regulatory risk assessment of such products, producing a comprehensive catalog of any off-target effects using profiling methods is unnecessary and would be ineffective in supporting decision-making. Instead, problem formulation should derive criteria that indicate acceptable risk and devise a plan to test the hypothesis that the product meets those criteria. The key to effective risk assessment of dsRNA-based biocontrols is determining whether their properties indicate acceptable or unacceptable risk, not whether they arise from on- or off-target effects of dsRNA.

A case report of self-medication with over-the-counter fish antibiotic: Implications for pharmacists.

OBJECTIVE: The human use of over-the-counter antibiotics intended for the treatment of pet animals has been recognized as a potential barrier to antibiotic stewardship efforts. The objective of this report is to describe a case of self-medication with a fish antibiotic resulting in delayed medical treatment and provide recommendations for pharmacists practicing in outpatient settings on how to best identify and manage nonprescription antibiotic use. CASE SUMMARY: A 24-year-old man experienced dental pain and "flu-like" symptoms for which he attempted self-treatment with oral amoxicillin 250 mg daily purchased by a family member from a pet store. The amoxicillin was marketed for the treatment of bacterial infection in pet fish. After several days of increasing tooth pain despite the self-medication, the patient presented to an outpatient clinic where he was found to have a molar abscess requiring tooth extraction. The patient responded well to therapy and was counseled to discontinue antibiotic self-treatment. PRACTICE IMPLICATIONS: Undocumented use of nonprescription antibiotics represents a threat to patient safety. Potential deleterious outcomes include resistance, adverse drug events, and delays in definitive infection treatment. Pharmacists should screen patients for nonprescription antibiotic use, provide them counseling on appropriate antibiotic use, and educate other health care professionals on underrecognized sources of nonprescription antibiotics to increase awareness of this growing issue. Furthermore, antibiotic resistance should be considered when recommending an antibiotic agent for the treatment of infections.

Advancing ecological risk assessment on genetically engineered breeding stacks with combined insect-resistance traits.

To inform the ecological risk assessment (ERA) of a transgenic crop with multiple insecticidal traits combined by conventional breeding (breeding stack), a comparative field study is customarily conducted to compare transgenic protein concentrations in a breeding stack to those in corresponding component single events used in the breeding process. This study tests the hypothesis that transgenic protein expression will not significantly increase due to stacking, such that existing margins of exposure erode to unacceptable levels. Corroboration of this hypothesis allows for the use of existing non-target organism (NTO) effects tests results, where doses were based on the estimated environmental concentrations determined for a component single event. Results from over 20 studies comparing expression profiles of insecticidal proteins produced by commercial events in various combinations of conventionally-bred stacks were examined to evaluate applying previously determined no-observed-effect concentrations (NOECs) to stack ERAs. This paper presents a large number of tests corroborating the hypothesis of no significant increase in insecticidal protein expression due to combination by conventional breeding, and much of the variation in protein expression is likely attributed to genetic and environmental factors. All transgenic protein concentrations were well within conservative margins between exposure and corresponding NOEC. This work supports the conclusion that protein expression data generated for single events and the conservative manner for setting NTO effects test concentrations allows for the transportability of existing NOECs to the ERA of conventionally-bred stacks, and that future tests of the stated hypothesis are no longer critically informative for ERA on breeding stacks.

When the Whole is Not Greater than the Sum of the Parts: A Critical Review of Laboratory Bioassay Effects Testing for Insecticidal Protein Interactions.

Many studies have been conducted to investigate synergism among insecticidal proteins; however, a consensus on minimal data requirements and interpretation is lacking. While some have concluded that all additive predictive-type models should be abandoned, we advocate that additivity models can remain useful as assessment tools and that an appropriately designed interaction study will never systematically underestimate the existence of synergism, irrespective of which additivity model (or none at all) may be used. To generate the most meaningful synergy assessment datasets in support of safety assessments, we highlight two beneficial steps to follow: (i) select a testing model which is the most consistent with current knowledge regarding the action of the insecticidal proteins and (ii) avoid using bioassay methods which may result in excess response heterogeneity. We also outline other experimental design elements to consider, which may be crucial for conducting future studies of this type. A contrast of underlying testing assumptions associated with the additivity models is provided, along with a comprehensive review of interaction data for Cry1, Cry2, Cry3, Cry9, and Vip3A insecticidal proteins. Our review captures four recurrent findings: i) experiments reporting synergistic interactions are a minority, ii) the degree of synergism reported is low in magnitude, iii) reported interactions are sometimes equivocal/inconclusive due to unconfirmed model assumptions or other bioassay challenges, and iv) due to biological response variation many of the reported interactions may be artefactual. A brief overview of the positioning of interaction testing data in safety assessments of GM food crops is also provided.

A General Approach to Test for Interaction Among Mixtures of Insecticidal Proteins Which Target Different Orders of Insect Pests.

A shift toward transgenic crops which produce combinations of insecticidal proteins has increased the interest (Syngenta Seeds, Inc., Minnetonka, MN) in studying the potential for interactions amongst those proteins. We present a general testing method which accommodates proteins with nonoverlapping spectrums of activity. Our sequential testing approach first investigates groups of the proteins with overlapping activity; e.g., proteins active against Lepidoptera or Coleoptera, respectively. The Colby method is used to test for interactions within each respective group. Subsequently, the mixture of proteins within each group is regarded as a single entity and tests for interactions between the groups (when combined) is conducted using analysis of variance. We illustrate the method using Cry1Ab, Vip3Aa20, and Cry1F (a mixture of proteins active against Lepidoptera), and mCry3A and eCry3.1Ab (a mixture of proteins active against Coleoptera). These insecticidal proteins are produced by Bt11 × MIR162 × TC1507 × MIR604 × 5307 maize. We detected no interactions between Cry1Ab, Vip3Aa20, and Cry1F in tests using larvae of two different lepidopteran species, and possible slight antagonism between mCry3A and eCry3.1Ab with a coleopteran test species. We detected no effect of (eCry3.1Ab + mCry3A) on the potency of (Cry1Ab + Vip3Aa20 + Cry1F) to lepidopteran larvae, and no effect of (Cry1Ab + Vip3Aa20 + Cry1F) on the potency of (mCry3A + eCry3.1Ab) to coleopteran larvae. We discuss implications of these results for characterization of Bt11 × MIR162 × TC1507 × MIR604 × 5307 maize, and the value of the method for characterizing other transgenic crops that produce several insecticidal proteins.

Global Adoption of Genetically Modified (GM) Crops: Challenges for the Public Sector.

Advances in biotechnology continue to drive the development of a wide range of insect-protected, herbicide-tolerant, stress-tolerant, and nutritionally enhanced genetically modified (GM) crops, yet societal and public policy considerations may slow their commercialization. Such restrictions may disproportionately affect developing countries, as well as smaller entrepreneurial and public sector initiatives. The 2014 IUPAC International Congress of Pesticide Chemistry (San Francisco, CA, USA; August 2014) included a symposium on "Challenges Associated with Global Adoption of Agricultural Biotechnology" to review current obstacles in promoting GM crops. Challenges identified by symposium presenters included (i) poor public understanding of GM technology and the need for enhanced communication strategies, (ii) nonharmonized and prescriptive regulatory requirements, and (iii) limited experience with regulations and product development within some public sector programs. The need for holistic resistance management programs to enable the most effective use of insect-protected crops was also a point of emphasis. This paper provides details on the symposium discussion and provides background information that can be used in support of further adoption of beneficial GM crops. Overall, it emphasizes that global adoption of modern agricultural biotechnology has not only provided benefits to growers and consumers but has great potential to provide solutions to an increasing global population and diminishing agricultural land. This potential will be realized by continued scientific innovation, harmonized regulatory systems, and broader communication of the benefits of the high-yielding, disease-resistant, and nutritionally enhanced crops attainable through modern biotechnology.

High concentrations of protein test substances may have non-toxic effects on Daphnia magna: implications for regulatory study designs and ecological risk assessments for GM crops.

Laboratory testing for possible adverse effects of insecticidal proteins on non-target organisms (NTOs) is an important part of many ecological risk assessments for regulatory decision-making about the cultivation of insect-resistant genetically modified (IRGM) crops. To increase confidence in the risk assessments, regulatory guidelines for effects testing specify that representative surrogate species for NTOs are exposed to concentrations of insecticidal proteins that are in excess of worst-case predicted exposures in the field. High concentrations in effects tests are achieved by using protein test substances produced in microbes, such as Escherichia coli. In a study that exposed Daphnia magna to a single high concentration of a microbial test substance containing Vip3Aa20, the insecticidal protein in MIR162 maize, small reductions in growth were observed. These effects were surprising as many other studies strongly suggest that the activity of Vip3Aa20 is limited to Lepidoptera. A plausible explanation for the effect on growth is that high concentrations of test substance have a non-toxic effect on Daphnia, perhaps by reducing its feeding rate. A follow-up study tested that hypothesis by exposing D. magna to several concentrations of Vip3Aa20, and a high concentration of a non-toxic protein, bovine serum albumin (BSA). Vip3Aa20 and BSA had sporadic effects on the reproduction and growth of D. magna. The pattern of the effects suggests that they result from non-toxic effects of high concentrations of protein, and not from toxicity. The implications of these results for regulatory NTO effects testing and ERA of IRGM crops are discussed.

Nontarget organism effects tests on eCry3.1Ab and their application to the ecological risk assessment for cultivation of Event 5307 maize.

Event 5307 transgenic maize produces the novel insecticidal protein eCry3.1Ab, which is active against certain coleopteran pests such as Western corn rootworm (Diabrotica virgifera virgifera). Laboratory tests with representative nontarget organisms (NTOs) were conducted to test the hypothesis of no adverse ecological effects of cultivating Event 5307 maize. Estimates of environmental eCry3.1Ab concentrations for each NTO were calculated from the concentrations of eCry3.1Ab produced by 5307 maize in relevant plant tissues. Nontarget organisms were exposed to diets containing eCry3.1Ab or diets comprising Event 5307 maize tissue and evaluated for effects compared to control groups. No statistically significant differences in survival were observed between the control group and the group exposed to eCry3.1Ab in any organism tested. Measured eCry3.1Ab concentrations in the laboratory studies were equal to or greater than the most conservative estimates of environmental exposure. The laboratory studies corroborate the hypothesis of negligible ecological risk from the cultivation of 5307 maize.

Upward spirals of positive emotion and coping: Replication, extension, and initial exploration of neurochemical substrates.

The broaden-and-build theory (Fredrickson, 1998, 2001) predicts that positive emotions broaden the scopes of attention and cognition, thereby facilitating the building of personal resources and initiating upward spirals toward increasing emotional well-being. This study attempts to replicate and extend previous empirical support for this model. Using a sample of 185 undergraduates, we assessed whether positive affect and broad-minded coping, interpersonal trust, and social support reciprocally and prospectively predict one another over a two-month period, and whether this upward spiral might be partially based in changes in dopaminergic functioning. As hypothesized, PA and positive coping did mutually build on one another, as did PA and interpersonal trust. Contrary to expectation, PA did not demonstrate an upward spiral relation with social support. Results suggest further study of the relationship between PA and changes in dopamine metabolite levels over time is warranted.

Body mass index and depressive symptoms in older adults: the moderating roles of race, sex, and socioeconomic status.

OBJECTIVE: Although the long-term health risks associated with obesity in older adults have been well documented, less is known about the psychological consequences. The current study examined the relationship between body mass index (BMI) and subsequent depressive symptoms. The authors anticipated that BMI would predict depressive symptoms, and that this relationship would be greater among women, individuals of higher socioeconomic status (SES), and white subjects. METHODS: A three-year longitudinal epidemiological design was employed. Participants were obtained from a biracial sample of community-dwelling older adults (N = 2,406) and were interviewed in their home by trained interviewers. A comprehensive survey assessed age, gender, race, SES (education and income), and health functioning variables. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. BMI was derived from self-reported weight and height. RESULTS: BMI was found to predict depressive symptoms. Contrary to predictions, the influence of BMI on depressive symptoms was greater for African Americans than whites and, in particular, African Americans with less education. There were no sex differences. CONCLUSION: Among older adults, BMI was associated with depressive symptoms although the effect size was small. Factors contributing to this relationship may differ from those observed in younger populations, for example, health functioning may play a larger role. Obesity appears to have the most adverse impact on those who are most likely to be overweight, lower SES African Americans.

Receipt of negative feedback is related to increased negative feedback seeking among individuals with depressive symptoms.

In recent years, numerous studies have demonstrated a link between positive and negative feedback seeking by depressed individuals, interpersonal rejection, and depression chronicity. Nonetheless, many of the specific interpersonal patterns underlying these links have yet to be clearly specified. One important lingering question concerns how depressed individuals respond to negative evaluation or feedback from others, because continued negative feedback seeking could place depressed people at risk for further rejection and continuation/exacerbation of depressive symptoms. Two studies were conducted to investigate the influence of negative feedback provisions from others on the feedback seeking behaviors of individuals with depressive symptoms. The results from Study 1 indicated an increased tendency to seek negative feedback among depressive individuals in association with an independent negative evaluation by their college roommates. Using a sample of newlywed couples, Study 2 extended this finding by demonstrating that, when directly provided with negative feedback from their spouses, individuals with depressive symptomatology actively sought further negative feedback, while those without such symptoms did not. Together, the results from these studies suggest that depressed individuals are likely to respond to negative evaluation and feedback from others with behaviors that could place them at risk for further rejection and continuing, if not worsening problems with depression.

Suicidality in African American men: the roles of southern residence, religiosity, and social support.

The rise in suicide by African Americans in the United States is directly attributable to the dramatic, nearly three-fold increase in suicide rates of African American males. Gibbs (1997) hypothesized high social support, religiosity, and southern residence are protective factors against suicidality for Black people. This hypothesis was tested among 5,125 participants from the National Comorbidity Survey; 299 were African American males. In this study we hypothesized that there would be significantly lower suicidality in the South, and social support and religiosity would mediate this relationship. Our results indicate that Southern region is indeed a significant predictor of suicidal symptoms in African American men, such that suicidal symptoms were lower in the South, but religiosity and social support did not account for this effect. Other potential mediators were also examined.

Alcohol use and other psychiatric disorders in the formerly homeless and never homeless: prevalence, age of onset, comorbidity, temporal sequencing, and service utilization.

Interview survey data were collected on a large (n = 4730) general population sample of adults subsequently classified as "never homeless" (NH) or "formerly homeless" (FH), with the latter group consisting of persons who had past experience of at least a one-month period with no regular place to live. The objective was to analyze differences, as a function of this classification, in the prevalence, age of onset, comorbidity, temporal sequencing, and service utilization pertinent to alcohol-use and other psychiatric disorders. Almost half of the FH group were found to have a one-year DSM diagnosis, nearly twice the rate seen in the NH group. Moreover, at 15.1%, the prevalence of alcohol-use disorder (AUD) comorbid with one or more other psychiatric disorders was five times that reported by NH participants. Subsequent analyses addressed differences betweenthe FH (n = 167) and NH (n = 1031) groups within the subset who met criteria for one or more psychiatric diagnoses. Focusing on drinking behavior, we found that among the FH, dual-diagnosis was associated with elevated rates of alcohol-use problem symptoms and with greater alcohol consumption than were evident in the FH with AUD alone. Also, among the FH with comorbid AUD, as well as among those with two or more psychiatric disorders unrelated to alcohol, there was an earlier onset of psychiatric disorders than in the NH. This earlier onset may have placed these individuals at greater risk for later homelessness and AUD, and may also be indicative of a more severe course of illness. Differences between the FH and the NH suggest the importance of devoting special attention to this unique sample.