Early Introduction of Sugar-Sweetened Beverages and Caries Trajectories from Age 12 to 48 Months.

Early exposure to sweet tastes predicts similar food preferences and eating behavior in later life and is associated with childhood obesity. The aim of this study was to explore the associations of early (during the first year of life) and subsequent intake of sugar-sweetened beverages (SSBs) with 4-y caries trajectories among Scottish young children. We used data from 1,111 Scottish children who were followed annually from age 12 to 48 mo (4 sweeps in total). SSB intake was reported by parents in every sweep. SSB intake was broken down into 2 components, the initial SSB intake and the deviation over time from that initial value. Childhood dental caries was clinically determined (including noncavitated and cavitated lesions) every year. The association of SSB intake with baseline decayed, missing, and filled tooth surfaces (dmfs) (intercept) and rate of change in dmfs over time (slope) was examined in 2-level linear mixed-effects models, with repeated observations nested within children. Both the initial SSB intake and the deviation from the initial SSB intake were positively associated with steeper caries trajectories. By sweep 4, the predicted mean dmfs difference was 1.73 between children with low and high initial SSB intake (1 standard deviation below and above the mean) and 1.17 between children with low and high deviation from their initial SSB intake (1 SD below and above the mean). The findings of this prospective study among Scottish young children provide evidence that the introduction of SSBs during the first year of life can put children in a trajectory of high levels of dental caries. They support current recommendations to avoid sugars for very young children and interventions targeting early feeding practices for caries prevention.

An improved treatment planning and quality assurance process for Collaborative Ocular Melanoma Study eye plaque brachytherapy.

PURPOSE: To develop a treatment planning platform for episcleral Collaborative Ocular Melanoma Study plaque therapy in an established treatment planning software and to improve an existing quality assurance (QA) process for nonuniformly loaded plaques that measures air kerma strengths (AKSs) and loading profile. MATERIALS AND METHODS: Treatment planning is performed in Pinnacle using scripts that let the planner choose plaque size and notching. Scripts load seed positions for each plaque and five source groups corresponding to available stock seeds that can be placed into each seed position. Contours are loaded that display the model eye and the plaque itself. Plaque QA is performed using a modification of our previous pinhole apparatus by replacing x-ray film exposure with an optical camera and scintillating film system. The captured image is processed to remove background and to correct the intensity of seeds on the plaque periphery. Measured total optical counts provide an estimate of total plaque AKS. RESULTS: Treatment planning of eye plaques using Pinnacle, in conjunction with our stock inventory of seeds, is established as standard practice at our center. Planned plaques can vary from uniformly loaded to asymmetrically loaded notched plaques. Using the optical camera system for assessment of the seed loadings has decreased QA time from 40 min/plaque to 10 min/plaque. Total AKS of each plaque can be measured using the optical camera with an accuracy of 10%. CONCLUSIONS: Treatment planning is performed on a Health Canada-approved software that accommodates nonuniform plaque loading. Optical imaging of the plaque provides absolute total AKS and the relative seed arrangement in the plaque.

Does social deprivation in 1, 2, 3 and 4-year-old Scottish infants influence the frequency isolation of caries-associated micro-organisms?

OBJECTIVES: The aim of this study was to determine if there are associations between the level of social deprivation/affluence and the frequency isolation of caries-associated micro-organisms (Streptococcus mutans, Streptococcus sobrinus, lactobacilli and yeasts) in a large cohort of infants examined annually from 1 to 4 years of age. METHODS: DEPCAT was used to measure the socio-economic status of all consented infants (n=1099--1392) born in Dundee during a 1 year period (total n=1974). Caries-associated micro-organisms were cultured from saliva when the infants were 1, 2, 3 and 4 years of age. Standardised dental examinations were also carried out annually. Log linear analysis, which controlled for caries, was used to look for associations between DEPCAT and the isolation frequency of caries-associated micro-organisms. RESULTS: When controlling for caries, there was an association between DEPCAT and the isolation frequency of yeasts when the infants were 1 and 2 but not when 3 and 4 years old, whereas lactobacilli were associated only when the infants were 3 and 4 years old. Correlations between S. mutans and social deprivation were usually dependent on the caries status of the infants. CONCLUSIONS: The relationship between social deprivation and the isolation frequencies of caries-associated micro-organisms is complex with lactobacilli developing an association when the infants were 3 and 4 years old in contrast to yeasts which were only associated when the infants were 1 and 2 years old. Streptococcus mutans was associated with social deprivation when the infants were 2 years old and older, but dependent on caries status in the 3 and 4 year olds.

Caries-associated micro-organisms in infants from different socio-economic backgrounds in Scotland.

OBJECTIVES: The aims of this study were: (1) to compare the frequency of isolation of mutans streptococci, (Streptococcus mutans, Steptococcus sobrinus), lactobacilli and yeasts (caries-associated micro-organisms) in the saliva of 1-year-old infants with and without dental caries; and (2) to determine if socio-economic background influenced the frequency isolation of bacteria and caries status. METHODS: 1393 1-year-old consented infants, who comprised 70. 3% of children born in Dundee during a 1year period, had saliva samples taken (tongue-loop method) for microbiological culture and were examined for dental caries (d(1)-threshold: enamel and dentine diagnostic threshold). Thirty-nine infants were diagnosed with caries and the frequencies of isolation of caries-associated micro-organisms (and absolute microbial counts) were compared with infants who were caries-free. In addition, associations were sought between the infants' socio-economic background, the frequency of isolation of caries-associated micro-organisms and caries status. RESULTS: Streptococcus mutans, lactobacilli and yeasts were isolated more frequently from those infants with caries compared to those who were caries-free (S. mutans: 29.7 vs 9.8%, P=0.0008; lactobacilli: 15.4 vs 4.3%, P=0.0073; yeasts: 23.7 vs 10.4%, P=0.0016-Fisher's exact test). There were no significant differences between the isolation frequencies of S. sobrinus (2.7 vs 1.3%, P=0.39) from those with and without caries. Significantly, more infants living in areas of high deprivation had caries compared to those from more affluent areas (DEPCAT 6 and 7 vs 1-5: 3.6 vs 1.9%, P=0.049), but, apart from yeasts, socio-economic background was not significantly associated with the isolation frequencies of any of the caries-associated micro-organisms. CONCLUSIONS: In infants as young as 1year of age, salivary S. mutans, lactobacilli and yeasts but not S. sobrinus were isolated significantly more frequently from those with caries compared to those who were caries-free. Apart from yeasts, socio-economic background did not influence the frequency of isolation of caries-associated micro-organisms. However, infants living in areas of highest deprivation had significantly higher frequencies of caries compared to those from more affluent areas.

Actuarial status of the OASI and DI Trust Funds.

This article presents the summary of the 1988 Annual Report of the Board of Trustees of the Old-Age, Survivors, and Disability Insurance (OASDI) Trust Funds. It summarizes the financial condition and actuarial status of the OASDI program based on the alternative projections. The long-range 75-year estimates indicate that, under the intermediate (II-A and II-B) assumptions, the OASDI program will experience about three decades of positive annual balances, with continuing annual deficits thereafter. The positive balances in the first part of the 75-year projection period nearly offset the later deficits, so that the program, as a whole is in close actuarial balance. Over the long-range projection period, the OASDI program has an actuarial deficit of 0.58 percent of taxable payroll, based on the intermediate alternative II-B assumptions and calculated on a level-financing basis. The DI program by itself, however, is not in close actuarial balance for the next 75 years. The actuarial deficit for the DI program could be remedied by a small reallocation of the contribution rate from OASI to DI, in such a way that the OASI program would remain in close actuarial balance. Although the Trustees are not recommending such a reallocation, they note that the financial condition of the DI program will need to be carefully monitored.

Actuarial status of the OASI (old age survivors insurance) and DI (disability insurance) Trust Funds.

This article summarizes the current financial condition and actuarial status of the Old-Age, Survivors, and Disability Insurance (OASDI) program, as shown in the 1987 Annual Report of the Board of Trustees. The Trustees note that the assets of the OASI and DI Trust Funds, on a combined basis, will be sufficient to permit the timely payment of OASDI benefits for many years into the future, on the basis of all four sets of assumptions shown in the report. For the next 75 years, the estimates show that the OASDI program, overall, is in close actuarial balance, based on the two intermediate sets of assumptions. The DI program by itself, however, is not in close actuarial balance for the next 75 years. The actuarial deficit for the DI program could be remedied by a small reallocation of the contribution rate from OASI to DI, in such a way that the OASI program would remain in close actuarial balance and OASDI benefits would not be affected. Although the Trustees are not recommending such a reallocation, they note that the financial condition of the DI program will need to be carefully monitored.

Gram-negative bacteremia produces both severe systolic and diastolic cardiac dysfunction in a canine model that simulates human septic shock.

A canine sepsis model that simulates the human cardiovascular response to septic shock was produced in 10 conscious unsedated dogs by implanting an Escherichia coli-infected clot into the peritoneum, resulting in bacteremia. By employing serial, simultaneous measurements of radionuclide scan-determined left ventricular (LV) ejection fraction (EF) and thermodilution cardiac index (CI), the end-diastolic volume index (EDVI) was calculated (EDVI = stroke volume index divided by EF). By using three different methods of quantifying serial ventricular performance (EF, shifts in the Starling ventricular function curve using EDVI vs. stroke work index, and the ventricular function curve response to volume infusion), this study provides evidence (P less than 0.01) that septic shock produces a profound, but reversible, decrease in systolic ventricular performance. This decreased performance was not seen in controls and was associated with ventricular dilatation (P less than 0.01); the latter response was dependent on an adequate volume infusion. Further studies of EDVI and pulmonary capillary wedge pressure during diastole revealed a significant, though reversible, shift (P less than 0.001) in the diastolic volume/pressure (or compliance) relationship during septic shock.

Actuarial status of the OASI and DI Trust Funds.

This article summarizes the current financial condition and actuarial status of the old-age, survivors, and disability insurance (OASDI) program, as shown in the 1986 Annual Report of the Board of Trustees. The Trustees note that the assets of the OASI and DI Trust Funds will be sufficient to permit the timely payment of OASDI benefits for many years into the future, on the basis of all four sets of assumptions shown in the report. For the next 75 years, the estimates show that the OASDI program, overall, is in close actuarial balance, based on the two intermediate sets of assumptions. The DI program by itself, however, is not in close actuarial balance for the next 75 years. The actuarial deficit for the DI program could be remedied by a small reallocation of the contribution rate from OASI to DI, in such a way that the OASI program would remain in close actuarial balance and OASDI benefits would not be affected. Although the Trustees do not at this time recommend such a reallocation, they note that the financial condition of the DI program will need to be carefully monitored for the next several years.

Actuarial status of the OASI and DI Trust Funds.

This article summarizes the current financial and actuarial status of the old-age, survivors, and disability insurance (OASDI) program, as shown in the 1985 Annual Report of the Board of Trustees. The Trustees note that the combined assets of the OASI and DI programs will be sufficient to pay OASDI benefits on time well into the next century based on all four sets of economic and demographic assumptions. Based on the pessimistic assumptions, the DI program could become unable to pay benefits on time by the end of 1987, but this problem could be prevented by a reallocation of contribution rates between the OASI and DI programs. For the long range--the next 75 years--the Trustees estimate that the OASDI program is in close actuarial balance based on intermediate assumptions--that is, the average annual income rate is estimated to be between 95 percent and 105 percent of the average annual cost rate during that period. The long-range actuarial deficit based on the intermediate (Alternative II-B) assumptions represents about 3 percent of the average annual cost rate for the program.

Present policies and methods regarding the long-term adjustment of benefits.

If beneficiaries are to maintain their standard of living at a level close to what it was before they left the workforce, the payments they receive under the Social Security program must be periodically adjusted to account for changes in the cost of living. This article describes the policies and practices employed by the Social Security Administration to accomplish this objective. It describes the historical development of various automatic-adjustment provisions, how contributions are indexed to determine the initial benefit, and how the purchasing power of the benefit is adjusted as the result of changes in the Consumer Price Index. Other factors that will affect long-term benefits, such as changes in the normal retirement age and in the size of the delayed retirement credit, are also explored.

Actuarial status of the OASI and DI Trust Funds.

This article summarizes the current financial and actuarial status of the Old-Age, Survivors, and Disability Insurance (OASDI) program. The results presented are from the 1984 Trustees Report and are similar to the results in the 1983 report. This year's estimates show that the Social Security Amendments of 1983 restored the financial soundness of the OASDI program. According to the actuarial estimates, benefits can be paid on time throughout the 1980's and for many years thereafter. Because trust fund levels are projected to be relatively low through 1987, however, the program could again experience financial difficulties in the near future if economic conditions become worse than anticipated under the pessimistic (Alternative III) assumptions. After 1987, the program's ability to withstand economic downturns is projected to improve. On the basis of intermediate (Alternative II-B) assumptions, the OASDI program is in long-range close actuarial balance. This actuarial balance reflects substantial year-by-year surpluses during the first half of the 75-year projection period that are slightly out-weighed by substantial deficits later on.

Actuarial status of the Old-Age and Survivors Insurance and Disability Insurance Trust Funds.

This article summarizes the current financial and actuarial status of the Old-Age, Survivors, and Disability Insurance (OASDI) program. The data presented are from the 1983 Trustees Report for the program following enactment of the Social Security Amendments of 1983. The actuarial estimates show that benefits can be paid on time throughout the 1980's and for many years thereafter. However, trust fund levels are projected to be relatively low through 1987, and the program could again experience financial difficulties in the near future if economic conditions become worse than anticipated under the pessimistic Alternative III assumptions. After 1987, the program's ability to withstand economic downturns is projected to improve. On the basis of intermediate assumptions, the OASDI program is now in long-range actuarial balance. This actuarial balance reflects substantial year-by-year surpluses during the first half of the 75-year projection period that slightly outweigh substantial deficits later on.

Development of a primate model of exposure hypothermia.

A nonhuman primate model of exposure-induced hypothermia was developed and the hemodynamic effects of hypothermia were evaluated in five animals. With decreasing core temperature from 37 degrees C to 33 degrees C there was a 47% increase in heart rate, a 23% increase in mean arterial pressure, a 48% increase in cardiac output, a 260% increase in oxygen consumption, and a 237% increase in minute ventilation. As the core temperature decreased from 33 degrees C to 29 degrees C there were decreases in the heart rate, blood pressure, and cardiac output such that at 29 degrees C these values were not significantly different from the values obtained at 37 degrees C. However, the oxygen consumption was still 180% increased and the minute ventilation 40% higher at 29 degrees C than at 37 degrees C. This model will allow the evaluation of the physiology of hypothermia and the effectiveness of different rewarming techniques.

Actuarial status of the old-age and survivors insurance and disability insurance trust funds.

The 1982 Annual Report of the Board of Trustees of the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) Trust Funds indicates sever financial problems in both the short and the long range. The short-range financial status is significantly worse than was estimated last year, after enactment of the 1981 legislation, because of continuing unfavorable economic conditions. The estimated long-range deficit is the same as the deficit that was estimated last year before the 1981 legislation and is therefore somewhat worse than was estimated immediately after enactment of the legislation. Under present law, which authorizes temporary interfund borrowing amount the OASI, DI, and Hospital Insurance (HI) Trust Funds, the OASI Trust Fund would become unable to pay benefits on time by July 1983. The assets of the DI Trust Fund, on the other hand, are expected to grow rapidly in both the short and long range. If the assets of both the OASI and DI Trust Funds were combined, however, the two funds would still become unable to pay benefits on time by the latter half of 1983, based on all four sets of economic and demographic assumptions in the 1982 report. Even if the temporary interfund borrowing authority in present law were extended, the combined assets of the OASI, DI, and HI Trust Funds would become insufficient to pay benefits on time by 1984, based on the two less favorable sets of assumptions in the 1982 report. Based on the other two, more favorable, sets of assumptions, the three combined funds could pay benefits on time through the 1980's but there would be little or no margin of safety to permit timely payment of benefits if economic conditions are even slightly less favorable.