The caries experience of 11 to 12 year-old children in Scotland and Wales and 12 year-olds in England in 2008-2009: reports of co-ordinated surveys using BASCD methodology

OBJECTIVE

This paper brings together summarised findings on surveys of 106,828 mainstream school pupils aged 11-12 years old undertaken in Scotland, Wales and England in 2008/09. These surveys are the latest in a series using common criteria for measurement and a range of consent arrangements which, for this age group, allow comparison between the three "countries" and over time.

METHOD

Representative samples were drawn within the geographies of primary care organisations in the three countries and within English Local Authorities according to BASCD criteria for sampling. Consent was sought from pupils in Wales and England and passive consent was used in Scotland. Children aged twelve were examined in England and children in school year 7 (rising 12) were examined in Wales and Scotland. Examinations were conducted in schools by trained and calibrated examiners using BASCD standard criteria and caries was diagnosed at the dentinal threshold using visual criteria.

RESULTS

The trend for reducing caries prevalence and severity continues in this age group in all three countries. Unlike data for 5 year old children, the impact of seeking positive consent from pupils does not appear to have introduced bias into the results. Variation in caries levels between and within geographical areas continues.

CONCLUSION

Caries prevalence surveys of children aged 11-12 years have been conducted across Great Britain. Those carried out with positive consent appear to produce unbiased results, comparable with previous surveys. Health inequalities in this age group persist, as does the burden of disease for those with end-stage caries.

The caries experience of 5 year-old children in Scotland, Wales and England in 2007-2008 and the impact of consent arrangements. Reports of co-ordinated surveys using BASCD criteria

OBJECTIVE

This paper brings together summarised findings and comment on surveys of young children undertaken in Scotland, Wales and England in 2007-08. These surveys are the latest in a series using common criteria for measurement but changes in the consent arrangements for Wales and England mean that these datasets are no longer directly comparable with Scottish data.

METHOD

Representative samples were drawn within the geographies of primary care organisations in the three countries, and in England within Local Authorities also, according to BASCD criteria. Consent was sought in three different ways. Children aged five were examined in England and those in Primary 1 (rising 6) were examined in Wales and Scotland. Examinations were conducted in schools by trained and calibrated examiners and caries was diagnosed at the dentinal threshold using visual criteria.

RESULTS

The impact of seeking positive consent appeared to depress the caries severity and prevalence in Wales and England whilst the reduced caries levels in Scotland may be attributed to the pro-active health improvement measures affecting this cohort. The results for positive consent suggest bias against participation of children with higher levels of tooth decay.

CONCLUSION

Caries prevalence surveys of children at the start of formal education have been conducted in Great Britain. Those carried out with the need for positive parental consent have produced new baseline data. Data presented after 2007-08 should be annotated to show the participation rate and the inappropriateness of comparing data collected using different types of consent.

Evaluation of calf milk pasteurization systems on 6 Pennsylvania dairy farms

Waste milk has been fed to calves for many years, but concerns with bacterial contamination as well as possible transmission of diseases have discouraged widespread use of this feed. Pasteurization of waste milk is one option to reduce management risk while utilizing a valuable, low-cost, liquid feed source for calves. However, many farms currently pasteurizing waste milk lack a system to adequately monitor the efficiency of the process. A study was carried out to evaluate 6 on-farm pasteurization systems, including high-temperature, short-time pasteurizers and low-temperature, batch pasteurizers. Milk samples were taken pre- and postpasteurization as well as from the calf buckets and immediately frozen for later bacterial culture. Samples were collected twice daily for 15 d. Milk samples were examined for standard plate count (SPC), coagulase-negative staphylococci count, environmental streptococci count, coliform count, gram-negative noncoliform count, Streptococcus agalactiae count, and Staphylococcus aureus count. Before pasteurization, 68% of the samples had SPC <20,000 cfu/mL, and 39% of samples contained <100 cfu/mL of coliform bacteria. After pasteurization, 96% of samples had SPC <20,000 cfu/mL, and 92% had coliform counts <100 cfu/mL. Bacteria counts were significantly reduced by pasteurization, and pasteurized milk contained acceptable numbers of bacteria in >90% of samples. These results indicate that pasteurization can be very effective in lowering bacterial contamination of milk. However, bacteria numbers significantly increased after pasteurization and, in some cases, bacteria counts in milk fed to calves were similar to prepasteurization levels. Milk handling after pasteurization was identified as an important issue on the farms studied.

Diagnostic accuracy meta-analysis: review of an important tool in radiological research and decision making

The importance of evidence-based diagnostic practice has been increasingly recognised over the past decade. Meta-analyses are used to summarise and assess the literature and are therefore particularly important tools in radiological research. Diagnostic radiology is driven by emerging technologies that are increasingly under scrutiny in the radiological literature. Correspondingly, diagnostic meta-analyses are better at addressing the intricacies of diagnostic accuracy measures, whilst retaining robust methodology. The ability to interpret results for application to clinical practice is increasingly important for radiology owing to the close relationship with the diagnostic process. However, confusing terminology and a lack of understanding of the principles of diagnostic meta-analysis leads to difficulty in interpretation by clinicians. Hierarchical summary receiver operating characteristic analysis is becoming the standard method for diagnostic test meta-analysis. This article explains the basic principles of interpreting diagnostic meta-analyses.

2-APB protects against liver ischemia-reperfusion injury by reducing cellular and mitochondrial calcium uptake

Ischemia-reperfusion (I/R) injury is a commonly encountered clinical problem in liver surgery and transplantation. The pathogenesis of I/R injury is multifactorial, but mitochondrial Ca(2+) overload plays a central role. We have previously defined a novel pathway for mitochondrial Ca(2+) handling and now further characterize this pathway and investigate a novel Ca(2+)-channel inhibitor, 2-aminoethoxydiphenyl borate (2-APB), for preventing hepatic I/R injury. The effect of 2-APB on cellular and mitochondrial Ca(2+) uptake was evaluated in vitro by using (45)Ca(2+). Subsequently, 2-APB (2 mg/kg) or vehicle was injected into the portal vein of anesthetized rats either before or following 1 h of inflow occlusion to 70% of the liver. After 3 h of reperfusion, liver injury was assessed enzymatically and histologically. Hep G2 cells transfected with green fluorescent protein-tagged cytochrome c were used to evaluate mitochondrial permeability. 2-APB dose-dependently blocked Ca(2+) uptake in isolated liver mitochondria and reduced cellular Ca(2+) accumulation in Hep G2 cells. In vivo I/R increased liver enzymes 10-fold, and 2-APB prevented this when administered pre- or postischemia. 2-APB significantly reduced cellular damage determined by hematoxylin and eosin and terminal deoxynucleotidyl transferase dUTP-mediated nick-end labeling staining of liver tissue. In vitro I/R caused a dissociation between cytochrome c and mitochondria in Hep G2 cells that was prevented by administration of 2-APB. These data further establish the role of cellular Ca(2+) uptake and subsequent mitochondrial Ca(2+) overload in I/R injury and identify 2-APB as a novel pharmacological inhibitor of liver I/R injury even when administered following a prolonged ischemic insult.

Natatory-stage cymothoid isopods: description, molecular identification and evolution of attachment

Cymothoid isopods are parasites that have a biphasic life cycle comprised of free-swimming micropredatory stages that eventually attach permanently to fishes, on which they change sex and morphology. Thus, matching free-swimming and permanently attached life-history stages is difficult. We attempted to identify natatory-stage cymothoids by seeking matches of partial 16S rRNA gene sequences from these stages and described adult cymothoids. Natatory cymothoids were collected from light traps at Lizard Island, Great Barrier Reef and adult females were collected from fishes from several sites along the east coast of Australia. A 488bp alignment of 16S mtDNA was compared for nine species of adult cymothoids and 10 natatory-stage morphotypes. Sequences from five natatory morphotypes were similar or identical to described specimens. Sequences identical to those of Anilocra nemipteri and Cymothoa indica were collected and these are considered definitive identifications. Sequences of three other morphotypes were highly similar (97.1-99.8% homologous) to described species; the differences may reflect a low level of sequencing error, intra-specific variation or the presence of complexes of species. Figures and descriptions are provided for identified and unidentified natatory cymothoids. The sequences were also used to explore the phylogenetic relationships of these taxa using minimum evolution, maximum parsimony, maximum likelihood and Bayesian inference analyses. Topologies from each of the four phylogenetic analyses did not differ significantly. Bayesian inference and maximum likelihood methods produced identical topologies with the highest resolution. These analyses showed that some morphological characters (pereopods and uropods) of natatory stages were distributed consistently on these molecular phylogenies, raising the possibility of identifying some natatory stages to genus. Our results suggest that ancestral cymothoids attached in the buccal or gill cavity and that external attachment, as seen in Anilocra and Renocila is a derived condition that has arisen more than once.

Host specificity of two species of Gnathia (Isopoda) determined by DNA sequencing blood meals

Host specificity data for gnathiid isopods are scarce because the parasitic stages are difficult to identify and host-parasite contact is often brief. We examined two common nocturnal species, Gnathia falcipenis and Gnathia sp. C, collected in light traps from two locations at Lizard Island on the Great Barrier Reef, Australia. Engorged third stage gnathiids were photographed and permitted to moult into adults to allow identification. We compared approximately 580 bp sequences of 16S mtDNA from blood meals with host sequences available on GenBank using BLASTn. Where homology was <98%, familial identity was investigated with neighbour-joining trees. All blood meal sequences (n=60) and homologous fish sequences (n=87) from GenBank were used in a Bayesian analysis, which identified all but three sequences to family. The host frequency distributions used by each species were significantly different; only four host families were shared. No gnathiids fed on elasmobranchs, blennies or apogonids, and most fed on host families whose representatives are typically large. Gnathia sp. C showed a distinct predilection for nemipterids. Gnathia falcipenis often parasitised sand-dwelling families, and unlike sympatric diurnal gnathiid species, it also frequently parasitised pomacentrids. We conclude that G. falcipenis and Gnathia sp. C operate as generalist micropredators with preferences.

Soil microbial community analysis using two-dimensional polyacrylamide gel electrophoresis of the bacterial ribosomal internal transcribed spacer regions

Two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) of digested genomic DNA has been previously used in comparative genomics studies of closely related bacteria species. However, a two-dimensional gel electrophoresis approach for examining microbial community structures in environmental samples has not yet been developed. We determined that it is theoretically possible to separate internal transcribed spacer regions (ITS) of bacterial communities into hundreds of operational taxonomic units (OTUs) using 2D-PAGE. Application of 2D-PAGE for separating Bacterial ITS sequences that have been PCR-amplified from replicate soil samples taken from along a Zn gradient resulted in reproducible gels containing hundreds of spots. Clear differences in spot patterns were observed between soil samples that differed in both sampling location and Zn content. The number of OTUs detected using 2D-PAGE of ITS regions was much greater than that observed using Automated Ribosomal Internal Transcribed Spacer Analysis (ARISA), Terminal Restriction Fragment Length Polymorphism (T-RFLP), or Denaturing Gradient Gel Electrophoresis (DGGE). Principal Component Analysis (PCA) of community spot patterns resulted in similar groupings of samples as those obtained using other molecular methods, however, excised spots were found to contain a far lower diversity of different sequences than excised ITS bands of the same length, as determined by RFLP analysis of excision clone libraries and subsequent sequencing of DNA eluted from excised spots. This increase in resolution makes 2D-PAGE of Bacteria ITS fragments from complex microbial communities a viable method for detecting differences between highly similar communities, as well as in streamlining follow-on sequencing efforts by reducing the level of homoplasy (co-migration of heterogeneous sequences) often seen in band-based community fingerprinting methods.

Variability in Holstein heifer heart-girth measurements and comparison of prediction equations for live weight

Measurement of heart-girth (chest circumference) is commonly used to estimate dairy heifer body weight from previously derived equations or tables. In this experiment, variability of heart-girth measurements as they are taken in the field was analyzed to determine the standard deviation within a group of 26 Holstein heifers of various ages weighing 42-590 kg. Standard deviations were 2.19 cm among 26 observers and 2.74 cm within any one observer. Repeatability between two heart-girth measurements by an individual observer on the same animal using a blind heart-girth tape was >0.99. Correlation coefficients between two measurements by different observers using blind measuring tapes on the same animal also were >0.99, with 99% of total differences due to observer and heifer, indicating very little random variation. A second part of this study was the validation of the most recently derived equation to calculate body weight from heart-girth. The equation was validated with data sets from universities across the United States and field data collected specifically for this study. Experimental and field data comprised of heart-girth and body weight measurements upheld the previously derived equation and support its continued use. These results allow more precise interpretation of heart-girth data collected from field studies with Holstein dairy heifers and provide more complete validation of existing body weight-prediction equations.

The hook effect: a need for constant vigilance

The hook effect is a well-recognized problem that can occur in assays of most tumour markers, including alpha feto-protein (AFP). We present a case of hepatoblastoma in a baby. The diagnosis was delayed as a result of unrecognized 'hooking' of a very high AFP concentration in the automated immunoassay method used. The falsely low result obtained was considered normal for the patient's age and supported the diagnosis of benign haemangioendothelioma. Liaison between clinical and laboratory staff was critical in obtaining an accurate AFP result, proceeding to liver biopsy and establishing the definitive diagnosis of hepatoblastoma. While the reasons and solutions for hook effect have been well researched and published, we believe the presence of extremely high serum AFP concentration in some hepatoblastoma patients means that the hook effect remains a problem and can generate erroneously low AFP results despite assay reformulation by manufacturers. Therefore constant vigilance by laboratory staff is still needed.

The effects of fluid penetration and interfacial porosity on the fixation of cemented femoral components

We have investigated the role of the penetration of saline on the shear strength of the cement-stem interface for stems inserted at room temperature and those preheated to 37°C using a variety of commercial bone cements. Immersion in saline for two weeks at 37°C reduced interfacial strength by 56% to 88% after insertion at room temperature and by 28% to 49% after preheating of the stem. The reduction in porosity as a result of preheating ranged from 71% to 100%. Increased porosity correlated with a reduction in shear strength after immersion in saline (r = 0.839, p < 0.01) indicating that interfacial porosity may act as a fluid conduit.

Economic Returns to Holstein and Jersey Herds Under Multiple Component Pricing

This study analyzed component data from herds participating in the Mideast Federal Milk Marketing Order from 2000 through 2002, and its implications for herd profitability. A monthly simulation model was developed to evaluate the economic returns for a representative Holstein and Jersey herd in Pennsylvania under multiple component pricing. Component levels were highly seasonal and variable from farm to farm. A third of the herds during the course of a year realized a 1- to 3-mo temporary reduction in milk fat or protein greater than one standard deviation. Consistently producing milk fat and protein one standard deviation below the mean reduced the Class III value by $0.82/cwt (100 pounds), or 7.09%. The simulation model indicated that a herd of 100 Holstein cows generated $31,221 more income over feed costs (IOFC) a year than a herd of 100 Jersey cows. Although Jersey milk had greater gross value than Holstein milk due to higher component levels, total volume of milk and components produced by Holsteins offset this difference. Simulation results confirm that increasing milk fat and protein percentages by one standard deviation increased IOFC 7.7% for Holsteins and 9.2% for Jerseys relative to the baseline IOFC, with similar losses for component reductions. Increasing milk yield by one standard deviation increased IOFC by 19.6% for Holsteins and 23.9% for Jerseys relative to the baseline IOFC, again with similar losses for reductions in milk production. In all of the scenarios analyzed, the most important factor affecting IOFC was total amount of milk fat and protein produced, not the component percentage levels.

Influence of pooled colostrum or colostrum replacement on IgG and evaluation of animal plasma in milk replacer

Newborn Holstein (n = 48) and Jersey (n = 30) calves were studied to compare absorption of immunoglobulin G (IgG) from maternal colostrum (n = 39) or colostrum replacement containing an Ig concentrate derived from bovine serum (n = 39). Calves were also fed milk replacer with (n = 38) or without (n = 40) animal plasma (20% of crude protein) to 29 d of age to determine effect of plasma protein on IgG status, health, and growth. Calves were fed maternal colostrum or colostrum replacement at 1.5 and 13.5 h of age and provided a total of 250 or 249 and 180 or 186 g of IgG for Holsteins and Jerseys fed maternal colostrum or colostrum replacement, respectively. Milk replacer (12.5% DM) was fed at 31% of metabolic birth weight (2 feedings/d). Plasma was sampled at 0 h, 24 h, and weekly to determine IgG by turbidimetric immunoassay. At blood collection, calves were weighed and measured to determine growth. Health scores, fecal scores, and grain intake were measured daily. Plasma IgG at 24 h did not differ between calves fed maternal colostrum (13.78 ± 0.39 g/L) and colostrum replacement (13.96 ± 0.38 g/L). Average daily gain, withers height, hip height, body length, heart girth, health, and incidence of diarrhea were not different between treatment groups. Calves fed maternal colostrum used feed more efficiently than calves fed colostrum replacement. Plasma IgG and performance were not affected by the addition of animal plasma to milk replacer. The colostrum replacement used in this study provided adequate IgG for newborn calves. Animal plasma was an acceptable source of protein but did not enhance growth or immunity under the conditions of this study.

Kinetics of superoxide scavenging by glutathione: an evaluation of its role in the removal of mitochondrial superoxide

Superoxide radicals are produced in trace amounts by the mitochondrial respiratory chain. Most are removed rapidly by superoxide dismutase in the matrix. Superoxide is also known to react with glutathione. Reported values of the rate constant for this reaction range from 10(2) to in excess of 10(5) M(-1).s(-1). The magnitude of this rate constant has important physiological implications because, if it is at the upper end of the reported range, a significant proportion of mitochondrial superoxide will evade removal by superoxide dismutase, and will oxidize glutathione to the potentially harmful glutathionyl radical. Using EPR spectroscopy to monitor competition between glutathione and the spin trap 5,5-dimethyl-1-pyrroline N-oxide for reaction with superoxide, we have estimated that the rate constant for the reaction between superoxide and glutathione is only approximately 200 M(-1).s(-1). Hence superoxide dismutase will always out-compete glutathione for reaction with the superoxide radical, thereby preventing formation of the glutathionyl radical.