Metabolomics Insights in Early Childhood Caries.

Dental caries is characterized by a dysbiotic shift at the biofilm-tooth surface interface, yet comprehensive biochemical characterizations of the biofilm are scant. We used metabolomics to identify biochemical features of the supragingival biofilm associated with early childhood caries (ECC) prevalence and severity. The study's analytical sample comprised 289 children ages 3 to 5 (51% with ECC) who attended public preschools in North Carolina and were enrolled in a community-based cross-sectional study of early childhood oral health. Clinical examinations were conducted by calibrated examiners in community locations using International Caries Detection and Classification System (ICDAS) criteria. Supragingival plaque collected from the facial/buccal surfaces of all primary teeth in the upper-left quadrant was analyzed using ultra-performance liquid chromatography-tandem mass spectrometry. Associations between individual metabolites and 18 clinical traits (based on different ECC definitions and sets of tooth surfaces) were quantified using Brownian distance correlations (dCor) and linear regression modeling of log2-transformed values, applying a false discovery rate multiple testing correction. A tree-based pipeline optimization tool (TPOT)-machine learning process was used to identify the best-fitting ECC classification metabolite model. There were 503 named metabolites identified, including microbial, host, and exogenous biochemicals. Most significant ECC-metabolite associations were positive (i.e., upregulations/enrichments). The localized ECC case definition (ICDAS ≥1 caries experience within the surfaces from which plaque was collected) had the strongest correlation with the metabolome (dCor P = 8 × 10-3). Sixteen metabolites were significantly associated with ECC after multiple testing correction, including fucose (P = 3.0 × 10-6) and N-acetylneuraminate (p = 6.8 × 10-6) with higher ECC prevalence, as well as catechin (P = 4.7 × 10-6) and epicatechin (P = 2.9 × 10-6) with lower. Catechin, epicatechin, imidazole propionate, fucose, 9,10-DiHOME, and N-acetylneuraminate were among the top 15 metabolites in terms of ECC classification importance in the automated TPOT model. These supragingival biofilm metabolite findings provide novel insights in ECC biology and can serve as the basis for the development of measures of disease activity or risk assessment.

Determining the digestible lysine requirement of 22- to 47-week-old Lohmann laying hens using an increasing protein titration methodology.

A laying hen trial was conducted from 22 to 47 wk of age to determine the digestible lysine (DLYS) requirement of laying hens by using an increasing CP titration method. A total of 896 Lohmann LSL-Lite caged layers (22 wk of age) were allotted to 8 dietary treatments and each treatment had 8 replications of 14 hens. The first 7 experimental diets initially contained DLYS levels increasing from 0.565 to 0.980% with respective protein levels increasing from 13.8 to 21.7%. Dietary treatment 8 was a control diet which was calculated to contain 18.6% CP and 0.807% DLYS. These DLYS levels were reduced from 0.468 to 0.845% for diets 1 to 7 (0.688% for diet 8) at week 12 so that greater differences in production parameters could be obtained. Increasing DLYS levels had a significant (P < 0.05) effect on egg production, egg weight, egg mass, and feed efficiency. However, DLYS levels had no significant effect on egg component measurements such as percentage of yolk, white, and solids. Broken line regression, maximum of the quadratic polynomial (QP max) regression, and the intercept of the broken line and QP regressions were used to estimate the DLYS requirement. Broken line regression yielded the lowest requirement and QP max regression yielded the highest, with the intercept of the broken line and QP regressions yielding an intermediate requirement estimate. The DLYS requirements were consistently lower for egg production than for egg mass and feed efficiency. For egg mass and feed efficiency, DLYS requirements were 655 and 690, 817 and 866, and 706 and 778 mg/hen/d for the broken line, QP max, and the intercept of the broken line and QP regressions, respectively.

Medical outreach after hurricane Marilyn.

INTRODUCTION: Many geographical areas are subject to devastating disasters that leave the citizens not only without homes, but also without their local medical systems. Now medical-aid stations consisting of personnel, supplies, and equipment quickly can be deployed when needed to such areas under the aegis of the National Disaster Medical System (NDMS). Such teams can provide emergent medical care as well as daily medical care. However, these aid stations are of no help for the home-bound or nursing home patients too infirm to reach them. Thus, these citizens only can obtain medical care if medical teams make planned outreach excursions to reach them. OBJECTIVE: To describe a planned outreach program that was implemented for such patients on St. Thomas Island after it was devastated by Hurricane Marilyn in 1995. RESULTS: Over a five-day period, the outreach team provided medical care for 67 patients ranging in age from 11 days to 90 years. Play and art therapy was provided for non-injured children. The most common needs in the elderly were anti-hypertensive medications and insulin-loaded syringes. CONCLUSIONS: For outreach efforts of this nature, membership of the team should include a registered nurse, a paramedic, a respiratory therapist, a public health specialist, and a local authority familiar both with the area and its inhabitants. A physician does not need to be assigned to the team, but should be available by radio.

Behavioral response to ultrasound by the tiger beetle Cicindela marutha dow combines aerodynamic changes and sound production.

Tethered flying tiger beetles, Cicindela marutha, respond to trains of bat-like ultrasonic pulses with a short-latency, multi-component behavior. The head rolls to one side, the metathoracic legs kick to the opposite side, the elytra swing backwards towards the hindwings and pronate, the hindwings increase their stroke excursion and frequency, and the plane of the hindwing motion tilts forward. In addition, the beetles produce trains of ultrasonic clicks typically containing 100-200 clicks in response to a 1 s stimulus. The clicks average 85-90 dB SPL at 2 cm. The latencies for hindwing changes and elytra swing in response to stimuli more than 10 dB over threshold are 90-110 ms; the latency to clicking is 120-150 ms. Neither the head roll nor the leg kick appears to be directional relative to the sound source. The behavioral response is broadly tuned with greatest sensitivity at 30-60 kHz and mean behavioral thresholds of 75-80 dB SPL. Physiological audiograms from the auditory afferents show substantially greater sensitivity and sharper tuning than the behavioral response, which suggests that tiger beetles may use their hearing in other contexts as well as during flight. The combination of aerodynamic components and arctiid-month-like clicking may provide these insects with a powerful defense against attack by echolocating bats.

Activity of asynchronous flight muscle from two bee families during sonication (buzzing).

The indirect flight muscles of bees are used to produce a variety of actions in addition to flight, including sonication, which has a higher frequency than flight. We observed the dynamic movement of the scutum during sonication and the transition from tethered flight to sonication. During sonication, the scutum oscillated above its rest position, indicating that the conformation of the structural components of the thorax had been altered. Sonication vibrations of the thorax occurred by deformation of the scutum rather than by opening of the scutal fissure and are smaller than vibrations associated with flight. During tethered flight, the ratio of muscle activity (recorded via electromyograms) between the dorsal longitudinal muscles and the dorsoventral muscles approached 1, but during sonication the ratio was significantly higher (up to 4.0). This increase may cause the dorsal longitudinal muscles to contract further than the dorsoventral muscles and close the scutal fissure during sonication, so limiting the displacement of the wings and 'decoupling' them from the indirect flight muscles.

Characterization of auditory afferents in the tiger beetle, Cicindela marutha Dow.

We have identified a nerve carrying auditory afferents and characterized their physiological responses in the tiger beetle, Cicindela marutha. 1. The tympana are located at the lateral margins of the first abdominal tergum. The nerve carrying the tympanal afferents is a branch of the dorsal root from the first abdominal ganglion. 2. Both male and female auditory afferent responses are sharply tuned to 30 kHz with sensitivities of 50-55 dB SPL. 3. The auditory afferents show little adaptation and accurately code the temporal characteristics of the stimulus with the limit of a resolution of 6-10 ms. 4. The difference in threshold between contralateral and ipsilateral afferents for lateral stimuli is greatest at 30 kHz and is at least 10-15 dB. 5. Ablation studies indicate that the floppy membrane in the anterolateral corner of the tympanum is crucial for transduction while the medial portion of the tympanum is less important. 6. The tiger beetle and acridid (locust and grasshopper) ears have evolved independently from homologous peripheral structures. The neural precursor of the tympanal organs in both animals is likely the pleural chordotonal organ of the first abdominal segment.

[Effect of high-frequency ventilation on intracranial pressure]. / Auswirkungen hochfrequenter Beatmungstechniken auf den Verlauf der intrakraniellen Druckkurve.

The influence of respiratory frequency, tidal volume, inspiratory flow and ratio of inspiratory/expiratory time on ventilator-related intracranial pressure (ICP) fluctuations was studied in six patients with severe brain trauma. ICP fluctuations were found to be markedly reduced at frequencies of 20/min and usually eliminated at 30/min. We found an exponential correlation between ICP fluctuations and respiratory frequency, but there was no correlation between tidal volume and ICP. Central venous pressure amplitudes were found to be in linear correlation with respiratory frequency and tidal volumes as well. The amplitude of respiratory ICP fluctuations correlates with the length of expiratory time. Our findings demonstrate that artificial ventilation without ventilator-related fluctuations in ICP ("brain-protective" ventilation) may be performed by conventional volume-constant, time-cycled ventilators. To assess the therapeutic relevance of eliminating respirator-related fluctuations of the ICP course in brain-injured patients, we suggest that frequencies of 25-30/min and tidal volumes of 6-9 ml/kg body weight should be used.

[Haemarthros of the upper ankle joint (author's transl)]. / Hämarthros des oberen Sprunggelenkes.

34 patients with isolated, non-dislocated fractures of the medial malleolus and consecutive haemarthros of the upper ankle joint were followed up at an average of 8 years after the trauma. Special attention was given to arthrotic deformities and complaints. The results of this study seem to point to the conclusion that postraumatic haemarthros itself is of no special importance in the development of arthrotic changes of the upper ankle joint in man. This was judged from the pathophysiological reactions of articular cartilage due to haemarthros as shown in animal experiments.

[70 years traumatotherapy in the Viennese University Departments (author's transl)]. / 70 Jahre Unfallchirurgie an den Wiener Kliniken.

On the 3rd of November, 1909 both Surgical Departments of Vienna University, each opened an emergency casually ward. It was the first time in Europe, indeed probably in the whole world, that a special position had been accorded to traumatotherapy. Eiselsberg and Hochenegg are honoured as the founders of accident surgery. Although space was extremely restricted remarkable therapeutic results were achieved, whilst teaching and scientific research flourished. The number of patients and the attendant organizational problems rose continuously. Special mention is made of the great number of patients with heart wounds who could be saved owing to the perfect organization of a "cardiac alarm" system introduced at this unit from the earliest days. After a survey of the conservative and operative treatment of fractures, the transformation of both emergency wards into independent departments in 1976 is described. Interdisciplinary teamwork of all surgical departments at Vienna University is emphasized as a special merit of the clinical traumatotherapy units.

[Closed intramedullary nailing of femur shaft fractures - experiences in 245 cases (author's transl)]. / Erfahrungen bei 245 geschlossenen Marknagelungen des Oberschenkels.

A follow-up study is given of 245 femoral shaft fractures, treated 1961-1975 with closed reduction and intramedullary nailing. 141 patients were examined personally 19-5 years after operation. The results were excellent in 75,9%, fair in 20,6%, and poor in 3,5%. Deep infections occurred in 2,4%. The number of patients was also subdivided in regard to indication, concomitant injuries, postoperative fatalities, pathologic fractures etc.

Experimental tests concerning the biomechanical behaviour of pertrochanteric osteosyntheses.

The biomechanical behaviour of pertrochanteric fractures stabilized by means of an angled plate or flexible condylar nails was characterized by mechanical testing. The stability and the types of motion occurring under dynamic load in the vicinity of the fracture and the effect on the implant were examined. The mechanical test results corroborated clinical experiences. In the case of extramedullary anchorage of implants, stability under load is possible only if an intact cortex on the medial side of the fracture guarantees the bearing of compressive load. With flexible condylar nails, however, it is possible to achieve a permanent load capacity up to approximately 100 kp, even if medial support is lacking, by putting the fracture in a valgus position so that the load-bearing arm is shortened. It was also possible to estimate the actual loading on the operated leg within the immediate postoperative phase by means of the "stabilization effect".

[Pathological fractures of long medullary bones due to malignant tumours: indications for osteosynthesis (author's transl)]. / Pathologische Frakturen langer Röhrenknochen bei bösartigen Tumoren: Indikation zur Osteosynthese.

51 cases of pathological fracture, mostly due to metastatic malignant tumours, are reviewed in respect to the methods and results of operative treatment. These results are compared with those of other authors. It is found that resection of the tumour and osteosynthesis combined with the use of bone cement is the best way of treatment to relieve the patients of pain, mobilize them as soon as possible and improve the quality of their short, remaining lifespan. Despite the positive approach towards operative treatment there are some limiting findings which indicate that an operation should not be undertaken in those patients whose estimated survival time is less than the time of recovery and mobilization.

[The technic of fibrin glue in cancellous bone transplants (author's transl)]. / Die Technik der Fibrinspongiosaplastik.

The paper deals with the clinical experience in the use of a biological adhesive system in conjunction with bone transplants to close large bone defects. The gluing technique has been exactly described, 11 patients with a follow-up between 9 and 21 months are being presented. The application of this system which consists of highly concentrated native fibronogen, thrombin, and clotting factor XIII results in an acceleration of homogenous incorporation of the implants. No deterioration of wound healing occurred. The advantages of this method are: exact local hemostasis, adhesive strength, and plasticity.

[The action of high-concentrated fibria on bone healing (author's transl)]. / Die Beeinflussung der Knochenheilung durch hochkonzentrierties Fibrin.

The influence of a biological tissue glue--based on fibrinogen clotting--on bone healing has been investigated in animal experiments. Standardized cortical defects in the tibiae of rabbits were closed with a plug of homologous or heterologous fibrin. The course of restoration has been studied using histological techniques, x-ray examinations and isotopes (Ci 99 TC). Heterologous fibrin delays bone formation, due to a local immune response. Homologous fibrin on the other hand cubances and accelerates sprouting of capillary vessels and connective tissue cells which results in rapid new formation of bone.