Assessing the Oral Health Needs of Public Housing Residents

Objectives: “Tooth Smart Healthy Start” is a randomized clinical trial which aims to reduce the incidence of early childhood caries (ECC) in Boston public housing residents as part of the NIH funded Northeast Center for Research to Evaluate and Eliminate Dental Disparities. The purpose of this project was to assess public housing stakeholders' perception of the oral health needs of public housing residents and their interest in replicating “Tooth Smart Healthy Start” in other public housing sites across the nation. Methods: The target population was the 180 attendees of the 2010 meeting of the Health Care for Residents of Public Housing National Conference. A ten question survey which assessed conference attendees' beliefs about oral health and its importance to public housing residents was distributed. Data was analyzed using SAS 9.1. Descriptive statistics were calculated for each variable and results were stratified by participants' roles. Results: Thirty percent of conference attendees completed the survey. The participants consisted of residents, agency representatives, and housing authority personnel. When asked to rank health issues facing public housing residents, oral health was rated as most important (42%) or top three (16%) by residents. The agency representatives and housing authority personnel rated oral health among the top three (33% and 58% respectively) and top five (36% and 25% respectively). When participants ranked the three greatest resident health needs out of eight choices, oral health was the most common response. Majority of the participants expressed interest in replicating the “Tooth Smart Healthy Start” program at their sites. Conclusion: All stakeholder groups identified oral health as one of the greatest health needs of residents in public housing. Furthermore, if shown to reduce ECC, there is significant interest in implementing the program amongst key public housing stakeholders across the nation.

EVALUATION OF HARMONIC MOTION ELASTOGRAPHY AND ACOUSTO-­OPTIC IMAGING FOR MONITORING LESION FORMATION BY HIGH INTENSITY FOCUSED ULTRASOUND

Malignant or benign tumors may be ablated with high‐intensity focused ultrasound (HIFU). This technique, known as focused ultrasound surgery (FUS), has been actively investigated for decades, but slow to be implemented and difficult to control due to lack of real‐time feedback during ablation. Two methods of imaging and monitoring HIFU lesions during formation were implemented simultaneously, in order to investigate the efficacy of each and to increase confidence in the detection of the lesion. The first, Acousto‐Optic Imaging (AOI) detects the increasing optical absorption and scattering in the lesion. The intensity of a diffuse optical field in illuminated tissue is mapped at the spatial resolution of an ultrasound focal spot, using the acousto‐optic effect. The second, Harmonic Motion Imaging (HMI), detects the changing stiffness in the lesion. The HIFU beam is modulated to force oscillatory motion in the tissue, and the amplitude of this motion, measured by ultrasound pulse‐echo techniques, is influenced by the stiffness. Experiments were performed on store‐bought chicken breast and freshly slaughtered bovine liver. The AOI results correlated with the onset and relative size of forming lesions much better than prior knowledge of the HIFU power and duration. For HMI, a significant artifact was discovered due to acoustic nonlinearity. The artifact was mitigated by adjusting the phase of the HIFU and imaging pulses. A more detailed model of the HMI process than previously published was made using finite element analysis. The model showed that the amplitude of harmonic motion was primarily affected by increases in acoustic attenuation and stiffness as the lesion formed and the interaction of these effects was complex and often counteracted each other. Further biological variability in tissue properties meant that changes in motion were masked by sample‐to‐sample variation. The HMI experiments predicted lesion formation in only about a quarter of the lesions made. In simultaneous AOI/HMI experiments it appeared that AOI was a more robust method for lesion detection.

A Dopamine-Acetylcholine Cascade: Simulating Learned and Lesion-Induced Behavior ff Striatal Cholinergic Interneurons

The "teaching signal" that modulates reinforcement learning at cortico-striatal synapses may be a sequence composed of an adaptively scaled DA burst, a brief ACh burst, and a scaled ACh pause. Such an interpretation is consistent with recent data on cholinergic interneurons of the striatum are tonically active neurons (TANs) that respond with characteristic pauses to novel events and to appetitive and aversive conditioned stimuli. Fluctuations in acetylcholine release by TANs modulate performance- and learning- related dynamics in the striatum. Whereas tonic activity emerges from intrinsic properties of these neurons, glutamatergic inputs from thalamic centromedian-parafascicular nuclei, and dopaminergic inputs from midbrain are required for the generation of pause responses. No prior computational models encompass both intrinsic and synaptically-gated dynamics. We present a mathematical model that robustly accounts for behavior-related electrophysiological properties of TANs in terms of their intrinsic physiological properties and known afferents. In the model balanced intrinsic hyperpolarizing and depolarizing currents engender tonic firing, and glutamatergic inputs from thalamus (and cortex) both directly excite and indirectly inhibit TANs. If the latter inhibition, probably mediated by GABAergic NOS interneurons, exceeds a threshold, its effect is amplified by a KIR current to generate a prolongued pause. In the model, the intrinsic mechanisms and external inputs are both modulated by learning-dependent dopamine (DA) signals and our simulations revealed that many learning-dependent behaviors of TANs are explicable without recourse to learning-dependent changes in synapses onto TANs.