The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol 2013; 40 (Suppl. 14): S70-S84. doi: 10.1111/jcpe.12062. AbstractObjectives: The objective of this study was to systematically review the epidemiological evidence for an association between periodontitis (PD) and incident atherosclerotic cardiovascular disease (ACVD), including coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease. Methods: Systematic review of cohort and case-control studies on the association of clinically or radiographically diagnosed PD and ACVD. Results: Overall, 12 studies were included in this study (six studies on CHD, three studies on cerebrovascular disease, two studies on both coronary heart and cerebrovascular disease mortality and one study on peripheral arterial disease). All but one study reported positive associations between various periodontal disease measures and the incidence of ACVD, at least in specific subgroups. The association was stronger in younger adults and there was no evidence for an association between PD and incident CHD in subjects older than 65 years. Only one study evaluated the association between PD and secondary cardiovascular events. Conclusions: There is evidence for an increased risk of ACVD in patients with PD compared to patients without. However, this may not apply to all groups of the population. There is insufficient evidence for an association between PD and the incidence of secondary cardiovascular events. The possible association between periodontitis (PD) and atherosclerotic cardiovascular disease (ACVD) has received much attention over the past two decades, and a significant number of epidemiological studies have been conducted during this time. The evidence has been systematically reviewed several times during that period (Hujoel 2002, Janket et al. 2003, Khader et al. 2004, Bahekar et al. 2007, Humphrey et al. 2008, Blaizot et al. 2009). Most recently, a comprehensive review was performed by an American Heart Association (AHA) working group (Lockhart et al. 2012), which concluded that "periodontal disease is associated with atherosclerotic vascular disease independent of known confounders". It further concluded that there was no evidence for a causal link and that, therefore, "statements that imply a causative association between periodontal disease and specific atherosclerotic vascular disease events […] are unwarranted". The review further highlighted several research gaps and methodological issues relevant to further research, including the need for uniform criteria for PD measures and case definitions but mainly with regard to the need of well-designed controlled interventional studies with standard treatment protocols and considerations for issues such as the sustainability of treatment response over time.The aim of this review was to systematically review the evidence for the association between PD and incident ACVD, focusing on the most robust studies in terms ...

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This paper presents a view of the current state of monitoring track geometry condition from in-service vehicles. It considers technology used to provide condition monitoring; some issues of processing and the determination of location; how things have evolved over the past decade; and what is being, or could/should be done in future research. Monitoring railway track geometry from an in-service vehicle is an attractive proposition that has become a reality in the past decade. However, this is only the beginning. Seeing the same track over and over again provides an opportunity for observing track geometry degradation that can potentially be used to inform maintenance decisions. Furthermore, it is possible to extend the use of track condition information to identify if maintenance is effective, and to monitor the degradation of individual faults such as dipped joints. There are full unattended track geometry measurement systems running on in-service vehicles in the UK and elsewhere around the world, feeding their geometry measurements into large databases. These data can be retrieved, but little is currently done with the data other than the generation of reports of track geometry that exceeds predefined thresholds. There are examples of simpler systems that measure some track geometry parameters more or less directly and accurately, but forego parameters such as gauge. Additionally, there are experimental systems that use mathematics and models to infer track geometry using data from sensors placed on an in-service vehicle. Finally, there are systems that do not claim to measure track geometry, but monitor some other quantity such as ride quality or bogie acceleration to infer poor track geometry without explicitly measuring it.

Maintaining the alignment of railway track is vitally important for the smooth and safe passage of railway vehicles. Poor track alignment can result in poor ride quality, flange contact, or even flange climb. Accurate horizontal track geometry can be measured using a dedicated track recording vehicle or from a full track geometry recording system mounted on an in-service vehicle. This paper describes the use of sensors mounted on the bogie of an in-service vehicle to estimate the mean track alignment without the use of optical or contact sensors. In principle, either bogie lateral acceleration or yaw rate can be processed to give an estimate of mean lateral track irregularity, but a yaw rate gyro provides consistent estimates down to lower vehicle speeds than does an accelerometer and does not require compensation for the effects of bogie roll. An improved estimate can be obtained by inverting the dynamic relationship between the mean track alignment and the bogie yaw motion. This is demonstrated with results from a Class 175 vehicle. Continually monitoring the lateral response of a bogie on an in-service vehicle, using only a yaw rate gyro, can provide data enabling the prioritization of maintenance operations.

AimA double-blind randomized controlled trial to determine whether dietary supplementation with fruit/vegetable/berry juice powder concentrates, simultaneously with non-surgical periodontal therapy, improved 2-month treatment outcomes.MethodsVolunteers with chronic periodontitis were randomly assigned to one of three groups: fruit/vegetable (FV), fruit/vegetable/berry (FVB) or placebo. Supplements were taken daily during non-surgical debridement and maintenance and outcomes assessed at 2, 5 and 8 months after completion. Primary outcomes were mean probing pocket depth (PPD), clinical attachment gain, % sites bleeding on probing (% BOP) at 2 months. Adherence and plasma β-carotene were determined.ResultsSixty-one nutritionally replete (by serum biochemistry) volunteers enrolled and 60 (n = 20 per arm) completed the 2-month review. Clinical outcomes improved in all groups at 2 months, with additional improvement in PPD versus placebo for FV (p < 0.03). Gingival crevicular fluid volumes diminished more in supplement groups than placebo (FVB; p < 0.05) at 2 months, but not at later times. The % BOP (5 months) and cumulative plaque scores (8 months) were lowered more in the FV group (p < 0.05).ConclusionsAdjunctive juice powder concentrates appear to improve initial pocket depth reductions in nutritionally replete patients, where plasma micronutrient bioavailability is attainable. Definitive multicentre studies in untreated and treated patients are required to ascertain the clinical significance of such changes.