bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes Mellitus, Microalbuminuria, and Subclinical Cardiac Disease: Identification and Monitoring of Individuals at Risk of Heart Failure
Authors: Swoboda Peter P. , McDiarmid Adam K. , Erhayiem Bara , Ripley David P. , Dobson Laura E. , Garg Pankaj , Musa Tarique A. , Witte Klaus K. , Kearney Mark T. , Barth Julian H. , Ajjan Ramzi , Greenwood John P. , Plein Sven
Published: July 2017

Background

Patients with type 2 diabetes mellitus and elevated urinary albumin:creatinine ratio (
ACR
) have increased risk of heart failure. We hypothesized this was because of cardiac tissue changes rather than silent coronary artery disease.

Methods and Results

In a case‐controlled observational study 130 subjects including 50
ACR
+ve diabetes mellitus patients with persistent microalbuminuria (
ACR
>2.5 mg/mol in males and >3.5 mg/mol in females, ≥2 measurements, no previous renin–angiotensin–aldosterone therapy, 50
ACR
−ve diabetes mellitus patients and 30 controls underwent cardiovascular magnetic resonance for investigation of myocardial fibrosis, ischemia and infarction, and echocardiography. Thirty
ACR
+ve patients underwent further testing after 1‐year treatment with renin–angiotensin–aldosterone blockade. Cardiac extracellular volume fraction, a measure of diffuse fibrosis, was higher in diabetes mellitus patients than controls (26.1±3.4% and 23.3±3.0%
P
=0.0002) and in
ACR
+ve than
ACR
−ve diabetes mellitus patients (27.2±4.1% versus 25.1±2.9%,
P
=0.004).
ACR
+ve patients also had lower E′ measured by echocardiography (8.2±1.9 cm/s versus 8.9±1.9 cm/s,
P
=0.04) and elevated high‐sensitivity cardiac troponin T 18% versus 4% ≥14 ng/L (
P
=0.05). Rate of silent myocardial ischemia or infarction were not influenced by
ACR
status. Renin–angiotensin–aldosterone blockade was associated with increased left ventricular ejection fraction (59.3±7.8 to 61.5±8.7%,
P
=0.03) and decreased extracellular volume fraction (26.5±3.6 to 25.2±3.1,
P
=0.01) but no changes in diastolic function or high‐sensitivity cardiac troponin T levels.

Conclusions

Asymptomatic diabetes mellitus patients with persistent microalbuminuria have markers of diffuse cardiac fibrosis including elevated extracellular volume fraction, high‐sensitivity cardiac troponin T, and diastolic dysfunction, which may in part be reversible by renin–angiotensin–aldosterone blockade. Increased risk in these patients may be mediated by subclinical changes in tissue structure and function.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01970319.
Bare Nominal Adjuncts
Authors: Barrie Michael , Yoo Isaiah Won Ho
Published: July 2017

Larson (1985) and Emonds (1987) propose different mechanisms to account for English sentences in which a nominal acts as an adverbial but is not introduced by a preposition. We review their analyses and, in light of additional data, show that they are not tenable. Rather, we propose that the noun in such constructions is structurally deficient (hence does not need a preposition for Case) and has an inherent θ- role (hence does not need a preposition to assign one). Although in the same vein as Larson’s and Emonds’s proposals, ours accounts for a wider set of data and is thus preferable. It also has implications for the structure of θ-roles and for lexical entries.
Nonparametric test for connectivity detection in multivariate autoregressive networks and application to multiunit activity data
Authors: Gilson M. , Tauste Campo A. , Chen X. , Thiele A. , Deco G.
Published: July 2017

Directed connectivity inference has become a cornerstone in neuroscience to analyze multivariate data from neuroimaging and electrophysiological techniques. Here we propose a nonparametric significance method to test the nonzero values of multivariate autoregressive model to infer interactions in recurrent networks. We use random permutations or circular shifts of the original time series to generate the null-hypothesis distributions. The underlying network model is the same as used in multivariate Granger causality, but our test relies on the autoregressive coefficients instead of error residuals. By means of numerical simulation over multiple network configurations, we show that this method achieves a good control of false positives (type 1 error) and detects existing pairwise connections more accurately than using the standard parametric test for the ratio of error residuals. In practice, our method aims to detect temporal interactions in real neuronal networks with nodes possibly exhibiting redundant activity. As a proof of concept, we apply our method to multiunit activity (MUA) recorded from Utah electrode arrays in a monkey and examine detected interactions between 25 channels. We show that during stimulus presentation our method detects a large number of interactions that cannot be solely explained by the increase in the MUA level.
Peperomia tubericordata (Piperaceae), a new geophytic species from Oaxaca, Mexico
Authors: MATHIEU GUIDO
Published: July 2017

A new Peperomia species from the state of Oaxaca, Mexico is described and illustrated. It shows the typical morphological characters of subgenus Tildenia (presence of an underground tuber and leaves and inflorescences directly originating from that tuber), but differs from all other members of that subgenus by the orbicular to reniform, cordate, non-peltate leaves.
A new amphibious troglobitic styloniscid from Brazil (Isopoda, Oniscidea, Synocheta)
Authors: BASTOS-PEREIRA RAFAELA , SOUZA LEILA APARECIDA , FERREIRA RODRIGO L.
Published: July 2017

Xangoniscus (Styloniscidae, Synocheta, Isopoda) includes only two species, both occurring in Brazil. Here a new amphibious troglobitic species of this genus found at Olhos D’Água Cave, Northern Minas Gerais, Brazil, is described. Xangoniscus itacarambiensis sp. nov. differs from the congeneric species mainly due to the following characters: head well-detached from the first pereonite, second and third articles of antennula subequal in length, presence of six short aesthetascs in the antennula and reduced triangular lobe in the distal part of pleopod 2 endopod.
Contribution to the knowledge of North-American species Hyperomyzus subgenus Neonasonovia (Aphididae, Aphidinae, Macrosiphini)
Authors: NAFRÍA JUAN M. NIETO , HIDALGO NICOLÁS PÉREZ , GARCÍA-TEJERO SERGIO , CIRUELOS SARA I. LÓPEZ , DURANTE M. PILAR MIER
Published: July 2017

American specimens of the Hyperomyzus subgenus Neonasonovia conserved in the collections of the Muséum national d’Histoire naturelle (Paris, France) and the Natural History Museum (London, United Kingdom), have been studied. Data to complement previous descriptions of apterous and alate viviparous females of H. nabali and of apterous viviparae of H. nigricornis, H. inflatus, H. niger and H. pullatus, are presented. Apterous and alate virginogeniae females of H. nigricornis, alate viviparous females of H. inflatus, H. niger and H. pullatus, plus oviparous females of H. nabali, are described for the first time. The morphological and biological variability of H. pullatus is discussed. An identification key for viviparous females of the American species of Neonasonovia is presented for the first time. Microphotographs of apterous and alate viviparous females of H. nabali, H. nigricornis, H. inflatus and H. niger, alate viviparous females of H. pullatus, and oviparous female of H. nabali, are presented.
10. Paradise Lost: Love in Eden, and the Critics who Obey
Authors: Bryson Michael , Movsesian Arpi
Published: July 2017

This chapter analyses Elizabeth Cary’s The Tragedy of Mariam and Milton’s Paradise Lost in terms of each work’s presentation of disobedience as a deliberate (and arguably heroic) choice of love rather than obedience to authority. Cary’s Salome flouts the divorce laws and gender restrictions of her time to divorce her husband and choose another, while Milton's Adam and Eve serve as the ultimate example of fin’amor (for better and for worse) by choosing each other over the God (and Law) of the universe. The chapter engages with a great deal of criticism that suggests that Cary’s Mariam and Salome and Milton’s Adam and Eve should have chosen otherwise than they do, that they should have denied the desires of their hearts in favor of obedience to the demands of authority (husbands, kings, and God).
Aerosol–Cloud Interaction in Deep Convective Clouds over the Indian Peninsula Using Spectral (Bin) Microphysics
Authors: Gayatri K. , Patade S. , Prabha T. V.
Published: July 2017

The Weather Research and Forecasting (WRF) Model coupled with a spectral bin microphysics (SBM) scheme is used to investigate aerosol effects on cloud microphysics and precipitation over the Indian peninsular region. The main emphasis of the study is in comparing simulated cloud microphysical structure with in situ aircraft observations from the Cloud Aerosol Interaction and Precipitation Enhancement Experiment (CAIPEEX). Aerosol–cloud interaction over the rain-shadow region is investigated with observed and simulated size distribution spectra of cloud droplets and ice particles in monsoon clouds. It is shown that size distributions as well as other microphysical characteristics obtained from simulations such as liquid water content, cloud droplet effective radius, cloud droplet number concentration, and thermodynamic parameters are in good agreement with the observations. It is seen that in clouds with high cloud condensation nuclei (CCN) concentrations, snow and graupel size distribution spectra were broader compared to clouds with low concentrations of CCN, mainly because of enhanced riming in the presence of a large number of droplets with a diameter of 10–30 μm. The Hallett–Mossop ice multiplication process is illustrated to have an impact on snow and graupel mass. The changes in CCN concentrations have a strong effect on cloud properties over the domain, amounts of cloud water, and the glaciation of the clouds, but the effects on surface precipitation are small when averaged over a large area. Overall enhancement of cold-phase cloud processes in the high-CCN case contributed to slight enhancement (5%) in domain-averaged surface precipitation.
Long-Term Effects of Social and Personal Capital on Offending Trajectories in a Sample of White-Collar Offenders
Authors: Piquero Nicole Leeper , Piquero Alex R. , Weisburd David
Published: July 2017

Research has shown that investments in social and personal capital prevent future offending. These studies have focused exclusively on street crimes, as well as among both community and offender samples. Unknown is the extent to which the capital-oriented explanation relates among white-collar offenders and their offending. This study uses a unique source of data of convicted white-collar offenders to examine how social and personal capital distinguishes between offending trajectories estimated over a 10-year follow-up period. Results show that personal but not necessarily social capital distinguishes between low-and both medium-and high-rate offending trajectories. A combined measure of capital was related to membership in a low-rate offending trajectory and protective against both medium-and high-rate offending trajectories.
‘An Abundant Supply of Discourse’: Augustine and the Rhetoric of Monasticism
Authors: Martin Thomas F.
Published: July 2017

What is it therefore to speak not only eloquently but also wisely, unless to apply sufficient words in the subdued style, elegant words in the moderate style, powerful words in the grand style, all the while speaking only true things which ought to be heard. But if someone is not able to do both [speak eloquently and wisely], let him say wisely what he does not say eloquently, rather than say eloquently what he says foolishly. If, however, he cannot do even this, let him so live as to provide not only reward for himself but also offer example for others. Thus his way of living may provide the equivalent of an abundant supply of discourse.
Assess Yourself!
Authors: Easton Lois Brown
Published: July 2017

Take these quick surveys to discover your strengths and weaknesses in the classroom.
Giving Students a Voice: The Power of Feedback to Improve Teaching
Authors: Wiggins Grant
Published: July 2017

Asking students what's working and what's not can reveal some interesting patterns and help you improve your teaching skills.
Spend Less and Get More: How to Stock up Your Classroom without Breaking the Bank
Authors: McWilliams-Abendroth Christie
Published: July 2017

Your classroom is bare, and the school supplies you received are long gone. Check out these tips for finding school supplies without maxing out your credit card.
Sneaking Important Topics in through the Back Door — And other Ways to Engage Your Students
Authors: Grossman Eric
Published: July 2017

Try these 10 strategies in your classroom to hook students who would rather be anywhere else.
What Do Parents Want from Teachers?
Authors: Foster Anne
Published: July 2017

Check out these tips from parents for building a strong relationship with your students' families.
Invaluable Allies
Authors: Ginsberg Margery B.
Published: July 2017

Parents — whether they're biological parents, legal guardians, grandparents, or other family members who are primary caregivers — can be the most critical partners you have in your students' academic journeys. How can you build effective relationships that help students to succeed?
Four Tips for Surviving Standardized Testing
Authors: Martin Anna
Published: July 2017

Use these four tips to help your students — and yourself — stay sane during testing season. Plus, learn how you can plan now for post-testing, holistic assessments in your classroom.
Six People to Know
Authors: Young Robyn R.
Published: July 2017

You may feel overwhelmed, but these six people in your school can make your life a little easier.
The Next Step: A Hybrid Teaching Role
Authors: Zeichner Noah
Published: July 2017

You can advance your career without leaving the classroom. One Seattle teacher tells how he made it happen.
Overcoming Obstacles
Authors: Lewis Tamica
Published: July 2017

It's the season for the job hunt, whether you're looking for your first job or taking the next step along your career path. Read these first-person accounts to see how teachers balance the rewards and challenges of working in different types of schools. What's the right fit for you?
Pop Quiz: What Do I Do if I Get a Pink Slip?
Authors: Kronser Jack
Published: July 2017

Many first-year teachers get laid off at the end of the school year due to budget reductions. How prepared are you for this curve in your teaching career path?
Teaching with Hope
Authors: Hawkins-Jones Mary
Published: July 2017

Gallup's Most Hopeful Teacher in America talks about the role hope has played in her career.
Creating a Positive Classroom Culture: Minute by Minute
Authors: Wright Ali
Published: July 2017

Make your classroom a place where students want to be by building a positive culture with these tested strategies from a high school math teacher.
Pop Quiz: Group Work
Authors: Clement Mary C.
Published: July 2017

As a student, did you do a lot of group work? What did you learn in your college education classes about the value of group work? Take this quiz to see what you know and how this approach to teaching can be helpful.
Effect of Surface Etching on the Flexure Strength and Fracture Toughness of Dicor® Disks Containing Controlled Flaws
Authors: Thompson J.Y. , Anusavice KJ
Published: July 2017

Previous studies have shown an increase in the failure load of Dicor® glass-ceramic crowns of up to 97% when they were etched with NH4HF 2 and luted with a resin-based cement compared with the use of unetched crowns luted with zinc phosphate cement. The objective of this study was to evaluate the effect of the acid-etch treatment on the flexure strength and fracture toughness of Dicor® glass-ceramic specimens containing controlled flaws. Annealed disks were divided into two groups of 14 each, and microcracks were induced in the surface with a Vickers indenter. Seven specimens from each sample set were etched with 10% NH4HF2 (Dicor® etching gel) and were fractured in air using a piston-on-three-ball biaxial fixture. Fracture toughness values were determined from the flexure strengths and f ractographic measurements of fracture-initiating flaws. Analysis of data by ANOVA and the Tukey's Studentized Range Test revealed no significant difference (p > 0.05) in the mean flexure strength or fracture toughness of the etched and unetched samples within group A or group B. For the sample groups tested, flaw modification by etching had no effect on the flexure strength or on the fracture toughness of Dicor® specimens containing controlled flaws.
Immunocytochemical Localization of Blood Group ABH Antigens in the Human Parotid Gland
Authors: Lantini M.S. , Cossu M.
Published: July 2017

The aim of this study was to determine whether the parotid gland, like other salivary glands, produces blood group antigens. A post-embedding immunogold staining (IGS) method for ABH antigens was applied to osmicated and non-osmicated, routinely prepared specimens of normal human parotid glands. A and B antigens were not detected, whereas H antigen was found in acini and ducts of glands from A, B, and O subjects. In osmicated samples, the only sites of H labeling were secretory granules of a few acinar cells and those of most intercalated duct cells. In both cell types, only the pale matrix of the granules was stained. In non-osmicated samples, secretory granules showed the same distribution pattern of H, although gold particles were more abundant, and basolateral membranes of acinar and striated duct cells and the apical vesicles of striated duct cells were also labeled. Our results suggest that small amounts of H antigen are secreted by the parotid gland.
DMSA Administration to Patients with Alleged Mercury Poisoning from Dental Amalgams: A Placebo-controlled Study
Authors: Sandborgh Englund G. , Dahlqvist R. , Lindelöf B. , Söderman E. , Jonzon B. , Vesterberg O. , Larsson K.S.
Published: July 2017

The present investigation was performed to determine the effect of 14-day oral administration of meso-2.3-dimercaptosuccinic acid (DMSA) on the urinary mercury excretion and the potential reduction of blood and plasma mercury concentrations, and also to relate these effects to possible decrease of symptoms, allegedly associated with amalgam fillings. Twenty subjects, relating their symptoms to mercury from amalgam fillings, received 20 mg/kg DMSA or placebo for 14 days. Their symptoms and mood states were recorded during the study and at a check-up 3 months later. Interpretation was based on intra-individual differences. DMSA-treatment resulted in an average increase in urinary mercury excretion by 65% and a decrease in blood mercury levels of 0.04 μg/L/day. At the check-up after 3 months, urinary mercury excretion had returned to the pre-treatment level. No treatment effect of DMSA was apparent on subjective symptoms and mood state. One statistically significant treatment effect was noted—a decrease in fatigue-inertia in the DMSA-group—but there was no demonstrable correlation with increased urinary excretion or decreased blood concentration of mercury. Three subjects showed hypersensitive reactions, probably DMSA-specific, at the end of the treatment period. This placebo-controlled study provides no scientific support for diagnostic or therapeutic administration of DMSA for symptoms allegedly associated with chronic mercury exposition from dental amalgam fillings.
Role of Micro-organisms in Caries Etiology
Authors: van Houte J.
Published: July 2017

The microbial etiology of dental caries is discussed in terms of the dynamic relationship among the dental plaque microbiota, dietary carbohydrate, saliva, and the pH-lowering and cariogenic potential of dental plaque. The evidence supports a concept of caries as a dietary carbohydrate-modified bacterial infectious disease. Its key feature is a dietary carbohydrate-induced enrichment of the plaque microbiota with organisms such as the mutans streptococci and lactobacilli which causes an increase of plaque's pH-lowering and cariogenic potential. The shift in the plaque proportions of these organisms appears to be related to their relatively high acid tolerance.

A large body of evidence also supports a major effect of saliva on caries development. Integration of salivary effects with the concept of caries as a dietary carbohydrate-modified bacterial infectious disease suggests a broader concept whichincludes a major role of saliva in the regulation of the exposure of tooth surfaces to carbohydrate and of plaque acidity and, hence, the microbial composition and the pH-lowering and cariogenic potential of dental plaque. It is proposed that caries occurs preferentially in dentition sites characterized by a relatively high exposure to carbohydrate and diminished salivary effects. Some implications of this concept are discussed.
Affinity and Specificity of the Interactions between Streptococcus mutans Antigen I/II and Salivary Components
Authors: Hajishengallis G. , Koga T. , Russell M.W.
Published: July 2017

Adherence to salivary pellicle-coated tooth surfaces and aggregation by salivary components of Streptococcus mutans involves a major cell surface protein termed antigen (Ag) 1/II. The objectives of this study were to evaluate the affinity and specificity of the interactions between Agl/II and human saliva in assays of 125I-AgI/II binding to saliva-coated hydroxyapatite (SHA) and of S. mutans aggregation by salivary agglutinin (SAG), monitored turbidimetrically. 125I-AgI/II binding to SHA followed saturation kinetics, and Scatchard plot analysis indicated two binding sites with dissociation constants of the order of 10-10 mol/L and 10-9 mol/L. The binding to SHA of the C-terminal one-third of Agl/II which corresponds to AgII was less than one-fifth that of the whole molecule and did not show evidence of saturation. The binding of 125I-AgI/II was inhibited by native or recombinant fragments that mapped in the N-terminal part of the molecule and that contained the alanine-rich repeat region, whereas fragments mapping at the central or C-terminal one-third had no effect. As with binding to SHA, the regions of Agl/II which inhibited aggregation mapped at the N-terminal part of the molecule, but, in addition, a recombinant segment mapping at the central part and containing the proline-rich repeat region was also inhibitory. The S. mutans-aggregating activity of SAG or whole saliva was inhibited by amino compounds, and most strongly by L-lysine and analogues possessing w-primary amine groups. These data support the role of Agl/II as an adhesin with high-affinity binding for SHA receptors, mediated by the N-terminal part of the molecule. This region is also involved in SAG-induced S. mutans aggregation, which is sensitive to amino compounds.
Presence of Treponema denticola and Porphyromonas gingivalis in Children Correlated with Periodontal Disease of Their Parents
Authors: Watson M.-R. , Bretz WA , Loesche WJ
Published: July 2017

Considerable evidence exists suggesting that periodontal disease is due to the overgrowth of a finite number of specific bacteria such as Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Treponema denticola, Bacteroides forsythus, and Prevotella intermedia, among others. Three of these organisms- P. gingivalis, T. denticola, and B. forsythus—can be easily detected in plaque samples by the hydrolysis of the synthetic trypsin substrate benzoyl-DL-arginine-naphthylamide (BANA). The aim of the present study was to determine if a relationship could be found between the presence of either these organisms or periodontitis in the parent and the presence of BANA-positive species in the child. Thirty-four mothers or fathers and 34 children were examined for plaque scores, papillary bleeding scores, and the presence of P. gingivalis and T. denticola in four subgingival or marginal gingival plaque samples as assayed by the BANA test or specific polyclonal antibodies using an ELISA. Children whose parents were colonized by BANA-positive bacteria were 9.8 times more likely to be colonized by these BANA-positive species. Children whose parents had clinical evidence of periodontitis were 12 times more likely to be colonized by these BANA-positive species. These data are compatible with the hypothesis that children may acquire the BANA-positive species from their parents, especially if the parent has periodontitis.
Within-subject Comparisons of Implant-supported Mandibular Prostheses: Evaluation of Masticatory Function
Authors: Feine J.S. , Maskawi K. , De Grandmont P. , Donohue WB , Tanguay R. , Lund J.P.
Published: July 2017

In the past, fixed prostheses were believed to be more efficient implant-supported devices than removable types for edentulous patients. However, this hypothesis was never properly tested. Therefore, a within-subject crossover clinical trial was designed in which 15 completely edentulous subjects were tested wearing implant-supported mandibular fixed prostheses and long-bar overdentures. Eight subjects received the fixed appliance first and seven the removable type. The patients' perceptions of various characteristics of the implant-supported prostheses were measured after a minimum of two months' adaptation. Mandibular movements and jaw muscle electromyographic activity were recorded while the patients chewed five standard-sized test foods: bread, apple, hard cheese, sausage, and raw carrot. The prostheses were then changed, worn for the same period of adaptation, and the procedures repeated. There were three test sessions per prosthesis, and each included five trials per food. The measurements were repeated three times at one-week intervals. Mastication time was found to be shorter for three foods (bread, cheese, and sausage) when subjects wore the long-bar overdenture. The vertical amplitude of the masticatory strokes was significantly less with the overdenture for all foods except carrot. Cycle duration was significantly longer with the overdenture for sausage and carrot. Contrary to what might be expected, the long-bar overdenture appears to be no less efficient than the fixed prosthesis. Furthermore, these data suggest that patients are capable of adapting their masticatory movements to the characteristics of the two prostheses.
Chewing Performance Before and Af ter Rehabilitation of Post-canine Teeth in Man
Authors: van der Bilt A. , Olthoff L.W. , Bosman F. , Oosterhaven S.P.
Published: July 2017

Missing teeth are often replaced by fixed or removable prosthodontic appliances to improve masticatory function. However, there have been few studies directly determining the influence of prosthodontic treatment on masticatory function. Our aim was to obtain information on the objective and subjective masticatory function of partially edentulous subjects before and after prosthetic restoration. In this way, the improvement of the masticatory function as a result of the treatment could be quantified. The objective and subjective masticatory function of a group of 15 subjects was determined before and after replacement of an average of 3.1 post-canine teeth. The results were compared with data from a control group of 26 subjects having a complete dentition. The total number of occluding post-canine teeth increased as a result of the prosthodontic treatment, yielding a significantly improved objective masticatory function. The average masticatory performance was found to approach the level of the control group if all occlusal units of the longest posterior side were replaced. Subjects with an incomplete dentition tended to chew predominantly on the side of the longest posterior arch. The average subjective masticatory function improved as a result of the treatment. The appreciation of the masticatory function after treatment was equal to that of the control group, despite an average of 2.7 missing teeth. However, no correlation was found between the additional number of occlusal units and the change in subjective masticatory performance. Rehabilitation of postcanine teeth restores some objective masticatory function and leads to an increased appreciation of the masticatory function, although no correlation was found between the changes in objective and subjective masticatory function.
Coronal and Root Caries in the Dentition of Adults in the United States, 1988–1991
Authors: Winn D.M. , Brunelle J.A. , Selwitz R.H. , Kaste L.M. , Oldakowski R.J. , Kingman A. , Brown L.J.
Published: July 2017

Dental public health policy planning requires accurate and current information about the extent of caries in the United States population. These data are available from the caries examination from Phase 1 of the Third National Health and Nutrition Examination Survey, which found that 94% of adults in the United States show evidence of past or present coronal caries. Among the dentate, the mean number of decayed and filled coronal surfaces per person was 21.5. Dentate females had a lower number of untreated coronal tooth surfaces with caries (1.5), but a higher mean number of treated and untreated surfaces per person (22.7) than males, with scores of 2.1 and 20.2, respectively. Estimates for race-ethnicity groups were standardized by age and gender to control for population differences among them. Dentate non-Hispanic blacks (11.9) and Mexican-Americans (14.1) had half the number of decayed and filled coronal surfaces as non-Hispanic whites (24.3), but more untreated surfaces (non-Hispanic whites, 1.5; non-Hispanic blacks, 3.4; Mexican-Americans, 2.8). Mexican-Americans were most likely to be dentate, had the highest average number of teeth, and had 25% fewer decayed, missing, and filled coronal surfaces (37.6) than non-Hispanic blacks (49.2) and non-Hispanic whites (51.0). Root caries affected 22.5% of the dentate population. Blacks had the most treated and untreated root surfaces with caries (1.6), close to the value for Mexican-Americans (1.4). The score for non-Hispanic whites was 1.1. Untreated root caries is most common in dentate non-Hispanic blacks (1.5), followed by Mexican-Americans (1.2), with non-Hispanic whites (0.6) having the fewest untreated carious root surfaces. Race-ethnicity groups were disparate with respect to dental caries; effort is needed to treat active caries common in some population subgroups.
Landscape and the Kingdom of God
Authors: Stockton Ian
Published: July 2017

‘Landscape and the Kingdom of God’ examines how co-operation with secular partners in a World Heritage Status Bid may be seen as an expression of mission, and how the transformation of urban landscape and sacred space may reflect the Kingdom of God. The history of Wearmouth-Jarrow, explored through Bede’s story of the founding of the seventh-century monastery, highlights contemporary resonances in art, learning, community and Christian communication. The Wearmouth context is explored historically, practically and theologically, with the etching of cruciform pathways on the site’s surface seen as a means of interpreting access, encounter and human transformation.
Signpost to a Road Less Travelled
Authors: Chapman P. J.
Published: July 2017

Building on the observation that the commissions by the Risen Christ in Luke and Matthew cannot be historical, the proper context for them is located in the situation represented at the end of Acts. This context enables us to give significance to the differences between them and the possibility that they point to alternative understandings of mission in the New Testament churches. This, in turn, may help to recover some freedom in rethinking mission today.
Management of Oesophageal Foreign Bodies
Authors: Adeyemo Adebayo O , Odetoyinbo Olujinmi , Akinola Olayinka
Published: July 2017

In 90% of 213 patients, foreign bodies impacted in the oesophagus were removed during oesophago-scopy. Surgical intervention was necessary in the remainder. The complications recorded in 18 patients (8.5%) included bleeding, retropharyngeal abscess, paraoesophageal abscess, stricture, and mediastinitis. The mortality rate was 0.94%.
THE LANGUAGE OF HEALTH CARE: The alienating language of health care
Authors: Davies Peter
Published: July 2017

Please e-mail letters for publication to Dr Kamran Abbasi [ kamran.abbasi@rsm.ac.uk ]. Letters should be no longer than 300 words and preference will be given to letters responding to articles published in the JRSM. Our aim is to publish letters quickly. Not all correspondence will be acknowledged.
Bufala spotting, part one: assessing research papers
Authors: Jefferson Tom , Zarra Lucia
Published: July 2017

This is the second in a series of articles on making evidence-based medicine work for you. The series is based on the book ‘Atteni Alle Bufale’ by Tom Jefferson ( www.attentiallebufale.it ).
The demise of nursing in the United Kingdom: a warning for medicine
Authors: Shields Linda , Watson Roger
Published: July 2017

The 19th century teaches us that nurses must be central to the running of all aspects of hospitals, not just those areas deemed appropriate by the medical profession. This will require not only improved nursing leadership but also enhanced opportunities for nurses to realise their potential through education and training. 1 (p. 1396)
Research governance impediments to clinical trials: a retrospective survey
Authors: Salman Rustam Al-Shahi , Brock Timothy M , Dennis Martin S , Sandercock Peter A G , White Philip M , Warlow Charles
Published: July 2017

Objective

We sought to evaluate the delays, between-centre variations in practice, and opportunity costs attributable to delays in research governance approval of clinical trials in the United Kingdom.

Design

Retrospective survey.

Setting

Research and Development (R&D) departments at 50 UK National Health Service hospital trusts governing 57 hospital sites.

Participants

R&D departments participating in four randomized multicentre clinical trials coordinated by our Neurosciences Trials Unit.

Interventions

None.

Main outcome measures

Median delay between application and research governance approval.

Results

Only half of the R&D departments used the UK online R&D form. Only a single copy of the application was required by 96% of R&D departments. The median delay between application and research governance approval was 44 working days (interquartile range 23–80). A delay of >20 working days was incurred by 43 applications (75%), of which 24 (56%) were not explicable and 11 (20%) were attributable to local funding negotiations. Based on the trial randomization rates at each centre, 108 patients (17% of all patients randomized) could have been randomized during the delay, at a crude cost to funding agencies of £53,743; if a four week delay was deemed acceptable, 75 patients (12% of all patients randomized) could have been randomized during unacceptable delays, at a crude cost to funding agencies of £37,700.

Conclusions

The UK research governance system incurs unacceptably long and costly delays for clinical trials. Urgent reform is needed, including rapid design and uniform implementation of the ‘bureaucracy busting’ measures in Best Research for Best Health
Adverse effects of spinal manipulation: a systematic review
Authors: Ernst E
Published: July 2017

Objective

To identify adverse effects of spinal manipulation.

Design

Systematic review of papers published since 2001.

Setting

Six electronic databases.

Main outcome measures

Reports of adverse effects published between January 2001 and June 2006. There were no restrictions according to language of publication or research design of the reports.

Results

The searches identified 32 case reports, four case series, two prospective series, three case-control studies and three surveys. In case reports or case series, more than 200 patients were suspected to have been seriously harmed. The most common serious adverse effects were due to vertebral artery dissections. The two prospective reports suggested that relatively mild adverse effects occur in 30% to 61 % of all patients. The case-control studies suggested a causal relationship between spinal manipulation and the adverse effect. The survey data indicated that even serious adverse effects are rarely reported in the medical literature.

Conclusions

Spinal manipulation, particularly when performed on the upper spine, is frequently associated with mild to moderate adverse effects. It can also result in serious complications such as vertebral artery dissection followed by stroke. Currently, the incidence of such events is not known. In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.
Relationship Building and People Work
Authors: Anson Alison , Paulson Nels
Published: July 2017

Environmental activism is often studied as a social movement that advocates on behalf of marginalized populations who are faced with environmental injustices. We expand on previous environmental activism scholarship by focusing on a chronic, widespread environmental hazard affecting more communities not traditionally emphasized in such scholarship: phosphorus pollution and subsequent blue-green algae blooms. This is a socioenvironmental problem of increasing significance worldwide due to both its prevalence and the challenge of dealing with the numerous sources of such pollution. This article offers insight into the social networks of activists who work alongside government agencies on this issue in the Red Cedar Basin of Wisconsin, and how these networks may lead to civic engagement through mechanisms of social capital. Social network analysis is used here, coupled with binary logit regression, and an exploration of different types of social capital and the likelihood of civic engagement. We find that variation in leadership trait values is dependent on cultivation of different types of social capital. The type of social capital also relates to environmental activism and organization of or attendance at farm field days. In addition, government agents are particularly central to these social networks and thus are perhaps in the best position to help mobilize environmental civil society. However, findings here show that effectiveness of network expansion is inhibited by neoliberalizing forces and subsequent community capacity constraints.
Sharing Stories
Authors: Robinson Erin E.
Published: July 2017

The focus of this study is the role of health narratives play in mobilization when shared among community members experiencing exposure to air pollution from numerous sources of industrial pollution. Grounded in the practice of community-based participatory research, The Stories Project (as the collection of narratives has been colloquially named) highlights various aspects of both the process and outcome of community and academic partnerships. Drawing attention to the process illustrates the complexity of such relationships in the field, and how an understanding of these relationships is vital to successful engagement of community members in such studies. The process of storytelling became the tool for successful mobilization in this community. Narratives became strategies and vehicles for social justice. Throughout, the reflexivity of the researcher also informed the process. It is this complexity that serves as the primary focus of the study, for intertwined in a reflection of storytelling and empowerment is the role the researcher plays in such outcomes.
Glomus Vagale Tumor: The Significance of Early Vocal Cord Paralysis
Authors: Leonetti John P. , Brackmann Derald E.
Published: July 2017

Glomus body tumori most frequently originato in the middle ear (tympanlcum) or on the Jugular bulb (Jugulare). Tumors that arise from the vagal body account for less than 2.5% of these unique paraganglionic neoplasms. Otologic manifestations of tympanlcum and Jugulare tumors usually precede or accompany neurologic findings. In reviewing five cases of glomus vagale tumors, the Initial symptom of voice change, caused by vocal cord paralysis, preceded the presenting symptoms of hearing loss and tinnitus by an average of 2.5 years. The concept of early cranial nerve Involvement by glomus vagale tumors Is supported in a literature review. The evaluation of “Idiopathic” vocal cord paralysis must Include radiographic Inspection of the skull base, whereas an accurate, temporal account of presenting symptoms may help distinguish vagal body tumors from other vascular neoplasms of this region.
Anesthesia Effects on the Electrically Evoked Middle Latency Response in Guinea Pigs
Authors: Crowther John , Cannon Stephen C. , Miller Josef M. , Jyung Robert W. , Kileny Paul
Published: July 2017

Recent data indicate that the electrically evoked middle latency response (EMLR) is useful for patient selection for cochlear implantation and may provide a test for determining safe levels of electrical stimulation In cochlear implant recipients. Some anesthetic agents have been reported to alter the auditory evoked middle latency response. The aim of our study was to examine the effects of ketamine and xylazine anesthesia on the EMLR In guinea pigs. A consistent, reproducible, and significant depression in the EMLR was observed after anesthesia. Response latencies were increased and the suprathreshold amplitudes were depressed initially, but later increased above preanesthetic values. Changes followed a predictable time course of depression and overshoot, which allows the investigator to compensate for these effects of anesthesia. No change in threshold was observed. The lack of threshold change and the predictable course of suprathreshold depression indicates that the EMLR may be useful to evaluate responsiveness of the auditory system to electrical stimulation in the anesthetized animal.
Complications after Total Thyroidectomy
Authors: Shemen Larry J. , Strong Elliot W.
Published: July 2017

A retrospective review of 64 total thyroidectomies performed at Memorial Sloan‐Kettering Cancer Center was conducted. Only one patient had permanent hypocalcemia (1.6%) requiring calcium supplementation. Eight patients had a total of 11 complications, for a complication rate of 12.5%. These results are in sharp contrast to those published in 1972 from this institution, in which the permanent hypocalcemia rate was 29%. The reasons for this difference are discussed.
Computer‐Aided Three‐Dimensional Reconstruction and Measurement of the round Window and its Membrane
Authors: Takahashi Haruo , Takagi Akira , Sando Isamu
Published: July 2017

This study was performed to clarify the complex three‐dimensional shape of the round window and its membrane, and to measure these structures by using the computer‐aided three‐dimensional reconstruction method we developed. The equipment used included a personal computer, a high‐resolution, 14‐Inch color monitor, and a digitizer. Materials consisted of five normal temporal bones obtained from five individuals with negative otologic histories who had been 5 months and 14, 15, 18, and 59 years old at death. Round window membranes were found to be convex to the middle ear side when viewed in the coronal plane, but to be concave when viewed in the sagittal plane; thus the membrane in most cases seemed to be shaped like a saddle, tapered toward the vestibular end. The average maximal diameter, sagittal length, horizontal width, and surface area of the round window were 2.32 ± 0.19 mm, 2.08 ± 0.22 mm, 1.76 ± 0.10 mm, and 2.70 ± 0.43 mm2, respectively. The average surface area of the round window membrane was 2.98 ± 0.43 mm2.
An Artificial Myotatic Reflex: A Potential Avenue to Fine Motor Control
Authors: Grundfest‐Broniatowski Sharon , Broniatowski Michael , Davies Charles R. , Jacobs Gordon B. , Kasick Jerald C. , Chou Samuel S. , Nosé Yukihiko , Hermann Robert E. , Tucker Harvey M.
Published: July 2017

When a striated muscle becomes paralyzed, not only its motor function, but its sensory innervation may be Impaired. Methods of rehabilitation have previously focused only on motor innervation, although striated muscles are submitted to self‐regulation of length and tension. Indeed, reinnervated muscle may not contract appropriately unless sensory information is available, nor is it known whether sensory receptors are included in the reinnervation process. We hypothesized that the myotatic reflex (MR) would be absent in the event these sensory organs are not reinnervated, and that an artificial myotatic reflex (AMR) would be useful in reestablishing fine motor control. The strap muscles were exposed in six anesthetized rabbits. The MR was verified by stretching an intact sternohyoid muscle. Next, loss of the reflex was documented after the ipsllateral ansa hypoglossl was divided, and a crossover nerve‐muscle pedicle (NMP) was brought In from the opposite sternothyroid. After 3 months, the MR was still absent; however, stretch of the contralateral sternohyoid produced a reflex response on the reinnervated side. A strain gauge sutured to the reinnervated muscle was linked to an electronic modulator so that stretch induced electric stimulation of the NMP and contraction (the AMR). We conclude that (1) proprioception is not reestablished in the reinnervated muscle; (2) by contrast, sensory Information from the muscle of origin of the NMP Is conveyed to the reinnervated side; and (3) the AMR offers promise toward more sophisticated control of paralyzed (I.e., facial, laryngeal) musculature.
Adult Students in the Classroom: Attitudes and Teaching Practices of Marketing Faculty
Authors: Hite Robert E. , Bellizzi Joseph A. , Busch Catherine A.
Published: July 2017

The purpose of this study was to determine marketing faculty attitudes toward adult students and investigate the type and level of teaching adjustments that may follow as a result of adult student presence. The results indicate that marketing faculty feel that adult students are desirable in the classroom and bring special talents and characteristics which may elevate classroom ambiance.
Test Frequency, Student Performance and Teacher Evaluation in the Basic Marketing Class
Authors: Miller Fred
Published: July 2017

This article describes a study of test frequency in the basic marketing class. An increase from four to six exams per semester produced significant improvement in student performance. Improvement in the lowest quartile of the class was greater than in the highest. Student perception of teacher performance also improved significantly. The article considers alternative explanations of these results.
Inhaled Feed Particles in Experimental Pigs with and without Vitamin A Deficiency
Authors: Jericho K. W. F.
Published: July 2017

An attempt was made to experimentally reproduce an unusual respiratory disease of pigs fed a dusty mixture of finely ground peas, wheat, and barley. Groups of vitamin-A-deficient piglets from this herd were either given dry feed and daily exposure to dust from the feed or were given wet feed. Vitamin-A-fortified pigs of another stock were also given the dry feed and dust exposure. The upper and lower respiratory tracts, renal pelves, and interlobular ducts of salivary glands were studied histologically. The distinguishing features of lungs were starch particles from feed (up to 31.2 μm in diameter) in all lungs (but more in lungs of pigs given dry feed), free alveolar macrophages, giant cell formations, and mild degenerative processes of respiratory epithelium. The epithelium of most renal pelves was marked by mucinous degeneration.