bluuebunny/crossref_metadata_2025 huggingface dataset:
The African American Study of Kidney Disease and Hypertension (AASK) Trial: What More Have We Learned?
Authors: Sica Domenic A.
Published: May 2007

The final results of the African American Study of Kidney Disease and Hypertension (AASK) have shown that the angiotensin‐converting enzyme inhibitor ramipril was better than the β blocker metoprolol or the dihydropyridine calcium channel blocker amlodipine in slowing the rate of glomerular filtration rate decline in African American patients with mild to moderate renal insufficiency. Of note, there was no difference between the 92 mm Hg or less (lower group) and the 102–107 mm Hg (usual) mean arterial pressure groups as regards the secondary clinical composite end point. The secondary clinical composite end point in this study comprised a threshold drop of at least 50% or 25 mL/min in glomerular filtration rate, death, or reaching end‐stage renal disease. The final results from this study would suggest that reduction in blood pressure to levels below those currently advocated for cardiovascular risk reduction, although a clearly attainable goal in this population, does not provide readily identifiable benefits to African Americans with hypertensive nephrosclerosis. Importantly, this study provides the basis for the primary use of angiotensin‐converting enzyme inhibitors in an African American population with the characteristics of those studied in AASK. It remains to be determined if this represents a class effect for all angiotensin‐converting enzyme inhibitors.
Scleroderma Renal Crisis
Authors: Prisant L. Michael , Loebl Don H. , Mulloy Laura L.
Published: May 2007

Abrupt onset of severe uncontrolled hypertension and rapidly progressive oliguric renal failure characterizes scleroderma renal crisis. The etiology is unclear, but very high renin levels are present. While scleroderma is more common in women and whites, there is no difference in the prevalence of scleroderma renal crisis by gender. However, there appears to be a higher prevalence of scleroderma renal crisis among African Americans than whites. Survival was dismal prior to the introduction of the vigorous treatment of hypertension and use of converting‐enzyme inhibitors. However, most data on the benefit of these medications are derived from uncontrolled and unblinded studies. Prospective, randomized controlled trials are needed to assess the role of angiotensin receptor blockers. Prevention trials could define the role of various drugs in decreasing the rate of scleroderma renal crisis.
Comparative Effect of Lercanidipine, Felodipine, and Nifedipine GITS on Blood Pressure and Heart Rate in Patients With Mild to Moderate Arterial Hypertension: The Lercanidipine in Adults (LEAD) Study
Authors: Romito Roberta , Pansini Maria Ida , Perticone Francesco , Antonelli Gianfranco , Pitzalis Mariavittoria , Rizzon Paolo
Published: May 2007

This multicenter, double‐blind, parallel‐group study compared the effects of three dihydropyridine calcium channel blockers (lercanidipine, felodipine, and nifedipine gastrointestinal therapeutic system) on blood pressure and heart rate in 250 patients with mild to moderate hypertension (diastolic blood pressure 95 and 109 mm Hg). Patients were randomized to 4 weeks of treatment with once‐daily doses of lercanidipine 10 mg, felodipine 10 mg, or nifedipine gastrointestinal therapeutic system 30 mg. After 4 weeks of treatment, the dose was doubled in nonresponding patients. At 8 weeks, no significant differences in blood pressure were observed among the three groups. Increases in heart rate in all three groups induced by stressful conditions before and after treatment were not exacerbated during active treatment. The incidence of adverse drug reactions was lower in the lercanidipine and nifedipine groups than in the felodipine group (p<0.05); in particular, the incidence of edema for lercanidipine was 5.5% vs. 13% for felodipine and 6.6% for nifedipine.
Patient Knowledge and Awareness of Hypertension Is Suboptimal: Results From a Large Health Maintenance Organization
Authors: Alexander Mark , Gordon Nancy P. , Davis Catherine C. , Chen Roland S.
Published: May 2007

Patient knowledge and awareness of hypertension are important factors in achieving blood pressure control. To examine hypertensive patients' knowledge of their condition, the authors randomly surveyed 2500 hypertension patients from a large health maintenance organization; questionnaires were supplemented with clinic blood pressure measurements. Approximately 72% of the subjects completed surveys. Of patients with uncontrolled hypertension (systolic blood pressure [SBP] 140 mm Hg and/or diastolic blood pressure [DBP] 90 mm Hg), only 20.2% labeled their blood pressure as “high” and 38.4% as “borderline high.” Forty percent of respondents couldn't recall their most recent clinic‐based SBP and DBP values. Overall, 71.7% and 61% were unable to report a target SBP or DBP, respectively, or identify elevated targets based on the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) criteria. Most patients perceived DBP to be a more important risk factor than SBP. Hypertensive patients' awareness of blood pressure targets and current hypertension control status, particularly with respect to SBP, is suboptimal. The authors' findings support the need to improve patient education for better management of hypertension.
Response to Six Classes of Antihypertensive Medications by Body Mass Index in a Randomized Controlled Trial
Authors: Materson Barry J. , Williams David W. , Reda Domenic J. , Cushman William C. ,   for the Veterans Affairs Cooperative Study Group on Antihypertensive Agents
Published: May 2007

Blood pressure increases with increasing body mass index (BMI) and BMI is linearly related to blood pressure in population studies. Obesity has been said to cause resistance to antihypertensive medications. We compared short‐term and 1‐year blood pressure response by BMI category and weight change with hydrochlorothiazide, atenolol, diltiazem‐SR, captopril, clonidine, prazosin, or placebo in 1292 male veterans. Drug doses were titrated to achieve goal diastolic blood pressure <90 mm Hg over 4–8 weeks. Patients who achieved goal blood pressure were maintained for 1 year. BMI did not predict change in systolic, diastolic or pulse pressures during titration for any drug. At 1 year obese patients (BMI >30) were 2.5 times more likely to have diastolic blood pressure controlled by atenolol than normal weight (BMI <27) patients (p=0.01). Only prazosin patients gained weight: 1.7 lb (end‐titration,p<0.0001; 1‐year, p=0.02). Obesity does not appear to cause resistance to antihypertensive medications.
Prospective Surveillance of Hypertension in Firefighters
Authors: Soteriades Elpidoforos S. , Kales Stefanos N. , Liarokapis Dimitrios , Christiani David C.
Published: May 2007

The authors evaluated blood pressure and antihypertensive medication use in 334 firefighters in an occupational medical surveillance program. Firefighters received written summaries of their examination results, including blood pressures, and were encouraged to see their personal physicians for any abnormal results. The mean age of the participants was 39 years, and the vast majority were men (n=330). The prevalence of hypertension was 20% at baseline (1996), 23% in 1998, and 23% in 2000. Among firefighters with high blood pressure readings, only 17%, 25%, and 22% were taking antihypertensive medications at the baseline, 1998, and 2000 examinations, respectively. Medical surveillance was effective in detecting hypertension in firefighters; however, after 4 years of follow‐up, only 42% of hypertensives were receiving treatment with medications, including only 22% of firefighters with hypertensive readings. Overall, 74% of hypertensives were not adequately controlled. Possible reasons for low treatment rates may be the inadequate recognition among primary care physicians that mild hypertension is a significant risk factor for cardiovascular disease.
Epidemiology of Hypertension and Cardiovascular Disease in African Americans
Authors: Flack John M. , Ferdinand Keith C. , Nasser Samar A.
Published: May 2007

Hypertension is a major cause of cardiovascularrenal morbidity and mortality and all‐cause mortality. It is a highly significant problem for African Americans; about 30% of all deaths in this population are attributable to hypertension. Compared with whites, hypertension in African Americans is more prevalent, occurs earlier in life, is more severe, and is more often associated with target organ injury such as left ventricular hypertrophy and other cardiovascular complications. Only 25% of all African Americans with hypertension and fewer than 50% of those receiving drug treatment attain a blood pressure <140/90 mm Hg. These control rates are some‐what less than in white Americans. Enhanced awareness and understanding of the epidemiologic patterns of hypertension, other cardiovascular risk factors, risk‐factor control rates, and factors influencing these control rates should lead to better approaches to riskfactor control. This most likely would result in a reduction of cardiovascular disease complications.
Therapeutic Lifestyle Changes for Hypertension and Cardiovascular Risk Reduction
Authors: Watson Karol , Jamerson Kenneth
Published: May 2007

Elevated blood pressure is the most common chronic illness in the United States, affecting more than 50 million people. Hypertension is an even greater problem in the African American community. Traditionally, management of hypertension and cardiovascular risk reduction has focused on drug therapy; however, several studies have shown the benefits of therapeutic lifestyle changes for blood pressure lowering and cardiovascular risk reduction. Therapeutic lifestyle changes to reduce blood pressure have enormous potential as a means for preventing and controlling hypertension and thereby reducing the risk of coronary heart disease. Although the reductions in blood pressure are relatively modest with these approaches, they could potentially have a beneficial impact on overall cardiovascular morbidity and mortality when applied to the whole population. Because of their high prevalence of certain cardiovascular risk factors (e.g., obesity, diabetes mellitus) and greater salt sensitivity, therapeutic lifestyle changes have particular relevance for African Americans.
Blockade of the Renin‐Angiotensin System in African Americans With Hypertension and Cardiovascular Disease
Authors: Saunders Elijah , Gavin James R.
Published: May 2007

There is overwhelming evidence that the reninangiotensin system plays a significant role in the pathophysiology of hypertension and target organ damage. Agents that regulate the renin‐angiotensin system, such as angiotensin‐converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, and aldosterone antagonists, are not only effective antihypertensive agents but can prevent target organ damage. Although diuretics remain the agents of first choice for the treatment of hypertension in African Americans, ACE inhibitors have a clear role in the management of these patients. ACE inhibitors (usually when used with a diuretic) have been shown to reduce morbidity and mortality in a wide range of patient groups. ACE inhibitors are infrequently used in African Americans because of a belief that these agents are ineffective in this racial group; however, when adequate dosing and appropriate combinations are used, ACE inhibitor therapy provides effective blood pressure control. In particular, the addition of diuretics to ACE inhibitor therapy ameliorates the racial differences in efficacy seen when ACE inhibitors are administered as monotherapy. Although further confirmation in additional clinical trials is required, increased use of these agents in African Americans will likely result in a reduction in target organ damage.
Roundtable Discussion: The ALLHAT Trial
Authors: Moser Marvin , Cushman William , Weber Michael
Published: May 2007

Following a hypertension symposium in New York City on January 22, 2003, a roundtable was convened to discuss and critique the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), which was recently published in the Journal of the American Medical Association. Dr. Marvin Moser, Clinical Professor of Medicine at the Yale University School of Medicine, moderated the discussion. Panelists included Dr. William Cushman, Professor of Preventive Medicine and Medicine, University of Tennessee College of Medicine, Memphis, TN, one of the principal investigators in the ALLHAT trial, and Dr. Michael Weber, Professor of Medicine at the State University of New York Downstate College of Medicine in New York.
Calcium Channel Blocker‐Related Peripheral Edema: Can It Be Resolved?
Authors: Sica Domenic A.
Published: May 2007

Calcium channel blocker (CCB)‐related edema is quite common in clinical practice and can effectively deter a clinician from continued prescription of these drugs. Its etiology relates to a decrease in arteriolar resistance that goes unmatched in the venous circulation. This disproportionate change in resistance increases hydrostatic pressures in the precapillary circulation and permits fluid shifts into the interstitial compartment. CCB‐related edema is more common in women and relates to upright posture, age, and the choice and dose of the CCB. Once present it can be slow to resolve without intervention. A number of strategies exist to treat CCB‐related edema, including switching CCB classes, reducing the dosage, and/or adding a known venodilator such as a nitrate, an angiotensin‐converting enzyme inhibitor, or an angiotensin‐receptor blocker to the treatment regimen. Angiotensin‐converting enzyme inhibitors have been best studied in this regard. Diuretics may alter the edema state somewhat, but at the expense of further reducing plasma volume. Traditional measures such as limiting the amount of time that a patient is upright and/or considering use of graduated compression stockings are useful adjunctive therapies. Discontinuing the CCB and switching to an alternative antihypertensive therapy will resolve the edema.
Roundtable Discussion: Electrolytes in Cardiovascular Disease and Hypertension
Authors: Moser Marvin , Basile Jan , Sica Domenic
Published: May 2007

During the meeting of the American Society of Hypertension in New York City in May 2003, a discussion of electrolytes in cardiovascular disease and hypertension was held. Dr. Jan Basile of the Ralph Johnson VA Medical Center, Charleston, SC, and Dr. Domenic Sica of Virginia Commonwealth University, Richmond, VA, were participants in the roundtable discussion, which was moderated by Dr. Marvin Moser of the Yale University School of Medicine, New Haven, CT.
Rationale for Combination Therapy in the Management of Hypertension
Authors: Moser Marvin
Published: May 2007

Combination drug therapy in the management of hypertension has been used for many years. Recent recommendations of the Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and the results of several new multiple‐drug trials have focused on using the approach as initial therapy in many hypertensive patients. Results of these long‐term outcome trials, as well as short‐term and smaller studies, indicate the advantage of multiple‐drug therapy in the management of hypertension.
Management of Older Hypertensive Patients: Is There a Difference in Approach?
Authors: Black Henry R.
Published: May 2007

Hypertension is the most common reason Americans visit a physician. Recent analyses from the Framingham Heart Study and others have shown that there will be 70 million hypertensive Americans by the year 2020 and that the overwhelming majority of hypertensives will be 65 years of age or older (what we used to call “elderly”). The lifetime risk of Americans who live to age 85 years of becoming hypertensive is approximately 90% for both men and women. These individuals, even if they develop an elevated blood pressure late in life, are at significantly increased risk of the many medical complications attributable to hypertension (coronary artery disease, strokes, heart failure, chronic renal disease, and more). Older hypertensives are more likely to have an elevated systolic blood pressure and a low diastolic blood pressure, both of which are related to a loss of article compliance and have an increase in left ventricular mass and a decrease in peripheral resistance. We now have a substantial body of evidence from well done clinical trials that older hypertensives benefit as much or more than younger patients from antihypertensive therapy, so there is no longer any justification for withholding medication from any hypertensive patient whose competing risk or other medical problems are not a contraindication to treatment. These same studies, and practice‐based analyses, have shown that the major barrier to reaching blood pressure goal is our failure to reduce systolic blood pressure to <140 mm Hg in most patients and to <130 mm Hg in diabetics and those with renal failure. The basis for all antihypertensive therapy, especially in older people, is thiazide diuretics with either angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, β blockers, or calcium entry blockers as appropriate add‐on treatment. The choice of the second agent depends on other factors, such as comorbidity, lifestyle, and affordability. We must be more aggressive in getting the message out that older hypertensives benefit from treatment and we must overcome the “clinical inertia” that seems to be a factor in the decision of many physicians not to treat an older patient. No older person should suffer a preventable, life‐threatening event or become confined to a wheel chair if attention to lifestyle issues and a few pills a day could avoid that outcome.
The First Hypertension Trial Comparing the Effects of Two Fixed‐Dose Combination Therapy Regimens on Cardiovascular Events: Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH)
Authors: Jamerson Kenneth A.
Published: May 2007

Current recommendations for the treatment of hypertension clarify the need to achieve lower blood pressure levels in the general population (<140/90 mm Hg) and in specific high‐risk patient groups such as patients with diabetes or chronic renal disease (<130/80 mm Hg). Further, it is evident that to reach appropriate blood pressure control, most patients with high blood pressure will require two or more antihypertensive agents. There is scarce clinical trial outcome evidence to guide clinicians in the selection of optimal combinations of antihypertensive classes for high‐risk hypertensive patients. A new clinical trial, Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH), is the first large clinical trial to directly compare cardiovascular mortality and morbidity rates for two fixed‐dose combination therapies. Results from ACCOMPLISH should provide much‐needed guidance for selecting optimal combination therapy for high‐risk hypertensive patients.
Characteristics and Lipid Distribution of a Large, High‐Risk, Hypertensive Population: The Lipid‐Lowering Component of the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Authors: Papademetriou Vasilios , Piller Linda B. , Ford Charles E. , Gordon David , Hartney Thomas J. , Geraci Therese S. , Reisin Efrain , Sumner Brian Montgomery , Wong Nathan D. , Nwachuku Chuke , Narayan Puneet , Haywood L. Julian , Habib Gabriel ,   ALLHAT Collaborative Research Group
Published: May 2007

The Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) consisted of 42,418 participants randomized to one of four antihypertensive treatment groups: chlorthalidone, amlodipine, lisinopril, or doxazosin. A subset of these participants with fasting low‐density lipoprotein cholesterol levels 100–189 mg/dL were randomized into a lipid‐lowering component: 5170 to receive pravastatin (40 mg daily) and 5185 to receive usual care. This report describes the characteristics and lipid distribution of these participants. There were no important differences between the randomized treatment groups. Women had higher total cholesterol, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol than men. There was a similar finding for black participants compared with whites, except blacks had lower triglycerides. Diabetics had lower high‐density lipoprotein cholesterol and higher triglycerides than nondiabetics, and patients with body mass index <25 kg/m2 had higher high‐density lipoprotein cholesterol but lower low‐density lipoprotein cholesterol and triglycerides than patients with higher body mass index. The success of the randomization of this large, diverse population and the differences in the lipid distributions among its subgroups will allow further understanding of optimal lipid‐lowering treatment.
Treatment of High‐Risk African American Patients: Left Ventricular Dysfunction, Heart Failure, Renal Disease, and Postmyocardial Infarction
Authors: Arora Rohit , Clark Luther , Taylor Malcolm
Published: May 2007

African Americans experience more mortality and morbidity from hypertension‐related complications than other racial groups. Although angiotensin‐converting enzyme (ACE) inhibitors have clearly been shown to reduce mortality and morbidity in hypertensive white patients with heart failure, renal dysfunction, stroke, and acute myocardial infarction, African American patients have been underrepresented in these trials. The lack of direct evidence of the benefit of ACE inhibitors in these individuals and the suggestion that ACE inhibitors are less efficacious in this group has resulted in a reluctance to use ACE inhibitors in African Americans. However, retrospective analyses in black patients with heart failure and a recent randomized clinical trial in African Americans with renal dysfunction suggest that a regimen based on ACE inhibitors is efficacious in this racial group. Although diuretics remain first‐line therapy, data now suggest that ACE inhibitors provide additional benefit and should be considered for use in patients with high‐risk complications regardless of race.
Adsorption of PAA on the α‐Al2O3 Surface
Authors: Chen H. Y. T. , Wei W. C. J. , Hsu K. C. , Chen C. S.
Published: May 2007

The specific system of interest is the polyacrylic acid (PAA) and (0001) α‐Al2O3 surface, which was modeled and simulated by Cerius2 4.9 software with empirical potentials. The simulation predicted that the adsorbed conformations of PAA with a molecular weight (Mw) of 5000 were train and tail at pH <4 and >10, respectively. After gradually inserting additional PAA molecular chains, the adsorption reached a saturated amount. Gel permeation chromatography experimental results showed that the adsorption amount at pH 3.6 was three times greater than that at pH 11. Based on the results from simulations and experiments, a successively increasing pH environment was modeled to illustrate the possibility of optimizing electro‐steric effects by combining the higher adsorption density at a lower pH and strong steric repulsion of tail‐adsorbed configuration at a higher pH.
Is the Child Perceptions Questionnaire for 11–14 year olds sensitive to clinical and self‐perceived variations in orthodontic status?
Authors: Locker David , Jokovic Aleksandra , Tompson Bryan , Prakash Preeti
Published: May 2007

Abstract –  Objectives:  To assess the association between scores on the Child Perceptions Questionnaire for 11–14 year olds (CPQ11–14) and clinical and self‐perceived measures of malocclusion.

Methods:  Children were recruited from an orthodontic clinic just prior to starting orthodontic treatment. They completed a copy of the CPQ11–14 and a short questionnaire concerning their feelings about the condition of their teeth. Study models were taken and rated according to the Dental Aesthetic Index (DAI) and the Peer Assessment Rating (PAR) index by two sets of three examiners. Intra and inter‐rater reliabilities for the two sets of examiners ranged from 0.80 to 0.99. CPQ11–14 scores were calculated for the full 35‐item version and for 16 and 8‐item short forms by summing the item response codes. The association between these scores, the DAI and PAR ratings and self‐perceived measures of malocclusion were examined using appropriate parametric and nonparametric tests.

Results:  Complete data were collected for 141 children, 63 boys and 78 girls. The mean age was 12.5 (SD = 1.0). DAI scores ranged from 17.0 to 58.0 with a mean of 35.0 (SD = 8.0). The distribution of subjects across the four severity categories was minor/none – 6.6%, definite – 35.2%, severe – 15.6% and handicapping 42.6%. PAR scores ranged from 8.0 to 66.0 with a mean of 31.4 (SD = 11.1). Eight percent had scores of 50 or above indicating marked deviation from an ideal occlusion. Both the long and the short forms of the CPQ11–14 identified substantial variability in the impacts of malocclusion. Correlations between CPQ11–14 scores and the orthodontic indices ranged from 0.26 to 0.31 (P < 0.01). There was a clear gradient in CPQ11–14 scores across four categories of the PAR based on quartiles. The gradient across the DAI categories was less clear. There were significant associations between all CPQ11–14 scores and the children's self‐ratings of oral health, ratings of the extent to which the condition of the teeth affected life overall and expressions of happiness with the appearance and arrangement of the teeth.

Conclusion:  The results provide some evidence of the validity of the CPQ11–14 when used with children needing orthodontic treatment. However, because clinical samples are biased the study needs to be repeated in different treatment settings in order to confirm the utility of the measure.
The contributions of qualitative research towards dental public health practice
Authors: Bower Elizabeth , Scambler Sasha
Published: May 2007

Abstract –  Dental public health (DPH) researchers have traditionally relied on quantitative methods for scientific enquiry. This paper argues that qualitative methodology can make a significant contribution to DPH knowledge and practice because it allows researchers to answer important questions of relevance to procedure and policy that are difficult to answer satisfactorily using quantitative methods alone. Qualitative research can also challenge the norms and assumptions of DPH practice. There are tensions in the relationship between qualitative research and the prevailing paradigm of evidence‐based practice (EBP) which potentially influence the utility of DPH‐related qualitative research. However, the relevance of qualitative research is increasing as the scope of EBP enquiry extends beyond questions of effectiveness, and methods are developed for incorporating qualitative research into systematic reviews.
The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries
Authors: Ismail A. I. , Sohn W. , Tellez M. , Amaya A. , Sen A. , Hasson H. , Pitts N. B.
Published: May 2007

Abstract –  This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR‐OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR‐OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven‐point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.
Melatonin expression in periodontal disease
Authors: Gómez‐Moreno G. , Cutando‐Soriano A. , Arana C. , Galindo P. , Bolaños J. , Acuña‐Castroviejo D. , Wang H.‐L.
Published: May 2007

Background and Objective: It was the purpose of this study to examine the relationship between periodontal diseases and melatonin level.

Material and Methods: Forty‐six patients with periodontal disease, together with 26 age‐ and gender‐matched healthy controls, were included. Periodontal status was assessed using the Community Periodontal Index. Plasma and salivary melatonin levels were determined using specific commercial radioimmunoassays, whereas lymphocyte subpopulations (e.g. CD3, CD4, CD8, C19 and natural killer cells) were analyzed using flow cytometry.

Results: Patients with periodontal disease had significantly (p < 0.001) lower plasma (9.46 ± 3.18 pg/mL) and saliva (2.55 ± 0.99 pg/mL) melatonin levels than healthy control patients (14.33 ± 4.05 and 4.22 ± 0.87 pg/mL, respectively). A biphasic relationhip was observed between plasma melatonin levels and Community Periodontal Indices. The plasma melatonin level was reduced in patients with a lower Community Periodontal Index value (1 or 2) and increased in patients with a higher Community Periodontal Index value (3 or 4). Salivary melatonin parallels the changes of plasma melatonin. The higher the Community Periodontal Index, the older the patient and the higher the total lymphocyte counts. CD4 concentrations also increased as the disease worsened.

Conclusion: The results obtained from this study suggest that melatonin could act as a protective function in fighting periodontal infection. However, further studies in this area are encouraged.
Diabetes in the dental office: using NHANES III to estimate the probability of undiagnosed disease
Authors: Borrell L. N. , Kunzel C. , Lamster I. , Lalla E.
Published: May 2007

Background and Objective:  Recent data have suggested that in the past 15 years there has been a dramatic increase in the incidence of diabetes mellitus in the USA. However, evidence suggests that approximately one‐third of diabetes cases remain undiagnosed. Because 60% of Americans see a dentist at least once per year for routine, nonemergent, care, it is reasonable to propose that the dental office can be a healthcare location actively involved in screening for unidentified diabetes.

Material and Methods:  This study used NHANES III to develop a predictive equation that can form the basis of a tool to help dentists determine the probability of undiagnosed diabetes by using self‐reported data and periodontal clinical parameters routinely assessed in the dental office.

Results:  Our analyses reveal that individuals with a self‐reported family history of diabetes, hypertension, high cholesterol levels and clinical evidence of periodontal disease bear a probability of 27–53% of having undiagnosed diabetes, with Mexican–American men exhibiting the highest probability and white women the lowest.

Conclusion:  These findings suggest that the dental office could provide an important opportunity to identify individuals unaware of their diabetic status.
The interleukin‐10 promoter haplotype ATA is a putative risk factor for aggressive periodontitis
Authors: Reichert S. , Machulla H. K. G. , Klapproth J. , Zimmermann U. , Reichert Y. , Gläser C. H. , Schaller H. G. , Stein J. , Schulz S.
Published: May 2007

Background and Objective:  Interleukin‐10 has been described as an anti‐inflammatory cytokine and a B‐cell proliferation factor. Promoter polymorphisms of the interleukin‐10 gene have been associated with altered interleukin‐10 expression. Therefore, the aim of this study was to evaluate three polymorphisms at positions −1082G>A, −819C>T and −590C>A in patients with generalized chronic periodontitis (n = 27) and generalized aggressive periodontitis (n = 32) in comparison with periodontitis‐free controls (n = 34).

Material and Methods:  Interleukin‐10 promoter polymorphisms were analyzed by polymerase chain reaction with sequence‐specific primers (PCR‐SSP). Distributions of single alleles, genotypes and haplotypes were calculated by the chi‐square test. Risk factor analyses were carried out by logistic regression. Subgingival bacteria were subjected to molecular biological analyses using the micro‐Ident® test.

Results:  The combination ATA/ATA was found only in patients with aggressive periodontitis (15.6 vs. 0.0%, p = 0.023). Taking into account age, gender, smoking and plaque level, an increased odds ratio (3.7, p = 0.04) for aggressive periodontitis was shown for subjects with the haplotype ATA. Prevotella intermedia was found to be decreased in ACC‐ positive (41.3 vs. 66.7%, p = 0.022), ATA‐positive (33.3 vs. 57.1%, p = 0.032) and ACC/ATA‐positive (20.0 vs. 55.9%, p = 0.002) individuals. In GCC/GCC‐positive subjects, P. intermedia occurred more frequently (86.7 vs. 42.3%, p = 0.002).

Conclusion:  The haplotype ATA, which is known as a ‘low interleukin‐10 producer’ is a putative risk indicator for generalized aggressive periodontitis.
Buffering effect of a prophylactic gel on dental plaque in institutionalised elderly
Authors: Persson Anitha , Lingström Peter , Bergdahl Maud , Claesson Rolf , Dijken Jan W. V. van
Published: May 2007

Objectives:  The effect of multiple daily applications of a prophylactic gel, with buffering substances, on plaque acidogenicity in elderly institutionalised individuals was evaluated.

Background:  Many elderly suffer from reduced salivary flow, poor oral hygiene and increased levels of cariogenic bacteria and are considered to be at an increased risk for coronal and root caries. Reinforcing the buffering capacity of dental plaque by the addition of substances such as bicarbonate and phosphates may decrease their caries activity.

Materials and methods:  Fourteen elderly, with subjective dry mouth, were treated for 16‐day‐periods at random with: (i) Profylin fluoride gel with buffering components; (ii) Profylin fluoride gel without buffering components and (iii) rinsing with water. Applications were made four times a day and each period was followed by a 2‐week wash‐out period. The plaque pH was registered after a carbohydrate challenge and the following were recorded before and after each test period: stimulated salivary secretion rate, buffer capacity, number Colony Farming Units (CFU) mutans streptococci, lactobacilli and a sample of Candida albicans on oral mucosa.

Results:  Eleven participants (mean age 76.6 years) fulfilled the study. Changes in plaque pH measurements, when calculated as area under the curve (AUC6.2 and AUC5.7) values (pH × min), before and after each of the three treatments, showed no significant differences. A tendency to a higher plaque acidogenicity and amount of cariogenic microorganisms was found after the gel treatments. C. albicans was found in low levels.

Conclusion:  Frequent applications of the gel did not result in an improved neutralising effect in the elderly. This may be caused by a combination of several factors, such as the level of oral dryness of the individuals and low solubility, release and retention of the gel substances in plaque. Instead, an increased plaque acidogenicity was noted.
Patient ratings of chewing ability from a randomised crossover trial: lingualised vs. first premolar/canine‐guided occlusion for complete dentures
Authors: Heydecke Guido , Akkad Ahmed Shadi , Wolkewitz Martin , Vogeler Michael , Türp Jens C. , Strub Joerg R.
Published: May 2007

Background:  Complex procedures involving a facebow transfer and the use of lingualised teeth are deemed to have a positive influence on the chewing ability with complete dentures.

Objectives:  To determine if patients’ ratings of their ability to chew depend on the method of complete denture fabrication.

Methods:  Edentulous patients (n = 20) participated in a within‐subject crossover trial. Each patient received two sets of new complete dentures. One pair was manufactured based on intraoral tracing of centric relation and facebow transfer; semi‐anatomical teeth with lingualised occlusion denture (LOD) were chosen. The second pair was made using a simplified procedure without facebow transfer; jaw relations were recorded with wax occlusion rims, and anatomical teeth with a first premolar/canine‐guidance (CGD) were selected. The dentures were delivered in randomised order, and each was worn for 3 months. Three months after delivery, patients’ ratings of each new prosthesis were recorded on visual analogue scales for their ability to chew seven index foods. Repeated measurements analysis of variance was performed to investigate possible carry‐over effects accounting for confounding by treatment period.

Results:  When comparing the two treatments, participants rated their ability to chew in general, to masticate carrots, hard sausage, steak and raw apple in particular, was significantly better with the CGD (anatomical teeth) than with the LOD (p < 0.05).

Conclusion:  Comprehensive methods for the fabrication of complete dentures including semi‐anatomical lingualised teeth and a full registration do not seem to influence the perceived chewing ability, when compared with more simple procedures. Chewing ability for tough foods appears to benefit from the use of anatomical teeth.
Comparison of surface electromyographic (sEMG) activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia
Authors: Yoshida Mitsuyoshi , Groher Michael E. , Crary Michael A. , Mann Giselle Carnaby , Akagawa Yasumasa
Published: May 2007

Objective:  The present study compared surface electromyographic (sEMG) activity obtained from the submental muscle group for a tongue press and a head lift exercise as potential therapeutic exercises for dysphagic elderly.

Materials and methods:  Fifty‐three healthy volunteers with a mean age of 35.3 participated in this study. Subjects were required to perform an isometric task, pressing their tongue against the hard palate, and an isotonic task requiring sustained lingual force against the hard palate. Pressure sensors were used to measure the amount of lingual pressure against the hard palate. Submental sEMG data from these tasks were compared with those obtained from the isometric and isotonic aspects of a head lift exercise.

Results:  No sEMG differences were identified between the isometric tongue press task and head lift exercise. Isotonic tongue press exercises resulted in significantly higher maximum and mean sEMG values compared with the isotonic head lift exercise (p < 0.05). The submental sEMG activity from the tongue press exercise was equal (isometric) to, or greater (isotonic) than comparable muscle activation obtained during the head lift exercise.

Conclusions:  The tongue press exercise may be less strenuous than the head lift exercise while achieving the same therapeutic effect.
Gender Studies and Eighteenth‐Century British Literature
Authors: Bowers Toni
Published: May 2007

A chronological sketch of the kinds of questions and methods characteristic of recent work in eighteenth‐century gender studies, drawing on representative book‐length studies as examples. It compares the histories and purposes of Women's Studies, Feminist Studies and Gender Studies, and concentrates on critical work dealing with early novels.
The Current Position of Statistics: A Personal View
Authors: Cox D.R.
Published: May 2007

Some current aspects of statistical work are reviewed under three broad headings, applied probability modelling, design of investigations and statistical analysis and interpretation of data. The emphasis is on applications in science and science‐based technology, although some incidental comments are made about statistics in public affairs. While no technical details are given, there is some discussion of potential fields for development. The choice of topics reflects the author's personal interests.
Using On‐Line Process Data to Improve Quality: Challenges for Statisticians*
Authors: MacGregor John F.
Published: May 2007

In the process industries measurements on a large number of process variables are routinely collected at regular intervals by on‐line computers. This paper makes a case for incorporating these process variables into Statistical Process Control (SPC) schemes. Multivariate statistical methods such as Principal Component Analysis (PCA) and Partial Least Squares (PLS) can be used to project these data down into low dimensional spaces where analysis, monitoring and diagnosis are easily performed. Strong justifications for taking this approach are presented and examples are given.

The statistical process control community has been slow in adapting to the data explosion brought about by the computer era. It has continued to stick with traditional control charts on the quality variables and ignored this rich source of additional information on the process. This paper explores some of the reasons for this and argues that the SPC community must adapt rapidly or lose control of the field to scientists and engineers. The paper also tries to induce statisticians into looking more seriously at the many unsolved problems in this area of reduced rank multivariate statistics.
Geographical Information Systems, Spatial Analysis and Public Policy: the British Experience
Authors: Worrall Les , Bond Derek
Published: May 2007

Geographic information systems (GIS) have received considerable academic and practitioner attention in the last ten years. It is our view that these tools have been considerably oversold to public sector organisations‐particularly local government‐many of whom have failed to achieve the benefits they expected. In our paper, we attempt to develop a broad definition of GIS and discuss the relationship between GIS and policy analysis, spatial decision support systems, spatial analysis and spatial modelling. We also seek to explore how GIS fits into the management information systems and information architectures of public sector organisations and examine some of the human and organisational tensions which GIS adoption and use have brought about. Where possible, we have used examples of how GIS has been used to inform public development in several areas though these have generally been in academic settings and not in public sector organisations.
The New View on Editing
Authors: Granquist Leopold
Published: May 2007

Numerous evaluation and other studies show that the heavy cost of editing cannot be justified by quality improvement. It is necessary to replace the old paradigm‐the more and tighter the checks and recontacts, the better the quality‐by a new‐focus the editing on identifying and collecting data on errors, problem areas, and error causes to provide a basis for a continuous improvement of the whole survey vehicle.

The corner stone of the new view on editing is that the entire set of the query edits should be designed meticulously, be focused on errors influencing the estimates, and be targeted on existing error types which can be identified by edits, and finally that the effects of the edits should be continuously evaluated by analysis of performance measures and other diagnostics, which the process should be designed to produce.

The paper is a short introduction to modern editing under the new view. It presents, also, some facts to the low efficiency of traditional editing, and explains it by giving a historical review of editing.
Benchmarking by State Space Models
Authors: Durbin J. , Quenneville B.
Published: May 2007

We have a monthly series of observations which are obtained from sample surveys and are therefore subject to survey errors. We also have a series of annual values, called benchmarks, which are either exact or are substantially more accurate than the survey observations; these can be either annual totals or accurate values of the underlying variable at a particular month. The benchmarking problem is the problem of adjusting the monthly series to be consistent with the annual values. We provide two solutions to this problem. The first of these is a two‐stage method in which we first fit a state space model to the monthly data alone and then combine the results obtained at this stage with the benchmark data. In the second solution we construct a single series from the monthly and annual values together and fit a state space model to this series in a single stage. The treatment is extended to series which behave multiplicatively. The methods are illustrated by applying them to Canadian retail sales sereis.
SESAME: an Integrated Economic and Social Accounting System
Authors: Keuning Steven J.
Published: May 2007

This article outlines a statistical information system that serves to monitor and analyze the interactions between economic development and social change. This so‐called SESAME links the monetary data in the national accounts to non‐monetary social and environmental data, and yields a consistent set of core indicators on the development of national welfare.
Software for Learning and for Doing Statistics
Authors: Biehler Rolf
Published: May 2007

The community of statisticians and statistics educators should take responsibility for the evaluation and improvement of software quality from the perspective of education. The paper will develop a perspective, an ideal system of requirements to critically evaluate existing software and to produce future software more adequate both for learning and doing statistics in introductory courses. Different kinds of tools and microworlds are needed. After discussing general requirements for such programs, a prototypical ideal software system will be presented in detail. It will be illustrated how such a system could be used to construct learning environments and to support elementary data analysis with exploratory working style.
Intangible Economy and its Implications for Statistics and Statisticians*
Authors: Goldfinger Charles
Published: May 2007

This paper presents an interpretation of major changes affecting the modern economy. Our postulate is that the defining trend is the shift to the intangible. The source of economic value and wealth is no longer the production of material goods but the creation and manipulation of dematerialised content. The logic of dematerialisation is pervasive and ubiquitous and affects all sectors and activities. It profoundly transforms economic relationships and interactions, the ways firms and markets are organised and transactions are carried out. It is also unsettling, to the extent that it runs squarely against some of the key tenets of the conventional logic of economics. The intangible economy raises a whde series of measurement issues. More fundamentally, it changes the role, the function, and the perception of economic measurement data. Official agencies no longer have the monopoly of economic data: a lively and diversified measurement and monitoring industry has emerged. Statisticians need to undertake a comprehensive appraisal of their business. Adaptingto the new environment will require major changes in three key areas: conceptual foundations, modus operandi and temporal outlook. If measurement systems are to capture the essence of the economy of today and tomorrow, intangibles have to move from the periphery to the core of these systems.