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Adequate preparation by anesthesia providers promotes quality care and decreases the likelihood of morbidity and mortality. Unfortunately, many trauma cases occur after hours when support resources are less readily available. At a large midwest academic medical center, it was determined that a website on the institution's Intranet relating to anesthetic care of trauma patients would be a readily accessible, user-friendly resource for improved care. In recent years, media tools such as computers have become increasingly popular and accessible as effective learning tools. A comprehensive literature search was completed on anesthetic care of trauma patients and on adult and Web-based learning principles. Information was gathered from textbooks, research journals, existing web links on the institution's intranet, and staff at the medical center. Assistance was obtained from the institution's Internet/website Development Department for creation of the website. The information was placed on the institution's Intranet. The web page contains 17 subject categories, including initial considerations, common trauma drugs, circulation and fluid resuscitation, management of pregnant trauma patients, and intraoperative death. It is our goal that the systematic developmental process described in this article may provide a model for other institutions wanting to develop websites. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to determine the accuracy and reliability of 3-dimensional craniofacial measurements obtained from cone-beam computed tomography (CBCT) scans of a dry human skull. Methods: Seventeen landmarks were identified on the skull. CBCT scans were then obtained, with 2 skull orientations during scanning. Twenty-nine interlandmark linear measurements were made directly on the skull and compared with the same measurements made on the CBCT scans. All measurements were made by 2 operators on 4 separate occasions. Results: The method errors were 0.19, 0.21, and 0.19 mm in the x-, y- and z-axes, respectively. Repeated measures analysis of variance (ANOVA) showed no significant intraoperator or interoperator differences. The mean measurement error was -0.01 mm (SD, 0.129 mm). Five measurement errors were found to be statistically significantly different; however, all measurement errors were below the known voxel size and clinically insignificant. No differences were found in the measurements from the 2 CBCT scan orientations of the skull. Conclusions: CBCT allows for clinically accurate and reliable 3-dimensional linear measurements of the craniofacial complex. Moreover, skull orientation during CBCT scanning does not affect the accuracy or the reliability of these measurements. [ABSTRACT FROM AUTHOR]

To humans, the diverse array of display behaviors that animals use for communication can easily seem peculiar or bizarre. While ample research delves into the evolutionary principles that shape these signals' effectiveness, little attention is paid to evolutionary patterning of signal design across taxa, particularly when it comes to the potential convergent evolution of many elaborate behavioral displays. By taking a mechanistic perspective, we explore the physiological and neurobiological mechanisms that likely influence the evolution of communication signals, emphasizing the utilization of pre-existing structures over novel adaptations. Central to this investigation are the concepts of perceptual bias and ritualization that we propose contribute to the convergence of elaborate display designs across species. Perceptual bias explains a phenomenon where pre-existing perceptual systems of receivers, used for innate behaviors such as food and predator recognition, select for certain traits of a communication signal from a signaler. Ritualization occurs when traits with no functional role in communication are co-opted through selection and transformed into a new communicative signal. Importantly, susceptibility for ritualization can be brought about through physiological modifications that occurred early in evolutionary time. In this way, perceptual bias can be a selective force that causes the co-option of non-communicative traits into a new communication signal through ritualization involving pre-existing modifications to physiological systems. If the perceptual bias, non-communicative signal, and physiological modifications that increase susceptibility to ritualization are highly conserved, then we may see the convergent evolution of the new communication signal with unrelated taxa facing similar sensory constraints. We explore this idea here using the foot-flagging frog system as a theoretical case study., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology.)

Wettability is recognized as an important property of implant surfaces for ensuring improved biological responses. However, limited information exists on how bone grafting procedures including materials influence the hydrophilic behavior of implant surfaces. This in vitro study aimed to investigate the influence of two bovine grafting materials after hydration on the wettability of four different disk surfaces: commercially pure titanium (CP-Ti), titanium-zirconium dioxide (TiZrO 2 -Cerid ® ), zirconia (SDS ® ), and niobium. Wettability tests were performed on each of the four implant surfaces with a solution of 0.9% sodium chloride after mixture with W-bone TM (Group A) or Bio-Oss ® (Group B) or 0.9% sodium chloride alone (Group C). In total, 360 contact angle measurements were completed with n = 30 per group. Statistical analysis was performed using a one-way analysis with variance (ANOVA) test with a significant mean difference at the 0.05 level. For pure titanium, Group A demonstrated increased hydrophilicity compared to Group B. Both TiZrO 2 and zirconia showed significant differences for Groups A, B and C, exhibiting a decrease in hydrophilicity after the use of bovine grafting materials compared to titanium surfaces. Niobium remained consistently hydrophobic. In summary, this study revealed that bovine grafting materials may diminish the hydrophilicity of zirconia surfaces and exert varied effects on titanium and niobium. These findings contribute to the understanding of implant surface interactions with grafting materials, offering insights for optimizing biological responses in implantology.

Ventilation is critical to animal life-it ensures that individuals move air/water across their respiratory surface, and thus it sustains gas exchange with the environment. Many species have evolved highly specialized (if not unusual) ventilatory mechanisms, including the use of behavior to facilitate different aspects of breathing. However, these behavioral traits are often only described anecdotally, and the ecological conditions that elicit them are typically unclear. We study one such "ventilation behavior" in Lake Titicaca frogs (Telmatobius culeus). These frogs inhabit high-altitude (i.e., low oxygen) lakes in the Andean Mountains of South America, and they have become textbook examples of cutaneous gas exchange, which is essentially breathing that occurs across the skin. Accordingly, this species has evolved large, baggy skin-folds that dangle from the body to increase the surface area for ventilation. We show that individuals exposed to acute hypoxic conditions that mirror what free-living individuals likely encounter quickly (within minutes) decrease their activity levels, and thus become very still. If oxygen levels continue to decline, the frogs soon begin to perform push-up behaviors that presumably break the low-oxygen boundary layer around skin-folds to increase the conductance of the water/skin gas exchange pathway. Altogether, we suspect that individuals rapidly adjust aspects of their behavior in response to seemingly sudden changes to the oxygen environment as a mechanism to fine tune cutaneous respiration., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Zhao et al. recently reported results which, they claim, suggest that sexual selection produces the multimodal displays seen in little torrent frogs ( Amolops torrentis ) by co-opting limb movements that originally evolved to support parasite defense (Zhao et al., 2022). Here, we explain why we believe this conclusion to be premature., Competing Interests: NA, DP, MF No competing interests declared, (© 2023, Anderson et al.)

Sex steroids play an important role in regulation of the vertebrate reproductive phenotype. This is because sex steroids not only activate sexual behaviors that mediate copulation, courtship, and aggression, but they also help guide the development of neural and muscular systems that underlie these traits. Many biologists have therefore described the effects of sex steroid action on reproductive behavior as both "activational" and "organizational," respectively. Here, we focus on these phenomena from an evolutionary standpoint, highlighting that we know relatively little about the way that organizational effects evolve in the natural world to support the adaptation and diversification of reproductive behavior. We first review the evidence that such effects do in fact evolve to mediate the evolution of sexual behavior. We then introduce an emerging animal model - the foot-flagging frog, Staurois parvus - that will be useful to study how sex hormones shape neuromotor development necessary for sexual displays. The foot flag is nothing more than a waving display that males use to compete for access to female mates, and thus the neural circuits that control its production are likely laid down when limb control systems arise during the developmental transition from tadpole to frog. We provide data that highlights how sex steroids might organize foot-flagging behavior through its putative underlying mechanisms. Overall, we anticipate that future studies of foot-flagging frogs will open a powerful window from which to see how sex steroids influence the neuromotor systems to help germinate circuits that drive signaling behavior. In this way, our aim is to bring attention to the important frontier of endocrinological regulation of evolutionary developmental biology (endo-evo-devo) and its relationship to behavior., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: To evaluate decayed, missing, and filled surfaces in primary teeth (dmfs) in Down syndrome subjects (DS) compared to typically developed (TD) controls using analysis. Methods: A retrospective study of 440 matched subjects (220 DS and 220 TD) was conducted. Categorical variables were evaluated for association with dental caries, with mean dmfs as the main outcome measure. Pearson's chi-square and independent sample t-tests for unequal variances for means were employed. Results: Overall, the TD control group was found to have significantly higher mean dmfs scores than the DS group: TD Equals 17.65 (mean dmfs), 95% confidence interval (CI) equals 15.48 to 19.90; DS equals 10.30 (mean dmfs), at 95% CI equals 7.96 to 12.78, (P<0.001). However, when controlled for the variable factors African American status (P=0.11), Hispanic status (P=0.07) and income level at or below 200 percent of poverty level (P=0.24) there was no significant difference in mean dmfs. Conclusions: In the study population DS and TD exhibited dissimilar dmfs scores, while when taking into consideration social and economic factors dmfs was equivalent. Caries risk factors modulate disease experience and should be considered in all population-specific studies. Patients with multiple high-risk factors should be treated as such, regardless of DS status.

Background: The authors investigated the association between carotid artery calcifications (CACs) detected incidentally on dental cone-beam computed tomographic scans and positive diabetes status., Methods: Two patient groups were identified retrospectively from a patient database: positive for CACs based on cone-beam computed tomographic scans and positive diabetes status. In addition to demographic characteristics, data including diabetes status and presence, type, and absence of CACs were obtained. A χ 2 statistical analysis was completed by means of dividing the data into sets of known CAC and known history of diabetes; significance level was P < .05., Results: To satisfy the a priori power analysis, records from 2010 through 2021 were used. For the positive CAC group, data were obtained from 288 patients (171 men, 117 women) and 68 patients (24%) had a positive diabetes status at the time of cone-beam computed tomography (P < .001). There were significantly more male patients (n = 47) than female patients (n = 21) with diabetes (χ 2  = 9.9; P = .002). For the positive diabetes group, data were obtained from 225 patients (149 men, 76 women), and 100 patients (44%) had an identifiable CAC. There were significantly more male patients (n = 73) than female patients (n = 27) with CAC (χ 2  = 21.2; P < .001)., Conclusions: There was a significant relationship to diabetes for patients with CACs, indicating potential undiagnosed diabetes. Male patients with diabetes are significantly more at risk of developing CACs., Practical Implications: People with CAC may be at risk of having undiagnosed diabetes and require heightened awareness during implant treatment planning., (Copyright © 2022 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Objectives: To determine the effect of different dental lab materials on cone beam computed tomography (CBCT) metal artifact at different resolutions., Methods: A total of seven common dental lab materials were molded to a dental sextant of four extracted, restored teeth. In addition to base alone (control), each material was scanned using the Carestream 9600 CBCT unit at three resolutions - 0.3 mm, 0.15 mm, and 0.075 mm - at manufacturer established exposure parameters. A single, representative axial view of each trial was evaluated for metal artifact both quantitatively by histogram analysis and qualitatively by profile plot analysis in ImageJ., Results: No statistically significant differences between the control and the dental materials were found; however, post-hoc tests showed significance between Blu-mousse ® and polyvinyl siloxane with dental materials and control, predominantly in lower resolutions., Conclusions: The current study provides initial evidence on the influence of dental materials have on CBCT metal artifact as described by beam hardening, photon starvation, scatter, and noise, especially at lower resolutions. Blu-Mousse ® and polyvinyl siloxane reduced the perceived beam hardening and photon starvation artifact the greatest, relative to other materials, at all three resolutions and lower resolutions, respectively.

Many animals communicate by performing elaborate displays that are incredibly extravagant and wildly bizarre. So, how do these displays evolve? One idea is that innate sensory biases arbitrarily favour the emergence of certain display traits over others, leading to the design of an unusual display. Here, we study how physiological factors associated with signal production influence this process, a topic that has received almost no attention. We focus on a tropical frog, whose males compete for access to females by performing an elaborate waving display. Our results show that sex hormones like testosterone regulate specific display gestures that exploit a highly conserved perceptual system, evolved originally to detect 'dangerous' stimuli in the environment. Accordingly, testosterone makes certain gestures likely to appear more perilous to rivals during combat. This suggests that hormone action can interact with effects of sensory bias to create an evolutionary optimum that guides how display exaggeration unfolds.

AbstractUnrelated species often evolve similar phenotypic solutions to the same environmental problem, a phenomenon known as convergent evolution. But how do these common traits arise? We address this question from a physiological perspective by assessing how convergence of an elaborate gestural display in frogs (foot-flagging) is linked to changes in the androgenic hormone systems that underlie it. We show that the emergence of this rare display in unrelated anuran taxa is marked by a robust increase in the expression of androgen receptor (AR) messenger RNA in the musculature that actuates leg and foot movements, but we find no evidence of changes in the abundance of AR expression in these frogs' central nervous systems. Meanwhile, the magnitude of the evolutionary change in muscular AR and its association with the origin of foot-flagging differ among clades, suggesting that these variables evolve together in a mosaic fashion. Finally, while gestural displays do differ between species, variation in the complexity of a foot-flagging routine does not predict differences in muscular AR. Altogether, these findings suggest that androgen-muscle interactions provide a conduit for convergence in sexual display behavior, potentially providing a path of least resistance for the evolution of motor performance.

Definitions can generate actionable consensus for a given subject matter by resolving important differences in philosophy and best practices and by streamlining activities for a stronger strategic direction. Interest in the global dimensions of oral health, a generally neglected area of global health, is growing; yet, no previously published research has defined the term 'global oral health.' As such, the Global Oral Health Interest Group of the Consortium of Universities for Global Health determined a need for an introductory definition of 'global oral health' to guide program planning, implementation, and evaluation. With the oversight of an expert senior Task Force for the Definition of Global Oral Health, we employed a mixed-methods approach using the more common expert consensus-building Delphi technique combined with the lesser utilized Q methodology. This approach allowed us to identify the interconnectedness of global oral health themes and integrate multiple, seemingly disparate, topics into a single streamlined concept. Our resulting definition is as follows: Global Oral Health aims for optimal oral health for all people and elimination of global health inequities through health promotion, disease prevention, and appropriate oral care approaches that consider common determinants and solutions and acknowledge oral health as part of overall health . The purpose of this short communication is to generate a narrative around our proposed definition of global oral health to support establishing guidelines and developing best practices for academic global oral health programs, policies, and practices that aim to achieve a goal of oral health globally.

Background: Orthodontic braces have become symbols of wealth and fashion accessories in some parts of the world. However, there is a scarcity of information about the effects of fashion braces on various aspects of quality of life. Therefore, our aim was to investigate the effects of fashion braces on oral health related quality of life (OHRQoL)., Methods: A cross-sectional study was carried out with data collection from a Google form questionnaire distributed in Saudi Arabia via various forms of social media over a period of 4 months. OHRQoL was assessed using the validated Arabic version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The fashion braces group included respondents who had braces installed for fashion purposes only. Therapeutic braces group included subjects who were wearing braces to treat any malocclusion problems. Control group included subjects who did not have any kind of braces. People who had previously completed orthodontic treatments were excluded from the study. The negative impacts were divided into seven domains and a total OHIP score was calculated. Statistical analyses and data illustration were performed with SPSS v25 (IBM, NY)., Results: A total of 1141 people voluntarily participated in the study. More than 60% of the participants were in the control group while 33.7% had conventional braces for therapeutic reasons and 3.4% had fashion braces. Sociodemographic distributions varied among the groups, with the majority of the fashion braces group having education below the university level and family incomes less than average. There were significant group differences in OHIP domains. Physical pain was the most frequently reported complaint by all subjects and was the highest in the therapeutic braces group. People with therapeutic braces reported significantly higher functional limitation and physical disability than the controls. Fashion braces group reported significantly lower psychological discomfort and disability, social disability and handicap compared to control groups., Conclusions: The illustrated effects of fashion braces on OHRQoL suggest the need to study the role of social media and educate the public on the use of braces to minimize the negative effects experienced by individuals.

Background: Mindfulness-based programs show promise for promoting smoking cessation in diverse populations. Mobile health strategies could increase treatment engagement and in-the-moment support, thus enhancing the effects of mindfulness-based smoking cessation interventions. However, most mobile health programs have been developed without sufficient input from the target population., Objective: By eliciting input from the target population, predominantly low socioeconomic status (SES) African American adult smokers, throughout the development of an SMS (short message service) text messaging program that teaches mindfulness for smoking cessation, we aimed for the resulting program to be optimally effective and consistent with participants' needs and preferences., Methods: Two qualitative studies (N=25) were conducted with predominantly low SES, African American adult smokers. In Study 1 (initial qualitative input; n=15), participants engaged in focus groups to provide suggestions for program development. In Study 2 (abbreviated trial; n=10), participants received a 1-week version of the SMS text messaging program and provided feedback through in-depth interviews., Results: In Study 1, participants suggested that the SMS text messaging program should be personalized and interactive (ie, involve two-way messaging); provide strategies for coping with cravings and recovering from smoking lapses; involve relatively short, to-the-point messages; and include pictures. In Study 2, participants were highly engaged with the texts, indicated that the program was useful, and provided additional suggestions for improvement., Conclusions: Eliciting feedback from the target population throughout the intervention development process allowed for iterative revisions to increase feasibility, acceptability, and effectiveness. Overall, SMS text messaging appears to be a feasible, appealing way to provide in-the-moment personalized support and encourage mindfulness among low-income African American smokers., (©Claire A Spears, Sharrill A Bell, Charlayne A Scarlett, Natalie K Anderson, Cherell Cottrell-Daniels, Sadaf Lotfalian, Maitreyi Bandlamudi, Amanda Grant, Anna Sigurdardottir, Brittani P Carter, Lorien C Abroms, David W Wetter. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 07.01.2019.)

Objective: To examine cognitive and affective mechanisms underlying mindfulness-based addiction treatment (MBAT) versus cognitive-behavioral therapy (CBT) and usual care (UC) for smoking cessation., Method: Participants in the parent study from which data were drawn (N = 412; 54.9% female; 48.2% African American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual income <$30,000) were randomized to MBAT (n = 154), CBT (n = 155), or UC (n = 103). From quit date through 26 weeks postquit, participants completed measures of emotions, craving, dependence, withdrawal, self-efficacy, and attentional bias. Biochemically confirmed 7-day smoking abstinence was assessed at 4 and 26 weeks postquit. Although the parent study did not find a significant treatment effect on abstinence, mixed-effects regression models were conducted to examine treatment effects on hypothesized mechanisms, and indirect effects of treatments on abstinence were tested., Results: Participants receiving MBAT perceived greater volitional control over smoking and evidenced lower volatility of anger than participants in both other treatments. However, there were no other significant differences between MBAT and CBT. Compared with those receiving UC, MBAT participants reported lower anxiety, concentration difficulties, craving, and dependence, as well as higher self-efficacy for managing negative affect without smoking. Indirect effects of MBAT versus UC on abstinence occurred through each of these mechanisms., Conclusions: Whereas several differences emerged between MBAT and UC, MBAT and CBT had similar effects on several of the psychosocial mechanisms implicated in tobacco dependence. Results help to shed light on similarities and differences between mindfulness-based and other active smoking cessation treatments. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Pain from local anesthesia injections can be reduced by distraction and counter-stimulation techniques. This study investigated the DentalVibe® Injection Comfort System (third-generation, DV3), developed to lessen anesthesia pain through pulsed vibration, a form of counter-stimulation. The aim of the study was to evaluate both the efficacy of DV3 in reducing pain and discomfort from intraoral long buccal (LB) and inferior alveolar nerve (IAN) injections and the time needed to achieve complete anesthesia during an IAN block. The study enrolled 60 subjects, 30 men and 30 women, aged 21 to 32 years, who rated both injection pain on a visual analog scale and discomfort, unpleasantness, and difficulty in enduring the injection on a modified symptom severity index. Each subject received bilateral LB injections and an IAN block. Using block design, the third-generation DV (DV3) was randomly assigned to either the first or second LB injection and to 30 subjects on their third injection, the IAN block. No topical anesthesia was applied. Subjects receiving DV3 reported significantly less pain, discomfort, unpleasantness, and difficulty in enduring LB and IAN injections (P < .05), regardless of whether DV3 was used on the first or second LB injection. Time to complete anesthesia was not significantly different (P > .05) when DV3 was used on IAN block injections. The DV3 significantly (P < .02) reduced pain/discomfort from anesthetic injections in this pilot study, in which many subjects were either dental or medical students familiar with performing and enduring injections. More studies are warranted on layperson populations.

The aim of this study was to evaluate whether the objective structured clinical examination (OSCE) and case presentation (CP) as forms of active assessment were effective measures of overall didactic knowledge and clinical performance in a predoctoral dental curriculum. This evaluation was conducted by statistical analysis of quality points (QP) awarded for didactic and clinical performance, CP grades, and OSCE scores for 185 students at Harvard School of Dental Medicine who graduated during the period 2010-14. As part of the requirements for graduation, each student takes three OSCEs and presents two patient cases. Data for the study were obtained from the Office of the Registrar. The results showed no direct correlation between QP and CP grades and no correlation between CP grades and OSCE scores. However, there was a correlation between OSCE scores and QP. Students with honors-level scores on any of the three OSCEs received significantly more QP than students who did not receive honors. In addition, students with passing scores on OSCEs 2 and 3 received significantly more QP than students with failing or marginal OSCE scores. Innovative formats of active assessment such as OSCEs and CPs can promote a student-centered learning environment. These data indicated that, within this study population, there was a positive association between OSCE scores and clinical and didactic performance, supporting the value of OSCEs as a means of assessment.

Well-conducted systematic reviews can provide a foundation upon which to base educational curricula, practice guidelines and healthcare policy. We aim to provide an overview of important methodological issues that need to be addressed during the five phases of performing a systematic review. 1. The specific problems to be addressed by the systematic review need to be formulated as clear, unambiguous and structured question/s. 2. Literature from multiple resources should be searched to avoid publication biases, as positive outcomes are more likely to be published than null/negative results. 3. The quality of selected articles should be assessed using a checklist, while the reliability of graders, as well as the quality of the checklist, needs to be established a priori. 4. Statistical heterogeneity needs to be assessed to determine if a meta-analysis is appropriate to pool the data. If not, a narrative synthesis of the evidence/overall findings needs to be performed within a clinical context., (© The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Unlabelled: It is recommended that health-related materials for patients be written at sixth grade level or below. Many websites oriented toward patient education about dental implants are available, but the readability of these sites has not been evaluated., Objective: To assess readability of patient-oriented online information on dental implants., Materials and Methods: Websites containing patient-oriented information on dental implants were retrieved using the Google search engine. Individual and mean readability/grade levels were calculated using standardized formulas. Readability of each website was classified as easy (≤ 6th-grade level) or difficult (≥ 10th grade level)., Results: Thirty nine websites with patient-oriented information on dental implant were found. The average readability grade level of these websites was 11.65 ± 1.36. No website scored at/below the recommended 6th grade level. Thirty four of 39 websites (87.18%) were difficult to read. The number of characters, words, and sentences on these sites varied widely., Conclusion: All patient-oriented websites on dental implants scored above the recommended grade level, and majority of these sites were "difficult" in their readability. There is a dire need to create patient information websites on implants, which the majority can read., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: As large-scale genome sequencing technology advances, concerns surrounding the reporting of individual findings to study volunteers have grown and fueled controversy. This is especially true in mental health research, where the clinical importance of sequencing results is particularly unclear. The ethical, legal, and social issues are being widely debated, but less is known about the attitudes of actual study volunteers toward sequencing studies or what they wish to learn about their DNA sequence and its health implications. This study provides information on psychiatric research volunteers' attitudes, beliefs, and concerns with respect to participation in DNA sequencing studies and reporting of individual results., Method: We conducted a pilot study using a questionnaire that we developed to assess what information volunteers in an ongoing family study of bipolar disorder would like to receive if they underwent genome sequencing, what they would do with that information, and what concerns they may have., Results: Almost all of the respondents were willing to participate in genome sequencing. Most respondents wished to be informed about all their health-related genetic risks, including risks for diseases without known prevention or treatment. However, few respondents felt well informed about the nature of genome sequencing or its implications for their health, insurability, or offspring., Conclusions: Despite generally positive attitudes toward genome sequencing among study volunteers, most are not fully aware of the special issues raised by genome sequencing. The attitudes of study volunteers should be considered in the debate about the reporting of individual findings from genome sequencing.

We evaluated the Oral Physician Program, a dental residency sponsored by Harvard Medical School, Harvard School of Dental Medicine, and the Cambridge Health Alliance that offers an innovative model for training dentists to provide limited primary care. The didactic and clinical experiences increased residents' medical knowledge and interviewing skills, and faculty assessments supported their role as oral physicians. Oral physicians could increase patients'-especially patients from underserved groups-access to integrated oral and primary care services.

Children with unilateral cleft lip and palate (UCLP) suffer from negative public perceptions. A better treatment strategy should be established to help them live an ordinary life with improved perceptions. To do that, it is important to understand the relationship between physical facial features and perceptual judgment. In this paper, we present FaceReview, a new visualization system to support interactive exploration of a heterogeneous multidimensional dataset with facial measurement data and subjective judgment data. To seamlessly link the two data, we design FaceReview based on information visualization techniques that are proven to be useful and therefore commonly used, such as brushing and linking, small multiples, and dynamic query. Our design decisions successfully support exploratory tasks of our collaborators. We present a case study to show the efficacy of FaceReview.

Objectives: To test the hypothesis that the sagittal position of the anterior teeth has no effect on pharyngeal airway dimension or hyoid bone position and to investigate the influence of orthodontic retraction of the anterior teeth on each section of pharynx and hyoid position., Materials and Methods: Forty-four Class I bimaxillary protrusion adults, treated with preadjusted appliances and maximum anchorage after extraction of four premolars, were divided into two groups according to their vertical craniofacial skeletal patterns. Pretreatment and posttreatment variables were compared using paired t-test, and the relationship between pharyngeal airway size and dentofacial variables was analyzed using Pearson correlation coefficient. The changes of pharyngeal airway size and hyoid position after treatment were compared between two groups using independent t-test., Results: Upon retraction of the incisors, the upper and lower lips were retracted by 2.60 mm and 3.87 mm, respectively. The tip of upper incisor was retracted by 6.84 mm and lower incisor retracted by 4.95 mm. There was significant decrease in SPP-SPPW, U-MPW, TB-TPPW, V-LPW, VAL, C3H, and SH (P < .05). No statistically significant different changes were observed in the dentofacial structures, pharyngeal airway, and hyoid position between the two groups after the treatment. There was a significant correlation between the retraction distance of lower incisor and the airway behind the soft palate, uvula, and tongue., Conclusions: The pharyngeal airway size became narrower after the treatment. Extraction of four premolars with retraction of incisors did affect velopharyngeal, glossopharyngeal, hypopharyngeal, and hyoid position in bimaxillary protrusive adult patients.

Objective: To determine pain levels, function, and psychological symptoms in relation to predominant sidedness of pain (right or left) and gender in patients being treated for chronic spinal pain., Design: Prospective cohort study., Patients: Patients with chronic neck or low back pain undergoing a nerve block procedure in a specialty pain medicine clinic. INTERVENTIONS/OUTCOMES: Patients completed the Hospital Anxiety and Depression Scale and the Brief Pain Inventory just prior to the procedure. Pain history and demographic variables were collected from a chart review. Chi-square, Pearson correlations, and multivariate statistics were used to characterize the relationships between side of pain, gender, pain levels, pain interference, and psychological symptoms., Results: Among 519 subjects, men with left-sided pain (N = 98) were found to have significantly greater depression and anxiety symptoms and worse pain-related quality of life (P < 0.01), despite having similar pain levels as men with right-sided pain (N = 91) or women with left- or right-sided pain (N = 289). In men, psychological symptoms had a significantly greater correlation with pain levels than in women (P < 0.01)., Conclusion: In this sample, men with left-sided spinal pain report worse quality of life and more psychological symptoms than women. These data provide clinical evidence corroborating basic neuroscience findings indicating that the right cerebral hemisphere is preferentially involved in the processing of pain and negative affect. These data suggest that men appear more right hemisphere dominant in pain and affect processing. These findings have implications for multidisciplinary assessment and treatment planning in men., (Wiley Periodicals, Inc.)

Introduction: The aim of this study was to determine whether 2-dimensional (2D) images produced from cone-beam computed tomography (CBCT) images taken with an iCAT scanner (Imaging Sciences International, Hatfield, Pa) can substitute for traditional cephalograms., Methods: Lateral and frontal cephalograms were taken of a radiographic phantom with known dimensions. Landmarks on the 2D images were traced and measured manually by 2 examiners and then digitally in Dolphin 10 (Dolphin Imaging Sciences, Chatsworth, Calif) by the same examiners. A CBCT scan was taken of the phantom, and orthogonal and perspective projections were created from the scans. Frontal and lateral cephalograms were created by using the 3-dimensional function in Dolphin 10, digitized into Dolphin, and traced by the same 2 examiners. Linear measurements were compared to assess the accuracy of the generated images from the CBCT scans., Results: Measurements on the orthogonal projections were not significantly different from the actual dimensions of the phantom, and measurements on the perspective projections were highly correlated with those taken on standard 2D films., Conclusions: By constructing a perspective lateral cephalogram from a CBCT scan, one can replicate the inherent magnification of a conventional 2D lateral cephalogram with high accuracy.

Objective: To demonstrate the usefulness of a new imaging system for comparing the morphometric bases of children's self-perception of their facial profile with the perceptions of their mothers and treating clinicians., Materials and Methods: Rather than choosing among a series of static images, a computer imaging program was developed to elicit a range of acceptable responses or tolerance for change from which a midpoint of acceptability was derived. Using the method of Giddon et al, three profile features (upper and lower lips and mandible) from standardized images of 24 patients aged 8- 15 years were distorted and presented to patients, parents, and clinicians in random order as slowly moving images (four frames per second) from retrusive and protrusive extremes. Subjects clicked the mouse when the image became acceptable and released it when it was no longer acceptable. Subjects responded similarly to a neutral facial profile., Results: Patients and their mothers overestimated the protrusiveness of the mandible of the actual pretreatment profile. Consistent with related studies, mothers had a smaller tolerance for change in the soft tissue profile than the children or clinicians. The magnitudes of the children's self-preference and preferred change in a neutral face were also significantly correlated. Both patients and mothers preferred a more protrusive profile than that of the actual or neutral face for the patient and neutral face., Conclusion: Imaging software can be used with children to compare their preferences with those of parents and clinicians to facilitate treatment planning and patient satisfaction.

Aim: The purpose of this study was to determine differences in preference for Korean American facial profiles among Korean American orthodontic patients with 2 levels of acculturation, Asian American orthodontists, and Caucasian orthodontists., Methods: Images of 1 male and 1 female Korean American adult were animated to move parts of the faces from an extreme retrusive position to an extreme protrusive position by using the Perceptometrics computer program. Three movies were created of the nose, lips, and chin for each image. Three groups of judges, ie, 18 Korean American orthodontic patients, 17 Asian orthodontists, and 18 Caucasian orthodontists selected the most pleasing position and the zone of acceptability as a measure of tolerance., Results: Statistically significant differences were found between Caucasian orthodontists and Korean American orthodontic patients for the most pleasing and midpoint of acceptability positions of female nose and male chin, with no differences in the zone of acceptability position among the groups., Conclusion: In general, the Korean American orthodontic patients preferred a more protrusive nose on the female image and more retrusive chin on the male image than Caucasian orthodontists for the most pleasing and midpoint of acceptability positions, with similar zone of acceptability for all 3 groups.

Introduction: Facial profile disharmonies in the anteroposterior (AP) position of the mandible are among the most frequent reasons that patients seek orthodontic treatment. Various methods are available for assessing profile preferences, and differences between them could affect treatment decisions. The purposes of this study were to compare and contrast 3 methods of evaluating profile preferences for the AP position of the mandible., Methods: Facial profile preferences of white orthodontists (n = 28) and white (n = 56) and Japanese-American (n = 55) laypeople were evaluated. The esthetic significance of variations in the AP position of the mandible was investigated by using 3 methods: a traditional semantic differential scale, the Perceptometrics method (Health Programs Intl, Wellesley, Mass), and the implicit association test (IAT)., Results: Findings from the semantic differential scale show that, overall, there is a general preference among orthodontists and laypeople for an orthognathic profile (P <.001). Findings from the Perceptometrics method indicate that orthodontists consider the most pleasing profile to be more forward than do lay subjects (P <.001). The IAT results show a positive bias among all 3 groups toward orthognathic profiles and a negative bias toward profiles with mandibular retrognathism or prognathism. The IAT suggested that laypeople were more tolerant of mandibular prognathism in men than in women (P <.01), and more tolerant of mandibular retrognathia in white women than in men (P = .03)., Conclusions: These results support the benefits of using both implicit and explicit methods to assess facial profile preferences.

Introduction: The purposes of this study were to determine (1) profile preferences of black female patients and (2) whether they can recognize their own profile images before and after orthodontic treatment., Methods: Fifteen black orthodontists, 15 white orthodontists, and 15 black female patients were asked to indicate the images they considered most pleasing and to determine a zone of acceptability for 3 black female profiles. Raters used the PERCEPTOMETRICS computer program (Health Programs International, Wellesley, Mass). In addition, the 15 patients were asked to identify their most accurate pretreatment and posttreatment profile images., Results: Analyses of variance showed that the white orthodontists preferred flatter profiles than the black women, who in turn preferred fuller profiles than the black orthodontists. Significant differences in lip position were detected for most pleasing and midpoint of acceptability among the 3 groups of judges, with no significant differences in any variables measured between treatments in rating the 3 images. No significant differences were detected for the magnitude of the zone of acceptability. All 15 black women recalled having fuller profiles than they actually did before treatment, but they could correctly identify their own profile images after treatment., Conclusions: The results of this study will facilitate the understanding of the physical bases of the esthetic judgments of black and white orthodontists and black female patients.

The objective of this study was to determine differences between Mexican American and Caucasian judges in the acceptability of lip protrusion in computer animations of two male and two female persons of Mexican descent. Thirty Caucasians and 30 Mexican Americans of varying age, sex, education, and level of acculturation responded to facial profile computer animations that moved lips from an extreme protrusive to an extreme retrusive position. Judges were asked to complete two tasks: (1) to press the mouse button when the image was perceived to be most pleasing (MP) and (2) to determine the boundaries of a zone of acceptability (ZA) of lip protrusion by pressing the mouse button when the moving image became acceptable and releasing it when the image of the protrusion became unacceptable. In general, Mexican Americans preferred upper or lower lip positions to be less protrusive than did Caucasians. Larger mean ZAs for both upper and lower lip positions with male computer animation images and lower lip position for female computer animation images were found among Caucasians when compared with low-acculturated Mexican Americans. A significant mean difference in midpoint of acceptability (MA) for lip position between Caucasians and low-acculturated Mexican Americans was observed for both upper and lower lip position with female computer animation images.

Trans fatty acids (TFA) are found naturally in some foods (e.g., dairy products) as well as many processed foods made with partially hydrogenated vegetable oils (PHVO). Data from a growing literature suggest that some TFA decrease milk fat in lactating animals. Because the physiologic effects of TFA in lactating women are unknown, this study was designed to investigate the effects of TFA consumption on human milk fat. A randomized, crossover design (n = 12) was used to study the effect of 3 dietary treatments: high PHVO (regular margarine), low PHVO (low TFA margarine), or low PHVO but high in naturally occurring TFA (butter) on milk fat. Treatments were administered for 5 d, with 7-d washout periods. Maternal adiposity was estimated by dual-energy X-ray absorptiometry. Milk and blood were collected on d 5 of each intervention period. In general, milk and serum fatty acid concentrations mirrored those of the dietary treatments. There were significant interactions between treatment and maternal adiposity on milk fat and infant milk consumption, as well as on serum glucose and nonesterified fatty acid (NEFA) concentrations. Consumption of regular margarine, compared with low TFA margarine, resulted in lower milk fat in leaner, but not in more obese women. Consumption of either regular or low TFA margarine, compared with butter, elevated serum NEFA concentrations in the more obese women. In summary, consumption of regular margarine, compared with low TFA margarine, decreased milk fat in lean women. Further studies are required to determine whether infant milk consumption might compensate for this potentially important change in milk composition.

Purpose: Although scientific publications differ in displaying left- or right-facing profiles, there are few systematic studies of the possible effects of directional biases and laterality on patients' and clinicians' perceptions of treatment need, outcomes, and satisfaction. As part of a research program to quantitate the physical bases of the perceived zone of acceptability and most-pleasing facial profiles, responses to computer-animated left- and right-facing soft-tissue profile images were compared and related to eye and hand preference., Materials and Methods: Standardized left-facing, soft-tissue profile images were captured in color and digitized. The right-facing profile was created by reversing the left profile image to display a mirror image. Using imaging and customized morphing software, retrusive and protrusive extremes were created, from which transitional frames were developed to display five features of the soft-tissue profile: upper lip, chin, bimaxillary position, lower face height, and mandible. One left- and one right-facing profile for a Class II division 1 female, and Class III male were randomly presented to 24 subjects who were asked to indicate: 1) acceptability by pressing a mouse button and releasing the button when the images were no longer acceptable; and 2) most-pleasing image by pressing the mouse button once., Results: No differences were found between left- and right-profile images for zone of acceptability, midpoint of the zone of acceptability, or most pleasing; nor was there any relation to laterality measures. However, consistently higher intercorrelations among the features for the zone of acceptability were found for the left- than for the right-facing profiles for retrusive to protrusive and protrusive to retrusive excursions measured in millimeters (p < .001). The bimaxillary position accounted for most of the variance in judgments of acceptability with greater influence on the left than on the right profile., Conclusion: With the increasing use of computer-imaging in dental practices, the influence of psychophysical and other environmental variables on perception must be considered.