The reliability, validity and sensitivity of an individualised sub-maximal fitness test in elite rugby league athletes.

We aimed to examine the reliability, validity and sensitivity of an individualised sub-maximal fitness test (SMFTIFT60). Nineteen elite rugby league players performed a one-week test-retest of SMFTIFT60. Typical Errors and ICCs were: small (<3.5%) and extremely high (>0.90) for accelerometer-derived variables; moderate (<2.5% points) and moderate to very high (0.71-0.89) for exercise and recovery heart rate (HRex and HRR, respectively). Convergent validity correlations with the 10-week pre-season change in 30-15 Intermittent Fitness Test performance were large for changes in SMFTIFT60 HRex (r = -0.57) and HRR (0.60), and very large for changes in accelerometer measures (range: -0.71 to -0.79). For sensitivity, within-player dose-response relationships between SMFTIFT60 HRex and prior 3-day training loads were negative and ranged from moderate (session ratings of perceived exertion [sRPE-TL], r = -0.34), to large (high-speed running distance, -0.51; acceleration load, -0.73) and very large (heart rate Training Impulse [TRIMP], -0.83). All other relationships were unclear or trivial to small. Physiological and accelerometer-derived measures from the SMFTIFT60 are reliable and valid for the assessment of fitness in rugby league players. Only HRex appears sensitive to acute changes in training load. The SMFTIFT60 could be a useful monitoring tool in team sports.

Predictors of oropharyngeal cancer survival in Europe.

OBJECTIVES: HPV16-positive oropharyngeal cancer (OPC) patients experience better outcomes compared to HPV16-negative patients. Currently, strategies for treatment de-escalation are based on HPV status, smoking history and disease stage. However, the appropriate cut-point for smoking and the role of other non-clinical factors in OPC survival remains uncertain. MATERIALS AND METHODS: We examined factors associated with OPC outcome in 321 patients recruited in a large European multi-center study. Seropositivity for HPV16 E6 was used as a marker of HPV16 positive cancer. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox proportional models adjusted for potential confounders. RESULTS: Overall 5-year survival following OPC diagnosis was 50%. HPV16-positive OPC cases were at significantly lower risk of death (aHR = 0.51, 95% CI: 0.32-0.80). A significant effect on OPC survival was apparent for female sex (aHR 0.50: 95% CI: 0.29-0.85) and being underweight at diagnosis (aHR: 2.41, 95% CI: 1.38-4.21). A 10 pack year smoking history was not associated with overall survival. Higher stage at diagnosis appeared as the only factor significantly associated with OPC recurrence (aHR: 4.88, 95% CI: 2.12-11.21). CONCLUSION: This study confirms that HPV16 status is an independent prognostic factor for OPC survival while female sex lowers risk of death and being underweight at diagnosis increases the risk of death. Smoking was not an independent predictor of OPC survival.

Differences Between Relative and Absolute Speed and Metabolic Thresholds in Rugby League.

PURPOSE: To compare relative and absolute speed and metabolic thresholds for quantifying match output in elite rugby league. METHODS: Twenty-six professional players competing in the National Rugby League were monitored with global positioning systems (GPS) across a rugby-league season. Absolute speed (moderate-intensity running [MIRTh > 3.6 m/s] and high-intensity running [HIRTh > 5.2 m/s]) and metabolic (>20 W/kg) thresholds were compared with individualized ventilatory (first [VT1IFT] and second [VT2IFT]) thresholds estimated from the 30-15 Intermittent Fitness Test (30-15IFT), as well as the metabolic threshold associated with VT2IFT (HPmetVT2), to examine difference in match-play demands. RESULTS: VT2IFT mean values represent 146%, 138%, 167%, and 144% increases in the HIR dose across adjustables, edge forwards, middle forwards, and outside backs, respectively. Distance covered above VT2IFT was almost certainly greater (ES range = 0.79-1.03) than absolute thresholds across all positions. Trivial to small differences were observed between VT1IFT and MIRTh, while small to moderate differences were reported between HPmetVT2 and HPmetTh. CONCLUSIONS: These results reveal that the speed at which players begin to run at higher intensities depends on individual capacities and attributes. As such, using absolute HIR speed thresholds underestimates the physical HIR load. Moreover, absolute MIR and high metabolic thresholds may over- or underestimate the work undertaken above these thresholds depending on the respective fitness of the individual. Therefore, using relative thresholds enables better prescription and monitoring of external training loads based on measured individual physical capacities.

The Validity and Reliability of Global Positioning Systems in Team Sport: A Brief Review.

The use of global positioning systems (GPS) has increased dramatically over the last decade. Using signals from orbiting satellites, the GPS receiver calculates the exact position of the device and the speed at which the device is moving. Within team sports GPS devices are used to quantify the external load experienced by an athlete, allowing coaches to better manage trainings loads and potentially identify athletes who are overreaching or overtraining. This review aims to collate all studies that have tested either (or both) the validity or reliability of GPS devices in a team sport setting, with a particular focus on (a) measurements of distance, speed, velocities, and accelerations across all sampling rates and (b) accelerometers, player/body load and impacts in accelerometer-integrated GPS devices. A comprehensive search of the online libraries identified 22 articles that fit search criteria. The literature suggests that all GPS units, regardless of sampling rate, are capable of tracking athlete's distance during team sport movements with adequate intraunit reliability. One Hertz and 5Hz GPS units have limitations in their reporting of distance during high-intensity running, velocity measures, and short linear running (particularly those involving changes of direction), although these limitations seem to be overcome during measures recorded during team sport movements. Ten Hertz GPS devices seem the most valid and reliable to date across linear and team sport simulated running, overcoming many limitations of earlier models, whereas the increase to 15Hz GPS devices have had no additional benefit.

Aspirin and non-steroidal anti-inflammatory drug use and the risk of upper aerodigestive tract cancer.

BACKGROUND: Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are widely used as analgesics and preventative agents for vascular events. It is unclear whether their long-term use affects cancer risk. Data on the chemopreventative role of these drugs on the risk of the upper aerodigestive tract cancer (UADT) are insufficient and mostly refer to oesophageal cancer. The aim of this study was to investigate the effect of aspirin and other NSAIDs on the risk of UADT cancers. METHODS: A nested case-control study using the Primary Care Clinical Informatics Unit (PCCIU) database. Conditional logistics regression was used for data analysis. RESULTS: There were 2392 cases of UADT cancer diagnosed between 1996 and 2010 and 7165 age-, gender- and medical practice-matched controls from 131 general medical practices. Mean age of cases was 66 years (s.d. 12) and most were male (63%). Aspirin was prescribed in a quarter of cases and controls, COX-2 inhibitors in 4% of cases and 5% of controls and other NSAIDs in 33% of cases and 36% of controls. Aspirin prescription was associated with a nonsignificant risk reduction of cancer of UADT (adjusted OR=0.9, 95% CI=0.8, 1.0), head and neck (HN; adjusted OR=0.9, 95% CI=0.7, 1.1) or the oesophagus (adjusted OR=0.8, 95% CI=0.7, 1.0). Similar results were found for COX-2 inhibitors prescription. Prescription of other NSAIDs was associated with significantly reduced risk of cancer of UADT (adjusted OR=0.8, 95% CI=0.7, 0.9), HN (adjusted OR=0.8, 95% CI=0.7, 0.9) and the oesophagus (adjusted OR=0.8, 95% CI=0.7, 0.9). An increased volume of aspirin prescriptions was associated with a significant risk reduction (test for trend P<0.001). CONCLUSIONS: The decreased risk of cancer of the UADT associated with the use of non-COX-2 inhibitors, NSAIDs and long-term aspirin therapy warrants further exploration of the benefits vs risks of the use of these agents.

Calibration of the modified Huddart and Bodenham scoring system against the GOSLON/5-year-olds' index for unilateral cleft lip and palate.

The GOSLON/5-year-old scoring systems have been used in various national and international studies. This study aims to identify the range of Modified Huddart and Bodenham (MHB) scores, which correlate with each GOSLON and 5-year-old category and thereby create a new scoring system that allows comparison with historical data. Two hundred and eighty-three unilateral cleft lip and palate study models from England and Scotland that had all been previously scored using the 5-year-old and GOSLON indices by calibrated examiners were scored using MHB on two separate occasions a month apart by two examiners. Reliability analysis using intraclass correlation and Bland Altman plots were performed. Ordinal regression was used to define the categories of MHB that correspond to the 5-year-old and GOSLON categories. The results revealed a high level of repeatability for both the 5 and the 10 year old models. The MHB scale was grouped into the five categories of the GOSLON and 5-year-old indices with more precision for the 5 year than the 10 year scores. In conclusion, there was high intra-examiner and inter-examiner agreement using the MHB scoring system. It also correlates well with the 5-year-old and GOSLON indices and has been shown to be a much more sensitive scoring system.

Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

BACKGROUND: The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer. METHODS: A multicentre (10 European countries) case-control study [Alcohol-Related CAncers and GEnetic susceptibility (ARCAGE) project]. RESULTS: There were 1779 cases of UADT cancer and 1993 controls. History of warts or C. albicans infection was associated with a reduced risk [odds ratio (OR) 0.80, 95% confidence interval (CI) 0.68-0.94 and OR 0.73, 95% CI 0.60-0.89, respectively] but there was no association with herpetic lesions, heartburn, regurgitation or medication for related symptoms. Regurgitation was associated with an increased risk for cancer of the oesophagus (OR 1.47, 95% CI 0.98-2.21). Regular aspirin use was not associated with risk of UADT cancer overall but was associated with a reduced risk for cancer of oesophagus (OR 0.51, 95% CI 0.28-0.96), hypopharynx (OR 0.53, 95% CI 0.28-1.02) and larynx (OR 0.74, 95% CI 0.54-1.01). CONCLUSIONS: A history of some infections appears to be a marker for decreased risk of UADT cancer. The role of medical history and medication use varied by UADT subsites with aspirin use associated with a decreased risk of oesophageal cancer and suggestive of a decreased risk of hypopharyngeal and laryngeal cancers.

Life course social mobility and risk of upper aerodigestive tract cancer in men.

The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H --> H, H --> M, H --> L, M --> H, M --> M, M --> L, L --> H, L --> M and L --> L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04-1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H --> L gave an OR of 1.71 [0.75-3.87] as compared to H --> H. Subjects with M --> M and L --> L trajectories ORs were also elevated relative to subjects with H --> H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.

Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe.

INTRODUCTION: In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year--more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet. PATIENTS AND METHODS: A multicentre case-control study with 2198 cases of UADT cancer and 2141 controls from hospital and population sources was undertaken involving 14 centres from 10 countries. Personal interviews collected information on demographics, lifetime occupation history, smoking, alcohol consumption and diet. Socioeconomic status was measured by education, occupational social class and unemployment. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. RESULTS: When controlling for age, sex and centre significantly increased risks for UADT cancer were observed for those with low versus high educational attainment OR=1.98 (95% CI 1.67, 2.36). Similarly, for occupational socioeconomic indicators--comparing the lowest versus highest International Socio-Economic Index (ISEI) quartile for the longest occupation gave OR=1.60 (1.28, 2.00); and for unemployment OR=1.64 (1.24, 2.17). Statistical significance remained for low education when adjusting for smoking, alcohol and diet behaviours OR=1.29 (1.06, 1.57) in the multivariate analysis. Inequalities were observed only among men but not among women and were greater among those in the British Isles and Eastern European countries than in Southern and Central/Northern European countries. Associations were broadly consistent for subsite and source of controls (hospital and community). CONCLUSION: Socioeconomic inequalities for UADT cancers are only observed among men and are not totally explained by smoking, alcohol drinking and diet.

Vertical marginal and internal adaptation of all-ceramic copings made by CAD/CAM technology.

Vertical marginal and internal adaptation scores of all-ceramic copings made by Computer aided manufacturing/ computer aided design (CAD/CAM) were investigated. Scores were compared between Procera all-ceram copings, Cerec-in-lab copings and IPS Empress 2 copings. A stereomicroscope was used (at x45) to measure vertical marginal scores and also used to measure internal adaptation after dies were sectioned. Procera copings showed better vertical marginal adaptations on dies and master preparation and internal adaptation on dies than both IPS Empress 2 and Cerec- in-lab copings. All copings appeared to produce vertical marginal and internal adaptation scores well within the maximum clinically acceptable gaps.

The effect of voice recognition software on comparative error rates in radiology reports.

This study sought to confirm whether reports generated in a department of radiology contain more errors if generated using voice recognition (VR) software than if traditional dictation-transcription (DT) is used. All radiology reports generated over a 1-week period in a British teaching hospital were assessed. The presence of errors and their impact on the report were assessed. Data collected included the type of report, site of dictation, the experience of the operator, and whether English was the first language of the operator. 1887 reports were reviewed. 1160 (61.5%) were dictated using VR and 727 reports (38.5%) were generated by DT. 71 errors (3.8% of all reports) were identified. 56 errors were made using VR (4.8% of VR reports), whereas 15 errors were identified in DT reports (2.1% of transcribed reports). The difference in report errors between these two dictation methods was statistically significant (p = 0.002). Of the 71 reports containing errors, 37 (52.1%) had errors that affecting understanding. Other factors were also identified that significantly increased the likelihood of errors in a VR-generated report, such as working in a busy inpatient environment (p<0.001) and having a language other than English as a first language (p = 0.034). Operator grade was not significantly associated with increased errors. In conclusion, using VR significantly increases the number of reports containing errors. Errors using VR are significantly more likely to occur in noisy areas with a high workload and are more likely to be made by radiologists for whom English is not their first language.

The changing face of infection: a comparative review of admissions to a regional infection unit over three decades.

BACKGROUND AND AIMS: Our group previously published retrospective analyses of 12 months of admissions to the Grampian Regional Infectious Diseases Unit from 1980-81 and from 1991. This study aimed to collect data in 2001 and to compare annual admission numbers, diagnoses, duration of stay and outcome in 1980-81, 1991 and 2001. METHODS: Data on all admissions was collected prospectively throughout 2001. This was compared with the previously published data. RESULTS: Total admissions rose from 605 in 1980-81 to 900 in 1991 and to 1152 in 2001. Sixty one percent of admissions in 1980-81 were confirmed as having infection compared to 72% in 1991 and to 83% in 2001. The most common reason for admission in 2001 was skin and soft tissue infection, but this was only the ninth commonest reason in 1981. Mean length of stay fell from 9.6 days in 1980-81 to 7.4 days in 1991 and to 5.5 days in 2001. The mortality rate fell from 3.1% in 1981 and 1991 to 1.0% in 2001. CONCLUSIONS: This study demonstrates significant changes in type, number and outcome of admissions to a regional infection unit. We discuss possible reasons for these changes.

The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995-2004.

OBJECTIVES: This study aimed at investigating aspects of the epidemiology and chronobiology of emergency admissions with epistaxis in Scotland between 1995 and 2004. In particular, we sought to examine the epidemiology of hospital admission with epistaxis and effects of factors such as day of week, time of year and lunar cycle. DESIGN: A statistical analysis, in terms of descriptive statistics, logistical regression and linear regression, was carried out on data obtained from the Scottish Morbidity Records related to emergency Ear, Nose and Throat (ENT) admissions. SETTING AND PARTICIPANTS: All emergency inpatient admissions for Scottish residents to ENT wards in Scottish NHS hospitals during the 10-year period, between 1st January 1995 and December 31st 2004 were studied. This study only looked at admissions and thus excludes Accident and Emergency attendances caused by epistaxis. MAIN OUTCOME MEASURES: Age, gender, year, month and day of the week of admission were considered, as was relationship to the moon phase. RESULTS: During the study period, the mean daily admission rate with epistaxis was six. Epistaxis accounted for 33% of all ENT emergency admissions. The average age of non-epistaxis ENT emergency admission was 31 years. For epistaxis emergency admissions the median age was 70 years. There were fewer admissions in the summer months [August RR: 0.59 (95% CI: 0.54-0.65) P < 0.001]. There were more admissions at the weekends and on non-weekend public holidays [RR: -0.115 (95% CI -0.160-0.071) P < 0.001]. There was a trend towards a reduction in admission rates from the year 2001. Despite the fluctuations with season and weekday, there was no relationship with phase of the moon [RR: 0.98 (95% CI: 0.88-1.09) for day of the full moon compared with non-full moon weekday]. CONCLUSIONS: This study underlines the importance of epistaxis as the single most frequent emergency diagnosis in ENT. The frequency and patterns of admission show pronounced fluctuations. The observed increase in winter admissions confirms earlier work and may have implications for health resource allocation. Relationships between weekends/public holidays and increased admissions with epistaxis may correspond with social patterns of alcohol use (a known aetiological factor). The lunar cycle does not have an effect on the frequency of epistaxis admissions.

A randomized clinical trial comparing 'one-step' and 'two-step' orthodontic bonding systems.

OBJECTIVE: The primary objective of this prospective clinical trial was to assess the clinical bond failure rates of orthodontic brackets bonded using a self-etching primer (SEP), compared with brackets bonded using a conventional acid-etched technique with control adhesive (Transbond). A secondary aim was to investigate whether characteristics of the operator, patient or tooth bonded had any influence on bracket failure. DESIGN: Single-centre randomized controlled clinical trial. Thirty-four patients were bonded, each being randomly assigned to either the test or control adhesive. SETTING: NHS Hospital Orthodontic Department, Chester, UK. SUBJECTS: Orthodontic patients requiring fixed appliance treatment. MAIN OUTCOME MEASURES: Bond failure. MAIN OUTCOME RESULTS: Failure rates over the initial 6-month period were 2.0% (Transbond) and 1.7% (SEP) with no statistically significant difference between the two groups. Over the duration of the fixed appliance treatment, bond failure rates increased, but remained acceptable at 7.4 % (TB) and 7.0% (SEP), respectively. When operator, patient and tooth characteristics were analysed, only the bracket location was found to be significant. Maxillary brackets were more likely to fail than mandibular brackets (RR 0.47%; 95% CI 0.22, 1.03). The failure rate for brackets in our study was low when compared with previous studies. CONCLUSIONS: Both the acid-etched control and self-etching primer in combination with adhesive pre-coated brackets were successful for clinical bonding. Their combined failure rate was lower than that reported in similar trials.

Fluoridated milk for preventing dental caries.

BACKGROUND: Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of school children and the vast majority of adults. Milk provides a relatively cost-effective vehicle for fluoride in the prevention of dental caries. OBJECTIVES: To determine the effectiveness of fluoridated milk, as a means of delivering fluoride on a community basis, for preventing dental caries. SEARCH STRATEGY: We searched Cochrane Oral Health Group Trials Register (28 April 2005), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to 17 May 2005), OLDMEDLINE (1950 to 1965), EMBASE (1980 to 2005 week 20), LILACS (1982 to 17 May 2005), BBO (1986 to 17 May 2005), SIGLE (1980 to 17 May2005), Digital Dissertations (1861 to 17 May 2005) and reference lists of relevant articles. Attempts were made to identify both unpublished and ongoing studies. There were no language restrictions. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs), with an intervention or follow-up period of at least 3 years, comparing fluoridated milk with non-fluoridated milk. Primary outcome was change in caries experience, as measured by changes in decayed, missing and filled figures on tooth (dmft/DMFT) and surface (dmfs/DMFS). DATA COLLECTION AND ANALYSIS: Inclusion decisions, data extraction and quality assessment were carried out independently and in duplicate. Study authors were contacted for additional information where necessary. MAIN RESULTS: Two RCTs involving 353 children were included. For permanent teeth, after 3 years there was a significant reduction in the DMFT (78.4%, P < 0.05) between the test and control groups in one trial, but not in the other. The latter study only showed a significant reduction in the DMFT until the fourth (35.5%, P < 0.02) and fifth (31.2%,P < 0.05) years. For primary teeth, again there was a significant reduction in the dmft (31.3%, P< 0.05) between the test and control groups after 3 years in one study, but not in the other. The results could not be pooled because of the difference in concentration of fluoride in the milk. AUTHORS' CONCLUSIONS: There are insufficient studies with good quality evidence examining the effects of fluoridated milk in preventing dental caries. However, the included studies suggested that fluoridated milk was beneficial to school children, especially their permanent dentition. The data need to be supplemented by further RCTs to provide the highest level of evidence for practice.

Oral lichenoid lesions related to dental restorative materials.

OBJECTIVES: To determine the effectiveness of replacing restorations considered to be the cause of an oral lichenoid lesion (oral lichenoid reaction)(OLL). DESIGN: Clinical intervention and nine-month follow up. SETTING: The study was carried out in the University Dental Hospital of Manchester, 1998-2002. SUBJECTS AND METHODS: A total of 51 patients, mean age 53 (SD 13) years, who had oral lesions or symptoms suspected to be related to their dental restorations were investigated. Baseline patch tests for a series of dental materials, biopsies and photographs were undertaken. Thirty-nine out of 51 (76%) of patients had their restorations replaced. RESULTS: The clinical manifestations of OLL were variable; the majority of OLL were found to be in the molar and retro molar area of the buccal mucosa and the tongue. Twenty-seven (53%) patients had positive patch test reactions to at least one material, 24 of them for one or more mercury compound. After a mean follow up period of nine months, lesions adjacent to replaced restorations completely healed in 16 (42%) patients (10 positive and 6 negative patch tests). Improvement in signs and symptoms were found in 18 (47%) patients (11 positive and 7 negative patch tests). CONCLUSION: OLLs may be elicited by some dental restorations. Replacing restorations adjacent to these lesions is associated with healing in the majority of cases particularly when lesions are in close contact with restorations. A patch test seems to be of limited benefit as a predictor of such reactions.

Morphology, anatomy and histochemistry of Salicornioideae (Chenopodiaceae) fruits and seeds.

BACKGROUND AND AIMS: The subfamily Salicornioideae (Chenopodiaceae) are a taxonomically difficult group largely due to the lack of diagnostic characters available to delineate tribal- and generic-level boundaries; a consequence of their reduced floral and vegetative features. This study examined the variation in fruits and seeds across both tribes of the Salicornioideae to assess if characters support traditional taxonomic sections. METHODS: Light microscopy, environmental scanning electron microscopy and anatomical ultra-thin sectioning were employed to examine variation in fruits and seeds. Sixty-eight representatives across 14 of the 15 genera currently recognized within the tribes Halopeplideae and Salicornieae were examined to determine whether characters support current taxonomic groups. KEY RESULTS: Characters such as seed coat structure, embryo shape, seed orientation, the forms of seed storage proteins and carbohydrates show variation within the Salicornioideae and may be phylogenetically useful. The campylotropous ovule typical of the Chenopodiaceae generally results in a curved embryo; however, many Halosarcia and Sclerostegia species have straight embryos and in Salicornia and Sarcocornia the large peripheral embryo appears bent rather than curved. Seed coat ornamentation of Microcnemum and Arthrocnemum is distinct from other Salicornioideae as the elongated epidermal cells of the exotesta have convex walls. Histochemical stains of anatomical sections of cotyledon cells showed protein bodies were variable in shape, and starch grains were present in some species, namely Salicornia bigelovii, S. europaea and Allenrolfea occidentalis. CONCLUSIONS: While fruits and seeds were found to be variable within the subfamily, no synapomorphic characters support the tribe Halopeplideae as these genera have crustaceous seed coats, curved embryos and abundant perisperm; features characteristic of many of the tribe Salicornieae. The endemic Australian genera are closely related and few seed and fruit characters are diagnostic at the generic level. Nineteen characters identified as being potentially informative will be included in future phylogenetic analyses of the subfamily.

Predictors of outcome for orofacial pain in the general population: a four-year follow-up study.

Orofacial pain is often persistent, but it is not clear why it lasts in some patients but not in others. We aimed to describe the natural course of orofacial pain in a general population sample over a four-year period and to identify factors that would predict the persistence of pain. A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (participation rate 74%), of whom 646 (26%) reported orofacial pain. Overall, 424 (79% adjusted participation rate) of these individuals participated at the four-year follow-up, of whom 229 (54%) reported orofacial pain and 195 (46%) did not report such pain. Persistent orofacial pain was associated with females, older age, psychological distress, widespread body pain, and taking medication for orofacial pain at baseline. These findings may have implications for the identification and treatment of patients with orofacial pain.

An evaluation of the surface changes in PMMA biomaterial formulations as a result of toothbrush/dentifrice abrasion.

OBJECTIVES: The objective of this study was to evaluate the abrasion resistance and surface roughness of two injection-molded poly(methylmethacrylate) denture base materials (SR-Ivocap 'Plus', Ipsyl 60 RV), and also one compression-molded material (Trevalon). A fourth group of specimens (prepared from Trevalon using the injection-molding procedure) was compared to the compression-molded specimens. METHODS: Ten specimens were prepared according to manufacturers' instructions. An experiment involving toothbrush and dentifrice abrasion was performed on all specimens from each of the materials and the cumulative percentage weight-loss was calculated after 100,000 brush strokes. A series of surface roughness profile measurements were also obtained from each specimen within the groups. The data were analysed by using the Kolmogorov-Smirnov test. A level of significance of 0.017 was set in order to adjust for multiple comparisons between the three sets of materials. RESULTS: There was found to be no statistically significant difference between the three groups of materials in terms of percentage weight-loss, and no statistically significant difference between the Trevalon specimens when injection-molded or compression-molded. In terms of surface roughness, however, SR-Ivocap 'Plus' recorded the lowest surface roughness profile of the three groups. It was found that there was a statistically significant difference (P<0.017) between this material and Ipsyl RV 60 (producing the highest roughness), and compression-molded Trevalon. Furthermore, there was found to be no statistically significant difference between injection-molded and compression-molded specimens of Trevalon with regard to surface texture. SIGNIFICANCE: From a clinical standpoint, the surface roughness results suggest SR-Ivocap 'Plus' to be the material most likely to produce the least suitable substrate for the accumulation of denture plaque.

Association between local mechanical factors and orofacial pain: survey in the community.

OBJECTIVES: The aetiology of orofacial pain (OFP) is not well understood. We aimed to determine the relationship between OFP and local mechanical factors in an unselected general population sample. METHODS: A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (adjusted participation rate 74%). Postal questionnaire was used to collect information on OFP and local mechanical factors. RESULTS: A significant association was found between OFP and a history of tooth grinding, facial trauma, the jaw getting stuck or locked, a clicking or grating sound in the jaw joint when opening or closing the mouth, difficulty in opening the mouth wide, and chewing of pens or biting finger nails. The jaw getting stuck or locked had the highest relative risk of 2.7 (95% CI: 2.3-3.2). A history of orthodontic treatment, having any type of dentures and using chewing gum were not associated with OFP. There was some evidence of heterogeneity between types of OFP and local mechanical factors. CONCLUSIONS: Local factors play an important role in the aetiology of OFP.