bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Services Research and Data Linkages: Issues, Methods, and Directions for the Future
Authors: Bradley Cathy J. , Penberthy Lynne , Devers Kelly J. , Holden Debra J. 
Published: August 2010

Background. Research on pressing health services and policy issues requires access to complete, accurate, and timely patient and organizational data.Aim. This paper describes how administrative and health records (including electronic medical records) can be linked for comparative effectiveness and health services research.Materials and Methods. We categorize the major agents (i.e., who owns and controls data and who carries out the data linkage) into three areas: (1) individual investigators; (2) government sponsored linked data bases; and (3) public–private partnerships that facilitate linkage of data owned by private organizations. We describe challenges that may be encountered in the linkage process, and the benefits of combining secondary databases with primary qualitative and quantitative sources. We use cancer care research to illustrate our points.Results. To fill the gaps in the existing data infrastructure, additional steps are required to foster collaboration among institutions, researchers, and public and private components of the health care sector. Without such effort, independent researchers, governmental agencies, and nonprofit organizations are likely to continue building upon a fragmented and costly system with limited access.Discussion. Without the development and support for emerging information technologies across multiple health care settings, the potential for data collected for clinical and transactional purposes to benefit the research community and, ultimately, the patient population may go unrealized.Conclusion. The current environment is characterized by budget and technical challenges, but investments in data infrastructure are arguably cost‐effective given the need to reform our health care system and to monitor the impact of health reform initiatives.
Viewing Health Care Delivery as Science: Challenges, Benefits, and Policy Implications
Authors: Pronovost Peter J. , Goeschel Christine A. 
Published: August 2010

The need for health services research is likely to rise rapidly as the population ages, health care costs soar, and therapeutic and diagnostic choices proliferate. Building an effective and efficient health care delivery system is a national priority. Yet the national health care quality report concludes that we lack the ability to monitor progress toward even basic quality and patient safety goals effectively.The gap between the need to improve and our ability to do so exists in part because we fail to view the delivery of health care as science, we lack national improvement priorities, and we lack a national infrastructure to achieve our stated goals.We discuss key challenges implicit in correcting these failures and recommend actions to expedite progress.
Modeling Health Care Policy Alternatives
Authors: Ringel Jeanne S. , Eibner Christine , Girosi Federico , Cordova Amado , McGlynn Elizabeth A. 
Published: August 2010

Background. Computer models played an important role in the health care reform debate, and they will continue to be used during implementation. However, current models are limited by inputs, including available data.Aim. We review microsimulation and cell‐based models. For each type of model, we discuss data requirements and other factors that may affect its scope. We also discuss how to improve models by changing data collection and data access procedures.Materials and Methods. We review the modeling literature, documentation on existing models, and data resources available to modelers.Results. Even with limitations, models can be a useful resource. However, limitations must be clearly communicated. Modeling approaches could be improved by enhancing existing longitudinal data, improving access to linked data, and developing data focused on health care providers.Discussion. Longitudinal datasets could be improved by standardizing questions across surveys or by fielding supplemental panels. Funding could be provided to identify causal parameters and to clarify ranges of effects reported in the literature. Finally, a forum for routine communication between modelers and policy makers could be established.Conclusion. Modeling can provide useful information for health care policy makers. Thus, investing in tools to improve modeling capabilities should be a high priority.
Time's Arrow: Violence and Ethnohistorical Surrealism in the Lost Colony
Authors: HARKIN MICHAEL E. 
Published: August 2010

SUMMARYStandard ethnohistorical accounts of colonial encounters downplay violence and genocide in the interest of holistic ethnographic accounts. In particular, “upstreaming” is a technique that attempts to sublimate violence into interpretations of ethnological understanding. An argument is made for “ethnohistorical surrealism” as a methodology for preserving the ruptures of colonial contact. The principle of incommensurability is an important driver for the transformation of contact zone exchange systems into structures of violence. Drawing on Bataille's reading of the potlatch, exchange systems based on unreturnable gifts produce abjection in the recipient, which results in cycles of violence and ultimately subjection.
Violence and Recreation: Vacationing in the Realm of Dark Tourism
Authors: ROBB ERIKA M. 
Published: August 2010

SUMMARYTourist destinations are typically conceptualized as sites of leisure. However, in recent years places associated with human misery and death have become the focus of sizable touristic interest. This practice, called dark tourism (Lennon and Foley 2000), involves visiting destinations at which violence is the main attraction. Dark tourism includes both places with violent legacies and those at which violence is an ongoing reality. It encompasses a wide variety of visitor motivations—educational, memorial, or recreational. In this article, I take a cross‐regional approach to a diverse group of dark tourism sites, from Rwanda and Argentina to the United States and Brazil, considering their aesthetics and the experiences of visitors to contribute to the theoretical exploration of the relationship between tourism and violence.
Two cases of tongue cancer treated with intra‐ and peri‐tumoral injection of recombinant interleukin‐2 alone: immunohistochemical considerations to clinical tumor response
Authors: Hiratsuka H , Noguchi M , Kinjo H , Odajima T , Kohama G 
Published: August 2010

SUBJECTS AND METHODS: Two cases with stage II tongue cancer who exhibited different responses to intra‐and peri‐tumoral administration of rlL‐2 alone are presented. Special consideration is given to the relationship between tumor responses to rlL‐2 and clinicopatholog‐ical and immunohistopathological findings.RESULTS: The patient who responded completely to treatment showed an exophytic tumor growth pattern, low‐grade cancer invasion, and predominant infiltration of CD8+ lymphocytes over CD4+ lymphocytes in cancer cell nests. The non‐responder showed endophytic tumor growth, high‐grade cancer invasion, and uniform distribution of both CD4+ and CD8+ lymphocytes in cancer cell nests.CONCLUSIONS: Distribution of adequate amounts of T lymphocytes subsets may be necessary in order for good tumor response to biotherapy with rlL‐2; other clinical and histopathological variables predicting the effect for cancer chemotherapy remain to be identified.
Origins and functions of cells essential for periodontal repair: the role of fibroblasts in tissue homeostasis
Authors: McCulloch CAG 
Published: August 2010

OBJECTIVE: A review is undertaken of redent model systems and cell culture studies that address the role of periodontal fibroblasts in tissue homeostasis in both normal function and after wound healing.RATIONALE: Fibroblasts are the predominant cells of the periodontal ligament (PL) and of healthy gingiva and have important roles in the development, function and regeneration of the tooth support apparatus.REVIEW: In normally functioning periodontal tissues cell turnover involves generation of new cells by proliferation which in turn is balanced by apoptotic cell death. Consequently PL fibroblasts comprise a renewal cell system in steady‐state. PL cell progenitors can generate multiple types of more differentiated, specialized cells including latge numbers of fibroblastic cells and more limited numbers of osteogenic or cementogenic cells. However PL fibroblasts constitutively block osteogenesis and thereby maintain the PL width. Proliferating progenitor cell populations of the PL are enriched in locations adjacent to blood vessels and in contiguous endosteal spaces from where they migrate to the body of the PL. Large increases of cell formation and cell differentiation occur after wounding but surprisingly, the cells that repopulate the PL adjacent to the root surface are largely post‐mitotic. As PL cell populations comprise multiple lineages, it is likely that after wounding, the separate phenotypes repopulating the wound site will be selected by environmental factors. Further, the specific repopulating lineages will strongly influence the form and function of the nascent tissue. To illustrate the specificity of fibroblast functions, examples of migratory and contractile fibroblast phenotypes are provided which exhibit constitutively different levels of gelsolin and α‐smooth muscle actin respectively, cytoskeletal proteins which are markers for these cell types.CONCLUSION: Fibroblasts contribute to PL homeostasis by their abilities to remodel tissues, to repopulate wounds, to influence the metabolism of other cell types and to create a new fibrous attachment.
Desmoplastic and non‐desmoplastic ameloblastoma: a comparative clinicopathological analysis
Authors: Keszler A , Paparella ML , Dominguez FV 
Published: August 2010

OBJECTIVES: The aim of this study was to review a large series of ameloblastomas, accessioned during a period of 35 years in a single Oral Pathology Diagnostic Center, for the incidence of desmoplastic ameloblastoma (DA) and in order to analyze the clinical features of this unusual variant.MATERIALS AND METHODS: All cases diagnosed as ameloblastoma were reviewed and 14 were rediagnosed as DA. These cases were analyzed in terms of gender, patient age, location, clinical diagnosis, radiographic features and recurrence following treatment. Data from DA and non‐desmoplastic ameloblastoma (NDA) were compared.RESULTS: The incidence of DA in this series was 8.8%. The mean age of NDA and DA were 39.1 and 38.8 years respectively, and a higher female prevalence was observed in the latter. The mandible was the most affected bone in both groups of tumors, but with a different regional distribution. Most NDA arose in the angle and ramus of the mandible, but the premolar/molar region was the preferential location for DA. The most common radiographic feature in DA was the osteolytic type, either monolocular or multilocular. Most of these cases were clinically diagnosed as ameloblastoma. According to follow‐up data available, 21.4% of DA and 10.1% of NDA recurred.CONCLUSIONS: The results of this study do not support the hypothesis that DA should be a separate clinicopathological entity. It seems most likely that DA is another his‐tologic variant of ameloblastoma.
Analysis of oral manifestations of leukemia: a retrospective study
Authors: Hou G‐L , Huang J‐S , Tsai C‐C 
Published: August 2010

OBJECTIVE: To evaluate in detail the oral complications of leukemia at initial presentation. Associations between oral manifestations and laboratory data were also investigated.STUDY DESIGN: A retrospective study of 230 cases was conducted to investigate the nature and incidence of oral manifestations at initial presentation. The following data were determined for each patient: age, sex, haemogram at diagnosis (which included haemoglobin, red blood cell counts, differential white blood cell counts, platelet counts), classification of the type of leukemia's systemic symptoms and oral manifestations at the initial physical examination including the dental consultation.RESULTS: It was revealed that the type of leukemia diagnosed, except with CML, is related to the age prediliction of patients. The incidence of leukemia is higher in males than in females. The most common manifestations of leukemia are lymphadenopathy (71.4% in ALL; 45% in AML), laryngeal pain (52.7% in ALL; 37.3% in AML), gingival bleeding (43.2% in AML; 28.6% in ALL), oral ulceration, and gingival enlargement. Fever (92.2%) was the most common symptom in patients with all types of leukemia. Platelet counts from 25000 mm‐3 to 60000 mm‐3 are at sufficiently low levels to result in spontaneous bleeding. Most of the patients had WBC counts of greater than 10000 mm‐3.Only 12.6% of patients had normal WBC counts.CONCLUSIONS: It was concluded that the age predilic‐tion and prevalence of oral manifestations are closely related to the type of leukemia.
Extracts of Prevotella intermedia and Actinobacillus actinomycetemcomitans inhibit alkaline phosphatase activity in osteoblastic cells in vitro
Authors: Murata T. , Ansai T. , Takehara T. , Kobayashi S. , Haneji T. 
Published: August 2010

In order to study the effects of sonicated extracts from Prevotella intermedia, Actinobacillus actinomycetemcomit‐ans, Porphyromonas gingivalis, and other oral‐related bacteria, as well as Escherichia coli on bone formation, clone MC3T3‐E1 cells, which have retained osteoblastic activity, were cultured with various bacterial extracts.The addition of the sonicated extracts from Prevotella intermedia and Actinobacillus actinomycetemcomitans decreased the alkaline phosphatase activity in a dose‐dependent fashion over the concentration range of 1– 1000 ng ml‐1 compared with the control. By contrast, the sonicated extracts from other oral bacteria including Porphyromonas gingivalis, Capnocytophaga ochracea, Streptococcus milleri and Streptococcus sanguis, and Escherichia coli did not decrease the alkaline phosphatase activity even in the presence of 100 ng ml‐1 protein.The addition of Prevotella intermedia and Actinobacillus actinomycetemcomitans extracts that had been treated with heat and trypsin to the cell cultures also inhibited alkaline phosphatase activity in the cells, suggesting that inhibitory factors are not proteinaceouS. Polymyxin B did not change the alkaline phosphatase activity in the cells treated with the extracts from Prevotella intermedia and Actinobacillus actinomycetemcomitans, suggesting that the inhibitory activity of the extracts is not lipopolysaccha‐ride.The inhibitory effect of both extracts was observed in the molecular mass over 290 kDa eluted from Sephadex G‐200 column. The inhibitory substances of Prevotella intermedia were partially purified and showed broad band with estimated molecular weight of 170–190 kDa by sodium dodecyl sulfate‐polyacrylamide gel electro‐phoresis.These results indicate that Prevotella intermedia and Actinobacillus actinomycetemcomitans may play an important role in inhibiting bone formation as well as in stimulating bone resorption.
Granulomatous cheilitis: a study of six cases
Authors: Kolokotronis A. , Antoniades D. , Trigonidis G. , Papanagiotou P. 
Published: August 2010

OBJECTIVE: Granulomatous cheilitis (GC) is a very rare disorder of unknown etiology. Clinically, GC is characterised by recurrent swelling of the labial tissues, which may be followed by a permanent enlargement. Histologically, the typical form of GC is characterised by the formation of scattered aggregates of non‐caseating granulomaS. GC is the most frequent sign of orofacial granulomatosis, a disorder under which also encompasses sarcoidosis, Crohn's disease, atypical tuberculosis, Anderson‐Fabry disease, possibly some allergic reactions, and Melkersson‐Rosenthal syndrome (MRS).Some consider GC as an oli‐gosymptomatic or monosymptomatic form of MRS.SUBJECTS AND METHODS: In this study we examined the clinical records of six patients presenting with GC which were examined and treated in the Department of Oral Medicine and Pathology of the Dental School of Aristotle University of Thessaloniki (Greece) during a 16‐year period. In five of six patients a persistent swelling of the lower lip was recorded, one of whom also developed swelling in the upper lip. In one case the swelling was present in both lips and in another the GC was the only clinical finding, while in the other five cases it was accompanied by at least one other feature of MRS. In five cases, the histological picture revealed non‐caseating granulomas.RESULTS: The treatment with the intralesional infusion of corticosteroids in three cases and the oral administration of corticosteroids in two cases was successful. One of the patients refused to be treated. This patient also presented later with permanent swelling of the upper lip.
Intranodal injection of anticancer drugs into fixed cervical metastatic lymph nodes
Authors: Osaki T. , Ueta E. , Yoneda K. , Yamamoto T. 
Published: August 2010

OBJECTIVE: In patients with head and neck carcinoma, fixed enlarged metastatic lymph nodes (LNs) are sometimes inoperable and carry an increased risk of mortality. To control metastatic LNs, we attempted intranodal injection of anticancer agents.SUBJECTS AND METHODS: Fifteen patients with squamous cell carcinoma arising in the gingiva (8), tongue (3), floor of the mouth (1), or maxillary sinus (3) were enrolled. These patients consisted of two groups, those in the early era in which the fixed LNs of six patients were treated with 60Co (RA group) and those in the late era in which both radiation and intranodal injection of anticancer agents were administered to nine patients (IN group). Intranodal injection consisted of peplomycin, 5‐fiuorouracil, and cis‐diamminedichloroplatinum.RESULTS: In the IN group, LNs regressed from about 40% to nearly 100%, although two patients showed no appreciable response. The LNs treated by combination therapy regressed considerably while LNs in the same patients treated with 60Co alone showed a minor response or grew gradually. In three patients, the LNs regressed sufficiently to be extirpated safely. The good clinical response in the locally injected LNs was histologically associated with distinct evidence of tumor cell degeneration. In the RA group, none of the LNs responded to radiation with 60Co; one LN exhibited slight regression, but the others enlarged during and soon after the radiation. Compatible with the clinical effects, many patients in the IN group demonstrated a good prognosis; three are alive without disease, and four survived for prolonged periodS. However, all patients in the RA group died due to progression of the positive LNs or pulmonary complication within 10 months.CONCLUSION: These results indicate that intranodal injection of anticancer drugs is useful for the management of fixed enlarged LNs.
Snuff use and smoking among senior high school students: effects of a snuff sales ban
Authors: Merne MET , Tiekso JT , Syrjänen SM 
Published: August 2010

OBJECTIVES: The popularity of snuff especially among adolescents is rising. The association between long‐term snuff use and oral cancer discovered in epidemiological studies has prompted a variety of preventive measures to be taken to reduce snuff use and prevent adoption of the habit. In this study, the effect of a recent (I March, 1995) snuff sales ban introduced in Finland was investigated. Further, the rates of smoking, snuff use, alcohol use and drug experimenting were investigated before the introduction of the ban to characterize the study population.DESIGN AND SUBJECTS: Two questionnaire studies were carried out. The first was carried out 3 months prior to the ban in 1994 and the second 9 months after the ban in 1995 in a senior high school population in southwestern Finland. The participants were 793 students (aged 15–22 years) in the first survey and 545 students (aged 16–23) in the second. Associations between variables were analyzed using cross‐tabulation and stepwise logistic regression. The effects of the ban were determined on the basis of direct questions in the second questionnaire relating to the snuff sales ban.RESULTS: Snuff was used by 9% of the students participating in the first study. The results of the second questionnaire indicate that the implementation of the snuff sales ban reduced the rate of snuff use by 1% in the study population. The majority of the snuff users (76%) reported that they had maintained their snuff habit. Of those reporting that they were snuff users before implementation of the snuff sales ban, 12% had switched to smoking and 5% to drugs.CONCLUSIONS: The results of the present study suggest that the snuff sales ban in this population with a high rate of snuff use had little effect on snuff use rates and may have some short‐term negative consequences as some snuff users switch to other substitutes, such as smoking, with known adverse health effects.
The postantifungal effect (PAFE) of antimycotics on oral C. albicans isolates and its impact on candidal adhesion
Authors: Ellepola ANB , Samaranayake LP 
Published: August 2010

OBJECTIVE:Postantifungal effect (PAFE) is defined as the suppression of growth that persists following limited exposure of yeasts to antimycotics and subsequent removal of the drug. As there are no data on the PAFE of oral C albicans isolates the main aim of this investigation was to measure the PAFE of 10 oral isolates of C albicans following limited exposure (I h) to five antifungal drugs, including nystatin which has not been previously used in PAFE assays. A secondary aim of the study was to evaluate the biological significance of PAFE, using a nystatin pre‐exposed isolate of C albicans and observing its adherence to denture acrylic surfaces, during the PAFE period.DESIGN:A total of 10 oral isolates of C albicans were examined for the presence of the PAFE after I h exposure to five antifungal drugs, nystatin, amphotericin B, 5‐fluorocytosine, ketoconazole and fluconazole. PAFE was automatically assessed with the help of a Spectramax machine which utilizes the principle of periodic turbidometric assessment of growth rates at a given temperature over a given period. The data thus collected are automatically processed in a graphic format as a computer printout. The PAFE was determined as the difference in time (h) required for growth of the drug‐free control and the drug‐exposed test cultures to increase to 0.05 absorbance level following removal of the antifungal agent (by repeated washing). The adhesion of the single isolate to denture acrylic following limited exposure to nystatin was assessed by a previously described in vitro adhesion assay.RESULTS:Significant PAFE were observed for nystatin, amphotericin‐B and 5‐fluorocytosine. A marginal PAFE was observed for ketoconazole and little or none for fluconazole. The mean duration of the PAFE of nystatin, amphotericin‐B, 5‐fluorocytosine, ketoconazole and fluconazole were 2.89 (±0.27) h, 2.83 (±0.23) h, 3.18 (±0.31) h, 0.65 (±0.11) h and 0.16 (±0.06) h, respectively. The mean percentage reduction of adhesion of oral C albicans BU47204 to denture acrylic during the PAFE period following exposure to nystatin for 10, 30, 50, 70 and 90 min was 9.12%, 61.73%, 65.99%, 82.16% and 83.14%, respectively.CONCLUSIONS:These in vitro findings imply that even a short period of exposure to antifungals may result in modulation of the growth and the virulent attributes of C albicans, which however is largely dictated by the anti‐mycotic agent in question. Whether such mechanisms operate in vivo needs to be clarified by further studies.