bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of IPAA: Public Presentation — Key Issues in Governance
Authors: AC Michael Keating 
Published: March 2008

In the December 1997 issue of this journal our editors expressed concern about the decline in teaching of public administration. This does not reflect any decline in the overall level of involvement by government in the economy or society. Rather it seems to reflect changing perceptions of what is needed to succeed in public administration.This in turn raises the very important issue of what we as a society expect from our future public administrators. While many management skills are common to both business and the public sector, public administration needs to extend beyond the limits of business management to comprehend issues such as accountability, probity and policy processes. Indeed it is increasingly being recognised that what is at stake is not just management per se, but rather the broader array of relationships involved in good governance.The Institute of Public Administration Australia has over the years played an important role in bringing practitioners and teachers together to help foster a better appreciation of these issues. Now more than ever, when the public sector is experiencing considerable change, there needs to be a lively forum where these broader issues of public administration can be debated and new approaches can be tested.The National Council of the Institute has accordingly been considering how the Institute might encourage a wider public appreciation of good governance. In order to assist in this process and to provide some guidance to spokepersons, the Council has agreed the following Statement. We hope that all members of the Institute will find this Statement helpful and will be encouraged to promote the ideals it seeks to uphold.
Intrinsic muscle strength and voluntary activation of both lower limbs and functional performance after stroke
Authors: Horstman Astrid M. , Beltman Marijke J. , Gerrits Karin H. , Koppe Peter , Janssen Thomas W. , Elich Peter , De Haan Arnold 
Published: March 2008

SummaryThe objective of this study was to assess the nature of muscle weakness in both legs after stroke compared with able‐bodied control individuals and to examine whether there is a relationship between the degree of muscle weakness and coactivation of knee extensors and flexors as well as voluntary activation capacity of knee extensors of both paretic and non‐paretic legs and indices of functional performance. Maximal voluntary isometric torques of knee extensors (MVCe) and flexors (MVCf) were determined in 14 patients (bilaterally) and 12 able‐bodied controls. Simultaneous measurements were made of torque and surface EMG from agonist and antagonist muscles. Coactivation was calculated. Supramaximal triplets were evoked with electrical stimulation to estimate maximal torque capacity and degree of voluntary activation of knee extensors. MVCs, activation and coactivation parameters were correlated to scores of seven functional performance tests. MVCe, MVCf and voluntary activation were lower in paretic lower limb (PL) compared with both non‐paretic lower limb (NL) and control. Besides, all these parameters of NL were also lower than control. Electrically evoked torque capacity of knee extensors of PL was about 60% of both NL and control, which were not significantly different from each other. Strong significant correlations between strength, as well as voluntary activation, and functional performance were found. Coactivation did not correlate well with functional performance. Thus, whereas for NL activation failure can explain weakness, for PL both activation failure and reduced intrinsic torque capacity are responsible for the severe weakness. Activation capacity and muscle strength correlated strongly to functional performance, while coactivation did not.
Evaluating Health Care Programs by Combining Cost with Quality of Life Measures: A Case Study Comparing Capitation and Fee for Service
Authors: Grieve Richard , Sekhon Jasjeet S. , Hu Teh‐wei , Bloom Joan R. 
Published: March 2008

Objective.To demonstrate cost‐effectiveness analysis (CEA) for evaluating different reimbursement models.Data Sources/Study Setting.The CEA used an observational study comparing fee for service (FFS) versus capitation for Medicaid cases with severe mental illness (n=522). Under capitation, services were provided either directly (direct capitation [DC]) by not‐for‐profit community mental health centers (CMHC), or in a joint venture between CMHCs and a for‐profit managed behavioral health organization (MBHO).Study Design.A nonparametric matching method (genetic matching) was used to identify those cases that minimized baseline differences across the groups. Quality‐adjusted life years (QALYs) were reported for each group. Incremental QALYs were valued at different thresholds for a QALY gained, and combined with cost estimates to plot cost‐effectiveness acceptability curves.Principal Findings.QALYs were similar across reimbursement models. Compared with FFS, the MBHO model had incremental costs of −$1,991 and the probability that this model was cost‐effective exceeded 0.90. The DC model had incremental costs of $4,694; the probability that this model was cost‐effective compared with FFS was <0.10.Conclusions.A capitation model with a for‐profit element was more cost‐effective for Medicaid patients with severe mental illness than not‐for‐profit capitation or FFS models.
Use of VA and Medicare Services By Dually Eligible Veterans with Psychiatric Problems
Authors: Carey Kathleen , Montez‐Rath Maria E. , Rosen Amy K. , Christiansen Cindy L. , Loveland Susan , Ettner Susan L. 
Published: March 2008

Objective. To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders.Data Sources. Primary VA data sources were the Patient Treatment (acute care), Extended Care (long‐term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider‐of‐Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data.Study Design. We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one‐ and two‐part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs.Principal Findings. Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare‐certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures.Conclusions. As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans.
Biofilms in the Edentulous Oral Cavity
Authors: Sachdeo Amit , Haffajee Anne D. , Socransky Sigmund S. 
Published: March 2008

Abstract Purpose: The oral cavity presents numerous surfaces for microbial colonization. These surfaces produce biofilms of differing complexities unique to each individual. Several studies have looked at biofilms in dentate patients. There has been limited research regarding biofilms on dentures or soft tissues of edentulous patients. The purpose of the present investigation was to provide meaningful data describing microbial ecological relationships in the oral cavity of edentulous patients and to evaluate the microbiota on hard and soft tissue surfaces and saliva in edentulous patients wearing complete dentures. Materials and Methods: Sixty‐one edentulous subjects with complete maxillary and mandibular dentures were recruited. “Supragingival” biofilm samples were taken from 28 denture teeth for each subject. Biofilm samples were also taken from the dorsal, lateral, and ventral surfaces of the tongue, floor of mouth, buccal mucosa, hard palate, vestibule/lip, “attached gingiva,” and saliva. Samples were individually analyzed for their content of 41 bacterial species using checkerboard DNA–DNA hybridization. Levels and proportions of each species were determined for every sample location. Results: Periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were clearly present in the samples from the edentulous subjects. Microbial profiles in samples from the soft tissue surfaces differed among site locations. Samples from the dorsum of the tongue exhibited the highest bacterial counts followed by the “attached gingiva” and the lateral surfaces of the tongue, while the lowest mean counts were found in samples from the buccal mucosa and labial vestibules. Using cluster analysis of the proportions of the test species, three clusters were formed. The first cluster comprised saliva, supragingival plaque, and the lateral and dorsal surfaces of the tongue. The second cluster comprised the other six soft tissue surfaces. Species on the denture palate formed a third cluster. Conclusions: One of the major findings in this study was the detection of periodontal pathogens, A. actinomycetemcomitans and P. gingivalis, in the edentulous subjects, as these species were thought to disappear after removal of all natural teeth. This finding has implications regarding future dental treatment and the general health of individuals. Distinct patterns of microbial colonization were seen on the different soft tissue surfaces. Thus, this investigation provided the first step in defining the organisms that are associated with edentulous patients on both soft (mucosa) and hard surfaces (denture). The study also provided meaningful data that described microbial ecological relationships in the oral cavity of edentulous subjects. The authors believe that this study is the first comprehensive assessment of the microbiota in the complete denture‐wearing subject.
In Vitro Evaluation of the Effect of Thermal and Mechanical Fatigues on the Bonding of an Autopolymerizing Soft Denture Liner to Denture Base Materials Using Different Primers
Authors: Minami Hiroyuki , Suzuki Shiro , Minesaki Yoshito , Kurashige Hisanori , Tanaka Takuo 
Published: March 2008

Abstract Purpose: This in vitro study evaluated the effect of priming procedures on bonding of an autopolymerizing silicone denture liner (Sofreliner) to a denture base material after fatigue processes using cyclic thermal stressing and repetitive mechanical stressing. Materials and Methods: Denture base specimens were fabricated by use of an autopolymerizing denture base resin and Co–Cr alloy into a cylinder shape 8‐mm diameter and 4‐mm high. The bonding surfaces of denture base specimens were polished with 600‐grit silicon carbide paper. Resin denture base specimens were pretreated with applications of resin primer (Sofreliner Primer or Reline Primer for resin). Metal specimens were pretreated with application of metal primer (Reline Primer for metal) or coated with adhesive resin (C&B Metabond) followed by application of resin primer (Sofreliner Primer). Tensile specimens were fabricated by polymerizing a 2‐mm thickness of Sofreliner between a pair of pretreated denture base cylinders. Repetitive mechanical stressing was performed by using a University of Alabama‐type wear‐testing apparatus as a stress generator. Vertical 75 N load with 15° rotation was applied 66,700, 133,300, 266,700, and 400,000 times, then residual tensile resistance to failure was measured. Seven specimens were fabricated for 16 groups—four cyclic loading groups for four pretreatment groups. Residual tensile resistance to failure of specimens before the fatiguing process and after 5000, 10,000, 20,000, and 30,000 thermocycles were used as reference. The mean values of each group were statistically analyzed by three‐way ANOVA and Bonferroni/Dunn test at a 95% confidence level. Failure modes were assessed for all specimens measured. Results: In the denture‐bonded groups, residual tensile resistance to failure of Sofreliner Primer‐treated group was significantly higher than that of the Reline Primer at each thermocycling interval (p < 0.0001) and up to 133,300 times of cyclic loading (p < 0.0001). In the metal‐bonded groups, residual tensile resistance to failure of the intermediate adhesive resin group was higher than the metal primer‐applied group up to 5000 thermocycles (p < 0.0001); however, there was no significant difference between them after 66,667 cyclic loads (p= 0.1698). Although adhesive resin‐coated specimens of metal‐bonded groups showed mixed failure, metal primer‐applied groups and both denture‐bonded groups consistently revealed cohesive failure of the soft denture liner after cyclic loading. Conclusions: Application of Sofreliner Primer for a resin denture base provided better bonding after thermocycle and cyclic load testing than did Reline Primer. Using an intermediate adhesive resin layer on a Co–Cr denture base material improved the bonding for up to 5000 thermocycles; however, it did not affect cyclic loading parameters.
Fracture Strength and Fatigue Resistance of All‐Ceramic Molar Crowns Manufactured with CAD/CAM Technology
Authors: Zahran Mohammed , El‐Mowafy Omar , Tam Laura , Watson Philip A. , Finer Yoav 
Published: March 2008

Abstract Purpose: All‐ceramic crowns are subject to fracture during function, especially in the posterior area. The use of yttrium‐stabilized zirconium‐oxide ceramic as a substructure for all‐ceramic crowns to improve fracture resistance is unproven. The aim of this study was to compare fracture strength and fatigue resistance of new zirconium‐oxide and feldspathic all‐ceramic crowns made with computer‐aided design/computer‐aided manufacturing (CAD/CAM). Materials and Methods: An ivorine molar was prepared to receive an all‐ceramic crown. Using epoxy resin, 40 replication dies were made of the prepared tooth. Twenty feldspathic all‐ceramic crowns (Vita Mark II) (VMII) and 20 zirconium‐oxide crown copings (In‐Ceram YZ) (YZ) were made using CAD/CAM technique (CEREC‐3D). The YZ copings were sintered and veneered manually with a fine‐particle ceramic (VM9). All crowns were cemented to their respective dies using resin cement (Panavia F 2.0). Ten crowns in each group were subjected to compressive fatigue loading in a universal testing machine (instron). The other ten crowns from each group were loaded to fracture at a crosshead speed of 1 mm/min. Data were statistically analyzed using independent t‐test and Fisher's exact test at α= 0.05. Results: There was a significant difference between the survival rates of the two materials during the fatigue test (p < 0.001). All VMII crowns survived without any crack formation, while all YZ crowns fractured (40%) or developed cracks (60%). All the YZ crown fractures occurred within the veneering layer during the fatigue test. There was no significant difference in mean fracture load between the two materials (p= 0.268). Mean fracture loads (standard deviation) in N were: 1459 (492) for YZ crowns and 1272 (109) for VMII crowns. Conclusions: The performance of VMII crowns was superior to YZ crowns in the fatigue test. The premature fractures and cracks of the YZ crowns were attributed to weakness in the YZ veneer layer or in the core/veneer bond.
Comparative evaluation of techniques for the manufacturing of dendritic cell‐based cancer vaccines
Authors: Dohnal Alexander Michael , Graffi Sebastian , Witt Volker , Eichstill Christina , Wagner Dagmar , Ul‐Haq Sidrah , Wimmer Doris , Felzmann Thomas 
Published: March 2008

AbstractManufacturing procedures for cellular therapies are continuously improved with particular emphasis on product safety. We previously developed a dendritic cell (DC) cancer vaccine technology platform that uses clinical grade lipopolysaccharide (LPS) and interferon (IFN)‐y for the maturation of monocyte derived DCs. DCs are frozen after 6 hrs exposure at a semi‐mature stage (smDCs) retaining the capacity to secret interleukin (IL)‐12 and thus support cytolytic T‐cell responses, which is lost at full maturation. We compared closed systems for monocyte enrichment from leucocyte apheresis products from healthy individuals using plastic adherence, CD14 selection, or CD2/19 depletion with magnetic beads, or counter flow centrifugation (elutriation) using a clinical grade in comparison to a research grade culture medium for the following DC generation. We found that elutriation was superior compared to the other methods showing 36 ± 4% recovery, which was approximately 5‐fold higher as the most frequently used adherence protocol (8 ± 1%), and a very good purity (92 ± 5%) of smDCs. Immune phenotype and IL‐12 secretion (adherence: 1.4 ± 0.4; selection: 20 ± 0.6; depletion: 1 ±0.5; elutriation: 3.6 ± 1.5 ng/ml) as well as the potency of all DCs to stimulate T cells in an allogeneic mixed leucocyte reaction did not show statistically significant differences. Research grade and clinical grade DC culture media were equally potent and freezing did not impair the functions of smDCs. Finally, we assessed the functional capacity of DC cancer vaccines manufactured for three patients using this optimized procedure thereby demonstrating the feasibility of manufacturing DC cancer vaccines that secret IL‐12 (9.4 ± 6.4 ng/ml). We conclude that significant steps were taken here towards clinical grade DC cancer vaccine manufacturing.
A role for the transcription factor HEY1 in glioblastoma
Authors: Hulleman Esther , Quarto Micaela , Vernell Richard , Masserdotti Giacomo , Colli Elena , Kros Johan M. , Levi Daniel , Gaetani Paolo , Tunici Patrizia , Finocchiaro Gaetano , Baena Riccardo Rodriguez y , Capra Maria , Helin Kristian 
Published: March 2008

AbstractGlioblastoma multiforme (GBM), the highest‐grade glioma, is the most frequent tumour of the brain with a very poor prognosis and limited therapeutic options. Although little is known about the molecular mechanisms that underlie glioblastoma formation, a number of signal transduction routes, such as the Notch and Ras signalling pathways, seem to play an important role in the formation of GBM. In the present study, we show by in situ hybridization on primary tumour material that the transcription factor HEY1, a target of the Notch signalling pathway, is specifically up‐regulated in glioma and that expression of HEY1 in GBM correlates with tumour‐grade and survival. In addition, we show by chromatin immunoprecipitations, luciferase assays and Northern blot experiments that HEY1 is a bona fide target of the E2F family of transcription factors, connecting the Ras and Notch signalling pathways. Finally, we show that ectopic expression of HEY1 induces cell proliferation in neural stem cells, while depletion of HEY1 by RNA interference reduces proliferation of glioblastoma cells in tissue culture. Together, these data imply a role for HEY1 in the progression of GBM, and therefore we propose that HEY1 may be a therapeutic target for glioblastoma patients. Moreover, HEY1 may represent a molecular marker to distinguish GBM patients with a longer survival prognosis from those at high risk.
A critically severe gingival bleeding following non‐surgical periodontal treatment in patients medicated with anti‐platelet
Authors: Elad Sharon , Chackartchi Tali , Shapira Lior , Findler Mordechai 
Published: March 2008

AbstractBackground: Only a few dental procedures have been reported to cause life‐threatening bleeding. All of these cases followed surgical intervention.Material and Methods: In this paper, we report a case of severe bleeding following non‐surgical periodontal procedures in a patient treated with a dual anti‐platelet regimen post‐coronary stent insertion.Results: Her medical history included ischaemic heart disease, hypertension and diabetes mellitus. Haemostasis was achieved at the conclusion of the non‐surgical periodontal treatment. However, several hours later, the patient arrived at the emergency room and was diagnosed with hypovolemic shock.Conclusion: This case should raise the clinician's awareness of bleeding complications in non‐surgical procedures as well as the risk for bleeding when a dual anti‐platelet regimen is administered. The importance of patient monitoring and the use of local haemostatic agents is demonstrated in these cases.
Making sense of the porphyrias
Authors: Sarkany Robert P. E. 
Published: March 2008

SummaryPatients with cutaneous porphyrias can be worrying for dermatologists. The diseases are rare enough to be unfamiliar, are associated with internal diseases, can have genetic implications, and are associated with incomprehensible biochemical pathways.In this review, I will try to explain why porphyrias occur, why they present as they do in the clinic, and provide a checklist for treating patients with porphyria.
Does surface preparation alter ALA uptake in superficial non‐melanoma skin cancer in vivo?
Authors: Moseley Harry , Brancaleon Lorenzo , Lesar Andrea E. , Ferguson James , Ibbotson Sally H. 
Published: March 2008

SummaryBackground/purpose: Photodynamic therapy (PDT) using aminolaevulinic acid (ALA) is widely used in the treatment of non‐melanoma skin cancer. Surface preparation of the lesion is commonly performed before application of ALA but the extent of the preparation varies from centre to centre and there has been no study of its effects. The purpose of this study was to examine the effects of surface preparation on the local uptake of ALA by recording fluorescence from accumulated protoporphyrin IX (PPIX).Methods: The study was performed on 16 lesions, either superficial basal cell carcinoma (BCC) or Bowen's disease (BD). Each half of the lesion was randomly assigned to (a) no surface preparation or (b) surface preparation (randomly allocated to gentle curettage or abrasion with a spatula). ALA was left for 4 h (BCC) or 6 h (BD). PPIX fluorescence was measured using an excitation wavelength of 405±5 nm and emission spectrum recorded using a photodiode array. Spectra were measured (a) before and (b) after surface preparation, (c) immediately before and (d) after laser irradiation at 630 nm.Results: The ratio of fluorescence after incubation to that before incubation was 6.1±1.2 in the non‐prepared section. This increased slightly but not significantly to 6.8 ±1.8 in the prepared section (P<0.1). There was no significant difference between curettage and abrasion. There was also no significant difference in outcome after PDT.Conclusions: The clinical assessment agrees with the fluorescence data as no significant difference was seen between prepared and unprepared halves of the lesion 12 months after PDT. Overall our data seem to suggest that for most BCC and BD lesions, surface preparation did not increase ALA uptake.