bluuebunny/crossref_metadata_2025_split huggingface dataset:
Out-of-hours primary care. Implications of organisation on costs
Authors: van Uden Caro JT , Ament Andre JHA , Voss Gemma BWE , Wesseling Geertjan , Winkens Ron AG , van Schayck Onno CP , Crebolder Harry FJM 
Published: May 2006

Abstract

Background
To perform out-of-hours primary care, Dutch general practitioners (GPs) have organised themselves in large-scale GP cooperatives. Roughly, two models of out-of-hours care can be distinguished; GP cooperatives working separate from the hospital emergency department (ED) and GP cooperatives integrated with the hospital ED. Research has shown differences in care utilisation between these two models; a significant shift in the integrated model from utilisation of ED care to primary care. These differences may have implications on costs, however, until now this has not been investigated. This study was performed to provide insight in costs of these two different models of out-of-hours care.

Methods
Annual reports of two GP cooperatives (one separate from and one integrated with a hospital emergency department) in 2003 were analysed on costs and use of out-of-hours care. Costs were calculated per capita. Comparisons were made between the two cooperatives. In addition, a comparison was made between the costs of the hospital ED of the integrated model before and after the set up of the GP cooperative were analysed.

Results
Costs per capita of the GP cooperative in the integrated model were slightly higher than in the separate model (ε 11.47 and ε 10.54 respectively). Differences were mainly caused by personnel and other costs, including transportation, interest, cleaning, computers and overhead. Despite a significant reduction in patients utilising ED care as a result of the introduction of the GP cooperative integrated within the ED, the costs of the ED remained the same.

Conclusion
The study results show that the costs of primary care appear to be more dependent on the size of the population the cooperative covers than on the way the GP cooperative is organised, i.e. separated versus integrated. In addition, despite the substantial reduction of patients, locating the GP cooperative at the same site as the ED was found to have little effect on costs of the ED. Sharing more facilities and personnel between the ED and the GP cooperative may improve cost-efficiency.
The interferon gamma gene polymorphism +874 A/T is associated with severe acute respiratory syndrome
Authors: Chong Wai Po , Ip WK Eddie , Tso Gloria Hoi Wan , Ng Man Wai , Wong Wilfred Hing Sang , Law Helen Ka Wai , Yung Raymond WH , Chow Eudora Y , Au KL , Chan Eric YT , Lim Wilina , Peiris JS Malik , Lau Yu Lung 
Published: May 2006

AbstractBackgroundCytokines play important roles in antiviral action. We examined whether polymorphisms ofIFN-γ,TNF-αandIL-10affect the susceptibility to and outcome of severe acute respiratory syndrome (SARS).MethodsA case-control study was carried out in 476 Chinese SARS patients and 449 healthy controls. We tested the polymorphisms ofIFN-γ,TNF-αandIL-10for their associations with SARS.ResultsIFN-γ+874A allele was associated with susceptibility to SARS in a dose-dependent manner (P< 0.001). Individuals withIFN-γ+874 AA and AT genotype had a 5.19-fold (95% Confidence Interval [CI], 2.78-9.68) and 2.57-fold (95% CI, 1.35-4.88) increased risk of developing SARS respectively. The polymorphisms ofIL-10andTNF-αwere not associated with SARS susceptibility.ConclusionIFN-γ+874A allele was shown to be a risk factor in SARS susceptibility.
Different roles for non-receptor tyrosine kinases in arachidonate release induced by zymosan and Staphylococcus aureus in macrophages
Authors: Olsson Sandra , Sundler Roger 
Published: May 2006

AbstractBackgroundYeast and bacteria elicit arachidonate release in macrophages, leading to the formation of leukotrienes and prostaglandins, important mediators of inflammation. Receptors recognising various microbes have been identified, but the signalling pathways are not entirely understood. Cytosolic phospholipase A2is a major down-stream target and this enzyme is regulated by both phosphorylation and an increase in intracellular Ca2+. Potential signal components are MAP kinases, phosphatidylinositol 3-kinase and phospholipase Cγ2. The latter can undergo tyrosine phosphorylation, and Src family kinases might carry out this phosphorylation. Btk, a Tec family kinase, could also be important. Our aim was to further elucidate the role of Src family kinases and Btk.MethodsArachidonate release from murine peritoneal macrophages was measured by prior radiolabeling. Furthermore, immunoprecipitation and Western blotting were used to monitor changes in activity/phosphorylation of intermediate signal components. To determine the role of Src family kinases two different inhibitors with broad specificity (PP2 and the Src kinase inhibitor 1, SKI-1) were used as well as the Btk inhibitor LFM-A13.ResultsArachidonate release initiated by eitherStaphylococcus aureusor yeast-derived zymosan beads was shown to depend on members of the Src kinase family as well as Btk. Src kinases were found to act upstream of Btk, phosphatidylinositol 3-kinase, phospholipase Cγ2 and the MAP kinases ERK and p38, thereby affecting all branches of the signalling investigated. In contrast, Btk was not involved in the activation of the MAP-kinases. Since the cytosolic phospholipase A2in macrophages is regulated by both phosphorylation (viaERK and p38) and an increase in intracellular Ca2+, we propose that members of the Src kinase family are involved in both types of regulation, while the role of Btk may be restricted to the latter type.ConclusionArachidonate release induced by eitherStaphylococcus aureusor zymosan was found to depend on Src family kinases as well as Btk. While members of the Src kinase family were shown to act upstream of Btk and the MAP kinases, Btk plays another role independent of MAP kinases, but down-stream of the Src family kinases.
Validation of a patient satisfaction questionnaire for anemia treatment, the PSQ-An
Authors: Nordyke Robert J , Chang Chih-Hung , Chiou Chiun-Fang , Wallace Joel F , Yao Bin , Schwartzberg Lee S 
Published: May 2006

Abstract

Background
Treating anemia associated with chemotherapy and many cancers is often necessary. However, patient satisfaction with anemia treatment is limited by the lack of validated instruments. We developed and validated a new treatment-specific patient satisfaction instrument: the Patient Satisfaction Questionnaire for Anemia Treatment (PSQ-An). Treatment burden and overall satisfaction scales were designed for ease of use in clinical practice.

Methods
312 cancer patients (141 breast, 69 gynecological, and 102 non-small cell lung) were targeted to complete the PSQ-An at 4 week intervals. Data from weeks 5 and 9 were analyzed. Patients also completed the MOS SF-36 Global Health assessment and questions concerning resources devoted to anemia treatment. Item reduction used endorsement rates, floor/ceiling effects, and item-item correlations. Factor analysis identified meaningful subscales. Test-retest reliability was assessed. Construct validity was tested, using Pearson's correlations, by comparing subscale scores to Global Health, hemoglobin levels, and resources devoted to anemia treatment.

Results
The overall response rate was 92.9% (264/284) at week 5. Most (84.2%) of the patients were female, and the mean (SD) age was 60.2 (± 11.8) years. Two distinct subscales were identified measuring treatment burden (7 items) and overall satisfaction (2 items). Test-retest reliability was examined (ICC: 0.45–0.67); both were internally consistent (alpha = 0.83). Both subscales exhibited convergent and divergent validity with independent measures of health. ANOVA results indicated that the PSQ-An Satisfaction subscale discriminated between 5 levels of MOS SF-36 Global Health (P = 0.006).

Conclusion
The PSQ-An is a validated, treatment-specific instrument for measuring satisfaction with anemia treatment for cancer patients. PSQ-An subscales reflect the burden of injection anemia treatment on cancer patients and their assessment of the overall treatment value.
The basic principles of migration health: Population mobility and gaps in disease prevalence
Authors: Gushulak Brian D , MacPherson Douglas W 
Published: May 2006

AbstractCurrently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented.
Dosimetric comparison of intensity-modulated, conformal, and four-field pelvic radiotherapy boost plans for gynecologic cancer: a retrospective planning study
Authors: Chan Philip , Yeo Inhwan , Perkins Gregory , Fyles Anthony , Milosevic Michael 
Published: May 2006

Abstract

Purpose
To evaluate intensity-modulated radiation therapy (IMRT) as an alternative to conformal radiotherapy (CRT) or 4-field box boost (4FB) in women with gynecologic malignancies who are unsuitable for brachytherapy for technical or medical reasons.

Methods
Dosimetric and toxicity information was analyzed for 12 patients with cervical (8), endometrial (2) or vaginal (2) cancer previously treated with external beam pelvic radiotherapy and a CRT boost. Optimized IMRT boost treatment plans were then developed for each of the 12 patients and compared to CRT and 4FB plans. The plans were compared in terms of dose conformality and critical normal tissue avoidance.

Results
The median planning target volume (PTV) was 151 cm3 (range 58–512 cm3). The median overlap of the contoured rectum with the PTV was 15 (1–56) %, and 11 (4–35) % for the bladder. Two of the 12 patients, both with large PTVs and large overlap of the contoured rectum and PTV, developed grade 3 rectal bleeding. The dose conformity was significantly improved with IMRT over CRT and 4FB (p ≤ 0.001 for both). IMRT also yielded an overall improvement in the rectal and bladder dose-volume distributions relative to CRT and 4FB. The volume of rectum that received the highest doses (>66% of the prescription) was reduced by 22% (p < 0.001) with IMRT relative to 4FB, and the bladder volume was reduced by 19% (p < 0.001). This was at the expense of an increase in the volume of these organs receiving doses in the lowest range (<33%).

Conclusion
These results indicate that IMRT can improve target coverage and reduce dose to critical structures in gynecologic patients receiving an external beam radiotherapy boost. This dosimetric advantage will be integrated with other patient and treatment-specific factors, particularly internal tumor movement during fractionated radiotherapy, in the context of a future image-guided radiation therapy study.
A factor analysis of the Wechsler Adult Intelligence Scale 3rd Edition (WAIS‐III) in a low IQ sample
Authors: Jones Jill J. S. , van Schaik Paul , Witts Paul 
Published: May 2006

Objectives. Previous factor analytic studies of the WAIS, WAIS‐R and WAIS‐III used standardization samples, (representing the general population), clinical populations (e.g. psychiatric) and ‘non‐clinical’ groups (e.g. older adults). These studies endorsed the reliability of the scales in such samples and supported theoretical models of intelligence. The WAIS‐III (1997) includes four Indexes based on factor analysis, which provide clinically useful information to practitioners, but have not been validated in a low IQ population. However, the WAIS‐III is often administered to individuals with suspected or proven low IQ, as it offers service providers, legislators and the Department of Health with a reliable measure of IQ. The aim of this study was to investigate the factor structure of the WAIS‐III in a low IQ sample.Methods. WAIS‐III data was collected from assessments carried out in routine clinical practice from individuals with a full scale IQ of 74 or below (n=105). The data were subjected to factor analysis, using two types of factor analysis: principal axis factoring and principal components analysis. Orthogonal and oblique rotations were applied to the analyses.Results. Only one robust solution could be extracted. This contained two factors, analogous to traditional verbal and performance sub‐scales.Conclusions. This study does not support the four‐factor solution which underlies WAIS‐III index scores in a low IQ population.
Air permeability of aspen veneer and glueline: Experimentation and implications
Authors: Wang Brad Jianhe , Zhou Xiaoyan , Dai Chunping , Ellis Simon 
Published: May 2006

Abstract
Extensive experiments were conducted to investigate the transverse (vertical) air permeability of trembling aspen (Populus tremuloides) veneer and phenol formaldehyde (PF) gluelines, as well as aspen plywood and strandboard. The theory for permeability through laminates was used to determine the relative contribution of the veneer and glueline to panel permeability. Based on the classic Carman-Kozeny theory for porous materials, a concept of effective porosity was proposed to explain the difference in panel permeability and the resulting hot-pressing behavior. The results show that, for veneer-based panels, the panel compression ratio (CR) was the most important factor affecting panel permeability, followed by the sapwood/heartwood composition and glueline. As a 3–7% CR was reached, the panel permeability substantially decreased by approximately 80%. On average, the permeability of sapwood veneer panels was approximately four-fold higher than that of heartwood veneer panels. The glueline permeability decreased during glue curing, but the reduction from the uncured to the cured state was only ∼15%. In addition, the glueline permeability also decreased with increasing glue spread. At the normal level of glue spread for plywood, the average permeability of cured gluelines was approximately 20% of that for non-compressed veneer, but was close to that for veneer with a 3–7% CR. Since the thickness of the glueline was only ∼5% of that for normally peeled veneer, the net contribution of the glueline to panel permeability was limited. During hot pressing, therefore, the small deformation of the veneer ply effectively acts as the main barrier to gas and moisture movement, rather than the curing glueline. The rate of convection is negligible. The effective porosity in veneer panels was only ∼0.05–0.5% compared to the total panel voids, which ranged from 50% to 70%. At the same panel density, veneer panels had much lower permeability than strandboards. Although these commercial panel types had almost the same average permeability, the veneer panels showed approximately two-fold less variation due to the formation of layered and uniform gas and moisture barriers. As a result, the temperature and gas pressure responses during hot pressing were essentially different between plywood and strandboard.
Fracture cleavage analysis of PVAc latex adhesives: Influence of phenolic additives
Authors: López-Suevos Francisco , Frazier Charles E. 
Published: May 2006

Abstract
Mode I fracture cleavage testing was conducted on wood bonded with poly(vinyl acetate-co-NMA) latex adhesive containing two types/degrees of cross-linking: (1) cross-linking through AlCl3 catalysis of N-methylolacrylamide (NMA) comonomer; and (2) additional cross-linking using a phenol-formaldehyde resol additive, in addition to AlCl3 catalysis. The formulation lacking the phenolic additive performed well under dry conditions; but it completely failed during testing as a result of accelerated weathering. In contrast, fortification with the phenolic additive provided durability against accelerated weathering. In an effort to understand the effects of accelerated weathering, parallel-plate dynamic mechanical analysis was applied to freestanding neat adhesive films and to wood-bonded films (composites). Accelerated weathering dramatically altered the viscoelastic response of films and composites that lacked the phenolic additive; weathering caused a second, broad and reversible relaxation near 100°C, which might be because of softening of the poly(vinyl alcohol) interfacial agent used during emulsion polymerization. In contrast, samples formulated with the phenolic additive only displayed the typical base-polymer glass transition. Correlation of the fracture testing and the rheological analysis suggests that the phenolic additive promotes adhesive durability by cross-linking the interparticle boundaries, where poly(vinyl alcohol) is believed to reside.
Application of Periodontal Tissue Engineering Using Enamel Matrix Derivative and a Human Fibroblast‐Derived Dermal Substitute to Stimulate Periodontal Wound Healing in Class III Furcation Defects
Authors: Hovey Lawrence R. , Jones Archie A. , McGuire Michael , Mellonig James T. , Schoolfield John , Cochran David L. 
Published: May 2006

Background: Enamel matrix derivative (EMD) has been shown to promote several aspects of periodontal regeneration in vitro and in vivo. Recently, a bioengineered tissue (DG) was developed to promote wound healing of chronic skin ulcers. This pilot study sought to assess the effects of EMD and DG, alone or in combination, on periodontal wound healing in surgically created Class III furcation defects.Methods: Six female baboons received bilateral ostectomy of ∼10 mm around the first and second mandibular molars to achieve Class III, subclass C furcation defects. Wire ligatures and cotton pellets were left in place for 2 months to maintain the depth of the defects and promote plaque accumulation. Each furcally involved molar was then assigned to one of four treatments: open flap debridement (OFD), OFD plus EMD, OFD plus DG, or OFD plus DG and EMD. This resulted in six total sites per treatment group. Seven months after defect creation and 5 months after treatment, and after no oral hygiene, tissue blocks of the mandible were taken for blinded histometric analysis to assess parameters of periodontal regeneration adjacent to furcal root surfaces and from the mid‐furcal aspect (i.e., new bone, new connective tissue attachment, new epithelial attachment, and new cementum formation).Results: Histometric analysis demonstrated differential regenerative responses with respect to treatment within each animal. However, statistically significant differences between treatments from all six animals were not observed (P >0.20, mixed‐model analysis of variance). EMD‐treated sites presented mildly positive regenerative results and no negative responses. Both DG only and combination therapy demonstrated similar or less than positive responses relative to OFD controls.Conclusion: The descriptive analysis may suggest a positive effect of enamel matrix proteins and a negative effect of DG used alone or in combination with enamel matrix proteins on the regeneration of Class III furcation defects in baboons.
Inhibitory Effects of Tumor Necrosis Factor‐Alpha on Migration of Human Periodontal Ligament Cells
Authors: Takemura Akane , Nakagawa Ichiro , Kawai Shinji , Inaba Hiroaki , Kato Takahiro , Hamada Shigeyuki , Amano Atsuo 
Published: May 2006

Background: Tumor necrosis factor‐alpha (TNF‐α) is associated with chronic gingival inflammation and is suspected to influence periodontal destruction. However, the exact roles of TNF‐α in wound healing and periodontal tissue regeneration are largely unknown. In the present study, we examined the effects of TNF‐α on migration and proliferation of human periodontal ligament (PDL) cells.Methods: PDL cells were cultured in the presence of TNF‐α to determine its effects on cellular migration and proliferation. The protein expression profiles of α5 and β1 integrin subunits and their related molecules, paxillin and focal adhesion kinases (FAK), were investigated. Gene expression of fibronectin also was assayed. Further, the activation of Rho‐family small guanosine triphosphate (GTP)‐binding protein (RhoA) was evaluated using a GTP‐loading pull‐down assay, and focal adhesion formation by PDL cells after transfection with the expression vector of paxillin‐fused green fluorescent protein (GFP) also was observed with confocal microscopy.Results: Cellular migration was impaired by TNF‐α and recovered following the addition of anti‐TNF‐α antibodies. In contrast, PDL cell proliferation was not affected by TNF‐α. TNF‐α upregulated the expression of the α5 and β1 integrin subunits, whereas fibronectin was not overexpressed. Phosphorylation of paxillin and FAK by PDL cells was induced, and RhoA activation also was induced. Confocal microscopic analysis revealed that TNF‐α induced focal adhesion and stress fiber formation in all parts of the cells.Conclusion: Our results suggested that TNF‐α impairs cellular migration by enhancing cellular adhesive ability following significant focal adhesion and stress fiber formation.