Who's declining the "free lunch"? New evidence from the uptake of public child dental benefits.

This study provides the first evidence on the determinants of uptake of two recent public dental benefit programs for Australian children and adolescents from disadvantaged families. Using longitudinal data from a nationally representative survey linked to administrative data with accurate information on eligibility and uptake, we find that only a third of all eligible families actually claim their benefits. We provide new and robust evidence consistent with the idea advanced by recent economic literature that cognitive biases and behavioral factors are barriers to uptake. For instance, mothers with worse mental health or riskier lifestyles are much less likely to claim the available benefits for their children. These barriers to uptake are particularly large in magnitude: together, they reduce the uptake rate by up to 10 percentage points (or 36%). We also find some indicative evidence that a lack of information is a barrier to uptake.

Assessment of distributional characteristics and ecological risks of cyclic volatile methylsiloxanes in sediments from urban rivers in northern Vietnam.

In this report, four cVMSs including hexamethylcyclotrisiloxane (D3), octamethylcyclotetrasiloxane (D4), decamethylcyclopentasiloxane (D5), and dodecamethylcyclohexasiloxane (D6) were determined in 85 sediment samples collected from three rivers in northern Vietnam during the period from May to November 2020. Total mean concentrations of cVMSs ranged from 75.4 to 15,000 ng/g-dw. The highest levels of cVMS were found in sediment samples collected from the To Lich River (range, 260-15,000 ng/g-dw; median, 2840 ng/g-dw), followed by the Nhue River (range, 188-6800 ng/g-dw; median, 1370 ng/g-dw), and the Day River (range, 75.4-4600 ng/g-dw; median, 666 ng/g-dw). Among cVMSs, decamethylcyclopentasiloxane (D5) was found at the highest levels in all samples and ranged from 9.00 to 11,000 ng/g-dw. Significant correlations exist between the concentrations of D4/D6 and D5/D6 pairs in river sediment samples. Although the calculated ecological risk was not high, the presence of cVMSs in the sediment raises concerns about the impact on aquatic life because of their long-term accumulation capacity.

The Effects of Nutrition Intervention on Postoperative Patients with Tongue Cancer and Floor of Mouth Cancer.

The aim of this study is to evaluate the effect of intensive nutrition support on patients with tongue cancer and floor of mouth cancer after surgery at K Hospital, Tan Trieu campus. Study the clinical intervention with a control group. We conducted the intensive nutrition intervention for our patients by giving counseling materials, sample menu and nutritional supplements, while the control group had only advice about dietary regimens. We evaluated a group before and after the intervention, at the same time compare the two groups before and after the intervention. After 1 mo, the intervention group increased 0.51±1.43 kg in comparison with their weight at the beginning; the weight of the control group lost -0.59±2.33 kg; the difference had statistical significance (p=0.025). After 1 and 2 mo of intervention, the rates of the participants without risk of malnutrition in the intervention group increased significantly in comparison with that in the control group; the difference has statistical significance with p=0.001 and p=0.003. In terms of quality of life, patients' problems related to areas including health status, functioning, symptoms of the intervention group improved more greatly than those of the control group. Especially, anorexia symptoms and financial impact were improved well in the intervention group (p=0.033, p=0.018). Nutrition intervention in patients with tongue cancer and floor of mouth cancer has shown a beneficial effect of nutrition counseling and intervention to improve patients' status in terms of nutrition and their quality of life.

Distribution of cyclic volatile methylsiloxanes in drinking water, tap water, surface water, and wastewater in Hanoi, Vietnam.

In this study, four cyclic volatile methylsiloxanes (cVMSs) were determined in drinking water, tap water, surface water, and wastewater samples collected from Hanoi metropolitan area, Vietnam, during August to December 2020 (dry season) by using solid phase extraction combined with gas chromatography tandem mass spectrometry. Highest concentrations of cVMSs in the range of 63-7400 ng/L (mean/median: 1840/1310 ng/L) were found in wastewater samples. A significant difference existed in the concentrations of cVMSs between influent and effluent of a wastewater treatment plant. The sum concentrations of four cVMSs in lake water, tap water, and bottled water samples were in the ranges of 67.0-1100 ng/L (mean/median: 350/282 ng/L), 19.8-350 ng/L (12.6/12.3 ng/L), and 2.31-28.1 ng/L (10.3/8.23 ng/L), respectively. Among the four cVMSs, decamethylcyclopentasiloxane (D5) was found at the highest concentrations in all water samples analyzed. The mean exposure doses of cVMSs calculated for adults and children through the consumption of drinking were 0.409 and 0.412 ng/kg-bw/day, respectively. Human exposure to cVMSs calculated through drinking water consumption was significantly lower than that reported for inhalation.

Polymeric nanoparticles containing conjugated phospholipase A2 for nonviral gene delivery.

Polyethylenimine (PEI) was conjugated to phospholipase A(2) (PLA(2)) in an effort to improve transfection efficiency. PLA(2) was conjugated to PEI using EDC as a coupling reagent. The activity of enzyme in the conjugate was measured. DNA condensation ability of the conjugate to polymer was determined. The resultant nanoparticles were characterized by dynamic and electrophoretic light scattering. Two reporter genes were used to evaluate transfection efficiency in human embryonic kidney (HEK293) and human hepatoma (HepG2) cell lines. Conjugate was shown to retain PLA(2) activity and its ability to condense plasmid DNA, resulting in nanoparticles of a similar size to native PEI. The results demonstrated at N/P ratios of 15 and 20 showed 13- and 8-fold increase in transfection efficiency, respectively, compared to the maximum transfection efficiency of PEI (N/P ratio of 5) in the whole range of N/P ratios tested, from 5 to 60 in HepG2 cells. Toxicity studies in HepG2 cells showed uncomplexed conjugate had similar toxicity as PEI, and when complexed with DNA the conjugate had a significantly reduced toxicity. The results clearly indicate the potential for this approach to improve efficiencies of nonviral gene delivery vectors.

Comparison of arch dimension changes in 1-phase vs 2-phase treatment of Class II malocclusion.

INTRODUCTION: We compared arch dimension changes in 1-phase and 2-phase treatment of Class II malocclusion. This was a prospective randomized clinical trial conducted in the Department of Orthodontics at the University of Florida between 1990 and 2003. METHODS: During phase 1 treatment, 86 subjects were treated with a bionator, 93 were treated with headgear/biteplane, and 81 served as the observation group. For phase 2, all subjects were then treated with full orthodontic appliances. Arch dimensions were followed; maxillary and mandibular alginate impressions were taken at baseline, end of early Class II treatment or observation, beginning of fixed appliance treatment, end of orthodontic treatment, and approximately 3 years posttreatment. Alginate impressions were taken of each dental arch at each data collection point. These were poured in orthodontic stone, trimmed, and photocopied from the occlusal aspect. These images were then scanned and measured. RESULTS: Although differences between the treatment groups were found in both the maxillary and mandibular arches after phase 1, these differences were no longer evident by the end of full orthodontic treatment or after posttreatment retention. CONCLUSIONS: There were no differences in arch dimensions after 1-phase or 2-phase treatment of Class II malocclusion.

The framework for patient care at California community health center dental clinics.

Community health centers in the United States improve access to dental care for underserved populations and individuals who live in underserved areas. The not-for- profit health centers provide care to patients regardless of their ability to pay and must follow extensive federal and state regulations. There are 245 California health center sites that provide dental care. This article reviews the framework for patient care at the California community health center dental clinic.

Using a stakeholder-engaged approach to develop and validate electronic clinical quality measures.

OBJECTIVE: To describe the stakeholder-engaged processes used to develop, specify, and validate 2 oral health care electronic clinical quality measures. MATERIALS AND METHODS: A broad range of stakeholders were engaged from conception through testing to develop measures and test feasibility, reliability, and validity following National Quality Forum guidance. We assessed data element feasibility through semistructured interviews with key stakeholders using a National Quality Forum-recommended scorecard. We created test datasets of synthetic patients to test measure implementation feasibility and reliability within and across electronic health record (EHR) systems. We validated implementation with automated reporting of EHR clinical data against manual record reviews, using the kappa statistic. RESULTS: A stakeholder workgroup was formed and guided all development and testing processes. All critical data elements passed feasibility testing. Four test datasets, representing 577 synthetic patients, were developed and implemented within EHR vendors' software, demonstrating measure implementation feasibility. Measure reliability and validity were established through implementation at clinical practice sites, with kappa statistic values in the "almost perfect" agreement range of 0.80-0.99 for all but 1 measure component, which demonstrated "substantial" agreement. The 2 validated measures were published in the United States Health Information Knowledgebase. CONCLUSION: The stakeholder-engaged processes used in this study facilitated a successful measure development and testing cycle. Engaging stakeholders early and throughout development and testing promotes early identification of and attention to potential threats to feasibility, reliability, and validity, thereby averting significant resource investments that are unlikely to be fruitful.

Various methods for isolation of multipotent human periodontal ligament cells for regenerative medicine.

Periodontal ligament (PDL) is a specialized connective tissue that connects cementum and alveolar bone to maintain and support the teeth in situ and preserve tissue homeostasis. Recent studies have revealed the existence of stem cells in human dental tissues including periodontal ligament that play an important role, not only in the maintenance of the periodontium but also in promoting periodontal regeneration. In this study, human periodontal ligament cells (hPDLCs) were isolated by outgrowth and enzymatic dissociation methods. Expression of surface markers on PDLCs as human mesenchymal stem cells (MSCs) was identified by flow cytometry. In addition, proliferation and differentiation capacity of cultured cells to osteoblasts, adipocytes were evaluated. As a result, we successfully cultured cells from the human periodontal ligament tissues. PDLCs express mesenchymal stem cell (MSC) markers such as CD44, CD73, and CD90 and do not express CD34, CD45, and HLA-DR. PDLCs also possess the multipotential to differentiate into various types of cells, such as osteoblast and adipocytes, in vitro. Therefore, these cells have high potential to serve as materials for tissue engineering, especially dental tissue engineering.

Liposomes as carriers for colchicine-derived prodrugs: vascular disrupting nanomedicines with tailorable drug release kinetics.

Newly formed tumor vasculature has proven to be an effective target for tumor therapy. A strategy to attack this angiogenic tumor vasculature is to initiate local blood vessel congestion and consequently induce massive tumor cell necrosis. Vascular disrupting agents (VDAs) typically bind to tubulin and consequently disrupt microtubule dynamics. Colchicine and its derivatives (colchicinoids) are very potent tubulin binding compounds but have a narrow therapeutic index, which may be improved by employing a liposomal targeting strategy. However, as a result of their physicochemical properties, colchicinoids are problematic to retain in liposomes, as they are released relatively rapidly upon encapsulation. To overcome this limitation, two hydrolyzable PEGylated derivatives of colchicine were developed for encapsulation into the aqueous core of long-circulating liposomes: a moderately rapid hydrolyzing PEGylated colchicinoid containing a glycolic acid linker (prodrug I), and a slower hydrolyzing PEGylated colchicinoid with a lactic acid linker (prodrug II). Hydrolysis studies at 37°C and pH 7.4 showed that prodrug I possessed relatively rapid conversion characteristics (t(1/2)=5.4 h) whereas prodrug II hydrolyzed much slower (t(1/2)=217 h). Upon encapsulation into liposomes, colchicine was released rapidly, whereas both PEGylated colchicine derivatives were efficiently retained and appeared to be released only after cleavage of the PEG-linker. This study therefore demonstrates that, in contrast to colchicine, these novel PEGylated colchicine-derived prodrugs are retained within the aqueous interior after encapsulation into liposomes, and that the release of the active parent can be controlled by using different biodegradable linkers.

Community-based dental education and community clinic finances.

To develop a long-term, sustainable partnership with dental schools, federally qualified health centers (FQHCs) need to assess the financial impact of dental students on their financial operations. Primary concerns are that students will not cover their marginal costs and will reduce the productivity of clinic dentists. This study uses data from Asian Health Services, an FQHC in Oakland, California, to examine revenues generated by senior dental students and by FQHC dentists when students are and are not present. The analysis of ten months of electronic record data showed that two full-time equivalent students generated $420,549 in gross revenues and reduced dentist output by only $29,000. While the results are from just one FQHC, they strongly suggest that students make a significant contribution to clinic productivity and finances.