Kotter's change management approach to transforming oral healthcare delivery: A case study.

Introduction: Despite progress in research and technological advancements, the delivery of oral health care continues to be plagued by disparities in accessibility and affordability. Dental caries and periodontal disease remain major issues, and new challenges such as socioeconomic disparities and emerging public health dangers also contribute to the complexity of the issue. To address these challenges, dental education and oral healthcare delivery must shift their focus from disease treatment to disease prevention and health promotion.

Patterns of opioid use among Texas dental practitioners during the COVID-19 pandemic.

Objective: The primary objective of this study is to assess factors that influence opioid prescribing by dentists and the role of these factors in the practice of dental pain control.

Design: A 25-question survey instrument was distributed to the study population for anonymous responses, covering dentist and practice demographics and opioid prescribing characteristics.

Setting: Private solo and group practice settings, including general practitioners and dental specialists.

Designing audit and feedback dashboards for dentists to monitor their opioid prescribing.

Background And Objective: Prescription drug abuse is a major factor leading to drug overdose deaths in the US and dentists are one of the leading prescribers of opioid pain medication. Knowing that Audit & Feedback (A&F) dashboards are an effective tool and are used as quality improvement interventions, we aimed to develop such dashboards personalized for dental providers which could allow them to monitor their own opioid prescribing performance.

Methods: In this paper we report on the process for designing the A&F dashboards for dentists which were developed by using an iterative human-centered design process.

Provider-directed analgesia for dental pain.

Introduction: Extraction of impacted molar teeth is a common procedure performed by oral surgeons and general dentists, with postoperative pain being a significant adverse event post-surgery. If mismanaged, pain can lead to complications that impact oral and systemic health. The current scourge of the opioid epidemic has ushered in a new era of provider-directed analgesic (PDA) therapy in dentistry.

Evolution of biofilm-adapted gene expression profiles in lasR-deficient clinical Pseudomonas aeruginosa isolates.

The overall success of a pathogenic microbe depends on its ability to efficiently adapt to challenging conditions in the human host. Long-term evolution experiments track and predict adaptive trajectories and have contributed significantly to our understanding of the driving forces of bacterial adaptation. In this study, we conducted a cross-sectional study instead of long-term longitudinal evolution experiments.

Liposomal phytohemagglutinin: In vivo T-cell activator as a novel pan-cancer immunotherapy.

Immunotherapy is an attractive approach for treating cancer. T-cell engagers (TCEs) are a type of immunotherapy that are highly efficacious; however, they are challenged by weak T-cell activation and short persistence. Therefore, alternative solutions to induce greater activation and persistence of T cells during TCE immunotherapy is needed.

A pilot study of 3D tissue-engineered bone marrow culture as a tool to predict patient response to therapy in multiple myeloma.

Cancer patients undergo detrimental toxicities and ineffective treatments especially in the relapsed setting, due to failed treatment attempts. The development of a tool that predicts the clinical response of individual patients to therapy is greatly desired. We have developed a novel patient-derived 3D tissue engineered bone marrow (3DTEBM) technology that closely recapitulate the pathophysiological conditions in the bone marrow and allows ex vivo proliferation of tumor cells of hematologic malignancies.

Nanoparticle T cell engagers for the treatment of acute myeloid leukemia.

Acute myeloid leukemia (AML) is the most common type of leukemia and has a 5-year survival rate of 25%. The standard-of-care for AML has not changed in the past few decades. Promising immunotherapy options are being developed for the treatment of AML; yet, these regimens require highly laborious and sophisticated techniques.

Vector Strategies to Actualize B Cell-Based Gene Therapies.

Recent developments in genome editing and delivery systems have opened new possibilities for B cell gene therapy. CRISPR-Cas9 nucleases have been used to introduce transgenes into B cell genomes for subsequent secretion of exogenous therapeutic proteins from plasma cells and to program novel B cell Ag receptor specificities, allowing for the generation of desirable Ab responses that cannot normally be elicited in animal models. Genome modification of B cells or their progenitor, hematopoietic stem cells, could potentially substitute Ab or protein replacement therapies that require multiple injections over the long term.

3D tissue engineered plasma cultures support leukemic proliferation and induces drug resistance.

Chronic myeloid leukemia (CML), acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL) are hematological malignancies that remain incurable despite novel treatments. In order to improve current treatments and clinical efficacy, there remains a need for more complex models that mimic the intricate human leukemic microenvironment. This study aimed to use 3D tissue engineered plasma cultures (3DTEPC) derived from CML, AML and CLL patients to promote proliferation of leukemic cells for use as a drug screening tool for treatment.

Localized Delivery of Cisplatin to Cervical Cancer Improves Its Therapeutic Efficacy and Minimizes Its Side Effect Profile.

Purpose: Cervical cancer represents the fourth most frequent malignancy in the world among women, and mortality has remained stable for the past 4 decades. Intravenous cisplatin with concurrent radiation therapy is the standard-of-care for patients with local and regional cervical cancer. However, cisplatin induces serious dose-limiting systemic toxicities and recurrence frequently occurs.

Cytotoxic activity of the amphibian ribonucleases onconase and r-amphinase on tumor cells from B cell lymphoproliferative disorders.

Although major advancements in antitumor treatment have been observed, several B cell-derived malignancies still remain incurable. A promising approach that involves targeting RNA either by the use of specific antisense oligonucleotides or cytostatic/cytotoxic ribonucleases (RNases) is being promoted. Two amphibian RNases, onconase (ONC; ranpirnase) and, more recently, r-amphinase (r-Amph), have already been tested, but thus far, mostly on solid tumors.

Spontaneous in vitro apoptosis of de novo chronic lymphocytic leukemia cells correlates with risk of the disease progression.

Despite significant progress in treatment, chronic lymphocytic leukemia (CLL) still remains an incurable disease. Major advances have been recently made to understand the molecular pathogenesis underlying CLL, but defects in apoptosis are considered to be the most important factors. Although neoplastic cells are resistant to apoptosis in vivo, they show decreased level of spontaneous in vitro apoptosis, with significant differences among CLL patients.

Influence of a municipal waste landfill on the spatial distribution of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/Fs) in the natural environment.

The paper presents the influence of a municipal waste landfill on the pollution of soil, plants and groundwater by polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/Fs). Analysis of their migration in the environment was made in relation to the direction of groundwater flow in the study area. Determination of PCDDs/Fs was performed by isotope dilution high resolution chromatography/tandem mass spectrometry (ID-HRGC/MS-MS) on a Thermo Scientific GCQ-1100/Trace2000 system equipped with an Xcalibur data acquisition and analysis software.

Sumter S. Arnim, D.D.S., Ph.D.: Texas leader in evidence-based dentistry.

Many lessons can be learned from the career of Dr. Sumter Arnim, chief among them that we have a professional obligation to apply scientific knowledge to the practice of dentistry and to involve our patients in their dental care, and to share this translational knowledge with one's colleagues. Arnim's work was an honor not only for the University of Texas Dental Branch (now, The University of Texas School of Dentistry at Houston), but for every school and student with whom he interacted.

The American Dental Association's Center for Evidence-Based Dentistry: a critical resource for 21st century dental practice.

Through its website (http:// www.ada.org/prof/resources/ebd/index.

Apical root resorption is associated with comprehensive orthodontic treatment but not clearly dependent on prior tooth characteristics or orthodontic techniques.

SYSTEMATIC REVIEW CONCLUSION: Increased incidence and severity of external apical root resorption (EARR) occurred in patients undergoing comprehensive orthodontic therapy, especially when therapy involved higher levels of force than those commonly used for orthodontic tooth movement. CRITICAL SUMMARY ASSESSMENT: Results from a high-quality systematic review of 11 randomized clinical trials (RCTs) suggests that EARR has a multifactorial etiology; is associated with comprehensive orthodontics; supports the clinical use of light forces, especially during intrusion of teeth; and requires higher-quality research. EVIDENCE QUALITY RATING: Limited.

The curse of discovery: pioneers of dental and medical anesthesia.

The current practice of dental local anesthesia remains founded upon drugs and techniques that were developed over 100 years ago. 2009 marks the 125th anniversary of the pioneering use of cocaine as a topical anesthetic and the introduction of nerve block injections in the oral cavity and facial region. Four famous clinicians are recognized in this article, each for their unique contributions to "modern" local anesthesia (Carl Köller, Sigmund Freud and William Halsted) and general anesthesia (Horace Wells), with the recognition of the adverse impact of drug dependence on their personal lives, which fortunately did not preclude their positively revolutionizing the practices of dentists and physicians and their patients every since.

Comparative efficacy of 2 topical anesthetics for the placement of orthodontic temporary anchorage devices.

This study compared the effectiveness of topical benzocaine 20% versus a combination of lidocaine, tetracaine, and phenylephrine in providing sufficient analgesia for the placement of orthodontic temporary anchorage devices (TADs). The 2 topical anesthetics were tested against each other bilaterally using a randomized, double-blind, crossover design. The agents were left in place for the amount of time prescribed by the manufacturer.

HIV: medical milestones and clinical challenges.

Since its discovery in the 1980s, HIV has infected every continent on the globe by crossing socioeconomic, racial, ethnic, and gender barriers, and it continues to contribute to human morbidity and mortality. Advances in medicine and technology have led to new combination medications for HIV-positive patients, early HIV testing methodologies, and potential for an HIV vaccine, and they have given researchers and clinicians a larger armamentarium with which to treat and prevent the disease. Even with these vast improvements in HIV prevention, detection, and treatment, scientists have been unsuccessful in developing its vaccine.

The Texas Dental Association and advocacy: a TDA president's perspective.

The TDA can take pride in the joint efforts of its leadership, its grassroots members, and its elected representatives in the middle of the decade of the 1990's. When asked about his legacy for the leadership of our organization, Dr. Eggleston emphatically states, "You have to act.