bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resource Allocation in the National Health Service
Authors: Newdick Christopher 
Published: February 2021

In the United Kingdom, how does the National Health Service (NHS or the Service) respond to the pressures imposed on it by patients, doctors and the government? What techniques for distributing resources have been adopted for managing these pressures? Part I of this Article explains the administrative evolution of the NHS. Part II discusses the legal framework surrounding the allocation of resources throughout the different tiers of the NHS: (1) from the Secretary of State for Health to health authorities, (2) from health authorities to hospitals and general practitioners (GPs), and (3) from doctors to patients. Part III comments on the case for a standing committee to advise the government on matters of resource allocation within the NHS. It also considers the legal, political, and managerial contributions to the debate and, in particular, comments on the future of the traditional notion of clinical freedom.Section A describes the culture that developed within the NHS, Section B discusses the pressure for reform that developed during the 1980s, and Section C reviews the system of the “internal market” for health that was introduced in 1990.
Vicarious Liability: Relocating Responsibility For The Quality Of Medical Care
Authors: Havighurst Clark C. 
Published: February 2021

AbstractManaged health care has recently generated a great deal of distrust, even anger, in the public mind. To be sure, much of this public reaction is based on anecdotal evidence and one-dimensional thinking. But many unbiased experts observing managed care today are themselves unhappy with the health care industry's performance. While these observers find little justification for the current political backlash against managed care, they are also disappointed that today's health plans have not made a more positive difference. Indeed, informed observers commonly regret that the new arrangements for the financing and delivery of care have done so little to get physicians to adopt truly efficient practices, achieving not only cost reductions but also substantial improvements in health status and patient outcomes— that is, in the quality of care. Although managed care has not demonstrably harmed the overall quality of health care in the United States, it has done little to improve it.
Medicare Play-by-Play: A Review of Theodore Marmor's The Politics of Medicare
Authors: Thompson John Larkin 
Published: February 2021

For at least seven decades the issue of financing health care has been debated in this country. While the intensity of the battle has varied greatly, the underlying drive for reform has been well identified and remarkably consistent. Theodore Marmor's The Politics of Medicare is an exceptional book which documents this period.In its most general description the era has experienced persistent and growing support for financing reform that would have, at least, characteristics of universality, comprehensive coverage and delivery by a system capable of serving many diverse constituencies. Nothing in these attributes is novel, and each can be identified as present, to varying degrees, in health care financing systems operating throughout the industrial world. Broad goals always attract advocates of every stripe, but the scene changes rapidly when the process of definition commences. Even the most obvious component, universality, precipitates a conflict when the details of exactly who will be included in the covered population start to be hammered out. Endless examples of intense controversy exist over access to federal, state and local programs by the many different categories of individuals who live within this country.
The Class Action Suit As a Method of Patient Empowerment in the Managed Care Setting
Authors: Cerminara Kathy L. 
Published: February 2021

The American health care system has undergone tremendous transformation over the past few decades. The fee-for-service (FFS) health care system in which physicians enjoyed a great deal of autonomy has become a managed care system in which cost and utilization considerations play a larger role in physician decision making. Although physicians and other health care professionals are still patient advocates, this role often results in a conflict between their own economic interests and their duties to their patients.Rather than depending on self-sacrificing health care professionals to advocate for them, patients need to assert their own power in the managed care arena. One way to gain such power is to use the class action device in litigation aimed at improving medical care quality, cost and access. Class actions, in fact, are likely to proliferate as managed care organizations (MCOs) grow and affect more patients’ lives. There are well-recognized dangers to using the class action device, but if used properly, it could prove a valuable remedy for patients.
The Private Insurance Industry’s Tactics Against Suspected Homosexuals: Redlining Based on Occupation, Residence and Marital Status
Authors: Chi-Wen Li Katy 
Published: February 2021

Society has long associated acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) with homosexual men. One reason for this association is the statistics that establish a close connection between the homosexual lifestyle and HIV infection and AIDS. While there are an abundance of statistics and widespread perceptions that indicate a strong correlation between AIDS and HIV and homosexual males, there are statistical justifications that oppose the assertion. According to projections, the majority of gay and bisexual men will not develop AIDS. Reports show that in many foreign countries, AIDS is largely a heterosexual phenomenon. In addition, the percentage of AIDS cases resulting from transmission through heterosexual contact is rising dramatically. Furthermore, groups such as racial minorities and intravenous drug users also constitute a large proportion of AIDS cases.Statistics also demonstrate the high costs associated with treating AIDS patients and people infected with HIV. As the AIDS epidemic unfolded, the health insurance industry developed fears concerning the financial crisis that would result due to an increase in the number of AIDS cases and the emergence of expensive treatments.
Ionospheric Disturbances Over the Indian Sector During 8 September 2017 Geomagnetic Storm: Plasma Structuring and Propagation
Authors: Alfonsi L. , Cesaroni C. , Spogli L. , Regi M. , Paul A. , Ray S. , Lepidi S. , Di Mauro D. , Haralambous H. , Oikonomou C. , Shreedevi P. R. , Sinha A. K. 
Published: February 2021

AbstractThe series of X and M class flares and associated coronal mass ejections that occurred on the first days of September 2017 induced significant perturbations on the low‐latitude ionospheric electrodynamics. On 8 September in the Indian sector, the storm caused a severe modification of the equatorial electrojet (EEJ) with a consequent variation of the ionospheric structuring and dynamics. In our analysis, we propose an original method to isolate and identify EEJ variations from geomagnetic data and we detect the presence of equatorial plasma bubbles (EPB) from L‐band total electron content (TEC) data in order to understand their movement. Our results provide evidence of independent EPBs appearance freshly generated and inherited from a migrating plasma structure. The EPB (or EPBs) occurring in the south of India is/are freshly generated just above the magnetic equator, and is/are likely triggered by the sudden increase of EEJ just before the local sunset, acting as a pre‐reversal enhancement. The EPB appearing in the North‐East Indian region is associated with a migrating structure, resulting in a northward movement with a velocity of about 650 m/s, possibly testifying the passage of a large‐scale traveling ionospheric disturbance. The occurrence of severe post‐sunset scintillations in the northeastern sector suggests a possible cascade process forming small‐scale irregularities from the migrating EPB.
Machine Learning Predicted Redox Conditions in the Glacial Aquifer System, Northern Continental United States
Authors: Erickson M. L. , Elliott S. M. , Brown C. J. , Stackelberg P. E. , Ransom K. M. , Reddy J. E. 
Published: February 2021

AbstractGroundwater supplies 50% of drinking water worldwide and 30% in the United States. Geogenic and anthropogenic contaminants can, however, compromise water quality, thus limiting groundwater availability. Reduction/oxidation (redox) processes and redox conditions affect groundwater quality by influencing the mobility and transport of common geogenic and anthropogenic contaminants. In the glacial aquifer system, northern United States (GLAC, 1.87 million km2), groundwater with high arsenic or manganese concentration is associated with reducing conditions and high nitrate with oxidizing conditions. This study uses machine learning to identify the relative influence of drivers of redox conditions (e.g., residence time vs. reactivity) across the glacial landscape. We developed three‐dimensional boosted regression tree models to predict redox conditions using the likelihood of low dissolved oxygen or high iron as indicators of anoxic conditions. Results indicate that variation in redox condition is controlled primarily by residence time (e.g., groundwater age and relative depth) and to a lesser extent by geochemical reactivity (e.g., subsurface contact time, soil carbon). Older water and deeper wells, along with more water storage or slower water movement was associated with higher probability of anoxic conditions. Mapped model results illustrate regions where anoxic redox conditions may mobilize geogenic contaminants or oxic conditions may limit denitrification potential. Results may also provide simplified redox input for process or predictive models of, for example, arsenic, manganese, or nitrate. Machine learning modeling methods can lead to improved understanding of contaminant occurrence and what drives redox conditions, and the methods may be transferable to other settings.
The deubiquitinase (DUB) USP13 promotes Mcl-1 stabilisation in cervical cancer
Authors: Morgan Ethan L. , Patterson Molly R. , Barba-Moreno Diego , Scarth James A. , Wilson Adam , Macdonald Andrew 
Published: February 2021

AbstractProtein ubiquitination is a critical regulator of cellular homeostasis. Aberrations in the addition or removal of ubiquitin can result in the development of cancer and key components of the ubiquitination machinery serve as oncogenes or tumour suppressors. An emerging target in the development of cancer therapeutics are the deubiquitinase (DUB) enzymes that remove ubiquitin from protein substrates. Whether this class of enzyme plays a role in cervical cancer has not been fully explored. By interrogating the cervical cancer data from the TCGA consortium, we noted that the DUB USP13 is amplified in ~15% of cervical cancer cases. We confirmed that USP13 expression was increased in cervical cancer cell lines, cytology samples from patients with cervical disease and in cervical cancer tissue. Depletion of USP13 inhibited cervical cancer cell proliferation. Mechanistically, USP13 bound to, deubiquitinated and stabilised Mcl-1, a pivotal member of the anti-apoptotic BCL-2 family. Furthermore, reduced Mcl-1 expression partially contributed to the observed proliferative defect in USP13 depleted cells. Importantly, the expression of USP13 and Mcl-1 proteins correlated in cervical cancer tissue. Finally, we demonstrated that depletion of USP13 expression or inhibition of USP13 enzymatic activity increased the sensitivity of cervical cancer cells to the BH3 mimetic inhibitor ABT-263. Together, our data demonstrates that USP13 is a potential oncogene in cervical cancer that functions to stabilise the pro-survival protein Mcl-1, offering a potential therapeutic target for these cancers.
A phase 1b randomised, placebo-controlled trial of nabiximols cannabinoid oromucosal spray with temozolomide in patients with recurrent glioblastoma
Authors:   on behalf of the GWCA1208 study group, Twelves Chris , Sabel Michael , Checketts Daniel , Miller Sharon , Tayo Bola , Jove Maria , Brazil Lucy , Short Susan C. 
Published: February 2021

Abstract
Background
Preclinical data suggest some cannabinoids may exert antitumour effects against glioblastoma (GBM). Safety and preliminary efficacy of nabiximols oromucosal cannabinoid spray plus dose-intense temozolomide (DIT) was evaluated in patients with first recurrence of GBM.

Methods
Part 1 was open-label and Part 2 was randomised, double-blind, and placebo-controlled. Both required individualised dose escalation. Patients received nabiximols (Part 1, n = 6; Part 2, n = 12) or placebo (Part 2 only, n = 9); maximum of 12 sprays/day with DIT for up to 12 months. Safety, efficacy, and temozolomide (TMZ) pharmacokinetics (PK) were monitored.

Results
The most common treatment-emergent adverse events (TEAEs; both parts) were vomiting, dizziness, fatigue, nausea and headache. Most patients experienced TEAEs that were grade 2 or 3 (CTCAE). In Part 2, 33% of both nabiximols- and placebo-treated patients were progression-free at 6 months. Survival at 1 year was 83% for nabiximols- and 44% for placebo-treated patients (p = 0.042), although two patients died within the first 40 days of enrolment in the placebo arm. There were no apparent effects of nabiximols on TMZ PK.

Conclusions
With personalised dosing, nabiximols had acceptable safety and tolerability with no drug–drug interaction identified. The observed survival differences support further exploration in an adequately powered randomised controlled trial.

Clinical trial registration
ClinicalTrials.gov: Part 1– NCT01812603; Part 2– NCT01812616.
OutFin, a multi-device and multi-modal dataset for outdoor localization based on the fingerprinting approach
Authors: Alhomayani Fahad , Mahoor Mohammad H. 
Published: February 2021

AbstractIn recent years, fingerprint-based positioning has gained researchers’ attention since it is a promising alternative to the Global Navigation Satellite System and cellular network-based localization in urban areas. Despite this, the lack of publicly available datasets that researchers can use to develop, evaluate, and compare fingerprint-based positioning solutions constitutes a high entry barrier for studies. As an effort to overcome this barrier and foster new research efforts, this paper presents OutFin, a novel dataset of outdoor location fingerprints that were collected using two different smartphones. OutFin is comprised of diverse data types such as WiFi, Bluetooth, and cellular signal strengths, in addition to measurements from various sensors including the magnetometer, accelerometer, gyroscope, barometer, and ambient light sensor. The collection area spanned four dispersed sites with a total of 122 reference points. Each site is different in terms of its visibility to the Global Navigation Satellite System and reference points’ number, arrangement, and spacing. Before OutFin was made available to the public, several experiments were conducted to validate its technical quality.
Combination of a T cell activating therapy and anti-phosphatidylserine enhances anti-tumour immune responses in a HPV16 E7-expressing C3 tumour model
Authors: Dirk Brennan S. , Weir Genevieve , Quinton Tara , Hrytsenko Olga , Stanford Marianne M. 
Published: February 2021

AbstractDPX is a novel delivery platform that generates targeted CD8 + T cells and drives antigen-specific cytotoxic T cells into tumours. Cancer cells upregulate phosphatidylserine (PS) on the cell surface as a mechanism to induce an immunosuppressive microenvironment. Development of anti-PS targeting antibodies have highlighted the ability of a PS-blockade to enhance tumour control by T cells by releasing immunosuppression. Here, C57BL/6 mice were implanted with HPV16 E7 target-expressing C3 tumours and subjected to low dose intermittent cyclophosphamide (CPA) in combination with DPX-R9F treatment targeting an E7 antigen with and without anti-PS and/or anti-PD-1 targeting antibodies. Immune responses were assessed via IFN-γ ELISPOT assay and the tumour microenvironment was further analyzed using RT-qPCR. We show that the combination of DPX-R9F and PS-targeting antibodies with and without anti-PD-1 demonstrated increased efficacy compared to untreated controls. All treatments containing DPX-R9F led to T cell activation as assessed by IFN-γ ELISPOT. Furthermore, DPX-R9F/anti-PS treatment significantly elevated cytotoxic T cells, macrophages and dendritic cells based on RT-qPCR analysis. Overall, our data indicates that anti-tumour responses are driven through a variety of immune cells within this model and highlights the need to investigate combination therapies which increase tumour immune infiltration, such as anti-phosphotidylserine.
Analyzing the impact of 900 MHz EMF short-term exposure to the expression of 667 miRNAs in human peripheral blood cells
Authors: Lamkowski Andreas , Kreitlow Matthias , Radunz Jörg , Willenbockel Martin , Stiemer Marcus , Fichte Lars Ole , Rädel Carl Friedrich , Majewski Matthäus , Ostheim Patrick , Port Matthias , Abend Michael 
Published: February 2021

AbstractMore than ever before, people around the world are frequently exposed to different sections of the electromagnetic spectrum, mainly emitted from wireless modern communication technologies. Especially, the level of knowledge on non-thermal biological EMF effects remains controversial. New technologies allow for a more detailed detection of non-coding RNAs which affect the post-transcriptional control. Such method shall be applied in this work to investigate the response of human blood cells to electromagnetic irradiation. In this ex vivo in vitro study, we exposed peripheral blood cells from 5 male donors to a continuous wave of 900 MHz EMF for 0, 30, 60 and 90 min. Significant micro RNA (miRNA) expression changes (p ≤ 0.05) above or below the SHAM exposed samples were evaluated using a quantitative real time PCR platform for simultaneous detection of 667 miRNAs called low density array. Only significant miRNA expression changes which were detectable in at least 60% of the samples per exposure group were analyzed. The results were compared with data from room temperature + 2 °C (RT + 2 °C) samples (here referred to as hyperthermia) to exclude miRNA expression altered by hyperthermia. The validation study by using the same donors and study design was performed after an interval of 2 years. When analyzing a total of 667 miRNAs during the screening study, 2 promising candidate miRNAs were identified, which were down regulated almost twice and showed a complete separation from the unexposed control group (miR-194 at 30 min and miR-939 at 60 min). The p-values even survived the Bonferroni correction for multiple comparisons (p = 0.0007 and p = 0.004, respectively). None of these miRNAs were expressed at a second time point after EMF exposure. Following an alternative analysis approach, we examined for miRNAs revealing an expected significant association of differential miRNA expression with the dose-time EMF exposure product, separately for each donor. Donors 2 and 3 revealed 11 and 10 miRNA species being significantly associated with EMF exposure which differed significantly from the other donors showing a minor number of differentially expressed miRNAs and could identify donors 2 and 3 as particularly EMF-responsive. The measurements were repeated after 2 years. The number of expressed/non-expressed miRNAs was almost similar (97.4%), but neither the number nor the previously differentially expressed miRNAs could be reproduced. Our data neither support evidence of early changes at miRNA expression level in human whole blood cells after 900 MHz EMF exposure nor the identification of EMF-responsive individuals.
Observation of direction instability in a fiber ring laser
Authors: Arshad Muhammad Assad , Hartung Alexander , Pratiwi Arni Candra , Jäger Matthias 
Published: February 2021

AbstractWe report on the observation of a new phenomenon occurring in a fiber ring laser. This phenomenon is about the transition from an initially bidirectional emission of a reciprocal fiber ring laser to a unidirectional emission at a certain pump power threshold. In addition, the final direction is not predefined but appears to be randomly chosen every time the threshold is exceeded. Therefore, we term this new phenomenon direction instability. Furthermore, we provide a first discussion of how the instability threshold is influenced by the length and the loss of the cavity. We show that the threshold follows a power times length scaling, indicating a nonlinear origin.
Natural depolymerization of waste poly(ethylene terephthalate) by neutral hydrolysis in marine water
Authors: Stanica-Ezeanu Dorin , Matei Danuta 
Published: February 2021

AbstractPolyethylene terephthalate (PET) is one of the most widely used materials for food packaging and fishing nets. After use it become waste and, due to poor collection, most will be found floating in marine waters. This paper presents the results of a study of PET depolymerization by hydrolysis. We observed that marine water is a perfect reactant because it contains a multitude of metal ions that act as catalysts. A first-order kinetic model was developed and experimental data fitted to it. An activation energy of 73.5 kJ/mole and a pre-exponential factor of 5.33 × 107 h–1 were obtained. Considering that the global ocean is a huge batch reactor operating under isothermal conditions, the solution of the mathematical model shows that in tropical regions only 72 years is needed for total and only 4.5 years for 50% PET conversion.
Pseudohomogeneous metallic catalyst based on tungstate-decorated amphiphilic carbon quantum dots for selective oxidative scission of alkenes to aldehyde
Authors: Rezaei Aram , Hadian-Dehkordi Leila , Samadian Hadi , Jaymand Mehdi , Targhan Homa , Ramazani Ali , Adibi Hadi , Deng Xiaolei , Zheng Lingxia , Zheng Huajun 
Published: February 2021

AbstractHerein, we present an interesting role of tungstate-decorated amphiphilic carbon quantum dots (A-CQDs/W) in the selective oxidative cleavage of alkenes to aldehydes. In this work, for the first time, we disclose an unprecedented tungstate-based oxidative system incorporating A-CQDs as a bridge to the homogeneous catalyst for selective and efficient cleavage of a wide substrate scope of alkenes into aldehydes. The A-CQDs/W were synthesized via a one-step hydrothermal synthesis approach using 1-aminopropyl-3-methyl-imidazolium chloride and stearic acid for the surface modification, following by anion-exchange to immobilize WO4–2 to A-CQDs. The A-CQDs/W act as a pseudohomogeneous metallic catalyst (PMC) for selective oxidative scission of alkenes under phase transfer catalysts (PTC) free condition without over oxidation to acids, using water and H2O2 as a green oxidant. Thanks to the sub-nanometric size and novel engineered chemical structure, this PMC and reactants are in the same phase, besides they can be easily isolated from each other by extraction processes. The synthesized PMC exhibited excellent solubility and stability in various solvents. Interestingly, the system’s high conversion efficiency was preserved even after eight catalytic cycles indicating the recyclability of the synthesized PMC. We believe that this study provides a significant and conceptually novel advance in oxidative cleavage chemistry.