bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Future of Blue Cross
Authors: Schonbrun Michael 
Published: January 2008

This paper analyzes the reasons for the rise and decline of Blue Cross, a unique American institution. Its inability to respond to the crisis in today's health system is described as nothing more than the failure of the ailing American health system to cure itself.
The early rise of Blue Cross is attributed to its success in addressing pressing social needs: helping patients afford the costs of hospitalization and helping hospitals meet expenses. Its later decline is traced to several factors: the striking increase in the costs of health care; the rise of the state insurance commissioner; the anticipated passage of national health insurance; and the increased competition from commercial insurance carriers, specialty health care data and management firms and state governments.
In concluding, the question is raised whether society should invest further in the future of Blue Cross, a social institution which may have irrevocably lost the confidence of the general public, government and the health provider community. Four possible futures for Blue Cross are set forth: the outright collapse of several plans, a “Lockheed-type” bailout, a “Naderist” organization strongly allied with consumers, and a quasi-governmental agency.
Health Services Research and Health Policy Formulation: An Empirical Analysis and a Structural Solution
Authors: Williams Sherman R. , Wysong Jere A. 
Published: January 2008

This article examines the history of the National Center for Health Services Research (NCHSR) from 1970 to 1976 in terms of the research projects funded, the structural relationships of NCHSR to policy formulation, and the make-up of advisory committees. The analysis of support for research on substantive policy issues indicates that there are no major trends; the variations that do occur can be traced to publicly articulated concerns of Congress or the Executive. On the other hand, there have been major shifts in research strategies. from an early emphasis on large-scale development and demonstration to support for short-term, targeted analytical research. This shift has occurred without a thorough examination of the effectiveness of either strategy for policy-making. The analysis of the structural relationships of the Center do not provide any evidence of a stable, systematic linkage of research and policy-making functions. Nor does the analysis of the various advisory groups show that policy-makers have had a significant involvement in guiding the National Center program.
As a result of these analyses, it is our conclusion that measures need to be taken to provide a systematic, formal linkage of the National Center to health policymakers in the administrative and legislative arms of government. We propose that a National Council for Health Services Research and Policy be instituted for the National Center for Health Services Research to assure accountability in choice of priorities and research strategies, and to provide for policy-maker participation in the program of the agency. The objective of the Council would be to provide timely and comprehensive research information and policy alternatives to appropriate national policy-makers, health care providers and consumers.
Variations in State Medicaid Programs
Authors: Davidson Stephen M. 
Published: January 2008

Many federal laws permit the states considerable latitude in determining the important characteristics of programs created under them. Yet, frequently, this aspect is overlooked in the analyses of differences in state-level programs. The purpose of this paper is to present a measure to aid in the analysis of one such program, Medicaid, and to illustrate some of the ways it can be useful.
The Medicaid Program Index (MPI) differentiates among state Medicaid programs according to four important characteristics: inclusion of the medically indigent, the optional services covered, limitations on the provision of the basic services, and arrangements for paying providers. Data are presented to show that, in fact, the states do vary considerably on these factors, which can be analyzed in the aggregate (i.e., as the MPI) or separately. In addition, several uses for the MPI are discussed. They include: (1) identifying variations in state programs; (2) accounting for those differences by comparing them to promising explanatory variables; (3) identifying trends in program characteristics over time; and (4) developing hypotheses to account for those trends. Finally, it was suggested that similar measures can be developed to facilitate analyses of other federal/state programs.
Children's Advocacy and Primary Health Care
Authors: Tompkins Richard F. 
Published: January 2008

Children cannot always articulate their own interests or make their own decisions. Children's advocacy is fundamentally an attempt to improve the lives of children. The advocacy effort may be directed either toward improving the outcomes of the decision or the process through which the decision is made.
Children as a class are not well served by the health sector relative to other groups; poor children receive benefits and bear costs unequal to the nonpoor; and there is an unnecessary gap between what our technology is capable of offering and what is actually provided. These facts, in combination with the understanding that child health decisions are frequently made in arenas where the interests of children are not well represented, strongly suggest that child health care decision making can be improved. Children's advocacy offers opportunities for such improvement.
Protecting the Reproductive Health of Workers: Problems in Science and Public Policy
Authors: Valentine Jeannette M. , Plough Alonzo L. 
Published: January 2008

This paper first reviews the scientific problems involved in assessing the effects on reproductive health of toxic substances in the work environment. It then describes the current status of regulatory policies designed to control workers' exposures to toxins believed to affect reproduction. Finally, the paper discusses the relationship between scientific uncertainty and regulatory strategies.
Because demonstrating reproductive health effects is extremely difficult, the assessment of the health risks of exposures, as well as of the economic costs of regulation, is probabilistic. Therefore, uncertainty is inherent in any regulatory decision in this area. And the case of reproductive risks is illustrative of the more general problem of protecting the health of workers within a context of scientific uncertainty, and within a highly charged political environment characterized by anti-regulatory sentiment and industries in economic decline.
Preparation and in vitro characterization of gellan based floating beads of acetohydroxamic acid for eradication of H. pylori
Authors: Rajinikanth Parauvathanahalli , mishra Brahmeshwar 
Published: January 2008

Preparation andin vitrocharacterization of gellan based floating beads of acetohydroxamic acid for eradication ofH. pyloriGellan based floating beads of acetohydroxamic acid (AHA) were prepared by the ionotropic gellation method to achieve controlled and sustained drug release for treatment ofHelicobacter pyloriinfection. The prepared beads were evaluated for diameter, surface morphology and encapsulation efficiency. Formulation parameters like concentrations of gellan, chitosan, calcium carbonate and the drug influenced thein vitrodrug release characteristics of beads. Drug and polymer interaction studies were carried out using differential scanning calorimetry. Chitosan coating increased encapsulation efficiency of the beads and reduced the initial burst release of the drug from the beads. Kinetic treatment of the drug release data revealed a matrix diffusion mechanism. Prepared floating beads showed good antimicrobial activity (in vitro H. pyloriculture) as potent urease inhibitors. In conclusion, an oral dosage form of floating gellan beads containing AHA may form a useful stomach site specific drug delivery system for the treatment ofH. pyloriinfection.
New co-polymer zwitterionic matrices for sustained release of verapamil hydrochloride
Authors: Kostova Bistra , Rachev Dimitar 
Published: January 2008

New co-polymer zwitterionic matrices for sustained release of verapamil hydrochlorideStable co-polymer [vinyl acetate-co-3-dimethyl(methacryloyloxyethyl) ammonium propane sulfonate, p(VA-co-DMAPS)] latex of different compositions has been synthesized for the first time by emulsifier-free emulsion copolymerization. The unusual >>overshooting<< behavior of the co-polymer tablets has been explained by the formation of specific clusters from the opposite oriented dipoles-zwitterionic species. The change of their concentration with the DMAPS unit fraction (mDMAPS), pH and ionic strength has been considered responsible for the differences observed in the swelling kinetics. The results obtained prove that mDMAPSand ionic strength could be used to control the swelling degree of the p(VA-co-DMAPS) matrices and their sustained drug delivery. In this way, p(VA-co-DMAPS) matrices could be effectively used to control the sustained release of drugs with basic properties like verapamil hydrochloride from model tablets.
Hydroaminomethylation of n‐Alkenes in a Biphasic Ionic Liquid System
Authors: Hamers Bart , Bäuerlein Patrick S. , Müller Christian , Vogt Dieter 
Published: January 2008

AbstractHydroaminomethylation reactions were performed successfully in an imidazolium‐based ionic liquid using a rhodium/sulfoxantphos system by reacting piperidine with different n‐alkenes, affording yields higher than 95 % of the resulting amine with turnover frequencies of up to 16,000 h−1, along with high regioselectivity for the linear amines with l/b ratios up to 78. Additionally, facile quantitative catalyst recovery was accomplished and recycling of the catalyst and product separation was achieved by a fast phase separation after the reaction. The product distribution was monitored over time at different temperatures both in an organic solvent and in the ionic liquid in order to investigate and compare the course of the formation of (side) products and intermediates in these reactions. Furthermore, it was shown that the nature of the rhodium precatalyst has a profound effect on the activity and selectivity. Protic organic solvents and ionic liquids containing a CH acidic bond in the imidazolium part have a beneficial effect on the hydrogenation activity of the catalyst systems.
Heterogeneous Catalysis for Fine Chemicals in Dense Phase Carbon Dioxide
Authors: Ciriminna Rosaria , Carraro Massimo L. , Campestrini Sandro , Pagliaro Mario 
Published: January 2008

AbstractAn increasing number of fine chemicals is being produced using heterogeneously catalysed reactions in supercritical carbon dioxide with significant improvements in terms of process selectivity and purity of the products thereby obtained. A selection of examples and of recent findings shows the large potential of this technology for the synthetic chemistry of the future.
Highly Diastereo‐ and Enantioselective Catalytic Domino Thia‐Michael/Aldol Reactions: Synthesis of Benzothiopyrans with Three Contiguous Stereocenters
Authors: Zhao Gui‐Ling , Vesely Jan , Rios Ramon , Ibrahem Ismail , Sundén Henrik , Córdova Armando 
Published: January 2008

AbstractHighly enantioselective organocatalytic domino thia‐Michael/aldol reactions between 2‐mercaptoacetophenone and α,β‐unsaturated aldehydes are presented. The reactions proceed with excellent chemo‐, diastereo‐ and enantioselectivity to give the corresponding benzothiopyran derivatives in high yields with up to >15:1 dr and 96 to >99 % ee.
Moving finite elements method applied to dynamic population balance equations
Authors: Duarte Belmiro P. M. , Baptista Cristina M. S. G. 
Published: January 2008

AbstractA moving finite elements scheme is developed and used for solving 1‐D dynamic population balance equations (PBE). The method stands on the weighted finite‐elements based approach, and the local solutions are represented by cubic Hermite polynomials. The weighting function is the gradient of residuals with respect to time derivatives of the solution at the nodes and nodal velocities. The general PBE considered includes nucleation, growth, aggregation and breakage terms. The accuracy of the moving finite elements method (MFEM) is evaluated by comparing the results to the analytical solution in problems involving combinations of the first three phenomena considered. The formulation addressed was successful when used for solving a two‐ phase system representing a semibatch precipitation reactor. The MFEM enables one to achieve accurate results at reasonable CPU times, thus, showing to be adequate for these kind of problems. © 2008 American Institute of Chemical Engineers AIChE J, 2008
Passage of a bubble through a liquid–liquid interface
Authors: Dietrich N. , Poncin S. , Pheulpin S. , Li Huai Z. 
Published: January 2008

AbstractThe aim of this study is to investigate the bubble passage at a liquid–liquid interface using a high‐speed video camera (950 images per second) and a Particle Image Velocimetry (PIV) system. Experiments were conducted in a square Plexiglas column of 0.1 m. Bubbles were generated through a submerged orifice (D = 1 × 10−3 m). The Newtonian Emkarox (HV45) solution was employed for the heavy phase whereas two different organic liquids of different viscosity (Silicone oil 10 mPa s and 100 mPa s) were used as light phase. Experimental results show the effect of the bubble size and the viscosity of the light phase on the retention time, the length of the column of fluid entrained behind the bubble, the bubble velocity as well as the velocity fields at the liquid–liquid interface. © 2008 American Institute of Chemical Engineers AIChE J, 2008
Heparin‐induced thrombocytopenia in myeloproliferative disorders: A rare or under‐diagnosed complication?
Authors: Spectre Galia , Kalish Yossi , Schliamser Liliana , Varon David 
Published: January 2008

AbstractPatients with myeloproliferative disorders (MPD) are prone to develop thrombotic complications and thus frequently receive heparin. Surprisingly heparin‐induced thrombocytopenia (HIT) has been rarely reported in MPD and is potentially under‐diagnosed due to the relatively high platelet count. We report three patients with MPD who developed HIT; all presented with a relative fall of platelet counts (although without an absolute thrombocytopenia), thrombosis or skin necrosis and a positive test for HIT antibodies (particle gel immunoassay). Risk factors for developing HIT in our patients were exposure to unfractionated heparin, a recent surgical procedure and female gender. We review the literature on HIT in MPD and discuss the diagnosis of HIT in the absence of an absolute thrombocytopenia. Am. J. Hematol., 2008. © 2008 Wiley‐Liss, Inc.
Optimizing BeLPT criteria for beryllium sensitization
Authors: Middleton D.C. , Fink J. , Kowalski P.J. , Lewin M.D. , Sinks T. 
Published: January 2008

AbstractBackgroundThe beryllium lymphocyte proliferation test (BeLPT) is used to identify persons sensitized to beryllium. ATSDR convened an expert panel of physicians and scientists in April 2006 to discuss this test and to consider what BeLPT test results actually establish beryllium sensitization. The three criteria proposed by panel members were

one abnormal result,
one abnormal and one borderline result, and
two abnormal results.
MethodsComplete algorithms were developed for each of the three proposed criteria. Using single‐test outcome probabilities developed by Stange et al. [2004. Am J Ind Med 46:453–462], we calculated and compared the sensitivity, specificity, and positive predictive values (PPVs) for each set of criteria.ResultsThe overall sensitivity and specificity of the three criteria were similar. When the criteria required confirmation of an abnormal result the PPV was higher—whether the requirement was satisfied by a borderline result, or only by another abnormal result. Confirmation also reduced the likelihood of false positives. The differences between the three criteria decreased as the prevalence of sensitization increased.ConclusionsA single unconfirmed abnormal is usually insufficient to establish sensitization for an apparently healthy person. When the prevalence of beryllium sensitization in a group is high, however, even a single abnormal BeLPT can be a strong predictor. Am. J. Ind. Med. 51:166–172, 2008. © 2008 Wiley‐Liss, Inc.
Effect of UV and hygrothermal aging on the mechanical performance of polyurethane elastomers
Authors: Aglan H. , Calhoun M. , Allie L. 
Published: January 2008

AbstractIn this study, the effects of environmental aging on the mechanical performance of elastomeric polyurethane (PU) were investigated using two accelerated aging techniques, namely, ultraviolet (UV) and hygrothermal (HT). Samples were prepared and subjected to UV and HT exposure for a period of 5 months and removed and mechanically tested at different time intervals. Differential scanning calorimetry (DSC) was performed. A noticeable change in the chemical structure of the PU after 1 month of UV exposure was found, however, that was not the case after 1 month of HT exposure. The stress and strain to failure, tearing energy, and storage modulus were evaluated at different intervals for both aging techniques. It was found that the UV exposure caused severe degradation of the PU in comparison with the HT. A reduction of more than 98% in the tearing energy was observed for the UV‐exposed samples after 5 months when compared with only a 35% reduction in the tearing energy for the HT‐exposed samples. A similar trend was observed for tear strength and storage modulus. The degradation mechanisms of the PU elastomers have been identified using SEM and correlated with the tearing energy. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008
Shear‐induced migration of nanoclay during morphology evolution of PBT/PS blend
Authors: Hong Joung Sook , Kim Yong Kyoung , Ahn Kyung Hyun , Lee Seung Jong 
Published: January 2008

AbstractIn this study, we investigated clay migration and its localization in multiphase blend nanocomposite systems during the evolution of blend morphology to elucidate how a hydrodynamic stress and chemical affinity between the polymer and clay induce them. To observe the morphology evolution, a multilayered blend, alternatively superposed poly(butylenes terephthalate) (PBT) and polystyrene (PS)/clay films or PBT/clay and PS films, was subjected to homogeneous shear flow, 1 s−1. Furthermore, the morphology was observed at different shear rates 1 s−1. When the PBT/(PS/clay) multilayered blend is subjected to flow, the clay dispersed in the PS layer first migrates to the interface depending on the amount of applied strain. The clay at the interface causes the average drop size of blend morphology to become smaller and the blend morphology becomes more stable because of the coalescence suppression effect. As more shear is applied, the clay at the interface moves further into more compatible phase, PBT, although the viscosity of PBT is higher than PS. On the contrary, the clay in the PBT layer does not migrate to the PS phase at any shear rate, which means that its chemical affinity is strong enough to prevent shear‐induced migration. The clay increases the viscosity of the PBT phase and results in a different morphology with a droplet, cocontinuous structure. As a result, when the clay is induced to migrate by hydrodynamic stress, it migrates into thermodynamically more stable positions at the interface or in the chemically more compatible phase, depending on the applied strain. Once it is located at a thermodynamically more stable position, it is difficult to push it out only by hydrodynamic stress. The location of clay is significantly affected by the morphology during evolution, which means that the blend morphology can control the droplet form and cocontinuous structure by control of the clay migration kinetics. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008
Resultant synergism in the shear resistance of acrylic pressure‐sensitive adhesives prepared by emulsion polymerization of n‐butyl acrylate/2‐ethyl hexyl acrylate/acrylic acid
Authors: Moghbeli M. R. , Zamir S. M. , Molaee B. 
Published: January 2008

AbstractAcrylic emulsion pressure‐sensitive adhesives (PSAs) were synthesized by the copolymerization of n‐butyl acrylate with various levels of 2‐ethyl hexyl acrylate (2EHA) and a small constant amount of acrylic acid. The effect of varying the n‐butyl acrylate/2EHA monomer composition on the kinetic behavior of the polymerization and the characteristics of the copolymers prepared in a batch process were investigated. The results showed that increasing the amount of 2EHA in the monomer caused the polymerization rate and the glass‐transition temperature of the acrylic copolymers to decrease. Increasing the amount of 2EHA caused the gel content of the copolymers to decrease, reaching a minimum at 50 wt %; thereafter, the gel content increased at higher 2EHA levels. For the acrylic emulsion, the peel‐fracture energy of the PSAs decreased as the amount of 2EHA in the monomer was increased up to 50 wt %. At higher 2EHA levels, the peel‐fracture energy was relatively constant. Interestingly, a synergistic effect of increased shear resistance at 25 wt % 2EHA was observed without a significant trade‐off in terms of the peel and tack properties. This behavior was attributed to a good interconnection between the microgels and the free polymer chains inside the contacting particles in the adhesive film. Cooperation between various levels of 2EHA in the copolymer structure simultaneously changed the crosslink molecular weight (Mc) of the microgels and the entanglement molecular weight (Me) of the free chains in the adhesive network morphology. The adhesive performance of the PSAs was found to be correlated with their Mc/Me values as the 2EHA proportion was varied. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008
Dithioester functionalization of poly(cyclohexene oxide) and its application to obtain block copolymers
Authors: Acosta Ortiz Ricardo , Guerrero Santos Ramiro , Berlanga Duarte Lydia , Perez Alvarez Erik A. , Cabello Romero Judith N. , Garcia Valdez Aida E. 
Published: January 2008

AbstractA new method of introducing dithioester groups into the polymer chain of poly(cyclohexene oxide) is reported. It includes the use of diaryliodonium salt and an aromatic dithioacid as a redox couple to initiate the cationic polymerization of cyclohexene oxide. It was found that the dithioacid by itself cannot start the polymerization of cationic polymerizable monomers; however, in combination with a diaryliodonium salt, an exothermic reaction was produced, yielding a thiocarbonylthio‐functionalized polyether. Thermal profiles of the redox polymerizations were determined by means of optical pyrometry. A preliminary study showed that when the poly(cyclohexene oxide) functionalized with dithioester groups was introduced into the radical polymerization of styrene, the polystyryl growing radicals reacted with the dithioester‐functionalized polyether to form a block polymer. The amount of polyether actually incorporated into the block copolymer was calculated to be 70% of the initial amount of poly(cyclohexene oxide)/dithiobenzoic acid charged into the reactor. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008