bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health insurance sector in India: an analysis of its performance
Authors: Dutta Madan Mohan 
Published: November 2020

Purpose
Health insurance is one of the major contributors of growth of general insurance industry in India. It alone accounts for around 29% of total general insurance premium income earned in India. The growth of this sector is important from the perspective of overall growth of general insurance Industry. At the same time, problems in this sector are also many which are affecting its performance.

Design/methodology/approach
The paper provides an understanding on performance of health insurance sector in India. This study attempts to find out how much claims and commission and management expenses it has to incur to earn certain amount of premium. Methodology used for the study is regression analysis to establish relationship between dependent variable (Profit/Loss) and independent variable (Health Insurance Premium earned).

Findings
Findings of the study indicate that there is significant relationship between earned premium and underwriting loss. There has been increase of premium earnings which instead of increasing profit for the sector in fact has increased underwriting loss over the years. The earnings of the sector is growing at compounded annual growth rate of 27% still it is unable to earn underwriting profit.

Originality/value
This study is self-driven based on secondary data obtained from insurance regulatory and development authority site.
Patterns in intraspecific variation in root traits are species‐specific along an elevation gradient
Authors: Weemstra Monique , Freschet Grégoire T. , Stokes Alexia , Roumet Catherine 
Published: November 2020

Abstract

Intraspecific trait variation is an important driver of plant performance in different environments. Although roots acquire essential resources that vary with the environment, most studies have focused on intraspecific variation in leaf traits, and research on roots is often restricted to a few species. It remains largely unclear how and to what extent root traits vary with the environment and whether general intraspecific patterns exist across species.

We compared intraspecific variation in specific root length (SRL), root diameter, root tissue density (RTD) and root branching density of 11 species along a 1,000 m elevation gradient in the French Alps. We tested (a) the extent of intraspecific versus interspecific root trait variation along the gradient, (b) whether intraspecific trait patterns with elevation were consistent among species and (c) whether environmental variables better explained intraspecific variation in root traits than elevation. Specifically, we hypothesised that within a species, root trait values would adjust to enhance resource acquisition (either through an increase in SRL or root diameter, and/or in branching density) and/or conservation (increased RTD) at higher elevations.

Species identity explained most of the overall variation in root traits. Elevation explained only a minor proportion of intraspecific root trait variation, which was larger within than between elevations. Also, trait relationships with elevation rarely agreed with our hypotheses, varied strongly across species and were often differently related to environmental variation. Generally, climate, soil and vegetation properties better explained intraspecific root variation than elevation, but these relationships were highly species‐dependent.

Along complex environmental gradients where multiple properties simultaneously change, roots of different species vary in different ways, leading to species‐specific patterns in intraspecific root trait variation. The lack of support for our hypotheses may be caused by the multiple interactions between environmental properties, small‐scale soil heterogeneity, species phylogeny and changing plant–plant interactions. Our findings suggest that, to enhance our understanding of the effects of environmental change on plant performance, we need to better integrate the multiple dimensions of plant responses to change and measure a broader set of root traits and environmental variables.

A free Plain Language Summary can be found within the Supporting Information of this article.
A workflow for multimineralogic carbonate rock physics modelling in a Bayesian framework: Brazilian pre‐salt reservoir case study
Authors: Dias Jonatan , Lopez Jorge L. , Velloso Raquel , Perosi Fabio 
Published: November 2020

ABSTRACTWe develop a workflow to estimate elastic attributes ( and ) of Pre‐Salt carbonate reservoirs using the Xu and Payne rock physics model in a depth‐variant multimineralogic fashion and apply it to one calibration and four extrapolation wells in a field in the Brazilian Santos Basin. Some of the parameters were stochastically simulated in a Bayesian framework to handle the model non‐uniqueness. Nuclear magnetic resonance porosity and mineralogic logs and x‐ray powder diffraction data from the studied wells and literature reference values were used for elastic solid media and dual‐porosity network modelling, bringing geological reasoning to the proposed workflow. Using rock physics templates, we improved our understanding of the reservoir petroelastic trends and devised alternative model parameterizations. Since the model was parameterized in a multimineralogic fashion with depth‐variant mineralogic information (e.g. volumes of carbonate, quartz and clay) as input, we improved elastic attribute estimations within the reservoir, increasing the model predictive power, compared to the common practice of allowing only porosity to vary with depth and representing the matrix properties by a depth‐invariant homogeneous or mixed mineral. We also investigated the workflow robustness and non‐uniqueness by studying its dependence on the choice of calibration well.
What drives biodiversity patterns? Using long‐term multidisciplinary data to discern centennial‐scale change
Authors: Woodbridge Jessie , Fyfe Ralph , Smith David , Pelling Ruth , de Vareilles Anne , Batchelor Robert , Bevan Andrew , Davies Althea L. 
Published: November 2020

Abstract

Biodiversity plays an important role in ecosystem functioning, habitat recovery following disturbance and resilience to global environmental change. Long‐term ecological records can be used to explore biodiversity patterns and trends over centennial to multi‐millennial time‐scales across broad regions. Fossil pollen grains preserved in sediment over millennia reflect palynological richness and diversity, which relates to changes in landscape diversity. Other long‐term environmental data, such as fossil insects, palaeoclimate and archaeologically inferred palaeodemographic (population) data, hold potential to address questions about the drivers and consequences of diversity change when combined with fossil pollen records.

This study tests a model of Holocene palynological diversity change through a synthesis of pollen and insect records from across the British Isles along with palaeodemographic trends and palaeoclimate records. We demonstrate relationships between human population change, insect faunal group turnover, palynological diversity and climate trends through the Holocene.

Notable increases in population at the start of the British Neolithic (~6,000 calendar years before present [bp]) and Bronze Age (~4,200 bp) coincided with the loss of forests, increased agricultural activity and changes in insect faunal groups to species associated with human land use. Pollen diversity and evenness increased, most notably since the Bronze Age, as landscapes became more open and heterogeneous. However, regionally distinctive patterns are also evident within the context of these broad‐scale trends. Palynological diversity is correlated with population while diversity and population are correlated with some climate datasets during certain time periods (e.g. Greenland temperature in the mid‐late Holocene).

Synthesis. This study has demonstrated that early human societies contributed to shaping palynological diversity patterns over millennia within the context of broader climatic influences upon vegetation. The connections between population and palynological diversity become increasingly significant in the later Holocene, implying intensifying impacts of human activity, which may override climatic effects. Patterns of palynological diversity trends are regionally variable and do not always follow expected trajectories. To fully understand the long‐term drivers of biodiversity change on regionally relevant ecological and management scales, future research needs to focus on amalgamating diverse data types, along with multi‐community efforts to harmonise data across broad regions.
Work, Care and Gender during the COVID‐19 Crisis*
Authors: Hupkau Claudia , Petrongolo Barbara 
Published: November 2020

AbstractWe explore the effects of the COVID‐19 crisis and the associated restrictions to economic activity on paid and unpaid work for men and women in the United Kingdom. Using data from the COVID‐19 supplement of Understanding Society, we find evidence that labour market outcomes of men and women were roughly equally affected at the extensive margin, as measured by the incidence of job loss or furloughing. But, if anything, women suffered smaller losses at the intensive margin, experiencing slightly smaller changes in hours and earnings. Within the household, women provided on average a larger share of increased childcare needs, but in an important share of households fathers became the primary childcare providers. These distributional consequences of the pandemic may be important to understand its inequality legacy over the longer term.
Hippocampal volume and memory impairment after electroconvulsive therapy in patients with depression
Authors: Gbyl Krzysztof , Støttrup Mette Marie , Mitta Raghava Jayachandra , Xue Jie Song , Videbech Poul 
Published: November 2020

ABSTRACTObjectivePatients hesitate to consent to electroconvulsive therapy (ECT) because of the fear of memory impairment. The mechanisms underlying this impairment are unclear, but several observations suggest hippocampal alterations may be involved. We investigated whether ECT‐induced change in hippocampal volume correlates with memory impairment.MethodsUsing a 3 T MRI scanner, we acquired brain images and assessed cognitive performance in 22 severely depressed patients at three time points: (1) before ECT series, (2) within one week after the series, and (3) at six‐month follow‐up. The hippocampus was segmented into subregions using FreeSurfer. The dentate gyri (DG) were the primary regions of interest (ROIs) and major hippocampal subregions secondary ROIs. Cognitive performance was assessed using the Screen for Cognitive Impairment in Psychiatry and verbal memory using the Verbal Learning subtest. The linear mixed model and the repeated‐measures correlation were used for statistical analyses.ResultsECT induced an increase in the right and left DG volume with co‐occurring worsening in verbal memory, and these changes were within‐patients negatively correlated (right DG,rrm = −0.85, df = 18,p = 0.0000002; left DG,rrm = −0.58, df = 18,p = 0.008). At a six‐month follow‐up, the volume of both DG decreased with a co‐occurring improvement in verbal memory, and these changes were negatively correlated in the right DG (rrm = −0.64, df = 15,p = 0.005). Volume increases in 14 secondary ROIs were also negatively correlated with memory impairment.ConclusionECT‐related transient increases in the volume of major hippocampal subregions within‐patients are associated with memory impairment. Hippocampal alterations following ECT should be the focus in searching for causes of the cognitive side effects.
The association between cannabis use and testicular function in men: A systematic review and meta‐analysis
Authors: Belladelli Federico , Del Giudice Francesco , Kasman Alex , Kold Jensen Tina , Jørgensen Niels , Salonia Andrea , Eisenberg Michael L. 
Published: November 2020

AbstractObjectiveTo evaluate the association between cannabis use and testicular function (as assessed through semen quality and serum hormone levels) in different populations.Evidence ReviewSystematic review and meta‐analysis of population‐based retrospective cohort studies. PRISMA guidelines were used for abstracting data and assessing data quality and validity. Data were pooled using a fixed‐effects or random‐effects model depending on the heterogeneity of studies included. Pooled risk ratio (RR) of having any sperm abnormality and testosterone, FSH, and LH standardized mean differences among male cannabis users and non‐users, and meta‐regression analysis according to age and year of publication.ResultsNine studies were evaluated which included 4014 men with semen data and 4787 with hormonal data. Overall among 1158 cannabis users, 44.9% had impaired semen parameters, compared with 24.5% of the 2856 non‐users. The relative risk among cannabis users for any abnormal semen parameter was 1.159 (95% CI: 0.840; 1.599, P = 0.369). The standardized mean difference between user and non‐user testosterone levels was −0.139 (95% CI: −0.413; 0.134, P = 0.318). For FSH, the standardized mean difference estimate was −0.142 (95% CI: −0.243; −0.0425, P = 0.005), while for LH the standardized mean difference estimate was −0.318 (95% CI: −0.810‐0.175; P = 0.206).ConclusionsThe current evidence does not suggest clinically significant associations between cannabis use and testicular function. However, we cannot exclude an effect of cannabis because of the limited and heterogeneous studies. Additionally, well‐designed studies will be needed to define the association between cannabis use and the male reproductive system.
Ultrasound in the prediction of birthweight discordance in dichorionic twins
Authors: Lei Ting , Zheng Ju , Papageorghiou Aris T. , Feng Jie‐Ling , Lin Mei‐Fang , Zhang Fan , Xie Hong‐Ning 
Published: November 2020

AbstractIntroductionLarge birthweight discrepancy has been identified as a risk factor for perinatal morbidity and mortality in twin pregnancies. However, it remains unclear whether such discordance can be predicted by various biological indices with specific cut‐off values, and how these depend on the gestational age. We aimed to determine the most effective way to predict large birthweight discordance at various gestational ages.Material and methodsA retrospective cohort study of dichorionic twins, live‐born between 2008 and 2018, was conducted. Discordances in biparietal diameter, head circumference, humerus and femur length, abdominal circumference, and estimated fetal weight were calculated—([larger twin − smaller twin] / larger twin) × 100%—and compared between those with and without a large birthweight discordance (≥20%). Receiver operating characteristic curves were constructed to analyze the predictive characteristics of each parameter.ResultsOf 598 dichorionic twin pregnancies included, 83 (13.9%) had a birthweight discordance ≥20%. Group differences in biparietal diameter and head circumference discordance were the earliest to emerge (before 20 weeks of gestation), but became insignificant after 36 weeks, followed by humerus and femur length, estimated fetal weight discordance (after 20 weeks), and abdominal circumference discordance (after 28 weeks). The best predictors (with cut‐off values) were discordance in biparietal diameter ≥7.8% at <20 weeks, head circumference ≥4.5% at 20‐23+6 weeks, humerus length ≥4.5% at 24‐27+6 weeks, and estimated fetal weight discordance (≥11.6% at 28‐31+6 weeks, ≥10.5% at 32‐35+6 weeks, and ≥15.0% ≥36 weeks), with sensitivity and specificity of 52%‐77% and 69%‐82%, respectively.ConclusionsDifferent predictors and cut‐off values may be useful for predicting large inter‐twin birthweight discordance in dichorionic twins at different gestational ages. It is more accurate to use biparietal diameter and head circumference discordance in the early second trimester, humerus length discordance in the late second trimester, and estimated fetal weight discordance in the third trimester.
Altered colonic motility is associated with low anterior resection syndrome
Authors: Keane Celia , Paskaranandavadivel Nira , Vather Ryash , Rowbotham David , Arkwright John , Dinning Phil , Bissett Ian , O’Grady Greg 
Published: November 2020

AbstractAimPatients frequently suffer from low anterior resection syndrome (LARS) after distal colorectal resection. The pathophysiology of LARS has not been clearly elucidated. We hypothesized that rectosigmoid resection could impair motility patterns in the distal colon, such as the rectosigmoid brake, which contribute to control of stool form and frequency.MethodHigh‐resolution colonic manometry was performed in patients who had previously undergone distal colorectal resection (mean 6.8 years after resection) and non‐operative controls before and after a standardized meal. Symptoms were assessed using the LARS score. Propagating contractions were compared between patients with and without LARS, and controls.ResultsData were analysed from 23 patients (11 no‐LARS; 12 LARS) and nine controls. All groups demonstrated a significant meal response. LARS patients had fewer post‐prandial antegrade propagating contractions than controls (P = 0.028), and fewer retrograde propagating contractions both pre‐ (P = 0.005) and post‐prandially (P = 0.004). Post‐prandially, the LARS group had a significantly lower percentage of propagating contractions that met the criteria for the cyclic motor pattern compared to the control group (26% vs. 58%; P = 0.009). There were significant differences in antegrade and retrograde amplitude (P = 0.049; P = 0.018) and distance of propagation (P = 0.003; P = 0.002) post‐prandially between LARS patients and controls.ConclusionRectosigmoid resection alters the meal response following anterior resection, including impairment of the rectosigmoid brake cyclic motor pattern. These findings help to quantify the impaired functional motility after rectosigmoid resection and offer new insights into the mechanisms of LARS.
EB (Epidermolysis bullosa)‐Haus Austria: Pionierarbeit für die Betreuung von Patienten mit seltenen Erkrankungen
Authors: Prodinger Christine , Laimer Martin , Bauer Johann W , Hintner Helmut 
Published: November 2020

ZusammenfassungDie Versorgung von Patienten mit Epidermolysis bullosa (EB) stellt angesichts der Seltenheit, der Heterogenität und Komplexität der Erkrankungsgruppe eine besondere Herausforderung dar. Die primäre und sekundäre Beteiligung zahlreicher extrakutaner Organsysteme führt zudem zu erheblicher Morbidität und Mortalität. Um diese besser zu bewältigen, sind spezialisierte Behandlungszentren von Nöten, die eine individuelle, interdisziplinär akkordierte Betreuung nach aktuellem medizinischen Standard sowie Zugang zu innovativen Therapiemöglichkeiten gewährleisten. Mit diesem Ziel wurde 2005 das EB‐Haus Austria gegründet, das 2017 zum ersten österreichischen Expertisezentrum für Genodermatosen mit Schwerpunkt auf EB designiert wurde und auch als Mitglied in das Europäische Referenznetzwerk für seltene Hauterkrankungen (ERN Skin) aufgenommen wurde. Die Säulen dieser Institution (Ambulanz, Forschungseinheit, Akademie, Klinisches Studienzentrum) betreiben einen regen Austausch untereinander, mit zahlreichen nationalen sowie internationalen klinischen und wissenschaftlichen Partnern, wie auch insbesondere mit Patienten und deren Angehörige über die Selbsthilfegruppe DEBRA Austria. Die Entwicklung des EB‐Hauses Austria als Referenzzentrum war über weite Strecken von Pionierarbeit gekennzeichnet, die wegbereitend für die Optimierung der Betreuung vergleichbarer Erkrankungen sowie allgemeiner Versorgungsstrukturen sein kann.
Das subkutane weiße Fettgewebe: die unterste Etage der immunologischen Hautbarriere
Authors: Brüggen Marie‐Charlotte , Stingl Georg 
Published: November 2020

ZusammenfassungDie äußere Begrenzung des Körpers von Säugetieren, die Haut, besteht aus drei Schichten, Epidermis, Dermis und subkutanem weissem Fettgewebe (subcutaneous white adipose tissue, SWAT). Während die Epidermis und Dermis hinsichtlich ihrer Funktion als «Immunbarriere» eingehend charakterisiert sind, ist über das SWAT nur wenig bekannt. SWAT des Menschen setzt sich aus Läppchen zusammen, die vor allem aus Adipozyten bestehen und durch vaskularisierte Bindegewebssepten unterteilt und voneinander getrennt werden. Eine immun‐phänotypische Untersuchung von durch Fettabsaugung gewonnenem SWAT zeigte, dass gesundes SWAT keine Entzündungszeichen aufweist, jedoch Immunzellen beherbergt. Im Unterschied zur restlichen Haut handelt es sich dabei hauptsächlich um Makrophagen und, in geringerem Maße, T‐ Lymphozyten, deren Phänotyp darauf hinweist, dass ihnen primär anti‐inflammatorische und regulierende Funktionen zukommen. SWAT besitzt also nicht nur eine mechanische, sondern möglicherweise auch immunologische Schutzfunktion, die darin besteht, überschießende Immun‐ sowie Entzündungsreaktionen zu verhindern oder zumindest abzumildern.
Application of lung ultrasonography in critically ill patients with COVID‐19
Authors: Li Shuo , Qu Ya‐Li , Tu Mu‐Qin , Guo Li‐Yan , Zhang Qi‐Li , Lv Chao‐Yang , Guo Rui‐Jun 
Published: November 2020

AbstractPurposeLung ultrasonography (LU) is useful to assess lung lesions and variations at bedside. To investigate the results of LU in severe and critical patients with coronavirus disease 2019 (COVID‐19), we performed a single‐institution study to evaluate the related lung lesions and variations, and prophylactic strategies, in a large referral and treatment center.MethodsWe included 91 adult patients with severe and critical COVID‐19, namely 62 males and 29 females, with an average age of 59 ± 11 years, who underwent LU. We collected the following patient information: sex, age, days in hospital, and days in ICU. In the ultrasound examinations, we recorded the presence of discrete B lines, confluent B lines, consolidation, pleural thickening, pleural effusion, and pneumothorax (PTX).ResultsAmong the 91 severe and critical patients, 59 cases had scattered B lines, 56 cases had confluent B lines, 58 cases had alveolar‐interstitial syndrome (AIS), 48 cases had lung consolidation, six cases had pleural thickening, 39 cases had pleural effusion (average depth of the pleural effusion: 1.0 ± 1.5 cm), and 20 patients developed PTX. In the Cox multivariate analysis, there were significant differences in age, hospitalization days, ICU days, and lung consolidation.ConclusionLung ultrasonography performed at the bedside can detect lung diseases, such as B lines, PTX, pulmonary edema, lung consolidation, pleural effusion, and variations of these findings. Our findings support the use of LU and measurements for estimating factors, and monitoring response to therapy in severe and critical COVID‐19 patients.