bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the level and inequality in health insurance coverage in 36 sub-Saharan African countries
Authors: Barasa Edwine , Kazungu Jacob , Nguhiu Peter , Ravishankar Nirmala 
Published: April 2021

IntroductionLow/middle-income countries (LMICs) in sub-Saharan Africa (SSA) are increasingly turning to public contributory health insurance as a mechanism for removing financial barriers to access and extending financial risk protection to the population. Against this backdrop, we assessed the level and inequality of population coverage of existing health insurance schemes in 36 SSA countries.MethodsUsing secondary data from the most recent Demographic and Health Surveys, we computed mean population coverage for any type of health insurance, and for specific forms of health insurance schemes, by country. We developed concentration curves, computed concentration indices, and rich–poor differences and ratios to examine inequality in health insurance coverage. We decomposed the concentration index using a generalised linear model to examine the contribution of household and individual-level factors to the inequality in health insurance coverage.ResultsOnly four countries had coverage levels with any type of health insurance of above 20% (Rwanda—78.7% (95% CI 77.5% to 79.9%), Ghana—58.2% (95% CI 56.2% to 60.1%), Gabon—40.8% (95% CI 38.2% to 43.5%), and Burundi 22.0% (95% CI 20.7% to 23.2%)). Overall, health insurance coverage was low (7.9% (95% CI 7.8% to 7.9%)) and pro-rich; concentration index=0.4 (95% CI 0.3 to 0.4, p<0.001). Exposure to media made the greatest contribution to the pro-rich distribution of health insurance coverage (50.3%), followed by socioeconomic status (44.3%) and the level of education (41.6%).ConclusionCoverage of health insurance in SSA is low and pro-rich. The four countries that had health insurance coverage levels greater than 20% were all characterised by substantial funding from tax revenues. The other study countries featured predominantly voluntary mechanisms. In a context of high informality of labour markets, SSA and other LMICs should rethink the role of voluntary contributory health insurance and instead embrace tax funding as a sustainable and feasible mechanism for mobilising resources for the health sector.
Death of a parent during childhood and blood pressure in youth: a population-based cohort study of Swedish men
Authors: Chen Hua , Hemmingsson Tomas , Janszky Imre , Rostila Mikael , Forsell Yvonne , Meng Linghui , Liang Yajun , László Krisztina D. 
Published: April 2021

ObjectiveCompelling evidence suggests that childhood adversities are associated with an increased risk of hypertension in middle age and old age. The link between childhood adversities and blood pressure in youth is less clear. In this cohort study, we examined the association between death of a parent during childhood and blood pressure in early adulthood in men.SettingSweden.ParticipantsWe studied 48 624 men born in 1949–1951 who participated in the compulsory military conscription in 1969/1970 in Sweden. Information on death of a parent during childhood was obtained from population-based registers. Information on covariates was obtained from the questionnaire and the clinical examination completed at conscription and from population-based registers.Outcome measuresBlood pressure was measured at conscription according to standard procedures.ResultsThe multivariable least square means of systolic and diastolic blood pressure did not differ between bereaved (128.25 (127.04–129.46) and 73.86 (72.89–74.84) mm Hg) and non-bereaved study participants (128.02 (126.86–129.18) and 73.99 (73.06–74.93) mm Hg). Results were similar when considering the cause of the parent’s death, the gender of the deceased parent or the child’s age at loss. Loss of a parent in childhood tended to be associated with an increased hypertension risk (OR and 95% CI: 1.10 (1 to 1.20)); the association was present only in case of natural deaths.ConclusionWe found no strong support for the hypothesis that stress following the loss of a parent during childhood is associated with blood pressure or hypertension in youth in men.
Phase Space Analysis and Thermodynamics of Interacting Umami Chaplygin Gas in FRW Universe
Authors: Biswas Sujay Kr. , Biswas Atreyee 
Published: April 2021

AbstractIn this work interacting Umami Chaplygin gas has been studied in flat FRW model of universe in context of it’s thermodynamic and dynamical behaviour. In particular, considering Umami fluid as dark energy interacting with dark matter, irreversible thermodynamics has been studied both for apparent and event horizon as bounding horizon in two separate cases. Also the model has been investigated in purview of dynamical systems analysis by converting the cosmological evolution equations to an autonomous system of ordinary differential equations. With some restrictions on model parameter $$\omega $$
ω
and coupling parameter $$\lambda $$
λ
, some cosmologically interesting critical points describing late time accelerated evolution of the universe attracted by cosmological constant and accelerated scaling attractor in quintessence era have been found to alleviate coincidence problem.
Discussion on 'Shape fabrics and superimposed simple shear strain in a Precambrian shear belt, W Greenland' by John Grocott
Authors: Grocott John , Allen P. , Wells M. K. 
Published: April 2021

THE PRESIDENT (Professor P. Allen) asked Dr Grocott
if the structural history in his field area reflected
events in the broader context (e.g. jostling of the
Greenland blocks).
DR M. K. WELLS asked the author to comment on
possible variations of fabric which might be related to
lithological contrasts of major rock masses in different
parts of the region. Was there any evidence to suggest
that the development of some form of layered anisotropy
in the rocks was a necessary preliminary to the
development of the second kind of fabric he described?
Determinants of Response and Mechanisms of Resistance of CAR T-cell Therapy in Multiple Myeloma
Authors: van de Donk Niels W.C.J. , Themeli Maria , Usmani Saad Z. 
Published: April 2021

AbstractB-cell maturation antigen (BCMA)–specific chimeric antigen receptor (CAR) T cells have substantial therapeutic potential in multiple myeloma (MM), but most patients eventually relapse. Determinants of response and mechanisms of resistance are most likely multifactorial and include MM-related factors, premanufacturing T-cell characteristics, CAR T-cell–related features, and several components of the immunosuppressive microenvironment. Efforts to improve the potency and safety of CAR T-cell therapy include optimizing CAR design, combinatorial approaches to enhance persistence and activity, treatment of less heavily pretreated patients, and dual-antigen targeting to prevent antigen escape. We expect that these rationally designed strategies will contribute to further improvement in the clinical outcome of patients with MM.Significance:Although BCMA-specific CAR T-cell therapies are highly effective in heavily pretreated patients with MM, there has been, until now, no indication of a plateau in the survival curves. In this review, we provide an overview of the determinants of response and the mechanisms that contribute to the development of treatment failure after initial remission (acquired resistance). A better understanding of these mechanisms, underlying lack of disease response, and acquired resistance may lead to further improvements in the effectiveness of CAR T-cell therapy.
Glimpse of climber diversity in Saharanpur District, Uttar Pradesh, India
Authors: Saini Lalita , Tyagi Archasvi , Mohammad Inam , Malik Vijai 
Published: April 2021

The present paper focuses on the herbaceous and woody climbers of Saharanpur District. A total of 66 species of herbaceous climbers, 33 species of woody climbers, 15 species of climbing shrubs, and two species of parasitic climbers belonging 27 different families have been recorded. Climbers belonging to the families such as Convolvulaceae, Cucurbitaceae, Fabaceae, and Apocynaceae were found to be dominant in this region. This study also records the occurrence of 14 species of threatened climbers.
Marine mammal strandings in the northern Palk Bay from 2009 to 2020
Authors: Balaji Vedharajan , Sekar Veeramuthu 
Published: April 2021

Globally, the marine mammal population has been under threat due to various human activities. Data on stranding of these animals that are important for effective conservation planning and management, however, are not available in most of the developing countries. This paper presents observations on marine mammal strandings in northern Palk Bay, the southeastern coast of India over the last decade. In total, 21 stranding events consisting of 23 marine mammals were observed from 2009 to 2020. These stranded mammals include a Humpback Dolphin, a Blue Whale, two Finless Porpoises, and 19 Dugongs. The evident reason for the death of the dugongs and the porpoise being fishing activities, regulations on fishing practices, and intensive monitoring of the existing dugong population and their habitats are necessary. This study recommends for establishment of conservation reserve, and setting up district-level marine mammal rescue and release units in Nagapattinam, Tiruvarur, Thanjavur, Pudukkottai, and Ramanathapuram districts, comprising fishers and line departments. These units need to be sufficiently equipped in terms of equipment and infrastructure, and periodical technical training and workshops on marine mammal rescue and release procedures to quickly respond and handle marine mammal strandings in the area.
Seamless Multimodel Postprocessing for Air Temperature Forecasts in Complex Topography
Authors: Keller Regula , Rajczak Jan , Bhend Jonas , Spirig Christoph , Hemri Stephan , Liniger Mark A. , Wernli Heini 
Published: April 2021

AbstractStatistical postprocessing is applied in operational forecasting to correct systematic errors of numerical weather prediction models (NWP) and to automatically produce calibrated local forecasts for end-users. Postprocessing is particularly relevant in complex terrain, where even state-of-the-art high-resolution NWP systems cannot resolve many of the small-scale processes shaping local weather conditions. In addition, statistical postprocessing can also be used to combine forecasts from multiple NWP systems. Here we assess an ensemble model output statistics (EMOS) approach to produce seamless temperature forecasts based on a combination of short-term ensemble forecasts from a convection-permitting limited-area ensemble and a medium-range global ensemble forecasting model. We quantify the benefit of this approach compared to only postprocessing the high-resolution NWP. The multimodel EMOS approach (“mixed EMOS”) is able to improve forecasts by 30% with respect to direct model output from the high-resolution NWP. A detailed evaluation of mixed EMOS reveals that it outperforms either one of the single-model EMOS versions by 8%–12%. Temperature forecasts at valley locations profit in particular from the model combination. All forecast variants perform worst in winter (DJF); however, calibration and model combination improves forecast quality substantially. In addition to increasing skill as compared to single-model postprocessing, it also enables us to seamlessly combine multiple forecast sources with different time horizons (and horizontal resolutions) and thereby consolidates short-term to medium-range forecasting time horizons in one product without any user-relevant discontinuity.
The Effects of Child Support Payment Factors on Satisfaction With Levels of Parental Involvement by Noncustodial Fathers
Authors: White Gerry L. , Banks Leon , Briggs Harold E. , Allen Junior Lloyd , Lowe Tony 
Published: April 2021

Purpose: Research on the influences of child support on the parental involvement of non-custodial father is mixed. Method: This study uses one-way multivariate analysis of variance (MANOVA) to examine non-custodial fathers’ satisfaction with levels of accessibility to his child, degree of engagement in daily activities, level of responsibility for child’s wellbeing and custodial parents parenting practices. These variables were measured against child support payment related behaviors to include income levels, monthly child support obligation, view of fairness of payment, maintaining a current status, and the number of additional child support cases. Results: Results indicated significant mean differences in the combined parental satisfaction variable and specifically within custodial parent parenting practices. Mean differences in parental satisfaction with reference to degree of responsibility for the child were also effected by monthly child support payment amounts. No significance differences in parental satisfaction were found regarding fairness of child support payment amount or having multiple child support cases. However, small differences were noted concerning payment status of current or behind. Discussion: Implications for future study of fatherless families are explored.
Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers
Authors: Cardenas Valeria , Rahman Anna , Zhu Yujun , Enguidanos Susan 
Published: April 2021

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.
Student Conceptions of Assessment: Regulatory Responses to Our Practices
Authors: Brown Gavin T. L. 
Published: April 2021

Purpose: Universities assess and evaluate students concerning competence in essential disciplinary knowledge and skills. Those assessments impact learners’ attitudes, beliefs, and emotions. Negative impacts may be overcome if students regulate their responses to assessment and feedback. Design/Approach/Methods: This article systematically locates research studies that cite three key early papers around student conceptions of assessment (SCoA). A narrative synthesis is based on 22 papers. Findings: In addition to the SCoA, 11 different research inventories reveal a variety of regulatory responses that are enhanced when assessments are deliberately formative, fair, and trustworthy. There is broad interest in this phenomenon but little consistency in methods, and even the SCoA has little consistency in factor structure across jurisdictions. Only one study provided an objective behavioral measure to validate self-reports, which are the dominant form of research. Originality/Value: This review gives readers insights into how assessment influences student thinking and how student cognition can regulate success.
Competency-Based Methods in Adult Cardiac Sonography and its Application to Credentialing
Authors: Dunstatter Douglas 
Published: April 2021

Objectives: This research examined the effects of multiple combined competency-based methods in an adult cardiac Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited diagnostic medical sonography program on clinical and didactic scores. Materials and Methods: A quasi-experimental nonequivalent group research design was used to evaluate students enrolled in an adult cardiac CAAHEP accredited echocardiography curriculum. Their cumulative final examination and clinical competency evaluation scores from multiple cohorts (pre- and post-intervention) were used for statistical analyses. Results: There were no significant differences between multiple competency-based assessments and didactic or clinical scores but unveiled reasons that coincide with the literature, such as nonvalid and subjective clinical assessment. Conclusion: These results suggest further evaluation of the credentialing process to ensure clinical competency.
Systematic review and meta-analysis of outcomes in patients with suspected pulmonary embolism
Authors: Patel Parth , Patel Payal , Bhatt Meha , Braun Cody , Begum Housne , Nieuwlaat Robby , Khatib Rasha , Martins Carolina C. , Zhang Yuan , Etxeandia-Ikobaltzeta Itziar , Varghese Jamie , Alturkmani Hani , Bahaj Waled , Baig Mariam , Kehar Rohan , Mustafa Ahmad , Ponnapureddy Rakesh , Sethi Anchal , Thomas Merrill , Wooldridge David , Lim Wendy , Bates Shannon M. , Lang Eddy , Le Gal Grégoire , Haramati Linda B. , Kline Jeffrey , Righini Marc , Wiercioch Wojtek , Schünemann Holger , Mustafa Reem A. 
Published: April 2021

Abstract
Prompt evaluation and therapeutic intervention of suspected pulmonary embolism (PE) are of paramount importance for improvement in outcomes. We systematically reviewed outcomes in patients with suspected PE, including mortality, incidence of recurrent PE, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included 22 studies with 15 865 patients. Among patients who were diagnosed with PE and discharged with anticoagulation, 3-month follow-up revealed that all-cause mortality was 5.69% (91/1599; 95% confidence interval [CI], 4.56-6.83), mortality from PE was 1.19% (19/1597; 95% CI, 0.66-1.72), recurrent venous thromboembolism (VTE) occurred in 1.38% (22/1597; 95% CI: 0.81-1.95), and major bleeding occurred in 0.90% (2/221%; 95% CI, 0-2.15). In patients with a low pretest probability (PTP) and negative D-dimer, 3-month follow-up revealed mortality from PE was 0% (0/808) and incidence of VTE was 0.37% (4/1094; 95% CI: 0.007-0.72). In patients with intermediate PTP and negative D-dimer, 3-month follow-up revealed that mortality from PE was 0% (0/2747) and incidence of VTE was 0.46% (14/3015; 95% CI: 0.22-0.71). In patients with high PTP and negative computed tomography (CT) scan, 3-month follow-up revealed mortality from PE was 0% (0/651) and incidence of VTE was 0.84% (11/1302; 95% CI: 0.35-1.34). We further summarize outcomes evaluated by various diagnostic tests and diagnostic pathways (ie, D-dimer followed by CT scan).
The evolution of opsin genes in five species of mirid bugs: duplication of long-wavelength opsins and loss of blue-sensitive opsins
Authors: Xu Pengjun , Lu Bin , Chao Jiangtao , Holdbrook Robert , Liang Gemei , Lu Yanhui 
Published: April 2021

AbstractBackgroundColor vision and phototactic behavior based on opsins are important for the fitness of insects because of their roles in foraging and mate choice. Related topics, including the duplication and loss of opsin genes, have been well investigated in insect orders such as Coleoptera, Lepidoptera, Hymenoptera, Odonata and Orthoptera, and the findings have been used to develop pest management strategies involving light trapping. Mirid bugs of Hemiptera, which are pests that cause heavy economic losses, show capacity for color discrimination and phototaxis. However, the opsins in mirid bugs remain uncharacterized. Herein, we examined five species to investigate the evolution of opsins in the family Miridae.ResultsUsing RNA-seq, we identified several contigs showing high identity with opsins, including four contigs inApolygus lucorumand three contigs each inAdelphocoris suturalis,Adelphocoris fasciaticollis,Adelphocoris lineolatusandNesidiocoris tenuis. Phylogenetic analyses indicated that one of these genes clustered with ultraviolet-sensitive (UV) opsins and that the others clustered with long-wavelength (LW) opsins, suggesting that duplication of LW opsins and loss of blue light-sensitive (B) opsins occurred in mirid bugs. The existence of introns in the LW opsins of mirid bugs suggested that the duplication events were DNA based. Both LW1 and LW2 opsins of mirid bugs were found to be under strong purifying selection. The LW1 opsins were significantly more highly expressed than the LW2 and UV opsins.ConclusionsWe identified the opsins of mirid bugs using five selected mirid species as a representative sample. Phylogenetic analyses clustered one of the genes with UV opsins and the others with LW opsins, suggesting the occurrence of LW opsin duplication and B opsin loss during the evolution of mirid bugs. Intron detection suggested that the identified duplication event was DNA based. The evidence of strong purifying selection and the relatively high expression levels suggested that these opsins exhibit fundamental functions in mirid bugs.