bluuebunny/crossref_metadata_2025_split huggingface dataset:
A STUDY ON CUSTOMER AWARENESS LEVEL AND SATISFACTION OF HEALTH INSURANCE POLICIES IN CHENNAI CITY
Authors: Chitra Vijaya , Ramya V. , Gajenderan Vijayakumar 
Published: April 2021

The study proposed to examine product awareness of health insurance products on their satisfaction among the customers in Chennai city. The study employed primary and secondary data. The primary data is collected from the customers of health insurance policyholders in Chennai city. The responses are gathered from the policyholders through the well-designed questionnaire copy. The purpose of the secondary data is to familiarize the research area. The secondary information is collected from the research articles, magazines, Insurance Regulatory Development Authority, and daily newspapers. The study used a convenience sampling method. Overall, 300 questionnaires are distributed, out of which the customers return 283 filled responses. The filled answers are checked and finalized the entire 283 samples for the final study. Therefore, the total sample size of the study is 283. The study used frequency distribution, one-sample t-test, and General Linear Model of Multivariate Tests. The study confirmed that the customers are well aware of the health insurance companies and their products. The study also creates a significant relationship between awareness about health insurance products and the level of satisfaction
Preparation of poly(MPAEMA)/halloysite Nanocomposites and Investigation of Antiproliferative Activity
Authors: Çankaya Nevin , Yalç?n Serap , Turan Nevin 
Published: April 2021

Abstract. In this present work, the synthesis, characterization, and thermal properties of poly(2-(4-methoxyphenylamino)-2-oxoethyl methacrylate) (MPAEMA) polymer/clay-based nanocomposites were investigated by in-situ polymerization. At the characterizations of nanomaterials FTIR, XRD, SEM, and TGA techniques were used. It was determined from XRD and SEM measurements that the morphology of nanocomposites was exfoliated when the clay content in the polymer matrix was kept at 3% and 5%. From thermal analysis, a positive correlation was observed between the clay ratio and thermal stability of nanomaterials. Also, the cytotoxic effect of halloysite and its nanocomposites was investigated using XTT assay on HeLa cells. According to the results, nanocomposites showed a non-cytotoxic response and thus they may use safety in many research areas such as medicine, agriculture, cosmetics.

Resumen. En este trabajo, se reporta la síntesis, caracterización y propiedades térmicas de nanocompuestos de polímero / arcilla poli(2-(4-metoxifenilamino)-2-oxoetil metacrilato) (MPAEMA), obtenidos mediante polimerización in situ. Para caracterizar los nanomateriales se utilizaron las siguientes técnicas: FTIR, XRD, SEM y TGA. A partir de las mediciones de XRD y SEM se determinó que la morfología de los nanocompuestos muestra exfoliación, cuando el contenido de arcilla en la matriz de polímero se mantiene en 3% y 5%. Estudios mediante análisis térmico muestran una correlación positiva entre la relación de arcilla y la estabilidad térmica de los nanomateriales. También se investigó el efecto citotóxico de la halloysita y sus nanocompuestos utilizando el ensayo XTT en células HeLa. Los resultados muestran que los nanocompuestos tienen una respuesta no citotóxica y, por lo tanto, pueden utilizarse con seguridad en muchas áreas de investigación en disciplinas como la medicina, la agricultura y la cosmética.
Development and Implementation of the University of Texas Close Call Reporting System
Authors: Martin Sharon K. , Etchegaray Jason M. , Simmons Debora , Belt W. Thomas , Clark Kelly 
Published: April 2021

ABSTRACT
This report describes the development and implementation of The University of Texas Close Call Reporting System, an anonymous tool used to collect information about potential errors that do not reach the patient. The system was originally developed through experimentation, using a fund of knowledge collected in the aviation industry. A multidisciplinary health care team adapted this approach to develop a close call categorization scheme based on human-factor principles. This system, which is available in Web-based and paper formats, allows reporters to submit close calls in a risk-free manner and to enable the collection of rich information about the etiology of close calls. This information is used to identify areas of vulnerability and to develop interventions that can prevent problems from recurring. The development and implementation processes presented provide a comprehensive framework that can be used for future deployments of similar patient safety systems.
Professional Isolation and Performance: A Case-Control Study
Authors: St. George Ian M. 
Published: April 2021

ABSTRACT
Professional isolation appears to be associated with underperformance. We developed a set of professional isolation indicators and asked 26 experienced members of the Medical Council of New Zealand’s Competence Advisory Team, composed of senior medical educators and performance assessors, to list and describe indicators of professional isolation and ascribe a weight to each. We wanted to know if doctors found to be underperforming were more professionally isolated than those performing satisfactorily. The difference between the sample and the control group was significant: doctors underperforming were more professionally isolated than their peers. This paper should be regarded as an early communication of an interesting, but still unproved, hypothesis.
A Conceptual Model for Disclosure of Medical Errors
Authors: Fein Stephanie , Hilborne Lee , Kagawa-Singer Margie , Spiritus Eugene , Keenan Craig , Seymann Gregory , Sojania Kaveh , Wenger Neil 
Published: April 2021

ABSTRACTObjectivePatient safety is fundamental to high-quality patient care. Critical steps toward improving the safety of the health care system include ensuring the system is aware of its errors so effective remedies can be applied, and enhancing the trustworthiness of the health care system for patients by disclosing errors that are meaningful to them. This study aimed to construct a conceptual model of the factors that facilitate or hinder disclosure of medical errors.MethodsWe conducted 25 separate focus groups with attending physicians, nurses, residents, patients and hospital administrators at five academic medical centers in a university health care system. The protocol probed the ethical perceptions of participants and the details of disclosure expectations. Audiotapes of the focus groups were transcribed and analyzed using Atlas.ti software. Codes were assigned to the text in an iterative fashion. Themes were identified and assembled into a model of disclosure.ResultsAll groups believed that errors should be disclosed. Important influences on whether disclosure would occur fell into four categories: provider factors, patient factors, error factors and institutional culture. Provider issues included perceived professional responsibility, fears and training. Patient factors included their desire for information, level of health care sophistication and rapport with their provider. Error factors included level of harm and whether patients and others were aware of the error and the harm. Perceived tolerance for error and a supportive infrastructure were institutional factors that influenced disclosure.ConclusionThis grounded model of error disclosure delineates areas for interventions to increase disclosure as a step toward improving patient safety.
Association of inflammatory biomarkers with radiological severity for COVID-19 patient risk stratification: An Indian perspective
Authors: Gupta Prakhar , Halani Ankitkumar , Samuel Tasha , Singh Devendra P 
Published: April 2021

Background: Covid – 19 caused by SARS-CoV2 was declared a global pandemic by World Health Organization. Due to rapid disease progression causing severe and fatal complications, Effective biomarkers like D – Dimer, serum ferritin, CRP, IL-6, LDH would be helpful in screening, categorization of patients, their clinical management, and prevention of serious complications, especially in areas where radiological facilities arenot available immediately.
Aims and Objectives: The study was aimed to investigate association between levels of inflammatory biomarkers with Covid – 19 disease severity and correlate it with HRCT chest finding to identify patients at risk of fatal complications.
Materials and Methods: It was a retrospective monocentric observational study undertaken at a tertiary-care, COVID-19 dedicated centre. 200 Patients>18 year of age who were admitted from August 1, 2020 up to October 31,2020 with laboratory confirmed diagnosis of Covid – 19 were included in the study. Data was collected on demography, disease severity, laboratory measurements, radiology imaging retrospectively from electronic and laboratory records of patients. The disease severity was classified into mild to severe based on CT Severity scoring. HRCT Chest and inflammatory biomarkers were sent in every patient at the time of admission and the outcome was recorded.
Results: There were 133 male patients, 67 female patients in our study. Average age of patients having severe lung involvement is 54.1 years, whereas Average age of patients having non-severe lung involvement is 52 years but showed No significant association with severity of lung involvement. Severity of lung involvement according to HRCT chest findings was greater in patients with raised values of both D – Dimer and ferritin (RR:3.67, P value:<0.0001), compared to combination of raised value of D – Dimer with LDH (RR: 2.56, P value: 0.0383) or D – Dimer with CRP(RR:2.22, P value:0.0157) or isolated D– Dimer (RR:2.87, P value: 0.0727). Individually raised levels of serum ferritin, LDH and CRP were also found to be significantly associated with radiological severity among covid-19 patients. Neither raised IL-6 levels (p=0.368, RR: 0.76) nor did combined raised value of D – Dimer with IL-6 showed significant association with HRCT severity in our study (RR: 1.69, P value: 0.1193). Pearson correlation coefficients were also calculated and serum LDH showed strongest correlation with increasing lung involvement in HRCT chest, followed by serum ferritin.
Conclusion: Based on the significant association, combination of D – Dimer with ferritin as well as isolated levels of inflammatory markers can help in assessing the severity of Covid – 19 disease based on its correlation with radiological severity, thereby it will help in immediate categorization of patients into different risk groups following diagnosis, to ensure optimal resource allocation.
Patterns of maxillofacial fractures treated in a tertiary care government hospital of Puducherry – A descriptive cross-sectional study
Authors: Devakumari Shanmugam , Thanasekar Vijhayapriya , Biradar Nandini , Dominic Neil 
Published: April 2021

Background: Maxillofacial trauma is most common in both developing and developed countries. Descriptive studies from various parts of the world helps us in understanding the patterns of these injuries which in turn help in formulating tailor made prevention strategies for that particular geographic region.
Aims and Objectives: The aim of this study is to assess the patterns of maxillofacial fractures treated in IGMC & RI in Puducherry from 2011-2018. The objectives are to find out the type of maxillofacial fractures treated, to estimate the demographic data of maxillofacial fracture victims and to assess the treatment modality used(Closed reduction /open reduction and internal fixation (ORIF).
Materials and Methods: Data of surgically treated patients of maxillofacial fractures were retrieved, tabulated and analysed using SPSS software – 24 for descriptive and inferential statistics.
Results: The estimated results clearly indicate that males were most commonly affected by maxillofacial trauma. The common age group is 20 to 30 years. The major contributing aetiology for trauma is RTA and the common fracture that was encountered was fracture mandible and the fractures were largely managed by open reduction.
Conclusion: The results obtained are expected to greatly contribute for the planning of prevention actions and management in health, assistance practices to victims of facial trauma, epidemiological surveillance and road traffic rules.
Hysteroscopy is Gold standard in Uterine evaluation for Infertility, but HSG still has a place
Authors: Bajaj Manisha , Roy Rajib , Rahman Motiur , Roychowdhury Joydeb 
Published: April 2021

Background: Uterine abnormalities, congenital or acquired are implicated as causal factor in 10%-15% of infertile couplesreporting for treatment. Hysteroscopy, hysterosalpingography (HSG), saline-infusion-sonography and USG are available for evaluation of uterine cavity. HSG helps in initial evaluation of a sub-fertile woman, but hysteroscopy is gold standardas itallows direct visualisation ofintrauterine pathology and treatment in same-setting, if required.
Aims and Objective: To describe hysteroscopic findings of infertile patients and compare the observations with their respective HSG findings.
Materials and Methods: It’s a prospective analysis of 105 women with infertility who attendedtertiary-care hospital during 18 monthsfulfilling pre-defined inclusion and exclusion criteria. All cases were evaluated with both HSG and hysteroscopy, observations were recorded and co-related with each other.
Results: Among 105 cases, maximum (76.19%) were 25-35 years of age. The primary infertility accounted for 68.57% cases.Abnormal HSG findings observed in 19 cases (20%), most common being filling-defect.Hysteroscopy detected abnormalities in 39 cases (37.14%), commonest being endometrial polyp. Out of 39 cases of abnormal uterine cavity detected on hysteroscopy only 19 were picked-up by HSG, rest 20 cases failed to be identified. The strength of agreement between hysteroscopy and HSG calculated is moderate (Kappa=0.505).
Conclusion: As HSG hadlow false positivity (03%), high positive-predictive-value (90.48%) and negative-predictive-value (76.19%) and high specificity (96.96%) it is still considered as a first-choice screening method of uterine cavity. However, high false-negative-value (51.28%)of HSG makes Hysteroscopy a better diagnostic test. HSG couldn’t differentiate endometrial polyp, adhesions and submucous fibroid, shown them as filling defect only.
Early Proterozoic granite of the Taplejung Window, far eastern Lesser Nepal Himalaya
Authors: Upreti B. N. , Rai S. M. , Sakai H. , Koirala D. R. , Takigam Y. 
Published: April 2021

The Lesser Himalayan Sequence of the Taplejung Window in the far eastern Nepal Himalaya can be divided into Taplejung Formation, Mitlung Augen Gneiss and Linkhim Schist (from bottom to top respectively). The window is a large domal shaped anticline plunging to the east.
Two-mica granite bodies (Amarpur Granite, Kabeli Khola Granite and Tamor River Granite) have intruded the metasediments of Taplejung Formation. The granite bodies are discordant to subconcordant in relation to the country rocks. Quartz, alkali feldspar, plagioclase, muscovite, biotite and tourmaline are the main constituent minerals of the granite. Generally, the core of granite bodies is undeformed, whereas the marginal part is gneissfied with S-C mylonitic texture showing the top to south sense of shear. This sense of shear is related to the movement along the Main Central Thrust (MCT). All the samples from the granitic bodies fall under the granite field in the normative quartz-alkali feldspar-plagioclase (QAP) triangular diagram. The mineral composition shows that the granite is peraluminous in nature. The Kabeli Khola Granite has yielded a 40Ar/ 39Ar muscovite age older than 1.6 Ga indicating its magmatic age. The granites of the study area can also be correlated with the 1.8 Ga Ulleri type augen gneiss of central Nepal.
A contemporary insight into the sero-epidemiology of Toxoplasma gondii infection in the foot-hills of Himalayas: A cross-sectional study from a tertiary care center in Northern India
Authors: Deka Sangeeta , Kalita Deepjyoti , Gupta Pratima , Mathuria Yogendra Pratap 
Published: April 2021

Objective: Toxoplasma gondii (T. Gondii) infects 30-50% of the world human population with high diversity in geo-epidemiological data on its seroprevalence. Data on burden of toxoplasmosis and its determinants from remote and vulnerable regions of India are scarce. This study aimed to evaluate the prevalence of toxoplasma antibodies and factors associated with seropositivity among people from Uttarakhand and adjoining areas.
Methods: Serum samples from 442 cases were tested for anti-Toxoplasma IgG and IgM antibodies by Enzyme-linked Immunosorbent Assay. Correlation of seropositivity with age, sex, place of residence, dietary habits, and co-morbidity were analyzed by binary logistic regression.
Results: An overall Toxoplasma seropositivity of 36.88% [95% Confidence Interval (CI)=30.40–39.28] was observed. While anti-T. gondii IgG was present in 36.84% [95% CI=30.40–39.28], anti- T. gondii IgM was detected in 6.33% [95% CI=4.06–8.61]. The overall and IgG seroprevalence increased with age in both the genders and the slope was steeper after the age of 40 years [Adjusted Odds Ratio (AOR)=2.98, p-value=0.030]. The probability of seropositivity tended to be significantly higher in people from Uttarakhand in both the hilly region (AOR=5.61; 95%CI:[2.14-14.68]) and plains (AOR=5.14; 95%CI:[2.2-12.02]). Multivariable logistic regression analysis also showed that being rural residents (AOR=3.23; 95%CI:[1.67-6.23]) and presence of co-morbidity (AOR=8.64; 95%CI:[4.62-16.18]) were potential risk factors of Toxoplasmosis. Consumption of vegetarian diet was found to have a protective effect (AOR=0.46; 95%CI: [0.28-0.75]).
Conclusion: Seroprevalence of T. gondii antibodies was relatively high in Uttarakhand, particularly in rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region.
Coronal and lambdoid suture evolution following total vault remodeling for scaphocephaly
Authors: Beuriat Pierre-Aurélien , Szathmari Alexandru , Chauvel-Picard Julie , Gleizal Arnaud , Paulus Christian , Mottolese Carmine , Di Rocco Federico 
Published: April 2021

OBJECTIVE
Different types of surgical procedures are utilized to treat craniosynostosis. In most procedures, the fused suture is removed. There are only a few reports on the evolution of sutures after surgical correction of craniosynostosis. To date, no published study describes neosuture formation after total cranial vault remodeling. The objective of this study was to understand the evolution of the cranial bones in the area of coronal and lambdoid sutures that were removed for complete vault remodeling in patients with sagittal craniosynostosis. In particular, the investigation aimed to confirm the possibility of neosuture formation.

METHODS
CT images of the skulls of children who underwent operations for scaphocephaly at the Hôpital Femme Mère Enfant, Lyon University Hospital, Lyon, France, from 2004 to 2014 were retrospectively reviewed. Inclusion criteria were diagnosis of isolated sagittal synostosis, age between 4 and 18 months at surgery, and availability of reliable postoperative CT images obtained at a minimum of 1 year after surgical correction. Twenty-six boys and 11 girls were included, with a mean age at surgery of 231.6 days (range 126–449 days). The mean interval between total vault reconstruction and CT scanning was 5.3 years (range 1.1–12.2 years).

RESULTS
Despite the removal of both the coronal and lambdoid sutures, neosutures were detected on the 3D reconstructions. All combinations of neosuture formation were seen: visible lambdoid and coronal neosutures (n = 20); visible lambdoid neosutures with frontoparietal bony fusion (n = 12); frontoparietal and parietooccipital bony fusion (n = 3); and visible coronal neosutures with parietooccipital bony fusion (n = 2).

CONCLUSIONS
This is the first study to report the postoperative skull response after the removal of normal patent sutures following total vault remodeling in patients with isolated sagittal synostosis. The reappearance of a neosuture is rather common, but its incidence depends on the type of suture. The outcome of the suture differs with the incidence of neosuture formation between these transverse sutures. This might imply genetic and functional differences among cranial sutures, which still have to be elucidated.
Partial suturectomy for phenotypical craniosynostosis caused by incomplete fusion of cranial sutures: a novel surgical solution
Authors: Lobb David C. , Patel Smruti K. , Pan Brian S. , Skoch Jesse 
Published: April 2021

OBJECTIVE
Patients presenting with head shape changes phenotypical for craniosynostosis may have incomplete fusion of the involved sutures. The surgical literature is lacking in appropriate management strategies for these patients. In this paper, the authors evaluate their experience with a novel treatment strategy: suturectomy of only the fused portion followed by helmeting therapy in patients with skull deformity secondary to incomplete suture synostosis.

METHODS
Patients with craniosynostosis with incomplete suture fusion requiring operative intervention between 2018 and 2020 were included for evaluation. Patients were selected for partial suturectomy if the patent portion of the suture had a normal appearance. All patients underwent craniectomy of the involved portion of the synostosed suture. Intraoperative ultrasound was used to reassess the degree of fusion at the time of surgery and incision planning. A 2- to 3-cm strip craniectomy was performed under direct visualization through a single minimal access incision. Postoperative helmeting was utilized for all patients. Demographic and perioperative data were collected, including laser scan data in the form of cranial index (CI) and cranial vault asymmetry (CVA), defined as the difference between two diagonal measurements, from the frontozygomaticus to the opposite eurion.

RESULTS
Four males and 1 female with a mean age of 2.8 months (range 1.1–3.9 months) at presentation were included. All patients had incomplete sagittal synostosis (one patient also had an incomplete left lambdoid synostosis and another had an incomplete left coronal synostosis). The mean age at surgery was 3.5 months (range 2.0–4.7 months) without any major complications. All patients were compliant with postoperative helmeting. The average age at the last follow-up was 12.8 months (range 5.3–23.7 months) with a mean follow-up duration of 9.3 months (range 0.5–19.6 months). Final laser scan evaluations were available for 3 patients and showed an improvement of the CI from an average of 71.3 (range 70–73) to 84.3 (range 82–86). The CVA improved from an average of 9.67 mm (range 2–22 mm) to 1.67 mm (range 1–2 mm).

CONCLUSIONS
Minimally invasive direct excision of the involved portion of fused cranial sutures followed by helmet therapy for phenotypical craniosynostosis is a safe and effective treatment strategy. This technique is suitable for very young patients and appears to offer similar outcomes to complete suturectomy. Further studies are required to see if this approach reduces the deformity severity for patients requiring vault remodeling later in life.