bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Association between Clients’ Level of Satisfaction and Retention of National Health Insurance Scheme Membership in Ghana: A Study in the Greater Accra Region
Authors: Boateng Agartha Afful 
Published: March 2022

Introduction: Since the implementation of National Health Insurance Scheme (NHIS), fewer Ghanaians have been actively enrolled. Recently, there has been dwindling enrollment rate amongst the populace. Studies have revealed that clients’ satisfaction with services received may influence repurchasing behaviour.
Aim: This study aimed at investigating the association between clients’ satisfaction with services and the intention to maintain NHIS membership.
Methodology: This study was a household cross-sectional survey conducted in the Greater Accra Region. Data was gathered via distribution of 424 well-structured questionnaires amongst enrollees who were 18 years and above. Systematic random sampling was used in the selection of households and data was collected between November, 2018 and February, 2019. Client’s level of satisfaction was assessed on a Likert scale. The data was analyzed using SPSS version 23, chi-square test and Cramer’s V test.
Results: The response rate for this study was 94.3% and the result revealed that 60% of the participants expressed satisfaction with NHIS services, 34.5% were neutral, and 5.5% dissatisfied with NHIS services. Few of the respondents (28.3%) expressed the intention to maintain NHIS membership. Furthermore, there was no statistical association between clients’ overall satisfaction and retention of NHIS membership (p=.24). Retention of membership with NHIS was weakly associated with satisfaction with premium (p=.01, Cramer’s V=.16), geographical accessibility of health care facilities (p=.03, Cramer’s V=.13), and healthcare provider and clients’ interpersonal relationship (p=.04, Cramer’s=.12)
Conclusion: Clients’ satisfaction with NHIS services is necessary but not sufficient to influence retention of membership with the scheme. Hence, the need for health care providers to maintain good interpersonal relationship with clients, ensure geographical accessibility of NHIS accredited health care facilities, and further research of predictors to retention of NHIS membership is recommended.
Effective Diversified Uses of Tapioca (Manihot esculenta Crantz.) and Borkesseru (Ailanthus excelsa Roxb.): The Promising Secondary Host Plants of Eri Silkworm
Authors: Chamuah Priyanka , Borgohain Aparupa , Baruah Jyoti Prasad , Hatibaruah Dipankar 
Published: March 2022

Eri culture is an age old traditional activity associated with the socio-economic life of the rural population of the country. Eri silkworm (Samia ricini Donovan) is a multivoltine silkworm which is polyphagous in nature. It feeds on number of primary, secondary and tertiary host plants. Tapioca (Manihot esculenta Crantz.) and borkesseru (Ailanthus excelsa Roxb.) are regarded as the secondary host plants of eri silkworm and these plants species have enormous potentialities due to having certain properties for utilization in multiple purposes. Besides utilization as a host plant for silkworm rearing, the various parts of the plants can be exploited commercially. The plant parts can be used for human consumption, industrial as well as medicinal purposes. Moreover, they can also be utilized as a fodder, pesticides, fuel etc. Huge potentialities of product diversification of these plants will give a new dimension to eri industry. Hence, popularization of diversified uses of tapioca and borkesseru is very necessary to uplift the rural economy of the country. This review mainly focuses on the importance of tapioca and borkesseru not only as host plants of eri silkworm but also its utility in numerous purposes.
Obesity and Maternal Periodontal Disease do not Cause Changes in Offspring's Adult Life - Study in Rats
Authors: Petry De Paula Thayná N. , Balbo Sandra L. , Moi Milara B. , Suemi Valeria , Paiva João P. , Goncalves Silva Victor Miguel , Teleken Jakeline L. , Bonfleur Maria L. , A. Amorim Joao P. , Nassar Carlos A. 
Published: March 2022

Objective: To investigate the influence of MSG obesity and maternal periodontal disease on the mandibular bone loss of male offspring in adulthood.
Methods: 60 neonatal Wistar females were used and randomly separated into two groups. During the first 5 days of life, half of the female pups received subcutaneous injections in the cervical region of monosodium glutamate (MSG), and the other half-received of hyperosmotic saline solution (CTL). All animals used in the experiments received water and standard feed. At 70 days of life, animals were distributed into four experimental groups: control with no ligature (CTL NL), control with a ligature (CTL WL), MSG with no ligature (MSG NL), and MSG with a ligature (MSG WL). The four groups of females reproduced with control rats (2:1). Offspring (F1) were classified into 4 groups, according to the mothers' treatment. Hemimandibles were collected for histological, morphological, and radiographic analysis and a portion of gingival tissue for analysis by enzyme-linked immunosorbent assay (ELISA) of cytokines IL-6, IL-10, IL-17, and TNF-alpha. Data were assessed using Two-way ANOVA and Tukey's test.
Results: There were no changes related to maternal hypothalamic obesity associated with periodontal disease in alveolar bone loss in the male offspring of F1 rats at 120 days.
Conclusions: Hypothalamic obesity and maternal periodontal disease did not affect the body and plasma parameters of their male offspring in the first generation, demonstrating that there was no effect of fetal programming on these parameters.
Variation in some Haematological Parameters in Patients with Plasmodiasis Attending Antenatal Clinic in Primary Health Care Centre, Ozuoba, Port Harcourt
Authors: Echonwere-Uwikor B.E. , Chukwuigwe-Igbere O.E. , Chukwu P.H. , Uwikor F.K. , Aleruchi-Didia T.N. , Gogo B. 
Published: March 2022

Introdction: Haematological parameters are useful in making diagnosis of diseases and also help in the antenatal assessment of women during pregnancy. The physiological changes of pregnancy, due to the influence of hormones such as oestrogen, progesterone also affect haematological indices when compared with the non-pregnant state.
Aim: The study investigated haematological indices in pregnant women with plasmodiasis attending antenatal clinics in Primary health care centre Ozuoba, Port Harcourt.
Methodology: This was a cross sectional study, which recruited a total of one hundred (100) subjects, of which (40) were non parasitized pregnant women who served as control, while (60) were parasitized pregnant women who served as test. The samples were analyzed for haematological parameters using (Sysmex XP-300), while microscopy was used to investigated for the presence of malaria parasite.
Result: Comparing the hematological parameters of the study population at different level of plasmodiasis, showed that WBC, and Neutrophil were significant with p-Value of 0.001 and 0.0089 respectively at P<0.05.
The other haematological parameters such as, Red Blood Cell, Haemoglobin, Haematocrit, Mean Cell Volume, Mean Cell Haemoglobin, Mean CellHaemoglobin Concentration, Platelet, Plateletcrit, Neutrophils, lymphocyte, monocyte, eosinophil and basophil showed no statistical significant difference at p<0.05. While comparison of the haematological parameters of the study group according to parity showed that WBC count had statistical significance with a p-Value of 0.0035 at p<0.05.
Conclusion: Findings from this study has shown that there was statistical significant difference in the white blood cell count of malaria-parasitized pregnant subject. It was further revealed that there was no statistical significant difference in the other haematological parameters. The reason for the pattern of result obtained is that some of the pregnant women may have been receiving prophylactic antimalarial drugs before their recruitment, this will in turn minimize the impact of malaria infection on some haematological parameters.
Aqueous Hypoestes rosea Leaf extract Ameliorates Lead-Acetate-Induced Thyroid Hormones Disruption in Albino Wistar Rats
Authors: Uwikor F. K. , Echonwere-Uwikor B. E. , Chukwuigwe-Igbere O. E. , Bamigbowu O. E. 
Published: March 2022

Aim: To evaluate the effect of aqueous extract of Hypoestes rosea (AEHR) leaf extract on thyroid hormones in lead-acetate-induced Albino Rats.
Study design: Experimental study.
Place and Duration of Study: Department of Pharmacology, University of Port Harcourt and Department of Chemical Pathology, University of Port Harcourt, between October, 2019 and March, 2020.
Methodology: A total of 140 albino Wistar rats were used for the study. The animals were divided into 26 groups (6 post-treatment and 6 pre-treatment groups for female rats and the same number for male rats). Each group contained 5 rats for both sexes in both pre- and post-treatments groups, except the positive control groups that had 10 animals for both sexes. The study was carried out for 21 days in each sex. The negative control groups received rat feed only, the extract control (EC) group received 100mg/kg bwt/day for 21 days, the positive control (PC) group received 60mg/kg b.wt per day of lead acetate for 7 days. The other 3 groups received 100mgkg, 200mg/kg and 300mg/kg b.wt respectively for 14 days either as pre-treatment or post treatment, for both sexes of the albino rats. At the end of the experimental periods, the rats were sacrificed under chloroform anaesthesia and samples were taken through the jugular vein. Thyroid hormone levels (thyroid stimulating hormone (TSH), tri-iodothyronine (T3) and tetra-iodothyronine (T4)) were estimated using the Enzyme linked immunosorbent assay methods. Statistical analysis was done using Statistical Analysis System (SAS), STAT 15.1 and p values less than 0.05 were considered statistically significant.
Results: The results showed that the administration of lead acetate in male and female rats caused significant (p<0.05) fall in the levels of TSH, fT3 and fT4. The plant in a dose dependent pattern was able to significantly (p<0.05), reverse the effect of lead acetate in the post treatment phase and also protect the endocrine system from the deleterious effect of lead acetate in the pre-treatment phase.
Conclusion: This study shows that the consumption of AEHR by albino rats could help protect the endocrine system against endocrine disruptors.
The Physiological Aspect of Backbending Asana's
Authors: Verma Priyanka , Sharma Rashi , Pegu Biju 
Published: March 2022

The Hathyogic Asanas are the preparatory limbs for spiritual awakening, but they are also an essential health science. True, practicing Asanas takes more time and work for a long-term and beneficial effect, but it is a very potent and effective therapy.
The numerous organs and systems in the physical body each have their own function to fulfill, but there should be total coordination between them, which is achieved via the practice of Hathyogic Asanas. Asanas serve to control psychosomatic disorders by improving physiological efficiency, anatomic balance, and mental poise and equilibrium in the body.
It was employed by yogis and rishis in ancient times for the relief and elimination of all kinds of ailments and faults, and it was only recently recognized that asana are more powerful and effective techniques of managing the entire body. Hathyogic asana has been the subject of scientific research and investigations for the past three decades, proving that it offers biological benefits. In this study we have used a literature survey method on the basis of different yogic texts to find out the actual effect of back bending asana.
A Case Report on Diagnostic Evaluation and Management of Chikungunya
Authors: Sheikh Alfiya , Dhole Pallavi , Pathade Aniket , Pande P. S. 
Published: March 2022

Introduction: Chikungunya virus is spread by Aedes aegypti and Aedes albopictus mosquitos, which are found throughout the Asian, European, African, and American continents. Infection with the Chikungunya virus is spread via mosquitoes. (CHIKV). Fever and arthralgia are the most common symptoms. The same mosquitos that cause Chikungunya also spread Dengue and Zika viruses, and there have been occurrences of coinfections. To tackle the infection, there is currently no vaccine or specific therapy available. The goal of treatment is to reduce the severity of the disease's symptoms.
Patient Information: A 33-year-old male was admitted to AVBR hospital with a chief complaint of fever, & severe joint pain for 3 days, headache, muscle pain, nausea & vomiting.
Main Symptoms: He has the chief complaint of fever, & severe joint pain for 3 days, headache, muscle pain, Nausea & vomiting after careful history collection, physical examination, Complete blood count, RBS, CT scan, MRI Etc. my patient diagnoses as chikungunya.
Medical Management: Patient was provided with the medication as prescribed by the doctor. Among the major drugs are antipyretics, analgesics such as Tab. Paracetamol, Tab. acetaminophen, Tab. Emset.
Nursing Perspectives: After diagnosis, the patient’s vital signs are monitored hourly as medications are administered as per doctor’s prescription, maintaining the IV fluid 4 hourly with a concise record of an intake and output chart.
Conclusion: Patient’s health condition improved following early diagnosis and timely treatment of infection.
Designing and Development of a Nursing Care Plan Based on Johnson’s Behavioural Model in Patient with Carcinoma of Larynx: A Case study
Authors: Jose Neethu , Ravi Ramya Kundayi , Sebastian Sheeja 
Published: March 2022

Background: Behavioural model can be very easily applied in the clinical settings and nurses will be able to design and implement an appropriate nursing care planning using Johnson’s behaviour model in patients with carcinoma of larynx.
Aim: The aim of this paper was to investigate the application clinical function of Johnson’s Behavioural model in a patient with carcinoma of Larynx in a clinical setting.
Methodology: This is a case study, in which nursing process has been used in accordance with the Johnson’s Behavioural model applied in Mr.X who is affected with cancer of Larynx.
Result: After implementing Johnson’s Behaviour model in nursing process, the researcher achieved the goal easily. This case study was a very successful on application of Johnson’s Behaviour model.
Conclusion: Johnson’s behaviour model is related to a person’s environment and can be used in a clinical setting as a frame work for identifying the problems of a patient and helps in evaluating the quality of nursing care. The patient who has been studied in this paper reveals the application of Johnson’s Behaviour model in a clinical setting.
QbD Approach: A Framework for Integrating Quality into Pharmaceutical Products
Authors: Kharb Monika , Rathore Kamal Singh 
Published: March 2022

Introduction: The traditional development processes use a quality by testing (QbT) approach that needs continuous testing to determine quality. Such processes are fixed, averse to change, and focus only on process reproducibility. This approach does not allow variation in material and process controls. In order to overcome the shortcomings of the traditional process, regulatory bodies have issued guidelines for the industries to improve the understanding of the process and the quality of the product. It aims to shift from traditional process QbT to a scientific approach quality by design (QbD) to assure product quality in the pharmaceutical industry.
Methodology: Articles related to QbD published in many search engines such as Scopus, Google Scholar, and PubMed were reviewed.
Review Findings: In order to ensure the quality of pharmaceutical products, regulatory bodies have emphasized on the implementation of QbD. For this, various guidelines have been published from time to time. The Indian pharmaceutical industry has started to apply the principles of QbD. Implementation of QbD develops a detailed understanding of the manufacturing process. The design space is achieved by QbD within which the expected quality is achieved even with changes in process parameters.
Conclusion: In short, the QbD approach is a great tool for assuring pharmaceutical product quality and better understanding of the manufacturing process. Therefore, it is imperative to have a successful implementation of the QbD approach.
Perceptions of Self-Directed Learning among Nursing Students at Private Nursing Institutes in Karachi, Pakistan
Authors: Richard Bella , Arif Shireen , Ghouri Aftab , Khan Abdul Rehman , Sajid Sohail , Jokhio Faiza 
Published: March 2022

Background: Nursing is a profession where theory and skills runs vice-versa but advancement and new technology increasing challenges for professionals, to update their-selves for which they required to use self-directed learning (SDL). The SDL has become a key concept in nursing education and is considered as an essential as learning of skill for nursing students and nurses to keep them motivated for lifelong learning,
Objective: The objective of this study is to assess the readiness level of nursing students regarding self-directed learning (SDL) currently studying in the BSN program in private nursing institutes.
Study Design:
Method: This study used the descriptive cross-sectional study design.
Place and Duration of the Study: Study performed in three institutes of nursing, in Karachi, Pakistan, in duration between May to October 2019.
Methodology: 384 BS Nursing students of I- IV year were selected by stratified random sampling technique, 203 were females and 181 males participated. Mostly (200) aged between 26-30. The data was collected using a structured self-administered questionnaire focused on self-directed learning.
Result: Out of 384, 200 (52%) participants were between 26-30 years of age, 203 (52.8%) were females. The participants were belong from three different institutes and enrolled in BSN with the year I, II, III, IV. The 324 (84.3%) participants showed a high level of SDL, which indicates effective SDL abilities in students. All the sub-categories like awareness, evaluation, interpersonal skills, learning strategies, and learning activities were applied ANOVA; major difference observed in all sub-categories and participants’ age and total score with age group with P-value = .05.
Conclusion: There is no difference in male and female learning abilities. SDL may enhance confidence and empowerment among students. SDL can be equally beneficial in education and clinical area. To increase SDL, various considerations are required like teacher’s role, involvement in curriculum, and other professional or academic bodies that can bring learner-oriented positive teaching-learning environment; hence effective learning strategies can enhance the use of SDL.
Pattern of Injuries in Genito-Anal Area in Cases of Sexual Assault: A Cross Sectional Study
Authors: Aslam Nadia , Memon Abrar Ul Hasnain , Memon Haya Afzal , Kumar Pardeep , Rajper Sultan , Parveen Asiya 
Published: March 2022

Aim: To determine the pattern of injuries in the genito-anal area in cases of sexual assault
Study Design: Cross-sectional study
Place and Duration: This study was conducted at Liaquat University of Medical and Health sciences Jamshoro, Pakistan from June 2020 to July 2021
Methodology: A total of 96 victims of assault, who survived rape, were incorporated. The victims were from all groups of ages. All the patients considered in this study were both male and female. All of them had reported the case to the police and community.
Results: There were 84.5% cases of penile-anal penetration, 76% of penile-oral penetrate and 48% of assault victims presented with ano-genital bleeding. Most of the cases of sexual assault considered in this study were not completely investigated previously.
Conclusion: The study concludes that the most common pattern of injury after sexual assault was penile-anal penetration. Penile-oral penetration was the second most common injury. Nothing can undo whatever a sexual assault victim has to go through but catching and punishing the perpetrator is a necessary step. Genital injuries are not proof of a sexual assault. A sexual assault does not necessarily leave the genital area injured.
Angioid Streaks and Systemic Pathologies: Is This Association Always There?
Authors: Miguel Thiago Sande , Miguel Vinicius Sande , Costa Daniel Almeida Da , Pereira Maurício Bastos 
Published: March 2022

Aims :To describe Angioid Streaks and Systemic Pathologies
Presentation of Case: T.A.N., male, 32 years old, lawyer, born in Rio de Janeiro, attends the routine ophthalmologic appointment without specific ophthalmologic complaints.
In her previous pathological history, he claims not to have systemic comorbidities. Denies diabetes, eye trauma, previous eye surgeries and any eye pathologies. Denies previous ophthalmologic procedures, daily use of eye drops and family members with a history of glaucoma.
Discussion: The patient in the report, up to the time of the consultation, claimed not to be aware of any systemic pathology and did not present any ocular complaints, not even knowing the findings of his fundus examination. Systemic associations should always be considered when diagnosing Angioid Streaks on funduscopy. Patients with Pseudoxanthoma Elasticum must have their follow-up done in parallel with the dermatology service. Patients with hemoglobinopathies should be immediately referred for diagnostic clarification with the medical clinic team
Conclusions: It is essential that specialists are familiarized with the peculiar appearance , their potential to produce retinal and subretinal complications and, especially, remember that this finding in funduscopy can be unique without being associated with systemic diseases.
Improving autonomous vehicle in‐traffic safety using learning‐based action governor
Authors: Han Kyoungseok , Li Nan , Tseng Eric , Filev Dimitar , Kolmanovsky Ilya , Girard Anouck 
Published: March 2022

AbstractTheAction Governor (AG)is a supervisory scheme augmenting a nominal control system in order to enhance the system's safety and performance. It acts as an action filter, monitoring the action commands generated by the nominal control policy and adjusting the ones that might lead to undesirable system behavior. In this article, we present an approach based on learning to developing an AG for autonomous vehicle (AV) decision policies to improve their safety for operating in mixed‐autonomy traffic (i.e., traffic involving both AVs and human‐operated vehicles (HVs)). To achieve this, we demonstrate that it is possible to train the AG in a traffic simulator that is capable of representing in‐traffic interactions among AVs and HVs. We illustrate the effectiveness of this learning‐based AG approach to improving AV in‐traffic safety through simulation case studies.