bluuebunny/crossref_metadata_2025_split huggingface dataset:
More options, more problems? Lost in the health insurance maze
Authors: Biener Christian , Zou Lan 
Published: February 2024

AbstractWhile the opportunity to choose from a diverse range of options can be advantageous, consumers often struggle to make optimal decisions in the domain of health insurance. In this study, we examine the effects of decision aids on improving choice optimality in a health insurance setting that allows for variations in coverage but is standardized otherwise. While this relatively simplistic setting theoretically implies optimal conditions for observing large fractions of optimal choices, we observe widespread adoption of non‐welfare‐maximizing plans, with at least 36% of the population winding up with suboptimal insurance plans. In a hypothetical‐choice survey experimental setting, we estimate the treatment effects of increasing transparency through information provision and restricting choice on choice optimality. We find that decision quality cannot be improved meaningfully by our interventions and that nonoptimal choice is economically relevant, as it accounts for an increase of approximately 9.4% in total annual cost.
Classification of patients with migraine and healthy subjects using gross brain volume changes
Authors: De Fonseka Irushi , Lawanya Dewmi , Amarasinghe Dhilki , Wijewickrama Irusha , Wishwanthi Dineesha , Fernando Nikesha , Senanayake Gayani , Pushpakumara Saman , Arachchi Wasana Ediri 
Published: February 2024

AbstractBackground and PurposeDespite reports of changes in gray matter and white matter in individuals with migraines, research on detecting whole‐brain gross volume changes in migraines is very rare. Therefore, we aimed to investigate gross volume changes associated with migraine and test its potential in developing a neuroimaging biomarker for objective diagnosis of migraine.MethodologyIn this study, 45 patients with migraine and 46 healthy controls were scanned using a 3T MRI scanner, and 3D, T1‐weighted brain MR images were obtained. First, Tensor‐based morphometry and Voxel‐based morphometry were performed using Computational Anatomy Toolbox (CAT 12) to compute gross volumes, gray matter volumes, white matter volumes, and cerebrospinal fluid volumes. Univariate analyses were performed using two‐sample t‐test and the results were corrected for multiple comparisons. Second, multivariate pattern analyses (MVPA) were conducted to classify the patients with migraine and healthy controls.ResultsReduced gross volumes in patients were detected in middle frontal gyrus, superior frontal gyrus, inferior temporal gyrus and middle temporal gyrus of right cerebrum, middle temporal gyrus and angular gyrus of the left cerebrum, cuneus, and left cerebellum. Reduced gray matter volumes were detected in superior frontal, right middle frontal, right inferior temporal, and right middle temporal. The results of MVPA indicated that gross volume changes can improve the classification accuracy (73.63%) than other structural metrics such as gray matter (70%), white matter (66.3%), and cerebrospinal fluid volumes (58.69%).ConclusionWe conclude that the gross volumetric alterations can serve as a better neuroimaging marker for the objective diagnosis of migraine.
Analysis of admissions to intensive care units that could be supported on an intermediate care unit
Authors: Tack Jérôme , Bruyneel Arnaud , Taccone Fabio , Thys Fréderic , Mélot Christian , Van Wilder Phillipe , Pirson Magali 
Published: February 2024

AbstractBackgroundOnly one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels.Aim/sThe aim of our study was to analyse the profile of ICU patients in Belgium on the basis of registered nursing activity in order to quantify the number of ICU days potentially transferable to an IMC.Study DesignThe study was conducted on 310 ICU beds. Patients admitted to the study were recruited during two different one‐month periods in 2018 and were included into a prospective database that evaluated nursing workload carried out in 15 hospitals in the French‐speaking part of Belgium. The number of ICU days that could be supported on an IMC was defined according to the Nursing Activities Score (NAS) items.ResultsA total of 3279 ICU patients for a total of 13 942 ICU days were included. 4987 days (35.8%) were considered as “transferable” to an IMC. The proportion of ICU days transferable to an IMC was highly variable among hospitals, ranging from 20.4% to 59.5% of all ICU days. On the day of ICU admission, 665/2142 (31.0%) of the patients were already identified as transferable to an IMC; this percentage significantly increased on day 2 (972/2066, 47.1%) and day 3 (650/1390, 46.7%).ConclusionsIn Belgian ICUs, 35.8% of ICU hospital days, as per recorded NAS, do not necessitate intensive monitoring. These 35.8% of days of ICU hospitalization could be supported on an IMC.Relevance for Clinical PracticeIn this study, a significant number of days spent in the ICU could be supported on an IMC, this could alleviate the workload of nurses and reduce the occupancy rate of intensive care units.
The effect of the alliance on social recovery outcomes and usage in a moderated online social therapy for first‐episode psychosis
Authors: Stiles B. J. , Halverson T. F. , Stone A. , Still C. , Gleeson J. F. , Alvarez‐Jimenez M. , Perkins D. O. , Penn D. L. 
Published: February 2024

AbstractObjectivesWe investigated the effect of the therapeutic alliance on both change in social recovery outcomes and usage of a moderated online social therapy platform for first‐episode psychosis (FEP), Horyzons.DesignSecondary analysis of a single group pilot trial.MethodsClients completed an alliance measure adapted for guided digital interventions at mid‐treatment. A series of multi‐level models evaluated change in outcomes by mid‐ and post‐treatment assessments (relative to baseline) as a function of the overall alliance. Quasi‐Poisson models evaluated the effect of the overall alliance on aggregated counts of platform usage. Exploratory analyses repeated these models in terms of the bond (human–human) or the task/goal (human–program) alliance.ResultsStronger overall alliance at mid‐treatment predicted lower loneliness at mid‐treatment and lower social anxiety at mid‐ and post‐treatment. It was also associated with higher completion of therapy activities and authoring of comments and reactions. A strong bond with an online therapist was associated with lower loneliness and higher perceived social support at mid‐treatment, lower social anxiety at post‐treatment as well as a higher number of reactions made on the social network. Stronger alliance with the platform's tasks and goals facilitated lower social anxiety at both follow‐up assessments and was further associated with higher completion of therapy activities and reactions in the social network.ConclusionsThe alliance may impact aspects of social recovery and usage in digital interventions for FEP. Specific aspects of the alliance (human–human and human–program relationships) should be considered in future research.
Benefit and hidden cost of organizational support for telework amid the COVID‐19 pandemic on public employees' job satisfaction and retention intention
Authors: Ki Namhoon , Lee David 
Published: February 2024

AbstractThis study examines the impact of crisis‐induced telework during the COVID‐19 pandemic 2020 on public sector employees' job satisfaction (JS) and retention intention (RI). Analyses of the 2020 Federal Employee Viewpoint Survey data reveal a negative association between the amount of COVID‐induced telework and the federal employees' JS and RI. However, this negative effect is mitigated by offering adequate organizational telework support for mandatory telework during the COVID peak and subsequently decreasing the amount of telework after the peak. Nevertheless, the findings also indicate that solid organizational support for teleworkers during the pandemic's peak can ironically discourage them from returning to the regular work setting even when it is safe, potentially compromising organizational performance—a hidden cost of the organizational support. Still, this hidden cost does not appear to be significant enough to warrant revisions in the level of crisis‐specific organizational support.
Lebanese Phoenicianism: Rebutting Anthony Smith's Ethno‐Symbolism
Authors: Maxwell Alexander , Hannah David 
Published: February 2024

AbstractExamining national awakening in early twentieth‐century Lebanon tests the validity of Anthony D. Smith's ethno‐symbolism, which argues that modern national movements arise from older or ancient ethnic cores, which Smith calls ethnies. Since ethno‐symbolism contradicts Eric Hobsbawm's notion of an “invented tradition,” contrasting Smith with Hobsbawm illustrates the substance of Smith's argument. Supporters of independent Lebanon frequently proclaimed a Phoenician origin for the Lebanese nation, employing various Phoenician symbols to legitimise Lebanese independence. At first glance, Lebanese Phoenicianism seem to fit Smith's idea that nations are “based on, and being created out of, pre‐existing ethnies.” Other nationalists from Lebanon, however, rejected Phoenicianism and Lebanese particularist nationalism: self‐proclaimed “Syrian” nationalists imagined a nation that encompassed the entire Levant, while Pan‐Arab nationalists extended their national sympathies to the entire Arab world. Both Syrian and Pan‐Arab nationalists devised their own ancient pasts, suggesting that nationalists choose their own ancient pasts. If nationalists imagine the national past, ethnic symbols have no causal significance, so Smith's theory does not work.
STEM role models for students with disabilities: A systematic review highlighting recommendations for the classroom and future research
Authors: Locke Shannon , Rodrigues Jessica , Mirielli Lindsey G. 
Published: February 2024

AbstractMultiple learning theories encourage the use of role models within K‐12 settings and have guided research on role model representation to diversify the pursuit of science, technology, engineering, and mathematics (STEM) fields. Research has been clear on benefits of using role models, primarily focused on promoting gender and racial/ethnic diversity. Yet a critical need that has received less attention is the use of STEM role models for students with disabilities. The present systematic literature review identifies and synthesizes research on STEM role model mentorship programs and/or interventions for K‐12 students with disabilities. Sixteen studies met the inclusion criteria and were coded across categories, with a particular focus on practical recommendations for effective use of STEM role models for students with disabilities and suggestions for future research. Practice‐based recommendations emphasized, for example, the importance of establishing role model‐student rapport and mentors receiving adequate training to best support their mentees. Research‐focused recommendations included determining saliency of program/intervention components. Authors also suggest conducting future studies that investigate effectiveness of matching salient characteristics between role models and mentees. Overall, the findings suggest that STEM role models for students with disabilities is a promising avenue for supporting disability representation in STEM that warrants further investigation.
A survey of low titer O whole blood use within the trauma quality improvement program registry
Authors: Schauer Steven G. , April Michael D. , Fisher Andrew D. , Wright Franklin L. , Winkle Julie M. , Wright Angela R. , Rizzo Julie A. , Getz Todd M. , Nicholson Susannah E. , Yazer Mark H. , Braverman Maxwell A 
Published: February 2024

AbstractIntroductionThe use of low titer O whole blood (LTOWB) has expanded although it remains unclear how many civilian trauma centers are using LTOWB.MethodsWe analyzed data on civilian LTOWB recipients in the American College of Surgeons Trauma Quality Improvement Program (TQIP) database 2020–2021. Unique facility keys were used to determine the number of centers that used LTOWB in that period.ResultsA total of 16,603 patients received LTOWB in the TQIP database between 2020 and 2021; 6600 in 2020, and 10,003 in 2021. The total number of facilities that reported LTOWB use went from 287/779 (37%) in 2020 to 302/795 (38%) in 2021. Between 2020 and 2021, among all level 1–3 designated trauma facilities that report to TQIP LTOWB use increased at level‐1 centers (118 to 129), and level‐2 centers (81 to 86), but decreased in level‐3 facilities (9 to 4). Among pediatric and dual pediatric‐adult designated hospitals there was a decrease in the number of pediatric level‐1 centers (29 to 28) capable of administering LTOWB. Among centers with either single or dual level‐1 trauma center designation with adult centers, the number that administered LTOWB to injured pediatric patients also decreased from 17 to 10, respectively.ConclusionsThere was an increase in the number of facilities transfusing LTOWB between 2020 and 2021. The use of LTOWB is underutilized in children at centers that have it available. These findings inform the expansion of LTOWB use in trauma.
Numerical Study of the Fluid Flow Over the Array of Rough Cylindrical Particles: An Analysis of Porous Media Flow
Authors: Thakur Pooja , Gautam Shruti , Thakur Aruna 
Published: February 2024

Abstract
The objective of the study is to thoroughly analyze the flow and heat transfer of Bingham plastic fluids through an array of uniformly gapped rough surface cylinders embedded between two confined boundaries. Radial notches are used as the surface roughness in the model, evenly distributed. Due to the formation of front vortices in uniformly gapped cylinders, a negative pressure gradient is developed. The results of the numerical simulation analysis have shown that, when compared to the averaged Nusselt number, roughness has a minimal effect on the drag coefficient and pressure drop. As the degree of roughness increases, the size of the vortices decreases, resulting in a drop in heat transfer. Moreover, the analysis of each column shows that the first column array of cylinders has a higher total drag coefficient and average Nusselt number.
An adapted method for Cas9-mediated editing reveals the species-specific role of β-glucoside utilization driving competition between
Klebsiella
species
Authors: Almási Éva d. H. , Knischewski Nele , Osbelt Lisa , Muthukumarasamy Uthayakumar , El Mouali Youssef , Vialetto Elena , Beisel Chase L. , Strowig Till 
Published: February 2024

ABSTRACT

Cas9-based gene editing tools have revolutionized genetics, enabling the fast and precise manipulation of diverse bacterial species. However, widely applicable genetic tools for non-model gut bacteria are unavailable. Here, we present a two-plasmid Cas9-based system designed for gene deletion and knock-in complementation in three members of the
Klebsiella oxytoca
species complex (KoSC), which we applied to study the genetic factors underlying the role of these bacteria in competition against
Klebsiella pneumoniae
. Firstly, the system allowed efficient and precise full-length gene deletion via enhanced lambda Red expression. Furthermore, we tested the efficiency of two independent, functionally validated complementation strategies. Ultimately, the insertion of universal “bookmark” targets during gene deletion subsequently allows the most optimal genetic complementation in
K. oxytoca
,
Klebsiella michiganensis
, and
Klebsiella grimontii
. This approach offers a significant advantage by enabling the use of a single high-efficiency “bookmark” for complementing other loci or strains, eliminating the need for site-specific design. We revealed that the carbohydrate permease CasA is critical in
ex vivo
assays for
K. pneumoniae
inhibition by
K. oxytoca
but is neither sufficient nor required for
K. michiganensis
and
K. grimontii
. Thus, the adaptation of state-of-the-art genetic tools to KoSC allows the identification of species-specific functions in microbial competition.

IMPORTANCE

Cas9-based gene editing tools have revolutionized bacterial genetics, yet, their application to non-model gut bacteria is frequently hampered by various limitations. We utilized a two-plasmid Cas9-based system designed for gene deletion in
Klebsiella pneumoniae
and demonstrate after optimization its utility for gene editing in three members of the
Klebsiella oxytoca
species complex (KoSC) namely
K. oxytoca
,
Klebsiella michiganensis
, and
Klebsiella grimontii
. We then adapted a recently developed protocol for functional complementation based on universal “bookmark” targets applicable to all tested species. In summary, species-specific adaptation of state-of-the-art genetic tools allows efficient gene deletion and complementation in type strains as well as natural isolates of KoSC members to study microbial interactions.
The
ssgB
gene is required for the early stages of sporangium formation in
Actinoplanes missouriensis
Authors: Akutsu Takuya , Tezuka Takeaki , Maruko Manato , Hirata Aiko , Ohnishi Yasuo 
Published: February 2024

ABSTRACT

In
Streptomyces
, multiple paralogs of SsgA-like proteins (SALPs) are involved in spore formation from aerial hyphae. However, the functions of SALPs have not yet been elucidated in other actinobacterial genera. Here, we report the primary function of an SsgB ortholog (AmSsgB) in
Actinoplanes missouriensis
, which develops terminal sporangia on the substrate mycelia via short sporangiophores. Importantly, AmSsgB is the sole SALP in
A. missouriensis
. The transcription of
AmssgB
was upregulated during sporangium formation, consistent with our previous findings that
AmssgB
is a member of the AmBldD regulon. The
AmssgB
null mutant (Δ
AmssgB
) strain formed non-globose irregular structures on the substrate mycelium. Transmission electron microscopy revealed that the irregular structures contained abnormally septate hypha-like cells, without an intrasporangial matrix. These phenotypic changes were restored by complementation with
AmssgB
. Additionally, analysis of the heterologous expression of seven SALP-encoding genes from
Streptomyces coelicolor
A3(2) (
ssgA–G
) in the Δ
AmssgB
strain revealed that only
ssgB
could compensate for AmSsgB deficiency. This indicated that SsgB of
S. coelicolor
A3(2) and AmSsgB have comparable functions in
A. missouriensis
. In contrast to the Δ
AmssgB
strain, the
ftsZ
-disrupted strain showed a severe growth defect and produced small sporangium-like structures that swelled to some extent. These findings indicate that AmSsgB is crucial for the early stages of sporangium formation, not for spore septum formation in the late stages. We propose that AmSsgB is involved in sporangium formation by promoting the expansion of the “presporangium” structures formed on the tips of the substrate hyphae.

IMPORTANCE

SsgB has been proposed as an archetypical SsgA-like protein with an evolutionarily conserved function in the morphological development of spore-forming actinomycetes. SsgB in
Streptomyces coelicolor
A3(2) is involved in spore septum formation. However, it is unclear whether this is the primary function of SsgBs in actinobacteria. This study demonstrated that the SsgB ortholog (AmSsgB) in
Actinoplanes missouriensis
is essential for sporangium expansion, which does not seem to be related to spore septum formation. However, the heterologous expression of
ssgB
from
S. coelicolor
A3(2) restored morphological abnormalities in the Δ
AmssgB
mutant. We propose that the primary function of SsgB is to initiate sporulation in differentiating cells (e.g., aerial hyphae in
Streptomyces
and “presporangium” cells in
A. missouriensis
) although its molecular mechanism remains unknown.
Strain-specific requirements of susceptibility to rhesus enteric calicivirus infection
Authors: Farkas Tibor , Srivastava Vinod 
Published: February 2024

ABSTRACT

Recently, we identified the coxsackie and adenovirus receptor (CAR) as the entry receptor for rhesus enteric calicivirus (ReCV) isolate FT285 and demonstrated that co-expression of the CAR and the type B histo-blood group antigen (HBGA) is required to convert the resistant CHO cell line susceptible to infection. To address whether the CAR is also the functional entry receptor for other ReCV isolates and the requirement for specific HBGAs or other glycans, here we used a panel of recombinant CHO cell lines expressing the CAR and the type A, B, or H HBGAs alone or in combination. Infection studies with three diverse ReCV strains, the prototype GI.1 Tulane virus (TV), GI.2 ReCV-FT285, and GI.3 ReCV-FT7, identified that cell surface expression of the CAR is an absolute requirement for all three strains to promote susceptibility to infection, while the requirement for HBGAs varies among the strains. In addition to the CAR, ReCV-FT285 and TV require type A or B HBGAs for infection. In the absence of HBGAs, TV, but not Re-CV FT285, can also utilize sialic acids, while ReCV-FT7 infection is HBGA-independent and relies on CAR and sialic acid expression. In summary, we demonstrated strain-specific diversity of susceptibility requirements for ReCV infections and that CAR, type A and B HBGA, and sialic acid expression control susceptibility to infection with the three ReCV isolates studied. Our study also indicates that the correlation between
in vitro
HBGA binding and HBGAs required for infection is relatively high, but not absolute. This has direct implications for human noroviruses.

IMPORTANCE
Human noroviruses (HuNoVs) are important enteric pathogens. The lack of a robust HuNoV cell culture system is a bottleneck for HuNoV cell culture-based studies. Often, cell culture-adapted caliciviruses that rapidly replicate in conventional cell lines and recapitulate biological features of HuNoVs are utilized as surrogates. Particularly, rhesus enteric caliciviruses (ReCVs) display remarkable similarities, including the primate host, clinical manifestation of gastroenteritis, genetic/antigenic diversity, and reliance on histo-blood group antigens (HBGAs) for attachment. While the HuNoV entry receptor(s) is unknown, the coxsackie and adenovirus receptor (CAR) has recently been identified as the ReCV entry receptor. Here, we identified the CAR, the type A and B HBGAs, and sialic acids as critical cell surface molecules controlling susceptibility to ReCV infections. The CAR is required for all ReCV isolates studied. However, the requirement for the different carbohydrate molecules varies among different ReCV strains. Our findings have direct implications for HuNoVs.