bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Where There's a Will There's a Way”: The Impact of State Variations in the Implementation of Continuous Coverage on Access to Postpartum Care During the Pandemic Emergency
Authors: Fox Ashley , Howell Frances M. , Weber Ellerie , Janevic Teresa 
Published: January 2025

ABSTRACTObjectivesTo explore how the Medicaid continuous coverage requirement and unwinding process was implemented in three states with diverse existing policy environments and implications for the implementation of post‐emergency 12‐month postpartum extensions.Data SourcesState data on unwinding performance and qualitative in‐depth interviews with 48 stakeholders and patient‐facing healthcare workers in Texas, New York and New Jersey.Study DesignState Medicaid stakeholders and patient‐facing healthcare workers in each state were interviewed with the goal of gaining insights into: (1) How the continuous coverage requirement was implemented; (2) What effects continuous coverage had on access to care for postpartum mothers; (3) How states are implementing the pandemic unwinding and postpartum extensions.Data Collection/ExtractionInterviews were recorded and took place over Zoom between September 2022 and March 2024. Interview transcripts were analyzed thematically using an open coding approach.Principal FindingsThe study found that low awareness of the continuous coverage requirement blunted potential benefits: little changed in practice in recommended patient care or follow‐up procedures. Differences in state unwinding approaches reflected differential state capacity to minimize procedural disenrollment and political incentives to either rapidly reduce or maintain Medicaid rolls. Based on these findings, we describe how political will, state capacity and policy legacies interact to either increase or decrease administrative burdens associated with program enrollment/re‐enrollment.ConclusionsWhile the continuous coverage requirement in theory applies equally across US states, its implementation was inconsistent and influenced by state capacity and political objectives creating differential experiences across states. To ensure that postpartum Medicaid coverage extensions have maximal impact on improving maternal health, states should develop improved communication strategies to ensure that providers and community‐based organizations are aware of coverage changes and leverage available flexibilities to increase use of administrative renewal and ensure smooth coverage transitions.
A comparison and evaluation of strategies for bulk sequencing of mitogenomes from museum collections
Authors: Zhu Yao‐Wei , He Mao , Wang Hou‐Shuai , Liang Dan , Zhang Peng 
Published: January 2025

Abstract

Collecting mitochondrial genome sequences from museum collections has garnered increasing attention in recent years. Currently, several sequencing strategies have been proposed for this purpose, including direct DNA pooling, DNA labelling and mtDNA enrichment. It is important to understand the advantages and limitations of these methods before embarking on large‐scale sequencing efforts. However, there is currently no comprehensive comparison and evaluation of the performance of these sequencing methods.

In this study, we evaluated the performance of four different strategies for sequencing mitogenomes by comparing reagent expense, experiment time, bioinformatics time, and the length and the base error rate of the obtained mitochondrial sequences. The four sequencing strategies mainly differ in: (1) whether to label the DNA of each specimen and (2) whether to perform mtDNA enrichment. To reduce experiment difficulty and expenses, we presented an ‘in‐situ’ DNA labelling protocol for cost‐effectively ligating barcode sequences to DNA samples and used PCR‐generated baits for mtDNA enrichment.

The widely adopted ‘direct pooling’ sequencing strategy is the fastest but performs the worst among the four strategies. Of the 96 samples analysed, this approach yields averagely only 670 bp of mitochondrial sequences per sample. The most complicated sequencing strategy, which labels the DNA of each specimen and performs mtDNA enrichment, performs the best, producing mitogenome sequences of ~9.3 kb per sample. The sequencing accuracy is highly related to the sequencing depths of mtDNA but not the storage time of samples.

We hope that our comparisons will assist researchers in selecting suitable strategies for large‐scale sequencing of mitogenomes from museum specimens, thereby advancing museomics.
Timing for a surgically safe and oncologically prompt pancreatoduodenectomy after preoperative biliary drainage in patients with bile duct cancer
Authors: Lee Okjoo , Yoon So Jeong , Jeong Hye Jeong , Lim Soo Yeun , Chae Hochang , Kim Hongbeom , Han In Woong , Heo Jin Seok , Shin Sang Hyun 
Published: January 2025

AbstractBackgroundPreoperative biliary drainage (PBD) is commonly performed in patients with bile duct cancer (BDC). However, data regarding the timing of pancreatoduodenectomy (PD) after PBD are insufficient. This study aimed to investigate the optimal timing for surgically and oncologically safe PD after PBD.MethodsData of patients who underwent PD for BDC between 2018 and 2020 were reviewed. Risk factor analysis was performed to determine clinical associations of PBD with surgical and survival outcomes. Dose–response curves were plotted to indicate the effect of the time interval between PBD and PD on each outcome.ResultsA total of 109 patients underwent PBD before surgery. In multivariable analysis, PD after 20 days of PBD was significantly associated with improved survival after adjusting for other risk factors (hazard ratio 0.119, 95% confidence interval 0.028–0.5000; P = 0.004). Dose–response graphs showed that rates of postoperative complications and survival were lower when PD was performed around 20 days after PBD.ConclusionIn BDC patients, the rate of postoperative complications was lower with fair survival outcomes when PD was performed around 20 days after PBD. A large‐scale, prospective study is needed to investigate surgical and oncological effects of PBD in BDC patients.
Characterization of academic output (h‐index) by Australian urologists according to gender and rurality
Authors: Paynter Jessica A. , Wang Eugene , Wynn Jessica , Qin Kirby R. , Brennan Janelle 
Published: January 2025

AbstractBackgroundAs the number of practicing female urologists in Australia continues to increase alongside the academic development of the specialty, it is essential to examine how gender and rurality impact academic performance and expectations. This study aims to assess differences in h‐index related to both gender and rurality among Australian urologists.MethodsWe identified all active, practicing Australian urologists through the Urological Society of Australia and New Zealand (USANZ) membership database. Data on each practitioner's gender, subspecialty, academic rank or affiliation, seniority, and h‐index from the Web of Science were collected. Differences in h‐index by gender and rurality were analyzed using univariable and multivariable regression.ResultsA total of 463 Australian urologists were included, of whom 69 (14.9%) were female and 73 (15.8%) practiced in rural areas. Female urologists were less likely to hold an academic position of Associate Professor or Professor compared to their male counterparts (5.8% vs. 11.0%, P = 0.28). The average h‐index for female urologists was 39% lower than male urologists (univariable P < 0.001). Adjusting for demographic variables, h‐index remained 32% lower (multivariable P = 0.003). The average h‐index of rural urologists was 51% lower than their metropolitan colleagues (univariable P < 0.001); and after adjusting for demographics, the average h‐index was 30% lower (multivariable P = 0.006).ConclusionFemale and rural urologists in Australia produce significantly less research than their male and metropolitan counterparts. To address this disparity, it is crucial to implement enhanced institutional academic support, targeted mentorship, and greater recognition of the challenges posed by caregiving responsibilities and rural practice.
Primary versus secondary recurrent pregnancy losses: Clinical findings and live birth rate after comprehensive work‐up and personalized management
Authors: Tersigni Chiara , Onori Marianna , Beneduce Giuliana , Sannino Fabio , Franco Rita , Busnelli Andrea , Granieri Chiara , Milardi Domenico , Pontecorvi Alfredo , Lanzone Antonio , Scambia Giovanni , Di Simone Nicoletta 
Published: January 2025

AbstractIntroductionRecurrent pregnancy loss (RPL), defined as two or more consecutive pregnancy losses before 24 weeks of gestation, affects up to 1%–2% of couples. Aim of this retrospective cohort study was to report the main causes and pregnancy outcomes of a cohort of women with RPL and the efficacy of a personalized work‐up and treatment in terms of live birth rate.Material and MethodsWomen with primary (pRPL) and secondary (sRPL) RPL underwent a complete work‐up and personalized therapeutic management. Data related to clinical findings and subsequent pregnancy outcomes were collected. A retrospective comparison between clinical findings and pregnancy outcomes of pRPL versus sRPL was performed by Mann–Whitney U or Chi‐square test.ResultsMain findings after diagnostic work‐up in pRPL (n = 157) versus sRPL (n = 138) couples were hormonal and metabolic factors (75% vs. 90%, p < 0.01), autoimmunity (52% vs. 59%, p = 0.2), acquired uterine/endometrial factors (43% vs. 34%, p = 0.2), vaginal and/or cervical infections (19% vs. 49%; p < 0.0001), congenital Mullerian anomalies (15% vs. 9%; p = 0.1), inherited thrombophilias (13% vs. 21%; p = 0.1), female karyotype abnormalities (2% vs. 2%; p = 0.9), sperm infections (27% vs. 22%; p = 0.1), abnormal semen analysis (17% vs. 14%; p = 0.1), male karyotype abnormalities (2% vs. 0%; p = 0.1). Higher pregnancy and fetal loss rate was observed in pRPL compared with sRPL (85% vs. 56%, p < 0.0001and 9% vs. 0%, p < 0.01, respectively). Higher live birth rate was found in pRLP versus sRPL women (76% vs. 56%, p < 0.001). Increased live birth rate was observed among pRPL women aged <40 years (OR 2.76; CI 1.36–5.64, p < 0.01) and/or with an AMH >1 ng/mL (OR 3.96; CI 1.34–12.52, p < 0.05). Among sRPL women, the age < 40 years was significantly associated to higher live birth rate (OR 3.23; 1.55–6.94, p < 0.01).ConclusionsRPL is a heterogeneous multifactorial syndrome. A customized management can lead to a good pregnancy outcome in more than a half of cases. Age <40 and AMH >1 ng/mL are the major positive predictors of live birth rate in RPL women.
The Effects of Service Quality, Brand Loyalty, and Customer Satisfaction on Repurchase Intention: An Empirical Case Study of Online Travel Agents in Taiwan
Authors: Tsai Chih‐Ming , Huang Ying‐Feng , Lou Kuo‐Ren 
Published: January 2025

ABSTRACTThe rise of online travel agents (OTA) has substantially changed the ecology of the tourism industry, which in turn has impacted the market of traditional travel agencies. Although OTA is a future tourism trend, there is still much room for improvement in terms of its brand and customer service. Therefore, this study investigates the relationships among customer satisfaction, brand loyalty and consumer repurchase intentions from the perspective of service quality, and form a conceptual model for constructing consumer repurchase intentions. This study conducted a structural equation model (SEM) analysis of 226 samples. Based on the analysis results, there were two findings: First, for the influencing factors of consumer repurchase intentions, the positive direct impact of service quality is higher than brand loyalty and customer satisfaction. Second, in the proposed model, brand loyalty and customer satisfaction play the mediation variable between service quality and repurchase intention. The service quality will not only directly affect the repurchase intention, but also has an indirect impact through brand loyalty and customer satisfaction.
Ecotones Shape Ground‐Dwelling Mammal and Bird Diversity Along a Habitat Gradient in the Southern Coastal Dry Forests of Vietnam
Authors: Nguyen An , Tilker Andrew , Le Quy Tan , Nguyen Minh , Tran Van Tiep , Luu Hong Truong , Tran Van Bang , Le Duy , Pflumm Luisa , Niedballa Jürgen , Sollmann Rahel , Wilting Andreas 
Published: January 2025

ABSTRACTUnderstanding biodiversity patterns is essential for ecology and conservation. Globally, conservation efforts often prioritize tropical rainforests due to their high species richness. At the regional scale, the same is true in the Greater Annamites ecoregion of Vietnam and Laos, where conservation efforts have largely focused on broadleaf wet evergreen forest, despite the fact that other habitats remain threatened. One such habitat is the coastal dry forest landscape in southern Vietnam, which has received little conservation focus despite the fact that its forested areas have been severely reduced. Nui Chua National Park (NP) in southern Vietnam harbors one of the few remaining sizable areas of dry coastal forest. In this study, we used camera‐trap data and a community Royle‐Nichols model to explore community structure of ground‐dwelling mammal and birds along a complex habitat gradient in Nui Chua NP. We first investigated species associations among three habitat types: dry forest, semi‐dry forest, and broadleaf wet evergreen forest. We then used occupancy‐based diversity profiles to assess diversity in these three habitats. Overall species diversity tended to be highest in the transitional semi‐dry forest ecotone, which supported species from both dry and evergreen forests. Notably, the semi‐dry forest also had the highest occupancies for several endemic and threatened species. Our findings highlight the importance of the semi‐dry forest for conservation in the broader coastal dry forest landscape. We emphasize the need for fine‐scale biodiversity assessments to inform conservation strategies, especially in habitats that may be overlooked by broader‐scale conservation strategies.
Comprehensive Clinical and Genetic Characterization of a Spanish Cohort of 22 Patients With Bainbridge–Ropers Syndrome
Authors: Trujillano Laura , Valenzuela Irene , Costa‐Roger Mar , Cuscó Ivon , Fernandez‐Alvarez Paula , Cueto‐González Anna , Lasa‐Aranzasti Amaia , Masotto Bárbara , Abulí Anna , Codina‐Solà Marta , del Campo Miguel , Ruiz Moreno Juan Antonio , Pardo Domínguez Cristina , Palma Milla Carmen , Pérez de la Fuente Rubén , Quesada‐Espinosa Juan Francisco , Núñez‐Enamorado Noemí , Gener Blanca , Ballesta‐Martínez María Juliana , Brea‐Fernández Alejandro J. , Fernández‐Prieto Montse , Trujillo‐Quintero Juan Pablo , Ruiz Anna , Santos‐Simarro Fernando , Rosello Mónica , Orellana Carmen , Martinez Francisco , Martinez‐Monseny Antonio F. , Casas‐Alba Dídac , Serrano Mercedes , Palomares‐Bralo María , Rikeros‐Orozco Emi , Gómez‐Cano María Ángeles , Tirado‐Requero Pilar , Pié Juste Juan , Ramos Feliciano J. , García‐Arumí Elena , Tizzano Eduardo F. 
Published: January 2025

ABSTRACTBainbridge–Ropers Syndrome (BRPS) is a genetic condition resulting from truncating variants in the ASXL3 gene. The clinical features include neurodevelopmental and language impairments, behavioral issues, hypotonia, feeding difficulties, and distinctive facial features. In this retrospective study, we analyzed 22 Spanish individuals with BRPS, aiming to perform a detailed clinical and molecular description and establish a genotype–phenotype correlation. We identified 19 ASXL3 variants, nine of which are novel. We documented recurrence in nontwin siblings due to parental mosaicism. The predominant prenatal finding was intrauterine growth restriction (35%) followed, after birth, by feeding difficulties (90.5%), hypotonia (85.7%), and gastroesophageal reflux disease (82.4%). Later in life, intellectual disability, language impairment, autism spectrum disorder (75%), and joint laxity (73.7%) were noted. Individuals with variants in the 3′ mutational cluster region (MCR) of exon 12 exhibited more perinatal feeding problems, and those with variants in the 5′ MCR of exon 11 displayed lower percentiles in height and occipitofrontal circumference, as well as higher frequency of arched eyebrows. This study is the first characterization of a Spanish BRPS cohort, with more than 50 clinical features analyzed, representing the most detailed phenotypic analysis to date.
Single‐Cell Insights Into Cellular Response in Abdominal Aortic Occlusion‐Induced Hippocampal Injury
Authors: Ren Changhong , Kui Ling , Xu Jun , Tong Fang , Wang Xiaojie , Ma Jianping , Tian Xiaomei , Wang Guoyun , Liu Feng‐Yong , Li Sijie , Ji Xunming 
Published: January 2025

ABSTRACTObjectiveIschemia–reperfusion of the abdominal aorta often results in damage to distant organs, such as the heart and brain. This cellular heterogeneity within affected tissues complicates the roles of specific cell subsets in abdominal aorta occlusion model (AAO) injury. However, cell type–specific molecular pathology in the hippocampus after ischemia is poorly understood.AimsIn this study, we adopted a mouse AAO to investigate the single‐cell transcriptome in the hippocampi in AAO mice.MethodsMale C57BL/6 mice (8 weeks old) were used to create an AAO model, with animals divided into Sham and I/R groups. The I/R group was subjected to 2 h of ischemia followed by 24 h of reperfusion, after which hippocampal tissues were collected for single‐cell RNA sequencing and histological analysis. Behavioral tests, including the Rotarod, Y‐maze, and new object recognition tests, were performed daily for 28 days post‐surgery to evaluate neurological function. A total of 62,624 cells were corresponding 7 cell types with neuronal, glial, and vascular lineages. We next analyzed cell‐specific gene alterations in AAO mice and the function of these cell‐specific Genes.ResultsAAO injury upregulated astrocyte and oligodendrocyte precursor cell (OPC) proportions (p‐value < 0.05). Astrocytes showed unique gene expression related to neurogenesis and mRNA processing. Five distinct astrocyte subtypes emerged post‐injury. OPCs exhibited enhanced synapse organization. Microglia activation and the elevated expression level of the epithelial cell oxidative phosphorylation protein–protein interaction (PPI) module indicate an inflammatory response and metabolic changes in response to AAO injury.ConclusionsOur scRNA‐seq analysis provides insights into transcriptional changes at the single‐cell level in response to AAO‐induced hippocampal injury. This study illustrates how the hippocampal region responds to such injury and identifies potential therapeutic targets for intervention, thereby paving the way for future research and treatment strategies.
Application of Family Stress Theory: Predicting Wellbeing by Demands, Resources and Perceptions Among Caregivers of Older Adults
Authors: Choy Jacky C. P. , Lum Terry Y. S. , Yu Doris S. F. , Wong Gloria H. Y. 
Published: January 2025

ABSTRACTFamily caregivers of older adults are at risk of high care burden and reduced quality of life. Existing research and practices had primarily focused on the caregiving dyad. However, it is often observed that multiple family members are involved in caregiving for older adults. We applied family stress theory to understand family caregiving and examined how care demands, resources, and perceptions are associated with and predict caregiver well‐being. Participants in this study were low‐income family caregivers who received caregiver allowance and provided care for an older adult with care needs in the community in Hong Kong. Two waves of data, including baseline data from 358 caregivers and 2‐year follow‐up data from a subsample of 93 caregivers, were collected. We used hierarchical regression to predict care burden and quality of life at baseline and follow‐up, respectively, by care demands, resources, and perceptions after controlling for the context of care. Results show that additional caregiving roles, quality of relationship with the older adult, and satisfaction with family support were associated with care burden and quality of life at baseline. Predictors of lower care burden at 2‐year follow‐up were discontinuation of additional caregiving roles, increase in size of caregiving family, and the use of domestic helper. Applying family stress theory to understand the caregiving process reveals the significance of additional caregiving roles, the involvement of multiple caregivers, and caregivers' perceptions about family support in enhancing caregiver well‐being, underscoring the need to focus on these factors when designing and implementing caregiver support services.
Association between base excess and mortality in septic older adults
Authors: Zhou Qiang , Miao Yuxiu , Li Fenghua , Liu Jianhua , Li Jianing , Li Na 
Published: January 2025

AimSeptic older adults represent a vulnerable population with high mortality rates. Base excess (BE), an indicator of acid–base status, may serve as a prognostic marker in sepsis.This study aimed to investigate the association between BE and mortality in septic older adults.MethodsA retrospective analysis included septic older adults (age ≥ 65 years) from the Medical Information Mart for Intensive Care (MIMIC)‐IV database. The primary outcome was 30‐day mortality. Multivariate Cox regression models and Kaplan–Meier analysis were used to assess the association between BE and 30‐day mortality. A two‐segment linear regression model with smooth curve fitting was employed to examine threshold effects of BE on clinical outcomes.ResultsThe study comprised 7379 participants, with a 21.8% 30‐day mortality rate and an 18.6% in‐hospital mortality rate. A nonlinear, U‐shaped relationship (P < 0.001) was observed between BE and 30‐day mortality in septic older adults, indicating increased risk with higher or lower BE levels. Various BE groups showed different hazard ratios for mortality: 2.7 (2.26–3.22), 1.86 (1.65–2.09), 1.41 (1.19–1.67), and 1.9 (1.4–2.58), respectively, compared with the reference group (−3 mEq/L ≤ BE < 3 mEq/L). The inflection point was calculated as 0.5 mEq/L.ConclusionsOur findings suggest a U‐shaped relationship between BE and mortality in septic older adults, emphasizing the importance of monitoring acid–base status in sepsis management for this population. Geriatr Gerontol Int 2025; ••: ••–••.