bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using OCT Angiography as a Biomarker of Retinopathy Severity in Patients with Diabetes
Authors: Scheive Melanie , Reinhart Kathryn , Hajrasouliha Amir 
Published: December 2020

Background and Hypothesis: Diabetic retinopathy (DR), the leading microvasculature and blindness-causing complication of diabetes mellitus, can be diagnosed and monitored using optical coherence tomography angiography (OCT-A) to visualize all retinal vasculature layers with greater resolution and limited invasiveness compared to the established technique of fluorescein angiography. We hypothesize that OCT-A can be used as a biomarker to correlate retinal vessel density (VD) from OCT-A with clinical severity of DR, visual acuity, and patient demographics as well as track anti-vascular endothelial growth factor (VEGF) treatment efficacy.
Methods: This retrospective cohort study analyzed the automatically quantified VDs of the superficial vascular complex (SVC) and deep vascular complex (DVC), including the whole, foveal, and parafoveal VDs, on quality OCT-A scans in patients with diagnosed DR. A multivariate linear regression and ANOVA analysis was completed to compare VDs to DR severity, visual acuity, and demographic factors in patients with at least one quality OCT-A scan. A linear mixed analysis was performed to determine how VD was affected by whether anti-VEGF therapy was given to patients with OCT-A scans at two or more different timepoints.
Results: There was found to be a positive correlation of the VDs in both the SVC whole and parafoveal VD and DVC parafoveal VD with decreased DR severity and increased visual acuity in the cross-sectional analysis (p ≤0.001). The DVC whole VD was also positively correlated with increased visual acuity (p<0.001). There was no difference in the VDs associated with anti-VEGF treatment over time.
Conclusions and Potential Impact: OCT-A shows promise for the diagnosis and monitoring of DR as a biomarker for disease severity which correlates with visual acuity. Anti-VEGF did not show significant change in VD in DR patients. Longer follow-up periods may be needed to elaborate on the long-term effects of anti-VEGF.
Mixed method study focusing on cost effectiveness of utilizing Guideline Directed Medical Therapy using Secondary and Primary Data
Authors: Singh Lovekirat , Daley Carly , Wagner Shauna , Robertson Roy , Mirro Michael 
Published: December 2020

Background and Hypothesis:
In the United States, heart failure (HF) affects an increasing 5.8 million people, with healthcare costs estimated at $31 billion (2012). Guideline Directed Medical Therapy (GDMT) is the primary method to standardize medical care of patients diagnosed with Heart Failure reduced Ejection Fraction (HFrEF). GDMT lowers mortality rates, decreases readmission, and decreases the cost, but the success of GDMT is limited by adherence. We hypothesize increased GDMT prescription through integration of a pharmacist will decrease readmissions and hospital costs.

Methods:
This mixed-methods study involved a literature review and retrospective chart review. Online databases (PubMed, Embase, and Ovid) were searched using keywords related to GDMT and economic outcomes. The research was refined using empirical research and grey literature focusing on healthcare costs and readmission rates. The chart review is part of a larger study examining the impact of integrating a pharmacist into a cardiology center on GDMT prescription. Inpatient and outpatient charges data was analyzed to determine if integration of a pharmacist led to decreased healthcare costs. This project was supported by Parkview Health and received funding from ACC Accreditation Foundation Board.

Results:
The study is currently ongoing. 70 articles and abstracts were reviewed, and 10 articles fit the criteria focusing on GDMT, healthcare cost, or readmissions. Articles supported a correlation between decreased readmission and overall healthcare cost with compliance to GDMT. Literature also supports the addition of an intervention leading to decreased readmissions. Preliminary charges data analysis showed a decrease in cost by 46% in inpatients and 35% in outpatients after pharmacist intervention.

Conclusion:
We conclude GDMT is associated with decreased healthcare costs due to decreased readmissions. Although there are multiple confounding variables when evaluating the primary data, data showed a correlation between adding intervention (i.e. pharmacist) and decreasing readmissions and overall healthcare costs. Further studies need to be conducted to show causation.
Endogenous Maternal Lipids and Supplementation with Vitamin E Isoform Regulate Neonatal Dendritic Cells during Development of Allergic Disease
Authors: Tat Kiet , Cook-Mills Joan 
Published: December 2020

Background and Hypothesis: CDllb+CDllc+ dendritic cells (DCs) play a role in the development of allergic disease. It has been shown that of the vitamin E isoforms, α-Tocopherol decreases and γ-Tocopherol increases the generation of bone marrow-derived CD11b+CD11c+ DCs in vivo. And, in vivo experiments have also shown that β-glucosylceramides, endogenous maternal lipids, increase the neonate proliferation of this same subset of DCs. The mechanism for β-glucosylceramide regulation of these specific DC subsets is not known. Furthermore, it is also not known how vitamin E isoforms regulate DC development and differentiation. We determined whether α-tocopherol decreases and γ-tocopherol increases responses to β-glucosylceramide by regulating Protein Kinase C (PKC) activation during CDllb+CDllc+ DC differentiation and proliferation.
Project Methods: Cultured bone marrow cells (harvested from mice) were treated with lipid metabolites with and without supplementation of tocopherol isoforms, immunolabeled with antibodies that define DCs and with antibodies that detect active auto phosphorylated forms of PKC. Then, these cells were analyzed using flow cytometry.
Results: In vitro β-glucosylceramide elevated DC PKCα/β activity during CDllb+CDllc+ DC differentiation and proliferation/activation. Furthermore, these effects of β-glucosylceramide on DC PKCα/β activity were blocked by α-Tocopherol and elevated by γ-Tocopherol.
Potential Impact: These data provides a better understanding of how maternal β-glucosylceramide and dietary supplementation with vitamin E isoforms regulate DC proliferation and differentiation and ultimately development of allergic inflammation in offspring of allergic mothers.
Addressing Mental Health Needs of Health Care Workers through Peer Support Groups During the COVID-19 Crisis
Authors: Thornsberry Tanner , Nault Connors Jill , Welch Julie , Hayden Julie , Hartwell Jennifer , Ober Michael , Sotto Sylk , Draucker Claire , Wasmuth Sally , Boustani Malaz , Overley Ashley , Monahan Patrick , Kroenke Kurt 
Published: December 2020

Background:
The COVID-19 pandemic has placed a high psychological burden on frontline healthcare workers. Often quarantined away from their families and with little downtime to process their experiences, those on the frontlines of the pandemic are experiencing pronounced levels of distress and significantly elevated rates of burnout. Although many wellness and psychological resources are available to providers, there is low uptake and little is known about their effectiveness. In this study, we assess the impact of group-based peer support sessions on symptoms of acute distress, anxiety and depression, and provider burn out.

Methods:
An established peer support model is adapted for use with groups of frontline healthcare workers that will participate in 6 to 8 weekly group sessions using videoconferences. The study approach is a phased feasibility to research design. During the feasibility phase, we will initially test the intervention in 3 groups of 8 providers using a quasi-experimental, pre- post analysis of change. If preliminary results are positive, we will scale the intervention and progress to a more rigorous study design using a differences-in-differences approach to assess change over time between exposure and non-exposure groups. Outcomes will be measured at baseline, intervention completion, and 3- and 6- month follow ups. During the feasibility phase we will assess intervention fidelity and conduct qualitative analysis to assess the effects of the pandemic on work, family and social life.

Results:
This is a work in progress. At present we have recruited 28 emergency medicine physicians and residents with a target start date of August 1, 2020.

Potential Impact:
We anticipate the results of this study will provide evidence in support of a recent call for “the use of non-clinical mental health support, such as social or peer support” from the American College of Emergency Physicians in conjunction with 42 leading professional organizations in medicine. In addition, results may lead to advocacy for improved policies that mitigate against “fear of resultant loss of licensure, loss of income, or other career setbacks” for seeking mental health support.
Indiana Nonprofit Hospitals’ Community Health Needs Assessments Objectives and Evaluation
Authors: Walters Kevin , Savaiano Dennis 
Published: December 2020

Background/Objective:
Over half of the hospitals in the United States are not for profit and confer large tax advantages so long as they demonstrate community benefit. Since 2010 these hospitals have been required by law to conduct Community Health Needs Assessments (CHNAs) in order for community benefit to move from charity care to improved population health outcomes. For improved population health outcomes, we argue that effective community health programs must be put into place with high quality goals and evaluations to ensure effectiveness. We rated the objectives and evaluation plans of Indiana nonprofit hospitals’ CHNAs and then compared and correlated the quality of these plans with characteristics of the hospitals and health indicators of their community.

Methods:
CHNAs and Implementation Plans were obtained for 95 nonprofit hospitals in Indiana. The assessments and plans were independently scored by 2 assessors based on specific criteria for quality using a Likert scale which ranged from 0 to 5. We averaged the scores and then correlated and compared them to characteristics of the hospital, its local partnerships, and the health statistics of the communities in which they reside.

Results:
The average score for the objectives was 3.43 and for the evaluation 2.47 with large variations in the criteria met by each hospitals CHNA. Significant differences were found between the scores of system-based and independent hospitals for both evaluation and objectives (p=0.01, p<0.001).

Conclusion and Potential Impact:
Our data shows that the quality of CHNAs’ objectives and evaluation is universally poor and vary greatly from hospital to hospital. However, consistency and to a lesser degree quality of scores can be affected by system wide models. If the goal of these assessments is to create better population health outcomes through nonprofit hospitals, then the government needs to provide a high-quality model for hospitals to follow.
Decoding Mouse Behavior from neural activity in primary visual cortex
Authors: Williams Ari , Makin Maria 
Published: December 2020

Background and Hypothesis:
Brain-machine interfaces (BMIs) aim to restore motor control to patients. To develop effective BMIs, it is imperative that we build highly accurate models relating cortical neural activity with natural movements. Neurons in the visual cortex of the brain respond strongly to visual signals, but are also modulated by fluctuating internal states such as alertness, which closely correlates pupil size. We thus hypothesized that an animal’s pupil size can be decoded directly from the activity of a population of neurons in mouse primary visual cortex.

Project Methods:
We used an open-access dataset from the Allen Institute for Brain Science, which consisted of in-vivo 2 photon calcium imaging data of 128 neurons recorded from primary visual cortex of an awake mouse viewing a video screen. Video imaging was used to track the mouse’s pupil size.

To relate neural activity with pupil size, we used linear regression, first smoothing the data with a Savitzky Gall filter. The model was fit on the first 80% of the data, and tested on the remaining 20%, using the computed coefficients to predict pupil size from neural activity. A Pearson correlation coefficient between the true and predicted data was computed. All analyses were performed in Python.

Results:
We found that there was a strong linear relationship between neural activity and pupil size, as the correlation coefficient between the true and predicted data was 0.376. Therefore, we have shown quantitatively that pupil size can be modeled based on neuronal activity within the visual cortex with a high level of accuracy.

Conclusion and Potential Impact:
This experiment demonstrates the feasibility of linear regression for modeling neuronal behavior in the visual system, particularly related to pupil size. Results suggest opportunities for further experimental analysis of the relationship between neural activity and other physiological markers, such as running speed.
Depressive Symptom Screening in Youth – Using a Community Diabetes Prevention Clinic
Authors: Wright Alexander , Yazel-Smith Lisa , Hannon Tamara 
Published: December 2020

Background: Rates of youth diagnosed with diabetes and prediabetes are increasing and comorbidities like depression warrant strict monitoring to improve patient outcomes.
Objective: The aim was to determine if increased depressive symptoms are associated with worse clinical findings, including BMI, obesity, diabetes, prediabetes, hemoglobin A1c (HbA1c), and demographic variables including age, gender, and race.
Methods: The study is a retrospective chart review of patients referred to the Youth Diabetes Prevention Clinic (YDPC) based on increased risk for type 2 diabetes (T2D). The Patient Health Questionnaire (PHQ-9), a 9-question depressive symptom screening tool, was utilized to screen for depressive symptoms using a cut point of >=10 which indicates possible depression and a need for further evaluation. All available data were evaluated for clinic visits occurring between 2013 and 2020.
Results: 178 patients filled out PHQ-9 screening forms and returned them to clinic. Age (p <0.01), sex (p <0.01), BMI (p <0.01), HbA1c (p <0.01), and obesity diagnosis (p = 0.01) were associated with increased depressive symptoms based on screening score cutoff. Race (p > 0.05), BMI z-score (p = 0.18), prediabetes diagnosis (p = 0.92), and diabetes diagnoses (p = 0.05) were not. Middle adolescent (ages 14-17) youth were 3.5 times more likely than early adolescents to fall into the moderate/high risk category for depression. Females were 2.6 times more likely and those with higher HbA1c or an obesity diagnosis were ~3 times more likely. A modest portion (36.5%) in this sample met criteria for possible clinical depression.
Conclusion and Impact: Patients at risk for prediabetes and diabetes should be screened for depressive symptoms in order to intervene to decrease its adverse effects on diabetes management. Older youth, females, and those with obesity and higher HbA1c values are at particularly higher risk of having increased depressive symptoms.
Evaluation of Contraception Access within the Indianapolis Metropolitan Area
Authors: Yedlicka Grace , Theis Emily , Bernard Caitlin , Tucker Edmonds Brownsyne , Peipert Jeffrey , Wilkinson Tracey 
Published: December 2020

Background: Access to family planning care and the full-spectrum of contraception, including same-day access to long acting reversible contraception (LARC) is critical to reduce unintended pregnancy and maternal/infant mortality. However, access remains variable for many women in Indiana. We sought to examine access to various contraceptive practices within the Indianapolis metropolitan area.

Methods: A telephone survey of clinic managers was conducted between June-July 2020 of all identified IU Health, Eskenazi, and HealthNet primary care and OB/GYN providers in the Indianapolis metropolitan area. The 27-question survey gathered information regarding contraceptive practices (e.g. contraceptive method availability, same-day LARC insertion/removal, pregnancy intention screening, educational materials, and parental consent policies). The data was compared based on type of medical provider (OB/GYN, Family Medicine, and Pediatrics).

Results: In total, 82 sites were identified, 58 surveys (70.7%) were completed. Oral contraception is the most commonly offered contraception (91.4%), followed by depot medroxyprogesterone acetate (DMPA) injection (84.5%), and the contraceptive patch (81.0%). LARC placement is available in 51.7% of all clinics, but only 34.5% offer same-day placements. Routine pregnancy intention screening is offered in 43.1% and educational materials in 74.1% of practices. OB/GYN clinics provide the most comprehensive access, 69.2% provide same-day LARC insertion (84.6% LARC removals). Family medicine practices are variable regarding contraceptive choices: over 91% offer oral contraception and DMPA injections, but only 20.8% place LARCs and 41.7% remove LARCs. Half (50%) of pediatric clinics provide oral contraception, while 50% do not provide any contraceptives. Parental consent for minors to obtain contraception provision is highly variable.

Conclusion: Contraceptive practices vary among primary care and OB/GYN providers in the Indianapolis area. This variability in access leads to barriers for use, particularly for young women. Efforts to ensure comprehensive, same-day access to all forms of contraception (including LARCs), pregnancy intention screening, and contraceptive educational materials are needed.
Economic Valuation of Mangrove Forest in Tanakeke Island, Takalar District, South Sulawesi Province
Authors: Purwanti Rini 
Published: December 2020

Mangrove forests on Tanakeke Island provide many benefits, both direct and indirect benefits. All the benefits received/enjoyed by the community so far have never been calculated/valued in money so sometimes the community does not realize how much value is actually given by this mangrove forest and how much it contributes to their income. Resource economic valuation is a method used to estimate the monetary value of goods and services provided by mangrove forest resources. The purpose of this study was to determine the total economic value of the benefits of mangrove forests on Tanakeke Island. The total economic value of the benefits of mangrove forests is derived from the value of direct benefits (tree, firewood, charcoal, seaweed stake, fish and mangrove crabs), indirect benefits (anchoring abrasion and intrusion), optional benefits, existence benefits and inheritance benefits. Based on the results of calculations, the total economic value of mangrove forests on Tanakeke Island is Rp73,563,108,250.00/year or Rp127,492,388.00/ha/year. Direct benefits provide the greatest value of Rp44,173,560,000.00/year (60.05%), then indirect benefits of Rp14,257,696,532.00/year (19.38%), the benefit of being Rp10,597,566,668.00/year (14.41%), the inheritance benefit of Rp4,417,356,000/year (6.00%) and optional benefits of Rp116,929,050/year (0.16%).
Identification of a new chuvirus associated with febrile illness in China
Authors: Quan Liu , Wang Ze-Dong , Gao Yuan , Lv Xiaolong , Han Shuzheng , Zhang Xu , Shao Jian-Wei , Chen Chen , Li Liang , Hou Zhi-Jun , Sui Liyan , Zhao Yinghua , Wang Bo , Wang Wei , Song Mingxin 
Published: December 2020

Abstract
Chuviruses belong to the genus Mivirus in the newly classified family Chuviridae, and their medical significance remains undetermined1,2. Here, we identified a novel chuvirus, Nuomin virus (NOMV), from febrile patients in China. NOMV had a circular genome and presented enveloped spherical particles with a diameter of approximately 120–150 nm. Phylogenetically, NOMV formed a separate clade in the Chuviridae family, with 17.1–83.4% sequence identity to other chuviruses. NOMV infection was confirmed in 54 patients who had a tick-bitten history during 2017–2019, while both virus-specific antibodies and RNA were tested negative in healthy cohorts. The typical symptoms are characterized by fever and headache. Seroconversion or a four-fold elevation of antibody titers was observed in the available specimens of convalescent phase. NOMV was also detected in hard ticks, sheep, and cattle in northeastern China. Our findings showed that a novel chuvirus is associated with human febrile illness in China, necessitating investigation of this emerging virus in the tick-endemic areas worldwide.
Metabolic reprogramming in chondrocytes to promote mitochondrial respiration reduces downstream features of osteoarthritis
Authors: Ohashi Yoshifumi , Takahashi Nobunori , Terabe Kenya , Tsuchiya Saho , Kojima Toshihisa , Knudson Cheryl , Knudson Warren , Imagama Shiro 
Published: December 2020

Abstract
Metabolic dysfunction in chondrocytes drives the pro-catabolic phenotype associated with osteoarthritic cartilage. In this study, substitution of galactose for glucose in culture media was used to promote a renewed dependence on mitochondrial respiration for ATP production. Galactose replacement alone blocked enhanced usage of the glycolysis pathway by IL1β-activated chondrocytes as detected by real-time changes in the rates of proton acidification of the medium and changes in oxygen consumption. The change in mitochondrial activity due to galactose was visualized as a rescue of mitochondrial membrane potential but not an alteration in the number of mitochondria. Galactose-replacement reversed other markers of dysfunctional mitochondrial metabolism, including blocking the production of reactive oxygen species, nitric oxide, and the synthesis of inducible nitric oxide synthase. Of more clinical relevance, galactose-substitution blocked downstream functional features associated with osteoarthritis, including enhanced levels of MMP13 mRNA, MMP13 protein, and the degradative loss of proteoglycan from intact cartilage explants. Blocking baseline and IL1β-enhanced MMP13 by galactose-replacement in human osteoarthritic chondrocyte cultures inversely paralleled increases in markers associated with mitochondrial recovery, phospho-AMPK, and PGC1α. Comparisons were made between galactose replacement and the glycolysis inhibitor 2-deoxyglucose. Targeting intermediary metabolism may provide a novel approach to osteoarthritis care.