bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of Maryland’s payment reforms on hospital community benefit efforts
Authors: Cronin Cory E. , Singh Simone , Franz Berkeley 
Published: January 2021

Background
In 2014, Maryland established a global budget policy for all hospitals in the state. Under this policy, hospitals are incentivized to not only provide clinical care services to individual patients but also address the health needs of their broader patient population through prevention efforts and investment in the upstream social and economic factors that determine health.

Purpose
To better understand the incentives created for hospitals under this policy, our study assessed whether the implementation of global budgets changed the levels and patterns of Maryland hospitals’ investments in community benefits.

Approach
Data on hospital community benefit spending from the Internal Revenue Service Form 990 Schedule H for the years 2010–2016 were utilized for this study.

Results
We found that Maryland hospitals’ total spending on community benefits decreased under the global budget policy. Unlike hospitals in similar states without a global budget policy, Maryland hospitals did not experience any increases in Medicaid shortfalls between 2014 and 2016. Although Maryland hospitals provided more subsidized health services, their investment in broader community health improvement activities remained unchanged.

Conclusion
Our analysis suggests that Maryland hospitals have shifted strategies because of the implementation of the global budget policy. The ability to report community benefit in a way that accurately considers the context and constraints of a state’s policies would provide hospitals better means of communicating these efforts to stakeholders.

Practice Implications
Our results suggest that global budgets impact the levels and patterns of hospitals’ community benefit investments.
STELLATE NONHEREDITARY IDIOPATHIC FOVEOMACULAR RETINOSCHISIS: NOVEL FINDINGS AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY ANALYSIS
Authors: Schildroth Kathleen R. , Mititelu Mihai , Etheridge Tyler , Holman Ian , Chang Jonathan S. 
Published: January 2021

Purpose:
To present novel findings in stellate nonhereditary idiopathic foveomacular retinoschisis, including the largest series of optical coherence tomography angiography findings to date.

Methods:
A retrospective case series with multimodal imaging was obtained and reviewed.

Results:
All three patients were women, aged 59–63. Two cases were unilateral, and one was bilateral. Vision ranged from 20/20 to 20/60 in the affected eyes. Peripheral retinoschisis was observed in all three patients. All patients were followed for a minimum of 1 year. In one case, progressive macular retinoschisis leading to foveal involvement was observed over two years, with an associated vision decline from 20/25 to 20/60. Attempted interventions included topical dorzolamide in all cases and intravitreal bevacizumab in one patient; however, no treatment effect was observed. The foveal avascular zone size was within normal limits (mean 280 µm). In all stellate nonhereditary idiopathic foveomacular retinoschisis eyes, the retinoschisis cavities were nonvascular.

Conclusion:
Novel findings regarding stellate nonhereditary idiopathic foveomacular retinoschisis include the progressive nature of foveal involvement and the lack of response to topical dorzolamide and intravitreal bevacizumab. Foveal avascular zone was normal in all eyes, consistent with the relatively preserved vision in these cases. Retinoschisis cavities were nonvascular in all eyes, a finding which may give insight into the mechanism of this disease.
Fungal Necrotizing Scleritis After Intravitreal Injection Therapy
Authors: Hernández-Pons Antonio , Ortiz-Seller Amparo , López-Cruz Ian , Camarena Juan J. , Comín-Pérez Alberto , Ferrández-Pérez María A. , Martínez-Costa Lucía 
Published: January 2021

Purpose:
To report a case of infectious necrotizing scleritis secondary to Aspergillus terreus after intravitreal injection therapy.

Methods:
This is a case report with literature review.

Results:
A 98-year-old woman receiving intravitreal aflibercept injections for neovascular age-related macular degeneration in the left eye presented with severe pain, redness, and purulent discharge at the injection site. She was initially treated with topical fortified antibiotics, and clinical improvement was achieved, although microbial cultures showed negative results. Two months later, she presented with severe ocular pain and was diagnosed with anterior necrotizing scleritis. Scleral scrapings were collected for cultures, and intensive topical antibiotic therapy was reintroduced. Evaluation for autoimmune etiology and microbiological testing showed negative results. Because of the progression of the scleral necrotic area, empirical therapy with topical voriconazole was initiated, and surgical debridement was performed. Finally, the culture was positive for A. terreus. The modified therapy consisted of topical voriconazole and oral voriconazole for 3 months with an excellent clinical outcome.

Conclusions:
To our knowledge, this is the first case of fungal necrotizing scleritis secondary to intravitreal injection. Diagnosis was delayed due to its chronic clinical course and the slow fungal growth in culture media, but the combined medical and surgical approach resulted in a satisfactory outcome.
The Hydrus Microstent in Pseudophakic Patients With Medically Refractory Open-angle Glaucoma
Authors: Coventon James , Cronin Brendan 
Published: January 2021

Purpose:
Minimally invasive glaucoma surgery (MIGS) is an emerging therapy for glaucoma. The Hydrus Microstent is a MIGS device that stents Schlemm’s canal, thereby increasing aqueous drainage and lowering intraocular pressure (IOP). This article describes the use of the microstent in pseudophakic patients with medically refractory glaucoma, a patient population undocumented in the current literature.

Patients and Methods:
We present a retrospective case series of 11 pseudophakic eyes using 3 or more pressure lowering medications daily for open-angle glaucoma who underwent Hydrus Microstent insertion. Patients were followed up at 1, 3, 6, 12, 24, 36, 48, and 60 months postoperatively and assessed for reductions in IOP and medication burden.

Results:
At intervals 12 and 24 months, medication burden reduced by 75.6% at both junctures, and IOP reduced by 43.8% and 34.1%. Complications included 4 hyphaemas and 1 corneal epithelial defect, each of which resolved.

Discussion:
This case series demonstrated effective pressure and medication reduction in medically refractory open-angle glaucoma patients using the Hydrus Microstent. Use of this device in this population is thus far undocumented in the literature and may represent an optimal therapeutic modality in the future.
Yogic Pranayama and Diaphragmatic Breathing: Adjunct Therapy for Intraocular Pressure in Patients With Primary Open-angle Glaucoma: A Randomized Controlled Trial
Authors: Udenia Hemlata , Mittal Sunita , Agrawal Ajai , Singh Anvita , Singh Anupam , Mittal Sanjeev K. 
Published: January 2021

Précis:
Yogic pranayama and diaphragmatic breathing are potential adjunctive therapies for patients with glaucoma; however, they are not substitutes for medicine or eye drops.

Purpose:
Currently, medical or surgical lowering of intraocular pressure is the only therapeutic approach for treating primary open-angle glaucoma. Intraocular pressure maintenance is influenced by autonomic activity (sympathetic and parasympathetic). “Yogic pranayama” and “diaphragmatic breathing” are exercises that can affect autonomic activity by stimulating a wakeful hypometabolic state of parasympathetic dominance. We aimed to assess the effect of yogic pranayama and diaphragmatic breathing on intraocular pressure to determine whether it can be recommended for individuals with established glaucoma in combination with glaucoma medication as an adjuvant therapy.

Materials and Methods:
In this prospective, randomized trial, 90 patients with primary open-angle glaucoma (180 eyes, age: above 40 y) were assigned to either the control or yogic pranayama and diaphragmatic breathing exercise group. In the latter group, yogic pranayama and diaphragmatic breathing were practiced daily for 6 months. We measured the intraocular pressure at presentation and subsequently after 1, 3, and 6 months.

Results:
Compared with the wait-list group, the yogic pranayama and diaphragmatic breathing exercise group had significantly lowered intraocular pressure (right eye: 20.85±3.39 to 14.90±2.86 mm Hg; left eye: 20.30±4.12 to 14.25±3.85 mm Hg; P<0.001).

Conclusion:
Yogic pranayama and diaphragmatic breathing exercises can reduce intraocular pressure in patients with primary open-angle glaucoma and can therefore be recommended as an adjuvant therapy.
Diabetes: a silent player in musculoskeletal interventional radiology response
Authors: Dimitri-Pinheiro Sofia , Pimenta Madalena , Cardoso-Marinho Beatriz , Torrão Helena , Soares Raquel , Karantanas Apostolos 
Published: January 2021

Abstract
Diabetes has an important role in the development of several musculoskeletal disorders, such as adhesive capsulitis of the shoulder (ACs) and stenosing flexor tenosynovitis of the finger (SfTf). The etiopathophysiology of ACs and SfTf in diabetic patients is associated with both chronic hyperglycemia, increased amounts of visceral adiposity and chronic inflammation. Chronic hyperglycemia stimulates the creation of cross-links between collagen molecules, impairing degradation and resulting in the build-up of excessive collagen deposits in the cartilage, ligaments, tendon sheaths and tendons. Increased adipocytes in diabetic patients secrete proteins and cytocines such as TNF-α, IL-6 and IL-13 which result in overproduction of pro-inflammatory factors, destruction of normal tissue architecture and fibrosis. Both hyperglycemia and adipocytes inhibit efferocytosis, limiting natural resolution. Recently, multiple image-guided interventional radiology musculoskeletal treatment options have been developed, such as ultrasound-guided glenohumeral capsule hydrodistension for ACs and ultrasound-guided percutaneous pulley release for trigger finger. Diabetes can negatively influence outcomes in patients with ACs and SfTf and may impact the decision of which specific procedure technique should be employed. Further studies are necessary to define how diabetes influences response to interventional radiology treatments of these disorders, as well as the extent to which control of blood sugar levels can contribute towards the personalization and optimization of patient follow up.
The Buffering Effect of Perceived Organizational Support on the Relationships Among Workload, Work–Family Interference, and Affective Commitment: A Study on Nurses
Authors: TAYFUR EKMEKCI Ozge , XHAKO Dorela , METIN CAMGOZ Selin 
Published: January 2021

ABSTRACT

Background
Minimal research has been conducted to explore the associations among workload, work-to-family conflict, family-to-work conflict, support, and affective commitment.

Purpose
This study was designed to explore the moderating role of perceived organizational support on the mediating effects of work-to-family conflict, family-to-work conflict in perceived workload, and affective commitment linkage.

Methods
The data were collected using a self-report survey from 164 nurses working at two public hospitals. The hypothesized model was tested using PROCESS macro.

Results
Perceived organizational support was found to influence the mediating effect of work-to-family conflict on the linkage between workload and affective commitment, yet not to moderate the mediating effect of family-to-work conflict. The results revealed that workload predicts affective commitment negatively and work-to-family conflict positively. However, perceived organizational support was found to change the effect that workload has on affective commitment. The negative effect of workload on affective commitment was found to be weaker for nurses with adequate organizational support.

Conclusions/Implications for Practice
Perceived organizational support was found to have both main and buffering effects on the emotional attachment of nurses toward their organizations. The findings support the importance of creating supportive work settings to alleviate the adverse effects on nurses of workload and work–family interference.
A flexible, pan-species, multi-antigen platform for the detection and monitoring of SARS-CoV-2-specific antibody responses
Authors: Shen Huifeng , Forgacs David , Chapla Digantkumar , Moremen Kelley W. , Wells Lance , Hamer Sarah A. , Tompkins Stephen M. , Ross Ted M. , Rouphael Nadine , Edupuganti Srilatha , Collins Matthew H. , Tarleton Rick L. 
Published: January 2021

AbstractThe SARS-CoV-2 pandemic and the vaccination effort that is ongoing has created an unmet need for accessible, affordable, flexible and precise platforms for monitoring the induction, specificity and maintenance of virus-specific immune responses. Herein we validate a multiplex (Luminex-based) assay capable of detecting SARS-CoV-2-specific antibodies irrespective of host species, antibody isotype, and specimen type (e.g. plasma, serum, saliva or blood spots). The well-established precision of Luminex-based assays provides the ability to follow changes in antibody levels over time to many antigens, including multiple permutations of the most common SARS-CoV-2 antigens. This platform can easily measure antibodies known to correlate with neutralization activity as well as multiple non-SARS-CoV-2 antigens such as vaccines (e.g. Tetanus toxoid) or those from frequently encountered agents (influenza), which serve as stable reference points for quantifying the changing SARS-specific responses. All of the antigens utilized in our study can be made in-house, many inE. coliusing readily available plasmids. Commercially sourced antigens may also be incorporated and newly available antigen variants can be rapidly produced and integrated, making the platform adaptable to the evolving viral strains in this pandemic.Brief SummaryA multi-antigen assay for monitoring SARS-CoV-2-specific antibodies irrespective of host species, antibody isotype, and specimen type was developed.
COVID-19-related disruptions to routine vaccination services in India: perspectives from pediatricians
Authors: Shet Anita , Dhaliwal Baldeep , Banerjee Preetika , Carr Kelly , DeLuca Andrea , Britto Carl , Seth Rajeev , Parekh Bakul , Basavaraj GV , Gupta Piyush , Shastri Digant 
Published: January 2021

ABSTRACTBackground and ObjectiveThe COVID-19 pandemic has led to disruptions to routine immunization programs in India and around the world, setting the stage for potentially serious outbreaks of vaccine-preventable diseases.MethodsWe surveyed pediatric healthcare providers in India in 2 rounds in April-June and September 2020 to understand how COVID-19 control measures may have impacted routine vaccination.ResultsRespondents were predominantly pediatricians working in primary, secondary or tertiary healthcare centers, across 21 Indian states and two union territories. Among the 424 (survey 1) and 141 (survey 2) respondents, 33.4% and 7.8%, respectively, reported near complete suspension of vaccination services due to COVID-19. A 50% or greater drop in vaccination services was reported by 83.1% of respondents in June, followed by 32.6% four months later, indicating slow recovery of services. By September 2020, 83.6% were aware of updated guidelines on safe provision of immunization services, although awareness of specific catch-up vaccination plans was low, and 76.6% expressed concern about a vaccine coverage gap that could potentially lead to increased non-COVID-19 illnesses and deaths.ConclusionsPandemic-related disruptions to vaccination services were reported by pediatricians across India. Concerted efforts are needed from governing and academic groups to ensure that routine immunization and catch-up programs are implemented during this pandemic, which can sustain gains in vaccination coverage and provide a robust blueprint for the national roll-out of the COVID-19 vaccine.
Adolescent predatory stress increases peripheral TNFα response to LPS regardless of sex
Authors: Dyer Samya K. , Council Kimaya R. , Turkson Susie , Shaw Gladys A. , Neigh Gretchen N. 
Published: January 2021

AbstractChronic adolescent stress has been shown to cause increased adverse effects in response to an immune stressor later in life including the development of anxiety and PTSD. Following stress, the production of inflammatory cytokines including IL-1β and TNFα is expected to increase in response to an immune challenge such as LPS. Male and female mice underwent fifteen consecutive days of predatory stress. Chronic adolescent stress was shown to increase both anxiety-like behavior (F(1, 28)= 19.82, p = 0.0001) and TNFα levels within the periphery (F(1, 19)= 4.748, p = 0.0421).
Mathematical modeling of Erk activity waves in regenerating zebrafish scales
Authors: Hayden L.D. , Poss K.D. , De Simone A. , Di Talia S. 
Published: January 2021

AbstractErk signaling regulates cellular decisions in many biological contexts. Recently, we have reported a series of Erk activity traveling waves that coordinate regeneration of osteoblast tissue in zebrafish scales. These waves originate from a central source region, propagate as expanding rings, and impart cell growth, thus controlling tissue morphogenesis. Here, we present a minimal reaction-diffusion model for Erk activity waves. The model considers three components: Erk, a diffusible Erk-activator, and an Erk-inhibitor. Erk stimulates both its activator and inhibitor, forming a positive and negative feedback loop, respectively. Our model shows that this system can be excitable and propagate Erk activity waves. Waves originate from a pulsatile source which is modeled by adding a localized basal production of the activator that switches the source region from an excitable to an oscillatory state. As Erk activity periodically rises in the source, it can trigger an excitable wave which travels across the entire tissue. Analysis of the model finds that positive feedback controls the properties of the traveling wavefront and that negative feedback controls the duration of Erk activity peak and the period of Erk activity waves. The geometrical properties of the waves facilitate constraints on the effective diffusivity of the activator, indicating that waves are an efficient mechanism to transfer growth factor signaling rapidly across a large tissue.Significance statementSignaling waves represent a possible mechanism of spatiotemporal organization of multicellular tissues. We have recently shown that waves of activity of the kinase Erk control osteoblast regeneration in adult zebrafish scales. Here, we present a detailed characterization of a mathematical model of these signaling waves. We show that a source region poised in an oscillatory state can broadcast traveling waves of Erk activity in the surrounding excitable tissue. The dynamics of the source control the number and frequency of waves. Geometrical arguments support the notion that excitable Erk waves are an effective mechanism to transport growth factor signaling across a large regenerating tissue.
Perceptual Weighting of V1 Spikes Revealed by Optogenetic White Noise Stimulation
Authors: Day-Cooney Julian R. , Cone Jackson J. , Maunsell John H.R. 
Published: January 2021

AbstractDuring visually guided behaviors, mere hundreds of milliseconds can elapse between a sensory input and its associated behavioral response. How spikes occurring at different times are integrated to drive perception and action remains poorly understood. We delivered random trains of optogenetic stimulation (white noise) to excite inhibitory interneurons in V1 of mice while they performed a visual detection task. We then performed a reverse correlation analysis on the optogenetic stimuli to generate a neuronal-behavioral kernel: an unbiased, temporally-precise estimate of how suppression of V1 spiking at different moments around the onset of a visual stimulus affects detection of that stimulus. Electrophysiological recordings enabled us to capture the effects of optogenetic stimuli on V1 responsivity and revealed that the earliest stimulus-evoked spikes are preferentially weighted for guiding behavior. These data demonstrate that white noise optogenetic stimulation is a powerful tool for understanding how patterns of spiking in neuronal populations are decoded in generating perception and action.Significance StatementHow the brain decodes dynamic neuronal responses to generate perception and behavior remains uncertain. A critical challenge is determining the relative contribution of spikes that occur at different times on the timescale of brain computations (tens of ms). Optogenetic tools permit causal investigations into neuronal-behavioral relationships, but are generally impractical for obtaining millisecond resolution. We circumvented this by delivering random (white noise) patterns of optogenetic inhibition to the primary visual cortex of behaving mice during visual tasks. Aligning optogenetic stimuli to task outcomes (hit, miss) yielded a neuronal-behavioral kernel – a temporal weighting that describes how inhibition at different moments impacts perception of visual stimuli. Thus, this method is a powerful tool for linking neuronal spiking, perception, and behavior.
Targeted RNA-seq improves efficiency, resolution, and accuracy of allele specific expression for human term placentas
Authors: Wu Weisheng , Lovett Jennie L. , Shedden Kerby , Strassmann Beverly I. , Vincenz Claudius 
Published: January 2021

AbstractGenomic imprinting is an epigenetic mechanism that results in allele specific expression (ASE) based on parent of origin. It is known to play a role in the prenatal and postnatal allocation of maternal resources in mammals. ASE detected by whole transcriptome RNA-seq (wht-RNAseq) has been widely used to analyze imprinted genes using reciprocal crosses in mice to generate large numbers of informative SNPs. Studies in humans are more challenging due to the paucity of SNPs and the poor preservation of RNA in term placentas and other tissues. Targeted RNA-seq (tar-RNAseq) can potentially mitigate these challenges by focusing sequencing resources on the regions of interest in the transcriptome. Here we compared tar-RNAseq and wht-RNAseq in a study of ASE in known imprinted genes in placental tissue collected from a healthy human cohort in Mali, West Africa. As expected, tar-RNAseq substantially improved the coverage of SNPs. Compared to wht-RNAseq, tar-RNAseq produced on average four times more SNPs in twice as many genes per sample and read depth at the SNPs increased 4-fold. In previous research on humans, discordant ASE values for SNPs of the same gene have limited the ability to accurately quantify ASE. We show that tar-RNAseq reduces this limitation as it unexpectedly increased the concordance of ASE between SNPs of the same gene, even in cases of degraded RNA. Studies aimed at discovering associations between individual variation in ASE and phenotypes in mammals and flowering plants will benefit from the improved power and accuracy of tar-RNAseq.