bluuebunny/crossref_metadata_2025_split huggingface dataset:
Credit policy and the ‘debt shift’ in advanced economies
Authors: Bezemer Dirk , Ryan-Collins Josh , van Lerven Frank , Zhang Lu 
Published: October 2021

AbstractThe decline in the share of bank credit to non-financial firms since the 1990s, relative to credit for real estate and financial asset markets, has raised concerns over economic growth and financial stability and sparked renewed interest in credit policies, instruments and institutions. We examine their theoretical case and post-war use, and trace their demise during the wider market-oriented policy reconfiguration from the 1980s. Notably, this included home ownership polices favouring mortgage markets. We then examine the empirical relationship between credit policy and credit allocation in the 1973–2005 period for 17 advanced economies. Taking account of co-integration, we present evidence that the decline of credit policies is significantly associated with a lower share of lending to non-financial firms. It may be worth revisiting the potential of credit policies to support adequate financing for goals such as innovation, industrial development and the transition to a low-carbon economy.
Reducing Stress and Increasing Mindfulness in Nursing Students: An Online Mindfulness Intervention Study
Authors: Garmaise-Yee Joy S. , LeBlanc Raeann G. 
Published: October 2021

Abstract
This pilot study evaluated the outcomes of stress and mindfulness among a convenience sample (n = 60) of nursing students. Students participated in an online mindfulness-based intervention and completed the Perceived Stress Scale and the Five Facet Mindfulness Questionnaire. Although mean stress scores lowered, there was no statistically significant reduction in stress. There were significant increases in mindfulness scores (posttest, p = .000) that were sustained at four-week follow-up (p = .012). Larger increases in mindfulness were associated with larger decreases in stress.
Simulation to Develop Teaching Competencies in Health Professions Educators: A Scoping Review
Authors: Monsivais Diane B. , Nunez Franchesca 
Published: October 2021

Abstract

AIM
The aim of this study was to determine what is known about using simulation as an intervention to develop teaching competencies in health professions educators.

BACKGROUND
No reviews are available that integrate the body of evidence about simulation to develop role competency in clinical educators.

METHOD
Scoping review methodology was used to identify interventions that used simulation to develop teaching competencies for health professions educators.

RESULTS
Thirteen articles met inclusion criteria. Simulation contexts were academic settings, either as a single activity or being embedded in larger curriculum. Backgrounds were tied to specific objectives related to faculty role expectations. Facilitator and educational strategies varied from loosely to highly structured. Outcomes were primarily posteducational self-assessments.

CONCLUSION
Simulation to develop teaching competencies is a promising strategy and an important area of future research for nursing education.
Patient and Spine Surgeon Perceptions on Shared Decision-Making in the Treatment of Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity
Authors: Deme Palvasha , Perera Anjali , Chilakapati Sai , Stutzman Sonja , Singh Ravinderjit , Eldridge Cody M. , Caruso James , Vira Shaleen , Aoun Salah G. , Makris Una E. , Bagley Carlos A. , Adogwa Owoicho 
Published: October 2021

Study Design.
Retrospective.

Objective.
To understand patients’ and spine surgeons’ perspectives about decision-making around surgery for adult spinal deformity.

Summary of Background Data.
Surgery for correction of adult spinal deformity is often beneficial; however, in over 20% of older adults (≥ 65 yrs of age), outcomes from surgery are less desirable.

Materials and Methods.
We conducted semistructured, in-depth interviews with six patients and five spine surgeons. Two investigators independently coded the transcripts using constant comparative method, as well as an integrative, team-based approach to identify themes.

Results.
Patients themes: 1) patients felt surgery was their only choice because they were running out of time to undergo invasive procedures; 2) patients mentally committed to surgery prior to the initial encounter with their surgeon and contextualized the desired benefits while minimizing the potential risks; 3) patients felt that the current decision support tools were ineffective in preparing them for surgery; and 4) patients felt that pain management was the most difficult part of recovery from surgery. Surgeons themes: 1) surgeons varied substantially in their interpretations of shared decision-making; 2) surgeons did not consider patients’ chronological age as a major contraindication to undergoing surgery; 3) there is a goal mismatch between patients and surgeons in the desired outcomes from surgery, where patients prioritize complete pain relief whereas surgeons prioritize concrete functional improvement; and 4) surgeons felt that patient expectations from surgery were often established prior to their initial surgery visit, and frequently required recalibration.

Conclusion.
Older adult patients viewed the decision to have surgery as time-sensitive, whereas spine surgeons expressed the need for recalibrating patient expectations and balancing the risks and benefits when considering surgery. These findings highlight the need for improved understanding of both sides of shared decision-making which should involve the needs and priorities of older adults to help convey patient-specific risks and choice awareness.

Level of Evidence.
3
PREOPERATIVE GAS FOR PARS PLANA VITRECTOMY: A SURGICAL TECHNIQUE FOR REPAIR OF RHEGMATOGENOUS RETINAL DETACHMENTS WITH MULTIPLE, LARGE, OR INFERIOR BREAKS
Authors: Felfeli Tina , Mandelcorn Mark S. , Trussart Rachel , Mandelcorn Efrem D. 
Published: October 2021

Purpose:
To describe the role of preoperative gas for pars plana vitrectomy (PGP) as an adjunct to surgical repair of rhegmatogenous retinal detachment (RRD).

Methods:
This is a retrospective consecutive case series of all rhegmatogenous retinal detachments with multiple breaks in more than one quadrant, large breaks extending greater than one clock hour, and/or inferior breaks requiring PPV, who received intravitreal injection of sulfur hexafluoride (SF6) or perfluoropropane (C3F8) 1–2 weeks before PPV between 2016 and 2020 at a tertiary care center.

Results:
A total of 109 eyes underwent the PGP technique, 73% of which had macular involvement. The rhegmatogenous retinal detachments on average involved 5.5 (SD 2.1) clock hours with inferior retinal breaks in 51%. Based on clinical examination, subretinal fluid was noted to be dissipated in parts of the detached retina before PPV in 57% of cases. The use of perfluorocarbon heavy liquid or posterior drainage retinotomy was required in 16% of cases. A 95% primary anatomical success rate was achieved over the median 177 (interquartile range 105–526) follow-up days. A final visual acuity of 20/50 or better was achieved in 65%.

Conclusion:
PGP as an adjunct to PPV may facilitate ease of surgery, as well as anatomical and functional success for rhegmatogenous retinal detachments with multiple, large, and/or inferior breaks.
CALRETICULIN MUTATION ASSOCIATED WITH BILATERAL CENTRAL RETINAL VEIN OCCLUSION IN A YOUNG WOMAN
Authors: Kabanovski Anna , Donaldson Laura , Koushan Keyvan , Margolin Edward 
Published: October 2021

Background:
Bilateral central retinal vein occlusion (CRVO) is rare and is usually associated with an underlying systemic illness such as hypercoagulable state or systemic inflammatory disease. We present a case of bilateral CRVO in a young patent who was found to have a mutation in the calreticulin gene, which was presumed to be the culprit.

Methods:
Case report.

Results:
We report a 24-year-old woman with bilateral CRVO. Hypercoagulability work-up was positive for in-frame deletion in exon 9 of the calreticulin gene.

Conclusion:
We suggest that all young patients presenting with CRVO or any patient with bilateral CRVO have genetic testing for a limited set of known, prothrombotic mutations including the recently identified calreticulin gene.
HYPERREFLECTIVE FOCI PRECEDE MACULAR NEOVASCULARIZATION FORMATION IN ANGIOID STREAKS
Authors: Arrigo Alessandro , Antropoli Alessio , Bianco Lorenzo , Rosolia Andrea , Vuturo Alessia , Bandello Francesco , Battaglia Parodi Maurizio 
Published: October 2021

Purpose:
To describe the steps leading to the development and progression of macular neovascularization (MNV) in angioid streaks.

Methods:
The study was designed as retrospective, longitudinal case series. Patients with angioid streaks were investigated by means of multimodal imaging, including fundus autofluorescence and structural optical coherence tomography. Main outcome measures were hyperreflective foci and MNV progression steps.

Results:
Overall, 40 eyes (20 patients) affected by angioid streaks were evaluated. Over the follow-up, five eyes of five patients developed MNV. The mean follow-up was of 1.6 years. The mean number of anti–vascular endothelial growth factor injections was 4.35 ± 1.4. Mean best-corrected visual acuity was 0.53 ± 0.38 LogMAR at the MNV onset, improving to 0.42 ± 0.40 LogMAR at the end of the follow-up (P > 0.05). Intraretinal hyperreflective foci onset and coalescence represented the first alterations occurring before the onset of the MNV. Anti–vascular endothelial growth factor treatment was associated with exudation relapsing and remitting, with still present intraretinal hyperreflective foci and pigment accumulation. The longitudinal analysis of our cohort of eyes outlined the event timeline: 1.2 months to find concentrated hyperreflective foci, 4.5 months to observe pigment organization through the outer nuclear layer, and 1.5 years to detect MNV.

Conclusion:
Hyperreflective foci formation, concentration, and migration represent early alterations occurring before the onset of the MNV in angioid streaks.
The Effect of Sleep Position Preference on Eyelid and Eyebrow Symmetry
Authors: Tran Charlene , Choi Dabin , Ko Audrey C. , Carter Keith D. , Shriver Erin M. 
Published: October 2021

Purpose:
To investigate the relationship between sleep position preference and eyebrow and eyelid position and degree of upper eyelid dermatochalasis.

Methods:
A prospective study evaluating the impact of sleep position on facial asymmetry was conducted at an academic ophthalmology department. Eligibility criteria included the absence of periocular-altering trauma or surgery, contact lens use, or other periorbital disease processes. Patients reported their sleep position preference on a questionnaire. Standardized digital photographs of patients were obtained, and Image J software was used for measurements and converted into millimeters based on a standard corneal limbus-to-limbus ratio. Upper and lower eyelid position, upper eyelid dermatochalasis, and eyebrow position were assessed by the following image-derived measurements: marginal reflex distance 1 (iMRD1), marginal reflex distance 2 (iMRD2), tarsal platform show (iTPS), and central brow position (iBP). These results were compared with the patient reported sleep position preference to determine correlation.

Results:
Seventy-one patients were enrolled and reported the following sleep position preferences: 28 (right), 24 (left), 13 (both), and 6 (supine). Patients with a right- or left-sided preference demonstrated lower iMRD1 measurements for the preferred sleep side (p < 0.0004) with no other significant difference in periorbital measurements. A larger degree of upper eyelid height (iMRD1) asymmetry was observed among patients with a sleep side preference.

Conclusion:
Patients with a predominant sleep side preference demonstrate a significant increase in ipsilateral upper eyelid asymmetry and an inferior upper eyelid position on the sleep side. There were no differences noted in lower eyelid position, central eyebrow position, or amount of upper eyelid dermatochalasis.
Echographic Assessment of Extraocular Muscle Response to Teprotumumab
Authors: Tran Charlene , Pham Chau M. , Simmons Brittany A. , Warner Laura L. , Fuhrmeister Laura J. , Shriver Erin M. 
Published: October 2021

Purpose:
To evaluate extraocular muscle response to teprotumumab using orbital echography in thyroid eye disease.

Methods:
This retrospective study included adult thyroid eye disease patients with pre- and post-teprotumumab orbital echography. Data collected included: age, Hertel measurements, clinical activity score, Gorman diplopia scores, ocular motility, and recti muscle diameters measured by echography. The patient’s more proptotic eye before treatment initiation was designated as the study orbit. Ocular motility was assessed by totaling the ductions in all 4 cardinal directions. Orbital echography was obtained pre- and post-treatment to assess response of extraocular muscle diameters.

Results:
Six patients with a mean age of 67 years were included. There was a mean improvement in proptosis of 4.3 mm in the study eye with 11/12 orbits showing improvement in globe position (p < 0.05). All patients had a decrease in clinical activity score with a mean reduction of 2.5. Four patients had an improvement in Gorman diplopia score. Ocular motility in the study orbits improved by a total mean of 26.9° (p < 0.05). Mean total extraocular muscle diameter was reduced from 27.4 to 23.4 mm (p < 0.001). On average, superior recti were largest pre- and post-treatment, followed by inferior, medial, then lateral recti. However, inferior recti showed the greatest reduction of 23% (p < 0.02).

Conclusions:
Orbital echography demonstrated extraocular muscle reduction in all patients after teprotumumab, correlating with improved clinical activity score, ocular motility, and proptosis. Orbital echography is a safe and cost-effective imaging alternative to monitor therapeutic response to teprotumumab.
Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Paper 4—Infantile Acute Dacryocystitis (InAD)—Presentation, Management, and Outcomes
Authors: Bothra Nandini , Ali Mohammad Javed 
Published: October 2021

Purpose:
To study the presentation, management, and outcomes of infantile acute dacryocystitis.

Methods:
Retrospective study of infants diagnosed with acute dacryocystitis over a period from June 2016 to December 2019. Data collected include demographics, clinical history, presenting features, management, complications, and outcomes. Treatment provided was intensive medical care followed by early probing under endoscopic guidance. Further interventions, where needed, were performed based on intraoperative findings during probing. Successful outcomes were defined as resolution of infection, subjective relief from epiphora, and anatomical patency determined by a normal fluorescein dye disappearance test.

Results:
Twenty-seven eyes of 27 infants were analyzed during the study period. The mean age of infants was 3.26 months, and males were more affected than females (male:female 15:12). The mean duration of symptoms was 4.66 weeks, with 96% (26/27) presenting with symptoms of redness, watering, discharge, and swelling. Preseptal cellulitis was seen in 74% (20/27) infants, lacrimal abscess in 67% (18/27) infants, and lacrimal fistula in 37% (10/27). Most infants had complex congenital nasolacrimal duct obstruction (62%, 13/27), of which 7 also had intranasal cysts. One infant successfully underwent endoscopic dacryocystorhinostomy. At a mean follow-up period of 7.95 months, successful outcomes were observed in 90.4% (19/21) infants. The 2 failed cases were complex congenital nasolacrimal duct obstruction with associated sac diverticula and are scheduled for an endoscopic dacryocystorhinostomy.

Conclusion:
Infantile acute dacryocystitis is a distinct clinical entity. The outcomes of systemic antibiotics and early probing are excellent.
A policy analysis of nurse practitioner scope of practice in Massachusetts
Authors: Cuccovia Barbara Ann , Heelan-Fancher Lisa , Aronowitz Teri 
Published: October 2021

ABSTRACT
Nurse practitioner (NP) practice has evolved since inception of the role in 1965. Educational requirements have been standardized requiring a master's degree, yet variation in NPs scope of practice exists across the United States. As the population ages and more Americans have health insurance coverage, the demand for health care continues to increase. Shortages of clinical providers and changes in hospital models of care continue to burden the health care system. Nurse practitioners have been found to provide safe, high-quality patient care and are a potential solution to ease the burden on our health care system. Nurse practitioner scope of practice restrictions limit the ability for NPs to practice independently. The purpose of this article was to analyze the advanced practice registered nurse's (APRNs) scope of practice policy in Massachusetts (MA) where APRNs just recently obtained full practice authority. Legislation to remove NP scope of practice restrictions in MA had been presented several times but was met with resistance from physician advocacy groups stating that NPs lack the education requirements to practice independently. A recent report from the MA Health Policy Commission demonstrates the impact that NPs have on lowering health care costs and servicing individuals in underserved areas of the state. During the pandemic, restrictions on NP scope of practice in MA were temporarily removed. It was realized that if NPs can practice independently during a pandemic, then they certainly are competent to practice independently at other times. A reassessment of NP scope of practice to allow for full authority should be completed nationally.
Precision medicine in chronic obstructive pulmonary disease: how far have we come?
Authors: Khan Malik M. Khurram S. , Cole Adam G. , Mannino David M. 
Published: October 2021

Purpose of review
In this review, we will discuss the current status and recent developments in precision medicine in chronic obstructive pulmonary disease (COPD) through the lens of treatable traits.

Recent findings
Although the term ‘treatable traits’ in the treatment of COPD is relatively recent, this concept has been used for many years if one considers interventions such as long-term oxygen therapy or alpha-1 antitrypsin replacement therapy. Recent advances have included expanding the definition of COPD to include a broader population of people with lower respiratory disease but not meeting the strict criteria for obstruction, advances in imaging to aid in the diagnosis and treatment of COPD, advances in understanding symptoms and exacerbations to define severity, using biomarkers to guide therapy and better understanding and addressing polymorbidity and frailty. In addition, there is a concerted effort to use these concepts to identify COPD patients earlier in the disease process wherein disease modification may be possible.

Summary
Focusing on subsets of patients with COPD with certain characteristics should lead to better outcomes and fewer adverse effects from treatment.

Video abstract

http://links.lww.com/COPM/A30.
By wind or wing: pollination syndromes and alternate bearing in horticultural systems
Authors: Garcia Gabriela , Re Bridget , Orians Colin , Crone Elizabeth 
Published: October 2021

Cyclical fluctuations in reproductive output are widespread among perennial plants, from multi-year masting cycles in forest trees to alternate bearing in horticultural crops. In natural systems, ecological drivers such as climate and pollen limitation can result in synchrony among plants. Agricultural practices are generally assumed to outweigh ecological drivers that might synchronize alternate-bearing individuals, but this assumption has not been rigorously assessed and little is known about the role of pollen limitation as a driver of synchrony in alternate-bearing crops. We tested whether alternate-bearing perennial crops show signs of alternate bearing at a national scale and whether the magnitude of national-scale alternate bearing differs across pollination syndromes. We analysed the Food and Agriculture Organization of the United Nations time series (1961–2018) of national crop yields across the top-producing countries of 27 alternate-bearing taxa, 6 wind-pollinated and 21 insect-pollinated. Alternate bearing was common in these national data and more pronounced in wind-pollinated taxa, which exhibited a more negative lag-1 autocorrelation and a higher coefficient of variation (CV). We highlight the mutual benefits of integrating ecological theory and agricultural data for (i) advancing our understanding of perennial plant reproduction across time, space and taxa, and (ii) promoting stable farmer livelihoods and global food supply.This article is part of the theme issue ‘The ecology and evolution of synchronized seed production in plants’.
Macroevolutionary consequences of mast seeding
Authors: Dale Esther E. , Foest Jessie J. , Hacket-Pain Andrew , Bogdziewicz Michał , Tanentzap Andrew J. 
Published: October 2021

Masting characterizes large, intermittent and highly synchronous seeding events among individual plants and is found throughout the plant Tree of Life (ToL). Although masting can increase plant fitness, little is known about whether it results in evolutionary changes across entire clades, such as by promoting speciation or enhanced trait selection. Here, we tested if masting has macroevolutionary consequences by combining the largest existing dataset of population-level reproductive time series and time-calibrated phylogenetic tree of vascular plants. We found that the coefficient of variation (CVp) of reproductive output for 307 species covaried with evolutionary history, and more so within clades than expected by random. Speciation rates estimated at the species level were highest at intermediate values of CVpand regional-scale synchrony (Sr) in seed production, that is, there were unimodal correlations. There was no support for monotonic correlations between either CVpor Srand rates of speciation or seed size evolution. These results were robust to different sampling decisions, and we found little bias in our dataset compared with the wider plant ToL. While masting is often adaptive and encompasses a rich diversity of reproductive behaviours, we suggest it may have few consequences beyond the species level.This article is part of the theme issue ‘The ecology and evolution of synchronized seed production in plants’.
An assessment of temporal variability in mast seeding of North American Pinaceae
Authors: LaMontagne Jalene M. , Redmond Miranda D. , Wion Andreas P. , Greene David F. 
Published: October 2021

Our overall objective is to synthesize mast-seeding data on North American Pinaceae to detect characteristic features of reproduction (i.e. development cycle length, serotiny, dispersal agents), and test for patterns in temporal variation based on weather variables. We use a large dataset (n= 286 time series; mean length = 18.9 years) on crop sizes in four conifer genera (Abies,Picea,Pinus,Tsuga) collected between 1960 and 2014. Temporal variability in mast seeding (CVp) for 2 year genera (Abies,Picea,Tsuga) was higher than forPinus(3 year), and serotinous species had lower CVp than non-serotinous species; there were no relationships of CVp with elevation or latitude. There was no difference in family-wide CVp across four tree regions of North America. Across all genera, July temperature differences between bud initiation and the prior year (ΔT) was more strongly associated with reproduction than absolute temperature. Both CVp and ΔTremained steady over time, while absolute temperature increased by 0.09°C per decade. Our use of the ΔTmodel included a modification forPinus, which initiates cone primordia 2 years before seedfall, as opposed to 1 year. These findings have implications for how mast-seeding patterns may change with future increases in temperature, and the adaptive benefits of mast seeding.This article is part of the theme issue ‘The ecology and evolution of synchronized seed production in plants’.