A Comparison of Nonprofit Hospital Charity Care Policies and Community Benefit in Central Ohio to Peer Cities

Background: Nonprofit hospitals in the United States are required to provide community benefits, including charity care, to receive tax exemption from the federal government. Central Ohio's nonprofit hospitals have agreed to the same charity care policies, which may be unique compared to other communities across the county. The aim of this research is to compare the charity care policies of hospitals in Columbus, Ohio, to their peer cities, investigating if hospitals in similar cities have common shared charity care thresholds and to determine if hospitals in peer cities provided similar levels of community benefit. Methods: Tax data from nonprofit hospitals in 21 cities were collected and analyzed using Microsoft Excel (Microsoft Corporation). City community benefit data was summed and averaged using Excel to create a graphical representation of the data. Results: Only Columbus, Ohio, and Providence, Rhode Island, reported the same charity care thresholds across hospitals. Data demonstrate that Columbus provides less community benefit in dollars to total expenses compared to peer cities; however, this appears to be only true regarding other community benefit excluding charity care. Columbus was near the median among cities examined in regard to percentage of charity care to total community benefit. Conclusion: Results suggest variability in the amount and type of community benefit nonprofit hospitals provide. Central Ohio hospitals have the same charity care thresholds and spent approximately the same in total community benefit however it is not transparent how these funds are utilized. Current federal regulations do not assess whether the community benefits reported are affecting community health outcomes

The genetic overlap between mood disorders and cardiometabolic diseases: a systematic review of genome wide and candidate gene studies

© The Author(s) 2017 This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material.Meta-analyses of genome-wide association studies (meta-GWASs) and candidate gene studies have identified genetic variants associated with cardiovascular diseases, metabolic diseases and mood disorders. Although previous efforts were successful for individual disease conditions (single disease), limited information exists on shared genetic risk between these disorders. This article presents a detailed review and analysis of cardiometabolic diseases risk (CMD-R) genes that are also associated with mood disorders. First, we reviewed meta-GWASs published until January 2016, for the diseases ‘type 2 diabetes, coronary artery disease, hypertension’ and/or for the risk factors ‘blood pressure, obesity, plasma lipid levels, insulin and glucose related traits’. We then searched the literature for published associations of these CMD-R genes with mood disorders. We considered studies that reported a significant association of at least one of the CMD-R genes and ‘depression’ or ‘depressive disorder’ or ‘depressive symptoms’ or ‘bipolar disorder’ or ‘lithium treatment response in bipolar disorder’, or ‘serotonin reuptake inhibitors treatment response in major depression’. Our review revealed 24 potential pleiotropic genes that are likely to be shared between mood disorders and CMD-Rs. These genes include MTHFR, CACNA1D, CACNB2, GNAS, ADRB1, NCAN, REST, FTO, POMC, BDNF, CREB, ITIH4, LEP, GSK3B, SLC18A1, TLR4, PPP1R1B, APOE, CRY2, HTR1A, ADRA2A, TCF7L2, MTNR1B and IGF1. A pathway analysis of these genes revealed significant pathways: corticotrophin-releasing hormone signaling, AMPK signaling, cAMP-mediated or G-protein coupled receptor signaling, axonal guidance signaling, serotonin or dopamine receptors signaling, dopamine-DARPP32 feedback in cAMP signaling, circadian rhythm signaling and leptin signaling. Our review provides insights into the shared biological mechanisms of mood disorders and cardiometabolic diseases

Boosting Efficiency in Light‐Driven Water Splitting by Dynamic Irradiation through Synchronizing Reaction and Transport Processes **

Abstract This work elaborates the effect of dynamic irradiation on light‐driven molecular water oxidation to counteract deactivation. It highlights the importance of overall reaction engineering to overcome limiting factors in artificial photosynthesis reactions. Systematic investigation of a homogeneous three‐component ruthenium‐based water oxidation system revealed significant potential to enhance the overall catalytic efficiency by synchronizing the timescales of photoreaction and mass transport in a capillary flow reactor. The overall activity could be improved by a factor of more than 10 with respect to the turnover number and a factor of 31 referring to the external energy efficiency by controlling the local availability of photons. Detailed insights into the mechanism of light driven water oxidation could be obtained using complementary methods of investigation like Raman, IR, and UV/Vis/emission spectroscopy, unraveling the importance of avoiding high concentrations of excited photosensitizers.Water splitting : Dynamic irradiation enables a significant increase in catalytic performance of a homogeneous three‐component system for light‐driven water oxidation. Lower irradiation intensities and higher flowrates in a flow‐through reactor minimize photosensitizer degradation and thus improve catalyst lifetime, yield, and overall efficiency of a catalytic system for artificial photosynthesis. imag

Bauen in Brasilien

Im Herbst 2014 fand die große Exkursion 2014 der Fakultät Bauingenieurwesen der HTWG Konstanz nach Brasilien unter der Leitung von Prof. Dr. Horst Werkle und Prof. Dr. Peter Hirschmann statt. Auf dem Programm stand der Besuch der Städte Sao Paulo, Rio de Janeiro und Iguacu. Der Bericht schildert den Besuch interessanter Baustellen und großer Bauprojekte wie des im Bau befindlichen futuristisch anmutenden „Museum of Tomorrow“, des Maracana-Stadions mit seiner neuen Membrandachkonstruktion sowie des zweitgrößten Wasserkraftwerks der Welt

Simultaneous Infrared Spectroscopy, Raman Spectroscopy and Luminescence Sensing: A Multi-Spectroscopic Analyti-cal Platform

Scientific questions in fields such as catalysis, monitoring of biological processes or environmental chemistry demand for analytical technologies combining orthogonal spectroscopies. Combined spectroscopic concepts facilitate in-situ on-line monitoring of dynamic processes providing for a better understanding of the involved reaction pathways. In the present study, a low-liquid-volume multi-spectroscopic platform was developed based on infrared attenuated total reflection (IR-ATR) spectroscopy combined with Raman spectroscopy and lumines-cence sensing. For demonstrating the measurement capabilities, exemplary analyte systems including water / heavy water and aqueous solutions of ammonium sulfate were analyzed as proof-of-principle studies. It was successfully demonstrated that three optical techniques may be integrated into a single analytical platform with-out interference providing synchronized and complementary datasets by probing the same minute sample vol-ume. In addition, the developed assembly provides a gas-tight lid sealing the headspace above the probed liq-uid for monitoring the concentration of molecular oxygen also in the gas phase via luminescence quenching. Hence, the entire assembly may be operated at inert conditions, as required for example during the analysis of photocatalytic processes

Uncovering tumor−stroma inter-relationships using MALDI Mass spectrometry imaging

Tumorigenesis involves a complex interplay between genetically modified cancer cells and their adjacent normal tissue, the stroma. We used an established a breast cancer mouse model to investigate this interrelationship. Conditional activation of Rho-associated protein kinase (ROCK) in a model of mammary tumorigenesis enhances tumor growth and progression by educating the stroma and enhancing the production and remodeling of the extracellular matrix. We used peptide matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) to quantify the proteomic changes occurring within tu-mors and their stroma in their regular spatial context. Peptides were ranked according to their ability to discriminate between the two groups, using a receiver operating characteristic (ROC) tool. Peptides were identified by LC-MS/MS and protein expression was validated by quantitative immunofluorescence using an independent set of tumor samples. We have identified and validated four key proteins upregulated in ROCK-activated mammary tumors relative to those expressing kinase-dead ROCK, namely collagen I, α-SMA, Rab14 and tubulin-β4. Rab14 and tubulin-β4 are expressed within tumor cells, whereas collagen I is localized within the stroma. α-SMA is predominantly localized within the stroma but is also expressed at higher levels in the epithelia of ROCK-activated tumors. High expression of COL1A, the gene encoding the pro-α 1 chain of collagen, corre-lates with cancer progression in two human breast cancer genomic datasets, and high expression of COL1A and ACTA2, (the gene encoding α-SMA) are associated with a low survival probability (COLIA p=0.00013, ACTA2 p=0.0076) in estrogen receptor negative breast cancer patients. To investigate whether ROCK-activated tumor cells cause stromal cancer-associated fibroblasts (CAFs) to upregulate expression of collagen I and α-SMA, we treated cancer-associated fibroblasts with medium conditioned by primary mammary tumor cells in which ROCK had been activated. This led to abundant production of both proteins in CAFs, clearly highlighting the inter-relationship between tumor cells and CAFs and identifying CAFs as the potential source of high levels of collagen 1 and α-SMA and associated enhancement of tissue stiffness. Our research emphasizes the capacity of MALDI MSI to quantitatively assess tumor-stroma inter-relationships and to identify potential prognostic factors for cancer progression in human patients, using sophisticated mouse cancer models.Sarah T. Boyle, Parul Mittal, Gurjeet Kaur, Peter Hoffmann, Michael S. Samuel, and Manuela Klingler-Hoffman