bluuebunny/crossref_metadata_2025 huggingface dataset:
PRECARITY AND WORK IN LATER LIFE: EXPERIENCES OF OLDER WORKERS IN UNCERTAIN TIMES
Authors: Halvorsen Cal , Matz Christina , Miller Julie
Published: December 2023

Employees later in their careers often earn the highest income of their lives, enabling them save for retirement while living in relative comfort. Yet many workers do not experience this late-career economic boost and instead face age bias and discrimination, difficulty finding and keeping work, and social and economic inequalities. Using an intersectionality lens, these difficulties often lead to disparities by race, ethnicity, gender, and immigration status, highlighting the varied socioeconomic experiences of older adults. The economic and social effects of the COVID-19 pandemic have often exacerbated these disparities. This symposium will highlight the varied experiences of late-career workers since the advent of the pandemic, with an emphasis on lower income workers and disparities by race and ethnicity. Dr. Choi-Allum will describe the results from a nationally representative survey of 2,000 workers ages 40 and older by AARP, highlighting how perceived age discrimination and the sense of a weak economy is driving uncertainty in finding and keeping paid work. Dr. Carr will identify racial and ethnic disparities in pandemic-related job disruption and its associated financial setbacks using Health and Retirement Study data. Dr. Halvorsen will describe the experiences of older, lower-income, and often immigrant job seekers within the federally funded Senior Community Service Employment Program in Massachusetts. And Dr. Matz will outline research with older adults who live in public housing on how social resources obtained partly through work may buffer financial strain’s impact on health. To conclude, Dr. Miller will place the four studies into the broader socioeconomic context. This is an Aging Workforce Interest Group Sponsored Symposium.
SEXUAL FREQUENCY AND COGNITIVE DOMAINS: EVIDENCE FROM THE NATIONAL SOCIAL LIFE, HEALTH, AND AGING PROJECT
Authors: Shannon Shen
Published: December 2023

This research draws upon the life course perspective to examine how sexual frequency is related to different cognitive domains among community-dwelling, partnered older adults. I analyzed data from 1,526 respondents across two rounds of the National Social Life, Health, and Aging Project (NSHAP). I tested six cognitive domains: temporal orientation, visuospatial skills, attention, language, executive function, and short-term memory. I ran cross-lagged models to test for reciprocal relationships between sexual frequency and cognitive domain performance. Age-stratified results indicate that more frequent sex was related to better performance on temporal orientation, executive function, attention, and short-term memory domains over time for adults aged 75-90, with no significant results for adults aged 62-74. There was limited evidence that cognitive domain performance was related to later sexual frequency for the 75-90 age group. The results highlight nuanced pathways by which sexuality is tied to the health of older adults. Understanding which cognitive domains may be maintained through more frequent sex is informative for health care practitioners who consider sexual activity as a behavior to prevent cognitive impairment.
MUSICAL THEATER AND MEANING MAKING IN A RETIREMENT COMMUNITY
Authors: Powers James , Stone Robyn
Published: December 2023

“I think I’ve had it up to here with pickleball…” Thus begins the first song in “Movin”, an original musical written, produced, and performed by members of a continuing care retirement community (CCRC), which addresses themes ranging from dementia, death and widowhood to finding community, purpose, and late-life love. The idea began in informal conversation between two former university colleagues, Philip Sloane (a geriatrician, GSA member, and former CCRC board member) and Hugh Tilson (a CCRC resident, aged 82) about describing the aging experience through song. Hugh gathered a group of fellow CCRC residents, none of whom had professional songwriting or theater experience but several of whom had musical backgrounds or an interest in theater. Meeting regularly over nearly two years, they envisioned, created, and then produced an original musical around the theme of “freshman year in a retirement community.” The final production included 9 cast members, 12 original songs developed by five lyricists and two composers, many production-related volunteers, and a narration to link the songs together. This symposium will describe the process, present and illustrate aging-related themes from the production, place the musical in the context of existing research about meaning-making and the arts in later life, and conclude with a discussion by a senior leader in a major senior housing organization. Presentation about development and production of the musical will include videos of rehearsals, songs from the production, and interviews with performers. Sponsored by the Humanities, Arts, and Cultural Gerontology Advisory Panel
EXPLORING FACILITATORS AND BARRIERS TO CONDUCTING SPIRITUAL HISTORIES IN OLDER ADULTS
Authors: Beck Monica , Gallagher Amelia
Published: December 2023

Nurses can relieve spiritual suffering in older adult cancer patients through spiritual histories, yet may be reticent to engage in spiritual conversations. The qualitative aim of Lift the Spirit, a pilot feasibility and acceptability study, was to explore factors affecting cancer nurses’ perceptions of the barriers and facilitators to conducting spiritual histories in clinical practice. Lift the Spirit, an enhanced educational communication intervention, was designed to equip nurses with the knowledge, skills, and attitudes to conduct spiritual histories. A purposive sample of nurses (n = 17) independently engaged in an online multimedia course, Spiritual Assessment in Clinical Practice, then synchronously role-played conducting a spiritual history in dyads (nurse/patient), engaged in a skills performance, and participated in Debrief Interviews. Qualitative data were collected during Debriefing Interviews using the Debrief Interview Guide. Interpretive description guided the qualitative content analysis of Debrief Interview data. Structural coding was used to sort data into barriers and facilitators on the first pass. Next, within each structural code, data fitting the definition of barrier and facilitators were inductively descriptively coded. Participants described barriers and facilitators at the levels of institution/profession (lack of education and training), self (vulnerability, perceived riskiness), and patient (cultural difference) that were similar to barriers already noted in the literature. Facilitators included feeling equipped and supported and having external cues as reminders. The degree of angst, fear, and vulnerability expressed towards conducting spiritual histories was surprising. Equipping nurses with the knowledge, skills, and attitudes is essential to reduce spiritual suffering in older adults.
OLDER ADULT FALLS IN THE COMMUNITY: DOES UNSAFE HOME ENVIRONMENT HAVE A RISK ROLE?
Authors: Gupta Debasree Das , Kelekar Uma , Turner Sidney
Published: December 2023

Hazardous environmental conditions are frequent in older adult homes and are linked to a majority of the older adult falls in the community. However it is unclear whether it is the presence/absence of home hazards per se, or the interaction between unsafe home conditions and physical functioning that is of salience to older adults’ fall risk. To address this gap, we conduct a mediation analysis using the Karlson–Holm–Breen methodology to estimate: 1) whether home disorder (peeling/flaking paint, pests: cockroaches/rodents, broken furniture/lamp, unsafe flooring/tripping hazards, room clutter) and unsafe bathroom features (absence of bathtub/shower stall, grab bar, seat in shower/tub, raised toilet) adversely associated with subsequent fall risk of older adults, and 2) what proportion of those influences were mediated through limitations in daily and instrumental activities of daily living (ADL/IADL). Using a nationally representative large sample of Medicare beneficiaries (≥65 years) living in the community who were respondents in the 2018-2019 National Health and Aging Trends Study (NHATS; n=2,599), we examined baseline home environment in 2018 and its relation with subsequent falls in 2019, after controlling for covariates. Results indicate while home disorder had both a direct (adjusted Odds Ratio [aOR]: 1.11, 95% Confidence Interval [CI]:1.01,1.22) and an indirect (aOR: 1.01; 95% CI: 1.00,1.02) effect on subsequent falls through limitations in ADL and IADL, unsafe bathroom features did not significantly predict subsequent fall risk of older adults. Given these findings, addressing home disorder through policy/housing assistance initiatives and educational programs highlighting home environmental safety would be essential.
INTERGENERATIONAL REMINISCENCE AND DIGITAL STORYTELLING: EXPLORING THE EXPERIENCE OF COLLEGE STUDENT VOLUNTEERS
Authors: Fields Noelle , Xu Ling , Troutman Brooke , Daniel Kathryn , Miles Allyson
Published: December 2023

Research suggests that reminiscence combined with an intergenerational approach may yield significant psychosocial benefits for older adults with Alzheimer’s disease and related dementia (ADRD). Through intergenerational reminiscence, older persons may pass on their life experience and life lessons to younger generations. Intergenerational contact and relationships between older and younger adults can prevent stereotypes or negative attitudes from forming, or counter existing ones. Additionally, outcomes from intergenerational programming include the younger generation’s ability to build relationships with older adults and have positive changes in attitudes toward aging. The current paper is part of a larger telephone-based intervention that used intergenerational reminiscence with digital storytelling in sample of university student volunteers and community-dwelling older adults with ADRD. University student volunteers were provided with training before the intervention about the myths and facts about ADRD, communicating with persons with ADRD, and how to create a digital story. Using Rapid and Rigorous Qualitative Data Analysis (RADar), a research team examined the weekly written reflections of the student volunteers (N = 27) during the 10-week pilot study. The analysis yielded 6 themes: positive connections, resilience, life lessons, empathy, collaboration, and growth. Many students reported increased confidence in talking with older adults and shared an interested in remaining connected after the study ended. Few students reported technological challenges with the DST. Findings from the study extend the existing literature related to volunteer-based interventions for older adults with ADRD and highlight the potential of involving younger adults in new approaches to ADRD research and practice.
PERFORMANCE OF FUNCTION-FOCUSED CARE BY NURSING STAFF
Authors: Galik Elizabeth
Published: December 2023

To help acute care nurses learn to provide function focused care during care interactions the Function Focused Care intervention is implemented on nursing units. The Function Focused Care intervention is based on the Social Ecological Model, Social Cognitive Theory and the Evidence Integration Triangle and includes four components: (1) Development of a stakeholder team; (2) Education; (3) Development of functional care plans; and (4) Mentoring and motivating. Our nurse interventionist provides function focused care education as per the preference of the setting. Following education, direct observation during care interactions is done and the nurse interventionist provides recommendations related to the approach being used or provides positive reinforcement if function focused care is provided. The observation tool used to evaluate function focused care by the nursing staff includes 19 different care interactions (e.g., bathing, dressing, transferring). Guidelines are provided for what is and is not function focused care. In the first four treatment sites, at 2 months post implementation the nurses provided function focused care during 81% of the of care interactions observed, by 6 months this increased to 85% and by 10 months this increased to 88%. There was also a decline in the number of care interactions in which function focused care was not provided. The findings suggest that nurses can provide function focused care even during times of significant shortages and that continued oversight and education can help improve the use of this approach.
“IT SHOULDN’T BE LIKE THIS”: FAMILY CAREGIVERS NAVIGATING INSURANCE FOR FAMILY MEMBERS WITH DEMENTIA
Authors: Gordon-Wexler Mikayla , Watman Deborah , Reckrey Jennifer
Published: December 2023

Family caregivers of individuals with dementia who are dually eligible for Medicaid and Medicare must navigate the health insurance landscape to meet the complex medical and home care needs of their family members. The goal of this study is to explore how family caregivers make decisions around insurance and how these choices affect care. Semi-structured interviews were conducted from June-January 2022 with 15 family caregivers of dually eligible individuals with dementia enrolled in home-based primary care in New York City. Interviews were analyzed using both deductive and inductive thematic coding. Participants described how social workers and other professionals helped navigate insurance choices, but no centralized system for obtaining information existed. Once insurance plans were set-up, participants described advocating on behalf of their family member within the constraints of current insurance plans rather than considering alternatives due to high perceived burden of changing plans. Obtaining adequate home care hours (which frequently required multiple appeals) was a particular challenge. Caregivers did not see integrated Medicare-Medicaid plans as providing any inherent benefit to navigating insurance. This study highlights the barriers facing family caregivers as they navigate insurance choices and the limited support available. These challenges may contribute to resistance to changing plans even when gaps in needed coverage exist, especially gaps related to inadequate home care. Robust professional support for family members both immediately after loved one’s dementia diagnosis and as the disease progresses could alleviate burden on caregivers and increase their capacity to get their family members needed medical and home care.
ASSOCIATIONS BETWEEN SEDENTARY AND PHYSICAL INACTIVITY ON QUALITY OF LIFE IN THAI MIDDLE AGE AND OLDER OFFICE WORKERS
Authors: Akksilp Katika , Teerawattananon Yot , Chen Cynthia
Published: December 2023

Sedentary behaviour and physical inactivity negatively affect health-related quality of life in all age groups. Moreover, the ageing population needs even more sophisticated health promotion programmes to tackle the increasing prevalence of non-communicable diseases. This study aims to estimate the effects of sedentary behaviour and physical inactivity on health-related quality of life among middle-age and older office workers in Thailand. The analyses used secondary data from the Physical Activity at Work cluster-randomised trial. Objective physical activity data were collected using the ActiGraph™ accelerometer. Health-related quality of life was collected using EuroQol’s EQ-5D-5L. Sedentary was defined as spending more than nine hours per day in sedentary behaviours. Physically inactive was defined as spending less than 150 minutes of moderate-intensity equivalent activity per week. Tobit regression was used to compare utility indices. Being physically active alone was associated with a higher EQ-5D value (0.0746; 95%CI -0.0142 to 0.163) compared to the inactive. Also, non-sedentary participants had higher EQ-5D value (0.0548; 95%CI -0.0121 to 0.122) compared to sedentary, although not statistical significance. In addition, participants who were both physically active and not sedentary had a significant difference in the EQ-5D value of 0.0700 (95%CI 0.00187 – 0.138) compared to inactive and sendentary participants. This is the first study in Thailand to explore the association between sedentary behaviour, physical inactivity on health-related quality of life in middle-age and older population. It highlights the importance of incorporating health-related quality of life assessment for Thai physical activity promotion programmes, building a foundation for economic evaluation studies.
POWERFUL TOOLS FOR CAREGIVERS: THE ESTABLISHED BENEFITS OF A PERSON-CENTERED CARE INTERVENTION
Authors: Meinertz Naomi
Published: December 2023

Family caregivers account for 89% of caregivers in the United States, yet few evidence-based family care programs focus specifically on the caregiver’s needs rather than the care receiver. The challenges that caregivers experience, such as increased depression symptoms and feelings of burden, impede their ability to fulfill their role as care partner and can lead to lasting health and financial issues. Intervention literature underscores the importance of using person-centered models to incite behavior change, yet many caregiver interventions do not address the caregiver’s needs and instead approach caregiving from a practical perspective to caregiving such as establishing a power of attorney or educating caregivers about dementia. Powerful Tools for Caregivers (PTC) is a six-week program designed to provide caregivers with the skills to address their unique care challenges. Within in-person or virtual sessions, caregivers are provided with the skills to improve caregiver self-efficacy, emotional management, self-care, and resource access and knowledge. The study integrates empirical findings and demonstrates the effectiveness of PTC in improving caregiver well-being in each focus area. Findings also highlight the benefits of the group-based activities as well as improved depressive symptoms and reduced caregiver stress and burden. This research also demonstrates the same effectiveness of delivery format (in-person or virtual mediums) and location (rural or urban settings). The success of PTC sheds light on the need for more programs to approach family care through the lens of a person-centered model and emphasizes the benefit of evidence-based programs.
“WHEN WE ARRIVED IN THIS COUNTRY, WE WERE ALREADY VERY OLD”: HEALTH AND AGING IN WISCONSIN’S HMONG REFUGEE COMMUNITY
Authors: Engelman Michal , Lor Maichou , Xiong Mai , Lee Tou , Vang Casper
Published: December 2023

The Hmong arrived in Wisconsin as refugees following wars in Vietnam and Laos, and are the state’s largest Asian American group. They have a disadvantaged socioeconomic profile and face high rates of trauma-linked mental illness. Due to limited English proficiency, low literacy, and a lack of familiarity with and trust in research, the Hmong are underrepresented in existing data sources, which fold them into a pan-ethnic Asian-American group considered exceptionally successful. To address this gap, the Diversity, Inclusion, and Aging in the Midwest: Opportunities for New Directions with Wisconsin’s Hmong Community (DIAMOND-Hmong) project has engaged Hmong older adults in a research study designed to document their unique life experiences and social determinants of health. Drawing on semi-structured life history interviews with 40 older Hmong men and women in Wisconsin, we describe participants’ experiences during wars, forced relocations, and refugee camp spells, as well as the challenges and rewards of migrating to and aging in the U.S. Using a constructionist grounded theory approach, we show that participants’ narratives link life-course hardships with physical and mental health challenges, generating a historically and culturally-specific delineation of trauma as both individual and collective experiences. Our analysis situates individual trauma within broader geopolitical and institutional circumstances and demonstrates that familial and communal ties – and their absence – are sources of both tension and resilience in this population. Our findings point to the importance of a trauma-informed approach to health assessment for the Hmong, and the role of memory and storytelling in their healing process.
OLDER ADULTS AND CAREGIVERS AS PARTNERS IN PATIENT- AND FAMILY-CENTERED EDUCATION
Authors: Severance Jennifer , Cervantes Diana
Published: December 2023

Patient and family-centered education is an approach to the planning, delivery, and evaluation of curricula that is grounded in mutually beneficial partnerships among patients, families, students, and educators. Engaging patients and families in genuine partnerships through health professions education can broaden the student’s perspectives of health to include social, economic, and environmental factors while helping them recognize unique individual dimensions, such as cultural context, capacities, and values, that influence health. While patient-centeredness is a widely recognized component to high-quality healthcare, partnering with older adult patients and caregivers is a less recognized standard in health professions education. This symposium examines the role of older adults and caregivers in co-creating geriatric and gerontology education with a HRSA-funded Geriatric Workforce Enhancement Program (GWEP) to promote the knowledge, skills, and attitudes necessary for patient-centered clinical practice. First, presenters will share educational initiatives involving older adults as mentors and subject matter experts for health professions students and student teams. This is followed by projects engaging and empowering older adults and caregivers as advocates for quality care and advisors for educational improvements. Finally, presenters will explore evaluation tools and strategies to collect input and ensure the patient’s voice remains at the center of education planning, delivery, and improvement. Presenters discuss methods of adapting these models to a local context as well as strategies and opportunities to incorporate the input and feedback from older adults and caregivers into health professions education.
GENDERED PATHWAYS TO FINANCIAL CAPABILITY: IMPLICATIONS FOR PHYSICAL, MENTAL, AND FINANCIAL HEALTH IN LATER LIFE
Authors: Chen Yu-Chih , Sun Sicong
Published: December 2023

Financial capability, comprising financial literacy, access, and behavior, can influence an individual’s ability to effectively use financial resources, thus impacting their health and well-being. However, studies have predominantly focused on financial literacy and overlooked a more comprehensive measure of financial capability. Additionally, there is limited knowledge on the role of gender in these associations. This study investigated how gender may moderate the links between financial capability and health. The study recruited 1,109 community-dwelling adults (aged 45+) through an online survey and employed multivariate linear and logistic regression to examine the gender differences in the associations between financial capability and physical (perceived health and mobility limitations), mental (life satisfaction and depression), and financial (retirement worry and financial satisfaction) health. Results showed that financial access and behavior, compared to financial literacy, had a more significant influence on determining health outcomes. Gender differences in financial capability were also identified through simple slope analyses, with financial literacy being more important for men’s self-rated health and life satisfaction, while financial behavior was more critical for women. Additionally, although financial access was not related to retirement worry among men, it was significantly associated with lower retirement worry among women. Findings suggest that gender-specific pathways to financial capability may lead to health disparities. Policies and programs aimed at improving population’s health and well-being, particularly for women, should target not only financial literacy but also strengthen financial inclusion and encourage responsible financial behavior.
Causal relationships between risk of venous thromboembolism and 18 cancers: a bidirectional Mendelian randomization analysis
Authors: Cornish Naomi , Haycock Philip , Brenner Hermann , Figueiredo Jane C , Galesloot Tessel E , Grant Robert C , Johansson Mattias , Mariosa Daniela , McKay James , Pai Rish , Pellatt Andrew J , Samadder N Jewel , Shi Jianxin , Thibord Florian , Trégouët David-Alexandre , Voegele Catherine , Thirlwell Chrissie , Mumford Andrew , Langdon Ryan ,   InterLymph Consortium, INVENT-MVP Consortium
Published: December 2023

Background

People with cancer experience high rates of venous thromboembolism (VTE). Risk of subsequent cancer is also increased in people experiencing their first VTE. The causal mechanisms underlying this association are not completely understood, and it is unknown whether VTE is itself a risk factor for cancer.

Methods

We used data from large genome-wide association study meta-analyses to perform bidirectional Mendelian randomization analyses to estimate causal associations between genetic liability to VTE and risk of 18 different cancers.

Results

We found no conclusive evidence that genetic liability to VTE was causally associated with an increased incidence of cancer, or vice versa. We observed an association between liability to VTE and pancreatic cancer risk [odds ratio for pancreatic cancer: 1.23 (95% confidence interval: 1.08–1.40) per log-odds increase in VTE risk, P = 0.002]. However, sensitivity analyses revealed this association was predominantly driven by a variant proxying non-O blood group, with inadequate evidence to suggest a causal relationship.

Conclusions

These findings do not support the hypothesis that genetic liability to VTE is a cause of cancer. Existing observational epidemiological associations between VTE and cancer are therefore more likely to be driven by pathophysiological changes which occur in the setting of active cancer and anti-cancer treatments. Further work is required to explore and synthesize evidence for these mechanisms.
The individual- and community-level women's empowerment and utilization of maternity care services in Afghanistan: a multilevel cross-validation study
Authors: Dadras Omid
Published: December 2023

Background

This study aimed to explore the relationship between women's empowerment and utilization of maternity care for married Afghan women aged 15–49 y in Afghanistan, assessing the convergence validity of the Survey-based Women's Empowerment Index in Afghanistan (SWEI-A).

Methods

The study used data from the 2015 Afghanistan Demographic Health Survey to examine the association of different domains of women's empowerment with the utilization of maternity care using multilevel Poisson regression at both individual and community levels.

Results

The utilization of maternity services was considerably higher among women with high scores compared with those with low scores in almost all domains of the SWEI-A, except for property owning, in which women with high scores appeared to have lower rates of utilization of such services compared with those with low scores. At the community level, those communities with high participation of women in the labor force were less likely to have adequate antenatal care (ANC), institutional delivery and postnatal care (PNC). Individual-level literacy was associated with higher utilization of ANC, institutional delivery and PNC, contrary to community-level literacy.

Conclusions

Except for property owning, the high score in almost all other domains was associated with higher utilization of maternity care, which indicates an acceptable level of convergence validity for the developed index (i.e. the SWEI-A) in measuring women's empowerment among married Afghan women aged 15–49 y.
A national antimicrobial guide with local, customizable versions: how is it used? A two-year analysis
Authors: Schuts Emelie C , Boyd Anders , Natsch Stephanie , Veenman Arjen , Prins Jan M ,   SWAB-ID Study Group, Bax Hannelore I , de Jong Eefje , Lambregts Merel M C , Leverstein-van Hall Maurine A , van der Linden Paul D , Melles Damian C , Natsch Stephanie , Sebens Fre W , Wolfs Tom F , Prins Jan M
Published: December 2023

Objectives

Guideline adherence is one of the most important objectives for antibiotic stewardship. The Dutch Working Party on Antibiotic Policy (SWAB) developed an online national guide (SWAB-ID) in 2006. Every Dutch hospital is offered the opportunity to customize the national version to their local context and distribute it through an independent website. We studied user data to see how often the guidelines on therapy, prophylaxis and medication are used.

Methods

Data on usage between 19 June 2020 and 30 June 2022 were extracted through Google Analytics for the national site and the 53 hospitals using a customized version of the national guide. User data were divided into three main groups: users of the national guide SWAB-ID, and users of the sites of general hospitals and university hospitals.

Results

A total of 1 837 126 searches were analysed, of which 1 393 681 (75.9%) concerned therapy, 111 774 (6.1%) prophylaxis and 331 671 (18%) medication. Of these searches, 456 854 (24.9%) were performed on the national site, 950 887 (51.8%) by general hospitals and 429 385 (23.4%) by university hospitals. The most commonly searched tracts among all user groups were lower respiratory tract (21.8%), kidney and urinary tract (16.6%) and skin and soft tissues (11.8%). The most commonly searched conditions were community-acquired pneumonia (15.3%), cystitis (13.5%) and sepsis (11.3%). The top ranked pages on medication differed for the three categories of users.

Conclusions

The SWAB-ID antimicrobial guide is used extensively by both general and university hospitals. The online guide can help in prescribing therapy according to the guideline.
Semi-supervised ROC analysis for reliable and streamlined evaluation of phenotyping algorithms
Authors: Gao Jianhui , Bonzel Clara-Lea , Hong Chuan , Varghese Paul , Zakir Karim , Gronsbell Jessica
Published: December 2023

Objective

High-throughput phenotyping will accelerate the use of electronic health records (EHRs) for translational research. A critical roadblock is the extensive medical supervision required for phenotyping algorithm (PA) estimation and evaluation. To address this challenge, numerous weakly-supervised learning methods have been proposed. However, there is a paucity of methods for reliably evaluating the predictive performance of PAs when a very small proportion of the data is labeled. To fill this gap, we introduce a semi-supervised approach (ssROC) for estimation of the receiver operating characteristic (ROC) parameters of PAs (eg, sensitivity, specificity).

Materials and Methods

ssROC uses a small labeled dataset to nonparametrically impute missing labels. The imputations are then used for ROC parameter estimation to yield more precise estimates of PA performance relative to classical supervised ROC analysis (supROC) using only labeled data. We evaluated ssROC with synthetic, semi-synthetic, and EHR data from Mass General Brigham (MGB).

Results

ssROC produced ROC parameter estimates with minimal bias and significantly lower variance than supROC in the simulated and semi-synthetic data. For the 5 PAs from MGB, the estimates from ssROC are 30% to 60% less variable than supROC on average.

Discussion

ssROC enables precise evaluation of PA performance without demanding large volumes of labeled data. ssROC is also easily implementable in open-source R software.

Conclusion

When used in conjunction with weakly-supervised PAs, ssROC facilitates the reliable and streamlined phenotyping necessary for EHR-based research.
Exploring the impact of missingness on racial disparities in predictive performance of a machine learning model for emergency department triage
Authors: Teeple Stephanie , Smith Aria , Toerper Matthew , Levin Scott , Halpern Scott , Badaki-Makun Oluwakemi , Hinson Jeremiah
Published: December 2023

Objective

To investigate how missing data in the patient problem list may impact racial disparities in the predictive performance of a machine learning (ML) model for emergency department (ED) triage.

Materials and Methods

Racial disparities may exist in the missingness of EHR data (eg, systematic differences in access, testing, and/or treatment) that can impact model predictions across racialized patient groups. We use an ML model that predicts patients’ risk for adverse events to produce triage-level recommendations, patterned after a clinical decision support tool deployed at multiple EDs. We compared the model’s predictive performance on sets of observed (problem list data at the point of triage) versus manipulated (updated to the more complete problem list at the end of the encounter) test data. These differences were compared between Black and non-Hispanic White patient groups using multiple performance measures relevant to health equity.

Results

There were modest, but significant, changes in predictive performance comparing the observed to manipulated models across both Black and non-Hispanic White patient groups; c-statistic improvement ranged between 0.027 and 0.058. The manipulation produced no between-group differences in c-statistic by race. However, there were small between-group differences in other performance measures, with greater change for non-Hispanic White patients.

Discussion

Problem list missingness impacted model performance for both patient groups, with marginal differences detected by race.

Conclusion

Further exploration is needed to examine how missingness may contribute to racial disparities in clinical model predictions across settings. The novel manipulation method demonstrated may aid future research.
The bigger you are, the weaker you are: Multispecies evidence for the weakening combatant hypothesis
Authors: Levinton Jeffrey S
Published: December 2023

As fiddler crabs increase in size, closing force weakens proportionally because claw growth is not isometric. As a result, mechanical advantage decreases at the tip with increasing claw length. Closing force at an interior tubercle is greater at the tip, and a previous study of two species claimed evidence for compensation by relative movement of tubercles toward the hinge as size increases. I reconsidered this hypothesis with a biometric analysis of eight species from five genera and all three major biogeographic regions. I tested test two null hypotheses: 1) as claw length increases, mechanical advantage did not increase at the tubercle, relative to the claw tip, and 2) closing force did not increase at the tubercle, relative to the claw tip, as claw size increased. Both null hypotheses are largely supported, which in turn supports the weakening combatant hypothesis. In all cases, log force as a function of log claw length at an interior tubercle is 1.40, which is less than 2, the slope value expected if there was complete compensation. This is only slightly greater than the slope at the dactyl tip, which is 1.21. Thus, as a fiddler crab gets larger, with an incremental increase of claw length its closing force proportionally decreases, supporting the idea of a weakening combatant. But it gains a large showy claw with relatively narrow pincers and relatively less mass required to swing around while waving. This is indeed a beautiful weapon, but not for sheer closing force.
Biodiversity and genetic connectivity of Brachyura and Anomura (Decapoda) from artificial reefs in the Gulf of Mexico
Authors: Womacks Cara H , Janosik Alexis M
Published: December 2023

Artificial reefs act as islands of biodiversity that provide substrate where sessile organisms can settle and mobile invertebrates and fishes can find shelter and food. Though these structures are common and widespread in the Gulf of Mexico, their community composition is not well understood. We aimed to ameliorate understanding of the invertebrate communities living on artificial reefs in the northeastern Gulf of Mexico by using molecular techniques and morphological examination to describe the biodiversity and genetic connectivity of crabs (Infraorders Anomura and Brachyura) living on and among artificial reefs near Pensacola, FL, USA. Specimens (N = 1,241) were collected from six artificial reefs using Autonomous Reef Monitoring Structures (ARMS) after four, six, and ten months of submergence, respectively, and were identified using DNA barcoding and morphological examination. Spatial and temporal trends in biodiversity were examined by comparing Hill-Shannon and Hill-Simpson diversities, richness, and canonical correspondence analysis. Population genetic analyses were performed on the two most commonly recovered species, Pseudomedaeus agassizii (A. Milne-Edwards, 1880) and Hexapanopeus paulensis (Rathbun, 1930). A total of 11 taxa were identified, and artificial reef shape was found to be influential in shaping spatial patterns of biodiversity. Species turnover was common across the ten months of sampling, and richness peaked at the ten-month mark. Population genetics revealed that there is high gene flow between the six sampling locations. This study is the first to describe the biodiversity of crab communities on artificial reefs in the northeastern Gulf of Mexico.
On the function of a female-like signal type in the vibrational repertoire of Enchenopa male treehoppers (Hemiptera: Membracidae)
Authors: Escalante Ignacio , Kellner Jerald R , Desjonquères Camille , Noffsinger Gianna M , Cirino Lauren A , Rodríguez Ariel N , DeLong Sage A , Rodríguez Rafael L
Published: December 2023

Animals often mimic the behaviours or signals of conspecifics of the opposite sex while courting. We explored the potential functions of a novel female-like signal type in the courtship displays of male Enchenopa treehoppers. In these plant-feeding insects, males produce plant-borne vibrational advertisement signals, to which females respond with their own duetting signals. Males also produce a signal type that resembles the female duetting responses. We experimentally tested whether this signal modifies the behaviour of receivers. First, we tested whether the female-like signal would increase the likelihood of a female response. However, females were as likely to respond to playbacks with or without them. Second, we tested whether the female-like signal would inhibit competing males, but males were as likely to produce displays after playbacks with or without them. Hence, we found no evidence that this signal has an adaptive function, despite its presence in the courtship display, where sexual selection affects signal features. Given these findings, we also explored whether the behavioural and morphological factors of the males were associated with the production of the female-like signal. Males that produced this signal had higher signalling effort (longer and more frequent signals) than males that did not produce it, despite being in worse body condition. Lastly, most males were consistent over time in producing the female-like signal or not. These findings suggest that condition-dependent or motivational factors explain the presence of the female-like signal. Alternatively, this signal might not bear an adaptive function, and it could be a way for males to warm up or practice signalling, or even be a by-product of how signals are transmitted through the plant. We suggest further work that might explain our puzzling finding that a signal in the reproductive context might not have an adaptive function.
Geographic and seasonal variation of theforgene reveal signatures of local adaptation inDrosophila melanogaster
Authors: Padilla Perez Dylan J
Published: December 2023

In the early 1980s, the observation that Drosophila melanogaster larvae differed in their foraging behaviour laid the foundation for the work that would later lead to the discovery of the foraging gene (for) and its associated foraging phenotypes, rover and sitter. Since then, the molecular characterization of the for gene and our understanding of the mechanisms that maintain its phenotypic variants in the laboratory have progressed enormously. However, the significance and dynamics of such variation are yet to be investigated in nature. With the advent of next-generation sequencing, it is now possible to identify loci underlying the adaptation of populations in response to environmental variation. Here, I present the results of a genotype–environment association analysis that quantifies variation at the for gene among samples of D. melanogaster structured across space and time. These samples consist of published genomes of adult flies collected worldwide, and at least twice per site of collection (during spring and fall). Both an analysis of genetic differentiation based on Fs⁢t values and an analysis of population structure revealed an east–west gradient in allele frequency. This gradient may be the result of spatially varying selection driven by the seasonality of precipitation. These results support the hypothesis that different patterns of gene flow as expected under models of isolation by distance and potentially isolation by environment are driving genetic differentiation among populations. Overall, this study is essential for understanding the mechanisms underlying the evolution of foraging behaviour in D. melanogaster.
Copyright, platforms and NFT digital collections: exploring the proper regulatory mode in China
Authors: He Tianxiang , Zhang Huan
Published: December 2023

Non-fungible token (NFT) technology heralds a transformative era for the creative industry, offering unprecedented advantages to individual creators. For a robust and sustainable NFT trading ecosystem, it is imperative to ensure rigorous copyright protection. This article posits that an NFTized digital copyrighted work should be perceived as a virtual property, with its intrinsic value residing in the token itself. Given that NFT transactions implicate the exclusive rights of copyright holders, they ought to be under the purview of these rights holders. Yet, it is crucial to recognize that NFTs, in isolation, are not a panacea for addressing copyright infringements related to them. Given the pivotal role of NFT platforms in facilitating these transactions, this article advocates for a holistic regulatory framework that governs the conduct of these platforms, thereby fostering the sustainable growth of the NFT ecosystem in China.
Severe leptospirosis with rhabdomyolysis in a traveller visiting Thailand
Authors: Putri Anastasia , Charoenwisedsil Rachata , Techavachara Narissara , Imad Hisham , Chinpraditsuk Sutatip , Thaipadungpanit Janjira , Matsee Wasin
Published: December 2023

We present a case of leptospirosis in a 32-year-old German who exhibited a progressing fever, calf pain complicated with acute kidney injury, and rhabdomyolysis following engagement in freshwater activities at a waterfall in Thailand. Fortunately, the patient made a full recovery without the need for renal replacement therapy.
Imported malaria into Australia: surveillance insights and opportunities
Authors: Sohail Asma , Barry Alyssa , Auburn Sarah , Cheng Qin , Lau Colleen L , Lee Rogan , Price Ric N , Furuya-Kanamori Luis , Bareng Paolo , McGuinness Sarah L , Leder Karin
Published: December 2023

Background

Malaria continues to pose a significant burden in endemic countries, many of which lack access to molecular surveillance. Insights from malaria cases in travellers returning to non-endemic areas can provide valuable data to inform endemic country programmes. To evaluate the potential for novel global insights into malaria, we examined epidemiological and molecular data from imported malaria cases to Australia.

Methods

We analysed malaria cases reported in Australia from 2012 to 2022 using National Notifiable Disease Surveillance System data. Molecular data on imported malaria cases were obtained from literature searches.

Results

Between 2012 and 2022, 3204 malaria cases were reported in Australia. Most cases (69%) were male and 44% occurred in young adults aged 20–39 years. Incidence rates initially declined between 2012 and 2015, then increased until 2019. During 2012–2019, the incidence in travellers ranged from 1.34 to 7.71 per 100 000 trips. Cases were primarily acquired in Sub-Saharan Africa (n = 1433; 45%), Oceania (n = 569; 18%) and Southern and Central Asia (n = 367; 12%). The most common countries of acquisition were Papua New Guinea (n = 474) and India (n = 277). Plasmodium falciparum accounted for 58% (1871/3204) of cases and was predominantly acquired in Sub-Saharan Africa, and Plasmodium vivax accounted for 32% (1016/3204), predominantly from Oceania and Asia. Molecular studies of imported malaria cases to Australia identified genetic mutations and deletions associated with drug resistance and false-negative rapid diagnostic test results, and led to the establishment of reference genomes for P. vivax and Plasmodium malariae.

Conclusions

Our analysis highlights the continuing burden of imported malaria into Australia. Molecular studies have offered valuable insights into drug resistance and diagnostic limitations, and established reference genomes. Integrating molecular data into national surveillance systems could provide important infectious disease intelligence to optimize treatment guidelines for returning travellers and support endemic country surveillance programmes.
Exogenous methylglyoxal alleviates drought-induced ‘plant diabetes’ and leaf senescence in maize
Authors: Lin Yi-Hsuan , Zhou Ya-Ning , Liang Xiao-Gui , Jin Yu-Ka , Xiao Zu-Dong , Zhang Ying-Jun , Huang Cheng , Hong Bo , Chen Zhen-Yuan , Zhou Shun-Li , Shen Si
Published: December 2023

Drought-induced leaf senescence is associated with high sugar levels, which bears some resemblance to the syndrome of diabetes in humans; however, the underlying mechanisms of such ‘plant diabetes’ on carbon imbalance and the corresponding detoxification strategy are not well understood. Here, we investigated the regulatory mechanism of exogenous methylglyoxal (MG) on ‘plant diabetes’ in maize plants under drought stress applied via foliar spraying during the grain-filling stage. Exogenous MG delayed leaf senescence and promoted photoassimilation, thereby reducing the yield loss induced by drought by 14%. Transcriptome and metabolite analyses revealed that drought increased sugar accumulation in leaves through inhibition of sugar transporters that facilitate phloem loading. This led to disequilibrium of glycolysis and overaccumulation of endogenous MG. Application of exogenous MG up-regulated glycolytic flux and the glyoxalase system that catabolyses endogenous MG and glycation end-products, ultimately alleviating ‘plant diabetes’. In addition, the expression of genes facilitating anabolism and catabolism of trehalose-6-phosphate was promoted and suppressed by drought, respectively, and exogenous MG reversed this effect, implying that trehalose-6-phosphate signaling in the mediation of ‘plant diabetes’. Furthermore, exogenous MG activated the phenylpropanoid biosynthetic pathway, promoting the production of lignin and phenolic compounds, which are associated with drought tolerance. Overall, our findings indicate that exogenous MG activates defense-related pathways to alleviate the toxicity derived from ‘plant diabetes’, thereby helping to maintain leaf function and yield production under drought.