bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a benzodiazepine deprescribing quality improvement initiative for older adults in primary care
Authors: Chae Sulgi , Lee Emma , Lindenberg Julia , Shen Kaden , Anderson Timothy S. 
Published: December 2023

AbstractBackgroundOlder adults are commonly prescribed long‐term benzodiazepines for anxiety and insomnia despite evidence of risks and limited evidence of long‐term benefits. Recent quality measures and guidelines have recommended benzodiazepine deprescribing, yet there is little real‐world data on clinic‐based deprescribing programs.MethodsWe developed a benzodiazepine deprescribing quality improvement program for older adults at a large US academic medical center. The program targeted adults aged 65 years and older who were prescribed chronic benzodiazepines by their primary care physician (PCP). PCPs were contacted to opt‐out patients not suitable for deprescribing; then eligible patients were mailed a letter discussing patient‐specific risks and advising them to discuss deprescribing with their PCP or a pharmacist who was available to support tapering. The primary outcomes were the number of patients who discussed deprescribing and who initiated a taper within 90 days of outreach.ResultsOf 504 older adults prescribed benzodiazepines, 133 (26%) were opted out by their PCPs leaving a cohort of 371 (median age 71 years [IQR 68–75], 58% female, 82% White). The median daily diazepam milligram equivalent was 5 mg (IQR 3–6 mg) and 30% were prescribed long‐acting benzodiazepines. Three months following patient outreach, 97 patients (26%) had a documented discussion of benzodiazepines with their PCP or clinic pharmacist. Of these patients, 35 (36%) had documentation of a deprescribing discussion and 25 (26%) initiated a taper. At 12 months, 16 patients (64%) were tapered successfully, with nine (36%) patients taking a lower benzodiazepine dose and seven (28%) discontinuing benzodiazepines completely.ConclusionsA low‐intensity benzodiazepine deprescribing outreach program led to deprescribing conversations for a minority of patients, but one‐quarter of older adults who engaged in a conversation chose to taper and nearly two‐thirds sustained reduced use. Incorporating benzodiazepine deprescribing into routine care may require more intensive population‐health efforts to engage patients and clinicians.
Antagonistic MADS‐box transcription factors SEEDSTICK and SEPALLATA3 form a transcriptional regulatory network that regulates seed oil accumulation
Authors: He Shuangcheng , Min Yuanchang , Liu Zijin , Zhi Fang , Ma Rong , Ge Ankang , Wang Shixiang , Zhao Yu , Peng Danshuai , Zhang Da , Jin Minshan , Song Bo , Wang Jianjun , Guo Yuan , Chen Mingxun 
Published: December 2023

ABSTRACTTranscriptional regulation is essential for balancing multiple metabolic pathways that influence oil accumulation in seeds. Thus far, the transcriptional regulatory mechanisms that govern seed oil accumulation remain largely unknown. Here, we identified the transcriptional regulatory network composed of MADS‐box transcription factors SEEDSTICK (STK) and SEPALLATA3 (SEP3), which bridges several key genes to regulate oil accumulation in seeds. We found that STK, highly expressed in the developing embryo, positively regulates seed oil accumulation in Arabidopsis (Arabidopsis thaliana). Furthermore, we discovered that SEP3 physically interacts with STK in vivo and in vitro. Seed oil content is increased by the SEP3 mutation, while it is decreased by SEP3 overexpression. The chromatin immunoprecipitation, electrophoretic mobility shift assay, and transient dual‐luciferase reporter assays showed that STK positively regulates seed oil accumulation by directly repressing the expression of MYB5, SEP3, and SEED FATTY ACID REDUCER 4 (SFAR4). Moreover, genetic and molecular analyses demonstrated that STK and SEP3 antagonistically regulate seed oil production and that SEP3 weakens the binding ability of STK to MYB5, SEP3, and SFAR4. Additionally, we demonstrated that TRANSPARENT TESTA 8 (TT8) and ACYL‐ACYL CARRIER PROTEIN DESATURASE 3 (AAD3) are direct targets of MYB5 during seed oil accumulation in Arabidopsis. Together, our findings provide the transcriptional regulatory network antagonistically orchestrated by STK and SEP3, which fine tunes oil accumulation in seeds.
Certified Nurse‐Midwives as Teachers: Expanding Interprofessional Collaboration Learning Opportunities for Medical Students on the Obstetrics and Gynecology Clerkship
Authors: Liang Angela C. , Malone Anita , Kobernik Emily K. , Holman Elizabeth , Hammoud Maya M. , Majszak Christina , Kempner Samantha , Morgan Helen K. 
Published: December 2023

IntroductionInterprofessional experiences provide critical exposure to collaborative health care teams, yet medical students often lack this experience during clinical clerkships. We created a labor and delivery triage rotation exclusively staffed by certified nurse‐midwives in the obstetrics and gynecology clerkship to address this gap. We sought to evaluate the clinical learning experiences of medical students rotating on this midwife‐supervised collaborative team.MethodsBetween 2018 and 2020, we electronically sent all medical students an evaluation after each required clerkship. Our primary outcome was the quality of teaching score, as defined by level of agreement on a 5‐point Likert scale with a statement regarding teaching quality. A secondary outcome evaluated scores from the National Board of Medical Examiners (NBME) Obstetrics and Gynecology subject examination taken by all students at the end of the rotation. Evaluations and assessments were compared between students rotating on labor and delivery triage and those who did not. Evaluation comments from students rotating on labor and delivery triage were collated to identify common themes.ResultsOf 374 students, 370 (98.9%) completed the end‐of‐clerkship course evaluation and 312 (83.4%) completed teaching evaluations. Sixty‐seven students (17.9%) rotated in labor and delivery triage; of these, 52 (77.6%) completed both the course and triage rotation evaluations. There were no differences in the mean quality of teaching scores (3.9 ± 1.2 versus 3.8 ± 1.2, p = 0.54) or in NBME Obstetrics and Gynecology subject examination scores between students rotating in labor and delivery triage compared to all other rotations (79.9% ± 7.2% vs 80.2% ± 7.8%, P = 0.436). Comments from teaching evaluations highlighted student exposure to the midwifery philosophy of care model.DiscussionThis work demonstrates the feasibility and benefits of this midwife‐led authentic interprofessional collaborative experience for medical students. This model can serve as an example of how to implement and evaluate interprofessional collaboration experiences in the clinical setting.
Using experiments to study families and intimate relationships
Authors: Doan Long , Quadlin Natasha , Khanna Katharine 
Published: December 2023

AbstractSocial scientists increasingly are using experiments to examine causal processes and mechanisms in their research. Yet, experiments work much better for some research aims than others. Some goals that are of great interest to family scholars, such as testing theoretical arguments, are well‐suited to experimental approaches; other goals, such as documenting real‐world experiences, may be best served by another research design. Our aim in this article is to discuss the power and limits of experimental methods for the study of family, with an emphasis on describing the types of topics and approaches that work best in an experimental framework. We begin by briefly reviewing the current state of the literature and the types of experiments that are commonly used to study families and intimate relationships. We discuss recent examples and “best practices” to illustrate the potential strengths of experiments for the study of family. After walking through an in‐depth example of an experimental research design, we describe some unresolved theoretical puzzles in the family literature from the previous mid‐decade review that seem ripe for experimental study. In doing so, we demonstrate that experiments, when used appropriately, can provide powerful evidence of causal mechanisms that resonate with scholarly audiences and the public.
Redefining CT perfusion‐based ischemic core estimates for the ghost core in early time window stroke
Authors: Koneru Manisha , Hoseinyazdi Meisam , Lakhani Dhairya A. , Greene Cynthia , Copeland Karen , Wang Richard , Xu Risheng , Luna Licia , Caplan Justin M. , Dmytriw Adam A. , Guenego Adrien , Heit Jeremy J. , Albers Gregory W. , Wintermark Max , Gonzalez Luis F. , Urrutia Victor C. , Huang Judy , Nael Kambiz , Leigh Richard , Marsh Elisabeth B. , Hillis Argye E. , Llinas Rafael H. , Yedavalli Vivek S. 
Published: December 2023

AbstractBackground and PurposeIn large vessel occlusion (LVO) stroke patients, relative cerebral blood flow (rCBF)<30% volume thresholds are commonly used in treatment decisions. In the early time window, nearly infarcted but salvageable tissue volumes may lead to pretreatment overestimates of infarct volume, and thus potentially exclude patients who may otherwise benefit from intervention. Our multisite analysis aims to explore the strength of relationships between widely used pretreatment CT parameters and clinical outcomes for early window stroke patients.MethodsPatients from two sites in a prospective registry were analyzed. Patients with LVOs, presenting within 3 hours of last known well, and who were successfully reperfused were included. Primary short‐term neurological outcome was percent National Institutes of Health Stroke Scale (NIHSS) change from admission to discharge. Secondary long‐term outcome was 90‐day modified Rankin score. Spearman's correlations were performed. Significance was attributed to p‐value ≤.05.ResultsAmong 73 patients, median age was 66 (interquartile range 54‐76) years. Among all pretreatment imaging parameters, rCBF<30%, rCBF<34%, and rCBF<38% volumes were significantly, inversely correlated with percentage NIHSS change (p<.048). No other parameters significantly correlated with outcomes.ConclusionsOur multisite analysis shows that favorable short‐term neurological recovery was significantly correlated with rCBF volumes in the early time window. However, modest strength of correlations provides supportive evidence that the applicability of general ischemic core estimate thresholds in this subpopulation is limited. Our results support future larger‐scale efforts to liberalize or reevaluate current rCBF parameter thresholds guiding treatment decisions for early time window stroke patients.
Melatonin facts: Lack of evidence that melatonin is a radical scavenger in living systems
Authors: Boutin Jean A. , Liberelle Maxime , Yous Saïd , Ferry Gilles , Nepveu Françoise 
Published: December 2023

AbstractMelatonin is a small natural compound, so called a neuro‐hormone that is synthesized mainly in pineal gland in animals. Its main role is to master the clock of the body, under the surveillance of light. In other words, it transfers the information concerning night and day to the peripheral organs which, without it, could not “know” which part of the circadian rhythm the body is in. Besides its main circadian and circannual rhythms mastering, melatonin is reported to be a radical scavenger and/or an antioxidant. Because radical scavengers are chemical species able to neutralize highly reactive and toxic species such as reactive oxygen species, one would like to transfer this property to living system, despite impossibilities already largely reported in the literature. In the present commentary, we refresh the memory of the readers with this notion of radical scavenger, and review the possible evidence that melatonin could be an in vivo radical scavenger, while we only marginally discuss here the fact that melatonin is a molecular antioxidant, a feature that merits a review on its own. We conclude four things: (i) the evidence that melatonin is a scavenger in acellular systems is overwhelming and could not be doubted; (ii) the transposition of this property in living (animal) systems is (a) theoretically impossible and (b) not proven in any system reported in the literature where most of the time, the delay of the action of melatonin is over several hours, thus signing a probable induction of cellular enzymatic antioxidant defenses; (iii) this last fact needs a confirmation through the discovery of a nuclear factor—a key relay in induction processes—that binds melatonin and is activated by it and (iv) we also gather the very important description of the radical scavenging capacity of melatonin in acellular systems that is now proven and shared by many other double bond‐bearing molecules. We finally discussed briefly on the reason—scientific or else—that led this description, and the consequences of this claim, in research, in physiology, in pathology, but most disturbingly in therapeutics where a vast amount of money, hope, and patient bien‐être are at stake.
Kelp and sea urchin settlement mediated by biotic interactions with benthic coralline algal species
Authors: Twist Brenton A. , Mazel Florent , Zaklan Duff Stefanie , Lemay Matthew A. , Pearce Christopher M. , Martone Patrick T. 
Published: December 2023

AbstractSpecies interactions can influence key ecological processes that support community assembly and composition. For example, coralline algae encompass extensive diversity and may play a major role in regime shifts from kelp forests to urchin‐dominated barrens through their role in inducing invertebrate larval metamorphosis and influencing kelp spore settlement. In a series of laboratory experiments, we tested the hypothesis that different coralline communities facilitate the maintenance of either ecosystem state by either promoting or inhibiting early recruitment of kelps or urchins. Coralline algae significantly increased red urchin metamorphosis compared with a control, while they had varying effects on kelp settlement. Urchin metamorphosis and density of juvenile canopy kelps did not differ significantly across coralline species abundant in both kelp forests and urchin barrens, suggesting that recruitment of urchin and canopy kelps does not depend on specific corallines. Non‐calcified fleshy red algal crusts promoted the highest mean urchin metamorphosis percentage and showed some of the lowest canopy kelp settlement. In contrast, settlement of one subcanopy kelp species was reduced on crustose corallines, but elevated on articulated corallines, suggesting that articulated corallines, typically absent in urchin barrens, may need to recover before this subcanopy kelp could return. Coralline species differed in surface bacterial microbiome composition; however, urchin metamorphosis was not significantly different when microbiomes were removed with antibiotics. Our results clarify the role played by coralline algal species in kelp forest community assembly and could have important implications for kelp forest recovery.
A novel for an ageing population? Masculinity and demographic shift in David Lodge'sDeaf Sentence(2008)
Authors: Rossoni Stefano 
Published: December 2023

AbstractThis article examines David Lodge's novelDeaf Sentence(2008), which focuses on the life of Desmond, a retired professor of linguistics. I argue that this text offers a standpoint through which readers can visualise the global phenomenon of population ageing and address the question of global responsibility. I look atDeaf Sentencewithin the tradition of the Bakhtinian polyphonic novel and through the lens of the campus novel that Lodge discusses in his critical writing. The analysis of dialogism and self‐reflexivity illuminates the reverberations of global ageing on the life of Desmond, situating questions of wellbeing and demography within a narrative perspective. Detailing their struggles with isolation, incontinence and erectile dysfunction, the narration of Desmond and his father growing older sheds light on the limitations of biomedical scripts for older men based on bodily control and sexual performativity. Considering the tension of biomedical discourses and gender expectations informing the cultural construction of ageing in the global North, I contend that Lodge's writing exposes the limits of the neoliberal ideals of self‐sufficiency and individual responsibility at the heart of the notion of successful ageing. Echoing Desmond's self‐reflection,Deaf Sentenceoffers its reader a standpoint through which to reflect on his problematic participation in the neoliberal, patriarchal regimes that marginalise him. Interpreting the novel as a space for deconstructing the ideal of an autonomous and independent subject postulated by neoliberal discourses, I readDeaf Sentenceas an invitation to its readers to embrace their own vulnerability, fostering ethics of care towards themselves and the other.
Circadian clock‐ and temperature‐associated genes contribute to overall genomic differentiation along elevation in lichenized fungi
Authors: Valim Henrique F. , Grande Francesco Dal , Wong Edgar L. Y. , Schmitt Imke 
Published: December 2023

AbstractCircadian regulation is linked to local environmental adaptation, and many species with broad climatic niches display variation in circadian genes. Here, we hypothesize that lichenizing fungi occupying different climate zones tune their metabolism to local environmental conditions with the help of their circadian systems. We study two species of the genus Umbilicaria occupying similar climatic niches (Mediterranean and the cold temperate) in different continents. Using homology to Neurospora crassa genes, we identify gene sets associated with circadian rhythms (11 core, 39 peripheral genes) as well as temperature response (37 genes). Nucleotide diversity of these genes is significantly correlated with mean annual temperature, minimum temperature of the coldest month and mean temperature of the coldest quarter. Furthermore, we identify altitudinal clines in allele frequencies in several non‐synonymous substitutions in core clock components, for example, white collar‐like, frh‐like and various ccg‐like genes. A dN/dS approach revealed a few significant peripheral clock‐ and temperature‐associated genes (e.g. ras‐1‐like, gna‐1‐like) that may play a role in fine‐tuning the circadian clock and temperature‐response machinery. An analysis of allele frequency changes demonstrated the strongest evidence for differentiation above the genomic background in the clock‐associated genes in U. pustulata. These results highlight the likely relevance of the circadian clock in environmental adaptation, particularly frost tolerance, of lichens. Whether or not the fungal clock modulates the symbiotic interaction within the lichen consortium remains to be investigated. We corroborate the finding of genetic variation in clock components along altitude—not only latitude—as has been reported in other species.
Environmental change unlinks a gene from its trait
Authors: Wellenreuther Maren 
Published: December 2023

In Atlantic salmon (Salmo salar), sea age is a major life history trait governed by a sex‐specific trade‐off between reproductive success and survival. In this issue of Molecular Ecology, Besnier et al. (Molecular Ecology, 2023) found evidence to suggest that the disassociation between sea age and major effect loci, including the previously identified candidate genes vgll3 and six6, may be related to the recently observed trend towards slower growth and later maturation. These results are of importance because they challenge the prevailing view that evolution moves in a slow shuffle, and they provide a pertinent example of how an optimal phenotype can change due to growth‐driven plasticity and lead to contemporary molecular and phenotypic evolution.
Barriers and facilitators to offering post‐intensive care follow‐up services from the perspective of critical care professionals: A qualitative study
Authors: Zhang Feng , Chen Zhen , Xue Dan‐dan , Zhang Rui , Cheng Yun 
Published: December 2023

AbstractBackgroundVarious programmes and models for post‐intensive care unit (ICU) follow‐up services have been developed worldwide. In China, post‐ICU follow‐up remains in the exploratory stage and little is known regarding the appropriate form and challenges of implementation, which need to be further explored.AimThis study aimed to explore and describe the barriers to and facilitators of post‐ICU follow‐up services from the perspective of critical care professionals.DesignThis was a descriptive qualitative study. Semi‐structured interviews were conducted with 21 health care workers whose units had offered ICU survivors different forms of follow‐up services; the data were analysed by qualitative content analysis during August 2022 and December 2022.SettingThe study was conducted at 14 ICUs in 11 tertiary hospitals in Shanghai, China.FindingsSeventeen subthemes were extracted as barriers and facilitators in the follow‐up of ICU survivors. In the initiating process, the barriers included the restriction of decision‐making rights and scope of practice, indifferent attitude towards survivors and repeated work. The facilitators included admitted significance, the needs of ICU survivors, the conscientiousness of professionals and the pioneers and leadership support. In the implementation process, lack of confidence, lack of cooperation in medical consortium, distrusted relationships, restrictions of medical insurance, ageing problems and insufficient human resources acted as barriers, whereas lessons learned, positive feedback and digital support served as facilitators. Furthermore, recommendations and tips were identified for offering follow‐up services.ConclusionMedical personnel can better utilize available resources and develop strategies to overcome constraints by gaining insights into the abovementioned barriers and facilitators. The findings of this study can provide a useful reference for structured and systematic follow‐ups to ameliorate post‐intensive care syndrome in low‐ and middle‐income countries.Relevance to Clinical PracticePublicity and educational measures play a crucial role in enhancing the awareness of survivors and the consensus of health care professionals from medical consortium regarding impairments after critical care. Leadership and policy support can address numerous obstacles to guiding follow‐up services.