bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing clinician decision‐making about POLST use with nursing facility residents: A qualitative study
Authors: Cole Connie S. , Lum Hillary D. , Hickman Susan E. 
Published: December 2023

AbstractBackgroundNational POLST guidance indicates POLST is intended for individuals at risk of life‐threatening clinical events due to serious illness. Even though this patient population includes many, but not all, nursing facility residents, there is evidence that POLST is used broadly in this setting. This study aimed to identify clinician perspectives regarding factors that influence their decision‐making about whether to use POLST with nursing facility residents and to distinguish between inappropriate and appropriate use.MethodsWe conducted a descriptive qualitative study to explore the experience of nursing facility clinicians using POLST with residents and deciding who is appropriate and inappropriate for POLST. Participants were purposively sampled from multiple states using POLST. Interviews were audio‐recorded and professionally transcribed. We used rapid qualitative analysis to code data and identify themes.ResultsWe interviewed 28 clinicians from 14 states about how they decided whether to use POLST with nursing facility residents and to distinguish between inappropriate and appropriate use. Four themes emerged as factors driving clinician‐decision‐making POLST use: (1) belief that “everyone is appropriate”; (2) resident and family preferences; (3) resident health status; and (4) policies requiring POLST [Correction added after first online publication on 07 Feb 2024. The word “For” has been changed to “Four” in the previous sentence.]. In most cases, participants cited resident and family preferences for treatment limitations as well as prognosis and clinical assessments in determining when POLST use was appropriate. Factors influencing potentially inappropriate POLST use included nursing facility policies requiring POLST completion that preempted clinical judgments of appropriateness.ConclusionsFindings highlight the disconnect between National POLST guidance and current use of POLST in nursing facilities. Policies requiring POLST use in nursing facilities and the belief that “everyone is appropriate” may impede clinician autonomy and lead to potentially inappropriate POLST use. Given varying approaches to POLST use in nursing facilities, there is a need to refocus attention on the intended population for POLST.
Developing electronic health record‐based measures of the 4Ms to support implementation and evidence generation for Age‐Friendly Health Systems
Authors: Thombley Robert L. , Rogers Stephanie E. , Adler‐Milstein Julia 
Published: December 2023

AbstractBackgroundTo support implementation of the 4Ms framework and more rigorous evidence of 4Ms impact, we translated Institute for Healthcare Improvement's (IHI's) recommended 4Ms routine care practices into electronic health record‐based, encounter‐level adherence measures and then implemented measures at a large academic medical center.MethodsWe started with the 19 care practices in IHI's 4Ms implementation guide and developed encounter‐level adherence measures using structured EHR data. We also developed overall 4Ms‐level and M‐level composite measures. Next, we operationalized measures at UCSF Health—an academic medical center that has implemented the 4Ms using the IHI guide. We identified UCSF Health patients who should have received 4Ms care during their inpatient admission (19,335 individuals 65 years and older with an admission between January 1, 2019 and December 31, 2021), then implemented the individual measures and composite measures (all at the encounter level) using Epic EHR data. We focused on 4Ms inpatient care processes, but similar approaches can be followed for ambulatory, post‐acute, and other settings.ResultsWe developed 18 EHR‐based measures that captured all IHI care practices, 16 of which could be implemented using UCSF Health EHR data. For example, the EHR‐based measure for the Medication care practice “deprescribe high risk medications” was measured using EHR data as “Patient had no previously existing prescriptions for high‐risk medications OR patient had ≥1 previously existing prescriptions for high‐risk medications deprescribed during the encounter,” and 29.5% of UCSF Health encounters met this measure. For composite measures, on average, UCSF Health encounters had 61.1% adherence to the 4Ms (SD = 14.4%), with the lowest average adherence to What Matters (50.9%; SD = 44.3%) and the highest for Mentation (68.4%; SD = 13.4%).ConclusionsIt is feasible to construct encounter‐level measures of 4Ms adherence using EHR data and derive insights to guide ongoing implementation efforts. Future efforts should refine measures based on assessments of reliability and validity.
The requirement for external carbonic anhydrase in diatoms is influenced by the supply and demand for dissolved inorganic carbon
Authors: Keys Matthew , Hopkinson Brian , Highfield Andrea , Chrachri Abdul , Brownlee Colin , Wheeler Glen L. 
Published: December 2023

AbstractPhotosynthesis by marine diatoms contributes significantly to the global carbon cycle. Due to the low concentration of CO2 in seawater, many diatoms use extracellular carbonic anhydrase (eCA) to enhance the supply of CO2 to the cell surface. While much research has investigated how the requirement for eCA is influenced by changes in CO2 availability, little is known about how eCA contributes to CO2 supply following changes in the demand for carbon. We therefore examined how changes in photosynthetic rate influence the requirement for eCA in three centric diatoms. Modeling of cell surface carbonate chemistry indicated that diffusive CO2 supply to the cell surface was greatly reduced in large diatoms at higher photosynthetic rates. Laboratory experiments demonstrated a trend of an increasing requirement for eCA with increasing photosynthetic rate that was most pronounced in the larger species, supporting the findings of the cellular modeling. Microelectrode measurements of cell surface pH and O2 demonstrated that individual cells exhibited an increased contribution of eCA to photosynthesis at higher irradiances. Our data demonstrate that changes in carbon demand strongly influence the requirement for eCA in diatoms. Cell size and photosynthetic rate will therefore be key determinants of the mode of dissolved inorganic carbon uptake.
Variability in human tooth cementum thickness reflecting functional processes
Authors: Nicklisch Nicole , Hinrichs Christopher , Palaske Lukas , Vach Werner , Alt Kurt W. 
Published: December 2023

AbstractObjectiveThe aim of this study was to investigate the thickness of acellular extrinsic fibre cementum (AEFC) at four root positions of anterior and posterior teeth with special focus on functional aspects. Furthermore, the correlations between cementum thickness and chronological age and sex are investigated.BackgroundWhile numerous studies confirm continuous cementum apposition with age, masticatory forces as well as physiological and orthodontically induced tooth movements also have the potential to affect tooth cementum thickness.Materials and MethodsUndecalcified teeth were embedded in resin and transverse‐sectioned in the cervical third of the root. Two sections per root were selected, and digital images at four positions were obtained (mesial, distal, oral, and vestibular) using light microscopy. The AEFC thickness of 99 teeth (anterior = 66, posterior = 33, male = 54, female = 45) were measured in both sections. The differences in mean values between root positions and the association of root position variation with tooth type, age, sex, and subject as well as the overall effects of age and sex were analysed using a mixed model.ResultsFirst incisors and canines showed the greatest mean AFEC thickness, in contrast to premolars which had the lowest values. Differences were found across the four root positions, with a pattern varying considerably between anterior and posterior teeth and between maxilla and mandible in the anterior teeth. An interaction between root position and subject pointed to the existence of an individual component in the variation of AEFC thickness across the four root positions. There was an age trend with an almost linear increase in cementum thickness of 1 μm per year. Overall, females tended to exhibit a significantly lesser AEFC thickness compared to males.ConclusionsDistinct differences in the pattern of thickness values across the four root positions in anterior and posterior teeth support the assumption that the AEFC is strongly affected by functional processes. In addition to sex‐specific differences and age‐related trends, the root position variation of AEFC thickness varies from individual to individual.
Impact of Z chromosome inversions on gene expression in testis and liver tissues in the zebra finch
Authors: Viitaniemi Heidi M. , Leder Erica H. , Kauzál Ondřej , Stopková Romana , Stopka Pavel , Lifjeld Jan T. , Albrecht Tomáš 
Published: December 2023

AbstractChromosomal inversions have been identified in many natural populations and can be responsible for novel traits and rapid adaptation. In zebra finch, a large region on the Z chromosome has been subject to multiple inversions, which have pleiotropic effects on multiple traits but especially on sperm phenotypes, such as midpiece and flagellum length. To understand the effect, the Z inversion has on these traits, we examined testis and liver transcriptomes of young males at different maturation times. We compared gene expression differences among three inversion karyotypes: AA, B*B* and AB*, where B* denotes the inverted regions on Z with respect to A. In testis, 794 differentially expressed genes were found and most of them were located on chromosome Z. They were functionally enriched for sperm‐related traits. We also identified clusters of co‐expressed genes that matched with the inversion‐related sperm phenotypes. In liver, there were some enriched functions and some overrepresentation on chromosome Z with similar location as in testis. In both tissues, the overrepresented genes were located near the distal end of Z but also in the middle of the chromosome. For the heterokaryotype, we observed several genes with one allele being dominantly expressed, similar to expression patterns in one or the other homokaryotype. This was confirmed with SNPs for three genes, and interestingly one gene, DMGDH, had allele‐specific expression originating mainly from one inversion haplotype in the testis, yet both inversion haplotypes were expressed equally in the liver. This karyotype‐specific difference in tissue‐specific expression suggests a pleiotropic effect of the inversion and thus suggests a mechanism for divergent phenotypic effects resulting from an inversion.
Taxonomic studies of Araceae in Myanmar VI: Amorphophallus mirabilis – a new species and a new record for the genus Amorphophallus
Authors: Arcebal K. Naive Mark , Zaw Hein Khant , Serebryanyi Michael , Hetterscheid Wilbert 
Published: December 2023

Amorphophallus mirabilis is herein described and illustrated from Hpa‐an District, Kayin State, Myanmar. A detailed description, colour plates, phenology, and a provisional conservation status are provided. In addition, A. napalensis is reported as a newly recorded species for Myanmar. With the discovery of the new species and A. napalensis, Myanmar now holds 17 Amorphophallus species.Keywords: Amorphophallus napalensis, Burma, Chin State, Kayin State, mirabilis, new species
Evaluating plant lineage losses and gains in temperate forest understories: a phylogenetic perspective on climate change and nitrogen deposition
Authors: Padullés Cubino Josep , Lenoir Jonathan , Li Daijiang , Montaño‐Centellas Flavia A. , Retana Javier , Baeten Lander , Bernhardt‐Römermann Markus , Chudomelová Markéta , Closset Déborah , Decocq Guillaume , De Frenne Pieter , Diekmann Martin , Dirnböck Thomas , Durak Tomasz , Hédl Radim , Heinken Thilo , Jaroszewicz Bogdan , Kopecký Martin , Macek Martin , Máliš František , Naaf Tobias , Orczewska Anna , Petřík Petr , Pielech Remigiusz , Reczyńska Kamila , Schmidt Wolfgang , Standovár Tibor , Świerkosz Krzysztof , Teleki Balázs , Verheyen Kris , Vild Ondřej , Waller Donald , Wulf Monika , Chytrý Milan 
Published: December 2023

Summary

Global change has accelerated local species extinctions and colonizations, often resulting in losses and gains of evolutionary lineages with unique features. Do these losses and gains occur randomly across the phylogeny?

We quantified: temporal changes in plant phylogenetic diversity (PD); and the phylogenetic relatedness (PR) of lost and gained species in 2672 semi‐permanent vegetation plots in European temperate forest understories resurveyed over an average period of 40 yr.

Controlling for differences in species richness, PD increased slightly over time and across plots. Moreover, lost species within plots exhibited a higher degree of PR than gained species. This implies that gained species originated from a more diverse set of evolutionary lineages than lost species. Certain lineages also lost and gained more species than expected by chance, with Ericaceae, Fabaceae, and Orchidaceae experiencing losses and Amaranthaceae, Cyperaceae, and Rosaceae showing gains. Species losses and gains displayed no significant phylogenetic signal in response to changes in macroclimatic conditions and nitrogen deposition.

As anthropogenic global change intensifies, temperate forest understories experience losses and gains in specific phylogenetic branches and ecological strategies, while the overall mean PD remains relatively stable.
Rapid spatial assessment of leaf‐absorbed irradiance
Authors: Zhang Jiayu , Kaiser Elias , Marcelis Leo F. M. , Vialet‐Chabrand Silvere 
Published: December 2023

Summary
Image‐based high‐throughput phenotyping promises the rapid determination of functional traits in large plant populations. However, interpretation of some traits – such as those related to photosynthesis or transpiration rates – is only meaningful if the irradiance absorbed by the measured leaves is known, which can differ greatly between different parts of the same plant and within canopies. No feasible method currently exists to rapidly measure absorbed irradiance in three‐dimensional plants and canopies.
We developed a method and protocols to derive absorbed irradiance at any visible part of a canopy with a thermal camera, by fitting a leaf energy balance model to transient changes in leaf temperature. Leaves were exposed to short light pulses (30 s) that were not long enough to trigger stomatal opening but strong enough to induce transient changes in leaf temperature that was proportional to the absorbed irradiance.
The method was successfully validated against point measurements of absorbed irradiance in plant species with relatively simple architecture (sweet pepper, cucumber, tomato, and lettuce). Once calibrated, the model was used to produce absorbed irradiance maps from thermograms.
Our method opens new avenues for the interpretation of plant responses derived from imaging techniques and can be adapted to existing high‐throughput phenotyping platforms.
Consensus on pharmacological treatment of obesity in Latin America
Authors: Cappelletti Ana María , Valenzuela Montero Alex , Cercato Cintia , Duque Ossman John Jairo , Fletcher Vasquez Pablo Enrique , García García Juan Eduardo , Mancillas‐Adame Leonardo Guadalupe , Manrique Herald Andrés , Ranchos Monterroso Flor de María , Segarra Pablo , Navas Trina 
Published: December 2023

SummaryA panel of 10 experts in obesity from various Latin American countries held a Zoom meeting intending to reach a consensus on the use of anti‐obesity medicines and make updated recommendations suitable for the Latin American population based on the available evidence. A questionnaire with 16 questions was developed using the Patient, Intervention, Comparison, Outcome (Result) methodology, which was iterated according to the modified Delphi methodology, and a consensus was reached with 80% or higher agreement. Failure to reach a consensus led to a second round of analysis with a rephrased question and the same rules for agreement. The recommendations were drafted based on the guidelines of the American College of Cardiology Foundation/American Heart Association Task Force on Practice. This panel of experts recommends drug therapy in patients with a body mass index of ≥30 or ≥27 kg/m2 plus at least one comorbidity, when lifestyle changes are not enough to achieve the weight loss objective; alternatively, lifestyle changes could be maintained while considering individual parameters. Algorithms for the use of long‐term medications are suggested based on drugs that increase or decrease body weight, results, contraindications, and medications that are not recommended. The authors concluded that anti‐obesity treatments should be individualized and multidisciplinary.
Clinical course of suspected familial and sporadic idiopathic pulmonary fibrosis: Data from the PROOF‐Next registry
Authors: Froidure Antoine , Bondue Benjamin , Dahlqvist Caroline , Guiot Julien , Gusbin Natacha , Wirtz Gil , Brusselle Guy , Strens Danielle , Slabbynck Hans , Wuyts Wim A. 
Published: December 2023

AbstractBackground and ObjectiveReal‐life data on suspected familial fibrosis, defined as the occurrence of the disease in a patient younger than 50 and/or having at least one relative affected by pulmonary fibrosis remain scarce.MethodsThe Belgian and Luxembourg IPF registry (PROOF‐Next) is a multicentric prospective longitudinal and observational study set in Belgium and Luxembourg. We compared characteristics and clinical course of patients with suspected familial pulmonary fibrosis (FPF) and sporadic IPF.ResultsWe included 618 patients in the analysis, of whom 76 (12%) fulfilled criteria for FPF. They were significantly younger than sIPF (median age (range) 65 (43–87), vs. 72 (51–98), p = 0.0001). Male gender proportion and smoking status did not differ between groups, but the number of pack‐year among current and former smokers was lower in FPF (20 vs. 25, p = 0.02). Besides, 87% of FPF and 76% of sIPF were treated with antifibrotic (p = 0.047).Baseline pulmonary function tests were similar in both groups, as well as median time before progression and transplant‐free survival. Finally, genetic testing, performed in a minority, led to the identification of 10 telomerase‐related gene variants.ConclusionAlthough younger and exposed to less tobacco, patients with FPF show an equally aggressive progression as observed in sporadic IPF patients. These results warrant early referral of FPF patients to expert centres for optimal management.
The importance of risk and insurance teaching within the ARIA mission
Authors: Medders Lorilee , Epermanis Karen , Avila Stephen , Russell David 
Published: December 2023

AbstractThe American Risk and Insurance Association (ARIA) is a scholarly association devoted to the study of and promotion of risk and insurance economics and has a history of innovative scholarship in fields that are vital to economic development and resiliency throughout the world. Association members have an equally important mission and history of passing along important knowledge to students and the risk professions. The Risk and Insurance Teaching Society (RITS) was established as part of the pedagogical and academic program roles of ARIA. This paper outlines the importance of pedagogy within business higher education and more specifically within the academic discipline of risk and insurance and the increasing role that RITS plays in pedagogical innovation and idea sharing among risk and insurance academics.
Confidence bands for survival curves from outcome‐dependent stratified samples
Authors: Saegusa Takumi , Nandori Peter 
Published: December 2023

AbstractWe consider the construction of confidence bands for survival curves under the outcome‐dependent stratified sampling. A main challenge of this design is that data are a biased dependent sample due to stratification and sampling without replacement. Most literature on regression approximates this design by Bernoulli sampling but variance is generally overestimated. Even with this approximation, the limiting distribution of the inverse probability weighted Kaplan–Meier estimator involves a general Gaussian process, and hence quantiles of its supremum is not analytically available. In this paper, we provide a rigorous asymptotic theory for the weighted Kaplan–Meier estimator accounting for dependence in the sample. We propose the novel hybrid method to both simulate and bootstrap parts of the limiting process to compute confidence bands with asymptotically correct coverage probability. Simulation study indicates that the proposed bands are appropriate for practical use. A Wilms tumor example is presented.
New immigration destinations in Sweden: Migrant residential trajectories intersecting rural areas
Authors: Haandrikman Karen , Hedberg Charlotta , Chihaya Guilherme Kenji 
Published: December 2023

AbstractThis paper aims to examine the residential trajectories of immigrants that intersect rural areas in Sweden. It adds to the literature on new immigration destinations (NIDs) and addresses the need to include migration routes intersecting rural areas, immigrants’ secondary migration patterns and temporal dimensions of migration, as well as the multiplicity of migrants in such destinations. We examine whether NIDs have emerged in Sweden and immigrants’ subsequent internal mobility from such areas and its determinants. Employing sequence analysis to full‐population register data, we identify typical migration pathways. According to the results, NIDs are an emerging phenomenon in rural and small‐sized cities in Sweden. We find limited support for the Swedish discourse that the diverse groups of rural migrants leave soon after arrival; also, those leaving are not doing so for labour market–related reasons, nor are they heading for metropolitan areas. We suggest that NIDs offer an important contribution to understanding migration patterns.
How to … grow a team in clinical education research
Authors: Da Silva Ana , Bussey Sonia , Macdougall Colin , Alberti Hugh , Lett Aaron M. , Samuriwo Ray 
Published: December 2023

AbstractThe Incubator for Clinical Education Research (ClinEdR) is a UK‐wide network, established with support from the National Institute for Health and Care Research (NIHR), to lead initiatives to build capacity in the field. Our lived experiences as members of the NIHR ClinEdR Incubator and wider literature are woven into this ‘How to …’ paper, which outlines what to consider as you seek to grow and develop a ClinEdR team. This paper sets out pragmatic steps to grow an effective ClinEdR team that has a wider impact and mutual benefits for its members and their institution(s). Growing a ClinEdR team requires more than a dynamic character to bring people together. In our view, you can grow a ClinEdR team with other people through a structured, well‐thought‐out approach, in which its members develop through collaborative work to achieve a shared objective.