[J Contin Educ Nurs. 2020;51(3)109-117.]. Copyright 2020, SLACK Incorporated.There has been increasing focus on improving the quality and safety of health care globally. Understanding that the health of one nation impacts others worldwide drives initiatives for collaboration to improve the health of all. In this, the Year of the Nurse and Midwife as designated by the World Health Organization, The Quality and Safety Education for Nurses (QSEN) Competencies provide structure that transcends culture for framing the nursing role to contribute to improving patient safety and the quality of care delivery internationally. This article describes initiatives to share resources and strategies to support quality and safety education and practice with nurses across countries. [J Contin Educ Nurs. 2020;51(3)106-108.]. Copyright 2020, SLACK Incorporated.Associations come and go, as do their brands, missions, and visions. Nursing has many associations and affiliated groups because the profession is diverse, complex, and collaborative. Engagement in professional organizations is a critical contribution to career and leadership development. The organization formerly known as the Council on Graduate Education for Administration in Nursing has been functioning for nearly 50 years, but its new brand-Association for Leadership Science in Nursing-and mission bring a fresh and compelling value proposition. [J Contin Educ Nurs. 2020;51(3)104-105.]. Copyright 2020, SLACK Incorporated.Plenary panel planning and implementation, carried out by temporary teams, are described for nursing organizations and professional development across settings. The conference or meeting theme and objectives frame panel member selection and moderator focus. Panelist conversations highlight different career trajectories and connect with attendees. [J Contin Educ Nurs. 2020;51(3)100-102.]. Copyright 2020, SLACK Incorporated.Sex chromosomes contribute substantially to key evolutionary processes such as speciation and adaptation. Several theories suggest that evolution could occur more rapidly on sex chromosomes, but currently our understanding of whether and how this occurs is limited. Here, we present an analysis of the great tit (Parus major) genome, aiming to detect signals of faster-Z evolution. We find mixed evidence of faster divergence on the Z chromosome than autosomes, with significantly higher divergence being found in ancestral repeats, but not at 4-fold or 0-fold degenerate sites. Interestingly, some 4-fold sites appear to be selectively constrained, which may mislead analyses that use these sites as the neutral reference (e.g., dN/dS). Consistent with other studies in birds, the mutation rate is significantly higher in males than females, and the long-term Z-to-autosome effective population size ratio is only 0.5, significantly lower than the expected value of 0.75. These are indicative of male-driven evolution and high variance in male reproductive success, respectively. We find no evidence for an increased efficacy of positive selection on the Z chromosome. In contrast, the Z chromosome in great tits appears to be affected by increased genetic drift, which has led to detectable signals of weakened intensity of purifying selection. These results provide further evidence that the Z chromosome often has a low effective population size, and that this has important consequences for its evolution. They also highlight the importance of considering multiple factors that can affect the rate of evolution and effective population sizes of sex chromosomes. © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.CONTEXT/OBJECTIVE In insulin resistant subjects, hyperinsulinemia is a key compensatory mechanism, aimed at maintaining glucose homeostasis. Increased secretion and reduced clearance of insulin may both potentially contribute to this phenomenon. Insulin resistance and hyperinsulinemia are common findings in women with polycystic ovary syndrome (PCOS). While there is some information on insulin secretion, very few studies have investigated metabolic clearance rate of insulin (MCRI) in these women. Moreover, there is paucity of data on the relationships between MCRI and the pathophysiological characteristics of PCOS. The aim of the study was to explore these issues. PATIENTS One hundred and ninety women with PCOS, diagnosed according to the Rotterdam criteria, with normal glucose tolerance. DESIGN Assessment of MCRI and clinical, hormonal and metabolic characteristics of subjects. MCRI and insulin sensitivity were measured by the hyperinsulinemic euglycemic clamp. Serum androgens were assessed by liquid chromatography-mass spectrometry and equilibrium dialysis. A historical sample of healthy women was used to define the corresponding reference intervals. RESULTS MCRI was impaired in about two thirds of women with PCOS. Subjects with low MCRI differed from those with normal MCRI for a number of anthropometric, metabolic and endocrine features. In multivariate analysis, degree of adiposity, estimates of insulin secretion and serum androgen concentrations were independent predictors of MCRI. Conversely, age, adiposity, MCRI and insulin sensitivity, but not serum androgens, were independent predictors of insulin secretion. CONCLUSIONS In women with PCOS metabolic clearance of insulin is reduced, contributing to generating hyperinsulinemia. Serum androgens are independent predictors of this phenomenon. https://www.selleckchem.com/products/ly3023414.html © Endocrine Society 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.Importance In response to the national opioid public health crisis, there is an urgent need to develop nonopioid solutions for effective pain management. Neurosteroids are endogenous molecules with pleotropic actions that show promise for safe and effective treatment of chronic low back pain. Objective To determine whether adjunctive pregnenolone has therapeutic utility for the treatment of chronic low back pain in Iraq- and Afghanistan-era US military veterans. Design, Setting, and Participants Randomized, double-blind, placebo-controlled clinical trial that enrolled for 42 months, from September 2013 to April 2017. Participants were Iraq- and Afghanistan-era veterans aged 18 to 65 years with chronic low back pain who received treatment in the Durham VA Health Care System in Durham, North Carolina, over 6 weeks. Data analysis began in 2018 and was finalized in March, 2019. Interventions Following a 1-week placebo lead-in, participants were randomized to pregnenolone or placebo for 4 weeks. Pregnenolone and placebo were administered at fixed, escalating doses of 100 mg for 1 week, 300 mg for 1 week, and 500 mg for 2 weeks.