bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methane concentration in the heartwood of living trees in a cold temperate mountain forest: variation, transport and emission
Authors: Epron Daniel , Mochidome Takumi 
Published: September 2024

Abstract
Forest soils are the largest terrestrial sink of methane (CH4), but CH4 produced in tree trunks by methanogenic archaea and emitted into the atmosphere can significantly offset CH4 oxidation in the soil. However, our mechanistic understanding of CH4 accumulation in tree trunks, in relation to CH4 emission from the trunk surface, is still limited. We characterized temporal variations in the molar fraction of CH4 in the heartwood of trees ([CH4]HW) of four different species in a mountain forest and addressed the relationship between [CH4]HW and emission from the surface of the trunk (${F}_{CH_4}$), in connection with the characteristics of the wood. [CH4]HW measurements were made monthly for 15 months using gas-porous tubes permanently inserted into the trunk. [CH4]HW were above ambient CH4 molar fraction for all trees, lower than 100 p.p.m. for seven trees, higher for the nine other trees and greater than 200,000 p.p.m. (&gt;20%) for two of these nine trees. [CH4]HW varied monthly but were not primarily determined by trunk temperature. Heartwood diffusive resistance for CH4 was variable between trees, not only due to heartwood characteristics but probably also related to source location. ${F}_{CH_4}$were weakly correlated with [CH4]HW measured a few days after. The resulting apparent diffusion coefficient was also variable between trees suggesting variations in the size and location of the CH4 production sites as well as resistance to gas transport within the trunk. Our results highlight the challenges that must be overcome before CH4 emissions can be simulated at the tree level.
Complexity and Challenges of Cross-Cover Care in Graduate Medical Education: A Qualitative Study
Authors: Heidemann Lauren A. , Vinson Alexandra H. , Hughes David T. , McDermott Catherine , Hartley Sarah 
Published: September 2024

Abstract

Purpose
Cross-cover care (care for hospitalized patients when the primary team is absent) is a common graduate medical education responsibility; however, it may lead to increased preventable adverse events. Despite understanding the difficulties of cross-cover care, medical educators lack comprehensive knowledge of specific challenges that residents face and how they handle these challenges. This study explores the challenges residents experience when providing cross-cover care.

Method
The authors conducted 60 semistructured, qualitative interviews with 20 internal medicine and surgery residents at a single academic institution between October 2021 and April 2022. Each resident participated in 3 interviews, 2 immediately after a shift. Working inductively, the authors generated codes for important themes. Study design and data collection were guided by interpretive description, a qualitative approach for health care research focused on experiences and perceptions to develop meaningful findings. To illustrate residents’ workflow and aid in quality improvement efforts, the authors created a process map.

Results
Seventeen cross-cover challenges were organized into 7 interrelated and overlapping themes: lack of baseline knowledge, inadequate or inaccurate information transfer from the primary team, unfamiliarity with cross-cover patients, high task volume leading to increased interruptions, ill-defined roles leading to unmet expectations from others, perceived decreased access to resources, and fatigue. The process map illustrates 4 cross-cover workflow components: information transfer from the primary team to the cross-cover team, direct handling of cross-cover tasks that are assigned by the primary team or that arise during the time of cross-cover, information transfer back to primary team and other care team members, and responsibilities that residents have overnight that are not directly related to cross-cover.

Conclusions
Residents face substantial challenges when providing cross-cover care, which have important implications for patient safety and resident well-being. The medical community should strive to develop educational and structural interventions to improve this process.
Medial Patellofemoral Ligament Reconstruction Improves Patella Alta
Authors: Yang Daniel Z. , Orellana Kevin , Houlihan Nathan V. , Lee Julianna , Carter Michael V. , Ganley Theodore J. , Lawrence J. Todd R. , Williams Brendan A. , Maguire Kathleen J. 
Published: September 2024

Background:
Patellofemoral instability (PFI) is a common problem with various anatomic risk factors identified, including patella alta as one of the most powerful predictors. Given that the medial patellofemoral ligament (MPFL) is the primary soft tissue stabilizer of the patella, a common procedure to treat recurrent patellar instability is MPFL reconstruction. The aim of this study is to examine the relationship between MPFL reconstruction and patellar height. We hypothesize that after reconstruction, patellar instability patients would have demonstrable reduction in patella height and patella alta correction.

Methods:
Patient records were queried for patients who underwent MPFL reconstruction for recurrent patellar instability. Patient and operative demographics were collected. We measured Insall-Salvati ratio (ISR), Caton Deschamps index (CDI), and Blackburne-Peel ratio (BPR) in all patients at various time points. The height indices were compared across the preoperative, immediately postoperative, and 6-month time points in a pairwise fashion using paired-sample t-tests. Further subgroup analysis of patients (n=27) with elevated preoperative Caton Deschamps Index (defined as >1.3) was completed.

Results:
The final cohort was 103 patients. There was a significant difference between pre- and postoperative ISR (P<0.001) and at 6-month follow up (P<0.001), between preoperative CDI and the 6-month follow-up (P<0.0010), and between the postoperative and preoperative CDI (P<0.001). There was also a difference between preoperative and postoperative BPR (P<0.001), as well as between the preoperative and 6-month follow-up BPR (P=0.002). Twenty-seven patients had an initial CDI greater than 1.3. Differences were observed between pre- and postoperative mean CDI (P=0.001) and at 6-month follow-up (P=0.006), between both postoperative and 6-month ISR (both P<0.001), and preoperative mean BPR and the postoperative (P=0.004) and 6-month mean BPR (P=0.027).

Conclusions:
Patients with pre-existing patella alta and recurrent patella dislocations who undergo isolated MPFL reconstruction have decreased patella alta at their 6-month follow-up as measured by ISR, CDI, and BPR. Patients without patella alta do not demonstrate statistically significant differences after their MPFL reconstruction.

Level of Evidence:
III (retrospective comparative study)
Lessons Learned From Moving to Living Guidelines—The Canadian Clinical Practice Guideline for the Rehabilitation of Adults With Moderate-to-Severe TBI
Authors: Patsakos Eleni M. , Kua Ailene , Gargaro Judith , Yaroslavtseva Olga , Teasell Robert , Janzen Shannon , Harnett Amber , Bennett Phoebe , Bayley Mark 
Published: September 2024

Objective:
It is often challenging for providers to remain up to date with best practices gleaned from clinical research. Consequently, patients may receive inappropriate, suboptimal, and costly care. Living clinical practice guidelines (CPGs) maintain the methodological rigor of traditional CPGs but are continuously updated in response to new research findings, changes in clinical practice, and emerging evidence. The objective of this initiative was to discuss the lessons learned from the transformation of the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Traumatic Brain Injury (CAN-TBI) from a traditional guideline update model to a living guideline model.

Design:
The CAN-TBI Guideline provides evidence-based rehabilitative care recommendations for individuals who have sustained a TBI. The Guideline is divided into 2 sections: Section I, which provides guidance on the components of the optimal TBI rehabilitation system, and Section II, which focuses on the assessment and rehabilitation of brain injury sequelae. A comprehensive outline of the living guideline process is presented.

Results:
The CAN-TBI living guideline process has yielded 351 recommendations organized within 21 domains. Currently, 30 recommendations are supported by level A evidence, 81 recommendations are supported by level B evidence, and 240 consensus-based recommendations (level C evidence) comprise 68% of the CAN-TBI Guideline.

Conclusion:
Given the increasing volume of research published on moderate-to-severe TBI rehabilitation, the CAN-TBI living guideline process allows for real-time integration of emerging evidence in response to the fastest-growing topics, ensuring that practitioners have access to the most current and relevant recommendations.
FACTORS DEFINING DENSITY OF RETINAL MACROPHAGE-LIKE CELLS DISPLAYED WITH OPTICAL COHERENCE TOMOGRAPHY
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Gorlova Arina S. , Vasiliev Alexander S. 
Published: September 2024

Purpose:
To study the factors that define the density of macrophage-like cells (MLC) of the inner retinal surface in healthy eyes.

Methods:
Healthy individuals, including candidates for laser in situ keratomileusis surgery, and post–laser in situ keratomileusis patients were included. Density of MLC was calculated using structural en face projections of optical coherence tomography angiography scans. The status of the vitreoretinal interface was assessed as the distance from the inner limiting membrane to the posterior hyaloid membrane on cross-sectional scans and as the area of tight posterior vitreous adhesion on en face projections. The correlation between MLC density and various demographic and anatomical parameters, including the status of the vitreoretinal interface, was calculated.

Results:
Fifty-four healthy individuals, 30 post–laser in situ keratomileusis patients all without posterior vitreous detachment, and 20 patients with partial posterior vitreous detachment were included. Density of MLC showed a statistically significant correlation with axial length, refractive error, age, subfoveal choroidal thickness, and the status of the vitreoretinal interface (P < 0.05) in eyes without posterior vitreous detachment. In multiple regression analysis, the axial length was the main parameter independently correlated with MLC density (P = 0.025). The status of the vitreoretinal interface had a statistically significant correlation with the axial length (P < 0.001). Partial posterior vitreous detachment was associated with almost complete loss of MLC (P < 0.001).

Conclusion:
The status of the vitreoretinal interface is a characteristic directly defining the density of retinal MLC in healthy eyes. However, axial length seems to be a key anatomical parameter that correlates with MLC density because of its effects on the adhesion of the posterior hyaloid membrane to the retinal surface.
The evaluation of postoperative exocrine pancreatic insufficiency in patients with benign and low-malignant pancreatic tumor: A multicenter, prospective, observational study
Authors: Zhang Jingcheng , Wang Jingqiao , Wang Yutong , Wang Huaizhi , Jiang Kuirong , Qiu Yudong , Yuan Chunhui , Lou Wenhui , Tao Jing , Wu Wenming 
Published: September 2024

Objectives:
We assess the incidence of exocrine pancreatic insufficiency (EPI) at different time points after pancreatic surgery and explore pancreatic enzyme replacement therapy's (PERT) efficacy.

Background:
EPI is characterized by inadequate pancreatic enzymes, resulting in maldigestion and abdominal symptoms. EPI is a common postoperative complication of pancreatic surgery, yet often overlooked by surgeons. There is no clear answer to when EPI occurs after pancreatic surgery nor the duration of PERT after partial pancreatectomy.

Methods:
Benign or borderline pancreatic tumor patients undergoing surgeries were recruited between December 2020 and November 2021 from 10 medical centers in China. The EPI Questionnaire (EPI-Q) was performed at discharge, and 3-, 6-, 9-, and 12-month follow-ups to evaluate the occurrence of EPI. Statistical analyses were performed to identify the occurrence of EPI and explore PERT's efficacy.

Results:
Of the 146 patients, 105 (71.9%) were female, and the median age was 49 (range 16-78 yrs). Symptoms of EPI patients were most pronounced within 3 months post-surgery (15.7%), while most patients recovered after 1 year (96.9%). There was a negative correlation between symptom score and time since surgery. Lack of PERT in the 3-month post-surgery was associated with higher symptom scores in pancreatoduodenectomy (PD) patients, while not in distal pancreatectomy (DP) patients.

Conclusions:
Generally, the high-occurrence period for postoperative EPI is within 3 months after resection in patients with benign or borderline pancreatic tumors, and most will gradually recuperate with time. PERT can improve symptoms in PD patients, while reduced PERT duration may be considered for DP patients.
Diagnostic value of biochemical markers in prediction of perforation in acute appendicitis: a cross-sectional study
Authors: Basukala Sunil , Gurung Suman , Tamang Ayush , Shrestha Oshan , Devkota Manu , Thapa Niranjan , Pathak Bishnu Deep , Mehta Kshitij , Bhattarai Arabinda Mohan 
Published: September 2024

Background:
Acute appendicitis, despite being the most common surgery, can result in increased morbidity and mortality in the case of perforated appendicitis. Identifying a perforation early can reduce the impact on the patient. Bilirubin, C-reactive protein (CRP), and white blood cell (WBC) count have been shown to indicate perforation in appendicitis.

Methods:
A cross-sectional analytical study was conducted to observe the association between preoperative bilirubin, CRP, and white cell count with the histological findings of either the presence or absence of perforation of the appendix. The eligibility criteria included all patients above 18 years with appendicitis who were managed surgically in the study hospital, Shree Birendra Hosptial, between 1 December 2021 to 30 May 2022. The study was conducted after the approval from the ethics committee.

Results:
Out of 150 patients, 112 had open surgery and 38 underwent laparoscopic appendectomy. One hundred thirty-four had non-perforated appendix and 16 cases had perforated appendix. The older age group was associated with appendiceal perforation more than the younger age group. Patients with a duration of symptoms less than 24 h and more than 72 h developed perforated appendicitis less frequently. The odds of encountering perforated appendicitis increased by 2.644 times per 0.972 rise in total bilirubin (P= 0.004) and the odds of encountering perforated appendicitis increased by 6.474 times per 1.868 rise in conjugated bilirubin (P= 0.003). There was no significant difference in total leucocyte count and neutrophil percentage among perforated and non-perforated groups.

Conclusion:
The diagnostic value of the CRP, total bilirubin, and conjugated bilirubin levels was strong and significant when used in combination rather than their individual performance in the diagnosis of perforated acute appendicitis.
Prediction of the outcome of intracerebral hemorrhage by blood neutrophil to lymphocyte ratio: a prospective observational study
Authors: Shrestha Gyaneswhor , Gurung Ashim , Sedhain Gopal , Bajpai Swmaya , Hamal Aliza , Verma Rupesh , Bashyal Bibhav , Shrestha Aakriti , Dhakal Bishal , Shrestha Aayushi , Acharya Roshan , Neupane Ashish , Bhandari Shiva 
Published: September 2024

Introduction:
Intracerebral haemorrhage (ICH) is defined as bleeding within the brain parenchyma. Neutrophil lymphocyte ratio (NLR) is a dynamic parameter that can be affected by an underlying condition like microangiopathy (e.g. hemorrhagic stroke). The NLR value at the time of stress (e.g. ICH) could be a predictor among various other factors on the outcome of the disease. The aim of this study is to see if NLR could be a predictor of the outcome of the ICH.

Methods:
This is a prospective observational study conducted in the Department of Neurosurgery and Department of Neurology, from March 2020 to February 2021. The ICH cases presented to the emergency department within 24 h of symptoms were included. The baseline haematological and biochemical investigations were sent and the noncontrast computed tomography (NCCT) head was done for the diagnosis of ICH. The NLR was measured. The ICH volume was calculated by ABC/2. Follow-up of the patient to measure outcome was done with a modified Rankin scale (mRS) on 30 days. Student’s t-test was used to correlate NLR-mRS. Fischer’s exact test was used for a categorical association of NLR to mRS.

Results:
A total of 89 patients with ICH were enrolled in this study. In this study, 62.92% of patients had good outcomes (NLR of 4.88±3.06), whereas 37.08% of patients had bad outcomes (NLR of 9.09± 4.92). Statistically, higher NLR was significantly predictive of poorer outcomes.

Conclusions:
ICH causes stress in the body, which alters the value of NLR. Components of NLR are altered after haemorrhage due to a change in homeostasis of brain parenchyma. The NLR value obtained at the time of emergency department visits may help to predict the 30 days outcome of ICH.
Changes of the Buccal Fat Pad Volume According to the Different Age Groups, Gender, and Body Mass Index: An Evaluation With Computed Tomography
Authors: Akşamoğlu Melih , Bayar Muluk Nuray , Şahan Mehmet Hamdi 
Published: September 2024

Objectives
We investigated volumetric changes in buccal fat pad (BFP) in age groups and sexes by cranial or neck computed tomography (CT) or cranial CT angiography.

Methods
One hundred twenty patients underwent cranial or neck CT examinations or cranial CT angiography were retrospectively screened: 18–29 years old (group 1), 30–49 years old (group 2), and 50 years and older (group 3). Left buccal fat tissue measurements were performed in age groups, sexes, and body mass index (BMI) groups.

Results
Left buccal fat volume in the 30–49 age group and the ≥50 age group was significantly higher than that in the 18–29 age group (P < 0.05). Across all groups and specifically within the 18–29 age group, females exhibited significantly lower buccal fat volume than males (P < 0.05). The left buccal fat volume of individuals classified as overweight and obese was significantly higher than that of the underweight and normal weight groups. There was a negative relationship between buccal fat volume and fat density. Moreover, as age increased, within age groups 1 to 3, there was a notable increase in body weight, body length, BMI, and BMI groups (underweight and normal weight to obesity), accompanied by a significant rise in buccal fat volume. Conversely, fat density exhibited a significant decrease with advancing age.

Conclusions
Buccal fat volume, localized in the middle third of the face, increased with aging and increasing BMI values. Young females had lower buccal fat volume. Buccal fat tissue volume is important in facial rejuvenation procedures such as facial filler applications.
Evaluation of Pericoronary Fat Attenuation Index to Better Identify Culprit Lesions in Acute Coronary Syndrome According to Stenosis Severity
Authors: Li Lili , Tang Jia , Fang Pinyan , Sun YuLin , Gao Yanan , Qi Hanxiong , Liu Bing , Zhang Jiwang , Fan Lijuan 
Published: September 2024

Objective
To investigate the incremental value of pericoronary fat attenuation index (FAI) in routine coronary artery computed tomography angiography (CCTA) to identify culprit lesions in acute coronary syndrome (ACS).

Methods
We reviewed the CCTA data from 80 ACS patients and 40 individuals with stable coronary atherosclerosis. ACS patient plaques were categorized into culprit and nonculprit groups. The plaque-specific pericoronary FAI was assessed using the Perivascular Fat Analysis Tool. We applied a default prespecified window of −190 to −30 Hounsfield units (HU) and a broader prespecified window of −190 to 20 HU. FAI values within these prespecified windows and the types and severity of plaque stenosis were compared across the 3 groups. Additionally, we investigated high-risk characteristics of plaques in the ACS group and their correlation with FAI. The effectiveness and worthiness of FAI in identifying culprit lesions were analyzed based on the receiver operating characteristic curve.

Results
The FAI values under the 2 prespecified windows were higher in the culprit group than in the nonculprit and control groups (all P < 0.001). The culprit group showed the most mixed plaques and the most severe stenosis (all P < 0.001). In the ACS group, the FAI value was significantly lower around calcified lesions (−85.00 ± 9.97 HU) than around noncalcified (−78.00 ± 11.52 HU) and mixed plaques (−78.00 ± 9.24 HU) (both P < 0.001). The culprit group had more high-risk plaques, and high-risk plaques had higher FAI values than those without high-risk characteristics (−70.00 ± 7.67 HU vs −82.00 ± 10.16 HU, P < 0.001). The efficacy of FAI under the default prespecified window in identifying culprit lesions was higher compared than that under the broader prespecified window (area under the curve = 0.799 vs 0.761, P = 0.042), and the diagnostic cutoff values were −77 versus −58 HU. The FAI under the default prespecified window exhibited an incremental value for identifying culprit lesions, as compared with stenosis severity (area under the curve = 0.970 vs 0.939, P < 0.001).

Conclusion
The culprit lesions have higher FAI than the nonculprit lesions and the controls. FAI is a worthy parameter for identifying culprit lesions in routine CCTA according to stenosis severity, and the default prespecified window is a better option.
A Scopus-Based Bibliometric Analysis of the Journal of Craniofacial Surgery From 1990 to 2023
Authors: Durna Yusuf Muhammed , Tekin Mustafa Said , Duymaz Yaşar Kemal , Bahşi İlhan 
Published: September 2024

Objectives:
This study aims to conduct a Scopus-based bibliometric analysis of the studies published in the Journal of Craniofacial Surgery, which has a very important place in its field.

Methods:
In this bibliometric study, all articles in the Journal of Craniofacial Surgery in the Scopus database on 7 July 2024 were listed. The information of the listed articles was exported in CSV file format. When exporting these articles, the citation information, bibliographic information, abstract and keywords, funding details, and other information options were all selected. These exported CSV data were analyzed with VOSviewer software (version 1.6.18).

Results:
The bibliometric analysis of the Journal of Craniofacial Surgery from 1990 to 2023 included 15,271 articles listed in the Scopus database. The majority (84.7%) of these articles were original studies. The top 5 countries with the highest number of publications were the United States (4004 articles), Turkey (2124 articles), China (2111 articles), South Korea (1597 articles), and Italy (1109 articles).

Conclusion:
This comprehensive bibliometric analysis demonstrates the Journal of Craniofacial Surgery’s increasing prominence and impact in the field over the years. The diverse international contributions highlight the journal’s role in fostering global collaboration and knowledge dissemination in craniofacial and maxillofacial research. While the use of a single database (Scopus) is a limitation, the study provides a detailed overview of the journal’s scholarly contributions, influential authors, and publication trends. These findings underscore the journal’s pivotal position in advancing craniofacial surgery research and education.