bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wet canopy photosynthesis in a temperate Japanese cypress forest
Authors: Jiao Linjie , Kosugi Yoshiko , Sakabe Ayaka , Sempuku Yuichi , Chang Ting-Wei , Chen Siyu 
Published: April 2024

Abstract
This study aimed to reveal the mechanism and significance of wet canopy photosynthesis during and after rainfall in temperate coniferous ecosystems by evaluating the influence of abaxial leaf interception on wet canopy photosynthesis. We used the eddy covariance method in conjunction with an enclosed-path gas analyser to conduct continuous ecosystem CO2 flux observations in a Japanese cypress forest within the temperate Asian monsoon area over 3 years. The observation shows that wet-canopy CO2 uptake predominantly occurred during the post-rainfall canopy-wet period rather than the during-rainfall period. Then, the measured canopy-wet net ecosystem exchange was compared with the soil–vegetation–atmosphere transfer multilayer model simulations under different parameter settings of the abaxial (lower) leaf surface wet area ratio. The multilayer model predicted net ecosystem exchange most accurately when it assumed the wet area ratio of the abaxial surface was 50% both during and after rainfall. For the wet canopy both during and after rainfall, the model overestimated CO2 uptake when it assumed no abaxial interception in the simulation, but underestimated CO2 uptake when it assumed that the entire abaxial leaf surface was wet. These results suggest that the abaxial surface of the Japanese cypress leaf is only partly wet to maintain stomatal openness and a low level of photosynthesis. These results allow for an evaluation of the effect of rainfall on forest carbon circulation under a changing climate, facilitating an improvement of ecosystem carbon exchange models.
Zinc and manganese homeostasis closely interact in mammalian cells
Authors: Nishito Yukina , Kamimura Yoshiki , Nagamatsu Shino , Yamamoto Nao , Yasui Hiroyuki , Kambe Taiho 
Published: April 2024

AbstractUnderstanding the homeostatic interactions among essential trace metals is important for explaining their roles in cellular systems. Recent studies in vertebrates suggest that cellular Mn metabolism is related to Zn metabolism in multifarious cellular processes. However, the underlying mechanism remains unclear. In this study, we examined the changes in the expression of proteins involved in cellular Zn and/or Mn homeostatic control and measured the Mn as well as Zn contents and Zn enzyme activities to elucidate the effects of Mn and Zn homeostasis on each other. Mn treatment decreased the expression of the Zn homeostatic proteins metallothionein (MT) and ZNT1 and reduced Zn enzyme activities, which were attributed to the decreased Zn content. Moreover, loss of Mn efflux transport protein decreased MT and ZNT1 expression and Zn enzyme activity without changing extracellular Mn content. This reduction was not observed when supplementing with the same Cu concentrations and in cells lacking Cu efflux proteins. Furthermore, cellular Zn homeostasis was oppositely regulated in cells expressing Zn and Mn importer ZIP8, depending on whether Zn or Mn concentration was elevated in the extracellular milieu. Our results provide novel insights into the intricate interactions between Mn and Zn homeostasis in mammalian cells and facilitate our understanding of the physiopathology of Mn, which may lead to the development of treatment strategies for Mn‐related diseases in the future.
Acute liver failure
Authors: Beck James , Bolina Jasleen K. , Boyd Lisa H. 
Published: April 2024

ABSTRACT
Acute liver failure, commonly caused by acetaminophen overdose, is associated with numerous systemic complications including cerebral edema, hypotension, acute kidney injury, and infection. Management is primarily supportive, with an emphasis on excellent neurocritical care. Although some antidotes and targeted treatments exist, the only definitive treatment remains orthotopic liver transplant.
Gendered racial microaggressions and stress in PAs who are Black women
Authors: Lotson Fallon , Gathers Quinetra S. , Gordon A'yana C. , Litton Allison G. 
Published: April 2024

ABSTRACT

Objective:
This mixed-methods study explored whether physician associates/assistants (PAs) who are Black women (for brevity, called Black women PAs throughout this article) experience gendered racial microaggressions and whether these experiences correlated with psychologic distress. The phrase Black women encompasses those who identify with the sociocultural roles, behaviors, and expressions of being a Black woman.

Methods:
We conducted an online survey of Black women PAs using the Gendered Racial Microaggressions Scale during a 2-month period in 2019.

Results:
Black women PAs experienced gendered racial microaggressions in clinical settings. Gendered racial microaggressions were correlated with stress, being silenced and marginalized, and assumptions of beauty and sexual objectification. No correlations were found between stress and the angry Black woman and strong Black woman variables.

Conclusions:
This study revealed that Black women have interlocking forms of oppression related to their race and gender, which are associated with psychologic distress. Awareness of these occurrences can reduce the unknowing perpetuation of gendered racial microaggressions and create cultural awareness practices.
Career flexibility for PAs
Authors: Ward-Lev Eliana , Kuriakose Clair , Navoa Jesus (Jay) , Halley Meghan 
Published: April 2024

ABSTRACT
Switching specialties is common among physician associates/assistants (PAs) and important in combating burnout. Despite this, little is known about the PA experience with switching specialties. This study sought to identify factors associated with successfully switching specialties using semistructured interviews with PAs and hiring managers. Participants reported that switching specialties was initially challenging for managers and PAs because of insufficient onboarding and unrealistic expectations, but they also reported that they were generally satisfied with long-term outcomes. Our findings suggest that PAs hoping to switch specialties may want to focus on building a professional network, identifying areas where they can highlight relevant experience, and demonstrating their intent to remain in that role. Hiring managers could benefit from considering their hiring practices and tailoring onboarding expectations for new hires.
Original Research: Exploring U.S. Nurses' Perceived Duty to Care During the COVID-19 Pandemic
Authors: Sutherland Jodi , Collier Rosemary , Si Bing , Alramadeen Wesam , Palmer Deborah 
Published: April 2024

ABSTRACT

Background:
Duty to care is both an integral concept in health care and a fundamental nursing obligation. But nurses' perceptions of duty to care can be moderated by their experiences in the practice setting. Research examining nurses' perceptions of their duty to care during the COVID-19 pandemic could shed light on how the pandemic is affecting the nursing workforce.

Purpose:
This study aimed to examine nurses' sense of duty to care during the early months of the pandemic, using the Nash Duty to Care Scale (NDCS), and to compare the high-scoring nurses with the low-scoring nurses.

Methods:
This quantitative study used a descriptive, cross-sectional design. It was conducted among licensed RNs enrolled at two accredited nursing programs in the Northeast region of the United States. Data were collected via a demographics questionnaire and the NDCS. A two-step cluster procedure was used to categorize participants into two groups: those with high perceived duty to care (HPDC) and those with low perceived duty to care (LPDC). Independent t tests were performed to compare NDCS results between the two groups.

Results:
Nearly two-thirds (61%) of the participants had total NDCS scores indicating an HPDC, while 39% had scores indicating an LPDC. Of the NDCS's four subscales, perceived obligation and perceived risk were the most important in separating participants into the low- and high-scoring groups.

Conclusions:
This study adds to the literature about the components that affected nurses' perceived duty to care and willingness to report to work during the early months of the pandemic. Just as nurses have a duty to care, health care organizations have an obligation to provide a safe working environment so that nurses can fulfill that duty without sacrificing personal safety. The study findings may guide health care leaders, systems, and organizations regarding how to create safer work environments that support the nurse's duty to care during disasters.
Prevalence of Low or Very Low Food Security in Undergraduate Nursing Students
Authors: Rinaldi Kailey , Aul Karen , Phillips Amelia 
Published: April 2024

Abstract
Food insecurity occurs when there is a lack of resources to obtain food. This study sought to identify the prevalence of food insecurity in baccalaureate nursing students. Data on demographics, perceived stress, food security, and food access were collected using a survey from 201 baccalaureate nursing students. Nearly 43 percent of students reported food insecurity within the last year. Students reporting food insecurity reported higher levels of perceived stress (p < .01). Findings support that food insecurity is prevalent in nursing students. An increase in awareness, assessment, and efforts to provide early interventions should be considered.
Implementation of an Innovative Learning Experience to Address Vaccine Hesitancy
Authors: Townsend Haley , Kaylor Sara , Johnson Paige 
Published: April 2024

Abstract
The COVID-19 pandemic and subsequent vaccine hesitancy highlighted the need for additional learning experiences for nursing students to address person-centered care and communication. This project aimed to employ a three-step service-learning experience consisting of town hall meetings, motivational interviewing training, and rural health fairs to address vaccine hesitancy in communities surrounding the college. Evaluation of the project revealed satisfaction and increased confidence among participating nursing students.
Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study
Authors: McGillion Michael H. , Borges Flavia K. , Conen David , Sessler Daniel I. , Coleman Brenda L. , Marcucci Maura , Ouellette Carley , Bird Marissa , Whitmore Carly , Henry Shaunattonie , Ofori Sandra , Pettit Shirley M. , Bedini Deborah M. , Gauthier Leslie P. , Lounsbury Jennifer , Carter Nancy M. , Tandon Vikas , Patel Ameen , Cafaro Teresa , Simunovic Marko R. , Harlock John A. , Heels-Ansdell Diane , Elias Fadi , Rapanos Theodore , Forbes Shawn , Peter Elizabeth , Watt-Watson Judy , Metcalfe Kelly , Carroll Sandra L. , Devereaux Philip J. 
Published: April 2024

Objective:
To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery.

Background:
Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability.

Methods:
We undertook an international (28 centers, 14 countries) prospective cohort study of a representative sample of adults ≥45 years of age who underwent noncardiac surgery. Risk factors for readmission were assessed using Cox regression (ClinicalTrials.gov, NCT00512109).

Results:
Of 36,657 eligible participants, 2744 (7.5%; 95% confidence interval [CI], 7.2–7.8) were readmitted within 30 days of discharge. Rates of readmission were highest in the first 7 days after discharge and declined over the follow-up period. Multivariable analyses demonstrated that 9 baseline characteristics (eg, cancer treatment in past 6 months; adjusted hazard ratio [HR], 1.44; 95% CI, 1.30–1.59), 5 baseline laboratory and physical measures (eg, estimated glomerular filtration rate or on dialysis; HR, 1.47; 95% CI, 1.24–1.75), 7 surgery types (eg, general surgery; HR, 1.86; 95% CI, 1.61–2.16), 5 index hospitalization events (eg, stroke; HR, 2.21; 95% CI, 1.24–3.94), and 3 other factors (eg, discharge to nursing home; HR, 1.61; 95% CI, 1.33–1.95) were associated with readmission.

Conclusions:
Readmission following noncardiac surgery is common (1 in 13 patients). We identified perioperative risk factors associated with 30-day readmission that can help frontline clinicians identify which patients are at the highest risk of readmission and target them for preventive measures.
Security Comparison of Various Surgical Knots Using Nylon Suture
Authors: Lim SooA , Lee Dong Yun , Doh GyeongHyeon , Seo YeongKwon , Lim ChiYeon , Yoon JungSoo , Eo SuRak 
Published: April 2024

ABSTRACTOBJECTIVETo evaluate the strengths of various surgical knot techniques, including square knot, surgeon’s knot, granny knot, and random knot with the same three throws.METHODSThe authors tested each of the four knot techniques using four different gauges of nylon (polyamide [Ethicon]): 4-0, 5-0, 6-0, and 7-0. Each knot type was tested 20 times per nylon gauge, for a total of 320 knots tested. The authors used a static pull machine to measure elongation at yield and maximal force to break.RESULTSA comparison of elongation at yield revealed that the surgeon’s knot was superior to the square knot, granny knot, and random knots across all gauges of nylons. Further, a comparison of maximal force to break revealed that the surgeon’s knot was superior to the square knot, granny knot, and random knots when using 4-0, 5-0, and 6-0 nylon but not when using 7-0 nylon.CONCLUSIONSThe surgeon’s knot was the strongest, and random knot was the weakest when the authors used nylon 4-0, 5-0, and 6-0. While handling fine suture materials such as 7-0 nylon, knot failure appears to be unrelated to the knot technique used. This study provides not only fundamental guidance for tying surgical knots using nylon, but also a rational basis for an adequately strong knot choice in various fields of surgery.
A Novel Bone-Screw-Fastener Demonstrates Greater Maximum Compression Force Prior to Failure Compared to a Traditional Buttress Screw.
Authors: Thorne Tyler , Featherall Joseph , O’Neill Dillon , Lisitano Leonard , Haller Justin 
Published: April 2024

Objectives:
This study compared the maximal compression force prior to thread stripping of the novel bone-screw-fastener (BSF) compared to the traditional-buttress-screw (TBS) in synthetic osteoporotic and cadaveric bone models.

Methods:
Maximum compression force of the plate-bone interface prior to loss of screw purchase during screw tightening was measured between self-tapping 3.5mm BSF and 3.5mm TBS using calibrated load cells. Three synthetic biomechanical models were used: a synthetic osteoporotic diaphysis (model 1); a 3-layer biomechanical polyurethane foam with 50-10-50 pounds-per-cubic-foot (PCF) layering (model 2), and a 3-layer polyurethane foam with 50-15-50 PCF layering (model 3). For the cadaveric metaphyseal model, three sets of cadaveric tibial plafonds and three sets of cadaveric tibial plateaus were used. A plate with sensors between the bone-plate interface was used to measure compression force during screw tightening in the synthetic bone models, while an annular load cell that measured screw compression as it slid through a guide was used to measure compression in the cadaver models.

Results:
Across all synthetic osteoporotic bone models, the BSF demonstrated greater maximal compression force prior to stripping compared to the TBS (model 1, 155.51N(SD=7.77N) vs 138.78N(SD=12.74N), p=0.036; model 2, 218.14N (SD=14.15N) vs 110.23N(SD=8.00N), p<0.001; model 3, 382.72N(SD=20.15) vs 341.09N(SD=15.57N), p=0.003. The BSF had greater maximal compression force for the overall cadaver trials, the tibial plafond trials, and the tibial plateau trials (overall, 111.27N vs 97.54N(SD 32.32N), p=0.002; plafond, 149.6N vs 132.92N(SD 31.32N), p=0.006; plateau 81.33N vs 69.89N(SD 33.38N), p=0.03.

Conclusion:
The novel bone-screw-fastener generated 11-65% greater maximal compression force than the traditional-buttress-screw in synthetic osteoporotic and cadaveric metaphyseal bone models. A greater compression force may increase construct stability, facilitate early weight bearing, and reduce construct failure.
ChatGPT Responses to Common Questions About Slipped Capital Femoral Epiphysis: A Reliable Resource for Parents?
Authors: Adelstein Jeremy M. , Sinkler Margaret A. , Li Lambert T. , Mistovich R. Justin 
Published: April 2024

Background:
We sought to evaluate the ability of ChatGPT, an AI-powered online chatbot, to answer frequently asked questions (FAQs) regarding slipped capital femoral epiphysis (SCFE).

Methods:
Seven FAQs regarding SCFE were presented to ChatGPT. Initial responses were recorded and compared with evidence-based literature and reputable online resources. Responses were subjectively rated as “excellent response requiring no further clarification,” “satisfactory response requiring minimal clarification,” “satisfactory response requiring moderate clarification,” or “unsatisfactory response requiring substantial clarification.”

Results:
ChatGPT was frequently able to provide satisfactory responses that required only minimal clarification. One response received an excellent rating and required no further clarification, while only 1 response from ChatGPT was rated unsatisfactory and required substantial clarification.

Conclusions:
ChatGPT is able to frequently provide satisfactory responses to FAQs regarding SCFE while appropriately reiterating the importance of always consulting a medical professional.
Comparison of Open Surgery Versus Minimally Invasive Surgery in Nonsevere Adult Degenerative Scoliosis
Authors: Shao Zhenxuan , Liang Haibo , Li Sunlong , Ye Zhaoming , Wang Xiangyang 
Published: April 2024

Study Design.
A systematic review and meta-analysis.

Objective.
This study aimed to evaluate the clinical efficacy of minimally invasive surgery (MIS) and open surgery in correcting ADS.

Summary of Background Data.
Adult degenerative scoliosis (ADS) is a scoliosis secondary to degenerative changes in the intervertebral discs and facet joints in adults. Severe low back pain, radicular pain, and intermittent claudication are often present and require surgical treatment.

Methods.
PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI) Database, Wanfang Data, Weipu Database, and China Biomedical Document Service System (CBM) were systematically searched for studies that focused on the clinical efficacy of minimally invasive surgery and open surgery to correct ADS.

Results.
This meta-analysis included 11 studies, involving 1527 patients (581 in the MIS group and 946 in the open surgery group). Regarding surgery and outcome indicators, the operative time in the open surgery group was shorter, the MIS group had less intraoperative blood loss, shorter hospitalization time, and lower incidence of serious postoperative complications. In terms of imaging parameters, although there was no significant difference in Cobb angle improvement and sagittal balance, the open surgery group exhibited better lumbar lordosis improvement and pelvic tilt improvement. In terms of clinical scores, including changes in the ODI index and VAS scores for low back and leg pain, similar improvements were appreciated across both groups.

Conclusions.
In mild to moderate ADS, we found that the advantages of open surgery include greater improvement in lumbar lordosis and pelvic tilt angle and shorter operative time. The advantages of minimally invasive surgery are less intraoperative blood loss, shorter hospital stay, and fewer serious postoperative complications. There is no significant difference between the 2 surgical methods in terms of Cobb angle, clinical pain, and sagittal vertical axis improvement.
Perceptions on Specialist Palliative Care Involvement During and After Cardiopulmonary Resuscitation: A Qualitative Study
Authors: Tenge Theresa , Schallenburger Manuela , Batzler Yann-Nicolas , Roth Sebastian , M´Pembele René , Stroda Alexandra , Böhm Lennert , Bernhard Michael , Jung Christian , Meier Stefan , Kindgen-Milles Detlef , Kienbaum Peter , Schwartz Jacqueline , Neukirchen Martin 
Published: April 2024

IMPORTANCE:
Cardiopulmonary resuscitation (CPR) is an exceptional physical situation and may lead to significant psychological, spiritual, and social distress in patients and their next of kin. Furthermore, clinicians might experience distress related to a CPR event. Specialist palliative care (sPC) integration could address these aspects but is not part of routine care.

OBJECTIVES:
This study aimed to explore perspectives on sPC integration during and after CPR. A needs assessment for sPC, possible triggers indicating need, and implementation strategies were addressed.

DESIGN, SETTING, AND PARTICIPANTS:
A multiprofessional qualitative semistructured focus group study was conducted in a German urban academic teaching hospital. Participants were clinicians (nursing staff, residents, and consultants) working in the emergency department and ICUs (internal medicine and surgical).

ANALYSIS:
The focus groups were recorded and subsequently transcribed. Data material was analyzed using the content-structuring content analysis according to Kuckartz.

RESULTS:
Seven focus groups with 18 participants in total were conducted online from July to November 2022. Six main categories (two to five subcategories) were identified: understanding (of palliative care and death), general CPR conditions (e.g., team, debriefing, and strains), prognosis (e.g., preexisting situation, use of extracorporeal support), next of kin (e.g., communication, presence during CPR), treatment plan (patient will and decision-making), and implementation of sPC (e.g., timing, trigger factors).

CONCLUSIONS:
Perceptions about the need for sPC to support during and after CPR depend on roles, areas of practice, and individual understanding of sPC. Although some participants perceive CPR itself as a trigger for sPC, others define, for example, pre-CPR-existing multimorbidity or complex family dynamics as possible triggers. Suggestions for implementation are multifaceted, especially communication by sPC is emphasized. Specific challenges of extracorporeal CPR need to be explored further. Overall, the focus groups show that the topic is considered relevant, and studies on outcomes are warranted.
Vaginal dysbiosis – the association with reproductive outcomes in IVF patients: a systematic review and meta-analysis
Authors: Maksimovic Celicanin Milica , Haahr Thor , Humaidan Peter , Skafte-Holm Axel 
Published: April 2024

Purpose of review
To examine impact of vaginal dysbiosis (VD), including bacterial vaginosis (BV) and aerobic vaginitis (AV) on reproductive outcomes of in vitro fertilization (IVF) patients.

Recent findings
BV-bacteria (e.g. Gardnerella) and AV-bacteria (e.g. Streptococci and Enterococci) have been identified in the endometrium. However, there is inconclusive evidence whether IVF patients with VD have lower success rates.

Summary
The present systematic review and meta-analysis of PubMed/Medline, until December 2023 included 25 studies, involving 6835 IVF patients. Overall VD was defined as an approximation of community state type IV, including BV and AV-type dysbiosis based on either molecular or microscopy methods. Outcomes were live birth rate (LBR), early pregnancy loss (EPL), clinical pregnancy rate (CPR), and biochemical pregnancy rate (BPR).
Vaginal dysbiosis prevalence was 19% [1271/6835, 95% confidence interval (CI) 18–20%]. Six studies examined AV-type dysbiosis with a prevalence of 4% (26/628, 95% CI 3–6%). Vaginal dysbiosis correlates with a higher EPL [relative risk (RR) = 1.49, 95% CI 1.15–1.94] and lower CPR (RR = 0.82, 95% CI 0.70–0.95). No statistically significant impact of VD, BV, or AV was found on LBR and BPR.
Thus, the association between VD and reproductive outcome remains puzzling as it is difficult to explain how VD impacts CPR and EPL but not LBR and BPR.