bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental reduction of a primary nest predator fails to decrease nest predation rates of sagebrush songbirds
Authors: Rhea Ashleigh M , Chalfoun Anna D 
Published: September 2023

Abstract
Predator removal comprises one management strategy to increase the reproductive success of a prey species of concern, particularly within human-altered landscapes. The efficacy of such an approach, however, depends partly on the extent to which predation risk is additive or compensatory, which remains unknown for many systems. We experimentally reduced the local abundance of deer mice (Peromyscus maniculatus), a primary nest predator of three sagebrush-obligate songbirds—Brewer’s Sparrow (Spizella breweri), Sagebrush Sparrow (Artemisiospiza nevadensis), and Sage Thrasher (Oreoscoptus montanus)—during May to August 2019 in western Wyoming, USA, to assess whether nest predation risk was additive or compensatory, and whether nest predator removal could comprise a potentially effective management tool. Deer mouse removal did not affect the daily nest survival of songbirds between experimental and control plots, despite a reduction of 68%–85% in deer mouse abundance within treatment areas. Therefore, nest predation in this system likely operated in a compensatory way, in which deer mice that escaped removal, new immigrants, or other species of nest predator maintained similar levels of nest predation risk regardless of the prevalence of a primary predator. We caution that predator removal may not be an effective management tool in systems that lack barriers to predator immigration or have several alternative species of predators, even when a single species typically is responsible for the majority of predation events.
Soil–root interface hydraulic conductance determines responses of photosynthesis to drought in rice and wheat
Authors: Yang Yuhan , Ma Xiaolin , Yan Lu , Li Yingchao , Wei Suhan , Teng Zhipeng , Zhang Hong , Tang Wei , Peng Shaobing , Li Yong 
Published: September 2023

Abstract
Rice (Oryza sativa) production consumes a huge amount of fresh water, and improvement of drought tolerance in rice is important to conserve water resources and minimize yield loss under drought. However, processes to improve drought tolerance in rice have not been fully explored, and a comparative study between rice and wheat (Triticum aestivum) is an effective method to understand the mechanisms determining drought tolerance capacity. In the present study, we applied short-term drought stress to Shanyou 63 rice and Yannong 19 wheat to create a range of water potentials and investigated the responses of gas exchange, plant hydraulic conductance, and root morphological and anatomical traits to soil drought. We found that photosynthesis in rice was more sensitive to drought stress than that in wheat, which was related to differences in the decline of stomatal conductance and plant hydraulic conductance (Kplant). The decline of Kplant under drought was mainly driven by the decrease of soil–root interface hydraulic conductance (Ki) because Ki was more sensitive to drought than root and shoot hydraulic conductance and the soil–root interface contributed to &gt;40% of whole-plant hydraulic resistance in both crops. Root shrinkage in response to drought was more severe in rice than that in wheat, which explains the larger depression of Ki and Kplant under drought stress in rice. We concluded that the decline of Ki drives the depression of Kplant and photosynthesis in both crops, and the plasticity of root morphology and anatomy is important in determining drought tolerance capacity.
Validation of a Simulation-Based Resuscitation Curriculum for Maternal Cardiac Arrest
Authors: Shields Andrea D. , Vidosh Jacqueline , Thomson Brook A. , Minard Charles , Annis-Brayne Kristen , Kavanagh Laurie , Roth Cheryl K. , Lutgendorf Monica A. , Rahm Stephen J. , Becker Les R. , Mosesso Vincent N. , Schaeffer Brian , Gresens Andrea , Epley Sondie , Wagner Richard , Streitz Matthew J. , Bhalala Utpal S. , Melvin Lissa M. , Deering Shad , Nielsen Peter E. 
Published: September 2023

OBJECTIVE:
To assess the knowledge, skills, and self-efficacy of health care participants completing a simulation-based blended learning training curriculum on managing maternal medical emergencies and maternal cardiac arrest (Obstetric Life Support).

METHODS:
A formative assessment of the Obstetric Life Support curriculum was performed with a prehospital cohort comprising emergency medical services professionals and a hospital-based cohort comprising health care professionals who work primarily in hospital or urgent care settings and respond to maternal medical emergencies. The training consisted of self-guided precourse work and an instructor-led simulation course using a customized low-fidelity simulator. Baseline and postcourse assessments included multiple-choice cognitive test, self-efficacy questionnaire, and graded Megacode assessment of the team leader. Megacode scores and pass rates were analyzed descriptively. Pre– and post–self-confidence assessments were compared with an exact binomial test, and cognitive scores were compared with generalized linear mixed models.

RESULTS:
The training was offered to 88 participants between December 2019 and November 2021. Eighty-five participants consented to participation; 77 participants completed the training over eight sessions. At baseline, fewer than half of participants were able to achieve a passing score on the cognitive assessment as determined by the expert panel. After the course, mean cognitive assessment scores improved by 13 points, from 69.4% at baseline to 82.4% after the course (95% CI 10.9–15.1, P<.001). Megacode scores averaged 90.7±6.4%. The Megacode pass rate was 96.1%. There were significant improvements in participant self-efficacy, and the majority of participants (92.6%) agreed or strongly agreed that the course met its educational objectives.

CONCLUSION:
After completing a simulation-based blended learning program focused on managing maternal cardiac arrest using a customized low-fidelity simulator, most participants achieved a defensible passing Megacode score and significantly improved their knowledge, skills, and self-efficacy.
Human Papillomavirus Detectability and Cervical Cancer Prognosis
Authors: Volesky-Avellaneda Karena D. , Laurie Cassandra , Tsyruk-Romano Olga , El-Zein Mariam , Franco Eduardo L. 
Published: September 2023

OBJECTIVE:
To evaluate whether testing positive for human papillomavirus (HPV) before treatment is associated with cervical cancer recurrence and disease-free, cancer-specific, and overall survival and to report the relationship of HPV to cervical cancer histology, stage, grade, tumor size, lymph node involvement, and treatment response.

DATA SOURCES:
EMBASE and MEDLINE were searched from inception to January 27, 2022, with the use of MeSH terms and keywords relating to cervical cancer, HPV, and prognosis. ClinicalTrials.gov was not searched because of the nature of our review question.

METHODS OF STUDY SELECTION:
Studies must have assessed HPV DNA or RNA in cervical pretreatment biopsies or cells from 20 or more patients with invasive cervical cancer followed up for any length of time and reported the effect of testing positive or negative for HPV on cervical cancer recurrence, disease-free survival, cancer-specific survival, or overall survival. We extracted data on HPV-detection methods, patient and tumor characteristics, and clinical outcomes.

TABULATION, INTEGRATION, AND RESULTS:
Hazard ratios (HRs) and 95% CIs were pooled with a random-effects model. Meta-regression was performed to explore heterogeneity. Of 11,179 titles or abstracts and 474 full-text articles reviewed, 77 studies were included in the systematic review. Among these 77 studies, 30 reported on the relationship of HPV status to histology, 39 to cancer stage, 13 to tumor grade, 17 to tumor size, 23 to lymph node involvement, and four to treatment response. Testing positive for HPV was associated with better disease-free survival (HR 0.38, 95% CI 0.25–0.57; 15 studies with 2,564 cases), cancer-specific survival (HR 0.56, 95% CI 0.44–0.71; nine studies with 1,398 cases), and overall survival (HR 0.59, 95% CI 0.47–0.74; 36 studies with 9,169 cases), but not recurrence (HR 0.59, 95% CI 0.33–1.07; eight studies with 1,313 cases). Meta-regression revealed that the number of cases, tumor grade, specimen type, gene target, and HPV prevalence together explained 73.8% of the between-study heterogeneity.

CONCLUSION:
This review indicates that HPV detectability in cervical cancer is associated with a better clinical prognosis.

SYSTEMATIC REVIEW REGISTRATION:

https://osf.io/dtyeb.
Pregnancy and Childbirth After Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Landrum Matthew , Nocka Heidi R. , Ashebo Leta , Hilmara Didja , MacAlpine Elle , Flynn John M. , Ho Michelle , Newton Peter O. , Sponseller Paul D. , Lonner Baron S. ,   Harms Study Group, Cahill Patrick J. 
Published: September 2023

Background:
Little data exist on pregnancy and childbirth for adolescent idiopathic scoliosis (AIS) patients treated with a spinal fusion. The current literature relies on data from patients treated with spinal fusion techniques and instrumentation, such as Harrington rods, that are no longer in use. The objective of our study is to understand the effects of spinal fusion in adolescence on pregnancy and childbirth.

Methods:
Prospectively collected data of AIS patients undergoing posterior spinal fusion that were enrolled in a multicenter study who have had a pregnancy and childbirth were reviewed. Results were summarized using descriptive statistics and compared with national averages using χ2 test of independence.

Results:
A total of 78 babies were born to 53 AIS patients. As part of their pre-natal care, 24% of patients surveyed reported meeting with an anesthesiologist before delivery. The most common types of delivery were spontaneous vaginal delivery (46%, n=36/78) and planned cesarean section (20%, n=16/78). Compared with the national average, study patients had a higher rate of cesarean delivery (P=0.021). Of the women who had a spontaneous vaginal birth, 53% had no anesthesia (n=19/36), 19% received intravenous intermittent opioids (n=7/36), and 31% had regional spinal or epidural anesthesia (n=11/36). spontaneous vaginal delivery patients in our study cohort received epidural or spinal anesthesia less frequently than the national average (P<0.001). Of those (n=26 pregnancies) who did not have regional anesthesia (patients who had no anesthesia or utilized IV intermittent opioids), 19% (n=5 pregnancies) were told by their perinatal providers that it was precluded by previous spine surgery.

Conclusion:
The majority of AIS patients reported not meeting with an anesthesiologist before giving birth and those who had a planned C-section did so under obstetrician recommendation. The presence of instrumentation after spinal fusion should be avoided with attempted access to the spinal canal but should not dictate a delivery plan. A multidisciplinary team consisting of obstetrician, anesthesiologist, and orthopaedic surgeon can provide the most comprehensive information to empower a patient to make her decisions regarding birth experience anesthesia based on maternal rather than provider preference.

Level of Evidence:
IV
Cutaneous Atypical Fibroxanthoma With Osteoclast-Like Giant Cell: A Rare but Diagnostic Pitfall
Authors: Shaker Nada , Phelps Robert , Niedt George , Patel Ankush , Wu Douglas , Aung Phyu , Prieto Victor , Church Ann , Pradhan Dinesh 
Published: September 2023

Background:
Atypical fibroxanthoma (AFX) is a dermal-based, low-grade neoplasm with no specific lineage of differentiation. The occurrence of AFX with osteoclast-like giant cells is exceptionally rare. Less than 20 cases have been reported in the literature.

Case Presentation:
A 77-year-old man with a medical history of multiple basal and squamous cell carcinomas of the skin, presented with a progressively growing erythematous nodule on the sun-damaged right central parietal scalp. A shave biopsy showed a dermal spindle cell proliferation accompanied by numerous osteoclast-like multinucleated giant cells and predominant atypical mitotic figures. The immunohistochemical staining showed a diffuse positive staining for CD68 and SMA, patchy staining for CD10, and negative staining for SOX-10, pan-cytokeratin, CK5/6, S100, CD34, and desmin. The tumor was completely excised with negative margins. A subsequent follow-up over a period of 13 months showed no recurrence.

Conclusion:
Distinguishing AFX with osteoclast-like giant cells from both malignant and benign skin lesions with osteoclast-like giant cells is crucial. Although AFX tumors display worrisome malignant histologic features, most cases have a favorable prognosis with a local recurrence rate below 5% and exceedingly rare metastasis.
Scaling up essential surgery in rural Africa: outcomes of a novel regional initiative
Authors: Kintu-Luwaga Ronald , DeCiman Ring A. , Semakula Daniel , Makor Ajak , Mwanje Wilbrod 
Published: September 2023

Introduction:
South Sudan, like most of rural Africa, has a high surgical disease burden and profound unmet surgical needs. This is against a background of weak surgical service delivery systems, especially in the harder-to-reach areas. Here it is further fueled by armed conflict and poverty. The surgical service delivery models applied so far have not adequately improved surgical care. Through the Intergovernmental Authority on Development Regional Initiative for Capacity Building, a surgical team was deployed to Kuajok Hospital in Warrap state. The team mentored South Sudanese health workers for 2 years while working together with other agencies operating in the locality to improve surgical services. This paper is an account of the capacity building process for surgical service improvement at this site, from 2015 to 2017.

Methods:
A descriptive study of activities and patients seen over a 2-year period at this centre. Quantitatively, statistics were extracted and compiled from all areas of surgical care, including profiles of the various surgical conditions. Qualitatively, information was gathered through unstructured interviews.

Results:
There was a drastic increase in surgical outpatient consultations, admissions, and operations. There was an improvement in the level of surgical care and patient care systems. New facilities like operating theaters, emergency rooms, surgical consultation rooms, and surgical wards were established. Community attitude and health-seeking behavior improved, leading to improved access to care. An indirect financial benefit was experienced due to improved patient care outcomes and reduced expenditure on referrals.

Conclusion:
Improvement of surgical services in Africa’s hard-to-reach areas is readily attainable through partnerships and mentoring of native medical workers by personnel from fellow African countries.
GALAD outperforms aMAP and ALBI for predicting HCC in patients with compensated advanced chronic liver disease: A 12-year prospective study
Authors: Villa Erica , Donghia Rossella , Baldaccini Valentina , Tedesco Calogero C. , Shahini Endrit , Cozzolongo Raffaele , Ascari Sara , Pesole Pasqua Letizia , Coletta Sergio , Critelli Rosina Maria , Lasagni Simone , Schepis Filippo , Semellini Filippo , Giannelli Gianluigi 
Published: September 2023

Background and Aims:
Surveillance programs are strongly recommended in patients with liver cirrhosis for early detection of HCC development. Six-monthly ultrasound sonography is the most reliable and commonly used technique, especially when associated with serum determination of α-fetoprotein, but different score systems have been proposed to overcome the unsatisfactory diagnostic accuracy of α-fetoprotein. The aim of this 12-year prospective study is to compare the gender, age, AFP-L3, AFP, des-gamma-carboxy prothrombin (GALAD) versus age, gender, bilirubin, albumin, and platelets and albumin-bilirubin scores in predicting HCC onset.

Approach and Results:
A cohort of 545 consecutive patients with compensated advanced chronic liver disease without suspected focal lesions was followed up every 6 months by liver imaging and α-fetoprotein to detect HCC occurrence. Harrell’s C-index for censored data was employed to evaluate the performance of any parameters or scores helping to predict HCC development. ROC curve analysis showed that the GALAD score was more accurate in evaluating HCC development than albumin-bilirubin and age, gender, bilirubin, albumin, and platelets. The AUC ranged from 0.7268 to 0.6851 at 5 and 10 years, both in the total cohort and in the sub-cohorts (viral hepatitis, NASH, and alcohol). The HCC Risk model was constructed using univariate and multivariate Cox proportional hazard regression analysis, showing a strong association of GALAD with HR > 1, p < 0.05, in the total and sub-cohorts, and a better risk prediction in the alcohol cohort, both alone and standardized with other blood parameters.

Conclusions:
GALAD is the most reliable and accurate score system to detect HCC risk of development in patients with compensated advanced chronic liver disease.
Effect of Ambient Temperature on Hospital Admissions for Respiratory Disease in Suburban Rural Villages of a Semi-Arid Region in Northwest China
Authors: Zhang Yanan , Luo Xiaofeng , Ma Li , Ding Guowu , Zhang Benzhong 
Published: September 2023

Objective
This study evaluated the effects of extreme temperatures on hospital admissions for respiratory diseases (RDs) in a semi-arid region in the Northwest of China.

Methods
Distributed lag nonlinear model was constructed, and stratified analysis by gender and age was performed.

Results
The exposure–response curve between temperature and RD hospital admissions was almost W-shaped. Either extremely cold temperatures or moderately cold temperatures presented a short-term acute harmful effect, and the relative risks were higher among males (1.976, 95% confidence interval [CI]: 1.773–2.203; 1.242, 95% CI: 1.203–1.282) and the elderly (2.363, 95% CI: 1.724–3.240; 1.267, 95% CI: 1.154–1.390). Both extreme and moderately hot temperatures had higher risks among females (2.040, 95% CI: 1.815–2.292; 1.328, 95% CI: 1.276–1.381).

Conclusions
The relationship between air temperature and RD hospital admissions was nonlinear. Vulnerable populations varied according to extreme temperature conditions.
Creative Arts Therapy for Healthcare Professionals Is Associated With Long-Term Improvements in Psychological Distress
Authors: Avallone Mantelli Rafaela , Forster Jeri , Edelblute Anthony , Sinn Hillary , Torres Kristen , Adams Tisha , Morgan Courtney , Henry Michael , Reed Katherine , Moss Marc 
Published: September 2023

Objective
Burnout in healthcare professionals (HCPs) is a pressing issue in healthcare. We report the long-term impact of our previous creative arts therapy (CAT) intervention for reducing psychological distress in HCPs.

Methods
Healthcare professionals were randomized to CAT intervention or control group. The CAT group completed surveys evaluating symptoms of psychological distress at 4 months, 8 months, and 1 year postintervention, whereas the control group completed surveys at the 1-year mark.

Results
The CAT group demonstrated sustained improvement in distress scores for anxiety, depression, and affect at 4 and 8 months postintervention. At the 12-month mark, the CAT group exhibited improvements in anxiety, depression, and affect compared with the control group.

Conclusion
Creative arts therapy has lasting benefits for HCPs. Long-term follow-ups are crucial for assessing sustainability, and further investigation should focus on disseminating and implementing CAT programs for HCPs.
Clinical results after external reinforcement of colorectal anastomosis: A systematic review
Authors: Škrabec Clara Gené , Pérez Manel Cremades , Pujol Andrea Fernández , Cortinovis Sara , Rubio Javier Corral , Ibáñez Joan-Francesc Julián , Parés David 
Published: September 2023

Objective:
The aim of this review is to describe and assess the existing methods to cover colorectal anastomoses with biomaterials and their clinical impact in reducing anastomotic leakage. (AL).

Summary Background Data:
The most serious complication in colorectal surgery is AL. Despite improvements in its diagnosis and management, AL remains an unresolved issue. To prevent its appearance and clinical consequences, different external reinforcement techniques with synthetic or biomaterials have been described.

Methods:
A systematic review search of the available literature until June 2022 was performed, looking for all literature regarding external reinforcement of colonic or colorectal anastomoses. After the review process, a classification of materials was proposed into solid and liquid materials, and an assessment of their clinical impact was performed. The study protocol has been registered at PROSPERO and has been reported in the line with PRISMA and AMSTAR Guidelines 10,11.

Results:
97 articles fulfilled inclusion criteria, were identified and revised. Overall, 18 of the selected articles focused on human clinical trials and 79 on animal models. Only Fibrin sealants, collagen patches and omentoplasty have shown positive results in humans.

Conclusions:
Fibrin sealants, collagen patches and omentoplasty are, so far, the most studied biomaterials. However, further studies are required to confirm these findings before definite recommendations can be made.
Predictive Value of In-Program Academic Variables for Future Clinical Education Performance in Physical Therapist Education: An Exploratory Study
Authors: Birkmeier Marisa , Maring Joyce , Pinkus Rebecca , Costello Ellen 
Published: September 2023

Introduction.
The purposes of this study were to (1) explore the relationship of preclinical assessment outcomes and grade point averages (GPAs) with full-time clinical education experience (CEE) performance and (2) determine the predictive value of associated variables to full-time CEE performance.

Review of Literature.
In-program academic variables such as performance tests, comprehensive examinations, and GPAs reflect a measure of student performance before clinical education. Limited and conflicting physical therapist education research exists examining the relationship between preclinical in-program academic variables and CEE performance.

Subjects.
A retrospective convenience sample of 130 graduated PT student academic records with expected graduation years of 2018, 2019, and 2020.

Methods.
Academic records related to performance test outcomes, cumulative program GPAs, utilization of a practical retake appeal policy, and comprehensive examination performance were correlated with CEE performance. A dichotomous ordinal rating scale quantified CEE performance per full-time experience based on the presence of a learning contract. Overall CEE performance was defined as the percentage from the combined CEE performance scores across all experiences. Data analyses included Pearson's correlation coefficient, Spearman's rho, and a multiple linear regression analysis.

Results.
Ten of 25 course-specific performance tests had significant associations with CEE performance. Cumulative GPA and the practical retake appeal were significantly associated with the CEE III score and overall CEE performance. The practical retake appeal was a significant contributor to clinical performance, explaining 5.3% of the variance (β = 0.24, P = .01, 95% CI 0.01 to 0.09, part correlation = 0.23, tolerance = 0.91).

Discussion and Conclusion.
These findings support the use of performance tests as an effective assessment strategy before CEEs but only represent one aspect of the full picture of readiness to practice. Academic progression policies can offer a mechanism for early identification to support at-risk students before the CEEs.