Reviews and syntheses: Spatial and temporal patterns in seagrass metabolic fluxes

Seagrass meadow metabolism has been measured for decades to gain insight into ecosystem energy, biomass production, food web dynamics, and, more recently, to inform its potential in ameliorating ocean acidification (OA). This extensive body of literature can be used to infer trends and drivers of seagrass meadow metabolism. Here, we synthesize the results from 56 studies reporting in situ rates of seagrass gross primary productivity, respiration, and/or net community productivity to highlight spatial and temporal variability in oxygen (O2) fluxes. We illustrate that daytime net community production (NCP) is positive overall and similar across seasons and geographies. Full-day NCP rates, which illustrate the potential cumulative effect of seagrass beds on seawater biogeochemistry integrated over day and night, were also positive overall but were higher in summer months in both tropical and temperate ecosystems. Although our analyses suggest seagrass meadows are generally autotrophic, the effects on seawater oxygen are relatively small in magnitude. We also find positive correlations between gross primary production and temperature, although this effect may vary between temperate and tropical geographies and may change under future climate scenarios if seagrasses approach thermal tolerance thresholds. In addition, we illustrate that periods when full-day NCP is highest could be associated with lower nighttime O2 and increased diurnal variability in seawater O2. These results can serve as first-order estimates of when and where OA amelioration by seagrasses may be likely. However, improved understanding of variations in NCPdic:NCPO2 ratios and increased work directly measuring metabolically driven alterations in seawater pH will further inform the potential for seagrass meadows to serve in this context

Chronotype, Shift Work, and Sleep Problems Among Emergency Medicine Clinicians

Introduction: Extensive research has demonstrated that shift work can be detrimental to sleep. Chronotype, the preference for time of day to sleep or be active, can influence how we function at different times of day and how shift work impacts us. This study was designed to assess the chronotype of emergency physicians (EPs) and emergency advanced practice providers (EAPPs) and examine how chronotype was related to sleep problems and shifts worked over a three-month period. Methods: A survey assessing chronotype and sleep quality was sent to 225 EPs and EAPPs in a single, large academic Department of Emergency Medicine. An archival database indicated the shifts worked during the prior three months and the percentages of day, evening, and night shifts for each practitioner were calculated. Results: 127 people completed the survey (56.4%). Of the three chronotypes (morning, intermediate, evening), most EM clinicians were categorized as intermediate chronotype (56/127, 44.1%), followed by morning type (39/127, 30.7%) and then evening type (32/127, 25.2%). Those with an evening chronotype were more likely to report daytime dysfunction (a lack of enthusiasm and propensity to fall asleep during activities) (p \u3c 0.01) and worked a greater percentage of night shifts than other chronotypes (p \u3c 0.05). Interestingly, the effect of evening chronotype on daytime dysfunction was no longer significant when controlled for the relatively greater percentage of night shifts worked, suggesting that the observed dysfunction was more likely an artifact of the night shifts worked, rather than purely chronotype driven. Conclusion: This is the first study of a large cohort of EM practitioners investigating chronotype and its influence on shift preference and sleep quality. In this pilot investigation, most of the surveyed clinicians were categorized as an intermediate chronotype. Working night shifts was associated more closely with daytime dysfunction than was chronotype, strengthening the latent literature that working night shift carries with it significant challenges to the EM clinician. Future research should evaluate the relationship between chronotype malalignment to practitioner burnout and well-being

Optimizing Wellness in Academic Emergency Medicine

Introduction Academic Emergency Physicians (EPs) face additional unique challenges in optimizing wellness compared to community EPs. Objective Our objective was to explore specific individual and systems challenges that academic EPs encounter that affect their wellbeing and professional fulfillment in emergency medicine (EM). Methods An expert group of academic EPs convened in 2019 at the annual meeting of the Society of Academic Emergency Medicine to investigate the overall causes of burnout in healthcare providers, the effects of burnout on the healthcare system, specific causes of burnout in EM, and the distinct challenges facing academic emergency physicians. Results We outline specific causes of burnout in EM and the effects of burnout on the healthcare system. Scholarly productivity pressures, variable reimbursement gaps, time allotment, and work-life balance are challenges facing academic EPs. Conclusion Understanding the unique challenges of academic EPs in optimizing wellness is vital to inform future research and effective interventions