bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinct Impacts of Topographic versus Planetary PV Gradients on Baroclinic Turbulence
Authors: Deng Peng , Wang Yan 
Published: August 2024

Abstract
The impacts of topographic versus planetary potential vorticity (PV) gradients on fully developed geostrophic turbulence are often treated as dynamically equivalent in theoretical understanding and parameterizations of ocean mesoscale turbulence. Using a suite of homogeneous, two-layer quasigeostrophic (QG) turbulence simulations, we identify similarities and distinctions of topographic versus planetary PV gradients in modulating turbulent eddy energy and fluxes. We show that, while an elevated background PV gradient can suppress geostrophic turbulence, a positive (negative) bottom slope with respect to the orientation of isopycnal slope barotropizes (debarotropizes) the turbulent energy at large scales, which contrasts with a dynamically inert planetary PV gradient in the modewise energy transfer. Then, in the presence of weak bottom drag, a positive slope energizes large-scale along-slope jets and limits small-scale barotropic eddies, both of which yield stronger eddy suppression effects than from a planetary PV gradient; by contrast, a negative slope hinders along-slope jet formation by enhancing the dual-energy cascade cycling, which alleviates the topographic suppression on eddies. In the presence of strong bottom drag, a positive slope elevates barotropic eddy energy, which further enhances the eddy-driven fluxes; by contrast, a negative slope confines turbulent energy to the baroclinic mode, which is strongly damped, causing further weakened turbulent energy and eddy fluxes. A flow regime captured by linear QG theories also emerges as the turbulent energy cascade is jointly suppressed by negative slopes and strong bottom drag. This study provides insights into parameterizing mesoscale eddy effects across sloping bathymetry in predictive ocean models.
Teachers navigating the sociocultural challenges of teaching sexuality education to South African learners
Authors: Naidoo Jaqueline , Muza Elasmus 
Published: August 2024

Objective: Globally, South Africa has the highest rate of HIV infection, nevertheless, society and communities seem hesitant to entrust teachers with the responsibility to teach their children about sexuality issues. This study examined how Further Education and Training Life Orientation teachers navigate the sociocultural complexities of teaching sexuality education. Design: A qualitative, narrative study was conducted. Data were generated using narrative frames, collages, and lesson observations. Setting: Six Life Orientation teachers from six schools in the province of KwaZulu-Natal, South Africa participated. Results: Life Orientation teachers faced a range of sociocultural challenges when teaching sexuality education. The following strategies were used to mitigate these challenges: avoiding teaching about contradicting cultural and religious beliefs; using social media platforms; involving specialists, peer educators and role models; and adopting pastoral and parental roles. Conclusion: Collaborative opportunities between Life Orientation teachers, specialists, role models and community members or organisations could offer a supportive role and influence the teaching of sexuality education positively. Social media platforms and innovative teaching strategies could enhance the quality and teaching of sexuality education.
Regular cannabis use modulates gamma activity in brain regions serving motor control
Authors: Webert Lauren K , Schantell Mikki , John Jason A , Coutant Anna T , Okelberry Hannah J , Horne Lucy K , Sandal Megan E , Mansouri Amirsalar , Wilson Tony W 
Published: August 2024

Background: People who regularly use cannabis exhibit altered brain dynamics during cognitive control tasks, though the impact of regular cannabis use on the neural dynamics serving motor control remains less understood. Aims: We sought to investigate how regular cannabis use modulates the neural dynamics serving motor control. Methods: Thirty-four people who regularly use cannabis (cannabis+) and 33 nonusers (cannabis−) underwent structured interviews about their substance use history and performed the Eriksen flanker task to map the neural dynamics serving motor control during high-density magnetoencephalography (MEG). The resulting neural data were transformed into the time–frequency domain to examine oscillatory activity and were imaged using a beamforming approach. Results: MEG sensor-level analyses revealed robust beta (16–24 Hz) and gamma oscillations (66–74 Hz) during motor planning and execution, which were imaged using a beamformer. Both responses peaked in the left primary motor cortex and voxel time series were extracted to evaluate the spontaneous and oscillatory dynamics. Our key findings indicated that the cannabis+ group exhibited weaker spontaneous gamma activity in the left primary motor cortex relative to the cannabis− group, which scaled with cannabis use and behavioral metrics. Interestingly, regular cannabis use was not associated with differences in oscillatory beta and gamma activity, and there were no group differences in spontaneous beta activity. Conclusions: Our findings suggest that regular cannabis use is associated with suppressed spontaneous gamma activity in the left primary motor cortex, which scales with the degree of cannabis use disorder symptomatology and is coupled to behavioral task performance.
Food Shopping Strategies Among a Diverse Sample of East Harlem Residents: A Qualitative Study
Authors: Nieves Christina , Dannefer Rachel , Sacks Rachel , Zamula Arlen 
Published: August 2024

Purpose To inform food retail interventions, this study explored food shopping strategies employed by people constrained by limited budgets but residing in an urban environment offering numerous retail options. Approach Qualitative study incorporating semi-structured interviews and shop-alongs. Setting East Harlem, New York City. Participants 37 East Harlem residents participated in interviews, of whom 15 participated in shop-alongs. Methods Interviews and shop-alongs were conducted in English, Spanish, and Mandarin Chinese. Interview transcripts were analyzed using a grounded theory approach. Data from shop-alongs were used to supplement interview findings. Results Participants shopped 1-2 times at an average of 4 retail locations per week. Two key themes emerged: (1) planning trips and choosing venues; and (2) shopping experiences and perceptions of stores. Price was the primary driver of store choice, followed by product quality and variety. Substantial time was invested in shopping. Most English- and Spanish-speaking participants shopped in East Harlem. Chinese American participants shopped in Chinatown due to language concordance, availability of culturally-preferred foods, and proximity to other services. Conclusion East Harlem residents invested substantial planning, time and effort in food shopping to acquire sufficient food for their households on limited budgets. These findings offer insight into how residents interact with food environments and key drivers of decision-making about food shopping that affect decisions about where to shop and what to purchase.
Using the SCAR-Q to Evaluate Morbidity of Scars in Craniosynostosis Repair
Authors: Parikh Neil , Hu Kevin G. , Allam Omar , Lewis Katelyn , Ihnat Jacqueline M. , Rancu Albert L. , Boroumand Sam , Persing John A. , Alperovich Michael 
Published: August 2024

ObjectiveWhile previous literature has investigated the psychosocial impact and aesthetic satisfaction associated with post-operative scarring for certain pediatric craniofacial conditions, the impact of the scar burden resulting from craniosynostosis surgery has not been adequately studied.ParticipantsSCAR-Q was shared with patients ages 8 and older. Thirty-two complete patient responses were recorded.InterventionsSCAR-Q is a PROM that consists of three independent scales - appearance, symptoms, and psychosocial impact - associated with a scar.Main Outcome MeasuresMann-Whitney U, linear regression, and Pearson correlation tests were used to evaluate associations between the scales, in addition to patient characteristics such as sex and suture involvement.ResultsMean ages at time of surgery and survey completion were 9.65 ± 10.10 months and 12.10 ± 3.92 years, respectively. Mean scale scores were 81.5 ± 17.9 for appearance, 86.8 ± 12.4 for symptoms, and 79.3 ± 25.7 for psychosocial impact. Higher patient dissatisfaction with scar appearance correlated with more scar-related symptoms (r = 0.389; p = 0.028) and a greater psychosocial impact (r = 0.725; p < 0.001). SCAR-Q scales did not significantly correlate with age at surgery, age at survey completion, type of synostosis, or type of surgery; however, female patients reported lower mean appearance (65.4 vs. 86.0; p = 0.012) and psychosocial impact (57.3 vs. 85.5; p = 0.010) scores when compared to their male counterparts.ConclusionsIt is vital that surgeons discuss patients’ aesthetic satisfaction following craniosynostosis surgery in order to appropriately address and limit deleterious, long-term physical and psychosocial outcomes.
A Research Protocol for a Phase II Single-Arm Clinical Trial Assessing the Feasibility and Efficacy of Neoadjuvant Anastrozole in Patients With Luminal Breast Cancer and Low Proliferative Index: The ANNE Trial
Authors: Paiva Carlos Eduardo , Silva Alinne Tatiane Faria , Oliveira Izabella da Silva , Guimarães Vitor Souza , Lacerda Domício Carvalho , Teixeira Gustavo Ramos , Watanabe Anapaula Hidemi Uema , Onari Nilton , Paiva Bianca Sakamoto Ribeiro , Oliveira-Junior Idam de , Marques Marcia Maria Chiquitelli , Maia Yara Cristina de Paiva 
Published: August 2024

Introduction Neoadjuvant endocrine therapy (NET) is recommended for the treatment of invasive breast cancer (BC), particularly luminal subtypes, in locally advanced stages. Previous randomized studies have demonstrated the benefits of aromatase inhibitors in this context. However, NET is typically reserved for elderly or frail patients who may not tolerate neoadjuvant chemotherapy. Identifying non-responsive patients early and extending treatment for responsive ones would be ideal, yet optimal strategies are awaited. Aims This non-randomized phase 2 clinical trial aims to assess NET feasibility and efficacy in postmenopausal stage II and III luminal BC patients, identifying predictive therapeutic response biomarkers. Efficacy will be gauged by patients with Ki67 ≤ 10% after 4 weeks and Preoperative Endocrine Prognostic Index (PEPI) scores 0 post-surgery. Study feasibility will be determined by participation acceptance rate (recruitment rate ≥50%) and inclusion rate (>2 patients/month). Methods Postmenopausal women with luminal, HER2-tumors in stages II and III undergo neoadjuvant anastrozole treatment, evaluating continuing NET or receiving chemotherapy through early Ki67 analysis after 2 to 4 weeks. The study assesses NET extension for up to 10 months, using serial follow-ups with standardized breast ultrasound and clinical criteria-based NET suspension. Clinical and pathological responses will be measured overall and in the luminal tumor A subgroup. Toxicity, health-related quality of life, and circulating biomarkers predicting early NET response will also be evaluated.
Diagnostic ability of the corneal anterior and posterior surface area calculated by corneal modelling approach in early stage keratoconus patients
Authors: Özelbaykal Bahadır , Kaya Ozan , Kasım Burcu , Birkandan Tolga , Koçluk Yusuf 
Published: August 2024

Purpose To investigate the discrimination ability of the corneal anterior and posterior surface area between patients with keratoconus stage 1 and normal individuals. Methods In this retrospective study, 116 eyes of 116 normal individuals and 366 eyes of 366 keratoconus patients were included. Keratoconus patients were divided into six groups according to the topographic keratoconus classification of Pentacam. Anterior and posterior surface data of sagittal (SM) and elevation maps (EM) were exported from Pentacam, and human corneal models were created employing the software utilizing the PyVista module of Python programming language. The anterior and posterior corneal surface area (a-CSA and p-CSA) of SM and EM were calculated by the software ranging from central 3 to 8mm diameter. Results Anterior and posterior CSA values were higher in KC patients compared to normal individuals (p < 0.001). The p-CSA for SM and EM measured at the central 3mm was higher in patients with KC-1 compared to normal eyes ( p = 0.002, p = 0.005, respectively), For both maps, a-CSA and p-CSA measured at the central 4 and 5mm were higher in KC-1 compared to normal individuals ( p < 0.05). The highest area under the curve (AUC) values in the diagnosis patients with KC-1 were obtained from 3mm p-CSA for SM (AUC: 0.8338), 3mm p-CSA for EM (AUC: 0.7999), 4mm p-CSA for SM (AUC: 0.8531), 4mm p-CSA for EM (AUC:0.7948), 5mm p-CSA for SM (AUC: 0.8455), 5mm p-CSA for EM (AUC:0.7614). Conclusion The corneal surface area as a parameter, especially for central 3, 4, and 5mm, has a discrimination ability in diagnosing keratoconus disease and distinguishes normal eyes from KC-1 eyes.
Removable regulating sutures during trabeculectomy for a safer and more effective intraocular pressure control
Authors: Savastano Alfonso , Maiola Emanuele , Carlà Matteo Mario , Gambini Gloria , Boselli Francesco , Giannuzzi Federico , Rizzo Clara , Rizzo Stanislao 
Published: August 2024

Purpose Comparing the effect of standard trabeculectomy with direct sutures versus trabeculectomy with compression and everting sutures. Methods Mono-centric randomized prospective comparative study on 38 glaucomatous eyes undergoing trabeculectomy: 19 with standard fixed sutures (group A) and 19 withremovable regulating sutures (group B). Preoperatively and at day-7, 1-month, 2-months, 3-months and 6-months after surgery, we recorded best-corrected visual acuity (BCVA), intraocular pressure (IOP) and possible complications. Complete, partial success and failure rates were recorded at the end of the study. Results In group B, we pulled everting sutures with the “horse bridle” technique at the 14th day, and successively removed all sutures between the 14th-30th post-operative day. At month-1, we recorded a significant IOP reduction in both groups (mean reduction of 11.5 mmHg for group A and of 14.4 mmHg for Group B, p = 0.001 and p < 0.0001, respectively). Furthermore, group B showed a significantly lower IOP than group A (−4.2 mmHg, 95% confidence interval [CI] −7.0 to −0.5 mmHg for group B, p = 0.01). At 2, 3 and 6-months, no significant IOP differences were reported between the two groups (all p > 0.05), but failure rate was higher for group A (21%) than for group B (11%). No differences in visual outcomes at any timepoints were noted. Conclusions Trabeculectomy with removable regulating sutures showed a good safety profile, comparable to standard trabeculectomy. Moreover, we reported a lower IOP one month postoperatively, suggesting this technique may optimize early management of trabeculectomy.
Interactions with new-to-teacher language resources: Supporting translingual composing in a multilingual elementary classroom
Authors: Rowe Lindsey W. 
Published: August 2024

Educators should support multilingual students’ translingual writing. However, it can be challenging for teachers to support students’ composing in languages that teachers do not speak. Drawing on a community translanguaging lens, this paper explores this issue by asking: How did teachers talk about and interact with language resources that were new to them while supporting translingual writing in an English-medium classroom? Data were collected using ethnographic and practitioner research methods across 1 year in one second-grade writing workshop in the U.S. Students spoke Spanish, Korean, French, Tagalog, or English, and classroom teachers spoke English and Spanish. Data analysis first involved descriptive coding of videorecorded composing interactions to identify every teacher interaction involving a new-to-them named language. These events were then re-examined using constant comparative coding to identify interactional patterns. This yielded three main findings; teachers: (1) positioned students as language experts and themselves as language learners, (2) drew on shared language resources to support student writing in new-to-teacher languages, and (3) expanded audiences to support student writing in new-to-teacher languages. Implications include pedagogical steps teachers can take to support students’ use of new-to-teacher languages while writing, and ideological and social implications of teacher talk about those languages.
“How will I ever know I didn’t bring it on myself?”: Navigating personal responsibility in public health messaging on dementia risk
Authors: Peckham Allie , Maxfield Molly , James Dara L 
Published: August 2024

Background and Objectives Public health messaging increasingly emphasizes the importance of “lifestyle interventions” to reduce dementia risk. Our study aimed to understand how people interpret and respond to information about dementia risk. In a second sub-aim, we examined how these interpretations may contribute to dementia-related lifestyle stigma. Research Design and Methods We engaged in a secondary analysis of 50 semi-structured interviews using a framework approach to understand, from the perspective of community-dwelling middle-aged and older adults, how they may interpret, make sense of, and respond to information about dementia risk and risk reduction. During the interpretive and narrative phase, the authors began to elucidate participant responses analytically and identified that these responses could be interpreted within the health locus of control literature. Results Of the 23 participants who discussed dementia risk, 13 felt some sense of personal responsibility and control over their dementia risk. Of those 13, four participants believed they had personal responsibility and control and actively engaged in lifestyle interventions. The remaining nine participants also engaged in lifestyle interventions, aiming to find comfort in knowing they had done what they could to reduce their risk and working to alleviate self-attribution of blame if diagnosed with dementia. Discussion and Implications The tendency to internalize responsibility may inadvertently contribute to the stigmatization of dementia as a ‘lifestyle disease’ creating dementia-related lifestyle stigma. Recognizing the multifaceted nature of dementia risk, including environmental and external factors beyond individual control, is essential to combatting the ‘lifestyle stigma’ increasingly associated with the condition.
Should they stay or should they go? Stroke transfers across a hospital network pre- and post-implementation of an automated image interpretation and communication platform
Authors: Bonner James , Love Christopher J , Bhat Vipul , Siegler James E 
Published: August 2024

Background A key decision facing nonthrombectomy capable (spoke) hospitals is whether to transfer a suspected large vessel occlusion (LVO) patient to a comprehensive stroke center (CSC). In a retrospective cohort study, we investigated the rate of transfers resulting in endovascular thrombectomy (EVT) and associated costs before and after implementation of an artificial intelligence (AI)-based software. Methods All patients with a final diagnosis of acute ischemic stroke presenting across a five-spoke community hospital network in affiliation with a CSC were included. The Viz LVO (Viz.ai, Inc.) software was implemented across the spokes with image sharing and messaging between providers across sites. In a cohort of patients before (pre-AI, December 2018–October 2020) and after (post-AI, October 2020–August 2022) implementation, we compared the EVT rate among ischemic stroke patients transferred out of our health system to the CSC. Secondary outcomes included the EVT rate based on spoke computed tomography angiography (CTA) and estimated transfer costs. Results A total of 3113 consecutive eligible patients (mean age 71 years, 50% female) presented to the spoke hospitals with 162 transfers pre-AI and 127 post-AI. The rate of transfers treated with EVT significantly increased (32.1% pre-AI vs. 45.7% post-AI, p = 0.02). There was a sharp increase in CTA use post-AI at the spoke hospitals for all patients and transfers that likely contributed to the increased EVT transfer rate, but prior spoke CTA use alone was not sufficient to account for all improvement in EVT transfer rate (37.2% pre-AI vs. 49.2% post-AI, p = 0.12). In a binary logistic regression model, the odds of an EVT transfer in the intervention period were 1.85 greater as compared to preintervention (adjusted odds ratio 1.85, 95% confidence interval 1.12–3.06). The decrease in non-EVT transfers resulted in an estimated annual benefit of $206,121 in spoke revenue and $119,921 in payor savings (all US dollars). Conclusions The implementation of an automated image interpretation and communication platform was associated with increased CTA use, more transfers treated with EVT, and potential economic benefits.
Living with my diabetes – introducing eHealth into daily practices of patients with type 2 diabetes mellitus
Authors: van Leersum Catharina M , Konrad Kornelia E , Bults Marloes , den Ouden Marjolein EM 
Published: August 2024

Objective Diabetes patients can draw on an increasing number of eHealth apps to support them in the self-management of their disease. While studies so far have focused on patients with type 1 diabetes, we explored how patients with type 2 diabetes mellitus (T2DM) integrate eHealth apps into their practices aimed at managing and coping with the disease, which aspects were considered particularly valuable and which challenges users encountered. Methods Semi-structured interviews and focus group sessions were conducted to explore how patients cope with T2DM in their daily lives and their attitude towards eHealth. In a further step, four eHealth apps were tested by patients and their expectations and experiences studied by way of qualitative interviews and focus groups. Results The analysis showed that the study participants valued in particular the possibility to use eHealth apps to sense and gain a better understanding of their own body, to learn about specific responses of their body to nutrition and physical activity, and to support changes in daily routines and lifestyle. Key challenges encountered related to difficulties in interpreting the data, matching the data to other bodily sensations, getting overly occupied with the disease and difficulties in integrating the apps into personal, family, and care practices. Conclusion Under certain conditions, eHealth can play an important role for patients in developing a nuanced, personal understanding of their body and coping with T2DM. A prerequisite is that eHealth needs to be fitted into the specific practices of users, and patients desire a strong role by their care professionals in providing support in interpretation of data.