bluuebunny/crossref_metadata_2025_split huggingface dataset:
Downward Propagation and Trapping of Near-Inertial Waves by a Westward-Moving Anticyclonic Eddy in the Subtropical Northwestern Pacific Ocean
Authors: Chen Zifei , Yu Fei , Chen Zhiwu , Wang Jianfeng , Nan Feng , Ren Qiang , Hu Yibo , Cao Anzhou , Zheng Tongtong 
Published: June 2023

Abstract
Mesoscale eddies can alter the propagation of wind-generated near-inertial waves (NIWs). Different from previous studies, the subsurface mooring observed NIWs are generated outside an anticyclonic eddy (ACE) and then interact with the arriving ACE. It is found that with the arrival of the ACE, the NIWs accelerate to propagate downward and the maximum vertical wavelength and group velocity of NIWs reach ∼500 m and ∼35 m day−1, respectively. When entering the core of the ACE, the near-inertial energy is trapped and finally stalls at a critical depth, which basically corresponds to the base of the ACE located at around 750-m depth. Through a ray-tracing model and dynamic analyses, this critical depth is much deeper than that of NIWs generated directly inside an ACE. By using depth–time varying stratification and relative vorticity, ray-tracing experiments further demonstrate that NIWs generated outside and passed over by an ACE can propagate to deep depths. Furthermore, energy budget analyses indicate that the net energy transfer from the ACE to NIWs plays an important role in the enhancement of downward-propagating near-inertial energy and its long-term persistence (∼45 days) in the critical layer. Within the critical layer, the enhancement of shear instability and nonlinear interactions among internal waves account for the loss of the trapped near-inertial energy and provide energy for furnishing deep ocean mixing.

Significance Statement
The interactions between near-inertial waves and a westward-moving anticyclonic eddy are investigated in this study. Knowledge about the propagation of near-inertial waves continues to be a topic of interest because near-inertial waves transfer energy from the mixed layer to the interior ocean, which is an important source of turbulent mixing. While much is known about how near-inertial energy propagates inside an anticyclonic eddy, few studies have examined how near-inertial energy propagates when it is generated outside an anticyclonic eddy and then enters the arriving anticyclonic eddy. In this study, the deep propagation and trapping of near-inertial energy by a westward-moving anticyclonic eddy is observed, which contributes greatly to the energy budget and the deep-ocean mixing.
The longitudinal impact of war exposure on psychopathology in Syrian and Iraqi refugee youth
Authors: Hinchey Liza Marie-Emilie , Nashef Raya , Bazzi Celine , Gorski Kathleen , Javanbakht Arash 
Published: June 2023

Background: War and natural disasters lead to forced migration – and increased risk of adverse psychological outcomes – in approximately 1% of the global population. Though recent years have brought a greater understanding of the consequences of war exposure on mental health outcomes for refugee children, little is known about the longitudinal and developmental impact of these experiences on youth. Aims: The aim of this study was to assess the effect of direct exposure to war and/or combat on trajectories of symptoms related to anxiety and post-traumatic stress disorder (PTSD) in Syrian and Iraqi refugee youth following resettlement. Prevalence of possible anxiety disorders and PTSD was also assessed. Method: Participants included accompanied refugee youth resettled in the state of Michigan in the U.S. ( n = 74). Youth filled out self-report measures of trauma exposure, anxiety symptoms, and PTSD symptoms upon arrival and 2 years later. Linear mixed-effects modeling was used to assess the effect of war exposure over time. Results: Upon arrival, 38% screened positive for an anxiety disorder and 4.1% met diagnostic thresholds for PTSD. While war exposure did not predict changes to PTSD symptom trajectories ( p = .481), anxiety symptoms increased over time among children reporting war exposure ( B = 10.13, SE = 4.22, t = 2.40, p = .019). Conclusions: Our findings suggest that without appropriate interventions, anxiety- and trauma-related symptoms often do not decrease. Further, exposure to war trauma may lead to progressive worsening of symptoms. These findings suggest that assessing for type of trauma exposure, rather than focusing solely on migration status, may inform focused attention and interventions among trauma-exposed children resettling as refugees.
National Trends in Buprenorphine Treatment for Opioid Use Disorder From 2007 to 2018
Authors: Schuler Megan S. , Saloner Brendan , Gordon Adam J. , Dick Andrew W. , Stein Bradley D. 
Published: June 2023

Background: Buprenorphine is a key medication to treat opioid use disorder (OUD). Since its approval in 2002, buprenorphine access has grown markedly, spurred by major federal and state policy changes. This study characterizes buprenorphine treatment episodes during 2007 to 2018 with respect to payer, provider specialty, and patient demographics. Methods: In this observational cohort study, IQVIA Real World pharmacy claims data were used to characterize trends in buprenorphine treatment episodes across four time periods: 2007-2009, 2010-2012, 2013-2015, and 2016-2018. Results: In total, we identified more than 4.1 million buprenorphine treatment episodes among 2 540 710 unique individuals. The number of episodes doubled from 652 994 in 2007-2009 to 1 331 980 in 2016-2018. Our findings indicate that the payer landscape changed dramatically, with the most pronounced growth observed for Medicaid (increased from 17% of episodes in 2007-2009 to 37% of episodes in 2016-2018), accompanied by relative declines for both commercial insurance (declined from 35 to 21%) and self-pay (declined from 27 to 11%). Adult primary care providers (PCPs) were the dominant prescribers throughout the study period. The number of episodes among adults older than 55 increased more than 3-fold from 2007-2009 to 2016-2018. In contrast, youth under age 18 experienced an absolute decline in buprenorphine treatment episodes. Buprenorphine episodes increased in length from 2007-2018, particularly among adults over age 45. Conclusions: Our findings demonstrate that the U.S. experienced clear growth in buprenorphine treatment—particularly for older adults and Medicaid beneficiaries—reflecting some key health policy and implementation success stories. Yet, since the prevalence of OUD and fatal overdose rate have also approximately doubled during this period, the observed growth in buprenorphine treatment did not demonstrably impact the pronounced treatment gap. To date, only a minority of individuals with OUD currently receive treatment, indicating continued need for systemic efforts to equitably improve treatment uptake.
Clinicians’ perspectives on why young Aboriginal people are not testing for sexually transmissible infections in Western Sydney
Authors: Ubrihien Ashley , Lewis David A , Rambaldini Boe , Kirwan Morwenna , Gwynne Kylie 
Published: June 2023

Background Incidence of sexually transmissible infections (STI) amongst young Aboriginal people in Australia are significantly higher compared to the wider population. Low levels of engagement with public sexual health services also exacerbates health inequity. This study sought to understand the access barriers facing Aboriginal People with local Sexual Health services from the perspective of local clinicians within Western Sydney. Methods Six clinicians (six registered nurses, two medical practitioners) and two social workers, working in a Sexual Health service, were interviewed using a semi-structure questionnaire. Interviews were audio recorded and transcribed verbatim. Interview texts were analysed using NVIVO 12 and a thematic analysis undertaken. Results Thematic analysis revealed three broad themes: personal, practical, and programmatic. Clinicians believed the involvement of Aboriginal people in service delivery would contribute to greater inclusion and more culturally competent services. Clinicians also considered that young Aboriginal people were unaware of the risks of untreated STIs, and that greater STI-related education regarding risk and prevention may reduce STI incidence and improve participation in services. Clinicians believed that culturally-competent STI education would be more effective if co-designed with the local Aboriginal community. Clinicians identified that Aboriginal young people were concerned about their privacy when accessing services, and that barriers could be reduced by greater community engagement in service delivery design and quality improvement initiatives. Conclusion The three themes identified in this study provide guidance for service providers about approaches that may enhance the access, participation, and cultural safety sexual health services for Aboriginal clients.
Adapting Dance to Complex Clinical Contexts: A Methodology Model
Authors: Beaudry Lucie , Rochette Annie , Fortin Sylvie 
Published: June 2023

Background: While the content of health-related dance interventions is still relatively undocumented in the literature, the processes of adapting dance to specific situations are even less so, and rarely seem to be based on theoretical or practical guidelines. Yet the description of these processes could guide the adaptation of other interventions. Purpose: This study aimed to document the process of adapting a dance intervention in a complex clinical setting, in order to propose a methodology that could inspire the development of other interventions in specific clinical contexts. Methods: The adaptation methodology described in this article is part of an embedded single-case study, where the case unit was the adaptation process of a dance group intervention and the subunits of analysis were the intervention’s clinical and theoretical premises, content, and pedagogy. Participants were rehabilitation therapists (n=21), patients (n=6), relatives (n=4), and rehabilitation assistants (n=4). Data were collected through various techniques (focus groups, situational observation, pilot dance sessions, interviews, critical incidents, research journals, template for intervention description and replication/TIDieR checklist, and video recordings) to allow an iterative adaptation process. Data were analyzed using inductive qualitative analysis. Results: Adaptations were made prior to and throughout the intervention, taking into account relevant scientific and disciplinary knowledge, as well as the different actors’ implicit and explicit experiences. The intervention pedagogy focused on adapting the dance content to meet the participants’ needs while inviting them to self-adapt this content. The resulting methodology model includes four stages: preliminary design, validation with rehabilitation therapists, specific tailoring, and ongoing tailoring. Conclusion: Optimizing the adaptation of dance and ensuring its complementarity within a complex clinical context requires collaboration with the different disciplinary clinicians in order to offer synergistic coherence and ensure dance’s contribution to therapeutic objectives.
Retrospective review of diphenhydramine vs diphenhydramine plus glucocorticoid for the treatment of allergic reaction in cats
Authors: Krager Kayla L , Pigott Armi M 
Published: June 2023

Objectives The aims of the present study were to report the outcomes of treating allergic reactions in cats with diphenhydramine vs diphenhydramine plus glucocorticoid and to determine whether signs recurred or additional veterinary intervention was needed in the days after initial treatment. Methods This retrospective study evaluated 73 cats treated for allergic reaction with diphenhydramine alone or in combination with a glucocorticoid at a 24 h emergency and specialty referral veterinary hospital between 1 January 2012 and 31 March 2021. Results In total, 44 cats were treated with diphenhydramine alone, and 29 were treated with diphenhydramine plus dexamethasone sodium phosphate. The inciting cause was known or highly suspected in 50 patients. Vaccines were the most common (31 patients), followed by insect envenomation (17 cases). No cat in either group progressed to anaphylaxis. There was no difference in resolution of clinical signs between the groups. Follow-up contact was successfully made with 40/73 cat owners. All 40 cats were alive. Eight had persistent signs. There was no difference in the number of cats with persistent signs between groups. Five cats required additional treatment after the initial emergency visit. There was no difference between the two groups for persistent signs at follow-up. Conclusions and relevance There was no difference in measured outcomes between cats treated with diphenhydramine alone vs those treated with a glucocorticoid in addition to diphenhydramine in this population. The ideal treatment for allergic reactions is unknown. Based on currently available data in human and veterinary literature, glucocorticoids are not indicated to treat acute allergic reactions. The role of antihistamines as part of a symptomatic supportive treatment plan to shorten the duration of signs is unclear at this time and may be considered.
Effectiveness of dental monitoring system in orthodontics: A systematic review
Authors: Sangalli Linda , Alessandri-Bonetti Anna , Dalessandri Domenico 
Published: June 2023

Background: Dental monitoring (DM) constitutes a recent technological advance for the remote monitoring of patients undergoing an orthodontic therapy. Especially in times of health emergency crisis, the possibility of relying on remote monitoring could be particularly useful. Objectives: To assess the effectiveness of DM in orthodontic care. Eligibility: Studies conducted on healthy patients undergoing orthodontic care where DM was applied, assessing a change in treatment duration, emergency appointments, in-office visits, orthodontic relapse, early detection of orthodontic emergencies and improvement of oral health status. Information sources: PubMed, Web of Science and Scopus were searched for publications until November 2022. Risk of bias: Quality assessment was performed with the STROBE Checklist. Data extraction: Data were extracted independently by two reviewers, and discrepancies were resolved with a third reviewer. Included studies: Out of 6887 records screened, 11 studies were included. Synthesis of results: DM implemented to the standard orthodontic care was found to significantly decrease the number of in-office visits by 1.68–3.5 visits and showed a possible trend towards improvement of aligner fit. Conversely, evidence does not support a reduction of treatment duration and emergency appointments. The assessment of the remaining variables did not allow any qualitative synthesis. Conclusions: This review highlighted that DM implemented to standard orthodontic care can significantly decrease the number of in-office visits and may potentially result in an improved aligner fit. Due to the low quality of most of the included studies and the heterogeneity of the orthodontic system where DM was applied, studies with different investigation team and rigorous methodology are advocated.
Creating a smart classroom in intensive care using assisted reality technology
Authors: Willis Charlotte , Dawe Jessica , Leng Christopher 
Published: June 2023

Background: Medical students receive relatively little exposure to intensive care medicine throughout their undergraduate training. The COVID-19 pandemic further hindered students’ exposure with the entrance to intensive care units (ICU) limited. To address the problem, this study explored the use of assisted reality technology to create a smart classroom in intensive care. Methods: Six intensive care teaching sessions were live streamed to groups of medical students ( n = 33) using wearable assisted reality glasses, and the results were pooled for analysis. Feedback from students and educators was collected using the evaluation of technology-enhanced learning materials (ETELM). Results: The response rate for the ETELM-learner and ETELM-educator perceptions was 100%. Students strongly agreed that the session was well organised, relevant and that the navigation of technology-based components was logical and efficient. Students strongly disagreed that their learning was negatively affected by technology issues. Educators reported some difficulties with balancing teaching delivery alongside the clinical demands of the ICU and some minor technological issues. Discussion: There is potential for smart classrooms to revolutionise intensive care education. The use of smart classrooms on intensive care using assisted reality technology was well received by students and educators. The main limitations included the cost of the technology and risk of technology issues. There is a significant role for smart classrooms to continue in the post-pandemic period as they provide an open and safe platform for students to explore intensive care medicine and ask questions that they may feel less able to raise in the busy clinical environment.
Dietary habits and Helicobacter pylori infection: is there an association?
Authors: Soares Giovana Alice Sampaio , Moraes Felipe Augusto de Sousa , Ramos Amanda Ferreira Paes Landim , Santiago Silvana Barbosa , Germano Janaina Naiara , Fernandes Gisele Aparecida , Curado Maria Paula , Barbosa Mônica Santiago 
Published: June 2023

Background: Helicobacter pylori ( H. pylori) is a group 1 carcinogen and the etiological agent of gastric diseases such as gastritis, ulcers, and gastric cancer. It infects approximately half of the world’s population. Risk factors associated with H. pylori infection include socioeconomic status, lifestyle, and diet. Objectives: This study aimed to evaluate the association between eating habits and H. pylori infection in patients from a reference hospital in Central Brazil. Design: This cross-sectional study included 156 patients from 2019 to 2022. Methods: Data were collected using a structured questionnaire on sociodemographic and lifestyle characteristics and a validated food frequency questionnaire. The H. pylori infection status (positive versus negative) was determined using the histopathological method. After grams/day, foods were stratified into tertiles of consumption (low, medium, and high). Simple and multiple binary logistic regression models were used in the analysis of odds ratios (ORs) and their respective 95% confidence intervals (CIs), with a 5% significance level. Results: The prevalence of H. pylori infection was 44.2% (69/156 patients). Infected individuals had a mean age of 49.6 ± 14.6 years; 40.6% were men, 34.8% were aged 60 years or older, 42.0% were unmarried, 7.2% had higher education, 72.5% were non-white, and 30.4% were obese. In the H. pylori-positive group, 55.1% were alcohol drinkers and 42.0% were smokers. The results of multiple analyses showed that the chance of H. pylori infection was higher among male participants (OR = 2.25; CI = 1.09–4.68) and individuals with obesity (OR = 2.68; CI = 1.10–6.51). Participants with moderate consumption of refined grains (bread, cookies, cakes, breakfast cereal) (OR = 2.41; CI = 1.04–5.62) and fruits (OR = 2.53; CI = 1.08–5.94) were more likely to be infected. Conclusion: In this study, male sex, obesity, and the consumption of refined grains and fruits were positively associated with H. pylori infection. Further research is needed to investigate this association and elucidate the underlying mechanisms.
Screening for degenerative cervical myelopathy with the 10-second grip-and-release test using a smartphone and machine learning: A pilot study
Authors: Ibara Takuya , Matsui Ryota , Koyama Takafumi , Yamada Eriku , Yamamoto Akiko , Tsukamoto Kazuya , Kaburagi Hidetoshi , Nimura Akimoto , Yoshii Toshitaka , Okawa Atsushi , Saito Hideo , Sugiura Yuta , Fujita Koji 
Published: June 2023

Objective Early detection and intervention are essential for the mitigation of degenerative cervical myelopathy (DCM). However, although several screening methods exist, they are difficult to understand for community-dwelling people, and the equipment required to set up the test environment is expensive. This study investigated the viability of a DCM-screening method based on the 10-second grip-and-release test using a machine learning algorithm and a smartphone equipped with a camera to facilitate a simple screening system. Methods Twenty-two participants comprising a group of DCM patients and 17 comprising a control group participated in this study. A spine surgeon diagnosed the presence of DCM. Patients performing the 10-second grip-and-release test were filmed, and the videos were analyzed. The probability of the presence of DCM was estimated using a support vector machine algorithm, and sensitivity, specificity, and area under the curve (AUC) were calculated. Two assessments of the correlation between estimated scores were conducted. The first used a random forest regression model and the Japanese Orthopaedic Association scores for cervical myelopathy (C-JOA). The second assessment used a different model, random forest regression, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results The final classification model had a sensitivity of 90.9%, specificity of 88.2%, and AUC of 0.93. The correlations between each estimated score and the C-JOA and DASH scores were 0.79 and 0.67, respectively. Conclusions The proposed model could be a helpful screening tool for DCM as it showed excellent performance and high usability for community-dwelling people and non-spine surgeons.
Predictors of sustained use of mobile health applications: Content analysis of user perspectives from a fever management app
Authors: Hamideh Kerdar Sara , Gwiasda Moritz , Berger Bettina , Rathjens Larisa , Schwarz Silke , Jenetzky Ekkehart , Martin David D 
Published: June 2023

Objectives Mobile health applications could be means of educating and changing behaviours of their users. Their features and qualities determine the sustainability of use. The FeverApp with two main features of information and documentation is a research-based app. In this observational cohort study, to evaluate the influential predictors of use, users’ feedback on the FeverApp, were analyzed. Methods Feedback is given using a structured questionnaire, four Likert items and two open questions regarding positive and negative impressions, available via app menu. Conventional content analysis (inductive approach) on the two open questions was performed. Comments were grouped into 12 codes. These codes were grouped hierarchically in an iterative process into nine subcategories and lastly into two main categories ‘format’ and ‘content’. Descriptive and quantitative analysis were performed. Results Out of 8243 users, 1804 of them answered the feedback questionnaire. The features of the app ( N  =  344), followed by the information aspect ( N  =  330) were most frequently mentioned. Documentation process ( N  =  226), request for new features or improvement of the current ones ( N  =  193), and functioning ( N  =  132) were also highlighted in users’ feedback. App's ease of use, design and being informative were important for the users. The first impression of the app seems important as the majority of feedback were given during the first month of using the app. Conclusion In-app feedback function could highlight shortcomings and strengths of mobile health apps. Taking users’ feedback into consideration could increase the chance of sustained use. Besides ease of use and clear, likeable designs, users want apps that serve their needs while saving time.