bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dose-dependent effect of spent coffee grounds on intake, apparent digestibility, fermentation pattern, methane emissions, microbial protein supply, and antioxidant status in Latxa sheep
Authors: Medjadbi Mounir , Garcia-Rodriguez Aser , Atxaerandio Raquel , Charef Salah Eddine , Picault Clea , Ibarruri Jone , Iñarra Bruno , San Martin David , Serrano-Pérez Beatriz , Martin-Alonso Maria José , Goiri Idoia 
Published: November 2024

Abstract
Spent coffee grounds (SCG), a byproduct rich in polyphenols, can form part of enteric CH4 mitigation strategies while promoting the circular economy. This study aimed to evaluate the effect of 3 levels of SCG inclusion in the concentrate on enteric CH4 production, feed intake, apparent digestibility, ruminal fermentation pattern, microbial protein supply, and gene expression of immune and antioxidant markers in peripheral blood of dry dairy ewes. In a replicated 4 × 4 Latin square design, 8 nonproductive Latxa ewes were assigned to a concentrate that differed in the level of SCG: Control (0 g/kg DM), SCG100 (100 g/kg DM), SCG150 (150 g/kg DM) and SCG200 (200 g/kg DM). In each period, 14 d of adaptation were allowed, followed by 7 d in individual metabolic cages, and 3 d in respiratory chambers. To avoid a carry-over effect a minimum of 7 d were allotted between periods in which ewes consumed control concentrate and grass hay. Total organic matter intake (OMI) and CH4 emissions (g/d) presented a quadratic response (P = 0.008 and P &lt; 0.001, respectively) to increasing levels of SCG in the feed. However, when CH4 emissions were corrected for OMI, a linear decrease was observed with increasing levels of SCG in the concentrate (P = 0.009). This reduction in CH4 emissions (g/kg OMI) could be explained by the linear decrease (P = 0.034) observed in the apparent digestibility of organic matter (OM), particularly in crude protein (CP) and starch (P = 0.002 and P = 0.003, respectively), with increasing levels of SCG in the concentrate. No significant response was found on CH4 emissions corrected for digestible OM and on ruminal fermentation pattern. Regarding microbial protein supply, a linear increase in microbial protein supply efficiency (P = 0.008) was observed with increasing levels of SCG in the concentrate. Moreover, SCG inclusion linearly reduced interleukin 10 (P = 0.031), nuclear factor E2-related factor 2 (P = 0.007), nuclear factor kappa β (P = 0.014), superoxide dismutase 1 (P = 0.015) gene expression and tended to linearly reduce those of tumor necrosis factor-α (P = 0.074) and glutathione peroxidase 1 (P = 0.082). In conclusion, inclusion of SCG up to 200 g/kg in the concentrate did not modify ruminal fermentation pattern, but linearly reduced CH4 emissions per kg of OMI, due to a linear decrease in the apparent digestibility of CP and starch. Moreover, linearly increased the efficiency of microbial supply and improved sheep’s blood antioxidant-immune status.
Flavored Tobacco Product Use Among California Adolescents Before and Immediately After a Statewide Flavor Ban
Authors: Chaffee Benjamin W , Donaldson Candice D , Couch Elizabeth T , Guerra Castillo Claudia , Farooq Omara , Cheng Nancy F , Ameli Niloufar , Wilkinson Monica L , Gansky Stuart A , Zhang Xueying , Hoeft Kristin S 
Published: November 2024

Abstract

Introduction
In December 2022, a California law banned the retail sale of most flavored tobacco products (including e-cigarettes). This investigation evaluates adolescents’ use of flavored tobacco before and after enactment.

Aims and Methods
The Teens Nicotine and Tobacco Project included online surveys of California adolescents (age 12–17) in 2022 (N = 5127) and 2023 (N = 5015) that assessed past 30-day use of various tobacco products, flavored product use, and perceived access to flavored e-cigarettes. Eight focus groups conducted in 2023 and 2024 (total N = 35) queried flavored tobacco experiences and perceptions.

Results
Among participants who used specific products, the prevalence of flavored product use declined for cigarettes (2022: 72.0%; 2023: 57.2%), cigars (2022: 87.2%; 2023: 67.4%), and smokeless tobacco (2022: 93.1%; 2023: 83.1%) but not for e-cigarettes (2022: 91.0%; 2023: 90.7%) or hookah (2022: 88.1%; 2023: 85.6%; the flavor law exempted some hookah sales). In 2023, 10.2% of all participants used any flavored tobacco product (2022: 10.0%), primarily flavored e-cigarettes (2022: 8.6%; 2023: 8.8%). In 2023, 22.0% of all participants were aware of the statewide flavor ban, including 44.1% of participants who reported tobacco use. Few focus group participants were aware of the statewide law or perceived difficulties accessing flavored e-cigarettes.

Conclusions
Shortly following a statewide flavor ban, adolescent use of flavored cigarettes, cigars, and smokeless tobacco declined, but flavored e-cigarette use was unchanged. More time for implementation and enforcement may be needed to see full policy impact.

Implications
These findings suggest that a statewide flavored tobacco policy in California was followed shortly by declines in adolescent use of some flavored tobacco products. Additional time for implementation and enforcement, along with potential further actions, such as greater restrictions on online sales, could be necessary to curb youth access to flavored e-cigarettes.
Chemical Analysis and Flavor Distribution of Electronic Cigarettes in Australian Schools
Authors: Jenkins Caitlin , Powrie Fraser , Kelso Celine , Morgan Jody 
Published: November 2024

Abstract

Introduction
Adolescent usage of electronic cigarettes has increased globally. Inconsistent, or absent, labeling of nicotine and other ingredients requires chemical analysis to accurately determine the chemical composition of these products.

Aims and Methods
Electronic cigarettes confiscated from public and private high school students (N = 598) were provided for analysis from three regions in New South Wales, Australia. The products were examined for brand, model, and flavor and a subset was further analyzed for chemical composition (n = 410) quantifying nicotine, synthetic cooling agents, flavoring chemicals, and prohibited ingredients by gas chromatography–mass spectrometry (GC–MS).

Results
The majority of samples provided were fruit-flavored disposable e-cigarettes across three main brands (IGET, HQD, and Gunnpod). Nicotine was quantified in 97.3% of disposable samples with an average concentration of 40.0 mg/mL, while one refill e-liquid was found to contain nicotine at a low concentration. Almost all samples contained the coolant WS-23 in relatively high concentrations compared to other flavoring chemicals present. Chemicals prohibited under the TGO110 (Australian e-cigarette product standard) were identified in 3.4% of the samples which were chemically analyzed. This included the presence of ethylene glycol in moderately high concentrations (up to 13.2 mg/mL).

Conclusions
Australian students’ preferences for fruity, disposable e-cigarettes were identified regardless of region with the vast majority containing high concentrations of nicotine. WS-23 was found in most disposable e-cigarettes, potentially to reduce throat irritation from nicotine and other flavoring chemicals. The inhalational safety of the samples is of concern due to health risks associated with detected prohibited compounds, particularly ethylene glycol.

Implications
This is the first study to quantify nicotine, coolants, and flavoring chemicals in e-cigarette products seized from Australian high school students and has significant implications for future policy development. Students appear to be almost exclusively using disposable e-cigarettes with high nicotine concentrations and predominately fruity flavors. WS-23 may potentially be added to disposable e-cigarettes to facilitate the uptake of these products by adolescents unaccustomed to the throat irritation from nicotine and intense flavors. The e-cigarette coils were found to have degraded over time, potentially affecting the composition of the aerosol and leaching of metals.
Misperceptions About the Effectiveness of Cutting Down and Low-Rate Daily Smoking for Reducing the Risk of Tobacco-Caused Harm
Authors: Brennan Emily , Nuss Tegan , Haynes Ashleigh , Scollo Michelle , Winnall Wendy R , Wakefield Melanie , Durkin Sarah 
Published: November 2024

Abstract

Introduction
Reducing the amount smoked per day, or smoking at a low rate, confers limited protection from smoking harms. We aimed to quantify the prevalence of misperceptions about cutting down and low-rate smoking among Australian adults who smoke.

Methods
Cross-sectional online survey in April/May 2022 (N = 2740). Participants were asked whether they agreed (misperception) or disagreed that “Reducing the number of cigarettes smoked per day is an effective way to reduce the risk of experiencing the health harms of smoking.” They were also asked whether the statement “Smoking 1 cigarette per day is about 1/20th as dangerous as smoking a pack of 20 cigarettes per day” sounded about right (misperception) or if it was less dangerous (misperception) or more dangerous than that.

Results
The misperception that reducing the number of cigarettes smoked is an effective way to reduce risk was held by 72.0% of people who smoke overall, but was more common among those who smoked ≤5 cigarettes daily (76.3%; Adj PR = 1.11 [95% CI 1.01 to 1.21]) or only occasionally (79.7%; Adj PR = 1.14 [1.06 to 1.23]) compared with those who smoked &gt;5 cigarettes daily (66.7%). Over two-thirds (67.9%) underestimated the dangers of smoking one cigarette per day, and this misperception was also more common among low-rate smokers (77.6%, Adj PR = 1.14 [95% CI 1.04 to 1.26]) compared to those who smoked &gt;5 cigarettes daily (63.1%).

Conclusions
Misperceptions about the value of cutting down and low-rate smoking for reducing the risk of tobacco-caused harm are pervasive, especially among those who currently smoke at a low rate or only occasionally.

Implications
Recent epidemiological evidence confirms that the risks of harm associated with low-rate smoking and cutting down are much higher than would be expected if the relationship between consumption and harm was linear. Findings from this study indicate that misperceptions about the benefits conferred by these smoking patterns are pervasive among people who smoke, particularly among those who currently smoke at a low rate. Corrective education that explains the mechanisms for the increased risk posed by these behaviors could be delivered via package health warnings and/or public health campaigns and may provide low-rate and occasional smokers with additional reasons to quit.
Impacts of policy-driven public procurement: a methodological review
Authors: Kundu Oishee , Uyarra Elvira , Ortega-Argiles Raquel , Tirado Mayra M , Kitsos Tasos , Yuan Pei-Yu 
Published: November 2024

Abstract
In this paper, we review recent research on the impact of public procurement with a focus on methods and data. The growing interest in mobilizing procurement for strategic purposes, such as innovation, economic growth, social value, and sustainable development, has brought to light significant knowledge gaps on the impact of public procurement on products, solutions, actors, and markets. Using a comprehensive approach to analyse scholarly understandings of procurement, we find several notions of policy-driven public procurement and identify challenges in distinguishing between strategic and ‘regular’ public procurement. We then provide a critical discussion on data, examining the currently available data sources and highlighting the need for greater data integration and linkage at the firm level to enable the causal identification of innovation and other impacts from participation in procurement. To address these gaps, we propose a set of actions for research and practice.
Real-world outcomes of everolimus-based treatment in a Taiwanese cohort with metastatic HR+/HER2− breast cancer
Authors: Kao Yun-Chieh , Tsai Yi-Fang , Shen Shih-Che , Dai Ming-Shen , Chen Fang-Ming , Liu Liang-Chih , Chao Ta-Chung , Huang Chi-Cheng , Hou Ming-Feng , Chen Shin-Cheh , Liu Chun-Yu , Tseng Ling-Ming 
Published: November 2024

Background:
Everolimus was the first orally targeted therapy for certain cancers. It was introduced before CDK4/6 inhibitors and is widely used to treat advanced hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer. This study presents comprehensive findings including updated data and long-term survival analyses focusing on patients with HR+/HER2− metastatic breast cancer who received everolimus-based treatment. The objectives were to assess the impact of everolimus on overall survival (OS) and progression-free survival (PFS) by treatment line, and to evaluate its role in therapeutic strategies in a real-world setting.

Methods:
We included 299 women aged over 20 years with histologically confirmed HR+/HER2− breast cancer who received everolimus-based treatment from multiple medical centers in Taiwan. Survival curves were generated using the Kaplan-Meier method, with the log-rank test for comparisons. Univariate and multivariate analyses were performed using a Cox proportional hazards regression model. Adverse effects were graded according to the Common Terminology Criteria for Adverse Events version 5.0.

Results:
The median PFS was 5.6 months, and the median OS was 60.1 months. Patients receiving everolimus treatment in three or more lines and those who underwent chemotherapy before everolimus-based treatment had a significantly shorter PFS but longer OS. Patients with liver and central nervous system metastases had significantly shorter PFS and OS. The disease control rate was 51.5%, and the overall response rate was 8.0%.

Conclusion:
These findings support current guidelines and advocate for the inclusion of everolimus in treatment plans for patients with metastatic HR+/HER2− breast cancer, particularly in late-line treatment, with careful consideration of the benefit-risk profile for each patient.
Hepatoblastoma in a 13-Month-old Male With Oculofaciocardiodental Syndrome
Authors: Kumar Kriti , Prasad Chitra , Masse Diana , Seelisch Jennifer 
Published: November 2024

Background:
Oculofaciocardiodental (OFCD) syndrome is an X-linked dominant condition that is typically lethal in males.

Observations:
A 13-month-old male patient with OFCD syndrome presented with hepatoblastoma. He received chemotherapy per standard of care and had a surgical resection with few complications. He received sodium thiosulfate for otoprotection and dexrazoxane for cardioprotection. Five years after diagnosis, he remains well and in remission.

Conclusions:
Malignancies have been reported in patients with OFCD syndrome; however, our patient is the only male with OFCD syndrome described with hepatoblastoma. Given the rarity of this condition, malignancy may be part of the spectrum of disease.
Effects of surgeon specialization on the outcome of emergency colorectal surgery
Authors: Alselaim Nahar A. , AlAamer Ohood H. , Almalki Mohammed M. , Al-osail Abdualziz A. , Bin Gheshayan Sultanah F. 
Published: November 2024

Background:
Colonic emergencies remain a major life-threatening condition associated with high morbidity and mortality rates. Unlike elective colorectal surgical procedures, a large portion of emergency colorectal surgical procedures are performed by noncolorectal surgeons (NCRS). The impact of specialization on the outcome of emergency colorectal surgery has not yet been well described. The authors aimed to evaluate the impact of surgeon specialization on the outcomes of emergency colorectal surgeries.

Materials and methods:
A retrospective cohort study conducted in a tertiary care center in Riyadh, Saudi Arabia between July 2008 to July 2020. Patients underwent emergency colorectal surgeries and met study inclusion criteria were identified and grouped according to the specialty of the primary surgeon: colorectal surgeons [CRS] or NCRS. Relevant study data was obtained from patient medical files. Bivariate and multivariate regression analyses were used to assess the association between the surgeons’ specialty and outcomes.

Results:
Of 219 included patients, there were 126 men [57.5%] and 93 women [42.4%]. Of all population 128 patients [58%] were operated on by CRS while 91 patients [42%] were operated on by NCRS. Most common procedure performed by CRS was left hemicolectomy [n=45, 67.2%] while the most common procedure performed by NCRS was right hemicolectomy [n=26, 51%]. The most common reason for surgery was malignant pathologies [n=129, 58.9%]. Patients who had their surgeries performed by a CRS had a significant decrease in 30-day mortality [odds ratio [OR] 0.23, 95% CI: 0.065–0.834]. Reoperation also decreased in this group [OR 0.413, 95% CI: 0.179–0.956]. Moreover, both hospital length of stay and ICU length of stay decreased CRS compared with the NCRS [OR 0.636, 95% CI: 0.465–0.869, and OR 0.385, 95% CI: 0.235–0.63, respectively].

Conclusion:
Specialization in colorectal surgery has a significant influence on morbidity and mortality after emergency operations. These findings may in improving emergency services and support remodeling the referral system in the institutions.
Refinements in Gender-Affirming Feminizing Chest Surgery
Authors: Jagasia Puja , Briggs Westby R , Nemani Sriya , Chaya Bachar , Kassis Salam , Assi Patrick 
Published: November 2024

Background
Feminizing top surgery, or mammaplasty augmentation, has multiple variables that surgeons can adjust to work synergistically with patient anatomy including plane of implant placement, pocket size, and inframammary fold (IMF) location. In the gender diverse population receiving this procedure to reduce symptoms of gender dysphoria, surgeons should be aware of differing anatomy and surgical approaches for feminizing top surgery.

Methods
A retrospective chart review was conducted using our institution's electronic health record between December 2019 and May 2023 with a minimum follow up period of 12 months. Inclusion criteria included transgender women, nonbinary patients, and all patients who did not identify as cis-gender women and who underwent feminizing top surgery. Demographic data including age, race, ethnicity, and gender were collected. Complication rates were recorded for hematoma, infection, seroma, wound dehiscence, hypertrophic scar, minor contour abnormalities, implant asymmetry, and revision surgery.

Results
Our surgeons' subfascial approach, which uses 2 equations to calculate dissection pocket dimensions and determine placement of pocket and incision based on desired implant base diameter and projection, was performed on 140 gender-diverse patients and resulted in a hematoma rate of 4.29%, an infection rate of 2.86%, and a seroma rate of 1.42% with good cosmetic outcomes, as evidenced by our low rates of minor contour abnormalities (5.71%) and implant asymmetry (1.43%). Only 5 patients (3.57%) required revision surgery.

Conclusions
Bilateral breast augmentation with round implants in a subfascial plane using a concealed IMF incision following equations to determine the dissection pocket size and new IMF position and incision position is a reproducible technique that results in good aesthetic outcomes and minimizes complications.
Evaluating Repetitive Transcranial Magnetic Stimulation for Neuropsychiatric Symptoms in Long COVID
Authors: Bock Jonathan , Kung Simon , Ganesh Ravindra , Hurt Ryan T. , Lapid Maria I. 
Published: November 2024

Objective
To describe the immediate clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) in treating long COVID symptoms. Long COVID currently impacts approximately 5.3% of US adults, presenting with persistent fatigue, depression, anxiety, cognitive impairments, and social function decline. Repetitive transcranial magnetic stimulation targeting the left dorsolateral prefrontal cortex has improved these symptoms in some studies.

Methods
Five patients (ages 52–63 years, 3 female patients) underwent accelerated rTMS using intermittent theta burst stimulation (600 pulses over 3 minutes 20 seconds, 80%–120% of resting motor threshold) to the left dorsolateral prefrontal cortex. The treatment consisted of twice-daily sessions over 20–30 treatments. Outcomes were measured using the Patient-Reported Outcomes Measurement and Information System (PROMIS) questionnaires, assessing fatigue, depression, anxiety, cognitive function, and social function at baseline and immediately posttreatment.

Results
One patient discontinued immediately due to intolerable scalp pain. Posttreatment PROMIS scores showed the following: fatigue decreased from 74.5 to 61.8, depression from 60.3 to 51.5, and anxiety from 62.0 to 54.0. Scores increased for cognitive (26.8 to 32.3) and social (31.0 to 32.5) function. These changes, although not statistically significant, indicate a trend toward symptom reduction. Subjectively, 3 of 4 patients who completed the rTMS course reported improvements.

Conclusion
This case series suggests that rTMS may offer symptomatic relief in long COVID patients. Although the observed improvements in PROMIS were not statistically significant, even minimal improvements are clinically significant for patients enduring prolonged suffering. These preliminary findings are encouraging and underscore the need for further research with larger cohorts to validate the efficacy of rTMS in long COVID symptom relief.
Evaluating the effects of Toronto’s supervised consumption sites on crime: multiple baseline interrupted time series analyses with and without synthetic controls
Authors: Panagiotoglou Dimitra , Lim Jihoon , Ingram Geoff , Sheikh Mariam El , Farhat Imen , Bjornsson Xander , Schaefer Maximilian 
Published: November 2024

AbstractBackgroundBetween 2017 and 2018, nine overdose prevention sites and supervised consumption sites (OPS/SCS) began operating in Toronto, Canada. This paper aimed to evaluate the effects of the OPS/SCS on incidence and rates of crime (i.e., assault, auto theft, break and enter, robbery, theft over $5000, bicycle theft, and theft from motor vehicle) and mental health act apprehensions.MethodsPrimary analyses used multiple baseline interrupted time series to compare outcome incidences within 100m, 200m and 500m of each OPS/SCS pre- vs. post-implementation. Secondary analyses compared rates of outcomes in treated vs. synthetic control neighbourhoods. We used exclusively publicly available confirmed incidents that occurred within city boundaries between 1 January 2014 and 30 June 2024.ResultsWithin 100m of OPS/SCS, incidents of assaults (61%, 95%CI: 10 to 134%), robberies (62%, 95%CI: 10 – 138%), and break and enters (47%, 95%CI: 6 – 104%) increased following sites’ implementation; but monthly incident trends for robberies (-2%, 95%CI: -3 – 0%) and break and enters (- 2%, 95%CI: -3 – -1%) declined. At 200m and 500m, there were no observed level effects in incidents of assault or robberies, but level effects persisted for break and enters. Further, thefts from motor vehicles (- 2%, 95%CI: -3% – -1%) declined faster post-implementation. Our secondary analysis revealed rates of assaults increased faster (1%, 95%CI: 0 – 1%;p=0.003) in treated neighbourhoods compared with synthetic controls.Conclusions and relevanceThe effects of Toronto’s OPS/SCS on crime were complex; with immediate effects being attenuated or reversed over time.