bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection and Prediction of Toxic Aluminum Concentrations in High-Priority Salmon Rivers in Nova Scotia
Authors: Hart Kristin A. , Trueman Benjamin , Halfyard Edmund A. , Sterling Shannon M. 
Published: October 2024

Abstract
Elevated concentrations of toxic cationic aluminum (Ali) are symptomatic of terrestrial and freshwater acidification and are particularly toxic to salmonid fish species such as Atlantic salmon (Salmo salar). Speciated metal samples are rarely included in standard water monitoring protocols, and therefore the processes affecting Ali dynamics in freshwater remain poorly understood. Previous analysis of Ali concentrations in Nova Scotia (Canada) rivers found that the majority of study rivers had concentrations exceeding the threshold for aquatic health, but a wide-scale survey of Ali in Nova Scotia has not taken place since 2006 (Dennis, I. F., & Clair, T. A., 2012, Canadian Journal of Fisheries and Aquatic Sciences, 69(7), 1174–1183). The observed levels of dissolved aluminum in Atlantic salmon (Salmo salar) rivers of Atlantic Canada have potential serious and harmful effects for aquatic populations. We present the findings of the first large-scale assessment of the Ali status of Nova Scotia rivers in 17 years; we measured Ali concentrations and other water chemistry parameters at 150 sites throughout the Southern Uplands region of Nova Scotia from 2015 to 2022. We found that Ali concentrations exceeded toxic thresholds at least once during the study period at 80% of the study sites and that Ali concentrations increased during the study period at all four large-sample study sites. Modeling of relationships between Ali concentrations and other water chemistry parameters showed that the most important predictors of Ali are concentrations of the dissolved fractions of Al, iron, titanium, and calcium, as well as dissolved organic carbon and fluoride. We developed a fully Bayesian linear mixed model to predict Ali concentrations from a test data set within 15 μg/L. This model may be a valuable tool to predict Ali concentrations in rivers and to prioritize areas where Ali should be monitored. Environ Toxicol Chem 2024;43:2545–2556. © 2024 The Author(s). Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
Cocoa Pod Husk Meal as a Feed Ingredient for Livestock
Authors: Mael Sandy Hoffman 
Published: September 2024

ABSTRACTCocoa pod husk (CPH) is a by‐product of cocoa. Whilst this by‐product is converted into animal feed in some countries, it is largely left to decompose and cause environmental issues in most South Pacific countries, including Vanuatu. The husk represent 70%–80% of the whole fruit. Its use as animal feed is limited by the presence of antinutritional factors, of which, theobromine is the most prominent. Other antinutritional factors include tannin and phytate. Feeding value of the CPH is improved by reducing these antinutritional factors through broiling, alkaline, and microbial treatment. Exogenous feed enzymes are used to hydrolyze crude fiber. Up to 10% of this by‐product is included in broiler feed and 15% with supplementation of exogenous feed enzymes in layer feed. In pigs, up to 20% can be included into diets of both the sow and growing pig. In ruminants, up to 35% can be used in cattle diet if treated with urea, molasses and/or fermented. The by‐product is widely used as an ingredient and/or energy/protein sources in Africa and Asia. There is scanty literature on its use in the South Pacific countries. In this review, I compiled existing literature on its chemical composition, use in livestock and poultry diets, and existing strategies to improve feeding value. The aim of this review is to project cocoa pod husk meal (CPHM) as a potential feed ingredient as well as energy/protein sources for livestock and poultry in the South Pacific countries, including Vanuatu.
Evaluation of whey protein coating containing free and Pickering emulsion forms of Trachyspermum copticum L. essential oil on quality of refrigerated beef
Authors: Saghari Vida , Jalali Hossein , Shariatifar Nabi , Ziaolhagh Seyedhamidreza 
Published: September 2024

AbstractThe purpose of the present research was to prepare a novel biodegradable coating of whey protein (whey) and essential oil of Trachyspermum copticum L. (forms of free (EO) and Pickering emulsion (NEO)) to improve the shelf life of beef. In this study, various microbiological, chemical, and sensory analyses were performed. The results showed that after 18 days, the highest and lowest microbiological counts were related to control samples and whey‐NEO treatments, respectively. The total viable count (TVC) was 8.2 and 6.8 log CFU/g, the total psychrotrophic count (TPC) was 8.5 and 6.7 log CFU/g, and the lactic acid bacteria (LAB) count was 7.7 and 6.5 log CFU/g for control and whey‐NEO treatments, respectively. Chemical analysis of whey‐NEO treatment and control sample were 6.3 and 7.5 for pH, 9.8 and 13.9 meq/kg for PV (peroxide value), 5.45 and 8.85 mg/kg for TBARS (thiobarbituric acid reactive substances), and 25.1 and 39.4 mgN/100 g for TVB‐N (total volatile basic nitrogen), respectively. The best result was associated with the whey‐NEO treatment; consequently, coatings with whey and EO Pickering emulsion should be considered as a potential active coating in the meat industry.
Characterizing second line and beyond therapies for primary central nervous system lymphomas
Authors: Primeaux Brian , Luo Chelsea , Yeung Erin K. , Linger Caitlin , Chen Sheree , Do Bryan 
Published: September 2024

AbstractPrimary central nervous system (CNS) lymphoma (PCNSL) is a rare and aggressive lymphoma that affects the CNS without other systemic involvement. High‐dose methotrexate (HDMTX)‐based regimens are recommended frontline treatment, followed by consolidation with either high‐dose chemotherapy, whole brain radiation (WBRT) +/− sequential temozolomide (TMZ), or autologous stem cell transplant (autoSCT). Despite advancements with HDMTX and rituximab, up to half of patients will relapse. Treatment for relapsed or refractory (R/R) disease varies widely as preferred regimens are not well‐established. Our study aimed to provide real‐world characterization of R/R PCNSL therapies. The secondary objective was characterization of consolidation methods after frontline treatment. This retrospective, descriptive analysis included 54 adult PCNSL patients that received a HDMTX‐based frontline regimen between 4/1/2016 and 7/1/2022. Patients receiving HDMTX for the purpose of secondary CNS lymphoma, non‐B cell origin PCNSL, and intraocular lymphoma were excluded. Thirty‐one patients (57%) received consolidation therapy with rituximab and high‐dose cytarabine (R‐HDAC), WBRT, or both. Thirteen patients (24%) proceeded with autoSCT. Twenty‐five patients had disease progression, with 17 patients receiving second line treatment. The second line treatments were WBRT (24%), clinical trial (18%), rituximab with lenalidomide (R2; 18%), re‐induction with HDMTX‐based regimens (18%), ibrutinib with rituximab (12%) and R‐HDAC (12%). Seven patients progressed, and all received third line treatment. Treatments varied, including R2; ibrutinib +/− HDMTX; rituximab, methotrexate, and cytarabine; R‐HDAC; R‐nivolumab; and WBRT. Five patients received a fourth line regimen of R +/− lenalidomide, R‐HDMTX, or nivolumab monotherapy. Regimens used for the three patients who received fifth line treatment and beyond included R‐TMZ and pembrolizumab monotherapy in addition to previously described regimens. Regimen selection is varied and highly dependent on physician preference and patient factors, including clinical trial eligibility, prior therapies, performance status, organ function, and treatment intent. Prospective clinical trials are needed to guide optimal management.
A new treatment approach of toripalimab in combination with concurrent platinum‐based chemoradiotherapy for locally advanced cervical cancer: A phase II clinical trial
Authors: Chen Jie , Shi Jinming , Cao Yuanjie , Li Chen , Li Junyi , Yuan Zhiyong 
Published: September 2024

AbstractThis study investigated the efficacy and safety of toripalimab in combination with concurrent platinum‐based chemoradiation in patients with untreated locally advanced cervical cancer. Eligible patients received toripalimab 240 mg once every 3 weeks in combination with concurrent platinum‐based chemoradiotherapy, followed by the maintenance of toripalimab once every 6 weeks up to 1 year. The primary endpoint was objective response rate (ORR). Secondary endpoints included 2‐year and 3‐year progression‐free survival (PFS) rates, 3‐year overall survival (OS) rate, and safety. Biomarker analysis of PD‐L1 expression and genomic mutational analysis by next‐generation sequencing were conducted, as well as PD‐L1 expression on tumor biopsies. A total of 82 patients were enrolled. The median follow‐up was 21 months (range, 5.2–44.5 months). The ORR and disease control rate were both 87.8% among the 82 patients. Median PFS and OS were not reached. A trend toward longer PFS was observed in the populations with a PD‐L1 combined positive score ≥10, low tumor mutation burden and loss of heterozygosity in human leukocyte antigen (HLA LOH) detected populations. A total of 37 patients experienced treatment‐related adverse events, of which 17 (20.7%) patients experienced grade 3 or higher adverse events. Collectively, toripalimab plus concurrent platinum‐based chemoradiotherapy showed promising antitumor efficacy with acceptable safety profiles in patients with untreated locally advanced cervical cancer.
Menstrual management using the etonogestrel implant in individuals with intellectual disabilities in Joinville, Brazil
Authors: Braga Giordana Campo , Zarabia Carla Josene , da Trindade Adriana Kelly Soares de S. , Vieira Carolina Sales 
Published: October 2024

AbstractObjectiveThis study aimed to describe the use of etonogestrel (ENG) implants for menstrual management (i.e., management of bleeding and symptoms associated with menstruation) in individuals with intellectual disabilities.MethodsThis study retrospectively analyzed a cohort of individuals with intellectual disabilities who began using ENG implants between 2003 and 2018, in Joinville, Brazil. We collected sociodemographic, clinical, and reproductive data from the medical records, along with information related to ENG implant use.ResultsIn total, 369 implants were placed in 130 individuals with intellectual disabilities. The median age at the first implant was 20 (interquartile range [IQR], 17–26) years, and 43.8% of the patients were adolescents. By December 2018, 90 patients had received two or more subsequent implants. The median duration of current ENG implant use was 19 (IQR, 12.8–22) months. More than 40% of the patients had comorbidities, with epilepsy being the most common. During the use of the current implant, 80% of the patients had a favorable bleeding profile (no bleeding or ≤1 bleeding episode per month), and 53.8% (70/130) had no bleeding within 3 months before their last medical visit. Among patients experiencing dysmenorrhea and premenstrual syndrome (PMS), 79% (64/81) and 82% (54/66) reported complete improvement, respectively. The premature implant removal rate was 8.9% (33/369). Unfavorable bleeding was the main reason for premature implant removal (20 out 33 removals).ConclusionsENG implants might be a suitable option for individuals with intellectual disabilities who require management of menstrual bleeding and symptoms associated with menstruation. Most patients had a favorable bleeding profile and experienced significant improvements in dysmenorrhea and PMS, contributing to the high continuation rates of ENG implants.
Anticoagulant therapy in pregnant women with mechanical and bioprosthetic heart valves
Authors: Rhemtula Haroun A. , Schapkaitz Elise , Jacobson Barry , Chauke Lawrence 
Published: September 2024

AbstractObjectiveThe aim of the present study was to review maternal and fetal outcomes in pregnant women with prosthetic heart valves.MethodsA retrospective record review of pregnant women with prosthetic heart valves on anticoagulation was performed at the Specialist Cardiac Antenatal Clinic, Johannesburg South Africa from 2015 to 2023.ResultsFifty pregnancies with mechanical heart valves and three with tissue valves, on anticoagulation for comorbid atrial fibrillation were identified. The majority were of African ethnicity at a mean age of 33 ± 6 years. Anti‐Xa adjusted enoxaparin was commenced at 10.5 ± 5.6 weeks' gestation until delivery in 48 (90.6%) pregnancies and warfarin was continued in five (9.4%) pregnancies. The live birth rates on enoxaparin and warfarin were 56.3% (95% confidence interval [CI]: 42.3–69.3) and 20.0% (95% CI: 2.0–64.0), respectively. There were 12 (22.6%) miscarriages at a mean of 11.3 ± 3.7 weeks' gestation, four (7.5%) intrauterine fetal deaths on warfarin and two (3.8%) warfarin embryopathy/fetopathy. The rates of antepartum/secondary postpartum bleeding and primary postpartum bleeding were 29.4% (95% CI: 18.6–43.1) and 5.9% (95% CI: 1.4–16.9), respectively. Maternal complications included anemia (n = 11, 20.8%), arrhythmia (n = 2, 3.8%), heart failure (n = 2, 3.8%) and paravalvular leak (n = 2, 3.8%). There was one (1.9%) mitral valve thrombosis and one (1.9%) stuck valve in pregnancies who defaulted warfarin prior to pregnancy. There were no maternal deaths.ConclusionMultidisciplinary management of pregnant women with prosthetic heart valves with anti‐Xa adjusted low molecular weight heparin throughout pregnancy represents an effective anticoagulation option for low‐middle‐income countries.
Simultaneous robotic hemicolectomy and robotic partial nephrectomy via a posterior approach
Authors: Ishida Masaru , Yamada Toru , Takeuchi Rei , Jin Yuta , Katsumata Kaori , Saito Takafumi , Arai Masashi , Sanjo Tansei , Anno Tadatsugu , Egawa Tomohisa 
Published: September 2024

IntroductionAdvances in diagnostic technologies have resulted in an increase in patients with synchronous cancers. We report robotic hemicolectomy and robotic partial nephrectomy via a posterior approach.Case presentationA 72‐year‐old woman presented with synchronous ascending colon and right kidney cancers. We performed simultaneous robotic right hemicolectomy and robotic right partial nephrectomy. The renal tumor was located in a posterior and mid‐lower pole of the kidney, we positioned the ports similar to the retroperitoneal approach and to gain a confronting approach to the tumor.ConclusionConsidering preoperative evaluations and intraoperative conditions comprehensively, it is essential to flexibly adapt to the appropriate surgical position and port arrangement to perform the surgery with consideration for oncological principles.
Pascal's uncertainty principle: Managing drug–drug interactions when the risks are unclear
Authors: Hansten Philip D. , Gomez‐Lumbreras Ainhoa , Villa‐Zapata Lorenzo , Malone Daniel C. 
Published: September 2024

AbstractTherapeutic decision‐making (TDM) often occurs under conditions of scientific uncertainty, including decisions on how to manage the majority of drug–drug interactions (DDIs). The existence of many DDIs is not firmly established, and there is an unfortunate tendency to make decisions based on the binary assessment of whether or not a particular DDI is real, rather than taking a more probabilistic and holistic approach to TDM. There also seems to be an undue fear of making a Type I error (assuming the DDI is real when it is not) while ignoring the often much greater risk of a Type II error (assuming the DDI is not real, when it is). Thus, a more rational TDM process for such DDIs is needed. In his famous “Wager,” philosopher‐mathematician Blaise Pascal made a probabilistic argument for believing in God. Instead of considering probability in isolation, Pascal linked the probability of God's existence with the severity of the outcome (an eternity in Hell for non‐believers) and also added a third factor—the ease with which the risk can be avoided. We propose a novel paradigm for TDM that uses all three of Pascal's steps: probability, severity, and avoidability. We present several specific DDI examples to demonstrate how Pascal's Uncertainty Principle can help pharmacists make clinical management decisions for these DDIs. We suggest that this process be called “Pascal's Uncertainty Principle” rather than “Pascal's Wager,” because it can be used to make rational decisions in the presence of uncertainty in many non‐theological situations. This process reinforces the value of philosophical training for pharmacy students.
Resources for innovative learning of anatomy and foot ossification: Graphic design and virtual reality
Authors: Moreno‐Marin Ana Cristina , Pardo Rios Manuel , Lopezosa‐Reca Eva , Molina García Cristina , Díaz‐Miguel Salvador , Gómez‐Martín Beatriz , Cobos‐Moreno Paula 
Published: September 2024

AbstractIntroductionThis study addresses the ossification process of the foot, a topic of great relevance within podiatry courses. Understanding the chronology of foot bone formation is essential for evaluating pathological processes and establishing appropriate therapeutic actions to improve patient quality of life. The main objectives of this work are to understand the ossification process of the foot bones and to propose an appropriate didactic methodology for effective learning of this process.Materials and MethodsThe individual ossification sequences of the foot bones were established and virtually recreated to make these processes more didactic and usable as teaching aids. The literature search was conducted using the PRISMA statement, focusing on terms, such as “bone ossification,” “foot,” and “bone development,” and included relevant studies from medical databases.ResultsUpdating the ossification ages and providing previously unavailable visual teaching material offers a useful tool for improving the teaching of this subject. It was found that, in general, the tarsal bones show significant differences in ossification ages between sexes, with later and slower ossification in males. These differences are statistically analyzed and presented in detailed comparative tables.ConclusionsThe use of innovative teaching tools, such as virtual anatomical models, helps students to better understand the ossification process of foot bones. Implementing these tools in the podiatry curriculum not only facilitates knowledge acquisition but also enhances the quality of teaching and, consequently, the future clinical practice of students.
Neuroimaging Findings From Cerebral Structure and Function in Coronary Artery Disease
Authors: Wang Wanbing , Zhang Xinghua , Lyu Jinhao , Duan Qi , Yan Fei , Li Runze , Xing Xinbo , Li Yanhua , Lou Xin 
Published: September 2024

An increasing number of evidence suggests that bidirectional communication between the cardiovascular system and the central nervous system (CNS), known as the heart–brain interaction, is crucial in understanding the impact of coronary artery disease (CAD) on brain health. The multifactorial role of CAD in the brain involves processes such as inflammation, oxidative stress, neuronal activity, neuroendocrine imbalances, and reduced cerebral perfusion, leading to various cerebral abnormalities. The mechanisms underlying the relationship between CAD and brain injury are complex and involve parallel pathways in the CNS, endocrine system, and immune system. Although the exact mechanisms remain partially understood, neuroimaging techniques offer valuable insights into subtle cerebral abnormalities in CAD patients. Neuroimaging techniques, including assessment of neural function, brain metabolism, white matter microstructure, and brain volume, provide information on the evolving nature of CAD‐related cerebral abnormalities over time. This review provides an overview of the pathophysiological mechanisms of CAD in the heart–brain interaction and summarizes recent neuroimaging studies utilizing multiparametric techniques to investigate brain abnormalities associated with CAD. The application of advanced neuroimaging, particularly functional, diffusion, and perfusion advanced techniques, offers high resolution, multiparametric capabilities, and high contrast, thereby allowing for the early detection of changes in brain structure and function, facilitating further exploration of the intricate relationship between CAD and brain health.Level of Evidence5Technical EfficacyStage 3
Open or closed: Experience of head and neck radiotherapy masks – A mixed‐methods study
Authors: Lundin Erik , Axelsson Sofia , Ohlsson‐Nevo Emma 
Published: September 2024

AbstractIntroductionIn radiotherapy for head and neck cancer, a mask is used to immobilise the head and shoulders. An open mask that does not cover the face is expected to cause less anxiety, but there is need to further investigate the patients' experience of open versus closed masks. Therefore, the aim of this study is to evaluate patient preferences for open or closed masks and whether an open mask can reduce discomfort and anxiety for patients.MethodsTwenty participants were treated in alternating weeks using open and closed masks. Their distress was evaluated through semi‐structured interviews and patient‐reported outcome measures.ResultsWhen using the open mask, it took longer to position the patient correctly. The closed mask felt more confining and could induce a sense of claustrophobia. Participants employed both internal and external strategies to cope with the stressful situation. The Hospital Anxiety and Depression Scale (HADS) showed a significant reduction in anxiety over time during the treatment period, but no significant difference between the masks. When participants chose which mask to use for the final treatments, 12 chose the open mask, while 8 chose the closed mask. In addition to the 20 analysed participants, two participants withdrew from the study because they could only tolerate the open mask, one due to anxiety and the other due to swelling.ConclusionsThe open mask seems to provide a less confined experience but may lead to greater difficulties in achieving the correct treatment position. While both masks can be viable options for most patients, some cannot tolerate closed masks but do tolerate open masks.
Diagnosis of 42 Cases of Intrauterine Twin Pregnancy Complicated With Ectopic Pregnancy
Authors: Zheng Mingxiang , Wen Yi , Wang Hengxu , Peng Yangqin , Fei Gong , Hui Chen , Ouyang Yan , Li Xihong 
Published: September 2024

ObjectivesThe coexistence of intrauterine twin pregnancy and ectopic pregnancy (EP), known as heterotopic pregnancy, is a rare but potentially life‐threatening condition. In this study, we aimed to investigate the pregnancy outcomes in women with intrauterine twin pregnancies complicated with EP after assisted reproductive technology.MethodsThis retrospective study analyzed the medical records of 42 women diagnosed with intrauterine twin pregnancies complicated with EP via ultrasound or surgery at our hospital between January 2005 and December 2020. We collected data on patient general characteristics, high‐risk factors, clinical symptoms, ultrasound features, treatment methods, and pregnancy outcomes.ResultsAmong the 42 included women, 47.6% (20/42) had a history of tubal surgery, while 52.4% (22/42) and 47.6% (20/42) received the transfer of 2 and 3 embryos, respectively. In terms of treatment, 21.4% (9/42) women received expectant management, whereas 78.6% (33/42) underwent surgical treatment, with laparoscopic surgery accounting for 71.4% (30/42). Tracking the pregnancy outcomes revealed a live birth rate of 81.0% (34/42) and a full‐term birth rate of 50.0% (21/42). The preterm birth rate was 31.0% (13/42), with a breakdown of 1 singleton (7.7%, 1/13) and 12 twin births (92.3%, 12/13) among the total 13 premature deliveries. Among the neonates, 33.3% (14/42) were singletons and 47.6% (20/42) twins. Caesarean section accounted for 31 out of 34 deliveries (91.2%).ConclusionsThough the incidence of EP in twin pregnancies has declined in the last decade, early diagnosis and proper management are still crucial for favorable outcomes in twin pregnancies with EP.