bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anthropogenic gadolinium in the Tone River (Japan): an update showing a 7.7-fold increase from 1996 to 2020
Authors: Kumasaka Soma , Kartamihardja A. Adhipatria P. , Kumasaka Yuka , Kameo Satomi , Koyama Hiroshi , Tsushima Yoshito 
Published: May 2024

Abstract
Background
Anthropogenic gadolinium (Gd), originating from Gd-based contrast agents (GBCAs) used in magnetic resonance imaging (MRI), is widely identified in the aquatic environment with concerns about toxicity and accumulation. We aimed to present new data on anthropogenic Gd in the Tone River, which has the largest drainage area in Japan, and then to compare the current data with those obtained in 1996.

Methods
The water samples were collected on August 9−10, 2020, at 15 different locations of the Tone River in Japan. The concentrations of the rare earth elements (REEs) were measured by inductively coupled plasma-mass spectrometry and normalized to Post-Archean Australian Shale to construct shale-normalized REE patterns. The degree of Gd-anomaly was defined as the percentage of anthropogenic Gd to the geogenic background and used to compare the water samples from different locations. Pearson’s correlation coefficients were calculated.

Results
All the samples displayed positive Gd anomalies. The Gd-anomaly ranged from 121 to 6,545% and displayed a repeating decrease-and-increase trend. The Gd-anomaly showed strong positive correlations to the number of hospitals (r = 0.88; p < 0.001) and their MRI units (r = 0.89; p < 0.001).

Conclusions
Our study revealed notable anomalies of Gd concentrations in river water in Japan, with strong positive correlations to the number of major hospitals and their MRI units. Compared with the previous report in 2000, the Gd-anomaly in Tone River increased from 851% (sampled in 1996) to 6,545%, i.e., 7.7 times, reflecting the increased use of GBCAs in hospitals.

Relevance statement
Notable Gd concentration anomalies in river water in Japan were observed. This result underlines the importance of more extensive research on anthropogenic gadolinium, and investigations of risks to human health as well as the development of effective removal technologies may be necessary.

Key points
• All water samples from Tone River displayed positive Gd anomalies.
• The Gd anomalies increased to 7.7 times higher over the past 24 years.
• Correlations between Gd values and the number of hospitals and MRI units were observed.

Graphical Abstract
Predicting game-induced emotions using EEG, data mining and machine learning
Authors: Lim Min Xuan , Teo Jason 
Published: May 2024

Abstract
Background
Emotion is a complex phenomenon that greatly affects human behavior and thinking in daily life. Electroencephalography (EEG), one of the human physiological signals, has been emphasized by most researchers in emotion recognition as its specific properties are closely associated with human emotion. However, the number of human emotion recognition studies using computer games as stimuli is still insufficient as there were no relevant publicly available datasets provided in the past decades. Most of the recent studies using the Gameemo public dataset have not clarified the relationship between the EEG signal’s changes and the emotion elicited using computer games. Thus, this paper is proposed to introduce the use of data mining techniques in investigating the relationships between the frequency changes of EEG signals and the human emotion elicited when playing different kinds of computer games. The data acquisition stage, data pre-processing, data annotation and feature extraction stage were designed and conducted in this paper to obtain and extract the EEG features from the Gameemo dataset. The cross-subject and subject-based experiments were conducted to evaluate the classifiers’ performance. The top 10 association rules generated by the RCAR classifier will be examined to determine the possible relationship between the EEG signal's frequency changes and game-induced emotions.

Results
The RCAR classifier constructed for cross-subject experiment achieved highest accuracy, precision, recall and F1-score evaluated with over 90% in classifying the HAPV, HANV and LANV game-induced emotions. The 20 experiment cases’ results from subject-based experiments supported that the SVM classifier could accurately classify the 4 emotion states with a kappa value over 0.62, demonstrating the SVM-based algorithm’s capabilities in precisely determining the emotion label for each participant’s EEG features’ instance.

Conclusion
The findings in this study fill the existing gap of game-induced emotion recognition field by providing an in-depth evaluation on the ruleset algorithm’s performance and feasibility of applying the generated rules on the game-induced EEG data for justifying the emotional state prediction result.
Effects of suboccipital inhibition versus soft tissue manipulation on pain intensity and disability in tension-type headache among undergraduate physiotherapy students
Authors: Venugopal Pavithra , Manoharlal Manoj Abraham , Rajaram Yuvashree 
Published: May 2024

Abstract
Background
Tension-type headache (TTH) is prevalent among collegiate students due to academic stress. Manual therapies like suboccipital inhibition and soft tissue manipulation have shown efficacy in TTH management. However, comparative studies between these interventions in collegiate populations are scarce. Understanding their relative effectiveness can enhance treatment strategies and improve outcomes, shedding light on optimal manual therapy approaches for TTH among collegiate students. This study aimed to investigate the effects of suboccipital inhibition and soft tissue manipulation on pain intensity and disability in tension-type headache (TTH) among undergraduate physiotherapy students.

Methods
Forty undergraduate physiotherapy students diagnosed with TTH were randomly assigned to the suboccipital inhibition group (group A, n =  20) and the soft tissue manipulation group (group B, n =  20). The suboccipital inhibition group received manual therapy targeting the suboccipital muscles, while the soft tissue manipulation group received manipulation techniques focusing on the cervical and shoulder girdle muscles. Pain intensity and disability were assessed using Visual Analogue Scale (VAS) and Headache Disability Index (HDI) Questionnaire at baseline and after 6 weeks of intervention. The data were collected and analysed using independent t test.

Results
Both interventions demonstrated significant reductions in pain intensity and disability after 6 weeks, with the t value − 4.3150 and − 3.3106 at p < 0.05 for VAS and HDI respectively.

Conclusion
Suboccipital inhibition and soft tissue manipulation are effective interventions for reducing pain intensity and disability among undergraduate physiotherapy students with TTH. However, the suboccipital inhibition group showed improvement in pain intensity and disability and it has been statistically significant when compared to the soft tissue manipulation group.
COVID-19 and hospital activity: experience of the Nephrology Department of Ibn Sina Hospital-Rabat
Authors: El Maakoul Sara , Benamar Loubna , Ouzeddoun Naima , Bouattar Tarik 
Published: May 2024

AbstractThe COVID-19 pandemic has led to a major health crisis, responsible for a very high morbidity in the world. This context represented an organizational challenge and required an adaptation of health services. The purpose of this study is to evaluate the activity of the Nephrology Department of Ibn Sina Hospital of Rabat during the period of confinement of the COVID-19 pandemic.Material and methods Retrospective study of hospitalization, dialysis and consultation activities in the nephrology, and dialysis and kidney transplantation department, during the period of confinement in Morocco from March 12 to June 16, 2020.Results We have identified, for the considered period of three months, 65 patients hospitalized in the nephrology department versus 218 patients during the 3 months preceding the start of confinement in Morocco, which corresponds to a decrease of 70%. The mean age of the patients was 50 ± 16 years with a male predominance. Kidney biopsy was performed in 14 patients. Lupus nephritis was found in 5 patients. Twelve patients received a bolus of methylprednisolone, 7 patients required intravenous cyclophosphamide, and only 1 patient was treated with rituximab. One-hundred twenty-nine patients underwent dialysis, and 554 patients benefited from telemedicine during this period.Conclusion Data collected in this study highlights that the global pandemic due to COVID-19 had a great impact on the activity of our department. The continuity of care for our patients has been ensured by the implementation of telemedicine and the reorganization of our hospital activity.
Relationship between climate change and environmental microplastics: a one health vision for the platysphere health
Authors: Oliveri Conti Gea , Rapisarda Paola , Ferrante Margherita 
Published: May 2024

AbstractThe production, dispersal, and accumulation of microplastics (MPs) are interconnected with climate change. Plastic production, which involves fossil resources like oil, generates greenhouse gas emissions during extraction and processing, contributing to global warming. Simultaneously, climate change influences the dispersion, fragmentation, and accumulation of MPs; extreme weather events facilitate plastic transport to the sea and natural environments. The increasing environmental impact of MPs poses a global challenge. This review focuses on the dispersion of MPs due to climate change, with attention given to the "One Health" approach. This promotes interdisciplinary collaboration, recognizing the interrelationship of human, animal, and ecosystem health. Crucial for a broad perspective on global health, the "One Health" approach emphasizes the need to understand and address MPs in the environment. In conclusion, implementing protocols for health monitoring and educating the public on responsible plastic management are essential. These preventive indications can help mitigate the effects of MPs, promoting a sustainable lifestyle from a One Health perspective.
Graphical Abstract
Perinatal mental health care in the Italian mental health departments: a national survey
Authors: Lega Ilaria , Mastroeni Simona , Ferraro Claudia , Bauer Annette , Bucciarelli Mauro , Andreozzi Silvia , Pizzi Enrica , Donati Serena ,   the Group for Maternal Mental Health in the first 1,000 days of life
Published: May 2024

Abstract

Background
Evidence on the negative outcomes of untreated mental disorders during pregnancy and in the first year after childbirth on women’s and children’s health has stimulated interest in how to develop and sustain high-quality mental health care during the perinatal period. In Italy, there is a lack of knowledge about how mental health services support women with perinatal mental disorders (PMDs). This study aims to describe the adoption of good practices for the prevention and care of PMDs by the Italian mental health departments (MHDs).

Methods
This is a nationwide cross-sectional survey conducted online using LimeSurvey. Starting from the Ministry of Health Registry’s 127 MHDs were invited to participate between February and March, 2023. Characteristics of the participating MHDs were reported as descriptive statistics.

Results
One hundred nineteen MHDs participated, with a response rate of 93.7%. Regarding the prevention of PMDs, 69 (58.0%) MHDs offer preconception counseling, whereas only 6 (5.0%) have information material for this purpose. Written integrated care pathways for PMDs are not available in 94 (79.7%) MHDs. A reference professional for psychopharmacological treatment during pregnancy or breastfeeding is available in 55 (46.2%) MHDs, while a specific treatment plan for women with PMDs is adopted by 27 (22.7%) MHDs. Thirty-four (28.6%) MHDs have established an outpatient clinic for PMDs, whereas there are no inpatient psychiatric facilities designed for mothers and infants (mother-baby units).

Conclusions
There is a need to improve the care of women with PMDs in Italy. The provision of pre-conception counseling, integrated care pathways, and specialist skills and facilities for PMDs should be prioritized.
Abiraterone in Classic Congenital Adrenal Hyperplasia: Results of Medical Therapy Before Adrenalectomy
Authors: Stuckey Bronwyn G A , Dedic Deila , Zhang Rui , Rabbah Amira , Turcu Adina F , Auchus Richard J 
Published: May 2024

Abstract
We present the case of a 20-year-old woman with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency, with uncontrolled hyperandrogenemia despite supraphysiological glucocorticoid therapy. We used abiraterone acetate, an inhibitor of the 17-hydroxylase/17,20-lyase enzyme, to suppress adrenal androgen synthesis and allow physiological glucocorticoid and mineralocorticoid therapy, as a proof-of-concept, before proceeding to bilateral adrenalectomy. We report the patient's clinical course, the changes in adrenal steroids, and the immunohistochemistry of the adrenals.
The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study
Authors: Warncke Katharina , Tamura Roy , Schatz Desmond A , Veijola Riitta , Steck Andrea K , Akolkar Beena , Hagopian William , Krischer Jeffrey P , Lernmark Åke , Rewers Marian J , Toppari Jorma , McIndoe Richard , Ziegler Anette-G , Vehik Kendra , Haller Michael J , Elding Larsson Helena 
Published: May 2024

Abstract

Context
The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty.

Objective
We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes.

Methods
The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios.

Results
Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P &lt; .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes.

Conclusion
Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.
Stereotactic Radiosurgery for Ependymoma in Pediatric and Adult Patients: A Single-Institution Experience
Authors: Yoo Kelly H. , Marianayagam Neelan J. , Park David J. , Persad Amit , Zamarud Aroosa , Shaghaghian Elaheh , Tayag Armine , Ustrzynski Louisa , Emrich Sara C. , Gu Xuejun , Ho Quoc-Anh , Soltys Scott G. , Meola Antonio , Chang Steven D. 
Published: May 2024

BACKGROUND AND OBJECTIVES:
Ependymoma is commonly classified as World Health Organization grade 2 with the anaplastic variant categorized as grade 3. Incomplete resection or anaplastic features can result in unfavorable outcomes. Stereotactic radiosurgery (SRS) provides a minimally invasive approach for recurrent ependymomas. Our study investigates the efficacy and safety of SRS for grade 2 and 3 ependymomas in pediatric and adult populations.

METHODS:
We conducted a retrospective analysis on 34 patients with 75 ependymomas after CyberKnife SRS between 1998 and 2023. Fourteen were pediatric (3-18 years), and 20 were adult (19-75 years) patients. The median age was 21 years, and the median tumor volume was 0.64 cc. The median single-fraction equivalent dose was 16.6 Gy, with SRS administered at 77% of the median isodose line.

RESULTS:
After a median follow-up of 42.7 months (range: 3.8-438.3), 22.7% of ependymomas progressed. The 5-year local tumor control rate was 78.1%, varying between 59.6% and 90.2% for children and adults, with grade 2 at 85.9% compared with 58.5% for grade 3 tumors. The 5-year overall survival rate was 73.6%, notably higher in adults (94.7%) than in children (41%), and 100% for grade 2 but decreased to 35.9% for grade 3 patients. The 5-year progression-free survival rate was 68.5%, with 78.3% and 49.2% for adults and children, respectively, and a favorable 88.8% for grade 2, contrasting with 32.6% for grade 3 patients. Symptom improvement was observed in 85.3% of patients. Adverse radiation effects occurred in 21.4% of pediatric patients.

CONCLUSION:
Our study supports SRS as a viable modality for pediatric and adult patients with grade 2 and 3 ependymomas. Despite lower local tumor control in pediatric and grade 3 cases, integrating SRS holds promise for improved outcomes. Emphasizing careful patient selection, personalized treatment planning, and long-term follow-up is crucial for optimal neurosurgical outcomes.
Risk factors and prediction model of delirium in elderly patients after hip arthroplasty
Authors: Duan Yanli , Zhang Ruzhen 
Published: May 2024

Objective: To analyze the risk factors of delirium in elderly patients after hip arthroplasty and to construct a prediction model.
Methods: Clinical data of 248 elderly patients who underwent hip arthroplasty in the Department of Traumatology and Orthopedics at Wuhan Fourth Hospital were retrospectively collected from November 2021 to February 2023. Logistic regression analysis was used to identify the risk factors of delirium after hip arthroplasty, and a nomogram prediction model was constructed using the RMS package of R4.1.2 software. The accuracy and stability of the model was evaluated based on the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic (ROC) curve.
Results: Age, nighttime sleep, anesthesia method, intraoperative blood loss, hypoxemia, and C-reactive protein (CRP) level were all risk factors of delirium after the hip arthroplasty (P<0.05). These factors were used to construct a nomogram prediction model that was internally validated using the Bootstrap method. The prediction model had the area under ROC curve (AUC) of 0.980 (95% CI: 0.964-0.996), indicating that it has certain predictive value for postoperative delirium. When the optimal cut off value was selected, the sensitivity and specificity were 92.7% and 92.3%, respectively, indicating that the prediction model is effective.
Conclusions: Age, short nighttime sleep, general anesthesia, high intraoperative blood loss, hypoxemia, and high CRP levels are independent risk factors for delirium after hip arthroplasty. The nomogram prediction model constructed based on these risk factors can effectively predict delirium in elderly patients after hip arthroplasty.
doi: https://doi.org/10.12669/pjms.40.6.9306
How to cite this: Duan Y, Zhang R. Risk factors and prediction model of delirium in elderly patients after hip arthroplasty. Pak J Med Sci. 2024;40(6):1077-1082. doi: https://doi.org/10.12669/pjms.40.6.9306
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A Stochastic Inexact Sequential Quadratic Optimization Algorithm for Nonlinear Equality-Constrained Optimization
Authors: Curtis Frank E. , Robinson Daniel P. , Zhou Baoyu 
Published: May 2024

A stochastic algorithm is proposed, analyzed, and tested experimentally for solving continuous optimization problems with nonlinear equality constraints. It is assumed that constraint function and derivative values can be computed but that only stochastic approximations are available for the objective function and its derivatives. The algorithm is of the sequential quadratic optimization variety. Distinguishing features of the algorithm are that it only employs stochastic objective gradient estimates that satisfy a relatively weak set of assumptions (while using neither objective function values nor estimates of them) and that it allows inexact subproblem solutions to be employed, the latter of which is particularly useful in large-scale settings when the matrices defining the subproblems are too large to form and/or factorize. Conditions are imposed on the inexact subproblem solutions that account for the fact that only stochastic objective gradient estimates are employed. Convergence results are established for the method. Numerical experiments show that the proposed method vastly outperforms a stochastic subgradient method and can outperform an alternative sequential quadratic programming algorithm that employs highly accurate subproblem solutions in every iteration. Funding: This material is based upon work supported by the National Science Foundation [Awards CCF-1740796 and CCF-2139735] and the Office of Naval Research [Award N00014-21-1-2532].
Prediction-Driven Surge Planning with Application to Emergency Department Nurse Staffing
Authors: Hu Yue , Chan Carri W. , Dong Jing 
Published: May 2024

Determining emergency department (ED) nurse staffing decisions to balance quality of service and staffing costs can be extremely challenging, especially when there is a high level of uncertainty in patient demand. Increasing data availability and continuing advancements in predictive analytics provide an opportunity to mitigate demand uncertainty by using demand forecasts. In this work, we study a two-stage prediction-driven staffing framework where the prediction models are integrated with the base (made weeks in advance) and surge (made nearly real-time) nurse staffing decisions in the ED. We quantify the benefit of having the ability to use the more expensive surge staffing and identify the importance of balancing demand uncertainty versus system stochasticity. We also propose a near-optimal two-stage staffing policy that is straightforward to interpret and implement. Last, we develop a unified framework that combines parameter estimation, real-time demand forecasts, and nurse staffing in the ED. High-fidelity simulation experiments for the ED demonstrate that the proposed framework has the potential to reduce annual staffing costs by 10%–16% ($2 M–$3 M) while guaranteeing timely access to care. This paper was accepted by David Simchi-Levi, healthcare management. Funding: J. Dong was partially supported by the Division of Civil, Mechanical and Manufacturing Innovation [Grant CMMI-1944209]. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2021.02781 .