bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing Energy and Delay in Task Offloading for Connected Vehicles with Proximal Policy Optimization
Authors: Raza Salman
Published: September 2024

Electric-powered intelligent connected vehicles are becoming the pivotal point of the automotive industry. As vehicles integrate more applications, the computation tasks they generate increase substantially. Cloud servers cannot handle these tasks promptly, and current electric vehicles (EVs) have limited energy and computing resources. Multi-Access edge computing (MEC) performs various activities in proximity to the vehicles, resulting in decreased latency and the preservation of EV battery power. However, MEC servers have finite processing resources and may be unable to satisfy the required latency restrictions. We propose a task offloading scheme to optimize the allocation of computational resources from roadside servers across several EVs. We develop a mathematical model to optimize both computation latency and EV energy, represented as a Markov decision process (MDP). To address this, we employ the deep reinforcement learning-proximal policy optimization (DRL-PPO) algorithm. The implementation of our mathematical model, which is based on an MDP, together with the use of the DRL-PPO algorithm, showcases notable decreases in both energy consumption and latency when compared to alternative benchmark deep reinforcement learning (DRL) approaches.
A novel partition function for elementary particles
Authors: Arneth Borros
Published: September 2024

Three different partition functions are well-known and described in statistical physics. Here, a novel partition function for the description of intra-particular interactions and with this for the mass of particles is presented below. In statistical physics, three different partition
functions are already well-established. These are the microcanonical, the canonical, and the macro-canonical partition functions. Here a fourth, novel partition function is added to these already well-established three. Thereby due to the properties of quantum mechanics and superposition,
this novel partition function is of fundamental different nature. According to this concept, the new partition function for particles is first defined. The masses and energies of the elementary particles are then calculated using this novel partition function. The energy of an elementary particle
is proportional to the mass on the one hand and to the novel partition function on the other. The constant of proportionality with respect to the new partition function is found to be identical with Rydberg constant and Rydberg energy. The relationships found for the proton, the electron,
and the sigma particle are then generalized to all elementary particles.
Quantum mechanics emerging from complex Brownian motions
Authors: Farshad Mohsen
Published: September 2024

The connection between the Schrödinger equation and Einstein's diffusion theory based on the Brownian motion of independent particles is well known. However, in contrast to diffusion theory, quantum mechanics theory has suffered controversial interpretations due to the counterintuitive
concept of wavefunction. Here, while we confirm there is no difference in the mathematical form of these two equations, we derive the imaginary version of displacement. Using the diffusion theory of particles in a medium, as simple as it is, we describe that quantum mechanics is just an elegant
and subtle equation to describe the probability of all the trajectories that a particle can take to propagate in time by a predictive wavefunction. Therefore, information on the position of particles through time in quantum theory is embedded in the wavefunction, which predicts the evolution
of an ensemble of individual Brownian particles.
Quantum information processing in a neuron
Authors: Chawla Aman , Morgera Salvatore Domenic
Published: September 2024

It was recently argued that a neuron would decohere very rapidly from any quantum superposition of its “on” and “off” states. We argue that a hot, wet, biological device such as a neuron is not a two-state device but is better modeled as a “quasi-analog”
device with a very large number of basis states, using the presence of electric fields. Furthermore, the neuron is shown to have a decoherence time on the order of 1 ms, the timescale of an action potential. This would imply that quantum information may be stored and processed by a neuron.
The instant probability of object with deterministic motion. Another way to understand quantum mechanics
Authors: Zhang Guochang
Published: September 2024

Usually, the idea of probability is applied only to the random motion in physics. Here, the instant probability concept is obtained by applying the probability approach to objects with deterministic motion trajectories via a coin falling to the ground as an example. Applied this concept
to understand quantum mechanics, the following conclusions are inferred: The wave function/quantum state represents an instant probability distribution of physical quantities after taking into account Planck's constant; the collapse of the wave function is a special case of any function on
time-dependent probability prediction has to collapse when performing measurement. The arrangement of measurements will affect the observed results; Quantum mechanics reveals the existence of non-local effects, which have nothing to do with the interaction in classical physics. Quantum mechanics
cannot answer questions such as whether the cat is dead or alive before opening the box. The correct answer to this kind of question has to be from classic physics.
Manner Coffee
Authors: Appelgryn Henni
Published: September 2024

This case study examines Manner Coffee's journey in China's competitive coffee market, focusing on its strategic initiatives, market positioning, and brand identity challenges. Manner Coffee has differentiated itself by blending modern aesthetics with traditional Chinese elements, creating a unique coffee experience that resonates with local consumers. The case details how Manner Coffee has leveraged community engagement, sustainability practices, and technological innovation to build customer loyalty and drive growth. However, the company faces a significant trademark infringement issue with Josef Manner and Comp AG, affecting its brand identity and future expansion plans. Despite these challenges, Manner Coffee remains committed to delivering premium coffee experiences and navigating legal uncertainties to secure its position in China's burgeoning coffee culture. This study provides insights into brand management, market entry strategies, and the complexities of protecting intellectual property in international markets.
Keenon Robotics
Authors: He Qinghao
Published: September 2024

This case study delves into the rapid evolution and strategic initiatives of Keenon Robotics, a pioneering force in commercial service robots. Focusing on innovative technologies such as robot as a service (RaaS), Keenon Robotics has revolutionized sectors including catering, healthcare, hospitality, and epidemic management with its diverse range of robots. The case explores Keenon Robotics' journey from its historic breakthroughs in robotic technology to its pivotal role in addressing contemporary challenges like the COVID-19 pandemic through products like the Disinfection Robot M2. It also highlights the strategic expansions into new markets and industries, such as hotels and education, underscoring the company's commitment to technological innovation and societal impact. Through insightful analysis and strategic milestones, the case explains how Keenon Robotics navigates opportunities and challenges in the burgeoning field of service robotics, positioning itself at the forefront of industry transformation.
Medlinker
Authors: Wang Yuxin
Published: September 2024

This case study examines Medlinker, a leading figure in China's internet healthcare sector, focusing on its evolution, market strategy, and technological innovations. Founded in 2014 by Dr. Wang Shirui, Medlinker has transformed from a social networking platform for doctors to a comprehensive disease management service integrating AI-driven solutions. The study delves into Medlinker's pioneering role in leveraging MedGPT, China's first large language model for medical applications, and its strategic initiatives to enhance healthcare accessibility and efficiency. It examines Medlinker's way of doing business, competition, and market position in a rapidly growing industry with developing government regulations. Ultimately, the case explores how Medlinker continues to innovate and expand, shaping the future of digital healthcare in China.
Tuhu
Authors: Wu Chenyu
Published: September 2024

This case study explores the development and strategic growth of Tuhu Vehicle Co., Ltd., a leading player in China's automotive aftermarket, under the leadership of MIN Chen. It provides a comprehensive analysis of Chen's extensive background in software development, data management, and the automotive service sector, highlighting his pivotal role in transforming Tuhu from a tire-changing service to a diversified O2O one-stop automobile repair and maintenance company. The case delves into Tuhu's innovative approaches, including the implementation of standardized services, the creation of industry alliances, and the launch of an open product platform. It examines Tuhu's strategic expansion, its successful IPO on the Hong Kong Stock Exchange, and its forward-looking initiatives in the new energy vehicle market. By analyzing Tuhu's business model, supply chain revolutions, and market positioning, this case provides insights into the company's unique development path, operational resilience, and its impact on China's auto aftermarket industry.
Bytedance
Authors: Min Wei
Published: September 2024

This case study delves into ByteDance, a pioneering force in global technology led by visionary founder Zhang Yiming and CEO Shou Zi Chew. It explores ByteDance's journey from its inception, driven by innovative AI technologies and a global expansion strategy, to becoming a dominant player in social media with platforms like TikTok. The case examines ByteDance's multifaceted approach, including its development of the MegaScale AI system for large-scale language model training and its strategies for navigating complex data sovereignty issues across international markets. It also analyzes ByteDance's competitive landscape, encompassing key rivals in social media, AI development, e-commerce, and cloud services. Moreover, the case scrutinizes ByteDance's leadership strategies, emphasizing its efforts in user data privacy compliance and global regulatory challenges. Through these insights, the case offers a comprehensive view of ByteDance's evolution, strategic initiatives, and the broader implications for the tech industry.
Xiaohongshu
Authors: Yu Zhixuan
Published: September 2024

This case study explores the evolution and strategic trajectory of Xiaohongshu, a pioneering social commerce platform in China. Founded in 2013 by Miranda Qu and Charlwin Mao, Xiaohongshu has redefined consumer engagement by seamlessly integrating social media with e-commerce functionalities. Initially conceived as an online guide for Chinese shoppers abroad, the platform quickly developed into a vibrant community where users share product recommendations, reviews, and lifestyle insights. Xiaohongshu's strategic pivot on social commerce in 2014 marked a significant milestone, enabling direct product purchases within its app and fostering a dynamic ecosystem of user-generated content. The case examines Xiaohongshu's growth trajectory, challenges such as counterfeit goods, and strategic initiatives, including influencer marketing and blockchain integration. With a focus on expanding its user base, enhancing e-commerce capabilities, and exploring emerging technologies like Web3, Xiaohongshu continues to shape the future of digital commerce in China's competitive market landscape.
Ximalaya FM
Authors: Luo Danyu
Published: September 2024

This case study explores the dynamic evolution of China's audio economy industry, focusing on technological advancements, market trends, and key players, such as Ximalaya. With a historical perspective, it traces the industry's growth through distinct eras, from early audiobooks to the current era dominated by mobile internet and specialized audio services. Market data from AI Media Consulting underscores the industry's exponential growth, driven by factors like the increased demand for online learning and knowledge payment. Detailed demographic insights highlight the user composition and providing a comprehensive understanding of consumer behaviors and preferences. Central to this narrative is the pivotal role of Jianjun Yu, founder of Ximalaya, whose entrepreneurial journey and strategic vision have shaped the platform's prominence in delivering high-quality audio content. As the industry navigates developing media consumption habits and technological advancements, this case study offers valuable insights into the future trajectories of China's vibrant audio economy landscape.
Keep
Authors: Yu Xintong
Published: September 2024

This case study explores Keep, a pioneering company in the Chinese fitness industry known for its innovative approach to blending technology with fitness solutions. Founded by Wang Ning, Keep revolutionized home fitness during the COVID-19 pandemic by introducing interactive live classes and expanding its digital offerings. The study examines Keep's strategic adaptations amid market challenges, such as shifting from offline gyms to collaborative ventures with traditional fitness centers. It highlights Keep's successful integration of gamification and virtual events to enhance user engagement and retention. The case also delves into Wang Ning's entrepreneurial journey, emphasizing his vision to democratize access to fitness through accessible, tech-driven solutions. Through rigorous analysis of Keep's business strategies, technological innovations, and market positioning, this case study provides insights into the dynamics of digital transformation in the fitness sector and its implications for future industry trends.
Sustainable Universities to Promote Environmental Awareness in Higher Education Students in Mexico
Authors: Sánchez Nayeli Manzano , Cuevas Zuñiga Ingrid Yadibel , Flores María del Rocío Soto
Published: September 2024

Sustainable universities are training centers that play an important role in meeting the Sustainable Development Goals from their triple mission: training, research and transfer of knowledge to society. The above seeks to promote greater environmental awareness in students who will apply all this knowledge and experiences in the world of work. Therefore, the objective of this chapter is to propose that universities incorporate sustainability to promote environmental awareness in higher education students in Mexico. The structure of the chapter is as follows: 1) Contextualize how universities have incorporated sustainability; 2) Identify in theory what is related to environmental awareness and its application in Higher Education institutions; 3) Formulate actions so that universities incorporate sustainability with the purpose of promoting environmental awareness in higher level students in Mexico
A Machine Learning-Based Wrapper Method for Feature Selection
Authors: Patel Damodar , Saxena Amit , Wang John
Published: September 2024

This paper presents a two-stage feature selection scheme using machine learning techniques. In the first stage a wrapper method is adopted to select various combinations of subsets of features from the original dataset. The performance of the model is evaluated by three classifiers: K-Nearest Neighbor (KNN), Support Vector Machines (SVM), and Random Forest (RF). In the second and final stage, a sequential backward feature selection Method is applied. The proposed method is demonstrated on eighteen datasets and the average classification accuracy of eighteen datasets achieved is 89.81%, 87.55%, and 89.82% using the KNN, SVM, and RF classifiers, respectively with a maximum reduced size of the subset being ten only. Comparing the proposed method to eight other feature selection methods, the former achieves better classification accuracy in terms of selecting the most useful but a smaller number of features.
Automatic Question Answering From Large ESG Reports
Authors: Parikh Pulkit , Penfield Julia
Published: September 2024

ESG reports contain crucial information about the corporations' environmental impact, social responsibilities, and governance. Many compliance audits rely on answering questions based on these reports. Moreover, for tasks such as Scope 3 GHG emissions estimation, a company needs to look at the ESG reports of all its typically numerous suppliers to tabulate its own compliance reports. Manually finding specific information from these large documents is immensely time-consuming. This paper presents the first system that automatically answers questions from an ESG report, using advanced machine learning and natural language processing. The proposed system also locates and highlights a cropped screenshot from the report providing the answer. The authors devise two methods for inferring the textual answer, one based on a transformer model pre-trained for extractive question answering and another using a large language model. The task-agnostic method overcomes the challenge of the lengthiness of ESG reports in a cost-effective manner.
Enhanced Cross-Entropy Exponential TODIM Framework for Interval-Valued Pythagorean Fuzzy Information and Applications to Art Teaching Quality Evaluation
Authors: Han Shushu
Published: September 2024

Art teachers in preschool education need to possess not only high professional competence but also a commitment to continuous learning to enhance their comprehensive teaching abilities. The art teaching quality evaluation in preschool education programs at vocational colleges is multiple-attribute group decision-making (MAGDM). Currently, the Exponential TODIM and cross-entropy approach was employed to address MAGDM. Interval-valued Pythagorean fuzzy sets (IVPFSs) serve as a strategy for characterizing uncertain data during the art teaching quality evaluation in preschool education programs at vocational colleges. In this study, the interval-valued Pythagorean fuzzy number cross-entropy Exponential TODIM (IVPFN-CE-ExpTODIM) approach is developed to bring up MAGDM problems under IVPFSs. To validate the proposed method, a numerical study is conducted on the art teaching quality evaluation in preschool education programs at vocational colleges.
Financial Fraud Detection and Prevention
Authors: Miao Zeyi
Published: September 2024

Financial fraud has always been a serious challenge in the financial sector. With the continuous development of technology, fraud in the financial market has become increasingly complex and hidden. Therefore, financial fraud detection and prevention have become particularly important to our lives. But as of today, the financial fraud detection methods that have emerged often leave something to be desired. Traditional detection methods based on rules and statistical methods perform poorly when processing large-scale and high-dimensional data, and are prone to false positives and false negatives. Moreover, as fraud techniques continue to evolve, the adaptability of traditional methods is also challenged. As a powerful machine learning technology, deep learning has excellent feature extraction and pattern recognition capabilities, and has achieved remarkable achievements in various fields, including image recognition, natural language processing, and speech recognition. In the financial field, the application of deep learning is also gradually emerging.
O processo de ensino-aprendizagem de matemática em questão: perspectivas críticas
Authors: Wagner Guilherme
Published: September 2024

Nesta pesquisa, analisamos as convergências e divergências entre duas correntes críticas na Educação Matemática: a Educação Matemática Crítica (EMC) e a Pedagogia Histórico-Crítica (PHC), centrando-se nos processos de ensino-aprendizagem. Utilizando a metodologia dos referenciais exemplares de Marx, adotamos Ole Skovsmose como referência para a EMC e Dermeval Saviani e Newton Duarte para a PHC. O estudo, de natureza bibliográfica, busca compreender as concepções das teorias de forma positiva e estabelecer um diálogo crítico entre elas, visando orientações para futuras pesquisas e práticas pedagógicas. Exploramos a influência da psicologia histórico-cultural, as aproximações entre a teoria da atividade e a tese de familiaridade, com ênfase nas considerações didáticas para o ensino de matemática. Concluímos discutindo as possíveis razões para as diferenças entre essas abordagens tendo como principal resultado que suas diferenciações didático-pedagógicas emergem das diferenças de concepção de mundo das teorias.
High diversity and abundance of fish and coral in an artificial breakwater in Colombo, Sri Lanka
Authors: Smith A. K. , De Silva P. , Hui H.
Published: September 2024

The diversity of reef fishes and the diversity and abundance of corals in artificial breakwaters were studied between June and August 2023 in Port City, Colombo in the Western Province of Sri Lanka. Four methods were used: visual census using video, photographs, stationary point count and environmental DNA (eDNA). A total of 137 fish species, 74 coral species and 175 other species were recorded using the four methods. There were similarities and differences between the methods for recording fish, corals and other species. Only three fish species: Moon wrasse (Thalassoma lunare); Yellowtail fusilier (Caesio cuning) and Diamond fish (Monodactylus argenteus) were recorded by all methods. The highest number of fish species was recorded by video, followed by photographs, eDNA and stationary point count in the sequence. Coral cover ranged from 9 to 50.8% and mean live coral varied from 24.4% to 34.5 ± 5.2%. The dominant coral species was Pocillopora damicornis. Rare observations of coral bleaching (n=1) and frequent observations of marine debris (n=20) and coral damage (n=25) were recorded. Species detection using eDNA is a biomonitoring tool that did not add significantly to the list of fish and corals, but included many microscopic groups such as bacteria, diatoms and ciliates that were not recorded using other methods, and provided new ecological insights into marine systems. This is the first use of multiple monitoring tools to identify and compare methods for the biodiversity of marine fish, coral and other species in Sri Lankan marine waters.
Impact of Health Education Intervention on Fluid Management and Quality of Life Among Patients with Chronic Kidney Disease Undergoing Hemodialysis
Authors: Piyasena H. P. T. U. , Sandeepani W. G. P. , Ruwanthika M. P. S. , Wijesinghe S. G. C. D. , Sriyani K. A. , De Silva D. K. M.
Published: September 2024

Introduction: Chronic Kidney Disease (CKD) is a global concern, impacting over 13% of individuals. Hemodialysis (HD) poses challenges, and education on fluid management can improve quality of life (QOL) of individuals with CKD. This study is aimed to evaluate, the impact of health education intervention on fluid management and QOL among dialysis-receiving CKD patients in Dialysis units (DU) at the National Hospital of Sri Lanka (NHSL).Methods: One-group pretest-posttest design was utilized. Two interviewer-administered questionnaires were used to collect data from randomly selected 110 CKD patients receiving HD. The instrument consisted of items assessing the history of the disease condition, signs and symptoms of fluid overload, and fluid management status. The Kidney Disease Quality of Life (KDQOL) questionnaire was used as instrument II. Both instruments were administered before and after health education intervention regarding control of fluid intake during HD. Descriptive statistics and paired samples t-tests were performed for data analysis. The Ethics Review Committee of NHSL approved this study.Results: The study primarily involved CKD patients, with a significant majority (46.4%) falling in the 51-70 years age group, and a predominance of males (76.4%). Almost half (44.5%) had attained education up to the Ordinary Level, and the majority were married (80.9%). The findings revealed a positive impact of health education sessions on fluid management, with post-scores increasing from 67% to 79%, indicating a significant reduction in fluid overload symptoms (p<0.05). However, pre- and post-quality-of-life scores did not show significant differences (p=0.051) with the effect of education intervention.Conclusions: The results revealed a significant reduction in fluid overload symptoms after the educational intervention, indicating a positive impact on fluid management. However, the same intervention did not demonstrate an observable improvement in the patient's quality of life, emphasizing the need to explore the underlying reasons for remaining QOL unchanged. Since health education intervention has shown a positive impact on fluid status management of CKD patients undergoing HD, it would be beneficial to conduct such intervention across DU in Sri Lanka after further studies.
The Impact of Postgraduate Education in Nursing in Sri Lanka to Improve Clinical Practice; Are We on the Right Track?
Authors: Madhavi A. V. Pramuditha
Published: September 2024

No abstract available
Need for Change in the Current Crisis of Brain Drain of Health Care Professionals in Sri Lanka
Authors: Dharmasiri A. D. U.
Published: September 2024

No abstract available
Challenges in the Development of NK-92 Cells as an Effective Universal Off-the-Shelf Cellular Therapeutic
Authors: Niu Zhiyuan , Wang Mengjun , Yan Yangchun , Jin Xinru , Ning Linwei , Xu Bingqian , Wang Yanfeng , Hao Yuekai , Luo Zhixia , Guo Changjiang , Zhi Lingtong , Zhu Wuling
Published: September 2024

The human-derived NK-92 cell–based CAR-NK therapy exhibits inconsistency with overall suboptimal efficacy and rapid in vivo clearance of CAR-NK92 cells in cancer patients. Analysis indicates that although pre-existing IgM in healthy individuals (n = 10) strongly recognizes both NK-92 and CAR-NK92 cells, IgG and IgE do not. However, only a subset of cancer patients (3/8) exhibit strong IgM recognition of these cells, with some (2/8) showing pre-existing IgG recognition. These results suggest a natural immunoreactivity between NK-92 and CAR-NK92 cells and pre-existing human Abs. Furthermore, the therapy’s immunogenicity is evidenced by enhanced IgG and IgM recognition postinfusion of CAR-NK92 cells. We also confirmed that healthy plasma’s cytotoxicity toward these cells is reduced by complement inhibitors, suggesting that Abs may facilitate the rapid clearance of CAR-NK92 cells through complement-dependent cytotoxicity. Given that NK-92 cells lack known receptors for IgG and IgM, identifying and modifying the recognition targets for these Abs on NK-92 and CAR-NK92 cells may improve clinical outcomes. Moreover, we discovered that the 72nd amino acid of the NKG2D receptor on NK-92 cells is alanine. Previous studies have demonstrated polymorphism at the 72nd amino acid of the NKG2D on human NK cells, with NKG2D72Thr exhibiting a superior activation effect on NK cells compared with NKG2D72Ala. We confirmed this conclusion also applies to NK-92 cells by in vitro cytotoxicity experiments. Therefore, reducing the immunoreactivity and immunogenicity of CAR-NK92 and directly switching NK-92 bearing NKG2D72Ala to NKG2D72Thr represent pressing challenges in realizing NK-92 cells as qualified universal off-the-shelf cellular therapeutics.
24th Panhellenic Congress of Regional Anaesthesia, Pain Management and Palliative Care, September 19-22, 2024
Authors: Scientific Committee The
Published: September 2024

PARIS.SY.A. in collaboration with ESRA HELLAS and the 1st Anesthesiology Clinic - Pain and Palliative Care Center EKPA awaits you at the 24th Panhellenic Congress of Regional Anesthesia, Pain Treatment and Palliative Care, September 19 – 22, 2024, in Lefkada, Greece.
Understanding wise leadership: Employees’ perspective in Oman’s government sector
Authors: Awashreh Raed A. , Hamid Abdelsalam A.
Published: September 2024

Orientation: Success is a common goal in both personal and professional life, and wise leadership is key to achieving it. Effective leadership guides and motivates teams, driving them toward success and excellence.Research purpose: This study examines wise leadership in Oman’s government sector, using Hassi and Storti’s theoretical frameworks. It explores dimensions such as Intellectual Shrewdness, Spurring Action, Moral Conduct, and Cultivating Humility to improve employee awareness and perception.Motivation for the study: To assess wise leadership qualities across different dimensions and demographic groups to identify strengths and areas for improvement in leadership practices.Research approach/design and method: A descriptive method was employed, and a questionnaire was used as a data gathering tool. The data were analysed by several techniques including T-tests, ANOVA and descriptive statistics. Data were anonymously collected from 300 respondents across the Ministry of Labour, Ministry of Information and Taxation Authority, representing diverse demographic profiles and organisational ranks.Main findings: The findings highlight that practical wisdom is vital for organisational resilience, effective communication, and societal well-being in complex governance. While there is broad agreement on key leadership traits, minor discrepancies suggest challenges in applying theoretical ideals, especially concerning vulnerability and humility.Practical/managerial implications: Providing a detailed look at employees’ views on wise leadership and the impact of personal characteristics on these perceptions.Contribution/value-add: Provides a comprehensive view of employees’ perceptions of wise leadership and how personal characteristics influence these perceptions.
Insulinoma in Patients with Diabetes- A Systematic Review of Previously Reported Cases
Authors: Chatterjee Subhankar , Bhattacharjee Rana , Ghosh Ritwik , Chakraborty Partha P. , Sinha Anirban , Maiti Animesh
Published: September 2024

Introduction:

Paradoxical co-existence of insulinoma and diabetes is extremely rare. Although a few case reports addressed this association, a comprehensive study elucidating this relationship has been lacking. We performed a systematic review of published cases of insulinoma in diabetes.

Methods:

We conducted a literature search using PubMed and Google Scholar, employing various combinations of the following terms: ‘insulinoma’, ‘diabetes’, ‘nesidioblastosis’, ‘endogenous hyperinsulinism’, ‘hypoglycaemia’, and ‘hyperglycaemia’ (from January 1900 to January 30, 2024). Exclusion criteria included non-English publications, duplicate articles, reports lacking sufficient data, cases of endogenous hyperinsulinemic hypoglycaemia other than insulinoma, and inaccessible articles. Statistical analysis was performed using appropriate methods.

Results:

Sixty patients were considered for the final analysis. Mean age was 61 ± 15 years (range: 17–96 years) with a slight female preponderance; 88.3% had type-2 diabetes with a median duration of 8 years. The median delay in diagnosis of insulinoma was 6 months. Median blood glucose varied from 30.5 mg/dL to 235 mg/dL, with a mean HbA1c of 5.6 ± 1.3% (range: 2.9%–8.2%). Critical sampling data were available in 75% of cases. The median size of the insulinoma was 2 cm. Furthermore, 5.2% of insulinomas were extra-pancreatic. Among pancreatic insulinomas, 14.5% were multi-focal. One-third of cases were malignant. Surgical resection was done in 70.9% of cases, while 40% received drug therapy and 12.7% received both, with 20.7% overall mortality. Malignant insulinoma (P = 0.007), micro-angiopathic (P = 0.018) and macro-angiopathic complications (P = 0.039), and other co-morbidities (P = 0.009) were associated with unfavourable prognosis, while being overweight and obese (P = 0.020) at presentation was associated with favourable prognosis.

Conclusion:

This first systematic review provides insights into the uniqueness of insulinoma in diabetes.
Cytotoxic Lesion of the Corpus Callosum Caused by Dengue Virus Infection
Authors: Singh Akhilesh K. , Srivastava Anubhav , Agrahari Rahul
Published: September 2024

ABSTRACT

Dengue virus infection can cause a wide spectrum of clinical manifestations, ranging from mild fever to lethal dengue shock syndrome. Neurological manifestations include encephalitis, acute disseminated encephalomyelitis, Transverse myelitis, Guillain-Barre syndrome, and neuro-ophthalmic complications. We report a case of a 44-year-old male who was admitted to our hospital with high-grade fever, myalgia, retro-orbital pain, visual disturbances, and drowsiness. Hematological and serological parameters confirmed the diagnosis of dengue fever. Brain imaging demonstrated altered signal intensity in the splenium of the corpus callosum and eventually a diagnosis of a cytotoxic lesion of the corpus callosum (CLOCC) was made. The patient was managed conservatively and discharged 7 days after admission and imaging findings were resolved completely 3 weeks later.
Effects of Modified Atkins Diet on Neurocognitive Function in Refractory Epilepsy
Authors: Qamar Muhammad M. , Basharat Ayesha , Basharat Shahnai , Kiran Qurba
Published: September 2024

ABSTRACT

Background:

Diet therapy is an effective intervention to manage a wide range of seizures and has a wide range of acceptance. This anti-epileptic effect of the ketogenic diet and fasting has been linked with increased ketone levels and may lead to hypoproteinemia or growth issues. The modified Atkin diet is safe and can be taken without fluid or caloric restriction. Furthermore, the patient can use unlimited protein and fat.

Objective:

The study finds out the effects of the modified Atkins diet on fatigue and cognitive functional status in refractory epilepsy.

Materials and Methods:

Twenty-seven subjects (17 males, 10 females) suffering from refractory epilepsy were recruited. The mean age range was 09–15 years. The modified Atkins diet prescribed by diet specialists was introduced. The Visual Analog Scale was used for measuring fatigue levels, and the Quality of Life in Childhood Epilepsy was used to examine the effects on life quality in epileptic patients after 16 weeks.

Results:

The subject’s mean age was 11.7 ± 2.02 years. They had epilepsy for about 7.8 ± 3.1 years. The seizer frequency was about 2–5 days per week. The muscle fatigue level, seizer frequency, and quality of life were improved after 16 weeks (<0.05).

Conclusion:

The modified Atkins diet exhibits some encouraging results in refractory epilepsy patients.
The effectiveness of vedolizumab in advanced therapy-experienced ulcerative colitis patients: Real world data from the Inflammatory Bowel Disease of the Middle East (IBD-ME) Registry group
Authors: Azzam Nahla , Alharbi Othman , Altuwaijri Mansour , Alruthia Yazed , Alfarhan Heba , Alshankiti Suliman , Nafisah Faris , Ajlan Qusay , Aljebreen Abdulrahman , Almadi Majid , Mosli Mahmoud H.
Published: September 2024

Background:

Vedolizumab is an approved ulcerative colitis (UC) treatment. Multiple large randomized clinical trials have demonstrated the drug’s efficacy and safety. However, real-world data from Middle Eastern countries are spare. The study aims to evaluate the clinical efficacy of vedolizumab (VDZ) therapy in advanced therapy experienced UC patients.

Methods:

A retrospective electronic chart review of a cohort study of 153 moderately to severely active UC patients who failed or were intolerant to TNF antagonists and received vedolizumab from two large tertiary care centers was performed. Rates of clinical response and remission were retrospectively evaluated at 3,6, and 12 months post VDZ therapy using Patient Simple Clinical Colitis Activity Index (P-SCCAI); clinical response was defined as a decrease in P-SCCAI ≥3, and clinical remission was defined as a P-SCCAI score of ≤3 points. Logistic regression analysis was used to identify predictors of response to vedolizumab.

Results:

A total of 153 UC patients had sufficient data for analysis. Clinical remission rates were 61.9% for patients on vedolizumab every 8 weeks and 89.3% for those receiving every 4 (Q4) weeks dosing. A significant reduction in CRP and improvement of albumin post vedolizumab treatment were observed, and corticosteroids were stopped in most patients. In a multiple logistic regression analysis, several factors were found to influence the clinical effectiveness of VDZ in inducing remission. Female gender was associated with a higher likelihood of remission [OR =3.09, 95% CI = (1.05–9.13), P = 0.04]. Conversely, a greater number of biologics used prior to VDZ treatment was associated with a lower likelihood of remission [OR =0.418, 95% CI = (0.203–0.859), P = 0.017]. Patients with extensive disease (E3) had an increased likelihood of remission [OR =3.81, 95% CI = (1.32–10.97), P = 0.0129]. Additionally, a VDZ dosing frequency of Q4 weeks was associated with a significantly higher likelihood of remission [OR =6.08, 95% CI = (1.73–21.39), P = 0.0049]. No significant safety signals were reported.

Conclusions:

In this current real-world study, vedolizumab effectively achieved clinical response and remission in most advanced therapy experienced UC patients treated for up to 12 months. Future studies with larger sample sizes and more robust study designs should be conducted to further validate the results of this study.
The category $\Theta_{2}$, derived modifications, and deformation theory of monoidal categories
Authors: Panero Piergiorgio , Shoikhet Boris
Published: September 2024

A complex

C^{\bullet}(C,D)(F,G)(\eta,\theta)

, generalising the Davydov–Yetter complex of a monoidal category (Davydov (1998) and Yetter (1998)), is constructed. Here,

C,D

are

\Bbbk

-linear (corresp., dg) bicategories,

F,G\colon C\to D

are

\Bbbk

-linear (corresp., dg) strong functors, and

\eta,\theta\colon F\Rightarrow G

are strong natural transformations. Morally, it is a complex of “derived modifications”

\eta\Rrightarrow\theta

; likewise for the case of dg categories, one has the complex of “derived natural transformations”

F\Rightarrow G

, given by the Hochschild cochain complex of

C

with coefficients in

C

-bimodule

D(F-,G=)

.The complex

C^{\bullet}(C,D)(F,G)(\eta,\theta)

naturally arises from a 2-cocellular dg vector space

A(C,D)(F,G)(\eta,\theta)\colon\Theta_{2}\to C^{\bullet}(\Bbbk)

, as its

\Theta_{2}

-totalisation (here,

\Theta_{2}

is the category dual to the category of Joyal 2-disks (Joyal (1997))).It is shown that for a

\Bbbk

-linear monoidal category

C

, the third cohomology vector space

H^{3}(C^{\bullet}(C,C)(\mathrm{Id},\mathrm{Id})(\mathrm{id},\mathrm{id}))

is isomorphic to the vector space of the outer (modulo twists) infinitesimal deformations of the

\Bbbk

-linear monoidal category which we call the
full
deformations. It means that the following data is to be deformed: (a) the underlying dg category structure, (b) the monoidal product on morphisms (the monoidal product on objects is a set-theoretical datum and is maintained under the deformation), and (c) the associator. The data (a), (b), (c) is subject to the (infinitesimal versions of) numerous monoidal compatibilities, which we interpret as the closeness of the corresponding degree 3 element. Similarly,

H^{2}(C^{\bullet}(C,D)(F,F)(\mathrm{id},\mathrm{id}))

is isomorphic to the vector space of the outer infinitesimal deformations of the strong monoidal functor

F

.A relative totalisation

Rp_{*}A(C,D)(F,F)(\mathrm{id},\mathrm{id})

along the projection

p\colon\Theta_{2}\to\Delta

is defined, and it is shown to be a cosimplicial monoid, which fulfils the Batanin–Davydov 1-commutativity condition (Batanin and Davydov (2023)). Then it follows from loc. cit. that

C^{\bullet}(C,D)(F,F)(\mathrm{id},\mathrm{id})

is a

C_{\bullet}(E_{2};\Bbbk)

-algebra. Conjecturally,

C^{\bullet}(C,C)(\mathrm{Id},\mathrm{Id})(\mathrm{id},\mathrm{id})

is a

C_{\bullet}(E_{3};\Bbbk)

-algebra; however, the proof requires more sophisticated methods.
Convex ancient solutions to anisotropic curve shortening flow
Authors: Bourni Theodora , Richards Benjamin
Published: September 2024

We construct a translating solution to anisotropic curve shortening flow and show that for a given anisotropic factor

g\colon S^{1}\to\mathbb{R}_{+}

, and a given direction and speed, this translator is unique. We then construct an ancient compact solution to anisotropic curve shortening flow, and show that this solution, along with the appropriate translating solution, are the unique solutions to anisotropic curve shortening flow that lie in a slab of a given width, and in no smaller slab.
Machine learning as a tool predicting short-term postoperative complications in Crohn’s disease patients undergoing intestinal resection: What frontiers?
Authors: Pellegrino Raffaele , Gravina Antonietta Gerarda
Published: September 2024

The recent study, “Predicting short-term major postoperative complications in intestinal resection for Crohn’s disease: A machine learning-based study” investigated the predictive efficacy of a machine learning model for major postoperative complications within 30 days of surgery in Crohn’s disease (CD) patients. Employing a random forest analysis and Shapley Additive Explanations, the study prioritizes factors such as preoperative nutritional status, operative time, and CD activity index. Despite the retrospective design’s limitations, the model’s robustness, with area under the curve values surpassing 0.8, highlights its clinical potential. The findings align with literature supporting preoperative nutritional therapy in inflammatory bowel diseases, emphasizing the importance of comprehensive assessment and optimization. While a significant advancement, further research is crucial for refining preoperative strategies in CD patients.
Transjugular intrahepatic portosystemic shunt for esophagogastric variceal bleeding in patients with hepatocellular carcinoma and portal vein tumor thrombus
Authors: Wu Zhi-Qiang , Wang Fan , Wang Feng-Pin , Cai Hong-Jie , Chen Song , Yang Jian-Yong , Guo Wen-Bo
Published: September 2024

BACKGROUND

Whether hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) and acute esophagogastric variceal bleeding (EGVB) can improve the success rate of endoscopic hemostasis and overall survival (OS) from transjugular intrahepatic portosystemic shunt (TIPS) remains controversial.

AIM

To compare the clinical outcomes between TIPS and standard treatment for such HCC patients.

METHODS

This monocenter, retrospective cohort study included patients diagnosed as HCC with PVTT and upper gastrointestinal bleeding. Patients were grouped by the treatment (TIPS or standard conservative treatment). The success rate of endoscopic hemostasis, OS, rebleeding rates, and main causes of death were analyzed.

RESULTS

Between July 2015 and September 2021, a total of 77 patients (29 with TIPS and 48 with standard treatment) were included. The success rate of endoscopic hemostasis was 96.6% in the TIPS group and 95.8% in the standard treatment group. All the 29 patients in TIPS group successful underwent TIPS procedure and had a better OS compared with standard treatment within the first 160 days after treatment (68 days vs 43 days, P = 0.022), but shorter OS after 160 days (298 days vs 472 days, P = 0.022). Cheng’s Classification of PVTT, total bilirubin and Child-Pugh class were independently negative associated with OS (all P < 0.05). The main causes of death were liver failure or hepatic encephalopathy (75.9%) in the TIPS group and rebleeding (68.8%) in the standard treatment.

CONCLUSION

TIPS could reduce the risk of early death due to rebleeding and prolong short-term survival in HCC patients with PVTT and acute EGVB, which deserves further investigation.
Establishment and evaluation of prediction model of recurrence after laparoscopic choledocholithotomy
Authors: Wu Ying-Jie
Published: September 2024

BACKGROUND

Choledocholithiasis is a common clinical bile duct disease, laparoscopic choledocholithotomy is the main clinical treatment method for choledocholithiasis. However, the recurrence of postoperative stones is a big challenge for patients and doctors.

AIM

To explore the related risk factors of gallstone recurrence after laparoscopic choledocholithotomy, establish and evaluate a clinical prediction model.

METHODS

A total of 254 patients who underwent laparoscopic choledocholithotomy in the First Affiliated Hospital of Ningbo University from December 2017 to December 2020 were selected as the research subjects. Clinical data of the patients were collected, and the recurrence of gallstones was recorded based on the postoperative follow-up. The results were analyzed and a clinical prediction model was established.

RESULTS

Postoperative stone recurrence rate was 10.23% (26 patients). Multivariate Logistic regression analysis showed that cholangitis, the diameter of the common bile duct, the diameter of the stone, number of stones, lithotripsy, preoperative total bilirubin, and T tube were risk factors associated with postoperative recurrence (P < 0.05). The clinical prediction model was ln (p/1-p) = -6.853 + 1.347 × cholangitis + 1.535 × choledochal diameter + 2.176 × stone diameter + 1.784 × stone number + 2.242 × lithotripsy + 0.021 × preoperative total bilirubin + 2.185 × T tube.

CONCLUSION

Cholangitis, the diameter of the common bile duct, the diameter of the stone, number of stones, lithotripsy, preoperative total bilirubin, and T tube are the associated risk factors for postoperative recurrence of gallstone. The prediction model in this study has a good prediction effect, which has a certain reference value for recurrence of gallstone after laparoscopic choledocholithotomy.
Identifying timing and risk factors for early recurrence of resectable rectal cancer: A single center retrospective study
Authors: Tsai Tsung-Jung , Syu Kai-Jyun , Huang Xuan-Yuan , Liu Yu Shih , Chen Chang-Wei , Wu Yen-Hang , Lin Ching-Min , Chang Yu-Yao
Published: September 2024

BACKGROUND

Colorectal cancer is a common malignancy and various methods have been introduced to decrease the possibility of recurrence. Early recurrence (ER) is related to worse prognosis. To date, few observational studies have reported on the analysis of rectal cancer. Hence, we reported on the timing and risk factors for the ER of resectable rectal cancer at our institute.

AIM

To analyze a cohort of patients with local and/or distant recurrence following the radical resection of the primary tumor.

METHODS

Data were retrospectively collected from the institutional database from March 2011 to January 2021. Clinicopathological data at diagnosis, perioperative and postoperative data, and first recurrence were collected and analyzed. ER was defined via receiver operating characteristic curve. Prognostic factors were evaluated using the Kaplan–Meier method and Cox proportional hazards modeling.

RESULTS

We included 131 patients. The optimal cut off value of recurrence-free survival (RFS) to differentiate between ER (n = 55, 41.9%) and late recurrence (LR) (n = 76, 58.1%) was 8 mo. The median post-recurrence survival (PRS) of ER and LR was 1.4 mo and 2.9 mo, respectively (P = 0.008) but PRS was not strongly associated with RFS (R ² = 0.04). Risk factors included age ≥ 70 years [hazard ratio (HR) = 1.752, P = 0.047], preoperative concurrent chemoradiotherapy (HR = 3.683, P < 0.001), colostomy creation (HR = 2.221, P = 0.036), and length of stay > 9 d (HR = 0.441, P = 0.006).

CONCLUSION

RFS of 8 mo was the optimal cut-off value. Although ER was not associated with PRS, it was still related to prognosis; thus, intense surveillance is recommended.