bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning-based segmentation of kidneys and renal cysts on T2-weighted MRI from patients with autosomal dominant polycystic kidney disease
Authors: Sore Rémi , Cathier Pascal , Vlachomitrou Anna Sesilia , Bailleux Jérôme , Arnaud Karine , Juillard Laurent , Lemoine Sandrine , Rouvière Olivier
Published: October 2024

Background

Our aim was to train and test a deep learning-based algorithm for automatically segmenting kidneys and renal cysts in patients with autosomal dominant polycystic kidney disease (ADPKD).

Methods

We retrospectively selected all ADPKD patients who underwent renal MRI with coronal T2-weighted imaging at our institution from 2008 to 2022. The 20 most recent examinations constituted the test dataset, to mimic pseudoprospective enrolment. The remaining ones constituted the training dataset to which eight normal renal MRIs were added. Kidneys and cysts ground truth segmentations were performed on coronal T2-weighted images by a junior radiologist supervised by an experienced radiologist. Kidneys and cysts of the 20 test MRIs were segmented by the algorithm and three independent human raters. Segmentations were compared using overlap metrics. The total kidney volume (TKV), total cystic volume (TCV), and cystic index (TCV divided by TKV) were compared using Bland–Altman analysis.

Results

We included 164 ADPKD patients. Dice similarity coefficients ranged from 85.9% to 87.4% between the algorithms and the raters’ segmentations and from 84.2% to 86.2% across raters’ segmentations. For TCV assessment, the biases ± standard deviations (SD) were 3–19 ± 137–151 mL between the algorithm and the raters, and 22–45 ± 49–57 mL across raters. The algorithm underestimated TKV and TCV in two outliers with TCV > 2800 mL. For cystic index assessment, the biases ± SD were 2.5–6.9% ± 6.7–8.3% between the algorithm and the raters, and 2.1–9.4 ± 7.4–11.6% across raters.

Conclusion

The algorithm’s performance fell within the range of inter-rater variability, but large TKV and TCV were underestimated.

Relevance statement

Accurate automated segmentation of the renal cysts will enable the large-scale evaluation of the prognostic value of TCV and cystic index in ADPKD patients. If these biomarkers are prognostic, then automated segmentation will facilitate their use in daily routine.

Key Points

Cystic volume is an emerging biomarker in ADPKD.

The algorithm’s performance in segmenting kidneys and cysts fell within interrater variability.

The segmentation of very large cysts, under-represented in the training dataset, needs improvement.

Graphical Abstract
Machine learning-optimized non-invasive brain stimulation and treatment response classification for major depression
Authors: Albizu Alejandro , Indahlastari Aprinda , Suen Paulo , Huang Ziqian , Waner Jori L. , Stolte Skylar E. , Fang Ruogu , Brunoni Andre R. , Woods Adam J.
Published: October 2024

Background/Objectives

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation intervention that shows promise as a potential treatment for depression. However, the clinical efficacy of tDCS varies, possibly due to individual differences in head anatomy affecting tDCS dosage. While functional changes in brain activity are more commonly reported in major depressive disorder (MDD), some studies suggest that subtle macroscopic structural differences, such as cortical thickness or brain volume reductions, may occur in MDD and could influence tDCS electric field (E-field) distributions. Therefore, accounting for individual anatomical differences may provide a pathway to optimize functional gains in MDD by formulating personalized tDCS dosage.

Methods

To address the dosing variability of tDCS, we examined a subsample of sixteen active-tDCS participants’ data from the larger ELECT clinical trial (NCT01894815). With this dataset, individualized neuroimaging-derived computational models of tDCS current were generated for (1) classifying treatment response, (2) elucidating essential stimulation features associated with treatment response, and (3) computing a personalized dose of tDCS to maximize the likelihood of treatment response in MDD.

Results

In the ELECT trial, tDCS was superior to placebo (3.2 points [95% CI, 0.7 to 5.5; P = 0.01]). Our algorithm achieved over 90% overall accuracy in classifying treatment responders from the active-tDCS group (AUC = 0.90, F1 = 0.92, MCC = 0.79). Computed precision doses also achieved an average response likelihood of 99.981% and decreased dosing variability by 91.9%.

Conclusion

These findings support our previously developed precision-dosing method for a new application in psychiatry by optimizing the statistical likelihood of tDCS treatment response in MDD.
Systemic lupus erythematosus: pathogenesis and targeted therapy
Authors: Su Xu , Yu Hui , Lei Qingqiang , Chen Xuerui , Tong Yanli , Zhang Zhongyang , Yang Wenyong , Guo Yuanbiao , Lin Liangbin
Published: October 2024

Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder characterized by dysregulated immune responses and autoantibody production, which affects multiple organs and varies in clinical presentation and disease severity. The development of SLE is intricate, encompassing dysregulation within the immune system, a collapse of immunological tolerance, genetic susceptibilities to the disease, and a variety of environmental factors that can act as triggers. This review provides a comprehensive discussion of the pathogenesis and treatment strategies of SLE and focuses on the progress and status of traditional and emerging treatment strategies for SLE. Traditional treatment strategies for SLE have mainly employed non-specific approaches, including cytotoxic and immunosuppressive drugs, antimalarials, glucocorticoids, and NSAIDs. These strategies are effective in mitigating the effects of the disease, but they are not a complete cure and are often accompanied by adverse reactions. Emerging targeted therapeutic drugs, on the other hand, aim to control and treat SLE by targeting B and T cells, inhibiting their activation and function, as well as the abnormal activation of the immune system. A deeper understanding of the pathogenesis of SLE and the exploration of new targeted treatment strategies are essential to advance the treatment of this complex autoimmune disease.
Telephone Survey–Reported Perceptions of Telehealth Visits Among Black and Non-Black Patients Diagnosed With Cancer
Authors: Fridman Ilona , Neslund-Dudas Christine , Barrow Lauren C.J. , Dunn Matthew R. , Jones Regina , Kinlaw Alan C. , Smith Angela B. , Stein Jacob N. , Tam Samantha , Wood William A. , Lafata Jennifer Elston
Published: October 2024

PURPOSE

Empirical evidence underscores both benefits of telehealth visits and persistent disparities in use for Black adults. Guided by the Technology Acceptance Model, we evaluated perceptions regarding telehealth visits among Black and Non-Black adults receiving cancer care from two academic health systems.

METHODS

Between April 2022 and October 2023, a survey was conducted among adult patients treated for cancer in the past 3 years. Survey recruitment was stratified by visit type (telehealth or in-person) and race. Before a scheduled oncology visit, respondents completed a telephone survey to assess their perceptions of usefulness, ease of use, and attitudes toward telehealth visits. Frequency differences were estimated using chi-square tests, and prevalence differences using logistic regression.

RESULTS

The survey was completed by 773 respondents (42% Black) with a 15% response rate. Black respondents were younger and less likely to report male sex, being married, having a college education, comfortable income, or confidence in medical and e-literacy. Compared with Non-Black respondents, Black respondents perceived telehealth visits as less useful for determining health needs (37%
v
48%) and asking questions (9%
v
15%). They thought that telehealth visits were less easy with regard to understanding their health care provider (14%
v
21%) and the ability to connect (23%
v
30%). Black respondents expressed more concern about internet access (26%
v
15%), access to electronic devices (17%
v
9%), and finding assistance for connecting (24%
v
12%). They also found telehealth visits to be less private (19%
v
34%).

CONCLUSION

Racial differences in telehealth ease of use and usefulness perceptions highlight the need for oncology practices to couple connectivity support with effective communication strategies to avoid disparities in oncology telehealth services.
The Utility of Electroencephalograhy in Guiding General Anesthesia in Children
Authors: Bong Choon Looi , Yuan Ian
Published: October 2024

Traditional pediatric anesthetic dosing using pharmacokinetic estimates based on age and weight is often imprecise, frequently leading to oversedation. Intraoperative electroencephalography (EEG) allows visualization of the brain’s response to anesthetic agents in real time, facilitating precise titration of anesthetic drug doses optimized for the individual child. The goal of EEG-guided anesthesia management is to maintain an optimal state of hypnosis during various stages of the procedure while minimizing hemodynamic instability and other adverse effects of anesthesia. This is especially important in children with less predictable anesthetic requirements, such as children with atypical neurodevelopment, altered levels of consciousness before anesthesia, or those receiving total intravenous anesthesia, neuromuscular blockers, or a combination of anesthetic agents with different mechanisms of actions. Children with limited cardiorespiratory reserves and those undergoing high-risk procedures such as cardiopulmonary bypass also benefit from EEG guidance as they have a narrower therapeutic window for optimal anesthetic dosing. Various processed EEG (pEEG) monitors are available for intraoperative monitoring in children. These monitors display a pEEG index based on the manufacturer’s algorithm, purportedly indicating the patient’s hypnotic state. Due to differences in developmental neurophysiology and EEG dynamics in children, pEEG indices may not always reliably indicate the hypnotic state, especially in neonates and infants. Learning to interpret nonproprietary EEG parameters including the raw EEG, spectral-edge frequency 95% (SEF95), and density spectral array can prevent overreliance on pEEG indices. This review provides an overview of the advantages of EEG guidance during clinical anesthesia, including potential reduction in anesthetic dosage, prevention of EEG suppression, and reduction in peri-operative adverse events. We describe the use of nonproprietary EEG parameters in guiding anesthesia in children for various clinical end points including laryngoscopy, surgical incision, and maintenance of anesthesia, as well as sedation. We illustrate these principles with various case examples commonly encountered during pediatric anesthesia. Lastly, we discuss strategies to expand intraoperative EEG monitoring in children through education and training programs, as well as advocate for further research to assess clinical outcomes associated with EEG guidance to support its routine use in clinical care.
The Effect of Pexidartinib on Neuropathic Pain via Influences on Microglia and Neuroinflammation in Mice
Authors: Yang Liuyue , Gomm Ashley , Bai Ping , Ding Weihua , Tanzi Rudolph E. , Wang Changning , Shen Shiqian , Zhang Can
Published: October 2024

BACKGROUND:

Chronic pain is a debilitating medical condition that lacks effective treatments. Increasing evidence suggests that microglia and neuroinflammation underlie pain pathophysiology, which therefore supports a potential strategy for developing pain therapeutics. Here, our study is testing the hypothesis that the promise of pain amelioration can be achieved using the small-molecule pexidartinib (PLX-3397), a previously food and drug administration (FDA)-approved cancer medicine and a colony-stimulating factor-1 receptor (CSF-1R) inhibitor that display microglia-depleting properties.

METHOD:

We used the previously reported chronic constriction injury (CCI) mouse model, in which PLX-3397 or vehicle was orally administrated to mice daily for 21 days, then applied to the CCI model, followed by PLX-3397 or vehicle administration for an additional 28 days. Additionally, we examined microglia-related neuroinflammation markers using positron emission tomography (PET) neuroimaging and immunofluorescence (IF).

RESULTS:

We showed that PLX-3397 significantly ameliorated pain-related behavioral changes throughout the entire experimental period after CCI (vehicle versus PLX-3397 at day 14, effect size: 2.57, P = .002). Microglia changes were first analyzed by live-animal PET neuroimaging, revealing PLX-3397-associated reduction of microglia by probing receptor-interacting serine/threonine-protein kinase 1 (RIPK1), a protein primarily expressed in microglia, which were further corroborated by postmortem immunohistochemistry (IHC) analysis using antibodies for microglia, including ionized Ca2+ binding adaptor molecule 1 (Iba-1) (somatosensory cortex, hindlimb area; vehicle versus PLX-3397, effect size 3.6, P = .011) and RIPK1 (somatosensory cortex, hindlimb area; vehicle versus PLX-3397, effect size 2.9, P = .023. The expression of both markers decreased in the PLX-3397 group. Furthermore, we found that PLX-3397 led to significant reductions in various proteins, including inducible nitric oxide synthase (iNOS) (somatosensory cortex, hindlimb area; vehicle versus PLX-3397, effect size: 2.3, P = .048), involved in neuroinflammation through IHC.

CONCLUSIONS:

Collectively, our study showed PLX-3397-related efficacy in ameliorating pain linked to the reduction of microglia and neuroinflammation in mice. Furthermore, our research provided new proof-of-concept data supporting the promise of testing PLX-3397 as an analgesic.
Twenty Years of Feminist Engagement: Reflections on Practice
Authors: Hardi Choman
Published: October 2024

This article explores the author's personal and professional challenges as a feminist and the strategies employed to address them. It focuses on the interplay of knowledge production, positionality, and ethical considerations in contexts of conflict and trauma, and it explores the complexities of intertwining personal experiences with academic inquiry. After highlighting personal struggles of navigating two worlds, the author emphasizes the importance of a reflexive and ethical approach in feminist research that involves navigating power relations and positionality, managing expectations, and responding to the needs on the ground. It ends with addressing both a personal backlash the author experienced and critiques directed toward feminist work in the region. Drawing on her experiences in conducting PhD research with Kurdish women refugees in the UK, postdoctoral research on women survivors of the Anfal genocide in Kurdistan, and a comparative analysis of the experiences of women survivors of the Anfal and Yezidi genocides, the article provides insights into the intricate landscape of feminist research in challenging contexts.
Decolonizing Minds and Education: Critical Pedagogy and Epistemic Disobedience in Kurdistan
Authors: Kurt Mashuq
Published: October 2024

This article examines the intricacies involved in the process of decolonizing education. It draws on the author's first-hand teaching experiences and observations as an activist scholar and a critical pedagogue at Bingöl University in Turkey from 2013 to 2016, during a period marked by intense political tension between security forces and Kurdish insurgencies. It elucidates a transformative pedagogical endeavor aimed at decolonizing education, with a particular focus on Kurdish students who endure colonial domination and oppression. Grounded in critical pedagogy, border thinking, and the principles of epistemic disobedience, this intervention represents a deliberate departure from traditional educational paradigms. It endeavors to cultivate a more inclusive and liberatory learning environment by drawing on theoretical frameworks articulated by renowned scholars such as Freire, Fanon, Mignolo, and Illich. At its core, this endeavor seeks to transcend the conventional boundaries of education by fostering critical consciousness, agency, and alternative worldviews among marginalized communities. Through prioritizing interactive dialogue, problem-posing educational models, and participatory learning practices, the initiative empowers students to critically engage with their social, historical, and cultural contexts. Employing innovative pedagogical strategies like the marketplace of ideas and extracurricular reading groups, students are encouraged to reclaim their own forms of knowledge and challenge hegemonic narratives perpetuated by colonial structures. This initiative underscores the transformative potential of education in dismantling oppressive structures and fostering alternative visions of social change. By amplifying the voices of marginalized communities, the intervention not only challenges the status quo but also lays the groundwork for a more equitable and emancipatory educational landscape.
The Employer Perspective
Authors: Reed Rachelle , McAvoy Cayla , Gallo Paul M. , Newsome A'Naja M.
Published: October 2024

Apply It!

By reading this article, you will:

• Gather insight from key industry stakeholders on the latest fitness trends identified in the 2025 Trends report.

• Learn how industry stakeholders use the Trends report to inform their strategic planning and decision-making processes.

• Understand alignment of 2025 Trends report and real-world trends, through the perspective of industry stakeholders.
Exploring the Gut Microbiome's Influence on Colorectal Cancer Development and Management: A Review of Current Knowledge and Future Directions
Authors: Grela Wiktor , Niewiadomska Jagoda , Furtak Daria , Tulej Dawid , Głogowska Paulina , Dziedzic Alicja , Gniaź Natalia , Marciniuk Dominika , Marko Natalia , Górska Aleksandra
Published: October 2024

IntroductionColorectal cancer (CRC) is a significant global health concern, ranking as the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide, with over 1.9 million new cases and nearly 935,000 deaths annually. The rise in CRC incidence is attributed to various lifestyle changes, including dietary shifts, sedentary behavior, and increased obesity rates. These factors underscore the urgent need for new preventive strategies targeting the underlying mechanisms of CRC development.
PurposeThis review evaluates the intricate relationship between the gut microbiome and CRC, aiming to enhance our understanding of how microbial diversity and composition contribute to CRC pathogenesis.
State of Knowledge
Studies reveal a correlation between the onset and progression of CRC and changes in microbial diversity and specific taxa. In CRC patients, the presence of Fusobacterium nucleatum is linked to inflammation and poor prognosis, while Bacteroides fragilis is associated with promoting colitis and carcinogenesis. The Human Microbiome Project's findings reveal that unique microbial communities can impact inflammation and tumor growth. Meta-analyses underline the crucial role of microbial diversity, influenced by diet and health status, in cancer prevention and progression, particularly in CRC.
ConclusionsUnderstanding the interactions between the microbiome, diet, and host health is crucial for developing targeted treatment strategies and precision diagnostics for CRC. Insights from microbiome research could significantly improve patient outcomes in CRC management. Further high-quality studies are essential to fully elucidate the therapeutic potential of the microbiome in CRC treatment.
Significantly Increased Public Interest in Sleep Disorder during the COVID-19 Pandemic: An Analysis of Google Trends Data
Authors: Tan Qinyi , Chen Xiaolu , Cui Yidan , Sun Hao , Teng Luyan
Published: October 2024

Background: The COVID-19 pandemic has had a profound impact on sleep disorders. Previous studies have shown that people's sleep time is delayed. Methods: Analyze the public's interest to the keyword "sleep disorder" during the COVID-19 pandemic from December 2019 to December 2022 using Google Trends. The study also focused on the search trend data of the top three countries with high to low overall search frequency for this keyword. Results: It has been observed that during the peak period of the COVID-19 pandemic, the public's search interest for "sleep disorder" has significantly increased. Analyzing Google Trends from December 2019 to December 2022, the top three countries with high interest in searching for "sleep disorder" are the United States, the Philippines, and Canada. It shows that search interest in the United States is an increasing trend year by year, and the overall trend is relatively stable. The search trend for "sleep disorder" among Filipino netizens fluctuates greatly and is generally on a downward trend. The search trend for "sleep disorder" among Canadian netizens is moderate, and the overall trend is like that of Filipinos. It is worth noting that the Google Trends for "sleep disorder" among Filipino and Canadian netizens has changed from an overall increase to an overall decrease in 2020 as the watershed. This indicates a temporal correlation between the surge in COVID-19 cases and online search for "sleep disorder". Conclusion: It shows that public interest in "sleep disorder" has significantly increased during the COVID-19 pandemic, and there may be a certain correlation between the COVID-19 pandemic and sleep disorders. These are worthy of further exploration by researchers, especially the changes in people's daily routines caused by the COVID-19 pandemic, which in turn affect people's sleep quality.
DOS PÚLPITOS DOS CARDEAIS ÀS CÁTEDRAS DOS JURISTAS: O USO DA COR PÚRPURA NA LITURGIA DA VIRTUDE DA ORDO IURIS ACADÊMICA ENTRE MEDIOEVO E MODERNIDADE - DOI: 10.12818/P.0304-2340.2024v85p17
Authors: Dal Ri Júnior Arno
Published: October 2024

Os elementos cromáticos desempenharam no campo simbólico dos universos medieval e moderno um papel significativo, com impacto na política e no direito, delimitando categorias e salientando hierarquias. Transpassado por um e por outro, a ordo iuris acadêmica não teria como permanecer insensível a tal impacto, constituindo-se em um espaço de consolidação de um “direito das cores”. Inspirados nos cânones da Igreja e nas cerimônias nobiliárquicas, os professores de direito, aos quais vinha frequentemente outorgada a função de organizar os fatos e acomodá-los em normas antigas ou recentes, souberam transplantar desses para as solenidades acadêmicas os elementos cromáticos, usando-os como instrumento de legitimação na vida universitária. O uso da púrpura, cor que na liturgia católica recorda o sangue do martírio, mas também os dons do Espírito Santo, vem concedido pelo pontífice aos catedráticos de direito, tornando-se também símbolo das virtudes acadêmicas dos juristas. Servindo-se dos pressupostos teóricos oferecidos pela concepção de ordo medieval de Paolo Grossi, pelo “direito das cores” de António Manuel Hespanha e pela iconografia jurídica de Georges Martyn, esse artigo tem por objetivo analisar as etapas percorridas no itinerário histórico de transplante dos elementos simbólicos da cor púrpura dos púlpitos dos cardeais da igreja às cátedras dos juristas nas universidades, servindo como instrumento de distinção dos professores de direito. Para isso serão analisados por primeiro os cânones que regem a liturgia das cores na Igreja e o papel nessa da cor vermelha, seguida pela sua legitimação e uso nas universidades medievais pelos catedráticos de direito e, por fim, sua consolidação na Idade Moderna nos ritos e paramentos acadêmicos do estamento dos juristas. PALAVRAS-CHAVE: História do direito. História das universidades. Cerimônias acadêmicas. Vestuário acadêmico. Direito das cores.
O CONCEITO DE “ATAQUE ARMADO”, ATORES NÃO-ESTATAIS, E O USO DA FORÇA NO DIREITO INTERNACIONAL: RUPTURA OU CONTINUIDADE? - DOI: 10.12818/P.0304-2340.2024v85p291
Authors: Leão Soares Pereira Luíza
Published: October 2024

O direito internacional que regulamenta o uso da força se funda na sua proibição geral pelo esquema da Carta das Nações Unidas, Artigo 2(4). Uma das únicas exceções à proibição está no Artigo 51 da Carta, que prevê que o uso da força em legítima defesa é legal em resposta a um ataque armado. Um dos debates que surge é sobre quem poderia cometer ataque armado para fins de aplicação do artigo 51. Para a Corte Internacional de Justiça em Nicarágua1, um ataque armado somente pode ser cometido por um Estado contra outro Estado – a CIJ exige o “envolvimento substancial” de um Estado para que o ataque armado se configure. Após o 11 de Setembro de 2001, ganhou força o entendimento de que ataques armados podem ser cometidos por atores não-estatais, especificamente grupos terroristas, ampliando as possibilidades de emprego da força em legítima defesa. Surge também neste contexto a doutrina do Estado “indisposto ou incapaz” de suprimir a ameaça terrorista, que segundo alguns abriria terceiros Estados inocentes à intervenção armada externa. Este artigo se debruça sobre as diferentes perspectivas em relação ao tema, apontando divergências na prática estatal e de organizações internacionais, doutrina, e jurisprudência sobre o ratione personae do ataque armado. As conclusões da pesquisa são de que esse é um ponto “em negociação” dentro da prática estatal, doutrina, e mesmo dentro da jurisprudência da CIJ, como evidenciado pelas opiniões individuais de seus juízes, mas que uma interpretação restritiva ao uso da força é a mais apropriada e desejável.
SOBRE LA CREACIÓN DE LA REPÚBLICA Y LA EFICACIA DE LA CONSTITUCIÓN (1825-1832) - DOI: 10.12818/P.0304-2340.2024v85p373
Authors: Castro Ramiro
Published: October 2024

La creación del Estado Oriental del Uruguay fue la consecuencia de un complejo proceso que ha sido estudiado extensamente por la historiografía nacional. Sin embargo, los constitucionalistas uruguayos se han dedicado a describir la organización administrativa y la consagración de los derechos fundamentales en la primera Carta Magna, aportando un enfoque técnico que prescinde del análisis de las circunstancias fácticas que dificultaron su efectividad. En este sentido, el trabajo propone analizar la Constitución uruguaya de 1830 no solo como un problema estrictamente jurídico sino como un problema histórico, que abordaremos a través de la exposición publicada por Juan Antonio Lavalleja en 1833, con el objeto de estudiar el proceso de creación de la República y analizar la trascendencia de la Constitución en el discurso político de los primeros años del Estado Oriental.
Code and Data Repository for Branch-and-Price for the Capacitated Autonomous Vehicle Assisted Delivery Problem
Authors: Zhang Rui
Published: October 2024

The purpose of this repository is to share the instances and source code in the paper "Branch-and-Price for the Capacitated Autonomous Vehicle Assisted Delivery Problem" by Rui Zhang.
Code and Data Repository for Exact Simulation of Quadratic Intensity Models
Authors: Qu Yan , Dassios Angelos , Liu Anxin , Zhao Hongbiao
Published: October 2024

The codes can be used to generate all experimental results in this paper. All algorithms (our exact scheme) proposed in this paper are written in the form of functions based on R or MATLAB. We also provide the codes to compare the numerical experiment results by our exact scheme with discretisation scheme and projection scheme. "R_Simulation_Quadratic_OU_N.R" is the main code, and includes all algorithms proposed in our paper, and most numerical experiment results can be plotted by executing this code.
A Simple and Optimal Policy Design with Safety Against Heavy-Tailed Risk for Stochastic Bandits
Authors: Simchi-Levi David , Zheng Zeyu , Zhu Feng
Published: October 2024

We study the stochastic multi-armed bandit problem and design new policies that enjoy both optimal regret expectation and light-tailed risk for regret distribution. We first find that any policy that obtains the optimal instance-dependent expected regret could incur a heavy-tailed regret tail risk that decays slowly with T. We then focus on policies that achieve optimal worst-case expected regret. We design a novel policy that (i) enjoys the worst-case optimality for regret expectation and (ii) has the worst-case tail probability of incurring a regret larger than any regret threshold that decays exponentially with respect to T. The decaying rate is proved to be optimal for all worst-case optimal policies. Our proposed policy achieves a delicate balance between doing more exploration at the beginning of the time horizon and doing more exploitation when approaching the end, compared with standard confidence-bound-based policies. We also enhance the policy design to accommodate the “any-time” setting where T is unknown a priori, highlighting “lifelong exploration”, and prove equivalently desired policy performances as compared with the “fixed-time” setting with known T. From a managerial perspective, we show through numerical experiments that our new policy design yields similar efficiency and better safety compared to celebrated policies. Our policy design is preferable especially when (i) there is a risk of underestimating the volatility profile, or (ii) there is a challenge of tuning policy hyper-parameters. We conclude by extending our proposed policy design to the stochastic linear bandit setting that leads to both worst-case optimality in terms of regret expectation and light-tailed risk on regret distribution.

This paper was accepted by J. George Shanthikumar, data science.

Funding: The work of D. Simchi-Levi and F. Zhu is partially supported by the MIT Data Science Laboratory.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.03512 .
Political Districting to Minimize County Splits
Authors: Shahmizad Maral , Buchanan Austin
Published: October 2024

Political Districting to Minimize County Splits

When dividing a state into districts for elections, one traditional criterion is that political subdivisions like counties and cities should not be divided unnecessarily. Some states go as far as to say that the number of county splits should be minimized, but previously there was no scalable exact method for determining this. With new integer programming techniques, Shahmizad and Buchanan exactly compute this minimum number for all states and district types (congressional, state senate, state house) across the USA.
AFINAL, POR QUE PUNIMOS?
Authors: Silva Gabriel Braga
Published: October 2024

O presente artigo buscou confrontar a realidade com a lei, no tocante às finalidades designadas à sanção penal, tendo por base as teorias da pena. A pesquisa buscou responder qual finalidade da pena é compatível com o modelo sancionatório brasileiro, a partir de uma análise concreta da realidade prisional, com vistas a se vislumbrarem desdobramentos de caráter político-criminal. Para tanto, estruturou-se a construção metodológica pelo método dedutivo, realizando um recorte teórico amplo, por meio de revisão bibliográfica do tema, sobre as teorias utilitária – analisando-se a incapacitação, dissuasão e ressocialização -, e retribucionistas, para, em um segundo momento, recortarem-se os achados científicos aplicando-os à realidade brasileira. Estabelecidas tais premissas, sustentou-se que, no Brasil, dado o modelo aplicado, apenas a retributividade pode servir como base para orientações de caráter político criminal, tendo em vista os fins utilitários não terem ou aplicação real ou dados científicos concisos suficientes para tanto. Ao final, vislumbram-se possíveis reflexões de caráter político-criminal derivadas da prevalência majoritária da retributividade sobre os fins utilitários, em especial com a centralidade do princípio da proporcionalidade como condutor da justiça na aplicação das sanções penais.
Cats are not small dogs: assessment and stabilisation of emergency presentation
Authors: O'Byrne Lyn , Cole Laura
Published: October 2024

Cats are a common emergency presentation in practice, with a wide range of presenting conditions ranging from trauma caused by road traffic accidents or falling from height, to acute medical conditions or ingestion of toxins. When dealing with feline patients, it is important to remember that cats are not small dogs and therefore, the approach to their assessment and stabilisation must take this into account. Cats have unique behaviour and physiology. They are great pretenders and will often mask clinical signs until they are near-critical. As their response to disease differs to that of dogs, when they are presented to a veterinary clinic they often show non-textbook clinical signs. This, in conjunction with the fact their response to medical therapy can also differ from canine patients, can make them particularly challenging to manage in an emergency. The assessment process should be holistic, and all physical examination findings should be viewed in association with each other.
Clinicopathological Features of Membranous Nephropathy Complicated by IgA Nephropathy: A Retrospective Analysis of Seven Cases
Authors: Xu Beilei , Bao Qiuhong , Shen Wei , Hong Quxia
Published: October 2024

Aims/Background Both membranous nephropathy (MN) and immunoglobulin A nephropathy (IgAN) are immune complex-mediated glomerular diseases, but the concurrent occurrence of these two conditions in the same patient is not common, a phenomenon that is currently not supported by clinical data in terms of treatment and prognosis. This study explores the clinical and pathological characteristics, as well as the treatment outcomes, of patients affected by MN and IgAN simultaneously.

Methods The clinical data, pathological features, and diagnostic and therapeutic information of seven cases of MN complicated by IgAN, treated between December 2015 and December 2022, were retrospectively analyzed.

Results Among the seven cases, there were two male and five female patients, with an average age of 57.3 ± 9.2 years. All patients presented with clinical manifestations of proteinuria and edema upon admission, with an average 24-hour urine protein of 3716.6 ± 1519.4 mg/24 h. Phospholipase A2 receptor (PLA2R) expression was detected in all seven cases, and nephrotic syndrome was clinically diagnosed in five cases. Additionally, all seven cases showed microscopic hematuria, with intermittent gross hematuria in two cases. All seven patients included in this study underwent renal biopsy. After disease staging, the patients had MN stages I–III and IgAN stages II–III. Pathological findings revealed abnormal glomerular basement membrane (GBM) and diffuse immunoglobulin G (IgG) deposition in the subepithelial space, predominantly of the IgG4 subtype. Simultaneously, there was diffuse mesangial zone deposition of immunoglobulin A (IgA) to varying degrees, co-localization of complement component C3 and IgA, and mesangial cell proliferation. Treatment strategies included angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) in combination with steroids or immunosuppressive therapies such as tacrolimus, cyclophosphamide, and rituximab. After 2–6 months of treatment, all patients achieved complete remission with a favourable prognosis.

Conclusion MN accompanied by IgAN tends to occur more frequently in middle-aged and elderly individuals, with a relatively low incidence. The latent feature of the comorbidities manifests as a form of IgAN superimposed on the background of MN. Utilizing ACEI or ARB in combination with steroids or various immunosuppressive therapies represents a potentially effective treatment strategy.
Examining spinal mobility, aerobic capacity and functional movement in patients with non-specific chronic low back pain: a case-control study
Authors: Özyurt Fatih , Aksoy Cihan Caner , Özkaya Murat
Published: October 2024

Background/Aims

The increasing cost and incidence of non-specific chronic low back pain means that many physiotherapists are reconsidering the management of this condition. The primary aim of this study was to examine spinal mobility, aerobic capacity and functional movement screen in patients with non-specific chronic low back pain. The secondary aim was to determine the factors affecting the disability level.

Methods

Participants aged between 18–65 years old diagnosed with non-specific chronic low back pain for >3 months were recruited as a study group, while those without low back pain in the last 3 months were the control group. Outcome measures included the Functional Movement Screen for functional movement, the 2-Minute Step Test for aerobic capacity, the Spinal Mouse for spinal mobility and Oswestry Disability Index for disability level.

Results

A total of 60 participants, 30 people with non-specific chronic low back pain (42.7 ± 10.6 years) and 30 people without low back pain (42.0 ± 7.3 years), were included in this study. There were statistically significant differences in the total sagittal plane angle (P<0.001), total frontal plane angle (P=0.03), 2-Minute Step Test (P<0.001) and Functional Movement Screen (P<0.001) scores between groups. Pain and aerobic capacity explained 42.4% of the variance as determinants of disability in the study group.

Conclusions

In people with non-specific chronic low back pain, sagittal and frontal plane range of motion and aerobic capacity were decreased and their functional movements were impaired. Pain intensity and aerobic capacity affect the disability level of non-specific chronic low back pain.

Implications for practice

People with non-specific chronic low back pain have reduced spinal mobility, aerobic capacity and functional movement. These parameters should be included when determining treatment programmes. At the same time, the level of disability can be reduced by decreasing pain intensity and increasing aerobic capacity of people with low back pain.
Prevalence and antimicrobial resistance of Salmonella isolated from pork in the Northern part of Thailand
Authors:   Unit of Excellent in Infectious Disease, Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao Province, Thailand., Supadej Kanitapon , Nuanmuang Narong ,   Unit of Excellent in Infectious Disease, Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao Province, Thailand., Kummasook Aksarakorn ,   Unit of Excellent in Infectious Disease, Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao Province, Thailand.
Published: October 2024

Background: Salmonella is one of the most common foodborne bacteria frequently isolated from pork. It pose significant public health risks due to its potential to harbor antimicrobial resistance (AMR) genes. The emergence and spread of multidrug-resistant (MDR) Salmonella strains are of particular concern as these can be transferred to humans through food or contaminated environments. Objective: To determine Salmonella’s prevalence and antimicrobial resistance determinants from pork at retail markets in the Northern part of Thailand. Materials and methods: Salmonella was isolated and identified from 173 pork samples. The isolates were serotyped using the slide agglutination test with somatic- (O) and flagellar- (H) antigens, and tested for antimicrobial susceptibility using 23 different antimicrobials using the disc diffusion method. By polymerase chain reaction (PCR), the extended-spectrum β-lactamases (ESBL) genes (blaTEM, blaSHV, blaCTX-M-1, blaCTX-M-2, blaCTX-M-8/25 and blaCTX-M-9), quinolone-resistance determining region (QRDR) including gyrA, gyrB, parC and parE, plasmid-mediated quinolone resistance (PMQR) determinants including qnrA, qnrB, qnrD, qnrS, and aac(6’)-Ib-cr were determined. Results: In this study, 98.8% of the samples were identified as Salmonella. Among these, 72.5% of isolates showed resistance to at least 1 antimicrobial agent and 48.5% were MDR. Ampicillin/tetracycline/trimethoprim-sulfamethoxazole (AMP/ TE/SXT) was the most common phenotypic resistance pattern. The results revealed that 4 ESBL genes (blaTEM, blaCTX-M-1, blaCTX-M-2, and blaCTX-M-9) were detected in 3 isolates- identified as ESBL producers. Moreover, all 9 quinolone-mediated resistance determinants were observed in quinolone resistance isolates. Conclusion: The results demonstrated that most MDR isolates harbored quinolone resistance determinants. We report the distribution of MDR in Salmonella strains isolated from pork and the correlation between the phenotypic and the genotypic susceptibility. These findings raise great concern about the spread of resistant Salmonella strains in the Northern part of Thailand.
Traditional Chinese medicine treatment of insomnia based on microbial-gut-brain axis theory
Authors: Wang Xue-Jian
Published: October 2024

In recent years, insomnia has gradually become a common disease in society, which seriously affects people's quality of life. At present, with the deepening of research on intestinal microbiota-gut-brain axis in Western medicine, many studies suggest that regulating the gastrointestinal tract can treat brain-related diseases. It is found that brain-gut-bacteria axis plays an important role in the prevention and treatment of primary insomnia. At present, although the clinical treatment of insomnia with Western medicine can improve the insomnia symptoms of patients to a certain extent, there are still obvious adverse reactions, such as anxiety and depression, drug addiction, etc. , so long-term oral drug therapy cannot be carried out. Traditional Chinese medicine (TCM) and acupuncture techniques have certain therapeutic effects on insomnia. TCM believes that the brain and gastrointestinal system are connected through the meridian, and the pathophysiology is closely related. This paper will discuss the theory and feasibility of TCM for the treatment of insomnia from the pathological relationship between brain-gut axis, intestinal flora and insomnia.
Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: Banjade Prakash , Rijal Yasoda , Sharma Munish , Surani Salim
Published: October 2024

Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature, absence of radiation exposure, widespread availability, prompt results, high accuracy, and repeatability at the bedside. The diaphragm is a crucial respiratory muscle. Decline or dysfunction of the diaphragm can lead to dyspnea and even respiratory failure in AECOPD patients. In this editorial, we comment on an article, retrospectively analyzed ninety-four acute exacerbations of chronic obstructive pulmonary disease patients who received mechanical ventilation from January 2022 to December 2023. The study found that the diaphragm thickening fraction, an index from diaphragm ultrasound, can better predict the outcome of non-invasive ventilation in patients with AECOPD. The value of non-invasive ventilation in treating respiratory failure caused by AECOPD has been widely acknowledged. Diaphragmatic dysfunction diagnosed with ultrasound is associated with prolonged mechanical ventilation and weaning times and higher mortality.
Potential of traditional Chinese medicine lyophilized powder of Poecilobdella manillensis in the treatment of hyperuricemia
Authors: Huang Kang-Ming , Chen Hong-Bin , Lin Jin-Rong
Published: October 2024

Traditional Chinese medicine has a long and illustrious history, and with the development of modern science and technology, the research and application of traditional Chinese medicines have continued to progress significantly. Many traditional Chinese medicinal herbs have undergone scientific validation, reinvigorating with new life and vitality, and contributing unique strengths to the advancement of human health. Recently, the discovery that leech total protein extracted from Poecilobdella manillensis lyophilized powder reduces blood uric acid (UA) levels by inhibiting the activity of xanthine oxidase to decrease UA synthesis and promotes UA excretion by regulating different UA transporters in the kidney and intestine has undoubtedly injected new vitality and hope into this field of research. The purpose of this editorial is to comment on this study, explore its strengths and weaknesses, and there is a hope to treat a range of metabolic-related syndromes, including hyperuricemia, by targeting the gut microbiota.
Correction to: Marker Ki-67 is a potential biomarker for the diagnosis and prognosis of prostate cancer based on two cohorts
Authors: Song Zhen , Zhou Qi , Zhang Jiang-Lei , Ouyang Jun , Zhang Zhi-Yu
Published: October 2024

This is an erratum to the published paper titled “Marker Ki-67 is a potential biomarker for the diagnosis and prognosis of prostate cancer based on two cohorts”. We have discovered that Reference 4 was cited incorrectly. We sincerely apologize for this inadvertent error. Please note that these corrections do not impact our results.
Patterns of conquest, kingship and conflict. Sallustian intertext in Geoffrey of Monmouth's De gestis Britonum
Authors: Evans Jenyth H.
Published: October 2024

abstract: This article argues that Geoffrey of Monmouth engaged with the Roman historian Sallust in a more meaningful way than has been previously understood. First, it examines how Geoffrey structures the De gestis , and argues that it can be read through the lens of Sallustian historiography: the British kingdom rises and falls in a similar manner to Rome in Sallust's works. This offers a new way of reading the De gestis in the context of the civil war between King Stephen and Empress Matilda. By drawing upon Sallust's model, Geoffrey removes individual blame as a cause of civil war and instead makes it the inevitable result of greatness, such as that enjoyed by ancient Rome. It then argues that Geoffrey uses Sallustian watch-words and literary techniques in order to negatively characterise King Arthur. Therefore, it interrogates the interpretation of Arthur as a 'heroic' figure in the De gestis . In particular, it argues that the use of extended speech is a marker of Sallustian influence, and reading paired speeches together in the De gestis underscores the development of Arthur's character. Overall, this article argues that classical reception studies can open new ways of interpreting and understanding medieval texts like the De gestis .
'And they went with Caswallon over the sea after the Cesariaid'. Were there stories about Caswallon, Julius Caesar, and Fflur in medieval Wales?
Authors: Andrews Celeste L.
Published: October 2024

abstract: This article examines the evidence for a lost narrative in medieval Welsh cyfarwyddyd regarding a love triangle between the ancient British hero Caswallon, the Roman general Julius Caesar, and a woman named Fflur. References to these three figures exist in several triads belonging to the Trioedd Ynys Prydain corpus, as well as in a handful of other texts. However, I argue that these references are insufficient to demonstrate that a concrete narrative existed regarding these three figures and that the belief in such a story stems from work done in the twentieth century by Ifor Williams and his protégés.
Time, space, and identities of place. Chronotopic identities in Cornwall
Authors: Sandow Rhys
Published: October 2024

abstract: Cornwall's dynamic social history has led to Cornish identity being perpetually reinvented (Payton 1992). Fundamental socioeconomic and cultural changes are taking place, yet, there is widespread disagreement on how to respond to these changes—to reject or to embrace? Many Cornish people want to revert back to a 'golden age' when Cornwall was perceived to be more distinctly Celtic and was sustained by traditional industries. Other Cornish people feel that Cornwall's Celtic and industrial pasts add to the rich tapestry of Cornwall's history, but reject the notion that these pasts should be central to Cornwall's future. Instead, they favour capitalising on the demand for tourism and hospitality and exploring alternative future directions for development. Using data collected from ethnographic participant-observation and interviews with 87 Cornish people, I describe two chronotopic identities: the 'Industrial Celt' and 'Lifestyle Cornwall'.