bluuebunny/crossref_metadata_2025 huggingface dataset:
A critical examination of advanced approaches in green chemistry: microbial bioremediation strategies for sustainable mitigation of plastic pollution
Authors: Agarwal Tushar , Atray Neeraj , Sharma Jai Gopal
Published: June 2024

Background

The escalating concern regarding the environmental impact of plastic waste necessitates the adoption of biodegradable methodologies to curtail its adverse effects. A profound comprehension of the intricate interplay between bacteria and polymers becomes imperative for devising effective solutions to address plastic-induced environmental challenges.

Main body of the abstract

Numerous microorganisms have evolved specialized mechanisms for the degradation of plastics, rendering them amenable to application in green chemistry for the elimination of hazardous plastics from the ecosystem. This article offers a comprehensive survey of contemporary microbial bioremediation approaches geared towards augmenting plastic waste management and ameliorating plastic pollution. Emphasis is placed on elucidating the potential of microorganisms in mitigating the deleterious repercussions of plastics on ecosystems and human health, underscoring the significance of advanced strategies in green chemistry for sustainable plastic pollution mitigation.

Short conclusion

Current research emphasizes the effectiveness of naturally occurring soil microorganisms, particularly fungi like Aspergillus and bacteria like Bacillus, in breaking down plastics. To harness this potential on a broader scale, optimization of microbial activity conditions and pre-treatment with environmentally beneficial compounds are essential.
Retrospective study of ivosidenib for patients with recurrent IDH mutant gliomas.
Authors: El-Ghoubaira Joseph , Drappatz Jan , Mantica Megan
Published: June 2024

2040

Background: IDH mutant gliomas are the most common primary malignant brain tumors in adults under the age of 50 and accounts for approximately 12% of all glioma diagnoses each year. While lower grade gliomas (LGG) encompassing WHO grades II and III are less aggressive than their higher-grade counterparts, treatment is not curative, and most patients develop tumor recurrence in which there are a paucity of effective treatment options. Mutations in IDH1/ 2 occur upwards of 80% of patients with LGG and drive specific epigenetic programs to dysregulate and impair differentiation leading to tumorigenesis. As such, pharmacologic blockage of IDH mutant enzymes is being actively investigated as potential treatment option. Ivosidenib (AG-120), a second-generation IDH inhibitor, is an FDA approved medication for treatment of IDH-mutated acute myeloid leukemia and has demonstrated safety and clinical activity in patients with progressive IDH mutant gliomas. We explored the efficacy of Ivosidenib in IDH mutant gliomas. Methods: We retrospectively analyzed patients with IDHm gliomas treated with ivosidenib in our institution. We included patients with an IDH1 mutation who received at least one cycle of ivosidenib. Data collected included patient demographics, tumor histology, tumor location, grade, 1p/19q co-deletion, MGMT, CDKN2A, TERT, EGFR, P53, PTEN mutational status, prior treatment history, duration of treatment, toxicities, radiographic response, PFS, and OS. Descriptive statistics were used to summarize patients' characteristics. The distribution of mPFS was estimated by the Kaplan-Meier method. Results: Between April 2010 and December 2023, we identified 33 patients that received ivosidenib. 7 patients received ivosidenib in combination with bevacizumab, 3 patients received ivosidenib in combination with radiation, and 1 patient received ivosidenib and nivolumab. The median age was 52 (range 31-81). 21 (63%) were male. The median lines of medical therapy and radiation/surgery prior to starting ivosidenib were 3.03(range 0-6) and 1.5(range 0-4), respectively. 27(81%) were grade 2, 5(15%) were grade 3, and 1(3%) were grade 4. 19(57%) had 1p/19q co-deletion. As of 12/31/2023, 48%(16) patients were alive. The median PFS was 7.52 months (1-26) and median OS 12.7 months (3-25). 11(33%) patients experienced partial response (PR), 20(60%) experienced stable disease (SD) and 2(6%) demonstrated progressive disease (PD) at 12-week assessment. Nine patients experienced adverse events: grade 1 fatigue (3), grade 1 diarrhea (1), grade 2 fever (1), grade 2 weakness (1), and grade 3 confusion (1). One patient experienced grade 4 lobar hemorrhage thought to be related to concurrent bevacizumab use. Conclusions: Treatment with Ivosidenib therapy was associated with a manageable safety profile. In a subset of patients, there was disease stabilization in heavily pre-treated recurrent IDH mutant gliomas.
INB-200: Fully enrolled phase 1 study of gene-modified autologous gamma-delta (γδ) T cells in patients with newly diagnosed glioblastoma multiforme (GBM) receiving maintenance temozolomide (TMZ).
Authors: Lobbous Mina , Goswami Trishna , Lamb Lawrence S. , Rochlin Kate , Pillay Thriumaine , ter Haak Mariska , Nabors Louis B.
Published: June 2024

2042

Background: γδ T cells can target NKG2D ligands that are upregulated on tumor cells after alkylating chemotherapy exposure. IN8bio’s DeltEx drug resistant immunotherapy (DRI) are genetically engineered γδ T cells expressing methylguanine-DNA methyltransferase (MGMT), which conveys TMZ resistance to enable concomitant therapy and continued surveillance against tumor cells. Updated results from the Phase 1 trial which fully enrolled adult newly diagnosed GBM patients with adequate organ function, KPS ≥ 70% follow. Methods: Cohorts (C) 1, 2 and 3 received 1, 3 or 6 doses (1 x 107 DRI cells/dose) into the resection cavity with 150 mg/m2 of IV TMZ on Day (D) 1 of each Stupp maintenance cycle. The primary endpoint is safety and secondary endpoints include survival; immunologic correlative analyses are included. Dose limiting toxicities (DLTs) are defined as treatment related ≥ grade (G) 3 cardiopulmonary or hepatic toxicity, G4 toxicity exceeding 72 hours or neurologic deterioration that exceeds 2 weeks. Results: 23 patients were enrolled, with 11 dosed and 2 awaiting dosing (61% male; median age 68 (range: 21-74); 92% IDH-WT, 54% MGMT unmethylated). No DLTs, cytokine release syndrome (CRS) or neurotoxicity (ICANS) are reported. Most common adverse events were decreased WBC/platelet count, asthenia, fatigue, hydrocephalus, headache, decreased appetite, urinary tract infection, thrombosis and balance disorder. Conclusions: γδ T cells successfully infused with peripheral TMZ-based lymphodepletion evidenced with near or below normal range T, B, and NK subsets for up to 1 year. The majority of dosed patients who received DRI exceeded the expected median PFS of 7 months (5.8-8.2 months) with Stupp alone and had manageable toxicity with a continued encouraging trend in PFS. Long-term follow-up for durability of PFS and OS continue. Clinical trial information: NCT04165941 . [Table: see text]
Out-of-pocket cost modeling of adjuvant radiation therapy duration in standard-of-care treatment of glioblastoma across Medicaid and Medicare plans.
Authors: Wu Victoria , Khlopin Martha , McClelland Shearwood
Published: June 2024

2045

Background: The optimal radiation treatment (RT) length (6 weeks of 60 Gy in 30 fractions versus 3 weeks of 40 Gy in 15 fractions) for older adults with glioblastoma is debatable, with Level 1 evidence (PMID 15051755) revealing no difference in survival between RT regimens. However, there remains a paucity of evidence describing the role of insurance on out-of-pocket (OOP) costs for patients undergoing varying lengths of RT. This project aims to quantify expenses by insurance plans, enhancing transparency in treatment cost understanding. Methods: We utilized the National Comprehensive Cancer Network guidelines to determine the standard treatment protocol, including 30-fraction or 15-fraction RT with concurrent and post-radiation temozolomide for 12 cycles. The model assumes a Medicare- and/or Medicaid-eligible patient ≥ 65 years of age with glioblastoma. The total aggregate out-of-pocket (OOP) costs were determined from the sum of treatment costs, deductibles, and copays/coinsurance based on Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D Rx plan over a two-year time horizon (not adjusted for inflation). All procedures were assumed to take place within the premises of an Ohio hospital. Results: Treatment charges include neurosurgery, neuro-oncology, and radiation oncology initial consultation, follow-up visits, diagnostic head CT, MRI, craniotomy with maximum safe resection, surveillance brain MRI, temozolomide, antiemetics, prophylactic TMP-SMX, weekly CBC, and tumor treating fields. RT-specific treatment charges include treatment planning, simulation and verification, RT delivery, and on-treatment visits. Original Medicare beneficiaries face an OOP cost of 20% for Medicare Part B claims with no cost cap for approved procedures after the deductible. Medications are covered under Medicare Part D with copays. This results in a total OOP treatment charge of $4,454.01 for 30 fractions and $3,913.86 for 15 fractions. Medigap Plan G beneficiaries face a total OOP charge of $2,387.22 for 30 fractions and $2,369.61 for 15 fractions. For Medicaid beneficiaries (assuming all treatments are approved by Medicaid), all expenses are covered without limit, resulting in no OOP expense for either treatment plan. Conclusions: Three-week versus six-week RT for GBM reduces OOP costs facing patients by 10%. By understanding the financial implications, healthcare providers, policymakers, and patients can make informed decisions about treatment options, and healthcare systems can develop strategies to mitigate the economic burden associated with GBM care.
Development of a novel risk stratification model for immune-related adverse events for patients with advanced melanoma and non-small cell lung cancer treated with immune checkpoint inhibitors.
Authors: Gao Yizhuo Kelly , Tran Andrew , Gupta Mehul , Heng Daniel Yick Chin , Cheng Tina , Stukalin Igor , Meyers Daniel E. , Cheung Winson Y. , Monzon Jose Gerard , Navani Vishal
Published: June 2024

2649

Background: Immune checkpoint inhibitors (ICI) transformed treatment paradigm across cancers. There remain few reliable, clinically accessible predictors of ICI-induced immune related adverse events (irAEs). We derive a novel risk stratification model for irAEs using baseline patient, tumor and treatment variables in a large cohort of patients with advanced melanoma (AM) or non-small cell lung cancer (NSCLC) treated with ICI. Methods: We conducted a multi-centre retrospective observational cohort study of consecutive patients with AM or NSCLC receiving ≥ 1 cycle of single-agent or combination ICI, in any line, 2015 - 2023, in Alberta, Canada. Clinically significant irAEs, defined as those requiring treatment delay or systemic steroids/steroid sparing agents, were identified as outcome of interest. The association between irAEs, overall survival (OS), and time to next treatment (TTNT) was assessed with Cox Proportional Hazards regression. Stepwise logistic regression was used to select and weight baseline variables associated with development of irAEs to derive a predictive risk score. Model validation was carried out on 500 iterations of bootstrapped samples. Harrel’s C-index was calculated and internally validated to ascertain the model’s discriminatory performance. Results: 1,292 total patients were included, 519 (218/489 [44.6%] AM and 301/803 [37.5%] NSCLC) developing a clinically significant irAE. Using a subset of 801 patients with available baseline characteristics, the following variables were identified and weighted for creation of risk model (risk score attributed): tumor type (NSCLC) (+1), age >60 (+1), ECOG ≥1 (-1), BMI ≥ 25 (+1), ICI after first line (-1), combination ICI (+4), >10 cycles of ICI (+2), albumin level < LLN (+2), adrenal metastasis (+1), multiple sites of metastasis (-1). Patients were stratified into 3 irAE risk groups based on combined score: low (n = 230, risk score ≤ 0), intermediate (n = 412, risk score 1-2), high (n = 159, risk score ≥3). The risk model performed well with an optimism-corrected c-index of 0.707 in internal validation, and strong association with odds of irAE occurrence (Table). The development of irAE was associated with an improvement in OS (HR 0.48, 95% CI 0.41-0.44, p<0.001), with a median OS of 34.3 (95% CI 28.8-39.6) months compared to 12.0 (95% CI 10.6-14.3) months for those who did not develop an irAE. Similar robust stratification was also seen with TTNT. Conclusions: We presented and internally validated, a simple risk stratification tool that utilizes readily available baseline patient, tumor, and treatment characteristics to robustly stratify risk of irAE development. [Table: see text]
Introduction
Authors: Wark McKenzie
Published: June 2024

This short introduction by the volume editor highlights the author's importance as a founding mother of trans studies and, indeed, of a trans version of queer everyday life.
How Do the True Intraoperative Costs of Endoscopic Diskectomy Compare With Microdiskectomy for Lumbar Disk Herniations? A Time-Driven Activity-Based Cost Analysis
Authors: Leibold Adam , Sarikonda Advith , Tecce Eric , Sami Ashmal , Mansoor Ali Daniyal , Thalheimer Sara , Heller Joshua , Prasad Srinivas K. , Sharan Ashwini , Jallo Jack , Harrop James , Vaccaro Alexander R. , Sivaganesan Ahilan
Published: June 2024

BACKGROUND AND OBJECTIVES:

Endoscopic lumbar diskectomy (ED) is a minimally invasive option for addressing lumbar disk herniations. With the introduction of value-based care systems, assessing the true cost of certain procedures is critical when creating reimbursement models and comparing procedures. Here, we compared the costs of performing a microdiskectomy (MD) and ED using time-driven activity-based costing.

METHODS:

Total cost for the intraoperative episode was calculated using time-driven activity-based costing methodology. Individual costs were obtained by direct observation and electronic medical records and through querying multiple departments (business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented. A retrospective analysis was performed on 202 patients who underwent lumbar diskectomy through either MD (n = 167) or ED (n = 35) from 2018 to 2022. Personnel cost was calculated by multiplying the cost per unit time for each personnel type by the length of time spent in the operating room. Supply cost was calculated by aggregating the cost of all individual supplies, from medications to consumables to surgical trays, used during the case. Univariate and multivariable regression analyses were performed comparing the costs between these procedures.

RESULTS:

The average intraoperative cost per case for ED and MD was $3915 ± $1025 and $3162 ± $954, respectively. Multivariable regression analysis revealed that ED had higher total cost (β-coefficient: $912 ± $281, P = <.01) and supply cost (β-coefficient: $474 ± $155, P = <.01) than MD. When accounting for surgeon as a covariate, however, total cost (P = .478) and supply cost (P = .468) differences between ED and MD were negligible.

CONCLUSION:

ED has shown to be a better value option in addressing lumbar disk herniations, mostly because of advantages in perioperative care. Here, we show that when correcting for surgeon-level effects, the cost between the two procedures is statistically insignificant, reaffirming the value provided by ED.
Η αντιμετώπιση της ακίνητης ιδιοκτησίας στην Ελλάδα κατά την περίοδο της οικονομικής κρίσης υπό το πρίσμα νομοθετημάτων πολεοδομικού και φορολογικού χαρακτήρα
Authors: Βαϊούλη Μαρία
Published: June 2024

Η παρούσα διαθεματική διατριβή με σύνθετη μεθοδολογική προσέγγιση διερευνά το ιδιαίτερο κοινωνικό καθεστώς που ρυθμίζει τον χώρο, την κατοίκηση αλλά και την πολεοδομία στην Ελλάδα, όπως διαπλάσθηκε κατά την περίοδο της οικονομικής κρίσης. Ειδικότερα, εκκινώντας από τη σχετική βιβλιογραφία της δεκαετίας του 1990, το κοινωνικό αυτό καθεστώς, παρουσιάζει χαρακτηριστικά που προσιδιάζουν σε εκείνη της ανεπίσημης κατοικίας και διευκόλυνε ιστορικά την ικανοποίηση των βασικών στεγαστικών αναγκών μεγάλης μερίδας του πληθυσμού σε περιόδους μετάβασης (όπως μετά τον Β’ Παγκόσμιο Πόλεμο), μέσα από ιδιαίτερες κοινωνικές διεργασίες, την ανοχή της Πολιτείας και την εκ των υστέρων μαζική νομιμοποίηση των εκτός ή παρά τον νόμο ρυθμίσεων που το κοινωνικό καθεστώς είχε παράγει (πχ ένταξη στο πολεοδομικό σχεδιασμό περιοχών με αυθαίρετη δόμηση εκτός σχεδίου). Το ιδιαίτερο αυτό κοινωνικό καθεστώς, οδήγησε στην παγίωση μιας προστατευτικής αντιμετώπισης της ακίνητης ιδιοκτησίας στην Ελλάδα εκ μέρους της κρατικής εξουσίας μέχρι την επέλευση της οικονομικής κρίσης, κατά τη διάρκεια της οποίας μια σειρά νομοθετημάτων πολεοδομικού και φορολογικού χαρακτήρα επιβάλλουν όρους και εισάγουν επαχθείς ρυθμιστικές παρεμβάσεις για τον χώρο και την κατοικία. Επιπρόσθετα, η νομολογία στρέφεται ερμηνευτικά σε θέσεις περισσότερο προστατευτικές προς τη δημοσιονομική ταμειακή επιβίωση του κράτους και σε θέσεις λιγότερες προστατευτικές προς το περιβαλλοντικό κεκτημένο το οποίο - ακτιβιστικά- τα ελληνικά δικαστήρια με προεξάρχοντα το Συμβούλιο της Επικρατείας είχε οριοθετήσει κατά τις τελευταίες πριν την κρίση δεκαετίες. Η έρευνα βασίστηκε σε βιβλιογραφικές και δημοσιογραφικές πηγές, σε δευτερογενή ανάλυση δεδομένων που παρήγαγαν ιδρύματα ή εταιρίες (υπουργεία, οργανισμοί, επιχειρήσεις, κέντρα μελετών και ερευνών, στατιστικές υπηρεσίες), καθώς και σε ανάλυση - παρουσίαση της νομοθεσίας και της νομολογίας. Επιπρόσθετα, στο πλαίσιο της πολυσυλλεκτικής μεθόδου έρευνας από τα πεδία της νομικής, της κοινωνιολογίας και της κοινωνιολογίας του Δικαίου ιδιαίτερο βάρος δόθηκε στην έρευνα πεδίου και ιδιαίτερα στην συμμετοχική παρατήρηση. Ειδικότερα, η έρευνα πεδίου διακλαδίζεται σε δύο επίπεδα: αφενός στη διενέργεια τυποποιημένου ερωτηματολογίου με στόχο να αποτυπωθούν τα ποσοτικά στοιχεία του πεδίου έρευνας και αφετέρου στη διενέργεια συνεντεύξεων (ποιοτική έρευνα).
Public perception of wireless power transfer safety
Authors: You Sirui
Published: June 2024

Background Wireless Power Transfer (WPT) technology has changed how energy is distributed, allowing power to be transmitted without using wires. Despite being used in devices like cell phones, electric cars, and medical devices; people are worried about the safety and health effects of wireless power transfer. Methods Here this concern research work has used a survey method to gather information from a diverse group of people, focusing on various demographic factors and educational aspects. The research has analysed the knowledge of people regarding the application of wireless power transfer (WPT) technology. Further it has accumulated the safety aspects of using it in public or private places. However, the concerns of propel perspectives basing on their age, gender or other factors about safety of WPT is inducted within this survey. Results the finding from the survey within this research has demonstrated that many people are not much aware of WPT technologies, and some are worried about safety aspects of this concern technology within public places. From this result it has been seen that groups considering the age, education and gender has different perspective regarding the application and safety of WPT. The results have shown that people need to be taught more about it and to be made more aware of it. In addition, survey has showed that about 38% of respondent has some concerns about WPT technologies, which means that a significant number of people know about it. Conclusions From this analysis it has been interpreted that it is important to talk about safety worries and false facts about WPT. This concern paper has the potential to develop awareness about this technology. However, it is expected that future studies should look at more types of people and explore their personal experiences to figure out why people have different opinions about WPT.
Optimal control, well-posedness and sensitivity analysis for a class of generalized evolutionary systems
Authors: Li Xiuwen , Luo Zhi , Liu Zhenhai
Published: June 2024

In this paper, we are concerned with a generalized evolution dynamical system, called fractional differential
variational-hemivariational inequality (FDVHVI, for short), which is composed of a nonlinear fractional evolution inclusion and a time-dependent
mixed variational-hemivariational inequality in the framework of Banach spaces. The objective of this paper is four fold.
The first one is to investigate the nonemptiness as well as the compactness of the mild solutions set to the FDVHVI.
The second aim is to study the optimal control problems described by the FDVHVI. The third goal is to establish the well-posedness results of the FDVHVI,
including the existence, uniqueness, and stability. Furthermore, the sensitivity analysis of a perturbed problem associated to the FDVHVI with respect
to the initial state and the two parameters is also obtained. Finally, a comprehensive fractional model is given to illustrate the validity of our main results.
Normal forms of parabolic logarithmic transseries
Authors: Peran Dino
Published: June 2024

We give formal normal forms for parabolic logarithmic transseries $f=z+\dots $, with respect to parabolic logarithmic normalizations. Normalizations are given algorithmically, using fixed point theorems, as limits of Picard's sequences in appropriate complete metric spaces, in contrast to transfinite \emph{term-by-term} eliminations described in former works. Furthermore, we give the explicit formula for the residual coefficient in the normal form and show that, in the larger logarithmic class, we can even eliminate the residual term from the normal form.
Minimizers of L^2-critical inhomogeneous variational problems with a spatially decaying nonlinearity in bounded domains
Authors: Zhang Hongfei , Zhang Shu
Published: June 2024

We consider the minimizers of $L^{2}$-critical inhomogeneous variational problems with a spatially decaying nonlinear term in an open bounded domain $\Omega$
of $\mathbb{R}^{N}$ which contains $0$.
We prove that there is a threshold $a^{*}> 0$ such that minimizers exist for $0< a< a^{*}$ and the minimizer does not exist for any $a> a^{*}$.
In contrast to the homogeneous case, we show that both the existence and nonexistence of minimizers may occur at the threshold $a^*$ depending on the value of $V(0)$,
where $V(x)$ denotes the trapping potential. Moreover, under some suitable assumptions on $V(x)$,
based on a detailed analysis on the concentration behavior of minimizers as $a\nearrow a^*$, we prove local uniqueness of minimizers when $a$ is close enough to $a^*$.
La efectividad del medio de control de nulidad en la protección de los derechos colectivos: una aproximación desde el derecho colectivo al ambiente sano
Authors: González-Espinel María Paula , Páez-Páez Iván Andrés
Published: June 2024

La acción de nulidad, o como se conoce hoy día, el medio de control de nulidad de los actos administrativos, es el medio tradicional y primigenio de anulación de los actos administrativos. Con el advenimiento de la Ley 99 de 1993, se consagró dicho medio o acción como mecanismo particular para la protección del derecho colectivo al medio ambiente. Sin embargo, a pesar de la especial relevancia que desde el ordenamiento jurídico ambiental se dio a este medio de anulación de los actos administrativos, es dable concluir que se ha venido haciendo un esguince por parte de los operadores administrativos una vez la administración de justicia se pronuncia provisional o definitivamente sobre el acto administrativo sometido al enunciado medio de control, en detrimento de la efectividad en la protección del derecho colectivo a un ambiente sano.
An Efficient Scenario Reduction Method for Problems with Higher Moment Coherent Risk Measures
Authors: He Xiaolei , Zhang Weiguo
Published: June 2024

In this paper, we present an efficient scenario reduction method for optimization problems whose objective function is the higher moment coherent risk (HMCR) measures. Compared with existing approaches, our method places greater emphasis on the characteristics of optimization problems. Because the value of HMCR measures only depends on a small subset of scenarios that correspond to high cost or loss, our approach is based mostly on the concept of ineffective scenarios previously proposed in the literature, which entails identifying the scenarios whose removal from the problem results in no change of the optimal value. We test our method on a simple portfolio optimization problem with only nine risky assets and a realistic one with 50 risky assets and cardinality constraints. Results show that our scenario reduction method can yield a more accurate optimal solution and optimal value, along with a smaller reduced-scenario set. Even at the same reduction level, our method continues to outperform the existing scenario reduction methods. Interestingly, the portfolio produced by our method is also more diversified than others.

History: Accepted by Pascal Van Hentenryck, Area Editor for Computational Modeling: Methods & Analysis.

Funding: This work was supported by the National Natural Science Foundation of China [Grants 71720107002 and U1901223].

Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information ( https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2022.0375 ) as well as from the IJOC GitHub software repository ( https://github.com/INFORMSJoC/2022.0375 ). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/ .
Human-Robot Interactions in Investment Decisions
Authors: Bianchi Milo , Brière Marie
Published: June 2024

We study the introduction of robo-advising on a large set of employee saving plans. Different from many services that fully automate portfolio decisions, our robo-advisor proposes investment and rebalancing strategies, leaving investors free to follow or ignore them. The resulting human-robot interactions occur both at the time of the subscription and over time, as the robot sends alerts when the investor’s portfolio gets too far from the target allocation. We show that the robo-service is associated with an increase in investors’ attention and trading activities. Following the robot’s alerts, investors change their rebalancing behaviors so as to stay closer to their target allocation, which results in larger portfolio returns. Counterfactual returns induced by automatic rebalancing by the robot would be only slightly higher, suggesting that, on average, the financial cost of letting investors retain control is not large.

This paper was accepted by Jean-Edouard Colliard, special issue on the human-algorithm connection.

Funding: This work was supported by Observatoire epargne europeenne, as well as LTI@Unito and Agence Nationale de la Recherche [Grant ANR-17-EURE-0010] to M. Bianchi.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.03886 .
Anti-LGI1 autoimmune encephalitis in a patient with rheumatoid arthritis and MGUS
Authors: Bounou Lamprini , Kaklamanos Aimilios , Androutsakos Theodoros , Kemanetzoglou Elissavet , Moustaka Ioanna , Protogerou Athanasios , Euthimiou Athina
Published: June 2024

Background: Anti-leucine-rich glioma inactivated 1 limbic encephalitis (anti-LGI1 LE) is one of the most frequent autoimmune encephalitis, commonly coexisting with other autoimmune diseases. Rheumatoid arthritis (RA) and monoclonal gammopathy of unknown significance (MGUS) are commonly associated with autoimmune phenomena. However, neither RA nor MGUS have been described in the literature to date as coexisting with anti-LGI1 LE. Case description: We present the case of anti-LGI1 LE in a male patient with rheumatoid arthritis, who was also found to have an MGUS. The patient was initially treated with corticosteroids and IV immunoglobulin. After a mild relapse, his treatment was complemented with rituximab, resulting in complete regression of the disease symptoms. Conclusions: Our report provides evidence for the coexistence of anti-LGI1 LE with RA and/or MGUS, thus extending the differential diagnosis of patients suffering with these disease entities that present with neuropsychiatric symptoms suggestive of encephalitis. Moreover, this case raises challenges on the management of the coexistence of these diseases, given the lack of therapeutic guidelines and their potential interaction on a pathophysiological and a clinical level.
Clinical issues and challenges in imaging of gastrointestinal diseases: A minireview and our experience
Authors: Gulinac Milena , Kiprin Georgi , Tsranchev Ivan , Graklanov Vasko , Chervenkov Lyubomir , Velikova Tsvetelina
Published: June 2024

Imaging techniques play a crucial role in the modern era of medicine, particularly in gastroenterology. Nowadays, various non-invasive and invasive imaging modalities are being routinely employed to evaluate different gastrointestinal (GI) diseases. However, many instrumental as well as clinical issues are arising in the area of modern GI imaging. This minireview article aims to briefly overview the clinical issues and challenges encountered in imaging GI diseases while highlighting our experience in the field. We also summarize the advances in clinically available diagnostic methods for evaluating different diseases of the GI tract and demonstrate our experience in the area. In conclusion, almost all imaging techniques used in imaging GI diseases can also raise many challenges that necessitate careful consideration and profound expertise in this field.
Omics-imaging signature-based nomogram to predict the progression-free survival of patients with hepatocellular carcinoma after transcatheter arterial chemoembolization
Authors: Guan Qing-Long , Zhang Hai-Xiao , Gu Jun-Peng , Cao Geng-Fei , Ren Wei-Xin
Published: June 2024

BACKGROUND

Enhanced magnetic resonance imaging (MRI) is widely used in the diagnosis, treatment and prognosis of hepatocellular carcinoma (HCC), but it can not effectively reflect the heterogeneity within the tumor and evaluate the effect after treatment. Preoperative imaging analysis of voxel changes can effectively reflect the internal heterogeneity of the tumor and evaluate the progression-free survival (PFS).

AIM

To predict the PFS of patients with HCC before operation by building a model with enhanced MRI images.

METHODS

Delineate the regions of interest (ROI) in arterial phase, portal venous phase and delayed phase of enhanced MRI. After extracting the combinatorial features of ROI, the features are fused to obtain deep learning radiomics (DLR)_Sig. DeLong's test was used to evaluate the diagnostic performance of different typological features. K-M analysis was applied to assess PFS in different risk groups, and the discriminative ability of the model was evaluated using the C-index.

RESULTS

Tumor diameter and diolame were independent factors influencing the prognosis of PFS. Delong's test revealed multi-phase combined radiomic features had significantly greater area under the curve values than did those of the individual phases (P < 0.05).In deep transfer learning (DTL) and DLR, significant differences were observed between the multi-phase and individual phases feature sets (P < 0.05). K-M survival analysis revealed a median survival time of high risk group and low risk group was 12.8 and 14.2 months, respectively, and the predicted probabilities of 6 months, 1 year and 2 years were 92%, 60%, 40% and 98%, 90%,73%, respectively. The C-index was 0.764, indicating relatively good consistency between the predicted and observed results. DTL and DLR have higher predictive value for 2-year PFS in nomogram.

CONCLUSION

Based on the multi-temporal characteristics of enhanced MRI and the constructed Nomograph, it provides a new strategy for predicting the PFS of transarterial chemoembolization treatment of HCC.
Current state and influencing factors in airbag management among emergency department nurses: A multicenter study
Authors: Wei Xiao-Hui , Zhou Li-Jin , Li Rui , Li Xin-Yuan , Zhang Ye , Zhang Hai-Yue , Wang Si-Meng , Zhang Jia
Published: June 2024

BACKGROUND

The emergency department (ED) plays a critical role in establishing artificial airways and implementing mechanical ventilation. Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia. Nonetheless, existing research has largely overlooked the understanding, beliefs, and practical dimensions of airway airbag management among ED nurses, with a predominant focus on intensive care unit nurses.

AIM

To investigate the current status of ED nurses' knowledge, beliefs, and practical behaviors in airway airbag management and their influencing factors.

METHODS

A survey was conducted from July 10th to August 10th, 2023, using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai. Pathway analysis was utilized to analyze the influencing factors.

RESULTS

The scores for ED nurses' airway airbag management knowledge were 60.26 ± 23.00, belief was 88.65 ± 13.36, and behavior was 75.10 ± 19.84. The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training, department, and work experience in the department. Influencing factors of airbag management belief comprised knowledge, department, and participation in specialized nurse or mechanical ventilation training. Primary influencing factors of airbag management behavior included knowledge, belief, department, participation in specialized nurse or mechanical ventilation training, and professional title. The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior, with a total effect value of 0.513, and an indirect effect of 0.085, constituting 16.6% of the total effect.

CONCLUSION

ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices, yet there remains room for improvement in their knowledge levels. Nursing managers should implement interventions tailored to the characteristics of ED nurses' airbag management knowledge, beliefs, and practices to enhance their airbag management proficiency.
Facilitating and hindering factors of community nurses' emergency and critical care treatment abilities: A qualitative study
Authors: Cheng Wen-Lin , Li Rui , Song Yan , Qian Fei-Hu , Sha Si-Yuan , Song Shuang-Yuan
Published: June 2024

BACKGROUND

This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses' abilities in managing critical and emergency conditions. With the transition of healthcare systems to the community, the evolution of nursing practices, and the attention from policies and practices, community nurses play a crucial role in the management of critical and emergency conditions. However, there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.

AIM

To understand the facilitators and barriers of community nurses in managing critical and emergency conditions, exploring the fundamental reasons and driving forces influencing their treatment capabilities.

METHODS

This study utilized the destination sampling method between May 2023 and July 2023. It employed a descriptive phenomenological approach within qualitative research methodologies. Through objective sampling, 17 community nurses from 7 communities in Changning District, Shanghai, were selected as the study subjects. Semi-structured interviews were conducted to gather data, which were subsequently organized and analyzed using Colaizzi's seven-step analysis method, leading to the extraction of final themes.

RESULTS

The barrier factors identified from the interviews encompassed three topics: resource allocation, professional factors, and personal literacy. The facilitators comprised three themes: professionalism, management attention, and training and continuing education. We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses, insufficient awareness of self-directed learning, and limited knowledge and technical proficiency. The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.

CONCLUSION

To enhance the capability of community nurses in treating acute and critical patients, it is recommended to bolster training specifically tailored to acute and critical care, raise awareness of first aid practices, and elevate knowledge and skill levels.
Serum cystatin C, monocyte/high-density lipoprotein-C ratio, and uric acid for the diagnosis of coronary heart disease and heart failure
Authors: Li Ming , Yuan Da-Hao , Yang Zhi , Lu Teng-Xiang , Zou Xiao-Biao
Published: June 2024

BACKGROUND

Coronary heart disease (CHD) and heart failure (HF) are the major causes of morbidity and mortality worldwide. Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis. However, conventional diagnostic methods such as electrocardiography, echocardiography, and cardiac biomarkers have certain limitations, such as low sensitivity, specificity, availability, and cost-effectiveness. Therefore, there is a need for simple, noninvasive, and reliable biomarkers to diagnose CHD and HF.

AIM

To investigate serum cystatin C (Cys-C), monocyte/high-density lipoprotein cholesterol ratio (MHR), and uric acid (UA) diagnostic values for CHD and HF.

METHODS

We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023. The patients were divided into CHD (n = 20), HF (n = 20), CHD + HF (n = 20), and control groups (n = 20). The serum levels of Cys-C, MHR, and UA were measured using immunonephelometry and an enzymatic method, respectively, and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Serum levels of Cys-C, MHR, and UA were significantly higher in the CHD, HF, and CHD + HF groups than those in the control group. The serum levels of Cys-C, MHR, and UA were significantly higher in the CHD + HF group than those in the CHD or HF group. The ROC curve analysis showed that serum Cys-C, MHR, and UA had good diagnostic performance for CHD and HF, with areas under the curve ranging from 0.78 to 0.93. The optimal cutoff values of serum Cys-C, MHR, and UA for diagnosing CHD, HF, and CHD+HF were 1.2 mg/L, 0.9 × 109, and 389 µmol/L; 1.4 mg/L, 1.0 × 109, and 449 µmol/L; and 1.6 mg/L, 1.1 × 109, and 508 µmol/L, respectively.

CONCLUSION

Serum Cys-C, MHR, and UA are useful biomarkers for diagnosing CHD and HF, and CHD+HF. These can provide information for decision-making and risk stratification in patients with CHD and HF.
Evaluating the clinical application and effect of acupuncture therapy in anal function rehabilitation after low-tension rectal cancer surgery
Authors: Shen Li-Zhong , Li Wei , Liu Zhan-Lun , Wang Ni , Liu Yan-Feng , Miao Ling-Ling
Published: June 2024

BACKGROUND

According to the indexes of serum and anal function, acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.

AIM

To explore the clinical application and evaluate the effect of acupuncture therapy for anal function rehabilitation after low-tension rectal cancer surgery.

METHODS

From the anorectal surgery cases, we selected 120 patients who underwent colorectal cancer surgery between January 2020 and December 2022 and randomly divided them into a control group (n = 60), observation group (n = 60), and control group after surgery for lifestyle intervention (including smoking cessation and exercise), dietary factor adjustment, anal movement, and oral loperamide treatment. The serum levels of motilin, 5-hydroxytryptamine, and vasoactive intestinal peptide (VIP), Wexner score for anal incontinence, and incidence of complications were compared between groups.

RESULTS

After treatment, the VIP and 5-hydroxytryptamine levels in the observation group were lower than those in the control group (P < 0.05). The motilin level was higher than that in the control group (P < 0.05). Postoperative anal incontinence was better in the observation group than in the control group (P < 0.05). The incidence of complications in the observation group was 6.67%, which was significantly lower than that in the control group (21.67%; P < 0.05).

CONCLUSION

Acupuncture therapy has a positive effect on the rehabilitation of anal function after low-tension rectal cancer surgery; it can effectively help to improve the serum indices of patients, avoid the occurrence of anal incontinence, and reduce the incidence of complications. Popularizing and applying it will be valuable.
Exploring the potential mechanism of WuFuYin against hypertrophic scar using network pharmacology and molecular docking
Authors: Zhang Shu-Yang , Guo Song-Xue , Chen Lei-Lei , Zhu Jia-Yan , Hou Ming-Sheng , Lu Jia-Ke , Shen Xue-Xiang
Published: June 2024

BACKGROUND

Hypertrophic scar (HTS) is dermal fibroproliferative disorder, which may cause physiological and psychological problems. Currently, the potential mechanism of WuFuYin (WFY) in the treatment of HTS remained to be elucidated.

AIM

To explore the potential mechanism of WFY in treating HTS.

METHODS

Active components and corresponding targets were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. HTS-related genes were obtained from the GeneCards, DisGeNET, and National Center for Biotechnology Information. The function of targets was analyzed by performing Gene Ontology and Kyoto Encyclopaedia of Genes and Genome (KEGG) enrichment analysis. A protein + IBM-protein interaction (PPI) network was developed using STRING database and Cytoscape. To confirm the high affinity between compounds and targets, molecular docking was performed.

RESULTS

A total of 65 core genes, which were both related to compounds and HTS, were selected from multiple databases. PPI analysis showed that CKD2 , ABCC1 , MMP2 , MMP9 , glycogen synthase kinase 3 beta (GSK3B ), PRARG , MMP3 , and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit gamma (PIK3CG ) were the hub targets and MOL004941, MOL004935, MOL004866, MOL004993, and MOL004989 were the key compounds of WFY against HTS. The results of KEGG enrichment analysis demonstrated that the function of most genes were enriched in the PI3K-Akt pathway. Moreover, by performing molecular docking, we confirmed that GSK3B and 8-prenylated eriodictyol shared the highest affinity.

CONCLUSION

The current findings showed that the GSK3B and cyclin dependent kinase 2 were the potential targets and MOL004941, MOL004989, and MOL004993 were the main compounds of WFY in HTS treatment.
Eikenella corrodens isolated from pleural effusion: A case report
Authors: Liang Zi-Cong , Ouyang Hao , Song Xue-Jing , Liang Jian-Xin , Zheng Wei-Hua , Chen Jian-Jun , Yin Zheng-Gang , Chen Sha-Yan
Published: June 2024

BACKGROUND

The bacterium Eikenella , classified as a gram-negative member of the phylum Proteobacteria, is distinguished by its rarity, corrosive nature, facultative anaerobic properties, and conditional pathogenicity. It represents the sole species within its genus-Eikenella corrodens (E. corrodens )-and can be found colonizing both human and animal oral and nasopharyngeal regions. Additionally, it occasionally inhabits the gastrointestinal or urogenital tracts. However, its slow growth rate can be attributed to its high nutritional requirements. However, there is an uneven distribution of construction and diagnostic capacity in China which poses undeniable challenges for the clinical examination and analysis of this case, especially in the basic hospitals.

CASE SUMMARY

Here we presented a case of empyema associated with E. corrodens infection in a 67-year-old male patient without any previous history of infectious diseases in our primary hospital in Dongguan district of China. The patient was admitted due to recurrent worsening cough, sputum production, and dyspnea for 3 d, which had persisted for over 20 years. Moreover, the patient experienced a one-hour episode of unconsciousness. Upon admission, immediate comprehensive examinations were conducted on the patient which subsequently led to his admission to the intensive care unit. Meanwhile, the patient presented with drowsiness and profuse sweating along with bilateral conjunctival edema observed during initiation of non-invasive ventilation, suggesting empyema. A significant amount of coffee-colored malodorous pleural fluid was drained during the procedure above and sent to the laboratory department for inspection. Finally, laboratory culture results confirmed the presence of E. corrodens infection in the pleural fluid sample. The patient received antimicrobial therapy until died on day 22 in the hospital.

CONCLUSION

In this report, we presented a case of empyema associated with E. corrodens infection. Multiple courses of morphological examination, viable culture analysis, and biochemical identification revealed its difficulties in detecting distinctive characteristics, as well as a detection model worth promoting. It’s just that there were still certain deficiencies in terms of morphological assessment, biochemical identification, and drug susceptibility testing.
Endoscopic radial incision and cutting method for adult congenital duodenal webs: A case report
Authors: Shin Hyun Deok
Published: June 2024

BACKGROUND

Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea, vomiting, and postprandial fullness. The treatment for this disease is mostly surgical. Endoscopic treatment techniques have been developed and attempted for this disease. Endoscopic radial incision and cutting (RIC) techniques are reportedly very effective in benign anastomotic stricture. This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.

CASE SUMMARY

A 23-year-old female patient with indigestion was referred to a tertiary hospital. The patient complained of postprandial fullness in the epigastric region. Previous physical examinations or blood tests indicated no abnormalities. Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum. Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb; a very small hole was observed in the distal part of the second portion, and scope passage was not possible. Gastrografin upper gastrointestinal series was performed, revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim, a typical "windsock" sign. Endoscopic RIC was performed on the duodenal web. The patient recovered uneventfully. Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis. The patient reported complete resolution of symptoms at the 18-month follow-up.

CONCLUSION

Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.