Minimal Risk Research Articles

Overweight and obese women’s symptoms, knowledge, and preferences regarding endometrial biopsy for endometrial cancer detection: A threshold technique survey

BackgroundThe incidence of endometrial cancer (EC) in the United States continues to rise, driven mainly by the obesity epidemic. We sought to determine overweight and obese women’s cancer risk knowledge and preferences regarding diagnostic endometrial biopsy (EMB) for EC detection. MethodsAn online survey was administered to overweight and obese women without EC recruited through the electronic medical record’s online patient portal. Baseline questions queried gynecologic history, cancer risk knowledge, and factors potentially influencing decision-making for EMB. We used the threshold survey technique to identify the minimum acceptable risk (MAR) threshold at which each respondent would be willing to undergo an EMB to detect EC. ResultsOf 357 respondents (median age 45 years (interquartile range [IQR]: 38–54); median BMI 39 [IQR: 36.0–44.6]), fewer than half (48.7 %) were aware that obesity is a risk factor for EC, and 10 % considered their risk of EC to be high. Almost half (42 %) of respondents reported MAR thresholds characterized as very low (0–1 %), and these were more common among respondents with higher BMIs. Forty percent identified their weight as a factor influencing their MAR threshold decision, while 76 % identified their perceived personal risk as a factor. Less than half cited immediate risks of the procedure. ConclusionMany patients reported being willing to undergo an EMB at very low risk thresholds for EC. Perceived personal risk is a stronger factor in decision-making than immediate procedural risks. Providers should focus on communicating patients’ risk to motivate EMB to detect EC where appropriate.

Pricing Contingent Claims in a Two-Interest-Rate Multi-Dimensional Jump-Diffusion Model via Market Completion

This paper investigates a financial market where asset prices follow a multi-dimensional Brownian motion process and a multi-dimensional Poisson process characterized by diverse credit and deposit rates where the credit rate is higher than the deposit rate. The focus extends to evaluating European options by establishing upper and lower hedging prices through a transition to a suitable auxiliary market. Introducing a lemma elucidates the same solution to the pricing problem in both markets under specific conditions. Additionally, we address the minimization of shortfall risk and determine no-arbitrage price bounds within the framework of incomplete markets. This study provides a comprehensive understanding of the challenges posed by the multi-dimensional jump-diffusion model and varying interest rates in financial markets.

227 Early outcomes for a single-arm, single-stage phase I/II trial of Selective Avoidance of nodalVolumEs at minimal Risk (SAVER) in the contralateral neck of patients with p16-positiveoropharynx cancer

227 Early outcomes for a single-arm, single-stage phase I/II trial of Selective Avoidance of nodalVolumEs at minimal Risk (SAVER) in the contralateral neck of patients with p16-positiveoropharynx cancer

The Platelet Aggregation Inhibition Activity of Polyphenols can be mediated by 67kda Laminin Receptor: A New Therapeutic Strategy For the Treatment of Venous Thromboembolism.

Thrombotic disease is still a major killer. Aspirin, Ticagrelor, Clopidogrel, etc. are the most widely used conventional antiplatelet drugs. The significant number of patients who are resistant to this drug shows a poor outcome. Developing a new antiplatelet agent with a stable antiplatelet effect and minimal bleeding risk is required for a patient who is resistant to antiplatelet drugs. Protein-ligand docking was performed using Autodock Vina 1.1.2 to study the interaction of 67LR with different Polyphenols. Among the 18 polyphenols, thearubigin has the highest binding affinity towards 67LR and gallic acid shows the lowest binding affinity. Among the 18 molecules, the top 10 molecules from the highest to lowest binding affinity range from-10.6 (thearubigin) to -6.5 (Epigallocatechin). Polyphenols may inhibit platelet aggregation through 67 LR and can be an alternative treatment for Thrombotic Disease. Moreover, it will be interesting to know whether polyphenols interfere with the same pathways as aspirin and clopidogrel. Effective polyphenols could help prototype the compound development of novel antiplatelet agents.

An efficient eco-friendly adsorbent material based on waste copper slag-biomass ash geopolymer: dye sorption capacity and sustainable properties.

The primary intent of the research is to comprehensively assess the environmental benefits and cost dynamics associated with the adsorption process of CS-RHA (Copper Slag and Rice Husk Ash) to produce a novel geopolymer adsorbent material for application in wastewater treatment. The geopolymer forms a polyiron sialate network under alkali activation by dissolving fayalite, and aluminium silicate to ferro-ferri silicate hydrate gel. The mechanical strength, leaching characteristics, and microstructure of the geopolymer were determined using XRD and FTIR, and magnetic properties by VSM as well surface properties were derived from BET surface area and zeta potential. Recognizing the critical role of sodium iron silicate hydrate (NFS) in the sorption of methylene blue (MB) dyestuff, batch experiments were carried out using different adsorbents. The results indicated that the dye removal efficiency increased from 60% in control samples (FS) to 98% for the blend (FS1) under different pH values. The data was found to fit with the nonlinear form of Freundlich isotherm and follow pseudo-second-order kinetics. The active adsorption sites were deduced as -O-Fe-O-Si-O-Na and Si-OH groups. The addition of RHA increases the adsorption capacity of the geopolymer in a short time through chemical adsorption. The significant negative surface charge promotes MB adsorption via improved electrostatic attraction. The spent adsorbents were recovered through magnetic separation with a retrieval rate of 80-85% and active sites were rejuvenated by calcination. Consequently, waste copper slag emerges as a promising adsorbent with minimum potential ecological risk and high effective recycling capacity.

Refining antimicrobial photodynamic therapy: effect of charge distribution and central metal ion in fluorinated porphyrins on effective control of planktonic and biofilm bacterial forms

Antibiotic resistance represents a pressing global health challenge, now acknowledged as a critical concern within the framework of One Health. Photodynamic inactivation of microorganisms (PDI) offers an attractive, non-invasive approach known for its flexibility, independence from microbial resistance patterns, broad-spectrum efficacy, and minimal risk of inducing resistance. Various photosensitizers, including porphyrin derivatives have been explored for pathogen eradication. In this context, we present the synthesis, spectroscopic and photophysical characteristics as well as antimicrobial properties of a palladium(II)-porphyrin derivative (PdF2POH), along with its zinc(II)- and free-base counterparts (ZnF2POH and F2POH, respectively). Our findings reveal that the palladium(II)-porphyrin complex can be classified as an excellent generator of reactive oxygen species (ROS), encompassing both singlet oxygen (Φ△ = 0.93) and oxygen-centered radicals. The ability of photosensitizers to generate ROS was assessed using a variety of direct (luminescence measurements) and indirect techniques, including specific fluorescent probes both in solution and in microorganisms during the PDI procedure. We investigated the PDI efficacy of F2POH, ZnF2POH, and PdF2POH against both Gram-negative and Gram-positive bacteria. All tested compounds proved high activity against Gram-positive species, with PdF2POH exhibiting superior efficacy, leading to up to a 6-log reduction in S. aureus viability. Notably, PdF2POH-mediated PDI displayed remarkable effectiveness against S. aureus biofilm, a challenging target due to its complex structure and increased resistance to conventional treatments. Furthermore, our results show that PDI with PdF2POH is more selective for bacterial than for mammalian cells, particularly at lower light doses (up to 5 J/cm2 of blue light illumination). This enhanced efficacy of PdF2POH-mediated PDI as compared to ZnF2POH and F2POH can be attributed to more pronounced ROS generation by palladium derivative via both types of photochemical mechanisms (high yields of singlet oxygen generation as well as oxygen-centered radicals). Additionally, PDI proved effective in eliminating bacteria within S. aureus-infected human keratinocytes, inhibiting infection progression while preserving the viability and integrity of infected HaCaT cells. These findings underscore the potential of metalloporphyrins, particularly the Pd(II)-porphyrin complex, as promising photosensitizers for PDI in various bacterial infections, warranting further investigation in advanced infection models.Graphical abstract

Intravenous Cetirizine Premedication to Mitigate Infusion-Related Reactions

Infusion-related reactions (IRRs) are a recognized concern for chemotherapy, biologic agents, and newer immunotherapies. Antihistamines are frequently recommended to prevent or manage these reactions. For over 60 years, diphenhydramine has been the only H1 antihistamine for intravenous (IV) administration. It has been considered the standard of care as part of premedication regimens to prevent IRRs associated with these therapies despite the lack of a US Food and Drug Administration (FDA)-approved indication and no evidence of efficacy data. Intravenous cetirizine was approved in 2019 for acute urticaria treatment, making it the only second-generation H1 antihistamine that can be administered intravenously. Compared with diphenhydramine, cetirizine has an improved safety profile with less sedation, fewer contraindications, lower incidence of anticholinergic side effects, and minimal risk of adverse events in elderly patients. A head-to-head study demonstrated that IV cetirizine is as effective as IV diphenhydramine in reducing IRRs and may decrease chair time, treatment center visits, and the need for rescue medication. Over the past 3 decades, the FDA has addressed the issue of IRRs by mandating language regarding the requirement or recommendation for premedication in the label of over 50 FDA-approved infusion products. As more therapeutics have premedication required or recommended, IV cetirizine should be considered an antihistamine for preventing and treating IRRs. In this article, we describe a patient whose IRR was successfully managed with IV cetirizine and discuss first- vs. second-generation H1 antihistamines and their use in treating and preventing IRRs.

Evaluation of Communal WWTP Management in Supporting the Smart Environment in Mlati District, Sleman Regency

Communal Wastewater Treatment Plant (WWTP) is a solution used in the management and treatment of domestic waste. Mlati District is an area that has 8 active Communal WWTP units spread across four villages. Management by the local community to the type of technology used in each region certainly has differences. This research aims to determine the benchmark for the effectiveness of developing one of the smart city dimensions, that is the smart environment in Mlati District. This research was conducted using qualitative research methods, with data processing and presentation carried out descriptively. The existing conditions of the Communal WWTP were obtained by field observation, the management of the Communal WWTP was then carried out descriptive analysis based on the observations, indepth interviews and secondary data and then continued with descriptive analysis to find out management in supporting the smart environment in the Mlati District. The results of the study show that the management of the Communal WWTP in Mlati District has been going well with minimal risk of damage and obstacles. Communal WWTP is the main infrastructure in domestic waste processing which brings significant changes to the region and society. The existence of a waste water treatment installation unit is considered to be able to meet the community’s needs for waste handling. Although waste treatment is not discussed significantly in the elements of smart city development, centralized domestic waste management in Mlati District has proven to play a role in supporting the realization of a smart environment in the region.

A novel optimized eco-friendly simple spectrofluorimetric method for the determination of total catechins in green tea extract: Application to commercial tablet.

Green tea extract (GTE) contains antioxidants that are present in green tea. The active constituents of green tea extract are catechins. This study demonstrates a spectrofluorimetric method for measuring GTE's catechin concentration based on its native fluorescence. To design a quick, sensitive, and ecological spectrofluorimetric approach, all features were investigated and adjusted. This method relies on determining the GTE ethanolic solution's native fluorescence at 312 nm after excitation at 227 nm. The calibration graph displayed a linear regression for values between 0.05 and 1.0μg mL-1. The detection and quantification limits of the proposed technique were 0.008 and 0.026 μg mL-1, respectively. Two pure catechins present in GTE, (-)-epicatechin and (-)-epigallocatechin gallate, were examined by the proposed method. The analytical estimation of GTE in the pharmaceutical tablet was achieved effectively using this approach. An adequate degree of agreement was found when the findings were compared to those obtained by the comparative technique. Therefore, the novel strategy may be used in the GTE quality control study with minimal risks to people or the environment. The quantum yields of catechins were estimated. The validated technique was accepted by the International Council of Harmonization criteria.

Environmentally friendly tailor-made oleo-dispersions of electrospun cellulose acetate propionate nanostructures in castor oil for lubricant applications

The aim of this work is to find an alternative lubricating grease formulation that can be produced from renewable and biodegradable sources with minimal risks to human health and the environment. We used a castor oil and electrospun cellulose acetate propionate (CAp) as raw materials. We hypothesized that the acetyl and propionyl groups could provide an adequate chemical compatibility with the castor oil and that the electrospun nanostructures could enable improved physical stability by creating a variety of morphologies allowing the tailoring of the rheological and tribological properties of the resulting greases. The experimental results show that the use of electrospun CAp nanostructures can indeed yield physically stable formulations, even when used at low concentrations (3 ​wt%). The resulting dispersions went through structural transitions due to changes in the thickener morphologies and/or concentration, as shown by oscillatory rheology, oil holding capacity, tackiness, and lubrication performance in metal–metal contact. We found that the formulations, containing smooth or porous CAp nanofibers, at 5 ​wt% as a thickener, possess suitable rheological and tribological properties with a performance comparable to that of traditional lithium lubricating greases.

Sparsity-Constrained Invariant Risk Minimization for Domain Generalization With Application to Machinery Fault Diagnosis Modeling.

Machine learning has been widely applied to study AI-informed machinery fault diagnosis. This work proposes a sparsity-constrained invariant risk minimization (SCIRM) framework, which develops machine-learning models with better generalization capacities for environmental disturbances in machinery fault diagnosis. The SCIRM is built by innovating the optimization formulation of the recently proposed invariant risk minimization (IRM) and its variants through the integration of sparsity constraints. We prove that if a sparsity measure is differentiable, scale invariant, and semistrictly quasi-convex, the SCIRM can be guaranteed to solve the domain generalization problem based on a few predefined problem settings. We mathematically derive a family of such sparsity measures. A practical process of implementing the SCIRM for machinery fault diagnosis tasks is offered. We first verify our theoretical exploration of the SCIRM by using simulation data. We further compare SCIRM with a set of state-of-the-art methods by using real machinery fault data collected under a variety of working conditions. The computational results confirm that the machinery fault diagnosis model developed by the SCIRM offers a higher generalization capacity and performs better than the other benchmarks across the different testing datasets.

Self-Adaptive Training: Bridging Supervised and Self-Supervised Learning.

We propose self-adaptive training-a unified training algorithm that dynamically calibrates and enhances training processes by model predictions without incurring an extra computational cost-to advance both supervised and self-supervised learning of deep neural networks. We analyze the training dynamics of deep networks on training data that are corrupted by, e.g., random noise and adversarial examples. Our analysis shows that model predictions are able to magnify useful underlying information in data and this phenomenon occurs broadly even in the absence of any label information, highlighting that model predictions could substantially benefit the training processes: self-adaptive training improves the generalization of deep networks under noise and enhances the self-supervised representation learning. The analysis also sheds light on understanding deep learning, e.g., a potential explanation of the recently-discovered double-descent phenomenon in empirical risk minimization and the collapsing issue of the state-of-the-art self-supervised learning algorithms. Experiments on the CIFAR, STL, and ImageNet datasets verify the effectiveness of our approach in three applications: classification with label noise, selective classification, and linear evaluation. To facilitate future research, the code has been made publicly available at https://github.com/LayneH/self-adaptive-training.

ERMPD: causal intervention for popularity debiasing in recommendation via empirical risk minimization

ERMPD: causal intervention for popularity debiasing in recommendation via empirical risk minimization

Estimates of global mortality burden associated with short-term exposure to fine particulate matter (PM2·5)

The acute health effects of short-term (hours to days) exposure to fine particulate matter (PM2·5) have been well documented; however, the global mortality burden attributable to this exposure has not been estimated. We aimed to estimate the global, regional, and urban mortality burden associated with short-term exposure to PM2·5 and the spatiotemporal variations in this burden from 2000 to 2019. We combined estimated global daily PM2·5 concentrations, annual population counts, country-level mortality rates, and epidemiologically derived exposure-response functions to estimate the mortality attributable to short-term PM2·5 exposure from 2000 to 2019, in the continental regions and in 13 189 urban centres worldwide at a spatial resolution of 0·1° × 0·1°. We tested the robustness of our mortality estimates with different theoretical minimum risk exposure levels, lag effects, and exposure-response functions. Approximately 1 million (95% CI 690 000-1·3 million) premature deaths per year from 2000 to 2019 were attributable to short-term PM2·5 exposure, representing 2·08% (1·41-2·75) of total global deaths or 17 (11-22) premature deaths per 100 000 population. Annually, 0·23 million (0·15 million-0·30 million) deaths attributable to short-term PM2·5 exposure were in urban areas, constituting 22·74% of the total global deaths attributable to this cause and accounting for 2·30% (1·56-3·05) of total global deaths in urban areas. The sensitivity analyses showed that our worldwide estimates of mortality attributed to short-term PM2·5 exposure were robust. Short-term exposure to PM2·5 contributes a substantial global mortality burden, particularly in Asia and Africa, as well as in global urban areas. Our results highlight the importance of mitigation strategies to reduce short-term exposure to air pollution and its adverse effects on human health. Australian Research Council and the Australian National Health and Medical Research Council.

Asymmetric and time-frequency co-movements among innovation-themed investments and carbon emission efficiency: Thematic investing and hedging opportunities.

This study is aimed at investigating the asymmetric and time-frequency co-movements and the hedge or safe-haven properties of carbon efficient indices, the MSCI ACWI Sustainable Impact, and MSCI World EGS indices, in relation to technology and innovation-themed investments. In doing so, the ADCC-GJR-GARCH and wavelet coherence techniques are applied to a daily return series ranging from January 2019 to January 2023. Findings of the ADCC-GJR-GARCH model show negative and insignificant asymmetric linkage among underlying indices during the sample period. The S&P 500 carbon efficient index (CEI) acts as a strong hedge or safe-haven for technology and innovation-themed indices during tranquil and tumultuous periods. The MSCI ACWI Sustainable Impact, MSCI World EGS, and carbon efficient indices except for S&P 500 CEI exhibit weak hedge or safe-haven attributes. Wavelet coherence reveals negative (positive) co-movements between the thematic and carbon efficient indices in short-term (medium-term and long-term) horizons with consistent leading behavior of thematic indices to carbon efficient indices outcomes. It justifies the presence of short-lived hedging or safe-haven characteristics in the thematic domain for investors. These strong and weak hedge or safe-haven characteristics of low carbon and sustainability indices reveal that adding low carbon efficient and sustainable investments to a portfolio result in considerable diversification benefits for investors who tend to take minimal risk in both tranquil and tumultuous periods. The current findings imply that financial institutions, thematic investing companies, and governments need to encourage carbon efficient technology transfer and innovation-themed investments by increasing the fund allocations in underlying asset classes. Policy-making and regulatory bodies can encourage investors to make carbon-efficient and thematic investments and companies to issue carbon-efficient stocks or investments to safeguard social and economic risks during fragile periods. These investments can offer greater opportunities to combat the intensity of economic shocks on portfolios for responsible or sustainable investors.

Determination of Optimal Stock Portfolio Return by Single Index Model (Case Study on Banking Sector Stocks in Indonesia)

The optimal portfolio is a portfolio chosen by investors from the many options available in the collection of efficient portfolios. To get the optimal proportion, which is the maximum return and minimum risk, it is necessary to analyze the stocks to be selected in the investment model. The research objective is to determine the optimal return, risk, and proportion for each banking stock portfolio in Indonesia in the period February - July 2023. The method used is the Single Index Model. The process of determining the optimal proportion of stocks with the Single Index Model requires stock and market return data as the main basis for applying this method. This study involves the formation of an optimal portfolio of daily closing prices of 46 banking stocks. As a result of this research, there are 5 optimal stocks that meet the criteria for optimal portfolio formation with each fund proportion of 21.43% (BNII), 13.52% (BDMN), 35.02% (BBRI), 23.69% (BTPN), and 6.34% (BBCA). Expected return from optimal stocks is 0.152% and the risk that will be borne by investors is 0.0011% per day.

Application of dental pulp stem cells for bone regeneration.

Bone defects resulting from severe trauma, tumors, inflammation, and other factors are increasingly prevalent. Stem cell-based therapies have emerged as a promising alternative. Dental pulp stem cells (DPSCs), sourced from dental pulp, have garnered significant attention owing to their ready accessibility and minimal collection-associated risks. Ongoing investigations into DPSCs have revealed their potential to undergo osteogenic differentiation and their capacity to secrete a diverse array of ontogenetic components, such as extracellular vesicles and cell lysates. This comprehensive review article aims to provide an in-depth analysis of DPSCs and their secretory components, emphasizing extraction techniques and utilization while elucidating the intricate mechanisms governing bone regeneration. Furthermore, we explore the merits and demerits of cell and cell-free therapeutic modalities, as well as discuss the potential prospects, opportunities, and inherent challenges associated with DPSC therapy and cell-free therapies in the context of bone regeneration.

Nasal Dorsum Rotation-Transposition Flap Associated with Guitar-String Sutures: One-Stage Reconstruction of Large Defects on the Nose.

(1) Background: The preferred reconstructive option for closing small- or medium-sized defects of the distal half of the nose is the use of local flaps. The dorsal nasal (Rieger) flap is suitable for closing medium-sized defects at this location, especially when they are medially located, and are wider rather than tall. We describe a rotation-transposition dorsal nasal flap reconstruction for large nasal defects. The novelty of this design includes the addition of a small transposition lobe to the rotation flap, enabling the acquisition of tissue from either the lateral sidewall or the nasolabial sulcus, facilitating closure with guitar-string sutures. (2) Methods: We conducted a retrospective chart review of all the patients with large defects (>20 mm) of the nose who underwent nasal dorsum rotation-transposition flap repair between January 2019 and November 2022 at a single academic center. (3) Results: Fourteen patients (eight males, six females; ages 47-83, mean age 60 years) with defects (range: 20.00-35.00 mm) on the dorsum and nasal tip were recruited. Follow-up duration ranged from 12 months to 3 years, with all cases showing good or excellent oncologic and cosmetic results. (4) Conclusions: The rotation-transposition dorsal nasal flap was demonstrated to be a reproducible one-stage technique for large defects of the dorsum and nasal tip, with minimal risk of aesthetic or functional complications. Guitar-string sutures allowed the reduction of the defect size, facilitating a smaller flap design.

Leveraging hybrid ANN–AHP to optimize cement industry average inventory levels

In recent years, inventory has been critical due to the production cost and overstock risk related to the expiration date and the fluctuation price risk. This study's minimization of overstock and price fluctuation in the warehouse used a hybridized artificial neural network (ANN) and analytical hierarchy process (AHP) to produce an optimum model. The variables, such as average demand, reorder point, order quantity, factor service level, safety stock, and average inventory level, were used to obtain the optimal condition of the average inventory levels to maximize the profit. Then, the type of inventory system that guarantees the minimum risks in managing the inventory would be selected. The result shows that the data has a mean of 39.2 units, and the standard deviation (SD) was 12.9. This means that the order quantity is 20.2 units, the average inventory level is 57.3, and the average demand is 39. These conditions used the factor z, which is 97% service level. This study concludes that the optimum average inventory level is 91 units, the order quantity is 11 units with the maximum average profit is $1098, and the peak fluctuation condition maximum profit is $1463 when the average inventory level is 7.3, and the inventory policy system used to minimize the risk is the continuous review policy type. The study could be beneficial to reduce production costs and enhance overall profitability and operational efficiency in the sector by mitigating the risks associated with excessive inventory and price volatility while also minimizing the potential for expired inventory.

Reconstruction of Broad Lower Lip Defects Using Karapandzic-Type Flaps.

Reconstruction of lower lip defects is challenging because of the functional and aesthetic demands of the lower face. We review the functional and aesthetic outcomes of the Karapandzic-type flaps for reconstructing lower lip defects. A retrospective review of patients who underwent repair using Karapandzic-type flaps. Fifty patients with lower lip defects ranging from 20% to 95% (mean 59.2% ± 20%) were included. Eighteen patients (36%) were repaired using a bilateral flap, and 32 (64%) were reconstructed using a unilateral flap design. All patients had preservation of oral competency and a satisfactory aesthetic result. No patient complained of microstomia. A complication rate of 8% was noted (n = 4) with postoperative wound infection and small areas of dehiscence. There was no statistically significant difference in complication rates in patients older than 75 years, in patients with a history of head/neck radiation, or in defects greater than 70% of lower lip breadth. Karapandzic-type flaps are versatile and reliable for the reconstruction of a broad range of lower lip defects. This one-stage procedure can produce superior functional and aesthetic results as compared with other local and distant flaps with minimal risk of functional microstomia.