Single Option Research Articles

Efficacy and Safety of Variable Treatment Options in the Prevention of Hepatic Encephalopathy: A Systematic Review and Network Meta-Analysis.

There are no guidelines for the most effective medication to reduce hepatic encephalopathy (HE) or the associated mortality. The purpose of this study is to determine the most effective possible treatment among the single treatment options or the combined treatment options for decreasing the morbidity and mortality ofHE. We evaluated the outcomes by various parameters such as thequality of life, reduction in ammonia, all causes of mortality, adverse events, reversal of minimal HE, and development of overt HE. We systematically searched PubMed, Cochrane, Web of Science, and Scopus till the 19th of January 2023 for studies that assess various treatment options for HE. Data were extracted from eligible studies and pooled in a frequentist network meta-analysis as standardized mean difference (SMD) and their 95% confidence interval (CI) using the MetaInsight web-based tool. The Cochrane Tool was used to assess the randomized controlled trials' quality (RCT), while the NIH tool was used to assess the quality of the included cohort studies. Utilizing the R software, the network meta-analysis was conducted. In addition to a significant variation in cases of (Lactulose and Rifaximin) compared with Rifaximin (RR= 0.39, 95% CI [0.17; 0.89]), the results demonstrated a significantly lower incidence of overt HE in (Lactulose and Rifaximin) compared with placebo (RR=0.19, 95% CI [0.09; 0.40]). Most arms demonstrated a statistically significant reduction in the incidence of overt HE compared to albumin and placebo. The results alsodemonstrated a significant reduction in ammonia betweenL-ornithine-L-aspartate (LOLA) and probiotics (MD= -19.17, 95% CI [-38.01; -0.32]), as well as a significant difference in the incidence of LOLA compared to placebo (MD= -22.62, 95% CI [-39.16; -6.07]). This network meta-analysis has significant data for managing subclinical HE in people without a history of overt HE. Our analysis showed that (Lactulose and Rifaximin), followed by (Rifaximin and L-carnitine), followed by (Lactulose and Rifaximin with zinc) were the best combinations regarding overt HE. LOLA reduced ammonia best, followed by Nitazoxanide and finally Lactulose. (Lactulose and Nitazoxanide) have the least adverse effects, followed by (Rifaximin and L-carnitine), then Probiotics. Yet, all mortality outcomes and quality of life changes yielded no useful findings. Future studies like RCTs must be done to compare our therapies directly.

Current Mouse Models of Intracranial Aneurysms: Analysis of Pharmacological Agents Used to Induce Aneurysms and Their Impact on Translational Research.

Intracranial aneurysms (IAs) are rare vascular lesions that are more frequently found in women. The pathophysiology behind the formation and growth of IAs is complex. Hence, to date, no single pharmacological option exists to treat them. Animal models, especially mouse models, represent a valuable tool to explore such complex scientific questions. Genetic modification in a mouse model of IAs, including deletion or overexpression of a particular gene, provides an excellent means for examining basic mechanisms behind disease pathophysiology and developing novel pharmacological approaches. All existing animal models need some pharmacological treatments, surgical interventions, or both to develop IAs, which is different from the spontaneous and natural development of aneurysms under the influence of the classical risk factors. The benefit of such animal models is the development of IAs in a limited time. However, clinical translation of the results is often challenging because of the artificialcourse of IA development and growth. Here, we summarize the continuous improvement in mouse models of IAs. Moreover, we discuss the pros and cons of existing mouse models of IAs and highlight the main translational roadblocks and how to improve them to increase the success of translational IA research.

Operative technique: Pectoralis major flap with rib.

The osteomyocutaneous pectoralis major flap was first described in 1980 and provides a single stage reconstructive option for poor free flap or pectoralis major flap with reconstruction plate candidates requiring bony reconstruction. The flap provides good functional and cosmetic outcomes in appropriately selected patients. We describe the indications and operative techinique for harvesting this flap in written and video format.

Expression and Clinicopathological Significance of Extracellular Matrix Remodeling Markers in Esophageal Squamous Carcinoma.

Esophageal squamous cell carcinoma (ESCC) is a common malignancy of the gastrointestinal tract with a single therapeutic option and a lack of effective clinical therapeutic biomarkers. Extracellular matrix (ECM) remodeling plays a pro-carcinogenic role in a variety of malignancies, but its role in esophageal squamous carcinoma remains to be elucidated. In this study, we examined the expression levels of ECM remodeling markers in 71 pairs of esophageal squamous carcinoma tissues and normal tissues adjacent to the carcinoma using immunohistochemical staining, and analyzed their relationship with clinicopathological features and prognosis. The results suggested that extracellular matrix remodeling markers (integrin αV, fibronectin, MMP9) were abnormally highly expressed in esophageal squamous carcinoma tissues. There was a statistically significant difference between the positive expression of ECM remodeling and the TNM stage of esophageal squamous carcinoma, and there was no statistically significant correlation with age, gender and carcinoembryonic antigen expression, differentiation degree, T stage, and lymph node metastasis. Overall survival rate and overall survival time were significantly lower in patients with positive ECM remodeling expression, which was an independent risk factor for poor prognosisof esophageal squamous carcinoma.

Research on the option pricing of Amazon and Google based on B-S model and Monte Carlo simulation

The emergence of financial derivatives has helped people to effectively hedge the risks present in the financial markets while giving them the ability to make leveraged investments in the financial markets. Although derivatives did not originate in the financial market, it still has a huge role in the financial market so far. In recent years, science and technology innovation is known as a growing concern for governments due to factors such as environmental issues. In this paper, we choose to study the financial derivative, European call option pricing problem of technology-based companies AMZN and GOOGL. In this paper, the European call options of these two companies are priced by using the BSM model, and the results predicted by the BSM model are improved by using Monte Carlo Simulation. Ultimately, the paper finds that Monte Carlo Simulation prices European call options on technology-based firms nearly three times higher than those priced by the BSM model. The results suggest that using a single model to price European call options on technology-based firms is inaccurate. The purpose of this paper is to help investors in pricing European call options on technology-based firms and to warn investors about the inaccuracy of a single option pricing model.

Predictors of information needs among women with breast cancer receiving adjuvant therapy at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia: a cross-sectional study

BackgroundWomen undergoing adjuvant therapy for breast cancer have diverse information needs that remain unfulfilled. Extensive research has shown that access to relevant information about their condition can significantly enhance the quality of life for these women, making it an essential part of cancer care. However, various clinical and socioeconomic factors influence the information needs of these women. Hence, the primary aim of this study is to identify predictors of the information needs of women undergoing adjuvant therapy for breast cancer. In addition, this study will also describe the preferred sources of information and the optimal timing for its acquisition.MethodsA facility-based cross-sectional study was undertaken at Tikur Anbessa Specialty Hospital, enlisting a cohort comprising 121 women undergoing adjuvant therapy for breast cancer. Trained interviewers administered an Amharic-translated Toronto information needs questionnaire specifically designed for breast cancer to assess the information needs of the study participants Statistical analysis was executed using the sophisticated software SPSS (version 25). Descriptive statistics were employed to summarize the variables of the study. A linear regression analyses was then carried out to identify notable predictors that significantly influenced the information needs of the women.ResultsThe total mean score for overall information needs in the current study was 194.30 (± 28.01), with a range scale of 142–260 and a standardized mean score of 3.74 (± 0.54). The disease and treatment domains had the highest information needs, with standardized mean scores (standard deviation) of 4.00 (± 0.54) and 3.77 (± 0.59), respectively. 95% of the participants sought information from healthcare professionals, and 67.7% of the women needed the information before beginning the treatments. Predictors of information needs were following a single treatment option (β = 12.68; 95% CI (0.68, 24.68); P = 0.039) and joining higher education and above (β = 17.1; 95% CI (1.47, 34.14); P = 0.033).ConclusionThe women exhibited a substantial demand for information. Healthcare professionals need to consider the women’s educational background and treatment status while delivering the needed information.

Real-world practices of hormone monitoring during ovarian stimulation in assisted reproductive technology: a global online survey.

The aim of this study is to understand the global practice of routine hormonal monitoring (HM) during ovarian stimulation (OS) in the context of assisted reproductive technique (ART) treatment. An open-access questionnaire was available to 3,845 members of IVF-Worldwide.com from September 8 to October 13, 2021. The survey comprised 25 multiple-choice questions on when and how ultrasound (US) and hormone tests were conducted during ovarian stimulation OS. For most questions, respondents were required to select a single option. Some questions allowed the selection of multiple options. In all, 528 (13.7%) members from 88 countries responded to the questionnaire. Most respondents (98.9%) reported using US to monitor OS cycles. HM was used by 79.5% of respondents during any of the cycle monitoring visits and was most commonly performed on the day of, or a day prior to final oocyte maturation. Overall, 87% of respondents claimed adjusting the dose of gonadotropin during OS, with 61.7% adjusting the dose based on hormonal levels. Oestradiol (E2) was the most frequently monitored hormone during all visits and was used by 74% of respondents for the prediction of ovarian hyperstimulation syndrome (OHSS). On or a day prior to ovulation triggering (OT), the number of respondents who measured progesterone increased from 34.3% in the second/third visit to 67.7%. Approximately one-third of respondents measured luteinizing hormone during all visits. Globally, most ART specialists (~80%) use HM, along with US, for monitoring OS, especially for the prevention of OHSS.

Strategic investment under uncertainty: why multi-option firms lose the preemption run

We consider a dynamic duopoly game where firms choose both the timing and size of their investments. The existing real options literature predominantly consists of contributions where firms have a single option to invest. This paper relaxes this assumption by giving Firm A multiple options to undertake further investments with the purpose to expand whereas Firm B only holds the option to enter the market. In this asymmetric setting we get the surprising result that, in equilibrium, Firm B invests first. If Firm A invests first, Firm A and Firm B keep on being involved in preemption games for subsequent investments until Firm B enters the market, which leads to inefficiently early investments of Firm A. When Firm B invests first, then only one preemption game is played, which leads to Firm A being free to choose its unrestricted optimal investment moments.

Optimization of design parameter of V-shaped perforated blocks in rectangular duct of solar air heater by using hybrid BWM-CODAS technique

This study investigates the influence of different functional parameters of V-SP blocks on flow characteristics and heat enhancement in a rectangular duct via experimental analysis. The main focus of this work is on designing SAH using a novel multi-criteria decision-making (MCDM) method. The influence of the different geometrical parameter's e/H = 0.4–1.0, β = 5%–25 %, P/e = 4–12 on the f, Nu and η was investigated and optimized. The combination of Re = 16000, β = 0.2, P/e = 8, e/H = 0.8yielded the most significant Nu (303.70). In contrast, the combination of Re = 16000, e/H = 0.6, P/e = 12, β = 0.15 yield the lowest f (0.083). The maximum η of 2.74 was obtained using Re = 4000, β = 0.2, P/e = 8, e/H = 0.8. Choosing the most suitable SAH design alternative is a challenging task as no single option can fulfil all the attain performance criteria. To address this, a hybrid MCDM approach, namely hybrid BWM-CODAS architecture, was utilized. The design alternative A-20, having geometric and flow arrangement as Re = 16,000, β = 0.2, P/e = 8 and e/H = 0.8 gives the overall performance in addition to another examined alternative. Additionally, the implicit of the proposed decision-making framework was validated with other MCDM approaches, indicating the results' robustness.

Cost-minimisation analysis of chronic lymphocytic leukemia in Spain in the era of oral targeted therapies

ObjectiveChronic lymphocytic leukaemia places a considerable economic burden on the Spanish National Health System. This study estimated the direct costs of chronic lymphocytic leukaemia oral targeted therapies from 2011 to 2025, inclusive, in a scenario with fixed treatment oral targeted therapies and in a scenario without them. MethodThe clinical course of adult chronic lymphocytic leukaemia patients was represented by a Markov model with four health states: watchful waiting, first-line treatment, relapse, and death. The treatment pattern was defined according to patient type by disease status or situation, age, presence or absence of deletion in the short arm of chromosome 17, immunoglobulin heavy chain mutation status, and year of treatment. The treatment algorithm was simulated from 2011 to 2025, and included therapies funded by the Spanish National Health System and their use in routine clinical practice, validated by leading experts. A single treatment option was assumed for each type of patient and time period (the most widely option used at each time point). Direct costs were included: pharmacological, administration, tests performed, routine visits, hospitalizations, and adverse events. ResultsFrom 2011 to 2025, there would be a mean annual chronic lymphocytic leukaemia prevalence of 16,436 patients in the scenario without fixed treatment oral targeted therapies and 16,413 in the scenario with fixed treatment oral targeted therapies. In the same period, the total costs in the scenario without fixed treatment oral targeted therapies would be €4,676.7 million and in the scenario with fixed treatment oral targeted therapies they would be €4,111.8 million. Thus, the introduction of fixed treatment oral targeted therapies would entail a saving of €564.9 million (12.1% of the total cost of care of chronic lymphocytic leukaemia patients during the period assessed). In this period, the total cost per patient would decrease from €266,019 in the scenario without fixed treatment oral targeted therapies to €236,852 in the scenario with fixed treatment oral targeted therapies, representing a saving of €29,167 per patient. ConclusionsThis study estimates that, between 2011 and 2025, the introduction of fixed treatment oral targeted therapies for the treatment of chronic lymphocytic leukaemia would entail €564.9 million cost savings for the Spanish National Health System (12.1% of the total cost of care of chronic lymphocytic leukaemia patients during the period assessed).

A SOCIOLOGICAL SURVEY BASED ON QUESTIONNAIRE REGARDINGTHE INDIVIDUALIZED TRAINING OF THE OPPOSITE PLAYER IN PERFORMANCE VOLLEYBALL

Aim. The hereby research aims to develop and apply a questionnaire to a number of 20 male A1 division coaches and 20 female A1division coaches in order to find out their opinion on the specific physical training of volleyball players, and in particular, those acting as the opposite (universal), the scientific means used in their preparation, particularly targeting the scientific investigation methods applied. The work also intends to highlight differences when approaching some specific physical training of players in the two divisions.Method. The applied questionnaire contains 10 items, with a single answer option, the purpose being that of rendering objective data on the current working methodology in the volleyball game in terms of the specific physical training component, especially of the specific physical training of the players playing as opposite (universal).The questionnaire survey involved identifying the place and role of muscle training in senior physical training.We mention that within the questionnaire we used the best phrases that emerged from the discussions (conversations) held in advance with decision makers, coaches, managers, specialists in the field of physical education and sport (volleyball).Results. 67% of the answers look at the level of training of the volleyball players from the national team as being high, the rest think that the training of the athletes members of the national team is good or average.Conclusions. Most coaches consider it important to train individual volleyball players at senior level.

The Role of Injectables in the Treatment and Prevention of Cancer-Associated Thrombosis.

Cancer-associated thrombosis (CAT) is a leading cause of death among patients with cancer. CAT can manifest itself as venous thromboembolism (VTE), in the form of deep vein thrombosis or pulmonary embolism, or arterial thromboembolism. The pathophysiology of CAT is complex and depends on cancer-, patient-, treatment- and biomarkers-related factors. Treatment of VTE in patients with cancer is complex and includes three major classes of anticoagulant agents: heparin and its derivatives, e.g., low molecular weight heparins, direct oral anticoagulants (DOACs), and vitamin K inhibitors. Given the tremendous heterogeneity of clinical situations in patients with cancer and the challenges of CAT, there is no single universal treatment option for patients suffering from or at risk of CAT. Initial studies suggested that patients seemed to prefer an anticoagulant that would not interfere with their cancer treatment, suggesting the primacy of cancer over VTE, and favoring efficacy and safety over convenience of route of administration. Recent studies show that when the efficacy and safety aspects are similar, patients prefer the oral route of administration. Despite this, injectables are a valid option for many patients with cancer.

The sternoclavicular joint: a review of anatomy, injury and management

The sternoclavicular joint is the only true joint connecting the upper limb with the axial skeleton and is reliant on its capsular and ligamentous attachments for stability. Injuries to the sternoclavicular joint are uncommon and include sprains, dislocations, and fractures. Dislocations and medial clavicle fractures are often associated with high-energy trauma and can lead to life-threatening complications secondary to mediastinal injuries, particularly with posterior sternoclavicular joint dislocations. Given the rarity of these injuries, there are multiple case reports and retrospective studies detailing novel surgical techniques for managing injuries of the sternoclavicular joint and no single option has been implemented. We conducted a literature search on Medline, EMBASE and CINAHL to identify relevant articles focusing on sternoclavicular joint dislocation and subluxation, and medial clavicle fractures in adults. This review article aims to describe: the anatomy of the sternoclavicular joint; injuries including dislocation and medial clavicle fractures; and current investigation and management options including closed and open reduction techniques.

Barriers to childhood asthma care in sub-Saharan Africa: a multicountry qualitative study with children and their caregivers

ObjectivesThis study identifies barriers and provides recommendations to improve asthma care in children across sub-Saharan Africa, where qualitative data is lacking despite high rates.DesignOne of the aims of our National...

An Alternative Multiple Contracts Version of the SACRE

Taking into consideration that the SACRE (system of increasing amortization in real terms), as originally instituted by Caixa Econômica Federal, is not financially consistent, an exact procedure, denoted as SACRE*, was proposed in de Faro and Lachtermacher (2022). An alternative version (SACRE-F) of this system was proposed by Forger (2010). The present paper submits a multiple contract version of SACRE-F. It is shown that, taking into due account the financial institution cost of capital, it is always better to implement the multiple contracts approach instead of the single contract option. An comparison between the both alternatives are detailed.

Valuing photovoltaic power plants by compound real options

Meeting electricity demand with renewable generation requires spending trillions of dollars in investments exposed to financial risk. Renewable projects have multiple strategic real options to manage investment risk, but they are usually priced separately in isolation. This paper proposes a framework for valuing multistage decisions in a grid-scale photovoltaic (PV) power plant under uncertainty. The project is modelled as a compound portfolio of American sequential and mutually exclusive options to defer, expand and relocate. The compound options are jointly priced by a hierarchically nested least-squares Monte Carlo algorithm. The framework incorporates uncertainties related to decreasing costs in solar technology and the emergence of more profitable renewable tariffs elsewhere. The results show that the value of the compound option portfolio significantly exceeds the value of the single deferral option commonly considered in practice. Ignoring expansion and relocation flexibilities may lead to underinvestment by mispricing the value of PV projects. Incorporating these options encourages early commitment of the PV investment. Moreover, summation of individual option prices may not be a good approximation of the true portfolio value, as interactions among options exist. These findings may improve allocation efficiency of renewable investments, accelerate energy transition and benefit investors, funding agencies and regulators.

O-252 Genetic characterization of human sperm centrosome defects in infertile couples with complex embryo aneuploidy

Abstract Study question Can we characterize the genetic aspects related to sperm centrosome dysfunction in couples with high embryo aneuploidy that cannot exclusively be attributed to the oocyte? Summary answer We characterized structural and genomic abnormalities responsible for sperm centrosome dysfunction in infertile couples with complex embryo aneuploidy not exclusively related to the female partner. What is known already Conventional semen analysis provides only limited information on the proper function and embryo developmental competence of the male gamete. Therefore, an ancillary test, such as sperm chromatin fragmentation (SCF) and particularly double-stranded DNA breaks, has been claimed responsible for structural chromosomal abnormalities. It remains puzzling the source of complex embryo aneuploidy and chaotic chromosomal mosaicism that cannot solely be attributed to the female partner. The availability of genomic analysis may shed light on the integrity and function of the sperm centrosome responsible for ordaining chromosomal distribution at the first mitotic division. Study design, size, duration In the past 4 years, we identified 13 couples with unexpected high poor embryo cleavage resulting in a higher number of embryos with complex aneuploidy not solely attributable to the female gamete, resulting in extremely poor embryo implantation. Therefore, ancillary testing on the spermatozoa of the male partners was carried out to determine if the couple’s reproductive failure was eventually due to a stealth male gamete deficiency. Participants/materials, setting, methods Thirteen couples with poor clinical outcomes, characterized by poor embryo cleavage, high and complex embryo aneuploidy not exclusively due to the oocyte, with poor embryo implantation in multiple IVF/ICSI cycles, were offered adjuvant male partner testing including centrosome assessment through immunofluorescence staining on centrin (normal ≥ 60%), sperm chromatin fragmentation testing through terminal deoxynucleotide dUTP transferase nick-end labeling (TUNEL, normal ≤ 15%), transmission electron microscopy (TEM), and whole exome sequencing (WES) on spermatozoal DNA. Main results and the role of chance In 13 couples with an average paternal age of 38.1±2 years, semen analysis revealed a volume of 22.2±1.4mL, concentration of 58.2±37x10^6/mL, motility of 35.2±18% and normal morphology of 2.6±1%. They underwent with female partners (maternal age of 37.2±2 years) a total of 16 ICSI cycles with aneuploidy testing. Only 11 cycles yielded embryos for transfer due to poor embryo development with high aneuploidy rate, and none of them achieved a pregnancy. Centrosome staining revealed that only 45.8±22% of the spermatozoa displayed this key organelle. An overall SCF was observed at 16.7±10%. TEM confirmed that approximately 70% of the spermatozoa had irregular proximal centrioles. Moreover, genomic analysis by WES revealed mutations on PLK4 gene responsible for centriole duplication, BRSK1 gene involved in centrosome duplication, TUBGCP6 gene responsible for centrosomal microtubule nucleation, MARK4 for centrosome localization, MAP1S for microtubule anchoring and DNA binding, RIC8A for chromosome distribution, and CALM3 for cytokinesis. Of this cohort, 3 couples that subsequently underwent 3 ICSI cycles had their spermatozoa processed by microfluidics, aiming at selecting male gametes with higher genomic integrity. A fertilization rate of 78.3% (18/23) was achieved generating euploid embryos that resulted in 3 successful pregnancies. Limitations, reasons for caution We identified sperm centrosome dysfunction responsible for the peculiar and recurrent embryo aneuploidy. Although we identified shared gene mutations in those couples, these data are still preliminary. With exception of improving spermatozoa selection, there is a lack of a single effective treatment option to address sperm centrosome abnormality. Wider implications of the findings Ancillary tests with semen analysis were able to assess the function and competence of the male gamete. Corroborative genomic study can help provide insights into the reason for poor embryo implantation particularly those with high complex aneuploidy. Trial registration number Not applicable

Salmonella Combination Vaccines: Moving Beyond Typhoid.

There is now a robust pipeline of licensed and World Health Organization (WHO)-prequalified typhoid conjugate vaccines with a steady progression of national introductions. However, typhoid fever is responsible for less than half the total global burden of Salmonella disease, and even less among children aged <5 years. Invasive nontyphoidal Salmonella disease is the dominant clinical presentation of Salmonella in Africa, and over a quarter of enteric fever in Asia is due to paratyphoid A. In this article, we explore the case for combination Salmonella vaccines, review the current pipeline of these vaccines, and discuss key considerations for their development, including geographies of use, age of administration, and pathways to licensure. While a trivalent typhoid/nontyphoidal Salmonella vaccine is attractive for Africa, and a bivalent enteric fever vaccine for Asia, a quadrivalent vaccine covering the 4 main disease-causing serovars of Salmonella enterica would provide a single vaccine option for global Salmonella coverage.

DISHONESTY IN ONLINE LEARNING: DISTANCE LEARNING PERSPECTIVES DURING PANDEMIC

Academic dishonesty has become a serious concern, particularly during the Covid-19 pandemic era, where online learning is left as a single option in almost all academic activities. Lack of graduate ethics has an impact on attitudes in the workplace. Therefore, it is important to introduce academic integrity to students in higher education to foster an attitude of honesty in the world of work, especially ethics. Online lectures encourage students to violate academic integrity due to the lack of direct interaction and administration. This study aims to see the level of academic dishonesty that occurs during online lectures. The research was conducted by the Faculty of Economics and Business, public and private universities. The number of samples is 431 students of economics and business. We examine the effect of lecture administration, lecturerstudent interaction, and learning satisfaction on the impact of academic dishonesty. The results showed that clear administration and good interaction between lecturers and students would increase student learning satisfaction and reduce academic dishonesty. But the satisfaction that students want to achieve does not have a significant effect on the level of academic dishonesty. Implications for practice are discussed and future research directions are offered.

Chemotherapy-Induced Peripheral Neuropathy

Abstract: Chemotherapy-induced peripheral neuropathy is a frequent and dose-limiting complication of chemotherapeutic drugs such as platinum-based compounds, taxanes, vinca alkaloids, bortezomib, and thalidomide that damages peripheral nerves and has a severe influence on patients' well-being and sickness outcomes. Manifestations of CIPN include numbness, tingling, neuropathic pain, cramping, and trouble handling small objects and walking. Recent research in the CIPN pathogenesis has revealed new strategies and pathways for developing novel therapies that can be scrutinized clinically to improve the management of this devastating toxicity. Unfortunately, no single agent is completely protective against this adverse effect, and because no single treatment option works for everyone, duloxetine is the only treatment option that can be recommended. After a thorough review, alternative therapeutic options such as antidepressants, gabapentin, pregabalin, tricyclic and topical gels containing baclofen and ketamine can be considered. In addition, Vitamins, Omega-3 fatty acids, Calcium, Magnesium, Cannabinoids, Melittin, and other natural products, as well as non-drug methods such as exercise, may be used to reduce the adverse effects of CIPN treatment medications. This review focuses on the new strategies for the prophylactic and therapeutic approaches of CIPN, including pharmacological and non-pharmacological methods. Keywords: Chemotherapy-induced peripheral neuropathy, Mechanism of CIPN, Prophylactic and Therapeutic approaches of CIPN.