Neoadjuvant chemo-radiotherapy (CRT) followed by total mesorectal excision (TME) represents the standard treatment for patients with locally advanced (≥ T3 or N+) rectal cancer (LARC). Approximately ...15% of patients with LARC shows a complete response after CRT. The use of pre-treatment MRI as predictive biomarker could help to increase the chance of organ preservation by tailoring the neoadjuvant treatment. We present a novel machine learning model combining pre-treatment MRI-based clinical and radiomic features for the early prediction of treatment response in LARC patients. MRI scans (3.0 T, T2-weighted) of 72 patients with LARC were included. Two readers independently segmented each tumor. Radiomic features were extracted from both the "tumor core" (TC) and the "tumor border" (TB). Partial least square (PLS) regression was used as the multivariate, machine learning, algorithm of choice and leave-one-out nested cross-validation was used to optimize hyperparameters of the PLS. The MRI-Based "clinical-radiomic" machine learning model properly predicted the treatment response (AUC = 0.793, p = 5.6 × 10
). Importantly, the prediction improved when combining MRI-based clinical features and radiomic features, the latter extracted from both TC and TB. Prospective validation studies in randomized clinical trials are warranted to better define the role of radiomics in the development of rectal cancer precision medicine.
Clozapine, a dibenzodiazepine developed in 1961, is a multireceptorial atypical antipsychotic approved for the treatment of resistant schizophrenia. Since its introduction, it has remained the drug ...of choice in treatment-resistant schizophrenia, despite a wide range of adverse effects, as it is a very effective drug in everyday clinical practice. However, clozapine is not considered as a top-of-the-line treatment because it may often be difficult for some patients to tolerate as some adverse effects can be particularly bothersome (i.e. sedation, weight gain, sialorrhea etc.) and it has some other potentially dangerous and life-threatening side effects (i.e. myocarditis, seizures, agranulocytosis or granulocytopenia, gastrointestinal hypomotility etc.). As poor treatment adherence in patients with resistant schizophrenia may increase the risk of a psychotic relapse, which may further lead to impaired social and cognitive functioning, psychiatric hospitalizations and increased treatment costs, clozapine adverse effects are a common reason for discontinuing this medication. Therefore, every effort should be made to monitor and minimize these adverse effects in order to improve their early detection and management. The aim of this paper is to briefly summarize and provide an update on major clozapine adverse effects, especially focusing on those that are severe and potentially life threatening, even if most of the latter are relatively uncommon.
•A total number of 117 interdisciplinary studies relating to fake news are reviewed.•Only seven studies come from the marketing discipline.•Five themes related to fake news are ...identified.•Antecedents and outcomes of fake news are promising themes for marketing research.
There is growing concern amongst policy makers, managers and academic researchers over the role that social media plays in spreading misinformation, widely described as ‘Fake News’. However, research to date has mainly focussed on the implications of fake news for political communication and debate. There has been less focus on the implications of social media misinformation upon marketing and consumers. Given the key role of social media as a communication platform, there is a gap in our understanding of fake news through a consumer lens. We address this gap by conducting an interdisciplinary systematic review of the relevant literature. Through critical evaluation and synthesis of the literature, we identify five themes that explain the fake news phenomenon: the dissemination process, spreading channel features, outcomes, fabricated legitimacy and attitudes. Finally, we propose a theoretical framework that highlights themes’ relationships and research propositions to guide future research in this area.
Current theorizations of bricolage in entrepreneurship studies require refinement and development to be used as a theoretical framework for social entrepreneurship. Our analysis traces bricolage's ...conceptual underpinnings from various disciplines, identifying its key constructs as making do, a refusal to be constrained by limitations, and improvisation. Although these characteristics appear to epitomize the process of creating social enterprises, our research identifies three further constructs associated with social entrepreneurship: social value creation, stakeholder participation, and persuasion. Using data from a qualitative study of eight U.K. social enterprises, we apply the bricolage concept to social entrepreneurial action and propose an extended theoretical framework of social bricolage.
As countries in Europe implement strategies to control the COVID-19 pandemic, different options are chosen regarding schools. Through a stochastic age-structured transmission model calibrated to the ...observed epidemic in Île-de-France in the first wave, we explored scenarios of partial, progressive, or full school reopening. Given the uncertainty on children's role, we found that reopening schools after lockdown may increase COVID-19 cases, yet protocols exist to keep the epidemic controlled. Under a scenario with stable epidemic activity if schools were closed, reopening pre-schools and primary schools would lead to up to 76% 67, 84% occupation of ICU beds if no other school level reopened, or if middle and high schools reopened later. Immediately reopening all school levels may overwhelm the ICU system. Priority should be given to pre- and primary schools allowing younger children to resume learning and development, whereas full attendance in middle and high schools is not recommended for stable or increasing epidemic activity. Large-scale test and trace is required to keep the epidemic under control. Ex-post assessment shows that progressive reopening of schools, limited attendance, and strong adoption of preventive measures contributed to a decreasing epidemic after lifting the first lockdown.
Objective: The bidirectional communication between the user and the prosthesis is an important requirement when developing prosthetic hands. Proprioceptive feedback is fundamental to perceiving ...prosthesis movement without the need for constant visual attention. We propose a novel solution to encode wrist rotation using a vibromotor array and Gaussian interpolation of vibration intensity. The approach generates tactile sensation that smoothly rotates around the forearm congruently with prosthetic wrist rotation. The performance of this scheme was systematically assessed for a range of parameter values (number of motors and Gaussian standard deviation). Methods: Fifteen able-bodied subjects and one individual with congenital limb deficiency used vibrational feedback to control the virtual hand in the target-achievement test. Performance was assessed by end-point error and efficiency as well as subjective impressions. Results: The results showed a preference for smooth feedback and a higher number of motors (8 and 6 versus 4). With 8 and 6 motors, the standard deviation, determining the sensation spread and continuity, could be modulated through a broad range of values (0.1 - 2) without a significant performance loss (error: ∼ 10%; efficiency: ∼ 30%). For low values of standard deviation (0.1-0.5), the number of motors could be reduced to 4 without a significant performance decrease. Conclusion: The study demonstrated that the developed strategy provided meaningful rotation feedback. Moreover, the Gaussian standard deviation can be used as an independent parameter to encode an additional feedback variable. Significance: The proposed method is a flexible and effective approach to providing proprioceptive feedback while adjusting the trade-off between sensation quality and the number of vibromotors.
The COVID-19 pandemic is far more than a health crisis: it has unpredictably changed our whole way of life. As suggested by the analysis of economic data on sales, this dramatic scenario has also ...heavily impacted individuals' spending levels. To better understand these changes, the present study focused on consumer behavior and its psychological antecedents. Previous studies found that crises differently affect people's willingness to buy necessities products (i.e., utilitarian shopping) and non-necessities products (i.e., hedonic shopping). Therefore, in examining whether changes in spending levels were associated with changes in consumer behavior, we adopted a fine-grained approach disentangling between necessities and non-necessities. We administered an online survey to 3833 participants (age range 18-64) during the first peak period of the contagion in Italy. Consumer behavior toward necessities was predicted by anxiety and COVID-related fear, whereas consumer behavior toward non-necessities was predicted by depression. Furthermore, consumer behavior toward necessities and non-necessities was predicted by personality traits, perceived economic stability, and self-justifications for purchasing. The present study extended our understanding of consumer behavior changes during the COVID-19 pandemic. Results could be helpful to develop marketing strategies that consider psychological factors to meet actual consumers' needs and feelings.
Intrinsic motivation refers to people's spontaneous tendencies to be curious and interested, to seek out challenges and to exercise and develop their skills and knowledge, even in the absence of ...operationally separable rewards. Over the past four decades, experimental and field research guided by self-determination theory (SDT; Ryan and Deci, 2017) has found intrinsic motivation to predict enhanced learning, performance, creativity, optimal development and psychological wellness. Only recently, however, have studies begun to examine the neurobiological substrates of intrinsic motivation. In the present article, we trace the history of intrinsic motivation research, compare and contrast intrinsic motivation to closely related topics (flow, curiosity, trait plasticity), link intrinsic motivation to key findings in the comparative affective neurosciences, and review burgeoning neuroscience research on intrinsic motivation. We review converging evidence suggesting that intrinsically motivated exploratory and mastery behaviors are phylogenetically ancient tendencies that are subserved by dopaminergic systems. Studies also suggest that intrinsic motivation is associated with patterns of activity across large-scale neural networks, namely, those that support salience detection, attentional control and self-referential cognition. We suggest novel research directions and offer recommendations for the application of neuroscience methods in the study of intrinsic motivation.
Addressing the challenges created by rapidly aging populations is a topic of intense interest for marketers, policy makers, and researchers. However, relatively little research has been undertaken ...into the ways older consumers are adopting or rejecting new digital technologies. Given the shifting economic power and growing digital adoption rates among older consumers, understanding how they adopt technology and use digital channels is becoming increasingly important to marketers. For marketers and policy makers to fully understand the future shape of a data-driven digital society, research must take more account of its influence across different older generational cohorts. This article focuses on identifying research gaps across key digital marketing areas in relation to older-age consumers’ adoption and use of digital technology. Through a multidisciplinary review of the literature on aging, using the theoretical lens of generational cohorts, the authors identify key research challenges, opportunities, and implications for both marketers and policy makers.
As road transportation energy use and environmental impact are globally rising at an alarming pace, authorities seek in research and technological advancement innovative solutions to increase road ...traffic sustainability. The unclear and partial correlation between road congestion and environmental impact is promoting new research directions in traffic management. This paper aims to review the existing modeling approaches to accurately represent traffic behavior and the associated energy consumption and pollutant emissions. The review then covers the transportation problems and control strategies that address directly environmental performance criteria, especially in urban networks. A discussion on the advantages of the different methods and on the future outlook for the eco-traffic management completes the proposed survey.
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