Contact Endoscopy as a Novel Technique in the Detection and Diagnosis of Mucosal Lesions in the Head and Neck: A Brief Review

Background. There are a variety of described noninvasive optical detection techniques for evaluation of head and neck mucosal lesions. Contact endoscopy is a promising method of in vivo microscopic examination whereby a rigid telescope is placed on a previously dye-stained mucosa allowing evaluation of the superficial cell layers of the epithelium. This technique produces real-time, magnified images of cellular architecture of surface mucosa comparable to histology without the need for biopsy. In this review, we will briefly summarize the efficacy of CE in the detection of precancerous and cancerous mucosal lesions and its potential as a novel technique in early diagnosis, monitoring, and preoperative assessment of mucosal lesions of the head and neck. Methods. PUBMED, MEDLINE, and COCHRANE search revealed five prospective articles on contact endoscopy for the diagnosis of mucosal lesions in the head and neck. Results. The literature search yielded five prospective studies examining contact endoscopy for the diagnosis of benign versus malignant head and neck mucosal lesions. These reported a sensitivity and specificity of 77–100%, specificity of 66–100% and an accuracy of 72–92%. Conclusion. Contact endoscopy is a promising optical technology that may be a useful adjunct in the evaluation and diagnosis of benign and malignant head and neck mucosal lesions. Future prospective randomized double-blind studies of this detection method are required

Enhancing order management with ERP systems: A case study in a subcontractor company

The construction industry is constantly evolving and that affects the timeline of order, plus the requirement of clients have become more complicated. The report from the construction district showed that the delay in projects was due to various reasons, mainly because of clients and consultants. This study focuses on order management, as this department directly affects the company performance and client satisfaction. Therefore, it is important to study and improve the order management process. This study intended to understand the order management processes and determine the challenges and the root cause of delay in the order management department. In this case study, a series of interviews have been conducted with a representative of the ABC Engineering Sdn Bhd. A semi-structured interview protocol is used to support the interview. With the consensus of the interviewee, the discussions are recorded for transcript and data analysis purposes. This study identified the processes of order management and found that the project delay is mainly due to poor and ineffective communication between departments in the company when there is a change of client requirement. From the findings of order management processes, challenges, and root causes of the problem, this study proposes Epicor Enterprise Resource Planning (ERP) system to enhance the order management of ABC Engineering Sdn Bhd. The system is proposed because the company has the existing talent in the company for implementation and execution. This study believed that the implementation of the Epicor system with reinforcement in the company could help in minimizing the reoccurring problem of delay

Provably Efficient CVaR RL in Low-rank MDPs

We study risk-sensitive Reinforcement Learning (RL), where we aim to maximize the Conditional Value at Risk (CVaR) with a fixed risk tolerance $\tau$. Prior theoretical work studying risk-sensitive RL focuses on the tabular Markov Decision Processes (MDPs) setting. To extend CVaR RL to settings where state space is large, function approximation must be deployed. We study CVaR RL in low-rank MDPs with nonlinear function approximation. Low-rank MDPs assume the underlying transition kernel admits a low-rank decomposition, but unlike prior linear models, low-rank MDPs do not assume the feature or state-action representation is known. We propose a novel Upper Confidence Bound (UCB) bonus-driven algorithm to carefully balance the interplay between exploration, exploitation, and representation learning in CVaR RL. We prove that our algorithm achieves a sample complexity of $\tilde{O}\left(\frac{H^7 A^2 d^4}{\tau^2 \epsilon^2}\right)$ to yield an $\epsilon$-optimal CVaR, where $H$ is the length of each episode, $A$ is the capacity of action space, and $d$ is the dimension of representations. Computational-wise, we design a novel discretized Least-Squares Value Iteration (LSVI) algorithm for the CVaR objective as the planning oracle and show that we can find the near-optimal policy in a polynomial running time with a Maximum Likelihood Estimation oracle. To our knowledge, this is the first provably efficient CVaR RL algorithm in low-rank MDPs.Comment: The first three authors contribute equally and are ordered randoml

The difference in mediated effect between cyberbullying and cybervictimisation under the influence of problematic social media use

The influence between cyberbullying (CB) and cybervictimisation (CV) is known to be two-way, but the prominence of the two directions remains unclear especially under the influence of another factor. Uncovering the mystery helps policy makers decide how to allocate the limited resource between interventions against children CB and CV. Since social media becomes increasingly relevant to children cyberaggression, this study utilises two independent mediation models to examine how problematic social media use (PSMU) potentially influence CB-induced-CV (Model 1) and CV-induced-CB (Model 2) and the difference in the proportions of mediated effect between models. As a part of Health Behaviour in School-aged Children (HBSC) study, this study included a total of 11178 children (2643 from Hong Kong and 8535 from Netherland). Results showed that the paths in the models did not differ between culture. In Model 1, CB was a significant partial mediator between PSMU and CV, βindirect = .08, p < .001, and CV was a significant partial mediator between PSMU and CB in Model 2, βindirect = .06, p < .001. However, CB mediated 52.78% whilst CV mediated only 28.06% of the total effect from PSMU in respective models. The ratio of mediated effect proportions between models is 1.88:1, indicating that under the influence of PSMU, CB-induced-CV is nearly twice as prominent as CV-induced-CB in a relative sense. Implications on cyberaggression research assumptions are discussed

Public asset management companies in East Asia

https://www.bis.org/fsi/fsipapers03.ht

Effect of Genetic Variants, Especially CYP2C9 and VKORC1, on the Pharmacology of Warfarin

The genes encoding the cytochrome P450 2C9 enzyme (CYP2C9) and vitamin K-epoxide reductase complex unit 1 (VKORC1) are major determinants of anticoagulant response to warfarin. Together with patient demographics and clinical information, they account for approximately one-half of the warfarin dose variance in individuals of European descent. Recent prospective and randomized controlled trial data support pharmacogenetic guidance with their use in warfarin dose initiation and titration. Benefits from pharmacogenetics-guided warfarin dosing have been reported to extend beyond the period of initial dosing, with supportive data indicating benefits to at least 3 months. The genetic effects of VKORC1 and CYP2C9 in African and Asian populations are concordant with those in individuals of European ancestry; however, frequency distribution of allelic variants can vary considerably between major populations. Future randomized controlled trials in multiethnic settings using population-specific dosing algorithms will allow us to further ascertain the generalizability and cost-effectiveness of pharmacogenetics-guided warfarin therapy. Additional genome-wide association studies may help us to improve and refine dosing algorithms and potentially identify novel biological pathways