bluuebunny/crossref_metadata_2025 huggingface dataset:
Infantile fibrosarcoma–like tumor driven by novel RBPMS-MET fusion consolidated with cabozantinib
Authors: Gupta Ajay , Belsky Jennifer A. , Schieffer Kathleen M. , Leraas Kristen , Varga Elizabeth , McGrath Sean D. , Koo Selene C. , Magrini Vincent , Wilson Richard K. , White Peter , Mardis Elaine R. , Jatana Kris R. , Cottrell Catherine E. , Setty Bhuvana A.
Published: October 2020

Infantile fibrosarcoma (IFS) is nearly universally driven by gene fusions involving the NTRK family. ETV6-NTRK3 fusions account for ∼85% of alterations; the remainder are attributed to NTRK-variant fusions. Rarely, other genomic aberrations have been described in association with tumors identified as IFS or IFS-like. We describe the utility of genomic characterization of an IFS-like tumor. We also describe the successful treatment combination of VAC (vincristine, actinomycin, cyclophosphamide) with tyrosine kinase inhibitor (TKI) maintenance in this entity. This patient presented at birth with a right facial mass, enlarging at 1 mo to 4.9 × 4.5 × 6.3 cm. Biopsy demonstrated hypercellular fascicles of spindle cells with patchy positivity for smooth muscle actin (SMA) and negativity for S100, desmin, myogenin, and MyoD1. Targeted RNA sequencing identified a novel RBPMS-MET fusion with confirmed absence of ETV6-NTRK3, and the patient was diagnosed with an IFS-like tumor. A positron emission tomography (PET) scan was negative for metastatic disease. VAC was given for a duration of 10 mo. Resection at 13 mo of age demonstrated positive margins. Cabozantinib, a MET-targeting TKI, was initiated. The patient tolerated cabozantinib well and has no evidence of disease at 24 mo of age. We describe a novel RBPMS-MET driver fusion in association with a locally aggressive IFS-like tumor. MET functions as an oncogene and, when associated with the RNA binding protein RBPMS, forms an in-frame fusion product that retains the MET kinase domain. This fusion is associated with aberrant cell signaling pathway expression and subsequent malignancy. We describe treatment with cabozantinib in a patient with an IFS-like neoplasm.
Dynamics of genomic and immune responses during primary immunotherapy resistance in mismatch repair–deficient tumors
Authors: Takahashi Nobuyuki , Rajapakse Vinodh N. , Pongor Lorinc , Kumar Suresh , Tlemsani Camille , Erwin-Cohen Rebecca , Young Howard A. , Hewitt Stephen , Wei Jun S. , Khan Javed , Villarino Alejandro V. , Trepel Jane B. , Thomas Anish
Published: October 2020

Mismatch repair–deficient (dMMR) cancers generate a substantial number of immunogenic neoantigens, rendering them sensitive to immunotherapy. Yet, there is considerable variability in responses, and roughly one-half of dMMR cancers are refractory to immunotherapy. Here we study a patient with dMMR lung cancer refractory to immunotherapy. The tumor exhibited typical dMMR molecular features, including exceptionally high frameshift insertions and deletions (indels). Despite the treatment inducing abundant intratumoral T-cell infiltrates, it failed to elicit tumor regression, pointing to the T cells lacking cytotoxic activity. A post-treatment tumor demonstrated compound heterozygous frameshift deletions located upstream of the kinase domain in the gene encoding JAK1 protein, down-regulation of JAK1 and mediators of its signal transduction, and total loss of JAK1 phosphorylation. Importantly, one of the JAK1 mutations, despite not being detected in the pretreatment tumor, was found at low variant allele frequency in the pretreatment circulating tumor DNA, suggesting clonal selection of the mutation. To our knowledge, this report provides the most detailed look yet at defective JAK1 signaling in the context of dMMR and immunotherapy resistance. Together with observations of JAK1 frameshift indels being enriched in dMMR compared with MMR-proficient tumors, our findings demonstrate the critical function of JAK1 in immunological surveillance of dMMR cancer.
Attitude vs involvement: a systematic literature review at the intersection between engagement and innovation
Authors: Trabucchi Daniel , Bellis Paola , Di Marco Diletta , Buganza Tommaso , Verganti Roberto
Published: October 2020

Purpose

In a world where innovation became a “buzzword” and everyone within companies is required to foster innovation, the engagement of people toward innovation is fundamental to prompt individual motivation and actions to make innovation happen. However, despite the relevance of the relationship between engagement and innovation, the literature on the topic appears still fragmented. The purpose of this study is to provide an overview of the topic through a systematic literature review.

Design/methodology/approach

A final sample of 108 papers has been selected and analyzed through co-citation and text mining analyses. The former enabled the analysis of the structure of the theoretical foundation of the filed, while the latter facilitated a systematic and unbiased content-driven review of the literature.

Findings

The results of the analysis indicated two main areas of interest describing the relationship between engagement and innovation. On the one hand, there is the focus on “engagement as an attitude,” intended as the capacity of individuals to generate and realize innovation. On the other hand, there is a stream of literature focused on “engagement as involvement,” which refers to co-innovation paradigms, involving both internal and external stakeholders.

Research limitations/implications

From an academic perspective, this paper highlights the relevance of the “human-side” of innovation, proposing avenues for future research that dig into the relationship between people's engagement and innovation dynamics. Moreover, it shows how the recent developments in the innovation management literature are coherent with this emerging relevance of the human perspective in innovation.

Practical implications

From a practitioner’s perspective, this paper helps managers by highlighting the two different approaches that they can have in terms of engagement. The study aims to help them in identifying the kind of engagement they are looking for in their employees and other innovation stakeholder having the support to find relevant studies in that direction.

Originality/value

The study unveils how the evolution of both areas over the years is strictly related to the megatrends of innovation fields, which are the main areas of knowledge not covered yet. Therefore, a research agenda is proposed.
Political uncertainty and the choice of external audit: international evidence from private firms
Authors: Farooq Omar , Satt Harit , El Fadel Basma
Published: October 2020

Purpose

This paper documents the impact of political uncertainty on the decision of private firms to use external auditors to verify their financial statements.

Design/methodology/approach

The authors use the data from 141 countries and the pooled logistic regression to test our arguments. The data is provided by the World Bank's Enterprise Surveys and is collected during the period between 2006 and 2019.

Findings

The results show that firms with high exposure to political uncertainty are more likely to use external auditors to verify their financial statements. The results are robust across various sub-samples and hold when we use alternate proxy for political uncertainty. The results are also robust after controlling for potential endogeneity concerns. The authors also find that the effect of political uncertainty on the choice of external audit is more pronounced for firms that are headquartered in countries with weak institutional environment. The authors document significant role of democracy, rule of law and accountability in determining the relationship between political uncertainty and the choice of external audit.

Originality/value

The authors believe that theirs is one of the initial attempts (if not the first) to investigate the effect of political uncertainty on the choice of external audit among the private firms in developing countries.
Failure analysis and countermeasures of the SCM435 high-tension bolt of three-step injection mold
Authors: Nam Ki-Woo , Yun Seo-Hyun
Published: October 2020

Purpose

The objective of this study was to perform damage analysis of SCM435 high-tension bolts connecting upper and lower parts of a three-stage injection molding machine.

Design/methodology/approach

Damage material used in this study was a SCM435 high-strength bolt connecting upper and lower molds of a three-stage injection mold. Causes of damage were determined by macroscopic observation. Microstructure observation was done using a metallic microscope, scanning electron microscope (SEM, S-2400, HiTachi, Japan), energy dispersive X-ray spectroscopy (EDS, Kevex Ltd., Sigma) and Vickers hardness tester (HV-114, Mitutoyo). Fatigue limit of the damaged material was evaluated using equivalent crack length.

Findings

Bolts were fractured by cyclic bending stress in the observation of ratchet marks and beach marks. The damaged specimen showed an acicular microstructure. Impurity was observed. Chromium carbide was observed near the crack origin. Both shape parameters of the Vickers hardness were similar. However, the scale parameter of the damaged specimen was about smaller than that of the as-received specimen. Much degradation occurred in the damaged specimen. Bolts should undergo accurate heat treatment to prevent the formation of chromium carbide. They must prevent the action of dynamic stresses. Bolts need accurate tightening and accuracy of heat treatment. Screws require compression residual stress due to peening.

Originality/value

This study conducted failure analysis of damaged SCM435 bolts connecting upper and lower parts of the three-stage injection mold. Fatigue limit of the damaged material was evaluated using equivalent crack length. In order to control this fracture, accurate tightening of bolts, accuracy of heat treatment and screws are required for compression residual stress due to peening.
Determinants of Vietnam's rice and coffee exports: using stochastic frontier gravity model
Authors: Nguyen Dao Dinh
Published: October 2020

Purpose

The paper aims to estimate the factors affecting Vietnam's export in rice and coffee, the two most important agricultural products, especially in exploring the role of “behind-the-border” constraints.

Design/methodology/approach

The paper applies the stochastic frontier gravity model, which models the aggregate effect of “behind-the-border” factors for Vietnam's export in rice and coffee.

Findings

The paper finds that the impact of “behind-the-border” constraints is statistically significant, suggesting that Vietnam's exports in rice and coffee may be prevented from reaching their export potential by such factors. Moreover, technical efficiency and potential export suggest that Vietnam has a lot of potential to increase its exports in rice and coffee with its major trading partners. The Association of Southeast Asian Nations group continues to be the major market of Vietnamese rice and coffee. Vietnam can also take advantage of the opportunity to export these commodities to the European Union (EU) (not including the UK), and Comprehensive and Progressive Agreement for Trans-Pacific Partnership, especially in coffee to the EU.

Research limitations/implications

The study cannot identify specific “behind-the-border” factors due to the limitation of data availability.

Originality/value

Many existing studies suggest that export in agricultural products of Vietnam, especially in rice, is significantly affected by natural factors and “explicit beyond-the-border” constraints. They ignore the impact of “behind-the-border” constraints in Vietnam and its trading partners. My study proved the significant impact of such constraints. Therefore, Vietnam needs more policies to remove the “behind-the-border” constraints to promote export in rice and coffee.
The sequence of implementation of reconfigurability core characteristics in manufacturing systems
Authors: Maganha Isabela , Silva Cristovao , Ferreira Luis Miguel D.F.
Published: October 2020

Purpose

The objective of this study is to propose a sequence of implementation of the core characteristics of reconfigurability: modularity, integrability, diagnosability, adaptability and customization. For this purpose, the relationships among the core characteristics and Industry 4.0 technologies are analyzed as well as the impacts of one core characteristic on another.

Design/methodology/approach

This study presented tests and validated two hypothesized models based on the literature. This paper was based on a questionnaire survey. Portuguese manufacturing companies were the sampling frame. In total, 600 questionnaires were distributed and a total of 112 responses were eligible for statistical processing, representing a response rate of 18.7%. Structural equation modeling (SEM) was used to hypothesize the sequence of implementation of the core characteristics of reconfigurability.

Findings

The findings presented a roadmap to implement reconfigurability, which implies significant managerial contributions on how to make the transition from conventional to reconfigurable manufacturing systems (RMSs). This highlights the importance of the sequence of implementation of the core characteristics in order to make the most of each to achieve reconfigurability.

Originality/value

Implementing reconfigurability is crucial to manufacturing companies to respond to changes in production requirements and market fluctuations quickly. However, there is a gap between theory and practice in regard to achieve reconfigurability in existing manufacturing systems. This gap includes (1) understanding the type of relationships among the core characteristics of reconfigurability, (2) understanding the influence that one core characteristic has on another and (3) establishing a sequence of implementation for the core characteristics. This study makes a contribution to fill this gap in the research area.
The “additional costs” of being peripheral: developing a contextual understanding of micro-business growth constraints
Authors: Gherhes Cristian , Vorley Tim , Brooks Chay
Published: October 2020

Purpose

Despite their economic significance, empirical evidence on the growth constraints facing micro-businesses as an important subset of small and medium enterprises remains scarce. At the same time, little consideration has hitherto been given to the context in which entrepreneurial activity occurs. The purpose of this paper is to develop an empirically informed contextual understanding of micro-business growth, beyond firm-level constraints.

Design/methodology/approach

The paper draws on 50 in-depth interviews with stakeholders and micro-business owner–manager entrepreneurs (OMEs henceforth) in a peripheral post-industrial place (PPIP henceforth).

Findings

The paper shows that, beyond firm-level constraints generated by their OME-centric nature, there are “additional costs” for micro-businesses operating in PPIPs, specifically limited access to higher-skilled labour, a more challenging, “closed” business environment and negative outward perceptions stemming from place stigmatisation. All of these “additional costs” can serve to stymie OMEs' growth ambition.

Research limitations/implications

The paper is based on a limited number of interviews conducted in one region in England. However, the contextualisation of the findings through a focus on PPIPs provides valuable insights and enables analytical generalisation.

Originality/value

The article develops a context-sensitive model of micro-business growth constraints, one that goes beyond the constraints inherent in the nature of micro-businesses and is sensitive to their local (socio-institutional) operating context. The implications serve to advance both how enterprise in the periphery is theorised and how it is addressed by policymakers and business intermediaries to support the growth of micro-businesses.
Herding and BRICS markets: a study of distribution tails
Authors: Shrotryia Vijay Kumar , Kalra Himanshi
Published: October 2020

Purpose

The present study looks into the mimicking behaviour in both normal and asymmetric scenarios. It, then, considers the contagion between the USA and the BRICS stock markets. Finally, it examines herd behaviour in the wake of a major banking policy change concerning the bloc under study.

Design/methodology/approach

The current empirical analysis employs daily, weekly and monthly data points to estimate relevant herding parameters. Quantile regression specifications of Changet al.(2000)'s dispersion method have been applied to detect herd activity. Also, dummy regression specifications have been used to examine the impact of various crises and strategically crucial events on the propensity to herd in the BRICS markets. The time period under consideration ranges from January 2011 until May 2019.

Findings

The relevant herding coefficients turn insignificant in most cases for normal and asymmetric scenarios except for China and South Africa. This can be traced to the anti-herding behaviour of investors, where individuals tend to diverge from the consensus. However, turbulence makes all stock markets to show some collective trading except Russia. Further, the Chinese stock market seems immune to the frictions in the US stock market. Finally, the Indian and South African markets witness significant herding during the formation of a common depository institution.

Practical implications

Most stock markets seem to herd during turbulence. This revelation is of strategic importance to the regulators and capital market managers. They have to be cautious during crises periods as the illusion of being secured with the masses ends up creating unprecedented frictions in the financial markets.

Originality/value

The present study seems to be the very first attempt to test the relevant distributions' tails for convergent behaviour in the BRICS markets.
Beware of side effects on quality! Investigating the implications of home working on work-life balance in educational services
Authors: Palumbo Rocco , Manna Rosalba , Cavallone Mauro
Published: October 2020

Purpose

Telecommuting from home is back up on the agenda as a result of the unforeseen challenges brought by COVID-19. Working from home permits to avoid disruption in the ordinary functioning of educational institutions triggered by social distancing. However, home-based telecommuting may have some side effects on employees, especially in terms of work-life balance. Soft Total Quality Management (TQM) initiatives are needed to address these side effects. The article intends to shed light on these issues, providing some food for thought to scholars and practitioners.

Design/methodology/approach

Secondary data about the working conditions of 2,046 people employed in the education sector across Europe were investigated. A serial mediation analysis was designed to examine the direct and indirect implications of working from home on work-life balance.

Findings

The study suggests that home-based telecommuting may trigger work-to-life and life-to-work conflicts, due to the blurring of boundaries between work and everyday life. Soft tools, such as organizational meaningfulness (OM) and work-related well-being (WB), mediate the relationship between working from home (HW) and work-life conflicts (WLC), lessening the negative implications of working from home on work-life balance.

Practical implications

The design and the implementation of home-based telecommuting arrangements should include a special concern for soft TQM practices. Among others, OM and WB are likely to minimize the disruption of remote employees' jobs and interpersonal relationships. Failure to do so impairs the ability of home-based employees to make sense out of their working arrangements and to achieve a sustainable work-life balance.

Originality/value

This is one of the first attempts to illuminate the side effects of home-based telecommuting and to investigate the role of soft TQM in addressing these side effects.
Anisotropic attenuation of stratified viscoelastic media
Authors: Zeng Jing , Stovas Alexey , Huang Handong
Published: October 2020

An important cause of seismic anisotropic attenuation is the interbedding of thin viscoelastic layers. However, much less attention has been devoted to layer‐induced anisotropic attenuation. Here, we derive a group of unified weighted average forms for effective attenuation from a binary isotropic, transversely isotropic‐ and orthorhombic‐layered medium in the zero‐frequency limit by using the Backus averaging/upscaling method and analyse the influence of interval parameters on effective attenuation. Besides the corresponding interval attenuation and the real part of stiffness, the contrast in the real part of the complex stiffness is also a key factor influencing effective attenuation. A simple linear approximation can be obtained to calculate effective attenuation if the contrast in the real part of stiffness is very small. In a viscoelastic medium, attenuation anisotropy and velocity anisotropy may have different orientations of symmetry planes, and the symmetry class of the former is not lower than that of the latter. We define a group of more general attenuation‐anisotropy parameters to characterize not only the anisotropic attenuation with different symmetry classes from the anisotropic velocity but also the elastic case. Numerical tests reveal the influence of interval attenuation anisotropy, interval velocity anisotropy and the contrast in the real part of stiffness on effective attenuation anisotropy. Types of effective attenuation anisotropy for interval orthorhombic attenuation and interval transversely isotropic attenuation with a vertical symmetry (vertical transversely isotropic attenuation) are controlled only by the interval attenuation anisotropy. A type of effective attenuation anisotropy for interval TI attenuation with a horizontal symmetry (horizontal transversely isotropic attenuation) is controlled by the interval attenuation anisotropy and the contrast in the real part of stiffness. The type of effective attenuation anisotropy for interval isotropic attenuation is controlled by all three factors. The magnitude of effective attenuation anisotropy is positively correlated with the contrast in the real part of the stiffness. Effective attenuation even in isotropic layers with identical isotropic attenuation is anisotropic if the contrast in the real part of stiffness is non‐zero. In addition, if the contrast in the real part of stiffness is very small, a simple linear approximation also can be performed to calculate effective attenuation‐anisotropy parameters for interval anisotropic attenuation.
Scale‐dependent drivers of the phylogenetic structure and similarity of tree communities in northwestern Amazonia
Authors: González‐Caro Sebastián , Duivenvoorden Joost F. , Balslev Henrik , Cavelier Jaime , Grández César , Macía Manuel J. , Romero‐Saltos Hugo , Sánchez Mauricio , Valencia Renato , Duque Álvaro
Published: October 2020

The extent to which historical dispersal, environmental features and geographical barriers shape the phylogenetic structure and turnover of tree communities in northwestern Amazonia at multiple spatial scales remains poorly understood.

We used 85 floristically standardized 0.1‐ha plots (DBH ≥ 2.5 cm) distributed in three subregions of northwestern (NW) Amazonia across three main habitat types (floodplain, swamp and terra firme forests) to hypothesize that (a) historical dispersal overcome geographical barriers, which meant low local phylogenetic relatedness and low phylogenetic turnover. (b) Geographical barriers triggered dispersal limitation, causing high local and subregional phylogenetic clustering and high regional phylogenetic turnover. (c) Edaphic properties and flooding were negatively associated with stem size and determined the tree phylogenetic structure and turnover at local and regional scales in Amazon forests.

We found that the extent to which environmental or evolutionary features shaped the phylogenetic structure and phylogenetic similarity of tree communities in NW Amazonia was scale dependent. Specifically, we show that the relative importance of environmental factors increases as spatial scale and species pool decreases. Furthermore, we find that these results are generally robust for both adult and juvenile trees.

Synthesis. Our analysis at the regional (NW Amazon) scale lends support to the idea of Amazonian forests as a large meta‐community primarily structured by historical dispersal at large spatial scales with an increasing importance of environmental factors at finer spatial scales. The convergence of ancestral lineages across habitat types may have been due to the relatively recent formation of geographical barriers that promoted local isolation and allopatric speciation.
More than one way to kill a spruce forest: The role of fire and climate in the late‐glacial termination of spruce woodlands across the southern Great Lakes
Authors: Jensen Allison M. , Fastovich David , Watson Ben I. , Gill Jacquelyn L. , Jackson Stephen T. , Russell James M. , Bevington Joseph , Hayes Katherine , Lininger Katherine B. , Rubbelke Claire , Schellinger Grace C. , Williams John W.
Published: October 2020

In the southern Great Lakes Region, North America, between 19,000 and 8,000 years ago, temperatures rose by 2.5–6.5°C and spruce Picea forests/woodlands were replaced by mixed‐deciduous or pine Pinus forests. The demise of Picea forests/woodlands during the last deglaciation offers a model system for studying how changing climate and disturbance regimes interact to trigger declines of dominant species and vegetation‐type conversions.

The role of rising temperatures in driving the regional demise of Picea forests/woodlands is widely accepted, but the role of fire is poorly understood. We studied the effect of changing fire activity on Picea declines and rates of vegetation composition change using fossil pollen and macroscopic charcoal from five high‐resolution lake sediment records.

The decline of Picea forests/woodlands followed two distinct patterns. At two sites (Stotzel‐Leis and Silver Lake), fire activity reached maximum levels during the declines and both charcoal accumulation rates and fire frequency were significantly and positively associated with vegetation composition change rates. At these sites, Picea declined to low levels by 14 kyr BP and was largely replaced by deciduous hardwood taxa like ash Fraxinus, hop‐hornbeam/hornbeam Ostrya/Carpinus and elm Ulmus. However, this ecosystem transition was reversible, as Picea re‐established at lower abundances during the Younger Dryas.

At the other three sites, there was no statistical relationship between charcoal accumulation and vegetation composition change rates, though fire frequency was a significant predictor of rates of vegetation change at Appleman Lake and Triangle Lake Bog. At these sites, Picea declined gradually over several thousand years, was replaced by deciduous hardwoods and high levels of Pinus and did not re‐establish during the Younger Dryas.

Synthesis. Fire does not appear to have been necessary for the climate‐driven loss of Picea woodlands during the last deglaciation, but increased fire frequency accelerated the decline of Picea in some areas by clearing the way for thermophilous deciduous hardwood taxa. Hence, warming and intensified fire regimes likely interacted in the past to cause abrupt losses of coniferous forests and could again in the coming decades.
Tailoring education of adults with cognitive impairment in the inpatient hospital setting: A scoping review
Authors: D’Cruz Kate , Meikle Louise , White Megan , Herrmann Alicia , McCallum Carrie , Romero Lorena
Published: October 2020

Introduction

Education seeks to empower clients to attain and maintain knowledge and skills, and in the context of occupational therapy, to enable occupational participation. While education is routinely provided in the inpatient hospital setting, little is known about how education is best adapted to meet the needs of clients with cognitive impairment. The purpose of this scoping review was to determine what is currently known about approaches to educating adults with cognitive impairment in the inpatient hospital setting.

Methods

Five databases were systematically searched to find studies that reported on the use of education in the inpatient hospital setting with adults with cognitive impairment.

Results

Ten articles were retrieved from the search with duplication of authors across the articles, indicating a small group of research and researchers. Cognitive impairment was not well assessed across all the studies and none included participants with severe cognitive impairment. A number of barriers to education were identified, including time constraints, uncertainty around who should be providing education, a shortage of resources, and client‐related barriers such as cognitive deficits. From the retrieved studies it was found that education should occur at multiple time points, be individually tailored, and utilise mixed modal approaches such as verbal and written methods. There was also a preference for less use of jargon, and engagement with carers and clients where possible.

Conclusion

This scoping review highlights factors impacting the provision of education tailored to the needs of clients with cognitive impairment in the inpatient setting. The findings also call to attention the need for better assessment of cognition to guide provision of tailored education, as well as future studies exploring how to best educate clients with not only mild/moderate cognitive impairment but also more severe impairments.
Factors associated with the outcomes in ulcerative colitis patients undergoing granulocyte and monocyte adsorptive apheresis as remission induction therapy: A multicenter cohort study
Authors: Ishiguro Yoh , Ohmori Toshihide , Umemura Ken , Iizuka Masahiro
Published: October 2020

Ulcerative colitis (UC) patients harbor activated myeloid leukocytes, which exacerbate and perpetuate UC by releasing inflammatory cytokines. Granulocyte and monocyte adsorptive apheresis (GMA) with an Adacolumn depletes elevated myeloid leukocytes, inducing efficacy with favorable safety. To understand how the clinical outcome with GMA is affected by prior corticosteroid treatment or concomitant immunomodulators, a retrospective multicenter study in 102 UC patients, who had not responded well to first‐line medications was undertaken. The remission rates after a course of GMA therapy were significantly higher in corticosteroid‐naïve patients compared with those with prior corticosteroid exposure. Absence of corticosteroid background was an independent predictive factor of response to GMA. Further, in corticosteroid‐naïve patients, the 1‐year cumulative sustained remission rate in patients who did not receive immunomodulators was significantly higher than in patients who received immunomodulators. Accordingly, multivariate analysis revealed that immunomodulator was associated with higher risk of relapse. In conclusion, GMA was an effective treatment for corticosteroid‐naïve patients and the efficacy sustained longer in those not receiving immunomodulators during GMA. GMA fulfills the notion that apheresis is to induce disease remission by removing from the body factors known to perpetuate disease. In therapeutic settings, these findings should help better decision making and avoid futile use of medical resources.
Sequential intermittent therapeutic plasma exchange: A possible induction and maintenance therapy in the management of adult patients with neuromyelitis optica spectrum disorder
Authors: Viswanathan Shanthi , Schee Jie Ping , Omar Mohd Azahadi , Hiew Fu Liong
Published: October 2020

Evidence on the benefits of intermittent therapeutic plasma exchange (TPE) as maintenance therapy in neuromyelitis optica spectrum disorder (NMOSD) is limited. This study explores the possible effectiveness of sequential intermittent therapeutic plasma exchange (SITPE), a novel TPE protocol in the management of adult NMOSD patients. Through retrospective review of medical records in Kuala Lumpur Hospital, Malaysia, NMOSD patients who underwent SITPE, namely, an induction phase of monthly cycle of TPE (1 cycle = five exchange sessions) for three cycles with or without a subsequent maintenance phase of three‐monthly cycle of TPE for three cycles, were included in this controlled historical cohort study. We explored their serial improvements in Expanded Disability Status Scale (EDSS), limb power, visual acuity, and annualized relapse rate following SITPE initiation. Statistical significance was set at P < .05. Fifteen adults (mean age: 35.4 years, mean disease duration: 9.5 years, 73% female, 87% AQP4‐IgG positive) with corticosteroid‐refractory attacks were included. Upon SITPE initiation, significant improvements in EDSS and limb motor power for up to 12 months, in addition to significant improvements in visual acuity for up to 6 months, were recorded. Significant reduction in annualized relapse rates for up to 2 years was documented. These improvements were not significantly influenced by age groups, gender, or presence of cord atrophy. Notably, adverse events of SITPE were infrequent and manageable. Sequential intermittent therapeutic plasma exchange as induction and maintenance therapy may improve the disease outcomes and prevent relapses in adult NMOSD patients with severe, corticosteroid‐refractory attacks.
Somatosensory dysfunction related neuropathic pain component affects disease activity, functional status and quality of life in ankylosing spondylitis
Authors: Atar Emel , Askin Ayhan
Published: October 2020

Aim

To investigate the neuropathic pain (NP) component in ankylosing spondylitis (AS) and to assess the relations between NP and disease characteristics.

Methods

Eighty participants were included in this study. Demographic properties, duration of disease, laboratory values and clinical assessments (visual analog scale [VAS], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI], Bath Ankylosing Spondylitis Metrology Index [BASMI], Short Form [SF]‐36 questionnaire, Beck Depression Inventory [BDI]) were recorded. The NP component was assessed by both DN4 and PainDETECT questionnaires (PD‐Q) and patients were classified into groups according to questionnaire scores.

Results

NP component was detected by the DN4 and PD‐Q in 40% and 28.7% of our patients, respectively. Likely‐NP group had significantly higher scores in VAS‐pain, BASDAI, BASFI, BASMI and BDI compared with both uncertain‐NP and unlikely‐NP groups. There was no significant difference between the SF‐36 scores of the likely‐NP and uncertain‐NP groups. Moreover, all SF‐36 scores were significantly lower in the likely‐NP group than in the unlikely‐NP group. Based on DN4 scale, patients with NP had significantly higher erythrocyte sedimentation rate (ESR), VAS, BASDAI, BASFI, BASMI scores and significantly lower SF‐36 (except social functioning) scores compared to patients without NP. Both painDETECT and DN4 scores of the patients were significantly positively correlated with ESR, VAS, BASDAI, BASFI, BASMI, BDI scores and negatively correlated with all SF‐36 scores.

Conclusions

Our results revealed that the presence of NP component in patients with AS is associated with various disease‐related variables, including pain, high disease activity, reduced mobility of the axial skeleton, depression and poor quality of life.
Modelling and inference for the movement of interacting animals
Authors: Milner Jordan E. , Blackwell Paul G. , Niu Mu
Published: October 2020

Statistical modelling of animal movement data is a rapidly growing area of research. Typically though, these models have been developed for analysing the tracks of individual animals and we lose sight of the impact animals have on each other with regards to their movement behaviours. We aim to develop a model with a flexible social framework that allows us to capture that information.

Our approach is based on the concept of social hierarchies, and this is embedded in a multivariate diffusion process which models the movement of a group of animals. The possibility of switching between behavioural states facilitates dynamic social behaviours and we augment the observed data with sampled state switching times in order to model the animals' behaviour naturally in continuous time. In addition, this enables us to carry out exact inference in a Bayesian setting with the benefits of being able to handle regular, irregular and missing data. All movement and behaviour parameters are estimated with Markov chain Monte Carlo methods.

We examine the capability of our model with simulated data before fitting it to GPS locations of five wild olive baboons Papio anubis. The results enable us to identify which animals are influencing the movement of others and when, which provides both a dynamic and long‐term static insight into the group's social behaviours.

Our model offers a flexible method in continuous time with which to model the network of social interactions within animal movement. Doing so avoids the limitations caused by a discrete‐time approach and it allows us to capture rich information with regards to a group's social structure, leading to constructive applications in conservation and management decisions. However, currently it is a computationally expensive task to fit the model to data, which in turns limits extending the model to more fruitful but complex cases such as heterogeneity in space or individual characteristics. Furthermore, our social hierarchy approach assumes all relevant animals are tracked and that any interactions have some ordering, both of which narrow the scope within which this approach is appropriate.
CMRnet: An r package to derive networks of social interactions and movement from mark–recapture data
Authors: Silk Matthew J. , McDonald Robbie A. , Delahay Richard J. , Padfield Daniel , Hodgson David J.
Published: October 2020

Long‐term capture–mark–recapture data provide valuable information on the movements of individuals between locations, and the contemporary and/or co‐located captures of individuals can be used to approximate the social structure of populations.

We introduce an r package (CMRnet) that generates social and movement networks from spatially explicit capture–mark–recapture data. It also provides functions for network and datastream permutations for these networks. Here we describe the package and key considerations for its application, providing two example case studies.

The conversion of spatially explicit mark–recapture data into social and movement networks will provide insights into the interplay between demography and behaviour in wild animal populations, with important applications in their management and conservation.
Does Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms?
Authors: Caniglia Ellen C. , Stevens Elizabeth R. , Khan Maria , Young Kailyn E. , Ban Kaoon , Marshall Brandon D.L. , Chichetto Natalie E. , Gaither Julie R. , Crystal Stephen , Edelman Eva Jennifer , Fiellin David A. , Gordon Adam J. , Bryant Kendall J. , Tate Janet , Justice Amy C. , Braithwaite Ronald Scott
Published: October 2020

Background

We aimed to investigate the impact of reducing drinking in patients with unhealthy alcohol use on improvement of chronic pain interference, substance use, and psychiatric symptoms.

Methods

We analyzed longitudinal data from 2003 to 2015 in the Veterans Aging Cohort Study, a prospective, multisite observational study of US veterans, by emulating a hypothetical randomized trial (a target trial). Alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire, and outcome conditions were assessed via validated survey items. Individuals were followed from the first time their AUDIT score was ≥ 8 (baseline), a threshold consistent with unhealthy alcohol use. We compared individuals who reduced drinking (AUDIT < 8) at the next follow‐up visit with individuals who did not (AUDIT ≥ 8). We fit separate logistic regression models to estimate odds ratios for improvement of each condition 2 years postbaseline among individuals who had that condition at baseline: moderate or severe pain interference symptoms, tobacco smoking, cannabis use, cocaine use, depressive symptoms, and anxiety symptoms. Inverse probability weighting was used to account for potential selection bias and confounding.

Results

Adjusted 2‐year odds ratios (95% confidence intervals) for associations between reducing drinking and improvement or resolution of each condition were as follows: 1.49 (0.91, 2.42) for pain interference symptoms, 1.57 (0.93, 2.63) for tobacco smoking, 1.65 (0.92, 2.95) for cannabis use, 1.83 (1.03, 3.27) for cocaine use, 1.11 (0.64, 1.92) for depressive symptoms, and 1.33 (0.80, 2.22) for anxiety symptoms.

Conclusions

We found some evidence for improvement of pain interference symptoms and substance use after reducing drinking among US veterans with unhealthy alcohol use, but confidence intervals were wide.
Is Cannabis being used as a substitute for non‐medical opioids by adults with problem substance use in the United States? A within‐person analysis
Authors: Gorfinkel Lauren R. , Stohl Malki , Greenstein Eliana , Aharonovich Efrat , Olfson Mark , Hasin Deborah
Published: October 2020

Background and Aims

Ecological studies have suggested that Cannabis legalization might have led to a decrease in opioid overdose deaths. Such studies do not provide information about whether individuals are substituting Cannabis for opioids at different points in time. The current study assessed the magnitude of the daily association between Cannabis and opioid use in individual adults with and without pain who use non‐medical opioids.

Design

Prospective cohort study.

Setting

The greater New York area and a suburban inpatient addiction program.

Participants

Adults with problem substance use who use non‐medical opioids, recruited from May 2016–June 2019. The analytical sample included 13 271 days of observation among 211 participants (64% male, 41% white, 78% unmarried, 80% unemployed, mean age 43 years).

Measurements

Participants completed interviewer‐ and self‐administered computerized surveys, and then responded to an interactive voice response (IVR) system daily for the following 90 days. The main exposures, Cannabis use and pain, were defined as responding affirmatively to the IVR question: ‘Did you use Cannabis yesterday?’ and endorsing moderate or severe pain at baseline, respectively. The main outcome, non‐medical or illicit opioid use during 90‐day follow‐up, was defined as responding affirmatively to IVR question: ‘Did you use heroin yesterday?’ or ‘Did you use prescription opioids more than prescribed or without a prescription yesterday?’.

Findings

The mean IVR completion rate was 70%. The unadjusted odds ratio (aOR) indicating same‐day use of Cannabis and opioids was 2.00 [95% confidence interval (CI) = 1.54–2.59]. Controlling for demographic characteristics, recruitment method, opioid types at baseline and pain, the aOR was 1.86 (95% CI = 1.44–2.41). A test of interaction between pain and Cannabis use to determine if the association of Cannabis with opioid use differed between people with moderate‐to‐severe pain and less‐than‐moderate pain was inconclusive.

Conclusions

Among US adults with problem substance use who use non‐medical opioids, the odds of opioid use appear to be approximately doubled on days when Cannabis is used. This relationship does not appear to differ between people with moderate or more severe pain versus less than moderate pain, suggesting that Cannabis is not being used as a substitute for illegal opioids.
Powered toothbrushes for plaque control in fixed orthodontic patients: a network meta‐analysis
Authors: Sivaramakrishnan G , Alsobaiei M , Sridharan K
Published: October 2020

Background

Orthodontic patients are at greater risk due to the inability to clean around the components directly bonded to teeth. Hence, the aim of the present network meta‐analysis is to compare the utility of powered toothbrushes in plaque control in patients with orthodontic brackets compared with manual tooth brushing.

Methodology

Necessary data were extracted and analysed for Risk of Bias. Heterogeneity was assessed using Chi‐square and I2 tests. Random effects model was used for both direct and mixed treatment comparisons. Standardized mean difference with 95% confidence interval was the effect estimate for plaque and bleeding scores and mean difference for pocket depth. Inconsistencies between the direct and indirect estimates were evaluated by H‐statistics. GRADE approach was used to assess the quality of evidence.

Results

Pooled results from 14 studies showed significantly higher plaque scores in patients using manual toothbrushes. Pooled results from 13 studies showed significant higher bleeding scores as well with manual brushes. There was a significant reduction in pocket depth with electric toothbrushes.

Conclusion

Powered toothbrushes are a promising alternative for plaque control in patients with fixed orthodontic brackets. Stronger evidence can be established with addition of long‐term clinical trials based on the recommendations.
The efficacy of five different techniques in identifying C‐shaped canals in mandibular molars
Authors: Baghbani Atefeh , Bagherpour Ali , Ahmadis Zahra , Dehban Arezou , Shahmohammadi Reza , Jafarzadeh Hamid
Published: October 2020

Information regarding the canal anatomy especially in complex cases such as C‐shaped canals is essential for a successful treatment. In this study, five different methods for identification of C‐shaped canal configuration were compared. 108 extracted mandibular molars with fused roots were studied. Radiographic evaluation was carried out using periapical radiography and CBCT. After access cavity preparation, all specimens were evaluated by direct visual examination and then under dental operating microscope. Finally, the actual anatomy of each sample was determined by preparing horizontal cross sections of the roots (1 mm thick) and examining them under stereomicroscope as the gold standard. Among the techniques used, high‐resolution CBCT manifested the highest accuracy, whereas periapical radiography had the lowest. All approaches can be useful in reaching a correct diagnosis. CBCT, especially the low‐resolution modality, is an effective technique in the diagnosis of C‐shaped anatomy.
A survey of current trends in root canal treatment: access cavity design and cleaning and shaping practices
Authors: Tsotsis Polymnia , Dunlap Craig , Scott Raymond , Arias Ana , Peters Ove A.
Published: October 2020

The purpose of this study was to evaluate current trends in access cavity design and cleaning and shaping among endodontists. A survey was e‐mailed to active members of the American Association of Endodontists. Data showed that most respondents used traditional (57%) or conservative (43%) access cavities; less than 1% reported using ultraconservative access cavities. A glide path was created by 93% of respondents; NaOCl was used as lubricant by 51% of respondents, while 28% used RC Prep, 9% used liquid EDTA, 7% used Glyde, and 2% did not use any lubricant. Most respondents used NaOCl at 5.25% or higher concentration. Smear layer was removed by 92% of endodontists. Apical gauging was mostly accomplished with hand files. Clinical preferences varied among surveyed endodontists and among different age groups. Currently, very few endodontists use ultraconservative access preparations. There was large variation among the respondents suggesting a possible need for quality guidelines.