bluuebunny/crossref_metadata_2025 huggingface dataset:
Socio-economic and technological new normal in supply chain management: lessons from COVID-19 pandemic
Authors: Ajmal Mian M. , Khan Mehmood , Shad Muhammad Kashif , AlKatheeri Haseena , Jabeen Fauzia
Published: November 2021

Purpose

This paper explores the new normal activities and strategic responses of the service industry towards the challenges created by the coronavirus disease 2019 (COVID-19) outbreak and other constructs and validates the measurement scale for socio-economic and technological new normal activities following lockdown and social distancing practices.

Design/methodology/approach

First, structured interviews with 28 participants helped us generate items and develop survey instruments for cross-sectional data collection in the second phase. So, the authors received 256 complete responses from the top and middle management of the services industry. Exploratory factor analysis helped us explore the factors and reliability of the items. Confirmatory factor analysis aided us in generating and confirming the factorial structure of the constructs.

Findings

Results indicated that amid COVID-19's pandemic, new normal activities are emerging in which organizations are deploying crisis strategies to safeguard their business and stakeholders. Organizations are re-opening swiftly, focusing on digital transformation, developing digital platforms for ease in working and improved consumer services, to name a few operational changes.

Practical implications

Discussion on empirical analysis revolves around the guidelines to service industry's managers and top management to improve shortcomings in combating the challenges they face in their operations.

Originality/value

Prior studies have provided substantial insights on the COVID-19 pandemic, but relatively little research exists on new normal activities in the supply chain network of the service industry. Among other reasons for such less empirical evidence on new normal activities is the unavailability of a comprehensive tool for measuring the socio-economic and technological new normal activities. This paper is a contribution to bridging this knowledge gap.
Cannot keep up with the Joneses: how relative deprivation pushes internal migration in Austria
Authors: Jestl Stefan , Moser Mathias , Raggl Anna Katharina
Published: November 2021

Purpose

Using aggregated data at the municipality level allows the authors to assess the role of relative deprivation (RD) – a measure of income inequality – on top of absolute income in shaping internal migration in Austria.

Design/methodology/approach

In this study, the authors analyse the effect of regional income inequality on emigration rates of Austrian municipalities using a unique spatial dataset that is constructed based on Austrian administrative register data. The register-based data contain information on the municipality of residence of all individuals aged 16 and over that have their main residency in Austria, as well as their income and socio-demographic characteristics.

Findings

The authors find that increases in relative deprivation in a municipality are related to higher emigration from the municipality. Allowing for heterogeneous effects across income, education and age groups reveals that the effect is stronger among those with comparably low levels of income and among low-skilled and young individuals.

Originality/value

The unique spatially disaggregated perspective is based on novel data from Austrian administrative registers, which comprehensively capture the economic situation and geographic movements of the whole Austrian population. Most importantly, this approach allows for measuring income inequality within local communities and for a direct identification of social groups that are more sensitive to inequality.
Attention and behaviour on fashion retail websites: an eye-tracking study
Authors: Boardman Rosy , Mccormick Helen
Published: November 2021

Purpose

The purpose of this paper is to identify attention, cognitive and affective responses towards a fashion retailer's website and the behavioural outcomes when shopping online.

Design/methodology/approach

52 eye-tracking tests and 52 qualitative semi-structured interviews were conducted.

Findings

Consumer attention and behaviour differ across web pages throughout the shopping journey depending on its content, function and consumers' goal. Top-down attention is more dominant than bottom-up attention when consumers are shopping online for fashion items. The product listings page was the most frequented and had the most time spent on it. Consumers enjoy browsing for products and adding them to their basket to evaluate them together later. Customisation and personalisation features are the most valued due to their ability to make the experience more convenient and enjoyable.

Originality/value

This article contributes novel findings that the content and design of the website affects attention in different ways. It demonstrates that research cannot simplify viewing patterns for fashion shopping online. The study extends the SOR framework, showing that top-down attention, when provided with personalisation and customisation features, results in approach behaviour. A lack of personalisation or customisation features results in avoidance behaviour. The complex nature of consumer attention and behaviour during their holistic shopping journey advocates the need for eye-tracking research to be conducted on a live website for ecological validity, providing a methodological contribution which can be used for future research.
Exploring destination image through online reviews: an augmented mining model using latent Dirichlet allocation combined with probabilistic hesitant fuzzy algorithm
Authors: Luo Yuyan , Tong Tao , Zhang Xiaoxu , Yang Zheng , Li Ling
Published: November 2021

Purpose

In the era of information overload, the density of tourism information and the increasingly sophisticated information needs of consumers have created information confusion for tourists and scenic-area managers. The study aims to help scenic-area managers determine the strengths and weaknesses in the development process of scenic areas and to solve the practical problem of tourists' difficulty in quickly and accurately obtaining the destination image of a scenic area and finding a scenic area that meets their needs.

Design/methodology/approach

The study uses a variety of machine learning methods, namely, the latent Dirichlet allocation (LDA) theme extraction model, term frequency-inverse document frequency (TF-IDF) weighting method and sentiment analysis. This work also incorporates probabilistic hesitant fuzzy algorithm (PHFA) in multi-attribute decision-making to form an enhanced tourism destination image mining and analysis model based on visitor expression information. The model is intended to help managers and visitors identify the strengths and weaknesses in the development of scenic areas. Jiuzhaigou is used as an example for empirical analysis.

Findings

In the study, a complete model for the mining analysis of tourism destination image was constructed, and 24,222 online reviews on Jiuzhaigou, China were analyzed in text. The results revealed a total of 10 attributes and 100 attribute elements. From the identified attributes, three negative attributes were identified, namely, crowdedness, tourism cost and accommodation environment. The study provides suggestions for tourists to select attractions and offers recommendations and improvement measures for Jiuzhaigou in terms of crowd control and post-disaster reconstruction.

Originality/value

Previous research in this area has used small sample data for qualitative analysis. Thus, the current study fills this gap in the literature by proposing a machine learning method that incorporates PHFA through the combination of the ideas of management and multi-attribute decision theory. In addition, the study considers visitors' emotions and thematic preferences from the perspective of their expressed information, based on which the tourism destination image is analyzed. Optimization strategies are provided to help managers of scenic spots in their decision-making.
Relationships among absorptive capacity, creativity and job performance: the moderating role of social media usage
Authors: Ince Huseyin , Imamoglu Salih Zeki , Turkcan Hulya
Published: November 2021

Purpose

This paper investigates the impact of absorptive capacity (ACAP) on creativity and the effect of creativity on job performance. Further, the study investigates the moderating role of social media usage on the ACAP–creativity link and the creativity–job performance link. Accordingly, drawing on the ACAP perspective and social exchange theory (SET), the study develops a conceptual model and tests the proposed relationships.

Design/methodology/approach

The paper empirically tests the developed model using 512 survey responses from research and development (R&D) employees. Data were factor analyzed, and path estimates were determined using structural equation modeling to test the hypotheses.

Findings

The results reveal that (1) individual ACAP is positively related to creativity; (2) creativity is positively associated with job performance and (3) social media usage positively moderates the relationship between individual ACAP and creativity.

Originality/value

This paper contributes to the ACAP and creativity literature by establishing a comprehensive and empirically grounded framework that enlightens the relationships between ACAP, creativity, job performance and the moderating role of social media usage.
“Once an entrepreneur, always an entrepreneur” positioning analysis of written narratives
Authors: Järvensivu Anu , von Bonsdorff Monika E.
Published: November 2021

Purpose

The negative stereotypes concerning late-career workers are found to prevail and lead to negative circulation of narratives and actions between individuals and societies. Using the context of late-career entrepreneurs, the paper aims to find an alternative and a more positive narrative concerning late-career work by focusing on entrepreneurs and the narrative positioning related to them.

Design/methodology/approach

The authors used a narrative-positioning analysis, cycling through three levels of analysis and then returning to level two, in order to study our sample of seven narratives written by Finnish late-career entrepreneurs. The authors present in detail one story-telling narrative, by Matthew, and then layer the remaining six narratives to present themes, positioning and actions surrounding being a late-career entrepreneur.

Findings

A more positive narrative circulation was found, which related to the master narrative of entrepreneurs as continuing “until the end” and taking care of themselves, their enterprises and different stakeholder groups even after exiting the enterprise into so-called “retirement.” The entrepreneurs were found to actively use this positive narrative to position themselves both in the story-telling world and in their local interactions. By positioning themselves as “never ending caretakers,” the entrepreneurs gave a strong account that their reasons to continue working centered on the factors social.

Research limitations/implications

The research findings and analysis should be interpreted in the context of the Nordic countries and especially Finland.

Practical implications

The results of this study can inform the ways in which these “never ending caretakers” can transition into retirement and adjust to life spent in retirement.

Originality/value

In the study, entrepreneurs' written answers were analyzed with narrative-positioning analyses. An alternative story of people at work was found, and a more positive narrative circulation was constructed based on their narratives.
Gender as moderator of the influence of tourists’ risk perception on destination image and visit intentions
Authors: Carballo Rita R. , León Carmelo J. , Carballo María M.
Published: November 2021

Purpose

This paper aims to study the influence of gender on the theoretical and empirical relationships between tourists’ risk perceptions and both destination image and behavioural intentions.

Design/methodology/approach

An empirical study was carried out with potential tourists at home in Germany and the UK considering travelling to Spain, Egypt, Morocco, Brazil, Colombia and Indonesia. Data were analysed using structural equation modelling with multi-group analysis.

Findings

Results show that gender moderates the theoretical relationships between risk perception and both destination image and behavioural intentions. Risk perception is higher for women than for men and depends on the type of risks and the characteristics of the destination. Women are more likely than men to reduce their visit to a destination whenever there is an increase in their risk perceptions. However, the influence of risk perception on destination image is higher for men than for women. Thus, results prove there are significant gender differences in the theoretical relationships between risk perceptions and destination image and visiting intentions.

Originality/value

This paper provides new evidence on the gender differences in risk perceptions in tourism and their impact on destination image and visiting intentions, showing that whenever there are higher risks at a tourist destination women do change more than men their behavioural intentions. The results are useful for designing risk management and promotion policies at destinations that avoid the masculinisation bias, thereby considering the impact of gender differences on travel behaviour and consumption decisions.
Understanding distributed sensemaking in crisis management: The case of the Utrecht terrorist attack
Authors: Wolbers Jeroen
Published: November 2021

On Monday morning March 18, 2019 a terrorist opened fire inside a tram in the middle of the city of Utrecht. A key challenge in the Utrecht attack was making sense of the situation and organizing a coherent response in a distributed command and control structure. This is a recurrent challenge in crisis management. As command structures expand, sensemaking becomes distributed when groups at different locations develop partial images of a complex environment. While most sensemaking studies focus on how specific groups attempt to collectively construct a plausible representation of the situation, few accounts of distributed sensemaking have appeared. This study explains how crisis managers made sense of the volatile situation across different command structures. Twenty‐five crisis managers from different teams were interviewed by making use of the critical decision methodology. The analysis points to five factors that influence the quality of distributed sensemaking: type of interdependence, sensitivity to operations, plausibility, hierarchy, and identity. It signals that updating one's sensemaking does not only require noticing discrepant cues but is especially related to key social‐cognitive and organisational processes that stimulate doubt, questioning, and a plurality of perspectives.
The impact of radiation therapist‐led structured peer review meetings on compliance to Radiation Oncology Practice Standards
Authors: West Katrina , Hardcastle‐Fowler Tegan , Coburn Natalie , Beldham‐Collins Rachael , Harris Jill , Ahern Verity
Published: November 2021

Introduction

Regular tumour‐specific peer review meetings (TPRMs) were established by our group during 2016. A dedicated Quality Assurance Radiation Therapist (QART) was employed in 2018 to co‐ordinate the meetings and for each patient, complete the Peer Review Audit Tool (PRAT) of the Royal Australian and New Zealand College of Radiologists (RANZCR). The aim of the current quality assurance study was to investigate the impact of the TPRMs and appointment of the QART on compliance to relevant RANZCR Radiation Oncology Practice Standards (ROPS).

Methods

Tumour‐specific peer review meetings for eight tumour sites were assessed across our group’s three hospitals from January 2017 to December 2019. Data from meetings were collected using the PRAT or from paper‐based minutes and assessed against four ROPS (ROPS 3, 4, 8 and 9). Compliance with each of the four standards was measured by presence of the required documentation and presentation at TPRM, as recorded by the PRAT.

Results

There was an increase in the overall number of peer review cases audited from 173 in the 2017 calendar year to 469 in 2018 and 619 in 2019, representing 7%, 18% and 22% of all treatment courses started during these years, respectively. Staging was the most incompletely documented item across all years for audited patients. The request for radiation treatment plan modifications increased year‐on‐year: modifications were requested for 5% of plans in 2017 (8/172), 18% in 2018 (81/452) and 19% (119/619) in 2019.

Conclusion

This study has shown that an increase in the number of cases for peer‐review audit corresponded to the QART‐facilitated TPRMs. Application of the PRAT has identified radiation treatment plan modifications that would otherwise go undetected and without opportunity to improve the quality of patients’ treatment or avoid harm.
Time to get real with qPCR controls: The frequency of sample contamination and the informative power of negative controls in environmental DNA studies
Authors: Hutchins Patrick R. , Simantel Leah N. , Sepulveda Adam J.
Published: November 2021

Environmental (e)DNA methods have enabled rapid, sensitive and specific inferences of taxa presence throughout diverse fields of ecological study. However, use of eDNA results for decision‐making has been impeded by uncertainties associated with false positive tests putatively caused by sporadic or systemic contamination. Sporadic contamination is a process that is inconsistent across samples and systemic contamination occurs consistently over a group of samples. Here, we used empirical data and laboratory experiments to (i) estimate the sporadic contamination rate for each stage of a common, targeted eDNA workflow employing best practice quality control measures under simulated conditions of rare and common target DNA presence, (ii) determine the rate at which negative controls (i.e., “blanks”) detect varying concentrations of systemic contamination, and (iii) estimate the effort that would be required to consistently detect sporadic and systemic contamination. Sporadic contamination rates were very low across all eDNA workflow steps, and, therefore, an intractably high number of negative controls (>100) would be required to determine occurrence of sporadic contamination with any certainty. Contrarily, detection of intentionally introduced systemic contamination was more consistent; therefore, very few negative controls (<5) would be needed to consistently alert to systemic contamination. These results have considerable implications to eDNA study design when resources for sample analyses are constrained.
allodb: An R package for biomass estimation at globally distributed extratropical forest plots
Authors: Gonzalez‐Akre Erika , Piponiot Camille , Lepore Mauro , Herrmann Valentine , Lutz James A. , Baltzer Jennifer L. , Dick Christopher W. , Gilbert Gregory S. , He Fangliang , Heym Michael , Huerta Alejandra I. , Jansen Patrick A. , Johnson Daniel J. , Knapp Nikolai , Král Kamil , Lin Dunmei , Malhi Yadvinder , McMahon Sean M. , Myers Jonathan A. , Orwig David , Rodríguez‐Hernández Diego I. , Russo Sabrina E. , Shue Jessica , Wang Xugao , Wolf Amy , Yang Tonghui , Davies Stuart J. , Anderson‐Teixeira Kristina J.
Published: November 2021

Allometric equations for calculation of tree above‐ground biomass (AGB) form the basis for estimates of forest carbon storage and exchange with the atmosphere. While standard models exist to calculate forest biomass across the tropics, we lack a standardized tool for computing AGB across boreal and temperate regions that comprise the global extratropics.

Here we present an integrated R package, allodb, containing systematically selected published allometric equations and proposed functions to compute AGB. The data component of the package is based on 701 woody species identified at 24 large Forest Global Earth Observatory (ForestGEO) forest dynamics plots representing a wide diversity of extratropical forests.

A total of 570 parsed allometric equations to estimate individual tree biomass were retrieved, checked and combined using a weighting function designed to ensure optimal equation selection over the full tree size range with smooth transitions across equations. The equation dataset can be customized with built‐in functions that subset the original dataset and add new equations.

Although equations were curated based on a limited set of forest communities and number of species, this resource is appropriate for large portions of the global extratropics and can easily be expanded to cover novel forest types.
Phylogenetic multilevel meta‐analysis: A simulation study on the importance of modelling the phylogeny
Authors: Cinar Ozan , Nakagawa Shinichi , Viechtbauer Wolfgang
Published: November 2021

Meta‐analyses in ecology and evolution require special attention due to certain study characteristics in these fields. First, the primary articles in these fields usually report results that are observed from studies conducted with different species, and the phylogeny among the species violates the independence assumption. Second, articles frequently allow the computation of multiple effect sizes which cannot be accounted for by conventional meta‐analytic models. While both issues can be dealt with by utilizing a multilevel model that accounts for phylogeny, the performance of such a model has not been examined extensively. In this article, we investigate the performance of this model in comparison with some simpler models.

We conducted an extensive simulation study where data with different hierarchical structures (in terms of study and species levels) were generated and then various models were fitted to examine their performance. The models we used include the conventional random effects and multilevel random‐effects models along with more complex multilevel models that account for species‐level variance with different variance components. Furthermore, we present an illustrative application of these models based on the data from a meta‐analysis on sizeassortative mating and comment on the results in light of the findings from the simulation study.

Our simulation results show that, when the phylogenetic relationships among the species are at least moderately strong, only the most complex model that decomposes the species‐level variance into nonphylogenetic and phylogenetic components provides approximately unbiased estimates of the overall mean and variance components and yields confidence intervals with an approximately nominal coverage rate. Contrarily, removing the phylogenetic or non‐phylogenetic component leads to biased variance component estimates and an increased risk for incorrect inferences about the overall mean. These findings are supported by the results derived from the illustrative application.

Based on our results, we suggest that meta‐analyses in ecology and evolution should use the model that accounts for both the nonphylogenetic and phylogenetic species‐level variance in addition to the multilevel structure of the data. Any attempts to simplify this model, such as using only the phylogenetic variance component, may lead to erroneous inferences from the data.
Long‐term cognitive and pulmonary functions following a lower versus a higher oxygenation target in the HOT‐ICU trial: protocol and statistical analysis plan
Authors: Crescioli Elena , Riis Jens Ø. , Weinreich Ulla M. , Jensen Jens Ulrik S. , Poulsen Lone M. , Brøchner Anne C. , Lange Theis , Perner Anders , Klitgaard Thomas L. , Schjørring Olav L. , Rasmussen Bodil S.
Published: November 2021

Background

Although supplemental oxygen can be lifesaving, liberal oxygen administration causing hyperoxaemia may be harmful. The targets for oxygenation in patients with acute hypoxaemic respiratory failure acutely admitted to the intensive care unit (ICU) are strongly debated, and consensus on which targets to recommend has not been reached. The Handling Oxygenation Targets in the ICU (HOT‐ICU) trial is a multicentre, randomised, parallel‐group trial of a lower oxygenation target (arterial partial pressure of oxygen [PaO2] = 8 kPa) versus a higher oxygenation target (PaO2 = 12 kPa) in adult ICU patients with acute hypoxaemic respiratory failure. In this study, we aim to evaluate the effects of these targets on long‐term cognitive and pulmonary function in Danish patients, enrolled in the HOT‐ICU trial and surviving to 1‐year follow‐up. We hypothesise that a lower oxygenation target throughout the ICU stay may result in cognitive impairment, whereas a higher oxygenation target may result in impaired pulmonary function.

Methods

All patients enrolled in the HOT‐ICU trial at Danish sites and surviving to 1 year after randomisation are eligible to participate. The last patient is expected to be included by November 2021. A Repeatable Battery for the Assessment of Neuropsychological Status and a body plethysmography, including diffusion capacity for carbon monoxide, both pre‐planned secondary long‐term outcomes of the HOT‐ICU trial, will be obtained.

Conclusion

This study will provide important information on the long‐term effects of a lower versus a higher oxygenation target on cognitive and pulmonary function in adult ICU patients with acute hypoxaemic respiratory failure.
Global estimates of the attributable risk of alcohol consumption on road injuries
Authors: Borges Guilherme , García‐Pacheco José Ángel , Familiar‐Lopez Itziar
Published: November 2021

Background

Alcohol consumption is one of the main risk factors for death by road injuries, but little is known about the global distribution of the population‐attributable risk (PAR) of alcohol use for death by road injuries.

Methods

We used publicly available data from the 2019 Global Burden of Disease Study (GBD) to estimate the PAR of alcohol use for 5 types of road injury, globally and individually for available countries, by socio‐demographic index (SDI), and by age, sex, and year from 1990 to 2019.

Results

6.6% of all road injuries in 2019 were attributable to alcohol consumption, with large variations worldwide; the highest burden was in Europe and among countries classified in the high–middle SDI. PAR was higher in men than in women, and among younger individuals. Important variations in PAR of alcohol were also observed by road injury type, with motorcyclist road injuries having the highest PAR. Overall, PAR showed a small increase during 1990–2019; younger (<39 years old) men showed an increasing trend during this period, while older women had a decreasing trend in PAR.

Conclusions

PAR for alcohol and road injuries is not homogenous. Large PAR for alcohol and road deaths was found in Europe, among men, young adults, and motorcyclists. These results could help public health agencies, law enforcement, and the public guide efforts to reduce these deaths.
Age‐related changes in the fractal dimension of the retinal microvasculature, effects of cardiovascular risk factors and smoking behaviour
Authors: Lemmens Sophie , Luyts Martial , Gerrits Nele , Ivanova Anna , Landtmeeters Charlien , Peeters Reinout , Simons Anne‐Sophie , Vercauteren Julie , Sunaric‐Mégevand Gordana , Van Keer Karel , Molenberghs Geert , De Boever Patrick , Stalmans Ingeborg
Published: November 2021

Purpose

This cross‐sectional study investigates the association between retinal vessel complexity and age and studies the effects of cardiovascular health determinants.

Methods

Retinal vessel complexity was assessed by calculating the box‐counting fractal dimension (Df) from digital fundus photographs of 850 subjects (3–97 years). All photographs were labelled as ‘non‐pathological’ by the treating ophthalmologist.

Results

Statistical models showed a significantly decreasing relationship between age and Df (linear: R‐squared = 0.1897, p < 0.0001; quadratic: R‐squared = 0.2343, p < 0.0001; cubic: R‐squared = 0.2721, p < 0.0001), with the cubic regression model offering the best compromise between accuracy and model simplicity. Multivariate cubic regression showed that age, spherical equivalent and smoking behaviour have an effect (p < 0.0001) on Df. A significantly increasing effect of the number of pack‐years on Df was observed (effect: 0.0004, p = 0.0017), as well as a significantly decreasing effect of years since tobacco abstinence (effect: −0.0149, p < 0.0001).

Conclusion

We propose using a cubic trend with age, refractive error and smoking behaviour when interpreting retinal vessel complexity.
Financial incentives for bowel cancer screening: Results from a mixed methods study in the United Kingdom
Authors: Wilding Sarah , O’Connor Daryl B. , Conner Mark
Published: November 2021

Objectives

The purpose of bowel cancer screening is to test for signs of cancer before symptoms develop. Financial incentives are one potential method to increase participation rates. Few studies have tested incentives in relation to bowel screening in the United Kingdom (UK). The current research explored reactions to different financial incentives to participate in population‐level bowel cancer screening in a UK sample.

Design

An online mixed methods study. Recruitment was via a study recruitment website (https://prolific.ac/).

Methods

499 participants (aged 60–74 years) completed a survey on invitations for population‐level bowel cancer screening using different levels of financial incentives.

Result

Respondents were generally positive about the use of financial incentives. A £10 voucher was most frequently selected as the appropriate amount to incentivise screening participation. The current invitation method with no voucher was judged to be most acceptable but suggested to produce the lowest likelihood of others participating. Offering a £10 voucher that the NHS would not be charged for if not used was the second most acceptable invitation method. There were few differences between invitation methods on own perceived likelihood of participation in bowel screening. Offering a £10 voucher was seen as leading to the greatest likelihood of others participating in bowel screening. Findings were largely unaffected by participant demographics.

Conclusion

The use of small financial incentives to increase bowel cancer screening uptake was generally well received. Impacts of incentives on actual bowel screening rates in UK samples need to be established in the light of the current findings.
Performance of artificial intelligence for detection of subtle and advanced colorectal neoplasia
Authors: Ahmad Omer F. , González‐Bueno Puyal Juana , Brandao Patrick , Kader Rawen , Abbasi Faisal , Hussein Mohamed , Haidry Rehan J. , Toth Daniel , Mountney Peter , Seward Ed , Vega Roser , Stoyanov Danail , Lovat Laurence B.
Published: November 2021

Objectives

There is uncertainty regarding the efficacy of artificial intelligence (AI) software to detect advanced subtle neoplasia, particularly flat lesions and sessile serrated lesions (SSLs), due to low prevalence in testing datasets and prospective trials. This has been highlighted as a top research priority for the field.

Methods

An AI algorithm was evaluated on four video test datasets containing 173 polyps (35,114 polyp‐positive frames and 634,988 polyp‐negative frames) specifically enriched with flat lesions and SSLs, including a challenging dataset containing subtle advanced neoplasia. The challenging dataset was also evaluated by eight endoscopists (four independent, four trainees, according to the Joint Advisory Group on gastrointestinal endoscopy [JAG] standards in the UK).

Results

In the first two video datasets, the algorithm achieved per‐polyp sensitivities of 100% and 98.9%. Per‐frame sensitivities were 84.1% and 85.2%. In the subtle dataset, the algorithm detected a significantly higher number of polyps (P < 0.0001), compared to JAG‐independent and trainee endoscopists, achieving per‐polyp sensitivities of 79.5%, 37.2% and 11.5%, respectively. Furthermore, when considering subtle polyps detected by both the algorithm and at least one endoscopist, the AI detected polyps significantly faster on average.

Conclusions

The AI based algorithm achieved high per‐polyp sensitivities for advanced colorectal neoplasia, including flat lesions and SSLs, outperforming both JAG independent and trainees on a very challenging dataset containing subtle lesions that could have been overlooked easily and contribute to interval colorectal cancer. Further prospective trials should evaluate AI to detect subtle advanced neoplasia in higher risk populations for colorectal cancer.
Longitudinal drifting pattern of larval assemblages in the lower reach of the Yangtze River: Impact of the floodplain lakes and conservation implementation
Authors: Ren Peng , Hou Gang , Schmidt Bjorn V. , Fang Dian , Xu Dongpo
Published: November 2021

Floodplain lakes are significant lateral habitats that play an important role in structuring larval fish assemblages in large river–floodplain ecosystems. The abundance of floodplain lakes, including both naturally connected and main stem‐isolated lakes, declines in a downstream direction in the lower reach of the Yangtze River, forming a longitudinal reduction gradient. We investigated whether this longitudinal reduction gradient of floodplain lakes is an essential driver of the larval fish assemblage patterns in the river. Drifting larval fish were investigated weekly during the prevailing spawning season both in 2014 and 2015 among three locations at Wangjiang (WJ), Zhenjiang (ZJ) and Nantong (NT). Thirty‐four species belonging to 28 genera and eight families were identified. The number and abundances of collected species, the reproduction duration for dominant species and the niche breadth of dominant species all exhibit a longitudinal decrease (WJ > ZJ > NT) in the downstream direction. Additionally, the bloom of larval fish tended to occur earlier at WJ than at ZJ and NT. We suggest that these results reflect the crucial effect of floodplain lake distribution in shaping the longitudinal distribution pattern of larval assemblages. Both natural connected lakes and isolated lakes (with irregular connectivity patterns) play a crucial role in recruitment success of freshwater fish in the system. Hence, conservation and management approaches for fish resources should be concentrated on restoring and maintaining river–lake connectivity in the upstream sections of the lower reach of the Yangtze River.
Siderophores drive invasion dynamics in bacterial communities through their dual role as public good versus public bad
Authors: Figueiredo Alexandre R. T. , Özkaya Özhan , Kümmerli Rolf , Kramer Jos
Published: November 2021

Microbial invasions can compromise ecosystem services and spur dysbiosis and disease in hosts. Nevertheless, the mechanisms determining invasion outcomes often remain unclear. Here, we examine the role of iron‐scavenging siderophores in driving invasions of Pseudomonas aeruginosa into resident communities of environmental pseudomonads. Siderophores can be ‘public goods’ by delivering iron to individuals possessing matching receptors; but they can also be ‘public bads’ by withholding iron from competitors lacking these receptors. Accordingly, siderophores should either promote or impede invasion, depending on their effects on invader and resident growth. Using supernatant feeding and invasion assays, we show that invasion success indeed increased when the invader could use its siderophores to inhibit (public bad) rather than stimulate (public good) resident growth. Conversely, invasion success decreased the more the invader was inhibited by the residents’ siderophores. Our findings identify siderophores as a major driver of invasion dynamics in bacterial communities under iron‐limited conditions.
Habitat percolation transition undermines sustainability in social‐ecological agricultural systems
Authors: Bengochea Paz Diego , Henderson Kirsten , Loreau Michel
Published: November 2021

Steady increases in human population size and resource consumption are driving rampant agricultural expansion and intensification. Habitat loss caused by agriculture puts the integrity of ecosystems at risk and threatens the persistence of human societies that rely on ecosystem services. We develop a spatially explicit model describing the coupled dynamics of an agricultural landscape and human population size to assess the effect of different land‐use management strategies, defined by agricultural clustering and intensification, on the sustainability of the social‐ecological system. We show how agricultural expansion can cause natural habitats to undergo a percolation transition leading to abrupt habitat fragmentation that feedbacks on human's decision making, aggravating landscape degradation. We found that agricultural intensification to spare land from conversion is a successful strategy only in highly natural landscapes, and that clustering agricultural land is the most effective measure to preserve large connected natural fragments, prevent severe fragmentation and thus, enhance sustainability.
Efficacy and safety of ocrelizumab in patients with relapsing‐remitting multiple sclerosis with suboptimal response to prior disease‐modifying therapies: A primary analysis from the phase 3b CASTING single‐arm, open‐label trial
Authors: Vermersch Patrick , Oreja‐Guevara Celia , Siva Aksel , Van Wijmeersch Bart , Wiendl Heinz , Wuerfel Jens , Buffels Regine , Kadner Karen , Kuenzel Thomas , Comi Giancarlo ,   the CASTING Investigators
Published: November 2021

Background and purpose

Using the treatment goal of “no evidence of disease activity” (NEDA) incorporating magnetic resonance imaging (MRI) re‐baselining, we aimed to assess the efficacy of ocrelizumab in patients with relapsing‐remitting multiple sclerosis with a prior suboptimal response, defined by MRI or relapse criteria, to one or two disease‐modifying therapies (DMTs).

Methods

CASTING was a prospective, international, multicenter, single‐arm, open‐label phase 3 trial (NCT02861014). Patients (Expanded Disability Status Scale [EDSS] score ≤ 4.0, with discontinued prior DMT of ≥6 months duration due to suboptimal disease control) received intravenous ocrelizumab 600 mg every 24 weeks for 96 weeks. The primary endpoint was NEDA (defined as absence of relapses, disability progression, and inflammatory MRI measures, with prespecified MRI re‐baselining at Week 8) over 96 weeks.

Results

A total of 680 patients were enrolled, 167 (24.6%) based on MRI activity only. At Week 96, 74.8% (95% confidence interval [CI] 71.3–78.0, n/N = 492/658) of patients had NEDA. NEDA was highest among patients enrolled due to MRI activity alone (80.6% [95% CI 68.6–89.6], n/N = 50/62) versus those enrolled for relapse (75.1% [95% CI 69.0–80.6], n/N = 172/229) or for relapse with MRI (70.5% [95% CI 60.0–79.0], n/N = 74/105). NEDA across subgroups was highest in patients with a baseline EDSS score <2.5 (77.2% [95% CI 72.8–81.2], n/N = 315/408). NEDA was higher in patients receiving one prior DMT (77.6% [95% CI 73.2–81.6], n/N = 312/402) versus two prior DMTs (70.3% [95% CI 64.3–75.8], n/N = 180/256).

Conclusions

In patients switching therapy due to suboptimal disease control, treatment with ocrelizumab led to an overall high NEDA rate across a wide range of disease‐related and demographic subgroups, regardless of prior treatment background, with no new safety signals detected.
Epidemiology and survival trends of motor neurone disease in Northern Ireland from 2015 to 2019
Authors: McCluskey Gavin , Duddy William , Haffey Stephen , Morrison Karen , Donaghy Colette , Duguez Stephanie
Published: November 2021

Background and purpose

This study evaluates the incidence, prevalence and survival trends of motor neurone disease (MND) in Northern Ireland from 2015 to 2019.

Methods

A capture–recapture analysis was performed using five independent data sources. Incidence and prevalence rates were standardized to the European Standard Population. Survival outcomes were analysed using Kaplan–Meier curves and Cox regression analysis.

Results

Amongst 254 total cases of MND, capture–recapture analysis estimated three missing cases (case ascertainment 98.8%). Age standardized incidence of captured cases was 3.12 per 100,000 (2.73, 3.50) and standardized prevalence ranged from 9.45 to 6.49 per 100,000 from 2015 to 2019. Standardized incidence and prevalence rates in 2006 were 1.4 and 3.3 per 100,000 respectively. Of identified cases, 133 (52.4%) were male; 94.5% had amyotrophic lateral sclerosis; median age of onset was 67 years; median time to diagnosis was 12 months (95% confidence interval 11.2, 12.8); survival from diagnosis was 12 months (95% confidence interval 10.6, 15.4); 25 (9.8%) reported a family history of MND or frontotemporal dementia; and a known MND‐associated genetic mutation was identified in 7.9% of total cases, of which the most common was C9orf72 (5.7% of all patients). Factors associated with improved survival were younger age at onset, longer time to diagnosis, attendance at regional MND clinic, and initial neurology presentation as outpatient (all p < 0.001).

Conclusion

The incidence and prevalence of MND in Northern Ireland has increased over the last 10 years, in line with increasing rates reported from other European countries. Improved survival was associated with younger age at onset, longer time to diagnosis, attendance at a regional MND clinic and outpatient presentation to a Neurology Department.
Congenital myasthenic syndrome: Correlation between clinical features and molecular diagnosis
Authors: Estephan Eduardo P. , Zambon Antonio A. , Thompson Rachel , Polavarapu Kiran , Jomaa Danny , Töpf Ana , Helito Paulo V. P. , Heise Carlos O. , Moreno Cristiane A. M. , Silva André M. S. , Kouyoumdjian Joao A. , Morita Maria da Penha , Reed Umbertina C. , Lochmüller Hanns , Zanoteli Edmar
Published: November 2021

Objectives

To present phenotype features of a large cohort of congenital myasthenic syndromes (CMS) and correlate them with their molecular diagnosis.

Methods

Suspected CMS patients were divided into three groups: group A (limb, bulbar or axial weakness, with or without ocular impairment, and all the following: clinical fatigability, electrophysiology compatible with neuromuscular junction involvement and anticholinesterase agents response), group B (limb, bulbar or axial weakness, with or without ocular impairment, and at least one of additional characteristics noted in group A) and group C (pure ocular syndrome). Individual clinical findings and the clinical groups were compared between the group with a confirmed molecular diagnosis of CMS and the group without molecular diagnosis or with a non‐CMS molecular diagnosis.

Results

Seventy‐nine patients (68 families) were included in the cohort: 48 in group A, 23 in group B and 8 in group C. Fifty‐one were considered confirmed CMS (30 CHRNE, 5 RAPSN, 4 COL13A1, 3 DOK7, 3 COLQ, 2 GFPT1, 1 CHAT, 1 SCN4A, 1 GMPPB, 1 CHRNA1), 7 probable CMS, 5 non‐CMS and 16 unsolved. The chance of a confirmed molecular diagnosis of CMS was significantly higher for group A and lower for group C. Some individual clinical features, alterations on biopsy and electrophysiology enhanced specificity for CMS. Muscle imaging showed at least mild alterations in the majority of confirmed cases, with preferential involvement of soleus, especially in CHRNE CMS.

Conclusions

Stricter clinical criteria increase the chance of confirming a CMS diagnosis, but may lose sensitivity, especially for some specific genes.
Paroxysmal slow wave events predict epilepsy following a first seizure
Authors: Zelig Daniel , Goldberg Ilan , Shor Oded , Ben Dor Shira , Yaniv‐Rosenfeld Amit , Milikovsky Dan Z. , Ofer Jonathan , Imtiaz Hamza , Friedman Alon , Benninger Felix
Published: November 2021

Objective

Management of a patient presenting with a first seizure depends on the risk of additional seizures. In clinical practice, the recurrence risk is estimated by the treating physician using the neurological examination, brain imaging, a thorough history for risk factors, and routine scalp electroencephalogram (EEG) to detect abnormal epileptiform activity. The decision to use antiseizure medication can be challenging when objective findings are missing. There is a need for new biomarkers to better diagnose epilepsy following a first seizure. Recently, an EEG‐based novel analytical method was reported to detect paroxysmal slowing in the cortical network of patients with epilepsy. The aim of our study is to test this method's sensitivity and specificity to predict epilepsy following a first seizure.

Methods

We analyzed interictal EEGs of 70 patients admitted to the emergency department of a tertiary referral center after a first seizure. Clinical data from a follow‐up period of at least 18 months were available. EEGs of 30 healthy controls were also analyzed and included. For each EEG, we applied an automated algorithm to detect paroxysmal slow wave events (PSWEs).

Results

Of patients presenting with a first seizure, 40% had at least one additional recurring seizure and were diagnosed with epilepsy. Sixty percent did not report additional seizures. A significantly higher occurrence of PSWEs was detected in the first interictal EEG test of those patients who were eventually diagnosed with epilepsy. Conducting the EEG test within 72 h after the first seizure significantly increased the likelihood of detecting PSWEs and the predictive value for epilepsy up to 82%.

Significance

The quantification of PSWEs by an automated algorithm can predict epilepsy and help the neurologist in evaluating a patient with a first seizure.
Antiseizure medications and thyroid hormone homeostasis: Literature review and practical recommendations
Authors: Rochtus Anne Maria , Herijgers Dorien , Jansen Katrien , Decallonne Brigitte
Published: November 2021

Thyroid hormones play an essential role in central nervous system development, normal physiological brain function, and repair mechanisms. On one hand, thyroid hormone alterations influence cortical excitability, and on the other hand antiseizure medications (ASMs) are associated with alterations in thyroid hormone metabolism. Although this interaction has long been described, and epilepsy is a common and chronic neurological disease, studies describing the interplay are often small and retrospective. We performed a systematic review of the current literature on epilepsy, ASMs, and thyroid hormone metabolism according to PRISMA guidelines. Forty‐seven studies were included. Most studies were retrospective cross‐sectional studies (n = 25) and investigated thyroid function alterations in patients on older ASMs such as phenobarbital, phenytoin, carbamazepine, and valproate. Overall, almost one third of patients with epilepsy had thyroid hormone alterations, especially patients on valproate (25%) and carbamazepine (10%–25%). Studies with patients receiving polytherapy are scarce, but reported a higher risk for hypothyroidism in patients with older age (p = .004), female sex (p = .014), longer duration of epilepsy (p = .001), intractable epilepsy (p = .009), and polytherapy. Studies on newer ASMs are also limited, and further studies on an interplay with thyroid hormone homeostasis are essential to improve the care for epilepsy patients. ASMs are associated with alterations in thyroid hormone metabolism. Thyroid function monitoring is indicated in patients on ASMs, especially those with refractory epilepsy and those on polytherapy. We provide a practical guidance for thyroid function monitoring for the clinician taking care of patients on ASMs.