Loose Criteria Research Articles

Outcomes of root canal treatment of first permanent molars among children in Jeddah, Saudi Arabia: A retrospective cohort study

ObjectivesThe first permanent molar (FPM) is considered the tooth most susceptible to caries, as it is the first permanent tooth to erupt in the oral cavity, making it susceptible to environmental conditions that may appear as caries, hypoplasia, or hypomineralization. Several treatment options are available for managing deep caries, including root canal treatment (RCT). However, there is a lack of data on the success and failure rates of RCT in FPM among children. This study aimed to determine the success and failure rates of RCT in FPM among children and related factors. MethodsThis retrospective cohort study was conducted at three major centers in Jeddah, Saudi Arabia. Children aged 9–18 years who underwent an RCT between 2010 and 2019 were included. Clinical and radiographic examinations were also performed. ResultsBased on the loose criteria, most of the evaluated teeth (79.6%) were successfully treated. The treatment failed in only 20.4% of participants. Older patients and teeth with acceptable restoration quality had an increased success rate compared to younger patients and teeth with unacceptable restoration quality. A shorter time lapse between treatment and assessment resulted in a lower success rate compared to a longer time lapse. Based on strict criteria, 72.9% of the patients were successfully treated. The use of a microscope and teeth with acceptable restoration quality resulted in an increased success rate compared to teeth treated without the microscope and with unacceptable restoration quality. ConclusionsThe success rate of this procedure was high. Several factors, including older age, acceptable restoration quality, and the use of a microscope, increase the probability of success.

Epigenome-wide gene-age interaction study reveals reversed effects of MORN1 DNA methylation on survival between young and elderly oral squamous cell carcinoma patients.

DNA methylation serves as a reversible and prognostic biomarker for oral squamous cell carcinoma (OSCC) patients. It is unclear whether the effect of DNA methylation on OSCC overall survival varies with age. As a result, we performed a two-phase gene–age interaction study of OSCC prognosis on an epigenome-wide scale using the Cox proportional hazards model. We identified one CpG probe, cg11676291MORN1 , whose effect was significantly modified by age (HRdiscovery = 1.018, p = 4.07 × 10−07, FDR-q = 3.67 × 10−02; HRvalidation = 1.058, p = 8.09 × 10−03; HRcombined = 1.019, p = 7.36 × 10−10). Moreover, there was an antagonistic interaction between hypomethylation of cg11676291MORN1 and age (HRinteraction = 0.284; 95% CI, 0.135–0.597; p = 9.04 × 10−04). The prognosis of OSCC patients was well discriminated by the prognostic score incorporating cg11676291MORN1 –age interaction (HRhigh vs. low = 3.66, 95% CI: 2.40–5.60, p = 1.93 × 10−09). By adding 24 significant gene–age interactions using a looser criterion, we significantly improved the area under the receiver operating characteristic curve (AUC) of the model at 3- and 5-year prognostic prediction (AUC3-year = 0.80, AUC5-year = 0.79, C-index = 0.75). Our study identified a significant interaction between cg11676291MORN1 and age on OSCC survival, providing a potential therapeutic target for OSCC patients.

Outcomes of primary root canal therapy: An updated systematic review of longitudinal clinical studies published between 2003 and 2020.

BackgroundA comprehensive effort to evaluate outcomes of primary root canal therapy (RCT) between 1966 and 2002 was published by Ng et al. (2007, International Endodontic Journal, 40, 921; 2008, International Endodontic Journal, 41, 6). Changes in endodontic materials and treatment methods warrant an updated analysis of outcomes.ObjectivesThis study aimed to (1) quantify the success rates of primary RCT published between 2003 and 2020; and (2) investigate the influence of some characteristics known/suspected to be associated with treatment outcomes.MethodsAn electronic search was performed in the following databases (01‐01‐2003 to 12‐31‐2020): Pubmed, Embase, CINHAL, Cochrane and Web of Science. Included study designs were longitudinal clinical studies (randomized control trials, cohort studies, retrospective observational studies). Studies with at least twelve‐months of post‐operative review and success rates based on clinical and radiographic criteria were analysed. The terms ‘strict’ (complete resolution of periapical lesion) or ‘loose’ (reduction in size of existing periapical lesion) were used to describe the outcome criteria. Weighted, pooled success rates were calculated. Random effects meta‐regression models were used to investigate potential sources of statistical heterogeneity. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate for quality assessment of the included studies.ResultsForty‐two studies were included in the review. Meta‐analyses showed that the weighted pooled success rates were estimated to be 92.6% (95% CI: 90.5%–94.8%) under ‘loose criteria’ and 82.0% (95% CI: 79.3%–84.8%) under ‘strict’ criteria. The most significant areas of study heterogeneity were year of publication and qualification of operator. The majority (64.29%) of studies were considered to be of low quality of evidence.DiscussionBiological factors continue to have the most significant impact on RCT outcomes. The technological method of instrumentation had no significant effect. The quality of evidence was based primarily on study design and only randomized control trials were considered to be ‘high’ quality of evidence.ConclusionsThe reported success rates show improvement over time. Weighted success rates for studies with a minimum of four‐years follow‐up had better outcomes, compared to those with less than four years, when ‘strict criteria’ were used.RegistrationPROSPERO database (CRD42021226311).

The Time is Ripe for a Consensus Definition of Clinical Recovery in First-episode Psychosis: Suggestions Based on a 10-Year Follow-up Study

ObjectivesA consensus definition of clinical recovery in first-episode psychosis (FEP) is required to improve knowledge about recovery rates in this population. To propose criteria for a future consensus definition, this study aims to investigate rates of clinical recovery when using a standard definition (full psychotic symptom remission and adequate functioning for minimum one year) across both affective and nonaffective FEP groups (bipolar spectrum and schizophrenia spectrum disorders). Second, we aim to explore changes in rates when altering the standard definition criteria. Third, to examine the extent to which healthy controls meet the functioning criteria.Study designIn total, 142 FEP participants and 117 healthy controls preselected with strict criteria, were re-assessed with structured clinical interviews at 10-year follow-up.Study resultsA total of 31.7% were in clinical recovery according to the standard definition, with significantly higher recovery rates in bipolar (50.0%) than in schizophrenia spectrum disorders (22.9%). Both groups’ recovery rates decreased equally when extending duration and adding affective symptom remission criteria and increased with looser functioning criteria. In healthy controls, 18.8% did not meet the standard criteria for adequate functioning, decreasing to 4.3% with looser criteria.ConclusionsFindings suggest that clinical recovery is common in FEP, although more in bipolar than in schizophrenia spectrum disorders, also when altering the recovery criteria. We call for a future consensus definition of clinical recovery for FEP, and suggest it should include affective symptom remission and more reasonable criteria for functioning that are more in line with the general population.

Epigenome-wide three-way interaction study identifies a complex pattern between TRIM27, KIAA0226, and smoking associated with overall survival of early-stage NSCLC.

The interaction between DNA methylation of tripartite motif containing 27 (cg05293407 TRIM27 ) and smoking has previously been identified to reveal histologically heterogeneous effects of TRIM27 DNA methylation on early‐stage non‐small‐cell lung cancer (NSCLC) survival. However, to understand the complex mechanisms underlying NSCLC progression, we searched three‐way interactions. A two‐phase study was adopted to identify three‐way interactions in the form of pack‐year of smoking (number of cigarettes smoked per day × number of years smoked) × cg05293407 TRIM27 × epigenome‐wide DNA methylation CpG probe. Two CpG probes were identified with FDR‐q ≤ 0.05 in the discovery phase and P ≤ 0.05 in the validation phase: cg00060500 KIAA0226 and cg17479956 EXT2 . Compared to a prediction model with only clinical information, the model added 42 significant three‐way interactions using a looser criterion (discovery: FDR‐q ≤ 0.10, validation: P ≤ 0.05) had substantially improved the area under the receiver operating characteristic curve (AUC) of the prognostic prediction model for both 3‐year and 5‐year survival. Our research identified the complex interaction effects among multiple environment and epigenetic factors, and provided therapeutic target for NSCLC patients.

Clinical Efficacy of Sealer-based Obturation Using Calcium Silicate Sealers: A Randomized Clinical Trial

IntroductionThis randomized controlled clinical trial compared the clinical efficacy and outcome of a sealer-based obturation technique (SBO) with calcium silicate sealers and a continuous wave of condensation technique (CWC) with a resin-based sealer. MethodsRoot canals were prepared using rotary instruments and 2.5% sodium hypochlorite. At the next visit, patients were enrolled and randomly assigned into 2 groups on the basis of the obturation protocol: CWC with AH Plus sealer and SBO with Endoseal TCS. Patients were assessed for the level of postoperative pain using a numeric rating scale. The quality of root canal obturation was evaluated in terms of the sealer extrusion, root-filling voids, and level of root filling. The participants were recalled after at least 6 months. Healing of the teeth was determined as a decrease in Periapical Index score and resolution of symptoms. The results were statistically compared by using the χ2 test or Fisher exact test, followed by multivariate analysis with logistic regression. ResultsA total of 74 teeth were included in the analysis (79% recalls), and the mean follow-up period was 17 months (6–29 months). Two groups expressed identical distribution of postoperative pain (P = .973) and similar quality of root canal obturation. The total success rates were 93.2% (CWC 92.3%, SBO 94.3%) by loose criteria and 60.8% (CWC 51.3%, SBO 71.4%) by strict criteria, with no significant differences between the 2 groups. The success rate by loose criteria in teeth with sealer extrusion was significantly lower than those in teeth without sealer extrusion (P = .049). ConclusionsSBO using an Endoseal TCS could be a possible alternative to CWC using AH Plus. Sealer extrusion and postoperative pain were found to negatively impact prognosis of the endodontic treatment.

Speech tested for Zipfian fit using rigorous statistical techniques

Zipf’s law describes the relationship between the frequencies of words in a corpus and their rank. Its most basic form is a simple series, indicating that the frequency of a word is inverselyproportional to its rank:1/2, 1/3, 1/4,...The past two decades have seen the emergence of usage-based and cognitive approaches to language study. A key observation of these approaches, along with the importance of frequency, is that speech differs in substantial and structural ways from writing. Yet, except for a few older analyses performed on very small corpora, most studies of Zipf’s law have been done on written corpora. Further, a judgement of Zifianness in much of this work is based on loose and informal criteria. In fact, sophisticated statistical techniques have been developed for curve fitting in recent years in the mathematics and physics literature. These include the use of the Kolmogorov-Smirnov statistic, along with maximum likelihood estimation to generate p-values and the use of the complementary error function for normal distributions. The latter helps determine if a corpus, failing a Zipfian fit, might be better described by another distribution. In this paper, we will:Show that three corpora of recorded speech follow a power law distribution using rigorous statis- tical techniques: Buckeye, Santa Barbara, MiCaseDescribe preliminary results showing that the techniques outlined in this paper may be useful in the diagnoses of those conditions that can include disordered speech.Explain how to do the analyses described in this paper.Explain how to download and use the R/Python code we have written and packaged as the Zipf Tool Kit

Radiographic periapical healing associated with root-treated teeth accessed through existing crowns: a historical controlled cohort study.

The aim of this study was to determine the periapical healing rate and complications arising from non-surgical root canal treatment (NSRCT) conducted through the existing and retained restoration, compared to that conducted after removal of restoration (direct or indirect) with subsequent placement of a new crown. Two-hundred-and-forty-five teeth met the inclusion criteria and were followed up for 2 years. One-hundred-and-six teeth had NSRCT completed through existing cast restorations, and 57 and 82 had the existing crowns and direct restorations removed (respectively) and received a new crown after NSRCT. Periapical healing was assessed radiographically using strict (complete healing) and loose (complete and incomplete healing) criteria. Multivariable logistic regression models were used to investigate the effect of prior restoration removal on periapical healing following NSRCT, adjusting for potential confounding (p < 0.05). There was no significant (p > 0.05) difference in the periapical healing rates amongst teeth accessed through existing crowns (72%, 90%) versus those where crowns (79%, 93%) or direct restorations (77%, 90%) were removed for NSRCT. The findings were adjusted for the significant influencing factor: size of pre-operative radiolucency (p < 0.05). Of the 109 teeth that were initially accessed through existing crowns, 9 (8%) displayed porcelain fracture or crown de-cementation. Performing root canal treatment through an existing full coverage restoration did not compromise periapical healing and was associated with a low incidence of associated complications. Crown removal before NSRCT is not mandatory for periapical healing but requires a judicious pre-assessment of current and future marginal and restorative integrity.

Artefacts: the big picture in broad terms

My aim in this programmatic paper is to explore the relationship among three important notions: intentionality, disposition and artefact. There wouldn’t be artefacts without what I call “intentional work,” a sustained activity directed to the production of some good. I first present contextualism as a method. Then I use it to delimit the problematic concept ARTEFACT, with the intention to apply it to repertoires of mental dispositions that affect directly our personal identity. The unavoidable but loose criterion of human intervention is used, at least to some degree. Attitudes are intentional states with conceptual content, and concepts are dispositions. We acquire concepts during our lives, sometimes unconsciously, sometimes explicitly through definition of some kind, and each cognitive agent has a unique repertoire of concepts and a unique idiolect as well. The idea that our mental representations (at least some of them) are artefacts might sound strange at first sight, but I shall try to show that it makes full sense. Most of our mental dispositions –those provided with a conceptual content– are themselves artefacts. At the end, we are all different psychologically and culturally because our idiolects and repertoires of concepts are different. For a large part, what makes our species so special is an ongoing process through which homo sapiens makes itself what it is.Keywords: Intentionality, disposition, artefact, contextualism, repertoire.

Effects of data preprocessing on results of the epidemiological analysis of coronary heart disease and behaviour-related risk factors

Background We carried out this study to demonstrate the effects of outcome sensitivity, participant exclusions, and covariate manipulations on results of the epidemiological analysis of coronary heart disease (CHD) and its behaviour-related risk factors. Material and methods Our study population consisted of 1592 54-year-old men, who participated in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. We used the Cox proportional-hazards model to predict the hazard of CHD and applied different sets of outcomes concerning outcome sensitivity and data preprocessing procedures regarding participant exclusions and covariate manipulations. Results The mean follow-up time was 23 years, and 730 men received the CHD diagnosis. Cox regressions based on data with no participant exclusions most often discovered statistically significant associations. Loose inclusion criteria for study participants with any CVD during the follow-up and strict exclusion criteria for participants with no CVD were best in discovering the associations between risk factors and CHD. Outcome sensitivity affected the associations, whereas the covariate type, continuous or categorical, did not. Conclusions This study suggests that excluding study participants who are not disease-free at baseline is probably unnecessary for epidemiological analyses. Epidemiological research reports should present results based on no data exclusions together with results based on reasoned exclusions.

Assessing green bond risk: an empirical investigation

<abstract> Green bonds have gained a significant share in the bond market. However, dynamic risk and its spillover to other conventional bond investments plays an important role in its understanding. In this paper, we analyze the volatility and correlation dynamics between conventional bond and green bond assets under both loose and stringent eligibility green-labeled criteria. We build dynamic conditional correlation (DCC) model specifications using alternative distributional assumptions. We also assess risk dynamics expressed by Value-at-Risk (VaR) and its corresponding loss function. We illustrate risk assessment in within and out-of-sample periods using conventional and green bond returns. The results show that there is significant spillover between conventional and green bond assets, triggering significant hedging strategies. However, these spillover effects are subjected to the type of green-labeled criteria. Finally, a risk assessment using VaR forecasting and its corresponding loss function estimation also demonstrates significant differentiation between green and conventional bonds. </abstract>

Robust and Efficient Optimization Using a Marquardt-Levenberg Algorithm with R Package marqLevAlg

Implementations in R of classical general-purpose algorithms for local optimization generally have two major limitations which cause difficulties in applications to complex problems: too loose convergence criteria and too long calculation time. By relying on a Marquardt-Levenberg algorithm (MLA), a Newton-like method particularly robust for solving local optimization problems, we provide with marqLevAlg package an efficient and general-purpose local optimizer which (i) prevents convergence to saddle points by using a stringent convergence criterion based on the relative distance to minimum/maximum in addition to the stability of the parameters and of the objective function; and (ii) reduces the computation time in complex settings by allowing parallel calculations at each iteration. We demonstrate through a variety of cases from the literature that our implementation reliably and consistently reaches the optimum (even when other optimizers fail), and also largely reduces computational time in complex settings through the example of maximum likelihood estimation of different sophisticated statistical models.

Fake and dishonest participant location scheme in secret image sharing.

A (k,n) threshold secret image sharing (SIS) scheme divides a secret image into n shadows. One can reconstruct the secret image only when holding k or more than k shadows but cannot know any information on the secret from fewer than k shadows. Based on this characteristic, SIS has been widely used in access control, information hiding, distributed storage and other areas. Verifiable SIS aims to prevent malicious behaviour by attackers through verifying the authenticity of shadows and previous works did not solve this problem well. Our contribution is that we proposed a verifiable SIS scheme which combined CRT-based SIS and (2,n+1) threshold visual secret sharing(VSS). Our scheme is applicable no matter whether there exists a third party dealer. And it is worth mentioning that when the dealer is involved, our scheme can not only detect fake participants, but also locate dishonest participants. In general, loose screening criterion and efficient encoding and decoding rate of CRT-based SIS guarantee high-efficiency shadows generation and low recovery computation complexity. The uncertainty of the bits used for screening prevents malicious behavior by dishonest participants. In addition, our scheme has the advantages of lossless recovery, no pixel expansion and precise detection.

Disinfection and outcome of root canal treatment using single-file or multifile systems and Ca(OH)2 medication.

This clinical study reports on the antibacterial effects and outcome of endodontic treatment using either a single-file or a multifile system, associated with calcium hydroxide interappointment medication. The root canals of single-rooted teeth with apical periodontitis were treated by using either Reciproc or BioRaCe instrument systems, 2.5% NaOCl irrigation, and calcium hydroxide medication. Bacteriological samples taken before preparation and immediately before obturation were evaluated for total bacterial counts by quantitative real-time polymerase chain reaction (qPCR). Patients were followed up and the treatment outcome was assessed by clinical and radiographic criteria. Decreasing lesions were classified as success in a lenient criterion or failure in a rigid one. Bacteria were detected in all initial samples (47 cases) and were significantly reduced after treatment in both groups (p<0.001). In the Reciproc and BioRaCe groups, 7/25 (28%) and 11/22 (50%) root canals yielded negative qPCR results before obturation, respectively (p>0.05). Quantitative bacterial reduction was similar between groups (p>0.05). The success rate in the BioRaCe group was 95.5% and 77% in the loose and rigid criterion, respectively. In the Reciproc group, corresponding figures were 88% and 76%. Differences in outcome were not significant (p>0.05). No diseased case showed negative qPCR results for bacteria. A difference of >1 Log10 counts was observed between healed and diseased cases. Root canal treatments of teeth with apical periodontitis using a single-file or a multifile system for preparation, associated with NaOCl irrigation and calcium hydroxide interappointment medication, showed similar antibacterial effectiveness and success rate.

&lt;p&gt;&lt;strong&gt;Areas of endemism on Brazilian mountaintops revealed by taxonomically verified records of Microlicieae (Melastomataceae)&lt;/strong&gt;&lt;/p&gt;

In this study we describe areas of endemism from Brazilian mountaintops associated with campo rupestre vegetation based on taxonomically verified records of Microlicieae (Melastomataceae). To test the relevance of taxonomically vetted data, we compared these areas with those recovered using records downloaded from the Global Biodiversity Information Facility (GBIF) website. A total of 12 areas of endemism are recognized and described, of which only eight (66%) were retrieved using GBIF data. With 1º and 0.5º cells, analyses of GBIF data didn’t detect both individual and consensus areas of endemism with Endemicity scores as high as analyses of taxonomically verified data. Records based on misidentified specimens and/or incorrect coordinates affected the detection of areas of endemism using GBIF data. Our results show that taxonomically verified data may improve the efficiency of areas of endemism identification. Besides, the results suggest that the recovery of stable and continuous areas of endemism may be improved by using larger cells and adopting the loose criterion rule to merge individual areas of endemism into consensus areas. Biogeographically, the results indicate that the evolutionary histories of Chapada Diamantina, Southern Espinhaço and Brazilian Central Plateau were related to the radiation of Microlicieae, especially the genera Lavoisiera, Microlicia, and Trembleya. The expansion of areas of endemism in the Cadeia do Espinhaço was probably accelerated by climatic instability and glaciation cycles from Pliocene to Pleistocene.

A wavelet multi-resolution enabled interpolation Galerkin method for two-dimensional solids

A novel wavelet multi-resolution formulation in which arbitrary specified nodal coefficients can be exactly the function values at the corresponding nodes is proposed to approximate field functions for solid mechanics problems. This wavelet approximation is explicitly constructed based only on properly scattered nodes without any matrix inversion or ad-hoc parameters. It allows easy and automatic node generation and further refinement at any targeted zones, with a loose and explicit criterion. Using this wavelet multi-resolution approximation to create trial and weighted functions, a wavelet multi-resolution enabled interpolation Galerkin method (WMEIGM) is developed. In the proposed WMEIGM, the stiffness matrix can be efficiently evaluated through semi-analytical method. The essential boundary conditions can be imposed with ease as in the finite element method (FEM). The accuracy and convergence of the proposed WMEIGM are examined theoretically and numerically. Numerical results show that the present WMEIGM has an excellent stability against irregular nodal distribution even with an extremely large ratio of the maximum grid size to the minimum, and a strong capacity for handling irregular problem domains with complicated shape. Moreover, a robust multi-resolution enrichment technique is developed for the present WMEIGM for improving local accuracy and for capturing localized steep gradients.

Outcome of Root Canal Treatments Using a New Calcium Silicate Root Canal Sealer: A Non-Randomized Clinical Trial.

Background: The aim of this study was to compare the success rate of root canal treatments undertaken using a calcium silicate root canal sealer in combination with a single cone with non-calcium silicate cement and warm vertical condensation. Methods: 150 necrotic or pulpitic teeth were treated. (REC: 08/H0804/79). Following standardized root canal chemo-debridement. The canals were obturated using warm vertical condensation of gutta-percha and epoxy-based sealer (AH plus) or a calcium silicate sealer (BioRootTM RCS) with a single cone technique. Follow-up assessment was conducted at 12 months using Cone Beam Computed Tomography (CBCT). Results: At 1-year recall, 104 teeth were assessed (51 AH plus, 53 BioRootTM RCS). The success rate using loose criteria for the CBCT images and PA radiographs was respectively 80% and 89% in the AH plus/warm vertical condensation group, 84% and 90% in the BioRootTM RCS/single cone group. There was no statistically significant difference between the two groups (Fisher exact test p value 0.6099 for the CBCT images). Conclusion: Within the limitations of this non-randomized trial, a calcium silicate cement in combination with single cone resulted in a similar proportion of successful cases compared to warm vertical condensation and epoxy-based sealer.

Age differences in false memories for visual scenes and the effect of prior recall

This study investigated age differences in false memory for visual scenes and the effect of immediate recall on subsequent recognition. Eighty children (7–9 years), 74 adolescents (14–16 years), 92 young adults (19–26 years) and 82 older adults (50–80 years) studied four visual scenes and then took a recognition test after either a free-recall task or a filler task. Results showed an age-related decline in false recognition for visual scenes, but this trend was eliminated when participants were asked to free-recall before recognition. Prior recall decreased false recognition in children, but increased false recognition in older adults. Across the lifespan, adolescents had the loosest criterion, children had the lowest false recall, and prior recall increased true recognition in older adults.

The impact of different criteria sets on early remission and identifying its predictors in rheumatoid arthritis: results from an observational cohort (2009-2018).

To assess rates of early remission and investigate the concordance across different remission definitions, and to identify predictors of early remission in Chinese patients with rheumatoid arthritis (RA). For this study, clinical records were retrospectively reviewed for RA patients at rheumatologic clinic in Peking University First Hospital from 2009 to 2018. Disease activity and remission were determined according to DAS28-ESR, CDAI, SDAI, and Boolean criteria. Early remission was defined as time to remission ≤ 6 months. A secondary definition evaluated early remission as ≤ 3 months. Logistic-regression analyses were performed to identify determinants of early remission. A total of 869 consecutive patients contributing 8640 clinic visits were studied. Early remission rates were respectively 42.0% (DAS28-ESR), 25.0% (CDAI), 29.4% (SDAI), and 26.1% (Boolean). Notably, patients achieving remission within 6 months more frequently attained sustained remission in contrast to those not achieving early remission (68.7-75.1% vs. 31.2-33.1%, p < 0.0001). Further logistic-regression analyses revealed male, early RA, as well as initial hydroxycloroquine treatment were independently associated higher probability of early remission, as demonstrated by nearly all definitions, while a higher baseline disease activity (DAS28-ESR, CDAI, and SDAI) lowered the possibility of early remission in corresponding remission indices. The significant associations of treatment-naïve, serological features with early remission were not confirmed. Early remission was strongly associated with sustained remission, however. infrequently achievable in real-life practice. Male, early RA, a low baseline disease activity, and initial hydroxycloroquine treatment were stable independent predictors of early remission.Key Points• Early remission was infrequently achievable in real-life practice, especially measured by stringent indices.DAS28-based early remission appears to be the loosest criterion and the remaining three broadly agreed with each other.• Early remission was significantly associated with sustained remission.• Male, early RA, a low baseline disease activity, and initial hydroxycloroquine treatment were positively correlated with early remission.

Abstract 2771: Identification of novel genes associated with metastasis from TCGA transcriptomic data

Abstract Introduction: Many cancer patients suffer from metastasis in bone, brain, liver and lung. However, understanding of metastasis in molecular level is quite limited. To improve survival rate and quality of life, preventing metastasis is crucial. In this study, we analyzed transcriptomic data with tumor node metastasis (TNM) classification from The Cancer Genome Atlas (TCGA) to identify genes associated with metastasis. Method: TCGA samples in 20 solid tumor types with both transcriptome and TNM annotation data are used. To obtain the best cut point separating cohorts of high and low gene expression, Hothorn and Lausen’s method is used. A contingency table is created with expression separated by the the cut point and presence of staging T, N, M for each gene. Association between the staging category and the gene was calculated with Fisher’s exact test. Results: In total, 13,220 distinct genes including miRNAs are associated with either lymph node or distant metastasis for some cancer types with a loose criteria of p-value &amp;lt; 1.0e-3. Among them, we identified 1,357 genes with p-value &amp;lt; 1.0e-8. ADAMTS12, AURKB, BUB1, C17orf53, CCNA2, CEP55, EPR1, KIF4A, KIF11, KRT80, MELK, MKI67, NCAPG, NEIL3, PBK, PLK1, RRM2, TPX2, miR139, miR30a, miR375, and miR379 appear most commonly in lymph node metastasis for many cancer types. Likewise, NOP56, PKD1L2, miR150, miR365, miR9, miR149, miR210, miR425, miR675, and miR937 are most commonly associated genes in distant metastasis. Many of these genes have been already reported in association with metastasis. Conclusions: This study created comprehensive list of metastasis associated genes for the 20 solid tumors in TCGA. They would be useful as diagnostic and prognostic biomarkers; however, we found therapeutically relevant genes such as PLK1, AURKB, MET, MELK, CDK1, BUB1, and PBK. Some adhesion molecules associated with a particular cancer type might explain its organ destination preference. Among distant metastatic miRNAs discovered, metastasis promoting miRNAs in high abundance might be engaged in homing as exosomal miRNAs by reprogramming destination niche in favor of migrating tumor cells. Further work to reveal metastasis mechanism and to discover some pharmaceutical agents to prevent metastasis will be conducted. Citation Format: Takahiko Koyama, Laxmi Parida. Identification of novel genes associated with metastasis from TCGA transcriptomic data [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2771.