Sleep as a mediator of the relationship between social class and health in higher education students

A substantial body of research indicates that higher education students from lower social class backgrounds tend to have poorer health than those from higher social class backgrounds. To investigate sleep as a potential mediator of this relationship, online survey responses of students from five large Australian universities, one Irish university and one large Australian technical college were analysed in three studies (Study 1 N = 628; Study 2 N = 376; Study 3 N = 446). The results revealed that sleep quality, sleep duration, sleep disturbances, pre-sleep worries and sleep schedule variability mediated the relationship between social class and physical and mental health. Sleep remained a significant mediator when controlling for related variables and other mediators. Thus, the findings suggest that sleep partly explains social class differences in health. We discuss the importance of addressing sleep issues among students from lower social class backgrounds.

Content appraisal and age moderate the relationship between passive social media use and mental ill-being

An important distinction to make when assessing the impact of social media use on mental health is whether the use is passive (e.g., browsing) or active (e.g., posting). Recent research suggests that the connection between passive social media use and mental ill-being is inconsistent, with some research finding a significant negative association, while other research finds no such association. In the present research, we sought to investigate this relationship, as well as two potential moderators of this relationship: the subjective appraisal of social media content social media users consume (i.e., positively or negatively-appraised) and age of users. In a cross-sectional survey of Australian and United States Facebook users (N = 991), there was no direct relationship between passive use and mental ill-being, however user age and positive (but not negative) content appraisal were found to moderate the relationship between passive use and mental ill-being. Specifically, the relationship between passive use and mental ill-being became weaker as subjective positive appraisal increased, and it reversed to become negative at high levels of positive appraisal. Additionally, the positive relationship between passive use and mental ill-being became weaker as age of social media users increased, and the direction of this relationship became negative at the oldest ages of social media users. These results suggest that the relationship between social media use and mental ill-being is more nuanced than previous research suggests. In particular, higher amounts of passive Facebook use may have a less negative, or even a positive effect on social media users' mental health when the content being (passively) consumed is positively appraised, or when users are older.

Intersectional Person Perception: A Scoping Review of Studies Investigating the Roles of Category Relationships and Cognitive Processes

This review considered experimental studies that used an intersectional framework in order to examine (1) how perceived relationship between the categories in a given intersection impacts the perception of its members and (2) how intersectional person perception has been studied through different cognitive processes. A systematic search in databases identified 5,393 records, and a screening processes resulted in 43 articles reporting 110 studies. The way intersectional targets were cognitively processed depended on contextual factors as well as on the perceived relationship between intersected identities (e.g., perceived [in-]congruence between identities). Less prototypical intersectional targets (e.g., Black gay men) sometimes experienced intersectional invisibility, facing both relative advantages (e.g., being less associated with certain negative stereotypes), and disadvantages (e.g., being overlooked, less recognized) compared to more prototypical members of their constituent ingroups (e.g., Black people, gay men). Future work should incorporate observed exceptions to these patterns and expand the cultural context of analysis.

Covariate-specific evaluation of continuous biomarker

Diagnostic tests usually need to operate at a high sensitivity or specificity level in practice. Accordingly, specificity at the controlled sensitivity, or vice versa, is a clinically sensible performance metric for evaluating continuous biomarkers. Meanwhile, the performance of a biomarker may vary across sub-populations as defined by covariates, and covariate-specific evaluation can be informative. In this article, we develop a novel modeling and estimation method for covariate-specific specificity at a controlled sensitivity level. Unlike existing methods which typically adopt elaborate models of covariate effects over the entire biomarker distribution, our approach models covariate effects locally at a specific sensitivity level of interest. We also extend our proposed model to handle the whole continuum of sensitivities via dynamic regression and derive covariate-specific ROC curves. We provide the variance estimation through bootstrapping. The asymptotic properties are established. We conduct extensive simulation studies to evaluate the performance of our proposed methods in comparison with existing methods, and further illustrate the applications in two clinical studies for aggressive prostate cancer.

Evaluation of daily environmental cleaning and disinfection practices in veterans affairs acute and long-term care facilities: A mixed methods study

OBJECTIVES

To describe daily environmental cleaning and disinfection practices and their associations with cleaning rates while exploring contextual factors experienced by healthcare workers involved in the cleaning process.

METHODS

A convergent mixed methods approach using quantitative observations (ie, direct observation of environmental service staff performing environmental cleaning using a standardized observation form) and qualitative interviews (ie, semistructured interviews of key healthcare workers) across 3 Veterans Affairs acute and long-term care facilities.

RESULTS

Between December 2018 and May 2019 a total of sixty-two room observations (N = 3602 surfaces) were conducted. The average observed surface cleaning rate during daily cleaning in patient rooms was 33.6% for all environmental surfaces and 60.0% for high-touch surfaces (HTS). Higher cleaning rates were observed with bathroom surfaces (Odds Ratio OR = 3.23), HTSs (OR = 1.57), and reusable medical equipment (RME) (OR = 1.40). Lower cleaning rates were observed when cleaning semiprivate rooms (OR = 0.71) and rooms in AC (OR = 0.56). In analysis stratified by patient presence (ie, present, or absent) in the room during cleaning, patient absence was associated with higher cleaning rates for HTSs (OR = 1.71). In addition, the odds that bathroom surfaces being cleaned more frequently than bedroom surfaces decreased (OR = 1.97) as well as the odds that private rooms being cleaned more frequently than semi-private rooms also decreased (OR = 0.26; 0.07-0.93). Between January and June 2019 eighteen qualitative interviews were conducted and found key themes (ie, patient presence and semiprivate rooms) as potential barriers to cleaning; this supports findings from the quantitative analysis.

CONCLUSION

Overall observed rates of daily cleaning of environmental surfaces in both acute and long-term care was low. Standardized environmental cleaning practices to address known barriers, specifically cleaning practices when patients are present in rooms and semi-private rooms are needed to achieve improvements in cleaning rates.

Further evidence that system justification amongst the disadvantaged is positively related to superordinate group identification

Members of disadvantaged groups sometimes support societal systems that enable the very inequalities that disadvantaged them. Is it possible to explain this puzzling system-justifying orientation in terms of rational group-interested motives, without recourse to a separate system motive? The social identity model of system attitudes (SIMSA) claims that it is. SIMSA proposes that the system justification shown by a disadvantaged group (e.g., African American women) can sometimes support identity needs that are tied to a more inclusive (superordinate) in-group (e.g., Americans). There is already some supportive evidence for this proposition, but it is not yet clear whether: (1) such trends are visible in a wider range of disadvantaged contexts, and (2) this explanation also applies to those who are strongly invested in their subgroup (e.g., feminists). In two waves of a large nationally representative survey from 21 to 23 European states (N_total = 84,572) and two controlled experiments (N_total = 290 women), we found that: (a) system justification was positively associated with superordinate ingroup identification across multiple cases of disadvantage (Studies 1-3), (b) system justification increased when this inclusive identity was made more salient (Studies 2 & 3), and (c) system justification was visible even amongst feminists when they activated their superordinate (Italian) identity (Study 3).

An exploratory investigation of the reliability and validity of the Independent-Interdependent Problem-Solving Style Scale

The Independent-Interdependent Problem-Solving Scale is based on Cross et al.'s conceptualisation of relational-interdependent self-construal. The IIPSS provides a relatively context-free measure of people's tendencies to solve problems independently or with the help of others. Because previous investigations have not provided extensive evidence for the reliability and validity of the IIPSS, the current research aimed to test the psychometric properties of this novel measure. Investigations of four student samples (combined N = 1157) and one sample comprised of academic researchers (N = 198) generally supported the reliability and validity of the IIPSS. Exploratory factor analysis of IIPSS items yielded a single factor structure. However, confirmatory factor analyses did not demonstrate good model fit for the one factor solution and instead yielded good model fit for two underlying factors. The IIPSS showed adequate test-retest reliability and predicted positive associations with social personality traits. It also showed no significant associations with measures of demand characteristics and social desirability. Future research needs to be undertaken to further assess the factor structure and address shortcomings of the present research such as utilising objective data in addition to self-reports to assess the scale's validity.

Aberrant hyperexpression of the RNA binding protein FMRP in tumors mediates immune evasion

Many human cancers manifest the capability to circumvent attack by the adaptive immune system. In this work, we identified a component of immune evasion that involves frequent up-regulation of fragile X mental retardation protein (FMRP) in solid tumors. FMRP represses immune attack, as revealed by cancer cells engineered to lack its expression. FMRP-deficient tumors were infiltrated by activated T cells that impaired tumor growth and enhanced survival in mice. Mechanistically, FMRP’s immunosuppression was multifactorial, involving repression of the chemoattractant C-C motif chemokine ligand 7 (CCL7) concomitant with up-regulation of three immunomodulators—interleukin-33 (IL-33), tumor-secreted protein S (PROS1), and extracellular vesicles. Gene signatures associate FMRP’s cancer network with poor prognosis and response to therapy in cancer patients. Collectively, FMRP is implicated as a regulator that orchestrates a multifaceted barrier to antitumor immune responses.

What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021

Patients with advanced prostate cancer (APC) may be at greater risk for severe illness, hospitalisation, or death from coronavirus disease 2019 (COVID-19) due to male gender, older age, potential immunosuppressive treatments, or comorbidities. Thus, the optimal management of APC patients during the COVID-19 pandemic is complex. In October 2021, during the Advanced Prostate Cancer Consensus Conference (APCCC) 2021, the 73 voting members of the panel members discussed and voted on 13 questions on this topic that could help clinicians make treatment choices during the pandemic. There was a consensus for full COVID-19 vaccination and booster injection in APC patients. Furthermore, the voting results indicate that the expert's treatment recommendations are influenced by the vaccination status: the COVID-19 pandemic altered management of APC patients for 70% of the panellists before the vaccination was available but only for 25% of panellists for fully vaccinated patients. Most experts (71%) were less likely to use docetaxel and abiraterone in unvaccinated patients with metastatic hormone-sensitive prostate cancer. For fully vaccinated patients with high-risk localised prostate cancer, there was a consensus (77%) to follow the usual treatment schedule, whereas in unvaccinated patients, 55% of the panel members voted for deferring radiation therapy. Finally, there was a strong consensus for the use of telemedicine for monitoring APC patients. PATIENT SUMMARY: In the Advanced Prostate Cancer Consensus Conference 2021, the panellists reached a consensus regarding the recommendation of the COVID-19 vaccine in prostate cancer patients and use of telemedicine for monitoring these patients.

Management of Patients with Advanced Prostate Cancer: Report from the Advanced Prostate Cancer Consensus Conference 2021

BACKGROUND

Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but various areas of management still lack high-level evidence to inform clinical practice. The 2021 Advanced Prostate Cancer Consensus Conference (APCCC) addressed some of these questions to supplement guidelines that are based on level 1 evidence.

OBJECTIVE

To present the voting results from APCCC 2021.

DESIGN, SETTING, AND PARTICIPANTS

The experts identified three major areas of controversy related to management of advanced prostate cancer: newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC), the use of prostate-specific membrane antigen ligands in diagnostics and therapy, and molecular characterisation of tissue and blood. A panel of 86 international prostate cancer experts developed the programme and the consensus questions.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The panel voted publicly but anonymously on 107 pre-defined questions, which were developed by both voting and non-voting panel members prior to the conference following a modified Delphi process.

RESULTS AND LIMITATIONS

The voting reflected the opinions of panellists and did not incorporate a standard literature review or formal meta-analysis. The answer options for the consensus questions received varying degrees of support from panellists, as reflected in this article and the detailed voting results reported in the Supplementary material.

CONCLUSIONS

These voting results from a panel of experts in advanced prostate cancer can help clinicians and patients to navigate controversial areas of management for which high-level evidence is scant. However, diagnostic and treatment decisions should always be individualised according to patient characteristics, such as the extent and location of disease, prior treatment(s), comorbidities, patient preferences, and treatment recommendations, and should also incorporate current and emerging clinical evidence and logistic and economic constraints. Enrolment in clinical trials should be strongly encouraged. Importantly, APCCC 2021 once again identified salient questions that merit evaluation in specifically designed trials.

PATIENT SUMMARY

The Advanced Prostate Cancer Consensus Conference is a forum for discussing current diagnosis and treatment options for patients with advanced prostate cancer. An expert panel votes on predefined questions focused on the most clinically relevant areas for treatment of advanced prostate cancer for which there are gaps in knowledge. The voting results provide a practical guide to help clinicians in discussing treatment options with patients as part of shared decision-making.

Identification and characterization of a new ensemble of cometary organic molecules

In-situ study of comet 1P/Halley during its 1986 apparition revealed a surprising abundance of organic coma species. It remained unclear, whether or not these species originated from polymeric matter. Now, high-resolution mass-spectrometric data collected at comet 67P/Churyumov-Gerasimenko by ESA’s Rosetta mission unveil the chemical structure of complex cometary organics. Here, we identify an ensemble of individual molecules with masses up to 140 Da while demonstrating inconsistency of the data with relevant amounts of polymeric matter. The ensemble has an average composition of C₁H_1.56O_0.134N_0.046S_0.017, identical to meteoritic soluble organic matter, and includes a plethora of chain-based, cyclic, and aromatic hydrocarbons at an approximate ratio of 6:3:1. Its compositional and structural properties, except for the H/C ratio, resemble those of other Solar System reservoirs of organics—from organic material in the Saturnian ring rain to meteoritic soluble and insoluble organic matter –, which is compatible with a shared prestellar history.

A new analysis of Rosetta mass spectra reveals an ensemble of complex organic molecules with striking similarities to other organic reservoirs in the Solar System, including Saturn’s ring rain material, pointing at a likely joint prestellar history.

Brexit and Trump: Which Theory of Social Stasis and Social Change Copes Best With the New Populism?

Why do voters seek to change the political landscape or to retain it? System justification theory (SJT) proposes that a separate system motive to preserve the existing order drives support for the status-quo, and that this motivation operates independently from personal and collective interests. But how does this explanation apply to recent populist shifts in the political order such as Brexit and the emergence of Donald Trump? While the system motive may seem useful in understanding why the usual progressives (Remain/Clinton voters) may want to stick with an established order, it seems insufficient to explain why the more conservative voters (Brexit/Trump voters) would want to upend the establishment. Thus, we compared SJT’s system motive explanation for the system attitudes of voters on both sides of the political divide to an alternative explanation drawn from the newer social identity model of system attitudes (SIMSA). According to SIMSA, the difficulty in explaining the system attitudes of Brexit/Trump and Remain/Clinton voters from SJT’s system motive standpoint can be resolved by focusing instead on the collective interests that both camps seek to satisfy with their votes. We examined these explanations in two studies conducted soon after Brexit (N = 313) and Trump’s election (N = 289) in 2016, with results providing more support for SIMSA than for SJT.

Yield of ASPECTS and collateral CTA Selection for mechanical thrombectomy within 6-24 hours from symptom onset in a hub and spoke system

BACKGROUND

Recent extended window trials support the benefit of mechanical thrombectomy in anterior circulation large vessel occlusions with clinical-radiographic dissociation. Using trial imaging criteria, 6% were found eligible for MT in the EW in a hub-and-spoke system. We examined the eligibility and outcomes in consecutive extended window-mechanical thrombectomy patients using more pragmatic selection criteria.

METHODS

We retrospectively analyzed single-institution data of anterior circulation large vessel occlusions patients presenting between 6-24 h who underwent mechanical thrombectomy based on a priori determined criteria including non-contrast CT head ASPECTS ≥ 6 and/or CTA collateral scores ASITN/SIR 2-4. Primary outcomes consisted of post-mechanical thrombectomy TICI 2b-3 and 3-month modified Rankin scores; safety outcomes consisted of in-hospital mortality and symptomatic intracerebral hemorrhage.

RESULTS

767 consecutive acute ischemic strokes patients presented within the 6-24 hour window, and of these 48 (6%) anterior circulation large vessel occlusions patients underwent mechanical thrombectomy. In this cohort the mean age was 63±17 years, 56% were male, the median NIHSS was 16 [IQR 10-19], the median ASPECTS was 9 (IQR 8-10), and 79% (n=38) had good CTA collaterals. Occlusions were primarily M1 MCA (46%), with 29% tandem occlusions. Successful recanalization (mTICI 2b or 3) was achieved in 73% (n=35), while 6% (n=3) of patients developed symptomatic intracerebral hemorrhage. In-hospital mortality was 25% (n=12) while 40% (n=19) achieved 3-month modified Rankin Scores 0-2.

CONCLUSIONS

Our data suggest the use of pragmatic imaging approach of ASPECTS ≥6 with CTA collateral grade in extended time window which is already established in most hospitals.

Abstract 5708: The DNA methylation landscape of prostate cancer brain metastases

Introduction: Improved survival in prostate cancer through more effective therapies has also led to an increase in the diagnosis of metastases to infrequent locations such as the brain. In the largest cohort of prostate cancer brain metastases (PCBM) yet studied, we investigated the DNA methylation landscape of PCBM.

Methods: Using Illumina EPIC arrays, we profiled the DNA methylation landscapes of 95 metastatic samples from 42 patients, with multi-regional analysis of the metastases from 31 patients. We compared DNA methylation profiles from metastases to the primary prostate cancer (PCa) samples of 18 of these patients. Multi-regional data was obtained for 15 of these. We performed unsupervised analyses of DNA methylation profiles across sample types, and identified differentially methylated CpG sites and regions (DMRs) between PCBM and PCa samples, and PCBM/PCa samples and normal prostate tissue. We integrated our data with targeted-RNA sequencing and whole exome sequencing (WES).

Results: We highlight the epigenetic heterogeneity present in different regions of the PCBM from patients for which multi-regional data were available. While substantial DNA methylation changes were detected in PCa compared to normal prostate tissue, epigenetic dysregulation was strikingly more pronounced in PCBM samples. DNA methylation changes in PCBM involved striking hypermethylation particularly enriched at CpG islands, and associated with activity of the PRC2 complex. We observed a marked distinction of the methylation profiles of SPOP mutant and TMPRSS2-ERG samples. SPOP mutant samples acquired substantially more epigenetic aberrations, particularly enriched at CpG islands which were hypermethylated genome-wide compared to TMPRSS2-ERG PCBM samples, as well as SPOP mutant PCa samples. These changes were strongly associated with the activity of EZH2 and MYC, both of which were overexpressed specifically in SPOP mutant PCBM. TMPRSS2-ERG samples showed fewer DNA methylation changes, but those detected were associated with targets of the SP1 transcription factor.

Conclusion: We show that epigenetic heterogeneity is present in different regions of PCBM. While the distinct methylation landscapes of SPOP mutant and TMPRSS2-ERG PCa has been previously reported, we show that metastasis-specific DNA methylation changes emerge in each of these settings. These observations suggest that the acquisition of DNA methylation changes may be an important feature of PCBM, and may help to improve our understanding of the processes driving the occurrence of these rare metastases.

Citation Format: John Gallon, Antonio Rodriguez-Calero, Sina Maletti, Charlotte Ng, Mark Rubin, Salvatore Piscuoglio. The DNA methylation landscape of prostate cancer brain metastases [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5708.