Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings

BACKGROUND

Innovations in treatments, imaging and molecular characterisation have improved outcomes for people with advanced prostate cancer; however, many aspects of clinical management are devoid of high-level evidence. At the Advanced Prostate Cancer Consensus Conference (APCCC) 2019, many of these topics were addressed, and consensus was not always reached. The results from clinical trials will most reliably plus the gaps.

METHODS

An invited panel of 57 experts voted on 123 multiple-choice questions on clinical management at APCCC 2019. No consensus was reached on 88 (71.5%) questions defined as <75% of panellists voting for the same answer option. We reviewed clinicaltrials.gov to identify relevant ongoing phase III trials in these areas of non-consensus.

RESULTS

A number of ongoing phase III trials were identified that are relevant to these non-consensus issues. However, many non-consensus issues appear not to be addressed by current clinical trials. Of note, no phase III but only phase II trials were identified, investigating side effects of hormonal treatments and their management.

CONCLUSIONS

Lack of consensus almost invariably indicates gaps in existing evidence. The high percentage of questions lacking consensus at APCCC 2019 highlights the complexity of advanced prostate cancer care and the need for robust, clinically relevant trials that can fill current gaps with high-level evidence. Our review of these areas of non-consensus and ongoing trials provides a useful summary, indicating areas in which future consensus may soon be reached. This review may facilitate academic investigators to identify and prioritise topics for future research.

Following the best of us to help them: Group member prototypicality and collective action

While considering the role of group-level factors as predictors of collective action, research has overlooked the role of group prototypes in determining willingness to engage in collective action. To begin to investigate this area, we conducted two correlational studies ( Ns = 141 and 98) in high schools examining the association between prototypical ingroup members’ desire to engage in collective action and participants’ collective action on behalf of a disadvantaged group (immigrants). Results showed a positive association between these two variables. We also investigated boundaries of this effect, finding that the association emerged when participants lacked personal experiences with the disadvantaged group (cross-group friendships; Study 1) or identified more with their ingroup, an effect also found when including a behavioral measure of collective action (Study 2). Intentions to follow the prototypical ingroup member emerged as the mediator (Study 2). It is worth noting that our methodology allowed us to assess prototypicality in a naturalistic context by calculating a metacontrast ratio for each group member, in line with self-categorization theory’s conceptualization of prototypicality. We discuss the theoretical and practical implications, with reference to the role of prototypicality as a means of social influence and to developing social norms in the context of collective action.

Measuring Disability in Consumers of mental health services - psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in Ghana

The World Health Disability Assessment Scale (WHODAS-2.0) has widely been accepted as the standard measure of disability. However, psychometric testing is mostly performed in developed countries. This paper aims to assess the psychometric properties (reliability, validity) of the WHODAS-2.0 among consumers of mental health services in Ghana. Two translators (expert in English language and Akan language) performed forward and backward translation of the WHODAS-2.0 from English language to Ghanaian language (Twi). A total of 510 consumers of mental health services were recruited consecutively to complete the WHODAS-2.0 using RedCAP. Confirmatory factor analysis was used to analyse the data. All domains in the 6-factor solutions had excellent internal consistency (ω = 0.90-0.98), sufficient convergent validity and had satisfactory discriminant validity except for domain on participation. The CFA model confirmed that the data had a good model fit, CFI = 0.97, TLI = 0.96, RMESA = 0.05, RMR = 0.03; NFI = 0.94; χ²  = 1243.8, df = 529, P < 0.001. Although the WHODAS 2.0 had satisfactory psychometric properties and was thus considered to be a reliable and valid measure for assessing disability and level of functioning in consumers of mental health services, researchers and clinicians should re-consider items within the participation domain. Also, practitioners are encouraged to integrate the WHODAS-2.0 into the collection of data on clinical outcomes, as well as, collecting data on government social protection intervention programmes for consumers.

Molecular medicine tumor board: whole-genome sequencing to inform on personalized medicine for a man with advanced prostate cancer

PURPOSE

Molecular profiling of cancer is increasingly common as part of routine care in oncology, and germline and somatic profiling may provide insights and actionable targets for men with metastatic prostate cancer. However, all reported cases are of deidentified individuals without full medical and genomic data available in the public domain.

PATIENT AND METHODS

We present a case of whole-genome tumor and germline sequencing in a patient with advanced prostate cancer, who has agreed to make his genomic and clinical data publicly available.

RESULTS

We describe an 84-year-old Caucasian male with a Gleason 10 oligometastastic hormone-sensitive prostate cancer. Whole-genome sequencing provided insights into his tumor's underlying mutational processes and the development of an SPOP mutation. It also revealed an androgen-receptor dependency of his cancer which was reflected in his durable response to radiation and hormonal therapy. Potentially actionable genomic lesions in the tumor were identified through a personalized medicine approach for potential future therapy, but at the moment, he remains in remission, illustrating the hormonal sensitivity of his SPOP-driven prostate cancer. We also placed this patient in the context of a large prostate-cancer cohort from the PCAWG (Pan-cancer Analysis of Whole Genomes) group. In this comparison, the patient's cancer appears typical in terms of the number and type of somatic mutations, but it has a somewhat larger contribution from the mutational process associated with aging.

CONCLUSION

We combined the expertise of medical oncology and genomics approaches to develop a molecular tumor board to integrate the care and study of this patient, who continues to have an outstanding response to his combined modality treatment. This identifiable case potentially helps overcome barriers to clinical and genomic data sharing.

Abstract 1434: Uncovering the mechanism of adaptive resistance to RET inhibitors in RET rearranged thyroid cancer

Kinase inhibitors are a critical tool for cancer treatment, but their efficacy is limited by resistance mechanisms. In thyroid and lung cancer RET gene rearrangements result in constitutive MAPK pathway activation and drive malignancy. While treatment with new selective RET inhibitors has been associated with significant clinical responses, a majority of patients experience a partial response or disease stabilization as their best clinical outcome. Resistance to RET inhibitors has emerged as a clinical problem requiring new treatment strategies. Using a combination of drug screening, proteomic, and biochemical profiling we identified a strategy to overcome adaptive resistance to RET inhibitors in human thyroid cancer cell lines and vertebrate animal models. The identification of alternative signaling pathways that reactivates ERK signaling as a mechanism of resistance to RET inhibitors provides an opportunity to anticipate resistance to selective RET inhibitors and use combination therapy that leads to more significant and durable anti-tumor responses in patients with RET rearranged cancers.

Citation Format: Renuka Raman, Jacques Villefranc, Timothy Ullmann, Jessica Thiesmeyer, Viviana Anelli, Chantal Pauli, Rohan Bareja, Kenneth Wha Eng, Princesca Dorsaint, David Wilkes, Shaham Beg, Reid Shaw, Michael Churchill, Naveen Gumpeni, Theresa Scognamiglio, Mark Rubin, Carla Grandori, Juan Mosquera, Juan Mosquera, Juan Mosquera, Noah Dephoure, Andrea Sboner, Olivier Elemento, Yariv Houvras. Uncovering the mechanism of adaptive resistance to RET inhibitors in RET rearranged thyroid cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1434.

Emotions in Intergroup Contact: Incidental and Integral Emotions' Effects on Interethnic Bias Are Moderated by Emotion Applicability and Subjective Agency

This research draws from three distinct lines of research on the link between emotions and intergroup bias as springboard to integrative, new hypotheses. Past research suggests that emotions extrinsic to the outgroup (or “incidental”), and intrinsic to the outgroup (or “integral”), produce valence-congruent effects on intergroup bias when relevant or “applicable” to the outgroup (e.g., incidental/integral anger and ethnic outgroups). These emotions produce valence incongruent effects when irrelevant or “non-applicable” to the outgroup (e.g., incidental/integral sadness and happiness, and ethnic outgroups). Internally valid and ecologically sound tests of these contrasting effects are missing; hence we examined them experimentally in meaningful settings of interethnic contact. To this end, we hybridized established research paradigms in mood and intergroup contact research; this approach enabled us to use same materials and induction methods to instigate incidental and integral emotions in a single research design. In Experiment 1, White Australian students (N = 93) in in vivo real face-to-face contact with an ethnic tutor in their classroom displayed less interethnic bias when incidentally sad (vs. happy) or integrally happy (vs. sad). In Experiment 2, White American males' (N = 492) anti-Arab bias displayed divergent effects under incidental vs. integral (non-applicable) sadness/happiness and similar effects under incidental vs. integral (applicable) anger. The role of perceptions of agency in the emotion-inducing situation is also explored, tested, and explained drawing from mainstream emotion theory. As expected, integral and incidental applicable emotions caused valence congruent effects, at the opposite sides of the subjective agency spectrum, by encouraging the generalization of dislike from the outgroup contact partner to the outgroup as a whole. On the other hand, incidental-non-applicable emotions caused valence-incongruent effects on bias, under high agency conditions, by encouraging (non-partner-centered) heuristic processing. Because of the improved methodology, these effects can be regarded as genuine and not the byproduct of methodological artifacts. This theory-driven and empirically sound analysis of the interplay between emotion source, emotion applicability and subjective agency in intergroup contact can increase the precision of emotion-based bias reduction strategies by deepening understanding of the emotion conditions that lead to intergroup bias attenuation vs. exacerbation.

Factors Predicting Trial Engagement, Treatment Satisfaction, and Health-Related Quality of Life During a Web-Based Treatment and Social Networking Trial for Binge Drinking and Depression in Young Adults: Secondary Analysis of a Randomized Controlled Trial

BACKGROUND

Mental health and alcohol use problems are among the most common causes of disease burden in young Australians, frequently co-occur (comorbidity), and lead to significant lifetime burden. However, comorbidities remain significantly underdetected and undertreated in health settings. Digital mental health tools designed to identify at-risk individuals, encourage help-seeking, or deliver treatment for comorbidity have the potential to address this service gap. However, despite a strong body of evidence that digital mental health programs provide an effective treatment option for a range of mental health and alcohol use problems in young adults, research shows that uptake rates can be low. Thus, it is important to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e-mental health interventions for comorbidity.

OBJECTIVE

In this study, we seek to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e-mental health interventions for comorbid alcohol and mood disorders. The aim is to determine the importance of personality (ie, Big Five personality traits and intervention attitudes), affective factors (ie, depression, anxiety, and stress levels), and baseline alcohol consumption in predicting intervention trial engagement at sign-up, satisfaction with the online tool, and quality of life at the end of the iTreAD (Internet Treatment for Alcohol and Depression) trial.

METHODS

Australian adults (N=411) aged between 18 and 30 years who screened positive for depression and alcohol use problems signed up for the iTreAD project between August 2014 and October 2015. During registration, participants provided information about their personality, current affective state, alcohol use, treatment expectations, and basic demographic information. Subsequent follow-up surveys were used to gauge the ongoing trial engagement. The last follow-up questionnaire, completed at 64 weeks, assessed participants' satisfaction with web-based treatment and quality-of-life outcomes.

RESULTS

Multiple linear regression analyses were used to assess the relative influence of predictor variables on trial engagement, treatment satisfaction, and quality-of-life outcomes. The analyses revealed that the overall predictive effects of personality and affective factors were 20% or lower. Neuroticism constituted a unique predictor of engagement with the iTreAD study in that neuroticism facilitated the return of web-based self-assessments during the study. The return of incentivized follow-up assessments predicted treatment satisfaction, and state-based depression predicted variance in quality-of-life reports at study completion.

CONCLUSIONS

Our findings suggest that traditional predictors of engagement observed in face-to-face research may not be easily transferable to digital health interventions, particularly those aimed at comorbid mental health concerns and alcohol misuse among young adults. More research is needed to identify what determines engagement in this population to optimally design and execute digital intervention studies with multiple treatment aims.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN): 12614000310662; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365137&isReview=true.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1186/s12889-015-2365-2.

In a Class on Their Own: Investigating the Role of Social Integration in the Association Between Social Class and Mental Well-Being

It has been established that people from lower social classes tend to have poorer mental well-being compared with people from higher classes. Research also suggests that people from the lower classes are also less socially integrated. This research investigated the role of social integration in the relationship between social class and mental well-being across three studies (Study 1 N = 15,028; Study 2 N = 1,946; Study 3 N = 461). Across all studies, social class had an indirect effect on mental well-being via social integration. Moderation results found that social integration buffers the negative impact of financial issues on mental well-being, social support buffers the effects of class on mental ill-health, and family support amplifies rather than reduces social class differences in mental well-being. We propose that although improving social integration has the potential to improve the mental well-being of lower class populations, some caveats need to be considered.

Explaining the association between subjective social status and mental health among university students using an impact ratings approach

Previous research has found a positive association between social class and mental health among university students. Various mediators of this association have been proposed. However, the extent to which students perceive these mediators as having an impact on their mental health has not been investigated. It is important to investigate this issue because students who do not perceive issues as having an impact on their mental health may not be motivated to address those issues. In the current study, 402 first-year undergraduate psychology students from a large Australian university indicated the extent to which 32 issues had a negative impact on their mental health over the past six months. Students rated lack of money, time management, coursework assessment items, lack of sleep, and course marks as having the largest impact on their mental health. Lack of money and time management mediated the positive association between subjective social status and mental health over (a) the past week and (b) the past month. Coursework assessment items and course marks mediated the positive association between subjective social status and satisfaction with the university experience. It is concluded that interventions should focus on these relatively high impact issues in order to address social class differences in students' mental health and university satisfaction.

Openness to Experience Moderates the Association Between Problem-Solving Style and Negative Affect

Abstract. Everyday problem-solving situations can be approached on an independent or interdependent basis. The current article investigated the moderating effects of openness to experience and self-efficacy on the relation between an independent versus interdependent problem-solving style and negative affect (stress, anxiety, depression, and neuroticism). Australian university students ( Ns = 399, 186, 337, and 248) and international academic researchers ( N = 199) took part in research studies examining the relations between personality, problem-solving-style, and mental health. Openness to experience moderated the association between problem-solving style and negative affect in all five studies. When openness was low, independent problem-solvers reported greater negative emotionality compared to interdependent problem-solvers. Further, the moderating effect of openness to experience on trait-based negative affectivity (i.e., neuroticism) was mediated by state-based negative emotional experiences of anxiety and stress. The moderating effect of self-efficacy appraisals was only statistically significant on specific anxiety about solving problems. Openness to experience seems to help alleviate the negative mental consequences of independent problem-solvers. These findings have implications for clinical practice with regard to building a therapeutic relationship and retaining clients.

Subjective status and perceived legitimacy across countries

The relationships between subjective status and perceived legitimacy are important for understanding the extent to which people with low status are complicit in their oppression. We use novel data from 66 samples and 30 countries (N = 12,788) and find that people with higher status see the social system as more legitimate than those with lower status, but there is variation across people and countries. The association between subjective status and perceived legitimacy was never negative at any levels of eight moderator variables, although the positive association was sometimes reduced. Although not always consistent with hypotheses, group identification, self-esteem, and beliefs in social mobility were all associated with perceived legitimacy among people who have low subjective status. These findings enrich our understanding of the relationship between social status and legitimacy.

Work Group Report: Perspectives in Diagnosis and Management of Exercise-Induced Bronchoconstriction in Athletes

Exercise-induced bronchoconstriction, otherwise known as exercise-induced bronchoconstriction with asthma or without asthma, is an acute airway narrowing that occurs as a result of exercise and can occur in patients with asthma. A panel of members from the American Academy of Allergy, Asthma & Immunology Sports, Exercise, & Fitness Committee reviewed the diagnosis and management of exercise-induced bronchoconstriction in athletes of all skill levels including recreational athletes, high school and college athletes, and professional athletes. A special emphasis was placed on the recommendations and regulations set forth by professional athletic organizations after a detailed review of their collective bargaining agreements, substance abuse policies, antidoping program manuals, and the World Anti-Doping Agency antidoping code. The recommendations in this review are based on currently available evidence in addition to providing guidance for athletes of all skill levels as well as their treating physicians to better understand which pharmaceutical and nonpharmaceutical management options are appropriate as well as which medications are permitted or prohibited, and the proper documentation required to remain compliant.

Young People's Voices Regarding the Use of Social Networking Sites to Plan for a Night Out Where Alcohol Is Involved

The risk of alcohol related harm is experienced disproportionality by young people aged 15-24 years. Harmful use of alcohol has serious effects on individual physical and mental wellbeing and is considered by the World Health Organization to be one of the main risk factors for poor health globally. It is crucial to understand the factors that influence drinking behavior in young people in order to inform prevention strategies to prevent problematic drinking. This is particularly paramount during the transition into young adulthood (around 18-25 years), when risky health behaviors are likely to become embedded. This pilot study adopted a qualitative descriptive methodology that facilitates exploration of what young people say about their own experiences and behavior, as it relates to SNS use and alcohol consumption. Semi-structured interviews were conducted in Newcastle, NSW Australia. An inductive, semantic approach to thematic analysis was selected to analyze the data as this method supported the exploratory nature of the pilot study and ensured that the themes identified were strongly linked to the data. Four main organizing themes that arose from the collected data were: organizing friends; safety amongst friends, planning not to plan; and different event - different plans. All of the participants stated they preferred to use Facebook Messenger™ to connect and share in a group conversation with peers. Convenience, cost and accessibility emerged as the main reasons for using SNSs to plan nights out. Planning for a night out using SNSs allows young people to impulsively plan and change plans - making planning fluid and asynchronous. To date, despite the global use of SNSs, the influence of SNSs in young adults' planning for events during which alcohol is served is relatively unknown. This pilot study gives us a some understanding of how young people use SNSs to plan and prepare for a night out where alcohol is served. Further research needs to be conducted to determine whether SNSs can be used effectively to promote health behavior change or be used as forums for advice seeking and support when attending events where alcohol is served, with the ultimate goal of lowering risky behaviors and thereby improving health outcomes for young people.

Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review

This integrative review aimed to identify and synthesize evidence on workplace stress and resilience in the Australian nursing workforce. A search of the published literature was conducted using EMBASE, MEDLINE, CINAHL (EBSCO), PsycINFO, Web of Science, and Scopus. The search was limited to papers published in English from January 2008 to December 2018. The review integrated both qualitative and quantitative data into a single synthesis. Of the 41 papers that met the inclusion criteria, 65.85% (27/41) used quantitative data, 29.26% (12/41) used qualitative data, and 4.87% (2/41) used mixed methods. About 48.78% (20/41) of the papers addressed resilience issues, 46.34% (19/41) addressed workplace stress, and 4.87% (2/41) addressed both workplace stress and resilience. The synthesis indicated that nurses experience moderate to high levels of stress. Several individual attributes and organizational resources are employed by nurses to manage workplace adversity. The individual attributes include the use of work-life balance and organizing work as a mindful strategy, as well as self-reliance, passion and interest, positive thinking, and emotional intelligence as self-efficacy mechanisms. The organizational resources used to build resilience are support services (both formal and informal), leadership, and role modelling. The empirical studies on resilience largely address individual attributes and organizational resources used to build resilience, with relatively few studies focusing on workplace interventions. Our review recommends that research attention be devoted to educational interventions to achieve sustainable improvements in the mental health and wellbeing of nurses.

Management of Patients with Advanced Prostate Cancer: Report of the Advanced Prostate Cancer Consensus Conference 2019

BACKGROUND

Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guidelines that are based on level 1 evidence.

OBJECTIVE

To present the results from the APCCC 2019.

DESIGN, SETTING, AND PARTICIPANTS

Similar to prior conferences, experts identified 10 important areas of controversy regarding the management of advanced prostate cancer: locally advanced disease, biochemical recurrence after local therapy, treating the primary tumour in the metastatic setting, metastatic hormone-sensitive/naïve prostate cancer, nonmetastatic castration-resistant prostate cancer, metastatic castration-resistant prostate cancer, bone health and bone metastases, molecular characterisation of tissue and blood, inter- and intrapatient heterogeneity, and adverse effects of hormonal therapy and their management. A panel of 72 international prostate cancer experts developed the programme and the consensus questions.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The panel voted publicly but anonymously on 123 predefined questions, which were developed by both voting and nonvoting panel members prior to the conference following a modified Delphi process.

RESULTS AND LIMITATIONS

Panellists voted based on their opinions rather than a standard literature review or formal meta-analysis. The answer options for the consensus questions had varying degrees of support by the panel, as reflected in this article and the detailed voting results reported in the Supplementary material.

CONCLUSIONS

These voting results from a panel of prostate cancer experts can help clinicians and patients navigate controversial areas of advanced prostate management for which high-level evidence is sparse. However, diagnostic and treatment decisions should always be individualised based on patient-specific factors, such as disease extent and location, prior lines of therapy, comorbidities, and treatment preferences, together with current and emerging clinical evidence and logistic and economic constraints. Clinical trial enrolment for men with advanced prostate cancer should be strongly encouraged. Importantly, APCCC 2019 once again identified important questions that merit assessment in specifically designed trials.

PATIENT SUMMARY

The Advanced Prostate Cancer Consensus Conference provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference, which has been held three times since 2015, aims to share the knowledge of world experts in prostate cancer management with health care providers worldwide. At the end of the conference, an expert panel discusses and votes on predefined consensus questions that target the most clinically relevant areas of advanced prostate cancer treatment. The results of the voting provide a practical guide to help clinicians discuss therapeutic options with patients as part of shared and multidisciplinary decision making.

Examining the Dimensionality, Reliability, and Invariance of the Depression, Anxiety, and Stress Scale–21 (DASS-21) Across Eight Countries

This study evaluated the dimensionality, invariance, and reliability of the Depression, Anxiety, and Stress Scale–21 (DASS-21) within and across Brazil, Canada, Hong Kong, Romania, Taiwan, Turkey, United Arab Emirates, and the United States ( N = 2,580) in college student samples. We used confirmatory factor analyses to compare the fit of four different factor structures of the DASS-21: a unidimensional model, a three-correlated-factors model, a higher order model, and a bifactor model. The bifactor model, with three specific factors (depression, anxiety, and stress) and one general factor (general distress), presented the best fit within each country. We also calculated ancillary bifactor indices of model-based dimensionality of the DASS-21 and model-based reliability to further examine the validity of the composite total and subscale scores and the use of unidimensional modeling. Results suggested the DASS-21 can be used as a unidimensional scale. Finally, measurement invariance of the best fitting model was tested across countries indicating configural invariance. The traditional three-correlated-factors model presented scalar invariance across Canada, Hong Kong, Romania, Taiwan, and the United States. Overall, these analyses indicate that the DASS-21 would best be used as a general score of distress rather than three separate factors of depression, anxiety, and stress, in the countries studied.

Comparison of neutral outgassing of comet 67P/Churyumov-Gerasimenko inbound and outbound beyond 3 AU from ROSINA/DFMS

CONTEXT

Pre-equinox measurements of comet 67P/Churyumov-Gerasimenko with the mass spectrometer ROSINA/DFMS on board the Rosetta spacecraft revealed a strongly heterogeneous coma. The abundances of major and various minor volatile species were found to depend on the latitude and longitude of the nadir point of the spacecraft. The observed time variability of coma species remained consistent for about three months up to equinox. The chemical variability could be generally interpreted in terms of surface temperature and seasonal effects superposed on some kind of chemical heterogeneity of the nucleus.

AIMS

We compare here pre-equinox (inbound) ROSINA/DFMS measurements from 2014 to measurements taken after the outbound equinox in 2016, both at heliocentric distances larger than 3 AU. For a direct comparison we limit our observations to the southern hemisphere.

METHODS

We report the similarities and differences in the concentrations and time variability of neutral species under similar insolation conditions (heliocentric distance and season) pre- and post-equinox, and interpret them in light of the previously published observations. In addition, we extend both the pre- and post-equinox analysis by comparing species concentrations with a mixture of CO₂ and H₂O.

RESULTS

Our results show significant changes in the abundances of neutral species in the coma from pre- to post-equinox that are indicative of seasonally driven nucleus heterogeneity.

CONCLUSIONS

The observed pre- and post-equinox patterns can generally be explained by the strong erosion in the southern hemisphere that moves volatile-rich layers near the surface.

mHealth Interventions to Reduce Alcohol Use in Young People: A Systematic Review of the Literature

Harmful use of alcohol has serious effects on public health and is considered a significant risk factor for poor health. mHealth technology promotes health behavior change and enhances health through increased social opportunities for encouragement and support. It remains unknown whether these types of applications directly influence the health status of young people in reducing harmful levels of alcohol consumption. The purpose of this systematic review is to examine current evidence on the effectiveness of mHealth technology use in positively influencing alcohol-related behaviors of young people without known alcohol addiction. Relevant articles published from 2005 to January 2017 were identified through electronic searches of eight databases. Studies with interventions delivered by mHealth (social networking sites, SMS and mobile phone applications) to young people aged 12-26 years were included. Outcome measures were alcohol use, reduction in alcohol consumption or behavior change. Eighteen studies met the inclusion criteria. Interventions varied in design, participant characteristics, settings, length and outcome measures. Ten studies reported some effectiveness related to interventions with nine reporting a reduction in alcohol consumption. Use of mHealth, particularly text messaging (documented as SMS), was found to be an acceptable, affordable and effective way to deliver messages about reducing alcohol consumption to young people. Further research using adequately powered sample sizes in varied settings, with adequate periods of intervention and follow-up, underpinned by theoretical perspectives incorporating behavior change in young people's use of alcohol, is needed.

Is a system motive really necessary to explain the system justification effect? A response to Jost (2019) and Jost, Badaan, Goudarzi, Hoffarth, and Mogami (2019)

The debate between the proponents of SIMSA and SJT does not pivot on whether system justification occurs - we all agree that system justification does occur. The issue is why it occurs? System justification theory (SJT; Jost & Banaji, 1994, British Journal of Social Psychology, 33, 1) assumes that system justification is motivated by a special system justification motive. In contrast, the social identity model of system attitudes (SIMSA; Owuamalam, Rubin, & Spears, , Current Directions in Psychological Science, 27, 2) argues that there is insufficient conclusive evidence for this special system motive, and that system justification can be explained in terms of social identity motives, including the motivation to accurately reflect social reality and the search for a positive social identity. Here, we respond to criticisms of SIMSA, including criticisms of its social reality, ingroup bias, and hope for future ingroup status explanations of system justification. We conclude that SJT theorists should decide whether system justification is oppositional to, or compatible with social identity motives, and that this dilemma could be resolved by relinquishing the theoretically problematic notion of a system justification motivation.

Revisiting 25 years of system motivation explanation for system justification from the perspective of social identity model of system attitudes

Do the disadvantaged have an autonomous system justification motivation that operates against their personal and group interests? System justification theory (SJT; Jost & Banaji, 1994, Br. J. Soc. Psychol, 33, 1) proposes that they do and that this motivation helps to (1) reduce cognitive dissonance and associated uncertainties and (2) soothe the pain that is associated with knowing that one's group is subject to social inequality. However, 25 years of research on this system justification motivation has given rise to several theoretical and empirical inconsistencies. The present article argues that these inconsistencies can be resolved by a social identity model of system attitudes (SIMSA; Owuamalam, Rubin, & Spears, 2018, Curr. Dir. Psychol. Sci, 27, 91). SIMSA assumes that instances of system justification are often in alignment with (rather than opposed to) the interests of the disadvantaged. According to SIMSA, the disadvantaged may support social systems (1) in order to acknowledge social reality, (2) when they perceive the wider social system to constitute a superordinate ingroup, and (3) because they hope to improve their ingroup's status through existing channels in the long run. These propositions are corroborated by existing and emerging evidence. We conclude that SIMSA offers a more coherent and parsimonious explanation for system justification than does SJT.

Abstract A074: Aberrant activation of a gastrointestinal transcriptional circuit in prostate cancer mediates castration resistance

Prostate cancer exhibits a remarkable lineage-specific dependence on androgen signaling. Lineage-directed therapy using androgen deprivation has been the mainstay of prostate cancer treatment for 70 years. Castration resistance involves reactivation of androgen signaling or activation of alternative lineage programs to bypass androgen requirement. Our studies found that an aberrant gastrointestinal lineage transcriptome is expressed in ~5% of primary prostate cancer that is characterized by abbreviated response to androgen deprivation therapy and in ~30% of castration-resistant prostate cancer. This program is governed by a transcriptional circuit consisting of HNF4G and HNF1A. Cistrome and chromatin analyses revealed that HNF4G is a pioneer factor that generates and maintains enhancer landscape at gastrointestinal lineage genes, independent of AR signaling. In HNF4G/1A-negative prostate cancer, exogenous expression of HNF4G at physiologic levels recapitulates the GI transcriptome, chromatin landscape and leads to relative castration resistance.

Citation Format: Shipra Shukla, Joanna Cyrta, Devan Murphy, Edward Walczak, Leili Ran, Praveen Agrawal, Yuanyuan Xie, Yuedan Chen, Shangqian Wang, Yu Zhan, Wai Pung E. Wong, Andrea Sboner, Himisha Beltran, Juan-Miguel Mosquera, Jessica Sher, Zhen Cao, John Wongvipat, Richard P. Koche, Anuradha Gopalan, Deyou Zheng, Mark Rubin, Howard I. Scher, Ping Chi, Yu Chen. Aberrant activation of a gastrointestinal transcriptional circuit in prostate cancer mediates castration resistance [abstract]. In: Proceedings of the AACR Special Conference: Prostate Cancer: Advances in Basic, Translational, and Clinical Research; 2017 Dec 2-5; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(16 Suppl):Abstract nr A074.