Enhanced metastatic risk assessment in cutaneous squamous cell carcinoma with the 40-gene expression profile test

Aim: To clinically validate the 40-gene expression profile (40-GEP) test for cutaneous squamous cell carcinoma patients and evaluate coupling the test with individual clinicopathologic risk factor-based assessment methods. Patients & methods: In a 33-site study, primary tumors with known patient outcomes were assessed under clinical testing conditions (n = 420). The 40-GEP results were integrated with clinicopathologic risk factors. Kaplan–Meier and Cox regression analyses were performed for metastasis. Results: The 40-GEP test demonstrated significant prognostic value. Risk classification was improved via integration of 40-GEP results with clinicopathologic risk factor-based assessment, with metastasis rates near the general cutaneous squamous cell carcinoma population for Class 1 and ≥50% for Class 2B. Conclusion: Combining molecular profiling with clinicopathologic risk factor assessment enhances stratification of cutaneous squamous cell carcinoma patients and may inform decision-making for risk-appropriate management strategies

The Leicester 500 Project. Social support and the development of postnatal depressive symptoms, a prospective cohort study

Background. A prospective epidemiology study evaluated the role of specific social and psychological variables in the prediction of depressive symptomatology and disorders following childbirth in a community sample. Measures of social support used previously in clinically depressed populations facilitated further comparison. Methods. Nulliparous pregnant women (N=507) were interviewed during pregnancy with the Interview Measure of Social Relationships (IMSR) and a contextual assessment of pregnancy-related support and adversity and 427 were followed up at 3 months postpartum with the 30-item GHQ, including six depression items. To establish the clinical representativeness of the GHQ, high GHQ scorers and a random subsample of low scorers were interviewed using the SCAN. Regression models were developed using the GHQ Depression scale (GHQ-D), the IMSR and other risk factor data. Results. GHQ-D after childbirth was predicted by lack of perceived support from members of the woman's primary group and lack of support in relation to the event becoming pregnant; this held even after controlling for antenatal depression, neuroticism, family and personal psychiatric history and adversity. Informant-rated deficits in provision of social support also predicted later depression. The size of the primary social network group previously found to be related to depression in women, did not predict depressive symptom development. Conclusion. Predictors of depressive symptom development differ from predictors of recovery from clinical depression in women. Interventions should be designed to reduce specific deficits in social support observed in particular study populations

Multi-modal and short-range transmission loss in thin, ice-covered, near-shore Arctic waters

In the past century, extensive research has been done regarding the sound propagation in Arctic ice sheets. The majority of this research has focused on low-frequency propagation over long distances. Due to changing climate conditions in these environments, experimentation is warranted to determine sound propagation characteristics in, through, and under first-year, thin ice sheets, in shallow water, over short distances. In April 2016 several experiments were conducted approximately 2 km off the coast of Barrow, Alaska on shore-fast, first-year ice, approximately 1 m thick. To determine the propagation characteristics of various sound sources, frequency response functions were measured between a source location and several receiver locations at various distances from 1 m to 1 km. The primary sources used for this experiment were, an underwater speaker with various tonal outputs, an instrumented impact hammer on the ice, and a propane cannon that produced an acoustic blast wave in air. The transmission loss (TL) characteristics of the multipath propagation (air, ice, water) are investigated and reported. Data indicate that TL in frequency bands between 125 and 2000 Hz varied from approximately 3-6 dB per doubling of distance which is consistent with geometrical spreading losses, cylindrical and spherical, respectively