Secondary mathematics teachers' descriptions of student engagement.

There is a need for a more robust conceptualization of engagement in mathematics education research. Investigating how teachers describe engagement can provide insight into relationships between purposes of engagement and dimensions of engagement. In this exploratory study, we examined how 28 secondary mathematics teachers in two states in the USA talked about their students' engagement. During interviews, we asked teachers to provide their definitions for engagement, describe their teaching strategies for engaging students, and describe their observations of engagement during a video clip from their own classroom. We interpreted teachers' talk to identify how they described the nature of mathematics engagement (dimensions such as behavioral, cognitive, affective, and/or social engagement) and purposes of engagement (engagement in learning or in schooling [Harris, 2011]). When teachers described the purpose of engagement as engagement in learning, they also tended to describe the nature of engagement with cognitive and social dimensions and with multiple dimensions of engagement.

Nonlinear pulse compression to 22 fs at 15.6 µJ by an all-solid-state multipass approach.

We demonstrate nonlinear compression of pulses at 1.03 µm and repetition rate of 200 kHz generated by a ytterbium fiber laser using two cascaded all-solid-state multipass cells. The pulse duration has been compressed from 460 to 22 fs, corresponding to a compression factor of ∼21. The compressed pulse energy is 15.6 µJ, corresponding to an average power of 3.1 W, and the overall transmission of the two compression stages is 76%. The output beam quality factor is M2 ∼1.2 and the excess intensity noise introduced by nonlinear broadening is below 0.05%. These results show that nonlinear pulse compression down to ultrashort durations can be achieved with an all-solid-state approach, at pulse energies much higher than previously reported, while preserving the spatial characteristics of the laser.

Fiber laser system for standoff coherent Raman spectroscopy.

A fiber laser system for standoff detection of chemical and biological species by coherent anti-Stokes Raman scattering is presented. The system is based on an ytterbium fiber laser and a hollow-core photonic crystal fiber for generation of broadband pump/Stokes pulses. High-resolution Raman spectra encompassing the fingerprint region (600-1600cm-1) are obtained for toluene, and two simulants of chemical and biological warfare agents, specifically dimethyl methylphosphonate and sodium dipicolinate. The system is operated at standoff distances of 2 m and integration times of 8 ms. The fiber technology makes the approach suitable for implementation as a compact standoff detection and identification system.

Real-Time Detection of HIV-2 by Reverse Transcription-Loop-Mediated Isothermal Amplification.

Currently, there are no FDA-approved nucleic acid amplification tests (NAATs) for the detection or confirmation of HIV-2 infection. Here, we describe the development of a real-time assay for the detection of HIV-2 DNA and RNA using reverse transcription-loop-mediated isothermal amplification (RT-LAMP) and the ESEQuant tube scanner, a portable isothermal amplification/detection device.

Risk factors for significant wound complications following wide resection of extremity soft tissue sarcomas.

BACKGROUND: Wound complications following resection of a localized soft tissue sarcoma have been associated with lower extremity location, large tumor volume, and use of preoperative radiation. Some of these wounds, however, show the potential for healing with local wound care and nonsurgical techniques. We are unaware of any published data establishing factors associated with nonhealing wounds that ultimately are treated with local or free vascularized tissue transfer. QUESTIONS/PURPOSES: The purpose of this study was to determine the variables associated with development of a significant wound complication defined as one that underwent a secondary procedure using local or free tissue transfer after resection of a localized soft tissue sarcoma. METHODS: Using our institution's cancer center database, we identified 140 patients who underwent resection of a localized extremity soft tissue sarcoma at our institution between 1997 and 2010. Thirty-two patients were excluded who underwent immediate planned vascularized tissue transfer, along with 26 patients who did not receive radiation, and an additional three patients were excluded who were followed for less than 1 month. This left 79 patients, including 18 treated with postoperative external beam radiotherapy and 61 with preoperative external beam radiotherapy. Of patients receiving radiation treatment before surgery, 13 received no additional radiation treatment, 33 underwent intraoperative radiation with electrons (IOERT) to sites considered at high risk for local recurrence, and an additional 15 had perioperative brachytherapy. Univariate and multiple regression analyses were performed using frequency of local or free tissue transfer at 3 weeks or greater postoperatively owing to wound-related complications as a dependent variable. RESULTS: Lower extremity location and vascular involvement were associated with use of delayed vascularized tissue coverage for wound-healing problems. Patients in this series who underwent preoperative external beam radiotherapy coupled with dose-escalated IOERT or chemotherapy had a similar rate of flap use compared with patients treated with postoperative radiation. CONCLUSIONS: Patients with tumors of the lower extremity involving major neurovascular structures and for whom radiation therapy is planned should be counseled specifically because they appear to be at increased risk for use of delayed local or free vascularized tissue transfer for a nonhealing wound following resection of a localized extremity soft tissue sarcoma.

Standoff detection of bacterial spores by field deployable coherent Raman spectroscopy.

Vibrational spectroscopies offer great potential for standoff detection of chemical and biological warfare agents, avoiding contamination to the operator and equipment. Among them, particularly promising is Coherent anti-Stokes Raman scattering (CARS) spectroscopy, using synchronized pump/Stokes laser pulses to set up a vibrational coherence of target molecules at a laser focus, which is read by further interaction with a probe pulse, resulting in the emission of a coherent beam detectable at a distance. CARS has previously demonstrated the capability to detect bacterial spores based on the Raman spectrum of the characteristic molecule calcium dipicolinate (CaDPA); however, a complex and bulky laser technology, which is only suitable for a laboratory environment, was employed. Here we develop a broadband CARS setup based on a compact, industrial grade ytterbium laser system. We demonstrate high signal-to-noise ratio detection of Bacillus atrophaeus spores at a concentration of 105 cfu/mm2, at a standoff distance of 1 m, and an acquisition time of 1 s. Our system, which combines chemical specificity and sensitivity along with improved ruggedness and portability, paves the way to a new generation of instruments for real-world standoff detection of chemical and biological threats.

An isothermal amplification reactor with an integrated isolation membrane for point-of-care detection of infectious diseases.

A simple, point of care, inexpensive, disposable cassette for the detection of nucleic acids extracted from pathogens was designed, constructed, and tested. The cassette utilizes a single reaction chamber for isothermal amplification of nucleic acids. The chamber is equipped with an integrated, flow-through, Flinders Technology Associates (Whatman FTA®) membrane for the isolation, concentration, and purification of DNA and/or RNA. The nucleic acids captured by the membrane are used directly as templates for amplification without elution, thus simplifying the cassette's flow control. The FTA membrane also serves another critical role-enabling the removal of inhibitors that dramatically reduce detection sensitivity. Thermal control is provided with a thin film heater external to the cassette. The amplification process was monitored in real time with a portable, compact fluorescent reader. The utility of the integrated, single-chamber cassette was demonstrated by detecting the presence of HIV-1 in oral fluids. The HIV RNA was reverse transcribed and subjected to loop-mediated, isothermal amplification (LAMP). A detection limit of less than 10 HIV particles was demonstrated. The cassette is particularly suitable for resource poor regions, where funds and trained personnel are in short supply. The cassette can be readily modified to detect nucleic acids associated with other pathogens borne in saliva, urine, and other body fluids as well as in water and food.

Multicenter, Open-Label, Phase I Study of DSP-7888 Dosing Emulsion in Patients with Advanced Malignancies.

BACKGROUND: Wilms' tumor 1 (WT1) is overexpressed in various malignancies. DSP-7888 Dosing Emulsion, also known as ombipepimut-S (United States Adopted Name; International Nonproprietary Name: adegramotide/nelatimotide), is an investigational therapeutic cancer vaccine comprising two synthetic peptides derived from WT1 to promote both cytotoxic T-lymphocyte (CTL) and helper T-lymphocyte-mediated immune responses against WT1-expressing tumors. OBJECTIVE: The aim of this study was to report the results from a phase I dose-escalation study (NCT02498665) that evaluated DSP-7888, administered either intradermally (ID) or subcutaneously (SC), in patients with recurrent or advanced malignancies associated with overexpression of WT1. PATIENTS AND METHODS: In this phase I dose-escalation study, patients with recurrent or advanced malignancies associated with overexpression of WT1 who progressed on, were intolerant to, or not a candidate for standard therapy or who presented with a malignancy that had no definite standard therapy received escalating doses of ID or SC DSP-7888 in a rolling-six study design. DSP-7888 3.5, 10.5, or 17.5 (ID only) mg was administered until disease progression or other discontinuation event. Primary objectives were safety, tolerability, and identification of the recommended phase II dose (RP2D). Overall survival (OS) and WT1-specific CTL induction were included as secondary and exploratory objectives, respectively. RESULTS: Twenty-four patients received either ID (3.5 mg, n = 4; 10.5 mg, n = 3; 17.5 mg, n = 3) or SC DSP-7888 (3.5 mg, n = 9; 10.5 mg, n = 5). No dose-limiting toxicity was observed. The most frequent treatment-emergent adverse event was injection site reactions (ID, 100% [10/10]; SC, 35.7% [5/14]); all were grade 1 or 2. Four patients (ID 17.5 mg, n = 1; SC 3.5 mg, n = 1; SC 10.5 mg, n = 2) had stable disease, 16 had progressive disease, and four were not evaluable. Median (95% confidence interval) OS duration was 180.0 (136.0-494.0) days. Among evaluable patients, WT1-specific CTL induction was observed in 66.7% (6/9) and 41.7% (5/12) of those administered ID and SC DSP-7888, respectively. CONCLUSIONS: DSP-7888 Dosing Emulsion was well tolerated, with no dose-limiting toxicities, in patients with recurrent or advanced malignancies. Higher WT1-specific CTL induction activity was noted with ID compared with SC administration; because of this, the ID route was selected for further evaluation in the clinical program. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02498665.

Altered Antibody Responses in Persons Infected with HIV-1 While Using Preexposure Prophylaxis.

Preexposure prophylaxis (PrEP) is an effective HIV prevention tool, although effectiveness is dependent upon adherence. It is important to characterize the impact of PrEP on HIV antibody responses in people who experience breakthrough infections to understand the potential impact on timely diagnosis and treatment. Longitudinal HIV-1-specific antibody responses were evaluated in 42 people who inject drugs (PWID) from the Bangkok Tenofovir Study (BTS) (placebo = 28; PrEP = 14) who acquired HIV while receiving PrEP. HIV-1 antibody levels and avidity to three envelope proteins (gp41, gp160, and gp120) were measured in the plasma using a customized Bio-Plex (Bio-Rad Laboratories, Hercules, CA) assay. A time-to-event analysis was performed for each biomarker to compare the distribution of times at which study subjects exceeded the recent/long-term assay threshold, comparing PrEP and placebo treatment groups. We fit mixed-effects models to identify longitudinal differences in antibody levels and avidity between groups. Overall, longitudinal antibody levels and avidity were notably lower in the PrEP breakthrough group compared to the placebo group. Time-to-event analyses demonstrated a difference in time to antibody reactivity between treatment groups for all Bio-Plex biomarkers. Longitudinal gp120 antibody levels within the PrEP breakthrough group were decreased compared to the placebo group. When accounting for PrEP adherence, both gp120 and gp160 antibody levels were lower in the PrEP breakthrough group compared to the placebo group. We demonstrate hindered envelope antibody maturation in PWID who became infected while receiving PrEP in the BTS, which has significant implications for HIV diagnosis. Delayed maturation of the antibody response to HIV may increase the time to detection for antibody-based tests. Clinical Trial Registration Number, NCT00119106.

Evaluation of the Abbott ARCHITECT HIV Ag/Ab combo assay for determining recent HIV-1 infection.

BACKGROUND: Given the challenges and costs associated with implementing HIV-1 incidence assay testing, there is great interest in evaluating the use of commercial HIV diagnostic tests for determining recent HIV infection. A diagnostic test with the capability of providing reliable data for the determination of recent HIV infection without substantial modifications to the test protocol would have a significant impact on HIV surveillance. The Abbott ARCHITECT HIV Ag/Ab Combo Assay is an antigen/antibody immunoassay, which meets the criteria as the first screening test in the recommended HIV laboratory diagnostic algorithm for the United States. METHODS: In this study, we evaluated the performance characteristics of the ARCHITECT HIV Ag/Ab Combo signal-to-cutoff ratio (S/Co) for determining recent infection, including estimation of the mean duration of recent infection (MDRI) and false recent rate (FRR), and selection of recency cutoffs. RESULTS: The MDRI estimates for the S/Co recency cutoff of 400 is within the 4 to 12 months range recommended for HIV incidence assays, and the FRR rate for this cutoff was 1.5%. Additionally, ARCHITECT Combo S/Co values were compared relative to diagnostic test results from two prior prospective HIV-1 diagnostic studies in order to validate the use of the S/Co for both diagnostic and recency determination. CONCLUSION: Dual-use of the ARCHITECT Combo assay data for diagnostic and incidence purposes would reduce the need for separate HIV incidence testing and allow for monitoring of recent infection for incidence estimation and other public health applications.

Machine learning utilising spectral derivative data improves cellular health classification through hyperspectral infra-red spectroscopy.

The objective differentiation of facets of cellular metabolism is important for several clinical applications, including accurate definition of tumour boundaries and targeted wound debridement. To this end, spectral biomarkers to differentiate live and necrotic/apoptotic cells have been defined using in vitro methods. The delineation of different cellular states using spectroscopic methods is difficult due to the complex nature of these biological processes. Sophisticated, objective classification methods will therefore be important for such differentiation. In this study, spectral data from healthy/traumatised cell samples using hyperspectral imaging between 2500-3500 nm were collected using a portable prototype device. Machine learning algorithms, in the form of clustering, have been performed on a variety of pre-processing data types including 'raw' unprocessed, smoothed resampling, background subtracted and spectral derivative. The resulting clusters were utilised as a diagnostic tool for the assessment of cellular health and quantified using both sensitivity and specificity to compare the different analysis methods. The raw data exhibited differences for one of the three different trauma types applied, although unable to accurately cluster all the traumatised samples due to signal contamination from the chemical insult. The background subtracted and smoothed data sets reduced the accuracy further, due to the apparent removal of key spectral features which exhibit cellular health. However, the spectral derivative data-types significantly improved the accuracy of clustering compared to other data types, with both sensitivity and specificity for the background subtracted data set being >94% highlighting its utility to account for unknown signal contamination while maintaining important cellular spectral features.

Sequence-specific detection method for reverse transcription, loop-mediated isothermal amplification of HIV-1.

HIV diagnosis at the point-of-care or in resource-limited settings poses considerable challenges due to time and cost limitations. Currently, nucleic acid-based tests are the only reliable method for diagnosing recent infections during the window period post-infection and pre-seroconversion, but these tests are only suitable for well-equipped laboratory settings. The reverse transcription loop-mediated isothermal amplification (RT-LAMP) technology exhibits characteristics that are ideal for the development of a rapid, cost-effective nucleic acid-based test for detection of HIV DNA and RNA. In this study, a sequence-specific detection method was developed for immediate, naked-eye visualization of RT-LAMP products with high sensitivity and specificity. The rapid detection method was incorporated into the HIV-1-specific RT-LAMP assay and validated using minute volumes of whole blood from HIV-1-infected individuals. Together with the minimal sample preparation time and one-step, isothermal amplification reaction, the sequence-specific detection method adds to the overall versatility of the RT-LAMP assay and enhances the applicability for use at point-of-care or resource-limited sites.

Prevalence of malingering in patients with chronic pain referred for psychologic evaluation in a medico-legal context.

OBJECTIVE: To provide an empirical estimate of the prevalence of malingered disability in patients with chronic pain who have financial incentive to appear disabled. DESIGN: Retrospective review of cases. SETTING: A private neuropsychologic clinic in a southeastern metropolitan area. PARTICIPANTS: Consecutive patients (N=508) referred for psychologic evaluation related to chronic pain over a 10-year period (1995-2005). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence of malingering was examined using 2 published clinical diagnostic systems (Malingered Pain-Related Disability and Malingered Neurocognitive Dysfunction) as well as statistical estimates based on well validated indicators of malingering. RESULTS: The prevalence of malingering in patients with chronic pain with financial incentive is between 20% and 50% depending on the diagnostic system used and the statistical model's underlying assumptions. Some factors associated with the medico-legal context such as the jurisdiction of a workers' compensation claim or attorney representation were associated with slightly higher malingering rates. CONCLUSIONS: Malingering is present in a sizable minority of patients with pain seen for potentially compensable injuries. However, not all excess pain-related disability is a result of malingering. It is important not to diagnose malingering reflexively on the basis of limited or unreliable findings. A diagnosis of malingering should be explicitly based on a formal diagnostic system.

Detecting malingered pain-related disability with the pain catastrophizing scale: a criterion groups validation study.

Objective: Intentional exaggeration of symptoms is a potential problem in contexts where there are financial incentives to appear disabled. Therefore, calibration of tools to accurately evaluate malingering in these contexts is important. The present study used a criterion groups validation design to determine the ability of the Pain Catastrophizing Scale (PCS) to detect Malingered Pain-Related Disability (MPRD). Method: Individuals meeting inclusionary/exclusionary criteria were selected for this study (n = 219) from a larger dataset of chronic pain patients referred for a psychological evaluation. Patients were classified into malingering groups using the Bianchini, Greve, and Glynn classification system for MPRD. PCS T scores were compared in patients who met MPRD criteria and those who showed no indication of malingering on multiple validity tests. Results: No group differences were observed regarding medicolegal and injury characteristics. Group analyses showed that the Not MPRD group had a significantly lower PCS score (Estimated Marginal Mean [EMM] = 62.3) than all other groups. The Probable and Definite MPRD groups (which together comprise the MPRD group) had the highest PCS T scores (EMM = 77.2 and EMM = 83.8, respectively). A PCS T score of 81 was associated with a 7% false-positive (FP) error rate, sensitivity of 47%, likelihood ratio (LR) of 6.7, and a positive predictive value (PPV) of .74 at base rates around 30%. Conclusions: PCS T scores greater than 81 should raise concerns about the validity of the PCS report and provide additional information that can be helpful in identifying intentional symptom exaggeration in patients with chronic pain.

A Multiplex HIV Incidence Assay for Inferring Recent HIV-1 Transmission and Time of Infection.

BACKGROUND: Laboratory assays for determining recent HIV-1 infection are an important public health tool for aiding in the estimation of HIV incidence. Some incidence assay analytes are remarkably predictive of time since seroconversion and may be useful for additional applications, such as predicting recent transmission events during HIV outbreaks and informing prevention strategies. METHODS: Plasma samples (n = 154) from a recent HIV-1 outbreak in a rural community in Indiana were tested with the customized HIV-1 Multiplex assay, based on the Bio-Rad Bio-Plex platform, which measures antibody response to HIV envelope antigens, gp120, gp160, and gp41. Assay cutoffs for each analyte were established to determine whether an individual seroconverted within 30, 60, or 90 days of the sample collection date. In addition, a novel bioinformatics method was implemented to infer infection dates of persons newly diagnosed with HIV during the outbreak. RESULTS: Sensitivity/specificity of the HIV-1 Multiplex assay for predicting seroconversion within 30, 60, and 90 days, based on a training data set, was 90.5%/95.4%, 94.1%/90%, and 89.4%/82.9%, respectively. Of 154 new diagnoses in Indiana between December 2014 and August 2016, the majority (71%) of recent infections (≤3 months since seroconversion) were identified between February and May 2016. The epidemiologic curve derived from the bioinformatics analysis indicated HIV transmission began as early as 2010, grew exponentially in 2014, and leveled off in April 2015. CONCLUSIONS: The HIV-1 Multiplex assay has the potential to identify and monitor trends in recent infection during an epidemic to assess the efficacy of programmatic or treatment interventions.

Biological and technical variables affecting immunoassay recovery of cytokines from human serum and simulated vaginal fluid: a multicenter study.

The increase of proinflammatory cytokines in vaginal secretions may serve as a surrogate marker of unwanted inflammatory reaction to microbicide products topically applied for the prevention of sexually transmitted diseases, including HIV-1. Interleukin (IL)-1beta and IL-6 have been proposed as indicators of inflammation and increased risk of HIV-1 transmission; however, the lack of information regarding detection platforms optimal for vaginal fluids and interlaboratory variation limit their use for microbicide evaluation and other clinical applications. This study examines fluid matrix variants relevant to vaginal sampling techniques and proposes a model for interlaboratory comparisons across current cytokine detection technologies. IL-1beta and IL-6 standards were measured by 12 laboratories in four countries, using 14 immunoassays and four detection platforms based on absorbance, chemiluminescence, electrochemiluminescence, and fluorescence. International reference preparations of cytokines with defined biological activity were spiked into (1) a defined medium simulating the composition of human vaginal fluid at pH 4.5 and 7.2, (2) physiologic salt solutions (phosphate-buffered saline and saline) commonly used for vaginal lavage sampling in clinical studies of cytokines, and (3) human blood serum. Assays were assessed for reproducibility, linearity, accuracy, and significantly detectable fold difference in cytokine level. Factors with significant impact on cytokine recovery were determined by Kruskal-Wallis analysis of variance with Dunn's multiple comparison test and multiple regression models. All assays showed acceptable intra-assay reproducibility; however, most were associated with significant interlaboratory variation. The smallest reliably detectable cytokine differences ( P < 0.05) derived from pooled interlaboratory data varied from 1.5- to 26-fold depending on assay, cytokine, and matrix type. IL-6 but not IL-1beta determinations were lower in both saline and phosphate-buffered saline as compared to vaginal fluid matrix, with no significant effect of pH. The (electro)chemiluminescence-based assays were most discriminative and consistently detected <2-fold differences within each matrix type. The Luminex-based assays were less discriminative with lower reproducibility between laboratories. These results suggest the need for uniform vaginal sampling techniques and a better understanding of immunoassay platform differences and cross-validation before the biological significance of cytokine variations can be validated in clinical trials. This investigation provides the first standardized analytic approach for assessing differences in mucosal cytokine levels and may improve strategies for monitoring immune responses at the vaginal mucosal interface.

Live, attenuated varicella zoster vaccination of an immunocompromised patient.

A vaccine for the prevention of herpes zoster outbreaks in adults over the age of 60 years has recently been approved. A 76-year-old white female with a history of recurrent left axillary breast cancer undergoing chemotherapy was given a Zostavax injection by her primary care physician. Eight days later, the patient developed a rash. Given the recent administration of live, attenuated varicella zoster virus (VZV), a diagnosis of disseminated cutaneous herpes zoster was made. The patient was treated successfully with a course of famciclovir for 10 days and cephalexin for 7 days for a secondary bacterial infection. A review of the medical literature disclosed no reports of Zostavax given to adult cancer patients immunocompromised by systemic chemotherapy. Therefore, we believe this report is the first to describe the consequences of Zostavax administration to such a host. Clinicians should take care to review contraindications and precautions prior to administering the Zostavax vaccine.

Rapid detection of HIV-1 by reverse-transcription, loop-mediated isothermal amplification (RT-LAMP).

A rapid, cost-effective diagnostic or confirmatory test for the detection of early HIV-1 infection is highly desired, especially for use in resource-poor or point-of-care settings. The reverse-transcription loop-mediated isothermal amplification (RT-LAMP) technology has been evaluated for the detection of HIV-1 DNA and RNA, using six RT-LAMP primers designed against highly conserved sequences located within the protease and p24 gene regions. Amplification from lab-adapted HIV-1 DNA and RNA was detected as early as 30 min, with maximum sensitivity of 10 and 100 copies per reaction, respectively, reached at 60 min. Comparable sensitivity was observed with extracted nucleic acid from plasma and blood samples of HIV-1-infected individuals. Furthermore, the RT-LAMP procedure was modified for the direct detection of HIV-1 nucleic acid in plasma and blood samples, eliminating the need for an additional nucleic acid extraction step and reducing the overall procedure time to approximately 90 min.

Anaemia following initiation of androgen deprivation therapy for metastatic prostate cancer: a retrospective chart review.

OBJECTIVE: Haemoglobin levels often decline into the anaemic range with androgen deprivation therapy (ADT). We conducted a chart review of patients receiving ADT for metastatic prostate cancer to assess anaemia-related symptoms. METHODS: 135 stage IV prostate cancer cases were reviewed for treatment type; haemoglobin values before and after treatment; and symptoms of anaemia. Mean haemoglobin levels before and after for all treatment forms, for leuprolide alone, and for combination leuprolide/bicalutamide were calculated and evaluated for significant differences. The numbers of patients developing symptoms were recorded and the effects of specific therapies evaluated. RESULTS: For all ADT treated patients, mean haemoglobin declined by -1.11 g/dL (p<.0001). Leuprolide-alone treated patients had a mean decline of -1.66 g/dL (p<0.0001). Leuprolide and bicalutamide combination treatment caused a mean decline of -0.78 g/dL (p=0.0426). 16 of 43 patients had anemia symptoms. Contingency analysis with Fisher's exact test shows patients receiving leuprolide therapy alone versus other forms of ADT were significantly less likely to have symptoms (chi(2)=0.0190). CONCLUSIONS: The present study confirms that ADT results in a significant drop in haemoglobin levels into the anaemic range. A number of patients become symptomatic from this change. Practitioners should monitor haemoglobin levels, and treat symptomatic patients.

Further validation of booklet category test subscales for learning, set loss, and memory in a mixed clinical sample.

Although it has long been proposed that performance on the Booklet Category Test (BCT) relies on a number of different cognitive abilities, including executive functioning, perceptual reasoning, and memory, only a single total error score is typically derived and interpreted in clinical practice. BCT subscales based on factor analyses of subtest errors or designed specifically to measure specific cognitive domains have been proposed to better assess the multidimensional abilities underlying BCT performance. The aim of this study was to independently replicate and extend previous findings regarding the validity of these subscales. A mixed clinical sample of 137 patients completed the BCT and a number of additional measures used to assess neuropsychological domains of selective attention, various aspects of executive functioning, intellectual functioning, and memory. Correlation and regression analyses were used to explore the convergent and discriminant validity of each subscale. Subscales varied in the number and magnitude of their significant correlations with scores derived from traditional measures. In general, findings supported the convergent validity of BCT category learning, set loss, and memory subscales. However, findings regarding discriminant validity were more variable across subscales. Results provide additional support for the multidimensional nature of the BCT and the validity of derived subscales to measure specific aspects of cognitive functioning beyond what is measured by a total errors score. The recently proposed subscales examined in the current study appear to be worthy of further investigation by clinicians and researchers to determine their clinical utility.