The Queen’s English: An Alternative,Biosocial Hypothesis for the Distinctive Features of “Gay Speech”

Popular stereotypes concerning the speech of homosexuals typically attribute speech patterns characteristic of the opposite-sex, i.e., broadly feminized speech in gay men and broadly masculinized speech in lesbian women. A small body of recent empirical research has begun to address the subject more systematically and to consider specific mechanistic hypotheses to account for the potentially distinctive features of homosexual speech. Results do not yet fully endorse the stereotypes but they do not entirely discount them either; nor do they cleanly favor any single mechanistic hypothesis. To contribute to this growing body of research, we report acoustic analyses of 2,875 vowel sounds from a balanced set of 125 speakers representing heterosexual and homosexual individuals of each sex from southern Alberta, Canada. Analyses focused on voice pitch and formant frequencies which together determine the principle perceptual features of vowels. There was no significant difference in mean voice pitch between heterosexual and homosexual men or between heterosexual and homosexual women, but there were significant differences in the formant frequencies of vowels produced by both homosexual groups compared to their heterosexual counterparts. Formant frequency differences were specific to only certain vowel sounds and some could be attributed to basic differences in body size between heterosexual and homosexual speakers. The remaining formant frequency differences were not obviously due to differences in vocal tract anatomy between heterosexual and homosexual speakers, nor did they reflect global feminization or masculinization of vowel production patterns in homosexual men and women, respectively. The vowel-specific differences observed could reflect social modeling processes in which only certain speech patterns of the opposite-sex, or of same-sex homosexuals, are selectively adopted. However, we introduce an alternative biosocial hypothesis, specifically that the distinctive, vowel-specific features of homosexual speakers relative to heterosexual speakers arise incidentally as a product of broader psychobehavioral differences between the two groups that are, in turn, continuous with and flow from the physiological processes that affect sexual orientation to begin with.     

Prospective, non-randomized phase 2 clinical trial of carboplatin plus paclitaxel with sequential radical pelvic radiotherapy for uterine papillary serous carcinoma

Objective

Uterine Papillary Serous Carcinoma (UPSC) is uncommon and accounts for less than 5% of all uterine cancers. Therefore the majority of evidence about the benefits of adjuvant treatment comes from retrospective case series. We conducted a prospective multi-centre non-randomized phase 2 clinical trial using four cycles of adjuvant paclitaxel plus carboplatin chemotherapy followed by pelvic radiotherapy, in order to evaluate the tolerability and safety of this approach.

Methods

This trial enrolled patients with newly diagnosed, previously untreated patients with stage 1b-4 (FIGO-1988) UPSC with a papillary serous component of at least 30%. Paclitaxel (175 mg/m²) and carboplatin (AUC 6) were administered on day 1 of each 3-week cycle for 4 cycles. Chemotherapy was followed by external beam radiotherapy to the whole pelvis (50.4 Gy over 5.5 weeks). Completion and toxicity of treatment (Common Toxicity Criteria, CTC) and quality of life measures were the primary outcome indicators.

Results

Twenty-nine of 31 patients completed treatment as planned. Dose reduction was needed in 9 patients (29%), treatment delay in 7 (23%), and treatment cessation in 2 patients (6.5%). Hematologic toxicity, grade 3 or 4 occurred in 19% (6/31) of patients. Patients' self-reported quality of life remained stable throughout treatment. Thirteen of the 29 patients with stages 1-3 disease (44.8%) recurred (average follow-up 28.1 months, range 8-60 months).

Conclusion

This multimodal treatment is feasible, safe and tolerated reasonably well and would be suitable for use in multi-institutional prospective randomized clinical trials incorporating novel therapies in patients with UPSC.     

Spontaneous acute tumour lysis syndrome in patients with metastatic germ cell tumours

Acute tumour lysis syndrome (TLS), a condition resulting from rapid destruction of tumour cells with massive release of cellular breakdown products, has been described following the treatment of various malignancies. However, spontaneous TLS has been described only rarely. Germ cell tumours (GCT) have a rapid cell turnover and often present with bulky metastatic disease. We report two cases of patients with metastatic GCT presenting with acute renal failure attributable to spontaneous TLS. All clinical and biochemical features of the syndrome were present. Both patients were treated with haemodialysis and intravenous administration of single-agent etoposide between dialysis sessions, resulting in recovery of renal function and marked decrease in tumour bulk within the first week after presentation. These cases are the first reported instances of spontaneous TLS in poor-risk metastatic GCT. Successful treatment with dialysis and chemotherapy is possible, and prophylactic vigorous hydration and allopurinol may be warranted in this setting.     

Carboplatin and pegylated liposomal doxorubicin versus carboplatin and paclitaxel in partially platinum-sensitive ovarian cancer patients: results from a subset analysis of the CALYPSO phase III trial

BackgroundTo perform a subset analysis of patients with partially platinum-sensitive recurrent ovarian cancer (ROC) who received either CD [carboplatin–pegylated liposomal doxorubicin (PLD)] or CP (carboplatin–paclitaxel) in the CALYPSO trial.Patients and methodsCALYPSO, an international phase III, non-inferiority trial, enrolled women with ROC that relapsed >6 months following first- or second-line therapy. Patients were randomized to CD or CP. Patients with a treatment-free interval of >6 and ≤12 months were evaluated for progression-free survival (PFS), the primary end point of CALYPSO trial, and safety.ResultsA total of 344 partially platinum-sensitive patients were included (N = 161, CD and N = 183, CP). The hazard ratio for PFS was 0.73 (95% confidence interval: 0.58–0.90; P = 0.004 for superiority) in favor of CD. Median PFS times were 9.4 months (CD) and 8.8 months (CP). Toxicities more common with CP versus CD included grade 3/4 neutropenia (50% versus 39%; P = 0.015), grade 2 alopecia (86% versus 9%; P < 0.001), neuropathy and hypersensitivity reactions. Hand-foot syndrome was more common with CD; however, grade 3/4 reactions were low (one patient in each arm).ConclusionCarboplatin–PLD has a more favorable risk-benefit profile than CP in patients with partially platinum-sensitive ROC and should be considered an effective treatment option for these patients.     

Does aggressive surgery only benefit patients with less advanced ovarian cancer? Results from an international comparison within the SCOTROC-1 Trial.

PURPOSE: Studies indicate that ovarian cancer patients who have been optimally debulked survive longer. Although chemotherapy has been variable, they have defined standards of care. Additionally, it is suggested that patients from the United Kingdom (UK) have inferior survival compared with some other countries. We explored this within the context of a large, international, prospective, randomized trial of first-line chemotherapy in advanced ovarian cancer (docetaxel-carboplatin v paclitaxel-carboplatin; SCOTROC-1). The Scottish Randomised Trial in Ovarian Cancer surgical study is a prospective observational study examining the impact on progression-free survival (PFS) of cytoreductive surgery and international variations in surgical practice. PATIENTS AND METHODS: One thousand seventy-seven patients were recruited (UK, n = 689; Europe, United States, and Australasia, n = 388). Surgical data were available for 889 patients. These data were analyzed within a Cox model. RESULTS: There were three main observations. First, more extensive surgery was performed in non-UK patients, who were more likely to be optimally debulked (< or = 2 cm residual disease) than UK patients [corrected] (71.3% v 58.4%, respectively; P < .001). Second, optimal debulking was associated with increased PFS mainly for patients with less extensive disease at the outset (test for interaction, P = .003). Third, UK patients with no visible residual disease had a less favorable PFS compared with patients recruited from non-UK centers who were similarly debulked (hazard ratio = 1.85; 95% CI, 1.16 to 2.97; P = .010). This observation seems to be related to surgical practice, primarily lymphadenectomy. CONCLUSION: Increased PFS associated with optimal surgery is limited to patients with less advanced disease, arguing for case selection rather than aggressive debulking in all patients irrespective of disease extent. Lymphadenectomy may have beneficial effects on PFS in optimally debulked patients.