Conservative Beliefs,Male Gender,and Beliefs About Means Safety Among Firearm Owners

Cognitive Therapy and Research - Reducing access to highly lethal methods for suicide (i.e., means safety) has been promoted as a way to reduce suicide risk. Research by Anestis et al. (J Affect...     

Speech intelligibility in noise using throat and acoustic microphones

INTRODUCTION: Helicopter cockpits are very noisy and this noise must be reduced for effective communication. The standard U.S. Army aviation helmet is equipped with a noise-canceling acoustic microphone, but some ambient noise still is transmitted. Throat microphones are not sensitive to air molecule vibrations and thus, transmittal of ambient noise is reduced. It is possible that throat microphones could enhance speech communication in helicopters, but speech intelligibility with the devices must first be assessed. In the current study, speech intelligibility of signals generated by an acoustic microphone, a throat microphone, and by the combined output of the two microphones was assessed using the Modified Rhyme Test (MRT). METHODS: Stimulus words were recorded in a reverberant chamber with ambient broadband noise intensity at 90 and 106 dBA. Listeners completed the MRT task in the same settings, thus simulating the typical environment of a rotary-wing aircraft. RESULTS: Results show that speech intelligibility is significantly worse for the throat microphone (average percent correct = 55.97) than for the acoustic microphone (average percent correct = 69.70), particularly for the higher noise level. In addition, no benefit is gained by simultaneously using both microphones. A follow-up experiment evaluated different consonants using the Diagnostic Rhyme Test and replicated the MRT results. DISCUSSION: The current results show that intelligibility using throat microphones is poorer than with the use of boom microphones in noisy and in quiet environments. Therefore, throat microphones are not recommended for use in any situation where fast and accurate speech intelligibility is essential.     

Agitation as a Moderator of the Relationship Between Insomnia and Current Suicidal Ideation in the Military

Research has established a link between agitation and insomnia, both of which are considered to be risk factors for suicide. The present study aimed to investigate the moderating role of agitation within the relationship between insomnia and current suicidal ideation in a sample of U.S. military personnel. Consistent with hypotheses, the relationship between insomnia and current suicidal ideation was significant only at high levels of agitation. Results support previous findings indicating that both insomnia and agitation are suicide risk factors. These findings clarify the role of known risk factors in the pathway to suicide and may contribute to the advancement of suicide detection and prevention, as these factors may be more easily identified in individuals unwilling to admit thoughts of death and suicide, such as many military personnel.     

Familial Paget's disease in The Netherlands: occurrence, identification of new mutations in the sequestosome 1 gene, and their clinical associations

OBJECTIVE: To estimate the occurrence of familial Paget's disease of bone in The Netherlands, to examine the prevalence of mutations of the sequestosome 1 gene (SQSTM1) in identified families, and to assess potential genotype-phenotype associations. METHODS: We performed a case-control study of patients with Paget's disease and a mutation analysis of the SQSTM1 gene of index patients with familial disease and of the relatives of those with a mutation. Serum alkaline phosphatase (AP) activity was assessed, and bone scintigraphy was performed. RESULTS: Five percent of patients had at least 1 first-degree relative with the disease, compared with 0.5% of the controls (relative risk 10; 95% confidence interval 1.3-75.6). In 38.9% of patients with familial disease, heterozygous mutations in the SQSTM1 gene were identified. These were the previously described P392L mutation, which was present in 22.2% of patients, and 3 new mutations, S399P, G425R, M404T, 9 of which were present in 3 different families. All mutations were located in the ubiquitin-associated domain of the gene. There was a relationship between serum AP activity, as a marker of the disease, and the presence or absence of the G425R and P392L mutations, the subject's age, and the presence of Paget's disease. CONCLUSION: Our data provide further evidence of a causal role of SQSTM1 gene mutations in the pathogenesis of Paget's disease and allow the design of a strategy based on measurements of serum AP activity and age for investigating asymptomatic relatives of patients with familial Paget's disease of bone.     

Investigating the Relationship Between Social and Economic Policy Views,Firearm Ownership,and Death by Firearm in a Sample of Suicide Decedents

Extant literature provides evidence for the frequent use and lethality of firearms in suicide and the ability of means safety measures to prevent suicides; however, little evidence exists to provide an understanding of the characteristics that differentiate suicide decedents who die by firearm from those who die by other methods. In this study, we build on prior findings regarding the characteristics of those who die by firearms by examining the relationship between social and economic policy views and both firearm ownership and death by firearm in a sample of 160 American suicide decedents. We hypothesized that individuals with more conservative social and economic policy views would have higher rates of firearm ownership and would be more likely to die by firearm than would individuals with more liberal social and economic policy views. Furthermore, we hypothesized that differences in the likelihood of dying by a firearm would be accounted for by firearm ownership, providing preliminary evidence for a specific mechanism through which risk for death by firearm is conferred. As expected, suicide decedents with conservative social and economic policy views owned firearms at higher rates than did decedents with moderate or liberal views. The use of a firearm, the most common method across all decedents, was higher in individuals with conservative policy views. These results represent a novel angle from which to consider the importance of means safety efforts focused on firearm ownership and storage and limit concerns that firearm specific suicide research has relied too heavily on samples that are not representative of typical American suicide decedents.     

Support Systems: How Post-Deployment Support Impacts Suicide Risk Factors in the United States Army National Guard

Suicide rates within the military have continued to rise in recent years, resulting in re-doubled efforts to understand and remedy this trend. In an attempt to clarify unique pathways to suicide risk in this population, the current study examined the relationship between length of time since most recent deployment and several suicide risk factors (hopelessness, suicidal ideation, and resolved plans and preparations). Furthermore, this study examined the moderating influence of post-deployment social support in the prediction of suicide risk. Results indicated that the interaction of time since deployment and post-deployment support predicted both hopelessness and resolved plans and preparations, but did not predict suicidal ideation. These findings suggest that the negative effects of time spent away from recognized military support may be compounded by the isolating effect of decreased access to alternative supports at home, resulting in increased hopelessness and/or resolved plans and preparations. Implications for the necessity of improved post-deployment programs are discussed.     

Real-world Data of Nivolumab for Patients With Advanced Renal Cell Carcinoma in the Netherlands: An Analysis of Toxicity,Efficacy, and Predictive Markers

BackgroundNivolumab, a programmed death 1 inhibitor, has been approved as second-line treatment for advanced renal cell carcinoma (RCC) in Europe since 2016. We investigated the toxicity and efficacy of nivolumab as well as potential predictive biomarkers in the Dutch population.Patients and MethodsThis was a retrospective, multicenter study of the Dutch national registry of nivolumab for the treatment of advanced RCC. The main outcome parameters included toxicity, objective response rate (ORR), overall survival (OS), progression-free survival (PFS), time to progression (TTP), and time to treatment failure (TTF). In addition, potential predictive and prognostic biomarkers for outcomes were evaluated.ResultsData on 264 patients were available, of whom 42% were International Metastatic RCC Database Consortium (IMDC) poor risk at start of nivolumab, 16% had ≥ 3 lines of previous therapy, 7% had non–clear-cell RCC, 11% had brain metastases, and 20% were previously treated with everolimus. Grade 3/4 immune-related adverse events occurred in 15% of patients. The median OS was 18.7 months (95% confidence interval, 13.7-23.7 months). Progression occurred in 170 (64.4%) of 264 patients, with a 6-and 12-months TTP of 49.8% and 31.1%, respectively. The ORR was 18.6% (49 of 264; 95% confidence interval, 14%-23%). Elevated baseline lymphocytes were associated with improved PFS (P = .038) and elevated baseline lactate dehydrogenase with poor OS, PFS, and TTF (P = .000). On-treatment increase in eosinophils by week 8 predicted improved OS (P = .003), PFS (P = .000), and TTF (P = .014), whereas a decrease of neutrophils was associated with significantly better TTF (P = .023).ConclusionsThe toxicity and efficacy of nivolumab for metastatic RCC after previous lines of therapy are comparable with the results in the pivotal phase III trial and other real-world data. On-treatment increase in eosinophil count is a potential biomarker for efficacy and warrants further investigation.     

Germline variants in the CYP19A1 gene are related to specific adverse events in aromatase inhibitor users: a substudy of Dutch patients in the TEAM trial

Musculoskeletal adverse events (MSAEs) and vasomotor symptoms (VMSs) are known side-effects of aromatase inhibitors, and may be related to genetic variations of the aromatase gene (CYP19A1). We investigated the relationship between these specific AEs and single nucleotide polymorphisms (SNPs) in the CYP19A1 gene in postmenopausal, hormone receptor-positive early breast cancer (BC) patients treated with adjuvant exemestane for 5 years. Dutch patients who were randomized to receive 5 years of exemestane in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial were included. A tagging-SNP approach was performed, covering 80 % of variations of the CYP19A1 gene with 30 SNPs. Logistic regression analyses were used to assess the risk of reporting VMSs or MSAEs in relation to genotypes within selected SNPs. Of 737 included patients, 281 patients reported at least one MSAE (n = 210) or VMS (n = 163). Homozygous AA genotype of rs934635 was associated with a significantly higher odds of MSAEs (multivariate odds ratio (OR) 4.66, p = 0.008) and VMSs (multivariate OR 2.78, p = 0.044). Regarding both rs1694189 and rs7176005, the homozygous variant genotypes (TT) were associated with a higher odds of VMSs, but not MSAEs (OR 1.758, p = 0.025 and OR 6.361, p = 0.021, respectively). Our exploratory analysis demonstrated that some CYP19A1 gene variations may be associated with MSAEs and/or VMSs. Specifically, patients with the homozygous variant rs934635 genotype reported more MSAEs and VMSs. Although further confirmatory studies are warranted, genomic profiling can help identify patients at an increased risk of reporting these specific AEs, potentiating further personalized BC treatment.