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6076 Background: The De-ESCALaTE trial confirmed the superiority of cisplatin over cetuximab in combination with radiotherapy for the treatment of low risk human papillomavirus positive oropharyngeal cancer (HPV+OPC). The most common serious adverse events (SAEs) for cisplatin were due to vomiting and nausea, in contrast with oral mucositis and vomiting for concurrent cetuximab. In this study, we examined the efficacy of different hydration and anti-emetic policies in preventing cisplatin-related gastrointestinal and renal toxicities as well as related SAEs in the cisplatin arm of the De-ESCALaTE trial. Methods: This was a post-hoc pre-specified analysis of data collected within the De-ESCALaTE trial including pre-hydration, diuretics, the amount of intravenous (IV) fluids before, during and after chemotherapy, whether oral fluid hydration was advised and type of antiemetic regimen prescribed, if any, after chemotherapy administration, including if a triple antiemetic regimen with a NK1 receptor antagonist, steroids and a serotonin 5-HT3 antagonist was given before and after chemotherapy. The primary outcome was number of SAEs per patient; secondary outcome was number per patient of cisplatin-induced severe toxicity events of interest: nausea, vomiting, dehydration or renal toxicity. Results: 166 (mean age 57 yrs; 132 m, 34 f) patients received cisplatin. Hydration and anti-emetics policies for cisplatin treatment are significantly correlated with the rate of SAEs and acute severe nausea, vomiting, dehydration or renal toxicities. Using stepwise backwards multivariable ordinal logistic regression in the presence of baseline characteristics, use of a triple anti-emetics regimen (OR 0.41,p = 0.032) and 2.5 to 3L IV fluids given before and during cisplatin chemotherapy (OR 0.161, p = 0.009) as well as oral fluids advised post chemotherapy (OR 0.365, p = 0.03) were associated with a significantly lower incidence of SAEs and severe toxicities of interest. We will also present data on relative cost-effectiveness of the different regimens. Conclusions: Based on our results, we recommend the use of a triple anti-emetic regimen, adequate hydration of 2.5-3L before and during chemotherapy as well as advising patients to take oral fluids advised to reduce cisplatin toxicities related to nausea, vomiting, dehydration and/or renal injury. Clinical trial information: ISRCTN33522080.

Since the year 2000 the Waikato Institute of Technology has been reviewing the list of “Notable and Historic” trees of New Zealand first published by the Forest Service in 1974. Since that time 29.7% of those trees have been lost – 53% of those losses due to development, 29% to natural causes such as storms and disease, and a further 18% that could not be located. Despite this tree loss New Zealand has an impressive list of trees of international significance, many of which are regarded as the largest of their species in the world.

Near the centers of Ulysses and Finnegans Wake Joyce models the forge of artistic creation as an abstraction of the female pelvis, an image originating in Plato’s Timaeus wherein divine, artistic, and sexual making are isomorphic. In the Wake Shem tricks Shaun into drawing a figure from Euclid that also depicts their mother’s reproductive and excretory organs. Stephen’s aesthetic theory in Ulysses unfolds amidst comparable imagery. Although Plato and Homer are its generative elements, both renderings of Joyce’s forge cast Shakespeare as the Demiurge, the agent of creation in Plato.

Needle-use practices of intravenous drug users (IVDUs) were examined in a region (Seattle, King Country, Washington State, USA) where needle purchase is legal. IVDUs in treatment (n = 313) were administered extensive structured interviews concerning drug and injection equipment-use practices. Of the 80.2% reporting intravenous drug use in the previous year, 78.3% reported sharing needles. Of the 47.7% reporting intravenous use in the previous 30 days, only 40.5% shared needles, with 59.3% sharing with only one other person. Most needle-sharing partners were very well known (63%) or well known (17%) to the subjects. The most frequent method for obtaining needles was 'buying in a drug store', ranked first by 65% of the sample. Subjects whose primary source was 'buying in a drug store' shared equipment less frequently during drug-use events in the previous year (mean: 16.2%) than those with other primary sources (mean: 28.5%). Compared with findings from other regions where needle purchase and possession are illegal without a prescription, fewer subjects in the current investigation shared needles, and those who did shared with a smaller number of people. The apparent association between legalized injection equipment and reduced sharing of equipment among IVDUs should be further examined in longitudinal studies of needle-sharing before and after legalization is instituted.

The effectiveness of education in reducing high-risk human immunodeficiency virus (HIV) transmission behaviors was examined in 313 injection drug users. Involvement in high-risk behaviors was assessed via structured interview at study entry and 4 months following the intervention. Subjects were randomly assigned to (1) AIDS education, (2) AIDS education with optional HIV antibody testing, or (3) a wait list. The sample as a whole decreased its involvement in high-risk behaviors, but there were no significant differences as a function of experimental group assignment.

A system and method for speech file processing which provides users with differentially selectable speech file transcripts which can be sent to one or more other users. The speech files may be voicemail messages from which respective voicemail transcripts are created. The voicemail transcripts are provided in a user selectable format from which users may select non-contiguous portions of the transcript.

This study investigated the nature of cueing behaviours in 3-, 6- and 9-year-old children in a spatial memory task. Although few subjects spontaneously generated the target strategy, it was found that they could be induced to do so, following prompting. The second part of the study probed children's understanding of cueing behaviour. It was found that 3-year-olds could be induced to produce appropriate cueing behaviours without understanding their implications. Older children, in contrast, understood the principles underlying cueing, but sometimes failed to produce cueing strategies spontaneously. The implications of these results for theories of the development of memory strategies are discussed.

Three pigeons were exposed to two-key discrete-trial concurrent schedules of reinforcement. Red and white key colors alternated irregularly and the assignment of reinforcers depended on key color. The red-key schedules were held constant, with the scheduled relative frequency of reinforcement for left-key pecks set at 0.75, while the white-key schedules varied. When the location of white-key reinforcement was changed from one side to the other, while its overall frequency was constant, red-key choices shifted in the same direction as white-key choices, an induction effect. When the overall frequency of white-key reinforcement was changed while its location remained constant, red key choices shifted in a direction opposite to white-key choices, a contrast effect. Both induction and contrast effects were clearer when the overall frequency of red-key reinforcement was reduced. These data demonstrate that the allocation of responding may exhibit schedule interaction effects similar to those commonly reported for response rate.

There has been some controversy over how children learning verb inflections sort out the semantic distinctions between tense and aspect. Three experiments that manipulated aspectual parameters are reported. Children aged 3–6 years were asked to watch and later to describe various situations acted out by puppets. Experiment I presented telic and atelic situations and Experiment 2 iterated and noniterated situtations. The vast majority of responses had appropriate tense, either the simple past or the past progressive. The 3-year-olds encoded the majority of situations in the simple past regardless of manipulation of progressive aspect. By contrast the 4- and 5-year-olds encoded the majority of situations in the past progressive but also displayed some selective choice of past tense as a function of aspect. A third experiment showed that the 3-year-old children are capable of using the past progressive. A model of the development of the semantics of the English past and progressive inflections is proposed.

Pigeons were trained to discriminate temporal stimuli in a discrete-trial signal-detection procedure. Pecks to one side key were reinforced intermittently after exposure to one duration, and pecks to the other side key were reinforced intermittently after exposure to a different duration. In Experiment I, the allocation of reinforcers was varied systematically for correct responses and for errors, using a procedure that controlled the obtained numbers of reinforcers. When reinforcers were allocated symmetrically, the level of discrimination decreased as the proportion of reinforcers for errors increased. When reinforcers were allocated asymmetrically, the decrease in discrimination was less systematic. Bias toward one or the other side key roughly matched the ratio of reinforcers obtained by pecks at those keys, independent of the level of discrimination. In Experiment II, the overall rate of reinforcement for correct responses was varied both within and between experimental conditions. The level of discrimination was positively related to the overall rate of reinforcement. The discrimination data of both experiments were interpreted in relation to the contingencies of reinforcement and nonreinforcement, characterized by the average difference in reinforcement probability for correct responses and errors.

Possibly no other area of the lexicon is as complex as verbs. They not only convey information about events and states but also about motives, intentions, causality—to mention but a few dimensions. In addition, verbs can be inflected for tense and aspect and thus are the major means of conveying temporal information. An account of how the child masters the verb system would necessarily play a central role in a complete account of language development.