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Simple Summary For high-grade soft tissue sarcomas (STS), combined modality treatment with surgery and radiation therapy is the standard of care. The addition of chemotherapy has been shown to decrease the risk of local recurrence and improve survival. Evaluating treatment response with surrogate modalities such as MRI, CT and PET imaging have substantial limitations. Pathologic necrosis of the surgical specimen is a direct indicator of the effect of treatment on tumor cells. Studies in STS and other malignancies have shown that increasing rates of treatment-induced tumor necrosis correlate with improvement of oncological outcomes and survival. However, the relationship between pathologic response and outcomes of specific neoadjuvant treatments for STS remains indeterminate. We hypothesized that sequential neoadjuvant chemotherapy and radiation yields higher rates of pathologic complete response (pCR) than neoadjuvant radiation or chemotherapy alone. Our results indicate that neoadjuvant chemotherapy and radiation yields superior pCR compared to other neoadjuvant regimens. Abstract (1) Background: Pathologic necrosis of soft tissue sarcomas (STS) has been used to determine treatment response, but its relationship to neoadjuvant treatments remains indeterminate. In this retrospective, single institution study, we hypothesized that neoadjuvant chemoradiation (NA-CRT) yields higher rates of pathologic complete response (pCR) than neoadjuvant radiation (NA-XRT) or chemotherapy (NA-CT) alone. (2) Methods: Patients with extremity STS between 2011–2020 who received neoadjuvant treatment were included. pCR was defined as percent necrosis of the surgical specimen greater than or equal to 90%. (3) Results: 79 patients were analyzed. 51.9% of the population were male with a mean age of 58.4 years. 49.4% identified as Non-Hispanic White. Twenty-six (32.9%) patients achieved pCR while 53 (67.1%) did not. NA-CT (OR 15.82, 95% CI = 2.58–96.9, p = 0.003 in univariate (UVA) and OR 24.7, 95% CI = 2.88–211.2, p = 0.003 in multivariate (MVA), respectively) and NA-XRT (OR 5.73, 95% CI = 1.51–21.8, p = 0.010 in UVA and OR 7.95, 95% CI = 1.87–33.7, p = 0.005 in MVA, respectively) was significantly associated with non- pCR when compared to NA-CRT. The analysis also demonstrated that grade 3 tumors, when using grade 2 as reference, also had significantly higher odds of achieving pCR (OR 0.23, 95% CI = 0.06–0.80, p = 0.022 in UVA and OR 0.16, 95% CI = 0.04–0.70, p = 0.015 in MVA, respectively). (4) Conclusion: NA-CRT yields superior pCR compared to other neoadjuvant regimens. This extends to higher grade tumors.

This study examines the basic psychometric properties of the Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale (SKAMP), a measure intended to assess functional impairment related to attention deficit hyperactivity disorder, in a sample of 1,205 elementary students. Reliability, factor structure, and convergent, discriminant and predictive validity are evaluated. Results provide support for two separate but related subscales, Attention and Deportment, and provide evidence that the SKAMP predicts school functioning above and beyond symptoms alone. Boys, African American children, and children living in poverty are rated as having higher impairment scores than girls, Caucasian children, and more advantaged peers. Norm-referenced data are provided by gender, race, and parental concern level. This study supports the reliability and validity of the SKAMP in a large, diverse community sample and broadens its clinical utility.

Predictors of attrition from individual parent-child interaction therapy were examined for 99 families of preschoolers with disruptive behavior disorders. Seventy-one percent of treatment dropouts were identified by lower SES, more maternal negative talk, and less maternal total praise at pretreatment. Following PCIT, families were randomly assigned to an Assessment-Only or Maintenance Treatment condition. Higher maternal distress predicted 63% of dropouts in the Assessment-Only condition. Lower maternal intellectual functioning predicted 83% of dropouts from Maintenance Treatment. Findings highlight a continuing need for evidence-based retention strategies at various phases of engagement in PCIT.

We review existing studies of attrition in Parent-Child Interaction Therapy (PCIT), an empirically supported treatment for preschool-aged children with disruptive behavior disorders. Variables identified as pretreatment predictors of attrition in a statistically derived search for pretreatment predictors included maternal distress, negative maternal verbal behaviors during parent-child interaction, and therapist verbal behaviors during initial parent-therapist interactions. The most frequently reported reasons provided by mothers for premature termination of treatment were logistical problems such as difficulty finding transportation or sibling child care. Continued study of variables related to attrition in PCIT is essential to retention of a greater number of families in treatment.

To examine psychometric properties of the SNAP-IV, parent (N = 1,613) and teacher data (N = 1,205) were collected from a random sample of elementary school students in a longitudinal study on detection of attention deficit hyperactivity disorder (ADHD). Reliability, factor structure, predictive validity, and effect sizes (ES) for differences in ratings across age, gender, and race were examined. Performance as a screening and diagnostic tool was evaluated through calculation of likelihood ratios (LR) and posttest probabilities. Reliability of the parent and teacher SNAP-IV was acceptable. Factor structure was consistent with a two-factor solution of ADHD symptoms and a third ODD factor. Parent and teacher scores varied significantly by gender and poverty status (d = .49 to .56), but not by age; only teacher scores varied by race (d = .25 to .55). SNAP-IV parent and teacher ratings satisfactorily distinguished children by increasing levels of ADHD concerns, but only parent ratings by diagnostic status. Parent SNAP-IV scores above 1.2 increased the probability of concern (LR > 10) and above 1.8 of ADHD diagnosis (LR > 3). Teacher hyperactivity/impulsivity scores above 1.2 and inattention scores above 1.8 increased the probabilities of concern (LR = 4.2 and > 5, respectively), but teacher SNAP-IV scores did not usefully change the probability of diagnosis. Further research should address reasons for higher teacher scores for African American children and the differences in measurement models by race.

Obsessive-compulsive disorder is a common, chronic, and oftentimes disabling disorder. The only established first-line treatments for obsessive-compulsive disorder are exposure and response prevention therapy and the serotonin reuptake inhibitors. Many patients do not experience complete symptom resolution with either modality and require augmentation approaches. Recent animal and clinical data suggest that D-cycloserine, a partial agonist that acts at the strychnine-insensitive glycine-recognition site of the N-methyl-D-aspartate receptor complex, may enhance extinction learning that occurs in exposure-based psychotherapies. Given this, this study examined if D-cycloserine (250 mg) enhances the overall efficacy and rate of change of exposure and response prevention therapy for adult obsessive-compulsive disorder. Participants were 24 adults meeting Diagnostic and Statistical Manual of Mental Disorders-IV criteria for obsessive-compulsive disorder. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining exposure and response prevention therapy+D-cycloserine versus exposure and response prevention therapy+placebo. All patients received 12 weekly sessions of exposure and response prevention treatment. The first session involved building a ritual hierarchy and providing psychoeducation about obsessive-compulsive disorder. The second session involved a practice exposure. Sessions 3-12 involved exposure and response prevention exercises. D-cycloserine or placebo (250 mg) was taken 4 h before every session. No significant group differences were found across outcome variables. The rate of improvement did not differ between groups. The present results fail to support the use of D-cycloserine with exposure and response prevention therapy for adult obsessive-compulsive disorder. As this study is the first to explore this question and a number of methodological issues must be considered when interpreting the findings, the conclusions that may be drawn from our results are limited.

We report on the factor structure of the Yale Global Tic Severity Scale. Participants were 76 children and adolescents diagnosed with tic disorders. Overall, the model proposed by Leckman et al. [Leckman, J.F., Riddle, M.A., Hardin, M.T., Ort, S.I., Swartz, K.L., Stevenson, J., Cohen, D.J., 1989. The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child and Adolescent Psychiatry 28, 566–573.] represented an adequate fit. The internal consistency of the factors was acceptable and the convergent and divergent validity was supported vis-a-vis correlations with parent ratings of Tourette's Disorder symptoms. These findings support the use of the original scoring structure in assessing pediatric tic severity.