Citation counts and journal impact factors do not capture some indicators of research quality in the behavioural and brain sciences

Citation data and journal impact factors are important components of faculty dossiers and figure prominently in both promotion decisions and assessments of a researcher's broader societal impact. Although these metrics play a large role in high-stakes decisions, the evidence is mixed about whether they are strongly correlated with indicators of research quality. We use data from a large-scale dataset comprising 45 144 journal articles with 667 208 statistical tests and data from 190 replication attempts to assess whether citation counts and impact factors predict three indicators of research quality: (i) the accuracy of statistical reporting, (ii) the evidential value of the reported data and (iii) the replicability of a given experimental result. Both citation counts and impact factors were weak and inconsistent predictors of research quality, so defined, and sometimes negatively related to quality. Our findings raise the possibility that citation data and impact factors may be of limited utility in evaluating scientists and their research. We discuss the implications of these findings in light of current incentive structures and discuss alternative approaches to evaluating research.

RADI-02. Hippocampal-sparing whole brain volumetric modulated arc therapy (VMAT) planning in Monaco: a “How-to” not pull your hair out

Purpose

NRG-CC001 recently reported positive results on hippocampal-sparing IMRT (HS-IMRT) in conjunction with memantine for the reduction in cognitive decline compared to conventional whole brain radiation therapy. Herein, we report our experience in planning volumetric modulated arc therapy (VMAT) cases in Monaco® with the anticipation of increased utilization of the planning technique for delivery on Elekta linear accelerators.

Methods and Materials

Twelve patients previously treated with whole brain radiation therapy who would have been eligible for NRG-CC001 were replanned with VMAT HS-IMRT for to a dose of 30Gy/10fx using constraints from the trial.

Results

All twelve patients were able to be planned with VMAT and achieve NRG-CC001 dose constraints. Median maximum and D100% to the right and left hippocampi were: 13.37Gy and 13.43Gy, respectively and 8.76Gy and 8.86Gy, respectively. Median coverage of the brain minus the hippocampi with 30Gy was 96.53%. All cases passed quality assurance testing with 3%/3mm and 2%/2mm criterion.

Conclusions

Hippocampal-sparing IMRT whole brain radiation therapy can be feasibly planned with VMAT technique in Monaco® and delivered on Elekta linear accelerators.

Combination radiation and immunotherapy in gynecologic malignancies-a comprehensive review

Definitive and adjuvant radiation and chemoradiation have been mainstays in the management of multiple gynecologic malignancies for decades. However, despite these treatments, the prognosis of patients with locally advanced, recurrent, refractory, and metastatic disease continues to be poor. Over the last decade, immune checkpoint inhibitors have emerged as a promising therapeutic modality, but response rates to monotherapy are low. Mounting basic science and translational research suggests that immunotherapy and radiation may act synergistically with the potential to improve clinical outcomes across multiple disease sites relative to monotherapy with either radiation or immunotherapy alone. Results from early clinical trials in other disease sites, and burgeoning trials within the gynecologic malignancies space hold promise for combined modality treatment. With increasing clinical data supporting combined modality therapy, there is interest in reevaluating treatment paradigms in gynecologic malignancies to improve the current standards of care. In this review, current proposed mechanisms, rationale, and evidence for treatment of gynecologic malignancies with combined radiation and immunotherapy, specifically immune checkpoint inhibitors, will be discussed. Additionally, although currently early and limited, existing clinical data will be summarized as it applies to cervical, endometrial, ovarian, and vulvar cancers. The status of current clinical trials investigating the sequencing, dosing, and fractionation of combined radiation and immunotherapy in these disease sites will also be reviewed.

Predictors of Treatment Interruption During Frameless Gamma Knife Icon Stereotactic Radiosurgery

Purpose

The Gamma Knife (GK) Icon allows for the delivery of stereotactic radiosurgery using a thermoplastic mask in combination with intrafraction motion monitoring using high definition motion management. The system pauses treatment if the magnitude of motion in all directions exceeds 1 to 1.5 mm, causing a break in treatment and prolongation of the session. We reviewed the records of patients treated in a frameless manner on our GK Icon system to determine predictors for treatment interruption.

Methods and Materials

We reviewed the records of patients treated between May 2019 and May 2020 on the GK Icon using a frameless technique for brain metastases, gliomas, schwannomas, and meningiomas. We recorded treatment time as noted in the plan document, actual treatment delivery time, and any pauses in treatment. We tabulated baseline characteristics including age, gender, diagnosis, performance status, and shifts at time of treatment. We used a receiver operating curve analysis to determine a timepoint corresponding with treatment interruption. We then conducted a logistic regression analysis to generate odds ratios for likelihood of treatment.

Results

We identified 150 patients meeting inclusion criteria. The majority (82%) were patients with brain metastases. The median age was 63 and the median dose was 27 Gy (16-30 Gy) in 3 fractions (1-5 fractions). The median treatment time was 23 minutes (4-108 minutes). Sixty-nine patients (46%) had at least 1 pause in treatment (range, 1-7). Receiver operating curve analysis revealed treatment time >19 minutes and rotation >0.47 degrees to be associated with interruption. Multivariable logistic regression revealed rotation >0.47 degrees and treatment time >19 minutes as predictive of interruption.

Conclusions

For patients with rotations exceeding 0.47 degrees or an extended treatment time, physicians should expect treatment interruptions, consider fractionation to lessen table time, or use a frame-based approach.

RADT-32. NATIONAL TRENDS IN RADIATION DOSE FOR LOW GRADE GLIOMAS

BACKGROUND

Adjuvant radiation is used in patients with low grade gliomas (LGG) with high risk characteristics. Randomized trials have examined dosing schemes ranging from as low as 45 Gy to higher than 60 Gy, with no difference in outcome. We used the National Cancer Database (NCDB) to see which doses were used in this patient population, and if any difference were seen in outcome.

METHODS

We queried the NCDB for patients with WHO Grade 2 brain tumors treated with surgery and adjuvant radiotherapy. We divided the cohort into dose groups: 45-50 Gy, 50.4-54 Gy, and >54 Gy. Multivariable logistic regression was used to identify predictors of low and high dose radiation. Propensity matching was used to account for indication bias.

RESULTS

We identified 1,437 patients meeting the above criteria. Median age was 45 years. Forty-eight percent had astrocytoma subtype and 70% had subtotal resection. The majority of patients (69%) were treated to between 50.4-54 Gy. Half of all patients were treated with radiation alone. 1p19q status was recorded in 32% of patients, and 13% overall were co-deleted. Predictors of high dose radiation were increased income, astrocytoma subtype, chemotherapy receipt, and treatment in 2014. Patients treated to a dose of >54 Gy had a median survival of 73.5 months and was not reached in those treated to a lower dose (p=0.0041). Subset analysis of patients with astrocytoma subtype showed median survivals of 79.0 and 51.2 months for low and high dose, respectively (p=0.13). When limited to oligodendrogliomas corresponding 5 year survival rates were 86% and 65%, in favor of lower doses (p=0.0004).

CONCLUSIONS

This analysis shows that 50.4-54 Gy is the most widely used radiation regimen for ow grade gliomas. There appeared to be no benefit to higher doses, although factors not recorded are likely confounding the RESULTS:

COVD-01. ADAPTATION OF A GAMMA KNIFE ICON STEREOTACTIC RADIOSURGERY PROGRAM IN THE FACE OF A GLOBAL PANDEMIC

PURPOSE

The COVID-19 pandemic necessitated drastic and rapid changes throughout the field of radiation oncology, some of which were unique to the discipline of radiosurgery. Available guidelines called for reduced frame use, postponing non-urgent cases, and reducing the number of fractions delivered. Our institution enacted many of these guidelines, and herein we show the resultant effect on patient treatments on our Gamma Knife Icon system.

METHODS & MATERIALS

In early to mid-March of 2020 our institution rapidly implemented suggested changes according to ASTRO and other consensus guidelines as they relate specifically to stereotactic radiosurgery in the COVID-19 era. We reviewed the GK Icon schedule at our institution between January 01 and April 30, 2020. We documented age, condition treated, technique (frame vs. mask), and number of fractions. We then tabulated and graphed the number of patients, framed cases, and fractions across that time period.

RESULTS

Seventy-seven patients were treated on the GK Icon between January and April 2020, for a total of 231 fractions. The number of unique patients per month varied from 18 (April) to 22 (January). Of the 77 patients only 5 were treated using a frame. The number of fractions per month decreased significantly over time, from 70 in January to 36 in April. Likewise, the percentage of single fraction cases increased from 4.5% per month in January to 67% in April.

CONCLUSIONS

The results presented here show that it is possible to quickly and efficiently change work flows to allow for reduced fractionation and frame use in the time of a global pandemic. Multidisciplinary cooperation and ongoing communication are integral to the success of such programs.

Intuitions about personal identity are rooted in essentialist thinking across development

What aspects of a person determine whether they are the same person they were in the past? This is one of the fundamental questions of research on personal identity. To date, this literature has focused on identifying the psychological states (e.g., moral beliefs, memories) that people rely on when making identity judgments. But the notion of personal identity depends on more than just psychological states. Most people also believe that the physical matter that makes up an individual is an important criterion for judging identity; changes to the physical stuff in a person's body, even if they are not accompanied by any psychological changes, are judged to change who the person is at some level. Here, we investigate the sources of these beliefs and propose that they stem from the broader cognitive tendency to assume that unseen physical essences make things what they are-psychological essentialism. Four studies provided support for this claim. In Studies 1 and 2, exposing participants to essentialist reasoning led to stronger endorsement of physical continuity as a criterion for personal identity. Similarly, individual differences in participants' essentialist thinking predicted the extent of their reliance on physical continuity (Study 3), and this relationship was observed even among 6- to 9-year-old children (Study 4). These studies advance theory on the psychology of personal identity by identifying a reason why people assign a central role to physical composition when judging identity.

Impact of histological grade on oncologic outcomes in clinical stage I patients with endometrial carcinoma patients after definitive primary radiation therapy

OBJECTIVES

To determine the impact of histological grade on overall survival in patients with clinical stage I endometrioid endometrial adenocarcinoma when radiation therapy is used as primary definitive treatment.

METHODS

Patients with stage I endometrioid endometrial adenocarcinomas who underwent definitive radiation therapy with brachytherapy ± external beam radiation therapy were identified from the National Cancer Database. Overall survival was estimated using the Kaplan-Meier method. Univariable and multivariable analyses were performed to determine factors affecting overall survival. Inverse probability of treatment weights were also used in multivariable analysis to estimate casual effects of external beam radiation therapy.

RESULTS

A total of 947 patients were identified. Median overall survival for grade 1, grade 2, and grade 3 tumors was 62 months (95% CI 53.8 to 70.2), 48.5 months (95% CI 38.2 to 58.8), and 33.5 months (95% CI: 23.1 to 43.8), respectively. Grade, age, and insurance status were associated with overall survival in univariate analysis with only grade and age remaining significant in multivariate analysis. Brachytherapy with external beam radiation therapy was not associated with survival in comparison with brachytherapy alone. Compared with grade 1 tumors, patients with grade 3 (HR 1.4, 95% CI 1.15 to 1.89), but not grade 2 (HR 1.0, 95% CI 0.82 to 1.26), had an increased risk of death, which persisted in an inverse probability of treatment weights-adjusted model (HR 1.56, 95% CI 1.21 to 1.93).

CONCLUSIONS

Patients with grade 3 stage I endometrioid endometrial adenocarcinoma treated with primary definitive radiation therapy have worse survival than those with lower grade tumors. Addition of external beam radiation therapy to brachytherapy did not affect survival.

Stereotactic Body Radiation Therapy for Pulmonary Oligometastases Arising from Non-lung Primaries in Patients Without Extrapulmonary Disease

Purpose

Stereotactic body radiation therapy (SBRT) is increasingly used in the management of patients with oligometastatic cancers and is under prospective evaluation by the Radiation Therapy Oncology Group (RTOG). Here we report outcomes from a high-volume institution of patients treated with SBRT for pulmonary oligometastases.

Materials and methods

We conducted a retrospective review of 105 patients who had one to five pulmonary oligometastases (185 lesions) without extrapulmonary disease treated with SBRT from 2002-2014. Target failure-free survival (TFFS), progression-free survival (PFS), and overall survival (OS) were calculated. Univariate and multivariate Cox regression analyses were performed on factors predictive of outcomes.

Results

The median age at first SBRT was 68 years and the median follow-up was 29.5 months. The median time from initial diagnosis of primary to SBRT was 42.7 months; 14.3% had synchronous oligometastases and 76.7% had one to two pulmonary lesions at first SBRT. The distribution of primaries was as follows: 36.2% colorectal, 16.2% head/neck, 9.5% genitourinary, 9.5% sarcoma, 7.6% gynecologic, 6.7% other, 5.7% breast, 5% melanoma, and 4% esophageal. The median lesion size was 1.6 cm and the most common regimen was 60 Gy in three fractions (range: 12-60 Gy in one to five fractions).

TFFS was 94.4% and 90.8% at two and three years, respectively. Two and three year OS were 87.9% and 60.2%, respectively. Median PFS and OS were 16.2 and 45.3 months, respectively. In multivariate analysis, age at primary cancer diagnosis and biologically effective dose with an alpha-beta ratio of 10 (BED10) were identified as factors significantly affecting OS (p<0.05).

Conclusions

Comprehensive treatment of pulmonary oligometastases with SBRT in the absence of extrapulmonary disease results in excellent target control and modest survival outcomes.

Moral Severity is Represented as a Domain-General Magnitude

The severity of moral violations can vary by degree. For instance, although both are immoral, murder is a more severe violation than lying. Though this point is well established in Ethics and the law, relatively little research has been directed at examining how moral severity is represented psychologically. Most prominent moral psychological theories are aimed at explaining first-order moral judgments and are silent on second-order metaethical judgments, such as comparisons of severity. Here, the relative severity of 20 moral violations was established in a preliminary study. Then, a second group of participants were asked to decide which of two moral violations was more severe for all possible combinations of these 20 violations. Participant's response times exhibited two signatures of domain-general magnitude comparisons: we observed both a distance effect and a semantic congruity effect. These findings suggest that moral severity is represented in a similar fashion as other continuous magnitudes.

Registered Replication Report: Rand, Greene, and Nowak (2012)

In an anonymous 4-person economic game, participants contributed more money to a common project (i.e., cooperated) when required to decide quickly than when forced to delay their decision (Rand, Greene & Nowak, 2012), a pattern consistent with the social heuristics hypothesis proposed by Rand and colleagues. The results of studies using time pressure have been mixed, with some replication attempts observing similar patterns (e.g., Rand et al., 2014) and others observing null effects (e.g., Tinghög et al., 2013; Verkoeijen & Bouwmeester, 2014). This Registered Replication Report (RRR) assessed the size and variability of the effect of time pressure on cooperative decisions by combining 21 separate, preregistered replications of the critical conditions from Study 7 of the original article (Rand et al., 2012). The primary planned analysis used data from all participants who were randomly assigned to conditions and who met the protocol inclusion criteria (an intent-to-treat approach that included the 65.9% of participants in the time-pressure condition and 7.5% in the forced-delay condition who did not adhere to the time constraints), and we observed a difference in contributions of -0.37 percentage points compared with an 8.6 percentage point difference calculated from the original data. Analyzing the data as the original article did, including data only for participants who complied with the time constraints, the RRR observed a 10.37 percentage point difference in contributions compared with a 15.31 percentage point difference in the original study. In combination, the results of the intent-to-treat analysis and the compliant-only analysis are consistent with the presence of selection biases and the absence of a causal effect of time pressure on cooperation.

How Large Is the Role of Emotion in Judgments of Moral Dilemmas?

Moral dilemmas often pose dramatic and gut-wrenching emotional choices. It is now widely accepted that emotions are not simply experienced alongside people's judgments about moral dilemmas, but that our affective processes play a central role in determining those judgments. However, much of the evidence purporting to demonstrate the connection between people's emotional responses and their judgments about moral dilemmas has recently been called into question. In the present studies, we reexamined the role of emotion in people's judgments about moral dilemmas using a validated self-report measure of emotion. We measured participants' specific emotional responses to moral dilemmas and, although we found that moral dilemmas evoked strong emotional responses, we found that these responses were only weakly correlated with participants' moral judgments. We argue that the purportedly strong connection between emotion and judgments of moral dilemmas may have been overestimated.

Marginally Significant Effects as Evidence for Hypotheses: Changing Attitudes Over Four Decades

Some effects are statistically significant. Other effects do not reach the threshold of statistical significance and are sometimes described as "marginally significant" or as "approaching significance." Although the concept of marginal significance is widely deployed in academic psychology, there has been very little systematic examination of psychologists' attitudes toward these effects. Here, we report an observational study in which we investigated psychologists' attitudes concerning marginal significance by examining their language in over 1,500 articles published in top-tier cognitive, developmental, and social psychology journals. We observed a large change over the course of four decades in psychologists' tendency to describe a p value as marginally significant, and overall rates of use appear to differ across subfields. We discuss possible explanations for these findings, as well as their implications for psychological research.

The Frequency of "Brilliant" and "Genius" in Teaching Evaluations Predicts the Representation of Women and African Americans across Fields

Women and African Americans-groups targeted by negative stereotypes about their intellectual abilities-may be underrepresented in careers that prize brilliance and genius. A recent nationwide survey of academics provided initial support for this possibility. Fields whose practitioners believed that natural talent is crucial for success had fewer female and African American PhDs. The present study seeks to replicate this initial finding with a different, and arguably more naturalistic, measure of the extent to which brilliance and genius are prized within a field. Specifically, we measured field-by-field variability in the emphasis on these intellectual qualities by tallying-with the use of a recently released online tool-the frequency of the words "brilliant" and "genius" in over 14 million reviews on RateMyProfessors.com, a popular website where students can write anonymous evaluations of their instructors. This simple word count predicted both women's and African Americans' representation across the academic spectrum. That is, we found that fields in which the words "brilliant" and "genius" were used more frequently on RateMyProfessors.com also had fewer female and African American PhDs. Looking at an earlier stage in students' educational careers, we found that brilliance-focused fields also had fewer women and African Americans obtaining bachelor's degrees. These relationships held even when accounting for field-specific averages on standardized mathematics assessments, as well as several competing hypotheses concerning group differences in representation. The fact that this naturalistic measure of a field's focus on brilliance predicted the magnitude of its gender and race gaps speaks to the tight link between ability beliefs and diversity.

Complete Pathologic Response Following Neoadjuvant Chemoradiotherapy and High-Dose-Rate Brachytherapy for Locally Advanced Endometrial Carcinoma

The majority of uterine cancers present at an early stage because of abnormal post-menopausal bleeding. Locally advanced endometrial carcinoma with extension to the parametria represents a rare subset of patients with treatment options involving neoadjuvant therapy followed by extrafascial hysterectomy or definitive non-operative management. Neoadjuvant therapy enables R0 resection in the majority of patients but with relatively low rates of complete pathologic response. Herein, we detail the case of a patient with bulky FIGO Stage IIIB endometrial carcinoma with pelvic and para-aortic lymphadenopathy who achieved a complete response with neoadjuvant chemoradiotherapy and high-dose-rate brachytherapy prior to extrafascial hysterectomy.

Immunohistochemical evidence for an association of ribosomes with microfilaments in 3T3 fibroblasts

Ribosome distribution in cultured fibroblasts was investigated immunohistochemically using antibodies which recognize the 60S ribosomal subunit. After treatment of cells with buffer containing 25mM KCl and 0.05% Nonidet-P40 immunostained material was present in punctate patterns and linear arrays consistent with some ribosomes being associated with the cytoskeleton. Treatment of the cells with 130mM KCl caused loss of both the beaded lines of immunostaining and micro-filaments. Double immunostaining showed ribosomes to be closely associated with microfilaments.

Increased association of ribosomes with myofibrils during the skeletal-muscle hypertrophy induced either by the beta-adrenoceptor agonist clenbuterol or by tenotomy

Ribosome distribution in skeletal-muscle myofibres was investigated by immunohistochemistry and microdensitometry by using anti-(60 S ribosomal subunit) antibodies. Administration of the beta-adrenoceptor agonist clenbuterol caused an increase in the staining of the myofibrillar region with this antibody relative to that found in the subsarcolemmal cytoplasm. A similar effect was observed during hypertrophy of the plantaris muscle following severance of the tendon to the gastrocnemius. The results suggest that increased association of ribosomes with the myofibrils occurs during muscle hypertrophy.

Immunological localization of ribosomes in striated rat muscle. Evidence for myofibrillar association and ontological changes in the subsarcolemmal:myofibrillar distribution

Ribosome distribution in skeletal-muscle fibres was investigated immunohistochemically by using polyclonal antibodies raised against large-ribosomal-subunit proteins isolated from rat liver. Immunoblot analysis showed the antibodies to recognize five major proteins of the large subunit; these were identified as L4, L6, L7, L15 and L17 by two-dimensional electrophoresis. Immunohistochemistry of frozen rat skeletal-muscle sections showed staining of both the subsarcolemmal and intermyofibrillar cytoplasm. A distinct banding pattern was observed, and when peroxidase and phase-contrast images of the same field were compared by image analysis the anti-ribosome staining was found to correspond to the A-bands. These results suggest that a proportion of muscle ribosomes are present in the myofibrillar cytoplasm in a regular fashion, possibly associated with myosin. Densitometric analysis of the peroxidase immunostaining showed that the ratio of myofibrillar to sub-sarcolemmal ribosomal material was lower in muscle from 51-day-old rats compared with those from 14-day-old animals.