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Simple Summary: The adrenal glands represent a frequent localization area for metastases of various primary tumors. The standard of care for treating adrenal metastases is currently surgical resection, but radiotherapy is becoming a feasible and well-tolerated treatment alternative. However, the literature shows contradictory results regarding the optimal local treatment for adrenal metastases. This study analyzed oncological outcomes (local control, progression free survival, and overall survival) and complication rates after stereotactic body radiotherapy or surgical resection of adrenal metastases to further asses the benefits of stereotactic body radiotherapy. To our knowledge, this analysis is the first direct comparison of stereotactic body radiotherapy and adrenalectomy for adrenal metastases. Background: This single-center retrospective study aimed to evaluate the efficacy and toxicity profiles of stereotactic body radiotherapy (SBRT) and surgical resection in patients with adrenal metastases originating from solid tumors. Methods/Materials: Patients with advanced tumor conditions or comorbidities typically received SBRT, whereas those considered physically fit underwent standard surgical treatment. Endpoints included local control (LC), progression free survival (PFS), overall survival (OS), and complication rates (CR). Results: 41 patients with 48 adrenal metastases were included, with 27 (65.9%) patients receiving SBRT and 14 (34.1%) patients undergoing adrenalectomy. One- and two-year LC values were 100% for both periods after adrenalectomy, and 70.0% and 52.5% after SBRT (p = 0.001). PFS showed values of 40.2% and 32.1% at one and two years after adrenalectomy and of 10.6% for both periods after SBRT (p = 0.223). OS was 83.3% both one and two years after surgery and 67.0% and 40.2% after SBRT (p = 0.031). There was no statistically significant difference between the two groups regarding acute complications (p = 0.123). Conclusion: Despite potential confounders, adrenalectomy exhibited statistically significant superior LC and OS compared to SBRT in managing adrenal metastases, while both treatment methods displayed acceptable toxicity profiles. However, patient selection bias must be taken into account when directly comparing the two therapy modalities. Nevertheless, the study provides new and important results for the scientific and medical communities regarding oncological outcomes after SBRT or surgical resection of adrenal metastases. [ABSTRACT FROM AUTHOR]

Background: Discontinuation of radiotherapy is rarely discussed in the scientific literature. The goal of this study was, therefore, to estimate the frequency of and reasons for treatment discontinuations in patients receiving radiotherapy for brain metastases from solid tumors and to identify factors predicting said discontinuations. Methods: All patients treated for brain metastases from solid tumors between 2010 and 2020 at our institution were retrospectively reviewed. In addition to collecting relevant patient characteristics, the Recursive Partitioning Analysis (RPA) and disease-specific Graded Prognostic Assessment (GPA) groups for each patient were calculated to assess the performance of these scores in predicting treatment discontinuations. Results: Out of 468 patients who underwent cranial radiotherapy, 35 treatments (7.5%) were discontinued. The most frequent reason was clinical deterioration, which was documented in 26 (74.3%) of discontinued treatments. Patients whose radiotherapy was discontinued had, on average, more leptomeningeal disease (20.0% vs. 12.6%), worse ECOG performance status (mean ECOG performance status 1.86 vs. 1.39), and more uncontrolled extracranial metastases (85.3% vs. 70.8%). The frequencies of treatment discontinuation increased with worse prognosis and differed significantly across RPA groups (p = 0.037) but not across GPA groups (p = 0.612). Conclusions: Treatment discontinuation occurred in 7.5% of cases, mostly due to clinical deterioration. Poor performance status, as well as more advanced disease and, in turn, poor prognosis, were associated with higher discontinuation rates. [ABSTRACT FROM AUTHOR]

The plastic deformation and martensite evolution of austenitic CrMnNi–N stainless steel with 8.6 wt% Mn and 4 wt% Ni is investigated in a temperature range of −40 to 100 °C. Martensite evolution is determined by in situ magnetic measurements during tensile test. The triggering stress and strain for martensite formation decrease with decreasing temperature. Ex situ volumetric magnetic measurements are used to determine the strain‐induced α′‐martensite volume fractions. The characterization of the microstructure is carried out with scanning electron microscope. Using electron backscatter diffraction, strain‐induced α′‐martensite is detected within deformation bands in the austenite. The strain hardening curve at −40 °C shows a typical progression for metastable austenitic stainless steels with pronounced strain‐induced α′‐martensite formation and can be divided into four hardening stages. At this temperature, the studied steel achieves the highest strain hardening rate. The amount of martensite increases with decreasing test temperature and reaches a maximum volume fraction of 76 vol% at −40 °C. The highest ductility of 83% is achieved at 40 °C, accompanied by a tensile strength of 732 MPa. The in situ magnetic measurement confirms that the inflection point in the strain hardening curve coincides with the maximum martensite formation rate. [ABSTRACT FROM AUTHOR]

The present study deals with the pitting and repassivation behavior of a nickel‐reduced austenitic stainless steel with different nitrogen contents. While nitrogen promoted the resistance to pitting, no significant effect on repassivation was found. The study also aims to address the experimental difficulties in determining repassivation potentials owing to the occurrence of crevice corrosion. Furthermore, the mechanism of the ongoing reactions was investigated, indicating that pitting was initiated in regions where manganese sulfide inclusions were present next to the remaining δ‐ferrite. [ABSTRACT FROM AUTHOR]

Introduction: In the spring of 2020, coronavirus disease 2019 posed a substantial challenge for countries and their healthcare systems. In Germany, over 70% of all cancer patients are treated in an outpatient setting, so gynecologic oncology practices are the guarantors of optimal patient care. We developed a survey to evaluate the management of gynecologic oncology patients. Methods: The survey consisted of 38 questions and was sent to the members of the Berufsverband Niedergelassener Gynäkologischer Onkologen in Deutschland e.V. (BNGO), a professional association of gynecologic oncologists in the outpatient sector in Germany. Results: The survey was completed by 54 out of 133 (41%) gynecologic oncologists from 14 out of 15 (93%) federal states where the BNGO is represented. Facing the pandemic, popular measures were mask requirements (100%), restriction of access to practices (94%), increased number of disinfectant dispensers (85%), installment of panes of acrylic glass (76%), or spatial alterations (67%). For most patients the pandemic had no influence on prioritization of therapies (82%) or prescribed systemic treatments (87%). Despite an increase in perceived psychological burden among the staff (72%), 85% (45/54) of the practices were not offered any additional psychological support. Discussion and Conclusion: As most cancer patients in Germany are treated in an outpatient setting, a suitable reaction of oncology centers to the new circumstances was crucial to secure optimal treatment and patient care. Nevertheless, the low prioritization of mental health or distress of healthcare workers poses a serious threat to the maintenance of optimal medical care in further waves of the pandemic. [ABSTRACT FROM AUTHOR]

It is unclear how frequently the Apple Watch produces spO2 measurements outside of the normal range in healthy individuals at rest. We conducted a head-to-head comparison in 38 healthy individuals between two watches and two medical-grade pulse oximeters. Fourteen percent of watch measurements yielded spO2 values below 95%, with no values below 92%. Results suggest that outliers measured by the watch should not be a cause for concern in otherwise healthy individuals. [ABSTRACT FROM AUTHOR]