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Background and objectives: Epithelioid sarcoma (ES) is an aggressive malignancy scarcely reported on due to its rarity. This study is a review of its traits and features of prognosis and survival by analyzing both the literature and a national cancer database.Methods: Data were acquired from both the Survival, Epidemiology, and End Results database and literature. 1, 5, and 10-year Disease Specific Survival rates and hazard ratios (HR) were determined. Data were split into pre-2000 ( 2000) groups. Overall survival, recurrence, and metastasis rates were obtained.Results: Ninety hundred and ninety eight and 992 cases of ES were identified from the database and literature, respectively. Age, anatomical site, grade, TNM staging, treatment modality and year of diagnosis were demonstrated to be independent predictors of survival. Overall 5- and 10-year survival were 60.4% and 50.2%, respectively. Overall recurrence and metastasis rates were 63.4% and 40.3%. Using cases diagnosed prior to 2000 as reference, those diagnosed after 2000 had a worse prognosis (HR: 1.55).Conclusions: We report using the largest cohort of ES to date. Despite ES's often dismal prognosis, there are factors associated with better outcomes. A worsening survival over the years warrants further investigation into this sarcoma.

As discussed in the literaturę, more and more transnational corporations (TNCs) were attaching importance to research and development (R&D) activity from the 1970s through the 2000s. This growing involvement of TNCs in R&D resulted in their dominant role in global R&D expenditure. Indeed, a comparative analysis of financial data collected for the group of the 102 largest corporate R&D spenders worldwide in 2007 showed that this group of TNCs accounted for a significant share of the worlds R&D expenditure not only in 2007 alone but also in the period of 2000-2011. Moreover, a similarity between their home countries and the countries being top R&D spenders was found; however, most of these corporations were conducting their R&D at international level. Furthermore, the analysed TNCs operated mostly in technology-intensive industries, for which the foun- dations were provided by a multidisciplinary science and technology basis.

Rhabdomyosarcoma is the most common soft-tissue sarcoma in children and adolescents and accounts for 3% of all pediatric tumors. Subtypes include alveolar, spindle cell, embryonal, mixed-type, pleomorphic, and rhabdomyosarcoma with ganglionic differentiation. The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was queried for patients diagnosed with any type of rhabdomyosarcoma between 1973 and 2014. Patient demographics, tumor characteristics, and incidence were studied with χ2 analysis. Survival was modeled with Kaplan-Meier survival curves and Cox proportional hazards models were used to assess the effect of age and gender on survival. Pleomorphic subtype had higher grade and larger sized tumors compared to other subtypes (p 0.05). This study highlights key differences in the demographic and survival rates of the different types of rhabdomyosarcoma that can be used for more tailored patient counseling. We also demonstrate that large, population-level databases provide sufficient data that can be used in the analysis of rare tumors. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2226-2230, 2019.

Knowledge of the low-lying monopole strength in $\mathrm{^{12}C}$, the Hoyle state in particular, is crucial for our understanding of both the astrophysically important $3\alpha$ reaction and of $\alpha$-particle clustering. The $\mathrm{^{12}C}(\alpha, \alpha^{\prime})\mathrm{^{12}C}$ and $\mathrm{^{14}C}(p, t)\mathrm{^{12}C}$ reactions were employed to populate states in $^{12}$C. A self-consistent, simultaneous analysis of the inclusive spectra with lineshapes was performed, which accounted for distortion due to nuclear dynamics and experimental effects. Clear evidence was found for excess monopole strength at $E_{x} \sim 9$ MeV, particularly in the $\mathrm{^{12}C}(\alpha, \alpha^{\prime})\mathrm{^{12}C}$ reaction at $0^{\circ}$. This additional strength cannot be reproduced by the previously established monopole states between $E_{x} = 7$ and 13 MeV. An additional $0^{+}$ state at $E_{x} \sim 9$ MeV yielded a significantly improved fit of the data and is the leading candidate for the predicted breathing-mode excitation of the Hoyle state. Alternatively, the results may suggest that a more sophisticated, physically motivated parameterization of the astrophysically important monopole strengths in $\mathrm{^{12}C}$ is required., Comment: 25 pages (including appendix and bibliography), 16 figures

Purpose Hand infections are a common source of potentially debilitating morbidity, particularly in patients with comorbid disease. We hypothesize that there is a difference in predictive value between two commonly used comorbidity indices for the prognosis of hand infections, which may have clinical implications in the management of these conditions. Methods The Nationwide Inpatient Sample 2001–2013 database was queried for hand infections using International Classification of Diseases, Ninth Revision codes. The Elixhauser (ECI) and Charlson (CCI) comorbidity scores were calculated based on validated sets of ICD-9 codes. Primary outcomes included mortality, prolonged length of stay (LOS, defined as >95 percentile), discharge destination, and postoperative complications. Indices were compared using receiver operating characteristic (ROC) curves and the areas under the curve (AUC). If confidence intervals overlapped, significance was determined using the DeLong method for correlated ROC curves. This is a validated, non-parametric comparison used for the calculation of the difference between two AUCs. Results A weighted total of 1,511,057 patients were included in this study. The majority were Caucasian (57.1%) males (61.4%). Complication rates included 0.9% mortality, 5.3% prolonged length of stay, 25.3% discharges to non-home destinations, and 5.3% post-operative complications. The ECI and CCI each demonstrated good predictive value for mortality, but poor predictive value for non-routine discharge, prolonged LOS, and post-operative complications. There was a significantly increased likelihood of each complication with increasing comorbidity score for both indices, with the greatest odds ratio in the ECI ≥4 cohort. Conclusions The CCI was superior in predicting mortality while the ECI was superior in predicting non-routine discharge, prolonged length of stay, and postoperative complications, but these indices may not be clinically relevant. While both represent good predictive models, a score specifically designed for patients with hand infections may have superior prognostic value. Level of evidence Level IV.

ispartof: PHYSICS LETTERS B vol:809 status: published

Excited states in $^{98}$Ru were investigated using γ-ray spectroscopy following the β-decay of $^{98}$Rh, and via the $^{100}$Ru(p,t) reaction. Combining the results from the two experiments, two states were revised to have spin-parity of 4+ and subsequently assigned to the 02+ and “γ” bands, respectively. The observed structures in $^{98}$Ru are suggested to be deformed and rotational, rather than spherical and vibrational, and fit well into the systematics of these excitations in the Ru isotopes. The 02+ excitation is suggested as a shape coexisting configuration. This observation eliminates some of the last remaining candidates for nearly harmonic vibrational nuclei in the Z≈50 region. Beyond-mean-field calculations are presented that support shape coexistence throughout the Ru isotopes with N=52–62, and suggest a smooth evolution of the shapes.

We used a high-resolution magnetic spectrograph to study neutron pair-correlated 0+ states in $^{136}$Ba, produced via the Ba138(p,t) reaction. In conjunction with state-of-the-art shell model calculations, these data benchmark part of the dominant Gamow-Teller component of the nuclear matrix element (NME) for $^{136}$Xe neutrinoless double beta (0νββ) decay. We demonstrate for the first time an evaluation of part of a 0νββ decay NME by use of an experimental observable, presenting a new avenue of approach for more accurate calculations of 0νββ decay matrix elements.

Purpose Frailty is a well-known predictor of adverse postoperative outcomes and is often considered in the preoperative planning stage of surgery. In recent years, the modified frailty index (mFI), a novel metric used to quantify frailty, has become increasingly used in the orthopedic literature as a risk assessment tool. In this study, we analyze the utility of the mFI in predicting unplanned repeat operations and morbidity in the surgical treatment forearm fractures. Methods We used the American College of Surgeons National Surgical Quality Improvement Program 2006–2014 dataset to identify patients undergoing open fixation of forearm fractures. The mFI was calculated based on 5 possible comorbid conditions. Demographic and predictor variables were analyzed for associations with each outcome. In order to assess frailty in both the general and elderly population, two analyses were completed: one for the entire population and one for a population of age 65 or older. The primary outcome of interest was unplanned repeat operation. Secondary outcomes included discharge destination and major post-operative complications. Chi square and logistic regression analyses were used to identify associations. Results A total of 4641 patients were included in our final analysis. There was a higher prevalence of females and patients between the ages of 61 and 80 compared to other age groups. An mFI score ≥2 was a positively associated with unplanned repeat operation in the general population. An mFI score ≥2 was also positively associated with a discharge destination other than home and major post-operative complications. In the elderly population, mFI ≥2 was similarly associated with a discharge destination other than the patient’s home. Conclusions Patients undergoing open treatment of forearm fractures were at an increased likelihood of having an unplanned repeat operation and having major complications as frailty score increased, demonstrating that the mFI may be clinically applicable risk assessment tool for these patients.

Background: Synovial sarcoma (SyS) is a rare malignancy that is typically located on the limbs and occurs predominantly in adolescents. A study in a large population for SyS comparing subtypes has not yet been reported. Methods: National Cancer Institute’s Surveillance, Epidemiology, and End Results database was queried for patients diagnosed with SyS between January 1975 and December 2016. Patients were classified demographically according to gender, age, race/ethnicity, and marital status, and they were also classified by tumors, subtypes, localization, grade, year of diagnosis, laterality, type of treatment, and follow-up results. Results: A total of 3228 patients were included, with a mean age of 39.3 ± 18.8 (range: 1–94), of which 1521 (47.1%) were females and 1707 (52.9%) were males. According to its subtypes, 47.2% were SyS not otherwise specified, 32.3% were spindle cell, 19.9% were biphasic, and 0.6% were epithelioid type. The overall survival period is 138.0 (95% confidence interval: 113.2–162.8) months. Survival duration was found to be significantly different between groups according to gender (log-rank test; p < 0.001), age groups (log-rank test; p < 0.001), race (log-rank test; p = 0.001), marital status (log-rank test; p < 0.001), tumor subtypes (log-rank test; p < 0.001), tumor location (log-rank test; p < 0.001), tumor laterality (log-rank test; p < 0.001), date of diagnosis (log-rank test; p = 0.025), tumor grade (log-rank test; p < 0.001), historic stage (log-rank test; p < 0.001), state of chemotherapy (log-rank test; p < 0.001), state of radiotherapy (log-rank test; p < 0.001), presence of metastasis (log-rank test; p < 0.001), and total number of malignant tumors (log-rank test; p < 0.001). Conclusion: Male gender, being colored individual, being over 35 years at the time of diagnosis, epithelioid type, non-head and neck region localization is associated with poor prognosis. While radiotherapy improves survival, benefit of chemotherapy is unclear. Level of Evidence: III retrospective analysis.

Objectives/Interrogation: Scapholunate advanced collapse (SLAC) of the wrist is one of the most common pattern of degenerative arthritis in the wrist. The hallmark of SLAC is scaphoid or scapholunate ligament injury with collapse on the radial side of the wrist. Surgical intervention is warranted[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

The amount of solar radiation received at the Earth’s surface is influenced by local weather conditions. This paper investigates the effects of meteorological parameters on daily average solar radiation (DASR) in Duhok city, Iraq. Artificial Neural Networks (ANNs) based on multilayer preceptor feed-forward (MLP-FF) techniques are used to predict daily average solar radiation (DASR). The input variables used are a daily average of the relative humidity (RH), minimum temperature (T min ), maximum temperature (T max ), wind speed (WS), cloud layer (CL), atmospheric pressure (AP) and ultraviolet (UV) levels to estimate DASR. To identify and evaluate the effects of various input parameters on solar radiation, eight ANN-based models have been developed. To obtain the best estimation results, the number of neurons in the hidden layer has been varied. The best values of the Root Mean Square Error (RMSE), Mean Absolute Error (MAE) and correlation coefficient (R) have been calculated. For some models, the results obtained show good and better predictive accuracy than others. The present study indicates that various of the meteorological parameters can have a significant effect on the forecasting of solar radiation.

Venous thromboembolism (VTE) is a potentially life-threatening condition associated with both orthopaedic surgery and tumour growth. In this study, we identify risk factors associated with VTE in patients with musculoskeletal tumours using two national datasets. The ACS-NSQIP and NIS databases were queried for patients undergoing surgery with a diagnosis of benign or malignant musculoskeletal tumours. Chi-square and binary logistic regression analyses were used to determine risk factors for VTE. The incidence of VTE was 2% in both databases. Patients with malignant tumours, those with tumours of the pelvis, sacrum, or coccyx, obesity, arrhythmias, paralysis, metastatic disease, coagulopathy, and recent weight loss were at increased risk for VTE. In patients with benign tumours, those who were African American, those with tumours of the pelvis, sacrum, or coccyx, diabetes, anaemia, and coagulopathy were at increased risk of VTE. Patients with malignant or benign lesion are at greater risk of VTE if they are age 30 and over, of the African American population, or with tumors of the pelvis/sacrum/coccyx, or any of the following comorbidities: pulmonary disease, paralysis, other neurological disorders, or coagulopathy.

Background - Psychosomatic health of adolescent girls at crossroads of childhood and mature adulthood, may lead to various health problems in future. To measure the prevalence and identify factors associated with psychiatric morbidity & psychosomatic symptoms among adolescent secondary school girls in Khartoum. Methods - This ‘Study’ was conducted, in three secondary schools of Khartoum North. The Simple Random Sampling Technique was applied to select three schools from the spot map of Khartoum North for this study, and 491 girl students in the adolescent age group were selected from the completed updated list of students from the enrollment registers in these schools. Results - according to the cut-off point (≥ 24 in the G.H.Q -28) findings showed that the prevalence of psychiatric morbidity (severe depression and anxiety) was 60.89% among the adolescent secondary school girls while the psychosomatic disorder was 34.62%. The psychosomatic disorder was found to be significant (P0.05) relation between the fathers' level of education and the occurrence of psychosomatic however, the odds ratio of disease is 28% higher among the girls whose fathers were illiterate in comparison to the girls whose fathers were of high level of education. among adolescent school girls.