Pretreatment tumor sampling and prognostic factors in patients with soft-tissue sarcoma of the head and neck

Correction: DOI10.1007/s00405-021-07205-6 Early AccessDEC 2021Background Insufficient preoperative work-up and consequent intralesional or marginal resection of soft-tissue sarcomas of the head and neck (STSHNs) is common. Methods This retrospective cohort study comprised 63 patients with STSHN treated at the Helsinki University Hospital between 2005 and 2017. We assessed the effect of pretreatment tumor sampling on surgical margin status and need for supplemental surgery, as well as prognostic factors and survival. Results The lack of representative pretreatment biopsy specimen was associated with unfavorable margin status. Primary surgery at a non-academic center was associated with need for supplemental surgery. The 3-year overall survival (OS) was 68%, disease-specific survival (DSS) 71%, and recurrence-free survival (RFS) 61%. Higher tumor grade and primary tumor size over 5 cm were associated with reduced DSS. Conclusions Diagnosis and management of STSHNs should be centralized to experienced academic centers. Decision-making between needle biopsy, open biopsy, or upfront radical surgery depends on tumor location and size.Peer reviewe

Depressive symptoms predict smoking cessation in a 20-year longitudinal study of adult twins

Depression has been suggested to hinder smoking cessation, especially when co-occurring with nicotine dependence. The study aimed to examine the longitudinal association of depressive symptoms with smoking cessation among daily smokers. The study utilized adult Finnish twin cohort where 1,438 daily smokers (mean age: 38.3, range: 33-45) in 1990 were re-examined for their smoking status in 2011. We assessed baseline depressive symptoms with the Beck Depression Inventory, and the self-reported smoking status at follow-up. The methods included multinomial logistic regression and time to event analyses, adjusted for multiple covariates (age, sex, marital status, social class, heavy drinking occasions, and health status) and smoking heaviness at baseline assessed by cigarettes per day (CPD). Additionally, within-twin-pair analyses were conducted. Results indicated that moderate/severe depressive symptoms at baseline were associated with a lower likelihood of smoking cessation two decades later. Adjusting for covariates, those with moderate/severe depressive symptoms (vs. no/minimal depressive symptoms) had 46% lower likelihood of quitting (relative risk ratio, RRR=0.54, 95% CI: 0.30-0.96). After including CPD, the association of depressive symptoms with smoking cessation attenuated modestly (RRR=0.62, 95% CI: 0.34-1.12). Further, time to event analysis for quitting year since baseline yielded similar findings. In the within-pair analysis, depressive symptoms were not associated with quitting smoking. The results suggest that reporting more depressive symptoms is associated with a lower likelihood of smoking cessation during a 20-year period. The baseline amount of smoking and familial factors partly explain the observed association. Smoking cessation programs should monitor depressive symptoms.Peer reviewe

The prognostic value of extramural venous invasion in preoperative MRI of rectal cancer patients

Aim This study aimed to examine the prognostic value of extramural venous invasion observed in preoperative MRI on survival and recurrences. Method In total, 778 rectal cancer patients were evaluated in multidisciplinary meetings in Helsinki University Hospital during the years 2016-2018. 635 patients met the inclusion criteria of stage I-III disease and were intended for curative treatment at the time of diagnosis. 128 had extramural venous invasion in preoperative MRI. Results The median follow-up time was 2.5 years. In a univariate analysis extramural venous invasion was associated with poorer disease-specific survival (hazard ratio [HR] 2.174, 95% CI 1.118-4.224, P = 0.022), whereas circumferential margin = T3c or nodal positivity were not. Disease recurrence occurred in 17.3% of the patients: 13.4% had metastatic recurrence only, 1.7% mere local recurrence and 2.2% both metastatic and local recurrence. In multivariate analysis, extramural venous invasion (HR 1.734, 95% CI 1.127-2.667, P = 0.012) and nodal positivity (HR 1.627, 95% CI 1.071-2.472, P = 0.023) were risk factors for poorer disease-free survival (DFS). Circumferential marginPeer reviewe

Recess physical activity and school-related social factors in Finnish primary and lower secondary schools : cross-sectional associations

Abstract Background Participation in physical activities provides students with opportunities for social interaction and social skills development. The purpose of this study was to investigate the associations of students&#8217; recess physical activity with school-related social factors. Methods Data were collected in 19 schools countrywide in autumn 2010, and 1463 students from grades 4 and 5 (primary school) and from grades 7 and 8 (lower secondary school) completed an anonymous questionnaire. Multiple linear regression analysis was used to investigate whether self-reported physical activity at recess was associated with peer relationships at school, relatedness to school and school climate. Analyses were adjusted for self-reported overall physical activity and conducted for primary and lower secondary schools. Multi-group analysis was used to test sex differences among the associations. Results In primary school, physical activity at recess was positively associated with peer relationships at school (boys: b = 0.17, p = 0.007 and girls: b = 0.21, p &lt;0.001), relatedness to school (boys: b = 0.18, p = 0.002 and girls: b = 0.24, p &lt;0.001) and school climate (girls: b = 0.17, p = 0.001), after adjusting for overall physical activity. In lower secondary school, physical activity at recess was positively associated with peer relationships at school (boys: b = 0.09, p = 0.006 and girls: b = 0.12, p = 0.010) but not with other school-related social factors. No sex differences were observed in these associations. Conclusions Our results suggest that students&#8217; participation in physical activities during school recess is positively associated with students&#8217; school-related social factors. In the future, it would be worthwhile to study how physical activity at recess should be organised in order to support the development of school-related social factors.Background: Participation in physical activities provides students with opportunities for social interaction and social skills development. The purpose of this study was to investigate the associations of students’ recess physical activity with school-related social factors. Methods: Data were collected in 19 schools countrywide in autumn 2010, and 1463 students from grades 4 and 5 (primary school) and from grades 7 and 8 (lower secondary school) completed an anonymous questionnaire. Multiple linear regression analysis was used to investigate whether self-reported physical activity at recess was associated with peer relationships at school, relatedness to school and school climate. Analyses were adjusted for self-reported overall physical activity and conducted for primary and lower secondary schools. Multi-group analysis was used to test sex differences among the associations. Results: In primary school, physical activity at recess was positively associated with peer relationships at school (boys: b = 0.17, p = 0.007 and girls: b = 0.21, p <0.001), relatedness to school (boys: b = 0.18, p = 0.002 and girls: b = 0.24, p <0.001) and school climate (girls: b = 0.17, p = 0.001), after adjusting for overall physical activity. In lower secondary school, physical activity at recess was positively associated with peer relationships at school (boys: b = 0.09, p = 0.006 and girls: b = 0.12, p = 0.010) but not with other school-related social factors. No sex differences were observed in these associations. Conclusions: Our results suggest that students’ participation in physical activities during school recess is positively associated with students’ school-related social factors. In the future, it would be worthwhile to study how physical activity at recess should be organised in order to support the development of school-related social factors.peerReviewe

Dental Students’ Perceptions of and Experiences with Prosthodontics: Ten Graduating Classes at One Institution

It is important for members of the dental specialties to understand what motivates students to enter the specialty in order to ensure its continuing development and ability to meet patient needs. The aim of this study was to compare ten graduating classes at Harvard School of Dental Medicine (HSDM) regarding students' experiences with and perceptions of prosthodontics and factors influencing those interested in pursuing prosthodontics as a specialty. In 2013, HSDM students in the classes of 2012-16 were surveyed, achieving a response rate of 81%. Survey questions sought information regarding specialty choice, factors influencing the choice, student experiences with prosthodontics, and student perceptions of the dental disciplines. Responses were compared to those from a prior study of the HSDM classes of 2007-11. The responses showed a decrease in negative student experiences with prosthodontics. The students regarded prosthodontics highly for its impact on patient quality of life; however, students interested in pursuing prosthodontics as a specialty decreased. All students said provider enjoyment was most important in choice of specialty. Cost of program, patient type, and program location were factors that especially influenced students interested in prosthodontics. The improved student experiences with and perspectives on prosthodontics may be a result of a curriculum change that led to more prosthodontics procedures and case completions by students. The fall in students interested in prosthodontics may have resulted from prosthodontic faculty transitions that occurred when the survey was conducted, as well as large debt burdens in spite of the fact that prosthodontists' earnings are among the highest in dentistry. Faculty must educate and mentor students about the realities of the profession, provide positive learning experiences in the field, and encourage students who enjoy prosthodontics to pursue specialty training

Randomized Controlled Trial of the Effectiveness of Genetic Counseling and a Distance, Computer-Based, Lifestyle Intervention Program for Adult Offspring of Patients with Type 2 Diabetes: Background, Study Protocol, and Baseline Patient Characteristics

Relatives of type 2 diabetic patients are at a high risk of developing type 2 diabetes and should be regarded as target of intervention for diabetes prevention. However, it is usually hard to motivate them to implement preventive lifestyle changes, because of lack of opportunity to take advises from medical professionals, inadequate risk perception, and low priority for preventive behavior. Prevention strategy for them therefore should be highly acceptable and suited for them. The parallel, three-group trial is now being conducted to investigate the effects of genetic counseling and/or a computerized behavioral program on the prevention of type 2 diabetes in that population. The preventive strategies used in this study could provide a novel solution to the numbers of genetically high-risk individuals, if found to be effective. The objective of this paper is to describe the background, protocol, and baseline patient characteristics of the trial

Factors Influencing Dental Students’ Specialty Choice: A Survey of Ten Graduating Classes at One Institution

The aim of this study was to survey ten graduating classes at Harvard School of Dental Medicine regarding students' specialty choice and factors influencing that choice. Students were surveyed once in 2008 (for the Classes of 2007-11) and again in 2013 (for the Classes of 2012-16). A prior article reported results regarding students' interest in and experiences with prosthodontics; this article presents results regarding their interest in all dental specialties and factors influencing those interests. Of a total 176 students in the Classes of 2012-16, 143 responded to the survey, for a response rate of 81%, compared to a 95% response rate (167 of total 176 students) for the Classes of 2007-11. The results showed that orthodontics was the most popular specialty choice, followed by oral and maxillofacial surgery. From the 2008 to the 2013 survey groups, there was an increase in the percentages of students planning to pursue oral and maxillofacial surgery, pediatric dentistry, and postdoctoral general dentistry. The educational debt these students expected to accrue by graduation also increased. The largest percentage of students chose "enjoyment of providing the specialty service" as the factor most influencing their specialty choice. "Prior dental school experience" and "faculty influence" were greater influences for students pursuing specialties than those pursuing postdoctoral general dentistry. Increased interest in particular disciplines may be driven by high debt burdens students face upon graduation. Factors related to mentoring especially influenced students pursuing specialties, demonstrating the importance of student experiences outside direct patient care for exposure to the work of specialists beyond the scope of predoctoral training. This finding suggests that dental schools should increase mentoring efforts to help students make career decisions based not on financial burden but rather on personal interest in the specialty, which is likely to have a more satisfying result for them in the long run

Smoking status and abdominal obesity among normal- and overweight/obese adults : Population-based FINRISK study

Peer reviewe

Smoking and suicidality among adolescent psychiatric patients

Purpose: To investigate the relationship between smoking and suicidality among adolescent psychiatric patients in Finland. Methods: Data from 157 patients (aged 12-17 years) admitted to inpatient psychiatric hospitalization between April 2001 and July 2002 were collected. Logistic regression analyses were used to examine the association between regular daily smoking and suicidality. The data were adjusted for several sociodemographic and clinical characteristics. Results: The results showed over four-fold risk for definite and/or life-threatening suicide attempts among smoking adolescents in inpatient psychiatric facility compared with nonsmoking ones (OR 4.33, 95% CI 1.23-15.20). Also, the smoking adolescents had three times greater risk for occasional (OR 3.32, 95% CI 1.09-10.10) or frequent (OR 3.00, 95% CI 1.08-10.10) self-mutilation. Suicidality was more common among girls than boys and among those adolescents who suffered from depression. Conclusions: Among teens hospitalized for psychiatric illnesses, daily smoking was significantly related to suicide attempts and self-mutilation, even after controlling for several confounding factors, including psychiatric diagnosis. (C) Society for Adolescent Medicine, 2004.Peer reviewe