Surgical salvage in patients with advanced testicular cancer: indications, risks and outcomes

The purpose of this review is to present a comprehensive and updated review of the literature and summary of the indications, risks and outcomes related to salvage, desperation and late relapse surgery for advanced testicular cancer. After completing a thorough review of the current literature, this review has attempted to provide an overview of the indications for salvage, desperation and late relapse retroperitoneal lymph node dissection (RPLND) followed by a summary of the histopathologic and clinical outcomes regarding each. Recent literature, combined with a significant contribution from historical studies suggest that while testicular cancer is a relatively uncommon malignancy overall, it represents the most common solid organ malignancy for young men. Although a significant number of men are cured with a combination of first-line treatments, the remaining men are a diverse and often challenging cohort who require the benefit of expertise to improve their outcomes. The role of surgical strategies in the salvage, desperation and late relapse settings is unquestionable, although the most important question remains who will benefit. This often requires a multi-disciplinary approach at centers specializing in this disease process in order to recognize who should get surgery, what surgery to do and how to minimize the potential morbidity associated with the operation

Oncologic outcomes following surgical management of clinical stage II sex cord stromal tumors

Objective To investigate the clinical history of patients with clinical stage II sex cord stromal tumors who underwent RPLND at our institution. Methods Our prospectively maintained testicular cancer database was queried to identify patients who presented with or developed clinical stage II sex cord stromal tumors and underwent RPLND at our institution between 1980 and 2018. Demographic, clinical and pathological characteristics were reviewed. Kaplan-Meier curves were graphed to assess recurrence-free and overall survival. Results Fourteen patients were included in the study with a median age of 44.2 years. Four patients presented with clinical stage II disease and 10 patients developed metastatic disease during follow-up of initial clinical stage I disease with a median time to metastasis of 2.7 years (range: 0.4-19.5 years). Of the 10 patients with orchiectomy pathology data available, all patients had at least 1 risk factor on testis pathology (mean: 2.9 risk factors). Nine patients received treatment prior to referral to our institution. All patients recurred post-RPLND at Indiana University. Median recurrence-free survival was 9.8 months. Twelve patients died of disease with a median overall survival of 14.4 months. Conclusions Metastatic sex cord stromal tumors are rare and are more resistant to standard treatment modalities than metastatic germ cell tumors. Patients presenting with sex cord stromal tumors should consider prophylactic primary RPLND in the setting of one or more pathological predictor of malignancy

The Impact of Select Socio-demographic and Lifecycle Variables on the Importance Ratings of Vacation Enjoyment Attributes

The primary objective of this investigation was to identify the soft amenity attribute factors considered most important by interval resort owners in contributing to a satisfying resort vacation. A second objective was to determine whether attribute factor importance scores were effected by select socio-demographic and lifecycle variables. Using both focus groups and a Delphi survey technique, 1,200 randomly selected interval resort owners were asked to rate the mean importance of 75 soft amenity attributes on a five point Likert scale. Through factor analysis with varimax rotation, 18 vacation soft amenity attribute factors were identified. These factors accounted for 65.4% of the variance relating to vacation enjoyment. For subsequent analysis certain amenities were assigned to their second highest loading factor or omitted because they related to specific interval resort owner/manager issues. Mean scores for each of the remaining 14 factors was computed for each respondent and an analysis of variance or t-test was performed to compare the mean factor scores among different groups defined by the demographic and lifecycle variables. Hospitality and operating effectiveness and information on area attractions were rated as the most important vacation soft amenity factors. The independent variables of income, age and presence of children in the home exerted to greatest influence on attribute factor importance scores

An extension of the concept of the order dual of a Riesz space

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Revising the role of the history of mathematics in post-pandemic world

In this short philosophical and discursive paper, the main objective is to reassess a new emergent role of the history of mathematics in order to bring about greater diversity and engagement in the mathematical sciences. The discussion is based around the project undertaken at a North London university and their partner pre-university college, which piloted the larger national project in the UK in the local context. The success of the project, it is further suggested, would greatly benefit from a framework in which the history of mathematics as a humanistic discipline is closely related to viewing mathematics as a virtuous practice. We also include a short summary about the lives and careers of two Serbian mathematicians, Judita Cofman, and Milica Ilić-Dajović, to showcase how learning about the ways in which marginalisation takes place can help students position themselves and contextualise their priorities as they enter the professional mathematics landscape

School and Public Library Collaboration: Identifying Facilitators and Barriers

This study surveyed school and public youth services librarians to discover the nature of collaboration between their organizations as well as their perceptions of factors that facilitate and act as barriers to collaboration between their institutions. Previous studies have identified a plethora of potential facilitators and barriers to collaboration and cooperation, such as support from managers, colleagues, and fellow collaborators, or a lack of time and money. Recent studies on collaboration between school and public libraries, however, have centered on case studies of successful collaborative endeavors rather than on ways that collaboration might not work between these two organizations. This study builds on the broader survey studies from the past to continue the discussion on the nature of collaboration and its purpose in school and public libraries. It concludes with suggestions for further research on this topic