PURPOSE To examine (1) the trend and associated factors of Oncotype DX (ODX) use among hormone receptor-positive (HR+) breast cancer (BC) patients in 2004-2015; (2) the trend of reported chemotherapy by Recurrence Score (RS); and (3) the survival differences associated with ODX use. METHODS ODX data from Genomic Health Inc. were linked with 17 SEER registries data. HR + BC cases with lymph node negative (N0) or 1-3 positive LNs (N1) from 2004-2015 were analyzed. The Cochrane-Armitage trend test, logistic regression, Kaplan-Meier survival curve, and stratified Cox model were performed. Survival analysis was restricted to HR+/HER2- patients from 2010 to 2014, matched on propensity score. RESULTS ODX use increased substantially from 2004 to 2015 (N0 2.0% to 42.7%; N1 0.3% to 27.9%). Non-Hispanic black and Medicaid insured patients had lower odds of receiving ODX. N0 patients with moderately differentiated or 2.1-5.0 cm tumor and N1 patients with well-differentiated or  less then  2.0 cm tumor had higher odds of using ODX. The reported chemotherapy use decreased significantly with low and intermediate RS, and increased for high RS among N0 patients. ODX use was associated with better breast cancer-specific survival [hazard ratio (95% CI) N0 1.96 (1.60-2.41), N1 1.90 (1.42-2.54)] and overall survival [N0 2.06 (1.83-2.31), N1 1.72 (1.42-2.09)], especially in the first 36 months. CONCLUSION ODX use has increased significantly since 2004, nonetheless disparities remain, especially for racial/ethnic minorities and Medicaid insured patients. Administering chemotherapy based on ODX results has been improved among N0 patients. Patients receiving ODX had better survival than those not.OBJECTIVE To evaluate the value of Bayesian penalized likelihood (BPL) reconstruction for improving lesion conspicuity of malignant lung tumors on 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography computed tomography (PET/CT) as compared with the ordered subset expectation maximization (OSEM) reconstruction incorporating time-of-flight (TOF) model and point-spread-function (PSF) correction. METHODS Twenty-nine patients with primary or metastatic lung cancers who underwent 18F-FDG PET/CT were retrospectively studied. PET images were reconstructed with OSEM + TOF, OSEM + TOF + PSF, and BPL with noise penalty strength β-value of 200, 400, 600, and 800. The signal-to-noise ratio (SNR) was determined in normal liver parenchyma. Lung lesion conspicuity was evaluated in 50 lung lesions by using a 4-point scale (0, no visible; 1, poor; 2, good; 3, excellent conspicuity). Two observers were independently asked to choose the most preferred reconstruction for detecting the lung lesions on a per-patient levwith β-value of 600 did not provide increased SUVmax for the lesions  ≥ 10 mm in diameter. CONCLUSION BPL reconstruction significantly improves the detection of small inconspicuous malignant tumors in the lung, improving the diagnostic performance of PET/CT.Demographic aging has led to an increase in the prevalence of different diseases, including the so-called geriatric syndromes (GS), like depression, disability and frailty phenotype (FP). Spirituality and religious practices (RP) have been associated with positive health outcomes and could be a protective factor against the development of some GS. Study aims was to determine the frequency of spirituality and RP, and their associations between some GS in adults 60 years of age or older, who attended a geriatric clinic in a university hospital in Mexico. Cross-sectional study in adults aged ≥ 60 years, recruited in 2018, was performed. Participants underwent a comprehensive geriatric assessment, with which spirituality and religious practices model and the diagnosis of GS were obtained. Linear regression analyses were determined to establish the association between RP and GS. We included 128 subjects; mean age was 79 years (SD ± 8). Lowers scores for mass and communion assiduity were associated with worst disability and FP scores (b = - 0.35, P = 0.02; b = - 0.37, P = 0.03). The RP model explained 8% (R2 = 0.083) of the total variance of the depressive symptoms score (P = 0.03). This study showed that the prevalence of RP is higher in Mexican older adults. The RP model can explain 8 and 9% of the variation in dependent variables (depressive symptoms and disability). These results suggest the importance of monitoring RP, as they seem to have a positive impact on health status of the elderly.PURPOSE Obstructive sleep apnea (OSA) has been associated with a 2- to 7-fold risk of motor vehicle accidents (MVAs). Continuous positive airway pressure (CPAP) treatment may reduce MVA risk. We further explored this issue in long-term CPAP users and untreated controls. METHODS We used both before-after and case-control study designs. The observational cohort consisted of CPAP-treated and untreated patients matched for gender, age, and apnea-hypopnea index. All MVAs reported to the police were identified.  https://www.selleckchem.com/products/AZD6244.html  RESULTS A total of 2060 patients (75.8% male, mean age 56.0 ± 10.5 years) were included. The CPAP-treated patients (N = 1030) were screened for MVAs for a median of 9.0 years before and after treatment. The median CPAP usage was 6.4 h/day. The control patients (N = 1030) were screened for MVAs for a median of 6.5 years after discontinuation of CPAP. No significant differences were observed between the incidences of MVAs per 1000 person years before treatment (3.2), after treatment (3.9), or in controls (2.6). Compared with controls, patients who had MVA after treatment had a higher body mass index (BMI), but did not differ in terms of other baseline characteristics, sleep study data, or accident conditions. In the majority of these patients, daytime sleepiness was reduced, whereas BMI tended to increase during treatment. CONCLUSIONS The MVA incidence did not change after CPAP treatment. Among the patients who had MVA, BMI was the only baseline characteristic that differed between the groups and tended to further increase after CPAP treatment. Differences in sleep study data or accident conditions were not observed.