Background The global COVID-19 pandemic has placed tremendous physical and mental strain on the US healthcare system. Studies examining the effects of outbreaks have demonstrated both an increased prevalence and long-term development of Post-Traumatic Stress Disorder (PTSD) symptoms in healthcare providers. We sought to assess the impact of the COVID-19 pandemic on the psychological well-being of medical providers, medical trainees, and administrators at a large academic center to identify stressors and moderators to guide future mental health and hospital-system interventions. Methods A 42-item survey examining specific stressors, grit, and resilience was widely distributed to physicians, residents, fellows, and administrators a large academic institution for departmental distribution. Survey results were analyzed using descriptive statistics, ANOVA, and multivariate linear regressions. A p-value <0.05 was considered statistically significant. Results A total of 785 participants completed the survey. The majority of respondents rated their stress to be significantly increased during the pandemic. Respondents' fear of transmitting the virus to their family members was a significant stressor. Higher resilience was associated with lower stress, anxiety, fatigue, and sleep disturbances. Overall, respondents felt supported by their departments and institution and felt contingency plans and personal protective equipment were adequate. Conclusions Healthcare workers have increased resilience in the face of heightened stress during a pandemic. Higher resilience and grit were protective factors in managing personal and system-level stressors at the peak of the COVID-19 pandemic in our institution. Implementing an intervention designed to enhance healthcare workers’ resilience in response to the COVID-19 pandemic is warranted.

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Context. We present the results from a detailed X-ray variability analysis of 66 AGN in the Lockman Hole, which have optical spectroscopic identifications. Aims. We compare, quantitatively, their variability properties with the properties of local AGN, and we study the "variabilityluminosity" relation as a function of redshift, and the "variability -redshift" relation in two luminosity bins. Methods. We use archival data from the last 10 XMM-Newton observations of the Lockman Hole field to extract light curves for the rest frame 2-10 keV band. We use the "normalized excess variance" to quantify the variability amplitude. Using the results about the AGN power spectral shape and its dependence on black hole mass and accretion rate, we are able to compute model "variabilityluminosity" curves, which we compare with the relations that we observe. Results. When we consider all the sources in our sample, we find that their variability amplitude decreases with increasing redshift and luminosity. These global anti-correlations become weaker when we split the objects into various luminosity and redshift bins. We do not find a significant correlation between variability amplitude and spectral slope, Γ. We measure a "variability -luminosity" relation that has a larger amplitude that for local AGN. At a given luminosity we also find that the variability amplitude increases with redshift up to z ∼ 1, and then remains approximately constant. Conclusions. Our results imply that the AGN X-ray mechanism operates in the same way at all redshifts. The accretion rate (in units of the Eddington limit) for the objects in our sample increases from ∼0.25, at z ∼ 0.5, to 0.5 at z ∼ 3. It does not exceed unity even in the case of the most luminous AGN. Their black hole mass also increases with redshift. The upper limit we find is consistent with the largest black hole masses found to date in the local Universe. The increase in the black hole mass, and the decrease in the rest frame light curve duration with increasing redshift, can explain the global variability amplitude -redshift/luminosity anti-correlations that we observe. For objects of similar luminosity, the black hole mass decreases and the accretion rate increases as the redshift becomes higher. This effect explains the increase in the variability amplitude up to redshift ∼ 1 (at fixed luminosity bins). At higher redshifts, the decrease in the light curves duration affects the variability amplitude significantly, forcing it to remain essentially constant.

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Highlights Osteosarcoma is the most common primary bone sarcoma. Neoadjuvant chemotherapy combined with limb salvage surgery (LSS) or amputation are the main strategies in treating limb osteosarcoma. LSS is associated with a higher 5-year overall survival. Local recurrence was more frequently encountered in patients treated with LSS, however not affecting overall survival.

Background/Aim: Adrenal glands are one of the most common sites of cancer metastasis. The treatment options include either surgery or chemotherapy and/or radiotherapy while certain diagnosis is made via percutaneous biopsy or fine needle aspiration (FNA), guided by CT scan. This review aimed to present the current practice regarding the diagnosis and treatment of adrenal cancer metastasis.

Background/Aim: Anaplastic thyroid cancer (ATC) is one of the most aggressive human malignancies, remaining generally incurable. Histone deacetylase (HDAC) seems to play a role in regulating transcription of genes involved in ATC, making HDAC inhibitors (HDACI) promising anticancer drugs for ATC. The purpose of this review was to evaluate the role of HDACIs in ATC treatment and describe the latest trends of current research on this field. Materials and Methods: This literature review was performed using the MEDLINE database. The keywords/

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