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Article: Assimilation of Ocean‐Color Plankton Functional Types to Improve Marine Ecosystem Simulations

Ciavatta, S. / Brewin, R. J. W. / Skákala, J. / Polimene, L. / de Mora, L. / Artioli, Y. / Allen, J. I.

Journal of geophysical research. 2018 Feb., v. 123, no. 2

2018

Abstract: We assimilated phytoplankton functional types (PFTs) derived from ocean color into a marine ecosystem model, to improve the simulation of biogeochemical indicators and emerging properties in a shelf sea. Error‐characterized chlorophyll concentrations of ... ...

Abstract	We assimilated phytoplankton functional types (PFTs) derived from ocean color into a marine ecosystem model, to improve the simulation of biogeochemical indicators and emerging properties in a shelf sea. Error‐characterized chlorophyll concentrations of four PFTs (diatoms, dinoflagellates, nanoplankton, and picoplankton), as well as total chlorophyll for comparison, were assimilated into a physical‐biogeochemical model of the North East Atlantic, applying a localized Ensemble Kalman filter. The reanalysis simulations spanned the years 1998–2003. The skill of the reference and reanalysis simulations in estimating ocean color and in situ biogeochemical data were compared by using robust statistics. The reanalysis outperformed both the reference and the assimilation of total chlorophyll in estimating the ocean‐color PFTs (except nanoplankton), as well as the not‐assimilated total chlorophyll, leading the model to simulate better the plankton community structure. Crucially, the reanalysis improved the estimates of not‐assimilated in situ data of PFTs, as well as of phosphate and pCO₂, impacting the simulation of the air‐sea carbon flux. However, the reanalysis increased further the model overestimation of nitrate, in spite of increases in plankton nitrate uptake. The method proposed here is easily adaptable for use with other ecosystem models that simulate PFTs, for, e.g., reanalysis of carbon fluxes in the global ocean and for operational forecasts of biogeochemical indicators in shelf‐sea ecosystems.
Keywords	Miozoa ; carbon ; chlorophyll ; color ; community structure ; ecological models ; geophysics ; marine ecosystems ; nitrates ; oceans ; phosphates ; phytoplankton ; research ; simulation models ; statistics
Language	English
Dates of publication	2018-02
Size	p. 834-854.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	161667-5
ISSN	2169-9291 ; 2169-9275 ; 0148-0227 ; 0196-2256
ISSN (online)	2169-9291
ISSN	2169-9275 ; 0148-0227 ; 0196-2256
DOI	10.1002/2017JC013490
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: National Study of Burnout and Career Satisfaction Among Physician Assistants in Oncology: Implications for Team-Based Care.

Tetzlaff, Eric Daniel / Hylton, Heather Marie / DeMora, Lyudmila / Ruth, Karen / Wong, Yu-Ning

Journal of oncology practice

2017 Volume 14, Issue 1, Page(s) e11–e22

Abstract: Purpose: A high rate of burnout has been reported in oncology physicians. Physician assistants (PAs) may also face similar risks of burnout. We sought to measure the personal and professional characteristics associated with burnout and career ... ...

Abstract	Purpose: A high rate of burnout has been reported in oncology physicians. Physician assistants (PAs) may also face similar risks of burnout. We sought to measure the personal and professional characteristics associated with burnout and career satisfaction and the potential impact on the oncology PA workforce. Participants and methods: A national survey of PAs in oncology was completed by using the Maslach Burnout Inventory from September 2015 to January 2016. Results: In all, 855 PAs were contacted and 250 submitted complete surveys (response rate, 29.2%). Respondents were representative of PAs in oncology with a mean age of 41.8 years, females (88.8%), academic practice (55.2%), urban location (61.2%), outpatient (74.4%), medical oncology (75.2%), worked 41 to 50 hours per week (52.8%), and had a mean of 9.6 years as a PA in oncology. Burnout was reported in 34.8% of PAs, 30.4% reported high emotional exhaustion, 17.6% reported high depersonalization, and 19.6% reported a low sense of personal accomplishment. In multivariable analysis, age, time spent on indirect patient care, oncology subspecialty, and relationship with collaborating physician were factors associated with burnout. Career and specialty satisfaction was high (86.4% and 88.8%, respectively). In the next 2 years, only 3.6% of PAs plan to pursue a different career or specialty and only 2.0% plan to retire. Conclusion: Despite high career and specialty satisfaction, burnout is reported in one third of PAs in oncology. Further exploration of the relationship between PAs and collaborating physicians may provide insight on methods to decrease burnout. Negligible short-term attrition of the current oncology PA workforce is anticipated.
MeSH term(s)	Adult ; Burnout, Professional ; Female ; Humans ; Job Satisfaction ; Male ; Medical Oncology ; Patient Care Team ; Physician Assistants/psychology ; Surveys and Questionnaires
Language	English
Publishing date	2017-11-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2236338-5
ISSN	1935-469X ; 1554-7477
ISSN (online)	1935-469X
ISSN	1554-7477
DOI	10.1200/JOP.2017.025544
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Article ; Online: Preoperative Delays in the Treatment of DCIS and the Associated Incidence of Invasive Breast Cancer.

Ward, William H / DeMora, Lyudmila / Handorf, Elizabeth / Sigurdson, Elin R / Ross, Eric A / Daly, John M / Aggon, Allison A / Bleicher, Richard J

Annals of surgical oncology

2019 Volume 27, Issue 2, Page(s) 386–396

Abstract: Background: Although treatment delays have been associated with survival impairment for invasive breast cancer, this has not been thoroughly investigated for ductal carcinoma in situ (DCIS). With trials underway to assess whether DCIS can remain ... ...

Abstract	Background: Although treatment delays have been associated with survival impairment for invasive breast cancer, this has not been thoroughly investigated for ductal carcinoma in situ (DCIS). With trials underway to assess whether DCIS can remain unresected, this study was performed to determine whether longer times to surgery are associated with survival impairment or increased invasion. Methods: A population-based study of prospectively collected national data derived from women with a clinical diagnosis of DCIS between 2004 and 2014 was conducted using the National Cancer Database. Overall survival (OS) and presence of invasion were assessed as functions of time by evaluating five intervals (≤ 30, 31-60, 61-90, 91-120, 121-365 days) between diagnosis and surgery. Subset analyses assessed those having pathologic DCIS versus invasive cancer on final pathology. Results: Among 140,615 clinical DCIS patients, 123,947 had pathologic diagnosis of DCIS and 16,668 had invasive ductal carcinoma. For all patients, 5-year OS was 95.8% and unadjusted median delay from diagnosis to surgery was 38 days. With each delay interval increase, added relative risk of death was 7.4% (HR 1.07; 95% CI 1.05-1.10; P < 0.001). On final pathology, 5-year OS for noninvasive patients was 96.0% (95% CI 95.9-96.1%) versus 94.9% (95% CI 94.6-95.3%) for invasive patients. Increasing delay to surgery was an independent predictor of invasion (OR 1.13; 95% CI 1.11-1.15; P < 0.001). Conclusions: Despite excellent OS for invasive and noninvasive cohorts, invasion was seen more frequently as delay increased. This suggests that DCIS trials evaluating nonoperative management, which represents infinite delay, require long term follow up to ensure outcomes are not compromised.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/epidemiology ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Ductal, Breast/surgery ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Carcinoma, Intraductal, Noninfiltrating/surgery ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mastectomy/statistics & numerical data ; Middle Aged ; Preoperative Care ; Prognosis ; Prospective Studies ; Time-to-Treatment/statistics & numerical data ; Young Adult
Language	English
Publishing date	2019-09-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-019-07844-4
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Article: What can ecosystem models tell us about the risk of eutrophication in the North Sea?

Saux Picart, S / Allen, J I / Butenschön, M / Artioli, Y / de Mora, L / Wakelin, S / Holt, J

Climatic change

2014 Volume 132, Issue 1, Page(s) 111–125

Abstract: Eutrophication is a process resulting from an increase in anthropogenic nutrient inputs from rivers and other sources, the consequences of which can include enhanced algal biomass, changes in plankton community composition and oxygen depletion near the ... ...

Abstract	Eutrophication is a process resulting from an increase in anthropogenic nutrient inputs from rivers and other sources, the consequences of which can include enhanced algal biomass, changes in plankton community composition and oxygen depletion near the seabed. Within the context of the Marine Strategy Framework Directive, indicators (and associated threshold) have been identified to assess the eutrophication status of an ecosystem. Large databases of observations (
Language	English
Publishing date	2014-03-22
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	751086-x
ISSN	0165-0009
ISSN	0165-0009
DOI	10.1007/s10584-014-1071-x
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Article ; Online: Prospective analysis of public management scenarios modeled by the Fuzzy Delphi method

N. Batista Hernandez / M. Bernarda Ruilova Cueva / B. Narcisa Mazacón / K. de Mora L., J. Alipio Sobeni / A. Verónica Palma Villegas / J. Irene Escobar Jara

Neutrosophic Sets and Systems, Vol 26, Pp 114-

2019 Volume 119

Abstract: In the Latin American region, public management systems are driven almost exclusively by a formal mechanism. This is a difficulty when implementing study methodologies that provide objective data for the analysis and evaluation of the effectiveness, ... ...

Abstract	In the Latin American region, public management systems are driven almost exclusively by a formal mechanism. This is a difficulty when implementing study methodologies that provide objective data for the analysis and evaluation of the effectiveness, relevance and sustainability of the policies established by the states governments. Given that the political-social contexts of each nation determine a series of subjective and imprecise factors, and that the main officials and social actors that rule the development of strategic plans regarding public services are inscribed within a certain reality for internal and external incidents; a neutrosophic analysis of the fuzzy, gray and / or undefined zones of the relations between the political system and the administrative system becomes evident. Neutrosophy, as a discipline that studies undefined areas between opposing ideas or sentences, offers a theoretical framework suitable for the analysis of the previously described problematic. This article summarizes a prospective analysis of public management scenarios, developed through the Fuzzy Delphi method, in order to detect the main difficulties faced by current public management mechanisms and propose solutions accordingly. For this, it relies on a survey conducted in Argentina to officials of the Administration sector. A fuzzy approach to improve public management, methodological applications even case. Buenos Aires: University of Buenos Aires. School of Economics.
Keywords	Mathematics ; QA1-939 ; Electronic computers. Computer science ; QA75.5-76.95
Subject code	320
Language	English
Publishing date	2019-11-01T00:00:00Z
Publisher	University of New Mexico
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction: On the Potential of Surfers to Monitor Environmental Indicators in the Coastal Zone.

Brewin, Robert J W / de Mora, Lee / Jackson, Thomas / Brewin, Thomas G / Shutler, Jamie

PloS one

2016 Volume 11, Issue 9, Page(s) e0162591

Abstract: This corrects the article DOI: 10.1371/journal.pone.0127706.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0127706.].
Language	English
Publishing date	2016
Publishing country	United States
Document type	Published Erratum
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0162591
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Article: Concurrent chemoradiation for resected gall bladder cancers and cholangiocarcinomas.

Fareed, Muhammad M / DeMora, Lyudmila / Esnaola, Nestor F / Denlinger, Crystal S / Karachristos, Andreas / Ross, Eric E / Hoffman, John / Meyer, Joshua E

Journal of gastrointestinal oncology

2018 Volume 9, Issue 4, Page(s) 762–768

Abstract: Background: Gallbladder cancer (GBC) and cholangiocarcinoma (CCA) are rare entities with relatively poor prognoses. We compared treatment outcomes of definitive resection with or without neoadjuvant therapy in GBC and CCA patients.: Methods: All non- ... ...

Abstract	Background: Gallbladder cancer (GBC) and cholangiocarcinoma (CCA) are rare entities with relatively poor prognoses. We compared treatment outcomes of definitive resection with or without neoadjuvant therapy in GBC and CCA patients. Methods: All non-metastatic GBC and CCA patients at a single institution who underwent definitive resection from 1992-2016 were analyzed. We compared overall survival (OS), locoregional failure (LRF) and distant failure (DF) in patients who received neoadjuvant therapy (chemotherapy and/or radiation) versus those who did not receive neoadjuvant treatment. OS was analyzed using the Kaplan-Meier method and log rank tests. Cox proportional hazard models were used to analyze time to recurrence. Results: Out of 128 patients, 90 had GBC and 38 had CCA, 25 patients (27%) among GBC and 8 patients (21%) with CCA were T3, T4 or node positive. Overall, 52 (40%) GBC and 25 (20%) CCA patients received neoadjuvant treatment, chemotherapy alone 60 patients (47%) or radiation with or without chemotherapy 17 patients (13%). Chemotherapy was single agent in 44 patients (34%) and multi-agent in 25 (20%). The median OS for GBC patients was 3.1 years with 2.6 years for no neoadjuvant group and 3.1 years for neoadjuvant group (P=0.6786). Median OS was 2.6 years for CCA patients, 3.6 years for no neoadjuvant therapy versus 2.0 years for neoadjuvant group (P=0.1613). There was a trend towards increased DF in patients with CCA and GBC receiving neoadjuvant therapy: HR 2.74, 95% CI, 0.73-10.3, P=0.14 and 0.92, 95% CI, 0.44-1.93, P=0.82 respectively. The hazard ratio for time to LRF in CCA patients receiving neoadjuvant treatment was 3.17, 95% CI, 0.62-16.31, P=0.16 whereas HR was 0.15, 95% CI, 0.10-1.76, P=0.23 for GBC patients. Among GBC patients, the pattern of first failure was locoregional in 8 (10%) having 3 LRF in neoadjuvant group (2 with chemotherapy, 1 with CRT, 0 with RT alone) as compared to 5 in adjuvant group. Among 28 (35%) patients with DF first, 15 patients received neoadjuvant therapy versus 13 patients in non-neoadjuvant group. In CCA patients, LRF occurred first in 6 patients receiving neoadjuvant treatment (3 with chemotherapy, 1 with CRT, 2 with RT alone) as compared to 2 patients who were treated with non-neoadjuvant CRT. DF was the first site of failure in 9 patients treated with neoadjuvant CRT (8 with chemotherapy, 0 with CRT and 1 with RT alone) as compared to 4 patients without neoadjuvant treatment. Conclusions: In this retrospective data set, a trend towards better survival was seen in adjuvantly treated CCA patients, but not in GBC patients. Recurrence patterns also appear different among the two, which might be attributed to treatment modality used, patient selection or unmeasured factors. Keywords: Gallbladder cancer (GBC); cholangiocarcinoma (CCA); neoadjuvant; resection; chemoradiation; chemotherapy.
Language	English
Publishing date	2018-08-22
Publishing country	China
Document type	Journal Article
ZDB-ID	2594644-4
ISSN	2219-679X ; 2078-6891
ISSN (online)	2219-679X
ISSN	2078-6891
DOI	10.21037/jgo.2018.05.09
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Article ; Online: Does the Surgical Apgar Score predict serious complications after elective major cancer surgery?

Goel, Neha / Manstein, Samuel M / Ward, William H / DeMora, Lyudmila / Smaldone, Marc C / Farma, Jeffrey M / Uzzo, Robert G / Esnaola, Nestor F

The Journal of surgical research

2018 Volume 231, Page(s) 242–247

Abstract: Background: Major cancer surgery is associated with significant risks of perioperative morbidity and mortality, resulting in delayed adjuvant therapy, higher recurrence rates, and worse overall survival. Previous retrospective studies have used the ... ...

Abstract	Background: Major cancer surgery is associated with significant risks of perioperative morbidity and mortality, resulting in delayed adjuvant therapy, higher recurrence rates, and worse overall survival. Previous retrospective studies have used the Surgical Apgar Score (SAS) for perioperative risk assessment. This study prospectively evaluated the predictive value of SAS to predict serious complication (SC) after elective major cancer surgery. Methods: Demographic, comorbidity, procedure, and intraoperative data were collected prospectively for 405 patients undergoing elective major cancer surgery between 2014-17. The SAS was calculated immediately postoperative and outcome data were collected prospectively. Rates of SC according to SAS risk category were compared using Cochran-Armitage trend test. Receiver operating characteristic curves and area under the receiver operating characteristic curves were generated and 95% confidence intervals were calculated. Results: Eighty percent, 17.3%, and 2.7% of patients were low (SAS 7-10), intermediate (SAS 5-6), and high risk (SAS 0-4), respectively, for SC based on their SAS. Forty-six (11.4%) had an SC within 30 days; 3.7% returned to the operating room, 3.7% experienced a urinary tract infection, 3.2% experienced a respiratory complication, 2.7% experienced a wound complication, and 1.2% experienced a cardiac complication. Overall, 9.3%, 18.6%, and 27.3% of patients with SAS 7-10, 5-6, and 0-4 experienced an SC, respectively (P = 0.005). The overall discriminatory ability of the SAS was modest (area under the receiver operating characteristic curves 0.661; 95% confidence intervals, 0.582-0.740). Conclusions: Although there was an overall association between SAS and higher risk of subsequent postoperative SC in our cohort, the ability of the SAS to accurately predict risk of postoperative SC at the patient level was limited.
MeSH term(s)	Aged ; Elective Surgical Procedures/adverse effects ; Female ; Health Status Indicators ; Humans ; Male ; Middle Aged ; Neoplasms/surgery ; Philadelphia/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prospective Studies ; Risk Assessment
Language	English
Publishing date	2018-06-23
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2018.05.037
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Article ; Online: Predictors of Distant Recurrence Following Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer.

Wong, Jessica Karen / Shaikh, Talha / DeMora, Lyudmila / Zhang, Eddie / Borghaei, Hossein / Hayes, Shelly B / Kumar, Sameera / Meyer, Joshua E / Hallman, Mark A

American journal of clinical oncology

2020 Volume 43, Issue 4, Page(s) 243–248

Abstract: Objective: The objective of this study was to characterize patients at an increased risk of distant metastasis (DM) following stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC).: Materials and methods: We ... ...

Abstract	Objective: The objective of this study was to characterize patients at an increased risk of distant metastasis (DM) following stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC). Materials and methods: We identified patients undergoing SBRT for stage I NSCLC between 2005 and 2016. Patients with a prior lung cancer diagnosis, receiving a biological effective dose <100 Gy, or receiving chemotherapy were excluded. Patients underwent pretreatment staging and were classified according to the American Joint Committee for Cancer (AJCC) 8th edition staging. The primary endpoint was DM. The Kaplan-Meier method and the Cox proportional hazards model were used for survival analysis and to identify predictors of DM. Results: A total of 174 patients were included, with a median age 75 years (range, 49 to 96 y) and a median follow-up of 24 months (range, 3 to 123 mo). The 2- and 4-year cumulative incidences of DM were 14.2% and 19.1%, respectively. Patients who developed DM had worse overall survival versus patients developing a locoregional recurrence (P=0.023). On multivariable analysis, having stage IB disease (hazard ratio: 2.95; 95% confidence interval: 1.06-8.23; P=0.039) or a lower/middle lobe tumor (hazard ratio: 2.67; 95% confidence interval: 1.07-6.69; P=0.036) was associated with increased risk of DM. The 2-year cumulative incidences of DM were 10.9% and 35.7% (P=0.002) for patients with stage IA versus IB tumors, respectively, and 11.3% and 19.7% (P=0.049) for patients with upper lobe versus lower/middle lobe tumors, respectively. Conclusions: Patients with stage IB disease or lower/middle lobe tumors may have an increased risk of DM following SBRT. Randomized controlled trials are needed to further identify patients who may benefit from adjuvant systemic therapy after SBRT for stage I NSCLC.
MeSH term(s)	Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Carcinoma, Non-Small-Cell Lung/secondary ; Female ; Humans ; Lung Neoplasms/pathology ; Lung Neoplasms/radiotherapy ; Male ; Middle Aged ; Neoplasm Staging ; Radiosurgery ; Retrospective Studies ; Risk Assessment ; Survival Analysis
Language	English
Publishing date	2020-01-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	604536-4
ISSN	1537-453X ; 0277-3732
ISSN (online)	1537-453X
ISSN	0277-3732
DOI	10.1097/COC.0000000000000662
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Article ; Online: Patterns of Multidisciplinary Care of Head and Neck Squamous Cell Carcinoma in Medicare Patients.

Hansen, Chase C / Egleston, Brian / Leachman, Brooke K / Churilla, Thomas M / DeMora, Lyudmila / Ebersole, Barbara / Bauman, Jessica R / Liu, Jeffrey C / Ridge, John A / Galloway, Thomas J

JAMA otolaryngology-- head & neck surgery

2020 Volume 146, Issue 12, Page(s) 1136–1146

Abstract: Importance: Multidisciplinary care (MDC) yields proven benefits for patients with cancer, although it may be underused in the complex management of head and neck squamous cell carcinoma (HNSCC).: Objective: To characterize the patterns of MDC in the ... ...

Abstract	Importance: Multidisciplinary care (MDC) yields proven benefits for patients with cancer, although it may be underused in the complex management of head and neck squamous cell carcinoma (HNSCC). Objective: To characterize the patterns of MDC in the treatment of HNSCC among elderly patients in the US. Design, setting, and participants: This nationwide, population-based, retrospective cohort study used Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from January 1, 1991, to December 31, 2011, to identify patients 66 years or older diagnosed with head and neck cancer and determine the dates of diagnosis, oncology consultations, treatment initiation, and speech therapy evaluation in addition to MDC completion. Multidisciplinary care was defined in a stage-dependent manner: localized disease necessitated consultations with radiation and surgical oncologists, and advanced-stage disease also included a medical oncology consultation, all before definitive treatment. Data were analyzed between December 2016 and September 2020. Main outcomes and measures: Rates of MDC across all subsites of head and neck cancer as measured by the presence of an evaluation for each oncologist on the MDC team and its effect on treatment initiation. Results: This cohort study assessed 28 293 patients with HNSCC (mean [SD] age, 75.1 [6.6] years; 67% male; 87% White) from the SEER-Medicare linked database. The HNSCC subsites included larynx (40%), oral cavity (30%), oropharynx (21%), hypopharynx (7%), and nasopharynx (2%). Overall, the practice of MDC significantly increased over time, from 24% in 1991 to 52% in 2011 (P < .001). For patients with localized (stage 0-II) tumors, 60% received care in the multidisciplinary setting, whereas 28% of those with advanced-stage disease did. A total of 18 181 patients (64%) were treated with initial definitive nonsurgical therapy across all stages. Regardless of stage and subsite, few patients (2%) underwent evaluation by a speech-language pathologist before definitive therapy. Multidisciplinary care prolonged the time to initiation of definitive treatment by 11 days for localized disease and 10 days for advanced disease. Conclusions and relevance: This cohort study found that most elderly patients with localized HNSCC received MDC, whereas few patients with advanced-stage disease received such care, although a significant proportion received adjuvant therapy. Multidisciplinary care may prolong time to initiation of definitive treatment with an uncertain impact. Consultation with a speech-language pathologist before definitive therapy was rare.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Head and Neck Neoplasms/mortality ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/therapy ; Humans ; Male ; Medicare ; Neoplasm Staging ; Retrospective Studies ; SEER Program ; Squamous Cell Carcinoma of Head and Neck/mortality ; Squamous Cell Carcinoma of Head and Neck/pathology ; Squamous Cell Carcinoma of Head and Neck/therapy ; Survival Rate ; United States
Language	English
Publishing date	2020-12-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2020.3496
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