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Habitat fragmentation describes the division of a more extensive, continuous habitat into smaller, discontinuous areas. Human activities such as land conversion, as well as slower geological processes leading to changes in the physical environment, are the two leading causes of habitat fragmentation. The fragmentation process typically follows the same steps: perforation, dissection, fragmentation, shrinkage, and attrition.
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Chemistry is the study of matter and the changes it undergoes. Matter is anything that has mass and occupies space. Matter is all around us; the air, water, soil, mountains, even our bodies are all examples of matter. Matter is divided into three states — solid, liquid, and gas — that are commonly found on earth. The fourth state of matter, plasma, occurs naturally in the interiors of stars. 
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Matter: Pure Substances and Mixtures
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The substance of the universe—from a grain of sand to a star—is called matter. Scientists define matter as anything that occupies space and has mass. An object’s mass and its weight are related concepts, but not quite the same. An object’s mass is the amount of matter contained in the object and is the same whether that object is on Earth or in the zero-gravity environment of outer space. An object’s weight, on the other hand, is its mass as affected by the pull of...
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The earliest recorded discussion of the basic structure of matter comes from ancient Greek philosophers. Leucippus and Democritus argued that all matter was composed of small, finite particles that they called atomos, meaning “indivisible.” Later, Aristotle and others came to the conclusion that matter consisted of various combinations of the four “elements” — fire, earth, air, and water — and could be infinitely divided. Interestingly, these philosophers...
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Organizing Care Matters: Fragmented Pathways Double Early Local Recurrence Risk in Sarcoma.

Markus Schärer1,2, Philip Heesen3, Gabriela Studer4,5

  • 1Sarcoma Service, Department of Orthopedics and Trauma, Kantonsspital Winterthur, 8400 Winterthur, Switzerland.

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Summary
This summary is machine-generated.

Fragmented care pathways significantly increase early local recurrence risk in musculoskeletal sarcoma. Comprehensive care, including expert surgery, is crucial for better patient outcomes and reducing recurrence.

Keywords:
care pathwayfragmented carelocal recurrencemultidisciplinary carereal-world datasarcomasurgical marginsunplanned “whoops” excision

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Health Services Research

Background:

  • Early local recurrence (ELR) in musculoskeletal sarcoma correlates with poor oncologic outcomes.
  • The influence of care pathways versus tumor biology on ELR risk is not well understood.

Purpose of the Study:

  • To investigate if the initial care pathway impacts the risk and timing of ELR in musculoskeletal sarcoma.
  • To evaluate system-level factors in the context of tumor biology for ELR.

Main Methods:

  • Multicenter study of 158 patients with sarcoma and local recurrence.
  • Classification of patients into Comprehensive Care Pathway (CCP) or Fragmented Care Pathway (FCP) based on initial management.
  • Analysis using Cox proportional hazards models and Firth-penalized logistic regression, adjusting for clinicopathologic factors.

Main Results:

  • Fragmented care was independently associated with a higher risk of ELR (HR 2.00, OR 2.83).
  • Unplanned procedures and incomplete resection margins were more common in FCP, predicting ELR.
  • ELR was linked to increased metastases and poorer survival compared to late recurrence.

Conclusions:

  • Modifiable system-level factors, particularly care pathway fragmentation, significantly influence ELR in musculoskeletal sarcoma.
  • Optimizing care through early referral, multidisciplinary evaluation, and expert surgery is vital for reducing ELR.
  • Surgical quality, not adjuvant therapy alone, was key in mitigating ELR risk.