Song and Dance Man

With the back-to-back successes of Grand Hotel and The Will Rogers Follies, no one would have imagined that these would be the final Tommy Tune hits seen on Broadway. A series of flops (1994’s garish, vulgar The Best Little Whorehouse Goes Public, the antithesis of the elegant simplicity of his earlier work) and stillborn projects (1995’s Busker Alley, whose pre-Broadway tour collapsed when Tune broke his foot, and the abandoned Irving Berlin jukebox musical Easter Parade in the late 1990s) tarnished Tune’s status as a director who could rescue any show from disaster. In the years when he was one of Broadway’s most consistently inventive and successful directors of musicals, Tune had continued his performing career. Now, he increasingly spent more time on stage. His intimate, convivial “new vaudeville” act, built around Tune’s easygoing vocals and smooth tapping, featured songs by the Gershwins, Cole Porter, Irving Berlin, and other golden-age composers and underscored his affinity for music of an early time. The act proved remarkably flexible and durable, playing nightclubs and concert halls across the country and the world for more than thirty years. His enthusiasm for touring brought him a unique kind of celebrity. For many, he became the quintessential “Broadway Baby,” a man who summoned the spirit and continuity of the theater, even for those with little knowledge of the art form.

The Broadway Melody of 1991

The Will Rogers Follies was Tune’s most opulent show, far different from the sleek, stylized minimalism of his recent musicals, with a score by Cy Coleman (music) and Betty Comden and Adolph Green (lyrics), and a book by Peter Stone, by this time a frequent Tune collaborator. The story of Will Rogers, the beloved, Oklahoma-born star of radio, vaudeville, and films, and one of the most popular headliners of the Ziegfeld Follies, was told as a series of routines played out on the stage of the Follies. This look back at a bygone theatrical era played to Tune’s strengths, and his staging recalled show business antecedents from the stage and screen updated with present-day flourishes. Tune’s staging feats were even more impressive because they were performed on a grand staircase that covered the entire expanse of the stage. The Will Rogers Follies opened during a moment of resurgent patriotism in the wake of the success of Operation Desert Storm. Following a decade in which British hits like Cats, Les Misérables, and The Phantom of the Opera dominated the Broadway musical, an air of jingoism and a determination to reclaim Broadway for American musicals hovered over the success of The Will Rogers Follies in 1991.

Effect of Changes in MS Diagnostic Criteria Over 25 Years on Time to Treatment and Prognosis in Patients With Clinically Isolated Syndrome

Objectives:To explore whether time to diagnosis, time to treatment initiation and age to reach disability milestones has changed in patients with clinically isolated syndrome (CIS) according to different multiple sclerosis (MS)-diagnostic criteria periods.Methods:Retrospective study based on data prospective collected from the Barcelona-CIS cohort between 1994 and 2020. Patients were classified into five periods according to different MS criteria, and the time to MS diagnosis and treatment initiation were evaluated. The age at which MS patients reached an EDSS ≥3.0 was assessed by Cox regression analysis according to diagnostic criteria periods. Finally, in order to remove the classical “Will Rogers” phenomenon by which the use of different MS criteria over time might result on changes of prognosis, 2017 McDonald criteria were applied and age at EDSS ≥ 3.0 was also assessed by Cox regression.Results:1174 patients were included. The median time from CIS to MS diagnosis, and from CIS to treatment initiation showed a 77% and 82 reduction from the Poser to the McDonald 2017 diagnostic criteria periods, respectively. Patients of a given age diagnosed in more recent diagnostic criteria periods had a lower risk of reaching EDSS ≥3.0 than patients of the same age diagnosed in earlier diagnostic periods (reference category Poser period): Adjusted hazard ratio (aHR) 0.47 (95% confidence interval 0.24-0.90) for McDonald 2001, aHR 0.25 (0.12-0.54) for McDonald 2005, aHR 0.30 (0.12-0.75) for McDonald 2010 and aHR 0.07 (0.01-0.45) for McDonald 2017. Early-treatment patients displayed an aHR of 0.53 (0.33-0.85) of reaching age at EDSS ≥3.0 compared to late-treatment. Changes in prognosis together with early-treatment effect were maintained after excluding possible bias derived from the use of different diagnostic criteria over time (so called, “Will Rogers” phenomenon)Conclusion:A continuous decrease in the time to MS diagnosis and treatment initiation were observed across diagnostic criteria periods. Overall, patients diagnosed in more recent diagnostic criteria periods displayed a lower risk of reaching disability. Importantly, the prognostic improvement is maintained after discarding the “Will Rogers” phenomenon, and early treatment appears to be the most likely contributing factor.

Impacto del fenómeno de migración de estadio ganglionar en la supervivencia y la recurrencia de pacientes con cáncer papilar de tiroides sometidos a vaciamiento ganglionar profiláctico

Introducción. Dado que un ensayo clínico aleatorio es irrealizable, el rol del vaciamiento ganglionar profiláctico en pacientes con cáncer papilar de tiroides sin comprobación clínica de compromiso ganglionar metastásico (cN0) es controversial. El vaciamiento ganglionar profiláctico acarrea un proceso de reclasificación de pacientes, al hacer evidente la positividad ganglionar micrometastásica antes ignorada, lo que genera una aparente pero falsa mejoría en los desenlaces de los grupos de estadificación, mientras el pronóstico individual y total de la población no cambia, fenómeno conocido como migración de estadio o fenómeno de Will Rogers. Métodos. Se ejecutaron simulaciones de poblaciones con cáncer papilar de tiroides con compromiso ganglionar metastásico clínicamente evidente (cN+) y cN0, para determinar el impacto del fenómeno de migración de estadio en los pacientes sometidos a vaciamiento ganglionar profiláctico. Resultados. Con la simulación de las poblaciones y sus estadios ganglionares, se observa cómo la migración de estadio ganglionar genera una aparente mejoría en los desenlaces de recurrencia loco regional y supervivencia, sin cambiar los desenlaces de la población total ni individuales. Discusión. El fenómeno de migración de estadio es uno de los sesgos más importantes que limitan el uso de grupos históricos de control en ensayos de tratamiento experimental. De acuerdo con nuestros resultados, este fenómeno podría explicar los beneficios observados con el vaciamiento ganglionar profiláctico en algunos de los estudios agregativos publicados hasta el momento, hallazgos que no han sido documentados para el cáncer papilar de tiroides.

The Will Rogers phenomenon, breast cancer and race

Background The Will Rogers phenomenon [WRP] describes an apparent improvement in outcome for patients’ group due to tumor grade reclassification. Staging of cancers is important to select appropriate treatment and to estimate prognosis. The WRP has been described as one of the most important biases limiting the use of historical cohorts when comparing survival or treatment. The main purpose of this study is to assess whether the WRP exists with the move from the AJCC 7th to AJCC 8th edition in breast cancer [BC] staging, and if racial differences are manifested in the expression of the WRP. Methods This is a retrospective analysis of 300 BC women (2007–2017) at an academic medical center. Overall survival [OS] and disease-free survival [DFS] was estimated by Kaplan-Meier analysis. Bi and multi-variate Cox regression analyses was used to identify racial factors associated with outcomes. Results Our patient cohort included 30.3% Caucasians [Whites] and 69.7% African-Americans [Blacks]. Stages I, II, III, and IV were 46.2, 26.3, 23.1, and 4.4% of Whites; 28.7, 43.1, 24.4, and 3.8% of Blacks respectively, in anatomic staging (p = 0.043). In prognostic staging, 52.8, 18.7, 23, and 5.5% were Whites while 35, 17.2, 43.5, and 4.3% were Blacks, respectively (p = 0.011). A total of Whites (45.05% vs. 47.85%) Blacks, upstaged. Whites (16.49% vs. 14.35%) Blacks, downstaged. The remaining, 38.46 and 37.79% patients had their stages unchanged. With a median follow-up of 54 months, the Black patients showed better stage-by-stage 5-year OS rates using 8th edition compared to the 7th edition (p = 0.000). Among the Whites, those who were stage IIIA in the 7th but became stage IB in the 8th had a better prognosis than stages IIA and IIB in the 8th (p = 0.000). The 8th showed complex results (p = 0.176) compared to DFS estimated using the 7th edition (p = 0.004). Conclusion The WRP exists with significant variability in the move from the AJCC 7th to the 8th edition in BC staging (both White and Black patients). We suggest that caution needs to be exercised when results are compared across staging systems to account for the WRP in the interpretation of the data.

Fenômeno de Will Rogers: O Que Todo Médico Deve Saber

William Penn Adair Rogers, ou simplesmente Will Rogers, foi um showman norte-americano que viveu entre 1879 e 1935. Nos dias de hoje, seu nome é pouco conhecido, mas Will Rogers foi muito famoso em seu tempo. Sua morte prematura após um trágico acidente aéreo rendeulhe várias homenagens e memoriais em solo americano. Curiosamente, chegou a morar nos pampas argentinos durante sua juventude, seguindo o estilo de vida e de trabalho gaúcho por um breve período.

Will Rogers’ 1920s (1976), An American Family (1973) and The War Room (1993): A Cowboy’s Guide to the Pristine Sunshine and Wars in the Name of Peace

The study compares the responses of an artist, a common man and an American president to the times by analyzing the content of three documentary films: Will Rogers’ 1920s: A Cowboy’s Guide to the Times, An American Family (1973) and The War Room (1993) from the twentieth century. Will Rogers’1920s gives an insight into the simple life of a jongleur and a troubadour, cowboy cum actor, Will Rogers who was famous for topical humor in 1920s and whose life size sculpture occupies space in the American White House to keep an eye on the deeds of the greatest world leaders. An American Family, the world’s first ever reality show, documents real life events of seven members of a common American family and provide a contrast to the perfect Hollywood family portrait in 12 episodes. The War Room focuses on the president Clinton’s political agenda during his 1992 election campaign. The authors reviewed literature on the said documentaries and history of documentary film, American institutions and movements by Jack C. Ellis and Betsy A. McLane, Jeffrey Ruoff, Peter C. Rollins, Peter Ian Crawford, Klin Richard, Chris Hegedus, Shawn J. Parry-Giles and Trevor Parry-Giles. The study finds that Will Rogers learned to share his inherent happiness with the American audience by mollifying and disciplining many of their anxieties in the context of industrialization and the world war in 1920s. An American family is disturbing yet hilarious and presents a real portrait of the American family against 70s “culturally polyglot confluence backdrops” (Ellis and McLane 254). Pat Loud divorces her husband on air and their son Lance Loud becomes the first gay icon of the ‘gay decade,’ as several feminist, gay/lesbian, and civil rights, antiwar, ecology, and environmental protection movements takeover America. An American Family shows the mundane truth of everyday life in its social context. Its controlled realism reflects the filmmaker’s social conscience for audience’s identification and political action. The War Room celebrates the ideology of war during the president Clinton’s election campaign.

The Will Rogers phenomenon, Breast Cancer and Race

Background: The Will Rogers phenomenon [WRP] describes an apparent improvement in outcome for patients’ group due to tumor grade reclassification. Staging of cancers is important to select appropriate treatment and to estimate prognosis. The WRP has been described as one of the most important biases limiting the use of historical cohorts when comparing survival or treatment. The main purpose of this study is to assess whether the WRP exists with the move from the AJCC 7th to AJCC 8th edition in breast cancer [BC] staging, and if racial differences are manifested in the expression of the WRP.Methods: This is a retrospective analysis of 300 BC women (2007- 2017) at an academic medical center. Overall survival [OS] and disease-free survival [DFS], estimated by Kaplan-Meier analysis. Bi and multi-variate Cox regression analyses, used to identify racial factors associated with outcomes.Results: Our patient cohort included 30.3% Caucasians [C] and 69.7% African-Americans [AA]. Stages I, II, III, and IV were 46.2%, 26.3%, 23.1%, and 4.4% of C; 28.7%, 43.1%, 24.4%, and 3.8% of AA respectively, in anatomic staging (p=0.043). In prognostic staging, 52.8%, 18.7%, 23%, and 5.5% were C while 35%, 17.2%, 43.5%, and 4.3% were AA, respectively (p=0.011). A total of C (45.05% vs. 47.85%) AA, upstaged. C (16.49% vs. 14.35%) AA, down-staged. Remaining, 38.46% and 37.79% patients had their stages unchanged.With a median follow-up of 54 months, the AA patients showed better stage-by-stage 5-year OS rates using 8th edition compared to the 7th edition (p=0.000). Among the C, those who were stage IIIA in the 7th but became stage IB in the 8th had a better prognosis than stages IIA and IIB in the 8th (p=0.000). The 8th showed complex results (p=0.176) compared to DFS estimated using the 7th’s (p=0.004).Conclusion: The WRP exists with significant variability in the move from the AJCC 7th to the 8th edition in BC staging (both C and AA patients). We suggest that caution needs to be exercised when results are compared across staging systems to account for the WRP in the interpretation of the data.