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54 (0.50-0.6 in the multivariate-adjusted analysis. Similar results were also observed in the sub-distribution hazard function model (SD model) with corresponding multivariate HRs (95%CI) of 0.57 (0.52-0.63). Our study suggested that PTR was associated with improved survival in female stage IV breast cancer patients. The role of PTR in these patients needs to be re-evaluated. The World Health Organization (WHO) Trauma Care Checklist (TCC) has been documented to improve care of the injured. Factors that promote TCC use have not been

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