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Pathological margin assessment is an essential component of surgical management of oral cavity squamous cell carcinoma (OCSCC), however, in many studies, variable definitions of involved margins have been used. The purpose of the present study was to compare the prognostic ability of involved margins according to Royal College of Pathologists (RCPath) and College of American Pathologists (CAP) guidance.

Retrospective study of 300 patients with previously untreated OCSCC undergoing definitive surgical management. Main specimen margin status was defined according to RCPath guidance and CAP guidance. “Final margin status”, incorporated the results of frozen sections and extra tumour bed resections. The prognostic impact of each margin definition was studied using univariate analysis, and in multivariate models including T-stage (AJCC 8th edition), nodal status (pN+), extranodal extension (ENE), and use of adjuvant radiotherapy.

Both RCPath and CAP positive margins were associated with local recurrence (LR), disease-specific survival (DSS), and overall survival (OS) on univariate analysis, while final margin status was associated with LR and DSS, but not OS. On multivariate analysis, only CAP positive main specimen margin status was independently associated with LR (odds ratio 2.44, 95% CI 1.37, 4.34), DSS (odds ratio 2.28, 95% CI 1.31, 3.82), and OS (odds ratio 1.59, 95% CI 1.04, 2.42).

Involved main specimen margin as defined by CAP guidance has the advantage of being an independent prognosticator of LR and survival in our cohort.

Involved main specimen margin as defined by CAP guidance has the advantage of being an independent prognosticator of LR and survival in our cohort.Small water resource recovery facilities (WRRFs) serving communities with populations of less than 10,000 people account for 70% of centralized wastewater treatment systems in the United States. With growing interest globally in improving the sustainability of these systems, this study evaluated the environmental life cycle impact and land use tradeoffs of different lagoon and mechanical WRRFs across the diverse climate of Nebraska. Life cycle inventory including construction and operations was collected for 35 existing systems representing a range of commonly used mechanical WRRFs oxidation ditch, extended aeration, and sequencing batch reactors, and lagoon treatment systems complete retention, irrigation, and controlled discharge lagoons. Lagoons exhibit a significantly smaller environmental impact relative to mechanical WRRFs in all impact categories with exception of the smog category based on a 20-year design lifespan provided land is available for use; in contrast, on-site land use of lagoons was significantly higher than mechanical WRRFs, 73.7 ± 35.9 m2/capita and 2.4 ± 1.9 m2/capita, respectively. Lagoons on average exhibited significantly more impact associated with the construction phase in most impact categories (up to 80% in case of smog impacts) relative to mechanical WRRFs ( less then 25%). The differences in contribution of the construction leads to the environmental impacts and comparisons between the technologies being sensitive to system lifespan and type of electric grid mix. Irrigation lagoon per capita excavation and cast-iron resource use was observed to decrease with increasing differences between evaporation and precipitation rates. Uncertainty of the environmental impacts within sites is primarily driven by variations in energy intensity within mechanical WRRFs and volumes of treated water within lagoons. Variability between facilities of similar technology groups is largely driven by a combination of site-specific factors including climate, design, and operations.This study investigated the relative contributions of adsorption vs. biodegradation towards 2-methylisoborneol (MIB) and geosmin removal in the granular activated carbon (GAC) harvested from six filter-adsorbers in three drinking water treatment plants in the Great Lakes region. Column tests using azide-treated (sterilized) and untreated GAC in parallel were used to isolate the two effects. It was identified that substantial MIB and geosmin biodegradation in the GAC was occurring in one location, and that GAC in some cases had significant adsorption capacity after as much as 9 years of operation. Four alternative biological parameters (adenosine triphosphate, esterase activity, phosphatase activity, and 14C-glucose respiration rate) were measured to quantify the biological activity of the GAC, and 14C-glucose respiration rate was identified to be a potential indicator for GAC biodegradative capacity in terms of MIB, geosmin, and dissolved organic carbon. Several potential MIB and geosmin biodegradation products were also identified using non-targeted screening analysis. By using the new tools identified in this study, we can begin to better understand where adsorption vs. biodegradation may predominate under real-world conditions (e.g., different temperatures, influent concentrations, and empty bed contact time), leading ultimately to more cost-effective use of GAC.Regional anesthesia is widely used in peripheral nerve block and in neuraxial anesthesia to reduce anesthetics systemic side effects and shorten recovery times. However, when applied as a single injection (e.g., peripheral nerve block) it is limited by the duration of its effect. Herein, we develop a thermoresponsive nanogel based on poly(oligoethylene glycol methacrylate) containing the long-lasting anesthetic bupivacaine, which can be externally activated by using near-infrared light due to the photothermal properties of hollow gold nanoparticles embedded in the nanogel which facilitate its phase transition, triggering drug release at a controlled temperature above body temperature. Bupivacaine in vitro release can be repeatedly triggered to achieve a controlled pulsatile release of the drug due to the reversible nature of the thermosensitive nanogel, achieving a spatio-temporal control of the release. In vivo sciatic nerve block demonstrates that whereas the administered dose of free bupivacaine produces sensory block and impaired motor function for 2 h, the equivalent bupivacaine dose included in the developed release system can significantly prolong its neurobehavioral anesthetic effect for over 6 h. This release system can also be reactivated multiple times by subsequent irradiation cycles without observing detrimental toxicity in the infiltrated tissues.Although promising, the efficiency of aggregation-induced emission luminogens (AIEgens)-based photodynamic therapy (PDT) is limited by cellular glutathione (GSH). GSH is not a terminal reducing agent but it can be oxidized and subsequently reduced to its original state by reductases to further participate in antioxidant activity. It is therefore imperative to control GSH for effectively inducing oxidation within tumor cells. Recent studies showed that tumor cell metabolism depends mainly on glutamine, which is also the nitrogen and ATP source for GSH synthesis. Therefore, glutamine-based starvation therapy may be effective in enhancing photodynamic therapy. In this work, tumor-derived exosomes were developed for co-delivering AIEgens and proton pump inhibitors (PPI) for tumor combination therapy. Tumor-derived exosomes could specifically deliver drugs to the tumor sites, where PPI inhibited cell glutamine metabolism, suppressed tumor cell GSH and ATP production, and improved the effect of type-I PDT from AIEgens. When used in the treatment of MGC803 gastric cancer subcutaneous model, our system shows a high tumor growth inhibition rate, and even promoting tumor immunogenic death. This is the first work which combine inhibition of glutamine metabolism with PDT, and it has the potential to be applied for future designs of new tumor metabolic therapies and photodynamic systems.This study applies a multilevel model approach to test the predictive effect of the theory of planned behaviour (TPB) plus moral norm, past behaviour and crash history to account for intentions to avoid traffic violations within the context of commuting to or from work. This study also extended the theory by adding psychological stressors of perceived stress and work-family conflict. In this study, we systematically tested the direct and mediated models. A sample of Malaysian drivers (N = 482; 44.6% were men and 55.4% women), with the average age of 36.7 years (SD = 10.0) was surveyed. The self-report questionnaire contained multiple observations nested within individual drivers, with respect to 3 different driving violations. As predicted, multi-level modelling showed that within-person predictor variables of all the TPB components emerged as independent predictors, with injunctive norm being the most predictive variable, followed by self-efficacy and cognitive attitude. Intention was also predicted by moral norms and crash history. Between-person variables, gender, commuting hours and work-family conflict also had direct influences on intention (i.e., men and those with longer commuting hours and higher work-family conflict reported lower intentions). Substantial support for the mediation model was found, confirming that stressors indirectly influence intentions through effects on the social cognitive components. The implications of the linkage between the social cognition and stressors for developing potential broader interventions focusing on multiple violation behaviours and designing appropriate safety policies to reduce commuting crashes are discussed.With the popularity of smartphones and the increasing dependence on cellphones, cellphone-use-involved distracted driving has become a global traffic safety concern. Calling, texting, or watching videos while driving could have harmful impacts on driving abilities and increase crash-injury severities. To investigate the temporal stability and the heterogeneity of cellphone-involved crash injury severity determinants, a series of likelihood ratio tests and random parameters logit models with heterogeneity in means and variances are estimated. Cellphone-involved single-vehicle crash datasets of Pennsylvania from 2004 to 2019 are utilized. Marginal effects are also applied to investigate the impact of explanatory variables on injury severity outcomes. see more The results indicate an overall temporal instability of cellphone-involved crashes across different periods. However, driving without seatbelts and overturns are observed to produce relatively stable and positive influence on the increased injury severities of cellphone-involved crashes. Besides, it is noteworthy that a combination of cellphone usage with risky driving behaviors (aggressive driving, alcohol- or drug-related driving, speeding, or fatigue driving) significantly increase driver injury-severities. This finding highlights the necessity of identifying drivers with multiple risk-taking behaviors and enacting laws to prohibit these drivers from using cellphones while driving. Applications of smartphones provide another feasible approach to prevent using cellphones while driving. Insights and suggestions of this study would be valuable to mitigate the negative outcomes of cellphone-involved crashes and prevent the crashes caused by cellphone-involved distracted driving in the future.