Background This study assessed the influence of extrathyroid extension (EE) on cause-specific mortality (CSM) and tumor recurrence (TR) in patients treated for papillary thyroid carcinoma (PTC). ...Methods We studied outcome in 3,524 patients with PTC without distant metastases at diagnosis. CSM and TR were investigated in 422 patients with gross EE (GEE) or microscopic EE (MEE). Results The 30-year CSM rate for GEE of 25% was 12-fold greater ( P < .001) than 2% seen with surgically intra-thyroid tumors (SIT); no patient who underwent MEE died of PTC. No difference ( P = .36) existed in CSM rates between 127 MEE and 3,102 microscopically intra-thyroid tumors (MITs). The 20-year TR rate for GEE was 43% versus 12% with SIT ( P < .001). Analyzing only 2,067 pN0 tumors, we found that GEE patients had greater TR rates (all sites), compared with SIT or MEE ( P < .001). When 44 MEE were compared with 1,941 MIT cases, TR (all sites) rates were not different ( P = .74). In patients aged >45 with tumors <41 mm, 20-year TR rates for MIT (stages I/II) and MEE (stage III) were not different at 4.7% and 3.8% ( P = .71). Conclusion MEE without concomitant GEE did not increase rates of either CSM or TR in PTC. Accordingly, these results raise concerns regarding current AJCC staging recommendations.
Despite the existing literature assessing various aspects of marriage, there is a lack of understanding of adults’ motives for pursuing marriage. Thus, this research advanced the literature by ...assessing adults’ motives for marriage via four novel studies in which the Motives for Marriage Scale (MMS) was developed, refined, and validated. In study one, semi-structured focus groups were conducted to capture the range of motives for marriage. In study two, the factor structure of the MMS was assessed. The factor structure was then validated and the psychometric properties were established in study three. Finally, the temporal consistency of the scale was established in study four. The results confirmed that adults’ marital motives are complex and that they are best conceptualized using Social Determination Theory (i.e., intrinsic, extrinsic, and instrumental motives). Investigation of the psychometric properties demonstrated the MMS to be reliable and valid. Implications for investigators and practitioners are discussed.
AbstractIn case of failure, hazardous liquid pipelines can have adverse environmental consequences. This study presents a method to predict the occurrence of certain environmental impacts resulting ...from hazardous liquid pipeline accidents. Explanatory variables, including pipe diameter, commodity transported, and incident area type, are used to train an adaptive neuro-fuzzy inference system (ANFIS). Three impact types are analyzed: water contamination, soil contamination, and impact on wildlife. Results show that the model can accurately predict whether a pipeline segment with given design characteristics could lead to adverse environmental impacts due to failure (14%, 6%, and 3% error for soil and water contamination and impact on wildlife, respectively). This model can be used in pipeline design and risk management planning to minimize the potential for environmental consequences. However, more comprehensive and robust reporting requirements beyond simple occurrence would improve our ability to prioritize these mitigative actions.
Fieldwork is a critical tool for scientific research, particularly in applied disciplines. Yet fieldwork is often unsafe, especially for members of historically marginalized groups and people whose ...presence in scientific spaces threatens traditional hierarchies of power, authority, and legitimacy. Research is needed to identify interventions that prevent sexual harassment and assault from occurring in the first place. We conducted a quasi-experiment assessing the impacts of a 90-min interactive training on field-based staff in a United States state government agency. We hypothesized that the knowledge-based interventions, social modeling, and mastery experiences included in the training would increase participants' sexual harassment and assault prevention knowledge, self-efficacy, behavioural intention, and behaviour after the training compared to a control group of their peers. Treatment-control and pre-post training survey data indicate that the training increased participants' sexual harassment and assault prevention knowledge and prevention self-efficacy, and, to a lesser extent, behavioural intention. These increases persisted several months after the training for knowledge and self-efficacy. While we did not detect differences in the effect of the training for different groups, interestingly, post-hoc tests indicated that women and members of underrepresented racial groups generally scored lower compared to male and white respondents, suggesting that these groups self-assess their own capabilities differently. Finally, participants' likelihood to report incidents increased after the training but institutional reports remained low, emphasizing the importance of efforts to transform reporting systems and develop better methods to measure bystander actions. These results support the utility of a peer-led interactive intervention for improving workplace culture and safety in scientific fieldwork settings. PROTOCOL REGISTRATION: "The stage 1 protocol for this Registered Report was accepted in principle on August 24, 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.6084/m9.figshare.21770165 .
Background
Contemporary guidelines for managing PTC advise an approach wherein primary tumor and regional metastases (RM) are completely resected at first surgery and radioiodine remnant ablation ...(RRA) is restricted to high-risk patients, policies our group has long endorsed. To assess our therapeutic efficacy, we studied 190 children and 4242 adults consecutively treated during 1936–2015.
Subjects and methods
Mean follow-up durations for children and adults were 26.9 and 15.2 years, respectively. Bilateral lobar resection was performed in 86% of children and 88% of adults, followed by RRA in 30% of children and 29% of adults; neck nodes were excised in 86% of children and 66% of adults. Tumor recurrence (TR) and cause-specific mortality (CSM) details were taken from a computerized database.
Results
Children, when compared to adults, had larger primary tumors which more often were grossly invasive and incompletely resected. At presentation, children, as compared to adults, had more RM and distant metastases (DM). Thirty-year TR rates were no different in children than adults at any site. Thirty-year CSM rates were lower in children than adults (1.1 vs. 4.9%;
p
= 0.01). Comparing 1936–1975 (THEN) with 1976–2015 (NOW), 30-year CSM rates were similar in MACIS <6 children (
p
= 0.67) and adults (
p
= 0.08). However, MACIS <6 children and adults in 1976–2015 had significantly higher recurrence at local and regional, but not at distant, sites. MACIS 6+ adults, NOW, compared to THEN, had lower 30-year CSM rates (30 vs. 47%;
p
< 0.001), unassociated with decreased TR at any site.
Conclusions
Children, despite presenting with more extensive PTC when compared to adults, have postoperative recurrences at similar frequency, typically coexist with DM and die of PTC less often. Since 1976, both children and adults with MACIS <6 PTC have a <1% chance at 30 years of CSM; adults with higher MACIS scores (6 or more) have a 30-year CSM rate of 30%.
Background
Controversy exists regarding the aggressiveness of initial therapy in childhood papillary thyroid cancer (PTC). Few studies with long-term outcome exist and second primary malignancies ...have rarely been analyzed.
Methods
We studied 215 PTC patients younger than 21 years old managed during 1940 through 2008. The patients were aged 3–20 year old (median age = 16 years); the median follow-up was 29 years. Recurrence and mortality details were taken from a computerized database.
Results
Median primary tumor size was 2.2 cm. Six percent had distant metastases at presentation, 5% had incomplete tumor resection, 86% had nodes removed at initial surgery, and 78% had nodal metastases. After complete surgical resection, PTC recurred in 32% by 40 years. At 20 years, the recurrence rates at local, regional, and distant sites were 7, 21, and 5%, respectively. During 1940–1969, local and regional recurrence rates after unilateral lobectomy (UL) were significantly (
P
< 0.001) higher than after bilateral lobar resection (BLR). During 1950–2008 radioiodine remnant ablation (RRA) was administered within 18 months to 32%; it did not diminish the 25-year regional recurrence rate of 16% seen after BLR alone (
P
= 0.86). Only two fatal events from PTC occurred at 28 and 30 years, for a cause-specific mortality at 40 years of only 2%. All-causes mortality rates did not exceed expectation through 20 years, but from 30 through 50 years, the number of deaths was significantly (
P
< 0.001) higher than predicted. Fifteen of 22 deaths (68%) resulted from nonthyroid malignancy.
Conclusion
Survival from childhood PTC should be expected, but later death from nonthyroid malignancy is disconcerting. Seventy-three percent of those who died from nonthyroid malignancy had received postoperative therapeutic irradiation.
To determine whether radioiodine remnant ablation (RRA) reduces cause-specific mortality (CSM) or tumor recurrence (TR) rate after bilateral lobar resection (BLR).
There were 2952 low-risk adult ...papillary thyroid cancer (LRAPTC) patients (with MACIS scores <6) who underwent potentially curative BLR during 1955-2014. During 1955-1974, 1975-1994, and 1995-2014, RRA was administered in 3%, 49%, and 28%. Statistical analyses were performed using SAS software.
During 1955-1974, the 20-year CSM and TR rates after BLR alone were 1.0% and 6.8%; rates after BLR+RRA were 0% (P=.63) and 5.9% (P=.82). During 1975-1994, post-BLR 20-year rates for CSM and TR were 0.3% and 7.5%; after BLR+RRA, rates were higher at 0.9% (P=.31) and 12.8% (P=.01). When TR rates were examined separately for 448 node-negative and 317 node-positive patients, differences were nonsignificant. In 1995-2014, post-BLR 20-year CSM and TR rates were 0% and 9.2%; rates after BLR+RRA were higher at 1.4% (P=.19) and 21.0% (P<.001). In 890 pN0 cases, 15-year locoregional recurrence rates were 3.4% after BLR and 3.7% after BLR+RRA (P=.99). In 740 pN1 patients, 15-year locoregional recurrence rates were 10% higher after BLR+RRA compared with BLR alone (P=.01). However, this difference became nonsignificant when stratified by numbers of metastatic nodes.
RRA administered to LRAPTC patients during 1955-2014 did not reduce either the CSM or TR rate. We would therefore not recommend RRA in LRAPTC patients undergoing BLR with curative intent.
Although pipelines are the safest method to transport fuels, they are associated with risks due to failures, leading to significant negative consequences. This paper investigates pipeline accident ...data provided by PHMSA (Pipeline and Hazardous Material Safety Administration) between 2010 and 2017, with a focus on environmental consequences of hazardous liquid pipeline accidents. The average amount of released product, the average time elapsed between the accident, the emergency response from the oil company, and the average costs of environmental remediation are estimated. The impact on soil, water, and wildlife is investigated for frequency and magnitude, where possible. It was found that, on average, 85% of product released after an accident remained unrecovered, 53% of accidents led to soil contamination, 41% of accidents impacted environmentally sensitive areas, and 92% of water crossing pipelines involved in accidents were uncased. From an annual average total cost of USD 326 million, annual average environmental damage and remediation costs were USD 140 million. This analysis assists in the diagnosis of challenges that might be addressed with improved maintenance and inspection programs, especially for pipelines at higher risk of negative environmental consequences. Finally, the performance of safety management systems should be improved to efficiently respond to emergencies.
In Canada, the National Energy Board (NEB) regulates inter-provincial oil and gas pipelines and maintains historical records that contain data on oil and gas pipeline accidents; these data include ...information about operators, the accidents’ cause, and the resulting consequences. New inter-provincial pipelines are being built in Canada to transport fuels, but no comprehensive statistical analysis of the risk to environmental receptors exists. This study assesses the quality and quantity of NEB pipeline failure data available in Canada with a focus on environmental consequences and investigates differences between Canada and a more thoroughly studied jurisdiction, the United States, in tracking accident data. The discrepancies in agencies’ jurisdiction and regulated mileage are analyzed, along with reporting criteria and initial recording year. The level of detail provided by the two agencies is compared, identifying deficiencies in data collection. The Pipeline and Hazardous Materials Safety Administration (PHMSA) regulates 76% of pipelines in the United States, whereas the NEB only monitors 9% of pipelines in Canada. PHMSA provides four databases that include accidents from the 1980s for most pipelines and from 2011 for liquefied natural gas facilities; the NEB database includes accident data starting from 2008, which derive primarily from transmission pipelines. Information about environmental consequences is quite detailed in the US database, which reports 21 descriptive fields, whereas in Canada only two NEB database fields describe environmental outcomes. Moreover, dissimilarities in accident reporting criteria prevent the combination of data from the two agencies. Consequently, the NEB database does not allow for statistically robust and system wide analysis of the environmental consequences of pipeline failures in Canada. Furthermore, to calculate failure rates (annual number of accidents per kilometre of pipeline) for regulated pipelines, annual total mileage estimates are required. Mileage per year is provided by PHMSA for gas gathering, transmission, and distribution pipelines starting from 1984, and for hazardous liquid pipelines from 2004; the NEB provides annual mileage from 2010, a shorter period of record. The Canadian federal agencies are encouraged to improve accuracy and consistency in recording past accidents and in collecting pipeline data, with the goal of preventing and minimizing future pipeline failures.
In higher plants, three subfamilies of sucrose nonfermenting-1 (Snf1)-related protein kinases have evolved. While the Snf1-related protein kinase 1 (SnRK1) subfamily has been shown to share pivotal ...roles with the orthologous yeast Snf1 and mammalian AMP-activated protein kinase in modulating energy and metabolic homeostasis, the functional significance of the two plant-specific subfamilies SnRK2 and SnRK3 in these critical processes is poorly understood. We show here that SnRK2.6, previously identified as crucial in the control of stomatal aperture by abscisic acid (ABA), has a broad expression pattern and participates in the regulation of plant primary metabolism. Inactivation of this gene reduced oil synthesis in Arabidopsis (Arabidopsis thaliana) seeds, whereas its overexpression increased Suc synthesis and fatty acid desaturation in the leaves. Notably, the metabolic alterations in the SnRK2.6 overexpressors were accompanied by amelioration of those physiological processes that require high levels of carbon and energy input, such as plant growth and seed production. However, the mechanisms underlying these functionalities could not be solely attributed to the role of SnRK2.6 as a positive regulator of ABA signaling, although we demonstrate that this kinase confers ABA hypersensitivity during seedling growth. Collectively, our results suggest that SnRK2.6 mediates hormonal and metabolic regulation of plant growth and development and that, besides the SnRK1 kinases, SnRK2.6 is also implicated in the regulation of metabolic homeostasis in plants.
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