Risk prioritisation of stormwater pollutant sources

This paper describes the development of a pollutant risk prioritisation methodology for the comparative assessment of stormwater pollutants discharged from differing land use types and activities. Guidelines are presented which evaluate available data with respect to ‘likelihood of occurrence’ and ‘severity of impact’. The use of the developed approach is demonstrated through its application to total suspended solids, biochemical oxygen demand, lead and cadmium. The proposed benchmarking scheme represents a transparent and auditable mechanism to support the synthesis of data from a variety of sources and is sufficiently flexible to incorporate the use of chemical, physical and/or ecological data sets. Practitioners involved in developing and implementing pollutant mitigation programmes are assisted in two key ways. Firstly through enabling the risks to receiving waters from diffuse pollution on a source-by-source and/or pollutant-by-pollutant basis at a catchment scale to be comparatively assessed and prioritised. Secondly, the methodology informs the selection of appropriate diffuse pollution control strategies

Constructing a transnational timber legality assurance regime: Architecture, accomplishments, challenges

The emerging transnational timber legality assurance regime comprises a set of interrelated policy instruments, both public and private, aimed at controlling trade in illegally logged wood and wood products. The potentially productive interactions among these instruments in the emerging forestry regime create prospects for engendering learning, stimulating cross-fertilization, and enhancing accountability. In this article, we analyze the EU's Forest Law Enforcement Governance and Trade (FLEGT) initiative, interacting with public legal timber regulations and private certification schemes, as the core of an emerging transnational experimentalist regime. An experimentalist regime of this type may provide a promising approach to addressing contentious transnational environmental issues like forest governance where there is no global hegemon to impose a single set of rules. However, experience with FLEGT implementation suggests that there are also a number of outstanding challenges to constructing an effective timber legality assurance regime, which if unresolved could undermine its promise. The argument proceeds in three steps, based on an exhaustive analysis of recent developments. First, we outline the architecture and promise of the emerging timber legality assurance regime. Then, we review key accomplishments to date. Finally, we examine the ongoing challenges facing this innovative regime as it moves forward, and consider how they might be overcome through the adoption of a more consistent experimentalist approach

Managing complications in cancer immunotherapy in head and neck cancer

International Journal of Head and Neck Science23107-11

Diagnostic Imaging of Nasopharyngeal Carcinoma

10.1007/978-981-15-3188-0_2Diagnostic Imaging in Head and Neck Cancer13-42Singapor

Sentinel lymph node mapping using ICG fluorescence and cone beam CT – a feasibility study in a rabbit model of oral cancer

Abstract Background Current sentinel lymph node biopsy (SLNB) techniques, including use of radioisotopes, have disadvantages including the use of a radioactive tracer. Indocyanine green (ICG) based near-infrared (NIR) fluorescence imaging and cone beam CT (CBCT) have advantages for intraoperative use. However, limited literature exists regarding their use in head and neck cancer SLNB. Methods This was a prospective, non-randomized study using a rabbit oral cavity VX2 squamous cell carcinoma model (n = 10) which develops lymph node metastasis. Pre-operatively, images were acquired by MicroCT. During surgery, CBCT and NIR fluorescence imaging of ICG was used to map and guide the SLNB resection. Results Intraoperative use of ICG to guide fluorescence resection resulted in identification of all lymph nodes identified by pre-operative CT. CBCT was useful for near real time intraoperative imaging and 3D reconstruction. Conclusions This pre-clinical study further demonstrates the technical feasibility, limitations and advantages of intraoperative NIR-guided ICG imaging for SLN identification as a complementary method during head and neck surgery

Defining a cohort of oligometastatic nasopharyngeal carcinoma patients with improved clinical outcomes

10.1002/hed.26061HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK425945-95

Cell-free DNA and circulating tumor cell kinetics in a pre-clinical head and neck Cancer model undergoing radiation therapy

Abstract Background Monitoring circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs), known as liquid biopsies, continue to be developed as diagnostic and prognostic markers for a wide variety of cancer indications, mainly due to their minimally invasive nature and ability to offer a wide range of phenotypic and genetic information. While liquid biopsies maintain significant promising benefits, there is still limited information regarding the kinetics of ctDNA and CTCs following radiation therapy which remains a vital treatment modality in head and neck cancers. This study aims to describe the kinetics of ctDNA and CTCs following radiation exposure in a preclinical rabbit model with VX2 induced buccal carcinoma. Methods Seven rabbits were inoculated with VX2 cells in the buccal mucosa and subjected to radiation. At selected time points, blood sampling was performed to monitor differing levels of ctDNA and CTC. Plasma ctDNA was measured with quantitative PCR for papillomavirus E6 while CTCs were quantified using an immunomagnetic nanoparticles within a microfluidic device. Comparisons of CTC detection with EpCAM compared to multiple surface markers (EGFR, HER2 and PSMA) was evaluated and correlated with the tumor size. Results Plasma ctDNA reflects the overall tumor burden within the animal model. Analysis of correlations between ctDNA with tumor and lymph node volumes showed a positive correlation (R = 0.452 and R = 0.433 [p < 0.05]), respectively. Over the course of treatment, ctDNA levels declined and quickly becomes undetectable following tumor eradication. While during the course of treatment, ctDNA levels were noted to rise particularly upon initiation of radiation following scheduled treatment breaks. Levels of CTCs were observed to increase 1 week following inoculation of tumor to the primary site. For CTC detection, the use of multiple surface markers showed a greater sensitivity when compared to detection using only EpCAM. Plasma CTC levels remained elevated following radiation therapy which may account for an increased shedding of CTCs following radiation. Conclusion This study demonstrates the utility of ctDNA and CTCs detection in response to radiation treatment in a preclinical head and neck model, allowing for better understanding of liquid biopsy applications in both clinical practice and research development