Risk factors for smoking in adolescence: evidence from a cross-sectional survey in Switzerland.

BACKGROUND: Cigarette smoking during adolescence is a major public health concern with far-reaching health implications. Adolescents who smoke are at an increased risk of developing long-term health problems and are more likely to continue smoking into adulthood. Therefore, it is vital to identify and understand the risk factors that contribute to adolescent smoking - which in turn facilitate the development of targeted prevention and intervention programs. METHODS: Data was drawn from a cross-sectional survey conducted between October and December 2021, encompassing adolescents of adolescents aged 14 to 19 residing in Switzerland (n = 2,683). Multiple logistic regression analysis was employed to explore which demographic, household, behavioural and psychographic factors are associated with current smoking status. RESULTS: The regression results showed higher odds of smoking for female respondents (OR 1.39; p-value 0.007); older adolescents (OR 1.30; p-value < 0.001); those living in the French-speaking part of Switzerland (OR 1.39; p-value 0.021), in suburban areas (OR 1.35; p-value 0.023) and with a smoker in the same household (OR 2.41; p-value < 0.001); adolescents consuming alcohol (OR 4.10; p-value < 0.001), cannabis products (OR 6.72; p-value < 0.001) and hookah (OR 5.07; p-value < 0.001) at least once a month; respondents not engaging in sports (OR 1.90; p-value < 0.001) or music (OR 1.42; p-value 0.031) as top five leisure activities and those experiencing high stress levels at home (OR 1.74; p-value < 0.001). Adolescents with high scores in health awareness (OR 0.33; p-value < 0.001), on the relational self-esteem scale (OR 0.78; p-value 0.054) and on the general well-being scale (OR 0.52; p-value 0.022) were less likely to smoke than their counterparts with lower scores. High risk-seeking was associated with higher odds of smoking (OR 2.15; p-value < 0.001). CONCLUSIONS: Our results suggest the importance of a comprehensive approach at both individual and institutional levels to reduce smoking rates in adolescents. More specifically, a holistic strategy that encompasses adolescents, families, schools and policymakers ranging from strengthening adolescents' self-esteem, smoking cessation support for parents, to increasing engagement in musical and physical activities, and enhancing health awareness in the school curriculum.

Classification in Early Fire Detection Using Multi-Sensor Nodes-A Transfer Learning Approach.

Effective early fire detection is crucial for preventing damage to people and buildings, especially in fire-prone historic structures. However, due to the infrequent occurrence of fire events throughout a building's lifespan, real-world data for training models are often sparse. In this study, we applied feature representation transfer and instance transfer in the context of early fire detection using multi-sensor nodes. The goal was to investigate whether training data from a small-scale setup (source domain) can be used to identify various incipient fire scenarios in their early stages within a full-scale test room (target domain). In a first step, we employed Linear Discriminant Analysis (LDA) to create a new feature space solely based on the source domain data and predicted four different fire types (smoldering wood, smoldering cotton, smoldering cable and candle fire) in the target domain with a classification rate up to 69% and a Cohen's Kappa of 0.58. Notably, lower classification performance was observed for sensor node positions close to the wall in the full-scale test room. In a second experiment, we applied the TrAdaBoost algorithm as a common instance transfer technique to adapt the model to the target domain, assuming that sparse information from the target domain is available. Boosting the data from 1% to 30% was utilized for individual sensor node positions in the target domain to adapt the model to the target domain. We found that additional boosting improved the classification performance (average classification rate of 73% and an average Cohen's Kappa of 0.63). However, it was noted that excessively boosting the data could lead to overfitting to a specific sensor node position in the target domain, resulting in a reduction in the overall classification performance.

[Are the concepts of "chronic mania" in German-speaking psychiatry around 1900 early contributions to the disorder of the adult form of attention deficit hyperactivity disorder (ADHD)?] / Sind die Konzepte zur "chronischen Manie" der deutschsprachigen Psychiatrie um 1900 frühe Beiträge zum Störungsbild der adulten Form der Aufmerksamkeitsdefizit­/Hyperaktivitätsstörung (ADHS)?

The adult form of attention deficit hyperactivity disorder (ADHD) has increasingly become a focus of adult psychiatry. Despite long-established diagnostic criteria and specific therapeutic approaches for the disorder, the common misconception that ADHD is a "fad" has persisted. Examining the history of psychiatry can make an educational contribution by showing that the adult form of ADHD is a continuously existing illness phenomenon. The present study examines the discussion of sometimes prominent authors about "chronic mania" in German-speaking psychiatry around 1900. The individual concepts were analyzed for their content and compared with each other and with modern diagnostic manuals for adult ADHD. The aim of this work is to question and discuss whether these "chronic-manic concepts" are part of the conceptual history of adult ADHD and whether a gap in the history of this disorder can be filled with their help. It is concluded that in the early twentieth century neurologists reported and discussed about patients who nowadays would almost certainly receive the diagnosis of ADHD. The psychiatrists had difficulty in classifying this disorder into their nosological schemes but their "chronic-manic concepts" show clear parallels to the current diagnostic criteria for adult ADHD and its symptoms.

Laser-Based Door Localization for Autonomous Mobile Service Robots.

For autonomous mobile service robots, closed doors that are in their way are restricting obstacles. In order to open doors with on-board manipulation skills, a robot needs to be able to localize the door's key features, such as the hinge and handle, as well as the current opening angle. While there are vision-based approaches for detecting doors and handles in images, we concentrate on analyzing 2D laser range scans. This requires less computational effort, and laser-scan sensors are available on most mobile robot platforms. Therefore, we developed three different machine learning approaches and a heuristic method based on line fitting able to extract the required position data. The algorithms are compared with respect to localization accuracy with help of a dataset containing laser range scans of doors. Our LaserDoors dataset is publicly available for academic use. Pros and cons of the individual methods are discussed; basically, the machine learning methods could outperform the heuristic method, but require special training data when applied in a real application.

OHO: A Multi-Modal, Multi-Purpose Dataset for Human-Robot Object Hand-Over.

In the context of collaborative robotics, handing over hand-held objects to a robot is a safety-critical task. Therefore, a robust distinction between human hands and presented objects in image data is essential to avoid contact with robotic grippers. To be able to develop machine learning methods for solving this problem, we created the OHO (Object Hand-Over) dataset of tools and other everyday objects being held by human hands. Our dataset consists of color, depth, and thermal images with the addition of pose and shape information about the objects in a real-world scenario. Although the focus of this paper is on instance segmentation, our dataset also enables training for different tasks such as 3D pose estimation or shape estimation of objects. For the instance segmentation task, we present a pipeline for automated label generation in point clouds, as well as image data. Through baseline experiments, we show that these labels are suitable for training an instance segmentation to distinguish hands from objects on a per-pixel basis. Moreover, we present qualitative results for applying our trained model in a real-world application.

Point Cloud Hand-Object Segmentation Using Multimodal Imaging with Thermal and Color Data for Safe Robotic Object Handover.

This paper presents an application of neural networks operating on multimodal 3D data (3D point cloud, RGB, thermal) to effectively and precisely segment human hands and objects held in hand to realize a safe human-robot object handover. We discuss the problems encountered in building a multimodal sensor system, while the focus is on the calibration and alignment of a set of cameras including RGB, thermal, and NIR cameras. We propose the use of a copper-plastic chessboard calibration target with an internal active light source (near-infrared and visible light). By brief heating, the calibration target could be simultaneously and legibly captured by all cameras. Based on the multimodal dataset captured by our sensor system, PointNet, PointNet++, and RandLA-Net are utilized to verify the effectiveness of applying multimodal point cloud data for hand-object segmentation. These networks were trained on various data modes (XYZ, XYZ-T, XYZ-RGB, and XYZ-RGB-T). The experimental results show a significant improvement in the segmentation performance of XYZ-RGB-T (mean Intersection over Union: 82.8% by RandLA-Net) compared with the other three modes (77.3% by XYZ-RGB, 35.7% by XYZ-T, 35.7% by XYZ), in which it is worth mentioning that the Intersection over Union for the single class of hand achieves 92.6%.

[The German Version of the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF): Latent Structure, Convergent Validity and Norm Values in the General Population]. / Die deutsche Version der Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF): Faktorenstruktur, konvergente Validität und Normwerte in der Allgemeinbevölkerung.

The Alternative DSM-5 Model of Personality Disorders describes the level of personality functioning, defined by impairments in self functioning (self pathology) and problems in interpersonal functioning (interpersonal pathology), as the core feature of all personality disorders. A brief self-report measure to assess the level of personality functioning, the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF) comprising 12 items, was developed by a Dutch work group. The present study aimed at a first and comprehensive psychometric evaluation of the German version of the LPFS-BF in a large and representative general population sample (n=2470) as well as a non-clinical sample (n=849), particularly focusing on the factor structure, convergent validity and norm values. Confirmatory factor analyses revealed that the theoretically assumed and for the original version empirically confirmed two-factor solution was replicated in both samples with acceptable fit. Reliability of the total scale as well as both subscales (defined by the internal consistency) was high in both samples (McDonalds ω ≥0.83). Satisfactory convergent validity was indicated by high correlations of the German version of the LPFS-BF with other measures assessing personality dysfunction (r ≥0.72). The association with current psychological distress was similarly high. In the general population sample, the mean norm value (T50) of the total scale was 15 and T70 was 33. Although psychometric evaluations of the German LPFS-BF in patients with mental disorders, particularly those with personality disorders, have not yet been performed, this measure can be recommended as it provides a quick and user-friendly impression of the severity of personality functioning in the domains of self and interpersonal pathology.

Implant survival or implant success? Evaluation of implant-based prosthetic rehabilitation in head and neck cancer patients-a prospective observational study.

OBJECTIVES: Definition of implant success is unclear in prosthetic implant-based rehabilitation of head neck cancer patients. MATERIALS AND METHODS: Fifty-two patients with 309 inserted implants were included in this prospective observational study. Implant survival (in situ and loaded) and implant success (modified Albrektsson criteria) at 2-year follow-up were evaluated under the influence of patient- and implant-specific variables. RESULTS: Thirty-nine patients with 234 implants finished the study. Overall implant survival after 2 years was 92.3% (216/234) with an osseointegration rate of 94% (220/234). Implant success was 78.6% (184/234). Main reasons for failure were "bone resorption > 1.7mm" (n = 27, 11.5%) and "implant not in situ or not loaded" (n = 18, 7.7%). Smoking (OR 3.1, p = 0.034), bone grafts (OR 2.4, p = 0.021) and radiation dose > 60 Gy (OR 3.8, p = 0.025) revealed as significant predictors for implant failure. CONCLUSION: Implant survival differs significantly from implant success in head and neck cancer patients. Implant success is mainly determined by radiographic peri-implant bone resorption. CLINICAL RELEVANCE: Dealing with head and neck cancer patients a higher amount of peri-implant bone resorption must be taken into account and warrants for intensified implant monitoring.

A Multi-Modal Person Perception Framework for Socially Interactive Mobile Service Robots.

In order to meet the increasing demands of mobile service robot applications, a dedicated perception module is an essential requirement for the interaction with users in real-world scenarios. In particular, multi sensor fusion and human re-identification are recognized as active research fronts. Through this paper we contribute to the topic and present a modular detection and tracking system that models position and additional properties of persons in the surroundings of a mobile robot. The proposed system introduces a probability-based data association method that besides the position can incorporate face and color-based appearance features in order to realize a re-identification of persons when tracking gets interrupted. The system combines the results of various state-of-the-art image-based detection systems for person recognition, person identification and attribute estimation. This allows a stable estimate of a mobile robot's user, even in complex, cluttered environments with long-lasting occlusions. In our benchmark, we introduce a new measure for tracking consistency and show the improvements when face and appearance-based re-identification are combined. The tracking system was applied in a real world application with a mobile rehabilitation assistant robot in a public hospital. The estimated states of persons are used for the user-centered navigation behaviors, e.g., guiding or approaching a person, but also for realizing a socially acceptable navigation in public environments.

Multiple-Joint Isokinetic Dynamometry: A Critical Review.

Dvir, Z and Müller, S. Multiple-joint isokinetic dynamometry: a critical review. J Strength Cond Res 34(2): 587-601, 2020-Angular isokinetic dynamometry (AID) is widely regarded as the gold standard for dynamic muscle performance testing. Based on the rotational movement of its actuator, AID targets "single-joint" (knee, shoulder, hip, etc.) configurations namely measurement of muscle potential while it moves the lever arm-limb assembly ostensibly around a single fixed axis. On the other hand, the application of multiple-joint isokinetic dynamometry (MID) is relatively narrow, both in research and in practice. This situation is due, possibly, to the fact that these dynamometers are generally more limited in scope namely to testing/conditioning of combined hip, knee, ankle motion (leg press), combined shoulder, elbow motion, and lifting motion patterns, despite the fact that all 3 are associated with higher functionality. However, with the emerging importance of MID, this critical review takes a fresh look at its various aspects including the terminology and classification of multiple-joint isokinetic dynamometers; the problem of scaling namely the need to adjust the range of motion and linear velocities to subjective anthropometric measures; specific technical and methodological issues that underlie the valid application of these dynamometers; available reference values; and the reproducibility of MID-based test findings. Analysis of these topics indicates that MID may validly and effectively be applied for the assessment and conditioning of specific muscle action patterns. However, there is a clear need for standardization of tests and for conditioning protocols alongside research into the use of this method in various clinical cohorts.

Identification of Fc Gamma Receptor Glycoforms That Produce Differential Binding Kinetics for Rituximab.

Fc gamma receptors (FcγR) bind the Fc region of antibodies and therefore play a prominent role in antibody-dependent cell-based immune responses such as ADCC, CDC and ADCP. The immune effector cell activity is directly linked to a productive molecular engagement of FcγRs where both the protein and glycan moiety of antibody and receptor can affect the interaction and in the present study we focus on the role of the FcγR glycans in this interaction. We provide a complete description of the glycan composition of Chinese hamster ovary (CHO) expressed human Fcγ receptors RI (CD64), RIIaArg131/His131 (CD32a), RIIb (CD32b) and RIIIaPhe158/Val158 (CD16a) and analyze the role of the glycans in the binding mechanism with IgG. The interactions of the monoclonal antibody rituximab with each FcγR were characterized and we discuss the CHO-FcγRIIIaPhe158/Val158 and CHO-FcγRI interactions and compare them to the equivalent interactions with human (HEK293) and murine (NS0) produced receptors. Our results reveal clear differences in the binding profiles of rituximab, which we attribute in each case to the differences in host cell-dependent FcγR glycosylation. The glycan profiles of CHO expressed FcγRI and FcγRIIIaPhe158/Val158 were compared with the glycan profiles of the receptors expressed in NS0 and HEK293 cells and we show that the glycan type and abundance differs significantly between the receptors and that these glycan differences lead to the observed differences in the respective FcγR binding patterns with rituximab. Oligomannose structures are prevalent on FcγRI from each source and likely contribute to the high affinity rituximab interaction through a stabilization effect. On FcγRI and FcγRIIIa large and sialylated glycans have a negative impact on rituximab binding, likely through destabilization of the interaction. In conclusion, the data show that the IgG1-FcγR binding kinetics differ depending on the glycosylation of the FcγR and further support a stabilizing role of FcγR glycans in the antibody binding interaction.

Nuclear Localised MORE SULPHUR ACCUMULATION1 Epigenetically Regulates Sulphur Homeostasis in Arabidopsis thaliana.

Sulphur (S) is an essential element for all living organisms. The uptake, assimilation and metabolism of S in plants are well studied. However, the regulation of S homeostasis remains largely unknown. Here, we report on the identification and characterisation of the more sulphur accumulation1 (msa1-1) mutant. The MSA1 protein is localized to the nucleus and is required for both S-adenosylmethionine (SAM) production and DNA methylation. Loss of function of the nuclear localised MSA1 leads to a reduction in SAM in roots and a strong S-deficiency response even at ample S supply, causing an over-accumulation of sulphate, sulphite, cysteine and glutathione. Supplementation with SAM suppresses this high S phenotype. Furthermore, mutation of MSA1 affects genome-wide DNA methylation, including the methylation of S-deficiency responsive genes. Elevated S accumulation in msa1-1 requires the increased expression of the sulphate transporter genes SULTR1;1 and SULTR1;2 which are also differentially methylated in msa1-1. Our results suggest a novel function for MSA1 in the nucleus in regulating SAM biosynthesis and maintaining S homeostasis epigenetically via DNA methylation.

[Levels of structural integration in adolescents and the relationship to later mental disorders - A longitudinal study]. / Psychisches Strukturniveau im Jugendalter und der Zusammenhang mit späterer psychischer Erkrankung ­ eine Langzeitstudie.

Levels of structural integration in adolescents and the relationship to later mental disorders - A longitudinal study Abstract. Objective: Psychological disorders frequently manifest during adolescence. Because of the multifactorial influencing factors, the courses of the diseases are heterogeneous, from relapsing-remitting to chronic. This study investigated whether the level of structural integration of the Operationalized Psychodynamic Diagnostics in Childhood and Adolescence (OPD-CA) correlates with later symptomatic burden. Method: This long-term study assessed the levels of structural integration according to the OPD-CA of 60 adolescents (mean age = 15.6; SD = 0.9). Seven years later, we then measured symptomatic burden (SCID axis I and II) and overall burden (GAF, BSI-GSI) (73.3 % follow-up participation rate). Results: The results showed high correlations between deficient structural integration in adolescence and later symptoms and overall burden in early adulthood. Conclusion: The follow-up examination after a 7-year time period showed significant correlations, which argue for the predictive value of structural integration. This suggests that early specific treatment, e.g., in the form of intensive psychotherapy, be urgently recommended in order to influence this course.

Acute epileptiform activity induced by gabazine involves proteasomal rather than lysosomal degradation of KCa2.2 channels.

Voltage-independent, Ca2+-activated K+ channels (KCa2.2, previously named SK2) are typically activated during a train of action potentials, and hence, are powerful regulators of cellular excitability by generating an afterhyperpolarizing potential (AHP) following prolonged excitation. In the acute in vitro epilepsy model induced in hippocampal brain slice preparations by exposure to the GABAA receptor blocker gabazine (GZ), the AHP was previously shown to be significantly decreased. Here, we asked the question whether KCa2.2 protein degradation occurs in this model and which pathways are involved. To this end, we applied either gabazine alone or gabazine together with inhibitors of proteasomal and lysosomal protein degradation pathways, Z-Leu-Leu-Leu-CHO (MG132) and chloroquine (CQ), respectively. Western blot analysis showed a significant decrease of total KCa2.2 protein content in GZ-treated slices which could be rescued by concomitant incubation with MG132 and CQ. Using HEK293 cells transfected with a green fluorescent protein-tagged KCa2.2 construct, we demonstrated that proteasomal rather than lysosomal degradation was involved in KCa2.2 reduction. We then recorded epileptiform afterdischarges at hippocampal Schaffer collateral-CA1 synapses and confirmed that the GZ-induced increase was significantly attenuated by both MG132 and CQ, with MG132 being significantly more effective than CQ. Epileptiform afterdischarges were almost prevented by co-application of protein degradation inhibitors. Furthermore, epileptiform afterdischarges could be re-established by using the KCa2.2 blocker UCL 1684 suggesting involvement of KCa2.2. We conclude that in GZ-induced acute epilepsy, KCa2.2 degradation by proteasomal rather than lysosomal pathways plays a major role in the generation of epileptiform afterdischarges.

Stability of the zwitterionic liquid butyl-methyl-imidazol-2-ylidene borane.

Modification of the C2 position of the standard 1-butyl-3-methyl imidazolium cation by a borohydride group leads to a zwitterionic liquid (ZIL). The resulting imidazol-2-ylidene borane ZIL is liquid at room temperature. Dynamic viscosity as well as thermal and electrochemical stability are investigated. Thermal decomposition follows a similar pathway as in comparable imidazolium ionic liquids. The surprisingly low viscosity and good reductive stability make it a promising candidate for electrochemical applications.

Green Imidazolium Ionics-From Truly Sustainable Reagents to Highly Functional Ionic Liquids.

We report the synthesis of task-specific imidazolium ionic compounds and ionic liquids with key functionalities of organic molecules from electro-, polymer-, and coordination chemistry. Such products are highly functional and potentially suitable for technology applications even though they are formed without elaborate reactions and from cheap and potentially green reagents. We further demonstrate the versatility of the used synthetic approach by introducing different functional and green counterions to the formed ionic liquids directly during the synthesis or after metathesis reactions. The influence of different cation structures and different anions on the thermal and electrochemical properties of the resulting ionic liquids is discussed. Our goal is to make progress towards economically competitive and sustainable task-specific ionic liquids.

Functional Metaplasticity of Hippocampal Schaffer Collateral-CA1 Synapses Is Reversed in Chronically Epileptic Rats.

Spatial learning and associating spatial information with individual experience are crucial for rodents and higher mammals. Hence, studying the cellular and molecular cascades involved in the key mechanism of information storage in the brain, synaptic plasticity, has led to enormous knowledge in this field. A major open question applies to the interdependence between synaptic plasticity and its behavioral correlates. In this context, it has become clear that behavioral aspects may impact subsequent synaptic plasticity, a phenomenon termed behavioral metaplasticity. Here, we trained control and pilocarpine-treated chronically epileptic rats of two different age groups (adolescent and adult) in a spatial memory task and subsequently tested long-term potentiation (LTP) in vitro at Schaffer collateral-CA1 synapses. As expected, memory acquisition in the behavioral task was significantly impaired both in pilocarpine-treated animals and in adult controls. Accordingly, these groups, without being tested in the behavioral training task, showed reduced CA1-LTP levels compared to untrained young controls. Spatial memory training significantly reduced subsequent CA1-LTP in vitro in the adolescent control group yet enhanced CA1-LTP in the adult pilocarpine-treated group. Such training in the adolescent pilocarpine-treated and adult control groups resulted in intermediate changes. Our study demonstrates age-dependent functional metaplasticity following a spatial memory training task and its reversal under pathological conditions.

Diffusion-weighted imaging in oral squamous cell carcinoma using 3 Tesla MRI: is there a chance for preoperative discrimination between benign and malignant lymph nodes in daily clinical routine?

BACKGROUND: Preoperative staging of cervical lymph nodes is important to determine the extent of neck dissection in patients with oral squamous cell carcinoma (OSCC). PURPOSE: To evaluate whether a preoperative discrimination of benign and malignant cervical lymph nodes with diffusion-weighted imaging (DWI) (3T) is feasible for clinical application. MATERIAL AND METHODS: Forty-five patients with histological proven OSCC underwent preoperative 3T-MRI. DWI (b = 0, 500, and 1000 s/mm(2)) was added to the standard magnetic resonance imaging (MRI) protocol. Mean apparent diffusion coefficients (ADCmean) were measured for lymph nodes with 3 mm or more in short axis by two independent readers. Finally, these results were matched with histology. RESULTS: Mean ADC was significantly higher for malignant than for benign nodes (1.143 ± 0.188 * 10(-3) mm(2)/s vs. 0.987 ± 0.215 * 10(-3) mm(2)/s). Using an ADC value of 0.994 * 10(-3) mm(2)/s as threshold results in a sensitivity of 80%, specificity of 65%, positive predictive value of 31%, and negative predictive value of 93%. CONCLUSION: Due to a limited sensitivity and specificity DWI alone is not suitable to reliably discriminate benign from malignant cervical lymph nodes in daily clinical routine. Hence, the preoperative determination of the extent of neck dissection on the basis of ADC measurements is not meaningful.

Influence of Load on Three-Dimensional Segmental Trunk Kinematics in One-Handed Lifting: A Pilot Study.

Stability of the trunk is relevant in determining trunk response to different loading in everyday tasks initiated by the limbs. Descriptions of the trunk's mechanical movement patterns in response to different loads while lifting objects are still under debate. Hence, the aim of this study was to analyze the influence of weight on 3-dimensional segmental motion of the trunk during 1-handed lifting. Ten asymptomatic subjects were included (29 ± 3 y; 1.79 ± 0.09 m; 75 ± 14 kg). Subjects lifted 3× a light and heavy load from the ground up onto a table. Three-dimensional segmental trunk motion was measured (12 markers; 3 segments: upper thoracic area [UTA], lower thoracic area [LTA], lumbar area [LA]). Outcomes were total motion amplitudes (ROM;[°]) for anterior flexion, lateral flexion, and rotation of each segment. The highest ROM was observed in the LTA segment (anterior flexion), and the smallest ROM in the UTA segment (lateral flexion). ROM differed for all planes between the 3 segments for both tasks (P < .001). There were no differences in ROM between light and heavy loads (P > .05). No interaction effects (load × segment) were observed, as ROM did not reveal differences between loading tasks. Regardless of weight, the 3 segments did reflect differences, supporting the relevance of multisegmental analysis.

Long-term outcome and subjective quality of life after surgical treatment of lower lip cancer.

OBJECTIVES: Squamous cell carcinoma of the lower lip represents a common type of cancer with a favourable prognosis. Different types of defect reconstruction after ablative surgery are described for maintenance of patients' quality of life. MATERIALS AND METHODS: The study retrospectively evaluates the outcome of 105 patients treated for lower lip cancer. Oncological data as well as individual quality of life were investigated. RESULTS: Cervical lymph node metastases rarely occurred (7.6 %) and were correlated to larger-sized tumours (p = 0.041). Only five patients (4.8) died related to the tumour disease, especially after lymph node metastasis and tumour recurrence (p < 0.001). The 5-year rates for recurrence-free, overall and disease-specific survival were 84.5, 61.2 and 93.9 %. Tumour recurrence correlated with a resection margin of less than 0.75 cm (p = 0.089). With view to postoperative quality of life, the modified Bernard-Fries technique showed the most unfavourable results, particularly referring to sensibility, paraesthesia, lip pursing and mouth opening compared to a stair-step and/or Abbe reconstructions. CONCLUSIONS: Squamous cell carcinoma of the lower lip shows a very favourable prognosis. Neck dissection seems often negligible particularly in small tumours. Patients' functional quality of life after lip surgery depends on the size of the primary and the used technique. Stair-step and/or Abbe reconstructions should be preferred to a Bernard-Fries technique in comparable defect sizes. CLINICAL RELEVANCE: Proper treatment of lower lip cancer provides favourable prognosis and preserves patients' functional and aesthetic quality of life.