Long-term results of radio(chemo)therapy in metastatic carcinoma to cervical lymph nodes from an unknown primary. Adult Comorbidity Evaluation 27 score as a predictor of survival.

PURPOSE: To evaluate the effectiveness and toxicity of curative (chemo)radiotherapy in patients with metastatic carcinoma to cervical lymph nodes from an unknown primary. METHODS: Retrospective study of 90 consecutive patients, treated with curative radiotherapy from 2003 to 2018 (median age 59 years; current/former smokers 76%) was conducted. The distribution of nodal staging was as follows: N1: 12%, N2a: 21%, N2b: 43%, N2c: 10%, N3: 13%. In 62% of patients, neck dissection was performed before radiotherapy. Concomitant chemotherapy was given to 64% of patients. RESULTS: The median follow-up of surviving patients was 86 months. The median total radiotherapy dose achieved was 70 Gy. The 5­ and 10-year locoregional control were 84% in both cases, while 5­ and 10-year distant control were 90% and 89%, respectively. A primary tumor in the head and neck area was detected in only 2 patients. No patient had an initial failure in the pharyngeal axis or contralateral cervical nodes. The 5­ and 10-year overall survival were 55% and 42%, respectively. Severe early toxicity occurred in 71%; severe late toxicity in 33% of patients. Multivariate analysis demonstrated N­status (hazard ratio [HR] 2.424; 95% confidence interval [CI] 1.121-5.241; p = 0.024) and comorbidity scores assessed by ACE-27 (Adult Comorbidity Evaluation; HR 3.058; 95% CI 1.489-6.281; p = 0.002) as two independent prognostic factors for overall survival. CONCLUSION: The results of our work study demonstrate the high effectiveness of curative (chemo)radiotherapy on the pharyngeal axis and bilateral cervical nodes with long-term locoregional and distant control in 3/4 of the treated patients. N­status and comorbidity scores were shown as strong prognostic factors influencing overall survival.

A comprehensive study of food waste management and processing in the Czech Republic: Potential health risks and consumer behavior.

Food waste is currently a widely discussed phenomenon with significant economic and social consequences. One third of the food produced in the world is wasted at various points along the food supply chain. This article presents a comprehensive study that examines consumer behavior in dealing with food waste and activities in the composting process that enable waste sanitation. The survey conducted as part of this study showed that consumers want to eliminate odors, are concerned about potential infections, and generally sort less food waste. This study suggested that the addition of appropriate additives could be a solution. The results indicated that additives could eliminate negative side effects such as unpleasant odors, the presence of insects and rodents, and act as a prevention of the occurrence of pathogenic organisms. Tea tree oil showed the best positive physical and chemical properties among the additives tested (CaCO3 and citric acid) with a significant effect on inhibiting the growth of bacterial strains such as Salmonella strains and had the strongest antibacterial effect, neutralized unpleasant odors, and stabilized the waste. The use of additives could be a future solution to meet consumer demands, improve the quality of food waste and advance the circular economy to improve the sustainability of agricultural systems.

From the shopping basket to the landfill: Drivers of consumer food waste behaviour.

The EU, where nearly 57 million tonnes of food waste are generated annually, has set a target to halve this amount by 2030. However, the amount of food waste produced varies greatly between EU countries. While several EU countries are far from reaching this target, the Czech Republic already meets it. Despite this, little to no attention is paid to Czech consumers' food waste behaviour. This study responds to the unfulfilled need by drawing attention to food waste and its reduction, and possibly even serving as a model example for the EU target. We identify key factors influencing food waste by conducting a survey with 1,551 respondents on stated preferences. The results using the PLS-SEM approach show that the price of food does not have as great an impact on the level of food waste as its characteristics or planning, which is part of consumers' purchasing behaviour. Furthermore, consumers' attitudes and awareness of food waste reduce food losses. The causes of food waste remain decidedly similar before and during the pandemic COVID-19, except that people paid more attention to food attributes during the pandemic. Product attributes are an essential part of decision-making, especially for women and people with higher levels of education. We conclude that it is desirable to sufficiently educate and teach consumers to properly plan their consumption and better estimate the amount of food needed when shopping, which should be a conscious decision rather than an impulsive one.