In breast conservation therapy, the margin status of the specimen predicts local recurrence and determines the need for reexcision. Many surgeons now take, at the time of lumpectomy, multiple separate "cavity margins" (CM) (the entire wall of the residual cavity) as final margins that supersede the oriented lumpectomy margins (LMs). We studied the efficacy of this method in 126 patients (23 with ductal carcinoma in situ [DCIS] only and 103 with invasive carcinoma with or without DCIS) who had an oriented lumpectomy specimen and also had four to six additional CMs. The tumors were evaluated for the following: size, grade, LM status (distance of tumor from margin and, if involved, extent of involvement), vascular invasion, lymph node status, and presence or absence of extensive intraductal component. The additional CM specimens were evaluated for residual carcinoma (if any) and its distance from the inked true margins, and the results were correlated with the corresponding LMs. Only approximately 50% of patients (52 of 103) with histologically positive LMs (defined as carcinoma within 2 mm of the inked surface) had residual carcinoma in their CMs. Additional CM sampling rendered the overall final margin status histologically negative in 61 of 103 (59%) cases with histologically positive LMs, therefore significantly reducing the need for reexcision. Younger patient age, higher number of positive LMs, high tumor grade, and the presence of extensive intraductal component were predictive of residual carcinoma in CM specimens, whereas the distance of carcinoma from the inked surface and the extent of tumor involvement of histologically positive LMs were not. Because CM specimens taken from patients with histologically positive LMs usually lack tumor, we suspect that many positive LMs are likely false positives. Possible factors accounting for false-positive LMs include seepage of ink into crevices of the specimen promoted by excessive inking, tumor friability promoting displacement of tumor into ink, manipulation of specimens for radiographs, and retraction artifact.

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This study investigated the effects of fashion consumer's browsing motives and risk perception on impulse buying and purchase intention in social commerce. The online survey results of 317 customers who experienced using fashion products via social commerce were used for the final analysis. Exploratory factor analysis, reliability analysis, and frequency analysis were conducted using SPSS 18.0, and confirmatory factor analysis and path analysis were performed with AMOS 18.0. Three browsing motives (hedonic motive, rational motive, and informational motive) and three risk perceptions (products-related risk, customer service risk, and opportunity loss risk) were identified. The results from the structure equation model were as follows. 1) It was deducted that the browsing motive did not have a significant effect on risk perception due to the rejection of most of the hypotheses in regards to the browsing motive influence on risk perception. 2) Product-related risk and customer service risk had a significantly negative effect on purchase intention. Opportunity loss risk had significantly positive effect on impulse buying and purchase intention. 3) Hedonic browsing motive had a significant effect on impulse buying, and rational motive had a significant effect on impulse buying and purchase intention. The informational browsing motive had a significant effect only on purchase intention.

Alaskan wildfires are becoming more frequent and severe, but very little is known regarding exposure to wildfire smoke, a risk factor for respiratory and cardiovascular illnesses. We estimated long-term, present-day and future exposure to wildfire-related fine particulate matter (PM 2.5 ) across Alaska for the general population and subpopulations to assess vulnerability using observed data for the present day (1997–2010), modelled estimates for the present day (1997–2001), and modelled estimates for the future (2047–2051). First, we assessed wildfire-PM 2.5 exposure by estimating monthly-average wildfire-specific PM 2.5 levels across 1997–2010 for 158 Alaskan census tracts, using atmospheric transport modelling based on observed area-burned data. Second, we estimated changes in future (2047–2051) wildfire-PM 2.5 exposure compared to the present-day (1997–2001) by estimating the monthly-average wildfire-specific PM 2.5 levels for 29 boroughs/census areas (county-equivalent areas), under the Intergovernmental Panel on Climate Change (IPCC) A1B scenario from an ensemble of 13 climate models. Subpopulation risks for present and future exposure levels were estimated by summing area-weighted exposure levels utilizing the 2000 Census and State of Alaska’s population projections. We assessed vulnerability by several subpopulation characteristics (e.g. race/ethnicity, urbanicity). Wildfire-PM 2.5 exposure levels during 1997–2010 were highest in interior Alaska during July. Among subpopulations, average summer (June-August) exposure levels for urban dwellers and African-American/Blacks were highest at 9.1 μg m −3 and 10 μg m −3 , respectively. Estimated wildfire-PM 2.5 varied by Native American tribe, ranging from average summer levels of 2.4 μg m −3 to 13 μg m −3 for Tlingit-Haida and Alaskan Athabascan tribes, respectively. Estimates indicate that by the mid-21st century, under climate change, almost all of Alaska could be exposed to increases of 100% or more in levels of wildfire-specific PM 2.5 levels. Exposure to wildfire-PM 2.5 likely presents a substantial public health burden in the present day for Alaska communities, with different impacts by subpopulation. Under climate change, wildfire smoke could pose an even greater public health risks for most Alaskans.