Long-term frailty trajectory in older ICU survivors requiring mechanical ventilation: a prospective cohort study in Norway.

Non-melanoma skin cancer (NMSC), consisting primarily of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most frequently diagnosed malignancy in the United States, with over 5.4 million cases treated annually and $4.8 to $8.9 billion in associated healthcare costs. Achieving complete tumor clearance while preserving healthy tissue is particularly important in anatomically sensitive regions such as the face and neck. Mohs micrographic surgery (MMS) is widely used for high-risk or cosmetically sensitive NMSC because it combines staged excision with microscopic assessment of peripheral and deep margins. Frozen-section (FS) histopathology remains the intraoperative reference standard in MMS because it provides relatively fast cellular-level resolution and supports recognition of tumor architecture and growth patterns. However, FS introduces practical constraints in the MMS staging loop: processing and interpretation require specialized infrastructure and personnel, and prolonged turnaround can result in longer patient waiting times between stages. Because case complexity is often unpredictable in medium- to high-volume practices, this can lead to workflow inefficiencies, scheduling variability, staff overtime, and a limited ability to triage cases or manage backlogs. The steady increase in MMS procedures and the resulting long waiting times in densely populated regions further increase the total cost and logistical burden of care. Several adjunctive technologies have been explored for dermal margin assessment, including confocal microscopy (in vivo and ex vivo), optical coherence tomography variants, and Raman spectroscopy. While these modalities can offer useful structural or molecular contrast, they often carry significant capital and training requirements and can be challenging to integrate into the Mohs workflow at scale. As a result, a gap remains for an adjunctive approach that (i) preserves FS histopathology as the definitive diagnostic reference, (ii) integrates into the existing staging loop with minimal disruption, (iii) produces actionable output that can guide the surgeon to the subsequent excision within a timeframe compatible with the staging loop, and (iv) is operationally straightforward and cost-conscious.