Mechanical properties of municipal solid waste under different stress paths: Effects of plastic content and particle gradation.

Plastics within municipal solid waste (MSW) are non-degradable. As MSW continues to degrade, the relative content of plastics rises, and particle gradation may also change. Moreover, throughout the landfilling process, MSW is subjected to various stress conditions, potentially influencing its mechanical properties. This study explored the effects of varying plastic contents, different particle gradations, and distinct stress paths on the mechanical properties of MSW, and consolidated drained triaxial tests of 42 groups of reconstituted MSW specimens were conducted. The results showed that there was an optimal plastic content of 6-9 % for MSW, where the shear strength of MSW was higher than that of MSW with other plastic contents. When the stress path changed from TC45 to TC72, the optimal plastic content of MSW changed from 6 % to 9 %. As the plastic content increased, both the cohesion and internal friction angle of the MSW initially increased, then subsequently decreased. The impact of plastic content on cohesion was more pronounced than on the internal friction angle, especially at larger strains. Under various stress paths, MSW with distinct particle size distributions demonstrated diverse stress-strain behaviors. Traditional criteria for evaluating well-graded conditions in soils are not suitable for MSW. The effect of gradation on the cohesion of MSW is essentially due to the predominant role of fiber content; the relationship between gradation and the internal friction angle in MSW is complex and correlates closely with the content of both coarse and fine particles, as well as fibers. This study serves as an essential reference for predicting deformations in landfills and analyzing the stability of landfill slopes.

Short-term associations of particulate matter with different aerodynamic diameters with mortality due to mental disorders and dementia in Ningde, China.

Limited evidence is available regarding the impact of ambient inhalable particulate matter (PM) on mental disorder (MD) or dementia-related deaths, particularly PM1, PM1-2.5, and coarse particles (PM2.5-10). Moreover, individual confounders have rarely been considered. In addition, evidence from low-pollution areas is needed but is inadequate. Using death records from the Death Registration System during 2015-2021 in Ningde, a coastal city in southeast China, we combined a conditional quasi-Poisson model with a distributed lag nonlinear model to estimate the nonlinear and lagged associations of PM exposure with MD or dementia-related deaths in Ningde, China, comprehensively controlling for individual time-invariant confounders using a time-stratified case-crossover design. The attributable fraction and number were calculated to quantify the burden of MD or dementia-related deaths that were related to PMs. We found J-shaped relationships between MD or dementia-related deaths and PMs, with different thresholds of 13, 9, 19, 33 and 12 µg/m3 for PM1, PM1-2.5, PM2.5, PM10 and PM2.5-10. An inter-quartile range increase for PM1, PM1-2.5, PM2.5, PM10 and PM2.5-10 above the thresholds led to an increase of 31.8% (95% confidence interval, 14.3-51.9%), 53.7% (22.4-93.1%), 32.6% (15.0-53.0%), 35.1% (17.7-55.0%) and 25.9% (13.0-40.3%) in MD-related deaths at lag 0-3 days, respectively. The associations were significant in the cool season rather than in the warm season and were significantly greater among people aged 75-84 years than in others. The fractions of MD-related deaths attributable to PM1, PM1-2.5, PM2.5, PM10 and PM2.5-10 were 5.55%, 6.49%, 7.68%, 10.66%, and 15.11%, respectively; however, only some of them could be protected by the concentrations recommended by the World Health Organisation or China grade I standard. Smaller associations and similar patterns were observed between PMs and dementia-related death. These findings suggest stricter standards, and provide evidence for the development of relevant policies and measures.

The interaction and mediation effects between the host genetic factors and Epstein-Barr virus VCA-IgA in the risk of nasopharyngeal carcinoma.

Previous studies have demonstrated strong associations between host genetic factors and Epstein-Barr virus (EBV) VCA-IgA with the risk of nasopharyngeal carcinoma (NPC). However, the specific interplay between host genetics and EBV VCA-IgA on NPC risk is not well understood. In this two-stage case-control study (N = 4804), we utilized interaction and mediation analysis to investigate the interplay between host genetics (genome-wide association study-derived polygenic risk score [PRS]) and EBV VCA-IgA antibody level in the NPC risk. We employed a four-way decomposition analysis to assess the extent to which the genetic effect on NPC risk is mediated by or interacts with EBV VCA-IgA. We consistently found a significant interaction between the PRS and EBV VCA-IgA on NPC risk (discovery population: synergy index [SI] = 2.39, 95% confidence interval [CI] = 1.85-3.10; replication population: SI = 3.10, 95% CI = 2.17-4.44; all pinteraction < 0.001). Moreover, the genetic variants included in the PRS demonstrated similar interactions with EBV VCA-IgA antibody. We also observed an obvious dose-response relationship between the PRS and EBV VCA-IgA antibody on NPC risk (all ptrend < 0.001). Furthermore, our decomposition analysis revealed that a substantial proportion (approximately 90%) of the genetic effects on NPC risk could be attributed to host genetic-EBV interaction, while the risk effects mediated by EBV VCA-IgA antibody were weak and statistically insignificant. Our study provides compelling evidence for an interaction between host genetics and EBV VCA-IgA antibody in the development of NPC. These findings emphasize the importance of implementing measures to control EBV infection as a crucial strategy for effectively preventing NPC, particularly in individuals at high genetic risk.

Spatiotemporal distribution and pollution control of pollutants in a Cr(VI)-contaminated site located in Southern China.

Soil and groundwater Cr(VI) pollution resulting from improper disposal and accidental spills is a critical problem worldwide. In this study, a comprehensive study was conducted to assess the hydrogeological conditions of a contaminated site, obtain spatiotemporal distribution and trend forecasts of pollutant Cr(VI), and determine the feasibility of applying clayey engineered barriers for pollution control. The results showed that the hydraulic conductivity (K) of the clayey barrier (1.56E-5 m/d) is several orders of magnitude lower than that of the stratum beneath the contaminated site, with K values ranging from 0.0014 to 4.76 m/d. Cr(VI) exhibits high mobility and a much higher concentration in the vadose zone, with maximum values of 6100 mg/kg in topsoil and 2090 mg/L in the perched aquifer. The simulation results indicated that the groundwater in the vicinity of the contaminated site, as well as downstream of the Lianshui River, is seriously threatened by Cr(VI). Notably, the pollution plume could occur downstream of the Lianshui River after 8 years. The retention efficiency of clayey engineered barriers will decrease over time, at 61.6% after 8 years and 33% after 20 years. This work contributes to an in-depth understanding of Cr(VI) migration at contaminated sites.

Laboratory investigation on the retention performance of a soil-bentonite mixture used as an engineered barrier: insight into the effects of ionic strength and associated heavy metal ions.

Soil-bentonite (S-B) materials are promising backfill materials for use as engineered barriers in heavy metal-contaminated sites. The effects of contaminant exposure on the retention performance of the S-B barrier remain unrevealed. In this study, based on the pollution status of an abandoned ferroalloy factory located in southern China, the retention performance of the S-B mixture toward Cr(VI) and Zn(II) was studied through adsorption and diffusion experiments sequentially; the separate effect of ionic strength (binary solution) and the combined effect of ionic strength and associated heavy metal ion (ternary solution) were discussed. In NaCl-Cr(VI)/Zn(II) binary solutions, the adsorption of Zn(II) onto the S-B mixture is larger than that of Cr(VI). Kd, Qmax, and ɛacc (accessible porosity) of Cr(VI) increase through increasing ionic strength, while Zn(II) shows the opposite trend; De (effective diffusion coefficient) values for both Cr(VI) and Zn(II) increased with increasing ionic strength and follow a sequence of Cr(VI) > Zn(II), indicating a better retention performance of the S-B mixture to Zn(II). For a given ionic strength, the adsorption of Zn(II) was larger than that of Cr(VI), which can be attributed to the retention specificity of the S-B mixture to anion and cation. In Cr(VI)-Zn(II)-NaCl ternary solutions, the adsorptions of Cr(VI) and Zn(II) are enhanced in varying degrees when compared with their binary solution, which probably could be attributed to the ion bridge role of Cr(VI)/Zn(II) to connect each other that relatively increased the adsorption capacity of S-B material. This work will contribute to an in-depth understanding of the retention performance of the S-B mixture in complicated chemical environments and facilitate the selection of future remediation strategies.

Machine learning-based models for predicting gas breakthrough pressure of porous media with low/ultra-low permeability.

Gas breakthrough pressure is a significant parameter for the gas exploration and safety evaluation of engineering barrier systems in the carbon dioxide storage, remediation of contaminated sites, and deep geological repository for disposal of high-level nuclear waste, etc. Test for determining gas breakthrough pressure is very difficult and time-consuming, due to the low/ultra-low conductivity of the specimen. It is also difficult to get a comprehensive and high-precision model based on limited results obtained through individual experiments, as the measurements of gas breakthrough pressure were influenced by many factors. In this study, a collected database was built that covered a lot of former test data, and then, two models were developed by the random forest (RF) algorithm and multiexpression programming (MEP) method. The MEP model constructed with explicit expressions for the gas breakthrough pressure overcame the drawbacks of common "black box" models. Meanwhile, five significant indicators were selected from ten common features using the permutation importance algorithm. The RF model was interpreted by the Shapley value and the PDP/ICE plots, while the MEP model was analyzed through the proposed explicit expression, showing strong consistence with that in former studies. Finally, robustness analysis was conducted, and stability of the proposed two models was verified.

Identification of multiple single-nucleotide variants for clinical evaluation of Helicobacter pylori drug resistance.

Helicobacter pylori infections are threats to public health due to their high infection rate and drug resistance. Identification of single-nucleotide variants (SNVs) in H. pylori is crucial for both diagnosis and therapy. Yet the clinical testing of resistant H. pylori mutants is still facing some challenges, such as the selectivity is not good enough for SNVs in abundant wild-type DNA, the lack of clinical validation and the economical burden on patients. Herein, an X-shaped DNA probe with a toehold initiator was designed, which could specifically hybridize with certain genotype DNA due to the thermodynamically driven reaction. A competitive reaction was developed to amplify the thermodynamic difference between wild-type DNA and SNVs, diminishing the interference of wild-type DNA. By this means, multiple SNVs in H. pylori were successfully identified and two SNVs related to clarithromycin resistance are chosen as model targets. A paper strip was fabricated for visual, fast screening of SNVs. Furthermore, the approach was validated using clinical samples, and a point-of-care (POCT) testing diagnosis was executed on saliva samples, demonstrating its potential for the prevention and cure of H. pylori infections.

Analysis of Immunological Characteristics and Genomic Alterations in HPV-Positive Oropharyngeal Squamous Cell Carcinoma Based on PD-L1 Expression.

Programmed death-ligand 1 (PD-L1) expression has been approved as an immune checkpoint inhibitor (ICI) response predictive biomarker; however, the clinicopathological and molecular features of HPV-positive oropharyngeal squamous cell carcinoma [HPV(+)OPSCC] based on PD-L1 expression are not well studied. We aimed to characterize clinicopathological, tumor immune microenvironmental, and molecular features of HPV(+)OPSCC with different PD-L1 expression scored by combined positive score (CPS). A total of 112 cases were collected from 2008-2021 and received PD-L1 and CD8 immunohistochemistry (IHC) staining. 71 samples received DNA sequencing out of which 32 samples received RNA sequencing for immune-related gene alterations or expression analysis. The 32 samples were also subjected to analysis of CD20, CD4, CD8, CD68, Foxp3 and P16 by multiplex immunofluorescence (mIF) staining, and the immune markers were evaluated in the tumor body (TB), tumor margin (TM) and normal stroma (NS) regions separately. Our results showed that of 112 HPV(+)OPSCC tumors, high(CPS≥20), intermediate(1≤CPS<20), and low(CPS<1) PD-L1 expression was seen in 29.5%, 43.8% and 26.8% cases respectively. Non-smoking patients and patients with tumors occurring at the tonsils or having rich lymphocytes infiltration had significantly higher PD-L1 expression. Patients with CPS≥20 had significantly higher tumor mutation burden (TMB, p=0.0058), and PD-L1 expression correlated significantly with CD8+ T cells infiltration, which were ample in tumor regions than in NS in mIF. CD20+, CD4+, CD68+, Foxp3+CD4+ cells were demonstrated to infiltrate higher in TM while CD20+ and CD68+ cells were also enriched in NS and TB regions respectively. However, none of them showed correlations with PD-L1 expression. ARID1A, STK11 alterations were enriched in the low PD-L1 group significantly, while anti-viral immune associated APOBEC mutation signature and immune-related genes expression such as XCL1 and IL11 were positively associated with PD-L1 expression (p<0.05). This is a comprehensive investigation revealing immune and molecular features of HPV(+)OPSCC based on PD-L1 expression. Our study suggested that 73.2% of HPV(+)OPSCC patients may benefit from immunotherapy, and high PD-L1 expression reflects immune-active status of HPV(+)OPSCC accompanied by higher immune effect factors such as TMB, CD8+ cytotoxic T cells and immune-related genomic alterations. Our study offers valuable information for understanding the immune features of HPV(+)OPSCC.

The sorption performance of corroded Gaomiaozi bentonite by evolved cement water at different temperatures: the case of europium removal.

In the Chinese high-level radioactive waste geological disposal program, Gaomiaozi (GMZ) bentonite has been selected as the potential buffer/backfill material. After the closure of the repository, the Ca-OH-type alkaline solution (evolved cement water) released by cement degradation may last for more than 100,000 years. The bentonite will undergo the corrosion of evolved cement water (ECW) for a long period. This work focuses on the sorption property of GMZ bentonite altered by ECW. Firstly, the corrosion experiments on compacted GMZ specimens with the dry density of 1.70 Mg/m3 were carried out under constant volume conditions at two temperatures. Then, the sorption of europium (Eu (III)) onto the corroded GMZ bentonite was studied by batch experiments. The results of batch sorption tests indicate that the altered GMZ bentonite keeps an effective removal property with the uptake of Eu (III) more than 99%. The effect of high-temperature conditions of the repository on the sorption property of bentonite is not significant. The results also suggest that the evolved cement water presents no detrimental effect on the long-term adsorption performance of bentonite even under higher temperature conditions.

Calcitonin gene-related peptide enhances osteogenic differentiation and recruitment of bone marrow mesenchymal stem cells in rats.

The present study evaluated the effects of calcitonin gene-related peptide (CGRP) on bone marrow mesenchymal stem cells (BMMSCs) in vitro and in a rat model of mandibular distraction osteogenesis (MDO). Rat BMMSCs were isolated then treated with CGRP or CGRP antagonist (CGRP8-37). The proliferation and migration ability of BMMSCs was determined using 5-bromo-2'-deoxyuridine and Transwell assays, respectively. Osteogenic-related gene expression was analyzed with reverse transcription-quantitative polymerase chain reaction. For the in vivo analysis, thirty MDO rats were randomly assigned to control, CGRP or CGRP8-37 groups. To evaluate the mobilization of BMMSCs, nestin and stromal cell-derived factor 1 (SDF-1) were detected by immunohistochemistry and ELISA. Rats were sacrificed following 14 days and new bone formation was assessed by histological and micro-computed tomography analysis. In the in vitro results, the CGRP group demonstrated significantly higher migration and proliferation, as well as enhanced alkaline phosphatase and runt-related transcription factor 2 expression compared with the control. In the in vivo experiments, bone mineral density of the newly formed bone in the CGRP group was significantly higher than controls. The nestin and SDF-1 expression in the CGRP group was also significantly upregulated. In conclusion, the present study demonstrated that CGRP administration increased new bone formation, possibly via enhancing BMMSC migration and differentiation in MDO rats.

Experimental and numerical study on heavy metal contaminant migration and retention behavior of engineered barrier in tailings pond.

Heavy metal pollution is a serious environmental problem globally, particularly in mines and tailings ponds. In this study, based on laboratory and field tests, the migration of heavy metal contaminants in a tailings pond and the retention behavior of a compacted bentonite engineered barrier system on the heavy metal contaminants were analyzed by a numerical simulation. The results demonstrate that the hydraulic conductivity of compacted bentonite is lower than that of the tailings from the laboratory tests. The hydraulic conductivity of the tailings sand decreased with an increase in the dry density and increased with an increase in the concentration of the chemical solution, which could be attributed to the large amounts of fine-grained soil contained in the tailings, according to the grain size distribution test. The hydraulic conductivity of the tailings from the engineering geological survey was between 2.0 × 10-6 and 9.0 × 10-5 m/s, and followed the order: tail coarse sand ＞ tail silty sand ＞ tail medium sand ＞ tail fine silt. The numerical simulation of the seepage could satisfactorily describe the actual working condition of the tailings dam. With the groundwater seepage, the migration range of the heavy metal contaminant in the researched tailings pond reached a maximum of 45 m for 5 years. The retention efficiencies of the 0.2 m engineered barrier against the heavy metal contaminant for 15 and 30 years were 45.4% and 57.2%, respectively. Moreover, the retention efficiency would exceed 87% when the engineered barrier thickness is increased to 0.5 m. The results of model validation show that the calculated results are in good agreement with the measured ones. These findings can provide effective ideas for the prevention and control of environmental pollution in mines and tailings ponds.

Short sleep duration is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females.

PURPOSE: The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population. METHODS: Cross-sectional data of 20,505 individuals aged 35-64 years from Taizhou longitudinal study was used. Logistic regression models were used to calculate odds ratios (ORs) for the risk of pre-hypertension and hypertension in association with sleep duration. RESULTS: Short sleep duration was associated with high systolic and diastolic blood pressure in comparison with sleep duration of 7-8 h in females. Short sleep duration was also associated with an increased risk of hypertension in females. Age-stratified analysis showed that as compared with sleep duration of 7-8 h, sleep duration <6 h increased risk of hypertension after controlling for multiple covariates with an OR of 1.766 (1.024-2.775) in early middle-aged females of 35-44 years. More importantly, sleeping less than 6 h is associated with increased risk of pre-hypertension in females of this age category, after controlling for multiple covariates with an OR of 1.769 (1.058-2.958). CONCLUSIONS: Sleeping less than 6 h a day is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. The high-risk populations require sufficient sleep, which could probably prevent the increased risk of pre-hypertension as well as hypertension.

Application of Computed Tomography Angiography Mapping and Located Template for Accurate Location of Perforator in Head and Neck Reconstruction with Anterolateral Thigh Perforator Flap.

BACKGROUND: The authors introduce a new method of preoperative computed tomography angiography mapping and virtual and printed located template for accurate location of perforators in the anterolateral thigh perforator flap for head and neck reconstruction. METHODS: Between April and December of 2014, a cohort study was performed with 29 patients who underwent head and neck reconstruction with anterolateral thigh perforator flaps. Computed tomography angiography images were processed for maximum intensity projection and volume rendering to obtain and evaluate the perforator information. The virtual and printed templates with grid were used to transfer the perforator information for intraoperative guidance during flap harvest. The preoperative angiography results were compared with the high-frequency color Doppler results and with the intraoperative real-time findings to evaluate the accuracy of computed tomography angiography mapping. RESULTS: The source vessel, origin, location, direction, number, and caliber of the perforators were determined by preoperative computed tomography angiography mapping. All of the perforator data were accurately mapped on a virtual template and printed on the located template to guide flap harvest. The flap was actually used and survived successfully in 20 patients. The results for perforators identified by mapping were more accurate than those for perforators identified by Doppler. There was no significant difference between the preoperative computed tomography angiography results and the intraoperative findings (p > 0.05). CONCLUSIONS: The role of preoperative computed tomography angiography mapping in guiding anterolateral thigh perforator flap harvest and reducing the unpredictable risk of surgery is acceptable. Located virtual and printed template with grid can transform preoperative computed tomography angiography information to the intraoperative setting accurately and easily. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.

Pseudospin-induced chirality with staggered optical graphene.

Pseudospin has an important role in understanding many interesting physical phenomena that are associated with two-dimensional materials such as graphene. Pseudospin has been proposed to be directly related to angular momentum, and orbital angular momentum was recently experimentally demonstrated to be an intrinsic property of pseudospin in a photonic honeycomb lattice. However, in photonics, the interaction between spin and pseudospin for light has not been investigated. In this letter, we propose that in an optical analog of staggered graphene (that is, a photonic honeycomb lattice waveguide with in-plane inversion symmetry breaking), the pseudospin mode can strongly couple to the spin of an optical beam that is incident in certain directions. The spin-pseudospin coupling that is caused by the spin-orbit conversion in the scattering process induces a strong optical chiral effect for the transmitted optical beam. Spin-pseudospin coupling of light opens the door to the design of pseudospin-mediated spin or valley-selective photonic devices.

STAT3 is a key pathway in primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst.

PURPOSE: Primary intraosseous squamous cell carcinoma (PIOSCC) arising within an odontogenic keratocyst (OKC) is rare malignancy, entailing a poor prognosis for delayed diagnosis. The number of reports concerning this entity is extremely small. The aim of this study is to present the clinical and pathologic characteristics of PIOSCC and investigate its pathogenesis. MATERIALS AND METHODS: This study describes three patients with mandibular PIOSCC derived from an OKC over a seven-year period, each of which suffering from decompression in mandible. Important diagnostic criteria included the absence of overlying oral mucosal ulceration, the absence of a distant potential primary tumor, and the presence of a completely intraosseus lesion. The malignant transformation of OKC to PIOSCC was confirmed by pathologic evaluation of surgical resection specimens. Immunohistochemistry (IHC) was used to evaluating expression of Ki-67, p65, EGFR, phospho-AKT, and STAT3 in each of the three tumors and adjacent cyst walls. RESULTS: Analysis by IHC indicated that Ki67, P65, EGFR and STAT3 were substantially elevated in PIOSCC. There was an obvious positive correlation between Ki67, P65, EGFR and STAT3 expression in adjacent benign epithelium. Each tumor exhibited long-standing chronic inflammation in the benign odontogenic cyst, suggesting that a sustained immune response may be partially responsible for malignant transformation of the benign cystic lining cells. CONCLUSIONS: These findings indicate that inflammation may be the principal mediator in PIOSCC ex-OKC, and the STAT3 signaling pathway is an important contributor to this process. Combined detection of Ki67, P65, and EGFR in the lesional epithelium can support the diagnosis of PIOSCC.

Long-term results of a randomized phase III trial of TPF induction chemotherapy followed by surgery and radiation in locally advanced oral squamous cell carcinoma.

Previously, we conducted a randomized phase III trial of TPF (docetaxel, cisplatin, and 5-fluorouracil) induction chemotherapy in surgically managed locally advanced oral squamous cell carcinoma (OSCC) and found no improvement in overall survival. This study reports long-term follow-up results from our initial trial. All patients had clinical stage III or IVA locally advanced OSCC. In the experimental group, patients received two cycles of TPF induction chemotherapy (75mg/m2 docetaxel d1, 75mg/m2 cisplatin d1, and 750mg/m2/day 5-fluorouracil d1-5) followed by radical surgery and post-operative radiotherapy; in the control group, patients received upfront radical surgery and post-operative radiotherapy. The primary endpoint was overall survival. Among 256 enrolled patients with a median follow-up of 70 months, estimated 5-year overall survival, disease-free survival, locoregional recurrence-free survival, and distant metastasis-free survival rates were 61.1%, 52.7%, 55.2%, and 60.4%, respectively. There were no significant differences in survival rates between experimental and control groups. However, patients with favorable pathologic responses had improved outcomes compared to those with unfavorable pathologic responses and to those in the control group. Although TPF induction chemotherapy did not improve long-term survival compared to surgery upfront in patients with stage III and IVA OSCC, a favorable pathologic response after induction chemotherapy may be used as a major endpoint and prognosticator in future studies. Furthermore, the negative results observed in this trial may be represent type II error from an underpowered study. Future larger scale phase III trials are warranted to investigate whether a significant benefit exists for TPF induction chemotherapy in surgically managed OSCC.

Design of ultrathin plasmonic quarter-wave plate based on period coupling.

Based on an analysis of the surface admittance of a plasmonic film with a substrate, we propose an ultrathin quarter-wave plate consisting of a periodic plane array of symmetrical L-shaped plasmonic antennas. The period, which determines the coupling among L-shaped antennas, is an important parameter for optimizing the performance of the structure. Numerical simulation results show that an Au quarter-wave plate designed in this Letter can efficiently convert a linearly polarized light at normal incidence into circularly polarized light, whose ellipticity is 0.994 at an operating wavelength of 1550 nm. The thickness is only 30 nm, which is nearly 1/50 of the wavelength of incident light.

Randomized phase III trial of induction chemotherapy with docetaxel, cisplatin, and fluorouracil followed by surgery versus up-front surgery in locally advanced resectable oral squamous cell carcinoma.

PURPOSE: To evaluate induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) followed by surgery and postoperative radiotherapy versus up-front surgery and postoperative radiotherapy in patients with locally advanced resectable oral squamous cell carcinoma (OSCC). PATIENTS AND METHODS: A prospective open-label phase III trial was conducted. Eligibility criteria included untreated stage III or IVA locally advanced resectable OSCC. Patients received two cycles of TPF induction chemotherapy (docetaxel 75 mg/m(2) on day 1, cisplatin 75 mg/m(2) on day 1, and fluorouracil 750 mg/m(2) on days 1 to 5) followed by radical surgery and postoperative radiotherapy (54 to 66 Gy) versus up-front radical surgery and postoperative radiotherapy. The primary end point was overall survival (OS). Secondary end points included local control and safety. RESULTS: Of the 256 patients enrolled onto this trial, 222 completed the full treatment protocol. There were no unexpected toxicities, and induction chemotherapy did not increase perioperative morbidity. The clinical response rate to induction chemotherapy was 80.6%. After a median follow-up of 30 months, there was no significant difference in OS (hazard ratio [HR], 0.977; 95% CI, 0.634 to 1.507; P = .918) or disease-free survival (HR, 0.974; 95% CI, 0.654 to 1.45; P = .897) between patients treated with and without TPF induction. Patients in the induction chemotherapy arm with a clinical response or favorable pathologic response (≤ 10% viable tumor cells) had superior OS and locoregional and distant control. CONCLUSION: Our study failed to demonstrate that TPF induction chemotherapy improves survival compared with up-front surgery in patients with resectable stage III or IVA OSCC.

Interval cancers in nasopharyngeal carcinoma screening: comparing two screening intervals after a negative initial screening result.

OBJECTIVES: To examine the optimal screening interval among the individuals who received a negative Epstein-Barr virus immunoglobulin A antibodies against viral capsid antigen (VCA-IgA) serum test result and who comprised the majority of the population screened for nasopharyngeal carcinoma (NPC). METHODS: Screening was performed in Sihui, Guangdong, China, offering a repeated screening for participants with an initial negative test either after 4-5 years in one centre (short interval centre), or 9-10 years in another (long interval centre). The characteristics and incidence rates (IRs) of interval NPCs (defined as cases diagnosed outside the screening protocol while within the screening interval) were compared between these two centres. Standard incidence ratios (SIRs) were also calculated using the general Sihui population as the reference. RESULTS: Seven interval NPCs were detected in the short interval centre (IR: 17.8/10(5) person-years) and 20 in the long interval centre (IR: 20.8/10(5) person-years during the first four years and 43.5/10(5) person-years during the remaining years). The SIR in the short interval centre was 0.43 (95% confidence interval [CI]: 0.17-0.89); SIR in the long interval centre was 0.47 (95% CI: 0.17-1.02) during the first four years and 0.90 (95% CI: 0.49-1.51) during the remaining years. No aggressive interval NPC was observed in the short interval centre; four were identified in the long interval centre. CONCLUSIONS: The incidence of NPC, especially aggressive NPC, was low during the first few years after a negative screening; the incidence increased to the general population level afterwards. A screening interval of 4-5 years may therefore be more suitable than 9-10 years after a negative VCA-IgA test in NPC screening.

Improving the room-temperature confinement of light by miniaturizing mode sizes into a deep subwavelength scale using dielectric spheres in metal cavities.

The confinement of light within nanometer-scale regions may result in the significant enhancement of light-matter interactions. However, light confinement to nanometers is hindered by the diffraction limit of a dielectric material. For a dielectric cavity, if the material loss is negligible, reducing the cavity size usually causes a significantly increase in radiation loss. Surface plasmons show great promise for potential subwavelength light confinement. However, in most circumstances, light confinement by dissipative metallic materials can cause ohmic losses at optical frequencies. In such cases, the realization of light confinement with deep subwavelength mode sizes results in great losses and thus has low quality factors. In the present study, a three-dimensional light confinement with deep subwavelength mode sizes is achieved using dielectric spheres in metal cavities. Contrary to other mechanisms for subwavelength light confinement that are based on the use of dielectric or metal cavities, the nanometer-scale regions ensure that most of the light energy is confined away from the metal-dielectric interfaces, thereby decreasing light absorption in the metal cavity. In turn, the metal cavity decreases the radiation loss of light. Thus, high quality factors ranging from 2×10(2) to 6×10(2) can be obtained at room temperature. An effective electrical mode volume ranging from 7×10(-5)λ(0)(3) to 2×10(-4)λ(0)(3) (where λ(0) is the resonant wavelength in a vacuum) can be achieved. Therefore, this method of three-dimensional light confinement with deep subwavelength mode sizes using dielectric spheres in metal cavities may have potential applications in the design of nanolasers, nanophoton detectors, nonlinear optical switches, and so on.