Two-fractionated stereotactic magnetic resonance-guided adaptive radiation therapy for patients with prostate cancer (SMART PRO trial): protocol for a confirmatory clinical trial.

INTRODUCTION: In an MRI-guided linear accelerator (MR-LINAC) system, the planned doses for organs at risk and for tumours are assessed by MR imaging and re-contouring at every treatment. This allows treatment to be safer and more precise by ensuring that it is suitable for the state of the patient's organs on that day, as well as by allowing images to be acquired during radiation therapy to prevent radiation while organs are in motion.Here, we will conduct a confirmatory study of two-fractionated stereotactic magnetic resonance-guided adaptive radiation therapy for patients with localised prostate cancer. METHODS AND ANALYSIS: This will be a single-arm study to demonstrate the safety and efficacy of ultra-hypofractionated radiation (26 Gy/2 Fr) using an MR-LINAC system in patients with very low-intermediate risk prostate cancer.The primary endpoint will be the incidence of grade ≥2 acute urinary tract adverse events occurring within 90 days of the start of radiation therapy.The sample size has been determined to be 58. ETHICS AND DISSEMINATION: This study is performed in accordance with Ethical Guidelines for Medical and Health Research Involving Human Subjects, published by Japan's Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare and the modified act on the Protection of Personal Information as well as the Declaration of Helsinki. This study was approved by the institutional ethics committee of the National Cancer Center on 20 November 2021.The findings of this trial will be submitted to an international peer-reviewed journal and the key findings will be presented at an international scientific conference.Authorship will be ascribed in accordance with the International Committee of Medical Journal Editors guidance. TRIAL REGISTRATION NUMBER: UMIN000049746.

Effects of maxillofacial prosthetic treatment on oral health-related quality of life and masticatory ability of patients with head and neck tumors.

PURPOSE: Using multivariate analysis, this study investigated the effectiveness of maxillofacial prosthetic treatment in relation to oral health-related quality of life (OHR-QoL), masticatory ability (food intake status score and gum-jelly test score) and related factors in patients who had undergone surgery for head and neck tumors. METHODS: The study cohort comprised 112 patients who underwent surgical resection and prosthetic treatment among 224 patients with head and neck tumors seen at the Maxillofacial Prosthetics Clinic of Tohoku University Hospital in a 2-year period. Correlations between OHR-QoL, food intake status score, and gum-jelly test score (criterion variables), and age, sex, maxillary defect, tongue/soft tissue defect, reconstructive surgery, and chemoradiotherapy (explanatory variables) were investigated, and the data were examined statistically. RESULTS: Maxillary defect, tongue and soft palate tissue defect, and chemoradiotherapy were identified as factors that hindered the effectiveness of maxillofacial prosthetic treatment for improvement of the OHR-QoL, food intake status score, and gum-jelly test score. On the other hand, reconstructive surgery was a factor that facilitated the improvement of OHR-QoL and masticatory ability with maxillofacial prosthetic treatment. CONCLUSION: The factors identified to be related to the success or failure of maxillofacial prosthetic treatment suggest the importance of combining prosthetic intervention with surgical reconstruction.

First-principles study on unidirectional proton transfer on anatase TiO2 (101) surface induced by external electric fields.

The electric field (EF) effect on hydrogen or proton transfer (PT) via hydroxyl groups on an anatase TiO2 (101) surface is examined using first-principles density functional theory and the modern theory of polarization. This study focuses on unidirectional surface PT caused by external EFs at various orientations toward the surface. The preferred PT pathway can change depending on the magnitude and direction of the EF. Detailed analysis reveals that the variation in the energy profile with the EF is significantly different from that determined by the classical electric work of an EF carrying a point charge. The EF effect on the energy profile of the PT is governed by the rearrangement of the chemical bond network at the interface between the water molecules and the surface.

Giant gate-controlled odd-parity magnetoresistance in one-dimensional channels with a magnetic proximity effect.

According to Onsager's principle, electrical resistance R of general conductors behaves as an even function of external magnetic field B. Only in special circumstances, which involve time reversal symmetry (TRS) broken by ferromagnetism, the odd component of R against B is observed. This unusual phenomenon, called odd-parity magnetoresistance (OMR), was hitherto subtle (< 2%) and hard to control by external means. Here, we report a giant OMR as large as 27% in edge transport channels of an InAs quantum well, which is magnetized by a proximity effect from an underlying ferromagnetic semiconductor (Ga,Fe)Sb layer. Combining experimental results and theoretical analysis using the linearized Boltzmann's equation, we found that simultaneous breaking of both the TRS by the magnetic proximity effect (MPE) and spatial inversion symmetry (SIS) in the one-dimensional (1D) InAs edge channels is the origin of this giant OMR. We also demonstrated the ability to turn on and off the OMR using electrical gating of either TRS or SIS in the edge channels. These findings provide a deep insight into the 1D semiconducting system with a strong magnetic coupling.

Slip versus Slop: A Head-to-Head Comparison of UV-Protective Clothing to Sunscreen.

Ultraviolet radiation (UVR) exposure is the most important modifiable risk factor for skin cancer development. Although sunscreen and sun-protective clothing are essential tools to minimize UVR exposure, few studies have compared the two modalities head-to-head. This study evaluates the UV-protective capacity of four modern, sun-protective textiles and two broad-spectrum, organic sunscreens (SPF 30 and 50). Sun Protection Factor (SPF), Ultraviolet Protection Factor (UPF), Critical Wavelength (CW), and % UVA- and % UVB-blocking were measured for each fabric. UPF, CW, % UVA- and % UVB-blocking were measured for each sunscreen at 2 mg/cm2 (recommended areal density) and 1 mg/cm2 (simulating real-world consumer application). The four textiles provided superior UVR protection when compared to the two sunscreens tested. All fabrics blocked erythemogenic UVR better than the sunscreens, as measured by SPF, UPF, and % UVB-blocking. Each fabric was superior to the sunscreens in blocking full-spectrum UVR, as measured by CW and % UVA-blocking. Our data demonstrate the limitations of sunscreen and UV-protective clothing labeling and suggest the combination of SPF or UPF with % UVA-blocking may provide more suitable measures for broad-spectrum protection. While sunscreen remains an important photoprotective modality (especially for sites where clothing is impractical), these data suggest that clothing should be considered the cornerstone of UV protection.

Elemental Topological Dirac Semimetal α-Sn with High Quantum Mobility.

α-Sn provides an ideal avenue to investigate novel topological properties owing to its rich diagram of topological phases and simple elemental material structure. Thus far, however, the realization of high-quality α-Sn remains a challenge, which limits the understanding of its quantum transport properties and device applications. Here, epitaxial growth of α-Sn on InSb (001) with the highest quality thus far is presented. The studied samples exhibit unprecedentedly high quantum mobilities of both the surface state (30 000 cm2 V-1 s-1 ), which is ten times higher than the previously reported values, and the bulk heavy-hole state (1800 cm2 V-1 s-1 ), which is never obtained experimentally. These excellent features allow quantitative characterization of the nontrivial interfacial and bulk band structure of α-Sn via a thorough investigation of Shubnikov-de Haas oscillations combined with first-principles calculations. The results firmly identify that α-Sn grown on InSb (001) is a topological Dirac semimetal (TDS). Furthermore, a crossover from the TDS to a 2D topological insulator and a subsequent phase transition to a trivial insulator when varying the thickness of α-Sn are demonstrated. This work indicates that α-Sn is an excellent model system to study novel topological phases and a prominent material candidate for topological devices.

Brainstem Infiltration Predicts Survival in Patients With High-grade Gliomas Treated With Chemoradiotherapy.

BACKGROUND/AIM: High-grade gliomas have a poor prognosis despite standard treatment. The aim of the study was to identify new prognostic factors to select patients who need more intense treatment. PATIENTS AND METHODS: Forty-three consecutive patients underwent surgery plus chemoradiotherapy for pathologically diagnosed high-grade gliomas (grade III, IV). RESULTS: The median survival time was 989 days, and the 1-year survival rate was 87.6%. Among patients with grade IV disease, the median survival time, 1-year, and 2-year survival rate were 814 days, 82.6%, and 58.7%, respectively. In the univariate analysis, unmethylated MGMT promoter (p=0.0495), brainstem infiltration (p=0.0004), basal ganglia as the primary lesion site (p=0.0056), 3-dimensional conformal radiotherapy (p=0.0286), and <50 Gy (p=0.0049) were associated with a poor prognosis. In the multivariate analysis, only brainstem infiltration retained significance (HR for death, 0.21; 95% CI=0.06-0.70; p=0.011). CONCLUSION: Brainstem infiltration is a novel prognostic factor for poor prognosis in patients with high-grade gliomas.

Transforming growth factor-ß1 suppresses bone morphogenetic protein-2-induced mesenchymal-epithelial transition in HSC-4 human oral squamous cell carcinoma cells via Smad1/5/9 pathway suppression.

Squamous cell carcinoma is the most common cancer in the oral cavity. We previously demonstrated that transforming growth factor-ß1 (TGF-ß1) promotes the epithelial-mesenchymal transition (EMT) of human oral squamous cell carcinoma (hOSCC) cells; however, it remains to be clarified whether the TGF-ß superfamily member bone morphogenetic protein (BMP) affects this process in hOSCC cells. Here, we examined the independent and collective effects of TGF-ß1 and BMP-2 on EMT and mesenchymal­epithelial transition (MET) in a panel of four hOSCC cell lines. Notably, we found that HSC-4 cells were the most responsive to BMP-2 stimulation, which resulted in the upregulation of Smad1/5/9 target genes such as the MET inducers ID1 and cytokeratin 9 (CK9). Furthermore, BMP-2 downregulated the mesenchymal marker N-cadherin and the EMT inducer Snail, but upregulated epithelial CK9 expression, indicating that BMP-2 prefers to induce MET rather than EMT. Moreover, TGF-ß1 dampened BMP-2-induced epithelial gene expression by inhibiting Smad1/5/9 expression and phosphorylation. Functional analysis revealed that TGF-ß1 and BMP-2 significantly enhanced HSC-4 cell migration and proliferation, respectively. Collectively, these data suggest that TGF-ß positively regulates hOSCC invasion in the primary tumor, whereas BMP-2 facilitates cancer cell colonization at secondary metastatic sites. Thus, the invasive and metastatic characteristics of hOSCC appear to be reciprocally regulated by BMP and TGF-ß.

[Multivariate analysis of factors affecting the status of wearing removable partial dentures].

PURPOSE: The purpose of this retrospective cohort study was to investigate factors that affected the status of wearing removable partial dentures (RPDs) using a multivariate analysis. METHODS: One hundred and sixty-one patients were treated with definitive dentures that were delivered by dental students under teacher supervision at Tohoku University Hospital between 1996 and 2001. Of the 161 patients, 67 patients who agreed to undergo a follow-up examination participated in this study. The subjects were 18 men and 49 women with a mean age of 66.0+/-9.5 years. They were re-examined 5 years after treatment. The status of wearing the RPDs was categorized into three groups, i.e: successful, wearing their original RPDs constantly for 5 years; replaced, wearing re-fabricated RPDs within 5 years, and failed; interrupted wearing the RPDs within 5 years. Factors that affected the status were also examined. The analyzed variables in this study were sex and age of subjects, previous experience in wearing RPDs, location of RPDs and edentulous area, number of occluding pairs, number of missing teeth, placement of RPDs on opposite jaw, denture base type, number of abutment teeth, type of clasp, and number of rests. A stepwise multiple logistic regression analysis was used to determine factors affecting the status of wearing RPDs. RESULTS: The response rate was 41.6%. Of the 90 RPDs, 55 RPDs were regarded as successful, 21 as replaced, and 14 as failed. Statistically significant correlations were found between denture usage and the age of subjects, the location of edentulous area, number of occluding pairs, and number of rests (p<0.05). CONCLUSION: The results suggest the importance of considering the significant factors mentioned above for treatment planning and designing of RPDs.