Neoadjuvant chemotherapy is noninferior to chemoradiotherapy for early-onset locally advanced rectal cancer in the FOWARC trial.

BACKGROUND: The early-onset rectal cancer with rapidly increasing incidence is considered to have distinct clinicopathological and molecular profiles with high-risk features. This leads to challenges in developing specific treatment strategies for early-onset rectal cancer patients and questions of whether early-onset locally advanced rectal cancer (LARC) needs aggressive neoadjuvant treatment. METHODS: In this post hoc analysis of FOWARC trial, we investigated the role of preoperative radiation in early-onset LARC by comparing the clinicopathological profiles and short-term and long-term outcomes between the early-onset and late-onset LARCs. RESULTS: We revealed an inter-tumor heterogeneity of clinical profiles and treatment outcomes between the early-onset and late-onset LARCs. The high-risk features were more prevalent in early-onset LARC. The neoadjuvant radiation brought less benefits of tumor response and more risk of complications in early-onset group (pCR: OR = 3.75, 95% CI = 1.37-10.27; complications: HR = 11.35, 95% CI = 1.46-88.31) compared with late-onset group (pCR: OR = 5.33, 95% CI = 1.83-15.58; complications: HR = 5.80, 95% CI = 2.32-14.49). Furthermore, the addition of radiation to neoadjuvant chemotherapy didn't improve long-term OS (HR = 1.37, 95% CI = 0.49-3.87) and DFS (HR = 1.05, 95% CI = 0.58-1.90) for early-onset patients. CONCLUSION: Preoperative radiation plus chemotherapy may not be superior to the chemotherapy alone in the early-onset LARC. Our findings provide insight into the treatment of early-onset LARC by interrogating the aggressive treatment and alternative regimens.

Hierarchically structured passive radiative cooling ceramic with high solar reflectivity.

Passive radiative cooling using nanophotonic structures is limited by its high cost and poor compatibility with existing end uses, whereas polymeric photonic alternatives lack weather resistance and effective solar reflection. We developed a cellular ceramic that can achieve highly efficient light scattering and a near-perfect solar reflectivity of 99.6%. These qualities, coupled with high thermal emissivity, allow the ceramic to provide continuous subambient cooling in an outdoor setting with a cooling power of >130 watts per square meter at noon, demonstrating energy-saving potential on a worldwide scale. The color, weather resistance, mechanical robustness, and ability to depress the Leidenfrost effect are key features ensuring the durable and versatile nature of the cooling ceramic, thereby facilitating its commercialization in various applications, particularly building construction.

Investigations on asymmetric transmittivity of optical devices and different diode-like behaviors.

This study theoretically proved that although reciprocal optical devices can show asymmetric transmittivity (AT) under controlled incident modes (i.e., conditional AT), they cannot guarantee AT with arbitrary incident light modes, whereas only nonreciprocal optical devices can possibly guarantee AT. Besides, the thermodynamics of both reciprocal and nonreciprocal optical devices were discussed to show that the second law of thermodynamics is valid anyway. Furthermore, the diode-like behaviors of optical and electronic devices were compared. Electrons are identical to electronic devices, so electronic devices could have asymmetric conductance regardless of electrons. In contrast, electromagnetic waves are different from optical devices as transmittivity of different modes can be different, so reciprocal optical devices showing conditional AT cannot guarantee AT when incident modes are arbitrary. The mathematical proof and characteristic comparisons between electronic and optical diodes, which are firstly presented here, should help clarifying the necessary nonreciprocity required for being optical diodes.

Radiative Cooling Nanofabric for Personal Thermal Management.

A wearable textile that is engineered to reflect incoming sunlight and allow the transmission of mid-infrared radiation simultaneously would have a great impact on the human body's thermal regulation in an outdoor environment. However, developing such a textile is a tough challenge. Using nanoparticle-doped polymer (zinc oxide and polyethylene) materials and electrospinning technology, we have developed a nanofabric with the desired optical properties and good applicability. The nanofabric offers a cool fibrous structure with outstanding solar reflectivity (91%) and mid-infrared transmissivity (81%). In an outdoor field test under exposure of direct sunlight, the nanofabric was demonstrated to reduce the simulated skin temperature by 9 °C when compared to skin covered by a cotton textile. A heat-transfer model is also established to numerically assess the cooling performance of the nanofabric as a function of various climate factors, including solar intensity, ambient air temperature, atmospheric emission, wind speed, and parasitic heat loss rate. The results indicate that the nanofabric can completely release the human body from unwanted heat stress in most conditions, providing an additional cooling effect as well as demonstrating worldwide feasibility. Even in some extreme conditions, the nanofabric can also reduce the human body's cooling demand compared with traditional cotton textile, proving this material as a feasible solution for better thermoregulation of the human body. The facile fabrication of such textiles paves the way for the mass adoption of energy-free personal cooling technology in daily life, which meets the growing demand for healthcare, climate change, and sustainability.