Investigation of nonlinear optical properties in α-A2BB'O6 (A = Li, Na, K; B = Ti, Zr, Hf; B' = Se, Te) by first-principles calculations.

Nonlinear optical (NLO) crystals based on oxides typically have wide bandgaps and large laser damage thresholds (LDTs), which are important for generating high-power and continuous terahertz radiation. Recently, a new family of NLO materials α-A2BB'O6 including Li2TiTeO6 (LTTO) with a strong second harmonic generation (SHG) efficiency of 26 × KH2PO4 (KDP) and a large LDT of 550 MW cm-2 were reported. Herein, we systematically study the electronic structures and NLO properties of α-A2BB'O6 (A = Li, Na, K; B = Ti, Zr, Hf; B' = Se, Te) to explore the relationship between the structure and SHG coefficient. First, 15 members of the A2BB'O6 family are demonstrated to be highly stable and NLO materials, excluding K2TiTeO6, K2TiSeO6 and K2ZrSeO6. Then, the electronic band structure, dipole moment and distortion of BO6/B'O6 octahedrons, SHG coefficient and terahertz absorption spectrum are calculated comprehensively with the element variation of A-site, B-site and B'-site. Finally, the magnitude of the SHG coefficient is found to be directly proportional to the value of total dipole moment and distortion, and inversely proportional to the bandgap value. Most importantly, among the A2BB'O6 materials, K2HfSeO6 shows the smallest direct bandgap of 2.99 eV, the largest SHG coefficient d33 of about 5 × LTTO and low terahertz absorbance from 0.1 to 9 THz. Our results provide new NLO crystals that may have potential application in terahertz radiation sources and other nonlinear electronics.

A gene cluster encoding a nonribosomal peptide synthetase-like enzyme catalyzes γ-aromatic butenolides.

Sea cucumber-derived fungi have attracted much attention due to their capacity to produce an incredible variety of secondary metabolites. Genome-wide information on Aspergillus micronesiensis H39 obtained using third-generation sequencing technology (PacBio-SMRT) showed that the strain contains nonribosomal peptide synthetase (NRPS)-like gene clusters, which aroused our interest in mining its secondary metabolites. 11 known compounds (1-11), including two γ-aromatic butenolides (γ-AB) and five cytochalasans, were isolated from A. micronesiensis H39. The structures of the compounds were determined by NMR and ESIMS, and comparison with those reported in the literature. From the perspective of biogenetic origins, the γ-butyrolactone core of compounds 1 and 2 was assembled by NRPS-like enzyme. All of the obtained compounds showed no inhibitory activity against drug-resistant bacteria and fungi, as well as compounds 1 and 2 had no anti-angiogenic activity against zebrafish.

A combined recall and rank framework with online negative sampling for Chinese procedure terminology normalization.

MOTIVATION: Medical terminology normalization aims to map the clinical mention to terminologies coming from a knowledge base, which plays an important role in analyzing electronic health record and many downstream tasks. In this article, we focus on Chinese procedure terminology normalization. The expressions of terminology are various and one medical mention may be linked to multiple terminologies. Existing studies based on learning to rank does not fully consider the quality of negative samples during model training and the importance of keywords in this domain-specific task. RESULTS: We propose a combined recall and rank framework to solve these problems. A pair-wise Bert model with deep metric learning is used to recall candidates. Previous methods either train Bert in a point-wise way or based on a multi-class classification problem, which may lead serious efficiency problems or not be effective enough. During model training, we design a novel online negative sampling algorithm to activate the pair-wise method. To deal with multi-implication scenarios, we train the task of implication number prediction together with the recall task in a multi-task learning setting, since these two tasks are highly complementary. In rank step, we propose a keywords attentive mechanism to focus on domain-specific information such as procedure sites and procedure types. Finally, a fusion block merges the results of the recall and the rank model. Detailed experimental analysis shows our proposed framework has a remarkable improvement on both performance and efficiency. AVAILABILITY AND IMPLEMENTATION: The source code will be available at https://github.com/sxthunder/CMTN upon publication.

Reconstructing community structure of online social network via user opinions.

User opinion affects the performance of network reconstruction greatly since it plays a crucial role in the network structure. In this paper, we present a novel model for reconstructing the social network with community structure by taking into account the Hegselmann-Krause bounded confidence model of opinion dynamic and compressive sensing method of network reconstruction. Three types of user opinion, including the random opinion, the polarity opinion, and the overlap opinion, are constructed. First, in Zachary's karate club network, the reconstruction accuracies are compared among three types of opinions. Second, the synthetic networks, generated by the Stochastic Block Model, are further examined. The experimental results show that the user opinions play a more important role than the community structure for the network reconstruction. Moreover, the polarity of opinions can increase the accuracy of inter-community and the overlap of opinions can improve the reconstruction accuracy of intra-community. This work helps reveal the mechanism between information propagation and social relation prediction.

Laryngeal function-preserving of frontolateral vertical partial laryngectomy (FLVPL) for selected T4a glottic cancer with thyroid cartilage invasion adherence to the anterior commissure: an innovative attempt.

OBJECTIVE: To evaluate the feasibility and efficacy in selected T4a glottic cancer (thyroid cartilage invasion adherence to the anterior commissure) treated with frontolateral vertical partial laryngectomy (FLVPL) and laryngeal framework reconstruction using titanium mesh. METHODS: Six patients with the limited T4a glottic cancer with thyroid cartilage destruction adherence to the anterior commissure, underwent FLVPL from 2009 to 2016 in Sun Yat-Sen University Cancer Center. All patients were followed up postoperatively. RESULTS: All patients comprised radical tumor resection and favorable functional outcomes, and no aspiration and laryngeal stenosis were observed. According to postoperative pathology, four patients should go through postsurgical radiotherapy with a mean dose of 66 Gy. But one of them refused to undergo postoperative radiotherapy, who observed local recurrence in postcricoid area underwent total laryngectomy (TL) and ipsilateral selected neck dissection in post-surgery two year. During follow-up period, all patients were still alive, and five patients without local recurrence and distant metastases. CONCLUSION: FLVPL and laryngeal framework reconstruction using titanium mesh is one viable surgical procedure to obtain adequate oncologic and functional outcomes.

The operation experience of endoscopic thyroidectomy by areola and axilla approach.

To explore the feasibility of endoscopic thyroidectomy via breast areola and axilla approach. The clinical data of 36 cases that underwent endoscopic thyroidectomy via breast areola and axilla approach from February 2012 to December 2013 were reviewed. All cases were completed, the mean operation time was 136.3 min (95-183 min), intraoperative blood loss was 15.8 ml (5-60 ml). The average hospitalization time was 5 days (4-6 days). There were no conversions to open surgery, no permanent nerve injuries, and no cases of hypoparathyroidism. Three patients had postoperative subcutaneous ecchymosis who were cured spontaneously after 1 month. Endoscopic thyroidectomy is safe and feasible for patients with thyroid diseases with good cosmetic results, and is worthy of being widely applied for patients who have cosmetic demand.

A Stable High-Performance Zn-Ion Batteries Enabled by Highly Compatible Polar Co-Solvent.

Uncontrollable growth of Zn dendrites, irreversible dissolution of cathode material and solidification of aqueous electrolyte at low temperatures severely restrict the development of aqueous Zn-ion batteries. In this work, 2,2,2-trifluoroethanol (TFEA) with a volume fraction of 50% as a highly compatible polar-solvent is introduced to 1.3 M Zn(CF3SO3)2 aqueous electrolyte, achieving stable high-performance Zn-ion batteries. Massive theoretical calculations and characterization analysis demonstrate that TFEA weakens the tip effect of Zn anode and restrains the growth of Zn dendrites due to electrostatic adsorption and coordinate with H2O to disrupt the hydrogen bonding network in water. Furthermore, TFEA increases the wettability of the cathode and alleviates the dissolution of V2O5, thus improving the capacity of the full battery. Based on those positive effects of TFEA on Zn anode, V2O5 cathode, and aqueous electrolyte, the Zn//Zn symmetric cell delivers a long cycle-life of 782 h at 5 mA cm-2 and 2 mA h cm-2. The full battery still declares an initial capacity of 116.78 mA h g-1, and persists 87.73% capacity in 2000 cycles at -25 °C. This work presents an effective strategy for fully compatible co-solvent to promote the stability of Zn anode, V2O5 cathode and aqueous electrolyte for high-performance Zn-ion batteries.

GC-CDSS: Personalized gastric cancer treatment recommendations system based on knowledge graph.

BACKGROUND: Gastric cancer (GC) is one of the most common malignant tumors in the world, posing a serious threat to human health. Currently, gastric cancer treatment strategies emphasize a multidisciplinary team (MDT) consultation approach. However, there are numerous treatment guidelines and insights from clinical trials. The application of AI-based Clinical Decision Support System (CDSS) in tumor diagnosis and screening is increasing rapidly. OBJECTIVE: The purpose of this study is to (1) summarize the treatment decision process for GC according to the treatment guidelines in China, and then create a knowledge graph (KG) for GC, (2) based on aforementioned KG, built a CDSS and conducted an initial feasibility evaluation for the current system. METHODS: Firstly, we summarized the decision-making process for treatment of GC. Then, we extracted relevant decision nodes and relationships and utilized Neo4j to create the KG. After obtaining the initial node features for building the graph embedding model, graph embedding algorithm, such as Node2Vec and GraphSAGE, were used to construct the GC-CDSS. At last, a retrospective cohort study was used to compare the consistency between GC-CDSS and MDT in treatment decision making. RESULTS: In current study, we introduce a GC-CDSS, which is constructed based on Chinese GC treatment guidelines knowledge graph (KG). In the KG, we define four types of nodes and four types of relationships, and it comprise a total of 207 nodes and 300 relationships. Regarding GC-CDSS, the system is capable of providing dynamic and personalized diagnostic and treatment recommendations based on the patient's condition. Furthermore, a retrospective cohort study is conducted to compare GC-CDSS recommendations with those of the MDT group, the overall consistency rate of treatment recommendations between the auxiliary decision system and MDT team is 92.96%. CONCLUSIONS: We construct a GC treatment support system, GC-CDSS, based on KG. The GC-CDSS may help oncologists make treatment decisions more efficient and promote standardization in primary healthcare settings.

Low expression of PTK6/Brk predicts poor prognosis in patients with laryngeal squamous cell carcinoma.

BACKGROUND: Protein tyrosine kinase 6 (PTK6), also known as breast tumor kinase (Brk), was a nonreceptor tyrosine kinase containing SH3, SH2, and tyrosine kinase catalytic domains. The deregulated expression of PTK6 was observed in various human cancers. However, little was known about PTK6 expression and its clinicopathological significance in human laryngeal squamous cell carcinoma (LSCC). MATERIALS: PTK6 expression was evaluated in 7 pairs of surgically resectable laryngeal tissues by Western blotting and in 13 pairs of surgically resectable laryngeal tissues by reverse transcription-PCR (RT-PCR). Using immunohistochemistry, we performed a retrospective study of the PTK6 expression levels on 134 archival LSCC paraffin-embedded samples. Prognostic outcomes correlated with PTK6 were examined using Kaplan-Meier analysis and Cox proportional hazards model. RESULTS: The PTK6 expression level was lower in LSCC tissues than in the adjacent noncancerous epithelial laryngeal tissues by Western blots and RT-PCR. By immunohistochemical analysis, we observed high expression of PTK6 in 25 of 76 (32.9%) adjacent noncancerous epithelial laryngeal tissues and in 39 of 134 (29.1%) of LSCC, respectively. Multivariate analysis demonstrated that pN status and the expression level of PTK6 (P < 0.05) were independent and significant prognostic factors. In the primary LSCC category, median DFS (disease free survival) of high, medium and low PTK6 expression patients were 88.5 months ,74.5 months and 49.0 months (log-rank test, P = 0.002); median OS (overall survival) of high, medium and low PTK6 expression patients were 88.5 months ,76.3 months and 65.7 months (log-rank test, P = 0.002). Reduced cytoplasmic PTK6 expression in LSCC was significantly associated with late pN status (P =0.005, r = 0.27), advanced pTNM stages (III and IV) (P =0.027, r = 0.147), and poor differentiated LSCC (P <0.0001, r = 0.486). In adjacent paracancerous laryngeal epithelial samples, median DFS of high, medium and low PTK6 expression patients were 92.6 months ,75.6 months and 48.5 months (log-rank test, P = 0.020); median OS of high, medium and low PTK6 expression patients were 92.9 months ,78.9 months and 74.6 months (log-rank test, P = 0.042). CONCLUSION: The present findings indicated that cytoplasmic PTK6 expression is a potential prognostic factor for survival in LSCC patients. High expression of PTK6 was associated with favorable OS and DFS in LSCC patients.

Total synthesis of (-)-sessilifoliamide J.

An efficient synthesis of the Stemona alkaloid (-)-sessilifoliamide J (1) in 12 steps and 7.7% overall yield from the known building block 8 is presented. The synthesis features the Corey lactonization reaction and a highly diastereoselective α-methylation reaction to build the spiro-lactone moiety.

Reconstruction of through-and-through cheek defects with folded free anterolateral thigh flaps.

PURPOSE: The purpose of this study was to assess the clinical application and therapeutic efficacy of through-and-through cheek defects reconstructed with folded anterolateral thigh (ALT) flaps. PATIENTS AND METHODS: From January 2009 to May 2012, 10 patients with through-and-through cheek defects resulting from resection of cheek tumor underwent reconstruction with the folded ALT flap at Sun Yat-Sen University Cancer Center, Guangzhou, China. Surgical procedures in harvesting the ALT flap, as well as the surgical anatomy, are described, and the success rate is reported. RESULTS: All ALT flaps were fasciocutaneous flaps. One patient with a thrombotic event required operative exploration in the perioperative period. All 10 flaps were based on a single perforator for reconstruction of defects. In all 10 cases, the donor site was closed primarily for the ALT flap, leaving only a linear scar that was inconspicuous with normal clothing, and the thigh had no functional deficit. CONCLUSIONS: The free ALT flap has good pliability and can be folded for the reconstruction of both the inner and outer lining of through-and-through cheek defects. This flap presents good functional results at the recipient site with the additional advantages of minimal donor-site morbidity, a very acceptable esthetic result, and a high level of patient satisfaction.

Two-Dimensional Octuple-Atomic-Layer M2Si2N4 (M = Al, Ga and In) with Long Carrier Lifetime.

Bulk III-nitride materials MN (M = Al, Ga and In) and their alloys have been widely used in high-power electronic and optoelectronic devices, but stable two-dimensional (2D) III-nitride materials, except h-BN, have not been realized yet. A new kind of 2D III-nitride material M2Si2N4 (M = Al, Ga and In) is predicted by choosing Si as the appropriate passivation element. The stability, electronic and optical properties of 2D M2Si2N4 materials are studied systematically based on first-principles calculations. The results show that Al2Si2N4 and Ga2Si2N4 are found to be indirect bandgap semiconductors, while In2Si2N4 is a direct bandgap semiconductor. Moreover, Al2Si2N4 and In2Si2N4 have good absorption ability in the visible light region, while Ga2Si2N4 is an ultraviolet-light-absorbing material. Furthermore, the carrier lifetimes of Ga2Si2N4 and In2Si2N4 are as large as 157.89 and 103.99 ns, respectively. All these desirable properties of M2Si2N4 materials make them attractive for applications in electronics and photoelectronics.

Understanding Trends in Electrochemical Methanol Oxidation Reaction Activity on a Single Transition-Metal Atom Embedded in N-Coordinated Graphene Catalysts.

The lack of efficient catalysts and research on the mechanism for the methanol oxidation reaction (MOR) impedes the development of direct methanol fuel cells. In this work, based on density functional theory calculations, we systematically investigated the activity trends of electrochemical MOR on a single transition-metal atom embedded in N-coordinated graphene (M@N4C). By calculating the free energy diagrams of MOR on M@N4C, Co@N4C was screened out to be the most effective MOR catalyst with a low limiting potential of 0.41 V due to the unique charge transfers and electronic structures. Importantly, one- and two-dimensional volcano relationships in MOR on M@N4C catalysts are established based on the d-band center and the Gibbs free energy of ΔG*CH3OH and ΔG*CO, respectively. In one word, this work provides theoretical guides toward the improved activity of MOR on M@N4C and hints for the design of active and efficient MOR electrocatalysts.

[Interleukin 34 (IL-34) promotes the proliferation and odontogenic differentiation of rat apical papillary stem cells].

Objective To investigate the effect of interleukin-34 (IL-34) on the odontogenic and osteogenic differentiation of stem cells from the apical papilla (SCAPs) in rats. Methods SCAPs were isolated and cultured by enzyme digestion method, and the expression of IL-34 in SCAPs was detected by real-time fluorescence quantitative PCR(RT-PCR). MTT assay was used to analyze the effects of different concentrations of IL-34 on SCAPs' proliferation in rats. The mineralization was observed by alizarin red staining, and the proliferation capacity was detected by scratch test. The expressions of alkaline phosphatase (ALP), dentin sialophosphoprotein (DSPP), runt-related transcription factor 2 (Runx2) and critical transcription factor osterix (OSX) were detected by RT-PCR. The protein expressions of ALP, DSPP, Runx2 and OSX were detected by Western blot analysis. Results The maximum concentration of IL-34 promoting the proliferation of SCAPs in rats was 100 ng/mL. Aalizarin red staining showed that IL-34 could promote the mineralization of SCAPs. RT-PCR and Western blot analysis showed that 100 ng/mL IL-34 could promote the expression of ALP, DSPP, Runx2 and OSX. Conclusion IL-34 can promote the proliferation and odontogenic/osteogenic differentiation of SCAPs in rats.

Ultralow Lattice Thermal Transport and Considerable Wave-like Phonon Tunneling in Chalcogenide Perovskite BaZrS3.

Chalcogenide perovskites provide a promising avenue for nontoxic, stable thermoelectric materials. Here, the thermal transport and thermoelectric properties of BaZrS3 as a typical orthorhombic perovskite are investigated. An extremely low lattice thermal conductivity κL of 1.84 W/mK at 300 K is revealed for BaZrS3, due to the softening effect of Ba atoms on the lattice and the strong anharmonicity caused by the twisted structure. We demonstrate that coherence contributions to κL, arising from wave-like phonon tunneling, lead to an 18% thermal transport contribution at 300 K. The increasing temperature softens the phonons, thus reducing the group velocity of materials and increasing the scattering phase space. However, it simultaneously reduces the anharmonicity, which is dominant in BaZrS3 and ultimately improves the particle-like thermal transport. In addition, via replacement of the S atom with Se- and Ti-alloying strategy, the ZT value of BaZrS3 is significantly increased from 0.58 to 0.91 at 500 K, making it an important candidate for thermoelectric applications.

In vitro corrosion resistance and dual antibacterial ability of curcumin loaded composite coatings on AZ31 alloy: Effect of amorphous calcium carbonate.

Rapid corrosion and bacterial infection are obstacles to put into use biodegradable magnesium (Mg) alloy as biomedical materials. In this research, an amorphous calcium carbonate (ACC)@curcumin (Cur) loaded poly-methyltrimethoxysilane (PMTMS) coating prepared by self-assembly method on micro-arc oxidation (MAO) coated Mg alloy has been proposed. Scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy are adopted to analyze the morphology and composition of the obtained coatings. The corrosion behaviour of the coatings is estimated by hydrogen evolution and electrochemical tests. The spread plate method without or with 808 nm near-infrared irradiation is applied to evaluate the antimicrobial and photothermal antimicrobial ability of the coatings. Cytotoxicity of the samples is tested by 3-(4,5)-dimethylthiahiazo(-z-y1)-2,5-di- phenytetrazoliumromide (MTT) and live/dead assay culturing with MC3T3-E1 cells. Results show that the MAO/ACC@Cur-PMTMS coating exhibited favourable corrosion resistance, dual antibacterial ability, and good biocompatibility. Cur was employed as an antibacterial agent and photosensitizer for photothermal therapy. The core of ACC significantly improved the loading of Cur and the deposition of hydroxyapatite corrosion products during degradation, which greatly promoted the long-term corrosion resistance and antibacterial activity of Mg alloys as biomedical materials.

Atypical Sweet syndrome: skin sinus tracts in an acutely febrile patient after lymphoma treatment: a case report.

Sweet syndrome (SS) is an uncommon inflammatory disease that involves painful skin, edematous, red papules, plaques, or nodules often accompanied by fever and leukocytosis. SS has three subtypes, including classical, malignant-tumor associated, and drug-induced SS (DISS). Patients with DISS have clear histories of recent drug exposure. The incidence of SS is high in hematological malignancy but rare in lymphomas. Glucocorticoid treatment is the recommended treatment for all subtypes of SS. This case study describes a male patient who had a history of sALCL(Systemic anaplastic large cell lymphoma) and was treated with multiple cycles of monoclonal-antibody (mAb) therapy. They also received the G-CSF injection at the site where skin lesions later developed. They met the diagnosis criteria for DISS, which was considered to be caused by the G-CSF injection. In addition, BV(Brentuximab vedotin) administration might predispose them to DISS. This case illustrates the first reported SS during the lymphoma treatment, with rare clinical presentations of local crater-like suppurative skin lesions. This case expands the available literature on SS and hematologic neoplasms and reminds clinicians to promptly recognize and diagnose SS to minimize patient morbidity and long-term sequelae.

One-pot reductive coupling of N-acylcarbamates with activated alkenes: application to the asymmetric synthesis of pyrrolo[1,2-a]azepin-5-one ring system and (-)-xenovenine.

The one-pot reductive coupling of N-acylcarbamates with activated alkenes is described. The method is based on partial reduction of N-acylcarbamates with DIBAL-H, followed by N-acyliminium ion formation and SmI(2)-mediated radical coupling with activated alkenes. Both acyclic and cyclic N-acylcarbamates can be used as stable substrates, and a range of activated alkenes serve as effective radical receptors. The reductive coupling of l-N-acylcarbamates 12/13 gave 2,5-disubstituted pyrrolidine derivatives in high trans-diastereoselectivities. The reductive coupling with penta-2,4-dienoate proceeded exclusively in a 1,6-addition fashion, producing a single non-conjugated E-isomer. On the basis of this method, a three-step construction of pyrrolo[1,2-a]azepin-5-one 16, the skeleton of many stemona alkaloids and lehmizidine alkaloids, and a seven-step synthesis of (-)-xenovenine (pyrrolizidine cis-223H, ent-6), the unnatural enantiomer of the frog/ant venom alkaloid possessing potent inhibitory activity towards nAChR channel, were achieved starting from L-12.

A "watch window" technique for monitoring buried free jejunum flaps during circumferential pharyngolaryngectomy reconstruction.

The free jejunum flap approach is the optimal option for circumferential pharyngolaryngectomy reconstruction. In this study, we designed a "watch window" for monitoring buried free jejunum flaps, thereby allowing us to assess graft viability. From 2007 to 2011, 14 patients with hypopharyngeal cancer underwent circumferential pharyngolaryngectomy that was reconstructed using a free jejunum flap at the Sun Yat-sen University Cancer Centre. During the closing of the neck incision, a "watch window" was designed for postoperative monitoring. Two patients experienced thrombosis of the pedicle. One was detected early and successfully rescued by removal of the thrombosis, the other one managed with a second free jejunum flap. The success rate of the buried flaps was 92.9%. No pharyngocutaneous fistulas or strictures occurred. All patients eventually resumed oral feeding and swallowing. The "watch window" technique for monitoring buried free jejunum flaps is simple, reliable and useful for finding vascular problems. Level of evidence Case series.

Planned neck dissection before combined chemoradiation in organ preservation protocol for N2-N3 of supraglottic or hypopharyngeal carcinoma.

OBJECTIVE: To investigate the clinical therapeutic outcomes and neck node control of a pretreatment neck dissection in the chemoradiation protocol of organ preservation for N2-N3 of supraglottic and hypopharyngeal carcinoma. METHODS: Forty-six patients (group A) with untreated N2 or N3 squamous cell carcinoma of the supraglottis or hypopharynx underwent pretreatment neck dissection in a chemoradiation protocol, while 39 patients (group B) did not undergo pretreatment neck dissection in a chemoradiation protocol. Salvage surgeries were used for local or cervical node residual tumor or recurrence after chemoradiotherapy. RESULTS: In group A, the mean time between neck dissection and chemoradiation was 21 days (range 15-29). Only 3 patients (6.5%) experienced wound complications. A 'boost' of radiation of 12 Gy was delivered after 33 neck dissections (64.8%) in patients with extracapsular spread. The Kaplan-Meier 5-year overall survival rate was 42.5%. The 5-year overall survival rate and disease-specific survival rate in group A was 42.5 and 46.4%. The rate of neck node control in group A was better than that in group B (86.3 vs. 65.9%, p = 0.02). CONCLUSIONS: Pretreatment neck dissection in a chemoradiation protocol for supraglottic or hypopharyngeal carcinoma showed low complication rates, no delay for radiation, optimal radiation doses, and a high nodal disease control.