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Abstract Purpose Concurrent chemoradiotherapy (CCRT) is a standard treatment choice for locally advanced hypopharyngeal carcinoma. The aim of this study was to investigate whether induction chemotherapy (IC) followed by CCRT is superior to CCRT alone to treat locally advanced hypopharyngeal carcinoma. Methods and materials Patients (n = 142) were randomized to receive two cycles of paclitaxel/cisplatin/5-fluorouracil (TPF) IC followed by CCRT or CCRT alone. The primary end point was overall survival (OS). The secondary end points included the larynx-preservation rate, progression-free survival (PFS), distant metastasis-free survival (DMFS), and toxicities. Results Ultimately, 113 of the 142 patients were analyzed. With a median follow-up of 45.6 months (interquartile range 26.8–57.8 months), the 3-year OS was 53.1% in the IC + CCRT group compared with 54.8% in the CCRT group (hazard ratio, 1.004; 95% confidence interval, 0.573–1.761; P = 0.988). There were no statistically significant differences in PFS, DMFS, and the larynx-preservation rate between the two groups. The incidence of grade 3–4 hematological toxicity was much higher in the IC+ CCRT group than in the CCRT group (54.7% vs. 10%, P

Objective: This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index (SII) in non-metastatic nasopharyngeal carcinoma (NPC). Methods: We retrospectively analyzed the data of 839 patients with non-metastatic NPC recruited from two independent institutions. The training-set cohort and the external validation-set cohort was comprised of 459 and 380 patients from each institution, respectively. The optimal cut-off value of SII was determined, and a prognostic risk stratification model was developed based on the training cohort and further assessed in the validation cohort. The propensity score matching (PSM) method was applied to minimize the confounding effects of unbalanced covariables. Results: The optimal cut-off value of the SII in the training cohort was 686, which was confirmed using the validation cohort. Multivariate analysis showed that both before and after PSM, SII values > 686 were independently associated with worse progression-free survival (PFS) ratio in both cohorts (before PSM, P = 0.008 and P = 0.008; after PSM, P = 0.008 and P = 0.007, respectively). Based on the analysis of independent prognostic factors of SII and N stage, we developed a categorical risk stratification model, which achieved significant discrimination among risk indexes associated with PFS and distant metastasis-free survival (DMFS) in the training cohort. There was no significant difference in PFS between RT alone and combined therapies within the low- and intermediate-risk groups (5-year PFS, 77.5% vs. 75.3%, P = 0.275). Patients in the high-risk group who received concurrent chemoradiotherapy experienced superior PFS compared with those who received other therapies (5-year PFS, 64.9% vs. 40.3%, P = 0.003). Conclusion: Pretreatment SII predicts PFS of patients with non-metastatic NPC. Prognostic risk stratification incorporating SII is instructive for selecting individualized treatment.

Abstract Background To investigate the clinical characteristics of metachronous second primary malignancies (Met‐SPMs) and its impact on prognosis in hypopharyngeal carcinoma (HPC). Methods We reviewed 593 newly diagnosed HPC patients without invasive synchronous SPMs (Syn‐SPMs) who were treated in our cancer center between 2009 and 2019. According to the status during follow‐up, patients were classified into three groups: (a) without SPMs (No‐SPMs, n = 440), (b) with tumors in situ in the esophagus or stomach (Tis, n = 80), or (c) with Met‐SPMs (n = 73). Results The median follow‐up time for entire cohort (n = 593) was 66.7 months. Met‐SPMs were present in 12.3% of the cohort (73/593). The predominant site of SPMs was esophagus, followed by lung, oral cavity, thyroid, stomach, and oropharynx. In Met‐SPMs group, both index tumor and SPMs were the main causes of death. Tis group exhibited comparable 5‐year overall survival (OS) and disease‐specific survival (DSS) with that of No‐SPMs group. The Met‐SPMs group had similar 5‐year OS rate and better 5‐year DSS rate of 47.3% versus 43.6% (odds ratio [OR], 0.931; 95% confidence interval [CI], 0.681–1.274, p = 0.657) and 66.3% vs. 46.2% (OR, 0.600; 95% CI, 0.402–0.896, p = 0.012), respectively, compared with the No‐SPMs group. Conclusion The overall incidence of Met‐SPMs in HPC was 12.3%. The occurrence of Met‐SPMs does not jeopardize the survival outcome of HPC. Routine surveillance of Met‐SPMs was requisite for patients with HPC.

The work shows that volcanic-related elevated continental chemical weathering could have played a significant role in global environmental perturbations during the Triassic-Jurassic mass extinction.

Abstract Purpose To define the clinical characteristics of irradiation-induced nasopharyngeal necrosis (INN) after intensity-modulated radiotherapy (IMRT) and identify the influence of treatment strategies on INN in primary nasopharyngeal carcinoma (NPC) patients. Patients and methods From 2008 to 2019, NPC patients pathologically diagnosed with INN after primary IMRT were reviewed. Those patients were matched with propensity scores for patients without INN in our center. The impact of treatment strategies on INN occurrence was assessed using univariate and multivariate logistic regression analysis. Results The incidence rate of INN was 1.9% among the primary NPC population, and 53 patients with INN were enrolled. Headache and foul odor were the main symptoms, and 71.7% of cases had pseudomembrane during or at the end of radiotherapy. All patients were in early or middle stage INN, and no one presented with skull-based osteoradionecrosis. Then 212 non-INN patients were included based on propensity scores match. Overall survival (p = 0.248) and progression-free survival (p = 0.266) curves were similar between the INN and non-INN groups. Treatment strategies including combining chemotherapy or molecular targeted therapy with radiotherapy were not associated with INN occurrence, while boost dose (OR 7.360; 95% CI 2.301–23.547; p = 0.001) was a predictor factor for it. However, the optimal threshold for an accumulated dose to predict INN's occurrence was failed to determine. Conclusion In the IMRT era, the severity of INN in primary NPC patients is lessened. This study showed that treatment strategies contributed little to develop INN, while the accumulated dose of radiation may relate to its occurrence.

Swarming is one of the important trends in the development of small multi-rotor UAVs. The stable operation of UAV swarms and air-to-ground cooperative operations depend on precise relative position information within the swarm. Existing relative localization solutions mainly rely on passively received external information or expensive and complex sensors, which are not applicable to the application scenarios of small-rotor UAV swarms. Therefore, we develop a relative localization solution based on airborne monocular sensing data to directly realize real-time relative localization among UAVs. First, we apply the lightweight YOLOv8-pose target detection algorithm to realize the real-time detection of quadcopter UAVs and their rotor motors. Then, to improve the computational efficiency, we make full use of the geometric properties of UAVs to derive a more adaptable algorithm for solving the P3P problem. In order to solve the multi-solution problem when less than four motors are detected, we analytically propose a positive solution determination scheme based on reasonable attitude information. We also introduce the maximum weight of the motor-detection confidence into the calculation of relative localization position to further improve the accuracy. Finally, we conducted simulations and practical experiments on an experimental UAV. The experimental results verify the feasibility of the proposed scheme, in which the performance of the core algorithm is significantly improved over the classical algorithm. Our research provides viable solutions to free UAV swarms from external information dependence, apply them to complex environments, improve autonomous collaboration, and reduce costs.

In recent years, real-time global ionospheric map (RT-GIM) products have been actively developed by the international global navigation satellite system (GNSS) service (IGS) and its ionosphere associate analysis centers (IAACs) along with the increase of RT-GNSS multi-frequency and multi-constellation observations. In this study, the accuracy and consistency of three RT-GIM products from the Chinese Academy of Sciences (CAS), Wuhan University (WHU), and IGS are evaluated and analyzed utilizing three validation methods, namely, comparison with JASON-3 vertical total electron content (VTEC), the difference of slant total electron content (dSTEC), and IGS combined final GIM (IGSG) data. The test period was from 1 January 2019 to 31 December 2022, including the different solar activities. First, the comparison with JASON-3 data illustrates that the quality of the three RT-GIM products over oceans is in great consistency with that of the IGSG during different levels of solar activity and the daily mean bias (MEAN) values in low and high solar activities are approximately 5 and 10 TECU, respectively. The root mean square (RMS) values under low and high solar activities can be up to 7 and 12 TECU. Furthermore, the dSTEC validation results present that the MEAN values of RT-GIM products from different IAACs at high- and mid-latitude stations are about 0.5 TECU, which is smaller than those at low-latitude stations at about 1 TECU over continental regions. The standard deviation (STD) and RMS values for various RT-GIM products are within 3 and 4 TECU at low latitudes, respectively. In terms of the comparison with IGSG, the result shows that IGS combined RT-GIM (IRTG) presents better consistency than CAS RT-GIM (CRTG) and WHU RT-GIM (WRTG) in 2021 and 2022, with average annual STD and RMS values of 2.56 and 2.78 TECU, respectively. The daily biases of the RT-GIM products relative to IGSG can reach 4 TECU in high solar activities and the daily STD and RMS values are mainly within the 5 to 6 TECU range, respectively.

Abstract Purpose Conditional survival (CS) and failure hazard estimations can provide important dynamic prognostic information for clinical decision‐making and surveillance counseling. The current study aimed to investigate the CS and dynamic failure hazard in non‐metastatic nasopharyngeal carcinoma (NPC) treated with intensity‐modulated radiotherapy (IMRT). Methods Conditional overall survival (COS) and progression‐free survival (CPFS) estimates adjusted for age and gender against each AJCC 8th stage were calculated. Multivariable Cox regression (MCR) models were fitted in the entire population at baseline and subsequently separate MCR models were fitted in patients who have maintained event‐free time of 1 to 10 years to generate respective hazard ratio (HR). Annual hazard rates of death and progression over 10 years for each stage were also estimated. Results A total of 1993 patients were eligible for analysis. The estimated 5‐year OS and PFS for entire cohort were 79.0% and 70.7% at initial diagnosis. After 5 years of event‐free follow‐up, additional 5‐year COS and CPFS increased to 85.9% and 85.5%, respectively. Stage I/II maintained dramatically favorable CS and low hazard (< 5%) of death and progression over time. Relative to stage I/II, stage III manifested non‐significantly higher failure hazard for the first 3 years of survivorship and approached to similar level of stage I/II afterwards. Stage IVA presented most impressive improvement in terms of both COS (∆=9.8%) and CPFS (∆ = 16.8%) whereas still drastically inferior to that of stage I‐III across all conditional time points. After 4 years of follow‐up, progression hazard of stage IVA became relatively steady of approximate 6%. Conclusions Survival prospect of non‐metastatic NPC improves over years with distinct dynamic patterns across stages, providing important implications for personalized decision‐making in terms of both clinical management and surveillance counseling. Stage‐dependent and hazard‐adapted clinical management and surveillance are warranted.

ObjectivesTo analyze the incidence and spread of lymph node metastasis (LNM) and the effectiveness of prophylactic neck irradiation in patients with SNSCC.MethodsA total of 255 patients with SNSCC were retrospectively reviewed. The LNM spread pattern was revealed. The clinical parameters related to LNM, and the prognostic value of elective neck irradiation (ENI) were assessed. A 1:1 matching with propensity scores was performed between ENI group and observation (OBS) group.ResultsThe initial LNM rate was 20.8%, and the regional recurrence (RR) rate was 7.5%. Lymphatic spreading in SNSCC followed the common trajectories: a. level Ib ➔ level II ➔ level Va/level III/IV lymph nodes (LNs); b. retropharyngeal lymph nodes (RPLNs) ➔ level II LNs. The most frequently involved site was level II LNs (16.1%), followed by level Ib LNs (10.2%), RPLNs (4.7%), level III LNs (3.2%), level Va LNs (1.6%), level IVa LNs (1.4%) and level VIII LNs (0.8%). The median follow-up time was 105 months. The 5-year overall survival (OS) was 55.7% for N0 patients and 38.5% for patients with initial N+ or N- relapse (p = 0.009). After PSM, the 5-year regional recurrence-free survival was 71.6% and 94.7% (p = 0.046) in OBS and ENI group, respectively. The multivariate analysis showed that ENI (p = 0.013) and absence of nasopharynx involvement (p = 0.026) were associated with a significantly lower RR rate.ConclusionsPatients with LNM had poorer survival than those who never experienced LNM. Lymphatic spread in SNSCC followed predictable patterns. ENI effectively reduced the RR rate in patients at high risk.

Abstract Background The aim of this study is to evaluate the efficacy of different treatment strategies and the potential prognostic factors of esthesioneuroblastoma (ENB). Materials and methods Between April 1984 and December 2018, 138 patients with non-metastatic ENB were retrospectively analyzed. The treatment modalities mainly included surgery alone (n = 7), radiotherapy alone (n = 33), concurrent chemoradiotherapy (n = 17), surgery combined with current chemoradiotherapy (n = 32), and surgery plus radiotherapy (n = 49). Results The median follow-up time for the entire cohort was 61 months (range, 4–231 months). The 5-year overall survival (OS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS) rate were 69.6, 78.0 and 73.9%, respectively. Surgery combined with radiotherapy elicited superior survival results, and the combination of surgery and current chemoradiotherapy achieved the best prognoses for all patients, patients with advanced Kadish disease, patients receiving intensity modulated radiation therapy and those with positive surgical margin. Univariate analysis identified orbital invasion and treatment modalities were predictors for OS, LRFFS and DMFS. Lymph node metastasis was associated with OS and DMFS, but not LRFFS. Intracranial invasion, advanced Kadish stage and not receiving concurrent chemotherapy were also predictive of lower OS. Multivariate analyses indicated that lymph node metastasis was an independent prognostic factor affecting DMFS, whereas treatment modalities was independent prognostic factors for OS and LRFFS. Conclusion Orbital invasion, intracranial invasion, lymph node metastasis and advanced Kadish disease at initial diagnosis were significantly associated with inferior prognosis. Regarding the treatment modality, the optimal strategy remined surgery with radiotherapy-based multimodality treatment. The concurrent chemoradiotherapy may play a more beneficial role.

Abstract Purpose The purpose of this study was to determine the associations between pathological complete remission (pCR) and clinical outcomes in patients with locally advanced head and neck squamous cell carcinoma (HNSCC) who received preoperative radiotherapy or chemoradiotherapy in a phase 3 clinical study. Methods A total of 222 newly diagnostic stage III/IVM0 HNSCC patients were randomly assigned to a preoperative concurrent chemoradiotherapy group (n = 104) or preoperative radiotherapy alone group (n = 118). Over a mean follow-up of 59 months, 72 patients were defined as non-responders to preoperative therapy and subsequently underwent resection of the primary lesion with or without neck dissection. The relationship between the pathological tumor response of the primary lesion and treatment prognosis was analyzed. Kaplan–Meier and Cox regression multivariate analyses were performed to evaluate the impact of pCR on local control (LC), overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). Results Among the 72 non-responders, 25 patients, 10 in the chemotherapy group and 15 in the radiotherapy group, achieved pCR. The 5-year LC, OS, PFS, and DMFS of pCR patients and non-pCR patients were 93.2% vs. 67.7% (p = 0.007), 83.3% vs. 39.7% (p = 0.0006), 76.1% vs. 44.0% (p = 0.009), and 90.4% vs. 56.3% (p = 0.005), respectively. In multivariate analysis, pCR is also an independent prognostic factor in prognosis, with statistically significant differences. Conclusion pCR after preoperative radiotherapy or concurrent chemoradiotherapy is a good prognostic factor in locally advanced HNSCC. Trial registration Number:ChiCTR-TRC-114004322 Date:05 Mar, 2014

Background: Sinonasal squamous cell carcinoma (SNSCC) can arise as either inverted papilloma–associated SCC (IP-SCC) or as de novo SCC (DN-SCC). It is controversial as to whether survival differences between IP-SCC and DN-SCC exist. Methods: Between January 2000 and December 2016, 234 patients with SNSCC were analyzed retrospectively, including 68 with IP-SCC and 166 with DN-SCC. Propensity score matching (PSM) was performed to balance baseline characteristics. The Kaplan–Meier method and Cox proportional hazard model were used to determine risk factors on survival outcomes. Results: The median follow-up time was 98.4 months. Before PSM, lymph node metastasis was noted to be lower in patients with IP-SCC. After PSM, the 5-year DFS, DSS and OS between IP-SCC and DN-SCC were 43.0% vs. 44.5% (p = 0.701), 49.2% vs. 56.2% (p = 0.753), and 48.2% vs. 52.9% (p = 0.978). The annual hazards of local failure, respectively, peaked at 28.4% and 27.8% for IP-SCC and DN-SCC within 12 months after treatment. Afterward, the hazards gradually decreased and the hazard for IP-SCC was always higher before approaching null. Conclusions: This study provides novel evidence to support the clinical utility of improved distinction between IP-SCC and DN-SCC. Further studies are necessary to validate these findings before considering escalation of IP-SCC.

Aluminum (Al) has been widely used in micro-electromechanical systems (MEMS), polymer bonded explosives (PBXs) and solid propellants. Its typical core-shell structure (the inside active Al core and the external alumina (Al2O3) shell) determines its oxidation process, which is mainly influenced by oxidant diffusion, Al2O3 crystal transformation and melt-dispersion of the inside active Al. Consequently, the properties of Al can be controlled by changing these factors. Metastable intermixed composites (MICs), flake Al and nano Al can improve the properties of Al by increasing the diffusion efficiency of the oxidant. Fluorine, Titanium carbide (TiC), and alloy can crack the Al2O3 shell to improve the properties of Al. Furthermore, those materials with good thermal conductivity can increase the heat transferred to the internal active Al, which can also improve the reactivity of Al. Now, the integration of different modification methods is employed to further improve the properties of Al. With the ever-increasing demands on the performance of MEMS, PBXs and solid propellants, Al-based composite materials with high stability during storage and transportation, and high reactivity for usage will become a new research focus in the future.

ObjectiveTo investigate the prevalence and distribution of cervical lymph node metastasis (LNM) in locally advanced supraglottic squamous cell carcinoma (LASCC) and guide the delineation of clinical lymph node target volumes.Materials and MethodsWe reviewed patients defined as LASCC from January 2000 to December 2017 in our hospital. The primary tumor was operated on using partial or total laryngectomy, and all patients underwent bilateral neck dissection (levels II–IV at least). Univariate and multivariate logistic regressions were used to find risk factors associated with LNM.ResultsA total of 206 patients were enrolled. In the whole group, the rate of ipsilateral metastasis (IM) was 60.9% (67 patients), whereas contralateral metastasis was 25.5% (28 patients). Only positive ipsilateral lymph nodes contributed to contralateral metastasis (p = 0.001). Seventy-six cases were diagnosed with clinical positive lymph nodes (cN+). IM of primary lesions mainly located within the unilateral sites (n = 49 patients) was detected in levels II, III, and IV with lymph node metastasis ratios of 73.5% (36 patients), 63.3% (31 patients), and 20.4% (10 patients), respectively, and contralateral metastasis of 36.7% (18 patients), 16.3% (8 patients), and 6.1% (3 patients), respectively. Involvement of level II or III was associated with metastasis of level IV. No one developed contralateral level IV involvement without metastasis of contralateral levels II and III. A total of 130 cases had clinically negative neck lymph nodes (cN0). The prevalence of occult metastasis (OM) was 35.4%. Among 62 patients with unilateral lesions, the rates of OM to ipsilateral neck levels II, III, and IV were 21, 11.1, and 1.6%, respectively, whereas contralateral neck levels were 6.3, 4.8, and 0%, respectively. In terms of the risk factors, histopathological differentiation was related to OM (p = 0.003). Two of 25 people were with level VIb metastasis, and both of them were with subglottic involvement.ConclusionNeck levels II to IV are most frequently involved and should be included in clinical target volume (CTV) in cN+ patients. Contralateral IV may be omitted when contralateral levels II and III are negative. In cN0 patients, ipsilateral levels II and III are suggested to be included in the CTV, whereas whether contralateral levels II and III should be included needs further research.

Purpose: To explore the efficacy of concomitant chemotherapy in intensity-modulated radiotherapy (IMRT) to treat stage II nasopharyngeal carcinoma (NPC).Methods and Materials: In this randomized phase 2 study [registered with ClinicalTrials.gov (NCT01187238)], eligible patients with stage II (2010 UICC/AJCC) NPC were randomly assigned to either IMRT alone (RT group) or IMRT combined with concurrent cisplatin (40 mg/m2, weekly) (CCRT group). The primary endpoint was overall survival (OS). The second endpoints included local failure-free survival (LFFS), regional failure-free survival (RFFS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and acute toxicities.Results: Between May 2010 to July 2012, 84 patients who met the criteria were randomized to the RT group (n = 43) or the CCRT group (n = 41). The median follow-up time was 75 months. The OS, LFFS, RFFS, DFS, and DMFS for the RT group and CCRT group were 100% vs. 94.0% (p = 0.25), 93.0% vs. 89.3% (p = 0.79), 97.7% vs. 95.1% (p = 0.54), 90.4% vs. 86.6% (p = 0.72), and 95.2% vs. 94.5% (p = 0.77), respectively. A total of 14 patients experienced disease failure, 7 patients in each group. The incidence of grade 2 to 4 leukopenia was higher in the CCRT group (p = 0.022). No significant differences in liver, renal, skin, or mucosal toxicity was observed between the two groups.Conclusion: For patients with stage II NPC, concomitant chemotherapy with IMRT did not improve survival or disease control but had a detrimental effect on bone marrow function.

Massive multiple-input multiple-output (MIMO) systems and small cell networks are both regarded as promising candidates to meet the exponential growth of mobile data traffic for the next generation (5G) wireless communications. Hence, a new kind of multitier networks which combine massive MIMO macro cells with a secondary tier of small cells is proposed to resolve the contradiction of large network coverage and high data rate. In such multitier networks, it is inevitable to allocate nonorthogonal uplink pilot sequences to user equipment (UE) due to the large number of users. We propose a pilot reuse scheme by exploiting the unique architecture of this networks and analyse the special mixed channel state information (CSI) yielded by the pilot reuse scheme. Based on the mixed CSI, we formulate a downlink transmit beamforming problem of minimizing the total power consumption while satisfying the quality of service (QoS) requirements with outage constraints. After decomposing the original problem into simpler subproblems, we provide an efficient algorithm to combine these subproblems and solve them iteratively for generating the beamforming vectors. Monte Carlo simulations show that the average power consumption of the proposed pilot reuse scheme and its associated beamforming algorithm is close to that of the perfect CSI case.

This study applies the zero-differenced integer ambiguity method, named PPP-Fixed, to extract real-time ionospheric data and eliminate the latencies of rapid/final Global Ionosphere Maps (GIMs). The PPP-Fixed method is also used to derive ionospheric data for post-processed GIM generation, named SGG Post- GIM, combined with low earth orbit satellite data. The obtained hardware delays are applied to revise real-time ionospheric data. Meanwhile, the estimated multi-source ionospheric model is regarded as historical data to estimate an ionospheric prediction model for constraint using the semi-parameter model. Then, the Kalman filter is employed to estimate the parameters to generate real-time GIM. Finally, the accuracy of estimated real-time GIM, named SGG RT-GIM, and SGG Post-GIM is assessed. During the experimental period, the mean differences of SGG Post-GIM and SGG RT-GIM relative to GIMs provided by the international Global Navigation Satellite System service, named IGSG, are _ 0.46 and _ 0.57 Total Electron Content Unit (TECU), respectively. The corresponding Root Mean Square (RMS) values are 1.64 and 3.08 TECU. Over the test period, the mean positioning errors of the single-frequency precise point positioning corrected by IGSG, SGG Post- GIM, SGG RT-GIM, and Klobuchar model are 0.14, 0.19, 0.21, and 0.25 m in the horizontal direction, respectively, while the corresponding errors are 0.36, 0.33, 0.38, and 0.64 m in the up direction. Further, the mean biases of experimental days for the self-consistency assessment are 0.06, _ 0.01, and _ 0.07 TECU for IGSG, SGG Post-GIM, and SGG RT-GIM, respectively. The corresponding RMS values are 1.19, 1.15, and 1.57 TECU. [ABSTRACT FROM AUTHOR]