625 research outputs found

    Current management of stage IV nasopharyngeal carcinoma without distant metastasis

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    Up to one in four patients with nasopharyngeal carcinoma present with non-metastatic stage IV disease (i.e. T4 or N3). Distinct failure patterns exist, despite the routine adoption of contemporary treatment modalities such as intensity modulated radiotherapy and systemic chemotherapy. Concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy or induction chemotherapy followed by CCRT are commonly employed in this setting, with the latter emerging as the preferred option. Additionally, emerging radiation technologies like proton therapy has become available offering new opportunities for prevention of radiation-induced side effects. This article reviews not only the current treatment strategies, but also discusses novel ways to tackle this challenging disease with respect to the patterns of failure

    Management of locally recurrent nasopharyngeal carcinoma

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    As a consequence of the current excellent loco-regional control rates attained using the generally accepted treatment paradigms involving intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC), only 10-20% of patients will suffer from local and/or nodal recurrence after primary treatment. Early detection of recurrence is important as localized recurrent disease is still potentially salvageable, but this treatment often incurs a high risk of major toxicities. Due to the possibility of radio-resistance of tumors which persist or recur despite adequate prior irradiation and the limited tolerance of adjacent normal tissues to sustain further additional treatment, the management of local failures remains one of the greatest challenges in this disease. Both surgical approaches for radical resection and specialized re-irradiation modalities have been explored. Unfortunately, available data are based on retrospective studies, and the majority of them are based on a small number of patients or relatively short follow-up. In this article, we will review the different salvage treatment options and associated prognostic factors for each of them. We will also propose a treatment algorithm based on the latest available evidence and discuss the future directions of treatment for locally recurrent NPC.Peer reviewe

    Nanoencapsulation of luminescent 3-hydroxypicolinate lanthanide complexes

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    We have synthesized luminescent nanoparticles comprising a core of lanthanide complexes and shells of amorphous silica using reverse micelles as nanoreactors. 3-Hydroxypicolinate complexes of Eu(III), Tb(III), and the corresponding heteronuclear complexes have been investigated as the photoactive cores. The size of the silica particles is within the nanometer scale, which, together with the ability for surface biofunctionalization, opens up perspectives for their use in bioapplications. Optical studies of the as-prepared nanoparticles reveal that the luminescence properties of the 3-hydroxypicolinate complexes in the matrices are markedly different from their original features

    Ice fabric in an Antarctic ice stream interpreted from seismic anisotropy

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    Here we present new measurements of an anisotropic ice fabric in a fast moving (377 ma−1) ice stream in West Antarctica. We use ∼6000 measurements of shear wave splitting observed in microseismic signals from the bed of Rutford Ice Stream, to show that in contrast to large-scale ice flow models, which assume that ice is isotropic, the ice in Rutford Ice Stream is dominated by a previously unobserved type of partial girdle fabric. This fabric has a strong directional contrast in mechanical properties, shearing 9.1 times more easily along the ice flow direction than across flow. This observed fabric is likely to be widespread and representative of fabrics in other ice streams and large glaciers, suggesting it is essential to consider anisotropy in data-driven models to correctly predict ice loss and future flow in these regions. We show how passive microseismic monitoring can be effectively used to provide these data

    Sensitivity of Metrics of Phylogenetic Structure to Scale, Source of Data and Species Pool of Hummingbird Assemblages along Elevational Gradients

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    Patterns of phylogenetic structure of assemblages are increasingly used to gain insight into the ecological and evolutionary processes involved in the assembly of co-occurring species. Metrics of phylogenetic structure can be sensitive to scaling issues and data availability. Here we empirically assess the sensitivity of four metrics of phylogenetic structure of assemblages to changes in (i) the source of data, (ii) the spatial grain at which assemblages are defined, and (iii) the definition of species pools using hummingbird (Trochilidae) assemblages along an elevational gradient in Colombia. We also discuss some of the implications in terms of the potential mechanisms driving these patterns. To explore how source of data influence phylogenetic structure we defined assemblages using three sources of data: field inventories, museum specimens, and range maps. Assemblages were defined at two spatial grains: coarse-grained (elevational bands of 800-m width) and fine-grained (1-km2 plots). We used three different species pools: all species contained in assemblages, all species within half-degree quadrats, and all species either above or below 2000 m elevation. Metrics considering phylogenetic relationships among all species within assemblages showed phylogenetic clustering at high elevations and phylogenetic evenness in the lowlands, whereas those metrics considering only the closest co-occurring relatives showed the opposite trend. This result suggests that using multiple metrics of phylogenetic structure should provide greater insight into the mechanisms shaping assemblage structure. The source and spatial grain of data had important influences on estimates of both richness and phylogenetic structure. Metrics considering the co-occurrence of close relatives were particularly sensitive to changes in the spatial grain. Assemblages based on range maps included more species and showed less phylogenetic structure than assemblages based on museum or field inventories. Coarse-grained assemblages included more distantly related species and thus showed a more even phylogenetic structure than fine-grained assemblages. Our results emphasize the importance of carefully selecting the scale, source of data and metric used in analysis of the phylogenetic structure of assemblages
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