Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma.

INTRODUCTION: The aim of this study was to investigate the impact of primary transoral robotic surgery (TORS) versus radiotherapy (RT) on progression-free survival (PFS), overall survival (OS), and 1-year swallowing function for patients with early-stage HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). METHODS: Patients with stage I-II (AJCC 8th Ed.) HPV-associated OPSCC treated with TORS followed by risk-adapted adjuvant therapy or (chemo)radiotherapy between 2014 and 2019 were identified. PFS, OS, and swallowing outcomes including gastrostomy tube (GT) use/dependence, and Functional Oral Intake Scale (FOIS) change over 1 year were compared. RESULTS: One hundred sixty-seven patients were analyzed: 116 treated with TORS with or without adjuvant RT and 51 treated with RT (50 chemoRT). The RT group had more advanced tumor/nodal stage, higher comorbidity, and higher rates of concurrent chemotherapy. There were no differences in 3-year PFS (88% TORS vs. 75% RT) or OS (90% vs. 81%) between groups, which persisted after adjusting for stage, age, and comorbidity. GT use/dependence rates were higher in the RT group. Mean (SD) FOIS scores in the TORS group were 6.9 (0.4) at baseline and 6.4 (1.0) at 1 year, compared with 6.7 (0.6) and 5.6 (1.7) for the RT group. Only clinical nodal stage was found to be significantly associated with FOIS change from baseline to 1 year. CONCLUSION: There were no differences in PFS or OS between patients treated with primary TORS or RT for early-stage HPV-associated OPSCC. Clinical N2 status is associated with FOIS change at 1 year and may be the major factor affecting long-term swallowing function, irrespective of primary treatment modality.

Evidence of a Thermal Diffusivity Gap in Sintered Li-Co-Sb-O Solid Solutions.

In this work, the thermal properties of ternary Li3x Co7-4x Sb2+x O12 solid solutions are studied for different concentrations in the range 0 ≤ x ≤ 0.7. Samples are elaborated at four different sintering temperatures: 1100, 1150, 1200 and 1250 °C. The effect of increasing the content of Li+ and Sb5+, accompanied by the reduction of Co2+, on the thermal properties is studied. It is shown that a thermal diffusivity gap, which is more pronounced for low values of x, can be triggered at a certain threshold sintering temperature (around 1150 °C in this study). This effect is explained by the increase of contact area between adjacent grains. Nevertheless, this effect is found to be less pronounced in the thermal conductivity. Moreover, a new framework for heat diffusion in solids is presented that establishes that both the heat flux and the thermal energy (or heat) satisfy a diffusion equation and therefore highlights the importance of thermal diffusivity in transient heat conduction phenomena.

Comparing Outcomes for Patients with Human Papillomavirus (HPV) Type 16 versus Other High-Risk HPV Types in Oropharyngeal Squamous Cell Carcinoma.

Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is related to improved treatment outcomes. What remains unclear is whether all HPV DNA genotypes carry similar prognostic relevance. We aimed to evaluate disease control and survival outcomes by HPV DNA genotype. Patients with primary OPSCC without distant metastases treated with curative intent were retrospectively identified from an IRB-approved institutional database. Patients that underwent HPV DNA polymerase chain reaction (PCR) testing with available genotype were included and dichotomized by the presence of HPV type 16 (HPV-16) or other high-risk HPV genotype (HPV-non16). Overall survival (OS), disease-free survival (DFS), locoregional control (LRC) and distant control (DC) were determined using the Kaplan-Meier method and compared using the log-rank test. In our cohort of 193 patients treated from 2012 to 2018 with HPV DNA PCR, 10% were detected as HPV-non16 high-risk types. Patients with HPV-16 were significantly younger than those with HPV-non16, but no other baseline factors were associated with HPV-non16. With a median follow-up of 42.9 months, there were no significant differences in outcomes between the HPV-16 and HPV-non16 groups for 3-year OS (87.7% v. 73.6%), DFS (82.9% v. 68.7%), LRC (92.8% v. 88.5%) or DC (91% v. 89.2%). There is no statistically significant difference in outcomes between OPSCC with HPV-16 and HPV-non16 high-risk genotypes in our cohort, though trends of overall worse survival and disease-free survival in HPV-non 16 OPSCC were seen. Further studies with larger cohorts of patients with HPV-non 16-associated OPSCC are required to make definitive conclusions regarding the prognostic and clinical significance of HPV type.

Design of Multimodal Absorption in the Mid-IR: A Metal Dielectric Metal Approach.

Specific control on the mid-infrared (mid-IR) emission properties is attracting increasing attention for thermal camouflage and passive cooling applications. Metal-dielectric-metal (MDM) structures are well known to support strong magnetic polariton resonances in the optical and near-infrared range. We extend the current understanding of such an MDM structure by specifically designing Au disc arrays on top of ZnS-Au-Si substrates and pushing their resonances to the mid-IR regime. Therefore, we combine fabrication via lift-off photolithography with the finite element method and an inductance-capacitance model. With this combination of techniques, we demonstrate that the magnetic polariton resonance of the first order strongly depends on the individual disc diameter. Furthermore, the fabrication of multiple discs within one unit cell allows a linear combination of the fundamental resonances to conceive broadband absorptance. Quite importantly, even in mixed resonator cases, the absorptance spectra can be fully described by a superposition of the individual disc properties. Our contribution provides rational guidance to deterministically design mid-IR emitting materials with specific narrow- or broadband properties.

Tunable daytime passive radiative cooling based on a broadband angle selective low-pass filter.

Passive daytime cooling could contribute to the reduction of our global energy consumption. It is capable of cooling materials down to below ambient temperatures without the necessity of any additional input energy. Yet, current devices and concepts all lack the possibility to switch the cooling properties on and off. Here, we introduce dynamic control for passive radiative cooling during daytime. Using an angle-selective solar filter on top of a nocturnal passive radiator allows tuning the surface temperature of the latter in a wide range by just tilting the filter from normal incidence up to around 23°. This angle-selective filter is based on optically engineered, one-dimensional photonic crystal structures. We use numerical simulations to investigate the feasibility of a switchable low-pass filter/emitter device.

Pharyngeal swallowing mechanics associated with upper esophageal sphincter pressure wave.

BACKGROUND: Opening of the upper esophageal sphincter (UES) is a critical element of swallowing. Understanding the functional pharyngeal anatomy during UES opening would be clinically useful for dysphagia evaluation and treatment. METHODS: Simultaneous high-resolution pharyngeal manometry and videofluoroscopy (VFS) videos for 18 nondysphagic subjects were evaluated. UES pressure readings were segmented into six pressure phases, including a poorly understood pre-relaxation contraction. Anatomic landmarks were tracked in VFS imaging and evaluated morphometrically to determine the movement of key swallowing structures within each UES pressure phase. RESULTS: There were significant differences in pharyngeal mechanics by UES pressure stage (range of D-values = 1.7-2.2, P < .0001). The soft palate maximally elevates during the pre-relaxation contraction of the UES. Early during UES relaxation, the hyolaryngeal complex and pharyngeal structures maximally elevate and pharyngeal structures constrict around the bolus. CONCLUSION: The mechanics underlying the UES pressure wave suggest generation of a sealed pharyngeal cavity, possibly integral to pharyngeal pressure generation and bolus propulsion.

Endoscopic repair of cribriform plate cerebrospinal fluid leaks: An easy and reproducible technique sparing the middle turbinate.

OBJECTIVE: The purpose of this study was to evaluate the outcomes of patients with cribriform cerebrospinal fluid leaks undergoing endoscopic repair with an easy and reproducible middle turbinate-sparing technique. MATERIAL AND METHODS: Date was obtained by retrospective chart review and includes a description of the technique with technical pearls and contraindications to the approach. RESULTS: We report 17 patients who underwent repair of cribriform cerebrospinal fluid leaks with a middle turbinate-sparing technique with 100% success rate at a mean follow up of 38 months. One patient complained of hyposmia. There were no other complications. CONCLUSIONS: The endoscopic middle turbinate-sparing approach to repair cribriform cerebrospinal fluid leaks using a free mucosal graft is easy, effective, and reproducible.

Direct Measurement of the In-Plane Thermal Diffusivity of Semitransparent Thin Films by Lock-In Thermography: An Extension of the Slopes Method.

We present an extension of the well-known slopes method for characterization of the in-plane thermal diffusivity of semitransparent polymer films. We introduce a theoretical model which considers heat losses due to convection and radiation mechanisms, as well as semitransparency of the material to the exciting laser heat source (visible range) and multiple reflections at the film surfaces. Most importantly, a potential semitransparency of the material in the IR detection range is also considered. We prove by numerical simulations and by an asymptotic expansion of the surface temperature that the slopes method is also valid for any semitransparent film in the thermally thin regime. Measurements of the in-plane thermal diffusivity performed on semitransparent polymer films covering a wide range of absorption coefficients (to the exciting wavelength and in the IR detection range of our IR camera) validate our theoretical findings.

Thermal transport in binary colloidal glasses: Composition dependence and percolation assessment.

The combination of various types of materials is often used to create superior composites that outperform the pure phase components. For any rational design, the thermal conductivity of the composite as a function of the volume fraction of the filler component needs to be known. When approaching the nanoscale, the homogeneous mixture of various components poses an additional challenge. Here, we investigate binary nanocomposite materials based on polymer latex beads and hollow silica nanoparticles. These form randomly mixed colloidal glasses on a sub-µm scale. We focus on the heat transport properties through such binary assembly structures. The thermal conductivity can be well described by the effective medium theory. However, film formation of the soft polymer component leads to phase segregation and a mismatch between existing mixing models. We confirm our experimental data by finite element modeling. This additionally allowed us to assess the onset of thermal transport percolation in such random particulate structures. Our study contributes to a better understanding of thermal transport through heterostructured particulate assemblies.

Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke.

BACKGROUND: Computational analysis of swallowing mechanics (CASM) is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke-related dysphagia, (2) decipher the impact of left and right hemispheric strokes on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. METHODS: Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age- and gender-matched controls were selected from well-controlled data sets. Patient data including laterality and penetration-aspiration status were collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. RESULTS: Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke versus controls (D = 2.19, P < .0001), right hemispheric stroke versus controls (D = 3.64, P < .0001), left hemispheric stroke versus controls (D = 2.06, P < .0001), right hemispheric stroke versus left hemispheric stroke (D = 2.89, P < .0001), and penetration-aspiration versus within normal limits (D = 2.25, P < .0001). Differences in pharyngeal swallowing mechanics associated with each comparison were visualized using eigenvectors. CONCLUSIONS: Whereas current literature focuses on timing changes in stroke-related dysphagia, these data suggest that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by the affected hemisphere and the penetration-aspiration status. CASM can be used to identify patient-specific swallowing impairment associated with stroke injury that could help guide rehabilitation strategies to improve swallowing outcomes.

Generalizing the flash technique in the front-face configuration to measure the thermal diffusivity of semitransparent solids.

In this work, we have extended the front-face flash method to retrieve simultaneously the thermal diffusivity and the optical absorption coefficient of semitransparent plates. A complete theoretical model that allows calculating the front surface temperature rise of the sample has been developed. It takes into consideration additional effects, such as multiple reflections of the heating light beam inside the sample, heat losses by convection and radiation, transparency of the sample to infrared wavelengths, and heating pulse duration. Measurements performed on calibrated solids, covering a wide range of absorption coefficients (from transparent to opaque) and thermal diffusivities, validate the proposed method.

Photoacoustic monitoring of sedimentation of micro-particles in low viscosity fluids.

In this work, the potential of photoacoustic technique in the study of the sedimentation process of particles in liquids is explored. Experiments were performed using zirconia particles of 50 and 100 µm in three different low viscosity liquids, water, citronella, and ethylene glycol. It is shown that the evolution of the PA signal depends not only on the kind of liquids used but also on the size of the particles. An effective thermal model is developed in order to study the process and to infer the evolution of the thermal conductivity of the sedimented layer when it behaves as thermally thin, or the thermal effusivity if it behaves as thermally thick. It is shown that based on these results, the time evolution of the volume fraction of particles, in the region in which the sediment is deposited, can be obtained. These results can be useful in establishing a methodology for the photoacoustic monitoring of the process of sedimentation in more complex systems.