Explore the vast range of titles available.

Background To compare the differences in long-term quality of life (QoL) between survivors of paediatric and adult patients with nasopharyngeal carcinoma (NPC) and assess the clinical factors that predict long-term QoL. Methods We enrolled 420 long-term NPC survivors who were alive for at least 8 years after treatment, including 195 paediatric and 225 adult patients diagnosed and treated with intensity-modulated radiotherapy (IMRT) at Sun Yat-sen University Cancer Centre (SYSUCC) between 2011 and 2015. Data on clinical factors and EORTC QLQ-C30 were collected from all participants. The QoL of paediatric and adult NPC survivors was compared. Results The paediatric group had significantly better outcomes in global health status (paediatric: 80.2 ± 12.7; adult: 77.2 ± 11.5; P  = 0.027), physical function (paediatric: 98.5 ± 4.6; adult: 95.1 ± 7.0; P  < 0.001), role function (paediatric: 97.0 ± 9.2; adult: 90.5 ± 15.2; P  < 0.001), social function (paediatric: 96.0 ± 8.9; adult: 93.5 ± 11.8; P  = 0.038), insomnia (paediatric: 1.9 ± 7.8; adult: 13.1 ± 22.3; P  < 0.001), constipation (paediatric: 1.3 ± 7.5; adult: 8.0 ± 17.4; P  < 0.001), diarrhea (paediatric: 0.7 ± 4.6; adult: 2.8 ± 9.3; P  = 0.010), and financial difficulties (paediatric: 1.9 ± 7.8; adult: 11.0 ± 19.8; P  < 0.001), but poorer cognitive function (paediatric: 88.3 ± 9.9; adult: 93.8 ± 12.6; P  < 0.001) than the adult group. Pretreatment clinical factors, including T stage, N stage, and pre-treatment EBV (Epstein-Barr Virus) DNA, showed a strong association with QoL. However, the factors that affected the QoL outcomes differed between the two groups. In survivors of paediatric cancer, global health status/QoL was strongly correlated with T stage ( P  < 0.001) and clinical stage ( P  = 0.018), whereas it was strongly correlated with pre-treatment EBV DNA ( P  = 0.008) in adults. Conclusion Paediatric survivors of NPC have a significantly better QoL than adult NPC survivors. Moreover, pre-treatment T stage, N stage, and EBV DNA significantly influenced the overall health status of the survivors. These results highlight the need to tailor care to both age groups to promote better long-term health outcomes.

Transformerless photovoltaic (PV) inverters are widely used in grid-connected solar energy systems due to their high efficiency and compact design. However, conventional transformerless inverters suffer from oscillating common-mode voltage (CMV), which leads to higher common-mode leakage current (CM-LC) due to the lack of galvanic isolation. This issue adversely affects system performance, safety, and compliance with grid standards. To address these challenges, this paper proposes a novel H6 Neutral Point Clamped (NPC) transformerless inverter topology, termed the H6-Diode (H6-D) topology, which integrates the advantages of AC-bypass low-loss switching and common-mode leakage current (CM-LC) elimination. The proposed topology features a clamping circuit that restricts the freewheeling voltage to half of the DC-link voltage, effectively minimizing CM-LC. The theoretical framework of the proposed design is rigorously validated through comprehensive simulations in MATLAB/Simulink and experimental verification using a laboratory prototype. The performance of the proposed inverter is evaluated based on key criteria, including common-mode voltage (CMV), common-mode leakage current (CM-LC), total harmonic distortion (%THD), switching and conduction losses, and overall efficiency. Compared to recent transformerless inverter topologies, the proposed H6-D topology demonstrates superior performance, achieving higher efficiency, lower THD, reduced voltage stress across components, and effective suppression of CM-LC. These results highlight its potential as a promising solution for high-performance grid-connected photovoltaic (PV) applications.

Background: Nasopharyngeal cancer (NPC) is a type of malignancy that is highly prevalent in Asian countries. Therefore, an understanding between NPC epidemiological trend, the clinico-pathological and aetiological profiles are needed. This systematic review focuses on asian countries demographic and clinico-pathological presentation reported in 9982 NPC cases diagnosed from the year 2010 to 2021. Methodology: Data were extracted from databases, such as PubMed, Springer Link, Science Direct, Google Scholar and general search engines, by using pre-determined keywords (e.g. clinico-pathological data, age, sex, tumour stage, nasopharyngeal cancer, nasopharyngeal carcinoma, naso-pharynx and cancer in Asia). Results and Conclusion: Findings from our systematic review shows that from 2010 to 2021, males in age range below 50 years old are at a higher risk of developing NPC in Asia. NPC is mostly diagnosed at advanced stage in Asia, which is likely due to the deep-seated location of the cancer. Type III NPC and EBV proteins (EBNA1 and LMP2A) are frequently associated with reported EBV-positive NPC cases in Asian countries. Meanwhile, NPC type I, II, and III are associated with EBV-negative NPC cases in Asia. Human leucocyte antigen (HLA) alleles (A2, B27, and B46) are frequently present in reported EBV-negative NPC cases in Asia. In Asia, males below 50 years old are more prone to NPC and often diagnosed at late stage. EBV-positive and EBV-negative NPC in Asia have unique histological profiles. Systemic approach of this study may help to provide better knowledge on reported NPC cases especially on the risk factors and clinical presentation focusing in Asian countries.

Lithium-ion (Li-ion) batteries have been competitive in Electric Vehicles (EVs) due to their high energy density and long lifetime. However, there are still issues, which have to be solved, related to the fast-charging capability of EVs. The pulsed current charging technique is expected to improve the lifetime, charging speed, charging/discharging capacity, and the temperature rising of Li-ion batteries. However, the impact of the pulsed current parameters (i.e., frequency, duty cycle, and magnitude) on characteristics of Li-ion batteries has not been fully understood yet. This paper summarizes the existing pulsed current modes, which are positive Pulsed Current Mode (PPC) and its five extended modes, and Negative Pulsed Current (NPC) mode and its three extended modes. An overview of the impact of pulsed current techniques on the performance of Li-ion batteries is presented. Then the main impact factors of the PPC strategy and the NPC strategy are analyzed and discussed. The weight of these impact factors on lifetime, charging speed, charging/discharging capacity, and the temperature rising of batteries is presented, which provides guidance to design advanced charging/discharging strategies as well as to determine future research gaps.

Purpose Malnutrition is highly prevalent in head and neck cancer (HNC) patients, with weight loss being one of the major nutritional indicators. The objective of this study was to investigate the impact of weight loss on treatment interruptions and unplanned hospital admissions in HNC patients undergoing radiotherapy (RT) with or without chemotherapy. Methods In this retrospective cohort study, consecutive HNC patients who started RT between January 2011 and December 2019 were included. Data from a total of 1086 subjects with 747 (68.8%) nasopharyngeal carcinomas (NPCs) and 31.2% ( N =339) non-NPC patients were analysed. Body weight (BW) was measured before, during, and after RT treatment. Factors associated with ≥10% weight loss, treatment interruption, and unplanned admissions were analysed using multivariate logistic regression. Results The prevalence of ≥10% weight loss was 26.8% ( N =288), with 32.7% ( N =243) in NPC and 13.5% ( N =45) in non-NPC patients. The prevalence of RT delay in patients with ≥10% vs. <10% weight loss was 6.2% vs. 7.0% ( p =0.668) in NPC patients and 42.2% vs. 50.5% ( p =0.300) in non-NPC patients. The prevalence of unplanned admissions in patients with ≥10% vs. <10% weight loss was 51.9% vs. 25.3% ( p <0.001) in NPC patients and 68.9% vs. 27.0% ( p <0.001) in non-NPC patients. Conclusion In our study, ≥10% weight loss was found to be associated with a higher rate of unplanned admissions but not with RT delay or chemotherapy interruption. Clinical implications: With the knowledge of the impact of weight loss on hospital admissions and the characteristics of patients with weight loss, nutritional intervention can be effectively focused on the stratification of patients for intensive nutritional support to reduce weight loss.

This study was conducted to analyze the comparative advantage and competitiveness of wheat crop and its implications for resource allocation towards competing crops. The extent of policy distortion and agricultural protection was also determined by the study. The data were collected from APCom on cost of production of wheat crop over the three year period (2001-2003). Two main provinces contributing towards wheat production i.e. Punjab and Sindh were selected as the sample. This data were then averaged to obtain a national scenario. The crop budgets were prepared initially in financial terms and later on economic prices were utilized to evaluate the comparative advantage and competitiveness of the wheat crop. The Policy Analysis Matrix (PAM) was selected as the analytical framework. The policy distortions were measured through Nominal Protection Coefficient (NPC) and Effective Protection Coefficient (EPC). The Domestic Resource Cost ratio (DRC) was selected as a measuring tool for comparative advantage. Keeping in view the importance of wheat in the economy, the analysis was conducted in two price regimes i.e. import and export parity prices. The analysis results showed that at import parity price Pakistan has a comparative advantage in the production of wheat only as an import substitution crop. At export parity price, Pakistan is not competitive in the world wheat market and has no comparative advantage in wheat production.

Niemann-Pick Type C (NPC) is a progressive and life limiting autosomal recessive disorder caused by mutations in either the NPC1 or NPC2 gene. Mutations in these genes are associated with abnormal endosomal-lysosomal trafficking, resulting in the accumulation of multiple tissue specific lipids in the lysosomes. The clinical spectrum of NPC disease ranges from a neonatal rapidly progressive fatal disorder to an adult-onset chronic neurodegenerative disease. The age of onset of the first (beyond 3 months of life) neurological symptom may predict the severity of the disease and determines life expectancy. NPC has an estimated incidence of ~ 1: 100,000 and the rarity of the disease translate into misdiagnosis, delayed diagnosis and barriers to good care. For these reasons, we have developed clinical guidelines that define standard of care for NPC patients, foster shared care arrangements between expert centres and family physicians, and empower patients. The information contained in these guidelines was obtained through a systematic review of the literature and the experiences of the authors in their care of patients with NPC. We adopted the Appraisal of Guidelines for Research & Evaluation (AGREE II) system as method of choice for the guideline development process. We made a series of conclusive statements and scored them according to level of evidence, strengths of recommendations and expert opinions. These guidelines can inform care providers, care funders, patients and their carers of best practice of care for patients with NPC. In addition, these guidelines have identified gaps in the knowledge that must be filled by future research. It is anticipated that the implementation of these guidelines will lead to a step change in the quality of care for patients with NPC irrespective of their geographical location.

Disulfiram/copper (DSF/Cu) is a promising antitumor reagent for clinical application due to its excellent anticancer activity and safety. However, the anticancer mechanism of DSF/Cu has not been fully elucidated. Our study showed that DSF/Cu strongly induced cytotoxic effects on both nasopharyngeal carcinoma (NPC) cells and α-smooth muscle actin (α-SMA)-positive fibroblasts. Fluorescence activated cell sorting (FACS) analysis further showed that DSF/Cu induced a higher late apoptosis rate in α-SMA-positive fibroblasts than in tumor cells, and DSF/Cu promoted apoptosis and necrosis by an aldehyde dehydrogenase (ALDH)-independent method. Furthermore, we found that the antitumor activity of DSF/Cu against NPC cells occurred through ROS/MAPK and p53-mediated ferroptosis pathways, and that the ROS scavenger N-acetyl-l-cysteine (NAC) could reverse the cellular and lipid ROS levels. In 5-8F xenografts, both TUNEL and immunohistochemical (IHC) analyses indicated that DSF/Cu could induce apoptosis and inactivate cancer-associated fibroblasts (CAFs) by inhibiting the expression of α-SMA. In addition, combined with cisplatin (CDDP), DSF/Cu was well tolerated in vivo and could significantly suppress the growth of NPC tissues. Our study demonstrated that DSF/Cu induced antitumor activity against both tumor cells, as well as CAFs and suggested that the use of DSF/Cu as an adjunctive therapy for NPC is worthy of consideration.

Wide bandgap (WBG) power devices such as silicon carbide (SiC) can viably supply high speed electrical drives, due to their capability to increase efficiency and reduce the size of the power converters. On the other hand, high frequency operation of the SiC devices emphasizes the effect of parasitics, which generates reflected wave transient overvoltage on motor terminals, reducing the life time and the reliability of electric drives. In this paper, a SiC metal-oxide-semiconductor field-effect transistor (MOSFET) based two level (2L) inverter is systematically studied and compared to the performance of Si insulated-gate bipolar transistor (IGBT) based three level (3L) neutral point clamped (NPC) inverter topologies, for high speed AC motor loads, in terms of efficiency, overvoltages, heat sink design, and cost. A fair comparison was introduced for the first time, having the same output voltage capabilities, output current total harmonic distortion (THD), and overvoltages for the three systems. The analysis indicated the convenience of using the SiC MOSFET based 2L inverter for lower output power. In the case of the maximum output power, the heat sink volume was found to be 20% higher for the 2L SiC based inverter when compared to 3L NPC topologies. Simulations were carried out by realistic dynamic models of power switch modules obtained from the manufacturer’s experimental tests and verified both in the LTspice and PLECS simulation packages.

Background: Afatinib, a second-generation tyrosine kinase inhibitor (TKI), exerts its radiosensitive effects in nasopharyngeal carcinoma (NPC). However, the detailed mechanism of afatinib-mediated sensitivity to radiation is still obscure in NPC. Methods: Quantitative phosphorylated proteomics and bioinformatics analysis were performed to illustrate the global phosphoprotein changes. The activity of the CD44-Stat3 axis and Epithelial-Mesenchymal Transition (EMT)-linked markers were evaluated by Western blotting. Wound healing and transwell assays were used to determine the levels of cell migration upon afatinib combined IR treatment. Cell proliferation was tested by CCK-8 assay. A pharmacological agonist by IL-6 was applied to activate Stat3. The xenograft mouse model was treated with afatinib, radiation or a combination of afatinib and radiation to detect the radiosensitivity of afatinib in vivo. Results: In the present study, we discovered that afatinib triggered global protein phosphorylation alterations in NPC cells. Further, bioinformatics analysis indicated that afatinib inhibited the CD44-Stat3 signaling and subsequent EMT process. Moreover, functional assays demonstrated that afatinib combined radiation treatment remarkably impeded cell viability, migration, EMT process and CD44-Stat3 activity in vitro and in vivo. In addition, pharmacological stimulation of Stat3 rescued radiosensitivity and biological functions induced by afatinib in NPC cells. This suggested that afatinib reversed the EMT process by blocking the activity of the CD44-Stat3 axis. Conclusion: Collectively, this work identifies the molecular mechanism of afatinib as a radiation sensitizer, thus providing a potentially useful combination treatment and drug target for NPC radiosensitization. Our findings describe a new function of afatinib in radiosensitivity and cancer treatment.