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Standard of care (SoC) for resectable locally advanced head and neck squamous cell carcinoma (LA-HNSCC) is surgery with adjuvant radiotherapy (RT) or chemoradiotherapy (for tumors at high risk of recurrence). As long-term prognosis is suboptimal with SoC, this study aimed to summarize findings from recent studies comparing alternative treatments to SoC. A broad systematic literature review (search date: December 1, 2025) searched Embase, MEDLINE, and CENTRAL to identify randomized controlled trials evaluating surgery with RT and/or systemic treatments in the neoadjuvant and/or adjuvant setting in LA-HNSCC. Trials published since 2004 were included in this report if they compared interventions to SoC in terms of event-free survival (EFS) and overall survival (OS) or reported pathological response following neoadjuvant therapy. Fifty-six trials were included in the broader review, of which 25 were included in this report. Trials reporting EFS counted at least recurrence/progression and death as events, except one that did not provide a definition. Improvement in EFS (regardless of definition) was reported with the addition of perioperative pembrolizumab or addition of perioperative camrelizumab with neoadjuvant nab-paclitaxel + carboplatin to surgery + RT ± cisplatin, addition of adjuvant cetuximab or adjuvant cisplatin to surgery + RT, and addition of adjuvant nivolumab to surgery + RT + cisplatin. EFS with other interventions was comparable to SoC. OS was generally comparable between interventions and SoC. Across treatment arms with at least one neoadjuvant chemotherapy agent, pathological complete response rates ranged from 10.5% to 42.6% while it ranged from 0 to 12.9% in treatment arms without any neoadjuvant chemotherapy agent. Some trials reported an association between achieving pathological response and improved survival outcomes in exploratory analyses. Immunotherapy shows promise as an addition to the SoC in LA-HNSCC. OS results are generally comparable and may still be immature in some trials. Evidence on pathological response suggests potential prognostic value for long-term survival outcomes. People with head and neck squamous cell carcinoma that is locally advanced but still able to be removed with surgery are usually treated with surgery followed by radiotherapy. If the tumor has a high risk of coming back, doctors also add chemotherapy to the radiotherapy. Because long-term outcomes remain disappointing with this usual treatment (the standard of care), we reviewed recent randomized controlled trials that tested other options. We searched major databases up to December 1, 2025 to identify trials published since 2004 that compared new approaches with the standard of care and reported event-free survival (time until the cancer returns, worsens, or the patient dies) and overall survival (time alive), or reported tumor response following treatments given before surgery. Our review identified 25 trials that were suitable for inclusion in this report. Some treatments improved event-free survival, including pembrolizumab and camrelizumab (both help the immune system attack cancer) given before and after surgery with radiotherapy and chemotherapy, cetuximab or cisplatin given after surgery with radiotherapy, and nivolumab given after surgery with radiotherapy and chemotherapy. Overall survival was similar between the tested treatments and the standard of care. When chemotherapy was given before surgery, complete disappearance of tumor cells in the removed tissue occurred more often (10.5–42.6%) than when it was not (0–12.9%). Some studies also suggested that better pathological response may result in better long-term outcomes. Overall, immunotherapy appears to be a promising addition to the standard of care, and pathological response may help predict long-term survival.

While data fitting is extensively used in polymer processing to extract fundamental rheological properties, its application for direct macroscopic geometric transfer between complex operational dies remains largely unexplored. Optimizing extrusion dies for corrugated plastic pipes traditionally requires time-consuming offline laboratory rheology, creating a major development bottleneck when dealing with proprietary, undocumented blends. To address this gap, this study introduces a novel, data-driven protocol for predicting the die pressure drop that eliminates the need for independent laboratory rheometry. Unlike traditional in situ methods that seek pure material properties, our approach back-calculates lumped, effective Power Law parameters directly from macroscopic pressure drops of existing converging dies. This uniquely embeds both material and geometric flow characteristics under actual processing conditions. Experimental validation demonstrates that this workflow, supported by an iterative refinement strategy, yields prediction errors typically within 10%. Ultimately, this lightweight computational tool provides engineers with a rapid-iteration framework to significantly accelerate early-stage die design.

Every 2 minutes, a woman dies from cervical cancer, resulting in over 300 000 preventable deaths globally. Nearly all cervical cancers are caused by human papillomavirus (HPV) and are preventable with HPV vaccination and screening through Papanicolaou (Pap) and HPV tests. In Canada, cervical cancer mortality rates have declined in recent decades with more accessible cervical cancer screening programmes. However, screening rates remain low, particularly among Black women and people with a cervix (WPC).Cervical cancer screening studies of Black WPC in Ontario-Canada's most populous province-are limited. These studies indicate Black WPCs are at elevated risk for under-screening, with many overdue for screening.An innovative approach to begin addressing delays is HPV self-sampling (HPVSS). Self-sampling is a cost-effective and more accurate test for detecting high-risk HPV infections associated with precancerous changes versus the Pap test. Self-sampling supports Canada's action plan-a response to WHO's global strategy-to eliminate cervical cancer by 2040.Despite Canada's plan, research on the state of Black WPCs' HPV knowledge and self-sampling interventions tailored to them is scant. These scarcities are concerning as Ontario plans to implement HPV primary screening and offer HPVSS soon.The study objective is to codevelop an HPVSS intervention tailored for and made by Black WPC in Peel region, Ontario. This protocol focuses on phase one of a two-phased study. In phase one, a qualitative, community-informed approach, co-led by community research assistants, will be used to purposively recruit 10 service providers (eg, clinicians, social workers, community care workers) and 40 Black WPC who will undergo one-on-one semistructured interviews and sociodemographic surveys to explore the state of: (1) Black WPC's level of HPV, cervical cancer and cervical cancer screening knowledge; (2) Black WPC's motivators, beliefs, attitudes and misconceptions towards HPVSS; (3) Black WPC's perceived barriers and facilitators to HPVSS and (4) service providers' perspectives on Black WPC's barriers and facilitators to HPVSS. Charmaz's grounded theory approach and intersectionality will guide data collection and analysis. Ethical approval has been obtained from the Trillium Health Partners Research Ethics Board (ID#1207). Study findings will be disseminated through community healthcare events, conference presentations, peer-reviewed publications and virtual and physical pamphlets. Additionally, summaries of the findings will be shared and tailored to collaborators, healthcare leadership and researchers and community health centres. Wide dissemination will help enhance understanding of the state of cervical cancer screening, HPV and HPVSS among Black WPC. Given Canada's commitment to eliminating cervical cancer, study findings will be used to begin developing an HPVSS intervention for Black communities.

Data routing protocols play a vital role in Wireless Sensor Networks (WSNs). However, large network sizes and constrained resources demand more energy-efficient routing strategies. In this context, conventional routing protocols often show weak load balancing and inefficient energy use. Low-Energy Adaptive Clustering Hierarchy (LEACH) and Low-Energy Adaptive Clustering Hierarchy Centralized (LEACH-C) remain the two most widely adopted hierarchical routing protocols in WSNs. LEACH operates as a non-geographic distributed routing protocol, whereas LEACH-C is a geographic-based centralized routing protocol. Compared with flat routing protocols, both can prolong network lifetime, but they still suffer from limited energy efficiency. To address this limitation, we in this research proposed an enhanced LEACH protocol based on cluster configuration and Quantum Beluga Whale Optimization (QBWO-LEACH). During the setup phase, the central base station (BS) employs the proposed QBWO approach, which integrates Beluga Whale Optimization (BWO) with the strengths of quantum computing, to centrally organize the clusters. This process includes determining the cluster centroids, assigning cluster members, and evaluating cluster energy, cluster priority, and cluster lifetime. In the cluster heads (CHs) rotation phase, local clusters use the position and energy information of all cluster members to perform distributed CHs switching, distributing cluster energy approximately evenly among all members. In the steady-state phase, the relay forwarding of monitored data flows is implemented. Compared with traditional LEACH and other improved variants of the LEACH protocols, the comprehensive performance of the protocol proposed in the present research is found to be superior. We compare our proposed QBWO-LEACH with the existing LEACH protocols in terms of node survival, network residual energy, half node dies (HND), last node dies (LND), and first node dies (FND), in all four cases using both simulation and statistical analysis. QBWO-LEACH demonstrates an average improvement of 51.87% over LEACH, 17.69% over Particle Filter LEACH (PF-LEACH) and 4.31% over a 2-stage Genetic Algorithm-based LEACH (GA2-LEACH) in node survival and network residual energy in all four cases.

Full-coverage restorations are often required for primary molars with extensive carious destruction. Stainless steel crowns remain the long-standing reference, while prefabricated zirconia and polymer-based crowns have become tooth-colored alternatives. Direct comparisons under a single thermomechanical protocol, with separate wear and fracture cohorts, remain limited. This in vitro study quantified post-aging occlusal wear and compressive fracture load in four prefabricated crown systems for mandibular second primary molars. Eighty crowns were tested, with 10 specimens per material for each outcome: two prefabricated zirconia crowns, one polymer-based crown, and one stainless steel crown. Identical resin dies were 3D-printed and all crowns were luted with glass-ionomer cement. All specimens underwent 10,000 thermal cycles between 5&#xa0;&#xb0;C and 55&#xa0;&#xb0;C. The wear cohort underwent 150,000 chewing cycles at 50 N and 1.2&#xa0;Hz, and wear was scored on a 0-3 scale by two blinded examiners. The fracture cohort was loaded to failure. Wear scores were compared using Kruskal-Wallis and Dunn-Bonferroni tests; fracture loads were analyzed using one-way ANOVA and Tukey HSD. Mean wear scores were 1.1&#x2009;&#xb1;&#x2009;0.3 for NuSmile, 1.2&#x2009;&#xb1;&#x2009;0.4 for ProfZr, 1.7&#x2009;&#xb1;&#x2009;0.4 for SSC, and 2.2&#x2009;&#xb1;&#x2009;0.4 for BioFlx. The zirconia groups did not differ significantly (p&#x2009;=&#x2009;0.68), whereas both showed lower wear scores than SSC (p&#x2009;=&#x2009;0.04) and BioFlx (p&#x2009;=&#x2009;0.01). SSC also showed lower wear scores than BioFlx (p&#x2009;=&#x2009;0.03). Mean fracture loads were 3148.4&#x2009;&#xb1;&#x2009;643.4 N for BioFlx, 2703.4&#x2009;&#xb1;&#x2009;243.1 N for SSC, 1076.1&#x2009;&#xb1;&#x2009;186.9 N for NuSmile, and 565.5&#x2009;&#xb1;&#x2009;159.6 N for ProfZr (p&#x2009;<&#x2009;0.001). BioFlx and SSC did not differ significantly (p&#x2009;=&#x2009;0.093), while both exceeded the zirconia groups (p&#x2009;<&#x2009;0.001). NuSmile exceeded ProfZr (p&#x2009;=&#x2009;0.043). Under this in vitro model, zirconia crowns showed the lowest wear scores, whereas BioFlx and SSC showed the highest fracture loads. Each material demonstrated a distinct mechanical profile. Laboratory rankings alone should not guide clinical recommendations; long-term clinical studies are needed.

This paper investigates an integrated blank separation process combining cutting and plastic deformation (longitudinal upsetting) to ensure high volumetric and geometric accuracy. The relevance of the study stems from the need to produce high-quality blanks for cold forging and extrusion, where simple blanks made from long rolled products often exhibit unacceptable dimensional deviations. Based on 3D finite element modeling in DEFORM software and experimental studies, an optimal two-support cutting scheme was determined. Unlike cantilever (single-support) cutting, this scheme creates oppositely directed inclination angles at the ends of the blank, minimizing their axial displacement and preventing loss of stability during subsequent upsetting. A key feature of the proposed method is the use of elastic press unloading energy, which is typically considered &#xab;detrimental&#xbb; due to the vibrations and impact loads it imposes on the equipment. The authors demonstrated that this energy can be redirected to perform useful work during plastic forming. Calculations and experiments showed that the work required for double-sided cutting is approximately 53% of that required for longitudinal upsetting. This energy is sufficient to correct the shape of the workpiece; however, achieving high accuracy requires the use of additional energy sources in modernized presses with combined dies. As a result of the research, a die design was developed and proposed that implements an integrated cutting and longitudinal upsetting process. This design ensures high geometric accuracy of workpieces, increased process productivity, and improved operational reliability of the pressing equipment.

This longitudinal qualitative study, encompassing nearly three decades, evolved from interviews with the "Suzuki" couple conducted for my PhD thesis in the period 1992-1997. Following Mr. Suzuki's death in1997, the aim was to follow turning points and crises in Ms. Suzuki's life and show how she handled them in relation to how she wanted to live her life as an aging (widowed) woman in the Japanese society in transition. The empirical material consists of written notes from our conversations. The findings are described as a 'field note narrative'. The analysis of the ongoing process of life storytelling, in which past, present and future were intertwined, was guided by narrative gerontology and autoethnography, as I was a co-creator of her story. The narrative is sorted into three chronological phases: 1) Mr. Suzuki dies; Ms. Suzuki lives alone, actively maintaining her way of life. 2) Continuation of Ms. Suzuki's lifestyle, with signs of forgetfulness. 3) Ms. Suzuki visits a 'day service' regularly, finally moving to a care home, where she dies in 2021. The story of Ms. Suzuki, who is an active agent in how she presents and positions herself, is discussed in terms of narrative learning and integrative life storytelling. Through her long-term narrative process, the unique dynamics of an aging woman emerge - one who, respectfully supported by her children, boldly pursues individual choices, learning and meaning-making, even when dementia becomes evident.

As a typical Cr-Mo-V series hot work die steel, H13 steel is widely used in hot extrusion dies under harsh service conditions. Tempering is a vital post-quenching process for regulating microstructural evolution and comprehensive mechanical properties. Since relevant systematic comparative studies remain insufficient, industrial-grade H13 steel was adopted in this work. Specimens were quenched at 1000 &#xb0;C, followed by single tempering at 520 &#xb0;C and double tempering at 580 &#xb0;C. Their microstructure, microhardness, and wear resistance at 25 &#xb0;C and 580 &#xb0;C were characterized, and the underlying mechanisms were analyzed. The results show that single tempering at 520 &#xb0;C produces tempered martensite and finely dispersed carbides with secondary hardening behavior. Its microhardness reaches 590.83 HV, resulting in the best wear resistance at both room and high temperatures. Double tempering at 580 &#xb0;C causes carbide coarsening, and the microhardness slightly declines to 580.60 HV. Although toughness is enhanced and residual stress is fully released, wear resistance deteriorates. This study optimizes the tempering parameters for H13 steel, provides technical support for die production, and offers theoretical guidance for the technical upgrading of the hot work die steel industry.

Seasonal forage scarcity and elevated feed costs necessitate sustainable alternatives to conventional ruminant diets. This study evaluated urea-molasses-treated crop residues as alternative to corn silage in Sahiwal calf dies, focusing on growth performance, nutrient digestibility, and economic efficiency. Sixteen calves (124&#x2009;&#xb1;&#x2009;12&#xa0;kg BW; 12-14 months old) were randomly assigned to four dietary treatments (n&#x2009;=&#x2009;4 per treatment) for 85 days: corn silage (Ctrl, T1), treated corn stover (CS, T2), treated rice straw (RS, T3) and treated corn cobs (CC, T4). All diets were supplemented with concentrate at 1.20% BW on a dry matter basis. Treated residues showed higher crude protein contents (9.01-10.12% of DM) due to ammonization, though preservation occurred through alkaline stabilization (pH 8.11-8.21) rather than lactic acid fermentation characteristic of conventional silage. Growth performance differed significantly (p&#x2009;<&#x2009;0.01) among treatments. Average daily gain (ADG) was 0.81, 0.71, 0.63, and 0.54&#xa0;kg/day, while feed conversion ratio (FCR) was 6.22, 6.61, 7.48, and 8.00&#xa0;kg/kg for T1-T4, respectively. Calves fed treated corn stover (T2) achieved ADG statistically equivalent to Ctrl (p&#x2009;=&#x2009;0.32), representing a non-inferiority margin of 12.3%. Despite slightly lower growth performance, T2 generated 25.22% and T3 12.61% higher economic return per kg gain than T1, although market weight was reached later (107, 120 vs. 94 days), an important consideration for capital turnover in commercial operations. Nutrient digestibility and nitrogen retention were lowest (p&#x2009;<&#x2009;0.05) in calves fed treated corn cobs (T4), likely due to higher lignin and ash contents. Overall, corn stover (T2) offers the best balance between performance and profitability, the urea-molasses-treated corn stover (T2) provided the optimal trade-off between growth performance (87.7% of Ctrl ADG) and feed cost reduction (29.6% lower cost/kg gain). These findings indicate that treated corn stover and to less extent rice straw is a practical feeding option for resources-limited livestock systems, although extended feeding periods require careful cash-flow planning and capital turnover management.

Engineering microbial consortia to perform robust population-level computations requires principled ways to achieve majority consensus in the presence of multiscale stochasticity. We develop a hybrid framework that couples time-varying intracellular gene-expression dynamics, including burst-like jump noise, to population-level birth, death, and collision reactions through the random time-change representation. Birth and death hazards are allowed to depend on evolving intracellular states through bounded hazard maps, while interspecific collisions are modeled by biologically interpretable SD or NSD encounter rules. The construction uses instantaneous hazard integrals, rather than frozen-rate SSA propensities, so that reaction times remain consistent with continuously evolving intracellular states. Under explicit bounded-per-capita hazard assumptions, we prove order-wise sufficient majority thresholds for two biologically motivated collision rules. With self-destructive collisions, where one cell of each species is removed per encounter, a new potential-supermartingale argument controls temporary excursions of the minority population above a given level and shows that only O(log&#x2009;n) non-collision events occur before consensus with high probability. Consequently, an &#x3a9;(log&#x2009;n) initial gap suffices for correctness with high probability. With non-self-destructive collisions, where only one side dies per encounter, the species-count difference after subtracting its predictable drift is a bounded-increment martingale at embedded gap-changing reaction times. Thus, if the number of such steps is O(nlog&#x2009;n) with high probability and the predictable drift is neutral or favorable to the initial majority, an &#x3a9;(nlogn) initial gap suffices. Heavy-tailed intracellular fluctuations alter event timing and consensus-time distributions, but not these order-wise sufficient gap scales, provided hazard maps are bounded. We also establish non-explosion of the hybrid process, clarify the distinction between the exact random-time-change model and numerical simulation, and treat representative-pool hazard approximations as simulation accelerations rather than assumptions used in the proofs. Expanded numerical diagnostics test the SD non-collision bound, the NSD step-count assumption, multi-size NSD normalized transitions, heavy-tail versus light-tail ablations, representative-pool accuracy, and thinning acceptance rates. The result is an assumption-transparent mathematical and computational framework for majority-like decision making in noisy synthetic microbial consortia.

Education is a well-established determinant of lifespan and mortality risk. Individuals with lower education levels experience higher mortality from nearly all causes. Yet since everyone ultimately dies from some condition, how does education affect the causes of death? We show that the distribution of causes of death is remarkably similar across education levels in both Denmark and the United States. Despite notable differences in age at death between education groups, the underlying and contributing conditions leading to death remain consistent across education levels. These findings indicate that education mainly influences when people die, not what they die from.

Advanced packaging devices integrate multiple heterogeneous materials and components (e.g., mold compounds, redistribution/interposer structures, stacked memory, and logic dies) into compact assemblies whose failures can propagate into high-impact system-level outages. High-resolution, layer-by-layer 3D imaging is therefore essential for (i) failure analysis (FA) and root-cause determination, (ii) verification and validation (V&V) via as-designed versus as-built comparison, and (iii) security-focused inspection aimed at identifying unintended or malicious structural modifications. However, conventional approaches-mechanical polishing, chemical etching, and focused ion beam (FIB) delayering-are often slow, limited in precision, inconsistent over large areas, or difficult to scale for systematic workflows. In this work, we have shown that laser delayering can promise an effective alternative that is simultaneously fast and precise. Here, we demonstrate an integrated femtosecond-laser workflow for advanced package-on-package deprocessing that combines decapsulation, DRAM/component removal, sequential redistribution-layer exposure and removal, and targeted logic-die cross-sectioning on a single laser-processing platform. Process outcomes were validated using laser-scanning confocal microscopy for high-fidelity surface topography and scanning electron microscopy (SEM) for microstructural assessment. The results demonstrate a practical, rapid, and reproducible pathway for advanced-package system deconstruction and design reconstruction workflows supporting FA, V&V, and hardware assurance.