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Objective: Rare disease. Background: Small cell carcinoma is an aggressive malignant neuroendocrine tumor that most commonly occurs in the lung. Primary small cell carcinoma of the esophagus (PSCCE) is rare and is an aggressive malignancy with poor prognosis and no clear management guidelines. This report describes the case of a 36-year-old man presenting with epigastric pain, dysphagia, and melena due to a primary esophageal small cell carcinoma. Case Report: A 36-year-old presented to the Emergency Department (ED) with epigastric pain associated with food intake. Initial workup was unremarkable, and a presumed clinical diagnosis of reflux esophagitis and peptic strictures was made, prompting empiric treatment with anti-secretory therapies. Despite these therapies, he presented to the emergency room with progressively worsening dysphagia. Endoscopic examination (EGD) revealed a large necrotic mass, and computed tomography (CT) imaging revealed liver metastasis. Biopsies from both the liver and esophageal masses confirmed small cell carcinoma. His clinical course was complicated by a broncho-esophageal fistula, leading to massive hemoptysis, necessitating intubation. Unfortunately, his condition deteriorated rapidly, and he chose to pursue hospice care. He died 3 months after his initial presentation. Conclusions: This report has presented a rare case of primary esophageal small cell carcinoma and our approach to management. We highlight the importance of early diagnosis, supported by histopathology, and the need for management guidelines. [ABSTRACT FROM AUTHOR]

Small cell neuroendocrine carcinoma of the cervix (SCNCC) is prone to lymphatic metastasis in the early stage, unique pathological manifestations, easy to recur, and poor prognosis. Data from one case of SCNCC (stage ⅢC1r) is reported. The patient presented with intermittent vaginal bleeding with lower abdominal pain for more than 1 month. Combined with the results of pelvic magnetic resonanace imaging (MRI), total abdominal CT and hysteroscopy with endometrial biopsy, it was diagnosed as SCNCC at ⅢC1r stage. According to the 2022 National Comprehensive Cancer Network (NCCN) guidelines, the patient was given 3 cycles of neoadjuvant chemotherapy (carboplatin plus etoposide neoadjuvant), followed by laparoscopic extensive hysterectomy plus bilateral oophorectomy plus bilateral salpingectomy plus pelvic lymph node dissection plus abdominal para-aortic lymphadenectomy plus antitumor drug intraperitoneal perfusion therapy (nidaplatin flushing the abdominal cavity) plus bilateral ureteral stent implantation. After surgery, the patient was given 3 cycles of chemotherapy again. No recurrence was seen in 13 months of postoperative follow-up. [ABSTRACT FROM AUTHOR]

Background: Large cell neuroendocrine carcinoma (LCNEC) of the lung is a rare, aggressive cancer most commonly found in the lungs but not exclusively, with a worse prognosis than non-small cell lung carcinomas. Currently, LCNEC patients are treated using small cell and non-small cell protocols. This study aims to use the SEER database to identify demographic, clinical, pathological, and therapeutic factors affecting the prognosis and survival of patients with LCNEC of the lung. Methods: Demographic, clinical, and management data of patients with lung LCNEC were extracted from the SEER database for the period 2000–2018. Results: In the USA, LCNEC has a higher incidence in elderly white men: M:F ratio = 1.2:1, Caucasian: 83.3%, mean age: 67 ± 10.2 years. The most common treatment modality was chemotherapy only: 29.2%, followed by surgery: 21.5% (but in this group the statuses of chemotherapy were unknown), and combination surgery/chemotherapy: 8.8%. The overall and cause-specific 5-year survival was 17.5% (95% CI 16.3–18.8) and 21.9% (95% CI 20.5–23.4), respectively. By treatment, the best 5-year survival was for surgery alone (48%), followed by multimodality therapy (chemo + surgery + radiation) at 35% (95% CI 27–43). Age > 60 years, male gender, size > 7 cm, and nodal and liver metastasis were independent risk factors associated with increased mortality. Conclusion: Lung LCNEC is an aggressive neoplasm most common in older white males that presents at an advanced stage despite small primary tumors. Most patients die within 2 years. The best predictor of survival is surgery with chemotherapy. Given its dismal prognosis, new treatment guidelines are needed for this aggressive cancer. [ABSTRACT FROM AUTHOR]

Interference alignment (IA) ideas have been used into wireless communication in recent years to increase network users' capacity, sum rate, and spectral efficiency. This manuscript presents a multi-variate clustering (MC) for small-cell user communications through dynamic interference alignment (DIA). The clustering and interference alignment process focuses on retaining cluster stability and communication reliability by mitigating interference that is both intra and inter-cluster. The stability of the cluster is evaluated using the quality factor that is useful in mitigating intrauser interference. The inter-user interference is thwarted by classifying the transmitting signal based on time sequence and processing it through an appropriate cancellation matrix and rank-based analysis. Regardless of the user and cell density, the pre-coding process is based on this rank-based examination of the obtained power. The proposed MC-DIA is capable of handling both intra and inter-cluster interference for the allocated channels in the small cell scenarios. Experimentation results showed that the MC-DIA achieved a spectral efficiency of 84%. The proposed scheme performances are verified utilizing the simulation for metrics sum rate, spectral efficiency, and average degree of freedom (DoF). [ABSTRACT FROM AUTHOR]

Prostate cancer is typically of acinar adenocarcinoma type but can occasionally present as neuroendocrine and/or ductal type carcinoma. These are associated with clinically aggressive disease, and the former often arises on a background of androgen deprivation therapy, although it can also arise de novo. Two prostate cancer cases were sequenced by exome capture from archival tissue. Case 1 was de novo small cell neuroendocrine carcinoma and ductal adenocarcinoma with three longitudinal samples over 5 years. Case 2 was a single time point after the development of treatment-related neuroendocrine prostate carcinoma. Case 1 showed whole genome doubling in all samples and focal amplification of AR in all samples except the first time point. Phylogenetic analysis revealed a common ancestry for ductal and small cell carcinoma. Case 2 showed 13q loss (involving RB1) in both adenocarcinoma and small cell carcinoma regions, and 3p gain, 4p loss, and 17p loss (involving TP53) in the latter. By using highly curated samples, we demonstrate for the first time that small-cell neuroendocrine and ductal prostatic carcinoma can have a common ancestry. We highlight whole genome doubling in a patient with prostate cancer relapse, reinforcing its poor prognostic nature. [ABSTRACT FROM AUTHOR]

Simple Summary: Small cell lung cancer (SCLC) remains a difficult-to-treat disease and is associated with a poor prognosis in most patients. Discovering biomarkers and developing targeted treatment options for patients with SCLC has been challenging though there are emerging therapies that are showing promise. A better understanding of the underlying biology and specific molecular targets in SCLC has led to newer drug strategies and combinations that can hopefully lead to better outcomes for our patients. Small cell lung cancer is an aggressive subtype of lung cancer with limited treatment options. Precision medicine has revolutionized cancer treatment for many tumor types but progress in SCLC has been slower due to the lack of targetable biomarkers. This review article provides an overview of emerging strategies for precision therapy in SCLC. Targeted therapies include targeted kinase inhibitors, monoclonal antibodies, angiogenesis inhibitors, antibody–drug conjugates, PARP inhibitors, and epigenetic modulators. Angiogenesis inhibitors and DNA-damaging agents, such as PARP and ATR inhibitors, have been explored in SCLC with limited success to date although trials are ongoing. The potential of targeting DLL3, a NOTCH ligand, through antibody–drug conjugates, bispecific T-cell engagers, and CAR T-cell therapy, has opened up new therapeutic options moving forward. Additionally, new research in epigenetic therapeutics in reversing transcriptional repression, modulating anti-tumor immunity, and utilizing antibody–drug conjugates to target cell surface-specific targets in SCLC are also being investigated. While progress in precision therapy for SCLC has been challenging, recent advancements provide optimism for improved treatment outcomes. However, several challenges remain and will need to be addressed, including drug resistance and tumor heterogeneity. Further research and biomarker-selected clinical trials are necessary to develop effective precision therapies for SCLC patients. [ABSTRACT FROM AUTHOR]

Plant growth and development rely heavily on cyclins, which comprise an important class of cell division regulators. D-type cyclins (CYCDs) are responsible for the rate-limiting step of G1 cells. In the plant kingdom, despite the importance of CYCDs in herbaceous plants, there is little knowledge of these proteins in perennial woody plants. Here, the gene of a nucleus-localized cyclin, PsnCYCD1;1 , was cloned from Populus simonii × P. nigra. PsnCYCD1;1 was highly expressed in tissues with active cell division, especially the leaf buds, and could be induced by sucrose and phytohormones. Moreover, overexpression of PsnCYCD1;1 in poplar could stimulate cell division, resulting in the generation of small cells and causing severe morphological changes in the vascular bundles, resulting in 'S'-shaped tortuous stems and curled leaves. Furthermore, transcriptomic analysis revealed that endogenous genes related to cell division and vascular cambium development were significantly up-regulated in the transgenic plants. In addition, using yeast two-hybrid and bimolecular fluorescence complementation assays PsnCDKA1, PsnICK3, and PsnICK5 were identified as proteins interacting with PsnCYCD1;1. Our study demonstrates that PsnCYCD1;1 accelerates plant cell division and participates in secondary growth of vascular bundles in poplar. [ABSTRACT FROM AUTHOR]

Metastatic neuroendocrine prostate cancer (NEPC) is a rare, aggressive disease with limited data on secondline treatment. In this retrospective, multi-institutional study, clinical and treatment data were collected for 58 patients with NEPC who received second-line systemic therapy after first-line platinum. Treatments were highly varied but uniformly poor in improving survival. Further study and consensus are needed for second-line NEPC treatment. Background: De novo neuroendocrine prostate cancer (NEPC) and treatment-emergent neuroendocrine prostate cancer (T-NEPC) are rare diseases with a poor prognosis. After first-line platinum chemotherapy, there is no consensus on second-line treatments. Patients and Methods: Patients with a pathologic diagnosis of de novo NEPC or T-NEPC between 2000 and 2020 who received first-line platinum and any second-line systemic therapy were selected and standardized clinical data was collected via the electronic health record at each institution. The primary endpoint was overall survival (OS) based on second-line therapy. Secondary endpoints included objective response rate (ORR) to second-line therapy, PSA response, and time on treatment. Results: Fifty-eight patients (32 de novo NEPC, 26 TNEPC) from 8 institutions were included. At de novo NEPC or T-NEPC diagnosis, the overall cohort had a median age of 65.0 years (IQR 59.2-70.3) and median PSA of 3.0 ng/dL (IQR 0.6-17.9). Following first-line platinum chemotherapy, 21 patients (36.2%) received platinum chemotherapy, 10 (17.2%) taxane monotherapy, 11 (19.0%) immunotherapy, 10 (17.2%) other chemotherapy, and 6 (16.2%) other systemic therapy. Among 41 evaluable patients, the ORR was 23.5%. The mOS after start of second-line therapy was 7.4 months (95% CI 6.1-11.9). Conclusions: In this retrospective study, patients with de novo NEPC or T-NEPC who received second-line therapy were treated with wide variety of treatment regimens, reflecting the lack of consensus in this setting. Most patients received chemotherapy-based treatments. Overall prognosis was poor and ORR was low in the second line regardless of treatment choice. [ABSTRACT FROM AUTHOR]

Concurrent chemoradiotherapy (CRT) is the standard of care for limited-stage small cell lung cancer (LS-SCLC). Local therapy—surgery or stereotactic body radiotherapy (SBRT)—with adjuvant chemotherapy may be appropriate for very early (T1-T2, N0) disease. There is variability in the management of these cases, which may lead to variability in patient outcomes. This study aimed to determine practice patterns for the management of very early LS-SCLC in Canada. A survey was developed and distributed to Canadian medical and radiation oncologists specialising in lung cancer. The survey consisted of three sections: (1) physician demographics, (2) general practice approach, and (3) preferred approach for three clinical scenarios (1: peripheral T1 lesion; 2: central T1 lesion; 3: peripheral T2 lesion). Responses were analysed to detect differences across cases and among physician groups. There were 77 respondents. In case 1, assuming medical operability, most respondents (73%) chose surgery and adjuvant chemotherapy, with 19% choosing CRT. CRT was selected by a higher proportion in case 2 (48%) and case 3 (61%) (p < 0.05). If medically inoperable, most chose CRT over local therapy in all cases, with more choosing CRT in case 2 (84%) and case 3 (86%) than in case 1 (55%) (p < 0.05). Subgroup analysis showed a predilection towards CRT in Western Canada and among more experienced physicians, and towards SBRT in Ontario. There is variability in the management of very early LS-SCLC in Canada. CRT remains the most popular strategy in most cases, with surgery preferred for small peripheral lesions. Larger and more central tumours are more likely to be managed with CRT. Variation in practice is correlated with region and physician experience. Our study illustrates the variability in the management of very early LS-SCLC in Canada and highlights the need for more robust investigations into the ideal approach for these patients. [ABSTRACT FROM AUTHOR]

Of particular interest within fifth generation (5G) cellular networks are the typical levels of radiofrequency (RF) electromagnetic fields (EMFs) emitted by 'small cells', low-power base stations, which are installed such that both workers and members of the general public can come in close proximity with them. In this study, RF-EMF measurements were performed near two 5G New Radio (NR) base stations, one with an Advanced Antenna System (AAS) capable of beamforming and the other a traditional microcell. At various positions near the base stations, with distances ranging between 0.5 m and 100 m, both the worst-case and time-averaged field levels under maximized downlink traffic load were assessed. Moreover, from these measurements, estimates were made of the typical exposures for various cases involving users and non-users. Comparison to the maximum permissible exposure limits issued by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) resulted in maximum exposure ratios of 0.15 (occupational, at 0.5 m) and 0.68 (general public, at 1.3 m). The exposure of non-users was potentially much lower, depending on the activity of other users serviced by the base station and its beamforming capabilities: 5 to 30 times lower in the case of an AAS base station compared to barely lower to 30 times lower for a traditional antenna. [ABSTRACT FROM AUTHOR]

Primary small cell neuroendocrine carcinoma (SCNEC) is a rare high-grade malignant neoplasm with neuroendocrine differentiation derived from the urothelium. Herein, we report a case which presented with symptomatic anaemia secondary to haematuria, complicated with acute kidney injury following obstructive uropathy caused by the SCNEC, along with the discussion of the clinical presentation, radiological imaging and pathological findings of the disease. [ABSTRACT FROM AUTHOR]

The article analyzes the clinical features, treatment modalities and outcomes of primary poorly differentiated neuroendocrine carcinoma (PDNEC) of the oral cavity. Data shows the demographics and clinical outcomes of patients including average age, gender, smoking status, tumor site, development of systemic metastasis and survival status. Treatments for PDNEC include chemotherapy, ablative surgery combined with adjuvant radiotherapy and/or chemotherapy, and chemoradiotherapy.

Patients with neuroendocrine tumours (NETs) need alternative therapies after failure of first-line therapy. This phase II trial evaluated lurbinectedin, a selective inhibitor of oncogenic transcription, at 3.2 mg/m2 as a 1-h intravenous infusion every 3 weeks in 32 NETs patients treated in the second- or third-line setting. The primary efficacy endpoint was overall response rate (ORR) according to RECIST v1.1 assessed by the investigators. Secondary endpoints included duration of response (DoR), progression-free survival (PFS), overall survival (OS) and safety. Two of 31 evaluable patients had confirmed partial responses (ORR = 6.5%; 95%CI, 0.8–21.4%). Median DoR was 4.7 months (95% CI, 4.0–5.4 months), median PFS was 1.4 months (95% CI, 1.2–3.0 months) and median OS was 7.4 months (95% CI, 3.4–16.2 months). Lurbinectedin showed an acceptable, predictable and manageable safety profile. The most common grade 3/4 toxicity was neutropenia (40.6%; grade 4, 12.4%; febrile neutropenia, 3.1%). Considering the exploratory aim of this trial that evaluated a heterogeneous population of NETs patients, and the signs of antitumour activity observed (two confirmed partial responses and seven long disease stabilisations), further development of lurbinectedin is warranted in a more selected NETs population. Sponsor Study Code: PM1183-B-005-14. EudraCT number: 2014-003773-42. ClinicalTrials.gov reference: NCT02454972. • ORR with lurbinectedin in patients with NETs was 6.5% (95%CI, 0.8–21.4%). • Median DoR, PFS and OS were 4.7, 1.4 and 7.4 months, respectively. • Safety profile was predictable and manageable. • Development of lurbinectedin in a selected NETs population is warranted. [ABSTRACT FROM AUTHOR]

Background: The authors assessed the association between radon decay products (RDP) exposure and histologic types of incident lung cancer in a cohort of 16,752 (91.6% male) Eldorado uranium workers who were first employed from 1932 to 1980 and were followed through 1969-1999.Methods: Substantially revised identifying information and RDP exposures were obtained on workers from the Port Radium and Beaverlodge uranium mines and from the Port Hope radium and uranium refinery and processing facility in Canada. Poisson regression was conducted using the National Research Council's Biological Effects of Ionizing Radiation (BEIR) VI-type models to estimate the risks of lung cancer by histologic type from RDP exposures and γ-ray doses.Results: Lung cancer incidence was significantly higher in workers compared with the general Canadian male population. Radiation risks of lung cancer for all histologic types (n = 594; 34% squamous cell, 16% small cell, 17% adenocarcinoma) increased with increasing RDP exposure, with no indication of curvature in the dose response (excess relative risk per 100 working level months = 0.61; 95% confidence interval, 0.39-0.91). Radiation risks did not differ by histologic type (p = .144). The best-fitting BEIR VI-type model included adjustments for the significant modifying effects of time since exposure, exposure rate, and attained age. The addition of γ-ray doses to the model with RDP exposures improved the model fit, but the risk estimates remained unchanged.Conclusions: The first analysis of radiation risks of lung cancer histologic types in the Eldorado cohort supported the use of BEIR VI-type models to predict the future risk of histologic types of lung cancer from past and current RDP exposures.Lay Summary: Lung cancer survival depends strongly on the cell type of lung cancer. The best survival rates are for patients who have the adenocarcinoma type. This study included 16,752 Eldorado uranium workers who were exposed to radon and γ-ray radiation during 1932-1980, were alive in 1969, and were followed for the development of new lung cancer during 1969-1999. One third of all lung cancers were of the squamous cell type, whereas the adenocarcinoma and small cell types accounted for less than 20% each. Radiation risks of lung cancer among men increased significantly with increasing radon exposure for all cell types, with the highest risks estimated for small cell and squamous cell lung cancers. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to summarize the clinical characteristics and analyze the independent prognostic factors in patients with high‐grade endometrial neuroendocrine carcinoma (ENC). Methods: Patients diagnosed with ENC, endometrioid adenocarcinoma (EAC), endometrial clear‐cell carcinoma (ECC), endometrial serous carcinoma (ESC), endometrioid carcinoma with mucinous features (EMC) from 1987 to 2016 were screened from the National Cancer Institute database (surveillance, epidemiology, and end results [SEER]). Kaplan–Meier were used to assess survival. Univariate and multivariate Cox proportional hazards analysis were done to examine factors affecting survival. Results: The median survival times of ENC were 11 months, shorter than that of EAC, ECC, ESC, and EMC (p < 0.01). There was no significant difference in ages, survival rate, and median survival time between large‐cell ENC (LCENC) and small‐cell ENC (SCENC), which were all belong to ENC. In a multivariable model, the hazard ratio (HR) of death for women with Federation International of Gynecology and Obstetrics (FIGO) stage I‐II of ENC was 0.37 compared to FIGO stage III‐IV (p < 0.01). The HR of patients who under the surgery was 0.39 compared to the patients who without surgery (p < 0.01), and the HR of patients who received chemotherapy was 0.51 compared to the patients who did not received chemotherapy (p < 0.01). Radiotherapy did not significantly reduce the mortality risk of patients. Conclusion: ENC was a kind of devastating endometrial cancers with the poorest prognosis. Surgical treatment and chemotherapy were necessary for improving prognosis of ENC. Early diagnosis favored better prognosis. There was no prognostic difference between with and without radiotherapy. [ABSTRACT FROM AUTHOR]

Millimeter wave (mmW) is being deployed in hotspot scenarios for providing high bandwidths. However, the coverage of mmW cell is limited due to the rapid attenuation during the propagation and sensitivity to blockage by obstacles. In this paper, we propose a novel dynamic programming approach for automated dimensioning and appropriate placement of mmW small cells (SCs) in dense urban under the constraints of coverage and budget. Being cognizant of the blockage by city buildings, a fast search algorithm based on vector is introduced to enable most line-of-sight (LOS) communication links between base stations (BSs) and mobile stations (MSs). The analysis of time complexity is also derived in closed forms. The evaluation of our approach was carried out in both hypothetic and realistic scenarios. Results show that the studied model is effective for a real large-scaled network and 4 or 5 times faster than the conventional ones based on grid-map. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the survival differences between cisplatin/etoposide versus carboplatin/etoposide chemotherapy regimens in the management of patients with extrapulmonary neuroendocrine carcinomas (NECs). Methods: Administrative cancer care databases in the province of Alberta, Canada, were reviewed, and patients with extrapulmonary NECs (including those with small cell and large cell neuroendocrine carcinomas) who were treated with either cisplatin/etoposide or carboplatin/etoposide, 2004–2019, were reviewed. Kaplan-Meier survival estimates were used to compare the survival outcomes according to the type of platinum agent, and multivariable Cox regression analysis was used to assess the impact of the type of platinum agent on overall survival outcomes. Results: A total of 263 eligible patients were included in this analysis. These include 176 patients who received cisplatin/etoposide and 87 patients who received carboplatin/etoposide. Using Kaplan-Meier survival estimates, patients treated with cisplatin had better overall survival compared to patients treated with carboplatin (p = 0.005). Multivariable Cox regression analysis suggested that the following factors were associated with worse overall survival: higher Charlson comorbidity index (HR: 1.17; 95% CI: 1.05–1.30), gastrointestinal primary site (HR: 1.55; 95% CI: 1.12–2.14), stage IV disease (HR: 1.75; 95% CI: 1.28–2.38), and use of carboplatin (HR: 1.40; 95% CI: 1.02–1.92). Conclusions: The current study suggested that cisplatin/etoposide might be associated with better overall survival compared to carboplatin/etoposide among patients with extrapulmonary NECs. It is unclear if this is related to differences in inherent responsiveness to the 2 platinum agents or due to differences in comorbidity burden between the 2 treatment groups. [ABSTRACT FROM AUTHOR]

This paper investigates the application of non-orthogonal multiple access (NOMA) and millimeter-wave (mmWave) transmission in the fifth-generation (5G) of heterogeneous cellular networks (HetNets). Due to the high penetration loss of mmWave, we propose that a small cell base station (SBS) serves small cell user (SCU) equipment in the mmWave band, and a macrocell base station (MBS) serves macrocell users (MCUs) in the microwave band. Cell association, user grouping, and power allocation are fundamental challenges in NOMA-based transmission. We formulate optimization problems for SCU and MCU to maximize the energy efficiency (EE) subject to the required minimum data rates and maximum transmission powers. User grouping algorithms are introduced to demonstrate the significance of selecting the best users. To allocate transmission powers, we formulate an EE maximization problem that is non-convex and NP-hard. We propose to use the Bat algorithm, which is one of the popular and efficient metaheuristic algorithms in solving non-convex problems. Analytical expressions for cell association and outage probabilities are derived. We present Monte Carlo simulation results to validate the analytical expressions and show that: (1) choosing the best user among far users influences the overall EE of system impressively; (2) the optimum values of transmission powers can be obtained by Bat algorithm; (3) the proposed grouping algorithms with power allocation methods outperform the other scenarios in terms of EE and spectral efficiency (SE). [ABSTRACT FROM AUTHOR]

• There has been relatively little progress in the treatment of small cell lung cancer. • Disialoganglioside 2 is commonly expressed in SCLC. • Dinutuximab, an anti-GD2 antibody is approved for neuroblastoma and is synergistic with irinotecan. • Dinutuximab + irinotecan vs. topotecan vs irinotecan in recurrent SCLC did not improve outcomes. Topotecan is approved as second-line treatment for small cell lung cancer (SCLC). Irinotecan is also frequently used given its more convenient schedule and superior tolerability. Preclinical studies support disialoganglioside (GD2) as an SCLC target and the combination of dinutuximab, an anti-GD2 antibody, plus irinotecan in this setting. We tested dinutuximab/irinotecan versus irinotecan or topotecan as second-line therapy in relapsed/refractory (RR) SCLC. Patients with RR SCLC and Eastern Cooperative Oncology Group performance status 0–1 were randomized 2:2:1 to receive dinutuximab 16–17.5 mg/m2 intravenous (IV)/irinotecan 350 mg/m2 IV (day 1), irinotecan 350 mg/m2 IV (day 1), or topotecan 1.5 mg/m2 IV (days 1–5) in 21-day cycles. The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS), objective response rate (ORR; complete response [CR] + partial response [PR]), and clinical benefit rate (CBR; CR + PR + stable disease). Safety/tolerability were also assessed. A total of 471 patients were randomized to dinutuximab/irinotecan (n = 187), irinotecan (n = 190), or topotecan (n = 94). Age, sex, performance status, prior therapies, and metastatic disease sites were similar between groups. Survival and response rates were not improved for patients receiving dinutuximab/irinotecan versus those receiving irinotecan or topotecan (median OS 6.9 vs 7.0 vs 7.4 months [ p = 0.3132]; median PFS 3.5 vs 3.0 vs 3.4 months [ p = 0.3482]; ORR confirmed 17.1% vs 18.9% vs 20.2% [ p = 0.8043]; and CBR 67.4% vs 58.9% vs 68.1% [ p = 0.0989]), respectively. Grade 3/4 adverse events (≥5% receiving dinutuximab/irinotecan) included neutropenia, anemia, diarrhea, and asthenia. Dinutuximab/irinotecan treatment did not result in improved OS in RR SCLC versus irinotecan alone. Irinotecan administered every 21 days demonstrated comparable activity to topotecan administered daily × 5 every 21 days. ClinicalTrials.gov Identifier. NCT03098030. [ABSTRACT FROM AUTHOR]

Diagnosing hematolymphoid neoplasm by evaluating fine-needle aspiration (FNA) cytology sample is controversial and requires experience and clinical skills. This concept becomes more challenging when evaluating hematolymphoid neoplasm in body fluid. Differentiating between low-grade lymphoma and reactive lymphocytes is often difficult by morphology alone as reactive lymphoid cells may acquire activation morphology from being exposed to different cytokines within the body fluid. However, in most cases there are specific features that may aid in differentiating small reactive from non-reactive lymphocytes including the round shape of the nucleus, the absence of visible nucleoli and the presence of fine clumped chromatin. In large cell lymphoma and leukemia cells involvement of body fluid this concept becomes less challenging. Large cell lymphoma and leukemia cells tend to have large size nuclei, less mature chromatin, and visible nucleoli with and without cytoplasmic vacuoles. However, to reach accurate diagnosis and subclassification, the utilizing of flow cytometry, to confirm monoclonality, and other ancillary studies such immunocytochemistry, cytogenetics and molecular studies is needed. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors in the first edition of Diagnostic Cytopathology of Serous Fluids. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Small cell carcinoma (SCC) is usually aggressive and associated with a poor prognosis. This type of cancer is rarely found in extra-pulmonary or digestive-tract locations. This report describes an unusual presentation in terms of clinical symptoms and primary location (even among head and neck presentations), and unexpected occupational exposure. Case Report: This case report is a novel observation of SCC in the paranasal sinuses and is to the best of our knowledge the first case associated with occupational exposure to sawdust, with almost no ear, nose, and throat (ENT) symptoms related to the primary tumor location. Our patient had no past medical history and none of the usual risk factors, apart from a smoking history of 32 pack-years. He was not taking any regular treatment. The inaugural clinical presentation was mainly digestive, with neither ENT nor neurological symptoms. Diagnostic wavering ensued and numerous paraclinical tests were performed. This is one of the very few cases of an ethmoidal location ever reported for SCC. This cancer type is unusual in neck and head locations, but has occasionally been reported in the larynx and hypopharynx. To the best of our knowledge, this is only the second report of an ethmoidal location. In addition, this patient was a carpenter, implying exposure to sawdust, which is usually associated with adenocarcinoma of the ethmoid. We illustrate here that SCC, which has been described elsewhere without sawdust exposure, is also possible. Conclusions: Exposure to sawdust should suggest a possible ethmoidal cancer location, even if there are few ENT symptoms. Adenocarcinoma is the most prevalent but clearly not the only possible histological pattern. [ABSTRACT FROM AUTHOR]

Increasing data capacity requirements in cellular networks have raised the demand of low-cost and energy-efficient small cells to reduce the overall operating cost of the access network. This paper reports on the development of an energy-efficient and low-cost power amplifier design for TD-LTE outdoor pico base station. The proposed design of the power amplifier uses double-stage balanced configuration by exploiting the latest available process technologies on low-power devices and avoids commonly used a high-power LDMOS transistor. We examined the conceptual design of the power amplifier through ADS and SystemVue simulations and subsequently validated through practical implementation. The contribution of this paper is that the proposed design of pico base station operates at 12 V DC input supply rather than conventional −48 V which avoids the requirement of −48 V to 28 V DC–DC converter. As a result, the overall power efficiency of the proposed power amplifier for outdoor pico base station is increased by 2.7% in addition to the reduction of cost by 40%. Due to the light weight and small size, IP-65 compliant outdoor pico BS with proposed power amplifier can be contained in a single box. [ABSTRACT FROM AUTHOR]

As mobile devices become more and more popular, mobile traffic demands are increasing exponentially. To deal with such challenge, caching at small cell base stations (SBSs) is one of the most effective techniques for reducing the transmission delay of mobile applications. However, due to the limitation of the SBS storages, the improvement of reducing transmission delay is limited in small cell networks. In this paper, we propose a novel cooperative caching framework in a small cell network in which SBSs are grouped into disjoint clusters and cooperate through backhaul links to make use of SBS storages. A backhaul-based cooperative caching (BCC) scheme is introduced, and the problem for content placement is formulated to minimize the average download delay in small cell networks. Then, we show that the problem is equivalent to the maximization of a monotone submodular function subject to matroid constraints and propose a low-complexity greedy strategy with 1/2 performance guarantee. Simulation results demonstrate that the proposed scheme achieves lower download delay and better cache hit rate than other schemes. [ABSTRACT FROM AUTHOR]

The energy-efficient deployment of small cells helps to reduce environmental pollution in an ultra-dense network. In contrast, demand for massive connectivity and higher data rate are the promise of the present cellular system and small cell networks. Hence, energy consumption is reduced if base stations are optimally used. One way to improve the energy efficiency is by shutting down the redundant BSs while sustaining the Quality of Service for each user. This paper proposes an efficient cell modeling (ECM) algorithm for small cell formation, and binary particle swarm optimization-based small cell deployment (BPSD) to optimize the deployment of small base stations in the small cell network. The small base stations (s-BSs) exist in two modes: active and sleep which is decided by the proposed algorithm without compromising the network performance. The proposed ECM and BPSD algorithms are implemented and evaluated in MATLAB. The results demonstrate that the proposed approaches improve the energy efficiency and connectivity in the ultra-dense small cell network. [ABSTRACT FROM AUTHOR]

Introduction: Gall bladder (GB) small cell carcinoma (SCC) comprises 0.5% of all gall bladder cancers. It carries a poor prognosis in view of its aggressive nature. Case report: We here report a case of small cell carcinoma of GB in a female who presented with obstructive jaundice. Examination revealed a hard lump in the right upper abdomen. Tumour markers showed raised CA 19-9. Staging CECT of the thorax and abdomen reported polypoidal enhancing wall thickening of the gall bladder with multiple metastatic deposits close to the pancreatic head encasing the main portal vein and common bile duct. Histopathology report was suggestive of small cell carcinoma, which was confirmed by immunohistochemistry. Patient was referred to the Oncology Department for palliative chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Primary breast small cell neuroendocrine carcinoma is a rare subtype of breast cancer with about 57 cases reported in the literature. This rare type of cancer represents about 0.1% of breast carcinomas. Recently, the World Health Organization defined this type of cancer as a separate entity from other breast cancer types. The diagnosis of this type of cancer in the breast is difficult because the histological pattern is similar to the small cell neuroendocrine carcinoma of other more common primary sites of origin, including the lung. Case Report: A 39-year-old woman presented to our hospital with a left breast mass and recurrent mastitis. Physical examination revealed a painless lump in her left breast with a brown-colored discharge from the nipple, and her child refused breastfeeding from the left breast. A high-density well-defined rounded mass was observed upon mammography in the upper lateral aspect of the left breast. This mass lesion appeared hypoechoic with no posterior acoustic shadowing on ultrasound scan. A core-needle biopsy of the mass was performed and the diagnosis of small cell neuroendocrine carcinoma was rendered after histopathologic examination. Positron emission tomography scanning was helpful in the exclusion of primary origin from other organ sites; thus, the primary breast origin of the tumor was confirmed. Conclusions: This case report provides a comprehensive approach to diagnose this type of small cell carcinoma originating primarily in the breast. The suspicion of this type of breast cancer should be raised if there is presence of characteristic histopathologic findings with the exclusion of any primary origin from other organ sites by the help of imaging studies. [ABSTRACT FROM AUTHOR]

Background: Primary small cell carcinoma of the pancreas (SCCP) is a rare malignant neuroendocrine carcinoma (NEC). Typically, it presents with lymphovascular invasion as well as metastasis at the time of diagnosis which portends a dismal prognosis. Treatment is typically based on therapy used for other aggressive NECs such as small cell lung cancer. Although multimodal surgery, radiation and chemotherapy may improve prognosis, the outcome generally remains poor.Case Presentation: Here we present a primary SCCP managed with neoadjuvant multi-agent chemotherapy combined with radiotherapy and surgery CONCLUSIONS: Multi-disciplinary therapy resulted in an ongoing 28 + month radiographic complete response and overall survival. [ABSTRACT FROM AUTHOR]

• CALGB 30610/RTOG 0538 used a novel design in order to select one of two high dose radiotherapy regimens to compare against standard 45 Gy BID in LSCLC. • The experimental regimen, either 70 Gy once-daily (QD) and 61.2 Gy concomitant boost (CB), would be chosen based on interim toxicity and tolerability. • Both experimental regimens appeared tolerable and had similar toxicity scores. • The decision to discontinue the 61.2 Gy CB arm was based on the observation that more patients experience grade 4 pulmonary toxicity with this regimen. It was also believed that studying 70 Gy QD would have the larger potential impact on clinical practice. • Suggestions for improvement in similar trial designs are discussed. • Long-term outcomes of the study will provide further data regarding the therapeutic ratio of high dose QD radiotherapy in LSCLC. The CALGB 30610/RTOG 0538 randomized trial was designed to test whether high-dose thoracic radiotherapy (TRT) would improve survival compared with 45 Gy twice-daily (BID) TRT in limited stage small cell lung cancer (LSCLC). Two piloted experimental TRT regimens were of interest to study, 70 Gy daily (QD) and 61.2 Gy concomitant boost (CB). Driven by concerns about adequate patient accrual, a study design was employed that eliminated one experimental TRT arm based on early interim toxicity and tolerability, with the study then continuing as a traditional 2-arm phase III study. Patients with LSCLC were assigned to receive four cycles of cisplatin and etoposide chemotherapy with one of 3 TRT regimens starting with either the first or second cycle of chemotherapy. The interim endpoint was the cumulative highest toxicity calculated from a scoring system based on treatment-related grade 3 and higher toxicity and the ability to complete therapy in the experimental arms. The final interim analysis was performed after 70 patients accrued to each experimental cohort, and a difference in treatment related toxicity scoring was not found (p = 0.739). Severe esophageal toxicity was comparable in both cohorts. Pulmonary toxicity was low overall, though 4 patients (5.7 %) on the 61.2 Gy arm developed grade 4 dyspnea, which was not observed in the 70 Gy arm. A protocol mandated decision was made to discontinue the 61.2 Gy arm following review of toxicity with the Data and Safety Monitoring Board. A randomized trial design using a planned early interim toxicity analysis to discriminate between experimental treatment arms is feasible in a phase III setting. Refinement of the design could increase the likelihood of detecting clinically meaningful differences in toxicity in future studies. [ABSTRACT FROM AUTHOR]

The high data traffic requirements of the new generation 5G networks will be satisfied with effective and efficient mobility and handover management. However, dense or ultra-dense small cell (eNB) placements in 5G networks may lead to some problems, such as latency, handover failures, frequent handover, ping-pong effect, etc. In this study, we proposed an Entropy-based simple additive weighting decision-making method for multi-criteria handover in software-defined networking (SDN) based 5G small cells for the solution of the aforementioned problems. This method provides the connection of the mobile node to the most suitable eNB using bandwidth, user density and SINR parameters. The proposed handover method is compared with conventional LTE handover and distributed approach in terms of delay, block ratio, handover failure and throughput according to the varying number of mobile users. The scalability of handovers for both approaches according to the user number are also analysed. According to the simulation results, the proposed approach achieved 15%, 48% and 22% improvement in handover delay, blocking probability and throughput, respectively, compared to the conventional LTE handover. [ABSTRACT FROM AUTHOR]

The recent World Health Organization classification for gastroenteropancreatic neuroendocrine neoplasms (GEP‐NENs) classified poorly differentiated GEP‐NENs into small cell and large cell categories. The present study aimed to assess the differences in outcomes between patients with both histological categories. The Surveillance, Epidemiology and End Results (SEER) database (1975‐2016) was accessed and patients with small cell and large cell GEP‐neuroendocrine carcinomas (NECs) were extracted. Differences in survival outcomes were explored through Kaplan‐Meier survival estimates and multivariable Cox regression models. In total, 2204 patients with GEP‐NEC were identified in the survival cohort, including 1698 patients with small cell NEC (77%) and 506 patients with large cell NEC (23%). Using Kaplan‐Meier analysis/log‐rank testing, large cell GEP‐NEC was associated with better overall survival compared to small cell NEC (P < 0.01). Using multivariable Cox regression analysis, large cell GEP‐NEC was associated with better overall survival (large cell GEP‐NEC versus small cell GEP‐NEC, hazard ratio = 0.77; 95% confidence interval = 0.68‐0.86) and cancer‐specific survival (large cell GEP‐NEC versus small cell GEP‐NEC, hazard ratio = 0.79; 95% 95% confidence interval = 0.69‐0.91). Patients with small cell GEP‐NEC have worse survival outcomes compared to those with large cell GEP‐NEC. Further efforts are needed to identify biological differences and treatment sensitivities between both histological categories. [ABSTRACT FROM AUTHOR]

In this study, a new model is developed that performs handover prediction in fifth generation small cell networks with Long Short Term Memory (LSTM) based deep neural networks. Firstly, the data set to be used for training in handover prediction was created with simulation scenarios designed in Riverbed Modeler. Through these scenarios, three input (RSSI, SNR and Jitter) variables and one output variable (desired value) were obtained to be used in the data set of the neural network. This data set was trained with machine learning algorithms LSTM, SVM, Tree, and Linear Regression techniques. LSTM-based deep neural network was compared with other regression algorithms and was found to have higher performance. When the test results of the trained model for LSTM are examined; R2 0.94, MAE 0.3315, MSE 0.3670, and RMSE value 0.6058 was found. It was observed that LSTM-based deep neural networks show high performance in regression processes. As a result, study shows that handover decisions can be predicted in 5G small cell networks with the proposed regression model. [ABSTRACT FROM AUTHOR]

The target of this paper is to show the impact of polarization adaptation on the received signal quality in an outdoor small-cell deployment scenario. The signal-to-interference ratio (SIR) is the key factor in defining the achievable data rate, and the capacity of the cell. At the cell border area, the SIR value is typically low and causes a significant decrease in the system capacity and achievable data rates. These bad SIR areas at the cell border can be improved by using orthogonal polarizations in the neighboring cells rather than using all polarizations over the whole cell coverage area. For the research work of this paper, a series of measurements were carried out to measure a received signal power and a cross polarization discrimination (XPD) ratio while the signal is transmitted and received with a different set of polarizations. In the measurements, we have considered horizontal, vertical, +/− 45° slanted polarizations, and two different environments, urban street and open space, and three frequency bands, 970−1030 MHz, 2000−2030 MHz and 3364−3400 MHz. The measurement results revealed that at a different distance from the transmitter, for horizontal/vertical polarization, the average XPD is around 24.7 dB and 31.7 dB in the urban street and open area environments, respectively. For +/− 45° slanted polarization, the average XPD is around 11.5 dB and 12.1 dB in the urban street and open area environments, respectively. This paper goes on to propose polarization adaptation in each cell, where the primary polarization is valid for the whole service area of the cell, and secondary polarization is only used in close proximity of the base station antenna. Considering the results, it is emphasized that system capacity can be significantly improved by having only one channel with good SIR values compared to multiple channels with bad SIR values. However, MIMO channels with orthogonal polarizations or with spatial multiplexing can be utilized in the closed vicinity of the base station, i.e., in an area with good SIR values. It is shown that the overall cell capacity can be increased by almost 35% by utilizing polarization adaptation compared to MIMO 2 × 2. [ABSTRACT FROM AUTHOR]

Trans -differentiation from an adenocarcinoma to a small cell neuroendocrine state is associated with therapy resistance in multiple cancer types. To gain insight into the underlying molecular events of the trans -differentiation, we perform a multi-omics time course analysis of a pan-small cell neuroendocrine cancer model (termed PARCB), a forward genetic transformation using human prostate basal cells and identify a shared developmental, arc-like, and entropy-high trajectory among all transformation model replicates. Further mapping with single cell resolution reveals two distinct lineages defined by mutually exclusive expression of ASCL1 or ASCL2. Temporal regulation by groups of transcription factors across developmental stages reveals that cellular reprogramming precedes the induction of neuronal programs. TFAP4 and ASCL1/2 feedback are identified as potential regulators of ASCL1 and ASCL2 expression. Our study provides temporal transcriptional patterns and uncovers pan-tissue parallels between prostate and lung cancers, as well as connections to normal neuroendocrine cell states. [Display omitted] • PARCB temporal model profiling informs key aspects of SCNPC trans -differentiation • Trans -differentiation trajectory resembles a common developmental arc-like pattern • ASCL1 and ASCL2 mark distinct bifurcating SCNPC trans -differentiation trajectories • TFAP4 as a common regulator of ASCL1/2 implicated in SCNPC trans -differentiation Chen et al. use temporal profiling of a small cell neuroendocrine prostate cancer model to inform anti-androgen therapy-induced trans -differentiation. An arc-like trajectory common to developmental biology is observed, and a bifurcation marked by ASCL1 and ASCL2, with parallels to SCLC. TFAP4 is identified as a common regulator of ASCL1 and ASCL2. [ABSTRACT FROM AUTHOR]

To construct a femtocell based ultra-dense network (UDN) is the important way to satisfy the ever-growing data traffic demands in the next generation mobile networks. However, it causes frequent handovers (HOs), thus leading to negative consequences such as increased power consumption and poor quality of service (QoS). This paper represents a research on the uplink handover (UL-HO) being watched recently and proposes a new method to further improve the energy efficient and QoS. First, we confirm the UL-HO mechanism, formulate the power consumption caused by UL-HO and compare downlink handover (DL-HO) with UL-HO in terms of the performance parameters including the power consumption, handover rate (HOR), handover failure rate (HOFR), ping-pong rate (PPR), delay, packet loss rate (PLR) and throughput during handover (HO). Then, it is proved through simulation that the reliable target cell determination scheme considering uplink reference signal received power (UL-RSRP), available bandwidth, direction of user equipment (UE), and admission control is lower in HOR, HOFR, PPR, power consumption, delay and PLR. In particular, we propose a new algorithm to determine the reasonable target cell considering UL-RSRP, available bandwidth and moving direction of UE, thus reducing HOR and PPR. The improved UL-HO scheme can be implemented easily by adding some functions besides the upper-layer protocol, while it can provide a lot of benefits such as reduced power consumption, delay, frequent HOs resulting in reducing HOR and PPR. Accordingly, this can be introduced into 5G as a HO scheme. [ABSTRACT FROM AUTHOR]

Objectives: The ECOG‐ACRIN Cancer Research Group trial E2511 recently demonstrated a potential benefit for the addition of veliparib to cisplatin‐etoposide (CE) in patients with extensive stage small cell lung cancer (ES‐SCLC) in a phase II randomized controlled trial. Secondary trial endpoints included comparison of the incidence and severity of neurotoxicity, hypothesized to be lower in the veliparib arm, and tolerability of the addition of veliparib to CE. Physician‐rated and patient‐reported neurotoxicity was also compared. Materials and Methods: Patients randomized to veliparib plus CE (n = 64) or placebo plus CE (n = 64) completed the 11‐item Functional Assessment of Cancer Therapy Gynecologic Oncology Group Neurotoxicity (questionnaire pre‐treatment, end of cycle 4 [ie 3 months after randomization] and 3 months post‐treatment [ie 6‐months]). Adherence analysis was based on treatment forms. Results and Conclusion: No significant differences in mean or magnitude of change in neurotoxicity scores were observed between treatment arms at any time point. However, patients in the placebo arm reported worsening neurotoxicity from baseline to 3‐months (M difference = −1.5, P =.045), compared to stable neurotoxicity in the veliparib arm (M difference = −0.2, P =.778). Weakness was the most common treatment‐emergent (>50%) and moderate to severe (>16%) symptom reported, but did not differ between treatment arms. The proportion of adherence to oral therapy in the overall sample was 75%. Three percent of patients reported clinically significant neurotoxicity that was not captured by physician assessment. Neurotoxicity scores were not different between treatment arms. The addition of veliparib to CE appeared tolerable, though weakness should be monitored. ClinicalTrials.gov Identifier: NCT01642251. [ABSTRACT FROM AUTHOR]

Non-orthogonal multiple access (NOMA) and millimeter-wave (mmWave) communication are two important technologies considered for the fifth generation (5G) of mobile networks. In this paper, we propose a machine-to-machine (M2M) communication underlaying heterogeneous network (HetNet) with mmWave-NOMA transmission, where small cell users (SCUs) and machine type communication (MTC) devices share the same resource block (RB) to increase the network capacity. We formulate an optimization problem to select efficient users and allocate transmission powers to SCUs and MTC devices. The object of optimization is to maximize the energy efficiency (EE) subject to the minimum spectral efficiency (SE) requirements and maximum transmission powers. We present a low computational complexity sub-optimum solution based on the non-cooperative game. An iterative algorithm with fast convergence speed and a reduced complexity search-based algorithm are respectively presented to solve the power control and user selection problems. The comparison between the proposed solution and optimum solution for different number of transmit antennas indicate that there is a small gap between SEs and EEs of the proposed and optimum solutions. Further, the results of user selection scheme demonstrate that the location of strong user affects the performance. We also derive analytical expressions for the outage probability which confirm Monte Carlo simulations. [ABSTRACT FROM AUTHOR]

To investigate the efficacy and safety of pembrolizumab in women with recurrent small cell neuroendocrine tumors of the lower genital tract. We conducted an open-label, investigator-initiated phase II basket trial of pembrolizumab 200 mg intravenously every 3 weeks in patients with rare tumors (ClinicalTrials.gov : NCT02721732). The trial had prespecified cohorts, including small cell malignancies of extrapulmonary origin. Eligibility criteria included disease progression during standard treatment in the 6 months before study enrollment. Patients were enrolled from February 2017 to February 2019. The primary endpoint was the proportion of patients alive without progression at 27 weeks. Response to pembrolizumab was evaluated every 9 weeks (3 cycles) with radiographic imaging. Seven women with gynecologic extrapulmonary small cell carcinoma were enrolled, 6 with cervical and 1 with vulvar carcinoma. No patient was progression free at 27 weeks. At first radiologic assessment, 1 patient had stable disease, while 6 had progression. The single patient with stable disease at 6 weeks had disease progression at 14 weeks. The median progression-free interval was 2.1 months (range 0.8–3.3 months). Severe treatment-related adverse events (≥grade 3) were seen in 2 of 7 patients (29%); 1 patient had grade 3 asymptomatic elevation of serum alkaline phosphatase, and 1 had grade 3 asymptomatic elevation of serum alanine aminotransferase. Pembrolizumab alone showed minimal activity in women with recurrent small cell neuroendocrine tumors of the lower genital tract. Treatment was well tolerated in the majority of study participants, and the rate of severe adverse events was low. • Single-agent pembrolizumab had minimal antitumor activity against small cell neuroendocrine tumors of the gynecologic tract. • Single-agent pembrolizumab had acceptable toxicity in patients with small cell neuroendocrine tumors of the gynecologic tract. • Primary small cell neuroendocrine tumors of the gynecologic tract were associated with low PD-L1 expression. [ABSTRACT FROM AUTHOR]

Package-integrated and ultrathin power dividers with footprint smaller than unit $\lambda ~_{0}~^{\mathrm{ 2}}$ at the operating frequency of 28-GHz 5G new radio (NR) n257 and n258 bands are presented for the first time for small-cell applications. These power dividers are also configured as antenna arrays using endfire Yagi–Uda antenna elements. Utilizing minimal matching techniques, two-, three-, and four-element antenna arrays are designed without compromising on the bandwidth of operation or electrical performance. These thin-film power dividers exhibit a cross-sectional height of $147~\mu \text{m}$ and can be implemented in the top metal layer of front-end module packages. Panel-compatible semiadditive patterning (SAP) process is utilized to realize these structures, which yields precise line space dimensions required for millimeter-wave (mm-wave) applications. This results in power dividers with low added insertion loss, low VSWR, and minimal phase difference between output ports. The added insertion loss is 25% less than similar structures reported on integrated fan-out architectures. The antenna arrays exhibit high gain and efficiency. Excellent model-to-hardware correlation is observed with multiple coupons of the same structure. Package-integrated power dividers and antenna arrays based on ultrathin laminated glass substrate represent a major step toward realizing compact mm-wave antenna-in-package for 5G small-cell applications. [ABSTRACT FROM AUTHOR]

Neuroendocrine breast neoplasms are uncommon invasive carcinomas that have historically been poorly defined due to various definitions of what constitutes a neuroendocrine carcinoma. The 5th Edition of the World Health Organization (WHO) Classification of Breast Tumors has moved to a dichotomous classification of neuroendocrine neoplasms in the breast in order to become standardized with classifications of other organ systems. Neuroendocrine breast neoplasms in the new edition are classified as "neuroendocrine tumor" and "neuroendocrine carcinoma." Key changes are exclusion of special histologic types (solid papillary carcinoma and hypercellular variant of mucinous carcinoma) and the inclusion of large cell neuroendocrine carcinoma. Neuroendocrine tumors are genetically heterogenous and harbor molecular alterations that differ from invasive carcinoma, no special type. Neuroendocrine carcinomas (high‐grade) show some overlapping molecular alterations with their counterparts in other organ systems. Data regarding the prognostic significance of neuroendocrine differentiation are conflicting, and histologic grade and tumor stage remain the main prognostic parameters. Current management of neuroendocrine neoplasms is not different from other types of breast carcinoma. This review will provide an update to the current WHO classification of neuroendocrine breast neoplasms and describe pertinent clinical, histologic, and molecular features of these uncommon tumors. [ABSTRACT FROM AUTHOR]

Small cell tumors arise from the neuroendocrine cell system and they are most frequently found in the lung (SCLC). Small cell tumor could occasionally arise in other body sites, such as the cervix, prostate, gastrointestinal tract, and very rarely from other sites. Metastatic SCLC patients present with metastatic disease in 80% of cases, and the metastases typically are reported in brain, liver, lung, and bone; they rarely could be found in the ovary. Differently, primitive small cell carcinoma of the ovary of pulmonary type is a rare and highly aggressive tumor arising from the ovarian cells; no suitable treatment strategy has been established yet. In this paper, we talk about a 72-year-old woman who presented with abdominal bleeding and a large mass in her pelvic region. A primary ovarian carcinoma was suspected, and she underwent hysterectomy with laparoscopic surgery and bilateral oophorectomy, lymph node resection, omentectomy, complementary appendix and sigmoid resection. The postoperative pathologic diagnosis was a differential diagnosis between small cell ovarian carcinoma of the pulmonary type and metastasis of SCLC. [ABSTRACT FROM AUTHOR]

Aim: Small cell lung cancer (SCLC) is associated with an aggressive course and short survival. Conventional chemotherapy (CT) is the mainstay of SCLC treatment. In this study, we aimed to determine the current demographic and clinical characteristics of patients with SCLC and to determine their responses to the treatments. Patients and Methods: This was a retrospective, cross-sectional, cohort study. Definitions of survival were overall survival (TOS) and survival after metastasis (MOS). TOS was calculated as the time from the diagnosis to the date of death or last visit. MOS was calculated as the time from the diagnosis of metastasis to the date of death or last visit. Results: The data of 161 patients were analyzed. Response rates obtained with 1st line CT, 2nd line CT, and 3rd line CT were 72.2%, 43.3%, and 40.4%, respectively. The median TOS and median MOS were calculated as 15.7 months (0.03-106.97) and 13.79 months (0.03-79.54), respectively. The presence of metastatic disease at the time of diagnosis and refusal of treatment were statistically significant parameters affecting the median TOS. Conclusions: It was shown that the patients who received and were able to tolerate the treatment had obtained a survival advantage, regardless of the disease phase. [ABSTRACT FROM AUTHOR]

Background and Objectives: Small cell lung cancer (SCLC) constitutes 14%-20% of all lung cancers. Clinical data on SCLC are scarce in literature. To report clinical features and treatment outcome of SCLC treated at our center. Materials and Methods: This is a single institutional data review of SCLC patients treated between June 2011 and December 2018. Patients were staged as either localized or extensive disease after appropriate staging work-up. Patients with localized disease were treated with concurrent chemoradiation with platinum-based chemotherapy. Those with extensive disease were treated with platinum based palliative chemotherapy. Clinicopathological characteristics, treatment details, and outcome were recorded in this study. Patients who received at least one cycle of chemotherapy were included for survival analysis as intent-to-treat analysis. Results: A total of 181 were patients registered with a median age of 62 years (range: 35-86 years) and male: female ratio of 166:15. Eighty-seven percent (n = 157) of patients had smoking history and 15% (n = 28) of patients had symptom of superior vena cava obstruction at baseline. Twenty-seven (15%) patients had localized disease at presentation. One hundred and twenty (66%) patients took systemic chemotherapy. Chemotherapy regimen was carboplatin only in 9 (7%), etoposide-carboplatin in 54 (45%), and cisplatin-etoposide in 57 (48%). Patients received median cycle number of 6 (range: 1-6). Of the evaluable 87 (73%) patients, initial response was complete response in 4, partial response in 57, stable disease in 20, and progressive disease in 6. Twenty patients received second-line chemotherapy at time of disease progression. After a median follow-up of 8.8 months (range: 0.3-46.1), median progression-free survival (PFS) of the whole population was 9.3 months. Conclusions: Small cell carcinoma in our series had a high incidence of advanced stage (85%) and 13% of patients were nonsmoker. Only 66% of patients received palliative chemotherapy and achieved high disease control rate (>75%) in the evaluable patients with median PFS of 9.3 months. [ABSTRACT FROM AUTHOR]

Dense deployment of small cells escalates the network capacity, making it a candidate technology for the future wireless network. However, backhauling of such a large number of small cells becomes a major challenge in its successful deployment. In this paper, a framework for massive MIMO enabled wireless backhauling in a two-tier heterogeneous network is developed. The framework considers massive MIMO enabled macro base station and in-band full-duplex (IBFD) small cell base station. Massive MIMO system provides high spectral efficiency and high energy efficiency. Besides, due to IBFD capability, the small cells can utilize the same frequency band to communicate over the access link and the backhaul link simultaneously. Tools from the stochastic geometry are utilized to model and derive the analytical expressions of coverage probability and area spectral efficiency (ASE). Furthermore, a trade-off between ASE and coverage probability is observed. All the analytical results are verified by simulation. Simulation results show that massive MIMO and IBFD communication may be useful technologies from the backhauling perspective in the dense small cell network. It is observed that the proposed framework provides 42.30% improvement in the coverage performance over the other existing framework for rate threshold of 1 bps/Hz. Furthermore, optimal performance for the proposed model can be achieved by tuning of bandwidth allocation factor. [ABSTRACT FROM AUTHOR]

By combining massive multiple-input and multiple-output (Ma-MIMO) and small-cell approaches, it is possible to improve the capacity of the network, with the features like energy efficiency and high coverage. Ma-MIMO helps in advancing the wireless communication, to incorporate it in the wireless broadband standards such as Wi-Fi and LTE. The use of Ma-MIMO is expected to increase the spectral efficiency for the mobile networks. In this paper, these two different technologies are incorporated for improving the 5G wireless communication. The concern of the whole paper is to satisfy the user with high quality of service. The effective technologies like Ma-MIMO and small cell are analyzed by employing beamforming and power allocation while operated in full-duplex transmission mode. The simulation is conducted to prove the optimal as well as low-complexity beamforming and power allocation, which is required for improving the total power consumption. [ABSTRACT FROM AUTHOR]

This paper introduces a combined calibrated learning and bandit approach to online distributed power control in small cell networks operated under the same frequency bandwidth. Each small base station (SBS) is modelled as an intelligent agent who autonomously decides on its instantaneous transmit power level by predicting the transmitting policies of the other SBSs, namely the opponent SBSs, in the network, in real-time. The decision making process is based jointly on the past observations and the calibrated forecasts of the upcoming power allocation decisions of the opponent SBSs who inflict the dominant interferences on the agent. Furthermore, we integrate the proposed calibrated forecast process with a bandit policy to account for the wireless channel conditions unknown a priori, and develop an autonomous power allocation algorithm that is executable at individual SBSs to enhance the accuracy of the autonomous decision making. We evaluate the performance of the proposed algorithm in cases of maximizing the long-term sum-rate, the overall energy efficiency and the average minimum achievable data rate. Numerical simulation results demonstrate that the proposed design outperforms the benchmark scheme with limited amount of information exchange and rapidly approaches towards the optimal centralized solution for all case studies. [ABSTRACT FROM AUTHOR]

The continuing rise of the amount of mobile traffic is daunting, but the deploying of indoor small cells provides exciting opportunities to boost network capacity, extend cell coverage, and eventually thrive on an increased level of customers' quality of experience (QoE). Unfortunately, in current wireless systems, traffic exhibits great variations in uplink and downlink directions, which introduces challenges of efficient resource allocation. Through using a dynamic time-division duplexing (TDD) method, network operators can flexibly adapt to such variations. However, cross-link interference appears in a dynamic TDD network and seriously suppresses uplink transmission. In this work, we proposed a decentralized QoE-aware reinforcement learning based approach to dynamic TDD reconfiguration. The objective is to maximize the utility function of the users' QoE in an indoor small cell network. This was done by empowering each base station to select the best configuration to avoid the occurrence of cross-link interference while maintaining as many users that can enjoy their service at a satisfactory QoE as possible. At each episode, after collecting local reports of the QoE state and traffic load of the users, every base station dynamically chooses the best configuration according to the learning model. The learning process repeats itself until convergence. We implemented a simulator to evaluate the performances of the proposed algorithms. The results show that the proposed strategy achieves the best utility of QoE in comparison with other approaches, especially in the direction of the uplink transmission. The study demonstrates the great potential of harnessing reinforcement learning algorithms to attain higher QoE in small cell networks. [ABSTRACT FROM AUTHOR]

This paper investigates the source and implication of efficiency minima that is typically observed during the second-harmonic load–pull of transistor amplifiers. The study starts with the theoretical derivation of time-domain voltage and current waveforms as a function of conduction angle ($\alpha$) at the second-harmonic efficiency minima, where the output power and drain efficiency (DE) are at minimum. Thereafter, this paper unfolds a systematic re-engineering approach that is developed to recover the performance degradation and to exploit the region of efficiency minima in favor of design and implementation of high-efficiency inverse class-F power amplifiers (PAs). Interestingly, the inferences drawn from the in-depth analysis are shown to provide a simplified first-pass design approach that guarantees inverse class-F PA operation without an a priori knowledge of device parasitic elements. Theoretical postulations and simulation results are experimentally validated using an on-wafer active harmonic load–pull and a prototype design using 1.95-mm NXP gallium nitride die at a frequency of 2.6 GHz. The designed PA delivers an output power of 40 dBm with DE of 76% and gain of 12 dB at 3-dB gain compression. The measurement results confirm the theoretical framework reported in this paper. [ABSTRACT FROM AUTHOR]

In this paper, we analyze the impact of the small cell user density on the power consumption and the number of served users by the macro cell and small cells. It is assumed that users are distributed uniformly in all coverage area with different density and small cell user density is related linearly with macro cell user density. In the simulations, three different mean values are chosen, where the power consumption and the number of served users by the macro cell and small cells are investigated according to these values. The simulation results show that small cells with low mean value enable to save more power. When user density of macro cell is λ0 = 5x10-4 and mean value of small cell user density equals to 15, saved power by using the small cells sleeping technique is 695 Watts. When λ0 = 10x10-4 this saved power decreases to 372 Watts. Similarly, as the mean value of the small cell user density increases, the power gain obtained by the algorithm decreases. [ABSTRACT FROM AUTHOR]

Summary Survival in limited stage small cell lung cancer (LS-SCLC) improves with faster initiation of hyper-fractionated thoracic radiotherapy (TRT) following chemotherapy, however, it is unknown if this association exists for more commonly employed daily fractionated regimens. Our results suggest that this association is present even with daily fractionation. [ABSTRACT FROM AUTHOR]

The limited fronthaul capacity imposes a challenge on the uplink of a centralized radio access network (C-RAN). We propose to boost the fronthaul capacity of a massive multiple-input multiple-output (MIMO)-aided C-RAN by globally optimizing the power sharing between channel estimation and data transmission both for the user devices (UDs) and the remote radio units (RRUs). Intuitively, allocating more power to the channel estimation will result in more accurate channel estimates, which increases the achievable throughput. However, increasing the power allocated to the pilot training will reduce the power assigned to data transmission, which reduces the achievable throughput. In order to optimize the powers allocated to the pilot training and to the data transmission of both the UDs and the RRUs, we assign an individual power sharing factor to each of them and derive an asymptotic closed-form expression of the signal-to-interference-plus-noise ratio for the massive MIMO-aided C-RAN consisting of both the UD-to-RRU links and the RRU-to-baseband unit (BBU) links. We then exploit the C-RAN architecture's central computing and control capability for jointly optimizing the UDs’ power sharing factors and the RRUs’ power sharing factors aiming at maximizing the fronthaul capacity. Our simulation results show that the fronthaul capacity is significantly boosted by the proposed global optimization of the power allocation between channel estimation and data transmission both for the UDs and for their host RRUs. As a specific example of 32 receive antennas (RAs) deployed by the RRU and 128 RAs deployed by the BBU, the sum rate of 10 UDs achieved with the optimal power sharing factors improves by 33% compared with the one attained without optimizing power sharing factors. [ABSTRACT FROM AUTHOR]