Evaluating the Efficacy of Machine Performance Checks as an Alternative to Winston-Lutz Quality Assurance Testing in the TrueBeam Linear Accelerator with HyperArc

HyperArc is a preferred technique for treating brain metastases, employing a single isocenter for multiple lesions. Geometrical isocentricity in the TrueBeam linear accelerator with HyperArc is crucial. We evaluated machine performance checks (MPCs) as an alternative to the Winston-Lutz (WL) test to verify the treatment isocenter. Between January and July 2023, we assessed 53 data points using MPC and Winston-Lutz tests. The isocenter size obtained from the MPC and its sum, including the rotation-induced couch shift, were compared with the maximum total delta value from the Winston-Lutz test. The maximum total delta was 0.68 ± 0.10 mm, while the isocenter size was 0.28 ± 0.02 mm. The sum of the isocenter size and rotation-induced couch shift measured by MPC was 0.61 ± 0.03 mm. During the Winston-Lutz test (without couch rotation), the maximum total delta value was 0.56 ± 0.13 mm. A t-test analysis revealed a significant difference in the isocenter size averages between the Winston-Lutz and MPC outcomes, whereas the Pearson's correlation coefficient yielded no correlation. Our study highlights the necessity for separate MPC and Winston-Lutz tests for isocenter verification. Therefore, the Winston-Lutz test should precede stereotactic radiosurgery for isocenter verification.

Structural phase transition and resistive switching properties of CuxO films during post-thermal annealing

We studied the phase change and resistive switching characteristics of copper oxide (CuxO) films through post-thermal annealing. This investigation aimed to assess the material's potential for a variety of electrical devices, exploring its versatility in electronic applications. The CuxO films deposited by RF magnetron sputtering were annealed at 300, 500, and 700 °C in ambient air for 4 min by rapid thermal annealing (RTA) method, and then it was confirmed that the structural phase change from Cu2O to CuO occurred with increasing annealing temperature. Resistive random-access memory (ReRAM) devices with Au/CuxO/p+-Si structures were fabricated, and the ReRAM properties appeared in CuO-based devices, while Cu2O ReRAM devices did not exhibit resistive switching behavior. The CuO ReRAM device annealed at 500 °C showed the best properties, with a on/off ratio of 8 × 102, good switching endurance of ∼100 cycles, data retention for 104s, and stable uniformity in the cumulative probability distribution. This characteristic change could be explained by the difference in the grain size and density of defects between the Cu2O and CuO films. These results demonstrate that superior and stable resistive switching properties of RF-sputtered CuxO films can be obtained by low-temperature RTA.

Investigating charge traps in MoTe2field-effect transistors: SiO2insulator traps and MoTe2bulk traps

Two-dimensional material-based field-effect transistors are promising for future use in electronic and optoelectronic applications. However, trap states existing in the transistors are known to hinder device performance. They capture/release carriers in the channel and lead to hysteresis in the transfer characteristics. In this work, we fabricated MoTe2field-effect transistors on two different gate dielectrics, SiO2and h-BN, and investigated temperature-dependent charge trapping behavior on the hysteresis in their transfer curves. We observed that devices with SiO2back-gate dielectric are affected by both SiO2insulator traps and MoTe2intrinsic bulk traps, with the latter becoming prominent at temperatures above 310 K. Conversely, devices with h-BN back-gate dielectric, which host a negligible number of insulator traps, primarily exhibit MoTe2bulk traps at high temperatures, enabling us to estimate the trap energy level at 389 meV below the conduction band edge. A similar energy level of 396 meV below the conduction band edge was observed from the emission current transient measurement. From a previous computational study, we expect these trap states to be the tellurium vacancy. Our results suggest that charge traps in MoTe2field-effect transistors can be reduced by careful selection of gate insulators, thus providing guidelines for device fabrication.

One-Step Passivation of Both Sulfur Vacancies and SiO2 Interface Traps of MoS2 Device

Transition metal dichalcogenides (TMDs) benefit electrical devices with spin-orbit coupling and valley- and topology-related properties. However, TMD-based devices suffer from traps arising from defect sites inside the channel and the gate oxide interface. Deactivating them requires independent treatments, because the origins are dissimilar. This study introduces a single treatment to passivate defects in a multilayer MoS2 FET. By applying back-gate bias, protons from an H-TFSI droplet are injected into the MoS2, penetrating deeply enough to reach the SiO2 gate oxide. The characterizations employing low-temperature transport and deep-level transient spectroscopy (DLTS) studies reveal that the trap density of S vacancies in MoS2 drops to the lowest detection level. The temperature-dependent mobility plot on the SiO2 substrate resembles that of the h-BN substrate, implying that dangling bonds in SiO2 are passivated. The carrier mobility on the SiO2 substrate is enhanced by approximately 2200% after the injection.

Effects of Thermal Annealing on Optical and Microscopic Ferromagnetic Properties in InZnP:Ag Nano-Rods

InZnP:Ag nano-rods fabricated by the ion milling method were thermally annealed in the 250~350 °C temperature range and investigated the optimum thermal annealing conditions to further understand the mutual correlation between the optical properties and the microscopic magnetic properties. The formation of InZnP:Ag nano-rods was determined from transmission electron microscopy (TEM), total reflectivity and Raman scattering analyses. The downward shifts of peak position for LO and TO modes in the Raman spectrum are indicative of the production of Ag ion-induced strain during the annealing process of the InZnP:Ag nano-rod samples. The appearance of two emission peaks of both (A⁰ X) and (e, Ag) in the PL spectrum indicated that acceptor states by Ag diffusion are visible due to the effective incorporation of Ag-creating acceptor states. The binding energy between the acceptor and the exciton measured as a function of temperature was found to be 21.2 meV for the sample annealed at 300 °C. The noticeable MFM image contrast and the clear change in the MFM phase with the scanning distance indicate the formation of the ferromagnetic spin coupling interaction on the surface of InZnP:Ag nano-rods by Ag diffusion. This study suggests that the InZnP:Ag nano-rods should be a potential candidate for the application of spintronic devices.

Pattern of pericardial calcification determines the mid-term postoperative outcome after pericardiectomy in chronic constrictive pericarditis

Background/Introduction

Although pericardiectomy is an effective treatment of constrictive pericarditis (CP), clinical outcome is not always successful. Pericardial calcification is a unique finding in CP. However, the amount and localization of calcification vary. Computer tomography (CT) can visualize the pericardial calcification with high sensitivity and provide the anatomical assessment.

Purpose

We investigated that how the pattern and amount of pericardial calcification affect the mid-term postoperative outcome after pericardiectomy in CP.

Methods

All of the patients who underwent total pericardiectomy in our hospital from 2010 to 2020 were derived from electrical medical records (n=105). Among them, preoperative CT scans (non-gated non-contrast) of 98 patients were available and, thus, 98 consecutive patients were finally analyzed. Medical records were reviewed in a retrospective manner. Cardiovascular event is defined as cardiovascular death or hospitalization associated with a heart failure symptom and all cause event is defined as all events that require admission. CT scan was analyzed by Aquarius Workstation, and the volume and localization pattern of pericalcification were derived. Pericardium calcium score was given as an Agatston score.

Results

Of 98 patients, 25 (25.5%) patients were hospitalized with heart failure symptom after pericardiectomy. Median follow up duration of patients is 172 weeks. A group with cardiovascular event had higher NYHA grade (P<0.001), lower calcium volume (P=0.004), and lower calcium score (P=0.01). Multivariate cox proportional analysis showed that high ln(calcium score) before pericardiectomy was dependent predictor of cardiovascular event (hazard ratio, 0.90; P=0.04) and all cause event (hazard ratio, 0.91, P=0.04) after pericardiectomy. When we set the cut off value at 7.22, based on ROC curve, there was a significant difference in cardiovascular event between the groups divided by this cutoff value in Kaplan-Meier curve (P=0.002) and multivariate cox proportional analysis (P=0.04). In the subgroup analysis, myocardium invasion and circumferential calcification were more common in the high calcium score group. Idiopathic & tuberculosis pericarditis were more associated with high calcium score group and post-operative pericarditis, other reasons (infection, radiation, etc) were more associated with low calcium group.

Conclusion

Low burden of pericardial calcification was associated high rate of mid-term clinical event after pericardiectomy CP. Preoperative evaluation of pericardial calcification pattern can be used as predictor of postoperative outcomes.

Funding Acknowledgement

Type of funding sources: None.

Role of combined exercise stress echocardiography and cardiopulmonary exercise test in chronic thromboembolic disease

Background

Chronic thromboembolic pulmonary disease (CTEPD) without pulmonary hypertension could cause significant exercise limitations. However, interventional or surgical treatments for CTEPD with mild pulmonary hypertension or normal pressure are on controversy.

Purpose

We aimed to evaluate cardiopulmonary function through cardiopulmonary exercise test (CPET) with stress echocardiography and to determine whether exercise pulmonary hypertension can explain exercise limitations in CTEPD patients with mPAP <30mmHg.

Methods

Patients diagnosed as CTEPD with mPAP less than 30mmHg was derived from our pulmonary hypertension center registry from April 2014 to October 2021.Transthoracic echocardiography (TTE) was performed at baseline (resting state) and immediately after CPET. TTE derived parameters and CPET parameters were compared with hemodynamic parameters measured by right catheterization.

Results

Total 37 patients were enrolled. Of these, Thirty-five patients had previously been diagnosed with CTEPH and had undergone PEA, BPA, or both. Most of the patients complained dyspnea of WHO functional class II or III. Pulmonary vascular resistance (PVR) was slightly higher than normal (185.0±102.2 dyne sec cm–5). Also VO2max was decreased in CPET (23.1±6.5 mL/kg/min). In correlation analysis, the higher the mPAP and PVR at rest, the lower VO2max during exercise. Meanwhile basal right ventricular (RV) function was normal, an increase in RVSP was notably observed during exercise (RVSP: pre-exercise 36.2±11.9, post-exercise 60.7±19.3, p value <0.001). Furthermore RV function deteriorated during exercise (TAPSE: pre-exercise 16.1±4.8, post-exercise 12.9±5.0, p value <0.001).

Conclusions

CTEPD patients with mild or normal PAP showed limited exercise capacity with exercise induced hypertension. Even in the mPAP less than 30mmHg, PVR and mPAP was significantly associated with exercise capacity. CPET with stress echocardiography could help to identify the main cause of exercise limitation in CTEPD patients and possibly provide the guideline for treatment plan.

Funding Acknowledgement

Type of funding sources: None.

Risk factors and clinical effects of late leaflet thrombosis after transcatheter aortic valve replacement

Background

As the indications for trans-catheter aortic valve replacement (TAVR) expand, it is expected that the number of TAVR patients would increase and the follow-up duration would be longer. It is known that the incidence of leaflet thrombosis is higher in TAVR than in surgical aortic valve replacement (SAVR), but not much is known about the risk factors of late leaflet thrombosis in TAVR.

Aim

Therefore, in this study, the incidence and risk factors of late leaflet thrombosis at late term after TAVR and the effect on clinical course of late leaflet thrombosis would be investigated.

Method

There were 176 patients undergone TAVR from January 2015 to October 2020 in one tertiary hospital of south korea. 94 patients had follow-up cardiovascular computed tomography (CT) between 3 months and 2 years after TAVR. Among 94 patients, late leaflet thrombosis was discovered at 20 patients, and risk factors were analyzed by comparing clinical factors, echocardiographic and cardiovascular CT information, and angiographic data between the group with and without late leaflet thrombosis. And the difference in aortic valve hemodynamics between the group with and without leaflet thrombosis was examined and clinical outcomes were compared. Clinical outcome was defined as the composite of all-cause death, stroke, heart failure (HF) admission, redo-aortic valve (AV) replacement and major bleeding after detection of late leaflet thrombosis.

Results

Indexed mean sinus of Valsalva diameter, AV calcium score and post procedure estimated orifice area (EOA) had predictability of late leaflet thrombosis with AUC value of 0.670 (95% CI [0.546–0.795], p value = 0.020), AUC value of 0.698 (95% CI [0.544–0.851], p value = 0.012) and AUC value of 0.665 (95 percent CI [0.548–0.782], p value = 0.031), respectively (Figure 1).

In echocardiography performed at the time of follow-up CT, AV max velocity and AV mean pressure gradient were higher in thrombosis group and EOA and Doppler velocity index were lower in thrombosis group than in no thrombosis group within normal range (Figure 2). Clinical outcome was not significant different between the two groups (log rank p value = 0.560).

Conclusion

Larger indexed sinus of Valsalva diameter, higher AV calcium score and smaller post procedure AV EOA were risk factors for late leaflet thrombosis after TAVR. Subclinical late leaflet thrombosis have a benign course when properly managed.

Funding Acknowledgement

Type of funding sources: None.

Feasibility of anomaly score detected with deep learning in irradiated breast cancer patients with reconstruction

The aim of this study is to evaluate cosmetic outcomes of the reconstructed breast in breast cancer patients, using anomaly score (AS) detected by generative adversarial network (GAN) deep learning algorithm. A total of 251 normal breast images from patients who underwent breast-conserving surgery were used for training anomaly GAN network. GAN-based anomaly detection was used to calculate abnormalities as an AS, followed by standardization by using z-score. Then, we reviewed 61 breast cancer patients who underwent mastectomy followed by reconstruction with autologous tissue or tissue expander. All patients were treated with adjuvant radiation therapy (RT) after reconstruction and computed tomography (CT) was performed at three-time points with a regular follow-up; before RT (Pre-RT), one year after RT (Post-1Y), and two years after RT (Post-2Y). Compared to Pre-RT, Post-1Y and Post-2Y demonstrated higher AS, indicating more abnormal cosmetic outcomes (Pre-RT vs. Post-1Y, P = 0.015 and Pre-RT vs. Post-2Y, P = 0.011). Pre-RT AS was higher in patients having major breast complications (P = 0.016). Patients with autologous reconstruction showed lower AS than those with tissue expander both at Pre-RT (2.00 vs. 4.19, P = 0.008) and Post-2Y (2.89 vs. 5.00, P = 0.010). Linear mixed effect model revealed that days after baseline were associated with increased AS (P = 0.007). Also, tissue expander was associated with steeper rise of AS, compared to autologous tissue (P = 0.015). Fractionation regimen was not associated with the change of AS (P = 0.389). AS detected by deep learning might be feasible in predicting cosmetic outcomes of RT-treated patients with breast reconstruction. AS should be validated in prospective studies.

Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity

SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV₁).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV₁, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV₁ decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.

Aesthetic Scar-Less Mastectomy and Breast Reconstruction

Surgical approaches in breast cancer have been changing to ensure both oncologic safety and cosmetic results. Although the concept of "oncoplastic breast surgery" has been accepted for decades, breast and plastic surgeons have been striving to develop more advanced surgical skills that ensure non-inferior oncologic outcomes with better cosmetic outcomes. Endoscopic or robotic devices, which are currently available only for chest or abdominal surgeries, could be used for breast surgery to ensure better cosmetic outcomes. The authors refer to this surgical concept as "aesthetic scar-less breast surgery and reconstruction," a term that encompasses the consequential concepts rather than naming it with simple technical words such as endoscopy-assisted or robot-assisted surgery. The "scar-less" term simply means leaving less of a scar, and better results can be expected by designing incisions on invisible areas. Herein, we summarize our experiences with various techniques of "aesthetic scar-less" surgery and review the existing literature on this topic.

Photoelectric Characteristics of a Large-Area n-MoS2/p-Si Heterojunction Structure Formed through Sulfurization Process

Two-dimensional (2D) materials, such as molybdenum disulfide (MoS₂) of the transition metal dichalcogenides family, are widely investigated because of their outstanding electrical and optical properties. However, not much of the 2D materials research completed to date has covered large-area structures comprised of high-quality heterojunction diodes. We fabricated a large-area n-MoS₂/p-Si heterojunction structure by sulfurization of MoO_x film, which is thermally evaporated on p-type silicon substrate. The n-MoS₂/p-Si structure possessed excellent diode characteristics such as ideality factor of 1.53 and rectification ratio in excess of 10⁴. Photoresponsivity and detectivity of the diode showed up to 475 mA/W and 6.5 × 10¹¹ Jones, respectively, in wavelength ranges from visible to near-infrared. The device appeared also the maximum external quantum efficiency of 72%. The rise and decay times of optical transient response were measured about 19.78 ms and 0.99 ms, respectively. These results suggest that the sulfurization process for large-area 2D heterojunction with MoS₂ can be applicable to next-generation electronic and optoelectronic devices.

Hypofractionated versus conventional fractionated radiotherapy for breast cancer in patients with reconstructed breast: Toxicity analysis

PURPOSE

This study investigated whether hypofractionated adjuvant radiotherapy (RT) increased breast-related complication(s) compared to conventional fractionated RT in reconstructed breast cancer patients.

METHODS

We conducted a retrospective review including 349 breast cancer patients who underwent immediate breast reconstruction following mastectomy or breast-conserving surgery (BCS) between 2009 and 2018 at two institutions. All patients were treated with adjuvant RT via either a conventional fractionated or hypofractionated regimen. We defined a major breast complication as a breast-related toxic event requiring re-operation or re-hospitalization during the follow-up period after the end of RT.

RESULTS

The median follow-up was 32.3 months (4.8-118.5 months); 126 patients had conventional fractionated RT, and 223 patients received hypofractionated RT. In patients with mastectomy, there was no significant difference in the occurrence of any or major breast-related complications between the two fractionation regimens. In patients undergoing BCS, incidence of any breast complication showed no difference between two RT groups and no major breast complication was reported as well. Hypofractionated RT did not increase major wound problem (infection and dehiscence) compared to conventional RT. Incidence of major contracture was significantly lower in hypofractionated RT.

CONCLUSIONS

There was no significant difference in the occurrence of any or major breast-related complications between the two different fractionation regimens, even in patients with mastectomy. Hypofractionated RT may be used comparable to conventional fractionated RT in terms of breast-related complications in reconstructed breast cancer patients. The prospective randomized trial would be necessary to clarify this issue.

Plasmonic-Layered InAs/InGaAs Quantum-Dots-in-a-Well Pixel Detector for Spectral-Shaping and Photocurrent Enhancement

The algorithmic spectrometry as an alternative to traditional approaches has the potential to become the next generation of infrared (IR) spectral sensing technology, which is free of physical optical filters, and only a very small number of data are required from the IR detector. A key requirement is that the detector spectral responses must be engineered to create an optimal basis that efficiently synthesizes spectral information. Light manipulation through metal perforated with a two-dimensional square array of subwavelength holes provides remarkable opportunities to harness the detector response in a way that is incorporated into the detector. Instead of previous experimental efforts mainly focusing on the change over the resonance wavelength by tuning the geometrical parameters of the plasmonic layer, we experimentally and numerically demonstrate the capability for the control over the shape of bias-tunable response spectra using a fixed plasmonic structure as well as the detector sensitivity improvement, which is enabled by the anisotropic dielectric constants of the quantum dots-in-a-well (DWELL) absorber and the presence of electric field along the growth direction. Our work will pave the way for the development of an intelligent IR detector, which is capable of direct viewing of spectral information without utilizing any intervening the spectral filters.

The enhancement mechanism of photo-response depending on oxygen pressure for Ga2O3 photo detectors

We have optimized the responsivity and response speed of a β-Ga₂O₃-based photodetector. The β-Ga₂O₃ thin films were deposited on a glass substrate under various oxygen partial pressures from 0 to 50 mTorr using pulsed laser deposition. Time-response measurements show that the as-grown β-Ga₂O₃ at an oxygen partial pressure of 50 mTorr has the fastest response speed and decay times of 33 and 100 ms, which are better than those prepared at lower oxygen pressures. This sample also showed a high photoresponsivity of 5 A W^-1 and detectivity of 10¹² cmHz^1/2/W. The high performance of the β-Ga₂O₃ detector grown at the oxygen partial pressure of 50 mTorr might be due to the reduction of oxygen vacancies caused by the increase in oxygen content during deposition. The results reveal the importance of the oxygen processing gas in promoting photodetector performance.

Analysis of ZnS and MgF2 layered nanostructures grown by glancing angle deposition for optical design

This study investigated the multilayer growth and properties of ZnS and MgF₂ using glancing angle deposition. We used deposition angles of 85°-89° for ZnS and 70°-88° for MgF₂ to obtain the structural properties. The film properties primarily followed Tait's rule with a deposition angle of less than 87° in the vapor flux. However, film growth with a vapor flux angle of 88°-89° followed the tangent rule. Mathematical and cross-sectional scanning electron microscopy examinations found a transition point for the growth mechanisms at 87°, which comes from an extreme angle property for glancing angle deposition. We also performed mathematical derivations for the well-known empirical formula of the tangent rule and its generalized version. To stabilize the interface structure and surface roughness of multilayer structures, film growth at slightly tilted angles is recommended. Based on these results, an optical structure was designed, fabricated, and analyzed for a 550 nm wavelength pass filter on a glass substrate.

Current Transport Mechanism in Palladium Schottky Contact on Si-Based Freestanding GaN

In this study, the charge transport mechanism of Pd/Si-based FS-GaN Schottky diodes was investigated. A temperature-dependent current–voltage analysis revealed that the I-V characteristics of the diodes show a good rectifying behavior with a large ratio of 10³–10⁵ at the forward to reverse current at ±1 V. The interface states and non-interacting point defect complex between the Pd metal and FS-GaN crystals induced the inhomogeneity of the barrier height and large ideality factors. Furthermore, we revealed that the electronic conduction of the devices prefers the thermionic field emission (TFE) transport, not the thermionic emission (TE) model, over the entire measurement conditions. The investigation on deep level transient spectroscopy (DLTS) suggests that non-interacting point-defect-driven tunneling influences the charge transport. This investigation about charge transport paves the way to achieving next-generation optoelectronic applications using Si-based FS-GaN Schottky diodes.

Effects of hydrochlorothiazide on drainage volume and seroma formation in deep inferior epigastric perforator flap breast reconstruction: Randomized controlled trial

BACKGROUND

Seroma is a recognized complication encountered at the reconstructed breast and donor site after abdominal-based breast reconstruction. Seroma is caused by lymphatic channel disruption and the formation of a large space between the deep fascia during flap elevation. Surgical techniques to preserve the lymphatics and secure the closure of the donor site can reduce seroma formation. This study investigated the safety and effectiveness of the diuretic hydrochlorothiazide at reducing interstitial fluid accumulation and seroma formation during deep inferior epigastric perforator (DIEP) flap breast reconstruction.

METHODS

Sixty patients with breast cancer who underwent skin- or nipple-sparing mastectomy and DIEP flap reconstruction were enrolled between August 2016 and June 2017. The patients were randomly assigned to receive either 25 mg per day of hydrochlorothiazide from the second to the twentieth day after surgery (treatment) or no diuretic (control). The clinicopathological characteristics, drainage time, and drainage volume were statistically compared between the two groups.

RESULTS

The average total drainage volume at the donor site was 291 mL in the treatment group and 434 mL in the control group (p = 0.003). The differences in body mass index and flap weight between the two groups were not statistically significant (p = 0.879 and p = 0.963, respectively). No hypotension or electrolyte imbalance was noted during the follow-up.

CONCLUSIONS

Intake of 25 mg per day of hydrochlorothiazide tablets effectively reduced the total abdominal drainage volume and removal time of indwelling drains. However, the adverse effects should be further investigated in a large population and multiracial cohort before using hydrochlorothiazide for seroma prevention.

P5279Pericardial inflammation basced on cardiac magnetic resonance imaging in patients with tuberculous pericarditis

Background

While constrictive pericarditis has been traditionally considered a disabling disease, reversible constrictive pericarditis has been described in previous studies. But there are limited studies on cardiac imaging of tuberculous pericarditis. In particular, no studies on cardiac magnetic resonance imaging (CMR) have been reported. We aimed to investigate CMR findings including pericardial late gadolinium enhancement (LGE) and T2 fat suppression and black blood sequences in patients with tuberculous pericarditis.

Methods

We retrospectively analyzed medical records of patients with tuberculous pericarditis between January 2010 and January 2017 in Samsung Medical Center. Definite diagnosis of tuberculous pericarditis is based on the identification of Mycobacterium tuberculosis in pericardial fluid or tissue; probable diagnosis was made when there was other evidence of tuberculosis elsewhere in patients with unexplained pericarditis. We performed CMR at initial diagnosis. Treatment consists of the standard 4-drug antituberculosis regimen for 6 months with or without steroids. Echocardiography was also conducted at initial diagnosis and 6 months later.

Results

Total 39 cases with tuberculous pericarditis in immunocompetent patients were enrolled. Ten patients were diagnosed as definite tuberculous pericarditis. CMR finding at initial diagnosis divided into five groups: 1) pericardial effusion only (n=20, 51.3%), 2) effusive constrictive pericarditis (n=5, 12.8%), 3) constrictive pericarditis (n=11, 28.2%), 4) pericardial abscess formation (n=4, 10.3%) and 5) absence of pericardial effusion and constrictive physiology (n=1, 2.6%). One of the 4 patients with pericardial abscess formation was together with pericardial effusion and the other was accompanied by effusive constrictive pericarditis. Pericardial thickness increased to more than 4mm in 25 patients (64.1%) and the mean pericardial thickness was 10.0±6.9mm. Delayed enhancement of pericardium was noticed in 29 patients (74.4%). In T2 fat suppression and black blood sequences, 30 patients showed increased T2 signal intensity indicating inflammation with extensive edema. Pericardial thickening (>4mm) with constriction (n=15) was not statistically significant in the delayed enhancement and increased T2 signal intensity compared with pericardial thickening without constrictive pericarditis (n=10) (delayed enhancement 93.8% vs. 77.8% p=0.287; increased T2 signal intensity 88.9% vs. 87.5%, p=0.713). After 6 months, only 3 patients still had constrictive pericarditis in echocardiography.

Effusive constrictive pericarditis

Conclusions

Pericardial thickening is associated with delayed enhancement and increased T2 signal intensity in patients with tuberculous pericarditis regardless of constrictive pericarditis. Even though there were hemodynamic feature of constrictive pericarditis and pericardial inflammation with extensive edema in CMR at initial diagnosis, 80% of the patients were improved from constrictive pericarditis.

Acknowledgement/Funding

None

Characteristics of p-Type Conduction in P-Doped MoS2 by Phosphorous Pentoxide during Chemical Vapor Deposition

We demonstrated p-type conduction in MoS2 grown with phosphorous pentoxide via chemical vapor deposition (CVD). Monolayer MoS2 with a triangular shape and 15-µm grains was confirmed by atomic force microscopy. The difference between the Raman signals of the A1g and E12g modes for both the pristine and P-doped samples was 19.4 cm-1. In the X-ray photoelectron spectroscopy results, the main core level peaks of P-doped MoS2 downshifted by about 0.5 eV to a lower binding energy compared to the pristine material. Field-effect transistors (FETs) fabricated with the P-doped monolayer MoS2 showed p-type conduction with a field-effect mobility of 0.023 cm2/V⋅s and an on/off current ratio of 103, while FETs with the pristine MoS2 showed n-type behavior with a field-effect mobility of 29.7 cm2/V⋅s and an on/off current ratio of 105. The carriers in the FET channel were identified as holes with a concentration of 1.01 × 1011 cm-2 in P-doped MoS2, while the pristine material had an electron concentration of 6.47 × 1011 cm-2.

Long-Term Chemical Aging of Hybrid Halide Perovskites

Because the power conversion efficiency (PCE) of hybrid halide perovskite solar cells (PSCs) could exceed 24%, extensive research has been focused on improving their long-term stability for commercialization in the near future. In a previous study, we reported that the addition of a number of ionized iodide (triiodide: I₃^-) ions during perovskite film formation significantly improved the efficiency of PSCs by reducing deep-level defects in the perovskite layer. Understanding the relationship between the concentration of these defects and the long-term chemical aging of PSCs is important not only for obtaining fundamental insight into the perovskite materials but also for studying the long-term chemical stability of PSCs. Herein we aim to identify the origin of the natural decay in PCE during long-term chemical aging of PSCs in the dark based on formamidinium lead triiodide by comparing the performance of control and low-defect (LD) devices. After aging for 200 days, the change in the PCE of the LD devices (1.3%) was found to be half that of the control devices (2.6%). We investigated this difference using grazing incidence wide-angle X-ray scattering, deep-level transient spectroscopy, scanning photoelectron microscopy, and high-resolution photoemission spectroscopy. The addition of I₃^- was found to reduce the amounts of hydroxide and O_x in the halide perovskites (HPs), affecting the migration of defects and the structural transformation of the HPs.

First observation of electronic trap levels in freestanding GaN crystals extracted from Si substrates by hydride vapour phase epitaxy

The electronic deep level states of defects embedded in freestanding GaN crystals exfoliated from Si substrates by hydride vapour phase epitaxy (HVPE) is investigated for the first time, using deep level transient spectroscopy (DLTS). The electron traps are positioned 0.24 eV (E1) and 1.06 eV (E2) below the conduction band edge, respectively. The capture cross sections of E1 and E2 are evaluated to be 1.65 × 10-17 cm2 and 1.76 × 10-14 cm2 and the corresponding trap densities are 1.07 × 1014 cm-3 and 2.19 × 1015 cm-3, respectively. The DLTS signal and concentration of the electronic deep levels are independent of the filling pulse width, and the depth toward the bottom of the sample, evidenced by the fact that they are correlated to noninteracting point defects. Furthermore, Photoluminescence (PL) measurement shows green luminescence, suggesting that unidentified point defects or complex, which affect the optical characterisitics, exhibit. Despite the Si-based materials, the freestanding GaN exhibits deep level characteristics comparable to those of conventional freestanding GaN, suggesting that it is a desirable material for use in the next generation optoelectronic devices with the large-scalibilityand low production costs.

Performance of thyristor memory device formed by a wet etching process

Thyristor random access memory without a capacitor has been highlighted for its significant potential to replace current dynamic random access memory. We fabricated a two-terminal (2-T) thyristor by wet chemical etching techniques on n⁺-p-n-p⁺ silicon epitaxial layers, which have the proper thicknesses and carrier concentrations, as provided by technology computer-aided design simulation. The etched features such as etch rate, surface roughness, and morphologies, in a potassium hydroxide (KOH) and an isotropic etchant, were compared. The type of silicon etchant strongly affected the etched shapes of the side wall and therefore critically influenced the device performance with varying turn-on voltages. The turn-on voltage of thyristor fabricated with a KOH solution showed a consistent tendency of operation voltage in the range of 2.2-2.5 V regardless of the cell size, while the thyristor formulated with isotropic etchant had an operation voltage which increased from about 2.3-4.4 V as the device dimension decreased from 200 μm to 10 μm. The optimized 2-T thyristor showed a memory window of about 2 V, a nearly zero-subthreshold swing, and a current on-off ratio of about 10⁴-10⁵.

Fabry-Perot cavity resonance enabling highly polarization-sensitive double-layer gold grating

We present experimental and theoretical investigations on the polarization properties of a single- and a double-layer gold (Au) grating, serving as a wire grid polarizer. Two layers of Au gratings form a cavity that effectively modulates the transmission and reflection of linearly polarized light. Theoretical calculations based on a transfer matrix method reveals that the double-layer Au grating structure creates an optical cavity exhibiting Fabry-Perot (FP) resonance modes. As compared to a single-layer grating, the FP cavity resonance modes of the double-layer grating significantly enhance the transmission of the transverse magnetic (TM) mode, while suppressing the transmission of the transverse electric (TE) mode. As a result, the extinction ratio of TM to TE transmission for the double-layer grating structure is improved by a factor of approximately 8 in the mid-wave infrared region of 3.4–6 μm. Furthermore, excellent infrared imagery is obtained with over a 600% increase in the ratio of the TM-output voltage (V_θ = 0°) to TE-output voltage (V_{θ = 90°}). This double-layer Au grating structure has great potential for use in polarimetric imaging applications due to its superior ability to resolve linear polarization signatures.

Defect States in InP/InGaAs/InP Heterostructures by Current-Voltage Characteristics and Deep Level Transient Spectroscopy

We studied defect states in In0.53Ga0.47As/InP heterojunctions with interface control by group V atoms during metalorganic chemical vapor (MOCVD) deposition. From deep level transient spectroscopy (DLTS) measurements, two defects with activation energies of 0.28 eV (E1) and 0.15 eV (E2) below the conduction band edge, were observed. The defect density of E1 for In0.53Ga0.47As/InP heterojunctions with an addition of As and P atoms was about 1.5 times higher than that of the heterojunction added P atom only. From the temperature dependence of current- voltage characteristics, the thermal activation energies of In0.53Ga0.47As/InP of heterojunctions were estimated to be 0.27 and 0.25 eV, respectively. It appeared that the reverse light current for In0.53Ga0.47As/InP heterojunction added P atom increased only by illumination of a 940 nm-LED light source. These results imply that only the P addition at the interface can enhance the quality of InGaAs/InP heterojunction.

Sentinel node biopsy after neoadjuvant chemotherapy for breast cancer with axillary node metastasis: A survey of clinical practice

BACKGROUND

A survey of breast surgeons was conducted to evaluate changes in clinical practice regarding sentinel node biopsy (SNB) among clinically node-negative patients after neoadjuvant chemotherapy for breast cancer with axillary node metastasis.

METHODS

We conducted two surveys among 252 members of the Korean Breast Cancer Society. The questionnaire comprised a case presentation and two associated questions. The case outlined a woman diagnosed with right breast cancer; core needle biopsy had confirmed invasive ductal carcinoma and tumor size was 4 cm on imaging examination. Fine needle aspiration examination for axillary lymph node enlargement showed metastatic carcinoma. The patient underwent neoadjuvant chemotherapy and tumor size was decreased by 2 cm; axillary lymph node enlargement was not observed on palpitation or imaging examination. Finally, the patient underwent breast conserving surgery. Survey recipients were asked: 1. Would you perform SNB in this patient? 2. If you perform SNB and no axillary node metastasis is seen, would you perform additional axillary lymph node dissection (ALND)?

RESULTS

The response rate was 28.2% (71/252) and 15.1% (38/252) in 2013 and 2017, respectively. For the first question, the SNB to ALND ratio increased significantly from 54% versus 46% in 2013 to 92% versus 8% in 2017 (p < 0.001). The proportion of surgeons performing no additional ALND versus additional ALND increased from 38% versus 54% in 2013 to 53% versus 37% in 2017, but did not reach statistical significance (p = 0.1).

CONCLUSIONS

These data show that application of SNB among clinically node-negative patients after neoadjuvant chemotherapy for breast cancer with node metastasis has increased among surgeons in Korea.

Locally Gated SnS2/hBN Thin Film Transistors with a Broadband Photoresponse

Next-generation flexible and transparent electronics demand newer materials with superior characteristics. Tin dichalcogenides, Sn(S,Se)₂, are layered crystal materials that show promise for implementation in flexible electronics and optoelectronics. They have band gap energies that are dependent on their atomic layer number and selenium content. A variety of studies has focused in particular on tin disulfide (SnS₂) channel transistors with conventional silicon substrates. However, the effort of interchanging the gate dielectric by utilizing high-quality hexagonal boron nitride (hBN) still remains. In this work, the hBN coupled SnS₂ thin film transistors are demonstrated with bottom-gated device configuration. The electrical transport characteristics of the SnS₂ channel transistor present a high current on/off ratio, reaching as high as 10⁵ and a ten-fold enhancement in subthreshold swing compared to a high-κ dielectric covered device. We also demonstrate the spectral photoresponsivity from ultraviolet to infrared in a multi-layered SnS₂ phototransistor. The device architecture is suitable to promote diverse studied on flexible and transparent thin film transistors for further applications.

Neutrophil-lymphocyte ratio predicts response to chemotherapy in triple-negative breast cancer

Background

The neutrophil-lymphocyte ratio (nlr) has been reported to correlate with patient outcome in several cancers, including breast cancer. We evaluated whether the nlr can be a predictive factor for pathologic complete response (pcr) after neoadjuvant chemotherapy (nac) in patients with triple-negative breast cancer (tnbc).

Methods

We analyzed the correlation between response to nac and various factors, including the nlr, in 87 patients with tnbc who underwent nac. In addition, we analyzed the association between the nlr and recurrence-free survival (rfs) in patients with tnbc.

Results

Of the 87 patients, 25 (28.7%) achieved a pcr. A high Ki-67 index and a low nlr were significantly associated with pcr. The pcr rate was higher in patients having a high Ki-67 index (≥15%) than in those having a low Ki-67 index (35.7% vs. 0%, p = 0.002) and higher in patients having a low nlr (≤1.7) than in those having a high nlr (42.1% vs. 18.4%, p = 0.018). In multiple logistic analysis, a low nlr remained the only predictive factor for pcr (odds ratio: 4.274; p = 0.008). In the survival analysis, the rfs was significantly higher in the low nlr group than in the high nlr group (5-year rfs rate: 83.7% vs. 66.9%; log-rank p = 0.016).

Conclusions

Our findings that the nlr is a predictor of pcr to nac and also a prognosticator of recurrence suggest an association between response to chemotherapy and inflammation in patients with tnbc. The pretreatment nlr can be a useful predictive and prognostic marker in patients with tnbc scheduled for nac.

Iodide management in formamidinium-lead-halide-based perovskite layers for efficient solar cells

The formation of a dense and uniform thin layer on the substrates is crucial for the fabrication of high-performance perovskite solar cells (PSCs) containing formamidinium with multiple cations and mixed halide anions. The concentration of defect states, which reduce a cell's performance by decreasing the open-circuit voltage and short-circuit current density, needs to be as low as possible. We show that the introduction of additional iodide ions into the organic cation solution, which are used to form the perovskite layers through an intramolecular exchanging process, decreases the concentration of deep-level defects. The defect-engineered thin perovskite layers enable the fabrication of PSCs with a certified power conversion efficiency of 22.1% in small cells and 19.7% in 1-square-centimeter cells.

Formation and magnetic properties of InFeP:Ag nanorods fabricated with noble metal Ag using an ion milling method

The formation, including the density and height of the InFeP:Ag nanorods doped with noble metal Ag using an ion milling method, was preponderantly determined from transmission electron microscopy and x-ray diffraction analyses. We investigate, in particular, the enhanced ferromagnetism of the well-aligned InFeP:Ag nanorods. Auger electron spectroscopy and x-ray photoelectron spectroscopy measurements were carried out in order to investigate the incorporation of Ag and to verify the local chemical bonding of the InFeP:Ag nanorods. The variation of FWHM for the double-crystal x-ray rocking curve and triple-axis diffraction peaks demonstrates that noble metal Ag is incorporated into the InFeP:Ag nanorods. The noticeable ferromagnetic signature (M-H curve) of the InFeP:Ag nanorods is observed and T _c persists up to almost 350 K (3.9 × 10^-4 emu g^-1), as determined by temperature-dependence magnetization (M-T curve) measurements. This study suggests that the InFeP:Ag nanorods should be a potential candidate for the application of spintronic devices.

Enhancement of near-infrared detectability from InGaZnO thin film transistor with MoS2 light absorbing layer

We report an enhancement of near-infrared (NIR) detectability from amorphous InGaZnO (α-IGZO) thin film transistor in conjunction with randomly distributed molybdenum disulfide (MoS₂) flakes. The electrical characteristics of the α-IGZO grown by radio-frequency magnetron sputtering exhibit high effective mobility exceeding 15 cm² V^-1 s^-1 and current on/off ratio up to 10⁷. By taking advantages of the high quality α-IGZO and MoS₂ light absorbing layer, photodetection spectra are able to extend from ultra-violet to NIR range. The α-IGZO channel detector capped by MoS₂ show a photo-responsivity of approximately 14.9 mA W^-1 at 1100 nm wavelength, which is five times higher than of the α-IGZO device without MoS₂ layer.

A study on setting of the fatigue limit of temporary dental implants

A temporary dental implant is a medical device which is temporarily used to support a prosthesis such as an artificial tooth used for restoring patient's masticatory function during implant treatment. It is implanted in the oral cavity to substitute for the role of tooth. Due to the aging and westernization of current Korean society, the number of tooth extraction and implantation procedures is increasing, leading to an increase in the use and development of temporary dental implants. Because an implant performs a masticatory function in place of a tooth, a dynamic load is repeatedly put on the implant. Thus, the fatigue of implants is reported to be the most common causes of the fracture thereof. According to the investigation and analysis of the current domestic and international standards, the standard for fatigue of implant fixtures is not separately specified. Although a test method for measuring the fatigue is suggested in an ISO standard, it is a standard for permanent dental implants. Most of the test standards for Korean manufacturers and importers apply 250 N or more based on the guidance for the safety and performance evaluation of dental implants. Therefore, this study is intended to figure out the fatigue standard which can be applied to temporary dental implants when measuring the fatigue according to the test method suggested in the permanent dental implant standard. The results determined that suitable fatigue standards of temporary dental implants should be provided by each manufacturer rather than applying 250 N. This study will be useful for the establishment of the fatigue standards and fatigue test methods of the manufacturers and importers of temporary dental implants.

Reduction of interface traps between poly-Si and SiO2 layers through the dielectric recovery effect during delayed pulse bias stress

We investigate the interface trap behavior between tunneling oxide and poly-Si channel layer post erase/write cycling with a delayed pulse by using deep level transient spectroscopy. For comparison of the defect states depending on the stress pulses, a Schottky and a metal-oxide semiconductor device were fabricated. A defect state at about E _c -0.51 eV in the Schottky device was measured before the annealing process. Three-hole trap states with activation energies of E _v +0.28 eV, E _v +0.53 eV, and E _v +0.76 eV appeared after the post-annealing process. The electron trap was about E _c -0.15 eV after erase/write 3000 cycling was applied at ±10 V for 100 ms at 25 °C and 85 °C. These defect states may have an effect on the charge loss behavior of the electrons localized in the charge trap layer at the retention mode of three-dimensional non-volatile memory devices. Dramatically, after the endurance stress was applied with a delayed pulse of 300 cycling at 85 °C for 50.4 h, no interface traps of the deep level transient spectroscopy spectra appeared. Dielectric recovery can decrease the density of the interface trap and improve the retention properties. This may have been caused by the passivation effect on the dangling bond of the interface traps.

Electrical and photovoltaic properties of residue-free MoS2 thin films by liquid exfoliation method

Molybdenum disulfide (MoS₂) film fabricated by a liquid exfoliation method has significant potential for various applications, because of its advantages of mass production and low-temperature processes. In this study, residue-free MoS₂ thin films were formed during the liquid exfoliation process and their electrical properties were characterized with an interdigitated electrode. Then, the MoS₂ film thickness could be controlled by centrifuge condition in the range of 20 ∼ 40 nm, and its carrier concentration and mobility were measured at about 7.36 × 10¹⁶ cm^-3 and 4.67 cm² V^-1 s^-1, respectively. Detailed analysis on the films was done by atomic force microscopy, Raman spectroscopy, and high-resolution transmission electron microscopy measurements for verifying the film quality. For application of the photovoltaic device, a Au/MoS₂/silicon/In junction structure was fabricated, which then showed power conversion efficiency of 1.01% under illumination of 100 mW cm^-2.

Selective control of electron and hole tunneling in 2D assembly

Recent discoveries in the field of two-dimensional (2D) materials have led to the demonstration of exotic devices. Although they have new potential applications in electronics, thermally activated transport over a metal/semiconductor barrier sets physical subthermionic limitations. The challenge of realizing an innovative transistor geometry that exploits this concern remains. A new class of 2D assembly (namely, "carristor") with a configuration similar to the metal-insulator-semiconductor structure is introduced in this work. Superior functionalities, such as a current rectification ratio of up to 400,000 and a switching ratio of higher than 10⁶ at room temperature, are realized by quantum-mechanical tunneling of majority and minority carriers across the barrier. These carristors have a potential application as the fundamental building block of low-power consumption electronics.

Anti-inflammatory effects of simvastatin in nonsteroidal anti-inflammatory drugs-induced small bowel injury

Small bowel injury can occur as the result of a multifaceted process that includes increased acid secretion, generation of reactive oxygen species, and cyclooxygenase inhibition. However, no effective medication for small bowel ulceration is available. Simvastatin is an important lipid-lowering agent with anti-inflammatory activity. We aimed to validate the effects of simvastatin in vitro and in vivo. In presence or absence of simvastatin, IEC-6 small bowel cell line with 50 ng/ml of tumor nectosis factor α (TNF-α) was investigated by western blotting, qRT-PCR, and DCF-DA assay. In addition, an in vivo study of nonsteroidal anti-inflammatory drugs (NSAID)-induced small bowel inflammation was performed using 7-week-old specific-pathogen-free (SPF) male C57BL/6 mice. Simvastatin treatment reduced the mRNA levels of interleukin-6 and interleukin-8 by approximately 50% in TNF-α-stimulated IEC-6 cells. Treatment with a combination of 50 ng/ml TNF-α and μM simvastatin decreased activation of Akt, IκBα, and nuclear factor-κB p65 level in IEC-6 cells. By DCF-DA staining, intracellular reactive oxygen species (ROS) production was increased in TNF-α-stimulated cells, and treatment with simvastatin decreased the level of ROS. In addition, in vivo mouse model of NSAID-induced small bowel inflammation, the administration of simvastatin reduced the number of small bowel hemorrhagic lesions and the level of ROS production as determined by gross examination and 8-hydroxydeoxyguanosine immunohistochemistry of small bowel tissue, respectively. Simvastatin reduced NSAID-induced injuries by both suppression of ROS generation and modulation of inflammatory cytokines in vitro and in vivo. Therefore, simvastatin, an HMG-CoA reductase inhibitor, has potential as a prophylactic and therapeutic agent for NSAID-induced small bowel injury.

Semiconducting properties of perchlorate-doped graphene using an electrochemical method

We report a band gap opening and p-type doping for single layer graphene by an electrochemical method.

Association between basal-like phenotype and BRCA1/2 germline mutations in Korean breast cancer patients

INTRODUCTION

BRCA mutation testing allows index patients and their families to be provided with appropriate cancer risk-reduction strategies. Because of the low prevalence of BRCA mutations in unselected breast cancer patients and the high cost of genetic testing, it is important to identify the subset of women who are likely to carry BRCA mutations. In the present study, we examined the association between BRCA1/2 germline mutations and the immunohistochemical features of breast cancer.

METHODS

In a retrospective review of 498 breast cancer patients who had undergone BRCA testing at Seoul National University Bundang Hospital between July 2003 and September 2012, we gathered immunohistochemical information on estrogen receptor (er), progesterone receptor (pr), her2 (human epidermal growth factor receptor 2), cytokeratin 5/6, egfr (epidermal growth factor receptor), and p53 status.

RESULTS

Among the 411 patients eligible for the study, 50 (12.2%) had germline mutations in BRCA1 or BRCA2. Of the 93 patients with triple-negative breast cancer (tnbc), 25 with BRCA1/2 mutations were identified (BRCA1, 20.4%; BRCA2, 6.5%). On univariate analysis, er, pr, cytokeratin 5/6, egfr, and tnbc were found to be related to BRCA1 mutations, but on multivariate analysis, only tnbc was significantly associated with BRCA1 mutations. Among patients with early-onset breast cancer or with a family history of breast or ovarian cancer, BRCA1 mutations were significantly more prevalent in the tnbc group than in the non-tnbc group.

CONCLUSIONS

In the present study, tnbc was the only independent predictor of BRCA1 mutation in patients at high risk of hereditary breast and ovarian cancers. Other histologic features of basal-like breast cancer did not improve the estimate of BRCA1 mutation risk.

Work Function Modification of Tungsten-Doped Indium Oxides Deposited by the Co-Sputtering Method

We have studied the work function modification of tungsten-doped indium oxides (IWOs) through the co-sputtering of indium oxide (In2O3) and indium tungsten oxide (In2O3 80 wt% + WO3 20 wt%) via a radio frequency (RF) magnetron sputtering system. By controlling the elemental deposition of IWOs, the resultant work functions varied from 4.37 eV to 4.1 eV. The IWO thin films showed excellent properties for application as transparent conducting oxide materials in the region of 0 to 2.43 at.% of tungsten versus the total metal content. The carrier concentration of n-type IWO thin films varied from 8.39 x 10(19) cm(-3) to 8.58 x 10(21) cm(-3), while the resistivity varied from 3.15 x 10(-4) Ωcm to 2.26 x 10(-3) Ωcm. The largest measured optical band gap was 3.82 eV determined at 2.43 at.% of tungsten atoms relative to the total amount of metal atoms, while the smallest optical band gap was 3.6 eV at 4.78 at.% of tungsten. IWO films containing more than 2.43 at.% of tungsten atoms relative to the total number of metal atoms revealed an average transmittance of over 80% within the visible light region.

Identifying the potential long-term survivors among breast cancer patients with distant metastasis

BACKGROUND

We aimed to develop a prediction model to identify long-term survivors after developing distant metastasis from breast cancer.

PATIENTS AND METHODS

From the institution's database, we collected data of 547 patients who developed distant metastasis during their follow-ups. We developed a model that predicts the post-metastasis overall survival (PMOS) based on the clinicopathologic factors of the primary tumors and the characteristics of the distant metastasis. For validation, the survival data of 254 patients from four independent institutions were used.

RESULTS

The median duration of the PMOS was 31.0 months. The characteristics of the initial primary tumor, such as tumor stage, hormone receptor status, and Ki-67 expression level, and the characteristics of the distant metastasis presentation including the duration of disease-free interval, the site of metastasis, and the presence of metastasis-related symptoms were independent prognostic factors determining the PMOS. The association between tumor stage and the PMOS was only seen in tumors with early relapses. The PMOS score, which was developed based on the above six factors, successfully identified patients with superior survival after metastasis. The median PMOS for patients with a PMOS score of <2 and for patients with a PMOS score of >5 were 71.0 and 12 months, respectively. The clinical significance of the PMOS score was further validated using independent multicenter datasets.

CONCLUSIONS

We have developed a novel prediction model that can classify breast cancer patients with distant metastasis according to their survival after metastasis. Our model can be a valuable tool to identify long-term survivors who can be potential candidates for more intensive multidisciplinary approaches. Furthermore, our model can provide a more reliable survival information for both physicians and patients during their informed decision-making process.

Transport properties of unrestricted carriers in bridge-channel MoS2 field-effect transistors

Unsuppressed carrier scattering from the underlying substrate in a layered two-dimensional material system is extensively observed, which degrades significantly the performance of devices. Beyond the material itself, understanding the intrinsic interfacial and surficial properties is an important issue for the analysis of a high-κ/MoS2 heterostructure. Here, we report on the electronic transport properties of bridge-channel MoS2 field-effect transistors fabricated by a contamination-free transfer method. After neglecting all the surrounding perturbations, it is possible to reveal the significant improvement of room-temperature mobility and subthreshold slope. A systematic study on variable-temperature transport measurements has quantified the trap density of states both in free-standing and SiO2-supported MoS2 systems. Compared to the bridge-channel MoS2 devices with an ideal interface, the unsuspended devices have a large amount of band tail states, and then the impact of their electronic states on the device performance is also discussed.

Electrically Tunable and Negative Schottky Barriers in Multi-layered Graphene/MoS2 Heterostructured Transistors

We fabricated multi-layered graphene/MoS2 heterostructured devices by positioning mechanically exfoliated bulk graphite and single-crystalline 2H-MoS2 onto Au metal pads on a SiO2/Si substrate via a contamination-free dry transfer technique. We also studied the electrical transport properties of Au/MoS2 junction devices for systematic comparison. A previous work has demonstrated the existence of a positive Schottky barrier height (SBH) in the metal/MoS2 system. However, analysis of the SBH indicates that the contacts of the multi-layered graphene/MoS2 have tunable negative barriers in the range of 300 to -46 meV as a function of gate voltage. It is hypothesized that this tunable SBH is responsible for the modulation of the work function of the thick graphene in these devices. Despite the large number of graphene layers, it is possible to form ohmic contacts, which will provide new opportunities for the engineering of highly efficient contacts in flexible electronics and photonics.

Comparison of Cancer Yields and Diagnostic Performance of Screening Mammography vs. Supplemental Screening Ultrasound in 4394 Women with Average Risk for Breast Cancer

PURPOSE

The effectiveness of supplemental screening ultrasound (US) was investigated in women ≥ 40 years at average risk for breast cancer regardless of breast parenchymal density. A total of 4394 women at average risk and having previously undergone screening mammography were classified as the mammography group. 

MATERIALS AND METHODS

Of 4394 women, 2005 underwent screening US after a final assessment of category 1 or 2 on screening mammography, and were categorized as the US group. Category 0, 4, and 5 on mammography and 3, 4, and 5 on US were defined as positive. The cancer yields per 1000 women and diagnostic performance of two groups were compared.

RESULTS

The total cancer and invasive cancer yields for the mammography group were 3.0 (95 % confidence interval 1.6, 5.1) and 2.0 (95 % CI, 0.9, 3.9) per 1000 women, higher than the US values of 2.0 (0.5, 5.1) and 1.0 (0.1, 3.6), not statistically significant. The specificity, accuracy, and positive predictive value (PPV) for mammography were 88.90 % (87.93, 89.81), 88.85 % (87.88, 89.76), and 2.61 % (1.39, 4.41), significantly higher than the US values of 69.07 % (66.99, 71.09), 69.13 % (67.05, 71.15), and 0.64 % (0.18, 1.64). The short-term follow-up rate of mammography was 5.51 % (4.85, 6.22), significantly lower than the rate of 26.58 (24.66, 28.58) for US. 

CONCLUSION

Supplemental screening US in mammographically negative breasts can find additional carcinomas in women at average risk but is not as effective as screening mammography because of the lower cancer yield, invasive cancer yield, specificity, accuracy, PPV and a high short-term follow-up rate.

Inhibition of TGFBIp expression reduces lymphangiogenesis and tumor metastasis

Transforming growth factor-β-induced protein (TGFBIp) is an extracellular matrix protein that has a role in a wide range of pathological conditions. However, the role of TGFBIp signaling in lymphangiogenesis is poorly understood. The purpose of this study was therefore to analyze the effects of TGFBIp on lymphangiogenesis and determine whether TGFBIp-related lymphangiogenesis is important for the metastasis of tumor cells. TGFBIp increased adhesion, migration, and morphologic differentiation of human lymphatic endothelial cells (LECs), consistent with an increase in lymphatic vessel sprouting in a three-dimensional lymphatic ring assay. TGFBIp also induced phosphorylation of intracellular signaling molecules SRC, FAK, AKT, JNK and ERK. TGFBIp-induced lymphatic vessel sprouting was inhibited by addition of anti-integrin β3 antibody and pharmacologic inhibitors of FAK, AKT, JNK or ERK. TGFBIp increased both CCL21 expression in LECs, a chemokine that actively recruits tumor cells expressing the cognate chemokine receptors to lymphatic vessels and LEC permeability by inducing the dissociation of VE-cadherin junctions between LECs via the activation of SRC signaling. In vivo, inhibition of TGFBIp expression in SW620 cancer cells dramatically reduced tumor lymphangiogenesis and metastasis. Collectively, our findings demonstrate that TGFBIp is a lymphangiogenic factor contributing to tumor dissemination and represents a potential target to inhibit metastasis.

Stable p-type properties of single walled carbon nanotubes by electrochemical doping

We report a highly stable p-type doping for single walled carbon nanotubes using an electrochemical method.

Overexpression of PI3K-p110α in the progression of uterine cervical neoplasia and its correlation with pAkt and DJ-1

OBJECTIVE

To investigate the expression of PI3K-p110α, pAkt, PTEN, the signaling molecules from PI3K/Akt signaling pathway, DJ-1, an oncoprotein and HSP90a, a molecular chaperone, and their correlation in uterine cervical neoplasia, in order to elucidate their role in cervical carcinogenesis.

MATERIALS AND METHODS

Using immunohistochemistry, the authors analyzed the expression of PI3K-p110α, pAkt, PTEN, DJ-1 and HSP90α, and their correlation in ten normal tissues, cervical intraepithelial neoplasia (CIN) including 30 CIN1 and 31 CIN3, and 33 cases of invasive squamous cell carcinoma (SCC).

RESULTS

The expression of all proteins significantly increased in CIN3 compared to CIN1, and only the expression of PI3K-p110α significantly increased in invasive SCC compared to CIN3. There was a significant positive correlation between the expression of PI3K-p110α and DJ-1, as well as PI3K-p110α and pAkt in CIN3 and invasive SCC.

CONCLUSION

Overexpression of PI3K-p110α is associated with progression of uterine cervical neoplasia, and the expression of pAkt and DJ-1 is positively correlated with PI3K-p110α expression in this process.

Memory effect by carrier trapping into V3Si nanocrystals among SiO2 layers on multi-layered graphene layer

We report the electrical characteristics and conduction mechanism of a resistive switching memory device consisting of V3Si nanocrystals embedded in the SiO2 layer on multi-layered graphene. The V3Si nanocrystals with average size of 5 nm were formed between the SiO2 layers by thin film deposition and post-annealing process at 800 degrees C for 5 s. The current values of high (HRS) and low resistance states (LRS) at 1 V were measured to be about 3.26 x 10(-9) A and 3.11 x 10(-8) A, respectively. The ratio of the HRS and LRS after applying sweeping bias of ± 6 V appeared to be about 9.54 at 1 V. The resistance switching could originate from the effect of carrier trap and emission into the V3Si nanocrystals via the tunneling, space charge limited current, and thermionic emission mechanisms controlled by the modulation of the Fermi level of the graphene layer. The V3Si nanocrystals memory device has a strong possibility for the application of nonvolatile memory devices.

Thermal annealing effects on ZnO films grown on graphene buffered Si substrates

ZnO films deposited on SiO2/Si substrate with a graphene single layer (GSL) were studied by using an ultra-high vacuum sputter. The as-prepared films were annealed at temperature ranges from 500 degrees C to 800 degrees C for 1 min under ambient N2 gas. When the annealing temperature was increased up to 800 degrees C, the root mean square roughness of the ZnO/Si sample surface decreased down to 3.4 nm, and the grain sizes increased about 50.8 nm with a clear grain boundary. From the photoluminescence (PL) spectra, the high intensity of near-band-edge UV emission at 380 nm (3.26 eV) and the broad band emission between 450 and 650 nm, known as the visible defect related PL band, decreased with increasing annealing temperature up to 800 degrees C. The ZnO thin films on the growth on the GSL and post-annealing at 700 degrees C for 1 min under ambient N2 gas had the best structural and optical properties.