Search

This study aimed to evaluate the effect of Astragalus polysaccharides (PG2) on reducing chemotherapy-induced fatigue (CIF) and toxicity, thereby encouraging compliance to chemotherapy. This was a randomized, placebo-controlled, phase 2 study. Patients with stage II/III early breast cancer planning to undergo adjuvant anthracycline-based chemotherapy were randomly assigned to receive PG2 500 mg or placebo on days 1, 3, and 8 every 21 days. The fatigue global score (FGS) was assessed using the brief fatigue inventory (BFI)-Taiwan. The Breast Cancer-Specific Module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Core30 evaluated the health-related quality of life during the first four cycles of adjuvant chemotherapy. Overall, 66 eligible patients were equally randomized into the PG2 and placebo groups between March 01, 2018, and March 09, 2021. The mean change in the FGS and fatigue intensity did not significantly differ between both groups. However, the FGS and fatigue intensity were less aggravated in the first four cycles in the premenopausal-PG2 group than in the placebo group. Our study concluded PG2 combined with adjuvant chemotherapy can reduce CIF, insomnia, the negative effect on future perspectives, and improve global health status, especially for premenopausal patients with breast cancer. Trial registration number: NCT03314805 registered on 19/10/2017. [ABSTRACT FROM AUTHOR]

Background: Due to the presence of other comorbidities and multi-therapeutic modalities in breast cancer, renally cleared chemotherapeutic regimens may cause nephrotoxicity. The aim of this retrospective study is to compare the chemotherapy types and outcomes in breast cancer patients with or without chronic renal disease. Patients and Methods: We retrospectively enrolled 62 female patients with breast cancer and underlying late stages (stage 3b, 4, and 5) of chronic kidney disease (CKD) treated from 2000 to 2017. They were propensity score-matched 1:1 with patients in our database with breast cancer and normal renal function (total n = 124). Results: The main subtype of breast cancer was luminal A and relatively few patients with renal impairment received chemotherapy and anti-Her-2 treatment. The breast cancer patients with late-stage CKD had a slightly higher recurrent rate, especially at the locally advanced stage. The 5-year overall survival was 90.1 and 71.2% for patients without and with late-stage CKD, but the breast cancer-related mortality rate was 88.9 and 24.1%, respectively. In multivariate analyses, dose-reduced chemotherapy was an independent negative predictor of 5-year recurrence-free survival and late-stage CKD was associated with lower 5-year overall survival rate. Conclusions: Breast cancer patients with late-stage CKD may receive insufficient therapeutic modalities. Although the recurrence-free survival rate did not differ significantly by the status of CKD, patients with breast cancer and late-stage CKD had shorter overall survival time but a lower breast cancer-related mortality rate, indicated that the mortality was related to underlying disease. [ABSTRACT FROM AUTHOR]

Simple Summary: Neoadjuvant chemotherapy (NAC) is widely used to treat stage II and III primary, operable triple-negative breast cancer (TNBC). The response to NAC critically affects the subsequent treatment plan, including not only curative surgical planning but also adjuvant therapy. There is no standard prediction model that accurately predicts NAC response. Therefore, the development of an easy-to-apply and cost-effective clinical prediction model for NAC treatment response would improve clinical practice. We propose an integrative clinical prediction model for the prediction of pathologically complete response in patients with operable stage II and stage III TNBC receiving NAC based on findings from tumor ultrasound and blood tests. All included parameters were readily available during and before NAC. This clinical prediction model could provide a reference to guide clinicians' decisions in planning a patient's NAC treatment as early as after the first cycle of NAC. Triple-negative breast cancer (TNBC) is treated with neoadjuvant chemotherapy (NAC). The response to NAC, particularly the probability of a complete pathological response (pCR), guides the surgical approach and adjuvant therapy. We developed a prediction model using a nomogram integrating blood tests and pre-treatment ultrasound findings for predicting pCR in patients with stage II or III operable TNBC receiving NAC. Clinical data before and after the first cycle of NAC collected from patients between 2012 and 2019 were analyzed using univariate and multivariate analyses to identify correlations with pCR. The coefficients of the significant parameters were calculated using logistic regression, and a nomogram was developed based on the logistic model to predict the probability of pCR. Eighty-eight patients were included. Five parameters correlated with the probability of pCR, including the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte (PLR) ratio, percentage change in PLR, presence of echogenic halo, and tumor height-to-width ratio. The discrimination performance of the nomogram was indicated by an area under the curve of 87.7%, and internal validation showed that the chi-square value of the Hosmer–Lemeshow test was 7.67 (p = 0.363). Thus, the integrative prediction model using clinical data can predict the probability of pCR in patients with TNBC receiving NAC. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant chemotherapy (NACT) was initially applied to locally advanced breast cancer to convert advanced lesions to an operable status. Currently, its application has been expanded to enhance overall oncological results, especially in patients with triple-negative or HER-2-positive breast cancer. With more NACT being applied, the role and impact of this approach on breast reconstruction needs to be determined. This study aimed to perform a complete reconstructive outcome analysis of patients receiving NACT who underwent immediate breast reconstruction.Methods: A retrospective review of a single reconstructive surgeon's immediate breast reconstructions performed from July 2008 to December 2018 was undertaken. The results were stratified by the use of NACT. Patient demographics, delivery of NACT, adjuvant treatment, incidence of surgical complications, and postoperative photographs were analyzed.Results: A total of 269 patients were included. The mean follow-up was 46.3 months. Forty-six out of 269 patients received NACT and were included in the NACT group. The other patients were included in the non-NACT group. When implant-based reconstruction was planned, the NACT group had a higher rate of two-stage tissue expander-implant reconstruction than direct-to-implant reconstruction (p < 0.001). The requirement for postmastectomy radiotherapy was higher in the NACT group (p < 0.001). The surgical complication rates were similar between groups after adjusting for confounding factors. The objective aesthetic outcomes assessed by 6 plastic surgeons were also similar between groups.Conclusions: Immediate breast reconstruction is a safe and reliable procedure, with an acceptable reconstructive complication rate and satisfactory aesthetic outcomes, for patients treated with NACT. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant chemotherapy (NAC) has been the standard treatment for locally advanced breast cancer for the purpose of downstaging or for conversion from mastectomy to breast conservation surgery (BCS). Locoregional recurrence (LRR) rate is still high after NAC. The aim of this study was to determine predictive factors for LRR in breast cancer patients in association with the operation types after NAC.Methods: Between 2005 and 2017, 1047 breast cancer patients underwent BCS or mastectomy after NAC in Chang Gung Memorial Hospital, Linkou. We obtained data regarding patient and tumor characteristics, chemotherapy regimens, clinical tumor response, tumor subtypes and pathological complete response (pCR), type of surgery, and recurrence.Results: The median follow-up time was 59.2 months (range 3.13-186.75 months). The mean initial tumor size was 4.89 cm (SD ± 2.95 cm). Of the 1047 NAC patients, 232 (22.2%) achieved pCR. The BCS and mastectomy rates were 41.3% and 58.7%, respectively. One hundred four patients developed LRR (9.9%). Comparing between patients who underwent BCS and those who underwent mastectomy revealed no significant difference in the overall LRR rate of the two groups, 8.8% in BCS group vs 10.7% in mastectomy group (p = 0.303). Multivariate analysis indicated that independent factors for the prediction of LRR included clinical N2 status, negative estrogen receptor (ER), and failure to achieve pCR. In subgroups of multivariate analysis, only negative ER was the independent factor to predict LRR in mastectomy group (p = 0.025) and hormone receptor negative/human epidermal growth factor receptor 2 positive (HR-/HER2 +) subtype (p = 0.006) was an independent factor to predict LRR in BCS patients. Further investigation according to the molecular subtype showed that following BCS, non-pCR group had significantly increased LRR compared with the pCR group, in HR-/HER2 + subtype (25.0% vs 8.3%, p = 0.037), and HR-/HER2- subtype (20.4% vs 0%, p = 0.002).Conclusion: Clinical N2 status, negative ER, and failure to achieve pCR after NAC were independently related to the risk of developing LRR. Operation type did not impact on the LRR. In addition, the LRR rate was higher in non-pCR hormone receptor-negative patients undergoing BCS comparing with pCR patients. [ABSTRACT FROM AUTHOR]

Motivation: Fire prevention is critical in an intensive care unit because it is a special environment with many instruments and pieces of equipment and numerous immobile patients in critical conditions who depend on breathing devices. Problems: In August 2014, an unused extension cord under a patient's bed in an intensive care unit accidentally caused a fire. Fortunately, the fire was extinguished within 20 seconds and did not cause a disaster. We investigated the current status of fire safety and discovered a lack of a standard procedure and audit system for extension cords, no relevant in-service education training, and insufficient awareness among staff members of the safety of the environment with respect to electricity. Purpose: To improve electricity safety management for health care workers in an intensive care unit to ensure patient safety. Solutions: The establishment of electricity safety management methods, the provision of relevant on-the-job education, the establishment of electricity safety checkpoints, and the implementation of auditing units concerning the electricity environment. Results: Electricity safety increased from 8.3% at the initial inspection to 97%, and electricity safety awareness was achieved among the staff. The correct response rate rose from 37.1% to 95.2%. Conclusion: Through this project, electricity safety and electricity safety awareness among personnel increased, creating a safe environment to ensure patient safety. This project can provide a reference for how to reduce the risk of fire incidents in a hospital intensive care unit. [ABSTRACT FROM AUTHOR]

High-κ barium zirconate nickelate (BZN) gate dielectric layer was prepared through the low-temperature sol--gel method and was used in pentacene-based organic thin-film transistor (OTFT) applications. In comparison with its barium zirconate oxide (BZO) counterpart, experimental results show that the threshold voltage of the BZN-based OTFTs decreases from -2 to -1.1 V, the gate leakage decreases from 10-8 to 10-12 A, the carrier mobility increases from 2.1 to 5.2 cm²/Vs, and the subthreshold swing decreasesfrom2.4 to 0.4 V/decade. The effect of Ni on device characteristics is discussed in this paper.Ni(II) acetylacetone possesses two pairs of symmetrical bidentate ligands, which can chelate with Zr ion to smoothen surface roughness. The dielectric constant can be increased. The enhancement ofmobility is partly attributed to the smoother surfaceto reduce the scatteringeffectsof the carrier. In addition, the improved film qualitymay also increase the barrier height and reduce the leakage current, which enhances the ON/OFF ratio through the chelate effect due to the addition of Ni in BZO. Furthermore, excellent operation stability can be achieved. [ABSTRACT FROM AUTHOR]

A one-transistor and one-resistor (1T1R) architecture with a resistive random access memory (RRAM) cell connected to an organic thin-film transistor (OTFT) device is successfully demonstrated to avoid the cross-talk issues of only one RRAM cell. The OTFT device, which uses barium zirconate nickelate (BZN) as a dielectric layer, exhibits favorable electrical properties, such as a high field-effect mobility of 2.5 cm2/Vs, low threshold voltage of -2.8 V, and low leakage current of 10-12 A, for a driver in the 1T1R operation scheme. The 1T1R architecture with a TiO2-based RRAM cell connected with a BZN OTFT device indicates a low operation current (10 μA) and reliable data retention (over ten years). This favorable performance of the 1T1R device can be attributed to the additional barrier heights introduced by using Ni (II) acetylacetone as a substitute for acetylacetone and the relatively low leakage current of a BZN dielectric layer. The proposed 1T1R device with low leakage current OTFT and excellent uniform resistance distribution of RRAM exhibits a good potential for use in practical low-power electronic applications. [ABSTRACT FROM AUTHOR]

This work illustrates the effect of thermal mechanical processing parameters on the Past studies in humans have demonstrated horizontal and vertical bone loss after six months following tooth extraction. Many biomaterials have been developed to preserve bone volume after tooth extraction. Type I collagen serves as an excellent delivery system for growth factors and promotes angiogenesis. Calcium phosphate ceramics have also been investigated because their mineral chemistry resembles human bone. The aim of this study was to compare the performance of a novel bioresorbable purified fibrillar collagen and hydroxyapatite/β-tricalcium phosphate (HAβ-TCP) ceramic composite versus collagen alone and a bovine xenograft-collagen composite in beagles. Collagen plugs, bovine graft-collagen composite and HA/β-TCP-collagen composite were implanted into the left and right first, second and third mandibular premolars, and the fourth molar was left empty for natural healing. In total, 20 male beagle dogs were used, and quantitative and histological analyses of the extraction ridge was done. The smallest width reduction was 19.09% ± 8.81% with the HA/β-TCP-collagen composite at Week 8, accompanied by new bone formation at Weeks 4 and 8. The HA/β-TCP-collagen composite performed well, as a new osteoconductive and biomimetic composite biomaterial, for socket bone preservation after tooth extraction. [ABSTRACT FROM AUTHOR]

Flat epithelial atypia ( FEA) and atypical ductal hyperplasia ( ADH) are precursors of breast malignancy. Management of FEA or ADH after image-guided core needle biopsy ( CNB) remains controversial. The aim of this study was to evaluate malignancy underestimation rates after FEA or ADH diagnosis using image-guided CNB and to identify clinical characteristics and imaging features associated with malignancy as well as identify cases with low underestimation rates that may be treatable by observation only. We retrospectively reviewed 2,875 consecutive image-guided CNBs recorded in an electronic data base from January 2010 to December 2011 and identified 128 (4.5%) FEA and 83 (2.9%) ADH diagnoses (211 total cases). Of these, 64 (30.3%) were echo-guided CNB procedures and 147 (69.7%) mammography-guided CNBs. Twenty patients (9.5%) were upgraded to malignancy. Multivariate analysis indicated that age ( OR = 1.123, p = 0.002, increase of 1 year), mass-type lesion with calcifications ( OR = 8.213, p = 0.006), and ADH in CNB specimens ( OR = 8.071, p = 0.003) were independent predictors of underestimation. In univariate analysis of echo-guided CNB ( n = 64), mass with calcifications had the highest underestimation rate (p < 0.001). Multivariate analysis of 147 mammography-guided CNBs revealed that age ( OR = 1.122, p = 0.040, increase of 1 year) and calcification distribution were significant independent predictors of underestimation. No FEA case in which, complete calcification retrieval was recorded after CNB was upgraded to malignancy. Older age at diagnosis on image-guided CNB was a predictor of malignancy underestimation. Mass with calcifications was more likely to be associated with malignancy, and in cases presenting as calcifications only, segmental distribution or linear shapes were significantly associated with upgrading. Excision after FEA or ADH diagnosis by image-guided CNB is warranted except for FEA diagnosed using mammography-guided CNB with complete calcification retrieval. [ABSTRACT FROM AUTHOR]

The article discusses research investigating the role of fungal immunomodulatory protein (FIP-fve) isolated from Flammulina velutipes in alleviation of asthma and inflammation induced from house dust mite (HDM) Dermatophagoides microceras (Der m) in mice. Topics discussed include HDM as a major risk factor for asthma, evaluation of hyper-responsiveness (AHR), pathological changes, and cytokines in mice, and suppression of asthma, inflammation, and respiratory pathogenesis from FIP-fve.

Background Fine particulate air pollution (PM2.5) is a global health concern, as exposure to PM2.5 has consistently been found to be associated with increased cardiovascular morbidity and mortality. Although adult exposure to traffic related PM2.5, which is largely derived from diesel exhaust (DE), has been associated with increased cardiac hypertrophy, there are limited investigations into the potential effect of in utero and early life exposure on adult susceptibility to heart disease. In this study, we investigate the effect of in utero and early life exposure to DE on adult susceptibility to heart failure. Methods Female C57BL/6 J mice were exposed to either filtered air (FA) or DE for 3 weeks (≈300 μg/m3 PM2.5 for 6 hours/day, 5 days/week) and then introduced to male breeders for timed matings. Female mice were exposed to either FA or DE throughout pregnancy and until offspring were 3 weeks of age. Offspring were then transferred to either FA or DE for an additional 8 weeks of exposure. At 12 weeks of age, male offspring underwent a baseline echocardiographic assessment, followed by a sham or transverse aortic constriction (TAC) surgery to induce pressure overload. Following sacrifice three weeks post surgery, ventricles were processed for histology to assess myocardial fibrosis and individual cardiomyocyte hypertrophy. mRNA from lung tissue was isolated to measure expression of inflammatory cytokines IL6 and TNFα. Results We observed that mice exposed to DE during in utero and early life development have significantly increased susceptibility to cardiac hypertrophy, systolic failure, myocardial fibrosis, and pulmonary congestion following TAC surgery compared to FA control, or adult DE exposed mice. In utero and early life DE exposure also strongly modified the inflammatory cytokine response in the lung following adult DE exposure. Conclusions We conclude that exposure to diesel exhaust air pollution during in utero and early life development in mice increases adult susceptibility to heart failure. The results of this study may imply that the effects of air pollution on cardiovascular disease in human populations may be strongly mediated through a 'fetal origins' of adult disease pathway. Further investigations on this potential pathway of disease are warranted. [ABSTRACT FROM AUTHOR]

Purpose: Little evidence can be found about the long-term outcome of breast cancer patients after axillary lymph node recurrence (ALNR) and its survival benefit after different kinds of management. The present study intends to evaluate the risk factors associated with axillary recurrence after definite surgery for primary breast cancer. The prognosis after ALNR and particularly outcome of different management methods also were studied. Methods: We retrospectively reviewed data from 4,473 patients who were diagnosed with primary breast cancer and received surgical intervention in a single institute from January 1990 to December 2002. Medical files were reviewed and data on survival were updated annually. Risk factors and prognosis of patients with axillary recurrence were analyzed. Breast-cancer-specific survival of patients with ALNR and outcomes after different management methods also were studied. Results: After a median follow-up of 70.2 months, axillary recurrence developed in 0.8% of patients. Factors associated with ALNR included: age younger than 40 years, medial tumor location, no initial standard level I & II axillary dissection, and not receiving hormonal therapy. The 5-year breast-cancer-specific survival after ALNR was 57.9%. For patients who received further axillary dissection, the 5-year survival rate was 82.5% compared with 44.9% for patients who did not receive further dissection. Conclusions: ALNR is a rare event in treating breast cancer. Young age at diagnosis and medially located tumor are associated with higher risk, but standardized initial axillary dissection to level II and adjuvant hormonal therapy is protective against ALNR. In patients with ALNR, the outcome is not dismal and survival may be improved if further axillary dissection is given. [ABSTRACT FROM AUTHOR]

In this letter, we proposed the design of novel dual-band bandpass filter (BPF) with a broad upper rejection band using only two asymmetric stepped impedance resonators (SIRs), which has a smaller circuit size in comparison of previous works. The feature of the asymmetric SIR is only one-step discontinuity, which is different from the conventional SIR with two-step discontinuities. By selecting properly the impedance ratio (R) and physical length ratio (α) of the proposed asymmetric SIRs, the low loss dual-band BPF centered at 2.4/5.2 GHz with a wide upper rejection band from 6 to 14 GHz can be implemented perfectly. The bandwidths and the coupling coefficients of the two passbands can be tunable by adjusting the coupling gap distance between the resonators, which are calculated by using full-wave simulator IE3D. Good agreement between the electromagnetic (EM) simulation and measurement is reported. © 2009 Wiley Periodicals, Inc. Microwave Opt Technol Lett 51: 1143–1146, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.24227 [ABSTRACT FROM AUTHOR]

In this article, a dual-band bandpass filter (BPF) using the multilayered structure is presented. The BPF consists of a pair of uniform impedance resonators on the top layer and a pair of step-impedance resonators on the middle layer. By using the multilayered structure, the multitransmission zeros located near the passband edges, which is introduced by the crosscoupling effect, can be created to improve the filter selectivity. In addition, the bandwidths of the two passbands (2.4/5.2 GHz) can be tunable by adjusting the coupling gap distance between the resonators. The fabricated filter has a very compact size. Experimental results of the fabricated filter are well agreed with the simulation results. © 2008 Wiley Periodicals, Inc. Microwave Opt Technol Lett 50: 2010–2013, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.23585 [ABSTRACT FROM AUTHOR]

In this article, a novel compact dual-band bandpass filter (BPF) using asymmetric stepped impedance resonators (SIRs) has been presented for the first time. The feature of the proposed asymmetric SIR is only one step discontinuity, which is different from the conventional SIR with two step discontinuities. The frequency response of the dual-band at 2.4/5.2 GHz can be achieved by determining the impedance ratio (K) and physical length ratio (α) of the asymmetric SIR. The coupling coefficient between the coupled asymmetric SIRs is calculated by using full-wave simulator IE3D. A dual band BPF is designed, fabricated, and measured. The measured results are in good agreement with the full-wave simulation results. Additionally, the BPF has a smaller circuit size in comparison of previous works. © 2008 Wiley Periodicals, Inc. Microwave Opt Technol Lett 50: 1237–1240, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.23339 [ABSTRACT FROM AUTHOR]

Effects of sodium azide (NaN3) on spontaneously generated action potential and bursts of potential elicited by d-amphetamine ( d-amphetamine-elicited BoP) were studied on the right parietal 4 (RP4) neuron of the snail Achatina fulica Ferussac in vitro. Sodium azide altered the spontaneous action potential of RP4 neuron in a concentration-dependent manner. In lower concentrations, neither NaN3 (30, 100, 300 µM; 1 and 3 mM) nor d-amphetamine (135 µM) affect the resting membrane potential, amplitude and frequency of RP4 neurons, while in the higher concentrations NaN3 (30 mM) did abolish the spontaneous action potential on RP4 neurons and depolarized the RP4 neurons reversibly. At lower concentration, NaN3 (30 µM) facilitated the d-amphetamine-elicited BoP. The BoP elicited by NaN3 (30 µM) and d-amphetamine (135 µM) were decreased following treatment with KT5720 (protein kinase A inhibitor), or intracellular injection of EGTA [ethylene glycol-bis(2-aminoethyl ether)-N,N,N′,N′-tetraacetic acid]. However, the BoP was not affected by applying U73122 (1-[6-[((17β)-3-methoxyestra-1,3,5[10]-trien-17-yl)amino]hexyl]-1H-pyrrole-2,5-dione) or neomycin (phospholipase inhibitors). Voltage clamp studies revealed that NaN3 (30 µM) did not alter the total fast inwards currents (70 msec.) and the steady-state outwards currents (5 sec.). It appeared that the BoP elicited by NaN3 (30 µM) and d-amphetamine (135 µM) was mainly due to protein kinase A-related messenger system and intracellular calcium. It is concluded that d-amphetamine-elicited BoP was not mainly due to inhibition of the function of mitochondria in the neuron while the function of mitochondria did alter the BoP elicited by amphetamine. [ABSTRACT FROM AUTHOR]

This letter proposes a parallel coupled-line bandpass filter (BPF) using the folded slotted ground structures (SGSs) to improve the wide stopband. It is shown that the designed folded SGS has a very small area in comparison of previous works. The folded SGS exhibits a dual stopband characteristic owing to the bandgap resonant characteristic of SGS to suppress the harmonic frequency of the parallel coupled-line BPF. Good agreement with electro-magnetic simulation and measurement is demonstrated. © 2006 Wiley Periodicals, Inc. Microwave Opt Technol Lett 49: 159–162, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.22065 [ABSTRACT FROM AUTHOR]

Probabilistic Roadmaps (PRM) have been successfully used to plan complex robot motions in configuration spaces of small and large dimensionalities. However, their efficiency decreases dramatically in spaces with narrow passages. This paper presents a new methodsmall-step retractionthat helps PRM planners find paths through such passages. This method consists of slightly fattening robot's free space, constructing a roadmap in fattened free space, and finally repairing portions of this roadmap by retracting them out of collision into actual free space. Fattened free space is not explicitly computed. Instead, the geometric models of workspace objects (robot links and/or obstacles) are thinned around their medial axis. A robot configuration lies in fattened free space if the thinned objects do not collide at this configuration. Two repair strategies are proposed. The optimist strategy waits until a complete path has been found in fattened free space before repairing it. Instead, the pessimist strategy repairs the roadmap as it is being built. The former is usually very fast, but may fail in some pathological cases. The latter is more reliable, but not as fast. A simple combination of the two strategies yields an integrated planner that is both fast and reliable. This planner was implemented as an extension of a pre-existing single-query PRM planner. Comparative tests show that it is significantly faster (sometimes by several orders of magnitude) than the pre-existing planner. [ABSTRACT FROM AUTHOR]

The double exponentially weighted moving average (dEWMA) controller is a popular run-to-run controller for a drifted process. It uses the information collected from past process data to adjust the process parameters for the later runs. The dEWMA controller can guarantee long-term stability under suitably fixed discount factors and fairly regular conditions. However, it usually requires a large number of runs to bring the process output to meet its target and, thus, may leave the output out of its specification at the beginning of the first few runs. Hence, dEWMA controller is not suitable for the processes with short production runs. To reduce the possibility of high rework rate, we propose an enhanced dEWMA controller, which we refer to as the initial intercept iteratively adjusted (IIIA) controller, to further eliminate the off-target (nonrandom biases) of the process output. We derive an analytic expression of the process output of the IIIA controller, and present several examples to show that the IIIA reduces the process mean square error significantly, as well as the rework rate. [ABSTRACT FROM AUTHOR]

Simple Summary: Very limited studies so far have analyzed the long-term oncologic outcomes of breast cancer patients that developed metachronous isolated supraclavicular nodal metastasis (miSLNM) with no available treatment strategy for the critical issue. The study enrolled 139 miSLNM patients; 61 patients underwent selective neck dissection. In median follow-up of 73.1 months, significantly better 5-year overall survival rate was found in the neck dissection group compared to the no-dissection group (68.9% vs. 57.7%, respectively; HR, 1.77 (1.22–2.55), p = 0.003). The findings suggest surgery for miSLNM should be integrated into multimodal therapy of miSLNM, and the restaging of miSLNM as rN3c rather than M1 disease if detected earlier. We retrospectively enrolled 139 patients who developed metachronous isolated supraclavicular lymph node metastasis (miSLNM) from 8129 consecutive patients who underwent primary surgery between 1990 and 2008 at a single medical center. The median age was 47 years. The median follow-up time from date of primary tumor surgery was 73.1 months, and the median time to the date of neck relapse was 43.9 months in this study. Sixty-one (43.9%) patients underwent selective neck dissection (SND). The 5-year distant metastasis-free survival (DMFS), post-recurrence survival, and overall survival (OS) rates in the SND group were 31.1%, 40.3%, and 68.9%, respectively, whereas those of the no-SND group were 9.7%, 32.9%, and 57.7%, respectively (p = 0.001). No SND and time interval from primary tumor surgery to neck relapse ≤24 months were the only significant risk factors in the multivariate analysis of DMFS (hazard ratio (HR), 1.77; 95% confidence interval (CI), 1.23–2.56; p = 0.002 and HR, 1.76, 95% CI, 1.23–2.52; p = 0.002, respectively) and OS (HR, 1.77; 95% CI, 1.22–2.55; p = 0.003 and HR, 3.54, 95% CI, 2.44–5.16; p < 0.0001, respectively). Multimodal therapy, including neck dissection, significantly improved the DMFS and OS of miSLNM. Survival improvement after miSLNM control by intensive surgical treatment suggests that miSLNM is not distant metastasis. [ABSTRACT FROM AUTHOR]

Using the biomaterial of Al-chelated gelatin (ACG) prepared by sol-gel method in the ITO/ACG/ ITO structure, a highly transparent resistive random access memory (RRAM) was obtained. The transmittance of the fabricated device is approximately 83% at 550 nm while that of Al/gelatin/ITO is opaque. As to the ITO/gelatin/ITO RRAM, no resistive switching behavior can be seen. The ITO/ACG/ITO RRAM shows high ON/OFF current ratio (>105), low operation voltage, good uniformity, and retention characteristics at room temperature and 85 °C. The mechanism of the ACG-based memory devices is presented. The enhancement of these electrical properties can be attributed to the chelate effect of Al ions with gelatin. Results show that transparent ACG-based memory devices possess the potential for next-generation resistive memories and bio-electronic applications. [ABSTRACT FROM AUTHOR]

Simple Summary: Mammography frequently detects the early breast cancers manifesting microcalcifications only. By means of mammographically guided vacuum-assisted core needle biopsy, noninvasive ductal carcinoma in situ (DCIS) is often diagnosed. Unfortunately, invasive components are occasionally embedded within the noninvasive cancer bed, which will alter the preoperative planning. Whether or not to perform single-step sentinel lymph node sampling is an area of controversy. In order to minimize the overtreatment or undertreatment, we retrospectively reviewed the enhanced features of DCIS and invasive ductal carcinomas (IDCs) on contrast-enhanced spectral mammograms (CESMs). The CESM is a modern technique enabling the provision of conventional mammograms and contrast-enhanced images. The results of our study revealed low DCIS upgrade of the unenhanced DCIS. Otherwise, DCIS tended to appear as nonmass and pure ground glass enhancements, and IDC tended to appear as mass and unpurified solid enhancement. The enhanced features allow distinguishing DCIS and IDC. Background: The contrast-enhanced mammographic features of ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) manifesting microcalcifications only on mammograms were evaluated to determine whether they could predict IDC underestimation. Methods: We reviewed patients who underwent mammography-guided biopsy on suspicious breast microcalcifications only and received contrast-enhanced spectral mammography (CESM) within 2 weeks before the biopsy. Those patients who were proven to have cancers (DCIS or IDC) by biopsy and subsequently had surgical treatment in our hospital were included for analysis. The presence or absence, size, morphology and texture of enhancement on contrast-enhanced spectral mammography were reviewed by consensus of two radiologists. Results: A total of 49 patients were included for analysis. Forty patients (81.6%) showed enhancement, including 18 (45%) DCIS and 22 (55%) IDC patients. All nine unenhanced cancers were pure DCIS. Pure DCIS showed 72.22% nonmass enhancement and 83.33% pure ground glass enhancement. IDC showed more mass (72.2% vs. 27.8%) and solid enhancements (83.33% vs. 16.67%). The cancer and texture of enhancement were significantly different between pure DCIS and IDC, with moderate diagnostic performance for the former (p-value < 0.01, AUC = 0.66, sensitivity = 93%, specificity = 39%) and the latter (p-value < 0.01, AUC = 0.74, sensitivity = 65%, specificity = 83%). Otherwise, pure DCIS showed a significant difference in enhanced texture compared with upgraded IDC and IDC (p = 0.0226 and 0.0018, respectively). Conclusions: Nonmass and pure ground glass enhancements were closely related to pure DCIS, and cases showing mass and unpurified solid enhancements should be suspected as IDC. Unenhanced DCIS with microcalcifications only has a low DCIS upgrade rate. The CESM-enhanced features could feasibly predict IDC underestimation. [ABSTRACT FROM AUTHOR]

Simple Summary: Routine sentinel lymph node (SLN) biopsy (SLNB) is not necessary for breast-conserving surgery (BCS)-treated ductal carcinoma in situ (DCIS) but is indicated for underestimated invasive carcinoma (IC) postoperatively. In this retrospective study, we aimed to investigate the factors contributing to SLN metastasis in underestimated IC patients with an initial diagnosis of DCIS by core needle biopsy. We found that only the features related to IC, including an IC tumor size (>0.5 cm) and the presence of LVI, could be used as risk predictors of SLN metastasis. In the absence of any predictors, the incidence of positive SLNs was very low (2.6%) in the total population and extremely low (1.3%) in the BCS subgroup. Therefore, we suggest that SLNB may be omitted in patients who initially underwent BCS without risk predictors on final pathological assessment. However, further prospective studies are warranted before its clinical application. Sentinel lymph node (SLN) biopsy (SLNB) usually need not be simultaneously performed with breast-conserving surgery (BCS) for patients diagnosed with ductal carcinoma in situ (DCIS) by preoperative core needle biopsy (CNB), but must be performed once there is invasive carcinoma (IC) found postoperatively. This study aimed to investigate the factors contributing to SLN metastasis in underestimated IC patients with an initial diagnosis of DCIS by CNB. We retrospectively reviewed 1240 consecutive cases of DCIS by image-guided CNB from January 2010 to December 2017 and identified 316 underestimated IC cases with SLNB. Data on clinical characteristics, radiologic features, and final pathological findings were examined. Twenty-three patients (7.3%) had SLN metastasis. Multivariate analysis indicated that an IC tumor size > 0.5 cm (odds ratio: 3.11, p = 0.033) and the presence of lymphovascular invasion (odds ratio: 32.85, p < 0.0001) were independent risk predictors of SLN metastasis. In the absence of any predictors, the incidence of positive SLNs was very low (2.6%) in the total population and extremely low (1.3%) in the BCS subgroup. Therefore, omitting SLNB may be an acceptable option for patients who initially underwent BCS without risk predictors on final pathological assessment. Further prospective studies are necessary before clinical application. [ABSTRACT FROM AUTHOR]

In this letter, a novel compact wideband bandpass filter (BPF) using single asymmetric stepped-impedance resonator with one-step discontinuity is designed and fabricated. The first two resonant modes of the asymmetric SIR are coupled together and applied to create a wide passband. The proposed filter at center frequency f0 of 4.2 GHz has very good measured characteristics including the bandwidth of 2.9–5.05 GHz (3-dB fractional bandwidth of 52%), average low insertion loss of 0.2 dB, and sharp rejection of 53 and 88 dB/GHz in lower and higher passband edges. Additionally, the wideband BPF has a smaller circuit size in comparison of previous works. © 2008 Wiley Periodicals, Inc. Microwave Opt Technol Lett 51: 242–244, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.24023 [ABSTRACT FROM AUTHOR]

In this letter, a novel compact wideband bandpass filter using the asymmetric stepped-impedance resonator (SIR) with one step discontinuity is designed and implemented to achieve characteristics of low loss, wide stopband and very high passband selectivity, simultaneously. The first two resonant modes of the asymmetric SIR are coupled together and applied to create a wide passband. The design procedure is discussed in detail. The proposed filter at center frequency f0 of 4 GHz has very good measured characteristics including a low insertion loss of 0.5 plusmn 0.3 dB, the bandwidth of 2.9-5.3 GHz, sharp rejection due to two transmission zeros in the passband edge. Experimental results of the fabricated filter show a good agreement with the predict results. [ABSTRACT FROM PUBLISHER]

The mammographic appearance of ductal carcinoma in situ (DCIS) is mostly observed as microcalcifications. Although stereotactic vacuum-assisted breast biopsy (VABB) is a reliable alternative to surgical biopsy for suspicious microcalcifications, underestimation of VABB-proven DCIS is inevitable in clinical practice. We therefore retrospectively analyzed the variables in the prediction of DCIS underestimation manifesting as microcalcifications only proved by stereotactic VABB. In 1147 consecutive VABB on microcalcification-only lesions from 2010 to 2016, patients diagnosed with DCIS were selected to evaluate the underestimation rate. The analyzed variables included clinical characteristics, mammographic features, VABB procedure, and biomarkers. Univariate and multivariate analyses were used, and a p value < 0.05 was considered statistically significant. Of the 131 VABB-proven DCIS, 108 cases were diagnosed with DCIS and 23 were upgraded to invasive ductal carcinoma (IDC) after subsequent surgery. The small extent of microcalcification, grouped microcalcifications distribution, nearly complete microcalcification removal, and non-calcified specimens without DCIS were low for DCIS underestimation. Among them, the results of non-calcified specimens with or without DICS were the only statistically significant variables by multivariate logistic regression. These results indicate that the histology of non-calcified specimens was highly predictive of DCIS underestimation. Specimens without DCIS had a low upgrade rate to IDC. [ABSTRACT FROM AUTHOR]