Search

A multiple quantum barrier (MQB) avalanche photodiode (APD) structure based on GaN/AlxGa $_{1{-}x}\text{N}$ material system has been proposed in this paper which is capable of detecting infrared (IR) signal up to $6.0~\mu \text{m}$ wavelength. A self-consistent quantum drift-diffusion (SCQDD) model developed by the authors, has been used to determine the current-voltage characteristics under dark and illuminated conditions, spectral response, excess noise properties, signal-to-noise ratio, time and frequency responses. Results show that the proposed MQB APD attains peak responsivity of 60 AW $^{-1}$ at $3.0\, \mu \text{m}$ wavelength. Incorporation of a dedicated thin $n$ -type GaN layer for avalanche multiplication in between the $p^{+}$ -GaN contact layer and MQB constant-field drift-layer ensures significantly low noise equivalent power under normal operating conditions at room temperature (300 K). Optical pulse response of the device reveals that special restriction over the charge multiplication able to supress the minor peaks of the current response and consequently significantly narrow pulse response can be achieved. Narrow pulse response leads to broad bandwidth of 274.5 GHz, which is significantly broader than the existing IR photo-detectors.

Abstract Background The factors that predict the clinical response to ramucirumab plus docetaxel (RD) after first‐line chemoimmunotherapy are unresolved. We explored whether the therapeutic efficacy of prior chemoimmunotherapy could predict the outcome of RD as sequential therapy in patients with advanced non‐small cell lung cancer (NSCLC). Methods Our study comprised 288 patients with advanced NSCLC who received RD as the second‐line treatment after first‐line chemoimmunotherapy at 62 Japanese institutions. Chemoimmunotherapy consisted of a platinum‐based regimen and immune checkpoint inhibitors (ICIs). The association between several variables and the therapeutic outcome of RD was determined via logistic regression analysis. Results Of the 288 patients, 225 (78.1%) received maintenance therapy and 108 (37.5%) received both ICI treatment for >180 days and maintenance therapy. All of 108 patients having ICIs for >180 days received maintenance therapy. Univariate analysis identified performance status, histology (adenocarcinoma), maintenance therapy, and ICI treatment >180 days as significant predictors of better progression‐free survival (PFS) and overall survival (OS) after RD administration. Multivariate analysis confirmed that these factors independently predicted favorable PFS and OS. The therapeutic response and PD‐L1 expression were not closely associated with outcome after RD treatment. In particular, maintenance therapy >4 cycles was more predictive of the better prognosis for RD treatment. Conclusion Extended ICI treatment after chemoimmunotherapy and maintenance therapy enhanced the efficacy of second‐line RD treatment in patients with advanced NSCLC.

In our pursuit of high-power terahertz (THz) wave generation, we propose innovative edge-terminated single-drift region (SDR) multi-quantum well (MQW) impact avalanche transit time (IMPATT) structures based on the AlxGa1−xN/GaN/AlxGa1−xN material system, with a fixed aluminum mole fraction of x = 0.3. Two distinct MQW diode configurations, namely p+-n junction-based and Schottky barrier diode structures, were investigated for their THz potential. To enhance reverse breakdown characteristics, we propose employing mesa etching and nitrogen ion implantation for edge termination, mitigating issues related to premature and soft breakdown. The THz performance is comprehensively evaluated through steady-state and high-frequency characterizations using a self-consistent quantum drift-diffusion (SCQDD) model. Our proposed Al0.3Ga0.7N/GaN/Al0.3Ga0.7N MQW diodes, as well as GaN-based single-drift region (SDR) and 3C-SiC/Si/3C-SiC MQW-based double-drift region (DDR) IMPATT diodes, are simulated. The Schottky barrier in the proposed diodes significantly reduces device series resistance, enhancing peak continuous wave power output to approximately 300 mW and DC to THz conversion efficiency to nearly 13% at 1.0 THz. Noise performance analysis reveals that MQW structures within the avalanche zone mitigate noise and improve overall performance. Benchmarking against state-of-the-art THz sources establishes the superiority of our proposed THz sources, highlighting their potential for advancing THz technology and its applications.

Abstract Aims For long‐term management of diabetes, patients with type 2 diabetes mellitus require a high level of treatment adherence, which is associated with treatment satisfaction and their quality of life (QOL). To achieve it, patient education about diabetes self‐management is essential. We routinely conduct a 7 day inpatient diabetes education program and administer the diabetes treatment‐related (DTR)‐QOL questionnaire to all participants, both before admission and at discharge. Here, we investigated whether our program improves QOL and post‐discharge glycemic control. Materials and Methods This retrospective study utilized data from patients with type 2 diabetes mellitus who participated in our program between July 2017 and March 2020 and who had been treated in our outpatient department for more than 1 year. We evaluated the relationship between at admission and at discharge diabetes treatment‐related quality of life scores and glycemic control after discharge. Results Data from 140 patients were analyzed in this study, which showed a significant improvement in the total, ‘Anxiety and dissatisfaction with treatment’, and ‘Satisfaction‐with‐treatment’ scores. A significant improvement was evident in HbA1c at 12 months after discharge. Multiple regression analysis showed that HbA1c after 12 months was independently associated with gender, duration of diabetes, and HbA1c at admission. Conclusions Our program effectively improves quality of life and post‐discharge glycemic control in patients with type 2 diabetes mellitus. It is particularly effective in patients of the male gender, with a shorter duration of diabetes mellitus and higher HbA1c at admission.

Abstract Background This study investigated the sex differences in the risk of end‐stage kidney disease (ESKD) and mortality, as well as the effect modification of sex on associated factors in patients with type 2 diabetes. Methods This multicenter observational cohort study included 4328 patients with type 2 diabetes. Hazard ratios (HRs) with 95% confidence intervals (CIs) of sex for ESKD and death were estimated using Cox proportional regression with adjustment for baseline covariates. For assessing risk modification, HRs and incidence rates for ESKD and death were compared between sexes across patient characteristics using Cox proportional and Poisson regression models. Results During a median follow‐up of 7 years, 276 patients (70% men) developed ESKD, and 241 patients (68% men) died. Men had higher risks of ESKD (HR 1.34; 95% CI 1.02–1.75; p = .034) and death (HR 1.64; 95% CI 1.24–2.16; p = .001) versus women after adjusting for multiple covariates. Among patients with microalbuminuria, men had a substantially higher risk of ESKD versus women, compared to those with normo‐ and macroalbuminuria (p for interaction .04). Incidence rates were also increased in men versus women with albuminuria of around 300 mg/g. No differences were detected in the association of sex and death across baseline patient subgroups. Conclusions In type 2 diabetes, men had an increased risk of ESKD and death versus women. Moderately increased albuminuria was strongly associated with sex difference in developing ESKD.

To improve the responsivity of terahertz (THz) antenna-coupled bolometer, heater (load) resistance has to be increased to suppress the thermal conduction and realize larger temperature rise of the thermistor. Proper design of antenna is therefore essential to assure the impedance matching between antenna and heater. From this viewpoint, a high-impedance folded-dipole antenna (FDA) has been studied numerically by the finite element simulation. The effect of FDA structural parameters such as number of arms, antenna width, and arm spacing are discussed with the lumped port and resistive heater coupled to the antenna gap for the cases of radiating and receiving modes, respectively. The product of resonant resistance and area efficiency is used to predict the improvement made by FDA as a figure of merit (FOM) correlated to the bolometer responsivity. This study revealed that the optimum FOM in FDA-coupled bolometer operating at 1 THz was obtained with three arms, 1- $\mu \text{m}$ antenna width and 4- $\mu \text{m}$ arm spacing. A comparison was made with the result from a half-wave dipole antenna and revealed that FDA could enhance the bolometer responsivity by a factor of 15. This research demonstrated the effectiveness of the FDA to improve the performance of THz antenna-coupled bolometer for applications such as imaging for non-destructive inspection.

Abstract Background The prognosis of lung cancer patients with interstitial lung disease (ILD) is poor, and acute exacerbation (AE) of ILD can occur during chemotherapy as a fatal adverse event. Although AE‐ILD development is correlated with various factors, no reports are investigating the disease activity of lung cancer at the time of AE‐ILD development. Methods All consecutive lung cancer patients with ILD who developed chemotherapy‐related AE‐ILD within 28 days after the last administration of cytotoxic chemotherapy between 2011 and 2020 were retrospectively reviewed. Results Among 206 lung cancer patients with ILD who were treated with cytotoxic chemotherapy, 30 patients were included. The median age was 72 years and all patients were men with smoking history. Usual interstitial pneumonia (UIP) and non‐UIP patterns of ILD was observed in 17 and 13 patients. Most of AE‐ILD occurred during second‐ or later‐line (22/30, 73.3%) and developed within first or second courses during chemotherapy (19/30, 63.3%). Regarding tumor response to chemotherapy at AE‐ILD development, majority of patients (18 patients, 60.0%) experienced progressive disease and only one patient (3.3%) experienced a partial response. Notably, 27 patients (90.0%) did not exhibit any tumor shrinkage of the thoracic lesions. Conclusion Lung cancer was uncontrolled with cytotoxic chemotherapy at the time of AE‐ILD development. Although AE‐ILD during chemotherapy has been generally discussed in terms of drug‐specific adverse effects, uncontrolled lung cancer may be also correlated with AE‐ILD development.

This study demonstrates the conversion of metallic titanium (Ti) to titanium oxide just by conducting electrical current through Ti thin film in vacuum and increasing the temperature by Joule heating. This led to the improvement of electrical and thermal properties of a microbolometer. A microbolometer with an integrated Ti thermistor and heater width of 2.7 µm and a length of 50 µm was fabricated for the current study. Constant-voltage stresses were applied to the thermistor wire to observe the effect of the Joule heating on its properties. Thermistor resistance ~14 times the initial resistance was observed owing to the heating. A negative large temperature coefficient of resistance (TCR) of −0.32%/K was also observed owing to the treatment, leading to an improved responsivity of ~4.5 times from devices with untreated Ti thermistors. However, this does not improve the noise equivalent power (NEP), due to the increased flicker noise. Microstructural analyses with transmission electron microscopy (TEM), transmission electron diffraction (TED) and energy dispersive X-ray (EDX) confirm the formation of a titanium oxide (TiOx) semiconducting phase on the Ti phase (~85% purity) deposited initially, further to the heating. Formation of TiOx during annealing could minimize the narrow width effect, which we reported previously in thin metal wires, leading to enhancement of responsivity.

Background: The Great East Japan Earthquake and the Fukushima Daiichi nuclear disaster forced the evacuation of residents and led to many changes in lifestyle for the evacuees. The Comprehensive Health Check was implemented to support the prevention of lifestyle-related disease and we analyzed the effect of prolonged evacuation (average of 3.0 years) on the new onset of hyper-LDL cholesterolemia. Methods: The study participants were Japanese adults living near the Fukushima Daiichi nuclear power plant in Fukushima Prefecture. Annual health checkups focusing on metabolic syndromes were conducted for persons ≥40 years by the Specific Health Checkup. Based on data from annual checkups from 2011 or 2012, we followed 18,670 participants without hyper-LDL cholesterolemia who underwent at least one other annual checkup during 2013–2015. Results: We found that the new onset of hyper-LDL cholesterolemia was 31% higher in evacuees than in non-evacuees. Evacuees had a significantly higher prevalence of obesity, hypertension, and diabetes, and higher frequency of weight change. Furthermore, logistic regression model analysis showed that the evacuation was significantly associated with the new onset of hyper-LDL cholesterolemia after adjusting age, gender, body mass index, smoking habit, alcohol consumption, diabetes, weight change, sleep deprivation, and exercise. Conclusion: The findings of the present study suggest that prolonged evacuation after a disaster is a risk factor for the new onset of hyper-LDL cholesterolemia, and lead to an increase in cardiovascular disease. It is therefore important to follow-up evacuees and recommend lifestyle changes where necessary.

Anti-melanoma differentiation-associated gene-5 (MDA-5) antibody is an autoantibody found in patients with dermatomyositis. These antibody-positive patients are clinically characterized by complications of rapidly progressive interstitial pneumonia resistant to treatment and with poor prognosis. We describe herein a patient with MDA-5 antibody-positive interstitial lung disease, which progressed rapidly to death after a period of slow progress. Recently, attention has been paid to the similarities in clinical courses and CT images between MDA-5 antibody-positive interstitial lung disease and coronavirus disease 2019 (COVID-19)-associated pneumonia. Patients with MDA-5 antibody do not always have diffuse and evenly distributed bilateral opacities at the time of first presentation. This patient had significant laterality of such opacities. It should be considered that MDA-5 antibody-positive patients with such laterality in opacities might progress rapidly. Chest physicians, dermatologists, and dermatologists need to be aware of the characteristics of the disease for optimal treatment choices.

Residents were forced to evacuate owing to the radiation released after the Fukushima Nuclear Power Plant (NPP) accident following the Great East Japan Earthquake on 11/03/2021; thus, their lifestyles drastically changed. The Comprehensive Health Check (CHC) of the Fukushima Health Management Survey (FHMS) was performed to evaluate health statuses and prevent lifestyle-related diseases in evacuation area residents. The first part of the CHC survey is a retrospective analysis of pre- and post-disaster data on health check-ups of evacuation area residents. The second part is a cross-sectional, prospective analysis of post-disaster (fiscal year (FY) 2011–2017) data on health check-ups. Subjects were men and women living in 13 municipalities in areas surrounding the NPP in Fukushima Prefecture. Post-disaster (FY 2011–2012) overweight, hypertension, dyslipidemia, diabetes mellitus, metabolic syndrome, liver dysfunction, hyperuricemia, polycythemia and atrial fibrillation cases increased from the pre-disaster (FY 2008–2010) levels. This tendency was strongest among residents who were forced to evacuate. Proportion of overweight people remained unchanged, the prevalence of liver dysfunction decreased and the proportion of people with treated hypertension and dyslipidemia increased during FY 2011–2017. Meanwhile, the prevalence of diabetes mellitus and mean levels of HbA1c increased. Furthermore, Evacuees showed higher risks of diabetes mellitus, dyslipidemia, chronic kidney diseases and liver dysfunction than non-evacuees. Therefore, residents in the evacuation area, especially evacuees, are at high risk of developing lifestyle-related diseases, especially cardiovascular diseases; therefore, it is necessary to observe health statuses and implement measures to prevent lifestyle-related diseases.

A Schottky barrier high-electron-mobility avalanche transit time (HEM-ATT) structure is proposed for terahertz (THz) wave generation. The structure is laterally oriented and based on AlGaN/GaN two-dimensional electron gas (2-DEG). Trenches are introduced at different positions of the top AlGaN barrier layer for realizing different sheet carrier density profiles at the 2-DEG channel; the resulting devices are equivalent to high–low, low–high and low-high–low quasi-Read structures. The DC, large-signal and noise simulations of the HEM-ATTs were carried out using the Silvaco ATLAS platform, non-sinusoidal-voltage-excited large-signal and double-iterative field-maximum small-signal simulation models, respectively. The breakdown voltages of the devices estimated via simulation were validated by using experimental measurements; they were found to be around 17–18 V. Under large-signal conditions, the series resistance of the device is estimated to be around 20 Ω. The large-signal simulation shows that the HEM-ATT source is capable of delivering nearly 300 mW of continuous-wave peak power with 11% conversion efficiency at 1.0 THz, which is a significant improvement over the achievable THz power output and efficiency from the conventional vertical GaN double-drift region (DDR) IMPATT THz source. The noise performance of the THz source was found to be significantly improved by using the quasi-Read HEM-ATT structures compared to the conventional vertical Schottky barrier IMPATT structure. These devices are compatible with the state-of-the-art medium-scale semiconductor device fabrication processes, with scope for further miniaturization, and may have significant potential for application in compact biomedical spectroscopy systems as THz solid-state sources.

Background and objectivesChronic inflammatory airway diseases, including asthma and chronic obstructive pulmonary disease (COPD), are complex syndromes with diverse clinical symptoms due to multiple pathophysiological conditions. In this study, using common and shared risk factors for the exacerbation of asthma and COPD, we sought to clarify the exacerbation-prone phenotypes beyond disease labels, and to specifically investigate the role of the IL4RA gene polymorphism, which is related to type 2 inflammation, in these exacerbation-prone phenotypes.MethodsThe study population comprised patients with asthma (n = 117), asthma-COPD overlap (ACO; n = 37) or COPD (n = 48) and a history of exacerbation within the previous year. Cluster analyses were performed using factors associated with both asthma and COPD exacerbation. The association of the IL4RA gene polymorphism rs8832 with each exacerbation-prone phenotype was evaluated by multinomial logistic analyses using non-asthma non-COPD healthy adults as controls (n = 1,529). In addition, the genetic influence of rs8832 was also examined in asthma patients with allergic rhinitis and no history of exacerbation (n = 130).ResultsTwo-step cluster analyses identified five clusters that did not necessarily correspond to the diagnostic disease labels. Cluster 1 was characterized by high eosinophil counts, cluster 2 was characterized by smokers with impaired lung function, cluster 3 was characterized by the presence of gastroesophageal reflux, cluster 4 was characterized by non-allergic females, and cluster 5 was characterized by allergic rhinitis and elevated total immunoglobulin E levels. A significant association with rs8832 was observed for cluster 5 (odds ratio, 3.88 (1.34-11.26), p = 0.013) and also for the type 2 exacerbation-prone phenotypes (clusters 1 and 5: odds ratio, 2.73 (1.45-5.15), p = 1.9 × 10-3).DiscussionOur results indicated that the clinical heterogeneity of disease exacerbation may reflect the presence of common exacerbation-prone endotypes across asthma and COPD, and may support the use of the treatable traits approach for the prevention of exacerbations in patients with chronic inflammatory airway diseases.

This paper proposes a new optical biosensor composed of a silicon-on-insulator (SOI) p–n junction photodiode (PD) with a surface plasmon (SP) antenna. When the phase-matching condition between two lateral wavelengths of the diffracted light from the SP antenna and the waveguiding mode in the SOI PD is satisfied, we observe sharp peaks in the spectroscopic light sensitivity. Since the peak wavelength depends on the RI change around the SP antenna corresponding to the phase-matching condition, the SOI PDs with an SP antenna can be applied to the optical biosensor. The RI detection limit is evaluated in the measurements with bulk solutions, and 1.11 × 10−5 RIU (refractive index unit) can be obtained, which is comparable to that of a surface plasmon resonance (SPR) sensor, which is well known as a representative optical biosensor. In addition, the response for intermolecular bonds is estimated by the electromagnetic simulations using the finite-difference time-domain (FDTD) method to clarify its ability to detect biomolecular interactions. The results of this paper will provide new ground for high-throughput label-free biosensing, since a large number of SOI PDs with an SP antenna can be easily integrated on a single chip via an SOI complementary metal-oxide-semiconductor (CMOS) fabrication process.

Dear Editor, We read with interest the article by Balis et al. on pulmonary tuberculosis and actinomyces co-infection as a lung mass....

Based on the time-dependent master equation and taking the dynamic gate current into account, a new single-electron transistor (SET) model is proposed, which can represent intrinsic terminal capacitances and transcapacitances. By using this model, bias, frequency and temperature dependences of these capacitances are evaluated. Since the model is implemented in the SPICE circuit simulator, it can be used to analyze the high-frequency behavior of circuits, including SETs and is applied to the characterization of a SET-based inverting amplifier this time.

The antenna-coupled microbolometer with suspended titanium heater and thermistor was attractive as a terahertz (THz) detector due to its structural simplicity and low noise levels. In this study, we attempted to improve the responsivity and noise-equivalent power (NEP) of the THz detector by using high-resistance heater stacked on the meander thermistor. A wide range of heater resistances were prepared by changing the heater width and thickness. It was revealed that the electrical responsivity and NEP could be improved by increasing the heater’s resistance. To make the best use of this improvement, a high-impedance folded dipole antenna was introduced, and the optical performance at 1 THz was found to be better than that of the conventional halfwave dipole antenna combined with a low-resistance heater. Both the electrical and optical measurement results indicated that the increase in heater resistance could reduce the thermal conductance in the detector, thus improved the responsivity and NEP even if the thermistor resistance was kept the same.

Background/Aim: The COVID-19 pandemic has forced medical institutions to scale back their practice. Changes in patient behavior seemed to be having an impact. We conducted a survey with the aim of reviewing lung cancer treatment during the pandemic period and identifying problems. Patients and Methods: We examined the medical records of all patients pathologically diagnosed with nonsmall cell lung cancer (NSCLC) in our hospital from 2017 to 2022. NSCLC patients were divided into two groups: those diagnosed between 2017 and 2019 (first period) and those diagnosed between 2020 and 2022 (second period). Results: Within the study period, 267 NSCLC patients (first period: 147 patients, second period: 121 patients) were diagnosed in our hospital. The patients in the two study periods did not differ significantly in age (p=0.613), ECOG performance status (p=0.125), and clinical stage (p=0.354). Tumor size was significantly larger in the second period with a mean of 5.88 cm ± 3.02, compared to 4.24 cm ± 1.76 in the first period (p<0.001). In the standard treatment group, the median survival time was 457 days in the first period and 313 days in the second period (p=0.063). In the best supportive care group, median survival time was 122 days in the first period and 57 days in the second period (p=0.004). Conclusion: Patients themselves refrained from seeking consultation for lung cancer treatment during the pandemic period. It is inconclusive how to reduce the delay due to the suppression of consultations, but this is an important issue for the future. [ABSTRACT FROM AUTHOR]

Background/Aim: Atezolizumab is a monoclonal antibody that targets programmed death-ligand 1 (PD-L1) expressed on cancer cells derived from various organs and antigen-presenting cells and is currently commonly used in combination with chemotherapy. We conducted a study to clarify the current status of response to atezolizumab monotherapy in clinical practice and clarify the factors that contribute to long-term response and survival. Patients and Methods: We conducted a retrospective review of patients with advanced non-small cell lung cancer (NSCLC) treated with atezolizumab monotherapy from April 2018 to March 2023 at 11 Hospitals. Results: The 147 patients evaluated had a progression-free survival (PFS) of 3.0 months and an overall survival of 7.0 months. Immune-related adverse events of any grade were observed in 13 patients (8.8%), grade 3 or higher in nine patients (6.1%), and grade 5 with pulmonary toxicity in one patient (0.7%). Favorable factors related to PFS were ‘types of NSCLC other than adenocarcinoma’. Favorable factors for overall survival were ‘performance status 0-1’ and ‘treatment lines up to 3’. There were 16 patients (10.9%) with PFS >1 year. No characteristic clinical findings were found in these 16 patients compared to the remaining 131 patients. Conclusion: Efficacy and immune-related adverse events of NSCLC patients associated with atezolizumab monotherapy were comparable to those of previous clinical trial results. Knowledge of characteristics of patients who are most likely to benefit from atezolizumab monotherapy is a crucial step towards implementing appropriate prescribing. [ABSTRACT FROM AUTHOR]