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BACKGROUND To date, no data on the effect of adjuvant whole breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available in women with left-side breast intraductal carcinoma (IDC) and heart failure with reduced ejection fraction (HFrEF). PATIENTS AND METHODS : We enrolled 294 women with left-breast IDC at clinical stages IA–IIIC and HFrEF receiving breast-conserving surgery (BCS) followed by adjuvant WBRT or non-adjuvant WBRT. We categorized them into two groups based on their adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. We calculated the propensity score and applied inverse probability of treatment weighting (IPTW) to create a pseudo-study cohort. Furthermore, we performed a multivariate analysis of the propensity score–weighted population to obtain hazard ratios (HRs). RESULTS In the IPTW-adjusted model, adjuvant WBRT (adjusted HR [aHR]: 0.60; 95% confidence interval [CI]: 0.44–0.94) was a significant independent prognostic factor for all-cause death (P = 0.0424), and the aHR (95% CI) of LRR and DM for adjuvant WBRT was 0.33 (0.24–0.71; P = 0.0017) and 0.37 (0.22–0.63; P = 0.0004), respectively, compared with the no adjuvant WBRT group. The aHR (95% CI) of breast cancer death for adjuvant WBRT was 0.54 (0.44–0.85; P = 0.0201) compared with no adjuvant WBRT group. CONCLUSION Adjuvant WBRT was associated with a decrease in all-cause death, breast cancer death, LRR, and DM in women with left IDC and HFrEF compared with no adjuvant WBRT.

Purpose: To identify novel radiological features and clinical characteristics to improve diagnostic criteria for early detection of small hepatocellular carcinoma (HCC). Patients and Methods: We retrospectively recruited asymptomatic patients with no history of HCC but a high risk of HCC in whom a new, solitary, well-defined, solid nodule between 10 and 20 mm was detected through a screening ultrasound. We retrospectively collected all clinical data, and patients were examined using dynamic contrast-enhanced computed tomography or magnetic resonance imaging; subsequently, fine-needle biopsy was performed. A multivariate analysis of the predictors of small HCCs was performed by fitting a multiple logistic regression model with the stepwise variable selection method. Results: In total, 392 and 347 patients with a small liver nodule received a final pathologic confirmation of HCC and non-HCC, respectively. The estimated odds ratios and 95% confidence intervals of tumor size > 12.45 mm, age > 56.61 years, liver cirrhosis, hepatitis C virus (HCV) carrier status, ln alpha-fetoprotein (AFP) > 1.954, arterial phase enhancement, and portal or venous phase washout appearance without arterial phase enhancement were 2.0735 (1.4746-2.9155), 1.8878 (1.2949-2.7521), 1.6927 (1.1294-2.5369), 1.6186 (1.0347-2.5321), 2.0297 (1.3342-3.0876), 3.7451 (2.3845-5.8821), and 2.0327 (1.3500-3.0608), respectively. The area under the receiver operating characteristic curves for the diagnosis of small HCCs was 0.79 for arterial phase enhancement and 0.75 for portal or venous phase washout appearance without arterial phase enhancement. Conclusion: Clinical and contrast-enhanced image features are valuable in the prediction model for the detection and early diagnosis of small HCCs in patients with a high risk of HCC. In addition to negative portal or venous washout and negative arterial enhancement in images, age > 56.61 years, tumor size > 12.45 mm, HCV carrier status, and ln(AFP) > 1.954, are useful indicators for the early detection of small HCCs.

PURPOSE: The survival effect of smoking-related chronic obstructive pulmonary disease (COPD) and COPD with acute exacerbation (COPDAE) on patients with muscle-invasive bladder urothelial carcinoma (MIBUC) receiving concurrent chemoradiotherapy (CCRT) for bladder preservation is unclear. METHODS: We recruited patients with MIBUC, clinical stages IIA–IVB, who had received maximal transurethral resection of bladder tumor (TURBT) followed by CCRT from the Taiwan Cancer Registry Database. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into two groups by using propensity score matching based on the preexisting COPD status (within 1 year before CCRT) to compare overall survival outcomes: Group 1 (never smokers without COPD) and Group 2 (current smokers with COPD). RESULTS: In multivariate Cox regression analyses, the adjusted hazard ratio (aHR, 95% confidence interval (CI)) of all-cause mortality in Group 2 compared with Group 1 was 1.89 (1.12–3.18), p = 0.017. The aHRs (95% CIs) of all-cause mortality for ≥1 and ≥2 hospitalizations for COPDAE within 1 year before CCRT for bladder preservation were 3.26 (1.95–5.46) and 6.33 (3.55–11.281) compared with non-COPDAE patients with MIBUC undergoing CCRT for bladder preservation. CONCLUSIONS: Among patients with MIBUC undergoing TURBT followed by CCRT for bladder preservation, current smokers with smoking-related COPD had worse survival outcomes than did nonsmokers without COPD. Condensed Abstract: This was the first study to estimate the survival impact of smoking-related chronic obstructive pulmonary disease (COPD) on patients with muscle-invasive bladder urothelial carcinoma (MIBUC) receiving maximal transurethral resection of bladder tumor (TURBT) followed by concurrent chemoradiotherapy (CCRT) for bladder preservation. Smoking-related COPD was a significant independent risk factor for all-cause mortality in patients with clinical stages IIA–IVB receiving TURBT followed by CCRT. Hospitalization frequency for COPD with at least one acute exacerbation within 1 year before CCRT was highly associated with high mortality for patients with MIBUC receiving CCRT for bladder preservation. Not only all-cause death but also bladder cancer death and COPD death were significantly higher in the current-smoking COPD group than in the never-smoking non-COPD group.

Organic thin-film transistor (OTFT) with solution-process, low process temperature (< 120°C), high performance, good uniformity and excellent stability is achieved. Also, a systematic comparison of device performance and reliability of OTFT and a-Si:H TFT is performed in this research. Due to the excellent device characteristics, especially of the bias stability, the OTFT technology nowadays is comparable even overwhelming to the mass production a-Si:H TFT technology. The commercialization of organic electronics driven by OTFT backplane is expected.

In this paper, the electrical stability of organic thin-film transistors (OTFTs) were investigated. Solution and photolithography technologies were used for organic thin film formation and patterning. All stacks were constructed with organic materials. However, the polymer-type organic semiconductor material was used for active layer. Also, all process temperatures taken place below 120D. In addition, the OTFTs exhibit a good process uniformity and high stability. Furthermore, the OTFTs integrated with 6-inch active matrix organic light emitting diodes (AMOLEDs) was realized.

The organic thin film transistors (OTFTs) were fabricated and investigated in this study. Solution and photography technology were used for organic thin film formation and patterning. Also, the process temperatures were kept below 120 degree C for low temperature process development. Furthermore, the performances of OTFTs were investigated in this study, including electrical characteristics and reliability.

A novel semiconducting polymer, PDPP3T, with alternating diketopyrrolopyrrole and terthiophene units is presented in this study. Due to PDPP3T has a small band gap of 1.3 eV, and high hole mobility of 0.04 cm(2) V(-1) s(-1), it can be used for organic photo sensor to absorb the near infrared (NIR) parts of the spectrum. The photo sensor are fabricated from Poly (diketopyrrolopyrrole-terthiophene) (PDPP3T) and [6,6]-phenyl C61-butylric acid methyl ester (PCBM) using a solution-based, temperature assisted deposition protocol. Devices made by this protocol lead to photo and dark current of around 4.6µA/cm2 and 2.1nA/cm2 at -1V. The device yields a good linear response of photocurrent to the near infrared exposure (from 50-400µW/cm2) for a range of operating biases

We report the controllable UV-Visible-to-NIR Si-nanocrystals photonic sensor, photo-spectrum band-gap engineering technology, and integrated in TFT-LCD as multi-function intelligent display. Photonic Sensor using Si-nanocrystals as sensitizer sandwiched between two electrodes structure is proposed to integrate optical input function for new application in next generation mobile devices. The optical input function, used for image scanner, fingerprint recognition, and touch-input application, are achieved by integrating these image sensor elements within each display pixel. A 2-transistor (2T) active pixel sensor (APS) is used to integrate a VGA (> 250 dpi) image sensor within an LCD panel.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Reflux oesophagitis is a common clinical disorder associated with significant morbidity. Proton pump inhibitors are the current pharmacotherapy of choice, but not all treated patients achieve symptom relief. Little is known about the efficacy of mosapride, a prokinetic agent which decreases episodes of gastro-oesophageal reflux, as an adjunct to proton pump inhibitors in improving the symptoms of reflux oesophagitis. WHAT THIS STUDY ADDS Mosapride was generally not more effective than placebo as an adjunct therapy to a standard dose of lansoprazole in decreasing the symptom burden of patients with reflux oesophagitis. However, in a subgroup with more severe symptoms, combination therapy with lansoprazole and mosapride was possibly superior to monotherapy with lansoprazole. AIMS To investigate if mosapride, a prokinetic agent, was an effective adjunct to acid suppression in improving the symptoms of reflux oesophagitis. METHODS Patients (n= 96) with reflux oesophagitis were randomly assigned to either mosapride (5 mg three times daily) or placebo for 4 weeks. Symptom severity was assessed by a validated questionnaire at enrolment, 4 and 8 weeks after medication. The primary outcome for the first 4 weeks was decrease in symptom scores. After a 3 day washout period, patients initially allocated to mosapride crossed over to placebo and vice versa for the next 4 weeks. The outcome of the second phase was maintenance of symptom control. All patients received lansoprazole (30 mg once daily) throughout study. RESULTS The decreased symptom score after 4 weeks of treatment with lansoprazole and mosapride (n= 50) was 13.42 +/- 1.16 (mean +/- SEM), similar to that of lansoprazole plus placebo (10.85 +/- 1.03, n= 46), with an insignificant difference of 2.57 (95% CI -0.53, 5.67, P= 0.103). However, a sub-group analysis for patients with pre-treatment scores of >18 points (n= 48) revealed that lansoprazole plus mosapride achieved a greater reduction of symptom score than lansoprazole plus placebo (18.22 +/- 1.91 vs. 12.88 +/- 1.65; mean difference of 5.34, 95% CI 0.28, 10.40, P= 0.039). In the second phase, there was no difference between lansoprazole with mosapride or placebo in maintaining symptom control (39/44 or 86.64% vs. 41/50 or 82%, P= 0.401). Subgroup analysis for those with substantial residual symptoms revealed similar results. CONCLUSION Compared with placebo, mosapride generally does not provide additional benefit to a standard dose of lansoprazole in patients with reflux oesophagitis, except possibly in the subgroup of severely symptomatic patients.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • An adjunct to endoscopy, proton pump inhibitor (PPI) is effective pharmacotherapy in high-risk patients with peptic ulcer bleeding (PUB). • An intravenous 80-mg bolus and 192 mg day−1 successive infusion for 3 days is the currently recommended dosing modality in administering PPI. WHAT THIS STUDY ADDS • Clinical outcomes are not different in PUB patients receiving infusional pantoprazole at either 192 mg or 160 mg day−1 for 3 days. • The effective dosage of PPI may not be as high as currently recommended. • In view of cost-effectiveness, a lower dosage (160 mg day−1) of infusional PPI may be adopted in the management of PUB. AIM The optimal dosage of proton pump inhibitor in bleeding peptic ulcers remains controversial. The aim was to compare the clinical effectiveness of two doses of infusional pantoprazole in peptic ulcer bleeding. METHODS Peptic ulcer patients (n= 120) with bleeding stigmata were enrolled after successful endoscopic therapy. After an initial bolus injection of 80 mg pantoprazole, patients were randomized to receive continuously infused pantoprazole at either 192 mg day−1 or 40 mg every 6 h (i.e. 160 mg day−1) for 3 days. Clinical outcomes between the two groups within 14 days were compared, with 14-day recurrent bleeding regarded as the primary end-point. RESULTS Both groups (n= 60 each) were well matched in demographic and clinical factors upon entry. Bleeding totally recurred in 11 (9.2%) patients, with six (10%) in the 192 mg day−1 group and five (8.3%) in the 160 mg day−1 group (relative risk of bleeding recurrence between two treatments 1.2; 95% CI 0.39, 3.72). All secondary outcomes between the two groups were similar, including the amount of blood transfusion (mean 1179 ml vs. 1203 ml, P > 0.1), hospital stay (mean 9.5 days vs. 9.9 days, P > 0.1), need for surgery (n= 1 vs. n= 0, P > 0.1), and mortality (n= 1 vs. n= 0, P > 0.1). CONCLUSIONS Following endoscopic haemostasis, infusional pantoprazole at either 192 mg day−1 or 40 mg every 6 h appear similar.

The unplugged electronic display were fabricated and investigated in this study. The electro phoretic display (EPD) and solar cell device were laminated as an ultra thin structure, leading to a flexible, light and unbroken characteristics. Also, surface engineering for dust-proof and water-proof was performed for product application. Furthermore, the electricity generated by solar cells can support the operation of EPD device by maximum power point tracking (MPPT) technology.

The behaviors of dynamic gate bias stress for Indium-Gallium-Zinc-Oxide (IGZO) TFTs were investigated in this study. The device after storage represents a parasitic traneffect after positive gate bias stress. Furthermore, the stability of IGZO TFTs can be improved by adding passivation layer.

Electrolyte-insulator-semiconductor (EIS) and Extended-gate Field Effect Transistor (EGFET) devices with programmable HfO2/Si3N4/SiO2 structures are demonstrated for pH detection. The proposed programmable EIS and EGFET sensors with pH sensing membranes exhibit a high pH sensitivity (larger than the ideal Nernstain response, 59.16 mV/pH at 25°C) owing to the hydrogen ions attraction by electrons trapped within the embedded trapping layer(Si3N4) after programming. When compared with the conventional devices, the programmable sensors with programming provide the possibility for the small pH fluctuation detection and can be used in future pH sensor applications owing to its high pH sensing response.

Background & Aims This study investigated whether serum level of hepatitis B surface antigen (HBsAg) at the end of entecavir treatment was associated with risk of relapse. Methods We performed a prospective multicenter study of 161 consecutive patients with chronic hepatitis B in whom the hepatitis B virus was no longer detected after 3 years or more of entecavir therapy. Treatment ended between July 1, 2011 and July 1, 2015. Patients were monitored for clinical relapse (hepatitis B virus DNA >2000 IU/mL and level of alanine aminotransferase more than 2-fold the upper limit of normal) and virologic relapse (hepatitis B virus DNA >2000 IU/mL). Outcomes were calculated using the Kaplan-Meier method and risk factors were identified by Cox proportional hazards modeling. Results Two years after therapy ended, 49.2% of patients in the entire cohort had a clinical relapse (95% confidence interval [CI], 40.9%–58.1%) and 81.7% had a virologic relapse (95% CI, 74.3%–88.0%). Among patients who were hepatitis B e antigen–negative at the end of therapy, 39.2% had a clinical relapse (95% CI, 30.3%–49.6%) and 77.4% had a virologic relapse (95% CI, 68.6%–85.2%). Serum level of HBsAg was associated with relapse in the hepatitis B e antigen–negative patients ( P trend = .006 for clinical relapse; P trend = .0001 for virologic relapse). In multivariate Cox regression analysis, the hazard ratio (per log IU/mL increment) for clinical relapse was 2.47 (95% CI, 1.45–4.23) and for virologic relapse was 1.80 (95% CI, 1.33–2.45). The 11 (9%) patients with levels of HBsAg Conclusions Serum level of HBsAg is associated with risk of relapse in patients who are hepatitis B e antigen–negative after treatment with entecavir. A low titer of HBsAg might be used to identify patients at low risk for relapse after treatment.

This paper investigates the impact of a train of input Gaussian pulses wavelength on semiconductor optical amplifier (SOA) gain uniformity for high speed applications. In high speed applications, the linear output gain of the input pulses is necessary in order to minimize the gain standard deviation and power penalties. A segmentation model of the SOA is demonstrated to utilize the complete rate equations. The SOA gain profile when injected with a burst of input signal is presented. A direct temporal analysis of the effect of the burst wavelength on the SOA gain and the output gain standard deviation is investigated. The output gain uniformity dependence on the input burst power and wavelength within the C-band spectrum range is analyzed. Results obtained show the proportionality of the peak-gain conditions for the SOA on the nonlinearity of the output gain achieved by the input pulses.

This paper characterizes the gain and the carrier density responses of a semiconductor optical amplifier (SOA). In order to achieve the switching functions in SOA-based optical switches, such as Symmetric Mach-Zehnder (SMZ), the effect of the input signal on the total gain response of the SOA is investigated. The theoretical operation principle is demonstrated using a segmentation model that employs the complete rate equation with third order gain coefficients. Results obtained show the input boundaries and requirements in which the SOA can be efficiently used as an amplifier and as a switch.

An all-optical 1times2 high contrast ratio (CR) switch based on the symmetric Mach-Zehnder (SMZ) interferometers is presented. Simulation results show a remarkable improvement of the inter-output CR (~25 dB) between the two outputs compared with an existing SMZ switch. It is shown that the proposed switch offers high values of inter-output CR (Gt 32dB) over a wide range of input powers using appropriate power of the control pulses.

In this paper we present the modeling and simulation of multiple-hop routing in ultrafast all-optical packet switching based routers employing multiple pulse position modulation (PPM) formatted routing table. In multiple PPM routing tables (PPRTs) with reduced entry length, only a subset of the header address is converted into a PPM format in order to reduce the packet header recognition time. Packet header address correlation is carried out using only a single optical AND gate to improve the processing time. We show that the proposed scheme offers unicast/multi-cast/broadcast transmitting capabilities. The simulation results for the optical signal-to-noise ratio (OSNR) at each hop are presented and compared with the theoretical calculations.

This paper presents a high-speed multiple-channel optical time division multiplexed (OTDM) demultiplexer based on a chained symmetric Mach-Zehnder (CSMZ) switch. In CSMZ switch semiconductor optical amplifier (SOA) are shared between two chained arms in contrast to the MZ based multiple-channel demultiplexers where there is an SOA in each arm. The analysis for bit error rate (BER) and the average received power penalty is presented and the results are compared with the simulated data. It is shown that the power penalty incurred is highly dependent on the value of coupling ratio and the channel number.

This paper presents the characterization and simulation of the ultrafast multiple-input AND gate exploiting the four-wave-mixing effect in a single semiconductor optical amplifier device. The on/off-contrast and amplitude-modulation ratios of the AND-gate outputs and their performances are investigated. It is shown that the proposed three-input AND gate has a large dynamic input-power range (> 20 dB) while offering on/off contrast ratio of more than 15 dB and maintaining the amplitude modulation ratio margin of 2.5 dB.

A 6-inch rollable active-matrix electrophoretic display driven by organic thin-film transistor is demonstrated by using solution and photolithography processes. All process temperature are kept below 120 degree C. Pixel OTFT devices exhibit an average mobility of 0.6 cm2/Vs and good reliability. The rollable EPD prototype has thin (125um) and light (14g) features. The minimum rolling diameter can reach 25 mm.

In a wavelength division multiplexed-passive optical network (WDM-PON), different fiber lengths and optical components would intro- duce different power budgets to different optical networking units (ONUs). Besides, the power decay of the distributed optical carrier from the optical line terminal owing to aging of the optical transmitter could also reduce the injected power into the ONU. In this work, we propose and demonstrate a carrier distributed WDM-PON using a reflective semiconductor optical amplifier-based ONU that can adjust its upstream data rate to accom- modate different injected optical powers. The WDM-PON is evaluated at standard-reach (25 km) and long-reach (100 km). Bit-error rate measure- ments at different injected optical powers and transmission lengths show that by adjusting the upstream data rate of the system (622 Mb/s, 1.25 and 2.5 Gb/s), error-free (

Background: Clopidogrel is a prodrug requiring a cytochrome (CYP)2C19-dependent conversion to become active. Usage of proton pump inhibitors (PPIs) might attenuate clopidogrel's platelet inhibitory effect. Methods: We performed a meta-analysis of studies in Pubmed, Ovid, ISI Science, and Embase. Primary analysis was based on definite outcomes including all cause mortality, cardiac death, myocardial infarction, and/or stroke. Secondary analysis also incorporated probable cardiac events which included re-hospitalization for cardiac symptoms or revascularization procedures. Odds ratios were obtained for studies with definite and probable endpoints and were combined using a random-effects model. Risk difference (RD) was defined as the difference in disease/event rate between the control and treatment. Results: We reviewed 898 publications and found 8 relevant studies: 2 were excluded due to data quality and 1 was excluded because controls used PPIs. 5 studies were analyzed, including 2 published articles and 3 abstracts. 2 meta-analysis were conducted: the first considered only the published articles and the second considered all 5 studies. (Figure) Usage of clopidogrel + PPI was associated with a small non-significant increase in definite events (Risk Difference (RD) 0.0083, 95% CI -0.00022 to 1.2). When probable events were included, the risk difference was significant (RD 0.066, 95% CI 0.055 to 0.077). There was evidence of heterogeneity (p=0.028) between studies. Conclusions: This metaanalysis does not support an adverse relationship between clopidogrel and PPIs when the primary focus was death or definite cardiovascular events.

Des-gamma-carboxy prothrombin (DCP) has been reported to be more sensitive and specific in diagnosing hepatocellular carcinoma (HCC) when compared with alpha-fetoprotein (AFP). However, its ability to identify small HCC still remains unclear. Thus, we conducted a cross-sectional case control study to evaluate whether DCP is better than AFP for differentiating HCC from nonmalignant liver disease and further evaluate the usefulness of DCP in early diagnosis of small HCC.Serum DCP and AFP levels were determined in 127 patients. Among these patients, 32 were with non-cirrhotic chronic hepatitis, 34 were with compensated cirrhosis, and 61 were with HCC. The cut-off value for the DCP and AFP were set as 40 mAU/mL and 20 ng/mL, respectively. To compare the diagnostic value of DCP and AFP in distinguishing HCC from nonmalignant chronic liver disease, receiver operating characteristic (ROC) curves were constructed for each assay.The accuracy, sensitivity and specificity of DCP were higher than AFP in detecting HCC (81.9%, 77% and 86.4% vs 68.5%, 59% and 77.3%, respectively). The area under the ROC (AUROC) curves revealed that DCP had a better accuracy than AFP in diagnosis of HCC (0.85 [95%CI, 0.78-0.91] vs 0.73 [95%CI, 0.65-0.81], P = 0.013). In 39 patients with solitary HCC, the positive rates of DCP were 100% in patients with tumor size larger than 3 cm, 66.7% in patients with tumor size 2-3 cm and 50% in patients with tumor size less than 2 cm. The positive rates of AFP in patients with tumor size larger than 3 cm, 2-3 cm and less than 2 cm were 55.6%, 50%, and 33.3%, respectively. The median level of DCP in HCC patients with tumor size larger than 3 cm was significantly higher than those with tumor size 2-3 cm and those with the size of less than 2 cm.Our study indicates that DCP has a better diagnostic value than AFP in differentiating HCC from nonmalignant chronic liver disease. DCP has not only a stronger correlation with HCC than AFP in tumor size but also more effectiveness than AFP in detecting small size of HCC.