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ObjectivesWe aim to assess the pooled incidence of immune effector cell-associated neurotoxicity syndrome (ICANS) in clinical trials and real-world studies of chimeric antigen receptor (CAR) T-cell therapy for hematologic malignancy and compare the incidences among different agents.MethodsThe PubMed, Embase, and Web of Science databases were searched for clinical trials and real-world studies. An inverse-variance weighting model was used to calculate pooled incidences and subgroup analyses. Multivariable analysis was conducted using binomial-normal modeling.ResultsSeventy-five trials comprising 3,184 patients were included. The overall pooled incidence was 26.9% (95% CI, 21.7–32.7%) for all-grade and 10.5% (95% CI, 8.1–13.6%) for high-grade ICANS. In subgroup analysis, cohorts with anti-CD19 drugs had significantly higher ICANS incidences than cohorts with other agents. The multivariable analysis demonstrated higher odds of ICANS in anti-CD19 drug studies for high-grade (OR, 4.6) compared to anti-BCMA drug studies. In 12 real-world studies, studies used axicabtagene ciloleucel with CD28 (54.0% all-grade, 26.4% high-grade) exhibited significantly higher rates of all-grade and high-grade ICANS than studies using tisagenlecleucel with 4-1BB (17.2% all-grade, 6.1% high-grade).ConclusionsThe overall incidences of ICANS with CAR T-cell therapy were 26.9% for all-grade and 10.5% for high-grade. Compared with other agents, patients with anti-CD19 drugs had a significantly increased risk of developing high-grade ICANS. Therefore, careful monitoring of ICANS should be considered for patients undergoing CAR T-cell therapy.

Abstract We developed artificial intelligence models to predict the brain metastasis (BM) treatment response after stereotactic radiosurgery (SRS) using longitudinal magnetic resonance imaging (MRI) data and evaluated prediction accuracy changes according to the number of sequential MRI scans. We included four sequential MRI scans for 194 patients with BM and 369 target lesions for the Developmental dataset. The data were randomly split (8:2 ratio) for training and testing. For external validation, 172 MRI scans from 43 patients with BM and 62 target lesions were additionally enrolled. The maximum axial diameter (Dmax), radiomics, and deep learning (DL) models were generated for comparison. We evaluated the simple convolutional neural network (CNN) model and a gated recurrent unit (Conv-GRU)-based CNN model in the DL arm. The Conv-GRU model performed superior to the simple CNN models. For both datasets, the area under the curve (AUC) was significantly higher for the two-dimensional (2D) Conv-GRU model than for the 3D Conv-GRU, Dmax, and radiomics models. The accuracy of the 2D Conv-GRU model increased with the number of follow-up studies. In conclusion, using longitudinal MRI data, the 2D Conv-GRU model outperformed all other models in predicting the treatment response after SRS of BM.

Abstract Vertebral artery dissection (VAD) is often associated with medullary infarction; however, an underlying cause may be underestimated. This study aimed to assess the diagnostic potential of hypointense signal lesions along the arterial pathways using susceptibility-weighted imaging (SWI) as a feasible indicator of VAD in medullary infarction. A retrospective analysis was conducted using clinical data, brain magnetic resonance imaging, and angiography records of 79 patients diagnosed with medullary infarction between January 2014 and December 2021. Patients were categorized into an angiography-confirmed dissection group and a non-dissection group based on imaging findings. A new possible dissection group was identified using SWI, including cases with hypointense signals along the arteries without calcification or cardioembolism. We compared the clinical characteristics of the two groups before and after the addition of the hypointense signal as a marker of VAD. The angiography-confirmed dissection group included 12 patients (15%). Among patients lacking angiographic VAD evidence, 14 subjects displayed hypointense signals on SWI: nine patients along the vertebral artery and five subjects at the posterior inferior cerebellar artery without calcification or cardioembolism. The newly classified dissection group was younger, had a lower prevalence of diabetes mellitus and stroke history, and revealed increased headaches compared to the non-dissection group. Hypointense signal detection on SWI in medullary infarctions shows promise as a diagnostic indicator for VAD. Suspicion of VAD is needed when the hypointense signal on SWI is noted, and considering different treatment strategies with angiographic follow-up will be helpful.

Purpose This study investigated the clinical and ultrasonographic (US) findings of suture granulomas and recurrent tumors, and aimed to identify specific characteristics of suture granulomas through an experimental study. Methods This retrospective study included 20 pathologically confirmed suture granulomas and 40 recurrent tumors between January 2010 and December 2020. The clinical findings included suture material, surgery, and initial TNM stage. The US findings included shape, size, margin, echogenicity, heterogeneity, vascularity, and internal echogenic foci. The distribution, paired appearance, and "knot-and-ear" appearance of internal echogenic foci were assessed. An experiment using pork meat investigated the US configuration of suture knots. Results Eighteen patients with 20 suture granulomas (15 women; mean age, 52±13 years) and 37 patients with 40 recurrent tumors (24 women; 54±18 years) were included. Patients with suture granulomas exhibited earlier initial T and N stages than those with recurrent tumors. The knot-and-ear appearance, defined as an echogenic dot accompanied by two adjacent echogenic dots or lines based on experimental findings, was observed in 50% of suture granulomas, but not in recurrent tumors (P

Purpose This study aimed to evaluate the technical feasibility, efficacy, and safety of anterolateral hydrodissection (ALHD) in radiofrequency ablation (RFA) for benign thyroid nodules. Methods Between November 2019 and April 2020, 39 patients underwent 41 sessions of RFA with the ALHD technique to treat benign thyroid nodules. ALHD was performed with cold (0°C-4°C) 5% dextrose solution during RFA to minimize pain and secure sufficient safety margins from critical neck structures. The initial ablation ratio (IAR) was measured to assess the technique’s efficiency. Ultrasound examinations, symptoms, and cosmetic scores were evaluated pre-procedure and at 6 and 12 months post-procedure. Procedure-related pain during RFA and complications were recorded. Results The mean index nodule volume was 20.5±21.6 mL. ALHD was technically feasible in all patients. The mean IAR was 90.7%±8.3%, and significant reductions in mean nodule volume were noted at 6- and 12-month follow-ups (P

Background To assess the effects of radiofrequency ablation (RFA) using an internally-cooled wet (ICW) electrode in ex vivo bovine liver and evaluate the feasibility of the ICW electrode for benign thyroid nodules.Methods We developed an 18-gauge ICW electrode with a microhole at the distal tip for tissue infusion of chilled (0 − 4 °C) isotonic saline (rate = 1.5 ml/min). RFA using ICW and IC electrodes were performed in bovine livers (40 pairs, 1-cm active tip, 50 W, 1-min). We compared the morphological characteristics of ablation zones and presence of carbonization. Twenty patients with benign thyroid nodules larger than 5 ml were prospectively enrolled in a clinical study and underwent ultrasound-guided RFA with ICW electrodes. Ultrasound examinations, laboratory data, and symptom and cosmetic scores were evaluated preprocedure and 1 and 6 months after the procedure.Results In the ex vivo study, the ICW achieved significantly larger ablation zones than the IC (p

The incidence of neurodegenerative diseases in the older population has increased in recent years. A considerable number of studies have been performed to characterize these diseases. Imaging analysis is an important biomarker for the diagnosis of neurodegenerative disease. Objective and reliable assessment and precise detection are important for the early diagnosis of neurodegenerative diseases. Artificial intelligence (AI) using brain MRI applied to the study of neurodegenerative diseases could promote early diagnosis and optimal decisions for treatment plans. MRI-based AI software have been developed and studied worldwide. Representatively, there are MRI-based volumetry and segmentation software. In this review, we present the development process of brain volumetry analysis software in neurodegenerative diseases, currently used and developed AI software for neurodegenerative disease in the Republic of Korea, probable uses of AI in the future, and AI software limitations.

Purpose Radiofrequency ablation (RFA) and ethanol ablation (EA) are effective and safe for benign symptomatic thyroid nodules (BSTNs). However, relatively little is known about the effects of these procedures on patients’ quality of life (QoL). This prospective, multicenter study evaluated the effects of RFA and EA on changes in thyroid-specific QoL in patients with BSTNs and assessed the volume reduction and safety of these procedures. Methods Eighty-six consecutive patients with 86 BSTNs were prospectively included from two medical centers. RFA was performed for 55 BSTNs with solidity ≥50% and EA was performed for 31 BSTNs with solidity

Abstract Recently, as state‐of‐the‐art displays, wearable electronic devices and free‐form displays have begun to attract attention to the point that much research on textile‐based displays has been actively conducted as an ultimate platform for wearable displays. However, although many studies have reported organic light‐emitting diodes (OLEDs) as the most suitable type for textile‐based displays due to their high opto‐electronic performance and flexibility, most research on textile‐based OLEDs (textile OLEDs) has left for the future improvements that require the use of transparent OLEDs (trOLEDs) for applications where aesthetics are important, such as fashion displays and automobile interiors. Herein, RGB‐color trOLEDs are designed using a dielectric‐metal‐dielectric transparent electrode to overcome the limitations of previous works on textile‐based non‐transparent OLEDs and to improve the aesthetic elements of textile displays. The opto‐electronic performance and the mechanical characteristics of textile RGB trOLEDs are analyzed, and specifically, this study suggests a new method and a novel equation for an optical analysis to quantify the clarity of printed color images (i.e., information) on a textile substrate when trOLEDs on the textile substrate are not operated, as needed to optimize and maximize the aesthetic elements of textile displays.

Abstract Wearable electronic devices are being developed because of their wide potential applications and user convenience. Among them, wearable organic light emitting diodes (OLEDs) play an important role in visualizing the data signal processed in wearable electronics to humans. In this study, textile-based OLEDs were fabricated and their practical utility was demonstrated. The textile-based OLEDs exhibited a stable operating lifetime under ambient conditions, enough mechanical durability to endure the deformation by the movement of humans, and washability for maintaining its optoelectronic properties even in water condition such as rain, sweat, or washing. In this study, the main technology used to realize this textile-based OLED was multi-functional near-room-temperature encapsulation. The outstanding impermeability of TiO2 film deposited at near-room-temperature was demonstrated. The internal residual stress in the encapsulation layer was controlled, and the device was capped by highly cross-linked hydrophobic polymer film, providing a highly impermeable, mechanically flexible, and waterproof encapsulation.

As the demand for flexible, rollable, and foldable displays grows, various state-of-the-art component technologies, including thin-film transistors (TFTs), electrodes, thin-film encapsulations (TFEs), and touch screen panels, have been developed based on organic light-emitting diodes (OLEDs) with flexible organic layers. Developing highly reliable flexible OLEDs is essential to realize flexible displays, but the flexible encapsulation technology still has technical difficulties and issues to be addressed. This review covers the recent developments in encapsulation technologies, particularly their material and structural designs, for highly reliable, flexible OLEDs. The solution concepts for the existing technical hurdles in flexible encapsulations are addressed. Among the various advanced flexible encapsulation technologies developed so far, neutral-axis engineering with a thin metal layer and a crack arrester is introduced.

It is extremely rare that near‐infrared organic light‐emitting diodes (NIR OLEDs) have been actually applied to various fields such as sensors, night‐vision displays, or phototherapy owing to device reliability and stability. Therefore, developing a novel deep red to NIR (DR/NIR) emitter for the high‐performance DR/NIR OLED has become a prominent research area. Herein, a novel thienothiophene‐isoquinoline‐based Ir(III) complex DR/NIR emitter with narrow full width half maximum (FWHM, 38 nm), a shallow highest occupied molecular orbital (HOMO) energy level, and short radiative lifetime of 0.66 μs is designed and synthesized. The best device based on a new Ir(III) complex yields record‐high radiant emittance (> 5 mW cm−2) at low voltage (6 V), low external quantum efficiency (EQE) roll‐off, low driving voltage (2.5–6 V), and stable operational lifetime for biomedical application with an emission peak wavelength of 696 nm. From all perspectives, this is notably an outstanding performance among other reported Ir(III)‐based DR/NIR OLEDs. Moreover, DR/NIR OLEDs are applied to the biomedical field and an in vitro experiment shows an increase in cell proliferation effect of up to 24% under diverse conditions.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with type 2 diabetes and a developing several cancers including esophageal cancer (EC). However, the association between MASLD and EC in diabetic patients has not been investigated. Therefore, we aimed to investigate the relation between MASLD and developing EC in diabetic patients. This was a population-based retrospective cohort study of data from the Korean National Health Insurance Service (NHIS). A total of 1,904,468 subjects diagnosed with diabetes who underwent NHIS-provided health checkups from 2009 to 2012 were included. We constructed a Cox proportional hazard model for the association of fatty liver index (FLI) and the risk of EC stratified by potential confounders. Over a mean follow-up duration of 6.9 years, the incidence of EC was higher in the high (≥60) FLI group compared to the low (<30) FLI group (14.4 vs. 13.7 event per 100,000 person-years). The risk of EC correlated with the degree of FLI, particularly in older (P =  0.002), female (P =  0.033), non-smoking (P =  0.002), and non-drinking patients (P =  0.025). Among obese patients, the risk of EC was not associated with FLI; however, the risk of EC was higher in the high FLI group in non-obese patients. Lean MASLD patients had the highest risk of EC (adjusted hazard ratio 1.78; 95% confidence interval, 1.5–2.13). MASLD was associated with an increased risk of EC in diabetic patients, and lean MASLD has the highest risk. Further studies are required to determine the causal relationship between MASLD and EC. [ABSTRACT FROM AUTHOR]

OBJECTIVES Unlike the initial plan, some patients with oesophageal squamous cell carcinoma cannot or do not receive surgery after neoadjuvant chemoradiotherapy (nCRT). This study aimed to report the epidemiology of patients not receiving surgery after nCRT and to evaluate the potential risk of refusing surgery. METHODS We analysed patients with clinical stage T3-T4aN0M0 or T1-T4aN1-N3M0 oesophageal squamous cell carcinoma who underwent nCRT as an initial treatment intent between January 2005 and March 2020. Patients not receiving surgery were categorized using predefined criteria. To evaluate the risk of refusing surgery, a propensity-matched comparison with those who received surgery was performed. Recurrence-free (RFS) and overall survival (OS) was compared between groups, according to clinical response to nCRT. RESULTS Among the study population (n  = 715), 105 patients (14.7%) eventually failed to reach surgery. There were three major patterns of not receiving surgery: disease progression before surgery (n  = 25), functional deterioration at reassessment (n  = 47), and patient's refusal without contraindications (n  = 33). After propensity-score matching, the RFS curves of the surgery group and the refusal group were significantly different (P  <   0.001), while OS curves were not significantly different (P  =   0.069). In patients who achieved clinical complete response on re-evaluation, no significant difference in the RFS curves (P  =   0.382) and in the OS curves (P  =   0.290) was observed between the surgery group and the refusal group. However, among patients who showed partial response or stable disease on re-evaluation, the RFS and OS curves of the refusal group were overall significantly inferior compared to those of the surgery group (both P  <   0.001). The 5-year RFS rates were 10.3% for the refusal group and 48.2% for the surgery group, and the 5-year OS rates were 8.2% for the refusal group and 46.1% for the surgery group. CONCLUSIONS Patient's refusal remains one of the major obstacles in completing the trimodality therapy for oesophageal squamous cell carcinoma. Refusing surgery when offered may jeopardize oncological outcome, particularly in those with residual disease on re-evaluation after nCRT. These results provide significant implications for consulting patients who are reluctant to oesophagectomy after nCRT. [ABSTRACT FROM AUTHOR]