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We describe a novel pre-liver transplant (LT) approach in colorectal liver metastasis, allowing for improved monitoring of tumor biology and reduction of disease burden before committing a patient to transplantation. Patients undergoing LT for colorectal liver metastasis at Cleveland Clinic were included. The described protocol involves intensive locoregional therapy with systemic chemotherapy, aiming to reach minimal disease burden revealed by positron emission tomography scan and carcinoembryonic Ag. Patients with no detectable disease or irreversible treatment-induced liver injury undergo transplant. Nine patients received liver transplant out of 27 who were evaluated (33.3%). The median follow-up was 700 days. Seven patients (77.8%) received a living donor LT. Five had no detectable disease, and 4 had treatment-induced cirrhosis. Pretransplant management included chemotherapy (n = 9) +/- bevacizumab (n = 6) and/or anti-EGFR (n = 6). The median number of pre-LT cycles of chemotherapy was 16 (range 10-40). Liver-directed therapy included Yttrium-90 (n = 5), ablation (n = 4), resection (n = 4), and hepatic artery infusion pump (n = 3). Three patients recurred after LT. Actuarial 1- and 2-year recurrence-free survival were 75% (n = 6/8) and 60% (n = 3/5). Recurrence occurred in the lungs (n = 1), liver graft (n = 1), and lungs+para-aortic nodes (n = 1). Patients with pre-LT detectable disease had reduced RFS ( p = 0.04). All patients with recurrence had histologically viable tumors in the liver explant. Patients treated in our protocol (n = 16) demonstrated improved survival versus those who were not candidates (n = 11) regardless of transplant status ( p = 0.01). A protocol defined by aggressive pretransplant liver-directed treatment and transplant for patients with the undetectable disease or treatment-induced liver injury may help prevent tumor recurrence.
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Non-reciprocal electronic transport in a spatially homogeneous system arises from the simultaneous breaking of inversion and time-reversal symmetries. Superconducting and Josephson diodes, a key ingredient for future non-dissipative quantum devices, have recently been realized. Only a few examples of a vertical superconducting diode effect have been reported and its mechanism, especially whether intrinsic or extrinsic, remains elusive. Here we demonstrate a substantial supercurrent non-reciprocity in a van der Waals vertical Josephson junction formed with a Td-WTe2 barrier and NbSe2 electrodes that clearly reflects the intrinsic crystal structure of Td-WTe2. The Josephson diode efficiency increases with the Td-WTe2 thickness up to critical thickness, and all junctions, irrespective of the barrier thickness, reveal magneto-chiral characteristics with respect to a mirror plane of Td-WTe2. Our results, together with the twist-angle-tuned magneto-chirality of a Td-WTe2 double-barrier junction, show that two-dimensional materials promise vertical Josephson diodes with high efficiency and tunability.
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Colorectal cancer is the second most common cause of cancer-related death worldwide, and half of patients present with colorectal liver metastasis (CRLM). Liver transplant (LT) has emerged as a treatment modality for otherwise unresectable CRLM. Since the publication of the Lebeck-Lee systematic review in 2022, additional evidence has come to light supporting LT for CRLM in highly selected patients. This includes reports of >10-year follow-up with over 80% survival rates in low-risk patients. As these updated reports have significantly changed our collective knowledge, this article is intended to serve as an update to the 2022 systematic review to include the most up-to-date evidence on the subject.
Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Transplante de Fígado , Humanos , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Colorretais/patologia , Hepatectomia , Neoplasias Hepáticas/secundário , Revisões Sistemáticas como AssuntoRESUMO
Spin-triplet supercurrent spin valves are of practical importance for the realization of superconducting spintronic logic circuits. In ferromagnetic Josephson junctions, the magnetic-field-controlled non-collinearity between the spin-mixer and spin-rotator magnetizations switches the spin-polarized triplet supercurrents on and off. Here we report an antiferromagnetic equivalent of such spin-triplet supercurrent spin valves in chiral antiferromagnetic Josephson junctions as well as a direct-current superconducting quantum interference device. We employ the topological chiral antiferromagnet Mn3Ge, in which the Berry curvature of the band structure produces fictitious magnetic fields, and the non-collinear atomic-scale spin arrangement accommodates triplet Cooper pairing over long distances (>150 nm). We theoretically verify the observed supercurrent spin-valve behaviours under a small magnetic field of <2 mT for current-biased junctions and the direct-current superconducting quantum interference device functionality. Our calculations reproduce the observed hysteretic field interference of the Josephson critical current and link these to the magnetic-field-modulated antiferromagnetic texture that alters the Berry curvature. Our work employs band topology to control the pairing amplitude of spin-triplet Cooper pairs in a single chiral antiferromagnet.
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Efficient doping for modulating electrical properties of two-dimensional (2D) transition metal dichalcogenide (TMDC) semiconductors is essential for meeting the versatile requirements for future electronic and optoelectronic devices. Because doping of semiconductors, including TMDCs, typically involves generation of charged dopants that hinder charge transport, tackling Coulomb scattering induced by the externally introduced dopants remains a key challenge in achieving ultrahigh mobility 2D semiconductor systems. In this study, we demonstrated remote charge transfer doping by simply inserting a hexagonal boron nitride layer between MoS2 and solution-deposited n-type dopants, benzyl viologen. A quantitative analysis of temperature-dependent charge transport in remotely doped devices supports an effective suppression of the dopant-induced scattering relative to the conventional direct doping method. Our mechanistic investigation of the remote doping method promotes the charge transfer strategy as a promising method for material-level tailoring of electrical and optoelectronic devices based on TMDCs.
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Simultaneous breaking of inversion and time-reversal symmetries in a conductor yields a non-reciprocal electronic transport1-3, known as the diode or rectification effect, that is, low (ideally zero) conductance in one direction and high (ideally infinite) conductance in the other. So far, most of the diode effects observed in non-centrosymmetric polar/superconducting conductors4-7 and Josephson junctions8-10 require external magnetic fields to break the time-reversal symmetry. Here we report zero-field polarity-switchable Josephson supercurrent diodes, in which a proximity-magnetized Pt layer by ferrimagnetic insulating Y3Fe5O12 serves as the Rashba(-type) Josephson barrier. The zero-field diode efficiency of our proximity-engineered device reaches up to ±35% at 2 K, with a clear square-root dependence on temperature. Measuring in-plane field-strength/angle dependences and comparing with Cu-inserted control junctions, we demonstrate that exchange spin-splitting11-13 and Rashba(-type) spin-orbit coupling13-15 at the Pt/Y3Fe5O12 interface are key for the zero-field giant rectification efficiency. Our achievement advances the development of field-free absolute Josephson diodes.
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Recently there has been growing interest in avalanche multiplication in two-dimensional (2D) materials and device applications such as avalanche photodetectors and transistors. Previous studies have mainly utilized unipolar semiconductors as the active material and focused on developing high-performance devices. However, fundamental analysis of the multiplication process, particularly in ambipolar materials, is required to establish high-performance electronic devices and emerging architectures. Although ambipolar 2D materials have the advantage of facile carrier-type tuning through electrostatic gating, simultaneously allowing both carrier types in a single channel poses an inherent difficulty in analyzing their individual contributions to avalanche multiplication. In ambipolar field-effect transistors (FETs), two phenomena of ambipolar transport and avalanche multiplication can occur, and both exhibit secondary rise of output current at high lateral voltage. We distinguished these two competing phenomena using the method of channel length modulation and successfully analyzed the properties of electron- and hole-initiated multiplication in ambipolar WSe2 FETs. Our study provides a simple and robust method to examine carrier multiplication in ambipolar materials and will foster the development of high-performance atomically thin electronic devices utilizing avalanche multiplication.
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2D transition metal dichalcogenides (TMDCs) have revealed great promise for realizing electronics at the nanoscale. Despite significant interests that have emerged for their thermoelectric applications due to their predicted high thermoelectric figure of merit, suitable doping methods to improve and optimize the thermoelectric power factor of TMDCs have not been studied extensively. In this respect, molecular charge-transfer doping is utilized effectively in TMDC-based nanoelectronic devices due to its facile and controllable nature owing to a diverse range of molecular designs available for modulating the degree of charge transfer. In this study, the power of molecular charge-transfer doping is demonstrated in controlling the carrier-type (n- and p-type) and thermoelectric power factor in platinum diselenide (PtSe2 ) nanosheets. This, combined with the tunability in the band overlap by changing the thickness of the nanosheets, allows a significant increase in the thermoelectric power factor of the n- and p-doped PtSe2 nanosheets to values as high as 160 and 250 µW mK-2 , respectively. The methodology employed in this study provides a simple and effective route for the molecular doping of TMDCs that can be used for the design and development of highly efficient thermoelectric energy conversion systems.
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Nonequilibrium studies of two-dimensional (2D) superconductors (SCs) with Ising spin-orbit coupling are prerequisite for their successful application to equilibrium spin-triplet Cooper pairs and, potentially, Majorana Fermions. By taking advantage of the recent discoveries of 2D SCs and their compatibility with any other materials, we fabricate here nonlocal magnon devices to examine how such 2D Ising superconductivity affects the conversion efficiency of magnon spin to quasiparticle charge in superconducting flakes of 2H-NbSe2 transferred onto ferrimagnetic insulating Y3Fe5O12. Comparison with a reference device based on a conventionally paired superconductor shows that the Y3Fe5O12-induced in-plane (IP) exchange spin-splitting in the NbSe2 flake is hindered by its inherent out-of-plane (OOP) spin-orbit field, which, in turn, limits the transition-state enhancement of the spin-to-charge conversion efficiency. Our out-of-equilibrium study highlights the significance of symmetry matching between underlying Cooper pairs and exchange-induced spin-splitting for the giant transition-state spin-to-charge conversion and may have implications toward proximity-engineered spin-polarized triplet pairing via tuning the relative strength of IP exchange and OOP spin-orbit fields in ferromagnetic insulator/2D Ising SC bilayers.
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The controllability of carrier density and major carrier type of transition metal dichalcogenides(TMDCs) is critical for electronic and optoelectronic device applications. To utilize doping in TMDC devices, it is important to understand the role of dopants in charge transport properties of TMDCs. Here, the effects of molecular doping on the charge transport properties of tungsten diselenide (WSe2 ) are investigated using three p-type molecular dopants, 2,3,5,6-tetrafluoro-7,7,8,8-tetracyanoquinodimethane (F4 -TCNQ), tris(4-bromophenyl)ammoniumyl hexachloroantimonate (magic blue), and molybdenum tris(1,2-bis(trifluoromethyl)ethane-1,2-dithiolene) (Mo(tfd-COCF3 )3 ). The temperature-dependent transport measurements show that the dopant counterions on WSe2 surface can induce Coulomb scattering in WSe2 channel and the degree of scattering is significantly dependent on the dopant. Furthermore, the quantitative analysis revealed that the amount of charge transfer between WSe2 and dopants is related to not only doping density, but also the contribution of each dopant ion toward Coulomb scattering. The first-principles density functional theory calculations show that the amount of charge transfer is mainly determined by intrinsic properties of the dopant molecules such as relative frontier orbital positions and their spin configurations. The authors' systematic investigation of the charge transport of doped TMDCs will be directly relevant for pursuing molecular routes for efficient and controllable doping in TMDC nanoelectronic devices.
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Recently, there have been numerous studies on utilizing surface treatments or photosensitizing layers to improve photodetectors based on 2D materials. Meanwhile, avalanche breakdown phenomenon has provided an ultimate high-gain route toward photodetection in the form of single-photon detectors. Here, the authors report ultrasensitive avalanche phototransistors based on monolayer MoS2 synthesized by chemical vapor deposition. A lower critical field for the electrical breakdown under illumination shows strong evidence for avalanche breakdown initiated by photogenerated carriers in MoS2 channel. By utilizing the photo-initiated carrier multiplication, their avalanche photodetectors exhibit the maximum responsivity of ≈3.4 × 107 A W-1 and the detectivity of ≈4.3 × 1016 Jones under a low dark current, which are a few orders of magnitudes higher than the highest values reported previously, despite the absence of any additional chemical treatments or photosensitizing layers. The realization of both the ultrahigh photoresponsivity and detectivity is attributed to the interplay between the carrier multiplication by avalanche breakdown and carrier injection across a Schottky barrier between the channel and metal electrodes. This work presents a simple and powerful method to enhance the performance of photodetectors based on carrier multiplication phenomena in 2D materials and provides the underlying physics of atomically thin avalanche photodetectors.
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Ruddlesden-Popper (RP) perovskites have attracted a lot of attention as the active layer for optoelectronic devices due to their excellent photophysical properties and environmental stability. Especially, local structural properties of RP perovskites have shown to play important roles in determining the performance of optoelectronic devices. Here, we report the photodetector performance variation depending on the crystallinity of n = 4 two-dimensional (2D) RP perovskite polycrystalline films. Through controlling the solvent evaporation rate, 2D RP perovskite films could be tuned between highly- and randomly-orientated phases. We investigated how different factors related to the film crystallinity are reflected in the variation of photodetector performances by considering grain boundary and low energy edge state effects in n = 4 RP perovskites. Better understanding the interplay between these factors that govern the photophysical properties of the devices would be beneficial for designing high-performance RP perovskite-based optoelectronic devices.
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We report two organocompatible strategies to enhance the output performance of all-solution-processed poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) thermoelectric generators (TEGs): introducing an additive spray printing process and functionalized polymer interlayers to reduce the module resistance. The spray printing enabled the deposition of 1-µm-thick PEDOT:PSS layers with a high degree of design freedom, resulting in a significantly reduced sheet resistance of 16 Ω sq-1 that is closely related to the thermoelectric output performance. Also, by inserting an ultrathin silane-terminated polystyrene (PS) interlayer between the PEDOT:PSS thermoelectric layers and inkjet-printed Ag interconnects selectively, the contact resistivity extracted by the transmission line method was reduced from 6.02 × 10-2 to 2.77 × 10-2 Ω cm2. We found that the PS interlayers behaved as a thin tunneling layer, which facilitated the carrier injection from the inkjet-printed Ag electrodes into the PEDOT:PSS films by field emission with an effectively lowered energy barrier. The activation energy was also extracted using the Richardson equation, resulting in a reduction of 2.59 ± 0.04 meV after the PS treatment. Scalable plastic-compatible processability and selective interface engineering enabled to demonstrate the flexible 74-leg PEDOT:PSS TEGs exhibiting the open-circuit voltage of 9.21 mV and the output power of 2.23 nW at a temperature difference of 10 K.
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PURPOSE: To evaluate effectiveness of the apparent diffusion coefficient (ADC) values of the peripancreatic lymphadenopathy to differentiate tuberculous lymphadenopathy from metastatic lymphadenopathy. MATERIALS AND METHODS: Twenty-nine patients with 65 peripancreatic necrotic tuberculous lymphadenopathy and 31 patients with 47 peripancreatic necrotic metastatic lymphadenopathy from pancreatic ductal adenocarcinoma, who underwent magnetic resonance imaging (MRI), were included in this study. MRI features in the T1-weighted image (WI), T2WI, and diffusion-weighted image were analyzed. The ADC values of necrotic and non-necrotic portions of the lymph nodes were measured and compared using t test. Receiver operating characteristic analysis was performed to obtain the optimal ADC threshold value and diagnostic accuracy for differentiating tuberculous lymphadenopathy from metastatic lymphadenopathy. RESULTS: On T2WI, the signal intensity of necrotic portions was variable in tuberculous lymphadenopathy, but was mostly high in metastatic lymphadenopathy. The mean ADCs of necrotic portions of tuberculous lymphadenopathy were significantly lower than those of metastatic lymphadenopathy ([0.919 ± 0.272] × 10-3 mm2/s vs. [1.553 ± 0.406] × 10-3 mm2/s, p < 0.001). Receiver operating characteristic analysis for differentiating tuberculous from metastatic lymphadenopathy demonstrated an area under the curve for the ADC values of necrotic portions of 0.929 (95% CI, 0.865-0.969) with an ADC threshold of 1.022. The sensitivity and specificity for the differentiation of tuberculous from metastatic lymphadenopathy were 80.0% and 97.8%, respectively. CONCLUSION: The ADC values of necrotic portions of peripancreatic lymphadenopathy may be useful for differentiating tuberculous from metastatic lymphadenopathy.
Assuntos
Linfadenopatia , Neoplasias Pancreáticas , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Humanos , Linfonodos , Linfadenopatia/diagnóstico por imagem , Metástase Linfática , Neoplasias Pancreáticas/diagnóstico por imagem , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeAssuntos
Enfisema/diagnóstico , Endoscopia/efeitos adversos , Dilatação Gástrica/diagnóstico , Gastrostomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Adulto , Meios de Contraste/administração & dosagem , Enfisema/etiologia , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Dilatação Gástrica/etiologia , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Estômago/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
We investigated the electrical and optoelectronic characteristics of ambipolar WSe2 field-effect transistors (FETs) via facile p-doping process during the thermal annealing in ambient. Through this annealing, the oxygen molecules were successfully doped into the WSe2 surface, which ensured higher p-type conductivity and the shift of the transfer curve to the positive gate voltage direction. Besides, considerably improved photoswitching response characteristics of ambipolar WSe2 FETs were achieved by the annealing in ambient. To explore the origin of the changes in electrical and optoelectronic properties, the analyses via X-ray photoelectron, Raman, and photoluminescence spectroscopies were performed. From these analyses, it turned out that WO3 layers formed by the annealing in ambient introduced p-doping to ambipolar WSe2 FETs, and disorders originated from the WO3/WSe2 interfaces acted as non-radiative recombination sites, leading to significantly improved photoswitching response time characteristics.
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In the past decade, intensive studies on monolayer MoS2-based phototransistors have been carried out to achieve further enhanced optoelectronic characteristics. However, the intrinsic optoelectronic characteristics of monolayer MoS2 have still not been explored until now because of unintended interferences, such as multiple reflections of incident light originating from commonly used opaque substrates. This leads to overestimated photoresponsive characteristics inevitably due to the enhanced photogating and photoconductive effects. Here, we reveal the intrinsic photoresponsive characteristics of monolayer MoS2, including its internal responsivity and quantum efficiency, in fully transparent monolayer MoS2 phototransistors employing a van der Waals heterostructure. Interestingly, as opposed to the previous reports, the internal photoresponsive characteristics do not significantly depend on the wavelength of the incident light as long as the electron-hole pairs are generated in the same k-space. This study provides a deeper understanding of the photoresponsive characteristics of MoS2 and lays the foundation for two-dimensional materials-based transparent phototransistors.
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The irradiation effect of high energy proton beams on tungsten diselenide (WSe2) ambipolar field-effect transistors was investigated. We measured the electrical characteristics of the fabricated WSe2 FETs before and after the 10 MeV proton beam irradiation with different doses of 1012, 1013, 1014, and 1015 cm-2. For low dose conditions (1012, 1013, and 1014 cm-2), the threshold voltages shifted to the negative gate voltage direction, and the current in the hole and electron accumulation regimes decreased and increased, respectively. However, the trends were opposite for the high dose condition (1015 cm-2); the threshold voltages shifted to the positive gate voltage direction, and the current in the hole and electron accumulation regimes increased and decreased, respectively. These phenomena can be explained by the combined effect of proton irradiation-induced traps and the applied gate bias condition. Specifically, irradiation-induced positive oxide traps in SiO2 dielectrics play a role in enhancing electron accumulation and reducing hole accumulation in the WSe2 channel, whereas the irradiation-induced holes near the WSe2/SiO2 interface act as electron trapping sites, with enhancing hole accumulation and reducing electron accumulation in the WSe2 channel. This work will help improve the understanding of the effect of high energy irradiation on WSe2-based and other ambipolar nanoelectronic devices. In addition, this work shows the possibility of tuning the electrical properties of WSe2-based devices.