Design of a CMOS Image Sensor with Bi-Directional Gamma-Corrected Digital-Correlated Double Sampling.

We present a 640 × 480 CMOS image sensor (CIS) with in-circuit bi-directional gamma correction with a proposed digital-correlated double sampling (CDS) structure. To operate the gamma correction in the CIS, the transfer function of the analog-to-digital converter can be changed by controlling the clock frequency of the counter using analog CDS. However, the analog CDS is vulnerable to capacitor mismatch, clock feedthrough, etc. Therefore, we propose a digital-CDS method with a hold-and-go counter structure to operate the bi-directional gamma correction in the CIS. The proposed CIS achieves a 10-bit resolution using a global log-exponential counter and configurable column reset counter with a resolution of 8/9 bits. The sensor was fabricated in a 0.11 µm CIS process, and the full chip area was 5.9 mm × 5.24 mm. The measurement results showed a maximum SNR improvement of 10.41% with the proposed bi-directional gamma-corrected digital-CDS with the hold-and-go counter. The total power consumption was 6.3 mW at a rate of 16.6 frames per second with analog, pixel, and digital supply voltages of 3.3 V, 3.3 V, and 1.5 V, respectively.

Effect of Different Surface Designs on the Rotational Resistance and Stability of Orthodontic Miniscrews: A Three-Dimensional Finite Element Study.

High orthodontic forces and various directions of applied forces can be associated with loosening of the screw anchorage in the bone. Screw designs have been modified to increase the stability of the miniscrews. This research evaluates the influence of three-designs on the stability of orthodontic miniscrews. A conventionally cylinder-type miniscrew design (Bio-Action screw, Jin-Biomed co., Bucheon, Korea) was set as a control, and three conditions were studied based on modifications of this control design. Condition-1 has narrowed threads in the upper part of the screw; Condition-2 has a notch at the middle part; and Condition-3 has the combination of Condition-1 and Condition-2. The moment required to unwind the miniscrew to five degrees is tested, and the moment generated at the cortical bone and the trabecular bone were calculated with finite element analysis. Compared to the control, all three conditions showed a higher moment required to unwind the miniscrew and a higher moment generated at the cortical bone. At the trabecular bone, condition-2 and -3 showed higher moment than the control, and condition-1 showed similar moment to the control. Condition-3 required a higher overall moment to unwind the miniscrew. These findings validate the design modifications used to increase the rotational resistance.

Idiopathic pulmonary fibrosis lung transplant recipients are at increased risk for EBV-associated posttransplant lymphoproliferative disorder and worse survival.

Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder (EBV-PTLD) is a serious complication in lung transplant recipients (LTRs) associated with significant mortality. We performed a single-center retrospective study to evaluate the risks for PTLD in LTRs over a 7-year period. Of 611 evaluable LTRs, we identified 28 cases of PTLD, with an incidence of 4.6%. Kaplan-Meier analysis showed a decreased freedom from PTLD in idiopathic pulmonary fibrosis (IPF)-LTRs (P < .02). Using a multivariable Cox proportional hazards model, we found IPF (hazard ratio [HR] 3.51, 95% confidence interval [CI] 1.33-8.21, P = .01) and alemtuzumab induction therapy (HR 2.73, 95% CI 1.10-6.74, P = .03) as risk factors for PTLD, compared to EBV mismatch (HR: 34.43, 95% CI 15.57-76.09, P < .0001). Early PTLD (first year) was associated with alemtuzumab use (P = .04), whereas IPF was a predictor for late PTLD (after first year) (P = .002), after controlling for age and sex. Kaplan-Meier analysis revealed a shorter time to death from PTLD in IPF LTRs compared to other patients (P = .04). The use of alemtuzumab in EBV mismatch was found to particularly increase PTLD risk. Together, our findings identify IPF LTRs as a susceptible population for PTLD. Further studies are required to understand the mechanisms driving PTLD in IPF LTRs and develop strategies to mitigate risk.

Polarized ultraviolet emitters with Al wire-grid polarizers fabricated by solvent-assisted nanotransfer process.

Polarized ultraviolet (UV) emitters are essential for various applications, such as photoalignment devices for liquid crystals, high-resolution imaging devices, highly sensitive sensors, and steppers. To increase the high polarization ratio (PR) of a UV emitter, the grating period should be decreased than that of the visible emitter. However, the fabrication of the short period grating directly on UV emitters is still limited. In this study, we demonstrate that 200, 100, and 50 nm period aluminum (Al)-based wire-grid polarizers (WGPs) can be fabricated directly on UV emitters by a solvent-assisted nanotransfer process. The UV emitter with a grating period of 100 nm shows a PR of 84%, and an electroluminescence efficiency that is 22.5% and 48% higher than those of UV emitters with 50 nm and 200 nm period WGPs, respectively, due to the increased photon extraction efficiency (PEE). The higher PEE is attributed to the optical cavity property of the Al metal reflector with low light loss and the surface plasmon effect of the Al grating layer.

Autotransplanted premolars with incomplete root formation in a growing patient with multiple missing teeth.

A boy aged 8 years 11-months with 4 missing teeth in his mandibular arch and with a skeletal Class II pattern was treated with autotransplantation of developing premolars from his maxillary arch with the aid of temporary skeletal anchorage devices. The active treatment duration was 25 months. After treatment, he had a normal occlusion, and his profile was improved. Posttreatment records at 12 months showed stable occlusion and successfully autotransplanted premolars.

Social Media Use and Well-Being in People with Physical Disabilities: Influence of SNS and Online Community Uses on Social Support, Depression, and Psychological Disposition.

This study examined the relationships across social media use, social support, depression, and general psychological disposition among people with movement or mobility disabilities in Korea. First, with survey data (n = 91) collected from users of social network sites (SNSs) and online communities, hypotheses regarding positive associations between intensity of an individual's engagement in social media and four different types of social support-emotional, instrumental, informational, and appraisal support-were tested as well as hypotheses regarding mediation effects of the social support variables in the association between social media use and depression. Second, through focus group interviews (n = 15), influences of social media use on social support were more thoroughly explored as well as their influences on general psychological disposition. Results from hierarchical regression analyses confirmed that both intensity of SNS use and online community use significantly predicted instrumental, informational, and appraisal support, while they did not predict emotional support. Further regression and Sobel tests showed that higher levels of intensity of SNS use and of online community use both led to lower levels of depression through the mediation of instrumental and informational support. Analysis of the interviews further revealed the positive roles of social media use in building social support and healthy psychological dispositions. However, analysis also revealed some negative consequences of and limitations to social media use for those with physical disabilities. These findings expand our knowledge of the context and implications of engaging in online social activities for people with physical disabilities.

What Motivates Users to Continue Using Diet and Fitness Apps? Application of the Uses and Gratifications Approach.

This study explored how the gratifications obtained from the use of diet and fitness apps may motivate users to continue their use of these apps. The effects of seven gratifications obtained were analyzed through hierarchical regression analyses. Results showed that the five gratifications of recordability, networkability, credibility, comprehensibility, and trendiness significantly predicted user intention to continue using diet/fitness apps; the hypothesized gratifications of accuracy and entertainment were not significant predictors. These findings contribute to broadening our theoretical and practical knowledge of new digital, mobile media phenomena by identifying use motivations specific to diet/fitness apps. Based on the findings, recommendations for researchers, practitioners, and developers are provided.

Distinct U-shape efficiency-versus-current curves in AlGaN-based deep-ultraviolet light-emitting diodes.

The efficiency of an AlGaN deep-ultraviolet light-emitting diode with peak emission wavelength of 285 nm is investigated as a function of current over a wide range of temperatures (110 K to 300 K). We find that the efficiency-versus-current curve exhibits unique and distinct features over the entire temperature range including three points of inflection. At low temperatures, the change in slope in the efficiency-versus-current curve is particularly pronounced producing a minimum in the efficiency after which the efficiency rises again. Furthermore, at high current density, the low-temperature efficiency exceeds the room-temperature efficiency. The feature-rich efficiency-versus-current curve is consistent with an enhancement in p-type conductivity by field-ionization of acceptors that occurs in the high-injection regime and is particularly pronounced at low temperatures. Differential conductivity measurements show a marked rise in the high-injection regime that is well correlated to the minimum point in the efficiency-versus-current curve.

Size dependence of silica nanospheres embedded in 385 nm ultraviolet light-emitting diodes on a far-field emission pattern.

We demonstrate that the use of silica nanospheres (SNs) with sizes close to the emission wavelength of light-emitting diodes (LEDs) can enhance the light output power and manipulate the far-field emission pattern. Near-ultraviolet (NUV)-LEDs grown on a patterned sapphire substrate embedded with 300 nm SNs show a three times higher light output power than that without SNs, when measured through the top side. For far-field emission measurements, the LEDs embedded with 300 nm SNs show the significant increase of front emission due to the improved crystal quality of epitaxial films as well as the increase of Mie scattering effect of SNs. These experimental results indicate the important role of the size of embedded SNs in enhancing the light output power for NUV-LEDs.

Five-year experience with mini-volume priming in infants ≤5 kg: safety of significantly smaller transfusion volumes.

Reducing the cardiopulmonary bypass (CPB) priming volume in congenital cardiac surgery is important because it is associated with fewer transfusions. This retrospective study was designed to compare safety and transfusion volumes between the mini-volume priming (MP) and conventional priming (CP) methods. Between 2007 and 2012, congenital heart surgery using CPB was performed on 480 infants (≤5 kg): the MP method was used in 331 infants (MP group, 69.0%), and the CP method was used in 149 infants (CP group, 31.0%). In the MP group, narrow-caliber (3/16″) tubing was used, and the pump heads were vertically aligned to shorten the tubing lengths. The smallest possible oxygenators and hemofilters were used, and vacuum drainage was applied. Ultrafiltration was vigorously applied during CPB to avoid excessive hemodilution. The mean age and body weight of the patients were 48 ± 41 (0-306) days and 3.8 ± 0.8 (1.3-5.0) kg, respectively. The total priming and transfusion volumes during CPB were lower in the MP group than in the CP group (141 ± 24 mL vs. 292 ± 50 mL, P < 0.001, and 82 ± 40 mL vs. 162 ± 82 mL, P < 0.001, respectively). In the MP group, the smallest priming volume was 110 mL. However, there was no significant difference in the lowest hematocrit level during CPB between the two groups (22 ± 3% vs. 22 ± 3%, P = 0.724). The incidence of postoperative neurological complications was not significantly different between the MP and CP groups (1.8% vs. 2.7%, P = 0.509). After adjustment for the Risk Adjustment for Congenital Heart Surgery category, body surface area, and age, MP was not an independent risk factor of postoperative neurological complications or early mortality (P = 0.213 and P = 0.467, respectively). The MP method reduced the priming volume to approximately 140 mL without increasing the risk of morbidity or mortality in infants ≤5 kg. The total transfusion volume during CPB was reduced by 50% without compromising hematocrit levels. We recommend the use of mini-volume priming, which is a safe and effective method for reducing transfusion volumes.

Cognitive factors of using health apps: systematic analysis of relationships among health consciousness, health information orientation, eHealth literacy, and health app use efficacy.

BACKGROUND: Interest in smartphone health apps has been increasing recently. However, we have little understanding of the cognitive and motivational factors that influence the extent of health-app use. OBJECTIVE: This study aimed to examine the effects of four cognitive factors-health consciousness, health information orientation, eHealth literacy, and health-app use efficacy-on the extent of health-app use. It also explored the influence of two different use patterns-information and information-behavior use of health apps-with regard to the relationships among the main study variables. METHODS: We collected and analyzed 765 surveys in South Korea. According to the results, there was a negligible gender difference: males (50.6%, 387/765) and females (49.4%, 378/765). All participants were adults whose ages ranged from 19 to 59. In order to test the proposed hypotheses, we used a path analysis as a specific form of structural equation modeling. RESULTS: Through a path analysis, we discovered that individuals' health consciousness had a direct effect on their use of health apps. However, unlike the initial expectations, the effects of health information orientation and eHealth literacy on health-app use were mediated by health-app use efficacy. CONCLUSIONS: The results from the path analysis addressed a significant direct effect of health consciousness as well as strong mediating effects of health-app use efficacy. These findings contribute to widening our comprehension of the new, digital dimensions of health management, particularly those revolving around mobile technology.

A Short Fully Covered Self-Expandable Metal Stent for Management of Benign Biliary Stricture Not Caused by Living-Donor Liver Transplantation.

Background: This study evaluated the effectiveness of short fully covered self-expanding metal stents (FCSEMS) with an anti-migration design in treating benign biliary strictures (BBS) not related to living donor liver transplantation (LDLT). Methods: A retrospective analysis was conducted on 75 patients who underwent FCSEMS insertion for BBS management. Stents were initially kept for 3 months and exchanged every 3 months until stricture resolution. Adverse events and stricture recurrence after FCSEMS removal were assessed during follow-up. Results: The study outcomes were technical success, stenosis resolution, and treatment failure. Technical success was 100%, with stricture resolution in 99% of patients. The mean onset time of BBS post-surgery was 4.4 years, with an average stent indwelling period of 5.5 months. Stricture recurrence occurred in 20% of patients, mostly approximately 18.8 months after stent removal. Early cholangitis and stent migration were noted in 3% and 4% of patients, respectively. Conclusions: This study concludes that short FCSEMS demonstrate high efficacy in the treatment of non-LDLT-related BBS, with a low incidence of interventions and complications. Although this is a single-center, retrospective study with a limited sample size, the findings provide preliminary evidence supporting the use of short FCSEMS as a primary treatment modality for BBS. To substantiate these findings, further research involving multicenter studies is recommended to provide additional validation and a broader perspective.

Enhanced broadband and omni-directional performance of polycrystalline Si solar cells by using discrete multilayer antireflection coatings.

The performance enhancement of polycrystalline Si solar cells by using an optimized discrete multilayer anti-reflection (AR) coating with broadband and omni-directional characteristics is presented. Discrete multilayer AR coatings are optimized by a genetic algorithm, and experimentally demonstrated by refractive-index tunable SiO2 nano-helix arrays and co-sputtered (SiO2)x(TiO2)1₋x thin film layers. The optimized multilayer AR coating shows a reduced total reflection, leading to the high incident-photon-to-electron conversion efficiency over a correspondingly wide range of wavelengths and incident angles, offering a very promising way to harvest more solar energy by virtually any type of solar cells for a longer time of a day.

Top-Down Fabrication of Luminescent Graphene Quantum Dots Using Self-Assembled Au Nanoparticles.

A new graphene quantum dot (GQD) fabrication method is presented, which employs a lithographic approach based on self-assembled Au nanoparticles formed by solid-state dewetting. The GQDs are formed by the patterned etching of a graphene layer enabled by Au nanoparticles, and their size is controllable through that of the Au nanoparticles. GQDs are fabricated with four different diameters: 12, 14, 16, and 27 nm. The geometrical features and lattice structures of the GQDs are determined using transmission electron microscopy (TEM). Hexagonal lattice fringes in the TEM image and G- and 2D-band Raman scattering evidence the graphitic characteristics of the GQDs. The oxygen content can be controlled by thermal reduction under a hydrogen atmosphere. In GQDs, the absorption peak wavelengths in the ultraviolet range tend to decrease as the size of the GQDs decreases. They also exhibit apparent photoluminescence (PL). The PL peak wavelength is approximately 600 nm and becomes shorter as the size of the GQDs decreases. The blue shift in the optical absorption and PL of the smaller GQDs is attributed to the quantum confinement effect. The proposed GQD fabrication method can provide a way to control the physical and chemical properties of GQDs via their size and oxygen content.

Experimental and theoretical study of the optical and electrical properties of nanostructured indium tin oxide fabricated by oblique-angle deposition.

Oblique-angle deposition of indium tin oxide (ITO) is used to fabricate optical thin-film coatings with a porous, columnar nanostructure. Indium tin oxide is a material that is widely used in industrial applications because it is both optically transparent and electrically conductive. The ITO coatings are fabricated, using electron-beam evaporation, with a range of deposition angles between 0 degrees (normal incidence) and 80 degrees. As the deposition angle increases, we find that the porosity of the ITO film increases and the refractive index decreases. We measure the resistivity of the ITO film at each deposition angle, and find that as the porosity increases, the resistivity increases superlinearly. A new theoretical model is presented to describe the relationship between the ITO film's resistivity and its porosity. The model takes into account the columnar structure of the film, and agrees very well with the experimental data.

The pathway of injectate spread during thoracic intertransverse process (ITP) block: Micro-computed tomography findings and anatomical evaluations.

STUDY OBJECTIVE: To investigate the mechanism of action of the thoracic intertransverse process (ITP) block. DESIGN: Three-dimensional micro-computed tomography (3D micro-CT) study and cadaveric evaluation. SETTING: A translational research unit for anatomy and analgesia in a university hospital. PATIENTS: Twelve embalmed and three non-embalmed human cadavers were used in this study. MEASUREMENTS: Micro-CT images of the mid-thoracic paravertebral space and its adjacent ligamentous tissues were acquired and 3D images were reconstructed. Manual dissection and histologic examination of these structures complemented the images. To confirm our findings, the dye-spreading pattern after ultrasound-guided ITP injection of 20 mL dye solution at T4-T5 was evaluated. MAIN RESULTS: Micro-CT and histologic findings showed that the costotransverse foramen (the medial slit of the superior costotransverse ligament) and the costotransverse space (between the rib and the transverse process) were potential pathways to the thoracic paravertebral space during ITP block. Single-level ITP injection with a dye solution resulted in a multilevel segmental paravertebral spread in cadaveric evaluation. CONCLUSIONS: The space posterior to the superior costotransverse ligament, the target area for ITP blocks, has potential anatomical pathways to the thoracic paravertebral space. The costotransverse foramen and the costotransverse space provided the anatomical conduit for the anterior and intersegmental paravertebral spread of the ITP block.

Influence of Handgrip Strength and Psoas Muscle Index on Analgesic Efficacy of Epidural Steroid Injection in Patients With Degenerative Lumbar Spinal Disease.

BACKGROUND: Handgrip strength (HGS) and psoas muscle index (PMI) are widely used protocols for screening or diagnosing sarcopenia by measuring muscle strength and mass. Epidural steroid injection (ESI) is a common intervention for the treatment of spinal pain; however, the influence of pre-procedural sarcopenic status on therapeutic effects after ESI has not been investigated. OBJECTIVES: In the present study, whether pre-procedural HGS or PMI predicts analgesic efficacy of ESI in elderly patients with degenerative lumbar spinal disease was investigated. STUDY DESIGN: This was a retrospective observational study. SETTING: The study included patients from the outpatient department for interventional pain management at a university hospital. METHODS: Following institutional review board (IRB) approval, patients >= 65 years of age who underwent fluoroscopy-guided lumbar ESI from 2016 to 2017 in our clinic were enrolled in the present study. Good analgesia was defined as >= 50% reduction in pain score at 4 weeks after injection. Patient characteristics, pain-related factors, clinical factors, HGS, and PMI measurements were collected and analyzed using multivariate analysis to identify the predictors of good analgesia after lumbar ESI. In addition, a receiver operating characteristic curve (ROC) analysis was performed, and area under the curve (AUC) values with 95% confidence interval (CI) were calculated for the HGS. RESULTS: A total of 259 patients satisfied the study protocol requirements. HGS was significantly higher in the good analgesia group (23.12 ± 7.54 vs 16.55 ± 6.66 kg, P < 0.001). However, the PMI did not differ between the 2 groups (5.25 ± 1.55 vs 5.08 ± 1.69 cm2/m2, P = 0.406). Multivariate analysis revealed higher HGS (odds ratio, OR = 1.142, 95% CI = 1.094-1.193, P < 0.001) and low-grade foraminal stenosis (OR = 0.403, 95% CI = 0.199-0.814, P = 0.011) were significantly associated with good analgesia after injection. The AUC values with 95% CI for HGS were 0.819 (0.718-0.920) in men and 0.800 (0.732-0.869) in women. In addition, HGS cutoff values for predicting good analgesic outcomes were 26.5 kg in men and 16.5 kg in women. LIMITATIONS: This study was conducted in a single center, and sample size was relatively small. The lack of physical performance evaluation did not fully meet the current criteria for sarcopenia. In addition, post-procedural clinical data associated with disability or quality of life could not be collected. CONCLUSION: In the present study, pre-procedural HGS was an independent predictor of analgesic efficacy after ESI in elderly patients with degenerative lumbar spinal disease. However, the PMI was not associated with pain relief after injection.

Validation of IL-7R as an Immunological Biomarker for Human Pancreatic Ductal Adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer for which no early diagnostic method is available. The immune surveillance hypothesis suggests that the immune system plays crucial roles in tumor development and progression. We validated a PDAC-specific biomarker derived from peripheral blood mononuclear cells (PBMCs) to facilitate early PDAC diagnosis. mRNA levels of interleukin-7R (IL-7R), reportedly a potential immunological marker for PDAC, were measured in PBMCs isolated prospectively from healthy controls (n = 100) and patients with PDAC (n = 135), pancreatic cysts (n = 82), chronic pancreatitis (n = 42), acute pancreatitis (n = 47), and other malignancies (n = 116). The IL-7R level was significantly higher in patients with PDAC than in healthy controls, patients with benign pancreatic disease, and patients with other malignancies. As diagnostic parameters, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for IL-7R were 58.5%, 92%, 90.8%, 62.2%, and 72.8%, respectively. The area under the receiver operating characteristic curve (AUROC) was 0.766. IL-7R levels did not differ between resectable and unresectable PDAC cases. The combined measurement of IL-7R and carbohydrate antigen 19-9 (CA19-9) significantly improved the diagnostic parameters and AUROC compared with the use of IL-7R or CA19-9 alone. IL-7R is significantly upregulated in PBMCs in patients with PDAC, and it may be a novel diagnostic marker for PDAC. The combined use of IL-7R and CA19-9 enhanced the diagnostic performance.

Safety and Efficacy of Allogeneic Natural Killer Cells in Combination with Pembrolizumab in Patients with Chemotherapy-Refractory Biliary Tract Cancer: A Multicenter Open-Label Phase 1/2a Trial.

BACKGROUND AND AIM: This study investigated the administration of combination therapy, allogeneic natural killer (NK) cells and pembrolizumab in the treatment of advanced biliary tract cancer to determine the safety and tolerability (phase 1) and the efficacy and safety (phase 2a). METHODS: Forty patients (phase 1, n = 6; phase 2a, n = 34) were enrolled between December 2019 and June 2021. The patients received highly activated allogeneic NK cells ("SMT-NK") on weeks 1 and 2 and pembrolizumab on week 1. This 3-week schedule (one cycle) was repeated until confirmed disease progression, intolerable adverse events (AEs), patient withdrawal, or finishing the maximum treatment schedule. The tumor response was evaluated after every three cycles. RESULTS: In phase 1, four patients (66.7%) experienced seven AEs, but no severe AE was observed. In phase 2a, 126 AEs occurred in 29 patients (85.3%). Severe AEs (≥grade 3) were reported in 16 patients (47.1%). The overall response rate (ORR) was 17.4% in the full analysis set and 50.0% in the per-protocol set. CONCLUSIONS: SMT-NKs plus pembrolizumab resulted in no severe AEs directly related to the drug combination. The combination therapy also exerted antitumor activity with improved efficacy compared to the recent monotherapy with pembrolizumab in patients with advanced biliary tract cancer.

Effects of the refractive index of the encapsulant on the light-extraction efficiency of light-emitting diodes.

We investigate the effects of the refractive index of the encapsulant on the light-extraction efficiency (LEE) of light-emitting diodes (LEDs) for GaN LEDs (n ≈ 2.5) and AlGaInP LEDs (n ≈ 3.0). For non-absorbing rectangular parallelepiped LED chips, as the refractive index of the encapsulant increases, the LEE first increases quasi-linearly, then increases sub-linearly, and finally a saturation is reached. Furthermore, LEDs with a dual-layer graded-refractive-index (GRIN) encapsulant (n(encapsulant 1) = 1.57 and n(encapsulant 2) = 1.41) is fabricated through a two-step curing process. We demonstrate that such an LED further enhances the LEE by reducing Fresnel reflection loss at the encapsulant/air interface by 35% compared with an LED encapsulated with a single-layer encapsulant (n(encapsulant) = 1.57).