Second harmonic generation and simplified bond hyperpolarizability model analyses on the intermixing of Si/SiGe stacked multilayers for gate-all-around structure.

Si/SiGe stacked multilayers are key elements in fabrication of gate-all-around (GAA) structures and improvement of electrical properties, with the evolution of the Si/SiGe interfaces playing a crucial role. In this work, a model is developed based on the simplified bond hyperpolarizability model (SBHM) to analysis the anisotropic reflective second harmonic generation (Ani-RSHG) on a three-period stacked Si/Si1-xGexmultilayer, which builds on Si(100) diamond structures. TheC4vsymmetry of the Si(100) structure enables the second harmonic generation (SHG) contribution from the bonds to be simplified and the effective hyperpolarizabilities of the interfacial and bulk sources to be obtained. The effective interface dipolar and bulk quadrupolar SHG hyperpolarizabilities in the Si1-xGexsample with various Ge concentration profiles are modeled by interpreting the concentration of a component element as the probability of the element occupying an atomic site. On the basis of the developed model, the Ani-RSHG spectra of the as-grown samples with various Ge ratios for each layer and the samples annealed at 850 °C and 950 °C are analyzed to inspect the change in Ge distribution and its gradient in depth. The ani-RSHG analysis on as-grown samples showed difference in Ge distribution in samples with the multi Si/SiGe structure, which is not well observed in synchrotron x-ray diffraction (XRD) spectra. For the annealed samples, the response to changes in Ge concentration and its gradient in depth reveal the Si/Si1-xGexinterface intermixing. Results of high-angle annular dark-field scanning transmission electron microscopy and energy dispersive x-ray spectroscopy agree well with the Ani-RSHG with SBHM findings. Compared with the Raman and synchrotron XRD spectra, the Ani-RSHG with SBHM simulation result demonstrates much better response to changes in compositions of the Si/Si1-xGexstacked multilayered structures, verifying the potential for characterizing the concentration distribution in stacked multilayered thin films for GAA structures.

The effect of patient volume on mortality and morbidity of extremely low birth weight infants in Taiwan.

BACKGROUND: To assess whether the number of extremely low birth weight (ELBW) infants treated annually in neonatal intensive care units (NICUs) in Taiwan affects the mortality and morbidity of this patient population. METHODS: This retrospective cohort study included preterm infants with ELBW (≤1000 g). NICUs were divided into three subgroups according to the annual admissions of ELBW infants (low, ≤10; medium, 11-25; and high, >25). Perinatal characteristics, mortality, and short-term morbidities were compared between groups. RESULTS: A total of 1945 ELBW infants from 17 NICUs were analyzed (low-volume, n = 263; medium-volume, n = 420; and high-volume, n = 1262). After risk adjustments, infants from NICUs with low patient volumes were at a higher risk of death. The risk-adjusted odds ratios (aOR) for mortality were 0.61 (95% CI, 0.43-0.86) in the high-volume NICUs and 0.65 (95% CI, 0.43-0.98) in medium-volume NICUs, compared with infants admitted to low-volume NICUs. Infants in medium-volume NICUs had the lowest incidence of prenatal steroid exposure (58.1%, P < 0.001) and were associated with the highest risk of necrotizing enterocolitis (aOR, 2.35 [95% CI, 1.48-3.72]), severe intraventricular hemorrhage (aOR, 1.55 [95% CI, 1.01-2.28]), and bronchopulmonary dysplasia (aOR, 1.61 [95% CI, 1.10-2.35]). However, survival without major morbidity did not differ between the groups. CONCLUSION: The mortality risk was higher among ELBW infants admitted to NICUs with a low annual patient volume. This may emphasize the importance of systematically referring patients from these vulnerable populations to appropriate care settings.

Atomic Imaging and Thermally Induced Dynamic Structural Evolution of Two-Dimensional Cr2S3.

In this study, facile salt-assisted chemical vapor deposition (CVD) was used to synthesize ultrathin non-van der Waals chromium sulfide (Cr2S3) with a thickness of ∼1.9 nm. The structural transformation of as-grown Cr2S3 was studied using advanced in situ heating techniques combined with transmission electron microscopy (TEM). Two-dimensional (2D) and quasi-one-dimensional (1D) samples were fabricated to investigate the connection between specific planes and the dynamic behavior of the structural variation. The rearrangement of atoms during the phase transition was driven by the loss of sulfur atoms at elevated temperatures, resulting in increased free energy. A decrease in the ratio of the (001) plane led to an overall increase in surface energy, thus lowering the critical phase transition temperature. Our study provides detailed insight into the mechanism of structural transformation and the critical factors governing transition temperature, thus paving the way for future studies on intriguing Cr-S compounds.

Taking the good with the bad?: Social Media and Online Racial Discrimination Influences on Psychological and Academic Functioning in Black and Hispanic Youth.

Though increasing attention is being paid to adolescents' social media use, racially/ethnically-marginalized youth remain under-represented in that literature, and the effect of social media and its mechanism on these youth remain unclear. This study examined the effects of social media use on Black and Hispanic youth's psychological and academic functioning, with an attempt to investigate the role of online racial discrimination in accounting for these associations. Participants consisted of 356 Black and Hispanic youth (Mage = 16.01 years, SD = 1.60), and 78% female. The findings revealed a positive association between social media use and academic self-efficacy. A negative indirect association also emerged where social media use was associated with more exposure to vicarious, but not individual, online racial discrimination, which was related to more depressive symptoms and in turn lower academic self-efficacy. There was no direct effect of social media use on Black and Hispanic youth's anxiety symptoms, but its effect occurred indirectly via both individual and vicarious online racial discrimination. There was no evidence of group differences between Black and Hispanic youth. The findings confirm that social media is a space that proffers positive and negative effects on adolescents' psychological and academic functioning, suggesting the need for unique protections for racially/ethnically marginalized youth as they explore these online environments.

Associations between Vitamin D Deficiency and Carbohydrate Intake and Dietary Factors in Taiwanese Pregnant Women.

This cross-sectional observation study investigated the vitamin D (VD) status in Taiwanese pregnant women and the effects of VD supplementation and macronutrient intake on serum 25-hydroxy-vitamin D (25[OH]D) level. Data on VD intake, daily sunlight exposure, and carbohydrate intake were obtained from 125 pregnant women at 30−37 weeks' gestation. Serum 25[OH]D level was measured before delivery in all enrolled women; and the mean 25(OH)D level was 43 nmol/L or 17.2 ng/mL. The 25(OH)D level was significantly correlated with total VD intake of pregnant women (r = 0.239; p = 0.007). The severe VD deficiency group (n = 16; mean of 25(OH)D level = 8.5 ng/mL) had significantly lower total VD intake and supplementation than the groups with VD deficiency (n = 69), insufficiency (n = 32), and sufficiency (n = 8). Those with ≥400 IU/day total VD intake (including VD from food and supplementation) had significantly higher 25(OH)D concentration than those with <400 IU/day total VD intake. Those with 400 IU/day VD supplementation could significantly increase serum 25(OH)D concentrations for pregnant women. Among 85 pregnant women with carbohydrate intake of ≥300 g/day, serum 25(OH)D levels were negatively correlated with carbohydrate intake (p = 0.031). In conclusion, VD deficiency was highly prevalent in Taiwanese pregnant women. VD supplementation was the most effective method for increasing 25(OH)D concentration in pregnant women. Higher carbohydrate intake might reduce 25(OH)D levels.

Revealing Resistive Switching Mechanism in CaFeOx Perovskite System with Electroforming-Free and Reset Voltage-Controlled Multilevel Resistance Characteristics.

Recently, perovskite (PV) oxides with ABO3 structures have attracted considerable interest from scientists owing to their functionality. In this study, CaFeOx is introduced to reveal the resistive switching properties and mechanism of oxygen vacancy transition in PV and brownmillerite (BM) structures. BM-CaFeO2.5 is grown on an Nb-STO conductive substrate epitaxially. CaFeOx exhibits excellent endurance and reliability. In addition, the CaFeOx also demonstrates an electroforming-free characteristic and multilevel resistance properties. To construct the switching mechanism, high-resolution transmission electron microscopy is used to observe the topotactic phase change in CaFeOx . In addition, scanning TEM and electron energy loss spectroscopy show the structural evolution and valence state variation of CaFeOx after the switching behavior. This study not only reveals the switching mechanism of CaFeOx , but also provides a PV oxide option for the dielectric material in resistive random-access memory (RRAM) devices.

Association of annexin A10 expression with poor prognosis of intrahepatic cholangiocarcinoma.

BACKGROUND: Annexin A10 expression influences the prognosis of several gastrointestinal cancers. We explored the association of annexin A10 expression with the overall survival (OS) of patients who underwent curative surgery for cholangiocarcinoma. METHODS: Patients who underwent curative surgery for cholangiocarcinoma (except gallbladder cancer) and had pathological stage T1-3N0M0 disease were enrolled. Annexin A10 expression was examined by performing immunohistochemical staining. Patient demographics and survival outcome data were retrieved from medical records. RESULTS: In total, 185 patients were enrolled. The primary tumor location was intrahepatic and extrahepatic (including the perihilar region) for 89% and 11% of patients, respectively. Positive annexin A10 staining was detected for 61 (33%) patients and associated with extrahepatic or perihilar cholangiocarcinoma (p = 0.001) and lower histological grade (p < 0.001). Patients with positive annexin A10 staining exhibited significantly poorer survival relative to patients with negative staining results (median OS, 2.5 vs. 4.9 years, p = 0.025). In the multivariate analysis adjusting for age, sex, tumor location, tumor grade, hepatitis infection, and disease stage, positive annexin A10 remained an independent predictor of poor OS (hazard ratio 1.572, p = 0.034). In the subgroup analysis, the association between annexin A10 and prognosis was restricted to intrahepatic cholangiocarcinoma. Among patients with intrahepatic cholangiocarcinoma, patients with positive annexin A10 staining exhibited significantly poorer survival compared with patients with negative annexin A10 staining (median OS, 2.3 vs. 4.9 years, p = 0.008). CONCLUSION: Positive annexin A10 expression was associated with poor prognosis of intrahepatic cholangiocarcinoma.

A 20-cm cut umbilical cord milking may not benefit the preterm infants < 30 week's gestation: A randomized clinical trial.

BACKGROUND/PURPOSE: To evaluate whether a shorter length (20 cm) of C-UCM has potential benefits, compared to immediate cord clamping (ICC), in very preterm babies. METHODS: Inborn preterm infants less than 30 weeks of gestational age (GA) were randomly assigned to the 20-cm C-UMC and ICC groups. The primary outcome was the need for packed red blood cell (pRBC) transfusion before the 21st day of life. The secondary outcomes were short- and long-term outcomes related to premature birth. RESULTS: Seventy-six neonates were randomized to the two groups. GA were 27.2 ± 1.8 and 27.5 ± 1.7 weeks (p = 0.389) and birth weights were 987 ± 269 and 1023 ± 313 g (p = 0.601) in the 20-cm C-UCM and ICC groups, respectively. There was no significant difference between the groups in terms of the need for pRBC transfusion before the 21st day of life (59.4% versus 71.8%, adjusted odds ratio [aOR] 0.311, 95% confidence interval [CI] 0.090-1.079). An increased prevalence of late-onset sepsis was observed in the 20-cm C-UCM group compared to the ICC group (21.6% versus 5.1%, aOR 5.434, 95% CI 1.033-23.580). The mortality rates were 13.5% and 2.6% in the 20-cm C-UCM and ICC groups, respectively (aOR 5.339, 95% CI 0.563-50.626). The neurodevelopmental outcomes at 2 years of corrected age between the groups were also not statistically significant. CONCLUSION: A 20-cm C-UCM showed no effect on reducing the incidence of pRBC transfusion in preterm babies with GA less than 30 weeks compared with ICC in this small-scale randomized controlled trial.

Purpose Trajectories During Middle Adolescence: The Roles of Family, Teacher, and Peer Support.

While studies on youth's purpose have flourished in the last two decades, the work was mostly cross-sectional and derived from Western settings. This research examined the developmental trajectories of purpose exploration and commitment of Taiwanese youth during middle adolescence, with a focus on how they associate with youth's psychological functioning in terms of life satisfaction and depressive symptoms and whether social support moderates such development. A total of 369 vocational high school students in Taiwan (45% females; Mage = 15.82 years) participated in a four-wave study spanning two years with a one-semester interval. The results of piecewise growth curve modeling in the context of structural equation modeling suggested that purpose commitment increased over 10th grade, decreased initially in 11th grade, and then continued to increase. Purpose exploration similarly increased over 10th grade, but after the initial 11th grade dip remained stable. In addition to the higher initial levels, the steeper the rate of purpose exploration and commitment ascent and the slighter the rate of reduction predicted enhanced youth life satisfaction. The trajectory of purpose commitment also predicted reduced depressive symptoms, but such effects did not occur for purpose exploration. Moreover, multi-group analyses revealed that the more family, teacher, and peer support youth perceived, the more likely youth explored and committed to purpose over time.

Deleterious alterations of DNA damage response and repair genes and clinical benefit to anti-PD-1 therapy in esophageal squamous cell carcinoma.

BACKGROUND: Although DNA damage response and repair (DDR) gene alteration has been demonstrated as a biomarker for anti-PD-1 therapy in several cancer types, its role in esophageal squamous cell carcinoma (ESCC) is unknown. METHODS: Patients with advanced ESCC treated with anti-PD-1-based immunotherapy were enrolled. Tumor response was evaluated according to RECIST 1.1. Archival ESCC tissues were analyzed using FoundationOne CDx. Deleterious alterations, defined by loss of function, of DDR genes were correlated with patient survival by Cox proportional hazards model. The prognostic significance of deleterious alterations of DDR genes in The Cancer Genome Atlas (TCGA)-ESCC cohort was explored. RESULTS: Forty-three patients were enrolled. The objective response rate (ORR) was 19%. The median tumor mutational burden was 4 mutations/Mb (0-20); none of the tumors were microsatellite instable. Compared with patients with wild-type or other alterations of DDR genes (N = 35, 81%), those with deleterious alterations of DDR genes (N = 8, 19%) had a higher ORR (38 vs. 14%), longer median progression-free survival (4.1 vs. 2.0 months), and significantly longer median overall survival (OS; 27.7 vs. 6.1 months, P = 0.011). In multivariate analysis, harboring deleterious alterations of DDR genes was a favorable prognostic factor for OS (HR = 0.31 [95% CI: 0.11-0.91], P = 0.033). In the TCGA-ESCC cohort, the presence of deleterious alterations of DDR genes was not a favorable prognostic factor. CONCLUSIONS: Deleterious alterations of DDR genes may be associated with improved prognosis and efficacy of anti-PD-1 therapy in patients with advanced ESCC.

Response to Immune Checkpoint Inhibitors in Recurrent or Metastatic Esophageal Squamous Cell Carcinoma May Be Affected by Tumor Sites.

INTRODUCTION: Heterogeneous tumor response has been reported in cancer patients treated with immune checkpoint inhibitors (ICIs). This study investigated whether the tumor site is associated with the response to ICIs in patients with recurrent or metastatic esophageal squamous cell carcinoma (ESCC). METHODS: Patients with ESCC who had measurable tumors in the liver, lung, or lymph node (LN) according to the response evaluation criteria in solid tumors (RECIST) 1.1 and received ICIs at 2 medical centers in Taiwan were enrolled. In addition to RECIST 1.1, tumor responses were determined per individual organ basis according to organ-specific criteria modified from RECIST 1.1. Fisher test or χ2 test was used for statistical analysis. RESULTS: In total, 37 patients were enrolled. The overall response rate per RECIST 1.1 was 13.5%. Measurable tumors in the LN, lung, and liver were observed in 26, 17, and 13 patients, respectively. The organ-specific response rates were 26.9%, 29.4%, and 15.4% for the LN, lung, and liver tumors, respectively (p = 0.05). The organ-specific disease control rates were 69.2%, 52.9%, and 21.1% for the LN, lung, and liver tumors, respectively (p = 0.024). Five (27.8%) among 18 patients harboring at least 2 involved organs had heterogeneous tumor response. CONCLUSION: The response and disease control to ICIs may differ in ESCC tumors located at different metastatic sites, with a lesser likelihood of response and disease control in metastatic liver tumors than in tumors located at the LNs and lung.

Gaseous infrared spectra of the simplest geminal diol CH2(OH)2 and the isotopic analogues in the hydration of formaldehyde.

The infrared spectrum of the simplest geminal diol, methanediol or methylene glycol (CH2(OH)2), was successfully probed in the gaseous hydration of formaldehyde. The observed absorption bands coincided with the anharmonic vibrational wavenumbers predicted by B3LYP/aug-cc-pVTZ calculation. Based on the predicted rotational parameters and dipole derivatives, the simulated rovibrational contours of CH2(OH)2 agreed with the experimental spectrum, and the band origins of the OCO symmetric stretching mode (b-type) and the OCO asymmetric stretching mode (a-type) were determined to be 1027 and 1058 cm-1, respectively. In addition, the isotopic analogues, CD2(OH)2, CH2(OD)2, and CD2(OD)2, were also investigated. The band origins of the CD2 wagging mode (a-type) and the COH bending mode (a, c-type) of CD2(OH)2 were also determined to be 1121 and 1301 cm-1, respectively. The successful infrared characterization of gaseous methanediol makes it possible to directly investigate the relevant chemical reactions of geminal diols in atmosphere, astrophysics, and water-mediated reactions.

Impact of inhaled corticosteroids on the neurodevelopmental outcomes in chronically ventilated extremely low birth weight preterm infants.

BACKGROUND: Few studies have assessed the long-term impact of inhaled corticosteroids (ICS) in preterm infants. This study evaluated the neurodevelopmental outcomes of chronically ventilated extremely low birth weight (ELBW) preterm infants exposed to ICS. METHODS: The medical records of ELBW preterm infants admitted to two tertiary-level neonatal intensive care units from 2008 to 2014 were reviewed. Infants intubated for more than 28 days were included. The neurodevelopmental outcomes were compared at 24 months corrected age, between those with ICS exposure (inhaled group, IH) and those without it (non-inhaled group, NIH), by using the Bayley-Scale-of-Infant-and-Toddler Development-III (BSID-III). RESULTS: Out of the 115 infants included, 64 had an ICS exposure. The incidence of the morbidities at the time of discharge, was comparable between the two groups, except for the duration of oxygen and mechanical ventilation dependence (IH 124.8 ± 40.3 days vs. NIH: 101.0 ± 28.6 days, p < 0.001 and IH 60.0 ± 25.8 days vs. NIH: 42.3 ± 14.2 days, p < 0.001, respectively). Multiple logistic regression analysis at 24 months corrected age revealed no significant differences in the BSID-III scores and in the incidence of cerebral palsy and neurodevelopmental impairment. CONCLUSION: The late ICS exposure was not associated with neurodevelopmental impairment at 24 months corrected age in chronically ventilated ELBW infants; however, it did not reduce the duration of their dependence on oxygen and mechanical ventilation.

Why is Self-Esteem Higher Among American than Chinese Early Adolescents? The Role of Psychologically Controlling Parenting.

Little is known about why American youth tend to have higher self-esteem than do Chinese youth. This research examined the role of psychologically controlling parenting during early adolescence. 825 youth (48% females; Mage = 12.73 years) in the United States and China reported on their self-esteem and parents' psychological control every 6 months from the fall of 7th grade to spring of 8th grade. Both American and Chinese youth's self-esteem decreased over time, but American youth consistently had higher self-esteem. American parents were less psychologically controlling than were Chinese parents who, unlike American parents, became more psychologically controlling over time. These differences in psychologically controlling parenting contributed to the tendency for American youth to have higher self-esteem than their Chinese counterparts.

Developmental trajectory of purpose identification during adolescence: Links to life satisfaction and depressive symptoms.

INTRODUCTION: Whereas evidence has shown that a sense of purpose is linked to optimal adjustment, longitudinal work investigating the development of purpose identification as well as its effect on psychological functioning among non-Western samples during adolescence is needed. METHODS: Three hundred and eighty-seven senior high school students (253 female, 65.37%; mean age = 15.76 years at the first investigation) from Taiwan completed surveys four times beginning in the fall of tenth grade and ending in the spring of eleventh grade with a six-month interval. Using self-ratings, purpose identification was evaluated in all four assessments and psychological functioning was examined through life satisfaction and depressive symptoms in the first and the last survey. RESULTS: Growth curve analyses revealed an increased slope in purpose identification over the first two years of high school, and such a trajectory was similar across boys and girls. Additionally, increases in purpose identification predicted enhanced life satisfaction and reduced depressive symptoms among both boys and girls. There was only one gender difference: The negative association between purpose identification trajectory and depressive symptoms was stronger for girls than for boys. CONCLUSIONS: There is an increase in the development of identified purpose during middle adolescence among high school students in Taiwan. Such change not only promotes life satisfaction in adolescents but is also preventive of adolescent depression. As such, the current findings highlight the significance for adolescents to discover and commit to a purpose.

Non-fullerene electron acceptors for use in organic solar cells.

The active layer in a solution processed organic photovoltaic device comprises a light absorbing electron donor semiconductor, typically a polymer, and an electron accepting fullerene acceptor. Although there has been huge effort targeted to optimize the absorbing, energetic, and transport properties of the donor material, fullerenes remain as the exclusive electron acceptor in all high performance devices. Very recently, some new non-fullerene acceptors have been demonstrated to outperform fullerenes in comparative devices. This Account describes this progress, discussing molecular design considerations and the structure-property relationships that are emerging. The motivation to replace fullerene acceptors stems from their synthetic inflexibility, leading to constraints in manipulating frontier energy levels, as well as poor absorption in the solar spectrum range, and an inherent tendency to undergo postfabrication crystallization, resulting in device instability. New acceptors have to address these limitations, providing tunable absorption with high extinction coefficients, thus contributing to device photocurrent. The ability to vary and optimize the lowest unoccupied molecular orbital (LUMO) energy level for a specific donor polymer is also an important requirement, ensuring minimal energy loss on electron transfer and as high an internal voltage as possible. Initially perylene diimide acceptors were evaluated as promising acceptor materials. These electron deficient aromatic molecules can exhibit good electron transport, facilitated by close packed herringbone crystal motifs, and their energy levels can be synthetically tuned. The principal drawback of this class of materials, their tendency to crystallize on too large a length scale for an optimal heterojunction nanostructure, has been shown to be overcome through introduction of conformation twisting through steric effects. This has been primarily achieved by coupling two units together, forming dimers with a large intramolecular twist, which suppresses both nucleation and crystal growth. The generic design concept of rotationally symmetrical aromatic small molecules with extended π orbital delocalization, including polyaromatic hydrocarbons, phthalocyanines, etc., has also provided some excellent small molecule acceptors. In most cases, additional electron withdrawing functionality, such as imide or ester groups, can be incorporated to stabilize the LUMO and improve properties. New calamitic acceptors have been developed, where molecular orbital hybridization of electron rich and poor segments can be judiciously employed to precisely control energy levels. Conformation and intermolecular associations can be controlled by peripheral functionalization leading to optimization of crystallization length scales. In particular, the use of rhodanine end groups, coupled electronically through short bridged aromatic chains, has been a successful strategy, with promising device efficiencies attributed to high lying LUMO energy levels and subsequently large open circuit voltages.

The Prognostic Impact of Type 2 Diabetes Mellitus on Early Cervical Cancer in Asia.

BACKGROUND: Many studies have shown that type 2 diabetes mellitus (DM) increases the risk for several types of cancer but not cervical cancer (CC). Although DM and insulin-like growth factor 1 have preclinical and clinical implications for CC, less is known about the prognostic impact of DM on patients with early stage CC. PATIENTS AND METHODS: We used the nationwide Taiwan Cancer Registry database to collect the characteristics of stage I-IIA cervical cancer patients diagnosed between 2004 and 2008. DM and other comorbidities were retrieved from the National Health Insurance database. Cervical cancer-specific survival (CSS) and overall survival (OS) times of patients according to DM status were estimated using the Kaplan-Meier method. We used a Cox proportional hazards model to calculate adjusted hazard ratios (HRs) for the effects of DM and other risk factors on mortality. RESULTS: A total of 2,946 patients had primary stage I-IIA CC and received curative treatments, and 284 (9.6%) had DM. The 5-year CSS and OS rates for patients with DM were significantly lower than those without DM (CSS: 85.4% vs. 91.5%; OS: 73.9% vs. 87.9%). After adjusting for clinicopathologic variables and comorbidities, DM remained an independent unfavorable prognostic factor for CSS (adjusted HR: 1.46) and OS (adjusted HR: 1.55). CONCLUSION: In Asian patients with early cervical cancer, DM is an independent unfavorable prognostic factor influencing both OS and CSS, even after curative treatments. IMPLICATIONS FOR PRACTICE: Type 2 diabetes mellitus (DM) increases the incidence of several types of cancer but not cervical cancer (CC); however, less is known about the impact of DM on patients who already have CC. This study suggests that DM may increase the risk of cancer recurrence and death for early stage CC patients, even after curative treatments. Incorporating DM control should be considered part of the continuum of care for early stage CC patients, and close surveillance during routine follow-up in this population is recommended.