Endoscopic detection and diagnosis of gastric cancer using image-enhanced endoscopy: A systematic review and meta-analysis.

Objectives: We aimed to conduct a systematic review and meta-analysis to assess the value of image-enhanced endoscopy including blue laser imaging (BLI), linked color imaging, narrow-band imaging (NBI), and texture and color enhancement imaging to detect and diagnose gastric cancer (GC) compared to that of white-light imaging (WLI). Methods: Studies meeting the inclusion criteria were identified through PubMed, Cochrane Library, and Japan Medical Abstracts Society databases searches. The pooled risk ratio for dichotomous variables was calculated using the random-effects model to assess the GC detection between WLI and image-enhanced endoscopy. A random-effects model was used to calculate the overall diagnostic performance of WLI and magnifying image-enhanced endoscopy for GC. Results: Sixteen studies met the inclusion criteria. The detection rate of GC was significantly improved in linked color imaging compared with that in WLI (risk ratio, 2.20; 95% confidence interval [CI], 1.39-3.25; p < 0.01) with mild heterogeneity. Magnifying endoscopy with NBI (ME-NBI) obtained a pooled sensitivity, specificity, and area under the summary receiver operating curve of 0.84 (95 % CI, 0.80-0.88), 0.96 (95 % CI, 0.94-0.97), and 0.92, respectively. Similarly, ME-BLI showed a pooled sensitivity, specificity, and area under the curve of 0.81 (95 % CI, 0.77-0.85), 0.85 (95 % CI, 0.82-0.88), and 0.95, respectively. The diagnostic efficacy of ME-NBI/BLI for GC was evidently high compared to that of WLI, However, significant heterogeneity among the NBI studies still existed. Conclusions: Our meta-analysis showed a high detection rate for linked color imaging and a high diagnostic performance of ME-NBI/BLI for GC compared to that with WLI.

Efficacy of texture and color enhancement imaging for the visibility and diagnostic accuracy of non-polypoid colorectal lesions.

Objective: A newly launched endoscopy system (EVIS X1, CV-1500; Olympus) is equipped with texture and color enhancement imaging (TXI). We aimed to investigate the efficacy of TXI for the visibility and diagnostic accuracy of non-polypoid colorectal lesions. Methods: We examined 100 non-polypoid lesions in 42 patients from the same position, angle, and distance of the view in three modes: white light imaging (WLI), narrow-band imaging (NBI), and TXI. The primary outcome was to compare polyp visibility in the three modes using subjective polyp visibility score and objective color difference values. The secondary outcome was to compare the diagnostic accuracy without magnification. Results: Overall, the visibility score of TXI was significantly higher than that of WLI (3.7 ± 1.1 vs. 3.6 ± 1.1; p = 0.008) and lower than that of NBI (3.7 ± 1.1 vs. 3.8 ± 1.1; p = 0.013). Color difference values of TXI were higher than those of WLI (11.5 ± 6.9 vs. 9.1 ± 5.4; p < 0.001) and lower than those of NBI (11.5 ± 6.9 vs. 13.1 ± 7.7; p = 0.002). No significant differences in TXI and NBI (visibility score: 3.7 ± 1.0 vs. 3.8 ± 1.1; p = 0.833, color difference values: 11.6 ± 7.1 vs. 12.9 ± 8.3; p = 0.099) were observed for neoplastic lesions. Moreover, the diagnostic accuracy of TXI was significantly higher than that of NBI (65.5% vs. 57.6%, p = 0.012) for neoplastic lesions. Conclusions: TXI demonstrated higher visibility than that of WLI and lower than that of NBI. Further investigations are warranted to validate the performance of the TXI mode comprehensively.

Exciton Dissociation and Recombination Afford Narrowband Organic Afterglow Through Efficient FRET.

Organic afterglow with long-persistent luminescence (LPL) after photoexcitation is highly attractive, but the realization of narrowband afterglow with small full-width at half-maximum (FWHM) is a huge challenge since it is intrinsically contradictory to the triplet- and solid-state emission nature of organic afterglow. Here, narrow-band, long-lived, and full-color organic LPL is realized by isolating multi-resonant thermally activated delayed fluorescent (MR-TADF) fluorophores in a glassy steroid-type host through a facile melt-cooling treatment. Such prepared host becomes capable of exciton dissociation and recombination (EDR) upon photoirradiation for both long-lived fluorescence and phosphorescence; and, the efficient Förster resonance energy transfer (FRET) from the host to various MR-TADF emitters leads to high-performance LPL, exhibiting small FWHM of 33 nm, long persistent time over 10 s, and facile color-tuning in a wide range from deep-blue to orange (414-600 nm). Moreover, with the extraordinary narrowband LPL and easy processability of the material, centimeter-scale flexible optical waveguide fibers and integrated FWHM/color/lifetime-resolved multilevel encryption/decryption devices have been designed and fabricated. This novel EDR and singlet/triplet-to-singlet FRET strategy to achieve excellent LPL performances illustrates a promising way for constructing flexible organic afterglow with easy preparation methods, shedding valuable scientific insights into the design of narrow-band emission in organic afterglow.

Phototherapy for the treatment of cutaneous graft-versus-host disease: A systematic review.

BACKGROUND: Cutaneous graft-versus-host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplantation. Phototherapy has been used to treat cutaneous GVHD, but data on its safety and efficacy are sparse. AIM: Review the current medical literature regarding the efficacy, dosing, and safety of various types of phototherapies for the treatment of cutaneous GVHD. METHODS: A systematic review of PubMed, Embase, Cochrane, and ClinicalTrials databases was performed. Publications were screened according to the PRISMA guidelines. Exclusion criteria comprised case reports and case series reporting less than five patients, review articles, and articles not published in English. RESULTS: A total of 28/1304 (2.5%) studies were included. Fifteen studies (n = 267 patients) focused on psoralen and ultraviolet (UV) A (PUVA), in which 65.5% of patients received concomitantly other systemic treatments. The response rate was 89.9%, with a mean of 33.2 treatments. Adverse events were recorded in 54% but were mainly mild. Eight studies, encompassing 95 patients, focused on narrow-band (NB) UVB. A response was observed in 94%, with a mean number of 26 treatments and 8.6% adverse effects. UVA1 was reported in six studies (n = 132 patients). A response was recorded in 89.3% with a mean of 26.2 treatments. Adverse events were noted in 70.1%, with a discontinuation rate of 10.9%. It should be noted that adverse events were recorded during the follow-up period of the studies, which varied significantly, ranging from no follow-up to 31 months. CONCLUSIONS: Current data regarding the use of phototherapy for the treatment of cutaneous GVHD are based on retrospective studies and case series. The present report advocates the use of one of the three modalities of phototherapy as an effective and safe adjunctive treatment for cutaneous GVHD, especially NB UVB phototherapy.

Endoscopic detection and diagnostic strategies for minute gastric cancer: A real-world observational study.

BACKGROUND: Minute gastric cancers (MGCs) have a favorable prognosis, but they are too small to be detected by endoscopy, with a maximum diameter ≤ 5 mm. AIM: To explore endoscopic detection and diagnostic strategies for MGCs. METHODS: This was a real-world observational study. The endoscopic and clinicopathological parameters of 191 MGCs between January 2015 and December 2022 were retrospectively analyzed. Endoscopic discoverable opportunity and typical neoplastic features were emphatically reviewed. RESULTS: All MGCs in our study were of a single pathological type, 97.38% (186/191) of which were differentiated-type tumors. White light endoscopy (WLE) detected 84.29% (161/191) of MGCs, and the most common morphology of MGCs found by WLE was protruding. Narrow-band imaging (NBI) secondary observation detected 14.14% (27/191) of MGCs, and the most common morphology of MGCs found by NBI was flat. Another three MGCs were detected by indigo carmine third observation. If a well-demarcated border lesion exhibited a typical neoplastic color, such as yellowish-red or whitish under WLE and brownish under NBI, MGCs should be diagnosed. The proportion with high diagnostic confidence by magnifying endoscopy with NBI (ME-NBI) was significantly higher than the proportion with low diagnostic confidence and the only visible groups (94.19% > 56.92% > 32.50%, P < 0.001). CONCLUSION: WLE combined with NBI and indigo carmine are helpful for detection of MGCs. A clear demarcation line combined with a typical neoplastic color using nonmagnifying observation is sufficient for diagnosis of MGCs. ME-NBI improves the endoscopic diagnostic confidence of MGCs.

A Systematic Review Evaluating the Diagnostic Efficacy of Narrow-Band Imaging for Laryngeal Cancer Detection.

Background: Narrow-band imaging is an advanced endoscopic technology used to detect changes on the laryngeal tissue surface, employing a comparative approach alongside white-light endoscopy to facilitate histopathological examination. Objective: This study aimed to assess the utility and advantages of NBI (narrow-band imaging) in identifying malignant laryngeal lesions through a comparative analysis with histopathological examination. Methods: We conducted a systematic literature review, utilizing databases such as PubMed, the CNKI database, and Embase for our research. Results: We analyzed the articles by reviewing their titles and abstracts, selecting those we considered relevant based on determined criteria; in the final phase, we examined the relevant studies according to the specific eligibility criteria. Conclusions: Narrow-band imaging is an advanced endoscopic technology that demonstrates its efficacy as a tool for diagnosing malignant laryngeal lesions and comparing them to premalignant lesions. The European Society of Laryngology has implemented a standardized classification system for laryngeal lesions to enhance data correlation and organization.

A Sensitive Fluorescence Analysis Method of Pathogenic Microorganisms Based on Silicon Photomultiplier.

The monitoring of pathogenic microorganisms in water is important for public health and disease outbreaks prediction. Recently, optical detection techniques have drawn much attention due to the advantages of rapid response, security and high sensitivity. In this paper, a fluorescence spectrometer based on 375 nm exciting laser and the microchannel liquid sample flow technology is proposed. The 4 × 4 narrowband filter array was coupled to a Silicon Photomultiplier (SiPM) array with single-photon sensitivity. B500 fluorescent microspheres and Escherichia coli were used for performance evaluation of the spectrometer. As a result, it is feasible to use random particle counting method to detect the bacteria concentration level in water even low to several CFU/mL. In addition, based on Python tools and neural network algorithm models, the fluorescence spectra of different kinds of substances (biotic and abiotic) can be classified with an accuracy of more than 97%. The method was successfully applied to tap water samples. The results suggest that the proposed method is applicable for on-site bacteria detection.

Towards laryngeal cancer diagnosis using Dandelion Optimizer Algorithm with ensemble learning on biomedical throat region images.

Laryngeal cancer exhibits a notable global health burden, with later-stage detection contributing to a low mortality rate. Laryngeal cancer diagnosis on throat region images is a pivotal application of computer vision (CV) and medical image diagnoses in the medical sector. It includes detecting and analysing abnormal or cancerous tissue from the larynx, an integral part of the vocal and respiratory systems. The computer-aided system makes use of artificial intelligence (AI) through deep learning (DL) and machine learning (ML) models, including convolution neural networks (CNN), for automated disease diagnoses and detection. Various DL and ML approaches are executed to categorize the extraction feature as healthy and cancerous tissues. This article introduces an automated Laryngeal Cancer Diagnosis using the Dandelion Optimizer Algorithm with Ensemble Learning (LCD-DOAEL) method on Biomedical Throat Region Image. The LCD-DOAEL method aims to investigate the images of the throat region for the presence of laryngeal cancer. In the LCD-DOAEL method, the Gaussian filtering (GF) approach is applied to eliminate the noise in the biomedical images. Besides, the complex and intrinsic feature patterns can be extracted by the MobileNetv2 model. Meanwhile, the DOA model carries out the hyperparameter selection of MobileNetV2 architecture. Finally, the ensemble of three classifiers such as bidirectional long short-term memory (BiLSTM), regularized extreme learning machine (ELM), and backpropagation neural network (BPNN) models, are utilized for the classification process. A comprehensive set of simulations is conducted on the biomedical image dataset to highlight the efficient performance of the LCD-DOAEL technique. The comparison analysis of the LCD-DOAEL method exhibited a superior accuracy outcome of 97.54% over other existing techniques.

Organoboron Polymorphs with Different Molecular Packing Modes for Optical Waveguides.

Organoboron compounds offer a new strategy to design optoelectronic materials with high fluorescence efficiency. In this paper, the organoboron compound B-BNBP with double B←N bridged bipyridine bearing four fluorine atoms as core unit is facilely synthesized and exhibits a narrowband emission spectrum and a high photoluminescence quantum yield (PLQY) of 86.53% in solution. Its polymorphic crystals were controllable prepared by different solution self-assembly methods. Two microcrystals possess different molecular packing modes, one-dimensional microstrips (1D-MSs) for H-aggregation and two-dimensional microdisks (2D-MDs) for J-aggregation, owing to abundant intermolecular interactions of four fluorine atoms sticking out conjugated plane. Their structure-property relationships were investigated by crystallographic analysis and theoretical calculation. Strong emission spectra with the full width at half maximum (FWHM) of less than 30 nm can also be observed in thin film and 2D-MDs. 1D-MSs possess thermally activated delayed fluorescence (TADF) property and exhibit superior optical waveguide performance with an optical loss of 0.061 dB/µm. This work enriches the diversity of polymorphic microcrystals and further reveals the structure-property relationship in organoboron micro/nano-crystals.

Narrow-band imaging to enhance intraneural dissection in head and neck schwannoma surgery: a quantitative evaluation.

OBJECTIVE: The objective of this study was to assess the utility of narrow-band imaging (NBI) for improving intraneural dissection during gross total resection of head and neck schwannoma. Specifically, we aimed to quantitatively evaluate whether NBI can enhance the identification of pseudocapsule and true capsule within the tumor. METHODS: Nine schwannoma surgery cases conducted between February 2018 and October 2022 were retrospectively analyzed. The surgical procedures followed established principles with a specific focus on utilizing NBI to distinguish between the pseudocapsule and true capsule. Intraneural dissection was performed by searching for a tumor surface with a fascicle-free window, followed by longitudinal incision of the pseudocapsule. NBI was used to distinguish between the pseudocapsule and true capsule. Surgical views were captured under both white light (WL) illumination and NBI for further analysis. The brightness and contrast of the pseudocapsule and true capsule were quantitatively measured using ImageJ and were compared. RESULTS: Under NBI, the pseudocapsule consistently appeared greenish-gray, whereas the true capsule exhibited a white appearance. Quantitative analysis revealed a statistically significant difference (p < 0.0001) in brightness between the pseudocapsule (mean grayscale value 52.1, 95%CI; 46.4-75.3) and true tumor capsule (mean grayscale value 120.8, 95%CI; 155.7-109.0) under NBI. Conversely, there was no statistically significant difference in the brightness of these structures under WL (p = 0.2067). NBI also showed significantly higher contrast between the two structures than did WL (contrast 73.6, 95%CI; 53.1-89.5 vs. 30.9, 95%CI; 1.0-47.5, p = 0.0034). Further spectral analysis revealed that the most substantial difference in brightness between the pseudocapsule and the true tumor capsule was observed in the red spectrum, with a difference in brightness of -0.6 (95%CI; -16.8-14.8) under WL and 83.5 (95%CI; 50.3-100.0) under NBI (p < 0.0001). CONCLUSION: NBI proved to be a valuable tool for enhancing the identification of pseudocapsule and true capsule during intraneural dissection in head and neck schwannoma surgery. The improved contrast and membrane visibility offered by NBI might have the potential to reduce postoperative neurological deficits and improve surgical outcomes. Further research is warranted to validate our findings and explore the broader applications of NBI in schwannoma surgery.

Adjunctive treatment of atopic dermatitis with novel at-home handheld narrow-band UVB phototherapy.

While conventional in-office phototherapy has long been utilized as a successful treatment for atopic dermatitis (AD), it is associated with potential barriers including inconvenience, poor adherence, time and financial expense. In this retrospective study, we examine the efficacy, adherence, and patient-satisfaction of using adjunctive at-home, self-administered phototherapy utilizing a novel handheld narrow-band ultraviolet B (NB-UVB) device for the treatment of refractory mild to severe AD. Included AD patients were initially trained on proper use of the device. These patients treated involved areas three times per week for a period of 12 weeks. Phototherapy dosing protocol was based on skin type. The cohort included 52 patients, who were aged 20-69 and represented all skin types. They were initially categorized by disease involvement as mild, moderate, and severe. Patients were also queried to self-score their disease severity and level of satisfaction. Compared to baseline, at 12 weeks, 48% percent of patients indicated that at least one site was Clear/Almost Clear, 38% stated that more than 50% of body locations were Clear/Almost Clear, and 28% reported that 100% (all) treated sites were Clear/Almost Clear. After using at-home hand-held NB-UVB for the study duration, 67% (35/52) of patients experienced disease improvement. Mean overall satisfaction was extremely high at 4.43 on a 5-point scale. Skin type, age, gender, and disease severity at inception did not significantly affect patient satisfaction scores. Overall adherence rate among participants across all groups was 73%. In this small retrospective study, at-home handheld NB-UVB phototherapy was found to be an effective, well-tolerated, adjunctive treatment method for patients with refractory AD, which was associated with a high level of patient satisfaction and adherence.

The Fast and Reliable Detection of Multiple Narrowband FH Signals: A Practical Framework.

Frequency hopping (FH) is a well-known technique that is commonly used in communication systems owing to its many advantages, including its strong anti-jamming capability. In this technique, basically, radio signals are transmitted by switching the carrier between different frequency channels. As a result, the FH signal is not stationary; hence, its spectrum is expected to change over time. Therefore, the task of detection and parameter estimation of FH signals is very challenging in practice. To address this challenge, the study presented in this article proposes a method that detects and estimates the parameters of multiple narrowband FH signals. In the proposed method, first, short-time Fourier transform (STFT) is utilized to analyze FH signals, and a practical binarization process based on thresholding is used to detect FH signals. Then, a new algorithm is proposed to ensure that the center frequencies of the detected signals are successfully separated. Next, another algorithm is proposed to estimate the parameters of the detected signals. After estimating the parameters for the entire spectrum, an approach is used to detect FH signals. Lastly, the hop-clustering process is applied to separate the hops into groups without time overlap. The simulation results show that the proposed method can be an efficient way for the fast and accurate parameter estimation and detection of multiple narrowband FH signals.

Comparative study of the efficacy of azathioprine, dapsone, and NB-UVB phototherapy as steroid-sparing modalities in generalised lichen planus.

Background Generalised lichen planus (GLP) is a chronic disease with an overall prevalence of 1% requiring longer treatment. Limited studies are available on GLP and its treatment in the literature, unlike oral lichen planus. Objective To determine the best steroid-sparing treatment modality for GLP by comparing the efficacy, response, safety, side effects, and remission with azathioprine, dapsone, and narrowband UV-B (NB-UVB) along with their impact on itching severity and life quality. Methodology Open-label, prospective, comparative, interventional study on generalised lichen planus patients treated with systemic steroids along with one of three steroid-sparing modalities. Totally 90 patients were studied including 30 patients each who received azathioprine (Group A), dapsone (Group B), and narrow band UVB (NB-UVB) (Group C), respectively, for 16 weeks. Itch severity index (ISI) and Dermatology life quality Index (DLQI) were assessed at baseline and week 24. All patients received oral prednisolone until there was no more active disease. Response was assessed in terms of occurrence of new lesions, flattening of lesions, post-inflammatory hyperpigmentation (PIH), and grading of lesions two weeks once for 6 months followed by six months of follow-up after treatment completion. Results Females outnumbered males in all 3 groups. Mean patient ages (34, 38, and 34) and the presence of one or more co-morbidities (50%, 42.3%, 37.5%) in Groups A, B, and C, respectively, were comparable. ISI and DLQI improvement at 24 weeks were greatest with NB-UVB, followed by azathioprine and dapsone in that order; the differences in improvement between groups showed high statistical significance. At week 24, occurrence of new lesions (0%, 0%, 3.8%), flattening (100% - all groups), PIH (100% - all groups), grade 3 lesions i.e. poor response, resolution of 20-50% of lesions (7.1%, 11.5%, 0%), grade 2 lesions i.e. partial response, resolution of 50-90% of lesions (35.7%, 76.9%, 8.3%) and grade 1 lesions i.e. complete response, resolution of >90% lesions (57.1%, 11.5%, 91.3%) were noted in Groups A, B and C, respectively; the differences in the extent of resolution of lesions between the groups were highly significant statistically. Remission was seen in 100%, 76.9%, and 87.5% in Groups A, B, and C, respectively, after six months. Limitations The sample size was small. Only 3 treatment options were compared in this study but many more options have been used for lichen planus. Long term follow-up is required. Conclusions NB-UVB with oral steroids showed a better response in terms of improvement in DLQI, ISI, disease control, and side effects than azathioprine and dapsone. Azathioprine showed a faster response and more prolonged remission. Dapsone showed poor response with multiple side effects.

Design of Thermally Activated Delayed Fluorescence Materials: Transition from Carbonyl to Amide-Based Acceptor.

Benzophenone skeletons containing a carbonyl unit (O=C) have been widely used as electron acceptors in the thermally activated delayed fluorescence (TADF) materials. Herein, we present a novel molecular design concept for TADF materials by transitioning from a carbonyl to an amide (O=C-N) skeleton as the acceptor. The amide unit, compared to its carbonyl counterpart, offers a more stable electronic configuration. Leveraging this insight, we have developed a series of high-performance TADF molecules based on benzoyl carbazole and carbazoline acceptors. These molecules exhibit exceptionally small singlet-triplet energy gaps and pronounced aggregation-enhanced emission properties, achieving photoluminescence quantum yields in neat films as high as 99 %. Consequently, these materials serve as efficient emitters in non-doped organic light-eimtting diodes (OLEDs), reaching a maximum quantum efficiency (EQEmax) of up to 26.0 %, significantly higher than the 17.0 % obtained with benzophenone acceptor-based TADF molecules. Additionally, they have been used as TADF hosts in narrowband red fluorescent OLEDs, setting a record-high EQEmax of 22.4 %.

Narrowband Blue Circularly Polarized Luminescence Emitter Based on BN-Doped Benzo[6]helicene with Stimuli-Responsive Properties.

Boron-doped helicenes, known for their unique electronic and photophysical properties, are of great interest for numerous applications. This research introduces two new azabora[6]helicenes, H[6]BN1 and H[6]BN2, synthesized through an efficient method. These molecules have boron and nitrogen atoms in opposing positions, enhancing their distinctive attributes. Both helicenes show excellent emission properties, with H[6]BN1 and H[6]BN2 exhibiting narrowband blue fluorescence and circularly polarized luminescence (CPL), achieving glum values of 4~5×10-4 which is beneficial for chiroptical applications. The addition of a donor group, 3, 6-di-tert-butyl-9H-carbazole, in H[6]BN2 improves luminescence, likely due to enhanced molecular orbital overlap and electron delocalization. H[6]BN1's needle-like single crystals exhibit mechanochromism, changing luminescent color from yellow to green under mechanical stress, which is promising for stimulus-responsive materials. In conclusion, this study presents a novel class of BN[6]helicenes with superior chiroptical properties. Their combination of electronic features and mechanochromism makes them ideal for advanced chiroptical materials, expanding the potential of helicene-based compounds and offering new directions for the synthesis of molecules with specific chiroptical characteristics.

Four-Membered Ring-Embedded Cycloarene Enabling Anti-Aromaticity and Ultra-Narrowband Emission.

Synthesis of fully fused π-conjugated cycloarenes embedded nonbenzenoid aromatics is challenging. In this work, the first example of four-membered ring-embedded cycloarene (MF2) was designed and synthesized in single-crystal form by macrocyclization and ring fusion strategies. For comparison, single bond-linked chiral macrocycle MS2 without two fused four-membered rings and its linear-shaped polycyclic benzenoid monomer L1 were also synthesized. The pronounced anti-aromaticity of four-membered rings significantly adjusts the electronic structures and photophysical properties of cycloarene, resulting in an enhancement of the photoluminescence quantum yield (PLQY) from 10.66% and 10.74% for L1 and MS2, respectively, to 54.05% for MF2, which is the highest PLQY among the reported cycloarenes. Notably, owing to the embedded four-membered rings that reduce structural displacements, MF2 exhibits an ultra-narrowband emission with a single-digit full-width at half-maximum (FWHM) of only 7 nm (0.038 eV), which sets a new record among all reported organic narrowband luminescent molecules, and represents the first example of ultra-narrowband emission in conventional polycyclic aromatic hydrocarbons (PAHs) devoid of heteroatoms.

Tumor thickness as a novel risk factor for lymph node metastasis by superficial squamous cell carcinoma of head and neck.

Narrow-band imaging combined with magnified endoscopy has enabled the detection of superficial squamous cell carcinoma of the head and neck (SSCCHN) that has been resected with minimally invasive treatment, preserving vocalization and swallowing functions. However, risk factors of lymph node metastasis (LNM) must be identified, as some patients with LNM have a poor prognosis. From an initial 599 patients with 700 lesions who underwent trans-oral surgery in 27 Japanese hospitals (a nationwide registration survey), we enrolled 541 patients with 633 SSCCHNs, as indicated by central pathological diagnoses. All pathological specimens for each patient were examined using 20 pathological factors that are thought to affect the LNM of SSCCHN. In all, 24 (4.4%) of the 568 SSCCHNs exhibited LNM, and all 24 had at least one solitary nest of epithelial neoplastic cells present in the stroma, clearly separated from the intraepithelial carcinoma. Multivariate analysis also showed that tumor thickness (p = 0.0132, RR: 7.85, 95% confidence interval [CI]: 1.54-40.02), and an INFc pattern classified as infiltrating growth (INF) with unclear boundaries between tumor and non-tumor tissues (p = 0.0003, RR: 14.47, 3.46-60.46), and tumor budding (p = 0.0019, RR: 4.35, CI: 1.72-11.01) were significantly associated with LNM. Solitary nests may be indicative of LNM. In addition, tumor thickness was revealed to be a risk factor for LNM in SSCCHNs using pT factors that do not include an invasion depth element because of the anatomical absence of the muscularis mucosae.

Self-Assembled Chiral Polymers Exhibiting Amplified Circularly Polarized Electroluminescence.

Circularly polarized electroluminescence (CPEL) is highly promising in realm of 3D display and optical data storage. However, designing a groundbreaking chiral material with high comprehensive CPEL performance remains a formidable challenge. In this work, a pair of chiral polymers with self-assembled behavior is designed by integrating a chiral BN-moiety into polyfluorene backbone, named R-PBN and S-PBN, respectively. The chiral polymers show narrowband emission centered at 490 nm with full-width half maximum (FWHM) of 29 nm and high photoluminescence quantum yield (PLQY) of 79%. After thermal annealing treatment, the chiral polymers undergo self-assembly, exhibiting amplified circularly polarized luminescence (CPL) with asymmetry factor (|glum|) of up to 0.11. Moreover, the solution-processed nondoped CP-OLEDs based on the chiral polymers as emitting layers exhibit maximum external quantum efficiency (EQEmax) of 9.8%, intense CPEL activities with |gEL| of up to 0.07, and small FWHM of 36 nm, simultaneously. This represents the first case of self-assembled chiral polymers that combines high EQE, large gEL value and narrowband emission.

A Narrowband IoT Personal Sensor for Long-Term Heart Rate Monitoring and Atrial Fibrillation Detection.

Long-term patient monitoring is required for detection of episodes of atrial fibrillation, one of the most widespread cardiac pathologies. Today, the most used non-invasive technique is Holter electrocardiographic (ECG) monitoring, which can often prove ineffective because of the short duration of recordings (e.g., one day). Other techniques such as photo-plethysmography are adopted by smartwatches for much longer duration monitoring, but this has the disadvantage of offering only intermittent measurements. This study proposes an Internet of Things (IoT) sensor that can provide a very long period of continuous monitoring. The sensor consists of an ECG-integrated Analog Front End (MAX30003), a microcontroller (STM32F401RE), and an IoT narrowband module (STEVAL-STMODLTE). The instantaneous heart rate is extracted from the ECG recording in real time. At intervals of two minutes, the sequence of inter-beat intervals is transmitted to an IoT cloud platform (ThingSpeak). Settled atrial fibrillation event recognition software runs on the cloud and generates alerts when it recognizes such arrhythmia. Performances of the proposed sensor were evaluated by generating analog ECG signals from a public dataset of ECG signals with atrial fibrillation episodes, the MIT-BIH Atrial Fibrillation Database, each recording lasting approximately 10 h. Software implementing the Lorentz algorithm, one of the best detectors of atrial fibrillation, was implemented on the cloud platform. The accuracy, sensitivity, and specificity in recognizing atrial fibrillation episodes of the proposed system was calculated by comparison with a cardiologist's reference data. Across all patients, the proposed method achieved an accuracy of 0.88, a sensitivity 0.71, and a specificity 0.99. The results obtained suggest that the developed system can continuously record and transmit heart rhythms effectively and efficiently and, in addition, offers considerable performance in recognizing atrial fibrillation episodes in real time.