One-year clinical outcomes of MR-guided stereotactic body radiation therapy with rectal spacer for patients with localized prostate cancer.

BACKGROUND AND PURPOSE: This prospective study aimed to investigate adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (MRgSBRT) with rectal spacer for localized prostate cancer (PC) and report 1-year clinical outcomes. MATERIALS AND METHODS: Thirty-four consecutive patients with low- to high-risk localized PC that underwent 5-fraction adaptive MRgSBRT with rectal spacer were enrolled. The dosimetric comparison was performed on a risk- and age-matched cohort treated with MRgSBRT but without a spacer at a similar timepoint. Clinician-reported outcomes were based on Common Terminology Criteria for Adverse Events. Patient-reported outcomes were based on the Expanded Prostate Cancer Index Composite (EPIC) questionnaire at baseline, acute (1-3 months), subacute (4-12 months), and late (> 12 months) phases. RESULTS: The median follow-up was 390 days (range 28-823) and the median age was 70 years (range 58-82). One patient experienced rectal bleeding soon after spacer insertion that subsided before MRgSBRT. The median distance between the midline of the prostate midgland and the rectum after spacer insertion measured 7.8 mm (range 2.6-15.3), and the median length of the spacer was 45.9 mm (range 16.8-62.9) based on T2-weighted MR imaging. The use of spacer resulted in significant improvements in target coverage (V100% > 95% = 98.6% [range 93.4-99.8] for spacer vs. 97.8% [range 69.6-99.7] for non-spacer) and rectal sparing (V95% < 3 cc = 0.7 cc [range 0-4.6] for spacer vs. 4.9 cc [range 0-12.5] for non-spacer). Nine patients (26.5%) experienced grade 1 gastrointestinal toxicities, and no grade ≥ 2 toxicities were observed. During the 1-year follow-up period, EPIC scores for the bowel domain remained stable and were the highest among all other domains. CONCLUSIONS: MRgSBRT with rectal spacer for localized PC showed exceptional tolerability with minimal gastrointestinal toxicities and satisfactory patient-reported outcomes. Improvements in dosimetry, rectal sparing, and target coverage were achieved with a rectal spacer. Randomized trials are warranted for further validation.

Death education interventions for people with advanced diseases and/or their family caregivers: A scoping review.

BACKGROUND: People with life-threatening diseases and their family caregivers confront psychosocial and spiritual issues caused by the persons' impending death. Reviews of death education interventions in the context of life-threatening diseases are scarce and limited to certain intervention types. AIMS: This study aims to ascertain existing evidence on death education interventions for the population of adults with advanced diseases and/or their family caregivers and identify gaps for future research. DESIGN: A scoping review guided by Arksey and O'Malley's framework. DATA SOURCES: Thirteen electronic databases were searched for experimental and qualitative studies on death education interventions for the advanced disease population and/or their family caregivers between 1 January 1960 and 25 October 2023. RESULTS: Nine types of interventions were identified in 47 studies, which included 5 qualitative and 42 experimental designs, half of which were pilot and feasibility trials. Most of the studies focused on people with advanced cancer, and only seven investigated caregivers or families/couples. Death-related outcomes were less likely to be assessed relative to psychological outcomes, spiritual well-being, and quality of life. Life review interventions, cognitive-behavior therapy, narrative therapy, and general psychosocial interventions decreased depression and anxiety, but evidence was limited. Factors contributing to the interventions' success included intervention content, which enabled the disclosure of personal experience and death concerns comfortably, trained professionals, and connection to family caregivers. CONCLUSIONS: This work identified a few potentially effective death education interventions for psychological outcomes for people with advanced cancer or their caregivers. Additional trials are needed to confirm the effectiveness of these interventions.

Empiric vs Preemptive Antifungal Strategy in High-Risk Neutropenic Patients on Fluconazole Prophylaxis: A Randomized Trial of the European Organization for Research and Treatment of Cancer.

BACKGROUND: Empiric antifungal therapy is considered the standard of care for high-risk neutropenic patients with persistent fever. The impact of a preemptive, diagnostic-driven approach based on galactomannan screening and chest computed tomography scan on demand on survival and on the risk of invasive fungal disease (IFD) during the first weeks of high-risk neutropenia is unknown. METHODS: Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) and allogeneic hematopoietic cell transplant recipients were randomly assigned to receive caspofungin empirically (arm A) or preemptively (arm B), while receiving fluconazole 400 mg daily prophylactically. The primary end point of this noninferiority study was overall survival (OS) 42 days after randomization. RESULTS: Of 556 patients recruited, 549 were eligible: 275 in arm A and 274 in arm B. Eighty percent of the patients had AML or MDS requiring high-dose chemotherapy, and 93% of them were in the first induction phase. At day 42, the OS was not inferior in arm B (96.7%; 95% confidence interval [CI], 93.8%-98.3%) when compared with arm A (93.1%; 95% CI, 89.3%-95.5%). The rates of IFDs at day 84 were not significantly different, 7.7% (95% CI, 4.5%-10.8%) in arm B vs 6.6% (95% CI, 3.6%-9.5%) in arm A. The rate of patients who received caspofungin was significantly lower in arm B (27%) than in arm A (63%; P < .001). CONCLUSIONS: The preemptive antifungal strategy was safe for high-risk neutropenic patients given fluconazole as prophylaxis, halving the number of patients receiving antifungals without excess mortality or IFDs. Clinical Trials Registration. NCT01288378; EudraCT 2010-020814-27.

A phase 1/2a safety, pharmacokinetics, and efficacy study of the novel nucleoside analog FF-10502-01 for the treatment of advanced solid tumors.

BACKGROUND: The nucleoside FF-10502-01, structurally similar to but with different biologic effects than gemcitabine, shows promising activity both alone and combined with cisplatin in preclinical gemcitabine-resistant tumor models. We conducted an open-label, single-arm, 3 + 3 first-in-human trial to explore the safety, tolerability, and antitumor activity of FF-10502-01 in patients with solid tumors. METHODS: Patients with inoperable metastatic tumors refractory to standard therapies were enrolled. Escalating intravenous FF-10502-01 doses (8-135 mg/m2 ) were administered weekly for 3 weeks in 28-day cycles until progressive disease or unacceptable toxicity was observed. Three expansion cohorts were subsequently evaluated. RESULTS: A phase 2 dose of 90 mg/m2 was determined after evaluating 40 patients. Dose-limiting toxicities included hypotension and nausea. Phase 2a enrolled patients with cholangiocarcinoma (36), gallbladder cancer (10), and pancreatic/other tumors (20). Common adverse events were grade 1-2 rash, pruritus, fever, and fatigue. Grade 3 or 4 hematologic toxicities were observed at low incidences, including thrombocytopenia (5.1%) and neutropenia (2%). Confirmed partial responses (PRs) occurred in five patients with gemcitabine-refractory tumors, including three with cholangiocarcinoma and one each with gallbladder and urothelial cancer. Median progression-free and overall survival rates in patients with cholangiocarcinoma were 24.7 and 39.1 weeks, respectively. Prolonged progression-free survival in patients with cholangiocarcinoma was associated with BAP1 and PBRM1 mutations. CONCLUSION: FF-10502-01 was well tolerated with manageable side effects and limited hematologic toxicity. Durable PRs and disease stabilizations were observed in heavily pretreated biliary tract patients who had received prior gemcitabine. FF-10502-01 is distinct from gemcitabine and may represent an effective therapy.

A pilot study of MRI radiomics for high-risk prostate cancer stratification in 1.5 T MR-guided radiotherapy.

PURPOSE: To investigate the potential value of MRI radiomics obtained from a 1.5 T MRI-guided linear accelerator (MR-LINAC) for D'Amico high-risk prostate cancer (PC) classification in MR-guided radiotherapy (MRgRT). METHODS: One hundred seventy-six consecutive PC patients underwent 1.5 T MRgRT treatment were retrospectively enrolled. Each patient received one or two pretreatment T2 -weighted MRI scans on a 1.5 T MR-LINAC. The endpoint was to differentiate high-risk from low/intermediate-risk PC based on D'Amico criteria using MRI-radiomics. Totally 1023 features were extracted from clinical target volume (CTV) and planning target volume (PTV). Intraclass correlation coefficient of scan-rescan repeatability, feature correlation, and recursive feature elimination were used for feature dimension reduction. Least absolute shrinkage and selection operator regression was employed for model construction. Receiver operating characteristic area under the curve (AUC) analysis was used for model performance assessment in both training and testing data. RESULTS: One hundred and eleven patients fulfilled all criteria were finally included: 76 for training and 35 for testing. The constructed MRI-radiomics models extracted from CTV and PTV achieved the AUC of 0.812 and 0.867 in the training data, without significant difference (P = 0.083). The model performances remained in the testing. The sensitivity, specificity, and accuracy were 85.71%, 64.29%, and 77.14% for the PTV-based model; and 71.43%, 71.43%, and 71.43% for the CTV-based model. The corresponding AUCs were 0.718 and 0.750 (P = 0.091) for CTV- and PTV-based models. CONCLUSION: MRI-radiomics obtained from a 1.5 T MR-LINAC showed promising results in D'Amico high-risk PC stratification, potentially helpful for the future PC MRgRT. Prospective studies with larger sample sizes and external validation are warranted for further verification.

Effects of Bis(imino)acenaphthene (Bian)-Derived Ligands on the Cytotoxicity, DNA Interactions, and Redox Activity of Palladium(II) Bipyridine Complexes.

A series of heteroleptic bipyridine Pd(II) complexes based on 1,2-bis[(2,6-diisopropylphenyl)imino]acenaphthene (dpp-Bian) or 1,2-bis[(2,4,6-trimethylphenyl)imino]acenaphthene (tmp-Bian) were prepared. All complexes were fully characterized by spectrochemical methods, and their crystal structures were confirmed by X-ray diffraction analysis. The 72 h stability of heteroleptic bipyridine Pd(II) complexes with Bian ligands under physiological conditions was investigated using 1H NMR spectroscopy. The anticancer activity of all complexes was assessed in a panel of cancer cell lines in comparison with uncoordinated ligands and clinically used drugs cisplatin and doxorubicin. The ability of the complexes to bind DNA was investigated using several methods, including EtBr replacement assay, density functional theory calculations, circular dichroism spectroscopy, DNA gel electrophoresis, and TUNEL assay. The electrochemical activity of all complexes and the uncoordinated ligands was studied using cyclic voltammetry, and reactive oxygen species production in cancer cells was investigated using confocal microscopy. Heteroleptic bipyridine PdII-Bian complexes were cytotoxic in a low micromolar concentration range and showed some selectivity toward cancer cells in comparison with noncancerous MRC-5 lung fibroblasts.

Newly graduated nurses' stress, coping, professional identity and work locus of control: Results of a cross-sectional study in Shanghai, Hong Kong and Taipei.

AIM: The study aimed to explore and compare stress, coping, professional identity and work locus of control of new graduate nurses among Shanghai, Hong Kong and Taipei. BACKGROUND: The transition from a student to a staff nurse role is recognized as a stressful experience and can be a rough journey. Many newly graduated nurses find it challenging to cope with their new roles in their first few months. METHODS: A cross-sectional research was used in the study. This study was completed in Shanghai, Hong Kong and Taipei with newly graduated nurses working in hospitals. A total of 591 graduate nurses who had worked within 1 year in hospitals were recruited using convenient sampling. Data were collected using a structured questionnaire, including demographics, the occupational stress scale, the Chinese trait coping style questionnaire, the nurse professional identity scale and the work locus of control scale (Chinese version). RESULTS: The newly graduated nurses in Shanghai had significantly lower (p < 0.05) work stress score (2.65 ± 0.67) compared with their counterparts in Hong Kong (2.99 ± 0.69) and Taipei (2.94 ± 0.60). Newly graduated nurses in Shanghai tended to choose positive coping to deal with stressful situations, whereas those in Hong Kong would be more likely to adopt negative attitudes (p < 0.05). The newly graduated nurses in Taipei had the lowest level of professional identity (3.25 ± 0.55, p < 0.05), and their work control tended to be external (46.13 ± 6.20). In contrast, those in Shanghai (52.75 ± 6.04) and Hong Kong (59.41 ± 7.29) tended to be controlled internally. CONCLUSIONS: The study findings revealed the differences among newly graduated nurses in Shanghai, Hong Kong and Taipei with their level of stress, coping, professional identity and work locus of control. Proper leadership, mentoring for newly graduated nurses, and emphasis on first aid nursing training, emotional management and management of stress in newly graduated nurse transition programmes were suggested. IMPLICATIONS FOR NURSING MANAGEMENT: By comparing the results in the three regions, we recommend that nursing managers promote the right leadership style. In addition to coaching, nursing managers can assign additional mentors to newly graduated nurses to help them supplement their clinical knowledge and skills with psychological support. These mentors can come from senior nurses or nursing managers working on less demanding tasks. In addition to the existing post transfer training programmes, new graduate nurses should also focus on emergency nursing training, emotional management training and stress management training.

Integration of text messaging interventions into hypertension management among older adults: A systematic review and meta-analysis.

BACKGROUND: An aging population and required hypertension control are global concerns that burden the healthcare system. Text messaging interventions have been developed to support hypertension management, but their effects on the older population are unknown. OBJECTIVES: This review aimed to identify the effects of a text messaging intervention on hypertension management among older adults. METHODS: Four English and two Chinese databases with randomized controlled trials published between January 2010 and December 2020 were searched. The mean age of the participants was 60 years or above. Participants were also diagnosed with hypertension. The Cochrane risk-of-bias tool was used for the critical appraisal. Data in each study were extracted, and a meta-analysis was presented in terms of mean difference (MD) and standardized mean difference (SMD). RESULTS: A total of 1670 records were screened, of which six were included in the final review. The intervention of the included studies lasted up to 6 months, and one-way text messaging was commonly used. Meta-analysis showed that a text messaging intervention significantly reduced systolic blood pressure (MD = -6.11, p < .01) but not diastolic blood pressure. Regarding medication adherence, a moderate effect was noted with the use of text messaging among older adults with hypertension (SMD = 0.65, p = .01). LINKING EVIDENCE TO ACTION: A text messaging intervention can improve hypertension management among older adults. The standardized content of one-way text messaging is suggested to be delivered weekly.

Cervical carcinomas with serous-like papillary and micropapillary components: illustrating the heterogeneity of primary cervical carcinomas.

Recent changes in the classification of cervical adenocarcinomas have re-categorized serous carcinoma as potentially nonexistent. However, clinical and pathological profiles of cervical adenocarcinomas with serous-like morphological features have not been systematically evaluated using the latest taxonomy and biomarkers. We studied 14 cases of primary cervical carcinomas with serous-like morphologies (papillary and micropapillary patterns). None of these cases exhibited evidence of serous carcinoma involving the upper tracts. Patient ages ranged between 34 and 86 years, most presented with abnormal uterine bleeding. Histologically, ten cases were classified as human papillomavirus (HPV)-associated carcinomas (eight usual-type endocervical adenocarcinomas and two adenosquamous carcinomas), of which six exhibited a papillary pattern and four had a micropapillary pattern. The four remaining cases were HPV-independent gastric-type adenocarcinomas, which displayed a papillary pattern in one case and a micropapillary pattern in three others. All ten HPV-associated carcinomas displayed block positive p16 and wild-type p53 by immunohistochemistry, with nine of them confirmed by HPV testing. Two of the four gastric-type adenocarcinomas had mutation-type p53, one of which also being p16 block positive. HER2 overexpression was demonstrated in 3/14 (21.4%) cases (2 HPV-associated and 1 HPV-independent). PD-L1 expression was identified in 4/10 (40%) cases, all HPV-associated. Targeted next-generation sequencing was performed in two cases with a micropapillary pattern, revealing a missense variant in ATM in an HPV-associated tumor and missense variants in TP53 and SMARCB1 in an HPV-independent tumor. The results demonstrated that primary endocervical adenocarcinomas can mimic the appearance of serous carcinoma, while not representing serous carcinoma. Serous-like papillary and micropapillary patterns may be present in both HPV-associated and HPV-independent cervical carcinomas, but none of the cases studied were unequivocally serous upon detailed analysis. Our findings support the exclusion of "cervical serous carcinoma" from existing classifications of cervical adenocarcinoma.

Reliability of radiomics features due to image reconstruction using a standardized T2 -weighted pulse sequence for MR-guided radiotherapy: An anthropomorphic phantom study.

PURPOSE: To prospectively investigate the impact of image reconstruction on MRI radiomics features. METHODS: An anthropomorphic phantom was scanned at 1.5 T using a standardized sequence for MR-guided radiotherapy under SENSE and compressed-SENSE reconstruction settings. A total of 93 first-order and texture radiomics features in 10 volumes of interest were assessed based on (1) accuracy measured by the percentage deviation from the reference, (2) robustness on reconstruction in all volumes of interest measured by the intraclass correlation coefficient, and (3) repeatability measured by the coefficient of variance over the repetitive acquisitions. Finally, reliable and unreliable radiomics features were comprehensively determined based on their accuracy, robustness, and repeatability. RESULTS: Better accuracy and robustness of the radiomics features were achieved under SENSE than compressed-SENSE reconstruction. The feature accuracy under SENSE reconstruction was more affected by acceleration factor than direction, whereas under compressed-SENSE reconstruction, accuracy was substantially impacted by the increasing denoising levels. Feature repeatability was dependent more on feature types than on reconstruction. A total of 45 reliable features and 13 unreliable features were finally determined for SENSE, compared with 22 reliable and 26 unreliable features for compressed SENSE. First-order and gray-level co-occurrence matrix features were generally more reliable than other features. CONCLUSION: Radiomics features could be substantially affected by MRI reconstruction, so precautions need to be taken regarding their reliability for clinical use. This study helps the guidance of the preselection of reliable radiomics features and the preclusion of unreliable features in MR-guided radiotherapy.

Long-Term Outcome on the Mal-Seating of Ceramic-on-Ceramic Articulation in Total Hip Arthroplasty.

BACKGROUND: Total hip arthroplasty with ceramic-on-ceramic articulation aims to decrease wear, osteolysis, and aseptic loosening. A metal-backed ceramic liner was developed to reduce the risk of liner fracture. However, a significant number of cases of mal-seating of the metal-backed ceramic liner were observed in the 2000s, and there were concerns about their outcome. This review aims to investigate the long-term performance of the mal-seated ceramic liner. METHODS: From July 2003 to March 2007, 35 ceramic-on-ceramic total hip arthroplasties were performed with the Trident acetabular system. Clinical assessment, radiological analysis, and outcome assessment were performed. The prevalence of liner mal-seating and its long-term outcomes were investigated. RESULTS: There was liner mal-seating in 8 hips (22.9%). One liner was exchanged in the early postoperative period. No revision surgery was required for the remaining 7 hips at a mean follow-up of 14 years. All patients were free of hip pain with a mean Harris Hip Score of 94.7 at the most recent follow-up. No adverse event was observed. CONCLUSION: The long-term outcomes of the mal-seated liner were favorable. However, surgeons should exercise meticulous surgical technique to achieve a properly aligned liner within the acetabular shell to minimize this potentially correctable error.

Nonresonant Transmission Line Probe for Sensitive Interferometric Electron Spin Resonance Detection.

Electron spin resonance (ESR) spectroscopy measures paramagnetic free radicals, or electron spins, in a variety of biological, chemical, and physical systems. Detection of diverse paramagnetic species is important in applications ranging from quantum computation to biomedical research. Countless efforts have been made to improve the sensitivity of ESR detection. However, the improvement comes at the cost of experimental accessibility. Thus, most ESR spectrometers are limited to specific sample geometries and compositions. Here, we present a nonresonant transmission line ESR probe (microstrip geometry) that effectively couples high frequency microwave magnetic field into a wide range of sample geometries and compositions. The nonresonant transmission line probe maintains detection sensitivity while increasing availability to a wider range of applications. The high frequency magnetic field homogeneity is greatly increased by positioning the sample between the microstrip signal line and the ground plane. Sample interfacing occurs via a universal sample holder which is compatible with both solid and liquid samples. The unavoidable loss in sensitivity due to the nonresonant nature of the transmission line probe (low Q) is recuperated by using a highly sensitive microwave interferometer-based detection circuit. The combination of our sensitive interferometer and nonresonant transmission line provides similar sensitivity to a commercially available ESR spectrometer equipped with a high-Q resonator. The nonresonant probe allows for transmission, reflection, or dual-mode detection (transmission and reflection), where the dual-mode results in a √2 signal enhancement.

A novel method for monitoring the constancy of beam path accuracy in CyberKnife.

The aim of current work was to present a novel evaluation procedure implemented for checking the constancy of beam path accuracy of a CyberKnife system based on ArcCHECK. A tailor-made Styrofoam with four implanted fiducial markers was adopted to enable the fiducial tracking during beam deliveries. A simple two-field plan and an isocentric plan were created for determining the density override of ArcCHECK in MultiPlan and the constancy of beam path accuracy respectively. Correlation curves for all diodes involved in the study were obtained by analyzing the dose distributions calculated by MultiPlan after introducing position shifts in anteroposterior, superoinferior, and left-right directions. The ability of detecting systematic position error was also evaluated by changing the position of alignment center intentionally. The one standard deviation (SD) result for reproducibility test showed the RMS of 0.054 mm and the maximum of 0.263 mm, which was comparable to the machine self-test result. The mean of absolute value of position errors in the constancy test was measured to 0.091 mm with a SD of 0.035 mm, while the root-mean-square was 0.127 mm with a SD of 0.034 mm. All introduced systematic position errors range from 0.3 to 2 mm were detected successfully. Efficient method for evaluating the constancy of beam path accuracy of CyberKnife has been developed and proven to be sensitive enough for detecting a systematic drift of robotic manipulator. Once the workflow is streamlined, our proposed method will be an effective and easy quality assurance procedure for medical physicists.

Ferroelectricity in Polar Polymer-based FETs: A Hysteresis Analysis.

There is an increasing number of reports on polar polymer-based Ferroelectric Field Effect Transistors (FeFETs), where the hysteresis of the drain current - gate voltage (Id-Vg) curve is investigated as the result of the ferroelectric polarization effect. However, separating ferroelectric effect from many of the factors (such as charge injection/trapping and the presence of mobile ions in the polymer) that confound interpretation is still confusing and controversial. This work presents a methodology to reliably identify the confounding factors which obscure the polarization effect in FeFETs. Careful observation of the Id-Vg curves, as well as monitoring the Id-Vg hysteresis and flat band voltage shift as a function of temperature and sweep frequency identifies the dominant mechanism. This methodology is demonstrated using 15-nm thick high glass transition temperature polar polymer-based FeFETs. In these devices, room temperature hysteresis is largely a consequence of charge trapping and mobile ions, while ferroelectric polarization is observed at elevated temperatures. This methodology can be used to unambiguously prove the effect of ferroelectric polarization in FeFETs.

Analysis and Control of RRAM Overshoot Current.

To combat the large variability problem in RRAM, current compliance elements are commonly used to limit the in-rush current during the forming operation. Regardless of the compliance element (1R-1R or 1T-1R), some degree of current overshoot is unavoidable. The peak value of the overshoot current is often used as a predictive metric of the filament characteristics and is linked to the parasitic capacitance of the test structure. The reported detrimental effects of higher parasitic capacitance seem to support this concept. However, this understanding is inconsistent with the recent successes of compliance-free ultra-short pulse forming which guarantees a maximum peak overshoot current. We use detailed circuit analysis and experimental measurements of 1R-1R and 1T-1R structures to show that the peak overshoot is independent of the parasitic capacitance while the overshoot duration is strongly dependent on the parasitic capacitance. Forming control can be achieved, in ultra-short pulse forming, since the overshoot duration is always less than the applied pulse duration. The demonstrated success of ultra-short pulse forming becomes easier to reconcile after identifying the importance of overshoot duration.

Wafer-Level Electrically Detected Magnetic Resonance: Magnetic Resonance in a Probing Station.

We report on a novel semiconductor reliability technique that incorporates an electrically detected magnetic resonance (EDMR) spectrometer within a conventional semiconductor wafer probing station. EDMR is an ultrasensitive electron paramagnetic resonance technique with the capability to provide detailed physical and chemical information about reliability limiting defects in semiconductor devices. EDMR measurements have generally required a complex apparatus, not typically found in solid-state electronics laboratories. The union of a semiconductor probing station with EDMR allows powerful analytical measurements to be performed within individual devices at the wafer level. Our novel approach replaces the standard magnetic resonance microwave cavity or resonator with a small non- resonant near field microwave probe. Using this new approach we have demonstrated bipolar amplification effect and spin dependent charge pumping in various SiC based MOSFET structures. Although our studies have been limited to SiC based devices, the approach will be widely applicable to other types of MOSFETs, bipolar junction transistors, and various memory devices. The replacement of the resonance cavity with the very small non- resonant microwave probe greatly simplifies the EDMR detection scheme and allows for the incorporation of this powerful tool with a wafer probing station. We believe this scheme offers great promise for widespread utilization of EDMR in semiconductor reliability laboratories.

Impact of RRAM Read Fluctuations on the Program-Verify Approach.

The stochastic nature of the conductive filaments in oxide-based resistive memory (RRAM) represents a sizeable impediment to commercialization. As such, program-verify methodologies are highly alluring. However, it was recently shown that program-verify methods are unworkable due to strong resistance state relaxation after SET/RESET programming. In this paper, we demonstrate that resistance state relaxation is not the main culprit. Instead, it is fluctuation-induced false-reading (triggering) that defeats the program-verify method, producing a large distribution tail immediately after programming. The fluctuation impact on the verify mechanism has serious implications on the overall write/erase speed of RRAM.

The impact of personal-, disease- and work-related factors on work ability of women with breast cancer living in the community: a cross-sectional survey study.

PURPOSE: The aims of this study were to identify the work ability (WA) of breast cancer (BC) survivors during the course of their illness, and the relationships between personal-, disease-, and work-related factors, and their WA. METHODS: This is a cross-sectional survey study. One hundred fifty-one participants with the response rate of 88.9% were recruited from the community in 2014 and 2015. RESULTS: BC survivors' WA was at its highest before diagnosis, and then dropped to the lowest during treatment. Although their current WA had improved, it has not bounced back to that before diagnosis. The resignation rate was 35.8%. Factors positively associated with current WA included (a) age and year of diagnosis, (b) physical and psychological health and (c) WA before diagnosis or during treatment, working years, work control and mastery. However, compliance with appropriate healthy eating habits and believing in personal health controlled by chance were negatively associated with current WA. Furthermore, the participants would more likely to have higher current WA if they (a) were more optimistic with good stress management; (b) currently were not receiving treatment or other illnesses; (c) perceived less effects of their health problems, physical workloads or their cancer diagnoses on their work and (d) perceived continue to work in the next 2 years, with good ability to handle physical and mental work. CONCLUSIONS: This study confirmed that most BC survivors continued to work after their diagnoses. The factors affecting their WA were multifactorial. It is important to enhance their positive thinking.

Local field effect on charge-capture/emission dynamics.

Charge-capture/emission is ubiquitous in electron devices. Its dynamics often play critical roles in device operation and reliability. Treatment of this basic process is found in many text books and is considered well understood. As in many electron device models, the individuality of immobile charge is commonly replaced with the average quantity of charge density. This has worked remarkably well when large numbers of individual charges (ensemble) are involved. As device geometries become very small, the ensemble "averaging" becomes far less accurate. In this work, the charge-capture/emission dynamic of Metal-Oxide-Semiconductor-Field-Effect-Transistor (MOSFET) is re-examined with full consideration of individual charges and the local field in their immediate vicinity. A dramatic modification of the local band diagram resulted, forcing a drastic change in emission mechanism. The implication is that many well-understood phenomena involving charge capture/emission will need to be reconsidered. As an example, this new picture is applied to the random telegraph noise (RTN) phenomenon. When the screening of a trapped charge by a polar medium such as SiO2 is quantitatively accounted for in this local field picture, a new physically sound RTN emission mechanism emerges. Similarly, the dynamics of post-stress recovery of Negative-Bias-Instability of p-channel MOSFET can be more rationally explained.

Daclatasvir plus simeprevir with or without ribavirin for the treatment of chronic hepatitis C virus genotype 1 infection.

BACKGROUND & AIMS: We evaluated the combination of daclatasvir (pan-genotypic NS5A inhibitor) and simeprevir (NS3/4A protease inhibitor), with or without ribavirin, in hepatitis C virus genotype 1-infected patients. METHODS: This phase II, open-label study enrolled treatment-naive patients or prior null responders with genotype 1b (n=147) or 1a (n=21) infection. Genotype 1b-infected patients were randomized 1:1 to receive daclatasvir 30mg plus simeprevir 150mg once daily with or without ribavirin; those who completed the initial 12-week treatment were re-randomized 1:1 to stop treatment or continue treatment through to week 24. Genotype 1a-infected patients received daclatasvir plus simeprevir with ribavirin for 24weeks. The primary endpoint was the proportion of patients with sustained virologic response at posttreatment week 12 (SVR12). RESULTS: For genotype 1b, 84.9% (45/53) and 74.5% (38/51) of treatment-naive patients and 69.6% (16/23) and 95.0% (19/20) of prior null responders to peginterferon and ribavirin achieved SVR12 with daclatasvir plus simeprevir alone and with ribavirin, respectively. Treatment duration did not have a well-defined impact on response. For genotype 1a, daclatasvir plus simeprevir with ribavirin provided a 66.7% (8/12) response rate in treatment-naive patients and was not effective in prior null responders. Data suggest that baseline resistance polymorphisms influenced SVR12 rates. Daclatasvir plus simeprevir was well tolerated with or without ribavirin with low incidences of serious adverse events and adverse events leading to discontinuation. CONCLUSIONS: Daclatasvir plus simeprevir, with or without ribavirin, was effective with a 12- or 24-week duration in genotype 1b-infected patients and was well tolerated. ClinicalTrials.gov identifier: NCT01628692.