Various accessibility activities are improving blind access to the increasingly indispensable WWW. These approaches use various metrics to measure the Web's accessibility. “Ease of navigation” ...(navigability) is one of the crucial factors for blind usability, especially for complicated webpages used in portals and online shopping sites. However, it is difficult for automatic checking tools to evaluate the navigation capabilities even for a single webpage. Navigability issues for complete Web applications are still far beyond their capabilities.
This study aims at obtaining quantitative results about the current accessibility status of real world Web applications, and analyzes real users' behavior on such websites. In Study 1, an automatic analysis method for webpage navigability is introduced, and then a broad survey using this method for 30 international online shopping sites is described. The next study (Study 2) focuses on a fine-grained analysis of real users' behavior on some of these online shopping sites. We modified a voice browser to record each user's actions and the information presented to that user. We conducted user testing on existing sites with this tool. We also developed an analysis and visualization method for the recorded information. The results showed us that users strongly depend on scanning navigation instead of logical navigation. A landmark-oriented navigation model was proposed based on the results. Finally, we discuss future possibilities for improving navigability, including proposals for voice browsers.
Microwave-assisted magnetization reversal was verified by a cavity method with intention to apply homogenous microwave to a millimeter-size CoPtCr-SiO2 medium. By applying 34 GHz microwave with ...various power, magnetization reversal of the medium was assisted. The amount of the reversal magnetization was estimated using an internal magnetic field evaluated with ferromagnetic resonance (FMR) field. As a result, it is found that: 1) when the incident angle of external field is set at 90° (perpendicular), assisting effect depends on microwave power and magnetization of the media; 2) mode value of switching field distribution of the media was reduced 300 Oe by 160-mW microwave assisting; and 3) when the incident angle of external field is set at 45° during the microwave assisting, dispersion of the SFD decreased with increasing microwave power.
Background
The association between the development of checkpoint inhibitor pneumonitis (CIP) with tumor response and survival has remained unclear so far. The aim of the present study was to evaluate ...the association between CIP and the clinical efficacy of anti‐programmed cell death‐1 antibody in patients with advanced non‐small cell lung cancer (NSCLC).
Methods
Between January 2016 and August 2019, 203 advanced NSCLC patients were administered with nivolumab or pembrolizumab. Comparisons were made between patients with and without CIP. We evaluated the time‐to‐treatment failure (TTF), progression‐free survival (PFS), and overall survival (OS).
Results
CIP was observed in 28 (14%) patients. CIP was associated with a longer PFS (18.9 months 95% confidence interval, CI: 8.7 months–not reached vs. 3.9 months 95% CI: 3.4–5.1 months, p < 0.01) and longer OS (27.4 95% CI: 20.7 months–not reached vs. 14.8 months 95% CI: 11.2–17.9 months, p = 0.003). Most patients discontinued the immune checkpoint inhibitor (ICI) treatment when they developed CIP. Seven patients (25%) lived for more than 300 days from treatment discontinuation and did not show any long‐term tumor growth after treatment discontinuation.
Conclusion
CIP was associated with prolonged PFS and OS. Additionally, 25% of CIP patients did not show any tumor growth for long periods after treatment discontinuation. Careful management of CIP can help in obtaining the best clinical efficacy from anti‐PD‐1 antibody.
This study aimed to evaluate the association between checkpoint inhibitor pneumonitis (CIP) and the clinical efficacy of anti‐programmed cell death‐1 monotherapy in patients with advanced non‐small cell lung cancer (NSCLC). CIP was associated with a longer PFS (18.9 months vs. 3.9 months, p < 0.01) and longer OS (27.4 vs. 14.8 months, p = 0.003), and 25% of CIP patients did not grow tumors long after treatment was discontinued. We believe that cautious management of irAEs (especially early detection and treatment) can facilitate achieving the maximum clinical benefit from nivolumab or pembrolizumab monotherapy.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background and Purpose- Endovascular therapy is effective against acute cerebral large vessel occlusion (LVO). However, many patients do not receive such interventions because of the lack of timely ...identification of the type of stroke. If the types of stroke (any stroke, LVO, intracranial hemorrhage ICH, and subarachnoid hemorrhage SAH) were to be predicted at the prehospital stage, better access to appropriate interventions would be possible. Japan Urgent Stroke Triage (JUST) score was clinical prediction rule to classify suspected patients of acute stroke into different types at the prehospital stage. Methods- We obtained information for signs and symptoms and medical history of consecutive suspected patients of acute stroke at prehospital stage from paramedics and final diagnosis from the receiving hospital. We constructed derivation cohort in the historical multicenter cohort study from June 2015 to March 2016 and validation cohort in the prospective multicenter cohort study from August 2016 to July 2017. The derivation and the validation cohorts included 1229 and 1007 patients, respectively. We constructed multivariate logistic regression models with 21 variables to develop clinical prediction rules, which distinguish between different types of stroke: any stroke, LVO, ICH, and SAH. Results- Among the 1229 patients (median age, 72 years; 55% men) in the derivation cohort, 533 stroke, 104 LVO, 169 ICH, and 57 SAH cases were observed. The developed rules showed that the areas under the receiver operating curves were 0.88 for any stroke, 0.92 for LVO, 0.84 for ICH, and 0.89 for SAH. The validation cohort of 1007 patients (median age, 75 years; 56% men) showed that the areas under the curves of any stroke, LVO, ICH, and SAH were 0.80, 0.85, 0.77, and 0.94, respectively. Conclusions- These clinical prediction rules can help paramedics classify the suspected patients of stroke into any stroke, LVO, ICH, and SAH groups with excellent accuracy.
Investigation of magnetic properties and microstructure of granular media with various double oxides including B2O3 as the grain boundary material is reported. By adding a high Tm second oxide ...together with B2O3 for the grain boundary material, comparable magnetic properties with that of the single oxide granular media and smaller crystallite size evaluated by X-ray diffraction (GDinplane) than that of the single oxide granular media can be obtained. Among the evaluated media, the granular medium with B2O3− TiO2 is promising for the grain boundary material, showing comparable average Ms and Ku of 806 emu/cm3 and 7.7×106 erg/cm3 with that of the single B2O3 and smaller GDinplane of 4.8 nm than that of the single B2O3 of 5.4 nm. In the TEM image, thin grain boundaries inside the grains can be observed which indicates that small grains with one-on-one grains growth is expected when an underlayer with smaller grain size is utilized.
Background
Leiomyosarcoma is a rare tumor that could originate from the gastrointestinal tract, uterus, kidney, retroperitoneum, and the soft tissues of the extremities. It accounts for only 1% of ...all gastrointestinal mesenchymal tumors and primary leiomyosarcoma of the stomach is extremely rare. Most cases reported as leiomyosarcoma of the stomach before the development of KIT immunohistochemistry might be gastrointestinal stromal tumors (GISTs) of the stomach and only 18 cases of leiomyosarcoma of the stomach have been reported since early 2000s. We report here a patient with leiomyosarcoma of the stomach treated by laparoscopic and endoscopic cooperative surgery (LECS).
Case presentation
A 59-year-old man was referred to our hospital for an early gastric cancer, which was initially treated by endoscopic submucosal dissection. Six months after his initial treatment, a follow-up esophagogastroduodenoscopy revealed a small polypoid lesion at the lesser curvature of the proximal stomach, which appeared to be a hyperplastic polyp. However, one and a half years later, the lesion grew and showed more irregular surface. Biopsy at the time revealed smooth muscle cell proliferation suggestive of leiomyoma. Three years later, the lesion grew even larger and biopsy showed pleomorphic spindle cells. Immunohistochemical study showed positive staining for alpha-smooth muscle actin and desmin, but negative for c-kit and CD34. Ki-67 labeling index was nearly 60%. Based on these findings, the diagnosis of leiomyosarcoma was established. The patient subsequently underwent a partial gastrectomy by LECS. The patient is currently in good condition without recurrence or metastasis at 12 months after surgery.
Conclusions
Leiomyosarcoma of the stomach is extremely rare. This is the first report of leiomyosarcoma of the stomach treated by LECS. We could also follow its appearance change through endoscopic examination for 3 years.
The spin Hall effect, Dzyaloshinskii-Moriya interaction, Rashba effect, etc. are extremely important effects for the development of the conduction phenomenon of spin electronics due to the breaking ...of the spatial inversion symmetry of the hetero interface made of heavy metals such as Pt and W. These are due to SOI (spin-orbit interaction). Most of these studies have been conducted in the frequency domain below GHz, and there are few studies in the energy domain of light. Therefore, in the region of light energy, the magnetic optical Kerr effect spectra of the TbCo/Pt hetero-structured film with large SOI from the Pt interface and the TbCo/Cu hetero-structured film with small SOI from the Cu interface were measured, and the permittivity tensors were investigated respectively. As a result, in the TbCo/Pt hetero-structured film, the dielectric constant off-diagonal component real part of the thin TbCo layer increased about twice as much as that of bulk TbCo in the energy region smaller than 2.5 eV. However, this increase was not observed in the TbCo/Cu hetero-structured film. This result suggests that the influence of the Pt hetero interface where the spatial inversion symmetry is broken may appear even in the energy region of light. Furthermore, it has been confirmed that TbCo/W hetero-structured film using W with a large SOI has the same increasing effect as that of the TbCo/Pt.
Germanium (Ge) (111) fins of 320 nm in height were successfully fabricated using a combination of flattening sidewalls of a silicon (Si) fin structure by anisotropic wet etching with ...tetramethylammonium hydroxide, formation of thin Ge fins by selective Si oxidation in SiGe layers, and enlargement of Ge fins by Ge homogeneous epitaxial growth. The excellent electrical characteristics of Ge(111) fin light-emitting diodes, such as an ideality factor of 1.1 and low dark current density of 7.1 × 10−5 A cm−2 at reverse bias of −2 V, indicate their good crystalline quality. A tensile strain of 0.2% in the Ge fins, which originated from the mismatch of the thermal expansion coefficients between Ge and the covering SiO2 layers, was expected from the room-temperature photoluminescence spectra, and room-temperature electroluminescence corresponding to the direct band-gap transition was observed from the Ge fins.
Here we report first 2 cases of patients with nonvalvular atrial fibrillation with acute cardioembolic stroke in whom thrombi in the left atrial appendage (LAA) were resolved by edoxaban ...administration. Case 1 reports an 86-year-old woman who suddenly showed right hemiparesis and aphasia due to occlusion of the left middle cerebral artery. She received mechanical thrombectomy and recovered neurologically. Transesophageal echocardiography (TEE) performed on day 1 demonstrated thrombus in the LAA. The thrombus was resolved on day 13 after initiation of edoxaban (30 mg once daily) instead of warfarin, which was administered before stroke onset. Case 2 reports a 49-year-old man who was admitted because of the sudden onset of left hemiparesis and aphasia. TEE demonstrated thrombus in the LAA on day 4, and edoxaban therapy (60 mg once daily) was initiated. The thrombus resolution was observed on day 16, and no embolic stroke occurred.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Investigation of magnetic properties and nanostructure of stacked media with a CoPt-B2O3 granular recording layer (GRL) and granular cap layers (CL) with CoPt and a typical ferromagnetic oxide of ...rare earth (RE) oxide (RE oxide: Gd2O3, Nd2O3, Sm2O3, and CeO2) are reported. CoPt-RE oxide granular layer shows higher saturation magnetization and magnetic anisotropy than that of CoPtCrB continuous layer. In stacked media with CoPt-Gd2O3 granular CL (9 nm), nucleation field increases from 0.7 to 0.8 kOe and saturation field decreases from 21.5 to 12.5 kOe with comparable values to those of CoPtCrB continuous CL. This indicates that CoPt-RE oxide granular CL is effective to control intergranular exchange coupling. Reduction of coercivity distribution ratio (∆Hc/Hc) from 0.15 to 0.09 which is comparable to that of CoPtCrB continuous CL when CoPt-Gd2O3 granular CL thickness is changed from 4 to 9 nm is observed. This means CoPt-Gd2O3 granular CL is effective to reduce switching field distribution. Furthermore, significant reduction of surface roughness (Ra) for media with CoPt-Gd2O3 granular CL (9 nm) from 0.32 to 0.25 nm is observed. This reveals that CoPt-RE oxide granular CL has a great impact to induce stacked media with flat surface. Based on the cross-section observation by TEM, the media with CoPt-Gd2O3 granular CL shows continuous structure of grain boundaries from the GRL up to the CL and which results in one-on-one growth of magnetic grain with homogeneous columnar structure. Focusing on the surface morphology, media with CoPt-Gd2O3 granular CL shows smoother surface than that of media with CoPtCrB continuous CL which supports the Ra evaluation result. These results indicate that the employment of granular CoPt-RE oxide for CL is not only to reduce switching field distribution but also to flatten surface of the stacked media.
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