To evaluate whether tumor extracellular volume fraction (fECV) on contrast-enhanced computed tomography (CT) aids in the differentiation between intrahepatic cholangiocarcinoma (ICC) and ...hepatocellular carcinoma (HCC).
In this retrospective study, 113 patients with pathologically confirmed ICC (n = 39) or HCC (n = 74) who had undergone preoperative contrast-enhanced CT were enrolled. Enhancement values of the tumor (E
) and aorta (E
) were obtained in the precontrast and equilibrium phase CT images. fECV was calculated using the following equation: fECV % = E
/E
× (100 - hematocrit %). fECV values were compared between the ICC and HCC groups using Welch's
-test. The diagnostic performance of fECV for differentiating ICC and HCC was assessed using receiver-operating characteristic (ROC) analysis. fECV and the CT imaging features of tumors were evaluated by two radiologists. Multivariate logistic regression analysis was performed to identify factors predicting a diagnosis of ICC.
Mean fECV was significantly higher in ICCs (43.8% ± 13.2%) than that in HCCs (31.6% ± 9.0%, p < 0.001). The area under the curve for differentiating ICC from HCC was 0.763 when the cutoff value of fECV was 41.5%. The multivariate analysis identified fECV (unit OR: 1.10; 95% CI: 1.01-1.21; p < 0.05), peripheral rim enhancement during the arterial phase (OR: 17.0; 95% CI: 1.29-225; p < 0.05), and absence of washout pattern (OR: 235; 95% CI: 14.03-3933; p < 0.001) as independent CT features for differentiating between the two tumor types.
A high value of fECV, peripheral rim enhancement during the arterial phase, and absence of washout pattern were independent factors in the differentiation of ICC from HCC.
Recently, several studies have reported age-associated increases in muscle coactivation during postural control. A rigid posture induced by strong muscle coactivation reduces the degree of freedom to ...be organized by the postural control system. The purpose of this study was to clarify the effect of balance training on muscle coactivation during postural control in older adults.
Forty-eight subjects were randomized into an intervention (mean age: 81.0 ± 6.9 years) and a control group (mean age: 81.6 ± 6.4 years). The control group did not receive any intervention. Postural control ability (postural sway during quiet standing, functional reach, and functional stability boundary) was assessed before and after the intervention. A cocontraction index was measured during the postural control tasks to assess muscle coactivation.
Cocontraction index values in the intervention group significantly decreased following the intervention phase for functional reach (p < .0125). Cocontraction index values had a tendency to decrease during functional stability boundary for forward and quiet standing tasks. Functional improvements were observed in some of the tasks after the intervention, that is, functional reach, functional stability boundary for forward, one-leg stance, and timed up and go (p < .05).
Our study raised the possibility that balance training for older adults was associated with decreases in muscle coactivation during postural control. Postural control exercise could potentially lead older adults to develop more efficient postural control strategies without increasing muscle coactivation. Further research is needed to clarify in greater detail the effects of changes in muscle coactivation.
Impact of oesophagectomy on physical fitness and health‐related quality of life in patients with oesophageal cancer
Although several studies have reported the impact of oesophagectomy on ...health‐related quality of life (HRQOL), none has objectively assessed its impact on physical fitness. This study aimed to evaluate the impact of oesophagectomy on physical fitness and HRQOL in patients with oesophageal cancer. In this prospective study, we investigated 30 consecutive patients with newly diagnosed resectable oesophageal cancer who were scheduled to receive either neoadjuvant chemotherapy followed by surgery or surgery alone. The primary end‐points were change from baseline in two measures of physical fitness (knee‐extensor muscle strength and 6‐min walking distance) after oesophagectomy. The secondary end‐point was change from baseline in HRQOL measured with the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire with 30 items (EORTC QLQ‐C30). Physical fitness was significantly lower after oesophagectomy than before oesophagectomy (P < 0.001). With regard to HRQOL, there was a significant pre‐ to post‐oesophagectomy change in most of the scales. In the multiple regression analysis, the change in 6‐min walking distance was the only significant variable affecting the change in physical functional score on the EORTC QLQ‐C30 (P = 0.032). In conclusion, oesophagectomy adversely affects physical fitness and HRQOL in patients with oesophageal cancer. Six‐minute walking distance may be a good indicator of HRQOL shortly after oesophagectomy.
We are developing monolithic pixel sensors based on a 0.2μm fully depleted silicon-on-insulator (FD-SOI) technology for high-energy physics experiment applications. With this SOI technology, the ...wafer resistivities for the electronics and sensor parts can be chosen separately. Therefore, a device with full depletion and fast charge collection is realized. The total ionizing dose (TID) effect is the major challenge for application in hard radiation environments. To compensate for TID damage, we introduced a double SOI structure that implements an additional middle silicon layer (SOI2 layer). Applying a negative voltage to the SOI2 layer should compensate for the effects induced by holes trapped in the buried oxide layers. We studied the recovery from TID damage induced by 60Co γ and other characteristics of the integration-type double SOI sensor INTPIXh2. When the double SOI sensor was irradiated to 100kGy, it showed a response to the infrared laser similar to that of a non-irradiated sensor when we applied a negative voltage to the SOI2 layer. Thus, we concluded that the double SOI sensor is very effective at sufficiently enhancing the radiation hardness for application in experiments with harsh radiation environments, such as at Belle II or ILC.
We have developed monolithic CMOS pixel sensor using fully-depleted (FD) silicon-on-insulator (SOI) pixel process technology. The SOI substrates consist of high-resistivity silicon with p-n junctions ...and low-resistivity silicon layers for forming SOI-CMOS circuitry. Tungsten vias are used to make connections between p-n junctions in the silicon substrate and the first metal layers in the top-layer circuitry. Using this sensor construction, high sensor gain in small pixel areas can be achieved. In 2014, a high-resolution, integrated SOI pixel sensor, called INTPIX8, was developed with two types of substrates: a float-zone, p-type layer on a single SOI (SSOI) wafer and a Czochralski, p-type layer on a double SOI (DSOI) wafer. The X-ray spectra were obtained using Am-241 radiation source. The SSOI-based and DSOI-based sensors exhibited different levels of sensor gain and there were no large differences in the noise levels between them.
A Silicon-On-Insulator (SOI) Technology is suitable for vertex detectors for high energy physics experiments since complex functions can be fabricated on the SOI wafer with a small amount of material ...thanks to the monolithic structure. We developed a new sensor processing scheme “PIXOR(PIXel OR)” for pixel detectors using a LAPIS 0.20μm SOI process.
An analog signal from each pixelated sensor is divided into two dimensional directions, and 2n signal channels from a small n by n pixel matrix are ORed as n column and n row channels, then the signals are processed by a readout circuit in each small matrix. This PIXOR scheme reduces the number of readout channels and avoids a deterioration of intrinsic position resolution due to large circuit area, that was a common issue for monolithic detectors. This feature allows high resolution, low occupancy and on-sensor signal processing at the same time. We present the successful results of the PIXOR readout scheme using a first prototype.
•We develop SOI pixel detector to apply for a vertex detector in high energy experiments.•The new readout scheme, Pixel OR(PIXOR), allows high resolution and low occupancy at the same time.•The PIXOR readout scheme works well through the evaluation of the protype PIXOR1.•The digital circuit for the trigger processing works well through the evaluation.
Abstract Objectives To investigate the prevalence of fear of falling, and identify factors associated with fear of falling during activities of daily living after total hip arthroplasty (THA). Design ...Cross-sectional study. Setting Community. Participants Two hundred and fourteen women who had undergone THA. Main outcome measures Fear of falling after THA was assessed for 12 activities of daily living using a fear of falling score. The number of falls in the past year, total Oxford Hip Score (OHS), total Penn State Worry Questionnaire (PSWQ) score and walking capacity were recorded as descriptive statistics. Multiple linear regression analysis was performed, with total fear of falling score as the dependent variable and age, body mass index, time since THA, bilateral THA, total OHS, history of falling, walking capacity and total PSWQ score as the independent variables. Results A number of participants (mean age = 64.2) experienced fear of falling while ascending and descending stairs: 45% (97/214), taking a bath: 26% (56/214), bending to pick something up off the floor: 26% (55/214), and getting up from lying on the floor: 25% (54/214). Fear of falling during activities of daily living after THA was significantly correlated with total OHS, history of falling, walking capacity, total PSWQ score and age ( P < 0.05). Conclusions Fear of falling develops in certain activities of daily living after THA. It is associated with poorer functional outcome, history of falling, lower walking capacity, higher anxiety level and older age.
Summary
Background
Severe adverse drug reactions in response to intravascular contrast media used in computed tomography, although rare, are potentially life-threatening. This retrospective cohort ...study aimed to estimate the incidence rate of severe adverse drug reactions to nonionic contrast media at the National Hospital Organization Osaka National Hospital and to report individually on each fatality.
Methods
In total, 42,501 relevant cases were obtained from the individual case safe reports of the Ministry of Health, Labour and Welfare and the reports of code blue from our hospital database for the period of January 2013 to December 2017. The cases were studied, and the rate of adverse drug reactions was calculated from these data.
Results
Severe adverse drug reactions occurred in 0.019% (8/42,501) of the patients, including two deaths. All eight of these patients presented with disturbance of consciousness. Additionally, one patient had dyspnea, five had distributive shock that recovered after treatment, and two died. However, a causal relationship to the contrast media could not be established in one death. When examining the medical histories, four patients were found to have renal dysfunction.
Discussion
Although the rate of severe adverse drug reactions in this study appears to be higher than expected, the sample size of 42,501 patients is insufficient to conclusively determine the incidence and mortality rates of adverse drug reactions, as these rates are extremely low. Further studies are required to estimate the countrywide prevalence of adverse drug reactions in response to contrast media.
Double silicon-on-insulator (DSOI) sensors composed of two thin silicon layers and one thick silicon layer have been developed since 2011. The thick substrate consists of high resistivity silicon ...with p-n junctions while the thin layers are used as SOI-CMOS circuitry and as shielding to reduce the back-gate effect and crosstalk between the sensor and the circuitry. In 2014, a high-resolution integration-type pixel sensor, INTPIX8, was developed based on the DSOI concept. This device is fabricated using a Czochralski p-type (Cz-p) substrate in contrast to a single SOI (SSOI) device having a single thin silicon layer and a Float Zone p-type (FZ-p) substrate. In the present work, X-ray spectra of both DSOI and SSOI sensors were obtained using an Am-241 radiation source at four gain settings. The gain of the DSOI sensor was found to be approximately three times that of the SSOI device because the coupling capacitance is reduced by the DSOI structure. An X-ray imaging demonstration was also performed and high spatial resolution X-ray images were obtained.
We are developing a method for removing holes trapped in the oxide layer of a silicon-on-insulator (SOI) monolithic pixel detector after irradiation. Radiation that passes through the detector ...generates positive charge by trapped holes in the buried oxide layer (BOX) underneath the MOSFET. The positive potential caused by these trapped holes modifies the characteristics of the MOSFET of the signal readout circuit. In order to compensate for the effect of the positive potential, we tried to recombine the trapped holes with electrons via Fowler–Nordheim (FN) tunneling. By applying high voltage to the buried p-well (BPW) under the oxide layer with the MOSFET fixed at 0V, electrons are injected into the BOX by FN tunneling. X-rays cause a negative shift in the threshold voltage Vth of the MOSFET. We can successfully recover Vth close to its pre-irradiation level after applying VBPW≥120V. However, the drain leakage current increased after applying VBPW; we find that this can be suppressed by applying a negative voltage to the BPW.
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