This paper presents a high-precision and high-yield nanotemplate-guided self-assembly process for spherical gold nanoparticles. This process enables us to arrange particles in designated patterns on ...a substrate with nanotemplates. These particles are trapped on the nanotemplate by liquid-air interfacial force during drying of the colloidal solution. In this method, particle concentration and electrostatic interaction between particles have a considerable effect on the assembly yield. The particle concentration should be optimized based on the template pattern. A nanogap-controlled particle arrangement with a high yield is achieved by controlling the electrostatic interaction, which is accomplished by adding an electrolyte. This technique enables control of the plasmonic resonance properties of metal nanoparticles on substrates for many emerging applications. Among them, this paper discusses the application of nanotemplate-guided self-assembly to an ultrasensitive nanostructure for surface-enhanced Raman spectroscopy. The gold nanoparticle dimer, which has been reported as the highest Raman enhancing structure, is directionally arrayed on a substrate. The highest enhancement can be achieved when the direction of a particle connection for a dimer is matched to the polarization direction of incident light. A considerable enhancement can be achieved at all dimers. The fabricated structures are evaluated by focusing on the polarization angle. The 10
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-M limit of detection and a 0.05-s rapid detection are achieved by using 4,4-bipyridine molecules with single-molecule sensitivity.
Although currently many advanced colorectal cancer patients continuously receive chemotherapy, there are very few findings with regard to the supportive care needs of such patients.
The purposes of ...this study were to investigate the patients' perceived needs and the association with psychological distress and/or quality of life, and to clarify the characteristics of patients with a high degree of unmet needs. Ambulatory colorectal cancer patients who were receiving chemotherapy were asked to complete the Short-Form Supportive Care Needs Survey questionnaire, which covers five domains of need (health system and information, psychological, physical, care and support, and sexuality needs), the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.
Complete data were available for 100 patients. Almost all of the top 10 most common unmet needs belonged to the psychological domain. The patients' total needs were significantly associated with both psychological distress (r = 0.65, P < 0.001) and quality of life (r = -0.38, P < 0.001). A multiple regression analysis revealed that the female gender was significantly associated with higher total needs.
The moderate to strong associations that exist between patients' needs and psychological distress and/or quality of life suggest that interventions that respond to patients' needs may be one possible strategy for ameliorating psychological distress and enhancing quality of life. Female patients' needs should be evaluated more carefully.
A 53-year-old man with chronic dyspnea and bilateral pleural effusion was subsequently diagnosed with idiopathic chylothorax. Lymphatic scintigraphy confirmed lymphatic fluid leakage at the left ...venous angle, prompting management with lymphaticovenular anastomosis (LVA). Although the left pleural effusion was controlled, the right pleural effusion continued to increase, resulting in bilateral leg lymphedema that was refractory to LVA. Approximately three years and three months after the presentation, the patient succumbed to CO2 narcosis and renal failure. It is crucial to study additional cases in order to uncover new causes and develop pathology-based treatments for this condition.
Abstract
Objective
the role of benzodiazepines in relieving dyspnea in patients with cancer has not yet been established. This systematic review and meta-analysis aimed to determine the efficacy and ...safety of benzodiazepines alone or in combination with opioids for dyspnea in patients with cancer.
Methods
Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and Ichushi-Web were searched for articles published from database inception to 23 September 2019. Studies of benzodiazepines alone or in combination with opioids for dyspnea were included. The primary outcome measure was the relief of dyspnea. The secondary outcome measures were anxiety, somnolence and severe adverse events.
Results
of 505 publications initially identified, two trials and one trial were included in the meta-analysis of midazolam alone and in combination with morphine, respectively. With regard to the relief of dyspnea, midazolam alone showed no significant difference compared with morphine alone, with a relative risk of 0.95 (95% confidence interval: 0.47–1.89). Meanwhile, midazolam plus morphine was significantly more effective than morphine alone, with a relative risk of 1.33 (95% confidence interval: 1.02–1.75). For anxiety relief, a meta-analysis could not be performed because of insufficient data. The incidence of somnolence and severe adverse events was not significantly different between the experimental and control groups for either midazolam alone or in combination with morphine.
Conclusions
benzodiazepines alone do not significantly improve dyspnea compared with opioids alone, but a combination of benzodiazepines and opioids may be more effective. Evidence from randomized controlled trials focusing on patients with cancer has not been generated in recent years. Further appropriately designed randomized controlled trials are required.
The current systematic review did not demonstrate the efficacy of benzodiazepines alone for dyspnea in patients with cancer. However, an additive effect was suggested when used in combination with opioids.
The Japanese Psycho-Oncology Society and Japanese Association of Supportive Care in Cancer recently launched the clinical practice guidelines for delirium in adult cancer patients. The aim of the ...guidelines was to provide evidence-based recommendations for the clinical assessment and management of delirium in cancer patients. This article reports the process of developing the guideline and summarizes the recommendations made.
The guidelines were developed in accordance with the Medical Information Network Distribution Service creation procedures. The guideline development group, consisting of multidisciplinary members, formulated nine clinical questions. A systematic literature search was conducted to identify relevant articles published prior to through 31 May 2016. Each article was reviewed by two independent reviewers. The level of evidence and the strength of the recommendations were graded using the grading system developed by the Medical Information Network Distribution Service, following the concept of The Grading of Recommendations Assessment, Development and Evaluation system. The modified Delphi method was used to validate the recommendation statements.
This article provides a summary of the recommendations with rationales for each, as well as a short summary.
These guidelines will support the clinical assessment and management of delirium in cancer patients. However, additional clinical studies are warranted to further improve the management of delirium.
A microelectromechanical systems (MEMS) optical chopper with a silicon-on-glass structure has been developed for time-resolved micro-Raman stress measurements of single-crystal silicon resonators. ...The chopper was inserted directly into the optics of a commercial micro-Raman spectrometer to modulate the incident laser light. The slit portion of the chopper (<inline-formula> <tex-math notation="LaTeX">\varnothing 500\,\,\mu \text{m} </tex-math></inline-formula>) was actuated by electrostatic force using slanted parallel plate capacitors. The chopper was fabricated in a 15-<inline-formula> <tex-math notation="LaTeX">\mu \text{m} </tex-math></inline-formula>-thick silicon layer on a 600-<inline-formula> <tex-math notation="LaTeX">\mu \text{m} </tex-math></inline-formula>-thick glass substrate on which aluminum shutters were formed. The stopper structure and pull-in driving realized low-voltage operation at 12 V and a quick mechanical response time of 77 <inline-formula> <tex-math notation="LaTeX">\mu \text{s} </tex-math></inline-formula>. The modulation of incident light for measuring an out-of-plane silicon resonator made from a silicon-on-insulator wafer resonated at 1 kHz, and a 10% duty cycle and an extinction ratio of 31 were achieved. The dynamic stress was measured and its amplitude (303 MPa) was found to be in good agreement with the results of finite-element analysis. 2015-0159
This paper reports on a novel and simple 3-D fabrication technique of microstructures embedded in a single-layer negative resist. The proposed technique allows one the fabrication of an embedded ...microstructure with a single exposure and the subsequent development process. The unique feature of the proposed fabrication technique is the development method which enables the rapid fabrication of polymer-based microfluidic systems with relatively large areas but with micrometer-sized features. For example, features of microchannels, on the order of 100 m in width and 50 mm in length, sufficient for microfluidic systems, were successfully fabricated with a relatively short (<; 20 min) development time. These features are realized by the interesting physical response of the top-membrane to the developer; the developer permeates through the top-membrane region made of semi-cross-linked photoresist, and the permeated developer dissolves the uncross-linked photoresist at the same time. As a step toward the practical use of the proposed development method, process parameter sets (exposure dose, postexposure bake (PEB) time, and temperature) related to the cross-linking reaction of the top-membrane region were investigated by employing the cross-linking reaction model describing the chemical reaction during the UV exposure and the PEB. Through a series of experiments, 1) a criterion of process parameter sets for the fabrication of centimeter-long embedded microchannels was obtained, and 2) the applicability to polymer-based microfluidic systems was successfully demonstrated.
This study aims to explore the characteristics of a good death for children with cancer.
A total of 10 pediatric cancer survivors, 10 bereaved family members and 20 medical professionals participated ...in in-depth interviews. Qualitative content analysis was performed on the transcribed data obtained from semi-structured interviews.
Thirteen characteristics including unique and specific for children of a good death were identified: (i) sufficient opportunities to play freely, (ii) peer supporters, (iii) continued access to the patient's usual activities and relationships, (iv) assurance of privacy, (v) respect for the patient's decisions and preferences, (vi) a sense that others acknowledge and respect the patient's childhood, (vii) comfort care to minimize distressing symptoms, (viii) hope, (ix) not aware of the patient's own impending death, (x) constant dignity, (xi) strong family relationships, (xii) no sense of being a burden to family members and (xiii) good relationships with medical staffs.
This study identifies important characteristics of a good death for children with cancer. These findings may help medical staffs provide optimal care for children with cancer and their families, enabling them to achieve a good death.
The mechanical properties of an epoxy-based chemically amplified resists with various cross-linking ratios were simulated using a newly developed coarse-grained molecular dynamics simulation that ...employs a bead–spring model. Models with the different cross-linking ratios were created in the molecular dynamics calculation step and uniaxial elongation simulations were performed. The results reveal that the simulated elastic modulus of the resist modeled by the Kremer–Grest model with an extended angle bending potential depends on the cross-linking ratio, its dependency exhibits good agreement with that determined by nanoindentation tests.
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Decision-making capacity to provide informed consent regarding treatment is essential among cancer patients. The purpose of this study was to identify the frequency of decision-making incapacity ...among newly diagnosed older patients with hematological malignancy receiving first-line chemotherapy, to examine factors associated with incapacity and assess physicians' perceptions of patients' decision-making incapacity.
Consecutive patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Decision-making capacity was assessed using the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory-Revised (SICIATRI-R). Cognitive impairment, depressive condition and other possible associated factors were also evaluated.
Among 139 eligible patients registered for this study, 114 completed the survey. Of these, 28 (25%, 95% confidence interval CI: 17%-32%) were judged as having some extent of decision-making incompetency according to SICIATRI-R. Higher levels of cognitive impairment and increasing age were significantly associated with decision-making incapacity. Physicians experienced difficulty performing competency assessment (Cohen's kappa -0.54).
Decision-making incapacity was found to be a common and under-recognized problem in older patients with cancer. Age and assessment of cognitive impairment may provide the opportunity to find patients that are at a high risk of showing decision-making incapacity.
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