Dynamic liver volume change in predicting hepatic decompensation and long-term effects of stereotactic body radiation therapy.

BACKGROUND AND AIM: This study aimed to investigate the association between liver volume change and hepatic decompensation and compare the risk of hepatic decompensation in patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC) who underwent stereotactic body radiation therapy (SBRT). METHODS: A retrospective review of SBRT-treated HCC and compensated LC without HCC patients was conducted. Liver volume was measured using auto-segmentation software on liver dynamic computed tomography scans. The decompensation event was defined as the first occurrence of refractory ascites, esophageal variceal bleeding, hepatic encephalopathy, or spontaneous bacterial peritonitis. We evaluated the association between the rate of liver volume decrease and hepatic decompensation and compared decompensation events between the SBRT and LC cohorts using propensity score matching. RESULTS: A total of 138 patients from the SBRT cohort and 488 from the LC cohort were analyzed. The rate of liver volume decrease was associated with the risk of decompensation events in both cohorts. The 3-year rate of decompensation events was significantly higher in the group with a liver volume decreasing rate > 7%/year compared with the group with a rate < 7%/year. In the propensity score-matched cohort, the 3-year rate of decompensation events after a single session of SBRT was not significantly different from that in the LC cohort. CONCLUSIONS: The rate of liver volume decrease was significantly associated with the risk of hepatic decompensation in both HCC patients who received SBRT and LC patients. A single session of SBRT for HCC did not result in a higher decompensation rate compared with LC.

Application of surface-guided radiation therapy in prostate cancer: comparative analysis of differences with skin marking-guided patient setup.

PURPOSE: Surface-guided radiation therapy is an image-guided method using optical surface imaging that has recently been adopted for patient setup and motion monitoring during treatment. We aimed to determine whether the surface guide setup is accurate and efficient compared to the skin-marking guide in prostate cancer treatment. MATERIALS AND METHODS: The skin-marking setup was performed, and vertical, longitudinal, and lateral couch values (labeled as "M") were recorded. Subsequently, the surface-guided setup was conducted, and couch values (labeled as "S") were recorded. After performing cone-beam computed tomography (CBCT), the final couch values was recorded (labeled as "C"), and the shift value was calculated (labeled as "Gap (M-S)," "Gap (M-C)," "Gap (S-C)") and then compared. Additionally, the setup times for the skin marking and surface guides were also compared. RESULTS: One hundred and twenty-five patients were analyzed, totaling 2,735 treatment fractions. Gap (M-S) showed minimal differences in the vertical, longitudinal, and lateral averages (-0.03 cm, 0.07 cm, and 0.06 cm, respectively). Gap (M-C) and Gap (S-C) exhibited a mean difference of 0.04 cm (p = 0.03) in the vertical direction, a mean difference of 0.35 cm (p = 0.52) in the longitudinal direction, and a mean difference of 0.11 cm (p = 0.91) in the lateral direction. There was no correlation between shift values and patient characteristics. The average setup time of the skin-marking guide was 6.72 minutes, and 7.53 minutes for the surface guide. CONCLUSION: There was no statistically significant difference between the surface and skin-marking guides regarding final CBCT shift values and no correlation between translational shift values and patient characteristics. We also observed minimal difference in setup time between the two methods. Therefore, the surface guide can be considered an accurate and time-efficient alternative to skin-marking guides.

Outcome of dose-escalated intensity-modulated radiotherapy for limited disease small cell lung cancer.

PURPOSE: An optimal once-daily radiotherapy (RT) regimen is under investigation for definitive concurrent chemoradiotherapy (CCRT) in limited disease small cell lung cancer (LD-SCLC). We compared the efficacy and safety of dose escalation with intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS: Between January 2016 and March 2021, patients treated with definitive CCRT for LD-SCLC with IMRT were retrospectively reviewed. Patients who received a total dose <50 Gy or those with a history of thoracic RT or surgery were excluded. The patients were divided into two groups (standard and dose-escalated) based on the total biologically effective dose (BED, α/ß = 10) of 70 Gy. The chemotherapeutic regimen comprised four cycles of etoposide and cisplatin. RESULTS: One hundred and twenty-two patients were analyzed and the median follow-up was 27.8 months (range, 4.4 to 76.9 months). The median age of the patients was 63 years (range, 35 to 78 years) and the majority had a history of smoking (86.0%). The 1- and 3-year overall survival rates of the escalated dose group were significantly higher than those of the standard group (93.5% and 50.5% vs. 76.7% and 33.3%, respectively; p = 0.008), as were the 1- and 3-year freedom from in-field failure rates (91.4% and 66.5% vs. 73.8% and 46.9%, respectively; p = 0.018). The incidence of grade 2 or higher acute and late pneumonitis was not significantly different between the two groups (p = 0.062, 0.185). CONCLUSION: Dose-escalated once-daily CCRT with IMRT led to improved locoregional control and survival, with no increase in toxicity.

Large-Scale Complementary Logic Circuit Enabled by Al2O3 Passivation-Induced Carrier Polarity Modulation in Tungsten Diselenide.

Achieving effective polarity control of n- and p-type transistors based on two-dimensional (2D) materials is a critical challenge in the process of integrating transition metal dichalcogenides (TMDC) into complementary metal-oxide semiconductor (CMOS) logic circuits. Herein, we utilized a proficient and nondestructive method of electron-charge transfer to achieve a complete carrier polarity conversion from p-to n-type by depositing a thin layer of aluminum oxide (Al2O3) onto tungsten diselenide (WSe2). By utilizing the Al2O3 passivation layer, we observed precisely tuned n-type behavior in contrast to transistors fabricated on the as-grown WSe2 film without any passivation layer, which display prominent p-type behavior. The polarity-transformed n-type WSe2 transistor from the pristine p-type shows the maximum ON current of ∼0.1 µA accompanied by a high electron mobility of 7 cm2 V-1 s-1 at a drain voltage (VDS) of 1 V. We successfully showcased a homogeneous CMOS inverter utilizing 2D-TMDC which exhibits an impressive voltage gain of 7 at VDD = 5 V. Moreover, this effective polarity control approach was further expanded upon to successfully demonstrate a range of logic circuits such as AND, OR, NAND, NOR logic gates, and SRAM. The proposed methodology possesses significant promise for facilitating the advancement of high-density circuitry components utilizing 2D-TMDC.

Doping-Free All PtSe2 Transistor via Thickness-Modulated Phase Transition.

Achieving a high-quality metal contact on two-dimensional (2D) semiconductors still remains a major challenge due to the strong Fermi level pinning and the absence of an effective doping method. Here, we demonstrate high performance "all-PtSe2" field-effect transistors (FETs) completely free from those issues, enabled by the vertical integration of a metallic thick PtSe2 source/drain onto the semiconducting ultrathin PtSe2 channel. Owing to its inherent thickness-dependent semiconductor-to-metal phase transition, the transferred metallic PtSe2 transforms the underlying semiconducting PtSe2 into metal at the junction. Therefore, a fully metallized source/drain and semiconducting channel could be realized within the same PtSe2 platform. The ultrathin PtSe2 FETs with PtSe2 vdW contact exhibits excellent gate tunability, superior mobility, and high ON current accompanied by one order lower contact resistance compared to conventional Ti/Au contact FETs. Our work provides a new device paradigm with a low resistance PtSe2 vdW contact which can overcome a fundamental bottleneck in 2D nanoelectronics.

Intrinsic limit of contact resistance in the lateral heterostructure of metallic and semiconducting PtSe2.

High contact resistance (Rc) limits the ultimate potential of two-dimensional (2-D) materials for future devices. To resolve the Rc problem, forming metallic 1T phase MoS2 locally in the semiconducting 2H phase MoS2 has been successfully demonstrated to use the 1T phase as source/drain electrodes in field effect transistors (FETs). However, the long-term stability of the 1T phase MoS2 still remains as an issue. Recently, an unusual thickness-modulated phase transition from semiconducting to metallic has been experimentally observed in 2-D material PtSe2. Metallic multilayer PtSe2 and semiconducting monolayer PtSe2 can be used as source/drain electrodes and channel, respectively, in FETs. Here, we present a theoretical study on the intrinsic lower limit of Rc in the metallic-semiconducting PtSe2 heterostructure through density functional theory (DFT) combined with non-equilibrium Green's function (NEGF). Compared with Rc in the 1T-2H MoS2 heterostructure, the multilayer-monolayer PtSe2 heterostructure can offer much lower Rc due to the better capability of providing more transmission modes.

Cardiovascular Protective Effects and Clinical Applications of Resveratrol.

Resveratrol is a naturally occurring phenol that is generated by plant species following injury or attack by bacterial and fungal pathogens. This compound was first described as the French Paradox in 1992. Later in 2003, resveratrol was reported to activate sirtuins in yeast cells. Recent experimental studies have found that resveratrol offers a variety of benefits that include both anticarcinogenic and anti-inflammatory effects in addition to the ability to reverse obesity, attenuate hyperglycemia and hyperinsulinemia, protect heart and endothelial function, and increase the life span. Multiple molecular targets are associated with the cardioprotective capabilities of resveratrol, and therefore, resveratrol has potential for a wide range of new therapeutic strategies for atherosclerosis, ischemia/reperfusion, metabolic syndrome, cardiac failure, and inflammatory alterations during aging. Expectations for application in human patients, however, suffer from a lack of sufficient clinical evidence in support of these beneficial effects. This article reviews recently reported basic research results that describe the beneficial effects of resveratrol in an attempt to condense the evidence observed in clinical trials and provide support for the future development of novel clinical therapeutics in patients with cardiovascular diseases.