The Nerve/Tunnel Index: A New Diagnostic Standard for Carpal Tunnel Syndrome Using Sonography

Objectives—To define the relationship between body indices of healthy adults and cross-sectional areas of the carpal tunnel and median nerve and to obtain the nerve/tunnel index, which represents a new standard for diagnosing carpal tunnel syndrome using sonography. Methods—Body indices (height, weight, and body mass index) were analyzed in 60 healthy adults, and electromyography and sonography were also performed. The crosssectional areas of the proximal and distal median nerve and carpal tunnel were obtained by sonography. The proximal and distal nerve/tunnel indices were obtained by calculating the ratio between the proximal and distal cross-sectional areas of the median nerve to those of the carpal tunnel and multiplying the value by 100. Results—Although the proximal cross-sectional areas of the median nerve and body indices showed statistically significant relationships with weak positive correlations, the proximal and distal areas of the carpal tunnel showed relatively stronger correlations with body indices. Between sexes, there were significant differences in the proximal median nerve cross-sectional area (mean ± SD: male, 10.48 ± 3.21 mm2; female, 8.81 ± 3.21 mm2; P < .05) and proximal carpal tunnel area (male, 182.50 ± 21.15 mm2; female, 151.23 ± 21.14 mm2; P < .05). There was no difference in the proximal nerve/tunnel index (male, 5.80% ± 1.72%; female, 5.91% ± 1.63%). There was a statistically significant difference in the distal carpal tunnel cross-sectional area (male, 138.90 ± 20.95 mm2; female, 121.50 ± 18.99 mm2; P < .05) between sexes, but the distal median area (male, 9.99 ± 3.42 mm2; female, 8.46 ± 1.84 mm2) and distal nerve/tunnel index (male, 7.15% ± 2.00%; female, 7.01% ± 1.38%) showed no significant differences. The proximal index was significantly higher than the distal index (proximal, 5.85% ± 1.66%; distal, 7.08% ± 1.71%). Conclusions—The nerve/tunnel index is unaffected by body indices or sex and thus may be a useful and objective standard for diagnosing carpal tunnel syndrome

Detection of Acidic Pharmaceutical Compounds Using Virus-Based Molecularly Imprinted Polymers

Molecularly imprinted polymers (MIPs) have proven to be particularly effective chemical probes for the molecular recognition of proteins, DNA, and viruses. Here, we started from a filamentous bacteriophage to synthesize a multi-functionalized MIP for detecting the acidic pharmaceutic clofibric acid (CA) as a chemical pollutant. Adsorption and quartz crystal microbalance with dissipation monitoring experiments showed that the phage-functionalized MIP had a good binding affinity for CA, compared with the non-imprinted polymer and MIP. In addition, the reusability of the phage-functionalized MIP was demonstrated for at least five repeated cycles, without significant loss in the binding activity. The results indicate that the exposed amino acids of the phage, together with the polymer matrix, create functional binding cavities that provide higher affinity to acidic pharmaceutical compounds

Contact holes in vertical electrode structures analyzed by voltage contrast-SEM and conducting AFM

Soaring demands of multi-stacked memory devices request urgent development of backside contact electrode technologies, such as high aspect ratio etching, metallization, and inspection methods. Especially the complex metal contact process should be monitored for each manufacturing step to filter the defective samples and to maintain the high yield of production. Among the inspection methods for detecting the electrical connections, there is voltage contrast (VC)-SEM and conducting AFM (C-AFM). In this report, we investigated the two inspection methods for testing designed samples with different contact hole states. The VC-SEM data shows the contrast variation at the contact holes, from which one may discern the contact status with an optimum voltage. The C-AFM results clearly demonstrate a finite electrical current in the connected contact, while a negligible current in the disconnected one. Finally, we discuss insights of using the two methods for analyzing the contact hole technologies with high aspect ratios.Comment: 17 pages, 4 figure

A Passivity-based Nonlinear Admittance Control with Application to Powered Upper-limb Control under Unknown Environmental Interactions

This paper presents an admittance controller based on the passivity theory for a powered upper-limb exoskeleton robot which is governed by the nonlinear equation of motion. Passivity allows us to include a human operator and environmental interaction in the control loop. The robot interacts with the human operator via F/T sensor and interacts with the environment mainly via end-effectors. Although the environmental interaction cannot be detected by any sensors (hence unknown), passivity allows us to have natural interaction. An analysis shows that the behavior of the actual system mimics that of a nominal model as the control gain goes to infinity, which implies that the proposed approach is an admittance controller. However, because the control gain cannot grow infinitely in practice, the performance limitation according to the achievable control gain is also analyzed. The result of this analysis indicates that the performance in the sense of infinite norm increases linearly with the control gain. In the experiments, the proposed properties were verified using 1 degree-of-freedom testbench, and an actual powered upper-limb exoskeleton was used to lift and maneuver the unknown payload.Comment: Accepted in IEEE/ASME Transactions on Mechatronics (T-MECH

Recent Advances in Adjuvant Therapy for Non–Small-Cell Lung Cancer

After the successful development of targeted therapy and immunotherapy for the treatment of advanced-stage non-small cell lung cancer (NSCLC), these innovative treatment options are rapidly being applied in the adjuvant setting for early-stage NSCLC. Some adjuvants that have recently been approved include osimertinib for epidermal growth factor receptor-mutated tumors and atezolizumab and pembrolizumab for selected patients with resectable NSCLC. Numerous studies on various targeted therapies and immunotherapy with or without chemotherapy are currently ongoing in the adjuvant setting. However, several questions regarding optimal strategies for adjuvant treatment remain unanswered. The present review summarizes the available literature, focusing on recent advances and ongoing trials with targeted therapy and immunotherapy in the adjuvant treatment of early-stage NSCLC

A high degree of knee flexion after TKA promotes the ability to perform high-flexion activities and patient satisfaction in Asian population

Background This study investigated whether achieving a higher degree of knee flexion after TKA promoted the ability to perform high-flexion activities, as well as patient satisfaction and quality of life. Methods Clinical data on 912 consecutive primary TKA cases involving a single high-flexion posterior stabilized fixed-bearing prosthesis were retrospectively analyzed. Demographic and clinical data were collected, including knee flexion angle, the ability to perform high-flexion activities, and patient satisfaction and quality of life. Results Of the cases, 619 (68%) achieved > 130° of knee flexion after TKA (high flexion group). Knee flexion angle and clinical scores showed significant annual changes, with the maximum improvement seen at 5 years and slight deterioration observed at 10 years postoperatively. In the high flexion group, more than 50% of the patients could not kneel or squat, and 35% could not stand up from on the floor. Multivariate analysis revealed that > 130° of knee flexion, the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient satisfaction after TKA, while the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient quality of life after TKA. Conclusions High knee flexion angle (> 130°) after TKA increased the ease of high-flexion activities and patient satisfaction. The ease of high-flexion activities also increased quality of life after TKA in our Asian patients, who frequently engage in these activities in daily life

A multicenter phase II study of everolimus in patients with progressive unresectable adenoid cystic carcinoma

BACKGROUND: The aim of this study was to examine the efficacy and safety of everolimus in patients with progressive unresectable adenoid cystic carcinoma (ACC). METHODS: Histologically confirmed ACC patients with documented disease progression within 12 months prior to the study entry were eligible. Everolimus was given at a dose of 10 mg daily until progression or occurrence of unacceptable toxicities. The primary endpoint was a 4-month progression-free survival (PFS). RESULTS: A total of 34 patients were enrolled. The 4-month PFS probability was 65.5% (95% one-sided confidence interval [CI], 47.7 to infinity). Median PFS duration was 11.2 months (95% CI, 3.6 to 15.8). Complete or partial response was not achieved. Twenty-seven (79.4%, 95% CI, 63.2 to 89.6) patients showed stable disease (SD). Tumor shrinkage within SD criteria was observed in 15 patients (44.1%) and SD lasting 6 months was observed in 13 patients (38.2%). Four patients had disease progression. Among the 18 patients with both pre- and post-treatment (at 8 weeks) FDG-PET scans available, 8 patients (44.4%) showed a partial metabolic response, defined as a ≥25% reduction in maximum standardized uptake values (SUVmax). The most common adverse events were stomatitis, anemia, asthenia, and leukopenia. No unexpected everolimus related toxicities were reported. CONCLUSIONS: Everolimus showed promising efficacy and good tolerability in progressive unresectable ACC. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT0115284

Sign-tunable anomalous Hall effect induced by two-dimensional symmetry-protected nodal structures in ferromagnetic perovskite oxide thin films

Magnetism and spin-orbit coupling (SOC) are two quintessential ingredients underlying novel topological transport phenomena in itinerant ferromagnets. When spin-polarized bands support nodal points/lines with band degeneracy that can be lifted by SOC, the nodal structures become a source of Berry curvature; this leads to a large anomalous Hall effect (AHE). Contrary to three-dimensional systems that naturally host nodal points/lines, two-dimensional (2D) systems can possess stable nodal structures only when proper crystalline symmetry exists. Here we show that 2D spin-polarized band structures of perovskite oxides generally support symmetry-protected nodal lines and points that govern both the sign and the magnitude of the AHE. To demonstrate this, we performed angle-resolved photoemission studies of ultrathin films of SrRuO$_3$, a representative metallic ferromagnet with SOC. We show that the sign-changing AHE upon variation in the film thickness, magnetization, and chemical potential can be well explained by theoretical models. Our study is the first to directly characterize the topological band structure of 2D spin-polarized bands and the corresponding AHE, which could facilitate new switchable devices based on ferromagnetic ultrathin films