Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature

AIMS: To describe the currently available evidence regarding the efficacy and safety of preoperative tumor marking using indocyanine green (ICG) prior to laparoscopic or robotic colorectal resections. METHODS: A systematic search for relevant studies was conducted using the following databases: Embase (OVID), MEDLINE® (OVID), APA PsycInfo (OVID), Global Health (OVID) and HMIC Health Management Information Consortium (OVID) through June 2022 reported according to PRISMA 2020 guidelines. Primary outcome was the detection rate of the tumor sites preoperatively marked with ICG. Secondary outcomes were timing of ICG injection in days prior to the operation and technique-related complications. RESULTS: Eight single center studies, published between 2008 and 2022, were identified yielding a total of 1,061 patients, of whom 696 were preoperatively tattooed with ICG. Injection dosage of diluted ICG ranged from 0.1–1.5 ml. Four studies used the saline test injection method prior to ICG injection. When the marking was placed within one week, the visualization rate was 650/668 (97%), whereas when it was longer than one week, the detection rate was 8/56 (14%). No severe complications were reported. CONCLUSION: Preoperative tumor marking using ICG prior to minimally invasive colorectal resections is safe and effective, allowing intraoperative tumor site location when performed up to a week prior to surgery without disturbing the surgical view in potential mild complications

Performance of a novel wafer scale CMOS active pixel sensor for bio-medical imaging

Recently CMOS Active Pixels Sensors (APSs) have become a valuable alternative to amorphous Silicon and Selenium Flat Panel Imagers (FPIs) in bio-medical imaging applications. CMOS APSs can now be scaled up to the standard 20 cm diameter wafer size by means of a reticle stitching block process. However despite wafer scale CMOS APS being monolithic, sources of non-uniformity of response and regional variations can persist representing a significant challenge for wafer scale sensor response. Non-uniformity of stitched sensors can arise from a number of factors related to the manufacturing process, including variation of amplification, variation between readout components, wafer defects and process variations across the wafer due to manufacturing processes. This paper reports on an investigation into the spatial non-uniformity and regional variations of a wafer scale stitched CMOS APS. For the first time a per-pixel analysis of the electro-optical performance of a wafer CMOS APS is presented, to address inhomogeneity issues arising from the stitching techniques used to manufacture wafer scale sensors. A complete model of the signal generation in the pixel array has been provided and proved capable of accounting for noise and gain variations across the pixel array. This novel analysis leads to readout noise and conversion gain being evaluated at pixel level, stitching block level and in regions of interest, resulting in a coefficient of variation ≤ 1.9%. The uniformity of the image quality performance has been further investigated in a typical X-ray application, i.e. mammography, showing a uniformity in terms of CNR among the highest when compared with mammography detectors commonly used in clinical practise. Finally, in order to compare the detection capability of this novel APS with the currently used technology (i.e. FPIs), theoretical evaluation of the Detection Quantum Efficiency (DQE) at zero-frequency has been performed, resulting in a higher DQE for this detector compared to FPIs. Optical characterization, X-ray contrast measurements and theoretical DQE evaluation suggest that a trade off can be found between the need of a large imaging area and the requirement of a uniform imaging performance, making the DynAMITe large area CMOS APS suitable for a range of bio-medical applications

Re: A review of continuous vs intermittent androgen deprivation therapy: Redefining the gold standard in the treatment of advanced prostate cancer. Myths, facts and new data on a ?perpetual dispute?

Objectives: To review the literature and present new data of continuous androgen deprivation therapy (ADT) vs intermittent androgen deprivation (IAD) as therapies for prostate cancer in terms of survival and quality of life and clarify practical issues in the use of IAD. Materials and Methods: We conducted a systematic search on Medline and Embase databases using “prostatic neoplasm” and “intermittent androgen deprivation” as search terms. We reviewed meta-analyses, randomised controlled trials, reviews, clinical trials and practise guidelines written in English from 2000 and onwards until 01/04/2013. Ten randomized controlled trials were identified. Seven of them published extensive data and results randomizing 4675 patients to IAD versus CAD. Data from the other three randomized trials were limited. Results: Over the last years studies confirmed that IAD is an effective alternative approach to hormonal deprivation providing simultaneously several potential benefits in terms of quality of life and cost effectiveness. Thus, in patients with non metastatic, advanced prostate cancer IAD could be used as standard treatment, while in metastatic prostate cancer IAD role still remains ambiguous. Conclusions: Nowadays, revaluation of the gold standard of ADT in advanced prostate cancer appears essential. Recent data established that IAD should no longer be considered as investigational, since its effectiveness has been proven, especially in patients suffering from non-metastatic advanced prostate cancer

Temperature dependence of ESR intensity for the nanoscale molecular magnet V15

The electron spin resonance (ESR) of nanoscale molecular magnet ${\rm V}_{15}$ is studied. Since the Hamiltonian of ${\rm V}_{15}$ has a large Hilbert space and numerical calculations of the ESR signal evaluating the Kubo formula with exact diagonalization method is difficult, we implement the formula with the help of the random vector technique and the Chebyshev polynominal expansion, which we name the double Chebyshev expansion method. We calculate the temperature dependence of the ESR intensity of ${\rm V}_{15}$ and compare it with the data obtained in experiment. As another complementary approach, we also implement the Kubo formula with the subspace iteration method taking only important low-lying states into account. We study the ESR absorption curve below $100{\rm K}$ by means of both methods. We find that side peaks appear due to the Dzyaloshinsky-Moriya interaction and these peaks grows as temperature decreases.Comment: 9 pages, 4 figures. To appear in J. Phys. Soc. Jpn. Supp

High Power Self-Aligned, Trench-Implanted 4H-SiC JFETs

The process technology for the fabrication of 4H-SiC trenched-implanted-gate 4H–SiC vertical-channel JFET (TI-VJFET) has been developed. The optimized TIVJFETs have been fabricated with self-aligned nickel silicide source and gate contacts using a process sequence that greatly reduces process complexity as it includes only four lithography steps. A source-pillars sidewall oxidation and subsequent removal of the metallization from the top of the sidewall oxide ensured isolation between gate and source. Optimum planarization of the source pillars top has been performed by cyclotene spin coating and etch back. The effect of the channel geometry on the electrical characteristics has been studied by varying its length (0.3 and 1.2μm) and its width (1.5-5μm). The voltage blocking exhibits a triode shape, which is typical for a static-induction transistor (SIT) operation. The transistors exhibited high ON current handling capabilities (Direct Current density >1kA/cm2) and values of RON ranging from 6 - 12 mΩ•cm2 depending on the channel length. Maximum voltage blocking was 800V limited by the edge termination. The maximum voltage gain was 51. Most transistors were normally-on. Normally-off operation has been observed for transistors lower than 2μm channel width (mask level) and deep implantation

ROCker Models for Reliable Detection and Typing of Short-Read Sequences Carrying beta-Lactamase Genes

Identification of genes encoding beta-lactamases (BLs) from short-read sequences remains challenging due to the high frequency of shared amino acid functional domains and motifs in proteins encoded by BL genes and related non-BL gene sequences. Divergent BL homologs can be frequently missed during similarity searches, which has important practical consequences for monitoring antibiotic resistance. To address this limitation, we built ROCker models that targeted broad classes (e.g., class A, B, C, and D) and individual families (e.g., TEM) of BLs and challenged them with mock 150-bp- and 250-bp-read data sets of known composition. ROCker identifies most-discriminant bit score thresholds in sliding windows along the sequence of the target protein sequence and hence can account for nondiscriminative domains shared by unrelated proteins. BL ROCker models showed a 0% false-positive rate (FPR), a 0% to 4% false-negative rate (FNR), and an up-to-50-fold-higher F1 score [2 x precision x recall/(precision + recall)] compared to alternative methods, such as similarity searches using BLASTx with various e-value thresholds and BL hidden Markov models, or tools like DeepARG, ShortBRED, and AMRFinder. The ROCker models and the underlying protein sequence reference data sets and phylogenetic trees for read placement are freely available through http://enve-omics.ce.gatech.edu/data/rocker-bla. Application of these BL ROCker models to metagenomics, metatranscriptomics, and high-throughput PCR gene amplicon data should facilitate the reliable detection and quantification of BL variants encoded by environmental or clinical isolates and microbiomes and more accurate assessment of the associated public health risk, compared to the current practice. IMPORTANCE Resistance genes encoding beta-lactamases (BLs) confer resistance to the widely prescribed antibiotic class beta-lactams. Therefore, it is important to assess the prevalence of BL genes in clinical or environmental samples for monitoring the spreading of these genes into pathogens and estimating public health risk. However, detecting BLs in short-read sequence data is technically challenging. Our ROCker model-based bioinformatics approach showcases the reliable detection and typing of BLs in complex data sets and thus contributes toward solving an important problem in antibiotic resistance surveillance. The ROCker models developed substantially expand the toolbox for monitoring antibiotic resistance in clinical or environmental settings

Accurate Results from Perturbation Theory for Strongly Frustrated S=1/2S=1/2 Heisenberg Spin Clusters

We investigate the use of perturbation theory in finite sized frustrated spin systems by calculating the effect of quantum fluctuations on coherent states derived from the classical ground state. We first calculate the ground and first excited state wavefunctions as a function of applied field for a 12-site system and compare with the results of exact diagonalization. We then apply the technique to a 20-site system with the same three fold site coordination as the 12-site system. Frustration results in asymptotically convergent series for both systems which are summed with Pad\'e approximants. We find that at zero magnetic field the different connectivity of the two systems leads to a triplet first excited state in the 12-site system and a singlet first excited state in the 20-site system, while the ground state is a singlet for both. We also show how the analytic structure of the Pad\'e approximants at $|\lambda| \simeq 1$ evolves in the complex $\lambda$ plane at the values of the applied field where the ground state switches between spin sectors and how this is connected with the non-trivial dependence of the $$ number on the strength of quantum fluctuations. We discuss the origin of this difference in the energy spectra and in the analytic structures. We also characterize the ground and first excited states according to the values of the various spin correlation functions.Comment: Final version, accepted for publication in Physical review