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This study aimed to clarify the relationship between obesity and postoperative C-reactive protein (CRP) and assess the usefulness of obesity status-adjusted CRP levels for predicting early complications following laparoscopic gastrectomy for gastric cancer. This study retrospectively analyzed 527 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2013 and March 2019. Patients were classified into three groups according to body mass index (BMI): BMI < 20; BMI ≥ 20 to < 25; and BMI ≥ 25. The correlation between BMI and perioperative CRP was investigated in 447 patients, excluding 80 with postoperative complications. The optimal CRP cutoff value of Clavien–Dindo (CD) grade ≥ 3 for predicting severe complications for each group was determined. BMI was significantly correlated with CRP on postoperative day (POD) 3 (p < 0.001) in 447 patients without complications. According to the receiver operating characteristic curve analysis, CRP cutoff values on POD 3 for predicting severe complications were 92.4, 111.1, and 171.9 in the BMI < 20, BMI ≥ 20 to < 25, and BMI ≥ 25 groups, respectively. In multivariate analysis for CD grade ≥ 3 complications, cardiac history and POD 3 CRP levels higher than the adjusted cutoff were identified as independent factors significantly associated with severe complications (p = 0.021 and 0.015, respectively). CRP cutoff values on POD 3 adjusted for BMI were useful for predicting severe complications in gastrectomy for gastric cancer.

Bleeding from unresectable gastric cancer is a localized condition that adversely affects quality of life. Radiotherapy can be used to treat gastric cancer bleeding when surgery, endoscopic treatment, and intravascular embolization are ineffective. This study evaluated the utility of radiotherapy for unresectable hemorrhagic gastric cancer. We retrospectively analyzed data from 33 patients with gastric cancer bleeding who underwent palliative radiotherapy in our hospital between April 2013 and May 2020. In this study, successful hemostasis was defined as > 1 month after starting radiotherapy with the patient alive and showing no need for blood transfusion, no drop in hemoglobin, and no evidence of melena or hematemesis. Patients comprised 26 men (79%) and 7 women (21%), with a median age of 71 years (range, 41–78 years). Hemostasis was achieved in 24 patients (73%). Thirty-two patients (94%) have been discharged home or transferred to the hospice. Patients with successful hemostasis from radiotherapy showed significantly longer overall survival than patients with unsuccessful hemostasis (p = 0.0026). No toxicities of grade 2 or more were encountered. This retrospective study found that palliative radiotherapy for gastric cancer bleeding was useful and safe and can improve remaining quality of life in patients with poor prognosis.

ArF lithography is still applied to the majority of critical layers, even with increasing of extreme ultraviolet lithography in leading-edge production. As wafer design shrinks, conventional 6% phase shift mask (PSM) becomes hard to meet the ArF lithography requirements especially for array dot on mask (hole on wafer). Therefore, transmission dependency was evaluated by mask 3D simulation, and it was found that 30% transmission has the best lithographic performances for array dot. Based on these results, mask blank and mask making process for new 30% PSM were developed. Wafer printability test using negative tone development demonstrated that new 30% PSM has better process window and mask error enhancement factor (MEEF) than conventional 6% PSM for array dot (hole on wafer). To investigate further application of new 30% PSM, lithography performances of various patterns were evaluated by mask 3D simulation and aerial image measurement system (AIMSTM). The results indicated that new 30% PSM has larger lithography margin than 6% PSM for iso dot, iso line and logic pattern. Additionally, wafer printability test demonstrated that new 30% PSM has better process window than 6% PSM for iso dot. Defect control is also an important factor in high volume manufacturing. Therefore, it is necessary to evaluate the repairability and printability of the defects on new 30% PSM. We repaired various types of defects by electron-beam repair tool and confirmed the repairability by AIMS. And the defect printability of new 30% PSM and 6% PSM to critical dimension (CD) on wafer was evaluated by program defect mask that has pin dot, extrusion and intrusion defects.

Summary Sarcopenia, which involves two important aspects, namely skeletal muscle loss and decreased physical function, was suggested as a poor prognostic factor in esophageal cancer surgery. The purpose of this study was to clarify the perioperative change in daily physical activity and propose effective preventive strategies. We prospectively enrolled patients with esophageal cancer who were scheduled to undergo radical esophagectomy. Their daily physical activities were recorded using an accelerometer before surgery, immediately after discharge, and 6 months after surgery. The relationships of physical activity level and the perioperative factors, especially skeletal muscle change, with the risk factors of low daily activity level were investigated. The data of 20/28 enrolled patients were analyzed. The mean activity level of the 20 patients decreased after discharge and subsequently recovered on postoperative month 6. The percentage of activity levels >1.5 metabolic equivalents/day after discharge significantly correlated to the change rate in total muscle cross-sectional area from baseline to POM 6 (r = 0.452, P = 0.045). In a stepwise multiple regression analysis, age, neoadjuvant chemotherapy, and anastomotic leakage were identified as negative associated factors of activity time at >1.5 metabolic equivalents at postoperative month 6. Activity level immediately after discharge was significantly associated with skeletal muscle loss at postoperative month 6 in patients with esophageal cancer who underwent esophagectomy. Elderly patients and patients who received neoadjuvant chemotherapy and had an anastomotic leakage might require intensive prevention. Prospective interventions aimed at increasing daily activity can prevent sarcopenia.

Even with the increase in need for next-generation lithography, immersion ArF lithography is still applied to the majority of critical layers. However, as circuit designs shrink, conventional 6% phase-shift mask (PSM) will become difficult to meet the lithography requirements for dense dot pattern compared to dense line pattern. To enhance immersion ArF lithographic performances for dot pattern, high-transmission PSM (High-T PSM) is attracting attention because the transmission of PSM has a significant impact on lithographic performances. From results of transmission dependency evaluated by mask three-dimensional (3D) simulation, it was found that 30% transmission has the best lithographic performances for dense dot. Based on these results, mask blank and mask making process for the new 30% PSM were developed. The results showed good cross-section profile, mask pattern resolution, and defect repairability. In addition, the durability against chemical cleaning and ArF irradiation were also improved. Wafer printability test using negative tone development demonstrated that new PSM has advantages in process window and mask error enhancement factor for dense dots (holes on wafer). Finally, the potential for further application of new PSM was investigated by mask 3D simulation. The results showed that new PSM has lithographic benefits not only for dense dots but also other patterns.

Summary Background The purpose of the current study was to clarify the relationship between clinical features of dysphagia after esophagectomy and preoperative sarcopenia. Methods A total of 187 cases were included in the current study. The psoas cross-sectional area on pre-treatment computed tomography was measured in thoracic esophageal cancer patients who underwent curative resection. The psoas muscle index (PMI) cut-off levels for sarcopenia were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women. Swallowing function was evaluated using videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) at postoperative days 7–15, and classified according to the food intake level scale (FILS). Perioperative swallowing rehabilitation was performed in all cases. Results In the 187 included patients, the median PMI was 5.42 cm2/m2 for men and 3.43 cm2/m2 for women, and 133 cases (71%) met the sarcopenia criteria. The FILS Conclusions Sarcopenic patients with esophageal cancer develop postoperative dysphagia more often than non-sarcopenic patients. Prehabilitation and nutritional support for patients with preoperative sarcopenia could play an important role to mitigate postoperative dysphagia.

Postoperative pneumonia is a serious prognostic problem that can appear after esophagectomy in patients with esophageal cancer. The past reports have considered the usefulness of perioperative culture examinations for predicting postoperative pneumonia; however, the direct relationship between these examinations and postoperative complications remains unclear. This study retrospectively analyzed esophageal cancer patients who underwent esophagectomy followed by sputum culture on the first postoperative day. The bacterial species that frequently cause hospital-acquired pneumonia were chosen as the target species in this study. The relationship between culture examination and postoperative pneumonia within one week (7 days) after esophagectomy was investigated. Sputum cultures on the first postoperative day were investigated in 238 patients who underwent esophagectomy for esophageal cancer. Forty-one patients developed pneumonia within one week after surgery. The target bacterial species were detected in 26 of 238 sputum cultures (10.9%). In the univariate analysis, a Brinkman index, detection of target bacterial species, detection of Gram-positive cocci, and Gram-negative rods were significantly associated with postoperative pneumonia. In the three independent multivariate analyses, the target bacterial species, Gram-positive cocci, and Gram-negative rods (p = 0.001, 0.042, and

Even with the increasing need for next-generation lithography, ArF lithography is still applied to the majority of critical layers. However, as wafer design shrinks, conventional 6% phase shift mask (PSM) becomes unable to sufficiently meet the lithography requirements for dense dot pattern compared to dense line pattern. To enhance ArF lithographic performances for dot pattern, high-transmission phase shift mask (High-T PSM) is attracting attention because the transmission of PSM has a significant impact on lithographic performances[1-4]. From the evaluation results of transmission dependency by mask 3D simulation, it was found that 30% transmission has the best lithographic performances for dot pattern. Based on these results, mask blank and mask making process for the new 30% PSM were developed. The result showed good cross-section profile, mask pattern resolution and defect repairability. In addition, the durability against chemical cleaning and ArF irradiation were also improved. Wafer printability test using negative tone development demonstrated that new PSM has advantages in process window and MEEF for dense dots (holes on wafer). Finally, the potential for further application of new 30% PSM was investigated by mask 3D simulation. The results showed that new 30% PSM has lithographic benefits not only for dense dots but also for other patterns. The new 30% PSM is a strong candidate capable of enhancing ArF lithographic performances for 5nm node or hp 1Xnm and beyond.

Postoperative sarcopenia following esophagectomy for esophageal cancer has become a severe problem due to the increasing number of elderly patients undergoing surgery. This study aimed to clarify the relationship between early postoperative skeletal muscle change and cancer prognosis, and propose effective interventions to prevent sarcopenia. This study retrospectively analyzed 152 patients who underwent esophagectomy for esophageal cancer. Total psoas muscle area (TPA) was measured before surgery as baseline and on postoperative day 7 (± 2). The effect of early postoperative skeletal muscle loss on 5-year survival was investigated. Moreover, 5-year survival in patients with postoperative complications and a high inflammatory status, which were previously reported as poor prognostic factors of esophageal cancer, was also investigated. Among the 152 patients, 52 (34.2%) showed a decrease in TPA, while 100 (65.8%) maintained their TPA. The TPA decreasing group exhibited poor 5-year overall survival (OS) (p = 0.003) and 5-year recurrence-free survival (RFS) (p

314 Background: As surgery for esophageal carcinoma in the elderly people has been increasing, sarcopenia is a severe problem not only in complications, but also in long-term prognosis. However, the relationship between perioperative skeletal muscle loss especially in the early postoperative period and long-term prognosis has not been clarified. Methods: This study retrospectively analyzed 152 patients with thoracic esophageal carcinoma who had underwent radical esophagectomy in our institution from April 2008 to March 2015 (Patients with postoperative hospital stay longer than 6 weeks were excluded). As an index of perioperative sarcopenia, total psoas muscle area (TPA) was measured before surgery (as baseline), at postoperative day (POD) 7 and postoperative month (POM) 6 from CT images. We investigated the correlation between the change of TPA and the postoperative survival. Results: Of 152 patients, 52 (34.2%) showed a TPA decrease from baseline to POD 7, and 98 (64.5%) showed a TPA decrease from baseline to POM 6. At the time of POD 7, overall survival (OS) decreased significantly in a TPA decrease group (P = 0.008, 5-year survival rate: non-decrease group 82.3% / decrease group 56.8%). Recurrence free survival (RFS) was also significantly decreased in a TPA decrease group (P < 0.001, 5-year recurrence free survival rate: non-decrease group 73.7% / decrease group 44.9%). On the other hand, at the time of POM 6, OS and also RFS had no significant difference between decrease and non-decrease groups. In univariate analysis for OS, pStage ≥3 and TPA decrease at POD 7 had poor prognosis. In multivariate analysis for OS, pStage ≥3 (HR:5.516, P < 0.001, 95%CI:2.634-11.551) and TPA decrease at POD 7 (HR:2.036, P = 0.047, 95%CI:1.010-4.103) were also independent poor prognostic factors. In the univariate analysis for RFS, pStage ≥3, TPA decrease at POD 7 and age ≥60 years had poor prognosis. In multivariate analysis, pStaeg ≥3 (HR:3.831, P < 0.001, 95%CI:2.182-6.728) and TPA decrease at POD 7 (HR:1.942, P = 0.021, 95%CI:1.104-3.416) were independent poor prognostic factors. Conclusions: Our findings suggest that the TPA decrease early in a postoperative period has poor prognosis on OS and also RFS.

Role and potentials of nuclear energy system in the energy options are discussed from the viewpoint of sustainable development with protecting from global warming by using the energy module structure of GRAPE model. The analysis with respect to carbon emission control and nuclear fissile transaction among regions indicates the need of coordinated further developments of energy conservation, renewable and nuclear energies, and rather drastic nuclear introduction in the presently developing world. The analysis also suggests the need of long-term planning and R&D efforts under the wisdom.

The economic growth of recent Asia is rapid, and the GDP and the energy consumption growth rate are about 8–10% in China and India. The energy consumption forecast of Asia in this century was estimated based on the GDP growth rate by Goldman Sachs. As a result, about twice in India and Association of South East Asian Nations (ASEAN) and about 1.5 times in China of SRES B (Special Report on Emission Scenarios) are forecasted. The simulation was done by Grape Code to analyze the impact of energy increase in Asia. As for the nuclear plant in Asia, it is expected 1500 GWe in 2050 and 2000 GWe in 2100, in the case of the environmental constrain. To achieve this nuclear utilization, there are two important aspects, technically and institutionally. A. Development of the CANDLE core and/or the Breed and Burn core. B. The establishment of the stable nuclear fuel supply system like “Asian nuclear fuel supply organization”.

Processes and technologies to produce hydrogen synergistically by the nuclear-heated steam reforming reaction of fossil fuels are reviewed. Formulas of chemical reactions, required heats for reactions, saving of fuel consumption, reduction of carbon dioxide emission, and possible processes are investigated for such fossil fuels as natural gas, petroleum and coal. In this investigation, examined are the steam reforming processes using the “membrane reformer” and adopting the recirculation of reaction products in a closed loop configuration. The recirculation-type membrane reformer process is considered to be the most advantageous among various synergistic hydrogen production processes. Typical merits of this process are; nuclear heat supply at medium temperature around 550°C, compact plant size and membrane area for hydrogen production, efficient conversion of a feed fossil fuel, appreciable reduction of carbon dioxide emission, high purity hydrogen without any additional process, and ease of separating carbon dioxide for future sequestration requirements. The synergistic hydrogen production using fossil fuels and nuclear energy can be an effective solution in this century for the world which has to use fossil fuels to some extent, according to various estimates of global energy supply, while reducing carbon dioxide emission.

Ecosystems have a limited buffering capacity of multiple ecosystem functions against biodiversity loss (i.e. low multifunctional redundancy). We developed a novel theoretical approach to evaluate multifunctional redundancy in a microbial community using the microbial genome database (MBGD) for comparative analysis. In order to fully implement functional information, we defined orthologue richness in a community, each of which is a functionally conservative evolutionary unit in genomes, as an index of community multifunctionality (MF). We constructed a graph of expected orthologue richness in a community (MF) as a function of species richness (SR), fit the power function to SR (i.e. MF = c SR a ), and interpreted the higher exponent a as the lower multifunctional redundancy. Through a microcosm experiment, we confirmed that MF defined by orthologue richness could predict the actual multiple functions. We simulated random and non-random community assemblages using full genomic data of 478 prokaryotic species in the MBGD, and determined that the exponent in microbial communities ranged from 0.55 to 0.75. This exponent range provided a quantitative estimate that a 6.6–8.9% loss limit in SR occurred in a microbial community for an MF reduction no greater than 5%, suggesting a non-negligible initial loss effect of microbial diversity on MF.

EUV blank defect is one of the key issues the industry has to overcome to implement EUV lithography for HVM (high volume manufacturing). Several inspection techniques for EUV blank defect detection have been proposed, but the blank defect criteria for EUV mask is assumed to be very tight, thus, high sensitivity performance is required for blank inspection. However, it is important how the blank inspection tool to be assessed with appropriate test blanks with properly characterized defects. New programmed defect fabrication method has been introduced and verified that the method enables to fabricate natural-like programmed defects. In this study, it was attempted to fabricate more complex shape defects and investigated how multilayer defects are grown during multilayer deposition. Then, printability simulation was conducted for 3 different defect transition models, and critical multilayer defect shapes and sizes were discussed based on the simulation work.

EUV lithography is the most promising candidate for semi conductor device manufacturing of 1x nm half pitch and beyond. For the practical use, EUV mask with a thin absorber could be adopte d because of less shadowing effect. EUV reflectivity from the thin absorber is about 1~3%. It would cause CD change on wafer especially at the exposure field edge due to the leakage of the EUV light from neighboring exposure shots. 1 To avoid this phenomenon, light shield black border is needed at the edge of pattern area on mask. Stacked absorber type and ML-etched type of light shield black border have been proposed in the past. 2. The most important things for these black borders are that there is no reflection of EUV light and no defect which affects pattern CD on wafer. ML-etched black border is considered to be applied for early practical use from a viewpoint of manufacturability. Because CD degradation and defect increase might happen due to 2 nd litho and etch process on its main pattern area in manufacturing process of stacked absorber type. In this paper, we will show several evaluation results rega rding ML-etched black border we have developed. It has a good light shield performance for EUV and low DUV light reflection. Defect inspection in black border area can be performed successfully by three kinds of inspection tools. As a result, most of the defects seemed not to be printable to wafer. We also evaluated CD change, flat ness change linked to mask IP shift and particle contamination on main pattern area. What it comes down to is that there is no show-stopper for ML-etched BB process for now. Keywords: EUV lithography, mask, absorber, multilayer, light-shield, black border, reflectivity, OoB, image placement

EUV blank inspection is the key technology for EUV mask fabrication. To assess blank inspection tools, it is important to obtain appropriate test blanks with properly characterized defect types. In this study, new programmed defect blank was fabricated with conventional programmed defect fabrication and several new methods for natural-like programmed defects. And defect characterization work has been conducted to verify the difference of conventional programmed defects and natural-like programmed defects, and confirmed wide range of defect sizes from minimum below 1nm-height × 18nm-width to micron order defects were successfully fabricated. Furthermore, the blank was inspected by Actinic Blank Inspection (ABI) tool and evaluated the effectiveness of the new defect fabrication methods. And it was confirmed that the new programmed defect showed similar characteristics as natural defects.

Processes and technologies to produce hydrogen synergistically by the steam reforming reaction using fossil fuels and nuclear heat are reviewed. Formulas of chemical reactions, required heats for reactions, saving of fuel consumption or reduction of carbon dioxide emission, possible processes and other prospects are examined for such fossil fuels as natural gas, petroleum and coal...