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Owning to their unusual optical properties, such as electrical tunability and strong spatial confinement, two-dimensional surface polaritons (2DSPs) hold great promise for deep sub-wavelength manipulation of light in a reduced low-dimensional space. Control of 2DSPs is possible by using their interaction with a boundary between two media, similar to how light behaves in three-dimensional (3D) space. The understanding of the interaction in the 2D case is still in its early stages, unlike the 3D case, as in-depth investigations are only available in a few cases including the interaction of 2DSPs with structured 2D crystals. Here, we extend the scope of our understanding to the interaction of 2DSPs with metallic nano-plates on 2D crystals, focusing on the reflection of 2DSPs. Through our rigorous model, we reveal that, for strongly confined 2DSPs having much larger momentum than free space photons, the interaction results in almost total internal reflection of 2DSPs as the radiative coupling of the 2DSPs to free space is negligible. We also find that the reflection involves an anomalous phase shift dependent on the thickness of the nano-plate, due to the temporary storing of electromagnetic energy in the evanescent waves induced near the edge of the nano-plate. Our theory predicts that the phase shift saturates to an anomalous value, 0.885π, as the nano-plate becomes thicker. Our work provides a detailed understanding of how to manipulate the 2DSPs by using one of the simplest nanostructures, essential for the further development of nanostructure-integrated low-dimensional devices for polariton optics.

Objective Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are considered substitutes for each other for evaluating Crohn's disease (CD). However, the adequacy of mixing them for routine periodic follow-up for CD has not been established. This study aimed to compare MRE alone with the mixed use of CTE and MRE for the periodic follow-up of small bowel inflammation in patients with CD. Materials and methods We retrospectively compared two non-randomized groups, each comprising 96 patients with CD. One group underwent CTE and MRE (MRE followed by CTE or vice versa) for the follow-up of CD (interval, 13-27 months [median, 22 months]), and the other group underwent MRE alone (interval, 15-26 months [median, 21 months]). However, these two groups were similar in clinical characteristics. Three independent readers from three different institutions determined whether inflammation had decreased, remained unchanged, or increased within the entire small bowel and the terminal ileum based on sequential enterography of the patients after appropriate blinding. We compared the two groups for inter-reader agreement and accuracy (terminal ileum only) using endoscopy as the reference standard for enterographic interpretation. Results The inter-reader agreement was greater in the MRE alone group for the entire small bowel (intraclass correlation coefficient [ICC]: 0.683 vs. 0.473; p = 0.005) and the terminal ileum (ICC: 0.656 vs. 0.490; p = 0.030). The interpretation accuracy was higher in the MRE alone group without statistical significance (70.9%-74.5% vs. 57.9%-64.9% in individual readers; adjusted odds ratio = 3.21; p = 0.077). Conclusion The mixed use of CTE and MRE was inferior to MRE alone in terms of inter-reader reliability and could probably be less accurate than MRE alone for routine monitoring of small bowel inflammation in patients with CD. Therefore, the consistent use of MRE is favored for this purpose.

This study aimed to systematically determine the inter-reader reliability of the functional liver imaging score (FLIS) and explore the factors affecting it.Original articles reporting the inter-reader reliability of FLIS derived from gadoxetic acid-enhanced magnetic resonance imaging (MRI) were systematically searched in the MEDLINE and EMBASE databases from January 2013 to June 2022. Data synthesis was performed to calculate the meta-analytic pooled estimates of the FLIS and its three subcategories, including enhancement quality score (EnQS), excretion quality score (ExQS), and portal vein sign quality score (PVsQS) using the DerSimonian-Laird random-effects model. To explore any cause of study heterogeneity, we conducted a meta-regression analysis.Six studies with data from 1419 patients were included. The meta-analytic pooled inter-reader reliability of FLIS was 0.93 (95% confidence interval [CI], 0.88-0.98). That of the three FLIS subcategories were 0.93 (95% CI, 0.85-1.00), 0.95 (95% CI, 0.91-1.00), and 0.90 (95% CI, 0.81-0.99) for EnQS, ExQS, and PVsQS, respectively. The pooled FLIS data was moderately heterogenous, but heterogeneity was not associated with the study methodology, MRI-related factors, and reader experience.The FLIS and its three subcategories showed almost perfect inter-reader reliability. Therefore, FLIS may be a reliable imaging parameter that reflects liver function and outcomes in patients with chronic liver disease. Further studies should be conducted to confirm any factors affecting the inter-reader reliability of FLIS.

PURPOSE According to the American Association for the Study of Liver Diseases (AASLD) guidelines, biopsy is a diagnostic option for focal hepatic lesions depending on the Liver Imaging Reporting and Data System (LI-RADS) category. We evaluated the diagnostic performance of ultrasonography-guided core-needle biopsy (CNB) according to LI-RADS categories. METHODS A total of 145 High-risk patients for hepatocellular carcinoma (HCC) who underwent magnetic resonance imaging (MRI) followed by CNB for a focal hepatic lesion preoperatively were retrospectively enrolled. Focal hepatic lesions on MRI were evaluated according to LI-RADS version 2018. Pathologic results were categorized into HCC, non-HCC malignancies, and benignity. The categorization was defined as correct when the CNB pathology and surgical pathology reports were identical. Nondiagnostic results were defined as inadequate CNB pathology findings for a specific diagnosis. The proportion of correct categorizations was calculated for each LI-RADS category, excluding nondiagnostic results. RESULTS After excluding 16 nondiagnostic results, 131 lesions were analyzed (45 LR-5, 24 LR-4, 4 LR-3, and 58 LR-M). All LR-5 lesions were HCC, and CNB correctly categorized 97.8% (44/45) of LR-5 lesions. CNB correctly categorized all 24 LR-4 lesions, 16.7% (4/24) of which were non-HCC malignancies. All LR-M lesions were malignant, and 62.1% (36/58) were non-HCC malignancies. CNB correctly categorized 93.1% (54/58) of LR-M lesions, and 12.5% (3/24) of lesions with CNB results of HCC were confirmed as non-HCC malignancies. CONCLUSION In agreement with AASLD guidelines, CNB could be helpful for LR-4 lesions, but is unnecessary for LR-5 lesions. In LR-M lesions, CNB results of HCC did not exclude non-HCC malignancy.

To systematically determine the inter-reader reliability of the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS), with emphasis on its major features for hepatocellular carcinoma (HCC) and LR-M (LI-RADS category M) features for non-HCC malignancy. MEDLINE, EMBASE, and Cochrane databases were searched from January 2016 to March 2021 to identify original articles reporting the inter-reader reliability of CEUS LI-RADS. Meta-analytic pooled kappa values (κ) were calculated for major features [nonrim arterial-phase hyperenhancement (APHE), mild and late washout], LR-M features (rim APHE, early washout), and LI-RADS categorization using the DerSimonian-Laird random-effects model. Meta-regression analysis was performed to explore any causes of study heterogeneity. Twelve studies with a total of 2862 lesions were included. The meta-analytic pooled κ of nonrim APHE, mild and late washout, rim APHE, early washout, and LI-RADS categorization were 0.73 [95% confidence interval (CI), 0.67 − 0.79], 0.69 (95% CI, 0.54–0.84), 0.54 (95% CI, 0.37–0.71), 0.62 (95% CI, 0.45–0.79), and 0.75 (95% CI, 0.64–0.87), respectively. Compared with the major features, LR-M features had a lower meta-analytic pooled κ. Substantial study heterogeneity was noted in the LI-RADS categorization, and lesion size (p = 0.03) and the homogeneity in reader experience (p = 0.03) were significantly associated with study heterogeneity. CEUS LI-RADS showed substantial inter-reader reliability for major features and LI-RADS categorization, but relatively lower reliability was found for LR-M features. In our opinion, the definitions of imaging features require further refinement to improve the inter-reader reliability of CEUS LI-RADS.

To establish inter-reader reliability of CT Liver Imaging Reporting and Data System (LI-RADS) and explore factors that affect it. MEDLINE and EMBASE databases were searched from January 2014 to March 2020 to identify original articles reporting the inter-reader reliability of CT LI-RADS. The imaging analysis methodology of each study was identified, and pooled intraclass correlation coefficient (ICC) or kappa values (κ) were calculated for lesion size, major features (arterial-phase hyperenhancement [APHE], nonperipheral washout [WO], and enhancing capsule [EC]), and LI-RADS categorization (LR) using random-effects models. Subgroup analyses of pooled κ were performed for the number of readers, average reader experience, differences in reader experience, and LI-RADS version. In the 12 included studies, the pooled ICC or κ of lesion size, APHE, WO, EC, and LR were 0.99 (0.96−1.00), 0.69 (0.58–0.81), 0.67 (0.53–0.82), 0.65 (0.54–0.76), and 0.70 (0.59–0.82), respectively. The experience and number of readers varied: studies using readers with ≥ 10 years of experience showed significantly higher κ for LR (0.82 vs. 0.45, p = 0.01) than those with < 10 years of reader experience. Studies with multiple readers including inexperienced readers showed significantly lower κ for APHE (0.55 vs. 0.76, p = 0.04) and LR (0.45 vs. 0.79, p = 0.02) than those with all experienced readers. CT LI-RADS showed substantial inter-reader reliability for major features and LR. Inter-reader reliability differed significantly according to average reader experience and differences in reader experience. Reported results for inter-reader reliability of CT LI-RADS should be understood with consideration of the imaging analysis methodology. • The CT Liver Imaging Reporting and Data System (LI-RADS) provides substantial inter-reader reliability for three major features and category assignment. • The imaging analysis methodology varied across studies. • The inter-reader reliability of CT LI-RADS differed significantly according to the average reader experience and the difference in reader experience.

Seasonal flu is an infectious disease of the respiratory tract caused by influenza viruses. The development of anti-influenza drugs has significantly reduced the threat from the influenza virus; however, frequent mutations of this negative RNA virus result in antiviral-resistant strains, and constantly intimidate the human race. Thus, identifying novel therapeutic targets for the prevention and treatment of influenza virus infections is critical. We aimed to determine whether the kinesin superfamily protein 11 (KIF11) inhibitors, monastrol and K858, inhibit viral cytopathogenesis and influenza A virus (IAV) replication. When MDCK or HEK293 cells were treated with monastrol and K858 that did not induce significant cytotoxicity, IAV-induced cytopathic effect was attenuated significantly. Furthermore, these inhibitors effectively suppressed the production of viral RNA, proteins, and infectious viral particles. Inhibition of KIF11 activity effectively attenuates virus-mediated cytopathic effect and suppresses viral replication. Hence, KIF11 is a potential therapeutic target against the influenza virus.

To differentiate the computed tomography (CT) and magnetic resonance imaging (MRI) features of porto-sinusoidal vascular disease (PSVD) and liver cirrhosis (LC). In this retrospective case–control study of patients with PSVD matched in a 1:3 ratio with LC patients according to liver function, initial diagnosis and time to final diagnosis were analyzed. Imaging features on CT and the parenchymal enhancement on hepatobiliary phase of hepatobiliary agent-enhanced MRI (HBA-MRI) were compared using a generalized linear mixed model. Focal hepatic lesions in the PSVD group were analyzed. In total, 43 PSVD patients and 129 LC patients were included. Among PSVD patients, 72.1% were initially misdiagnosed with LC. PSVD patients had a longer diagnostic delay than LC patients (32 months vs. 4 months; p

We aimed to assess the ability of CT-determined resectability, as defined by a recent version of NCCN criteria, and associated CT findings to predict margin-negative (R0) resection in patients with PDAC after neoadjuvant FOLFIRINOX chemotherapy. Sixty-four patients (36 men and 28 women; mean age, 58.8 years) with borderline resectable or unresectable PDAC who received neoadjuvant FOLFIRINOX were evaluated retrospectively. CT findings were independently assessed by two abdominal radiologists according to NCCN criteria (version 3. 2019). Tumor resectability was classified as resectable, borderline resectable, or unresectable, and change in resectability was classified as regression, stability, or progression. The associations of R0 resection rate with CT-determined resectability and change in resectability categories were evaluated, as were the sensitivity and specificity of NCCN criteria for R0 resection. Factors associated with R0 resection were identified by logistic regression analysis. R0 resection rate did not differ significantly among the resectable, borderline resectable, or unresectable PDAC (67–73%, p = 0.95) or among PDAC with regression, stability, or progression (56–77%, p = 0.39). The sensitivity and specificity for R0 resection were 67% and 37%, respectively, for resectability (resectable/borderline vs. unresectable) and 80% and 21%, respectively, for changes in resectability (regression/stable vs. progression). Low-contrast enhancement of soft tissue contacting artery (≤ 46.4 HU) was independently associated with R0 resection (p = 0.01). CT-determined resectability after neoadjuvant FOLFIRINOX chemotherapy was relatively insensitive and non-specific for predicting R0 resection. Low-contrast enhancement of soft tissue contacting artery may increase the ability of CT to predict R0 resection. • Margin-negative resection rate of pancreatic cancer following FOLFIRINOX therapy did not differ among each resectability (67–73%, p = 0.95) based on NCCN criteria or changes in resectability categories (56–77%, p = 0.39). • The sensitivity and specificity for margin-negative resection were 67% and 37% for resectability (resectable/borderline vs. unresectable) and 80% and 21% for changes in resectability (regression/stable vs. progression). • Low-contrast enhancement of soft tissue contacting artery (≤ 46.4 HU) was independently associated with margin-negative resection (p = 0.01).

The influenza virus is one of the major public health threats. However, the development of efficient vaccines and therapeutic drugs to combat this virus is greatly limited by its frequent genetic mutations. Because of this, targeting the host factors required for influenza virus replication may be a more effective strategy for inhibiting a broader spectrum of variants. Here, we demonstrated that inhibition of a motor protein kinesin family member 18A (KIF18A) suppresses the replication of the influenza A virus (IAV). The expression of KIF18A in host cells was increased following IAV infection. Intriguingly, treatment with the selective and ATP‐competitive mitotic kinesin KIF18A inhibitor BTB‐1 substantially decreased the expression of viral RNAs and proteins, and the production of infectious viral particles, while overexpression of KIF18A enhanced the replication of IAV. Importantly, BTB‐1 treatment attenuated the activation of AKT, p38 MAPK, SAPK and Ran‐binding protein 3 (RanBP3), which led to the prevention of the nuclear export of viral ribonucleoprotein complexes. Notably, administration of BTB‐1 greatly improved the viability of IAV‐infected mice. Collectively, our results unveiled a beneficial role of KIF18A in IAV replication, and thus, KIF18A could be a potential therapeutic target for the control of IAV infection.

To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard.A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity90% and specificity90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set.Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%).In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.

The electrical performances of III-nitride blue micro-light-emitting diodes ( µLEDs) with different tunnel junction (TJ) epitaxial architectures grown by metalorganic chemical vapor deposition are investigated. A new TJ structure that employs AlGaN is introduced. The current density–voltage characteristic is improved by incorporating AlGaN layer above the n-side of the TJ layer, and the effects of the AlGaN/GaN superlattices is examined. Based upon the data from band diagram simulation, net positive polarization charge is formed at the AlGaN/GaN interface, which results in a reduction in tunneling distance and increase in tunneling probability. Moreover, similar electrical improvement is observed in various device dimensions and is independent of operating current density, suggesting that AlGaN/GaN biaxial tensile strain or current spreading is not the main contribution for the improvement. Finally, the effects on the efficiency performances are determined. While the maximum external quantum efficiency of the TJ devices remains identical, the wall-plug efficiency of µLEDs is enhanced significantly by the proposed AlGaN-enhanced TJ design. This work reveals the possibility of energy efficient TJ contact with high transparency in the visible wavelength range.

To determine the strength of association with hepatocellular carcinoma (HCC) of each ancillary feature (AF) in LI-RADS version 2018, and to develop an appropriate strategy for applying AFs to improve the diagnosis of HCC ≤ 3 cm on gadoxetate-enhanced MRI. A total of 385 nodules (283 HCCs, 18 non-HCC malignancies, 84 benign nodules) of ≤ 3 cm in 266 patients at risk for HCC who underwent gadoxetate-enhanced MRI in 2016 were retrospectively evaluated. Two radiologists independently evaluated the presence/absence of AFs, and assigned a LI-RADS category to each nodule. Diagnostic odds ratio (DOR) of each AF was assessed. To improve the diagnostic performance for HCC, various criteria were developed based on the number of AFs favoring malignancy in general or HCC in particular. Generalized estimating equation models were used to compare the diagnostic performance of each criterion with that of the major features (MFs) only. All AFs favoring HCC in particular and malignancy in general were more common in the HCC group than in the non-HCC group. Of these AFs, hepatobiliary-phase hypointensity had the strongest association with HCC (DOR, 21.82; 95% confidence interval, 5.59–85.20). When we applied AFs in addition to MFs, the new criterion (with a number of AFs ≥ 4) had significantly higher sensitivity (80.6% vs. 70.0%; p

BACKGROUND Use of the Liver Imaging Reporting and Data System (LI-RADS) is increasing, but the reported results for interreader agreement seem quite variable. PURPOSE To systematically determine the interreader agreement of LI-RADS on magnetic resonance imaging (MRI) and to determine the sources of heterogeneity between the reported results. STUDY TYPE Systematic review and meta-analysis. SUBJECTS Fifteen original articles with 2968 lesions. FIELD STRENGTH 1.5T and 3.0T. ASSESSMENT Two reviewers independently performed the data extraction. The reviewers identified and reviewed the original articles reporting the interreader agreement of LI-RADS using MRI. STATISTICAL TESTS The meta-analytic pooled intraclass correlation coefficient (ICC) for lesion size and kappa value (κ) for major features (arterial-phase hyperenhancement [APHE], nonperipheral washout [WO], enhancing capsule [EC]) and LI-RADS categorization (LR) were calculated using the random-effects model. Sensitivity analysis and meta-regression analysis were performed to explore the cause of study heterogeneity. RESULTS The meta-analytic pooled ICC of lesion size was 0.97 (95% confidence interval [CI], 0.94-1.00). Meta-analytic pooled κ of APHE, WO, EC, and LR were 0.72 (95% CI, 0.62-0.82), 0.69 (95% CI, 0.60-0.78), 0.66 (95% CI, 0.58-0.74), and 0.70 (95% CI, 0.56-0.85), respectively. Substantial study heterogeneity was noted in all five variables (I2 ≥ 89.1%, P

Although gadoxetate disodium-enhanced magnetic resonance imaging (MRI) shows higher sensitivity for diagnosing hepatocellular carcinoma (HCC), its arterial-phase images may be unsatisfactory because of weak arterial enhancement. We investigated the clinical effectiveness of arterial subtraction images from gadoxetate disodium-enhanced MRI for diagnosing early-stage HCC using the Liver Imaging Reporting and Data System (LI-RADS) v2018.In 258 patients at risk of HCC who underwent gadoxetate disodium-enhanced MRI in 2016, a total of 372 hepatic nodules (273 HCCs, 18 other malignancies, and 81 benign nodules) of 3.0 cm or smaller were retrospectively analyzed. Final diagnosis was assessed histopathologically or clinically (marginal recurrence after treatment or change in lesion size on follow-up imaging). The detection rate for arterial hyperenhancement was compared between ordinary arterial-phase and arterial subtraction images, and the benefit of arterial subtraction images in diagnosing HCC using LI-RADS was assessed.Arterial subtraction images had a significantly higher detection rate for arterial hyperenhancement than ordinary arterial-phase images, both for all hepatic nodules (72.3% vs. 62.4%, p0.001) and HCCs (91.9% vs. 80.6%, p0.001). Compared with ordinary arterial-phase images, arterial subtraction images significantly increased the sensitivity of LI-RADS category 5 for diagnosis of HCC (64.1% [173/270] vs. 55.9% [151/270], p0.001), without significantly decreasing specificity (92.9% [91/98] vs. 94.9% [93/98], p = 0.155). For histopathologically confirmed lesions, arterial subtraction images significantly increased sensitivity to 68.8% (128/186) from the 61.3% (114/186) of ordinary arterial-phase images (p0.001), with a minimal decrease in specificity to 84.8% (39/46) from 89.1% (41/46) (p = 0.151).Arterial subtraction images of gadoxetate disodium-enhanced MRI can significantly improve the sensitivity of early-stage HCC diagnosis using LI-RADS, without a significant decrease in specificity.Gadoxetate disodium-enhanced magnetic resonance imaging is an imaging technique with a high sensitivity for the diagnosis of hepatocellular carcinoma. However, arterial-phase images may be unsatisfactory because of weak arterial enhancement. We found that using arterial subtraction images led to clinically meaningful improvements in the diagnosis of early-stage hepatocellular carcinoma.

BACKGROUND We designed a new 1-handed chest compression method, the "elbow-lock" chest compression (ELCC), for a single rescuer in pediatric cardiopulmonary resuscitation (CPR). Then, we compared the effectiveness between the ELCC and standard chest compression (SCC) method. METHODS This prospective, randomized controlled, crossover simulation trial studied 34 emergency medical professionals, including physicians, nurses, and EMTs. We compare the quality of chest compression and fatigue point time between the ELCC and the SCC. RESULTS Participants who performed the ELCC method maintained a proper depth of compression compared with SCC method (50.0 ± 0.3 mm vs 40.5 ± 0.4 mm, P < 0.001). However, the 2 methods did not differ in terms of compression velocity since neither reached the standard velocity (96.7 ± 7.1/minutes vs 91.7 ± 7.0/minutes, P < 0.016). With respect to the overall score, ELCC was more effective than the SCC (91.6 ± 3.7% vs 85.3 ± 8.8%, P = 0.002). In addition, the fatigue point time was slower in the ELCC group than the SCC group (7.3 ± 0.3/minutes vs 6.1 ± 0.4/minutes, P < 0.001). CONCLUSIONS The single rescuer ELCC method is an effective alternative to the SCC method for pediatric CPR because the ELCC method can prevent elbow flexion.Trial registration: Our research is simulation manikin study. So we do not need to "trial registration".

Background This study aimed to find out the change in the rate and pattern of suicide attempts during severe acute respiratory syndrome COVID-19 pandemic period. Methods This study was a retrospective analysis of data collected as a part of an emergency room-based post-suicide management program. The data were collected through interviews and from medical records of suicide attempts, maintained in the emergency room, from January 19 to October 31, 2020, during the “COVID-19 period,” and those who attempted suicide from January 19 to October 31, 2019 “pre-COVID-19 period.” We extracted educational background, marital status, occupation, presence of domestic partner, history of mental illness, alcohol consumption, history of previous suicide attempts; suicide attempt method and location (i.e., at home or a place other than home) at the time of attempt, and whether the attempt was a mass suicide. In addition, we compared patient severity between “COVID-19 period” and “pre-COVID-19 period” using the initial KTAS (South Korean triage and acuity scale) level, consciousness level, and systolic blood pressure. In 2012, KTAS was developed through the Ministry of Health and Welfare’s research project to establish triage system in South Korea. Results The analysis of the number of suicide attempts during “pre-COVID-19 period” and “ COVID-19 period” showed that the number of suicide attempts during “COVID-19 period” (n = 440) increased compared to the “pre-COVID-19 period” (n = 400). Moreover, the method of suicide attempts during “COVID-19 period” included overdose of drugs such as hypnotics, antipsychotics, and pesticides that were already possessed by the patient increased compared to the “pre-COVID-19 period” (P Conclusion With the worldwide COVID-19 virus spread, suicide rate and suicide attempts at home have significantly increased. In addition, patient severity was higher in the “COVID-19 period” than that in the “pre-COVID-19 period.” The increasing suicide attempt rate should be controlled by cooperation between the emergency room and regional organizations.

To differentiate the computed tomography (CT) and magnetic resonance imaging (MRI) features of porto-sinusoidal vascular disease (PSVD) and liver cirrhosis (LC).In this retrospective case-control study of patients with PSVD matched in a 1:3 ratio with LC patients according to liver function, initial diagnosis and time to final diagnosis were analyzed. Imaging features on CT and the parenchymal enhancement on hepatobiliary phase of hepatobiliary agent-enhanced MRI (HBA-MRI) were compared using a generalized linear mixed model. Focal hepatic lesions in the PSVD group were analyzed.In total, 43 PSVD patients and 129 LC patients were included. Among PSVD patients, 72.1% were initially misdiagnosed with LC. PSVD patients had a longer diagnostic delay than LC patients (32 months vs. 4 months; p 0.001). Liver surface nodularity was less common in the PSVD group than in the LC group (16.3% vs. 89.2%, p 0.001). Increased caudate-to-right lobe ratio, heterogeneous parenchymal enhancement, and portal vein abnormalities were more frequently noted in the PSVD group than in the LC group (all p 0.001). The grade of portal hypertension was significantly higher in the PSVD group than in the LC group (p 0.001), and they also had brighter parenchymal enhancement during the hepatobiliary phase of HBA-MRI (p 0.001). In the PSVD group, 14% patients had at least one focal hepatic lesion, primarily a focal nodular hyperplasia (FNH)-like nodule.Some imaging features on CT and HBA-MRI can distinguish PSVD from LC. Benign focal lesions, most commonly FNH-like nodules, can develop in PSVD.

To identify multiparametric MRI biomarkers to predict the tumor response to neoadjuvant FOLFIRINOX therapy in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). From May 2016 to March 2018, adult patients with BR or LA PDAC were prospectively enrolled in this study. They received eight cycles of FOLFIRINOX therapy and underwent multiparametric MRI twice (at baseline and after the second cycle). MRI evaluations included dynamic contrast-enhanced MRI, intravoxel incoherent motion diffusion-weighted imaging, and assessment of T2* relaxivity (R2*) and the change in T1 relaxivity (ΔR1, equilibrium phase R1 minus non-enhanced R1) of the tumors. Factors to predict the responders determined by the best overall response during FOLFIRINOX therapy and those to predict progression-free survival (PFS) and overall survival (OS) were evaluated using multivariable logistic regression and the Cox proportional hazard model. Forty-one patients (mean age, 60.3 years ± 9.3; 24 men) were included. Among the clinical and MRI factors, the baseline ΔR1 (adjusted odds ratio, 31.07; p = 0.008) was the only independent predictor for tumor response. The baseline ΔR1 was also an independent predictor for PFS (adjusted hazard ratio, 0.40; p = 0.033) along with R0 resection. The use of a cutoff ΔR1 value of ≥ 1.31 s-1 enabled prognostic stratification (median PFS, 16.0 months vs.10.0 months; p = 0.029; median OS, 34.9 months vs. 16.6 months; p = 0 .023, respectively). The baseline tumor ΔR1 value may be useful to predict tumor response and survival in patients with BR or LA PDAC receiving FOLFIRINOX neoadjuvant therapy. • Baseline ΔR1 was an independent predictor for tumor response (adjusted odds ratio, 31.07; p = 0.008) and progression-free survival (adjusted hazard ratio, 0.40; p = 0.033) in patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma receiving neoadjuvant FOLFIRINOX therapy. • The criterion of baseline ΔR1 value ≥ 1.31 s -1 allowed for the prediction of favorable tumor response and survival outcome after neoadjuvant FOLFIRINOX therapy.

Polaritons in two-dimensional (2D) materials have shown their unique capabilities to concentrate light into deep subwavelength scales. Precise control of the excitation and propagation of 2D polaritons has remained a central challenge for future on-chip nanophotonic devices and circuits. To solve this issue, we exploit Cherenkov radiation, a classic physical phenomenon that occurs when a charged particle moves at a velocity greater than the phase velocity of light in that medium, in low-dimensional material heterostructures. Here, we report an experimental observation of Cherenkov phonon polariton wakes emitted by superluminal one-dimensional plasmon polaritons in a silver nanowire and hexagonal boron nitride heterostructure using near-field infrared nanoscopy. The observed Cherenkov radiation direction and radiation rate exhibit large tunability through varying the excitation frequency. Such tunable Cherenkov phonon polaritons provide opportunities for novel deep subwavelength-scale manipulation of light and nanoscale control of energy flow in low-dimensional material heterostructures.

We theoretically and experimentally demonstrate the drastic changes in the wavelength scaling of tightly coupled metasurfaces caused by deep subwavelength variations in the distance between the unit resonators but no change in the length scale of the units themselves. This coupling-dependent wavelength scaling is elucidated by our model metasurfaces of ring resonators arranged with deep subwavelength lattice spacing g, and we show that narrower g results in rapider changes in wavelength scaling. Also, by using terahertz time-domain spectroscopy, we experimentally observed a significant shift of the spectral response arising from very small variations in lattice spacing, confirming our theoretical predictions.

Understanding light interaction with metallic structures provides opportunities of manipulation of light, and is at the core of various research areas including terahertz (THz) optics from which diverse applications are now emerging. For instance, THz waves take full advantage of the interaction to have strong field enhancement that compensates their relatively low photon energy. As the THz field enhancement have boosted THz nonlinear studies and relevant applications, further understanding of light interaction with metallic structures is essential for advanced manipulation of light that will bring about subsequent development of THz optics. In this review, we discuss THz wave interaction with deep sub-wavelength nano structures. With focusing on the THz field enhancement by nano structures, we review fundamentals of giant field enhancement that emerges from non-resonant and resonant interactions of THz waves with nano structures in both sub- and super- skin-depth thicknesses. From that, we introduce surprisingly simple description of the field enhancement valid over many orders of magnitudes of conductivity of metal as well as many orders of magnitudes of the metal thickness. We also discuss THz interaction with structures in angstrom scale, by reviewing plasmonic quantum effect and electron tunneling with consequent nonlinear behaviors. Finally, as applications of THz interaction with nano structures, we introduce new types of THz molecule sensors, exhibiting ultrasensitive and highly selective functionalities.

It has been demonstrated that circular dichroism (CD) signals from chiral molecules can be boosted by plasmonic nanostructures inducing strong local electromagnetic fields. To optimize nanostructures to improve CD enhancement, numerical simulations such as the finite element method (FEM) have been widely adopted. However, FEM calculations for CD have been frequently hampered by unwanted numerical artifacts due to improperly discretizing problem spaces. Here, we introduce a new meshing rule for FEM that provides CD simulations with superior numerical accuracy. We show that unwanted numerical artifacts can be suppressed by implementing the mirror-symmetric mesh configuration that generates identical numerical artifacts in the two-opposite circularly polarized waves, which cancel each other out in the final CD result. By applying our meshing scheme, we demonstrate a nanostructure/chiral molecule coupled system from which the CD signal is significantly enhanced. Since our meshing scheme addresses the previously unresolved issue of discriminating between very small CD signals and numerical errors, it can be directly applied to numerical simulations featuring natural chiral molecules which have intrinsically weak chiroptical responses.

Light is reflected at the interface between heterogeneous media due to the mismatch of impedance1–3. Removing this mismatch using additional materials, a technique known as anti-reflection, has so far been restricted to specific frequencies and incidence angles3–7. The anti-reflection of white light, which requires the simultaneous matching of impedance over extremely wide angular and spectral ranges, has until now been considered impossible. Here, we develop a theory of universal impedance matching and introduce a matching layer that enables the perfect transmission of white light. The ability of a matching layer to assist in omnidirectional and frequency-independent anti-reflection has been confirmed analytically and numerically. We explain the feasibility of a universal matching layer using metamaterials, and demonstrate a transmission rate of over 99% for white light in the visible range with a double-layered dielectric metamaterial. This is confirmed experimentally by demonstrating the omnidirectional anti-reflection of microwaves in heterogeneous media. An impedance matching layer that enables perfect transmission of all-angle, broadband white light is proposed. The concept is experimentally demonstrated in the microwave regime.

The optical and electrical characteristics of InGaN blue and green micro-light-emitting diodes (μLEDs) with GaN tunnel junction (TJ) contacts grown by metalorganic chemical vapor deposition (MOCVD) were compared at different activation temperatures among three activation methods from the literature, namely, sidewall activation, selective area growth (SAG), and chemical treatment before sidewall activation. The devices with chemical treatment before activation resulted in uniform electroluminescence and higher light output power, compared to the devices with sidewall activation and SAG. Moreover, the green μLEDs showed greater optical degradation at elevated activation temperatures, whereas the blue μLEDs yielded trivial difference with activation temperatures from 670 to 790 °C. The 5 × 5 μm2 devices with chemical treatment before activation and SAG yielded almost identical voltage at 20 A/cm2, and the voltage penalty significantly decreased with activation temperature in the case of devices with sidewall activation. The devices with chemical treatment before activation resulted in higher external quantum efficiency (EQE) and wall-plug efficiency (WPE) in low current density range compared to the devices with SAG. The enhancements in EQE and WPE were observed in different μLED sizes, suggesting that chemical treatment before sidewall activation enables the use of TJ contacts grown by MOCVD and is advantageous for applications that require high brightness and efficiency.