This paper introduces an on-chip ESD detection circuit and methodology for high current ESD discharges occurring to the back-side bulk silicon during wafer fabrication and assembly process.

ESD protection schemes are not common on internal circuitry and are often overlooked. This paper demonstrates the use of ESD techniques and EDA tools to analyze and address process damage induced during discharge events in the control circuitry of the internal 3D NAND metal source plate.

AimsThis multicentric retrospective study reports long-term clinical outcomes of non-metastatic grade group 5 prostate cancers treated with external beam radiotherapy (EBRT) alone with long-term androgen deprivation therapy (ADT).Materials and methodsPatients treated across 19 institutions were studied. The key endpoints that were evaluated were 5-year biochemical recurrence-free survival (bRFS), metastases-free survival (MFS), overall survival, together with EBRT-related acute and late toxicities. The impact of various prognostic factors on the studied endpoints was analysed using univariate and multivariate analyses.ResultsAmong the 462 patients, 88% (405) had Gleason 9 disease and 31% (142) had primary Gleason pattern 5. A prostate-specific membrane antigen positron emission tomography-computed tomography scan was used for staging in 33% (153), 80% (371) were staged as T3/T4 and 30% (142) with pelvic nodal disease. The median ADT duration was 24 months; 66% received hypofractionated EBRT and 71.4% (330) received pelvic nodal irradiation. With a median follow-up of 56 months, the 5-year bRFS, MFS and overall survival were 73.1%, 77.4% and 90.5%, respectively. Primary Gleason pattern 5 was associated with worse bRFS, MFS and overall survival with hazard ratios of 0.51 (95% confidence interval 0.35 to 0.73, P < 0.001), 0.64 (95% confidence interval 0.43 to 0.96, P = 0.031) and 0.52 (95% confidence interval 0.28 to 0.97, P = 0.040), respectively, whereas pelvic nodal disease was associated with worse bRFS (hazard ratio 0.67, 95% confidence interval 0.46 to 0.98, P = 0.039) and MFS (hazard ratio 0.56, 95% confidence interval 0.37 to 0.85, P = 0.006). The acute and late radiation-related toxicities were low overall and pelvic nodal irradiation was associated with higher toxicities.ConclusionContemporary EBRT and long-term ADT led to excellent 5-year clinical outcomes and low rates of toxicity in this cohort of non-metastatic grade group 5 prostate cancers. Primary Gleason pattern 5 and pelvic node disease portends inferior clinical outcomes.

Purpose/Objective(s)To study the prevalence of HPV negative Carcinoma Cervix (CC) and its prognostic impact on survival.Materials/MethodsData of all CC who were treated with concurrent chemoradiotherapy followed by brachytherapy from 1st Jan 2014 to 31st December 2018 was retrieved. A total of 79 patients whose biopsy samples were available for genotyping were included in the study. DNA was extracted from cervical cell suspensions using Qiagen DSP virus kit (Ref-60704). The genotyping was done using 3B Black Bio TRUPCR HPV HR with 16/18 genotyping kit which is based on amplification of E6/E7 region by primers and probes specific for detection of 14 HPV subtypes. All procedures were followed as per instructions on the kit insert. Survival analysis was done using Kaplan Meier survival curves with log rank test used to compare the factors with respect to Overall survival (OS) and recurrence free survival (RFS). Statistical software was used for all statistical analyses.ResultsSeventy one percent (56/79) of the patients were HPV positive whereas 29% (23/76) were HPV negative. Out of the HPV positive patients, P16 positivity was the most predominant genotype with 73.2% (41/56) patients testing positive for it followed by P18 (14.3%). The remaining 12.5% of patients tested positive for HPV 31,35,51,52,56,58,59 and 68 subtypes. The unusual high rates of HPV negativity could be due to cervical cancers evolving independent of high-risk HPV, loss of expression of HPV, misclassification of cancers and inherent false negativity rates of the methods used for testing of HPV. All these factors were kept to a minimum by ensuring that the low and intermediate risk subtypes of HPV responsible were also tested for, the misclassification of uterine endometrioid adenocarcinoma or metastasis as CC was minimized by independent review of two experienced pathologists and testing related errors were kept at bare minimum by following the standard procedures provided by the manufacturers. Based on the extant literature, the combined false negativity rate of all the above factors, combined together, was approximately 7-8%, leaving an unexplained 21-22% of the HPV negative prevalence in the cohort. This could well be due to the rising trend of HPV negative carcinoma cervix which need a nuanced look on a broader basis as it might lead to a readjustment of our tactics in prevention and management of CC. The estimated 5-year OS of the HPV positive and HPV negative population within the study group was 84.5% and 82.6% respectively (P value=0.425). Median overall survival was not reached and needs a longer follow-up.ConclusionThe HPV negativity rates among patients of CC in our study cohort were unusually high (29%). Detailed and systematic perusal of possible factors contributing to such high rates still left an uncharted void of approximately 21% which might be an early pointer towards rising trend of HPV negative CC.

Presently, the treatment of localized adenocarcinoma cervix patients is the same as squamous cell carcinoma. This study analyzes the long-term survival outcome and pattern of failure of adenocarcinoma patients treated at our institute.

Purpose/Objective(s) Surgery remains the mainstay of curative treatment for gastric cancer. However, there is varied practice across the globe regarding adjuvant treatment. This single institute retrospective study analyzed all gastric cancer patients who underwent curative surgery with D2 lymph nodal dissection, followed by either adjuvant chemotherapy (CT) alone or concurrent chemoradiation (CRT). Materials/Methods The study period was from January 2010 to December 2017. The patient data was gathered from electronic files and analyzed using Statistical Package for the Social Sciences, version 23. A comparison was made between the two adjuvant arms in terms of clinical outcomes, including overall survival (OS), recurrence-free survival (RFS), and failure patterns. Results 247 eligible patients who met the criteria were considered for analysis. There was a male preponderance, with 65.99% (163) males and 34.01% (84) females. The median age at diagnosis was 58 (18 to 87 years). The distal stomach was the most common location of tumors, with 64.3% occurring in the antro-pyloric region. Histopathological examination revealed stage-III cancer in the majority of the patients {44.53% (110)}, followed by stage-II {29.14% (72)}, and stage-I {12.96% (32)}. Adjuvant CRT was received by 49.39% (122) patients, and perioperative or adjuvant CT alone by 50.61% (125) patients. 19.02% (47) developed disease recurrence following treatment. Amongst these 47 patients, 61.70 % (29/47) had a locoregional, and 38.30% (18/47) failed distally. Lymph nodes were the most common sites of local failure accounting for 48.93% (23/47) of all cases, and the liver was the most common site of isolated distal failure 10% (5/47), followed by lung and bone (8%) each. Local recurrence was lower in the CRT group {34.49% (10/29) in the CRT arm and 65.51% (19/29) in CT alone arm, p-value – 0.087}. While distant metastasis was lower in CT alone arm {38.89% (7/18) vs. 61.11% (11/18), p-value – 0.302}. Of the entire study, the 5-year OS and RFS were 66.7% and 64.3%, respectively. The OS was 63.2% in the CRT arm and 67.8% in CT alone arm (p-value – 0.607). The RFS was 61.9% in the CRT arm and 65.6% in CT alone arm (0.138) Conclusion In our analysis, patients on the CRT arm had lower local recurrence; however, patients on the CT alone arm had lower distant metastasis. The CT alone arm showed a trend towards improved survival compared to the CRT arm; nevertheless, the difference was statistically non-significant. This warrants further studies to effectively combine radiation and chemotherapy in the adjuvant setting to lower both locoregional and distal metastasis.

Purpose/Objective(s) To study the effect of radiation treatment delay due to COVID-19 infection. Materials/Methods This study is a descriptive analysis. We studied all patients who were COVID-19 positive while undergoing radiation treatment. In addition, those COVID-19 positive patients before the start of radiation during their neoadjuvant treatment period or surgery were also analyzed. However, patients detected with COVID-19 infection after the radiation treatment course were excluded. The study period was from June 2020 to May 2021. A radiation treatment delay was defined as a delay in starting the treatment, a break in therapy during their scheduled radiation course, or treatment discontinuation. Patients who had a radiation treatment delay were followed-up till December 2021. Results Ninety-four patients who met the criteria were identified for the analysis. Seventy-seven of them had a mild infection, while 17 had a moderate or severe infection. Of the 94 patients identified, 83 patients had a treatment delay. The median treatment delay (MTD) was 18 (6 to 47) days and the median follow-up period was 13 months. In this cohort, 66 patients were treated with a curative intent, of which 51 are on follow-up {34 patients are disease-free (MTD – 18.5, 10 to 43), seven had either a residual disease or locoregional recurrence (MTD – 22, 10 to 32), seven had distant metastasis (MTD – 18, 15 to 47), and three patients died (MTD – 20, 8 to 27)}. Amongst the three patients who died, only one died of COVID-19 infection or sequel (Case Fatality Rate, CFR – 1.06%). Conclusion The CFR due to COVID-19 infection amongst those who underwent radiotherapy was low. At the same time, higher MTD might have been the reason for residual or locoregional recurrences. However, a longer follow-up is required to confirm this. Till then, it will remain debatable whether it was worth delaying radiotherapy for mild to moderate COVID-19 infection for a significant time to cause a potential cancer treatment failure.

Best-in-class (BIC) High-Voltage (HV) Electrostatic Discharge (ESD) solutions for 8-12V power pad protection in first-of-its-kind GlobalFoundries ® 28nm low-cost BCDLite process are evaluated. A comparative analysis between different types of devices, namely gate-grounded NMOS (GGNMOS), NPN, PNP and Diode, showing DC & 100ns Transmission Line Pulse (TLP) performance from Technology Computer-Aided Design (TCAD) simulations and silicon measurement results with performance metrics in terms of core device ESD protection effectiveness w.r.t Safe Operating Area (SOA) boundary and key Figures of Merit (FOMs) is elucidated.

Purpose/Objective(s)Though the etiological role of HPV infection in development of Carcinoma Cervix (CC) is well established, the prognostic impact of HPV genotyping is a question that still demands a categorical answer in the extant literature. This study intended to explore the relationship of HPV genotype and the locally advanced carcinoma cervix (LACC) patients in a prognostic milieu.Materials/MethodsData of all LACC who were treated with concurrent chemoradiotherapy followed by brachytherapy from 1st Jan 2014 to 31st December 2018 was retrieved. A total of 79 patients whose biopsy samples were available for genotyping were included in the study. DNA was extracted from cervical cell suspensions using Qiagen DSP virus kit (Ref-60704). The genotyping was done using 3B Black Bio TRUPCR HPV HR with 16/18 genotyping kit which is based on amplification of E6/E7 region by primers and probes specific for detection of all 14 HPV subtypes. Survival analysis was done using Kaplan Meier survival curves with log rank test used to compare the factors with respect to overall survival (OS) and recurrence free survival (RFS). Multivariate analysis (MVA) was done using cox proportional hazard regression model. Statistical software was used for all statistical analyses.ResultsSeventy one percent (56/79) of the patients were HPV positive whereas 29% (23/76) were HPV negative. Out of the HPV positive patients, P16 positivity was the most predominant genotype with 73.2% (41/56) patients testing positive for it followed by P18 (14.3%). The 5-year RFS was 83.5% and the mean time to recurrence was 71.32 months (95% CI, 65.5-77.15). The estimated 5-year OS of the HPV positive population within the study group was 84.5% and the corresponding survival for HPV negative patients was 82.6% (P value=0.425). Median overall survival was not reached as the number of events that occurred were insufficient in either of the group. The estimated 5-year OS of the HPV16 population was 83.9% and the corresponding survival statistic for HPV18 patients was 100% but this difference was statistically non-significant (P value=0.225). Univariate analysis showed that stage at presentation, MRI based post treatment response and presence of recurrence post treatment seemed to have an impact on OS and were therefore enrolled in MVA. On MVA, the factors found to have significant impact on OS were MRI based post treatment response (P value=0.001) and the presence of recurrence post-treatment (P value=0.048).ConclusionThough the HPV genotyping did not have any statistically significant prognostic impact on the OS of patients diagnosed with LACC, a larger cohort of patients and longer follow-up may give a definitive answer as suggested by the early trends of survival analysis in our cohort.

Purpose/Objective(s) Hypofractionated EBRT is beneficial in localized prostate cancer in view of the low alpha by beta ratio of prostate cancer cells, however, the role of elective nodal irradiation with the hypofractionated regimen is not well established, as concern regarding toxicity with hypofractionated nodal irradiation remains. Materials/Methods Patients with Carcinoma prostate were prospectively selected for treatment with hypofractionated EBRT. Patients with high-risk prostate cancer (T3a-T3b, GS>/= 8, PSA>20ng/ml) with an estimated risk of nodal involvement > 30% were radically treated with 60Gy and 44 Gy in 20 fractions to the primary and elective nodal area, respectively. Similarly, postoperative patients with high-risk features (pT3a-T3b, GS>/=8, estimated risk of nodal involvement >30%) were treated with early salvage EBRT, upon two consecutive rises of serum PSA above 0.1ng/ml. The dose prescribed was 52.5Gy and 44Gy in 20 fractions to primary bed and elective nodal area, respectively. Contouring for radical and salvage EBRT was done as per CHHiP and RADICALS RT protocol, respectively. Nodal volume was contoured as per the RTOG contouring guideline. Acute toxicities were recorded during and 6 months after treatment, as per RTOG grading criteria. All patients were treated with IMRT or VMAT plan. All patients received concurrent & adjuvant hormonal therapy. Results Between 1st January 2020 to 30th June 2021, 26 patients were treated with the hypofractionated regimen and elective nodal irradiation, of which 14 patients (54%) received radical EBRT and 12 patients (46%) received early salvage EBRT. The median age of patients was 66 years. Patients were prospectively followed up with a median follow-up period of 12 months. For patients treated with radical EBRT, D95% to primary PTV was 60.06 Gy (Median, IQ range 59.8-60.2Gy) and D95% to nodal PTV was 44.1 Gy (Median, IQ range 43.7-44.3Gy). V48Gy of Bladder was 23.2% (Median, IQ range 21.5-26.6%). V40Gy for bowel bag was 112cc (Median, IQ range 90-145cc). Similarly in patients receiving early salvage EBRT, D95% to primary bed was 51.5Gy (Median, IQ range 51.2-51.7 Gy), D95% to the nodal area was 43.9Gy (Median, IQ range 43.1-44.5 Gy). V48Gy of bladder was 38% (Median, IQ range 28-47.6%) and V40Gy for bowel bag was 210cc (Median, IQ range 123-253cc). Overall, 5 patients (19%) had grade 2 genitourinary toxicities and 6 patients (23%) had grade 2 bowel toxicity. No patients experienced grade 3 or 4 bowel and bladder toxicity. Historical data for grade 2 or more acute bowel and bladder toxicities were 38% and 49% respectively in the CHHiP trial, which used IMRT plan for only 30% of patients. No patient in our study had a biochemical recurrence in the short follow-up period. Conclusion Hypofractionated elective nodal irradiation can be safely delivered in high-risk prostate cancer patients without any undue increase in acute bowel and bladder toxicities.

Novel ESD compact modeling methodology using machine learning techniques is proposed for the first time in this paper. Comparisons between conventional, novel fitting methodology and different machine learning models are discussed. The advantages of this novel methodology are introduced and methods to further improve the model accuracy are also discussed.

The COVID-19 pandemic in India has had an unequal impact on women in a number of ways In terms of economic opportunity, it has been seen that more women lost jobs compared to men and fewer have been able to rejoin labour force This is in the context of gendered labour markets where female labour force participation has been low and declining This paper presents an analysis of the situation of women's employment pre-lockdown and some indications on what the impact of COVID-19 could be, based on microstudies and other literature available Further, the adequacy of the social protection and employment generation programmes of the government that are specifically aimed at improving female labour force participation is assessed © 2021 Economic and Political Weekly All rights reserved

Cascoded FETs in FDSOI under ESD stress are characterized and modeled for the first time. A novel characterization structure is developed to regulate channel modulation precisely. ESD failure voltage (Vt2) modulation of cascoded FETs is explained and excellent model to hardware correlation is demonstrated.

A predictive ESD TCAD deck including the workflow is developed for the 12nm FinFET technology. ESD failure in the I/O FET and ESDNFET is analyzed through TCAD simulation with calibrated silicon fin dimension-dependent thermal conductivity.

Neoadjuvant short course RT (scRT) and chemotherapy followed by delayed surgery and adjuvant completion chemotherapy have been hypothesized to increase the pathological complete response (pCR), decrease distant failures and improve survival in locally advanced rectal cancer patients. Patients who have undergone scRT from November 2018 till July 2019 have been included in an intention to treat analysis. They received 25Gy/5fractions/5 days followed by FOLFOX based chemotherapy for 4-6 cycles followed by surgery and completion chemotherapy. Radio-biological evaluation was done by PET MRI at baseline and after completion of 4 cycles of chemotherapy. Inclusion criteria was locally advanced T3/T4, N0/N+ lesions including synchronous liver only metastasis patients. The primary endpoint is complete pathological response (cPR). Secondary endpoints are survival analysis, toxicity evaluation, additional radiological/ biological response grading and analysis. 65 patients were enrolled of whom 50 completed scRT.T3 disease was 86% (43/50) and T4, 14% (7/50). All except 3 (94%) had node positive on MRI.20% (10/50) had liver only metastatic disease and 80% (40/50) had locoregional disease. Local radical surgery was done in 52% (26/50) patients: 3/10 in the metastatic group after hepatic resection and 23/40 in non-metastatic group. In the metastatic cohort: 5 patients had progressive disease (PD) and 2 were lost to follow up (LFU). In non-metastatic cohort: 5 patients refused for surgery, 6 patients were LFU and 6 had PD. Surgery was done in 26 patients: 12/26 had ELAPE, 3/26 had APR, 9/26 had LAR and 2/16 had total proctocolectomy. All achieved negative resection margins. AJCC pathological tumor regression grade (pTRG) was assessed: 9/26(34.6%) had pTRG 0 (Complete response), 10/26(38.4%) patients had pTRG 1 (Moderate/significant response), 7/26(27%) had pTRG 2 (Minimal response), 0/26 (0%) had pTRG3 (Poor response). 8 patients had pathological node positivity. in which 62.5% (5/8) had a minimal response (TRG2), 25% (2/8) had pTRG1 and 12.5% (1/8) patient had pTRG0.PNI positivity in surgical specimen seen in 2/16 patients who had liver only metastasis and had minimal response (TRG2). GI toxicity was assessed in terms of diarrhea, pain abdomen, need for admission. Grade 2/3 neutropenia was seen in 49% of patients during chemotherapy. MRTRG& ADC value change in MRI and biological SUV change in PET were statistically analyzed in pretreatment and post neoadjuvant RT + chemotherapy scans. All parameters were correlated with pTRG and pathological T staging but none had a direct significant correlation (p<0.05) In our study, scRT followed by adjuvant chemotherapy and a delayed surgery, achieved high complete and near complete pathological response rates (73%). Such regimen looks promising and has the potential to change management paradigm in near future. Post-surgical complication rates, survival analysis and other late effects are awaited.

Human papillomavirus (HPV) and smoking are independent factors affecting survival in OPSCC. Radiomics has emerged as a promising tool for imaging biomarker discovery in era of precision medicine. We investigate the ability of Radiomics to predict molecular phenotype from a study population of OPSCC. Further we explored potential of Radiomics alone and in combination with diffusion imaging derived quantitative parameter apparent diffusion co-efficient (ADC), clinical parameters (addiction- smoking) using supervised classification algorithms in predicting outcomes. Retrospective evaluation of the imaging was conducted for a study cohort of 40 patients in whom p16, EGFR and p53 molecular phenotype was done using immunohistochemistry (IHC). One radiologist having 6 years of experience manually drew the region of interest on the tumor for purposes of segmentation and textural analysis. ADC values were calculated from conventional from the darkest part of the tumor, both before and post treatment with chemo radiation. The segmented tumor was validated independently by two radiologists having 30 years of experience each. A total of 851 Radiomics features were extracted from the available imaging using slicer 3D software and Pyradiomics. Feature selection (48 for molecular phenotype and 32 for clinical determinants) was done by taking the union of the features which had Pearson correlation >0.3 with p16 and EGFR status, > 0.4 for p53, > 0.3 with Grade of tumor and > 0.6 with T Stage. Models were trained to predict the biomarkers using leave one out cross-validation and different algorithms for biomarker prediction and prognostic outcomes (T stage, Grade of tumor and Recurrence). Using Radiomics features alone and different machine learning models in prediction of molecular phenotypes we were able to achieve an accuracy of 89% for p16 and 80% for EGFR. The Kappa score (0.51) and the area under the curve (AUC) was 0.79 for EGFR expression. Using the Monotype multilayer perceptron neural network to determine grade of tumor best results (accuracy 89%, kappa 0.61 and AUC 0.82) were achieved when Radiomics was used alone. The combination of Radiomics with addiction provided better AUC of 0.86 and accuracy of 88%. Accuracy for T staging was 60 % with AUC 0.81, while for recurrence combination of Radiomics, baseline ADC values and clinical addiction gave us best model with accuracy of 81%, AUC 0.76 and kappa of 0.45. (Details in table) The study is an effort to bridge the unmet need of translational predictive biomarkers in stratification of HPV positive OPSCC patients based on prognosis value. Radiomics features on imaging could be vital in deciphering molecular phenotypes, serve as tools for prognostication and predict recurrence.