A thin-film transistor (TFT) with a Ti-IGZO channel layer and Hf1-xAlxO gate dielectric is proposed to improve the performance and reliability of the device. The experimental results show that in three types of TFTs based on HfO2/IGZO, Hf1-xAlxO/IGZO and Hf1-xAlxO/Ti-IGZO gate dielectric/channel structures, the Hf0.88Al0.12O/Ti (2.0%)-IGZO TFT exhibits the best device performance with the subthreshold swing of 86 mV dec−1, field-effect mobility of 28.63 cm2∙V−1∙s−1 and on/off current ratio of 3.26 × 108. In particular, it shows a hysteresis voltage as low as 0.02 V and a threshold voltage shift after 1000 s positive/negative gate bias stress/white light illumination of 0.134 V/−0.089 V/−0.195 V, compared with 0.45 V and 0.612 V/−0.507 V/−0.657 V of the HfO2/IGZO TFT. These improvements are due to the incorporation of Ti into the IGZO channel, which reduces defect density, while adding Al to HfO2 improves surface roughness to inhibit surface scattering and charge capture during stress testing.

Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation leads to high morbidity and mortality. The Stapfer classification divides patients with different perforation locations and suggests management accordingly. The classification may be unknown if perforation is not detected during endoscopy. We classified patients with ERCP-related perforation (ERP) through computed tomography (CT) and observed the clinical outcomes with varyingly invasive management. Fifty-two cases of ERP between July 2009 and December 2017 were retrospectively reviewed. Of them, 41 who underwent CT for ERCP were included. According to their CT findings, we divided patients into air-alone (n = 16), air-fluid (n = 18), and fluid-alone (n = 7) groups. Perforation severity was graded using the Clavien-Dindo classification for surgical complications. Demographic data and clinical outcomes among different groups were analyzed. Fifteen patients (37%) had an unknown Stapfer classification. More than half of the patients in the air-fluid group had a Clavien-Dindo complication grade of >3. Four patients underwent surgical repair; all of them were from the airfluid group. All patients in the air-and fluid-alone groups underwent medical treatment without need for subsequent salvage surgery. The air-fluid group had the longest mean hospital stay (25.1 ± 21.9 days) and the exclusive two mortality cases in this study. Patients with ERCP can be divided into groups with different outcomes according to the presence of air or fluid on CT images. Because patients with both air and fluid have the worst clinical outcome, they may require more aggressive treatment than patients with either air or fluid alone. K E Y W O R D S air, computed tomography, endoscopic retrograde cholangiopancreatography, fluid, perforation 1 | INTRODUCTION Complications from endoscopic retrograde cholangiopancreatography (ERCP) include cholangitis, pancreatitis, bleeding, and perforation. The likelihood of these complications is 5%-12% in all cases, and they can increase morbidity and mortality. 1 Among these complications, endoscopic retrograde cholangiopancreatography-related perforation (ERP)remains a clinical challenge to endoscopists because it may be overlooked during these procedures and there is no consensus on its management. Overall, the incidence of ERP is approximately 0.1%-1.6% 2,3 with a mortality rate of 3%-35.7%. 4,5 Surgical debridement and repair is the mainstay of treatment options for ERP. It is, however, associated with high morbidity and mortality; recent studies have suggested more conservative treatment for certain

Conflicts of interest The author discloses no conflicts.

Background and study aims Early detection of upper gastrointestinal (UGI) rebleeding is not easy by observing clinical symptoms. We developed a novel UGI monitoring system and aimed to test its feasibility of continuous tracking of UGI bleeding. Patients and methods A prospective study was conducted on patients with moderate to high risk of rebleeding. The UGI monitoring system was installed to monitor their gastric contents. It would alarm if rebleeding was suspected and the physician could review the images to make a further decision. The patient’s comfort level was also evaluated. Results Sixteen patients were enrolled. Rebleeding occurred in one patient and was detected by this system more than 5 hours earlier than with clinical symptoms. The interobserver reliability for reviewing the images to define the blood clearance in the stomach was excellent (intraclass correlation coefficient 0.79–0.96). The comfort level assessed by patients was 1.90 ± 1.39 (on the scale of 0–5). Conclusions This pilot study demonstrated the potential of this UGI monitoring system for early detection of rebleeding.