Recently, negative differential resistance devices have attracted considerable attention due to their folded current-voltage characteristic, which presents multiple threshold voltage values. Because ...of this remarkable property, studies associated with the negative differential resistance devices have been explored for realizing multi-valued logic applications. Here we demonstrate a negative differential resistance device based on a phosphorene/rhenium disulfide (BP/ReS
) heterojunction that is formed by type-III broken-gap band alignment, showing high peak-to-valley current ratio values of 4.2 and 6.9 at room temperature and 180 K, respectively. Also, the carrier transport mechanism of the BP/ReS
negative differential resistance device is investigated in detail by analysing the tunnelling and diffusion currents at various temperatures with the proposed analytic negative differential resistance device model. Finally, we demonstrate a ternary inverter as a multi-valued logic application. This study of a two-dimensional material heterojunction is a step forward toward future multi-valued logic device research.
It is unclear whether laparoscopic distal gastrectomy for locally advanced gastric cancer is oncologically equivalent to open distal gastrectomy. The noninferiority of laparoscopic subtotal ...gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer compared with open surgery in terms of 3-year relapse-free survival rate was evaluated.
A phase III, open-label, randomized controlled trial was conducted for patients with histologically proven locally advanced gastric adenocarcinoma suitable for distal subtotal gastrectomy. The primary end point was the 3-year relapse-free survival rate; the upper limit of the hazard ratio (HR) for noninferiority was 1.43 between the laparoscopic and open distal gastrectomy groups.
From November 2011 to April 2015, 1,050 patients were randomly assigned to laparoscopy (n = 524) or open surgery (n = 526). After exclusions, 492 patients underwent laparoscopic surgery and 482 underwent open surgery and were included in the analysis. The laparoscopy group, compared with the open surgery group, suffered fewer early complications (15.7%
23.4%, respectively;
= .0027) and late complications (4.7%
9.5%, respectively;
= .0038), particularly intestinal obstruction (2.0%
4.4%, respectively;
= .0447). The 3-year relapse-free survival rate was 80.3% (95% CI, 76.0% to 85.0%) for the laparoscopy group and 81.3% (95% CI, 77.0% to 85.0%; log-rank
= .726) for the open group. Cox regression analysis after stratification by the surgeon revealed an HR of 1.035 (95% CI, 0.762 to 1.406; log-rank
= .827;
for noninferiority = .039). When stratified by pathologic stage, the HR was 1.020 (95% CI, 0.751 to 1.385; log-rank
= .900;
for noninferiority = .030).
Laparoscopic distal gastrectomy with D2 lymphadenectomy was comparable to open surgery in terms of relapse-free survival for patients with locally advanced gastric cancer. Laparoscopic distal gastrectomy with D2 lymphadenectomy could be a potential standard treatment option for locally advanced gastric cancer.
This paper is a study on the application position of skew in order to reduce the cogging torque of a magnetic geared synchronous motor (MGM). The cogging torque affects the noise and vibration of the ...motor, so it should be reduced as much as possible. To solve this problem, a conventional permanent magnet (PM) synchronous motor is skewed to a PM. However, unlike other synchronous motors, the MGM has pole pieces (PPs), and a larger cogging torque is generated due to a larger reluctance difference. There have been few studies on the reduction of cogging torque of MGM, so it is essential to study the skew structure of MGM. Therefore, this paper has derived the optimum skew method by comparing and analyzing three models of MGM skewed to PM, PP, and PM and PP simultaneously.
Neuromorphic olfactory systems have been actively studied in recent years owing to their considerable potential in electronic noses, robotics, and neuromorphic data processing systems. However, ...conventional gas sensors typically have the ability to detect hazardous gas levels but lack synaptic functions such as memory and recognition of gas accumulation, which are essential for realizing human‐like neuromorphic sensory system. In this study, a seamless architecture for a neuromorphic olfactory system capable of detecting and memorizing the present level and accumulation status of nitrogen dioxide (NO2) during continuous gas exposure, regulating a self‐alarm implementation triggered after 147 and 85 s at a continuous gas exposure of 20 and 40 ppm, respectively. Thin‐film‐transistor type gas sensors utilizing carbon nanotube semiconductors detect NO2 gas molecules through carrier trapping and exhibit long‐term retention properties, which are compatible with neuromorphic excitatory applications. Additionally, the neuromorphic inhibitory performance is also characterized via gas desorption with programmable ultraviolet light exposure, demonstrating homeostasis recovery. These results provide a promising strategy for developing a facile artificial olfactory system that demonstrates complicated biological synaptic functions with a seamless and simplified system architecture.
An artificial olfactory sensor system capable of detecting gas accumulation via memory characteristics is investigated, all in a seamless architecture. The neuromorphic olfactory system exhibits excitatory action in response to NO2 gas, triggering an alarm at dangerous levels of gas adsorption. Furthermore, inhibitory properties from pulsed UV light are analyzed, demonstrating autonomous recovery that mimic the biological homeostasis function.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Alkaline water electrolysis (AWE) systems offer a cost‐effective and scalable approach for large‐scale hydrogen production using renewable energy sources. However, their susceptibility to load ...fluctuations, particularly the reverse‐current (RC) phenomenon during shutdown events, poses a significant challenge to the long‐term stability and scalability of these systems. Herein, a catalytic approach for enhancing the RC tolerance in AWE systems by using Pb‐decorated Ni cathode catalysts (Pb/Ni) is introduced. The oxidation of Pb/Ni by repeated RC lowers the electromotive force for the reverse current operation, and consequently, imparts RC tolerance. Intriguingly, contrary to the expectation that the decoration with lead, an inert material for the hydrogen evolution reaction (HER), will interfere with the hydrogen generation of the Ni catalyst, the presence of Pb on the Ni cathode after the RC flow promotes both the proton desorption and water‐dissociation steps, improving the HER activity. Furthermore, the AWE stack testing with Pb/Ni catalysts is perfectly operated, demonstrating remarkably enhanced RC tolerance during startup/shut‐down (SU/SD) testing protocol. This paper presents a new strategy for mitigating the AWE performance degradation induced by RC flow and for achieving Pb/Ni catalysts with improved operational durability against RC flow in AWE systems.
The transient stability of the catalyst caused by the reverse‐current phenomenon during the shutdown of the AWE system by load fluctuations is one of the most challenging limitations to address. This study introduces a catalytic approach for enhancing the RC by decorating lead on Ni catalysts. The surface decoration of the Ni catalyst with Pb (Pb/Ni) catalyst exhibits improved HER activity as well as remarkable RC‐flow resistance.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
OBJECTIVE:To compare short-term surgical outcomes including financial cost of robotic and laparoscopic gastrectomy.
BACKGROUND:Despite a lack of supporting evidence, robotic surgery has been ...increasingly adopted as a minimally invasive modality for the treatment of gastric cancer because of its assumed technical superiority over conventional laparoscopy.
METHODS:A prospective, multicenter comparative study was conducted. Patients were matched according to the surgeon, extent of gastric resection, and sex. The primary endpoint was morbidity and mortality. Outcomes were analyzed on an intention-to-treat and per-protocol basis.
RESULTS:A total of 434 patients were enrolled for treatment with either robotic (n = 223) or laparoscopic (n = 211) gastrectomy for intention-to-treat analysis, and a total of 370 patients (n = 185 per treatment) were compared in per-protocol analysis. Results were similar between both analyses. In per-protocol analysis, both group s showed similar overall complication rates (robotic = 11.9% vs laparoscopic = 10.3%) and major complication rates (robotic = 1.1% vs laparoscopic = 1.1%) with no operative mortality in either group. Patients treated with robotic surgery showed significantly longer operative time (robotic = 221 minutes vs laparoscopic = 178 minutes; P < 0.001) and significantly higher total costs (robotic = US$13,432 vs laparoscopic = US$8090; P < 0.001), compared with those who underwent laparoscopic gastrectomy. No significant differences between groups were noted in estimated blood loss, rates of open conversion, diet build-up, or length of hospital stay.
CONCLUSIONS:The use of robotic systems is assumed to provide a technically superior operative environment for minimally invasive surgery. However, our analysis of perioperative surgical outcomes indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. Clinical trials identificationNCT01309256.
This paper proposes an all-in-one system for hyperloop that conducts propulsion, levitation, and guidance. Currently demand on high-speed long-distance transportation is increasing, so that hyperloop ...is getting attention and studied hard globally. Hyperloop is a new innovative transportation in which a levitated subsonic speed train travels through a vacuum cylindrical tube. Hyperloop needs functions of propulsion, levitation, and guidance for its service, and many devices are necessary for those functions. In the tube, a constrained space, many devices make the entire system complicated, and the size of the vehicle and tube are increased. Therefore, the costs of maintenance, manufacture, and construction are increased and control of each device becomes very difficult. But a non-symmetric double-sided linear induction motor (NSDLIM), the subject of this paper, is an all-in-one system that could conduct all functions. In this paper, the concept of NSDLIM was introduced and its possibility was suggested. Requirements of NSDLIM were investigated considering very high acceleration, velocity, and low air pressure. An NSDLIM model was designed and analyzed by using the finite-element method. Then, NSDLIM parameters that affect performance were investigated and adjusted to improve performance. The derived model performance was shown, and its possibility was considered.
Myogenic progenitors (MPs) generate myocytes that fuse to form myofibers during skeletal muscle development while maintaining the progenitor pool, which is crucial for generating sufficient muscle. ...Notch signaling has been known to reserve a population of embryonic MPs during primary myogenesis by promoting cell cycle exit and suppressing premature differentiation. However, the roles of individual Notch receptors (Notch1-4) during embryonic/fetal myogenesis are still elusive. In this study, we found that Notch1 and Notch2, which exhibit the highest structural similarity among Notch receptors, maintain the MP population by distinct mechanisms: Notch1 induces cell cycle exit and Notch2 suppresses premature differentiation. Moreover, genetic and cell culture studies showed that Notch1 and Notch2 signaling in MPs are distinctively activated by interacting with Notch ligand-expressing myofibers and MP-lineage cells, respectively. These results suggest that through different activation modes, Notch1 and Notch2 distinctively and cooperatively maintain MP population during fetal myogenesis for proper muscle development.
The advantages of laparoscopic resection over open surgery in the treatment of gastric gastrointestinal stromal tumor (GIST) are not conclusive. This study aimed to evaluate the postoperative and ...oncologic outcome of laparoscopic resection for gastric GIST, compared to open surgery. We retrospectively reviewed the prospectively collected database of 1019 patients with gastric GIST after surgical resection at 13 Korean and 2 Japanese institutions. The surgical and oncologic outcomes were compared between laparoscopic and open group, through 1:1 propensity score matching (PSM). The laparoscopic group (N = 318) had a lower rate of overall complications (3.5% vs. 7.9%, P = 0.024) and wound complications (0.6% vs. 3.1%, P = 0.037), shorter hospitalization days (6.68 ± 4.99 vs. 8.79 ± 6.50, P < 0.001) than the open group (N = 318). The superiority of the laparoscopic approach was also demonstrated in patients with tumors larger than 5 cm, and at unfavorable locations. The recurrence-free survival was not different between the two groups, regardless of tumor size, locational favorableness, and risk classifications. Cox regression analysis revealed that tumor size larger than 5 cm, higher mitotic count, R1 resection, and tumor rupture during surgery were independent risk factors for recurrence. Laparoscopic surgery provides lower rates of complications and shorter hospitalizations for patients with gastric GIST than open surgery.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Spinal muscular atrophy (SMA) is a neuromuscular disorder characterized by the deficiency of the survival motor neuron (SMN) protein, which leads to motor neuron dysfunction and muscle atrophy. In ...addition to the requirement for SMN in motor neurons, recent studies suggest that SMN deficiency in peripheral tissues plays a key role in the pathogenesis of SMA. Using limb mesenchymal progenitor cell (MPC)-specific SMN-depleted mouse models, we reveal that SMN reduction in limb MPCs causes defects in the development of bone and neuromuscular junction (NMJ). Specifically, these mice exhibited impaired growth plate homeostasis and reduced insulin-like growth factor (IGF) signaling from chondrocytes, rather than from the liver. Furthermore, the reduction of SMN in fibro-adipogenic progenitors (FAPs) resulted in abnormal NMJ maturation, altered release of neurotransmitters, and NMJ morphological defects. Transplantation of healthy FAPs rescued the morphological deterioration. Our findings highlight the significance of mesenchymal SMN in neuromusculoskeletal pathogenesis of SMA and provide insights into potential therapeutic strategies targeting mesenchymal cells for the treatment of SMA.
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