Various low-volume bowel cleansing formulations that improve compliance have been approved and are being used in clinical practice. This study aimed to compare the effectiveness of 1 L polyethylene ...glycol (PEG) with ascorbic acid with that of sodium picosulfate (PICO) with magnesium citrate. This was a multicenter, randomized controlled, non-inferiority study. Patients were randomized into a 1 L PEG with ascorbic acid group and a PICO with magnesium citrate group according to the bowel cleansing agent used. Colonoscopy was performed as a single-blind study wherein the endoscopist had no information about any bowel preparation agent. The efficacy of bowel cleansing was assessed using the Harefield Cleansing Scale (HCS), and adverse events, preferences, and satisfaction were evaluated using a patient-reported questionnaire before colonoscopy. A total of 254 participants were randomly assigned to two groups: 115 in the 1 L PEG with ascorbic acid group and 113 in the PICO with magnesium citrate group. Overall bowel cleansing success was not statistically different between the two groups (97.4 vs. 97.3%), confirming that 1 L PEG with ascorbic acid was not inferior to PICO with magnesium citrate (lower confidence limit, -4.15%; p = 1.00). High-quality bowel cleansing was achieved in 87% of the 1 L PEG with ascorbic acid group and 77% of the PICO with magnesium citrate group (Lower confidence limit, 1.29%, p = 0.05). In terms of patient satisfaction, PICO with magnesium citrate was better, but compliance and side effects were similar in both groups. The 1 L PEG with ascorbic acid showed similar efficacy and adverse events as PICO with magnesium citrate. Although 1 L PEG with ascorbic acid is very effective in bowel preparation despite its small volume, it is necessary to increase satisfaction such as taste and feeling.
With the rapid deployment of present-day mobile communication systems, user traffic requirements have increased tremendously. An ultra-dense network is a configuration in which the density of small ...base stations is greater than or equal to that of the user equipment. Ultra-dense networks are considered as the key technology for 5th generation networks as they can improve the link quality and increase the system capacity. However, in an ultra-dense network, small base stations are densely positioned, so one user equipment may receive signals from two or more small base stations. This may cause a severe inter-cell interference problem. In this study, we considered a coordinated multi-point scenario, a cooperative technology between base stations to alleviate the interference. In addition, to suppress the occurrence of severe interference at the cell edges, link formation was carried out by considering the degree of cell load for each cluster. After the formation of links between all the base stations and user equipment, a subcarrier allocation procedure was performed. The subcarrier allocation method used in this study was based on the location of base stations with clustering to improve the data rate and reduce the interference between the clusters. Power allocation was based on the channel gain between the base station and user equipment. Simulation results showed that the proposed scheme delivered a higher sum rate than the other resource allocation methods reported previously for various types of user equipment.
Flash memory is a promising candidate for use in in‐memory computing (IMC) owing to its multistate operations, high on/off ratio, non‐volatility, and the maturity of device technologies. However, its ...high operation voltage, slow operation speed, and string array structure severely degrade the energy efficiency of IMC. To address these challenges, a novel negative capacitance‐flash (NC‐flash) memory‐based IMC architecture is proposed. To stabilize and utilize the negative capacitance (NC) effect, a HfO2‐based reversible single‐domain ferroelectric (RSFE) layer is developed by coupling the flexoelectric and surface effects, which generates a large internal field and surface polarization pinning. Furthermore, NC‐flash memory is demonstrated for the first time by introducing a RSFE and dielectric heterostructure layer in which the NC effect is stabilized as a blocking layer. Consequently, an energy‐efficient and high‐throughput IMC is successfully demonstrated using an AND flash‐like cell arrangement and source‐follower/charge‐sharing vector‐matrix multiplication operation on a high‐performance NC‐flash memory.
An HfO2‐based reversible single‐domain ferroelectric (RSFE) film is developed by coupling the flexoelectric and surface effects to stabilize the NC effect. Moreover, the negative capacitance‐flash (NC‐flash) device is demonstrated by integrating a blocking layer composed of RSFE/dielectric heterostructure where the NC effect is stabilized. Furthermore, an AND flash‐like array and source‐follower/charge‐sharing vector‐matrix multiplication‐operation is applied to the NC‐flash for in‐memory computing.
Background
There are few studies on electrocoagulation syndrome after colorectal endoscopic submucosal dissection (ESD). This study aimed to investigate the various risk factors associated with ...thermal injury and to determine the prognosis of post-colorectal ESD electrocoagulation syndrome (PECS).
Methods
We conducted a retrospective analysis of the medical records of 395 colorectal neoplasms of 508 patients who were treated with colorectal ESD between January 2013 and December 2019. The incidence, risk factors, and clinical outcomes of colorectal PECS were evaluated and analyzed.
Results
Colorectal PECS occurred in 25 patients (6.3%). The PECS group had a larger lesion size (≥ 40 mm), lesions with fibrosis, longer procedure time, older age, and a larger amount of submucosal injection per square meter than the non-PECS group. In multivariate analysis, lesion with size ≥ 40 mm (odds ratio OR 16.941, 95% confidence interval CI 3.869–74.178), lesions with fibrosis (OR 7.127, 95% CI 2.541–19.984), old age (OR 1.068, 95% CI 1.010–1.130), and amount of submucosal injection per square meter (OR 1.067, 95% CI 1.015–1.121) were independent risk factors. The PECS group had more fasting days (3.08 vs 1.56 days,
P
< 0.001), longer hospital stays (7.04 vs 4.09 days,
P
< 0.001), and higher medical costs (2367 vs 2046, US$,
P
= 0.004) than the non-PECS group.
Conclusion
Lesions with size ≥ 40 mm, lesions with fibrosis, old age, and amount of submucosal injection per square meter were independent risk factors. Therefore, caution should be exercised when performing colorectal ESD in patients with these risk factors.
Proliferating cell nuclear antigen (PCNA) plays a critical role as a processivity clamp for eukaryotic DNA polymerases and a binding platform for many DNA replication and repair proteins. The ...enzymatic activities of PCNA loading and unloading have been studied extensively in vitro. However, the subcellular locations of PCNA loaders, replication complex C (RFC) and CTF18-RFC-like-complex (RLC), and PCNA unloader ATAD5-RLC remain elusive, and the role of their subunits RFC2-5 is unknown. Here we used protein fractionation to determine the subcellular localization of RFC and RLCs and affinity purification to find molecular requirements for the newly defined location. All RFC/RLC proteins were detected in the nuclease-resistant pellet fraction. RFC1 and ATAD5 were not detected in the non-ionic detergent-soluble and nuclease-susceptible chromatin fractions, independent of cell cycle or exogenous DNA damage. We found that small RFC proteins contribute to maintaining protein levels of the RFC/RLCs. RFC1, ATAD5, and RFC4 co-immunoprecipitated with lamina-associated polypeptide 2 (LAP2) α which regulates intranuclear lamin A/C. LAP2α knockout consistently reduced detection of RFC/RLCs in the pellet fraction, while marginally affecting total protein levels. Our findings strongly suggest that PCNA-mediated DNA transaction occurs through regulatory machinery associated with nuclear structures, such as the nuclear matrix.
Resistive nonvolatile memory (NVM) is considered to be a leading candidate for next-generation memory. However, maintaining a target sensing margin is a challenge with technology scaling because of ...the increased process variation and decreased read cell current. This paper proposes an offset-canceling current-sampling sense amplifier (OCCS-SA) that is intended for use in deep submicrometer resistive NVM. The proposed OCCS-SA has the three major advantages of: 1) offset voltage cancellation; 2) double sensing margin structure; and 3) strong positive feedback. The measurement results from a 65 nm test chip show that the proposed OCCS-SA achieves 2.4 times faster sensing time (t SEN ) at a nominal supply voltage (V DD ) of 1.0 V and a greater than 20% reduction in V DD at the same t SEN , compared to the state-of-the-art current-sampling-based SA, which features offset voltage cancellation and weak positive feedback.
Abstract
R-loops are formed when replicative forks collide with the transcriptional machinery and can cause genomic instability. However, it is unclear how R-loops are regulated at ...transcription-replication conflict (TRC) sites and how replisome proteins are regulated to prevent R-loop formation or mediate R-loop tolerance. Here, we report that ATAD5, a PCNA unloader, plays dual functions to reduce R-loops both under normal and replication stress conditions. ATAD5 interacts with RNA helicases such as DDX1, DDX5, DDX21 and DHX9 and increases the abundance of these helicases at replication forks to facilitate R-loop resolution. Depletion of ATAD5 or ATAD5-interacting RNA helicases consistently increases R-loops during the S phase and reduces the replication rate, both of which are enhanced by replication stress. In addition to R-loop resolution, ATAD5 prevents the generation of new R-loops behind the replication forks by unloading PCNA which, otherwise, accumulates and persists on DNA, causing a collision with the transcription machinery. Depletion of ATAD5 reduces transcription rates due to PCNA accumulation. Consistent with the role of ATAD5 and RNA helicases in maintaining genomic integrity by regulating R-loops, the corresponding genes were mutated or downregulated in several human tumors.
Although gastric cancer patients have a high incidence and risk of colorectal cancer, evidence is lacking regarding whether early gastric neoplasms (EGNs), such as gastric adenomas and early gastric ...cancer, are risk factors for colorectal adenoma. This study aimed to investigate the incidence of colorectal adenomas in patients with EGN. This prospective study was conducted between January 2015 and December 2016. Of the 307 patients who underwent gastric endoscopic submucosal dissection for EGN, 110 patients were enrolled in the EGN group, and 110 age- and sex-matched healthy persons from the screening population were included in the control group in a 1:1 ratio. Demographic factors and results of colonoscopy, including quality assessment, were collected, and analyzed. No significant differences in the quality of colonoscopy, including bowel preparation, cecal intubation rate, and withdrawal time between the 2 groups, were observed. The incidence of colorectal adenoma was significantly higher in the EGN group than in the control group (55.5% vs 26.4%, P = .001). Multivariate analysis confirmed that old age (odds ratio: 1.04, 95% confidence interval: 1.01-1.08, P = .005) and a history of EGN (odds ratio: 4.99, 95% confidence interval: 2.60-9.57, P = .001) were independent risk factors for colorectal adenoma. This is the first prospective study to reflect the quality indicator of colonoscopy and confirmed that old age and a history of EGN are significant risk factors for colorectal adenomas. Therefore, more stringent colonoscopy surveillance should be considered in elderly patients with EGN.
In this work, we propose a structural approach to mitigate device-to-device variation and performance degradation of ferroelectric (FE) field-effect transistors (FeFETs) due to the inhomogeneity of ...FE and dielectric (DE) phases of the FE layer. We found that by inserting a floating gate below the FE layer, the polarization effect of FE grains is equalized, thus suppressing the formation of an undesired current percolation path through the channel of the FeFET. This also results in a wider memory window and improved device variation, which ultimately improves the accuracy of in-memory computing. We believe that the proposed approach could be an important strategy enabling reliable and unified operation of FeFETs with the scaling of device.
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