Simulation of a randomly percolated CNT network for an improved analog physical unclonable function

Carbon nanotube networks (CNTs)-based devices are well suited for the physically unclonable function (PUF) due to the inherent randomness of the CNT network, but CNT networks can vary significantly during manufacturing due to various controllable process conditions, which have a significant impact on PUF performance. Therefore, optimization of process conditions is essential to have a PUF with excellent performance. However, because it is time-consuming and costly to fabricate directly under various conditions, we implement randomly formed CNT network using simulation and confirm the variable correlation of the CNT network optimized for PUF performance. At the same time, by implementing an analog PUF through simulation, we present a 2D patterned PUF that has excellent security and can compensate for error occurrence problems. To evaluate the performance of analog PUF, a new evaluation method different from the existing digital PUF is proposed, and the PUF performance is compared according to two process variables, CNT density and metallic CNT ratio, and the correlation with PUF performance is confirmed. This study can serve as a basis for research to produce optimized CNT PUF by applying simulation according to the needs of the process of forming a CNT network.

Adaptive Extended State Observer for the Dual Active Bridge Converters

The DC-DC dual active bridge (DAB) converter has become one of the essential units for bidirectional energy distribution and connecting various renewable energy sources. When it comes to regulating the converter's output voltage, integrating an extended state observer (ESO) offers the advantage of eliminating the need for a current sensor, thereby reducing system costs. The ESO with a high observer bandwidth tends to acquire a faster system convergence and greater tracking accuracy. However, its disturbance suppression performance will become poor compared to the ESO with a low observer bandwidth. Based on this, the adaptive ESO (AESO) is proposed in this study to make a compromise between tracking performance and disturbance suppression. When the system is subjected to a high voltage error, the observer bandwidth will increase to improve the tracking performance and decrease to enhance the disturbance suppression. In order to demonstrate that the proposed method is effective, it is compared to the ESO with a fixed observer bandwidth and the improved model-based phase-shift control (MPSC). These comparisons are made through simulation and experimental results in various operation scenarios.

Gate Capacitance Coupling of Double-Gate Carbon Nanotube Network Transistors

Carbon nanotube (CNT) network channels constructed using a high-purity CNT solution for use in CNT thin-film transistors have the advantages of the possibility of requiring a low-temperature process and needing no special equipment. However, there are empty spaces between individual CNTs, resulting in unexpected effects. In this study, double-gate (DG) CNT network transistors were fabricated and measured in four different configurations to observe the capacitive coupling effects between the top gate (TG) and bottom gate (BG) in the DG structure. As a result, the electrical characteristics measured with the BG with a thicker gate oxide while floating the TG were similar to those measured with the TG with a thinner gate oxide. A comparison of the measured transfer curves showed that TG and BG were strongly coupled through the empty spaces in the channels. In addition, we evaluated the capacitance coupling effect due to changes in the CNT density, which is closely related to the empty space of the network channel. Finally, we proposed a method to determine the effective gate capacitance by considering the empty spaces between CNTs, which enabled the accurate evaluation of mobility. The effects of these materials were demonstrated by fabricating transistors using Al2O3, HfO2, and ZrO2 as TG oxide materials. By focusing on considerations based on the properties of CNT materials, our study provides valuable insights into accurate electrical modeling and potential advancements in CNT-based devices.

Wafer-scale striped network transistors based on purified semiconducting carbon nanotubes for commercialization

Highly purified and solution-processed semiconducting carbon nanotubes (s-CNTs) have developed rapidly over the past several decades and are near-commercially available materials that can replace silicon due to its large-area substrate deposition and room-temperature processing compatibility. However, the more s-CNTs are purified, the better their electrical performance, but considerable effort and long centrifugation time are required, which can limit commercialization due to high manufacturing costs. In this work, we therefore fabricated 'striped' CNT network transistor across industry-standard 8 inch wafers.-The stripe-structured channel is effective in lowering the manufacturing cost because it can maintain good device performance without requiring high-purity s-CNTs. We evaluated the electrical performances and their uniformity by demonstrating striped CNT network transistors fabricating from various s-CNT solutions (e.g., 99%, 95%, and 90%) in 8-inch wafers. From our results, we concluded that by optimizing the CNT network configurations, CNTs can be sufficiently utilized for commercialization technology even at low semiconducting purity. Our approach can serve as a critical foundation for future low-cost commercial CNT electronics.&#xD.

Robust Adaptive Control Strategy for a Bidirectional DC-DC Converter Based on Extremum Seeking and Sliding Mode Control

This paper presents a new control strategy that combines classical control and an optimization scheme to regulate the output voltage of the bidirectional converter under the presence of matched and mismatched disturbances. In detail, a control-oriented modeling method is presented first to capture the system dynamics in a common canonical form, allowing different disturbances to be considered. To estimate and compensate for unknown disturbances, an extended state observer (ESO)-based continuous sliding mode control is then proposed, which can guarantee high tracking precision, fast disturbance rejection, and chattering reduction. Next, an extremum seeking (ES)-based adaptive scheme is introduced to ensure system robustness as well as optimal control effort under different working scenarios. Finally, comparative simulations with classical proportional-integral-derivative (PID) control and constant switching gains are conducted to verify the effectiveness of the proposed adaptive control methodology through three case studies of load resistance variations, buck/boost mode switching, and input voltage variation.

Effect of Post-Annealing on Barrier Modulations in Pd/IGZO/SiO2/p+-Si Memristors

In this article, we study the post-annealing effect on the synaptic characteristics in Pd/IGZO/SiO₂/p⁺-Si memristor devices. The O-H bond in IGZO films affects the switching characteristics that can be controlled by the annealing process. We propose a switching model based on using a native oxide as the Schottky barrier. The barrier height is extracted by the conduction mechanism of thermionic emission in samples with different annealing temperatures. Additionally, the change in conductance is explained by an energy band diagram including trap models. The activation energy is obtained by the depression curve of the samples with different annealing temperatures to better understand the switching mechanism. Moreover, our results reveal that the annealing temperature and retention can affect the linearity of potentiation and depression. Finally, we investigate the effect of the annealing temperature on the recognition rate of MNIST in the proposed neural network.

Compact SPICE Model of Memristor with Barrier Modulated Considering Short- and Long-Term Memory Characteristics by IGZO Oxygen Content

This paper introduces a compact SPICE model of a two-terminal memory with a Pd/Ti/IGZO/p⁺-Si structure. In this paper, short- and long-term components are systematically separated and applied in each model. Such separations are conducted by the applied bias and oxygen flow rate (OFR) during indium gallium zinc oxide (IGZO) deposition. The short- and long-term components in the potentiation and depression curves are modeled by considering the process (OFR of IGZO) and bias conditions. The compact SPICE model with the physical mechanism of SiO₂ modulation is introduced, which can be useful for optimizing the specification of memristor devices.

Cost-effective method for fabricating carbon nanotube network transistors by reusing a 99% semiconducting carbon nanotube solution

Carbon nanotubes (CNTs) are one-dimensional materials that have been proposed to replace silicon semiconductors and have been actively studied due to their high carrier mobility, high current density, and high mechanical flexibility. Specifically, highly purified, pre-separated, and solution-processed semiconducting CNTs are suitable for mass production. These CNTs have advantages, such as room-temperature processing compatibility, while enabling a fast and straightforward manufacturing process. In this paper, CNT network transistors were fabricated on a total of five 8 inch wafers by reusing a highly purified and pre-separated 99% semiconductor-enriched CNT solution. The results confirmed that the density of semiconducting CNTs deposited on the five selected wafers was notably uniform, even though the CNT solution was reused up to four times after the initial CNT deposition. Moreover, there was no significant degradation in the key CNT network transistor metrics. Therefore, we believe that our findings regarding this CNT reuse method may provide additional guidance in the field of wafer-scale CNT electronics and may contribute strongly to the development of practical device applications at an ultralow cost.

Immune cell-derived small extracellular vesicles in cancer treatment

Small extracellular vesicles (sEVs) secreted by most cells carry bioactive macromolecules including proteins, lipids, and nucleic acids for intercellular communication. Given that some immune cell-derived sEVs exhibit anti-cancer properties, these sEVs have received scientific attention for the development of novel anti-cancer immunotherapeutic agents. In this paper, we reviewed the latest advances concerning the biological roles of immune cell-derived sEVs for cancer therapy. sEVs derived from immune cells including dendritic cells (DCs), T cells, natural-killer (NK) cells, and macrophages are good candidates for sEV-based cancer therapy. Besides their role of cancer vaccines, DC-shed sEVs activated cytotoxic lymphocytes and killed tumor cells. sEVs isolated from NK cells and chimeric antigen receptor (CAR) T cells exhibited cytotoxicity against cancer cells. sEVs derived from CD8⁺ T and CD4⁺ T cells inhibited cancer-associated cells in tumor microenvironment (TME) and activated B cells, respectively. M1-macrophage-derived sEVs induced M2 to M1 repolarization and also created a pro-inflammatory environment. Hence, these sEVs, via mono or combination therapy, could be considered in the treatment of cancer patients in the future. In addition, sEVs derived from cytokine-stimulated immune cells or sEV engineering could improve their anti-tumor potency.

Characterization of Spatial Distribution of Trap Across the Substrate in Metal-Insulator-Semiconductor Structure with Band Bending Effect

We report the technique of trap distribution extraction according to the vertical position of the substrate in the p-MOSFET. This study was conducted on a single device. This technique is an experimental method. C_trap was extracted based on the deep depletion C-V characteristics. In V_FB, the trap level is neutral. When bias is applied, the energy band bends, resulting in modulation of the quasi-Fermi level. The area created by the bending of the energy band is equal to the area created by the Fermi level modulation. The trap level existing in this area becomes charged. Considering this, the spatial distribution of Trap was extracted. The trap extracted by the proposed method has a maximum value at the interface, rapidly decreases, and is distributed up to 8 nm in the vertical direction. The study of trap spatial distribution is expected to be applicable to the separation of trap interface state and bulk trap extraction later.

Defect spectroscopy of sidewall interfaces in gate-all-around silicon nanosheet FET

Through time-dependent defect spectroscopy and low-frequency noise measurements, we investigate and characterize the differences of carrier trapping processes occurred by different interfaces (top/sidewall) of the gate-all-around silicon nanosheet field-effect transistor (GAA SiNS FET). In a GAA SiNS FET fabricated by the top-down process, the traps at the sidewall interface significantly affect the device performance as the width decreases. Compare to expectations, as the width of the device decreases, the subthreshold swing (SS) increases from 120 to 230 mV/dec, resulting in less gate controllability. In narrow-width devices, the effect of traps located at the sidewall interface is significantly dominant, and the 1/f ² noise, also known as generation-recombination (G-R) noise, is clearly appeared with an increased time constant (τ _i ). In addition, the probability density distributions for the normalized current fluctuations (ΔI _D) show only one Gaussian in wide-width devices, whereas they are separated into four Gaussians with increased in narrow-width devices. Therefore, fitting is performed through the carrier number fluctuation-correlated with mobility fluctuations model that separately considered the effects of sidewall. In narrow-width GAA SiNS FETs, consequently, the extracted interface trap densities (N _T ) distribution becomes more dominant, and the scattering parameter ([Formula: see text]) distribution increases by more than double.

Radiomics-based model for predicting pathological complete response to neoadjuvant chemotherapy in muscle-invasive bladder cancer

AIM

To develop and validate a radiomics-based model for predicting response to neoadjuvant chemotherapy (NAC) using baseline computed tomography (CT) images in patients with muscle-invasive bladder cancer (MIBC).

MATERIALS AND METHODS

A radiomics signature for predicting pathological complete response (pCR) was developed using radiomics features selected by a random forest classifier on baseline CT images, and imaging predictors were identified in the training set (87 patients). By incorporating imaging predictors and radiomics signature, an imaging-based model was constructed using multivariate logistic regression analysis and validated in an independent validation set consisting of 48 patients with CT from outside institutions. The performance and clinical usefulness of the imaging-based model for predicting pCR were evaluated using area under the receiver operating characteristic curve (AUC) and decision curve analysis. Using a cut-off determined in the training set, the positive likelihood ratios of the imaging-based model were calculated and compared with imaging and histological predictors.

RESULTS

The radiomics signature was developed based on six stable radiomics features. An imaging-based model incorporating radiomics signature, tumour shape, tumour size, and clinical stage showed good performance for predicting pCR in both the training (AUC, 0.85; 95% confidence interval [CI], 0.78-0.93) and validation (AUC, 0.75; 95% CI, 0.60-0.86) sets, providing a larger net benefit in decision curve analysis. The imaging-based model showed a higher positive likelihood ratio (1.91) for pCR than imaging and histological predictors (1.33-1.63).

CONCLUSIONS

The radiomics-based model using baseline CT images may predict the response of patients with MIBC to NAC.

Analysis of Threshold Voltage Shift for Full VGS/VDS/Oxygen-Content Span under Positive Bias Stress in Bottom-Gate Amorphous InGaZnO Thin-Film Transistors

In this study, we analyzed the threshold voltage shift characteristics of bottom-gate amorphous indium-gallium-zinc-oxide (IGZO) thin-film transistors (TFTs) under a wide range of positive stress voltages. We investigated four mechanisms: electron trapping at the gate insulator layer by a vertical electric field, electron trapping at the drain-side GI layer by hot-carrier injection, hole trapping at the source-side etch-stop layer by impact ionization, and donor-like state creation in the drain-side IGZO layer by a lateral electric field. To accurately analyze each mechanism, the local threshold voltages of the source and drain sides were measured by forward and reverse read-out. By using contour maps of the threshold voltage shift, we investigated which mechanism was dominant in various gate and drain stress voltage pairs. In addition, we investigated the effect of the oxygen content of the IGZO layer on the positive stress-induced threshold voltage shift. For oxygen-rich devices and oxygen-poor devices, the threshold voltage shift as well as the change in the density of states were analyzed.

Wafer-scale carbon nanotube network transistors

Highly purified, preseparated semiconducting carbon nanotubes (CNTs) hold great potential for high-performance CNT network transistors due to their high electrical conductivity, high mechanical strength, and room-temperature processing compatibility. In this paper, we report our recent progress on CNT network transistors integrated on an 8-inch wafer. We observe that the key device performance parameters of CNT network transistors at various locations on an 8-inch wafer are highly uniform and that the device yield is impressive. Therefore, this work validates a promising path toward mass production and will make a significant contribution to the future field of wafer-scale CNT electronics.

Indentation and Transverse Diameter of the Meckel Cave: Imaging Markers to Diagnose Idiopathic Intracranial Hypertension

BACKGROUND AND PURPOSE

Clinical and imaging manifestations of idiopathic intracranial hypertension should prompt early diagnosis and treatment to avoid complications. Multiple diagnostic imaging criteria are reported to suggest the diagnosis of idiopathic intracranial hypertension with questionable sensitivity and/or specificity. Increased intracranial pressure results in dilation of the perineural cisternal spaces such as the optic nerve sheaths and the Meckel cave. It may also cause protrusion of cisternal structures of the Meckel cave through the skull base foramina, which could result in indentation or a bilobed appearance of the Meckel cave. We investigated the changes in the Meckel cave in patients with proved idiopathic intracranial hypertension versus healthy controls.

MATERIALS AND METHODS

We studied 75 patients with a diagnosis of idiopathic intracranial hypertension and 75 age-and sex-matched healthy controls. The transverse diameter of Meckel cave was measured in the axial and coronal planes of T2-weighted MR imaging sequences, and comparison was made between the 2 groups.

RESULTS

The mean diameters of the Meckel cave on the coronal T2 plane in patients with idiopathic intracranial hypertension were 5.21  ± 1.22 mm on the right side and 5.16  ± 0.90 mm on the left side, while in the control group, they measured 3.89  ± 0.62 mm and 4.09  ± 0.68 mm, respectively (P value < .001). Of 75 patients with an approved diagnosis of idiopathic intracranial hypertension, 57 (76%) showed an indented Meckel cave as opposed to 21 (28%) in the control group.

CONCLUSIONS

Our results confirm for the first time that the shape and size of the Meckel cave can be used as sensitive and specific diagnostic imaging markers for the diagnosis of idiopathic intracranial hypertension.

Directly drawn top-gate semiconducting carbon nanotube thin-film transistors and complementary inverters

As the emerging demand for electronic devices that are simple, cost effective and capable of rapid fabrication has increased, novel fabrication techniques for designing and manufacturing such devices have attracted remarkable research interest. One method for prototyping these electronic devices is to draw them using a handwriting tool that is commonly available. In this work, we demonstrate a transistor and complementary logic inverter that are directly drawn using a brush and that are based on solution-based materials such as semiconducting carbon nanotubes (CNTs), silver ink and paste, and cross-linked poly(4-vinylphenol) (cPVP). The directly drawn CNT thin-film transistor (TFT) has p-type behavior due to the adsorption of oxygen and moisture, a high current on/off ratio (approximately 10³), and a low operating voltage. By employing a solution-based chemical doping treatment with an amine-rich polymer, polyethyleneimine (PEI), that has strong electron-donating ability, the drawn p-type CNT-TFT is successfully converted to an n-type CNT-TFT. Therefore, we fabricate a drawn complementary logic inverter consisting of the p-type CNT-TFT and PEI-treated n-type CNT-TFT and evaluate its electrical performance.

Characterization of Subgap Density-of-States by Sub-Bandgap Optical Charge Pumping in In0.53Ga0.47As Metal-Oxide-Semiconductor Field-Effect Transistors

We report an experimental characterization of the interface states (D_it(E)) by using the subthreshold drain current with optical charge pumping effect in In_0.53Ga_0.47As metal-oxide-semiconductor fieldeffect transistors (MOSFETs). The interface states are derived from the difference between the dark and photo states of the current-voltage characteristics. We used a sub-bandgap photon (i.e., with the photon energy lower than the bandgap energy, E_ph < E_g) to optically excite trapped carriers over the bandgap in In_0.53Ga_0.47As MOSFETs. We combined a gate bias-dependent capacitance model to determine the channel length-independent oxide capacitance. Then, we estimated the channel length-independent interface states in In_0.53Ga_0.47As MOSFETs having different channel lengths (L_ch = 5, 10, and 25 [μm]) for a fixed overlap length (L_ov = 5 [μm]).

Parallel weight update protocol for a carbon nanotube synaptic transistor array for accelerating neuromorphic computing

Brain-inspired neuromorphic computing has the potential to overcome the inherent inefficiency of the conventional von Neumann architecture by using the massively parallel processing power of artificial neural networks. Neuromorphic parallel processing can be implemented naturally using the crossbar geometry of synaptic device arrays with Ohm's and Kirchhoff's laws. However, selective and parallel weight updates of the synaptic crossbar array are still very challenging due to the unavoidable crosstalk between adjacent devices and sneak path currents. Here, we experimentally demonstrate a weight update protocol in a carbon nanotube synaptic transistor array, where selective and parallel weight updates can be executed by exploiting the individually controllable three terminals of the synaptic device via a localized carrier trapping mechanism. The trained 9 × 8 synaptic array solves four different convolution operations simultaneously for the feature extraction of an image. The massive parallelism and robustness of the weight update protocol are important features toward effective manipulation of big data through neuromorphic computing systems.

Precision-extension technique for accurate vector-matrix multiplication with a CNT transistor crossbar array

Most machine learning algorithms involve many multiply-accumulate operations, which dictate the computation time and energy required. Vector-matrix multiplications can be accelerated using resistive networks, which can be naturally implemented in a crossbar geometry by leveraging Kirchhoff's current law in a single readout step. However, practical computing tasks that require high precision are still very challenging to implement in a resistive crossbar array owing to intrinsic device variability and unavoidable crosstalk, such as sneak path currents through adjacent devices, which inherently result in low precision. Here, we experimentally demonstrate a precision-extension technique for a carbon nanotube (CNT) transistor crossbar array. High precision is attained through multiple devices operating together, each of which stores a portion of the required bit width. A 10 × 10 CNT transistor array can perform vector-matrix multiplication with high accuracy, making in-memory computing approaches attractive for high-performance computing environments.

Impact of Synaptic Device Variations on Classification Accuracy in a Binarized Neural Network

Brain-inspired neuromorphic systems (hardware neural networks) are expected to be an energy-efficient computing architecture for solving cognitive tasks, which critically depend on the development of reliable synaptic weight storage (i.e., synaptic device). Although various nanoelectronic devices have successfully reproduced the learning rules of biological synapses through their internal analog conductance states, the sustainability of such devices is still in doubt due to the variability common to all nanoelectronic devices. Alternatively, a neuromorphic system based on a relatively more reliable digital-type switching device has been recently demonstrated, i.e., a binarized neural network (BNN). The synaptic device is a more mature digital-type switching device, and the training/recognition algorithm developed for the BNN enables the task of facial image classification with a supervised training scheme. Here, we quantitatively investigate the effects of device parameter variations on the classification accuracy; the parameters include the number of weight states (N_state), the weight update margin (ΔG), and the weight update variation (G_var). This analysis demonstrates the feasibility of the BNN and introduces a practical neuromorphic system based on mature, conventional digital device technologies.

Effect of Simultaneous Mechanical and Electrical Stress on the Electrical Performance of Flexible In-Ga-Zn-O Thin-Film Transistors

We investigated the effect of simultaneous mechanical and electrical stress on the electrical characteristics of flexible indium-gallium-zinc oxide (IGZO) thin-film transistors (TFTs). The IGZO TFTs exhibited a threshold voltage shift (∆VTH) under an application of positive-bias-stress (PBS), with a turnaround behavior from the positive ∆VTH to the negative ∆VTH with an increase in the PBS application time, whether a mechanical stress is applied or not. However, the magnitudes of PBS-induced ∆VTH in both the positive and negative directions exhibited significantly larger values when a flexible IGZO TFT was under mechanical-bending stress than when it was at the flat state. The observed phenomena were possibly attributed to the mechanical stress-induced interface trap generation and the enhanced hydrogen diffusion from atomic layer deposition-grown Al2O3 to IGZO under mechanical-bending stress during PBS. The subgap density of states was extracted before and after an application of PBS under both mechanical stress conditions. The obtained results in this study provided potent evidence supporting the mechanism suggested to explain the PBS-induced larger ∆VTHs in both directions under mechanical-bending stress.

Effect of Oxygen Content on Current Stress-Induced Instability in Bottom-Gate Amorphous InGaZnO Thin-Film Transistors

The effect of oxygen content on current-stress-induced instability was investigated in bottom-gate amorphous InGaZnO (a-IGZO) thin-film transistors. The observed positive threshold voltage shift (ΔV_T) was dominated by electron trapping in the gate insulator (GI), whereas it was compensated by donor creation in a-IGZO active regions when both current flows and a high lateral electric field were present. Stress-induced ΔV_T increased with increasing oxygen content irrespective of the type of stress because oxygen content influenced GI quality, i.e., higher density of GI electron traps, as well as typical direct current (DC) performance like threshold voltage, mobility, and subthreshold swing. It was also found that self-heating became another important mechanism, especially when the vertical electric field and channel current were the same, independent of the oxygen content. The increased ΔV_T with oxygen content under positive gate bias stress, positive gate and drain bias stress, and target current stress was consistently explained by considering a combination of the density of GI electron traps, electric field relaxation, and self-heating-assisted electron trapping.

ALK-positive anaplastic large cell lymphoma with a monomorphic small-cell pattern masquerading as inflammatory gastric lesions

INTRODUCTION

Anaplastic lymphoma kinase-positive (ALK+) anaplastic large cell lymphoma (ALCL) with a non-common pattern can be diagnostic challenging. Pathologists can be unavoidably and unintentionally blind to non-descript tumor cells in a lymphohistiocytic- (LH) or small-cell (SC)-pattern. We report a case of primary systemic ALK+ ALCL with a SC pattern that presented as secondary gastric lesions with a mixed LH and SC pattern that was masqueraded as inflammatory lesions.

CASE REPORT

A 34-year-old woman with intractable epigastric pain was referred to have repeated endoscopy with biopsy. She was found to multiple gastric erosions and nodules that were diagnosed as inflammatory lesions both endoscopically and histologically. Meanwhile, she developed an acute onset of severe back pain associated with a pathologic compression fracture in the T3 thoracic vertebral body. Imaging studies disclosed a disseminated systemic disease involving abdominopelvic lymph nodes and cervical and thoracic vertebral bodies. The needle biopsy of the pelvic lymph node disclosed diffuse proliferation of monomorphic small round cells that were diffusely positive for CD30 and ALK. A diagnosis of ALK+ ALCL with a monomorphic SC pattern was rendered.

DISCUSSION

A retrospective review of the gastric biopsies with the aid of immunohistochemistry enabled us to recognise the presence of lymphomatous infiltrates with a mixed LH and SC pattern in every piece of gastric biopsies that were repeatedly misdiagnosed as inflammatory lesions. This case illustrates a significant diagnostic pitfall of the LH- and SC-patterns in ALK+ ALCL, in which the tumour cells featuring lymphoid, plasmacytoid or histiocytoid appearance can be masqueraded as inflammatory cells.

Hyperprogressive disease during PD-1/PD-L1 blockade in patients with non-small-cell lung cancer

BACKGROUND

Immune checkpoint blockade with Programmed cell death 1 (PD-1)/PD-L1 inhibitors has been effective in various malignancies and is considered as a standard treatment modality for patients with non-small-cell lung cancer (NSCLC). However, emerging evidence show that PD-1/PD-L1 blockade can lead to hyperprogressive disease (HPD), a flair-up of tumor growth linked to dismal prognosis. This study aimed to evaluate the incidence of HPD and identify the determinants associated with HPD in patients with NSCLC treated with PD-1/PD-L1 blockade.

PATIENTS AND METHODS

We enrolled patients with recurrent and/or metastatic NSCLC treated with PD-1/PD-L1 inhibitors between April 2014 and November 2018. Clinicopathologic variables, dynamics of tumor growth, and treatment outcomes were analyzed in patients with NSCLC who received PD-1/PD-L1 blockade. HPD was defined according to tumor growth kinetics (TGK), tumor growth rate (TGR), and time to treatment failure (TTF). Immunophenotyping of peripheral blood CD8+ T lymphocytes was conducted to explore the potential predictive biomarkers of HPD.

RESULTS

A total of 263 patients were analyzed. HPD was observed in 55 (20.9%), 54 (20.5%), and 98 (37.3%) patients according to the TGK, TGR, and TTF. HPD meeting both TGK and TGR criteria was associated with worse progression-free survival [hazard ratio (HR) 4.619; 95% confidence interval (CI) 2.868-7.440] and overall survival (HR, 5.079; 95% CI, 3.136-8.226) than progressive disease without HPD. There were no clinicopathologic variables specific for HPD. In the exploratory biomarker analysis with peripheral blood CD8+ T lymphocytes, a lower frequency of effector/memory subsets (CCR7-CD45RA- T cells among the total CD8+ T cells) and a higher frequency of severely exhausted populations (TIGIT+ T cells among PD-1+CD8+ T cells) were associated with HPD and inferior survival rate.

CONCLUSION

HPD is common in NSCLC patients treated with PD-1/PD-L1 inhibitors. Biomarkers derived from rationally designed analysis may successfully predict HPD and worse outcomes, meriting further investigation of HPD.

Hydroxychloroquine treatment during pregnancy in lupus patients is associated with lower risk of preeclampsia

Background

Hydroxychloroquine (HCQ) is regarded as a mainstay in the treatment of systemic lupus erythematosus (SLE) because of its efficacy in preventing flares, achieving remission, and reducing overall mortality. However, the impact of HCQ on pregnancy outcomes remains controversial.

Objective

We aimed to investigate the effect of HCQ on pregnancy outcomes in patients with SLE.

Methods

We performed a retrospective cohort study of 151 pregnancies in 122 patients with SLE (80 pregnancies in the HCQ treatment group and 71 pregnancies in the HCQ nontreatment group). We reviewed baseline characteristics including maternal comorbidities such as antiphospholipid syndrome, lupus nephritis, and autoimmune hepatitis. Pregnancy outcomes (preeclampsia, preterm delivery, and fetal growth restriction) and neonatal outcomes (gestational age at delivery and birth weight) were compared between HCQ treatment and nontreatment groups.

Results

Preeclampsia was significantly less complicated (7.5% vs 19.7%, p = 0.032) and neonatal birth weight was significantly greater (2757.0 ± 583.5 g vs 2542.3 ± 908.3 g, p = 0.001) in the HCQ treatment group than in the HCQ nontreatment group. Multiple logistic analysis adjusting for body mass index (BMI), lupus nephritis, serum uric acid, and estimated glomerular filtration rate revealed HCQ treatment was associated with exceedingly lower risk of preeclampsia in SLE pregnancy (odds ratio (OR) 0.106 (confidence interval (CI) 0.017–0.671)). Other independent risk factors for preeclampsia were a high prepregnancy BMI (OR 1.575 (CI 1.114–2.227)) and low eGFR level (OR 0.931 (CI 0.886–0.979)) before pregnancy.

Conclusion

Our data showed pregnancy outcomes in SLE patients can be improved in the HCQ treatment group with about 90% reduction of preeclampsia.

Flexible carbon nanotube Schottky diode and its integrated circuit applications

Carbon nanotubes (CNTs), a low-dimensional material currently popular in industry and academia, are promising candidates for addressing the limits of existing semiconductors. In particular, CNTs are attractive candidates for flexible electronic materials due to their excellent flexibility and potential applications. In this work, we demonstrate a flexible CNT Schottky diode based on highly purified, preseparated, solution-processed 99% semiconducting CNTs and an integrated circuit application using the CNT Schottky diodes. Notably, the fabricated flexible CNT diode can greatly modulate the properties of the contact formed between the semiconducting CNT and the anode electrode via the control gate bias, exhibiting a high rectification ratio of up to 2.5 × 10⁵. In addition, we confirm that the electrical performance of the CNT Schottky diodes does not significantly change after a few thousand bending/releasing cycles of the flexible substrate. Finally, integrated circuit (IC) applications of logic circuits (OR and AND gates) and an analog circuit (a half-wave rectifier) were presented through the use of flexible CNT Schottky diode combinations. The correct output responses are successfully achieved from the circuit applications; hence, we expect that our findings will provide a promising basis for electronic circuit applications based on CNTs.

We demonstrate a flexible Schottky diode based on highly purified, preseparated, 99% semiconducting carbon nanotubes and an integrated circuit application using the diodes.

Diagnostic Performance of Multidetector Computerized Tomography in the Detection of Abdominal Complications Early and Late After Liver Transplantation: A 10-Year Experience

BACKGROUND

Multidetector computerized tomography (MDCT) is considered to be a fast noninvasive diagnostic technique for the evaluation of postoperative complications in patients with liver transplantation (LT). However, its role has not been fully established in the diagnosis for detecting complications after liver transplantation. The aim of this work was to evaluate the diagnostic performance of MDCT for detecting abdominal complications in the early and late periods after LT.

METHODS

We retrospectively enrolled 75 patients who had undergone LT from March 2006 to January 2010, followed by MDCT from March 2006 to November 2017. Patients were divided into 2 groups according to the timing after LT: within the first 3 months (early period) or ≥3 months after LT (late period). We evaluated vascular, biliary, and other complications on MDCT. Angiography, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography were used as reference standards.

RESULTS

We initially found 77 complications in 45 patients (60.0%) with the use of MDCT. After comparison with the reference standards, 83 complications were diagnosed in 49 patients (65.3%). Forty-seven complications (34 vascular, 10 biliary, 3 other complications) were diagnosed in 33 patients (44.0%) during the early period, and 36 complications (6 vascular, 20 biliary, 10 other complications) were detected in 27 patients (36.0%) in the late period. The sensitivity, specificity, and diagnostic accuracy of MDCT for diagnosing overall complications were, respectively, 93.6%, 90.2%, and 92.0% in the early period (for vascular complications: 97.1%, 92.6%, and 94.3%,; for biliary complications: 80.0%, 100%, and 97.7%) and 77.8%, 98.1%, and 89.8% in the late period (for vascular complications: 83.3%, 100%, and 98.9%; for biliary complications: 65.0%, 98.6%, and 90.9%).

CONCLUSIONS

Although MDCT in the late period should be interpreted with caution in patients with suspected biliary complication, MDCT is a reliable diagnostic technique for the identification of early and late abdominal complications after LT.

Tacrolimus-Induced Apoptosis is Mediated by Endoplasmic Reticulum-derived Calcium-dependent Caspases-3,-12 in Jurkat Cells

Apoptotic signal pathways are delivered to caspase-3, caspase-9, or both in different cells via the death receptor pathway, mitochondrial pathway, or by the endoplasmic reticulum (ER) pathway through initiators of caspase-3, -8, -9, or -12. Tacrolimus (Tac)-induced apoptosis was characterized by nuclear fragmentation and caspase-3 activation. We examined the effect of tacrolimus on ER-derived calcium and caspase-3,-12-mediated apoptosis on Jurkat human T lymphocyte. Tac decreased the viability of Jurkat cells in a dose-dependent manner. Tac also increased continuously intracellular concentration of calcium from 24 hours to 72 hours. We did not find intracellular calcium changes on the treatment of calcium ionorpore (A23187) regardless of 1 nmol/L Tac concentration level. However, calcium adenosine triphosphatase inhibitor (thapsigargin) increased intracellular calcium accumulation and co-treating 1 nmol/L Tac further induced intracellular calcium accumulation. Interestingly, we found that 1 nmol/L Tac treatment induced activation of caspase-12 protease as well as the catalytic activity of caspase-3 but not catalytic activation of caspase-6, -8, and -9 proteases in Jurkat cells. These data advance our understanding of Tac-induced apoptosis is ER-derived calcium and caspases-3,-12- mediated apoptosis in human Jurkat cell line.

Synaptic Device Network Architecture with Feature Extraction for Unsupervised Image Classification

For the efficient recognition and classification of numerous images, neuroinspired deep learning algorithms have demonstrated their substantial performance. Nevertheless, current deep learning algorithms that are performed on von Neumann machines face significant limitations due to their inherent inefficient energy consumption. Thus, alternative approaches (i.e., neuromorphic systems) are expected to provide more energy-efficient computing units. However, the implementation of the neuromorphic system is still challenging due to the uncertain impacts of synaptic device specifications on system performance. Moreover, only few studies are reported how to implement feature extraction algorithms on the neuromorphic system. Here, a synaptic device network architecture with a feature extraction algorithm inspired by the convolutional neural network is demonstrated. Its pattern recognition efficacy is validated using a device-to-system level simulation. The network can classify handwritten digits at up to a 90% recognition rate despite using fewer synaptic devices than the architecture without feature extraction.

Three-Dimensional Printed Poly(vinyl alcohol) Substrate with Controlled On-Demand Degradation for Transient Electronics

Electronics that degrade after stable operation for a desired operating time, called transient electronics, are of great interest in many fields, including biomedical implants, secure memory devices, and environmental sensors. Thus, the development of transient materials is critical for the advancement of transient electronics and their applications. However, previous reports have mostly relied on achieving transience in aqueous solutions, where the transience time is largely predetermined based on the materials initially selected at the beginning of the fabrication. Therefore, accurate control of the transience time is difficult, thereby limiting their application. In this work, we demonstrate transient electronics based on a water-soluble poly(vinyl alcohol) (PVA) substrate on which carbon nanotube (CNT)-based field-effect transistors were fabricated. We regulated the structural parameters of the PVA substrate using a three-dimensional (3D) printer to accurately control and program the transience time of the PVA substrate in water. The 3D printing technology can produce complex objects directly, thus enabling the efficient fabrication of a transient substrate with a prescribed and controlled transience time. In addition, the 3D printer was used to develop a facile method for the selective and partial destruction of electronics.

Three-Dimensionally Printed Micro-electromechanical Switches

Three-dimensional (3D) printers have attracted considerable attention from both industry and academia and especially in recent years because of their ability to overcome the limitations of two-dimensional (2D) processes and to enable large-scale facile integration techniques. With 3D printing technologies, complex structures can be created using only a computer-aided design file as a reference; consequently, complex shapes can be manufactured in a single step with little dependence on manufacturer technologies. In this work, we provide a first demonstration of the facile and time-saving 3D printing of two-terminal micro-electromechanical (MEM) switches. Two widely used thermoplastic materials were used to form 3D-printed MEM switches; freely suspended and fixed electrodes were printed from conductive polylactic acid, and a water-soluble sacrificial layer for air-gap formation was printed from poly(vinyl alcohol). Our 3D-printed MEM switches exhibit excellent electromechanical properties, with abrupt switching characteristics and an excellent on/off current ratio value exceeding 10⁶. Therefore, we believe that our study makes an innovative contribution with implications for the development of a broader range of 3D printer applications (e.g., the manufacturing of various MEM devices and sensors), and the work highlights a uniquely attractive path toward the realization of 3D-printed electronics.

Depigmentation efficacy of galacturonic acid through tyrosinase regulation in B16 murine melanoma cells and a three-dimensional human skin equivalent

Sugar is a well-known cosmetic ingredient for moisturizing skin with minimal side-effects. Several reports have demonstrated an antimelanogenic effect of sugar in melanocytes. We evaluated the whitening efficacy of galacturonic acid (GA), the main component of pectin, as an anti-melanogenic agent. GA significantly suppressed melanin synthesis and secretion in a concentration-dependent manner in α-melanocyte stimulating hormone-treated B16 melanoma cells, and inhibited tyrosinase activity and expression at a dose of 10 mmol/L. In a three-dimensional human skin equivalent (MelanoDerm), GA clearly brightened tissue colour. Haematoxylin and eosin and Fontana-Masson (F&M) staining of tissue sections revealed decreased melanin production without skin tissue collapse in the presence of GA. Interestingly, GA dramatically suppressed gene expression of the melanogenic proteins tyrosinase, tyrosinase-related protein (TYRP)-1 and microphthalmia-associated transcription factor, but not TYRP-2. The results support the utility of GA as an effective candidate antimelanogenic agent.

Impact of Synaptic Device Variations on Pattern Recognition Accuracy in a Hardware Neural Network

Neuromorphic systems (hardware neural networks) derive inspiration from biological neural systems and are expected to be a computing breakthrough beyond conventional von Neumann architecture. Interestingly, in neuromorphic systems, the processing and storing of information can be performed simultaneously by modulating the connection strength of a synaptic device (i.e., synaptic weight). Previously investigated synaptic devices can emulate the functionality of biological synapses successfully by utilizing various nano-electronic phenomena; however, the impact of intrinsic synaptic device variability on the system performance has not yet been studied. Here, we perform a device-to-system level simulation of different synaptic device variation parameters in a designed neuromorphic system that has the potential for unsupervised learning and pattern recognition. The effects of variations in parameters such as the weight modulation nonlinearity (NL), the minimum-maximum weight (G_min and G_max), and the weight update margin (ΔG) on the pattern recognition accuracy are analyzed quantitatively. These simulation results can provide guidelines for the continued design and optimization of a synaptic device for realizing a functional large-scale neuromorphic computing system.

Associations between SLC2A9 polymorphisms and gout susceptibility : A meta-analysis

OBJECTIVE

The aim of this study was to determine whether polymorphisms in solute carrier family 2 and facilitated glucose transporter member 9 (SLC2A9) are associated with susceptibility to gout.

METHODS

A meta-analysis was conducted on associations between the rs12510549, rs16890979, and rs1014290 polymorphisms of SLC2A9 and gout susceptibility using fixed and random effects models.

RESULTS

Eleven comparative studies comprising 1,472 patients and 3,269 controls from Caucasian and Asian populations were included in this meta-analysis. The meta-analysis identified a significant negative association between gout and allele 2 (minor) of the rs12510549 polymorphism in the overall population (OR = 0.641, 95 % CI = 0.540-0.761, P = 4.1 × 10^-7). Stratification by ethnicity identified a significant negative association between this polymorphism and gout in Caucasians (OR = 0.647, 95 % CI = 0.542-0.771, P = 1.2 × 10^-6) but not in Asians (OR = 0.515, 95 % CI = 0.214-1.236, P = 0.137). The meta-analysis showed a significant negative association between gout and allele 2 of the rs16890979 polymorphism in all study subjects (OR = 0.229, 95 % CI = 0.084-0.628, P = 0.004). Stratification by ethnicity identified a significant negative association between this polymorphism and gout in Caucasians (OR = 0.469, 95 % CI = 0.317-0.695, P = 1.6 × 10^-6) and in Asians (OR = 0.192, 95 % CI = 0.072-0.513, P = 0.001). A significant negative association was found between allele 2 of the rs1014290 polymorphism and gout susceptibility in Asians (OR = 0.597, 95 % CI = 0.478-0.746, P = 5.4 × 10^-6) but not in Caucasians (OR = 0.778, 95 % CI = 0.595-1.043, P = 0.095).

CONCLUSIONS

This meta-analysis shows that the rs12510549, rs16890979, and rs1014290 polymorphisms of SLC2A9 protect against the development of gout in Caucasians and/or Asians.

Transparent, Flexible Strain Sensor Based on a Solution-Processed Carbon Nanotube Network

The demands for transparent, flexible electronic devices are continuously increasing due to their potential applications to the human body. In particular, skin-like, transparent, flexible strain sensors have been developed to realize multifunctional human-machine interfaces. Here, we report a sandwich-like structured strain sensor with excellent optical transparency based on highly purified, solution-processed, 99% metallic CNT-polydimethylsiloxane (PDMS) composite thin films. Our CNT-PDMS composite strain sensors are mechanically compliant, physically robust, and easily fabricated. The fabricated strain sensors exhibit a high optical transparency of over 92% in the visible range with acceptable sensing performances in terms of sensitivity, hysteresis, linearity, and drift. We also found that the sensitivity and linearity of the strain sensors can be controlled by the number of CNT sprays; hence, our sensor can be applied and controlled based on the need of individual applications. Finally, we investigated the detections of human activities and emotions by mounting our transparent strain sensor on various spots of human skins.

A novel flexible drill device enabling arthroscopic transosseous repair of Bankart lesions

We have developed a flexible drill device that makes arthroscopic transosseous repair possible, and report preliminary results. Twelve patients with post-traumatic anterior inferior glenohumeral instability were selected.

SURGICAL TECHNIQUE

the flexible drill device is inserted into the shoulder joint through the posterior portal and the guide pipe unit is placed 5mm posterior to the margin of the anterior glenoid rim. The flexible drill is driven through the glenoid with the power drill, creating a hole in the glenoid. A non-absorbable suture is passed through the hole and a sliding knot tying is performed over the capsule and labrum after completing stitches with the suture hook loaded. The same procedures are repeated in the 2, 3 and 4 o'clock positions of the glenoid. There was no recurrence of dislocation at the mean follow-up period of 52.3 months. The mean Rowe score was 89.5.

Pattern Recognition Using Carbon Nanotube Synaptic Transistors with an Adjustable Weight Update Protocol

Recent electronic applications require an efficient computing system that can perform data processing with limited energy consumption. Inspired by the massive parallelism of the human brain, a neuromorphic system (hardware neural network) may provide an efficient computing unit to perform such tasks as classification and recognition. However, the implementation of synaptic devices (i.e., the essential building blocks for emulating the functions of biological synapses) remains challenging due to their uncontrollable weight update protocol and corresponding uncertain effects on the operation of the system, which can lead to a bottleneck in the continuous design and optimization. Here, we demonstrate a synaptic transistor based on highly purified, preseparated 99% semiconducting carbon nanotubes, which can provide adjustable weight update linearity and variation margin. The pattern recognition efficacy is validated using a device-to-system level simulation framework. The enlarged margin rather than the linear weight update can enhance the fault tolerance of the recognition system, which improves the recognition accuracy.

Association of Interleukin 10 Gene Polymorphisms with Autoimmune Thyroid Disease: Meta-Analysis

The aim of this study was to perform a meta-analysis of eligible studies and to derive a precise estimate of the association between interleukin 10 (IL10) polymorphisms and susceptibility to autoimmune thyroid disease (AITD). Meta-analyses were conducted on the associations between AITD and the -1082 G/A (rs1800896), -819 C/T (rs1800871) and -592 C/A (rs1800872) polymorphisms in IL10, and the haplotype of these polymorphisms and AITD. A total of 2903 AITD patients and 3060 controls in 10 eligible studies were included in the meta-analysis. This meta-analysis showed significant associations between IL10 at the -1082 G allele and overall AITD (OR: 1.44, 95% CI 1.13-1.82, P = 0.003), but no association between the IL10 -592 C allele and the -819 C allele and AITD. Subgroup studies demonstrated significant associations between the -1082 G allele and susceptibility to Graves' disease. Ethnicity-specific meta-analysis revealed significant associations between the -1082 G allele and AITD susceptibility in Asian populations; however, in Middle Eastern populations, no association was evident. Meta-analysis of the IL10 haplotype revealed an association between the ATA haplotype and AITD (OR: 1.17, 95% CI 1.00-1.36, P = 0.04). Meta-analysis demonstrates that the IL10 polymorphisms are associated with susceptibility to AITD.

Three-Dimensional Fin-Structured Semiconducting Carbon Nanotube Network Transistor

Three-dimensional (3-D) fin-structured carbon nanotube field-effect transistors (CNT-FETs) with purified 99.9% semiconducting CNTs were demonstrated on a large scale 8 in. silicon wafer. The fabricated 3-D CNT-FETs take advantage of the 3-D geometry and exhibit enhanced electrostatic gate controllability and superior charge transport. A trigated structure surrounding the randomly networked single-walled CNT channel was formed on a fin-like 3-D silicon frame, and as a result, the effective packing density increased to almost 600 CNTs/μm. Additionally, highly sensitive controllability of the threshold voltage (V_TH) was achieved using a thin back gate oxide in the same silicon frame to control power consumption and enhance performance. Our results are expected to broaden the design margin of CNT-based circuit architectures for versatile applications. The proposed 3-D CNT-FETs can potentially provide a desirable alternative to silicon based nanoelectronics and a blueprint for furthering the practical use of emerging low-dimensional materials other than CNTs.

High-quality cell block preparation from scraping of conventional cytology slide: a technical report on a modified cytoscrape cell block technique

BACKGROUND

Immunocytochemistry (ICC) on formalin-fixed paraffin embedded cell blocks is an ancillary tool commonly recruited for differential diagnoses of fine needle aspiration cytology (FNAC) samples. However, the quality of conventional cell blocks in terms of adequate cellularity and evenness of distribution of cytologic material is not always satisfactory for ICC. We introduce a modified agarose-based cytoscrape cell block (CCB) technique that can be effectively used for the preparation of cell blocks from scrapings of conventional FNAC slides.

METHODS

A decoverslipped FNAC slide was mounted with a small amount of water. The cytological material was scraped off the slide into a tissue mold by scraping with a cell scraper. The cytoscrape material was pelleted by centrifugation and pre-embedded in ultra-low gelling temperature agarose and then re-embedded in conventional agarose. The final agarose gel disk was processed and embedded in paraffin.

RESULTS

The quality of the ICC on the CCB sections was identical to that of the immunohistochemical stains on histological sections. By scrapping and harvesting the entirety of the cytological material off the cytology slide into a compact agarose cell button, we could avoid the risk of losing diagnostic material during the CCB preparation.

CONCLUSION

This modified CCB technique enables concentration and focusing of minute material while maintaining the entire amount of the cytoscrape material on the viewing spot of the CCB sections. We believe this technique can be effectively used to improve the level of confidence in diagnosis of FNAC especially when the FNAC slides are the only sample available.

Crystal structure of a DNA aptamer bound to PvLDH elucidates novel single-stranded DNA structural elements for folding and recognition

Structural elements are key elements for understanding single-stranded nucleic acid folding. Although various RNA structural elements have been documented, structural elements of single-stranded DNA (ssDNA) have rarely been reported. Herein, we determined a crystal structure of PvLDH in complex with a DNA aptamer called pL1. This aptamer folds into a hairpin-bulge contact by adopting three novel structural elements, viz, DNA T-loop-like motif, base-phosphate zipper, and DNA G·G metal ion zipper. Moreover, the pL1:PvLDH complex shows unique properties compared with other protein:nucleic acid complexes. Generally, extensive intermolecular hydrogen bonds occur between unpaired nucleotides and proteins for specific recognitions. Although most protein-interacting nucleotides of pL1 are unpaired nucleotides, pL1 recognizes PvLDH by predominant shape complementarity with many bridging water molecules owing to the combination of three novel structural elements making protein-binding unpaired nucleotides stable. Moreover, the additional set of Plasmodium LDH residues which were shown to form extensive hydrogen bonds with unpaired nucleotides of 2008s does not participate in the recognition of pL1. Superimposition of the pL1:PvLDH complex with hLDH reveals steric clashes between pL1 and hLDH in contrast with no steric clashes between 2008s and hLDH. Therefore, specific protein recognition mode of pL1 is totally different from that of 2008s.

Association between shortened telomere length and systemic lupus erythematosus: a meta-analysis

Objective We aimed to evaluate the relationship between telomere length and systemic lupus erythematosus (SLE). Methods PUBMED and EMBASE databases were searched; meta-analyses were performed comparing telomere length in SLE patients and healthy controls, and on SLE patients in subgroups based on ethnicity, sample type, assay method and data type. Results Eight studies including 472 SLE patients and 365 controls were ultimately selected which showed that telomere length was significantly shorter in the SLE group than in the control group (standardized mean difference (SMD) = -0.835, 95% confidence interval (CI) = -1.291 to -0.380, p = 3.3 × 10^-4). Stratification by ethnicity showed significantly shortened telomere length in the SLE group in Caucasian, Asian and mixed populations (SMD = -0.455, 95% CI = -0.763 to -0.147, p = 0.004; SMD = -0.887, 95% CI = -1.261 to -0.513, p = 3.4 × 10^-4; SMD = -0.535, 95% CI = -0.923 to -0.147, p = 0.007; respectively). Furthermore, telomere length was significantly shorter in the SLE group than in the control group in whole blood and peripheral blood mononuclear cell groups (SMD = -0.361, 95% CI = -0.553 to -0.169, p = 2.3 × 10^-4; SMD = -1.546, 95% CI = -2.583 to -0.510, p = 0.003; respectively); a similar trend was observed in leukocyte groups (SMD = -0.699, 95% CI = -1.511 to -0.114, p = 0.092). Meta-analyses based on assay method or data type revealed similar associations. Conclusions Our meta-analysis demonstrated that telomere length was significantly shorter in patients with SLE, regardless of ethnicity, sample type or assay method evaluated.

The functional p53 codon 72 polymorphism is associated with systemic lupus erythematosus

The aim of the study is to investigate whether the functional p53 codon 72 polymorphism is associated with susceptibility to SLE and its clinical features. A polymerase chain reaction of genomic DNA-restriction fragment length polymorphism was used to determine genotypes of the p53 codon 72 in 90 SLE patients and 114 healthy controls. Clinical/serological manifestations were analysed in each patient and correlated with the genotypes. The OR of the association of the Pro allele with SLE was 1.70 (95% CI, 1.15-2.53, P = 0.0079) and the OR of the Pro/Pro (a recessive model) was significantly increased (OR = 2.58, 95% CI = 1.24-5.39, P = 0.0093). The Armitage’s trend test indicated a significant dosage effect of the Pro allele for SLE (OR = 1.73, chi-square = 7.08, P = 0.0078). However, there was no significant association of the polymorphism with clinical/serological manifestations studied here. In conclusion, our finding suggests the functional p53 codon 72 polymorphism may be associated with SLE susceptibility, suggesting individuals who carry the Pro allele may have a higher risk to SLE susceptibility than those with the Arg allele. Further studies for replications are needed to confirm that the p53 polymorphism contributes to SLE.

Compact Two-State-Variable Second-Order Memristor Model

A key requirement for using memristors in functional circuits is a predictive physical model to capture the resistive switching behavior, which shall be compact enough to be implemented using a circuit simulator. Although a number of memristor models have been developed, most of these models (i.e., first-order memristor models) have utilized only a one-state-variable. However, such simplification is not adequate for accurate modeling because multiple mechanisms are involved in resistive switching. Here, a two-state-variable based second-order memristor model is presented, which considers the axial drift of the charged vacancies in an applied electric field and the radial vacancy motion caused by the thermophoresis and diffusion. In particular, this model emulates the details of the intrinsic short-term dynamics, such as decay and temporal heat summation, and therefore, it accurately predicts the resistive switching characteristics for both DC and AC input signals.

Logic circuits composed of flexible carbon nanotube thin-film transistor and ultra-thin polymer gate dielectric

Printing electronics has become increasingly prominent in the field of electronic engineering because this method is highly efficient at producing flexible, low-cost and large-scale thin-film transistors. However, TFTs are typically constructed with rigid insulating layers consisting of oxides and nitrides that are brittle and require high processing temperatures, which can cause a number of problems when used in printed flexible TFTs. In this study, we address these issues and demonstrate a method of producing inkjet-printed TFTs that include an ultra-thin polymeric dielectric layer produced by initiated chemical vapor deposition (iCVD) at room temperature and highly purified 99.9% semiconducting carbon nanotubes. Our integrated approach enables the production of flexible logic circuits consisting of CNT-TFTs on a polyethersulfone (PES) substrate that have a high mobility (up to 9.76 cm(2) V(-1) sec(-)1), a low operating voltage (less than 4 V), a high current on/off ratio (3 × 10(4)), and a total device yield of 90%. Thus, it should be emphasized that this study delineates a guideline for the feasibility of producing flexible CNT-TFT logic circuits with high performance based on a low-cost and simple fabrication process.

The Analysis of Characteristics in Dry and Wet Environments of Silicon Nanowire-Biosensor

Our study investigates differences in sensitivity of dry and wet environment in the field of biosensing experiment in detail and depth. The sensitivity of biosensing varies by means of surrounding conditions of silicon nanowire field effect transistor (SiNW FET). By examining charged polymer reaction in the silicon nanowire transistor (SiNW), we have discovered that the threshold voltage (V(T)) shift and change of subthreshold slope (SS) in wet environment are smaller than that of the air. Furthermore, we analyzed the sensitivity through modifying electrolyte concentration in the wet condition, and confirmed that V(T) shift increases in low concentration condition of phosphate buffered saline (PBS) due to the Debye length. We believe that the results we have found in this study would be the cornerstone in contributing to advanced biosensing experiment in the future.

Overall and cause-specific mortality in systemic lupus erythematosus: an updated meta-analysis

AIMS

This study aimed to assess all-cause and cause-specific standardized mortality ratios (SMRs) in patients with systemic lupus erythematosus (SLE).

METHODS

We surveyed studies examining all-cause and/or cause-specific SMR in patients with SLE compared to the general population using PUBMED, EMBASE and Cochrane databases and manual searches. We performed a meta-analysis of all-cause, sex-specific, ethnicity-specific, and cause-specific SMRs in SLE patients.

RESULTS

Fifteen reports including 26,101 patients with SLE with 4640 deaths met the inclusion criteria. Compared to the general population, all-cause SMR was significantly increased 2.6-fold in patients with SLE (SMR 2.663, 95% CI 2.090-3.393, p < 1.0 × 10(-8)). Stratification by ethnicity showed that all-cause SMR was 2.721 (95% CI 1.867-3.966, p = 1.9 × 10(-6)) in Caucasians and 2.587 (95% CI 1.475-4.535, p = 0.001) in Asians. Sex-specific meta-analysis revealed that all-cause SMR was 3.141 (95% CI 2.351-4.198, p < 1.0 × 10(-8)) for women and 3.516 (95% CI 2.928-4.221, p < 1.0 × 10(-8)) for men. The risk of mortality was significantly increased for mortality due to renal disease (SMR 4.689, 95% CI 2.357-9.330, p = 1.10 × 10(-5)), cardiovascular disease (CVD) (SMR 2.253, 95% CI 1.304-3.892, p = 0.004), and infection (SMR 4.980, 95% CI 3.876-6.398, p < 1.0 × 10(-8)), although there was no significant increase in SMR for mortality due to cancer (SMR 1.163, 95% CI 0.572-2.363, p = 0.676).

CONCLUSIONS

Patients with SLE had higher rates of death from all causes, regardless of sex, ethnicity, renal disease, CVD or infection. However, the risk of death due to malignancy was not increased.

Association between toll-like receptor polymorphisms and systemic lupus erythematosus: a meta-analysis update

OBJECTIVE

The aim of this study was to determine whether polymorphisms of the Toll-like receptor (TLR) genes are associated with susceptibility to systemic lupus erythematosus (SLE).

METHODS

The authors conducted a meta-analysis of the relationship between 12 TLR polymorphisms and SLE susceptibility.

RESULTS

In total, 26 studies that involved 11,984 patients and 14,572 controls were included in the meta-analysis. The meta-analysis showed no association between the two alleles of the rs352140, rs5743836, and rs352139 polymorphisms of TLR9 and SLE, but indicated an association between the two alleles of the rs187084 polymorphism (TLR9) and SLE in the overall population (OR = 0.869, 95% CI = 0.762-0.992, P = 0.038). No association was detected between rs3764880 (TLR8) and SLE; however, our meta-analysis indicated an association between rs3764879 (TLR8) and SLE in Caucasians (OR = 1.414, 95% CI = 1.139-1.756, P = 0.002). An association between rs179008 (TLR7) and SLE was found in the African (OR = 0.430, 95% CI = 0.238-0.775, P = 0.005), but not in the Caucasian population (OR = 1.206, 95% CI = 0.932-1.614, P = 0.145). Furthermore, our meta-analysis indicated a significant association between rs3853839 (TLR7) and SLE in the Asian population (OR = 0.773, 95% CI = 0.735, 0.823, P < 1.0 × 10(-9)). No associations were found between rs5744168 (TLR5), rs4986791 (TLR4), rs4986790 (TLR4), and rs3775291 (TLR3) polymorphisms and SLE susceptibility.

CONCLUSIONS

Our meta-analysis suggests that TLR7, TLR8, and TLR9 polymorphisms are associated with the development of SLE in Caucasian, Asian, and African populations.

Changes in lung function according to disease extent before and after pulmonary tuberculosis

OBJECTIVE

To evaluate changes in lung function in individuals before and after treatment for pulmonary tuberculosis (PTB) in relation to extent of disease.

DESIGN

Using a retrospective cohort design, changes in and predictors of lung function were evaluated.

RESULTS

A total of 41 patients were included in the final analysis. The median decline in annualised forced expiratory volume in 1 sec (FEV1) was 180.0 ml/year (95%CI 118.9-356.1) in advanced PTB and 94.7 ml/year (95%CI 33.4-147.3) in localised PTB (ΔFEV1% predicted/year 9.4%, 95%CI 4.4-14.0 vs. 3.8%, 95%CI 1.8-6.2). The median decline in annualised forced vital capacity (FVC) was 309.6 ml/year (95%CI 137.0-359.0) in advanced PTB and 101.1 ml/year (95%CI 30.3-219.6) in localised PTB (ΔFVC % predicted/year 7.3%, 95%CI 5.3-12.3 vs. 2.9%, 95%CI 0.9-6.5).

CONCLUSIONS

As the sample size of our study was small, the conclusions could be biased. Nevertheless, our findings show that PTB causes a significant decline in lung function even in localised PTB, whereas advanced PTB was associated with excessive or even higher decline. This study suggests that early diagnosis and treatment of PTB is needed to preserve lung function.

Palmitate induces ER calcium depletion and apoptosis in mouse podocytes subsequent to mitochondrial oxidative stress

Pathologic alterations in podocytes lead to failure of an essential component of the glomerular filtration barrier and proteinuria in chronic kidney diseases. Elevated levels of saturated free fatty acid (FFA) are harmful to various tissues, implemented in the progression of diabetes and its complications such as proteinuria in diabetic nephropathy. Here, we investigated the molecular mechanism of palmitate cytotoxicity in cultured mouse podocytes. Incubation with palmitate dose-dependently increased cytosolic and mitochondrial reactive oxygen species, depolarized the mitochondrial membrane potential, impaired ATP synthesis and elicited apoptotic cell death. Palmitate not only evoked mitochondrial fragmentation but also caused marked dilation of the endoplasmic reticulum (ER). Consistently, palmitate upregulated ER stress proteins, oligomerized stromal interaction molecule 1 (STIM1) in the subplasmalemmal ER membrane, abolished the cyclopiazonic acid-induced cytosolic Ca²⁺ increase due to depletion of luminal ER Ca²⁺. Palmitate-induced ER Ca²⁺ depletion and cytotoxicity were blocked by a selective inhibitor of the fatty-acid transporter FAT/CD36. Loss of the ER Ca²⁺ pool induced by palmitate was reverted by the phospholipase C (PLC) inhibitor edelfosine. Palmitate-dependent activation of PLC was further demonstrated by following cytosolic translocation of the pleckstrin homology domain of PLC in palmitate-treated podocytes. An inhibitor of diacylglycerol (DAG) kinase, which elevates cytosolic DAG, strongly promoted ER Ca²⁺ depletion by low-dose palmitate. GF109203X, a PKC inhibitor, partially prevented palmitate-induced ER Ca²⁺ loss. Remarkably, the mitochondrial antioxidant mitoTEMPO inhibited palmitate-induced PLC activation, ER Ca²⁺ depletion and cytotoxicity. Palmitate elicited cytoskeletal changes in podocytes and increased albumin permeability, which was also blocked by mitoTEMPO. These data suggest that oxidative stress caused by saturated FFA leads to mitochondrial dysfunction and ER Ca²⁺ depletion through FAT/CD36 and PLC signaling, possibly contributing to podocyte injury.