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BACKGROUND Clopidogrel is a platelet aggregation inhibitor used for the management of cardiovascular disease. While antiplatelet therapy decreases cardiovascular events after successful coronary drug-eluting stenting, it increases the risk of gastrointestinal (GI) bleeding. About 20% of the patients who take clopidogrel exhibit resistance to the drug. CASE SUMMARY We report the first case of a small bowel bleeding ulcer in an 86-year-old man with clopidogrel resistance. He had a history of taking clopidogrel due to unstable angina. There was no evidence of bleeding in the stomach, duodenum, or colon through upper and lower GI endoscopies. The abdominal computed tomography showed the extravasation of radiocontrast media at the ileum. Because of unstable vital signs, emergency surgery was performed. Multiple ulcers with inflammation were found in the ileum. The pathologic findings revealed simple inflammation. The VerifyNow P2Y12 test showed clopidogrel resistance. One year after changing to aspirin, capsule endoscopy was performed and the small bowel ulcers were improved. CONCLUSION Small bowel ulcers and bleeding due to clopidogrel are not very common, but the prevalence is expected to increase in older age patients with risk factors despite clopidogrel resistance.

Background Cholecystoduodenal fistula is a rare complication of cholelithiasis. Symptoms are usually non-specific and often indistinguishable from those of etiologic diseases, but it rarely presents as severe gastrointestinal bleeding. Bleeding associated with cholecystoduodenal fistula usually requires surgery because significant bleeding from the cystic artery is unlikely to be resolved by conservative management or endoscopic hemostasis. Case summary We report a case of cholecystoduodenal fistula that presented with hematemesis which was diagnosed by endoscopy and computed tomography. Endoscopic hemostasis could not be achieved, but surgical treatment was successful. Additionally, we have presented a literature review. Conclusion Cholecystoduodenal fistula should be considered as differential diagnosis when a patient with history of gallstone disease presents with gastrointestinal bleeding.

Conventional epitaxy of semiconductor films requires a compatible single crystalline substrate and precisely controlled growth conditions, which limit the price competitiveness and versatility of the process. We demonstrate substrate-tolerant nano-heteroepitaxy (NHE) of high-quality formamidinium-lead-tri-iodide (FAPbI3) perovskite films. The layered perovskite templates the solid-state phase conversion of FAPbI3 from its hexagonal non-perovskite phase to the cubic perovskite polymorph, where the growth kinetics are controlled by a synergistic effect between strain and entropy. The slow heteroepitaxial crystal growth enlarged the perovskite crystals by 10-fold with a reduced defect density and strong preferred orientation. This NHE is readily applicable to various substrates used for devices. The proof-of-concept solar cell and light-emitting diode devices based on the NHE-FAPbI3 showed efficiencies and stabilities superior to those of devices fabricated without NHE., Though literature reports metal halide perovskite epitaxial growth on various substrates, controlling film growth for device applications remains a challenge. Here, the authors report kinetic-controlled growth of halide perovskite thin films on various substrates via layered perovskite templates.

Two-dimensional (2D) semiconductors are attractive for electronic devices with atomically thin channels. However, controlling the electronic properties of the 2D materials by incorporating impurity dopants is inherently difficult due to the limited physical space in the atomically thin lattices. Here we show that a solid-state ionic doping approach can be used to tailor the carrier type in 2D semiconductors and create programmable devices. Our strategy exploits a superionic phase transition in silver iodide to induce switchable ionic doping. We create few-layer tungsten diselenide (WSe2) devices that can be reversibly transformed into transistors with reconfigurable carrier types and into diodes with switchable polarities by controllably poling the van der Waals integrated silver iodide above the superionic phase transition temperature. We also construct complementary logic gates by integrating and programming identical transistors, and show that the programmed functions can be erased by an external trigger (temperature or ultraviolet irradiation) to create the temporary and delible electronics that are desirable for electronic security. The superionic phase transition in silver iodide can be used to tailor the carrier type in two-dimensional tungsten diselenide and create programmable transistors, diodes and logic gates, the functions of which can be erased by external triggers such as ultraviolet irradiation.

Serrated polyposis syndrome (SPS) can transform to malignant lesions through the sessile serrated pathway and traditional serrated pathway. These pathways may cause rapid neoplastic progression compared to the adenoma-carcinoma sequence, which may cause interval colorectal cancer. The authors experienced a case of SPS with a synchronous colon adenocarcinoma that was treated with an endoscopic mucosal resection. In pathology reviews, other parts of the adenocarcinoma showed sessile serrated adenoma. Therefore, patients with SPS have a potential for malignant transformation, highlighting the need for strict colonoscopy surveillance starting at the time of SPS diagnosis.

Summary Toward memristor scaling, it becomes increasingly challenging to maintain reliable switching as the interelectrode distance shrinks to smaller and smaller scale. In particular, the memristive active layers are usually fragile and prone to metal-integration-induced damage. To adapt an ultrathin active switching layer for low-voltage operation requires alternative damage-free metal-integration strategies. Here, by adopting a van der Waals (vdW) metal-integration approach, we construct memristors with vdW contact between metal electrode and ultrathin native oxide on 2D material SnSe. The mild vdW-integration process preserves the delicate SnOx and enables reliable Ag/SnOx/SnSe memristor with low operation voltage, high ON/OFF ratio >103, and excellent endurance and retention properties. Furthermore, the memristors feature gate-tunable neuromorphic functions. By carrying out multiterminal measurements and elemental analyses, we reveal an electrochemical metallization and Ag filament formation switching mechanism. Our strategy defines a unique vdW-integration solution for fragile memristive materials.

BACKGROUND AND AIM The efficacy and safety of the recently introduced low-volume purgatives in elderly people are not well known. Therefore, in this trial, we aimed to evaluate and compare the efficacy of two low-volume agents, oral sulfate solution (OSS) and 2-L polyethylene glycol with ascorbic acid (PEG-Asc), in elderly people. METHODS A prospective, randomized, single-blinded, multicenter, non-inferiority trial was performed at three university-affiliated hospitals in South Korea. Outpatients aged 65-80 years, who underwent elective colonoscopy, were enrolled. The primary outcome was the rate of adequate bowel preparation assessed using the Boston Bowel Preparation Scale. RESULTS A total of 199 subjects were randomized into the OSS (n = 99) or the 2-L PEG-Asc (n = 100) group. Of them, 189 subjects were included in the analysis of the primary outcome (OSS group 95 vs PEG-Asc group 94). The proportion of adequate bowel preparation was 89.5% (85/95) in the OSS group and 93.6% (88/94) in the 2-L PEG-Asc group. OSS was not inferior to 2-L PEG-Asc according to the prespecified non-inferiority margin of -15% (95% confidence interval for the difference, -12.1 to 3.8). Vomiting (11.6% vs 2.1%) and thirst (24.2% vs 11.7%) were more common in the OSS group than in the 2-L PEG-Asc group. CONCLUSIONS OSS is an effective low-volume purgative that is non-inferior to 2-L PEG-Asc in elderly people. Both the low-volume agents were identified to be well tolerated and safe in the healthy elderly population.

Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis. Malignant conditions must be considered in cases of actinomycosis with no response to antimicrobial therapy. (Korean J Gastroenterol 2019;74:46-50)

Two-dimensional (2D) semiconductors have attracted intense interest for their unique photophysical properties, including large exciton binding energies and strong gate tunability, which arise from their reduced dimensionality1–5. Despite considerable efforts, a disconnect persists between the fundamental photophysics in pristine 2D semiconductors and the practical device performances, which are often plagued by many extrinsic factors, including chemical disorder at the semiconductor–contact interface. Here, by using van der Waals contacts with minimal interfacial disorder, we suppress contact-induced Shockley–Read–Hall recombination and realize nearly intrinsic photophysics-dictated device performance in 2D semiconductor diodes. Using an electrostatic field in a split-gate geometry to independently modulate electron and hole doping in tungsten diselenide diodes, we discover an unusual peak in the short-circuit photocurrent at low charge densities. Time-resolved photoluminescence reveals a substantial decrease of the exciton lifetime from around 800 picoseconds in the charge-neutral regime to around 50 picoseconds at high doping densities owing to increased exciton–charge Auger recombination. Taken together, we show that an exciton-diffusion-limited model well explains the charge-density-dependent short-circuit photocurrent, a result further confirmed by scanning photocurrent microscopy. We thus demonstrate the fundamental role of exciton diffusion and two-body exciton–charge Auger recombination in 2D devices and highlight that the intrinsic photophysics of 2D semiconductors can be used to create more efficient optoelectronic devices. Two-dimensional transition metal dichalcogenide diodes with defect-free van der Waals contacts allows minimization of the extrinsic interfacial disorder-dominated recombination and access to the intrinsic excitonic behaviour in two-dimensional semiconductor devices.

All-inorganic lead halide perovskites have attracted tremendous interest for their excellent stability when compared with hybrid perovskites. Here we report a large-area growth of monocrystalline all-inorganic perovskite thin films and further patterning them into heterostructure arrays. We show that highly oriented CsPbBr3 microcrystal domains can be readily grown on muscovite mica substrates with a well-defined epitaxial relationship, which can further expand and eventually merge into large-area monocrystalline CsPbBr3 thin films with an excellent optical quality. Taking a step further, we show the large-area CsPbBr3 thin film can be further patterned and selectively transformed into CsPbI3 using a selective anion-exchange process to produce CsPbBr3-CsPbI3 lateral heterostructure arrays with spatially modulated photoluminescence emission and an apparent current rectification behavior. The capability to grow large-area CsPbBr3 monocrystalline thin films and heterostructure arrays defines a robust material platform for both the fundamental investigations and potential applications in optoelectronics.

Defect passivation constitutes one of the most commonly used strategies to fabricate highly efficient perovskite solar cells (PSCs). However, the durability of the passivation effects under harsh operational conditions has not been extensively studied regardless of the weak and vulnerable secondary bonding between the molecular passivation agents and perovskite crystals. Here, we incorporated strategically designed passivating agents to investigate the effect of their interaction energies on the perovskite crystals and correlated these with the performance and longevity of the passivation effects. We unraveled that the passivation agents with a stronger interaction energy are advantageous not only for effective defect passivation but also to suppress defect migration. The prototypical PSCs treated with the optimal passivation agent exhibited superior performance and operational stability, retaining 81.9 and 85.3% of their initial performance under continuous illumination or nitrogen at 85 °C after 1008 h, respectively, while the reference device completely degraded during that time. This work provides important insights into designing operationally durable defect passivation agents for perovskite optoelectronic devices.

Noroviruses are the leading cause of acute gastroenteritis and food poisoning worldwide. In this study, we investigated the anti-noroviral activity of Lindera obtusiloba leaf extract (LOLE) using murine norovirus (MNV-1), a surrogate of human norovirus. Preincubation of MNV-1 with LOLE at 4, 8, or 12 mg/mL for 1 h at 25 &deg, C significantly reduced viral infectivity, by 51.8%, 64.1%, and 71.2%, respectively. Among LOLE single compounds, &beta, pinene (49.7%), &alpha, phellandrene (26.2%), and (+)-limonene (17.0%) demonstrated significant inhibitory effects on viral infectivity after pretreatment with MNV-1, suggesting that the anti-noroviral effects of LOLE may be due to the synergetic activity of several compounds, with &beta, pinene as a key molecule. The inhibitory effect of LOLE was tested on the edible surfaces of lettuce, cabbage, and oysters, as well as on stainless steel. After one hour of incubation at 25&deg, C, LOLE (12 mg/mL) pretreatment significantly reduced MNV-1 plaque formation on lettuce (76.4%), cabbage (60.0%), oyster (38.2%), and stainless-steel (62.8%). These results suggest that LOLE effectively inhibits norovirus on food and metal surfaces. In summary, LOLE, including &beta, pinene, may inactivate norovirus and could be used as a natural agent promoting food safety and hygiene.

저자들은 최근 구역과 구토로 내원한 65세 남자에서 위내시경을 통하여 위체부에 다발성 홍반을 발견하였고, 조직 검사 결과 다수의 호산구 침윤을 확인하였다. 또한 생식을 한 과거력을 바탕으로 혈청과 뇌척수액 검사를 통한 기생충 검사 그리고 뇌 자기공명영상을 시행하여 뇌 스파르가눔증을 의심하였다. 뇌 스파르가눔에 대한 수술적 치료는 시행하지 못하였으나 프라지콴텔을 투여하여 소화기 증상 및 신경학적 증상이 호전되었다. 호산구성 위염의 치료를 위해서는 기생충 감염, 약물, 알레르기 질환 등 이차성 호산구성 위염의 원인을 배제하는 것이 중요하며, 특히 뱀과 개구리를 생식하는 우리나라에서는 병력 청취 및 검사를 통하여 기생충 감염증을 고려하는 것이 필요할 것으로 사료된다.

Objective This study was performed to assess the effectiveness and safety of percutaneous cholecystostomy (PC) for biliary decompression. Methods We retrospectively analyzed our institution’s PC database from March 2015 to August 2017 and selected patients with biliary obstruction. The primary outcomes were the technical and clinical success rates. As secondary outcomes, adverse events and pain after PC were compared with those of patients who underwent PC for acute cholecystitis during the same period. Results Twenty patients underwent PC for biliary obstruction (cholangitis, 19; pancreatitis, 1). The technical and clinical success rates were 100%. The median serum total bilirubin level decreased considerably from 4.5 to 1.4 mg/dL after PC. An adverse event (catheter migration) occurred in 1 patient, and 17 patients developed pain after PC. During the same period, 104 patients underwent PC for cholecystitis. Adverse events occurred in 7 patients, and 62 developed pain. There was no significant difference in the adverse event rate between the cholangitis/pancreatitis and cholecystitis groups (5.0% vs. 6.7%, respectively), but pain occurred considerably more frequently in the cholangitis/pancreatitis group (94.4% vs. 63.9%, respectively). Conclusions PC is an effective and safe method for biliary decompression in selected patients. However, attention should be paid to postoperative pain.

The junctions formed at the contact between metallic electrodes and semiconductor materials are crucial components of electronic and optoelectronic devices 1 . Metal-semiconductor junctions are characterized by an energy barrier known as the Schottky barrier, whose height can, in the ideal case, be predicted by the Schottky-Mott rule2-4 on the basis of the relative alignment of energy levels. Such ideal physics has rarely been experimentally realized, however, because of the inevitable chemical disorder and Fermi-level pinning at typical metal-semiconductor interfaces2,5-12. Here we report the creation of van der Waals metal-semiconductor junctions in which atomically flat metal thin films are laminated onto two-dimensional semiconductors without direct chemical bonding, creating an interface that is essentially free from chemical disorder and Fermi-level pinning. The Schottky barrier height, which approaches the Schottky-Mott limit, is dictated by the work function of the metal and is thus highly tunable. By transferring metal films (silver or platinum) with a work function that matches the conduction band or valence band edges of molybdenum sulfide, we achieve transistors with a two-terminal electron mobility at room temperature of 260 centimetres squared per volt per second and a hole mobility of 175 centimetres squared per volt per second. Furthermore, by using asymmetric contact pairs with different work functions, we demonstrate a silver/molybdenum sulfide/platinum photodiode with an open-circuit voltage of 1.02 volts. Our study not only experimentally validates the fundamental limit of ideal metal-semiconductor junctions but also defines a highly efficient and damage-free strategy for metal integration that could be used in high-performance electronics and optoelectronics.

This paper presents a field-programmable mixed-signal IC named CHIMERA, for low-cost and rapid prototyping of mixed-signal systems. The proposed IC implements field-programmable analog functions with time-domain configurable analog blocks (TCABs). A single TCAB can be programmed to various analog circuits, including a time-to-digital converter, digitally-controlled oscillator, digitally-controlled delay cell, digital pulse-width modulator, and phase interpolator. The TCABs convey and process analog information using the frequency, pulse width, delay, or phase of digital pulses or pulse sequences, rather than using analog voltage or current signals for reduced susceptibility to attenuation and noise. The overall CHIMERA chip also includes arrays of configurable logic blocks (CLBs) and programmable arithmetic logic units (ALUs) for programmable digital functions. By programming the functionality of the TCAB, CLB, and ALU arrays and configuring the interconnects, the chip can implement various mixed-signal systems. A prototype IC fabricated with 65-nm CMOS technology demonstrates the versatile programmability of CHIMERA by being successfully operated as a 1-GHz phase-locked loop with a 12.3-psrms integrated jitter, as a 50-MS/s analog-to-digital converter with a 32.5-dB SNDR, and as a 1.2-to-0.7 V DC–DC converter with 95.5% efficiency.

Desiccant-enhanced evaporative (DEVap) cooling system have been recently introduced as an alternative to conventional air conditioning systems. This system consists of a liquid desiccant dehumidifier and a dew point evaporative cooler. In this research, workable operation strategies for the DEVap system were suggested and applied to an energy simulation for estimating the energy saving potential of the system over the conventional variable air volume (VAV) system. Four different modes of operation determined according to outdoor air conditions were suggested for annual operation of the DEVap system. Energy simulations for both DEVap and VAV systems were performed for a model office building. The results showed that 2–3% of annual primary energy could be saved by using the DEVap cooling system compared with the conventional VAV system.

The purpose of this research is to evaluate the primary energy savings of a desiccant-enhanced evaporative (DEVap) cooling system with a district heat source. The DEVap system consists of an internally cooled liquid desiccant dehumidifier and dew point evaporative cooler connected in series. The liquid desiccant unit requires a heat source for regenerating the weak desiccant solution, which means that the DEVap cooler is a thermally driven cooling system. It can provide energy benefits when the supplied heat comes from waste heat or renewable heat sources. In this research, district heat obtained from a combined heat and power (CHP) system was used as the heat source for the DEVap system. The primary energy consumption and CO 2 emission rate of the proposed system with a district heat source were estimated using a detailed energy simulation and compared with those powered by a conventional gas boiler. The results showed that the DEVap system with district heat source consumed 46.2% less primary energy and produced 40.5% less CO 2 compared with the system using the conventional gas boiler.

High-resolution doping patterns can be reversibly written in van der Waals heterostructures using a combination of an electron beam and a back-gate voltage.

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

The purpose of this study is to comparatively evaluate the energy performances of a dedicated outdoor air system (DOAS) and desiccant-enhanced evaporative air conditioner (DEVap) in building applications. The DOAS effectively accommodates latent cooling loads and some of the sensible cooling loads of the space by introducing cooled and dehumidified ventilation air into a building while integrating a parallel system aimed at reducing the remaining sensible load. The DEVap enhances the energy performance of a variable air volume system by reducing cooling coil loads through preconditioning of the supply air before it reaches a coil. The preconditioning is accomplished by using a liquid desiccant system and dew-point indirect evaporative cooler. In this paper, the operating and annual primary energy consumptions of both the DOAS and DEVap systems are compared based on detailed energy simulations. The results indicated the energy saving potential of DOAS to be greater than that of the DEVap. Specifically, a DOAS with ceiling radiant cooling panels experienced 20% less primary energy consumption compared to a DEVap.

The main purpose of this research was to propose a practical correlation for predicting the dehumidification effectiveness of a liquid desiccant (LD) system. The experimental data were collected during the operation of a typical liquid desiccant dehumidification unit. A lithium chloride (LiCl) solution was used as the liquid desiccant solution. The 2000 m3/h LD unit was installed in a real building, and the variation of the dehumidification effectiveness values was monitored under various operating conditions. The data were statistically analyzed by the response surface methodology (RSM), and the impact of each system operation parameter on the dehumidification effectiveness was estimated quantitatively. Six operating parameters – the mass flow rate of process air, the mass flow rate of the desiccant solution, the dry-bulb temperature and the humidity ratio of the inlet air, and the inlet temperature and concentration of the desiccant solution – significantly affected the dehumidification performance of the LD unit. Consequently, a simplified linear equation model was derived as a function of the operation parameters that significantly impacted the dehumidification effectiveness. The proposed model was verified by comparison with existing models.

The main purpose of this study is to develop a liquid desiccant and dew point evaporative cooling-assisted 100% outdoor air system (LDEOS), and to evaluate its energy saving potentials. In recent years, non-vapor-compression air conditioning systems are becoming available without compromising energy efficiency, thermal comfort, and ventilation requirements. A quasi-dynamic simulation model of LDEOS including a dew point evaporative cooler model was developed to compare the energy performance of LDEOS against a typical variable air volume (VAV) system. A sequence of operation for LDEOS was also proposed. Simulation results showed that LDEOS could save 12% of primary energy compared to a conventional VAV, while 100% of outdoor air was conditioned and delivered to the space without using vapor compression technology.

Interstitial cells of Cajal (ICC) are known as the pacemaker cells of gastrointestinal tract, and it has been reported that acute gastroenteritis induces intestinal dysmotility through antibody to vinculin, a cytoskeletal protein in gut, resulting in small intestinal bacterial overgrowth, so that anti-vinculin antibody can be used as a biomarker for irritable bowel syndrome. This study aimed to determine correlation between serum anti-vinculin antibody and ICC density in human stomach. Gastric specimens from 45 patients with gastric cancer who received gastric surgery at Kangwon National University Hospital from 2013 to 2017 were used. ICC in inner circular muscle, and myenteric plexus were counted. Corresponding patient's blood samples were used to determine the amount of anti-vinculin antibody by enzyme-linked immunosorbent assay. Analysis was done to determine correlation between anti-vinculin antibody and ICC numbers. Patients with elevated anti-vinculin antibody titer (above median value) had significantly lower number of ICC in inner circular muscle (71.0 vs. 240.5, p = 0.047), and myenteric plexus (12.0 vs. 68.5, p < 0.01) compared to patients with lower anti-vinculin antibody titer. Level of serum anti-vinculin antibody correlated significantly with density of ICC in myenteric plexus (r = −0.379, p = 0.01; Spearman correlation). Increased level of circulating anti-vinculin antibody was significantly correlated with decreased density of ICC in myenteric plexus of human stomach.

Background/aims Proton pump inhibitors (PPIs) are frequently used to treat non-erosive reflux disease (NERD), but their effect is limited. It is not known whether a potential alternative, AlbisD, containing ranitidine hydrochloride, sucralfate hydrate, and tripotassium dicitrato bismuthate, is effective and safe in treating NERD. The aim of the study is to evaluate the efficacy and safety of AlbisD compared with omperazole in patients with NERD. Methods This was a multicenter, randomized, open-label, parallel-group, non-inferiority comparative study. A total of 126 patients with NERD were randomly allocated to either AlbisD twice daily or omeprazole 20 mg once daily for 4 weeks from February 2016 to August 2016. The study patients had histories of heartburn or regurgitation of moderate severity (> score 2) and a frequency of at least 2 episodes per week, and had no mucosal breaks of the esophagus on endoscopy. The primary efficacy variable was complete cure of heartburn at week 4. Secondary efficacy variables evaluating symptoms of heartburn and acid reflux as well as safety profiles were compared in the 2 groups at week 2 and 4 after treatment. Results A total of 113 patients completed the study (57 and 56 in AlbisD and omeprazole groups, respectively). The proportion of patients with complete cure of heartburn at week 4 was not significantly different between the AlbisD and omeprazole groups (35.1% vs 32.1% respectively, P = 0.740). There were no significant differences between the 2 groups in the any secondary variables including proportions of days without heartburn or acid reflux over 4 weeks (including daytime and nighttime). Adverse events were similarly reported in the 2 groups (7 [12.3%] vs 6 [10.7%]), and there were no serious adverse events. Conclusions The efficacy and safety of AlibsD in treating NERD patients are not inferior to those of omeprazole. Therefore, AlbisD can be an alternative to PPIs for NERD.

We report graphene/self-assembly monolayer vertical molecular transistors operating in the quantum tunneling regime., Molecular transistors operating in the quantum tunneling regime represent potential electronic building blocks for future integrated circuits. However, due to their complex fabrication processes and poor stability, traditional molecular transistors can only operate stably at cryogenic temperatures. Here, through a combined experimental and theoretical investigation, we demonstrate a new design of vertical molecular tunneling transistors, with stable switching operations up to room temperature, formed from cross-plane graphene/self-assembled monolayer (SAM)/gold heterostructures. We show that vertical molecular junctions formed from pseudo-p-bis((4-(acetylthio)phenyl)ethynyl)-p-[2,2]cyclophane (PCP) SAMs exhibit destructive quantum interference (QI) effects, which are absent in 1,4-bis(((4-acetylthio)phenyl)ethynyl)benzene (OPE3) SAMs. Consequently, the zero-bias differential conductance of the former is only about 2% of the latter, resulting in an enhanced on-off current ratio for (PCP) SAMs. Field-effect control is achieved using an ionic liquid gate, whose strong vertical electric field penetrates through the graphene layer and tunes the energy levels of the SAMs. The resulting on-off current ratio achieved in PCP SAMs can reach up to ~330, about one order of magnitude higher than that of OPE3 SAMs. The demonstration of molecular junctions with combined QI effect and gate tunability represents a critical step toward functional devices in future molecular-scale electronics.

Compositional engineering has been used to overcome difficulties in fabricating high-quality phase-pure formamidinium perovskite films together with its ambient instability. However, this comes alongside an undesirable increase in bandgap that sacrifices the device photocurrent. Here we report the fabrication of phase-pure formamidinium-lead tri-iodide perovskite films with excellent optoelectronic quality and stability. Incorporation of 1.67 mol% of 2D phenylethylammonium lead iodide into the precursor solution enables the formation of phase-pure formamidinium perovskite with an order of magnitude enhanced photoluminescence lifetime. The 2D perovskite spontaneously forms at grain boundaries to protect the formamidinium perovskite from moisture and suppress ion migration. A stabilized power conversion efficiency (PCE) of 20.64% (certified stabilized PCE of 19.77%) is achieved with a short-circuit current density exceeding 24 mA cm−2 and an open-circuit voltage of 1.130 V, corresponding to a loss-in-potential of 0.35 V, and significantly enhanced operational stability., Utilizing mixed-cation-halide can improve stability of the formamidinium perovskite films and devices but sacrifices the photocurrent due to an increase in bandgap. Here Lee et al. introduced small amounts of 2D perovskite to obtain high efficiency and stability based on phase-pure formamidinium based perovskite.

Purpose: The study aimed to provide an understanding of how business strategic planning affected the business performance of small businesses. To achieve this aim, the study examined what type of mediating role opportunity exploration and resource exploitation played in the relationship between business strategic planning and business performance. Research design, data, and methodology: The study drew out a total of 14 variables from preceding research. Furthermore, it conducted a survey targeting 153 domestic small business founders for data collection. SMartPLS 2.0 was chosen among PLS analysis software and used for statistical analysis of the research model based on the collected data. Results: Empirical analysis revealed that, in order for business strategic planning to affect the business performance of small businesses, the process of actively exploiting resources currently possessed played an important mediating role. Also, focus on exploration into new business opportunities was not directly linked to performance improvement. However this result does not mean that exploration into new business opportunities were unrelated to business performance. Conclusions: The study confirmed that business strategic planning affected business performance through the process of resource exploitation. Therefore, from the viewpoint of the small businesses, the special role of business strategy is to kick-start the recognition toward the need for resource development, such as human resource investment and differentiated marketing programs, which can contribute to short and long-term performance.

This study is to analyze the effects of the FDI inflows service industry on China's economic growth using panel data from China's service industry for the period 1990-2012. The results of this study show that the FDI inflows into service industry in China is behind a key driving force to develop its economic growth, and that other factors like investment in the fixed assets and investment in human capital and labor make contribution to promoting its economic development. The results suggest that in order to enhance its growth, the government should expend a great deal of effort trying to make a good environment for investment to increase the FDI inflows into China's service industry.

Although coffee is known to have antioxidant, anti-inflammatory, and antitumor properties, there have been few reports about the effect and mechanism of coffee compounds in colorectal cancer. Heat shock proteins (HSPs) are molecular chaperones that prevent cell death. Their expression is significantly elevated in many tumors and is accompanied by increased cell proliferation, metastasis and poor response to chemotherapy. In this study, we investigated the cytotoxicity of four bioactive compounds in coffee, namely, caffeine, caffeic acid, chlorogenic acid, and kahweol, in HT-29 human colon adenocarcinoma cells. Only kahweol showed significant cytotoxicity. Specifically, kahweol increased the expression of caspase-3, a pro-apoptotic factor, and decreased the expression of anti-apoptotic factors, such as Bcl-2 and phosphorylated Akt. In addition, kahweol significantly attenuated the expression of HSP70. Inhibition of HSP70 activity with triptolide increased kahweol-induced cytotoxicity. In contrast, overexpression of HSP70 significantly reduced kahweol-induced cell death. Taken together, these results demonstrate that kahweol inhibits colorectal tumor cell growth by promoting apoptosis and suppressing HSP70 expression.

Study design Retrospective comparative study. Objective Two polyetheretherketone (PEEK) cages of different designs were compared in terms of the postoperative segmental kyphosis after anterior cervical discectomy and fusion. Summary of background data Segmental kyphosis occasionally occurs after the use of a stand-alone cage for anterior cervical discectomy and fusion. Although PEEK material seems to have less risk of segmental kyphosis compared with other materials, the occurrence of segmental kyphosis for PEEK cages has been reported to be from 0% to 29%. There have been a few reports that addressed the issue of PEEK cage design. Method A total of 41 consecutive patients who underwent single-level anterior discectomy and fusion with a stand-alone cage were included. Either a round tube-type (Solis; 18 patients, S-group) or a trapezoidal tube-type (MC+; 23 patients, M-group) cage was used. The contact area between the cage and the vertebral body is larger in MC+ than in Solis, and anchoring pins were present in the Solis cage. The effect of the cage type on the segmental angle (SA) (lordosis vs. kyphosis) at postoperative month 24 was analyzed. Results Preoperatively, segmental lordosis was present in 12/18 S-group and 16/23 M-group patients (P=0.84). The SA was more lordotic than the preoperative angle in both groups just after surgery, with no difference between groups (P=0.39). At 24 months, segmental lordosis was observed in 9/18 S-group and 20/23 M-group patients (P=0.01). The patients in M-group were 7.83 times more likely than patients in S-group (P=0.04; odds ratio, 7.83; 95% confidence interval, 1.09-56.28) not to develop segmental kyphosis. Conclusions The design of the PEEK cage used may influence the SA, and this association needs to be considered when using stand-alone PEEK cages.

The incidence of rectal neuroendocrine tumor (NET), which is often diagnosed during routine surveillance endoscopy, is increasing. The majority of these tumors are small and asymptomatic, possessing benign features with favorable prognoses. At present, small rectal NETs without high-risk factors are typically treated by local resection, including endoscopic mucosal resection, endoscopic submucosal dissection, or transanal endoscopic microsurgery, with or without additional imaging follow-up by abdominal computed tomography or magnetic resonance imaging. The present study, however, describes a case of a small rectal NET without any known risk factors, which was accompanied by substantial locoregional lymph node metastasis, underscoring the importance of imaging studies for rectal NETs.

This paper describes a high-radix crossbar switch design with low latency and power dissipation for Network-on-Chip (NoC) applications. The reduction in latency and power is achieved by employing a folded-clos topology, implementing the switch organized as three stages of low-radix switches connected in cascade. In addition, to facilitate the uniform placement of wires among the sub-switch stages, this paper proposes a Mux-Matrix-Mux structure, which implements the first and third switch stages as multiplexer-based crossbars and the second stage as a matrix-type crossbar. The proposed 256-radix, 8-bit crossbar switch designed in a 65㎚ CMOS has the simulated power dissipation of 1.92-W and worst-case propagation delay of 0.991-ns while operating at 1.2-V supply and 500-㎒ frequency. Compared with the state-of-the-art designs in literature, the proposed crossbar switch achieves the best energy-delay-area efficiency of 0.73-fJ/cycle·㎱·λ².

Angiolipoma is a morphological variation of the lipoma and is a benign tumour that consists of mature adipose tissue and proliferating blood vessels. It occurs very rarely in the digestive tract, especially the stomach. We report a gastric angiolipoma in a 58-year-old woman admitted for anaemia and melena. Endoscopy showed a large polypoid mass with superficial ulceration in the anterior wall of the gastric antrum. Endoscopic ultrasound showed an about 2 cm sized isoechoic lesion at the third echo layer, with the echogenic portion on the luminal side of the lesion. Laparoscopic wedge resection was performed and histological examination showed that the lesion had encapsulated adipose tissue at the submucosal layer and stromal fibrosis just below superficial ulceration. There were blood vessels with thick walls among the mature fat cells. Therefore, the lesion was diagnosed as an angiolipoma.

Although metal halide perovskite (MHP) light-emitting diodes (LEDs) have demonstrated great potential in terms of electroluminescence efficiency, the operational stability of MHP LEDs currently remains the biggest bottleneck toward their practical usage. Well-confined excitons/charge carriers in a dielectric/quantum well based on conventional spatial or potential confinement approaches substantially enhance radiative recombination in MHPs, but an increased surface-to-volume ratio and multiphase interfaces likely result in a high degree of surface or interface defect states, which brings about a critical environmentally/operationally vulnerable point on LED stability. Here, an effective solution is suggested to mitigate such drawbacks using strategically designed surface-2D/bulk-3D heterophased MHP nanograins for long-term-stable LEDs. The 2D surface-functionalized MHP renders significantly reduced trap density, environmental stability, and an ion-migration-immune surface in addition to a fast radiative recombination owing to its spatially and potentially confined charge carriers, simultaneously. As a result, heterophased MHP LEDs show substantial improvement in operational lifetime (T50 : >200 h) compared to conventional pure 3D or quasi-2D counterparts (T50 : < 0.2 h) as well as electroluminescence efficiency (surface-2D/bulk-3D: ≈7.70 ph per el% and pure 3D: ≈0.46 ph per el%).

Background and aimVarious drugs have been developed for inflammatory bowel disease (IBD), but still there are limitations in the treatment due to the insufficient responses and significant adverse effects of immunosuppressant. Apocynin is an NADPH-oxidase inhibitor with established safety profiles. We aimed to investigate the protective efficacy of apocynin in IBD using chemical-induced mouse colitis model.MethodWe induced experimental colitis by administrating 5% dextran sulfate sodium (DSS) to 8-week old BALB/c mouse for 11 days. Apocynin (400 mg/kg) or sulfasalazine (150 mg/kg) were administeredduring7 days. We monitored bodyweight daily and harvested colon and spleen at day 11 to check weight and length. We also examined histopathologic change and pro-, anti-inflammatory cytokines and enzymes from harvested colons (iNOS, COX-2, TNF-α, MCP-1, p-NrF2, and HO-1).ResultApocynin significantly alleviated weight reduction induced by DSS treatment (21.64 ± 0.55 for Apocynin group vs. 20.33 ± 0.90 for DSS group, p = 0.005). Anti-inflammatory efficacy of apocynin was also shown by the recovery of colon weight and length. Histopathologic examination revealed significantly reduced inflammatory foci and erosions by apocynin treatment. Colonic expression of iNOS, COX-2, TNF-α, and MCP-1 was decreased significantly in the apocynin treated group. Anti-inflammatory mediators Nrf2 and HO-1 were activated significantly in apocynin treated mouse.ConclusionApocynin showed significant anti-inflammatory efficacy against chemically induced colonic inflammation. This study also revealed the unique action of apocynin compared to the currently prescribed drug, sulfasalazine. Given its excellent safety profile and potent efficacy with novel action mechanism, apocynin can be a new therapeutic molecule for the IBD treatment, which can be added to the currently available drugs.

Pancreatic metastasis from cervical cancer is extremely rare. We report a case of metastatic adenocarcinoma of the pancreas from uterine cervical cancer. A 70-year-old woman was referred because of a pancreatic mass detected by CT. She had been diagnosed with uterine cervical adenocarcinoma 20 months previously. After concurrent chemoradiotherapy, CT showed no evidence of the cervical mass, and follow-up showed no evidence of recurrence. Endoscopic ultrasound-guided fine needle aspiration biopsy of the pancreatic mass resulted in a diagnosis of metastatic adenocarcinoma from uterine cervix.

After gastrojejunostomy, a small space can occur between the jejunum at the anastomosis site, the transverse mesocolon, and retroperitoneum, which may cause an intestinal hernia. This report presents a rare case of intestinal ischemic necrosis caused by retroanastomotic hernia after subtotal gastrectomy. A 56-year-old male was admitted to Kangwon National University Hospital with melena, abdominal pain, and nausea. His only relevant medical history was gastrectomy due to stomach cancer. Endoscopic findings revealed subtotal gastrectomy with Billroth-II reconstruction and a bluish edematous mucosal change with necrotic tissue in afferent and efferent loops including the anastomosis site. Abdominopelvic CT showed strangulation of proximal small bowel loops due to mesenteric torsion and thickening of the wall of the gastric remnant. Emergency laparotomy was performed. Surgical findings revealed the internal hernia through the defect behind the anastomosis site with strangulation of the jejunum between 20 cm below the Treitz ligament and the proximal ileum. Roux-en-Y anastomosis was performed, and he was discharged without complication. Retroanastomotic hernia, also called Petersen’s space hernia, is a rare complication after gastric surgery, cannot be easily recognized, and leads to strangulation.

In this paper, the performance improvement of the sensorless control of IPMSM employing the active flux concept by the improved current estimator is presented. The accuracy of the current estimator used in a previous report is degraded when the motor parameters are not known exactly. A simple current estimator derived from estimated flux is proposed to improve the position estimation performance. In order to show the usefulness of the proposed estimation method, the simulation results using Matlab/Simulink and the experiment results are presented.

A field-programmable mixed-signal IC for fast-prototyping and low-cost production of mixed-signal system is presented. The IC contains time-domain configurable analog blocks (TCABs) that can be programmed into a time-to-digital converter (TDC), digitally controlled oscillator (DCO), digitally controlled delay element, digital pulse-width modulator (DPWM), or phase interpolator (PI). The prototype IC fabricated in 65-nm CMOS demonstrates its versatile programmability with the successful operations as a 1-GHz PLL with 12.3-ps rms integrated jitter, 50-MS/s ADC with 32.5-dB SNDR, and 1.2-to-0.7V DC-DC converter with 95.5% efficiency.

he principal objective of this experiment was to evaluate the anti-atherosclerotic activity of hempseed water extract in apolipoprotein E knockout (ApoE KO) mice. Fourteen male ApoE KO mice were divided into 2 groups and were treated via intragastric inoculation for 14 weeks. The hempseed water extract (HWE) inoculation group exhibited greater gains in weight as compared to the control group, which was inoculated with distilled water. Plaque lesion areas in the aortic sinus were reduced in the HWE group. Total plasma cholesterol, LDL-cholesterol, atherosclerotic index, and cardiac risk factor were all reduced in the HWE group. These results demonstrate that HWE is an excellent nutritional resource and evidences anti-atherosclerotic activity in ApoE KO mice. Further studies will be required to assess the pharmacological mechanisms underlying these effects.

Background and Aims: Bronchial asthma (BA) is considered an extra-esophageal syndrome of gastroesophageal reflux disease (GERD) with poor pathophysiological background. We analyzed the correlation between GERD and BA, examining esophageal epithelium with transmission electron microscopy (TEM), along with clinical findings. Methods: BA patients of controlled and partly-controlled levels were enrolled in the study. A pulmonary and gastrointestinal (GI) questionnaire was given. Patients with no symptoms joined the control group. Esophageal mucosal tissue was taken by esophagogastroduodenoscopy from both groups and processed for TEM. Intercellular space (IS) was measured with an image analyzing program, 100 times for each patient. Results: The control (n = 20) and BA (n = 20) groups revealed no significant differences in baseline characteristics. All BA patients were using corticosteroid inhalers, with seven patients having a recent history of acute exacerbation. Patients with at least one GI symptom made up 70% (14/20) of the BA group, and heartburn and/or regurgitation were detected in 40% of patients. Endoscopic findings of GERD were mucosal breaks (n = 3). The IS of the control group was 0.389 ± 0.297 um, while the BA group was 0.806 ± 0.556 um (P = 0.001). The presence of GERD symptoms (P = 0.306) and a history of recent asthma attacks (P = 0.710) did not show significant differences. Conclusions: The BA group showed a significant difference in the dilatation of IS compared to the control group, suggesting a higher prevalence of GERD in BA patients and a close pathophysiological correlation.