Phase-Centric MOCVD Enabled Synthetic Approaches for Wafer-Scale 2D Tin Selenides.

Following an initial nucleation stage at the flake level, atomically thin film growth of a van der Waals material is promoted by ultrafast lateral growth and prohibited vertical growth. To produce these highly anisotropic films, synthetic or post-synthetic modifications are required, or even a combination of both, to ensure large-area, pure-phase, and low-temperature deposition. A set of synthetic strategies is hereby presented to selectively produce wafer-scale tin selenides, SnSex (both x = 1 and 2), in the 2D forms. The 2D-SnSe2 films with tuneable thicknesses are directly grown via metal-organic chemical vapor deposition (MOCVD) at 200 °C, and they exhibit outstanding crystallinities and phase homogeneities and consistent film thickness across the entire wafer. This is enabled by excellent control of the volatile metal-organic precursors and decoupled dual-temperature regimes for high-temperature ligand cracking and low-temperature growth. In contrast, SnSe, which intrinsically inhibited from 2D growth, is indirectly prepared by a thermally driven phase transition of an as-grown 2D-SnSe2 film with all the benefits of the MOCVD technique. It is accompanied by the electronic n-type to p-type crossover at the wafer scale. These tailor-made synthetic routes will accelerate the low-thermal-budget production of multiphase 2D materials in a reliable and scalable fashion.

Double-Floating-Gate van der Waals Transistor for High-Precision Synaptic Operations.

Two-dimensional materials and their heterostructures have thus far been identified as leading candidates for nanoelectronics owing to the near-atom thickness, superior electrostatic control, and adjustable device architecture. These characteristics are indeed advantageous for neuro-inspired computing hardware where precise programming is strongly required. However, its successful demonstration fully utilizing all of the given benefits remains to be further developed. Herein, we present van der Waals (vdW) integrated synaptic transistors with multistacked floating gates, which are reconfigured upon surface oxidation. When compared with a conventional device structure with a single floating gate, our double-floating-gate (DFG) device exhibits better nonvolatile memory performance, including a large memory window (>100 V), high on-off current ratio (∼107), relatively long retention time (>5000 s), and satisfactory cyclic endurance (>500 cycles), all of which can be attributed to its increased charge-storage capacity and spatial redistribution. This facilitates highly effective modulation of trapped charge density with a large dynamic range. Consequently, the DFG transistor exhibits an improved weight update profile in long-term potentiation/depression synaptic behavior for nearly ideal classification accuracies of up to 96.12% (MNIST) and 81.68% (Fashion-MNIST). Our work adds a powerful option to vdW-bonded device structures for highly efficient neuromorphic computing.

Low flow velocity in the middle cerebral artery predicting infarction after bypass surgery in adult moyamoya disease.

OBJECTIVE Direct and indirect bypass surgeries are recognized as the most effective treatments for preventing further stroke in adults with moyamoya disease (MMD). However, the risk factors for postoperative infarction after bypass surgery for MMD are not well established. Therefore, the objective of this study was to investigate the risk factors for postoperative infarction. In particular, the authors sought to determine whether transcranial Doppler (TCD) ultrasonography measurements of mean flow velocity (MFV) in the middle cerebral artery (MCA) could predict postrevascularization infarction. METHODS The medical records of patients with MMD who underwent direct bypass surgery at the authors' institution between July 2012 and April 2015 were reviewed. The MFV in the MCA was measured with TCD ultrasonography and categorized as high (> 80 cm/sec), medium (40-80 cm/sec), and low (< 40 cm/sec). Postoperative MRI, including diffusion-weighted imaging, was performed for all patients within a week of their surgery. Angiographic findings were classified according to the Suzuki scale. Postrevascularization infarction was defined as any diffusion restriction on postoperative MRI scans. Postoperative neurological status was assessed through a clinical chart review, and the modified Rankin Scale was used to evaluate clinical outcomes. RESULTS Of 43 hemispheres in which bypass surgery for MMD was performed, 11 showed postrevascularization infarction. Ten of these hemispheres had low MFV and 1 had medium MFV in the ipsilateral MCA. In both univariate and multivariate analyses, a low MFV was associated with postrevascularization infarction (adjusted OR 109.2, 95% CI 1.9-6245.3). A low MFV was also statistically significantly associated with more advanced MMD stage (p = 0.02). CONCLUSIONS A low MFV in the ipsilateral MCA may predict postrevascularization infarction. Bypass surgery for MMD appears to be safe in early-stage MMD. Results of TCD ultrasonography provide clinical data on the hemodynamics in MMD patients before and after revascularization.

Symptomatic Large Spinal Extradural Arachnoid Cyst: A Case Report.

Spinal extradural arachnoid cysts (SEACs) are relatively rare cause of compressive myelopathy. SEACs can be either congenital or acquired, but the etiology and the mechanism for their development are still unclear. A number of cases have been reported in the literature, and the one-way valve mechanism is the most widely accepted theory which explains the expansion of cysts and spinal cord compression. We report two cases of SEAC in this article. Patients had intermittent, progressive cord compressing symptoms. MRI image showed large SEAC which caused compression of the spinal cord. Pre-operative cystography and CT myelography were performed to identify the communicating tract. Pre-operative epidural cystography showed a fistulous tract. The patients underwent primary closure of the dural defect which was a communicating tract. The operative finding (nerve root herniation through the tract) suggested that the SEAC developed through a checkvalve mechanism. Postoperatively, the patients had no surgical complications and symptoms were relieved. Based on our experience, preoperative identification of the communicating tract is important in surgical planning. Although surgical excision is the standard surgical treatment, primary closure of the dural defect which was a communicating tract can be an acceptable surgical strategy.

Feasibility and Efficacy of Olfactory Protection Using Gelfoam and Fibrin Glue during Anterior Communicating Artery Aneurysm Surgery.

OBJECTIVE: Patients treated with surgical clipping for anterior communicating artery (A-com) aneurysm often complain of anosmia, which can markedly impede their quality of life. We introduce a simple and useful technique to reduce postoperative olfactory dysfunction in A-com aneurysm surgery. METHODS: We retrospectively reviewed the medical records of patients who underwent surgical clipping for unruptured aneurysm from 2011-2013 by the same senior attending physician. Since March 2012, olfactory protection using gelfoam and fibrin glue was applied in A-com aneurysm surgery. Therefore we categorized patients in two groups from this time-protected group and unprotected group. RESULTS: Of the 63 enrolled patients, 16 patients showed postoperative olfactory dysfunction-including 8 anosmia patients (protected group : unprotected group=1 : 7) and 8 hyposmia patients (protected group : unprotected group=2 : 6). Thirty five patients who received olfactory protection during surgery showed a lower rate of anosmia (p=0.037, OR 10.516, 95% CI 1.159-95.449) and olfactory dysfunction (p=0.003, OR 8.693, 95% CI 2.138-35.356). Superior direction of the aneurysm was also associated with a risk of olfactory dysfunction (p=0.015, OR 5.535, 95% CI 1.390-22.039). CONCLUSION: Superior direction of aneurysm appears associated with postoperative olfactory dysfunction. Olfactory protection using gelfoam and fibrin glue could be a simple, safe, and useful method to preserve olfactory function during A-com aneurysm surgery.