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INTRODUCTION: To evaluate the effect of Embrella, a novel-designed colonoscopic distal attachment, on adenoma detection rate (ADR) and adenoma per colonoscopy (APC), compared with standard colonoscopy in routine practice. METHODS: All consecutive participants who underwent routine colonoscopic examinations at 3 endoscopy centers in China were enrolled. Participants were randomly assigned in a 1:1 ratio to the Embrella-assisted colonoscopy (EAC) or standard colonoscopy (SC) groups. ADR, APC, inspection time, pain scores, and adverse events were recorded. RESULTS: Overall, 1,179 participants were randomized into the EAC (n = 593) and SC groups (n = 586). EAC increased the overall ADR from 24.6% to 34.2% ( P < 0.001) and improved APC from 0.44 to 0.64 ( P = 0.002). Subgroup analyses indicated that EAC significantly improved ADR for adenomas < 10 mm (13.8% vs 8.5%, P = 0.004 for 5-9 mm and 27.0% vs 17.2%, P < 0.001 for < 5 mm), nonpedunculated adenomas (26.6% vs 18.8%, P < 0.001), and adenomas in the transverse (10.8% vs 6.1%, P = 0.004) and left colon (21.6% vs 13.7%, P < 0.001). APC in the subgroup analyses was consistent with ADR. The mean inspection time was shorter with EAC (6.52 vs 6.68 minutes, P = 0.046), with no significant impact on participants' pain scores ( P = 0.377). Moreover, no EAC-related adverse events occurred. DISCUSSION: EAC significantly increased ADR and APC compared with SC, particularly for adenomas <10 mm, nonpedunculated adenomas, and adenomas in the transverse and left colon.
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The kinetics of optical switching due to the insulator-metal phase transition in a VO2 thin film is studied experimentally at different laser pulse repetition frequencies (PRFs) in the NIR range and compared with temperature kinetics obtained through the thermal conductance calculations. Two switching processes have been found with characteristic times <2â ms and <15â ms depending on the PRF; the former is explained by the accumulation of metallic domains remaining after a single-pulse phase transition, and the latter is referred to the heat accumulation in the film. Consequently, the dynamics of the microscopic domains is leading in the initiation of phase transition under pulse-periodic conditions compared to the macroscopic heat transfer. The reverse transition at the radiation turn-off depends on the PRF with a time coefficient of 17.5â µs/kHz and is determined by the metallic domains' decay in the film. The results are important for understanding the nature of the insulator-metal transition in thin films of VO2 as well as using them in all-optical switches of pulse-periodic laser radiation.
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The distinctive properties and facile integration of 2D materials hold the potential to offer promising avenues for the on-chip photonic devices, and the expeditious and nondestructive identification and localization of diverse fundamental building blocks become key prerequisites. Here, we present a methodology grounded in digital image processing and deep learning, which effectively achieves the detection and precise localization of four monolayer-thick triangular single crystals of transition metal dichalcogenides with the mean average precision above 90%, and the approach demonstrates robust recognition capabilities across varied imaging conditions encompassing both white light and monochromatic light. This stands poised to serve as a potent data-driven tool enhancing the characterizing efficiency and holds the potential to expedite research initiatives and applications founded on the utilization of 2D materials.
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BACKGROUND: Gastric hamartomatous inverted polyps (GHIPs) are not well characterized and remain diagnostically challenging due to rarity. Therefore, this study aims to investigate the clinicopathologic and endoscopic characteristics of patients with GHIP. METHODS: We retrospectively reviewed clinicopathologic and endoscopic features of ten patients with GHIP who were admitted to Beijing Friendship Hospital from March 2013 to July 2022. All patients were treated successfully by endoscopic resection. RESULTS: GHIPs were usually asymptomatic and found incidentally during gastroscopic examination. They may be sessile or pedunculated, with diffuse or local surface redness or erosion. On endoscopic ultrasonography, the sessile submucosal tumor-type GHIP demonstrated a heterogeneous lesion with cystic areas in the third layer of the gastric wall. Histologically, GHIPs were characterized by a submucosal inverted proliferation of cystically dilated hyperplastic gastric glands accompanied by a branching proliferation of smooth muscle bundles. Inflammatory cells infiltration was observed in the stroma, whereas only one patient was complicated with glandular low-grade dysplasia. Assessment of the surrounding mucosa demonstrated that six patients (60%) had atrophic gastritis or Helicobacter pylori-associated gastritis, and four patients (40%) had non-specific gastritis. Endoscopic resection was safe and effective. CONCLUSIONS: GHIPs often arise from the background of abnormal mucosa, such as atrophic or H.pylori-associated gastritis. We make the hypothesis that acquired inflammation might lead to the development of GHIPs. We recommend to make a full assessment of the background mucosa and H. pylori infection status for evaluation of underlying gastric mucosal abnormalities, which may be the preneoplastic condition of the stomach.