Demonstration of In-Memory Biosignal Analysis: Novel High-Density and Low-Power 3D Flash Memory Array for Arrhythmia Detection.

Smart healthcare systems integrated with advanced deep neural networks enable real-time health monitoring, early disease detection, and personalized treatment. In this work, a novel 3D AND-type flash memory array with a rounded double channel for computing-in-memory (CIM) architecture to overcome the limitations of conventional smart healthcare systems: the necessity of high area and energy efficiency while maintaining high classification accuracy is proposed. The fabricated array, characterized by low-power operations and high scalability with double independent channels per floor, exhibits enhanced cell density and energy efficiency while effectively emulating the features of biological synapses. The CIM architecture leveraging the fabricated array achieves high classification accuracy (93.5%) for electrocardiogram signals, ensuring timely detection of potentially life-threatening arrhythmias. Incorporated with a simplified spike-timing-dependent plasticity learning rule, the CIM architecture is suitable for robust, area- and energy-efficient in-memory arrhythmia detection systems. This work effectively addresses the challenges of conventional smart healthcare systems, paving the way for a more refined healthcare paradigm.

Reconfigurable Manipulation of Oxygen Content on Metal Oxide Surfaces and Applications to Gas Sensing.

Oxygen vacancies and adsorbed oxygen species on metal oxide surfaces play important roles in various fields. However, existing methods for manipulating surface oxygen require severe settings and are ineffective for repetitive manipulation. We present a method to manipulate the amount of surface oxygen by modifying the oxygen adsorption energy by electrically controlling the electron concentration of the metal oxide. The surface oxygen control ability of the method is verified using first-principles calculations based on density functional theory (DFT), X-ray photoelectron spectroscopy (XPS), and electrical resistance analysis. The presented method is implemented by fabricating oxide thin film transistors with embedded microheaters. The method can reconfigure the oxygen vacancies on the In2O3, SnO2, and IGZO surfaces so that specific chemisorption dominates. The method can selectively increase oxidizing (e.g., NO and NO) and reducing gas (e.g., H2S, NH3, and CO) reactions by electrically controlling the metal oxide surface to be oxygen vacancy-rich or adsorbed oxygen species-rich. The proposed method is applied to gas sensors and overcomes their existing limitations. The method makes the sensor insensitive to one gas (e.g., H2S) in mixed-gas environments (e.g., NO2+H2S) and provides a linear response (R2 = 0.998) to the target gas (e.g., NO2) concentration within 3 s. We believe that the proposed method is applicable to applications utilizing metal oxide surfaces.

Energy Efficient Artificial Olfactory System with Integrated Sensing and Computing Capabilities for Food Spoilage Detection.

Artificial olfactory systems (AOSs) that mimic biological olfactory systems are of great interest. However, most existing AOSs suffer from high energy consumption levels and latency issues due to data conversion and transmission. In this work, an energy- and area-efficient AOS based on near-sensor computing is proposed. The AOS efficiently integrates an array of sensing units (merged field effect transistor (FET)-type gas sensors and amplifier circuits) and an AND-type nonvolatile memory (NVM) array. The signals of the sensing units are directly connected to the NVM array and are computed in memory, and the meaningful linear combinations of signals are output as bit line currents. The AOS is designed to detect food spoilage by employing thin zinc oxide films as gas-sensing materials, and it exhibits low detection limits for H2 S and NH3 gases (0.01 ppm), which are high-protein food spoilage markers. As a proof of concept, monitoring the entire spoilage process of chicken tenderloin is demonstrated. The system can continuously track freshness scores and food conditions throughout the spoilage process. The proposed AOS platform is applicable to various applications due to its ability to change the sensing temperature and programmable NVM cells.

Periorbital cutaneous angiomyolipoma: a case report.

Angiomyolipomas are usually found in the kidneys of patients with tuberous sclerosis. They occur less frequently in organs such as the liver, the oral cavity, the nasal cavity, the heart, the large intestines, and the lungs. Angiomyolipomas of the skin are extremely rare, and cutaneous angiomyolipomas generally occur on the elbow, the ends of digits, the ear, and the glabella. Herein we present a rare case of angiomyolipoma occurring on the face-specifically, the right upper eyelid. We propose that upper eyelid angiomyolipoma is a hamartomatous, rather than neoplastic, lesion. Although angiomyolipoma in the periocular area is rare, it should be considered in the differential diagnosis of clinically benign masses. and regular follow-up is warranted.

Single-photon avalanche diode fabricated in standard 55†nm bipolar-CMOS-DMOS technology with sub-20†V breakdown voltage.

This paper presents a single-photon avalanche diode (SPAD) in 55 nm bipolar-CMOS-DMOS (BCD) technology. In order to realize a SPAD having sub-20 V breakdown voltage for mobile applications while preventing high tunneling noise, a high-voltage N-well available in BCD is utilized to implement the avalanche multiplication region. The resulting SPAD has a breakdown voltage of 18.4 V while achieving an excellent dark count rate of 4.4 cps/µm2 at the excess bias voltage of 7 V in spite of the advanced technology node. At the same time, the device achieves a high peak photon detection probability (PDP) of 70.1% at 450 nm thanks to the high and uniform E-field. Its PDP values at 850 and 940 nm, wavelengths of interest for 3D ranging applications reach 7.2 and 3.1%, respectively, with the use of deep N-well. The timing jitter of the SPAD, full width at half maximum (FWHM), is 91 ps at 850 nm. It is expected that the presented SPAD enables cost-effective time-of-flight and LiDAR sensors with the advanced standard technology for many mobile applications.

Clinical Applications of the Intercostal Artery Perforator Flap for Trunk Reconstruction.

Background Trunk defects can occur because of surgical site infections after spinal surgery, resection of malignant tumors, or trauma. Herein, we present our experience of using intercostal artery perforator (ICAP) flaps to reconstruct trunk defects without noteworthy complications. Fourteen patients underwent reconstruction with ICAP flaps between March 2015 and March 2019. Methods Patients' data, including age, sex, the cause of the defect, defect size, perforator location, flap size, complications, and follow-up period, were retrospectively reviewed. The mean age of the patients was 56.5 years (range, 19-80 years). All operations were performed after the results of bacterial culture from the wound showed no microbial growth. We found reliable perforators around the defect using Doppler ultrasonography. The perforator flaps were elevated with a pulsatile perforator and rotated in a propeller fashion to the defects. We performed five dorsal and two lateral ICAP flaps. The mean flap dimensions were 12 × 5.5 cm 2 (range, 6 × 5 to 18 × 8 cm 2 ). Results Primary closure of the donor site was performed. Marginal congestion was observed as a complication in one case, but it healed with no need for revision. The mean follow-up period was 8 months. All patients were satisfied with the surgical outcomes. Conclusion ICAP flaps can be easily mobilized, thereby reducing donor site morbidity without sacrificing the underlying muscles for trunk reconstruction. Therefore, these flaps are useful options for the reconstruction of trunk defects.

Glaucomatous optic neuropathy: Mitochondrial dynamics, dysfunction and protection in retinal ganglion cells.

Glaucoma is a leading cause of irreversible blindness worldwide and is characterized by a slow, progressive, and multifactorial degeneration of retinal ganglion cells (RGCs) and their axons, resulting in vision loss. Despite its high prevalence in individuals 60 years of age and older, the causing factors contributing to glaucoma progression are currently not well characterized. Intraocular pressure (IOP) is the only proven treatable risk factor. However, lowering IOP is insufficient for preventing disease progression. One of the significant interests in glaucoma pathogenesis is understanding the structural and functional impairment of mitochondria in RGCs and their axons and synapses. Glaucomatous risk factors such as IOP elevation, aging, genetic variation, neuroinflammation, neurotrophic factor deprivation, and vascular dysregulation, are potential inducers for mitochondrial dysfunction in glaucoma. Because oxidative phosphorylation stress-mediated mitochondrial dysfunction is associated with structural and functional impairment of mitochondria in glaucomatous RGCs, understanding the underlying mechanisms and relationship between structural and functional alterations in mitochondria would be beneficial to developing mitochondria-related neuroprotection in RGCs and their axons and synapses against glaucomatous neurodegeneration. Here, we review the current studies focusing on mitochondrial dynamics-based structural and functional alterations in the mitochondria of glaucomatous RGCs and therapeutic strategies to protect RGCs against glaucomatous neurodegeneration.

Age, Body Mass Index, and Spur Size Associated with Patients' Symptoms in Plantar Fasciitis.

Background: Plantar fasciitis is a common cause of heel pain affecting 10% of the general population. This study aimed to investigate the specific symptoms in patients with plantar fasciitis using the Foot and Ankle Outcome Score (FAOS) questionnaire and their relationship with demographic and radiographic factors. Methods: We retrospectively analyzed 73 consecutive patients (mean age, 53.8 ± 10.0 years; 20 men and 53 women) with plantar fasciitis who had visited our foot and ankle clinic and undergone weight-bearing foot X-ray examinations. Their demographic data, anteroposterior and lateral talo-first metatarsal angles, intermetatarsal and hallux valgus angles, and responses to the FAOS questionnaire were recorded. Results: The quality-of-life subscale showed the lowest score of all FAOS subscales. Age was significantly correlated with quality of life (r = 0.297, p = 0.011), and body mass index was correlated with the function in sports and recreational activities (r = -0.251, p = 0.032). Age and body mass index were statistically significantly correlated with calcaneal spur size (r = 0.274, p = 0.027 and r = 0.324, p = 0.008, respectively). The calcaneal spur size was significantly correlated with pain (r = -0.348, p = 0.004), function in daily living (r = -0.410, p = 0.001), and function in sports and recreational activities (r = -0.439, p < 0.001). Conclusions: Demographic factors were associated with specific symptoms in patients with plantar fasciitis. Calcaneal spur size was the only radiographic parameter correlated with symptoms. These findings help communicate with patients, set appropriate treatment goals, and evaluate treatment effectiveness.

Noise optimization of single-photon avalanche diodes fabricated in 110 nm CMOS image sensor technology.

This paper presents the effect of shallow trench isolation (STI) on the dark count rate (DCR) and after-pulsing probability (APP) of deep-junction-based single-photon avalanche diodes (SPADs). Two different SPADs were fabricated in 110 nm CMOS image sensor technology, one with STI and the other without STI between its anode and cathode. With TCAD simulations and measurements, we have clearly demonstrated that the SPAD without STI enables a dramatic decrease in DCR by more than three orders of magnitude without suffering from the lateral leakage current between the anode and cathode. By excluding the STI from the device, the proposed SPAD also achieves a negligible APP while the SPAD with STI shows a very high APP of 92%. Thanks to the low-noise performance, the proposed SPAD becomes operable with higher excess bias voltage so that it achieves good photon detection probability, 58.3% at 500 nm and 3% at 940 nm, and timing jitter, 71 ps full width at half maximum at 670 nm, when the reverse bias voltage is 17 V.

Modeling of Statistical Variation Effects on DRAM Sense Amplifier Offset Voltage.

With the downscaling in device sizes, process-induced parameter variation has emerged as one of the most serious problems. In particular, the parameter fluctuation of the dynamic random access memory (DRAM) sense amplifiers causes an offset voltage, leading to sensing failure. Previous studies indicate that the threshold voltage mismatch between the paired transistors of a sense amplifier is the most critical factor. In this study, virtual wafers were generated, including statistical VT variation. Then, we numerically investigate the prediction accuracy and reliability of the offset voltage of DRAM wafers using test point measurement for the first time. We expect that this study will be helpful in strengthening the in-line controllability of wafers to secure the DRAM sensing margin.

Data-Driven Object Vehicle Estimation by Radar Accuracy Modeling with Weighted Interpolation.

For accurate object vehicle estimation using radar, there are two fundamental problems: measurement uncertainties in calculating an object's position with a virtual polygon box and latency due to commercial radar tracking algorithms. We present a data-driven object vehicle estimation scheme to solve measurement uncertainty and latency problems in radar systems. A radar accuracy model and latency coordination are proposed to reduce the tracking error. We first design data-driven radar accuracy models to improve the accuracy of estimation determined by the object vehicle's position. The proposed model solves the measurement uncertainty problem within a feasible set for error covariance. The latency coordination is developed by analyzing the position error according to the relative velocity. The position error by latency is stored in a feasible set for relative velocity, and the solution is calculated from the given relative velocity. Removing the measurement uncertainty and latency of the radar system allows for a weighted interpolation to be applied to estimate the position of the object vehicle. Our method is tested by a scenario-based estimation experiment to validate the usefulness of the proposed data-driven object vehicle estimation scheme. We confirm that the proposed estimation method produces improved performance over the conventional radar estimation and previous methods.

Si photonic-electronic monolithically integrated optical receiver with a built-in temperature-controlled wavelength filter.

We present a Si photonic-electronic integrated ring-resonator based optical receiver that contains a temperature-controlled ring-resonator filter (RRF), a Ge photodetector, and receiver circuits in a single chip. The temperature controller automatically determines the RRF temperature at which the maximum transmission of the desired WDM signal is achieved and maintains this condition against any temperature or input wavelength fluctuation. This Si photonic-electronic integrated circuit is realized with 0.25-µm photonic BiCMOS technology, and its operation is successfully confirmed with measurement.

Numerical analysis on a viewing angle enhancement of a digital hologram by attaching a pixelated random phase mask.

In a digital hologram, the maximum viewing angle of a computer-generated hologram (CGH) is limited by pixel pitch due to the diffraction grating equation. Since reducing pixel size of display panel is challenging and costly, we propose a method to expand the viewing angle of a digital hologram by attaching an aligned pixelated random phase mask (PRPM) onto the CGH pattern based on analysis of simulation results. By introducing a phase-averaging process to the widely used iterative Fourier transform algorithm, an optimized CGH pattern can be obtained in conjunction with a PRPM. Based on scalar diffraction theory, viewing angle enhancement characteristics were verified by comparing the perspective views of a two-plane hologram using a virtual eye model. In addition, we performed full electromagnetic simulations that included effects due to potential fabrication errors such as misalignment, thickness variation, and internal reflections and diffractions between the CGH and random mask patterns. From the simulation results, by attaching a 1.85 µm-sized pixel pitch PRPM to a 3.7 µm CGH, the viewing angle can be easily expanded almost identical to that of a CGH with 1.85 µm-pixel pitch.

Leg length discrepancy, overgrowth, and associated risk factors after a pediatric tibial shaft fracture.

BACKGROUND: This study was performed to investigate leg length discrepancy (LLD), overgrowth, and associated risk factors after pediatric tibial shaft fractures. MATERIALS AND METHODS: This study included 103 patients younger than 14 years of age (mean age 7.1 years; 75 boys, 28 girls) with unilateral tibial shaft fracture and a minimum follow-up of 24 months. LLD was calculated as the difference between the lengths of the injured and uninjured limbs. Overgrowth was calculated by adding the fracture site shortening from the LLD. Risk factors were assessed in patients with LLD < 1 cm and ≥ 1 cm and overgrowth < 1 cm and ≥ 1 cm. RESULTS: Casting and titanium elastic nailing (TEN) were performed on 64 and 39 patients, respectively. The mean LLD and overgrowth were 5.6 and 6.4 mm, respectively. There were significant differences in sex (p = 0.018), age (p = 0.041), fibular involvement (p = 0.005), injury mechanism (p = 0.006), and treatment methods (p < 0.001) between patients with LLDs < 1 cm and ≥ 1 cm. There were significant differences in sex (p = 0.029), fibular involvement (p = 0.002), injury mechanism (p = 0.008), and treatment methods (p < 0.001) between patients with overgrowth < 1 cm and ≥ 1 cm. Sex and treatment methods were risk factors associated with LLD ≥ 1 cm and overgrowth ≥ 1 cm following pediatric tibial shaft fracture. The boys had a 7.4-fold higher risk of LLD ≥ 1 cm and 5.4-fold higher risk of overgrowth ≥ 1 cm than the girls. Patients who underwent TEN had a 4.3-fold higher risk of LLD ≥ 1 cm and 4.8-fold higher risk of overgrowth ≥ 1 cm than those treated by casting. CONCLUSIONS: Patients undergoing TEN showed greater LLD and overgrowth than those undergoing casting, with boys showing greater LLD and overgrowth than girls. Surgeons should consider the possibility of LLD and overgrowth after pediatric tibial shaft fractures, especially when performing TEN for boys. LEVEL OF EVIDENCE: Level III.

Growth arrest and its risk factors after physeal fracture of the distal tibia in children and adolescents.

BACKGROUND: . This study performed to investigate the incidence of growth arrest such as leg length discrepancy (LLD) and ankle joint angular deformity and its risk factors after physeal fracture of the distal tibia in children and adolescents. MATERIALS AND METHODS: . Consecutive 78 patients (mean age 11.4 ± 2.0 years; mean follow-up period 2.0 ± 1.2 years) treated for the distal tibia physeal fracture were included. All patients underwent preoperative ankle radiographs, three-dimensional computed tomography (CT) scans, and postoperative follow-up teleradiogram. Patients were divided into two groups according to the LLD and the difference of lateral distal tibial angle (LDTA) with the contralateral limb as follows: Group 1 (growth arrest), patients with LLD ≥ 1cm or difference of LDTA ≥ 5°; Group 2 (normal growth), patients with LLD < 1cm and difference of LDTA < 5°. RESULTS: . The overall incidence of growth arrest was 12.8% (10 of 78). The mean displacement measured using CT scan was 4.4 ± 3.2 mm (range, 0.8-14.9). Of the total 78 fractures, 65 were treated surgically and 13 fractures were treated conservatively. The initial fracture displacement was significantly different between the two groups (p<0.001). However, there were no statistically significant differences between the two groups with respect to other factors. Initial displacement was the only significant risk factor for growth arrest (p<0.003). The cutoff values of initial displacement between the two groups were 5.2mm. CONCLUSIONS: . This study showed that degree of initial displacement was the only significant risk factor for growth arrest after physeal fracture of the distal tibia in children and adolescents. Therefore, physicians should consider the possibility of growth arrest for patients with severely displaced physeal fractures of the distal tibia.

A case of SFTS coinfected with E. coli bacteremia.

BACKGROUND: Severe fever thrombocytopenia syndrome virus (SFTSV) is the causative agent of severe fever thrombocytopenia syndrome (SFTS). SFTS is an emerging infectious disease, characterized by high fever, gastrointestinal symptoms, leukopenia, thrombocytopenia, and a high mortality rate. Until now, little importance has been given to the association of SFTS with leukocytosis and bacterial co-infection. CASE PRESENTATION: A 51-year old man visited our hospital with fever and low blood pressure. He was a farmer by occupation and often worked outdoors. He had a Foley catheter inserted due to severe BPH. Laboratory tests revealed thrombocytopenia, elevated liver function, and elevated CRP levels. He had marked leukocytosis, proteinuria, hematuria, and conjunctival hemorrhage. Initially, we thought that the patient was suffering from hemorrhagic fever with renal syndrome (HFRS). However, we confirmed SFTS through PCR and increasing antibody titer. However, his blood culture also indicated E. coli infection. CONCLUSION: SFTS displays characteristics of fever, thrombocytopenia, elevated liver function, and leukocytopenia. We described a case of SFTS with leukocytosis due to coinfection with E. coli. Since patients with SFTS usually have leukocytopenia, SFTS patients with leukocytosis are necessarily evaluated for other causes of leukocytosis. Here, we report the first case of an SFTS with concurrent E. coli bacteremia.

Progesterone increases blood glucose via hepatic progesterone receptor membrane component 1 under limited or impaired action of insulin.

Hepatic gluconeogenesis is the main pathway for blood glucose maintenance activated during fasting. Retardation of insulin action, such as in diabetes mellitus, activates gluconeogenesis during the fed state. While the role of progesterone (P4) in diabetes is controversial, the P4 receptor, progesterone receptor membrane component 1 (PGRMC1), is known to stimulate pancreatic insulin secretion. We investigated the role of P4, via hepatic PGRMC1, during gluconeogenesis. The PGRMC1 binding chemical, AG-205, induced PGRMC1 monomer (25 kDa) abundance, and increased PEPCK expression and glucose production in parallel with cyclic AMP (cAMP) induction in Hep3B cells. PGRMC1-mediated cyclic AMP was inhibited by an adenylate cyclase inhibitor (MDL-12,330A). PEPCK suppression in Pgrmc1 KO hepatocyte was not observed after treatment of MDL-12,330A. PGRMC1 knockdown or overexpression systems in Hep3B cells confirmed that PGRMC1 mediates PEPCK expression via phosphorylation of cAMP-response element binding protein (CREB). CREB phosphorylation and PEPCK expression in primary hepatocytes were greater than that in PGRMC1 knock-out hepatocytes. Progesterone increased PGRMC1 expression, which induced cAMP and PEPCK induction and glucose production. In vivo, P4 suppressed gluconeogenesis following plasma insulin induction under normal conditions in a mouse model. However, P4 increased blood glucose via gluconeogenesis in parallel with increases in PGRMC1 and PEPCK expression in mice in both insulin-deficient and insulin-resistant conditions. We conclude that P4 increases hepatic glucose production via PGRMC1, which may exacerbate hyperglycaemia in diabetes where insulin action is limited.

Negative Capacitance Vacuum Channel Transistors for Low Operating Voltage.

This study proposes negative capacitance vacuum channel transistors. The proposed negative capacitance vacuum channel transistors in which a ferroelectric capacitor is connected in series to the gate of the vacuum channel transistors have the following two advantages: first, adding a ferroelectric capacitor in series with a gate capacitor makes the turn-on voltage lower and on-off transition steeper without causing hysteresis effects. Second, the capacitance matching between a ferroelectric capacitor and a vacuum channel transistor becomes simplified because the capacitance of a vacuum channel transistor as seen from a ferroelectric capacitor is constant.

The efficacy of dermofat grafts from the groin for correction of acquired facial deformities.

BACKGROUND: Posttraumatic acquired facial deformities require surgical treatment, with options including scar revision, fat grafts, implant insertion, and flap coverage. However, each technique has specific advantages and disadvantages.
. METHODS: From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressed scar) were treated using dermofat grafts from the groin. The harvested dermofat was then inserted into the undermined dead space after the contracture was released, and a bolster suture was done for fixation considering the patient's contour and asymmetry. A modified version of the Vancouver Scar Scale and satisfaction survey were used to compare deformity improvements before and after surgery.
. RESULTS: In most cases, effective volume correction and an aesthetically satisfactory contour were maintained well after dermofat grafting, without any major complications. In some cases, however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated. A significant difference was found in the modified Vancouver Scar Scale before and after surgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20 points.
. CONCLUSION: A dermofat graft with the groin as the donor site can be considered as an effective surgical option that is the simplest and most cost-effective method for the treatment of acquired facial deformities with scar contracture.

Long-term postoperative satisfaction and complications in nasal bone fracture patients according to fracture type, site, and severity.

BACKGROUND: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. METHODS: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. RESULTS: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. CONCLUSION: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.