Computer-assisted detection versus conventional colonoscopy for proximal colonic lesions: a multicenter, randomized, tandem-colonoscopy study.

BACKGROUND AND AIMS: Computer-assisted detection (CADe) is a promising technologic advance that enhances adenoma detection during colonoscopy. However, the role of CADe in reducing missed colonic lesions is uncertain. The aim of this study was to determine the miss rates of proximal colonic lesions by CADe and conventional colonoscopy. METHODS: This was a prospective, multicenter, randomized, tandem-colonoscopy study conducted in 3 Asian centers. Patients were randomized to receive CADe or conventional white-light colonoscopy during the first withdrawal of the proximal colon (cecum to splenic flexure), immediately followed by tandem examination of the proximal colon with white light in both groups. The primary outcome was adenoma/polyp miss rate, which was defined as any adenoma/polyp detected during the second examination. RESULTS: Of 223 patients (48.6% men; median age, 63 years) enrolled, 7 patients did not have tandem examination, leaving 108 patients in each group. There was no difference in the miss rate for proximal adenomas (CADe vs conventional: 20.0% vs 14.0%, P = .07) and polyps (26.7% vs 19.6%, P = .06). The CADe group, however, had significantly higher proximal polyp (58.0% vs 46.7%, P = .03) and adenoma (44.7% vs 34.6%, P = .04) detection rates than the conventional group. The mean number of proximal polyps and adenomas detected per patient during the first examination was also significantly higher in the CADe group (polyp: 1.20 vs .86, P = .03; adenoma, .91 vs .61, P = .03). Subgroup analysis showed that CADe enhanced proximal adenoma detection in patients with fair bowel preparation, shorter withdrawal time, and endoscopists with lower adenoma detection rate. CONCLUSIONS: This multicenter trial from Asia confirmed that CADe can further enhance proximal adenoma and polyp detection but may not be able to reduce the number of missed proximal colonic lesions. (Clinical trial registration number: NCT04294355.).

High-order harmonic generation from a dual-gas, multi-jet array with individual gas jet control.

We present a gas jet array for use in high-order harmonic generation experiments. Precise control of the pressure in each individual gas jet has allowed a thorough investigation into mechanisms contributing to the selective enhancement observed in the harmonic spectra produced by dual-gas, multi-jet arrays. Our results reveal that in our case, the dominant enhancement mechanism is the result of a compression of the harmonic-producing gas jet due to the presence of other gas jets in the array. The individual control of the gas jets in the array also provides a promising method for enhancing the harmonic yield by precise tailoring of the length and pressure gradient of the interaction region.

Three-dimensional electronic spectroscopy of excitons in asymmetric double quantum wells.

We demonstrate three-dimensional (3D) electronic spectroscopy of excitons in a double quantum well system using a three-dimensional phase retrieval algorithm to obtain the phase information that is lost in the measurement of intensities. By extending the analysis of two-dimensional spectroscopy to three dimensions, contributions from different quantum mechanical pathways can be further separated allowing greater insight into the mechanisms responsible for the observed peaks. By examining different slices of the complete three-dimensional spectrum, not only can the relative amplitudes be determined, but the peak shapes can also be analysed to reveal further details of the interactions with the environment and inhomogeneous broadening. We apply this technique to study the coupling between two coupled quantum wells, 5.7 nm and 8 nm wide, separated by a 4 nm barrier. Coupling between the heavy-hole excitons of each well results in a circular cross-peak indicating no correlation of the inhomogeneous broadening. An additional cross-peak is isolated in the 3D spectrum which is elongated in the diagonal direction indicating correlated inhomogeneous broadening. This is attributed to coupling of the excitons involving the two delocalised light-hole states and the electron state localised on the wide well. The attribution of this peak and the analysis of the peak shapes is supported by numerical simulations of the electron and hole wavefunctions and the three-dimensional spectrum based on a density matrix approach. An additional benefit of extending the phase retrieval algorithm from two to three dimensions is that it becomes substantially more reliable and less susceptible to noise as a result of the more extensive use of a priori information.

Perturbative optical parametric amplification in the extreme ultraviolet.

The response of a medium illuminated with a light field can be expanded in many orders in perturbative non-linear optics. Here we use two multiple-cycle high-intensity laser pulses at 800 and 1,400 nm to generate extreme ultraviolet radiation where the multi-photon processes can be treated as the driving force of a perturbative optical parametric amplification. When a very high-intensity pulse (>7.10(14) W cm(-2)) at 800 nm is applied in addition to a high-intensity pulse at 1,400 nm, we are able to enhance the flux of the coherent extreme ultraviolet radiation in the photon energy range around 80 eV by more than an order of magnitude compared with the generation with a single-wavelength pulse. This opens the way to extend the powerful techniques of perturbative non-linear optics to the case of a high-intensity-driving field in multiple-photon processes.

Spectrally resolved femtosecond 2-colour 3-pulse photon echoes: a new spectroscopic tool to study molecular dynamics.

We present a new multidimensional femtosecond spectroscopy technique based on spectrally resolved 2-colour 3-pulse photon echoes for investigating molecular dynamics in a variety of systems including proteins. In this technique the sample is illuminated by two femtosecond 'pump' pulses with wave vectors k1, k2 and wavelength lambda(pump) and a femtosecond 'probe' pulse with wave vector k3 and wavelength lambda(probe). Nonlinear signals are generated in the phase-matching directions k4 = - k1 + k2 + k3 and k6 = - k3 + k1 + k2. These signals are analysed in spectrometers equipped with CCD detectors and the spectra of the signals are recorded for various values of (i) the delay t12 between pulses 1 and 2, (ii) the delay t23 between pulses 2 and 3, and (iii) the wavelengths lambda(pump), lambda(probe). The technique has been used for studying vibrational and electronic dynamics of dye molecules, such as cresyl violet in methanol, and ultra-fast transient processes that occur during the photo-dissociation of carbonmonoxy myoglobin (MbCO) into myoglobin (Mb) and CO.

Noninterferometric two-dimensional fourier-transform spectroscopy of multilevel systems.

We demonstrate a technique that determines the phase of the photon-echo emission from spectrally resolved intensity data without requiring phase-stabilized input pulses. The full complex polarization of the emission is determined from spectral intensity measurements. The validity of this technique is demonstrated using simulated data, and is then applied to the analysis of two-color data obtained from the light-harvesting molecule lycopene.

Suppression of the internal electric field effects in ZnO/Zn(0.7)Mg(0.3)O quantum wells by ion-implantation induced intermixing.

Strong suppression of the effects caused by the internal electric field in ZnO/ZnMgO quantum wells following ion-implantation and rapid thermal annealing, is revealed by photoluminescence, time-resolved photoluminescence, and band structure calculations. The implantation and annealing induces Zn/Mg intermixing, resulting in graded quantum well interfaces. This reduces the quantum-confined Stark shift and increases electron-hole wavefunction overlap, which significantly reduces the exciton lifetime and increases the oscillator strength.