Bidirectional Optical Neural Networks Based on Free-Space Optics Using Lens Arrays and Spatial Light Modulator.

This paper introduces a novel architecture-bidirectional optical neural network (BONN)-for providing backward connections alongside forward connections in artificial neural networks (ANNs). BONN incorporates laser diodes and photodiodes and exploits the properties of Köhler illumination to establish optical channels for backward directions. Thus, it has bidirectional functionality that is crucial for algorithms such as the backpropagation algorithm. BONN has a scaling limit of 96 × 96 for input and output arrays, and a throughput of 8.5 × 1015 MAC/s. While BONN's throughput may rise with additional layers for continuous input, limitations emerge in the backpropagation algorithm, as its throughput does not scale with layer count. The successful BONN-based implementation of the backpropagation algorithm requires the development of a fast spatial light modulator to accommodate frequent data flow changes. A two-mirror-like BONN and its cascaded extension are alternatives for multilayer emulation, and they help save hardware space and increase the parallel throughput for inference. An investigation into the application of the clustering technique to BONN revealed its potential to help overcome scaling limits and to provide full interconnections for backward directions between doubled input and output ports. BONN's bidirectional nature holds promise for enhancing supervised learning in ANNs and increasing hardware compactness.

Scalable Optical Convolutional Neural Networks Based on Free-Space Optics Using Lens Arrays and a Spatial Light Modulator.

A scalable optical convolutional neural network (SOCNN) based on free-space optics and Koehler illumination was proposed to address the limitations of the previous 4f correlator system. Unlike Abbe illumination, Koehler illumination provides more uniform illumination and reduces crosstalk. The SOCNN allows for scaling of the input array and the use of incoherent light sources. Hence, the problems associated with 4f correlator systems can be avoided. We analyzed the limitations in scaling the kernel size and parallel throughput and found that the SOCNN can offer a multilayer convolutional neural network with massive optical parallelism.

Improved Bone Conduction Hearing After Middle Ear Surgery: Investigation of the Improvement Mechanism

Objectives@#. When performing middle ear operations, such as ossiculoplasty or stapes surgery, patients and surgeons expect an improvement in air conduction (AC) hearing, but generally not in bone conduction (BC). However, BC improvement has often been observed after surgery, and the present study investigated this phenomenon. @*Methods@#. We reviewed the preoperative and postoperative surgical outcomes of 583 patients who underwent middle ear surgery. BC improvement was defined as a BC threshold decrease of >15 dB at two or more frequencies. Subjects in group A underwent staged ossiculoplasty after canal wall up mastoidectomy (CWUM), group B underwent staged ossiculoplasty after canal wall down mastoidectomy (CWDM), group C underwent ossiculoplasty only (thus, they had no prior history of CWUM or CWDM), and group D received stapes surgery. We created a hypothetical circuit model to explain this phenomenon. @*Results@#. BC improvement was detected in 12.8% of group A, 9.1% of group B, and 8.5% of group C. The improvement was more pronounced in group D (27.0%). A larger gain in AC hearing was weakly correlated with greater BC improvement (Pearson’s r=0.395 in group A, P<0.001; r=0.375 in group B, P<0.001; r=0.296 in group C, P<0.001; r=0.422 in group D, P=0.009). Notably, patients with otosclerosis even experienced postoperative BC improvements as large as 10.0 dB, from a mean value of 30.3 dB (standard error [SE], 3.2) preoperatively to 20.3 dB (SE, 3.2) postoperatively, at 1,000 Hz, as well as an improvement of 9.2 dB at 2,000 Hz, from 37.8 dB (SE, 2.6) to 28.6 dB (SE, 3.1). @*Conclusion@#. BC improvement may be explained by a hypothetical circuit model applying the third window theory. Surgeons should keep in mind the possibility of BC improvement when making a management plan.

A Case of the Soft Palate Reconstruction Using the Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Wide Resection / 대한두경부종양학회지

The soft palate of carcinoma limited to the uvular region is infrequent among oropharyngeal cancers. The oropharynx regulates swallowing and speech through dynamic motions. Failure to reconstruct after surgical resection of the oropharynx structure can lead to permanent velopharyngeal insufficiency. Therefore, suitable reconstruction is important in establishing proper functional outcomes while maintaining oncological safety.We present a case of a 66-year-old male who was diagnosed with oropharynx cancer limited in the uvula accompanied by lymph node metastasis. After surgical resection, reconstruction was performed with the united arrangement of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap. There was no aspiration or reflux after feeding and epithelialization completely occurred after 1 month postoperatively. We report a successful case that the reconstruction with the local flap described above could preserve proper oropharyngeal function after primary surgery in small-sized oropharyngeal cancer.

A compact photonic resonator absorption microscope for point of care digital resolution nucleic acid molecular diagnostics.

Rapid, sensitive, and selective detection of nucleic acid biomarkers for health diagnostic applications becomes feasible for point of care scenarios when the detection instrument is inexpensive, simple, and robust. Here, we report the design, implementation, and characterization of a point of care instrument for photonic resonator absorption microscopy (PRAM) that takes advantage of resonant optical coupling between plasmonic gold nanoparticle tags and a photonic crystal (PC) surface. Matching the PC resonant wavelength to the gold nanoparticle's surface plasmon wavelength generates localized and efficient quenching of the PC resonant reflection intensity, resulting in the ability to clearly detect and count individual gold nanoparticles when they are captured on the PC surface. Surface-captured nanoparticles are observed by illuminating the PC at normal incidence with polarized light from a low-intensity red LED, and recording of PC reflected intensity on an inexpensive CMOS image sensor. A contrast limited adaptive histogram equalization (CLAHE) image processing algorithm was applied to derive counts of captured nanoparticles. The instrument is utilized in the context of an activate capture + digital counting (AC + DC) assay for a specific miRNA sequence, using nucleic acid toehold probes applied to gold nano-urchin (AuNU) nanoparticles to achieve 160 aM detection limits in a 30 min. assay.

Erratum: A compact photonic resonator absorption microscope for point of care digital resolution nucleic acid molecular diagnostics: publisher's note.

[This corrects the article on p. 4637 in vol. 12.].

Regional-scale monitoring of underwater and dry ground subsidence in high phreatic areas of North China Plain.

Land subsidence monitoring provides information required when developing land use plans and allows for proactive management of subsidence issues. However, it has been challenging to accurately detect land subsidence areas, especially those under waterbodies. This study evaluated the applicability of integrated use of the optical Landsat-8 OLI and microwave Sentinel-1A TOPSAR imagery to delineate subsidence areas and quantify subsidence rates in a typical coal mining area of North China Plain. An Enhanced Modified Normalized Difference Water Index (E-MNDWI) was combined with Short BAseline Subset-Interferometric Synthetic Aperture Radar (SBAS-InSAR) image to monitor underwater and dry ground subsidence. The results demonstrated that the method could delineate underwater and dry ground subsidence and quantify its rates accurately. The proposed method estimated subsidence area corresponded to 34.8% (16.7 km2) of the study area. The size of underwater subsidence areas was substantial and accounted for 43.7% of the subsidence areas. Seasonal underwater subsidence areas were generally distributed in the vicinity of perennial ones. Dry ground subsidence covered 9.4 km2 of the study area and generally occurred in urban and rural residential areas with the maximum subsidence of up to 80.1 mm/year. This study demonstrates the efficiency and capacity of integrating optical and microwave images to monitor the subsidence progresses, which thus can help develop effective rehabilitation policy and strategy to mitigate the impacts of land subsidence.

Effect of udenafil administration on postmicturition dribbling in men: a prospective, multicenter, double-blind, placebo-controlled, randomized clinical study.

PURPOSE: Postmicturition dribbling (PMD) is a stressful symptom in middle-aged men characterized by urinary leakage after the completion of normal voiding. Appropriate treatments have not yet been introduced. This study assessed the efficacy of treatment of PMD with 75 mg udenafil daily. MATERIALS AND METHODS: The study included 138 men with regular sexual lifestyles. The Hallym PMD questionnaire (HPMDQ) was used to assess PMD symptoms. After all basic examinations, patients were randomly assigned to either udenafil or placebo. Patients completed the surveys, uroflowmetry (UFM), a bladder scan, and the paper test during the follow-up visit. RESULTS: The mean age of the patients was 57.6 years. PMD with one of every three urinations was experienced by 59 patients (42.8%), whereas 45 patients (32.6%) experienced PMD with two of every three urinations. PMD with every urination was experienced by 34 patients (24.6%). More than half of the patients (89 patients, 65.4%) indicated that persistent PMD symptoms would likely result in moderate to severe discomfort in their daily activities. As time passed, the udenafil group showed significant improvement in PMD symptoms (p = 0.001). CONCLUSION: Udenafil 75 mg once daily can be an effective treatment for patients with PMD symptoms.

Tratamiento de alta intensidad con estatinas para pacientes estables en monoterapia con ácido acetilsalicílico a los 12 meses de un implante de stent farmacoactivo: estudio aleatorizado / High-intensity statin treatments in clinically stable patients on aspirin monotherapy 12 months after drug-eluting stent implantation: A randomized study

Introducción y objetivos: La vigente guía de práctica clínica para el tratamiento de la hipercolesterolemia recomienda mantener la terapia intensiva con estatinas de los pacientes tratados con implante de stent farmacoactivo (SFA). Sin embargo, el tratamiento intensivo con estatinas, una vez estabilizado el paciente, con frecuencia no se lleva a cabo en la práctica clínica tras la revascularización con SFA. Actualmente se desconoce el impacto de mantener esa terapia intensiva con estatinas en estos pacientes estables. Se estudia la reducción de eventos adversos en pacientes clínicamente estables en monoterapia con ácido acetilsalicílico tras el implante de un SFA según la terapia de alta o baja intensidad con estatinas. Métodos: Se aleatorizó a pacientes estables a los 12 meses del implante de un SFA y en monoterapia con ácido acetilsalicílico a recibir terapia de alta intensidad con estatinas (atorvastatina 40 mg; n = 1.000) o terapia de baja intensidad (pravastatina 20 mg; n = 1.000). El objetivo primario fueron los eventos clínicos adversos a los 12 meses de seguimiento (objetivo compuesto de muerte, infarto de miocardio, revascularización, trombosis del stent, accidente cerebrovascular, insuficiencia renal, necesidad de intervención arterial periférica y nuevo ingreso hospitalario por eventos cardiacos). Resultados: El objetivo primario a los 12 meses de seguimiento se produjo en 25 pacientes (2,5%) en tratamiento de alta intensidad con estatinas y en 40 (4,1%) en tratamiento de baja intensidad (HR = 0,58; IC95%, 0,36-0,92; p = 0,018). Esta diferencia se debió principalmente a la menor incidencia de muerte cardiaca (0 frente al 0,4%; p = 0,025) y de infarto de miocardio no relacionado con el vaso diana (el 0,1 frente al 0,7%; p = 0,033) en el grupo de tratamiento de alta intensidad con estatinas. Conclusiones: Entre los pacientes clínicamente estables en monoterapia con ácido acetilsalicílico, el tratamiento de alta intensidad con estatinas redujo la incidencia de eventos comparado con el tratamiento de baja intensidad

Introduction and objectives: Current guidelines on the treatment of blood cholesterol recommend continuous maintenance of high-intensity statin treatment in drug-eluting stent (DES)-treated patients. However, high-intensity statin treatment is frequently underused in clinical practice after stabilization of DES-treated patients. Currently, the impact of continuous high-intensity statin treatment on the incidence of late adverse events in these patients is unknown. We investigated whether high-intensity statin treatment reduces late adverse events in clinically stable patients on aspirin monotherapy 12 months after DES implantation. Methods: Clinically stable patients who underwent DES implantation 12 months previously and received aspirin monotherapy were randomly assigned to receive either high-intensity (40 mg atorvastatin, n = 1000) or low-intensity (20 mg pravastatin, n = 1000) statin treatment. The primary endpoint was adverse clinical events at 12-month follow-up (a composite of all death, myocardial infarction, revascularization, stent thrombosis, stroke, renal deterioration, intervention for peripheral artery disease, and admission for cardiac events). Results: The primary endpoint at 12-month follow-up occurred in 25 patients (2.5%) receiving high-intensity statin treatment and in 40 patients (4.1%) receiving low-intensity statin treatment (HR, 0.58; 95%CI, 0.36-0.92; P = .018). This difference was mainly driven by a lower rate of cardiac death (0 vs 0.4%, P = .025) and nontarget vessel myocardial infarction (0.1 vs 0.7%, P = .033) in the high-intensity statin treatment group. Conclusions: Among clinically stable DES-treated patients on aspirin monotherapy, high-intensity statin treatment significantly reduced late adverse events compared with low-intensity statin treatment

Effects of Organizational Culture of Dental Office and Professional Identity of Dental Hygienists on Organizational Commitment / 치위생과학회지

The purpose of this study was to identify the effect of dental hygienists' perceptions of dental organizational culture and professional identity on organizational commitment. A survey was conducted with 310 dental hygienists working in dental hospitals and dental offices. If dental hygienists experience organizational cultures as having different degrees of organizational commitment, then the type of organizational culture and commitment may be important variables in understanding and reducing the turnover rate of dental hygienists and improving workplace performance. Efforts to form a healthy and positive organizational culture may therefore be necessary. The organizational culture most recognized by the dental hygienist was hierarchical culture (3.39) and the least recognized was task-orientated culture (2.71). The professional identity of the dental hygienist was 3.75 and the organizational commitment was 2.98. Correlation analysis was conducted to investigate the relationship between dental organization culture type, professional dental hygienist identity, and organizational commitment. As a result, professional identity and organizational commitment showed positive(+) correlation with innovation oriented culture and relationship oriented culture. Among the organizational culture types, relationship-orientated culture (p<0.001) and innovation-orientated culture (p=0.006) were significant influences on organizational commitment, and professional identity did not have a significant influence. The regression model was found to be statistically appropriate (F=11.857, p<0.001) and the model explaining power was 14.9%. These results suggest that efforts to create a relationship-orientated culture and an innovation-orientated culture and to reduce the hierarchical culture can be a strategy to enhance the organizational commitment and the professional identity of dental hygienists.

Analysis of Serum Homocysteine and Risk of Coronary Heart Disease in Patients with Pseudoexfoliation Syndrome

PURPOSE: To investigate levels of serum homocysteine in patients with pseudoexfoliation syndrome and the association between serum homocysteine levels and risk of coronary heart disease. METHODS: From March 2013 to September 2013, 37 patients with pseudoexfoliation syndrome and 59 age-matched patients (control group) were enrolled in this prospective study. Serum homocysteine levels were compared between the 2 groups. We compared the estimated 10-year risk of coronary heart disease based on Framingham risk score between the 2 groups. Additionally, we analyzed correlations between risk of coronary heart disease and serum homocysteine levels. RESULTS: The mean homocysteine level of patients with pseudoexfoliation syndrome was significantly higher than the control group (13.3 ± 6.8 µmol/L vs. 10.0 ± 5.2 µmol/L, p = 0.009). The rate of high risk defined as a 10-year coronary heart disease risk >20% in the patients with pseudoexfoliation syndrome was significantly higher than in the control group (21.4% vs. 4.4%, p = 0.048). Correlation between serum homocysteine levels and estimated 10-year risk of coronary heart disease was statistically significant (r = 0.578, p < 0.001). CONCLUSIONS: Hyperhomocysteinemia and high risk of coronary heart disease were observed in patients with pseudoexfoliation syndrome. Therefore, we suggest efforts to prevent coronary heart disease in pseudoexfoliation syndrome patients with hyperhomocysteinemia are necessary.

A Case of Biliary Fascioliasis Mimicking Neoplasia of the Common Hepatic Duct / 대한내과학회지

Fascioliasis is a rare zoonotic disease caused by Fasciola hepatica, the liver fluke. Humans can become accidental hosts of this parasite by ingesting contaminated drinking water or plants containing viable metacercariae. There are two disease stages: the hepatic (acute) and biliary (chronic) stages. The biliary stage of this zoonotic infection is often misdiagnosed because the symptoms are subclinical, with intermittent cholangitis as the only sign. Endoscopic retrograde cholangiopancreatography (ERCP) has been described in the diagnosis of a few cases of fascioliasis. We used this modality to diagnose biliary fascioliasis in a 39-year-old woman with chronic hepatitis B who had intermittent abdominal pain for three years with irregular wall thickening and luminal narrowing of the common hepatic duct (CHD), which resembled neoplasia of the CHD. Following the correct diagnosis, the adult worm was removed using endoluminal forceps via endoscopic sphincterotomy. This case report confirms the diagnostic and therapeutic value of ERCP in patients with biliary fascioliasis that may mimic neoplasia of the CHD.

A Case of Gallbladder Cancer Associated with a Choledochocele / 대한내과학회지

Choledochal cysts are congenital lesions involving cystic dilatation of the bile ducts. The choledochocele, the rarest type of choledochal cyst, is a cystic dilatation of the distal common bile duct that protrudes into the duodenum. There have been few reports concerning malignancy in the biliary tree associated with choledochoceles. We recently experienced a case of a choledochocele with gallbladder cancer.

Improvement of optical extraction efficiency of organic light-emitting diode using a large area nano-pattern.

In order to improve optical extraction efficiencies, we propose a nano-patterned organic light-emitting diode (OLED) which doesn't rely on high precision lithography nor rigorous periodicity. The nano-pattern is fabricated by spin-coating PS (poly-styrene) spheres on the substrate and carrying out reactive ion etching and flattening using dielectric material. The verification of the optical properties of the nano patterns was carried out by fabricating OLED-like structures using quantum dot and distributed Bragg reflector (DBR). As a result, the nano-patterned structure showed a 28% increase in optical efficiency compared to the non-patterned sample. In addition, the use of a prism sheet on the backside of a glass substrate also showed a 23% increase in optical efficiency by disturbing the total internal reflection between glass and air. In this way, the large area nano-patterns can be fabricated and applied to increasing the optical extraction in OLED.

Effects of Temporary Amniotic Membrane Patch after Surgical Excision of Primary Pterygium

PURPOSE: To investigate the clinical results, recurrence rates, and recurrence-related risk factors of temporary amniotic membrane patch (TAMP) after excision of primary pterygium. METHODS: Recurrence grade was evaluated for 73 eyes with a mean follow-up of 15.5 months (range 9 to 56 months). Surgical results were classified into surgical success (G0/G1), conjunctival recurrence (G2), and corneal recurrence (G3). Recurrence rates were analyzed based on gender, age, Tan's preoperative grading system, horizontal and vertical length of the preoperative pterygium, the corneal involvement size of the preoperative pterygium, planned or unplanned removal of amniotic membrane, and epithelial healing time. Using Kaplan-Meier survival analysis, the cumulative proportion of integrated G0/G1 was evaluated. RESULTS: In the postoperative grading, 58 (79.5%) and 9 (12.3%) eyes were graded as clinically recurrence-free G0 and G1, respectively; 4 (5.5%) and 2 (2.7%) eyes were graded as clinically recurrence-occurred G2 and G3, respectively. The cumulative proportion of integrated recurrence-free G0/G1 at 24 months after surgery was 0.83 +/- 0.08. T3 of Tan's preoperative grading system was identified as the only risk factor for recurrence above G1 through multivariate logistic regression analysis (p = 0.02). CONCLUSIONS: The recurrence rate of the present TAMP study showed better results in comparison with 9.1 to 56.1% of recurrence rates in other studies. The TAMP has advantages of surgical procedure with ease, low complications, and low recurrence rates. Therefore, after surgical excision of primary pterygium, the authors concluded the TAMP is highly recommended for good clinical outcomes and low recurrence rates.

A study on group key agreement in sensor network environments using two-dimensional arrays.

These days, with the emergence of the concept of ubiquitous computing, sensor networks that collect, analyze and process all the information through the sensors have become of huge interest. However, sensor network technology fundamentally has wireless communication infrastructure as its foundation and thus has security weakness and limitations such as low computing capacity, power supply limitations and price. In this paper, and considering the characteristics of the sensor network environment, we propose a group key agreement method using a keyset pre-distribution of two-dimension arrays that should minimize the exposure of key and personal information. The key collision problems are resolved by utilizing a polygonal shape's center of gravity. The method shows that calculating a polygonal shape's center of gravity only requires a very small amount of calculations from the users. The simple calculation not only increases the group key generation efficiency, but also enhances the sense of security by protecting information between nodes.

Effects of metallic absorption and the corrugated layer on the optical extraction efficiency of organic light-emitting diodes.

The absorption of a metallic cathode in OLEDs is analyzed by using FDTD calculation. As the light propagates parallel to the layer, the intensity of E(z) polarization decreases rapidly. The intensity at 2.0 microm from the dipole is less than a quarter of that at 0.5 microm. The strong absorption by a cathode can be a critical factor when considering the increase of optical extraction by means of bending the optical layers. The calculation indicates that the corrugation of layers helps the guided light escape the guiding layer, but also increases the absorption into a metallic cathode. The final optical output power of the corrugated OLED can be smaller than that of the flat OLED. On the contrary, the corrugated structure with a non-absorptive cathode increases the optical extraction by nearly two times.

Learning Curve for Endonasal Dacryocystorhinostomy

PURPOSE: To determine the learning curve of dacryocystorhinostomy (DCR) performed by a single oculoplastic surgeon after one year of fellowship training. METHODS: This retrospective review study comprised nasolacrimal duct obstruction patients that underwent endonasal DCR at our hospital between February 2006 and February 2008. The patients that completed at least six months of follow-up were included in the analysis. Exclusion criteria were patients less than 20 years of age and NLD obstructions due to malignancy or canalicular obstructions. Success was defined as duct patency on syringing at the final follow-up and no complaints of epiphora. RESULTS: Out of 161 eyes, the overall surgical success rate was 83.2% (134/161 eyes) and the mean postoperative follow-up period was 6.5 months (6-18 months). Success rates gradually increased as follows: 71.2% (37/52 eyes) for the first group, 88.7% (47/53 eyes) for the second group, and 89.3% (50/56 eyes) for the third group (second and third group compared to first group, p = 0.025, p = 0.017, respectively). CONCLUSIONS: To ensure high DCR success rates, the novice surgeon should perform at least 50 surgeries.

Phacovitrectomy versus Vitrectomy only for Primary Rhegmatogenous Retinal Detachment Repair

PURPOSE: To compare the outcomes of phacovitrectomy and vitrectomy only for treatment of primary rhegmatogenous retinal detachment. METHODS: The anatomical success, functional success, and complications between Group I patients who underwent vitrectomy only and Group II patients who underwent phacovitrectomy for primary rhegmatogenous retinal detachment were retrospectively compared. RESULTS: Twenty-one eyes (84.0%) in Group I had reattachment after vitrectomy only, and 27 eyes (90.0%) in Group II had reattachment after phacovitrectomy. However, the differences in the measures attributes were not statistically significant (p = 0.271). The logMAR visual acuity improved in both groups with no statistically significant difference between the two groups (p = 0.102). Postoperative complications included cataract progression in 20 eyes (80.0%) in Group I and 17 of the 20 eyes (68.0%) underwent cataract surgery within one year after the first surgery. CONCLUSIONS: Phacovitrectomy, irrespective of severe lens opacity, is a relatively effective combined surgical procedure in older patients with primary rhegmatogenous retinal detachment and impending presbyopia. The procedure allows for easy access to the periphery during vitreous shaving and prevents the need for a second cataract operation.

Superior optical properties of homogeneous liquid crystal alignment on a tin (IV) oxide surface sequentially modulated via ion beam irradiation.

We first investigated the alignment characteristics of tin (IV) oxide (SnO(2)) thin films deposited by radio-frequency (RF) magnetron sputtering. This study demonstrates that liquid crystal (LC) molecules could be aligned homogeneously by controlling the Ion Beam (IB) irradiation energy densities. We also show that the pretilt angle of the LC molecules has a close relation with the surface energy. X-ray photoelectron spectroscopy (XPS) indicates that a non-stoichiometric SnO(2-x) surface converted by ion beam irradiation can horizontally align the LC molecules. The measured electro-optical (EO) characteristics showed high performance, comparable with those of rubbed and ion-beam irradiated polyimide (PI) layers.