Valley-Spin Hall Effect-based Nonvolatile Memory with Exchange-Coupling-Enabled Electrical Isolation of Read and Write Paths

Valley-spin hall (VSH) effect in monolayer WSe2 has been shown to exhibit highly beneficial features for nonvolatile memory (NVM) design. Key advantages of VSH-based magnetic random-access memory (VSH-MRAM) over spin orbit torque (SOT)-MRAM include access transistor-less compact bit-cell and low power switching of perpendicular magnetic anisotropy (PMA) magnets. Nevertheless, large device resistance in the read path (RS) due to low mobility of WSe2 and Schottky contacts deteriorates sense margin, offsetting the benefits of VSH-MRAM. To address this limitation, we propose another flavor of VSH-based MRAM that (while inheriting most of the benefits of VSH-MRAM) achieves lower RS in the read path by electrically isolating the read and write terminals. This is enabled by coupling VSH with electrically-isolated but magnetically-coupled PMA magnets via interlayer exchange-coupling. Designing the proposed devices using object oriented micro magnetic framework (OOMMF) simulation, we ensure the robustness of the exchange-coupled PMA system under process variations. To maintain a compact memory footprint, we share the read access transistor across multiple bit-cells. Compared to the existing VSH-MRAMs, our design achieves 39%-42% and 36%-46% reduction in read time and energy, respectively, along with 1.1X-1.3X larger sense margin at a comparable area. This comes at the cost of 1.7X and 2.0X increase in write time and energy, respectively. Thus, the proposed design is suitable for applications in which reads are more dominant than writes

XNOR-VSH: A Valley-Spin Hall Effect-based Compact and Energy-Efficient Synaptic Crossbar Array for Binary Neural Networks

Binary neural networks (BNNs) have shown an immense promise for resource-constrained edge artificial intelligence (AI) platforms as their binarized weights and inputs can significantly reduce the compute, storage and communication costs. Several works have explored XNOR-based BNNs using SRAMs and nonvolatile memories (NVMs). However, these designs typically need two bit-cells to encode signed weights leading to an area overhead. In this paper, we address this issue by proposing a compact and low power in-memory computing (IMC) of XNOR-based dot products featuring signed weight encoding in a single bit-cell. Our approach utilizes valley-spin Hall (VSH) effect in monolayer tungsten di-selenide to design an XNOR bit-cell (named 'XNOR-VSH') with differential storage and access-transistor-less topology. We co-optimize the proposed VSH device and a memory array to enable robust in-memory dot product computations between signed binary inputs and signed binary weights with sense margin (SM) > 1 micro-amps. Our results show that the proposed XNOR-VSH array achieves 4.8% ~ 9.0% and 37% ~ 63% lower IMC latency and energy, respectively, with 4 % ~ 64% smaller area compared to spin-transfer-torque (STT)-MRAM and spin-orbit-torque (SOT)-MRAM based XNOR-arrays

Effects of transcutaneous electrical nerve stimulation on myocardial protection in patients undergoing aortic valve replacement: a randomized clinical trial

Abstract Background Cardiopulmonary bypass-related myocardial ischemia-reperfusion injury is a major contributor to postoperative morbidity. Although transcutaneous electrical nerve stimulation (TENS) has been found to have cardioprotective effects in animal studies and healthy volunteers, its effects on cardiac surgery under cardiopulmonary bypass patients have not been evaluated. We investigated the effects of TENS on myocardial protection in patients undergoing aortic valve replacement surgery using cardiopulmonary bypass. Methods Thirty patients were randomized to receive TENS or sham in three different anesthetic states – pre-anesthesia, sevoflurane, or propofol (each n = 5). TENS was applied with a pulse width of 385 μs and a frequency of 10 Hz using two surface electrodes at the upper arm for 30 min. Sham treatment was provided without stimulation. The primary outcome was the difference in myocardial infarct size following ischemia-reperfusion injury in rat hearts perfused with pre- and post-TENS plasma dialysate obtained from the patients using Langendorff perfusion system. The cardioprotective effects of TENS were determined by assessing reduction in infarct size following treatment. Results There were no differences in myocardial infarct size between pre- and post-treatment in any group (41.4 ± 4.3% vs. 36.7 ± 5.3%, 39.8 ± 7.3% vs. 27.8 ± 12.0%, and 41.6 ± 2.2% vs. 37.8 ± 7.6%; p = 0.080, 0.152, and 0.353 in the pre-anesthesia, sevoflurane, and propofol groups, respectively). Conclusions In our study, TENS did not show a cardioprotective effect in patients undergoing aortic valve replacement surgery. Trial registration This study was registered at clinicaltrials.gov ( NCT03859115 , on March 1, 2019)

Intraoperative mild hyperoxia may be associated with improved survival after off-pump coronary artery bypass grafting: a retrospective observational study

Background : The effect of hyperoxia due to supplemental oxygen administration on postoperative outcomes in patients undergoing cardiac surgery remains unclear. This retrospective study aimed to evaluate the relationship between intraoperative oxygen tension and mortality after off-pump coronary artery bypass grafting (OPCAB). Methods : The study included adult patients who underwent isolated OPCAB between July 2010 and June 2020. Patients were categorised into three groups based on their intraoperative time-weighted average arterial oxygen partial pressure (PaO2): normoxia/near-normoxia ( 250 mmHg). The risk of in-hospital mortality was compared using weighted logistic regression analysis. Restricted cubic spline analysis was performed to analyse intraoperative PaO2 as a continuous variable. The risk of cumulative all-cause mortality was compared using Cox regression analysis. Results : The normoxia/near-normoxia, mild hyperoxia, and severe hyperoxia groups included 229, 991, and 173 patients (n = 1393), respectively. The mild hyperoxia group had a significantly lower risk of in-hospital mortality than the normoxia/near-normoxia (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.06–0.22) and severe hyperoxia groups (OR, 0.06; 95% CI, 0.03–0.14). Intraoperative PaO2 exhibited a U-shaped relationship with in-hospital mortality in the non-hypoxic range. The risk of cumulative all-cause mortality was significantly lower in the mild hyperoxia group (hazard ratio, 0.72; 95% CI, 0.52–0.99) than in the normoxia/near-normoxia group. Conclusions : Maintaining intraoperative PaO2 at 150–250 mmHg was associated with a lower risk of mortality after OPCAB than PaO2 at 250 mmHg. Future randomised trials are required to confirm if mildly increasing arterial oxygen tension during OPCAB to 150–250 mmHg improves postoperative outcomes

Regulation of synaptic Rac1 activity, long-term potentiation maintenance, and learning and memory by BCR and ABR Rac GTPase-activating proteins

Rho family small GTPases are important regulators of neuronal development. Defective Rho regulation causes nervous system dysfunctions including mental retardation and Alzheimer's disease. Rac1, a member of the Rho family, regulates dendritic spines and excitatory synapses, but relatively little is known about how synaptic Rac1 is negatively regulated. Breakpoint cluster region (BCR) is a Rac GTPase-activating protein known to form a fusion protein with the c-Abl tyrosine kinase in Philadelphia chromosome-positive chronic myelogenous leukemia. Despite the fact that BCR mRNAs are abundantly expressed in the brain, the neural functions of BCR protein have remained obscure. We report here that BCR and its close relative active BCR-related (ABR) localize at excitatory synapses and directly interact with PSD-95, an abundant postsynaptic scaffolding protein. Mice deficient for BCR or ABR show enhanced basal Rac1 activity but only a small increase in spine density. Importantly, mice lacking BCR or ABR exhibit a marked decrease in the maintenance, but not induction, of long-term potentiation, and show impaired spatial and object recognition memory. These results suggest that BCR and ABR have novel roles in the regulation of synaptic Rac1 signaling, synaptic plasticity, and learning and memory, and that excessive Rac1 activity negatively affects synaptic and cognitive functions.This work was supported by the National Creative Research Initiative Program of the Korean Ministry of Education, Science and Technology (E.K.), Neuroscience Program Grant 2009-0081468 (S.-Y.C.), 21st Century Frontier R&D Program in Neuroscience Grant 2009K001284 (H.K.), Basic Science Research Program Grant R13-2008-009-01001-0 (Y.C.B.), and United States Public Health Service Grants HL071945 (J.G.) and HL060231 (J.G., N.H.)

Role of Pelvic Lymph Node Dissection in Prostate Cancer Treatment

Pelvic lymph node dissection (PLND) is the most accurate and reliable staging procedure for detecting lymph node invasion (LNI) in prostate cancer. Recently, [11C]-choline positron emission tomography imaging and magnetic resonance imaging with lymphotropic superpara-magnetic nanoparticles have shown potential for detecting LNI but are still under investigation. The risk of LNI in low-risk groups could be underestimated by use of the current nomograms, which rely on data collected from patients who underwent only limited PLND. Extended PLND (ePLND) shows higher lymph node yield, which leads to the removal of more positive nodes and fewer missed positive nodes. It may be possible to refrain from performing PLND on low-risk patients with a prostate-specific antigen value <10 ng/ml and a biopsy Gleason score ≤6, but the risk of biopsy-related understaging should be kept in mind. Theoretically, meticulous ePLND may also impact prostate cancer survival by clearing low-volume diseases and occult micrometastasis even in pN0. The therapeutic role of PLND in prostate cancer patients is still an open question, especially in individuals with low-risk disease. Patients with intermediate- to high-risk disease are more likely to benefit from ePLND

Effects of intraoperative inspired oxygen fraction (FiO2 0.3 vs 0.8) on patients undergoing off-pump coronary artery bypass grafting: the CARROT multicenter, cluster-randomized trial

Background To maintain adequate oxygenation is of utmost importance in intraoperative care. However, clinical evidence supporting specific oxygen levels in distinct surgical settings is lacking. This study aimed to compare the effects of 30% and 80% oxygen in off-pump coronary artery bypass grafting (OPCAB). Methods This multicenter trial was conducted in three tertiary hospitals from August 2019 to August 2021. Patients undergoing OPCAB were cluster-randomized to receive either 30% or 80% oxygen intraoperatively, based on the month when the surgery was performed. The primary endpoint was the length of hospital stay. Intraoperative hemodynamic data were also compared. Results A total of 414 patients were cluster-randomized. Length of hospital stay was not different in the 30% oxygen group compared to the 80% oxygen group (median, 7.0 days vs 7.0 days; the sub-distribution hazard ratio, 0.98; 95% confidence interval [CI] 0.83–1.16; P = 0.808). The incidence of postoperative acute kidney injury was significantly higher in the 30% oxygen group than in the 80% oxygen group (30.7% vs 19.4%; odds ratio, 1.94; 95% CI 1.18–3.17; P = 0.036). Intraoperative time-weighted average mixed venous oxygen saturation was significantly higher in the 80% oxygen group (74% vs 64%; P < 0.001). The 80% oxygen group also had a significantly greater intraoperative time-weighted average cerebral regional oxygen saturation than the 30% oxygen group (56% vs 52%; P = 0.002). Conclusions In patients undergoing OPCAB, intraoperative administration of 80% oxygen did not decrease the length of hospital stay, compared to 30% oxygen, but may reduce postoperative acute kidney injury. Moreover, compared to 30% oxygen, intraoperative use of 80% oxygen improved oxygen delivery in patients undergoing OPCAB. Trial registration ClinicalTrials.gov (NCT03945565; April 8, 2019)

Varieties of living things: Life at the intersection of lineage and metabolism

publication-status: Publishedtypes: Articl