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Colometer:A real-time quality feedback system for screening colonoscopy

World Journal of Gastroenterology 2012年第32期18卷 4270-4277页

作者： Dobromir Filip Xuexin Gao Leticia Angulo-Rodriguez Martin P Mintchev Shane M Devlin Alaa Rostom Wayne Rosen christopher n andrews Department of Electrical and Computer Engineering University of Calgary Calgary AB T2N 1N4 Canada Faculty of Medicine University of Calgary Calgary AB T2N 1N4 Canada

AIM:To investigate the performance of a new software-based colonoscopy quality assessment ***:The software-based system employs a novel image processing algorithm which detects the levels of image clarity,withdrawal velocity,and level of the bowel preparation in a real-time fashion from live video *** levels of image blurriness and the withdrawal velocity below which the visualization could be considered adequate have initially been determined arbitrarily by review of sample colonoscopy videos by two experienced ***,an overall colonoscopy quality rating was computed based on the percentage of the withdrawal time with adequate visualization(scored 1-5;1,when the percentage was 1%-20%;2,when the percentage was 21%-40%,etc.).In order to test the proposed velocity and blurriness thresholds,screening colonoscopy withdrawal videos from a specialized ambulatory colon cancer screening center were collected,automatically processed and *** ratings on the withdrawal were compared to the insertion in the same ***,3 experienced endoscopists reviewed the collected videos in a blinded fashion and rated the overall quality of each withdrawal(scored 1-5;1,poor;3,average;5,excellent) based on 3 major aspects:image quality,colon preparation,and withdrawal *** automated quality ratings were compared to the averaged endoscopist quality ratings using Spearman correlation ***:Fourteen screening colonoscopies were *** polyps were detected in 4/14(29%) of the collected colonoscopy video *** a proof of concept,the Colometer software rated colonoscope withdrawal as having better visualization than the insertion in the 10 videos which did not have any polyps(average percent time with adequate visualization:79% ± 5% for withdrawal and 50% ± 14% for insertion,P ng which no polyps were removed ranged from 4-12 *** median quality rating from the automa

关键词： Colonoscopy Quality assurance Quality improvement Withdrawal time Colon cancer Bowel preparation

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neurological and neuropsychological consequences of electrical and lightning shock： review and theories of causation

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neural Regeneration Research 2017年第5期12卷 677-686页

作者： christopher J.andrews Andrew D.Reisner Faculty of Medicine-The University of Queensland HerstonAustraliaLightning and Electrical InjuriesMt Ommaney Family PracticeMt OmmaneyBrisbaneAustralia Forensic Diagnostic Center of District nine CambridgeOHUSA

Injuries from lightning and electrical injuries involve multiple systems of the body, however neurological symptoms are very widely reported. A disabling neuropsychological syndrome is also noted. This paper presents a comprehensive review of neurological and neuropsychological symptoms. Partial theories of causation for these injuries have been advanced, however, there is no convincing explanation for both delay in onset of symptoms and also the genesis of the neuropsychological syndrome. A theory of causation is proposed which satisfies both these constraints. This theory suggests circulating hormones such as cortisol, together with nitric oxide and oxidant free radicals from glutamatergic hyper-stimulation, act on tissues remote from the injury path including the hippocampus. This theory opens a research path to explore treatment options.

关键词： electrical injury lightning injury neurology neuropsychology neuropsychiatry injury trauma

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Post electrical or lightning injury syndrome: a proposal for an American Psychiatric Association's Diagnostic and Statistical Manual formulation with implications for treatment

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neural Regeneration Research 2017年第9期12卷 1405-1412页

作者： christopher J.andrews Andrew D.Reisner Mary Ann Cooper Medicine The University of Queensland Lightning and Electrical Injuries Mt Ommaney Family Practice Forensic Diagnostic Center of District nine Lightning Injury Research Program University of Illinois at Chicago African Centres for Lightning and Electromagnetics network

In the past, victims of electrical and lightning injuries have been assessed in a manner lacking a system- atic formulation, and against ad hoc criteria, particularly in the area of neuropsychological disability. In this manner patients have, for example, only been partially treated, been poorly or incorrectly diagnosed, and have been denied the full benefit of compensation for their injuries. This paper contains a proposal for diagnostic criteria particularly for the neuropsychological aspects of the post injury syndrome. It pays attention to widely published consistent descriptions of the syndrome, and a new cluster analysis of post electrical injury patients. It formulates a proposal which could be incorporated into future editions of the American Psychiatric Association＇s Diagnostic and Statistical Manual （DSM）. The major neuropsycholog- ical consequences include neurocognitive dysfunction, and memory subgroup dysfunction, with ongoing consequences, and sometimes including progressive or delayed psychiatric, cognitive, and/or neurological symptoms. The proposed diagnostic criteria insist on a demonstrated context for the injury, both specifying the shock circumstance, and also physical consequences. It allows for a certain delay in onset of symptoms. It recognizes exclusory conditions. The outcome is a proposal for a DSM classification for the post electrical or lightning injury syndrome. This proposal is considered important for grounding patient treatment, and for further treatment trials. Options for treatment in electrical or lightning injury are summarised, and future trials are foreshadowed.

关键词： electrical injury lightning injury neuropsychology neuropsychiatry injury American Psychiatric Association's Diagnostic and Statistical Manual

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Evaluation of the mechanisms of damage to flexible ureteroscopes and suggestions for ureteroscope preservation

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Asian Journal of Andrology 2005年第4期7卷 433-438,页

作者： P.Sooriakumaran R.Kaba H.O.andrews n.P.n.Buchholz Department of Urology Royal Surrey County HospitalGuildfordGU2 7XXUK Department of Urology St Bartholomew's HospitalLondon EC1A 7BEUK

Aim： To investigate the causes and costs of flexible ureteroscope damage, and to develop recommendations to limit damage. Methods： The authors analysed repair figures and possible causes of damage to 35 instruments sent for repair to a leading UK supplier over a 1-year period, and calculated cost figures for maintenance of the instruments as opposed to repair and replacement costs. Results： All damages were handling-induced and therefore did not fall under the manufacturer＇s warranty： 28 % were damaged by misfiring of the laser inside the instrument; 72 %, mainly crushing and stripping of the ureteroscope shaft tube, were likely to have occurred during out-of-surgery handling, washing and disinfection. Seventeen （4 %） instruments were not repaired and consequently taken out of service due to the extensive costs involved. Eighteen （51%） ureteroscopes were repaired at an average cost of 10 833 USD. Conclusion： Damages to flexible ureteroscopes bear considerable costs. Most damages occur during handling between surgical procedures. Thorough adherence to handling procedures, and courses for theater staff and surgeons on handling flexible instruments may help to reduce these damages and prove a cost-saving investment. The authors provide a list of recommended procedural measures that may help to prevent such damages.

关键词： ureteroscopes manufacturer's assessment durability instrument handling

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Emergency Medicine and COVID-19:now and next year

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Emergency and Critical Care Medicine 2021年第1期1卷 14-19页

作者： Theodore A.christopher Adrienne n.christopher Department of Emergency Medicine Thomas Jefferson University HospitalPhiladelphiaPennsylvania Department of Surgery Thomas Jefferson University HospitalPhiladelphiaPennsylvania

The COVID-19 pandemic is responsible for infecting to date more than 93 million people worldwide and causing more than 2 million *** the vast majority of deaths have occurred in the United States(U.S.)can be attributed to nonadherence by Americans to basic public health mitigation strategies that are known to curtail coronavirus *** Departments(ED’s)throughout the *** a dramatic decrease in patient visits during the first surge of COVID-19,followed by an ED patient visit rebound to approximately 80%of pre-COVID-19 numbers,which have remained relatively stable through the current second COVID-19 *** pandemic highlighted the significant role that hospital ED’s and emergency physicians played in combatting COVID-19“on the front lines.”Wearing extensive and escalating personal protective equipment(PPE)layers became the norm in seeing emergency patients,and many infrastructure and process changes occurred included evaluating and treating patients in outdoor tents,cohorting confirmed and suspected COVID-19 patients in designated ED and hospital sections,and repeatedly amending COVID-19 evaluation and treatment guidelines as more information became available on a sometimes daily *** other clinical venues in which emergency physicians were working during COVID-19 surges,Observation Unit patient visits decreased,although patient acuity increased;urgent care(UC)patient visits decreased dramatically,whereas Telehealth(TH)patient visits to our 24/7 available platform,JeffCOnnECT,saw a dramatic increase in ***,Dexamethazone and more recently,the monoclonal antibody Bamlanivimab,have formed the mainstay of treatment offered to our patients with COVID-19;all these agents are offered to patients in our ED’s and Observation *** current second COVID-19 surge,with our ED and hospital patient visits remaining essentially stable,has intensified the public health crisis as record numbers of *** continue to a

关键词： Coronavirus COVID-19 Emergency Medicine

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Varicella zoster meningitis complicating combined anti-tumor necrosis factor and corticosteroid therapy in Crohn's disease

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World Journal of Gastroenterology 2013年第21期19卷 3347-3351页

作者： christopher Ma Brennan Walters Richard n Fedorak Division of Gastroenterology University of AlbertaEdmontonAL T6G 2X8Canada

Opportunistic viral infections are a well-recognized complication of anti-tumor necrosis factor (TnF) therapy for inflammatory bowel disease (IBD). Cases of severe or atypical varicella zoster virus infection, both primary and latent reactivation, have been described in association with immunosuppression of Crohn's disease (CD) patients. However, central nervous system varicella zoster virus infections have been rarely described, and there are no previous reports of varicella zoster virus meningitis associated with anti-TnF therapy among the CD population. Here, we present the case of a 40-year-old male with severe ileocecal-CD who developed a reactivation of dermatomal herpes zoster after treatment with prednisone and adalimumab. The reactivation presented as debilitating varicella zoster virus meningitis, which was not completely resolved despite aggressive antiviral therapy with prolonged intravenous acyclovir and subsequent oral valacyclovir. This is the first reported case of opportunistic central nervous system varicella zoster infection complicating anti-TnF therapy in the CD population. This paper also reviews the literature on varicella zoster virus infections of immunosuppressed IBD patients and the importance of vaccination prior to initiation of anti-TnF therapy.

关键词： Varicella zoster virus Meningitis Crohn’s disease Adalimumab Infliximab corticosteroids Antitumor necrosis factor

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Deletion or underexpression of the Y-chromosome genes CDY2 and HSFY is associated with maturation arrest in American men with nonobstructive azoospermia

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Asian Journal of Andrology 2012年第5期14卷 676-682页

作者： Peter J Stahl Anna n Mielnik christopher E Barbieri Peter n Schlegel Darius A Paduch Department of Urology Weill Cornell Medical CollegeNew York Presbyterian HospitaI-CornellNew YorkNY 10065USA

Maturation arrest （MA） refers to failure of germ cell development leading to clinical nonobstructive azoospermia. Although the azoospermic factor （AZF） region of the human Y chromosome is clearly implicated in some cases, thus far very little is known about which individual Y-chromosome genes are important for complete male germ cell development. We sought to identify single genes on the Y chromosome that may be implicated in the pathogenesis of nonobstructive azoospermia associated with MA in the American population. Genotype-phenotype analysis of 132 men with Y-chromosome microdeletions was performed. Protein-coding genes associated with MA were identified by visual analysis of a genotype-phenotype map. Genes associated with MA were selected as those genes within a segment of the Y chromosome that, when completely or partially deleted, were always associated with MA and absence of retrievable testicular sperm. Expression of each identified gene transcript was then measured with quantitative RT-PCR in testicular tissue from separate cohorts of patients with idiopathic MA and obstructive azoospermia. Ten candidate genes for association with MA were identified within an 8.4-Mb segment of the Y chromosome overlapping the AZFb region. CDY2and HSFYwere the only identified genes for which differences in expression were observed between the MA and obstructive azoospermia cohorts. Men with obstructive azoospermia had 12-fold higher relative expression of CDY2transcript （1.33__.0.40 vs. 0.11＋_0.04; P=O.O003） and 16-fold higher expression of HSFYtranscript （0.78__.0.32 vs. 0.05_0.02; P=O.O005） compared to men with MA. CDY2 and HSFYwere also underexpressed in patients with Sertoli cell only syndrome. These data indicate that CDY2and HSFYare located within a segment of the Y chromosome that is important for sperm maturation, and are underexpressed in testicular tissue derived from men with MA. These observations suggest that impairments in CDY2 or HSFYexpression could be impli

关键词： CDY1 protein CDY2 protein genetics histology HSFY human make infertility nonobstructive azoospermia spermato-genesis sperm maturation

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Satisfaction with patient-doctor relationships in inflammatory bowel diseases:Examining patient-initiated change of specialist

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World Journal of Gastroenterology 2012年第18期18卷 2212-2218页

作者： Daniel R van Langenberg Jane M andrews Department of Gastroenterology and Hepatology Royal Adelaide HospitalSchool of MedicineUniversity of AdelaideSouth Australia 5000Australia Department of Gastroenterology and Hepatology Eastern Health Clinical SchoolMonash UniversityVictoria 3128Australia

AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and *** reasons included loss of confidence,disagreement,and/or personality clash with the ***:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding *** with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,Mann-Whitney tests,all P nders(n = 132).Patients with a recent change(for any reason) were more likely to have Crohn's disease,currently active disease,previous bowel resection and recent hospitalization [OR 2.6,95% CI(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP nCLUSIOn:Changing specialist appears associated with patient-related(age,nonadherence) and contemporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.

关键词： Inflammatory bowel disease Patient-doctor relationship Quality of care Disease outcomes Quality of life

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A comparative investigation on wear behaviors of physical and chemical vapor deposited bronze coatings for hydraulic piston pump

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Chinese Journal of Aeronautics 2024年第3期37卷 391-403页

作者： Wei HAO andrews LARBI Hongkang DOnG Dongyun WAnG Shenghu LI Zhejiang Provincial Key Laboratory of Urban Rail Transit Intelligent Operation and Maintenance Technology and Equipment Zhejiang Normal UniversityJinhua 321004China College of Engineering Zhejiang Normal UniversityJinhua 321004China Hangzhou Lilong Hydraulic Co. LtdHangzhou 311200China

The cylinder block/valve plate interface is one of the most critical frictional interfaces of the swashplate-type axial piston ***,the poor lubrication interface caused rapid wear and high friction loss in an elastohydrodynamic lubrication system,decreasing the pump *** resistant bronze coatings were fabricated on 38CrMoAl substrate by Physical Vapor Deposition(PVD)and Chemical Vapor Deposition(CVD),***-on-disc wear tests were performed to comparatively investigate the wear behaviors of the coatings and bulk ductile iron *** can be found that the PVD-bronze coating exhibited better wear resistance than the other two *** enhanced wear resistance was attributed to the unique composite microstructure and desired mechanical strength,which could resist to mechanical shear and spallation,decreasing friction *** appropriate hardness of(1.33±0.07)GPa could be beneficial for enhancing its wear *** PVD-bronze coating possessed a much lower and stable coefficient of friction(about 0.1)and wear rate(about 6000μm3.n-1.m-1)under the loading forces of about 100 n after 20 *** wear mechanism was the abrasive wear.

关键词： Aircraft hydraulic pump Bronze Coatings Wear resistance Mechanisms

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Post-testing measurement of freely movable and diffusible hydrogen in context of WEC formation at cylindrical roller thrust bearings from 100Cr6

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Friction 2021年第4期9卷 876-890页

作者： Martin LInZMAYER Francisco GUTIÉRREZ GUZMÁn Gregor MAnKE Georg JACOBS christopher SOUS Michael POHL Institute for Machine Elements and System Engineering RWTH Aachen UniversitySchinkelstrasse 10Aachen 52062Germany Institute for Materials Material TestingRuhr University BochumUniversitatsstr 150Bochum 44801Germany

Sub-surface crack networks in areas of altered microstructure are a common cause for bearing *** to its appearance under light microscopy,the damage pattern is referred to as White Etching Cracks(WEC).The root causes leading to the formation of WEC are still under ***,it has already been shown that atomic hydrogen can have an accelerating effect on the formation and propagation of *** addition to hydrogen pre-charging,hydrogen can be released and absorbed during rolling/sliding due to the decomposing of the lubricant and *** current work focuses on the analysis of the hydrogen content of cylindrical roller thrust bearings after testing in a FE8 type test rig using two different *** the framework of this work,two different hydrogen analysis methods were used and assessed regarding their *** results show that the so-called Hydrogen Collecting Analysis(HCA)is more suitable to investigate the correlation between lubricant chemistry and hydrogen content in the test bearings than the Local Hydrogen Analysis(LHA).The measurements with the HCA show a continuously increasing freely movable and diffusible hydrogen content under tribological conditions,which leads to the formation of *** tests with an oil without hydrogen showed that the tendency of the system to fail as a result of WEC can be reduced by using a lubricant without hydride compounds.

关键词： White Etching Crack(WEC) White Etching Areas(WEA) hydrogen content Hydrogen Collecting Analysis(HCA) freely movable hydrogen diffusible hydrogen cylindrical roller thrust bearing roller bearings roller contact fatigue

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