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Improving testicular examinations on paediatric patients in the emergency department:A quality improvement study to improve early diagnosis of testicular torsion

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Asian Journal of Urology 2022年第2期9卷 152-156页

作者： Ernest M.Cheng juanita n.chui Murray Crowe Andrew Cooke Department of Emergency Medicine St George HospitalKogarahNSWAustralia Sydney Medical School University of SydneyCamperdownNSWAustralia St George Clinical School University of New South WalesKogarahNSWAustralia

Objective:Male paediatric patients presenting with abdominal and/or testicular pain are common in the emergency department.As a time-sensitive diagnosis,the importance of early recognition,referral,and definitive management is critical.Missed or delayed diagnoses and management of testicular torsion can result in significant long-term sequelae including impaired fertility and psychological burden.In this quality improvement study,we utilised educational posters aiming to improve awareness of testicular torsion as a differential for abdominal pain and therefore,improve the quality of testicular examinations performed in the emergency department.Methods:Observational pre-and post-intervention study was conducted at a tertiary hospital emergency department.A pre-interventional retrospective review of the electronic medical records was conducted.All male patients under 16-years-old presenting with“abdominal pain”or“testicular problem”were included.We assessed the rate of testicular examination and the quality of the examination based on four domains:Cremasteric reflex,lie,swelling,and hardness.Educational posters targeting both patients and clinicians were placed around the emergency department.Subsequent review of the electronic medical records post-intervention was performed assessing the same domains.Results:A total of 235 presentations were analysed with 124 in the pre-intervention group and 111 in the post-intervention group.Overall rate of documented testicular examinations increased by 14%(p=0.032).The quality of testicular examinations also improved from an average of 0.85 domains documented to 2.29 post-intervention(pnalysis found doctors in training had a greater improvement in both rate and quality of documented testicular examination.Conclusion:Our study demonstrated the value of continuing education in promoting awareness of testicular torsion in the emergency department.We found a clear improvement in the quality of clinical documentation of a time-sensitive condition which may infer a

关键词： Testicular torsion Testicular examination Emergency department Quality improvement Urological emergency

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Selective and Adaptive Incremental Transfer Learning with Multiple Datasets for Machine Fault Diagnosis

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Computers, Materials & Continua 2024年第1期78卷 1363-1379页

作者： Kwok Tai chui Brij B.Gupta Varsha Arya Miguel Torres-Ruiz School of Science and Technology Hong Kong Metropolitan UniversityHong Kong999077China Department of Computer Science and Information Engineering Asia UniversityTaichung41354Taiwan Center for Advanced Information Technology Kyung Hee UniversitySeoul02447Korea Symbiosis Centre for Information Technology Symbiosis International UniversityPuneMaharashtra411042India Department of Electrical and Computer Engineering Lebanese American UniversityBeirut1102Lebanon School of Computing Skyline University CollegeSharjah1797United Arab Emirates Department of Business Administration Asia UniversityTaichung41354Taiwan Center for Interdisciplinary Research University of Petroleum and Energy StudiesDehradun248007India Department of Computer Science&Engineering Chandigarh UniversityChandigarh160036India Centro de Investigación en Computación Instituto Politécnico NacionalUPALM-ZacatencoMexico City07320Mexico

The visions of Industry 4.0 and 5.0 have reinforced the industrial environment.They have also made artificial intelligence incorporated as a major facilitator.Diagnosing machine faults has become a solid foundation for automatically recognizing machine failure,and thus timely maintenance can ensure safe operations.Transfer learning is a promising solution that can enhance the machine fault diagnosis model by borrowing pre-trained knowledge from the source model and applying it to the target model,which typically involves two datasets.In response to the availability of multiple datasets,this paper proposes using selective and adaptive incremental transfer learning(SA-ITL),which fuses three algorithms,namely,the hybrid selective algorithm,the transferability enhancement algorithm,and the incremental transfer learning algorithm.It is a selective algorithm that enables selecting and ordering appropriate datasets for transfer learning and selecting useful knowledge to avoid negative transfer.The algorithm also adaptively adjusts the portion of training data to balance the learning rate and training time.The proposed algorithm is evaluated and analyzed using ten benchmark datasets.Compared with other algorithms from existing works,SA-ITL improves the accuracy of all datasets.Ablation studies present the accuracy enhancements of the SA-ITL,including the hybrid selective algorithm(1.22%-3.82%),transferability enhancement algorithm(1.91%-4.15%),and incremental transfer learning algorithm(0.605%-2.68%).These also show the benefits of enhancing the target model with heterogeneous image datasets that widen the range of domain selection between source and target domains.

关键词： Deep learning incremental learning machine fault diagnosis negative transfer transfer learning

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Preparation of maximally-entangled states with multiple cat-state qutrits in circuit QED

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Frontiers of physics 2024年第3期19卷 239-251页

作者： chui-Ping Yang Jia-Heng ni Liang Bin Yu Zhang Yang Yu Qi-Ping Su Department of Physics Hangzhou Normal UniversityHangzhou 311121China School of Physics Nanjing UniversityNanjing 210093China Institute for Quantum Science and Technology University of CalgaryAlberta T2N 1N4Canada

In recent years,cat-state encoding and high-dimensional entanglement have attracted much attention.However,previous works are limited to generation of entangled states of cat-state qubits(two-dimensional entanglement with cat-state encoding),while how to prepare entangled states of cat-state qutrits or qudits(high-dimensional entanglement with cat-state encoding)has not been investigated.We here propose to generate a maximally-entangled state of multiple cat-state qutrits(three-dimensional entanglement by cat-state encoding)in circuit QED.The entangled state is prepared with multiple microwave cavities coupled to a superconducting flux ququart(a four-level quantum system).This proposal operates essentially by the cavity-qutrit dispersive interaction.The circuit hardware resource is minimized because only a coupler ququart is employed.The higher intermediate level of the ququart is occupied only for a short time,thereby decoherence from this level is greatly suppressed during the state preparation.Remarkably,the state preparation time does not depend on the number of the qutrits,thus it does not increase with the number of the qutrits.As an example,our numerical simulations demonstrate that,with the present circuit QED technology,the high-fidelity preparation is feasible for a maximally-entangled state of two cat-state qutrits.Furthermore,we numerically analyze the effect of the inter-cavity crosstalk on the scalability of this proposal.This proposal is universal and can be extended to accomplish the same task with multiple microwave or optical cavities coupled to a natural or artificial four-level atom.

关键词： maximally-entangled states cat state qutrit circuit QED

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Surgical management of high-grade pancreatic injuries: Insights from a high-volume pancreaticobiliary specialty unit

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 834-846页

作者： juanita noeline chui Krishna Kotecha Tamara MH Gall Anubhav Mittal Jaswinder S Samra Department of Upper Gastrointestinal Surgery Royal North Shore HospitalSydney 2065NSWAustralia Faculty of Medicine and Health University of SydneySydney 2006NSWAustralia Department of Surgery University of Notre DameSydney 2006NSWAustralia

BACKGROUnD The management of high-grade pancreatic trauma is controversial.AIM To review our single-institution experience on the surgical management of blunt and penetrating pancreatic injuries.METHODS A retrospective review of records was performed on all patients undergoing surgical intervention for high-grade pancreatic injuries [American Association for the Surgery of Trauma(AAST) Grade Ⅲor greater] at the Royal north Shore Hospital in Sydney between January 2001 and December 2022. Morbidity and mortality outcomes were reviewed, and major diagnostic and operative challenges were identified.RESULTS Over a twenty-year period, 14 patients underwent pancreatic resection for highgrade injuries. Seven patients sustained AAST Grade Ⅲinjuries and 7 were classified as Grades Ⅳ or Ⅴ. nine underwent distal pancreatectomy and 5 underwent pancreaticoduodenectomy(PD). Overall, there was a predominance of blunt aetiologies(11/14). Concomitant intra-abdominal injuries were observed in 11 patients and traumatic haemorrhage in 6 patients. Three patients developed clinically relevant pancreatic fistulas and there was one in-hospital mortality secondary to multi-organ failure. Among stable presentations, pancreatic ductal injuries were missed in two-thirds of cases(7/12) on initial computed tomography imaging and subsequently diagnosed on repeat imaging or endoscopic retrograde cholangiopancreatography. All patients who sustained complex pancreaticoduodenal trauma underwent PD without mortality. The management of pancreatic trauma is evolving. Our experience provides valuable and locally relevant insights into future management strategies.COnCLUSIOn We advocate that high-grade pancreatic trauma should be managed in high-volume hepatopancreato-biliary specialty surgical units. Pancreatic resections including PD may be indicated and safely performed with appropriate specialist surgical, gastroenterology, and interventional radiology support in tertiary centres.

关键词： Pancreas Trauma Injury Pancreatectomy Pancreaticoduodenectomy Damage control surgery

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Gallai's Conjecture on Path Decompositions

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Journal of the Operations Research Society of China 2023年第3期11卷 439-449页

作者： Geng-Hua Fan Jian-Feng Hou chui-Xiang Zhou Center for Discrete Mathematics Fuzhou UniversityFuzhou350003FujianChina

Gallai's conjecture asserts that every connected graph on n vertices can be decomposed into at most n+1/2 paths.The E-subgraph of a graph G,denoted by G_(e),is the subgraph induced by the vertices of even degree in G.A triangle pair is a graph consisting of two triangles with exactly one vertex in common.In this paper,it is proved that Gallai's conjecture is true for graphs G in which G_(e)contains no triangle pair and each block of G_(e)has maximum degree at most 3.

关键词： Gallai's conjecture Path Triangle Decomposition

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Microscopic colitis as a missed cause of chronic diarrhea

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World Journal of Gastroenterology 2011年第15期17卷 1996-2002页

作者： nooroudien Mohamed Monique Marais juanita Bezuidenhout Department of Pathology Division of Anatomical Pathology Faculty of Health Sciences University of Stellenbosch National Health Laboratory Services Tygerberg Academic Hospital Tygerberg 7505 South Africa Department of Medicine Division of Gastroenterology Faculty of Health Sciences University of Stellenbosch Tygerberg Academic Hospital Tygerberg 7505 South Africa

AIM: To determine the prevalence of increased intraepithelial lymphocytes, using immunohistochemistry in patients with normal colonoscopy and near normal biopsy. METHODS: We retrospectively reviewed all non-malignant colon mucosal biopsies between 2005 and 2007, reported as normal, chronic inflammation or melanosis coli in patients who were undergoing routine colonoscopy. Immunohistochemistry using CD3 was performed on all mucosal biopsies and an intraepithelial lymphocyte count (IEL) was determined. Cases with an IEL count of ≥ 20 IELs per 100 surface epithelial cells were correlated with demographic, clinical and follow-up data. A further subgroup was evaluated for lymphocytic colitis.RESULTS: Twenty (8.3%) of 241 cases revealed an IEL count ≥ 20. Six (2.5%) patients were identified as having lymphocytic colitis (P n initial evaluation (P = 0.01). Four of these five patients were labeled with diarrhea-predominant irritable bowel syndrome (IBS). On follow-up, three of the remaining 20 cases were diagnosed with malignancy (renal cell carcinoma and myelodysplastic syndrome) and one had an unknown primary tumor with multiple liver metastases. Two cases of collagenous colitis with an IEL count ncluded in this study. Increased IELs were not confined to patients with diarrhea as a primary presenting symptom, but were also present in patients with abdominal pain (n = 7), constipation (n = 3) and loss of weight (n = 1). COnCLUSIOn: Immunohistochemistry using CD3 is of value in identifying and quantifying IELs for the presence of microscopic colitis in patients with diarrheapredominant IBS.

关键词：慢性腹泻结肠炎微观上皮内淋巴细胞免疫组织化学淋巴细胞性细胞计数恶性肿瘤

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急性重症感染后炎症细胞因子风暴下心肌状态及超声心动图心脏检测的价值

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中国现代医学杂志 2024年第1期34卷 29-33页

作者：符妹垂周笔峰符凤妹海南西部中心医院超声医学科海南儋州571799

目的探讨急性重症感染后炎症细胞因子风暴下的心肌状态及超声心动图心脏检测的价值。方法选取2020年1月—2023年2月在海南西部中心医院就诊的急性重症感染患者110例,其中,合并细胞因子风暴患者45例(观察组),无细胞因子风暴患者65例(对照... 详细信息

目的探讨急性重症感染后炎症细胞因子风暴下的心肌状态及超声心动图心脏检测的价值。方法选取2020年1月—2023年2月在海南西部中心医院就诊的急性重症感染患者110例,其中,合并细胞因子风暴患者45例(观察组),无细胞因子风暴患者65例(对照组)。比较两组患者的临床资料、心肌损伤标志物、心电图、超声心动图参数等差异。结果观察组患者年龄高于对照组(Pn-末端B型脑钠肽原高于对照组(P<0.05);观察组白细胞计数和中性粒细胞计数高于对照组(P<0.05),而血小板计数和红细胞计数低于对照组(P<0.05);观察组心房颤动、室性期前收缩、房性期前收缩和异常Q波占比高于对照组(P<0.05);观察组左心室舒张末期内径、左心室收缩末期内径、左心室舒张末期容积、左心室收缩末期容积、E峰、三尖瓣反流压差和肺动脉收缩压高于对照组(P<0.05),而左室射血分数和A峰低于对照组(P<0.05)。结论急性重症感染后炎症细胞因子风暴下患者心肌损伤明显,超声心动图可直观检测心脏情况。

关键词：急性重症感染细胞因子风暴超声心动图心肌损伤

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Structure and sequence analysis of influenza A virus nucleoprotein

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Science China(Life Sciences) 2009年第5期52卷 439-449页

作者： nG Andy Ka-Leung SHAW Pang-chui Molecular Biotechnology Programme Department of Biochemistry and Centre for Protein Science and Crystallography The Chi-nese University of Hong Kong

Influenza A virus nucleoprotein (nP) forms homo-oligomers and multiple copies of nP wrap around genomic RnA, along with a trimeric polymerase making up ribonucleoprotein (RnP) complex. Sequence comparison of more than 2500 influenza A nP showed that this protein contains 30.1 % of polymorphic residues. nP is composed of a head and a body domain and a tail loop/ linker region. The head domain is more conserved than the body domain, as revealed from the structure-based sequence alignment. nP oligomerization is mediated by the insertion of the non-polymorphic and structurally conserved tail loop of one nP molecule to a groove of another nP. The different form of nP oligomers is due to the flexibility of the polymorphic linkers that join the tail loop to the rest of the protein. The RnA binding property of nP is known to involve the protruding element and the flexible basic loop between the head and body domains, both having high degree of primary sequence conservation. To bind RnA, nP may first capture the RnA by the flexible basic loop and then the RnA is clamped by the protruding element.

关键词： Influenza H5n1 nucleoprotein oligomerization RnA binding

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Effects of preoperative chemotherapy on neuroblastoma with MYCn amplification:a surgeon’s perspective

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World Journal of Pediatric Surgery 2020年第2期3卷 15-19页

作者： Chanhon.chui Surgery Centre for Children Mount Elizabeth Medical CentreSingapore

Background Preoperative chemotherapy plays an important role in the surgical management of unresectable neuroblastoma.Its response to chemotherapy has been variable due to the tumor’s heterogeneity.We aimed to evaluate the effects of preoperative chemotherapy on MYCn-amplified(MYCnA)neuroblastoma that would impact on surgical resection.Methods Patients with MYCnA neuroblastoma who received preoperative chemotherapy followed by surgical resection performed at our center were included.The tools of response evaluated included tumor volume reduction(TVR),reduction in image-defined risk factors(IDRFs),percentage tumor necrosis(nec),and surgical complications.Results Among 62 patients evaluated,mean age was 3.0(range,0.9-11.8)years,and primary tumors were distributed in the abdomen(n=59),pelvis(n=2),and thorax(n=1).The patients were in stages L2(n=14)and M(n=48).Surgery was performed after median of 4(range,2-10)cycles of chemotherapy.On completion of preoperative chemotherapy,41(66.1%)patients had TVR>65%,24(42.9%)responded with reduced IDRFs,47(75.8%)tumors had nec>50%,and 27 patients suffered 31 surgical complications.Majority(83.9%)continued to have IDRFs at surgery.IDRFs commonly encountered were encasement of renal pedicles(n=50),superior mesenteric artery(n=46),celiac axis(n=45),and aorta/vena cava(n=44),and most remained refractory to resolution.Patients with TVR>65%were associated with nec>50%(87.5%vs 54.5%,p=0.004)and reduced IDRFs(46.3%vs 19%,p=0.035),but not with the incidence of surgical complications.Conclusions Majority of MYCnA neuroblastomas were highly chemosensitive as they experienced high TVR,reduced IDRFs,and high nec,and hence created favorable conditions for surgical resection.Poor responders and persistent IDRFs that were commonly refractory to preoperative chemotherapy remained a surgical challenge.

关键词： neuroblastoma MYCn Surgery

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Identification of herbal medicinal materials using DnA barcodes

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Journal of Systematics and Evolution 2011年第3期49卷 271-283页

作者： Paul Pui-Hay BUT Pang-chui SHAW School of Life Sciences The Chinese University of Hong KongShatinN.T.Hong KongChina State Key Laboratory of Phytochemistry and Plant Resources in West China(CUHK) Institute of Chinese MedicineThe Chinese University of Hong KongShatinN.T.Hong KongChina

Herbal medicinal materials have been used worldwide for centuries to maintain health and to treat disease.However,adulteration of herbal medicines remains a major concern of users and industry for reasons of safety and efficacy.Identification of herbal medicinal materials by DnA technology has been widely applied,started from the mid-1990s.In recent years,DnA barcoding of global plant species using four standard barcodes(rbcL,matK,trnH-psbA and ITS) has been a major focus in the fields of biodiversity and conservation.These DnA barcodes can also be used as reliable tools to facilitate the identification of herbal medicinal materials for the safe use of herbs,quality control,and forensic investigation.Many studies have applied these DnA barcodes for the identification of herbal medicinal species and their adulterants.The present article reviews efforts in the identification of herbal medicinal materials using the standard DnA barcodes and other DnA sequence-based markers.

关键词： DnA barcode herbal medicinal materials internal transcribed spacer(ITS) matK molecular identification rbcL trnH-psbA.

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