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直肠癌根治术中的盆腔自主神经保护:30年变迁

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Gastroenterology Report 2016年第3期4卷 173-185,I0001页

作者： min-hoe chew Yu-Ting Yeh Evan Lim Francis Seow-Choen Department of Colorectal Surgery Singapore General HospitalSingapore Singhealth Academy Singapore General HospitalSingapore Seow-Choen Colorectal Centre Singapore

全直肠系膜切除(TME)理念及微创技术(如腹腔镜结直肠手术和机器人手术)的出现大大提高直肠癌的外科疗效。然而,术后排尿功能和性功能障碍率仍然较高,从而给患者造成巨大的痛苦,同时也会给手术医生带来困扰。新辅助和辅助放疗应用的增多... 详细信息

全直肠系膜切除(TME)理念及微创技术(如腹腔镜结直肠手术和机器人手术)的出现大大提高直肠癌的外科疗效。然而,术后排尿功能和性功能障碍率仍然较高,从而给患者造成巨大的痛苦,同时也会给手术医生带来困扰。新辅助和辅助放疗应用的增多也带来了更多的功能问题。在本文中,我们对盆腔神经解剖的目前认识进行了评价,将盆腔神经分为肠系膜下动脉根部、侧盆壁及泌尿生殖器官周围等区域,探讨了在这些区域如何进行手术操作。同时,我们也讨论了过去30年不同手术方式(包括开腹、腹腔镜和机器人)的功能状况。

关键词：全直肠系膜切除术盆腔自主神经保护排尿功能障碍性功能障碍

Paradigm shift in gastrointestinal surgery−combating sarcopenia with prehabilitation:Multimodal review of clinical and scientific data

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World Journal of Gastrointestinal Surgery 2021年第8期13卷 734-755页

作者： Frederick H Koh Jason MW Chua Joselyn LJ Tan Fung-Joon Foo Winson J Tan Sharmini S Sivarajah Leonard ming Li Ho Bin-Tean Teh min-hoe chew Division of Surgery Sengkang General HospitalSingapore 544886Singapore Institute of Molecular and Cell Biology Agency for Science Technology and ResearchSingapore 138673Singapore Duke-NUS Graduate Medical School National Cancer Centre SingaporeSingapore 169610Singapore

A growing body of evidence has demonstrated the prognostic significance of sarcopenia in surgical patients as an independent predictor of postoperative complications and *** included an increased risk of total complications,major complications,re-admissions,infections,severe infections,30 d mortality,longer hospital stay and increased hospitalization expenditures.A program to enhance recovery after surgery was meant to address these complications;however,compliance to the program since its introduction has been less than *** the last decade,the concept of prehabilitation,or"pre-surgery rehabilitation",has been *** presurgical period represents a window of opportunity to boost and optimize the health of an individual,providing a compensatory"buffer"for the imminent reduction in physiological reserve *** results have been *** review the literature to critically review the utility of prehabilitation,not just in the clinical realm,but also in the scientific realm,with a resource management point-of-view.

关键词： Sarcopenia Prehabilitation Surgery Frailty Value Gastrointestinal surgery

Prediction of overall survival following colorectal cancer surgery in elderly patients

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 247-260页

作者： Isaac Seow-En Winson Jianhong Tan Sreemanee Raaj Dorajoo Sharon Hui Ling Soh Yi Chye Law Soo Yeun Park Gyu-Seok Choi Wah Siew Tan Choong Leong Tang min hoe chew Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang General HospitalSingapore 544886Singapore Department of Pharmacy National University of SingaporeSingapore 117559Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Colorectal Cancer Center Kyungpook National University Chilgok HospitalKyungpook National University School of MedicineDaegu 702-210South Korea

BACKGROUND With advanced age and chronic illness,the life expectancy of a patient with colorectal cancer(CRC)becomes less dependent on the malignant disease and more on their pre-morbid *** major surgery for these elderly patients can be *** accurate tool demonstrating post-operative survival probability would be useful for surgeons and their *** To integrate clinically significant prognostic factors relevant to elective colorectal surgery in the elderly into a validated pre-operative scoring *** In this retrospective cohort study,patients aged 70 and above who underwent surgery for CRC at Singapore General Hospital between 1 January 2005 and 31 December 2012 were identified from a prospectively maintained *** with evidence of metastatic disease,and those who underwent emergency surgery or had surgery for benign colorectal conditions were excluded from the *** primary outcome was overall 3-year overall survival(OS)following surgery.A multivariate model predicting survival was derived and validated against an equivalent external surgical cohort from Kyungpook National University Chilgok Hospital,South *** analyses were performed using Stata/MP Version *** A total of 1267 patients were identified for *** median post-operative length of stay was 8[interquartile range(IQR)6-12]d and median follow-up duration was 47(IQR 19-75)*** OS was 78(IQR 65-85)*** multivariate analysis,the factors significant for predicting overall mortality were serum albumin<35 g/dL,serum carcinoembryonic antigen≥20μg/L,T stage 3 or 4,moderate tumor cell differentiation or worse,mucinous histology,rectal tumors,and pre-existing chronic obstructive lung *** age alone was not found to be *** Korean cohort consisted of 910 *** Singapore cohort exhibited a poorer OS,likely due to a higher proportion of advanced *** the clinicopathologic di

关键词： Colorectal cancer surgery Elderly Overall survival Pre-operative prognostic score

Six-Writings multimodal processing with pictophonetic coding to enhance Chinese language models

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Frontiers of Information Technology & Electronic Engineering 2024年第1期25卷 84-105页

作者： Li WEIGANG Mayara chew MARINHO Denise Leyi LI Vitor Vasconcelos DE OLIVEIRA Department of Computer Science University of BrasiliaBrasilia 70910-900Brazil Faculty of Economics AdministrationAccounting and ActuariesUniversity of Sao PauloSao Paulo 05508-010Brazil

While large language models(LLMs)have made significant strides in natural language processing(NLP),they continue to face challenges in adequately addressing the intricacies of the Chinese language in certain *** propose a framework called Six-Writings multimodal processing(SWMP)to enable direct integration of Chinese NLP(CNLP)with morphological and semantic *** first part of SWMP,known as Six-Writings pictophonetic coding(SWPC),is introduced with a suitable level of granularity for radicals and components,enabling effective representation of Chinese characters and *** conduct several experimental scenarios,including the following:(1)We establish an experimental database consisting of images and SWPC for Chinese characters,enabling dual-mode processing and matrix generation for CNLP.(2)We characterize various generative modes of Chinese words,such as thousands of Chinese idioms,used as question-and-answer(Q&A)prompt functions,facilitating analogies by *** experiments achieve 100%accuracy in answering all questions in the Chinese morphological data set(CA8-Mor-10177).(3)A fine-tuning mechanism is proposed to refine word embedding results using SWPC,resulting in an average relative error of≤25%for 39.37%of the questions in the Chinese wOrd Similarity data set(COS960).The results demonstrate that SWMP/SWPC methods effectively capture the distinctive features of Chinese and offer a promising mechanism to enhance CNLP with better efficiency.

关键词： Chinese language model Chinese natural language processing(CNLP) Generative language model Multimodal processing Six-Writings

Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases

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World Journal of Gastrointestinal Oncology 2017年第5期9卷 218-227页

作者： min hoe chew Yu-Ting Yeh Ee-Lin Toh Stephen Aditya Sumarli Ghee Kheng chew Lui Shiong Lee Mann Hong Tan Tiffany Priyanthi Hennedige Shin Yi Ng Say Kiat Lee Tze Tec Chong Hairil Rizal Abdullah Terence Lin Hon Goh Mohamed Zulfikar Rasheed Kok Chai Tan Choong Leong Tang Department of Colorectal Surgery Singapore General Hospital Department of Obstetrics and Gynaecology Singapore General Hospital Department of Urology Singapore General Hospital Department of Orthopaedic Surgery Singapore General Hospital Division of Oncological Imaging National Cancer Centre Singapore Department of Anaesthesiology Singapore General Hospital Vascular Surgery Singapore General Hospital Department of Plastic Reconstructive and Aesthetic SurgerySingapore General Hospital

AIM To critically appraise short-term outcomes in patientstreated in a new Pelvic Exenteration(PE) *** This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients(16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists(ASA) score, Eastern Cooperative Oncology Group(ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit(ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ~2 test or Fisher's exact test, as *** All 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were local y invasive rectal adenocarcinoma(n = 13), advanced colonic adenocarcinoma(n = 5), recurrent cervical carcinoma(n = 3) and malignant sacral chordoma(n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedural interventions.

关键词： Colorectal 癌症先进的骨盆的瘤 Sacrectomy Oncological 结果骨盆的取出肚肠 Chordoma

A holistic approach to improving safety for battery energy storage systems

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Journal of Energy Chemistry 2024年第5期92卷 422-439页

作者： James Close Jonathan E.Barnard Y.M.John chew Semali Perera Department of Chemical Engineering Centre for DigitalManufacturing&DesignUniversity of BathBath BA27AYUK ioMosaic International Limited 16-18 Queen SquareBath BA12HNUK

The integration of battery energy storage systems(BESS)throughout our energy chain poses concerns regarding safety,especially since batteries have high energy density and numerous BESS failure events have *** spread adoption will only increase the prevalence of these failure events unless there is a step change in the management and design of *** understand the causes of failure,the main challenges of BESS safety are *** consequences and failure events are discussed,including specific focus on the chain of events causing thermal runaway,and a case study of a BESS explosion in Surprise Arizona is *** on the technology and past events,a paradigm shift is required to improve BESS *** this review,a holistic approach is *** combines currently adopted approaches including battery cell testing,lumped cell mathematical modelling,and calorimetry,alongside additional measures taken to ensure BESS safety including the requirement for computational fluid dynamics and kinetic modelling,assessment of installation level testing of the full BESS system and not simply a single cell battery test,hazard and layers of protection analysis,gas chromatography,and composition *** holistic approach proposed in this study aims to address challenges of BESS safety and form the basis of a paradigm shift in the safety management and design of these systems.

关键词： Energy storagesystems Process safety Battery safety Thermal safety

Review on laser directed energy deposited aluminum alloys

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International Journal of Extreme Manufacturing 2024年第2期6卷 84-131页

作者： Tian-Shu Liu Peng Chen Feng Qiu Hong-Yu Yang Nicholas Tan Yew Jin Youxiang chew Di Wang Ruidi Li Qi-Chuan Jiang Chaolin Tan Singapore Institute of Manufacturing Technology(SIMTech) Agency for ScienceTechnology and Research(A∗STAR)5 Cleantech LoopSingapore 636732Singapore State Key Laboratory of Automotive Simulation and Control Jilin UniversityChangchun 130025People’s Republic of China Key Laboratory of Automobile Materials Ministry of Education and Department of Materials Science and EngineeringJilin UniversityChangchun 130025People’s Republic of China School of Mechanical&Automotive Engineering South China University of TechnologyGuangzhou 510640People’s Republic of China State Key Laboratory of Powder Metallurgy Central South UniversityChangsha 410083People’s Republic of China

Lightweight aluminum(Al)alloys have been widely used in frontier fields like aerospace and automotive industries,which attracts great interest in additive manufacturing(AM)to process high-value Al *** a mainstream AM technique,laser-directed energy deposition(LDED)shows good scalability to meet the requirements for large-format component manufacturing and ***,LDED Al alloys are highly challenging due to their inherent poor printability(*** laser absorption,high oxidation sensitivity and cracking tendency).To further promote the development of LDED high-performance Al alloys,this review offers a deep understanding of the challenges and strategies to improve printability in LDED Al *** porosity,cracking,distortion,inclusions,element evaporation and resultant inferior mechanical properties(worse than laser powder bed fusion)are the key challenges in LDED Al *** parameter optimizations,in-situ alloy design,reinforcing particle addition and field assistance are the efficient approaches to improving the printability and performance of LDED Al *** underlying correlations between processes,alloy innovation,characteristic microstructures,and achievable performances in LDED Al alloys are *** benchmark mechanical properties and primary strengthening mechanism of LDED Al alloys are *** review aims to provide a critical and in-depth evaluation of current progress in LDED Al *** opportunities and perspectives in LDED high-performance Al alloys are also outlined.

关键词： additive manufacturing laser directed energy deposition(LDED) aluminum alloys printability aluminum matrix composite auxiliary fields mechanical properties

Monogenic features of urolithiasis: A comprehensive review

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Asian Journal of Urology 2024年第2期11卷 169-179页

作者： Kyo Chul Koo Abdulghafour Halawani Victor K.F.Wong Dirk Lange Ben H.chew Department of Urology Yonsei University College of MedicineSeoulRepublic of Korea Department of Urology King Abdulaziz UniversityJeddahSaudi Arabia Department of Urological Sciences University of British ColumbiaStone Centre at Vancouver General HospitalVancouverBritish ColumbiaCanada

Objective: Urolithiasis formation has been attributed to environmental and dietary factors. However, evidence is accumulating that genetic background can contribute to urolithiasis formation. Advancements in the identification of monogenic causes using high-throughput sequencing technologies have shown that urolithiasis has a strong heritable ***: This review describes monogenic factors implicated in a genetic predisposition to urolithiasis. Peer-reviewed journals were evaluated by a PubMed search until July 2023 to summarize disorders associated with monogenic traits, and discuss clinical implications of identification of patients genetically susceptible to urolithiasis ***: Given that more than 80% of urolithiases cases are associated with calcium accumulation, studies have focused mainly on monogenetic contributors to hypercalciuric urolithiases, leading to the identification of receptors, channels, and transporters involved in the regulation of calcium renal tubular reabsorption. Nevertheless, available candidate genes and linkage methods have a low resolution for evaluation of the effects of genetic components versus those of environmental, dietary, and hormonal factors, and genotypes remain undetermined in the majority of urolithiasis ***: The pathophysiology underlying urolithiasis formation is complex and multifactorial, but evidence strongly suggests the existence of numerous monogenic causes of urolithiasis in humans.

关键词： Gene Genetic expression Inheritance pattern Urolithiasis

Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

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Asian Pacific Journal of Tropical Medicine 2024年第2期17卷 61-70页

作者： Siew-Keah Lee Ang-Lim Chua Clement Heng Yew Fong Ban Hao Brian Cong Wen Ling Ng Jing Feng Kong Yik-Ling chew Kai Bin Liew Yang Shao M.Kandiah Faculty of Medicine and Health Sciences Universiti Tunku Abdul RahmanMalaysia Faculty of Medicine Universiti Teknologi MARAMalaysia Faculty of Pharmaceutical Sciences UCSI UniversityMalaysia Faculty of Pharmacy University of CyberjayaMalaysia The First Affiliated Hospital of Hainan Medical University China

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in ***:A cross-sectional survey with convenience sampling was conducted during November 2022 and January *** completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final *** were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent ***:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural ***,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting car

关键词： Cardiovascular risk Knowledge Risk perception Behavioural intention INTERHEART Middle-aged Lifestyle Physical activity Psychosocial stress