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Quality of colonoscopy performed by medical or surgical specialists and trainees in five Australian hospitals

World Journal of Gastrointestinal Endoscopy 2022年第11期14卷 672-683页

作者： Tsai-Wing Ow Olga A Sukocheva Vy Tran Richard Lin shawn zhenhui lee Matthew Chu Bianca Angelica Christopher K Rayner Edmund Tse Guru Iyngkaran Peter A Bampton Department of Gastroenterology and Hepatology Royal Adelaide HospitalAdelaide 5000SAAustralia Department of Gastroenterology and Hepatology Flinders Medical CentreBedford Park 5042SAAustralia Department of Gastroenterology and Hepatology The Queen Elizabeth HospitalWoodville South 5011SAAustralia Department of Gastroenterology Royal Darwin HospitalDarwin 0810NTAustralia Department of Gastroenterology and Hepatology Royal Melbourne HospitalParkville 3050VICAustralia

BACKGROUND Ensuring colonoscopy procedure quality is vital to the success of screening and surveillance programmes for bowel cancer in Australia. However, the data on the performance of quality metrics, through adequate adenoma detection, bowel preparation, and procedure completion rates, in the Australian public sector is limited. Understanding these can inform quality improvement to further strengthen our capacity for prevention and early detection of colorectal *** To determine the quality of colonoscopy in Australian teaching hospitals and their association with proceduralist specialty, trainee involvement, and *** We retrospectively evaluated 2443 consecutive colonoscopy procedure reports from 1 January to 1 April, 2018 from five public teaching tertiary hospitals in Australia(median 60 years old, 49% male). Data for bowel preparation quality,procedure completion rates, and detection rates of clinically significant adenomas, conventional adenomas, and serrated lesions was collected and compared to national criteria for quality in colonoscopy. Participating hospital, proceduralist specialty, and trainee involvement indicators were used for stratification. Data was analysed using Chi-squared tests of independence, MannWhitney U, One-way ANOVA, and multivariate binary logistic *** Fifty-two point two percent(n = 1276) and 43.3%(n = 1057) were performed by medical and surgical proceduralists respectively, whilst 29.8%(n = 728) involved a trainee. Inadequate bowel preparation affected 7.3% of all procedures. The procedure completion rate was 95.1%, which increased to 97.5% after adjustment for bowel preparation quality. The pooled cancer, adenoma, and serrated lesion detection rates for all five hospitals were 3.5%, 40%, and 5.9% respectively. Assessed hospitals varied significantly by patient age(P < 0.001), work-force composition(P < 0.001), adequacy of bowel preparation(P < 0.001), and adenoma detection rate(P < 0.001). Two hosp

关键词： Colonoscopy Quality of health care Adenoma detection rate Bowel preparation quality Hospital-based teaching

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Enhanced RuBisCO activity and promoted dicotyledons growth with degradable carbon dots

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Nano Research 2019年第7期12卷 1585-1593页

作者： Hao Li Jian Huang Yang Liu Fang Lu Jun Zhong Yong Wang Shuiming Li Yeshayahu Lifshitz Shuit-Tong lee zhenhui Kang Institute of Functional Nano & Soft Materials (FUNSOM) Jiangsu Key Laboratory for Carbon-Based Functional Materials & DevicesJoint International Research Laboratory of Carbon-Based Functional Materials and DevicesSoochow UniversitySuzhou 215123China School of biology & basic medical sciences Soochow universitySuzhou 215123China College of Life Science and Oceanography Shenzhen Key Laboratory of Marine Bioresources and EcologyShenzhen UniversityShenzhen 518060China School of Basic Medical Sciences Beijing University of Chinese MedicineBeijing 100029China Department of Materials Science and Engineering TechnionIsrael Institute of TechnologyHaifa 3200003Israel

The ~ 5 nm degradable carbon dots (CDs) were synthesized directly from carbon rod by a one-step electrochemical method at room *** as-prepared CDs can effectively enhance the ribulose bisphosphate carboxylase oxygenase (RuBisCO) activity,and then promote the dicotyledons growth (soybean,tomato,eggplant and so on) and finally increase their ***,we used Arabidopsis thaliana and Trifolium repens *** model plants to systematically study the beneficial effects of CDs on plant *** include:(i) accelerating seed germination;(ii) enlarging root elongation;(iii) increasing metal ions absorption and delivery;(iv) improving enzymes activity;(v) enhancing the carbohydrate content;(vi) degradation into plant hormone analogues and CO2;and finally (vii) enhancing the grain production by about 20%.

关键词： carbon dots bio-degradation photosynthesis plant life cycle improve growth

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A humidity resistant and high performance triboelectric nanogenerator enabled by vortex-induced vibration for scavenging wind energy

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Nano Research 2022年第4期15卷 3246-3253页

作者： Yan Wang Tianyu Chen Shuowen Sun Xiangyu Liu Zhiyuan Hu zhenhui Lian Long Liu Qiongfeng Shi Hao Wang Jianchun Mi Tongming Zhou Chengkuo lee Minyi Xu Dalian Key Lab of Marine Micro/Nano Energy and Self-powered System Marine Engineering CollegeDalian Maritime UniversityDalian 116026China Center for Intelligent Sensors and MEMS(CISM) National University of Singapore Engineering Drive 3 Singapore 117576Singapore3 College of EngineeringPeking UniversityBeijing 100871China School of Civil Environmental and Mining EngineeringThe University of Western AustraliaWA 6009Australia

Wind energy is a promising renewable energy source for a low-carbon *** study is to develop a fully packaged vortexinduced vibration triboelectric nanogenerator(VIV-TENG)for scavenging wind *** VIV-TENG consists of a wind vane,internal power generation unit,an external frame,four springs,a square cylinder and a circular *** internal power generation unit consists of polytetrafluoroethylene(PTFE)balls,a honeycomb frame and two copper *** from most of the previous wind energy harvesting TENGs,the bouncing PTFE balls are fully packaged in the square *** distinct design separates the process of contact electrification from the external environment,and at the same time avoids the frictional wear of the ordinary wind energy harvesting *** corresponding VIV parameters are investigated to evaluate their influence on the vibration behaviors and the energy *** state of the VIV-TENG corresponds to the high output performance from the *** distinct,robust structure ensures the full-packaged VIV-TENG can harvest wind energy from arbitrary directions and even in undesirable weather *** study proposes a novel TENG configuration for harvesting wind energy and the VIV-TENG proves promising powering micro-electro-mechanical appliances.

关键词： vortex-induced vibration wind energy triboelectric nanogenerator self-powered

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Isolated colonic neurofibroma in the setting of Lynch syndrome:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2020年第1期12卷 28-33页

作者： Warren YL Sun Armaan Pandey Mark lee shawn Wasilenko Shahzeer Karmali Division of General Surgery University of AlbertaEdmonton T6G 2B7AlbertaCanada Cumming School of Medicine University of CalgaryCalgary T2N 4Z6AlbertaCanada Department of Laboratory Medicine&Pathology University of AlbertaEdmonton T5H 3V9AlbertaCanada Division of Gastroenterology University of AlbertaEdmonton T5H 3V9Canada

BACKGROUND Gastrointestinal neurofibromas are commonly found in patients diagnosed with neurofibromatosis type ***,isolated gastrointestinal neurofibromas are a rare entity and only fourteen cases of isolated colorectal neurofibromas have been documented in *** gastrointestinal neurofibromas have not been associated with Lynch syndrome(LS).Patients with LS are at an increased risk of colorectal cancer,and are recommended to undergo screening *** SUMMARY A 33-year-old healthy female with a family history of LS was found to have unresectable polyp in the ascending colon on screening colonoscopy suspicious for *** patient was asymptomatic and had no stigmata of neurofibromatosis.A staging workup for colorectal cancer revealed no evidence of metastatic disease.A discussion with the patient resulted in the decision to undergo a segmental resection with ongoing *** patient underwent a laparoscopic right *** was consistent with a gastrointestinal ***-operatively,the patient recovered *** will not require further treatment with regards to her colonic neurofibroma,but will continue to follow-up for ongoing surveillance of her *** We present the first case of an isolated colonic neurofibroma in a patient with *** case explores considerations for the management of isolated gastrointestinal neurofibromas given the lack of guidelines in literature.

关键词： Isolated gastrointestinal neurofibroma Colonic neurofibroma Gastrointestinal neurofibromatosis Lynch syndrome Case report

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Experimental and modeling study of de novo formation of PCDD/PCDF on MSW fly ash

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Journal of Environmental Sciences 2007年第1期19卷 117-122页

作者： LI Xiao-dong ZHANG Ji YAN Jian-hua CEN Ke-fa RYAN shawn P GULLETT Brian K lee Chunwai State key Laboratory of Clean Energy Utilization Institute for Thermal Power Engineering Zhefiang University Hangzhou 310027 China U.S. Environmental Protection Agency Office of Research and Development National Risk Management Research Laboratory E305-01 Research Triangle Park North Carolina 27711 USA

The effect of sulfur dioxide （SO2） on the formation of polychlorinated dibenzo-p-dioxins （PCDDs） and polychlorinated dibenzofurans （PCDFs） has been studied in an entrained-flow reactor （EFR） under simulated waste combustion conditions. A chlorination model based on conditional probability was employed to evaluate the homologue patterns of PCDDs and PCDFs. Results revealed that the presence of SO2 did not alter the formation pathway although SO2 suppressed PCDD/F formation. The prediction model of PCDF showed good agreement with the experimental data （R--0.95）, whereas the prediction for PCDDs did not correlate well with the experimental data. This may be explained because potential chlorination pathways play a significant role in PCDF formation, whereas PCDDs are mainly formed through condensation reactions. Furthermore, the result indicated that the steric hindrance during formation has more effects on PCDD than on PCDF due to the symmetric molecular structures of PCDDs.

关键词： PCDDs PCDFs de novo synthesis formation chlorination model sulfur dioxide air pollution waste combustion

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Patterns of in-hospital mortality and bleeding complications following PCI for very elderly patients： insights from the Dartmouth Dynamic Registry

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Journal of Geriatric Cardiology 2018年第2期15卷 131-136页

作者： shawn X Li Hannah I Chaudry Jiyong lee Theodore B Curran Vishesh Kumar Kendrew K Wong Bruce W Andrus James T DeVries Dartmouth Geisel School of Medicine Hanover NH USA Department of Internal Medicine Dartmouth-Hitcheock Medical Center Lebanon NH USA Section of Cardiovascular Medicine Dartmouth-Hitchcock Medical Center Lebanon NH USA

Background Very elderly patients （age 〉 85 years） are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneous coronary intervention （PCI）. However, the relationship between bleeding and mortality in the very elderly is unknown. Methods Retrospective review was performed on 17,378 consecutive PCI procedures from 2000 to 2015 at Dartmouth-Hitchcock Medical Center. Incidence of bleeding during the index PCI admission （bleeding requiring transfusion, access site hematoma 〉 5 cm, pseudoaneurysm, and retroperitoneal bleed） and in-hospital mortality were reported for four age groups （〈 65 years, 65-74 years, 75-84 years, and ≥ 85 years）. The mortality of patients who suffered bleeding complications and those who did not was calculated and multivariate analysis was performed for in-hospital mortality. Lastly, known predictors of bleeding were compared between patients age 〈 85 years and age ≥85 years. Results Of 17,378 patients studied, 1019 （5.9%） experienced bleeding and 369 （2.1%） died in-hospital following PCI. Incidence of bleeding and in-hospital mortality increased monotonically with increasing age （mortality： 0.94%, 2.27%, 4.24% and 4.58%; bleeding： 3.96%, 6.62%, 10.68% and 13.99% for ages 〈 65, 65-4, 75-84 and ≥ 85 years, respectively）. On multivariate analysis, bleeding was associated with increased mortality for all age groups except patients age ≥85 years [odds ratio （95% CI）： age 〈 65 years, 3.65 （1.99-6.74）; age 65-74 years, 2.83 （1.62-4.94）; age 75-84 years, 3.86 （2.56-5.82）, age ≥ 85 years 1.39 （0.49-3.95）]. Conclusions Bleeding and mortality following PCI increase with increasing age. For the very elderly, despite high rates of bleeding, bleeding is no longer predictive of in-hospital mortality following PCI.

关键词： Complications In-hospital mortality Percutaneous coronary intervention The elderly

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Current applications of propeller flaps in reconstruction of trunk wounds

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Plastic and Aesthetic Research 2017年第11期4卷 204-208页

作者： shawn Moshreif Gordon K.lee Division of Plastic&Reconstructive Surgery Stanford University Medical CenterPalo AltoCA 94305USA

Aim: Propeller flaps provide excellent reconstructive options for defects of many etiologies. Trunk wounds are a commonly encountered issue for the plastic surgeon and multiple techniques to address them should be prepared for implementation. Propeller flaps are a subject rarely brought up as an option to address these wounds. The authors sought to elucidate this topic in the current plastic surgery literature available. Methods: A PubMed search was conducted based upon the defined inclusion and exclusion criteria and publications reviewed in detail. Search terms included 'trunk wound propeller flap', 'trunk propeller flap', and 'freestyle trunk wound flap'. Duplicate studies were excluded. Data was extracted from each study pertaining to trunk wounds and reconstructions with propeller flaps. Results: The electronic search yielded 49 results with 21 studies ultimately meeting inclusion criteria. A total of 365 flaps were described collectively amongst the included studies. Among them, 190 propeller flaps addressing trunk defects were performed across all studies reviewed to address a total of 165 defects of the trunk: 14 abdomen, 101 back, 50 chest defects and adjacent respective flaps were utilized for surgical reconstruction. Overall, cancer excision wounds were by far the most prevalent with 105 cases (59.0%). Defect sizes of those specified in the articles ranged from 2 cm × 5 cm to 30 cm × 24 cm. Of the 190 propeller flaps identified, 63 total complications were identified. The most common complication was 48 total cases of transient venous congestion (25.3%). The second most common complication was partial flap necrosis (6.3%). No total flap loss was noted. There were 2 cases of seroma (1.1%) and 1 case of wound breakdown (0.5%). Conclusion: Propeller flaps are a viable reconstructive option for trunk wounds and should be in the armamentarium of plastic and reconstructive surgeons. Few studies are available in the literature regarding propeller flap reconstruc

关键词： Propeller flaps trunk wounds microvascular dissection

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Implementation science for the adductor canal block:A new and adaptable methodology process

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World Journal of Orthopedics 2021年第11期12卷 899-908页

作者： Nikhil Crain Chun-Yuan Qiu Stephen Moy shawn Thomas Vu Thuy Nguyen Mijin lee-Brown Diana Laplace Jennifer Naughton John Morkos Vimal Desai Bowman Gray Center for Medical Education Wake Forest School of MedicineWinston-SalemNC 27103United States Perioperative Service and Anesthesiology Kaiser Permanente Medical CenterBaldwin ParkCA 91706United States Department of Anesthesiology Baldwin Park Medical CenterSouthern California Kaiser Permanente Medical GroupBaldwin ParkCA 91706United States Johns Hopkins University The Johns Hopkins University School of MedicineBaltimoreMD 21205United States

BACKGROUND Following the successful Perioperative Surgical Home(PSH)practice for total knee arthroplasty(TKA)at our institution,the need for continuous improvement was realized,including the deimplementation of antiquated PSH elements and introduction of new *** To investigate the transition from femoral nerve blocks(FNB)to adductor canal nerve blocks(ACB)during *** Our 13-month study from June 2016 to 2017 was divided into four periods:a three-month baseline(103 patients),a one-month pilot(47 patients),a three-month implementation and hardwiring period(100 patients),and a six-month evaluation period(185 patients).In total,435 subjects were *** within 30 postoperative days were extracted from electronic medical records,such as physical therapy results and administration of oral morphine equivalents(OME).RESULTS Our institution reduced FNB application(64% to 3%)and increased ACB utilization(36% to 97%)at 10 *** in the ACB group were found to have increased ambulation on the day of surgery(4.1 vs 2.0 m)and lower incidence of falls(0 vs 1%)and buckling(5% vs 27%)compared with FNB patients(P<0.05).While ACB patients(13.9)reported lower OME than FNB patients(15.9),the difference(P=0.087)did not fall below our designated statistical threshold of P value<*** By demonstrating closure of the“knowledge to action gap”within 6 mo,our institution’s findings demonstrate evidence in the value of implementation *** education,technical support,and performance monitoring were deemed key facilitators of our program’s *** patient populations and additional orthopedic procedures are recommended for future study.

关键词： Total knee arthroplasty Femoral nerve block Adductor canal block Physical therapy Oral morphine equivalent Action-related information gap

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高性能、高可加工性能的新型热塑性聚酰亚胺

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现代塑料 2007年第3期 62-64页

作者： shawn lee

在军事以及航空电子．卫生保健．油气井等领域需要具有极高性能的树脂材料，包括极高的耐热．耐化学品性能以及良好的热塑性塑料熔融加工性能。为满足这些领域的需求，一种新的无定型．可熔融加工的热塑性聚酰亚胺（TPI）由GE塑料公司... 详细信息

在军事以及航空电子．卫生保健．油气井等领域需要具有极高性能的树脂材料，包括极高的耐热．耐化学品性能以及良好的热塑性塑料熔融加工性能。为满足这些领域的需求，一种新的无定型．可熔融加工的热塑性聚酰亚胺（TPI）由GE塑料公司开发出来。

关键词：热塑性聚酰亚胺可加工性能可熔融加工 GE塑料公司热塑性塑料树脂材料卫生保健航空电子

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A 3D-printed magnetic digital microfluidic diagnostic platform for rapid colorimetric sensing of carbapenemase-producing Enterobacteriaceae

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Microsystems & Nanoengineering 2021年第3期7卷 173-184页

作者： Pojchanun Kanitthamniyom Pei Yun Hon Aiwu Zhou Mohammad Yazid Abdad Zhi Yun Leow Nurhidayah Binte Mohamed Yazid Vanessa Lim Wei Xun shawn Vasoo Yi Zhang Singapore Centre for 3D Printing School of Mechanical and Aerospace EngineeringNanyang Technological UniversitySingapore CitySingapore National Center for Infectious Disease Tan Tock Seng HospitalSingapore CitySingapore lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore CitySingapore

Carbapenemase-producing Enterobacteriaceae(CPE)are a group of drug-resistant Gram-negative pathogens that are classified as a critical threat by the World Health Organization(WHO).Conventional methods of detecting antibiotic-resistant pathogens do not assess the resistance mechanism and are often time-consuming and *** have developed a magnetic digital microfluidic(MDM)platform,known as MDM Carba,for the identification of CPE by measuring their ability to hydrolyze carbapenem *** Carba offers the ability to rapidly test CPE and reduce the amount of reagents used compared with conventional phenotypic *** the MDM Carba platform,tests are performed in droplets that function as reaction chambers,and fluidic operations are accomplished by manipulating these droplets with magnetic *** simple droplet-based magnetic fluidic operation allows easy system automation and simplified hands-on *** of the unique“power-free”operation of MDM technology,the MDM Carba platform can also be operated manually,showing great potential for point-of-care testing in resource-limited *** tested 27 bacterial isolates on the MDM Carba platform,and the results showed sensitivity and specificity that were comparable to those of the widely used Carba NP *** Carba may shorten the overall turnaround time for CPE identification,thereby enabling more timely clinical decisions for better clinical *** Carba is a technological platform that can be further developed to improve diagnostics for other types of antibiotic resistance with minor modifications.

关键词： thereby operations consuming

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