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Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

International Journal of Clinical Medicine 2016年第5期7卷 320-333页

作者： Ling Antonia Zeng shin yi ng Sze ying Thong Department of Anaesthesia Singapore General Hospital Singapore City Singapore

Introduction: Critical incident monitoring is important in quality improvement as it identifies potential risks to patients by analyzing adverse events or near-misses. Methods: This study analyses the reported incidents in a tertiary hospital over a 4-year period. Results: A total of 441 incidents were reported out of 98,502 anesthetics performed during the study period. Of these incidents, 67 resulted in no harm caused, 116 with unanticipated ICU admissions and 20 mortalities. The odds of having a critical incident increased with ASA status: from an odds ratio of 2.08 (95% CI: 1.58 to 2.74) for ASA 2 patients compared to ASA1, to OR of 13.70 (5.91 to 31.74) in ASA 5 compared to ASA 1. Critical incidents also have higher odds occurring out of hours (OR 1.7 (1.45 to 2.23) compared to daytime hours (08:00-17:00). They occurred most commonly in maintenance phase (142, 32.7%), followed by induction (120, 27.6%). The most common types of incidents include airway and respiratory (110, 24.9%) followed by drug related incidents (67, 15.2%). Human error was attributed as a significant contributing factor in 276 incidents (61.5%) followed by patient factors in 112 incidents (25.4%). Mitigating factors such as vigilance by staff involved were significant in 136 incidents (30.3%). Conclusion: Higher ASA status appears to be the most important factor associated with actual or potential patient harm in our study. Also significant, was time of incident, with incidents more likely out of hours. Critical incident reporting is a valuable part of quality assurance. We should continue to invest in incident reporting, incident analysis and improvement plans.

关键词： Critical Incidents Anaesthesia Patient Safety Human Error Complications

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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

To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis 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 χ2 test or Fisher’s exact test, as applicable. RESULTSAll 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 locally 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 procedura

关键词： Colorectal cancer Advanced pelvic tumour Sacrectomy Oncological outcome Pelvic exenteration Chordoma

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Dysfunction of synaptic endocytic trafficking in Parkinson's disease

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Neural Regeneration Research 2024年第12期19卷 2649-2660页

作者： Xin yi ng Mian Cao Programme in Neuroscience and Behavioural Disorders Duke-NUS Medical SchoolSingaporeSingapore Department of Physiology National University of SingaporeSingaporeSingapore

Parkinson's disease is characterized by the selective degeneration of dopamine neurons in the nigrostriatal pathway and dopamine deficiency in the *** precise reasons behind the specific degeneration of these dopamine neurons remain largely *** investigations have identified over 20 causative PARK genes and 90 genomic risk loci associated with both familial and sporadic Parkinson's ***,several of these genes are linked to the synaptic vesicle recycling process,particularly the clathrinmediated endocytosis *** suggests that impaired synaptic vesicle recycling might represent an early feature of Parkinson's disease,followed by axonal degeneration and the eventual loss of dopamine cell bodies in the midbrain via a"dying back"***,several new animal and cellular models with Parkinson's disease-linked mutations affecting the endocytic pathway have been created and extensively *** models faithfully recapitulate certain Parkinson's disease-like features at the animal,circuit,and cellular levels,and exhibit defects in synaptic membrane trafficking,further supporting the findings from human genetics and clinical *** this review,we will first summarize the cellular and molecular findings from the models of two Parkinson's disease-linked clathrin uncoating proteins:auxilin(DNAJC6/PARK19)and synaptojanin 1(SYNJ1/PARK20).The mouse models carrying these two PARK gene mutations phenocopy each other with specific dopamine terminal pathology and display a potent synergistic ***,we will delve into the involvement of several clathrin-mediated endocytosis-related proteins(GAK,endophilin A1,SAC2/INPP5 F,synaptotagmin-11),identified as Parkinson's disease risk factors through genome-wide association studies,in Parkinson's disease *** will also explore the direct or indirect roles of some common Parkinson's disease-linked proteins(alpha-synuclein(PARK1/4),Parkin(PARK2),and LRRK2(PARK

关键词： autophagy auxilin/PARK19 clathrin-mediated endocytosis dopamine neurons neurodegeneration nigrostriatal pathway Parkinson's disease synaptic vesicle recycling synaptojanin1/PARK20

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NADPH oxidase 4(NOX4)as a biomarker and therapeutic target in neurodegenerative diseases

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Neural Regeneration Research 2024年第9期19卷 1961-1966页

作者： Napissara Boonpraman Sun shin yi BK21 four Program Department of Medical SciencesSoonchunhyang UniversityAsanSouth Korea Department of Biomedical Laboratory Science Soonchunhyang UniversityAsanSouth Korea iConnectome Co.Ltd.CheonanSouth Korea

Diseases like Alzheimer’s and Parkinson’s diseases are defined by inflammation and the damage neurons undergo due to oxidative stress. A primary reactive oxygen species contributor in the central nervous system, NADPH oxidase 4, is viewed as a potential therapeutic touchstone and indicative marker for these ailments. This in-depth review brings to light distinct features of NADPH oxidase 4, responsible for generating superoxide and hydrogen peroxide, emphasizing its pivotal role in activating glial cells, inciting inflammation, and disturbing neuronal functions. Significantly, malfunctioning astrocytes, forming the majority in the central nervous system, play a part in advancing neurodegenerative diseases, due to their reactive oxygen species and inflammatory factor secretion. Our study reveals that aiming at NADPH oxidase 4 within astrocytes could be a viable treatment pathway to reduce oxidative damage and halt neurodegenerative processes. Adjusting NADPH oxidase 4 activity might influence the neuroinflammatory cytokine levels, including myeloperoxidase and osteopontin, offering better prospects for conditions like Alzheimer’s disease and Parkinson’s disease. This review sheds light on the role of NADPH oxidase 4 in neural degeneration, emphasizing its drug target potential, and paving the path for novel treatment approaches to combat these severe conditions.

关键词： Alzheimer’s disease astrocytes mitochondrial dysfunction myeloperoxidase NADPH oxidase 4 NADPH oxidase 4 inhibitors neurodegenerative diseases osteopontin Parkinson’s disease reactive oxygen species

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Visual attention and clustering-based automatic selection of landmarks using single camera

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Journal of Central South University 2014年第9期21卷 3525-3533页

作者： CHUHO yi YOngMIN shin JUngWON Cho Future IT R&D Lab LG Electronics Home Appliance R&D Lab LG ElectronicsSeoul 153721 Korea Department of Computer Education Jeju National University Department of Mathematics and Computer Science Salisbury University

An improved method with better selection capability using a single camera was presented in comparison with previous method. To improve performance, two methods were applied to landmark selection in an unfamiliar indoor environment. First, a modified visual attention method was proposed to automatically select a candidate region as a more useful landmark. In visual attention, candidate landmark regions were selected with different characteristics of ambient color and intensity in the image. Then, the more useful landmarks were selected by combining the candidate regions using clustering. As generally implemented, automatic landmark selection by vision-based simultaneous localization and mapping(SLAM) results in many useless landmarks, because the features of images are distinguished from the surrounding environment but detected repeatedly. These useless landmarks create a serious problem for the SLAM system because they complicate data association. To address this, a method was proposed in which the robot initially collected landmarks through automatic detection while traversing the entire area where the robot performed SLAM, and then, the robot selected only those landmarks that exhibited high rarity through clustering, which enhanced the system performance. Experimental results show that this method of automatic landmark selection results in selection of a high-rarity landmark. The average error of the performance of SLAM decreases 52% compared with conventional methods and the accuracy of data associations increases.

关键词： simultaneous localization and mapping automatic landmark selection visual attention clustering

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MODIFIED NEWTON＇S ALGORITHM FOR COMPUTIng THE GROUP INVERSES OF SIngULAR TOEPLITZ MATRICES

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Journal of Computational Mathematics 2006年第5期24卷 647-656页

作者： Jian-feng Cai Michael K. ng yi-min Wei Department of Mathematics The Chinese University of Hong Kong Hong Kong Department of Mathematics Hong Kong Baptist University Hong Kong School of Mathematical Sciences Fudan University Shanghai 200433 China ~ Key Laboratory of Mathematics for Nonlinear Sciences (Fudan University) Ministry of Education

Newton＇s iteration is modified for the computation of the group inverses of singular Toeplitz matrices. At each iteration, the iteration matrix is approximated by a matrix with a low displacement rank. Because of the displacement structure of the iteration matrix, the matrix-vector multiplication involved in Newton＇s iteration can be done efficiently. We show that the convergence of the modified Newton iteration is still very fast. Numerical results are presented to demonstrate the fast convergence of the proposed method.

关键词： Newton's iteration Group inverse Toeplitz matrix Displacement rank.

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Carbonyl compounds in dining areas,kitchens and exhaust streams in restaurants with varying cooking methods in Kaohsiung,Taiwan

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Journal of Environmental Sciences 2016年第3期28卷 218-226页

作者： Jen-Hsuan Cheng yi-Shiun Lee Kang-shin Chen Institute of Environmental Engineering "National" Sun Yat-Sen University

Eighteen carbonyl species in C_1-C_（10） were measured in the dining areas,kitchens and exhaust streams of six different restaurant types in Kaohsiung,southern *** results in the dining areas show that Japanese barbecue（45.06 ppb） had the highest total carbonyl concentrations（sum of 18 compounds）,followed by Chinese hotpot（38.21 ppb）,Chinese stir-frying（8.99 ppb）,Western fast-food（8.22 ppb）,Chinese-Western mixed style（7.38 ppb）,and Chinese buffet（3.08 ppb）,due to their different arrangements for dining and cooking spaces and different cooking *** average,low carbon-containing species（C_1-C_4）,e.g.,formaldehyde,acetaldehyde,acetone and butyraldehyde were dominant and contributed 55.01%-94.52%of total carbonyls in the dining areas of all ***,Chinese-Western mixed restaurants（45.48 ppb） had high total carbonyl concentrations in kitchens mainly because of its small kitchen and poor ***,high carbon-containing species（C_5-C_（10）） such as hexaldehyde,heptaldehyde and nonanaldehyde（16.62%-77.00%of total carbonyls） contributed comparatively with low carbon-containing compounds（23.01%-83.39%of total carbonyls） in ***,Chinese stir-frying（132.10 ppb）,Japanese barbecue（125.62 ppb）,Western fast-food（122.67 ppb）,and Chinese buffet（119.96 ppb） were the four restaurant types with the highest total carbonyl concentrations in exhaust streams,indicating that stir-frying and grilling are inclined to produce polluted *** risk assessments indicate that Chinese hotpot and Japanese barbecue exceeded the limits of cancer risk（10^（-6）） and hazard index（=1）,mainly due to high concentrations of *** other four restaurants were below both limits.

关键词： Carbonyl compounds Restaurant Exhaust stream Health effect

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Ringing cancellation in Carr-Purcell-Meiboom-Gill-type sequences

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Magnetic Resonance Letters 2022年第4期2卷 233-242页

作者： shin Utsuzawa Marcus Donaldson yi-Qiao Song Schlumberger-Doll Research CambridgeMA02139USA John A.Paulson School of Engineering and Applied Sciences Harvard UniversityCambridgeMA02138USA Athinoula A.Martinos Center for Biomedical Imaging Department of RadiologyMassachusetts General HospitalCharlestownMA02129USA

We propose a four-step phase cycling scheme that can cancel ringings from both the excitation and the refocusing pulses in Carr-Purcell-Meiboom-Gill(CPMG)*** allows accurate measurements of the first echo with short echo spacing tE,yielding improved precision of porosity,permeability,and fluid type identification in porous media study,at a cost of~25%signal *** our example,we achieved tE=100 ms on a 6.8 MHz unilateral NMR sensor without using a *** methods can be integrated in all nuclear magnetic resonance(NMR)protocols using CPMG,such as relaxation(T1,T2)and diffusion measurements,and do not require additional hardware(e.g.,Qswitches)to cancel ringing(although it can be used with a Q-switch to further reduce residual ringing).

关键词： CPMG Ringing cancellation Phase cycling

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Achromatic diffractive liquid-crystal optics for virtual reality displays

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Light(Science & Applications) 2023年第10期12卷 2215-2227页

作者： Zhenyi Luo Yannanqi Li John Semmen yi Rao shin-Tson Wu College of Optics and Photonics University of Central FloridaOrlandoFL 32816USA Goertek Electronics 5451 Great America ParkwaySuite 301Santa ClaraCA 95054USA

Diffractive liquid-crystal optics is a promising optical element for virtual reality(VR)and mixed reality as it provides an ultrathin formfactor and lightweight for human factors and ***,its severe chromatic aberrations impose a big challenge for full-color display *** this study,we demonstrate an achromatic diffractive liquid-crystal device to overcome this longstanding chromatic aberration *** proposed device consists of three stacked diffractive liquid crystal optical elements with specifically designed spectral response and polarization *** concept is validated by both simulations and *** experimental results show a significant improvement in imaging performance with two types of light engines:a laser projector and an organic light-emitting diode display *** addition,our simulation results indicate that the lateral color shift is reduced by~100 times in comparison with conventional broadband diffractive liquid-crystal *** applications for VR-enabled metaverse,spatial computing,and digital twins that have found widespread applications in smart tourism,smart education,smart healthcare,smart manufacturing,and smart construction are foreseeable.

关键词： crystal optics chromatic

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Noise robustness of an operational modal-based structural damage-detection scheme using impact-synchronous modal analysis

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Journal of Zhejiang University-Science A(Applied Physics & Engineering) 2023年第9期24卷 782-800页

作者： Pei yi SIOW Zhi Chao Ong shin Yee KHOO Kok-Sing LIM Department of Mechanical Engineering Faculty of EngineeringUniversiti MalayaKuala Lumpur 50603Malaysia Photonics Research Centre Deputy Vice Chancellor(Research and Innovation)OfficeUniversiti MalayaKuala Lumpur 50603Malaysia

Data-driven damage-detection schemes are usually unsupervised machine-learning models in practice,as these do not require any ***-based features are commonly used in these schemes but often require several other parameters to accurately correlate with damage,as they may not globally represent the model,making them less sensitive to *** data,such as frequency response functions(FRFs)and principal component analysis(PCA)reduced FRFs(PCA-FRFs),inherits the dynamic characteristics of the structure,and it changes when damage occurs,thus showing sensitivity to ***,noise from the environment or external sources such as wind,operating machines,or the in-service system itself,can reduce the modal data's sensitivity to damage if not handled properly,which affects damage-detection *** study proposes a noise-robust operational modal-based structural damage-detection scheme that uses impact-synchronous modal analysis(ISMA)to generate clean,static-like FRFs for damage *** allows modal data collection without requiring shutdown conditions,and its denoising feature aids in generating clean,static-like FRFs for damage *** results showed that the FRFs obtained through ISMA under noise conditions have frequency response assurance criterion(FRAC)and cross signature assurance criterion(CSAC)scores greater than 0.9 when compared with FRFs obtained through experimental modal analysis(EMA)under static conditions;this validates the denoising feature of *** the denoised FRFs are reduced to PCA-FRFs and used in an unsupervised learning-based damage-detection scheme,zero false alarms occur.

关键词： Impact-synchronous modal analysis(ISMA) Frequency response function(FRF) Principal component analysis(PCA) Unsupervised learning Damage detection

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