26 results on '"T. Barker"'
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2. Finding Pluto: An Analytics-Based Approach to Safety Data Ecosystems
- Author
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Thomas T. Barker
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big data ,data science ,safety ,Public aspects of medicine ,RA1-1270 - Abstract
This review article addresses the role of safety professionals in the diffusion strategies for predictive analytics for safety performance. The article explores the models, definitions, roles, and relationships of safety professionals in knowledge application, access, management, and leadership in safety analytics. The article addresses challenges safety professionals face when integrating safety analytics in organizational settings in four operations areas: application, technology, management, and strategy. A review of existing conventional safety data sources (safety data, internal data, external data, and context data) is briefly summarized as a baseline. For each of these data sources, the article points out how emerging analytic data sources (such as Industry 4.0 and the Internet of Things) broaden and challenge the scope of work and operational roles throughout an organization. In doing so, the article defines four perspectives on the integration of predictive analytics into organizational safety practice: the programmatic perspective, the technological perspective, the sociocultural perspective, and knowledge-organization perspective. The article posits a four-level, organizational knowledge-skills-abilities matrix for analytics integration, indicating key organizational capacities needed for each area. The work shows the benefits of organizational alignment, clear stakeholder categorization, and the ability to predict future safety performance.
- Published
- 2021
- Full Text
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3. Animal-Assisted Interventions in Hospitals
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Randolph T. Barker and Sandra B. Barker
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medicine.medical_specialty ,business.industry ,Animal assisted interventions ,medicine ,Intensive care medicine ,business - Published
- 2019
4. List of Contributors
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Maryam M. Abdullah, Barbara Abrams, Julie D. Albright, Phil Arkow, Randolph T. Barker, Sandra B. Barker, Alan M. Beck, Andrea Beetz, Jessica L. Bibbo, Klaus Peter Biermann, Annika Bremhorst, Regina M. Bures, Gretchen Carlisle, Molly K. Crossman, Renate Deimel, Erica Elvove, Marie-Jose Enders-Slegers, Layla Esposito, Tracie Faa-Thompson, Steven Feldman, Aubrey H. Fine, Patricia Flaherty Fischette, Lisa M. Freeman, Erika Friedmann, Robin Gabriels, Nancy R. Gee, Ken Gorczyca, Temple Grandin, James A. Griffin, Sophie Hall, Lynette A. Hart, Lynette Harvey, Karin Hediger, Harold Herzog, Karyl J. Hurley, Brinda Jegatheesan, Molly Anne Jenkins, Amy Johnson, Rebecca A. Johnson, Michael Kaufman, Alan E. Kazdin, Greta Kerulo, Miyako Kinoshita, Katherine A. Kruger, Kimberley D. Lakes, Donna Latella, Deborah E. Linder, John L. Lipp, Maureen MacNamara, Patricia McConnell, Sandra McCune, Lindsey Melfi, Gail F. Melson, Daniel Mills, Jeannine Moga, Kevin N. Morris, Megan Kiely Mueller, Francesca Mugnai, Zenithson Y. Ng, Karen Ni, Marguerite E. O’Haire, Meg Daley Olmert, Christopher Pachel, Nancy Parish-Plass, Patricia Pendry, Jose M. Peralta, Ashley R. Prokopiak, Jennifer Rogers, Kaushik Roy, Sabrina E.B. Schuck, James A. Serpell, Philip Tedeschi, Dennis Turner, Risë VanFleet, Melissa Y. Winkle, Mariko Yamamoto, Rick A. Yount, and Roswitha Zink
- Published
- 2019
5. Reducing the sensation of electrical stimulation with dry electrodes by using an array of constant current sources
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Martin Slovak, Cassandra D Solomons, Anthony T. Barker, and Ben Heller
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Male ,030506 rehabilitation ,Resistive touchscreen ,Materials science ,Current distribution ,Electric Conductivity ,Sensation ,Biomedical Engineering ,Biophysics ,Stimulation ,Equipment Design ,Electric Stimulation ,03 medical and health sciences ,0302 clinical medicine ,Electrode ,Humans ,Constant current ,Female ,Hogging ,Current (fluid) ,0305 other medical science ,Electrodes ,030217 neurology & neurosurgery ,Biomedical engineering - Abstract
Hydrogel electrodes are commonly used for functional and other electrical stimulation applications since the hydrogel layer has been shown to considerably reduce the perception of stimulation compared to dry electrodes. However, these hydrogel electrodes must be changed regularly as they dry out or become contaminated with skin cells and sweat products, thus losing their adhesiveness and resistive properties. Dry electrodes are longer lasting but are more uncomfortable due to unequal current distribution (current hogging). We hypothesise that if current through a dry electrode is equally shared amongst an array of small sub-electrodes, current hogging and thus the sensitivity perceived due to stimulation will be reduced. We constructed an 8 × 8 array of millimetre sized dry electrodes that could either be activated as individual current sources, or together as one large source. A study was performed with 13 participants to investigate the differences in sensation between the two modes of operation. The results showed that 12 out of 13 participants found the new (distributed-constant-current) approach allowed higher stimulation for the same sensation. The differences in sensation between single and multiple sources became larger with higher intensity levels.
- Published
- 2017
6. A review of the design and clinical evaluation of the ShefStim array-based functional electrical stimulation system
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Anmin Liu, Jamie Healey, Mark L. Reeves, Laurence Kenney, Anthony T. Barker, Sarah Prenton, David Howard, Tim Good, Ning Sha, Glen Cooper, and Ben Heller
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Male ,030506 rehabilitation ,Foot drop ,Engineering ,0206 medical engineering ,Biomedical Engineering ,Biophysics ,Electric Stimulation Therapy ,02 engineering and technology ,RT ,03 medical and health sciences ,Search algorithm ,Electrode array ,medicine ,Electronic engineering ,Humans ,Functional electrical stimulation ,Electrodes ,Gait Disorders, Neurologic ,Simulation ,Aged ,business.industry ,Iterative learning control ,Equipment Design ,Middle Aged ,020601 biomedical engineering ,R1 ,Proof of concept ,Feasibility Studies ,Systems design ,Female ,medicine.symptom ,0305 other medical science ,Engineering design process ,business - Abstract
Functional electrical stimulation has been shown to be a safe and effective means of correcting foot 12 drop of central neurological origin. Current surface-based devices typically consist of a single channel stimulator, 13 a sensor for determining gait phase and a cuff, within which is housed the anode and cathode. The cuff-mounted 14 electrode design reduces the likelihood of large errors in electrode placement, but the user is still fully responsible 15 for selecting the correct stimulation level each time the system is donned. Researchers have investigated different 16 approaches to automating aspects of setup and/or use, including recent promising work based on iterative learning 17 techniques. This paper reports on the design and clinical evaluation of an electrode array-based FES system for 18 the correction of drop foot, ShefStim. The paper reviews the design process from proof of concept lab-based study, 19 through modelling of the array geometry and interface layer to array search algorithm development. Finally, the 20 paper summarises two clinical studies involving patients with drop foot. The results suggest that the ShefStim 21 system with automated setup produces results which are comparable with clinician setup of conventional systems. 22 Further, the final study demonstrated that patients can use the system without clinical supervision. When used 23 unsupervised, setup time was 14 minutes (9 minutes for automated search plus 5 minutes for donning the 24 equipment), although this figure could be reduced significantly with relatively minor changes to the design.
- Published
- 2016
7. Feasibility study of a take-home array-based functional electrical stimulation system with automated setup for current functional electrical stimulation users with foot-drop
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Mark L. Reeves, Sarah Prenton, Tracey Williamson, Laurence Kenney, David Howard, Tim Good, Ben Heller, Sibylle B. Thies, Glen Cooper, Jamie Healey, Claire Stapleton, Mohammad Sobuh, and Anthony T. Barker
- Subjects
Adult ,Male ,RM ,Foot drop ,medicine.medical_specialty ,Time Factors ,Computer science ,Electrical stimulator ,Monitoring, Ambulatory ,Physical Therapy, Sports Therapy and Rehabilitation ,Electric Stimulation Therapy ,Walking ,Physical medicine and rehabilitation ,Gait (human) ,Assistive technology ,medicine ,Functional electrical stimulation ,Humans ,Electrodes ,Gait ,Gait Disorders, Neurologic ,Aged ,Rehabilitation ,Outcome measures ,health_and_wellbeing ,Swing ,Middle Aged ,R1 ,Preferred walking speed ,Self Care ,Patient Satisfaction ,Feasibility Studies ,Equipment Failure ,Female ,medicine.symptom ,Ankle Joint - Abstract
Objective\ud \ud To investigate the feasibility of unsupervised community use of an array-based automated setup functional electrical stimulator for current foot-drop functional electrical stimulation (FES) users.\ud \ud Design\ud \ud Feasibility study.\ud \ud Setting\ud \ud Gait laboratory and community use.\ud \ud Participants\ud \ud Participants (N=7) with diagnosis of unilateral foot-drop of central neurologic origin (>6mo) who were regular users of a foot-drop FES system (>3mo).\ud \ud Intervention\ud \ud Array-based automated setup FES system for foot-drop (ShefStim).\ud \ud Main Outcome Measures\ud \ud Logged usage, logged automated setup times for the array-based automated setup FES system and diary recording of problems experienced, all collected in the community environment. Walking speed, ankle angles at initial contact, foot clearance during swing, and the Quebec User Evaluation of Satisfaction with Assistive Technology version 2.0 (QUEST version 2.0) questionnaire, all collected in the gait laboratory.\ud \ud Results\ud \ud All participants were able to use the array-based automated setup FES system. Total setup time took longer than participants' own FES systems, and automated setup time was longer than in a previous study of a similar system. Some problems were experienced, but overall, participants were as satisfied with this system as their own FES system. The increase in walking speed (N=7) relative to no stimulation was comparable between both systems, and appropriate ankle angles at initial contact (N=7) and foot clearance during swing (n=5) were greater with the array-based automated setup FES system.\ud \ud Conclusions\ud \ud This study demonstrates that an array-based automated setup FES system for foot-drop can be successfully used unsupervised. Despite setup's taking longer and some problems, users are satisfied with the system and it would appear as effective, if not better, at addressing the foot-drop impairment. Further product development of this unique system, followed by a larger-scale and longer-term study, is required before firm conclusions about its efficacy can be reached.
- Published
- 2014
8. Contribution of the primary and supplementary motor cortices to sensorimotor synchronization: a TMS study
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Anthony T. Barker, Kwang-Hyuk Lee, Peter W.R. Woodruff, and Janine D. Bijsterbosch
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Computer science ,General Neuroscience ,Synchronization (computer science) ,Biophysics ,Neurology (clinical) ,Neuroscience ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,lcsh:RC321-571 - Published
- 2008
9. The role of the cerebellum in error correction during rhythmic finger movements: a transcranial magnetic stimulation study
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Sudheer T. Lankappa, Kwang-Hyuk Lee, Peter W.R. Woodruff, Anthony T. Barker, Janine D. Bijsterbosch, and D.T. Tsoi
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Cerebellum ,business.industry ,General Neuroscience ,medicine.medical_treatment ,Biophysics ,lcsh:RC321-571 ,Transcranial magnetic stimulation ,Finger movement ,Rhythm ,medicine.anatomical_structure ,Medicine ,Neurology (clinical) ,business ,Error detection and correction ,Neuroscience ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry - Published
- 2008
10. Documentation for Software and IS Development
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Thomas T. Barker
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Documentation ,Software ,Development (topology) ,business.industry ,Computer science ,Software engineering ,business - Published
- 2003
11. HERMES: A MACROSECTORAL MODEL FOR THE UK ECONOMY
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I. Stern, R. Van Der Putten, and T. Barker
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Set (abstract data type) ,Equilibrium level ,Economy ,media_common.quotation_subject ,Value (economics) ,Wage ,Economics ,Wage equation ,Production (economics) ,Term (time) ,Standard model (cryptography) ,media_common - Abstract
Publisher Summary This chapter discusses a Hermes macrosectoral model for the UK economy. The HERMES-UK model was constructed by Cambridge Econometrics along the lines set out for the standard model used as a basis for all the national models. The dynamic properties of the model were examined in several studies undertaken in cooperation with the European Commission. The HERMES-UK putty-clay production block for the manufacturing sectors largely follows the specification of Italianer. The wage equations adopted in the HERMES-UK model are similar to the one proposed in d’Alcantara and Italianer. The main difference is that the HERMES-UK wage equation has an error correction mechanism where the long term equilibrium level is determined by the share of wages in value added, rather than a partial adjustment mechanism. The import equations in HERMES-UK are slightly different from the specification in d’Alcantara and Italianer.
- Published
- 1993
12. DISAGGREGATED MODEL-BUILDING USING THE IDIOM SOFTWARE SYSTEM
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T. Barker and W. Peterson
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Structure (mathematical logic) ,Econometric model ,Computer science ,Econometrics ,Construct (python library) ,Software system ,Model building ,Session (web analytics) ,Supply and demand - Abstract
In this paper we describe how we have used the IDIOM software system, outlined in a paper presented to the Modelling Languages session of the Third SEDC conference, to construct a large disaggregated model of the UK economy. This model, MDM5, is based on an accounting structure which is expressed in terms of balance equations for 40 distinct commodities. Individual components of demand and supply, and the behaviour of households, firms and institutions are explained by a combination of input-output techniques and econometric relationships estimated using time-series data. The aim of the paper is to illustrate how the use of a purpose-built economic software system can simplify the construction of a large econometric model with more than 8000 endogenous variables of which over 1000 are explained by stochastic equations. The paper discusses the features of the software system which allow it to implement a model of this size in a computationally efficient way.
- Published
- 1984
13. Application of phylodynamics to identify spread of antimicrobial-resistant Escherichia coli between humans and canines in an urban environment.
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Walas N, Müller NF, Parker E, Henderson A, Capone D, Brown J, Barker T, and Graham JP
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- Animals, Humans, Dogs, Escherichia coli, Bayes Theorem, Anti-Bacterial Agents pharmacology, Drug Resistance, Bacterial genetics, Escherichia coli Infections epidemiology, Anti-Infective Agents
- Abstract
The transmission of antimicrobial resistant bacteria in the urban environment is poorly understood. We utilized genomic sequencing and phylogenetics to characterize the transmission dynamics of antimicrobial resistant Escherichia coli (AMR-Ec) cultured from putative canine (canine
p ) and human feces present on urban sidewalks in San Francisco, California. We isolated a total of fifty-six AMR-Ec isolates from human (n = 20) and caninep (n = 36) fecal samples from the Tenderloin and South of Market (SoMa) neighborhoods of San Francisco. We then analyzed phenotypic and genotypic antimicrobial resistance (AMR) of the isolates, as well as clonal relationships based on cgMLST and single nucleotide polymorphisms (SNPs) of the core genomes. Using Bayesian inference, we reconstructed the transmission dynamics between humans and caninesp from multiple local outbreak clusters using the marginal structured coalescent approximation (MASCOT). Our results provide evidence for multiple sharing events of AMR-Ec between humans and caninesp . In particular, we found one instance of likely transmission from caninesp to humans as well as an additional local outbreak cluster consisting of one caninep and one human sample. Based on this analysis, it appears that non-human feces act as an important reservoir of clinically relevant AMR-Ec within the urban environment for this study population. This work showcases the utility of genomic epidemiology to reconstruct potential pathways by which antimicrobial resistance spreads., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)- Published
- 2024
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14. Using PROGRESS-plus to identify current approaches to the collection and reporting of equity-relevant data: a scoping review.
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Karran EL, Cashin AG, Barker T, Boyd MA, Chiarotto A, Dewidar O, Mohabir V, Petkovic J, Sharma S, Tejani S, Tugwell P, and Moseley GL
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- Humans, Educational Status, Social Class
- Abstract
Objectives: Our objectives were to identify what and how data relating to the social determinants of health are collected and reported in equity-relevant studies and map these data to the PROGRESS-Plus framework., Study Design and Setting: We performed a scoping review. We ran two systematic searches of MEDLINE and Embase for equity-relevant studies published during 2021. We included studies in any language without limitations to participant characteristics. Included studies were required to have collected and reported at least two participant variables relevant to evaluating individual-level social determinants of health. We applied the PROGRESS-Plus framework to identify and organize these data., Results: We extracted data from 200 equity-relevant studies, providing 962 items defined by PROGRESS-Plus. A median of 4 (interquartile range = 2) PROGRESS-Plus items were reported in the included studies. 92% of studies reported age; 78% reported sex/gender; 65% reported educational attainment; 49% reported socioeconomic status; 45% reported race; 44% reported social capital; 33% reported occupation; 14% reported place and 9% reported religion., Conclusion: Our synthesis demonstrated that researchers currently collect a limited range of equity-relevant data, but usefully provides a range of examples spanning PROGRESS-Plus to inform the development of improved, standardized practices., Competing Interests: Declaration of competing interest E.L.K. has received speaker fees for lectures on pain and rehabilitation from professional and scientific bodies and reimbursement of travel costs related to presentations at scientific conferences/symposia. G.L.M. has received support from Reality Health, ConnectHealth UK, Institutes of Health California, AIA Australia, Workers’ Compensation Boards and professional sporting organisations in Australia, Europe, South America, and North America. Professional and scientific bodies have reimbursed him for travel costs related to presentation of research on pain and pain education at scientific conferences/symposia. He has received speaker fees for lectures on pain, pain education, and rehabilitation and conference travel support from Sequirus. He receives royalties for books on pain and pain education. P.T. has received consulting fees to provide independent medical consultation and professional services. He is an independent Committee Member for clinical trial Data Safety Monitoring Boards for FDA-approved trials being conducted by UCB Biopharma GmbH & SPRL, Parexel International, and Prahealth Sciences. P.T. is an [unpaid] Chair of the Management Subcommittee of the Executive Committee of a registered non-profit independent medical research organization, OMERACT. OMERACT receives unrestricted educational grants from the American College of Rheumatology, European League of Rheumatology, and several pharmaceutical companies listed in this section, which is used to support fellows and international patient groups and support a major international bi-annual conference which results in many peer-reviewed publications. There are no competing interests for any other author., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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15. Clinical outcomes and resource utilisation in patients with major burns treated with NovoSorb® BTM.
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Betar N, Maher D, Wheatley L, Barker T, and Brown J
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- Adult, Humans, Male, Female, Retrospective Studies, Length of Stay, Cadaver, Skin Transplantation, Burns surgery
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Introduction: Patients with major burns can undergo temporary coverage while skin graft donor sites heal, where dermal templates have an emerging role. The aim of this study was to evaluate the clinical outcomes and resource utilisation in patients with major burns treated with a bilayer biodegradable synthetic matrix (NovoSorb BTM)., Method: This retrospective cohort study included patients admitted to the Royal Brisbane and Women's Hospital Adult Burn Unit with burns to at least 40 % TBSA who survived their acute admission. Patients treated from July 2017 to June 2022 with BTM were compared with patients with similar injuries treated using cadaveric allograft as temporising full thickness wound coverage between January 2013 and June 2017. Outcomes measures included number of operations, total operative time, hospital and intensive care unit (ICU) length of stay (LOS), cadaveric allograft and BTM use, and blood product use. Unadjusted comparisons were made with Wilcoxon Rank-Sum tests and Fisher's exact tests. Multivariate linear regression was used to adjust for the effect of TBSA on each outcome., Results: Fifty-five patients were included (78 % male), 22 of whom were treated with BTM. We found no significant differences in age, sex, or TBSA between groups. One patient had half of the BTM removed due to infection and replaced with allograft. Patients treated with BTM had significantly less operative theatre time (median 1361.5 min [BTM] vs 1768 min [no BTM], P = 0.044). Number of operations, allograft use, hospital and ICU LOS, and blood product use were similar between groups. Adjusted models accounting for TBSA supported unadjusted models., Conclusion: Resource utilisation and clinical outcomes were similar in patients with at least 40 % TBSA treated with BTM and those who were treated with allograft before the introduction of BTM. Patients treated with BTM had significantly less total operative time and no difference in number of operations, allograft use and ICU LOS., Competing Interests: Declarations of interest Timothy Barker is an employee of PolyNovo Biomaterials Pty Ltd., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2023
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16. Arthroscopic Assisted, Lateral Ligament Reconstruction with Suture Tape Augmentation and Knotless All Suture Anchors: A Technique Guide.
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Pettit DP, Munjal V, Alvarez PM, Barker T, and Martin KD
- Abstract
More than 30,000 ankle sprains occur each day in the United States, and the majority of ankle sprains involve the anterior talofibular ligament. Up to 30% of patients develop functional ankle instability and chronic pain after a severe ankle sprain. When nonoperative measures are unsuccessful, operative reconstruction of the lateral ankle ligaments is recommended. To further strengthen the repair, accelerate rehabilitation, and allow for a quicker return to sport, augmentation with suture tape has recently become an alternative among surgeons in the reconstruction of the lateral ankle ligaments. Moreover, the advent of knotless all-suture anchors decreases the number of knots required in the procedure and, in theory, reduces lateral soft tissue irritation and accentuates recovery after surgery. Here we present our technique for arthroscopic assisted, lateral ligament reconstruction with suture tape augmentation and knotless all suture anchors., (© 2023 The Authors.)
- Published
- 2023
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17. Familial Clustering and Genetic Analysis of Severe Thumb Carpometacarpal Joint Osteoarthritis in a Large Statewide Cohort.
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Gavile CM, Kazmers NH, Novak KA, Meeks HD, Yu Z, Thomas JL, Hansen C, Barker T, and Jurynec MJ
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- Chondroitin Sulfates, Cluster Analysis, Female, Genetic Predisposition to Disease, Humans, Thumb, Carpometacarpal Joints surgery, Osteoarthritis epidemiology
- Abstract
Purpose: Our goals were to identify individuals who required surgery for thumb carpometacarpal (CMC) joint osteoarthritis (OA), determine if CMC joint OA clusters in families, define the magnitude of familial risk of CMC joint OA, identify risk factors associated with CMC joint OA, and identify rare genetic variants that segregate with familial CMC joint OA., Methods: We searched the Utah Population Database to identify a cohort of CMC joint OA patients who required surgery. Affected individuals were mapped to pedigrees to identify high-risk families with excess clustering of CMC joint OA. Cox regression models were used to calculate familial risk of CMC joint OA in related individuals. Risk factors were evaluated using logistic regression models. Whole exome sequencing was used to identify rare coding variants associated with familial CMC joint OA., Results: We identified 550 pedigrees with excess clustering of severe CMC joint OA. The relative risk of CMC joint OA requiring surgical treatment was elevated significantly in first- and third-degree relatives of affected individuals, and significant associations with advanced age, female sex, obesity, and tobacco use were observed. We discovered candidate genes that dominantly segregate with severe CMC joint OA in 4 independent families, including a rare variant in Chondroitin Sulfate Synthase 3 (CHSY3)., Conclusions: Familial clustering of severe CMC joint OA was observed in a statewide population. Our data indicate that genetic and environmental factors contribute to the disease process, further highlighting the multifactorial nature of the disease. Genomic analyses suggest distinct biological processes are involved in CMC joint OA pathogenesis., Clinical Relevance: Awareness of associated comorbidities may guide the diagnosis of CMC joint OA in at-risk populations and help identify individuals who may not do well with nonoperative treatment. Further pursuit of the genes associated with severe CMC joint OA may lead to assays for detection of early stages of disease and have therapeutic potential., (Copyright © 2022. Published by Elsevier Inc.)
- Published
- 2022
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18. Evaluation for Kienböck Disease Familial Clustering: A Population-Based Cohort Study.
- Author
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Kazmers NH, Yu Z, Barker T, Abraham T, Romero R, and Jurynec MJ
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- Cluster Analysis, Cohort Studies, Humans, Risk Factors, Utah epidemiology, Genetic Predisposition to Disease, Osteonecrosis epidemiology, Osteonecrosis genetics
- Abstract
Purpose: Kienböck disease (KD) is rare and its etiology remains unknown. As a result, the ideal treatment is also in question. Our primary purpose was to test the hypothesis that KD would demonstrate familial clustering in a large statewide population with comprehensive genealogical records, possibly suggesting a genetic etiologic contribution. Our secondary purpose was to evaluate for associations between KD and known risk factors for avascular necrosis., Methods: Patients diagnosed with KD were identified by searching medical records from a comprehensive statewide database, the Utah Population Database. This database contains pedigrees dating back to the early 1800s, which are linked to 31 million medical records for 11 million patients from 1996 to the present. Affected individuals were then mapped to pedigrees to identify high-risk families with an increased incidence of KD relative to control pedigrees. The magnitude of familial risk of KD in related individuals was calculated using Cox regression models. Association of risk factors related to KD was analyzed using conditional logistic regression., Results: We identified 394 affected individuals linked to 194 unrelated high-risk pedigrees with increased incidence of KD. The relative risk of developing KD was significantly elevated in first-degree relatives. There was a significant correlation between alcohol, glucocorticoid, and tobacco use and a history of diabetes, and the diagnosis of KD., Conclusions: Familial clustering of KD observed in the Utah Population Database cohort indicates a potential genetic contribution to the etiology of the disease. Identification of causal gene variants in these high-risk families may provide insight into the genes and pathways that contribute to the onset and progression of KD., Clinical Relevance: This study suggests that there is a potential genetic contribution to the etiology of KD and that the disease has a significant association with several risk factors., (Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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19. Antibiotic stewardship in the retail clinic setting: Implementation in 1100 clinics nationwide.
- Author
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Polinski JM, Harmon SL, Henderson KJ, Barker T, Sussman A, and Gagliano NJ
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- Ambulatory Care Facilities statistics & numerical data, Antimicrobial Stewardship statistics & numerical data, Drug Resistance, Microbial drug effects, Humans, Pharmacists statistics & numerical data, Primary Health Care methods, Primary Health Care standards, Primary Health Care statistics & numerical data, Ambulatory Care Facilities standards, Antimicrobial Stewardship methods, Pharmacists standards
- Abstract
In light of increasing antibiotic resistance and a slowed antibiotic development pipeline, stewardship is more urgent than ever. To date, most stewardship guidelines and best practice recommendations for implementation focus on local or regional health care organizations. CVS MinuteClinic has implemented a consistent, evidence-based stewardship approach in its >1100 clinics in 33 states. The approach is associated with higher quality antibiotic use than that in primary care practices and emergency departments. Given MinuteClinic's scale, sharing this approach and lessons learned may assist other organizations in implementing large-scale stewardship programs that foster judicious use of antibiotics for the public's health., (Copyright © 2017. Published by Elsevier Inc.)
- Published
- 2017
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20. Management and closure of the open abdomen after damage control laparotomy for trauma. A systematic review and meta-analysis.
- Author
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Sharrock AE, Barker T, Yuen HM, Rickard R, and Tai N
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- Abdominal Wound Closure Techniques, Fascia, Hernia, Ventral etiology, Humans, Injury Severity Score, Practice Guidelines as Topic, Time Factors, Treatment Outcome, Abdominal Injuries surgery, Fasciotomy, Hernia, Ventral surgery, Laparotomy methods, Negative-Pressure Wound Therapy methods
- Abstract
Introduction: Damage control laparotomy for trauma (DCL) entails immediate control of haemorrhage and contamination, temporary abdominal closure (TAC), a period of physiological stabilisation, then definitive repair of injuries. Although immediate primary fascial closure is desired, fascial retraction and visceral oedema may dictate an alternate approach. Our objectives were to systematically identify and compare methods for restoration of fascial continuity when primary closure is not possible following DCL for trauma, to simplify these into a standardised map, and describe the ideal measures of process and outcome for future studies., Methods: Cochrane, OVID (Medline, AMED, Embase, HMIC) and PubMed databases were accessed using terms: (traum*, damage control, abbreviated laparotomy, component separation, fascial traction, mesh closure, planned ventral hernia (PVH), and topical negative pressure (TNP)). Randomised Controlled Trials, Case Series and Cohort Studies reporting TAC and early definitive closure methods in trauma patients undergoing DCL were included. Outcomes were mortality, days to fascial closure, hospital length of stay, abdominal complications and delayed ventral herniation., Results: 26 studies described and compared early definitive closure methods; delayed primary closure (DPC), component separation (CS) and mesh repair (MR), among patients with an open abdomen after DCL for trauma. A three phase map was developed to describe the temporal and sequential attributes of each technique. Significant heterogeneity in nomenclature, terminology, and reporting of outcomes was identified. Estimates for abdominal complications in DPC, MR and CS groups were 17%, 41% and 17% respectively, while estimates for mortality in DPC and MR groups were 6% and 0.5% (data heterogeneity and requirement of fixed and random effects models prevented significance assessment). Estimates for abdominal closure in the MR and DPC groups differed; 6.30 (95% CI=5.10-7.51), and 15.90 (95% CI=9.22-22.58) days respectively. Reporting poverty prevented subgroup estimate generation for ventral hernia and hospital length of stay., Conclusion: Component separation or mesh repair may be valid alternatives to delayed primary closure following a trauma DCL. Comparisons were hampered by the lack of uniform reporting and bias. We propose a new system of standardised nomenclature and reporting for further investigation and management of the post-DCL open abdomen., (Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2016
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21. Use of pelleted sericea lespedeza (Lespedeza cuneata) for natural control of coccidia and gastrointestinal nematodes in weaned goats.
- Author
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Kommuru DS, Barker T, Desai S, Burke JM, Ramsay A, Mueller-Harvey I, Miller JE, Mosjidis JA, Kamisetti N, and Terrill TH
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- Animal Feed analysis, Animals, Coccidiosis prevention & control, Diarrhea veterinary, Diet veterinary, Feces parasitology, Gastrointestinal Tract parasitology, Goats, Male, Nematode Infections prevention & control, Parasite Egg Count veterinary, Plant Leaves, Weaning, Coccidiosis veterinary, Eimeria drug effects, Goat Diseases prevention & control, Lespedeza, Nematoda drug effects, Nematode Infections veterinary
- Abstract
Infection with Eimeria spp. (coccidia) can be devastating in goats, particularly for young, recently-weaned kids, resulting in diarrhea, dehydration, and even death. Feeding dried sericea lespedeza [SL; Lespedeza cuneata (Dum.-Cours.) G. Don.] to young goats has been reported to reduce the effects of internal parasites, including gastrointestinal nematodes (GIN) but there have been no reports of the effects of feeding this forage on Eimeria spp. in goats. Two confinement feeding experiments were completed on recently-weaned intact bucks (24 Kiko-cross, Exp. 1; 20 Spanish, Exp. 2) to determine effects of SL pellets on an established infection of GIN and coccidia. The bucks were assigned to 1 of 2 (Exp. 1) or 3 (Exp. 2) treatment groups based upon the number of Eimeria spp. oocysts per gram (OPG) of feces. In Exp. 1, the kids were fed 1 of 2 pelleted rations ad libitum; 90% SL leaf meal+10% of a liquid molasses/lignin binder mix and a commercial pellet with 12% crude protein (CP) and 24% acid detergent fiber (n=12/treatment group, 2 animals/pen). For Exp. 2, treatment groups were fed (1) 90% SL leaf meal pellets from leaves stored 3 years (n=7), (2) 90% SL pellets from leaf meal stored less than 6 months, (n=7), and the commercial pellets (n=6) ad libitum. For both trials, fecal and blood samples were taken from individual animals every 7 days for 28 days to determine OPG and GIN eggs per gram (EPG) and packed cell volume (PCV), respectively. In Exp. 2, feces were scored for consistency (1=solid pellets, 5=slurry) as an indicator of coccidiosis. In Exp. 1, EPG (P<0.001) and OPG (P<0.01) were reduced by 78.7% and 96.9%, respectively, 7 days after initiation of feeding in goats on the SL pellet diet compared with animals fed the control pellets. The OPG and EPG remained lower in treatment than control animals until the end of the trial. In Exp. 2, goats fed new and old SL leaf meal pellets had 66.2% and 79.2% lower (P<0.05) EPG and 92.2% and 91.2% lower (P<0.05) OPG, respectively, than control animals within 7 days, and these differences were maintained or increased throughout the trial. After 4 weeks of pellet feeding in Exp. 2, fecal scores were lower (P<0.01) in both SL-fed groups compared with control animals, indicating fewer signs of coccidiosis. There was no effect of diet on PCV values throughout either experiment. Dried, pelleted SL has excellent potential as a natural anti-coccidial feed for weaned goats., (Copyright © 2014 Elsevier B.V. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
22. A comparison of the speed, success rate, and retention of rescue airway devices placed by first-responder emergency medical technicians: a high-fidelity human patient simulation study.
- Author
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Voscopoulos C, Barker T, Listwa T, Nelson S, Pozner C, Liu X, Zane R, and Antoine JA
- Subjects
- Adolescent, Adult, Aged, Clinical Competence, Emergency Medical Technicians education, Female, Humans, Intubation, Intratracheal instrumentation, Male, Middle Aged, Patient Simulation, Prospective Studies, Time Factors, Young Adult, Emergency Medical Technicians standards, Intubation, Intratracheal standards
- Abstract
Background: Current airway management for most first-responder basic emergency medical technicians (EMT-Bs) does not include the use of blind-advanced-airway devices., Objective: To compare the speed, success rates, and skill retention with which EMT-Bs providers can place three blind-advanced-airway devices., Methods: Prospective study of 43 EMT-Bs trained in the use of the Esophageal-Tracheal-Combitube(®) (ETC), King LT(®) (KLT), and Laryngeal Mask Airway(™) (LMA). The time it took each participant to place each device correctly and ventilate a human patient simulator was assessed. Primary outcome measures were the success rate of proper insertion for each device and time interval from initiation of mouth insertion to initiation of chest rise. To assess skill retention, at 3 months the providers were reassessed under exact conditions., Results: At Day 1, time required to place an ETC, LMA, and KLT were 32.7 ± 12.3, 19.2 ± 6.2, and 20.1 ± 6.6 s, respectively. Using paired t-tests, LMA and KLT were faster than ETC, p < 0.0001. At 3 months, pair-wise comparisons showed the ETC took longer to place than the KLT and LMA, p < 0.0001; and the LMA took longer to place than the KLT, p = 0.0034 (36.4 ± 13.1 ETC, 24.8 ± 12.4 LMA, 19.0 ± 6.9 KLT). There was no statistical difference of failures in placing any device., Conclusions: Comparison of three rescue airway devices placed by EMT-Bs providers showed that it takes significantly longer to place an ETC compared to an LMA and KLT both on Day 1 and 3 months later. Three-month retention studies revealed that it took significantly longer to place an LMA compared to the KLT., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
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23. Malignant melanoma re-excision specimens: the need for analysis.
- Author
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Patel NG, Shah AK, Barker T, Garioch J, and Moncrieff MD
- Subjects
- Aged, 80 and over, Biopsy, Cheek, Facial Neoplasms surgery, Female, Humans, Melanoma surgery, Neoplasm, Residual, Skin Neoplasms surgery, Facial Neoplasms pathology, Melanoma pathology, Reoperation, Skin Neoplasms pathology, Specimen Handling
- Published
- 2010
- Full Text
- View/download PDF
24. Defective innate immunity predisposes murine neonates to poor sepsis outcome but is reversed by TLR agonists.
- Author
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Wynn JL, Scumpia PO, Winfield RD, Delano MJ, Kelly-Scumpia K, Barker T, Ungaro R, Levy O, and Moldawer LL
- Subjects
- Animals, Animals, Newborn, Bacteremia drug therapy, Bacteremia immunology, Female, Interferon Type I biosynthesis, Male, Membrane Glycoproteins agonists, Mice, Mice, Inbred C3H, Mice, Inbred C57BL, Mice, Knockout, Peritonitis drug therapy, Peritonitis immunology, Sepsis drug therapy, Signal Transduction, Systemic Inflammatory Response Syndrome drug therapy, Systemic Inflammatory Response Syndrome immunology, Toll-Like Receptor 3 agonists, Toll-Like Receptor 4 agonists, Toll-Like Receptor 7 agonists, Toll-Like Receptor 8 agonists, Toll-Like Receptors immunology, Immunity, Innate drug effects, Sepsis immunology, Toll-Like Receptors agonists
- Abstract
Neonates exhibit an increased risk of sepsis mortality compared with adults. We show that in contrast to adults, survival from polymicrobial sepsis in murine neonates does not depend on an intact adaptive immune system and is not improved by T cell-directed adaptive immunotherapy. Furthermore, neonates manifest an attenuated inflammatory and innate response to sepsis, and have functional defects in their peritoneal CD11b(+) cells. Activation of innate immunity with either a Toll-like receptor 4 (TLR4) or TLR7/8 agonist, but not a TLR3 agonist, increased the magnitude, but abbreviated the early systemic inflammatory response, reduced bacteremia, and improved survival to polymicrobial sepsis. TLR4 agonist pretreatment enhanced peritoneal neutrophil recruitment with increased oxidative burst production, whereas the TLR7/8 agonist also enhanced peritoneal neutrophil recruitment with increased phagocytic ability. These benefits were independent of the adaptive immune system and type I interferon signaling. Improving innate immune function with select TLR agonists may be a useful strategy to prevent neonatal sepsis mortality.
- Published
- 2008
- Full Text
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25. Role of non-protein amino acid L-canavanine in autoimmunity.
- Author
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Akaogi J, Barker T, Kuroda Y, Nacionales DC, Yamasaki Y, Stevens BR, Reeves WH, and Satoh M
- Subjects
- Amino Acids, Animals, Arginine, Autoantibodies analysis, Female, Haplorhini, Humans, Lupus Erythematosus, Systemic blood, Lupus Erythematosus, Systemic immunology, Mice, Mice, Inbred BALB C, Autoimmunity, Canavanine poisoning, Lupus Erythematosus, Systemic chemically induced, Medicago sativa adverse effects
- Abstract
Association of SLE and alfalfa was first reported in a volunteer who developed lupus-like autoimmunity while ingesting alfalfa seed for a hypercholesterolemia study. This was corroborated with studies in monkeys fed with alfalfa sprout that developed SLE. Re-challenge with L-canavanine relapsed the disease. Arginine homologue L-canavanine, present in alfalfa, was suspected as a cause. L-canavanine can be charged by arginyl tRNA synthetase to replace L-arginine during protein synthesis. Aberrant canavanyl proteins have disrupted structure and functions. Induction or exacerbation of SLE by alfalfa tablets reported in a few cases remains controversial. Epidemiological studies on the relationship between alfalfa and SLE are sparse. In mice, NZB/W F1, NZB, and DBA/2 mice fed with L-canavanine show exacerbation/triggering of the SLE, however, BALB/c studies were negative. L-canavanine incorporation may be more efficient in the presence of inflammation or other conditions that can cause arginine deficiency. The L-canavanine induced apoptotic cells can be phagocytosed and a source of autoantigens processed by endosomal proteases. Endogenous canavanyl proteins are ubiquitinated and processed via proteasome. Incorporation of L-canavanine into proteasome or endosome can also cause disruption of antigen processing. Alfalfa/L-canavanine-induced lupus will be an interesting model of autoimmunity induced by the modification of self-proteins at the translational level.
- Published
- 2006
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26. Physical differences of virus-associated depolymerases.
- Author
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Barker T, Eklund C, and Wyss O
- Subjects
- Bacterial Proteins analysis, Bacteriolysis, Electrophoresis, Hydrogen-Ion Concentration, Polysaccharides, Bacterial metabolism, Temperature, Azotobacter, Bacteriophages enzymology, Glycoside Hydrolases metabolism
- Published
- 1968
- Full Text
- View/download PDF
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