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Healthcare Overuse： A Literature Review and Taxonomy Proposal

Journal of Health Science 2016年第2期4卷 83-92页

作者： Eva Koeller colleen barclay Tina L. Velasquez Russell Harris Melissa R. Partin Elisheva R. Danan Nancy Greer Timothy J. Wilt Center for Chronic Disease Outcomes Research and the Minneapolis Vii High Value Care Initiative Minneapolis VA Health Care System Minneapolis MN 55417 USA Sheps Center for Health Services Research University of North Carolina at Chapel Hill Chapel Hill NC 27599 USA Department of Medicine Section of General Internal Medicine University of Minnesota Minneapolis MN 55417 USA

Healthcare overuse is the provision of care in which the benefits do not justify the harms and/or costs. Overuse literature is poorly categorized thus impeding research, practice, and policy to reduce overuse and improve healthcare quality. We developed an overuse taxonomy and searched for and reviewed the healthcare overuse literature in an attempt to better understand and categorize research on overuse practice and patterns. We found that more than two-thirds of articles were observational （70%）, the most prevalent purpose of overuse was treatment/secondary prevention （69%）, the most common type of overuse was overtreatment （73 %）, drivers of and methods to reduce overuse were each discussed in about 40% of abstracts, and the most frequently mentioned clinical area was pharmacy. A high volume of overuse literature exists. However, the majority of overuse research is observational, descriptive, and focuses on overtreatment and overprescribing rather than methods to reduce overuse. Some overuse is not labelled as such. Our taxonomy adequately organized the existing literature and identified areas where additional research efforts are most needed. A common taxonomy, such as ours, could help researchers categorize their work, assist clinicians and policymakers in identifying and implementing findings, and guide future research to improve healthcare quality.

关键词： Healthcare overuse overtreatment overuse healthcare utilization.

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Remembering,Forgetting,and Absencing Disasters in the Post-disaster Recovery Process

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International Journal of Disaster Risk Science 2020年第3期11卷 287-299页

作者： Charlotte Monteil Jenni barclay Anna Hicks Lancaster Environment Center Lancaster UniversityBailrigg LAI 4YWUK School of Environmental Sciences University of East AngliaNorwich NR47TJUK Edinburgh Office British Geological SurveyEdinburgh EH 144BAUK

Sustainable post-disaster recovery implies learning from past experience in order to prevent recreating forms of *** construction supports both the healing process and redevelopment ***,memory of disaster results from the balance between remembering,forgetting,and absencing elements of the disaster,and can be both a tool and an obstacle to sustainable *** explore here how collective memory is built in a post-disaster context to respond to the needs of this critical period,and how it shapes *** ethnographic study,conducted between 2015 and 2017,explores the recovery processes in Montserrat,a small Caribbean island affected by an extended volcanic crisis from 1995 to *** this study does not give tangible solutions for disaster risk reduction in a post-disaster context,it highlights potential obstacles for learning from a disaster and how they may be *** argue that it is crucial to acknowledge evolving collective memory in order to implement effective measures for preserving and sharing a shared understanding of disaster across generations and social groups in a way that supports disaster risk *** also maintain that acknowledging the dilemma faced by authorities and disaster management agencies during a period of conflicting needs may encourage the reconsideration of risk framing,and hence reveal how to improve implementation of disaster risk reduction measures.

关键词： Absencing risk information Disaster remembering Forgetting processes Montserrat Post-disaster recovery

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Online machine learning for stream wastewater influent flow rate prediction under unprecedented emergencies

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Frontiers of Environmental Science & Engineering 2023年第12期17卷 137-147页

作者： Pengxiao Zhou Zhong Li Yimei Zhang Spencer Snowling Jacob barclay Department of Civil Engineering McMaster UniversityHamiltonOntario L8S 4L8Canada MOE Key Laboratory of Resources and Environmental System Optimization College of Environmental Science and EngineeringNorth China Electric Power UniversityBeijing 102206China Laboratory of Environmental Remediation and Functional Material Suzhou Research Academy of North China Electric Power UniversitySuzhou 215213China Hatch Ltd. Sheridan Science&Technology ParkMississaugaOntario L5K 2R7Canada

Accurate influent flow rate prediction is important for operators and managers at wastewater treatment plants(WWTPs),as it is closely related to wastewater characteristics such as biochemical oxygen demand(BOD),total suspend solids(TSS),and *** studies have been conducted to predict influent flow rate,and it was proved that data-driven models are effective ***,most of these studies have focused on batch learning,which is inadequate for wastewater prediction in the era of COVID-19 as the influent pattern changed *** learning,which has distinct advantages of dealing with stream data,large data set,and changing data pattern,has a potential to address this *** this study,the performance of conventional batch learning models Random Forest(RF),K-Nearest Neighbors(KNN),and Multi-Layer Perceptron(MLP),and their respective online learning models Adaptive Random Forest(aRF),Adaptive K-Nearest Neighbors(aKNN),and Adaptive Multi-Layer Perceptron(aMLP),were compared for predicting influent flow rate at two Canadian *** learning models achieved the highest R2,the lowest MAPE,and the lowest RMSE compared to conventional batch learning models in all *** R2 values on testing data set for 24-h ahead prediction of the aRF,aKNN,and aMLP at Plant A were 0.90,0.73,and 0.87,respectively;these values at Plant B were 0.75,0.78,and 0.56,*** proposed online learning models are effective in making reliable predictions under changing data patterns,and they are efficient in dealing with continuous and large influent data *** can be used to provide robust decision support for wastewater treatment and management in the changing era of COVID-19 and also under other unprecedented emergencies that could change influent patterns.

关键词： Wastewater prediction Data stream Online learning Batch learning Influent flow rates

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Verifiable Badging System for scientific data reproducibility

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Blockchain(Research and Applications) 2021年第2期2卷 68-81页

作者： Swapna Krishnakumar Radha Ian Taylor Jarek Nabrzyski Iain barclay Center for Research Computing University of Notre DameIN46556USA School of Computer Science and Informatics Cardiff UniversityCardiffWalesCF103ATUK

Reproducibility can be considered as one of the basic requirements to ensure that a given research finding is accurate and *** paper presents a new layered approach that allows scientific researchers to provide a)data to fellow researchers to validate research and b)proofs of research quality to funding agencies,without revealing sensitive details associated with the *** conclude that by integrating smart contracts,blockchain technology,and self-sovereign identity into an automated system,it is possible to assert the quality of scientific materials and validate the peer review process without the need of a central authority.

关键词： Blockchain technology Self-sovereign identity Decentralized identifiers Verifiable credentials Smart contracts

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Esophagogastroduodenoscopy-assisted bowel preparation for colonoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 95-101页

作者： Robert L barclay Rockford Gastroenterology Associates RockfordIL 61107-5078United States

AIM:To compare the quality and tolerance of esophag ogastroduodenoscopy(EGD)-assisted and conventional split-dose polyethylene glycol electrolyte solution for inpatient ***:The study was a randomized controlled trial in hospitalized *** patients undergoing colonoscopy the day following EGD for evaluation of gastrointestinal(GI) bleeding or other *** randomized to either EGD-assisted bowel prep [2 L polyethylene glycol(PEG) administered endoscopically into distal duodenum at time of EGD,plus 1 L PEG orally the following day] or conventional-PEG(2 L PEG orally the evening prior and 1 L PEG orally the following day).The main outcome measurements are bowel preparation quality and patient tolerance of bowel ***:Forty-two patients randomized to EGD-assisted bowel prep and 40 patients to *** mean ± SD preparation quality was superior for EGD-PEG(4.1 ± 2.8) vs conventional-PEG(6.5 ± 3.1;P = 0.0005).Seventy-four percent of patients rated EGDPEG as easy or slightly difficult to tolerate compared to 46% for standard-PEG(P = 0.0133).Mean EGD-procedural time was greater for EGD-assisted subject(24 ± 10 min) compared to conventional-PEG prep subjects(15 ± 7 min;P < 0.0001).Conscious sedation requirements did not differ between *** were no significant prep-related adverse events in either ***:In selected hospitalized patients,compared to a conventional split-dose regimen,use of EGD to administer the majority of PEG solution improves patient tolerance and quality of bowel preparation for colonoscopy.

关键词： Colonoscopy Bowel preparation Tolerability Esophagogastroduodenoscopy-assisted

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Strengthening the emergency health response to children wounded by explosive weapons in conflict

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World Journal of Pediatric Surgery 2022年第4期5卷 196-203页

作者： Hannah Wild Paul Reavley Emily Mayhew Emmanuel A Ameh Mehmet Emin Celikkaya barclay Stewart Department of Surgery University of WashingtonSeattleWAUSA Bristol Royal Hospital for Children University Hospitals BristolBristolUK Department of Bioengineering Imperial College LondonLondonUK Division of Pediatric Surgery Department of SurgeryNational HospitalAbujaNigeria Department of Pediatric Surgery Mustafa Kemal UniversityHatayTurkey Global Injury Control Section Harborview Injury Prevention and Research CenterSeattleWAUSA

The 2022 war in Ukraine has highlighted the unacceptable consequences wrought on civilians and health infrastructure by *** are among the most vulnerable of those affected and constitute an increasing percentage of non-combatants injured in conflicts globally.A disproportionate number of these injuries are caused by blast mechanisms from munitions including‘conventional’landmines and indiscriminate explosive weapons such as barrel bombs and improvised explosive *** 21st century conflict,children are no longer only accidental casualties of war,but are increasingly targeted by parties through acts such as bombing of school buses and playgrounds,conscription as child soldiers,and use as human *** the present viewpoint article,we review the state of pediatric blast injury studies,synthesizing current understandings of injury epidemiology and identifying gaps in research to advance the field towards a concrete agenda to improve care for this vulnerable population.

关键词： consequences injuries globally

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SLC11A1 polymorphisms in inflammatory bowel disease and Mycobacterium avium subspecies paratuberculosis status

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World Journal of Gastroenterology 2010年第45期16卷 5727-5731页

作者： Lucy C Stewart Andrew S Day John Pearson Murray L barclay Richard B Gearry Rebecca L Roberts Robert W Bentley Department of Paediatrics University of OtagoChristchurch 8140New Zealand Department of Paediatrics Christchurch HospitalChristchurch 8140New Zealand Department of Pathology University of OtagoChristchurch 8140New Zealand Department of Medicine University of OtagoChristchurch 8140New Zealand Department of Gastroenterology Christchurch HospitalChristchurch 8140New Zealand Department of Biochemistry University of OtagoDunedin 9054New Zealand

AIM: To test for association of SLC11A1 with inflammatory bowel disease (IBD) and Mycobacterium avium subspecies paratuberculosis (MAP) status in a Caucasian cohort. METHODS: Five hundred and seven Crohn's disease (CD) patients, 474 ulcerative colitis (UC) patients, and 569 healthy controls were genotyped for SLC11A1 1730G>A and SLC11A1 469+14G>C using pre-designed TaqMan  SNP assays. χ 2 tests were applied to test for association of single nucleotide polymorphisms (SNPs) with disease, and the presence of MAP ***:SLC11A1 1730G>A and SLC11A 1469+14G>C were not associated with CD, UC, or IBD. The SLC11A1 1730A minor allele was over-represented in patients who did not require immunomodulator therapy (P = 0.002, OR: 0.29, 95% CI: 0.13-0.66). The frequency of the SLC11A1 469+14C allele was higher in the subset of study participants who tested positive for MAP DNA (P = 0.02, OR: 1.56, 95% CI: 1.06-2.29). No association of SLC11A1 1730G>A with MAP was ***: Although SLC11A1 was not associated with IBD, association with MAP suggests that SLC11A1 is important in determining susceptibility to bacteria implicated in the etiology of CD.

关键词： NRAMP1 Crohn’s disease Ulcerative colitis IS900 polymerase chain reaction

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The complexity of providing humanitarian surgical care in armed conflict: a framework to help categorize needs

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Emergency and Critical Care Medicine 2022年第2期2卷 41-44页

作者： Kevin Gianaris barclay T.Stewart Sherry M.Wren Adam L.Kushner Indiana University School of Medicine IndianapolisINUSA Department of Surgery University of WashingtonSeattleWAUSA Harborview Injury Prevention and Research Center University of WashingtonSeattleWAUSA Department of Surgery Stanford UniversityPalo AltoCAUSA Surgeons OverSeas New York CityNYUSA Department of International Health Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA

Armed conflicts are increasing globally due to political unrest and the broader effects of climate *** resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income *** understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict,a matrix to identify variables and help with interventions was *** published global surgery matrix based on the PIPES(Personnel,Infrastructure,Procedures,Equipment and Supplies)surgical capacity tool was adapted to this *** novel matrix incorporates 108 *** variables are grossly divided into local and international agency components to address the issue of who is providing *** a time continuum of pre-conflict,conflict,and post-conflict allows organizations to concentrate on when during the conflict to target their *** addition to the previously used personnel,infrastructure,procedures,equipment,and supplies categories,a sixth category called standards was included that addresses the issues such as information technology,data systems,quality improvement programs,and patient *** testing of this matrix to obtain feedback from end users is the next step in ***,peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.

关键词： Armed conflict Emergency care Global surgery Humanitarian assistance Trauma care

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漫长之路

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杂交水稻 2010年第2期25卷 80-81页

作者：袁隆平 Adam barclay 国家杂交水稻工程技术研究中心湖南长沙410125

45年精心的研究表明,现代的集约化水稻种植方式可持续不衰甚至能增进土壤的健康马尼拉以南约60km的洛斯巴诺斯镇郊外,有一块1hm2的土地。对于不少亚洲人来说,一块土地很可能是他们最有价值的财产。这片土地不是用来出售的,即使如此,也... 详细信息

45年精心的研究表明,现代的集约化水稻种植方式可持续不衰甚至能增进土壤的健康马尼拉以南约60km的洛斯巴诺斯镇郊外,有一块1hm2的土地。对于不少亚洲人来说,一块土地很可能是他们最有价值的财产。这片土地不是用来出售的,即使如此,也不会用来建房屋、

关键词：种植方式马尼拉集约化土地亚洲人土壤水稻

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Techniques and strategies for regional anesthesia in acute burn care—a narrative review

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Burns & Trauma 2021年第1期9卷 383-392页

作者： Clifford C.Sheckter barclay T.Stewart Christopher Barnes Andrew Walters Paul I.Bhalla Tam N.Pham Department of Surgery UWMedicine Regional Burn Center at Harborview Medical CenterUniversity ofWashington3259th Ave.SeattleWA 98104USA Harborview Injury Prevention and Research Center University ofWashington401 Broadway.SeattleWA 98122USA Department of Anesthesia and Pain Medicine Harborview Medical Center.University ofWashington3259th Ave.SeattleWA 98104USA

Burn injuries and their treatments result in severe *** traumatic injuries that are characterized by a discrete episode of pain followed by recovery,burn-injured patients endure pain for a prolonged period that lasts through wound closure(*** pain,procedural pain,breakthrough pain,neuropathic pain and itch).Regional anesthesia,including peripheral nerve blocks and neuraxial/epidural anesthesia,offers significant benefits to a multimodal approach in pain treatment.A‘regional-first’approach to pain management can be incorporated into the workflow of burn centers through engaging regional anesthesiologists and pain medicine practitioners in the care of burn patients.A detailed understanding of peripheral nerve anatomy frames the burn clinician’s perspective when considering a peripheral nerve block/*** infra/supraclavicular nerve block provides excellent coverage for the upper extremity,while the trunk can be covered with a variety of blocks including erector spinae plane and quadratus lumborum plane *** lower extremity is targeted with fascia iliaca plane and sciatic nerve blocks for both donor and recipient *** centers that adopt regional anesthesia should be aware of potential complications and contraindications to prevent adverse events,including management of local anesthetic toxicity and epidural *** of anticoagulation around regional anesthesia placement is crucial to prevent hematoma and nerve ***,regional anesthesia can facilitate a better patient experience and allow for early therapy and mobility goals that are hallmarks of burn care and rehabilitation.

关键词： Burn Regional anesthesia Nerve block Epidural Nerve catheter Pain

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