Publications by authors named "Thomas Barkley"

Electron storage capacity (ESC) is the capacity of a black carbon to store and reversibly donate and accept electrons in redox processes. Electrochemical and chemical analyses have shown the ESC of black carbon (e.g.

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Purpose Deleterious germline mutations contribute to pancreatic cancer susceptibility and are well documented in families in which multiple members have had pancreatic cancer. Methods To define the prevalence of these germline mutations in patients with apparently sporadic pancreatic cancer, we sequenced 32 genes, including known pancreatic cancer susceptibility genes, in DNA prepared from normal tissue obtained from 854 patients with pancreatic ductal adenocarcinoma, 288 patients with other pancreatic and periampullary neoplasms, and 51 patients with non-neoplastic diseases who underwent pancreatic resection at Johns Hopkins Hospital between 2000 and 2015. Results Thirty-three (3.

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Heart failure, a complex clinical syndrome affecting millions of Americans, is associated with high morbidity and mortality and a significant financial burden on the health care system. Recent health care reform efforts have focused on reducing 30-day heart failure hospital readmissions, increasing the cost-effectiveness of care provided to heart failure patients, and improving health outcomes for these patients. This case report describes an acutely ill patient with multiple comorbidities who was not initially admitted for heart failure but who developed acute decompensated heart failure during his hospital stay.

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Background: Prospective studies have identified obstructive sleep apnea (OSA) as a risk factor for increased overall cancer incidence and mortality. The potential role of OSA in the risk or progression of specific cancers is not well known. We hypothesized that pathological differences in pancreatic cancers from OSA cases compared to non-OSA cases would implicate OSA in pancreatic cancer progression.

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Objective: Secretin-stimulated pancreatic juice contains DNA shed from cells lining the pancreatic ducts. Genetic analysis of this fluid may form a test to detect pancreatic ductal neoplasia.

Design: We employed digital next-generation sequencing ('digital NGS') to detect low-abundance mutations in secretin-stimulated juice samples collected from the duodenum of subjects enrolled in Cancer of the Pancreas Screening studies at Johns Hopkins Hospital.

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Objective: Our objective was to develop an approach for selecting combinatorial markers of pathology from diverse clinical data types. We demonstrate this approach on the problem of pancreatic cyst classification.

Materials And Methods: We analyzed 1026 patients with surgically resected pancreatic cysts, comprising 584 intraductal papillary mucinous neoplasms, 332 serous cystadenomas, 78 mucinous cystic neoplasms, and 42 solid-pseudopapillary neoplasms.

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Hereditary hemorrhagic telangiectasia is a rare, autosomal dominant genetic disease that causes abnormal growth of blood vessels and, subsequently, life-threatening arteriovenous malformations in vital organs. Epistaxis may be one of the initial clues that a patient has more serious, generalized arteriovenous malformations. Recommended treatment involves careful evaluation to determine the severity and risk of spontaneous rupture of the malformations and the management of various signs and symptoms.

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The International Association for the Study of Pain neuropathic pain guidelines are presented. Nursing considerations, including neuropathic pain assessment and medication efficacy, are reported to explain medications' primary mechanisms of action and provide a nursing reference for patient education.

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Background: Von Hippel-Lindau (VHL) is a rare autosomal dominant hereditary disorder that predisposes individuals to benign and malignant tumors in the brain, eyes, kidneys, pancreas, genital tract, or other body parts. The VHL gene, which is located on the short arm of chromosome 3, prevents cells from dividing too rapidly. Mutations in the VHL gene result in uncontrollable cell growth and tumor formation.

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Atrial fibrillation is an important risk factor for thromboembolic stroke and it significantly increases the risk of stroke. The left atrial appendage (LAA) is the most common site of thrombus formation in nonvalvular atrial fibrillation, and the recent applications of percutaneous LAA closure devices offer a promising alternative for patients who are unable to tolerate lifelong anticoagulation. Critical care nurses who understand the procedures and are familiar with the various devices used for LAA closure will be well prepared to provide optimum care and appropriate education for these patients.

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It is estimated that 375,000 Americans are utilizing insulin pump therapy to manage their diabetes. This article will educate community health care nurses regarding use of the insulin pump, and how to operate special settings for more effective glycemic control. Complications of pump therapy, as well as hyperglycemia, are not always avoidable; however, interventions are in place to prevent and treat complications.

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Background & Aims: Pancreatic imaging can identify neoplastic cysts but not microscopic neoplasms. Mutation analysis of pancreatic fluid after secretin stimulation might identify microscopic neoplasias in the pancreatic duct system. We determined the prevalence of mutations in KRAS and guanine nucleotide-binding protein α-stimulating genes in pancreatic juice from subjects undergoing endoscopic ultrasound for suspected pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms, or pancreatic adenocarcinoma.

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The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP.

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People living with HIV infection have a significantly higher rate of anal cancer as compared with that of uninfected people. It is believed that high-grade anal dysplasia secondary to human papillomavirus infection is a precursor to anal cancer. Considering this, screening and treatment of high-grade anal dysplasia is a possible means of preventing the development of anal cancer.

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We examined condom attitudes, perceived vulnerability to HIV, HIV testing experiences, and sexual and substance use risk behaviors of 161 active Latino male gang members, aged 18-26 years old, living in Los Angeles, California. Gang members reported negative condom attitudes and a perceived vulnerability to HIV. The majority (53%) of gang members reported unprotected vaginal intercourse (UVI) in the previous 12 months.

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