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Identifying novel data-driven subgroups in congenital heart disease using multi-modal measures of brain structure
No full textIndividuals with congenital heart disease (CHD) have an increased risk of neurodevelopmental impairments. Given the hypothesized complexity linking genomics, atypical brain structure, cardiac diagnoses and their management, and neurodevelopmental outcomes, unsupervised methods may provide unique insight into neurodevelopmental variability in CHD. Using data from the Pediatric Cardiac Genomics Consortium Brain and Genes study, we identified data-driven subgroups of individuals with CHD from measures of brain structure. Using structural magnetic resonance imaging (MRI; N = 93; cortical thickness, cortical volume, and subcortical volume), we identified subgroups that differed primarily on cardiac anatomic lesion and language ability. In contrast, using diffusion MRI (N = 88; white matter connectivity strength), we identified subgroups that were characterized by differences in associations with rare genetic variants and visual-motor function. This work provides insight into the differential impacts of cardiac lesions and genomic variation on brain growth and architecture in patients with CHD, with potentially distinct effects on neurodevelopmental outcomes
Improving access to first-line treatment for pediatric obesity: Lessons from the dissemination of SmartMoves
No full textOBJECTIVE: The increasing prevalence of and inequities in childhood obesity demand improved access to effective treatment. The SmartMoves curriculum used in Bright Bodies, a proven-effective, intensive health behavior and lifestyle treatment (IHBLT), was disseminated to ≥30 US sites from 2003 to 2018. We aimed to identify barriers to and facilitators of IHBLT implementation/sustainment. METHODS: We surveyed and interviewed key informants about experiences acquiring/implementing SmartMoves. In parallel, we analyzed and then integrated survey findings and themes from interviews using the constant comparative method. RESULTS: Participants from 16 sites (53%) completed surveys, and 12 participants at 10 sites completed interviews. The 11 sites (63%) that implemented SmartMoves varied in both use of training opportunities/materials and fidelity to program components. In interviews, demand for obesity programming, organizational priorities, and partnerships facilitated implementation. Seven sites discontinued SmartMoves prior to the COVID-19 pandemic. Funding insecurity and insufficient staffing emerged as dominant barriers to implementation/sustainment discussed by all interviewees, and some also noted participants\u27 competing demands and the program\u27s fit with population as challenges. CONCLUSIONS: System- and organizational-level barriers impeded sustainment of an evidence-based IHBLT program. Adequate funding could enable sufficient staffing and training to promote fidelity to the intervention\u27s core functions and adaptation to fit local populations/context
Comparing Cognitive Behavioral Therapy (CBT) versus Yoga for Helping Older Adults Address High Levels of Worry
Get PDFSome older adults have high levels of worry that cause them to feel restless, tired, or tense. Two ways to treat worry are Cognitive Behavior Therapy (CBT) and yoga.https://knowledgeconnection.mainehealth.org/reach/1010/thumbnail.jp
Virtual Reality in Pain Management and its Role in Replacing Traditional Pharmacological Therapies
Get PDFPICOT Question: In the adult inpatient population does engaging in virtual reality manage pain in a significant way?https://knowledgeconnection.mainehealth.org/nurseresidency/1041/thumbnail.jp
Fall Reduction: Using Exercise Interventions to Reduce the Number of Falls Among People with Parkinson\u27s Disease
Get PDFPICOT Question: In geriatric patients with Parkinson\u27s, what is the effectiveness of lower extremity strength training combined with medication management for the reduction of unplanned falls?https://knowledgeconnection.mainehealth.org/nurseresidency/1049/thumbnail.jp
Evaluating the Effectiveness of Silicone Foam Dressing in Preventing Pressure Ulcers in Intensive Care Settings
Get PDFPICOT Question: For critically ill patients and high-risk aged care residents, does the use of multi-layer silicone foam dressing reduce the future risk of developing pressure injuries compared with those who receive the standard pressure injury preventions without the application of the dressing on their sacrum and heels?https://knowledgeconnection.mainehealth.org/nurseresidency/1047/thumbnail.jp
Noise Levels in the Operating Room
Get PDFPICOT Question: For patients undergoing surgical interventions, how does reduced noise levels compared to unreduced noise levels influence patient outcomes and satisfaction?https://knowledgeconnection.mainehealth.org/nurseresidency/1057/thumbnail.jp
Constipation in Postoperative Cardiovascular Patients
Get PDFWould postoperative cardiovascular patients that receive a preoperative bowel preparation as opposed to those who receive no bowel prep have a shorter ICU stay and less complications postoperatively?https://knowledgeconnection.mainehealth.org/nurseresidency/1068/thumbnail.jp
Multi-Scale Digital Pathology Patch-Level Prostate Cancer Grading Using Deep Learning: Use Case Evaluation of DiagSet Dataset.
No full textProstate cancer remains a prevalent health concern, emphasizing the critical need for early diagnosis and precise treatment strategies to mitigate mortality rates. The accurate prediction of cancer grade is paramount for timely interventions. This paper introduces an approach to prostate cancer grading, framing it as a classification problem. Leveraging ResNet models on multi-scale patch-level digital pathology and the Diagset dataset, the proposed method demonstrates notable success, achieving an accuracy of 0.999 in identifying clinically significant prostate cancer. The study contributes to the evolving landscape of cancer diagnostics, offering a promising avenue for improved grading accuracy and, consequently, more effective treatment planning. By integrating innovative deep learning techniques with comprehensive datasets, our approach represents a step forward in the pursuit of personalized and targeted cancer care
Glycemic Control in Type II Diabetics
Get PDFIn type two diabetics, how does in-patient insulin protocols compare to interventions at home influence glycemic control over 6 months?https://knowledgeconnection.mainehealth.org/nurseresidency/1104/thumbnail.jp