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Utilizing Clinical Nurse Specialists to Improve Care & Management of Suprapubic Catheters
Get PDFPoster presented at Nursing Research Symposium 2022.
Purpose:
Utilize the Advance Practice Registered Nurse (APRN) knowledge and skill of the CNS in management of chronic SPT to decrease unnecessary consults to urology for routine SPT exchanges and maintenance • Streamline SPT consults to decrease urology workload as the CNS will assess the patient and identify any urgent needs that require urology • This will allow urology to focus on acute and emergent patient needs • CNS consults for SPT management and exchange will also decrease time to patient catheter exchang
Cultivating the Community: Inferring Influence within Eating Disorder Networks on Twitter
No full textProceedings of the ACM on Human-Computer Interaction 6(GROUP)
A growing body of HCI research has sought to understand how online networks are utilized in the adoption and maintenance of disordered activities and behaviors associated with mental illness, including eating habits. However, individual-level influences over discrete online eating disorder (ED) communities are not yet well understood. This study reports results from a comprehensive network and content analysis (combining computational topic modeling and qualitative thematic analysis) of over 32,000 public tweets collected using popular ED-related hashtags during May 2020. Our findings indicate that this ED network in Twitter consists of multiple smaller ED communities where a majority of the nodes are exposed to unhealthy ED contents through retweeting certain influential central nodes. The emergence of novel linguistic indicators and trends (e.g., #meanspo ) also demonstrates the evolving nature of the ED network. This paper contextualizes ED influence in online communities through node-level participation and engagement, as well as relates emerging ED contents with established online behaviors, such as self-harassment.
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Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer
Get PDFObjectives: Small cell lung cancer (SCLC) is a lethal histologic subtype of lung cancer. Although the Commission on Cancer recommends pathological examination of at least 10 lymph nodes dissected (LNDs) for resected early-stage non-small cell lung cancer, its survival benefit of LNDs in patients with early-stage SCLC is unknown.
Methods: The National Cancer Database was queried for SCLC patients with clinical stage I-II and clinical N0, NX disease per AJCC 7th edition who had undergone lobectomy between 2004 and 2017. Overall survival of SCLC patients by the number of LNDs was compared using Log-rank tests. Univariate and multivariable Cox proportional hazards analyses were performed.
Results: In total, 688 (42%), 311 (20%), 247 (16%), 196 (12%), 126 (8%), and 36 (2%) of 1,584 patients with early-stage SCLC had ≥10, 7-9, 5-6, 3-4, 1-2, and 0 LNDs, respectively. The sequential improvement in the HRs was no longer evident if the number of LNDs exceeds 4. Patients with ≥3 LNDs (n = 1,422) had a significantly longer overall survival than those with (n = 162) (hazard ratio for death: 0.76, 95% confidence interval: 0.62–0.94, P = 0.0087). Multivariate analysis revealed that ≥3 LNDs was an independent factor for predicting overall survival (hazard ratio for death: 0.76, 95% confidence interval: 0.61–0.93, P = 0.0083).
Conclusions: Although we are reluctant to recommend a definitive “optimal number” of LNDs, our findings suggest the prognostic and therapeutic roles for performing ≥3 LNDs in patients with early-stage SCLC who undergo lobectomy
Digital distraction or accessible aid? Parental media use during feedings and parent-infant attachment, dysfunction, and relationship quality
No full textHighlights • The vast majority of mothers use media while feeding their infant. • Mothers report a number of adaptive reasons why they use media during feeding times. • Media use while feeding was not related to attachment problems in the future. • Media use while feeding was related to lower levels of parent/infant dysfunction over time. Abstract Often parents are discouraged from using media around their infants, particularly during feeding time, as media use is thought to harm the development of parent-infant attachment. Little research, however, has examined the relationship between parent media use during infant feeding and parent-infant dysfunction and attachment over time. This paper involves two separate studies (using quantitative and qualitative approaches) to examine why parents use media while feeding their infants and how media use during feeding relates to parent-infant relationships, particularly attachment. The overwhelming majority of parents (mostly mothers in this study) reported using media at least sometimes while feeding their infants. Parents reported using media to cope with the difficulties of feeding, to remain productive during feeding time, and to connect with others. Parent media use during infant feeding was not longitudinally associated with attachment, and media use during infant feeding was longitudinally linked to decreases in parent-toddler dysfunction. Overall, we believe that media may be a helpful tool to support parents (particularly mothers) cope with the difficulties of parenting infants. Limitations and other implications are discussed
Audicor Remote Patient Monitoring: FDA Breakthrough Device and Technology for Heart Failure Management
Get PDFLymph node dissections and survival in sublobar resection of non-small cell lung cancer ≤ 20 mm.
Get PDFBACKGROUND: A randomized trial of lobectomy versus segmentectomy for small-sized (≤ 20 mm) non-small cell lung cancer (NSCLC) showed that patients who had undergone segmentectomy had a significantly longer overall survival (OS) than those who had lobectomy. More attention is needed regarding the required extent of thoracic lymphadenectomy in patients with small-sized NSCLC who undergo sublobar resection.
METHODS: The National Cancer Database was queried for patients with clinically node-negative NSCLC ≤ 20 mm who had undergone sublobar resection between 2004 and 2017. OS of NSCLC patients by the number of lymph node dissections (LNDs) was analyzed using log-rank tests and Cox proportional hazards model. The cutoff value of the LNDs was set to 10 according to the Commission on Cancer\u27s recommendation.
RESULTS: This study included 4379 segmentectomy and 23,138 wedge resection cases. The sequential improvement in the HRs by the number of LNDs was evident, and the HR was the lowest if the number of LNDs exceeded 10. Patients with ≤ 9 LNDs had a significantly shorter OS than those with ≥ 10 LNDs (hazard ratio [HR] 1.50, 95% confidence interval [CI] 1.40-1.61, P \u3c 0.0001). Multivariable analysis revealed that performing ≤ 9 LNDs was an independent factor for predicting OS (HR for death: 1.34, 95% CI 1.24-1.44, P \u3c 0.0001). These results remained significant in subgroup analyses by the type of sublobar resection (segmentectomy, wedge resection).
CONCLUSIONS: Performing ≥ 10 LNDs has a prognostic role in patients with small-sized NSCLC even if the resection is sublobar
Synchronized diaphragmatic stimulation for heart failure using the VisONE system: a first-in-patient study.
Get PDFAIMS: Synchronized diaphragmatic stimulation (SDS) modulates intrathoracic and intra-abdominal pressures with favourable effects on cardiac function for patients with a reduced left ventricular ejection fraction (LVEF) and heart failure (HFrEF). VisONE-HF is a first-in-patient, observational study assessing the feasibility and 1 year effects of a novel, minimally invasive SDS device.
METHODS AND RESULTS: The SDS system comprises a pulse generator and two laparoscopically delivered, bipolar, active-fixation leads on the inferior diaphragmatic surface. Fifteen symptomatic men with HFrEF and ischaemic heart disease receiving guideline-recommended therapy were enrolled (age 60 [56, 67] years, New York Heart Association class II [53%] /III [47%], LVEF 27 [23, 33] %, QRSd 117 [100, 125] ms, & N terminal pro brain natriuretic peptide [NT-proBNP] 1779 [911, 2,072] pg/mL). Implant success was 100%. Patients were evaluated at 3, 6, and 12 months for device-related or lead-related complications, quality of life (SF-36 QOL), 6 min hall walk distance (6MHWd), and by echocardiography. No implant procedure or SDS-related adverse event occurred, and patients were unaware of diaphragmatic stimulation. By 12 months, left ventricular end-systolic volume decreased (136 [123, 170] mL to 98 [89, 106] mL; P = 0.05), 6MHWd increased (315 [300, 330] m to 340 [315, 368] m; P = 0.004), and SF-36 QOL improved (physical scale 0 [0, 0] to 25 [0, 50], P = 0.006; emotional scale 0 [0, 33] to 33 [33, 67], P = 0.001). Although neither reached statistical significance, LVEF decreased (28 [23, 40]% vs. 34 [29, 38]%; P = ns) and NT-proBNP was lower (1784 [920, 2540] pg/mL vs. 1492 [879, 2028] pg/mL; P = ns).
CONCLUSIONS: These data demonstrate the feasibility of laparoscopic implantation and delivery of SDS without raising safety concerns. These encouraging findings should be investigated further in adequately powered randomized trials
Diaphragmatic Function in Cardiovascular Disease: JACC Review Topic of the Week.
Get PDFIn addition to the diaphragm\u27s role as the primary respiratory muscle, it also plays an under-recognized role in cardiac function. It serves as a pump facilitating venous and lymph return, modulating left ventricular afterload hemodynamics and pericardial pressures, as well as regulating autonomic tone. Heart failure (HF) is associated with diaphragmatic changes (ie, muscle fiber atrophy and weakness, increased ratio of type I to type II muscle fibers, and altered muscle metaboreflex) that lead to diaphragmatic dysfunction with subsequent symptomatic manifestations of HF. Herein, it is proposed that targeting the diaphragm in patients with HF via inspiratory muscle training or device-based stimulation can provide a novel treatment pathway for HF. Reviewed are several potential mechanisms through which therapies targeting the diaphragm can be beneficial in HF (ie, improving preload reserve, atrial and ventricular synchrony, and metaboreflex activity; reducing pericardial restraint; and restoring diaphragm strength)
Application of artificial intelligence in pancreaticobiliary diseases
No full textThe role of artificial intelligence and its applications has been increasing at a rapid pace in the field of gastroenterology. The application of artificial intelligence in gastroenterology ranges from colon cancer screening and characterization of dysplastic and neoplastic polyps to the endoscopic ultrasonographic evaluation of pancreatic diseases. Artificial intelligence has been found to be useful in the evaluation and enhancement of the quality measure for endoscopic retrograde cholangiopancreatography. Similarly, artificial intelligence techniques like artificial neural networks and faster region-based convolution network are showing promising results in early and accurate diagnosis of pancreatic cancer and its differentiation from chronic pancreatitis. Other artificial intelligence techniques like radiomics-based computer-aided diagnosis systems could help to differentiate between various types of cystic pancreatic lesions. Artificial intelligence and computer-aided systems also showing promising results in the diagnosis of cholangiocarcinoma and the prediction of choledocholithiasis. In this review, we discuss the role of artificial intelligence in establishing diagnosis, prognosis, predicting response to treatment, and guiding therapeutics in the pancreaticobiliary system
17th Annual Parkview Research Symposium 2020 and COVID-19: An Extraordinary Year for Science and Innovation
No full text17th Annual Parkview Research Symposium 2020 and COVID-19: An Extraordinary Year for Science and Innovation- March 4, 2021
Topics:
Clinical Trial Support Throughout COVID-19 - Scott Steinecker, MD, FACP, FSHEA, FIDSA, CIC
Updates from the Fairbanks Prevalence Study: How Far is Indiana from Herd Immunity? - Nir Menachemi, Ph.D
Hyperlocal Modeling of COVID-19 at Parkview Health - Jessica Pater, Ph.D, Shion Guha, Ph.D
Vaccinating Patients Every 28.8 Seconds: A Practical Application of Process Improvement and Innovation - Victor Cornet - Charlotte Gabet - Erica Cumbee, MPA
COVID-19-Neutralizing Antibodies: BLAZE Trial - Janelle Sabo, PharmD
COVID-19 Panel Discussion and Speaker Questions - Michael Mirro, MD Scott Steinecker, MD Nir Menachemi, Ph.D Jeffery Boord, M