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A Randomized, Clinical Trial Investigating the use of a Digital Intervention to Reduce Delirium-Associated Agitation

Nicholas M, Wittmann J, Norena M, Ornowska M, Reynolds S. A randomized, clinical trial investigating the use of a digital intervention to reduce delirium-associated agitation. NPJ Digit Med. Oct 30 2023;6(1):202. doi:10.1038/s41746-023-00950-4

This randomized clinical trial examined the effectiveness of a novel digital intervention “MindfulGarden” in reducing agitation in patients with delirium. Delirium is an acute neuropsychiatric disorder that is commonly seen in critical care patients. Patients experience cognitive impairment, hallucinations, and bouts of physical aggression, termed agitation. Reducing agitation in patients with delirium without the use of physical or chemical restraints remains a challenge. “Mindful Garden” is a screen-based interactive platform developed to reduce agitation. Seventy patients (Age = 19-89, 70% male) were recruited from the critical care (n = 65) and high acuity cardiac telemetry (n = 5) units of the Royal Columbian Hospital (New Westminster, Canada). In both groups, normal behavioral re-orientation provided by nursing staff continued (i.e., changing clocks, using whiteboards, physiotherapy). In the experimental group, each participant had “MindfulGarden” installed at the foot of their hospital bed for 4 consecutive hours, spanning one nursing shift. Any increasing changes in speech (tone, loudness) or movement (speed, location) by participants induced visual stimuli to move and scenes to change on the “MindfulGarden” screen. The use of MindfulGarden reduced agitation measures (Richmond Agitation Sedation Scale; RASS; 70.6%) compared to care as usual (40%) within the first hour (p = 0.01). This difference between the intervention and control groups persisted across the four-hour block (p = 0.04). Exposure to “MindfulGarden” failed to differentiate control and experimental groups in the proportion of patients who received unscheduled medication for delirium and measures of delirium itself (Intensive care delirium screening checklist; ICDSC, p > 0.05). Further research is needed to explore the benefits of this tool in reducing agitation in other in-patient populations marked by cognitive impairment and distress. Studies with an increased sample size may provide insight into the early, but not sustained decrease of unplanned chemical intervention with the use of “MindfulGarden” compared to control care.


Dartmouth Joins International AI Alliance

Article Excerpt: With the rapid development of artificial intelligence poised to impact society more quickly and broadly than ever, Dartmouth has joined more than 50 other leaders in industry, government, research, and higher education as a founding member of the newly formed AI Alliance… Dartmouth researchers are continuing the institution’s legacy as the birthplace of AI to study and deploy AI technology across a spectrum of areas. The Center for Precision Health and Artificial Intelligence, launched this year, is unique among its peers in fostering collaboration between AI scientists and physicians to individualize treatment using patients’ unique biomedical data while also identifying strategies for safely and ethically deploying AI in health care. Faculty also are applying AI to digital health therapeutics and diagnosis, medical education, and policy enforcement, as well as working to eliminate bias in large language models and even using AI to understand the extinction of the dinosaurs.

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Article Source: Dartmouth News


A Year After Launching, ChatGPT Is Already Changing Medicine

Article Excerpt: It’s passed medical licensing exams. It’s advanced how researchers develop new medicines and cut down on doctors’ hefty paperwork. And it’s nudged health care closer to a world where AI can offer diagnoses. Why it matters: One year after OpenAI’s ChatGPT exploded onto the scene, the generative AI model is already upending health care — an industry not exactly known for its speedy adoption of tech — while accelerating questions about AI’s promises and limitations. The big picture: While AI and algorithms have been used in health care for decades, ChatGPT and other generative AI models that quickly followed have supercharged their use across research and the delivery of care.

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Article Source: Axios


Your Smartphone Can Determine Your Level of Intoxication

Article Excerpt: In an innovative approach to public health and safety, a recent study suggests that everyday technology, like smartphones, could play a pivotal role in reducing alcohol-related accidents by determining if you are intoxicated. This study, a collaborative effort between Stanford Medicine and the University of Toronto, uncovers how smartphones and smart speakers might be utilized to assess a person’s alcohol intoxication through changes in their voice… The study stands as a clarion call to action for the creation of digital biomarker repositories by institutions like the National Institutes of Health. The ultimate aim is to forge an intervention system that is both user-friendly and effective in preventing injuries and saving lives, leveraging the power of technology for societal well-being.

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Today’s Topic: Cannabis

Article Excerpt: Although lawmakers in New Hampshire won’t pass a bill to legalize recreational cannabis this year, they are grinding away at plans that might gain traction next year. They gave a study commission until Dec. 1 to recommend a path forward, with an implied mission to satisfy the demands of Governor Chris Sununu, who dropped his opposition to legalization in May. Sununu, a Republican, signaled support for a model that would give the state control over marijuana distribution, marketing, and more… Jacob T. Borodovsky, Ph.D., a senior research scientist at Dartmouth’s Center for Technology and Behavioral Health, said Sununu seems to have the right idea about striking a balance to protect public health. While the blanket criminalization of cannabis has been harmful and should end, a purely laissez-faire approach to drug policy would be harmful as well for individuals and society alike, Borodovsky said. “There’s no correct answer. There’s only trade-offs,” he said. “And the trade-offs that you’re willing to accept depend on the values of the community that is making these decisions.”

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Article Source: Boston Globe New Hampshire Morning Report


Recreational Cannabis Has Arrived in Minnesota. What Are Its Health Benefits, Risks?

Article Excerpt: Despite its use in medicine, cannabis is a cause for concern for some clinicians, especially when they consider the developing brains of children and young adults. It is also an understudied substance, due in part to its federal classification as a Schedule 1 drug, limiting what we know, scientifically, about its potential benefits and harms on the human body. “Cannabis is not one drug,” said Jacob Borodovsky, a senior research scientist at the Geisel School of Medicine at Dartmouth. “The cannabis plant itself, we’ve identified over 150 cannabinoid compounds that are present in the cannabis plant. THC and CBD are just two of those 150 or more identified compounds.” So, what do we know about cannabis and its health impacts?

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Article Source: Post Bulletin


Close The Behavioral Health EMR Gap

Article Excerpt: There is increasing consensus that we must act to improve the nation’s behavioral health outcomes and capabilities. And the critical first step to fulfilling this goal is modernizing our behavioral health information technology infrastructure.

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Article Source: Health Affairs


How Does Marijuana Affect the Brain? Psychological Researchers Examine Impact on Different Age Groups Over Time

Article Excerpt: Although scientists are working to answer important questions about consuming cannabis, one of the gaping holes in the field is a reliable method of quantifying how many milligrams of THC are in the multitude of products available, said Dartmouth College’s Alan Budney, PhD, a professor of psychiatry and biomedical science who specializes in cannabis research… Budney is now preparing to launch a survey of 15,000 users who will report not only the detailed information about their cannabis consumption but also how the products are affecting them in terms of depression, anxiety, cannabis use disorder symptoms, and quality of life.

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Article Source: American Psychological Association


Spotting Opioid Overdoses Before They Happen, With AI

Article Excerpt: A Stony Brook University computer professor with an AI algorithm that detects substance abuse through language has refocused the impressive prediction technology on opioids – with startling results. Associate Computer Science Professor H. Andrew Schwartz is the senior author of a new study detailing the use of artificial intelligence to predict opioid mortalities. The work builds on Schwartz’s earlier success identifying high- and low-risk alcohol abuse via an AI application that interpreted language used in Facebook posts. This time, Schwartz and four other authors – including lead author Matthew Matero, an SBU computer-science student, and National Institute on Drug Abuse Data Scientist Salvatore Giorgi – hope to create some desperately needed “location-specific aid for the U.S. opioid crisis,” according to the abstract of an article published last week by the peer-reviewed open-access journal Npj Digital Medicine.

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Article Source: Innovate LI