Perioperative Cognitive Anesthesia Network Extension for Socially Vulnerable Older Adults

针对社会弱势老年人的围手术期认知麻醉网络扩展

• 批准号: 10633174
• 负责人: Patrick J Tighe
• 金额: $ 15.47万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10633174
• 关键词: Academic/Teacher Award; Acceleration; Address; Advisory Committees; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Anesthesia procedures; Anesthesiology; Anesthetics; Area; Artificial Intelligence; Awareness; Basic Science; Clinic; Clinical; Clinical Sciences; Cognition; Cognitive; Collection; Communities; Conduction Anesthesia; Data; Data Linkages; Data Science; Databases; Disparate; Disparity; Documentation; Early Diagnosis; Elderly; Electricity; Fellowship; Florida; Food; Funding; Geriatrics; Grant; Health; Health system; Healthcare Systems; High Performance Computing; Hospitals; Impaired cognition; Individual; Inequity; Infrastructure; Institution; Interdisciplinary Study; Investigation; Lead; Leadership; Link; Machine Learning; Measures; Medicine; Mentorship; Modeling; Neighborhoods; Nerve Degeneration; Neurodegenerative Disorders; Neuropsychology; Operative Surgical Procedures; Orthopedic Surgery; Outcome; Pain; Pathway interactions; Patients; Performance; Perioperative; Perioperative Care; Population; Population Heterogeneity; Postoperative Pain; Postoperative Period; Process; Proxy; Records; Recovery; Research; Research Infrastructure; Research Personnel; Research Training; Resources; Role; Scientist; Secure; Social Functioning; Social Network; Social support; Structure; Supplementation; System; Time; Training; Training Programs; Transportation; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Update; Vulnerable Populations; aspirate; care systems; certificate program; clinical diagnosis; cognitive change; cohort; curriculum development; data modeling; deep learning; deprivation; disparity reduction; electronic health record system; experience; frailty; indexing; learning strategy; meetings; mild cognitive impairment; multidisciplinary; neglect; neuropathology; novel; postoperative recovery; programs; prospective; provider factors; recruit; risk stratification; sex; social; social determinants; social disparities; social factors; social health determinants; social vulnerability; success; surgery outcome; symposium; timeline; unstructured data

ABSTRACT The U.S. healthcare system cares for increasing numbers of older adults, including those with Alzheimer’s disease and related dementias, who require surgery with anesthesia. Regional social inequities, as measured by spatial indices such as area deprivation and social vulnerability indices, independently contribute to differences in perioperative and neurodegenerative outcomes. Data also support a significant association between neighborhood-level area deprivation indices with Alzheimer’s disease neuropathology. Despite emerging evidence linking social determinants of health with disparities in postoperative outcomes in older adults, investigations in these areas increasingly require expertise with disparate subject matters, including clinical perioperative practice, geriatrics, neuropsychology, social determinants of health, geospatial analyses, and even artificial intelligence. The K07 applicant is a National Institutes of Health (NIH)-funded independent investigator and fellowship-trained anesthesiologist with expertise in regional anesthesia and orthopedic surgery, as well as research experience in machine learning, geospatial disparities, and perioperative pain and cognition. The purpose of this proposal is to promote institutional and community awareness of how social vulnerabilities impact perioperative outcomes in older adults, including those with Alzheimer’s disease and related dementias, and particularly those outcomes related to postoperative pain and cognition. The overall strategy of this proposal is to develop interdisciplinary research infrastructure along with transdisciplinary training programs to crosspollinate research teams. This structure will be organized via the Perioperative Cognitive Anesthesia Network-Social Vulnerability (PeCANSV) construct in three aims: Aim 1: Convene a PeCANSV multidisciplinary advisory team to establish three supplemental cores in 1) geospatial infrastructure; 2) social determinants of health; 3) artificial intelligence. Aim 2: Accelerate research discovery through interdisciplinary research pathways by formalizing nascent linkages between supplemental PeCANSV cores and UF resources and extant geospatial, environmental, cognitive, and clinical perioperative databases at UF Health and throughout Florida. Aim 3: Develop a transdisciplinary workforce of clinical and basic science researchers to lead interdisciplinary teams addressing the social vulnerability of older adult surgical patients. Milestones include regular analysis of strengths, opportunities, aspirations, and results, interdisciplinary proposal submissions, and evidence of trainee success in perioperative research in social disparities of older adults, including those with Alzheimer’s disease and related dementias.

抽象的 美国医疗保健系统照顾越来越多的老年人，包括患有阿尔茨海默氏症的老年人 疾病和相关痴呆症，需要麻醉手术。衡量的区域社会不平等 通过空间指数，如面积剥夺和社会脆弱性指数，独立地贡献 围手术期和神经退行性结果的差异。数据也支持显着的关联 邻里区域剥夺指数与阿尔茨海默病神经病理学之间的关系。尽管 新的证据将健康的社会决定因素与老年人术后结果的差异联系起来 成年人，这些领域的调查越来越需要不同主题的专业知识，包括 临床围手术期实践、老年病学、神经心理学、健康的社会决定因素、地理空间分析、 甚至人工智能。 K07 申请人是美国国立卫生研究院 (NIH) 资助的独立机构 具有区域麻醉和骨科手术专业知识的研究者和经过专科培训的麻醉师， 以及机器学习、地理空间差异以及围手术期疼痛和认知方面的研究经验。 该提案的目的是提高机构和社区对社会脆弱性如何影响的认识 影响老年人的围手术期结果，包括患有阿尔茨海默病和相关痴呆症的老年人， 特别是与术后疼痛和认知相关的结果。本提案的总体策略 是开发跨学科研究基础设施以及跨学科培训计划 异花授粉研究团队。该结构将通过围手术期认知麻醉来组织 网络社会脆弱性 (PeCANSV) 的构建分为三个目标： 目标 1：召集 PeCANSV 多学科研究 咨询团队将在以下方面建立三个补充核心：1）地理空间基础设施； 2）社会决定因素 健康; 3）人工智能。目标 2：通过跨学科研究途径加速研究发现 通过正式确定补充 PeCANSV 核心与 UF 资源和现有地理空间之间的新生联系， 佛罗里达大学健康中心和整个佛罗里达州的环境、认知和临床围手术期数据库。目标 3： 培养一支由临床和基础科学研究人员组成的跨学科队伍来领导跨学科团队 解决老年外科患者的社会脆弱性。里程碑包括定期分析 优势、机会、愿望和结果、跨学科提案提交以及受训者的证据 针对老年人（包括阿尔茨海默病患者）社会差异的围手术期研究取得成功 以及相关的痴呆症。

项目成果

Fairness in the prediction of acute postoperative pain using machine learning models.

使用机器学习模型预测急性术后疼痛的公平性。

• DOI: 10.3389/fdgth.2022.970281
• 发表时间: 2022
• 期刊: FRONTIERS IN DIGITAL HEALTH
• 作者: Davoudi, Anis;Sajdeya, Ruba;Ison, Ron;Hagen, Jennifer;Rashidi, Parisa;Price, Catherine C;Tighe, Patrick J
• 通讯作者: Tighe, Patrick J

Human IPSC-Derived PreBötC-Like Neurons and Development of an Opiate Overdose and Recovery Model.

人类 IPSC 衍生的 PreBötC 样神经元以及阿片类药物过量和恢复模型的开发。

• DOI: 10.1002/adbi.202300276
• 发表时间: 2023
• 期刊: Advanced biology
• 影响因子: 3.7
• 作者: Guo,Xiufang;Akanda,Nesar;Fiorino,Gabriella;Nimbalkar,Siddharth;Long,ChristopherJ;Colón,Alisha;Patel,Aakash;Tighe,PatrickJ;Hickman,JamesJ
• 通讯作者: Hickman,JamesJ

Perioperative Use of Gabapentinoids and Risk for Postoperative Long-Term Opioid Use in Older Adults Undergoing Total Knee or Hip Arthroplasty.

• DOI: 10.1016/j.arth.2022.05.018
• 发表时间: 2022-11
• 期刊: JOURNAL OF ARTHROPLASTY
• 影响因子: 3.5
• 作者: Chen, Cheng;Tighe, Patrick J.;Lo-Ciganic, Wei-Hsuan;Winterstein, Almut G.;Wei, Yu-Jung
• 通讯作者: Wei, Yu-Jung

Concurrent Use of Prescription Opioids and Gabapentinoids in Older Adults.

• DOI: 10.1016/j.amepre.2021.08.024
• 发表时间: 2022-04
• 期刊: AMERICAN JOURNAL OF PREVENTIVE MEDICINE
• 影响因子: 5.5
• 作者: Chen, Cheng;Lo-Ciganic, Wei-Hsuan;Winterstein, Almut G.;Tighe, Patrick;Wei, Yu-Jung J.
• 通讯作者: Wei, Yu-Jung J.