535 research outputs found

    Essential pediatric hypertension: defining the educational needs of primary care pediatricians

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    BACKGROUND: In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. METHODS: We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. RESULTS: Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. CONCLUSIONS: There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN

    SuperNet in Neural Architecture Search: A Taxonomic Survey

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    Deep Neural Networks (DNN) have made significant progress in a wide range of visual recognition tasks such as image classification, object detection, and semantic segmentation. The evolution of convolutional architectures has led to better performance by incurring expensive computational costs. In addition, network design has become a difficult task, which is labor-intensive and requires a high level of domain knowledge. To mitigate such issues, there have been studies for a variety of neural architecture search methods that automatically search for optimal architectures, achieving models with impressive performance that outperform human-designed counterparts. This survey aims to provide an overview of existing works in this field of research and specifically focus on the supernet optimization that builds a neural network that assembles all the architectures as its sub models by using weight sharing. We aim to accomplish that by categorizing supernet optimization by proposing them as solutions to the common challenges found in the literature: data-side optimization, poor rank correlation alleviation, and transferable NAS for a number of deployment scenarios

    Association between vitamin D and pressure ulcers in older ambulatory adults: results of a matched case–control study

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    Usha R Kalava1, Stephen S Cha2, Paul Y Takahashi1,31Department of Internal Medicine, Division of Primary Care Internal Medicine, 2Department of Biostatistics, 3Kogod Center of Aging, Mayo Clinic, Rochester, MN, USABackground: Pressure ulcers are common among older adults, but knowledge about nutritional risk factors is still developing. Vitamin D deficiency is common in the elderly population and is required for normal skin proliferation. The role of vitamin D in pressure ulceration and wound healing is not known. The purpose of this case–control study was to determine the association between vitamin D levels and pressure ulceration in an older community-dwelling cohort.Methods: All cases and controls were community-dwelling elderly older than 60 years in a primary care panel in Olmsted County, MN. Pressure ulcer cases were defined clinically. The controls were age-matched and gender-matched to controls without pressure ulceration. The main exposure variable was 25-hydroxyvitamin D levels in both groups. The other exposure variable was the Charlson Comorbidity Index used to measure medical comorbidity. The analysis included univariate and conditional logistic regression for 25-hydroxyvitamin D levels.Results: The average (standard deviation) age of the study participants with a pressure ulcer was 80.46 years (±8.67), and the average vitamin D level was 30.92 ng/mL (±12.46). In univariate analysis, Vitamin D deficiency (levels < 25 ng/mL) was associated with pressure ulcers (odds ratio: 1.871, P = 0.0154). Comorbidities of the subjects calculated using the Charlson Comorbidity Index were also associated with pressure ulcers (odds ratio: 1.136, P < 0.001). In the final conditional logistical regression model, the association of Vitamin D and pressure ulcers became nonsignificant after adjustment for comorbid illness.Conclusion: Medical comorbidities increased the risk of pressure ulceration. Vitamin D deficiency was not an independent risk factor for pressure ulceration, and may be a marker of comorbid illness.Keywords: pressure ulcer, vitamin D, case–control study, aging, geriatric

    The Effects of Hypertension on Cognitive Function in Children and Adolescents

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    Hypertension (HTN) is found in about 3-4% of the pediatric population with long-term risks of end organ damage if untreated or poorly controlled. Although children with HTN are being more frequently screened for end organ damage (i.e., LVH), the cognitive effects of HTN and methods to screen for cognitive dysfunction have not been extensively explored. In recent years, there have been a small number of studies that have provided important insights that can guide future research in this area. These studies show that HTN can be associated with headaches, restlessness, sleep disturbance, anxiety, depression, decreased attention, and also poor executive functioning. By increasing the utilization of cognitive tests in hypertensive children and adolescents, important cognitive defects secondary to HTN may be detected. More research is needed in the area, and the results of future studies could have far reaching implications for long-term outcomes in hypertensive children and adolescents

    Identification and Field Evaluation of Grape Shoot Volatiles Attractive to Female Grape Berry Moth ( Paralobesia viteana )

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    Solid-phase microextraction (SPME) and gas chromatography coupled with electroantennographic detection (GC-EAD) were used to identify volatile compounds from shoots of riverbank grape (Vitis riparia) that attract the female grape berry moth (GBM, Paralobesia viteana). Consistent EAD activity was obtained for 11 chemicals: (Z)-3-hexen-1-yl acetate, (E)-linalool oxide, (Z)-linalool oxide, nonanal, linalool, (E)-4,8-dimethyl-1,3,7-nonatriene, methyl salicylate, decanal, β-caryophyllene, germacrene-D, and α-farnesene. In flight-tunnel tests that involved female GBM and rubber septa loaded with subsets of these 11 compounds, we found that both the 11-component blend and a seven-component blend, composed of (E)-linalool oxide, (Z)-linalool oxide, nonanal, (E)-4,8-dimethyl-1,3,7-nonatriene, decanal, β-caryophyllene and germacrene-D, elicited equivalent levels of upwind flight as freshly cut grape shoots. The removal of any of the seven compounds from the seven-component blend resulted in a significant decrease in female upwind flight responses. In a field trial with these two synthetic blends, traps equipped with either blend captured more female GBM compared to traps baited with hexane only (control), although the number of females caught was generally low. There were no differences in the number of males captured among treatments. Although in flight-tunnel trials, moths readily flew upwind to both grape shoots and rubber septa loaded with the best lures, they landed on shoots but not on rubber septa. Coupled with relatively low field catches, this suggests that additional host finding cues need to be identified to improve trap efficac

    Flight Tunnel Responses of Female Grape Berry Moth ( Paralobesia viteana ) to Host Plants

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    Semiochemicals play important roles in mate and host recognition of herbivorous insects, such as moths, and flight tunnels have been an effective tool in the identification of these bioactive compounds. However, more work has been carried out on pheromones than on host plant cues, and few examples exist where flight tunnel evaluations of host cues have resulted in a lure that is attractive under field conditions. Our goal was to determine whether the flight tunnel could be used to evaluate the response of a specialist moth, grape berry moth (GBM), to its host plant (grapevines), by incorporating ecological and physiological aspects of GBM biology. We found grape shoot tips and mature leaves were more attractive to female GBM than unripe and ripe berries or flowers. Under optimized flight tunnel conditions, approximately 80% of tested females flew upwind and closely approached or landed on the most preferred target. Mating status, wind speed, the time of day, and the presence/absence of patterns that resemble grape tissues on the top of the flight tunnel all significantly affected the responses of female GBM. Consideration of these factors in flight tunnel assays will aid in the development of a synthetic lure that can be used to monitor female moths in the fiel

    Fine-Tuning the Retrieval Mechanism for Tabular Deep Learning

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    While interests in tabular deep learning has significantly grown, conventional tree-based models still outperform deep learning methods. To narrow this performance gap, we explore the innovative retrieval mechanism, a methodology that allows neural networks to refer to other data points while making predictions. Our experiments reveal that retrieval-based training, especially when fine-tuning the pretrained TabPFN model, notably surpasses existing methods. Moreover, the extensive pretraining plays a crucial role to enhance the performance of the model. These insights imply that blending the retrieval mechanism with pretraining and transfer learning schemes offers considerable potential for advancing the field of tabular deep learning.Comment: Table Representation Learning Workshop at NeurIPS 202
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