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Implementing brief behavioral treatment for insomnia in Department of Veterans Affairs Primary Care Mental Health Integration clinics: Reach outcomes from a hybrid type 3 effectiveness-implementation trial.
Psychol Serv
January 2025
Center for Health Equity Research and Promotion, Department of Veterans Affairs Pittsburgh Healthcare System.
Chronic insomnia is one of the most common health problems among veterans and can significantly impact health, function, and quality of life. Brief behavioral treatment for insomnia (BBTI), an adaptation of cognitive behavioral therapy for insomnia (CBT-I), was developed to help increase access to care outside of specialty settings. However, training providers alone is rarely sufficient, and implementation strategies are needed for successful uptake, adoption, and sustainable delivery of care.
View Article and Find Full Text PDFComparative analysis of sleep physiology using qualitative and quantitative criteria for insomnia symptoms.
Sleep
December 2024
Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA.
Despite decades of research, defining insomnia remains challenging due to its complex and variable nature. Various diagnostic systems emphasize the chronic nature of insomnia and its impact on daily functioning, relying heavily on patient self-reporting due to limitations in objective measures like polysomnography (PSG). Discrepancies between subjective experiences and objective PSG results highlight the need for more nuanced approaches, such as electroencephalogram (EEG) spectral analysis, which reveals distinct patterns of high-frequency activity in individuals with insomnia.
View Article and Find Full Text PDFValidation and Epidemiologic Definition of the Novel Steatotic Liver Disease Nomenclature in a National United States Cohort With Cirrhosis.
Clin Gastroenterol Hepatol
December 2024
Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania. Electronic address:
Background & Aims: Novel steatotic liver disease (SLD) definitions were introduced in 2023. Accurate and meaningful classifications using clinical data are needed to study interventions and outcomes.
Methods: In a national cohort of Veterans with cirrhosis and imaging-confirmed steatosis, 7 algorithms differentially emphasizing cardiometabolic risk factors (CMRFs) and alcohol exposure were developed to define alcohol-associated liver disease (ALD), metabolic dysfunction associated SLD (MASLD), and MASLD with increased alcohol intake (MetALD).
Denoising diffusion model for increased performance of detecting structural heart disease.
medRxiv
November 2024
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104.
Recent advancements in generative artificial intelligence have shown promise in producing realistic images from complex data distributions. We developed a denoising diffusion probabilistic model trained on the CheXchoNet dataset, encoding the joint distribution of demographic data and echocardiogram measurements. We generated a synthetic dataset skewed towards younger patients with a higher prevalence of structural left ventricle disease.
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