After careful peer review of 34 applications submitted in November 2017, we are pleased to announce the five Round 1 Northern New England Clinical & Translational Research Network pilot project award winners:
Alexa Craig (MMC)
Leveraging Telemedicine to Reduce Disparities in Time to Initiation of Therapeutic Hypothermia in Rural Settings: a Pilot Feasibility Study
Neonatal Encephalopathy is a condition that can occur in newborn babies who experience traumatic births and can lead to death or adverse neurological outcomes including cerebral palsy and epilepsy due to the combined effects of lack of oxygen and blood flow to the brain. Therapeutic hypothermia, the only known treatment for neonatal encephalopathy, must be started within the first 6 hours of life and is known to greatly improve the outcomes for treated babies. However, babies born in rural hospitals in Maine do not have readily available access to providers with expertise and confidence in the assessment of neonatal encephalopathy. Through a pilot study that will use live telemedicine consults between rural hospitals and our tertiary care center, we aim to demonstrate a reduction in the time to initiate hypothermia for infants born in rural hospitals and thereby decrease the impact of this health care disparity on rural Maine families.
Reviewers: Jane Lian (UVM), Susan Santangelo (MMC), David Seder (MMC)
Paul Han (MMC) and Robert Gramling (UVM)
Northern New England Palliative Care Teleconsult Research Laboratory
The proposed project will conduct innovative research to expand access to palliative care for rural underserved communities in Vermont and Maine using telehealth technology. The project will focus on patients with advanced-stage cancer and heart failure, and on optimizing telemedicine-based physician-patient communication of complex information. The project’s specific aims are to: 1) Develop, implement, and evaluate the feasibility and acceptability of palliative care teleconsultation in the target populations. 2) Develop and evaluate multimodal, laboratory-based methods (including machine learning and psychophysiological measurement) to assess patients’ cognitive, emotional, and behavioral responses to telemedicine-based communication to understand the pathway by which palliative care improves patient outcomes.
Reviewers: Donald St. Germain (MMC), Kimberly Luebbers (UVM), Scot Remick (MMC)
Susan Miesfeldt (MMC)
Influence of Sociodemographic Factors on Access to Cancer Surgery Facilities in Maine
In Maine, statistics show a significant connection between income, place of residence, and risk for/outcome from cancer. Data indicate a volume-outcome relationship for some types of cancers treated with technically-complex surgical procedures, including lung, gynecologic, urinary system and gastrointestinal cancers. As high volume hospitals are more often located in populated areas, or in areas serving a large geographic region, we hypothesize that geographic isolation and low income limit a newly diagnosed, surgically treatable cancer patient’s access to technically complex surgical care at high-volume hospitals. We will test this hypothesis by examining the influence of rural place of residence and other sociodemographic factors on utilization of high volume hospitals for surgical treatment of early stage target cancers (nonsmall cell lung, ovarian cancer, bladder and upper gastrointestinal) in Maine. Data collected will be valuable to future grant proposals dedicated to exploring solutions to geographic barriers to cancer care among rural, socioeconomically disadvantaged cancer patients from Northern New England and nationally.
Reviewers: Erika Ziller (MMC), Frances Carr (UVM), Bernard Cole (UVM)
Timothy Plante (UVM) and Kathleen Fairfield (MMC)
Leveraging Health Records to Explain Rural Cardiovascular Disease Disparities
Recent medical advancements in the prevention of and care for heart attacks and strokes have reduced the rates of occurrence of these conditions (cumulatively known as cardiovascular disease, or CVD). Unfortunately, rural populations have been left out of these gains and the rate of CVDs among these populations remain high. The reasons for these disparities is poorly documented. We seek to leverage the electronic health records at the University of Vermont Medical Center and Maine Medical Center to explain why this rural disparity exists and identify specific steps that could be taken at these institutions to reduce the burden of CVD in these communities.
Reviewers: Douglas Sawyer (MMC), Jan Carney (UVM), Bernard Cole (UVM)
Janet Stein (UVM) Nicholas Farina (UVM),
Discovering the Potential of tsRNA as Breast Cancer Biomarkers and Therapeutic Targets
Cancer patients in rural communities often forego cancer screening due to their isolation and distance from a comprehensive cancer center. Many times, the disease has progressed to a late stage by the time it is detected. Developing a blood-based test for breast cancer that can be performed by physicians in rural areas will help alleviate this problem and may provide a way to monitor response to treatment strategies without the need to travel to a cancer treatment center. Further, a simple blood draw is far less stressful and costly then a screening MRI. Our proposed work will determine if a recently discovered class of small molecules, tsRNAs, 1) promote aggressive characteristics of breast cancer cells and 2) are a non-invasive biomarker of breast cancer, potentially in parallel with microRNAs, and may provide novel therapeutic targets.
Reviewers: Bob Friesel (MMC), Frances Carr (UVM), Pradeep Sathayanarayana (MMC)