Aim: As heart failure (HF) with preserved ejection fraction (HFpEF) prevalence increases, it remains frequently underdiagnosed and poorly managed. Recent positive pharmacological trials have increased interest in HFpEF but challenges of diagnosis and management remain. The survey aim was to examine consensus between primary and secondary care providers regarding HFpEF diagnosis and management.
View Article and Find Full Text PDFObjectives: To describe the population that meets the criteria for major depressive disorder (MDD) in British Columbia (BC), compare patterns of healthcare utilisation between those with MDD who are and are not prescribed pharmacotherapy, and assess these relationships in models that control for potential confounding variables.
Design: We used a population cross-sectional study design among a cohort of individuals living with MDD and examined the relationship between pharmacotherapy and healthcare utilisation between 2019 and 2020 using linked billing and administrative data.
Setting: This study identified individuals with MDD using a validated case definition of International Classification of Diseases (ICD) codes in BC, Canada.
Background: Total hip arthroplasty (THA) practices are evolving under the influence of the current value-based healthcare system and bundled payment models. This study aimed to (1) evaluate national trends in discharge disposition and postoperative outcomes after THA, (2) compare discharge cohorts on episode-of-care parameters, and (3) determine predictors of nonhome discharge from 2011 to 2021.
Methods: The National Surgical Quality Improvement Program database was queried for THA data from 2011 to 2021.
Background: Cardiovascular disease (CVD) is associated with higher rates of incident cancer. Data are scarce regarding the association of incident CVD with oncologic outcomes after a cancer diagnosis.
Objectives: This study sought to determine whether incident myocardial infarction (MI) or heart failure (HF) in breast cancer survivors is associated with oncologic outcomes.
Background And Aims: The 2020 United States Multi-Society Task Force on Colorectal Cancer guidelines for surveillance after colonoscopy with polypectomy introduced significant changes in surveillance intervals. We sought to identify rates of adherence to these new guidelines at an academic medical center.
Methods: Average-risk screening colonoscopies where 1 to 4 polyps <10 mm were removed between January 1, 2020, and June 30, 2021 were included.
Introduction: Children and young adults diagnosed with sarcoma often present with pulmonary metastases requiring wedge resection. It is important to balance the risk of pulmonary recurrence against the desire to limit resection of benign parenchyma. This study aims to determine the impact of resection margins on survival and recurrence among pediatric and young adult sarcoma patients.
View Article and Find Full Text PDFIntroduction: The ability of healthcare, community and public health systems to effectively implement and disseminate research innovations depends on contextual factors at multiple interconnected levels of influence (eg, the innovation, individual, provider/implementor, organisation and health system). Recently, there has been an increase in the development of complex interventions designed to target multiple levels, designed for or adapted to the context in which they are delivered. Two concepts from complex systems thinking have been increasingly used to operationalise such interventions-core functions (theory and evidence-driven purposes of interventions) and forms (adaptable activities that perform each core function).
View Article and Find Full Text PDFEpigenetic therapies facilitate transcription of immunogenic repetitive elements that cull cancer cells through 'viral mimicry' responses. Paradoxically, cancer-initiating events also facilitate transcription of repetitive elements. Contributions of repetitive element transcription towards cancer initiation, and the mechanisms by which cancer cells evade lethal viral mimicry responses during tumor initiation remain poorly understood.
View Article and Find Full Text PDFFriendships are vital for the well-being of young adults, yet their social network is often reduced during episodes of life-disruptive mental distress, such as psychosis. Despite this, our study shows that young adults do either maintain or build friendships during such periods and that these relationships are crucial for recovery in youth. As research on the role of friendships in the recovery journey of this group is limited, this study explores the significance of friendships for young adults engaged in early psychosis interventions to generate insights that can inform mental health recovery practices.
View Article and Find Full Text PDFAlkane monooxygenase (AlkB) is the dominant enzyme that catalyzes the oxidation of liquid alkanes in the environment. Two recent structural models derived from cryo-electron microscopy (cryo-EM) reveal an unusual active site: a histidine-rich center that binds two iron ions without a bridging ligand. To ensure that potential photoreduction and radiation damage are not responsible for the absence of a bridging ligand in the cryo-EM structures, spectroscopic methods are needed.
View Article and Find Full Text PDFCurrently, available technologies and procedures enable aesthetic dermatologists to provide their patients with beneficial treatment outcomes for a wide variety of skin conditions. These treatments range from laser resurfacing and radiofrequency procedures to chemical peels and microneedling. The concept of integrated skincare is based on the application of adjunct therapies before, during, or after cosmetic medical procedures to promote healing, minimize discomfort, shorten down-time, and enhance overall aesthetic outcomes.
View Article and Find Full Text PDFIntroduction: Studies have shown that early weight gain in family-based treatment (FBT) predicts treatment response in adolescents with anorexia nervosa (AN); however, research examining factors associated with early weight gain in FBT is limited. This study tested the feasibility and acceptability of ecological momentary assessment (EMA) in early FBT, particularly to capture momentary data on family climate during mealtimes.
Methods: Using multiple methods, quantitative (EMA) and qualitative (interviews) data were collected in the first 4 weeks of FBT.
To broaden our understanding of bradyarrhythmias and conduction disease, we performed common variant genome-wide association analyses in up to 1.3 million individuals and rare variant burden testing in 460,000 individuals for sinus node dysfunction (SND), distal conduction disease (DCD) and pacemaker (PM) implantation. We identified 13, 31 and 21 common variant loci for SND, DCD and PM, respectively.
View Article and Find Full Text PDFIntroduction: Ineffective coordination during care transitions from hospitals to skilled nursing facilities (SNFs) costs Medicare US$2.8-US$3.4 billion annually and results in avoidable adverse events.
View Article and Find Full Text PDFStructured medication reviews (SMRs) were introduced into the National Health Service (NHS) Primary Care to support the delivery of the NHS Long-Term Plan for medicines optimization. SMRs improve the quality of care, reduce harm and offer value for money. However, evidence to support SMRs for patients with chronic kidney disease (CKD) stage G4-5D with elevated risk of cardiovascular disease and premature mortality is unknown.
View Article and Find Full Text PDFHighly visual and appearance-focused social media often exhibit appearance ideals that center around fairness and whiteness, resulting in the promotion of dangerous over-the-counter skin-lightening products to consumers to achieve such ideals. Our study aims to better understand the skin-lightening claims and products that TikTok users are exposed to on the platform. We conducted a cross-sectional content analysis to examine the top 100 most-viewed videos across the most popular skin-lightening hashtag (#skinlightening) through the TikTok website interface (N = 79) and generated descriptive statistics.
View Article and Find Full Text PDFBackground: The work and life of a resident (or "junior") doctor has changed dramatically over the past 50 years. Descriptions of historic working conditions are usually anecdotal and tinted with nostalgia, but do today's burns and plastic surgery doctors feel working conditions have improved or declined over the last 50 years, and does this have an impact on recruitment and retention?
Methods: An interview was conducted with a retired surgeon who, in 1970, worked as a house surgeon (Year 2 doctor equivalent) in a burns unit for the pioneering burn surgeon Mr. Douglas MacGregor Jackson.
Background: The treatment of locally recurrent rectal cancer has evolved dramatically in recent decades. As the boundaries of exenterative surgery continue to be pushed, one of the unanswered and controversial questions is the role of radical salvage surgery for locally recurrent rectal cancer in the setting of oligometastatic disease.
Objective: To investigate the impact of synchronous or previously treated distant metastases on survival following pelvic exenteration for locally recurrent rectal cancer.
Background: Children born very preterm (VPT; <32 weeks) are at increased risk of executive functioning (EF) difficulties. But less is known about the nature and extent of these executive difficulties during late adolescence, particularly across multiple EF domains and in response to varying degrees of executive demand.
Methods: Using data from a prospective longitudinal study, this paper describes the EF profiles of 92 VPT and 68 full-term (FT) adolescents at age 17 years.
Biochemical and evolutionary interactions between mitochondrial and nuclear genomes ('mitonuclear interactions') are proposed to underpin fundamental aspects of biology including evolution of sexual reproduction, adaptation and speciation. We investigated the role of pre-mating isolation in maintaining functional mitonuclear interactions in wild populations bearing diverged, putatively co-adapted mitonuclear genotypes. Two lineages of eastern yellow robin Eopsaltria australis-putatively climate-adapted to 'inland' and 'coastal' climates-differ by ~7% of mitogenome nucleotides, whereas nuclear genome differences are concentrated into a sex-linked region enriched with mitochondrial functions.
View Article and Find Full Text PDFBackground: Transition to adulthood is a vulnerable time for emerging adults (16-25 years of age) with sickle cell disease (SCD), as there is a seven-fold increase in mortality rates during the transition period. Emerging adults with SCD also have the highest rates of hospitalizations, emergency room visits, and hospital readmissions compared to other age groups. Community health worker (CHW) programs have been developed to address outcomes such as patient activation which includes an individual's knowledge, skill, and confidence for managing one's health and healthcare, quality of life, and healthcare utilization for patients with chronic illnesses.
View Article and Find Full Text PDFObjective: Family-based treatment (FBT) is the leading evidence-based treatment for adolescent eating disorders, but research exploring access and engagement in FBT is sparse. This paper focuses on findings from a broader study, specifically addressing the social determinants of health (SDH) impeding access and engagement in FBT for diverse families (i.e.
View Article and Find Full Text PDFTraditionally, medical research is based on randomized controlled trials (RCTs) for interventions such as drugs and operative procedures. However, increasingly, there is a need for health research to evolve. RCTs are expensive to run, are generally formulated with a single research question in mind, and analyze a limited dataset for a restricted period.
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