Building a learning health care community in rural and remote areas: a systematic review.

Background: A Learning Health Care Community (LHCC) is a framework to enhance health care through mutual accountability between the health care system and the community. LHCC components include infrastructure for health-related data capture, care improvement targets, a supportive policy environment, and community engagement. The LHCC involves health care providers, researchers, decision-makers, and community members who work to identify health care needs and address them with evidence-based solutions.

Quantitative background parenchymal enhancement and fibro-glandular density at breast MRI: Association with BRCA status.

Objectives: To investigate whether MRI-based measurements of fibro-glandular tissue volume, breast density (MRBD), and background parenchymal enhancement (BPE) could be used to stratify two cohorts of healthy women: BRCA carriers and women at population risk of breast cancer.

Methods: Pre-menopausal women aged 40-50 years old were scanned at 3 T, employing a standard breast protocol including a DCE-MRI (35 and 30 participants in high- and low-risk groups, respectively). The dynamic range of the DCE protocol was characterised and both breasts were masked and segmented with minimal user input to produce measurements of fibro-glandular tissue volume, MRBD, and voxelwise BPE.

Mental health conditions of Chinese international students and associated predictors amidst the pandemic.

The current study aims to examine the mental health conditions and the associated predictors among Chinese international students. A sample of 256 Chinese international students aged 16 or above living primarily in Canada were asked to complete an online survey. Mental health conditions were assessed with the Depression, Anxiety, and Stress Scale-21 and the Physical and Mental Health Summary Scales.

Spreading pathways of Pilgrim Nuclear Power Station wastewater in and around Cape Cod Bay: Estimates from ocean drifter observations.

Near-surface drifter observations were used to study the spreading pathways in and around the Cape Cod Bay from a source region located just offshore of the Pilgrim Nuclear Power Station. The study was motivated by the recent closing of the power plant and a possible release of accumulated wastewater. The investigation applies several different techniques to the drifter data set to estimate and quantify various aspects of the circulation and spreading.

NO dynamics in the western Arctic Ocean during the summer of 2017.

The western Arctic Ocean (WAO) has experienced increased heat transport into the region, sea-ice reduction, and changes to the WAO nitrous oxide (NO) cycles from greenhouse gases. We investigated WAO NO dynamics through an intensive and precise NO survey during the open-water season of summer 2017. The effects of physical processes (i.

Imaging in clinical trials: a patient-led questionnaire study to assess impact of imaging regimes on patient participation.

Background: Cancer trials often incorporate intensive imaging with Magnetic Resonance Imaging (MRI) and Positron Emission Tomography with Computerised Tomography (PET/CT), which can be physically and mentally exhausting for patients. This questionnaire study aimed to determine the aspects of imaging that affect a patient's decision to participate in clinical trials in order to inform the design of future trials that utilise imaging. This should achieve greater patient compliance and improve the patient experience.

Latitudinal Distributions and Controls of Bacterial Community Composition during the Summer of 2017 in Western Arctic Surface Waters (from the Bering Strait to the Chukchi Borderland).

The western Arctic Ocean is experiencing some of the most rapid environmental changes in the Arctic. However, little is known about the microbial community response to these changes. Employing observations from the summer of 2017, this study investigated latitudinal variations in bacterial community composition in surface waters between the Bering Strait and Chukchi Borderland and the factors driving the changes.

An automated approach for the optimised estimation of breast density with Dixon methods.

Objective: To present and evaluate an automated method to correct scaling between Dixon water/fat images used in breast density (BD) assessments.

Methods: Dixon images were acquired in 14 subjects with different weightings (flip angles, FA, 4°/16°). Our method corrects intensity differences between water () and fat () images via the application of a uniform scaling factor (SF), determined subject-by-subject.

Recent Transport History of Fukushima Radioactivity in the Northeast Pacific Ocean.

The large inventory of radioactivity released during the March, 2011 Fukushima Dai-ichi nuclear reactor accident in Japan spread rapidly across the North Pacific Ocean and was first observed at the westernmost station on Line P, an oceanographic sampling line extending 1500 km westward of British Columbia (BC), Canada in June 2012. Here, time series measurements of Cs and Cs in seawater on Line P and on the CLIVAR-P16N 152°W line reveal the recent transport history of the Fukushima radioactivity tracer plume through the northeast Pacific Ocean. During 2013 and 2014 the Fukushima plume spread onto the Canadian continental shelf and by 2015 and early 2016 it reached Cs values of 6-8 Bq/m in surface water along Line P.

Monitoring Tumor Volume in Patients With Prostate Cancer Undergoing Active Surveillance: Is MRI Apparent Diffusion Coefficient Indicative of Tumor Growth?

Objective: The purpose of this study was to measure longitudinal change in tumor volume of the dominant intraprostatic lesion and determine whether baseline apparent diffusion coefficient (ADC) and change in ADC are indicative of tumor growth in patients with prostate cancer undergoing active surveillance.

Subjects And Methods: The study group included 151 men (mean age, 68.1 ± 7.

Accelerated freshening of Antarctic Bottom Water over the last decade in the Southern Indian Ocean.

Southern Ocean abyssal waters, in contact with the atmosphere at their formation sites around Antarctica, not only bring signals of a changing climate with them as they move around the globe but also contribute to that change through heat uptake and sea level rise. A repeat hydrographic line in the Indian sector of the Southern Ocean, occupied three times in the last two decades (1994, 2007, and, most recently, 2016), reveals that Antarctic Bottom Water (AABW) continues to become fresher (0.004 ± 0.

Diffusion-weighted Imaging as a Treatment Response Biomarker for Evaluating Bone Metastases in Prostate Cancer: A Pilot Study.

Purpose To determine the usefulness of whole-body diffusion-weighted imaging (DWI) to assess the response of bone metastases to treatment in patients with metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods A phase II prospective clinical trial of the poly-(adenosine diphosphate-ribose) polymerase inhibitor olaparib in mCRPC included a prospective magnetic resonance (MR) imaging substudy; the study was approved by the institutional research board, and written informed consent was obtained. Whole-body DWI was performed at baseline and after 12 weeks of olaparib administration by using 1.

Past, Present and Future: The Outlook from Mid-Career Nurse Informaticians.

Nursing informatics (NI), as a specialty of nursing, can trace its origins back as far as the 1960s. While difficult to find empirical evidence to pinpoint exactly when NI moved from the fringes of nursing to more mainstream recognition, the late 1990s to early 2000s was a period of significant growth in the desire to leverage information technology as a means of collecting more robust and reliable healthcare information. This, in turn, has led to a significant increase in the number of nurses working as NI specialists.

Comparison of Dixon Sequences for Estimation of Percent Breast Fibroglandular Tissue.

Objectives: To evaluate sources of error in the Magnetic Resonance Imaging (MRI) measurement of percent fibroglandular tissue (%FGT) using two-point Dixon sequences for fat-water separation.

Methods: Ten female volunteers (median age: 31 yrs, range: 23-50 yrs) gave informed consent following Research Ethics Committee approval. Each volunteer was scanned twice following repositioning to enable an estimation of measurement repeatability from high-resolution gradient-echo (GRE) proton-density (PD)-weighted Dixon sequences.

Delivering breast cancer care in urban India: Heterotopia, hospital ethnography and voluntarism.

Despite substantial strides to improve cancer control in India, challenges to deliver oncology services persist. One major challenge is the provision and accessibility of adequate infrastructure. This paper offers ethnographic insight on the conceptual and material conditions that are currently shaping the delivery of oncology in Mumbai, focusing specifically on the way India's socio-economic context necessitates non-biomedical acts of voluntarism or 'seva' (selfless service).

Frontal fibrosing alopecia: a review of 60 cases.

Background: Frontal fibrosing alopecia (FFA) is a variant of lichen planopilaris primarily affecting postmenopausal women, with a predilection for the frontotemporal hairline.

Objectives: We sought to examine possible causal associations and review the clinical features, natural history, and response to treatment of patients with FFA attending a specialist hair clinic.

Methods: This was a case note review of 60 patients with FFA.

Fukushima-derived radionuclides in the ocean and biota off Japan.

The Tōhoku earthquake and tsunami of March 11, 2011, resulted in unprecedented radioactivity releases from the Fukushima Dai-ichi nuclear power plants to the Northwest Pacific Ocean. Results are presented here from an international study of radionuclide contaminants in surface and subsurface waters, as well as in zooplankton and fish, off Japan in June 2011. A major finding is detection of Fukushima-derived (134)Cs and (137)Cs throughout waters 30-600 km offshore, with the highest activities associated with near-shore eddies and the Kuroshio Current acting as a southern boundary for transport.

EHR Implementation: One Organization's Road to Success.

This paper describes Ontario Shores Centre for Mental Health Sciences' successful journey in the implementation of a fully integrated single proprietary solution health care information system over approximately 22 months. The paper describes the various phases involved, the approach for implementation, lessons learned throughout the process and the organization's future plans for optimization.

The secretory clear cell of the eccrine sweat gland as the probable source of excess sweat production in hyperhidrosis.

Primary hyperhidrosis is characterized by excessive sweating in palmar, plantar and axillary body regions. Gland hypertrophy and the existence of a third type of sweat gland, the apoeccrine gland, with high fluid transporting capabilities have been suggested as possible causes. This study investigated whether sweat glands were hypertrophied in axillary hyperhidrotic patients and if mechanisms associated with fluid transport were found in all types of axillary sweat glands.