Publications by authors named "Allan K"

Background: Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017.

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Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have risen exponentially in usage and have been shown to exert neuroprotective and anti-inflammatory effects across multiple organ systems. This study investigates whether GLP-1RAs influence the risk for age-related ocular diseases.

Design: Retrospective cohort study.

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Article Synopsis
  • The study investigated risk factors for spotted fever group rickettsioses (SFGR) in the Kilimanjaro Region, Tanzania, focusing on febrile patients from local hospitals between 2012 and 2014.
  • Of 1,190 participants, 54.6% had SFGR exposure, with 9.2% displaying acute SFGR; factors such as age, rural living, and temperature were significant in determining risk.
  • The findings highlight that children under 2 years, rural residents, and those in cooler areas may be at higher risk for SFGR, suggesting a need for targeted prevention strategies and additional research on tick exposure.
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Lack of data on the aetiology of livestock diseases constrains effective interventions to improve livelihoods, food security and public health. Livestock abortion is an important disease syndrome affecting productivity and public health. Several pathogens are associated with livestock abortions but across Africa surveillance data rarely include information from abortions, little is known about aetiology and impacts, and data are not available to inform interventions.

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Background: Disparities in atrial fibrillation ablation rates have been studied previously, with a focus on either patient characteristics or systems factors, rather than geographic factors. The impact of electrophysiology (EP) centre practice patterns on ablation rates has not been well studied.

Methods: This population-based cohort study used linked administrative datasets covering physician billing codes, hospitalizations, prescriptions, and census data.

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Background: A peri-urban outbreak of Rift Valley fever virus (RVFV) among dairy cattle from May through August 2018 in northern Tanzania was detected through testing samples from prospective livestock abortion surveillance. We sought to identify concurrent human infections, their phylogeny, and epidemiologic characteristics in a cohort of febrile patients enrolled from 2016-2019 at hospitals serving the epizootic area.

Methods: From September 2016 through May 2019, we conducted a prospective cohort study that enrolled febrile patients hospitalized at two hospitals in Moshi, Tanzania.

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Background: British Columbia (BC) faces more than 7000 out-of-hospital cardiac arrests annually, which disproportionately affect rural areas, owing to their slower emergency medical service response and limited specialized care. Despite the known benefits of automated external defibrillator (AED) access and cardiopulmonary resuscitation (CPR) training, their status in rural BC schools is poorly documented.

Methods: We used an online survey of principals and vice-principals of rural schools in BC.

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Background: At the time of AtTEnd trial design, standard treatment for advanced or recurrent endometrial cancer included carboplatin and paclitaxel chemotherapy. This trial assessed whether combining atezolizumab with chemotherapy might improve outcomes in this population.

Methods: AtTEnd was a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial done in 89 hospitals in 11 countries across Europe, Australia, New Zealand, and Asia.

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Objectives: Parents' decisions to vaccinate their children against COVID-19 are complex and often informed by discussions with primary care physicians. However, little is known about physicians' perspectives on COVID-19 vaccinations for children or their experiences counselling parents in their decision-making. We explored physicians' experiences providing COVID-19 vaccination recommendations to parents and their reflections on the contextual factors that shaped these experiences.

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Objectives The coronavirus disease 2019 (COVID-19) pandemic has impacted public health systems and individuals' behaviour, with decreasing survival rates among out-of-hospital cardiac arrest (OHCA) patients. Bystander cardiopulmonary resuscitation (CPR) improves OHCA outcomes, which may have been affected by COVID-19. We sought to understand the impacts of COVID-19 on bystanders' willingness to administer CPR in three Canadian provinces.

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Article Synopsis
  • * The study identifies RNU4-2, a non-coding RNA gene, as a significant contributor to syndromic NDD, revealing a specific 18-base pair region with low variation that includes variants found in 115 individuals with NDD.
  • * RNU4-2 is highly expressed in the developing brain, and its variants disrupt splicing processes, indicating that non-coding genes play a crucial role in rare disorders, potentially aiding in the diagnosis of thousands with NDD worldwide.
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  • - The study examines the effect of the timing of adjuvant chemotherapy after colorectal cancer surgery on long-term outcomes, specifically disease-free survival, but there isn't a clear agreement on the best timing for treatment.
  • - Conducted as a post hoc analysis of the SCOT trial involving 5,719 patients from multiple countries, the research compares outcomes for those starting chemotherapy within 6 weeks after surgery versus those starting later.
  • - Results show that patients starting chemotherapy early (within 6 weeks) had a 5-year disease-free survival rate of 78%, compared to 73.2% for those who started later, highlighting potential benefits of earlier treatment initiation.
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Background: Patients resuscitated from out-of-hospital cardiac arrest (OHCA) are at high risk of recurrence, posing a substantial burden on healthcare systems. Despite the established benefit of implantable cardioverter defibrillator (ICD) therapy in many such patients, and recommendations by guidelines, few studies have described the proportion of OHCA patients who receive guideline-concordant care.

Methods: The Canadian Institute for Health Information Discharge Abstract Database dataset was used to identify OHCA patients admitted to hospitals across Canada, excluding Quebec.

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Background: The ketogenic diet (KD) is a high fat, moderate protein and very low carbohydrate diet. It can be used as a medical treatment for drug-resistant epilepsy (DRE), glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency. The aim of this scoping review was to map the KD literature, with a focus on epilepsy and associated metabolic conditions, to summarise the current evidence-base and identify any gaps.

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Objective: To describe the clinical impact of lowering the peripheral parenteral nutrition (PPN) maximum osmolarity limit from 1000 to 900 mOsm/L in patients in two neonatal intensive care units (NICUs).

Methods: This was a retrospective cohort study including inborn neonates that received PPN for at least 3 consecutive days within the first 14 days of life. Data were evaluated to compare the ability of PPN with a maximum osmolarity limit of 1000 to 900 mOsm/L to provide daily recommended macronutrient doses, and daily recommended goal calories, as well as to compare the incidence of significant peripheral intravenous (PIV) infiltrates.

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Around 60% of individuals with neurodevelopmental disorders (NDD) remain undiagnosed after comprehensive genetic testing, primarily of protein-coding genes. Increasingly, large genome-sequenced cohorts are improving our ability to discover new diagnoses in the non-coding genome. Here, we identify the non-coding RNA as a novel syndromic NDD gene.

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Article Synopsis
  • Exportin-1 (XPO1) is crucial for transporting proteins from the nucleus to the cytoplasm and also plays a role in processes like centrosome duplication; it is targeted by small molecules for cancer treatment, notably selinexor for multiple myeloma.
  • Research highlights a cell-type-dependent function of XPO1 in binding to chromatin, which is vital for the activity of NFAT transcription factors and proper T cell activation.
  • A new class of XPO1-targeting small molecules has been developed that disrupt XPO1's chromatin binding specifically, providing a potential therapeutic avenue for treating T cell-driven autoimmune disorders without causing cell death.
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We conducted a cross-sectional study of Crimean-Congo hemorrhagic fever virus (CCHFV) in northern Tanzania. CCHFV seroprevalence in humans and ruminant livestock was high, as were spatial heterogeneity levels. CCHFV could represent an unrecognized human health risk in this region and should be included as a differential diagnosis for febrile illness.

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Disease, injury and aging induce pathological reactive astrocyte states that contribute to neurodegeneration. Modulating reactive astrocytes therefore represent an attractive therapeutic strategy. Here we describe the development of an astrocyte phenotypic screening platform for identifying chemical modulators of astrocyte reactivity.

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Objectives: Leptospira, the spirochaete causing leptospirosis, can be classified into >250 antigenically distinct serovars. Although knowledge of the animal host species and geographic distribution of Leptospira serovars is critical to understand the human and animal epidemiology of leptospirosis, current data are fragmented. We aimed to systematically review, the literature on animal host species and geographic distribution of Leptospira serovars to examine associations between serovars with animal host species and regions and to identify geographic regions in need of study.

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Low socioeconomic status (SES) is associated with poor outcomes after out-of-hospital cardiac arrest (OHCA). Patient characteristics, care processes, and other contextual factors may mediate the association between SES and survival after OHCA. Interventions that target these mediating factors may reduce disparities in OHCA outcomes across the socioeconomic spectrum.

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Background: Leptospirosis is suspected to be a major cause of illness in rural Tanzania associated with close contact with livestock. We sought to determine leptospirosis prevalence, identify infecting Leptospira serogroups, and investigate risk factors for leptospirosis in a rural area of Tanzania where pastoralist animal husbandry practices and sustained livestock contact are common.

Methods: We enrolled participants at Endulen Hospital, Tanzania.

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Background: Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of Covid-19 VH and under-vaccination among marginalized populations in the U.S. and Canada.

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Objectives: , the spirochaete causing leptospirosis, can be classified into >250 antigenically distinct serovars. Although knowledge of the animal host species and geographic distribution of serovars is critical to understand the human and animal epidemiology of leptospirosis, currently data are fragmented. We aimed to systematically review the literature on animal host species and geographic distribution of serovars to examine associations between serovars with animal host species and regions, and to identify geographic regions in need of study.

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