Publications by authors named "Caplan L"

Objective: To describe intraoperative cardiac arrest in patients undergoing congenital heart surgery.

Methods: The Society of Thoracic Surgeons Congenital Heart Surgery Database was queried. Predictors of intraoperative cardiac arrest were assessed using univariate and multivariable analyses.

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  • - The study analyzed 3847 patients who suffered from a transient ischemic attack or minor ischemic stroke, focusing on those without traditional risk factors (like hypertension and diabetes) to compare their outcomes with those who did have risk factors.
  • - After one year, the risk of major cardiovascular events (MACE) was similar between the two groups, but after five years, those without traditional risk factors had a significantly lower risk of MACE (7.9% vs 13.9%).
  • - In patients without traditional risk factors, arterial stenosis was identified as a critical predictor for MACE, indicating that while their long-term risk was lower, they were not entirely without risk.
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Congenital cardiac anesthesiologists practice in a unique environment with high risk for morbidity and mortality. Quality metrics can be used to focus clinical initiatives on evidence-based care and provide a target for local quality improvement measures. However, there has been no comprehensive review on appropriate quality metrics for congenital cardiac anesthesia to date.

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Tuft cells are a rare epithelial cell type that play important roles in sensing and responding to luminal antigens. A defining morphological feature of this lineage is the actin-rich apical "tuft," which contains large fingerlike protrusions. However, details of the cytoskeletal ultrastructure underpinning the tuft, the molecules involved in building this structure, or how it supports tuft cell biology remain unclear.

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Objectives: The objectives are to assess smoking abstinence and its effects on vascular risk and to report tobacco-cessation counselling and pharmacotherapy use in patients who had a recent minor stroke or transient ischaemic attack (TIA).

Design And Setting: The TIA registry.org project is a prospective, observational registry of patients with TIA and minor stroke that occurred in the previous 7 days with a 5-year follow-up, involving 61 sites with stroke specialists in 21 countries (Europe, Asia, Latin America and Middle East).

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Axial spondyloarthritis (axSpA) has been long classified as an autoimmune disease caused by a breakdown in the ability of the immune system to delineate self from foreign, resulting in self-reactive T cells. The strong genetic association of HLA-B27 supports this role for T cells. More recently, genetic and clinical studies indicate a prominent role of the environment in triggering axSpA, including an important role for microbes and the innate immune response.

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Background & Aims: All tissues consist of a distinct set of cell types, which collectively support organ function and homeostasis. Tuft cells are a rare epithelial cell type found in diverse epithelia, where they play important roles in sensing antigens and stimulating downstream immune responses. Exhibiting a unique polarized morphology, tuft cells are defined by an array of giant actin filament bundles that support ∼2 μm of apical membrane protrusion and extend over 7 μm towards the cell's perinuclear region.

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Background And Objectives: Intubation for acute stroke is common in the United States, with few established guidelines.

Methods: This is a retrospective observational study of acute stroke admissions from 2011 to 2018 among fee-for-service Medicare beneficiaries aged 65-100 years. Patient demographics and chronic conditions as well as hospital characteristics were identified.

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Purpose Of Review: This review summarizes the recent evidence available regarding the epidemiology of cardiovascular disease in spondyloarthritis (SpA), including the effect of disease modifying drugs on cardiovascular risk.

Recent Findings: People with SpA suffer from an increased risk of cardiovascular disease compared to the general population. This elevated risk is explained by the high prevalence of traditional cardiovascular risk factors and inflammation from disease activity leading to endothelial dysfunction and accelerated atherosclerosis.

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  • The objective is to update recommendations for preventing and treating glucocorticoid-induced osteoporosis (GIOP) in patients on glucocorticoids for more than three months at doses of 2.5 mg daily or higher.
  • A systematic review was conducted to address various treatment approaches, assessing the quality of evidence and reaching a consensus on recommendations for fracture risk assessment and appropriate therapies.
  • The guidelines emphasize early assessment of fracture risk, strongly advise pharmacologic treatment for high-risk individuals, and provide tailored recommendations for specific populations, while ensuring these guidelines do not restrict access to necessary therapies.
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  • The text aims to update guidelines for preventing and treating glucocorticoid-induced osteoporosis (GIOP) in patients using glucocorticoids for over three months at daily doses of 2.5 mg or more.
  • A systematic review of literature was conducted, and recommendations were developed with consensus from a panel, focusing on both medication and non-medication strategies for managing GIOP.
  • Strong recommendations include early fracture risk assessments for patients starting glucocorticoids and pharmacologic treatment for those at medium to very high fracture risk, along with specific guidance for certain populations.*
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Objective: Polymorphisms in the antifungal signalling molecule are associated with ankylosing spondylitis (AS). Here, we investigated the cellular mechanism by which CARD9 controls pathogenic Th17 responses and the onset of disease in both experimental murine AS and patients.

Methods: Experiments in SKG, Card9SKG, neutrophil-deplete SKG mice along with murine, neutrophil and CD4 T cell cocultures examined Card9 function in neutrophil activation, Th17 induction and arthritis in experimental AS.

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Importance: The coexistence of underlying causes in patients with transient ischemic attack (TIA) or minor ischemic stroke as well as their associated 5-year risks are not well known.

Objective: To apply the ASCOD (atherosclerosis, small vessel disease, cardiac pathology, other cause, or dissection) grading system to assess coexistence of underlying causes of TIA and minor ischemic stroke and the 5-year risk for major vascular events.

Design, Setting, And Participants: This international registry cohort (TIAregistry.

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  • - The COVID-19 pandemic significantly affected individuals with inflammatory bowel disease (IBD), initially causing uncertainty about the virus's impact, especially for those on immunosuppressive medications.
  • - As research advanced, Crohn's and Colitis Canada created a task force to develop clinical guidelines, revealing that the risk of contracting COVID-19 for IBD patients is similar to the general public, although those actively flaring or on high doses of prednisone are more vulnerable to severe outcomes.
  • - Vaccination with a three-dose mRNA regimen shows strong antibody responses in IBD patients; however, breakthrough infections still occur, reinforcing the need for booster shots, while ongoing studies are required to understand long-term effects.
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Inflammatory bowel disease (IBD), consisting of Crohn's disease and ulcerative colitis, is recognized across the world, though Canada has among the highest burdens of IBD in the world. The Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC) led a six-province study that demonstrated the compounding prevalence of IBD in Canada from 400 per 100,000 in 2002 to 636 per 100,000 in 2014. The prevalence in 2023 is estimated at 825 per 100,000, meaning that over 320,000 people in Canada are living with IBD.

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Context: Studies have found that COVID-19 stay-at-home orders (SHOs) and face mask policies (FMPs) were associated with reduced COVID-19 transmission and deaths. But it is unknown whether exposure to these policies varied by sociodemographic characteristics across the US population.

Objective: The goal of this study was to quantify and characterize the sociodemographic characteristics and geographic distribution of populations exposed to evidence-based COVID-19 mitigation policies.

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Patients with pancreatic cancer commonly develop weight loss and muscle wasting. Whether adipose tissue and skeletal muscle losses begin before diagnosis and the potential utility of such losses for earlier cancer detection are not well understood. We quantify skeletal muscle and adipose tissue areas from computed tomography (CT) imaging obtained 2 months to 5 years before cancer diagnosis in 714 pancreatic cancer cases and 1748 matched controls.

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Background: Injuries resulting from collisions between a bicyclist and driver are preventable and have high economic, personal and societal costs. Studying the language choices used by police officers to describe factors responsible for child bicyclist-motor vehicle collisions may help shift prevention efforts away from vulnerable road users to motorists and the environment. The overall aim was to investigate how police officers attribute blame in child (≤18 years) bicycle-motor vehicle collision scenarios.

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Introduction: We determined adverse events after 4 doses of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine in those with inflammatory bowel disease (IBD), associations between antibodies and injection site reactions (ISR), and risk of IBD flare.

Methods: Individuals with IBD were interviewed for adverse events to SARS-CoV-2 vaccine. Multivariable linear regression assessed the association between antibody titers and ISR.

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The National Research Mentoring Network (NRMN) Strategic Empowerment Tailored for Health Equity Investigators (SETH) study evaluates the value of adding Developmental Network to Coaching in the career advancement of diverse Early-Stage Investigators (ESIs). Focused NIH-formatted Mock Reviewing Sessions (MRS) prior to the submission of grants can significantly enhance the scientific merits of an ESI's grant application. We evaluated the most prevalent design, analysis-related factors, and the likelihood of grant submissions and awards associated with going through MRS, using descriptive statistics, Chi-square, and logistic regression methods.

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The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated existing inequities within the research field, particularly for early-stage investigators (ESIs). This study examines the effects of the COVID-19 pandemic on traditionally underrepresented ESIs enrolled in an NIH-supported study evaluating the effectiveness of developmental networks, grant writing coaching, and mentoring on research career advancement. The survey consisted of 24 closed-ended (quantitative) and 4 open-ended questions (qualitative) linked to a participant's ability to meet grant submission deadlines, research and professional development disruptions, stress level, career transition level, self-efficacy and management of scholarly tasks, and familial responsibilities.

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Background: The prevalence of atherosclerosis and the long-term risk of major vascular events in people who have had a transient ischaemic attack or minor ischaemic stroke, regardless of the causal relationship between the index event and atherosclerosis, are not well known. In this analysis, we applied the ASCOD (atherosclerosis, small vessel disease, cardiac pathology, other causes, and dissection) grading system to estimate the 5-year risk of major vascular events according to whether there was a causal relationship between atherosclerosis and the index event (ASCOD grade A1 and A2), no causal relationship (A3), and with or without a causal relationship (A1, A2, and A3). We also aimed to estimate the prevalence of different grades of atherosclerosis and identify associated risk factors.

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