Impact of COVID-19 Public Health Restrictions on the Pregnancy Experience: A Mixed-Methods Study.

The COVID-19 pandemic impacted the provision of obstetrical care. This mixed-methods study explores pregnant women's experiences during the COVID-19 pandemic using an explanatory sequential design. The experiences and opinions of obstetrical patients were elicited using an online questionnaire and semi-structured interview as a follow-up.

A Pharmacist-Driven Glycemic Control Protocol to Reduce the Rate of Severe Hypoglycemia in High-Risk Patients.

Hospital pharmacists contribute to patient safety and quality initiatives by overseeing the prescribing of antidiabetic medications. A pharmacist-driven glycemic control protocol was developed to reduce the rate of severe hypoglycemia events (SHE) in high-risk hospitalized patients. We retrospectively analyzed the rates of SHE (defined as blood glucose ≤40 mg/dL), before and after instituting a pharmacist-driven glycemic control protocol over a 4-year period.

HCV compliance and treatment success rates are higher with DAAs in structured HCV clinics compared to general hepatology clinics.

The real-world cure rates for hepatitis C (HCV) with direct-acting antivirals (DAAs) based on intention-to-treat (ITT) analysis may be lower than reported in the literature because of non-compliance.To determine whether patients treated in a structured outpatient HCV clinic (SHC) had higher compliance and treatment success rates compared to those treated in general hepatology clinics (GHC).In this study, we compared the treatment and compliance success rates of 488 and 840 patients treated in the SHC and GHC, respectively.

How a Culture of Kindness Can Improve Employee Engagement and Patient Experience - and Five Ways to Get There.

Aware of the evidence demonstrating how important employee engagement is to patient experience, outcomes and cost containment, leadership at Bluewater Health, Sarnia, was looking for strategic solutions to improve engagement. Work with compassion fatigue and resilience specialists suggested focusing on kindness. This article shares the hospital's experience designing and implementing their campaign - from a core committee that empowers and encourages teams to find their own creative ways to promote kindness, through to leadership's commitment to changing organizational culture.

Are There Differences between Women who Choose Elective Repeat Caesarean Versus Trial of Labour in St. John's, NL?

Objectives: To compare the demographic and clinical characteristics between women who chose elective repeat Caesarean section (ERCS) versus trial of labour after Caesarean section (TOLAC) in St. John's, Newfoundland and Labrador (NL).

Methods: We conducted a retrospective case control study of women with live singleton gestations delivering at term in St.

Erythropoietic protoporphyria in an adult with sequential liver and hematopoietic stem cell transplantation: A case report.

Erythropoietic protoporphyria (EPP) is a rare inherited disorder of the heme biosynthesis pathway resulting in the accumulation of protoporphyrins in the blood, erythrocytes, and other tissues. Because of a gene mutation in the FECH gene, ferrochelatase, the enzyme involved in the final step of heme synthesis, is deficient in these patients. Although the major symptom of this disorder is photosensitivity, rarely, it can cause progressive liver disease requiring liver transplantation (LT).

Epigenetic Memory Underlies Cell-Autonomous Heterogeneous Behavior of Hematopoietic Stem Cells.

Stem cells determine homeostasis and repair of many tissues and are increasingly recognized as functionally heterogeneous. To define the extent of—and molecular basis for—heterogeneity, we overlaid functional, transcriptional, and epigenetic attributes of hematopoietic stem cells (HSCs) at a clonal level using endogenous fluorescent tagging. Endogenous HSC had clone-specific functional attributes in vivo.

Epigenetic Memory Underlies Cell-Autonomous Heterogeneous Behavior of Hematopoietic Stem Cells.

Stem cells determine homeostasis and repair of many tissues and are increasingly recognized as functionally heterogeneous. To define the extent of-and molecular basis for-heterogeneity, we overlaid functional, transcriptional, and epigenetic attributes of hematopoietic stem cells (HSCs) at a clonal level using endogenous fluorescent tagging. Endogenous HSC had clone-specific functional attributes over time in vivo.

Specific bone cells produce DLL4 to generate thymus-seeding progenitors from bone marrow.

Production of the cells that ultimately populate the thymus to generate α/β T cells has been controversial, and their molecular drivers remain undefined. Here, we report that specific deletion of bone-producing osteocalcin (Ocn)-expressing cells in vivo markedly reduces T-competent progenitors and thymus-homing receptor expression among bone marrow hematopoietic cells. Decreased intrathymic T cell precursors and decreased generation of mature T cells occurred despite normal thymic function.

Inhibiting stromal cell heparan sulfate synthesis improves stem cell mobilization and enables engraftment without cytotoxic conditioning.

The glycosyltransferase gene, Ext1, is essential for heparan sulfate production. Induced deletion of Ext1 selectively in Mx1-expressing bone marrow (BM) stromal cells, a known population of skeletal stem/progenitor cells, in adult mice resulted in marked changes in hematopoietic stem and progenitor cell (HSPC) localization. HSPC egressed from BM to spleen after Ext1 deletion.

D-cyclins repress apoptosis in hematopoietic cells by controlling death receptor Fas and its ligand FasL.

D-type cyclins (D1, D2, and D3) are components of the mammalian core cell-cycle machinery and function to drive cell proliferation. Here, we report that D-cyclins perform a rate-limiting antiapoptotic function in vivo. We found that acute shutdown of all three D-cyclins in bone marrow of adult mice resulted in massive apoptosis of all hematopoietic cell types.

Inferior epigastric artery pseudoaneurysm following trocar injury.

Herein is described the development of an inferior epigastric pseudoaneurysm caused by a trocar injury during laparoscopic surgery. After the accessory trocar was placed in the left lower quadrant, the patient's condition became clinically unstable, requiring blood transfusions postoperatively and transfer to our tertiary care center. On arrival, she continued to have pain, with a palpable tender mass in the left lower quadrant.

Inhibition of bone morphogenetic protein signaling attenuates anemia associated with inflammation.

Anemia of inflammation develops in settings of chronic inflammatory, infectious, or neoplastic disease. In this highly prevalent form of anemia, inflammatory cytokines, including IL-6, stimulate hepatic expression of hepcidin, which negatively regulates iron bioavailability by inactivating ferroportin. Hepcidin is transcriptionally regulated by IL-6 and bone morphogenetic protein (BMP) signaling.

Incorporating computer-aided language sample analysis into clinical practice.

Purpose: During the evaluation of language abilities, the needs of the child are best served when multiple types and sources of data are included in the evaluation process. Current educational policies and practice guidelines further dictate the use of authentic assessment data to inform diagnosis and treatment planning. Language sampling and analysis (LSA) offers an important clinical tool for gathering such authentic assessment data, and computer-aided methods of LSA make it clinically feasible.

User library service expectations in health science vs. other settings: a LibQUAL+ Study.

Objectives: To explore how the library service expectations and perceptions of users might differ across health-related libraries as against major research libraries not operating in a medical context; to determine whether users of medical libraries demand better library service quality, because the inability of users to access needed literature promptly may lead to a patient who cannot be properly diagnosed, or a diagnosis that cannot be properly treated.

Methodology: We compared LibQUAL+ total and subscale scores across three groups of US, Canadian and British libraries for this purpose.

Results: Anticipated differences in expectations for health as other library settings did not emerge.