The effect of increased vascular afterload measures on flow rate and survival in severe aortic stenosis.

Aims: Although an association between the systemic circulation and transaortic flow rate (TFR) is frequently hypothesized in patients with aortic stenosis (AS), it has not been demonstrated previously. We sought to explore the relationship between blood pressure (BP), vascular afterload measures, clinical history of hypertension, TFR, and survival in patients with severe AS (aortic valve area ≤ 1 cm²).

Methods And Results: We studied 323 patients ≥ 65 years (110 prospective, 213 registry analysis) who underwent transcatheter aortic valve replacement over a 5-year period.

Systemic Circulation in Advanced Heart Failure and Cardiogenic Shock: State-of-the-Art Review.

The integrative physiology of the left ventricle and systemic circulation is fundamental to our understanding of advanced heart failure and cardiogenic shock. In simplest terms, any increase in aortic stiffness increases the vascular afterload presented to the failing left ventricle. The net effect is increased myocardial oxygen demand and reduced coronary perfusion pressure, thereby further deteriorating contractile function.

Association Between Serum Thyrotropin and Cancer Recurrence in Differentiated Thyroid Cancer: A Population-Based Retrospective Cohort Study.

Levothyroxine to suppress thyrotropin (TSH) to <0.5 mIU/L following thyroidectomy in differentiated thyroid cancer (DTC) may reduce recurrence in higher-risk DTC. However, there is limited evidence to support guideline recommendations to maintain TSH in the low-normal range of 0.

Expectations and Perspectives About Infant Feeding of Their First Child Among Rural Women.

Objective: To explore expectations and perspectives related to infant feeding of their first child among rural women.

Design: Qualitative descriptive.

Setting: Rural women who were first-time mothers (N = 18).

COVID-19 vaccine effectiveness among South Asians in Canada.

We evaluated the effectiveness of COVID-19 vaccines among South Asians living in Ontario, Canada compared to non-South Asians and compared the odds of symptomatic COVID-19 infection and related hospitalizations and deaths among non-vaccinated South Asians and non-South Asians. This was a test negative design study conducted in Ontario, Canada between December 14, 2020 and November 15, 2021. All eligible individuals >18 years with symptoms of COVID-19 were subdivided by ethnicity (South Asian vs other) and vaccination status (vaccinated versus not).

Persistent disparities in insulin pump uptake despite a universal pump programme for type 1 diabetes in Ontario, Canada.

Aim: To evaluate associations between social disadvantage and insulin pump use among adults with type 1 diabetes (T1D) in the context of a universal publicly funded insulin pump programme in Ontario, Canada, and to ascertain whether social disparities in insulin pump programme enrolment have decreased over time.

Methods: Population-based cross-sectional studies were conducted using administrative healthcare data in Ontario, Canada. First, among adults aged older than 18 years diagnosed with T1D before 31 March 2021, logistic regression was used to assess the association between neighbourhood social disadvantage (Ontario marginalization index quintiles) and insulin pump use.

Thermal tolerance for the tropical clawed frog, Xenopus tropicalis with comments on comparative methods for amphibian studies.

Thermal tolerance data are important for identifying the potential range of non-native species following introduction and establishment. Such data are particularly important for understanding invasion risks of tropical species introduced to temperate climates and identifying whether they can survive outside tropical regions. A breeding population of the tropical clawed frog (Xenopus tropicalis) was recently discovered in west-central Florida, U.

Supporting parents with acutely ill children: Environment scan and user evaluation of mobile applications (the SuPa kids project).

Background: Children are one of the biggest users of emergency departments in the UK, sometimes utilising services when experiencing acute illnesses that can be managed at home. mHealth can be an efficacious way for parents/guardians to manage acute illnesses. It has also become a ubiquitous resource to promote public health interests within a resource constrained health system.

Short-term equine interaction for reducing test anxiety and facilitating coping skill development in college students during examination periods: A preliminary study.

Mental health concerns are common among college students and more prevalent during examination periods when stress and anxiety are heightened. While the benefits of equine interaction have been reported, the impact of short-term equine interaction on coping skills valuable for managing test anxiety have yet to be studied. Therefore, the purpose of this preliminary study was to evaluate the impact of short-term equine interaction during the college examination period on development of coping skills and anxiety levels associated with testing, both self-reported and those reflected in physiological measures.

Association between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, Canada.

Background: People with opioid use disorder (OUD) are at risk of premature death and can benefit from palliative care. We sought to compare palliative care provision for decedents with and without OUD.

Methods: We conducted a cohort study using health administrative databases in Ontario, Canada, to identify people who died between July 1, 2015, and Dec.

Recent Improvements in Attainment of the Hemoglobin A1c Target of ≤7.0% Among Adults with Type 1 Diabetes in Ontario: A Retrospective Cohort Study.

We evaluated attainment of the hemoglobin A1c (HbA1c) target of ≤7.0%, its temporal trends, and associated factors among adults with type 1 diabetes in Ontario, Canada, using administrative data. We conducted a retrospective cohort study, including Ontarians with type 1 diabetes ≥18 years old with ≥1 HbA1c test between April 1, 2012 (fiscal year 2013), and March 31, 2023.

A population-based time-series analysis of opioid agonist treatment dispensed during pregnancy.

Background And Aims: Identifying effective opioid treatment options during pregnancy is a high priority due to the growing prevalence of opioid use disorder across North America. We assessed the temporal impact of three population-level interventions on the use of opioid agonist treatment (OAT) during pregnancy in Ontario, Canada.

Design: This was a population-based time-series analysis to identify trends in the monthly prevalence of pregnant people dispensed methadone and buprenorphine.

Hepatitis C Attributable Healthcare Costs and Mortality among Immigrants: A Population-Based Matched Cohort Study.

Background: Data on the economic burden of chronic hepatitis C (CHC) among immigrants are limited. Our objective was to estimate the CHC-attributable mortality and healthcare costs among immigrants in Ontario, Canada.

Methods: We conducted a population-based matched cohort study among immigrants diagnosed with CHC between May 31, 2003, and December 31, 2018, using linked health administrative data.

Impact of a Transitional Pain Service on postoperative opioid trajectories: a retrospective cohort study.

Introduction: It has been well described that a small but significant proportion of patients continue to use opioids months after surgical discharge. We sought to evaluate postdischarge opioid use of patients who were seen by a Transitional Pain Service compared with controls.

Methods: We conducted a retrospective cohort study using administrative data of individuals who underwent surgery in Ontario, Canada from 2014 to 2018.

New Persistent Opioid Use After Childbirth.

Objective: To examine factors associated with new persistent opioid use after childbirth.

Methods: We conducted a population-based cohort study of individuals who initiated opioid therapy within 7 days of discharge from hospital after delivery between September 1, 2013, and September 30, 2021. The primary outcome was new persistent opioid use , which was defined as one or more prescriptions for an opioid within 90 days of the first postpartum prescription and one or more subsequent opioid prescriptions in the 91-365 days afterward.

A Population-Based Test-Negative Matched Case-Control Analysis of SARS-CoV-2 Vaccine Effectiveness Among Pregnant People in Ontario, Canada.

Objective: Pregnancy is a risk factor for severe SARS-CoV-2 infection, which can result in adverse pregnancy outcomes, thus making understanding vaccine effectiveness (VE) in this population important. This study aimed to assess the VE of mRNA COVID-19 vaccines against symptomatic SARS-CoV-2 infection and COVID-19-related hospitalization in pregnant people.

Methods: Population-based matched test-negative case-control study of pregnant people aged 18-49 years, of 12 or more weeks gestation in Ontario, Canada, symptomatic with possible SARS-CoV-2 infection, and having at least 1 positive (n = 1842) or negative (n = 8524) real-time polymerase chain reaction (RT-PCR) SARS-CoV-2 test between December 14, 2020, and December 31, 2021.

Leveraging National Data and Regional Innovations to Right-Size Tobacco Treatment Policy for Behavioral Health in a Midwestern State.

Background: People with mental health (MH) and substance use disorders (SUD) have high rates of tobacco use and tobacco-related mortality. They want to stop smoking and studies have shown they can quit, but few behavioral health facilities provide tobacco treatment. The purpose of this paper is to describe how a midwestern statewide behavioral health collaboration used regional data to pinpoint strengths and weaknesses in tobacco treatment trends, identified policies in neighboring states that were associated with high rates of tobacco treatment, and worked with state leaders to implement these policies to enhance treatment.

Engagement with the HCV care cascade among high-risk groups: A population-based study.

Background: HCV elimination requires a thorough understanding of the care cascade. A direct-acting antiviral (DAA)-era description of the care cascade has not been undertaken in Ontario, Canada's most populous jurisdiction. Our primary objective was to describe the current population-level care cascade in the general Ontario population and among key risk groups ─ baby boomers, immigrants, and individuals experiencing residential instability.