Higher blood pressure targets for hypertension in older adults.

Background: This is an update of the original Cochrane review, published in 2017. Eight out of 10 major antihypertensive trials in adults, 65 years of age or older, attempted to achieve a target systolic blood pressure (BP) of < 160 mmHg. Collectively, these trials demonstrated cardiovascular benefit for treatment, compared to no treatment, for older adults with BP > 160 mmHg.

Antihypertensive deprescribing in frail long-term care residents (OptimizeBP): protocol for a prospective, randomised, open-label pragmatic trial.

Introduction: Although antihypertensive medication use is common among frail older adults, observational studies in this population suggest blood pressure (BP) lowering may convey limited benefit and perhaps even harm. This protocol describes an antihypertensive deprescribing trial in frail older adults powered for mortality and morbidity outcomes.

Methods And Analysis: Prospective, parallel, randomised, open-label pragmatic trial.

Exploring the relationship between depression and delinquency: a sibling comparison design using the NLSY.

Relative to the general population, adolescents with psychiatric disorders such as major depression disorder are incarcerated (and reincarcerated) at higher rates. Current research is mixed on whether this association is a cause, consequence, or the product of selection. For example, aggression can lead to more depressive symptoms, yet depression is associated with antisocial behaviors (e.

Parent, Physician, and Therapist Experience of In-Person, Hybrid, and All-Virtual Models of Physiatry Care for Children with Special Health Care Needs.

Objective: The purpose of this study was to compare three models of pediatric physiatry care (in-person, hybrid, and all-virtual) in terms of parent experience and physician- and therapist-reported quality of care. We hypothesized that the all-virtual model would have lower parent experience scores and lower quality scores compared with the other two models of care.

Methods: We designed a convergent parallel mixed methods study incorporating a cluster-randomized crossover design.

How promotes transdisciplinary convergence science: an academic health center for women's cardiovascular and brain health.

Cardiovascular disease (CVD) is largely preventable, and the leading cause of death for men and women. Though women have increased life expectancy compared to men, there are marked sex disparities in prevalence and risk of CVD-associated mortality and dementia. Yet, the basis for these and female-male differences is not completely understood.

Advancing Diversity in Behavior Genetics: Strategies for Incorporating Undergraduates into Student-Driven Research.

Undergraduate research experiences are crucial for fostering the next generation of behavior genetics researchers. However, incorporating undergraduates into research can be challenging for faculty mentors. In this article, we provide strategies for successfully integrating undergraduates into behavior genetics research based on our experiences mentoring undergraduates in our lab.

Intolerance upon statin rechallenge: A systematic review and meta-analysis of randomized controlled trials.

Background: Although statins are often discontinued when myalgia arises, a causal relationship may not always exist. How well-tolerated statins are when rechallenge is blinded and controlled is unclear.

Methods And Findings: We performed a systematic review and meta-analysis (PROSPERO CRD42023437648) to evaluate the success of statin rechallenge versus matched placebo in those who were previously statin intolerant.

Lipid-lowering therapies for cardiovascular disease prevention and management in primary care: PEER umbrella systematic review of systematic reviews.

Objective: To assess the benefits and harms of lipid-lowering therapies used to prevent or manage cardiovascular disease including bile acid sequestrants (BAS), ezetimibe, fibrates, niacin, omega-3 supplements, proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, and statins.

Data Sources: MEDLINE, the Cochrane Database of Systematic Reviews, and a grey literature search.

Study Selection: Systematic reviews of randomized controlled trials published between January 2017 and March 2022 looking at statins, ezetimibe, PCSK9 inhibitors, fibrates, BAS, niacin, and omega-3 supplements for preventing cardiovascular outcomes were selected.

PEER simplified lipid guideline 2023 update: Prevention and management of cardiovascular disease in primary care.

Objective: To update the 2015 clinical practice guideline and provide a simplified approach to lipid management in the prevention of cardiovascular disease (CVD) for primary care.

Methods: Following the Institute of Medicine's , a multidisciplinary, pan-Canadian guideline panel was formed. This panel was represented by primary care providers, free from conflicts of interest with industry, and included the patient perspective.

Effects of Genetic Relatedness of Kin Pairs on Univariate ACE Model Performance.

The current study explored the impact of genetic relatedness differences (ΔH) and sample size on the performance of nonclassical ACE models, with a focus on same-sex and opposite-sex twin groups. The ACE model is a statistical model that posits that additive genetic factors (A), common environmental factors (C), and specific (or nonshared) environmental factors plus measurement error (E) account for individual differences in a phenotype. By extending Visscher's (2004) least squares paradigm and conducting simulations, we illustrated how genetic relatedness of same-sex twins (H) influences the statistical power of additive genetic estimates (A), AIC-based model performance, and the frequency of negative estimates.

Degrading stimuli by reducing image resolution impairs performance in a rodent continuous performance test.

Attention is a cognitive domain often disrupted in neuropsychiatric disorders and continuous performance tests (CPTs) are common clinical assays of attention. In CPTs, participants produce a behavioral response to target stimuli and refrain from responding to non-target stimuli. Performance in CPTs is measured as the ability to discriminate between targets and non-targets.

Bedtime versus morning use of antihypertensives in frail continuing care residents (BedMed-Frail): protocol for a prospective, randomised, open-label, blinded end-point pragmatic trial.

Introduction: BedMed-Frail explores risks and benefits of switching antihypertensives from morning to bedtime in a frail population at greater risk of hypotensive adverse effects.

Methods And Analysis: : Prospective parallel randomised, open-label, blinded end-point trial.: Hypertensive continuing care residents, in either long-term care or supportive living, who are free from glaucoma, and using ≥1 once daily antihypertensive.

Risk and distribution of chronic obstructive pulmonary disease-related hospitalizations among primary care patients.

Objective: To determine the extent of chronic obstructive pulmonary disease (COPD) hospitalization in easily identifiable high-risk subgroups within a typical primary care practice.

Design: Prospective cohort analysis of administrative claims data.

Setting: British Columbia.

Who provides chronic disease management? Population-based retrospective cohort study in Alberta.

Objective: To determine the proportions of patients who receive care from family physicians, specialists, and nurse practitioners for the management of common chronic medical conditions.

Design: Population-based retrospective cohort study.

Setting: Province of Alberta.

Neurotensin and energy balance.

The neurotensin system spans across the central nervous system, to the enteric nervous system (gut), and the periphery to govern behaviors and physiological responses that tune energy balance to maintain homeostasis. Neurotensin transmission is not only modulated by metabolic signals, neurotensin transmission itself can also impact metabolic state by exerting control over consumption, physical activity, and satiety signals. Many responses to sensory experiences and sleep processes are dictated by neurotensinergic activity via mechanisms that allow the organism to balance energy seeking and utilization to thrive in its environment.

Tolerability of bedtime diuretics: a prospective cohort analysis.

Objectives: We sought to validate, or refute, the common belief that bedtime diuretics are poorly tolerated due to nocturia.

Design: Prespecified prospective cohort analysis embedded within the randomised BedMed trial, in which hypertensive participants are randomised to morning versus bedtime antihypertensive administration.

Setting: 352 community family practices across 4 Canadian provinces between March 2017 and September 2020.

Confounding Effect of Undergraduate Semester-Driven "Academic" Internet Searches on the Ability to Detect True Disease Seasonality in Google Trends Data: Fourier Filter Method Development and Demonstration.

Background: Internet search volume for medical information, as tracked by Google Trends, has been used to demonstrate unexpected seasonality in the symptom burden of a variety of medical conditions. However, when more technical medical language is used (eg, diagnoses), we believe that this technique is confounded by the cyclic, school year-driven internet search patterns of health care students.

Objective: This study aimed to (1) demonstrate that artificial "academic cycling" of Google Trends' search volume is present in many health care terms, (2) demonstrate how signal processing techniques can be used to filter academic cycling out of Google Trends data, and (3) apply this filtering technique to some clinically relevant examples.