Unnecessary antibiotic prescribing in a Canadian primary care setting: a descriptive analysis using routinely collected electronic medical record data.

Background: Unnecessary antibiotic use in the community in Canada is not well defined. Our objective was to quantify unnecessary antibiotic prescribing in a Canadian primary care setting.

Methods: We performed a descriptive analysis in Ontario from April 2011 to March 2016 using the Electronic Medical Records Primary Care database linked to other health administrative data sets at ICES.

A Bayesian experimental autonomous researcher for mechanical design.

While additive manufacturing (AM) has facilitated the production of complex structures, it has also highlighted the immense challenge inherent in identifying the optimum AM structure for a given application. Numerical methods are important tools for optimization, but experiment remains the gold standard for studying nonlinear, but critical, mechanical properties such as toughness. To address the vastness of AM design space and the need for experiment, we develop a Bayesian experimental autonomous researcher (BEAR) that combines Bayesian optimization and high-throughput automated experimentation.

Understanding basic concepts of developmental diagnosis in children.

Developmental diagnosis is based on an understanding of basic concepts of typical and atypical developmental progression. Child development is influenced by multiple factors, including the development of the nervous system and other organ systems, and the child's physical and social environment. Different factors interplay with each other in influencing the overall development of the child.

Neurodevelopmental outcomes of preterm infants: a recent literature review.

Background: Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, motor and sensory abnormalities, developmental delay, and poorer academic performance, while other studies have found no significant difference.

Methods: A literature search was conducted through PubMed for articles published between January 2018 and September 2019.

Tissue Engineering Models for the Study of Breast Neoplastic Disease and the Tumor Microenvironment.

The development of adequate experimental models is crucial to furthering the current mechanistic understanding of the etiopathogenesis, subsequent growth, and ultimate metastasis of breast cancer, to develop targeted diagnostics and therapeutics such as the identification of new treatments for multidrug-resistant tumors and triple-negative breast cancers. The utility of new therapeutic options is limited by the platforms currently used to test their efficacy . The use of three-dimensional models, which incorporate patient-specific, primary cells, offers significant advantages over traditional two-dimensional models by providing a means of accurately recapitulating the complex tumor microenvironment.

High-Throughput Proteomics Enabled by a Photocleavable Surfactant.

Mass spectrometry (MS)-based proteomics provides unprecedented opportunities for understanding the structure and function of proteins in complex biological systems; however, protein solubility and sample preparation before MS remain a bottleneck preventing high-throughput proteomics. Herein, we report a high-throughput bottom-up proteomic method enabled by a newly developed MS-compatible photocleavable surfactant, 4-hexylphenylazosulfonate (Azo) that facilitates robust protein extraction, rapid enzymatic digestion (30 min compared to overnight), and subsequent MS-analysis following UV degradation. Moreover, we developed an Azo-aided bottom-up method for analysis of integral membrane proteins, which are key drug targets and are generally underrepresented in global proteomic studies.

Antibiotic Prescribing Choices and Their Comparative C. Difficile Infection Risks: A Longitudinal Case-Cohort Study.

Background: Antibiotic use is the strongest modifiable risk factor for the development of Clostridioides difficile infection, but prescribers lack quantitative information on comparative risks of specific antibiotic courses. Our objective was to estimate risks of C. difficile infection associated with receipt of specific antibiotic courses.

Inhibition of EZH2 Catalytic Activity Selectively Targets a Metastatic Subpopulation in Triple-Negative Breast Cancer.

Epigenetic changes are increasingly being appreciated as key events in breast cancer progression. However, breast cancer subtype-specific epigenetic regulation remains poorly investigated. Here we report that EZH2 is a leading candidate of epigenetic modulators associated with the TNBC subtype and that it predicts poor overall survival in TNBC patients.

Discontinuing Contact Precautions for Vancomycin-Resistant Enterococcus (VRE) Is Associated With Rising VRE Bloodstream Infection Rates in Ontario Hospitals, 2009-2018: A Quasi-experimental Study.

In Ontario, Canada, since 2012, some hospitals discontinued contact precautions for vancomycin-resistant Enterococcus (VRE). Between 2009 and 2018, there was an associated rise in VRE bloodstream infections in hospitals where contact precautions were discontinued but not in hospitals that maintained contact precautions. These data suggest contact precautions are important for hospital VRE control programs.

Long-term outcome and effect of diagnostic analgesia in horses undergoing interspinous ligament desmotomy for overriding dorsal spinous processes.

Objective: To report the long-term outcome of horses treated with interspinous ligament desmotomy (ISLD) for pain associated with overriding dorsal spinous processes (ORDSP) and determine the influence of preoperative diagnostic analgesia on long-term outcome.

Study Design: Retrospective study.

Animals: Eighteen horses.

Dorsoventral-Specific Effects of Nerve Agent Surrogate Diisopropylfluorophosphate on Synaptic Transmission in the Mouse Hippocampus.

Although there has been an increasing appreciation for functional differences between the dorsal (dH) and ventral (vH) hippocampal sectors, there is a lack of information characterizing the cholinergic and noncholinergic mechanisms of acetylcholinesterase inhibitors on synaptic transmission along the hippocampal dorsoventral axis. Diisopropylfluorophosphate (DFP) is an organophosphate (OP) that is commonly employed as a nerve agent surrogate in vitro as well as in rodent models of disease states, such as Gulf War Illness. The present study investigated the cholinergic and noncholinergic mechanisms responsible for the effects of acute DFP exposure on dH and vH synaptic transmission in a hippocampal slice preparation.

Machine Learning in Nanoscience: Big Data at Small Scales.

Recent advances in machine learning (ML) offer new tools to extract new insights from large data sets and to acquire small data sets more effectively. Researchers in nanoscience are experimenting with these tools to tackle challenges in many fields. In addition to ML's advancement of nanoscience, nanoscience provides the foundation for neuromorphic computing hardware to expand the implementation of ML algorithms.

Purchase trends of processed foods and beverages in urban India.

•Unique dataset allows analysis of urban Indian shopping habits of processed foods.•Beyond staples, purchases of processed foods and beverages for home use are low.•Fastest rate of growth seen in sweet and salty snacks, and edible oil purchases.

Interfacility patient sharing and infection incidence in the Ontario hospital system: A 13-year cohort study.

Objective: Interfacility patient movement plays an important role in the dissemination of antimicrobial-resistant organisms throughout healthcare systems. We evaluated how 3 alternative measures of interfacility patient sharing were associated with C. difficile infection incidence in Ontario acute-care facilities.

Sustainable Diet Dimensions. Comparing Consumer Preference for Nutrition, Environmental and Social Responsibility Food Labelling: A Systematic Review.

Global food systems are currently challenged by unsustainable and unhealthy consumption and production practices. Food labelling provides information on key characteristics of food items, thereby potentially driving more sustainable food choices or demands. This review explores how consumers value three different elements of sustainable diets: Comparing consumer response to nutrition information on food labels against environmental and/or social responsibility information.

Cognitive Rehabilitation for Individuals With Parkinson's Disease: Developing and Piloting an External Aids Treatment Program.

Purpose Cognitive deficits are common in Parkinson's disease (PD) and can have a detrimental effect on daily activities. To date, most cognitive treatments have had an impairment-based focus with primary outcome measures of formal neuropsychological test scores. Few, if any, studies have focused on functional improvement or patient-centered goals.

Nudging In MicroBiology Laboratory Evaluation (NIMBLE): A scoping review.

Background: Nudging in microbiology is an antimicrobial stewardship strategy to influence decision making through the strategic reporting of microbiology results while preserving prescriber autonomy. The purpose of this scoping review was to identify the evidence that demonstrates the effectiveness of nudging strategies in susceptibility result reporting to improve antimicrobial use.

Methods: A search for studies in Ovid MEDLINE, Embase, PsycINFO, and All EBM Reviews was conducted.

Coupling biology to synthetic nanomaterials for semi-artificial photosynthesis.

Biohybrid artificial photosynthesis aims to combine the advantages of biological specificity with a range of synthetic nanomaterials to create innovative semi-synthetic systems for solar-to-chemical conversion. Biological systems utilize highly efficient molecular catalysts for reduction-oxidation reactions. They can operate with minimal overpotentials while selectively channeling reductant energy into specific transformation chemistries and product forming pathways.

High versus low intensity: What is the optimal approach to prospective audit and feedback in an antimicrobial stewardship program?

Background: Antimicrobial stewardship program (ASP) interventions, such as prospective audit and feedback (PAF), have been shown to reduce antimicrobial use and improve patient outcomes. However, the optimal approach to PAF is unknown.

Objective: We examined the impact of a high-intensity interdisciplinary rounds-based PAF compared to low-intensity PAF on antimicrobial use on internal medicine wards in a 400-bed community hospital.

Validating a popular outpatient antibiotic database to reliably identify high prescribing physicians for patients 65 years of age and older.

Objective: Many jurisdictions lack comprehensive population-based antibiotic use data and rely on third party companies, most commonly IQVIA. Our objective was to validate the accuracy of the IQVIA Xponent antibiotic database in identifying high prescribing physicians compared to the reference standard of a highly accurate population-wide database of outpatient antimicrobial dispensing for patients ≥65 years.

Methods: We conducted this study between 1 March 2016 and 28 February 2017 in Ontario, Canada.

Researching the Effectiveness of Tree of Life: an Imbeleko Approach to Counseling Refugee Youth.

With the growing worldwide refugee crisis, there is a need for evidence-based interventions that specifically deal with the consequences of cumulative trauma-exposure in refugee youth. Refugee children have unique service needs and differ from their non-refugee peers in terms of sociocultural trauma, language, culture, and educational barriers. This article explains the complexities associated with understanding refugee youth and presents a proposal for studying the possible benefits of Tree of Life therapy.