Publications by authors named "McArthur C"

Objectives: incidental thyroid nodules (ITNs) are found in up to 25% of CT scans. Increased use of cross-sectional imaging has contributed to the increased incidence of thyroid cancer worldwide. ITNs pose a management dilemma since nodule malignancy rate is 5-15% but most cancers are indolent and prognosis in differentiated thyroid cancer is excellent.

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Across sub-Saharan Africa, the heavy reliance on mycotoxin-susceptible staple foods means that populations in the region are particularly vulnerable to chronic mycotoxin exposure. This study assessed the exposure risk to ochratoxin A (OTA) and aflatoxins (AFs) from 18 samples of selected staple foods (maize, millet, groundnut) and 56 fresh cow milk samples collected from across Ghana. The foods were sampled simultaneously to maximise comparability, and at two timepoints in March/April (during the dry season) and July/August (during the rainy season) to assess the effects of duration of storage and seasonal conditions on the mycotoxin levels as measured by high-performance liquid chromatography.

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Article Synopsis
  • * Researchers compared data from residents admitted during the pandemic (2020/2021) with those from two pre-pandemic years (2018/2019 and 2019/2020) using complex statistical models to account for various resident characteristics.
  • * The findings revealed that antipsychotic medication use rose during the pandemic, with new residents more likely to start these medications and less likely to stop them, indicating that pandemic-related factors influenced treatment patterns.
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Falls and hip fractures are a major health concern among older adults in long term care (LTC) with almost 50% of residents experiencing a fall annually. Hip fractures are one of the most important and frequent fall-related injuries in LTC. There is moderate to strong certainty evidence that multifactorial interventions may reduce the risk of falls and fractures; however, there is little evidence to support its implementation.

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Background: Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain.

Methods: In a multicenter, noninferiority trial, we randomly assigned hospitalized patients (including patients in the intensive care unit [ICU]) who had bloodstream infection to receive antibiotic treatment for 7 days or 14 days.

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People living with HIV (PLWH) may experience premature physical deficits, including walking, mobility, and balance problems. The purpose was to measure deficits in walking, mobility, balance, and dual tasking in PLWH. The secondary objective was to make recommendations regarding the use of rehabilitation outcome measures.

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Objectives: To describe delirium incidence before and during the COVID-19 pandemic and examine factors associated with delirium incidence in the long-term care setting.

Methods: We conducted a retrospective cohort study of Ontario long-term care residents without severe cognitive impairment or baseline delirium with an assessment between February 1, 2019, and March 31, 2021. Data were collected from the interRAI Minimum Data Set (MDS) 2.

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Article Synopsis
  • Albumin infusions may either protect or harm patients with septic shock and kidney issues, influencing their need for kidney replacement therapy and survival rates during their hospital stay.
  • A study analyzed nearly 10,000 patients with septic shock and kidney impairment, comparing outcomes for those who received albumin within 24 hours of admission versus those who didn't.
  • Results showed that the use of albumin was linked to a higher risk of requiring kidney replacement therapy or in-hospital death, especially with the use of 25% hyperoncotic albumin compared to iso-oncotic albumin.
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Background: Rehabilitation can help long-term care (LTC) residents with dementia maintain their independence. However, many residents do not receive rehabilitation. This study aimed to identify the barriers and facilitators to providing rehabilitation for LTC residents with dementia and propose practical interventions for overcoming them.

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Objectives: COVID-19 treatment guidelines recommend baricitinib or tocilizumab for the management of hospitalized patients with COVID-19. We compared the effectiveness of baricitinib vs. tocilizumab on mortality and clinical outcomes among hospitalized patients with COVID-19.

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Article Synopsis
  • The study investigates acute respiratory distress syndrome (ARDS) in ICU patients from Australia and New Zealand, focusing on patient characteristics and management practices during a multi-center analysis.
  • Among the 200 participants, the average age was 55.5 years; notable findings included a low adherence to lung protective ventilation (only 10.5% on day one) and significant use of adjunctive therapies like systemic steroids.
  • The in-hospital mortality rate by day 28 was 30.5%, highlighting the need for improved implementation of established treatment protocols in ARDS care.
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Background: Fall risk and incidence increase with age, creating significant physical and mental burden for the individual and their care provider. Lift assistive devices are used in multiple healthcare facilities, but are generally not portable nor self-operational, limiting their use outside of medical supervision. The Raymex™ lift is a novel lift assistance device within a rollator to address these limitations.

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Objectives: COVID-19 severity prediction scores need further validation due to evolving COVID-19 illness. We evaluated existing COVID-19 risk prediction scores in Aotearoa New Zealand, including for Māori and Pacific peoples who have been inequitably affected by COVID-19.

Methods: We conducted a multicenter retrospective cohort study in adults hospitalized with COVID-19 from January to May 2022, including all Māori and Pacific patients, and every second non-Māori, non-Pacific (NMNP) patient to achieve equal analytic power by ethnic grouping.

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Objectives: This multicenter cohort study describes Aotearoa New Zealand children hospitalized during the country's first wave of sustained SARS-CoV-2 transmission, Omicron variant.

Methods: Children younger than 16 years, hospitalized for >6 hours with COVID-19 across New Zealand from January to May 2022 were included. Admissions for all Māori and Pacific and every second non-Maori non-Pacific children were selected to support equal explanatory power for ethnic grouping.

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The COVID-19 pandemic had profound effects on the long-term care (LTC) setting worldwide, including changes in admission practices. We aimed to describe the characteristics and medical complexity of newly admitted LTC residents before (March 1, 2019 to February 29, 2020) and during (March 1, 2020 to March 31, 2021) the COVID-19 pandemic via a population-based serial cross-sectional study in Ontario, Alberta, and British Columbia, Canada. With data from the Minimum Data Set 2.

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Background: Clinical trials suggest that therapeutic-dose heparin may prevent critical illness and vascular complications due to COVID-19, but knowledge gaps exist regarding the efficacy of therapeutic heparin including its comparative effect relative to intermediate-dose anticoagulation.

Objectives: The authors performed 2 complementary secondary analyses of a completed randomized clinical trial: 1) a prespecified per-protocol analysis; and 2) an exploratory dose-based analysis to compare the effect of therapeutic-dose heparin with low- and intermediate-dose heparin.

Methods: Patients who received initial anticoagulation dosed consistently with randomization were included.

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Article Synopsis
  • * Residents in long-term care often experience poor physical functioning; the study synthesizes various studies to better understand rehabilitation's impact specifically for these individuals.
  • * The review included various research studies that met specific criteria and utilized comprehensive methods to gather data, evaluate quality, and analyze results to provide evidence-based recommendations.
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Background And Objectives: Although the association between self-reported and capacity-based mobility outcomes is prominently researched, the pathways through which self-reported measures affect capacity-based measures remains poorly understood. Therefore, our study examines the association between self-reported and capacity-based mobility measures and explores which mobility determinants mediate the association in Nigerian community-dwelling older adults.

Research Design And Methods: This cross-sectional study included 169 older adults [mean age () = 67.

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The 2019-2020 Australian bushfire season had a devastating impact on native wildlife. It was estimated that 3 billion native animals were impacted by the fires, yet there are few estimates of the number of animals that were rescued and rehabilitated post-fire. Focusing on the state of New South Wales (NSW) and Kangaroo Island, South Australia, we used a case study approach to determine the number of marsupials that were reported rescued due to the 2019-2020 bushfires in these areas and analysed species-specific trends in rescue and release success.

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Background: New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years.

Methods: We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions.

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BACKGROUND: Nafamostat mesylate is a potent in vitro antiviral agent that inhibits the host transmembrane protease serine 2 enzyme used by severe acute respiratory syndrome coronavirus 2 for cell entry. METHODS: This open-label, pragmatic, randomized clinical trial in Australia, New Zealand, and Nepal included noncritically ill hospitalized patients with coronavirus disease 2019 (Covid-19). Participants were randomly assigned to usual care or usual care plus nafamostat.

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Mammalian herbivores browse palatable plants of ecological and economical value. Undesirable neighbours can reduce browsing to these plants by providing 'associational refuge', but they can also compete for resources. Here we recreated the informative odour emitted by undesirable plants.

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