Publications by authors named "McDONALD W"

Introduction: Antimicrobial resistance (AMR) is a growing threat to the efficacy of antimicrobials in humans and animals, including those used to control bovine respiratory disease (BRD) in high-risk calves entering western Canadian feedlots. Successful mitigation strategies require an improved understanding of the epidemiology of AMR. Specifically, the relative contributions of antimicrobial use (AMU) and contagious transmission to AMR emergence in animal populations are unknown.

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We engaged with health sector stakeholders and public health professionals within the health system through a participatory modeling approach to support policy-making in the early COVID-19 pandemic in Saskatchewan, Canada. The objective was to use simulation modeling to guide the implementation of public health measures and short-term hospital capacity planning to mitigate the disease burden from March to June 2020. We developed a hybrid simulation model combining System Dynamics (SD), discrete-event simulation (DES), and agent-based modeling (ABM).

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Green stormwater infrastructure is growing in adoption across the world due to its ability to capture and treat stormwater runoff at the source; however, while green stormwater infrastructure is effective at reducing the concentration of many priority pollutants, bioretention often increases the concentration of dissolved phosphorus in the stormwater it treats. This is a significant shortcoming, as dissolved phosphorus can promote algae growth in receiving water bodies resulting in negative impacts to human and aquatic health. This study seeks to address this shortcoming through an end-of-pipe filter at the end of bioretention effluent pipes designed to reduce the concentration of dissolved phosphorus.

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Background: Electroconvulsive therapy (ECT) is an effective treatment for treatment-resistant depression (TRD). There are limited data on the improvement of anxiety symptoms in patients receiving ECT for TRD.

Objective: The aim of the study was to examine the extent to which anxiety symptom severity improves, relative to improvements in depressive symptoms, in TRD patients receiving an acute course of ECT.

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  • MDMA, also known as Ecstasy or Molly, has been used since the 1970s for both recreational and therapeutic purposes, with the FDA recognizing its potential for treating PTSD as a Breakthrough Therapy in 2017.
  • The effects of MDMA in therapeutic settings are distinct, promoting trust and self-compassion while allowing cognitive clarity, which differentiates it from other psychedelics.
  • Preliminary evidence indicates that MDMA-Assisted Therapy is effective, with 67%-71% of PTSD patients no longer meeting diagnostic criteria after treatment, significantly more than those receiving placebo therapy.
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Objective: The authors critically examine the evidence base for psilocybin administered with psychological support/therapy (PST) in the treatment of psychiatric disorders and offer practical recommendations to guide future research endeavors.

Methods: PubMed was searched for English-language articles from January 1998 to November 2023, using the search term "psilocybin." A total of 1,449 articles were identified and screened through titles and abstracts.

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Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.

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Objectives: Concussion is a common injury in rugby union ('rugby') and yet its diagnosis is reliant on clinical judgment. Oculomotor testing could provide an objective measure to assist with concussion diagnosis. NeuroFlex® evaluates oculomotor function using a virtual-reality headset.

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Posttraumatic stress disorder (PTSD) is a highly prevalent psychiatric disorder that can become chronic and debilitating when left untreated. The most commonly recommended first-line treatments for PTSD among adults are individual trauma-focused psychotherapies. Other evidence-based treatments include specific antidepressant medications and non-trauma-focused psychotherapies.

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  • The study aimed to assess how tourniquet use during intramedullary tibial nailing affects clinical outcomes at a Level I Trauma Center, covering 194 patients over five years.
  • No significant differences were noted in key outcome measures—such as narcotic use, operating room time, or blood loss—between patients who did and didn’t use a tourniquet.
  • Significant differences were observed between patients with isolated tibial fractures and those with polytrauma, particularly in postoperative morphine use, length of hospital stay, and estimated blood loss.
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  • Concussions in contact sports pose significant challenges in prevention, detection, and management for athletes, medical professionals, and sporting organizations.
  • Recent technological advancements have led to the creation of a comprehensive database by researchers and clinicians from the Australasian National Rugby League to analyze head impacts and track clinical outcomes.
  • This protocol aims to enhance understanding of concussions in rugby through detailed data collection, informing injury prevention strategies and improving overall player safety.
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Genome-wide association studies (GWASs) of major depressive disorder (MDD) have recently achieved extremely large sample sizes and yielded substantial numbers of genome-wide significant loci. Because of the approach to ascertainment and assessment in many of these studies, some of these loci appear to be associated with dysphoria rather than with MDD, potentially decreasing the clinical relevance of the findings. An alternative approach to MDD GWAS is to focus on the most severe forms of MDD, with the hope that this will enrich for loci of larger effect, rendering their identification plausible, and providing potentially more clinically actionable findings.

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  • N-of-1 trials provide a personalized way for patients to compare the effectiveness of treatments using their own health data, particularly in the context of managing heart failure with preserved ejection fraction (HFpEF).
  • The study involved qualitative interviews with patients participating in these trials to refine a data visualization tool that helps them understand their treatment results, promoting informed decision-making about their medication.
  • Feedback from participants revealed key preferences for the visualization tool, including clear symptom scores, helpful reference images, and the use of descriptive language to convey changes in health instead of just numerical data.
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  • Physicians often struggle with underprescribing and patients not taking medications due to concerns about side effects, but there's little research on how to address these issues.
  • Interviews with doctors revealed that poor communication and conflicting information from families hinder discussions about side effects, while guiding questions and open communication improve the process.
  • The study identified major hurdles in determining the cause of side effects and suggested that improving communication and structured approaches can enhance heart failure medication management.
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Objectives: The gold standard metric for centre-level performance in orthotopic heart transplantation (OHT) is 1-year post-OHT survival. However, it is unclear whether centre performance at 1 year is predictive of longer-term outcomes. This study evaluated factors impacting longer-term centre-level performance in OHT.

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In recent history, the world has witnessed a trend towards liberalization of abortion laws driven by an increasing understanding of the negative personal and public health consequences of criminalizing abortion. By contrast, several countries have recently implemented restrictive reproductive laws, joining the 112 countries where access to abortion care is banned completely or with narrow exceptions. On June 24, 2022, the US Supreme Court ruling in Dobbs v Jackson Women's Health Organization overturned its landmark decisions in Roe v Wade that established abortion until the point of viability of the fetus as a constitutional right.

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The nonstructural protein 1 (Nsp1) of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is a virulence factor that targets multiple cellular pathways to inhibit host gene expression and antiviral response. However, the underlying mechanisms of the various Nsp1-mediated functions and their contributions to SARS-CoV-2 virulence remain unclear. Among the targets of Nsp1 is the mRNA (messenger ribonucleic acid) export receptor NXF1-NXT1, which mediates nuclear export of mRNAs from the nucleus to the cytoplasm.

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  • The study focuses on the structural and proteomic analysis of Cag T4SSs derived from deletion mutants.
  • It emphasizes the surprising structural independence between two key subdomains: the outer membrane complex (OMC) and the pilot region (PR).
  • This finding challenges previous assumptions about the interdependence of these components within the T4SS structure.
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Objective: In this review, the authors update the 2018 position statement of the American Psychiatric Association Council of Research Workgroup on Biomarkers and Novel Treatments on pharmacogenomic (PGx) tools for treatment selection in depression.

Methods: The literature was reviewed for new clinical trials and meta-analyses, published from 2017 to 2022, of studies using PGx tools for treatment selection in depression. The blinding and control conditions, as well as primary and secondary outcomes and post hoc analyses, were summarized.

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  • * The OMCC consists of a 14-fold symmetric outer membrane cap (OMC), a 17-fold symmetric periplasmic ring (PR), and an undefined stalk, with specific proteins (CagY, CagX, CagM, CagT) involved in organization.
  • * Cryo-electron microscopy revealed that while the PR maintains structure without some proteins, the OMC’s organization requires multiple proteins, indicating a structural independence between the OMC and PR within the Cag T4SS
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Objectives: The aim of this study was to compare the incidence, severity, and burden of injury in starting and replacement players from professional men's teams of five rugby unions.

Methods: Match injuries of greater than 24 h time-loss (including data on the severity, match quarter, event, body region) and player minutes of match exposure data were collated for all starting and replacement players in the men's English Premiership, Welsh Pro14 (both 2016/17-2018/19 seasons), and Australian, New Zealand, and South African Super Rugby (all 2016-2018 seasons) teams. Injury incidences and mean injury burden (incidence × days missed) were calculated, and rate ratios (RRs) (95% confidence intervals [CIs]) were used to compare injury incidence and burden between starting (reference group) and replacement players.

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  • - The study focuses on understanding what factors influence individuals to complete follow-up genetic visits after receiving potentially actionable genetic disease risk results from a genomic screening program.
  • - Conducted as a cohort study using biobank data in Pennsylvania, it revealed that less than half of the 1,160 participants completed a genetics visit, indicating a need for better engagement strategies.
  • - Key factors that encouraged visit completion included being younger, female, married or divorced, and having lower health comorbidity levels, suggesting targeted interventions could improve follow-up rates.
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Objective: For nursing home residents with severe dementia, high-intensity medical treatment offers little possibility of benefit but has the potential to cause significant distress. Nevertheless, mechanical ventilation and intensive care unit (ICU) transfers have increased in this population. We sought to understand how and why such care is occurring.

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Antibiotic resistance poses an urgent public health concern, with the environment playing a crucial role in the development and dissemination of resistant bacteria. There is a growing body of research indicating that stormwater is a significant source and transport vector of resistance elements. This research sought to characterize the role of green stormwater infrastructure (GSI), designed for stormwater infiltration, in accumulating and propagating antibiotic resistance in the urban water cycle.

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