Application of quantitative bias analysis for unmeasured confounding in cost-effectiveness modelling.

Due to uncertainty regarding the potential impact of unmeasured confounding, health technology assessment (HTA) agencies often disregard evidence from nonrandomized studies when considering new technologies. Quantitative bias analysis (QBA) methods provide a means to quantify this uncertainty but have not been widely used in the HTA setting, particularly in the context of cost-effectiveness modelling (CEM). This study demonstrated the application of an aggregate and patient-level QBA approach to quantify and adjust for unmeasured confounding in a simulated nonrandomized comparison of survival outcomes.

Lower Gastrointestinal Tract Disorders: Clinical Updates in Women's Health Care Primary and Preventive Care Review.

Lower gastrointestinal (GI) diseases and associated symptoms account for a large number of health care visits each year. Many women visit their obstetrician-gynecologists more often than their primary care physicians or use them as primary health care providers. Many gynecologic and lower GI disorders share symptoms, such as lower abdominal or pelvic pain and bloating.

Attention-deficit hyperactivity disorder in children born to mothers with infertility: a population-based cohort study.

Study Question: Is the risk of attention-deficit hyperactivity disorder (ADHD) increased in children born to mothers with infertility, or after receipt of fertility treatment, compared to mothers with unassisted conception?

Summary Answer: Infertility itself may be associated with ADHD in the offspring, which is not amplified by the use of fertility treatment.

What Is Known Already: Infertility, and use of fertility treatment, is common. The long-term neurodevelopmental outcome of a child born to a mother with infertility, including the risk of ADHD, remains unclear.

Part II: a step-by-step guide to latent class analysis.

Latent Class Analysis (LCA) is an analytical approach for the identification of more homogeneous subgroups within an otherwise dissimilar patient population. In the current paper, Part II, we present a practical step-by-step guide for LCA of clinical data, including when LCA might be applied, selecting indicator variables, and choosing a final class model. We also identify some common pitfalls of LCA, and some related solutions.

Persistence of abnormal uterine artery flow postpartum: Case-control study.

Cohort study of singleton pregnancies with risk factors for placental insufficiency, managed at St. Michael's Hospital in Toronto, Canada. Patients undergone UA Doppler assessment at 18-22 weeks' gestation and 6 weeks postpartum.

An open source computational workflow for the discovery of autocatalytic networks in abiotic reactions.

A central question in origins of life research is how non-entailed chemical processes, which simply dissipate chemical energy because they can do so due to immediate reaction kinetics and thermodynamics, enabled the origin of highly-entailed ones, in which concatenated kinetically and thermodynamically favorable processes enhanced some processes over others. Some degree of molecular complexity likely had to be supplied by environmental processes to produce entailed self-replicating processes. The origin of entailment, therefore, must connect to fundamental chemistry that builds molecular complexity.

Part I: A friendly introduction to latent class analysis.

Latent class analysis (LCA) offers a powerful analytical approach for categorizing groups (or "classes") within a heterogenous population. LCA identifies these hidden classes by a set of predefined features, known as "indicators". Unlike many other grouping analytical approaches, LCA derives classes using a probabilistic approach.

Ultrasound Identifies First Rib Stress Fractures: A Case Series in National Collegiate Athletic Association Division I Athletes.

Isolated first rib stress fractures in athletes are thought to be rare. In this case series, 3 National Collegiate Athletic Association Division I athletes developed isolated first rib stress fractures over the span of 1 year, indicating that these injuries may occur more often than previously understood. These fractures can be easily missed because of the low incidence, lack of clinical suspicion, and vague presentation.

Categorization of Opioid Use Among Pregnant People and Association With Overdose or Death.

Importance: Early identification of people who use opioids in pregnancy may improve health outcomes for pregnant people and infants. However, characterization of diverse circumstances surrounding type of opioid use and indications for opioid use are lacking.

Objective: To develop clinically distinct groups of people who use opioids in pregnancy and to evaluate their association with drug overdose or death up to 1 year post partum.

Evaluation of Adverse Pregnancy Outcomes in Physicians Compared With Nonphysicians.

Importance: Physicians may be at risk of pregnancy complications due to prolonged work hours, overnight shifts, occupational hazards, and older maternal age at first birth compared with nonphysicians. Observational studies of physicians, including comparisons across physician specialties, are needed.

Objective: To compare adverse maternal and perinatal outcomes between pregnant physicians and nonphysicians and between physicians of different specialties.

Improving patient and clinician safety during COVID-19 through rapidly adaptive simulation and a randomised controlled trial: a study protocol.

Introduction: COVID-19 required healthcare systems to iteratively adapt for safe and up-to-date care as knowledge of the disease rapidly evolved. Rates of COVID-19 infections continue to fluctuate and patients without COVID-19 increasingly return to the emergency department (ED) for care. This leads to new challenges and threats to patient and clinician safety as suspected patients with COVID-19 need to be quickly detected and isolated among other patients with non-COVID-19-related illnesses.

Infertility treatment and postpartum mental illness: a population-based cohort study.

Background: Subfertility and infertility treatment can be stressful experiences, but it is unknown whether each predisposes to postpartum mental illness. We sought to evaluate associations between subfertility or infertility treatment and postpartum mental illness.

Methods: We conducted a population-based cohort study of individuals without pre-existing mental illness who gave birth in Ontario, Canada, from 2006 to 2014, stratified by fertility exposure: subfertility without infertility treatment; noninvasive infertility treatment (intrauterine insemination); invasive infertility treatment (in vitro fertilization); and no reproductive assistance.

Longitudinal associations of parental monitoring and delinquent peer affiliation: The potential influence of parental solicitation and monitoring rules.

Introduction: Poor parental monitoring has been theorized as a key risk factor for an adolescent's association with deviant peers. However, measurements of parental monitoring often only measure parental knowledge rather than parental monitoring actions, leaving the true longitudinal associations between parental monitoring and peer delinquency unclear.

Methods: The current sample consisted of 1095 male justice-involved adolescents (13-17 years old at baseline collected between 2011 and 2013) from across the United States who provided survey data every 6 months for 3 years.

Added value of Joint ENT-Rheumatology clinic in the management of ANCA-associated vasculitis: One year's experience.

Purpose: ANCA-associated vasculitides (AAV) represent a group of diagnoses, including granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) and microscopic polyangiitis (MPA). Most commonly, they present initially with ENT-associated symptomatology, and therefore they often pose a diagnostic challenge. We aim to present our one-year experience in the joint management of AAV in a multi-disciplinary setting.

Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice.

Objectives: Agitation, defined as excessive psychomotor activity leading to aggressive or violent behaviour, is prevalent in the emergency department (ED) due to rising behavioural-related visits. Experts recommend use of verbal de-escalation and avoidance of physical restraint to manage agitation. However, bedside applications of these recommendations may be limited by system challenges in emergency care.

High-Intensity Hospital Utilization Among Adults With Diabetic Foot Ulcers: A Population-based Study.

Background: Diabetic foot ulcers (DFUs) are common and disabling, necessitating lengthy hospitalizations. In this study we sought to identify potentially modifiable determinants of high-intensity hospital care use among adults with DFUs.

Methods: Three related case-control studies were conducted using Canada-wide cohorts of adults hospitalized with a DFU from 2011 to 2015.

Pre-phototherapy total serum bilirubin levels in extremely preterm infants.

Background: Extremely preterm infants are prone to hyperbilirubinemia and its sequelae. Currently recommended thresholds for initiating phototherapy in these newborns are consensus-based (CB).

Methods: A multi-site retrospective cohort study of 642 infants born at 24 to 28 weeks' gestation, between January 2013 and June 2017, was conducted at three NICUs in Canada.

Prioritization of autoimmune disease-associated genetic variants that perturb regulatory element activity in T cells.

Genome-wide association studies (GWASs) have uncovered hundreds of autoimmune disease-associated loci; however, the causal genetic variants within each locus are mostly unknown. Here, we perform high-throughput allele-specific reporter assays to prioritize disease-associated variants for five autoimmune diseases. By examining variants that both promote allele-specific reporter expression and are located in accessible chromatin, we identify 60 putatively causal variants that enrich for statistically fine-mapped variants by up to 57.

The prevalence of headache disorders in Postural Tachycardia Syndrome: A systematic review and meta-analysis of the literature.

Background: Headache is a common presentation of postural tachycardia syndrome, yet robust prevalence data is lacking.

Objectives: To undertake a systematic review and meta-analysis to estimate the prevalence of headache disorders in postural tachycardia syndrome, and to explore the potential shared pathophysiological mechanisms that underpin these conditions as well as treatment options.

Methods: Three databases were searched for publications evaluating prevalence of migraine (primary outcome) and general and orthostatic headache (secondary outcomes) in patients with postural tachycardia syndrome.

COVAN Leading to ESKD Despite Minimal COVID Symptoms.

We report a case of dialysis dependence in a patient with COVID-19-associated nephropathy (COVAN) who had minimal respiratory manifestations. A 25-year-old man with a history of multiple sclerosis in remission presented with mild dyspnea due to COVID-19 pneumonia and was found to have rapidly worsening kidney function. He only required nasal cannula and was able to be weaned off within a few days.

Examining Differences in the Effect of Vicarious and Personal Procedural Justice on Legal Orientations and Offending Across Race/Ethnicity Among a Sample of Serious Juvenile Offenders.

In the current study it is examined if the impact of vicarious and personal perceptions of procedural justice on legal cynicism, legitimacy, and offending across time is invariant across race/ethnicity. Using longitudinal data from a sample of serious juvenile offenders from the Pathways to Desistance, the within- and between-individual associations of procedural justice, legal orientations, and offending were tested. Race/ethnic-specific models were estimated to examine differences across race/ethnicity.

Interpregnancy Weight Change Among Mothers of a Child with a Major Congenital Anomaly: A Danish Nationwide Cohort Study.

Background: The mother of an infant with a major congenital anomaly is at a higher risk of premature cardiometabolic disease, possibly from chronic caregiver stress and distraction from self-care, including maintaining a healthy lifestyle and body weight.

Objective: To compare the interpregnancy weight gain in women whose first infant had a major congenital anomaly vs those without an affected child.

Methods: Multivariable linear regression compared women whose infant had an anomaly vs those whose infant did not, adjusting for interpregnancy time interval, demographics, smoking and health status at the first pregnancy.