Cost-Effectiveness of Breast Cancer Screening Using Digital Mammography in Canada.

Importance: Evolving breast cancer treatments have led to improved outcomes but carry a substantial financial burden. The association of treatment costs with the cost-effectiveness of screening mammography is unknown.

Objective: To determine the cost-effectiveness of population-based breast cancer screening in the context of current treatment standards.

A Multicenter Physician Survey Evaluating the Use of Ki-67 in Breast Cancer Management in Canada.

Background: Ki-67's response to pre-operative endocrine therapy (ET) in early breast cancer is an evidence-based tool to guide adjuvant treatment decisions. Physicians across Canada were surveyed to explore current practice patterns and perceived barriers to the use of Ki-67 in practice.

Methods: Physicians were invited to participate in an anonymous survey and were eligible if they prescribed systemic therapy for breast cancer in Canada.

Basic life support training: Is student confidence enhanced by advanced levels of simulation?

Background: Basic life support (BLS) is a mandatory skill for nurses. The confidence of the BLS provider should be enhanced by regular training. Traditionally, BLS training has used low-fidelity manikins, but more recent studies have suggested the use of high-fidelity manikins and alternative levels of simulation such as virtual reality.

First-principles study of lithium aluminosilicate glass scintillators.

Radiation sensors are an important enabling technology in several fields, such as medicine, scientific research, energy, defence, meteorology, and homeland security. Glass-based scintillators have been in use for more than 50 years and offer many benefits, including their ability to respond to different types of radiation, and to be readily formed into various shapes. There is, however, the prospect to develop new and improved glass scintillators, with low self-absorption, low refractive indices, and high radiative recombination rates.

Young Women with Breast Cancer: The Current Role of Precision Oncology.

Young adults aged 40 years and younger with breast cancer represent less than 5% of all breast cancer cases, yet it is the leading cause of death among young women with cancer worldwide. Breast cancer that develops at a young age is more aggressive and has biological features that carry an increased risk of relapse and death. Young adults are more likely to have a genetic predisposition and key biomarkers, including endocrine receptors, the HER2 receptor, and proliferation biomarkers, that appear different compared to older adults.

Capturing the True Cost of Breast Cancer Treatment: Molecular Subtype and Stage-Specific per-Case Activity-Based Costing.

Background: Breast cancer (BC) treatment is rapidly evolving with new and costly therapeutics. Existing costing models have a limited ability to capture current treatment costs. We used an Activity-Based Costing (ABC) method to determine a per-case cost for BC treatment by stage and molecular subtype.

Management of genitourinary symptoms in patients with breast cancer: an updated systematic review of available evidence from randomized trials.

Purpose: The purpose of this systematic review update is to synthesize available data on management of genitourinary symptoms (GUS) in breast cancer patients, a common and challenging clinical scenario.

Methods: EMBASE, Ovid Medline, and the Cochrane Library were searched from September 2014 to December 2021 for randomized controlled trials which examined various interventions for GUS in breast cancer patients. Outcomes of interest included improvements in vaginal symptoms (e.

Reproductive Outcomes in Young Breast Cancer Survivors Treated (15-39) in Ontario, Canada.

We conducted a population-based, retrospective, matched-cohort study to examine the impact of breast cancer diagnosis and treatment on fertility outcomes. Relative risks of infertility, childbirth, premature ovarian insufficiency (POI; age < 40) and early menopause (age < 45) were calculated using modified Poisson regression. Our primary cohort included young women (15-39) with early stage BC diagnosed 1995-2014.

Results of the phase I CCTG IND.231 trial of CX-5461 in patients with advanced solid tumors enriched for DNA-repair deficiencies.

CX-5461 is a G-quadruplex stabilizer that exhibits synthetic lethality in homologous recombination-deficient models. In this multicentre phase I trial in patients with solid tumors, 40 patients are treated across 10 dose levels (50-650 mg/m) to determine the recommended phase II dose (primary outcome), and evaluate safety, tolerability, pharmacokinetics (secondary outcomes). Defective homologous recombination is explored as a predictive biomarker of response.

Cardiac Monitoring and Heart Failure in Advanced Breast Cancer Patients Treated With Trastuzumab in Ontario, Canada.

Background: Trastuzumab has improved patient outcomes in HER2 + breast cancer (BC) but carries a risk of cardiotoxicity. Routine cardiac imaging is recommended for advanced breast cancer (aBC) patients during trastuzumab treatment despite a lack of evidence that this improves patient outcomes. This study was conducted to understand predictive factors for cardiac events and determine the impact of cardiovascular monitoring in aBC.

Augmented Reality in Supporting Healthcare and Nursing Independent Learning: Narrative Review.

New advances in technology have brought challenges and opportunities for education and instructional methods. Compared with traditional education, the increased use of technology-enhanced blended learning in healthcare and nursing education requires students to take more responsibility for their learning. The use of advanced technology has resulted in independent learning skills becoming increasingly important.

Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial.

Background: The role of remdesivir in the treatment of patients in hospital with COVID-19 remains ill defined in a global context. The World Health Organization Solidarity randomized controlled trial (RCT) evaluated remdesivir in patients across many countries, with Canada enrolling patients using an expanded data collection format in the Canadian Treatments for COVID-19 (CATCO) trial. We report on the Canadian findings, with additional demographics, characteristics and clinical outcomes, to explore the potential for differential effects across different health care systems.

Use of an electronic seizure diary in a randomized, controlled trial of natalizumab in adult participants with drug-resistant focal epilepsy.

Objective: To analyze electronic diary (e-diary) use in a phase 2, randomized, controlled clinical trial (OPUS; NCT03283371) of natalizumab in adult participants with drug-resistant focal epilepsy.

Methods: We developed an e-diary, which incorporated an episodic seizure diary and a daily diary reminder, for use as the primary source to record participants' daily seizure activity in the OPUS phase 2 clinical trial. Participants and/or their designated caregivers made e-diary entries by selecting seizure descriptions generated in the participants' and/or caregivers' own words at the time of screening.

Self-diffusion in garnet-type LiLaZrO solid electrolytes.

Tetragonal garnet-type LiLaZrO is an important candidate solid electrolyte for all-solid-state lithium ion batteries because of its high ionic conductivity and large electrochemical potential window. Here we employ atomistic simulation methods to show that the most favourable disorder process in LiLaZrO involves loss of LiO resulting in lithium and oxygen vacancies, which promote vacancy mediated self-diffusion. The activation energy for lithium migration (0.

Optimization of a new interatomic potential to investigate the thermodynamic properties of hypo-stoichiometric mixed oxide fuel U Pu O.

The behaviour of stoichiometric U Pu O compounds used as nuclear fuel is relatively well understood. Conversely, the effects of stoichiometry deviation on fuel performance and fuel stability are intricate and poorly studied. In order to investigate what affect these have on the thermophysical properties of hypo-stoichiometric U Pu O mixed oxide fuel, new interaction parameters based on the many-body CRG (Cooper-Rushton-Grimes) potential formalism were optimized.

Anthracycline-induced cardiotoxicity in patients with early-stage breast cancer: the Canadian Cancer Trials Group (CCTG) MA.21 experience.

Purpose: Anthracyclines are frequently used in adjuvant treatment for early-stage breast cancer (ESBC). The purpose of this study was to evaluate cardiotoxic effects in the first five years after treatment with different anthracycline-based regimens.

Methods: CCTG MA.

Optimization of a new interatomic potential to investigate the thermodynamic properties of hypo-stoichiometric mixed oxide fuel UPuO.

The behaviour of stoichiometric UPuOcompounds used as nuclear fuel is relatively well understood. Conversely, the effects of stoichiometry deviation on fuel performance and fuel stability are intricate and poorly studied. In order to investigate what affect these have on the thermophysical properties of hypo-stoichiometric UPuOmixed oxide fuel, new interaction parameters based on the many-body CRG (Cooper-Rushton-Grimes) potential formalism were optimized.

Transition to naïve human pluripotency mirrors pan-cancer DNA hypermethylation.

Epigenetic reprogramming is a cancer hallmark, but how it unfolds during early neoplastic events and its role in carcinogenesis and cancer progression is not fully understood. Here we show that resetting from primed to naïve human pluripotency results in acquisition of a DNA methylation landscape mirroring the cancer DNA methylome, with gradual hypermethylation of bivalent developmental genes. We identify a dichotomy between bivalent genes that do and do not become hypermethylated, which is also mirrored in cancer.

Impact of Stopping Trastuzumab in Early Breast Cancer: A Population-Based Study in Ontario, Canada.

Background: Adjuvant trastuzumab for early-stage (I-III) HER2-positive breast cancer (BC) has led to statistically significant improvement in cancer outcomes but carries a risk of cardiotoxicity. Trastuzumab is discontinued early in many patients for asymptomatic changes in left ventricular ejection fraction. We evaluated the impact of early discontinuation of trastuzumab on cancer outcomes.

An international survey of healthcare providers' knowledge of cardiac complications of cancer treatments.

Background: Cardio-oncology is a young sub-specialty that addresses the needs of cancer patients at risk of, or who have experienced cancer therapy related cardiac dysfunction (CTRCD). This study assessed clinicians' understanding of cardio-oncology, opinions towards current practice, and approach to diagnosing and managing CTRCD.

Methods: A 45-question survey was administered online via Survey Monkey and WeChat to health care providers (HCPs) comprising of cardiologists, oncologists, and others from September 2017 to March 2018.

The Use of Immersive and Virtual Reality Technologies to Enable Nursing Students to Experience Scenario-Based, Basic Life Support Training-Exploring the Impact on Confidence and Skills.

The link between effective basic life support and survival following cardiac arrest is well known. Nurses are often first responders at in-hospital cardiac arrests and receive annual basic life support training to ensure they have the adequate skills, and student nurses are taught this in preparation for their clinical practice. However, it is clear that some nurses still lack confidence and skills to perform basic life support in an emergency situation.

How to measure a patient's temperature non-invasively.

Temperature is a vital sign that is included in all early warning scoring tools and as part of patient observations. This article outlines the main non-invasive methods that can be used to measure a patient's temperature. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based.

Clinical experience of patients referred to a multidisciplinary cardio-oncology clinic: an observational cohort study.

Introduction: Cardiovascular disease is the 2nd leading cause of long-term morbidity and mortality in cancer survivors. Cardio-oncology clinics (cocs) have emerged to address the issue; however, there is a paucity of data about the demographics and clinical outcomes of patients seen in the coc setting.

Methods: Cancer patients referred to The Ottawa Hospital coc were included in this retrospective observational study.

Stoichiometry deviation in amorphous zirconium dioxide.

Amorphous zirconia (a-ZrO) has been simulated using a synergistic combination of state-of-the-art methods: employing reverse Monte-Carlo, molecular dynamics and density functional theory together. This combination has enabled the complex chemistry of the amorphous system to be efficiently investigated. Notably, the a-ZrO system was observed to accommodate excess oxygen readily - through the formation of neutral peroxide (O ) defects - a result that has implications not only in the a-ZrO system, but also in other systems employing network formers, intermediates and modifiers.