Effectiveness of the Sub-Acute Care for Frail Elderly (SAFE) Transitional Care Unit on Short-Term Functional Independence in Frail Older Patients Discharged from Hospital.

Background: Transitional care programs help improve continuity of care and post-discharge outcomes for frail older adults who are hospitalized. In this study, we examined the effectiveness of a transitional care model, based in a long-term care (LTC) home, on the functional independence of older hospitalized patients post-discharge.

Methods: We used a propensity-score matched cohort, whereby cases comprised patients who were admitted to a transitional care program-called the Sub-Acute Care for Frail Elderly (SAFE) Unit-following a hospitalization between March 1, 2018 and June 30, 2019.

Factors Affecting Managers' Technology Adoption Decisions in Long-Term Care Homes: A Canadian Exploratory Study Post-COVID-19 Pandemic.

Health information technologies (HIT) provide opportunities to support staff as well as residents and their families in long-term care (LTC) homes. Yet, LTC homes lag behind other healthcare organizations in HIT adoption, and little is known about the factors that inform and shape LTC home managers' decisions. We conducted an exploratory Delphi study with a panel of 19 Canadian LTC managers who were surveyed through three iterative rounds (brainstorming, narrowing down, and ranking) to solicit their input on the key factors that influence HIT adoption decisions.

Older Adults' Quality of Life in Long-Term Care: A Cross-Sectional Comparison Before and During the COVID-19 Pandemic.

This study aims to assess changes in long-term care (LTC) residents' quality of life (QoL) before and during the COVID-19 pandemic. A pre-test post-test study of 49 QoL measures, across four dimensions from the interRAI self-reported QoL survey, was conducted. Secondary data from 2019 ( = 116) and 2020 ( = 128) were analysed to assess the change in QoL.

A Novel Concept of Transperineal Focused Ultrasound Transducer for Prostate Cancer Local Deep Hyperthermia Treatments.

Design, embodiment, and experimental study of a novel concept of extracorporeal phased array ultrasound transducer for prostate cancer regional deep hyperthermia treatments using a transperineal acoustic window is presented. An optimized design of hyperthermia applicator was derived from a modelling software where acoustic and thermal fields were computed based on anatomical data. Performance tests have been experimentally conducted on gel phantoms and tissues, under 3T MRI guidance using PRFS thermometry.

The cost-effectiveness of a nursing home-based transitional care unit for increasing the potential for independent living in the community among hospitalized older adults.

Objective: In Canada, a persistent barrier to achieving healthcare system efficiency has been patient days accumulated by individuals with an alternate level of care (ALC) designation. Transitional care units (TCUs) may address the capacity pressures associated with ALC. We sought to assess the cost-effectiveness of a nursing home (NH) based TCU leveraging existing infrastructure to support a hospitalized older adult's transition to independent living at home.

Three-dimensional assessment of vascular cooling effects on hepatic microwave ablation in a standardized ex vivo model.

The aim of this study was a three-dimensional analysis of vascular cooling effects on microwave ablation (MWA) in an ex vivo porcine model. A glass tube, placed in parallel to the microwave antenna at distances of 2.5, 5.

Program Evaluation of SeeMe™: Understanding Together.

Background: Perley Health has implemented (www.perleyhealth.ca), a comprehensive approach to care that integrates the assessment and management of frailty, with an emphasis on goals of care planning.

Deep Learning for Ultrasound Image Formation: CUBDL Evaluation Framework and Open Datasets.

Deep learning for ultrasound image formation is rapidly garnering research support and attention, quickly rising as the latest frontier in ultrasound image formation, with much promise to balance both image quality and display speed. Despite this promise, one challenge with identifying optimal solutions is the absence of unified evaluation methods and datasets that are not specific to a single research group. This article introduces the largest known international database of ultrasound channel data and describes the associated evaluation methods that were initially developed for the challenge on ultrasound beamforming with deep learning (CUBDL), which was offered as a component of the 2020 IEEE International Ultrasonics Symposium.

Utility of Hypertonic Saline and Diazepam in COVID-19-Related Hydroxychloroquine Toxicity.

Background: Hydroxychloroquine (HCQ) poisoning is a life-threatening but treatable toxic ingestion. The scale of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) and the controversial suggestion that HCQ is a treatment option have led to a significant increase in HCQ use. HCQ poisoning should be at the top-of-mind for emergency providers in cases of toxic ingestion.

A Case-Control Study of the Sub-Acute Care for Frail Elderly (SAFE) Unit on Hospital Readmission, Emergency Department Visits and Continuity of Post-Discharge Care.

Objectives: In Canada, alternate-level-of-care (ALC) beds in hospitals may be used when patients who do not require the intensity of services provided in an acute care setting are waiting to be discharged to a more appropriate care setting. However, when there is a lack of care options for patients waiting to be discharged, it contributes to prolonged hospital stays and bottlenecks in the health care system manifested as "hallway medicine." We examined the effectiveness of a function-focused transitional care program, the Sub-Acute care for Frail Elderly (SAFE) Unit, in reducing the length of stay (LOS) in hospital, as well as post-discharge acute care use and continuity of care.

Cardiac phenotype in -related syndromes: A multicenter cohort study.

Objective: To define the risks and consequences of cardiac abnormalities in -related syndromes.

Methods: Patients meeting clinical diagnostic criteria for rapid-onset dystonia-parkinsonism (RDP), alternating hemiplegia of childhood (AHC), and cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) with genetic analysis and at least 1 cardiac assessment were included. We evaluated the cardiac phenotype in an knock-in mouse (Mashl) to determine the sequence of events in seizure-related cardiac death.

Building confidence in digital health through metrology.

Healthcare is increasingly and routinely generating large volumes of data from different sources, which are difficult to handle and integrate. Confidence in data can be established through the knowledge that the data are validated, well-curated and with minimal bias or errors. As the National Measurement Institute of the UK, the National Physical Laboratory (NPL) is running an interdisciplinary project on digital health data curation.

Knockout of the X-linked in the hypothalamic paraventricular nucleus impairs sympathetic output to brown fat and causes obesity.

Fibroblast growth factor (FGF)13, a nonsecreted, X-linked, FGF homologous factor, is differentially expressed in adipocytes in response to diet, yet 's role in metabolism has not been explored. Heterozygous knockouts fed normal chow and housed at 22°C showed hyperactivity accompanying reduced core temperature and obesity when housed at 30°C. Those heterozygous knockouts showed defects in thermogenesis even at 30°C and an inability to protect core temperature.

Establishing an integrated model of subacute care for the frail elderly.

The current health system in Ontario is not designed to meet the needs of frail older adults. This is particularly true for older adults hospitalized due to exacerbation of chronic illness or medical crisis. This article describes the Subacute Care Unit for the Frail Elderly (SAFE) program, one which is designed to serve frail older patients who are at risk of deconditioning or disability associated with prolonged hospitalization but who may safely return home or to a retirement home following up to 4 weeks of subacute care in a restorative environment.

Numerical and Experimental Study of Mechanisms Involved in Boiling Histotripsy.

The aim of boiling histotripsy is to mechanically fractionate tissue as an alternative to thermal ablation for therapeutic applications. In general, the shape of a lesion produced by boiling histotripsy is tadpole like, consisting of a head and a tail. Although many studies have demonstrated the efficacy of boiling histotripsy for fractionating solid tumors, the exact mechanisms underpinning this phenomenon are not yet well understood, particularly the interaction of a boiling vapor bubble with incoming incident shockwaves.

Inducible ablation enhances caveolae-mediated cardioprotection during cardiac pressure overload.

The fibroblast growth factor (FGF) homologous factor FGF13, a noncanonical FGF, has been best characterized as a voltage-gated Na channel auxiliary subunit. Other cellular functions have been suggested, but not explored. In inducible, cardiac-specific knockout mice, we found-even in the context of the expected reduction in Na channel current-an unanticipated protection from the maladaptive hypertrophic response to pressure overload.

FGF13 modulates the gating properties of the cardiac sodium channel Na1.5 in an isoform-specific manner.

FGF13 (FHF2), the major fibroblast growth factor homologous factor (FHF) in rodent heart, directly binds to the C-terminus of the main cardiac sodium channel, Na1.5. Knockdown of FGF13 in cardiomyocytes induces slowed ventricular conduction by altering Na1.

Jak-STAT regulation of cyst stem cell development in the Drosophila testis.

Establishment and maintenance of functional stem cells is critical for organ development and tissue homeostasis. Little is known about the mechanisms underlying stem establishment during organogenesis. Drosophila testes are among the most thoroughly characterized systems for studying stem cell behavior, with germline stem cells (GSCs) and somatic cyst stem cells (CySCs) cohabiting a discrete stem cell niche at the testis apex.

Cyclosporine up-regulates Krüppel-like factor-4 (KLF4) in vascular smooth muscle cells and drives phenotypic modulation in vivo.

Cyclosporine A (CSA, calcineurin inhibitor) has been shown to block both vascular smooth muscle cell (VSMC) proliferation in cell culture and vessel neointimal formation following injury in vivo. The purpose of this study was to determine molecular and pathological effects of CSA on VSMCs. Using real-time reverse transcription-polymerase chain reaction, Western blot analysis, and immunofluorescence microscopy, we show that CSA up-regulated the expression of Krüppel-like factor-4 (KLF4) in VSMCs.

Pseudomonas mutant strains that accumulate androstane and seco-androstane intermediates from bile acids.

Transposon mutant strains which were affected in bile acid catabolism were isolated from four Pseudomonas spp. Two of the mutant groups isolated were found to accumulate 12 alpha-hydroxyandrosta-1,4-diene-3,17-dione as the major product from deoxycholic acid. Strains in one of these two groups were able to grow on steroids such as chenodeoxycholic acid, which lacks a 12 alpha-hydroxy function, whereas the one member of the second group could not.

Insertion of a MalE beta-galactosidase fusion protein into the envelope of Escherichia coli disrupts biogenesis of outer membrane proteins and processing of inner membrane proteins.

The synthesis of a membrane-bound MalE beta-galactosidase hybrid protein, when induced by growth of Escherichia coli on maltose, leads to inhibition of cell division and eventually a reduced rate of mass increase. In addition, the relative rate of synthesis of outer membrane proteins, but not that of inner membrane proteins, was reduced by about 50%. Kinetic experiments demonstrated that this reduction coincided with the period of maximum synthesis of the hybrid protein (and another maltose-inducible protein, LamB).