Multidisciplinary approach to redefining thyroid hormone reference intervals with big data analysis.

Objectives: This study aimed to employ big data analysis to harmonize reference intervals (RI) for thyroid function tests, with refinement to the TSH upper reference limit, and to optimize the TSH reflex algorithm to improve clinical management and test utilization.

Design & Methods: TSH, free T4, and free T3 results tested in Alberta, Canada, on Roche Cobas and Siemens Atellica were extracted from the laboratory information system (N = 1,144,155 for TSH, N = 183,354 for free T4 and N = 92,632 for free T3). Results from specialists, inpatients, or repeat testing, as well as from positive thyroid disease, autoimmune disease, and pregnancy biomarkers were excluded.

Full wave function cloning for improving convergence of the multiconfigurational Ehrenfest method: Tests in the zero-temperature spin-boson model regime.

In this paper, we report a new algorithm for creating an adaptive basis set in the Multiconfigurational Ehrenfest (MCE) method, which is termed Full Cloning (FC), and test it together with the existing Multiple Cloning (MC) using the spin-boson model at zero-temperature as a benchmark. The zero-temperature spin-boson regime is a common hurdle in the development of methods that seek to model quantum dynamics. Two versions of MCE exist.

Taming Friedrich-Wintgen Interference in a Resonant Metasurface: Vortex Laser Emitting at an On-Demand Tilted Angle.

Friedrich-Wintgen (FW) interference is an atypical coupling mechanism that grants loss exchange between leaky resonances in non-Hermitian classical and quantum systems. Intriguingly, such a mechanism makes destructive interference possible for scenarios in which a radiating wave becomes a bound state in the continuum (BIC) by giving away all of its losses. Here we propose and demonstrate experimentally an original concept to tailor FW-BICs with polarization singularity at on-demand wavevectors in an optical metasurface.

The Prospective Implementation of the 2015 ATA Guidelines and Modified ATA Recurrence Risk Stratification System for Treatment of Differentiated Thyroid Cancer in a Canadian Tertiary Care Referral Setting.

To present clinical outcomes of the prospective implementation of the 2015 American Thyroid Association (ATA) guidelines for the management of thyroid nodules and differentiated thyroid cancer (DTC) using the modified ATA recurrence risk (RR) stratification system. We prospectively analyzed 612 patients with DTC treated between April 2017 and December 2021 in Calgary, Alberta. Each patient was prospectively assigned a modified ATA RR and American Joint Committee Cancer 8th edition stage.

Exploring the benefits of surface analysis techniques to develop double multilayer transfer printing of J-Aggregates cyanine dyes by integrating L-b-L and μCp processes.

Layer-by-layer self-assembly (L-b-L assembly) makes possible to obtain polyelectrolyte multilayers (PEMs) and one of the polyelectrolytes could be replaced by a dye molecule to obtain multilayers which may exhibit optical properties of great interest. On the other hand, μCp has become a routine technique for the preparation of micro- and nanostructured surfaces. In our development in progress of a surface engineering strategy to transfer J-Agg cyanine dyes onto surfaces by integrating L-b-L process and μCp, this contribution highlights how surface analysis imaging techniques can bring valuable information for the development of the process involving a double Multilayers Transfer Printing (MTP) with a Moiré effect.

Performance of Confirmatory Tests for Diagnosing Primary Aldosteronism: a Systematic Review and Meta-Analysis.

Background: Confirmatory tests are recommended for diagnosing primary aldosteronism, but the supporting evidence is unclear.

Methods: We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies evaluating any guideline-recommended confirmatory test (ie, saline infusion test, salt loading test, fludrocortisone suppression test, and captopril challenge test), compared with a reference standard were included.

Improvement in thyroid ultrasound report quality with radiologists' adherence to 2015 ATA or 2017 TIRADS: a population study.

Objectives: There has been slow adoption of thyroid ultrasound guidelines with adherence rates as low as 30% and no population-based studies investigating adherence to guideline-based malignancy risk assessment. We therefore evaluated the impact of adherence to the 2015 ATA guidelines or 2017 ACR-TIRADS guidelines on the quality of thyroid ultrasound reports in our healthcare region.

Methods: We reviewed 899 thyroid ultrasound reports of patients who received fine-needle aspiration biopsy and were diagnosed with Bethesda III or IV nodules or thyroid cancer.

A retrospective review of the community medicine needs from osteoporosis services in Canada.

Background: Comprehensive, real-world osteoporosis care has many facets not explicitly addressed in practice guidelines. We sought to determine the areas of knowledge and practice needs in osteoporosis medicine for the purpose of developing an osteoporosis curriculum for specialist trainees and knowledge translation tools for primary care.

Methods: This was a retrospective review of referral questions received from primary care and specialists to an academic, multi-disciplinary tertiary osteoporosis and metabolic bone clinic.

Accuracy of Thyroid Fine-Needle Aspiration Cytology: A Cyto-Histologic Correlation Study in an Integrated Canadian Health Care Region with Centralized Pathology Service.

Introduction: The reported ROM within TBSRTC categories varies widely and depends on several factors in the clinical care pathway for thyroid nodules, including sonographic risk stratification, cytology expertise, selection criteria for surgical resection, and definitions of malignancy used.

Methods: We present 5,867 consecutive thyroid FNAC and corresponding surgical pathology in the context of a comprehensive, single-payer health care system with centralized cytology and surgical pathology services for over 1.5 million inhabitants.

Response of Pediatric Choroidal Neovascularization to Anti-Vascular Endothelial Growth Factor.

Choroidal neovascularization (CNV) is a rare condition in children but poses a substantial threat to vision. Anti-vascular endothelial growth factor (anti-VEGF) therapy is commonly used in the pediatric population to treat retinopathy of prematurity. However, the use of anti-VEGF is less common for childhood CNV due to the rarity of CNV in the pediatric population.

Comparison of k-wire insertion using oscillatory and unidirectional drilling modes under constant thrust force.

Heat generation during the Kirschner wire (K-wire) insertion process, under either unidirectional or oscillatory drilling mode, places bone at risk of thermal osteonecrosis which can lead to infection. There is a lack of quantitative understanding of the heat generation difference between the two drilling modes and knowledge of optimal thrust force level under each mode is missing. The goal of this study is to investigate the effects of drilling modes and thrust force levels on the bone drilling outcomes.

Comparison of 2 fracture risk estimation processes in Alberta: a cross-sectional chart review.

Background: In Canada, decisions regarding osteoporosis pharmacotherapy are based on estimated 10-year risk of osteoporotic fracture. We aimed to determine how frequently 2 common approaches (Canadian Association of Radiologists and Osteoporosis Canada [CAROC] tool and Fracture Risk Assessment Tool [FRAX]) produced different estimates and to seek possible explanations for differences.

Methods: We conducted a cross-sectional chart review at a tertiary osteoporosis centre (Dr.

A novel hybrid scale for the assessment of cognitive and executive function: The Free-Cog.

Background: Scales measuring cognitive and executive functions are integral to the assessment and management of patients with suspected cognitive impairment. Some of the most commonly used cognitive tests are now subject to copyright restrictions. Furthermore, no existing scale assesses both executive and cognitive abilities.

Tamm plasmons in metal/nanoporous GaN distributed Bragg reflector cavities for active and passive optoelectronics.

We theoretically and experimentally investigate Tamm plasmon (TP) modes in a metal/semiconductor distributed Bragg reflector (DBR) interface. A thin Ag (silver) layer with a thickness (55 nm from simulation) that is optimized to guarantee a low reflectivity at the resonance was deposited on nanoporous GaN DBRs fabricated using electrochemical (EC) etching on freestanding semipolar (2021¯) GaN substrates. The reflectivity spectra of the DBRs are compared before and after the Ag deposition and with that of a blanket Ag layer deposited on GaN.

Selective grating obtained by dye microstructuration based on local photobleaching using a laser writer.

We propose a method to pattern organic optically active materials based on local photobleaching for creating a wavelength-selective grating. Usually, photobleaching is considered a limitation for an organic emitter. Here, this property is exploited to locally suppress dye emission and absorption at the microscale with an abrupt interface and no changes in layer thickness.

Levothyroxine prescribing and laboratory test use after a minor change in reference range for thyroid-stimulating hormone.

Background: Prescribing of levothyroxine and rates of thyroid function testing may be sensitive to minor changes in the upper limit of the reference range for thyroid-stimulating hormone (TSH) that increase the proportion of abnormal results. We evaluated the population-level change in levothyroxine prescribing and TSH testing after a minor planned decrease in the upper limit of the reference range for TSH in a large urban centre with a single medical laboratory.

Methods: Using provincial administrative data, we compared predicted volumes of TSH tests with actual TSH test volumes before and after a planned change in the TSH reference range.

Myc stimulates cell cycle progression through the activation of Cdk1 and phosphorylation of p27.

Cell cycle stimulation is a major transforming mechanism of Myc oncoprotein. This is achieved through at least three concomitant mechanisms: upregulation of cyclins and Cdks, downregulation of the Cdk inhibitors p15 and p21 and the degradation of p27. The Myc-p27 antagonism has been shown to be relevant in human cancer.

Anisotropy and Controllable Band Structure in Suprawavelength Polaritonic Metasurfaces.

In this Letter, we exploit the extended coherence length of mixed plasmon-exciton states to generate active metasurfaces. For this purpose, periodic stripes of organic dye are deposited on a continuous silver film. Typical metasurface effects, such as effective behavior and geometry sensitivity, are measured for periods exceeding the polaritonic wavelength by more than one order of magnitude.

Ultrafast photodissociation dynamics of pyrazole, imidazole and their deuterated derivatives using ab initio multiple cloning.

We present results obtained using the ab initio multiple cloning (AIMC) method to simulate fully quantum dynamics for imidazole and its structural isomer pyrazole along with their selectively deuterated species. We simulate the ultrafast dissociation of the N-H/D bond for these molecules along the repulsive 1πσ* state which agrees well with previous experimental results. Our results give evidence for a two-stage dissociation of the N-H/D bond on the sub-50 fs regime for imidazole, pyrazole and their selectively deuterated species, and give evidence for the importance of the repulsive 1πσ* state along the N-H/D bond coordinate for the relaxation of both imidazole and pyrazole.

Ultrafast photodissociation dynamics of 2-ethylpyrrole: adding insight to experiment with ab initio multiple cloning.

The ultrafast photodissociation dynamics of 2-ethylpyrrole (2-EP) is simulated in a fully quantum manner on the S1 and S2 πσ* states by the ab initio multiple cloning (AIMC) method. AIMC treats electrons with accurate electronic structure methods "on the fly", and nuclear dynamics with wavefunction propagation via a basis set of Ehrenfest trajectory guided Gaussian wavepackets. Total kinetic energy release (TKER) spectra are produced, as well as velocity map images and N-H dissociation times.

The Calgary Audit and Feedback Framework: a practical, evidence-informed approach for the design and implementation of socially constructed learning interventions using audit and group feedback.

Background: Audit and feedback interventions may be strengthened using social interaction. The Calgary office of the Alberta Physician Learning Program (CPLP) developed a process for audit and group feedback for physicians. This paper extends previous work in which we developed a conceptual model of physician responses to audit and group feedback based on a qualitative analysis of six audit and group feedback sessions.

How do physicians behave when they participate in audit and feedback activities in a group with their peers?

Background: Audit and feedback interventions may be strengthened using social interaction. With this in mind, the Calgary office of the Alberta Physician Learning Program developed a process for audit and group feedback for physician groups. As a part of a larger project to develop a practical approach to the design and implementation of audit and group feedback projects, we explored patterns of physician behavior during facilitated audit and group feedback sessions.

Thyroid nodule ultrasound reports in routine clinical practice provide insufficient information to estimate risk of malignancy.

Purpose: Ultrasonographic characteristics of thyroid nodules play an important role in estimating the risk of malignancy (ROM). Guidelines mandate all thyroid nodules be characterized by six key ultrasonographic features to estimate the ROM. Our objective was to evaluate how frequently these characteristics were identified by radiologists and the ensuing utility to estimate ROM.

The effect of sampling techniques used in the multiconfigurational Ehrenfest method.

In this paper, we compare and contrast basis set sampling techniques recently developed for use in the ab initio multiple cloning method, a direct dynamics extension to the multiconfigurational Ehrenfest approach, used recently for the quantum simulation of ultrafast photochemistry. We demonstrate that simultaneous use of basis set cloning and basis function trains can produce results which are converged to the exact quantum result. To demonstrate this, we employ these sampling methods in simulations of quantum dynamics in the spin boson model with a broad range of parameters and compare the results to accurate benchmarks.