Active learning of enhancers and silencers in the developing neural retina.

Deep learning is a promising strategy for modeling cis-regulatory elements. However, models trained on genomic sequences often fail to explain why the same transcription factor can activate or repress transcription in different contexts. To address this limitation, we developed an active learning approach to train models that distinguish between enhancers and silencers composed of binding sites for the photoreceptor transcription factor cone-rod homeobox (CRX).

Clinical Utility of Broad-Range PCR Testing and Impact on Outcomes in Adults with Suspected Infection.

: The development of broad-range polymerase chain reaction (BR-PCR) and next-generation sequencing techniques has significant implications for antimicrobial stewardship by increasing clinicians' ability to provide a tailored antimicrobial regimen. We sought to explore the clinical utility of BR-PCR testing and its impact on antimicrobial treatment among an adult cohort in a large hospital system. : We retrospectively evaluated samples that underwent BR-PCR testing between 2017 and 2021 and summarized their clinical characteristics and impact on antimicrobial therapy.

Building Engagement-Capable Environments for Health System Transformation: Development and Early Implementation of a Capability Framework for Patient, Family and Caregiver Engagement in Ontario Health Teams.

Introduction: Despite widespread calls to involve patients, families and caregivers (PFCs) as partners at all levels of health system planning and design, there is unevenness in how engagement efforts are supported across these settings. The concept of 'engagement-capable environments' offers a way forward to uncover the key requirements for sustainable, high-quality engagement, but more work is needed to identify the specific competencies required to create these environments. We addressed this gap by developing a capability framework for Ontario Health Teams (OHTs), a newly established structure for planning, designing, organizing and delivering care in Ontario, Canada.

Patient partner perspectives on compensation: Insights from the Canadian Patient Partner Survey.

Introduction: There is a growing role for patients, family members and caregivers as consultants, collaborators and partners in health system settings in Canada. However, compensation for this role is not systematized. When offered, it varies in both type (e.

The emergence of a suburban penalty during the 1918/19 influenza pandemic in Malta: The role of a marketplace, railway, and measles.

The Malta 1918/19 influenza experience adds to our understanding of the pandemic by illustrating the importance of suburban populations, their vulnerabilities, and elevated mortality rates. Studies on the socio-geographical variation in the 1918/19 influenza mortality has largely overlooked the suburban experience, and thus the often-hidden heterogeneity of the disease experience is missing. A comparison of mortality rates across the three settlement types (urban, suburban, and rural) for the second wave of the pandemic revealed that there were significant differences across the settlement types (x2 = 22.

Evaluating the impacts of patient engagement on a national health research network: results of a case study of the Chronic Pain Network.

Background: The Chronic Pain Network (CPN) is a pan-Canadian research network focused on innovating and improving the quality and delivery of pain prevention, assessment, management and research for all Canadians. An important focus of the CPN is to work in collaboration with patient partners. Patient partners, researchers and clinicians work together in all aspects of the research network including on funded research projects and in the governance of the Network.

Development of the Engage with Impact Toolkit: A comprehensive resource to support the evaluation of patient, family and caregiver engagement in health systems.

Introduction: Recent shifts in the patient, family and caregiver engagement field have focused greater attention on measurement and evaluation, including the impacts of engagement efforts. Current evaluation tools offer limited support to organizations seeking to reorient their efforts in this way. We addressed this gap through the development of an impact measurement framework and accompanying evaluation toolkit-the Engage with Impact Toolkit.

Towards conceptualizing patients as partners in health systems: a systematic review and descriptive synthesis.

Background: With the sharp increase in the involvement of patients (including family and informal caregivers) as active participants, collaborators, advisors and decision-makers in health systems, a new role has emerged: the patient partner. The role of patient partner differs from other forms of patient engagement in its longitudinal and bidirectional nature. This systematic review describes extant work on how patient partners are conceptualized and engaged in health systems.

Understanding patient partnership in health systems: lessons from the Canadian patient partner survey.

Objectives: To examine the sociodemographic characteristics, activities, motivations, experiences, skills and challenges of patient partners working across multiple health system settings in Canada.

Design: Online cross-sectional survey of self-identified patient partners.

Setting: Patient partners in multiple jurisdictions and health system organisations.

The impact of COVID-19 on patient engagement in the health system: Results from a Pan-Canadian survey of patient, family and caregiver partners.

Introduction: The COVID-19 pandemic has had an impact on all aspects of the health system. Little is known about how the activities and experiences of patient, family and caregiver partners, as a large group across a variety of settings within the health system, changed due to the substantial health system shifts catalysed by the pandemic. This paper reports on the results of a survey that included questions about this topic.

Effects of seawater scrubbing on a microplanktonic community during a summer-bloom in the Baltic Sea.

The International Maritime Organization (IMO) has gradually applied stricter regulations on the maximum sulphur content permitted in marine fuels and from January 1, 2020, the global fuel sulphur limit was reduced from 3.5% to 0.5%.

Assessing a syndemic: Gibraltar in the time of cholera.

More than a decade ago Singer (2009) described Gibraltar's experience with cholera and smallpox in 1865 as a syndemic. In this study, we provide a reassessment of that event and, consequently, propose a methodology to identify a syndemic at the population level. We propose that the concept of the harvesting effect from demographic studies on crisis mortality provides a useful framework for evaluating the presence of a syndemic.

Supporting women at average risk to make informed decisions about mammography when there is no "right" answer: a qualitative citizen deliberation study.

Background: Women are encouraged to make informed choices about mammography screening that align with their values and preferences, yet information materials developed by screening programs rarely provide complete, balanced information about screening. Through a series of deliberations with Ontario citizens, we elicited perspectives on materials developed by screening programs to support informed decision-making.

Methods: We held 4 deliberative engagement events with citizens to discuss the current evidence about mammography and informed decision-making for the general population (i.

Supporting the evaluation of public and patient engagement in health system organizations: Results from an implementation research study.

Background: As citizens, patients and family members are participating in numerous and expanding roles in health system organizations, attention has turned to evaluating these efforts. The context-specific nature of engagement requires evaluation tools to be carefully designed for optimal use. We sought to address this need by assessing the appropriateness and feasibility of a generic tool across a range of health system organizations, engagement activities and patient groups.

Ethical Challenges Related to Patient Involvement in Health Technology Assessment.

Including information and values from patients in HTA has the potential to improve both the process and outcomes of health technology policy decisions. Accordingly, funding and structural incentives to include patients in HTA activities have increased over the past several years. Unfortunately, these incentives have not yet been accompanied by a corresponding increase in resources, time, or commitment to responsiveness.

Addressing the affordability of cancer drugs: using deliberative public engagement to inform health policy.

Background: Health system expenditure on cancer drugs is rising rapidly in many OECD countries given the costly new treatments and increased rates of use due to a growing and ageing population. These factors put considerable strain on the sustainability of health systems worldwide, sparking public debate among clinicians, pharmaceutical companies, policy-makers and citizens on issues of affordability and equity. We engaged Canadians through a series of deliberative public engagement events to determine their priorities for making cancer drug funding decisions fair and sustainable in Canada's publicly financed health system.

'I just want to be able to make a choice': Results from citizen deliberations about mammography screening in Ontario, Canada.

Despite Canada's long history with mammography screening, little is known about citizens' perspectives about mammography and how best to support women to make informed choices about screening. To address this gap, a series of four citizen deliberation events were held in 2015-16 in Ontario, a Canadian province with an organized population-based breast screening program in place since 1990. Forty-nine individuals participated in four citizen panels, each comprising an information session highlighting the evidence about mammography, and large- and small-group deliberations about approaches to support informed decision making for screening.

Vigilance Tasks: Unpleasant, Mentally Demanding, and Stressful Even When Time Flies.

Objective: To determine whether perceived time progression (PTP) moderates participants' negative reactions to vigilance tasks.

Background: Vigilance tasks are rated by participants to be unenjoyable and as having high levels of workload and stress. Based on the adage, "You are having fun when time flies," we tested the possibility that accelerating PTP might reduce these negative experiences.

Uncertain times: A survey of Canadian women's perspectives toward mammography screening.

Evolving scientific evidence about mammography has raised new questions about the net benefits of organized screening, yet gaps remain about women's current screening practices, knowledge, attitudes and values toward screening to support informed decision making in this area. We addressed this gap through an online survey of 2000 screen-eligible women from Ontario, Canada in January 2016. Likert-scaled and categorical questions were used to collect information about screening practices, knowledge of benefits and risks of screening and underlying attitudes and values toward screening.

Insights into secular trends of respiratory tuberculosis: The 20th century Maltese experience.

Over half a century ago, McKeown and colleagues proposed that economics was a major contributor to the decline of infectious diseases, including respiratory tuberculosis, during the 19th and 20th centuries. Since then, there is no consensus among researchers as to the factors responsible for the mortality decline. Using the case study of the islands of Malta and Gozo, we examine the relationship of economics, in particular, the cost of living (Fisher index) and its relationship to the secular trends of tuberculosis mortality.

Situating mortality: quantifying crisis points and periods of stability.

A wide range of stressors can cause a dramatic and sudden rise in the death rate in populations, typically resulting in what is referred to as crisis mortality. Here we present a method to standardize the assessment of identifying moments of crises. A modification of the mortality Z-score methodology which is combined with time series analysis was used to investigate mortality events over the course of nearly two centuries for two populations: Gibraltar and Malta.