Publications by authors named "Warren L"

Breast ultrasound is one of several tools proposed for supplemental screening of women with dense breasts but is not widely available in Canada. An IRB-approved, evaluation of ultrasound-guided breast biopsies prompted by screening breast ultrasound performed from August 1, 2021, to December 31, 2022, offered to asymptomatic women with category C and D breast tissue density after normal screening mammography (2D) in the provincial organized screening program, or surveillance diagnostic mammography after breast cancer. Risk factors, stage (AJCC 8th ed), incremental cancer detection rate (ICDR), biopsy rates, and positive predictive values for biopsy (PPV3) were evaluated.

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Plume from surgical diathermy systems is recognised as a hazard to healthcare providers but is often ignored during ambulatory care procedures. The development of a squamous cell carcinoma of the larynx in a dermatologist, despite the absence of recognised risk factors, prompted this review and recommendations for change in procedural practices.

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Introduction: Reference ranges for determining pathological versus normal postoperative return of bowel function are not well characterised for general surgery patients. This study aimed to characterise time to first postoperative passage of stool after general surgery; determine associations between clinical factors and delayed time to first postoperative stool; and evaluate the association between delay to first postoperative stool and prolonged length of hospital stay.

Methods: This study included consecutive admissions at two tertiary hospitals across a two-year period whom underwent a range of general surgery operations.

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Sulfur-oxidizing bacteria (SOB) play a vital role in the occurrence of sulfur oxidation intermediate (SOI) compounds often recalcitrant to currently available, abiotic treatment within metal mine tailings impoundments (TI). As inadvertent SOI discharge post-treatment can lead to the uncontrolled acidification of receiving environments, it becomes increasingly important to elucidate the environmental controls on SOB identities and sulfur cycling within these relatively unstudied systems. Here, results identified controlling factors on SOB community differentiation and associated metabolic pathway occurrence through integrated physicochemical, geochemical, and microbial field and experimental investigation across three summers (2016, 2017, 2021) in a stratified Northern Ontario base metal TI.

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Temperate fishes often spawn in response to environmental cues, such as temperature, thereby facilitating larval emergence concurrent with suitable biotic and abiotic conditions, such as plankton blooms. Climatic changes may alter the reproductive phenology of spring- and autumn-spawning freshwater fish populations. Such effects may depend on the sensitivity of reproductive phenology to ambient temperatures.

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Genomic plasticity helps adapt to extreme environmental conditions. We tested the hypothesis that exposure to space environment (ESE) impacts the epigenome inducing genomic plasticity. Murine skin samples from the Rodent Research Reference Mission-1 were procured from the International Space Station (ISS) National Laboratory.

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The environmental impact of large language models (LLMs) in medicine spans carbon emission, water consumption and rare mineral usage. Prior-generation LLMs, such as GPT-3, already have concerning environmental impacts. Next-generation LLMs, such as GPT-4, are more energy intensive and used frequently, posing potentially significant environmental harms.

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Given their frontline role in Australia and Aotearoa New Zealand (ANZ) healthcare, trainee medical officers (TMOs) will play a crucial role in the development and use of artificial intelligence (AI) for clinical care, ongoing medical education and research. As 'digital natives', particularly those with technical expertise in AI, TMOs should also be leaders in informing the safe uptake and governance of AI within ANZ healthcare as they have a practical understanding of its associated risks and benefits. However, this is only possible if a culture of broad collaboration is instilled while the use of AI in ANZ is still in its initial phase.

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Background: This study evaluated the accuracy, clinical concordance, and readability of the chatbot interface generative pretrained transformer (ChatGPT) 3.5 as a source of breast cancer information for patients.

Methods: Twenty questions that patients are likely to ask ChatGPT were identified by breast cancer advocates.

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Importance: Postmastectomy radiation therapy (PMRT) improves local-regional disease control and patient survival. Hypofractionation (HF) regimens have comparable efficacy and complication rates with improved quality of life compared with conventional fractionation (CF) schedules. However, the use of HF after mastectomy in patients undergoing breast reconstruction has not been prospectively examined.

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Base Mine Lake (BML), the first full-scale demonstration of oil sands tailings pit lake reclamation technology, is experiencing expansive, episodic hypolimnetic euxinia resulting in greater sulfur biogeochemical cycling within the water cap. Here, Fluid Fine Tailings (FFT)-water mesocosm experiments simulating the in situ BML summer hypolimnetic oxic-euxinic transition determined sulfur biogeochemical processes and their controlling factors. While mesocosm water caps without FFT amendments experienced limited geochemical and microbial changes during the experimental period, FFT-amended mesocosm water caps evidenced three successive stages of S speciation in ∼30 days: (S1) rising expansion of water cap euxinia from FFT to water surface; enabling (S2) rapid sulfate (SO) reduction and sulfide production directly within the water column; fostering (S3) generation and subsequent consumption of sulfur oxidation intermediate compounds (SOI).

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Sulfur oxidizing bacteria (SOB) play a key role in sulfur cycling in mine tailings impoundment (TI) waters, where sulfur concentrations are typically high. However, our understanding of SOB sulfur cycling via potential S oxidation pathways (, r, and SI) in these globally ubiquitous contexts, remains limited. Here, we identified TI water column SOB community composition, metagenomics derived metabolic repertoires, physicochemistry, and aqueous sulfur concentration and speciation in four Canadian base metal mine, circumneutral-alkaline TIs over four years (2016 - 2019).

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Smiling is an embodied and complex social act. Smiling is presented as facilitating individual health and wellbeing, but the value placed on smiling raises questions about structural conditions acting on the body. While smiling has been considered sociologically, psychologically and historically, we argue that further exploration of the embodied smile offers fruitful avenues for future research.

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In breast cancer (BC) pathogenesis models, normal cells acquire somatic mutations and there is a stepwise progression from high-risk lesions and ductal carcinoma in situ to invasive cancer. The precancer biology of mammary tissue warrants better characterization to understand how different BC subtypes emerge. Primary methods for BC prevention or risk reduction include lifestyle changes, surgery, and chemoprevention.

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Purpose To develop an artificial intelligence (AI) deep learning tool capable of predicting future breast cancer risk from a current negative screening mammographic examination and to evaluate the model on data from the UK National Health Service Breast Screening Program. Materials and Methods The OPTIMAM Mammography Imaging Database contains screening data, including mammograms and information on interval cancers, for more than 300 000 female patients who attended screening at three different sites in the United Kingdom from 2012 onward. Cancer-free screening examinations from women aged 50-70 years were performed and classified as risk-positive or risk-negative based on the occurrence of cancer within 3 years of the original examination.

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Article Synopsis
  • - The study aimed to investigate how socioeconomic factors affect the time between abnormal cervical cancer screenings and follow-up colposcopy in patients at a large urban medical center, focusing on differences based on insurance status.
  • - Researchers looked at data from patients aged 21-65 who had colposcopy appointments between January 2021 and January 2022, comparing patient demographics and the waiting times for colposcopy based on whether they were seen by resident or faculty practices.
  • - Findings revealed that publicly insured patients in the resident practice waited significantly longer for colposcopy (median of 79.5 days) compared to those in the faculty practice (median of 34 days), suggesting a need to address these disparities in healthcare access.
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As the International Space Station comes to the end of a transformative era of in-space research, NASA's Commercial Low Earth Orbit (LEO) Destinations (CLD) Program aims to catalyze a new generation of platforms with co-investment from the private sector, preventing a potential gap in research performed in LEO, while building a robust LEO economy. In this paper, we provide insight into the CLD Program focusing on Orbital Reef, describing its operational and technical characteristics as well as new opportunities it may enable. Achieving about a third of the pressurized volume of the ISS with the launch of a single pressurized module and growing to support hundreds of Middeck Locker Equivalents (MLE) in passive and active payloads internally and externally, Orbital Reef will enable government, academic, and commercial institutions to continue and expand upon research and development (R&D) efforts currently performed on ISS.

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Aim: This study aimed to explore student midwives' theoretical knowledge of intrapartum intermittent auscultation, their confidence in, and their experience of this mode of fetal monitoring.

Design And Setting: An online cross-section survey with closed and open questions. Descriptive statistics were used to analyse participants' intermittent auscultation knowledge, confidence, and experience.

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Article Synopsis
  • - The study assessed how well radiation oncologists and their teams educate patients about radiation therapy, aiming to improve and make patient education more accessible.
  • - An anonymous survey was conducted with members of the Radiation Oncology Education Collaborative Study Group, revealing that most respondents worked in academic settings and primarily used institution-specific resources for patient education.
  • - Results indicated significant differences in educational practices based on the type of clinical encounter and highlighted challenges such as time constraints and a lack of diverse, customizable resources for patient education.
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Objective: Increasing placental thickness is associated with adverse outcomes including earlier gestational age at delivery, lower birthweight, and lower umbilical artery pH. We aim to determine whether mid-trimester placenta previa thickness is associated with persistence of previa at time of delivery.

Study Design: Single-center retrospective cohort study of singleton gestations with previa diagnosed at 18-24 weeks delivering between 2015 and 2019.

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Background: Despite highly effective targeted therapies for rheumatoid arthritis, about 40% of patients respond poorly, and predictive biomarkers for treatment choices are lacking. We did a biopsy-driven trial to compare the response to rituximab, etanercept, and tocilizumab in biologic-naive patients with rheumatoid arthritis stratified for synovial B cell status.

Methods: STRAP and STRAP-EU were two parallel, open-label, biopsy-driven, stratified, randomised, phase 3 trials done across 26 university centres in the UK and Europe.

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Article Synopsis
  • The study compared stage III inflammatory breast cancer patients who underwent either 1 or 2-3 lines of neoadjuvant chemotherapy before surgery, focusing on their pathologic complete response (pCR), breast cancer-free survival (BCFS), and overall survival (OS).
  • Out of 808 patients analyzed, 91% received the first line of chemotherapy, with lower pCR rates and poorer BCFS observed in those requiring additional lines, although pCR rates showed no significant difference between the two groups.
  • The findings suggest that while patients needing more chemotherapy before surgery had worse BCFS and OS rates overall, those with pCR had similar outcomes regardless of the number of chemotherapy lines.
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