Organisational factors associated with burnout among emergency and internal medicine physicians: a qualitative study.

Objective: To identify physician perspectives on factors associated with physician burnout, protective factors against burnout, and to seek potential solutions for this pervasive problem.

Design: A qualitative study with semistructured focus group interviews using a systematic framework analysis.

Setting And Participants: Physicians from general internal medicine (GIM) and the emergency department (ED) at two urban tertiary care hospitals in Vancouver, Canada, were recruited.

Descriptive retrospective cross-sectional study of rehabilitation care for poststroke users in Québec during the COVID-19 pandemic.

Objectives: During the COVID-19 pandemic, designated rehabilitation centres were established in the province of Québec, where strict sociosanitary measures such as isolation and mandatory personal protection equipment requirements were followed. This study aimed to describe the impact of the pandemic on rehabilitation care indicators for poststroke users with (COV+) and without (COV-) COVID-19 infection in designated rehabilitation centres compared with those admitted in the previous year (pre-COV).

Method: A retrospective analysis of 292 medical files was performed in 3 rehabilitation centres.

Understanding the impact of racism on surgical outcomes in settler nation-states USA and Canada: a protocol for a systematic review and meta-analysis.

Introduction: To improve surgical quality and safety, health systems must prioritise equitable care for surgical patients. Racialised patients experience worse postoperative outcomes when compared with non-racialised surgical patients in settler colonial nation-states. Identifying preventable adverse outcomes for equity-deserving patient populations is an important starting point to begin to address these gaps in care.

Efficacy of the Foodbot Factory digital curriculum-based nutrition education intervention in improving children's nutrition knowledge, attitudes and behaviours in elementary school classrooms: protocol for a cluster randomised controlled trial.

Introduction: Schools are an important setting for supporting children's development of food literacy, but minimal research has assessed which strategies are most suitable for school nutrition education. The Foodbot Factory intervention, consisting of serious game (ie, a digital game designed for education) and curriculum-based lesson plans, was developed to support teachers and children ages 8-12 with nutrition education. Pilot data have demonstrated that Foodbot Factory can significantly improve children's nutrition knowledge, but it has not yet been evaluated in classrooms.

Latest revisions to the International Health Regulations will fail to prevent future travel chaos.

The poor management of public health risks associated with travel by most countries proved among the most contentious issue areas during the COVID-19 pandemic. Evidence from previous outbreaks suggested travel restrictions were largely unnecessary and counterproductive to timely reporting. This led to initial WHO recommendations against the use of travel restrictions.

Arithmetic normalisation models for the effects of lipid on carbon stable isotope values in silver carp () tissue.

Invasive silver carp () threaten Mississippi River basin ecosystems due to their ability to outcompete native species. Stable carbon (δC) and nitrogen (δN) isotope analysis has been used to study how silver carp impact native ecosystems, but lipids in fish tissues commonly bias their δC values. Chemical lipid extraction and mathematical equations that normalise δC values for lipid content can account for this bias, but have not been assessed for silver carp.

Peripheral Artery Disease Centres of Excellence in Canada - A Call to Action.

Peripheral artery disease (PAD) is responsible for a significant burden of morbidity and mortality in Canada. Despite the publication of recent guidelines outlining the diagnosis and management of PAD, delivery of care continues to be fragmented. With a growing number of medical and surgical techniques available, Centres of Excellence are a natural evolution in the advancement of care for patients living with PAD.

The inflammatory profiling in a cohort of older patients suffering from cognitive decline and dementia.

Background: During aging, there is a progressive impairment of immune cell function that triggers the production of pro-inflammatory cytokines causing the so-called "inflammaging". Frailty represents a condition of increased vulnerability to stresses and reduced homeostatic reserve reflecting not only health status but also biological age. In older subjects without dementia, we showed that markers of inflammaging were differently associated with chronological age than with frailty.

Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report.

Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization (WAO) published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

Factor structure and measurement invariance of the GAD-7 across time, sex, and language in young adults.

Introduction: The Generalized Anxiety Disorder-7 Scale (GAD-7) is widely used to measure anxiety symptom severity. One-factor, two-factor, and bifactor latent structures are supported by previous research. Yet, measurement invariance of the GAD-7 across sex and language (i.

Advancing Cancer Diagnosis and Treatment: Integrating Molecular Biomarkers and Emerging Technologies.

Cancer biomarkers can be derived from tumor cells or neighboring cells within the tumor microenvironment. Over the past few decades, various molecular markers, including DNA (mutations, copy number variations), RNA (mRNA, microRNA, circular RNA), proteins, and metabolites, have been identified with the aid of rapidly evolving technologies. Some of these markers have demonstrated potential clinical utility, while others have provided new insights into the deregulation of normal molecular and cellular processes that lead to tumorigenesis.

Alpha-1-Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Meta-analysis and Clinical Practice Guideline.

Alpha-1-Antitrypsin (A1AT) deficiency is a common hereditary disorder associated with increased risk of developing chronic obstructive pulmonary disease (COPD). Many individuals with severe A1AT deficiency go undiagnosed, or are diagnosed late, and fail to benefit from disease-specific counseling and modifying care. Since the 2012 Canadian Thoracic Society (CTS) A1AT deficiency clinical practice guideline, new approaches to optimal diagnosis using modern genetic testing and studies of A1AT augmentation therapy have been published.

Evaluating the Management of Intermittent Claudication before and after Publication of the Society of Vascular Surgery's Appropriate Use Criteria.

Objectives: In April 2022, the Society for Vascular Surgery (SVS) published the Appropriate Use Criteria (AUC) for the management of intermittent claudication (IC). Our goal was to compare practice patterns before and after publication of the AUC to identify changes.

Methods: The Vascular Quality Initiative (VQI) peripheral vascular intervention (PVI), and suprainguinal, and infrainguinal bypass registries were analyzed for interventions for IC.

The Society of Thoracic Surgeons General Thoracic Surgery Database: 2024 Update on Outcomes and Research.

The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) remains the largest and most comprehensive audited thoracic surgical database in the world. As the STS GTSD grows to nearly 1 million cases, the pulmonary resection for cancer and esophagectomy short-term risk models have been refined to provide participants with benchmarked performance reports to facilitate quality improvement efforts. New for 2025 will be the development of long-term risk models and the online release of both short- and long-term risk calculators.

Production and use of lignocellulosic wood vinegar and tar as organic pesticides to fight bacterial canker disease.

This study investigated the production and application of lignocellulosic wood vinegar and tar as organic pesticides to combat bacterial canker disease in trees, caused by pathogenic bacteria. Lignocellulosic wood vinegar and tar were produced from various lignocellulosic wastes through pyrolysis at different temperatures, with sawdust at 300 °C, 350 °C, and 400 °C yielding the highest quantity and quality of vinegar. Chemical analysis revealed that the lignocellulosic vinegar contained significant concentrations of acetic acid, methanol, and phenolic compounds, all known for their strong antimicrobial properties.

Genomic insights into the biogeography and evolution of Galápagos iguanas.

Galápagos iguanas are a monophyletic group endemic to the Galápagos archipelago, comprising the marine iguana Amblyrhynchus cristatus and three species of land iguanas: Conolophus subcristatus, C. pallidus and C. marthae.

Individual vocal identity may be obscured following colony assembly in captive black-capped chickadees.

Black-capped chickadee (Poecile atricapillus) vocalisations remain plastic throughout their lifespans. Although fledglings employ vocal plasticity to refine their vocalisations through the use of tutor mimicry, adults employ vocal plasticity to create unique population dialects. Vocal convergence is one mechanism by which flockmates' vocalisations become increasingly similar to each other and distinct from the calls of other flocks.

Evaluation of online videos and websites on inspiratory muscle training for individuals with chronic lung disease.

Background: Inspiratory muscle training (IMT) is an effective rehabilitation modality for individuals with chronic lung disease. IMT can improve dyspnea, exercise capacity, and health-related quality of life. Online resources are common sources of health information for individuals.

Cadmium-cardiolipin disruption of respirasome assembly and redox balance through mitochondrial membrane rigidification.

The environmental pollutant cadmium (Cd) poses a threat to human health through consumption of contaminated foodstuffs culminating in chronic nephrotoxicity. Mitochondrial dysfunction and excessive reactive oxygen species (ROS) are key to Cd cellular toxicity. Cd-lipid interactions have been less considered.

Assessing the Impacts of Drug Loading and Polymer Type on Dissolution Behavior and Diffusive Flux of GDC-6893 Amorphous Solid Dispersions.

It is desirable but remains challenging to develop high drug load amorphous solid dispersions (ASDs) without compromising their quality attributes and bio-performance. In this work, we investigated the impacts of formulation variables, such as drug loading (DL) and polymer type, on dissolution behavior, diffusive flux, and in vitro drug absorption of ASDs of a high T compound, GDC-6893. ASDs with two polymers (HPMCAS and PVPVA) and various DLs (20 - 80%) were produced by spray drying and their drug-polymer miscibility was evaluated using solid-state nuclear magnetic resonance (ssNMR).

Observation of Ɛ-AlKeggin-Oligonucleotide Complexes in Analytical Sample Solutions.

Complexes formed between aluminum cluster molecules that adopt a Ɛ-Al-Keggin structure and antisense oligonucleotides were observed as new impurity peaks during drug product stability testing. The Ɛ-Al-Keggin molecules were determined to be artifacts of the analysis, originating from contact between antisense oligonucleotide drug product solution and aluminum weigh boats used to prepare the analytical sample solutions The presence of the Ɛ-Al-Keggin molecules was confirmed through synthesis of the Keggin molecule through an established route and subsequent spiking studies. Binding affinity studies revealed that the Ɛ-Al-Keggin bound to oligonucleotide sequences of various lengths (10 to 20 bases) and base compositions, though there is some evidence for preferential binding to 5-methylcytosine-containing sequences.

Structure and self-association of Arrestin-1.

Arrestins halt cell signaling by binding to phosphorylated activated G protein-coupled receptors. Arrestin-1 binds to rhodopsin, arrestin-4 binds to cone opsins, and arrestins-2,3 bind to the rest of GPCRs. In addition, it has been reported that arrestin-1 is functionally expressed in mouse cone photoreceptors.