TGFβ1 Restores Energy Homeostasis of Human Trophoblast Cells Under Hyperglycemia In Vitro by Inducing PPARγ Expression, AMPK Activation, and HIF1α Degradation.

Elevated glucose levels at the fetal-maternal interface are associated with placental trophoblast dysfunction and increased incidence of pregnancy complications. Trophoblast cells predominantly utilize glucose as an energy source, metabolizing it through glycolysis in the cytoplasm and oxidative respiration in the mitochondria to produce ATP. The TGFβ1/SMAD2 signaling pathway and the transcription factors PPARγ, HIF1α, and AMPK are key regulators of cell metabolism and are known to play critical roles in extravillous trophoblast cell differentiation and function.

Evaluation of the implementation in primary care of genetic testing for the screening of MODY2 (iMOgene): protocol for an implementation pilot study.

Introduction: MODY2 (maturity-onset diabetes of the young type 2, MIM125851) is a monogenic diabetes with an autosomal dominant transmission caused by a variant of the gene. MODY2 is often confused with type 1 or type 2 diabetes, but despite a slightly elevated blood glucose level, it does not induce long-term vascular complications, nor does it require pharmacological treatment. Genetic testing for the diagnosis of MODY2 is currently reserved for genetic specialists and some physicians.

Critical Evaluation of the 2016 SOSORT Clinical Guidelines on the Detection and Clinical Management of Adolescent Idiopathic Scoliosis Using the AGREE II Tool: A Chiropractic Perspective.

Objective: The objective of this study is to assess the methodological quality of the 2016 Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) guidelines for the detection and management of adolescent idiopathic scoliosis.

Methods: A diverse group of experts, including practicing chiropractors, chiropractors with a Diplomate by the American Chiropractic Board of Radiology, chiropractors with PhD degrees, and chiropractors involved in teaching within chiropractic programs was invited to participate in the study. Experts independently evaluated the guidelines using the Appraisal of Guidelines for Research and Evaluation II tool.

DNA methylation levels may contribute to severe hypertriglyceridemia in multifactorial chylomicronemia syndrome.

Background And Aims: Familial chylomicronemia syndrome (FCS) and multifactorial chylomicronemia syndrome (MCS) are the two main causes of severe hypertriglyceridemia (sHTG). FCS is a rare autosomal recessive form of sHTG, whereas MCS is mainly polygenic in nature with both common and rare variants accumulating and leading to sHTG. However, 30 to 50% of MCS patients have no identified genetic cause of sHTG.

Understanding the Components of Eating Behaviour-Focused Weight Management Interventions Adjunct to Metabolic Bariatric Surgery: Systematic Review of Published Literature.

Purpose Of Review: Eating behaviour-focused interventions are essential for improving health and weight-related outcomes in patients undergoing metabolic bariatric surgery (MBS). This work aims to examine the content of eating behaviour-focused weight management interventions adjunct to MBS in terms of the type and quantity of behaviour change techniques (BCTs). A literature search retrieved randomised controlled and parallel group trials up to March 2024.

Patterns of cortical thickness in MCI patients with and without semantic impairment.

Background: About half of MCI patients experience semantic deficits, which may predict progression to Alzheimer's disease (AD). The neural basis of these deficits in MCI is not well understood. This study aimed to examine the relationship between semantic memory performance and cortical thickness in MCI patients.

Impact of vitamin C on the reduction of opioid consumption for acute musculoskeletal pain: A double-blind randomized control pilot study.

Introduction: Recent evidence has shown that vitamin C has analgesic and opioid sparing properties in immediate postoperative context. However, this has never been studied for acute musculoskeletal (MSK) emergency department (ED) injuries. The aim of this pilot study is to evaluate the feasibility of conducting a randomized placebo-controlled study to determine the opioid sparing and analgesic effect of vitamin C compared to placebo, in acute MSK injured ED patients.

Enhancing meniscal repair with tough adhesive puncture sealing (TAPS) suture: A proof-of-concept study on bovine cadaveric knees.

Purpose: The objective was to use cyclic tensile loading to compare the gap formation at suture site of three different suture materials to repair bovine radial meniscal tears: (1) polyglactin sutures, (2) tough adhesive puncture sealing (TAPS) sutures and (3) ultra-high molecular weight polyethylene (UHMWPE) sutures.

Methods: Twelve ex vivo bovine knees were dissected to retrieve the menisci. Complete radial tears were performed on 24 menisci, which were then separated into three groups and repaired using either pristine 2-0 polyglactin sutures, TAPS sutures (2-0 polyglactin sutures coated with adhesive chitosan/alginate hydrogels) or 2-0 UHMWPE sutures with a single stitch.

Audit of a Novel Nurse-Led Program for Non-Antibiotic Management of Acute Uncomplicated Diverticulitis.

Background: Non-antibiotic outpatient treatment of acute uncomplicated diverticulitis is safe; however, uptake remains low.

Objective: To assess the success of non-antibiotic management of uncomplicated diverticulitis through a nurse clinician-led outpatient program.

Design: Retrospective audit from June 2022-March 2024.

Descriptive analysis of durvalumab use in unresectable stage III non-small cell lung cancer in patients treated in Quebec's University teaching hospitals.

Introduction: Consolidation durvalumab post chemo-radiotherapy (CRT) has been demonstrated to improve survival in locally advanced non-small-cell lung cancer (NSCLC). Real-world data to assess its use and impact on patients, particularly in Quebec, remain limited.

Methods: We, therefore, aimed to assess real-world durvalumab use in inoperable stage III NSCLC in Quebec, to describe progression-free survival (PFS) and overall survival (OS) outcomes as reported in the PACIFIC trial, and to evaluate safety and toxicity.

Measurement Properties of the Dysphagiameter for the Assessment of Dysphagia in Oculopharyngeal Muscular Dystrophy.

Oculopharyngeal muscular dystrophy (OPMD) is a rare late-onset muscle disease with progressive dysphagia as a major symptom. The Dysphagiameter is a newly developed patient-reported outcome measure (PROM) to assess the severity of dysphagia and its impact in patients with OPMD. This article reports on item reduction and a first assessment of the Dysphagiameter's psychometrics properties, in a French and English-speaking population of individuals with OPMD.

People living with chronic pain in Canada face difficult decisions and decisional conflict concerning their care: data from the national DECIDE-PAIN survey.

Background: Shared decision-making is an imperative in chronic pain care. However, we know little about the decision-making process, especially in primary care where most chronic pain care is provided. We sought to understand decisional needs of people living with chronic pain in Canada.

Does a Prolonged Sham Theta Burst Stimulation Intervention Regimen Outperform Standard Care in Terms of Functional Recovery and Pain Relief After an Upper Limb Fracture?

Objective: In a recent sham-controlled 13-session prolonged continuous theta burst stimulation intervention protocol, recovery from upper limb fracture at both 1 and 3 months was better than anticipated in patients assigned to the sham intervention group. To determine whether potential placebo effect and close patient monitoring affected recovery, the current study aimed to compare clinical outcomes between sham-treated participants who also received standard care with similarly injured patients who only received standard care.

Methods: Twenty participants with isolated upper limb fractures from the sham group were seen 13 times post-fracture (1 baseline session, 10 treatments, and 2 follow-ups [1 and 3 months]) over 3 months.

Long Sleep Duration, Cognitive Performance, and the Moderating Role of Depression: A Cross-Sectional Analysis in the Framingham Heart Study.

Introduction: We investigated whether depression modified the associations between sleep duration and cognitive performance.

Methods: Multivariable linear regression models examined the associations between sleep duration and cognition in 1,853 dementia- and stroke-free participants from the Framingham Heart Study. Participants were categorized in four groups: no depressive symptoms, no antidepressants; depressive symptoms without antidepressants use; antidepressant use without depressive symptoms; both depressive symptoms and antidepressant use.

Understanding the Needs and Experiences With Health Services of Gay and Bisexual Men (GBM) Who Engaged in Chemsex During the First Year of the COVID-19 Pandemic in Quebec, Canada.

Gay and bisexual men (GBM) engaging in chemsex can face various health and well-being-related challenges, the extent of which remains unknown given the limited research in the context of the COVID-19 pandemic. This paper examines the pandemic impacts on the health needs of GBM who engaged in chemsex and their experiences with related services. We applied interpretive description to produce knowledge with direct implications for improving practices and policies.

Mild hypohydration in healthy older adults increases pain-related brain activity without affecting pain perception: a single-blind study.

Understanding how hydration status influences pain perception is particularly important in older adults, as both dehydration and pain are prevalent in this population. Ten individuals (70 ± 4 yr) completed two randomized and counterbalanced trials. They were exposed to passive heat until they lost 1% body mass through sweat and urine (∼100 min), with the loss either unreplaced (sham infusion, HYPO) or fully replaced via 0.

Exploring Indigenous food sovereignty and food environments characteristics through food interventions in Canada: a scoping review.

Indigenous food sovereignty (IFS) has the potential to reconnect Indigenous peoples in Canada to their food systems, reduce health problems and improve food security. Using PRISMA-ScR guidelines to search Medline, Web of Science, Embase and Cabi databases, this review sought to explore the characteristics of IFS promotion and the food environments involved through food and nutrition interventions in Indigenous communities in Canada. Data from 30 relevant studies published between 2004 and 2022 were included, analysed and synthesised using a thematic approach based on key IFS principles and a food environment typology.

Theory-Informed Development of a Multicomponent Intervention to Implement Clinical Practice Guideline Recommendations in the Management of Shoulder Pain.

Objective: Suboptimal primary health care management of shoulder pain has been reported in previous studies. Implementing clinical practice guidelines (CPGs) recommendations using a theoretical approach is recommended to improve shoulder pain management. This study aims to identify determinants for implementing recommendations from shoulder CPGs to help develop an intervention based on the identified determinants.

Hypertension Canada Statement on the use of cuffless blood pressure monitoring devices in clinical practice.

Background: Cuffless blood pressure (BP) devices are an emerging technology marketed as providing frequent, non-intrusive and reliable BP measurements. With the increasing interest in these devices, it is important for Hypertension Canada to provide a statement regarding the current place of cuffless BP measurements in hypertension management.

Methods: An overview of the technology in cuffless BP devices, the potential with this technology and the challenges related to determining the accuracy of these devices.

Validation and Reliability of the Dyslexia Adult Checklist in Screening for Dyslexia.

Dyslexia is a language-based neurobiological and developmental learning disability marked by inaccurate and disfluent word recognition, poor decoding, and difficulty spelling. Individuals can be diagnosed with and experience symptoms of dyslexia throughout their lifespan. Screening tools such as the Dyslexia Adult Checklist allow individuals to self-evaluate common risk factors of dyslexia prior to or in lieu of obtaining costly and timely psychoeducational assessments.

Modulation of cardiac autonomic activity across consciousness states and levels of sleep depth in individuals with sleep complaints and bipolar disorder or unipolar depressive disorders.

Objective: Autonomic nervous system dysfunction and reduced heart rate variability (HRV) often co-exist with mood disorders, a phenomenon likely influenced by sleep disturbances. This study investigated heart rate (HR) and HRV across wake, rapid eye movement (REM) sleep, and non-REM (NREM) sleep in individuals with sleep complaints and bipolar or unipolar depressive disorder.

Methods: Polysomnographic data was retrospectively collated for 120 adult patients with sleep complaints and depressive symptoms [60 diagnosed with bipolar disorder, 60 diagnosed with a unipolar depressive disorder], and 60 healthy controls.

Unique Needs and Challenges Experienced by Young People With Stroke: An International Qualitative Analysis.

Background And Objectives: Stroke in young adults has a lifelong impact on activities of daily life, including driving, leisure, and community-based activities; social participation; and reduced productivity. The needs of young people with stroke (YPwS) are likely to vary across different countries, and the development of age-adapted information and interventions is therefore critical in addressing those needs. This study aims to (1) identify the unmet needs of people with stroke aged 18 to 55 years across countries with varied income levels and cultural backgrounds and (2) determine their preferred means to access knowledge and information about stroke in the young.

Mental disorder diagnoses and symptoms and functional impairment in school-age children in the care of child protective services.

Background: About 50 % of children in the care of child protective services present at least one mental disorder, but few studies have looked at whether there are differences in mental disorders or symptoms between children placed in out-of-home care (foster care and residential care) and their community peers.

Objective: This study documents the mental disorder diagnoses and symptoms among children in out-of-home care and their associations with children functional impairment. It also compares out-of-home care children with those from the community.