Using Implementation Science to Evaluate the Implementation of Patient-Reported Outcome Measures (PROMs) in a Clinical Heart Failure Care Setting.

Background: Patients with heart failure (HF) can experience a poor quality-of-life (QOL), recurring hospitalizations, and progressive disease symptoms. Patient-reported outcome measures (PROMs) integrate patients' voices into clinical care, by assessing patient symptoms, function, and QOL. In 2022, PROMs were incorporated into the electronic health record system (Epic) at a large academic hospital in Toronto, Ontario, Canada.

Transfabric Leaks After Percutaneous Left Atrial Appendage Occlusion Procedures with the WATCHMAN FLX Device.

Background: Cardiac computed tomography imaging with contrast is being used increasingly to image left atrial appendage occlusion (LAAO) devices. Contrast flow across a device, also known as a transfabric leak (TFL), may indicate a lack of complete LAAO-device endothelialization. The data on the rate, predictors, and clinical events associated with TFL are limited.

Implementation of a High-sensitivity Troponin Assay for Adult Patients Who Present to the Emergency Department With Chest Pain: The Role of Clinical Decision Support.

Background: The objective of this study was to assess the health outcomes for patients who present to the emergency department (ED) with cardiac chest pain after the implementation of an accelerated diagnostic protocol using a high-sensitivity troponin assay (hs-TnI).

Methods: This prospective before-after cohort study used population-based linked health administrative data for adult patients who presented to a Canadian urban ED with chest pain of suspected cardiac origin over a 2-year study period. The primary outcome was ED length of stay (LOS).

Midterm Outcomes of Right Anterior Mini Thoracotomy Aortic Valve Replacement.

Background: Contemporary surgical approaches for aortic valve replacement (AVR) include full median sternotomy, hemi-sternotomy, and a right anterior mini thoracotomy (RAMT) approach. We report the midterm outcomes of RAMT for isolated AVR.

Methods: A retrospective study was conducted, reporting the midterm outcomes of patients who underwent isolated RAMT AVR.

Unveiling the Longitudinal Journey: 3-Year Follow-up of Women with MINOCA and INOCA in a Specialized Heart Centre.

Background: Myocardial infarction with no obstructive coronary arteries (MINOCA), and ischemia with no obstructive coronary arteries (INOCA), are female-predominant conditions; clinical trials are lacking to guide medical management for the common underlying vasomotor etiologies. Data on long-term outcomes of (M)INOCA patients following attendance at a women's heart centre (WHC) are lacking.

Methods: Women diagnosed with MINOCA (n = 51) or INOCA (n = 112) were prospectively followed for 3 years at the Leslie Diamond WHC (LDWHC) in Vancouver.

Bringing Care Close to Home: Remote Management of Heart Failure In Partnership with Indigenous Communities In Northern Ontario, Canada.

Background: The Weeneebayko Area Health Authority (WAHA) is a regional, community-based Indigenous health authority in Northern Ontario, Canada. From September 2022 to March 2023, the WAHA and University Health Network engaged in a partnership that designed a collaborative model of care to address inequities in cardiology specialist access in Northern Ontario. This model implemented a digital therapeutic for heart failure, (the Medly program) and in-person cardiology clinics in the region.

Thrombus on Mitral Annular Calcification: A Systematic Review of Management and Outcomes.

Background: Mitral annular calcification (MAC) is a common chronic degenerative process of the mitral valve. Thrombus formation on MAC is a rare complication that likely contributes to the increased risk of thromboembolic events. Outcomes and management strategies for this condition are unknown.

Impact of Vanessa's Law on the Reporting of Serious Adverse Events: A Retrospective Study Among Antiplatelet Users in a Tertiary-Care Cardiology Centre.

Background: Antiplatelet drugs, such as clopidogrel, ticagrelor, prasugrel, and acetylsalicylic acid, may be associated with a risk of adverse events (AEs). Vanessa's Law was enacted to strengthen regulations to protect Canadians from drug-related side effects (with mandatory reporting of serious adverse events [SAEs]).

Objective: To determine whether Vanessa's Law has led to an increase in SAE reporting among antiplatelet users.

Catch-AF-Early Diagnosis of Symptomatic Arrythmias in the Waiting Period Prior to Seeing a Cardiologist in Victoria, British Columbia.

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Given its often-paroxysmal nature, screening at a single time point, using a 12-lead electrocardiogram (ECG) or a Holter monitor, has limited benefit. The AliveCor KardiaMobile device is a validated ECG recorder that can be used for patient-directed arrhythmia diagnosis and symptom-rhythm correlation.

Deprescribing Cardiovascular Medications in Older Adults Living with Frailty.

Certain medications have shown significant effectiveness in reducing the incidence of cardiovascular events and mortality, leading them to be among those that are prescribed most commonly for Canadian seniors. However, polypharmacy, which disproportionately affects older adults, is particularly concerning for frail individuals who are at higher risk for adverse medication-related events. The deprescribing process is the discontinuation, either immediate or gradual, of inappropriate medications, to address polypharmacy and improve outcomes.

Quantitative Characterization of Partitioning Stringency in SELEX.

Maintaining stringent conditions in SELEX (Systematic Evolution of Ligands by EXponential enrichment) is crucial for obtaining high-affinity aptamers. However, excessive stringency greatly increases the risk of SELEX failure. Controlling stringency has remained a technical challenge, largely dependent on intuition, due to the absence of a clear, quantitative measure of stringency.

Proximity to Practice: The Role of Technology in the Next Era of Assessment.

The integration of technology into health professions assessment has created multiple possibilities. In this paper, we focus on the challenges and opportunities of integrating technologies that are used during clinical activities or that are completed by raters after a clinical encounter. In focusing on technologies that are more proximal to practice, we identify tradeoffs with different data collection approaches.

What Outcomes Are Associated with Learning About Colonialism and Its Impacts on Indigenous Peoples in Health Professional Programs? A Critical Integrative Review.

Background: The Truth and Reconciliation Commission of Canada called upon health professional programs to teach about historical and on-going colonalism. Since these calls to action, there has been an increase in educational opportunities on the topic. Although it is generally assumed that learning about colonialism will reduce racism and improve allyship towards Indigenous Peoples, an evaluation of this assumption is needed.

Differences in smoking cessation behaviors and vaping status among adult daily smokers with and without depression, anxiety, and alcohol use: Findings from the 2018 and 2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) Surveys.

This study examined differences in quit attempts, 1-month quit success, and vaping status at follow-up among a cohort of 3709 daily smokers with and without depression, anxiety, and regular alcohol use who participated in both the 2018 and 2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) Surveys. At baseline, a survey with validated screening tools was used to classify respondents as having no, or one or more of the following: 1) depression, 2) anxiety, and 3) regular alcohol use. Multivariable adjusted regression analyses were used to examine whether baseline (2018) self-report conditions were associated with quit attempts; quit success; and vaping status by follow-up (2020).

Horticultural additives influence peat biogeochemistry and increase short-term CO production from peat.

Aims: Peat is used as a major ingredient of growing media in horticulture. Peat extracted from bogs can be acidic and low in nutrient availability and is therefore mixed with liming agents, nutrients, surfactants, perlite and so on. This study aims to estimate the rates at which raw peat and the modified peat ('growing media') decompose to release carbon dioxide (CO), to estimate the release of carbon (C) from liming agents and to estimate how peat biogeochemistry is changed.

PreVISE: an efficient virtual reality system for SEEG surgical planning.

Epilepsy is a neurological disorder characterized by recurring seizures that can cause a wide range of symptoms. Stereo-electroencephalography (SEEG) is a diagnostic procedure where multiple electrodes are stereotactically implanted within predefined brain regions to identify the seizure onset zone, which needs to be surgically removed or disconnected to achieve remission of focal epilepsy. This procedure is complex and challenging due to two main reasons.

Prediction of Acute Kidney Injury After Cardiac Surgery With Combined Arterial and Venous Intrarenal Doppler.

Background: Acute kidney injury (AKI) occurs in up to 50% of cardiac surgical patients and is often hemodynamically mediated. Point-of-care ultrasound is a non-invasive tool that has the potential to characterize intrarenal hemodynamics and predict the risk of AKI.

Objectives: We aimed to determine the predictive characteristics of intrarenal arterial and venous Doppler markers for postoperative AKI in cardiac surgical patients.

Canadian Highly Sensitized Patient Program Report: A 1000 Kidney Transplants Story.

Purpose: Highly sensitized patients (HSPs) with kidney failure have limited access to kidney transplantation and poorer post-transplant outcomes. Prioritizing HSPs in kidney allocation systems and expanding the pool of deceased donors available to them has helped to reduce their wait times for transplant and enhanced post-transplant outcomes. The Canadian HSP Program was established by Canadian Blood Services in collaboration with provincial organ donation and transplantation programs throughout the country to increase transplant opportunities for transplant candidates needing very specific matches from deceased kidney donors.

Incidence, Prediction, and Prevention of Fractures After Kidney Transplantation: A Systematic Review Protocol.

Background: Kidney transplant recipients are uniquely exposed to the disordered bone metabolism associated with chronic kidney disease beginning before transplantation followed by chronic corticosteroid use after transplantation. Previous efforts to synthesize the rapidly accruing evidence regarding estimation and management of fracture risk in kidney transplant recipients are outdated and incomplete.

Objective: To synthesize the evidence informing the overall incidence, patient-specific risk prediction, and methods of prevention of fractures in patient living with a kidney transplant.

Insights into targeting LKB1 in tumorigenesis.

Genetic alterations to serine-threonine kinase 11 () have been implicated in Peutz-Jeghers syndrome and tumorigenesis. Further exploration of the context-specific roles of liver kinase B1 (LKB1; encoded by ) observed that it regulates AMP-activated protein kinase (AMPK) and AMPK-related kinases. Given that both migration and proliferation are enhanced with the loss of LKB1 activity combined with the prevalence of genetic alterations in cancer biopsies, LKB1 was marked as a tumor suppressor.

Temporal changes of spinal microglia in murine models of neuropathic pain: a scoping review.

Neuropathic pain (NP) is an ineffectively treated, debilitating chronic pain disorder that is associated with maladaptive changes in the central nervous system, particularly in the spinal cord. Murine models of NP looking at the mechanisms underlying these changes suggest an important role of microglia, the resident immune cells of the central nervous system, in various stages of disease progression. However, given the number of different NP models and the resource limitations that come with tracking longitudinal changes in NP animals, many studies fail to truly recapitulate the patterns that exist between pain conditions and temporal microglial changes.

Comparison of different group-level templates in gradient-based multimodal connectivity analysis.

The study of large-scale brain connectivity is increasingly adopting unsupervised approaches that derive low-dimensional spatial representations from high-dimensional connectomes, referred to as gradient analysis. When translating this approach to study interindividual variations in connectivity, one technical issue pertains to the selection of an appropriate group-level template to which individual gradients are aligned. Here, we compared different group-level template construction strategies using functional and structural connectome data from neurotypical controls and individuals with autism spectrum disorder (ASD) to identify between-group differences.

Patterns of the left thalamus embedding into the connectome associated with reading skills in children with reading disabilities.

We examined how thalamocortical connectivity structure reflects children's reading performance. Diffusion-weighted MRI at 3 T and a series of reading measures were collected from 64 children (33 girls) ages 8-14 years with and without dyslexia. The topological properties of the left and right thalamus were computed based on the whole-brain white matter network and a hub-attached reading network, and were correlated with scores on several tests of children's reading and reading-related abilities.

Conservation of structural brain connectivity in people with multiple sclerosis.

Multiple sclerosis (MS) is a neurodegenerative disease that affects the central nervous system. Structures affected in MS include the corpus callosum, connecting the hemispheres. Studies have shown that in mammalian brains, structural connectivity is organized according to a conservation principle, an inverse relationship between intra- and interhemispheric connectivity.