Cardiovascular, kidney and safety outcomes with canagliflozin in older adults: A combined analysis from the CANVAS Program and CREDENCE trial.

Aim: SGLT2 inhibitors may be underused in older adults with type 2 diabetes due to concerns about safety and tolerability. This pooled analysis of the CANVAS Program and CREDENCE trial examined the efficacy and safety of canagliflozin according to age.

Methods: Pooled individual participant data from the CANVAS Program (n = 10 142) and CREDENCE trial (n = 4401) were analysed by baseline age (<65 years, 65 to <75 years, and ≥75 years).

Predictors of Change in Cannabis Use Status from Pre- to Post-Recreational Cannabis Legalization in Canada: Evidence from a Two-Wave Longitudinal National Survey.

Objective: In October 2018, the Government of Canada legalized cannabis for recreational use nationwide. The effects of legalization on cannabis use have been primarily assessed through cross-sectional surveys.

Method: In the present study, a two-wave longitudinal design was used to explore potential demographic, substance use and behavioral addiction, and mental health predictors of change in cannabis use status following legalization.

Legal Recreational Cannabis Sales and Opioid-Related Mortality in the 5 Years Following Cannabis Legalization in Canada: A Granger Causality Analysis.

Objective: Little is known about the population-level impact of recreational cannabis legalization on trends in opioid-related mortality. Increased access to cannabis due to legalization has been hypothesized to reduce opioid-related deaths because of the potential opioid-sparing effects of cannabis. The objective of this study was to examine the relations between national retail sales of recreational (non-medical) cannabis and opioid overdose deaths in the 5 years following legalization in Canada.

Examining the Potential Impact of Recreational Cannabis Legalization on Individuals Receiving Treatment for Substance Use Disorder: An Interrupted Time Series Study in Guelph, Ontario, Canada.

Objective: The present research evaluated the impact of legalizing recreational cannabis among individuals with substance use disorders (SUDs) who may already use cannabis at high rates.

Method: Using an interrupted time series study design, we evaluated the potential impact of legalizing recreational cannabis among individuals seeking treatment for SUD within a hospital-based treatment setting in Guelph, Ontario. We examined 2,925 individuals who entered an inpatient SUD treatment program between April 2017 and December 2021.

Mental Health and Dispositional Predictors of Simultaneous Versus Concurrent Cannabis and Alcohol Use in a Canadian Context.

Objective: Cannabis has become more available in Canada since its legalization in 2018. Many individuals who use cannabis also use alcohol (co-use), which can be used either at the same time such that their effects overlap (simultaneous use) or at different times (concurrent use). Though studies have identified predictors of co-use relative to single-substance use, less is known about the predictors of specific types of co-use.

Examining the Relationship Between Cannabis Use and Mood, Anxiety, and Psychotic Symptoms in Psychiatric Patients with Severe Concurrent Mental Health and Substance Use Disorders Before and After Recreational Cannabis Legalization in Canada.

Objective: The relationship between cannabis use and mental health has garnered significant attention in recent decades. However, studies have largely been in general populations or in countries in which recreational cannabis use is illegal.

Method: The current cross-sectional study examines the relationship between cannabis use, mood disorders, anxiety, and psychosis in an inpatient psychiatric population with severe concurrent mental health and substance use disorders, exploring the potential moderating effect of the legalization of recreational cannabis in Canada.

Potential Risks from Cannabis-Infused Beverages: A Critical Review.

Unlabelled: Although Canada legalized cannabis beverages in 2019, most available research on acute cannabis intoxication derives from dried flower and edible products. The distinct bioavailability and pharmacokinetic properties of phytocannabinoids ingested from beverages, however, contribute to significantly different acute and long-term effects that need to be better understood to ensure consumer safety.

Objective: This review investigates existing cannabis beverage literature, with a particular focus on acute intoxication effects.

Perceived Risk of Medical Cannabis and Prescribed Cannabinoids for Chronic Pain: A Cross-Sectional Study Among Quebec Clinicians.

Objective: An increase in medical cannabis and prescribed cannabinoids use for chronic pain management has been observed in Canada in the past years. This study aimed to: 1) Describe clinicians' perceived risk associated with the use of medical cannabis and prescribed cannabinoids for the management of chronic pain; and 2) Identify sociodemographic and professional factors associated with perceived risk of adverse effects.

Method: A web-based cross-sectional study was conducted in Quebec, Canada in 2022.

Exploring Cannabis-Associated Presentations to Canadian Pediatric Emergency Departments: A Cross-Sectional Study.

Objective: Recent studies found that recreational legalization of cannabis consumption for Canadian adults has increased presentation to the emergency department (ED) among children. In this descriptive study, our objectives were to (1) understand Canadian pediatric emergency medicine (PEM) providers' training and knowledge of clinical presentations associated with cannabis exposure in children and (2) describe pediatric ED presentations related to cannabis exposure across Canada following legalization in 2018.

Method: In 2021, following ethics board approval, 230 Pediatric Emergency Research Canada (PERC) network pediatric emergency medicine (PEM) physicians were invited to share about their knowledge, training, and experience with patients presenting with cannabis-associated emergencies using an anonymized survey administered through REDCap.

Changes in Cannabis Use Patterns in Psychiatric Populations Pre- and Post-Legalization of Recreational Cannabis Use in Canada: A Repeated Cross-Sectional Survey.

Objective: Since the federal Canadian government legalized cannabis in 2018, cannabis use in the general population has slightly increased. However, little is known about the impact of cannabis legalization on pattens of cannabis use in psychiatric populations.

Method: We studied changes in daily/almost daily and average 30-day cannabis use amongst individuals currently using cannabis who reported past 12-month experiences of specific mental health disorders and among those without past 12-month experiences of any mental health disorder before and after Canadian legalization of recreational cannabis use ( = 13,527).

Cardiorespiratory fitness in COPD and HF from the Fitness Registry and the Importance of Exercise: a National Database.

Aims: To better characterize functional consequences of the presence of COPD on cardiorespiratory fitness in patients with HF.

Methods And Results: Patients with any clinical indication for cardiopulmonary exercise testing (CPET) were included in the international FRIEND registry. Diagnosis of COPD was confirmed by a ratio of forced expiratory volume in 1 s and forced vital capacity (FEV/FVC) < 0.

Hospital-level volume in extracorporeal membrane oxygenation cases and death or disability at 6 months.

Objective: Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with significant morbidity and mortality and there is an uncertain volume-outcome relationship, especially regarding long-term functional outcomes. The aim of this study was to examine the association between ECMO centre volume and long-term death and disability outcomes.

Design Setting And Participants: This is a registry-embedded observational cohort study.

Abnormal skeletal muscle and myocardial vasoreactivity manifests prior to heart failure in a diabetic cardiomyopathy rat model.

Background: Microvascular dysfunction (MVD) is a recognized sign of disease in heart failure progression. Intact blood vessels exhibit abnormal vasoreactivity in early stage, subsequently deteriorating to rarefaction and reduced perfusion. In managing heart failure with preserved ejection fraction (HFpEF), earlier diagnosis is key to improving management.

A cross-sectional survey examining Canadian veterinarians' experiences with and perceptions of canine importation.

Background: As numbers of dogs entering Canada from abroad are increasing, it is essential to understand the scope, challenges, and risks associated with canine importation. Canadian veterinarians' collective experience with and clinical knowledge of imported dogs can provide valuable insights into this practice.

Objective: To describe Canadian veterinarians' experiences with, and perspectives of, imported dogs in clinical practice.

Prevalence of enteropathogens and endoparasites in cats at an animal shelter in Ontario.

Objective: To determine the prevalence of fecal microorganisms and parasites in a population of sheltered cats, and to identify specific animal factors associated with infection.

Animals: A total of 79 sheltered cats and kittens in Guelph, Ontario.

Procedure: A fecal sample was collected from each animal upon shelter entry.

Functional reconstruction following bilateral amputation of the manus and pes in a cat with frostbite injury.

This case report describes metacarpophalangeal (MCP)- and metatarsophalangeal (MTP)-level amputation and reconstruction of all 4 paws of a young female domestic shorthair cat. All 4 paws, the ears, and the distal portion of the tail underwent severe frostbite injury resulting in tissue death. Following MCP and MTP amputation, weight-bearing surface reconstruction was achieved using metacarpal and metatarsal paw-pad advancement flaps.

Hepatic infection in a dog with cavitary lung disease.

A 9-year-old neutered male cairn terrier dog was initially presented because of inappetence, increased respiratory effort, and occasional coughing. A cavitary lung mass was diagnosed using CT and removed with lung lobectomy. Histopathology of the mass revealed necrosuppurative inflammation with acid-fast rod bacteria in macrophages, with spp.

Cutaneous pseudolymphoma successfully treated with intralesional triamcinolone acetonide: A case report.

Cutaneous pseudolymphoma refers to a group of skin conditions that simulate lymphoma either clinically and/or histologically. Cutaneous pseudolymphoma is a benign disorder that can often be misdiagnosed and has a wide range of treatment modalities. Currently, there is no gold standard of treatment, and the literature would benefit from more reports on successful and unsuccessful treatments of cutaneous pseudolymphoma.

Genital porokeratosis: A case report and review of pathogenesis and genitogluteal subtypes of porokeratosis.

Porokeratosis is a condition characterized by abnormal epidermal keratinization with a unique morphology of papules or plaques surrounded by a thread-like border of scale corresponding to the cornoid lamella on histology. Many established subtypes have been described; however, genitogluteal porokeratosis is a rare entity. We present the case of a 58-year-old male with pruritic reddish lesions affecting the genitals and thighs, diagnosed with genital porokeratosis.

A case of pityriasis rubra pilaris secondary to ponatinib.

Ponatinib, a tyrosine kinase inhibitor used for chronic myeloid leukemia and acute lymphoblastic leukemia, can cause rare cutaneous side effects. In this case, a 63-year-old woman developed a pityriasis rubra pilaris-like eruption 1 month after starting the drug. The skin reaction improved with dose reduction and recurred more mildly at a lower dose.

A Behavioral Analysis of Factors That Influence Antibiotic Prescribing in Hospitals: A Metasynthesis of Reviews.

Antibiotic resistance is a global public health threat driven, in part, by antibiotic overprescription. Behavior change theories are increasingly used to try to modify prescriber behavior. A metasynthesis of 8 reviews was conducted to identify factors influencing antibiotic prescribing for adults in hospital settings and to analyze these factors using 4 behavior change frameworks.

Early intervention in psychosis programs in Africa, Asia and Latin America; challenges and recommendations.

Background: While early intervention in psychosis (EIP) programs have been increasingly implemented across the globe, many initiatives from Africa, Asia and Latin America are not widely known. The aims of the current review are (a) to describe population-based and small-scale, single-site EIP programs in Africa, Asia and Latin America, (b) to examine the variability between programs located in low-and-middle income (LMIC) and high-income countries in similar regions and (c) to outline some of the challenges and provide recommendations to overcome existing obstacles.

Methods: EIP programs in Africa, Asia and Latin America were identified through experts from the different target regions.

The Effect of Balance-Based Interventions on Cognitive Functions of the Healthy and MCI Elderly: A Systematic Review and Meta-analysis.

Background: Aging is an inseparable part of life, accompanied by mild to severe cognitive disorders. This study aimed to investigate the influence of balance-based interventions on cognitive function in older adults, encompassing both healthy individuals and those with mild cognitive impairment (MCI).

Methods: A systematic review was conducted by searching multiple databases up to April 2023, and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was followed for reporting.

Influence of global warming and human activity on mercury accumulation patterns in wetlands across the Qinghai-Tibet Plateau.

Wetlands in the Qinghai-Tibet Plateau are a unique and fragile ecosystem undergoing rapid changes. We show two unique patterns of mercury (Hg) accumulation in wetland sediments. One is the 'surface peak' in monsoon-controlled regions and the other is the 'subsurface peak' in westerly-controlled regions.

Testing Phylogenetic Placement Accuracy of DNA Barcode Sequences on a Fish Backbone Tree: Implications of Backbone Tree Completeness and Species Representation.

Advancements in DNA sequencing technology have facilitated the generation of a vast number of DNA sequences, posing opportunities and challenges for constructing large phylogenetic trees. DNA barcode sequences, particularly COI, represent extensive orthologous sequences suitable for phylogenetic analysis. Phylogenetic placement analysis offers a promising method to integrate COI data into tree-building efforts, yet the impacts of backbone tree completeness and species composition remain under-explored.