Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative Delirium: A Cluster Randomized Crossover Trial.

Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.

Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.

Persistent cross-species transmission systems dominate Shiga toxin-producing O157:H7 epidemiology in a high incidence region: A genomic epidemiology study.

Several areas of the world suffer a notably high incidence of Shiga toxin-producing . To assess the impact of persistent cross-species transmission systems on the epidemiology of O157:H7 in Alberta, Canada, we sequenced and assembled O157:H7 isolates originating from collocated cattle and human populations, 2007-2015. We constructed a timed phylogeny using BEAST2 using a structured coalescent model.

The Calgary Kids' Hand Rule: External Validation of a Prediction Model to Triage Pediatric Hand Fractures.

The Calgary Kids' Hand Rule (CKHR) is a clinical prediction rule intended to guide referral decisions for pediatric hand fractures presenting to the emergency department, identifying "complex" fractures that require surgical referral and optimizing care through better matching of patients' needs to provider expertise. The objective of this study was to externally validate the CKHR in two different tertiary pediatric hospitals in Canada. We partnered with British Columbia Children's Hospital (BCCH) and the Children's Hospital of Eastern Ontario (CHEO) to externally validate the CKHR using data from retrospective cohorts of pediatric hand fractures (via electronic medical record and x-ray review).

Magnetic resonance imaging in traumatic brain injury: a survey of clinical practitioners' experiences and views on current practice and obstacles.

Introduction: Magnetic resonance imaging (MRI) has revolutionized our capacity to examine brain alterations in traumatic brain injury (TBI). However, little is known about the level of implementation of MRI techniques in clinical practice in TBI and associated obstacles.

Methods: A diverse set of health professionals completed 19 multiple choice and free text survey questions.

Pericapsular nerve group cryoneurolysis as an option for palliative nonoperative management of hip fracture in a patient with end-stage medical comorbidities.

Purpose: We report the use of a pericapsular nerve group (PENG) cryoneurolysis for longer-term analgesia in a patient with a hip fracture and severe medical comorbidities as an alternative to hip fracture surgery.

Clinical Features: A frail but lucid and fully autonomous 97-yr-old female from an assisted living facility sustained a subcapital fracture of her right proximal femur following a ground level fall. She had significant comorbidities including end-stage respiratory disease.

Tumor Metabolism as a Factor Affecting Diversity in Cancer Cachexia.

Cancer cachexia is a multifaceted metabolic syndrome characterized by muscle wasting, fat redistribution, and metabolic dysregulation, commonly associated with advanced cancer but sometimes also evident in early-stage disease. More subtle body composition changes have also been reported in association with cancer, including sarcopenia, myosteatosis, and increased fat radiodensity. Emerging evidence reveals that body composition changes including sarcopenia, myosteatosis, and increased fat radiodensity, arise from distinct biological mechanisms and significantly impact survival outcomes.

The Soundtrack of a Clinic Day.

There is a hum and drum to the clinical day, sounds and rhythms that pervade physician and patient's soundscape. We hear but we do not listen. The soundtrack of the daily grind is experienced as an audio blanket of white noise.

Identifying the Views and Needs of Family Physicians on Providing Care to Living Kidney Donors: A Cross-Sectional Survey.

Optimizing the long-term care and follow-up of living kidney donors (LKDs) has been challenging, and prior LKDs have reported suboptimal healthcare experiences. Long-term care of LKDs is largely undertaken by primary care practitioners such as family physicians (FPs). We conducted a cross-sectional survey of Canadian FPs (n = 151).

Dispersion-based cognitive intra-individual variability in former American football players: Association with traumatic encephalopathy syndrome, repetitive head impacts, and biomarkers.

Exposure to repetitive head impacts (RHI), such as those experienced in American football, is linked to cognitive dysfunction later in life. Traumatic encephalopathy syndrome (TES) is a proposed clinical syndrome thought to be linked to neuropath-ology of chronic traumatic encephalopathy (CTE), a condition associated with RHI from football. Cognitive intra-individual variability (d-CIIV) measures test-score dispersion, indicating cognitive dysfunction.

Symptomatic Cervical Carotid Artery Stenosis: Evolving Paradigms in Risk Stratification and Intervention.

Symptomatic carotid disease, characterized by atherosclerotic or non-atherosclerotic internal carotid artery disease with ipsilateral stroke symptoms, represents a critical condition in stroke neurology. This "hot carotid" state carries a high risk of stroke recurrence, with almost one-fourth of the patients experiencing recurrent ischemic events within 2 weeks of initial presentation. The global prevalence of significant carotid stenosis (conventionally defined as ≥50% narrowing) is estimated at around 1.

A retrospective evaluation of patient characteristics and recommendations of a novel multidisciplinary clinic for persons with advanced disability from multiple sclerosis.

Context: Persons with advanced multiple sclerosis (MS) require care beyond the disease modifying treatments offered in conventional MS clinics to address their complex physical and psychosocial needs. In the novel MS Comprehensive and Palliative Care (MSCPC) Program, an MS neurologist, palliative care specialist, and physiatrist collaborate to identify these needs and improve symptom control.

Objectives: To characterize the medical, physical, and psychosocial concerns of persons with advanced disability from MS and describe the recommended interventions of the MSCPC Program.

CHD6 has poly(ADP-ribose)- and DNA-binding domains and regulates PARP1/2-trapping inhibitor sensitivity via abasic site repair.

To tolerate oxidative stress, cells enable DNA repair responses often sensitive to poly(ADP-ribose) (PAR) polymerase 1 and 2 (PARP1/2) inhibition-an intervention effective against cancers lacking BRCA1/2. Here, we demonstrate that mutating the CHD6 chromatin remodeler sensitizes cells to PARP1/2 inhibitors in a manner distinct from BRCA1, and that CHD6 recruitment to DNA damage requires cooperation between PAR- and DNA-binding domains essential for nucleosome sliding activity. CHD6 displays direct PAR-binding, interacts with PARP-1 and other PAR-associated proteins, and combined DNA- and PAR-binding loss eliminates CHD6 relocalization to DNA damage.

Characterizing tumor-infiltrating group 1 innate lymphoid cells in PyMT breast tumors.

Breast cancer is the most common cancer in women and continues to have a significant impact in cancer-associated deaths worldwide. Investigating the complex roles of infiltrating immune subsets within the tumor microenvironment (TME) will enable a better understanding of disease progression and reveal novel therapeutic strategies for patients with breast cancer. The mammary-specific expression of polyomavirus middle T oncoprotein (MMTV-PyMT) was first established in 1992 by William Muller and is the most commonly used genetically engineered mouse model (GEMM) for breast cancer research.

Differences in Postoperative Disposition by Kidney Disease Severity: A Population-Based Cohort Study.

Rationale & Objective: People with advanced kidney disease undergo more non-cardiac operations compared to the general population, with a higher risk of perioperative cardiac events and death. However, little is known about the associations between severity of preoperative kidney dysfunction with postoperative length of hospitalization and discharge disposition; these were the focus of this study.

Study Design: Population-based retrospective cohort.

Intranasal oxytocin for apathy in people with frontotemporal dementia (FOXY): a multicentre, randomised, double-blind, placebo-controlled, adaptive, crossover, phase 2a/2b superiority trial.

Background: No treatments exist for apathy in people with frontotemporal dementia. Previously, in a randomised double-blind, placebo-controlled, dose-finding study, intranasal oxytocin administration in people with frontotemporal dementia improved apathy ratings on the Neuropsychiatric Inventory over 1 week and, in a randomised, double-blind, placebo-controlled, crossover study, a single dose of 72 IU oxytocin increased blood-oxygen-level-dependent signal in limbic brain regions. We aimed to determine whether longer treatment with oxytocin improves apathy in people with frontotemporal dementia.

A forward genetic screen identifies potassium channel essentiality in SHH medulloblastoma maintenance.

Distinguishing tumor maintenance genes from initiation, progression, and passenger genes is critical for developing effective therapies. We employed a functional genomic approach using the Lazy Piggy transposon to identify tumor maintenance genes in vivo and applied this to sonic hedgehog (SHH) medulloblastoma (MB). Combining Lazy Piggy screening in mice and transcriptomic profiling of human MB, we identified the voltage-gated potassium channel KCNB2 as a candidate maintenance driver.

A randomized control trial to compare Quiet Eye training efficacy to traditional technical training with undergraduate student nurses' peripheral intravenous cannulation performance: a protocol.

Introduction: Peripheral intravenous cannulation (PIVC) is a common and complex procedure with low first-attempt success rates, causing patient suffering and increased healthcare costs. Quiet Eye (QE) training, a gaze-focused approach, has shown promise in improving procedural PIVC skills. We will examine the effectiveness of traditional technical training (TT) and QE training (QET) on student nurse PIVC performance.

Vitamins K2 and D3 Improve Long COVID, Fungal Translocation, and Inflammation: Randomized Controlled Trial.

Background: Long COVID (LC) is characterized by persistent symptoms at least 3 months after a SARS-COV-2 infection. LC has been associated with fungal translocation, gut dysfunction, and enhanced systemic inflammation. Currently, there is no approved treatment for this condition.

Effect of Model of Neonatal Care on Neurodevelopment at the 18 Month Follow-Up in Moderate and Late Preterm Infants.

Preterm birth, even for moderate or late preterm infants (MLPIs), is associated with longer-term developmental challenges. Family Integrated Care (FICare) models of care, like Alberta FICare, aim to improve outcomes by integrating parents into neonatal care during hospitalization. This follow-up study examined the association between models of care (Alberta FICare versus standard care) and risk of child developmental delay at 18 months corrected age (CA) and explored the influences of maternal psychosocial distress.

Perioperative Outcomes in Patients with and Without Chronic Preoperative Therapeutic Anticoagulation Undergoing Metabolic Surgery at an Academic Medical Center.

Patients on chronic anticoagulation undergoing metabolic surgery represent an increased risk of complications, including both bleeding and thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The optimal perioperative management of patients who are receiving chronic anticoagulation therapy (CAT) is complex. In the colorectal surgery literature, patients on CAT have a 10% rate of peri-procedural bleeding and a 3% rate of thromboembolism.

Transdiagnostic Predictors of Health-Related Quality of Life in Children with Autism and Epilepsy: A Cross-Sectional Study.

: Our understanding of the transdiagnostic factors that influence health-related quality of life (HRQOL) in individuals with neurodivergent conditions is very sparse and highly siloed by diagnosis labels. Research on transdiagnostic predictors of HRQOL across neurodevelopmental conditions is needed to enable care models that address shared needs of neurodivergent individuals beyond diagnostic boundaries. Our objective was to identify transdiagnostic factors associated with HRQOL in children with autism, epilepsy, or comorbid autism/epilepsy.

A Scoping Review of the Current Knowledge of the Social Determinants of Health and Infectious Diseases (Specifically COVID-19, Tuberculosis, and H1N1 Influenza) in Canadian Arctic Indigenous Communities.

Social determinants of health (SDHs) and the impact of colonization can make Canadian Arctic Indigenous communities susceptible to infectious diseases, including the coronavirus disease 2019 (COVID-19). This scoping review followed the PRISMA guidelines for scoping reviews and studied what is known about selected pandemics (COVID-19, tuberculosis, and H1N1 influenza) and SDHs (healthcare accessibility, food insecurity, mental health, cultural continuity, housing, community infrastructure, and socioeconomic status (SES)) for Canadian Arctic Indigenous communities. Original studies published in English and French up to October 2024 were located in databases (PubMed, Medline, and CINAHL), , and through reference tracking.