Does using the Lung Clearance Index (LCI) inform clinical decisions in children with cystic fibrosis?

Introduction: The Lung Clearance Index (LCI) is an established research test, but its role in clinical decision-making is not well defined. This study estimated the proportion of treatment decisions that are changed or supported by the added information provided by LCI.

Methods: A mixed methods prospective observational study was conducted in North America.

Systematic review of health and social outcomes among Indigenous People exposed to the child welfare system: a protocol.

Introduction: The link between parent-child separation through child welfare systems and negative health and social outcomes is well documented. In contrast, despite the over-representation of Indigenous children and youth in child welfare systems, the relationship between child welfare system involvement and health and social outcomes among Indigenous populations has not been systematically reviewed. Our objective is to assess whether Indigenous People who have been exposed to a child welfare system personally or intergenerationally (ie, parents and/or grandparents) within Canada, Australia, New Zealand and the USA (CANZUS countries) and the circumpolar region are at an increased risk for negative health and social outcomes compared with other exposed and non-exposed groups.

Modified Delphi Consensus on Interventions for Acute Radiation Dermatitis in Breast Cancer: A Canadian Expert Perspective.

Acute radiation dermatitis (ARD) is a prevalent adverse effect of radiotherapy in patients with breast cancer, and there is a lack of high-quality data regarding its prevention and management. This study employs a systematic and iterative process to compile the perspectives of Canadian radiation oncology, nursing, and dermatology experts, aiming to establish consensus-based recommendations for the prevention and management of ARD in breast cancer patients. A modified Delphi consensus was conducted with the participation of 19 experts from across Canada.

Melatonin Low-Dose for Prevention of Delirium in Critically Ill Patients: A Multi-centre, Randomized, Placebo-controlled Feasibility Trial (MELLOW).

Background: Delirium is a common and serious syndrome of acute brain dysfunction associated with negative outcomes. Melatonin may have a role in delirium prevention for critically ill adults based on data from non-critically ill patient populations. Our objective was to assess the feasibility of a multi-centre, randomized, placebo-controlled trial testing the hypothesis that low-dose melatonin prevents delirium in critically ill adults.

Marriage and postpartum major depressive disorder: A systematic review and meta-analysis of cohort studies.

Many studies have explored the relationships between demographic variables and postpartum major depressive disorder. However, there is no clear conclusion on the impact of different marital statuses and quality on postpartum major depressive disorder. This systematic review and meta-analysis examined the combined effects of different marital status and quality on postpartum major depressive disorder with cohort studies.

Developing a decision support tool to predict delayed discharge from hospitals using machine learning.

Background: The growing demand for healthcare services challenges patient flow management in health systems. Alternative Level of Care (ALC) patients who no longer need acute care yet face discharge barriers contribute to prolonged stays and hospital overcrowding. Predicting these patients at admission allows for better resource planning, reducing bottlenecks, and improving flow.

Skin Glue to Reduce Intravenous Catheter Failure in Children.

Study Objective: The peripheral intravenous catheter (IV) is the most common and painful invasive medical device in acute care settings. Our objective was to determine whether adding skin glue to secure IVs reduced catheter failure rate in children.

Methods: We conducted a randomized controlled trial in a tertiary-care pediatric emergency department (ED).

CAR/CSACI Practice Guidance for Contrast Media Hypersensitivity.

Contrast media, including iodinated contrast media and gadolinium-based contrast agents, are commonly administered pharmaceuticals with excellent safety profiles. However, a minority of the population may experience a hypersensitivity reaction following intravenous administration. Hypersensitivity reactions can be immediate or delayed, and range from mild, such as urticaria, to severe, including anaphylaxis.

Fracture Risk Assessment in the 2023 Osteoporosis Canada Guideline.

Radiologists and other diagnostic imaging specialists play a pivotal role in the management of osteoporosis, a highly prevalent condition of reduced bone strength and increased fracture risk. Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is a critical component of identifying individuals at high risk for fracture. Strategies to prevent fractures are consolidated in the Osteoporosis Canada clinical practice guideline which was updated in 2023.

CAR Practice Guideline on Bone Mineral Densitometry Reporting: 2024 Update.

This practice guideline serves as an update to the Canadian Association of Radiologists' 2013 Technical Standards for Bone Mineral Densitometry Reporting. It aims to align bone mineral density testing and reporting practices in Canada with current clinical best practices, including guidelines from Osteoporosis Canada and the International Society for Clinical Densitometry. Key updates include the endorsement of both FRAX and CAROC tools for evaluating fracture risk, guidance for analyzing male patients and transgender patients, and provision of clinical management guidance of relevance to BMD reporting harmonized with that of Osteoporosis Canada.

Lentivirus-mediated gene therapy for Fabry disease: 5-year End-of-Study results from the Canadian FACTs trial.

Background: Fabry disease is an X-linked lysosomal storage disorder due to a deficiency of α-galactosidase A (α-gal A) activity. Our goal was to correct the enzyme deficiency in Fabry patients by transferring the cDNA for α-gal A into their CD34+ hematopoietic stem/progenitor cells (HSPCs). Overexpression of α-gal A leads to secretion of the hydrolase; which can be taken up and used by uncorrected bystander cells.

Day-to-day variability in sleep and activity predict the onset of a hypomanic episode in patients with bipolar disorder.

Detecting transitions in bipolar disorder (BD) is essential for implementing early interventions. Our aim was to identify the earliest indicator(s) of the onset of a hypomanic episode in BD. We hypothesized that objective changes in sleep would be the earliest indicator of a new hypomanic or manic episode.

Pneumonectomy for Osteosarcoma Metastases: Two Compelling Cases With Unique Radiology.

Osteosarcoma, the most common primary bone tumor in young individuals, frequently metastasizes hematogenously to the lungs, necessitating pulmonary metastasectomy as a common surgical procedure. While sublobar and lobar resections are accepted approaches, pneumonectomy is considered a major intervention. In this report, we present 2 intriguing cases of patients who underwent pneumonectomy for pulmonary osteosarcoma metastases, emphasizing the challenges of careful patient selection and surgical planning.

Increased respiratory syncytial virus-associated hospitalizations and ambulatory visits in very preterm infants in the first year of life following discontinuation of access to palivizumab.

Background: From 2002 to 2023, palivizumab was the only intervention to reduce RSV-associated hospitalizations in high-risk infants in Canada, but advances in RSV prevention are drastically changing this landscape. Eligibility criteria for this monoclonal antibody for preterm infants varied over time across each of 10 Canadian provinces and 3 territories. The national professional pediatric association (Canadian Paediatric Society) revised its eligibility recommendations in 2015, removing access for preterm infants 30 to 32 weeks gestation (WG).

The moderating role of social media motives in the relationship between screen usage and cybervictimization.

Background: Screen time is on the rise among youth, and as a result, cyberbullying victimization has become increasingly prevalent. While prior research has established a positive correlation between screen usage and cyberbullying victimization, a paucity of research has explored how motives for screen usage are associated with cyberbullying victimization and moderate the positive association between screen usage and cyberbullying victimization.

Objective: The present study sought to address these research gaps by exploring the association between motives for screen usage and cyberbullying victimization and examining whether these motives moderate the association between screen time and cyberbullying.

Increased prehospital mortality in patients with combined burns and trauma in Canada: Analysis of a provincial trauma registry database.

Introduction: The combination of burns and non-thermal trauma may have a synergistic effect on mortality. Our objective was to determine if burn patients with concomitant trauma are at increased risk of mortality in both the prehospital and in-hospital settings.

Methods: Data were collected from a population-based provincial trauma registry (2001-2019).

A National Survey of Caregiver Needs and Experiences When Attending the Emergency Department.

Objectives: Despite being a frequent entry point of care, it remains unknown if families' needs are being met across pediatric emergency departments (PEDs). Study objectives were to describe caregivers' perceived overall PED experience and needs and to what extent these needs were met.

Methods: This descriptive, cross-sectional survey with medical record review was conducted in 10 Canadian PEDs.

Daily Path Areas and Location Use During and After Cardiac Rehabilitation.

Purpose: Little research has focused on the potential impact that the environment plays in shaping cardiac rehabilitation (CR) patient sedentary time (ST) and physical activity (PA). To address this, the current study generated daily path areas (DPAs) based on the locations they visited during and after they completed CR.

Methods: Patients in CR (n = 66) completed a survey and wore an accelerometer and Global Positioning System receiver for 7 days early (first month), late (last 2 weeks of program), and 3 months after completing CR.

Does ruminating about the previous night's drinking during a hangover predict changes in heavy episodic drinking? A two-wave, 30-day prospective study.

Objective: We examined whether hangover-related rumination-repeatedly dwelling on negative aspects of yesterday's drinking while hungover the following morning-predicts changes in three dimensions of heavy episodic drinking (HED) over time.

Method: = 334 emerging adults (aged 19-29) from three Eastern Canadian universities who had recently experienced a hangover completed online self-report questionnaires at baseline (Wave 1) and 30 days later (Wave 2; 71.6% retention).

Understanding the role of perfectionism in contributing to internalizing symptoms in youth with juvenile idiopathic arthritis.

Objective: Youth with juvenile idiopathic arthritis (JIA) experience elevated rates of internalizing symptoms, although more research is required to understand this phenomenon. Perfectionism, a multidimensional personality trait that involves dimensions such as striving for flawlessness (self-oriented perfectionism) and feeling that others demand perfection (socially-prescribed perfectionism), is a well-known risk factor for internalizing symptoms that has received minimal attention in pediatric populations. Preregistered hypotheses explored the relationships between youth and parent perfectionism and symptoms of depression and anxiety in youth with JIA, as mediated by (a) youth/parent negative self-evaluations and (b) youth self-concealment.

Resistance-Associated Substitution Testing Trends and Impact on HCV Treatment Outcomes in Canada: A CanHepC-CANUHC Analysis.

Resistance-associated substitutions (RASs) are mutations within the hepatitis C (HCV) genome that may influence the likelihood of achieving a sustained virological response (SVR) with direct acting antiviral (DAA) treatment. Clinicians conduct RAS testing to adapt treatment regimens with the intent of improving the likelihood of cure. The Canadian Network Undertaking against Hepatitis C (CANUHC) prospective cohort consists of chronic HCV patients enrolled between 2015 and 2023 across 17 Canadian sites.

Expressive Writing About One's Trauma Increases Accessibility of Cannabis Information in Memory Among Trauma-Exposed Individuals.

Objective: Trauma survivors are more likely than others to use cannabis, and post-traumatic stress disorder (PTSD) commonly co-occurs with cannabis use disorder (CUD). Automatic memory associations between trauma reminders and cannabis use have been suggested as contributing mechanisms. These associations can be studied experimentally by manipulating trauma cue exposure in a cue-reactivity paradigm (CRP) and examining effects on the accessibility of cannabis information in memory in trauma survivors with and without PTSD.