Moderators of cognitive and behaviour therapies for prevention and treatment of anxiety disorders in children and adolescents: A systematic review and meta-analysis.

Previous studies have indicated wide variation in the effectiveness of cognitive and behaviour therapies (CBTs) for preventing and treating anxiety disorders in children and adolescents, indicating the presence of moderators influencing outcomes. This meta-analysis investigated whether sample characteristics (child age, child baseline anxiety levels, parental baseline anxiety levels) and intervention characteristics (intervention duration, facilitator contact time, facilitator background, delivery formats, parental involvement) moderate the effectiveness of CBTs for universal prevention, targeted prevention, and treatment of anxiety disorders in children and adolescents. We identified 86 eligible randomized controlled trials (RCTs) assessing the effectiveness of 98 CBTs versus non-active controls.

Non-Allergist Delabeling - Should penicillin allergy delabeling only be performed by allergists?

Penicillin allergy labels (PAL) are common but rarely correspond with a patient's likelihood to tolerate penicillin. This results in unnecessary penicillin avoidance in many patients, driving numerous negative health outcomes. Evaluation strategies for PAL are driven by risk stratification and include a spectrum of modalities such as delabeling without any testing, direct oral challenge, and skin testing followed by challenge testing.

Exploring cytokine outputs for diagnostics in drug reaction with eosinophilia and systemic symptoms (DRESS).

Background: In an exploratory study to assess the potential to individualize T-cell diagnostics in antibiotic-associated severe T-cell mediated hypersensitivity, we focused on drug reaction with eosinophilia and systemic symptoms (DRESS) and the related cytokine outputs IL-4 and IL-5.

Methods: Patients with well-phenotyped RegiSCAR ≥4 DRESS, positive intradermal skin testing, and a previous negative IFN-γ Enzyme-Linked ImmunoSpot (ELISpot) assay were prospectively recruited. We specifically performed an ELISpot assay with IL-4 and IL-5 cytokine outputs.

Radiographic and visual response to the type II RAF inhibitor tovorafenib in children with relapsed/refractory optic pathway glioma in the FIREFLY-1 trial.

Background: Due to their anatomical locations, optic pathway gliomas (OPGs) can rarely be cured by resection. Given the importance of preserving visual function, we analyzed radiological and visual acuity (VA) outcomes for the type II RAF inhibitor tovorafenib in the OPG subgroup of the phase 2 FIREFLY-1 trial.

Methods: FIREFLY-1 investigated the efficacy (arm 1, n=77), safety, and tolerability (arms 1/2) of tovorafenib (420 mg/m2 once weekly; 600 mg maximum) in patients with BRAF-altered relapsed/refractory pediatric low-grade glioma (pLGG).

Guiding drug provocation testing for ibuprofen hypersensitivity in a pediatric population: Development of the I3A risk-stratification tool.

Background: Ibuprofen is a main cause of drug hypersensitivity reactions in children. The gold standard for diagnosis is the drug provocation test (DPT).

Objective: We aimed to create a clinical risk-stratification tool to guide this high-risk procedure.

Global differences and risk factors influencing drug hypersensitivity quality of life: A multicenter, multiethnic study of drug allergy across 3 continents.

Background: Penicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also have an impact on health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remains unknown.

Evaluating the Efficacy of Immunotherapy in Fragile Hospitalized Patients.

Background: Immunotherapy is the cornerstone of treatment for many cancers. The effectiveness of immunotherapy in hospitalized patients is unknown due to the exclusion of this fragile population from clinical trials. This study evaluates the efficacy of immunotherapy in fragile hospitalized patients.

Association Between Inability to Stand at ICU Discharge and Readmission: A Historical Cohort Study.

Objectives: The aim of this study was to determine if being unable to stand at ICU discharge was associated with an increased probability of ICU readmission.

Design: A multicenter retrospective cohort study was conducted using the Toronto Intensive Care Observational Registry (iCORE) project.

Setting: Nine tertiary academic ICUs in Toronto, Canada, affiliated with the University of Toronto.

Disentangling the Effects of Comorbidity and Polypharmacy on Cognitive Function and Physical Frailty in Individuals With HIV.

Objective: To estimate the extent to which comorbidity, polypharmacy, and anticholinergic/sedative burden interrelate to influence cognitive ability, perceived cognitive deficits (PCD), and physical frailty in people living with HIV.

Design: Cross-sectional Structural Equation Modeling of data from 824 older people living with HIV in Canada, participating in the Positive Brain Health Now study.

Method: Structural Equation Modeling was used to link observed variables, including comorbidity, polypharmacy, anticholinergic, and sedative burden, to cognitive ability and 2 latent constructs-physical frailty and PCD.

Knowledge and practices of youth awareness on death and dying in school settings: a systematic scoping review protocol.

Background: Awareness-raising and education have been identified as strategies to counter the taboo surrounding death and dying. As the favoured venue for youth education, schools have an essential role to play in informing future decision-makers. However, school workers are not comfortable addressing the subjects of death and dying, which, unlike other social issues, have no guidelines to influence awareness of these subjects in youth.

Inter-visit and inter-reader reproducibility of multi-parametric diffusion-weighted MR imaging in longitudinally imaged patients with metabolic dysfunction-associated fatty liver disease and healthy volunteers.

Background: Despite the widespread use of diffusion-weighted imaging (DWI) in metabolic dysfunction-associated fatty liver disease (MAFLD), MRI acquisition and quantification techniques vary in the literature suggesting the need for established and reproducible protocols. The goal of this study was to assess inter-visit and inter-reader reproducibility of DWI- and IVIM-derived parameters in patients with MAFLD and healthy volunteers using extensive sampling of the "fast" compartment, non-rigid registration, and exclusion voxels with poor fit quality.

Methods: From June 2019 to April 2023, 31 subjects (20 patients with biopsy-proven MAFLD and 11 healthy volunteers) were included in this IRB-approved study.

The relationship among vedolizumab drug concentrations, biomarkers of inflammation, and clinical outcomes in a Canadian real-world study.

Background And Aims: Therapeutic drug monitoring is used to optimize anti-tumour necrosis factor biologic effectiveness in inflammatory bowel disease, but its role with other biological classes is unclear. This study explores relationships between post-induction vedolizumab trough concentrations and biochemical outcomes in a real-world study of individuals with inflammatory bowel disease.

Methods: This retrospective analysis of data from a national patient support program between 2018 and 2020, included 436 individuals with Crohn's disease or ulcerative colitis receiving vedolizumab.

Age of obesity onset affects subcutaneous adipose tissue cellularity differently in the abdominal and femoral region.

Objective: We aimed to examine the effect of age of obesity onset, sex, and their interaction on abdominal and femoral subcutaneous adipose tissue (SAT) morphology (degree of adipocyte hyperplasia or hypertrophy).

Methods: In this cross-sectional study, we isolated adipocytes via collagenase digestion from abdominal and femoral SAT biopsies taken from male and female adults with childhood-onset obesity (CO; n = 8 males, n = 16 females) or adult-onset obesity (AO; n = 8 males, n = 13 females). Regional body composition was measured with dual-energy x-ray absorptiometry and a single-slice abdominal computed tomography scan.

Profiles of healthcare use of persons living with dementia: A population-based cohort study.

Aim: Persons living with dementia are a heterogeneous population with complex needs whose healthcare use varies widely. This study aimed to identify the healthcare use profiles in a cohort of persons with incident dementia, and to describe their characteristics.

Methods: This is a retrospective cohort study of health administrative data in Quebec (Canada).

Cognitive impact of anticholinergic and sedative burden in people with HIV.

Objective: This study aims to estimate the extent to which anticholinergic and sedative burden is associated with cognitive ability and self-reported cognitive difficulties (SCD) in middle-aged and older adults living with HIV.

Design: This cross-sectional analysis examined data from the inaugural visit of participants enrolled in the Positive Brain Health Now (BHN) study.

Methods: Cognitive ability was measured using the Brief Cognitive Ability Measure (B-CAM; higher is better) and SCD using the Perceived Deficits Questionnaire (PDQ; higher is worse).

Increasing exercise capacity and physical activity in the COPD patient.

Higher levels of exercise capacity and physical activity are desired outcomes in the comprehensive management of the COPD patient. In addition, improvements in exercise capacity and physical activity are instrumental to optimising other important therapeutic goals, such as improved health status, reduced healthcare utilisation and increased survival. Four general approaches towards increasing exercise capacity and physical activity in individuals with COPD will be discussed in this review: 1) pharmacological intervention, especially the administration of long-acting bronchodilators; 2) pulmonary rehabilitation, including exercise training and collaborative self-management; 3) behavioural interventions; and 4) web-based interventions.