Evidence for targeting autonomic dysfunction in systemic sclerosis: A scoping review.

Autonomic dysfunction is a common and early complication among patients with systemic sclerosis, suggesting that it may play a role in the pathogenesis of the disease and be a potential target for therapeutic interventions. Although the true prevalence of autonomic dysfunction among patients with systemic sclerosis is still unclear, it is estimated that as many as 80% of patients may be affected. Autonomic dysfunction may lead to widespread multi-organ dysfunction through its effects on the cardiovascular system, gastrointestinal tract, urinary tract, sweat and salivary glands, and pupils.

Stent Graft Migration Causing Two Aortic Wall Injuries 10 Years After Type II Hybrid Arch Repair.

Hybrid arch repair (HAR) combines surgical reconstruction of the ascending aorta and arch debranching with stent graft deployment into the descending thoracic aorta in an effort to reduce the morbidity associated with conventional open total arch replacement. We describe a case of delayed presentation for 2 thoracic aortic wall injuries caused by stent graft migration after type II HAR. This report highlights an important late complication of HAR and the need for careful device selection.

[The mediational role of cognitive function on occupational outcomes in persons with major depressive and bipolar disorder].

Background: Improving functioning in adults with major depressive disorder (MDD) and bipolar disorder (BD) is a priority therapeutic objective.

Methods: This retrospective post hoc secondary analysis evaluated 108 patients with MDD or BD receiving the antidepressants vortioxetine, ketamine, or infliximab. The analysis aimed to determine if changes in objective or subjective cognitive function mediated the relationship between depression symptom severity and workplace outcomes.

Development of a predictive model for loss of functional and cognitive abilities in long-term care home residents: a protocol.

Introduction: Long-term care (LTC) residents require extensive assistance with daily activities due to physical and cognitive impairments. Medical treatment for LTC residents, when not aligned with residents' wishes, can cause discomfort without providing substantial benefits. Predictive models can equip providers with tools to guide treatment recommendations that support person-centred medical decision-making.

Importance of infarct topography in determination of stroke mechanism and recurrence risk: a post-hoc analysis of the dabigatran acute treatment of stroke trial.

Objective: To evaluate the relationship between infarct pattern, inferred stroke mechanism and risk of recurrence in patients with ischaemic stroke. The question is clinically relevant to optimise secondary stroke prevention investigations and treatment.

Design: We conducted a retrospective analysis of the dabigatran treatment of acute stroke II (DATAS II) trial (ClinicalTrials.

Comparison of Maximum Isometric Strength of the Hip Joint Abductor and Knee Joint Extensor Muscles between Knee Osteoarthritis Patients with and without Self-reported Instability.

Patients with knee osteoarthritis (KOA) often have impaired muscle function of the weight-bearing muscles, particularly in the knee and hip joints. This can lead to a significant loss of strength and power and may play a role in the perceived instability of the knee joint. The purpose of this study was to compare the maximum isometric strength of the hip abductor and knee extensor muscles between patients with KOA with and without perceived instability.

The impact of new-onset atrial fibrillation in the setting of acute coronary syndrome.

Approximately 10 % of patients who have suffered from myocardial infarction develop new-onset atrial fibrillation (AF). Coronary artery disease implicating atrial branches has been associated with AF. The following variables have been associated with new-onset AF in the setting of acute coronary syndrome: older age, history of hypertension, history of angina, history of stroke, chronic renal failure, body mass index, no statin use, worse nutritional status, worse Killip class, admission heart rate ≥ 85 bpm, complete atrioventricular block, Glasgow prognostic score, Syntax score, CHEST score > 3, PRECISE-DAPT score ≥ 25, left ventricular ejection fraction ≤40 %, increased left atrial diameter, E/E' ratio > 12, epicardial fat tissue thickness, and thrombolysis in myocardial infarction flow <3.

Development of a framework to structure decision-making in environmental and occupational health: A systematic review and Delphi study.

Background: Environmental and occupational health (EOH) assessments increasingly utilize systematic review methods and structured frameworks for evaluating evidence about the human health effects of exposures. However, there is no prevailing approach for how to integrate this evidence into decisions or recommendations. Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence-to-decision (EtD) frameworks provide a structure to support standardized and transparent consideration of relevant criteria to inform health decisions.

Covert Vascular Brain Injury and Cognitive Dysfunction Among Chinese Adults Living in Canada and China: The CAHHM and PURE-MIND Studies.

Background And Objective: It is unclear whether variation in covert cerebrovascular disease prevalence is attributable to ethnic differences or to other factors. We aimed to examine the associations of country of residence with covert vascular brain injury (VBI) and cognitive dysfunction among Chinese adults residing in Canada and China.

Methods: This was a multisite cross-sectional study of Chinese adults aged 40-80 years in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM; January 1, 2014, to December 31, 2018) and Prospective Urban Rural Epidemiological-Mind (PURE-MIND; November 1, 2010, to July 31, 2015) cohorts living in Canada and China.

Association between clinical laboratory indicators and WOMAC scores in Qatar Biobank participants: The impact of testosterone and fibrinogen on pain, stiffness, and functional limitation.

Objectives: The association between baseline laboratory parameters and experienced well-being in healthy individuals remains uncertain. This study explored the relationship between clinical laboratory profiles and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical functional limitation in healthy individuals in Qatar.

Methods: Clinical laboratory data were collected from 1,764 Qatar Biobank participants who also completed the WOMAC questionnaire: lipid profiles (high-density lipoprotein, low-density lipoprotein, cholesterol, and triglycerides), endocrine markers (TSH, T3, T4, estradiol, and testosterone), and two inflammatory markers (CRP and fibrinogen).

Systematic Review: Efficacy of Medical Therapy on Outcomes Important to Pediatric Patients with X-Linked Hypophosphatemia.

Objective: To examine the evidence addressing the management of X-linked hypophosphatemia (XLH) in children to inform treatment recommendations.

Methods: We searched Embase, MEDLINE, Web of Science, and Cochrane Central up to May 2023. Eligible studies included RCTs and observational studies of individuals less than 18yrs with clinically or genetically confirmed XLH.

Performance of baseline quartile-stratified minimal clinically important difference estimates was superior to individual minimal clinically important difference estimates when compared with a gold standard comparator of important change.

A variety of minimal clinically important difference (MCID) estimates are available to distinguish subgroups with differing outcomes. When a true gold standard is absent, latent class growth curve analysis (LCGC) has been proposed as a suitable alternative for important change. Our purpose was to evaluate the performance of individual and baseline quartile-stratified MCIDs.

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.

The value of diabetes technology enabled coaching (DTEC) to support remission evaluation of medical interventions in T2D: Patient and health coach perspectives.

The multicomponent Remission Evaluation of Medical Interventions in T2D (REMIT) program has shown reduction of hazard of diabetes relapse by 34-43%, but could benefit from improved ability to scale, spread, and sustain it. This study explored, at the conceptualization phase, patient and health coach perspectives on the acceptability, adoption, feasibility, and appropriateness of a digital REMIT adaptation (diabetes technology enabled coaching (DTEC)). Twelve semi-structured interviews were conducted with patients (n = 6) and health coaches (n = 6) to explore their experiences with the REMIT study, opportunities for virtualisation, and a cognitive walkthrough of solution concepts.

Developing an EEG-based model to predict awakening after cardiac arrest using partial processing with the BIS Engine.

Introduction: Accurate prognostication in comatose survivors of cardiac arrest is a challenging and high-stakes endeavor. We sought to determine whether internal EEG subparameters extracted by the Bispectral Index (BIS) monitor, a device commonly used to estimate depth-of-anesthesia intraoperatively, could be repurposed to predict recovery of consciousness after cardiac arrest.

Methods: In this retrospective cohort study, we trained a 3-layer neural network to predict recovery of consciousness to the point of command following versus not based on 48 hours of continuous EEG recordings in 315 comatose patients admitted to a single US academic medical center after cardiac arrest (Derivation cohort: N=181; Validation cohort: N=134).

Protein alterations in patients with delirium after cardiac surgery: An exploratory case-control sub-study of the VISION Cardiac Surgery Biobank.

Background: Delirium is an acute state of confusion associated with adverse postoperative outcomes. Delirium is diagnosed clinically using screening tools; most cases go undetected. Identifying a delirium biomarker would allow for accurate diagnosis, application of therapies, and insight into causal pathways.

Simple method for the direct measurement of cohesive forces between microscopic particles.

We present a simple and inexpensive method for measuring weak cohesive interactions. This technique is applied to the specific case of oil droplets with a depletion interaction, dispersed in an aqueous solution. The experimental setup involves creating a short string of droplets while immobilizing a single droplet.

Guidelines for Accurate and Precise Stable Isotope Analysis of Calcite, Dolomite, and Magnesite Using a Carbonate Device for Continuous Flow-Isotope Ratio Mass Spectrometry (CF-IRMS).

Rationale: Carbonate minerals are one of the most popular samples for an automated sample preparation system for CF-IRMS, such as GasBench II and iso FLOW, but no standardized analytical protocols exist. This study gives guidelines on optimal analytic conditions for carbon and oxygen isotope analysis of Ca-Mg carbonates when using the carbonate-phosphoric acid reaction method.

Methods: Calcite (CaCO-McMaster Carrara), dolomite (CaMg(CO)-MRSI Dolomite), and magnesite (MgCO-ROM Brazil Magnesite) with two grain size fractions (< 74 and 149-250 μm) were reacted with 103% (specific gravity of 1.

Public Health.

Background: Several recent studies have used communality weights to calculate a combined population attributable fraction (PAF) of modifiable risks factors for dementia. Other research has suggested this method may be underestimating the true PAF. We applied multiple methods to calculate the combined PAF of 12 modifiable risk factors using record-level, national Canadian data.

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.

Public Health.

Background: While age is the most significant risk factor for dementia, increased awareness and understanding of other modifiable risk factors of dementia, coupled with proactive lifestyle behavior changes, hold the potential to prevent dementia and improve the quality of life for older adults. Defy Dementia is a public health initiative, led by the Baycrest Academy for Research and Education (BARE) and funded by the Public Health Agency of Canada. It involves curating, co-designing, and disseminating a series of knowledge products to raise public awareness of dementia prevention and reduce stigma associated with dementia.

Developing Topics.

Background: Caregiver burden associated with Alzheimer's disease (AD) increases with AD severity, and current treatment options are limited. We aimed to describe the caregiver and treatment landscapes for patients with AD in Canada, split by disease severity.

Method: Data were drawn from the Adelphi Real World AD Disease Specific Programme (DSP)™, a cross-sectional survey of physicians in Canada, from March to October 2023.

Developing Topics.

Background: Alzheimer's disease (AD) dementia progresses from preclinical brain changes, through mild cognitive impairment (MCI), to AD with dementia. Early diagnosis and confirmation of underlying AD pathology is crucial; however, there is still much to learn about patients' diagnostic journey. We aimed to describe the diagnostic journey and barriers to diagnosis for patients with MCI or dementia due to AD in Canada.

A review of the empirical evidence for costs of plasticity in ectothermic animals.

Phenotypic plasticity can represent a vital adaptive response to environmental stressors, including those associated with climate change. Despite its evolutionary advantages, the expression of plasticity varies significantly within and among species, and is likely to be influenced by local environmental conditions. This variability in plasticity has important implications for evolutionary biology and conservation physiology.

Dementia Care Research and Psychosocial Factors.

Background: Caregiver burden, or the impact of caregiving, commonly occurs in caregivers of persons with dementia (PWD); however, prior research focused on caregiver burden in this population has not considered the impact of dysphagia. Therefore, the purpose of this study was to measure dysphagia-specific burden in caregivers of PWD and examine its relationship to general caregiver burden, as well as the PWD's current diet level and dementia severity.

Method: Data were collected from PWD-caregiver dyads participating in a prospective, dysphagia-focused clinical trial at the initial study visit.