Allergic Reactivity and Memory Occur Independently of Sequential Switching Through IgG1.

Allergic reactions to foods are primarily driven by allergen-binding immunoglobulin (Ig)E antibodies. IgE-expressing cells can be generated through direct switching from IgM to IgE or a sequential class switching pathway where activated B cells first switch to an intermediary isotype, most frequently IgG1, and then to IgE. It has been proposed that sequential class switch recombination is involved in augmenting the severity of allergic reactions, generating high affinity IgE, differentiation of IgE plasma cells, and in holding the memory of IgE responses.

Risk of stroke with reduced dose direct oral anticoagulants vs standard dose anticoagulation after cardioversion of atrial fibrillation: A systematic review and meta-analysis.

Background: There is consensus on the safety of standard dose direct oral anticoagulants (DOACs) for stroke prevention in patients undergoing cardioversion of atrial fibrillation (AF), but outcomes of reduced dose DOACs in this setting remain unclear.

Objective: This systematic review and meta-analysis aimed to compare the rate of cardioversion-associated thromboembolic events between patients taking reduced dose DOACs and those receiving standard dose anticoagulation.

Methods: A systematic search was conducted for studies published between January 1, 2009, and February 16, 2024 in PubMed, Embase, and Cochrane Central Register of Controlled Trials.

Metaverse technologies in acute care medical education: A scoping review.

Background: The concept of the metaverse is a virtual world that immerses users, allowing them to interact with the digital environment. Due to metaverse's utility in collaborative and immersive simulation, it can be advantageous for medical education in high-stakes care settings such as emergency, critical, and acute care. Consequently, there has been a growth in educational metaverse use, which has yet to be characterized alongside other simulation modalities literature.

Opioid toxicity deaths in Indigenous people who experienced incarceration in Ontario, Canada 2015-2020: a whole population retrospective cohort study.

Background: While Indigenous people are overrepresented in Canada's prisons and in the toxic drug supply crisis, we lack data on the harms related to opioids for Indigenous people with experiences of incarceration. We aimed to examine opioid toxicity deaths in Indigenous peoples who experienced incarceration and to compare opioid toxicity mortality rates with rates for people with no incarceration.

Methods: This retrospective cohort study linked correctional data for all people who were incarcerated in provincial correctional facilities and coronial data for all people who died from opioid toxicity in Ontario, Canada between 2015 and 2020.

Optimal Dosage of Platelet-Rich Plasma Injections in Patients With Osteoarthritis of the Knee: A Scoping Review.

Knee osteoarthritis (KOA) is a healthcare burden affecting over 595 million people worldwide. Recently, intra-articular platelet-rich plasma (PRP) injections from the patient's blood have shown promise in slowing KOA progression due to platelets' regenerative properties. This study aimed to evaluate the optimal dosing and schedule for PRP therapy in managing mild to moderate KOA.

Combination Treatment with Thread-Embedding Acupuncture and Electroacupuncture for Knee Osteoarthritis Patients with Postoperative Pain: A Randomized Controlled Feasibility Study.

Purpose: This study aimed to evaluate the effectiveness and safety of combination treatment with thread-embedding acupuncture (TEA) and electroacupuncture (EA) in patients with persistent knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation.

Patients And Methods: Twelve patients with knee osteoarthritis (KOA) who experienced postoperative pain were randomized to either the treatment group (TG) or control group (CG) in a 1:1 ratio. The TG received TEA once a week for four sessions and EA twice a week for eight sessions while continuing usual care, defined as standard conventional treatments.

Cardiovascular Risk in Prostate Cancer: State-of-the-Art Review.

Cardiovascular disease is common in patients with prostate cancer and is a significant cause of death. Cardiovascular risk factors are frequent in this population and are often not addressed to thresholds recommended by cardiovascular practice guidelines. Androgen deprivation therapy reduces muscle strength and increases adiposity, increasing the risk for diabetes and hypertension, although its relationship with adverse cardiovascular events requires confirmation.

Cardiovascular Considerations During Cancer Therapy: Gaps in Evidence and Expert Panel Recommendations.

The administration of certain cancer therapies can be associated with the development of cardiovascular toxicity or complications. This spectrum of toxicities is broad and requires nuanced approaches for prevention, identification, and management. This expert panel summarizes the consensus of opinions of diverse health care professionals in several key areas: 1) cardioprotection involves strategies aimed at the primary prevention of cancer therapy-related cardiovascular toxicity; 2) surveillance entails monitoring for cancer therapy-related cardiovascular toxicity during cancer therapy; 3) permissive cardiotoxicity is the informed continuation of cancer therapy in the presence of cardiovascular toxicity, along with the implementation of mitigating cardiovascular treatments; and 4) special considerations include the invasive management of severe cardiovascular disease in patients receiving treatments for advanced cancer and the exploration of drug-drug interactions in cardio-oncology.

Impact of obesity on outcome in children diagnosed with cancer in Canada: A report from Cancer in Young People in Canada.

Background: Childhood obesity can result in adverse health outcomes. The objectives of this study were to describe the prevalence of obesity and determine the association between obesity at cancer diagnosis and event-free survival (EFS) and overall survival (OS) in children diagnosed with cancer in Canada.

Methods: The authors conducted a retrospective cohort study using the Cancer in Young People in Canada database, including all children with newly diagnosed cancer aged 2-18 years across Canada from 2001 to 2020.

Evaluating Intervention Reporting in Nursing Journal RCTs Using the TIDieR Checklist: A Cross-Sectional Study.

Aim: To assess the completeness of intervention reporting in randomised controlled trials (RCTs) published in nursing journals based on the Template for Intervention Description and Replication (TIDieR) checklist.

Design: A cross-sectional study.

Methods: RCTs published in English in nursing journals between January 2022 and December 2022 were identified through PubMed.

Defining Spine Cancer Pain Syndromes: A Systematic Review and Proposed Terminology.

Study Design: Systematic Review.

Objectives: Formalized terminology for pain experienced by spine cancer patients is lacking. The common descriptors of spine cancer pain as mechanical or non-mechanical is not exhaustive.

What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?

Study Design: Systematic review.

Objective: In patients with extradural metastatic spine disease, we sought to systematically review the outcomes and complications of patients with intermediate Spinal Instability Neoplastic Score (SINS) lesions undergoing radiation therapy, percutaneous interventions, minimally invasive surgeries, or open spinal surgeries.

Methods: Following PRISMA guidelines for systematic reviews, MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews and the Cochrane Center Register of Controlled Trials were queried for studies that reported on SINS intermediate patients who underwent: 1) radiotherapy, 2) percutaneous intervention, 3) minimally invasive, or 4) open surgery.

Impact of age-related changes in buccal epithelial cells on pediatric epigenetic biomarker research.

Cheek swabs, heterogeneous samples consisting primarily of buccal epithelial cells, are widely used in pediatric DNA methylation studies and biomarker creation. However, the decrease in buccal proportion with age in adults remains unexamined in childhood. We analyzed cheek swabs from 4626 typically developing children 2-months to 20-years-old.

Comparative assessment of Mini-FLOTAC, McMaster and semi-quantitative flotation for helminth egg examination in camel faeces.

Background: Faecal egg counts (FECs) are essential for diagnosing helminth infections and guiding treatment decisions. For camels, no evaluations of coproscopic methods regarding precision, sensitivity and correlation between individual and pooled faecal samples are currently available.

Methods: Here, 410 camel faecal samples were collected in 2022 from South Darfur State, Sudan, and analysed to compare the semi-quantitative flotation, McMaster and Mini-FLOTAC methods in terms of precision, sensitivity, inter-rater reliability and helminth egg count correlations, as well as the effects of pooling samples.

Understanding and measuring workplace violence in healthcare: a Canadian systematic framework to address a global healthcare phenomenon.

Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.

Patient and Healthcare Provider Perspectives on Showering for Patients With Hemodialysis Central Venous Catheters: A Survey Study.

Rationale & Objective: Patients on hemodialysis using a central venous catheter (CVC) are often advised not to shower due to infection risk. This study aimed to assess practices and attitudes of patients and healthcare providers about showering with CVCs.

Study Design: Survey study.

Peripheral neurofilament light chain and intracortical myelin in bipolar I disorder.

Background: Neurofilament light chain (NfL) is a cytoskeletal protein that supports neuronal structure. Blood NfL levels are reported to be higher in diseases where myelin is damaged. Studies investigating intracortical myelin (ICM) in bipolar disorder (BD) have reported deficits in ICM maturation over age.

What happened next? A survey of review clients evaluating impacts of rapid reviews.

Introduction: End-user evaluation of the impact of evidence syntheses is critical to demonstrating value. This study presents results of a survey evaluating the impact of rapid reviews undertaken by two teams based in Melbourne, Australia and Hamilton, Canada.

Methods: Clients were invited to participate in a short, written survey following delivery of a rapid review.

The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth.

Background: Inadequate and excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) has been associated with preterm birth. However, studies demonstrate inconsistent associations.

Objectives: We examined the associations between categorical and continuous total GWG and moderate to late preterm birth (32-<37 weeks), and evaluated differences in these associations by pre-pregnancy BMI.

Risk of ischemic stroke after cancer diagnosis: a population-based matched cohort study.

Background: There are limited data regarding the association between cancer and ischemic stroke, particularly among individuals with previous stroke. Our objective was to measure and compare the risk of ischemic stroke in individuals with and without cancer.

Methods: Population-based matched cohort study in Ontario, Canada.