Implementing a smoke-free generation policy for Canada: estimates of the long-term impacts.

Introduction: The aim of this study was to assess the potential impacts of the introduction of a smoke-free generation (SFG) policy in Canada with a perpetual ban on cigarette sales to anyone born after 2009 instigated on 1 January 2025.

Methods: An existing Canadian model relating to smoking cessation was adapted and augmented to assess the impact of an SFG policy on quality-adjusted life years (QALYs), life expectancy, health care costs, smoking-related taxes, and Canadian tobacco industry gross domestic product (GDP). The cumulative impact of the policy for the entire Canadian population was assessed for time horizons up to 90 years with an annual discount rate of 1.

Patterns and trends in burden of asthma and its attributable risk factors from 1990 to 2021 among south Asian countries: a systematic analysis for the Global Burden of Disease Study 2021.

Objective: Asthma poses a significant health burden in South Asia, with increasing incidence and mortality despite a global decline in age-standardized prevalence rates. This study aims to analyze asthma trends from 1990 to 2021, focusing on prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across South Asia. The study also assesses the impact of risk factors like high body mass index (BMI), smoking, and occupational exposures on asthma outcomes.

Burden of rheumatic diseases among people with diabetes: A systematic review and meta-analysis.

Diabetes mellitus type 2 (DM2) is a prevalent metabolic condition affecting over 500 million people globally and associated with serious comorbidities, including various rheumatologic conditions. Some studies have reported a significant association between rheumatological conditions and DM2. However, the global burden of rheumatological conditions among people with DM2 remains unknown.

Combining theory and usability testing to inform optimization and implementation of an online primary care depression management tool.

Background: The 'Ottawa Depression Algorithm' is an evidence-based online tool developed to support primary care professionals care for adults with depression. Uptake of such tools require provider behaviour change. Identifying issues which may impact use of an innovation in routine practice (i.

Intracellular tenofovir-diphosphate concentrations in HIV pre-exposure prophylaxis users who underwent bariatric surgery.

Objective: To measure concentrations of tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) among individuals taking tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) or tenofovir alafenamide plus emtricitabine (TAF/FTC) who were scheduled to undergo or had already undergone bariatric surgery.

Methods: We enrolled pre-exposure prophylaxis (PrEP) users attending clinics in Toronto or Ottawa who were undergoing or had undergone bariatric surgery. After participants completed a minimum of 7 days of consecutive PrEP dosing, we collected DBS samples immediately before they administered their next daily dose of PrEP.

Cost-effectiveness of targeted next-generation sequencing (tNGS) for detection of tuberculosis drug resistance in India, South Africa and Georgia: a modeling analysis.

Background: Targeted next-generation sequencing (tNGS) is promising alternative to phenotypic drug susceptibility testing (pDST) for detecting drug-resistant tuberculosis (DRTB). This study explored the potential cost-effectiveness of tNGS for the diagnosis of DR-TB across 3 settings: India, South Africa and Georgia.

Methods: To inform WHO guideline development group (GDG) on tNGS we developed a stochastic decision analysis model and assessed cost-effectiveness of tNGS for DST among rifampicin resistance individuals.

Masking in Active Comparator Designs in Pharmacovigilance: A Retrospective Bias Analysis on the Spontaneous Reporting of Thiazolidinediones and Cardiovascular Events.

Introduction: Masking is a reporting bias where drug safety signals are muffled by elevated reporting of other medications in spontaneous reporting databases. While the impact of masking is often limited, its effect when using restricted designs, such as active comparators, can be consequential.

Methods: We used data from the US Food and Drugs Administration Adverse Event Reporting System (1999Q3-2013Q3) to study masking in a real-world example.

Notification of blood donors who test positive for transfusion-transmissible infections.

Background And Objectives: Despite screening procedures, a few blood donors confirm positive for transfusion-transmissible infections and are deferred. Effective notification of laboratory results is essential to ensure that donors are advised of confirmed results and to seek medical care. Here we report results from post-notification interviews of Canadian Blood Services donors.

Nationwide cervical precancer screening in Ghana: concurrent HPV DNA testing and visual inspection under an expanded hub-and-spoke model.

Cervical cancer continues to disproportionately burden women in sub-Saharan Africa, and is the commonest gynecological cancer in Ghana. The Cervical Cancer Prevention and Training Centre (CCPTC), Battor, Ghana spearheaded the Ghana arm of the mPharma 10,000 Women Initiative (mTTWI) between September 2021 and October 2022. The aim of this study was to examine the outcomes of nationwide concurrent screening using high-risk human papillomavirus (hr-HPV) DNA testing and visual inspection methods, as well as factors associated with the screening outcomes.

Health-Care Utilization of Children Born to Women with and Without Inflammatory Bowel Disease in the First Five Years of Life: A Population-Cohort Study.

Background: Children born to women with inflammatory bowel disease (IBD) may have increased healthcare utilization in early life due to genetic susceptibilities and exposure to inflammation in utero, though this has not been robustly evaluated. We aimed to characterize healthcare use between these groups.

Methods: We accessed province-wide health administrative databases to identify children born to women with and without IBD between 2002-2019.

Burden of disease of respiratory syncytial virus in older adults and adults considered at high risk of severe infection.

Background: Availability of new vaccines for adults has increased interest in understanding Canada's respiratory syncytial virus (RSV) burden in older adults and adults considered at high risk of severe infection.

Objective: To characterize the burden of RSV disease in Canada by joint analysis of the published literature and hospitalization data from a healthcare administrative database.

Methods: Electronic databases of published literature were searched to identify studies and systematic reviews reporting data on outpatient visits, hospitalizations, intensive care unit (ICU) admissions and deaths associated with RSV infection in adults.

Changing or validating physician opioid prescribing behaviors through audit and feedback and academic detailing interventions in primary care.

Background: In Ontario, Canada, province-wide initiatives supporting safer opioid prescribing in primary care include voluntary audit and feedback reports and academic detailing. In this process evaluation, we aimed to determine the fidelity of delivery and receipt of the interventions, the observed change strategies used by physicians, potential mechanisms of action, and how complementary the initiatives can be to each other.

Method: Semi-structured interviews were conducted with academic detailers and with physicians who received both interventions.

Understanding Perceptions of Hepatitis C and Its Management Among People with Experience of Incarceration in Quebec, Canada: A Qualitative Study Guided by the Common Sense Self-Regulation Model.

Hepatitis C virus (HCV) disproportionately affects certain sub-populations, including people with experience of incarceration (PWEI). Little is known about how perceptions of HCV and treatment have changed despite simplifications in testing and treatment in carceral settings. Nineteen semi-structured interviews were conducted with people living with or having a history of HCV infection released from Quebec provincial prison.

Decoding Schizophrenia: How AI-Enhanced fMRI Unlocks New Pathways for Precision Psychiatry.

Schizophrenia, a highly complex psychiatric disorder, presents significant challenges in diagnosis and treatment due to its multifaceted neurobiological underpinnings. Recent advancements in functional magnetic resonance imaging (fMRI) and artificial intelligence (AI) have revolutionized the understanding and management of this condition. This manuscript explores how the integration of these technologies has unveiled key insights into schizophrenia's structural and functional neural anomalies.

The Impact of Artificial Intelligence on Healthcare: A Comprehensive Review of Advancements in Diagnostics, Treatment, and Operational Efficiency.

Background And Aims: Artificial Intelligence (AI) beginning to integrate in healthcare, is ushering in a transformative era, impacting diagnostics, altering personalized treatment, and significantly improving operational efficiency. The study aims to describe AI in healthcare, including important technologies like robotics, machine learning (ML), deep learning (DL), and natural language processing (NLP), and to investigate how these technologies are used in patient interaction, predictive analytics, and remote monitoring. The goal of this review is to present a thorough analysis of AI's effects on healthcare while providing stakeholders with a road map for navigating this changing environment.

Trends and projections of type 2 diabetes mellitus in South Asia: a three-decade analysis and forecast through 2031 using global burden of disease study (1990 - 2021).

Background: The rapid rise of non-communicable diseases, particularly type 2 diabetes mellitus (T2DM), poses a significant global public health challenge, with South Asia experiencing an increasingly severe burden. This study aimed to analyse historical trends of T2DM across South Asia from 1990 to 2021 and forecast incidence through 2031.

Research Design And Methods: We carried out analysis based on the data from the 2021 Global burden of disease study.

Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey.

Background: Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implementation science, and how confident nurses, other health professionals, and leaders are completing steps in the implementation process.

Rapid climate action is needed: comparing heat vs. COVID-19-related mortality.

The impacts of climate change on human health are often underestimated or perceived to be in a distant future. Here, we present the projected impacts of climate change in the context of COVID-19, a recent human health catastrophe. We compared projected heat mortality with COVID-19 deaths in 38 cities worldwide and found that in half of these cities, heat-related deaths could exceed annual COVID-19 deaths in less than ten years (at + 3.

Reporting of cluster randomised crossover trials: extension of the CONSORT 2010 statement with explanation and elaboration.

This article presents the CONSORT (consolidated standards of reporting trials) extension for cluster randomised crossover trials. A cluster randomised crossover trial involves randomisation of groups of individuals (known as clusters) to different sequences of interventions over time. The design has gained popularity in settings where cluster randomisation is required because it can largely overcome the loss in power due to clustering in parallel cluster trials.

Preventing zoonotic spillover through regulatory frameworks governing wildlife trade: A scoping review.

Wildlife trade can create adverse impacts for biodiversity and human health globally, including increased risks for zoonotic spillover that can lead to pandemics. Institutional responses to zoonotic threats posed by wildlife trade are diverse; understanding regulations governing wildlife trade is an important step for effective zoonotic spillover prevention measures. In this review, we focused on peer-reviewed studies and grey literature conducted on regulatory approaches that govern domestic and international wildlife trade in order to assess the role of local, national and global-level institutions in the prevention of zoonotic spillover and infection transmission between humans.

A Fast Nonparametric Sampling Method for Time to Event in Individual-Level Simulation Models.

The nonparametric sampling method is generic and can sample times to an event from any discrete (or discretizable) hazard without requiring any parametric assumption.The method is showcased with 5 commonly used distributions in discrete-event simulation models.The method produced very similar expected times to events, as well as their probability distribution, compared with analytical results.

Reliability and reproducibility of systematic reviews informing the 2020-2025 Dietary Guidelines for Americans: a pilot study.

Background: Although high-quality nutrition systematic reviews (SRs) are important for clinical decision making, there remains debate on their methodological quality and reporting transparency.

Objectives: The objective of this study was to assess the reliability and reproducibility of a sample of SRs produced by the Nutrition Evidence Systematic Review (NESR) team to inform the 2020-2025 Dietary Guidelines for Americans (DGAs).

Methods: We evaluated a sample of 8 SRs from the DGA dietary patterns subcommittee for methodological quality using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool and for reporting transparency using the PRISMA 2020 and PRISMA literature search extension (PRISMA-S) checklists.

Physical activity, sedentary behaviour, and cardiovascular disease risk factors in Canadians living with and without cardiovascular disease.

Background: To describe and compare the proportion of adult Canadians living with and without cardiovascular disease (CVD) meeting the physical activity (PA) and sedentary behaviour (SB) recommendations from the Canadian 24-Hour Movement Guidelines using accelerometer and self-reported measures.

Methods: Using adult (aged 18-79 years) accelerometer data (Actical worn during waking hours for 7 consecutive days) as well as chronic condition, socio-demographic, recreational screen time, and PA questions from three combined cycles of the Canadian Health Measures Survey, the PA, SB, and CVD risk factors of adults living with and without CVD were compared.

Results: A total of 7,035 Canadian adults who reported living with (n=363) and without (n=6,672) CVD were included.

Spatial and temporal analysis of West Nile virus infection in mosquito and human populations based on arboviral detection testing data.

West Nile virus (WNV) is a mosquito-borne zoonotic flavivirus which often causes asymptomatic infection in humans but may develop into a deadly neuroinvasive disease. In this study, we aimed to investigate variables potentially associated with human WNV infection using human and mosquito WNV surveillance and monitoring datasets, established over 20 years, from 2003 to 2022, across the province of Ontario, Canada. We combined climatic and geographic data, mosquito surveillance data (n = 3010 sites), blood donation arboviral detection testing data in the human population, and demographic and socio-economic data from Canadian population censuses.