Outcomes of Total Ankle Replacement Versus Ankle Arthrodesis for the Treatment of End-Stage Ankle Arthritis: A Concise Follow-up, at a Minimum of 10 Years, of a Previous Report.

Abstract: Despite the increasing utilization of total ankle replacement (TAR) for end-stage ankle arthritis, there remains a paucity of long-term follow-up data comparing arthroplasty to arthrodesis. The aim of the current paper was to provide the long-term clinical outcomes of TAR and ankle arthrodesis (AA), measured with use of validated scoring instruments, in a prospective multicenter cohort of patients with ankle arthritis. This cohort from the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database comprised patients who underwent TAR or AA between 2001 and 2007.

Restrictive versus Liberal Transfusion in Myocardial Infarction - A Patient-Level Meta-Analysis.

Background: Clinical guidelines have concluded that there are insufficient data to provide recommendations for the hemoglobin threshold for the use of red cell transfusion in patients with acute myocardial infarction (MI) and anemia. After the recent publication of the Myocardial Infarction and Transfusion (MINT) trial, we performed an individual patient-level data meta-analysis to evaluate the effect of restrictive versus liberal blood transfusion strategies.

Methods: We conducted searches in major databases.

Pressure estimation of ultra-high frequency ultrasound using gas vesicles.

Acoustic microscopy uses ultra-high frequency (UHF) ultrasound transducers over 80 MHz to perform high-resolution imaging. The pressure output of these transducers is unknown, as commercial calibrated hydrophones can measure pressure for transducers with frequencies only up to 80 MHz. This study used gas vesicle nanostructures (GVs) that collapse at 571 kPa to estimate the pressure of UHF transducers at 40, 80, 200, and 375 MHz.

Chronic active lesions in multiple sclerosis: classification, terminology, and clinical significance.

In multiple sclerosis (MS), increasing disability is considered to occur due to persistent, chronic inflammation trapped within the central nervous system (CNS). This condition, known as smoldering neuroinflammation, is present across the clinical spectrum of MS and is currently understood to be relatively resistant to treatment with existing disease-modifying therapies. Chronic active white matter lesions represent a key component of smoldering neuroinflammation.

Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients.

Objectives: To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients.

Design: Population-based retrospective cohort study emulating a target trial.

Setting And Participants: Linked, individual-level health system data were obtained from older adults (≥65 years of age) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.

Breaking Down Bias: A Methodological Primer on Identifying, Evaluating, and Mitigating Bias in Cardiovascular Research.

Systematic error, often referred to as bias is an inherent challenge in observational cardiovascular research, and has the potential to profoundly influence the design, conduct, and interpretation of study results. If not carefully considered and managed, bias can lead to spurious results, which can misinform clinical practice or public health initiatives and compromise patient outcomes. This methodological primer offers a concise introduction to the identification, evaluation, and mitigation of bias in observational cardiovascular research studies assessing the causal association of an exposure (or treatment) on an outcome.

Detecting occult hemorrhage and retroperitoneal bleeding using a new protocol called the UFOH protocol: Ultrasound Focused Occult Hemorrhage.

Point-of-care abdominal ultrasound (US) has emerged as a powerful tool for clinicians and is becoming a routine bedside tool to rapidly diagnose, manage hemodynamics, monitor fluid status, and guide procedures in emergency and critical care. Extended focused assessment with sonography for trauma (eFAST), is commonly used to detect free intraperitoneal blood in the trauma setting and may also be an option in non-trauma patients. However, it has significant limitations for detecting gastrointestinal or retroperitoneal bleeding.

Integrating cancer into crisis: a global vision for action from WHO and partners.

More than a billion people live in fragile, conflict-affected, and vulnerable settings requiring humanitarian support, where cancer is a substantial health issue. Despite its substantial effect on populations, cancer care remains underprioritised in emergency preparedness and response frameworks and humanitarian operational planning. This Policy Review summarises the perspectives and actionable recommendations from the First Global High-Level Technical Meeting on Non-communicable Diseases in Humanitarian Settings, with a focus on cancer.

Performance of ChatGPT in French language analysis of multimodal retinal cases.

Purpose: Prior literature has suggested a reduced performance of large language models (LLMs) in non-English analyses, including Arabic and French. However, there are no current studies testing the multimodal performance of ChatGPT in French ophthalmology cases, and comparing this to the results observed in the English literature. We compared the performance of ChatGPT-4 in French and English on open-ended prompts using multimodal input data from retinal cases.

De-escalating and discontinuing disease-modifying therapies in multiple sclerosis.

The development of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) has been highly successful in recent decades. It is now widely accepted that early initiation of DMTs after disease onset is associated with a better long-term prognosis. However, the question of when and how to de-escalate or discontinue DMTs remains open and critical.

Photoacoustic imaging of metabolic activities across biological length scales.

Imaging is ubiquitous with biomedical research and discovery. This article surveys the role of imaging in our understanding of metabolism, and introduces photoacoustic imaging as a compelling candidate for providing high-resolution, label-free, and real-time insights into metabolic processes. As a rapidly evolving modality, photoacoustics holds promising preclinical and clinical potential in imaging of metabolism as well as metabolism-related changes.

Cerebral spinal fluid analyses and therapeutic implications for leptomeningeal metastatic disease.

Purpose: To review applications of cerebral spinal fluid (CSF) biomarkers for the diagnosis, monitoring and treatment of leptomeningeal metastatic disease (LMD) among patients with metastatic solid tumors.

Methods: A narrative review identified original research related to CSF biomarkers among patients with metastatic solid tumors and LMD. Pre-clinical research (e.

Safety and Efficacy of Intravenous Thrombolysis by Infarct Type in Patients with No Visible Occlusion: A Secondary Analysis of the AcT Trial.

Background: About 25% of patients with acute ischemic stroke have lacunar infarct on follow-up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or efficacy of intravenous thrombolysis by infarct type in patients with no visible occlusion. We also determined if this effect differed between tenecteplase and alteplase.

Pre-alerts from critical care ambulances to trauma centers: a quantitative survey of trauma team leaders in Ontario, Canada.

Introduction: Pre-alerts from paramedics to trauma centers are important for ensuring the highest quality of trauma care. Despite this, there is a paucity of data to support best practices in trauma pre-alert notifications. Within the trauma system of Ontario, Canada, the provincial critical care transport organization, Ornge, provides pre-alerts to major trauma centers, but standardization is currently lacking.

The landscape of primary mismatch repair deficient gliomas in children, adolescents, and young adults: a multi-cohort study.

Background: Gliomas are a major cause of cancer-related death among children, adolescents, and young adults (age 0-40 years). Primary mismatch repair deficiency (MMRD) is a pan-cancer mechanism with unique biology and therapeutic opportunities. We aimed to determine the extent and impact of primary MMRD in gliomas among children, adolescents, and young adults.

International Validation of a Novel PEACE Scale to Improve the Quality of Upper Gastrointestinal Mucosal Inspection During Endoscopy.

Introduction: The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the Polprep: Effective Assessment of Cleanliness in EGD (PEACE) scale was created to assess the degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists.

Inner dialogue dysfunction and the abusive comments of the dominant hemisphere.

Inner dialogue and inner speech are normal systems of cerebral intrapersonal communication, crucial to self-awareness. Lesions affecting the cerebral network involved in these systems have been associated with the occurrence of Auditory Verbal Hallucinations (AVHs). These are regarde as a continuum phenomenon experienced by healthy, individuals, as well as those with psychiatric disorders.

Barriers and facilitators of HIV partner status notification in low- and lower-middle-income countries: A mixed-methods systematic review.

Background: The uptake of HIV partner status notification remains limited in low- and lower-middle-income countries. This mixed-methods systematic review aims to summarize the barriers and facilitators of HIV partner status notification in these settings.

Methods: We searched PubMed, Embase, CINAHL, PsychINFO, Scopus, and Web of Science from January 01, 2000, to August 31, 2023, for empirical qualitative and quantitative studies.

Changes in essential cancer medicines and association with cancer outcomes: an observational study of 158 countries.

Background: Cancer is a major cause of mortality worldwide, and differences in cancer mortality rates between countries are, in part, due to differences in access to cancer care, including medicines. National essential medicines lists (NEMLs) play a role in prioritization of healthcare expenditure and access to medicines. We examined the association between amenable cancer mortality and listing medicines used in the management of eight cancers (non-melanoma skin, uterine, breast, Hodgkin lymphoma, colon, leukemia, cervical, and testicular) in national essential medicines lists of 158 countries and summarized changes to the inclusion of cancer treatments in NEMLs.

Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry.

Background: Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.

Methods: Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents.

Deficiency of neutrophil gelatinase-associated lipocalin elicits Hemophilia-like bleeding and clotting disorder.

Coagulation is related to inflammation, but the key pathway, especially innate immune system and coagulation regulation, is not well understood and need to be further explored. Here, we demonstrated that neutrophil gelatinase-associated lipocalin (NGAL), an innate immune inflammatory mediator, is upregulated in thrombosis patients. Furthermore, it contributes to the initiation and amplification of coagulation, hemostasis, and thrombosis.

Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review.

Competent endoscopic ultrasound (EUS) performance requires a combination of technical, cognitive, and non-technical skills. Direct observation assessment tools can be employed to enhance learning and ascertain clinical competence; however, there is a need to systematically evaluate validity evidence supporting their use. We aimed to evaluate the validity evidence of competency assessment tools for EUS and examine their educational utility.