External Validation of a 5-Factor Risk Model for Breast Cancer-Related Lymphedema.

Importance: Secondary lymphedema is a common, harmful side effect of breast cancer treatment. Robust risk models that are externally validated are needed to facilitate clinical translation. A published risk model used 5 accessible clinical factors to predict the development of breast cancer-related lymphedema; this model included a patient's mammographic breast density as a novel predictive factor.

Outcomes of a Population-Based Congenital Cytomegalovirus Screening Program.

Importance: Detection of congenital cytomegalovirus (cCMV) infection has previously relied on targeted screening programs or clinical recognition; however, these approaches miss most cCMV-infected newborns and fail to identify those infants who are asymptomatic at birth but at risk for late-onset sensorineural hearing loss.

Objective: To determine the feasibility of using routinely collected newborn dried blood spots (DBS) in a population-based cCMV screen to identify infants at risk for hearing loss and describe outcomes of infants screened.

Design, Setting, And Participants: This diagnostic study of a population-based screening program in Ontario, Canada, took place from July 29, 2019, to July 31, 2023.

Randomized phase II study of bevacizumab with weekly anetumab ravtansine or weekly paclitaxel in platinum-resistant/refractory high grade ovarian cancer (NCI trial).

Purpose: Mesothelin (MSLN) is highly expressed in high grade serous/ endometrioid ovarian cancers (HGOC). Anetumab ravtansine (AR) is an antibody drug conjugate directed at MSLN antigen with a tubulin polymerization inhibitor. We assessed safety, activity and pharmacokinetics of the combination AR/bevacizumab (Bev) (ARB) versus weekly paclitaxel (wP)/Bev (PB) in patients with platinum resistant/refractory HGOC (prrHGOC).

A framework for flow time measured by Doppler ultrasound.

The duration of mechanical systole-also termed the flow time (FT) or left ventricular ejection time (LVET)-is measured by Doppler ultrasound and increasingly used as a stroke volume (SV) surrogate to guide patient care. Nevertheless, confusion exists as to the determinants of FT and a critical evaluation of this measure is needed. Using Doppler ultrasound of the left ventricular outflow tract velocity time integral (LVOT VTI) as well as strain and strain rate echocardiography as grounding principles, this brief commentary offers a model for the independent influences of FT.

Early vs. Delayed Switching from Controlled to Assisted Ventilation: A Target Trial Emulation.

Rationale: In critically ill patients receiving invasive mechanical ventilation, switching from controlled to assisted ventilation is a crucial milestone towards ventilator liberation. The optimal timing for switching to assisted ventilation has not been studied.

Objectives: Our objective was to determine whether a strategy of early as compared to delayed switching affects the duration of invasive mechanical ventilation, ICU length of stay, and mortality.

Kidney organ injury scaling: 2025 update.

The American Association for the Surgery of Trauma initially published the organ injury scaling for the kidney in 1989, which was subsequently updated in 2018. This current American Association for the Surgery of Trauma kidney organ injury scaling update incorporates the latest evidence in diagnosis and management of renal trauma and is based upon a multidisciplinary consensus. These changes reflect the near universal use of computed tomography for renal trauma evaluation and the widespread adoption of conservative management across all grades of renal trauma.

Sad Art Gives Voice to Our Own Sadness.

People tend to show greater liking for expressions of sadness when these expressions are described as art. Why does this effect arise? One obvious hypothesis would be that describing something as art makes people more likely to regard it as fictional, and people prefer expressions of sadness that are not real. We contrast this obvious hypothesis with a hypothesis derived from the philosophical literature.

Medulloblastoma Molecular Subgrouping and Outcomes Data of a Single Center From a Low- and Middle-Income Country.

Introduction: Medulloblastoma (MB) is the most common malignant childhood brain tumor. Molecular subgrouping of MB has become a major determinant of management in high-income countries. Subgrouping is still very limited in low- and middle-income countries (LMICs), and its relevance to management with the incorporation of risk stratification (low risk, standard risk, high risk, and very high risk) has yet to be evaluated in this setting.

Neutrophil-to-lymphocyte ratio at diagnosis predicts colonoscopic activity in pediatric inflammatory bowel diseases (pIBD).

Background: Neutrophil-to-lymphocyte ratio (NLR) is a novel biomarker studied in several autoimmune diseases including inflammatory bowel diseases (IBD) in adults, but poorly characterized in pediatric IBD (pIBD). We aimed to primarily investigate the relationship between NLR and pIBD endoscopic disease severity. We also examined whether NLR predicted hospitalization, surgery, and therapy response by 52 weeks.

A Multicentre Evaluation of a Ceramide-Containing Hydrating Cream-to-Foam Cleanser and Facial Moisturizing Lotion for Improving Topical Treatment Tolerability in Facial Acne.

Acne vulgaris (AV) is a common skin condition that can cause substantial psychosocial impact. Treatments of AV target clearing and prevention of lesions and reducing scarring and dyspigmentation. Numerous medications are used to target one or more of the pathogenetic factors contributing to AV.

A systematic review of current national hospital-based stroke registries monitoring access to evidence-based care and patient outcomes.

Background: National stroke clinical quality registries/audits support improvements in stroke care. In a 2016 systematic review, 28 registries were identified. Since 2016 there have been important advances in stroke care, including the development of thrombectomy services.

Larger Perfusion Mismatch Volume Is Associated With Longer Hospital Length of Stay in Medium Vessel Occlusion Stroke.

Background And Purpose: Prolonged length of stay (LOS) following a stroke is associated with unfavorable clinical outcomes. Factors predicting LOS in medium vessel occlusion (MeVO), impacting up to 40% of acute ischemic stroke (AIS) cases, remain underexplored. This study aims to investigate the predictors of LOS in AIS-MeVO.

Advances in physiological and clinical relevance of hiPSC-derived brain models for precision medicine pipelines.

Precision, or personalized, medicine aims to stratify patients based on variable pathogenic signatures to optimize the effectiveness of disease prevention and treatment. This approach is favorable in the context of brain disorders, which are often heterogeneous in their pathophysiological features, patterns of disease progression and treatment response, resulting in limited therapeutic standard-of-care. Here we highlight the transformative role that human induced pluripotent stem cell (hiPSC)-derived neural models are poised to play in advancing precision medicine for brain disorders, particularly emerging innovations that improve the relevance of hiPSC models to human physiology.

The effects of aerobic exercise and heat stress on the unbound fraction of caffeine.

Introduction: The fraction of drug circulating in the blood that is not bound to plasma proteins ( ) is considered pharmacologically active since it readily binds to its receptor. evidence suggests that changes in temperature and pH affect the affinity of drug binding to plasma proteins, resulting in changes in . In light of the well-established effects of exercise on body temperature and blood pH, we investigated whether an increase in blood temperature and decrease in pH facilitated through passive heating and exercise translated to a change in the of caffeine.

The impact of cycling on the physical and mental health, and quality of life of people with disabilities: a scoping review.

Adaptive cycling holds potential for promoting physical and mental health among individuals with disabilities, who often face barriers to traditional cycling and other forms of exercise. This scoping review systematically examines existing scientific literature to assess the effects of adaptive cycling on the physical and mental health of individuals with disabilities. Following a widely recognized methodological scoping review framework, 35 qualitative and quantitative studies were identified through comprehensive database searches and manual screenings.

Functional myocardial assessment in cine cardiac computerized tomographic angiography using echocardiographic feature-tracking software in patients with and without significant coronary disease.

Introduction: Cardiac computerized tomographic angiography (CCTA) is perceived as a non-invasive tool for assessment of coronary vessel anatomy. Feature tracking echocardiography has recently emerged as a tool for assessment of regional and global left ventricular function. We aimed to explore the applicability of echocardiographic strain on CCTA cine clips and assess whether global and regional strain parameters are associated with the extent of coronary stenosis.

Evaluating factors that impact scoring an open response situational judgment test: a mixed methods approach.

Introduction: Situational judgment tests (SJT) are commonly used in admissions to measure skills associated with professionalism. Although open-response SJTs have shown strong psychometric properties, assessors' personal beliefs, experiences, and cultural backgrounds may influence how they perceive, organize and evaluate information within test takers' diverse responses. Additionally, SJT research typically focuses on reliability and predictive validity, whereas the construct validity of open response SJTs remains underexplored.

Understanding Predictors of Crohn's Disease: Determinants of Altered Barrier Function in Pre-Disease Phase of Crohn's Disease.

The pathogenesis of Crohn's disease (CD) remains unknown. The current working theory is that genetic susceptibility influences host-microbe interactions, resulting in chronic inflammation. Case-control studies fail to explain the triggers or pathogenesis of the disease, notably due to confounding factors in patients with established disease.

Optimizing Prescribing for Individuals With Type 2 Diabetes and Chronic Kidney Disease Through the Development and Validation of Algorithms for Community Pharmacists.

Background: Diabetes is the leading cause of kidney disease and contributes to 38% of kidney failure requiring dialysis. A gap in detection and management of type 2 diabetes (T2D) in chronic kidney disease (CKD) exists in primary care. Community pharmacists are positioned to support those not able to access kidney care through traditional pathways.

Association between 24-hour movement behaviors and adiposity in children and adolescents: A compositional data meta-analysis.

Purpose: To quantitatively synthesize published evidence on the association between 24-hour movement behavior composition with adiposity in children and adolescents aged 3-18 years.

Methods: Systematic literature searches were conducted in five electronic databases to identify papers published between January 2015 and January 2024. A machine learning-assisted systematic review was conducted to identify studies applying compositional data analysis to examine the association between 24-hour movement behaviors and adiposity in children and youth.

A randomized controlled, trial on effects of mobile phone text messaging in combination with motivational interviewing versus standard infant feeding counselling on breastfeeding and child health outcomes, among women living with HIV.

Background: Despite efforts to promote optimal breastfeeding practices, the practice of exclusive breastfeeding is low in South Africa. We conducted a trial to determine whether text messaging plus motivational interviewing prolonged exclusive breastfeeding during the first six months of life and improved child health outcomes.

Methods: We conducted a randomized parallel group-controlled trial between July 2022 and May 2024, at a secondary-level healthcare facility.

Strengthening public health education and humanitarian response through academic volunteerism.

Introduction: Volunteers are an integral part of the International Red Cross and Red Crescent (RCRC) Movement, with over 16 million people actively contributing to humanitarian action worldwide. Academic volunteerism within the Movement includes contributions from students, volunteers and professionals from academic institutions who offer their time and expertise. In this study we aimed to understand the process of embedding academic volunteers in humanitarian organizations such as the Canadian Red Cross (CRC) and assess the impact of their activities within the realm of public health education.

Improving access to services in neuro-developmental disability: proceedings of a national meeting to advance community capacity.

As part of a participatory project to advance navigational service delivery systems for children with neurodevelopmental disability (NDD) and their families, this paper addresses proceedings from a capacity-building conference in Vancouver, Canada. A total of 29 invited key stakeholders attended the meeting with the following aims: knowledge sharing amongst provincial/territorial regions advancing NDD navigation capacity; sustainable action-oriented knowledge exchange; and operationalizing next steps to build navigation resources across Canadian regions. Regional representation included multiple and inter-sectoral partners (e.