Brief Report: Evaluating Early Stage Lung Cancer Survival Patterns in Patients at the Upper Age Limit for Lung Cancer Screening.

Introduction: Older individuals have an elevated lung cancer risk but may also have substantial comorbidities that preclude curative treatment options and limit the survival benefits of screening. The objective of this study was to assess early stage lung cancer survival patterns among those at the upper age limit for screening and identify older individuals who have the potential to benefit from lung cancer screening.

Methods: We identified all early stage (I or II) lung cancers diagnosed in Alberta, Canada between 2010 and 2020.

Hidden features: CD36/SR-B2, a master regulator of macrophage phenotype/function through metabolism.

Once thought to be in a terminally differentiated state, macrophages are now understood to be highly pliable, attuned and receptive to environmental cues that control and align responses. In development of purpose, the centrality of metabolic pathways has emerged. Thus, macrophage inflammatory or reparative phenotypes are tightly linked to catabolic and anabolic metabolism, with further fine tuning of specific gene expression patterns in specific settings.

The association between adverse childhood experiences and adult cardiac function in the UK Biobank.

Aims: The importance of early life factors in determining health in later adulthood is increasingly recognized. This study evaluated the association of adverse childhood experiences (ACEs) with cardiovascular magnetic resonance (CMR) phenotypes.

Methods And Results: UK Biobank participants who had completed CMR and the self-reported questionnaire on traumatic childhood experiences were included.

Management of Patients With Refractory Reflux-Like Symptoms Despite Proton Pump Inhibitor Therapy: Evidence-Based Consensus Statements.

Background: Many patients diagnosed with gastro-oesophageal reflux disease (GERD) have persistent symptoms despite proton pump inhibitor (PPI) therapy.

Aims: The aim of this consensus is to provide evidence-based statements to guide clinicians caring for patients with refractory reflux-like symptoms (rRLS) or refractory GERD.

Methods: This consensus was developed by the International Working Group for the Classification of Oesophagitis.

Exome Sequencing in the Diagnostic Pathway for Suspected Rare Genetic Diseases: Does the Order of Testing Affect its Cost-Effectiveness?

Background: Patients with suspected rare diseases often experience lengthy and uncertain diagnostic pathways. This study aimed to estimate the cost-effectiveness of exome sequencing (ES) in different positions in the diagnostic pathway for patients suspected of having a rare genetic disease.

Methods: Data collected retrospectively from 305 patients suspected of having a rare genetic disease (RGD), who received clinical-grade ES and participated in the Canadian multicentre Care4Rare-SOLVE study, informed a discrete event simulation of the diagnostic pathway.

The association between neighbourhood marginalization and SARS-CoV-2 outcomes in patients presenting to emergency departments.

Objective: Social and economic marginalizations have been associated with inferior health outcomes in Canada. Our objective was to describe the relationship between neighbourhood marginalization and COVID-19 outcomes among patients presenting to Canadian emergency departments (ED).

Methods: We conducted an observational study among consecutive COVID-19 patients recruited from 47 hospitals participating in the Canadian COVID-19 ED Rapid Response Network (CCEDRRN) between March 3, 2020, and July 24, 2022.

Refractory myasthenia gravis treated with autologous hematopoietic stem cell transplantation.

Objectives: Patients with refractory myasthenia gravis (MG) have few treatment options. Autologous hematopoietic stem cell transplantation (HSCT) has been used to treat immune diseases; however, its use in the treatment of MG is not broadly considered. Our objective is to report on the efficacy and safety of HSCT in refractory MG.

Clinical presentations and complications of lichen sclerosus: A systematic review.

Lichen sclerosus (LS) is a chronic, inflammatory dermatosis most commonly characterized by changes in skin pigmentation and pruritus, with associated dyspareunia and genital architectural changes. There are a variety of complications associated with LS, which further worsen a patient's health-related quality of life. A systematic review was conducted to summarize the literature regarding clinical features of LS, as well as LS-associated complications.

Use of advanced topic modeling to generate domains for a preference-based index in osteoarthritis.

Background: Health-related quality of life (HRQL) is an important endpoint when evaluating the effectiveness of interventions in people living with hip and knee osteoarthritis (OA). The aim of this study was to generate domains for a new OA-specific preference-based index of HRQL in people living with hip or knee OA.

Methods: The proposed HRQL index was based on a formative measurement model.

Implementation of a High-sensitivity Troponin Assay for Adult Patients Who Present to the Emergency Department With Chest Pain: The Role of Clinical Decision Support.

Background: The objective of this study was to assess the health outcomes for patients who present to the emergency department (ED) with cardiac chest pain after the implementation of an accelerated diagnostic protocol using a high-sensitivity troponin assay (hs-TnI).

Methods: This prospective before-after cohort study used population-based linked health administrative data for adult patients who presented to a Canadian urban ED with chest pain of suspected cardiac origin over a 2-year study period. The primary outcome was ED length of stay (LOS).

Deprescribing Cardiovascular Medications in Older Adults Living with Frailty.

Certain medications have shown significant effectiveness in reducing the incidence of cardiovascular events and mortality, leading them to be among those that are prescribed most commonly for Canadian seniors. However, polypharmacy, which disproportionately affects older adults, is particularly concerning for frail individuals who are at higher risk for adverse medication-related events. The deprescribing process is the discontinuation, either immediate or gradual, of inappropriate medications, to address polypharmacy and improve outcomes.

Proximity to Practice: The Role of Technology in the Next Era of Assessment.

The integration of technology into health professions assessment has created multiple possibilities. In this paper, we focus on the challenges and opportunities of integrating technologies that are used during clinical activities or that are completed by raters after a clinical encounter. In focusing on technologies that are more proximal to practice, we identify tradeoffs with different data collection approaches.

Two cases of childhood linear immunoglobulin A bullous dermatosis following multivisceral transplant: A case report.

Childhood linear immunoglobulin A bullous dermatosis is a well-recognized autoimmune blistering dermatosis that can be idiopathic, drug-induced, secondary to autoimmune diseases, malignancies, infections, or gastrointestinal diseases including inflammatory bowel disease. However, it has not been previously associated with a history of organ transplantation. Here, we report two cases of childhood linear immunoglobulin A bullous dermatosis in young infants following multivisceral organ transplant, including one with a particularly recalcitrant course.

Illnesses Associated With Increased Length of Stay for Individuals Experiencing Homelessness: A Retrospective Cohort Study of Emergency Department Visits and Hospitalisations.

Background: Individuals experiencing homelessness (IEH) tend to have increased length of stay (LOS) in acute care settings, which negatively impacts health care costs and resource utilisation. It is unclear however, what specific factors account for this increased LOS. This study attempts to define which diagnoses most impact LOS for IEH and if there are differences based on their demographics.

Towards a histological diagnosis of childhood small vessel CNS vasculitis.

Background: Primary small vessel CNS vasculitis (sv-cPACNS) is a challenging inflammatory brain disease in children. Brain biopsy is mandatory to confirm the diagnosis. This study aims to develop and validate a histological scoring tool for diagnosing small vessel CNS vasculitis.

A systematic review of the comparative effects of sound and music interventions for intensive care unit patients' outcomes.

Background: Despite syntheses of evidence showing efficacy of music intervention for improving psychological and physiological outcomes in critically ill patients, interventions that include nonmusic sounds have not been addressed in reviews of evidence. It is unclear if nonmusic sounds in the intensive care unit (ICU) can confer benefits similar to those of music.

Objective: The aim of this study was to summarise and contrast available evidence on the effect of music and nonmusic sound interventions for the physiological and psychological outcomes of ICU patients based on the results of randomised controlled trials.

Assessing the impact of the iPeer2Peer program for adolescents with juvenile idiopathic arthritis: a mixed-methods randomized controlled trial.

Background: Juvenile Idiopathic Arthritis (JIA) is a chronic pediatric illness, whereby youth experience physical, emotional and psychosocial challenges that result in reduced health related quality of life (HRQL). Peer mentoring has been shown to improve disease self-management in adults with chronic conditions, with mixed results in younger populations. Building on our pilot work - which supported the feasibility and initial effectiveness of the iPeer2Peer program - the objective of this study was to assess the clinical effectiveness of the program in youth with JIA through a waitlist randomized controlled trial.

Association between e-health literacy and perceived importance of future pandemic preparedness in sub-saharan Africa.

Introduction: Emerging and re-emerging infectious diseases continue to pose a severe threat to public health in Sub-Saharan Africa (SSA) and globally. Community-related interventions, such as community e-Health literacy, can contribute to the preparedness to respond effectively to emerging and re-emerging infectious diseases. This study investigated the relationship between e-Health literacy and SSA countries' perceptions of the importance of readiness for potential pandemics.

Urban environment during pregnancy, cognitive abilities, motor function, and externalizing and internalizing symptoms at 2-5 years old in 3 Canadian birth cohorts.

Background: More than 80% of the Canadian population lives in urban settings. Urban areas usually bring exposure to poorer air quality, less access to green spaces, and higher building density. These environmental factors may endanger child development.

Evaluation and Comparison of the Comprehensiveness of Canadian and American Ophthalmology Residency Program Websites.

Purpose: We descriptively and comparatively evaluated the comprehensiveness of Canadian and US-accredited ophthalmology residency program websites as of August 28, 2024.

Methods: Using Canadian Resident Matching Service ( = 15) and US Fellowship and Residency Electronic Interactive Database ( = 125), we assessed website content across seven criteria: recruitment, faculty, residents, education/research, teaching, benefits, and community. Two independent reviewers used a 40-point system, with Kruskal-Wallis and post-hoc pairwise tests for analysis by country and funding model.

Unraveling Ruminant Feed Efficiency Through Metabolomics: A Systematic Review.

Background: Advancements in metabolomic technologies have revolutionized our understanding of feed efficiency (FE) in livestock, offering new pathways to enhance both profitability and sustainability in ruminant production.

Methods: This review offers a critical and systematic evaluation of the metabolomics methods used to measure and assess FE in ruminants. We conducted a comprehensive search of PubMed, Web of Science, and Scopus databases, covering publications from 1971 to 2023.

Canadian Consensus Recommendations for Predictive Biomarker Testing in Gastric and Gastroesophageal Junction Adenocarcinoma.

Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify patients who can benefit from their use.

Fertility-Related Concerns in Long-Term Survivors of Childhood Cancer: A Canadian Cohort Study.

Survivors of childhood cancer face reduced fertility, which can be a significant cause for concern. Our study aimed to assess the prevalence of fertility-related concerns and identify associated factors. Self-report data were collected with the Long-Term Survivor Questionnaire at the Alberta Children's Hospital's Long-Term Survivor Clinic (LTSC) between January 2021 and September 2023.