Development and usability testing of a multifaceted intervention to reduce low-value injury care.

Background: Multifaceted interventions that address barriers and facilitators have been shown to be most effective for increasing the adoption of high-value care, but there is a knowledge gap on this type of intervention for the de-implementation of low-value care. Trauma is a high-risk setting for low-value care, such as unnecessary diagnostic imaging and the use of specialized resources. The aim of our study was to develop and assess the usability of a multifaceted intervention to reduce low-value injury care.

Inequities in the Use of Disease-Modifying Therapy Among Adults Living With Multiple Sclerosis in Urban and Rural Areas in Alberta, Canada.

Objectives: To compare disease-modifying therapy (DMT) use between people living with multiple sclerosis (pwMS) who resided in rural vs urban areas.

Methods: This retrospective cohort study used population-level individually linked administrative data to identify pwMS on April 1, 2019 (index date), in Alberta, Canada. DMT use was compared between pwMS who resided in rural vs urban areas during a 1-year postindex period.

Endosomal Escape and Nuclear Localization: Critical Barriers for Therapeutic Nucleic Acids.

Therapeutic nucleic acids (TNAs) including antisense oligonucleotides (ASOs) and small interfering RNA (siRNA) have emerged as promising treatment strategies for a wide variety of diseases, offering the potential to modulate gene expression with a high degree of specificity. These small, synthetic nucleic acid-like molecules provide unique advantages over traditional pharmacological agents, including the ability to target previously "undruggable" genes. Despite this promise, several biological barriers severely limit their clinical efficacy.

The Emerging Scenario of Ferroptosis in Pancreatic Cancer Tumorigenesis and Treatment.

Pancreatic cancer remains one of the most lethal forms of cancer. Currently, there is a lack of effective drug treatments for pancreatic cancer. However, as a newly discovered form of non-apoptotic cell death, ferroptosis has garnered increasing attention in relation to pancreatic cancer.

Correction: Harper et al. Alberta Childhood Cancer Survivorship Research Program. 2023, , 3932.

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The impact of oral contraceptive pill use on sympathetic transduction at rest in young females.

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Evidence-based Interventions for Youth With Concurrent Mental Health and Substance Use Disorders: A Scoping Review: Interventions fondées sur des données probantes pour les jeunes atteints de troubles concomitants de santé mentale et liés à l'usage de substances psychoactives : une étude de la portée.

Background: Mental health and substance use disorders typically onset during youth and commonly co-occur. Integrated treatment of two or more co-existing mental health and substance use disorders (i.e.

Impact of an Antenatal Family-based Behavioral Treatment with a Nutrition and Exercise Lifestyle Intervention Program on Infant Weight-for-length at Birth.

Background: World Health Organization (WHO) growth standards, including weight-for-length, are used to monitor infant size. Excessive infant weight-for-length at or above the 85th percentile is a risk for childhood overweight. Although antenatal interventions like the nutrition and exercise lifestyle intervention program (NELIP) have successfully prevented excessive gestational weight gain, strategies to improve the intervention remain of interest.

Effect of vasopressin on brain and cardiac tissue during neonatal cardiopulmonary resuscitation of asphyxiated post-transitional piglets.

Background: Epinephrine is currently the only recommended cardio-resuscitative medication for use in neonatal cardiopulmonary resuscitation (CPR), as per consensus of science and treatment recommendations. An alternative medication, vasopressin, may be beneficial, however there is limited data regarding its effect on cardiac and brain tissue following recovery from neonatal CPR.

Aim: To compare the effects of vasopressin and epinephrine during resuscitation of asphyxiated post-transitional piglets on cardiac and brain tissue injury.

Quantitative assessment of orthodontic treatments performed by graduate orthodontic students of an International School of Dentistry.

Context: Assessing and monitoring treatment quality within graduate courses are vital for maintaining high standards and addressing areas needing improvement. In this study, we evaluated the treatment quality delivered by measuring the total scores obtained from the comprehensive clinical assessment (CCA) index and the objective grading system (OGS) index.

Aims: This study aimed to evaluate the quality of orthodontic treatments administered by graduate students by using the CCA index and OGS index.

Early psilocybin intervention alleviates behavioral despair and cognitive impairment in stressed Wistar rats.

Chronic stress exerts profound effects on mental health, contributing to disorders such as depression, anxiety, and cognitive impairment. This study examines the potential of psilocybin to alleviate behavioral despair and cognitive deficits in a rodent model of chronic stress, focusing on the interplay between the Hypothalamic-Pituitary-Adrenal (HPA) axis and the Endocannabinoid System (ECS). Twenty-two male Wistar rats were divided into control and stress groups.

Validating a Case Definition for Transgender Adults Using Administrative Data.

Importance: Administrative health data serve as promising data sources to study transgender health at a population level in the absence of self-reported gender identity.

Objective: To develop and validate case definitions identifying transgender adults in administrative data compared with the reference standard of self-reported gender identity in a universal health care setting.

Design, Setting, And Participants: In this cohort study conducted in Alberta, Canada, data from provincial administrative health data sources including inpatient hospitalizations, emergency department encounters, primary care visits, prescription drug dispensations, and the provincial health insurance registry were linked and used to develop 15 case definitions (9 for transgender women and 6 for transgender men).

Emergency department trends for inguinal hernia and gallbladder disease before and after COVID-19 scheduled surgery interruptions: lessons for hospital capacity management.

Objectives: Postponing scheduled surgeries may alleviate emergency department (ED) crowding by increasing inpatient beds for ED patients but the impact of such measures are unclear. We determined if scheduled surgery cancellations for inguinal hernia and gallbladder disease during the coronavirus pandemic affected ED presentations, hospitalizations, and complications.

Methods: This database review included Albertans ≥ 18 with ED presentations for inguinal hernia and gallbladder disease from March 1, 2018 to May 31, 2022.

Cardiac fibroblast BAG3 regulates TGFBR2 signaling and fibrosis in dilated cardiomyopathy.

Loss of Bcl2-associated athanogene 3 (BAG3) is associated with dilated cardiomyopathy (DCM). BAG3 regulates sarcomere protein turnover in cardiomyocytes; however, the function of BAG3 in other cardiac cell types is understudied. In this study, we used an isogenic pair of BAG3-knockout and wild-type human induced pluripotent stem cells (hiPSCs) to interrogate the role of BAG3 in hiPSC-derived cardiac fibroblasts (CFs).

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 significant 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 potential to benefit from for 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.

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.

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).

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.