Machine learning reveals the dynamic importance of accessory sequences for outbreak clustering.

Unlabelled: Bacterial typing at whole-genome scales is now feasible owing to decreasing costs in high-throughput sequencing and the recent advances in computation. The unprecedented resolution of whole-genome typing is achieved by genotyping the variable segments of bacterial genomes that can fluctuate significantly in gene content. However, due to the transient and hypervariable nature of many accessory elements, the value of the added resolution in outbreak investigations remains disputed.

Maternal sucrose consumption alters steroid levels in the mother, placenta, and fetus.

Maternal diet has long-term effects on offspring brain development and behavior. Sucrose (table sugar) intakes are high in modern diets, but it is not clear how a maternal high-sucrose diet (HSD) affects the offspring. In rats, a maternal HSD (26% of calories from sucrose, which is human-relevant) alters maternal metabolism and brain and also alters adult offspring endocrinology and behavior in a sex-specific manner.

Experiences of violence and hospitalization rates among people living with HIV in British Columbia, Canada.

People living with HIV (PLWH) in Canada experience high rates of interpersonal violence which may lead to adverse health outcomes that require hospitalization. Using self-reported data on experiences of violence linked to administrative health data on hospitalizations, we used Poisson regression modelling to examine and compare the associations between experiences of violence (recent [in the past 6 months], non-recent [>6 months ago], or none) and hospitalization rates, among a sample of PLWH in British Columbia, Canada. Of 984 PLWH included in this study, 60.

Patient Preferences in Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Screening and ICD Implantation: Canadian ARVC Registry Substudy.

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is typically diagnosed following an arrhythmic event or during screening after a family member experiences sudden cardiac death. Implantation of a defibrillator (ICD) improves survival but can be associated with morbidity and risks, an important consideration within a shared decision-making context. This study examined patient decisional needs and preferences surrounding ARVC screening and prophylactic ICD implantation.

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Background: Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017.

The Canadian Heart Failure (CAN-HF) Registry: A Canadian Multicentre, Retrospective Study of Outpatients with Heart Failure.

Background: Guideline-directed medical therapy (GDMT) reduces events in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Despite this impact, underutilization of GDMT persists. This report sought to describe HF management in Canadian outpatients treated at specialized HF clinics (HFCs).

Severe Edematous Facial Myositis Following Dual Influenza and COVID-19 Vaccination: A Case Report.

Idiopathic inflammatory myopathies (IIM), or myositis, are a heterogeneous group of autoimmune disorders that can affect multiple organs, including the muscles, skin, joints, lungs, heart, and gastrointestinal tract. While new-onset myositis has been reported following SARS-CoV-2 infection, cases associated with COVID-19 vaccination remain rare. We describe a unique case of severe progressive edematous facial myositis resembling angioedema in a 22-year-old man, with onset one to two weeks after receiving dual SARS-CoV-2 and influenza vaccinations.

Association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy: A retrospective cohort study from British Columbia, Canada.

Aims: We measured the association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy (OAT) for opioid use disorder.

Design: Retrospective cohort study using the British Columbia Provincial Overdose Cohort, a linked administrative database.

Setting: We used data from British Columbia, Canada, from January 2015 through February 2020.

Population-Based Analysis of the Risk of Mycobacterial Infections Associated With Immune Checkpoint Inhibitors.

In this population-based study, we examined the risk of nontuberculous mycobacterial disease associated with immune checkpoint inhibitors among people with cancer. Using a nested case-control design, we identified 184 cases and 714 matched controls; there was no significant association on conditional logistic regression (adjusted odds ratio, 0.51 [95% confidence interval, .

Secondary Immunodeficiency.

The field of medicine is constantly changing and, as healthcare providers, we are fortunate to be practicing in a time when patients are living longer and novel therapeutic options continue to evolve. However, these new advances may be associated with adverse effects that practitioners need to be aware of. Some of these impair the immune system leading to secondary immunodeficiencies (SID) that increase host susceptibility to infections and other complications.

Echocardiographic assessment of aortic regurgitation: a practical guideline from the British Society of Echocardiography.

Aortic regurgitation is the third most common valve lesion with increasing prevalence secondary to an ageing population. Transthoracic echocardiography plays a vital role in the identification and assessment of aortic regurgitation and proves essential in monitoring severity and determining the timing of intervention. Building on the foundations of previous British Society of Echocardiography (BSE) recommendations, this BSE guideline presents an update on how to approach an echocardiographic assessment of aortic regurgitation.

Integrative genomic analysis of DLBCL identifies immune environments associated with bispecific antibody response.

Most diffuse large B-cell lymphoma (DLBCL) patients treated with immunotherapies such as bispecific antibodies (BsAb) or chimeric antigen receptor (CAR) T cells fail to achieve durable treatment responses, underscoring the need for a deeper understanding of mechanisms that regulate the immune environment and response to treatment. Here, an integrative, multi-omic approach was applied to multiple large independent datasets in order to characterize DLBCL immune environments, and to define their association with tumor cell-intrinsic genomic alterations and outcomes to CD19-directed CAR T-cell and CD20 x CD3 BsAb therapies. This approach effectively segregated DLBCLs into four immune quadrants (IQ) defined by cell-of-origin and immune-related gene set expression scores.

Power assist add-ons for adult manual wheelchair users: A scoping review.

Manual wheelchairs can promote independence among users. However, the user's level of disability, strength, stamina, and the environmental conditions within which the wheelchair is used may limit manual wheelchair functionality. The use of power assist add-ons may mitigate these limitations and help individuals to age in place.

From impact metrics and open science to communicating research: Journalists' awareness of academic controversies.

This study sheds light on how journalists respond to evolving debates within academia around topics including research integrity, improper use of metrics to measure research quality and impact, and the risks and benefits of the open science movement. It does so through a codebook thematic analysis of semi-structured interviews with 19 health and science journalists from the Global North. We find that journalists' perceptions of these academic controversies vary widely, with some displaying a highly critical and nuanced understanding and others presenting a more limited awareness.

Exploring the Relevance of Indigenous Knowledges to Dementia Care in Nursing.

In this paper, we engage in philosophical inquiry to consider the relevance of Indigenous Knowledges (IKs) for reimagining dementia care for individuals living with dementia. We outline the limitations of philosophical perspectives aligned with Eurocentric academic knowledge, arguing that such knowledge relies on an individualistic view of self and neglects the body and embodied experience in dementia care. We demonstrate how a personal diachronicity perspective diminishes the importance of valuing the fluid and dynamic self-identities of persons living with dementia.

Association of MASLD Phenotypes With Liver Fibrosis in Hepatitis C: The Role of Cardiometabolic Risk Factors.

Steatotic liver disease is prevalent among people with hepatitis C virus (HCV). The new definition of metabolic dysfunction-associated steatotic liver disease (MASLD) emphasises the metabolic drivers of steatosis and recognises its frequent coexistence with other chronic liver diseases, including HCV. We aimed to evaluate the association of coexisting MASLD and HCV with liver fibrosis.

Characterization of Allobodo yubaba sp. nov. and Novijibodo darinka gen. et sp. nov., cultivable free-living species of the phylogenetically enigmatic kinetoplastid taxon Allobodonidae.

Kinetoplastids are a large and diverse protist group, spanning ecologically important free-living forms to medically important parasites. The taxon Allobodonidae holds an unresolved position within kinetoplastids, and the sole described species, Allobodo chlorophagus, is uncultivated, being a necrotroph/parasite of macroalgae. Here we describe Allobodo yubaba sp.

Ultrastructure of Olkasia polycarbonata (Euglenozoa, Euglenida) demonstrates cytoskeletal innovations associated with the feeding and flagellar apparatuses.

Euglenids are flagellates with diverse modes of nutrition, including the photosynthetic Euglenophyceae, which acquired plastids via secondary endosymbiosis with green algae, and a diverse assemblage of predators of bacteria and other microeukaryotes. Most heterotrophic euglenids have never been cultivated, so their morphology remains poorly characterized and limited to only a few studies. "Ploeotids" are a paraphyletic group representing much of the diversity of heterotrophic euglenids and are characterized by their feeding apparatus and a rigid pellicle of 10-12 longitudinally arranged strips.

Distinct patterns of genome size evolution in each bryophyte lineage are not correlated with whole genome duplication.

Background And Aims: Genome size varies by orders of magnitude across land plants, and the factors driving evolutionary increases and decreases in genome size vary across lineages. Bryophytes have the smallest genomes relative to other land plants and there is growing evidence for frequent whole genome duplication (WGD) across the lineage. However, the broad patterns of genome size, chromosome number, and WGD have yet to be characterized across bryophytes in a phylogenetic context.

The Limits and Contributions of Formal Support: Service Providers' Perspectives on Balancing Formal and Natural Support for People with Disabilities and their Families in Canada.

Evidence suggests that integrated support, combining both natural and formal supports, is often essential for individuals with developmental disabilities to achieve their preferred quality of life. However, studies are limited on how to organize supports so that people with developmental disabilities and their families find a balance between formal and natural supports. Often, there are systemic and personal boundaries around the nature and extent of support that can be offered to persons with developmental disabilities through formal mechanisms, yet the value of natural supports in the lives of persons with developmental disabilities is often undervalued in society.

Management of Labral Tears in the Hip: A Consensus Statement.

Background: Inconsistencies in the workup of labral tears in the hip have been shown to result in a delay in treatment and an increased cost to the medical system.

Purpose: To establish consensus statements among Canadian nonoperative/operative sports medicine physicians via a modified Delphi process on the diagnosis, nonoperative and operative management, and rehabilitation and return to play (RTP) of those with labral tears in the hip.

Study Design: A consensus statement.