Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children: an open-label, international, multicentre, randomised, non-inferiority trial.

Background: Support for the treatment of uncomplicated appendicitis with non-operative management rather than surgery has been increasing in the literature. We aimed to investigate whether treatment of uncomplicated appendicitis with antibiotics in children is inferior to appendicectomy by comparing failure rates for the two treatments.

Methods: In this pragmatic, multicentre, parallel-group, unmasked, randomised, non-inferiority trial, children aged 5-16 years with suspected non-perforated appendicitis (based on clinical diagnosis with or without radiological diagnosis) were recruited from 11 children's hospitals in Canada, the USA, Finland, Sweden, and Singapore.

Light energy-driven carbonic anhydrase mediate CO sequestration system with variable-temperature adaptability.

The escalating atmospheric CO₂ concentration urgently demands ecologically friendly mitigation strategies. Compared to alternative catalysts, carbonic anhydrase (CA) demonstrates exceptionally high catalytic efficiency in CO₂ hydration reactions. Nevertheless, traditional CA immobilization techniques exhibit peak enzymatic activity exclusively at optimal temperatures, consequently constraining their effective application across diverse environmental thermal conditions in industrial settings.

Population genomics reveals strong impacts of genetic drift without purging and guides conservation of bull and giant kelp.

Kelp forests are declining in many parts of the northeast Pacific. In small populations, genetic drift can reduce adaptive variation and increase fixation of recessive deleterious alleles, but natural selection may purge harmful variants. To understand evolutionary dynamics and inform restoration strategies, we investigated genetic structure and the outcomes of genetic drift and purging by sequencing the genomes of 429 bull kelp (Nereocystis luetkeana) and 211 giant kelp (Macrocystis sp.

Reading words versus seeing font or handwriting style: a study of hemifield processing.

Tachistoscopic studies have established a right field advantage for the perception of visually presented words, which has been interpreted as reflecting a left hemispheric specialization. However, it is not clear whether this is driven by the linguistic task of word processing, or also occurs when processing properties such as the style and regularity of text. We had 23 subjects perform a tachistoscopic study while they viewed five-letter words in either computer font or handwriting.

Immunotherapy-Resistant Neuropathic Pain and Fatigue Predict Quality-of-Life in Contactin-Associated Protein-Like 2 Antibody Disease.

The long-term clinical outcomes and associated prognostic factors in contactin-associated protein-like 2 (CASPR2)-antibody diseases are unknown. A total of 75 participants with CASPR2 antibodies were longitudinally assessed for disability, quality-of-life, and chronic pain. Although most symptoms improved within 6 months of treatment, neuropathic pain and fatigue were the most immunotherapy refractory, and persisted for up to 6 years.

Population Genomics Reveals Local Adaptation Related to Temperature Variation in Two Stream Frog Species: Implications for Vulnerability to Climate Warming.

Identifying populations at highest risk from climate change is a critical component of conservation efforts. However, vulnerability assessments are usually applied at the species level, even though intraspecific variation in exposure, sensitivity and adaptive capacity play a crucial role in determining vulnerability. Genomic data can inform intraspecific vulnerability by identifying signatures of local adaptation that reflect population-level variation in sensitivity and adaptive capacity.

Implementation effectiveness of 'Problem solving for better health' training in Lesotho using mixed methods and the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework.

Background: Healthcare resources have been concentrated in urban areas, leaving rural regions vulnerable to poorer health outcomes. The Problem Solving for Better Health (PSBH) program was implemented to enhance healthcare systems in resource-limited regions by training personnel to maximize existing resources in problem-solving. This study evaluated the implementation effectiveness of PSBH-Nursing (PSBHN), a nationally led initiative to train nurses in PSBH in Lesotho.

Safety and Efficacy of Deutetrabenazine at High versus Lower Daily Dosages in the ARC-HD Study to Treat Chorea in Huntington Disease.

Background: Huntington disease (HD) is a progressive neurodegenerative disease that causes psychiatric and neurological symptoms, including involuntary and irregular muscle movements (chorea). Chorea can disrupt activities of daily living, pose safety issues, and may lead to social withdrawal. The vesicular monoamine transporter 2 inhibitors tetrabenazine, deutetrabenazine, and valbenazine are approved treatments that can reduce chorea.

The Impact of COVID-19 on the Division of Household Labor Among Women Physicians and Advanced Practice Providers.

Background: COVID-19 increased the burden of childcare on parents, leaving women vulnerable to increased disparities in the division of domestic labor. Women healthcare workers may be at heightened risk of worsening gender parity in the workplace as a result.

Objective: To examine the impact of the COVID-19 pandemic on gender parity in the division of household responsibilities among women healthcare workers.

Electrochemical approaches for CO point source, direct air, and seawater capture: identifying opportunities and synergies.

The world is increasingly facing the direct effects of climate change triggering warnings of a crisis for the healthy existence of humankind. The dominant driver of the climate emergency is the historical and continued accumulation of atmospheric CO altering net radiative forcing on the planet. To address this global issue, understanding the core chemistry of CO manipulation in the atmosphere and proximally in the oceans is crucial, to offer a direct partial solution for emissions handling through negative emissions technologies.

How gender shapes practice choices among family medicine residents and early career family physicians: a Canadian qualitative study.

Background: The practice choices of family medicine residents and early career family physicians shape access to primary care. A growing proportion of family physicians are women.

Aim: This study examined how gender operates in shaping family physician practice choices and subsequent practice patterns.

ECLS-SHOCK and DanGer Shock: Implications for optimal temporary mechanical circulatory support use for cardiogenic shock due to acute myocardial infarction.

Despite concerted efforts to rapidly identify patients with cardiogenic shock complicating acute myocardial infarction (AMI-CS) and provide timely revascularization, early mortality remains stubbornly high. While artificially augmenting systemic flow through the use of temporary mechanical circulatory support (tMCS) devices would be expected to reduce the rate of progression to multi-organ dysfunction and thereby enhance survival, reliable evidence for benefit has remained elusive with lingering questions regarding the appropriate selection of both patients and devices, as well as the timing of device implantation relative to other critical interventions. Further complicating matters are the resource-intensive multidisciplinary systems of care that must be brought to bear in this complex patient population.

Dual controls of vapour pressure deficit and soil moisture on photosynthesis in a restored temperate bog.

Despite only covering ~3 % of the land mass, peatlands store more carbon (C) per unit area than any other ecosystem. This is due to the discrepancy between C fixed by the plants (Gross primary productivity (GPP)) and decomposition. However, this C is vulnerable to frequent, severe droughts and changes in the peatland microclimate.

Split tendon transfer of the posterior tibialis for spastic equinovarus foot deformity: Does tendon routing impact post-operative ankle kinematics?

Background: Split tendon transfer of the posterior tibialis (SPOTT) is a surgical procedure in which the split posterior tibialis tendon is transferred posterior to the fibula (PO) with insertion on the peroneus brevis tendon to rebalance the forces across the hindfoot. Routing of the split tendon through the interosseous membrane (IO) is a variation with the potential benefit of augmenting ankle dorsiflexion in swing.

Research Question: Does IO routing improve ankle dorsiflexion in swing and/or varus in stance compared to PO routing?

Methods: A retrospective chart review was completed to identify forty-two patients who underwent a SPOTT procedure for equinovarus foot deformity.

Concordance of non-invasive plasma cell-free DNA with invasive diagnostics for diagnosis of invasive fungal disease.

Background: Mold plasma cell-free DNA (cfDNA) PCR is a promising non-invasive diagnostic modality for early diagnosis of invasive mold disease (IMD) in immunocompromised patients. Although mold cfDNA PCR has been shown to be highly accurate, the value of invasive procedures to collect specimens for conventional fungal diagnostics following plasma cfDNA testing remains unclear.

Methods: This retrospective single-center cohort study included patients with mold plasma cfDNA PCR performed 7 days before or 2 days after invasive specimen collection.

Single cell approaches define neural stem cell niches and identify microglial ligands that can enhance precursor-mediated oligodendrogenesis.

Here, we used single cell RNA sequencing and single cell spatial transcriptomics to characterize the forebrain neural stem cell (NSC) niche under homeostatic and injury conditions. We defined the dorsal and lateral ventricular-subventricular zones (V-SVZs) as two distinct neighborhoods and showed that, after white matter injury, NSCs are activated to make oligodendrocytes dorsally for remyelination. This activation is coincident with an increase in transcriptionally distinct microglia in the dorsal V-SVZ niche.

A Case Report of Cryoneurolysis With Factor VIII Administration for Cerebral Palsy-related Spasticity in a Patient With Hemophilia A.

Spasticity affects up to 80% of individuals with cerebral palsy and can lead to pain and difficulties with performing activities of daily living. If left untreated, spasticity can progress to contracture and neuro-orthopedic deformities. Cryoneurolysis is an emerging and mini-invasive ultrasound-guided technique that causes secondary axonotmesis of peripheral nerves through the formation of an ice ball and may result in months to years of improved range of motion and reduced pain in patients with spasticity.

NET Models Meeting 2024 white paper: the current state of neuroendocrine tumour research models and our future aspirations.

Current models for the study of neuroendocrine tumours (NETs) are severely limited. While (e.g.

Clinical decision points for two plasma p-tau217 laboratory developed tests in neuropathology confirmed samples.

Introduction: We evaluated the diagnostic performance of two commercial plasma p-tau217 immunoassays compared to cerebrospinal fluid (CSF) testing and neuropathology.

Methods: One hundred and seventy plasma samples from the University of British Columbia Hospital Clinic for Alzheimer's (AD) and Related Disorders were analyzed for p-tau217 using Fujirebio and ALZpath assays. Decision points were determined using CSF testing and autopsy findings as the standard.

Cryoneurolysis and Quadriplegia: A Case Report on Pain and Severe Spasticity Management.

Spasticity, a common symptom after spinal cord injury, often leads to pain, muscle contracture, and compromised daily activities. Cryoneurolysis, a minimally invasive, drug-free procedure for the treatment of pain, is now gaining recognition for treating spasticity. It involves using an ultrasound-guided probe to freeze and destroy overactive target nerves.

Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment, 7th edition practice guidelines update, 2024.

The Canadian Stroke Best Practice Recommendations (CSPR) 7th edition includes this new module on the diagnosis and management of vascular cognitive impairment (VCI) with or without neurodegenerative disease. An expert writing group and people with VCI lived experience (PWLE) reviewed current evidence. Existing recommendations were reviewed and revised, and new recommendations added.

Obstructive sleep apnea in bariatric surgery patients: a population-based study.

Purpose: A high proportion of obstructive sleep apnea (OSA) remains undiagnosed. The main objectives of this study were to measure the prevalence of diagnosed OSA and determine OSA predictors in patients who underwent bariatric surgery, who are predominantly female and pre-menopausal and represent an understudied population in OSA literature.

Methods: This was a cross-sectional population-based study using the Ontario Bariatric Registry (OBR) from 2010 to 2016, linked to ICES databases which include health administrative data on all encounters within a single public-payer system.