Patient Complexity, Social Factors, and Hospitalization Outcomes at Academic and Community Hospitals.

Importance: There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.

Objective: To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.

Rings and Rebuttals: A Quasi-Experimental Study on the Psychological Impact of Marriage Equality on Low-Income Black Sexual Minorities in the United Kingdom.

Critiques from queer theory have suggested that the legalization of same-sex marriage (SSM) predominantly benefits White, middle-class segments of the lesbian, gay, and bisexual (LGB) community. This study investigates the impact of the legalization of SSM on mental health among Black LGB individuals, focusing on those with lower incomes in the UK. Using a nationally representative panel sample and employing a quasi-experimental methodology, we analyzed changes in psychological distress and life dissatisfaction following the legalization of SSM.

Primary Graft Dysfunction after Heart Transplantation: Current Evidence and Implications for Clinical Practice.

Purpose Of Review: This review summarizes the current literature on primary graft dysfunction highlighting the current definition, reviewing epidemiology, and describing donor, recipient, and perioperative risk factors in the contemporary era.

Recent Findings: PGD, in its most severe form, complicates 8% of heart transplants and portends a 1-year mortality of close to 40%. PGD is multifactorial and heterogeneous with contributions from donor and recipient risk as well as organ recovery and preservation modalities.

Longitudinal qualitative assessment of meaningful symptoms and relevance of WATCH-PD digital measures for people with early Parkinson's.

Background: Longitudinal qualitative data on what matters to people with Parkinson's disease are lacking and needed to guide patient-centered clinical care and development of outcome measures.

Objective: To evaluate change over time in symptoms, impacts, and relevance of digital measures to monitor disease progression in early Parkinson's.

Methods: In-depth, online symptom mapping interviews were conducted with 33 people with early Parkinson's at baseline and 1 year later to evaluate (A) symptoms, (B) impacts, and (C) relevance of digital measures to monitor personally relevant symptoms.

Outcomes of mechanical thrombectomy for medium vessel occlusion in acute ischemic stroke patients with ASPECTS 4-5 vs. 6-7: a retrospective, multicenter, and multinational study.

Introduction: Mechanical thrombectomy (MT) efficacy in medium vessel occlusion (MeVO) stroke, particularly in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS), remains less explored.

Methods: This retrospective study analyzed data from 443 AIS patients treated with MT for MeVO and low ASPECTS (4-7) at 37 centers across North America, Asia, and Europe, from September 2017 to July 2021. Patients were categorized into ASPECTS of 4-5 and 6-7.

Comparative Performance of the Leading Large Language Models in Answering Complex Rhinoplasty Consultation Questions.

Various large language models (LLMs) can provide human-level medical discussions, but they have not been compared regarding rhinoplasty knowledge. To compare the leading LLMs in answering complex rhinoplasty consultation questions as evaluated by plastic surgeons. Ten open-ended rhinoplasty consultation questions were presented to ChatGPT-4o, Google Gemini, Claude, and Meta-AI LLMs.

Associations of Th1, Th2, Th17, and Treg cell levels and imbalance with recurrent spontaneous abortion: A meta-analysis.

Objective: Abnormal levels and imbalances of T cell subsets are common in recurrent spontaneous abortion (RSA) patients, but most studies have small sample sizes, and comprehensive evaluations are lacking. Therefore, this meta-analysis aimed to comprehensively investigate T cell subsets and their ratios in RSA patients.

Methods: Four databases (PubMed, EMBASE, Web of Science, and Cochrane Library databases) were searched until 10 January 2024.

The Relationship between Body Mass Index and Level of Response to Alcohol Across the Spectrum of Alcohol Use: Total Body Water and Beyond.

Background: A low level of response (LR) to alcohol is a known risk factor for alcohol use disorder (AUD). Although higher total body water (TBW) is associated with lower blood alcohol concentrations and reduced responses following alcohol consumption, the relationship between morphometric measures such as body mass index (BMI) and LR is less clear. This study aimed to examine the relationship between BMI and LR to alcohol, and the contribution of TBW to this relationship.

Intracellular tenofovir-diphosphate concentrations in HIV pre-exposure prophylaxis users who underwent bariatric surgery.

Objective: To measure concentrations of tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) among individuals taking tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) or tenofovir alafenamide plus emtricitabine (TAF/FTC) who were scheduled to undergo or had already undergone bariatric surgery.

Methods: We enrolled pre-exposure prophylaxis (PrEP) users attending clinics in Toronto or Ottawa who were undergoing or had undergone bariatric surgery. After participants completed a minimum of 7 days of consecutive PrEP dosing, we collected DBS samples immediately before they administered their next daily dose of PrEP.

Carbapenems in the management of valproic acid overdose (MPT-01166-24 R1).

Severe valproic acid (VPA) overdose is characterized by coma (sometimes with cerebral oedema), respiratory depression, hypotension and metabolic abnormalities. Traditional management of VPA poisoning has been limited to gastrointestinal decontamination, L-carnitine supplementation and, in severe cases, haemodialysis. Recently, interest has developed in the use of carbapenem antibiotics as an adjunctive therapy in patients with severe VPA poisoning.

Naturally Acquired Genotype-Specific HPV Seroreactivity and Subsequent HPV Detection Among Heterosexual Partners.

The protective effect of naturally acquired humoral immunity against human papillomavirus (HPV) infection remains unclear. To investigate the role of infection-induced antibodies on HPV detection in heterosexual partners, we used data from 392 unvaccinated couples (females aged 18-25 years attended up to six visits over 2 years; males aged 17-37 years attended up to two visits 4 months apart) enrolled (2005-2011) in Montreal. Genital and blood samples were HPV DNA genotyped and tested for L1 antibody titers of 14 HPV genotypes.

Rapid Parallel Adaptation in Distinct Invasions of Ambrosia Artemisiifolia Is Driven by Large-Effect Structural Variants.

When introduced to multiple distinct ranges, invasive species provide a compelling natural experiment for understanding the repeatability of adaptation. Ambrosia artemisiifolia is an invasive, noxious weed, and chief cause of hay fever. Leveraging over 400 whole-genome sequences spanning the native-range in North America and 2 invasions in Europe and Australia, we inferred demographically distinct invasion histories on each continent.

Using ecological momentary assessment to quantify Δ-9-tetrahydrocannabinol and cannabidiol use across different forms of cannabis: Feasibility in a sample of Canadian young adults reporting frequent cannabis use.

Aims: To establish the feasibility of using ecological momentary assessment (EMA) to estimate total quantities of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) used across different forms of cannabis, and to assess the predictive validity of THC estimates for predicting acute cannabis-related consequences.

Design: 14-day EMA using a smartphone application to assess cannabis use in real time.

Setting: Canada.

Alexithymia and attachment on mental health of people with multiple sclerosis: The mediating role of perceived social support and loneliness.

Background: Multiple sclerosis and its progressive relapsing-remitting nature for MS patients is challenging and significantly affects the mental health of people with MS. We examined the direct effects of alexithymia and attachment on mental health and the indirect effect of attachment, alexithymia, loneliness, and perceived social support on the mental health of people with MS.

Materials And Methods: Three hundred and forty-five diagnosed with multiple sclerosis (MS) were deemed eligible for inclusion in the study and selected through the Iranian MS Association.

Identifying cognitive test scores associated with early tau burden in Alzheimer's disease.

Introduction: This study aimed to identify cognitive tests that optimally relate to tau positron emission tomography (PET) signal in the inferior temporal cortex (ITC), a neocortical region associated with early tau accumulation in Alzheimer's disease (AD).

Methods: We analyzed cross-sectional data from the harvard aging brain study (HABS) (= 128) and the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study (= 393). We used elastic net regression to identify the most robust cognitive correlates of tau PET signal in the ITC.

Utilities Associated with the Treatment of Growth Hormone Deficiency (GHD): A Time Trade-off (TTO) Study in the UK and Canada.

Purpose: Growth hormone deficiency (GHD) causes decreased growth rate in children, resulting in short stature in childhood and adulthood. Daily subcutaneous injections with growth hormone (GH) have been standard treatment. Newer weekly GH formulations now exist.

Examining the association between public health unit spending and adolescent substance use.

Background: Based on the socio-ecological model of health, socioeconomic policy is an important determinant of population health. Spending decisions by public health units (PHU) have been shown to be associated with population health outcomes. Some studies have found greater PHU spending to be associated with improved population health, while others report mixed findings, warranting further research.

Visual Acuity, Full-field Stimulus Thresholds, and Electroretinography for 4 Years in The Rate of Progression of USH2A-related Retinal Degeneration (RUSH2A) Study.

Purpose: To describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the -related Retinal Degeneration study and to assess their suitability as clinical trial endpoints.

Design: Prospective natural history study.

Participants: Participants (n = 105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included.

Patient-reported outcome measures for life participation in patients with chronic kidney disease: a systematic review.

Background: The symptoms, comorbidities and treatment burden associated with chronic kidney disease (CKD) can be debilitating and limit life participation in patients with CKD not requiring kidney replacement therapy (KRT). The aim of this study was to identify the characteristics, content and psychometric properties of patient-reported outcome measures (PROMs) used to assess life participation in patients with CKD.

Methods: We searched MEDLINE, Embase, PsycINFO and CINAHL from database inception to February 2023 for all studies that reported life participation in patients with CKD (stages 1-5 not requiring kidney replacement therapy).

Assessment of Reproductive Endocrinology and Infertility Fellowship Programs Website.

The aim of the study was to assess the comprehensiveness of the Reproductive Endocrinology and Infertility (REI) fellowship program websites in North America. All active REI fellowship program websites in the United States of America (USA) and Canada were evaluated and assessed using 72-point scoring criteria. Any fellowship programs without publicly accessible websites were excluded.

Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series.

Purpose: Optimal treatment of retroperitoneal sarcoma (RPS) remains undefined. Here, we report the feasibility of using high-dose boost radiation (3-4 Gy) to the central part of the tumor in patients with unresectable RPS.

Methods And Materials: Five patients with unresectable RPS were treated with radiation therapy using a central boost technique with intensity modulated radiation therapy.

Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD.

Introduction: The GOAL trial, a cluster randomized controlled trial, investigated the effect of comprehensive geriatric assessment (CGA) on frail older people with chronic kidney disease (CKD). This paper describes the following: (i) participant baseline characteristics, and (ii) their relationship with CKD stage and frailty severity.

Methods: Sixteen kidney outpatient clinics (clusters) were randomly allocated 1:1 to CGA or usual care.

Neonatal Encephalopathy: Novel Phenotypes and Genotypes Identified by Genome Sequencing.

Background And Objectives: Neonatal encephalopathy (NE) is characterized by an abnormal level of consciousness with or without seizures in the neonatal period. It affects 1-6/1,000 live term newborns. We applied genome sequencing (GS) in term newborns with NE to investigate the underlying genetic causes.