Parental experiences of caring for their preschool children after declining vaccines: a qualitative systematic review.

Objective: This review synthesizes qualitative research about the experiences of parental caregivers enhancing their children's health after making the decision to not vaccinate their preschool children. This review aims to help health care providers understand the parental work involved in caring for under-vaccinated or unvaccinated children.

Introduction: Much of the current qualitative research literature about parents who are vaccine-hesitant or who decide not to vaccinate their children focuses on parental perceptions about the safety and efficacy of vaccines and decision-making.

The aerial epidermis is a major site of quinolizidine alkaloid biosynthesis in narrow-leafed lupin.

Lupins are promising protein crops that accumulate toxic quinolizidine alkaloids (QAs) in the seeds, complicating their end-use. QAs are synthesized in green organs (leaves, stems, and pods) and a subset of them is transported to the seeds during fruit development. The exact sites of biosynthesis and accumulation remain unknown; however, mesophyll cells have been proposed as sources, and epidermal cells as sinks.

Immunogenicity of bivalent versus monovalent mRNA booster vaccination among adult paramedics in Canada who had received three prior mRNA wild-type doses.

Comparative immunogenicity from different mRNA booster vaccines (directed at WT, BA.1 or BA.4/5 antigens) remains unclear.

Outcomes following resective and disconnective strategies in the treatment of epileptic spasms: a systematic review of the literature and individual patient data meta-analysis.

Epileptic spasms (ES) are a unique seizure type typically presenting in the form of infantile epileptic spasms syndrome (IESS) with characteristic hypsarrhythmia on scalp EEG and a preponderance with developmental delay or regression. While pharmacotherapy is the mainstay of treatment, surgical options, including disconnective or resective procedures, are increasingly recognized as viable therapeutic options for recurrent or persistent ES. However, limited data on safety, effectiveness, and prognostic factors hinder informed decision-making regarding surgery indications, timing, and intervention type.

Real-time evaluation of an automated computer vision system to monitor pain behavior in older adults.

Regular use of standardized observational tools to assess nonverbal pain behaviors results in improved pain care for older adults with severe dementia. While frequent monitoring of pain behaviors in long-term care (LTC) is constrained by resource limitations, computer vision technology has the potential to mitigate these challenges. A computerized algorithm designed to assess pain behavior in older adults with and without dementia was recently developed and validated using video recordings.

Creating a national breastfeeding and lactation policy for Canadian surgical residents.

Background: Despite known benefits of breastfeeding and challenges medical trainees face lactating at work, research specific to Canadian surgical trainees is lacking. Our objectives were to examine existing breastfeeding and lactation policies, query experiences and opinions of surgical trainees and program directors, and propose a comprehensive policy for programs nation-wide.

Methods: A multi-disciplinary team developed this two-part study.

A case study: exploring the impact of 3D printed models on cognitive integration during clinical skills training.

Background: Cognitive integration occurs when trainees make conceptual connections between relevant knowledges and is known to improve learning. While several experimental studies have demonstrated how text and audio-visual instruction can be designed to enhance cognitive integration, clinical skills training in real-world contexts may require alternative educational strategies. Introducing three-dimensional (3D) printed models during clinical skills instruction may offer unique learning opportunities to support cognitive integration.

Evaluating the Podcast as an Equity, Diversity and Inclusion resource: a cross-sectional survey analysis.

Background: Equity-deserving groups are communities marginalized from institutional power by oppressive forces (e.g., racism, sexism, homophobia, ableism).

Resident perceptions of learning challenges in concussion care education.

Background: Resident-focused curricula that support competency acquisition in concussion care are currently lacking. We sought to fill this gap by developing and evaluating Spiral Integrated Curricula (SIC) using the cognitive constructivism paradigm and the Utilization-Focused Evaluation (UFE) framework. The evidence-based curricula consisted of academic half-days (AHDs) and clinics for first- and second-year family medicine residents.

Freeze-dried plasma: Hemostasis and biophysical analyses for damage control resuscitation.

Background: Effective hemorrhage protocols prioritize immediate hemostatic resuscitation to manage hemorrhagic shock. Prehospital resuscitation using blood products, such as whole blood or alternatively dried plasma in its absence, has the potential to improve outcomes in hemorrhagic shock patients. However, integrating blood products into prehospital care poses substantial logistical challenges due to issues with storage, transport, and administration in field environments.

Early Initiation of Bundle Sheath Cells During Leaf Development as Visualised by SCARECROW Expression in Dicotyledonous C Plants.

The C type of dicotyledonous plants exhibit a higher density of reticulate veins than the C type, with a nearly 1:1 ratio of mesophyll cells (MCs) to bundle sheath cells (BSCs). To understand how this C-type cell pattern is formed, we identified two SCARECROW (SCR) genes in C Flaveria bidentis, FbSCR1 and FbSCR2, that fully or partially complement the endodermal cell layer-defective phenotype of Arabidopsis scr mutant. We then created FbSCRs promoter β-glucuronidase reporter (GUS) lines of F.

Bibliometric study and visual analysis of postoperative diabetes mellitus in kidney transplant recipients based on WoSCC database.

Background: In recent years, the increase of the post-transplantation diabetes mellitus (PTDM) after renal transplantation encourages people to do a lot of research on the disease. This paper conducted a bibliometric study on PTDM related literature to explore the risk factors of diabetes after kidney transplantation, as well as the current status, hotspots and development trends of PTDM research, so as to provide reference for researchers in related fields.

Methods: We searched the Web of Science Core Collection (WoSCC) database for PTDM literature from January 1, 1990, to August 20, 2023, and used VOSviewer, CiteSpace, and the R package 'bibliometrix' to do bibliometric analysis.

Syphilis Point of Care Rapid Test and Immediate Treatment Evaluation (SPRITE) study: a mixed-methods implementation science research protocol of eight public health units in Ontario, Canada.

Introduction: Urgent, tailored and equitable action is needed to address the alarming rise in syphilis rates in Canada. In the last decade, the rates of infectious syphilis have increased by 345% in Ontario, Canada. Underserved populations-people who use drugs, un(der)housed individuals and those living in rural and remote areas-face unique social and healthcare challenges that increase their vulnerability to syphilis infections and hinder their access to timely diagnosis and treatment.

Economic burden of acute kidney injury in children and adults: a protocol for a systematic review and meta-analysis.

Introduction: Acute kidney injury (AKI) is common in hospitalised adults and children and is associated with significantly increased mortality and worse short-term and long-term outcomes. This systematic review and meta-analysis will evaluate the cost associated with AKI.

Methods And Analysis: This health economic analysis will be performed using systematic search of databases, including MEDLINE, EMBASE, CINAHL, Scopus and Cochrane Library from 2009 to the present (search completed on 27 May 2024).

VRx@Home protocol: A virtual reality at-home intervention for persons living with dementia and their care partners.

Introduction: Virtual reality (VR) technology is increasingly used by researchers and healthcare professionals as a therapeutic intervention to improve the quality of life of persons living with dementia (PLwD). However, most VR interventions to date have mainly been explored in long-term or community care settings, with fewer being explored at home. Setting is important, given that the majority of PLwD live at home and are cared for by their family care partners.

Long-term blood glucose control via glucose-activated transcriptional regulation of insulin analogue in type 1 diabetes mice.

Aim: To achieve glucose-activated transcriptional regulation of insulin analogue in skeletal muscle of T1D mice, thereby controlling blood glucose levels and preventing or mitigating diabetes-related complications.

Materials And Methods: We developed the GANIT (Glucose-Activated NFAT-regulated INSA-F Transcription) system, an innovative platform building upon the previously established intramuscular plasmid DNA (pDNA) delivery and expression system. In the GANIT system, skeletal muscle cells are genetically engineered to endogenously produce the insulin analogue INSA-F (Insulin Aspart with Furin cleavage sites).

Epidemiology of Post-craniotomy Hypertension and Its Association With Adverse Outcome(s): A Systematic Review and Meta-analysis.

After intracranial surgery, sympathetic overdrive and increased blood catecholamine levels can contribute to postoperative hypertension, a significant clinical problem. The objective of this review was to summarize, quantify, and assess the epidemiological perspective of post-craniotomy hypertension and its association with adverse outcomes. This PROSPERO-registered systematic review was conducted following PRISMA guidelines.

Predictive equation derived from 6,497 doubly labelled water measurements enables the detection of erroneous self-reported energy intake.

Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years.

Comparison between ruptured anterior choroidal artery aneurysms and ruptured intracranial aneurysms in other locations in relation to aneurysm dimensions at rupture.

Purpose: It was noticed that anterior choroidal artery (AChoA) aneurysms appear to rupture at relatively smaller sizes compared with aneurysms in other intracranial locations, based on anecdotal clinical experience. We therefore aimed to compare ruptured AChoA aneurysms with other ruptured aneurysms in other intracranial locations, pertaining to aneurysm dimensions. This may help in finding out if the rupture risk stratification, based on the amalgamation of aneurysms of multiple locations in one group, precisely estimates aneurysm rupture risk.

Negative Staining Electron Microscopy of a Highly Flexible Sec1/Munc18 Protein Complex Stabilized by Glutaraldehyde Crosslinking.

Negative staining electron microscopy is one of the easiest ways to determine the shape and dimensions of multimeric protein complexes over 100 kDa molecular weight. This method requires small volumes (< 10 μL) of dilute protein (0.01-0.

Development and Implementation of a Structured and Innovative Faculty-Wide Mentorship Program for a Large Department of Psychiatry.

Objectives: Mentorship supports faculty to succeed in their careers with confidence, resilience, and satisfaction. To address inequities evident with an informal approach, a formal mentorship program was designed and implemented.

Methods: The Quality Implementation Framework (QIF) was applied.

Glycogen synthase GYS1 overactivation contributes to glycogen insolubility and malto-oligoglucan-associated neurodegenerative disease.

Polyglucosans are glycogen molecules with overlong chains, which are hyperphosphorylated in the neurodegenerative Lafora disease (LD). Brain polyglucosan bodies (PBs) cause fatal neurodegenerative diseases including Lafora disease and adult polyglucosan body disease (ABPD), for which treatments, biomarkers, and good understanding of their pathogenesis are currently missing. Mutations in the genes for the phosphatase laforin or the E3 ubiquitin ligase malin can cause LD.

Implementation and evaluation of a novel community-based urban mobile health clinic in Toronto, Ontario.

Setting: Despite Canada's single-payer health system, marginalized populations often experience poor health outcomes and barriers to healthcare access. In response, mobile health clinics (MHCs) have been deployed in several cities across Canada. MHCs are well established in the United States; however, little is known about their role and impact in a country with universal healthcare.

The birth of the virtual clinic: welcome to the Mediverse.

The COVID-19 pandemic triggered a global pivot to virtual care (VC) technologies. While there has been considerable academic work exploring the "how" of VC, few studies have explored the impact of this pivot, its unintended consequences, and its governing rationales. This study addresses this gap in relation to care, professional identity and the evolving requirements for health professions education.