A pilot, randomized controlled trial of Dual Daily HIV and sexually transmitted infection pre-exposure prophylaxis using tenofovir disoproxil fumarate/emtricitabine and doxycycline in gay, bisexual and other men who have sex with men and transgender women: The DuDHS Study.

Background: Men who have sex with men (MSM) and transgender women experience high sexually transmitted infection (STI) rates. This study evaluated the feasibility of doxycycline pre-exposure prophylaxis (doxyPrEP) for STI prevention in these key populations.

Methods: Sexually-active MSM and transgender women without HIV with prior syphilis were recruited.

Canadian Association of Radiologists Central Nervous System Diagnostic Imaging Referral Guideline.

The Canadian Association of Radiologists (CAR) Central Nervous System Expert Panel is made up of physicians from the disciplines of radiology, emergency medicine, neurosurgery, and neurology, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 24 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 55 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 51 recommendation statements across the 24 scenarios.

The design and rationale of the cardiac REHABilitation to improve metabolic health in Hypertrophic CardioMyopathy (REHAB-HCM) Study.

Study Objective: Hypertrophic cardiomyopathy (HCM) is the most common genetic myocardial disorder increasingly characterized by concomitant metabolic syndrome. Cardiac rehabilitation (CR) has been shown to improve metabolic parameters in populations with heart failure and myocardial infarction. However, there is a paucity of data on the impact of CR in the HCM population with metabolic syndrome.

Anesthesia for the Pregnant Patient Undergoing Intracranial Procedures.

This focused review explores the current literature on anesthetic care of pregnant patients requiring intracranial intervention. Neuropathology in pregnancy is rare, and existing evidence for management remains limited by the ethical complexities surrounding maternal and fetal research-related risks; pregnant women are typically excluded from randomized controlled trials. Physiological changes during pregnancy, combined with additional fetal considerations, alter pharmacodynamics and complicate the safety profile of maternal interventions.

Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?

Background: The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show a decreased Canal Flare Index.

Bat genomes illuminate adaptations to viral tolerance and disease resistance.

Zoonoses are infectious diseases transmitted from animals to humans. Bats have been suggested to harbour more zoonotic viruses than any other mammalian order. Infections in bats are largely asymptomatic, indicating limited tissue-damaging inflammation and immunopathology.

Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation and Hemodialysis: An International, Multicentric Registry.

Background: The net benefit of oral anticoagulation in patients with end-stage renal disease on hemodialysis (HD) is uncertain. In recent years, left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation; however, there is scant evidence of LAAC in patients on HD.

Objectives: This study aimed to assess the feasibility and safety of LAAC in patients on HD.

Organisational factors associated with burnout among emergency and internal medicine physicians: a qualitative study.

Objective: To identify physician perspectives on factors associated with physician burnout, protective factors against burnout, and to seek potential solutions for this pervasive problem.

Design: A qualitative study with semistructured focus group interviews using a systematic framework analysis.

Setting And Participants: Physicians from general internal medicine (GIM) and the emergency department (ED) at two urban tertiary care hospitals in Vancouver, Canada, were recruited.

Peripheral Artery Disease Centres of Excellence in Canada - A Call to Action.

Peripheral artery disease (PAD) is responsible for a significant burden of morbidity and mortality in Canada. Despite the publication of recent guidelines outlining the diagnosis and management of PAD, delivery of care continues to be fragmented. With a growing number of medical and surgical techniques available, Centres of Excellence are a natural evolution in the advancement of care for patients living with PAD.

Non-atherosclerotic coronary causes of myocardial infarction in women.

Ischemic heart disease is the most common cardiovascular cause of death in women worldwide. Obstructive coronary atherosclerosis is the primary cause of myocardial infarction (MI), however, non-atherosclerotic mechanisms of MI, such as spontaneous coronary artery dissection, vasospasm, microvascular dysfunction, embolization, inflammation, coronary anomalies, infectious and infiltrative causes are increasingly being recognized. Emerging data suggest that women are two to five times more likely to have an MI in the absence of coronary atherosclerosis compared to men, but they continue to remain underdiagnosed and undertreated, partly due to underdiagnosis and limited understanding of these mechanisms.

Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative Delirium: A Cluster Randomized Crossover Trial.

Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.

Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.

Is There a Need to Reassess Protein Intake Recommendations Following Metabolic Bariatric Surgery?

Purpose Of Review: Protein intake is recognized as a key nutritional factor crucial for optimizing Metabolic Bariatric Surgery (MBS) outcomes by preventing protein malnutrition, preserving fat-free mass, and inducing satiety. This paper discusses the current evidence regarding protein intake and its impact on clinical outcomes following MBS.

Recent Findings: There are considerable gaps in the understanding of protein requirements following MBS, as existing guidelines are based on limited and inconsistent reports.

EZH2 inhibition enhances the activity of Carboplatin in aggressive-variant prostate cancer cell lines.

Background: Aggressive Variant Prostate Cancers (AVPCs) are incurable malignancies. Platinum-based chemotherapies are used for the palliative treatment of AVPC. The Polycomb Repressive Complex 2 (PRC2) promotes prostate cancer progression histone H3 Lysine 27 tri-methylation (H3K27me3).

Minimally invasive compared to open surgery in patients with low-risk cervical cancer following simple hysterectomy: An exploratory analysis from the Gynegologic Cancer Intergroup/Canadian Cancer Trials Group CX.5/SHAPE trial.

Objective: The Laparoscopic Approach to Cervical Cancer trial demonstrated that minimally invasive radical hysterectomy was associated with worse disease-free survival and overall survival among women with early-stage cervical cancer. It is unknown whether this applies to patients with low-risk disease following simple hysterectomy.

Methods: Among patients who underwent simple hysterectomy in the Simple Hysterectomy And PElvic node assessment trial, univariate and multivariate Cox models were used to assess the association of minimally invasive versus open surgery with clinical outcomes, including pelvic and extra-pelvic recurrence-free survival, overall recurrence-free survival, and overall survival.

Surface immobilization of single atoms on heteroatom-doped carbon nanospheres through phenolic-mediated interfacial anchoring for highly efficient biocatalysis.

Single-atom catalysts (SACs) dispersed on support materials exhibit exceptional catalytic properties that can be fine-tuned through interactions between the single atoms and the support. However, selectively controlling the spatial location of single metal atoms while simultaneously harmonizing their coordination environment remains a significant challenge. Here, we present a phenolic-mediated interfacial anchoring (PIA) strategy to prepare SACs with Fe single atoms anchored on the surface of heteroatom-doped carbon nanospheres.

The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

Pre- and post-pandemic comparisons in cardiovascular markers: a population-based study.

Introduction: The COVID-19 pandemic, starting in 2020, raised concerns about potential long-term health impacts, including its effects on cardiovascular health and related biomarkers. This study part of the Bus Santé in Geneva, Switzerland, compared cardiovascular and metabolic profiles pre- (2016-2019) and post-pandemic (2023-2024) among individuals aged 30-75.

Methods: Participants completed questionnaires and underwent a clinical visit, including a physical examination and fasting blood test to assess lipid and glycemic profiles.

The Calgary Kids' Hand Rule: External Validation of a Prediction Model to Triage Pediatric Hand Fractures.

The Calgary Kids' Hand Rule (CKHR) is a clinical prediction rule intended to guide referral decisions for pediatric hand fractures presenting to the emergency department, identifying "complex" fractures that require surgical referral and optimizing care through better matching of patients' needs to provider expertise. The objective of this study was to externally validate the CKHR in two different tertiary pediatric hospitals in Canada. We partnered with British Columbia Children's Hospital (BCCH) and the Children's Hospital of Eastern Ontario (CHEO) to externally validate the CKHR using data from retrospective cohorts of pediatric hand fractures (via electronic medical record and x-ray review).

An Investigation of Gender Representation and Collaboration in Academic Plastic Surgery Research.

Gender disparities in academic leadership positions may be influenced by several factors, including research productivity. We aimed to describe the publication gender gap in major plastic surgery journals, assess gender-related and gender-neutral research publications, and identify any potential gender disparities associated with publication characteristics. For this cross-sectional study, we reviewed all original research publications in , and from 2014 through 2018.