Computed Tomography Perfusion and Angiography for Death by Neurologic Criteria.

Importance: Accurate and timely confirmation of death by neurologic criteria (DNC) is essential for clinical decision-making and organ-donation processes, yet currently available ancillary tests have suboptimal diagnostic performance or limited validation.

Objectives: To determine the diagnostic accuracy, interrater reliability, and safety of brain computed tomography (CT) perfusion and CT angiography as ancillary investigations for DNC.

Design, Setting, And Participants: Between April 25, 2017, and March 10, 2021, a prospective, multicenter, blinded diagnostic accuracy cohort study was conducted in 15 adult intensive care units across Canada.

The research activities of Canadian community hospitals: A bibliometric analysis.

Community hospitals represent 90% of Canadian hospitals, yet many lack the necessary infrastructure to conduct health research. This shortfall limits patient access to research studies, reduces study efficiency, and decreases the generalizability of study results. Previous work from our group identified an increase in publications from Ontario's large community hospitals between 2013 and 2022.

Machine Learning Accurately Predicts Need for Critical Care Support in Patients Admitted to Hospital for Community-Acquired Pneumonia.

Objectives: Hospitalized community-acquired pneumonia (CAP) patients are admitted for ventilation, vasopressors, and renal replacement therapy (RRT). This study aimed to develop a machine learning (ML) model that predicts the need for such interventions and compare its accuracy to that of logistic regression (LR).

Design: This retrospective observational study trained separate models using random-forest classifier (RFC), support vector machines (SVMs), Extreme Gradient Boosting (XGBoost), and multilayer perceptron (MLP) to predict three endpoints: eventual use of invasive ventilation, vasopressors, and RRT during hospitalization.

Coenrollment in a critical care trial: Characteristics and consequences.

Background: Objectives of this study were to determine the characteristics of patients, centers and studies involved in coenrollment, and the association of coenrollment with trial metrics and patient outcomes.

Methods: This pre-planned study within a stress ulcer prophylaxis trial testing pantopazole used descriptive analyses and multilevel regression analysis to examine patterns and predictors of coenrollment among patients in an intensive care unit (ICU).

Results: Among 4821 trial participants, 1719 (35.

Increasing research capacity in Canadian community hospitals: an intrinsic descriptive case study.

Background: Canada's clinical research landscape is limited by minimal community hospital engagement. However, research participation in community hospitals may increase the speed of trial enrolment, enhance the generalizability of results and accelerate knowledge translation to community hospitals, where most Canadians receive care. Two identified barriers to community hospital participation are limited financial support and a lack of research mentorship.

Embedding a culture of research in Canadian community hospitals: a qualitative study.

Background: In Canada, academic hospitals are the principal drivers of research and medical education, while community hospitals provide patient care to a majority of the population. Benefits of increasing community hospital research include improved patient outcomes and access to research, enhanced staff satisfaction and retention and increased research efficiency and generalizability. While the resources required to build Canadian community hospital research capacity have been identified, strategies for strengthening organizational research culture in these settings are not well defined.

The burden of COVID-19 care in community and academic intensive care units in Ontario, Canada: a retrospective cohort study.

Purpose: During the COVID-19 pandemic, neighbourhoods with high material deprivation and high proportions of racialized Canadians were disproportionately affected by COVID-19. Many of these neighbourhoods were served by community hospitals. We sought to compare the burden of COVID-19 care in community and academic intensive care units (ICUs) in Ontario, Canada.

Factors influencing community intensive care unit research participation: a qualitative descriptive study.

Purpose: Community hospitals account for 90% of hospitals in Canada, but clinical research is mainly conducted in academic hospitals. Increasing community hospital research participation can improve generalizability of study results, while also accelerating study recruitment and increasing staff engagement. We aimed to identify and describe the factors that influence community intensive care unit (ICU) research participation and the development, implementation, and sustainability of a community ICU research program.

Characterizing the SARS-CoV-2 antibody response and associations with patient factors: Serological profiling of participants enrolled in the GENCOV study.

Introduction: The GENCOV study sought to evaluate serological differences between individuals with differing COVID-19 severity and outcomes. We assessed the SARS-CoV-2 antibody response of GENCOV participants cross-sectionally 1-, 6-, and 12-months following COVID-19 diagnosis to identify patient factors associated with more robust and durable humoral immune responses.

Materials And Methods: COVID-19 patients and a control cohort of vaccinated infection-naïve participants were recruited at hospital sites across the Greater Toronto Area in Ontario, Canada.

Community versus academic hospital community-acquired pneumonia patients: a nested cohort study.

Background: Most Canadians receive their care in community hospitals, yet most clinical research is conducted in academic hospitals. This study aims to compare patients with community acquired pneumonia (CAP) treated in academic and community hospitals with respect to their demographics, clinical characteristics, treatments and outcomes.

Methods: This nested observational cohort substudy of the Community Acquired Pneumonia: Toward InnoVAtive Treatment (CAPTIVATE) trial included 1,329 hospitalized adults with CAP recruited between March 1st, 2018 and September 31st, 2023 from 15 Canadian hospitals.

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.

Background: Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain.

Methods: In a multicenter, noninferiority trial, we randomly assigned hospitalized patients (including patients in the intensive care unit [ICU]) who had bloodstream infection to receive antibiotic treatment for 7 days or 14 days.

The research activities of Ontario's large community hospitals: an updated scoping review.

Background: Community hospitals provide the majority of patient care in Canada but traditionally do not participate in clinical research. The disconnect between where most patients receive their health care and where health research is conducted leads to decreased study recruitment, reduced generalizability of study results, and inequitable patient access to novel therapies. A scoping review of the research activities of Ontario's large community hospitals (LCHs) between 2013 and 2015 reported an annualized output of 266 publications.

Identification of Novel DNA Methylation Prognostic Biomarkers for AML With Normal Cytogenetics.

Purpose: AML is a hematologic cancer that is clinically heterogeneous, with a wide range of clinical outcomes. DNA methylation changes are a hallmark of AML but are not routinely used as a criterion for risk stratification. The aim of this study was to explore DNA methylation markers that could risk stratify patients with cytogenetically normal AML (CN-AML), currently classified as intermediate-risk.

Barriers to participation in biosampling-based translational research: A cross-sectional survey of Canadian critical care researchers.

Background And Objective: Collection of biosamples for translational research studies is vital for understanding biological pathways, discovering disease-related biomarkers, and identifying novel therapeutic targets. However, a lack of infrastructure for sample procurement, processing, storage, and shipping may hinder the ability of clinical research units to effectively engage in translational research. The purpose of this study was to identify the barriers to biosampling-based translational research in the critical care setting in Canada.

COVID-19 vaccine reactogenicity among participants enrolled in the GENCOV study.

Background: GENCOV is a prospective, observational cohort study of COVID-19-positive adults. Here, we characterize and compare side effects between COVID-19 vaccines and determine whether reactogenicity is exacerbated by prior SARS-CoV-2 infection.

Methods: Participants were recruited across Ontario, Canada.

The impact of COVID-19 workload on psychological distress amongst Canadian intensive care unit healthcare workers during the 1st wave of the COVID-19 pandemic: A longitudinal cohort study.

Intensive care unit healthcare workers (ICU HCW) are at risk of mental health disorders during emerging disease outbreaks. Numerous cross-sectional studies have reported psychological distress, anxiety, and depression amongst ICU HCW during the COVID-19 pandemic. However, few studies have followed HCW longitudinally, and none of these have examined the association between COVID-19 workload and mental health.

Modelling the potential increase in eligible participants in clinical trials with inclusion of community intensive care unit patients in Alberta, Canada: a decision tree analysis.

Purpose: Critical care research in Canada is conducted primarily in academically affiliated intensive care units (ICUs) with established research infrastructure. Efforts are made to engage community hospital ICUs in research, although the impacts of their inclusion in clinical research have never been explicitly quantified. We therefore sought to determine the number of additional eligible patients that could be recruited into critical care trials and the change in time to study completion if community ICUs were included in clinical research.

Small-Volume Blood Collection Tubes to Reduce Transfusions in Intensive Care: The STRATUS Randomized Clinical Trial.

Importance: Blood collection for laboratory testing in intensive care unit (ICU) patients is a modifiable contributor to anemia and red blood cell (RBC) transfusion. Most blood withdrawn is not required for analysis and is discarded.

Objective: To determine whether transitioning from standard-volume to small-volume vacuum tubes for blood collection in ICUs reduces RBC transfusion without compromising laboratory testing procedures.