Physician-reported pediatric diabetes virtual visit quality and outcome not associated with social determinants of health.

Objectives: Social determinants of health (SDH) impact diabetes outcomes. In response to COVID-19, virtual care ensured healthcare access. However, socially disadvantaged groups have less technology access and skills, leading to potential disparities.

Impacting the physical activity confidence of children with medical conditions or disabilities: A randomized controlled trial.

Objectives: Youth with medical conditions or disabilities (MCD) seldom achieve healthy physical activity recommendations. Barriers include a perceived lack of competence, fear of pain/symptom exacerbation, or physical function changes. A 12-week intervention targeting physical activity confidence was evaluated among youth with MCD.

Development and Adaptive Function in Individuals With -Related Disorders.

Background And Objectives: Developmental impairment is common in individuals with -related disorders, although descriptions are limited. We aimed to determine trajectories and outcomes of development and adaptive function.

Methods: This was a mixed retrospective cross-sectional study of individuals from an international Natural History Study, who had neurologic/neurodevelopmental disorders due to an variant.

Prevalence of Orthostatic Autonomic Dysregulation in Pediatric Concussion.

Importance: Pediatric concussion can affect the autonomic nervous system. Understanding the prevalence and characteristics of physiological autonomic dysregulation (AD) and symptom provocation following concussion is crucial for optimizing recovery and developing targeted interventions.

Objectives: To determine the prevalence of AD and symptom provocation upon postural change and to (1) explore the overlap between AD and symptom provocation, (2) apply adult orthostatic tachycardia criteria (heart rate [HR] ≥30 bpm) to this pediatric population, (3) explore associations of demographic and injury characteristics with AD and symptom provocation, and (4) characterize AD presentation and identify the predominant orthostatic sign.

Structure and function of the neuromuscular junction in health and myasthenia gravis.

The neuromuscular junction (NMJ) connects a motor neuron to a skeletal muscle cell. Cholinergic synaptic transmission enables muscle contraction, which is crucial for survival. Although synaptic communication at the NMJ is robust, with an inherent safety margin, it becomes hampered in the neuro-immunological disorder myasthenia gravis (MG).

The nutritional adequacy of the ketogenic diet in paediatric epilepsy: Detailed nutrient analysis and dietary recommendations.

Background And Aims: Much of the focus of ketogenic diet (KD) literature has been on the macronutrient profile, as the appropriate distribution of carbohydrate, fat and protein is essential to inducing ketosis. Few studies have evaluated the micronutrient adequacy of the KD in paediatric epilepsy, despite the importance of adequate vitamin and mineral intake in growth and development. Our study evaluated the nutritional adequacy of the Modified Atkins Diet (MAD) and Classical Ketogenic Diet (CKD) in children with epilepsy, relative to baseline diets and Nutrient Reference Values (NRVs).

Carbene formation as a mechanism for efficient intracellular uptake of cationic antimicrobial carbon acid polymers.

Cationic polymers have emerged as promising next-generation antimicrobial agents, albeit with inherent limitations such as low potency and limited biocompatibility. Classical cationic polymers kill bacteria via physical membrane disruption. We propose a non-classical mechanism of crossing the bacterial plasma membrane barrier, a step required for subsequent inhibition of intracellular targets, by cationic polymers which are carbon acids.

Healthcare utilization in drug-resistant epilepsy: A retrospective cohort study into factors predictive of success during short pediatric EMU admissions.

Objective: The Epilepsy Monitoring Unit (EMU) plays a crucial role in a patient's diagnosis and management of seizures and epilepsy. This is a resource-intensive test; therefore, it is beneficial to be able to predict which patients may need a short admission and which patients may require repeated admissions. The duration of stay required to obtain adequate information is not clear, especially in the pediatric population.

Thrombectomy Versus Medical Management for Pediatric Arterial Ischemic Stroke With Large Baseline Infarct.

Background: Multiple recent randomized trials have demonstrated the benefit of thrombectomy over medical management alone in adult patients with large vessel occlusion (LVO) stroke and large infarct on baseline imaging. Cohort studies have also identified improved functional outcomes in pediatric patients who received thrombectomy. However, the role of thrombectomy in pediatric stroke with large baseline infarct remains uncertain.

Current impacts of elevated CO on crop nutritional quality: a review using wheat as a case study.

This review synthesises current research findings and modelling approaches to explore the impact of elevated atmospheric carbon dioxide (eCO) concentrations on crop productivity, water and nutrient use efficiency, plant nutritional quality, and the implications for global food security. Over recent decades, rising atmospheric CO levels have sparked significant concern due to their role in driving climate change. While some studies highlight the potential benefits of eCO, such as increased crop yields and improved water-use efficiency, many recent investigations reveal a concerning decline in crop nutritional quality.

TRANSCENDENT (Transforming Research by Assessing Neuroinformatics across the Spectrum of Concussion by Embedding iNterdisciplinary Data-collection to Enable Novel Treatments): protocol for a prospective observational cohort study of concussion patients with embedded comparative effectiveness research within a network of learning health system concussion clinics in Canada.

Introduction: Concussion affects over 400 000 Canadians annually, with a range of causes and impacts on health-related quality of life. Research to date has disproportionately focused on athletes, military personnel and level I trauma centre patients, and may not be applicable to the broader community. The TRANSCENDENT Concussion Research Program aims to address patient- and clinician-identified research priorities, through the integration of clinical data from patients of all ages and injury mechanisms, patient-reported outcomes and objective biomarkers across factors of intersectionality.

Structures of the human adult muscle-type nicotinic receptor in resting and desensitized states.

Muscle-type nicotinic acetylcholine receptor (AChR) is the key signaling molecule in neuromuscular junctions. Here, we present the structures of full-length human adult receptors in complex with Fab35 in α-bungarotoxin (αBuTx)-bound resting states and ACh-bound desensitized states. In addition to identifying the conformational changes during recovery from desensitization, we also used electrophysiology to probe the effects of eight previously unstudied AChR genetic variants found in patients with congenital myasthenic syndrome (CMS), revealing they cause either slow- or fast-channel CMS characterized by prolonged or abbreviated ion channel bursts.

Cerebrospinal fluid metabolomics in autistic regression reveals dysregulation of sphingolipids and decreased β-hydroxybutyrate.

Background: Autism is highly heritable, however actionable genetic findings are only found in a minority of patients. Many people with autism suffer loss of neurodevelopmental skills, known as autistic regression. The cause of regression is poorly understood, and the diagnostic and therapeutic pathways are lacking.

Enhanced Hydrogen Evolution Reaction in Alkaline Media via Ruthenium-Chromium Atomic Pairs Modified Ruthenium Nanoparticles.

Precisely optimizing the electronic metal support interaction (EMSI) of the electrocatalysts and tuning the electronic structures of active sites are crucial for accelerating water adsorption and dissociation kinetics in alkaline hydrogen evolution reaction (HER). Herein, an effective strategy is applied to modify the electronic structure of Ru nanoparticles (Ru) by incorporating Ru single atoms (Ru) and Ru and Cr atomic pairs (RuCr) onto a nitrogen-doped carbon (N-C) support through optimized EMSI. The resulting catalyst, Ru-RuCr-N-C, shows exceptional performance for alkaline HER, achieving a six times higher turnover frequency (TOF) of 13.

Characterizing the medical and social complexity experienced by Inuit children and their families from Nunavut who access care at an urban Canadian tertiary level paediatric hospital.

We aimed to characterise the medical and social complexities experienced by Inuit children and their families from Nunavut who were cared for at a general paediatrics clinic at an urban tertiary-level hospital located in Eastern Ontario. A retrospective chart review of this cohort was completed between 2016 and 2019. Two independent reviewers extracted data from charts.

Investigating the Role of Soybean Genetic Resistance on the Production of Sclerotia.

Sclerotia serve as survival structures for many plant pathogens, including , which causes Sclerotinia stem rot (SSR) in soybeans and leads to significant yield losses. While partially resistant soybean varieties are effective in reducing SSR incidence, the relationship between resistance and sclerotial production remains unclear. This study investigated the sclerotial production of two soybean recombinant inbred lines (RILs) with differential levels of SSR resistance under both greenhouse and field conditions.

High Extracellular K Skews T-Cell Differentiation Towards Tumour Promoting Th2 and T Subsets.

Potassium ions (K) released from dying necrotic tumour cells accumulate in the tumour microenvironment (TME) and increase the local K concentration to 50 mM (high-[K]). Here, we demonstrate that high-[K] decreases expression of the T-cell receptor subunits CD3ε and CD3ζ and co-stimulatory receptor CD28 and thereby dysregulates intracellular signal transduction cascades. High-[K] also alters the metabolic profiles of T-cells, limiting the metabolism of glucose and glutamine, consistent with functional exhaustion.

The novel quinoline derivative SKA-346 as a K3.1 channel selective activator.

The calcium-activated K3.1 channel plays a crucial role in T-cell immune response. Genetic manipulation of T-cells to upregulate the expression of K channels has been shown to boost T-cell cytotoxicity in cancer.

Decreased Incidence of Pediatric Neuro-Autoimmune Disorders During COVID-19 Pandemic Restrictions.

Infections are hypothesized to trigger certain autoimmune diseases; however, there is a lack of epidemiologic data surrounding pediatric neuro-autoimmune disorders during the COVID-19 pandemic. Our retrospective study assessed the incidence of pre-defined autoimmune disorders diagnosed at the Children's Hospital of Eastern Ontario in Ottawa, Canada, between October 2017 and June 2024. Inpatient and outpatient charts were queried to identify subjects with neuro-autoimmune disorders or type 1 diabetes as a nonneurologic autoimmune comparison group.

Beware the Boxer's Fracture Imposter: Where Does the Metaphysis End and the Diaphysis Begin?

Fractures of the fifth metacarpal are a common injury. In children, they are often stable and heal uneventfully, including after closed reduction. Fractures of the metacarpal diaphysis, conversely, tend to be unstable and may require surgical intervention.

Telemedicine in Pediatric Neurology: A Survey of Patient and Provider Experience.

Background: Over recent years there has been a shift in clinical practice to support care delivery via telemedicine. This study aims to highlight the patient and provider experience of telemedicine over 2.5 years within a Canadian Pediatric Neurology clinic.

Investigating the Risk Factors Associated With Acute Neurologic Dysfunction in Pediatric Hyperglycemic Emergencies on Transport.

Objective: This study aims to identify key characteristics of hyperglycemic emergencies in pediatric patients and those at risk for acute neurologic dysfunction during transport.

Methods: We conducted a retrospective chart review of pediatric patients during interfacility transport by Ornge, Ontario's critical care transport service, from January 1, 2009, to December 31, 2019. Data were extracted from electronic patient care records and included demographic, clinical, and transport-specific variables.

Mathematics skills in children with genetic generalized epilepsy: Cognitive and clinical correlates. Preliminary results.

Impairments in mathematics have been found in children with Genetic Generalized Epilepsy (GGE), yet little is known about the underpinnings of these difficulties. The aim of this study was to investigate basic numeracy and secondary mathematics skills in GGE and explore cognitive and clinical correlates that relate to those skills. Nineteen children with GGE and 22 typically developing controls aged 8-16 years completed a neuropsychological battery which assessed: (i) basic numeracy skills: non-symbolic and symbolic magnitude comparison; (ii) secondary mathematics skills: calculation, reasoning, and fluency; and (iii) cognitive skills: intelligence, fluid reasoning, processing speed, and working memory.