46,XY/46,XY Chimerism: Prenatal Presentation and Postnatal Outcome.

Background: Human chimerism is rare, and most prevalent with discordant chromosomal sex. We report a male 46,XY/46,XY chimera, born through a spontaneously conceived pregnancy to a healthy 32-year-old G1P0 Indian, African, and Scottish female and her 34-year-old healthy Chinese partner. The prenatal presentation and postnatal outcomes are described.

Rapid Brain Adaptation to Hearing Amplification: A Randomized Crossover Trial of Personal Sound Amplification Products.

Understanding speech in noise is a common challenge for older adults, often requiring increased listening effort that can deplete cognitive resources and impair higher-order functions. Hearing aids are the gold standard intervention for hearing loss, but cost and accessibility barriers have driven interest in alternatives such as Personal Sound Amplification Products (PSAPs). While PSAPs are not medical devices, they may help reduce listening effort in certain contexts, though supporting evidence remains limited.

'' Exploring long COVID (LC)'s impact on social and leisure well-being for individuals and caregivers.

Long COVID (LC) affects physical health and cognition, limiting participation in social and leisure activities. As a novel disabling condition following a COVID-19 infection, informal caregivers of those with LC have taken on expanded roles, including educating themselves on this diagnosis. Gathering insights from people living with LC (PWLC) and their caregivers is crucial for understanding its impact on well-being and identifying targeted rehabilitation practices across the LC care pathway.

Treatment of type 2 diabetes in pregnancy: Do we need to use metformin?

Maternal type 2 diabetes (T2D) is associated with an increased risk of several pregnancy complications and its prevalence is rising globally. Metformin, an oral medication that is first-line therapy for T2D outside of pregnancy, has the potential to improve glycemic control and reduce insulin requirements, without contributing to maternal hypoglycemia or weight gain. However, it crosses the placenta, and up until recently, very few clinical trials existed that studied its role in T2D pregnancies.

Benefit-risk of colchicine and spironolactone in acute myocardial infarction: a prespecified generalised pairwise comparisons analysis of the CLEAR trial.

Background: Composite outcomes in cardiovascular trials often group events of unequal clinical importance, and conventional analyses may obscure treatment trade-offs. Generalised pairwise comparisons (GPC), expressed as a win ratio (WR), allow for hierarchical ranking of events and incorporation of recurrent outcomes, providing a potentially more intuitive assessment of benefit-risk.

Methods: In a prespecified exploratory analysis of the 2×2 factorial, randomised CLEAR (Colchicine and Spironolactone in Patients with Myocardial Infarction) trial (7062 patients within 72 hours of acute myocardial infarction (MI) and percutaneous coronary intervention), we applied both time-to-first and recurrent-event GPC to reassess low-dose colchicine (0.

Prevalence, Age of Onset, Age at Diagnosis, and Family History of Hidradenitis Suppurativa in Pediatric Populations: A Systematic Review and Meta-Analysis.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent nodules and abscesses in intertriginous areas, ultimately resulting in scarring and formation of sinus tracts. HS significantly impacts quality of life and can also affect pediatric populations. We aimed to determine the prevalence, family history, age of onset, and age at diagnosis of HS in pediatric populations.

Efficacy of Stereotactic Ablative Body Radiotherapy (SABR) in uncommon subtypes of primary kidney cancer: An analysis from the International Radiosurgery Oncology Consortium of the Kidney.

Background: While stereotactic ablative body radiotherapy (SABR) is associated with excellent local control for primary renal cell carcinoma (RCC), outcomes based on clear-cell (ccRCC) and non-clear cell (nccRCC) histologies are not well defined.

Methods And Materials: Individual data of adult patient with biopsy confirmed primary RCC receiving SABR between 2007 and 2021 from 16 institutions in Australia, Canda, Germany, Japan and USA pooled. Patients with metastatic disease or upper tract urothelial carcinoma were excluded.

Patient-Reported Symptoms and Direct Health Care Costs in Head and Neck Cancer.

Importance: Head and neck cancer (HNC) and its associated treatments are associated with substantial functional, psychological, and financial consequences. Patient-reported outcome measures (PROMs) play a crucial role in capturing the full impact of disease. Understanding how PROMs are associated with health care costs is critical for cancer care planning; however, the association of health care expenditure and PROMs is yet to be clarified.

Using a novel psychosocial group intervention to improve adaption, coping and mental health outcomes following dysvascular limb amputations: A feasibility study.

Background: Individuals with lower extremity amputations (LEA) often face high rates of depression and anxiety that hinder their rehabilitation and post-discharge coping. Group therapy is a clinically and cost-effective way to address these mental health challenges, but evidence for its use with LEA inpatients is limited.

Objective: To determine the feasibility of a psychosocial group therapy intervention for individuals with dysvascular LEA undergoing inpatient rehabilitation.

Feature level quantitative ultrasound and CT information fusion to predict the outcome of head & neck cancer radiotherapy treatment: Enhanced principal component analysis.

Background: Radiation therapy is a common treatment for head and neck (H&N) cancers. Radiomic features, which are determined from biomedical imaging, can be effective biomarkers used to assess tumor heterogeneity and have been used to predict response to treatment. However, most studies employ only a single biomedical imaging modality to determine radiomic features.

Health Care Utilization and Costs in Ventilator-Dependent Children and Adults Receiving an eHealth Intervention During the COVID-19 Pandemic.

During the COVID-19 pandemic, we implemented the Long-term In-Home Ventilator Engagement (LIVE) intervention to provide virtual specialist care. Using a matched home mechanical ventilation control group, we compared publicly funded health-service utilization and costs for ventilator-dependent children and adults receiving the LIVE eHealth intervention. LIVE users were matched to controls on age, sex, ventilation type, years on ventilation, and reason for ventilation.

Accuracy of preferred language data in a multi-hospital electronic health record in Toronto, Canada.

Accurate preferred language data is a prerequisite for providing high-quality care. We investigated the accuracy of preferred language data in the electronic health record (EHR) of a large community hospital network in Toronto, Canada. We conducted a point-prevalence audit of patients admitted to intensive care, internal medicine, and nephrology services at three hospitals.

Integrating Continuing Professional Development, Continuing Education, and Quality Improvement: A Case Study and Implications for Practice.

Continuing professional development (CPD) and quality improvement (QI) are both dedicated to improving clinical practice and health outcomes. Although leaders in both disciplines have long recommended closer alignment, few case studies have demonstrated how such alignment can be developed and sustained within a health care system. Kaiser Permanente Colorado is an integrated health care delivery system in the United States that has worked toward coordination of CPD and QI for >20 years.

Association of Neighborhood Socioeconomic Status and Ethnic Diversity with Failure to Rescue in Curative-intent Colorectal Cancer Surgery: A Population-based Cohort Study.

Objective: To examine the association between neighborhood-level socioeconomic status (SES) and ethnic diversity and failure to rescue (FTR) after curative-intent colorectal cancer (CRC) resection.

Background Of Data: FTR is an outcome reflecting a system's ability to detect and treat clinical deterioration after complications. However, little is known about how social characteristics influence FTR in oncologic populations.

Emerging pharmacotherapies for brain metastases: a spotlight on angiogenesis inhibitors.

Introduction: Brain metastases represent a major cause of morbidity and mortality in cancer patients and are challenging to manage due to the protective blood-brain barrier and the aggressive nature of intracranial disease. Angiogenesis, particularly mediated by vascular endothelial growth factor (VEGF) and integrin pathways, plays a critical role in the growth and progression of brain metastases. Inhibiting angiogenesis has emerged as a therapeutic strategy to control tumor progression, reduce edema, and improve clinical outcomes.

Establishing a framework of measurement for use in Long COVID research and practice: protocol for a scoping review involving evidence review and consultation.

Introduction: Our aim is to develop a Framework of Measurement for people living with Long COVID and their caregivers for use in Long COVID research and clinical practice. Specifically, we will characterise evidence pertaining to outcome measurement and identify implementation considerations for use of outcome measures among adults and children living with Long COVID and their caregivers.

Methods And Analysis: We will conduct a scoping study involving: (1) an evidence review and (2) a two-phased consultation, using methodological steps outlined by the Arksey and O'Malley Framework and Joanna Briggs Institute.

Sex Differences in Cardiovascular Health Status and Long-Term Outcomes in a Primary Prevention Cohort.

Background: Poor cardiovascular health quantified by 8 health behaviors and factors is associated with incident cardiovascular disease (CVD). However, it is not clear if this association differs between women and men.

Objectives: The aim of the study was to determine whether the association between cardiovascular health status and incident CVD events differs by sex.

Efficacy and Safety of Transcatheter Mitral Valve Edge-to-Edge Repair with a MitraClip Device in Real-World Canadian Practice.

Background: Mitral transcatheter edge-to-edge repair (M-TEER) is a treatment option for patients with symptomatic mitral regurgitation (MR). The real-world experience with M-TEER in Canada has not been reported previously.

Methods: We conducted an observational study of 1191 patients from 11 Canadian centres undergoing M-TEER with a MitraClip device (Abbott, location).

Uptake of novel evidence-based therapies in patients with type 2 diabetes after a cardiovascular event: insights from CANHEART.

Background: A cardiovascular (CV) hospitalization is a seminal opportunity to implement guideline-directed medical therapy (GDMT). Sodium-glucose transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1RAs) can improve outcomes among those with type 2 diabetes mellitus (T2DM) and CV disease.

Methods: We conducted a population-based cohort study among patients aged ≥ 66 years with T2DM in Ontario hospitalized for a CV event (myocardial infarction, heart failure, peripheral arterial disease, ischemic stroke) from June 2015 to March 2022, who were followed until March 2023.

Win Ratio in Biomedical Science: A Bibliometric Analysis.

Background: The win ratio (WR), introduced in 2012, has emerged as a method to analyze hierarchical composite outcomes by prioritizing clinically significant events, unlike traditional composite time-to-event analyses, which treat events equally. However, use of the WR in biomedical research beyond cardiovascular trials remains unexplored. The study aims to investigate trends in the use of the WR in biomedical research and determine the characteristics of these articles.

Evaluating measurement quality and feasibility of neurocognitive screening instruments for adult survivors of out-of-hospital cardiac arrest: A systematic review.

Aim: To systematically review and appraise the measurement properties, interpretability, and feasibility of outcome measurement instruments (OMIs) for screening neurocognitive function among adult survivors of out-of hospital cardiac arrest (OHCA).

Methods: Online databases were searched (MEDLINE, EMBASE, CENTRAL, CINAHL, PsychINFO) from inception - August 23, 2024. Included articles evaluated measurement properties, interpretability (assigning meaning to scores), and/or feasibility (ease of application) of multidomain instruments for screening neurocognitive function among OHCA survivors.