Advanced search in
Research products
arrow_drop_down
Searching FieldsTerms
Any field
arrow_drop_down
includes
arrow_drop_down
Include:
The following results are related to Canada. Are you interested to view more results? Visit OpenAIRE - Explore.
12 Research products, page 1 of 2

  • Canada
  • Publications
  • Research data
  • 2021-2021
  • Restricted
  • Canadian Institutes of Health Research

10
arrow_drop_down
Relevance
arrow_drop_down
  • Restricted
    Authors: 
    Yannick Molgat-Seon; Sabina A. Guler; Carli M. Peters; Dragoş M. Vasilescu; Joseph H. Puyat; Harvey O. Coxson; Christopher J. Ryerson; Jordan A. Guenette;
    Publisher: Elsevier BV
    Project: NSERC , CIHR

    RATIONALE The pathophysiology of interstitial lung disease (ILD) impacts body composition, whereby ILD severity is linked to lower lean mass. OBJECTIVES To determine i) if pectoralis muscle area (PMA) is a surrogate for whole-body lean mass in ILD, ii) whether PMA is associated with ILD severity, and iii) if the longitudinal change in PMA is associated with pulmonary function and mortality in ILD. METHODS Patients with ILD (n = 164) were analyzed retrospectively. PMA was quantified from a chest computed tomography scan. Peripheral oxygen saturation (SpO2), 6-min walk distance (6MWD), and pulmonary function were obtained as part of routine clinical care. Dyspnea and quality of life were assessed using the UCSD Shortness of Breath Questionnaire and European Quality of Life 5 Dimensions questionnaire, respectively. RESULTS PMA was associated with whole-body lean mass (p  0.05). The annual negative PMA slope was associated with annual negative slopes in FVC, FEV1, and DLCO (all p < 0.05), but not FEV1/FVC (p = 0.46). Annual slope in PMA was associated with all-cause mortality (hazard ratio = -0.80, 95% CI:0.889-0.959; p < 0.001). CONCLUSION In patients with ILD, PMA is a suitable surrogate for whole-body lean mass. A lower PMA is associated with indices of ILD severity, which supports the notion that ILD progression may involve sarcopenia.

  • Publication . Article . 2021
    Restricted
    Authors: 
    Faizan Khan; Tobias Tritschler; Susan R Kahn; Marc A Rodger;
    Publisher: Elsevier BV
    Project: CIHR , SNSF | Development of a novel, e... (177999)

    Venous thromboembolism, comprising both deep vein thrombosis and pulmonary embolism, is a chronic illness that affects nearly 10 million people every year worldwide. Strong provoking risk factors for venous thromboembolism include major surgery and active cancer, but most events are unprovoked. Diagnosis requires a sequential work-up that combines assessment of clinical pretest probability for venous thromboembolism using a clinical score (eg, Wells score), D-dimer testing, and imaging. Venous thromboembolism can be considered excluded in patients with both a non-high clinical pretest probability and normal D-dimer concentrations. When required, ultrasonography should be done for a suspected deep vein thrombosis and CT or ventilation-perfusion scintigraphy for a suspected pulmonary embolism. Direct oral anticoagulants (DOACs) are the first-line treatment for almost all patients with venous thromboembolism (including those with cancer). After completing 3-6 months of initial treatment, anticoagulation can be discontinued in patients with venous thromboembolism provoked by a major transient risk factor. Patients whose long-term risk of recurrent venous thromboembolism outweighs the long-term risk of major bleeding, such as those with active cancer or men with unprovoked venous thromboembolism, should receive indefinite anticoagulant treatment. Pharmacological venous thromboembolism prophylaxis is generally warranted in patients undergoing major orthopaedic or cancer surgery. Ongoing research is focused on improving diagnostic strategies for suspected deep vein thrombosis, comparing different DOACs, developing safer anticoagulants, and further individualising approaches for the prevention and management of venous thromboembolism.

  • Restricted English
    Authors: 
    Faizan Khan; Tobias Tritschler; Miriam Kimpton; Philip S. Wells; Clive Kearon; Jeffrey I. Weitz; Harry R. Büller; Gary E. Raskob; Walter Ageno; Francis Couturaud; +27 more
    Countries: Italy, Netherlands, Italy
    Project: CIHR

    BACKGROUND The long-term risk for major bleeding in patients receiving extended (beyond the initial 3 to 6 months) anticoagulant therapy for a first unprovoked venous thromboembolism (VTE) is uncertain. PURPOSE To determine the incidence of major bleeding during extended anticoagulation of up to 5 years among patients with a first unprovoked VTE, overall, and in clinically important subgroups. DATA SOURCES MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception to 23 July 2021. STUDY SELECTION Randomized controlled trials (RCTs) and prospective cohort studies reporting major bleeding among patients with a first unprovoked VTE who were to receive oral anticoagulation for a minimum of 6 additional months after completing at least 3 months of initial anticoagulant treatment. DATA EXTRACTION Two reviewers independently abstracted data and assessed study quality. Unpublished data required for analyses were obtained from authors of included studies. DATA SYNTHESIS Among the 14 RCTs and 13 cohort studies included in the analysis, 9982 patients received a vitamin K antagonist (VKA) and 7220 received a direct oral anticoagulant (DOAC). The incidence of major bleeding per 100 person-years was 1.74 events (95% CI, 1.34 to 2.20 events) with VKAs and 1.12 events (CI, 0.72 to 1.62 events) with DOACs. The 5-year cumulative incidence of major bleeding with VKAs was 6.3% (CI, 3.6% to 10.0%). Among patients receiving either a VKA or a DOAC, the incidence of major bleeding was statistically significantly higher among those who were older than 65 years or had creatinine clearance less than 50 mL/min, a history of bleeding, concomitant use of antiplatelet therapy, or a hemoglobin level less than 100 g/L. The case-fatality rate of major bleeding was 8.3% (CI, 5.1% to 12.2%) with VKAs and 9.7% (CI, 3.2% to 19.2%) with DOACs. LIMITATION Data were insufficient to estimate incidence of major bleeding beyond 1 year of extended anticoagulation with DOACs. CONCLUSION In patients with a first unprovoked VTE, the long-term risks and consequences of anticoagulant-related major bleeding are considerable. This information will help inform patient prognosis and guide decision making about treatment duration for unprovoked VTE. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research. (PROSPERO: CRD42019128597).

  • Restricted
    Authors: 
    Philippe Ouellet; Simon Lafrance; Andrea Pizzi; Jean-Sébastien Roy; Jeremy Lewis; David Høyrup Christiansen; Blaise Dubois; Pierre Langevin; François Desmeules;
    Publisher: Elsevier BV
    Project: CIHR

    Abstract Objective To compare the efficacy of region-specific exercises to general exercises approaches for adults with spinal or peripheral musculoskeletal disorders (MSKDs). Data Sources Electronic searches were conducted up to April 2020 in Medline, Embase, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health. Study Selection Randomized control trials (RCTs) on the efficacy of region-specific exercises compared to general exercises approaches for adults with various MSKDs. Data Extraction Mean differences and standardized mean differences were calculated using random-effects inverse variance modeling. Eighteen RCTs (n=1719) were included. Cohorts were composed of participants with chronic neck (n=313) or low back disorders (n=1096) and knee osteoarthritis (OA) (n=310). Data Synthesis Based on low-quality evidence in the short-term and very low-quality in the mid- and long-term, there were no statistically significant differences between region-specific and general exercises in terms of pain and disability reductions for adults with spinal disorders or knee OA. Secondary analyses for pain reduction in the short-term for neck or low back disorders did not report any statistically significant differences according to very low- to low-quality of evidence. Conclusions The difference in treatment effect remains uncertain between region-specific and general exercises approaches. Based on very low- to low-quality evidence, there appear to have no differences between both types of exercise approaches for pain reduction or disability for adults with spinal disorders. Future trials may change the current conclusions. More evidence is needed for region-specific exercises compared to general exercises for other peripheral MSKDs including knee OA.

  • Restricted
    Authors: 
    Alia Arslanova; Sanam Shafaattalab; Kevin Ye; Parisa Asghari; Lisa Lin; BaRun Kim; Thomas M. Roston; Leif Hove‐Madsen; Filip Van Petegem; Shubhayan Sanatani; +6 more
    Publisher: John Wiley & Sons
    Country: Spain
    Project: CIHR

    Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a potentially lethal inherited cardiac arrhythmia condition, triggered by physical or acute emotional stress, that predominantly expresses early in life. Gain-of-function mutations in the cardiac ryanodine receptor gene (RYR2) account for the majority of CPVT cases, causing substantial disruption of intracellular calcium (Ca) homeostasis particularly during the periods of β-adrenergic receptor stimulation. However, the highly variable penetrance, patient outcomes, and drug responses observed in clinical practice remain unexplained, even for patients with well-established founder RyR2 mutations. Therefore, investigation of the electrophysiological consequences of CPVT-causing RyR2 mutations is crucial to better understand the pathophysiology of the disease. The development of strategies for reprogramming human somatic cells to human induced pluripotent stem cells (hiPSCs) has provided a unique opportunity to study inherited arrhythmias, due to the ability of hiPSCs to differentiate down a cardiac lineage. Employment of genome editing enables generation of disease-specific cell lines from healthy and diseased patient-derived hiPSCs, which subsequently can be differentiated into cardiomyocytes. This paper describes the means for establishing an hiPSC-based model of CPVT in order to recapitulate the disease phenotype in vitro and investigate underlying pathophysiological mechanisms. The framework of this approach has the potential to contribute to disease modeling and personalized medicine using hiPSC-derived cardiomyocytes. © 2021 Wiley Periodicals LLC. The authors gratefully acknowledge financial support from the Stem Cell Network(FY21/ACCT2-13 to GFT); the Canadian Institutes of Health Research Institute of Circulatory and Respiratory Health (GR020601 toGFT and FVP); and the Mining for Miraclesfund raising on behalf of the BC Children’s Hospital Foundation (to G.F.T., S.S., and F.L.). Peer reviewed

  • Restricted
    Authors: 
    Tina Moffat; Luseadra McKerracher; Sarah Oresnik; Stephanie A. Atkinson; Mary Barker; Sarah D. McDonald; Beth Murray-Davis; Deborah M. Sloboda;
    Publisher: Wiley
    Project: CIHR

    Objectives Gestational weight gain (GWG) is increasingly monitored in the United States and Canada. While promoting healthy GWG offers benefits, there may be costs with over-surveillance. We aimed to explore these costs/benefits. Methods Quantitative data from 350 pregnant survey respondents and qualitative focus group data from 43 pregnant/post-partum and care-provider participants were collected in the Mothers to Babies (M2B) study in Hamilton, Canada. We report descriptive statistics and discussion themes on GWG trajectories, advice, knowledge, perceptions, and pregnancy diet. Relationships between GWG monitoring/normalization and worry, knowledge, diet quality, and sociodemographics-namely low-income and racialization-were assessed using χ2 tests and a linear regression model and contextualized with focus group data. Results Most survey respondents reported GWG outside recommended ranges but rejected the mid-20th century cultural norm of "eating for two"; many worried about gaining excessively. Conversely, respondents living in very low-income households were more likely to be gaining less than recommended GWG and to worry about gaining too little. A majority had received advice about GWG, yet half were unable to identify the range recommended for their prepregnancy BMI. This proportion was even lower for racialized respondents. Pregnancy diet quality was associated with household income, but not with receipt or understanding of GWG guidance. Care-providers encouraged normalized GWG, while worrying about the consequences of pathologizing "abnormal" GWG. Conclusions Translation of GWG recommendations should be done with a critical understanding of GWG biological normalcy. Supportive GWG monitoring and counseling should consider clinical, socioeconomic, and community contexts.

  • Restricted
    Authors: 
    Theresa Pauly; Denis Gerstorf; Maureen C. Ashe; Kenneth M. Madden; Christiane A. Hoppmann;
    Publisher: American Psychological Association (APA)
    Country: Switzerland
    Project: CIHR

    Growing evidence points to systematic linkages in various physiological indices among romantic partners. This physiological synchrony may facilitate intimacy and connectedness in couples. However, synchronous increases in physiological arousal could also hamper the respective partners' health. To shed light on the consequences of physiological synchrony as well as their potential gender specificity, the current study examined associations between everyday cortisol synchrony and levels of and subsequent changes to relationship satisfaction and non-high-density lipoprotein (non-HDL) cholesterol levels over a 3-year period. Older couples (N = 85; age range = 60-87 years) provided saliva samples for cortisol estimation 5 times daily for 7 days. They further reported their relationship satisfaction and provided a blood sample that was analyzed for lipid levels up to three times in 1-year intervals. Data were analyzed using dyadic growth curve models. Among wives, higher cortisol synchrony was associated with stronger increases in relationship satisfaction over time (b = 1.61, p = .011) but also stronger increases in non-HDL cholesterol levels over time (b = 2.02, p = .042). For husbands, higher cortisol synchrony was not significantly associated with levels or changes of relationship satisfaction but with higher non-HDL cholesterol levels at Time 1 (b = 6.54, p = .015). Synchrony may be important for bonding and relationship maintenance. However, being strongly linked to a romantic partner's physiology may also have health costs due to the accumulative burden of repeated elevations in cortisol, possibly affecting husbands and wives in different ways. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

  • Restricted
    Authors: 
    Matthew Mouawad; Owen Lailey; Per Rugaard Poulsen; Melissa O'Neil; Muriel Brackstone; Michael Lock; Brian Yaremko; Olga Shmuilovich; Anat Kornecki; Ilanit Ben Nachum; +6 more
    Publisher: Elsevier BV
    Project: CIHR

    Abstract Background and purpose To quantify intra-fraction tumor motion using imageguidance and implanted fiducial markers to determine if a 5 mm planning-target-volume (PTV) margin is sufficient for early stage breast cancer patients receiving neoadjuvant stereotactic ablative radiotherapy (SABR). Materials and methods A HydroMark© (Mammotome) fiducial was implanted at the time of biopsy adjacent to the tumor. Sixty-one patients with 62 tumours were treated prone using a 5 mm PTV margin. Motion was quantified using two methods (separate patient groups): 1) difference in 3D fiducial position pre- and post-treatment cone-beam CTs (CBCTs) in 18 patients receiving 21 Gy/1fraction (fx); 2) acquiring 2D triggered-kVimages to quantify 3D intra-fraction motion using a 2D-to-3D estimation method for 44 tumours receiving 21 Gy/1fx (n = 22) or 30 Gy/3fx (n = 22). For 2), motion was quantified by calculating the magnitude of intra-fraction positional deviation from the pretreatment CBCT. PTV margins were derived using van Herkian analysis. Results The average ± standard deviation magnitude of motion across patients was 1.3 ± 1.15 mm Left/Right (L/R), 1.0 ± 0.9 mm Inferiorly/Superiorly (I/S), and 1.8 ± 1.5 mm Anteriorly/Posteriorly (A/P). 85/105 (81%) treatment fractions had dominant anterior motion. 6/62patients (9.7%) had mean intra-fraction motion during any fraction > 5 mm in any direction, with 4 in the anterior direction. Estimated PTV margins for single and three-fx patients in the L/R, I/S, and A/P directions were 6.0x4.1x5.9 mm and 4.5x2.9x4.3 mm, respectively. Conclusion Our results suggest that a 5 mm PTV margin is sufficient for the I/S and A/P directions if a lateral kV image is acquired immediately before treatment. For the L/R direction, either further immobilization or a larger margin is required.

  • Restricted English
    Authors: 
    Lena Karlsson; Christopher L.F. Sun; Christian Torp-Pedersen; Kirstine Wodschow; Annette Kjær Ersbøll; Mads Wissenberg; Carolina Malta Hansen; Laurie J. Morrison; Timothy C. Y. Chan; Fredrik Folke;
    Country: Denmark
    Project: CIHR

    Abstract Aim Quantifying the ratio describing the difference between “true route” and “straight-line” distances from out-of-hospital cardiac arrests (OHCAs) to the closest accessible automated external defibrillator (AED) can help correct likely overestimations in AED coverage. Furthermore, we aimed to examine to what extent the closest AED based on true route distance differed from the closest AED using “straight-line”. Methods OHCAs (1994–2016) and AEDs (2016) in Copenhagen, Denmark and in Toronto, Canada (2007–2015 and 2015, respectively) were identified. Three distances were calculated between OHCA and target AED: 1) the straight-line distance (“straight-line”) to the closest AED, 2) the corresponding true route distance to the same AED (“true route”), and 3) the closest AED based only on true route distance (“shortest true route”). The ratio between “true route” and “straight-line” distance was calculated and differences in AED coverage (an OHCA ≤ 100 m of an accessible AED) were examined. Results The “straight-line” AED coverage of 100 m was 24.2% (n = 2008/8295) in Copenhagen and 6.9% (n = 964/13916) in Toronto. The corresponding “true route” distance reduced coverage to 9.5% (n = 786) and 3.8% (n = 529), respectively. The median ratio between “true route” and “straight-line” distance was 1.6 in Copenhagen and 1.4 in Toronto. In 26.1% (n = 2167) and 22.9% (n = 3181) of all Copenhagen and Toronto OHCAs respectively, the closest AED in “shortest true route” was different than the closest AED initially found by “straight-line”. Conclusions Straight-line distance is not an accurate measure of distance and overestimates the actual AED coverage compared to a more realistic true route distance by a factor 1.4–1.6.

  • Restricted
    Authors: 
    Eli Puterman; Theresa Pauly; Geralyn Ruissen; Benjamin W. Nelson; Guy Faulkner;
    Publisher: American Psychological Association (APA)
    Country: Switzerland
    Project: CIHR

    Recent technological and methodological advances have seen a rapid increase in the development and use of wearable technologies, advancing the study and practice of precision health for individuals across real-world contexts and health statuses. This narrative review highlights the recent scientific advances and emerging challenges of wearable technologies. We first review the advantages of monitoring physical activity using wearable technologies over self-reports and examine commercially available devices' reliability and validity. Next, we point to the utility of wearable technologies in naturalistic environments to examine temporal associations between physical activity with other health behaviors, psychological processes, and ambulatory markers of disease that can inform the clinical practice of precision health. We further identify studies that use wearable technologies to facilitate behavior change across different populations, highlighting the need to adapt interventions for different individuals, contexts, and disorders. Balanced against these opportunities, we also highlight several challenges facing the field of precision monitoring. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Advanced search in
Research products
arrow_drop_down
Searching FieldsTerms
Any field
arrow_drop_down
includes
arrow_drop_down
Include:
The following results are related to Canada. Are you interested to view more results? Visit OpenAIRE - Explore.
12 Research products, page 1 of 2
  • Restricted
    Authors: 
    Yannick Molgat-Seon; Sabina A. Guler; Carli M. Peters; Dragoş M. Vasilescu; Joseph H. Puyat; Harvey O. Coxson; Christopher J. Ryerson; Jordan A. Guenette;
    Publisher: Elsevier BV
    Project: NSERC , CIHR

    RATIONALE The pathophysiology of interstitial lung disease (ILD) impacts body composition, whereby ILD severity is linked to lower lean mass. OBJECTIVES To determine i) if pectoralis muscle area (PMA) is a surrogate for whole-body lean mass in ILD, ii) whether PMA is associated with ILD severity, and iii) if the longitudinal change in PMA is associated with pulmonary function and mortality in ILD. METHODS Patients with ILD (n = 164) were analyzed retrospectively. PMA was quantified from a chest computed tomography scan. Peripheral oxygen saturation (SpO2), 6-min walk distance (6MWD), and pulmonary function were obtained as part of routine clinical care. Dyspnea and quality of life were assessed using the UCSD Shortness of Breath Questionnaire and European Quality of Life 5 Dimensions questionnaire, respectively. RESULTS PMA was associated with whole-body lean mass (p  0.05). The annual negative PMA slope was associated with annual negative slopes in FVC, FEV1, and DLCO (all p < 0.05), but not FEV1/FVC (p = 0.46). Annual slope in PMA was associated with all-cause mortality (hazard ratio = -0.80, 95% CI:0.889-0.959; p < 0.001). CONCLUSION In patients with ILD, PMA is a suitable surrogate for whole-body lean mass. A lower PMA is associated with indices of ILD severity, which supports the notion that ILD progression may involve sarcopenia.

  • Publication . Article . 2021
    Restricted
    Authors: 
    Faizan Khan; Tobias Tritschler; Susan R Kahn; Marc A Rodger;
    Publisher: Elsevier BV
    Project: CIHR , SNSF | Development of a novel, e... (177999)

    Venous thromboembolism, comprising both deep vein thrombosis and pulmonary embolism, is a chronic illness that affects nearly 10 million people every year worldwide. Strong provoking risk factors for venous thromboembolism include major surgery and active cancer, but most events are unprovoked. Diagnosis requires a sequential work-up that combines assessment of clinical pretest probability for venous thromboembolism using a clinical score (eg, Wells score), D-dimer testing, and imaging. Venous thromboembolism can be considered excluded in patients with both a non-high clinical pretest probability and normal D-dimer concentrations. When required, ultrasonography should be done for a suspected deep vein thrombosis and CT or ventilation-perfusion scintigraphy for a suspected pulmonary embolism. Direct oral anticoagulants (DOACs) are the first-line treatment for almost all patients with venous thromboembolism (including those with cancer). After completing 3-6 months of initial treatment, anticoagulation can be discontinued in patients with venous thromboembolism provoked by a major transient risk factor. Patients whose long-term risk of recurrent venous thromboembolism outweighs the long-term risk of major bleeding, such as those with active cancer or men with unprovoked venous thromboembolism, should receive indefinite anticoagulant treatment. Pharmacological venous thromboembolism prophylaxis is generally warranted in patients undergoing major orthopaedic or cancer surgery. Ongoing research is focused on improving diagnostic strategies for suspected deep vein thrombosis, comparing different DOACs, developing safer anticoagulants, and further individualising approaches for the prevention and management of venous thromboembolism.

  • Restricted English
    Authors: 
    Faizan Khan; Tobias Tritschler; Miriam Kimpton; Philip S. Wells; Clive Kearon; Jeffrey I. Weitz; Harry R. Büller; Gary E. Raskob; Walter Ageno; Francis Couturaud; +27 more
    Countries: Italy, Netherlands, Italy
    Project: CIHR

    BACKGROUND The long-term risk for major bleeding in patients receiving extended (beyond the initial 3 to 6 months) anticoagulant therapy for a first unprovoked venous thromboembolism (VTE) is uncertain. PURPOSE To determine the incidence of major bleeding during extended anticoagulation of up to 5 years among patients with a first unprovoked VTE, overall, and in clinically important subgroups. DATA SOURCES MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception to 23 July 2021. STUDY SELECTION Randomized controlled trials (RCTs) and prospective cohort studies reporting major bleeding among patients with a first unprovoked VTE who were to receive oral anticoagulation for a minimum of 6 additional months after completing at least 3 months of initial anticoagulant treatment. DATA EXTRACTION Two reviewers independently abstracted data and assessed study quality. Unpublished data required for analyses were obtained from authors of included studies. DATA SYNTHESIS Among the 14 RCTs and 13 cohort studies included in the analysis, 9982 patients received a vitamin K antagonist (VKA) and 7220 received a direct oral anticoagulant (DOAC). The incidence of major bleeding per 100 person-years was 1.74 events (95% CI, 1.34 to 2.20 events) with VKAs and 1.12 events (CI, 0.72 to 1.62 events) with DOACs. The 5-year cumulative incidence of major bleeding with VKAs was 6.3% (CI, 3.6% to 10.0%). Among patients receiving either a VKA or a DOAC, the incidence of major bleeding was statistically significantly higher among those who were older than 65 years or had creatinine clearance less than 50 mL/min, a history of bleeding, concomitant use of antiplatelet therapy, or a hemoglobin level less than 100 g/L. The case-fatality rate of major bleeding was 8.3% (CI, 5.1% to 12.2%) with VKAs and 9.7% (CI, 3.2% to 19.2%) with DOACs. LIMITATION Data were insufficient to estimate incidence of major bleeding beyond 1 year of extended anticoagulation with DOACs. CONCLUSION In patients with a first unprovoked VTE, the long-term risks and consequences of anticoagulant-related major bleeding are considerable. This information will help inform patient prognosis and guide decision making about treatment duration for unprovoked VTE. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research. (PROSPERO: CRD42019128597).

  • Restricted
    Authors: 
    Philippe Ouellet; Simon Lafrance; Andrea Pizzi; Jean-Sébastien Roy; Jeremy Lewis; David Høyrup Christiansen; Blaise Dubois; Pierre Langevin; François Desmeules;
    Publisher: Elsevier BV
    Project: CIHR

    Abstract Objective To compare the efficacy of region-specific exercises to general exercises approaches for adults with spinal or peripheral musculoskeletal disorders (MSKDs). Data Sources Electronic searches were conducted up to April 2020 in Medline, Embase, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health. Study Selection Randomized control trials (RCTs) on the efficacy of region-specific exercises compared to general exercises approaches for adults with various MSKDs. Data Extraction Mean differences and standardized mean differences were calculated using random-effects inverse variance modeling. Eighteen RCTs (n=1719) were included. Cohorts were composed of participants with chronic neck (n=313) or low back disorders (n=1096) and knee osteoarthritis (OA) (n=310). Data Synthesis Based on low-quality evidence in the short-term and very low-quality in the mid- and long-term, there were no statistically significant differences between region-specific and general exercises in terms of pain and disability reductions for adults with spinal disorders or knee OA. Secondary analyses for pain reduction in the short-term for neck or low back disorders did not report any statistically significant differences according to very low- to low-quality of evidence. Conclusions The difference in treatment effect remains uncertain between region-specific and general exercises approaches. Based on very low- to low-quality evidence, there appear to have no differences between both types of exercise approaches for pain reduction or disability for adults with spinal disorders. Future trials may change the current conclusions. More evidence is needed for region-specific exercises compared to general exercises for other peripheral MSKDs including knee OA.

  • Restricted
    Authors: 
    Alia Arslanova; Sanam Shafaattalab; Kevin Ye; Parisa Asghari; Lisa Lin; BaRun Kim; Thomas M. Roston; Leif Hove‐Madsen; Filip Van Petegem; Shubhayan Sanatani; +6 more
    Publisher: John Wiley & Sons
    Country: Spain
    Project: CIHR

    Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a potentially lethal inherited cardiac arrhythmia condition, triggered by physical or acute emotional stress, that predominantly expresses early in life. Gain-of-function mutations in the cardiac ryanodine receptor gene (RYR2) account for the majority of CPVT cases, causing substantial disruption of intracellular calcium (Ca) homeostasis particularly during the periods of β-adrenergic receptor stimulation. However, the highly variable penetrance, patient outcomes, and drug responses observed in clinical practice remain unexplained, even for patients with well-established founder RyR2 mutations. Therefore, investigation of the electrophysiological consequences of CPVT-causing RyR2 mutations is crucial to better understand the pathophysiology of the disease. The development of strategies for reprogramming human somatic cells to human induced pluripotent stem cells (hiPSCs) has provided a unique opportunity to study inherited arrhythmias, due to the ability of hiPSCs to differentiate down a cardiac lineage. Employment of genome editing enables generation of disease-specific cell lines from healthy and diseased patient-derived hiPSCs, which subsequently can be differentiated into cardiomyocytes. This paper describes the means for establishing an hiPSC-based model of CPVT in order to recapitulate the disease phenotype in vitro and investigate underlying pathophysiological mechanisms. The framework of this approach has the potential to contribute to disease modeling and personalized medicine using hiPSC-derived cardiomyocytes. © 2021 Wiley Periodicals LLC. The authors gratefully acknowledge financial support from the Stem Cell Network(FY21/ACCT2-13 to GFT); the Canadian Institutes of Health Research Institute of Circulatory and Respiratory Health (GR020601 toGFT and FVP); and the Mining for Miraclesfund raising on behalf of the BC Children’s Hospital Foundation (to G.F.T., S.S., and F.L.). Peer reviewed

  • Restricted
    Authors: 
    Tina Moffat; Luseadra McKerracher; Sarah Oresnik; Stephanie A. Atkinson; Mary Barker; Sarah D. McDonald; Beth Murray-Davis; Deborah M. Sloboda;
    Publisher: Wiley
    Project: CIHR

    Objectives Gestational weight gain (GWG) is increasingly monitored in the United States and Canada. While promoting healthy GWG offers benefits, there may be costs with over-surveillance. We aimed to explore these costs/benefits. Methods Quantitative data from 350 pregnant survey respondents and qualitative focus group data from 43 pregnant/post-partum and care-provider participants were collected in the Mothers to Babies (M2B) study in Hamilton, Canada. We report descriptive statistics and discussion themes on GWG trajectories, advice, knowledge, perceptions, and pregnancy diet. Relationships between GWG monitoring/normalization and worry, knowledge, diet quality, and sociodemographics-namely low-income and racialization-were assessed using χ2 tests and a linear regression model and contextualized with focus group data. Results Most survey respondents reported GWG outside recommended ranges but rejected the mid-20th century cultural norm of "eating for two"; many worried about gaining excessively. Conversely, respondents living in very low-income households were more likely to be gaining less than recommended GWG and to worry about gaining too little. A majority had received advice about GWG, yet half were unable to identify the range recommended for their prepregnancy BMI. This proportion was even lower for racialized respondents. Pregnancy diet quality was associated with household income, but not with receipt or understanding of GWG guidance. Care-providers encouraged normalized GWG, while worrying about the consequences of pathologizing "abnormal" GWG. Conclusions Translation of GWG recommendations should be done with a critical understanding of GWG biological normalcy. Supportive GWG monitoring and counseling should consider clinical, socioeconomic, and community contexts.

  • Restricted
    Authors: 
    Theresa Pauly; Denis Gerstorf; Maureen C. Ashe; Kenneth M. Madden; Christiane A. Hoppmann;
    Publisher: American Psychological Association (APA)
    Country: Switzerland
    Project: CIHR

    Growing evidence points to systematic linkages in various physiological indices among romantic partners. This physiological synchrony may facilitate intimacy and connectedness in couples. However, synchronous increases in physiological arousal could also hamper the respective partners' health. To shed light on the consequences of physiological synchrony as well as their potential gender specificity, the current study examined associations between everyday cortisol synchrony and levels of and subsequent changes to relationship satisfaction and non-high-density lipoprotein (non-HDL) cholesterol levels over a 3-year period. Older couples (N = 85; age range = 60-87 years) provided saliva samples for cortisol estimation 5 times daily for 7 days. They further reported their relationship satisfaction and provided a blood sample that was analyzed for lipid levels up to three times in 1-year intervals. Data were analyzed using dyadic growth curve models. Among wives, higher cortisol synchrony was associated with stronger increases in relationship satisfaction over time (b = 1.61, p = .011) but also stronger increases in non-HDL cholesterol levels over time (b = 2.02, p = .042). For husbands, higher cortisol synchrony was not significantly associated with levels or changes of relationship satisfaction but with higher non-HDL cholesterol levels at Time 1 (b = 6.54, p = .015). Synchrony may be important for bonding and relationship maintenance. However, being strongly linked to a romantic partner's physiology may also have health costs due to the accumulative burden of repeated elevations in cortisol, possibly affecting husbands and wives in different ways. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

  • Restricted
    Authors: 
    Matthew Mouawad; Owen Lailey; Per Rugaard Poulsen; Melissa O'Neil; Muriel Brackstone; Michael Lock; Brian Yaremko; Olga Shmuilovich; Anat Kornecki; Ilanit Ben Nachum; +6 more
    Publisher: Elsevier BV
    Project: CIHR

    Abstract Background and purpose To quantify intra-fraction tumor motion using imageguidance and implanted fiducial markers to determine if a 5 mm planning-target-volume (PTV) margin is sufficient for early stage breast cancer patients receiving neoadjuvant stereotactic ablative radiotherapy (SABR). Materials and methods A HydroMark© (Mammotome) fiducial was implanted at the time of biopsy adjacent to the tumor. Sixty-one patients with 62 tumours were treated prone using a 5 mm PTV margin. Motion was quantified using two methods (separate patient groups): 1) difference in 3D fiducial position pre- and post-treatment cone-beam CTs (CBCTs) in 18 patients receiving 21 Gy/1fraction (fx); 2) acquiring 2D triggered-kVimages to quantify 3D intra-fraction motion using a 2D-to-3D estimation method for 44 tumours receiving 21 Gy/1fx (n = 22) or 30 Gy/3fx (n = 22). For 2), motion was quantified by calculating the magnitude of intra-fraction positional deviation from the pretreatment CBCT. PTV margins were derived using van Herkian analysis. Results The average ± standard deviation magnitude of motion across patients was 1.3 ± 1.15 mm Left/Right (L/R), 1.0 ± 0.9 mm Inferiorly/Superiorly (I/S), and 1.8 ± 1.5 mm Anteriorly/Posteriorly (A/P). 85/105 (81%) treatment fractions had dominant anterior motion. 6/62patients (9.7%) had mean intra-fraction motion during any fraction > 5 mm in any direction, with 4 in the anterior direction. Estimated PTV margins for single and three-fx patients in the L/R, I/S, and A/P directions were 6.0x4.1x5.9 mm and 4.5x2.9x4.3 mm, respectively. Conclusion Our results suggest that a 5 mm PTV margin is sufficient for the I/S and A/P directions if a lateral kV image is acquired immediately before treatment. For the L/R direction, either further immobilization or a larger margin is required.

  • Restricted English
    Authors: 
    Lena Karlsson; Christopher L.F. Sun; Christian Torp-Pedersen; Kirstine Wodschow; Annette Kjær Ersbøll; Mads Wissenberg; Carolina Malta Hansen; Laurie J. Morrison; Timothy C. Y. Chan; Fredrik Folke;
    Country: Denmark
    Project: CIHR

    Abstract Aim Quantifying the ratio describing the difference between “true route” and “straight-line” distances from out-of-hospital cardiac arrests (OHCAs) to the closest accessible automated external defibrillator (AED) can help correct likely overestimations in AED coverage. Furthermore, we aimed to examine to what extent the closest AED based on true route distance differed from the closest AED using “straight-line”. Methods OHCAs (1994–2016) and AEDs (2016) in Copenhagen, Denmark and in Toronto, Canada (2007–2015 and 2015, respectively) were identified. Three distances were calculated between OHCA and target AED: 1) the straight-line distance (“straight-line”) to the closest AED, 2) the corresponding true route distance to the same AED (“true route”), and 3) the closest AED based only on true route distance (“shortest true route”). The ratio between “true route” and “straight-line” distance was calculated and differences in AED coverage (an OHCA ≤ 100 m of an accessible AED) were examined. Results The “straight-line” AED coverage of 100 m was 24.2% (n = 2008/8295) in Copenhagen and 6.9% (n = 964/13916) in Toronto. The corresponding “true route” distance reduced coverage to 9.5% (n = 786) and 3.8% (n = 529), respectively. The median ratio between “true route” and “straight-line” distance was 1.6 in Copenhagen and 1.4 in Toronto. In 26.1% (n = 2167) and 22.9% (n = 3181) of all Copenhagen and Toronto OHCAs respectively, the closest AED in “shortest true route” was different than the closest AED initially found by “straight-line”. Conclusions Straight-line distance is not an accurate measure of distance and overestimates the actual AED coverage compared to a more realistic true route distance by a factor 1.4–1.6.

  • Restricted
    Authors: 
    Eli Puterman; Theresa Pauly; Geralyn Ruissen; Benjamin W. Nelson; Guy Faulkner;
    Publisher: American Psychological Association (APA)
    Country: Switzerland
    Project: CIHR

    Recent technological and methodological advances have seen a rapid increase in the development and use of wearable technologies, advancing the study and practice of precision health for individuals across real-world contexts and health statuses. This narrative review highlights the recent scientific advances and emerging challenges of wearable technologies. We first review the advantages of monitoring physical activity using wearable technologies over self-reports and examine commercially available devices' reliability and validity. Next, we point to the utility of wearable technologies in naturalistic environments to examine temporal associations between physical activity with other health behaviors, psychological processes, and ambulatory markers of disease that can inform the clinical practice of precision health. We further identify studies that use wearable technologies to facilitate behavior change across different populations, highlighting the need to adapt interventions for different individuals, contexts, and disorders. Balanced against these opportunities, we also highlight several challenges facing the field of precision monitoring. (PsycInfo Database Record (c) 2021 APA, all rights reserved).