Recent publications
This study integrates proteome analysis of human breast milk (HBM) from a homogeneous group of mothers who are of similar age and live in the same geographical area, along with an analysis of essential and potentially toxic elements in HBM in relation to lifestyle and environmental factors. This preliminary proteomic study, which examined 11 samples of HBM from lactating women, identified a total of 1619 proteins across all samples, revealing significant differences in proteomes influenced by lactation stages, parity, and exposure to tobacco smoke. The pilot study aimed to explore the feasibility of correlating certain proteins with several elements, considered as indicators of tobacco smoke and environmental influences on HBM. Notably, a clear and significant correlation was found between altered calcium content in HBM and the proteome fraction associated with calcium-binding proteins. The findings suggest that all analyzed factors impact the HBM proteome and the activity of certain enzymes.
https://doi.org/10.1016/j.foodchem.2025.142959
There has been an increased interest over the past few decades from the engineering and scientific community regarding the transportation of microplastics in open water environments. As a result of the number of processes involved in the movement and behavior of microplastics in water, as well as their significant impact on aquatic environments, the movement and behavior of microplastics in water represents a complex problem. In order to describe the behavior of particles in water, one of the most important steps is to obtain the sedimentation (or floating) velocity, also known as the terminal velocity. With the use of Computational Fluid Dynamics (CFD) coupled with Discrete Element Methods (CFD-DEM), series of numerical simulations have been conducted to investigate the vertical movement of microplastics (settling or floating) in quiescent water. Several simulations were conducted in order to evaluate the potential capabilities of the CFD-DEM method to predict the behavior of microplastics in water under various conditions. A series of simulations of the terminal velocity of microplastics that are represented by round particles has been conducted by using different types of microplastics that are represented by round particles ranging in size from 1 to 5 mm. It was found that the simulation results and experimental data were in good agreement, showing that CFD-DEM can be used as a viable approach for predicting microplastics fate and transport under a wide range of environmental conditions.
As a class of turbulence models in RANS schemes, k − ε turbulence models are widely used in simulations for engineering applications due to their computational efficiency and adequate accuracy. This study aims to investigate and evaluate the performance of four commonly used k − ε models—the standard k − ε model, the realizable k − ε model, the Renormalization Group (RNG) k − ε model, and the (q-zeta) model–on the simulation of an inclined dense jet in a stagnant water environment. The important geometrical and dilution characteristics of inclined dense jets, such as terminal rise height, location of centerline peak, horizontal location of return point/impact point, and dilution at these points, were measured and analyzed. The mixing information was also investigated through the cross section and axial direction of the jet. Four turbulence models were analyzed in terms of their ability to simulate the mixing characteristics of inclined dense jets by comparing the results with previous experimental studies. They showed good performance when the discharge angle was smaller than 60°. The model and the realizable k − ε model show more accurate results than the other two models.
Importance
Obesity is a risk factor associated with multiple myeloma (MM) and its precursor, monoclonal gammopathy of unknown significance (MGUS). However, it is unclear how cumulative exposure to obesity affects the risk of MGUS progression to MM.
Objective
To determine the association of cumulative exposure to excess body mass index (EBMI), defined as BMI (calculated as weight in kilograms divided by height in meters squared) greater than 25, with risk of MGUS progression to MM.
Design, Setting, and Participants
This cohort study included patients with MGUS, including immunoglobin G, immunoglobin A, or light chain MGUS, from the nationwide US Veterans Health Administration database from October 1, 1999, to December 31, 2021. A published natural language processing–assisted model was used to confirm diagnoses of MGUS and progression to MM. Data were analyzed from February 12 to November 4, 2024.
Exposures
Cumulative EBMI was calculated by area under the curve of measured BMI subtracting the reference BMI at 25 during the first 3 years after MGUS diagnosis.
Main Outcomes and Measures
The main outcome was progression from MGUS to MM. Multivariable Fine-Gray time-to-competing-event analyses, with death as the competing event, were used to determine associations.
Results
The cohort included 22 429 patients with MGUS (median [IQR] age, 70.5 [63.5-77.9] years; 21 613 [96.4%] male), with 8329 Black patients (37.1%) and 14 100 White patients (62.9%). There were 4862 patients (21.7%) with reference range BMI (18.5 to <25), 7619 patients (34.0%) with BMI 25 to less than 30, and 8513 patients (38.0%) with BMI 30 or greater at the time of MGUS diagnosis. Compared with reference range BMI at MGUS diagnosis, patients with BMI 25 to less than 30 (adjusted hazard ratio [aHR], 1.17; 95% CI, 1.03-1.34) or 30 or greater (aHR, 1.27; 95% CI, 1.09-1.47) at MGUS diagnosis had higher risk of progression to MM. In patients with reference range BMI at MGUS diagnosis, each 1-unit increase of EBMI per year was associated with a 21% increase in progression risk (aHR, 1.21; 95% CI, 1.04-1.40). However, for patients with BMI 25 or greater at MGUS diagnosis, the incremental risk associated with cumulative EBMI exposure was not statistically significant.
Conclusions and Relevance
This cohort study found that, for patients with BMI 18.5 to less than 25 at the time of MGUS diagnosis, cumulative exposure to BMI 25 or greater was associated with an increased risk of progression. These findings suggest that for these patients, maintaining a healthy and stable weight following MGUS diagnosis may prevent progression to MM.
Background
Nearly 50,000 people who use drugs have died as a result of the ongoing drug poisoning crisis in Canada. To directly address concerns surrounding this crisis, safer supply pilot programs were implemented in several communities across the country. Since program implementation, discussions surrounding medication diversion have proliferated. We conducted surveys and interviews with current program participants to better understand medication diversion within the context of safer supply programs.
Methods
Safer supply program participants were recruited in Ottawa, Canada to complete semi-structured interviews and surveys. Surveys collected socio-demographic and substance use data. Survey results were reported using descriptive statistics. Semi-structured interviews were audio-recorded, transcribed, and analyzed thematically.
Results
30 people participated in this study. From interviews, seven themes arose on the topic of diversion, including 1) diversion in the context of being a person who uses drugs, 2) safety, 3) compassion, 4) meeting needs, 5) survival, 6) coercion, and 7) protecting youth.
Conclusion
Discussions with participants highlighted the importance of understanding why medication diversion occurs. Important factors influencing medication diversion included the need for safety, compassion, meeting needs, survival, and coercion faced by people who use drugs. Ultimately, medication diversion can be best understood as a measure implemented by people who use drugs to protect and care for their underserved community.
Background
Specialists review referrals for appropriateness and urgency. Limited capacity results in specialists declining referrals leaving primary care providers (PCP), patients, and specialists frustrated. Since specialist availability is unlikely to improve significantly, innovative solutions are required. This study evaluated the feasibility, acceptability, safety and impact of a new referral triage option Triaging Referrals to eConsult (TReC) which enables specialists to provide advice in lieu of an appointment (advice only) or provide advice to support the PCP until the appointment occurs (advice and appointment).
Methods
Utilization metrics were prospectively collected (number (%) of referrals converted, time from receipt of referral to completion (response time) and specialist self-reported billing time.
To assess PCP opinions on safety (advice was clearly identified and actionable) and acceptability (comfort in patient not seeing a specialist, additional time burden and support for expansion) two surveys, one for those referrals triaged to advice only and another for those triaged to advice and appointment, were faxed 14 days after the referral response.
Results
From November 1, 2022, to October 31, 2023, five specialties converted 930/16,880 referrals—656 (3.8%) to Advice Only and 274 (1.6%) to Advice and Appointment for an overall conversion rate of 5.5%. 192/1010 (19%) PCPs returned the survey with over 80% agreeing that the advice was easily recognizable, conversion to eConsult was acceptable and the advice was helpful and actionable.
Interpretation
Enabling specialists to provide advice to PCPs, often in lieu of an appointment, was acceptable, feasible with no major patient safety concerns.
Healthcare workers’ unplanned workplace absences are a global challenge with consequences for care recipients, employers, and healthcare systems. With rising home care demand, understanding drivers of home care personal support worker (PSW) absences can inform management of labor supply through government and employer policies. In this paper, we examined predictors of PSWs’ unplanned absences within a large, administrative, longitudinal dataset (2019–2021) from a home care organization in Ontario, stratified by time (pre-, early-, and mid-pandemic). After an initial spike, unplanned absence rates were generally lower during the pandemic. Cox-proportional hazard regression models for unplanned absences highlighted how increasing income and reducing travel distance between visits can be expected to decrease the hazard of unplanned absences. School closures significantly correlated with unplanned absences, highlighting disruptions within the broader care economy. As demand for home care accelerates, reducing unplanned absences will improve care consistency for those relying on PSWs to remain safe at home.
Importance
Cannabis use disorders (CUD) are associated with adverse health effects, including mental disorders and motor vehicle collision-related injuries. However, little is known about whether CUDs are associated with increased mortality risk.
Objective
To examine whether individuals receiving incident hospital-based care (an emergency department visit or hospitalization) for a CUD is associated with increased risk of death.
Design, Setting, and Participants
This population-based retrospective cohort study included all individuals aged 15 to 105 years living in Ontario, Canada, between 2006 and 2021 (n = 11 622 571 individuals). Overall and cause-specific mortality were compared between individuals with incident hospital-based CUD care and age- and sex-matched members of the general population or individuals with hospital-based care for other substance use disorders using cause-specific hazard models adjusted for comorbid mental health, substance use, and chronic health conditions. Statistical analysis was performed from September to December 2024.
Exposure
Incident hospital-based CUD care.
Main Outcomes and Measures
Overall and cause-specific mortality identified using vital statistics.
Results
The matched analysis included 527 972 individuals (mean [SD] age, 29.9 [13.6] years; 330 034 [62.5%] female) with a median (IQR) follow-up of 5 (3-9) years; 106 994 had incident CUD. Within 5 years of incident hospital-based CUD care, 3770 individuals (3.5%) died compared with 3770 (0.6%) of matched general population members. After adjusting for comorbid conditions, individuals with incident hospital-based CUD care were at increased risk of death relative to the general population (adjusted hazard ratio [aHR], 2.79 [95% CI, 2.62-2.97]). Individuals with hospital-based CUD care were at increased risk of all investigated types of death and particularly elevated risk of death by suicide (aHR, 9.70 [95% CI, 6.04-15.57]), trauma (aHR, 4.55 [95% CI, 3.55-5.82]), opioid poisoning (aHR, 5.03 [95% CI, 2.86-8.84]), other drug poisonings (aHR, 4.56 [95% CI, 3.11-6.68]), and lung cancer (aHR, 3.81 [95% CI, 2.39-6.07]) relative to the general population. Compared with an individual with hospital-based care for CUD, individuals with hospital-based care for alcohol (aHR, 1.30 [95% CI, 1.26-1.34]), stimulants (aHR, 1.69 [95% CI, 1.62-1.75]), and opioids (aHR, 2.19 [95% CI, 2.10-2.27]) were at relatively increased risk of death within 5 years.
Conclusions and Relevance
In this cohort study of all residents of Ontario, Canada, individuals with incident hospital-based CUD care were at markedly increased risk of death compared with the general population. These findings suggest important clinical and policy implications, given global trends toward cannabis legalization and market commercialization accompanied by increasing cannabis use and CUDs.
Objectives
The aim of the study was to investigate the correlation of a pattern recognition algorithm to the opioid overdose intervention activities of trained medical staff at a safe consumption site (SCS).
Methods
Continuous physiological data were collected using the Masimo Radius PPG pulse oximeter from volunteer users of nonprescribed, unregulated opioids at a SCS. The algorithm retrospectively calculated opioid-induced respiratory depression (OIRD) severity scores (Opioid Halo scores) were compared to interventions recorded by SCS staff.
Results
The study included data prospectively collected from 167 individuals, who underwent 370 sessions of intravenous injection of nonprescribed, unregulated opioids ( Fentanyl ). Interventions were documented for 150 sessions (~41%) by the SCS staff. The remaining 220 sessions had no interventions documented. The algorithm demonstrated a strong correlation with the intervention activities (Spearman ρ = 0.80, P < 0.001). The area under the receiver operating curve for the correlation with intervention activities (ie, supplemental oxygen or naloxone administration) was 0.94. The OIRD severity scores were significantly higher ( P < 0.001) in sessions requiring interventions compared to nonintervention sessions.
Conclusions
In this study, the algorithm generated OIRD severity scores had a strong correlation with the intervention activities provided by SCS staff who were blinded to the study pulse oximeter and algorithm scores. This suggests that the algorithm may be useful in detecting severe opioid-induced respiratory depression for which intervention is needed.
Under current nationally determined contributions (NDCs) to mitigate greenhouse gas emissions, global warming is projected to reach 2.7°C above preindustrial levels. In this review, we show that at such a level of warming, the Arctic would be transformed beyond contemporary recognition: Virtually every day of the year would have air temperatures higher than preindustrial extremes, the Arctic Ocean would be essentially ice free for several months in summer, the area of Greenland that reaches melting temperatures for at least a month would roughly quadruple, and the area of permafrost would be roughly half of what it was in preindustrial times. These geophysical changes go along with widespread ecosystem disruptions and infrastructure damage, which, as we show here, could be substantially reduced by increased efforts to limit global warming.
Bumble bees are key pollinators for natural and agricultural plant communities. Their health and performance are supported by a core gut microbiota composed of a few bacterial taxa. However, the taxonomic composition and community structure of bumble bee gut microbiotas can vary with bee species, environment, and origin (i.e., whether colonies come from the wild or a commercial rearing facility), and it is unclear whether metabolic capabilities therefore vary as well. Here we used metagenomic sequencing to examine gut microbiota community composition, structure, and metabolic potential across bumble bees from two different commercial Bombus impatiens suppliers, wild B. impatiens , and three other wild bumble bee species sampled from sites within the native range of all four species. We found that the community structure of gut microbiotas varied between bumble bee species, between populations from different origins within species, and between commercial suppliers. Notably, we found that Apibacter is consistently present in some wild bumble bee species—suggesting it may be a previously unrecognized core phylotype of bumble bees—and that commercial B. impatiens colonies can lack core phylotypes consistently found in wild populations. However, despite variation in community structure, the high-level metabolic potential of gut microbiotas was largely consistent across all hosts, including for metabolic capabilities related to host performance, though metabolic activity remains to be investigated.
IMPORTANCE
Our study is the first to compare genome-level taxonomic structure and metabolic potential of whole bumble bee gut microbiotas between commercial suppliers and between commercial and wild populations. In addition, we profiled the full gut microbiotas of three wild bumble bee species for the first time. Overall, our results provide new insight into bumble bee gut microbiota community structure and function and will help researchers evaluate how well studies conducted in one bumble bee population will translate to other populations and species. Research on taxonomic and metabolic variation in bumble bee gut microbiotas across species and origins is of increasing relevance as we continue to discover new ways that social bee gut microbiotas influence host health, and as some bumble bee species decline in range and abundance.
Spectral measurement is crucial in applications ranging from the investigation of matter and its electronic properties to the wavelength-multiplexed routing of optical signals. We propose and demonstrate a spectral measurement technique based on an all-optical approach. The signal spectrum is mapped to the time domain by dispersion in 1 km of fiber and is then optically gated by an intense ultrafast pulse in 10 cm of single-mode fiber. A portion of the signal spectrum can be recovered by sweeping the gate pulse through the stretched signal. Spectral fringes are measured down to the minimum bound for frequency-to-time mapping of 51.5 GHz. Our measurement technique expands the toolbox of ultrafast measurements from the time domain to the frequency domain.
Although charities are created expressly to benefit communities, it has proven difficult to capture the extent to which this mission is fulfilled. We tackle this challenge by focusing on charitable services provided to First Nations’ reserves and Inuit communities. Benefits are captured by their impact on a uniformly measured ‘community wellbeing’ (CWB) index, and on some individual outcomes. Geo-coding technology enables the matching of the location of charities, Indigenous communities, and their residents. OLS estimations reveal robustly positive associations between the charitable sector and the CWB; the inclusion of community fixed effects suggests some causality. Propensity Score Matching reveals that charities locate where the CWB is low, and points to an even stronger correlation between the presence of charities and CWB. Individual-level analysis provides additional support of a causal link. Causality is bolstered by nuanced evidence from a stacked-event study examining how the entry of charities affects CWB. We conclude that the services of charities contribute to community wellbeing.
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