University Health Network

Patient-identified barriers and facilitators to maternal health care in lmics: a qualitative study in Argentina and Ethiopia

Abstract Background Ninety-nine percent of global maternity deaths occur in low-and-middle-income countries (LMICs), despite availability of high quality evidence-based guidelines for common causes of maternal mortality. An understanding of barriers and facilitators (BFs) to acce...

Assessment of change in drug-induced parkinsonism in daily-life gait using vision-based machine learning

Drug-induced parkinsonism is a potentially reversible movement disorder that may be subtle and difficult to monitor in residential dementia care. Vision-based machine learning analysis of gait may provide unobtrusive longitudinal monitoring around medication changes. We conducted...

Ultraprocessed Food Intake and Adiposity, Vascular Brain Injury, and Cognition in Middle-Aged Adults

Importance Ultraprocessed foods (UPFs) account for a substantial and increasing proportion of dietary intake in Canada. Although UPFs are consistently associated with adiposity and cardiometabolic disease, their associations with subclinical vascular brain injury (VBI) and cognit...

High Yield of Pharmacogenetic Testing for Clopidogrel Resistance in a Canadian Outpatient Stroke Population

BACKGROUND: Clopidogrel is commonly prescribed for secondary stroke prevention, but routine pharmacogenetic testing is not typically performed. As the CYP2C19 enzyme activates clopidogrel into its effective form, clopidogrel-treated patients who carry CYP2C19 loss-of-function all...

Exploring the participation of people with lower limb absence or amputation: a mixed methods study

PURPOSE: People with lower limb absence or amputation (LLA) face challenges in their ability to participate in their communities. This study examines what influences how people with LLA participate in meaningful activities and social roles within the context of British Columbia....

Antimalarial exposure and renal histopathologic findings in lupus nephritis

Abstract Objectives This study aimed to evaluate the association between antimalarial exposure and renal histopathologic findings at kidney biopsy in patients with lupus nephritis (LN). Methods This study was conducted within the University of Toronto Lupus Clinic cohort. To ensu...

Delivery of cardiac rehabilitation through hybrid models and alternative settings by country income classification and decade: Comparisons from the International Council of Cardiovascular Prevention and Rehabilitation’s 2025 Global Audit Update

Objective Cardiac rehabilitation (CR) is an outpatient model of secondary prevention that improves patient outcomes, yet use remains limited. Hybrid/alternative CR addresses these challenges, but global availability, structure, and volumes have not been characterized since the pa...

Development and Validation of a Tool to Measure Documented Health Care Encounter Time

Importance Time toxicity, defined as the time patients spend receiving cancer treatment and interacting with health care systems, is an emerging treatment-related burden. Existing studies typically quantify time toxicity using health care contact days, which may inadequately capt...

Exploring the Mechanisms of in-Hospital Emergency Department Diversion: A Qualitative Single-Case Study

Healthcare workers (HCWs) are at risk of substance use disorders (SUD) due to factors such as burnout, stress, and occupational trauma, which may contribute to drug diversion (theft or unauthorized redirection of controlled substances), placing HCWs at risk of overdose, death, pr...

Health utilities in individuals with alpha-1 antitrypsin deficiency with and without COPD from the EARCO registry

Background Data on health utilities in Alpha-1 antitrypsin deficiency (AATD) are scarce. This study aimed to evaluate health-related quality of life (HRQoL) using the EQ-5D in a cohort of AATD Pi*ZZ individuals from the European AATD Research Collaboration (EARCO) registry and to...

Heterogeneity and ontogeny of mouse thymic macrophages reveal a requirement for Csf1r-expressing myeloid cells during early T cell development

Thymic macrophages (TMs) maintain tissue homeostasis by clearing the large numbers of apoptotic cells generated during T cell development, but how TM heterogeneity relates to their developmental origin and role in thymocyte maturation remains incompletely understood. Using comple...

Incidence and predictors of delirium-associated violence towards healthcare workers in a Swiss ICU: results from the CAVE study

Abstract Background To assess the frequency of delirium coinciding with aggressive and/or violent patient behavior in intensive care unit (ICU) patients as documented by nurses and to identify clinical associations or risk factors. Methods This was a retrospective observational c...

Ethical considerations for intraoperative implementation of artificial intelligence clinical decision support systems: a scoping review

Intraoperative artificial intelligence (AI)-based clinical decision support (CDS) systems are increasingly proposed for surgical decision-making, yet evidence supporting their clinical implementation and ethical governance remains limited. We searched five databases for studies p...

Peripheral microbial metabolites as indicators of gut microbiome disruption: systematic review and meta-analysis

ABSTRACT Gut microbiome disruption is often characterized by the loss of obligately anaerobic bacteria, which may lead to altered production of microbial metabolites that can be detected peripherally. The application of widely used sequencing-based microbiome analyses to clinical...

Housing-based support models for individuals experiencing homelessness, substance use and mental health needs: a rapid review

Abstract Background Individuals experiencing homelessness and substance use and mental health needs face high rates of mortality. Stable housing is a critical determinant of health, yet the evidence on existing housingbased support models and their effectiveness for improving beh...

Sex differences in mortality risk profiles across the life course in metabolic dysfunction-associated steatotic liver disease: a machine learning analysis of the Canadian Longitudinal Study on Aging

Abstract Background Prognostic models for metabolic dysfunction-associated steatotic liver disease (MASLD) are largely ‘one-size-fits-all’ and do not collectively account for sex differences and social determinants of health (SDoH). To address this gap, we trained and developed s...

Pneumocystis jirovecii Pneumonia Outbreaks in Solid Organ Transplant Recipients: A Systematic Review of Epidemiology, Transmission Dynamics, and Outbreak Investigations

BACKGROUND: Although Pneumocystis jirovecii pneumonia (PJP) outbreaks continue to occur in solid organ transplantation (SOT) recipients, no systematic review has synthesized the available evidence to provide an aggregated understanding of their epidemiology and transmission. METH...

Consensus-based clinical and research recommendations for use of glucagon-like peptide-1 receptor agonists in the context of eating disorders: a modified Delphi study.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for type 2 diabetes management and later expanded to obesity treatment, have shown preliminary efficacy in reducing binge eating episodes. However, the appetite-suppressing and weight-loss effects of GLP-1R...

Connectomic Determinants of Subcallosal Cingulate Deep Brain Stimulation for Depression

OBJECTIVE: Subcallosal cingulate (SCC) deep brain stimulation (DBS) has shown promise for treatment-resistant depression. This study retrospectively evaluated a large curated SCC-DBS dataset to identify connectomic factors associated with sustained clinical improvement across pat...

Assessing and Addressing Frailty in Candidates for Lung Transplantation: An ISHLT Consensus Statement.

The ISHLT Consensus document for the selection of lung transplant candidates recommends frailty assessment as part of a comprehensive candidacy evaluation. Missing from this and other recent consensus documents were practical recommendations on which frailty measures to consider...