Search Results (233)

Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication globally. Maternal vitamin D deficiency has been linked to the risk of GDM. The aim of this study was to explore and synthesise current evidence on the association between vitamin D deficiency and the development of gestational diabetes in Western countries. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodological framework. Relevant studies were identified through a comprehensive search across seven databases: ProQuest Public Health, Google Scholar, PubMed, ScienceDirect, The Lancet, BMC Public Health, the International Journal of Women’s Health, and Scopus. Studies were included based on predefined inclusion and exclusion criteria relevant to the research question. The review followed the JBI protocol, and the PRISMA flowchart was used to guide and visualise the study selection process. Results: Nineteen studies were included in the final analysis, comprising research predominantly from Australia (5), the United States (5), and Canada (4). The findings indicate a notable association between vitamin D deficiency and GDM risk, moderated by factors such as maternal age, ethnicity, seasonal variation, and body mass index (BMI). Older maternal age and higher BMI were linked with lower vitamin D levels and a higher incidence of GDM. Ethnic groups with darker skin tones showed higher rates of vitamin D deficiency, increasing vulnerability to GDM. Seasonal patterns revealed lower vitamin D levels during winter months, correlating with greater GDM risk. These patterns underscore the need for targeted preventive strategies, including the potential role of vitamin D supplementation. Conclusions: This review supports an observed association between maternal vitamin D deficiency and increased GDM risk, influenced by demographic and environmental factors. While the evidence points to a potential preventative role for vitamin D, further high-quality research, including systematic reviews and meta-analyses, is essential to establish causality and inform clinical guidelines. The review identifies knowledge gaps and suggests directions for future research and clinical practice. Full article

A high-throughput sequencing-based grapevine metagenomic survey was conducted across all grape-growing Canadian provinces (British Columbia, Ontario, Nova Scotia, and Québec) with the objective of better understanding the grapevine virome composition. In total, 310 composite grapevine samples representing nine Vitis vinifera red; five V. vinifera white; seven American–French red; and five white hybrid cultivars were analyzed. dsRNA, enriched using two different methods, was used as the starting material and source of viral nucleic acids in HTS. The virome status on the distribution and incidence in different regions and grapevine cultivars is addressed. Results from this study revealed the presence of 20 viruses and 3 viroids in the samples tested. Twelve viruses, which are in the regulated viruses list under grapevine certification, were identified in this survey. The major viruses detected in this survey and their incidence rates are GRSPaV (26% to 100%), GLRaV-2 (1% to 18%), GLRaV-3 (15% to 63%), GRVFV (0% to 52%), GRGV (0% to 52%), GPGV (3.3% to 77%), GFkV (1.5% to 31.6%), and GRBV (0% to 19.4%). This survey is the first comprehensive virome study using viral dsRNA and a metagenomics approach on grapevine samples from the British Columbia, Ontario, Nova Scotia, and Quebec provinces in Canada. Results from this survey highlight the grapevine virome distribution across four major grapevine-growing regions and their cultivars. The outcome of this survey underlines the need for strengthening current management options to mitigate the impact of virus spread, and the implementation of a domestic grapevine clean plant program to improve the sanitary status of the grapevine ecosystem. Full article

Background: Indigenous peoples in Canada endure lasting effects of colonialism including racism, marginalization, and social, political, and geographic inequities resulting in disproportionate rates of disease and inequitable healthcare. Indigenous infants and children in Canada experience a high incidence of birth complications and illnesses, and families are often left to navigate the care of their child with limited resources. Accordingly, improved, culturally responsive and safe healthcare is needed to enhance child outcomes and optimize family well-being. Purpose and Methods: A qualitative study was conducted by our research team including family members of Indigenous children with serious illnesses, a Cultural Advisor, researchers, and pediatric clinicians. In one component of the study, we explored pediatric healthcare providers’ (HCPs) experiences of caring for Indigenous families of children with serious illness. A purposive sample of 19 pediatric healthcare providers took part in semi-structured qualitative interviews or one focus group. The data were analyzed thematically to identify common experiences and priorities for improved supportive healthcare. Findings: Five themes were identified representing insights from pediatric HCPs, with a focus on barriers to effective healthcare at the interpersonal, institutional, and system levels for seriously ill Indigenous children and their families. Ideas for enhancing the social and cultural responsiveness and safety of supportive healthcare were identified. Implications and Conclusions: The findings offer valuable insights and strategies for HCPs to support holistic, comprehensive, and culturally safe and responsive healthcare. Full article

Background: Prostate cancer is a leading malignancy among men globally, with its incidence expected to rise due to aging populations and shifting lifestyles. While established risk factors include age, ethnicity, and genetics, the role of modifiable dietary factors, particularly sugar intake, remains less clear. Emerging evidence suggests that high sugar consumption may promote carcinogenesis through insulin resistance, chronic inflammation, and hormonal dysregulation. This systematic review aimed to evaluate the current evidence on the association between dietary sugar intake and prostate cancer risk. Methods: A systematic search was conducted across six databases for observational studies published between January 2005 and April 2025. Eligible studies assessed the associations between quantitative sugar intake and prostate cancer outcomes. Screening, data extraction, and a risk of bias assessment (using ROBINS-E) were performed independently by multiple reviewers. Results: Six studies met the inclusion criteria, comprising four prospective cohorts, one case–control study, and one cross-sectional study, with a combined sample of 11,583 men from the USA, Canada, Sweden, and France. Three studies reported a significant positive association between a high intake of dietary sugars and prostate cancer risk, two found no association, and one showed mixed findings depending on the type of sugar. Heterogeneity in the exposure assessments and confounder control limited the comparability. Conclusions: This review suggests a possible association between high dietary sugar intake and increased prostate cancer risk, especially from added sugars and sugar-sweetened beverages. However, inconsistent findings and methodological limitations highlight the need for robust, prospective studies with standardized assessments to understand this relationship better. Full article

Since its emergence in the United States in February 2022, Highly Pathogenic Avian Influenza (HPAI) H5N1 has caused significant losses for poultry operations, particularly in Iowa between February 2022 and December 2023. Branta canadensis (Canada goose), an abundant North American waterfowl species, is considered a potential reservoir host for H5N1. This study examined the relationship between Canada goose abundance and H5N1 occurrence in Iowa counties. Although counties with H5N1 cases comprised 13% of the state’s Canada goose population—and 32% of those counties had high goose abundance—an inverse relationship was observed. Bivariate analysis indicated that counties with high goose abundance were significantly less likely to report HPAI cases (χ² = 4.29, p = 0.04). Notably, intermediate goose abundance was associated with a 79% lower likelihood of HPAI occurrence (RR = 0.21, 95% CI [0.05, 0.90], p = 0.04). These findings highlight the limitations posed by the lack of accessible, high-resolution poultry farm location data, which hinders a definitive understanding of Canada geese’s role in H5N1 transmission. To address this gap, stakeholders should consider adopting next-generation surveillance tools like the Biothreats Emergence Analysis and Communication Network (BEACON) AI platform, or AI-integrated chemical sensors that generate real-time, actionable data for biosecurity decision-making. Given the uncertainty surrounding Canada goose role transmission dynamics, the species remains a relevant One Health concern. Full article

Background: Long-term clinical trials and real-world data have established a comprehensive risk–benefit profile for ibrutinib, informing adverse event (AE) management strategies to optimize safety and efficacy. Methods: We retrospectively assessed the incidence of AEs of special interest and management strategies in all patients treated with ibrutinib for chronic lymphocytic leukemia (CLL) in Saskatchewan, Canada, since 2014. Results: Among 187 patients (median age 75.7 years, 63% male), the median time from ibrutinib treatment initiation to data cutoff was 3.1 years. Approximately two-thirds of patients received ibrutinib for relapsed CLL (33.7% second-line and 32.6% third-line and beyond), with 33.7% receiving it first-line. All patients initiated ibrutinib as monotherapy at 420 mg. AEs of interest were observed in 81.3% of patients, with 42.8% experiencing ≥2 AEs. No grade 5 AEs were reported. Among the 284 first-onset AEs observed in 152 patients, 90.8% were successfully managed, allowing treatment continuation. The median time to successful management ranged from 27.0 days (range: 12.5–73.0) for infections to 84.0 days (range: 55.0–141.0) for hypertension. Both AE and discontinuation rates were comparable or favourable to previous reports. Conclusion: This real-world analysis suggests that ibrutinib may be safely used in the majority of CLL patients encountered in routine practice. Full article

Fire is important in boreal forest ecosystems, but comprehensive recovery analysis is lacking for soil nutrients and plant traits in China boreal forests, where the strict “extinguish at sight” fire prevention policy has been implemented. Based on over 50 years of forest fire recordings in the Daxing’anling Mts, 48 pairs of burnt and unburnt controls (1066 plots) were selected for 0–20 cm soil sampling and plant surveys. We recorded 18 plant parameters of the abundance of each tree, shrub, grass, and plant size (height, diameter, and coverage), 7 geo-topographic data parameters, and 2 fire traits (recovery year and burnt area). We measured eight soil properties (soil organic carbon, SOC; total nitrogen, TN; total phosphorus, TP; alkali-hydrolyzed P, AP; organic P, Po; inorganic P, Pi; total glomalin-related soil protein, T-GRSP; easily-extracted GRSP, EE-GRSP). Paired T-tests revealed that the most significant impact of the fire was a 25%–48% reduction in tree sizes, followed by decline in the plant diversity of arbors and shrubs but increasing plant diversity in herbs. GRSP showed an >18% increase and P_o decreased by 17% (p < 0.05). Redundancy ordination showed that the post-fire recovery years and burnt area were the most potent explainer for the variations (p < 0.05), strongly interacting with latitudes and longitudes. Plant richness and tree size were directly affected by fire traits, while the burnt area and recovery times indirectly increased the GRSP via plant richness. A fire/control ratio chronosequence found that forest community traits (tree size and diversity) and soil nutrients could be recovered to the control level after ca. 30 years. This was relatively shorter than in reports on other boreal forests. The possible reasons are the low forest quality from overharvesting in history and the low fire severity from China’s fire prevention policy. This policy reduced the human mistake-related fire incidence to <10% in the 2010s in the studied region. Chinese forest fire incidences were 3% that of the USA. The burnt area/fire averaged 5 hm² (while the USA averaged 46 hm², Russia averaged 380 hm², and Canada averaged 527 hm²). Overharvesting resulted in the forest height declining at a rate of >10 cm/year. Our finding supports forest management and the evaluation of forest succession after wildfires from a holistic view of plant–soil interactions. Full article

Background: Dedifferentiated liposarcoma (DDLPS) is a rare, aggressive tumour with poor survival outcomes in advanced settings. This study assessed the incidence/prevalence, treatment patterns, survival, healthcare resource utilization (HCRU), and costs for DDLPS patients in Ontario, Canada. Methods: A retrospective cohort study was conducted among DDLPS patients between 2010 and 2022 using administrative databases. Overall survival, all-cause HCRU, and costs (2023 Canadian dollars, CAD) were compared based on advanced disease and resection status. Results: The overall incidence and cumulative prevalence of DDLPS was 0.465 and 1.995 per 100,000 people, respectively. Of all 611 DDLPS cases (64.3% male, median age [IQR]: 67 [57–76] years), 40.3% and 61.0% had advanced and unresected disease, respectively. The median overall survival (mOS) was 69 months [IQR = 15–151] for the entire cohort, but this was significantly lower for advanced and unresected disease (p < 0.0001). Among patients receiving systemic treatments (N = 117), 81.2% were prescribed doxorubicin as first-line treatment. All-cause healthcare costs (2023 CAD) amounted to CAD 34,448 per person-year (PPY), with inpatient hospitalizations being the highest cost driver at CAD 14,522 PPY and 0.8 inpatient hospitalization PPY for all years. Advanced disease had higher HCRU and costs. Conclusions: This is the first comprehensive real-world evidence study that quantifies the high mortality and cost burden associated with DDLPS in Canada. Full article

Potato early dying (PED) disease complex is often called the Verticillium wilt of potato and is considered one of the most economically devastating diseases of potato worldwide. The severity of the disease greatly increases with the association of the soil-borne pathogens Verticillium dahliae and V. albo-atrum and the root lesion nematode (Pratylenchus sp.). Recently, an increase in wilt disease symptoms and a sharp decline in marketable tuber yield were observed in New Brunswick (NB), Canada. A survey of 71 fields, along with eight fumigated and eight non-fumigated fields, was carried out to determine and quantify nematodes and Verticillium in the soil. Techniques used included plate counts for Verticillium (CFU/g soil), real-time qPCR (RT-qPCR) for V. dahliae (cell/g soil), and nematode identification and counts (# of nematodes/kg of soil). The survey results of the 71 fields revealed that 55 fields had Verticillium sp. ranging from 2 to 66 CFU/g of soil by the plate method, and 68 fields had high V. dahliae ranging from 261 to 27,471 cell/g of soil by RT-qPCR method. All fields had high numbers of root lesion nematodes ranging from 560 to 14,240 nematodes/kg of soil. There was an uneven distribution of PED incidence in potato fields at various locations of NB. Fumigation with Chloropicrin significantly reduced the numbers of root lesion nematodes by 34.1–99.0%, Verticillium sp. CFU/g of soil by 50–100%, and V. dahliae cell/g soil by 38–91% in the eight fumigated fields. The management of the PED complex with various disease management products under field conditions was also studied in a field plot trial setup. The nematicide Velum applied in-furrow at the recommended label rate decreased the numbers of root lesion nematodes by up to 66% compared to other products. The combination of both Velum + Aprovia and the application of ammonium-lignosulfonate significantly reduced V. dahliae by 190.55% and 274.24%, respectively, compared to other products. The fungicide Aprovia applied in-furrow at the recommended rate for the management of Verticillium wilt significantly reduced Verticillium sp. CFU/g of soil in treated soil by 73.3% compared to Velum, Mustgrow, Senator PSPT, Vapam, ammonium-lignosulfonate, Nimitz, and the untreated control. Disease management products increased potato marketable yield by 27.38–97.74%. The results of this study suggest that the root lesion nematode and V. dahliae have a ubiquitous distribution in the fields cultivated with potatoes in NB. The co-infection of potato by both V. dahliae and the root lesion nematode can greatly increase the severity of PED. Fumigation with Chloropicrin significantly reduced the levels of root lesion nematodes and Verticillium in all fumigated fields. Management practices of PED using the fungicide Aprovia, the nematicide Velum, and a combination of both Velum + Aprovia had the greatest effect in reducing the population density of the root lesion nematode and Verticillium dahliae in soils of commercial potato fields in New Brunswick. Full article

This study analyzes cancer trends in Canada using machine learning techniques to extract insights from extensive cancer data sourced from the Canadian Cancer Society and Statistics Canada. It aims to enhance the understanding of cancer epidemiology and inform better prevention, diagnosis, and treatment strategies. Data preprocessing addressed issues like missing values and normalization, ensuring reliability. The findings indicate a steady increase in new cancer cases, with estimates reaching 248,700 in 2026, up from 244,000 in 2022. Male incidence rates are projected to rise slightly to 602.3 per 100,000, while female rates may decline to 530.6. Regions such as Alberta, British Columbia, Ontario, and Quebec show rising incidence rates, contrasted by declines in Newfoundland and Labrador, Nunavut, and Yukon. Notably, this research reveals significant increases in cancer cases among individuals aged 60 and older, particularly those 70+. The hybrid ARIMA-LSTM model demonstrated superior forecasting accuracy compared with the other selected models. These findings offer valuable insights for health policymakers and highlight the potential of machine learning in public health forecasting, providing a framework for future research in other disease areas. Full article

Background/Objectives: Thyroid cancer incidence has risen in both the United States and Canada, despite differing healthcare systems. While overdiagnosis likely partly explains this trend in adults, its impact on younger populations is unclear. We used the North American Association of Central Cancer Registries, which included 133,808 thyroid cancer cases from the United States and Canada, to assess incidence trends among pediatric, adolescent, and young adult (PAYA) populations. Methods: Age-adjusted incidence rates (AAIR) per 100,000 person-years (PY) were compared using rate ratios (RR), stratified by sex, age, race/ethnicity (United States only), and histology. Joinpoint regression estimated annual percentage changes (APC) and average APCs (AAPC) in AAIRs. From 1995 to 2014, thyroid cancer incidence increased by 137%. Significant increases occurred across all age groups (0–14, 15–24, 25–34, 35–39 years). The rate increase was highest for papillary thyroid cancer (AAPC = 5.50, 95% CI 5.06, 5.94), and among individuals aged 35–39 years (AAPC = 5.99, 95% CI 4.84, 7.15). Of racial/ethnic groups in the United States, non-Hispanic White individuals had the highest AAIR (6.22 per 100,000 PY). Mortality has changed minimally. Conclusions: Over the past two decades, thyroid cancer incidence has increased in individuals under 40. While evidence suggests that overdiagnosis primarily accounts for this trend, other contributing factors cannot be ruled out. Further research and surveillance of the drivers of increased incidence are critical. Full article

Glioblastoma is the most common and aggressive malignant brain tumor in adults, with an increasing incidence and a poor prognosis. Current challenges in glioblastoma management include rapid tumor growth, limited treatment effectiveness, high recurrence rates, and a significant impact on patients’ quality of life. Given the complexity of glioblastoma care and recent advancements in diagnostic and treatment modalities, updated guidelines are needed in Canada. This Delphi study aimed to develop Canadian consensus recommendations for the diagnosis, classification, and management of newly diagnosed and recurrent glioblastoma. A multidisciplinary panel of 14 Canadian experts in glioblastoma care was convened, and a comprehensive literature review was conducted to synthesize evidence and formulate initial recommendations. Consensus was achieved through three Delphi rounds, in which panelists rated their agreement with recommendation statements on a five-point Likert scale. Statements with ≥75% agreement were accepted, and others were revised for re-voting. Final recommendations were formulated based on the consensus level, strength of evidence, clinical expertise, and consideration of the Canadian healthcare context. These recommendations aim to standardize glioblastoma diagnosis and classification across Canada, provide evidence-based guidance for optimal treatment selection, integrate novel therapies, and enhance the overall quality of care for glioblastoma patients. Full article

At present, remote sensing serves as a key approach to track ecological recovery after fires. However, systematic and quantitative research on the research progress of post-fire remote sensing remains insufficient. This study presents the first global bibliometric analysis of post-fire remote sensing research (1994–2024), analyzing 1155 Web of Science publications and using CiteSpace to reveal critical trends and gaps. The key findings include the following: As multi-sensor remote sensing and big data technologies evolve, the research focus is increasingly pivoting toward interdisciplinary, multi-scale, and intelligent methodologies. Since 2020, AI-driven technologies such as machine learning have become research hotspots and continue to grow. In the future, more extensive time-series monitoring, holistic evaluations under compound disturbances, and enhanced fire management strategies will be required to addressing the global climate change challenge and sustainability. The USA, Canada, China, and multiple European nations work jointly on fire ecology research and technology development, but Africa, as a high wildfire-incidence area, currently lacks appropriate local research. Remote sensing of the environment and remote sensing and forests maintain a pivotal role in scholarly impact and information exchange. This work redefines post-fire remote sensing as a nexus of ecological urgency and social justice, demanding inclusive innovation to address climate-driven post-fire recovery regimes. Full article

Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and premature AIDS-related deaths among people living with HIV (PLWH), and simultaneously renders HIV non-transmissible, thus preventing onward HIV transmission. In addition, PrEP has proven effective against HIV transmission among high-risk individuals who are adherent to the regimen. PrEP traditionally consists of two antiretrovirals given orally as one pill daily: originally, tenofovir-DF plus emtricitabine (TDF-FTC), and later, tenofovir-AF (TAF) plus FTC (more recently, other options have become available, including long-acting parenteral formulations; however, these are still of limited availability). Over the last two decades, the province of British Columbia has rolled out TasP among all PLWH, and starting in 2018, PrEP was added as a strategy to reach individuals most at risk of acquiring HIV to further accelerate progress in addressing HIV/AIDS as a public health threat. Our “generalized TasP + focused PrEP” program proved to be synergistic (or multiplicative) as it relates to reducing the HIV effective reproduction number (${\mathrm{R}}_{\mathrm{e}}$). TasP lowers HIV incidence by reducing the pool of individuals able to transmit HIV, which is dependent on the extent of community plasma viral load (pVL) suppression. Meanwhile, PrEP reduces the number of potential new infections among those most susceptible to acquiring HIV in the community, independent of viral load suppression among PLWH. Our results strongly support widespread implementation of the combination of “generalized TasP + focused PrEP” strategy and underscore the importance of long-term monitoring of ${\mathrm{R}}_{\mathrm{e}}$ at a programmatic level to identify opportunities for optimizing TasP and PrEP programs. This approach aligns with the United Nations goal of “Ending HIV/AIDS as a pandemic by 2030”, both in Canada and globally. Full article

Background and Objectives: The COVID-19 pandemic globally has negative effects on mental health. Research from Western countries, such as the US, Canada, Australia, and Europe, shows that the COVID-19 pandemic is associated with an increased trend of anorexia nervosa (AN) among children and adolescents. However, the trend after the pandemic in Eastern countries, including Japan, is not well-understood, and it remains unclear whether the pandemic is associated with the trend in these countries. This study aimed to examine the association between the COVID-19 pandemic and the newly diagnosed AN among children and adolescents in Japan. Materials and Methods: Using the nationwide multi-hospital database in Japan, we analyzed the clinical outpatient data in the departments of pediatrics, psychosomatic medicine, and psychiatry. The participants comprised children and adolescents aged 7–19 years newly diagnosed with AN from January 2017 to January 2022. An interrupted time series analysis was used to compare the trends of newly diagnosed AN before and after the COVID-19 pandemic. Estimating the changes in the trends over the pandemic was performed using a Poisson regression model. Results: The total cases of newly diagnosed AN were 41 cases diagnosed in 38 months (1.08 cases per month) before the pandemic and 34 in 23 months (1.48 cases per month) after the pandemic. Notably, in the 7–14 age group, the cases per month increased from 0.74 to 1.13 cases per month over the period. Before the pandemic, a decrease in cases was observed (Incidence Rate Ratio [IRR] = 0.961; 95% CI = 0.932–0.990). Conversely, the after-pandemic period showed a contrasting trend, with increased cases (IRR = 1.096; 95% CI = 1.032–1.176). Furthermore, the number and cases per month in boys increased over the period, from 1 to 5 cases and from 0.03 to 0.22 cases per month, compared to girls from 28 to 26 cases and from 1.05 to 1.26 cases per month. Conclusions: Our findings suggest that sociocultural differences at a national level may not affect the trend of AN after the pandemic. The pandemic and lifestyle changes after the pandemic occurred in both Western and Eastern countries. Considering that, individual, parental, and peer factors related to the pandemic and the consequent lifestyle changes may be more associated with the development of AN. Further research in different countries is needed to elucidate the mechanisms of AN and the long-term impact of the pandemic. Full article