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ItemOpen Access
Long-term cardiac MRI follow up of MANTICORE (Multidisciplinary Approach to Novel Therapies in Cardio-Oncology REsearch)
(2025-02-08) Labib, Dina; Haykowsky, Mark; Sonnex, Emer; Mackey, John R.; Thompson, Richard B.; Paterson, D. I.; Pituskin, Edith
Abstract Background This study investigates the long-term cardiac effects of trastuzumab-based chemotherapy in early breast cancer (EBC) survivors. We extend the original MANTICORE trial which showed that angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers (BB) could mitigate the decline in left ventricular (LV) ejection fraction (EF) during the first year of trastuzumab treatment. Objectives We hypothesized that, over time, cardiac function would decline further and adverse changes in cardiac geometry would occur due to the aging of the population and prior treatment. Methods The study enrolled 52 participants from the original MANTICORE trial cohort, with cardiac magnetic resonance (CMR) imaging conducted at a median of 6.5 years post randomization to treatment. Results We found that, contrary to the hypothesis, participants maintained LV EF over the follow-up period. Specifically, the placebo group exhibited a recovery in LV EF to levels comparable with the treatment groups, suggesting no long-term differential impact on cardiac function. However, a significant reduction in LV mass was observed across all groups, the clinical implications of which remain unclear. Conclusions The findings suggest that in a selected population receiving trastuzumab-based chemotherapy, extended cardiac imaging surveillance beyond one-year post-treatment may be unnecessary. We posit that the presence of HER2 overexpressing breast cancer influenced hypertrophic changes to cardiac geometry observed at baseline and one year, which resolved after completing HER2-blocking treatment. The study also highlights the need for further research to understand the significance of changes in cardiac geometry during and after breast cancer treatment​.
ItemOpen Access
Examining differences in exposure to digital marketing of unhealthy foods reported by Canadian children and adolescents in two policy environments
(2025-02-07) Vergeer, Laura; Soto, Carolina; Bagnato, Mariangela; Pauzé, Elise; Amson, Ashley; Ramsay, Tim; Olstad, Dana L.; Welch, Vivian; Potvin Kent, Monique
Abstract Background There has been relatively little research on youth’s exposure to food marketing on digital media, which is important as new digital platforms emerge and youth spend more time online. Evidence evaluating different policy approaches to restricting digital food marketing to children is also limited. This study examined differences in self-reported exposure to digital food marketing between children and adolescents in different policy environments: Ontario (where food marketing is self-regulated) and Quebec (where advertising is government regulated). Methods An observational cross-sectional online survey was conducted in April 2023 among children (aged 10–12 years) and adolescents (13–17 years) from Ontario and Quebec, recruited by Leger Marketing. Participants self-reported their frequency of exposure to food marketing via various digital platforms and marketing techniques. Logistic regression and proportional odds models examined differences in exposure by province and age group, adjusting for sociodemographic characteristics and digital device usage. Results The odds of reporting more frequent exposure to marketing of sugary drinks (OR: 0.48; 95% CI: 0.33, 0.69), sugary cereals (OR: 0.59; 95% CI: 0.41, 0.86), salty/savoury snacks (OR: 0.67; 95% CI: 0.47, 0.96), fast food (OR: 0.65; 95% CI: 0.45, 0.92), and desserts/sweet treats (OR: 0.54; 95% CI: 0.37, 0.78) were lower among Quebec children than Ontario children. Quebec children were less likely than Ontario children (OR: 0.56; 95% CI: 0.38, 0.84), but more likely than Quebec adolescents (OR: 1.58; 95% CI: 1.04, 2.42), to report exposure to unhealthy food marketing on one or more gaming/TV/music streaming platform/website(s). Compared with Ontario children, Quebec children were less likely to report exposure to marketing featuring characters or child/teenage actors (OR: 0.51; 95% CI: 0.34, 0.76), child-appealing subjects, themes and language (OR: 0.59; 95% CI: 0.40, 0.89), and visual design, audio and special effects (OR: 0.64; 95% CI: 0.41, 0.99), and to report exposure to a greater number of marketing techniques (OR: 0.60; 95% CI: 0.43, 0.84). Conclusions Exposure to unhealthy food marketing on digital media is high for youth from Ontario and Quebec, particularly for Ontario children. These findings reinforce the need for federal regulations to protect Canadian youth from unhealthy food marketing on digital media.
ItemOpen Access
Exploring predictors of the five-time sit-to-stand test based on cross-sectional findings from the Swedish National Study on Aging and Care (SNAC)
(2025-02-04) Niklasson, Joakim; Fagerström, Cecilia; Backåberg, Sofia; Bergman, Patrick; Lindberg, Terese
Abstract Background As we age, staying physically active and reducing sedentary behavior becomes crucial. To understand how to achieve this, factors related to daily physical function such as five-time sit-to-stand (STS) time should be explored. This study aimed to investigate the associations between STS time, self-rated physical activity, physical function, health-related quality of life, physical and mental health in community-dwelling older adults aged ≥ 60 years. Method Cross-sectional design with self-reported and objectively measured data from adults aged ≥ 60 years (n = 819), acquired from the Swedish National Study on Aging and Care. Data was analyzed through multiple linear regression. Results The model (R2 = 0.268) showed that STS time was predicted by grip strength (β’ = -0.204, p < 0.05), age (β’ = 0.202, p < 0.05), health-related quality of life (β’ = -0.192, p < 0.05), having fallen within the preceding twelve months (β’ = -0.127, p < 0.05), physical activities of perceived light to moderate intensity (β’ = -0.121, p < 0.05), one-leg stand (β’ = -0.099, p < 0.05), and education level (β’ = -0.092, p < 0.05). For STS time, health-related quality of life (β = -0.354, confidence interval [CI] (-0.509)–(-0.199)), having fallen within the preceding twelve months (β = -0.222, CI (-0.365)–(-0.078)), and physical activities of perceived light to moderate intensity (β = -0.166, CI (-0.278)–(-0.053)) were the most prominent predictors. Conclusion The model highlights the importance of grip strength and health-related quality of life in predicting STS time in older adults. Clinicians can use these insights to develop interventions that maintain physical function by regularly assessing and monitoring these factors. Future research should explore the relationship between fall history, faster STS time, and the impact of grip strength and health-related quality of life on sedentary behavior among older adults.
ItemOpen Access
Incident prescriptions for common cardiovascular medications: comparison of recent versus pre-2020 medication adherence and discontinuation in three universal health care systems
(2025-02-05) McNaughton, Candace D.; Austin, Peter C.; Jackevicius, Cynthia A.; Chu, Anna; Holodinsky, Jessalyn K.; Hill, Michael D.; Norris, Colleen M.; Kumar, Mukesh; Kamal, Noreen; Lee, Douglas S.; Khan, Nadia; Vyas, Manav V.; Joundi, Raed A.; Kapral, Moira K.; Yu, Amy Y. X.
Abstract Background Health system disruptions since onset of the COVID-19 pandemic may have adversely impacted adherence to medications for common cardiovascular risk factors. Methods We examined adherence to and discontinuation of incident prescriptions for medications treating hypertension, dyslipidemia, diabetes, and atrial fibrillation in Ontario, Alberta, and Nova Scotia, Canada. We compared the recent period (April 1, 2020 through most recently available follow-up: September 30, 2021 for Ontario; March 31, 2021 for Alberta; and March 31, 2022 for Nova Scotia) to the baseline, pre-pandemic period (April 1, 2014 through March 31, 2019). In each province, people aged ≥66 years with a valid health number and corresponding incident prescription were included. For each medication class, adherence in the recent period, defined as ≥ 0.80 proportion-of-days-covered (PDC), was compared to the pre-pandemic period using modified Poisson regression with robust error variance, adjusted for patient characteristics. Similarly adjusted Cox proportional hazards models compared hazard of discontinuation over one year of follow-up between the two time periods. Results In the recent period, PDC ranged from 48.9% for dyslipidemia medications in Alberta to 82.2% for anticoagulants in Nova Scotia. Adherence was not different between periods, with the following exceptions: higher adherence in the recent period for antihypertensives (adjusted risk ratios [aRR] 1.08, 95% CI 1.06–1.10) and dyslipidemics (aRR 1.07, 95% CI 1.04–1.09) in Nova Scotia, and for antihyperglycemics (aRR 1.10, 95% CI 1.08–1.14) and anticoagulants (1.15, 95% CI 1.12, 1.18) in Alberta. Adherence was lower in the recent period only for antihypertensives in Alberta (aRR 0.95, 95% CI 0.93, 0.97). One-year rates of discontinuation ranged from 20.9% for anticoagulants in the Alberta recent period to 56.7% for antihypertensives in the Ontario baseline period. The adjusted hazard of discontinuation was lower or unchanged in the recent period for all medication classes. Conclusions Despite significant health system disruptions since 2020, recent adherence to incident cardiovascular prescriptions was similar or better than before and rates of medication discontinuation were lower. However, interventions are still needed to improve existing, suboptimal adherence.
ItemOpen Access
BioLake: an RNA expression analysis framework for prostate cancer biomarker powered by data lakehouse
(2025-02-04) Li, Qiaowang; Gamallat, Yaser; Rokne, Jon G.; Bismar, Tarek A.; Alhajj, Reda
Abstract Biomedical researchers must often deal with large amounts of raw data, and analysis of this data might provide significant insights. However, if the raw data size is large, it might be difficult to uncover these insights. In this paper, a data framework named BioLake is presented that provides minimalist interactive methods to help researchers conduct bioinformatics data analysis. Unlike some existing analytical tools on the market, BioLake supports a wide range of web-based bioinformatics data analysis for public datasets, while allowing researchers to analyze their private datasets instantly. The tool also significantly enhances result interpretability by providing the source code and detailed instructions. In terms of data storage design, BioLake adopts the data lakehouse architecture to provide storage scalability and analysis flexibility. To further enhance the analysis efficiency, BioLake supports online analysis for custom data, allowing researchers to upload their own data via a designed procedure without waiting for server-side approval. BioLake allows a one-time upload of custom data of up to 500 MB to ensure that researchers avoid issues with data being too large for upload. In terms of the built-in dataset, BioLake applies reactive continuous data integration, helping the analysis pipeline to get rid of most preprocessing steps. The only pre-built-in dataset of BioLake in the first public version is TCGA-PRAD mRNA expression data for prostate cancer research, which is the primary focus of the development team of BioLake. In summary, BioLake offers a lightweight online tool to facilitate bioinformatic mRNA data analysis with the support of custom online data processing.