Aim Cardiovascular disease (CVD) risk is lower in pre‐menopausal females vs age matched males. After menopause risk equals or exceeds that of males. CVD protection of pre‐menopausal females is ascribed to high circulating oestrogen levels. Despite experimental evidence that oestrogen are cardioprotective, oestrogen replacement therapy trials have not shown clear benefits. One hypothesis to explain the discrepancy proposed hearts remodel during peri‐menopause. Peri‐menopasual myocardial changes have never been investigated, nor has the ability of oestrogen to regulate heart function during peri‐menopause. Methods We injected female mice with 4‐vinylcyclohexene diepoxide (VCD, 160 mg/kg/d IP) to cause gradual ovarian failure over 120d and act as a peri‐menopausal model Results Left ventricular function assessed by Langendorff perfusion found no changes in VCD‐injected mice at 60 or 120 days compared to intact mice. Cardiac myofilament activity was altered at 60 and 120 days indicating a molecular remodelling in peri‐menopause. Myocardial TGF‐β1 increased at 60 days post‐VCD treatment along with reduced Akt phosphorylation. Acute activation of oestrogen receptor‐α (ERα) or ‐β (ERβ) depressed left ventricular contractility in hearts from intact mice. ER‐regulation of myocardial and myofilament function, and myofilament phosphorylation, were disrupted in the peri‐menopausal model. Disruption occurred without alterations in total ERα or ERβ expression. Conclusions This is the first study to demonstrate remodelling of the heart in a model of peri‐menopause, along with a disruption in ER‐dependent regulation of the heart. These data indicate that oestrogen replacement therapy initiated after menopause affects a heart that is profoundly different from that found in reproductively intact animals.

Background: Concussion prevalence is increasing in the pediatric population, and is a matter of public health concern. Concussion symptoms can be physical, cognitive, emotional and behavioural, and last longer in high school aged youth than adults. Concussions are underreported in youth due to their lack of knowledge, social environment, perceived outcomes of reporting, norms, and self-efficacy. The Youth Concussion Awareness Network (You-CAN) is a school-based peer-led program designed to increase high school students' intent to report a concussion, and provide social support to a peer. This study aims to investigate whether participation in You-CAN, a program grounded in service learning principles, impacts concussion knowledge, attitudes, intent to report a suspected concussion to an adult, and intent to provide social support to a peer. Secondary aims include assessing the implementation fidelity and acceptability of the intervention. Methods: This longitudinal study will use a cluster randomized trial design. Three high schools from six randomly selected Canadian school boards will participate and be randomized to three study arms: (1) You-CAN led by school staff; (2) You-CAN led by school staff and research team; and (3) untreated comparison group. Intervention arms 1 and 2 will deliver the You-CAN program and create a Concussion Council at their school. The Concussion Council will deliver a concussion awareness campaign and participate in an online showcase with other participating schools. In addition, arm 2 will have monthly video-calls with the research team. A survey based on the Theory of Planned Behaviour will be administered school-wide with all arms (1, 2, 3) at two time points (beginning {T 0 } and end {T 1 } of the school year). Exit interviews will be completed with the Concussion Councils and participating school staff. Discussion: This study will provide evidence of the effectiveness of a school-based peer-led concussion program on increasing concussion knowledge, attitudes, subjective norms, perceived behavioural control, intent to report a concussion to an adult, and intent to provide social support to a peer amongst Canadian high school students. It will also provide important information about the implementation and acceptability of the You-CAN program for high school students and staff.

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Background All Canadian Residency Matching Service (CaRMS) R1 interviews were conducted virtually for the first time in 2021. We explored the facilitators, barriers, and implications of the virtual interview process for the CaRMS R1 match and provide recommendations for improvement. Methods We conducted a cross-sectional survey study of CaRMS R1 residency applicants and interviewers across Canada in 2021. Surveys were distributed by email to the interviewers, and by email, social media, or newsletter to the applicants. Close-ended items were described, and open-ended items were thematically analyzed. Results A total of 127 applicants and 400 interviewers, including 127 program directors, responded to the survey. 193/380 (50.8%) interviewers and 90/118 (76.3%) applicants preferred virtual over in-person interview formats. Facilitators of the virtual interview format included cost and time savings, ease of scheduling, reduced environmental impact, greater equity, less stress, greater reach and participation, and safety. Barriers of the virtual interview format included reduced informal conversations, limited ability for applicants to explore programs at different locations, limited ability for programs to assess applicants’ interest, technological issues, concern for interview integrity, limited non-verbal communication, and reduced networking opportunities. The most helpful mediums for applicants to learn about residency programs were program websites, the CaRMS/AFMC websites, and recruitment videos. Additionally, panel interviews were preferred by applicants for their ability to showcase themselves and build connections with multiple interviewers. Conclusions Perceptions of 2021 CaRMS R1 virtual interviews were favourable among applicants and interviewers. Recommendations from this study can help improve future iterations of virtual CaRMS interviews.

Blended learning using augmented reality glasses during the COVID-19 pandemic: the present and the future.