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Beta-lactam allergy is reported in 5–10% of children in North America, but up to 94–97% of patients are deemed not allergic after allergist assessment. The utility of standardized skin testing for penicillin allergy in the pediatric population has been recently questioned. Oral drug challenges when appropriate, are preferred over skin testing, and can definitively rule out immediate, IgE-mediated drug allergy. To our knowledge, this is the only pediatric study to assess the reliability of a penicillin allergy stratification tool using a paper and electronic clinical algorithm. By using an electronic algorithm, we identified 61 patients (of 95 deemed not allergic by gold standard allergist decision) as low risk for penicillin allergy, with no false negatives and without the need for allergist assessment or skin testing. In this study, we demonstrate that an electronic algorithm can be used by various pediatric clinicians when evaluating possible penicillin allergy to reliably identify low risk patients. We identified the electronic algorithm was superior to the paper version, capturing an even higher percentage of low risk patients than the paper version. By developing an electronic algorithm to accurately assess penicillin allergy risk based on appropriate history, without the need for diagnostic testing or allergist assessment, we can empower non-allergist health care professionals to safely de-label low risk pediatric patients and assist in alleviating subspecialty wait times for penicillin allergy assessment. [ABSTRACT FROM AUTHOR]

Floating Catchment Area (FCA) methods are a popular tool to investigate accessibility to public facilities, in particular health care services. FCA approaches are attractive because, unlike other accessibility measures, they take into account the potential for congestion of facilities. This is done by 1) considering the population within the catchment area of a facility to calculate a variable that measures level of service, and then 2) aggregating the level of service by population centers subject to catchment area constraints. In this paper we discuss an effect of FCA approaches, an artifact that we term demand and level of service inflation. These artifacts are present in previous implementations of FCA methods. We argue that inflation makes interpretation of estimates of accessibility difficult, which has possible deleterious consequences for decision making. Next, we propose a simple and intuitive approach to proportionally allocate demandand and level of service in FCA calculations. The approach is based on a standardization of the impedance matrix, similar to approaches popular in the spatial statistics and econometrics literature. The result is a more intiuitive measure of accessibility that 1) provides a local version of the provider-to-population ratio; and 2) preserves the level of demand and the level of supply in a system. We illustrate the relevant issues with some examples, and then empirically by means of a case study of accessibility to family physicians in the Hamilton Census Metropolitan Area (CMA), in Ontario, Canada. Results indicate that demand and supply inflation/deflation affect the interpretation of accessibility analysis using existing FCA methods, and that the proposed adjustment can lead to more intuitive results. [ABSTRACT FROM AUTHOR]

Freely-available satellite data streams and the ability to process these data on cloud-computing platforms such as Google Earth Engine have made frequent, large-scale landcover mapping at high resolution a real possibility. In this paper we apply these technologies, along with machine learning, to the mapping of peatlands–a landcover class that is critical for preserving biodiversity, helping to address climate change impacts, and providing ecosystem services, e.g., carbon storage–in the Boreal Forest Natural Region of Alberta, Canada. We outline a data-driven, scientific framework that: compiles large amounts of Earth observation data sets (radar, optical, and LiDAR); examines the extracted variables for suitability in peatland modelling; optimizes model parameterization; and finally, predicts peatland occurrence across a large boreal area (397, 958 km2) of Alberta at 10 m spatial resolution (equalling 3.9 billion pixels across Alberta). The resulting peatland occurrence model shows an accuracy of 87% and a kappa statistic of 0.57 when compared to our validation data set. Differentiating peatlands from mineral wetlands achieved an accuracy of 69% and kappa statistic of 0.37. This data-driven approach is applicable at large geopolitical scales (e.g., provincial, national) for wetland and landcover inventories that support long-term, responsible resource management. [ABSTRACT FROM AUTHOR]

• Method to evaluate allowable differential settlement for open top tank is proposed. • The proposed method is based on GMNA of 21 different tank models. • GMNA is performed to obtain the limiting settlement value for a tank geometry. • Proposed method is validated by randomly selected tanks and settlement profiles. • The drawback of the existing API 653 method-1 are highlighted. A method for evaluating the mechanical integrity of open-top cylindrical storage tanks subjected to a differential settlement is given. The settlement profile underneath the bottom circumference of the tank shell can be transformed into different harmonic components using the Fourier transformation. The existing method in American Petroleum Institute's standard API 653, which is currently used by the industry in North America, does not differentiate the effect of different harmonic components. Nevertheless, the proposed method evaluates a cumulative damage factor by considering the effects of first five harmonic components individually. The paper further discusses other limitations of the existing method in API 653 document. Numerous finite element analysis (FEA) simulations are conducted to formulate and validate the proposed method by employing geometric nonlinear algorithm with nonlinear plastic material properties (GMNA) in ABAQUS finite element software. The trend for limiting settlement values with respect to different harmonic components under consideration and different tank geometries are discussed. The proposed method is validated by performing FEA using four actual settlement data profiles on different tank geometries. Lastly, the comparison is drawn between the FEA results, the existing API 653 method and the proposed method. The results of the allowable settlement indicate that the existing method is not consistent with the FEA findings. For some of the actual settlement data, the existing method results in overly conservative values and for others it gives non-conservative values. Thus, the existing method may not capture the true behavior of tanks under settlement and needs modifications. The results of allowable settlement from the proposed method are found to be consistent with the FEA results for all different settlement data and tank geometries. Therefore, it is recommended that the new method is used instead of the existing method. [ABSTRACT FROM AUTHOR]