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Simple Summary: The current approach to breast cancer screening, which is based on a person's age, overlooks individual-level differences in breast cancer risk. As a result, many people are over- or under-screened according to their actual risk of breast cancer. Risk-stratified breast screening may overcome the limitations of age-based screening, but there are still many knowledge gaps regarding how best to implement it in the population setting. This study will generate the first Canadian evidence on the adoption of breast cancer risk assessment in the population setting, to support the future implementation of risk-stratified breast cancer screening. This study demonstrated that, while risk assessment for risk-stratified screening at the population level is feasible, an equity lens must be considered in implementation to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40–69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. [ABSTRACT FROM AUTHOR]

With the continuous improvement of shale oil and gas recovery technologies and achievements, a large amount of geological information and data have been accumulated for the description of shale reservoirs, and it has become possible to use machine learning methods for "sweet spots" prediction in shale oil and gas areas. Taking the Duvernay shale oil and gas field in Canada as an example, this paper attempts to build recoverable shale oil and gas reserve prediction models using machine learning methods and geological and development big data, to predict the distribution of recoverable shale oil and gas reserves and provide a basis for well location deployment and engineering modifications. The research results of the machine learning model in this study are as follows: ① Three machine learning methods were applied to build a prediction model and random forest showed the best performance. The R2 values of the built recoverable shale oil and gas reserves prediction models are 0.7894 and 0.8210, respectively, with an accuracy that meets the requirements of production applications; ② The geological main controlling factors for recoverable shale oil and gas reserves in this area are organic matter maturity and total organic carbon (TOC), followed by porosity and effective thickness; the main controlling factor for engineering modifications is the total proppant volume, followed by total stages and horizontal lateral length; ③ The abundance of recoverable shale oil and gas reserves in the central part of the study area is predicted to be relatively high, which makes it a favorable area for future well location deployment. [ABSTRACT FROM AUTHOR]

The prevalence of breast cancer amongst older adults in Canada is increasing. This patient population faces unique challenges in the management of breast cancer, as older adults often have distinct biological, psychosocial, and treatment-related considerations. This paper presents an expert consensus of the Canadian treatment landscape, focusing on key considerations for optimizing selection of systemic therapy for advanced breast cancer in older adults. This paper aims to provide evidence-based recommendations and practical guidance for healthcare professionals involved in the care of older adults with breast cancer. By recognizing and addressing the specific needs of older adults, healthcare providers can optimize treatment outcomes and improve the overall quality of care for this population. [ABSTRACT FROM AUTHOR]

Geothermal energy exploration, development, and research have been ongoing in Canada for several decades. The country's cold climate and the push to develop renewable energy sources have driven interest in geothermal energy. Despite this drive, regulatory complexities and competition with other relatively inexpensive energy sources with existing infrastructure have hindered development. As such, interest has grown and waned with changes in the energy economy over several decades, leaving many projects at a standstill. As of January 2023, there are currently no operational geothermal power projects in Canada. Many hot spring pool and spa complexes remain active, and Canada is a leading country in the installation of ground source heat pumps (GSHPs; also called geo-exchange systems). However, in the last decade, the interest in deep geothermal systems has renewed, with many new projects starting up across several provinces and territories. Moreover, projects that had shown limited progress for many years—such as Mount Meager in British Columbia—have begun to renew their development efforts. Research is also expanding within prominent research groups and universities. The areas of focus include both building upon previous studies (such as thermal gradients and the heat flow in sedimentary basins) and researching new methods and resources (such as GSHPs, closed-loop systems, integrated geothermal operations, and hybrid systems, including heat storage). The development is supported by federal, provincial, and territorial governments through grants and the development of regulatory frameworks. Although challenges still remain for Canada to develop its geothermal energy resources, several power, thermal, and co-production projects, ongoing research, funding, and regulatory acts are all moving forward to support geothermal development. This paper aims to study Canada's geothermal energy update in 2023 regarding the aspects mentioned above. [ABSTRACT FROM AUTHOR]

On 15–16 June 2023, healthcare professionals and breast cancer patients and advocates from across Canada met in Toronto, Ontario, for the 2023 Canadian Breast Cancer Symposium (CBSC.). The CBSC. is a national, multidisciplinary event that occurs every 2 years with the goal of developing a personalized approach to the management of breast cancer in Canada. Experts provided state-of-the-art information to help optimally manage breast cancer patients, including etiology, prevention, diagnosis, experimental biology, and therapy of breast cancer and premalignant breast disease. The symposium also had the objectives of increasing communication and collaboration among breast cancer healthcare providers nationwide and providing a comprehensive and real-life review of the many facets of breast cancer. The sessions covered the patient voice, the top breast cancer papers from different disciplines in 2022, artificial intelligence in breast cancer, systemic therapy updates, the management of central nervous system metastases, multidisciplinary management of ductal carcinoma in situ, special populations, optimization-based individual prognostic factors, toxicity management of novel therapeutics, survivorship, and updates in surgical oncology. The key takeaways of these sessions have been summarized in this conference report. [ABSTRACT FROM AUTHOR]

Over the last two decades, patient engagement in cancer research has evolved significantly, especially in addressing the unique challenges faced by adolescent and young adult (AYA) cancer populations. This paper introduces a framework for meaningful engagement with AYA cancer patient research partners, drawing insights from the "FUTURE" Study, a qualitative study that utilizes focus groups to explore the impact of cancer diagnosis and treatment on the sexual and reproductive health of AYA cancer patients in Canada. The framework's development integrates insights from prior works and addresses challenges with patient engagement in research specific to AYA cancer populations. The framework is guided by overarching principles (safety, flexibility, and sensitivity) and includes considerations that apply across all phases of a research study (collaboration; iteration; communication; and equity, diversity, and inclusion) and tasks that apply to specific phases of a research study (developing, conducting, and translating the study). The proposed framework seeks to increase patient engagement in AYA cancer research beyond a supplementary aspect to an integral component for conducting research with impact on patients. [ABSTRACT FROM AUTHOR]

This paper presents the findings of fifteen energy audits conducted on industrial sites in Canada's Greater Toronto Area (GTA). The audits covered a range of industries including food processing, packaged goods, and finishing processes (powder-coating). The primary focus of the audits was to analyze the natural gas consumption and the performance of major-gas-consuming equipment. The audits identified natural-gas-consuming equipment that could be optimized to yield energy and operational cost savings and greenhouse gas (GHG) reduction opportunities. Food production plants' energy intensity ranges from 5.59 m3/ft2 to 17.73 m3/ft2. Therefore, there is a significant opportunity to improve energy consumption through better technology integration. The results of the audits indicate a trend of an increase in the percentage of non-productive consumption with non-productive time. The proposed energy-saving measures include reducing non-productive natural gas consumption, gas-fired equipment tune-up, optimizing boiler loads, and reducing oven exhaust by using variable frequency drives (VFDs). The findings of this study could be used to develop a demand-side management program specifically for small- and medium-sized industrial facilities in the Greater Toronto Area and other parts of Canada. [ABSTRACT FROM AUTHOR]

This is a consensus-based Canadian guideline whose primary purpose is to standardize and facilitate the management of chronic graft-versus-host disease (cGvHD) across the country. Creating uniform healthcare guidance in Canada is a challenge for a number of reasons including the differences in healthcare authority structure, funding and access to healthcare resources between provinces and territories, as well as the geographic size. These differences can lead to variable and unequal access to effective therapies for GvHD. This document will provide comprehensive and practical guidance that can be applied across Canada by healthcare professionals caring for patients with cGvHD. Hopefully, this guideline, based on input from GvHD treaters across the country, will aid in standardizing cGvHD care and facilitate access to much-needed novel therapies. This consensus paper aims to discuss the optimal approach to the initial assessment of cGvHD, review the severity scoring and global grading system, discuss systemic and topical treatments, as well as supportive therapies, and propose a therapeutic algorithm for frontline and subsequent lines of cGvHD treatment in adults and pediatric patients. Finally, we will make suggestions about the future direction of cGvHD treatment development such as (1) a mode-of-action-based cGvHD drug selection, according to the pathogenesis of cGvHD, (2) a combination strategy with the introduction of newer targeted drugs, (3) a steroid-free regimen, particularly for front line therapy for cGvHD treatment, and (4) a pre-emptive approach which can prevent the progression of cGvHD in high-risk patients destined to develop severe and highly morbid forms of cGvHD. [ABSTRACT FROM AUTHOR]

Canada has one of the most complex and rigorous drug approval and public reimbursement processes and is, unfortunately, one of the countries with the longest delays in drug access. To assess the overall impact of systemic delays in access to cancer therapy, a targeted literature review (TLR) was performed to identify studies associated with the clinical, economic, and quality of life impacts of delayed access to oncology drugs. Using MEDLINE/PubMed databases and snowballing, four unique records met the eligibility criteria. Results revealed that clinical outcomes were the most impacted by systemic delays in access to oncology drugs (e.g., life years lost, overall survival, and progression-free survival). The four articles retrieved by the TLR specifically illustrated that a substantial number of life years could potentially be saved by increasing systemic efficiency regarding the development, approval, and reimbursement processes of new drugs for advanced malignancies. It is imperative that initiatives are put in place to improve the performance and speed of Canadian drug regulatory and health technology assessment (HTA) processes, especially for new cancer therapeutics. The proposed solutions in this paper include better coordination between HTA and Canadian payers to harmonize coverage decisions, international collaborations, information sharing, and national standards for timeliness in oncology drug access. [ABSTRACT FROM AUTHOR]