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This paper highlights action research into the practices of environmental learning through two interconnected stories focusing respectively on educational policy and the details of classroom instruction. Together these illustrate how a framework guides teachers in educational planning and supports the implementation of a curriculum for environmental learning in diverse subjects. Teacher inquiry, focus groups and interviews informed a collaborative writing process involving teachers and academics. The framework offers a conceptual view for environmental learning in all settings providing principles of teaching and learning to guide teachers in activities in a variety of learning contexts. The broader study sets the scene and the context for imbedded teacher inquiry. This study provides a personal perspective on how environmentally focused lessons were developed and researched by teachers. It highlights the story of a Grade 2/3 teacher (Ms. P) as she embarks on a program of action research about outdoor learning exemplary of other elements of the imbedded action research in the broader study. Multiple, overlapping themes emerge as she documents her reflections and students' interactions with local environments. This paper and its narratives together relate how the concepts of environmental learning and teacher experience empower us to guide learning in new, exciting ways.

Background: Hitherto, little work has examined the proposition that teachers may simultaneously invest varying degrees of their energetic resources in the teaching and learning environment. Aims: Drawing on a multidimensional, person-centred perspective, the study aimed to identify profiles of teacher engagement, reflecting distinct configurations of teachers' energetic investments, and their generalizability across Canadian and Australian teachers. Additionally, we examined teachers' self-efficacy beliefs as predictors of engagement profile membership and the cross-country generalizability of these relations. We also examined emotional exhaustion (EE) and job satisfaction (JS) as outcomes of profile membership in Canadian and Australian teachers, respectively. Samples: The samples comprised 586 Canadian and 595 Australian teachers. Methods: Data on teachers' multidimensional engagement and teacher self-efficacy were collected in both the Canadian and Australian samples. Additionally, data on Canadian teachers' burnout and Australian teachers' job satisfaction were collected. Results: Latent profile analyses revealed three engagement profiles, representing distinct configurations of teachers' multidimensional energetic investments, which were found to mostly generalize. Additionally, self-efficacy beliefs were found to predict the likelihood of engagement profile membership equally in Canadian and Australian teachers, and EE in Canadian teachers and JS in Australian teachers were found to differ significantly across the profiles. Conclusions: The results of the study constitute among the first evidence that teachers may be differentially engaged in the teaching environment with respect to their distinct energetic investments, and such differential profiles of engagement have differential implications for well-being-related outcomes and can be predicted by their teaching capability beliefs.

The Schwartz Outcome Scale-10 (SOS-10) is an effective measure of change in inpatient and outpatient populations, as well as student counseling centers, chemically dependent populations, and research projects. The utility of the SOS-10 in Canada is limited because there is currently no French version of this instrument. This study reports on a three-phase process (initial translation from English to French, evaluation of the online English SOS-10, and establishing equivalency between English online and French online versions) of development and validation of a French version of the SOS-10.

Increasing greenhouse gas emissions from the conventional fleet of diesel buses has made Canadian transit agencies explore low-emission alternative fuels. Despite electric buses showing great potential to reduce emissions during their operational phase, the transformation from diesel buses to electric buses would require in-depth analysis pertaining to their economic and social implications. Published literature highlights the importance of developing a comprehensive framework that considers multiple decision parameters over a life cycle perspective for analyzing different fuel options to replace the existing fleet of diesel buses. This paper assesses the triple-bottom-line sustainability of diesel and electric buses in different regions of Canada. Moreover, a framework is proposed to incorporate multiple decision criteria (life cycle environmental, economic, and social impacts) over different perspectives to make the best decisions for transitioning the diesel bus fleet. The results showed that the environmental performance of electric buses highly depended on the electricity grid mix. Despite diesel buses having a low cost of production compared to electric buses, most provinces showed a low life cycle operational cost for electric buses. Electric buses' life cycle social impacts are high during their production stage, whereas diesel buses have the highest social impacts during their operational phase. Overall, electric buses have a high sustainability performance in all provinces and territories in Canada except Nunavut. The proposed framework and findings can aid policymakers and planners in implementing electric buses for public transit systems in Canada and beyond. [ABSTRACT FROM AUTHOR]

Objective: This retrospective analysis of electrocardiographic (ECG) data investigated the cardiovascular effects of paroxetine 10-50 mg/day in pediatric patients (7-18 years of age). Data were collected from three 8- to 10-week, randomized, placebo-controlled, double-blind trials of paroxetine in pediatric patients with major depressive disorder or obsessive-compulsive disorder. Method: Electrocardiograms (ECGs) were retrospectively retrieved from 63 study sites in the United States and Canada. Only patients with at least one screening and one on-treatment ECG were included. ECGs were analyzed for heart rate, QT interval corrected using Bazett's formula (QTcB) and Fridericia's formula (QTcF), at screening and while being treated. PR, R-R, and QRS intervals and the maximum change in QTcB and QTcF from screening to endpoint were determined. Clinically significant thresholds were defined a priori. Results: A total of 1,451 ECGs from 449 patients receiving placebo (n = 207), paroxetine (n = 200), or imipramine (n = 42) were analyzed. Treatment with paroxetine did not significantly increase QTcB or QTcF or any ECG parameters compared with placebo. Treatment with imipramine significantly increased heart rate and QTcB, R-R, and QRS intervals compared with either paroxetine or placebo. Conclusions: Data from this retrospective study indicate that paroxetine (10-50 mg/day) is unlikely to be associated with significant ECG changes in medically healthy pediatric patients. (Contains 4 tables.)

Background: Traumatic events are associated with psychological and physical health problems for women in the perinatal period (i.e., pregnancy-12-months after childbirth). Despite the negative impact of trauma on perinatal women, the long-term impact of such diverse trauma and women's experience during the perinatal period remains understudied. Methods: This study explored two research questions: 1) What are the psychological experiences of perinatal women who have experienced interpersonal traumatic events? And 2) What are the service needs and gaps expressed by women relating to perinatal medical protocols and psychological services? These questions were addressed via in-depth semi-structured qualitative interviews with nine perinatal women (one pregnant and eight postpartum) residing in central Canada who reported experiencing interpersonal traumatic events occurring from adolescence to the perinatal period. Recruitment and data collection occurred from October 2020 to June 2021. Interviews were audio-recorded, transcribed, and analyzed according to constructivist grounded theory. Results: The emergent grounded theory model revealed the central theme of the role of prior trauma in shaping women's perinatal experiences, with four related main themes including perinatal experiences during the COVID-19 pandemic, the role of social support in women's perinatal experiences, the barriers that women experienced while seeking psychological and medical services prior to the perinatal period and during the perinatal period, and the specific needs of perinatal women with a history of interpersonal trauma. Conclusions: Findings of this research highlight the negative and long-lasting impact of traumatic events experienced on women's psychological health and psychosocial functioning during the perinatal period, as well as perinatal women's unmet psychological and medical service needs. A call to action for perinatal researchers and clinicians is imperative in furthering this important area of research and practicing person-centered and trauma-informed care with this population. [ABSTRACT FROM AUTHOR]

Objective: The relationship between antiseizure medications (ASMs), which improve health outcomes by controlling seizures, and health‐related quality of life (HRQOL) is poorly understood and may involve intermediate variables. We evaluated the potential mediators of the association between ASMs and HRQOL. Methods: Data are from an outpatient registry of adult patients with epilepsy seen at the Foothills Medical Center, Calgary, Alberta, Canada. Quality of life was measured using the 10‐item Quality of Life in Epilepsy, and depression was measured using the Neurological Disorders Depression Inventory for Epilepsy. Propensity score matching was used to adjust for covariate imbalance between patients who received a single ASM (monotherapy) and those who received two or more ASMs (polytherapy) due to confounding. Mediation analysis was used to estimate the mediating effects of depression and ASM side effects on the association between patients' ASM polytherapy and HRQOL. Results: Of 778 patients included in this analysis, 274 (35.2%) were on two or more ASMs. Patient‐reported depression and ASM side effects jointly mediated the association between ASMs and HRQOL; these mediators accounted for 42% of the total average effect of ASM polytherapy (β = −13.6, 95% confidence interval = −18.2 to −8.6) on HRQOL. Significance: These findings highlight the importance of managing depression and ASM side effects for improving health outcomes of patients requiring treatment with ASMs. Intervention programs aimed at improving HRQOL of patients with epilepsy need to target these potential mediators. [ABSTRACT FROM AUTHOR]

Background: To evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada. Methods: Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal atresia to a participating center. Results: The health charts of 215 patients (59.6% female) with choanal atresia (CA) were reviewed. Mean age of initial surgical repair was 0.8 months for bilateral CA, and 48.6 months for unilateral CA. Approaches of surgical repair consisted of endoscopic transnasal (31.7%), non-endoscopic transnasal (42.6%), and transpalatal (25.2%). Stents were used on 70.7% of patients. Forty-nine percent of patients were brought back to the OR for a planned second look; stent removal being the most common reason (86.4%). Surgical success rate of initial surgeries was 54.1%. Surgical technique was not associated with rate of restenosis [χ2 (2) = 1.6, p =.46]. Conclusions: The present study is the first national multi-institutional study exploring the surgical outcomes of CA over a 30-year period. The surgical repair of CA presents a challenge to otolaryngologists, as the rate of surgical failure is high. The optimal surgical approach, age at surgical repair, use of stents, surgical adjuncts, and need for planned second look warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Methods: Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center. Results: The health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome. Conclusions: The present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of comorbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted. [ABSTRACT FROM AUTHOR]

Background: Estimating a population-level benchmark rate for use of surgery in the management of cancer helps to identify treatment gaps, estimate the survival impact of such gaps, and benchmark the workforce and other resources, including budgets, required to meet service needs. A population-based benchmark for use of surgery in high-income settings to inform policy makers and service provision has not been developed but was recommended by the Lancet Oncology Commission on Global Cancer Surgery. We aimed to develop and validate a cancer surgery benchmarking model.Methods: We examined the latest clinical guidelines from high-income countries (Australia, the UK, the EU, the USA, and Canada) and mapped surgical treatment pathways for 30 malignant cancer sites (19 individual sites and 11 grouped as other cancers) that were notifiable in Australia in 2014, broadly reflecting contemporary high-income models of care. The optimal use of surgery was considered as an indication for surgery where surgery is the treatment of choice for a given clinical scenario. Population-based epidemiological data, such as cancer stage, tumour characteristics, and fitness for surgery, were derived from Australia and other similar high-income settings for 2017. The probabilities across the clinical pathways of each cancer were multiplied and added together to estimate the population-level benchmark rates of cancer surgery, and further validated with the comparisons of observed rates of cancer surgery in the South Western Sydney Local Health District in 2006-12. Univariable and multivariable sensitivity analyses were done to explore uncertainty around model inputs, with mean (95% CI) benchmark surgery rates estimated on the basis of 10 000 Monte Carlo simulations.Findings: Surgical treatment was indicated in 58% (95% CI 57-59) of newly diagnosed patients with cancer in Australia in 2014 at least once during the course of their treatment, but varied by site from 23% (17-27) for prostate cancer to 99% (96-99) for testicular cancer. Observed cancer surgery rates in South Western Sydney were comparable to the benchmarks for most cancers, but were higher for some cancers, such as prostate (absolute increase of 29%) and lower for others, such as lung (-14%).Interpretation: The model provides a new template for high-income and emerging economies to rationally plan and assess their cancer surgery provision. There are differences in modelled versus observed surgery rates for some cancers, requiring more in-depth analysis of the observed differences.Funding: University of New South Wales Scientia Scholarship, UK Research and Innovation-Global Challenges Research Fund. [ABSTRACT FROM AUTHOR]

Background: Seven structurally related β-lactamase-producing plasmids have been characterized in penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates. We characterized a variant (i.e. pJRD20, Canada type) of the Africa-type (pJD5) plasmid isolated from N. gonorrhoeae strain 8903.Objectives: To compare the DNA sequence of pJRD20 with that of pJD5 and pJD4 (Asia-type) and their TEM-1 β-lactamases.Methods: N. gonorrhoeae 8903 was identified as part of the Gonococcal Antimicrobial Surveillance Program in Canada. β-Lactamase production was assessed using nitrocefin. MICs were determined by agar dilution and Etest methods (CLSI). The DNA sequences of pJRD20, pJD5 and pJD4 were assembled and annotated. The structure of TEM-1 and its penicillin-binding properties were determined by in silico molecular modelling and docking. TEM-1 proteins were characterized by western blot, mass spectrometry and ampicillin hydrolysis assays.Results: N. gonorrhoeae 8903 exhibited intermediate susceptibility to penicillin with slow β-lactamase activity (i.e. 35 min to hydrolyse nitrocefin). Except for a novel 6 bp deletion starting at the G of the ATG start codon of blaTEM-1, the DNA sequence of pJRD20 was identical to that of pJD5. The TEM-1 β-lactamase produced by pJRD20 is 24 kDa and hydrolyses ampicillin only after several hours.Conclusions: This unusual PPNG isolate might have been characterized as a non-PPNG owing to its low MIC of penicillin and its very slow hydrolysis of nitrocefin. Given the unusual nature of its TEM-1 β-lactamase, laboratories might consider extending the duration of nitrocefin hydrolysis assays. [ABSTRACT FROM AUTHOR]

Abstract Household energy consumption and carbon footprints change with household characteristics such as type of residence, energy system performance, vehicle performance, and users' behavioral patterns. Accordingly, alternative energy technologies, such as clean electricity, hydrogen fuel cells, and energy efficient interventions, are being adopted in many parts of the world to reduce the residential, industrial, and transportation emissions. This paper presents a comprehensive research framework to identify the most desirable building retrofits and incentive schemes for Canadian households. Globally available incentive policies for low-emission vehicles and locally available retrofit options for single-family detached houses were identified during this study. A decision support tool based on life cycle thinking was developed to assess economic parameters, such as capital investment and annualized consumer cost, and environmental parameters such as greenhouse gas emissions. In order to rank and select the most desirable building retrofit, the TOPSIS ranking method was used. The linear programing graphical method was used to select the best incentive policy for low-emission vehicles. Finally, scenario analysis was used to compare different households based on regional economic and environmental characteristics. Provinces which have low-emission electricity grids such as Manitoba, British Columbia, and Quebec can primarily focus on incentives for electrified transportation. Additionally, the incentives for retrofits such as greener appliances and heating, ventilation, and air conditioning systems would also significantly reduce building carbon footprint. Conventional residential buildings with fossil fuel vehicles are more desirable for provinces like Saskatchewan, Alberta, and Nova Scotia which have high-emission electricity grids. Based on the outcomes of this research, a scientific incentive planning and management approach considering regional economic and environmental characteristics was introduced. Highlights • Life cycle thinking-based economic factors and operating emissions of single-detached household were analyzed. • Possible retrofit incentives and retrofit combinations were ranked based on regional economic and environmental factors. • Regions with low emission electric grids can primarily focus on incentives for electrified transportation system. • Conventional households and fossil-vehicles are desired for the areas with higher emission factor electric grid. [ABSTRACT FROM AUTHOR]

Road transportation is responsible for 23% of Canada's Greenhouse Gas (GHG) inventory due to complete dependence on fossil fuels. Decarbonizing the transportation sector using alternative energy sources is one of the most effective strategies to achieve GHG emission reduction targets. Alternative transportation modes such as electric and hydrogen fuel cell based vehicles are considered as scalable technologies for decarbonizing the transportation sector. However, there is a knowledge gap for a systematic investigation approach on regional viability of aforementioned vehicles. The main objective of this paper is to evaluate the financial feasibility and environmental impact of the electric light duty vehicles (LD-EVs) and hydrogen fuel cell light duty vehicles (LD-HFCVs) use in Canada. A life cycle thinking based approach has been proposed to compare costs and emissions of transportation based on electric and Hydrogen with traditional fossil fuel. The carbon offset saving was used to quantify the economic impact of GHG reduction. The carbon taxes for selected provinces were recommended as a potential policy implementation to reduce transport based GHG emissions. The results indicate that the provinces with low emission factor electric grids have a higher potential for LD-EV based transportation system in terms of costs and footprint. Presently LD-HFCVs are less desirable due to high purchase and operational cost. Development of a Hydrogen based transportation system through the production of cost effective hydrogen is preferable for provinces with a higher emission factor electric grids. [ABSTRACT FROM AUTHOR]

Wildfires are frequent boreal forest disturbances in Canada, and emulating their patterns with forest harvesting has emerged as a common forest management goal. Wildfires contain many patches of residual vegetation of various size, shape, and composition; understanding their characteristics provides insights for improved emulation criteria. We studied the occurrence of residual vegetation within eleven boreal wildfire events in a natural setting; fires ignited by lightning, no suppression efforts, and no prior anthropogenic disturbances. Relative importance of the measurable geo-environmental factors and their marginal effects on residual presence are studied using Random Forests. These factors included distance from natural firebreaks (wetland, bedrock and non-vegetated areas, and water), land cover, and topographic variables (elevation, slope, and ruggedness index). We present results at spatial resolutions ranging from four to 64 m while emphasizing four and 32 m since they mimic IKONOS- and Landsat-type images. Natural firebreak features, especially the proximity to wetlands, are among the most important variables that explain the likelihood residual occurrence. The majority of residual vegetation areas are concentrated within 100 m of wetlands. Topographic variables, typically important in rugged terrain, are less important in explaining the presence of residuals within our study fires. [ABSTRACT FROM AUTHOR]

Despite an overall increase in total road salt used over the past 14 years (the data record in this manuscript), there has been a 26% reduction in the rate (normalized as tonnes of salt per cm of snow per km of road) of road salt application by the City of Toronto since that city implemented mitigations from the Road Salt Code of Practice. The ecological benefit of the reduced use of road salt was approximated by comparing the estimated 26% salt reduction to the distribution of chloride tolerances that has been recently published by the Canadian Council of Ministers of the Environment (i.e., CCME). Species sensitivity distributions predict that between 1 and 14% of taxa would benefit from a 26% reduction in chloride concentrations in surface waters. Assuming that a typical 'healthy' Canadian watercourse might support between 100 and 200 species of fish, invertebrates and plants, the Code of Practice might provide benefit to between 14 and 28 species. However, the net ecological benefit of implementing the Code may be undermined in rapidly urbanizing watersheds where road networks continue to expand at a rate of 3-5% per year and chloride loads to urban streams are steadily increasing. [ABSTRACT FROM AUTHOR]

Summary: Chloride from road salt enters streams primarily through surface runoff and groundwater discharge. Monitoring of dry-weather flow chloride concentrations in the Highland Creek watershed of the eastern Greater Toronto Area indicates the presence of a previously unrecognised, dual porosity aquifer system whereby preferential flow associated with “urban karst” exerts a significant influence on baseflow chloride concentrations early in the year. A chloride mass balance undertaken annually over four successive salting seasons suggests that as much as 40% of the chloride applied as road salt enters the shallow aquifer resulting in a net accumulation of chloride and a gradual increase in mean baseflow chloride concentrations. Assuming current road salt application rates are continued, late summer baseflow chloride concentrations will reach around 505mg/L, almost double present levels. Elevated chloride concentrations can affect the potability of water (the Canadian aesthetic drinking water quality guideline for chloride is 250mg/L) and can also be toxic to aquatic organisms (CCME aquatic chronic toxicity guideline is 208mg/L). Meeting these guidelines would require that the release of salt-laden runoff to the subsurface be reduced by over 50%. [Copyright &y& Elsevier]

Resource management strategies have begun to adopt natural landscape disturbance emulation as a means of minimizing risk to ecosystem integrity. Detailed understanding of the disturbance regime and the associated spatial landscape patterns are required to provide a “natural” baseline for comparison with the results of emulation strategies. Landscape pattern indices provide a useful tool to quantify spatial pattern for developing these strategies and evaluating their success. Despite an abundance of indices and tools to calculate these, practical knowledge of interpretation is rare. Quantifying changes in landscape pattern indices and the meaning of these changes is confounded by index sensitivity to input data characteristics such as spatial extent, spatial resolution, and thematic resolution. Sensitivity has been examined for simulated landscapes but rarely using real data for large areas as real landscapes are more difficult to manipulate systematically than simulated data. While simulated data offer a control, they do not provide an accurate portrayal of reality for practical applications. Our goal was to test the sensitivity of a suite of landscape pattern indices useful for disturbance emulation strategy development and evaluation to spatial extent, spatial resolution, and thematic resolution using current land cover data for a case study of the managed forest of Ontario, Canada. We also examined how sensitivity varies spatially across the study area. We used Landsat TM-based land cover data (> 45.5 million ha), controlling spatial extent (2,500 to 2,560,000 ha), spatial resolution (1 to 16 ha), and thematic resolution (2 to 26 classes). For each index we tested a hypothesis of insensitivity to changes in each input data characteristic using a combination of ANOVA and regression and compared our results with previous studies. Of the 18 indices studied, significant (p< 0.01) effects were found for 17 indices with changes in spatial extent, 13 indices with changes in spatial resolution and 18 indices with changes in thematic resolution. A significant (p < 0.01) linear trend accounted for the majority of the variance for all of the significant relationships identified. Most of the mean index responses were consistent with those interpreted from previous studies of simulated and real landscapes; however, sensitivity varied greatly among indices and over space. We suggest that variation in sensitivity to input data characteristics among indices and over space must be explicitly incorporated in the design of future natural disturbance emulation efforts. [ABSTRACT FROM AUTHOR]

To better manage southern Ontario's natural forests, the former and present status of old growth must be understood. We hypothesize that old-growth pine (Pinus spp.), although dominant elsewhere, was less common in southern Ontario than popular history suggests: we are obliged to evaluate historical information that has been filtered both by the original compilers and through our own biases. Beginning around 600 AD, the predominant beech (Fagus americana) forest was partially replaced by maple (primarily Acer saccharum), oaks (Quercus spp.) and eastern white pine (P. strobus). This pine increase either followed abandonment of pre-Columbian agriculture or, more plausibly, accompanied climate cooling. Eighteenth and 19[sup th] century European settlers encountered abundant large trees, which they hewed for square pine timber, milled timber, and tanbark. Other stands were cut and burned for agricultural clearance, with a potash by-product. Until recently, Ontario research emphasized the old-growth pine stands of central and northern Ontario to the relative exclusion of other kinds of old forest because very few southern Ontario old-growth stands remained to study. Ontario forest resource inventory data (FRI) show stands of over 150 years totalling only 1475 ha in 1978, concentrated on the Oak Ridges Moraine, the St. Lawrence Valley and the Awenda Peninsula. Red (P. resinosa) and eastern white pine stands constituted only 5.3% of the 1978 forested area, with virtually none of over 150 years, whereas eastern hemlock (Tsuga canadensis) stands constituted 12.8%. The difficulty in finding modern old growth necessitates historical reconstruction using physical, written and graphical resources, including early survey records and trade statistics. In a case study of 1822 survey data from Darling Township (Lanark Co.) and 1960 FRI, vegetation was classified using TWlNSPAN and mapped using ARC/INFO Thiessen polygons. In 1822, dominant hemlock occupied half the township but... [ABSTRACT FROM AUTHOR]

Compares three Advanced Very High Resolution Radiometer (AVHRR)/Normalized Difference Vegetation Index (NDVI) methods of fire detection and mapping for a case study in northern Ontario, Canada of the 1992, 1993 and 1995 fire seasons. Use of a decision-tree approach; Correlation of ground-truthed fire sizes and shapes with the AVHRR/NDVI-mapped areas.

Helps physicians and patients arrive at optimal strategies for breast radiotherapy after breast-conserving surgery (BCS) for early breast cancer. Outcomes; Evidence; Benefits; Harms; Recommendations.

The article presents a study on the transmission of Brucela melitensis at St. Michael's Hospital in Toronto, Ontario. It investigates the exposure among hospital workers during a hip joint procedure and aerosol-generating procedures. It is suggested that workers should use fit-tested N95 respirators, gloves, gown and facial protection to prevent the spread of the disease.

Occupant behavior in residential buildings has a direct impact on the effectiveness of energy-saving measures. In order to realize a buildings' carbon mitigation targets, the impact of individual occupancy profiles needs to be integrated with building simulation models. This paper introduces a decision support framework as a potential solution to make energy performance upgrade choices based on different occupancy profiles. This framework has been demonstrated through a case study of two single-family detached homes in Canada, which were highly instrumented with sensors for monitoring energy input and output. The case studies represented two common occupancy profiles-(1) a family of four (consisting of 2 working adults and 2 teenagers); and (2) a retired couple. Firstly, calibrated energy models were developed by using one-year energy use data collected through an intrusive load monitoring technique. Secondly, energy upgrade combinations were considered for each profile and tested for additional investment, payback period and greenhouse gas (GHG) emissions. Lastly, the most suitable combination of energy upgrade for each profile was ranked using a multi-criteria decision-making method (e.g., TOPSIS). Results indicated that the retired couple used more energy than the family of four and required energy upgrades with usually higher payback periods to achieve the same level of GHG emission reduction. The results of this research are timely for energy policymaking and developing best management practices, which need to be implemented along with the deployment of more stringent building standards and codes. • A scenario-based framework was developed for residential homes energy upgrades. • It considers occupant behavior and preference in selecting energy upgrades. • Field data is used to represent energy use of a family of four and a stay-at-home retired couple. • Energy upgrades are same under pro-economic choices for two profiles. • Energy upgrades vary under pro-environmental scenarios for two profiles. [ABSTRACT FROM AUTHOR]

Recharging infrastructure (RI) deployment plays a vital role in improving the public recharging availability for transport electrification. Decarbonizing transportation using low-emission electricity requires massive RI network. Even though the consumers are reluctant to purchase electric vehicles (EVs) until RIs are sufficiently placed, the investors are not willing to invest in RIs due to recharging demand uncertainties. Therefore, a scientific planning framework is needed to ensure the sustainable deployment of EV-RIs in complex networks. In this study, a lifecycle thinking-based multi-period infrastructure-planning framework is proposed to develop sustainable public EV-RIs in an urban context. This framework consists of a temporal model to find the dynamic EV-RI demands, a stochastic model to obtain travel distances, and a multi-objective optimization model to select the best desirable capacities and locations for potential EV-RIs. A case study of a typical medium-scale municipality in Canada was assessed using the proposed framework and validated using conventional infrastructure planning scenarios. The geo-processing data, regional travel behaviors, and recharging characteristics were used as model inputs. The results of the case study showed that the proposed framework can be used to estimate multi-period public recharging demands, minimize lifecycle costs, maximize service coverage and infrastructure utilization, and ensure reasonable paybacks compared to conventional planning approaches. Moreover, this framework can be used to compare different investment assistances, which are required in the early stages of the RI deployment process to encourage investors. Furthermore, government and private institutions can use this framework to identify recharging demands, permitting, and developing RIs in the long-run. • Lifecycle thinking-based planning framework is proposed to develop EV recharging infrastructure. • Temporal and spatial models were used to obtain EV recharging demands and travel distances. • Location-based data, regional travel behaviors, and temporal variations were used as inputs. • Multi-objective optimization was used to obtain capacities and locations for potential facilities. • The method was applied to medium-scale community and validated using expert opinion. [ABSTRACT FROM AUTHOR]

Modern computational methods using patient Human Immunodeficiency Virus type 1 (HIV-1) genetic sequences can model population-wide viral transmission dynamics. Accurate transmission inferences can play a critical role in the characterization of high-risk transmission clusters important for enhanced epidemiological control. We evaluated a phylogenetics-based analysis pipeline to infer person-to-person (P2P) infection dates and transmission relationships using 139 patient HIV-1 polymerase Sanger sequences curated by the Southern Alberta HIV Clinic. Parameter combinations tailored to HIV-1 transmissions were tuned with respect to inference accuracy. Inference accuracy was assessed using clinically confirmed P2P transmission patient data. The most accurate parameter settings correctly inferred 48.56% of the P2P relationships (95% confidence interval 63.89–33.33%), slightly lower than next-generation-sequencing methods. The infection date was correctly inferred 43.02% (95% confidence interval 49.89–35.63%). Several novel unsuspected transmission clusters of up to twelve patients were identified. An accuracy trade-off between inferring transmission relationships and infection dates was observed. Using clinically confirmed P2P transmission data as benchmark, our phylogenetic methods identified sufficient P2P transmission relationships using readily available low-resolution Sanger sequences. These approaches may give valuable information about HIV infection dynamics within a population and may be easily deployed to guide public health interventions, without a need for next generation sequencing technology. [ABSTRACT FROM AUTHOR]

Background: Whole breast irradiation delivered once per day over 3-5 weeks after breast conserving surgery reduces local recurrence with good cosmetic results. Accelerated partial breast irradiation (APBI) delivered over 1 week to the tumour bed was developed to provide a more convenient treatment. In this trial, we investigated if external beam APBI was non-inferior to whole breast irradiation.Methods: We did this multicentre, randomised, non-inferiority trial in 33 cancer centres in Canada, Australia and New Zealand. Women aged 40 years or older with ductal carcinoma in situ or node-negative breast cancer treated by breast conserving surgery were randomly assigned (1:1) to receive either external beam APBI (38·5 Gy in ten fractions delivered twice per day over 5-8 days) or whole breast irradiation (42·5 Gy in 16 fractions once per day over 21 days, or 50 Gy in 25 fractions once per day over 35 days). Patients and clinicans were not masked to treatment assignment. The primary outcome was ipsilateral breast tumour recurrence (IBTR), analysed by intention to treat. The trial was designed on the basis of an expected 5 year IBTR rate of 1·5% in the whole breast irradiation group with 85% power to exclude a 1·5% increase in the APBI group; non-inferiority was shown if the upper limit of the two-sided 90% CI for the IBTR hazard ratio (HR) was less than 2·02. This trial is registered with ClinicalTrials.gov, NCT00282035.Findings: Between Feb 7, 2006, and July 15, 2011, we enrolled 2135 women. 1070 were randomly assigned to receive APBI and 1065 were assigned to receive whole breast irradiation. Six patients in the APBI group withdrew before treatment, four more did not receive radiotherapy, and 16 patients received whole breast irradiation. In the whole breast irradiation group, 16 patients withdrew, and two more did not receive radiotherapy. In the APBI group, a further 14 patients were lost to follow-up and nine patients withdrew during the follow-up period. In the whole breast irradiation group, 20 patients were lost to follow-up and 35 withdrew during follow-up. Median follow-up was 8·6 years (IQR 7·3-9·9). The 8-year cumulative rates of IBTR were 3·0% (95% CI 1·9-4·0) in the APBI group and 2·8% (1·8-3·9) in the whole breast irradiation group. The HR for APBI versus whole breast radiation was 1·27 (90% CI 0·84-1·91). Acute radiation toxicity (grade ≥2, within 3 months of radiotherapy start) occurred less frequently in patients treated with APBI (300 [28%] of 1070 patients) than whole breast irradiation (484 [45%] of 1065 patients, p<0·0001). Late radiation toxicity (grade ≥2, later than 3 months) was more common in patients treated with APBI (346 [32%] of 1070 patients) than whole breast irradiation (142 [13%] of 1065 patients; p<0·0001). Adverse cosmesis (defined as fair or poor) was more common in patients treated with APBI than in those treated by whole breast irradiation at 3 years (absolute difference, 11·3%, 95% CI 7·5-15·0), 5 years (16·5%, 12·5-20·4), and 7 years (17·7%, 12·9-22·3).Interpretation: External beam APBI was non-inferior to whole breast irradiation in preventing IBTR. Although less acute toxicity was observed, the regimen used was associated with an increase in moderate late toxicity and adverse cosmesis, which might be related to the twice per day treatment. Other approaches, such as treatment once per day, might not adversely affect cosmesis and should be studied.Funding: Canadian Institutes for Health Research and Canadian Breast Cancer Research Alliance. [ABSTRACT FROM AUTHOR]

Purpose Optimal first-line systemic therapy for patients with advanced nonsquamous (nonsq) non-small-cell lung cancer (NSCLC) requires confirmation of EGFR/ALK status, which can delay treatment. We evaluated the impact of reflex testing, defined as pathologists initiating EGFR/ALK testing at the time of diagnosis of nonsq NSCLC, on time to treatment (TTT). Methods We conducted a retrospective review of patients with nonsq NSCLC with medical oncology consultation at Sunnybrook Odette Cancer Centre between March 18,2010 and April 30,2014. Data were compared during routine and reflex testing. TTT was defined as the interval between the first medical oncology visit with advanced NSCLC and the initiation of systemic therapy. Results A total of 306 patients were included (n = 232 for routine testing, n = 74 for reflex testing). There was a trend to improvement in median TTT with reflex testing (36 days [interquartile range {IQR}, 16 to 71 days v 26 days [IQR, 8 to 41 days], P = .071). Omitting patients with intentional delays in systemic therapy for low-volume disease, poor performance status, comorbidity management, and/or radiation therapy, median TTT improved (34 days [IQR, 15 to 67 days] v 22 days [IQR, 8 to 42 days], P = .049). Time to optimal first-line systemic therapy according to published guidelines improved (median, 36 days [IQR, 16 to 91 days] v 24 days [IQR, 8 to 43 days], P = .036). There was no impact on receipt of any first-line systemic therapy (55% v 59%, P = .66). The quality of biomarker testing improved, with fewer unsuccessful tests (EGFR, 14% v 4%, P = .039; and ALK, 17% v 3%, P = .037). Conclusion Reflex testing of EGFR/ALK improved the time to optimal systemic therapy and the quality of biomarker testing for patients with advanced nonsq NSCLC. [ABSTRACT FROM AUTHOR]