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We conducted a national study of the Collegiate Leadership Competition (CLC), which since inception in 2015, has included over 75 higher education institutions. The CLC brings students together in collaborative institution-based teams to compete with other teams in competitions to achieve goals and practice effective leadership skills. Our goal was to assess leadership capacity growth over the course of a four-month team practice period through the daylong inter-team competition and evaluate participant leadership assessed several months later. Results suggested students made significant and sustainable gains in leader-self-efficacy and short-term gains in leadership skill and motivation to lead. Our results also indicated the team's coach played a significant role in student leadership development. Leadership development programs for students in educational settings are proliferating in number and design. Curricular programs range from academic minors and certificates to doctoral programs in a variety of academic homes (e.g., education, business, healthcare). Co-curricular programs often take the form of drop-in workshops, day-long experiences, alternative spring breaks, service-learning trips, and other programs housed in student affairs and administrative offices (Guthrie & Jenkins, 2018). Moreover, the number of programs has steadily increased over the last 15 years from just under 1,000 in 2006 (Brungardt, et al., 2006) to more than 2,000 (ILA Program Directory, 2021). And while there is some commonality among the approach of these leadership programs in terms of content and delivery (see Harvey & Jenkins, 2014), vast differences exist in the structure and learning goals of student leadership programs compared to other social science disciplines. A potentially fruitful area in which to explore its effectiveness in supporting leadership development is the environment of competitive teams, where individuals work together as a group to compete against other teams. The purpose of our research was to investigate the degree to which such a competitive environment might support or detract from student leadership group, employing a potentially effective example of a formal program that utilizes the innovative approach of team competitions to motivate learning (the CLC).

Energy companies in the Athabasca Oil Sands Region in Alberta, Canada are evaluating the viability of incorporating pit lakes into reclamation closure designs to both sequester tailings and re-integrate the mining lease into the broader natural landscape. Lake Miwasin is a pilot-scale oil sands pit lake encompassed by a constructed catchment where the volume of the water cap is not actively managed. This study compared the water balance during the open water season over two consecutive years with contrasting levels of summertime precipitation. The first year had above average rainfall triggering surface water inflow events that diluted the over-winter water volume by ~ 25%. Flushing of the deepest layers of the water column was restricted from May – September as thermal stratification inhibited complete lake mixing. The second year had below average rainfall resulting in minimal surface water inflow and a drop in lake stage of ~ 30 cm. As the constructed catchment lacks both natural water bodies and connectivity to a legacy groundwater system, freshwater additions to the lake during the summer season were governed by rainfall. This research highlights challenges with constructing sustainable reclamation landscapes within a region characterised by variations in interannual and decadal water cycles. [ABSTRACT FROM AUTHOR]

Fire is the dominant disturbance agent in Alaskan and Canadian boreal ecosystems and releases large amounts of carbon into the atmosphere. Burned area and carbon emissions have been increasing with climate change, which have the potential to alter the carbon balance and shift the region from a historic sink to a source. It is therefore critically important to track the spatiotemporal changes in burned area and fire carbon emissions over time. Here we developed a new burned-area detection algorithm between 2001–2019 across Alaska and Canada at 500 m (meters) resolution that utilizes finer-scale 30 m Landsat imagery to account for land cover unsuitable for burning. This method strictly balances omission and commission errors at 500 m to derive accurate landscape- and regional-scale burned-area estimates. Using this new burned-area product, we developed statistical models to predict burn depth and carbon combustion for the same period within the NASA Arctic–Boreal Vulnerability Experiment (ABoVE) core and extended domain. Statistical models were constrained using a database of field observations across the domain and were related to a variety of response variables including remotely sensed indicators of fire severity, fire weather indices, local climate, soils, and topographic indicators. The burn depth and aboveground combustion models performed best, with poorer performance for belowground combustion. We estimate 2.37×106 ha (2.37 Mha) burned annually between 2001–2019 over the ABoVE domain (2.87 Mha across all of Alaska and Canada), emitting 79.3 ± 27.96 Tg (±1 standard deviation) of carbon (C) per year, with a mean combustion rate of 3.13 ± 1.17 kg C m -2. Mean combustion and burn depth displayed a general gradient of higher severity in the northwestern portion of the domain to lower severity in the south and east. We also found larger-fire years and later-season burning were generally associated with greater mean combustion. Our estimates are generally consistent with previous efforts to quantify burned area, fire carbon emissions, and their drivers in regions within boreal North America; however, we generally estimate higher burned area and carbon emissions due to our use of Landsat imagery, greater availability of field observations, and improvements in modeling. The burned area and combustion datasets described here (the ABoVE Fire Emissions Database, or ABoVE-FED) can be used for local- to continental-scale applications of boreal fire science. [ABSTRACT FROM AUTHOR]

Fire is the dominant disturbance agent in Alaskan and Canadian boreal ecosystems and releases large amounts of carbon into the atmosphere. Burned area and carbon emissions have been increasing with 40 climate change, which have the potential to alter the carbon balance and shift the region from a historic sink to a source. It is therefore critically important to track the spatiotemporal changes in burned area and fire carbon emissions over time. Here we developed a new burned area detection algorithm between 2001 - 2019 across Alaska and Canada at 500 meters (m) resolution that utilizes finer-scale 30 m Landsat imagery to account for land cover unsuitable for burning. This method strictly balances omission and commission 45 errors at 500 m to derive accurate landscape- and regional-scale burned area estimates. Using this new burned area product, we developed statistical models to predict burn depth and carbon combustion for the same period within the NASA Arctic-Boreal Vulnerability Experiment (ABoVE) core and extended domain. Statistical models were constrained using a database of field observations across the domain and were related to a variety of response variables including remotely-sensed indicators of fire severity, fire 50 weather indices, local climate, soils, and topographic indicators. The burn depth and aboveground combustion models performed best, with poorer performance for belowground combustion. We estimate 2.37 million hectares (Mha) burned annually between 2001-2019 over the ABoVE domain (2.87 Mha across all of Alaska and Canada), emitting 79.3 +/- 27.96 (+/- 1 standard deviation) Teragrams of carbon (C) per year, with a mean combustion rate of 3.13 +/- 1.17 kilograms C m-2. Mean combustion and burn 55 depth displayed a general gradient of higher severity in the northwestern portion of the domain to lower severity in the south and east. We also found larger fire years and later season burning were generally associated with greater mean combustion. Our estimates are generally consistent with previous efforts to quantify burned area, fire carbon emissions, and their drivers in regions within boreal North America; however, we generally estimate higher burned area and carbon emissions due to our use of Landsat imagery, 60 greater availability of field observations, and improvements in modeling. The burned area and combustion data sets described here (the ABoVE Fire Emissions Database, or ABoVE-FED) can be used for local to continental-scale applications of boreal fire science. [ABSTRACT FROM AUTHOR]

Northern peatlands have cooled the global climate by accumulating large quantities of soil carbon (C) over thousands of years. Maintaining the C sink function of these peatlands and their immense long‐term soil C stores is critical for achieving net‐zero global carbon dioxide (CO2) emissions by 2050 to mitigate climate warming. One‐quarter of the world's northern peatlands are in Canada, with these mostly intact ecosystems providing a global C service that is increasingly recognized as a critical part of nature‐based solutions to combat climate change. However, land‐use change and other disturbances threaten these globally important stores of "irrecoverable C" (that is, soil C lost to disturbance that will take centuries to recover). Inadequate policy safeguards to avoid conversion and degradation, and the limited quantification and reporting of peatland greenhouse‐gas emissions and removals, increase the vulnerability of these peatlands. Targeted policies from local to global scales will be needed for improved decision making and incentivizing long‐term C management of northern peatlands. [ABSTRACT FROM AUTHOR]

Oil and gas exploration has resulted in over 300,000 km of linear disturbances, known as seismic lines, throughout boreal peatlands across Canada. Sites are left with altered hydrologic and topographic conditions that prevent tree re-establishment. Restoration efforts have concentrated on tree recovery through mechanical mounding to re-create microtopography and support planted tree seedlings to block sightlines and deter the use of lines by wolves, but little is known about the impact of seismic line disturbance or restoration on peatland carbon cycling. This study looked at two mounding treatments and compared summer growing season carbon dioxide and methane fluxes to untreated lines and natural reference areas of a wooded fen in the first two years post-restoration. We found no significant differences in net ecosystem CO2 exchange, but untreated seismic lines were slightly more productive than natural reference areas and mounding treatments. Both restoration treatments increased ecosystem respiration, decreased net productivity by 6–21 g CO2 m−2 d−1, and created areas of increased methane emissions, including an increase in the contribution of ebullition, of up to 2000 mg CH4 m−2 d−1 over natural and untreated lines. Further research on this site to assess the longer-term impacts of restoration, as well as application on other sites with varied conditions, will help determine if these restoration practices are effective at restoring carbon cycling. [ABSTRACT FROM AUTHOR]

Across Canada's boreal forest, disturbances from in situ oil sands mining, including well‐pads, significantly impact vast areas of the landscape. The creation of well‐pads requires removal of vegetation and placement of mineral fill, which essentially stops any carbon (C) sequestration on the once peatland ecosystem. It is important that, once no longer in use, these well‐pads are restored as long‐term C (peat) accumulation is what defines peatland ecosystem. However, little is known about the recovery of greenhouse gas exchange post‐restoration of these features. We studied a decommissioned well‐pad located in a treed poor fen that was restored using three soil adjustment treatments (SATs): (1) complete mineral fill removal (Peat‐Dec); (2) partial pad removal and burial under peat layer (BUPL); and (3) mixing mineral and peat by inversion (Mixed‐P‐M). The recreated peat surface was revegetated with donor peatland species using the moss layer transfer technique (MLTT). The objectives of this paper were to (1) quantify plot‐scale seasonal carbon dioxide (CO2) and methane (CH4) exchange of the SATs, 2–4 years post‐restoration compared to reference sites and (2) determine the influence of several environmental variables on CO2 and CH4 exchange. All SATs proved effective in recreating a soil surface needed to support peatland vegetation as shown by similar rates of net ecosystem exchange (NEE). Equally, both types of vegetation reintroduced led this site on a trajectory toward functioning as a net C sink. [ABSTRACT FROM AUTHOR]

Ultrasound imaging is an essential component of healthcare services. This study sought to explore perceptions of access, and factors which shape access, to ultrasound imaging in two northern, remote, Indigenous communities in Canada. Using interpretive description as a methodological approach and a multi-dimensional conceptualisation of access to care as a theoretical framework, 15 semi-structured interviews were conducted in the northern Canadian communities of Stony Rapids and Black Lake, Saskatchewan. All participants had an obstetrical or non-obstetrical ultrasound exam performed in the past 10 years. Interviews were audio recorded and interview transcripts were analysed using constant comparative analysis. Geographic isolation from imaging facilities was a central barrier to participants accessing ultrasound imaging. Other barriers became apparent when participants had to travel for ultrasound, including fear of air travel, isolation from family, financial means, and unfamiliarity with larger cities. Barriers such as family and work responsibilities were exacerbated by the barrier of geography. Participants overcame these barriers as they were motivated by potential diagnostic benefits of ultrasound imaging. This study highlights disparities in access to ultrasound for northern, remote, Indigenous populations. Future efforts to improve access to imaging should consider barriers of distance to imaging facilities and strategies to bridge these barriers. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of chronic rhinosinusitis with nasal polyposis (CRSwNP). There remains a population in CRSwNP that despite medical therapy and endoscopic sinus surgery have persistent signs and symptoms of disease. Therefore, biologics, monoclonal antibody agents, could be beneficial therapeutic treatments for these patients. There have been eight randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL-5R, IL-33, and immunoglobulin (Ig)E. However, there are no formal recommendations for the optimal use of biologics in managing Chronic Rhinosinusitis (CRS) within the Canadian health care environment. Methods: A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. 17 fellowship trained rhinologists across Canada evaluated the 28 original statements on a scale of 1–10 and provided comments. A rating within 1–3 indicated disagreement, 8–10 demonstrated agreement and 4–7 represented being neutral towards a statement. All ratings were quantitively reviewed by mean, median, mode, range and standard deviation. Consensus was defined by removing the highest and lowest of the scores and using the "3 point relaxed system". Results: After three rounds, a total of 11 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with CRS. Conclusion: This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of patients with CRS, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years. [ABSTRACT FROM AUTHOR]

Imaging the heart is one of the most technically challenging applications of Computed Tomography (CT) due to the presence of cardiac motion limiting optimal visualization of small structures such as the coronary arteries. Electrocardiographic gating during CT data acquisition facilitates motion free imaging of the coronary arteries. Since publishing the first version of the Canadian Association of Radiologists (CAR) cardiac CT guidelines, many technological advances in CT hardware and software have emerged necessitating an update. The goal of these cardiac CT practice guidelines is to present an overview of the current evidence supporting the use of cardiac CT in various clinical scenarios and to outline standards of practice for patient safety and quality of care when establishing a cardiac CT program in Canada. [ABSTRACT FROM AUTHOR]

The cardiac computed tomography (CT) practice guidelines provide an updated review of the technological improvements since the publication of the first Canadian Association of Radiologists (CAR) cardiac CT practice guidelines in 2009. An overview of the current evidence supporting the use of cardiac CT in the most common clinical scenarios, standards of practice to optimize patient preparation and safety as well as image quality are described. Coronary CT angiography (CCTA) is the focus of Part I. In Part II, an overview of cardiac CT for non-coronary indications that include valvular and pericardial imaging, tumour and mass evaluation, pulmonary vein imaging, and imaging of congenital heart disease for diagnosis and treatment monitoring are discussed. The guidelines are intended to be relevant for community hospitals and large academic centres with established cardiac CT imaging programs. [ABSTRACT FROM AUTHOR]

Boreal peatlands represent a globally important store of carbon, and disturbances such as wildfire can have a negative feedback to the climate. Understanding how carbon exchange and greenhouse gas (GHG) dynamics are impacted after a wildfire is important, especially as boreal peatlands may be vulnerable to changes in wildfire regime under a rapidly changing climate. However, given this vulnerability, there is very little in the literature on the impact such fires have on methane (CH4) emissions. This study investigated the effect of wildfire on CH4 emissions at a boreal fen near Fort McMurray, Alberta, Canada, that was partially burned by the Horse River Wildfire in 2016. We measured CH4 emissions and environmental variables (2017–2018) and CH4 production potential (2018) in two different microform types (hummocks and hollows) across a peat burn severity gradient (unburned (UB), moderately burned (MB), and severely burned (SB)). Results indicated a switch in the typical understanding of boreal peatland CH4 emissions. For example, emissions were significantly lower in the MB and SB hollows in both years compared to UB hollows. Interestingly, across the burned sites, hummocks had higher fluxes in 2017 than hollows at the MB and SB sites. We found typically higher emissions at the UB site where the water table was close to the surface. However, at the burned sites, no relationship was found between CH4 emissions and water table, even under similar hydrological conditions. There was also significantly higher CH4 production potential from the UB site than the burned sites. The reduction in CH4 emissions and production in the hollows at burned sites highlights the sensitivity of hollows to fire, removing labile organic material for potential methanogenesis. The previously demonstrated resistance of hummocks to fire also results in limited impact on CH4 emissions and likely faster recovery to pre-fire rates. Given the potential initial net cooling effect resulting from a reduction in CH4 emissions, it is important that the radiative effect of all GHGs following wildfire across peatlands is taken into account. [ABSTRACT FROM AUTHOR]

Boreal peatlands represent a globally important store of carbon, and disturbances such as wildfire can have a negative feedback to the climate. Understanding how carbon exchange and greenhouse gas (GHG) dynamics are impacted after a wildfire is important, especially as boreal peatlands may be vulnerable to changes in wildfire regime under a rapidly changing climate. Yet, given this vulnerability, there is very little in the literature on the impact such fires have on methane (CH4) emissions. This study investigated the effect of wildfire on CH4 emissions at a boreal fen near Fort McMurray, AB, Canada, that was partially burned by the Horse River Wildfire in 2016. We measured CH4 emissions and environmental variables (2017-2018) and CH4 production potential (2018) in two different microform types (hummocks and hollows) across a burn severity gradient (unburned (UB), moderately burned (MB) and severely burned (SB)). Results indicated a switch in the typical understanding of boreal peatland CH4 emissions. For example, emissions were much lower in the MB and SB hollows in both years compared to UB hollows. Interestingly, across the burned sites, hummocks had higher fluxes in 2017 than hollows at the MB and SB sites. We found typically higher emissions at the UB site where the water table was close to the surface. However, at the burned sites, no relationship was found between CH4 emissions and water table, even under similar hydrological conditions. This further strengthens the argument on the overriding influence of fire. There was also significantly higher CH4 production potential from the UB site than the burned sites. The reduction in CH4 emissions and production in the hollows at burned sites highlights the sensitivity of hollows to fire, removing labile organic material for potential methanogenesis. The previously demonstrated resistance of hummocks to fire also results in limited impact to CH4 emissions and likely faster recovery to pre-fire rates. Given the potential initial net cooling effect resulting from a reduction in CH4 emissions, it is important that the radiative effect of all GHG following wildfire across peatlands is taken into account. [ABSTRACT FROM AUTHOR]

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Introduction/Purpose: The current classification system of progressive collapsing foot deformity (PCFD) is comprised of 5 possible classes that describe different deformity components. Each class is defined by clinical and radiographic findings. These components are ostensibly independent from one another during evaluation and treatment. However, PCFD is understood to be a complex, three-dimensional deformity occurring in many regions along the foot and ankle. The question remains whether a deformity in one area impacts other areas. The objective of this study is to assess how each one of the classes is influenced by other classes by evaluating each associated angular measurement. We hypothesized that positive and linear correlations would occur for each class with at least one other class and that this influence would be high. Methods: In this IRB-approved retrospective case-control study, we assessed 32 feet diagnosed with PCFD and 28 controls matched on gender, BMI and age. All measurements were performed using weight-bearing CT (WBCT) scans and completed by two foot and ankle surgeons. The classes and their associated radiographic measurements were defined as follows: Class A (hindfoot valgus) measured by the hindfoot moment arm (HMA), class B (midfoot abduction) measured by the talonavicular coverage angle (TNCA), class C (medial column instability) measured by the talus-first metatarsal (Meary) angle, class D (peritalar subluxation) measured by the medial facet uncoverage (MFU), and class E (ankle valgus) measured using the talar tilt angle (TTA). Multivariate analyses were completed comparing each class measurement to the other classes. Data were checked for multicollinearity with the Belsley-Kuh-Welsch technique. Heteroskedasticity and normality of residuals were assessed respectively by the Breusch-Pagan test and the Shapiro-Wilk test. A p-value <0.05 was considered significant. Results: After removing confounding variables, each class was separately evaluated. In Class A, Meary was positively correlated (rs=0.46; p=0.009) with HMA, explaining 21% of changes in this angle (R2=0.21). Class B evaluation showed that MFU was correlated with TNCA (rs=0.76; p=0.001), explaining 63% of TNCA variations (R2=0.63). In Class C, HMA (rs=0.71; p=0.001) and MFU (rs =0.75; p=0.001) were correlated to Meary's angle and both measures explained 58% of changes in this angle (R2=0.58). When assessing Class D, TNCA (rs =0.76; p=0.001) and Meary (rs=0.75; p=0.001) correlated with MFU and were responsible for 63% of variations on this angle. Finally, Class E deformity, determined by TTA, was not correlated with any other measurement. Conclusion: This study was able to find relations between components of PCFD deformity with exception of ankle valgus (Class E). Measurements associated with each class were found to be influenced by others, and in some instances with pronounced strength. The presented data may support the notion that PCFD is a three-dimensional complex deformity and suggests a possible relation among its ostensibly independent features. Further, these results support the concept that a specific component correction may impact other misalignments, decreasing the necessity for adjuvant procedures. This could have a direct effect in clinical practice, changing how providers assess PCFD and plan treatments. [ABSTRACT FROM AUTHOR]

The United States and Canada are interdependent along a number of dimensions, such as their mutual reliance on shared critical infrastructure. As a result, regulatory efforts aimed at securing critical infrastructure in one nation impact the other, including in the cybersecurity context. This article explores one such innovation in the form of the 2014 National Institute for Standards and Technology ("NIST") Cybersecurity Framework. It reviews the evolution of the NIST Framework, comparing and contrasting it with ongoing Canadian efforts to secure vulnerable critical infrastructure against cyber threats. Its purpose is to discover North American governance trends that could impact wider debates about the appropriate role of the public and private sectors in enhancing cybersecurity. [ABSTRACT FROM AUTHOR]

The study described in this article aimed at establishing a baseline assessment of the sanitary status of ice and guest rooms within Canadian hotels. Collectively, 54 hotel rooms belonging to six different national chains were sampled. High-contact surfaces (comforter, alarm clock, bedside lamp, TV remote, bathroom countertop, faucet, and toilet seat) were sampled using adenosine triphosphate (ATP) swabs and replicate organism detection and counting plates. ATP swab readings ranged from 2.12 to 4.42 log relative light units. Coliforms were recovered from 36% of surfaces with high prevalence being recovered from the comforter, TV remote, bathroom countertop, faucet, and toilet seat. Oxacillin-resistant bacteria were recovered from 19% of surfaces with 46% of isolates confirmed as methicillin-resistant Staphylococcus aureus. Two toxigenic Clostridium difficile isolates were recovered in the course of the study. Collectively, 24% of the ice samples harbored coliforms with a single sample testing positive for E. coli. The authors’ study demonstrates that hotel rooms represent a potential source of community-acquired infections and the need for enhanced sanitation practices. [ABSTRACT FROM AUTHOR]

Objectives. We examined relationships between implementation of tobacco quitline practices, levels of evidence of practices, and quitline reach and spending. Methods. In June and July 2009, a total of 176 quitline funders and providers in the United States and Canada completed a survey on quitline practices, in particular quitline-level implementation for the reported practices. From these data, we selected and categorized evidence-based and emerging quitline practices by the strength of the evidence for each practice to increase quitline efficacy and reach. Results. The proportion of quitlines implementing each practice ranged from 3% (text messaging) to 92% (providing a multiple-call protocol). Implementation of practices showing higher levels of evidence for increasing either reach or efficacy showed moderate but significant positive correlations with both reach outcomes and spending levels. The strongest correlation was between reach outcomes and spending levels (r = 0.80; P < .01). Conclusions. The strong relationship between quitline spending and reach reinforces the need to increase quitline funding to levels commensurate with national cessation goals. [ABSTRACT FROM AUTHOR]

In this article, the author discusses the landscape-scale patterns of the cyanobacterial toxin microcystin in Canadian lakes discovered by researchers through a regression tree model using the TREES module in the software SYSTAT 13. He mentions that the model helps to determine the relationship between microcystin concentrations, the concentration of total nitrogen (TN) to total phosphorus (TP) and the TN:TP ratio.

This research examines the awareness of evidence-based practices by the public organizations that fund services in the North American Quitline Consortium (NAQC). NAQC is a large, publicly funded, goal-directed "whole network," spanning both Canada and the United States, working to get people to quit smoking. Building on prior research on the dissemination and diffusion of innovation and evidence-based practices, and considering differences between network ties that are homophilous versus instrumental, we found that awareness of evidence-based practices was highest for quitline funders that were strongly connected directly to researchers and indirectly to the network administrative organization, controlling for quitline spending per capita and decision-making locus of control. The findings support the importance of maintaining instrumental (a technical/rational argument) rather than homophilous ties for acquisition of evidence-based practice knowledge. The findings also offer ideas for how public networks might be designed and governed to enhance the likelihood that the organizations in the network are better aware of what evidence-based practices exist. [ABSTRACT FROM AUTHOR]

Objectives. This study was designed to better understand how the network of quitlines in the North American Quitline Consortium (NAQC) interact and share new knowledge on quitline practices. Methods. Network relationship data were collected from all 63 publicly funded quitlines in North America, including information sharing, partner trust, and reputation. Results. There was a strong tendency for US and Canadian quitlines to seek information from other quitlines in the same country, with few seeking information from quitlines from the other country. Quitlines with the highest reputation tended to more centrally located in the network, but the NAQC coordinating organization is highly central to the quitline network-thus demonstrating their role as a broker of quitline information. Conclusions. This first "snapshot" of US and Canadian quitlines demonstrated that smoking cessation quitlines in North America are not isolated, but are part of an interconnected network, with some organizations more central than others. As quitline use expands with the inclusion of national toll-free numbers on cigarette packs, how quitlines share information to improve practice will become increasingly important. [ABSTRACT FROM AUTHOR]

Genetic testing for mutations in BRCA1 and BRCA2 is available in Canada for women with a significant family history of breast cancer. For the majority of tested women, a BRCA1 or BRCA2 mutation is not found, and counselling regarding breast cancer risk is based on the review of the pedigree. In this prospective study, we estimate breast cancer risks in women with a family history of breast cancer and for whom the proband tested negative for a mutation in BRCA1 or BRCA2. Families with two or more breast cancers under the age of 50 years, or with three cases of breast cancer at any age, and who tested negative for a BRCA1 or BRCA2 mutation were identified. Follow-up information on cancer status was collected on all first-degree relatives of breast cancer cases. The standardised incidence ratios (SIRs) for breast cancer were calculated by dividing the observed numbers of breast cancer by the expected numbers of breast cancers, based on the rates in the provincial cancer registries. A total of 1492 women from 365 families were included in the analyses. The 1492 first-degree relatives of breast cancer cases contributed 9109 person-years of follow-up. Sixty-five women developed breast cancer, compared to 15.2 expected number (SIR=4.3). The SIR was highest for women under the age of 40 (SIR=14.9) years and decreased with increasing age. However, the absolute risk was higher for women between the age of 50 and 70 (1% per year) years than for women between 30 and 50 (0.4% per year) years of age. There was no elevated risk for ovarian, colon or any other form of cancer. Women with a significant family history of breast cancer (ie, two or more breast cancers under the age of 50 years, or three or more breast cancers at any age), but who test negative for BRCA mutations have approximately a four-fold risk of breast cancer. Women in these families may be candidates for tamoxifen chemoprevention and/or intensified breast screening with an MRI.British Journal of Cancer (2009) 100, 421–425. doi:10.1038/sj.bjc.6604830 www.bjcancer.com Published online 16 December 2008 [ABSTRACT FROM AUTHOR]

Abstract: The boreal forest biome is one of the largest on Earth, covering more than 14% of the total land surface. Fire disturbance plays a dominant role in boreal ecosystems, altering forest succession, biogeochemical cycling, and carbon sequestration. We used two time-series data sets of Advanced Very High Resolution Radiometer (AVHRR) Normalized Differenced Vegetation Index (NDVI) imagery for North America to analyze vegetation recovery after fire. The Canadian Forest Service Large Fire Database was used to identify the location of fires and calculate scaled NDVI statistics from the Pathfinder AVHRR Land (PAL) and the Global Inventory Modeling and Mapping Studies (GIMMS) AVHRR data sets. Unburned areas were also identified, based on interannual variability metrics, in order to reduce the effects of factors other than fire on the temporal behavior of scaled NDVI. Burned and unburned areas were stratified by ecoregion to ensure the presence of comparable land cover types and account for influences of local environmental variability. Temporal anomalies in NDVI for burned and unburned areas show the impacts of fire and the recovery of the forest to pre-burn levels, and indicate changes in variability that might be associated with vegetation compositional changes consistent with early successional species. The rate of recovery varied in the three episodic fire years on which we focused our analysis (1981, 1989, and 1995), but were consistently shorter than previous studies that emphasized the most impacted areas within fires. Temporal variability in the time series, represented by the difference of burned and unburned area anomalies, increased beyond the observed post-fire recovery period. This indicates residual effects of fire disturbance over the regrowth period, perhaps associated with early successional vegetation and increased susceptibility to drought. Distinct differences were noted between the PAL and GIMMS data sets, with evidence for systematic data processing artifacts remaining in the PAL time series. [Copyright &y& Elsevier]

Background: Assessments of health-related quality of life and treatment satisfaction were conducted as part of a randomised, double-blind, placebo-controlled 52-week trial conducted in Canada, Australia, Europe, and South Africa (CAESAR). The Medical Outcomes Study HIV Health Survey (MOS-HIV) was self-administered during 3 scheduled clinic visits (baseline, week 28 and the end-of-treatment/withdrawal visit). A single question was used at the end of treatment to assess patient satisfaction with study medications. Methods: Patients were randomly allocated to receive placebo, lamivudine (150mg twice daily) or lamivudine (150mg twice daily) plus loviride (100mg 3 times daily) in addition to their current treatment regimen, which could be either zidovudine monotherapy, or zidovudine in combination with didanosine or zalcitabine at standard dosages. Results: Statistically significant differences across treatment groups were demonstrated for the Physical and Mental Health Summary scores, and for 5 of 10 MOS-HIV subscales (physical functioning, vitality, cognitive functioning, general health perceptions, social functioning). These differences favoured the lamivudine and lamivudine plus loviride groups over the placebo group (p < 0.05). No significant difference was found between the 3 treatment groups with regard to the percentages of patients who were satisfied with their study medication. Conclusion: The results suggest that, for treatment-experienced patients with HIV infection and CD4+ counts <250 cells/mm, the addition of lamivudine or lamivudine plus loviride to antiretroviral regimens containing zidovudine maintained patient-reported mental and physical health. [ABSTRACT FROM AUTHOR]

Boreal peatlands represent a globally important store of carbon, and disturbances such aswildfire can have a significant positive feedback to the climate. Understanding how carboncycling and greenhouse gas (GHG) dynamics are impacted after a wildfire is important,especially as boreal peatlands may be vulnerable to changes in wildfire regime under arapidly changing climate. Yet given this vulnerability, there is very little in the literature onthe impact such fires have on methane (CH4) emissions. This study investigated the effect of wildfire on CH4 emissions at a boreal fen near FortMcMurray, AB, Canada, partially burned by the Horse River Wildfire in 2016. We measuredCH4 emissions and environmental variables (2017-2018) and CH4 production potential(2018) in two different microform types (hummocks and hollows) across a burnseverity gradient (unburned (UB), moderately burned (MB) and severely burned(SB)). The average CH4 flux at the UB hollows was 96.5 and 66.6 mg CH4 m−2 d−1in 2017 and2018, respectively. Methane emissions were much lower in the MB and SB hollows in bothyears, with the average flux being 0.25 and 0.06 mg CH4 m−2d−1 in 2017 and 1.93 and 1.38mg CH4m−2 d−1, respectively. Interestingly, across the burned sites, hummocks had higherfluxes in 2017 than hollows with the average flux being 1.82 and 5.83 mg CH4m−2 d−1 at theMB and SB sites, respectively. Results of a linear mixed effects model (LMM) illustrate thereis a significant effect of burn severity on CH4 flux, although no significant difference betweenmicroform or year. Another LMM found a significant interaction between burnseverity and both soil temperature at 30 cm depth and water table. There was alsosignificantly higher CH4 production potential from the UB site than the burnedsites. The reduction in CH4 emissions and production in the hollows at burned sites highlightsthe sensitivity of hollows to fire, removing labile organic material for potentialmethanogenesis. The previously demonstrated resilience of hummocks to fire also results inlimited impact to methane emissions and likely faster recovery to pre-fire rates. [ABSTRACT FROM AUTHOR]

SummaryThis article highlights the crucial role of blood transfusion in trauma care and explores the historical and contemporary use of whole blood and freeze-dried plasma in Canadian health care. Early use of whole blood and freeze-dried plasma during global conflicts led to advancements in transfusion medicine. The transition to blood component therapy improved transfusion safety and precision. However, there is an increasing interest in using whole blood and freeze-dried plasma, supported by recent evidence suggesting potential benefits over blood component therapy, particularly in trauma cases. Canadian initiatives, such as leukoreduced whole blood production for the military, indicate efforts to address logistical challenges in delivering trauma care, especially in remote areas. Challenges remain, including logistical issues and regulatory complexities, requiring coordinated efforts for effective implementation. Overall, there's growing support for integrating whole blood and freeze-dried plasma into trauma care across Canada., Competing Interests: Competing interests:: None declared., (© 2024 CMA Impact Inc. or its licensors.)

Background: Aerococcus urinae and Aerococcus sanguinicola are emerging pathogens linked with urinary tract infections. We present a case series of A. urinae and A. sanguinicola isolates characterizing the spectrum of clinical presentation, microbiological characteristics and antimicrobial sensitivities. Methods: Retrospective chart review was performed on patients who grew positive cultures for A. urinae and A. sanguinicola identified on MALDI-TOF in Saskatchewan from January to June 2023. Demographic and clinical variables, antimicrobial susceptibility and prescription were documented. Results: This cohort (n = 115) had a median age 82 years. A. urinae and A. sanguinicola infections spanned from urinary tract infection (n = 96) to urosepsis (n = 6). These infections were predominantly monomicrobial (73.9%) and were susceptible to ceftriaxone, penicillin G and vancomycin. Antimicrobials were seldom prescribed within the urinary tract infection cohort (31.2%). Conclusion: Untreated A. urinae and A. sanguinicola infections can precipitate into urosepsis. The reported antimicrobial susceptibility for these Aerococcus isolates should be utilized to provide appropriate antimicrobial coverage.

Dysbiosis of the neonatal gut microbiome during early life has been suggested as the missing link that may explain higher rates of certain diseases in caesarean section-delivered infants. Many studies report delivery mode-related dysbiosis in infants due to a lack of maternal vaginal microbiome exposure, prompting interventions to correct the neonatal gut microbiome by transferring these missing microbes after caesarean delivery. The maternal vaginal microbiome is among the first microbial exposures that many infants experience, yet little is known about the extent of direct transmission of maternal vaginal microbes. As part of the Maternal Microbiome Legacy Project, we aimed to determine if maternal vaginal bacteria are vertically transmitted to infants. We employed cpn 60 microbiome profiling, culture-based screening, molecular strain typing, and whole-genome sequencing to determine whether identical maternal vaginal strains were present in infant stool microbiomes. We identified identical cpn 60 sequence variants in both halves of maternal-infant dyads in 204 of 585 Canadian women and their newborn infants (38.9%). The same species of Bifidobacterium and Enterococcus were cultured from maternal and corresponding infant samples in 33 and 13 of these mother-infant dyads, respectively. Pulsed-field gel electrophoresis and whole-genome sequencing determined that near-identical strains were detected in these dyads irrespective of delivery mode, indicating an alternative source in cases of caesarean delivery. Overall, we demonstrated that vertical transmission of maternal vaginal microbiota is likely limited and that transmission from other maternal body sites, such as the gut and breast milk, may compensate for the lack of maternal vaginal microbiome exposure during caesarean delivery. IMPORTANCE The importance of the gut microbiome in human health and disease is widely recognized, and there has been a growing appreciation that alterations in gut microbiome composition during a "critical window" of development may impact health in later life. Attempts to correct gut microbiome dysbiosis related to birth mode are underpinned by the assumption that the lack of exposure to maternal vaginal microbes during caesarean delivery is responsible for dysbiosis. Here, we demonstrate that there is limited transmission of the maternal vaginal microbiome to the neonatal gut, even in cases of vaginal delivery. Furthermore, the presence of identical strains shared between mothers and infants in early life, even in cases of caesarean delivery, highlights compensatory microbial exposures and sources for the neonatal stool microbiome other than the maternal vagina., Competing Interests: The authors declare no conflict of interest.

The purpose of this systematic literature review (SLR) was to methodically integrate peer-reviewed findings regarding lateral violence within Indigenous communities, with particular attention to the experiences of Indigenous women. Lateral violence describes aggression within systemically exploited groups. Interpretations from eligible articles were informed by intersectionality theory and post-colonial theory. Eligibility criteria included quantitative and qualitative peer-reviewed articles on lateral violence within Indigenous communities. Only articles that were primary sources, available to download in English, and published between 2000 and 2021 were included. Samples did not need to consist of Indigenous women exclusively, but Indigenous women had to be included. First, advanced searches were conducted in five databases (Academic Search Complete, PsycINFO, Indigenous Peoples: North America, ProQuest: Sociology Collection, and ERIC). Second, a multidisciplinary index (Google Scholar) was searched. Third, 23 peer-reviewed journals specializing in Indigenous topics were systematically searched. Lastly, forward and backward snowballing techniques were implemented. Articles were appraised following PRISMA-P guidelines. Ten articles passed the eligibility criteria. Findings suggest that lateral violence within Indigenous communities is a complex social concern, with participants disclosing both survivorship and contribution to lateral violence. Within Australian and Canadian contexts, lateral violence experiences are prevalent and persistent occurrences. Lateral violence is a controversial and taboo topic and is often silenced or normalized within Indigenous communities. For this reason, further research is warranted to raise awareness of lateral violence to disrupt the cycle of internalized oppression.

Background: Long-COVID (LC) encompasses diverse symptoms lasting months after the initial SARS-CoV-2 infection. Symptoms can be debilitating and affect the quality of life of individuals with LC and their families. Although the symptoms of LC are well described, the aetiology of LC remains unclear, and consequently, patients may be underdiagnosed. Identification of LC specific biomarkers is therefore paramount for the diagnosis and clinical management of the syndrome. This scoping review describes the molecular and cellular biomarkers that have been identified to date with potential use for diagnosis or prediction of LC., Methods: This review was conducted using the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews. A search was executed in the MEDLINE and EMBASE databases, as well as in the grey literature for original studies, published until October 5th, 2022, reporting biomarkers identified in participants with LC symptoms (from all ages, ethnicities, and sex), with a previous infection of SARS-CoV-2. Non-English studies, cross-sectional studies, studies without a control group, and pre-prints were excluded. Two reviewers independently evaluated the studies, extracted population data and associated biomarkers., Findings: 23 cohort studies were identified, involving 2163 LC patients [median age 51.8 years, predominantly female sex (61.10%), white (75%), and non-vaccinated (99%)]. A total of 239 candidate biomarkers were identified, consisting mainly of immune cells, immunoglobulins, cytokines, and other plasma proteins. 19 of the 239 candidate biomarkers identified were evaluated by the authors, by means of receiver operating characteristic (ROC) curves., Interpretation: Diverse cellular and molecular biomarkers for LC have been proposed. Validation of candidate biomarkers in independent samples should be prioritized. Modest reported performance (particularly in larger studies) suggests LC may encompass many distinct aetiologies, which should be explored e.g., by stratifying by symptom clusters and/or sex., Funding: Dr. Tebbutt has received funding from the Canadian Institutes of Health Research (177747) to conduct this work. The funding source was not involved in this scoping review, or in the decision to submit this manuscript for publication., Competing Interests: Declaration of interests All authors have completed the ICMJE uniform disclosure forms. C.Y. reports a grant from the Canadian Institutes of Health Research (grant number: 177747) as payment to their institution to support their work in Canada. The remaining authors have no conflicts of interest to declare., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Birth mode has been implicated as a major factor influencing neonatal gut microbiome development, and it has been assumed that lack of exposure to the maternal vaginal microbiome is responsible for gut dysbiosis among caesarean-delivered infants. Consequently, practices to correct dysbiotic gut microbiomes, such as vaginal seeding, have arisen while the effect of the maternal vaginal microbiome on that of the infant gut remains unknown. We conducted a longitudinal, prospective cohort study of 621 Canadian pregnant women and their newborn infants and collected pre-delivery maternal vaginal swabs and infant stool samples at 10-days and 3-months of life. Using cpn 60-based amplicon sequencing, we defined vaginal and stool microbiome profiles and evaluated the effect of maternal vaginal microbiome composition and various clinical variables on the development of the infant stool microbiome. Infant stool microbiomes showed significant differences in composition by delivery mode at 10-days postpartum; however, this effect could not be explained by maternal vaginal microbiome composition and was vastly reduced by 3 months. Vaginal microbiome clusters were distributed across infant stool clusters in proportion to their frequency in the overall maternal population, indicating independence of the two communities. Intrapartum antibiotic administration was identified as a confounder of infant stool microbiome differences and was associated with lower abundances of Escherichia coli , Bacteroides vulgatus , Bifidobacterium longum and Parabacteroides distasonis . Our findings demonstrate that maternal vaginal microbiome composition at delivery does not affect infant stool microbiome composition and development, suggesting that practices to amend infant stool microbiome composition focus factors other than maternal vaginal microbes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Dos Santos, Pakzad, Albert, Elwood, Grabowska, Links, Hutcheon, Maan, Manges, Dumonceaux, Hodgson, Lyons, Mitchell-Foster, Gantt, Joseph, Van Schalkwyk, Hill and Money.)

Introduction: Telerobotic ultrasound technology allows radiologists and sonographers to remotely provide ultrasound services in underserved areas. This study aimed to compare costs associated with using telerobotic ultrasound to provide ultrasound services in rural and remote communities to costs associated with alternate models., Methods: A cost-minimization approach was used to compare four ultrasound service delivery models: telerobotic ultrasound (Model 1), telerobotic ultrasound and an itinerant sonographer (Model 2), itinerant sonographer without telerobotic ultrasound (Model 3), and travel to another community for all exams (Model 4). In Models 1-3, travel was assumed when exams could not be successfully performed telerobotically or by an itinerant sonographer. A publicly funded healthcare payer perspective was used for the reference case and a societal perspective was used for a secondary non-reference case. Costs were based on the literature and experience using telerobotic ultrasound in Saskatchewan, Canada. Costs were expressed in 2020 Canadian dollars., Results: Average cost per ultrasound exam was $342, $323, $368, and $478 for Models 1, 2, 3, and 4, respectively, from a publicly funded healthcare payer perspective, and $461, $355, $447, and $849, respectively, from a societal perspective. In one-way sensitivity analyses, Model 2 was the lowest cost from a payer perspective for communities with population >2075 people, distance >350 km from the nearest ultrasound facility, or >47% of the population eligible for publicly funded medical transportation., Conclusion: Health systems may wish to consider solutions such as telerobotic ultrasound and itinerant sonographers to reduce healthcare costs and improve access to ultrasound in rural and remote communities., (© 2022 American Institute of Ultrasound in Medicine.)

Introduction: Obstetrical ultrasound imaging is critical in identifying at-risk pregnancies and informing clinical management. The coronavirus disease 2019 (COVID-19) pandemic has exacerbated challenges in accessing obstetrical ultrasound for patients in underserved rural and remote communities where this service is not available. This prospective descriptive study describes our experience of providing obstetrical ultrasound services remotely using a telerobotic ultrasound system in a northern Canadian community isolated due to a COVID-19 outbreak., Methods: A telerobotic ultrasound system was used to perform obstetrical ultrasound exams remotely in La Loche, Canada, a remote community without regular access to obstetrical ultrasound. Using a telerobotic ultrasound system, a sonographer 605 km away remotely controlled an ultrasound probe and ultrasound settings. Twenty-one exams were performed in a five-week period during a COVID-19 outbreak in the community, including limited first-, second- and third-trimester exams ( n  = 11) and complete second-trimester exams ( n  = 10). Participants were invited to complete a survey at the end of the telerobotic ultrasound exam describing their experiences with telerobotic ultrasound. Radiologists subsequently interpreted all exams and determined the adequacy of the images for diagnosis., Results: Of 11 limited obstetrical exams, radiologists indicated images were adequate in nine (81%) cases, adequate with some reservations in one (9%) case and inadequate in one (9%) case. Of 10 second-trimester complete obstetrical exams, radiologists indicated images were adequate in two (20%) cases, adequate with some reservations in three (30%) cases and inadequate in five (50%) cases. Second-trimester complete obstetrical exams were limited due to a combination of body habitus, foetal lie and telerobotic technology., Discussion: A telerobotic ultrasound system may be used to answer focused clinical questions such as foetal viability, dating and foetal presentation in a timely manner while minimising patient travel to larger centres and potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during the COVID-19 pandemic.

Background: Young men with osteoarthritis of the hip are a growing segment of the population requiring arthroplasty, and there is compelling evidence that the Birmingham Hip Resurfacing (BHR) system provides good functional outcomes and durability in young, active men. We reviewed the survivorship and clinical outcomes of patients who underwent BHR with a minimum follow-up of 10 years., Methods: We analyzed survivorship using the Kaplan-Meier method. Functional scoring was performed using the Harris Hip Score (HHS), the University of California, Los Angeles (UCLA) Activity Score, and a visual analogue scale (VAS)., Results: In total, 211 patients (243 hips) were included in the study. Of these, 107 patients (127 hips) were available for long-term clinical follow-up, with a mean duration of 12.4 ± 1.4 years. The proportion of male participants with BHRs surviving past 13 years was 93.8% (95% confidence interval [CI] 87.9%-100%) compared with 87% (95% CI 77.8%-97.3%) of female patients. Eleven patients (11 hips) underwent BHR revision. Upon final follow-up, the median HHS was 93.9 in males and 93.6 in females ( p = 0.27); median UCLA Activity Score was 8.2 in males and 7.2 in females ( p < 0.001), and the median VAS score was 81.9 in males and 81.3 in females ( p = 0.35). The median acetabular component inclination was 45.5° ± 6.0° (range 34.6°-57.2°) in males and 44.6° ± 5.9° (range 29°-58.9°) in females. The most common femoral head size was 50 mm with a 56 mm or 58 mm cup (36.3%)., Conclusion: This study confirms that BHR provides good to excellent functional outcomes, lasting functional improvements, and acceptable durability beyond 10 years in men. Survivorship following BHR is inferior in women; however, HHS and VAS scores were similar in women and men., Competing Interests: Competing interests: None declared., (© 2022 CMA Impact Inc. or its licensors.)

Objective: Ultrasound is one of the most commonly used imaging modalities, though some populations face barriers in accessing ultrasound services, potentially resulting in disparities in utilization. The objective of this study was to assess the association between sociodemographic and geographic factors and non-obstetrical ultrasound utilization in the province of Saskatchewan, Canada., Methods: All non-obstetrical ultrasound exams performed from 2014 to 2018 in Saskatchewan, Canada were retrospectively identified from province-wide databases. Univariate and multivariate Poisson regression analyses were performed to assess the association between ultrasound utilization and sex, age, First Nations status, Charlson Comorbidity Index, urban vs. rural residence, geographic remoteness, and neighborhood income., Results: A total of 1,324,846 individuals (5,857,044 person-years) were included in the analysis. Female sex (adjusted incidence rate ratio [aIRR], 2.20; 95% confidence interval [CI], 2.19-2.22), age (aIRR, 4.97; 95% CI, 4.90-5.05 for ≥57 years vs. <11 years), comorbidities (aIRR, 4.36 for Charlson Comorbidity Index >10 vs. 0; 95% CI, 3.78-5.03), and higher neighborhood income (aIRR, 1.04; 95% CI, 1.02-1.05 for highest vs. lowest quintile) were associated with higher rates of ultrasound utilization. Individuals who were status First Nations (aIRR, 0.91; 95% CI, 0.90-0.92) or resided in geographically remote areas (aIRR, 0.87 for most vs. least remote; 95% CI, 0.83-0.91) had lower rates of ultrasound utilization. Individuals who lived in a rural area also had lower rates of ultrasound utilization (aIRR, 0.93; 95% CI, 0.92-0.94)., Conclusion: Substantial disparities exist in non-obstetrical ultrasound utilization among individuals in low-income neighborhoods, status First Nations individuals, and individuals in rural and remote communities.

Rationale and Objectives: Obstetrical ultrasound imaging is an important part of prenatal care, though not all patients have readily available access to ultrasound services. This study aimed to assess the association between sociodemographic and geographic factors and (1) having a second trimester complete obstetrical ultrasound and (2) overall obstetrical ultrasound utilization., Methods: All pregnancies and obstetrical ultrasound exams billed from 2014-2018 in Saskatchewan, Canada were identified from province-wide databases. Generalized estimating equation (GEE) models with binomial and Poisson distributions were used to identify factors associated with having a second trimester ultrasound and overall obstetrical ultrasound utilization, respectively., Results: 80,536 pregnancies from 57,881 individuals were included. Of 57,186 pregnancies carried to ≥23 weeks, a second trimester ultrasound was performed in 50,180 (87.7%). Patients living in rural areas (adjusted odds ratio [aOR], 0.70; 95% confidence interval [CI], 0.63-0.77; p <0.0001), remote areas (aOR, 0.35 for greatest vs. least remoteness level; 95% CI, 0.32-0.39; p <0.0001), and status First Nations individuals (aOR, 0.50; 95% CI, 0.46-0.53; p <0.0001) were less likely to have a second trimester ultrasound. Patients living in higher income neighbourhoods (aOR, 1.86 for highest vs. lowest quintile; 95% CI, 1.62-2.13; p <0.0001) were more likely to have a second trimester ultrasound. GEE Poisson regression analysis demonstrated these same factors, except rural residence, were associated with overall obstetrical ultrasound utilization., Conclusion: Substantial disparities in obstetrical ultrasound utilization exist among patients in remote geographic areas, Indigenous peoples, and patients in low income neighbourhoods. Addressing barriers which these demographic groups face in accessing ultrasound imaging is critical to ensure health equity., (Copyright © 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Background: As smoking prevalence has decreased in Canada, particularly during pregnancy and around children, and technological improvements have lowered detection limits, the use of traditional tobacco smoke biomarkers in infant populations requires re-evaluation., Objective: We evaluated concentrations of urinary nicotine biomarkers, cotinine and trans-3'-hydroxycotinine (3HC), and questionnaire responses. We used machine learning and prediction modeling to understand sources of tobacco smoke exposure for infants from the CHILD Cohort Study., Methods: Multivariable linear regression models, chosen through a combination of conceptual and data-driven strategies including random forest regression, assessed the ability of questionnaires to predict variation in urinary cotinine and 3HC concentrations of 2017 3-month-old infants., Results: Although only 2% of mothers reported smoking prior to and throughout their pregnancy, cotinine and 3HC were detected in 76 and 89% of the infants' urine (n = 2017). Questionnaire-based models explained 31 and 41% of the variance in cotinine and 3HC levels, respectively. Observed concentrations suggest 0.25 and 0.50 ng/mL as cut-points in cotinine and 3HC to characterize SHS exposure. This cut-point suggests that 23.5% of infants had moderate or regular smoke exposure., Significance: Though most people make efforts to reduce exposure to their infants, parents do not appear to consider the pervasiveness and persistence of secondhand and thirdhand smoke. More than half of the variation in urinary cotinine and 3HC in infants could not be predicted with modeling. The pervasiveness of thirdhand smoke, the potential for dermal and oral routes of nicotine exposure, along with changes in public perceptions of smoking exposure and risk warrant further exploration., (© 2021. The Author(s).)

Objective: Gender demographics vary across specialties including surgery, internal medicine, cardiology, neurology, and oncology. Our objective was to determine whether residency selection or the decision to apply for training drives these differences., Study Design: Retrospective cohort study., Sample Population: Matched and unmatched residents lists from Veterinary Internship and Residency Matching Program (VIRMP) from 2011 to 2020. Comparative Data Reports from the American Association of Veterinary Medical Colleges from 2010 to 2019., Methods: Names for matched and unmatched residents with addresses in the United States or Canada were coded for gender for seven programs: large and small animal surgery, large and small animal medicine, cardiology, neurology, and oncology. Match rate by gender was compared using chi-square tests. Gender demographics of applicants were compared to demographics of graduates using tests of two proportions., Results: No differences were observed between genders for the likelihood of successfully matching into each residency program evaluated except in large animal internal medicine. Women (44.2%) were slightly more likely to match, overall, than men (39.0%, p = .003). The proportions of women applying for residencies overall (70.7%), in large and small animal surgery (66.1%, 62.2%), cardiology (70.2%), and neurology (70.7%) were lower than the proportion of female graduates (79%; p's < .001)., Conclusion: No evidence for gender bias was detected in the VIRMP resident selection process. Female veterinary graduates seemed less likely to apply for residencies than their male counterparts., Impact: Occupational segregation seems to stem from the decision to apply for residency. Interventions aimed at altering gender demographics in specialized medicine should target potential applicants., (© 2021 American College of Veterinary Surgeons.)

Purpose: To state the Society of Interventional Radiology's position on the use of image-guided thermal ablation for the treatment of early stage non-small cell lung cancer, recurrent lung cancer, and metastatic disease to the lung., Materials and Methods: A multidisciplinary writing group, with expertise in treating lung cancer, conducted a comprehensive literature search to identify studies on the topic of interest. Recommendations were drafted and graded according to the updated SIR evidence grading system. A modified Delphi technique was used to achieve consensus agreement on the recommendation statements., Results: A total of 63 studies, including existing systematic reviews and meta-analysis, retrospective cohort studies, and single-arm trials were identified. The expert writing group developed and agreed on 7 recommendations on the use of image-guided thermal ablation in the lung., Conclusion: SIR considers image-guided thermal ablation to be an acceptable treatment option for patients with inoperable Stage I NSCLC, those with recurrent NSCLC, as well as patients with metastatic lung disease., (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)

There is a lack of literature devoted to the Canadian genetic counseling workforce. Current and prospective genetic counseling students, graduates, employers, programs, and funding agencies remain largely uninformed of trends in the job market. The purpose of this study was to investigate the employment experiences of recent Canadian genetic counseling graduates and employers of genetic counselors (GCs) in Canada. An online survey was distributed to Canadians who had graduated from North American genetic counseling programs from 2014 to 2018 and to employers with experience hiring patient-facing genetic counselors from 2016 to 2018. Quantitative data were analyzed through descriptive statistics and, where appropriate, logistic regression. Qualitative data were reviewed to illustrate and support the quantitative data. Half of the employer responders (11/22) reported hiring more or many more genetic counselors compared to 3 years ago (2016), and a majority (n = 19, 86%) reported a desire to hire at least one more genetic counselor if funding were available. Most graduates (45/70, 64%) reported securing employment before graduation, 33% (n = 23) within 6 months of graduation, and no one taking longer than 1 year. For recent graduates, location was the most important factor when looking for work, and those who chose to work in Canada experienced significantly more challenges gaining employment as opposed to those who worked internationally (p = 0.03). The specialties in highest demand for genetic counselors and the most common areas of practice for recent graduates included adult general genetics, prenatal genetics, and cancer genetics. Overall, our findings suggest that there is a growth of employment opportunities in Canada and more employer-reported need for clinical genetic counselors; however, there is a lack of funding to support this expansion., (© 2020 National Society of Genetic Counselors.)