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Chatbots are "computer agents that can interact with the user" in a way that feels like human-to-human conversation.1 While the use of chatbots for reference service in academic libraries is a topic of interest for both library professionals and researchers, little is known about how they are used in library reference service, especially in academic libraries in Canada. This article aims to fill this gap by conducting a web-based survey of 106 academic library websites in Canada and analyzing the prevalence and characteristics of chatbot and live chat services offered by these libraries. The authors found that only two libraries were using chatbots for reference service. For live chat services, the authors found that 78 libraries provided this service. The article discusses possible reasons for the low adoption of chatbots in academic libraries, such as accessibility, privacy, cost, and professional identity issues. The article also provides a case study of the authors' institution, the University of Calgary, which integrated a chatbot service in 2021. The article concludes with suggestions for future research on chatbot use in libraries. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Generative artificial intelligence (AI) has proven to be a powerful tool with increasing applications in clinical care and medical education. ChatGPT has performed adequately on many specialty certification and knowledge assessment exams. The objective of this study was to assess the performance of ChatGPT 4 on a multiple-choice exam meant to simulate the Canadian urology board exam. METHODS: Graduating urology residents representing all Canadian training programs gather yearly for a mock exam that simulates their upcoming board-certifying exam. The exam consists of written multiple-choice questions (MCQs) and an oral objective structured clinical examination (OSCE). The 2022 exam was taken by 29 graduating residents and was administered to ChatGPT 4. RESULTS: ChatGPT 4 scored 46% on the MCQ exam, whereas the mean and median scores of graduating urology residents were 62.6%, and 62.7%, respectively. This would place ChatGPT's score 1.8 standard deviations from the median. The percentile rank of ChatGPT would be in the sixth percentile. ChatGPT scores on different topics of the exam were as follows: oncology 35%, andrology/benign prostatic hyperplasia 62%, physiology/anatomy 67%, incontinence/female urology 23%, infections 71%, urolithiasis 57%, and trauma/reconstruction 17%, with ChatGPT 4's oncology performance being significantly below that of postgraduate year 5 residents. CONCLUSIONS: ChatGPT 4 underperforms on an MCQ exam meant to simulate the Canadian board exam. Ongoing assessments of the capability of generative AI is needed as these models evolve and are trained on additional urology content. [ABSTRACT FROM AUTHOR]

Background: Due to the lack of clinical placements during the pandemic, virtual simulation was used to augment student practice experiences. Method: Using Kirkpatrick's evaluation model, a program evaluation study using a mixed-methods design was implemented to assess student and faculty satisfaction and usefulness of virtual simulation, the effectiveness of meeting learning needs, and the effects of the virtual simulation resource on the development of clinical judgment (n = 70). Results: Virtual simulation was rated as moderately useful with an overall mean of 1.7 (SD = 0.66, range 1 to 3). Only 21% to 49% of the students found online simulation either met or well met the various areas of learning needs. Qualitative data highlighted the benefits of this strategy as well as implementation factors that affected students' experience. Conclusion: Virtual simulation can be used in clinical courses to augment learning when implemented in a way that addresses students' needs. [J Nurs Educ. 2024;63(7):470–477.] [ABSTRACT FROM AUTHOR]

Objective: To estimate the impact on clinical outcomes and healthcare resource use from recommending that patients with 1–2 low-risk adenomas (LRAs) return to routine fecal immunochemical test (FIT) screening instead of surveillance colonoscopy, from a Canadian provincial healthcare system perspective. Methods: The OncoSim-Colorectal microsimulation model simulated average-risk individuals eligible for FIT-based colorectal cancer (CRC) screening in Alberta, Canada. We simulated two surveillance strategies that applied to individuals with 1–2 LRAs (<10 mm) removed as part of the average risk CRC screening program: (a) Surveillance colonoscopy (status quo) and (b) return to FIT screening (new strategy); both at 5 years after polypectomy. A 75 ng/mL FIT positivity threshold was used in the base case. The simulations projected average annual CRC outcomes and healthcare resource use from 2023 to 2042. We conducted alternative scenarios and sensitivity analyses on key variables. Results: Returning to FIT screening (versus surveillance colonoscopy) after polypectomy was projected to have minimal impact on long-term CRC incidence and deaths (not statistically significant). There was a projected decrease of one (4%) major bleeding event and seven (5%) perforation events per year. There was a projected increase of 4800 (1.5%) FIT screens, decrease of 3900 (5.1%) colonoscopies, and a decrease of $3.4 million (1.2%) in total healthcare costs per year, on average. The annual colonoscopies averted and healthcare cost savings increased over time. Results were similar in the alternative scenarios and sensitivity analyses. Conclusions: Returning to FIT screening would have similar clinical outcomes as surveillance colonoscopy but could reduce colonoscopy demand and healthcare costs. [ABSTRACT FROM AUTHOR]

Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of 'therapist' or 'client', forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy. [ABSTRACT FROM AUTHOR]

A complex dynamical network (CDN) can be considered as the composition system with the nodes subsystem (NS) and the links subsystem (LS), and both subsystems are coupled with each other. In this paper, two vector differential equations (VDE) are used to describe the dynamical behaviours of NS and LS, respectively, in which the dynamical behaviour of NS is considered as the VDE with the second derivative term (SDT). This paper mainly focuses on the dynamics of LS, which is represented as VDE with the intuitive topologic feature of outgoing links, and investigates the design of the tracking controller for NS and the auxiliary tracking objectives (ATO) for LS. Firstly, the dynamical models of NS and LS in CDN are proposed, and the corresponding assumptions are given. Secondly, based on Lyapunov stability theory, the controller of NS and the ATO of LS are designed so that the state of NS can asymptotically track the given reference signal. Finally, the effectiveness of the proposed control strategy in this paper is verified by the numerical simulation example with N two-links robots. Abbreviations: ATO: auxiliary tracking objectives; CDN: complex dynamical network; LS: links subsystem; MDE: matrix differential equation; NS: nodes subsystem; SDT:second derivative term; VDE: vector differential equation; [ABSTRACT FROM AUTHOR]

Background: Driving is the preferred mode of transportation for adults across the healthy age span. However, motor vehicle crashes are among the leading causes of injury and death, especially for older adults, and under distracted driving conditions. Understanding the neuroanatomical basis of driving may inform interventions that minimize crashes. This exploratory study examined the neuroanatomical correlates of undistracted and distracted simulated straight driving. Methods: One-hundred-and-thirty-eight participants (40.6% female) aged 17-85years old (mean and SD= 58.1± 19.9years) performed a simulated driving task involving straight driving and turns at intersections in a city environment using a steering wheel and foot pedals. During some straight driving segments, participants responded to auditory questions to simulate distracted driving. Anatomical T1-weighted MRI was used to quantify grey matter volume and cortical thickness for five brain regions: the middle frontal gyrus (MFG), precentral gyrus (PG), superior temporal cortex (STC), posterior parietal cortex (PPC), and cerebellum. Partial correlations controlling for age and sex were used to explore relationships between neuroanatomical measures and straight driving behavior, including speed, acceleration, lane position, heading angle, and time speeding or off-center. Effects of interest were noted at an unadjusted p-value threshold of 0.05. Results: Distracted driving was associated with changes in most measures of straight driving performance. Greater volume and cortical thickness in the PPC and cerebellum were associated with reduced variability in lane position and heading angle during distracted straight driving. Cortical thickness of the MFG, PG, PPC, and STC were associated with speed and acceleration, often in an agedependent manner. Conclusion: Posterior regions were correlated with lane maintenance whereas anterior and posterior regions were correlated with speed and acceleration, especially during distracted driving. The regions involved and their role in straight driving may change with age, particularly during distracted driving as observed in older adults. Further studies should investigate the relationship between distracted driving and the aging brain to inform driving interventions. [ABSTRACT FROM AUTHOR]

Background: Nurses need to recognize how intersectionality shapes the experiences of individuals and families navigating complex health systems. Guided reflection on complex social justice issues serves as an approach to move beyond simply understanding social determinants of health toward shaping core professional values of developing nurses to promote lasting change. Method: Third-year Canadian undergraduate prelicensure nursing students co-created assignment expectations, completed online modules, and submitted initial reflections before class in a mandatory social justice course. In-class debriefing was based on students' reflections and cofacilitated by subject matter experts. Students completed a final reflection that focused on advocating for social change. Results: Student feedback, reflections, and grades as well as faculty observations support the success of this interactive student-centered approach. Conclusion: A flexible approach to debriefing modular content informed by universal design for learning and simulation theory enables nurse educators to promote in-depth, meaningful, and lasting student learning. [J Nurs Educ. 2024;63(1):48–52.] [ABSTRACT FROM AUTHOR]

This paper presented a two-dimensional, well-balanced hydrodynamic and sediment transport model based on the solutions of variable-density shallow-water equations (VDSWEs) and the Exner equation for bed change for simulating sediment transport in unsteady flows. Those equations are solved in a coupled way by the first-order Godunov-type finite volume method. The Harten–Lax–van Leer–Contact (HLLC) Riemann solver is extended to find the local Riemann fluxes to maintain the exact balance between the momentum term and the bed slope term. A well-balanced scheme is superior to an unbalanced scheme to minimize numerical dispersion as demonstrated by the synthetic standing contact-discontinuity test case. Following this, the model is employed to simulate two laboratory experiments and a field case, the 1996 Lake Ha! Ha! flood event in Canada. The results of water surface elevations and bed surface profiles agree well with the measurements. The accuracy and robustness of the numerical schemes make the model a good candidate for practical engineering applications. [ABSTRACT FROM AUTHOR]

Rockfall constitutes a major threat to the safety and sustainability of transport corridors bordered by rocky cliffs. This research introduces a new approach to rockfall susceptibility modeling for the identification of potential rockfall source zones. This is achieved by developing a data-driven model to assess the local slope morphological attributes with respect to the rock slope evolution processes. The ability to address "where" a rockfall is more likely to occur via the analysis of historical event inventories with respect to terrain attributes and to define the probability of a given area producing a rockfall is a critical advance toward effective transport corridor management. The availability of high-quality digital volumetric change detection products permits new developments in rockfall assessment and prediction. We explore the potential of simulating the conceptualization of slope-scale rockfall susceptibility modeling using computer power and artificial intelligence (AI). We employ advanced 3D computer vision algorithms for analyzing point clouds to interpret high-resolution digital observations capturing the rock slope evolution via long-term, LiDAR-based 3D differencing. The approach has been developed and tested on data from three rock slopes: two in Canada and one in the UK. The results indicate clear potential for AI advances to develop local susceptibility indicators from local geometry and learning from recent rockfall activity. The resultant models produce slope-wide rockfall susceptibility maps in high resolution, producing up to 75% agreement with validated occurrences. [ABSTRACT FROM AUTHOR]

• The global uniform exponential stability is established for zero-order delayed systems. • The stability results for impulsive dynamical networks are obtained. • The event-triggered impulsive control (ETIC) is designed to stabilize dynamical networks. • ETIC has lower impulse frequency and control cost than the classic impulsive control. • A non-instantaneous ETIC is proposed to improve the instantanity and discontinuity of ETIC. This paper studies the stability for impulsive dynamical networks (IDN) where different nodes may have different impulse time sequences. By deriving the conditions of global uniform exponential stability for zero-order delayed systems, the criteria of stability for IDN are established. The stability results for IDN are then used to design event-triggered impulsive control (ETIC) for stabilization of continuous-time dynamical networks (CDN). In every node of CDN, three levels of event-triggering conditions are set for ETIC. The exponential stabilization of CDN is shown to be achieved by the designed ETIC and it also shows that the ETIC is robust w.r.t. time-delays. Moreover, a non-instantaneous ETIC (NI-ETIC) is proposed for the stabilization of CDN. Three examples with numerical simulations are given to show that the designed ETIC has lower impulse frequency and cost of control than the classic time-triggered impulsive control. It is also shown that the discontinuity and the instantanity of ETIC are improved by the NI-ETIC. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) has served the entertainment industry all the way to world-leading museums in delivering engaging experiences through multisensory virtual environments (VEs). Today, the rise of the Metaverse fuels a growing interest in leveraging this technology, bringing along an emerging need to better understand the way different dimensions of VEs, namely social and interactive, impact overall user experience (UX). This between-subject exploratory field study investigates differences in the perceived and lived experience of 28 participants engaging, either individually or in dyads, in a VR experience comprising different levels of interactivity, i.e., passive or active. A mixed methods approach combining conventional UX measures, i.e., psychometric surveys and user interviews, as well as psychophysiological measures, i.e., wearable bio- and motion sensors, allowed for a comprehensive assessment of users' immersive and affective experiences. Results pertaining to the social dimension of the experience reveal that shared VR elicits significantly more positive affect, whereas presence, immersion, flow, and state anxiety are unaffected by the copresence of a real-world partner. Results pertaining to the interactive dimension of the experience suggest that the interactivity afforded by the VE moderates the effect of copresence on users' adaptive immersion and arousal. These results support that VR can be shared with a real-world partner not only without hindering the immersive experience, but also by enhancing positive affect. Hence, in addition to offering methodological directions for future VR field research, this study provides interesting practical insights into guiding VR developers toward optimal multiuser virtual environments. [ABSTRACT FROM AUTHOR]

Unconventional oil and gas formations are abundant, have become an increasingly important part of the global energy supply, and are attracting increasing attention from the industry. Predicting key reservoir properties plays a significant role in both geological science and subsurface engineering workflows. With the advent of horizontal well drilling and multiple-stage hydraulic fracturing, the Montney Shale formation is one of the most promising and productive shale plays in Canada. However, very few academic papers discuss its in situ stress, reservoir pressure, and permeability, which are essential for the development of the Montney Shale. The objective of this study is to analyze the geo-stress, the pore pressure, and several key reservoir properties by using diagnostic fracture injection test (DFIT) data from the Montney Shale. One horizontal well from the Wapiti field has been analyzed with a set of DFIT data, and its results show that the general pressure and Gdp/dG responses from Well-A indicate a signature of height recession/transverse storage. In the study, the Tangent Line method, the Compliance method, and the Variable Compliance method have been applied to estimate the key reservoir properties. As a result, the Well-A DFIT analysis estimates that the closure pressure is ranging from 34.367 to 39.344 MPa, contributing to the stress gradient from 14.09 to 16.13 KPa/m for the formation. The pore pressure is ranging from 20.82 to 24.58 MPa, contributing to the pore pressure gradient from 8.54 to 10.07 KPa/m for the formation. The porosity is ranging from 3% to 6%. These reservoir properties are contoured cross the Montney Shale formation. Using the DFIT's numerical simulation and history matching, the reservoir permeability is 0.024 md, fracture length is 13.44 m, and fracture geometries are analyzed by different models. Moreover, the physics behind the DFIT are analyzed and discussed in detail. For the first time, three different analysis methods have been applied to estimate a series of key reservoir properties for the case wells in the Montney Shale formation. This approach can not only reduce the potential prediction error caused by a single method application but also increase the persuasiveness of the assessment and save time, ensuring the efficient implementation of engineering operations. Given the significance of quantifying in situ stress and reservoir pore pressure in unconventional hydrocarbon exploration and development, this study could help the operator to quickly understand the stress regimes, the fracture geometry, and the formation properties of the Montney Shale formation in the Wapiti field. Furthermore, the interpreted results demonstrated in this paper are adding substantial business value to the asset, especially in terms of improving the hydraulic fracturing design and, thus, accelerating the cashflow from production. [ABSTRACT FROM AUTHOR]

Background: Extended reality technology (XR) in simulation-based medical education is becoming more prevalent. This study examined Canadian simulation centre directors' perceptions toward XR and their self-reported adoption of XR within their centres., Methods: We conducted a national, cross-sectional survey study to examine five kinds of XR: Immersive Virtual Environments, Screen-based Virtual Worlds, Virtual Simulators, Immersive Augmented Reality, and Non-immersive Augmented Reality. An electronic survey with multiple-choice, Likert scales, and open-ended questions were developed to identify the current use, degree of satisfaction, and experienced and foreseen challenges with each XR technology. We used the Checklist for Reporting Results of Internet E-Surveys checklist to describe and justify our survey development. All twenty-three Royal College-accredited Canadian simulation centres were invited based on their Royal College membership to complete the survey. Directors and representatives of seventeen (74%) centres participated., Results: Each XR has been used for research or simulation education by about half of the simulation centres, at minimum. The degree of satisfaction among directors with XR ranged from 30% to 45%. Directors frequently cited logistical and fidelity challenges, along with concerns over maintenance. Cost and lack of evidence, and unclear needs were cited as foreseen challenges with the future implementation of XRs., Conclusions: This survey summarizes the status of XR in Canadian simulation centres. The pattern of use, satisfaction levels, and challenges reported by simulation centre directors varied depending on the types of XR., Competing Interests: There is nothing to disclose., (© 2024 Tokuno, Bilgic, Gorgy, Harley; licensee Synergies Partners.)

Background: Combining pathogen reduction technology (PRT) with blood screening may alleviate concerns over the risk of transfusion-transmitted infections (TTI) and support changes in blood donor selection to potentially increase blood availability. This study aimed to estimate the residual risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) transfusion-transmission in Canada after implementing PRT, while eliminating deferrals for sexual risk behaviors., Study Design and Methods: A probabilistic approach that combined Bayesian networks with Monte Carlo simulations was used to estimate the risk of transfusing HIV-, HBV-, or HCV-contaminated blood components. Different scenarios were considered to compare the current residual risk after PRT implementation, with and without donor deferral criteria for sexual risk behaviors. Donor profiles and blood component outcomes were simulated based on a literature review including the prevalence and incidence of HIV, HBV, and HCV in the Canadian blood donor population; the use of current blood screening assays; and HIV, HBV, and HCV blood donor viral loads., Results: In the universal PRT scenario (i.e., with PRT/without deferral criteria), the estimated risks of HIV, HBV, and HCV transmission were significantly lower than those in the currently observed scenario (i.e., without PRT/with deferral criteria)., Conclusions: This risk model suggests that PRT for platelets and plasma (and eventually for RBCs when available) significantly reduces the residual risks of HIV, HBV and HCV transfusion-transmission and could enable the removal of blood donor deferral criteria for sexual risk behaviors., (© 2024 AABB.)

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Background: Guidance during inquiry learning plays an important role in developing conceptual understanding and inquiry skills. This study analysed learner‐tutor interactions in a simulation‐assisted learning environment to investigate how tutor guidance enabled knowledge construction and fostered epistemic practice. Objectives: This research aimed to illuminate challenges learners encounter in the inquiry process and forms of guidance that support learning in both conceptual and epistemic aspects. Methods: This study uses a mixed methods approach. We analysed video recordings in which nine participants asked 72 questions and the microsequences of interactions immediately surrounding and including each question. We coded properties of each question and whether the tutors' utterances were intended to increase (upregulate) or decrease (downregulate) the complexity of the inquiry processes, and used a two‐step cluster analysis to explore groupings emerged from tutors' regulation guidance and learners' questions. Results and Conclusions: The regulatory intent of tutors' utterances depended on various characteristics of student questions. The microsequences clustered in five categories: 1) upregulated investigation and inference, 2) upregulated evidence‐based justification, 3) downregulated cognitive load, 4) downregulated procedural uncertainties, and 5) downregulated perceptual dissonance. Our findings suggest tutors offering guiding prompts should consider dual processes in the inquiry and, by strategically prompting them, strike a balance between the goals of guiding learners to discover scientific knowledge and grounding their conceptual understanding in concepts, data, and procedures. Implications: We emphasize conceptual and epistemic learning should be concurrently guided in scientific inquiry. We propose a bidirectional guidance model as a pedagogical approach to guide instructional practice. Lay Description: What is currently known about the subject matter: Rapid technological change urges schools to equip students with research and inquiry skills.Computer simulations provide an information‐rich environment for inquiry‐based learning.Guidance in inquiry learning is important for knowledge acquisition and the development of inquiry skills. What this paper adds: We illuminated challenges learners encounter in the inquiry learning process.We analysed forms of guidance that support learning in both conceptual and epistemic aspects.We identified dual processes involved in the inquiry process that have important implications.We proposed a bidirectional model for adaptive guidance in scientific inquiry. Implications of study findings for practitioners: Adaptive guidance facilitates conceptual and epistemic understanding by stimulating curiosity and reducing uncertainty in the inquiry process.Conceptual and epistemic learning need to be concurrently guided in scientific inquiry. [ABSTRACT FROM AUTHOR]

Tsunamis from earthquakes of various magnitudes have affected Cascadia in the past. Simulations of Mw 7.5–9.2 earthquake constrained by earthquake rupture physics and geodetic locking models show that Mw ≥ 8.5 events initiating in the middle segments of the subduction zone can create coastal tsunami amplitudes comparable to those from the largest expected event. Our rupture and tsunami simulations reveal that the concave coastline geometry of the Pacific Northwest coastline focuses tsunami energy between latitudes 44° and 45° in Oregon. The possible coastal tsunami amplitudes are largely insensitive to the choice of slip model for a given magnitude. These results are useful for identifying the most hazardous segments of the subduction zone and demonstrate that a worst‐case rupture scenario does not uniquely yield the worst‐case tsunami scenario at a given location. Plain Language Summary: Offshore earthquakes along the Pacific Northwest coast of the U.S. and Canada (Cascadia region) can have magnitudes as high as 9.2, as was probably the case for an earthquake in the year 1700 CE that resulted in a large tsunami in Cascadia and across the Pacific Ocean. To learn more about the future tsunami hazard in the region, we design computer models of tsunamis from a wide range of earthquake scenarios. We find that almost regardless of the earthquake source details, events larger than magnitude 8.5 near the coast of Oregon can create large and widespread tsunamis along the US west coast. These are consequences of the geometry of offshore earthquake faulting and the concave shape of coastline in the region. Key Points: A Mw = 8.5 event in central Cascadia (Oregon) can create coastal tsunami amplitudes comparable to those from the largest possible eventThe concave coastline contributes to larger coastal tsunami amplitudes in central CascadiaThe choice of slip model does not significantly affect the distribution of coastal tsunami amplitudes in Cascadia [ABSTRACT FROM AUTHOR]

In order to meet the objective requirements of the safety and comfort of the modern lightweight timber floors, and strengthen the research on the coupling performance of the lightweight timber floors vibration characteristics and the building comfort, this article discusses the floor of a two-story prefabricated lightweight timber building demonstration house. In this paper, the floor structure of a two-story light-weight wooden house has been carried out on structural calculation modal and experimental modal, static uniform load and concentrated load deflection value testing. The evaluation of the deflection value of the floor structure, the mode shape, the coupling of the fundamental frequency mode parameters, and the vibration comfort were also studied. The results show that the fundamental frequency simulation value, one-way modal test value and two-way modal test value of the floor structure all meet the requirements of BS-6472 (BS6472-1:2008). That is, the floor structure is not lower than 8 Hz design requirements, and meets the frequency of BS-6472(BS6472-1:2008). The weighted root mean square acceleration is lower than the requirement of 0.45 m/s ²; the first three natural frequencies of the floor structure calculated by the finite element simulation are 16.413, 31.847 and 48.921 Hz, and the fundamental frequency mode is the bending vibration in the length and width directions. The second order is the bending mode in the length direction, and the third order is the bending mode in the width direction. The fundamental frequency of the two-way modal test of the floor structure is the first-order bending mode in the X direction; and the second-order natural frequency is the secondorder bending vibration shape in the X direction. when the uniform load is mainly the weight of floor own, the simulated maximum deflection value is 1.0658 mm; the simulation is performed according to the standard value of 0.566 kN/m for the uniform load of the floor design, and the simulation is the largest. The maximum deflection value of the simulated floor is 1.47383 mm at its midpoint, which meets the requirements of National Building Code of Canada-2015 (NBCC). The maximum deflection limit of the light wood structure floor system is lower than 3 m and the maximum deflection limit is 2 mm; the six deflection value test lines simulated under a concentrated load of 1 kN all present a parabolic distribution and are symmetrical. The above results has engineering application value for promoting the research on the vibration characteristics of the fabricated lightweight timber floors structure and its optimization design. [ABSTRACT FROM AUTHOR]

Background: Needle and syringe programs (NSP) are effective harm-reduction strategies against HIV and hepatitis C. Although skin, soft tissue, and vascular infections (SSTVI) are the most common morbidities in people who inject drugs (PWID), the extent to which NSP are clinically and cost-effective in relation to SSTVI in PWID remains unclear. The objective of this study was to model the clinical- and cost-effectiveness of NSP with respect to treatment of SSTVI in PWID., Methods: We performed a model-based, economic evaluation comparing a scenario with NSP to a scenario without NSP. We developed a microsimulation model to generate two cohorts of 100,000 individuals corresponding to each NSP scenario and estimated quality-adjusted life-years (QALY) and cost (in 2022 Canadian dollars) over a 5-year time horizon (1.5% per annum for costs and outcomes). To assess the clinical effectiveness of NSP, we conducted survival analysis that accounted for the recurrent use of health care services for treating SSTVI and SSTVI mortality in the presence of competing risks., Results: The incremental cost-effectiveness ratio associated with NSP was $70,278 per QALY, with incremental cost and QALY gains corresponding to $1207 and 0.017 QALY, respectively. Under the scenario with NSP, there were 788 fewer SSTVI deaths per 100,000 PWID, corresponding to 24% lower relative hazard of mortality from SSTVI (hazard ratio [HR] = 0.76; 95% confidence interval [CI] = 0.72-0.80). Health service utilization over the 5-year period remained lower under the scenario with NSP (outpatient: 66,511 vs. 86,879; emergency department: 9920 vs. 12,922; inpatient: 4282 vs. 5596). Relatedly, having NSP was associated with a modest reduction in the relative hazard of recurrent outpatient visits (HR = 0.96; 95% CI = 0.95-0.97) for purulent SSTVI as well as outpatient (HR = 0.88; 95% CI = 0.87-0.88) and emergency department visits (HR = 0.98; 95% CI = 0.97-0.99) for non-purulent SSTVI., Conclusions: Both the individuals and the healthcare system benefit from NSP through lower risk of SSTVI mortality and prevention of recurrent outpatient and emergency department visits to treat SSTVI. The microsimulation framework provides insights into clinical and economic implications of NSP, which can serve as valuable evidence that can aid decision-making in expansion of NSP services., (© 2024. The Author(s).)

Abstract: The Human Monitoring Laboratory (HML) at Health Canada updated its whole-body counter with four new electrically cooled HPGe detectors. To optimize the counting efficiency of the new system, Monte Carlo simulation was used to model the whole-body counter using a reference BOMAB male phantom. The resulting modeled counting efficiencies showed that the best position to install the four new detectors could be obtained without performing laborious real measurements, thereby reducing the cost of preparing the BOMAB phantoms and reconfiguring the detector arrays in multiple geometries, saving time and energy., (Copyright © 2024 Health Physics Society.)

This paper aims to introduce a novel family of probability distributions by the well-known method of the T-X family of distributions. The proposed family is called a "Novel Generalized Exponent Power X Family" of distributions. A three-parameters special sub-model of the proposed method is derived and named a "Novel Generalized Exponent Power Weibull" distribution (NGEP-Wei for short). For the proposed family, some statistical properties are derived including the hazard rate function, moments, moment generating function, order statistics, residual life, and reverse residual life. The well-known method of estimation, the maximum likelihood estimation method is used for estimating the model parameters. Besides, a comprehensive Monte Carlo simulation study is conducted to assess the efficacy of this estimation method. Finally, the model selection criterion such as Akaike information criterion (AINC), the correct information criterion (CINC), the Bayesian information criterion (BINC), the Hannan-Quinn information criterion (HQINC), the Cramer-von-Misses (CRMI), and the ANDA (Anderson-Darling) are used for comparison purpose. The comparison of the NGEP-Wei with other rival distributions is made by Two COVID-19 data sets. In terms of performance, we show that the proposed method outperforms the other competing methods included in this study., (© 2024. The Author(s).)

Objective: We examined the contribution of binocular vision and experience to performance on a simulated helicopter flight task.Background: Although there is a long history of research on the role of binocular vision and stereopsis in aviation, there is no consensus on its operational relevance. This work addresses this using a naturalistic task in a virtual environment.Method: Four high-resolution stereoscopic terrain types were viewed monocularly and binocularly. In separate experiments, we evaluated performance of undergraduate students and military aircrew on a simulated low hover altitude judgment task. Observers were asked to judge the distance between a virtual helicopter skid and the ground plane.Results: Our results show that for both groups, altitude judgments are more accurate in the binocular viewing condition than in the monocular condition. However, in the monocular condition, aircrew were more accurate than undergraduate observers in estimating height of the skid above the ground.Conclusion: At simulated altitudes of 5 ft (1.5 m) or less, binocular vision provides a significant advantage for estimation of the depth separation between the landing skid and the ground, regardless of relevant operational experience. However, when binocular cues are unavailable aircrew outperform undergraduate observers, a result that likely reflects the impact of training on the ability to interpret monocular depth cues. [ABSTRACT FROM AUTHOR]

Background. Two methods that provide high fidelity experiences outside of clinical settings are laboratory simulation and virtual simulation. Virtual gaming simulations are emerging and currently, there are no guidelines regarding the process. Objectives. The purpose of this study was to conduct interviews with nursing educators who use virtual gaming simulation in education to better understand the extent of use, the process, the challenges and benefits they experience, and their recommendations. Design. A qualitative, descriptive study, using purposive maximum variation sampling and interviews was conducted. Setting/Participant. Participants were selected from nursing programs in different Canadian and American educational institutions who had teaching experience using virtual gaming simulations with nursing students in higher education. Methods. In-depth interviews were conducted using a semi-structured interview guide with opened-ended questions. The interviews were recorded and transcribed. Data analysis was completed using a thematic approach. Results. The final sample consisted of 17 participants, 11(65%) were from Canada and the remaining 6(35%) were from the United States. The data yielded three themes: Benefits of gaming for the student; Preparing students and educators for success and, The virtual gaming simulation process. Participants described the challenges of using virtual gaming simulation in education and made recommendations for best practice and future research. Conclusion. The results of this study can be used as guideposts for educators who embark on this new learning experience and researchers who wish to expand the body of knowledge in this emerging field. [ABSTRACT FROM AUTHOR]

Background: Both laparoscopy and endoscopy are image-based procedures, which are less intuitive than traditional open surgery and require extensive training to reach adequate proficiency. Currently, there is lack of understanding as to how the skills in one image-based procedure translate to another, such as endoscopy to laparoscopy and vice versa. The aim of our study was to explore the relationship between endoscopic and laparoscopic skills using a Fundamentals of Laparoscopic Surgery (FLS) trainer, a traditional virtual reality endoscopic trainer and a "desk-top" endoscopic physical simulator.Methods: Senior surgical residents from across Canada participating in an advanced laparoscopic foregut training course were enrolled in the study. Participants were assessed performing the FLS laparoscopic suturing task, the Endobubble 2 task (Simbionix, GI Mentor), and a forward viewing peg transfer on the novel Basics in Endoscopic Skills Training Box (BEST Box).Results: There was significant correlation between the participant's skill in simulated laparoscopic suturing and simulated endoscopic skill using the BEST box (Pearson coefficient (r) was 0.551 (p = 0.033) and the coefficient of determination (r2) was 0.304). There was a trend towards correlation between laparoscopic suturing time and Endobubble 2 score, but this did not reach statistical significance (r = 0.458, p = 0.086; r2 = 0.210).Conclusions: Performance in the two physical simulators, laparoscopic suturing and simulated flexible endoscopy using the BEST box, showed a correlation. This study adds to the growing body of evidence that laparoscopic and endoscopic skills are complementary and has the potential to impact simulation training involving both skill sets. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly changed life and work patterns and reshaped the healthcare industry and public health strategies. It posed considerable challenges to public health emergency operations centers (PHEOCs). In this period, digital technologies such as modeling, simulation, visualization, and mapping (MSVM) emerged as vital tools in these centers. Despite their perceived importance, the potential and adaptation of digital tools in PHEOCs remain underexplored. This study investigated the application of MSVM in the PHEOCs during the pandemic in Canada using a questionnaire survey. The results show that digital tools, particularly visualization and mapping, are frequently used in PHEOCs. However, critical gaps, including data management issues, technical and capacity issues, and limitations in the policy-making sphere, still hinder the effective use of these tools. Key areas identified in this study for future investigation include collaboration, interoperability, and various supports for information sharing and capacity building.

Communities interspersed throughout the Canadian wildland are threatened by fires that have become bigger and more frequent in some parts of the country in recent decades. Identifying the fireshed (source area) and pathways from which wildland fire may ignite and spread from the landscape to a community is crucial for risk-reduction strategy and planning. We used outputs from a fire simulation model, including fire polygons and rate of spread, to map firesheds, fire pathways and corridors and spread distances for 1980 communities in the forested areas of Canada. We found fireshed sizes are larger in the north, where the mean distances between ecumene and fireshed perimeters were greater than 10 km. The Rayleigh Z test indicated that simulated fires around a large proportion of communities show significant directional trends, and these trends are stronger in the Boreal Plains and Shields than in the Rocky Mountain area. The average distance from which fire, when spreading at the maximum simulated rate, could reach the community perimeter was approximately 5, 12 and 18 km in 1, 2 and 3 days, respectively. The average daily spread distances increased latitudinally, from south to north. Spread distances were the shortest in the Pacific Maritime, Atlantic Maritime and Boreal Plains Ecozones, implying lower rates of spread compared to the rest of the country. The fire corridors generated from random ignitions and from ignitions predicted from local fire history differ, indicating that factors other than fuel (e.g. fire weather, ignition pattern) play a significant role in determining the direction that fires burn into a community., (© 2024 His Majesty the King in Right of Canada. Global Change Biology published by John Wiley & Sons Ltd. Reproduced with the permission of the Minister of Natural Resources Canada.)

Purpose: To examine the diagnostic accuracy of performing two (frontloaded) versus one (clinical standard) visual field (VF) test per visit for detecting the progression of early glaucoma in data derived from clinical populations., Methods: A computer simulation model was used to follow the VFs of 10,000 glaucoma patients (derived from two cohorts: Heijl et al., Swedish cohort; and Chauhan et al., Canadian Glaucoma Study [CGS]) over a 10-year period to identify patients whose mean deviation (MD) progression was detected. Core data (baseline MD and progression rates) were extracted from two studies in clinical cohorts of glaucoma, which were modulated using SITA-Faster variability characteristics from previous work. Additional variables included follow-up intervals (six-monthly or yearly) and rates of perimetric data loss for any reason (0%, 15% and 30%). The main outcome measures were the proportions of progressors detected., Results: When the Swedish cohort was reviewed six-monthly, the frontloaded strategy detected more progressors compared to the non-frontloaded method up to years 8, 9 and 10 of follow-up for 0%, 15% and 30% data loss conditions. The time required to detect 50% of cases was 1.0-1.5 years less for frontloading compared to non-frontloading. At 4 years, frontloading increased detection by 26.7%, 28.7% and 32.4% for 0%, 15% and 30% data loss conditions, respectively. Where both techniques detected progression, frontloading detected progressors earlier compared to the non-frontloaded strategy (78.5%-81.5% and by 1.0-1.3 years when reviewed six-monthly; 81%-82.9% and by 1.2-2.1 years when reviewed yearly). Accordingly, these patients had less severe MD scores (six-monthly review: 0.63-1.67 dB 'saved'; yearly review: 1.10-2.87 dB). The differences increased with higher rates of data loss. Similar tendencies were noted when applied to the CGS cohort., Conclusions: Frontloaded VFs applied to clinical distributions of MD and progression led to earlier detection of early glaucoma progression., (© 2024 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

Introduction and Hypothesis: We developed a summative assessment tool to evaluate competent performance on three procedure-specific low fidelity simulation models for vaginal surgery. Our purpose was to determine a pass-fail score for each model., Methods: We enrolled participants (2011-2023, three Canadian academic centers) and grouped them according to operative competency in vaginal procedures. Novice operators were medical students recruited through targeted advertisement to clerkship level medical students. Proficient operators consisted of gynecology residents from the intervention arm of a randomized controlled trial, trained to competence in the use of the models; urogynecology fellows and attending gynecologic surgeons recruited through departmental rounds. All participants were asked to perform the three procedures on the models, were videotaped, and their performance assessed by evaluators familiar with the procedure and the scoring system, blinded to operator identity. A total performance score (range 0-400) assessed timing and errors. Basic skill deductions were set a priori. We calculated sensitivity and specificity scores and obtained an optimal cutoff based on Youden's J statistic., Results: For anterior repair, we rated 46 novice and 16 proficient videos. The pass-fail score was 170/400. For posterior repair, we rated 54 novice and 14 proficient videos. The pass-fail score was 140/400. For vaginal hysterectomy, we rated 47 novice and 12 proficient videos. The pass-fail score was 180/400. Scores of proficient operators were significantly better than those of novice participants (p < 0.001 for all)., Conclusions: A pass-fail score can distinguish between novice and proficient operators and can be used for summative assessment of surgical skill., (© 2024. The International Urogynecological Association.)

Background and Objectives: Virtual reality (VR) surgical rehearsal is an educational tool that exists in a safe environment. Validation is necessary to establish the educational value of this platform. The middle cranial fossa (MCF) is ideal for simulation because trainees have limited exposure to this approach and it has considerable complication risk. Our objectives were to assess the face, content, and construct validities of an MCF VR simulation, as well as the change in performance across serial simulations., Methods: Using high-resolution volumetric data sets of human cadavers, the authors generated a high-fidelity visual and haptic rendering of the MCF approach using CardinalSim software. Trainees from Neurosurgery and Otolaryngology-Head and Neck Surgery at two Canadian academic centers performed MCF dissections on this VR platform. Randomization was used to assess the effect of enhanced VR interaction. Likert scales were used to assess the face and content validities. Performance metrics and pre- and postsimulation test scores were evaluated. Construct validity was evaluated by examining the effect of the training level on simulation performance., Results: Twenty trainees were enrolled. Face and content validities were achieved in all domains. Construct validity, however, was not demonstrated. Postsimulation test scores were significantly higher than presimulation test scores ( P < .001 ). Trainees demonstrated statistically significant improvement in the time to complete dissections ( P < .001 ), internal auditory canal skeletonization ( P < .001 ), completeness of the anterior petrosectomy ( P < .001 ), and reduced number of injuries to critical structures ( P = .001 )., Conclusion: This MCF VR simulation created using CardinalSim demonstrated face and content validities. Construct validity was not established because no trainee included in the study had previous MCF approach experience, which further emphasizes the importance of simulation. When used as a formative educational adjunct in both Neurosurgery and Otolaryngology-Head and Neck Surgery, this simulation has the potential to enhance understanding of the complex anatomic relationships of critical neurovascular structures., (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)

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]

Research has shown that the quality of care is compromised when healthcare providers respond inappropriately to patient language and cultural factors. However, research indicates that medical education is not keeping pace with the changing composition of the patient population in culturally diverse societies such as Canada and the United States, and many healthcare providers do not possess the attitudes or skills required to be effective within a culturally diverse healthcare setting. Here, we present Fydlyty, a web-based, low-fidelity serious game for medical-based cultural competence education. Fydlyty includes both a scenario and dialogue editor providing the ability to develop conversations, interpret responses, and respond to questions/answers from the game player. These responses are based on predefined cultural characteristics of the virtual patient and on different moods that the virtual patient may express depending on the situation. The results of a usability experiment conducted with medical professionals and trainees revealed that the game is easy to use, intuitive, and engaging. [ABSTRACT FROM AUTHOR]

Marginal structural models (MSMs) allow estimating the causal effect of a time-varying exposure on an outcome in the presence of time-dependent confounding. The parameters of MSMs can be estimated utilizing an inverse probability of treatment weight estimator under certain assumptions. One of these assumptions is that the proposed causal model relating the outcome to exposure history is correctly specified. However, in practice, the true model is unknown. We propose a test that employs the observed data to attempt validating the assumption that the model is correctly specified. The performance of the proposed test is investigated with a simulation study. We illustrate our approach by estimating the effect of repeated exposure to psychosocial stressors at work on ambulatory blood pressure in a large cohort of white-collar workers in Québec City, Canada. Code examples in SAS and R are provided to facilitate the implementation of the test. [ABSTRACT FROM AUTHOR]

Seismological observations provide essential input parameters for numerical tsunami simulations. Here, we present source mechanism parameters, finite-fault source rupture models and numerical tsunami simulation results for the destructive October 28, 2012 Haida Gwaii-Canada (Mw 7.7) and September 16, 2015 Illapel-Chile (Mw 8.3) earthquakes and resulting tsunamis. These two earthquakes were controlled by active tectonic features along the subduction zones that had developed in response to the convergent movements of lithospheric plates. The faulting geometry (strike, dip, and rake angles), focal depth, fault dimensions, average and maximum slip values on the fault planes and seismic moments of the earthquakes are estimated by analyzing teleseismic long-period P- and SH-waves and broadband P-waveforms and using waveform inversion and hybrid back-projection methods. The obtained slip models of the earthquakes reveal heterogeneous slip distributions on fault planes with long source durations (~ 80 s and 150 s) and low stress drop values (10–15 bars). Numerical simulations of tsunami wave propagation are further performed using the uniform and non-uniform slip models and nonlinear long-wave equations in spherical coordinates. The shape and arrival times of leading tsunami waves are adequately constrained particularly with the heterogeneous slip distribution models. The general characteristics of synthetic tsunami waveforms (e.g., amplitude, shape, arrival time) calculated using the non-uniform slip model, are more consistent with the observed tsunami records than those of a uniform slip model. It is further seen that simulation results using preliminary and fast slip models for both earthquakes give only approximate early tsunami estimates; tsunami wave heights and arrival times to the coasts are mostly not well simulated. The results indicate that tsunami simulations based on finite-fault source slip models likely contribute to the determination of tsunamigenic coastal regions by revealing locations, arrival times, amplitudes, and directions of tsunami waves within a close approximation to observed records off-shore and far from the source region. They provide sufficient information to facilitate tsunami warning and mitigation challenges after the destructive earthquakes. We further suggest that joint inversions of GPS, tsunami, teleseismic and strong ground motion records and higher resolution bathymetry data are needed in order to obtain better correlations between observed and synthetic tsunami data, especially for the later arriving waves. [ABSTRACT FROM AUTHOR]

A 3‐year study (2014–2016) was conducted at Rocky Harbour near the west coast of Newfoundland, Canada, to record the abundance and phenology of adult spruce budworms captured at traps, using a factorial design (light traps and pheromone traps deployed contiguously or segregated spatially). Budworms were most abundant and occurred seasonally earlier in 2014 than in 2015 and 2016; these findings held generally true for males and females. The geographic setting of Newfoundland (large island isolated from the mainland by an oceanic barrier of >100 km across) provides an ideal location to discriminate local flight from long‐range immigrations; in our study, however, immigrations cannot be ruled out for any single day of trapping due to broad overlap in emergence patterns at Rocky Harbour relative to forest stands with known populations of budworms on the mainland. Based on moderate daily variation in adult abundance, however, major immigration events (defined as external deposition of budworms with large numerical amplitude) likely did not take place at Rocky Harbor between 2014 and 2016. Males were more abundant at light traps coupled with pheromone traps, whereas abundance of males at pheromone traps was similar with or without contiguous light traps. This outcome may be mediated by lower range of attraction for light traps (usually <100 m) and (generally assumed to be several hundreds of meters). Females were equally abundant at light traps with or without pheromone traps. As expected, males were captured earlier in the season at pheromone traps than at light traps, and females occurred later in the season due to protandry. The onset of flight observed at light traps or pheromone traps in 2015 and 2016 occurred 10–15 days later than simulated predictions; caution is thus warranted as to conclusions derived on computer modeling of adult emergence. [ABSTRACT FROM AUTHOR]

Purpose: Describe and quantify how people with transfemoral amputations (TFA) maintain stable gait over a variety of surfaces; including, downhill and uphill, top and bottom-cross-slopes, medial-lateral translations, rolling hills and simulated rocky surfaces. Methods: Ten TFA and ten matched people without amputations (NA) walked in a virtual environment with level, sloped and simulated uneven surfaces on a self-paced treadmill. Stability was quantified using medial-lateral margin of stability (ML-MoS), step parameters, and gait variability (standard deviations for speed, temporal-spatial parameters, foot clearance and root-mean-square of medial-lateral trunk acceleration). Results and conclusions: TFA and NA adapted to non-level conditions by changing their walking speed, step width, and foot clearance. Variability for most parameters increased across conditions, compared to level. TFA walked slower than NA with shorter, wider and longer duration steps (most differences related to speed). ML-MoS did not change compared to level; however, ML-MoS was greater on the prosthetic side than both intact side and NA limbs. Foot clearance and root-mean-square of medial-lateral trunk acceleration were greater on the prosthetic side than the intact side and NA limbs. This research provides a comprehensive analysis of the different adaptations made by people without amputations compared to people with transfemoral amputations over non-level conditions and establishes significant differences between slopes and simulated uneven surfaces for TFA. Transfemoral amputation and no amputation groups adapted walking biomechanics when traversing non-level surfaces. Greatest temporal-spatial gait adaptations were walking speed, step width and foot clearance. Gait parameter variability typically increased from the level condition in both groups. Transfemoral amputation group walked slower than no amputation group with shorter, wider steps and longer duration steps. This was related to speed. Transfemoral amputation group had more trunk motion variability on the prosthetic side than no amputation group; could be related to prosthetic fit. [ABSTRACT FROM AUTHOR]

Using a detailed data on 27 Canadian NAICS industries over the period 1999–2015, we estimate a small macro-econometric model for assessing the macro-economic impacts of inward and outward foreign direct investment (FDI) in Canada. The estimated coefficients of the model in turn are used to simulate the medium to longer-term macro-economic impacts of a 10 percent increase in the two FDI stocks in Canada. The simulation results show a significant positive impact of the two FDI stocks on investment, innovation, trade flows, employment creation and real GDP. The economic impacts of inward FDI on real GDP and employment, however, are significantly bigger than the outward FDI impacts. A sustained 10% increase in the two FDI stocks would raise Canada's real GDP in the medium term by 1.2% per year. [ABSTRACT FROM AUTHOR]

Introduction: Administrative health records (AHRs) are used to conduct population-based post-market drug safety and comparative effectiveness studies to inform healthcare decision making. However, the cost of data extraction, and the challenges associated with privacy and securing approvals can make it challenging for researchers to conduct methodological research in a timely manner using real data. Generating synthetic AHRs that reasonably represent the real-world data are beneficial for developing analytic methods and training analysts to rapidly implement study protocols. We generated synthetic AHRs using two methods and compared these synthetic AHRs to real-world AHRs. We described the challenges associated with using synthetic AHRs for real-world study., Methods: The real-world AHRs comprised prescription drug records for individuals with healthcare insurance coverage in the Population Research Data Repository (PRDR) from Manitoba, Canada for the 10-year period from 2008 to 2017. Synthetic data were generated using the Observational Medical Dataset Simulator II (OSIM2) and a modification (ModOSIM). Synthetic and real-world data were described using frequencies and percentages. Agreement of prescription drug use measures in PRDR, OSIM2 and ModOSIM was estimated with the concordance coefficient., Results: The PRDR cohort included 169,586,633 drug records and 1,395 drug types for 1,604,734 individuals. Synthetic data for 1,000,000 individuals were generated using OSIM2 and ModOSIM. Sex and age group distributions were similar in the real-world and synthetic AHRs. However, there were significant differences in the number of drug records and number of unique drugs per person for OSIM2 and ModOSIM when compared with PRDR. For the average number of days of drug use, concordance with the PRDR was 16% (95% confidence interval [CI]: 12%-19%) for OSIM2 and 88% (95% CI: 87%-90%) for ModOSIM., Conclusions: ModOSIM data were more similar to PRDR than OSIM2 data on many measures. Synthetic AHRs consistent with those found in real-world settings can be generated using ModOSIM. Synthetic data will benefit rapid implementation of methodological studies and data analyst training., Competing Interests: Competing interests: The authors declare that they have no competing interests.

Forecasting recruitments is a key component of the monitoring phase of multicenter studies. One of the most popular techniques in this field is the Poisson-Gamma recruitment model, a Bayesian technique built on a doubly stochastic Poisson process. This approach is based on the modeling of enrollments as a Poisson process where the recruitment rates are assumed to be constant over time and to follow a common Gamma prior distribution. However, the constant-rate assumption is a restrictive limitation that is rarely appropriate for applications in real studies. In this paper, we illustrate a flexible generalization of this methodology which allows the enrollment rates to vary over time by modeling them through B-splines. We show the suitability of this approach for a wide range of recruitment behaviors in a simulation study and by estimating the recruitment progression of the Canadian Co-infection Cohort., (© 2023 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.)

Polar lows (PLs), which are intense maritime polar mesoscale cyclones, are associated with severe weather conditions. Due to their small size and rapid development, PL forecasting remains a challenge. Convection-permitting models are adequate to forecast PLs since, compared to coarser models, they provide a better representation of convection as well as surface and near-surface processes. A PL that formed over the Norwegian Sea on 25 March 2019 was simulated using the convection-permitting Canadian Regional Climate Model version 6 (CRCM6/GEM4, using a grid mesh of 2.5 km) driven by the reanalysis ERA5. The objectives of this study were to quantify the impact of the initial conditions on the simulation of the PL, and to assess the skill of the CRCM6/GEM4 at reproducing the PL. The results show that the skill of the CRCM6/GEM4 at reproducing the PL strongly depends on the initial conditions. Although in all simulations the synoptic environment is favourable for PL development, with a strong low-level temperature gradient and an upper-level through, only the low-level atmospheric fields of three of the simulations lead to PL development through baroclinic instability. The two simulations that best captured the PL represent a PL deeper than the observed one, and they show higher temperature mean bias compared to the other simulations, indicating that the ocean surface fluxes may be too strong. In general, ERA5 has more skill than the simulations at reproducing the observed PL, but the CRCM6/GEM4 simulation with initialisation time closer to the genesis time of the PL reproduces quite well small scale features as low-level baroclinic instability during the PL development phase., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Moreno-Ibáñez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The performance of a new type of Air Source Heat Pump Water Heater (ASHPWH) has been investigated. ASHPWH has a better performance than the conventional electric water heater if it is installed in a hotter climate. However, the conditions are different in Canada, where outside air temperature is well below the freezing point for several months, and that diminishes the water heating capacity of these systems significantly. On the other hand, if it is installed in the indoor space (which is the case of this research), the presence of the system in the house affects the house heating and cooling loads. Therefore, an understanding of energy performance of this types water heaters is critical to justify their use in the Canadian houses. The research methodology involved, installation of the ASHPWH unit in an Archetype Sustainable House (ASH), reconfiguration of some parts of house plumbing system, build sensors and data acquisition system to collect real-time experimental data, developed and validated TRNSYS models. Furthermore, the validated models were applied to evaluate the performance of the unit to meet the year-round hot water demand and established its significance with respect to the conventional electric water heater. It was concluded that the temperature and humidity of surrounding air produced a considerable impact on the heating capacity of the ASHPWH. The best coefficient of performance (COP) was obtained at 20 °C and 35% RH from the chosen sets of air conditions. The outlet water temperature fluctuates in the range of 49.5 °C to 55.9 °C (while the setpoint temperature was taken at 54 °C). The system will increase the combined space heating and cooling electricity consumptions annually by 3%, on the other hand, a reduction of 55% of water heater related annual electricity consumption was noted relative to the conventional electric water heater. [ABSTRACT FROM AUTHOR]

Nitrate transport in heterogeneous bedrock aquifers is influenced by mechanisms that operate at different spatial and temporal scales. To understand these mechanisms in a fractured sandstone aquifer with high porosity, a groundwater-flow and nitrate transport model—reproducing multiple hydraulic and chemical targets—was developed to explain the actual nitrate contamination observed in groundwater and surface water in a study area on Prince Edward Island, Canada. Simulations show that nitrate is leached to the aquifer year-round, with 61% coming from untransformed and transformed organic sources originating from fertilizers and manure. This nitrate reaches the more permeable shallow aquifer through fractures in weathered sandstone that represent only 1% of the total porosity (17%). Some of the nitrate reaches the underlying aquifer, which is less active in terms of groundwater flow, but most of it is drained to the main river. The river-water quality is controlled by the nitrate input from the shallow aquifer. Groundwater in the underlying aquifer, which has long residence times, is also largely influenced by the diffusion of nitrate in the porous sandstone matrix. Consequently, following a change of fertilizer application practices, water quality in domestic wells and the river would change rapidly due to the level of nitrate found in fractures, but a lag time of up to 20 years would be necessary to reach a steady level due to diffusion. This demonstrates the importance of understanding nitrate transport mechanisms when designing effective agricultural and water management plans to improve water quality. [ABSTRACT FROM AUTHOR]

This study presents a three–step validation technique to compare the performance of the Canadian Precipitation Analysis (CaPA) product relative to actual observation as a hydrologic forcing in regional watershed simulation. CaPA is an interpolated (6 h or 24 h accumulation) reanalysis precipitation product in near real time covering all of North America. The analysis procedure involves point-to-point (P2P) and map-to-map (M2M) comparisons, followed by proxy validation using an operational version of the WATFLOOD™ hydrologic model from 2002 to 2005 in the Lake Winnipeg Basin (LWB), Canada. The P2P technique using a Bayesian change point analysis shows that CaPA corresponds with actual observations (Canadian daily climate data, CDCD), on both an annual and seasonal basis. CaPA has the same spatial pattern, dependency and autocorrelation properties as CDCD pixel by pixel (M2M). When used as hydrologic forcing in WATFLOOD™, results indicate that CaPA is a reliable product for water resource modeling and predictions, but that the quality of CaPA data varies annually and seasonally, as does the quality of observations. CaPA proved most beneficial as a hydrologic forcing during winter seasons where observation quality is the lowest. Reanalysis products, such as CaPA, can be a reliable option in sparse network areas, and is beneficial for regional governments when the cost of new weather stations is prohibitive. [ABSTRACT FROM AUTHOR]

Background: Dedicated practice using laparoscopic simulators improves operative performance. Yet, voluntary utilization is minimal. We hypothesized that skill competition between peers, at the local and national level, positively influences residents' use of laparoscopic simulators.Methods: A web-based survey evaluated the relationship between Canadian General Surgery residents' use of laparoscopic simulation and participation in competition. Secondary outcomes assessed attitudes regarding simulation training, factors limiting use, and associations between competition level and usage.Results: One hundred ninety (23%) of 826 potential participants responded. Eighty-three percent rated their laparoscopic abilities as novice or intermediate. More than 70% agreed that use of simulation practice improves intra-operative performance, and should be a mandatory component of training. However, 58% employed simulator practice less than once per month, and 18% never used a simulator. Sixty-five percent engaged in simulator training for 5 h or less over the preceding 6 months. Seventy-three percent had participated in laparoscopic skill competition. Of those, 51% agreed that competition was a motivation for simulation practice. No association was found between those with competition experience and simulator use. However, 83% of those who had competed nationally reported >5 h of simulator use in the previous 6 months compared to those with no competition experience (26%), local competition (40%), and local national-qualifying competition (23%) (p < 0.001).Conclusions: This study does not support the hypothesis that competition alone universally increases voluntary use of simulation-based training, with only the minority of individuals competing at the national level demonstrated significantly higher simulation use. However, simulation training was perceived as a valuable exercise. Lack of time and access to simulators, as opposed to lack of interest, were the most commonly reported to limited use. [ABSTRACT FROM AUTHOR]

Background: Approximately 2 in 3 US adults have prehypertension or hypertension that increases their risk of cardiovascular disease. Reducing sodium intake can decrease blood pressure and prevent hypertension. Approximately 9 in 10 Americans consume excess sodium (≥2300 mg/d). Voluntary sodium standards for commercially processed and prepared foods were established in North America, but their impact on sodium intake is unclear. Objective: We modelled the potential impact on US sodium intake of applying voluntary sodium standards for foods. Design: We used NHANES 2007-2010 data for 17,933 participants aged ≥1 y to model predicted US daily mean sodium intake and the prevalence of excess sodium intake with the use of the standards of the New York City's National Salt Reduction Initiative (NSRI) and Health Canada for commercially processed and prepared foods. The Food and Nutrient Database for Dietary Studies food codes corresponding to foods reported by NHANES participants were matched to NSRI and Health Canada food categories, and the published sales-weighted mean percent reductions were applied. Results: The US population aged ≥1 y could have reduced their usual daily mean sodium intake of 3417 mg by 698 mg (95% CI: 683, 714 mg) by applying NSRI 2014 targets and by 615 mg (95% CI: 597, 634 mg) by applying Health Canada's 2016 benchmarks. Significant reductions could have occurred, regardless of age, sex, race/ethnicity, income, education, or hypertension status, up to a mean reduction in sodium intake of 850 mg/d in men aged ≥19 y by applying NSRI targets. The proportion of adults aged ≥19 y who consume ≥2300 mg/d would decline from 88% (95% CI: 86%, 91%) to 71% (95% CI: 68%, 73%) by applying NSRI targets and to 74% (95% CI: 71%, 76%) by applying Health Canada benchmarks. Conclusion: If established sodium standards are applied to commercially processed and prepared foods, a significant reduction of US sodium intake could occur. [ABSTRACT FROM AUTHOR]

On 9 January 1982, in the Miramichi region of New Brunswick, Canada, an earthquake with body-wave magnitude ( mb) 5.7 occurred, and extensive aftershocks followed. The mainshock was felt throughout Eastern Canada and New England, USA. The mainshock and several principal aftershocks were digitally recorded worldwide, but smaller aftershocks were digitally recorded only at regional stations. Digital stations were not yet popular in 1982; therefore, available regional digital waveform records for modelling are very limited. Fortunately, two Eastern Canada Telemetered Network (ECTN) stations, EBN and KLN, produced excellent waveform records for most of the aftershocks until their closure at the end of 1990. The waveform records can be retrieved from the archive database at the Geological Survey of Canada (GSC). Since EBN had clear sPmP records of the larger aftershocks (with magnitude mN ≥ 2.8), we were able to determine focal depths for these larger events. Most of the focal depth solutions for the 113 larger aftershocks were within a depth range of 3-6 km. The majority of the depths were at about 4.5 km. Some aftershocks had depths of about 1-2 km. The focal depth solutions for the shallow events were confirmed by the existence of prominent crustal Rayleigh waves. As the records for the foreshock and the mainshock at EBN were not available, we used the records at station LMN for the foreshock and a teleseismic depth phase for the mainshock. The teleseismic depth phase comparison shows that the mainshock and its three principal aftershocks migrated from a depth of about 7 km to near the Earth's surface. [ABSTRACT FROM AUTHOR]

Objective: To estimate the distribution and drivers of the average direct cost of osteoarthritis (OA) in Canada using a population-based health microsimulation model of OA from 2003 to 2010.Methods: We used a previously published microsimulation model to estimate the distribution of average cost of OA across different cost components and OA stages. OA stages were defined according to the patient flow within the health care system. Cost components associated with pharmacologic and nonpharmacologic treatments, physician visits, and hospitalization were included. Scenario analysis was performed to evaluate average cost drivers from 2003 to 2010.Results: During the study period, the OA population size grew from 2.9 to 3.6 million, while the average cost increased from $577 to $811 (Canadian) per patient per year. The highest increase in share of cost components was for total joint replacement (TJR) surgery (24% to 32%). The highest average cost was incurred by patients in stage 4 (during and after revision surgery), while around 80% of OA patients were in stage 1 (OA diagnosed but has not visited an orthopedic surgeon). Increase in the proportion of OA patients receiving TJR surgeries (34%) and price inflation (29%) were the most significant drivers of average cost.Conclusion: The average cost of OA has been increasing during the study period mostly due to an increase in the proportion of patients receiving TJR surgeries and price inflation. The distribution of average cost of OA across disease stages needs to be considered when designing policies targeting specific aspects of OA care. [ABSTRACT FROM AUTHOR]

In the management of most chronic conditions characterized by the lack of universally effective treatments, adaptive treatment strategies (ATSs) have grown in popularity as they offer a more individualized approach. As a result, sequential multiple assignment randomized trials (SMARTs) have gained attention as the most suitable clinical trial design to formalize the study of these strategies. While the number of SMARTs has increased in recent years, sample size and design considerations have generally been carried out in frequentist settings. However, standard frequentist formulae require assumptions on interim response rates and variance components. Misspecifying these can lead to incorrect sample size calculations and correspondingly inadequate levels of power. The Bayesian framework offers a straightforward path to alleviate some of these concerns. In this paper, we provide calculations in a Bayesian setting to allow more realistic and robust estimates that account for uncertainty in inputs through the 'two priors' approach. Additionally, compared to the standard frequentist formulae, this methodology allows us to rely on fewer assumptions, integrate pre-trial knowledge, and switch the focus from the standardized effect size to the MDD. The proposed methodology is evaluated in a thorough simulation study and is implemented to estimate the sample size for a full-scale SMART of an internet-based adaptive stress management intervention on cardiovascular disease patients using data from its pilot study conducted in two Canadian provinces., (© 2022 The International Biometric Society.)