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American eel population status in Canada was last assessed in 2012 and 2014. The present report re-assessed American eel abundance indices and investigated temporal trends in relative abundance in five management regions. Assessment included fishery-dependent and - independent data; however, the lack of data in several regions and/or for different life stages limited our ability to fully evaluate American eel population trends in Canada. Between 1874 and 2016, reported American eel landings in Canada varied between 200.6 and 1411.7 tons. From the 1880s to 1990 reported landings fluctuated without an overall trend, but showed relative stability in the 1970s and 1980s. Since about 1990 reported landings have steadily decreased. Fishery-independent indices, updated since the last assessment, were developed using generalized linear mixed models including temporal, environmental, and effort variables to account for changes in catchability. Overall, 12 fishery-independent datasets were evaluated of which 9 reflected yellow eel abundance. Trend analysis indicated that American eel abundance was stable (6 surveys), declining (4 surveys) or increasing (2 surveys). The 25th percentile reference point when compared to the initial year indicated 8 downward trends; however, when the 25th percentile reference point in the terminal year was compared to those in 2012 an increase in abundance was observed for 5 surveys over the last 5 years. Reference points for defining the stock status of American eel in Canada were not estimated as further data and analysis are needed. However, trends in relative abundance are similar to the last stock assessment in 2012 and recovery plan in 2014. Commercial landings and fisheriesindependent surveys suggest that American eel abundance has been stable since 2000 but at low abundance and the downward trend in several surveys remains a concern for the recovery of the population in Canada. Therefore, the American eel population is similar to 2012 and its stock continues to be at risk. We recommend continued monitoring and data gathering in order to better evaluate American eel status in Canada. [ABSTRACT FROM AUTHOR]

Here we summarize harvest and biological information for the Eastern Beaufort Sea (EBS) beluga to provide an updated stock assessment that combines science and Indigenous hunter knowledge. The number of EBS beluga whales harvested annually across its range has been variable, declining significantly over the available record in Canada (1980-2015). Including estimated and known loss rates from Canada and Alaska, the average annual removal of EBS beluga 2006-2015 (includes landed and struck but lost) was 145 whales (Standard Deviation 20.7). Catches in Chukotka, Russia, are < 10 belugas per year and we estimate mortality through ice entrapment averaged < 5 belugas per year from 1966 through 2015, but that too is highly variable from year-to-year. Declining interest and dependence on traditional foods and hunting, the high cost of hunting equipment and fuel, and increasingly challenging hunting conditions due to windier weather are described by hunters as the main reasons for the decline of the harvest over time. The decline in struck but lost rates is attributed to the establishment and implementation of beluga hunting by-laws by the local Inuvialuit Hunters and Trappers Committees. [ABSTRACT FROM AUTHOR]

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One of the most energy efficient systems of biofuel production uses the sugar extracted from sugarcane (Saccharum officinarum L.) for fermentation into ethanol; while sugarcane will not grow in Canada, corn (Zea mays L.), another C4 crop can. The overall objective of our study was to determine if there was corn germplasm, adapted to the short-season regions of Canada, with high stalk sugar content. Thirty-nine genotypes from diverse backgrounds were evaluated for stalk sucrose accumulation and associated traits (juice percentage, plant height, weight, and moisture) in field trials from 2007 to 2009. Genotypic differences for stalk sucrose and juice percentage were highly significant. Mean stalk sucrose ranged from 5.1 to 16.4 Brix (°Bx) and fresh biomass from 45 to 135 Mg ha-1 suggesting the presence of exploitable genetic variation. Mean stalk sucrose concentration was significantly higher in plants where pollination was prevented. Calculated sucrose yield of experimental hybrids ranged from 4.3 to 6.0 Mg ha-1. At the current conversion efficiency, the products of sucrose and fresh biomass can be translated into 3600 L ha-1 ethanol plus 47 Mg ha-1 silage, indicating that this high stalk sugar corn (or "sugarcorn") would be a valuable and an economically viable crop for Canada and elsewhere. [ABSTRACT FROM AUTHOR]

With 1 table Fusarium graminearum Schwabe is one of the predominant fungal species responsible for stalk rot of maize in Canada and many other countries. Adapted sources of resistance to this disease are scarce but recently a few have been identified. To evaluate the usefulness of these sources in a breeding programme to improve stalk rot resistance, a complete diallel cross of five inbreds of varying susceptibility to stalk rot was conducted. Artificial inoculations of stalks were accomplished by injecting a conidial suspension into the first internode above the uppermost aerial root node. Stalk rot ratings, yield and lodging in the parents, crosses and reciprocals were evaluated over two field seasons. There were significant differences between inbred lines and hybrids for stalk rot ratings. Inbreds CM174 and CO325 were highly susceptible, whereas inbreds 73405 and 73353 were classified as resistant and both had good general combining ability. Those inbreds could be used as donors of favourable alleles in breeding programmes for Gibberella stalk rot resistance. [ABSTRACT FROM AUTHOR]

Summary: Atopic dermatitis (AD), also known as eczema, is characterized by red, oozy, and dry skin that can become cracked and infected. Intense itching, which can be very troublesome and can cause sleep disturbance, is the main complaint of patients with AD. AD often begins in childhood and affects 1 in 4 teenagers worldwide. For teenagers, the itchiness and appearance of AD skin can significantly reduce quality of life, but there are few effective treatment options for moderate‐to‐severe AD that are suitable for long‐term use. Dupilumab is a new drug that blocks key molecules that cause allergic conditions, such as AD. It has been shown to be effective in treating moderate‐to‐severe AD in adults and to be relatively safe for long‐term use. This study was conducted in multiple centres across Europe and Canada in 40 patients aged 12 to 17 who received treatment with dupilumab for up to a year. The researchers wanted to know whether dupilumab is effective and safe for treating AD with long‐term use in these patients. They also wanted to know how dupilumab is processed by the body in patients with AD in this age group. They found that treatment with dupilumab substantially improves the skin and symptoms of AD, including itching, in these younger patients, without causing any unexpected side effects. They also found that dupilumab is processed the same way in these younger patients as in adults. The improvements were maintained throughout the one year of treatment. The study results support the use of dupilumab in the continuous treatment of adolescents with moderate‐to‐severe AD. This summary relates to the study: Dupilumab in adolescents with uncontrolled moderate‐to‐severe atopic dermatitis: results from a phase IIa open‐label trial and subsequent phase III open‐label extension Linked Article: Cork et al. Br J Dermatol 2020; 182:85–96 [ABSTRACT FROM AUTHOR]

Most patients diagnosed with and dying from cancer in Canada are older adults, with aging contributing to the large projected growth in cancer incidence. Older adults with cancer have unique needs, and on a global scale increasing efforts have been made to address recognized gaps in their cancer care. However, in Canada, geriatric oncology remains a new and developing field. There is increasing recognition of the value of geriatric oncology and there is a growing number of healthcare providers interested in developing the field. While there is an increasing number of dedicated programs in geriatric oncology, they remain limited overall. Developing novel methods to delivery geriatric care in the oncology setting and improving visibility is important. Formal incorporation of a geriatric oncology curriculum into training is critical to both improve knowledge and demonstrate its value to healthcare providers. Although a robust group of dedicated researchers exist, increased collaboration is needed to capitalize on existing expertise. Dedicated funding is critical to promoting clinical programs, research, and training new clinicians and leaders in the field. By addressing challenges and capitalizing on opportunities for improvement, Canada can better meet the unique needs of its aging population with cancer and ultimately improve their outcomes.

Background: No study has examined the associations between peripheral saturated long-chain fatty acids (LCFAs) and conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). This study aimed to examine whether circulating saturated LCFAs are associated with both risks of incident MCI from cognitively normal (CN) participants and incident AD progressed from MCI in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort., Methods: We conducted analysis of data from older adults aged 55-90 years who were recruited at 63 sites across the USA and Canada. We examined associations between circulating saturated LCFAs (i.e., C14:0, C16:0, C18:0, C20:0) and risk for incident MCI in CN participants, and incident AD progressed from MCI., Findings: 829 participants who were enrolled in ADNI-1 had data on plasma saturated LCFAs, of which 618 AD-free participants were included in our analysis (226 with normal cognition and 392 with MCI; 60.2% were men). Cox proportional-hazards models were used to account for time-to-event/censor with a 48-month follow-up period for the primary analysis. Other than C20:0, saturated LCFAs were associated with an increased risk for AD among participants with MCI at baseline (Hazard ratios (HRs) = 1.3 to 2.2, P = 0.0005 to 0.003 in fully-adjusted models). No association of C20:0 with risk of AD among participants with MCI was observed. No associations were observed between saturated LCFAs and risk for MCI among participants with normal cognition., Interpretation: Saturated LCFAs are associated with increased risk of progressing from MCI to AD. This finding holds the potential to facilitate precision prevention of AD among patients with MCI., Funding: National Institutes of Health., Competing Interests: Declaration of interests KN received payment or honoraria for lectures and/or presentations from AIS symposium, outside the submitted work. SW received book royalties from American Psychiatric Publishing, Inc. and participated in DSMB for NIA funded study, not related to the submitted work. All other authors declare that they have no competing interests., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

As deforestation has become an increasingly urgent issue worldwide, global initiatives and national policies have been launched to reduce deforestation. However, existing measures pay little attention to indirect deforestation and consumers' responsibilities, overlooking the different roles played by countries in the trading network. Therewith, to identify the producer's and consumers' responsibilities for deforestation, and reveal the roles and interrelations of those countries in the trading system, this study applies input-output analysis to find the main producers and consumers of embodied deforestation and complex network method to construct a network to illustrate the interrelations of the countries and identify their roles in the network. The results show the United States, China, Germany and other developed countries are the main consumers while Canada, Brazil, Indonesia and other heavily forested countries are the critical providers of embodied deforestation. Further studies find these countries have the highest level of degree, strength, and centrality, dominating the trade activities in the network. Additionally, the network features small-world nature and heterogeneity, illustrating the close connection of the network and the decisive roles of key nodes. This analysis provides findings to help policymakers more effectively address deforestation worldwide, by highlighting the flow of resources to and from key economies which have previously been overlooked., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Primary febrile neutropenia (FN) prophylaxis with ciprofloxacin or granulocyte-colony stimulating factors (G-CSF) is recommended with docetaxel-cyclophosphamide (TC) chemotherapy for early-stage breast cancer (EBC). A pragmatic randomised trial compared the superiority of G-CSF to ciprofloxacin and a cost-utility analysis were conducted., Methods: EBC patients receiving TC chemotherapy were randomised to ciprofloxacin or G-CSF. The primary outcome was a composite of FN and non-FN treatment-related hospitalisation. Secondary outcomes included; rates of FN, non-FN treatment-related hospitalisation, chemotherapy dose reductions/delays/discontinuations. Primary analysis was performed with the intention to treat population. Cost-utility analyses were conducted from the Canadian public payer perspective., Results: 458 eligible patients were randomised: 228 to ciprofloxacin and 230 to G-CSF. For the primary endpoint there was non-statistically significant difference (Risk difference = -6.7%, 95%CI = -13.5%-0.1%, p = 0.061) between ciprofloxacin patients (46,20.2%) and G-CSF (31,13.5%). Patients receiving ciprofloxacin were more likely to experience FN (36/228, 15.8% vs 13/230, 5.7%) than patients receiving G-CSF (p < 0.001). Non-FN treatment-related hospitalisation occurred in 40/228 (17.5%) of ciprofloxacin patients vs 28/230 (12.2%) of G-CSF patients (p = 0.12). There were no differences in other secondary outcomes. G-CSF was associated with an incremental cost-effectiveness ratio of C$1,760,796 per one quality-adjusted life year gained., Conclusion: The primary endpoint of superiority of G-CSF over ciprofloxacin was not demonstrated. While there were reduced FN rates with G-CSF, there were no differences in chemotherapy dose delays/reductions or discontinuations. With the commonly used willingness to pay value of C$50,000/QALY, G-CSF use was not cost-effective compared to ciprofloxacin and deserves scrutiny from the payer perspective., Competing Interests: Declaration of competing interest MC reports personal fees (honoraria) from Pfizer. AAJ reports personal fees (honoraria or travel funds) from Mylan, Teva, Purdue, BMS, BI, Genomic Health, PUMA, Pfizer, Roche, Astra Zeneca, Novartis and Eli Lilly, outside the submitted work. JPH reports institutional research funds from Roche and BMS, outside the submitted work. JM reports personal fees (honorarium) from Pfizer and share ownership in Pacylex Pharmaceutical Inc, SMHeart Card Inc, and illumiSonics, outside the submitted work. TN reports personal fees (honoraria) from ARIAD, Takeda and Boehringer-Ingelheim, outside the submitted work. AA reports personal fees (honorarium for advisory board participation) from Novartis, outside the submitted work. LP reports personal fees (honorarium from advisory board participation) from Serono Oncology, outside the submitted work. NN reports personal fees (honorarium) from Roche, and institutional research funds from Pfizer, outside the submitted work. BH reports consulting fees from Cornerstone Research, outside the submitted work. JFH reports consulting fees from BMS, Pfizer, Eli-Lilly, Novartis and Merck, outside the submitted work. All other authors declare no competing interests., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The literature suggests that medical oncologists differ on how they use the Oncotype DX (ODX) genomic assay for making decisions about systemic therapy in breast cancer patients. Given the emergence of data supporting the use of genomic profiling for the prognosis and predicting benefit of chemotherapy, we surveyed medical oncologists in Canada to assess their usage and perception of the ODX assay., Methods: A 34-item survey was distributed to Canadian medical oncologists via the Canadian Association of Medical Oncologists. Data was collected on physician demographics, ODX usage patterns, and physicians' perception of the impact clinical and pathologic characteristics make on ODX utilization., Results: Response rate was 20.6% with 47 responses received from 228 survey sent. Forty-five responses were eligible for analysis. Sixty-two percent (28/45) of respondents treated predominantly breast cancer, and 60% (27/45) have been in practice for at least 10 years. The most cited reason for using ODX was to avoid giving patients unnecessary chemotherapy (64%; 29/45). Sixty-seven percent (30/45) deferred making treatment decisions until ODX testing was completed. Factors most strongly impacting ODX utilization included: patient request, medical comorbidities and tumor grade. In clinical scenarios, ODX was more frequently selected for patients aged 40-65 (vs. <40 or >65), grade 2 tumors (vs. grade 1 or 3), and Ki-67 index of 10-20% (vs. <10% or >20%)., Conclusions: This survey demonstrated that Canadian medical oncologists are preferentially using ODX to avoid giving patients unnecessary chemotherapy. The utilization of ODX is mainly in patients with intermediate clinical and pathologic features.

Background: Dermatome-induced lacerations are a known complication; however, there is a paucity of literature discussing the incidence and predisposing factors. The aim of this study was to determine the incidence and risk factors to develop a preventive algorithm., Methods: An 18-question survey was sent to all US and Canadian burn unit directors. Surgeons were queried about type and location of their practices, average annual caseload of skin graft harvesting, and number of dermatome-induced lacerations. The survey also asked about donor site location, harvesting technique and equipment, laceration severity, and causative factors. An algorithm was developed based on the results., Results: Fifty-six responses (42% response rate) were received from the burn unit directors. They reported an estimated 133 lacerations over the past 5 y. The overall incidence of dermatome-induced lacerations was approximately 0.1% per year (1.3 per 1000 cases). The most commonly attributed causes were excessive pressure (25.0%) and patient factors (18.4%). Most lacerations occurred when using air dermatomes (73.0%) with a 4-inch guard (63.5%), 0.010- to 0.015-inch thickness (78.4%), and 30°-45° angulation (47.3%); the most common brand was Zimmer (71.6%). The dermatome was typically set up by a scrub tech or nurse (48.6%), whereas the skin harvesting was performed by residents (39.2%) or attendings (35.1%). Lacerations typically extended to subcutaneous tissue (70.3%), with no neurovascular injury (86.5%)., Conclusions: Our study showed that dermatome-induced lacerations are rare events and that certain factors predispose patients to injury. An algorithm was developed to provide guidance on risk factor identification and the set up and use of dermatomes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The rising incidence of pediatric obesity may significantly affect bone marrow transplantation (BMT) outcomes. We analyzed outcomes in 3687 children worldwide who received cyclophosphamide-based BMT regimens for leukemias between 1990 and 2007. Recipients were classified according to age-adjusted body mass index (BMI) percentiles as underweight (UW), at risk of UW (RUW), normal, overweight (OW), or obese (OB). Median age and race were similar in all groups. Sixty-one percent of OB children were from the United States/Canada. Three-year relapse-free and overall survival ranged from 48% to 52% (P = .54) and 55% to 58% (P = .81) across BMI groups. Three-year leukemia relapses were 33%, 33%, 29%, 25%, and 21% in the UW, RUW, normal, OW, and OB groups, respectively (P < .001). Corresponding cumulative incidences for transplant-related mortality (TRM) were 18%, 19%, 21%, 22%, and 28% (P < .01). Multivariate analysis demonstrated a decreased risk of relapse compared with normal BMI (relative risk [RR] = 0.73; P < .01) and a trend toward higher TRM (RR = 1.28; P = .014). BMI in children is not significantly associated with different survival after BMT for hematologic malignancies. Obese children experience less relapse posttransplant compared with children with normal BMI; however, this benefit is offset by excess in TRM., (© 2014 by The American Society of Hematology.)

Background: Cultural variations in the relative emphasis on somatic versus psychological symptoms of distress are a common topic in cultural psychopathology. The most well-known example involves people of Chinese heritage, who are found to emphasize somatic symptoms in presenting depression as compared with people of Western European heritage. It remains unknown whether a similar cultural difference is found for anxiety disorders., Methods: Euro-Canadian (n=79) and Han Chinese (n=154) psychiatric outpatients with clinically significant concerns about both depression and anxiety were selected from a larger dataset based on their responses to a structured interview. They also completed two self-report questionnaires assessing somatization of depression and anxiety., Results: As expected, Chinese participants reported a greater tendency to emphasize somatic symptoms of depression, as compared to the Euro-Canadians. Contrary to expectations, the tendency to emphasize somatic symptoms of anxiety was higher among the Euro-Canadians as compared to the Chinese participants., Limitations: Characteristics of our participants limit the generalizability of our findings. The current study is preliminary and requires replication., Conclusions: Despite the exploratory nature of this study, the results suggest that the popular notion of 'Chinese somatization' should not be over-generalized. Our findings also imply that there may be important differences in the cultural understanding of depression and anxiety in both Chinese and 'Western' contexts. Future studies should seek to unpack potential cultural explanations for why Euro-Canadian outpatients may emphasize somatic symptoms in the presentation of anxiety to a greater degree than Chinese outpatients., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Objective: As clinical text mining continues to mature, its potential as an enabling technology for innovations in patient care and clinical research is becoming a reality. A critical part of that process is rigid benchmark testing of natural language processing methods on realistic clinical narrative. In this paper, the authors describe the design and performance of three state-of-the-art text-mining applications from the National Research Council of Canada on evaluations within the 2010 i2b2 challenge., Design: The three systems perform three key steps in clinical information extraction: (1) extraction of medical problems, tests, and treatments, from discharge summaries and progress notes; (2) classification of assertions made on the medical problems; (3) classification of relations between medical concepts. Machine learning systems performed these tasks using large-dimensional bags of features, as derived from both the text itself and from external sources: UMLS, cTAKES, and Medline., Measurements: Performance was measured per subtask, using micro-averaged F-scores, as calculated by comparing system annotations with ground-truth annotations on a test set., Results: The systems ranked high among all submitted systems in the competition, with the following F-scores: concept extraction 0.8523 (ranked first); assertion detection 0.9362 (ranked first); relationship detection 0.7313 (ranked second)., Conclusion: For all tasks, we found that the introduction of a wide range of features was crucial to success. Importantly, our choice of machine learning algorithms allowed us to be versatile in our feature design, and to introduce a large number of features without overfitting and without encountering computing-resource bottlenecks.

Background: Quantifying adherence to quality indicators can serve as a direct measure of quality of care and provide the foundation for quality improvement. However, quality indicators for percutaneous coronary intervention (PCI) have not been developed in Canada., Objective: To develop a set of quality and outcome indicators for PCI that can be used across Canada., Methods: A 12-member national expert panel was selected to represent practice in different regions of Canada. Potential quality indicators were identified by a detailed search of published guidelines, randomized trials and outcomes studies. A two-step modified Delphi process was employed with an initial screening round of indicator ratings, followed by a national quality indicator panel meeting, and follow-up discussions to obtain consensus., Results: A total of 26 indicators including six structure indicators, nine process indicators, and 11 outcomes indicators were identified by the national expert panel to be representative of high quality of care for PCI. Pharmacological indicators included prescription of acetylsalicylic acid, clopidogrel and statin therapy as adjunctive therapy for PCI. Nonpharmacological process indicators included minimal procedure volumes, door-to-balloon time in primary PCI, prevention of contrast-induced nephropathy and selected patient education counselling instructions. Outcome indicators included death, myocardial infarction, target vessel revascularization and vascular access complications after PCI., Conclusions: A new set of PCI quality indicators for use in the Canadian health care system was developed. The widespread adoption and implementation of PCI quality indicators in clinical practice will facilitate the identification of practice gaps to enable quality improvement efforts and to optimize the outcomes of patients undergoing PCI throughout Canada.

The expectation that Chinese people present distress somatically is a central prediction of cultural psychopathology and has been the subject of considerable theoretical speculation. At the same time, empirical studies have been infrequent and have yielded mixed results. The authors examined symptom presentation in Chinese (n=175) and Euro-Canadian (n=107) outpatients, using spontaneous problem report, structured clinical interview, and symptom questionnaire methods. All 3 methods yielded cross-culturally equivalent somatic and psychological symptom subscales. Chinese outpatients reported more somatic symptoms on spontaneous problem report and structured clinical interview compared with Euro-Canadians, who in turn reported more psychological symptoms on all 3 methods. The relation between culture and somatic symptom presentation was mediated by a tendency toward externally oriented thinking. Difficulties with identifying emotions or describing them to others did not differ significantly across cultures, supporting a nonpathological interpretation of observed differences. Psychological symptom effects were larger and more consistent than somatic symptom effects; because other studies have confirmed the ubiquity of somatic presentations worldwide, these results suggest that Western psychologization may be more culturally specific than is Chinese somatization.

To monitor severe acute respiratory syndrome (SARS) infection, a coronavirus protein microarray that harbors proteins from SARS coronavirus (SARS-CoV) and five additional coronaviruses was constructed. These microarrays were used to screen approximately 400 Canadian sera from the SARS outbreak, including samples from confirmed SARS-CoV cases, respiratory illness patients, and healthcare professionals. A computer algorithm that uses multiple classifiers to predict samples from SARS patients was developed and used to predict 206 sera from Chinese fever patients. The test assigned patients into two distinct groups: those with antibodies to SARS-CoV and those without. The microarray also identified patients with sera reactive against other coronavirus proteins. Our results correlated well with an indirect immunofluorescence test and demonstrated that viral infection can be monitored for many months after infection. We show that protein microarrays can serve as a rapid, sensitive, and simple tool for large-scale identification of viral-specific antibodies in sera.