The velocity of postglacial migration of fire-adapted boreal tree species in eastern North America.

The Earth's climate has been warming rapidly since the beginning of the industrial era, forcing terrestrial organisms to adapt. Migration constitutes one of the most effective processes for surviving and thriving, although the speed at which tree species migrate as a function of climate change is unknown. One way to predict latitudinal movement of trees under the climate of the twenty-first century is to examine past migration since the Last Glacial Maximum. In this study, radiocarbon-dated macrofossils were used to calculate the velocity of past migration of jack pine (Pinus banksiana) and black spruce (Picea mariana), two important fire-adapted conifers of the North American boreal forest. Jack pine migrated at a mean rate of 19 km per century (km-cent) from unglaciated sites in the central and southeastern United States to the northern limit of the species in subarctic Canada. However, the velocity increased between unglaciated and early deglaciated sites in southern Quebec and slowed from early to mid-Holocene in central and eastern Quebec. Migration was at its lowest speed in late-Holocene times, when it stopped about 3,000 y ago. Compared with jack pine, black spruce migrated at a faster mean rate of 25 km-cent from the ice border at the last interstadial (Bølling/Allerød) to the species tree limit. The modern range of both species was nearly occupied about 6,000 y ago. The factors modulating the changing velocity of jack pine migration were closely associated with the warm-dry climate of the late Pleistocene-Holocene transition and the more humid climate of the mid- and late-Holocene.

Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis.

BACKGROUND: Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS). METHODS: The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models. RESULTS: Seventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I(2) = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I(2) = 0%). CONCLUSIONS: Overall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.

Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE): epidemiology, emerging organisms, and economics.

BACKGROUND: Each year in Canada there are 5 million episodes of acute gastroenteritis (AGE) with up to 70% attributed to an unidentified pathogen. Moreover, 90% of individuals with AGE do not seek care when ill, thus, burden of disease estimates are limited by under-diagnosing and under-reporting. Further, little is known about the pathogens causing AGE as the majority of episodes are attributed to an "unidentified" etiology. Our team has two main objectives: 1) to improve health through enhanced enteric pathogen identification; 2) to develop economic models incorporating pathogen burden and societal preferences to inform enteric vaccine decision making. METHODS/DESIGN: This project involves multiple stages: 1) Molecular microbiology experts will participate in a modified Delphi process designed to define criteria to aid in interpreting positive molecular enteric pathogen test results. 2) Clinical data and specimens will be collected from children aged 0-18 years, with vomiting and/or diarrhea who seek medical care in emergency departments, primary care clinics and from those who contact a provincial medical advice line but who do not seek care. Samples to be collected will include stool, rectal swabs (N = 2), and an oral swab. Specimens will be tested employing 1) stool culture; 2) in-house multiplex (N = 5) viral polymerase chain reaction (PCR) panel; and 3) multi-target (N = 15) PCR commercially available array. All participants will have follow-up data collected 14 days later to enable calculation of a Modified Vesikari Scale score and a Burden of Disease Index. Specimens will also be collected from asymptomatic children during their well child vaccination visits to a provincial public health clinic. Following the completion of the initial phases, discrete choice experiments will be conducted to enable a better understanding of societal preferences for diagnostic testing and vaccine policy. All of the results obtained will be integrated into economic models. DISCUSSION: This study is collecting novel samples (e.g., oral swabs) from previously untested groups of children (e.g., those not seeking medical care) which are then undergoing extensive molecular testing to shed a new perspective on the epidemiology of AGE. The knowledge gained will provide the broadest understanding of the epidemiology of vomiting and diarrhea of children to date.

Estimating the impacts of nonoptimal temperatures on mortality: A study in British Columbia, Canada, 2001-2021.

Background: Studies show that more than 5.1 million deaths annually are attributed to nonoptimal temperatures, including extreme cold and extreme heat. However, those studies mostly report average estimates across large geographical areas. The health risks attributed to nonoptimal temperatures in British Columbia (BC) are reported incompletely or limit the study area to urban centers. In this study, we aim to estimate the attributable deaths linked to nonoptimal temperatures in all five regional health authorities (RHAs) of BC from 2001 to 2021. Methods: We applied the widely used distributed lag nonlinear modeling approach to estimate temperature-mortality association in the RHAs of BC, using daily all-cause deaths and 1 × 1 km gridded daily mean temperature. We evaluated the model by comparing the model-estimated attributable number of deaths during the 2021 heat dome to the number of heat-related deaths confirmed by the British Columbia Coroners Service. Results: Overall, between 2001 and 2021, we estimate that 7.17% (95% empirical confidence interval = 3.15, 10.32) of deaths in BC were attributed to nonoptimal temperatures, the majority of which are attributed to cold. On average, the mortality rates attributable to moderate cold, moderate heat, extreme cold, and extreme heat were 47.04 (95% confidence interval [CI] = 45.83, 48.26), 0.94 (95% CI = 0.81, 1.08), 2.88 (95% CI = 2.05, 3.71), and 3.10 (95% CI = 1.79, 4.4) per 100,000 population per year, respectively. Conclusions: Our results show significant spatial variability in deaths attributable to nonoptimal temperatures across BC. We find that the effect of extreme temperatures is significantly less compared to milder nonoptimal temperatures between 2001 and 2021. However, the increased contribution of extreme heat cannot be ruled out in the near future.

Validation of case definition algorithms for the ascertainment of congenital anomalies.

BACKGROUND: Congenital anomalies (CA) are one of the leading causes of infant mortality and long-term disability. Many jurisdictions rely on health administrative data to monitor these conditions. Case definition algorithms can be used to monitor CA; however, validation of these algorithms is needed to understand the strengths and limitations of the data. This study aimed to validate case definition algorithms used in a CA surveillance system in British Columbia (BC), Canada. METHODS: A cohort of births between March 2000 and April 2002 in BC was linked to the Health Status Registry (HSR) and the BC Congenital Anomalies Surveillance System (BCCASS) to identify cases and non-cases of specific anomalies within each surveillance system. Measures of algorithm performance were calculated for each CA using the HSR as the reference standard. Agreement between both databases was calculated using kappa coefficient. The modified Standards for Reporting Diagnostic Accuracy guidelines were used to enhance the quality of the study. RESULTS: Measures of algorithm performance varied by condition. Positive predictive value (PPV) ranged between approximately 73%-100%. Sensitivity was lower than PPV for most conditions. Internal congenital anomalies or conditions not easily identifiable at birth had the lowest sensitivity. Specificity and negative predictive value exceeded 99% for all algorithms. CONCLUSION: Case definition algorithms may be used to monitor CA at the population level. Accuracy of algorithms is higher for conditions that are easily identified at birth. Jurisdictions with similar administrative data may benefit from using validated case definitions for CA surveillance as this facilitates cross-jurisdictional comparison.

Sweet and sour: A quantitative analysis of methane emissions in contrasting Alberta, Canada, heavy oil developments.

Cold heavy oil production with or without sand (CHOPS, or CHOP) are prevalent methods of oil extraction in western Canada. CHOP(S) sites account for over 40% of all reported vented methane (CH4) from oil production in Alberta, and high rates of CH4 emissions have been confirmed in independent measurement studies. In this study, we used truck-based surveys coupled with qualitative optical gas imaging (OGI) to quantify and characterize methane emission rates and sources at nearly 1350 and 940 well sites in two major CHOP(S) developments respectively in 2016 and 2018. The studies were conducted in Lloydminster, Alberta, where produced gases are sweet (i.e., <0.5% sulfur) and non-olfactory, and Peace River, Alberta, where regulations were implemented in 2017 to manage sour (i.e., >0.5% sulfur) odorous emissions (hydrogen sulfide, BTEX, etc.). Based on results from all surveys, in Peace River, 43% of measured sites were emitting CH4, compared to 37% in Lloydminster. The measured CH4 emission rates in Peace River were, however, significantly lower than in Lloydminster for both years, and had fallen from 2016 to 2018. In 2018, emissions in Lloydminster were fairly unchanged relative to previous measurements taken in 2016. OGI showed that tanks in Peace River continue to emit CH4 despite regulatory interventions and a reported venting rate of zero. The continued emissions were thus classified as "unintended venting", which can be a consequence of the non-routine malfunction (e.g., inappropriate operator action or poor equipment design/sizing) of vapor recovery equipment. Mitigation strategies implemented in Peace River targeting olfactory compounds were beneficial in reducing and keeping CH4 emissions lower, since these gases are co-emitted, and could even be co-regulated provincially. Reciprocal to that, we might expect future air quality improvements as a consequence of the new provincial requirements to reduce CH4 emissions under amended Directives 060 and 017.

Clinical care pathway for the evaluation of patients with suspected VITT after ChAdOx1 nCoV-19 vaccination.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare complication after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) adenoviral vector vaccination. In British Columbia (BC), Canada, a provincial clinical care pathway was developed to guide clinicians in evaluating for VITT among patients who present with thrombocytopenia or thrombosis symptoms within 4 to 28 days after adenoviral vector vaccine exposure. All patients had enzyme-linked immunosorbent assay (ELISA) testing for platelet factor 4 (PF4) antibodies, and all cases with positive PF4-ELISA or d-dimer levels ≥2.0 mg/L fibrinogen equivalent units (FEU) had further testing for platelet-activating PF4 antibodies using a modified serotonin release assay (SRA). Between 1 May and 30 June 2021, 37% of 68 patients investigated for VITT had thrombosis, but only 3 had VITT confirmed by PF4-ELISA and SRA. Platelet counts, d-dimer levels, and ELISA optical density values were significantly different between those with and without VITT. Three patients had thrombocytopenia and thrombosis with d-dimer levels >4.0 mg/L FEU but had negative PF4-ELISA and SRA results. Patients with VITT were treated successfully with IV immunoglobulin, nonheparin anticoagulants, and corticosteroids. Our pathway demonstrated that thrombosis is common among patients investigated for VITT and that PF4-ELISA testing is necessary to confirm VITT in those presenting with thrombosis and thrombocytopenia.

Methane emissions from upstream oil and gas production in Canada are underestimated.

Methane emissions were measured at 6650 sites across six major oil and gas producing regions in Canada to examine regional emission trends, and to derive an inventory estimate for Canada's upstream oil and gas sector. Emissions varied by fluid type and geographic region, with the heavy oil region of Lloydminster ranking highest on both absolute and intensity-based scales. Emission intensities varied widely for natural gas production, where older, low-producing developments such as Medicine Hat, Alberta showed high emission intensities, and newer developments in Montney, British Columbia showed emission intensities that are amongst the lowest in North America. Overall, we estimate that the Canadian upstream oil and gas methane inventory is underestimated by a factor of 1.5, which is consistent with previous studies of individual regions.

An investigation into human pandemic influenza virus (H1N1) 2009 on an Alberta swine farm.

On May 2, 2009 the Canadian Food Inspection Agency notified the World Organization for Animal Health that an emerging novel influenza A virus (pandemic H1N1 2009) had been confirmed on a swine farm in Alberta. Over a 4-week period pigs in this farrow-to-finish operation were clinically affected by respiratory disease consistent with an influenza A virus infection and the presence of active viral infection was confirmed in all production areas by real-time polymerase chain reaction (RT-PCR). Despite clinical recovery of animals, there was reluctance by purchasers to receive animals from this operation due to concerns about the effect on both domestic and international markets. The owner decided to depopulate the entire herd due to impending welfare issues associated with overcrowding and economic concerns resulting from the inability to market these animals. Carcasses were rendered or composted and did not enter the human food or animal feed chain. The source of virus in this herd was determined to be an infected human. Zoonotic transmission to 2 individuals responding to the outbreak was suspected and recommendations to prevent occupational exposure are discussed.

Zoster prophylaxis after allogeneic hematopoietic cell transplantation using acyclovir/valacyclovir followed by vaccination.

Varicella zoster virus (VZV) disease (usually cutaneous zoster) occurs frequently after hematopoietic cell transplantation (HCT), and postherpetic neuralgia (PHN) results in poor quality of life. The optimal prophylaxis of VZV disease/PHN has not been established. At our center, before 2008, VZV prophylaxis consisted of ∼1 year of post-HCT acyclovir/valacyclovir ("old strategy"), whereas post-2008 prophylaxis consisted of 2 years of acyclovir/valacyclovir followed by immunization using varicella vaccine ("new strategy"). We performed a retrospective study comparing the cumulative incidence of VZV disease and PHN among patients who completed the old strategy (n = 153) vs the new strategy (n = 125). Patients who completed the old strategy had a significantly higher cumulative incidence of VZV disease (33% vs 17% at 5 years, P ≤ .01) and PHN (8% vs 0% at 5 years, P = .02). In conclusion, VZV prophylaxis with 2 years of acyclovir/valacyclovir followed by vaccination appears to result in a low incidence of VZV disease and may eliminate PHN.

Environmental factors explaining the vegetation patterns in a temperate peatland.

Although ombrotrophic temperate peatlands are important ecosystems for maintaining biodiversity in eastern North America, the environmental factors influencing their flora are only partly understood. The relationships between plant species distribution and environmental factors were thus studied within the oldest temperate peatland of Québec. Plant assemblages were identified by cluster analysis while CCA was used to related vegetation gradients to environmental factors. Five assemblages were identified; three typical of open bog and two characterized by more minerotrophic vegetation. Thicker peat deposit was encounter underlying the bog assemblages while higher water table level and percentage of free surface water distinguished the minerotrophic assemblages. Overall, the floristic patterns observed were spatially structured along the margins and the expanse. The most important environmental factors explaining this spatial gradient were the percentage of free surface water and the highest water-table level.