Temporal trends of aortic stenosis and comorbid chronic kidney disease in the province of Quebec, Canada

Objective: To investigate temporal trends of chronic kidney disease (CKD) among patients with incident aortic stenosis (AS) and to compare these trends with that of a matched control population. Methods: Using the Quebec Integrated Chronic Disease Surveillance System, we performed a population-based nested case-control study including 108 780 patients newly hospitalised with AS and 543 900 age-matched, sex-matched and fiscal year-matched patients without AS from 2000 to 2016 in Quebec (Canada). Three subgroups were considered. Dialysis subgroup had at least two outpatient billing codes of dialysis. The predialysis subgroup had at least one hospital or two billing diagnostic codes of CKD. The remaining individuals were included in the non-CKD subgroup. We estimated overall and sex-specific standardised annual proportions of CKD subgroups through direct standardisation using the 2016-2017 age structure of the incident AS cohort. The trends overtime were estimated through fitting robust Poisson regression models. Age-specific distribution of AS and control population were assessed for each subgroup. Results: From 2000 to 2016, age-standardised proportions of patients with AS with dialysis and predialysis increased by 41% (99% CI 12.0% to 78.1%) and by 45% (99% CI 39.1% to 51.6%), respectively. Inversely, age-standardised proportions of dialysis and pre-dialysis among non-AS patients decreased by 63% (99% CI 55.8% to 68.7%) and by 32% (99% CI 29.9% to 34.6%), respectively, during the same study period. In patients with and without AS, age-standardised annual proportions of males in predialysis were significantly higher than females in most of the study period. Patients with AS on dialysis and predialysis were younger than their respective controls (dialysis: 29.6% vs 45.1% had ≥80 years, predialysis: 60.8% vs 72.7% had ≥80 years). Conclusions: Over time, the proportion of patients with CKD increased significantly and remained consistently higher in incident AS individuals compared with controls. Our results highlight the need to investigate whether interventions targeting CKD risk factors may influence AS incidence in the future

Association between floods and acute cardiovascular diseases: a population-based cohort study using a geographic information system approach

Abstract: Background: Floods represent a serious threat to human health beyond the immediate risk of drowning. There is few data on the potential link between floods and direct consequences on health such as on cardiovascular health. This study aimed to explore the impact of one of the worst floods in the history of Quebec, Canada on acute cardiovascular diseases (CVD). Methods: A cohort study with a time series design with multiple control groups was built with the adult population identified in the Quebec Integrated Chronic Disease Surveillance System. A geographic information system approach was used to define the study areas. Logistic regressions were performed to compare the occurrence of CVD between groups. Results: The results showed a 25%–27% increase in the odds in the flooded population in spring 2011 when compared with the population in the same area in springs 2010 and 2012. Besides, an increase up to 69% was observed in individuals with a medical history of CVD. Conclusion: Despite interesting results, the association was not statistically significant. A possible explanation to this result can be that the population affected by the flood was probably too small to provide the statistical power to answer the question, and leaves open a substantial possibility for a real and large effect

The Habitable Exoplanet Observatory (HabEx) Mission Concept Study Final Report

The Habitable Exoplanet Observatory, or HabEx, has been designed to be the Great Observatory of the 2030s. For the first time in human history, technologies have matured sufficiently to enable an affordable space-based telescope mission capable of discovering and characterizing Earthlike planets orbiting nearby bright sunlike stars in order to search for signs of habitability and biosignatures. Such a mission can also be equipped with instrumentation that will enable broad and exciting general astrophysics and planetary science not possible from current or planned facilities. HabEx is a space telescope with unique imaging and multi-object spectroscopic capabilities at wavelengths ranging from ultraviolet (UV) to near-IR. These capabilities allow for a broad suite of compelling science that cuts across the entire NASA astrophysics portfolio. HabEx has three primary science goals: (1) Seek out nearby worlds and explore their habitability; (2) Map out nearby planetary systems and understand the diversity of the worlds they contain; (3) Enable new explorations of astrophysical systems from our own solar system to external galaxies by extending our reach in the UV through near-IR. This Great Observatory science will be selected through a competed GO program, and will account for about 50% of the HabEx primary mission. The preferred HabEx architecture is a 4m, monolithic, off-axis telescope that is diffraction-limited at 0.4 microns and is in an L2 orbit. HabEx employs two starlight suppression systems: a coronagraph and a starshade, each with their own dedicated instrument

The Habitable Exoplanet Observatory (HabEx) Mission Concept Study Final Report

The Habitable Exoplanet Observatory, or HabEx, has been designed to be the Great Observatory of the 2030s. For the first time in human history, technologies have matured sufficiently to enable an affordable space-based telescope mission capable of discovering and characterizing Earthlike planets orbiting nearby bright sunlike stars in order to search for signs of habitability and biosignatures. Such a mission can also be equipped with instrumentation that will enable broad and exciting general astrophysics and planetary science not possible from current or planned facilities. HabEx is a space telescope with unique imaging and multi-object spectroscopic capabilities at wavelengths ranging from ultraviolet (UV) to near-IR. These capabilities allow for a broad suite of compelling science that cuts across the entire NASA astrophysics portfolio. HabEx has three primary science goals: (1) Seek out nearby worlds and explore their habitability; (2) Map out nearby planetary systems and understand the diversity of the worlds they contain; (3) Enable new explorations of astrophysical systems from our own solar system to external galaxies by extending our reach in the UV through near-IR. This Great Observatory science will be selected through a competed GO program, and will account for about 50% of the HabEx primary mission. The preferred HabEx architecture is a 4m, monolithic, off-axis telescope that is diffraction-limited at 0.4 microns and is in an L2 orbit. HabEx employs two starlight suppression systems: a coronagraph and a starshade, each with their own dedicated instrument.Comment: Full report: 498 pages. Executive Summary: 14 pages. More information about HabEx can be found here: https://www.jpl.nasa.gov/habex

Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes—A Cross-Sectional Study for Quebec, Canada

This study aimed at determining the role of proximity to specific types of green spaces (GSes) as well as their spatial location in the relationship with the most morbid cardiovascular diseases (CVD) and diabetes. We measured the accessibility to various types of GS and used a cross-sectional approach at census Dissemination Area (DA) levels in the Montreal and Quebec City metropolitan zones for the period 2006–2011. Poisson and negative binomial regression models were fitted to quantify the relationship between distances to specific types of GS and CVD morbidity as well as some risk factors (diabetes and hypertension) while controlling for several social and environmental confounders. GSes that have sports facilities showed a significant relationship to cerebrovascular diseases: the most distant population had an 11% higher prevalence rate ratio (PRR) compared to the nearest, as well as higher diabetes risk (PRR 9%) than the nearest. However, the overall model performance and the understanding of the role of GSes with sport facilities may be substantially achieved with lifestyle factors. Significantly higher prevalence of diabetes and cerebrovascular diseases as well as lower access to GSes equipped with sports facilities were found in suburban areas. GSes can advantageously be used to prevent some CVDs and their risk factors, but there may be a need to reconsider their types and location

Ring debarking efficiency of frozen balsam fir logs is affected by the radial force but not by the log position on the stem

The effect of the radial force applied by a ring debarker tip to frozen balsam fir (Abies balsamea (L.) Mill.) logs, obtained at three positions on the stem, was studied. A one-armed ring debarker prototype was built, which controlled the radial force, the rake angle, and cutting and feed speeds. Balsam fir logs at −19 °C were debarked at three levels of radial force. The rake angle, tip overlap, tip edge radius, and cutting and feed speeds were kept constant. Debarking quality was evaluated by two criteria: the proportion of bark remaining on log surfaces and the amount of wood fibres in bark residues. Log characteristics (dimensions, eccentricity, bark thickness, and knot features), bark–wood shear strength, and the basic densities of sapwood and bark were also measured. Results showed that the radial force had a significant effect on debarking quality. The proportion of bark remaining on log surfaces increased while the amount of wood fibres in bark residues decreased as radial force decreased. A radial force of 18.5 N·mm−1 is suggested for an optimal debarking quality. In contrast, log position on the stem did not affect the debarking quality indicators. Results also showed that the proportion of bark remaining on log surfaces increases as bark–wood shear strength and the proportion of knot surface increase, while the amount of wood fibres in bark residues increases as bark–wood shear strength decreases and logs are more eccentric. The results give useful information to improve the debarking process within the studied range of log diameters and debarking parameters.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author