The use of asthma medications among asthma cases in Saskatchewan from January 1, 1991 to December 31, 2000

Asthma affects nearly two and a half million people in Canada. In Saskatchewan, the prevalence of asthma has increased across all age groups since 1981. Current literature indicates that the purchase of all asthma medications increased in the last 20 years both province and nationwide. Since the early 1990s, the Canadian Consensus Guidelines (CCG) for the treatment of asthma recommended increasing the use of inhaled corticosteroids as a mainstay for controlling asthma symptoms. The CCG have also encouraged decreasing the use of short-acting, inhaled beta2-agonist medication. The objective of this descriptive epidemiological study was to investigate asthma medication prescribing at the individual level among physician-diagnosed asthma patients, aged 0 to 64 years, in Saskatchewan from January 1, 1991 to December 31, 2000. Saskatchewan residents covered under the provincial health insurance plan who received a physician’s diagnosis of asthma, identified each calendar year, were included in the study (296,430 asthma patients in total). Nearly 80.0% of this asthma population purchased at least one asthma medication in each calendar year. From 1991 to 2000, users and the mean number of prescriptions of short-acting beta2-agonists decreased slightly. The proportion of users and mean number prescriptions per year of inhaled corticosteroids increased. The highest mean numbers of prescriptions and users of inhaled corticosteroids were among the 0-4 year olds. Short-acting beta2-agonists, inhaled corticosteroids, and oral corticosteroids were the most popular medications. Users of theophyllines and cromoglycates decreased. The 15-34 year old males showed the greatest "inappropriate" use as high users of short-acting beta2-agonists and low users of inhaled corticosteroids. There was increasing compliance with the CCG over the ten years. The combination of beta2-agonists with inhaled corticosteroids usurped beta2-agonist monotherapy as the most popular form of asthma therapy by the year 2000. Users of combination therapy increased from 19% to 38.7%, while users of beta2-agonists alone decreased from 34.5% to 23.1%. From 1996 to 2000, the monthly number of both short-acting beta2-agonists and inhaled corticosteroids prescriptions decreased for all users in July and August. Peak increases in the number of short-acting beta2-agonist prescriptions, for children under 15, occurred in September. For adults, peak increases occurred in December for both medications. These study results will enhance the understanding of asthma medication use among children and adults and will help healthcare professionals develop new treatment programs for the management of asthma

Accounting Information Systems (AIS) Course Design: Current Practices and Future Trajectories

The accounting information systems (AIS) course is a core component of most accounting programs, but what it typically covers and how it’s typically taught is as varied as the number of instructors. As the AACSB Standard A7 indicates: “accounting degree programs include learning experiences that develop skills and knowledge related to the integration of information technology in accounting and business”. In this panel presentation, we looked at the approach of five experienced AIS instructors and compared and contrasted them. We highlight lessons learned and best practices

Edna metabarcoding of avocado flowers: ‘Hass’ it got potential to survey arthropods in food production systems?

In the face of global biodiversity declines, surveys of beneficial and antagonistic arthropod diversity as well as the ecological services that they provide are increasingly important in both natural and agro-ecosystems. Conventional survey methods used to monitor these communities often require extensive taxonomic expertise and are time-intensive, potentially limiting their application in industries such as agriculture, where arthropods often play a critical role in productivity (e.g. pollinators, pests and predators). Environmental DNA (eDNA) metabarcoding of a novel substrate, crop flowers, may offer an accurate and high throughput alternative to aid in the detection of these managed and unmanaged taxa. Here, we compared the arthropod communities detected with eDNA metabarcoding of flowers, from an agricultural species (Persea americana—‘Hass’ avocado), with two conventional survey techniques: digital video recording (DVR) devices and pan traps. In total, 80 eDNA flower samples, 96 h of DVRs and 48 pan trap samples were collected. Across the three methods, 49 arthropod families were identified, of which 12 were unique to the eDNA dataset. Environmental DNA metabarcoding from flowers revealed potential arthropod pollinators, as well as plant pests and parasites. Alpha diversity levels did not differ across the three survey methods although taxonomic composition varied significantly, with only 12% of arthropod families found to be common across all three methods. eDNA metabarcoding of flowers has the potential to revolutionize the way arthropod communities are monitored in natural and agro-ecosystems, potentially detecting the response of pollinators and pests to climate change, diseases, habitat loss and other disturbances

Utility of Two iPhone Device Apps in Assessing Heart Rate at Rest and During Activity

Heart rate (HR) is a critical physiological variable used for prescribing exercise, assessing fitness level and tracking fitness improvements. Electrocardiography (ECG) stands as the criterion measure of HR. While recent development of HR-detecting mobile device applications (apps) has made evaluating HR more convenient; their degree of accuracy is unknown. Therefore, the purpose of this current study was to examine the accuracy and reliability of two-iPhone applications to detect HR at rest and during low-intensity exercise conditions. Eighteen female and 22 male subjects (26 + 9.5 yrs) were prepped for simultaneous detection of HR via three methods: ECG and two HR-detecting apps. App 1, a camera-based app called Azumio Instant Heart Rate (CAM), was used by placement of a finger over the camera lens of the mobile device. App 2, a microphone-based app called Heart Monitor by Bluespark, was employed via placement of an external microphone over the radial pulse. The participants underwent a series of 5-minute stages: seated rest followed by cycle then treadmill walking at low intensities. HR was recorded concurrently, at several time intervals from the three methods once a steady-state HR was reached. The means of the three devices were compared via ANOVA with the significance level set, a priori, at 0.05. Correlation analysis was employed to investigate relationships between the apps and ECG. No statistical difference was found between the CAM and ECG HR (p \u3e 0.05) during the resting and cycle stages. However, during the treadmill phase, there was a significant difference (p = 0.018) between CAM and ECG. Nevertheless, there was a significant (p \u3c 0.05), positive correlation between CAM and ECG under the resting, cycle and treadmill conditions (r = .966, r = .984, r = .877, respectively). Significant differences (p \u3c 0.05) were found for each condition when comparing ECG and MIC HR. Data also revealed poor correlations (p \u3e 0.05; r between -.004 and -.136) between MIC and ECG. The utility of CAM and MIC-based apps to detect HR remains in question as evidence appears to indicate exercise mode and app specificity. Caution should be shown when using these devices. The CAM-based app may accurately detect HR during resting and seated cycling but not during treadmill activity. The MIC-based app is not recommended for use in any condition. Of note, statistical significance may not mitigate usefulness when considering the accuracy of palpation. Additional research is necessary

Benign Conduction Abnormalities in Response to Acute, Moderately-High, Simulated Altitude Exposure

Acclimatization to altitude can improve endurance performance above levels achieved solely by training at sea level. There is natural limitation in the applicability of employing terrestrial altitude training – namely proximity. A simple, non-cumbersome method of simulating altitude is desirable to many types of endurance athletes. The Alto2Lab (Pharma Pacific Inc.), consisting of primarily a breathing tube and silo stack, has shown some potential in this role. There is a lack of evidence regarding whether simulated altitude exposure triggers abnormal cardiovascular responses. The aim of this study was to provide initial evidence of cardiac changes associated with usage patterns that follow distributor guidelines. Twenty-five participants (mean age 29 ± 10.7; 16 males; 9 females) volunteered for the study. Subjects underwent a baseline ECG recording followed by ECG recording during sham (4-5 mins), hypoxia (~6 mins), and recovery (3-4 mins) phases. The sham phase consisted of subjects breathing normoxive air through a foam-filled silo system. The sham stack mimicked the look and feel of the silo system used to produce hypoxia with the difference being a single, soda lime-filled silo. A recovery phase followed hypoxia. Pulse oximetry (SpO2) was used to assess oxygen saturation. Cochran’s Q was employed to test the frequencies of responses across the phases. An independent, blinded, experienced clinician (DK) analyzed the recordings. Two subjects were removed from the final analysis (inability to finish the protocol, baseline right bundle branch block). All subjects demonstrated an increase in heart rate (mean = +16.8 ± 8.0) during the hypoxia (mean oxygen saturation = 82 ± 4.1%) phase. No ECG ischemic changes were seen across any of the phases. Benign conduction abnormalities (sinus arrhythmia = 9; junctional rhythms = 4) occurred with some regularity during hypoxia. These abnormalities occurred with less frequency during the sham and recovery phases. It is possible that an altered breathing pattern or an inadequate washout period between phases might account for these findings. Overall, there was no significant relationship between the heart response and phase (p = .375). While the Alto2Lab did not produce any ECG changes indicative of an ischemic response, the present study used a small sample of healthy, recreationally-active participants. A larger study employing patients among higher risk categories would provide data that is not currently present in the literature and to which this trial cannot speak

Applications of environmental DNA (eDNA) in agricultural systems: Current uses, limitations and future prospects

Global food production, food supply chains and food security are increasingly stressed by human population growth and loss of arable land, becoming more vulnerable to anthropogenic and environmental perturbations. Numerous mutualistic and antagonistic species are interconnected with the cultivation of crops and livestock and these can be challenging to identify on the large scales of food production systems. Accurate identifications to capture this diversity and rapid scalable monitoring are necessary to identify emerging threats (i.e. pests and pathogens), inform on ecosystem health (i.e. soil and pollinator diversity), and provide evidence for new management practices (i.e. fertiliser and pesticide applications). Increasingly, environmental DNA (eDNA) is providing rapid and accurate classifications for specific organisms and entire species assemblages in substrates ranging from soil to air. Here, we aim to discuss how eDNA is being used for monitoring of agricultural ecosystems, what current limitations exist, and how these could be managed to expand applications into the future. In a systematic review we identify that eDNA-based monitoring in food production systems accounts for only 4 % of all eDNA studies. We found that the majority of these eDNA studies target soil and plant substrates (60 %), predominantly to identify microbes and insects (60 %) and are biased towards Europe (42 %). While eDNA-based monitoring studies are uncommon in many of the world\u27s food production systems, the trend is most pronounced in emerging economies often where food security is most at risk. We suggest that the biggest limitations to eDNA for agriculture are false negatives resulting from DNA degradation and assay biases, as well as incomplete databases and the interpretation of abundance data. These require in silico, in vitro, and in vivo approaches to carefully design, test and apply eDNA monitoring for reliable and accurate taxonomic identifications. We explore future opportunities for eDNA research which could further develop this useful tool for food production system monitoring in both emerging and developed economies, hopefully improving monitoring, and ultimately food security

Development of iGrow: A Curriculum for Youth/Adult Dyads to Increase Gardening Skills, Culinary Competence, and Family Meal Time for Youths and Their Adult Caregivers

This manuscript describes the development of a “learn by actively participating” curriculum for youth and their adult caregivers (dyad pair) to increase gardening skills, culinary competence, and family meal time. The curriculum was developed by integrating “iCook 4-H” and Junior Masters Gardener “Health and Nutrition from the Garden”, and “Essential Elements of 4-H Youth Development” curriculums with additional resources for gardening activities from the USDA’s My Plate and garden-based recipes. Expert reviewers (n = 11) provided feedback on the curriculum content, session structure, dosage, age appropriateness, and balance of the three focused areas. Seven family dyads (n = 14) participated in focus groups about understanding of need, interest, barriers, and potential engagement. A 10-week curriculum was developed and named: iGrow. The curriculum is a hands on, active learning program delivered through five, two-hour sessions using a family dyad model. Three main focus areas included gardening, culinary skills, and family conversation/interaction that all focused on togetherness. For the final iGrow curriculum, expert-level content review and feedback from focus group dyad pairs was used to revise the curriculum which further enhanced the approach and balance of the curriculum content. Focus group feedback supported appropriateness, dosage and learning objectives, and content depth. This curriculum has been developed to provide knowledge of gardening and culinary skills with the goal of increased consumption of fruit and vegetables

Longitudinal microstructural MRI markers of demyelination and neurodegeneration in early relapsing-remitting multiple sclerosis:Magnetisation transfer, water diffusion and g-ratio

INTRODUCTION: Quantitative microstructural MRI, such as myelin-sensitive magnetisation transfer ratio (MTR) or saturation (MTsat), axon-sensitive water diffusion Neurite Orientation Dispersion and Density Imaging (NODDI), and the aggregate g-ratio, may provide more specific markers of white matter integrity than conventional MRI for early patient stratification in relapsing-remitting multiple sclerosis (RRMS). The aim of this study was to determine the sensitivity of such markers to longitudinal pathological change within cerebral white matter lesions (WML) and normal-appearing white matter (NAWM) in recently diagnosed RRMS. METHODS: Seventy-nine people with recently diagnosed RRMS, from the FutureMS longitudinal cohort, were recruited to an extended MRI protocol at baseline and one year later. Twelve healthy volunteers received the same MRI protocol, repeated within two weeks. Ethics approval and written informed consent were obtained. 3T MRI included magnetisation transfer, and multi-shell diffusion-weighted imaging. NAWM and whole brain were segmented from 3D T1-weighted MPRAGE, and WML from T2-weighted FLAIR. MTR, MTsat, NODDI isotropic (ISOVF) and intracellular (ICVF) volume fractions, and g-ratio (calculated from MTsat and NODDI data) were measured within WML and NAWM. Brain parenchymal fraction (BPF) was also calculated. Longitudinal change in BPF and microstructural metrics was assessed with paired t-tests (α = 0.05) and linear mixed models, adjusted for confounding factors with False Discovery Rate (FDR) correction for multiple comparisons. Longitudinal changes were compared with test-retest Bland-Altman limits of agreement from healthy control white matter. The influence of longitudinal change on g-ratio was explored through post-hoc analysis in silico by computing g-ratio with realistic simulated MTsat and NODDI values. RESULTS: In NAWM, g-ratio and ICVF increased, and MTsat decreased over one year (adjusted mean difference = 0.007, 0.005, and −0.057 respectively, all FDR-corrected p < 0.05). There was no significant change in MTR, ISOVF, or BPF. In WML, MTsat, NODDI ICVF and ISOVF increased over time (adjusted mean difference = 0.083, 0.024 and 0.016, respectively, all FDR-corrected p < 0.05). Group-level longitudinal changes exceeded test-retest limits of agreement for NODDI ISOVF and ICVF in WML only. In silico analysis showed g-ratio may increase due to a decrease in MTsat or ISOVF, or an increase in ICVF. DISCUSSION: G-ratio and MTsat changes in NAWM over one year may indicate subtle myelin loss in early RRMS, which were not apparent with BPF or NAWM MTR. Increases in NAWM and WML NODDI ICVF were not anticipated, and raise the possibility of axonal swelling or morphological change. Increases in WML MTsat may reflect myelin repair. Changes in NODDI ISOVF are more likely to reflect alterations in water content. Competing MTsat and ICVF changes may account for the absence of g-ratio change in WML. Longitudinal changes in microstructural measures are significant at a group level, however detection in individual patients in early RRMS is limited by technique reproducibility. CONCLUSION: MTsat and g-ratio are more sensitive than MTR to early pathological changes in RRMS, but complex dependence of g-ratio on NODDI parameters limit the interpretation of aggregate measures in isolation. Improvements in technique reproducibility and validation of MRI biophysical models across a range of pathological tissue states are needed

Aerococcus urinae isolated from women with lower urinary tract symptoms: In vitro aggregation and genome analysis

Aerococcus urinae is increasingly recognized as a potentially significant urinary tract bacterium. A. urinae has been isolated from urine collected from both males and females with a wide range of clinical conditions, including urinary tract infection (UTI), urgency urinary incontinence (UUI), and overactive bladder (OAB). A. urinae is of particular clinical concern because it is highly resistant to many antibiotics and, when undiagnosed, can cause invasive and life-threatening bacteremia, sepsis, or soft tissue infections. Previous genomic characterization studies have examined A. urinae strains isolated from patients experiencing UTI episodes. Here, we analyzed the genomes of A. urinae strains isolated as part of the urinary microbiome from patients with UUI or OAB. Furthermore, we report that certain A. urinae strains exhibit aggregative in vitro phenotypes, including flocking, which can be modified by various growth medium conditions. Finally, we performed in-depth genomic comparisons to identify pathways that distinguish flocking and nonflocking strains. IMPORTANCE Aerococcus urinae is a urinary bacterium of emerging clinical interest. Here, we explored the ability of 24 strains of A. urinae isolated from women with lower urinary tract symptoms to display aggregation phenotypes in vitro. We sequenced and analyzed the genomes of these A. urinae strains. We performed functional genomic analyses to determine whether the in vitro hyperflocking aggregation phenotype displayed by certain A. urinae strains was related to the presence or absence of certain pathways. Our findings demonstrate that A. urinae strains have different propensities to display aggregative properties in vitro and suggest a potential association between phylogeny and flocking

Polycyclic aromatic hydrocarbons and postmenopausal breast cancer: An evaluation of effect measure modification by body mass index and weight change

Polycyclic aromatic hydrocarbons (PAHs) have been linked to breast cancer in many, but not all, previous studies. PAHs are lipophilic and stored in fat tissue, which we hypothesized may result in constant low-dose exposure to these carcinogens. No previous studies have evaluated whether obesity modifies associations between multiple measures of PAHs and breast cancer incidence