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The present study aimed to examine the availability and price of healthier compared with less healthy foods by geography, store category and store type for convenience stores, and by store size for grocery stores in Nova Scotia.
A cross-sectional study that examined differences in the overall availability and price of healthier compared to less healthy foods in grocery and convenience stores in Nova Scotia. The Nova Scotia Consumer Food Environment project was part of a larger initiative of the Nova Scotia government (Department of Health and Wellness) to assess the food and beverage environment in Nova Scotia in 2015/16.
Four geographic zones (Nova Scotia Health Authority Management Zones) in Nova Scotia, Canada.
A sample of forty-seven grocery stores and fifty-nine convenience stores were selected from a list of 210 grocery stores and 758 convenience stores in Nova Scotia to ensure geographic and store type representation in our sample.
Findings indicate that rurality had a significant effect on food availability as measured by the Nutrition Environment Measures Surveys (NEMS) score (P < 0·01); there was a higher availability of healthy foods in rural compared to urban areas for convenience stores but not grocery stores. Healthier foods were also more available in chain stores compared to independent stores (P < 0·01) and in large stores compared to small and medium stores (P < 0·001 and P < 0·01, respectively).
The availability of and accessibility to less healthy foods in Nova Scotia food environment suggests that there is a need for government policy action to support a food environment that contributes to healthier diets.
Evidence indicates that Antarctic minke whales (AMWs) in the Ross Sea affect the foraging behaviour, especially diet, of sympatric Adélie penguins (ADPEs) by, we hypothesize, influencing the availability of prey they have in common, mainly crystal krill. To further investigate this interaction, we undertook a study in McMurdo Sound during 2012–2013 and 2014–2015 using telemetry and biologging of whales and penguins, shore-based observations and quantification of the preyscape. The 3D distribution and density of prey were assessed using a remotely operated vehicle deployed along and to the interior of the fast-ice edge where AMWs and ADPEs focused their foraging. Acoustic surveys of prey and foraging behaviour of predators indicate that prey remained abundant under the fast ice, becoming successively available to air-breathing predators only as the fast ice retreated. Over both seasons, the ADPE diet included less krill and more Antarctic silverfish once AMWs became abundant, but the penguins' foraging behaviour (i.e. time spent foraging, dive depth, distance from colony) did not change. In addition, over time, krill abundance decreased in the upper water column near the ice edge, consistent with the hypothesis (and previously gathered information) that AMW and ADPE foraging contributed to an alteration of prey availability.
Field studies were conducted in 2017 and 2018 in Arkansas to evaluate the injury caused by herbicides on soybean canopy formation and yield. Fomesafen, acifluorfen, S-metolachlor + fomesafen, and S-metolachlor + fomesafen + chlorimuron alone and in combination with glufosinate were applied to glufosinate-resistant soybean at the V2 growth stage. Soybean injury resulting from these labeled herbicide treatments ranged from 9% to 25% at 2 wk after application. This level of injury resulted in a 4-, 5-, 6-, and 6-d delay in soybean reaching 80% groundcover following fomesafen, acifluorfen, S-metolachlor + fomesafen, and S-metolachlor + fomesafen + chlorimuron, respectively. There was a 2-d delay in soybean reaching a canopy volume of 15,000 cm3 following each of the four herbicide treatments. The addition of glufosinate to the herbicide applications resulted in longer delays in canopy formation with every herbicide treatment except glufosinate + fomesafen. Fomesafen, acifluorfen, S-metolachlor + fomesafen, and S-metolachlor + fomesafen + chlorimuron, each applied with glufosinate, delayed soybean from reaching 80% groundcover by 2, 7, 8, and 9 d, respectively, and delayed the number of days for soybean to reach a canopy volume of 15,000 cm3 by 2, 3, 2, and 2 d, respectively. No yield loss occurred with any herbicide application. A delay in percent groundcover in soybean allows sunlight to reach the soil surface for longer periods throughout the growing season, possibly promoting late-season weed germination and the need for an additional POST herbicide application.
Introduction: Emergency department (ED) crowding is a major problem across Canada. We studied the ability of artificial intelligence methods to improve patient flow through the ED by predicting patient disposition using information available at triage and shortly after patients’ arrival in the ED. Methods: This retrospective study included all visits to an urban, academic, adult ED between May 2012 and June 2019. For each visit, 489 variables were extracted including triage data that had been collected for use in the Canadian Triage Assessment Scale (CTAS) and information regarding laboratory tests, radiological tests, consultations and admissions. A training set consisting of all visits from April 2012 up to December 2018 was used to train 5 classes of machine learning models to predict admission to the hospital from the ED. The models were trained to predict admission at the time of the patient's arrival in the ED and every 30 minutes after arrival until 6 hours into their ED stay. The performance of models was compared using the area under the ROC curve (AUC) on a test set consisting of all visits from January 2019 to June 2019. Results: The study included 536,332 visits and the admission rate was 15.0%. Gradient boosting models generally outperformed other machine learning models. A gradient boosting model using all available data at 2 hours after patient arrival in the ED yielded a test set AUC 0.92 [95% CI 0.91-0.93], while a model using only data available at triage yielded an AUC 0.90 [95% CI 0.89-0.91]. The quality of predictions generally improved as predictions were made later in the patient's ED stay leading to an AUC 0.95 [95% CI 0.93-0.96] at 6 hours after arrival. A gradient boosting model with 20 variables available at 2 hours after patient arrival in the ED yielded an AUC 0.91 [95% CI 0.89-0.93]. A gradient boosting model that makes predictions at 2 hours after arrival in ED using only variables that are available at all EDs in the province of Quebec yielded an AUC 0.91 [95% 0.89-0.92]. Conclusion: Machine learning can predict admission to a hospital from the ED using variables that area collected as part of routine ED care. Machine learning tools may potentially be used to help ED physicians to make faster and more appropriate disposition decisions, to decrease unnecessary testing and alleviate ED crowding.
Introduction: The Canadian Syncope Risk Score (CSRS) is a validated risk tool developed using the best practices of conventional biostatistics, for predicting 30-day serious adverse events (SAE) after an Emergency Department (ED) visit for syncope. We sought to improve on the prediction ability of the CSRS and compared it to physician judgement using artificial intelligence (AI) research with modern machine learning (ML) methods. Methods: We used the prospective multicenter cohort data collected for the CSRS derivation and validation at 11 EDs across Canada over an 8-year period. The same 43 candidate variables considered for CSRS development were used to train and validate the four classes of ML models to predict 30-day SAE (death, arrhythmias, MI, structural heart disease, pulmonary embolism, hemorrhage) after ED disposition. Physician judgement was modeled using the two variables, referral for consultation and hospitalization. We compared the area under the curve (AUC) for the three models. Results: The proportion of patients who suffered 30-day SAE in the derivation cohort (N = 4030) was 3.6% and in validation phase (N = 2290) was 3.4%. Characteristics of the both cohorts were similar with no shift. The best performing ML model, a gradient boosting tree-based model used all 43 variables as predictors as opposed to the 9 final CSRS predictors. The AUC for the three models on the validation data were: best ML model 0.91 (95% CI 0.87–0.93), CSRS 0.87 (95% CI 0.83–0.90) and physician judgment 0.79 (95% CI 0.74 - 0.84). The most important predictors in the ML model were the same as the CSRS predictors. Conclusion: A ML model developed using AI method for risk-stratification of ED syncope performed with slightly better discrimination ability though not significantly different when compared to the CSRS. Both the ML model and the CSRS were better predictors of poor outcomes after syncope than physician judgement. ML models can perform with similar discrimination abilities when compared to traditional statistical models and outperform physician judgement given their ability to use all candidate variables.
Acute change in mental status (ACMS), defined by the Confusion Assessment Method, is used to identify infections in nursing home residents. A medical record review revealed that none of 15,276 residents had an ACMS documented. Using the revised McGeer criteria with a possible ACMS definition, we identified 296 residents and 21 additional infections. The use of a possible ACMS definition should be considered for retrospective nursing home infection surveillance.
Palmer amaranth is one of the most troublesome weeds of soybean in the United States. To effectively control this weed it is necessary to optimize timing of PRE residual herbicides to mitigate Palmer amaranth emergence. Field studies were conducted in 5 site-years to assess the effect of application timing 12 to 16 d prior to planting (preplant) and at planting (PRE) on soybean injury and longevity of Palmer amaranth control using five residual herbicide treatments. A reduction in longevity of Palmer amaranth control was observed when S-metolachlor + metribuzin and flumioxazin + chlorimuron-ethyl were applied preplant vs. PRE in 2 of the 5 site years. Sulfentrazone, sulfentrazone + cloransulam-methyl, and saflufenacil + dimethenamid-P + pyroxasulfone + metribuzin did not reduce longevity of Palmer amaranth control when applied preplant vs. PRE in all 5 site-years. Visible estimates of soybean injury were lower at 21 d after planting when herbicides were applied 12 to 16 d preplant vs. PRE. These findings suggest that preplant applications can be used to reduce the potential for crop injury and may not result in reduced longevity of control when herbicides with a prolonged residual activity are used. Preplant herbicides increase the likelihood of the residuals being activated prior to subsequent weed emergence as opposed to PRE herbicides applied at soybean planting.
Rapid crop canopy formation is important to reduce weed emergence and selection for herbicide resistance. Field experiments were conducted in 2017 and 2018 in Fayetteville, AR, to evaluate the impacts of PRE applications of flumioxazin on soybean injury, soybean density, canopy formation, and incidence of soil-borne pathogens. Flumioxazin was applied at 0, 70, and 105 g ai ha−1 to predetermined flumioxazin-tolerant and -sensitive soybean varieties. Flumioxazin at 70 g ha−1 injured the tolerant and sensitive varieties from 0% to 4% and 14% to 15%, respectively. When averaged over flumioxazin rates, density of the sensitive variety was only reduced in 2017 when activation of flumioxazin was delayed 7 d. Compared to the tolerant soybean variety, flumioxazin at 70 g ha−1 delayed the sensitive variety from reaching 20%, 40%, 60%, and 80% groundcover by 15, 16, 11, and 5 d, respectively. No delay in canopy closure (95% groundcover) was observed with either variety. Consequently, no yield loss occurred for either variety following a flumioxazin application. Flumioxazin did not impact root colonization of Didymella, Fusarium, Macrophomina, or Rhizoctonia. Pythium colonization of the soybean stem was increased by flumioxazin in 2017, but not in 2018. Increased injury, delays in percent groundcover, and an increase in Pythium colonization of soybean following a flumioxazin application may warrant the need for other soil-applied herbicides at soybean planting. Alternatively, soybean injury and delays in percent groundcover following flumioxazin applications can be mitigated through appropriate variety selection; however, comprehensive screening is needed to determine which varieties are most tolerant to flumioxazin.
Negative symptoms have been previously reported during the psychosis prodrome, however our understanding of their relationship with treatment-phase negative symptoms remains unclear.
We report the prevalence of psychosis prodrome onset negative symptoms (PONS) and ascertain whether these predict negative symptoms at first presentation for treatment.
Presence of expressivity or experiential negative symptom domains was established at first presentation for treatment using the Scale for Assessment of Negative Symptoms (SANS) in 373 individuals with a first episode psychosis. PONS were established using the Beiser Scale. The relationship between PONS and negative symptoms at first presentation was ascertained and regression analyses determined the relationship independent of confounding.
PONS prevalence was 50.3% in the schizophrenia spectrum group (n = 155) and 31.2% in the non-schizophrenia spectrum group (n = 218). In the schizophrenia spectrum group, PONS had a significant unadjusted (χ2 = 10.41, P < 0.001) and adjusted (OR = 2.40, 95% CI = 1.11–5.22, P = 0.027) association with first presentation experiential symptoms, however this relationship was not evident in the non-schizophrenia spectrum group. PONS did not predict expressivity symptoms in either diagnostic group.
PONS are common in schizophrenia spectrum diagnoses, and predict experiential symptoms at first presentation. Further prospective research is needed to examine whether negative symptoms commence during the psychosis prodrome.
Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD = 65 years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample.
Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age < vs = 65 years, and then divided on the basis of the median age of the sample (age < vs = 42 years). Socio-demographic and clinical variables were compared between groups (Pearson Chi-squared and t tests).
G-OCD compared with younger patients represented a significant minority of the sample (6% vs 94%, P < .001), showing a significantly later age at onset (29.4 ± 15.1 vs 18.7 ± 9.2 years, P < .001), a more frequent adult onset (75% vs 41.1%, P < .001) and a less frequent use of cognitive-behavioural therapy (CBT) (20.8% vs 41.8%, P < .05). Female gender was more represented in G-OCD patients, though not at a statistically significant level (75% vs 56.4%, P = .07). When the whole sample was divided on the basis of the median age, previous results were confirmed for older patients, including a significantly higher presence of women (52.1% vs 63.1%, P < .05).
G-OCD compared with younger patients represented a small minority of the sample and showed later age at onset, more frequent adult onset and lower CBT use. Age at onset may influence course and overall management of OCD, with additional investigation needed.
Almost all cases of human listeriosis are foodborne, however the proportion where specific exposures are identified is small. Between 1981 and 2015, 5252 human listeriosis cases were reported in England and Wales. The purpose of this study was to summarise data where consumption of specific foods was identified with transmission and these comprised 11 sporadic cases and 17 outbreaks. There was a single outbreak in the community of 378 cases (7% of the total) which was associated with pâté consumption and 112 cases (2% of the total) attributed to specific foods in all the other incidents. The proportion of food-attributed cases increased during this study with improvements in typing methods for Listeria monocytogenes. Ten incidents (one sporadic case and nine outbreaks of 2–9 cases over 4 days to 32 months) occurred in hospitals: all were associated with the consumption of pre-prepared sandwiches. The 18 community incidents comprised eight outbreaks (seven of between 3 and 17 cases) and 10 sporadic cases: food of animal origin was implicated in 16 of the incidents (sliced or potted meats, pork pies, pâté, liver, chicken, crab-meat, butter and soft cheese) and food of non-animal origin in the remaining two (olives and vegetable rennet).