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limited evidence of fungicide-driven triazole-resistant aspergillus fumigatus in hamilton, canada.aspergillus fumigatus is a ubiquitous opportunistic fungal pathogen that can cause aspergillosis in humans. over the last decade there have been increasing global reports of treatment failure due to triazole resistance. an emerging hypothesis states that agricultural triazole fungicide use causes clinical triazole resistance. here we test this hypothesis in hamilton, ontario, canada, by examining a total of 195 agricultural, urban, and clinical isolates using 9 highly polymorphic microsatellite ...201829156151
barriers, beliefs and practice patterns for breast cancer reconstruction: a provincial survey.the purpose of this study was to characterize beliefs and practice patterns for breast cancer reconstruction among physicians who treat patients with breast cancer, in order to delineate current clinical practice. this survey was administered prior to cancer care ontario guideline publication.201728038321
integrative analysis of the lake simcoe watershed (ontario, canada) as a socio-ecological system.striving for long-term sustainability in catchments dominated by human activities requires development of interdisciplinary research methods to account for the interplay between environmental concerns and socio-economic pressures. in this study, we present an integrative analysis of the lake simcoe watershed, ontario, canada, as viewed from the perspective of a socio-ecological system. key features of our analysis are (i) the equally weighted consideration of environmental attributes with socioe ...201728002784
detection of lyme disease bacterium, borrelia burgdorferi sensu lato, in blacklegged ticks collected in the grand river valley, ontario, canada.we document the presence of blacklegged ticks, ixodes scapularis, in the grand river valley, centre wellington, ontario. overall, 15 (36%) of 42 i. scapularis adults collected from 41 mammalian hosts (dogs, cats, humans) were positive for the lyme disease bacterium, borrelia burgdorferi sensu lato (s.l.). using real-time pcr testing and dna sequencing of the flagellin (fla) gene, we determined that borrelia amplicons extracted from i. scapularis adults belonged to b. burgdorferi sensu stricto (s ...201728260991
cluster analysis of campylobacter jejuni genotypes isolated from small and medium-sized mammalian wildlife and bovine livestock from ontario farms.using data collected from a cross-sectional study of 25 farms (eight beef, eight swine and nine dairy) in 2010, we assessed clustering of molecular subtypes of c. jejuni based on a campylobacter-specific 40 gene comparative genomic fingerprinting assay (cgf40) subtypes, using unweighted pair-group method with arithmetic mean (upgma) analysis, and multiple correspondence analysis. exact logistic regression was used to determine which genes differentiate wildlife and livestock subtypes in our stud ...201727492809
prevalence and risk factors for coxiella burnetii seropositivity in small ruminant veterinarians and veterinary students in ontario, canada.coxiella burnetii is a zoonotic pathogen that causes q fever in humans. serological and questionnaire data on c. burnetii were obtained from 32 small ruminant veterinarians and veterinary students in ontario, canada, in february 2012. overall, 59% of participants were seropositive; advanced stage of career and increased age were associated with seropositivity.201728373734
virological surveillance of influenza a subtypes isolated in 2014 from clinical outbreaks in canadian swine.influenza a viruses (iavs) are respiratory pathogens associated with an acute respiratory disease that occurs year-round in swine production. it is currently one of the most important pathogens in swine populations, with the potential to infect other host species including humans. ongoing research indicates that the three major subtypes of iav-h1n1, h1n2, and h3n2-continue to expand in their genetic and antigenic diversity. in this study, we conducted a comprehensive genomic analysis of 16 iavs ...201728335552
trichinella nativa outbreak with rare thrombotic complications associated with meat from a black bear hunted in northern ontario.although trichinellosis is known to cause thrombotic disease, serious thrombotic events are rare and have not been previously associated with trichinella nativa infection.201728329274
a geographic study of west nile virus in humans, dead corvids and mosquitoes in ontario using spatial scan statistics with a survival time application.surveillance of west nile virus (wnv) in ontario has included passive reporting of human cases and testing of trapped mosquitoes and dead birds found by the public. the dead bird surveillance programme was limited to testing within a public health unit (phu) until a small number of birds test positive. these dead corvid and mosquito surveillance programmes have not been compared for their ability to provide early warning in geographic areas where human cases occur each year. spatial scan statist ...201728220657
west nile virus in ontario, canada: a twelve-year analysis of human case prevalence, mosquito surveillance, and climate data.west nile virus (wnv) first arrived in ontario, canada in 2001 and has since spread throughout most of the province, causing disease in humans. the provincial government established a province-wide surveillance program to monitor wnv transmission throughout the 36 regional health units. here we have acquired records of wnv human and mosquito surveillance from 2002 to 2013 to describe seasonal and geographic trends in wnv activity in southern ontario. additionally, we obtained climate data from s ...201728829827
epidemiology of salmonella on the paws and in the faeces of free-ranging raccoons (procyon lotor) in southern ontario, canada.raccoons are common in urban and rural environments and can carry a wide range of bacteria, including salmonella, that can negatively affect human and livestock health. although previous studies have reported that raccoons shed a variety of salmonella serovars in their faeces, it is unknown whether salmonella is carried on raccoon paws. our objective was to compare the prevalence of salmonella on the paws and in the faeces of raccoons in south-western ontario. raccoons were sampled in a repeat c ...201626404182
mapping rural community and dairy cow heat stress in southern ontario: a common geographic pattern from 2010 to 2012.climate change has increased the occurrence of heat waves, causing heat stress among humans and livestock, with potentially fatal consequences. heat stress maps provide information about related health risks and insight for control strategies. weather data were collected throughout southern ontario, and the heat stress index (hsi) was estimated for 2010-2012. geostatistical kriging was applied to map heat stress, heat waves, and control periods. average hsi for each period ranged from 55 to 78 d ...201626067385
one-health simulation modelling: assessment of control strategies against the spread of influenza between swine and human populations using naadsm.simulation models implemented using a range of parameters offer a useful approach to identifying effective disease intervention strategies. the objective of this study was to investigate the effects of key control strategies to mitigate the simultaneous spread of influenza among and between swine and human populations. we used the pandemic h1n1 2009 virus as a case study. the study population included swine herds (488 herds) and households-of-people (29,707 households) within a county in ontario ...201625219283
one-health simulation modelling: a case study of influenza spread between human and swine populations using naadsm.the circulation of zoonotic influenza a viruses including ph1n1 2009 and h5n1 continue to present a constant threat to animal and human populations. recently, an h3n2 variant spread from pigs to humans and between humans in limited numbers. accordingly, this research investigated a range of scenarios of the transmission dynamics of ph1n1 2009 virus at the swine-human interface while accounting for different percentages of swine workers initially immune. furthermore, the feasibility of using naad ...201624661802
coxiella burnetii (q fever) seropositivity and associated risk factors in sheep and goat farm workers in ontario, canada.coxiella burnetii is a zoonotic bacterium that causes q fever, a potentially severe disease of humans. the objectives of this study were to determine the seroprevalence and risk factors for c. burnetii exposure in sheep and goat farm workers in ontario, canada. between august 2010 and march 2012, 172 farm workers from 78 sheep and goat farms were surveyed regarding demographics, lifestyle, farm practices, and medical history. sera from these people were collected and analyzed for q fever titers ...201627585364
red fox as sentinel for blastomyces dermatitidis, ontario, canada.blastomyces dermatitidis, a fungus that can cause fatal infection in humans and other mammals, is not readily recoverable from soil, its environmental reservoir. because of the red fox's widespread distribution, susceptibility to b. dermatitidis, close association with soil, and well-defined home ranges, this animal has potential utility as a sentinel for this fungus.201627314650
impact of season, demographic and environmental factors on salmonella occurrence in raccoons (procyon lotor) from swine farms and conservation areas in southern ontario.salmonella has been detected in the feces of many wildlife species, including raccoons (procyon lotor), but little is known about the epidemiology of salmonella in wildlife living in different habitat types. our objective was to investigate demographic, temporal, and climatic factors associated with the carriage of salmonella in raccoons and their environment on swine farms and conservation areas. using a repeated cross-sectional study design, we collected fecal samples from raccoons and environ ...201627611198
established population of blacklegged ticks with high infection prevalence for the lyme disease bacterium, borrelia burgdorferi sensu lato, on corkscrew island, kenora district, ontario.we document an established population of blacklegged ticks, ixodes scapularis, on corkscrew island, kenora district, ontario, canada. primers of the outer surface protein a (ospa) gene, the flagellin (fla) gene, and the flagellin b (flab) gene were used in the pcr assays to detect borrelia burgdorferi sensu lato (s.l.), the lyme disease bacterium. in all, 60 (73%) of 82 adult i. scapularis, were infected with b. burgdorferi s.l. as well, 6 (43%) of 14 unfed i. scapularis nymphs were positive for ...201627877080
prevalence of the lyme disease spirochete, borrelia burgdorferi, in blacklegged ticks, ixodes scapularis at hamilton-wentworth, ontario.lyme disease has emerged as a major health concern in canada, where the etiological agent, borrelia burgdorferi sensu lato (s.l.), a spirochetal bacterium, is typically spread by the bite of certain ticks. this study explores the presence of b. burgdorferi s.l. in blacklegged ticks, ixodes scapularis, collected at dundas, ontario (a locality within the region of hamilton-wentworth). using passive surveillance, veterinarians and pet groomers were asked to collect blacklegged ticks from dogs and c ...201627226771
menstrual cycle perturbation by organohalogens and elements in the cree of james bay, canada.persistent organohalogens (pohs) and metals have been linked to alterations in menstrual cycle function and fertility in humans. the cree first nations people living near james bay in ontario and quebec, canada, have elevated levels of pohs, mercury and lead compared to other canadians. the present study examines the interrelationships between selected pohs and elements on menstrual cycle function in these cree women. menstrual cycle characteristics were derived from structured daily diaries and ...201626855224
projecting fish mercury levels in the province of ontario, canada and the implications for fish and human health.fish mercury levels appear to be increasing in ontario, canada, which covers a wide geographical area and contains about 250 000 lakes including a share of the north american great lakes. here we project 2050 mercury levels in ontario fish, using the recently measured levels and rates of changes observed during the last 15 years, and present potential implications for fish and human health. percentage of northern ontario waterbodies where sublethal effects of mercury on fish can occur may increa ...201526592742
a spatial analysis of heat stress related emergency room visits in rural southern ontario during heat waves.in southern ontario, climate change may have given rise to an increasing occurrence of heat waves since the year 2000, which can cause heat stress to the general public, and potentially have detrimental health consequences. heat waves are defined as three consecutive days with temperatures of 32 °c and above. heat stress is the level of discomfort. a variety of heat stress indices have been proposed to measure heat stress (e.g., the heat stress index (hsi)), and has been shown to predict increas ...201526245846
longitudinal study of clostridium difficile shedding in raccoons on swine farms and conservation areas in ontario, canada.clostridium difficile is an important enteropathogen affecting humans, domestic animals, and wildlife. the objectives of this study were to 1) compare the prevalence and characteristics of c. difficile isolated from the feces of raccoons trapped on swine farms and conservation sites, and 2) investigate the role of raccoons as potential reservoirs for host-adapted strains of c. difficile using a longitudinal study. fecal swabs were collected from raccoons at 5 conservation sites and 5 swine farms ...201526446591
an evaluation of southeastern ontario recreational water quality.fecal contamination in recreational waters causes adverse health outcomes in humans; yet, surprisingly, a paucity of literature addresses recreational water quality in north america. the authors addressed this gap by evaluating e. coli contamination of southeastern ontario, canada, recreational beach waters between the years 2008-2011. they tested water samples for microbial contamination by the membrane filtration method. they used friedman's and repeated measures analyses of variance and descr ...201526058219
a cross-sectional study examining the prevalence and risk factors for anti-microbial-resistant generic escherichia coli in domestic dogs that frequent dog parks in three cities in south-western ontario, canada.anti-microbial resistance can threaten health by limiting treatment options and increasing the risk of hospitalization and severity of infection. companion animals can shed anti-microbial-resistant bacteria that may result in the exposure of other dogs and humans to anti-microbial-resistant genes. the prevalence of anti-microbial-resistant generic escherichia coli in the faeces of dogs that visited dog parks in south-western ontario was examined and risk factors for shedding anti-microbial-resis ...201423802858
fire, humans, and climate: modeling distribution dynamics of boreal forest waterbirds.understanding the effects of landscape change and environmental variability on ecological processes is important for evaluating resource management policies, such as the emulation of natural forest disturbances. we analyzed time series of detection/nondetection data using hierarchical models in a bayesian multi-model inference framework to decompose the dynamics of species distributions into responses to environmental variability, spatial variation in habitat conditions, and population dynamics ...201424640539
prevalence of antibodies to leptospira in wild mammals trapped on livestock farms in ontario, canada.to determine the prevalence and diversity of leptospira serogroups circulating in wildlife on farms in ontario, we tested samples from 51 raccoons (procyon lotor), seven skunks (mephitis mephitis), four rats (rattus norvegicus), and three opossums (didelphis virginiana) that were trapped on 27 livestock (swine [sus scrofa], cattle [bos taurus]) farms in 2010. seventeen of 51 raccoons (33%; 95% confidence interval [ci], 21-48%) sampled were positive for at least one leptospira serogroup using the ...201424807356
detection of leptospira spp. in wildlife reservoir hosts in ontario through comparison of immunohistochemical and polymerase chain reaction genotyping methods.a total of 460 kidney samples from wildlife (beavers, coyotes, deer, foxes, opossums, otters, raccoons, skunks) were obtained from road-kill and hunter/trapper donations in ontario between january 2010 and november 2012. the objectives of the study were to detect leptospira spp. by immunohistochemistry and polymerase chain reaction (pcr), to map presence of leptospires in wildlife relative to livestock and human populations, and to characterize positive samples by sequencing and comparison to le ...201424587507
a cross-sectional study examining campylobacter and other zoonotic enteric pathogens in dogs that frequent dog parks in three cities in south-western ontario and risk factors for shedding of campylobacter spp.an estimated 6 million pet dogs live in canadian households with the potential to transmit zoonotic pathogens to humans. dogs have been identified as carriers of salmonella, giardia and campylobacter spp., particularly campylobacter upsaliensis, but little is known about the prevalence and risk factors for these pathogens in pet dogs that visit dog parks. this study examined the prevalence of these organisms in the faeces of dogs visiting dog parks in three cities in south-western ontario, as we ...201423802765
clinical and tree hollow populations of human pathogenic yeast in hamilton, ontario, canada are different.yeast are among the most frequent pathogens in humans. the dominant yeast causing human infections belong to the genus candida and candida albicans is the most frequently isolated species. however, several non-c. albicans species are becoming increasingly common in patients worldwide. the relationships between yeast in humans and the natural environments remain poorly understood. furthermore, it is often difficult to identify or exclude the origins of disease-causing yeast from specific environm ...201424283796
using participatory epidemiology to assess factors contributing to common enteric pathogens in ontario: results from a workshop held at the ontario veterinary college, university of guelph, ontario.common enteric pathogens that cause gastrointestinal illness are transmitted to humans through food, water or direct contact. this poses a significant concern to public health as enteric pathogens can cause disease in a large number of people, and cost a substantial amount to treat and prevent. in order to gain a better understanding of the occurrence of enteric disease in ontario, this study explored public health professionals' perceptions of major contributing factors for common enteric patho ...201424767430
bioaccumulation of triclosan and triclocarban in plants grown in soils amended with municipal dewatered biosolids.biosolids generally contain the microbiocidal agents triclosan (tcs) and triclocarban (tcc) that are persistent during wastewater treatment and sorp to organic material. the present study investigated the concentration of tcs in tissues of radish, carrot, and soybean grown in potted soil amended with biosolids. highest mean concentrations of tcs in radish, carrot, and soybean root tissue midway through the life cycle were 24.8 ng/g, 49.8 ng/g, and 48.1 ng/g dry weight, respectively; by the concl ...201424375516
dietary n-nitroso compounds and risk of colorectal cancer: a case-control study in newfoundland and labrador and ontario, canada.several n-nitroso compounds (noc) have been shown to be carcinogenic in a variety of laboratory animals, but evidence of their carcinogenicity in humans is lacking. we aimed to examine the association between noc intake and colorectal cancer (crc) risk and possible effect modification by vitamins c and e and protein in a large case-control study carried out in newfoundland and labrador and ontario, canada. a total of 1760 case patients with pathologically confirmed adenocarcinoma and 2481 popula ...201424160559
evaluating the pathogenic potential of environmental escherichia coli by using the caenorhabditis elegans infection model.the detection and abundance of escherichia coli in water is used to monitor and mandate the quality of drinking and recreational water. distinguishing commensal waterborne e. coli isolates from those that cause diarrhea or extraintestinal disease in humans is important for quantifying human health risk. a dna microarray was used to evaluate the distribution of virulence genes in 148 e. coli environmental isolates from a watershed in eastern ontario, canada, and in eight clinical isolates. their ...201323377948
detection of clostridium difficile in small and medium-sized wild mammals in southern ontario, canada.we sampled 325 small and medium-sized wild mammals in ontario, canada in 2007 and 2010 to determine the prevalence and characteristics of clostridium difficile in wild mammals living in proximity to captive wildlife and livestock. clostridium difficile was isolated from five of 109 animals (4.6%) on four of 25 farms (16%), but was not isolated from any of the 216 samples from raccoons (procyon lotor) living on the grounds of the toronto zoo. the positive animals included two raccoons from one be ...201323568920
detection of cyclospora, cryptosporidium, and giardia in ready-to-eat packaged leafy greens in ontario, canada.numerous foodborne outbreaks of diarrheal illness associated with the consumption of produce contaminated with protozoan parasites have been reported in north america in recent years. the present study reports on the presence of cyclospora, cryptosporidium, and giardia in precut salads and leafy greens purchased at retail in ontario, canada. a total of 544 retail samples were collected between april 2009 and march 2010 and included a variety of salad blends and individual leafy greens. most of t ...201323433379
evaluating area-level spatial clustering of salmonella enteritidis infections and their socioeconomic determinants in the greater toronto area, ontario, canada (2007 - 2009): a retrospective population-based ecological study.there have been only a few region-level ecological studies conducted in canada investigating enteric infections in humans. our study objectives were to 1) assess the spatial clustering of salmonella enterica serotype enteritidis (s. enteritidis) human infections in the greater toronto area, and 2) identify underlying area-level associations between s. enteritidis infection rates and socioeconomic status (ses) indicators that might explain the clustering of infections.201324237666
subtyping of a large collection of historical listeria monocytogenes strains from ontario, canada, by an improved multilocus variable-number tandem-repeat analysis (mlva).listeria monocytogenes is responsible for severe and often fatal food-borne infections in humans. a collection of 2,421 l. monocytogenes isolates originating from ontario's food chain between 1993 and 2010, along with ontario clinical isolates collected from 2004 to 2010, was characterized using an improved multilocus variable-number tandem-repeat analysis (mlva). the mlva method was established based on eight primer pairs targeting seven variable-number tandem-repeat (vntr) loci in two 4-plex f ...201323956391
macrolide-resistant mycoplasma pneumoniae in humans, ontario, canada, 2010-2011.antimicrobial drug resistance rates for mycoplasma pneumoniae was determined in clinical specimens and isolates obtained during 2011-2012 in ontario, canada. of 91 m. pneumoniae drug-resistant specimens, 11 (12.1%) carried nucleotide mutations associated with macrolide resistance in the 23s rrna gene. none of the m. pneumoniae specimens were resistant to fluoroquinolones or tetracyclines.201323968896
loss of the preconditioning effect of rosuvastatin during sustained therapy: a human in vivo study.studies have demonstrated that the acute administration of 3-hydroxy-3 methylglutaryl coenzyme a (hmg-coa) reductase inhibitors has protective effects in the setting of ischemia-reperfusion (ir). previously, we demonstrated that a single dose of rosuvastatin prevented ir-induced endothelial dysfunction in humans through a cyclooxygenase-2-dependent mechanism. whether the chronic administration of hmg-coa reductase inhibitors provides similar protection remains controversial and is unknown in hum ...201222003053
Red blood cell storage lesions and related transfusion issues: a canadian blood services research and development symposium.For centuries, man has been trying to figure out how to revive sick and traumatized individuals using fluids of various types, even from animals. In the 17th century, it was determined that blood was the best fluid to use and, in the early 1900s, after the discovery of the ABO blood groups, human blood was found to provide significant benefit for patients with shock and/or anemia. In the 1950s and 1960s, various ways to obtain, process, and store human blood were developed. It soon became appare ...201221871777
medical physics staffing for radiation oncology: a decade of experience in ontario, canada.the january 2010 articles in the new york times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. the purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing ...201222231223
unrecognized risks of nickel-related respiratory cancer among canadian electrolysis workers.objectives: nickel compounds, inclusive of water-soluble salts, have been classified as human carcinogens by the international agency for research on cancer (iarc). nickel producers have disputed the classification of soluble nickel compounds for three decades with reference to an alleged absence of excess respiratory cancer among canadian nickel-exposed electrolysis workers. we evaluated historical data from two electrolytic refineries in ontario, both included i ...201222258056
identifying an outbreak of a novel swine disease using test requests for porcine reproductive and respiratory syndrome as a syndromic surveillance tool.animal disease monitoring and surveillance are crucial for ensuring the health of animals, humans and the environment. many studies have investigated the utility of monitoring syndromes associated with data from veterinary laboratory submissions, but no research has focused on how negative test results from a veterinary diagnostic laboratory data can be used to improve our knowledge of disease outbreaks. for example, if a diagnostic laboratory was seeing a disproportionate number of negative tes ...201223072647
molecular and phylogenetic approaches for assessing sources of cryptosporidium contamination in water.the high sequence diversity and heterogeneity observed within species or genotypes of cryptosporidium requires phylogenetic approaches for the identification of novel sequences obtained from the environment. a long-term study on cryptosporidium in the agriculturally-intensive south nation river watershed in ontario, canada was undertaken, in which 60 sequence types were detected. of these sequence types 33 were considered novel with no identical matches in genbank. detailed phylogenetic analysis ...201222841595
spatiotemporal analysis of cryptosporidium species/genotypes and relationships with other zoonotic pathogens in surface water from mixed-use watersheds.nearly 690 raw surface water samples were collected during a 6-year period from multiple watersheds in the south nation river basin, ontario, canada. cryptosporidium oocysts in water samples were enumerated, sequenced, and genotyped by detailed phylogenetic analysis. the resulting species and genotypes were assigned to broad, known host and human infection risk classes. wildlife/unknown, livestock, avian, and human host classes occurred in 21, 13, 3, and <1% of sampled surface waters, respective ...201223124241
long-term changes in fish mercury levels in the historically impacted english-wabigoon river system (canada).the english-wabigoon river system in northwestern ontario, canada, was one of the most heavily mercury-contaminated waterways in the world due to historical discharges in the 1960s from a chlor-alkali plant. this study examines long-term (1970-2010) monitoring data to assess temporal trends in mercury contamination in walleye, northern pike and lake whitefish, three species important for sport and subsistence fishing in this region, using dynamic linear modeling and piecewise regression. for all ...201222785387
dysregulation of cytokine response in canadian first nations communities: is there an association with persistent organic pollutant levels?in vitro and animal studies report that some persistent organic pollutants (pops) trigger the secretion of proinflammatory cytokines. whether pop exposure is associated with a dysregulation of cytokine response remains to be investigated in humans. we studied the strength of association between plasma pop levels and circulating cytokines as immune activation markers. plasma levels of fourteen pops and thirteen cytokines were measured in 39 caucasians from a comparator sample in québec city (cana ...201222768323
enantiospecific perfluorooctane sulfonate (pfos) analysis reveals evidence for the source contribution of pfos-precursors to the lake ontario foodweb.exposure to perfluorooctane sulfonate (pfos) may arise directly, from emission and exposure to pfos itself, or indirectly via the environmental release and degradation of pfos-precursors. human serum enantiomer fractions (efs) of 1m-pfos have been shown to be nonracemic, suggesting that pfos-precursors are a significant source of pfos in humans, but little is known about the importance of pfos-precursors in ecosystems. in the current work, concentrations of pfos, perfluorooctane sulfonamide (pfo ...201222676298
in vivo quantification of bone-fluorine by delayed neutron activation analysis: a pilot study of hand-bone-fluorine levels in a canadian population.humans can be exposed to fluorine (f) through their diet, occupation, environment and oral dental care products. fluorine, at proper dosages, is believed to have positive effects by reducing the incidence of dental caries, but fluorine toxicity can occur when people are exposed to excessive quantities of fluorine. in this paper we present the results of a small pilot in vivo study on 33 participants living in southwestern ontario, canada. the mean age of participants was 45 ± 18 years with a ran ...201222369953
enhancing effects of adjuvanted 2009 pandemic h1n1 influenza a vaccine on memory b-cell responses in hiv-infected individuals.to assess the humoral immune response to low-dose as03-adjuvanted and standard-dose nonadjuvanted 2009 pandemic h1n1 influenza a vaccine in hiv-infected aviremic individuals receiving antiretroviral therapy and in uninfected individuals.201121157297
immunohistochemical staining for smoothelin in the duplicated versus the true muscularis mucosae of barrett esophagus.the muscularis mucosa underlying the metaplastic mucosa of barrett esophagus is frequently duplicated, with an intervening layer of lamina propria between the superficial or neomuscularis mucosa (nmm) and the deep/true muscularis mucosa (tmm). this duplication causes difficulties with accurate staging of superficially invasive carcinoma in biopsy specimens and endoscopic mucosal resections (emrs), as invasion underneath the superficial muscle layers may be mistaken for submucosal invasion. mucos ...201121164287
postgraduate specialty training in northeastern ontario and subsequent practice location.physician specialists are under-represented in communities in northern ontario, even in larger communities of approximately 100 000 population. the positive association between postgraduate training in northern or rural areas and eventual practice in these locations has been well documented in the literature, but only for family medicine/general practice. few, if any, studies have explored the association for other specialties. the objective of this study was to determine if there was an associa ...201121381861
exposure to client aggression and burnout among community staff who support adults with intellectual disabilities in ontario, canada.background  studies have shown that staff who support adults with intellectual disabilities (id) are exposed to challenging behaviour in their work including client aggression. exposure to aggressive behaviour has been associated with staff stress and burnout. study samples have been small however, and there has been very little data exploring this issue among north american staff. methods  a cross-sectional survey which included demographics, measures of frequency and severity (including percei ...201121988339
Self-reported pH1N1 influenza vaccination coverage for Ontario.BACKGROUND: In the fall of 2009, Canada undertook a mass vaccination campaign against pH1N1. This report provides an overview of self-reported pH1N1 vaccination coverage of the Ontario population, building on an existing random digit-dialling telephone survey, in which 9,010 Ontario adults participated. Based on the results, 34.5% of Ontario residents were vaccinated: 33.3% of adults aged 18 or older and 38.6% of children and adolescents younger than age 18. Respondents reporting high-risk chron ...201122106787
automatic detection of the onset of nursing activities using accelerometers and adaptive segmentation.we used the recursive least squares algorithm and a predictor filter to automatically identify the start and stop times of 6 simple nursing activities. the dataset included continuous acceleration recordings obtained with a single accelerometer sensor attached to the backs of 8 nurses. the algorithm requires no training. it identifies the start and stop time of each activity when at least 2 of 3 axes show significant acceleration changes not more than a second apart. the overall accuracy of the ...201122027151
"Time is brain": only in the acute phase of stroke?INTRODUCTION AND OBJECTIVE: In Spain, stroke is the leading cause of death in women as well as the leading cause of disability in adults. This translates into a huge human and economic cost. In recent years there have been significant advances both in the treatment of acute stroke and in the neuro-rehabilitation process; however, it is still unclear when the best time is to initiate neurorehabilitation and what the consequences of delaying treatment are. To test the effect of a single day delay ...201121890240
Incidental nest predation in freshwater turtles: inter- and intraspecific differences in vulnerability are explained by relative crypsis.There has long been interest in the influence of predators on prey populations, although most predator-prey studies have focused on prey species that are targets of directed predator searching. Conversely, few have addressed depredation that occurs after incidental encounters with predators. We tested two predictions stemming from the hypothesis that nest predation on two sympatric freshwater turtle species whose nests are differentially prone to opportunistic detection-painted turtles (Chrysemy ...201122009341
controlled blast exposure during forced explosive entry training and mild traumatic brain injury.there is a paucity of data regarding the pathophysiology and short- and long-term neurologic consequences of primary blast injury in humans. the purpose of this investigation was to test the feasibility of implementing a research protocol in the context of a forced explosive entry training course.201122072006
Autoantibody response to adjuvant and nonadjuvant H1N1 vaccination in systemic lupus erythematosus.It has been reported that influenza vaccination increases autoantibody production and/or disease activity in a significant proportion of patients with systemic lupus erythematosus (SLE). During the recent H1N1 epidemic, we investigated whether the use of adjuvant- and nonadjuvant-containing H1N1 vaccine induced increased autoantibody production in patients with SLE.201122034113
bearing response-ability: theater, ethics and medical education.this paper addresses a growing concern within the medical humanities community regarding the perceived need for a more empathically-focused medical curricula, and advocates for the use of creative pedagogical forms as a means to attend to issues of suffering and relationality. drawing from the ethical philosophy of emmanuel levinas, i critique the notion of empathy on the basis that it erases difference and disregards otherness. rather, i propose that the concept of empathy may be usefully repla ...201122109642
Sustained hyperaemia stimulus is necessary to induce flow-mediated dilation of the human brachial artery.We studied the relative importance of the magnitude and duration of the shear stimulus to induce flow-mediated dilation (FMD) in the brachial artery of 10 healthy men by ultrasound imaging. The shear stress stimulus was induced by different durations of reactive hyperaemia following 15-min forearm occlusion. The control condition of continuous postocclusion hyperaemia was compared to 20, 40 and 60 s of reactive hyperaemia followed by reapplication of circulatory arrest for 2 min and a second cuf ...201121981451
watershed and discharge influences on the phase distribution and tributary loading of total mercury and methylmercury into lake superior.knowledge of the partitioning and sources of mercury are important to understanding the human impact on mercury levels in lake superior wildlife. fluvial fluxes of total mercury (hg(t)) and methylmercury (mehg) were compared to discharge and partitioning trends in 20 sub-basins having contrasting land uses and geological substrates. the annual tributary yield was correlated with watershed characteristics and scaled up to estimate the basin-wide loading. tributaries with clay sediments and agricu ...201122019205
The sound of spiritual care: music interventions in a palliative care setting.The article describes how music has been integrated into spiritual and supportive care for palliative care patients at Brantford General Hospital (Ontario). Numerous case examples illustrate how a song or piece of music can play a vital role in the spiritual dimension of end of life care. The article expands the concept of the "living human document" by positing that a life story has an accompanying soundtrack: a musical memory and sensorial attunement that can be energized when music is offered ...201121919326
Health Care Access and Support for Disabled Women in Canada: Falling Short of the UN Convention on the Rights of Persons with Disabilities: A Qualitative Study.PURPOSE: The United Nations Convention on the Rights of Persons with Disabilities and other international human rights conventions guarantee the fundamental human rights to physical, social, and psychological health. The purpose of this study was to examine whether these rights are being upheld in Canada for disabled women. METHODS: An interpretive, qualitative, focus group design was employed. Participants were women 18 to 67 years of age with a self-identified physical, sensory, cognitive, and ...201121968028
the effects of regional angling effort, angler behavior, and harvesting efficiency on landscape patterns of overfishing.we used a coupled social-ecological model to study the landscape-scale patterns emerging from a mobile population of anglers exploiting a spatially structured walleye (sander vitreus) fishery. we systematically examined how variations in angler behaviors (i.e., relative importance of walleye catch rate in guiding fishing site choices), harvesting efficiency (as implied by varying degrees of inverse density-dependent catchability of walleye), and angler population size affected the depletion of w ...201122073644
Case series of fertility treatment in HIV-discordant couples (male positive, female negative): the Ontario experience.The success of combination antiretroviral therapies for the treatment of human immunodeficiency virus (HIV) has resulted in prolonged life expectancy (over 40 years from diagnosis) and an improved quality of life for people living with HIV. The risk of vertical HIV transmission during pregnancy has been reduced to less than 1%. As a result of these breakthroughs and as many of these individuals are of reproductive age, fertility issues are becoming increasingly important for this population. One ...201121969863
using a genetic network to parameterize a landscape resistance surface for fishers, martes pennanti.knowledge of dispersal-related gene flow is important for addressing many basic and applied questions in ecology and evolution. we used landscape genetics to understand the recovery of a recently expanded population of fishers (martes pennanti) in ontario, canada. an important focus of landscape genetics is modelling the effects of landscape features on gene flow. most often resistance surfaces in landscape genetic studies are built a priori based upon nongenetic field data or expert opinion. th ...201121883589
selective serotonin reuptake inhibitors and pulmonary arterial hypertension: a case-control study.abstract background: animal and human studies suggest that selective serotonin reuptake inhibitors (ssris) might be useful for the prevention or treatment of pulmonary arterial hypertension. methods: we conducted a population-based, nested case-control study to explore the hypothesis that ssris might reduce the risk of pulmonary arterial hypertension. cases were individuals who developed pulmonary arterial hypertension requiring pharmacological treatment. for each case, we selected up to 10 matc ...201121852294
recent workshops of the hupo human plasma proteome project (hppp): a bridge with the hupo cardiovascular initiative and the emergence of srm targeted proteomics.we hereby provide a two-year update on the hupo human plasma proteome project (hppp) informed by advances presented at the hppp sessions at the hupo world congresses in toronto in september 2009 and in sydney in september 2010.201121850651
government bodies and their influence on the 2009 h1n1 health sector pandemic response in remote and isolated first nation communities of sub-arctic ontario, canada.first nation communities were highly impacted by the 2009 h1n1 influenza pandemic. multiple government bodies (ie federal, provincial, and first nations) in canada share responsibility for the health sector pandemic response in remote and isolated first nation communities and this may have resulted in a fragmented pandemic response. this study aimed to discover if and how the dichotomy (or trichotomy) of involved government bodies led to barriers faced and opportunities for improvement during th ...201121863907
infectious milk: issues of pathogenic certainty within ideational regimes and their biopolitical implications.throughout the 19(th) century and early decades of the 20(th) century, milk was a dangerous food that required state intervention to make it safe. throughout this period, the germ theory of contagious disease came to prominence, but could not explicitly determine the causal relationships linking germs, milk, and human illness. using the notion of an ideational regime, i examine how (1) knowledge claims move from uncertainty to certainty and become privileged claims within ideational regimes that ...201122035726
awareness of, usage of and willingness to use hiv pre-exposure prophylaxis among men in downtown toronto, canada.pre-exposure prophylaxis (prep) is a promising strategy whereby hiv-uninfected people could take antiretroviral (arv) medications to reduce their risk of hiv acquisition. reports suggest that unsupervised prep use has been occurring in gay communities of usa cities before human safety and efficacy data became available. we administered a 20-item questionnaire to men undergoing hiv testing at hassle free clinic, a sexual health clinic in the gay village of toronto. questionnaire items enquired ab ...201122174057
The 2009 H1N1 pandemic response in remote First Nation communities of Subarctic Ontario: barriers and improvements from a health care services perspective.Objectives. To retrospectively examine the barriers faced and opportunities for improvement during the 2009 H1N1 pandemic response experienced by participants responsible for the delivery of health care services in 3 remote and isolated Subarctic First Nation communities of northern Ontario, Canada. Study design. A qualitative community-based participatory approach. Methods. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants represen ...201122030007
From theory to practice: a Canadian case study of the utility of climate change adaptation frameworks to address health impacts.OBJECTIVE: It is now recognized that climate change affects human health. The question is how to adapt. This article examines mainstreaming climate considerations into public health programs and the utility of climate change and health adaptation frameworks, using Ontario, Canada, as a case study. METHODS: A literature review identified climate change and health adaptation frameworks for comparison with the Ontario Public Health Standards. Key informant interviews gauged the extent to which clim ...201121931977
natural history of pandemic h1n1 2009 influenza infection in healthy pediatric outpatients.the pandemic influenza h1n1 2009 (ph1n1) virus is expected to remain a prominent circulating strain in the current and subsequent influenza seasons. the objective of this study was to compare the clinical course of infection with laboratory-confirmed ph1n1 and seasonal influenza a and b in a cohort of previously healthy children managed in the outpatient setting without antiviral therapy.201121272826
disinfection byproducts in canadian provinces: associated cancer risks and medical expenses.chlorination for drinking water forms various disinfection byproducts (dbps). some dbps are probably linked to human cancer (e.g., bladder, colorectal cancers) and other chronic and sub-chronic effects. this emphasizes the need to understand and characterize dbps in drinking water and possible risks to human health. in this study, occurrences of dbps throughout canada were investigated. trihalomethanes (thms) were observed to be highest in manitoba followed by nova scotia and saskatchewan, while ...201121292392
effectiveness of as03 adjuvanted pandemic h1n1 vaccine: case-control evaluation based on sentinel surveillance system in canada, autumn 2009.to assess the effectiveness of the pandemic influenza a/h1n1 vaccine used in canada during autumn 2009.201121292718
promoter methylation of wnt antagonists dkk1 and sfrp1 is associated with opposing tumor subtypes in two large populations of colorectal cancer patients.aberrant activation of canonical wnt signaling is a hallmark event in colorectal carcinogenesis. the dickkopf-1 (dkk1) and secreted frizzled related protein 1 (sfrp1) genes encode extracellular inhibitors of wnt signaling that are frequently silenced by promoter hypermethylation in colorectal cancer (crc). these methylation events have been identified as prognostic markers of patient outcome and tumor subtype in several cancers but similar roles in crc have not been comprehensively examined. in ...201121304055
knowledge-to-action processes in shrtn collaborative communities of practice: a study protocol. 201121310083
predictors of pandemic influenza infection in adults presenting to two urban emergency departments, toronto, 2009.identifying features that differentiate patients with h1n1 influenza infection from those with other conditions may assist clinical decision making during waves of pandemic influenza activity.201121324291
emsy and ccnd1 amplification in familial breast cancer: from the ontario site of the breast cancer family registry.emsy is a putative oncogene amplified in a minority of breast carcinomas, its protein product interacts with and transcriptionally silences brca2. we hypothesized that breast tumors from brca2 mutation carriers would be less likely than other familial breast cancers to exhibit emsy amplification. as emsy is located on 11q13 in proximity to ccnd1, an established breast cancer oncogene, we also examined the amplification of ccnd1 in the same tumor cohort. amplification of emsy and ccnd1 were exami ...201121327470
a retrospective economic analysis of the ontario red fox oral rabies vaccination programme.ontario initiated a red fox (vulpes vulpes) oral rabies vaccination (orv) programme in 1989. this study utilized a benefit-cost analysis to determine if this orv programme was economically worthwhile. between 1979 and 1989, prior to orv baiting, the average annual human post-exposure treatments, positive red fox rabies diagnostic tests and indemnity payments for livestock lost to rabies were 2248, 1861 and $246,809, respectively. after baiting, from 1990 to 2000, a 35%, 66% and 41% decrease in p ...201120819201
cost-effectiveness of ontario's pandemic vaccine program. 201120831912
genetic variation in the kiaa0319 5' region as a possible contributor to dyslexia.reading disabilities (rd) have been linked and associated with markers on chromosome 6p with results from multiple independent samples pointing to kiaa0319 as a risk gene and specifically, the 5' region of this gene. here we focus genetic studies on a 2.3 kb region spanning the predicted promoter, the first untranslated exon, and part of the first intron, a region we identified as a region of open chromatin. using dna from probands with rd, we screened for genetic variants and tested select vari ...201121207242
factors related to campylobacter spp. carriage in client-owned dogs visiting veterinary clinics in a region of ontario, canada.summaryfrom july 2008 until may 2009, 240 client-owned pet dogs from seven veterinary clinics in the region of waterloo, ontario, canada participated in a study to determine pet-related management factors that may be associated with the presence of campylobacter spp. in dogs. the prevalence of campylobacter spp. carriage in our study population of pet dogs was 22%, with 19% of the dogs positive for c. upsaliensis, and 3% positive for c. jejuni. a significant risk factor from multivariable logist ...201121208515
analytical and clinical validation of novel real-time reverse transcriptase-polymerase chain reaction assays for the clinical detection of swine-origin h1n1 influenza viruses.during the early stages of the 2009/2010 swine-origin h1n1 influenza a (s-oiv h1n1 flua) outbreak, the development and validation of sensitive and specific detection methods were a priority for rapid and accurate diagnosis. between may and june 2009, 2 real-time reverse transcriptase-polymerase chain reaction (rrt-pcr) assays targeting the hemagglutinin and neuraminidase genes of the s-oiv h1n1 flua virus were developed. these assays are highly specific, showing no cross-reactivity against a pan ...201121251560
source, concentration, and distribution of elemental mercury in the atmosphere in toronto, canada.atmospheric gaseous elemental mercury [gem] at 1.8, 4, and 59 m above ground, in parking lots, and in indoor and outdoor air was measured in toronto city, canada from may 2008-july 2009. the average gem value at 1.8 m was 1.89 ± 0.62 ng m(-3). the gem values increased with elevation. the average gem in underground parking lots ranged from 1.37 to 7.86 ng m(-3) and was higher than those observed from the surface parking lots. the gem in the indoor air ranged from 1.21 to 28.50 ng m(-3), was highe ...201121251742
neuraminidase-inhibitor resistance testing for pandemic influenza a (h1n1) 2009 in ontario, canada.oseltamivir resistance-associated h275y mutation in the neuraminidase (na) gene of pandemic influenza a (h1n1) 2009 was occasionally reported worldwide during the 2009-2010 influenza season. a significant proportion of those were found in immunocompromised or severely ill persons. this phenomenon remains infrequent and clear recommendations for resistance testing are lacking.201121251873
dietary exposure of pbdes resulting from a subsistence diet in three first nation communities in the james bay region of canada.concerns regarding the persistence, bioaccumulation, long-range transport, and adverse health effects of polybrominated dipheyl ethers (pbdes) have recently come to light. pbdes may potentially be of concern to indigenous (first nations) people of canada who subsist on traditional foods, but there is a paucity of information on this topic.201121255843
gallbladder disease in northwestern ontario: the case for canada's first rural ercp program.the rate of cholecystectomy in northwestern ontario is double the provincial rate. this paper explores the demographics of cholecystectomy and the role for rural endoscopic retrograde cholangiopancreatography (ercp) services in the central part of this region.201121453605
regional effects on the mental health of immigrant children: results from the new canadian children and youth study (nccys).children in immigrant families from hong kong, mainland china, and the philippines living in toronto and montreal are at higher risk of emotional problems than children in immigrant families in winnipeg, calgary, edmonton, and vancouver (beiser et al., 2010). the current publication explores human capital, social capital, institutional receptivity, and perceptions of welcome as explanations for regional disparities. parent's lack of linguistic fluency, and depressive symptoms provided the most l ...201121463966
dispersal of mycobacterium tuberculosis via the canadian fur trade.patterns of gene flow can have marked effects on the evolution of populations. to better understand the migration dynamics of mycobacterium tuberculosis, we studied genetic data from european m. tuberculosis lineages currently circulating in aboriginal and french canadian communities. a single m. tuberculosis lineage, characterized by the ds6(quebec) genomic deletion, is at highest frequency among aboriginal populations in ontario, saskatchewan, and alberta; this bacterial lineage is also domina ...201121464295
use of letrozole challenge test to adjust gonadotropin dose in non-down-regulated cycles.the use of a letrozole challenge test to predict ovarian response is described. the authors show that a ratio of cycle day 7 to cycle day 3 post-letrozole fsh level >1.5 is associated with poor ovarian response.201121481375
does user-centred design affect the efficiency, usability and safety of cpoe order sets?application of user-centred design principles to computerized provider order entry (cpoe) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on cpoe systems.201121486886
assessing secondary attack rates among household contacts at the beginning of the influenza a (h1n1) pandemic in ontario, canada, april-june 2009: a prospective, observational study.abstract:201121492445
gotflu channel: an online syndromic surveillance tool supporting college health practice and public health work.develop a tool to ease the burden of h1n1 influenza on a campus clinic by promoting self-care, generating medical notes, and identifying vulnerable students.201121500061
beta-blockade restores muscle sympathetic rhythmicity in human heart failure.background: muscle sympathetic nerve firing rate increases as chronic heart failure (chf) progresses, yet its oscillation, particularly within the frequency range encompassing 0.13hz, diminishes. the current study tested the hypothesis that chronic therapy with lipophilic β-adrenoceptor antagonists augments the modulation of muscle sympathetic nerve activity variability (msnav) at this frequency range. methods and results: in 21 chf angiotensin converting enzyme (ace) inhibitor-treated patients ...201121519151
modelling sediment-microbial dynamics in the south nation river, ontario, canada: towards the prediction of aquatic and human health risk.runoff from agricultural watersheds can carry a number of agricultural pollutants and pathogens; often associated with the sediment fraction. deposition of this sediment can impact water quality and the ecology of the river, and the re-suspension of such sediment can become sources of contamination for reaches downstream. in this paper a modelling framework to predict sediment and associated microbial erosion, transport and deposition is proposed for the south nation river, ontario, canada. the ...201121558043
estimating background rates of guillain-barre syndrome in ontario in order to respond to safety concerns during pandemic h1n1/09 immunization campaign.abstract: background: the province of ontario, canada initiated mass immunization clinics with adjuvanted pandemic h1n1 influenza vaccine in october 2009. due to the campaign's scale, temporal associations with guillain-barre syndrome (gbs) and vaccination were expected. the objectives of this analysis were to estimate the number of background gbs cases expected to occur in the projected vaccinated population and to estimate the number of additional gbs cases which would be expected if an associ ...201121586163
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