Differential permeability of rivers to raccoon gene flow corresponds to rabies incidence in Ontario, Canada

The correlation of landscape features with genetic discontinuities reveals barriers to dispersal that can contribute to understanding present and future spread of wildlife diseases. This knowledge can then be used for targeting control efforts. The impact of natural barriers on raccoon dispersal was assessed through genetic analysis of samples from two regions, Niagara ( N  = 666) and St. Lawrence ( N  = 802). These areas are transected by major rivers and are at the northern front of a raccoon rabies epizootic. Genetic clusters were identified in each region using Bayesian clustering algorithms. In the Niagara region, two clusters were identified corresponding to either side of the Niagara River. For the St. Lawrence region, spatially congruent clusters were not identified, despite the presence of the intervening St. Lawrence River. These genetic data are consistent with raccoon rabies incidence data where rabies has been detected across the St. Lawrence River in Ontario while no cases have been detected in Ontario across the Niagara River. This is despite expectations of rabies incidence in Niagara before the St. Lawrence based on the progression of rabies from New York. The results from the two regions suggest different permeabilities to raccoons between New York and Ontario that may be attributed to the rivers. However, other factors have also been explored that could contribute to this difference between these study sites including the shape of the landscape and resource distribution.     

Congestive heart failure complicating non-ST segment elevation acute coronary syndrome: incidence, predictors, and clinical outcomes

There are limited data regarding the incidence and clinical significance of congestive heart failure (CHF) in patients with non-ST segment elevation acute coronary syndromes (ACS). The objectives of this study were to examine the incidence, predictors, and clinical outcomes in patients with ACS without ST elevation who develop CHF. We studied patients with unstable angina or non-ST segment elevation myocardial infarction (NSTEMI) randomized to hirudin or unfractionated heparin in the Organisation to Assess Strategies for Ischemic Syndromes (OASIS-2) trial. The diagnosis of CHF was based on a combination of clinical and radiographic features. Patients were followed for 6 months. Of 10 141 randomized patients, 501 (4.9%) developed CHF within the first week and 643 (6.3%) during 6 months of followup. Independent predictors for the development of CHF were older age, female sex, diabetes, prior MI, prior CHF, and NSTEMI at presentation. Compared with patients who did not develop CHF, patients who developed CHF were at increased risk of death (odds ratio (OR) 3.4, 95% CI 2.7-4.3), new MI (OR 2.8, 95% CI 2.2-3.6), and the need for intra-aortic balloon pump insertion (OR 5.4, 95% CI 3.5-8.4) at 7 days and 6 months. There was no increase in use of cardiac catheterization (OR 0.8, 95% CI 0.7-1.0) or revascularization (OR 0.9, 95% CI 0.7-1.1) in patients who developed CHF. CHF is a common complication in patients presenting with non-ST segment elevation ACS and is strongly associated with adverse clinical outcomes including new MI and death. Despite this worse prognosis, patients with ACS developing CHF are less likely to be referred for invasive management.     

Sylvatic trichinosis in Ontario, Canada

Samples of muscle from 4,773 specimens of 18 species of wild mammals from Ontario were examined for Trichinella. One of 12 mink (Mustela vison), 83 of 1,821 fisher (Martes pennanti) and 68 of 1,980 marten (Martes americana) had T. spiralis. Prevalences of infections by Trichinella were determined for fisher and marten from the Algonquin region, over a 10-yr period. Prevalences ranged from 0.9-9.2% in fisher and 1.3-8.7% in marten indicating that the parasite is well-established in the region. Prevalences of Trichinella increased with age of both fisher and marten. Intensities determined for the 1981-1982 sample ranged from 0.4-15.8 larvae/g for fisher and 22.4-159.7 larvae/g for marten. Higher intensities were not correlated with older hosts. Fisher and marten appeared to be the key hosts maintaining Trichinella in the Algonquin region, but transmission dynamics were unclear. Transmission may include an unidentified small rodent or other host and natural carrion-feeding.     

Trends in Asthma-Related Direct Medical Costs from 2002 to 2007 in British Columbia,Canada: A Population Based-Cohort Study

Background

Asthma-related health resource use and costs may be influenced by increasing asthma prevalence, changes to asthma management guidelines, and new medications over the last decade. The objective of this work was to analyze direct asthma-related medical costs, and trends in total and per-patient costs of hospitalizations, physician visits, and medications.

Methods

A cohort of asthma patients from British Columbia (BC), Canada, was created. Asthma patients were identified using a validated case definition. Costs for hospitalizations, physician visits, and medications were calculated from billing records (in 2008 Canadian dollars). Trends in total and per-patient costs over the study period were analyzed using Generalized Linear Models.

Results

398,235 patients satisfied the asthma case definition (mid-point prevalence 8.0%). Patients consumed $315.9 million (M) in direct asthma-related health resources between 2002 and 2007. Hospitalizations, physician visits, and medication costs accounted for 16.0%, 15.7% and 68.2% of total costs, respectively. Cost of asthma increased from $49.4 M in 2002 to $54.7 M in 2007. Total annual costs attributable to hospitalizations and physician visits decreased (−39.8% and −25.5%, respectively; p<0.001), while medication costs increased (+38.7%; p<0.001).

Interpretation

This population-based analysis shows that the total direct cost of asthma in BC has increased since 2002, mainly due to a rise in asthma prevalence and cost of medication. Combination therapy with inhaled corticosteroids/long-acting beta-agonists has become a significant component of the cost of asthma. Although billing records capture only a fraction of the true burden of asthma, the simultaneous increase in medication costs and reductions in hospitalization and physician visit costs provides valuable insight for policy makers into the shifts in asthma-related resource use.     

Trends in the incidence of testicular germ cell cancer in Ontario by histologic subgroup, 1964-1996

BACKGROUND: Testicular cancer is rare but is notable because it affects mainly young men. The incidence of this disease has been increasing in developed countries throughout the world for several decades. The authors examined trends in the incidence of testicular germ cell cancer in Ontario for the period 1964-1996 according to the 2 main histologic groups, seminoma and non-seminoma. METHODS: Data on incident cases of testicular germ cell cancer diagnosed in Ontario residents aged 15-59 years between 1964 and 1996 were extracted from the population-based Ontario Cancer Registry. Annual rates of testicular cancer for the 2 histologic groups were analysed by means of log-linear regression to estimate average annual percent change. RESULTS: Between 1964 and 1996 the incidence of testicular germ cell cancer increased by 59.4%, from 4.01 to 6.39 per 100,000. This corresponded to an average annual increase of about 2% for both nonseminoma and seminoma. The relative increase in incidence was greatest in the lowest age group (15-29 years) for both histologic groups, although the data suggest that the incidence of nonseminoma cancer in this age group began to decline in the early 1990s. The increase in incidence appears to be due to a birth cohort effect, with more recent cohorts of men at increased risk. INTERPRETATION: The rise in the incidence of testicular germ cell cancer, not only in Ontario but also in many developed countries, requires investigation. The search for explanatory factors should focus on exposures whose prevalence may have increased over the past few decades and that are common enough to affect population incidence. The similarity of trends for seminoma and nonseminoma cancer suggests that the underlying risk factors are likely the same.     

Diatom Flora of the Grand River,Ontario, Canada

Summary This paper describes the diatom flora of the Grand River, Ontario, Canada. Samples were collected systematically from the river over a period of several years at tweleve stations. The diatom flora of the river is typical of temperate alkaline rivers. The flora is rich in species and variaties, and is similar to that from many parts from North Eastern United States. A total of 273 taxa of diatoms were identified. There is a tendency for the number of species per sample to increase downstream. The flora of the estuary in characteristic with a great variety of taxa occuring in small numbers. Most of the species are alkaliphilous and indifferent in the halolian spectra. Part of Ph. D. thesis (1970) of senior author     

Rabies in vaccinated raccoons from Ontario, Canada

From 1999 to 2006, 132 cases of raccoon rabies, caused by the raccoon variant of rabies virus, were confirmed in eastern Ontario, Canada. Trap-vaccinate-release (TVR) and point infection control (PIC) programs were implemented to control the disease; 43,014 raccoons (Procyon lotor) were vaccinated against rabies by injection (Imrab3) during that period. Two vaccinated raccoons were diagnosed with rabies at 6 mo and at 2 wk postvaccination. One may have been due to a vaccination failure. The other was likely due to the animal being in the late stages of incubation for rabies at the time of vaccination. This information will be useful to wildlife rehabilitators and agencies that hold raccoons in captivity in that a vaccinated raccoon is not necessarily immune to rabies.     

Behavior, movements, and demographics of rabid raccoons in Ontario, Canada: management implications

During 1999-2003, 127 cases of raccoon variant rabies were reported in raccoons (Procyon lotor) and striped skunks (Mephitis mephitis) in Ontario, Canada. Raccoons accounted for 98% (125/127) of the reported cases with behaviors/conditions including aggression, fighting with dogs, ataxia, vocalizations, appearance of being sick, and the presence of porcupine (Erethizon dorsatum) quills. Seventy-eight percent of the rabid raccoons were adults. Juveniles were underrepresented (22%) compared with the adult/juvenile ratios found in nonrabid Ontario raccoon populations. Of the known aged raccoons, 83% were < or = 3 yr of age, and 22% of the rabid adult female raccoons had evidence of having had a litter during the year in which they were found to be rabid. The majority of rabid raccoons were reported during the fall, winter, and spring, suggesting a relationship between raccoon behavioral activities such as denning and breeding and the timing of rabies outbreaks. Multiple cases of raccoon rabies occurred at several barns, suggesting that those structures serve as focal points of rabies transmission as a result of denning activities. Movements of five rabid raccoons (range 1,564-4,143 m) were not different from movements of nonrabid raccoons in Ontario. Sixty-six percent of the rabid animals were submitted by government staff, stressing the importance of those agencies in rabies control and surveillance operations. Increased knowledge of the behaviors of rabid raccoons should assist in the development of management strategies for rabies.     

Diagnosed hypertension in Canada: incidence, prevalence and associated mortality

Background:

Hypertension is a leading risk factor for cardiovascular diseases. Our objectives were to examine the prevalence and incidence of diagnosed hypertension in Canada and compare mortality among people with and without diagnosed hypertension.

Methods:

We obtained data from linked health administrative databases from each province and territory for adults aged 20 years and older. We used a validated case definition to identify people with hypertension diagnosed between 1998/99 and 2007/08. We excluded pregnant women from the analysis.

Results:

This retrospective population-based study included more than 26 million people. In 2007/08, about 6 million adults (23.0%) were living with diagnosed hypertension and about 418 000 had a new diagnosis. The age-standardized prevalence increased significantly from 12.5% in 1998/99 to 19.6% in 2007/08, and the incidence decreased from 2.7 to 2.4 per 100. Among people aged 60 years and older, the prevalence was higher among women than among men, as was the incidence among people aged 75 years and older. The prevalence and incidence were highest in the Atlantic region. For all age groups, all-cause mortality was higher among adults with diagnosed hypertension than among those without diagnosed hypertension.

Interpretation:

The overall prevalence of diagnosed hypertension in Canada from 1998 to 2008 was high and increasing, whereas the incidence declined during the same period. These findings highlight the need to continue monitoring the effectiveness of efforts for managing hypertension and to enhance public health programs aimed at preventing hypertension.Globally, raised blood pressure is the leading risk factor for death, accounting for about 13% of all deaths,^1,2 and it is the strongest risk factor for lost years of healthy life.¹ Left untreated, hypertension can increase the risk of stroke, coronary artery disease, dementia, heart and kidney failure, and other chronic diseases.^3–6 Managing hypertension through lifestyle modification or the use of antihypertensive medications, or both, can help mitigate these outcomes.⁷ Over the past decades in Canada, mortality associated with cardiovascular diseases has decreased,⁸ partly because of increased awareness and diagnosis of hypertension and better control of blood pressure.^9,10 However, the prevalence of hypertension remains high, and currently there are no mechanisms to track new cases at the national level.To date, information about hypertension in Canada has been mainly obtained by health surveys conducted at the provincial or national levels. Such surveys typically provide prevalence (not incidence) data and include limited data about trends over time.^11–15 National health surveys in Canada are resource intensive, do not include information about people who live in remote areas or institutions, and may underestimate hypertension prevalence because of recall bias and non-response.¹⁶ The use of administrative data that is population-based and routinely collected, such as physician claims and hospital discharge data, allows for a more comprehensive picture of this condition. Other important advantages of using administrative data include the readiness of the data to be analyzed, cost-efficiency, wide geographic coverage and the relatively complete capture of patient contact with the health care system (i.e., less prone to selection bias).Several recent studies in Canada and the United States have established valid methods for using administrative data to identify cases of hypertension.^16–23 In a study conducted in Ontario involving women and men aged 20 years and older, Tu and colleagues found that the prevalence and incidence of diagnosed hypertension were 24.5% in 2005 and 3.2% in 2004, respectively.²⁴ We used the same validated case definition to examine the prevalence and incidence of diagnosed hypertension in Canada from 1998/99 to 2007/08 by age and by province and territory. We also compared all-cause mortality by age and sex among those with and without diagnosed hypertension.     

Body size changes in elite junior rowers: 1997 to 2007

The aim of this study was to determine whether elite international junior rowers in 2007 were heavier and taller than those evaluated in 1997, and to compare this change among finalists and non-finalists, and sweep rowers and scullers. Body weight and height data obtained by a questionnaire from a total of 398 rowers (42% female, 58% male) at the Junior World Rowing Championships in Beijing, People's Republic of China, in 2007 (65.9% of all competitors), were compared with data from 603 rowers measured at the Junior World Rowing Championships in Hazewinkel, Belgium in 1997 (36.5% female, 63.5% male, representing 90% and 89% of all competitors, respectively, by gender). Male and female rowers in 2007 were significantly taller compared to those in 1997 (1.0 cm, p = 0.009 and 2.1 cm, p < 0.001, respectively; one-sample t-test). No statistically significant difference was found for body mass. The finalists and sweep rowers were taller and heavier compared to nonfinalists and scullers at both Championships respectively. The heights of elite level junior rowers increased significantly over the decade. The finalists at World Junior Rowing Championships were again taller and heavier compared to the nonfinalists.     

Mineral Precipitation by Epilithic Biofilms in the Speed River, Ontario, Canada

Epilithic microbial communities, ubiquitously found in biofilms on submerged granite, limestone, and sandstone, as well as on the concrete support pillars of bridges, were examined in the Speed River, Ontario, Canada. Transmission electron microscopy showed that attached bacteria (on all substrata) were highly mineralized, ranging from Fe-rich capsular material to fine-grained (<1 μm) authigenic (primary) mineral precipitates. The authigenic grains exhibited a wide range of morphologies, from amorphous gel-like phases to crystalline structures. Energy-dispersive X-ray spectroscopy indicated that the most abundant mineral associated with epilithic bacteria was a complex (Fe, Al) silicate of variable composition. The gel-like phases were similar in composition to a chamositic clay, whereas the crystalline structures were more siliceous and had compositions between those of glauconite and kaolinite. The consistent formation of (Fe, Al) silicates by all bacterial populations, regardless of substratum lithology, implies that biomineralization was a surface process associated with the anionic nature of the cell wall. The adsorption of dissolved constituents from the aqueous environment contributed significantly to the mineral formation process. In this regard, it appears that epilithic microbial biofilms dominate the reactivity of the rock-water interface and may determine the type of minerals formed, which will ultimately become part of the riverbed sediment. Because rivers typically contain high concentrations of dissolved iron, silicon, and aluminum, these findings provide a unique insight into biogeochemical activities that are potentially widespread in natural waters.     

Metal contamination in sediments and biota of the Bay of Quinte,Lake Ontario,Canada

The Bay of Quinte receives drainage from several large river systems, including the Moira River which carried sediment from mines into the Bay from the 1880s to the 1960s. We are investigating possible metal contamination of submerged weed beds and marsh biota which may contribute to the low diversity and biomass of macrophyte beds and Typha marshes in the Bay. In 1987, sediment, macrophytes and snails were sampled in wetlands close to the Moira River and at Hay Bay (part of the Bay of Quinte presumably unaffected by mine effluents) located 20 km from the Moira. Some element concentrations in sediment and biota were determined by neutron activation analysis (NAA) including Al, As, Br, Ca, Co, Cl, Cr, Cs, Fe, Hf, K, La, Na, Mg, Sb, Sc, Rb, Ta, Th, Ti, U, V and Zn. Other elements were analysed by acid dissolution and atomic absorption spectrophotometry (AAS) including Ag, As, Cu, Hg, Ni, Pb, and Zn. Levels of As in sediments and plants were higher close to the Moira River, whereas Cu and Ni showed the opposite pattern in sediments. The usefulness of species as bioassays differed: Stagnicola elodes Say accumulated significantly higher levels of Cu (35 vs 18 ppm) and V (l. l vs 0.5 ppm) than Planorbella trivolvis Say collected from the same sites. The macrophyte, Myriophyllum spicatum L. acted as an accumulator of Pb (up to 9.6 ppm), whereas Pb in Vallisneria americana Michx. at the same sites was undetectable.     

Amphibian species richness and distribution in relation to pond water chemistry in south-western Ontario, Canada

1. We assessed the patterns of amphibian species richness and distribution in relation to water chemistry over a large geographical area in 1992–94.
2. Thirteen amphibian species were observed at 180 ponds, with mean species richness 3.5 ± 0.13 species per pond (range zero to nine). Water samples were collected from 143 ponds, analysed for fifteen chemical variables, and further analysed by multivariate statistical techniques.
3. Water in the study area was hard, alkaline and well-buffered against pH change, and most ponds were eutrophic. Amphibian species richness was negatively correlated with five chemical variables (chloride, conductivity, magnesium, total hardness, turbidity).
4. Principle components analysis reduced the data set to four chemical components that explained 65.4% of the variance in the original variables. Principle component scores were retained for use in further multivariate tests. Multiple regression accounted for only 19.0% of the variance in amphibian species richness. Discriminant function analysis (DFA) was used to determine if water chemistry variables discriminated among species, but it was only able to classify 17.5% of cases correctly. DFA was also used to determine if water chemistry distinguished between used and unused sites for individual species. DFA was moderately successful, classifying 61–77% of cases correctly.
5. General water chemistry appears to play only a minor part in affecting amphibian species richness in south-western, Ontario. However, chemical variables may be helpful to distinguish between used and unused sites for some species.     

Amphibian species richness and distribution in relation to pond water chemistry in south-western Ontario, Canada

1. We assessed the patterns of amphibian species richness and distribution in relation to water chemistry over a large geographical area in 1992–94.
2. Thirteen amphibian species were observed at 180 ponds, with mean species richness 3.5 ± 0.13 species per pond (range zero to nine). Water samples were collected from 143 ponds, analysed for fifteen chemical variables, and further analysed by multivariate statistical techniques.
3. Water in the study area was hard, alkaline and well-buffered against pH change, and most ponds were eutrophic. Amphibian species richness was negatively correlated with five chemical variables (chloride, conductivity, magnesium, total hardness, turbidity).
4. Principle components analysis reduced the data set to four chemical components that explained 65.4% of the variance in the original variables. Principle component scores were retained for use in further multivariate tests. Multiple regression accounted for only 19.0% of the variance in amphibian species richness. Discriminant function analysis (DFA) was used to determine if water chemistry variables discriminated among species, but it was only able to classify 17.5% of cases correctly. DFA was also used to determine if water chemistry distinguished between used and unused sites for individual species. DFA was moderately successful, classifying 61–77% of cases correctly.
5. General water chemistry appears to play only a minor part in affecting amphibian species richness in south-western, Ontario. However, chemical variables may be helpful to distinguish between used and unused sites for some species.