Pedestrian movement modelling for a commercial street considering COVID-19 social distancing strategies.

This research attempts to understand the impacts of social distancing on dense urban pedestrian environments through pedestrian movement simulations. It develops a pedestrian microsimulation modelling framework that evaluates three scenarios for a commercial street in the Halifax Regional Municipality (HRM). The Business-as-Usual scenario mimics pre-COVID conditions with no social distancing protocols.

Outcomes of Radial Versus Femoral Access in Patients With Severe Aortic Stenosis Undergoing Percutaneous Coronary Intervention Prior to Transcatheter Aortic Valve Replacement.

Background: The safety and feasibility of radial access in patients undergoing percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) has not been studied.

Methods: This study included consecutive patients who underwent PCI within 30 days before TAVR at Mayo Clinic. Vascular access was left to the discretion of the operator.

Association Between the Acidemia, Lactic Acidosis, and Shock Severity With Outcomes in Patients With Cardiogenic Shock.

Background Lactic acidosis is associated with mortality in patients with cardiogenic shock (CS). Elevated lactate levels and systemic acidemia (low blood pH) have both been proposed as drivers of death. We, therefore, analyzed the association of both high lactate concentrations and low blood pH with 30-day mortality in patients with CS.

Regulatory strategies for early device development and approval.

The development of new technology to treat unmet clinical needs is an important component of modern cardiovascular disease. The need for this has been emphasized in the past several years beginning with the Food and Drug Administration (FDA) guidance document on Early Feasibility Studies in 2012 and then the 21st Century Cures legislation. A number of steps need to be considered in this process by the stakeholders involved including physician innovators and scientists, professional societies such as Society for Cardiovascular Angiography & Interventions, regulatory agencies, and medical device companies.

[The Multi-Clientele Assessment Tool as a control mechanism in home care: A poststructuralist analysis].

Introduction And Background: In Quebec (Canada), the Multi-clientele Assessment Tool (Outil d'évaluation multi-clientèle, OEMC) profoundly transformed the practice of home care professionals (HCP), including nurses. Since 2015, all home care patients with a completed OEMC have been counted to assess the performance of services. If performance targets are not reached, funding renewal is threatened, exerting pressure on HCPs.

Change of Heart: The Underexplored Role of Plaque Hemorrhage in the Evaluation of Stroke of Undetermined Etiology.

In the evaluation of embolic strokes of undetermined source, great emphasis is often placed on cardiovascular disease, namely on atrial fibrillation. Other pathophysiologic mechanisms, however, may also be involved. Carotid artery intraplaque hemorrhage (IPH)-the presence of blood components within an atheromatous plaque-has become increasingly recognized as a possible etiologic mechanism in some cryptogenic strokes.

Biopower under a state of exception: stories of dying and grieving alone during COVID-19 emergency measures.

During the COVID-19 pandemic, restrictions for visitors and caregivers in healthcare settings and long-term care (LTC) facilities were enacted in the larger context of public health policies that included physical distancing and shelter-in-place orders. Older persons residing in LTC facilities constituted over half of the mortality statistics across Canada during the first wave of the COVID-19 pandemic. Using the poststructuralist work of Agamben, Foucault and Mbembe we conducted a thematic analysis on news reports.

Device-related thrombus following left atrial appendage occlusion.

Thrombus formation on intracardiac devices remains a subject of importance, with rates in the 2-5% range. Device-related thrombus (DRT) following left atrial appendage occlusion is an area of particular concern considering its association with embolic events. DRT continues to present numerous questions, including the optimal definition, incidence, risk factors, monitoring, therapy, and clinical outcomes - all subjects of ongoing assessment.

The use of recovery model in forensic psychiatric settings: A Foucauldian critique.

Recovery, a model of care aimed at patient-led nursing practice emphasizing autonomy, hope and self-determination, has in recent years been adapted for the secure forensic psychiatric setting. Often referred to as 'secure recovery', this model suggests the aims of recovery are achievable even in highly restrictive settings. This paper will adopt a Foucauldian perspective to offer a critical analysis of recovery in forensic settings.

Enhancement effects of dissolved organic matter leached from sewage sludge on microbial reduction and immobilization of Cr(VI) by Geobacter sulfurreducens.

Sewage sludge has a high concentration of dissolved organic matter (DOM) which contains compounds that can serve as electron donors or shuttles for metal reduction by dissimilatory metal reducing bacteria (DMRB). In this study, Cr(VI) removal by G. sulfurreducens, a common DMRB present in anaerobic soils, was examined in the presence or absence of sludge DOM.

A new membrane formulation for modelling the flow of stomatocyte, discocyte, and echinocyte red blood cells.

In this work, a numerical model that enables simulation of the deformation and flow behaviour of differently aged Red Blood Cells (RBCs) is developed. Such cells change shape and decrease in deformability as they age, thus impacting their ability to pass through the narrow capillaries in the body. While the body filters unviable cells from the blood naturally, cell aging poses key challenges for blood stored for transfusions.

Clinical Impact of Residual Leaks Following Left Atrial Appendage Occlusion: Insights From the NCDR LAAO Registry.

Background: Data on the impact of residual peri-device leak after left atrial appendage occlusion (LAAO) are limited.

Objectives: The goal of this study was to explore the association of peri-device leak with adverse clinical events.

Methods: The National Cardiovascular Data Registry LAAO Registry was queried to identify patients undergoing LAAO between January 1, 2016, and December 31, 2019.

A Large-Scale Genome-Based Survey of Acidophilic Bacteria Suggests That Genome Streamlining Is an Adaption for Life at Low pH.

The genome streamlining theory suggests that reduction of microbial genome size optimizes energy utilization in stressful environments. Although this hypothesis has been explored in several cases of low-nutrient (oligotrophic) and high-temperature environments, little work has been carried out on microorganisms from low-pH environments, and what has been reported is inconclusive. In this study, we performed a large-scale comparative genomics investigation of more than 260 bacterial high-quality genome sequences of acidophiles, together with genomes of their closest phylogenetic relatives that live at circum-neutral pH.

Efficient nitrogen removal from leachate by coupling Anammox and sulfur-siderite-driven denitrification.

High concentrations of nitrate can be generated during anaerobic ammonium oxidation (Anammox) wastewater treatment processes. Addition of sulfur to Anammox reactors stimulates the growth of sulfur-driven denitrifying (SADN) bacteria that can reduce nitrate to nitrogen gas. However, protons released during the SADN process lower the pH of the system and inhibit Anammox activity.

AIDS cases in Ottawa: A review of simultaneous HIV and AIDS diagnoses.

Objectives: In Canada, HIV diagnoses continue unabated, with many of these cases being identified at a late stage of infection. While current public health surveillance data does not capture timing of diagnoses, locally, we identified a number of patients concurrently diagnosed with AIDS and HIV.

Design: To understand the key characteristics, presenting symptoms, and risk factors associated with an AIDS diagnosis, we undertook a prospective chart review of HIV and AIDS diagnoses in Ottawa, Canada.

The Heart Brain Team and Patient-Centered Management of Ischemic Stroke.

The multifaceted connections between the heart and the brain have been extensively studied at the anatomy, pathophysiology, and clinical levels. Studies have suggested a vital role for both cardiologists and neurologists in the management of various cardiovascular and neurological disorders. However, a true heart-brain team-based approach remained confined to large, specialized centers.

Time in therapeutic range of anticoagulation among patients with atrial fibrillation and cerebral amyloid angiopathy.

Atrial fibrillation (AF) and cerebral amyloid angiopathy (CAA) present risks of ischemic stroke and intracerebral hemorrhage (ICH). Vitamin K antagonist use is associated with fluctuations in international normalized ratio (INR), which predispose to a higher bleeding risk. Patients with a diagnosis of AF and ICH while on a vitamin K antagonist were identified using the Rochester Epidemiology Project.