Developing a Computational Phenotype of the Fourth Universal Definition of Myocardial Infarction for Inpatients.

: The fourth universal definition of myocardial infarction (MI) introduced the differentiation of acute myocardial injury from MI. In this study, we developed a computational phenotype for distinct identification of acute myocardial injury and MI within electronic medical records (EMRs). : Two cohorts were used from a Calgary-wide EMR system: a chart review of 3042 randomly selected inpatients from Dec 2014 to Jun 2015; and 11,685 episodes of care that included cardiac catheterization from Jan 2013 to Apr 2017.

Identifying personalized barriers for hypertension self-management from TASKS framework.

Objective: Effective management of hypertension requires not only medical intervention but also significant patient self-management. The challenge, however, lies in the diversity of patients' personal barriers to managing their condition. The objective of this research is to identify and categorize personalized barriers to hypertension self-management using the TASKS framework (Task, Affect, Skills, Knowledge, Stress).

Development of Data Quality Indicators for Improving Hospital International Classification of Diseases-Coded Health Data Quality Globally.

Background: Hospital inpatient data, coded using the International Classification of Diseases (ICD), is widely used to monitor diseases, allocate resources and funding, and evaluate patient outcomes. As such, hospital data quality should be measured before use; however, currently, there is no standard and international approach to assess ICD-coded data quality.

Objective: To develop a standardized method for assessing hospital ICD-coded data quality that could be applied across countries: Data quality indicators (DQIs).

Crop rotational diversity can mitigate climate-induced grain yield losses.

Diversified crop rotations have been suggested to reduce grain yield losses from the adverse climatic conditions increasingly common under climate change. Nevertheless, the potential for climate change adaptation of different crop rotational diversity (CRD) remains undetermined. We quantified how climatic conditions affect small grain and maize yields under different CRDs in 32 long-term (10-63 years) field experiments across Europe and North America.

Health data governance for research use in Alberta.

Alberta has rich clinical and health services data held under the custodianship of Alberta Health and Alberta Health Services (AHS), which is not only used for clinical and administrative purposes but also disease surveillance and epidemiological research. Alberta is the largest province in Canada with a single payer centralised health system, AHS, and a consolidated data and analytics team supporting researchers across the province. This paper describes Alberta's data custodians, data governance mechanisms, and streamlined processes followed for research data access.

Evaluating the coding accuracy of type 2 diabetes mellitus among patients with non-alcoholic fatty liver disease.

Background: Non-alcoholic fatty liver disease (NAFLD) describes a spectrum of chronic fattening of liver that can lead to fibrosis and cirrhosis. Diabetes has been identified as a major comorbidity that contributes to NAFLD progression. Health systems around the world make use of administrative data to conduct population-based prevalence studies.

Cerebrovascular disease case identification in inpatient electronic medical record data using natural language processing.

Background: Abstracting cerebrovascular disease (CeVD) from inpatient electronic medical records (EMRs) through natural language processing (NLP) is pivotal for automated disease surveillance and improving patient outcomes. Existing methods rely on coders' abstraction, which has time delays and under-coding issues. This study sought to develop an NLP-based method to detect CeVD using EMR clinical notes.

A comparison of machine learning algorithms and traditional regression-based statistical modeling for predicting hypertension incidence in a Canadian population.

Risk prediction models are frequently used to identify individuals at risk of developing hypertension. This study evaluates different machine learning algorithms and compares their predictive performance with the conventional Cox proportional hazards (PH) model to predict hypertension incidence using survival data. This study analyzed 18,322 participants on 24 candidate features from the large Alberta's Tomorrow Project (ATP) to develop different prediction models.

Personalized prediction of incident hospitalization for cardiovascular disease in patients with hypertension using machine learning.

Background: Prognostic information for patients with hypertension is largely based on population averages. The purpose of this study was to compare the performance of four machine learning approaches for personalized prediction of incident hospitalization for cardiovascular disease among newly diagnosed hypertensive patients.

Methods: Using province-wide linked administrative health data in Alberta, we analyzed a cohort of 259,873 newly-diagnosed hypertensive patients from 2009 to 2015 who collectively had 11,863 incident hospitalizations for heart failure, myocardial infarction, and stroke.

Integrating Care from Home to Hospital to Home: Using Participatory Design to Develop a Provincial Transitions in Care Guideline.

Introduction: Patients worldwide experience fragmented and uncoordinated care as they transition between primary and acute care. To improve system integration and outcomes for patients, in 2017/2018 Alberta Health Services (largest health services delivery organization in Canada) called for a coordinated approach to improve transitions in care (TiC). Healthcare leadership responded by initiating the development of a province-wide guideline outlining core components of effective transitions in care.

Supporting wild pollinators in agricultural landscapes through targeted legume mixtures.

Insect-pollinated legumes are rich in plant-based proteins making them a vital constituent of sustainable healthy diets for people and livestock. Furthermore, they deliver or support a range of ecosystem services that underpin agricultural production and their prevalence in agricultural landscapes is likely to increase. Under typical implementation and management, the value of legumes to pollinators has, however, been questioned.

Methane-derived carbon flows into host-virus networks at different trophic levels in soil.

The concentration of atmospheric methane (CH) continues to increase with microbial communities controlling soil-atmosphere fluxes. While there is substantial knowledge of the diversity and function of prokaryotes regulating CH production and consumption, their active interactions with viruses in soil have not been identified. Metagenomic sequencing of soil microbial communities enables identification of linkages between viruses and hosts.

Association between continuity and access in primary care: a retrospective cohort study.

Background: Continuity of care is a tenet of primary care. Our objective was to explore the relation between a change in access to a primary care physician and continuity of care.

Methods: We conducted a retrospective cohort study among physicians in a primary care network in southwest Alberta who measured access consistently between 2009 and 2016.

Evaluation of the nutritive value of legume alternatives to soybean meal for broiler chickens.

Five experiments were conducted to investigate the nutritional value of various legumes and a faba beans processing co-product for broilers. In Expt. 1 and 3, metabolizable energy (AME) content was evaluated for 2 batches of bean starch concentrate (BSC) that differed in physical and chemical characteristics.

ACSC Indicator: testing reliability for hypertension.

Background: With high-quality community-based primary care, hospitalizations for ambulatory care sensitive conditions (ACSC) are considered avoidable. The purpose of this study was to test the inter-physician reliability of judgments of avoidable hospitalizations for one ACSC, uncomplicated hypertension, derived from medical chart review.

Methods: We applied the Canadian Institute for Health Information's case definition to obtain a random sample of patients who had an ACSC hospitalization for uncomplicated hypertension in Calgary, Alberta.

A Comparative Nitrogen Balance and Productivity Analysis of Legume and Non-legume Supported Cropping Systems: The Potential Role of Biological Nitrogen Fixation.

The potential of biological nitrogen fixation (BNF) to provide sufficient N for production has encouraged re-appraisal of cropping systems that deploy legumes. It has been argued that legume-derived N can maintain productivity as an alternative to the application of mineral fertilizer, although few studies have systematically evaluated the effect of optimizing the balance between legumes and non N-fixing crops to optimize production. In addition, the shortage, or even absence in some regions, of measurements of BNF in crops and forages severely limits the ability to design and evaluate new legume-based agroecosystems.

Trade-Offs between Economic and Environmental Impacts of Introducing Legumes into Cropping Systems.

Europe's agriculture is highly specialized, dependent on external inputs and responsible for negative environmental impacts. Legume crops are grown on less than 2% of the arable land and more than 70% of the demand for protein feed supplement is imported from overseas. The integration of legumes into cropping systems has the potential to contribute to the transition to a more resource-efficient agriculture and reduce the current protein deficit.

Relationship between primary care physician visits and hospital/emergency use for uncomplicated hypertension, an ambulatory care-sensitive condition.

Background: Hospitalizations for ambulatory care-sensitive conditions (ACSCs) represent an indirect measure of access and quality of community care. The purpose of this study was to examine the association between one ACSC, uncomplicated hypertension, and previous primary care physician (PCP) utilization.

Methods: A cohort of patients with hypertension was identified using administrative databases in Alberta between fiscal years 1994 and 2008.

Hospitalization for uncomplicated hypertension: an ambulatory care sensitive condition.

Background: Hospitalizations for ambulatory care sensitive conditions (ACSC) represent an indirect measure of access and quality of community care. This study explored hospitalization rates for 1 ACSC, uncomplicated hypertension, and the factors associated with hospitalization.

Methods: A cohort of patients with incident hypertension, and their covariates, was defined using validated case definitions applied to International Classification of Disease administrative health data in 4 Canadian provinces between fiscal years 1997 and 2004.

Outcomes among 3.5 million newly diagnosed hypertensive Canadians.

Background: This population-based study assessed rates of all-cause mortality, myocardial infarction, heart failure, and stroke for up to 12 years of follow-up in 3.5 million Canadian adults newly diagnosed with hypertension.

Methods: Hypertension cohort, outcomes, and covariates were defined using validated case definitions applied to inpatient and outpatient administrative health databases.

Incidence, cardiovascular complications and mortality of hypertension by sex and ethnicity.

Objective: To compare ethnic and sex difference in the incidence of newly diagnosed hypertension, and subsequent risk of cardiovascular disease outcomes among South Asian, Chinese and white patients.

Methods: We identified patients with newly diagnosed hypertension aged ≥20 years. Patients were followed for 1-9 years for all-cause mortality and cardiovascular disease with myocardial infarction, heart failure and stroke.

Implementation of ICD-10 in Canada: how has it impacted coded hospital discharge data?

Background: The purpose of this study was to assess whether or not the change in coding classification had an impact on diagnosis and comorbidity coding in hospital discharge data across Canadian provinces.

Methods: This study examined eight years (fiscal years 1998 to 2005) of hospital records from the Hospital Person-Oriented Information database (HPOI) derived from the Canadian national Discharge Abstract Database. The average number of coded diagnoses per hospital visit was examined from 1998 to 2005 for provinces that switched from International Classifications of Disease 9(th) version (ICD-9-CM) to ICD-10-CA during this period.

Antihypertensive medication use, adherence, stops, and starts in Canadians with hypertension.

Background: Some of the greatest barriers to achieving blood pressure control are perceived to be failure to prescribe antihypertensive medication and lack of adherence to medication prescriptions.

Methods: Self-reported data from 6017 Canadians with diagnosed hypertension who responded to the 2008 Canadian Community Health Survey and the 2009 Survey on Living with Chronic Diseases in Canada were examined.

Results: The majority (82%) of individuals with diagnosed hypertension reported using antihypertensive medications.

Capitalizing on deliberate, accidental, and GM-driven environmental change caused by crop modification.

The transgenic traits associated with the majority of commercial genetically modified crops are focused on improving herbicide and insecticide management practices. The use of the transgenic technology in these crops and the associated chemistry has been the basis of studies that provide evidence for occasional improvement in environmental benefits due to the use of less residual herbicides, more targeted pesticides, and reduced field traffic. This is nicely exemplified through studies using Environmental Impact Quotient (EIQ) assessments.

Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

Background: Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification.

Methods: Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension.