How the Judiciary Has Driven Systemic Innovation During the Pandemic

In 1998, the Conference of State Court Administrators (COSCA)8 urged member state courts throughout the United States to join a national effort to exchange data and integrate information systems in ways that would improve case management.9 COSCA issued a position paper on information sharing in 2002,10 followed by joint resolutions adopted by the Conference of Chief Justices (CCJ)11 and COSCA that called for public access to electronic court records and removal of Social Security numbers from court records.12 In 2004, COSCA joined with the National Association for Court Management (NACM)13 to issue a policy statement for court acceptance of information technology.14 It established a "nine part agenda" that emphasized serving the court's business needs, stressed the importance of effective implementation, and addressed security and privacy issues.15 A series of incremental resolutions followed over several years, including one from the CCJ entitled "The Emergence of E-Everything. The Landscape of Civil Litigation determined that nonfamily civil litigation in state courts "takes too long and costs too much," which undermined access to justice.18 Court dockets were dominated by "lowervalue contract and small claims" cases that rarely were adjudicated on the merits.19 Courts were using outdated automated case management systems, and they were giving self-represented parties (involved in 76% of cases) and lawyers too much control over the pace of litigation.20 The Landscape of Civil Litigation lamented the decline in funding for court systems and observed that courts were expected to dispense more justice using fewer resources.21 B.The Call to Action in Civil Cases One year later, the NCSC published its influential Call to Action: Achieving Civil Justice for All22 That report built upon the Landscape of Civil Litigation and criticized the "cost, delay, and unpredictability of civil litigation" under existing court processes.23 It recommended that courts update differentiated case management processes to assign cases to three "pathways," which it designated as "Streamlined," "Complex," and "General. "31 States should design courthouses that incorporate emerging changes in technology.32 Six months before the CCJ and COSCA endorsed the Call to Action, the American Bar Association (ABA) House of Delegates approved the ABA Model Regulatory Objectives for the Provision of Legal Services (Model Regulatory Objectives).33 The Model Regulatory Objectives were drafted by the ABA's Commission on the Future of Legal Services not long before it released its innovative and controversial 2016 Report on the Future of Legal Services in the United States 24 The Model Regulatory Objectives provided guidelines for state courts to regulate nontraditional legal services providers, and discouraged blanket exclusions of nonlawyers based on unauthorized practice of law rules.35 The CCJ agreed, and resolved that state courts should consider broadening their regulatory frameworks to nonlawyers who provide legal services.36 Expanding the regulatory framework would give courts greater flexibility to implement the Call to Action21 In 2011, the NCSC advised state courts on how to automate court processes so that information technology could help assign cases to one of the three pathways.38 Pathway assignments should be data-driven and involve less human discretion. The NCSC joined in partnership with the Institute for the Advancement of the American Legal System (IAALS)41 and the National Council of Juvenile and Family Court Judges (NCJFCJ)42 to launch the Family Justice Initiative (FJI).43 The FJI would operate in collaboration with the CCJ and COSCA to build upon the research contained in the Landscape of Civil Litigation and the policy directives in the Call to Action 44 While the FJI was ramping up its operations, the NCSC issued a 2017 white paper that examined existing case management systems in family courts throughout the United States, titled Triage Protocols for Divorce and Child Custody Cases.45 The white paper noted "tension between what should ideally be done, what courts can afford to do, and what litigants want," and that courts may need to "identify[] 'good enough' solutions" that are more feasible due to resource limitations.46 "As long as budget constraints exist, a court that provides more services to one case is essentially reducing services in another case, so some sense of cost/benefit is definitely helpful in making these kinds of service and process tradeoffs. .

Mind the gap: Strategies from California on navigating access to public hearings

Public hearings play a critical role in U.S. local government. The evolution of public access to local government hearings and its related challenges have not been documented in a systematic way to encourage research and collaborative scholarship between practitioners and scholars. This article seeks to begin the dialogue by offering seven strategies for navigating access to public hearings in local government. In recent years, local governments have faced increasing pressure to keep pace with evolving technologies while balancing competing budget priorities and assuming a growing role in addressing policy issues that were previously the focus of state and national governments. The COVID‐19 pandemic context has presented further complexity. Left unaddressed, these challenges contribute to a widening gap between what is administratively sustainable versus politically acceptable. The strategies suggested address current challenges, attempt to bridge the gap between what is administratively sustainable and politically acceptable, and propose avenues for further study.

Impact of the COVID-19 pandemic on prehospital characteristics and outcomes of out-of-hospital cardiac arrest among the elderly in Japan: A nationwide study.

Aim: To assess the impact of the 2020 coronavirus disease (COVID-19) pandemic on the prehospital characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) in the elderly. Methods: In this population-based nationwide observational study in Japan, 563,100 emergency medical service-unwitnessed OHCAs in elderly (≥65 years) patients involving any prehospital resuscitation efforts were analysed (144,756, 140,741, 140,610, and 136,993 cases in 2020, 2019, 2018, and 2017, respectively). The epidemiology, characteristics, and outcomes associated with OHCAs in elderly patients were compared between 3 years pre-pandemic (2017-2019) and the pandemic year (2020). The primary outcome was neurologically favourable one-month survival. The secondary outcomes were the rate of bystander cardiopulmonary resuscitation (CPR), defibrillation by a bystander, dispatcher-assisted (DA)-CPR attempts, and one-month survival. Results: During the pandemic year, the rates of neurologically favourable 1-month survival (crude odds ratio, 95% confidence interval: 1.19, 1.14-1.25), bystander CPR (1.04, 1.03-1.06), and DA-CPR attempts (1.10, 1.08-1.11) increased, whereas the incidence of public access defibrillation (0.88, 0.83-0.93) decreased. Subgroup analyses based on interaction tests showed that the increased rate of neurologically favourable survival during the pandemic year was enhanced in OHCA at care facilities (1.51, 1.36-1.68) and diminished or abolished on state-of-emergency days (0.90, 0.74-1.09), in the mainly affected prefectures (1.08, 1.01-1.15), and in cases with shockable initial rhythms (1.03, 0.96-1.12). Conclusions: The COVID-19 pandemic increased the bystander CPR rate in association with enhanced DA-CPR attempts and improved the outcomes of elderly patients with OHCAs.

The value of sick pay

Not all countries provide universal access to publicly funded paid sick pay. Amongst countries that do, compensation rates can be low and coverage incomplete. This leaves a significant role for employer-provided paid sick pay in many countries. In this paper, we study who has access to employer-provided sick pay and how much it is valued by workers for themselves and others. We find that workers in jobs with high contact to others are particularly unlikely to have employer provided sick pay, as are economically insecure workers who are least able to afford unpaid time off work. We find that workers without sick pay are more likely to say that they will work when experiencing cold-like symptoms and are less willing to expose themselves to health risks at work during the pandemic. Using vignettes, we reveal that large shares of workers have a very high, but even more have a very low willingness to sacrifice earnings for access to sick pay. Together our findings highlight the unequal distribution of access to sick pay and the potentially strong negative externalities of not providing it publicly. The pandemic may have made these issues more salient as perceived probabilities of having to self-isolate are positively related to support for publicly provided sick pay. Finally, we find that providing information on the health externality of paid sick leave increases support for the public provision of sick pay, suggesting that there might be a public under-provision because individuals do not factor in the externalities. © 2022 The Authors

Mobile Hand Gesture Controlled Application using Transfer Learning

An increasing number of companies move to a touchless user interface, partly because of the pandemic's impact and the restricted rules of using public access objects. The market for Zero User Interface is increasing and industrial implementations are growing and promising. Currently, the knowledge of keeping yourself healthy and clean is essential to prevent the spread of Covid-19 disease. A proposed project - a hand gesture-controlled application to properly guide the user through the handwashing process can increase the overall level of hygiene in public. The solution is realized with a transfer learning method based on EfficientNet Lite models making it possible to run on Android, iOS, embedded Linux devices, and microcontrollers. © 2022 IEEE.

Small Magnitude Events Highlight the Correlation Between Hydraulic Fracturing Injection Parameters, Geological Factors, and Earthquake Occurrence

Hydraulic fracturing (HF) operations are widely associated with induced seismicity in the Western Canadian Sedimentary Basin. This study correlates injection parameters of 12,903 HF stages in the Kiskatinaw area in northeast British Columbia with an enhanced catalog containing 40,046 earthquakes using a supervised machine learning approach. It identifies relevant combinations of geological and operational parameters related to individual HF stages in efforts to decipher fault activation mechanisms. Our results suggest that stages targeting specific geological units (here, the Lower Montney formation) are more likely to induce an earthquake. Additional parameters positively correlated with earthquake likelihood include target formation thickness, injection volume, and completion date. Furthermore, the COVID‐19 lockdown may have reduced the potential cumulative effect of HF operations. Our results demonstrate the value of machine learning approaches for implementation as guidance tools that help facilitate safe development of unconventional energy technologies.Alternate :Plain Language SummaryHydraulic fracturing (HF), a technique used in unconventional energy production, increases rock permeability to enhance fluid movement. Its use has led to an unprecedented increase of associated earthquakes in the Western Canadian Sedimentary Basin in the last decade, among other regions. Numerous studies have investigated the relationship between induced earthquakes and HF operations, but the connection between specific geological and operational parameters and earthquake occurrence is only partly understood. Here, we use a supervised machine learning approach with publicly available injection data from the British Columbia Oil and Gas Commission to identify influential HF parameters for increasing the likelihood of a specific operation inducing an earthquake. We find that geological parameters, such as the target formation and its thickness, are most influential. A small number of operational parameters are also important, such as the injected fluid volume and the operation date. Our findings demonstrate an approach with the potential to develop tools to help enable the continued development of alternative energy technology. They also emphasize the need for public access to operational data to estimate and reduce the hazard and associated risk of induced seismicity.

Public-access defibrillation and favorable neurological outcome after out-of-hospital cardiac arrest during the COVID-19 pandemic in Japan.

BACKGROUND: Early public-access defibrillation (PAD) effectively improves the outcomes of out-of-hospital cardiac arrests (OHCA), but several strategies implemented to prevent the spread of coronavirus disease 2019 (COVID-19) could decrease the availability of PAD and worsen outcomes after OHCA. Previous studies have reported conflicting findings, and there is a paucity of nationwide observations. This study aims to investigate the impact of COVID-19 on PAD and OHCA outcomes using a nationwide OHCA registry in Japan, where PAD is well-documented. METHODS: This secondary analysis of the All-Japan Utstein Registry, a prospective population-based nationwide registry of OHCA patients, included patients aged ≥ 18 years with bystander-witnessed OHCA and an initial shockable rhythm who were transported to medical facilities between January 1, 2005, and December 31, 2020. The analytical parameters of this study were the proportion of patients who underwent PAD and patients with one-month survival with favorable neurological outcomes, defined as a cerebral performance category score of 1 or 2. We compared the data between 2019 and 2020 using a multivariable logistic regression analysis. RESULTS: During the study period, 1,930,273 OHCA patients were registered; of these, 78,302 were eligible for the analysis. Before the COVID-19 pandemic, the proportion of OHCA patients who underwent PAD and demonstrated favorable neurological outcomes increased gradually from 2005 to 2019 (P for trend < 0.001). The proportion of patient who had PAD were 17.7% (876/4959) in 2019 and 15.1% (735/4869) in 2020, respectively. The proportion of patient who displayed favorable neurological outcomes were 25.1% (1245/4959) in 2019 and 22.8% (1109/4869) in 2020, respectively. After adjusting for potential confounders, a significant reduction in the proportion of PAD was observed compared to that in 2019 (adjusted odds ratio [AOR], 0.86; 95% confidence interval [CI], 0.76-0.97), while no significant reduction was observed in favorable neurological outcomes (AOR, 0.97; 95% CI 0.87-1.07). CONCLUSION: The proportion of PAD clearly decreased in 2020, probably due to the COVID-19 pandemic in Japan. In contrast, no significant reduction was observed in favorable neurological outcomes.

Measuring Library Broadband Networks to Address Knowledge Gaps and Data Caps

In this paper, we present findings from a three-year research project funded by the US Institute of Museum and Library Services that examined how advanced broadband measurement capabilities can support the infrastructure and services needed to respond to the digital demands of public library users across the US. Previous studies have identified the ongoing broadband challenges of public libraries while also highlighting the increasing digital expectations of their patrons. However, few large-scale research efforts have collected automated, longitudinal measurement data on library broadband speeds and quality of service at a local, granular level inside public libraries over time, including when buildings are closed. This research seeks to address this gap in the literature through the following research question: How can public libraries utilize broadband measurement tools to develop a better understanding of the broadband speeds and quality of service that public libraries receive? In response, quantitative measurement data were gathered from an open-source broadband measurement system that was both developed for the research and deployed at 30 public libraries across the US. Findings from our analysis of the data revealed that Ookla measurements over time can confirm when the library's internet connection matches expected service levels and when they do not. When measurements are not consistent with expected service levels, libraries can observe the differences and correlate this with additional local information about the causes. Ongoing measurements conducted by the library enable local control and monitoring of this vital service and support critique and interrogation of the differences between internet measurement platforms. In addition, we learned that speed tests are useful for examining these trends but are only a small part of assessing an internet connection and how well it can be used for specific purposes. These findings have implications for state library agencies and federal policymakers interested in having access to data on observed versus advertised speeds and quality of service of public library broadband connections nationwide.

Public Access to Online Hearings

The shift to online hearings in many jurisdictions generated new avenues for public access but also raised concerns for the privacy and security of individuals, and for the administration of justice. [...]the conditions for accessing those hearings should reflect the different concerns that arise at the trial and appellate levels. [...]courts should strive to harmonize their approach to make it easier for members of the public to navigate the justice system. [...]the second aspect of the open court principle is the presumptive accessibility of court information, including court records as well as hearing schedules, procedures, and decisions, also called "information transparency.

Impact of the COVID-19 Pandemic on Prehospital Intervention and Survival of Patients With Out-of-Hospital Cardiac Arrest in Osaka City, Japan.

BACKGROUND: The coronavirus disease (COVID-19) pandemic may have influenced the prehospital emergency care and deaths of individuals experiencing an out-of-hospital cardiac arrest (OHCA).Methods and Results: We analyzed the registry data of 2,420 and 2,371 OHCA patients in Osaka City, Japan in 2019 and 2020, respectively, according to the 3 waves of the COVID-19 pandemic. Patient outcomes were compared using multivariable logistic regression analyses with the 2019 data as the reference. Bystander cardiopulmonary resuscitation (CPR) was initiated significantly less frequently in 2020 than in 2019 (2019: 48.0%, 2020: 42.7%, P<0.001), particularly during the first wave (2019: 47.2%, 2020: 42.9%, P=0.046) and second wave (2019: 48.1%, 2020: 41.2%, P=0.010), but not during the third wave (2019: 49.2%, 2020: 44.1%, P=0.066). The public-access automated external defibrillator was less frequently applied during the first wave (2019: 12.6%, 2020: 9.9%, P=0.043), with no significant difference during the second wave (2019: 12.5%, 2020: 12.8%, P=0.863) and third wave (2019: 13.7%, 2020: 13.0%, P=0.722). There was a significant difference in 1-month survival with favorable neurological outcomes (2019: 4.6%, 2020: 3.3%, P=0.018), with a 28% reduction in the adjusted odds ratio in 2020 (0.72; 95% confidence interval: 0.52-0.99, P=0.044). CONCLUSIONS: Bystander CPR and neurologically favorable outcomes after OHCA decreased significantly during the COVID-19 pandemic in Japan.

White House says US public must have free and immediate access to government funded research

Previous policy allowed such research to remain behind journal paywalls for a year after publication—in effect, a one year embargo before the public gained free access.1 Alondra Nelson, head of the White House Office of Science and Technology Policy, said, “The American people fund tens of billions of dollars of cutting edge research annually. To support scientific and research integrity, public access policies should transparently inform the public about critical information, said the White House statement, “including that which is related to the authorship, funding, affiliations, and development status of federally funded research.” Statement from Shelley Husband, senior vice president, government affairs, AAP, on decision by the White House Office of Science and Technology Policy to make private sector publications freely available. 25 Aug 2022. https://publishers.org/news/statement-from-shelley-husband-senior-vice-president-government-affairs-association-of-american-publishers-on-decision-by-white-house-office-of-science-and-techno 3 Nelson A, Executive Office of the President, Office of Science and Technology Policy.

Government Patent Use to Promote Public Health in the United States: Overcoming Nonpatent Exclusivities

GOVERNMENT PATENT USE One way to facilitate public access to high-cost medications is through government patent use.1 Given sovereign immunity-a legal doctrine immunizing the government from being sued without its consent-the federal government and its agents, such as generic drug manufacturers, have the ability to make or use patented inventions without the permission of the patent holder;in other words, protected by sovereign immunity, the federal government could use inventors' US patents without legal consequence (US patent rights do not apply overseas). [...]nonpatent exclusivities generally prohibit the approval of competing products only if they rely on data generated by another manufacturer. [...]the government or any third party could submit full new drug applications with original data.1,2 This strategy would not be able to circumvent Orphan Drug Act exclusivity for rare disease drugs because that act blocks the FDA from approving the "same drug" for the same disease or condition if it is a generic;however, because full trials would be needed, it might be feasible to pursue approval of a chemically distinct but therapeutically identical drug. [...]many agency actions are judicially reviewable under the Administrative Procedure Act (1946, Pub L No. 79-404)-a statute that waives the federal government's sovereign immunity. Fourth, Congress could amend the Federal Food, Drug, and Cosmetic Act (1938, Pub L No. 75-717) and the Public Health Service Act (1944, Pub L No. 78-410) to carve out exceptions to existing nonpatent exclusivities for government use.1,8 Although an exception exists for biologics the Public Health Service prepares when the biologic is unavailable from the license holder,9 this kind of authority could be expanded in terms of both to whom and to what it applies as well as under what conditions.

Every fifth published metagenome is not available to science

Have you ever sought to use metagenomic DNA sequences reported in scientific publications? Were you successful? Here, we reveal that metagenomes from no fewer than 20% of the papers found in our literature search, published between 2016 and 2019, were not deposited in a repository or were simply inaccessible. The proportion of inaccessible data within the literature has been increasing year-on-year. Noncompliance with Open Data is best predicted by the scientific discipline of the journal. The number of citations, journal type (e.g., Open Access or subscription journals), and publisher are not good predictors of data accessibility. However, many publications in high–impact factor journals do display a higher likelihood of accessible metagenomic data sets. Twenty-first century science demands compliance with the ethical standard of data sharing of metagenomes and DNA sequence data more broadly. Data accessibility must become one of the routine and mandatory components of manuscript submissions—a requirement that should be applicable across the increasing number of disciplines using metagenomics. Compliance must be ensured and reinforced by funders, publishers, editors, reviewers, and, ultimately, the authors.

A Long View of Change in Caring for Historic House Interiors: from Housekeeping to Preventive Conservation, Collections Care and Beyond

The care of historic interiors in the U.K. and abroad has evolved over many centuries, from historic housekeeping documented in early manuscripts, to preventive conservation, collections care and management widely practised in museums today. This paper takes a long view of this evolution, considering the causes and instigators of change in approaches taken by public institutions and private owners of historic collections. The influence of increasing professionalisation of the heritage sector and of statutory concern for the care of items of national interest is reviewed, and practice compared in the private and public spheres, to consider the future for conservation housekeeping.

Decentralising Data Collection and Centralising Information in the People's Republic of China: Decentralise, Manage, and Service Reforms

Xi Jinping's ascent to power as Chairman of the Chinese Communist Patty (CCP) was accompanied by changes in national governance strategies in the People's Republic of China (PRC) that have progressively incorporated the use of big data. Shortly after, in May 2015, the Chinese State Council released a set of policy reforms under the abbreviation fang guan fu í&iřlM (decentralise, manage, and service). These reforms promoted big data led (1) market regulation, (2) supervision and management systems, and (3) service provision processes. By applying a case study analytical approach, this paper explores how advancements in big data contributed to these reforms aimed at centralising information in China. Combining the joint knowledge of surveillance and China studies scholarship, this paper offers evidence of big data surveillance streamlining China's fragmented intergovernmental policy system. We build on David Murakami Wood's 2017 outline of a political theory of surveillance and argue that decentralisation of data collection points and centralisation of both bureaucratic and public access to information are keycomponents of the Party-states regulatory governance strategy- incorporating the use of big data and comprehensive surveillance. Our findings have implications for future analyses of the relationship between political organisations and surveillance within other nation-state contexts, particularly in situations where Chinese technologies and systems are being adopted and adapted.

Biometrically Trusted Personal Health Status for Pandemic Management

Undoubtedly COVID-19 is one of the most disruptive pandemics in recent history, adversely affecting individuals, societies, and economies through severe limitations imposed on activities involving gatherings and travel. Among many tools envisioned in battling such pandemics are immunity passports allowing vaccinated or immune individuals to bypass the restrictive measures. However, this proposal also raises many security, privacy, and ethical issues. Due to the sensitive medical records, companies and recreation centres do not have direct access to the COIVD vaccine database;on the other hand, the vaccine results are easily forgeable. One solution is public access to the vaccination database, which is not acceptable for privacy reasons. Our solution securely combines the vaccination results with the user's biometric authentication result to generate a binary result, such that 0 means this person either not authenticated or not vaccinated, and 1 means this person is vaccinated and authenticated so he/she may use an intended service. Our scheme is based on Secure MultiParty Computations (MPC) and preserves both the privacy of the biometric query and the database. At the same time, it also prevents the inquiring service provider from learning about the vaccination result. © 2021 IEEE.

Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose

Opioid use disorder is a well-established and growing problem in the United States. It is responsible for both psychosocial and physical damage to the affected individuals with a significant mortality rate. Given both the medical and non-medical consequences of this epidemic, it is important to understand the current treatments and approaches to opioid use disorder and acute opioid overdose. Naloxone is a competitive mu-opioid receptor antagonist that is used for the reversal of opioid intoxication. When given intravenously, naloxone has an onset of action of approximately 2 min with a duration of action of 60–90 min. Related to its empirical dosing and short duration of action, frequent monitoring of the patient is required so that the effects of opioid toxicity, namely respiratory depression, do not return to wreak havoc. Nalmefene is a pure opioid antagonist structurally similar to naltrexone that can serve as an alternative antidote for reversing respiratory depression associated with acute opioid overdose. Nalmefene is also known as 6-methylene naltrexone. Its main features of interest are its prolonged duration of action that surpasses most opioids and its ability to serve as an antidote for acute opioid overdose. This can be pivotal in reducing healthcare costs, increasing patient satisfaction, and redistributing the time that healthcare staff spend monitoring opioid overdose patients given naloxone.

Welcome to the revolution: COVID-19 and the democratization of spatial-temporal data.

On January 22, 2020, Johns Hopkins University launched its online COVID-19 dashboard to track in real time what began in December as the regional outbreak of a novel coronavirus first identified in Wuhan, China. The dashboard and its format were quickly adopted by other organizations, making global, national, and regional data on the pandemic available to all. The wealth of data freely offered in this way was collected by syndromic programs whose precise algorithms search official and popular sources for data on COVID-19 and other diseases. The dashboard signals a new phase in the maturation of the "digital revolution" from paper resources and, in their popular employ, a "democratizion" of data and their presentation. This perspective thus uses the COVID-19 experience as an example of the effect of this digital revolution on both expert and popular audiences. Understanding it permits a broader perspective on not simply the pandemic but also the cultural and socioeconomic context in which it has occurred.

Public defibrillator accessibility and mobility trends during the COVID-19 pandemic in Canada.

INTRODUCTION: The COVID-19 pandemic has led to closures of non-essential businesses and buildings. The impact of such closures on automated external defibrillator (AED) accessibility compared to changes in foot traffic levels is unknown. METHODS: We identified all publicly available online AED registries in Canada last updated May 1, 2019 or later. We mapped AED locations to location types and classified each location type as completely inaccessible, partially inaccessible, or unaffected based on government-issued closure orders as of May 1, 2020. Using location and mobility data from Google's COVID-19 Community Mobility Reports, we identified the change in foot traffic levels between February 15-May 1, 2020 (excluding April 10-12) compared to the baseline of January 3-February 1, 2020, and determined the discrepancy between foot traffic levels and AED accessibility. RESULTS: We identified four provincial and two municipal AED registries containing a total of 5848 AEDs. Of those, we estimated that 69.9% were completely inaccessible, 18.8% were partially inaccessible, and 11.3% were unaffected. Parks, retail and recreation locations, and workplaces experienced the greatest reduction in AED accessibility. The greatest discrepancies between foot traffic levels and AED accessibility occurred in parks, retail and recreation locations, and transit stations. CONCLUSION: A majority of AEDs became inaccessible during the COVID-19 pandemic due to government-mandated closures. In a substantial number of locations across Canada, the reduction in AED accessibility was far greater than the reduction in foot traffic.