Digital Commons Network^™

Adaptive Regulation For Ecosystem Restoration: A Context For Effective Environmental Permitting, Jennifer M. Auger

Antioch University Dissertations & Theses

This dissertation investigates the regulatory challenges faced by large-scale ecosystem restoration (LSER) projects by exploring the perspectives of practitioners and regulators. Focusing on the federal regulatory permitting process, the study aims to understand its impact on LSER projects and proposes the application of adaptive regulation for improvement. Employing Q methodology, participants expressed their views on 34 statements related to wetland permitting for LSER projects. Factor analysis revealed two distinct perspectives: Factor 1 emphasizes the reorganization of the permitting process within existing regulations, advocating for more documentation and structured processes. Factor 2 highlights the need for restructuring both the permitting process …

Time Allocation Pattern For Household And Expenditure Saving Market Activities By Using Economic Value Of Time: A Gender-Based Analysis In Pakistan, Hamna Nasir, Ambreen Fatima, Gulrukh Zahid

Business Review

The objective of this study is to estimate the opportunity cost of time spent on household work and expenditure saving market work performed by individuals by taking into account their personal and socio-demographic characteristics. Data is gathered from Labour Force Survey of Pakistan for different years. Pseudo panel technique is used by making cohorts of household and expenditure saving market activities, region and province. Increase in the opportunity cost of time increases female household work hours and expenditure saving market hours by 6.2 and 7.001 hours/week respectively, whereas increase in the opportunity cost of time increases male household hours and …

Endovenous Intervention: From The Legs To The Lungs, Guangming Tan, Bryan Py Yan

Journal of the Hong Kong College of Cardiology

Significant advancement in endovascular technology have enabled the treatment of a variety of venous diseases from the deep vein diseases to diseases in the pulmonary vasculatures. Understanding the principles and the limitations of these endovenous interventions is very important in selecting the appropriate patients for optimal clinical outcomes. In this review, the clinical evidence, guideline recommendations from various societies and the approaches to these endovenous procedures will be discussed.

The Clinical Outcomes Of Covid-19 Infection With Pre-Existing Heart Failure – A Scientific Review, Ka-Yi Chan, Hiu-Ching Chan, Calvin Ka-Lam Leung, Qing-Wen Ren, Kai-Hang Yiu

Journal of the Hong Kong College of Cardiology

The COVID-19 pandemic has caused major impact to our world in various aspects. Healthy individuals infected with COVID-19 often develop different complications, even more so for patients with medical comorbidities. Various reports and studies have suggested cardiovascular disease as one of the major comorbidities in patients with COVID, and COVID infection could be life threatening in patients with pre-existing heart diseases, such as heart failure. In view of such, we aim to review on the subset of COVID patients who have pre-existing heart failure, in terms of in-hospital mortality, delivery of in-patient care and in-hospital complications. In conclusion, heart failure …

Prediction Of Clinical Atrial Fibrillation By Cardiac Implantable Electronic Device Detected Atrial High Rate Episodes, Shek Joyce, Fung Chi Yan Raymond, Yuen Ho Chuen, Chan Ngai Yin, Yu Lok Man Ellen

Journal of the Hong Kong College of Cardiology

Background Current guidelines mainly address clinical atrial fibrillation and long Atrial Heart Rate Episodes (AHRE). This study focused on the clinical significance of incidental short AHRE detected by Cardiac Implantable Electronic Device (CIED).

Methods A single-centre retrospective observational study recruited patients from CIED clinic of Princess Margaret Hospital from 2015 to 2022, excluding patients with known clinical AF. The primary outcome was clinical AF and/or long AHRE more than 24 hours. Secondary outcomes included non-fatal stroke, admission for heart failure, myocardial infarction and death. AHRE+ vs AHRE- were compared using multivariate analysis, introducing AHRE duration as a time-dependent covariates. A …

Review On Molecular Genetic Basis Of Hypertrophic Cardiomyopathy, Derek Pok Him Lee

Journal of the Hong Kong College of Cardiology

Hypertrophic cardiomyopathy (HCM) is one of the most common types of inherited cardiomyopathy with a wide range of clinical manifestations ranging from subtle myocardial hypertrophy to debilitating heart failure, cardiac arrhythmias, and sudden cardiac death. We reviewed the literature on the latest knowledge regarding the pathophysiology and molecular genetic basis of HCM. This will include laboratory studies on animal models and human pluripotent stem-cell derived cardiomyocytes and the theory of proximal mechanisms involving calcium handling and energy expenditure underlying HCM. The current review will also illustrate the pathogenicity of various associated genetic variants, genotype-phenotype correlation and the optimal approach to …

Leadless Pacing In A Patient With Persistent Left Superior Vena Cava, Pedro Rocha Carvalho, José Paulo Fontes, Inês Silveira, José Ilídio Moreira

Journal of the Hong Kong College of Cardiology

We present the case of a 64-year-old male with complete atrioventricular block and unsuccessful traditional pacemaker lead implantation. Angiography confirmed a persistent left superior vena cava and atresia of the right vena cava draining into a dilated coronary vein. Subsequently, a leadless pacemaker was successfully implanted in the septal wall of the right ventricle, achieving optimal sensing and threshold values. This case highlights the challenges of anatomical anomalies in pacemaker implantation and the successful utilization of leadless pacemakers as an alternative. Awareness of such variations is crucial for decision-making and improved patient outcomes.

31st Annual Scientific Congress Of Hong Kong College Of Cardiology Proceedings

Journal of the Hong Kong College of Cardiology

No abstract provided.

Comparison Of Methods For Metabolite Extraction From Rat Polycystic Kidney Tissue For Gas Chromatography-Mass Spectrometry-Based Metabolomics, Matthew Oosthuizen

Theses: Doctorates and Masters

This study included a series of experiments focussed on comparing extraction protocols for metabolomics-based analysis of Lewis rat polycystic kidney (LPK) tissue samples and healthy Lewis rat tissue samples. Firstly, the optimal sample loading (mass of tissue) was investigated. Based on previous studies, the appropriate mass to test was approximately 5 mg. Three different volumes of tissue extract equivalent to 1, 2.5 and 5mg of pooled healthy kidney tissue and pooled polycystic kidney tissue were trialled to see how they differed in terms of the number of reproducible, uniquely identified peaks captured after metabolite extraction, derivatisation and gas chromatography-mass spectrometry …

Content And Frames Of ©Wechat And Chinese State Media - A Critical Literacy Reflection Of The Narratives During The Early Stage Of Covid-19 Pandemic, Zhe Jing

Theses: Doctorates and Masters

Governments back disruptive politics on the Internet platforms to influence people. During the global health crisis, because of the popularity and demographic penetration, ©WeChat is said to be one of these platforms. The influential dynamics, the circulated contents relevant to diasporic audiences and the app’s global users are yet to be contextually understood through the educational lens of critical literacy. This study is underpinned by a critical literacy reflective framework which synthesises components from several critical literacy practices: content and frame analysis, critical pedagogies, and specific literacy domain practices to provide guideline for the investigation. The findings demonstrate how state …

Woman-Centred Ethics: A Feminist Participatory Action Research, Katherine A. Buchanan

Theses: Doctorates and Masters

Background: The maternity system has a complexity of everyday ethical issues. The bioethical principles: non maleficence, beneficence justice and autonomy, that govern health care practice have been criticised as abstract, patriarchal and even rhetorical in maternity care practice (MacLellan, 2014) and consequently may be insufficient in guiding care of childbearing women. Midwifery-led care is guided by the International Confederation of Midwives International Code of Ethics, which considers more than the bioethical principles, such as the importance of relationship. Care ethics is a relational based feminist ethics first described by Gilligan (1983) and has been theorised as an alternate paradigm for …

Validity And Diagnostic Performance Of Computing Fractional Flow Reserve From 2-Dimensional Coronary Angiography Images, Vahid Mohammadi, Massoud Ghasemi, Reza Rahmani, Maryam Mehrpooya, Hamidreza Babakhani, Akbar Shafiee, Mohammad Sadeghian

The Texas Heart Institute Journal

BACKGROUND: Measurement of fractional flow reserve (FFR) is the gold standard for determining the physiologic significance of coronary artery stenosis, but newer software programs can calculate the FFR from 2-dimensional angiography images.

METHODS: A retrospective analysis was conducted using the records of patients with intermediate coronary stenoses who had undergone adenosine FFR (aFFR). To calculate the computed FFR, a software program used simulated coronary blood flow using computational geometry constructed using at least 2 patient-specific angiographic images. Two cardiologists reviewed the angiograms and determined the computational FFR independently. Intraobserver variability was measured using κ analysis and the intraclass correlation coefficient. …

Kounis Syndrome Associated With The Use Of Diclofenac, Ana V Pejcic, Milos N Milosavljevic, Slobodan Jankovic, Goran Davidovic, Marko M Folic, Nevena D Folic

The Texas Heart Institute Journal

BACKGROUND: Diclofenac is a widely used analgesic, anti-inflammatory, antipyretic drug. In several case reports, its use was associated with the occurrence of Kounis syndrome. The aim of this review was to investigate and summarize published cases of Kounis syndrome suspected to be associated with the use of diclofenac.

METHODS: Electronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Serbian Citation Index.

RESULTS: Twenty publications describing the 20 patients who met inclusion criteria were included in the systematic review. Specified patient ages ranged from 34 to 81 years. Eighteen (90.0%) patients were male. Five patients (25.0%) …

Biological Embedding Of Early Trauma: The Role Of Higher Prefrontal Synaptic Strength, Amanda J F Tamman, Lihong Jiang, Christopher L Averill, Graeme F Mason, Lynnette A Averill, Chadi G Abdallah

Staff and Researcher Publications

Background: Early trauma predicts poor psychological and physical health. Glutamatergic synaptic processes offer one avenue for understanding this relationship, given glutamate's abundance and involvement in reward and stress sensitivity, emotion, and learning. Trauma-induced glutamatergic excitotoxicity may alter neuroplasticity and approach/avoidance tendencies, increasing risk for psychiatric disorders. Studies examine upstream or downstream effects instead of glutamatergic synaptic processes in vivo, limiting understanding of how trauma affects the brain.Objective: In a pilot study using a previously published data set, we examine associations between early trauma and a proposed measure of synaptic strength in vivo in one of the largest human …

Care4ad: A Technology-Driven Platform For Care Coordination And Management: Acceptability Study In Dementia, Ram Kinker Mishra, Catherine Park, Anmol Salim Momin, Nesreen El Rafaei, Mark Kunik, Michele K York, Bijan Najafi

Center on Aging Staff Publications

Introduction: The technology-driven solution can reduce the caregiving burden; however, the needs of dementia caregiving are unique, and attitudes towards adopting technology from the perspectives of all the stakeholders involved in dementia caregiving are unclear. This study aims to assess the acceptability and feasibility of a technology-driven platform to facilitate care coordination platform, Care4AD, from the end-user perspective.

Methods: Care4AD includes three components: (1) Care4AD app: the app is used by caregivers to coordinate care, monitor physical activity, and schedule reminders; (2) Care4AD tablet: a smart tablet is used by the care recipient to display scheduled reminders; and (3) Care4AD …

Smart Offloading Boot System For Remote Patient Monitoring: Toward Adherence Reinforcement And Proper Physical Activity Prescription For Diabetic Foot Ulcer Patients, Catherine Park, Ramkinker Mishra, Davide Vigano, Maurizio Macagno, Stefano Rossotti, Karen D'Huyvetter, Jason Garcia, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Background: A critical factor in healing diabetic foot ulcers is patient adherence to offloading devices. We tested a smart offloading boot (SmartBoot) combined with a smartwatch app and cloud dashboard to remotely monitor patient adherence and activity. In addition, the impact of SmartBoot on balance, gait, and user experience was investigated.

Methods: Fourteen volunteers (31.6±8.7 years; 64% female) performed natural activities (eg, sitting, standing, walking) with and without the SmartBoot for approximately 30 minutes. All participants completed balance tests, 10-meter walking tests at slow, normal, and fast pace while wearing the SmartBoot, and a user experience questionnaire. The accuracy of …

Neurocognitive Correlates Of Cerebellar Volumetric Alterations In Youth With Pediatric Bipolar Spectrum Disorders And Bipolar Offspring, Kirti Saxena, Alessio Simonetti, Christopher D Verrico, Delfina Janiri, Marco Di Nicola, Antonello Catinari, Sherin Kurian, Johanna Saxena, Benson Mwangi, Jair C Soares

Faculty, Staff and Student Publications

BACKGROUND: Emerging evidence points towards the involvement of the cerebellum in the processing of emotions and pathophysiology of mood disorders. However, cerebellar and related cognitive alterations in youth with pediatric bipolar disorder (PBD) and those at high risk to develop the disorder, such as bipolar offspring (BD-OFF) are not clearly defined.

OBJECTIVE: To investigate cerebellar gray and white matter volumes, cognition, and their relationship in youth with PBD and BD-OFF.

METHODS: Thirty youth (7 to 17 years, inclusive) with PBD, 30 BD-OFF and 40 healthy controls (HC) were recruited. Study participants underwent a computer-based cognitive battery assessing affective processing, executive …

Neuroanatomical Correlates Of The Late Positive Potential In Youth With Pediatric Bipolar Disorder, Alessio Simonetti, Marijn Lijffijt, Sherin Kurian, Johanna Saxena, Delfina Janiri, Marianna Mazza, Giulio Carriero, Lorenzo Moccia, Benson Mwangi, Alan C Swann, Jair C Soares

Faculty, Staff and Student Publications

BACKGROUND: The late positive potential (LPP) could be a marker of emotion dysregulation in youth with pediatric bipolar disorder (PBD). However, the neuroanatomical correlates of the LPP are still not clarified.

OBJECTIVE: To provide cortical and deep gray matter correlates of the LPP in youth, specifically, youth with PBD.

METHODS: Twenty-four 7 to 17 years-old children with PBD and 28 healthy controls (HC) underwent cortical thickness and deep gray matter volumes measurements through magnetic resonance imaging and LPP measurement elicited by passively viewing emotional faces through electroencephalography. T-tests compared group differences in LPP, cortical thickness, and deep gray matter volumes. …

Development Of A Clinical Prediction Model For Diabetes In Chronic Pancreatitis: The Predict3c Study, Christie Jeon, Phil A Hart, Liang Li, Yunlong Yang, Eleanor Chang, Melena D Bellin, William E Fisher, Evan L Fogel, Christopher E Forsmark, Walter G Park, Stephen K Van Den Eeden, Santhi Swaroop Vege, Jose Serrano, David C Whitcomb, Dana K Andersen, Darwin L Conwell, Dhiraj Yadav, Mark O Goodarzi

Faculty, Staff and Student Publications

Objective: Diabetes that arises from chronic pancreatitis (CP) is associated with increased morbidity and mortality. Methods to predict which patients with CP are at greatest risk for diabetes are urgently needed. We aimed to examine independent risk factors for diabetes in a large cohort of patients with CP.

Research design and methods: This cross-sectional study comprised 645 individuals with CP enrolled in the PROCEED study, of whom 276 had diabetes. We conducted univariable and multivariable regression analyses of potential risk factors for diabetes. Model performance was assessed by area under the receiver operating characteristic curve (AUROC) analysis, and accuracy was …

Repair Of Complex Ovine Segmental Mandibulectomy Utilizing Customized Tissue Engineered Bony Flaps, Emma Watson, Hannah A Pearce, Katie J Hogan, Natasja W M Van Dijk, Mollie M Smoak, Sergio Barrios, Brandon T Smith, Alexander M Tatara, Timothy C Woernley, Jonathan Shum, Craig B Pearl, James C Melville, Tang Ho, Issa A Hanna, Nagi Demian, Jeroen J J P Van Den Beucken, John A Jansen, Mark E Wong, Antonios G Mikos

Faculty, Staff and Student Publications

Craniofacial defects require a treatment approach that provides both robust tissues to withstand the forces of mastication and high geometric fidelity that allows restoration of facial architecture. When the surrounding soft tissue is compromised either through lack of quantity (insufficient soft tissue to enclose a graft) or quality (insufficient vascularity or inducible cells), a vascularized construct is needed for reconstruction. Tissue engineering using customized 3D printed bioreactors enables the generation of mechanically robust, vascularized bony tissues of the desired geometry. While this approach has been shown to be effective when utilized for reconstruction of non-load bearing ovine angular defects and …

Editorial: Advances In The Biological Effects Of Ionizing Radiation, Fada Guan, Lina Zhao, Julianna K Bronk, Mirjana Maletic-Savatic, David R Grosshans, David J Carlson

Faculty, Staff and Student Publications

No abstract provided.

Mitral Valve Surgery In Patients With An Implanted Amplatzer Septal Occluder: A Review Of 2 Cases, Ufuk Sayar, Nurel Ertürk

The Texas Heart Institute Journal

Surgical approaches for mitral valve exploration vary, with the preferred approach being via the interatrial groove. Data on whether the interatrial groove approach can be used for mitral valve surgery in patients with a previously implanted Amplatzer septal occluder (ASO) (St Jude Medical, an Abbott company) are extremely limited. The authors performed mitral valve surgery using the transatrial septal approach on 2 patients following explantation of an ASO, which significantly impedes the interatrial groove approach. Concomitant surgical procedures with mitral valve replacement, removal of the ASO, and closure of an atrial septal defect with a patch significantly prolonged the cross-clamp …

Surgical Reconstruction Of The Anomalous Left Coronary Artery From The Pulmonary Artery, Slobodan Micovic, Petar Milacic, Miroslav Milicic, Milica Brkovic, Petar Vukovic, Igor Zivkovic

The Texas Heart Institute Journal

The anomalous left coronary artery from the pulmonary artery is a rare congenital disease. Early surgical reconstruction is mandatory to prevent adverse cardiac events. Direct coronary button transfer, vein graft interposition, ligation, and coronary artery bypass construction are the most commonly used techniques. This case report presents a modified technique of Dacron graft interposition and reimplantation anomalous left coronary artery from the pulmonary artery on the ascending aorta.

Is It Time To Switch To Bivalirudin For Ecmo Anticoagulation?, Amir Navaei, Vadim Kostousov, Jun Teruya

Faculty, Staff and Students Publications

For decades, unfractionated heparin (hereafter, heparin) has been the primary anticoagulant used for extracorporeal membrane oxygenation (ECMO) support. More recently, however, bivalirudin, a direct thrombin inhibitor, has emerged as an alternative. This systematic review based on PRISMA guidelines, aims to summarize 16 comparative studies and 8 meta-analysis and review articles published from January, 2011 till May, 2023 which directly compares ECMO courses using heparin versus bivalirudin as the anticoagulant. While this comparison is complicated by the lack of a standardized definition of major bleeding or thrombosis, our overall findings suggest there is no statistical difference between heparin and bivalirudin in …

The Gastrointestinal-Brain-Microbiota Axis: A Promising Therapeutic Target For Ischemic Stroke, Yan-Hao Wei, Ren-Tang Bi, Yan-Mei Qiu, Chun-Lin Zhang, Jian-Zhuang Li, Ya-Nan Li, Bo Hu

Faculty, Staff and Student Publications

Ischemic stroke is a highly complex systemic disease characterized by intricate interactions between the brain and gastrointestinal tract. While our current understanding of these interactions primarily stems from experimental models, their relevance to human stroke outcomes is of considerable interest. After stroke, bidirectional communication between the brain and gastrointestinal tract initiates changes in the gastrointestinal microenvironment. These changes involve the activation of gastrointestinal immunity, disruption of the gastrointestinal barrier, and alterations in gastrointestinal microbiota. Importantly, experimental evidence suggests that these alterations facilitate the migration of gastrointestinal immune cells and cytokines across the damaged blood-brain barrier, ultimately infiltrating the ischemic brain. …

Early Detection Of Mandible Osteoradionecrosis Risk In A High Comorbidity Veteran Population, David Chamberlayne Wilde, Sagar Kansara, Logan Banner, Rickey Morlen, David Hernandez, Andrew Tsao Huang, Weiyuan Mai, Clifton David Fuller, Stephen Lai, Vlad Constantin Sandulache

Faculty, Staff and Student Publications

OBJECTIVE: Osteoradionecrosis (ORN) of the mandible is a devastating complication of external beam radiation therapy (EBRT) for head and neck squamous cell carcinoma (HNSCC). We sought to ascertain ORN risk in a Veteran HNSCC population treatment with definitive or adjuvant EBRT and followed prospectively.

STUDY DESIGN: Retrospective analysis of prospective cohort.

SETTING: Tertiary care Veterans Health Administration (VHA) medical center.

METHODS: Patients with HNSCC who initiated treatment at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) are prospectively tracked for quality of care purposes through the end of the cancer surveillance period (5 years post treatment completion). We retrospectively …

Trends In Disease Severity Among Critically Ill Children With Severe Acute Respiratory Syndrome Coronavirus 2: A Retrospective Multicenter Cohort Study In The United States, Catherine E Ross, Jeffrey P Burns, Anne V Grossestreuer, Pallav Bhattarai, Christine A Mckiernan, Jennifer D Franks, Sonja Lehmann, Jill L Sorcher, Matthew P Sharron, Kitman Wai, Haitham Al-Wahab, Konstantinos Boukas, Mark W Hall, George Ru, Anita I Sen, Hariprem R Rajasekhar, Lawrence C Kleinman, John K Mcguire, Amy S Arrington, Flor Munoz-Rivas, Christopher M Osborne, Lara S Shekerdemian

Faculty, Staff and Student Publications

OBJECTIVES: To describe trends in critical illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children over the course of the COVID-19 pandemic. We hypothesized that PICU admission rates were higher in the Omicron period compared with the original outbreak but that fewer patients needed endotracheal intubation.

DESIGN: Retrospective cohort study.

SETTING: This study took place in nine U.S. PICUs over 3 weeks in January 2022 (Omicron period) compared with 3 weeks in March 2020 (original period).

PATIENTS: Patients less than or equal to 21 years old who screened positive for SARS-CoV-2 infection by polymerase chain reaction or …

Dietary Behaviours During Covid-19 Among Households At Risk For Food Insecurity, Maha Almohamad, Allison Marshall, Jayna Markand Dave, Ru-Jye Chuang, Christine Markham, Shreela Sharma

Faculty, Staff and Student Publications

The objective of the present study was to examine associations between variables of COVID-19-related concerns and changes in fruit and vegetable (FV) consumption among a sample of participants from the Brighter Bites program at risk for food insecurity. Cross-sectional data were collected during April-June 2020 using a rapid-response survey to understand social needs, COVID-19-related concerns and diet-related behaviours among families with children participating in Brighter Bites (

Upregulation Of The Escrt Pathway And Multivesicular Bodies Accelerates Degradation Of Proteins Associated With Neurodegeneration, Ron Benyair, Sai Srinivas Panapakkam Giridharan, Pilar Rivero-Ríos, Junya Hasegawa, Emily Bristow, Eeva-Liisa Eskelinen, Merav D Shmueli, Vered Fishbain-Yoskovitz, Yifat Merbl, Lisa M Sharkey, Henry L Paulson, Phyllis I Hanson, Samarjit Patnaik, Ismael Al-Ramahi, Juan Botas, Juan Marugan, Lois S Weisman

Duncan NRI Faculty and Staff Publications

Many neurodegenerative diseases, including Huntington’s disease (HD) and Alzheimer’s disease (AD), occur due to an accumulation of aggregation-prone proteins, which results in neuronal death. Studies in animal and cell models show that reducing the levels of these proteins mitigates disease phenotypes. We previously reported a small molecule, NCT-504, which reduces cellular levels of mutant huntingtin (mHTT) in patient fibroblasts as well as mouse striatal and cortical neurons from an HdhQ111 mutant mouse. Here, we show that NCT-504 has a broader potential, and in addition reduces levels of Tau, a protein associated with Alzheimer’s disease, as well as other tauopathies. We …

Cerebellar Dysfunction In Rodent Models With Dystonia, Tremor, And Ataxia, Meike E Van Der Heijden, Roy V Sillitoe

Duncan NRI Faculty and Staff Publications

Dystonia is a movement disorder characterized by involuntary co- or over-contractions of the muscles, which results in abnormal postures and movements. These symptoms arise from the pathophysiology of a brain-wide dystonia network. There is mounting evidence suggesting that the cerebellum is a central node in this network. For example, manipulations that target the cerebellum cause dystonic symptoms in mice, and cerebellar neuromodulation reduces these symptoms. Although numerous findings provide insight into dystonia pathophysiology, they also raise further questions. Namely, how does cerebellar pathophysiology cause the diverse motor abnormalities in dystonia, tremor, and ataxia? Here, we describe recent work in rodents …