Medicine and Health Sciences Commons^™

Objective Estimation Of Tracheoesophageal Speech Quality, Yousef S Ettomi Ali

Electronic Thesis and Dissertation Repository

Speech quality estimation for pathological voices is becoming an increasingly important research topic. The assessment of the quality and the degree of severity of a disordered speech is important to the clinical treatment and rehabilitation of patients. In particular, patients who have undergone total laryngectomy (larynx removal) produce Tracheoesophageal (TE) speech. In this thesis, we study the problem of TE speech quality estimation using advanced signal processing approaches. Since it is not possible to have a reference (clean) signal corresponding to a given TE speech (disordered) signal, we investigate in particular the non-intrusive techniques (also called single-ended or blind approaches) …

Sodium-Glucose Cotransporter-2 Inhibitor Use And The Risk Of Acute Kidney Injury In Older Adults In Routine Clinical Practice: A Population-Based Cohort Study, Carina Iskander

Electronic Thesis and Dissertation Repository

Regulatory agencies warn about acute kidney injury (AKI) risk following sodium-glucose cotransporter-2 (SGLT2) inhibitor use. This population-based retrospective cohort study in Ontario, Canada quantified the 90-day AKI risk in older adults who were newly dispensed either SGLT2 inhibitors or dipeptidyl peptidase-4 (DPP4) inhibitors in an outpatient setting between 2015 and 2017. Risk ratios (RR) were obtained using modified Poisson regression and risk differences using binomial regression. Relative to new use of a DPP4 inhibitor, initiation of an SGLT2 inhibitor was associated with a lower 90-day risk of a hospital encounter with AKI: 216 events in 19,611 patients (1.10%) versus 388 …

Clinical Application Of 3d Ultrasound In Neonatal Intraventricular Hemorrhage, Priyanka Roy

Electronic Thesis and Dissertation Repository

Preterm neonates are at risk for intraventricular hemorrhage (IVH) and subsequent post-hemorrhagic hydrocephalus (PHH). A well-accepted interventional therapy for PHH is ventricular tap (VT). Permanent treatment, ventriculo peritoneal shunt surgery (VPS) is required in the case of some neonates under some conditions (weight, immunological status, CSF protein level) who receive multiple interventions. The objective of this study was to apply a 3D ultrasound system clinically to determine CSF volume within the ventricle, to guide the neurosurgeon regarding the amount of CSF should be removed during every intervention, which lateral ventricle is better to intervene and to predict the possibilities of …

Reliability And Validity Of Two Performance-Based Outcome Measures In Rehabilitation Following Total Knee Arthroplasty, Jennifer L. Van Bussel

Electronic Thesis and Dissertation Repository

Objectives: Performance-based outcome measures (PBOM) are suggested to evaluate change in function during rehabilitation after total knee arthroplasty (TKA). The purpose of this study was to evaluate the measurement properties of the 30-Second Chair Stand Test (30CST) and 10-Metre Walk Test (10MWT) in patients following TKA.

Methods: Eighty-three patients completed two PBOM on three occasions following surgery. Patients also completed the Western Ontario and McMaster Universities Osteoarthritis Index and Global Rating of Change (GRC).

Results: Intraclass correlation coefficients ranged from 0.82 to 0.96. The standard errors of measurement at 6 and 12 weeks postop, respectively, were: 30CST ±0.67 and ±0.79, …

Investigating The Effects Of Tissue-Specific Extracellular Matrix On The Adipogenic And Osteogenic Differentiation Of Human Adipose-Derived Stromal Cells Within Composite Hydrogel Scaffolds, Arthi Shridhar, Brian G. Amsden, Elizabeth R. Gillies, Lauren E. Flynn

Bone and Joint Institute

© Copyright © 2019 Shridhar, Amsden, Gillies and Flynn. While it has been postulated that tissue-specific bioscaffolds derived from the extracellular matrix (ECM) can direct stem cell differentiation, systematic comparisons of multiple ECM sources are needed to more fully assess the benefits of incorporating tissue-specific ECM in stem cell culture and delivery platforms. To probe the effects of ECM sourced from decellularized adipose tissue (DAT) or decellularized trabecular bone (DTB) on the adipogenic and osteogenic differentiation of human adipose-derived stem/stromal cells (ASCs), a novel detergent-free decellularization protocol was developed for bovine trabecular bone that complemented our established detergent-free decellularization protocol …

Voice Analysis With Iphones: A Low Cost Experimental Solution, Benjamin Van Der Woerd

Electronic Thesis and Dissertation Repository

Background:

Acoustic voice analysis requires a resource intensive setup, including a soundproof booth. This project evaluates smartphone microphone and recording environment impacts on voice sample collection for acoustic voice analysis. A proprietary analysis algorithm is presented for validation.

Methods:

Microphone and recording environment were evaluated using previously collected voice samples presented in four conditions to test two microphones and two recording environments. Prospective samples were used to test the proprietary algorithm, whereby samples were analyzed using this and Praat.

Results:

Microphone and recording environment had small, clinically unimportant impacts on most measurements. The proprietary algorithm reliably analyzed sustained vowels, with …

Is Sabr Cost-Effective In Oligometastatic Cancer? An Economic Analysis Of Sabr-Comet Randomized Trial, Yujie Chen

Electronic Thesis and Dissertation Repository

The phase II randomized study SABR-COMET demonstrated that in cancer patients with 1-5 oligometastatic lesions, stereotactic ablative radiotherapy (SABR) was associated with an improvement in both progression-free survival and overall survival compared to standard of care (SoC). SABR, however, is associated with higher costs and treatment-related toxicity. The objective of this study was to assess the cost-effectiveness of SABR versus SoC in patients with oligometastatic disease.

A time-dependent Markov model with five health states was constructed from the Canadian health care system perspective. Utility values and transition probabilities were derived from the SABR-COMET trial. Costs were obtained from the published …

Evaluating The Utility Of Protein Biomarker, S100a7, And Diagnostic Test, Straticyte, In Predicting The Progression Of Oral Dysplasia, Lachlan Mclean

Electronic Thesis and Dissertation Repository

Five-year survival of oral cancer has remained relatively unchanged despite advancements in treatment, mostly because diagnosis is often made at an advanced stage of disease. The progression of dysplasia to oral cancer often follows a stepwise progression. Histopathology is considered the ‘gold standard’ for diagnosing dysplasia and lesions at a high risk of progression to oral cancer, but lends itself to subjectivity. The protein biomarker, S100A7, in oral dysplasia and squamous cell carcinoma has shown some predictive value for the transformation of dysplasia to cancer. Straticyte, a diagnostic test utilizing S100A7 to predict the probability of progression of oral dysplasia …

Biomechanics Analysis Of Anterior Cortical Perforation In Antegrade Femoral Nailing, Michael Ching

Electronic Thesis and Dissertation Repository

Hip and femur fractures are a common problem in an aging population. The number of hip and femur fractures are on the rise in Canada. Cephalomedullary fixation is a common method of treating hip and femur fractures, with a known complication of anterior cortical perforation of the distal femur. The literature describes risk factors, such as the influence of the start point at the greater trochanter, but there is no consensus on management. Some cases are treated with restricted weightbearing and other cases with revision surgery. Restricted weightbearing increases perioperative complications including mortality and decreases functional outcomes.

We analyze the …

Preventive Strategies For Acute Kidney Injury Among Patients Undergoing Abdominal Aortic Aneurysm Repair, Michaela Fernandes

Electronic Thesis and Dissertation Repository

Strategies for preventing acute kidney injury (AKI) in patients undergoing abdominal aortic aneurysm (AAA) repair were explored in a secondary data analysis of 601 patients from a randomized controlled trial (RCT). Bivariate analyses identified an association between intraoperative hypotension and postoperative AKI and suggested IV fluids as the best treatment option over inotropes/vasopressors which increased the odds of AKI (OR_crude=2.5 95%CI 1.2-5.0), however, our multivariable analysis was non-significant (OR_adjusted=1.7 95%CI 0.8-3.7). Further analysis found angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker use within 24 hours prior to repair were not associated with postoperative AKI (OR …

Junctophilin-2 Protects Cardiomyocytes Against Palmitate-Induced Injury, Xiaoyun Ji

Electronic Thesis and Dissertation Repository

Cardiac lipotoxicity may induce cardiomyocyte apoptosis, eventually leading to myocardial dysfunction and heart failure. This study investigated whether and how junctophilin-2 (JPH2) plays a role in palmitate-induced apoptosis in cardiomyocytes. Here, we found palmitate incubation reduced JPH2 protein levels, increased cytosolic Ca²⁺ and induced apoptosis in cardiomyocytes. JPH2 over-expression prevented the increased cytosolic Ca²⁺ and apoptosis in palmitate-stimulated cardiomyocytes. JPH2 over-expression also attenuated palmitate-induced CCAAT-enhancer-binding protein homologous protein (CHOP) expression and CHOP deletion alleviated palmitate-induced apoptosis. Furthermore, blocking Ca²⁺ release from ryanodine receptor-2 (RyR2) prevented palmitate-stimulated CHOP induction and apoptosis. Additionally, JPH2 silencing elevated cytosolic Ca^{2+ …}

A Macaque Connectome For Large-Scale Network Simulations In Thevirtualbrain, Kelly Shen, Gleb Bezgin, Michael Schirner, Petra Ritter, Stefan Everling, Anthony R. Mcintosh

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s). Models of large-scale brain networks that are informed by the underlying anatomical connectivity contribute to our understanding of the mapping between the structure of the brain and its dynamical function. Connectome-based modelling is a promising approach to a more comprehensive understanding of brain function across spatial and temporal scales, but it must be constrained by multi-scale empirical data from animal models. Here we describe the construction of a macaque (Macaca mulatta and Macaca fascicularis) connectome for whole-cortex simulations in TheVirtualBrain, an open-source simulation platform. We take advantage of available axonal tract-tracing datasets and enhance the existing …

Predator-Induced Fear Causes Ptsd-Like Changes In The Brains And Behaviour Of Wild Animals, Liana Y. Zanette, Emma C. Hobbs, Lauren E. Witterick, Scott A. Macdougall-Shackleton, Michael Clinchy

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s). Predator-induced fear is both, one of the most common stressors employed in animal model studies of post-traumatic stress disorder (PTSD), and a major focus of research in ecology. There has been a growing discourse between these disciplines but no direct empirical linkage. We endeavoured to provide this empirical linkage by conducting experiments drawing upon the strengths of both disciplines. Exposure to a natural cue of predator danger (predator vocalizations), had enduring effects of at least 7 days duration involving both, a heightened sensitivity to predator danger (indicative of an enduring memory of fear), and elevated neuronal …

Consciousness-Specific Dynamic Interactions Of Brain Integration And Functional Diversity, Andrea I. Luppi, Michael M. Craig, Ioannis Pappas, Paola Finoia, Guy B. Williams, Judith Allanson, John D. Pickard, Adrian M. Owen, Lorina Naci, David K. Menon, Emmanuel A. Stamatakis

Brain and Mind Institute Researchers' Publications

Prominent theories of consciousness emphasise different aspects of neurobiology, such as the integration and diversity of information processing within the brain. Here, we combine graph theory and dynamic functional connectivity to compare resting-state functional MRI data from awake volunteers, propofol-anaesthetised volunteers, and patients with disorders of consciousness, in order to identify consciousness-specific patterns of brain function. We demonstrate that cortical networks are especially affected by loss of consciousness during temporal states of high integration, exhibiting reduced functional diversity and compromised informational capacity, whereas thalamo-cortical functional disconnections emerge during states of higher segregation. Spatially, posterior regions of the brain’s default mode …

Altered Motor, Anxiety-Related And Attentional Task Performance At Baseline Associate With Multiple Gene Copies Of The Vesicular Acetylcholine Transporter And Related Protein Overexpression In Chat::Cre+ Rats, Craig P. Mantanona, Johan Alsiö, Joanna L. Elson, Beth M. Fisher, Jeffrey W. Dalley, Timothy Bussey, Ilse S. Pienaar

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s). Transgenic rodents expressing Cre recombinase cell specifically are used for exploring mechanisms regulating behavior, including those mediated by cholinergic signaling. However, it was recently reported that transgenic mice overexpressing a bacterial artificial chromosome containing choline acetyltransferase (ChAT) gene, for synthesizing the neurotransmitter acetylcholine, present with multiple vesicular acetylcholine transporter (VAChT) gene copies, resulting in altered cholinergic tone and accompanying behavioral abnormalities. Since ChAT::Cre+ rats, used increasingly for understanding the biological basis of CNS disorders, utilize the mouse ChAT promotor to control Cre recombinase expression, we assessed for similar genotypical and phenotypical differences in such rats compared …

Are Specific Learning Disorders Truly Specific, And Are They Disorders?, Lien Peters, Daniel Ansari

Brain and Mind Institute Researchers' Publications

© 2019 The Authors Specific learning disorders, such as dyslexia and dyscalculia, are frequently studied to inform our understanding of cognitive development, genetic mechanisms and brain function. In this Opinion Paper, we discuss limitations of this research approach, including the use of arbitrary criteria to select groups of children, heterogeneity within groups and overlap between domains of learning. By drawing on evidence from cognitive science, neuroscience and genetics, we propose an alternative, dimensional framework. We argue that we need to overcome the problems associated with a categorical approach by taking into account interacting factors at multiple levels of analysis that …

Perseverance, Faith And Stoicism: A Qualitative Study Of Medical Student Perspectives On Managing Fatigue, Taryn S Taylor, Alexandra L Raynard, Lorelei Lingard

Obstetrics & Gynaecology Publications

CONTEXT: Fatigue risk management (FRM) strategies offer a potential solution to the widespread problem of fatigued trainees in the clinical workplace. These strategies assume a shared perception that fatigue is hazardous. Despite the growing body of evidence suggesting that fatigue leads to burnout and medical errors, previous research suggests that residents perceive fatigue as a personal, surmountable burden rather than an occupational hazard. Before we can implement FRM, we need a better understanding of when and how such problematic notions of fatigue are adopted by medical trainees. Thus, we sought to explore how third-year medical students understand and manage the …

Production Of Physician Services Under Fee-For-Service And Blended Fee-For-Service: Evidence From Ontario, Canada., Nibene H Somé, Rose Anne Devlin, Nirav Mehta, Greg Zaric, Lihua Li, Salimah Shariff, Bachir Belhadji, Amardeep Thind, Amit Garg, Sisira Sarma

Epidemiology and Biostatistics Publications

We examine family physicians' responses to financial incentives for medical services in Ontario, Canada. We use administrative data covering 2003-2008, a period during which family physicians could choose between the traditional fee for service (FFS) and blended FFS known as the Family Health Group (FHG) model. Under FHG, FFS physicians are incentivized to provide comprehensive care and after-hours services. A two-stage estimation strategy teases out the impact of switching from FFS to FHG on service production. We account for the selection into FHG using a propensity score matching model, and then we use panel-data regression models to account for observed …

Genome-Wide Association Analysis Of Hippocampal Volume Identifies Enrichment Of Neurogenesis-Related Pathways, Emrin Horgusluoglu-Moloch, Shannon L. Risacher, Paul K. Crane, Derrek Hibar, Paul M. Thompson, Andrew J. Saykin, Kwangsik Nho, Michael W. Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowki, Arthur W. Toga, Laurel Beckett, Robert C. Green, John Morris, Leslie M. Shaw, Jeffrey Kaye, Joseph Quinn, Lisa Silbert, Betty Lind, Raina Carter, Sara Dolen, Lon S. Schneider, Sonia Pawluczyk, Mauricio Beccera, Liberty Teodoro, Bryan M. Spann, James Brewer, Helen Vanderswag, Adam Fleisher

Medical Biophysics Publications

© 2019, The Author(s). Adult neurogenesis occurs in the dentate gyrus of the hippocampus during adulthood and contributes to sustaining the hippocampal formation. To investigate whether neurogenesis-related pathways are associated with hippocampal volume, we performed gene-set enrichment analysis using summary statistics from a large-scale genome-wide association study (N = 13,163) of hippocampal volume from the Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) Consortium and two year hippocampal volume changes from baseline in cognitively normal individuals from Alzheimer’s Disease Neuroimaging Initiative Cohort (ADNI). Gene-set enrichment analysis of hippocampal volume identified 44 significantly enriched biological pathways (FDR corrected p-value < 0.05), of which 38 pathways were related to neurogenesis-related processes including neurogenesis, generation of new neurons, neuronal development, and neuronal migration and differentiation. For genes highly represented in the significantly enriched neurogenesis-related pathways, gene-based association analysis identified TESC, ACVR1, MSRB3, and DPP4 as significantly associated with hippocampal volume. Furthermore, co-expression network-based functional analysis of gene expression data in the hippocampal subfields, CA1 and CA3, from 32 normal controls showed that distinct co-expression modules were mostly enriched in neurogenesis related pathways. Our results suggest that neurogenesis-related pathways may be enriched for hippocampal volume and that hippocampal volume may serve as a potential phenotype for the investigation of human adult neurogenesis.

Multimodal Hippocampal Subfield Grading For Alzheimer’S Disease Classification, Kilian Hett, Vinh Thong Ta, Gwenaëlle Catheline, Thomas Tourdias, José V. Manjón, Pierrick Coupé, Michael W. Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowki, Arthur W. Toga, Laurel Beckett, Robert C. Green, Andrew J. Saykin, John Morris, Leslie M. Shaw, Zaven Khachaturian, Greg Sorensen, Maria Carrillo, Lew Kuller, Marc Raichle, Steven Paul, Peter Davies, Howard Fillit, Franz Hefti, Davie Holtzman, M. Marcel Mesulam, William Potter, Peter Snyder, Tom Montine

Medical Biophysics Publications

© 2019, The Author(s). Numerous studies have proposed biomarkers based on magnetic resonance imaging (MRI) to detect and predict the risk of evolution toward Alzheimer’s disease (AD). Most of these methods have focused on the hippocampus, which is known to be one of the earliest structures impacted by the disease. To date, patch-based grading approaches provide among the best biomarkers based on the hippocampus. However, this structure is complex and is divided into different subfields, not equally impacted by AD. Former in-vivo imaging studies mainly investigated structural alterations of these subfields using volumetric measurements and microstructural modifications with mean diffusivity …

Mousebytes, An Open-Access High-Throughput Pipeline And Database For Rodent Touchscreen-Based Cognitive Assessment, Flavio H. Beraldo, Daniel Palmer, Sara Memar, David I. Wasserman, Wai Jane V. Lee, Shuai Liang, Samantha D. Creighton, Benjamin Kolisnyk, Matthew F. Cowan, Justin Mels, Talal S. Masood, Chris Fodor, Mohammed A. Al-Onaizi, Robert Bartha, Tom Gee, Lisa M. Saksida, Timothy J. Bussey, Stephen S. Strother, Vania F. Prado, Boyer D. Winters, Marco A.M. Prado

Medical Biophysics Publications

© 2019, eLife Sciences Publications Ltd. All rights reserved. Open Science has changed research by making data accessible and shareable, contributing to replicability to accelerate and disseminate knowledge. However, for rodent cognitive studies the availability of tools to share and disseminate data is scarce. Automated touchscreen-based tests enable systematic cognitive assessment with easily standardised outputs that can facilitate data dissemination. Here we present an integration of touchscreen cognitive testing with an open-access database public repository (mousebytes.ca), as well as a Web platform for knowledge dissemination (https://touchscreencognition.org). We complement these resources with the largest dataset of age-dependent high-level cognitive assessment of …

3d Vessel-Wall Virtual Histology Of Whole-Body Perfused Mice Using A Novel Heavy Element Stain, P. Joy Dunmore-Buyze, Charmainne Cruje, Zengxuan Nong, Jason J. Lee, John A. Kiernan, J. Geoffrey Pickering, Maria Drangova

Medical Biophysics Publications

Virtual histology – utilizing high-resolution three-dimensional imaging – is becoming readily available. Micro-computed tomography (micro-CT) is widely available and is often coupled with x-ray attenuating histological stains that mark specific tissue components for 3D virtual histology. In this study we describe a new tri-element x-ray attenuating stain and perfusion protocol that provides micro-CT contrast of the entire vasculature of an intact mouse. The stain – derived from an established histology stain (Verhoeff’s) – is modified to enable perfusion through the vasculature; the attenuating elements of the stain are iodine, aluminum, and iron. After a 30-minute perfusion through the vasculature (10-minute …

Comparison Of Quality Control Methods For Automated Diffusion Tensor Imaging Analysis Pipelines, Seyyed M.H. Haddad, Christopher J.M. Scott, Miracle Ozzoude, Melissa F. Holmes, Stephen R. Arnott, Nuwan D. Nanayakkara, Joel Ramirez, Sandra E. Black, Dar Dowlatshahi, Stephen C. Strother, Richard H. Swartz, Sean Symons, Manuel Montero-Odasso, Robert Bartha

Medical Biophysics Publications

© 2019 Haddad et al. The processing of brain diffusion tensor imaging (DTI) data for large cohort studies requires fully automatic pipelines to perform quality control (QC) and artifact/outlier removal procedures on the raw DTI data prior to calculation of diffusion parameters. In this study, three automatic DTI processing pipelines, each complying with the general ENIGMA framework, were designed by uniquely combining multiple image processing software tools. Different QC procedures based on the RESTORE algorithm, the DTIPrep protocol, and a combination of both methods were compared using simulated ground truth and artifact containing DTI datasets modeling eddy current induced distortions, …

The Bin1 Rs744373 Snp Is Associated With Increased Tau-Pet Levels And Impaired Memory, Nicolai Franzmeier, Anna Rubinski, Julia Neitzel, Michael Ewers, Michael W. Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowski, Arthur W. Toga, Laurel Beckett, Robert C. Green, Andrew J. Saykin, John Morris, Leslie M. Shaw, Zaven Khachaturian, Greg Sorensen, Lew Kuller, Marcus Raichle, Steven Paul, Peter Davies, Howard Fillit, Franz Hefti, David Holtzman, Marek M. Mesulam, William Potter, Peter Snyder, Adam Schwartz, Tom Montine, Ronald G. Thomas, Michael Donohue

Medical Biophysics Publications

© 2019, The Author(s). The single nucleotide polymorphism (SNP) rs744373 in the bridging integrator-1 gene (BIN1) is a risk factor for Alzheimer’s disease (AD). In the brain, BIN1 is involved in endocytosis and sustaining cytoskeleton integrity. Post-mortem and in vitro studies suggest that BIN1-associated AD risk is mediated by increased tau pathology but whether rs744373 is associated with increased tau pathology in vivo is unknown. Here we find in 89 older individuals without dementia, that BIN1 rs744373 risk-allele carriers show higher AV1451 tau-PET across brain regions corresponding to Braak stages II–VI. In contrast, the BIN1 rs744373 SNP was not associated …

Healthcare Utilization Costs Of Emerging Adults With Mood And Anxiety Disorders In An Early Intervention Treatment Program Compared To A Matched Cohort, Ava A. John-Baptiste, Lihua Li, Wanrudee Isaranuwatchai, Elizabeth Osuch, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: The First Episode Mood and Anxiety Disorder Program (FEMAP) provides treatment to emerging adults with mood and anxiety disorders in an accessible, youth-friendly environment. We sought to investigate FEMAP's impact on the costs of care.

METHODS: We conducted a retrospective observational study of one-year health service costs using linked administrative datasets to compare emerging adults treated at FEMAP (FEMAP users) to propensity-score matched controls (non-users). Costs from the perspective of the Ontario Ministry of Health and Long-Term Care, included drug benefit claims, inpatient, physician and ambulatory care services. We used bootstrapping to perform unadjusted comparisons between FEMAP users and …

Trends In Asthma Prevalence In Canadians, Asthma Course Trajectories In Children, And The Effect Of Maternal Gestational Diabetes Mellitus On The Risk Of Asthma In The Offspring, Sharifa Nasreen

Electronic Thesis and Dissertation Repository

Asthma causes substantial public health burden. An enhanced understanding of asthma burden, asthma course and identification of intervenable risk factor is warranted.

The objectives of this research were to: 1) examine the age, period and cohort effects on asthma prevalence among Canadian adults during 1994–2011 (manuscript one); 2) identify the trajectories of asthma exacerbation and their predictors in children with incident asthma (manuscript two); and 3) examine the effect of maternal gestational diabetes mellitus on the risk of asthma in offspring (manuscript three).

Longitudinal data from 13,616 individuals in the National Population Health Survey, household component were used to address …

An Exploration Of How Persons Requiring Hemodialysis Treatment Explain The Ways In Which Access To Transportation For Such Treatment Influences Their Overall Health., Navpreet Kamboj

Electronic Thesis and Dissertation Repository

The number of Canadians being treated for kidney failure has more than tripled in the last 20 years, making hemodialysis (HD) a more common and expensive treatment option. Individuals having in-center HD require access to transportation to and from an HD center on average three days a week for a total of six trips. Therefore, access to transportation is a vital component for sustaining the health and well-being of this population. The purpose of this interpretive descriptive qualitative study was to explore how persons requiring in-center HD treatment explain the ways in which access to transportation for such treatment influences …

Does An Acute Achilles Tendon Rupture Become A Patient's Achilles Heel In The Long-Term?, Michaela Cm Khan

Electronic Thesis and Dissertation Repository

It is unknown if deficits in the involved limb following acute Achilles tendon rupture (AATR) persist in the long-term, or differ between patients treated operatively or non-operatively. This study investigated 43 patients 15±1 years post-AATR from a previous randomized controlled trial (RCT) that compared operative and non-operative treatment. Structural characteristics in the Achilles tendon and surrounding musculature were assessed using magnetic resonance imaging. We also performed physical examinations and evaluated performance-based and patient-reported outcomes. Overall, there were substantial differences between the involved and uninvolved limbs in most outcomes. Some outcomes improved over time from the initial RCT to the final …

The Difference In A1c Of Children And Adolescents With Type 1 Diabetes Mellitus Using Carbohydrate Counting Compared To Those Using A Structured Meal Plan, Alia El Kubbe

Electronic Thesis and Dissertation Repository

Carbohydrate counting (CHO) is a nutrition education tool used by patients with type 1 diabetes mellitus (T1DM). The primary objective was to assess glycated hemoglobin (A1C) in participants with T1DM using CHO counting vs. those using a structured meal plan (SMP). The secondary objectives were to determine if BMI-for-age, parental income, parental involvement, and mothers’ educational level were associated with their children’s glycemic control. A cross sectional study was conducted, where participants aged 4-18 years, or their parents completed a survey. Total sample size was 88 participants (77 in the CHO counting group and 11 in the SMP group). There …

Saponin Penetration And Interactions With Membranes, Sarai Guerrero

Electronic Thesis and Dissertation Repository

The saponin QS21 has been used and studied for years as an adjuvant agent to improve vaccines for both humans and animals. However, how the saponin interacts with the membrane and itself remains poorly understood. We studied the QS21-A majority isomer using all-atom classical molecular dynamics simulations in model bilayers composed of cholesterol and either DOPC or DPPC. As this is one of the few computational studies on QS21-A, we had very few resources to compare our results to. Nevertheless, we were able to gain insight into possible configurations that QS21-A takes after penetration, the effect of the bilayer on …