Medicine and Health Sciences Commons^™

Mobilising Expertise And Resources To Close The Radiotherapy Gap In Cancer Care., D Rodin, J Longo, T Sherertz, M M Shah, O Balagun, N Wendling, Jacob Van Dyk, C N Coleman, M J Xu, S Grover

Oncology Publications

Closing the gap in cancer care within low- and middle-income countries and in indigenous and geographically isolated populations in high-income countries requires investment and innovation. This is particularly true for radiotherapy, for which the global disparity is one of the largest in healthcare today. New models and paradigms and non-traditional collaborations have been proposed to improve global equity in cancer control. We describe recent initiatives from within the radiation oncology community to increase access to treatment, build the low- and middle-income countries' radiation oncology workforce, mobilise more professionals from within high-income countries and raise awareness of the global need for …

Analysis Of Global Radiotherapy Needs And Costs By Geographic Region And Income Level., E Zubizarreta, Jacob Van Dyk, Y Lievens

Oncology Publications

Recent years have seen various reviews on the lack of access to radiotherapy often based on geographic regions of the world such as Africa, Asia Pacific, Europe, Latin America and North America. Countries are often defined by their national income per capita levels based on World Bank definitions of high income, upper middle income, lower middle income and low income. Within the world regions, there are significant variations in gross national income (GNI) per capita among the different countries, and even within similar income levels, large variations exist. This report presents the actual status of radiotherapy and analyses the current …

Staying Current In Your Field Of Interest: Tips For Aspiring Students As Researchers, Dor D. Abelman

Health Studies Publications

Undergraduate students are becoming increasingly involved in research. They already posses the skills required to make meaningful contributions to their field of interest. Some important components of their success relates to a student's ability to stay up to date in the research of their field, and to learn practical skills pertaining to the publishing process. This article hopes to help with this through presenting easy-to-follow summary tables and short paragraphs on tips for success. Topics include staying up to date in a practical way, getting involved, reaching out for help, and publication. For students, by students, this report is relatable …

Translational Study Of Liver Cancer And Hypertrophy: Translich, Mauro Enrique Tun Abraham

Electronic Thesis and Dissertation Repository

Abstract

Background: Associating liver partition with portal vein ligation for staged-hepatectomy (ALPPS) is a technique for inducing accelerated hypertrophy in patients with insufficient future liver remnant (FLR). It remains unknown whether this hypertrophy may lead to rapid cancer cell dissemination and/or alteration of immune cell/function reconstitution in the FLR. We aimed to determine if the rapid hypertrophy during ALPPS procedure results in more circulating tumour cell (CTCs) dissemination and whether the FLR remains immunologically competent in patients with CRLM.

Methods: In our prospective, observational, 2-arm study, we assessed the utility of CTCs as an evaluation tool for disease dissemination. Moreover, …

Characterization Of N-Butyl Cyanoacrylate (Nbca) Glue Polymerization For The Embolization Of Brain Arteriovenous Malformations (Avms), Bill H. Wang

Electronic Thesis and Dissertation Repository

Brain AVMs are abnormal connections between arteries and veins. Endovascular glue embolization with NBCA is an accepted form of treatment. The reported complication rates of NBCA embolization varies widely from 2-15%, and timing of polymerization plays a major role.

Polymerization time was measured for mixtures of lipiodol/NBCA of 50/50, 70/30, 60/40. The influence of pH, temperature and presence of biological catalysts on polymerization time was investigated in-vivo. PVA-C, silicone and endothelium surfaces were compared. High-speed video analysis of glue injection through a microcatheter was performed.

Polymerization rate increases with pH and temperature. A hydrophilic surface such as PVA-C better mimics …

Accuracy Requirements And Uncertainties In Radiotherapy: A Report Of The International Atomic Energy Agency., Debbie Van Der Merwe, Jacob Van Dyk, Brendan Healy, Eduardo Zubizarreta, Joanna Izewska, Ben Mijnheer, Ahmed Meghzifene

Oncology Publications

BACKGROUND: Radiotherapy technology continues to advance and the expectation of improved outcomes requires greater accuracy in various radiotherapy steps. Different factors affect the overall accuracy of dose delivery. Institutional comprehensive quality assurance (QA) programs should ensure that uncertainties are maintained at acceptable levels. The International Atomic Energy Agency has recently developed a report summarizing the accuracy achievable and the suggested action levels, for each step in the radiotherapy process. Overview of the report: The report seeks to promote awareness and encourage quantification of uncertainties in order to promote safer and more effective patient treatments. The radiotherapy process and the radiobiological …

Radiation Oncology Quality And Safety Considerations In Low Resource Settings: A Medical Physics Perspective, Jacob Van Dyk, Ahmed Meghzifene

Oncology Publications

The last few years have seen a significant growth of interest in the global radiation therapy crisis. Various organizations have quantified the need and are providing aid in support of addressing the shortfalls existing in many low-to-middle income countries (LMICs). With the tremendous demand for new facilities, equipment and personnel, it is very important to recognize the quality and safety challenges and to address them directly. An examination of publications on quality and safety in radiation therapy indicates a consistency in a number of the recommendations; however, these authoritative reports were generally based on input from high-resourced contexts. Here we …

A Non-Canonical Role For Choline Acetyltransferase In Chromatin Organization And The Response To Beta-Amyloid, Warren R. Winick-Ng

Electronic Thesis and Dissertation Repository

The three-dimensional structure of chromatin is essential for context-dependent regulation of gene expression in post-mitotic neurons. Chromosomal rearrangements have been observed in the aging brain, and proteins involved in chromatin organization have altered expression and/or localization in Alzheimer’s disease (AD). A human- and primate-specific transcript of choline acetyltransferase produces an 82-kDa protein (82-kDa ChAT) that is localized to the nucleus of cholinergic neurons, but is found in the cytoplasm in individuals with mild cognitive impairment (MCI) and AD. The function of the 82-kDa ChAT protein is unknown, though recent evidence suggests it has a role in gene expression changes in …

Multi-Nuclear Magnetic Resonance Imaging Of Obstructive Lung Disease, Khadija Sheikh

Electronic Thesis and Dissertation Repository

Obstructive lung diseases such as chronic-obstructive-lung-disease (COPD), bronchiectasis, and asthma are characterized by airflow obstruction. They affect over six million Canadians costing the economy $12 billion/year. Despite decades of research, therapies that modify obstructive-lung-disease progression and control are lacking because patient diagnosis, monitoring, and response to therapy are currently made using airflow measurements that may conceal the independent contributions of underlying pathologies. One goal of obstructive-lung-disease research is to develop ways to identify patients with specific underlying pathological phenotypes to improve patient care and outcomes. Thoracic computed-tomography (CT) and magnetic-resonance-imaging (MRI) provide ways to regionally identify the underlying pathologies associated …

The Serotonin Transporter Promoter Polymorphism Moderates The Continuity Of Behavioral Inhibition In Early Childhood., Victoria C Johnson, Katie R Kryski, Haroon I Sheikh, Heather J Smith, Shiva M Singh, Elizabeth P Hayden

Brain and Mind Institute Researchers' Publications

Persistently elevated behavioral inhibition (BI) in children is a marker of vulnerability to psychopathology. However, little research has considered the joint influences of caregiver and child factors that may moderate the continuity of BI in early childhood, particularly genetic variants that may serve as markers of biological plasticity, such as the serotonin transporter linked polymorphic region (5-HTTLPR). We explored this issue in 371 preschoolers and their caregivers, examining whether parent characteristics (i.e., overinvolvement or anxiety disorder) and child 5-HTTLPR influenced the continuity of BI between ages 3 and 5. Measures were observational ratings of child BI, observational and questionnaire measures …

Resting-State Network-Specific Breakdown Of Functional Connectivity During Ketamine Alteration Of Consciousness In Volunteers., Vincent Bonhomme, Audrey Vanhaudenhuyse, Athena Demertzi, Marie-Aurélie Bruno, Oceane Jaquet, Mohamed Ali Bahri, Alain Plenevaux, Melanie Boly, Pierre Boveroux, Andrea Soddu, Jean François Brichant, Pierre Maquet, Steven Laureys

Brain and Mind Institute Researchers' Publications

BACKGROUND: Consciousness-altering anesthetic agents disturb connectivity between brain regions composing the resting-state consciousness networks (RSNs). The default mode network (DMn), executive control network, salience network (SALn), auditory network, sensorimotor network (SMn), and visual network sustain mentation. Ketamine modifies consciousness differently from other agents, producing psychedelic dreaming and no apparent interaction with the environment. The authors used functional magnetic resonance imaging to explore ketamine-induced changes in RSNs connectivity.

METHODS: Fourteen healthy volunteers received stepwise intravenous infusions of ketamine up to loss of responsiveness. Because of agitation, data from six subjects were excluded from analysis. RSNs connectivity was compared between absence of …

Design And Evaluation Of A Catheter Contact-Force Controller For Cardiac Ablation Therapy., Daniel Gelman, Allan C Skanes, Mohammad A Tavallaei, Maria Drangova

Medical Biophysics Publications

GOAL: Maintaining a constant contact force (CF) of an ablation catheter during cardiac catheter ablation therapy is clinically challenging due to inherent myocardial motion, often resulting in poor ablation of arrhythmogenic substrates. To enable a prescribed contact force to be applied during ablation, a catheter contact force controller (CCFC) was developed.

METHODS: The system includes a hand-held device attached to a commercial catheter and steerable sheath. A compact linear motor assembly attaches to an ablation catheter and autonomously controls its relative position within the shaft of the steerable sheath. A closed-loop control system is implemented within embedded electronics to enable …

Effect Of Left Atrial Wall Thickness On Radiofrequency Ablation Success., Jiro Inoue, Allan C Skanes, Lorne J Gula, Maria Drangova

Medical Biophysics Publications

INTRODUCTION: Radiofrequency (RF) ablation in thicker regions of the left atrium (LA) may require increased ablation energy in order to achieve effective transmural lesions. Consequently, many cases of recurrent atrial fibrillation (AF) postablation may be due to thicker-than-normal atrial tissue. The aim of this study was to test the hypotheses that patients with recurrent AF have thicker tissue overall and that electrical reconnection is more likely in regions of thicker tissue.

METHODS AND RESULTS: Retrospective analysis was performed on 86 CT images acquired preoperatively from a cohort of 119 patients who had undergone RF ablation for AF. Of these, 33 …

Positive Allosteric Modulator Of Gabab Receptor Alters Behavioral Effects But Not Afterdischarge Progression Induced By Partial Hippocampal Kindling., L Stan Leung, Miao Jin, Liangwei Chu, Jingyi Ma

Physiology and Pharmacology Publications

Hippocampal seizures decreased the function of GABAB receptors, which may further increase seizure susceptibility and contribute to development of schizophrenia-like behaviors. Recent literature indicates that GABAB receptor agonist may normalize schizophrenia-like behaviors and prevent drug-induced behavioral sensitization. We hypothesized that positive modulation of GABAB receptor function during seizure induction will reduce seizure-induced schizophrenia-like behaviors. Using a partial hippocampal kindling model, afterdischarges were induced after injection of saline or dimethyl sulfoxide (vehicle-kindled rats), or a GABAB receptor positive allosteric modulator CGP7930, at 1 mg/kg i.p. (CGP1-kindled) or 5 mg/kg i.p. (CGP5-kindled). The increase in the primary afterdischarge duration during kindling was …

Energy Subtraction Methods As An Alternative To Conventional X-Ray Angiography, Christiane S. Burton

Electronic Thesis and Dissertation Repository

Digital subtraction angiography (DSA) is a technique that is widely used to enhance the visibility of small vessels obscured by background structures by subtracting a mask and contrast image. However, DSA is generally unsuccessful for imaging the heart due to the motion that occurs between mask and contrasted images which cause motion artifacts. An alternative approach known as energy subtraction angiography (ESA) exploits the iodine k-edge by acquiring contrast images with a low and high kV in rapid succession to bring the benefits of DSA without motion artifacts. However, it was concluded that image quality for ESA could not compete …

Development Of Anatomical And Functional Magnetic Resonance Imaging Measures Of Alzheimer Disease, Samaneh Kazemifar

Electronic Thesis and Dissertation Repository

Alzheimer disease is considered to be a progressive neurodegenerative condition, clinically characterized by cognitive dysfunction and memory impairments. Incorporating imaging biomarkers in the early diagnosis and monitoring of disease progression is increasingly important in the evaluation of novel treatments. The purpose of the work in this thesis was to develop and evaluate novel structural and functional biomarkers of disease to improve Alzheimer disease diagnosis and treatment monitoring. Our overarching hypothesis is that magnetic resonance imaging methods that sensitively measure brain structure and functional impairment have the potential to identify people with Alzheimer’s disease prior to the onset of cognitive decline. …

Identification Of A Nuclear Localization Signal (Nls) Within The Pleckstrin Homology (Ph) Domain Of Rho Guanine Nucleotide Exchange Factor (Rgnef), Michael V. Tavolieri

Electronic Thesis and Dissertation Repository

Rho Guanine Nucleotide Exchange factor (RGNEF) is a 180 kDa protein which forms pathological neuronal cytoplasmic inclusions in degenerating spinal motor neurons in amyotrophic lateral sclerosis (ALS) and for which the gene (ARHGEF28) is mutated in a subset of cases. Despite having previously been shown to localize to the nucleus and to undergo a nuclear cytosolic shift in response to cellular injury, the mechanism of its nuclear import has yet to be elucidated. Here we use site-directed mutagenesis with a combination of subcellular fractionation and confocal microscopy to identify a functional nuclear localization signal (NLS) within the Pleckstrin …

Usage Of Swi (Susceptibility Weighted Imaging) Acquired At 7t For Qualitative Evaluation Of Temporal Lobe Epilepsy Patients With Histopathological And Clinical Correlation: An Initial Pilot Study., Benjamin Y M Kwan, Fateme Salehi, Pavlo Ohorodnyk, Donald H Lee, Jorge G Burneo, Seyed M Mirsattari, David Steven, Robert Hammond, Terry M Peters, Ali R Khan

Brain and Mind Institute Researchers' Publications

OBJECTIVES: Ultra high field MRI at 7T is able to provide much improved spatial and contrast resolution which may aid in the diagnosis of hippocampal abnormalities. This paper presents a preliminary experience on qualitative evaluation of 7T MRI in temporal lobe epilepsy patients with a focus on comparison to histopathology.

METHODS: 7T ultra high field MRI data, using T1-weighted, T2*-weighted and susceptibility-weighted images (SWI), were acquired for 13 patients with drug resistant temporal lobe epilepsy (TLE) during evaluation for potential epilepsy surgery. Qualitative evaluation of the imaging data for scan quality and presence of hippocampal and temporal lobe abnormalities were …

Quantifying And Comparing The Pattern Of Thalamic And Cortical Projections To The Posterior Auditory Field In Hearing And Deaf Cats., Blake E Butler, Nicole Chabot, Stephen G Lomber

Brain and Mind Institute Researchers' Publications

Following sensory loss, compensatory crossmodal reorganization occurs such that the remaining modalities are functionally enhanced. For example, behavioral evidence suggests that peripheral visual localization is better in deaf than in normal hearing animals, and that this enhancement is mediated by recruitment of the posterior auditory field (PAF), an area that is typically involved in localization of sounds in normal hearing animals. To characterize the anatomical changes that underlie this phenomenon, we identified the thalamic and cortical projections to the PAF in hearing cats and those with early- and late-onset deafness. The retrograde tracer biotinylated dextran amine was deposited in the …

The Biophysical Alterations To Pulmonary Surfactant During Lung Injury, Scott D. Milos

Electronic Thesis and Dissertation Repository

Pulmonary surfactant is a lipoprotein mixture responsible for reducing surface tension of the lung. In this thesis, we investigate the impact of lung injury on surfactant composition and function, with a specific focus on cholesterol content. First, the impact of a high cholesterol diet on surfactant function was assessed in three models of lung injury. It was hypothesized that serum hypercholesterolemia would increase host susceptibility to surfactant functional impairments. Secondly, the impact of injurious ventilation on intracellular surfactant within the lung was investigated. It was hypothesized injurious ventilation would produce alterations to lamellar body surfactant. Overall, the data suggest that …

Maternal Nutrient Restriction With Fetal Growth Restriction In Guinea Pigs Impacts Brain Development And Neuroimaging Correlates In Neonatal Offspring, Catherine Nevin

Electronic Thesis and Dissertation Repository

Aberrant brain development in utero accompanied by fetal growth restriction (FGR) increases the risk of neurodevelopmental disorders in later life. However there are limited non-invasive biomarkers in the brain for the early identification of said neurodevelopmental disorders in an animal model of FGR. Guinea pig sows were fed either ad libitum (Control) or 70% of the control diet pre-pregnancy, increasing to 90% at mid-pregnancy (MNR) creating appropriately grown (AGA) Control and FGR-MNR neonates, respectively. Three to four weeks corrected post-natal age, neonates were imaged using magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques, and were killed 48-72 hours later for …

Global Access To Radiation Therapy For Cervical Cancer: The Cost Of Inaction, Jacob Van Dyk, D Rodin, Timothy Paul Hanna, E Burger, Eduardo Zubizarreta, Mei Ling Yap, Michael Barton, Rifat Atun, Felicia Marie Knaul, Y Lievens, Mary K. Gospodarowicz, D A. Jaffray, M Milosevic

Oncology Publications

No abstract provided.

Neural Measures Reveal Implicit Learning During Language Processing., Laura J Batterink, Larry Y Cheng, Ken A Paller

Brain and Mind Institute Researchers' Publications

Language input is highly variable; phonological, lexical, and syntactic features vary systematically across different speakers, geographic regions, and social contexts. Previous evidence shows that language users are sensitive to these contextual changes and that they can rapidly adapt to local regularities. For example, listeners quickly adjust to accented speech, facilitating comprehension. It has been proposed that this type of adaptation is a form of implicit learning. This study examined a similar type of adaptation, syntactic adaptation, to address two issues: (1) whether language comprehenders are sensitive to a subtle probabilistic contingency between an extraneous feature (font color) and syntactic structure …

Carotid Artery Atherosclerosis In Patients With Active Rheumatoid Arthritis: Predictors Of Plaque Occurrence And Progression Over 24 Weeks, Janet E Pope, Tatiana Nevskaya, Lillian Barra, Grace Parraga

Medical Biophysics Publications

INTRODUCTION: This study evaluated the prevalence and progression of subclinical carotid artery atherosclerosis in active rheumatoid arthritis (RA).

METHODS: Carotid arteries of RA patients were scanned using 3D ultrasound at baseline and 24 weeks for total plaque area, vessel wall volume, and intima-media thickness (IMT), as well as arterial stiffness measured using pulse wave velocity. Variables related to inflammation, lipids and cardiovascular (CV) risk were assessed for associations with plaque progression. Of 195 screened patients, 31 met inclusion criteria (66 Swollen joint count (SJC) plus 68 Tender joint count (TJC)≥8 OR SJC plus TJC≥4 with elevated acute phase reactants) and …

Synthesis, Self-Assembly, And Immunological Activity Of Α-Galactose-Functionalized Dendron–Lipid Amphiphiles, John Trant, Namrata Jain, D. M. Mazzuca, J Trevor Mcintosh, Bo Fan, S M Mansour Haeryfar, Sebastien Lecommandoux, Elizabeth Gillies

Chemistry Publications

Nanoassemblies presenting multivalent displays of biologically active carbohydrates are of significant interest for a wide array of biomedical applications ranging from drug delivery to immunotherapy. In this study, glycodendron–lipid hybrids were developed as a new and tunable class of dendritic amphiphiles. A modular synthesis was used to prepare dendron–lipid hybrids comprising distearylglycerol and 0 through 4th generation polyester dendrons with peripheral protected amines. Following deprotection of the amines, an isothiocyanate derivative of C-linked α-galactose (α-Gal) was conjugated to the dendron peripheries, affording amphiphiles with 1 to 16 α-Gal moieties. Self-assembly in …

The Long Non-Coding Rna Malat1 Regulates Inflammatory Cytokine Production In Chronic Diabetic Complications, Andrew D. Gordon

Electronic Thesis and Dissertation Repository

We examined the role of MALAT1, a highly conserved nuclear lncRNA, in chronic diabetic complications affecting the heart and kidneys, specifically with respect to inflammatory cytokine production. Endothelial cells, exposed to various glucose levels, and MALAT1 knockout mice and controls, with or without streptozotocin-induced diabetes were examined. Endothelial cells cultured with high glucose, and renal and cardiac tissue from diabetic mice showed increased inflammatory cytokine (eg. IL-6, IL1β, TNFα) production along with transient MALAT1 upregulation. This was confirmed by both transcript and protein analyses, and such changes were prevented in the MALAT1 knockout diabetic animals. In the malat1 knockout animals, …

Probing The Nature Of Deficits In The ‘Approximate Number System’ In Children With Persistent Developmental Dyscalculia, S Bugden, Daniel Ansari

Brain and Mind Institute Researchers' Publications

In the present study we examined whether children with Developmental Dyscalculia (DD) exhibit a deficit in the so-called 'Approximate Number System' (ANS). To do so, we examined a group of elementary school children who demonstrated persistent low math achievement over 4 years and compared them to typically developing (TD), aged-matched controls. The integrity of the ANS was measured using the Panamath (www.panamath.org) non-symbolic numerical discrimination test. Children with DD demonstrated imprecise ANS acuity indexed by larger Weber fraction (w) compared to TD controls. Given recent findings showing that non-symbolic numerical discrimination is affected by visual parameters, we went further and …

Design, Development And Evaluation Of A Compact Telerobotic Catheter Navigation System., Mohammad Ali Tavallaei, Daniel Gelman, Michael Konstantine Lavdas, Allan C Skanes, Douglas L Jones, Jeffrey S Bax, Maria Drangova

Medical Biophysics Publications

BACKGROUND: Remote catheter navigation systems protect interventionalists from scattered ionizing radiation. However, these systems typically require specialized catheters and extensive operator training.

METHODS: A new compact and sterilizable telerobotic system is described, which allows remote navigation of conventional tip-steerable catheters, with three degrees of freedom, using an interface that takes advantage of the interventionalist's existing dexterity skills. The performance of the system is evaluated ex vivo and in vivo for remote catheter navigation and ablation delivery.

RESULTS: The system has absolute errors of 0.1 ± 0.1 mm and 7 ± 6° over 100 mm of axial motion and 360° of …

A Quantitative Comparison Of The Hemispheric, Areal, And Laminar Origins Of Sensory And Motor Cortical Projections To The Superior Colliculus Of The Cat., Blake E Butler, Nicole Chabot, Stephen G Lomber

Brain and Mind Institute Researchers' Publications

The superior colliculus (SC) is a midbrain structure central to orienting behaviors. The organization of descending projections from sensory cortices to the SC has garnered much attention; however, rarely have projections from multiple modalities been quantified and contrasted, allowing for meaningful conclusions within a single species. Here, we examine corticotectal projections from visual, auditory, somatosensory, motor, and limbic cortices via retrograde pathway tracers injected throughout the superficial and deep layers of the cat SC. As anticipated, the majority of cortical inputs to the SC originate in the visual cortex. In fact, each field implicated in visual orienting behavior makes a …

Sample Size Formulas For Estimating Intraclass Correlation Coefficients In Reliability Studies With Binary Outcomes, Mengxiao Xu

Electronic Thesis and Dissertation Repository

Introduction: Measurement errors can seriously affect quality of clinical practice and medical research. It is therefore important to assess such errors by conduct- ing studies to estimate a coefficients reliability and assessing its precision. The intraclass correlation coefficient (ICC), defined on a model that an observation is a sum of information and random error, has been widely used to quantify reliability for continuous measurements. Sample formulas have been derived for explicitly incorporation of a prespecified probability of achieving the prespecified precision, i.e., the width or lower limit of a confidence interval for ICC. Although the concept of ICC is applicable …