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Measles Outbreaks and Implications for Patients Receiving Stem Cell or Cellular Therapies in Canada: Cell Therapy Transplant Canada (CTTC) Infectious Diseases Working Committee
Get PDFMeasles exposures have historically been rare since the introduction of routine vaccination programs, resulting in a lack of attention from cancer patients, hematopoietic stem cell transplant (HCT) recipients, patients receiving cellular therapy (CT) and their healthcare providers. It is essential to acknowledge the importance of vigilance in these situations. Measles herd immunity has declined significantly in North America due to rising vaccine hesitancy, resulting in outbreaks. Measles can result in severe outcomes, and its reemergence has raised alarm among patients and healthcare professionals caring for HCT/CT recipients. Patients with severe immunocompromising conditions cannot receive live-attenuated vaccines, such as the measles vaccine. The lack of data on measles prevention in this vulnerable group presents significant clinical challenges. In response, Cell Therapy Transplant Canada (CTTC) Infectious Diseases Working Committee has developed a set of frequently asked questions to provide expert guidance to HCT and CT recipients, acknowledging the limited evidence base
Bevacizumab in Pediatric Neuro-Oncology
Get PDFBevacizumab is often used off-label in pediatric neuro-oncology, and evidence for indications of bevacizumab use in pediatric neuro-oncology is often fragmented. Therefore, this review aims to provide an organized summary of efficacy across different types of tumors, highlight outcomes, and link findings to the underlying biology. Gaps in the literature were also identified to guide future research. We narratively synthesized various pediatric studies, and the following tumor categories were identified for discussion: low-grade glioma, high-grade glioma, diffuse intrinsic pontine glioma, schwannoma, medulloblastoma, radiation necrosis, and cerebral edema. Key outcomes considered included overall survival, event-free survival, progression-free survival, vision and/or hearing improvements, steroid use, quality of life, and toxicity. The greatest benefits were observed in cases such as recurrent medulloblastoma in combination with temozolomide and irinotecan, optic pathway glioma visual function, and diminished steroid use in radiation necrosis. Results were poorer in cases of newly diagnosed high-grade gliomas and diffuse intrinsic pontine gliomas. The medication was overall well tolerated, with adverse events like hypertension, proteinuria, and epistaxis often being manageable with surveillance. In consideration of the results, bevacizumab should be considered based on the tumor profile, and its outcome measured along functional endpoints, besides radiological evolution. Continued investigations into outcome measures, as well as combination with targeted treatments and optimizing therapy, will contribute to improving outcomes in this vulnerable population
A redox-active polymeric network facilitates electrified reactive-capture electrosynthesis to multi-carbon products from dilute CO2- containing streams
Get PDFReactive capture – the integration of CO2 capture with electrochemical upgrade – offers the prospect of improving overall energy efficiency in captured-CO2-to-fuels by eliminating the gas-phase CO2 desorption step, and by further offering a CO2-free gas product stream. Two related challenges limit the potential impact of electrified reactive capture today: its propensity to produce lower-value C1 products (carbon products containing one carbon atom per molecule); and its failure to retain performance when fed dilute streams (e.g. ~1-10% CO2). We posit that these could be addressed using catalysts that locally concentrate and activate in-situ generated CO2: we integrate a redox-active polymeric network whose polymer fragments undergo reversible reduction during the electrochemical conversion process, enabling electron transfer to CO2 molecules generated in-situ from carbonate capture liquid. We report as a result a 55 ± 5% C2+ (carbon products containing two or more carbon atoms per molecule) Faradaic efficiency (FE) at 300 mA/cm2 in an electrochemical reactive capture system in which the electrolysis stage is fed
with 1 M K2CO3. We obtain 56 ± 4 wt% C2H4 in the product gas stream. When we use a dilute stream consisting of 1% CO2 in N2 at the KOH capture stage, we retain the C2+ FE to within 85% (relative) of its value achieved in the case of pure CO2.This work was financially supported by the Ontario Research Foundation: Research Excellence Program, the Canada Research Chairs Program and the Natural Sciences and Engineering Research Council of Canada (NSERC)
Trajectories of forest composition, structure, and productivity following an experimental ice storm disturbance
Get PDFDisturbance creates structural legacies that are important drivers of functional and compositional stability in forested ecosystems. We used an experimental ice storm disturbance to evaluate effects of disturbance severity on structural legacies and their functional consequences. We evaluated canopy structural characteristics (height, density, openness, and complexity) before and after disturbance using data from terrestrial lidar. We compared trajectories of structural characteristics and functional outcomes (composition, mortality, and productivity) among treatments and relative to controls. We found significant post-disturbance change for all canopy structural characteristics especially at higher severity levels, with persistent legacy effects on mean canopy height and canopy complexity. There were limited changes in biomass, productivity, and composition and mortality did not vary significantly among treatments. There was limited evidence for linkages between structural and functional responses, but plots that retained greater complexity had higher stability of net primary productivity. Our findings indicate persistent structural legacies associated with ice storm disturbance, but declining structural legacies over time may affect interactions with subsequent disturbance or stressors. Improved understanding of these trajectories could help with predicting outcomes of changing disturbance regimes associated with global change.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
Measuring Methane Emissions in the Urban Environment
No full textMitigating methane (CH4 ) emissions is a necessary intervention to address the immediate impacts of anthropogenic climate change. Bottom-up inventories and models are used to predict the quantity of CH4 emissions, but these estimates are poorly constrained, especially on a source-by-source basis. Measuring CH4 atmospheric concentrations enables direct estimation of emissions rates, and allows for the direct monitoring of the efficacy of emissions mitigation interventions. Within the GreaterToronto Area (GTA), high resolution CH4 inventories predict that anthropogenic CH4 comprises the majority of emissions, primarily from landfills. Atmospheric measurements of CH4 were conducted to quantify emissions from sources in the GTA and throughout Southern Ontario.
Within the GTA, a network of solar-viewing Fourier transform infrared (FTIR) spectrometers was used to quantify the total column dry air mole fractions of CH4 and other greenhouse gases (GHG). This network was expanded to five semi-permanent observatory sites and operated to measure emissions coming from the GTA. In order to confirm, quantify, and discover new sources of CH4 emissions in the GTA, a bicycle-based mobile in situ measurement laboratory was deployed
to measure CH4 concentrations downwind of sources in the city. These measurements were used to quantify emissions from various urban CH4 sources.
Over 650 downwind transects of solid waste and water resource recovery facilities (WRRFs) were used to quantify CH4 emissions from the waste sector in Southern Ontario. From these measurements, solid waste emissions in the GTA in bottom-up inventories were shown to be overestimated. These data were used to investigate correlations between emissions and predictive variables such as meteorological variability for landfills, and volume of treated water for WRRFs.
At a large, active landfill facility in Southern Ontario, six different emissions quantification technologies were compared. This study demonstrates that each technology was capable of quantifying emissions from this facility, and that their average measured emission rates all agreed within uncertainty. Lower measured emissions rates were observed from the ground-based in situ methodologies, and possible explanations for these differences are explored. Implications for monitoring Canadian landfill emissions are discussed with respect to the demonstrated detection limits of these technologies.Ph.D
Understanding how Infant Formula Information, Communication Channels, and Traditional Health Beliefs Affect Exclusive Breastfeeding Practices among Women in Palawan, the Philippines: A Convergent-parallel Mixed Methods Study
Get PDFExclusive breastfeeding (EBF) means that infants should only receive breast milk for the first six months of life. It is essential for both maternal and child health. In the Philippines, although various institutions have reported differing EBF rates, the overall prevalence remains low. According to the United Nations Children’s Fund (UNICEF), the country's EBF rate was only 40.9% in 2024. Existing research has shown the influence of infant formula (IF) marketing, communication channels, and traditional health beliefs on EBF, suggesting that these three factors may be possible contributors to the low EBF rate in the Philippines, including in its diverse regions. Palawan, an island province in the Mimaropa region, served as the primary study site due to its varied topographies, cultural diversity, limited EBF research, and existing collaboration with International Care Ministries (ICM).
The current study aimed to understand how infant formula information, communication channels, and traditional health beliefs (THBs) affect the low EBF rate among women in Palawan, Philippines. A mixed-method convergent research design and the Diffusion of Innovation (DoI) theory were applied.
Quantitative results show multiple factors were significantly associated with EBF, particularly those relevant to socioeconomic status and geographic remoteness. The qualitative results show that IF information had more influence on urban working mothers, leading them to adopt the use of IF, while people in remote areas had limited infrastructure, access, and exposure to IF. People in remote areas practiced more THBs, which were reflected in dominant societal narratives about breastfeeding, but not acknowledged by many health professionals.
By comparing and triangulating both strands, the current study shows that IF information and THBs disseminated through different communication channels influenced EBF in Palawan, the Philippines, and demonstrates that both mixed methods and DoI can deepen the understanding of EBF practices. Given the significant differences in infrastructure, communication channels, and social systems between urban and remote areas, different strategies should be designed to promote EBF in these different areas. Future research should focus on the under-reported and under-studied extremely remote areas to design projects that promote EBF in a manner compatible with local practices and contexts.Ph.D
Investigation of prestress loss in anchor cables and adaptive construction scheme for soft rock tunnelling
Get PDFThe construction and stabilisation of soft-rock tunnels pose significant challenges due to rock’s inherent properties, like low strength and high deformability. Traditional passive support systems often fail to effectively control tunnel deformation, leading to increased construction costs and delays. Alternatively, the adoption of prestressed anchor cables as an active support has proven effective in controlling soft-rock tunnel deformation. However, the issue of prestress loss in anchor cables has received scarce attention, hindering the widespread application of this active support system. This study investigates prestress loss in anchor cables and evaluates how their composition design and construction affect anchoring performance in the soft-rock Muzhailing tunnel (MZT) in China. Through comprehensive field and laboratory tests, the research identifies the original design of prestressed anchor cable system led to a significant prestress loss rate of 30%-55%. To mitigate this, an optimised construction scheme was proposed, adjusting specifications, configurations, and construction techniques according to geological conditions. Implementation of this scheme reduced the prestress loss to 25-35%. Based on these results, a generalised adaptive construction scheme for using prestressed anchor cables to support soft-rock tunnelling is proposed, aiming to provide some practical guidelines for enhancing soft-rock tunnel structural integrity and construction safety.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
Clozapine and Pharmacogenomics Testing: Opportunities and Challenges for Personalized Treatment in Schizophrenia
Get PDFClozapine remains the gold standard for treatment-resistant schizophrenia (TRS), offering unparalleled efficacy but accompanied by significant interindividual variability in response and risk of severe adverse effects. Pharmacogenomics (PGx), the study of how genetic variations influence drug response, has transformed treatment for other medications like warfarin but remains underutilized in clozapine prescribing. This review synthesizes current evidence on the potential of PGx to enhance clozapine treatment by improving the prediction of therapeutic response, metabolism, and adverse drug reactions. Key genetic markers, such as variants in serotonin receptor genes (e.g., HTR2A, HTR3A), metabolism-related enzymes (CYP1A2), and immunerelated genes (HLA-DQB1, HLA-B*59:01), show promise in guiding personalized clozapine prescribing. However, economic, educational, and systemic challenges, particularly in Canada, hinder broader implementation. PGx testing in psychiatry is available but lacks standardization in cost, accessibility, and test panels. Additionally, PGx research remains Eurocentric, with limited data on Indigenous and diverse populations. In Canada, initiatives like Go-PGx reflect growing national interest, but mental health applications remain minimal. Bridging research with practice through inclusive research, clinician education, artificial intelligence and machine learning, and cost-effectiveness analyses may help unlock PGx's full potential for over 200,000 Canadians living with schizophrenia.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
Adapting a facilitated, video-based, group, exercise program to improve mobility and physical activity of people post-stroke outside of therapy time in the inpatient stroke rehabilitation setting
Get PDFStroke rehabilitation inpatients spend 75-95% of their time sedentary, partly due to mobility limitations. This qualitative study explored how to adapt a facilitated, video-based, group exercise program for delivery during non-therapy time in the inpatient stroke rehabilitation setting and barriers and facilitators to implementation in a university-affiliated rehabilitation hospital. Twenty-five participants, including 12 people post-stroke, 3 caregivers, and 10 stroke team members, completed interviews or focus groups. Directed content analysis revealed key adaptations, including reducing the difficulty of select exercises, scheduling 3 optional weekly sessions, having one rehabilitation therapist and one volunteer facilitate the program in the dining room to a group of six, and safety check-ins by a rehabilitation professional. Barriers included concerns about fatigue/injury and inadequate familiarity or confidence to perform exercises. Facilitators included familiarity/confidence with performing exercises, physical program benefits, and supervision by facilitators and rehabilitation professionals. Findings can inform development of the program and implementation strategies.M.Sc
Investigating methods for electricity systems planning for uncertainty and socio-environmental sustainability with application to the electricity grid in Yukon, Canada
Get PDFPlanning electricity systems is a growing challenge amidst pressures to deliver affordable power whilst simultaneously addressing the many facets of social, economic, and environmental sustainability, with uncertainty amplifying this already formidable task. This thesis explores methods which leverage unique energy modelling techniques to inform policy and investment decisions which robustly support affordability, reliability, and socio-environmental sustainability objectives amidst uncertainty. Using the electricity system in Yukon, Canada as a case study, I investigate the trade-offs and co-benefits of advancing various sustainability goals, aiming to identify effective strategies, key system vulnerabilities, and robust generation technologies. Results from this work indicate flexible and moderate strategies are more effectively at efficiently achieving target outcomes of reducing greenhouse emissions and improving social and ecological sustainability with minimal trade-offs to costs. Additionally, I find rising peak load and energy demand are among the key risks which threaten sustainability in Yukon, with demand side management and pumped hydro technologies robustly supporting decarbonization and affordability objectives. This thesis produces insights for Yukon but also delivers generalized decision-support frameworks to further socio-environmental sustainability of the electricity sector.M.A.S