Queerly Joyful Experiences of K-12 Educators in Calgary, Alberta, Canada: A Policy Analysis and Arts-Based Research Study

While much has changed in the last decade in Canada regarding queer inclusion, oppressive hegemonic structures have and continue to perpetuate hetero/trans/allonormativity (the assumption that everyone experiences sexual attraction) and queerphobia in educational settings and the systems that control them. Prior research has lists of suggestions for combatting these systems and structures. Yet, progress is stagnant or even being retracted for queer rights in society and educational contexts. This study looked at how educators and policy created queer inclusion and joy through a lens of optimistic queer theory. The goal of this research was to understand better how queer joy was supported in K-12 schools, what school staff were doing to support queer joy, and why they were choosing to do so. This study looked at the questions: How do queer school staff and self-identified allies see/support queerly joyful practices in some of Calgary's public schools? Why do queer school staff and self-identified allies choose to embrace queer joy? What circumstances allow for fostering queer joy in Calgary public schools? This was captured through policy analysis of nine relevant sexual orientation and gender identity policies that impacted Alberta public school teachers while also drawing upon critical arts-based methodologies to understand better the art of six Calgary educators who upheld queer joy in their work. This research found inconsistencies between the various policies but also indicated the importance of safe spaces, allies, and quality policy to ensure that queer joy could exist in schools in Alberta, Canada

Body Composition Features Associated with Renal Cell Carcinoma: Exploring Molecular Mechanisms

Background: Renal cell carcinoma (RCC) is the most common form of kidney cancer, with clear cell RCC (ccRCC) being the most prevalent and aggressive subtype. This study seeks to identify body composition features visible on CT scans that are prognostic for ccRCC patients. In addition, I sought to determine if molecular features within the tumor are associated with one feature, sarcopenia. It is known that the clinical and molecular features of ccRCC are distinct in males and females. Therefore, I sought to identify sex-specific clinical and molecular features. Methods: Data from 538 patients with ccRCC were obtained from The Cancer Genome Atlas (TCGA) KIRC (Kidney renal clear cell carcinoma) cohort. Preoperative CT scans were available from The Cancer Imaging Archive (TCIA) for 200 patients. CT images at L3 were analyzed using Slice-O-Matic software to measure muscularity, fat distribution, muscle radiodensity, and fat radiodensity. Prognostic body composition features and clinical factors were identified in a multivariate manner. Subsequently, transcriptomic features in the tumor that were associated with low preoperative muscularity were identified in each sex. Gene set enrichment analysis (GSEA) was used to explore biological processes perturbed in ccRCC associated with sarcopenia. Results: Following a multivariate analysis, clinical stage, high subcutaneous fat density, and sarcopenia were found to be significantly associated with worse survival. Differentially expressed genes (DEGs) were compared in patients with low muscularity (sarcopenia) and high muscularity; the genes were different in males and females. Since sarcopenia was associated with T stage and M stage, DEGs that were also associated with advanced T- and M-stage were removed from the gene list, and only genes that were significantly correlated with skeletal muscle area (SMA) were kept in the final gene list. The final list of sarcopenia-associated DEGs consisted of 78 genes in males and 19 genes in females. GSEA demonstrated positive enrichment of pathways associated with proliferation. Interestingly, oxidative phosphorylation was negatively enriched in males and positively enriched in females, and the epithelial-mesenchymal transition was positively enriched in males and negatively enriched in females. The transcriptomic pattern of the sarcopenia-associated variant (SAV) of ccRCC was confirmed to be associated with a poor prognosis in validation cohorts. In addition, several of the gene sets were found to be enriched in the same manner in a small validation cohort. Conclusion: This thesis provides a comprehensive evaluation of the relationships of various body composition features measurable by CT scan, and overall survival. In addition, sex-specific transcriptomic and biological features of ccRCC associated with sarcopenia were identified

Suicidal ideation among mental health patients at hospital discharge: prevalence and risk factors

Abstract Background Evidence indicates that suicide risk is much higher for psychiatric patients in the weeks immediately following discharge from the hospital. It is, therefore, crucial to evaluate suicide risk accurately at discharge to provide supportive and lifesaving interventions as appropriate. Aim: In this study, the prevalence and risk factors for suicide ideations were examined among patients ready to be discharged from psychiatric units in Alberta province, Canada. Methods Researchers conducted face-to-face meetings with potential participants to determine if they were interested in participating. Eligible individuals in this epidemiological cross-sectional study used an online quantitative survey to assess suicide ideations using the appropriate question contained in the Patient Health Questionnaire (PHQ-9) scale. Information was also gathered regarding patient demographics, clinical information, and responses to the Generalized Anxiety Disorder (GAD-7), and World Health Organization Well-Being Index (WHO-5) questionnaires. Results We recruited 1,004 patients from an initial pool of 1,437 patients. We found that the prevalence of suicidal ideation among patients about to be discharged was 48.9%, i.e., nearly half of all patients had active suicidal thinking prior to discharge. We found that factors that were most significantly associated with this were age, ethnicity, employment status, primary mental health diagnoses, anxiety, and poor well-being at baseline. Conclusion Here, in a large cohort of psychiatric patients in Alberta, Canada, we found that nearly half of patients being discharged from an acute psychiatric unit reported suicidal ideation. Given the increased short-term risk to this group, there is an urgent need for additional research on the underlying reasons and reliable predictors of suicidal ideation in these patients. Additionally, appropriate interventions and supportive services must be provided both prior and after discharge to mitigate this substantial risk

Toward Better Policy: A Study of Healthcare Aides' Well-being and Working Conditions in Alberta's Long-Term Care Sector

In the backdrop of Alberta's Long-Term Care (LTC) sector, Health Care Aides (HCAs) play a pivotal role, often facing multifaceted challenges. This research provided a comprehensive understanding of these challenges by reviewing a combination of academic journals and grey literature. The methodology integrates qualitative and quantitative findings to provide a holistic view. Two dominant categories of challenges emerged: work environment challenges and relational processes. Regarding the work environment, HCAs grapple with staffing shortages, substantial workloads, financial strains, and compensation disparities. Meanwhile, relational processes reveal issues in resident-staff interactions and underscore systemic inequities and workplace discrimination. These challenges are further magnified by occupational marginalization and the intricate dynamics of workplace relationships. Drawing from these insights, this research proposed policy recommendations. For structural challenges, the research suggested standardizing care parameters and enhancing workers' rights to improve job security and working conditions. To address relational issues, recommendations include implementing strategies to improve resident-staff interactions and promoting diversity and inclusion using data-driven decision-making. In conclusion, the study underscores the importance of recognizing and integrating the perspectives of HCAs to address structural and relational challenges, intending to optimize the LTC sector in Alberta

Multifunctional hyaluronic acid-based biomimetic/pH-responsive hybrid nanostructured lipid carriers for treating bacterial sepsis

Abstract Introduction The application of biomimetic and stimuli-responsive nanocarriers displays considerable promise in improving the management of bacterial sepsis and overcoming antimicrobial resistance. Therefore, the study aimed to synthesize a novel hyaluronic acid-lysine conjugate (HA-Lys) and to utilize the attributes of the synthesized HA-Lys with Tocopherol succinate (TS) and Oleylamine (OLA) in the formulation of multifunctional biomimetic pH-responsive HNLCs loaded with vancomycin (VCM-HNLCs), to combat bacterial sepsis. Methods A novel hyaluronic acid-lysine conjugate (HA-Lys) was synthesized and characterized using FTIR and 1H NMR spectroscopy. Vancomycin-loaded hybrid nanosystems (VCM-HNLCs) were prepared through hot homogenization ultrasonication and evaluated for particle size, polydispersity index (PDI), zeta potential (ZP), and encapsulation efficiency (EE%). In vitro biocompatibility was assessed via MTT assay and red blood cell hemolysis test. The binding affinity to TLR2 and TLR4 was measured using microscale thermophoresis (MST). Drug release was evaluated using the dialysis bag method. Antimicrobial activity against MRSA and efflux pump inhibition were also determined. Efficacy was demonstrated in an MRSA-induced sepsis mice model. Results The VCM-HNLCs, produced via hot homogenization ultrasonication, exhibited particle size (PS), polydispersity index (PDI), zeta potential (ZP), and encapsulation efficiency (EE%) of 110.77 ± 1.692 nm, 0.113 ± 0.022, − 2.92 ± 0.210 mV, and 76.27 ± 1.200%, respectively. In vitro, biocompatibility was proven by hemolysis and cytotoxicity studies. The VCM-HNLCs demonstrated targetability to human Toll-like receptors (TLR 2 and 4) as validated by microscale thermophoresis (MST). VCM-HNLCs showed a twofold reduction in MIC values at physiological pH compared to the bare VCM against S. aureus and MRSA for 48 h. While at pH 6.0, MIC values were reduced by fourfold in the first 24 h and by eightfold in the subsequent 48 and 72 h against tested strains. Furthermore, VCM-HNLCs showed inhibitory effects against MRSA efflux pumps, reactive oxygen species (ROS), and lipopolysaccharide (LPS)-induced hyperinflammation. In an MRSA-induced sepsis mice model, VCM-HNLCs demonstrated superior efficacy compared to free VCM, significantly eliminated bacteria and improved survival rates. Conclusions Overall, these results highlight the potential of VCM-HNLCs as novel multifunctional nanocarriers to combat antimicrobial resistance (AMR) and enhance sepsis outcomes. Graphical Abstrac

Attitudes and perceptions regarding knowledge translation and community engagement in medical research: the PERSPECT qualitative study

Abstract Background The medical research community widely endorses the importance of ensuring that research outputs are relevant and accessible to knowledge users, as well as the value of engaging the latter in the conduct of research to achieve these goals. However, it appears these principles are reflected in actual medical research practices to a limited extent. To better understand this dissonance, we conducted a qualitative investigation into the perspectives of key stakeholders on bridging the knowledge-to-action gap and patient and public engagement. Methods The Priorities and Expectations of Researchers, Donors, Patients and the Public Regarding the Funding and Conduct of Medical Research (PERSPECT) qualitative study involved in-depth, semi-structured interviews with representatives of four stakeholder groups. Among other topics, participants were asked to discuss issues related to moving medical research knowledge into action (knowledge translation), including patient and public engagement during the research journey as a prerequisite to the success of this process. We analysed collected data employing an interpretative grounded theory approach. Data collection was ended once thematic saturation had been attained. Results A total of 41 interviews were completed and analysed (with 10 patients, 10 members of the general public, 11 researchers and 10 funders). Many participants expressed a belief in the importance of engaging patients in the research process, as well as ensuring that study findings reach beyond academic communities. However, multiple challenges and barriers were identified to implementing these values in practice, including: researchers having limited knowledge and tools to foster partnerships with community members; research outputs being inaccessible to the wider public; and the public having insufficient capacity – in view of the required time, effort and knowledge – to assimilate findings and contribute to ongoing research. Cumulatively, interviews indicated a continuing disconnect between research and lay communities, where each stakeholder group holds some responsibility for improving the current paradigm. Conclusions Existing gaps in communication, knowledge and relevant competencies are fuelling a disconnect between research and lay communities. Successfully moving research knowledge into action requires joint efforts of multiple stakeholder groups with support from external resources to ensure necessary training, expertise and credible dissemination platforms

Implication of region-dependent material properties of articular cartilage in the contact mechanics of porcine knee joint

Abstract Background The site-specific tissue properties of knee cartilage may play an essential role in knee joint mechanical function, and mitigate joint injury and cartilage degeneration. The present study aimed to determine the significance of tissue inhomogeneity in knee joint contact mechanics using a porcine model. Methods Finite element models were developed for a porcine knee with intact and total meniscectomy conditions to simulate whole-joint compression-relaxation tests under a 1.2-mm ramp-compression at 0.01, 0.1, or 1 mm/s. Two reference benchmarks were introduced for the implementation of poromechanical material properties of fibril-reinforced cartilage: Benchmark II consisted of 17 sets of cartilage properties, each for a region in the knee, representing site-specific inhomogeneity averaged from cartilage indentation maps of 14 porcine knees. Benchmark I was comprised of a single set of properties by taking the average properties of 17 regions in Benchmark II, assuming tissue homogeneity. To validate the modeling method, the reference benchmarks were used to produce results against whole-joint compression test data. Results Both benchmarks were able to approximate experimental force-compression data obtained from the same knee with intact menisci and total meniscectomy, provided that the average properties from 14 knees were appropriately scaled to account for individual joint differences. Noticeable differences in stress and pressure distributions were observed between the benchmarks. For instance, benchmark I generated higher peak contact and fluid pressures in the medial tibial cartilage, but benchmark II produced the higher ones in the lateral tibial cartilage. The load sharing asymmetry between the lateral and medial compartments was reduced in benchmark II which was more pronounced for higher compression rates. On the other hand, benchmark II produced a more uniform stress distribution or lower maxima. Meniscectomy caused a slight shift of the contact centers in the tibial plateaus as compared to the intact joint. Conclusion The modeling results demonstrated substantial differences in loading distributions in the joint between the homogeneous and nonhomogeneous models represented by the two benchmarks, indicating the role of tissue inhomogeneity in the joint contact mechanics. Region-dependent tissue properties may need to be implemented in joint mechanical modeling to evaluate the site of cartilage prone to injury or degeneration

Acute and Chronic Physiological Responses to Endurance Exercise of Varying Durations: Neuromuscular, Hematological, and Integrative Outcomes

The integrative action of several physiological systems supports increased skeletal muscle energy demand during exercise. Physiological systems structurally and functionally adapt when exercise stresses are regularly imposed during a period of training. These adaptations, in turn, reduce the homeostatic stress for a given exercise bout. In particular, the impacts of exercise duration and exercise frequency on acute and chronic exercise responses are poorly understood. During prolonged exercise, physiological systems are activated to support muscle contraction, but metabolite accumulation and substrate depletion inevitably occur. During a training program, the balance between the number of times an exercise stress is experienced and the amount of stress per instance implicates exercise frequency along with duration as factors influencing physiological adaptations. This dissertation sought to address gaps in our understanding of the acute responses to differing exercise durations, and to compare chronic training adaptations when total exercise volume is the same. Study 1(Chapter III) showed that near-infrared spectroscopy measures of muscle oxidative capacity are sensitive to contraction intensity, necessitating intensity controls when the technique is used in future studies. Study 2 (Chapter IV) characterized neuromuscular fatigue kinetics during high-intensity interval training and showed that the largest deficits occur early during exercise, implying that additional exercise stress diminished during later bouts. Study 3 (Chapter V) investigated erythropoietic signalling when exercise duration is doubled. I found that increases in erythropoietin mass were not different after both exercise durations, despite hypervolemia only occurring after longer exercise. Study 4 (Chapter VI) aimed to probe whether the acute differences I found between exercise durations impacted training adaptations. This study showed that both long, low-frequency (a Weekend Warrior pattern) and shorter, high-frequency training similarly improved maximal oxygen uptake, hemoglobin mass, muscle oxidative capacity, and exercise capacity. The findings of this dissertation suggest that for some exercise responses, duration does not substantially augment the magnitude of acute stress/signalling events; however, when comparing different frequencies of exposure to that exercise stress, training adaptations were not different. Future studies should address how this acute stress/signal-to-chronic adaptation discrepancy occurs in the context of exercise duration and training frequency

A (2 + 1)-Party One-Instruction Set Processor for Private Function Evaluation

Secure multiparty computation (MPC) is a powerful cryptographic technique which allows mutually distrusting parties to compute a function on their shared inputs. MPC can be viewed as encompassing two main categories, secure function evaluation (SFE) where the function being computed is known to all parties, but the input data is private, and private function evaluation (PFE) where one party has a private function while the other party has private data as input to the function. A major reason MPC has not seen more widespread adoption is due to the fact that to create an efficient MPC protocol for a specific function, traditionally expert cryptographers have had to hand build a custom protocol. One attempt to remedy this issue is the creation of MPC compilers which take as input code in a high-level language and output an optimized MPC protocol. Another attempt has been garbled processors which are hand optimized MPC protocols which emulate specific computer architectures. This thesis presents MPC SUBLEQ, a garbled processor designed for the PFE setting. In particular, it emulates the subtract-and-branch-if-less-than-or-equal-to-zero (SUBLEQ) one-instruction set computer (OISC). Because SUBLEQ only has a single instruction, there is no overhead cost to hide what instruction is currently being executed as there is only one instruction to execute. The data which the instruction is executing on must remain private, but the instruction itself is always known. We also test and compare MPC SUBLEQ against GC-Lite, a similar garbled processor designed for PFE using the SUBBLE OISC, a weaker version of SUBLEQ. We show that MPC SUBLEQ dramatically outperforms GC-Lite due to the significantly lower local computation and online communication costs

Approaches and outcomes of adalimumab discontinuation in patients with well-controlled inflammatory arthritis: a systematic search and review

Abstract Objective This systematic search and review aimed to evaluate the available literature on discontinuation of adalimumab and other tumor necrosis factor inhibitors (TNFi) for patients with well-controlled chronic inflammatory arthritides. Methods We conducted a publication search on adalimumab discontinuation from 2000–2023 using PubMed, CINAHL, EMBASE, and Cochrane Library. Included studies evaluated adalimumab discontinuation approaches, tapering schemes, and outcomes including successful discontinuation and recapture after flare, in patients with well-controlled disease. Studies included evaluated rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and juvenile idiopathic arthritis (JIA). Results Forty-nine studies were included. Studies evaluating adalimumab alone were limited, and many reported TNFi outcomes as a single entity. Studies on rheumatoid arthritis (RA) (32, 8 RCTs) reported flare rates from 33–87%. Flares with medication tapering were slightly lower than with abrupt stop, and successful recapture was generally high (80–100%). Studies on spondyloarthropathy (12, 4 RCTs), focused on tapering, noting lower flare rates in tapering rather than abruptly stopping, and high recapture rates (~ 90%). Studies on JIA (5) were observational and demonstrated modestly lower flare rates with tapering (17–63%) versus abrupt stopping (28–82%). There was notable variability in study design, follow-up duration, specificity for TNFi results, and controlled pediatric studies. Conclusion The literature evaluating adalimumab and other TNFi discontinuation, flare rates, and recapture success within the inflammatory arthritis population demonstrated less flare when medications were tapered, over abrupt stop in the RA, spondyloarthropathy, and JIA populations. When medications were restarted after flare, recapture of well-controlled disease was generally high in RA and spondyloarthropathy, and generally favorable in JIA