Bariatric Surgery Recipients\u27 Needs for Long-Term Health and Well-Being; Perspectives of Patients and Providers

The overall purpose of this dissertation was to examine what is needed in bariatric surgery programming to support long-term health and well-being from the perspectives of the patient and providers. Study 1 assessed what bariatric surgery recipients perceive they need to best support their long-term health and well-being from a provincial sample (Ontario, Canada), and from an international sample. Study 2 explored the physical, psychological, social, and clinic-related experiences of individuals who underwent bariatric surgery at least two years prior. Study 3 investigated what bariatric clinic staff believe surgery recipients need to best support their long-term health and well-being. Findings from study 1 identified encouragement from family, friends, bariatric team members, and peers as the most useful sources of support and services over the course of the surgery process. Access to immediate follow-up appointments after surgery for post-surgery concerns was reported as needed but not received. Recommendations to address excess skin and creating a mentorship program were proposed by participants. The results from Study 2 revealed that in general, participants experienced positive improvements in their physical, psychological, and social states since surgery. However, concerns pertaining to several unanticipated outcomes of the surgery were underscored and informed the recommendations for other patients, including being prepared to re-learn ones’ body, utilizing the support services available, and being aware that social relationships may change and/or require tending. The results from Study 3 identified follow-up appointments, bariatric surgery-related education, and assessing readiness to change as the most helpful aids by bariatric clinic staff for patients. A lack of ongoing counselling, financial support for excess skin removal, family physicians with expertise in bariatric surgery, and access to allied health professionals were deemed needed but unavailable. Bariatric clinic staff believed that offering one-on-one counselling, and providing education and resources for Family Health Teams and others may be able to address the challenges faced by bariatric surgery recipients. Overall, these three studies serve as the groundwork for future bariatric programming development, and tailoring components for optimal long-term health outcomes. This summary of work also provides an in-depth understanding of the experiences, insights, and challenges of bariatric surgery recipients and bariatric clinic staff in obesity management

Transcriptional regulation of FoxO3 gene by glucocorticoids in murine myotubes.

Glucocorticoids and FoxO3 exert similar metabolic effects in skeletal muscle. FoxO3 gene expression was increased by dexamethasone (Dex), a synthetic glucocorticoid, both in vitro and in vivo. In C2C12 myotubes the increased expression is due to, at least in part, the elevated rate of FoxO3 gene transcription. In the mouse FoxO3 gene, we identified three glucocorticoid receptor (GR) binding regions (GBRs): one being upstream of the transcription start site, -17kbGBR; and two in introns, +45kbGBR and +71kbGBR. Together, these three GBRs contain four 15-bp glucocorticoid response elements (GREs). Micrococcal nuclease (MNase) assay revealed that Dex treatment increased the sensitivity to MNase in the GRE of +45kbGBR and +71kbGBR upon 30- and 60-min Dex treatment, respectively. Conversely, Dex treatment did not affect the chromatin structure near the -17kbGBR, in which the GRE is located in the linker region. Dex treatment also increased histone H3 and/or H4 acetylation in genomic regions near all three GBRs. Moreover, using chromatin conformation capture (3C) assay, we showed that Dex treatment increased the interaction between the -17kbGBR and two genomic regions: one located around +500 bp and the other around +73 kb. Finally, the transcriptional coregulator p300 was recruited to all three GBRs upon Dex treatment. The reduction of p300 expression decreased FoxO3 gene expression and Dex-stimulated interaction between distinct genomic regions of FoxO3 gene identified by 3C. Overall, our results demonstrate that glucocorticoids activated FoxO3 gene transcription through multiple GREs by chromatin structural change and DNA looping

The Economics of Residential Building Deconstruction in Portland, OR

Impact analysis of the nascent deconstruction industry, in light of recent legislation

Can Text Messages Increase Empathy and Prosocial Behavior? The Development and Initial Validation of Text to Connect

To what extent can simple mental exercises cause shifts in empathic habits? Can we use mobile technology to make people more empathic? It may depend on how empathy is measured. Scholars have identified a number of different facets and correlates of empathy. This study is among the first to take a comprehensive, multidimensional approach to empathy to determine how empathy training could affect these different facets and correlates. In doing so, we can learn more about empathy and its multifaceted nature. Participants (N = 90) were randomly assigned to receive either an empathy-building text message program (Text to Connect) or one of two control conditions (active versus passive). Respondents completed measures of dispositional empathy (i.e. self-perceptions of being an empathic person), affective empathy (i.e. motivations to help, immediate feelings of empathic concern), and prosocial behavior (i.e. self-reports and observer-reports) at baseline, and then again after the 14 day intervention period. We found that empathy-building messages increased affective indicators of empathy and prosocial behaviors, but actually decreased self-perceptions of empathy, relative to control messages. Although the brief text messaging intervention did not consistently impact empathy-related personality traits, it holds promise for the use of mobile technology for changing empathic motivations and behaviors

A Model for the Two-Phase Behavior of Fluids in Dilute Porous Media

Experiments show that the coexistence region of a vapor-liquid system or binary liquid mixture is dramatically narrowed when the fluid is confined in a dilute porous medium such as a silica aerogel. We propose a simple model of the gel as a periodic array of cylindrical strands, and study the phase behavior of an Ising system confined in this geometry. Our results suggest that the coexistence region should widen out at lower temperatures, and that the narrowness observed near the critical point may be a fluctuation-induced effect

iVax: An integrated toolkit for the selection and optimization of antigens and the design of epitope-driven vaccines

Computational vaccine design, also known as computational vaccinology, encompasses epitope mapping, antigen selection and immunogen design using computational tools. The iVAX toolkit is an integrated set of tools that has been in development since 1998 by De Groot and Martin. It comprises a suite of immunoinformatics algorithms for triaging candidate antigens, selecting immunogenic and conserved T cell epitopes, eliminating regulatory T cell epitopes, and optimizing antigens for immunogenicity and protection against disease. iVAX has been applied to vaccine development programs for emerging infectious diseases, cancer antigens and biodefense targets. Several iVAX vaccine design projects have had success in pre-clinical studies in animal models and are progressing toward clinical studies. The toolkit now incorporates a range of immunoinformatics tools for infectious disease and cancer immunotherapy vaccine design. This article will provide a guide to the iVAX approach to computational vaccinology

Could a Kilonova Kill: a Threat Assessment

Binary neutron star mergers (BNS) produce high-energy emissions from several physically different sources, including a gamma-ray burst (GRB) and its afterglow, a kilonova, and, at late times, a remnant many parsecs in size. Ionizing radiation from these sources can be dangerous for life on Earth-like planets when located too close. Work to date has explored the substantial danger posed by the GRB to on-axis observers: here we focus instead on the potential threats posed to nearby off-axis observers. Our analysis is based largely on observations of the GW 170817/GRB 170817A multi-messenger event, as well as theoretical predictions. For baseline kilonova parameters, we find that the X-ray emission from the afterglow may be lethal out to $\sim 5$ pc and the off-axis gamma-ray emission may threaten a range out to $\sim 4$ pc, whereas the greatest threat comes years after the explosion, from the cosmic rays accelerated by the kilonova blast, which can be lethal out to distances up to $\sim 11$ pc. The distances quoted here are typical, but the values have significant uncertainties and depend on the viewing angle, ejected mass, and explosion energy in ways we quantify. Assessing the overall threat to Earth-like planets, have a similar kill distance to supernovae, but are far less common. However, our results rely on the scant available kilonova data, and multi-messenger observations will clarify the danger posed by such events.Comment: 21 pages, 5 figures. Comments welcom

xQSM: Quantitative Susceptibility Mapping with Octave Convolutional and Noise Regularized Neural Networks

Quantitative susceptibility mapping (QSM) is a valuable magnetic resonance imaging (MRI) contrast mechanism that has demonstrated broad clinical applications. However, the image reconstruction of QSM is challenging due to its ill-posed dipole inversion process. In this study, a new deep learning method for QSM reconstruction, namely xQSM, was designed by introducing modified state-of-the-art octave convolutional layers into the U-net backbone. The xQSM method was compared with recentlyproposed U-net-based and conventional regularizationbased methods, using peak signal to noise ratio (PSNR), structural similarity (SSIM), and region-of-interest measurements. The results from a numerical phantom, a simulated human brain, four in vivo healthy human subjects, a multiple sclerosis patient, a glioblastoma patient, as well as a healthy mouse brain showed that the xQSM led to suppressed artifacts than the conventional methods, and enhanced susceptibility contrast, particularly in the ironrich deep grey matter region, than the original U-net, consistently. The xQSM method also substantially shortened the reconstruction time from minutes using conventional iterative methods to only a few seconds.Comment: 37 pages, 10 figures, 3 tabl

Magnetization transfer ratio measures in normal-appearing white matter show periventricular gradient abnormalities in multiple sclerosis

In multiple sclerosis, grey matter pathology occurs mostly next to or near the outer surface of the brain. Using quantitative MRI, Liu et al. reveal that white matter abnormalities are also greatest near the surface of the brain, suggesting common elements in the genesis of grey and white matter patholog