VictorJuiz/thesis huggingface dataset:
Evaluating System-level Implementation of Telepsychiatry in Ontario from 2008-2016: Implications for the Sustainability and Growth of Telepsychiatry
Keywords: Adoption
Implementation Science
Telehealth
Telemedicine
Telepsychiatry
Virtual Care

Objectives The objective of this thesis was to understand the implementation of clinical telepsychiatry in Ontario. To do this, paper 1 described the characteristics of psychiatrists who delivered and patients who received telepsychiatry, calculated how many in-need patients received telepsychiatry, and identified trends in the distribution of telepsychiatry (where care was delivered to and from). Paper 2 described characteristics and predictors of family physicians who referred patients to telepsychiatry and paper 3 compared the costs of telepsychiatry with other traditional models of psychiatric outreach. Study Designs This thesis employed several study designs, including a serial panel study and retrospective cross-sectional studies using linked data from ICES, as well as a cost-minimization analysis. Results Paper 1 found that, in fiscal year (FY) 2012, a total of 3,801 people had 5,635 telepsychiatry visits, and 7% of Ontario psychiatrists provided these visits. Of 48,381 people discharged from a psychiatric hospitalization, 60% saw a local psychiatrist, 39% saw no psychiatrist, and less than 1% used telepsychiatry within 1 year of discharge. Paper 2 showed that the number of patients using telepsychiatry, and the number of family physicians referring to telepsychiatry increased fifteen-fold and nine-fold, respectively, from FY 2008 to FY 2016. 32% of Ontario family physicians referred to telepsychiatry in FY 2016, however, less than 1% of their rostered patients used telepsychiatry (n =12,449/3,513,638). Family physicians that referred to telepsychiatry were more likely to be from a rural residence, to have more nurse practitioners in their practice, and to be part of a Family Health Team, while their patients were more likely to live in rural areas, have increased complexity, and higher rates of mental health service utilization. Paper 3 found that costs per visit were lowest in telepsychiatry ($360), followed by travelling physicians ($558) and patient reimbursement for travel ($620). Conclusions This dissertation has demonstrated that while telepsychiatry has been increasingly adopted by providers, adoption by patients remains fairly low. Telepsychiatry is less costly than other in-person outreach models and shows signs of sustainability, such as the persistent increase in adoption and penetration throughout Ontario over the study period.
Complicated Truths: Hoaxes in Contemporary Canadian Literature and Visual Art
Keywords: Canadian
Contemporary
Heteronyms
Hoaxes
Iris Haussler
Jeff Wall

Abstract Complicated Truths: Hoaxes in Contemporary Canadian Literature and Visual Art Heather Jessup Department of English, University of Toronto Doctor of Philosophy, 2015 In this thesis I argue that hoaxes in contemporary Canadian literature and art disrupt personal and institutional habits and routines. I claim that the disturbance and disorientation hoaxes instil in readers and viewers is integral to an epistemology of pause, contemplation, and revision - forms of thinking that are of service to deeper self-reflection and institutional self-awareness. Through three distinct case studies, I argue that the insistent disobedience of hoaxes demands that we re-examine conventions of systematic and generic order, unquestioned institutional trust, and moments of self-assurance that can, at times, lead humans and institutions to become resistant to adaptation and change. In part one of this dissertation, using Iris Häussler's installation artwork He Named Her Amber, I discuss the trust that patrons place in the institution of the gallery, and the responses viewers have when that trust is broken. I argue that the disorientations and interventions spurred by a hoax rejuvenate reflection in the disciplines of art making, art history, and curation. In part two, I examine nineteenth-century ethnographic practices foundational to the expansion and establishment of Canada as a nation. Through an examination of Paul Kane's sketches and portraits of early Canada, and then through Sketches Solicited for Wall Drawings and Prototypes for a New Understanding by Brian Jungen and the photographs Mimic and Fieldwork by Jeff Wall - contemporary artworks that employ a postcolonial technique known as "reverse ethnography" - I demonstrate that these contemporary artworks disrupt myths of the "peaceful settler" and the "vanishing Indian," myths still existent in contemporary ideas of Canadian history and identity. In the third part of this dissertation, I turn to the heteronymic writings of Fernando Pessoa, Erin Mouré, and David Solway, and argue that their foregrounding of translational felicity over fidelity through unconventional translational approaches - particularly in their use of invented authors - disrupts the common conception that authorship, translation, and even selfhood, are seamless acts or identities. It is my claim that hoaxes, while seemingly disloyal to "truth" or reality, paradoxically ensure that galleries, museums, works of literature, and universities do not cease to be sites of learning and self-examination.
The Impact of CFTR Modulator Therapy on Exercise Intolerance and Oxygen Transport Metabolism in Cystic Fibrosis
Keywords: Exercise
Pediatrics
Respiratory Physiology

Cystic fibrosis (CF) is a fatal autosomal-recessive genetic disorder with multiorgan effects. Exercise intolerance is a common symptom, and exercise capacity is an important prognostic indicator in CF. Some CF patients now have access to novel pharmacological “modulator therapies” that improve pulmonary function by directly targeting the cystic fibrosis transmembrane regulator (CFTR) protein defect. However, the impact of these therapies on other organ systems and exercise tolerance remains unknown. This is compounded by the ongoing debate related to the pathophysiological impact of CF on central and peripheral contributors to oxygen transport metabolism that determine exercise tolerance. The purpose of this research was therefore to explore central and peripheral contributors to exercise tolerance in healthy controls, patients with CF, and CF patients treated with modulator therapy using non-invasive magnetic resonance-based assessments. Thirty-two participants were included in the study: 10 healthy non-CF controls, 10 CF controls naïve to modulator therapy, and 12 CF patients on long-term CFTR modulator therapy. Participants completed resting and exercise MRI testing to quantify quadriceps blood flow, mitochondrial metabolism, and oxygen extraction. Results showed that there were no differences in pulmonary function and central cardiac limitations at rest. However, there were differences in peripheral factors of the oxygen transport chain in patients taking modulator therapies. Peripheral arterial blood flow in participants on modulator therapy was significantly increased at rest versus healthy controls (healthy control: 120.4±24.8 mL•kg-1•min-1; CF Control: 135.5±45.3 mL•kg-1•min-1; CF Orkambi: 171.2±45.3 mL•kg-1•min-1, p=0.016). CF controls naïve to modulator therapy had a significantly slower recovery of muscle metabolism post-exercise measured by tau of phosphocreatine recovery (healthy control: 28.5±9.2s; CF Control: 41.0±9.4s; CF Orkambi: 36.0 ±9.7, p=0.025). Aerobic muscle metabolism measured using MR spectroscopy was correlated with resting arterial flow in modulator-naïve CF participants (r=0.78, p=0.013), but was not correlated in healthy controls or patients on modulator therapy. Results suggest that there are peripheral limitations to exercise capacity in patients with CF that may be alleviated by CFTR modulator therapy. These include a) blood flow delivery of substrates to tissues, and b) improvements in muscle metabolism.
Domestic Foodwork in Value and Practice: A Study of Food, Inequality and Health in Family Life
Keywords: Cooking
Culture
Family
Food
Gender
Health

This dissertation explores home-cooked family meals – the ideals and expectations around them, as well as how they are navigated by parents in diverse social positions. This exploration assesses how discourses and practices surrounding family foodwork reflect and shape inequalities in a variety of realms including gendered labour, economic disparities, health outcomes and consumer politics. It utilizes diverse methods including a discourse and content analysis of North American news media, as well as qualitative interviews, cooking observations and food recall conversations with parents in the Greater Toronto Area who are primary cooks in their families. These varied methods facilitate investigation into how home cooking is publicly presented, automatically understood, and emotionally experienced by parents from diverse backgrounds. The dissertation explores these ends in three analytically distinct chapters, offering three key insights. First, the media analysis reveals that public discourse promotes a complex allocation of responsibility for family meals that recognizes multiple structural conditions constraining meals (such as unhealthy food environments and inflated normative standards), yet assigns responsibility for resolving them to individuals (i.e. parents should work harder to combat these constraints and cook more at home). These findings apply to family meals but can also be extended to consider responsibility for social problems within neoliberalism more broadly. Second, interview analysis identifies the ubiquity of a cultural schema of “cooking by our mother’s side”: an automatic, semi-conscious understanding of learning to cook that privileges culinary knowledge acquired during childhood through the social reproductive work of mothers. Analysis of this schema reveals its role in reproducing gendered inequalities and obscuring diversity in food learning, especially by overemphasizing the importance of childhood and masking learning later in life. Third, I qualitatively analyze how socio-economic disadvantage (alongside its intersections with gender and race/ethnicity) negatively impacts the emotional experience of foodwork but does not necessarily predict cooking pleasure. In identifying and exploring five conditions of cooking pleasure, I examine how certain conditions can operate relatively independently from class and facilitate cooking enjoyment for low-income groups. Collectively, the dissertation advances scholarly understanding of the ideals, meanings and emotions encompassing family foodwork, their embeddedness with social inequalities, as well as opportunities for resistance and social change.
Learning to Attend with Neural Networks
Keywords: deep learning
machine learning
neural networks
optimization

As more computational resources become widely available, artificial intelligence and machine learning researchers design ever larger and more complicated neural networks to learn from millions of data points. Although the traditional convolutional neural networks (CNNs) can achieve superhuman accuracy in object recognition tasks, they brute-force the problem by scanning over every location in the input images with the same fidelity. This thesis introduces a new class of neural networks inspired by the human visual system. Unlike CNNs that process the entire image at once into the current hidden layer, attention allows for salient features to dynamically come to the forefront as needed. The ability to attend is especially important when there is a lot of clutter in a scene. However, learning attention-based neural networks poses some challenges to the current machine learning techniques: What information should the neural network ``pay attention''? Where does the network store its sequences of ``glimpses''? Can our learning algorithms do better than simply ``trial-and-error''? To address these computational questions, we first describe a novel recurrent visual attention model in the context of variational inference. Because the standard REINFORCE or the trial-and-error algorithm can be slow due to its high variance gradient estimates, we show a re-weighted wake-sleep objective can improve the training performance. We also demonstrate the visual attention models outperform the previous state-of-the-art methods based on CNNs in the images and captions generation tasks. Furthermore, we discuss how the visual attention mechanism can improve the working memory of recurrent neural networks (RNNs) through a novel form of self-attention. The second half of the thesis focuses on gradient-based learning algorithms. We developed a new first-order optimization algorithm to overcome the slow convergence of the stochastic gradient descent algorithms in RNNs and attention-based models. In the end, we explored the benefit of applying second-order optimization methods in training neural networks.
Multi-modal Fully-wireless Implantable SoCs for Interfacing with the Nervous System
Keywords: ADC
Analog front-end
Delta Sigma
passive integrator
Ultra-low power
Wireless power transfer

This dissertation presents the design and implementation of two single-die inductively-powered current/voltage-sensing micro-stimulation systems-on-chip for interfacing with the central and peripheral nervous systems, respectively. The first design is a wireless implant for biochemical sensing in the brain at high spatial resolution by an array of 32×32 active sensors. Each channel employs an ultra-low-power 1st-order ∆Σ ADC for biochemical monitoring. Each of the 0.004mm2 current-sensing channels consumes 50nW of power and achieves 6-bits ENOB at 200Hz-bandwidth with less than a 100pA current sensitivity. The opamp-less ADC is analytically proven to be equivalent to conventional active ∆Σ-modulated ADCs, under conditions that are typical for biochemical microsensors. The SoC utilizes a 4MHz safety-optimized inductive-powering link for maximum power transfer under a given specific-absorption-rate constraint. The second system is an active probe and microstimulator SoC for interfacing with peripheral nerves. It performs 64-channel artifact-tolerant neural recording, cuff imbalance compensation by impedance sensing, and closed-loop neurostimulation. Each recording channel is a 2nd-order opamp-less ∆Σ ADC that consumes 140nW and occupies 0.01mm2 area in 130nm CMOS. The single-loop ∆Σ architecture achieves 2nd-order noise shaping with two passive integrators. This yields the lowest power and area for a 2nd-order ∆Σ ADC; and the lowest FOM (fJ/conv. step) among all state-of-the-art passive 2nd-order ∆Σ ADC (27fJ/conv. step). The SoC uniquely performs multi-modal input signal recording: voltage (for neural recording) and current (for impedance sensing) are measured concurrently using frequency multiplexing. The SoC also features a 60MHz energy-efficient inductive powering link and a 600MHz RF data communication link. The prototype is validated in vivo in the rat sciatic nerve for ENG sensing and for the correction of impedance-imbalance in cuff electrodes. A comprehensive optimization guide for efficient inductive links is then presented. The inductive power transfer link is studied by two different approaches: a power-efficiency approach where the powering link is optimized to achieve the highest-possible link efficiency, and a safety-optimized approach where the maximum possible power delivery is targeted. The two links are analyzed and optimized to find the optimal geometries of the on-chip coils that result in the highest powering-link efficiency and the highest delivered power, respectively.
From Mammals to Fish and Back Again: Discovering Regulators Underlying Early Heart Development
Keywords: ATAC-seq
comparative genomics
enhancers
heart development
zebrafish

During the phylotypic period, embryos from different genera show similar gene expression patterns, implying common regulatory mechanisms. To identify enhancers involved in the initial events of cardiogenesis, which occurs during the phylotypic period, we isolated early cardiac progenitor cells from zebrafish embryos and characterized 3,838 open chromatin regions specific to this cell population. Of these regions, 162 overlapped with conserved non-coding elements (CNEs) that also mapped to open chromatin regions in human, which we referred to as accessible CNEs (aCNEs). Most of the zebrafish aCNEs (15/21) drove gene expression in the developing heart in stable lines. Despite modest sequence identity, human orthologous aCNEs could recapitulate the spatial-temporal expression patterns of the zebrafish sequence, potentially providing a basis for phylotypic gene expression patterns. Genome-wide, we discovered 5,598 zebrafish-human aCNEs. Chromatin state and transcription factor enrichment analyses supported that many aCNEs served as lineage-specific enhancers during development. To characterize the functional role of aCNEs, deletion mutants were made for two aCNEs (aCNE1 and aCNE21) proximal to cardiac genes. While most aCNE1 -/- mutants were viable, I detected a transient down-regulation of cardiac genes upon loss of aCNE1 at the phylotypic period and found that ~ 8% of the mutants displayed severe cardiac defects. Together, my work suggests that a diverse repertoire of deeply conserved enhancers is established prior to the phylotypic period, which may later contribute to the establishment of the conserved vertebrate body plan.
Make Nanomedicine Great Again ...... By Understanding Biological Barriers To Drug Delivery
Keywords: 3D Imaging
Biological Barriers
Cancer
Drug Delivery
Nanoparticles
Protein Corona

Cancer targeting nanoparticles face a variety of biological environments between the site of injection and cancer cells. While researchers can measure the properties of nanoparticles outside the body, interactions with biological environment and its effect on nanoparticle tumour delivery remains unexplored. Understanding these barriers for cancer nanomedicine is the first step towards overcoming them. Here, I focus on three aspects of 3 nano-bio interactions enroute to cancer that dictates its biological fate: 1) Nanoparticle-Blood: Serum protein adsorption on circulating nanoparticles can be used as input to develop a supervised learning algorithm that can predict the fate of nanoparticles. This model achieved 77-95% accuracy in its prediction and altering the proteins on the surface led to reduction in liver and spleen uptake. 2) Nanoparticle – Tumour Blood Vessels: The dominant mechanism of nanoparticle entry into solid tumours is trans-endothelial and not through inter-endothelial gaps via Enhanced Permeation and Retention (EPR) effect. Upto 97% of nanoparticles were found to extravasate into the tumour via trans-endothelial pathways. This changes our approach to developing cancer nanomedicine as we now have to utilize this active mechanism instead of relying of passive accumulation. 3) Nanoparticle-Tumour: We have developed an approach that allows 3D imaging of nanoparticles in intact tumours. This technique is high throughput, cost effective and is compatible with both organic and inorganic nanoparticles. This is now allowing us to map all the barriers to cancer nanomedicine in tumours. This map is powerful because it forms the basis for classifying tumours into zones of varying nanoparticle distribution and can make accurate predictions of nanoparticle targeting efficiency. The work presented here arms the field of cancer nanomedicine with the biological barriers that need to be taken into design considerations to improve its clinical translation.
Mindsets: Case Studies on Incremental and Entity Theories in Undergraduate Music Students
Keywords: Fixed
Growth
Mindsets
Music
Pedagogy
Piano

American psychologist Carol Dweck coined terms for two dichotomous theories of intelligence––entity and incremental theories––which depict the general trends of learners. Fixed mindset learners internalize entity theories and view their intelligence or ability as a fixed, stable unit that is incapable of growth past the individual’s own genetic limitations. Growth mindset learners believe in incremental theories and see their intelligence as dynamic, wherein their abilities are a direct product of their efforts. Dweck argues that adopting an incremental theory of learning (a growth mindset) can be beneficial to the learning process. Combining this body of psychological literature with auxiliary areas of psychology (e.g. self-determination theory), I conducted two case studies to analyze how these beliefs manifested in second-year instrumental music majors at Canadian post-secondary institutions. Through a six-week research period of one-on-one lessons, independent practice sessions, and interviews, I investigated the participants’ respective upbringings, their methods of framing goals, and their responses to challenges and criticisms with the aim of understanding how music students’ beliefs about mindsets affect their learning, as well as how music teachers may be able to maximize growth-oriented thinking in their interactions with students. After an analysis of the data, I concluded that the nurturing of growth mindsets had a positive effect on the students’ respective levels of patience, self-compassion, and resilience in dealing with the learning challenges inherent in music performance. The data highlighted how the participants’ implicit theories of intelligence were instilled in them by their parents and educators throughout their childhoods, and how growth-minded beliefs may be further nurtured through empathetic and process-oriented guidance.
The Politics and Aesthetics of Haunting in 1950s Japan
Keywords: Cinema
Ghosts
Haunting
Japan
Literature
Postwar

This thesis examines the politics and aesthetics of haunting in 1950s Japan. A distinct historical conjuncture separate from the social upheaval of the immediate postwar as well as the overt politicization of the 1960s, the 1950s is characterized by a narrative of national rebuilding and return that marginalized discrepant experiences of the present—producing a disjointedness that I articulate as a form of ‘haunting.’ In order to develop this, I turn to two triptychs of creators (two writers, two filmmakers, two composers) who collaborated to document the ‘haunted’ reality of 1950s Japan: Marguerite Duras, Alain Resnais, and Giovanni Fusco; and Abe Kōbō, Teshigahara Hiroshi, and Takemitsu Tōru. Collectively, these artists articulate a crisis where concrete lived experiences did not correspond with national narratives of recovery and the economic, social, and political modes of structuring that regulated people’s lives. Their fiction and theory attempted to bring this crisis into focus by representing the ghostly estrangement of modern subjects and also by theorizing alternative methods of historicization following a logic of ‘haunting,’ one that challenged the accepted reality—the taken-for-grantedness—of celebratory narratives of postwar life.