VictorJuiz/thesis huggingface dataset:
Assessing the Value and Impacts of Vision Care Services for Children in Ontario
Keywords: amblyopia
comprehensive eye exams
cost-effectiveness
refractive errors
vision impairment
vision screening

BACKGROUND: Refractive errors and amblyopia cause the most vision impairment in children. Early vision testing is crucial to prevent permanent impairment. The uptake of optometry exams amongst children in Ontario is unknown. Limited evidence exists on the accessibility and value of vision care services. This evidence is needed for equitable and cost-effective services to prevent needless vision loss in Ontario. OBJECTIVES: To 1) determine the uptake of comprehensive eye exams and test its associations with socioeconomic status amongst young children in Ontario, 2) synthesize and appraise the literature on economic evaluations of vision screening to detect vision impairment in children, and 3) determine the cost-effectiveness of (a) mandatory comprehensive eye exams by optometrists once between 2 to 5 years of age (CEE); and (b) universal school screening by contracted screeners at age 5 years (USS) compared to (c) usual care (i.e., vision screening as part of well-child visits annually from age 3 to 5 years [WCC(RS)] in Toronto, Ontario. METHODS: A population-based cohort study, systematic review of the literature, and a cost-utility analysis using a probabilistic health-state microsimulation model. RESULTS: Sixty-five percent of children in Ontario had at least one comprehensive eye exam by their 7th birthday, with children in neighborhoods of least material deprivation having a higher odds [adjusted odds ratio (aOR) 1.43; 95%CI 1.36, 1.51] compared to children in most deprived neighborhoods. The review yielded 13 economic evaluation studies, six of high quality with incremental cost-effectiveness ratios (ICER) between C$1,056 to C$151,274/case detected or prevented and between C$9,429 to C$30,254,703/QALY gained. From the societal perspective of the cost-utility analysis, USS was less costly and less effective than WCC(RS), and the ICER was C$500/QALY gained comparing CEE to WCC(RS). There was significant parameter uncertainty in the probabilistic analysis. At a willingness-to pay of C$50,000/QALY gained, USS was cost-effective in 19% of iterations relative to WCC(RS), CEE was cost-effective in 26% of iterations relative to WCC(RS). CONCLUSION: Low socioeconomic status is associated with poor uptake of comprehensive eye exams in Ontario however, USS and CEE are not cost-effective alternatives to usual care screening [WCC(RS)] at a willingness-to-pay of C$50,000/QALY gained.
The Effects of Urbanization on the Ecology and Evolution of Species Interactions
Keywords: Plant-herbivore
Plant-pollinator
Species interactions
Urban ecology
Urban evolution
Urbanization

Urbanization alters the environment in profound ways that affects both the ecology and evolution of species and their interactions with one another. My thesis explores how urbanization alters ecological processes in urban populations and communities and investigates how patterns of ecological change feedback to influence the evolution of populations. Throughout my thesis, I use a combination of perspective pieces, literature reviews, and empirical research to identify and test avenues of research in the field of urban evolutionary ecology. In my first chapter, I reviewed the literature and identified key questions that needed to be addressed by the field. I followed up on one of these questions in my second chapter, where I reviewed the literature to identify patterns on non-adaptive evolution in urban populations. In the next two chapters, I measured the effects of urbanization on plant-pollinator and plant-herbivore interactions. My results demonstrated that urbanization alters interactions between Brassica rapa and its pollinators, leading to altered patterns of pollen dispersal and reproductive success in cities. Similarly, my results demonstrated that even small human settlements lead to increased seed predation rates and modified natural selection in Tribulus cistoides. My sixth chapter looked at the effects of urbanization on the mating system and population genetic variation of Impatiens capensis, and found that despite high outcrossing, urban populations were less genetically diverse than rural populations. My last chapter broadens the scope of my research and identifies joint effects latitude and sexual system on resistance to herbivory in Sagittaria latifolia. My thesis identified consistent effects of urbanization on the ecology and evolution of species and their interactions with one another and provides research directives to develop and broaden the scope of the field of urban evolutionary ecology.
Intermaterial Collaboration: The Spatiotemporal Nexus of Nonhuman Agency in Cultural Heritage Knowledge Production
Keywords: Cataloguing
Collections Management
Cultural Heritage
Documentation
Knowledge Production
Nonhuman Agency

This exploratory research into cultural heritage collections management practice develops a process by which richer knowledge of prospective —and existing—collections can be cultivated while taking the agency of the bodies being considered seriously. Recognizing that interactions require documentation to be useful for knowledge production, perspectives for bolstering non-anthropocentric awareness are presented using the case study of an art collection created and assembled by Indo-Canadian artist P. Mansaram to bring nonhuman agency into the purview of cultural heritage documentation. Influenced by the preceding three decades of material culture theory, especially the theoretical lens of political theorist Jane Bennett (2010) that actively notices nonhuman agency, the dissertation presents multiple methods of reinforcing this awareness in the documentation of objects during the acquisitional process--a moment when contexts and relationships are at their most accessible to collections managers and curators. Recognizing that there is an ahistorical bias to these methods that decontextualizes the interactions from their spatiotemporal contexts, this research puts forward an augmentation of social anthropologist Alfred Gell’s art nexus (1998) to provide a richer method for capturing the agential roles and classifications of interactions in a standardized manner across objects and collections, positioning temporality and spatiality as capable of agential roles. This dissertation demonstrates how knowledge production of collections can be enriched through the application of the nexus to thick narratives developed in the acquisition moment by cultural heritage professionals with the intention of recognizing agency, as well as retroactively to interview and archival materials that were not generated with this purpose in mind. In doing so, it advocates for a fundamental change in how cultural heritage information is managed, building on the calls to evolve existing documentation practices that uphold limitations from rational and standardized contexts toward more relational, unexpected, "crunchy knowledge” (Chapman 2015).
Crafty Impressions: The (New) Visual Culture of Contemporary Fibre Craft
Keywords: craft
Instagram
knitting
labour
photography
platform economy

In recent years in the Global North, there has been an extraordinary resurgence of craft. Do-it yourself and domestic fibre-based arts and crafts have proliferated in homes, workshops and online. The pandemic has further extended these developments. Today, craft is practiced for its physical slowness, intrinsic rewards, creative expression and psychological benefits. Craft is also pursued as a form of paid work. This is particularly true for a growing number of middle-class,white women in Canada and the United States. Increasingly, many craft workers are turning to visual and digital mediums, such as photography, video, blogging and social media, in an effort to showcase their work, exchange creative and technical ideas, cultivate communities, and generate business opportunities. Drawing on a mixed-methods approach and focusing on the hand-knitting industry in Canada and the United States, this dissertation explores the ways in which photographs circulated on social media platforms are bound up in the creative and labour practices, subjectivities, bodies, affects and politics of particular craft workers. The research suggests as craft workers use visual and digital media for the purposes of cultivating creativity, income, communities and political solidarity, they are simultaneously caught up in broader techno-capitalist systems of power.These systems can create opportunities and pathways; they can also limit capacity to earn a secure and stable living, encourage the governing and surveillance of creativity, bodies and emotions, and facilitate the marginalization of transformative politics. Highlighting the ways in which the visual and material are not separate but conjoined, the case of the hand-knitting industry demonstrates how images circulated on social media platforms are bound up in networks of power that span across geography and time, and have important human, social, political and economic contexts and consequences. Adding empirical analysis to the ways in which images circulated on social media platforms do not just show things, but do things (Tolia-Kelly and Rose, 2012), this dissertation offers new perspectives on, and contributes to broader conversations about, visual culture, creative labour, platform economies and social justice, providing analysis on the interconnectedness of these systems, and how they relate to life both online and offline.
Brain-computer Interface-controlled Functional Electrical Stimulation Therapy for Upper-limb Motor Rehabilitation
Keywords: brain-computer interface
functional electrical stimulation
motor rehabilitation
physical therapy
spinal cord injury
stroke

Functional electrical stimulation therapy (FEST) is one of the few interventions that can engage paralyzed muscles in task-oriented exercises, regardless of impairment level. The recent adoption of brain-computer interfacing (BCI) in neurorehabilitation has brought about a novel FEST approach: BCI-controlled FEST or BCI-FEST. In this new intervention, the BCI monitors the patient’s brain activity during therapy, and it triggers the stimulation when it detects an imagined or attempted movement. A single-channel BCI for clinical application was designed, developed, and integrated with FEST for arm and hand rehabilitation. In the first study of this work, the feasibility of having a therapist and a BCI operator deliver BCI-FEST to an individual with chronic stroke was evaluated. The BCI-FEST was safe and feasible, with no adverse events recorded in 80 hours of therapy. Most importantly, the intervention resulted in the participant experiencing meaningful improvements even after other conventional rehabilitation strategies had previously failed to produce a change. Based on the participant’s experience using the BCI in the stroke case study and the therapists’ feedback, the system was upgraded into a new version named KITE-BCI. Motivated by the preliminary results in stroke, BCI-FEST was evaluated in individuals with spinal cord injury (SCI). An interventional study was conducted to assess the feasibility of delivering BCI-FEST in a clinical environment and to understand the potential clinical efficacy of BCI-FEST upper limb motor rehabilitation in five individuals with subacute SCI. The new BCI-FEST was safe and feasible and with a setup time of 11 minutes, comparable to other technology-enhanced interventions. The average success rate of KITE-BCI in triggering the stimulation surpassed the 70% threshold for a reliable BCI system. In terms of clinical efficacy, three out of five participants demonstrated increased scores in self-reported assessments of independence. Furthermore, all participants demonstrated increased scores in observational assessments of motor function. In conclusion, the work presented here validates BCI-FEST as a safe, feasible, and clinically viable rehabilitation strategy and, more importantly, with promising clinical efficacy for improving voluntary arm and hand motor function following a stroke or SCI.
Single Cell Transcriptional Approaches to Understanding the Life of Mammalian Neural Stem Cells
Keywords: Cell lineage and differentiation
Gliogenesis
Neural stem cells
Neurogenesis
Single cell RNA sequencing

Adult neural stem cells (NSCs) build, maintain and are involved in repair of the mammalian brain. Adult NSCs reside within two distinct niches of the forebrain: the hippocampal dentate gyrus and the ventricular-subventricular zone (V-SVZ) along the lateral ventricles. Both adult NSC populations exhibit specific functions within their niches: hippocampal NSCs produce granule neurons of the dentate gyrus involved in spatial learning and memory and V-SVZ NSCs produce neurons required for olfactory learning and oligodendrocytes for white matter development and repair. Adult NSCs derive from embryonic neural precursors which are tasked with building the brain. Unlike their adult NSC progeny, embryonic precursors produce a wide variety of neuronal and glial cell types during development. Whether adult NSCs are fundamentally different and intrinsically less multipotential than their embryonic predecessors are largely unknown. This thesis has addressed this by characterizing and comparing the molecular profiles of adult forebrain NSCs and their embryonic predecessors to ascertain whether they are similar or different. First, I performed single cell transcriptional profiling on embryonic neural precursors and identified a novel core signature for embryonic neural precursors that is largely maintained in adult V-SVZ NSCs indicating that the two populations are fundamentally molecularly similar. Second, I have coupled single cell transcriptional profiling with lineage tracing to follow different populations of embryonic precursors as they progress into adult V-SVZ NSCs. This analysis revealed that the transition from an embryonic precursor to an adult NSC does not involve a fundamental change in cell identity but rather reflects a conversion from an active to a dormant state. Third, I compared the molecular profiles of V-SVZ NSCs with hippocampal NSCs and show that both forebrain NSC populations share the same core signature and undergo similar transitions from embryogenesis to adulthood. These findings support a model in which NSCs of either hippocampal or V-SVZ origin possess conserved molecular properties regardless of their age or respective functions. This model further suggests that the different functions exhibited by NSCs at different ages may not be a product of intrinsic programming but may instead reflect the influence of the environment they reside in.
The Role of Soluble CD163, a Marker of Adipose Tissue Macrophage Activation, in the Etiology of Type 2 Diabetes Mellitus
Keywords: Adipose Tissue
Biomarker
Lifestyle
Macrophage Activation
Obesity
Type 2 Diabetes

Obesity is the most well-established risk factor for type 2 diabetes mellitus (T2DM), although the underlying pathophysiological mechanisms have yet to be fully described. A growing body of evidence suggests that obesity directly induces chronic subclinical inflammation, which is strongly linked with T2DM risk. The discovery of increased macrophage infiltration in the adipose tissue of obese individuals has offered new insights into the potential importance of adipose tissue as a primary driver of chronic subclinical inflammation. To date, however, few studies have investigated the association of adipose tissue inflammation with the natural history of T2DM in humans. The purpose of this thesis was to examine the association of adipose tissue inflammation, assessed using the novel biomarker soluble CD163 (sCD163), with the longitudinal progression of disorders underlying T2DM, and to identify factors related to the development and progression of adipose tissue inflammation. We conducted a systematic review of the current evidence on the association of sCD163 with T2DM and its underlying disorders. Our analytical assessment used data from a longitudinal cohort of well-characterized adults at-risk for T2DM. Insulin sensitivity and beta-cell function indices were calculated using glucose and insulin measures obtained from 75g oral glucose tolerance tests collected at each clinic examination. sCD163 concentrations were evaluated using an enzyme-linked immunosorbent assay. Our systematic review identified sixteen studies, demonstrating a consistent relationship between elevated sCD163 concentrations and insulin resistance, beta-cell dysfunction, and T2DM. Results from our analytical assessments showed that (1) changes in sCD163 concentrations over 6-years were longitudinally associated with impaired insulin sensitivity and beta-cell dysfunction, and with incident dysglycemia; (2) adipose tissue insulin resistance was associated with worsening adipose tissue inflammation as measured by increases in sCD163 and decreases in adiponectin concentrations; and (3) poor diet quality was associated with longitudinal changes in sCD163. Our findings on the association of sCD163 with changes in underlying pathophysiological disorders of T2DM support the concept of adipose tissue macrophage activation as an early abnormality in T2DM. Furthermore, the associations of sCD163 with adipose tissue insulin resistance and diet suggest that this phenomenon is responsive to early modification, setting the stage for future studies.
Modernism and the Sacred in the Music of Benjamin Britten
Keywords: Benjamin Britten
Great Britain
Modernism
music history
sacred music
Twentieth Century

This dissertation examines English musical modernism through the lens of Benjamin Britten’s engagement with the sacred, focussing on his affinity for sacred and liturgical imagery both on and off the stage, and inside and outside of the church. Although Britten’s oeuvre is shot through with ideas and themes that are in direct conversation with both sacred traditions and cultural indices of modernism, scholars have only recently positioned him as an emblematic modernist composer. This overlook is due in no small part to his lifelong interest in exploring themes and musical structures drawn from the Anglo-Catholic church which put his music at odds with dominant discourses of high modernism. This dominant modernist discourse has been construed not only in terms of an avant-garde aesthetic, but in a distinctly secular opposition to tradition. I examine Britten’s pervasive use of the narratives, tropes, liturgies, and framework of the institutional church in England, arguing for the need to foreground the sacred in Britten interpretation more broadly. My analysis includes liturgical works (e.g. Rejoice in the Lamb Op. 30, Missa Brevis in D Op. 63) alongside others for non-liturgical contexts (“Chorale [after an Old French Carol],” Curlew River Op. 71, Children’s Crusade Op. 82). Understanding Britten’s modernism as an intentional engagement with the present by means of shared reference points and traditions, I argue these works are best understood in connection with Britten’s collaborations with clergy and church musicians, and his investment in the communities which sustained both. The constellation of issues I bring together in this study includes: (1) the tensions within our conception of Britten as both a modernist figure and as a composer of church music; (2) how familiar tropes of musical modernism in the twentieth century find new contexts and new significance through their rapprochement with the sacred and liturgical in the Britten repertoire; and (3) the untenability of a simplistic division of sacred and secular as it functions within Britten’s oeuvre. My approach is to clarify where tensions exist, rather than seeking to resolve them; indeed, such tension indelibly inflects Britten’s own engagement with both the sacred and the modernist.
Aging and Referential Communication: Insights from Interactions with Artificial Agents
Keywords: Aging
Artificial agents
Pragmatic inference
Real-time processing
Referential communication
Social robots

The global aging population has led to an increase in research on patterns of change across the lifespan. The evidence to-date suggests that older adults experience declines in sensory and cognitive abilities, however, less is known about changes in the language domain. Language is a fundamental component of everyday communication, not only in the context of interactions with humans but also with artificial agents. There are now increasing multidisciplinary efforts to develop technologies that provide assistance and/or companionship to older adults through spoken language interfaces (e.g., smart homes, social robots). Yet, there is little research on how effectively older adults communicate with artificial agents. Given that a key aspect of everyday communication with humans and artificial agents involves reference to objects in the here-and-now, this dissertation explores age-related differences in referential abilities. The goal is to advance our understanding of patterns of change in referential communication by drawing on insights from interactions with artificial agents. The first study, which explored how speakers design descriptions for different addressees (younger adult, older adult, computer), revealed that although older speakers produced more redundant information than younger speakers, they were similar in terms of performance measures (speech onset latency, speech rate, fluency). Intriguingly, effects were similar regardless of addressee type. The next study examined potential age-related differences in pragmatic inferencing during comprehension. Like younger adults, older listeners generated inferences based on relevant visual information, but had more difficulty suppressing these inferences when warranted (i.e., when a robot speaker had limited perceptual abilities). The final study, which explored the effect of redundant information in descriptions produced by a robot, revealed no age-related differences in real-time processing. Paralleling human-human studies, redundant information that helped to narrow listeners' visual attention facilitated comprehension. Together, the results show that patterns of referential communication with artificial agents are quite similar to previously-observed patterns with humans. Further, although meaningful age-related differences were sometimes found, many aspects of referential communication seem to be preserved in aging. These findings enhance our understanding of referential behavior in aging in the context of interacting with artificial agents and also inform the design of future technologies.