CT Image Electron Density Quantification in Regions with Metal Implants: Implications for Radiotherapy Treatment Planning

In radiotherapy planning, computed tomography (CT) images are used to quantify the electron density of tissues and provide spatial anatomical information. Treatment planning systems use these data to calculate the expected spatial distribution of absorbed dose in a patient. CT imaging is complicated by the presence of metal implants which cause increased image noise, produce artifacts throughout the image and can exceed the available range of CT number values within the implant, perturbing electron density estimates in the image. Furthermore, current dose calculation algorithms do not accurately model radiation transport at metal-tissue interfaces. Combined, these issues adversely affect the accuracy of dose calculations in the vicinity of metal implants. As the number of patients with orthopedic and dental implants grows, so does the need to deliver safe and effective radiotherapy treatments in the presence of implants. The Medical Physics group at the Cancer Centre of Southeastern Ontario and Queen's University has developed a Cobalt-60 CT system that is relatively insensitive to metal artifacts due to the high energy, nearly monoenergetic Cobalt-60 photon beam. Kilovoltage CT (kVCT) images, including images corrected using a commercial metal artifact reduction tool, were compared to Cobalt-60 CT images throughout the treatment planning process, from initial imaging through to dose calculation. An effective metal artifact reduction algorithm was also implemented for the Cobalt-60 CT system. Electron density maps derived from the same kVCT and Cobalt-60 CT images indicated the impact of image artifacts on estimates of photon attenuation for treatment planning applications. Measurements showed that truncation of CT number data in kVCT images produced significant mischaracterization of the electron density of metals. Dose measurements downstream of metal inserts in a water phantom were compared to dose data calculated using CT images from kVCT and Cobalt-60 systems with and without artifact correction. The superior accuracy of electron density data derived from Cobalt-60 images compared to kVCT images produced calculated dose with far better agreement with measured results. These results indicated that dose calculation errors from metal image artifacts are primarily due to misrepresentation of electron density within metals rather than artifacts surrounding the implants.

UNDERSTANDING ESSAY RATING AS A SOCIALLY MEDIATED ACTIVITY: THE CASE OF A HIGH-STAKES ENGLISH TEST IN CHINA

Most essay rating research in language assessment has examined human raters’ essay rating as a cognitive process, thus overlooking or oversimplifying the interaction between raters and sociocultural contexts. Given that raters are social beings, their practices have social meanings and consequences. Hence it is important to situate essay rating within its sociocultural context for a more meaningful understanding. Drawing on Engeström’s (1987, 2001) cultural-historical activity theory (CHAT) framework with a sociocultural perspective, this study reconceptualized essay rating as a socially mediated activity with both cognitive (individual raters’ goal-directed decision-making actions) and social layers (raters’ collective object-oriented essay rating activity at related settings). In particular, this study explored raters’ essay rating at one provincial rating centre in China within the context of a high-stakes university entrance examination, the National Matriculation English Test (NMET). This study adopted a multiple-method multiple-perspective qualitative case study design. Think-aloud protocols, stimulated recalls, interviews, and documents served as the data sources. This investigation involved 25 participants at two settings (rating centre and high schools), including rating centre directors, team leaders, NMET essay raters who were high school teachers, and school principals and teaching colleagues of these essay raters. Data were analyzed using Strauss and Corbin’s (1990) open and axial coding techniques, and CHAT for data integration. The findings revealed the interaction between raters and the NMET sociocultural context. Such interaction can be understood through a surface structure (cognitive layer) and a deep structure (social layer) concerning how raters assessed NMET essays, where the surface structure reflected the “what” and the deep structure explained the “how” and “why” in raters’ decision-making. This study highlighted the roles of goals and rules in rater decision-making, rating tensions and raters’ solutions, and the relationship between essay rating and teaching. This study highlights the value of a sociocultural view to essay rating research, demonstrates CHAT as a sociocultural approach to investigate essay rating, and proposes a direction for future washback research on the effect of essay rating. This study also provides support for NMET rating practices that can potentially bring positive washback to English teaching in Chinese high schools.

QUADRUPOLE CENTRAL TRANSITION NMR SPECTROSCOPY OF QUADRUPOLAR NUCLEI IN SOLUTION

This thesis reports on 17O (I = 5/2) and 59Co (I = 7/2) quadrupole central transition (QCT) NMR studies of three classes of biologically important molecules: glucose, nicotinamide and Vitamin B12 derivatives. Extensive QCT NMR experiments were performed over a wide range of molecular motion by changing solvent viscosity and temperature. 17O-labels were introduced at the 5- and 6-positions respectively: D-[5-17O]-glucose and D-[6-17O]-glucose following the literature method. QCT NMR greatly increased the molecular size limit obtained by ordinary solution NMR. It requires much lower temperatures to get the optimal spectral resolution, which are preferable for biological molecules. In addition, quadrupolar product parameter (PQ) and shielding anisotropy product parameter (PSA) were obtained for hydroxide group and amide group for the first time. For conventional NMR studies of quadrupolar nuclei, only PQ is accessible while QCT NMR obtained both PQ and PSA simultaneously. Our experiments also suggest the resolution of QCT NMR can be even better than that obtained by conventional NMR. We observed for the first time that the second-order quadrupolar interaction becomes a dominant relaxation mechanism under ultraslow motion. All these observations suggest that QCT NMR can become a standard technique for studying quadrupolar nuclei in solution.

A cloud-based system for measuring radiation treatment plan similarity

PURPOSE: Radiation therapy is used to treat cancer using carefully designed plans that maximize the radiation dose delivered to the target and minimize damage to healthy tissue, with the dose administered over multiple occasions. Creating treatment plans is a laborious process and presents an obstacle to more frequent replanning, which remains an unsolved problem. However, in between new plans being created, the patient's anatomy can change due to multiple factors including reduction in tumor size and loss of weight, which results in poorer patient outcomes. Cloud computing is a newer technology that is slowly being used for medical applications with promising results. The objective of this work was to design and build a system that could analyze a database of previously created treatment plans, which are stored with their associated anatomical information in studies, to find the one with the most similar anatomy to a new patient. The analyses would be performed in parallel on the cloud to decrease the computation time of finding this plan. METHODS: The system used SlicerRT, a radiation therapy toolkit for the open-source platform 3D Slicer, for its tools to perform the similarity analysis algorithm. Amazon Web Services was used for the cloud instances on which the analyses were performed, as well as for storage of the radiation therapy studies and messaging between the instances and a master local computer. A module was built in SlicerRT to provide the user with an interface to direct the system on the cloud, as well as to perform other related tasks. RESULTS: The cloud-based system out-performed previous methods of conducting the similarity analyses in terms of time, as it analyzed 100 studies in approximately 13 minutes, and produced the same similarity values as those methods. It also scaled up to larger numbers of studies to analyze in the database with a small increase in computation time of just over 2 minutes. CONCLUSION: This system successfully analyzes a large database of radiation therapy studies and finds the one that is most similar to a new patient, which represents a potential step forward in achieving feasible adaptive radiation therapy replanning.

EDUCATING THE PUBLIC THROUGH NEWS MEDIA: CASE STUDIES OF NEWS LITERACY IN THE NEW MEDIA LANDSCAPE

Two decades of unprecedented changes in the media landscape have increased the complexity of informing the public through news media. With significant changes to the way the news industry does business and the way news consumers access this information, a new set of skills is being proposed as essential for today’s news consumer. News literacy is the use of critical thinking skills to assess the reliability and source of the information that people consume on a daily basis, as well as fostering self-awareness of personal news consumption habits and how it can create audience bias. The purpose of this study was to examine how adults experience the news in their everyday lives and to describe the nature of the news literacy skills people employ in their daily news consumption. This study purposefully selected four adults who have completed high school, and who regularly consume news information across a number of platforms, both traditional and digital. Two of the participants, one man and one woman, were over 50 years old. One other male participant was in his 30’s and the final participant, a young woman, was in her 20’s. They all utilized both traditional and digital media on a regular basis and all had differing skill levels when using social media for information. Their news experiences were documented by in-depth interviews and the completion of seven daily news logs. In their daily logs the participants differentiated news information from other information available on-line but the interviews revealed a contradiction between their intentions and their news consumption practices. All four participants had trouble distinguishing between news and opinion pieces in the news information realm. In addition all but one seemed unaware of their personal bias and any possible effect it was having on their news consumption. Further research should explore the benefits of an adult-centered news literacy curriculum on news consumers similar to the participants, and should examine the development of audience bias and its relationship to the daily exposure people have to the torrent of information that is available to them on a daily basis.

DEVELOPMENT OF AN ADJUSTABLE SUTURE TECHNIQUE FOR TRABECULECTOMY

This research presents a new design of an adjustable suture that could provide a better intraocular pressure (IOP) control in the post treatment of trabeculectomy surgery and limit associated complication with the current suturing techniques. A better control in tension suture brings a great deal of advantages to this surgical technique compared with the traditional adjustable suture. A length adjustment can be added in advance to a 10-0 nylon suture which enables suture tension to be released during the postoperative period of trabeculectomy surgery. This adjustment has a D-ring geometry made of 10-0 nylon suture adhered to a 10-0 nylon surgical suture which is used to close the scalar flap. The D ring was adhered with about 180 microdroplet of Loctite 4311that was found to form a strong joint to connect the D ring to the main 10-0 nylon suture and strong enough to carry the added tension instead after cutting the central suture between the two joints of the D ring. The geometry of adjustment is the key factor of maintaining the IOP at the normal range and keeping the scleral flap tight enough and secure so that aqueous humor continues to percolate under the subconjunctiva. It has been found that a 365, and 450 µm length extensions can release suture tension postoperatively and relieve the intraocular pressure within the eye by 33, and 66% respectively. The fabrication process of the new adjustable suture was divided into two steps: fabrication of micro jig and forming microdroplets. A micro jig was fabricated in order to form and bond a precise length extension to the new design of the adjustable suture. In addition, a new liquid separation technique has been followed in this study in order to generate micro adhesive droplets as small as 50µm for bonding the new adjustable suture structure.

SINGLE STAGE LED DRIVER TECHNOLOGY WITH LOW FREQUENCY RIPPLE CANCELLATION

Because of high efficacy, long lifespan, and environment-friendly operation, LED lighting devices become more and more popular in every part of our life, such as ornament/interior lighting, outdoor lightings and flood lighting. The LED driver is the most critical part of the LED lighting fixture. It heavily affects the purchasing cost, operation cost as well as the light quality. Design a high efficiency, low component cost and flicker-free LED driver is the goal. The conventional single-stage LED driver can achieve low cost and high efficiency. However, it inevitably produces significant twice-line-frequency lighting flicker, which adversely affects our health. The conventional two-stage LED driver can achieve flicker-free LED driving at the expenses of significantly adding component cost, design complexity and low the efficiency. The basic ripple cancellation LED driving method has been proposed in chapter three. It achieves a high efficiency and a low component cost as the single-stage LED driver while also obtaining flicker-free LED driving performance. The basic ripple cancellation LED driver is the foundation of the entire thesis. As the research evolving, another two ripple cancellation LED drivers has been developed to improve different aspects of the basic ripple cancellation LED driver design. The primary side controlled ripple cancellation LED driver has been proposed in chapter four to further reduce cost on the control circuit. It eliminates secondary side compensation circuit and an opto-coupler in design while at the same time maintaining flicker-free LED driving. A potential integrated primary side controller can be designed based on the proposed LED driving method. The energy channeling ripple cancellation LED driver has been proposed in chapter five to further reduce cost on the power stage circuit. In previous two ripple cancellation LED drivers, an additional DC-DC converter is needed to achieve ripple cancellation. A power transistor has been used in the energy channeling ripple cancellation LED driving design to successfully replace a separate DC-DC converter and therefore achieved lower cost. The detailed analysis supports the theory of the proposed ripple cancellation LED drivers. Simulation and experiment have also been included to verify the proposed ripple cancellation LED drivers.

Nonlinear soil-structure interaction for buried pressure pipes under differential ground motion

Pipelines extend thousands of kilometers across wide geographic areas as a network to provide essential services for modern life. It is inevitable that pipelines must pass through unfavorable ground conditions, which are susceptible to natural disasters. This thesis investigates the behaviour of buried pressure pipelines experiencing ground distortions induced by normal faulting. A recent large database of physical modelling observations on buried pipes of different stiffness relative to the surrounding soil subjected to normal faults provided a unique opportunity to calibrate numerical tools. Three-dimensional finite element models were developed to enable the complex soil-structure interaction phenomena to be further understood, especially on the subjects of gap formation beneath the pipe and the trench effect associated with the interaction between backfill and native soils. Benchmarked numerical tools were then used to perform parametric analysis regarding project geometry, backfill material, relative pipe-soil stiffness and pipe diameter. Seismic loading produces a soil displacement profile that can be expressed by isoil, the distance between the peak curvature and the point of contraflexure. A simplified design framework based on this length scale (i.e., the Kappa method) was developed, which features estimates of longitudinal bending moments of buried pipes using a characteristic length, ipipe, the distance from peak to zero curvature. Recent studies indicated that empirical soil springs that were calibrated against rigid pipes are not suitable for analyzing flexible pipes, since they lead to excessive conservatism (for design). A large-scale split-box normal fault simulator was therefore assembled to produce experimental data for flexible PVC pipe responses to a normal fault. Digital image correlation (DIC) was employed to analyze the soil displacement field, and both optical fibres and conventional strain gauges were used to measure pipe strains. A refinement to the Kappa method was introduced to enable the calculation of axial strains as a function of pipe elongation induced by flexure and an approximation of the longitudinal ground deformations. A closed-form Winkler solution of flexural response was also derived to account for the distributed normal fault pattern. Finally, these two analytical solutions were evaluated against the pipe responses observed in the large-scale laboratory tests.

A Poetics of Annotation: Alexander Pope's Footnotes

Studies of Alexander Pope's poetry tend to examine only the footnotes to his Dunciads, if they examine his footnotes at all. This dissertation will address this deficit in our understanding of Pope's poetics through an examination of Pope's use of footnotes in support of his verse throughout his career. With Gerard Genette's taxonomy of footnotes as variously paratext and text and Hugh Kenner's idea of the technological space of the printed page as frameworks within which Pope's footnotes operate, this dissertation will show that – over the course of his career – Pope developed a poetics of annotation that deployed footnotes rhetorically as appeals to ethos and pathos that both built up Pope's own authorial ethos for his audience in the literary market place of early eighteenth-century London and for posterity and used that authorial ethos in support of his literary and political friends.

The Flotation of Niobium Oxide Minerals from Carbonatite Ores

Global niobium production is presently dominated by three operations, Araxá and Catalão (Brazil), and Niobec (Canada). Although Brazil accounts for over 90% of the world’s niobium production, a number of high grade niobium deposits exist worldwide. The advancement of these deposits depends largely on the development of operable beneficiation flowsheets. Pyrochlore, as the primary niobium mineral, is typically upgraded by flotation with amine collectors at acidic pH following a complicated flowsheet with significant losses of niobium. This research compares the typical two stage flotation flowsheet to a direct flotation process (i.e. elimination of gangue pre-flotation) with the objective of circuit simplification. In addition, the use of a chelating reagent (benzohydroxamic acid, BHA) was studied as an alternative collector for fine grained, highly disseminated pyrochlore. For the amine based reagent system, results showed that while comparable at the laboratory scale, when scaled up to the pilot level the direct flotation process suffered from circuit instability because of high quantities of dissolved calcium in the process water due to stream recirculation and fine calcite dissolution, which ultimately depressed pyrochlore. This scale up issue was not observed in pilot plant operation of the two stage flotation process as a portion of the highly reactive carbonate minerals was removed prior to acid addition. A statistical model was developed for batch flotation using BHA on carbonatite ore (0.25% Nb2O5) that could not be effectively upgraded using the conventional amine reagent scheme. Results showed that it was possible to produce a concentrate containing 1.54% Nb2O5 with 93% Nb recovery in ~15% of the original mass. Fundamental studies undertaken included FT-IR and XPS, which showed the adsorption of both the protonized amine and the neutral amine onto the surface of the pyrochlore (possibly at niobium sites as indicated by detected shifts in the Nb3d binding energy). The results suggest that the preferential flotation of pyrochlore over quartz with amines at low pH levels can be attributed to a difference in critical hemimicelle concentration (CHC) values for the two minerals. BHA was found to be absorbed on pyrochlore surfaces by a similar mechanism to alkyl hydroxamic acid. It is hoped that this work will assist in improving operability of existing pyrochlore flotation circuits and help promote the development of niobium deposits globally. Future studies should focus on investigation into specific gangue mineral depressants and inadvertent activation phenomenon related to BHA flotation of gangue minerals.

From Where Do We Teach? Potential Positions in Public Education

This thesis is a conceptual examination of the positions from which we teach in public education. As it is philosophical in nature, it takes no qualitative or quantitative data. It offers a review of selected relevant literature and an analysis of personal and professional experience, with the intent to pose critical questions about teaching and learning. The framework of this thesis represents the following contentions: First, from its inception, public schooling served capital by preparing skilled labour for emerging industrial markets. This history is the hegemonic shadow that hangs over public education today. Second, movements toward the standardization of funding, curriculum, and evaluation support the further commodification of public schooling. The “accountability” that standardization offers, the “back to basics” that it aims for, is counter to the potential that public education might critically inform citizens and seek social justice. Third, movements toward the privatization of public schooling under the guise of “choice” and “mobility”, brought on by manufactured crisis, serve only to widen socio-economic inequities as capitalist neoliberal interests seek profit in both the product of public schools and in schooling itself. If we recognize and understand the power of public education to inform vast numbers of citizens who will, in turn, either maintain or reform society, we must ask: What do we want public education to be? What are the effects of continuing down historically conventional and increasingly standardized paths? What do progressive pedagogies offer? How might teachers destandardize their pedagogy and pursue equitable opportunities for marginalized students? How might students name themselves and their world, that they might play a part in its reimagining? For whom do we teach, and under what conditions? From where do we teach, and why? For educators to ask these questions, and to employ what they discover, will necessitate taking substantial risks. It will necessitate taking a stand and cannot be done alone. Teachers must seek out the collaboration of their students. They must offer students the time and the space to find their own voices, to create their own selves, and to envision previously uncharted paths on which we might walk together.

Processing the Intracardiac Electrogram for Atrial Fibrillation Ablation

Atrial fibrillation (AF) is a major global health issue as it is the most prevalent sustained supraventricular arrhythmia. Catheter-based ablation of some parts of the atria is considered an effective treatment of AF. The main objective of this research is to analyze atrial intracardiac electrograms (IEGMs) and extract insightful information for the ablation therapy. Throughout this thesis we propose several computationally efficient algorithms that take streams of IEGMs from different atrial sites as the input signals, sequentially analyze them in various domains (e.g., time and frequency), and create color-coded three-dimensional map of the atria to be used in the ablation therapy.

Measuring Scope of Practice Enactment among Primary Care Registered Nurses in Ontario

Background: Primary care is the sector of health care in which patients first establish contact with the health system, are provided person-focused care over time for all new or common needs, and receive coordinated integrated health services provided elsewhere by other members of the health care team. Registered Nurses (RNs) in Canada provide care within this sector in varying roles. The extent to which RNs enact their full scope of practice in primary care settings in Canada is not known. The Actual Scope of Practice questionnaire (ASCOP) is a 26 item Likert scale questionnaire developed by researchers in Canada and validated in the acute care setting to measure the extent to which RNs apply the knowledge, skills and competencies of the professional full scope of practice. Similar to the acute care setting, there is a need to measure scope of practice enactment in the primary care setting. Objectives: The overall aim of this thesis was to measure scope of practice enactment in the primary care setting. Two research objectives were addressed: (1) to revise and adapt the ASCOP questionnaire for use in the primary care setting, and (2) to determine internal consistency, construct validity, and sensitivity of the modified instrument, the ASCOP-PC. Methods: To address the first objective, a narrative literature review and synthesis and an expert panel review was conducted. To address the second objective a cross-sectional survey of 178 RNs working in primary care organizations in Ontario was conducted Results: The ASCOP, with few modifications, addressed key attributes of nursing scope of practice in the primary care setting. The ASCOP-PC yielded acceptable alpha coefficients ranging from 0.66 to 0.91 and explained variances from 44.2 to 62.6. Total mean score of 5.16 suggests that RNs within these models of care almost always engage in activities reflected in the ASCOP-PC. Interpretation: Findings from this study support the use of a the modified ASCOP questionnaire as a reliable and valid measure of scope of practice enactment among primary care nurses in the primary care setting.

Psychosocial Functioning in Women with Symptoms of Persistent Genital Arousal

Persistent genital arousal disorder (PGAD) is characterized by physiological sexual arousal (vasocongestion, sensitivity of the genitals and nipples) that is described as distressing, and sometimes painful. Although awareness of PGAD is growing, there continues to be a lack of systematic research on this condition. The vast majority of published reports are case studies. Little is known about the symptom characteristics, biological factors, or psychosocial functioning associated with the experience of persistent genital arousal (PGA) symptoms. This study sought to characterize a sample of women with PGA (Study One); compare women with and without PGA symptoms on a series of biopsychosocial factors (Study Two); and undertake an exploratory comparison of women with PGA, painful PGA, and genital pain (Study Three)—all within a biopsychosocial framework. Symptom-free women, women with PGA symptoms, painful PGA, and genital pain, completed an online survey of biological factors (medical history, symptom profiles), psychological factors (depression, anxiety) and social factors (sexual function, relationship satisfaction). Study One found that women report diverse symptoms associated with PGA, with almost half reporting painful symptoms. In Study Two, women with symptoms of PGA reported significantly greater impairment in most domains of psychosocial functioning as compared to symptom-free women. In particular, catastrophizing of vulvar sensations was related to symptom ratings (i.e., greater severity, distress) and psychosocial outcomes (i.e., greater depression and anxiety). Finally, Study Three found that women with PGA symptoms reported some overlap in medical comorbidities and symptom expression as those with combined PGA and vulvodynia and those with vulvodynia symptoms alone; however, there were also a number of significant differences in their associated physical symptoms. These studies indicate that PGA symptoms have negative consequences for the psychosocial functioning of affected women. As such, future research and clinical care may benefit from a biopsychosocial approach to PGA symptoms. These studies highlight areas for more targeted research, including the role of catastrophizing in PGA symptom development and maintenance, and the potential conceptualization of both PGA and vulvodynia (and potentially other conditions) under a general umbrella of ‘genital paraesthesias’ (i.e., disorders characterized by abnormal sensations, such as tingling and burning).

Individual Variation in VO2peak Response Following Sprint Interval Training: The Role of Peripheral Adaptation

There is a large degree of heterogeneity in response to regular physical activity at the individual level, with some exhibiting no or very small improvements in VO2peak following highly controlled exercise training. The purpose of this thesis was to examine individual variation in VO2peak response to sprint interval training (SIT) in relation to individual responses to multiple measures of peripheral physiological adaptation. Specifically, VO2peak, capillary density, fibre-specific SDH content, and type I fibre % were measured in 23 young, healthy, recreationally active males before and after 4 weeks SIT (Tabata protocol 4 x per week). The key findings of this experiment included that, when separated into tertiles of VO2peak response, the high (HI) and low (LO) groups differed significantly in VO2peak change after training. Secondly, there was no difference between HI and LO groups for response in any of capillary density, fibre-specific SDH content, or fibre type %, with no correlation found between individual VO2peak response and changes in any measured peripheral variable. Together, these results confirm that individuals respond heterogeneously to SIT and suggest that this heterogeneity does not result from differences in individual changes in capillary density, fibre-specific SDH content or type I fibre %. It is speculated that some other combination of peripheral physiological adaptation must explain variability in VO2peak response to 4 weeks of SIT.