- Overview
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My research is focused on improving health care and patient well-being in children with congenital and acquired heart disease. I am especially interested in the long-term follow-up of patients and how different factors influence their overall health and longevity. A specific interest of mine is how physical activity and exercise affect health outcomes and how we can use traditional and non-traditional methods to rehabilitate children with prolonged illness or following surgery. I am also interested in looking at environmental strategies for reducing greenhouse gas emissions and costs associated with healthcare travel. My colleagues and I are also using digital health tools to enhance communication between patients and their healthcare providers, improve medication adherence, and facilitate lifestyle behavioural change.
- Publications
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Text messaging to improve connection between adolescents and their health care providers
Digital Health
DOI: 10.1177/20552076241309228
2025Feasibility study of micronutrient status and body mass index of newly diagnosed pediatric oncology patients: Research commentary
Pediatric Blood and Cancer
DOI: 10.1002/pbc.30936
2024An 8-Week Virtual Exercise Training Program for Pediatric Solid Organ Transplant Recipients
Pediatric Exercise Science
DOI: 10.1123/pes.2023-0066
2024Effect of distance to tertiary centre on enrolment of paediatric patients with relapsed or refractory cancer on early phase clinical trials in British Columbia
Paediatrics and Child Health (Canada)
DOI: 10.1093/pch/pxad044
2024Head circumference assessment on routine paediatric brain MRI
Archives of Disease in Childhood
DOI: 10.1136/archdischild-2021-323491
2022Ductus arteriosus: more than just the patent ductus arteriosus
Pediatric Radiology
DOI: 10.1007/s00247-022-05387-7
2022Chest Radiograph Alone Is Sufficient as the Foreign Body Survey for Children Presenting with Coin Ingestion
Pediatric Emergency Care
DOI: 10.1097/PEC.0000000000001688
2021Association between in-line filtration and Type I hypersensitivity reactions in pediatric oncology patients receiving intravenous etoposide
Pediatric Hematology and Oncology
DOI: 10.1080/08880018.2020.1838011
2021Aortic Dimensions, Biophysical Properties, and Plasma Biomarkers in Children and Adults with Marfan or Loeys-Dietz Syndrome
CJC Open
DOI: 10.1016/j.cjco.2020.12.018
2021The relative incidence of cardiogenic and septic shock in neonates
Paediatrics and Child Health (Canada)
DOI: 10.1093/pch/pxz078
2020The Utility of PET/CT in Guiding Radiotherapy Reduction for Children with Hodgkin Lymphoma Treated with ABVD
Journal of Pediatric Hematology/Oncology
DOI: 10.1097/MPH.0000000000001534
2020Whole blood human transcriptome and virome analysis of ME/CFS patients experiencing post-exertional malaise following cardiopulmonary exercise testing
PLOS ONE
Jerome Bouquet and Tony Li and Jennifer L. Gardy and Xiaoying Kang and Staci Stevens and Jared Stevens and Mark VanNess and Christopher Snell and James Potts and Ruth R. Miller and Muhammad Morshed and Mark McCabe and Shoshana Parker and Miguel Uyaguari and Patrick Tang and Theodore Steiner and Wee-Shian Chan and Astrid-Marie De Souza and Andre Mattman and David M. Patrick and Charles Y. Chiu
DOI: 10.1371/journal.pone.0212193
03/2019Interdisciplinary Perspectives on the Value of Massage Therapy in a Pediatric Hospice
Journal of Hospice and Palliative Nursing
DOI: 10.1097/NJH.0000000000000576
2019Echocardiographic Assessment of Ventricular Function During Exercise in Adolescent Female Patients With Anorexia Nervosa
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2018.10.014
2019Physiological Responses to Exercise in Pediatric Heart Transplant Recipients
Medicine and Science in Sports and Exercise
DOI: 10.1249/MSS.0000000000001889
2019Cost Savings Analysis of Early Extubation Following Congenital Heart Surgery
Pediatric Cardiology
DOI: 10.1007/s00246-018-1970-0
2019Non-invasive assessment of aortic stiffness and blood pressure in young Turner syndrome patients
Journal of Pediatric Endocrinology and Metabolism
DOI: 10.1515/jpem-2018-0346
2019Does competitive swimming affect lung growth?
Physiological Reports
DOI: 10.14814/phy2.13816
2018The clinical and genetic spectrum of catecholaminergic polymorphic ventricular tachycardia: Findings from an international multicentre registry
Europace
DOI: 10.1093/europace/euw389
2018Catecholaminergic polymorphic ventricular tachycardia patients with multiple genetic variants in the PACES CPVT Registry
PLoS ONE
DOI: 10.1371/journal.pone.0205925
2018Doppler Echocardiography Assessment of Aortic Stiffness in Female Adolescents with Anorexia Nervosa
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2018.01.003
2018Response to: Comment on "assessment of Liver Stiffness in Pediatric Fontan Patients Using Transient Elastography"
Canadian Journal of Gastroenterology and Hepatology
DOI: 10.1155/2017/4217878
2017A novel treadmill protocol for exercise testing in children: The British Columbia Children's Hospital protocol
BMJ Open Sport and Exercise Medicine
DOI: 10.1136/bmjsem-2016-000197
2017Response Letter to ‘Optimising physiology for adolescents with dysautonomia’
Acta Paediatrica, International Journal of Paediatrics
DOI: 10.1111/apa.14058
2017Genetic Insurance Discrimination in Sudden Arrhythmia Death Syndromes Empirical Evidence from a Cross-Sectional Survey in North America
Circulation: Cardiovascular Genetics
DOI: 10.1161/CIRCGENETICS.116.001442
2017Stress Echocardiographic Evaluation for D-Transposition of the Great Arteries after Atrial Redirection: Unmasking Early Signs of Myocardial Dysfunction and Baffle Stenosis
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2016.09.005
2017A Doppler Echocardiographic Study of the Myocardial Inotropic Response to Peak Semisupine Exercise in Healthy Children: Development of a Simplified Index of Myocardial Reserve
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2017.04.008
2017Exercise and the multidisciplinary holistic approach to adolescent dysautonomia
Acta Paediatrica, International Journal of Paediatrics
DOI: 10.1111/apa.13750
2017An Echocardiographic Study of Left Ventricular Size and Cardiac Function in Adolescent Females with Anorexia Nervosa
European Eating Disorders Review
DOI: 10.1002/erv.2409
2016Characterization of Myocardial Repolarization Reserve in Adolescent Females with Anorexia Nervosa
Circulation
DOI: 10.1161/CIRCULATIONAHA.115.016697
2016Noninvasive Assessment of Vascular Function in Postoperative Cardiovascular Disease (Coarctation of the Aorta, Tetralogy of Fallot, and Transposition of the Great Arteries)
American Journal of Cardiology
DOI: 10.1016/j.amjcard.2016.05.055
2016Predictors of poor outcome among children with heterotaxy syndrome: A retrospective review
Open Heart
DOI: 10.1136/openhrt-2015-000328
2016Assessment of liver stiffness in pediatric Fontan patients using transient elastography
Canadian Journal of Gastroenterology and Hepatology
DOI: 10.1155/2016/7125193
2016Catecholaminergic Polymorphic Ventricular Tachycardia in Children: Analysis of Therapeutic Strategies and Outcomes from an International Multicenter Registry
Circulation: Arrhythmia and Electrophysiology
DOI: 10.1161/CIRCEP.114.002217
2015A randomized, double blind pilot study to assess the effects of losartan vs. atenolol on the biophysical properties of the aorta in patients with Marfan and Loeys-Dietz syndromes
International Journal of Cardiology
DOI: 10.1016/j.ijcard.2014.11.082
2015Current management of focal atrial tachycardia in children a multicenter experience
Circulation: Arrhythmia and Electrophysiology
DOI: 10.1161/CIRCEP.113.001423
2014Feasibility of optical coherence tomography in children with Kawasaki disease and pediatric heart transplant recipients
Circulation: Cardiovascular Imaging
DOI: 10.1161/CIRCIMAGING.113.001764
2014Permanent junctional reciprocating tachycardia in children: A multicenter experience
Heart Rhythm
DOI: 10.1016/j.hrthm.2014.04.033
2014Should early extubation be the goal for children after congenital cardiac surgery?
Journal of Thoracic and Cardiovascular Surgery
DOI: 10.1016/j.jtcvs.2014.06.093
2014Physical activity recommendations for patients with electrophysiologic and structural congenital heart disease: A survey of canadian health care providers
Pediatric Cardiology
DOI: 10.1007/s00246-013-0654-z
2013Postnatal outcome in patients with fetal tachycardia
Pediatric Cardiology
DOI: 10.1007/s00246-012-0392-7
2013Echo-doppler assessment of the biophysical properties of the aorta in children with chronic kidney disease
Pediatric Cardiology
DOI: 10.1007/s00246-013-0632-5
2013Presentation, diagnosis, and medical management of heart failure in children: Canadian cardiovascular society guidelines
Canadian Journal of Cardiology
DOI: 10.1016/j.cjca.2013.08.008
2013Echo-doppler assessment of arterial stiffness in pediatric patients with kawasaki disease
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2013.05.015
2013Noninvasive assessment of vascular function and hydraulic power and efficiency in pediatric Fontan patients
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2013.06.013
2013Anthracycline induced cardiac toxicity in pediatric Ewing sarcoma: A longitudinal study
Pediatric Blood and Cancer
DOI: 10.1002/pbc.24404
2013Exercise-induced intrapulmonary arteriovenous shunt in healthy women
Respiratory Physiology and Neurobiology
DOI: 10.1016/j.resp.2012.01.004
2012Biophysical properties of the aorta and left ventricle and exercise capacity in obese children
American Journal of Cardiology
DOI: 10.1016/j.amjcard.2012.05.019
2012Population-based review of tetralogy of Fallot with absent pulmonary valve: Is prenatal diagnosis really associated with a poor prognosis?
Ultrasound in Obstetrics and Gynecology
DOI: 10.1002/uog.11126
2012Balloon angioplasty for congenital aortic valve stenosis
American Journal of Cardiology
DOI: 10.1016/j.amjcard.2012.02.036
2012Assessing the knowledge of sudden unexpected death in the young among Canadian medical students and recent graduates: A cross-sectional study
BMJ Open
DOI: 10.1136/bmjopen-2012-001798
2012The study of antiarrhythmic medications in infancy (SAMIS): A multicenter, randomized controlled trial comparing the efficacy and safety of digoxin versus propranolol for prophylaxis of supraventricular tachycardia in infants
Circulation: Arrhythmia and Electrophysiology
DOI: 10.1161/CIRCEP.112.972620
2012Serial measurements of exercise performance in pediatric heart transplant patients using stress echocardiography
Pediatric Transplantation
DOI: 10.1111/j.1399-3046.2010.01467.x
2011Economic Evaluation of Palivizumab in Children With Congenital Heart Disease: A Canadian Perspective
Canadian Journal of Cardiology
DOI: 10.1016/j.cjca.2010.12.064
2011A review of sudden unexpected death in the young in British Columbia
Canadian Journal of Cardiology
DOI: 10.1016/S0828-282X(10)70329-9
2010Early Changes in the Biophysical Properties of the Aorta in Pre-Adolescent Children Born Small for Gestational Age
Journal of Pediatrics
DOI: 10.1016/j.jpeds.2009.10.002
2010Vitamin A is systemically bioavailable after intratracheal administration with surfactant in an animal model of newborn respiratory distress
Pediatric Research
DOI: 10.1203/PDR.0b013e3181da8fe8
2010Does biventricular pacing improve hemodynamics in children undergoing routine congenital heart surgery?
Pediatric Cardiology
DOI: 10.1007/s00246-009-9581-4
2010Primary pulmonary arterial hypertension and autoimmune polyendocrine syndrome in a pediatric patient
Pediatric Cardiology
DOI: 10.1007/s00246-010-9704-y
2010A model-based method to estimate pulse wave velocity
IFMBE Proceedings
DOI: 10.1007/978-3-642-03882-2_121
2009Are implantable loop recorders useful in detecting arrhythmias in children with unexplained syncope?
PACE - Pacing and Clinical Electrophysiology
DOI: 10.1111/j.1540-8159.2009.02486.x
2009Imaging of a carotid aneurysm in two patients following extracorporeal membrane oxygenation therapy
Pediatric Cardiology
DOI: 10.1007/s00246-009-9462-x
2009Fitness, fatigue, disease activity, and quality of life in pediatric lupus
Arthritis Care and Research
DOI: 10.1002/art.23534
2008Could we still improve early and interim outcome after prosthetic systemic-pulmonary shunt? A risk factors analysis
European Journal of Cardio-thoracic Surgery
DOI: 10.1016/j.ejcts.2008.06.001
2008A novel method to estimate the aortic pressure waveform using B-mode ultrasound images acquired from a suprasternal view
Proceedings of the 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS'08 - "Personalized Healthcare through Technology"
DOI: 10.1109/iembs.2008.4650407
2008A Population-Based Study of Cardiac Malformations and Outcomes Associated With Dextrocardia
American Journal of Cardiology
DOI: 10.1016/j.amjcard.2007.02.095
2007A stress echocardiography study of cardiac function during progressive exercise in pediatric oncology patients treated with anthracyclines
Pediatric Blood and Cancer
DOI: 10.1002/pbc.21122
2007Letter to the editor
Journal of the American Society of Echocardiography
DOI: 10.1016/j.echo.2007.06.008
2007Device closure of a secundum atrial septal defect in a 4-month-old infant with a marginal left ventricle following coarctation repair
Congenital Heart Disease
DOI: 10.1111/j.1747-0803.2007.00140.x
2007Minimally invasive approach to the child with palpitations
Expert Review of Cardiovascular Therapy
DOI: 10.1586/14779072.4.5.681
2006Medications used to manage supraventricular tachycardia in the infant a North American survey
Pediatric Cardiology
DOI: 10.1007/s00246-005-1126-x
2006Estimating arterial stiffness using transmission line model
Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
DOI: 10.1109/IEMBS.2006.260616
2006Right ventricular outflow tract tachycardia in children
Journal of Pediatrics
DOI: 10.1016/j.jpeds.2006.08.076
2006Exercise does not cause an arm-leg blood pressure gradient in healthy children
Heart
DOI: 10.1136/hrt.2005.084384
2006Cerebral oxygenation during defibrillator threshold testing of implantable cardioverter defibrillators
PACE - Pacing and Clinical Electrophysiology
DOI: 10.1111/j.1540-8159.2005.09518.x
2005The protean manifestations of blunt cardiac trauma in children
Pediatric Emergency Care
DOI: 10.1097/01.pec.0000159071.62938.5b
2005Echocardiographic Doppler assessment of the biophysical properties of the aorta in pediatric patients with the Marfan syndrome
American Journal of Cardiology
DOI: 10.1016/j.amjcard.2005.06.080
2005Diagnosis of fetal ductus arteriosus aneurysm: Importance of the three-vessel view
Ultrasound in Obstetrics and Gynecology
DOI: 10.1002/uog.1927
2005Documenting junctional ectopic tachycardia following pediatric open heart surgery.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet
2005Diagnosis and outcome of dextrocardia diagnosed in the fetus
American Journal of Cardiology
DOI: 10.1016/j.amjcard.2004.03.049
2004Kawasaki disease at British Columbia's Children's Hospital
Paediatrics and Child Health
DOI: 10.1093/pch/9.7.466
2004Myocardial Contractility in Premature Neonates with and Without Patent Ductus Arteriosus
Pediatric Cardiology
DOI: 10.1007/s00246-003-0452-0
2004A Novel Doppler Echocardiographic Method of Measuring the Biophysical Properties of the Aorta in Pediatric Patients
Journal of the American Society of Echocardiography
DOI: 10.1016/S0894-7317(03)00407-3
2003Outcome following repair of sinus venosus atrial septal defects in children
Asian Cardiovascular and Thoracic Annals
DOI: 10.1177/021849230201000309
2002Coronary arterial abnormalities in pulmonary atresia with intact ventricular septum diagnosed during fetal life
Cardiology in the Young
DOI: 10.1017/S1047951102000756
2002Surgical closure of secundum atrial septal defects: The cutting edge?
Asian Cardiovascular and Thoracic Annals
DOI: 10.1177/021849230100900307
2001Balloon angioplasty of right ventricular outflow tract conduits
Pediatric Cardiology
DOI: 10.1007/s002460010209
2001Coil occlusion of the patent ductus arteriosus: Lessons learned
CardioVascular and Interventional Radiology
DOI: 10.1007/s002709910019
2000Effect of body position on measurements of diffusion capacity after exercise
British Journal of Sports Medicine
DOI: 10.1136/bjsm.34.6.440
2000Cardiac responses to progressive exercise in normal children: A synthesis
Medicine and Science in Sports and Exercise
DOI: 10.1097/00005768-200002000-00001
2000The evolution of ductus arteriosus treatment
International Surgery
2000Cardiovascular responses to exercise in children and adolescents with myocardial dysfunction
American Heart Journal
DOI: 10.1016/S0002-8703(99)70468-0
1999The effect of repeat exercise on pulmonary diffusing capacity and EIH in trained athletes
Medicine and Science in Sports and Exercise
DOI: 10.1097/00005768-199901000-00016
1999Kawasaki disease in the older child.
Pediatrics
DOI: 10.1542/peds.102.1.e7
1998Risks of repeat sternotomy in pediatric cardiac operations
Annals of Thoracic Surgery
DOI: 10.1016/S0003-4975(98)00829-7
1998Is Surgical Closure of Patent Ductus Arteriosus a Safe Procedure in Premature Infants?
International Surgery
1998Intermediate follow-up of right ventricular outflow tract reconstruction with allograft conduits
Annals of Thoracic Surgery
DOI: 10.1016/S0003-4975(98)01032-7
1998The time course of pulmonary diffusing capacity for carbon monoxide following short duration high intensity exercise
Respiration Physiology
DOI: 10.1016/S0034-5687(98)00004-8
1998 - Research
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Did virtual health visits play a significant role in reducing travel-related greenhouse gas emissions during the COVID-19 pandemic? A comparison with travel to in-person visits to BC Children’s Hospital and community outreach clinics
This project examines the impact of virtual health visits (telehealth) on reducing travel-related greenhouse gas (GHG) emissions for pediatric patients seeking specialized cardiac services. As we reflect on all of the implications that the COVID-19 pandemic played on our personal health and that of our health care system in general, one of the strategic changes that occurred as a result of limited in-person visits to medical clinics and hospitals was a large increase in the number of virtual health visits offered by physicians to their patients. This was done to mitigate the risk of transmitting the virus, but there were a number of other benefits that resulted, including a reduction in the time to schedule an appointment, less time away from school or work, not having to worry about travelling long distances to and from the appointment and potentially lower costs associated with the travel. It is important to recognize that not all medical appointments can be held virtually and some medical conditions require in-person visits for diagnosis, specialized medical imaging and treatment. In addition, some rural areas may not have access to high-speed internet or may not have any internet at all. With this in-mind we seek to determine the role of virtual health visits in reducing GHG emissions and whether or not the pandemic played a moderating role.Virtual reality and active gameplay as a model for providing physical activity in children with congenital heart disease
Recently, virtual reality (VR), an artificial virtual environment that is created with software and presented in a way that is experienced similar to the real world, has been recognized and used as a viable approach to promote physiological, psychological and rehabilitative outcomes in both private and public health settings. In fact, VR-based rehabilitation programs have been found to be superior to traditional rehabilitation in some situations. Although the use of VR is promising, its use in pediatrics is extremely limited in scope. When used for therapeutic purposes, previous reviews have suggested that VR-based technologies provide distinct advantages when compared to traditional programs. Firstly, VR is perceived as more exciting and motivating than traditional programs which can improve adherence to otherwise repetitive and boring exercises. Secondly, VR can present any scenario in the virtual environment, allowing patients participating in the program to develop outcomes by performing similar, if not exact, behaviors that build toward the desired abilities in a safe and controlled environment. Lastly, the VR headset can eliminate distractions, allowing the patient’s full cognitive attention to be focused on the practice behaviors. Distractions can progressively be added to simulate additional cognitive load and stressors expected to present in the real world. In addition, VR could create exercise scenarios that are effective in improving cardiorespiratory fitness and strength, while improving QoL in patients with CHD. The goal of this project is to build on our previous experience with in-person, home-based exercise and live-streamed exercise to encourage and engage children with CHD to be physically active.Developing an electronic patient portal for modifying lifestyle behaviors in adolescent cardiac patients
Adolescence can be a vulnerable period of time for our youth. From a health perspective, approximately 18% of all adolescents in BC live with a chronic health condition. In addition to medication and treatment, lifestyle choices including diet and exercise can have a large impact on their physical and emotional well-being. Accessing and implementing lifestyle interventions provided only at specialized clinics at BC Children’s Hospital for these children and their families can be costly in terms of lost wages and travel expenses and time-consuming in terms of absence from work or school. These issues may impact the quality of care that patients receive and is neither equitable nor inclusive and may discriminate against families who live in remote parts of the Province or are socio-economically disadvantaged. Digital health interventions can offer affordable and scalable methods to support healthy lifestyle choices, especially in a province the size of B.C where 82% of children aged 0-19 live outside the lower mainland. For the past five years our group has used digital healthcare tools to support and change how we deliver care to our adolescent patients. We have launched a Short Message Service (SMS, text messaging service) to improve medication adherence in solid organ transplant patients and quality of life in patients with dysautonomia of adolescence. We have also developed and implemented a virtual exercise program and a virtual reality exercise program with our adolescent transplant patients. As we attempt to facilitate lifestyle behavior change, we are now employing coaching strategies and need a digital tool that will allow patients access to educational materials and care plans personalized for their individual health and well-being. One option we are exploring is to use an electronic patient portal. An electronic patient portal is a secure website that allows patients to access educational information, review test results and treatment plans, allows patients to communicate directly with their Health Care Provider (HCP), and it can be linked to an Institutional electronic health care record.GrantsCo-Investigator. Developing an electronic patient portal for modifying lifestyle behaviors in adolescent cardiac patients. Funding Source: CW Digital Health Research Accelerator Grant
Co-Investigator. Virtual reality and active gameplay as a model for promoting physical activity in children with congenital heart disease. Funding Source: Brett Boyer Foundation Discovery Award
Co-Investigator. A family-centered initiative to encourage physical activity in children/youth living with solid organ transplantation. Funding Source: Canadian Donation and Transplantation Research Program
Co-Principal-Investigator. Did virtual health visits play a significant role in reducing travel-related greenhouse gas emissions during the COVID-19 pandemic? A comparison with travel to in-person visits to BC Children’s Hospital and community outreach clinics. Funding Source: Medical and Allied Staff Engagement Fund
Co-Investigator. Expanding the use of a clinical digital messaging (CDM) platform in the Children’s Heart Centre. Funding Source: E2i Seed Grant
Co-Investigator. Virtual reality and gameplay as a model for exercise rehabilitation in pediatric solid organ transplant patients. A patient and family led initiative. Funding Source: Canadian Donation and Transplantation Research Program
Co-Investigator. Environmental impact of pediatric subspeciality outreach services on greenhouse gas emissions in British Columbia and the Yukon Territory. Funding Source: Medical and Allied Staff Engagement Fund
Co-Investigator. Using clinical digital messaging to improve pediatric congenital heart disease patient care: Health outcomes, patient satisfaction, facilitators and barriers to implementation. Funding Source: BCCHR
Co-Investigator. VEXT: An 8-week virtual exercise and texting program for pediatric solid organ. Funding Source: Transplant Research Foundation of BC
Co-Investigator. Observational study on the feasibility of collecting comprehensive longitudinal nutritional data on children and adolescents diagnosed with cancer: Correlation with side effects of therapy. Funding Source: Childhood Diseases Seed Grant
BC Children’s Hospital researchers bring Mini Med School to the Yukon for the first time
World-class researchers from BCCHR will travel to the Yukon on March 28 to present a day of discovery with Mini Med School. This health science youth outreach and public education program is designed for high school students to explore the world of health sciences, career opportunities in science and medicine, and connections with leading researchers and health experts.
