surgery

A diabetes drug promotes brain repair – but only in females, ��ֱ�� study shows

Christopher.Sorensen — Thu, 12 Sep 2019 14:49:05 +0000

A diabetes drug promotes brain repair – but only in females, ��ֱ�� study shows

Christopher.Sorensen Thu, 09/12/2019 - 10:49

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Cindi Morshead (centre) and graduate students Rebecca Ruddy (left) and Kelsey Adams. The study by Morshead's team highlights how sex bias in preclinical work can lead to failed clinical trials and inappropriate treatments (photo by Jovanna Drinjakovic)

Jovana Drinjakovic

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Breaking Research

Donnelly Centre for Cellular & Biomolecular Research

Faculty of Medicine

Global

Hospital for Sick Children

Institute for Biomaterials and Biomedical Engineering

Research & Innovation

surgery

Males are straightforward while females are complicated. This misguided view prompted a decades-long exclusion of female animals from research out of fear that their fluctuating hormone levels will muddle the data.

But now a new study by researchers at the University of Toronto shows that a female sex hormone plays a key role in promoting brain repair and opens the door to the development of more effective treatments.

The team of researchers led by Cindi Morshead, a professor at the Donnelly Centre for Cellular and Biomolecular Research and the department of surgery, found that metformin, a widely prescribed drug to treat diabetes, promotes repair in adult female brains and is dependent on the sex hormone estradiol.

Their findings are described in a study published in the Sept. 11, 2019 issue of the journal Science Advances.

The research builds on a previous study, in collaboration with Freda Miller’s group at the Hospital for Sick Children, that sought to find treatment for childhood brain injury. They found that the widely prescribed drug metformin can induce brain repair and improve motor function in newborn mice that had a stroke injury. Metformin works by activating stem cells in the brain, which can self-renew and give rise to different types of brain cells to replace those killed by injury.

Because brain injury in early life can lead to lifelong cognitive problems, the researchers wanted to find out if metformin also promoted cognitive recovery.

“You can fix a hole in someone’s brain, but if they don’t function better it’s irrelevant to them,” says Morshead, who is also a professor at ��ֱ��’s Institute of Medical Science and the Institute of Biomaterials and Biomedical Engineering.

Graduate student Rebecca Ruddy induced stroke in newborn mice, followed by daily metformin treatment before the animals were tested in a puzzle box test that measured learning and memory.

The metformin was able to activate neural stem cells in the brain and promote cognitive recovery. But the data also revealed something unexpected: Metformin did not affect all the animals in equal manner. It only worked in adult females.

“When we first looked at the data, we did not see the benefit of the metformin treatment,” says Morshead. “Then we noticed that adult females tended to do better than the males.”

A closer look revealed that metformin selectively activated the adult female neural stem cells while having no effect on the males. This turned out to be due to the female sex hormone estradiol which somehow enhances the stem cells’ ability to respond to metformin. Conversely, the male hormone testosterone appears to inhibit this process. When female mice had their ovaries removed and lacked the female sex hormone, the stem cells did not respond to metformin treatment.

“To know that there are both age and sex dependent effects – it has such implications for treatment and therapeutics,” says Morshead.

The findings come at a time when the research community is reckoning with the data sex bias stemming from an overwhelming exclusion of female mice from research.

“The thinking was that we’re going to study males because everything you need to know is found in the male brain, and then the female brain just complicates things with hormones,” says Morshead. “It’s very misguided and troublesome for advancing neurological health.”

As preclinical research informs human studies, the sex bias is believed to have led to failed clinical trials, misdiagnosis and inappropriate therapies for women, as highlighted in a recent article in Science.

Human trials focused on repurposing metformin as a brain repair drug are ongoing. Morsehead’s collaborators – Dr. Donald Mabbott, the head of neurosciences and mental health at SickKids, and Dr. Eric Bouffet, the director of the brain tumour program at SickKids – are leading a pilot study testing the drug in children who suffered brain injury. Although the current patient cohort is too small to detect any sex effects, the plan is to increase the number of patients to see if sex also affects treatment outcome in people, Morshead says.

The research was supported by the funding from the Canadian Institutes of Health Research, which in 2016 mandated its grant holders to consider animals of both sexes in their research, as well as from the Ontario Institute for Regenerative Medicine, Medicine by Design, Brain Canada, the Stem Cell Network and the Ontario Brain Institute.

'It's a great honour': Eleven ��ֱ�� faculty named fellows of the Royal Society of Canada

perry.king — Tue, 10 Sep 2019 13:53:13 +0000

'It's a great honour': Eleven ��ֱ�� faculty named fellows of the Royal Society of Canada

perry.king Tue, 09/10/2019 - 09:53

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From left to right: Pamela Klassen, Kathleen Gallagher and Heinz-Bernhard Kraatz are three of 11 ��ֱ�� researchers named fellows of the prestigious Royal Society of Canada (all photos by Perry King)

Perry King

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Pamela Klassen studies religion’s impact on the world at large. Kathleen Gallagher sees theatre as a way to understand students and their education. Heinz-Bernhard Kraatz is designing tools to detect biomolecules that cause cancer and other diseases.

They are just three of 11 University of Toronto researchers named fellows of the prestigious Royal Society of Canada – considered a major achievement for scholars in this country.

The other new fellows from ��ֱ�� are: Cheryl Grady, Eric Jennings, Sidney Kennedy, Zheng-Hong Lu, Locke Rowe, Kimberly Strong, Yu Sun and Michael Taylor. (See the full list below.)

“The University of Toronto congratulates its newest Royal Society of Canada fellows on their achievement and looks forward to the outstanding work they will continue to produce as members of the national academy,” says Vivek Goel, vice-president, research and innovation, and strategic initiatives.

“These 11 researchers, representing a wide array of disciplines, are contributing to new knowledge, insights and innovations that impact the lives of Canadians and people around the world.”

Founded in the 1880s, the Royal Society of Canada recognizes scholars and their work in order to help them build a better future in Canada and around the world.

Fellows have made remarkable contributions in the arts, humanities and sciences and will be mobilized to contribute knowledge, understanding, and insight through engagement with the Canadian public.

They are nominated and elected by their Royal Society of Canada peers.

��ֱ��’s 11 new fellows will join over 370 Royal Society of Canada fellows from ��ֱ��, and more than 2,000 active fellows overall.

Pamela Klassen

A professor in the department for the study of religion, Klassen seeks to understand how religion shapes our world – in the past, present and imagined future.

Since joining ��ֱ�� in 1997, she has researched religion, gender and secularism in North America, the intersection of gender and medicine and the role of Christianity in Canadian colonialism.

“Religion is at the heart of some of the most challenging issues in the contemporary world,” says Klassen, adding that it plays an integral role in personal decision-making, social structure and politics.

The subject has led Klassen down several seemingly disparate roads of inquiry. They include: research into Mennonite women refugees during the Second World War; the role of religion in the home birth movement; and the history of medicine, including the role of medical missionaries.

She describes her work as “people focused.”

“I want to take care to reflect on what people have told me in interviews or from diaries and letters I’ve found in archives in a way that is respectful of their stories – but set those stories in a wider context so we can learn from them in a broader political, social way,” says Klassen, who previously won an American Academy of Religion award of excellence.

Such personal engagement laid the groundwork for Klassen’s 2018 book The Story of Radio Mind: A Missionary’s Journey on Indigenous Land. The book, which combined meticulous historical research and many conversations with Indigenous historians and knowledge holders, examines the life of Frederick du Vernet, an early 20^th-century Anglican archbishop who journeyed through Ojibwe, Ts’msyen and Nisga’a territory and came to condemn the devastating effects of residential schools run by his church.

Klassen’s work on the book also led to the Kiinawin Kawindomowin Story Nations project, an interactive website that Klassen and her students continue to work on in consultation with the Kay-Nah-Chi-Wah-Nung Historical Centre of the Rainy River First Nations. It focuses on a diary Du Vernet wrote on an 1898 visit to Rainy River, and includes many stories of Ojibwe women and men expressing strong resistance to the missionary presence.

“My work has always been animated by – this is more grandiose than I want to make it sound – questions of injustice that I see around me and how religion plays into various kinds of inequality, or how religion shapes the political world in which we live,” Klassen says.

She thanks her peers for nominating and appointing her as a fellow of the Royal Society of Canada.

“It’s a great honour to be nominated and accepted,” she says. “It’s a community of such a wide array of scholars – people from so many different fields – so to have the recognition of colleagues from across the humanities really means a lot to me.”

Kathleen Gallagher

A professor in the department of curriculum, teaching and learning at the Ontario Institute for Studies in Education, Gallagher uses theatre to understand young people’s views on life in and out of the classroom.

Gallagher, who is interested in questions of pedagogy, artistic practice and the social contexts of schooling, sees theatre as a “mode of inquiry” that’s yielded important insights into young people’s views on democracy, civic engagement and inequality.

In order to conduct her global, ethnographic research, Gallagher has relied on collaborations with graduate students, who she calls her “most important intellectual community,” as well as the active participation of youth. Such collaborations are a “lifeblood,” she says.

“I can’t imagine operating as a researcher in any other way, frankly,” says Gallagher, who is cross-appointed at the Centre for Drama, Theatre & Performance Studies and won a ��ֱ�� President’s Impact Award last year. “The richness and the contributions of young people in my research projects make it possible for me to do the work I do.”

Gallagher has also worked with playwright Andrew Kushnir on Towards Youth – a play Kushnir wrote that brings to life the concept of hope among youth in drama classrooms around the world that Gallagher’s research has explored. She describes the collaboration with Kushnir as “next level” because working with a professional playwright gave her an opportunity to communicate some of her research findings to a broad audience. It was also an opportunity to work with a professional playwright.

“To be able to be in a long-term, close dialogue with someone who brings a whole other set of professional skills, understandings and experience to that research, is a gift with untold value,” she says.

Gallagher hopes her Royal Society of Canada fellowship opens up more avenues for cross-disciplinary work.

“The idea that I’m going to walk into new intellectual terrain with researchers beyond my ��ֱ�� network is enormously exciting to me,” she says. “It feels like a new beginning.”

Heinz-Bernhard Kraatz

A professor in the department of physical and environmental sciences at ��ֱ�� Scarborough, Kraatz wants to prevent diseases by creating tools that can help spot their underlying causes.

Kraatz is focused on creating new sensor materials that allow him to detect biomolecules, such as DNA and proteins – and even biological processes – that play a role in everything from cell division to cancer and viral infections.

He’s also conducting research that looks at the underlying molecular causes for conditions like Alzheimer’s disease.

“We’re looking at identification of organisms at the genetic level, but we’re also looking at detection of pathogens in the environment,” says Kraatz, who is also ��ֱ�� Scarborough’s vice-principal of research.

Finding ways to translate such research into real-world solutions can take decades – which is why Kraatz is grateful for his lab colleagues and students who have helped push ideas forward.

“You can have this crazy idea and a non-optimal model system to work it out,” he says. “But taking that next step to go to a model system that actually does allow you to answer that question in a definitive way – it’s really important.”

He hopes his passion for science rubs off on his students.

“I love discussing science with my students, first of all. This is fun, this is a dialogue. Students have ideas – I have ideas and we sort of bounce them off each other,” he says. “Students come up with brilliant ideas and offer some brilliant solutions to problems.”

In his role as vice-principal of research, Kraatz works to promote outstanding research and scholarship in all disciplines at ��ֱ�� Scarborough while also advancing collaborations and enhancing the research environment for students.

He considers himself a role model at the university – a responsibility he takes seriously.

“Ultimately, [the fellowship] enhances visibility and you have an obligation to contribute to the Royal Society, but also to university life by mentoring young faculty and students,” says Kraatz.

“Making sure they’re on a productive path going forward is critical.”

Here is the full list of new Royal Society of Canada fellows from ��ֱ��:

Kathleen Gallagher, department of curriculum, teaching and learning
Cheryl Grady, department of psychiatry, and Baycrest Health Sciences
Eric Jennings, department of history
Sidney Kennedy, department of psychiatry, University Health Network, St. Michael’s Hospital
Pamela Klassen, department for the study of religion
Heinz-Bernhard Kraatz, department of physical and environmental sciences, ��ֱ�� Scarborough
Zheng-Hong Lu, department of materials science and engineering
Locke Rowe, department of ecology and evolutionary biology
Kimberly Strong, department of physics
Yu Sun, department of mechanical and industrial engineering
Michael Taylor, departments of surgery and laboratory medicine and pathobiology, and the Hospital for Sick Children

��ֱ�� researchers part of international team awarded US$4 million by Chan Zuckerberg Initiative to map human liver

Christopher.Sorensen — Mon, 15 Jul 2019 20:07:17 +0000

��ֱ�� researchers part of international team awarded US$4 million by Chan Zuckerberg Initiative to map human liver

Christopher.Sorensen Mon, 07/15/2019 - 16:07

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From left to right: Sonya MacParland, Ian McGilvray and Gary Bader (photo courtesy of University Health Network)

Ann Perry

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University Health Network

A group of University of Toronto researchers are part of a 19-person international team awarded US$4 million by the Chan Zuckerberg Initiative to advance understanding of the human liver across diverse life stages and genetic backgrounds.

The ��ֱ�� researchers – all funded through Medicine by Design – published the first single-cell map of the human liver last fall. They are: Gary Bader, a professor and computational biologist at the Donnelly Centre for Cellular and Biomolecular Research; Sonya MacParland, a scientist at the Toronto General Hospital Research Institute (TGHRI) at the University Health Network (UHN) who is also an assistant professor in ��ֱ��’s departments of immunology and laboratory medicine and pathobiology; and Ian McGilvray, a senior scientist at TGHRI, a transplant surgeon at UHN and a professor in ��ֱ��’s department of surgery.

Part of the Human Cell Atlas, an international effort to map all cells in the human body, the collaboration brings together liver-mapping efforts from around the world to build a more complete picture of the human liver.

“We have been working on building a global team of researchers who are all interested in mapping the human liver in different ways,” said Bader, who is a member of the organizing committee of the Human Cell Atlas.

“This grant from the Chan Zuckerberg Initiative really speeds up the development of the human liver map and allows us to move in novel directions by combining diverse research projects and data into one map.”

The international collaboration, Bader added, is a “direct extension” of the liver mapping work he and his Toronto collaborators have already done with support from Medicine by Design, an interdisciplinary research program at ��ֱ�� focused on regenerative medicine and cell therapy.

Their project – titled “A Reference Cell Atlas of Human Liver Diversity Over a Lifespan” – is one of 38 that are sharing US$68 million in funding through the Chan Zuckerberg Initiative’s Seed Networks for the Human Cell Atlas program. Co-founded by Facebook chief executive officer Mark Zuckerberg and pediatrician Priscilla Chan, who is married to Zuckerberg, the Chan Zuckerberg Initiative seeks to harness technology to solve some of the world’s greatest problems and is actively supporting the Human Cell Atlas.

The three-year award is significant because it supports international collaborations that are often ineligible to receive money from country-specific research funders, Bader said. The liver project includes computational biologists, clinicians, engineers and life scientists from Canada, Singapore, Germany, Belgium, the U.K., the U.S. and Israel.

The team will meet in Toronto to kick off the project in late July.

The international nature of the research team means it will have access to samples that better represent the full diversity of human livers, including age, sex and genetics.

“One of the goals of the Human Cell Atlas is to capture human diversity,” Bader said. “We have a specific plan to collect a range of samples to cover a lot of diversity, allowing us to understand the variability in the human liver across the population.”

For the Toronto-led part of the project, Bader, MacParland and McGilvray have joined forces with a new collaborator, Mei Zhen, a senior investigator at the Lunenfeld-Tanenbaum Research Institute at Sinai Health System and a professor in ��ֱ��’s department of physiology. Zhen is an expert in volumetric electron microscopy, a technology that captures high-resolution, 3D images by assembling individual images of extremely thin slices of tissue samples. Zhen has been developing this technology for studying neural systems in C. elegans, tiny worms that are part of the nematode family.

This is believed to be the first time the technology will be used to image the liver as part of a tissue map project. Bader said the organ is a good candidate because it is made up of tiny, repeating, hexagonal-shaped structures called lobules.

“Because of the biology of the liver, it is an interesting opportunity to understand the whole organ by studying its individual modules,” Bader said.

The Toronto team plans to link these images with genomics data by applying computational methods and deep learning to analyze the vast amounts of data the project will generate, ultimately creating a unified map.

“Medicine by Design helped catalyze this team, and we are delighted it is taking a leadership role in international efforts to create a next-generation map of the human liver,” said Michael Sefton, the executive director of Medicine by Design, a University Professor at the Institute of Biomaterials and Biomedical Engineering (IBBME) and the Michael E. Charles Professor in the department of chemical engineering and applied chemistry in ��ֱ��’s Faculty of Applied Science & Engineering.

“This investment by the Chan Zuckerberg Initiative is an affirmation of the excellence and innovation of their research, and supports the collaborative, interdisciplinary approach that is at the core of Medicine by Design.”

All data, tools and protocols generated from the Chan Zuckerberg Seed Networks for the Human Cell Atlas projects will be freely available to the research community.

From AI to immigrant integration: 56 ��ֱ�� researchers supported by Canada Research Chairs Program

geoff.vendeville — Fri, 14 Jun 2019 18:56:08 +0000

From AI to immigrant integration: 56 ��ֱ�� researchers supported by Canada Research Chairs Program

geoff.vendeville Fri, 06/14/2019 - 14:56

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Three of ��ֱ��'s 56 new and renewed Canada Research Chairs (from left to right): Jonathan Kelly, Marzyeh Ghassemi and Vincent Kuuire (photos courtesy of Jonathan Kelly and Marzyeh Ghassemi, and by Blake Eligh)

Geoffrey Vendeville

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Vector Institute

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Survey after survey show doctors face burnout from heavy workloads. But what if they could use a machine learning algorithm to shoulder some of the burden?

Marzyeh Ghassemi (left), the first University of Toronto faculty member to be cross-appointed to the departments of computer science and medicine, is looking to lighten the load on health practitioners – and, by extension, improve patient health – by developing algorithms that can estimate the length of a person's hospital stay, need for intensive care or mortality risk.

“We have a really good body of clinical research that suggests patients respond better to all manner of treatments when it’s provided with compassion and with focus, and with an understanding of where they come from,” she said.

“So I think we should use machine learning to let doctors do the doctoring, to actually interface with patients and make decisions about care.”

Ghassemi is one of 56 ��ֱ�� faculty members awarded new Canada Research Chairs, or whose chairs were renewed, as part of a double, fall-spring cohort announced Friday by the federal government. Established in 2000, the federal program invests about $295 million annually to recruit and retain top minds in Canada. It supports research in engineering, natural sciences, health sciences, humanities and social sciences.

��ֱ��’s total allotment of research chairs in the program is 315, making it the largest in the country.

“I want to extend my warmest congratulations to ��ֱ��'s new and renewed research chairs,” said Vivek Goel, ��ֱ��'s vice-president of research and innovation.

“The work supported by the Canada Research Chairs Program benefits all Canadians by advancing our shared knowledge and fostering innovation.”

The new and renewed research chairs at ��ֱ�� focus on fields ranging from artificial intelligence, or AI, to studies of immigrant integration and well-being.

Ghassemi, who was named a tier-two chair in machine learning and health, is continuing work she began at the Massachusetts Institute of Technology during her PhD studies. That includes developing an algorithm to help physicians determine the best possible patient treatments by predicting the onset of acute conditions and the need for intervention. Part of her research involved tagging along with doctors and nurses at a Boston hospital during their morning rounds to get a better sense of their daily routines and determine where AI could offer assistance.

Also a faculty member at the Vector Institute for Artificial Intelligence, Ghassemi said her research chair will allow her to expand the scope of her research beyond acute cases. In fact, she said her research is increasingly focused not on sickness, but on being in good health.

“The majority of the research we’re able to do looks at people when they’re at their very sickest, and then tries to understand whether there are small differences in outcome that we can have at these very, very sick moments,” she said.

“We don’t really know what it means for a person to be healthy.”

She sees her tier-two chair, a five-year award reserved for “exceptional emerging scholars,” as a vote of confidence in her work.

“It’s recognizing that this area of research is one that Canadians care about,” she said.

Jonathan Kelly (left), an assistant professor at ��ֱ��’s Institute for Aerospace Studies, or UTIAS, is putting artificial intelligence to work for a different purpose. The new tier-two chair in collaborative robotics designs the software brain for machines with a wide variety of applications, from self-driving wheelchairs to robotic space explorers.

One focus of Kelly’s research is on warehouse-dwelling “cobots” – short for collaborative robots – that are intended to work side-by-side with people in logistics, packaging and assembly. The machines would be sophisticated enough to respond to a worker’s movements without being told explicitly what to do.

“In a manufacturing scenario, maybe both of you are working on adjusting a bolt on a part, but you need the robot to help support the piece so a bolt can be tightened,” Kelly said.

“We’ve actually looked at trying to program the robot to interpret forces that are applied to the part by the person, because that can guide the machine as to what the person’s intent is.”

Kelly sees cobots in the warehouse as a first step toward a Jetsons-like future where robots are interacting with humans in more unpredictable environments – including on the street or in the home.

The Canada Research Chairs Program, Kelly said, provides an advantage when trying to recruit top research talent.

“We want to attract really great students,” he said, “and when you’re in the pool with the MITs, the Stanfords and Berkeleys and Carnegie Mellons, anything you can do to enhance your visibility is extremely valuable.”

At ��ֱ�� Mississauga, health geographer Vincent Kuuire (right) said his tier-two chair in immigrant well-being and global health gives him more resources to explore health and well-being among newcomers to Canada.

The assistant professor in geography is presently focused on Greater Toronto’s Eritrean and Nigerian communities, which are among the fastest growing groups in Canada. He relies on both census data and information painstakingly gathered by visiting local churches and grocery stores, where he explains his research purpose and looks for volunteers.

He considers himself a “serial migrant,” having lived in seven different regions of his native Ghana before coming to Canada for graduate studies.

Kuuire said the goal of his research is to better understand Canadian immigration, which has been pursued as a population growth strategy for over three decades in response to an aging population and low fertility rates. In one recent paper in the Journal of Immigrant and Minority Health, he traces the relationship between an experience of “childhood adversity” – such as physical and sexual trauma before age 15 – to psychosocial health outcomes among immigrants later in life.

“It’s important to be able to understand the factors that are related to their (immigrants) general wellbeing and integration,” Kuuire said.

“Those findings can contribute to broader policies that may enhance or promote a more cohesive Canada.”

Here is the full list of new and renewed Canada Research Chairs:

New Canada Research Chairs (applied fall of 2018)

Jennifer Campos, in the department of psychology in the Faculty of Arts & Science and University Health Network, tier two in multisensory integration and aging
Sabine Cordes, in the department of molecular genetics in the Faculty of Medicine and Sinai Health System, tier one in molecular mechanisms of mood and mind
Ken Croitoru, in the department of medicine in the Faculty of Medicine and Sinai Health System, tier one in inflammatory bowel diseases
William Derry, in the department of molecular genetics in the Faculty of Medicine and the Hospital for Sick Children, tier one in genetic models of human disease
Natalie Enright Jerger, in the department of electrical and computer engineering in the Faculty of Applied Science & Engineering, tier two in computer architecture
Michael Garton, in the Institute of Biomaterials and Biomedical Engineering in the Faculty of Medicine and Faculty of Applied Science & Engineering, tier two in synthetic biology
Marzyeh Ghassemi, in the department of medicine in the Faculty of Medicine and the department of computer science in the Faculty of Arts & Science, tier two in machine learning for health
Maria Hupfield, in the department of visual studies and the department of English and drama at ��ֱ�� Mississauga, tier two in transdisciplinary Indigenous arts
Noah Ivers, in the department of family and community medicine in the Faculty of Medicine and Women’s College Hospital, tier two in implementation of evidence-based practice
Zhengping Jia, in the department of physiology in the Faculty of Medicine and the Hospital for Sick Children, tier one in synaptic plasticity and brain disorders
Brian Kavanagh, in the department of anesthesia in the Faculty of Medicine and the Hospital for Sick Children, tier one in acute lung injury
Jonathan Kelly, at University of Toronto Institute for Aerospace Studies in the Faculty of Applied Science & Engineering, tier two in collaborative robotics
Heather McFarlane, in the department of cell and systems biology in the Faculty of Arts & Science, tier two in plant cell biology
JoAnne McLaurin, in the department of laboratory medicine and pathobiology in the Faculty of Medicine and Sunnybrook Health Sciences Centre, tier one in Alzheimer’s disease therapeutics
Aleixo Muise, in the department of paediatrics and department of biochemistry in the Faculty of Medicine and the Hospital for Sick Children, tier one in pediatric inflammatory bowel disease
Emily Nalder, in the department of occupational science and occupational therapy in the Faculty of Medicine, tier two in resiliency and rehabilitation
Patricia O'Campo, at the Dalla Lana School of Public Health and Unity Health Toronto, tier one in population health intervention research
Meaghan O'Reilly, in the department of medical biophysics in the Faculty of Medicine and Sunnybrook Health Sciences Centre, tier two in biomedical ultrasound
Christopher Pearson, in the department of molecular genetics in the Faculty of Medicine and the Hospital for Sick Children, tier one in disease-associated genome instability
Beate Sander, at the Institute of Health Policy, Management & Evaluation in the Dalla Lana School of Public Health and University Health Network, tier two in economics of infectious diseases
Bojana Stefanovic, in the department of medical biophysics in the Faculty of Medicine and Sunnybrook Health Sciences Centre, tier one in neuroimaging
Sandra Styres, in the department of curriculum, teaching and learning at the Ontario Institute for Studies in Education, tier two in Iethi’nihsténha Ohwentsia’kékha (land), resurgence, reconciliation and the politics of education
Lillian Sung, in the department of paediatrics in the Faculty of Medicine and the Hospital for Sick Children, tier one in pediatric oncology supportive care
Wendy Ungar, at the Institute of Health Policy, Management and Evaluation in the Dalla Lana School of Public Health and the Hospital for Sick Children, tier one in economic evaluation and technology assessment in child health
Lu-Yang Wang, in the department of physiology in the Faculty of Medicine and the Hospital for Sick Children, tier one in brain development and disorders
Ding Yuan, in the department of electrical and computer engineering in the Faculty of Applied Science & Engineering, tier two in systems software
Gang Zheng, in the department of medical biophysics in the Faculty of Medicine and University Health Network, tier one in cancer nanomedicine

Renewals of Canada Research Chairs (applied fall of 2018)

Evdokia Anagnostou, in the department of paediatrics in the Faculty of Medicine and Holland Bloorview Kids Rehabilitation Hospital, tier two in translational therapeutics in autism

Michael Baker, in the department of economics in the Faculty of Arts & Science, tier one in economics and public policy
Timothy Chan, in the department of mechanical and industrial engineering in the Faculty of Applied Science & Engineering, tier 2 in novel optimization and analytics in health
Brendan Frey, in the department of electrical and computer engineering in the Faculty of Applied Science & Engineering, tier one in machine learning for genome biology and therapeutics
Marney Isaac, in the department of physical and environmental sciences at ��ֱ�� Scarborough, tier two in agroecosystems and development
Catherine Sabiston, in the Faculty of Kinesiology & Physical Education, tier two in physical activity and mental health
Bianca Schroeder, at the department of computer and mathematical sciences at ��ֱ�� Scarborough, tier two in data centre technologies
Wei Yu, in the department of electrical and computer engineering in the Faculty of Applied Science & Engineering, tier 1 in information theory and wireless communications

New Canada Research Chairs (applied spring of 2018)

Isabella Caniggia, in the department of obstetrics and gynaecology in the Faculty of Medicine and Sinai Health System, tier one in placental biology in pregnancy and disease
David Curtin, in the department of physics in the Faculty of Arts & Science, tier two in theoretical particle physics
Shiphra Ginsburg, in the department of medicine in the Faculty of Medicine and Sinai Health System, tier one in health professions education
Tara Gomes, in the Leslie Dan Faculty of Pharmacy and Unity Health Toronto, tier two in drug policy research and evaluation
Annie Huang, in the department of paediatrics in the Faculty of Medicine and the Hospital for Sick Children, tier one in rare childhood brain tumors
Mohit Kapoor, in the department of surgery and department of laboratory medicine and pathobiology in the Faculty of Medicine and University Health Network, tier one in the mechanisms of joint degeneration
Vincent Kuuire, in the department of geography at ��ֱ�� Mississauga, tier two in immigrant well-being and global health
Tony Lam, in the department of physiology in the Faculty of Medicine and University Health Network, tier one in diabetes and obesity
Hyun Lee, in the department of biochemistry in the Faculty of Medicine, tier two in biomolecular phase transitions in cellular repair
Philipp Maass, in the department of molecular genetics in the Faculty of Medicine and the Hospital for Sick Children, tier two in non-coding disease mechanisms
Julien Muffat, in the department of molecular genetics in the Faculty of Medicine and the Hospital for Sick Children, tier two in stem cell bioengineering and synthetic neuro immunology
Navindra Persaud, in the department of family and community medicine in the Faculty of Medicine and Unity Health Toronto, tier two in health justice
Hannes Röst, at the Donnelly Centre for Cellular and Biomolecular Research in the Faculty of Medicine, tier two in mass spectrometry-based personalized medicine
Adam Shlien, in the department of laboratory medicine and pathobiology in the Faculty of Medicine and the Hospital for Sick Children, tier two in childhood cancer genomics
Valerie Wallace, in the department of ophthalmology and vision sciences in the Faculty of Medicine and University Health Network, tier one in retina regeneration
Wendy Wong, in the department of political science in the Faculty of Arts & Science, tier two in global governance and civil society

Renewals of Canada Research Chairs (applied spring of 2018)

Aimy Bazylak, in the department of mechanical and industrial engineering in the Faculty of Applied Science & Engineering, tier two in thermofluidics for clean energy
Gustavo Bobonis, in the department of economics in the Faculty of Arts & Science, tier two in the political economy of development
Goldie Nejat, in the department of mechanical and industrial engineering in the Faculty of Applied Science & Engineering, tier two in robots for society
Scott Schieman, in the department of sociology in the Faculty of Arts & Science, tier one in social contexts of health
Dvira Segal, in the department of chemistry in the Faculty of Arts & Science, tier two in theoretical chemistry

'You could avoid huge numbers of deaths': ��ֱ�� researcher on gun fatalities in the U.S., Mexico, Brazil and Colombia

Christopher.Sorensen — Wed, 22 May 2019 16:38:38 +0000

'You could avoid huge numbers of deaths': ��ֱ�� researcher on gun fatalities in the U.S., Mexico, Brazil and Colombia

Christopher.Sorensen Wed, 05/22/2019 - 12:38

Cutline

Prabhat Jha, an epidemiologist with the University of Toronto’s Dalla Lana School of Public Health, and his fellow researchers analyzed more than 106 million deaths among men 15 to 34 (photo courtesy of the Dalla Lana School of Public Health)

Heidi Singer

Topic

Global Lens

Dalla Lana School of Public Health

Faculty of Medicine

Global

Guns

Research & Innovation

surgery

Professor Prabhat Jha, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, has published a comprehensive study that found race and education strongly correlates with a young man’s chances of dying from guns in the United States, Mexico, Colombia and Brazil.

Working with Anna Dare, a surgical resident at ��ֱ�� and St. Michael’s Hospital, Jha and his fellow researchers analyzed more than 106 million deaths among men aged 15 to 34 in the four countries, looking at how firearms-related mortality corresponded with race and education.

He said he expected to find a correlation with lower education and non-white races, but was still shocked at the strength of the connection the researchers uncovered – particularly in America.

“In the U.S., the differences are really driven by race,” said Jha, who is also the director of the Centre for Global Health Research at St. Michael’s Hospital and a world leader in collecting and analyzing data about why people die.

��ֱ��’s Heidi Singer caught up with Jha to ask him more about the study and its findings.

What surprised you most about these results?

The most surprising result was how big the ratio in equalities were between young Black men in the U.S. and other groups, including young Black men in these other countries. I was surprised by the extent to which the risk was so much higher in the U.S.

In the U.S., the differences are really driven by race, so a young Black man with a post-secondary education has 30 times [more] risk of being killed by firearms than his white counterpart. He’s even 14 times more likely to be shot and killed than an uneducated white man. We didn’t see anything like this in other countries we studied.

I was also surprised by how much gun deaths varied within a country by time and space, with factors such as drug wars. But we also saw that in Mexico and Colombia they were able to reduce mortality through firearms restrictions and broader social policies. It suggests that if the U.S. and Brazil were able to do the same, you could avoid huge numbers of deaths.

That said, generally firearms mortality has improved over time – the risk was much higher in the past.

Do you think these results could bolster gun control advocacy in the U.S.?

I’ve never taken the approach of trying to influence a political agenda. The only thing I do is rub the noses of politicians in the data. And the data here really jump out in saying that reducing young Black men’s deaths requires a reduction in firearms.

Was this really the first time anyone thought to correlate gun deaths with education and race in some of these countries?

Differences in education have been documented before. But differences in race and education and how much they contributed to the life expectancy has not been studied. Young men are generally healthy – we shouldn’t have many deaths at that age group. But when they do die, up to half of it is attributed to guns.

What prompted this study?

Counting the dead is an extremely powerful way to improve public health. These are routine data but we just looked at them carefully.

��ֱ�� researchers find firearm mortality in the Americas highest among young men, links to education and race

Christopher.Sorensen — Wed, 22 May 2019 14:23:50 +0000

��ֱ�� researchers find firearm mortality in the Americas highest among young men, links to education and race

Christopher.Sorensen Wed, 05/22/2019 - 10:23

Cutline

Students gather at a gun control rally in Washington, D.C. on March 14, 2019 (photo by Alex Wong via Getty Images)

Heidi Singer

Topic

Breaking Research

Dalla Lana School of Public Health

Faculty of Medicine

Global

Guns

Research & Innovation

St. Michael's Hospital

surgery

University of Toronto researchers have analyzed more than 106 million deaths and found that firearms are a leading cause of mortality in men aged 15 to 34 years in Mexico, Brazil, Colombia and the United States.

While the number of firearm deaths has previously been reported at the national level for countries in the Americas, the variations in firearm mortality at the state level, by race or ethnicity, and by education level have not been examined before. In addition, the impact of these deaths on life expectancy among subpopulations hadn’t been assessed.

The authors say that the variation in risk of firearm deaths in different populations and the changing patterns they have observed provide strong evidence that as many as 1.8 million dealths could have been avoided between 1990 and 2016 across all ages and genders, including one million in men aged 15 to 34.

The study, published this week in the journal The Lancet Public Health, also highlights the important role of education level and race in firearm deaths.

“Firearms are not only a leading and persistent cause of mortality in the USA, Mexico, Colombia, and Brazil – and as such must be considered a major public health concern – but the extreme variations in firearm mortality among sub-populations represent a societal challenge,” says study co-author Prabhat Jha, a professor at ��ֱ��’s Dalla Lana School of Public Health and the director of the Centre for Global Health Research at St. Michael’s Hospital.

“Changes in firearm mortality explain most of the variation in overall mortality among young men in these four countries over the past 25 years – and in the U.S. firearm homicides account for three quarters of the marked differences in overall mortality observed between young white and Black men, regardless of educational level.”

Read a Q&A with ��ֱ�� researcher Prabhat Jha on the study in The Lancet Public Health

Firearms have remained a persistent cause of premature death in the Americas for the past 25 years. While firearm mortality in the U.S. is markedly higher than in any other high-income country, the rates in several Central and South American countries are even higher.

In the study, the authors collected national data on individual deaths between 1990 and 2015 in the U.S., Mexico, Brazil and Colombia, which all have high-quality data on cause of death and high firearm mortality. Using information from death certificates, they compared overall and firearm mortality at the country and state levels. In addition, the authors analyzed these deaths by intent (homicide, suicide, unintentional or undetermined), and they also stratified cause of death data by age, gender and education level.

For homicide, the authors analyzed data by education in all four countries and by race in the U.S. and Brazil.

Brazil had the highest number of firearm deaths in all ages and genders between 1990 and 2015 (855,000 deaths), followed by the U.S. (851,000), Colombia (494,000), and Mexico (272,000). Homicide was the most common form of firearm death in Brazil, Colombia, and Mexico (accounting for 90 per cent, 94 per cent, and 83 per cent of cases, respectively), while suicide accounted for 56 per cent of all U.S. firearms deaths.

During the study period, the risk to young men of dying from firearms increased in Mexico and Brazil, but decreased in the U.S. and Colombia, according to the researchers.

Firearm mortality accounted for up to half of the overall risk of premature death for young men, ranging from 12.5 per cent of overall mortality risk in Mexico to 58 per cent in Colombia in 2000 to 2004. The authors found that where firearm mortality has fallen, the reductions account for much of the improved life expectancy in young men.

Place of residence, education and race were important risk factors in death from firearms. The researchers found more than a 10-fold variation in the risk of firearm mortality, ranging from 1.1 per cent in Louisiana to 0.1 per cent in Hawaii. In Mexico, the regional variation ranged from 4.7 per cent in Chihuahua to 0.05 per cent in Yucatán. Typically, deaths were concentrated in a few high-burden states, but these varied over time, particularly in Brazil and Colombia – highlighting the volatility of firearm violence and mortality, and suggesting that these deaths could be avoided.

The authors found that men with high school or lower levels of education were at greater risk of firearm homicide than those who received post-secondary education in all four countries.

When also considering race within these populations in Brazil and the U.S., the authors found that Black men in the U.S. and Black men in Brazil were among the groups at the highest risk of homicide, compared to Hispanic and white men.

In the U.S. in particular, Black men with lower educational attainment were 14 times more likely to die due to firearm homicide than comparably educated white men, and, in these groups, firearm homicides accounted for three quarters of the difference in overall mortality risk between Black and white men.

Black American men with low educational attainment were two to four times more likely to die by firearm homicide than Brazilian Black or white men, as well as men from Mexico. And Black American men who received post-secondary education were 30 times more likely to die by firearm homicide than comparably educated white men.

The effect of race on firearm homicide was much greater in the U.S. than in Brazil, where differences in men’s risk of firearm mortality were mostly due to differences in education, and where a higher education reduced the relative risk of firearm homicide among men of all races by similar amounts.

When focussing on suicide in the U.S., the pattern changed and the risk of firearm suicide was higher among young white men than Black or Hispanic men. The authors note that most people who survive a suicide attempt do not try again – thus, restricting access to firearms could avert tens of thousands of suicide deaths.

“Failure to address firearms as a major cause of mortality for Black men in the U.S. will hamper efforts to reduce disparities in mortality and improve life expectancy for Black men,” says co-author Anna Dare, a resident in ��ֱ��’s department of surgery and researcher at St. Michael’s Hospital.

“Interventions that reduce exposures to firearms are crucial, and well-supported by research and international comparisons. There is also a clear need to address the broader cultural, social and economic factors that contribute to such marked differences in mortality.”

The research was funded by the Canadian Institutes of Health Research and ��ֱ��’s Connaught Global Challenge.

��ֱ��'s Medicine by Design invests $1.2 million to advance regenerative medicine research and translation

Christopher.Sorensen — Tue, 14 May 2019 21:05:07 +0000

��ֱ��'s Medicine by Design invests $1.2 million to advance regenerative medicine research and translation

Christopher.Sorensen Tue, 05/14/2019 - 17:05

Cutline

Leo Chou, an assistant professor at ��ֱ��’s Institute of Biomaterials & Biomedical Engineering and a Medicine by Design investigator, is leading one of four projects selected for the 2019 New Ideas Awards (Photo by Bill Dai)

Ann Perry

Topic

Our Community

Pediatrics

Donnelly Centre for Cellular & Biomolecular Research

Lunenfeld-Tanenbaum Research Institute

Chemical Engineering

Electrical & Computer Engineering

Faculty of Applied Science & Engineering

Fields Institute

Hospital for Sick Children

Immunology

Institute of Biomaterials and Biomedical Engineering

Laboratory Medicine and Pathobiology

Leslie Dan Faculty of Pharmacy

Mechanical & Industrial Engineering

Regenerative Medicine

Research & Innovation

Sunnybrook Hospital

surgery

��ֱ�� Scarborough

University Health Network

UTIAS

What can a swarm of drones tell us about how our bodies make blood? Can folding strands of DNA into origami-like structures help researchers engineer more targeted treatments for lupus and multiple sclerosis? What new insights can mathematical and computational modelling offer into how tissues and organs form?

These are just a few of the questions that nine research teams across the University of Toronto and its affiliated hospitals are investigating thanks to $1.2 million in 2019 New Ideas and Seed Fund awards from Medicine by Design. The awards support basic and translational research aimed at advancing new concepts that are expected to be of critical importance to regenerative medicine in the coming decades, using tools such as synthetic biology and mathematical modelling.

“With these awards, we are pushing the frontiers of regenerative medicine by encouraging creativity, risk-taking and excellence at the convergence of science, engineering and medicine,” said University Professor Michael Sefton, who is executive director of Medicine by Design and a faculty member at the Institute of Biomaterials & Biomedical Engineering (IBBME) and the department of chemical engineering and applied chemistry.

“These projects exemplify the best of Medicine by Design by bringing people together across disciplines and institutions to tackle novel questions and test new approaches.”

Medicine by Design selected the nine funded projects from among 22 short-listed proposals, which were evaluated and ranked through an external peer review process. Sixty research teams at ��ֱ�� and its affiliated hospitals submitted expressions of intent last fall in response to an open call.

Medicine by Design is a regenerative medicine research initiative at ��ֱ�� with a mandate to accelerate transformational discoveries and translate them into new therapies for common diseases. It is made possible thanks in part to a $114-million grant from the Canada First Research Excellence Fund – the single-largest research award in ��ֱ��’s history.

New Ideas Awards

Leo Chou leads one of four projects selected for 2019 New Ideas Awards, which provide $100,000 per year for two years. Chou, an assistant professor at IBBME and a new Medicine by Design investigator, is collaborating with Bebhinn Treanor, an associate professor in the department of biological sciences at the ��ֱ�� Scarborough, to study how DNA nanotechnology could be used to ramp up or dampen immune responses, offering new ways to treat disease.

The project elegantly fuses their diverse expertise. Chou uses a process known as DNA origami to pinch and “staple” a long strand of DNA at precise points to create a variety of nanoscale shapes that can arrange biomolecules into precise two- and three-dimensional patterns. Treanor, an immunologist, studies how antigens – fragments of viruses or bacteria with unique markers – trigger immune cells in our bodies called B cells to produce specific antibodies to bind to and inactivate the associated virus or bacteria. Both are intrigued by the fact that, in nature, antigens arranged in periodic spacing provoke a much more potent immune response than individual antigens.

Together, they plan to use Chou’s DNA nanostructures as building blocks to study how the layout, structure, and nature of an array of antigens can affect the dynamics and strength of B cell activation.

The immediate goal is to figure out the basic design principles. “Like all good, fundamental studies, it might open up a lot of doors,” said Chou, who earned his PhD at IBBME in 2014 and returned to ��ֱ�� in January as a faculty member after a post-doctoral fellowship at the Wyss Institute at Harvard University and the Dana-Farber Cancer Institute in Boston.

“It might lead us to interesting biology that we just don’t understand, or haven’t discovered, yet.”

Ultimately, Chou and Treanor hope to create synthetically designed particles that can act as precision vaccines to heighten or dampen immune responses. This approach could lead to more targeted therapies for autoimmune diseases, such as lupus, arthritis and multiple sclerosis, in which the normal immune process goes haywire and mounts an attack on a person’s own cells. Chou also thinks their technology platform could be applied to better control the activation of other cell types, which could help enable cell-based therapies by making the cell-manufacturing process more efficient.

Other 2019 New Ideas projects include:

Dr. Robert Hamilton, a cardiologist and senior associate scientist at The Hospital for Sick Children (SickKids) and a professor in the department of paediatrics at ��ֱ��, is leading a project that aims to create precision immunotherapies for arrhythmogenic right ventricular cardiomyopathy. This heritable, autoimmune condition causes the myocardium, or heart muscle wall, to break down over time and can lead to sudden death. Sachdev Sidhu, a professor at ��ֱ��’s Donnelly Centre for Cellular and Biomolecular Research, is the co-investigator, and SickKids clinicians Dr. Donna Wall and Dr. Joerg Krueger are also part of the project team.
Dr. Sevan Hopyan, an orthopaedic surgeon and senior scientist at SickKids and an associate professor in the departments of molecular genetics and surgery at ��ֱ��, is making a computational tool to gain new insights into the physical processes that influence how embryonic tissues are organized and shaped. Known as morphogenesis, this process at the earliest stages of life remains poorly understood but could hold important clues for researchers developing regenerative medicine therapies. The co-investigator on this project is Yu Sun, a professor in the department of mechanical and industrial engineering at ��ֱ��, while Huaxiong Huang, the deputy director of the Fields Institute for Research in Mathematical Sciences, is collaborating.
Krishna Mahadevan, a professor in the department of chemical engineering and applied chemistry, is leading a team that aims to create new therapies for inflammatory bowel disease such as Crohn’s disease by engineering gut bacteria that can sense inflammation, and then secrete molecules that dampen it and promote regeneration of the intestinal lining. Combining synthetic biology and stem cell biology, the project also draws on the expertise of co-investigators Keith Pardee, an assistant professor in the Leslie Dan Faculty of Pharmacy and a Medicine by Design investigator, and Tae-Hee Kim, a scientist at SickKids and an assistant professor in ��ֱ��’s department of molecular genetics.

Seed Fund Awards

To increase the number of cutting-edge ideas it invests in, Medicine by Design created a new award this year called the Seed Fund Award, which provides $75,000 for one year to each of five projects.

Angela Schoellig (left) leads one of these projects, which is forging innovative ties between biomedical engineering and robotics. An assistant professor at ��ֱ��’s Institute for Aerospace Studies, she works at the interface of robotics, controls and machine learning, with research interests in self-driving vehicles and autonomous aerial vehicles, or drones.

Schoellig is using her award funding to study complex collective behaviour in living and non-living systems. Known as emergence, the phenomenon refers to the dynamic evolution of a system to develop complexity that cannot be easily predicted from the properties of its individual parts. In nature, a common example of emergence is murmuration, which occurs when hundreds of birds congregate and fly in organized, swooping patterns.

Schoellig and co-investigator Peter Zandstra, a University Professor at IBBME, are combining their respective expertise in robotic drones and blood-forming systems to gain new insights into emergence that could lead to advances in both fields. They hope that identifying common elements in these diverse systems will help them understand how a collection of individual entities in a disordered state develops complex, co-ordinated activities, ultimately advancing the capacity to predict and even control desirable emergent behaviour. Such findings could have many applications, including improving the reconstitution of healthy blood systems in patients who have undergone stem cell transplants. The research could also enhance the ability of robots to perform collaborative tasks in dynamic environments, such as airspace defence, search and rescue, and package delivery. Zandstra is also director of the School of Biomedical Engineering and the Michael Smith Laboratories at the University of British Columbia.

The other four successful Seed Fund Award projects range from brain organoids to new strategies to treat hearing loss.

Dr. Peter Carlen, a neurologist and senior scientist at the Krembil Research Institute at University Health Network (UHN) and a professor in ��ֱ��’s departments of medicine and physiology, as well as IBBME, is leading a project aimed at creating personalized treatments for the one-third of epilepsy patients whose disease does not respond to drugs. He plans to do this by generating cerebral organoids – brain-like mini-organs grown in a dish – from induced pluripotent stem cells derived from patients with drug-resistant epilepsy. His team will then use these organoids to study why the patients have not responded to medication, and to determine optimal pharmacotherapy options. Co-investigators on the project are Cathy Barr, a senior scientist at Krembil and SickKids and a professor in ��ֱ��’s department of psychiatry, and Roman Genov, a professor in ��ֱ��’s department of electrical and computer engineering.
Sarah Crome, a scientist at UHN, an assistant professor at ��ֱ��’s department of immunology and a Medicine by Design investigator, heads a project investigating whether immune cells known as innate lymphoid cells that reside in tissues can be harnessed to promote regeneration, prevent rejection and ultimately improve the success of cell-based immune therapies.
Alain Dabdoub, a senior scientist at Sunnybrook Research Institute and an associate professor in the departments of otolaryngology and laboratory medicine and pathobiology at ��ֱ��, leads a project aimed at regenerating the auditory neurons that transmit sound from the inner ear to the brain as a strategy to reverse hearing loss. Building on work he has already performed in mice in vitro, Dabdoub will investigate how to convert glial cells in a mouse model of neuropathy as well as human glial cells in vitro into auditory neurons.
Miguel Ramalho-Santos, a senior investigator at the Lunenfeld-Tanenbaum Research Institute at Sinai Health System, a professor at ��ֱ��’s department of molecular genetics and a Medicine by Design investigator, is using his Seed Fund Award to study whether the way genes are packed inside the nucleus of human pluripotent stem cells affects their ability to generate cerebral organoids, a tool that holds potential to model neurological diseases and test medications outside the body.

With these new awards, Medicine by Design funds more than 130 investigators across ��ֱ�� and its affiliated hospitals.

��ֱ�� PhD student publishes hip-surgery research in major U.S. medical journal

rasbachn — Tue, 28 Nov 2017 17:38:53 +0000

��ֱ�� PhD student publishes hip-surgery research in major U.S. medical journal

rasbachn Tue, 11/28/2017 - 12:38

Cutline

If patients are ready for the operating room, "there is no reason they need to wait until 24 hours, especially as they are suffering in pain," says Dr. Daniel Pincus, a resident in orthopedic surgery (photo by Randy Risling/Toronto Star via Getty Images)

Heidi Singer

Topic

Our Community

Dalla Lana School of Public Health

Faculty of Medicine

Health

Research & Innovation

surgery

Subheadline

Delaying hip fracture surgery more than one day associated with increased risk of death

Waiting more than 24 hours to undergo hip fracture surgery may be associated with an increased risk of death and complications, according to research published by a University of Toronto graduate student and medical resident.

Dr. Daniel Pincus, a resident in orthopedic surgery, found the link after studying wait times and health outcomes of more than 42,000 people who had hip fracture surgery in Canadian hospitals.

Patients who had surgery more than 24 hours after coming to the emergency room with a broken hip had a 6.5 per cent chance of death within 30 days, compared with a 5.8 per cent chance among patients who received more immediate care.

“Complications analyzed included heart attack, pneumonia, deep vein thrombosis and pulmonary embolism. These are not necessarily a direct result of the injury itself but can occur when patients wait bedridden prior to surgery.” says Pincus, a PhD candidate in the Faculty of Medicine’s clinician investigator program. “Patients also must fast before surgery, which is hard on an elderly person already dealing with intense inflammation from a break to the largest bone in the body.”

Pincus was not the first to establish a link between hip surgery wait times and death rates. But his study clarifies disagreement over the length of time that’s most dangerous. He found that risk of death only increased after 24 hours of waiting.

Read Pincus's research in JAMA

Interested in publicly funded research in Canada? Learn more at UofT’s #supportthereport advocacy campaign

“What is interesting is that we found a relationship between risk and delay, but only after 24 hours. Before 24 hours there was no increased risk of waiting. So surgery within 24 hours thus appears to be the ‘safe window,’" he says. “Some patients will benefit from pre-operative medical treatment and rushing them to the operating room before this happens is probably not the right answer. If patients are healthy and ready for the OR, however, there is no reason they need to wait until 24 hours, especially as they are suffering in pain.”

Hip fractures are the most common reason for urgent surgery in Canada, with more than 30,000 procedures occurring across the country annually. Currently, two thirds of patients in Ontario who enter the hospital with a hip fracture don’t receive surgery within 24 hours, says Pincus. “There have been improvements made in the last five or ten years to get patients to the operating room faster, but more work needs to be done.”

His research was published in the Journal of the American Medical Association (JAMA) on Nov. 28.

Pincus is a Vanier Scholar and is studying for his PhD as part of the Dalla Lana School of Public Health’s Institute of Health Policy, Management, and Evaluation.

The study was funded by the Vanier Scholarship Program and the Marvin Tile Chair in Orthopaedics at Sunnybrook Health Sciences Centre.

Not just for gamers: ��ֱ�� anesthesiologists taking virtual reality to patients facing surgery

ullahnor — Wed, 30 Nov 2016 15:01:41 +0000

Not just for gamers: ��ֱ�� anesthesiologists taking virtual reality to patients facing surgery

ullahnor Wed, 11/30/2016 - 10:01

Cutline

The virtual reality experience takes patients at SickKids through the various stages of surgical preparation, procedure and recovery

Dan Haves

Author legacy

Dan Haves

Topic

��ֱ�� Faculty of Medicine's Fahad Alam and Clyde Matava, both assistant professors of anesthesia, are hoping virtual reality can play an important role in reducing preoperative anxiety.

It’s common for many patients who are preparing for a surgical procedure to feel anxious. Whether it’s a fear of pain, being in a strange environment or worrying about the recovery, there are a number of concerns that doctors try to address with the patients before the surgery.

So Alam and Matava have created the Collaborative Human Immersive and Interactive Lab (CHISIL), which has virtual reality spaces at Sunnybrook Hospital and the Hospital for Sick Children.

The video below gives you a sense of what that virtual reality feels like.

A lot of the work CHISIL does is centred around patient education, an integral part of any surgical procedure. It helps the patient understand the procedure and what they can expect on the day of the surgery.

“My focus has always been around technology-enhanced learning,” says Alam. “And at times, I found patient education to be an underserviced realm. So it made sense to start to look at how immersive virtual content could be geared towards preoperative patients.

Patients don special virtual reality goggles that let them “experience” the journey of being prepped for surgery and being transferred to the operating room. Alam and Matava monitor the patients’ anxiety levels, blood pressure, heart rate and self-assessment. They then compare this to a control group who watched traditional instructional videos before their operation.

Assistant Professor Fahad Alam provides preoperative instruction using virtual reality technology

While the study is still ongoing, Alam and Matava are already receiving positive feedback from patients who have used the technology.

“I have never heard the phrase, ‘This is so cool!’ so often,” says Alam. “Everyone is amazed by the content and in awe of the environment we are able to immerse them in.”

CHISIL is the first lab of its kind in Canada and is an initiative under eLearning and Technological Innovations by the Faculty of Medicine's department of anesthesia. While the lab initially operated solely from Sunnybrook and SickKids, they now have mobile virtual reality units. They’re also developing ways of letting patients access the virtual reality technology right from their homes.

Alam is excited about the potential applications of virtual reality in health care.

“Immersive content is just in its infancy, and it has nearly limitless possibilities. We can create any type of virtual environment and immerse the user instantaneously into what we have created.”

Assistant Professor Fahad Alam talks to a patient about the surgical process using virtual reality technology

Behind the scenes of Canada's first hand/arm transplant

sgupta — Thu, 14 Jan 2016 16:49:45 +0000

Behind the scenes of Canada's first hand/arm transplant sgupta Thu, 01/14/2016 - 11:49

Cutline

Dr. Christian Veillette (r), orthopedic surgeon, looks at an x-ray to ensure proper alignment of the patient arm and donor arm as they are fused together (Photo by University Health Network)

Liam Mitchell

Author legacy

Liam Mitchell

Subheadline

Work by ��ֱ�� team means “this type of surgery will be available to more Canadians”

The surgery itself may have taken 14 hours, but the planning for it began five years earlier.

A 49-year-old woman received a new hand and forearm through a still rare type of surgery performed at UHN’s Toronto Western Hospital.

Known as Vascularized Composite Allotransplantation (VCA) it’s an emerging field of surgery that blends transplant surgery and microsurgery.

surgery

A diabetes drug promotes brain repair – but only in females, ��ֱ�� study shows

'It's a great honour': Eleven ��ֱ�� faculty named fellows of the Royal Society of Canada

Pamela Klassen

Kathleen Gallagher

Heinz-Bernhard Kraatz

��ֱ�� researchers part of international team awarded US$4 million by Chan Zuckerberg Initiative to map human liver

From AI to immigrant integration: 56 ��ֱ�� researchers supported by Canada Research Chairs Program

Here is the full list of new and renewed Canada Research Chairs:

'You could avoid huge numbers of deaths': ��ֱ�� researcher on gun fatalities in the U.S., Mexico, Brazil and Colombia

��ֱ�� researchers find firearm mortality in the Americas highest among young men, links to education and race

Read a Q&A with ��ֱ�� researcher Prabhat Jha on the study in The Lancet Public Health

��ֱ��'s Medicine by Design invests $1.2 million to advance regenerative medicine research and translation

New Ideas Awards

Seed Fund Awards

��ֱ�� PhD student publishes hip-surgery research in major U.S. medical journal

Read Pincus's research in JAMA

Interested in publicly funded research in Canada? Learn more at UofT’s #supportthereport advocacy campaign

Read more about research by Pincus

Not just for gamers: ��ֱ�� anesthesiologists taking virtual reality to patients facing surgery

Behind the scenes of Canada's first hand/arm transplant

Read more about the surgery

surgery

A diabetes drug promotes brain repair – but only in females, ����ֱ�� study shows

'It's a great honour': Eleven ����ֱ�� faculty named fellows of the Royal Society of Canada

Pamela Klassen

Kathleen Gallagher

Heinz-Bernhard Kraatz

����ֱ�� researchers part of international team awarded US$4 million by Chan Zuckerberg Initiative to map human liver

From AI to immigrant integration: 56 ����ֱ�� researchers supported by Canada Research Chairs Program

Here is the full list of new and renewed Canada Research Chairs:

'You could avoid huge numbers of deaths': ����ֱ�� researcher on gun fatalities in the U.S., Mexico, Brazil and Colombia

����ֱ�� researchers find firearm mortality in the Americas highest among young men, links to education and race

Read a Q&A with ����ֱ�� researcher Prabhat Jha on the study in The Lancet Public Health

����ֱ��'s Medicine by Design invests $1.2 million to advance regenerative medicine research and translation

New Ideas Awards

Seed Fund Awards

����ֱ�� PhD student publishes hip-surgery research in major U.S. medical journal

Read Pincus's research in JAMA

Interested in publicly funded research in Canada? Learn more at UofT’s #supportthereport advocacy campaign

Read more about research by Pincus

Not just for gamers: ����ֱ�� anesthesiologists taking virtual reality to patients facing surgery

Behind the scenes of Canada's first hand/arm transplant

Read more about the surgery

A diabetes drug promotes brain repair – but only in females, ��ֱ�� study shows

'It's a great honour': Eleven ��ֱ�� faculty named fellows of the Royal Society of Canada

��ֱ�� researchers part of international team awarded US$4 million by Chan Zuckerberg Initiative to map human liver

From AI to immigrant integration: 56 ��ֱ�� researchers supported by Canada Research Chairs Program

'You could avoid huge numbers of deaths': ��ֱ�� researcher on gun fatalities in the U.S., Mexico, Brazil and Colombia

��ֱ�� researchers find firearm mortality in the Americas highest among young men, links to education and race

Read a Q&A with ��ֱ�� researcher Prabhat Jha on the study in The Lancet Public Health

��ֱ��'s Medicine by Design invests $1.2 million to advance regenerative medicine research and translation

��ֱ�� PhD student publishes hip-surgery research in major U.S. medical journal

Not just for gamers: ��ֱ�� anesthesiologists taking virtual reality to patients facing surgery