Sunnybrook Health Sciences Centre

Department of Medicine

Cancer

Subheadline

Research led by scientists at Sunnybrook Health Sciences Centre and ��ֱ�� showed radioligand therapy to be an effective first-line treatment for advanced uncurable cancers

A novel approach for early cancer treatment known as radioligand therapy (RLT) has been shown to significantly reduce the risk of advanced neuroendocrine tumour progression and death, according to research led by scientists at Sunnybrook Health Sciences Centre and the University of Toronto.

Results of the multi-centre clinical trial, which were published in The Lancet, provided evidence for the first time that RLT – when applied in the early stages after a patient’s diagnosis – slowed down the progression of aggressive grade 2 and 3 neuroendocrine tumours of the gastrointestinal tract.

The treatment was shown to extend the average time of “progression-free survival” from approximately 8.5 months to 22.8 months.

“This is the first study to show the effectiveness of RLT as the ‘first-line’ treatment with advanced uncurable cancer, or any cancer,” said the study’s global principal investigator Simron Singh, a medical oncologist at Sunnybrook and associate professor in the department of medicine at ��ֱ��’s Temerty Faculty of Medicine. “This trial is groundbreaking not only for patients with neuroendocrine cancers, but for all cancer patients as it has implications for the practice of cancer treatment broadly.”

Singh described RLT as a “game changer” in the treatment of cancer, which has traditionally been carried out by surgery, drugs or radiation. “While it’s technically radiation, it is given via a chemotherapy route through the blood until it reaches the precise location of the tumour,” said Singh, who is also an affiliate scientist at Sunnybrook Research Institute and co-founder of the Susan Leslie Clinic for Neuroendocrine Tumours at Sunnybrook’s Odette Cancer Centre.

RLT involves injecting radioactive isotopes – in this case, the drug Lutathera – through an IV. This method targets specific cancer cell receptors, delivering precise radiation to kill cancer cells while preserving healthy tissue.

The study evaluated the use of RLT earlier as a first-line (or “up front”) treatment for patients newly diagnosed with grade 2 or 3 advanced gastrointestinal neuroendocrine tumours. Although neuroendocrine cancer is uncommon, incidence is rising rapidly, and few treatments exist for patients. This cancer is resistant to most therapies, making it challenging to treat.

The results confirm the clinical benefit of earlier use of RLT for patients diagnosed with aggressive and life-threatening tumours, said Singh. “This is the next step in personalized targeted cancer therapy for patients, focused on more effectively killing cancer cells, while limiting the damage to surrounding healthy tissues.”

Further investigations of RLT as a therapeutic option are ongoing to evaluate overall survival and long-term safety, which will better define next steps for how this therapy will change cancer treatment world-wide.

The multi-site trial included investigators and participants from Canada, the United States, France, Germany, Italy, Netherlands, South Korea, Spain and the UK. An overview of the results was presented at the 2024 American Society of Clinical Oncology (ASCO) Gastrointestinal (GI) Cancers Symposium in January 2024.

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Nadia Radovini

Hospitals with higher ratio of female surgeons, anaesthetists have better patient outcomes: Study

Christopher.Sorensen — Wed, 22 May 2024 14:48:30 +0000

Hospitals with higher ratio of female surgeons, anaesthetists have better patient outcomes: Study

Christopher.Sorensen Wed, 05/22/2024 - 10:48

Cutline

Reaching a critical mass of more than 35 per cent female anesthesiologists and surgeons was linked to lower odds of severe post-operative complications, according to a study from ICES, Sunnybrook Research Institute and ��ֱ�� (photo by Shannon Fagan/Getty Images)

Misty Pratt

Topic

Subheadline

"These results are the start of an important shift in understanding the way in which diversity contributes to better quality care around the time of surgery"

Greater sex diversity in hospital anaesthesia-surgery teams is associated with better post-operative outcomes for patients, according to a study from ICES, Sunnybrook Research Institute and the University of Toronto.

The study, published in the British Journal of Surgery, found that teams with more than 35 per cent female anesthesiologists and surgeons were associated with a three per cent reduction in odds of post-operative complications in the three months following surgery.

This is one of the first studies to focus on sex diversity of operating room teams, building on past work that has compared the impact of individual surgeon and anesthesiologist characteristics on patient outcomes.

“We wanted to challenge the binary approach of comparing female and male clinicians and rather highlight the importance of diversity as a team asset or bonus in enhancing quality care,” says lead author Julie Hallet, a scientist with ICES and Sunnybrook Research Institute, and associate professor of surgery at ��ֱ��’s Temerty Faculty of Medicine.

The study includes population-based, health-care data on 709,899 adult patients undergoing major in-patient surgeries in Ontario between 2009 and 2019.

Sex diversity of surgical teams was defined as the percentage of female anesthesiologists and surgeons among all anesthesiologists and surgeons working in the hospital each year. The primary outcome was 90-day major morbidity, which the researchers analyzed with a standardized classification scale to identify severe post-surgical complications.

The findings showed that reaching a critical mass of more than 35 per cent female anesthesiologists and surgeons was linked to lower odds of severe complications.

The association between greater sex diversity and reduced post-surgical complications was even greater for patients treated by female anesthesiologists and female surgeons – which aligns with previous studies comparing outcomes of male to female surgeons.

“These results are the start of an important shift in understanding the way in which diversity contributes to better quality care around the time of surgery,” says Hallet. “Ensuring a critical mass of female anesthesiologists and surgeons in operative teams is crucial to performance. Below a critical mass, female clinicians may withhold their perspectives, such that the benefits of diversity can only be achieved once minimum representation is reached.”

One limitation of the study is that the data did not include gender as a social construct. It is possible that gender roles, behaviours and attitudes would have influenced the strength of the association.

The study’s authors noted further research is also needed to explore diversity based on other sociodemographic variables, including but not limited to race and ethnicity.

Nevertheless, this study is the first to show a robust positive association between team sex diversity, patient outcomes and quality care.

“We hope that these results will encourage hospitals to intentionally foster sex diversity in operating room teams to reduce poor health outcomes, which, in turn, can improve patient satisfaction and promote sustainability of health systems,” says Gianni Lorello, staff anesthesiologist at Toronto Western Hospital, University Health Network and an associate professor in Temerty Medicine’s department of anesthesiology and pain medicine.

“Ensuring sex diversity in operative teams will require intentional effort for recruitment and retainment policies for female physicians, structural interventions such as minimum representation on teams, and monitoring and reporting of teams’ composition to build institutional accountability in existing systems.”

The research was supported by the Sunnybrook Alternate Funding Plan Innovation Fund.

��ֱ��, hospitals launch pilot program to boost commercialization of medical innovations

rahul.kalvapalle — Wed, 24 Apr 2024 14:19:19 +0000

��ֱ��, hospitals launch pilot program to boost commercialization of medical innovations

rahul.kalvapalle Wed, 04/24/2024 - 10:19

Cutline

(photo by Daria Perevezentsev)

Rahul Kalvapalle

Topic

Acceleration Consortium

Department of Computer Science

Artificial Intelligence

Department of Chemistry

Entrepreneurship

Faculty of Art & Science

Hospital for Sick Children

Leslie Dan Faculty of Pharmacy

Startups

The University of Toronto is collaborating with the University Health Network, the Hospital for Sick Children and Sunnybrook Research Institute on a new program that aims to leverage the expertise of entrepreneurs and business leaders to advance commercialization of emerging medical technologies and regenerative medicine research.

Funded by the Government of Ontario, the Entrepreneur-In-Residence program will support projects that display high potential for clinical impact and spin-off company formation, spanning areas ranging from regenerative therapies and medical devices to AI-powered clinical tools and apps for patient care.

The one-year pilot program is being launched with the help of a $300,000 grant from Intellectual Property Ontario (IPON), a provincial agency that was established in 2022 to provide IP resources and supports to researchers and businesses.

“The Entrepreneur-in-Residence program will help take medical innovations developed in academic and hospital environments and translate them into the commercial arena, generating economic opportunity for the region and expanding clinical impact globally,” said Leah Cowen, ��ֱ��’s vice-president, research and innovation, and strategic initiatives.

“The University of Toronto is grateful to IPON for its support of this initiative, which stands to strengthen existing networks of knowledge exchange and collaboration between the university and its partner hospitals.”

Jill Dunlop, left,Ontario’s minister of colleges and universities, said post-secondary institutions are critical incubators of innovation and commercialization (photo courtesy of IPON)

The program will see Entrepreneurs-in-Residence – individuals with a track record of launching science-based ventures and shepherding projects from proof-of-concept to incubation, acceleration and seed funding – liaise with ��ֱ��’s Innovations & Partnerships Office and IPON to generate and protect IP. It is designed to add capacity and scope to ��ֱ��’s thriving entrepreneurship and commercialization ecosystem, including existing Entrepreneur-in-Residence initiatives such as those offered by the Temerty Faculty of Medicine and Medicine By Design, an institutional strategic initiative (ISI).

“In today’s global knowledge-based economy, Ontario’s post-secondary institutions are critical – not just as centres of learning, but as incubators for innovation and commercialization,” said Jill Dunlop, minister of colleges and universities, in a recent announcement of new IPON-funded initiatives.

“Through the province’s support of IPON, our government is ensuring the social and economic benefits of publicly funded research stay in our province, so that Ontarians and the Ontario economy benefit from these new discoveries and innovations.”

Dunlop also spoke at an April 8 event with Christine Allen, a professor in ��ֱ��’s Leslie Dan Faculty of Pharmacy who has an extensive track record of translating and commercializing lab discoveries.

Christine Allen, far right, is a professor in the Leslie Dan Faculty of Pharmacy and the founder and CEO of Intrepid Labs (photo courtesy of IPON)

At the event, Allen highlighted the growth of her startup, Intrepid Labs Inc., which she co-founded with Alán Aspuru-Guzik, a professor in the departments of chemistry and computer science in ��ֱ��’s Faculty of Arts & Science and director of the Acceleration Consortium. The company marries Allen’s prowess in drug formulation and development with Aspuru-Guzik’s expertise in AI and advanced computing in order to accelerate the development of next-generation medicines. In the fall, the company closed a pre-seed round of US$4 million.

“The availability of top-notch talent in AI and life sciences made Toronto a great place to launch our company,” says Allen, who is Intrepid’s CEO, noting all four of the startup’s co-founders are from ��ֱ��.

She added that ��ֱ�� is a powerhouse for entrepreneurship and intellectual property, ranked second in North America for university-based startups, and that companies with founders or co-founders from ��ֱ�� make up a significant percentage of some of the fastest-growing companies in Ontario.

“This is the beauty of being at the University of Toronto and having the MaRS Discovery District across the street and all the hospitals around us. It’s such a rich environment,” she says.

“We can do this in Toronto.”

Allen stressed that a thriving lab-to-market ecosystem is critical to inspire the next generation of entrepreneurs.

“Students are increasingly seeking out roles in the private sector,” she says. “For them to see other students and faculty members [found startups] helps them realize that it’s possible for them to start companies, too.”

��ֱ�� receives $10 million from Ontario government for modernization of high containment facility

Christopher.Sorensen — Mon, 18 Mar 2024 18:15:01 +0000

��ֱ�� receives $10 million from Ontario government for modernization of high containment facility

Christopher.Sorensen Mon, 03/18/2024 - 14:15

Cutline

(photo by Julia Soudat)

Betty Zou

Topic

Emerging and Pandemic Infections Consortium

Sinai Health

Hospital for Sick Children

Unity Health

Health

Subheadline

Renewal of the 20-year-old facility, which allows researchers to study high-risk pathogens, will provide increased capacity to develop new vaccines and therapeutics

Canada’s ability to respond rapidly to emerging infectious diseases is taking a step forward with a $9.9-million investment from the Ontario government to support critical research infrastructure updates to the Toronto High Containment Facility (THCF), which houses the largest containment level 3 lab in the province.

The facility, located at the University of Toronto, is specially equipped to allow researchers to study high-risk pathogens, such as SARS-CoV-2, HIV, tuberculosis and mpox, in a safe and secure way.

Research undertaken at the current facility has advanced our understanding of infectious diseases and strengthened our ability to respond to emerging health threats.

“The THCF strengthens Ontario’s position as a prime location for globally leading companies and top talent to discover and commercialize cutting-edge technologies, while improving our preparedness for future health challenges,” says Leah Cowen, ��ֱ��’s vice-president, research and innovation, and strategic initiatives. “The updated facility will enhance Canada’s health infrastructure and health security, and ensure that Canadian researchers are trained and ready to respond to emerging infectious diseases.”

The provincial funding builds on a previous $35-million investment from the Canada Foundation for Innovation to support efforts to revitalize and expand the THCF and to transform it into the largest academic high-containment research centre in Canada.

The renewal of the 20-year-old facility will provide increased capacity to use state-of-the-art approaches supporting academic research projects as well as collaborative industry-led efforts to develop new vaccines and therapeutics for Canadians. The new provincial investment will also allow the facility to meet the growing demand from industry and public sector partners while maintaining ongoing research projects and an agile responsiveness to future outbreaks.

“The new THCF will allow our researchers to work on the most urgent infectious disease threats, provide greater opportunities to engage with government agencies and industry partners, and allow us to provide unique training opportunities for the next generation of infectious disease leaders, building a strong foundation for Canada’s response to future outbreaks,” says Scott Gray-Owen, academic director of the THCF and a professor of molecular genetics in ��ֱ��’s Temerty Faculty of Medicine.

The provincial support is part of a suite of investments through the Ontario Research Fund and the Early Researcher Awards that also include support for quantum and artificial intelligence projects at ��ֱ��. Support has also been extended to advance an infrastructure renewal of the province’s Advanced Research Computing (ARC) systems, including ��ֱ��’s Niagara ARC supercomputer, used by researchers across the country.

As the only high containment facility of its kind in the Greater Toronto Area, the THCF is a unique asset to the life sciences ecosystem in the region, which is home to 55 per cent of Canada’s pharmaceutical companies. The modernized facility will be able to support greater engagement with industry partners to advance made-in-Ontario therapeutics such as the experimental drug paridiprubart from Markham-based Edesa Biotech, which is currently being tested in a Phase 3 clinical trial to treat acute respiratory distress syndrome, a common complication from COVID-19 or influenza infections.

In addition to industry partners, the THCF has been used by federal and provincial agencies including the Public Health Agency of Canada, Bank of Canada, Rogers Hixon Ontario Human Milk Bank and Ontario Ministry of Natural Resources and Forestry.

The THCF renewal will also be undertaken in collaboration with ��ֱ��’s hospital partners: The Hospital for Sick Children, Sinai Health, Sunnybrook Health Sciences Centre, Unity Health Toronto and University Health Network. Construction of the facility has begun but the university is seeking additional funding to complete the project.

Based at the Temerty Faculty of Medicine, the THCF is the cornerstone of the Emerging and Pandemic Infections Consortium, a ��ֱ�� institutional strategic initiative that brings together the university and Toronto Academic Health Science Network (TAHSN) hospital partners to drive innovative approaches to infectious diseases and prepare for future pandemics. It is also a key infrastructure resource for the Canadian Hub for Health Intelligence and Innovation in Infectious Diseases (HI3) which was established through the Canada Biomedical Research Fund. The hub brings together over 90 partners across several sectors to bolster Canada’s biomanufacturing capacity to ensure a fast and co-ordinated response to future pandemics and infectious threats.

The revitalized THCF will also have the capacity to train more than 100 new highly qualified professionals over a five-year period with industry-relevant skills, including manufacturing practices and vaccine and therapeutics development.

At the beginning of the COVID-19 pandemic, the THCF was the first lab in Canada – and one of the first in the world – to isolate the new coronavirus in March 2020. The facility and its highly trained staff played a key role in accelerating research breakthroughs that guided the pandemic response including, for example, methods to allow safe reuse of personal protective equipment in health-care settings and to ensure safe human milk banking for premature infants.

The THCF was also a core element of EPIC’s mpox rapid research response, housing a biobank of samples from patients with mpox which are being used by researchers to better understand the dynamics of viral shedding and other important questions about the disease.

In addition to a larger physical space, the updated facility will include a state-of-the-art high containment insectary to enable research on mosquito-borne viruses like Chikungunya, dengue, Zika and yellow fever. With its modular design and enhanced safety features, the new facility will also be better positioned to respond to emerging pathogens like highly pathogenic avian influenza.

COVID-19 took a mental health toll on mothers, young women and adolescent girls: Researchers

Christopher.Sorensen — Fri, 15 Mar 2024 19:31:22 +0000

COVID-19 took a mental health toll on mothers, young women and adolescent girls: Researchers

Christopher.Sorensen Fri, 03/15/2024 - 15:31

Cutline

(photo by skynesher/Getty Images)

Chloe Panganiban

Topic

COVID-19

Institute for Pandemics

Institute of Health Policy Management and Evaluation

Centre for Addiction and Mental Health

Dalla Lana School of Public Health

Mental Health

Women

Subheadline

“The current road towards pandemic recovery needs to consider these at-risk populations. If not, there could be dire long-term consequences for the current generation and ones to come”

Two new studies supported by the Institute for Pandemics – a University of Toronto institutional strategic initiative – show that the non-pharmaceutical public health measures implemented during the COVID-19 pandemic were associated with increased mental health visits for mothers with young children, young women and adolescent girls.

As governments around the world imposed public health measures to reduce viral transmission, including stay-at-home orders, travel restrictions, and school closures, experts raised concerns about the potential lasting impact on the mental health of individuals, especially those belonging to vulnerable and at-risk populations.

In particular, mothers with young children faced obstacles related to parenting and caregiving, while young women and adolescent girls experienced major disruptions to school, social and daily routines.

The new studies – which built on previous research showing the COVID-19 pandemic had a larger impact on the mental health of men compared to women – aimed to examine how these pandemic-related non-pharmaceutical interventions have impacted the mental health of these groups.

“This work raises concerns about how to contain and address this issue,” says Geoffrey Anderson, a professor at the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation (IHPME) and lead of the pandemic recovery theme at the Institute for Pandemics.

“The current road towards pandemic recovery needs to consider these at-risk populations. If not, there could be dire long-term consequences for the current generation and ones to come.”

The research team also included: John Moin, a former post-doctoral researcher funded by the Institute for Pandemics; Shauna Brail, an associate professor at ��ֱ�� Mississauga who directs the Institute for Management & Innovation; and Simone Vigod, head of the department of psychiatry at Women’s College Hospital and a professor in the department of psychiatry in the Temerty Faculty of Medicine.

Both studies compared rates of doctor visits for mental health care in the pre-pandemic period from March 2016 to March 2020 to rates during the pandemic from April 2020 to November 2021.

The first, published in the Canadian Medical Association Journal (CMAJ) Open, found a rapid increase in doctor visits by mothers of young children for mental health care during the pandemic compared to the pre-pandemic period, with most of the care for mood, anxiety, depressive disorders and alcohol and substance abuse.

In the second study, published in the British Medical Journal (BMJ) Open, the team found an increase in doctor visits for adolescent girls and women aged 14 to 24 for mental health care largely driven by care for mood, anxiety and depressive disorders. Additionally, there was an increase in hospital visits for eating disorders for adolescent girls and women aged 14 to 19. There was no increase in doctor visits or hospitalizations for boys or young men.

Both studies show that the implementation of public health measures during the pandemic was associated with increased usage of mental health services among mothers of young children, young women and adolescent girls, and point to potential lessons for future public health crises.

“Our research raises concerns about the mental health impacts of public health measures on vulnerable women,” says Anderson. “We need to address these impacts as key part of any effective and equitable pandemic recovery strategy and we need to pay more attention to these consequences in future public health crises”.

"We saw the rapid and ongoing application of non-pharmaceutical interventions as public health measures throughout the pandemic,” says Moin, who was the lead author of both studies. “We also now know that they were associated with abrupt and prolonged changes in the utilization of mental health services. This association should be considered for future public health planning and strategy.”

Renzo Calderon, another post-doctoral fellow funded by the Institute for Pandemics, is leading a team that is further exploring this observed trend.

Despite nearly four years having passed since the beginning of the restrictions, the pandemic continues to alter the landscape of mental health. Hence, the researchers’ focus is not solely on exploring the overarching trends but also on better understanding if there are specific socio-demographic groups of women who were particularly affected.

Preliminary results indicate that the demand for mental health services around specific issues such as eating disorders and substance abuse, especially among young women, has not yet diminished.

Such a targeted approach aims to uncover nuanced insights into how the COVID-19 pandemic exacerbated these problems and lead to more effective interventions.

��ֱ��-anchored hospital network among leading life sciences research hubs, report finds

Christopher.Sorensen — Fri, 17 Nov 2023 23:24:07 +0000

��ֱ��-anchored hospital network among leading life sciences research hubs, report finds

Christopher.Sorensen Fri, 11/17/2023 - 18:24

Cutline

(photo by xubingruo/Getty Images)

Adina Bresge

Topic

Leah Cowen

Centre for Addiction and Mental Health

Women's College Hospital

The University of Toronto and its partner hospitals are propelling the Toronto region as a leading global hub for life sciences research – but its success is at risk from underinvestment.

That’s among the findings of a new report that examines the strengths and challenges within the Toronto Academic Health Science Network (TAHSN) – which comprises ��ֱ�� and 14 academic hospitals – and its surrounding ecosystem. The report was commissioned by ��ֱ�� and conducted by Shift Health.

In addition to leading on research, talent and public and private investment in Canada, the report finds that TAHSN rivals top-tier hubs in the United States despite receiving less funding.

“The TAHSN research outputs and impacts really do match or exceed those of our competitors across North America,” said Leah Cowen, ��ֱ��’s vice-president, research and innovation, and strategic initiatives.

“Our community is a phenomenal resource for Ontario, for Canada, and really inspiring around the world.”

Cowen was one of several health, research, industry and government leaders who gathered to discuss the report at an event hosted by the ��ֱ��’s Munk School of Global Affairs & Public Policy and ��ֱ��’s Government Relations Office, as part of the New Frontiers for Policymakers policy discussion series.

The report marks the first time TAHSN’s impact has been evaluated against leading hubs in North America. Measuring 10 quantitative indicators, the report finds that TAHSN’s strength lies in its fusion of discovery research, talent development, startup and commercialization supports, and robust industry partnerships.

From left: Aristotle Voineskos, Heather McPherson, Leah Cowen and Anne Mullin (photo by ��ֱ�� Government Relations Office)

It also adds to a body of evidence that demonstrates life sciences research at the university and its affiliated hospitals is supporting growth of the sector in Canada. A recent Nature ranking, for example, listed ��ֱ�� as the third-most prolific institution in the world (and second among universities) for health sciences research.

Research is at the foundation of the life sciences sector, one of Canada’s most intensive R&D industries. In 2022, life sciences contributed $89.6 billion to the national GDP and supported 200,000 jobs. The federal government and provincial governments, including Ontario, have developed strategies that seek to leverage new investments in bioinnovation and biomanufacturing, increase the competitiveness of Canadian companies and meet the projected demand for more workers.

Reaching those goals requires renewed investment, the report argues.

“There are two points,” Cowen said during the event. “One is that we’re great. But that’s not what we’re here to address. We’re here to do something much more ambitious, which is to recognize that our greatness is at risk if we don’t have considerably more investment.”

In particular, the report identified a significant gap in access to government health research funding for the TAHSN hub compared to its U.S. peers.

TAHSN is able to deliver globally leading results because of collaboration among its affiliated institutions and across disciplines through ��ֱ��’s institutional strategic initiatives, Cowen said. The institutional strategic initiatives facilitate research in areas of the life sciences that are transforming patient care, including regenerative medicine and machine learning.

The Toronto Academic Health Science Network comprises ��ֱ�� and 14 academic hospitals, including those found on Toronto’s “Hospital Row” (photo by Kenneth Chou)

These strategies are a foundation for global scale, Cowen added, but only if Canada invests more in life sciences research in a bid to increase health security and economic growth.

“Over and over again, we see how fundamental science is able to transform innovation and lead to huge economic growth – but public support is critical,” she said.

“This ecosystem can scale. We can do more. But we can't do more if we continue to stagnate in terms of levels of investment.”

TAHSN Chair Heather McPherson, president and CEO of Women’s College Hospital, noted the report’s finding of higher salaries for life sciences research talent south of the border, which can make it difficult to recruit and retain top researchers and ultimately affects research capacity and patient care. “I think about research in a very connected way,” said McPherson. “To me, it's the pathway to a better health system for everyone. Research drives innovation and innovation drives better patient care - We need both to stay competitive and create an environment that attracts the best and brightest. ”

Other issues outlined in the report include the lower number of early-phase clinical trials conducted in Canada compared to leading U.S. hubs and a lack of sufficient capital to scale startups into global champions.

“When I reflect on the report, it's all kind of a missed opportunity,” McPherson said.

“We're doing extremely well right now – the report shows that. But how well could we do if we had some more investment? And what innovations, particularly in patient care, are we leaving on the table?"

Aristotle Voineskos, vice-president of research and director of the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH), says Canada tends to have a lower appetite for risk than the U.S. when it comes to research – even though there are many examples of research projects deemed long shots that ultimately transformed human health.

“When there is that one success, it's enormous. It's massive,” says Voineskos, noting that TAHSN has all the ingredients to further increase its attractiveness as a site for early-stage clinical trials, from sharing of data findings among hospitals to the diversity of Toronto’s patient population.

“This is such as special environment. There’s just a lot of opportunity here that I think is untapped.”

Why is COVID-19 more severe in some people? Researchers use genetics, data science to find out

Christopher.Sorensen — Wed, 25 Oct 2023 14:08:53 +0000

Why is COVID-19 more severe in some people? Researchers use genetics, data science to find out

Christopher.Sorensen Wed, 10/25/2023 - 10:08

Cutline

(Photo by Cole Burston/AFP/Getty Images)

Tyler Irving

Topic

COVID-19

Data Sciences Institute

Princess Margaret Cancer Centre

Sinai Health

Dalla Lana School of Public Health

Unity Health

Computer Science

Faculty of Arts & Science

Hospital for Sick Children

Mount Sinai Hospital

St. Michael's Hospital

Statistical Sciences

Women's College Hospital

Subheadline

With the help of ��ֱ��'s Data Sciences Institute, researchers from the university and partner hospitals gathered more than 11,000 full genome sequences from across Canada

Why do some people have a more severe course of COVID-19 disease than others? A genome sequence database created by an international collaboration of researchers, including many from the University of Toronto and partner hospitals, may hold the answers to this question – and many more.

The origins of the Canadian COVID-19 Human Host Genome Sequencing Databank, known as CGEn HostSeq, can be traced to the earliest days of the pandemic.

Lisa Strug, senior scientist at The Hospital for Sick Children (SickKids) and academic director of ��ֱ��’s Data Sciences Institute, one of several ��ֱ�� institutional strategic initiatives, says genetic data was top of mind for her and other researchers in late 2019 and early 2020 as reports of a novel form of coronavirus emerged from China and then other locations across the globe.

Lisa Strug (Photo courtesy The Hospital for Sick Children)

“In my research, I use data science techniques to map the genes responsible for complex traits,” says Strug, who is a professor in ��ֱ��’s departments of statistical sciences and computer science in the Faculty of Arts & Science and in the biostatistics division of the Dalla Lana School of Public Health.

“We knew that genes were a factor in the severity of previous SARS infections, so it made sense that COVID-19, which is caused by a closely related virus, would have a genetic component, too.

“Very early on, I started getting messages from several scientists who wanted to set up different studies that would help us find those genes.”

Over the next few months, Strug – who is also the associate director of SickKids’ Centre for Applied Genomics, one of three sites across Canada that form CGEn, Canada’s national platform for genome sequencing infrastructure for research – collaborated with nearly 100 researchers from across ��ֱ�� and partner hospitals and institutions, as well as other researchers from across Canada to enrol individuals with COVID-19 and sequence their genomes.

Some of the key team members from the Toronto community included:

Stephen Scherer, chief of research at SickKids Research Institute and a University Professor in ��ֱ��’s Temerty Faculty of Medicine, as well as director of the ��ֱ�� McLaughlin Centre
Rayjean Hung, associate director of population health at the Lunenfeld-Tanenbaum Research Institute, Sinai Health, and a professor in ��ֱ��’s Dalla Lana School of Public Health
Angela Cheung, clinician-scientist at University Health Network, senior scientist at Toronto General Hospital Research Institute and a professor in ��ֱ��’s Temerty Faculty of Medicine
Upton Allen, head of the division of infectious diseases at SickKids and a professor in ��ֱ��’s Temerty Faculty of Medicine

The projected was initiated by Scherer and CGEn’s Naveed Aziz, along with Strug, and a $20-million grant was secured from Innovation, Science and Economic Development Canada, administered through Genome Canada.

“We had to go right to the top to get this project funded fast and our labs and teams worked seven days a week on the project right through the pandemic,” Scherer recalls.

Identifying associations between individual genes and complex traits typically requires thousands of genomes – both from those with the trait and those without. Though there was no shortage of cases to choose from, it was critical to gather and sequence DNA – and then organize the data in a way that would be ethical, efficient and useful to researchers now and in the future.

“One of our key mandates at the Data Sciences Institute is developing techniques and programs that ensure that data remains as open, accessible and as re-producible as it can be,” Strug says.

“That vision was brought to bear as we assembled the data infrastructure for this project – for example, ensuring that consent forms were as broad as possible so that this data could be linked with other sources, from electronic medical records to other health databases.

“We wanted to be sure that even after the COVID-19 pandemic was over this could be a national whole genome sequencing resource to ask all kinds of questions about health and our genes. The development of the database and its open nature also enabled Canada to collaborate effectively with similar projects in other countries.”

Partner hospitals and institutions:

The Hospital for Sick Children (SickKids)
Lunenfeld-Tanenbaum Research Institute, Sinai Health
Mount Sinai Hospital, Sinai Health
St Michael’s Hospital, Unity Health Toronto
University Health Network (UHN)
Princess Margaret Cancer Centre, UHN
Ontario Institute for Cancer Research
Women’s College Hospital
Toronto General Hospital, UHN
Baycrest Health Sciences

In the end, the project gathered more than 11,000 full genome sequences from across Canada, representing patients with a wide range of health outcomes. Those data were then combined with even more sequences from patients in other countries under what came to be called the COVID-19 Host Genetics Initiative.

It didn’t take long for patterns to start to emerge. A paper published in Nature in 2021 identified 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19.

Since then, even more data have been added, and subsequent analysis has confirmed the significance of existing loci while also identifying new ones. The most recent update to the project, published in Nature earlier this year, brings the total number of distinct, genome-wide significant loci to 51.

“Identification of these loci can help one predict who might be more prone to a severe course of COVID-19 disease,” says Strug.

“When you identify a trait-associated locus, you can also unravel the mechanism by which this genetic region contributes to COVID-19 disease. This potentially identifies therapeutic targets and approaches that a future drug could be designed around.”

While it will take many more years to fully untangle the effects of the different loci that have been identified, Strug says that the database is already showing its worth in other ways.

“It can be difficult to find datasets with whole genome sequence and approved for linkage with other health information that are this large, and we want people to know that it is open and available for all kinds of research well beyond COVID through a completely independent data access committee,” she says.

“For example, several investigators from across Canada have been approved to use these data and we’ve even provided funding to trainees to encourage them to develop new data science methodologies or ask novel health questions using the CGen HostSeq data.”

“This was a humongous effort, where researchers from across Canada came together during the COVID-19 pandemic to recruit, obtain and sequence DNA from more than 11,000 Canadians in a systematic, co-operative, aligned way to create a made-in-Canada data resource that will hopefully be useful for years to come. I think that was really miraculous.”

Faces of Temerty Medicine: Gazelle Halajha

Christopher.Sorensen — Tue, 12 Sep 2023 18:22:44 +0000

Faces of Temerty Medicine: Gazelle Halajha

Christopher.Sorensen Tue, 09/12/2023 - 14:22

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"During my surgery rotation at Sunnybrook’s trauma centre, I got to see and do so much," Halajha says. "I never felt more useful." (supplied image)

Deanna Cheng

Topic

Student Experience

Women's College Hospital

Gazelle Halajha, now entering her fourth year of medical school at the University of Toronto, believes it's important for doctors to recognize “when someone is struggling and needs more support.”

She witnessed those challenges first hand as her mother and “biggest role model” worked to give her children the best life possible, following the death of their father.

“I grew up in a single parent household and saw how often people in these situations can struggle to access care,” Halajha says. “I saw my mom’s health and well-being suffer as she worried about her next paycheque and how to provide for her children.”

The aspiring surgeon has conducted research in chemotherapy, quality improvement in trauma surgery and women’s health while working to help cover the cost of her education. Alongside the inspiration and support provided by her mother, Zena, she attributes her achievements and ability to balance her busy schedule to the support of multiple student awards.

She spoke with writer Deanna Cheng about what drew her to medicine and her dreams for the future.

Why did you decide to pursue medical school at the Temerty Faculty of Medicine?

I was born and raised in Toronto – my mom and my entire family lives here. When I was applying for medical school, I was looking at what was close to home and what fit my needs, as well as the kind of doctor I wanted to become. I wanted to be able to work in a place like Toronto, where there are people from all different walks of life coming into its hospitals who need help. Temerty Medicine trains you as a physician to recognize when someone is struggling and needs more support and that was big for me. It's a school that reflects my values.

What kind of doctor do you want to become?

I want to become a doctor who is inclusive and self-aware. I grew up in a single-parent household and saw how often people in these situations can struggle to access care. I saw my mom’s health and well-being suffer as she worried about her next paycheck and how to provide for her children.

What inspired you to become a doctor?

I always say that I wouldn't be anywhere in life without my mom. I learned through her what it meant to persevere and to be dedicated to what you love. My mom was 30 years old when my dad passed away in a car accident. To her, all that mattered was that she was working towards giving her two kids the best life possible. She is my biggest role model.

Now that you’re entering your fourth year of medical school, what can you tell me about your experience?

In my third year, I had my surgery rotation very early on and basically fell in love with the specialty. I know for certain it's what I want to do. During my surgery rotation at Sunnybrook’s trauma centre, I got to see and do so much. I never felt more useful. I soon realized that what I had a passion for was surgery especially in the areas of surgical oncology, breast cancer and trauma surgery.

Tell me more about your research in surgical oncology.

In my second year of the MD Program, I started working in the area of breast cancer. I found I was really interested in the surgical aspect of breast cancer treatment as well as in medications used and the effects they have on the body. I was mentored by and worked with Dr. Husam Abdel-Qadir, assistant professor of medicine at the University of Toronto and a staff cardiologist at Women's College Hospital, doing research related to chemotherapy and its cardiotoxicity. A lot of breast cancer patients are in their 20s and may wish to have children one day. I wanted to look at how chemotherapy affects egg fertilization and what it means for these patients. I’ve also started looking at caesarean section scarring. I haven't figured out exactly what I want to do in general surgery, but I just know that that feeling of excitement is something that I want to work towards.

You are also interested in trauma surgery. Can you tell me more about that?

While I was at Sunnybrook’s trauma centre, I saw patients coming in after experiencing vehicle accidents, shootings and stabbings. It's remarkable what these teams do to help patients in the operating room, while making sure their families are well supported. I lost my father quite young due to trauma from a car accident in Iran. The health-care system there is not the same as it is in Canada. Growing up, I spent a lot of time thinking about what would have happened to my dad if he had the car accident somewhere else in the world where the trauma response is faster. I'm curious to see what other parts of the world are like and am excited to take my knowledge and my skills to trauma centres around the world and to bring my experience back here, to Canada.

You received the T.S. Butcher Bursary and the Frank William Moore Award in Medicine from the Temerty Faculty of Medicine. In what ways has donor support helped bring you closer to this dream?

I committed to putting myself through school because my mom was a single parent. Medical school is costly, so I worked part time for my first two years. I was a nanny, I worked in retail, I also worked as an autism support worker at Woodview Mental Health and Autism Services and in research at Women's College Hospital. I was so thankful to have help from scholarships and bursaries, which made a huge difference. It was challenging to balance work with school and with my other extracurriculars. Support from donors meant I could focus more on my education and on myself and my well-being. Thanks to donors, I can dedicate my energy to learning and supporting patients and becoming a better doctor.

What has been your most memorable moment at Temerty Medicine so far?

One highlight was a Health Systems Research (HSR) course. I focused on types of cancers, like pancreatic cancer, which are caught so late in the game and are very devastating and very hard to recover from. A lot of my research was looking at young patients who receive chemotherapy treatments, and who later on have side-effects like heart failure. I wanted to investigate screening guidelines for these cancers. The research project yielded that lymphoma patients are at greater risk of cardiovascular events after treatment with chemotherapy. I created an abstract and was able to present it at the American College of Cardiology (ACC) annual meeting presentations. Now, we’re talking about creating guidelines that can be implemented across Toronto.

What do you think lies ahead for you?

Coming into medicine, my goal was to always, ultimately, give back. I hope that when I become a surgeon, I can make sure my patients are well supported and have adequate follow-ups. While I was clerking, I saw a lot of interdisciplinary work being done (involving social workers, occupational therapists, physical therapists, etc.). Many teams would come together to support individual patients. I hope my journey will include more training as part of interdisciplinary teams, so I can learn from different kinds of health professionals and take that knowledge to other hospitals.

Study suggests patients treated by female surgeons less likely to suffer post-op complications: Guardian, Wall Street Journal

bresgead — Wed, 30 Aug 2023 20:04:06 +0000

Study suggests patients treated by female surgeons less likely to suffer post-op complications: Guardian, Wall Street Journal

bresgead Wed, 08/30/2023 - 16:04

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(photo by Rubberball/Nicole Hill/Getty Images)

Topic

Sinai Health