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LONDON, ON – In a newly published study, scientists at Lawson Health Research Institute have adapted PET/MRI technology to accurately image salt within the kidneys of patients with kidney disease.  

“Salt is very difficult to image in an MRI because the signal is much weaker than water,” explains Dr. Christopher McIntyre, Lawson Scientist and Nephrologist at London Health Sciences Centre (LHSC). “We wanted to find a way to look at the fundamental role of the kidney in getting rid of salt and water by using a functional MRI.”

Imaging salt within the kidneys has never been accurately accomplished in patients with kidney disease, but Dr. McIntyre and his team developed new technology and software that was adaptable to a PET/MRI machine at St. Joseph’s Health Care London. The new technology allowed the machine to image salt and water levels within the kidney.

“Salt within the kidneys have only been imaged in pre-clinical models, and low weight, healthy volunteers,” says Dr. McIntyre. “Since the kidney is further away from the MRI coils, and the organ moves when a person breathes, it is definitely very hard to image.”

This was the first study to use MRI to look at salt within the kidneys with a wide range of participant with different body types (10 healthy volunteers), as well as patients with kidney disease (five patients). The research team also imaged patients who had a combination of kidney disease and heart failure, because it is especially important for those patients specifically to be able to release salt and water as part of their treatments.

Currently, clinicians rely on kidney biopsies to measure salt levels, but Dr. McIntyre says that method isn’t as accurate or effective as it could be.

 “The problem is that the biopsies are painful, they have risks, and because it is a small sample of the kidney, we don’t get an accurate perspective of the kidney as a whole,” Dr. McIntyre explains. 

The study, which is published in Radiology has now opened the door to new possibilities when it comes to clinical care for patients with kidney disease.

“Salt is very toxic in patients with kidney failure,” adds Dr. McIntyre. “This will now allow us to diagnose and manage both chronic and acute kidney disease. It is a significant step forward.”

The next steps for the research team will be to compare salt MRI’s to biopsies, while also examining potential new therapy developments. 

“We are hoping we will have a higher degree of certainty moving forward to predict what will happen within the kidneys of these patients, with the possibility of using new targeted and effective treatments in the future,” notes Dr. McIntyre.
 

It was a diagnosis that came as a shock for 28-year-old Mitch Kuska who found out he had Multiple Sclerosis (MS) at the age of 26.  “I went from being a young 26-year-old doing regular things, to having to learn about this disease and everything that goes along with it and how it will affect my life." Kuska, an avid cyclist, says knowing that one day he may not be able to physically do the things he loves has been the hardest part of his MS journey so far.  “The scariest part for sure is the uncertainty, because I don’t know what the future holds for me. Before I could look into the future and feel for the most part that I would be healthy.”

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From his doctors, Kuska learned about a study being conducted with London Health Sciences Centre (LHSC) patients by a group of hospital researchers from Lawson Health Research Institute, the research arm of London’s hospitals. They were examining the use of mindfulness as a possible tool for newly diagnosed relapsing MS (RMS) patients. Mindfulness is a type of meditation that focuses on being intensely aware of senses and feelings in the moment.

“It can be a stressful time for people as they have just been diagnosed with a chronic neurological disease that will last the rest of their life,” says Dr. Sarah Morrow, Neurologist and Associate Scientist at Lawson.

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“We do find that there is an increase in anxiety and depression for people with MS, especially depression. In fact, the rates are three times higher for people with MS compared to other neurological disease.” Dr. Morrow is also the Director of the London MS Clinic at LHSC.

As part of the study, 24 newly diagnosed RMS patients were recruited including Kuska. Participants were split up into two groups, either the treatment group or the control group. The treatment group took part in ten sessions of the Mindfulness Without Borders program.

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“Mindfulness is bringing people into the moment rather than worrying about what could happen in the future or thinking about what happened in the past,” says Dr. Arlene MacDougall, Psychiatrist and Lawson Scientist. “It’s about centering yourself and gaining a sense of control of how you will respond rather than react to what is happening inside or outside of you.” 

The participants were evaluated before the sessions and then six months later to see if there was a difference between the two groups. “Immediately after the sessions when we compared the two groups, those in the mindfulness were reporting better coping skills and less perceived stress, and their symptoms of depression had been reduced,” adds Dr. Morrow.

“During the study treatment, I definitely noticed myself being more mindful of my symptoms. Sensing little changes in my body and little feelings here and there,” explains Kuska. “I was more in tune with myself and I felt this mindfulness tool helped me get into the right mindset to start dealing with MS.”

Following these initial findings published in Multiple Sclerosis and Related Disorders, the London research team plans to examine them in a larger study. They are also working to examine if the use of mindfulness would be helpful for people who are in the more progressive stages of MS.  

 

Massive investment by the Workplace Safety and Insurance Board (WSIB) to St. Joseph’s Health Care London is largest-ever grant to transform occupational illness and injury

A “game-changer” investment of $65.75 million to Lawson Research Institute of St. Joseph’s Health Care London will transform the prevention, diagnosis and treatment of workplace injuries and illness for Ontarians.

The Workplace Safety and Insurance Board’s visionary 10-year commitment is the WSIB's largest-ever research injection; the largest non-government health research funding in London history; and the biggest single grant received and stewarded by St. Joseph’s Health Care Foundation.

The investment will launch the Occupational Injury Prevention and Treatment Research Network – a first-in-Canada hub where people, technology and science-backed innovation will help solve the human and health costs of occupational injury and illness across Ontario and around the world.

Landmark work, global leadership

“This is a game-changer, something that will transform how we work together to get ahead of work-related injury, pain and mental illness,” says Lisa Porter, PhD, Vice-President Research at St. Joseph’s and Scientific director of Lawson, the research arm of St. Joseph's.

“This investment will propel us to global leadership in finding solutions to some of the most pervasive issues affecting people in workplaces today,” Porter says.

Occupational injuries and illnesses – including chronic pain, physical disability and mental health conditions – accounted for more than 93,000 claims registered through the WSIB last year, with an average lost work time of 63.2 days.

Occupational injuries and illnesses – including chronic pain, physical disability and mental health conditions – have a significant impact on many people, families and businesses in Ontario. Every year they account for almost 250,000 claims registered through the WSIB, with benefit payments of approx. $2.5 billion.  

“Too many Ontario families experience the human cost of workplace injury,” says Jeffery Lang, President and CEO of the WSIB. “We want fewer injuries to happen, and if they do, to be able to help people with a safe and faster recovery. This research is going to help get us there and with their established expertise, the St. Joseph’s Health Care and Lawson Research Institute team are a natural partner for this important work.”  

 Investment and innovation

The network will innovate long-term solutions to prevent mental and physical injuries, accelerate recovery and ensure sustainable health for Ontario workers.

It will feature state-of-the-art infrastructure and expertise including:  

• A first-in-Canada positron emission tomography/magnetic resonance imagery (PET/MRI) scanner dedicated to research into rapid and accurate diagnosis of mental health conditions including post-traumatic stress and depression
• A cutting-edge Computer-Assisted Rehabilitation Environment (CAREN), a unique, virtual-reality environment that will test and solve workplace injury, rehabilitation and chronic pain in new ways
• Three new endowed research Chairs and teams of scientists solving the most critical research questions plaguing people injured at work, an investment that will ensure long-term consistency and sustainability of the work
• Deploying technology in data science, artificial intelligence (AI) and virtual reality, making the network accessible by centres and workplaces across Canada

Rapid-access research area to design and test assistive devices such as splints and mobility technology  

St. Joseph’s President and CEO Roy Butler says, “We know that discovery-driven, patient-focused research improves lives – that is the focus of our hospital-based research at Lawson, and we’re humbled that the WSIB has entrusted us to expand this vital work to minimize the effects of workplace injury, disease and disability. This significant investment will drive innovation opportunities that will translate into novel new treatments and tools that can be used to battle workplace injury and illness”

“This investment will enable us to leverage the deep expertise St. Joseph’s already has in mental health, chronic pain and rehabilitation, and creates the opportunity to expand our knowledge to support workplace wellness, including for frontline health-care workers,” Butler says.

Butler adds that the network will strengthen existing partnerships and create new collaborations – within St. Joseph’s as well as among a wide range of health professionals, researchers, post-secondary institutions and industry locally, across the province and nationally.  

Butler notes St. Joseph’s already excels in research and treatment for related injuries and illnesses.

That includes: preventing and treating chronic pain through the hospital’s Pain Management Program and the Gray Centre for Mobility and Activity hand and upper limb care and injury prevention through the Roth | McFarlane Hand and Upper Limb Centre; advanced imaging expertise; and mental health solutions for veterans and first responders at the MacDonald-Franklin OSI Research Centre. All are specialty research areas of St. Joseph’s with deep roots in addressing occupational injury and illness.

A partnership of promise

Many groundbreaking research initiatives at St. Joseph’s have been made possible by generous supporters of St. Joseph’s, says Michelle Campbell, President and CEO of St. Joseph’s Health Care Foundation.

Medical research in Canada, including the research done in our hospitals, relies heavily on private funding.  Donors to our foundation, invest in research because they know that innovation leads to better frontline care, and healthier communities,” Campbell says.  

“It’s a partnership of promise, a confident stride toward better outcomes for patients. The WSIB’s gift through St. Joseph’s Health Care Foundation is a whole new level of leadership, and we’re proud to be integral to this transformation in workplace health,” says Campbell.

Earlier this year, the WSIB announced a $20-million gift to Fanshawe College to create a Centre of Excellence in Immersive Technology for Workplace Safety, primarily to help first responders and responders-in-training learn to prevent and treat occupation-related mental health issues such as PTSD, anxiety and depression.

The Network at St. Joseph’s broadens that work to bring research-specific innovation aimed at benefiting the physical and mental wellbeing and safety of workers in all occupations.

The new hub at St. Joseph's will make use of the institution’s vast community and research partnerships throughout London and across Canada, in multiple collaborations across a wide range of health disciplines. 

Announced at the 2017 Lawson Impact Awards, Drs. Stewart Gaede and Gerald Wisenberg were recipients of Lawson’s annual Strategic Research Fund (SRF) competition. With their project, “Assessing acute cardiac inflammation after left-sided breast cancer radiotherapy with hybrid PET/MRI,” the Lawson researchers will explore the cardiovascular effects of radiation therapy for left-sided breast cancer.

Radiation therapy is critical to modern breast cancer treatment. It has led to improved survival rates with many patients living long lives following their treatment.

Unfortunately, when delivering radiation therapy, we cannot avoid irradiation around surrounding tissues, including the heart. This is a concern since such irradiation may lead to cardiovascular disease later in life.

Currently, the effects of radiation to the heart can only be detected one or two years afterwards. With the help of their Lawson SRF award, Drs. Gaede and Dr. Wisenberg will use PET/MR imaging to detect earlier effects of radiation and construct new guidelines and treatment strategies for left-sided breast cancer patients.

“We’re seeing more and more breast cancer survivors, but many women with left-sided breast cancer are now developing heart disease later in life,” says Dr. Gerald Wisenberg, Director of Cardiac Imaging Research at Lawson and cardiologist at London Health Sciences Centre (LHSC). “We hope to improve their outcomes through this research.”

Recently, Drs. Gaede and Wisenberg discovered that an increase in cardiac inflammation can be detected as early as one week after radiation using PET/MR imaging. This inflammation may be the cause of cardiovascular disease seen in women 10 to 15 years after treatment.

In the new pilot study, the researchers will follow 15 left-sided breast cancer patients undergoing radiation therapy. They will be imaged one week before as well as one week and one year after radiation therapy with Lawson’s hybrid PET/MRI scanner at St. Joseph’s Hospital in London, Ontario.

Areas of inflammation, changes in blood flow, scar formation and fibrosis will be measured by looking at the differences between images. The data will help in the design of new treatment strategies that can hopefully decrease or eliminate inadvertent heart damage. By doing so, it could help to improve patients’ quality of life.

“The earlier we can detect the effects of radiation for left-sided breast cancer, the earlier we can intervene,” says Dr. Gaede, a Lawson imaging scientist and medical physicist at LHSC’s London Regional Cancer Program. “We hope to learn more about the ways in which radiation is affecting the heart so that we can construct new radiation techniques to better spare the heart.”

Learn more about this research:

Now in its third year, Lawson’s Strategic Research Fund (SRF) supports research projects that will advance science in alignment with Lawson’s strategic research goals, as outlined in Lawson’s 2014-2018 Strategic Plan. This year’s competition once again focused on “inflammation”. Chosen projects received $50,000 over a two-year period.

Amanda McIntyre was presented with the 2018 Leadership Award for Fellows & Students at this year’s Lawson Impact Awards, recognizing her skills as a leader, researcher, clinician and community advocate. McIntyre is a PhD candidate in nursing at Western University and a part of Lawson researcher Dr. Robert Teasell’s team at St. Joseph’s Health Care London’s Parkwood Institute.

McIntyre began her career at Lawson as a research assistant in 2011 and since then has built an impressive academic and research record, while at the same time obtaining a nursing degree from Western University. In addition to her many research obligations, she continues to take regular nursing shifts in the emergency department to build her clinical experience.

“We nominated Amanda because she’s kind of like a renaissance person. She does a lot of things and whatever she does, she does really well,” says Dr. Robert Teasell, medical director of the Stroke Rehabilitation Unit at Parkwood Institute.

McIntyre is involved in a variety of research projects in the field of neurorehabilitation and has been an author on 50 peer-reviewed publications.

She is the project coordinator and an editor of the Spinal Cord Injury Evidence-Based Review (SCIRE), an extensive and comprehensive review of the Spinal Cord Injury (SCI) Rehabilitation literature considered to be the leading research synthesis of SCI rehabilitation anywhere in the world. She also had an active role in the development of the Canadian Best Practice Recommendations for Stroke Care.

McIntyre is a two-time recipient of the Mary Elizabeth Horney Fellowship in Rehabilitation Research, which is funded through St. Joseph’s Health Care Foundation. As part of her fellowship, she is conducting research on the transition of stroke patients from inpatient to outpatient rehabilitation, and back to the community. Her doctoral research will focus on the delivery and access of care in emergency departments and the influence this has on patient outcomes.

 

 

McIntyre has assumed a supervisory and mentorship role in Dr. Teasell’s lab. She has been instrumental to the development of many research assistants, students and volunteers.

She is also currently the graduate students’ representative on the Nursing Research Advisory Committee, and a research practicum mentor for Nurse Practitioner students at Western University, allowing her to act as an advocate for current and future nursing students.

She says, “Winning this award is a huge privilege. It represents not just my successes but our entire team’s success, so I think it’s a win for all of us.”

Sarah Best, research manager at Lawson Health Research Institute, was a recipient of this year’s Staff Award of Excellence, presented at the 2018 Lawson Impact Awards. The award was created to honour the contributions of dynamic, hardworking staff members who help advance science at Lawson.

Best is a part of the Cognitive Clinical Research Group at St. Joseph’s Heath Care London’s Parkwood Institute. In addition to managing the research group’s staff and trainees, she has a wide range of responsibilities, including developing strategies for recruitment and retention of clinical trial participants, budgeting, assisting with grant applications, and ensuring the team has the appropriate space, hardware and training to complete their research. 

“Sarah has grown a team of skilled, well-trained staff and her leadership has ultimately resulted in an increase in the volume and complexity of trials we can offer for patients with mild cognitive impairment and Alzheimer’s disease,” says Dr. Michael Borrie, Lawson researcher and medical director of the Cognitive Clinical Research Group. 

 

Best is also the budget officer for the Consortium of Canadian Centres for Clinical Cognitive Research and a member of the platform implementation team for the Canadian Consortium on Neurodegeneration and Aging (CCNA). The CCNA was formed by more than 350 clinicians and researchers throughout Canada to accelerate progress in age-related neurodegenerative disease research. 

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) Study is a CCNA study collecting clinical, neuropsychological, and MRI imaging data as well as blood, saliva, and urine samples from participants to learn about who is at risk of developing dementia, to determine how early dementia can be detected and to find out what tests are most effective at detecting dementia. Best has helped facilitate the study start-up and patient recruitment for the more than 30 sites involved in COMPASS-ND, including Parkwood Institute.

“Working in the field of neurodegeneration is really important right now as we see the numbers of individuals that have cognitive impairment growing exponentially. Currently, we only have symptomatic treatments so we’re really looking to find that breakthrough that will lead to a disease-modifying treatment to better serve patients and actually change the course of their disease,” says Best.

She adds, “I’m really honoured to receive this award, especially knowing the previous recipients and the impact that they've had on the London research community.”

Dr. Don Richardson was recognized at the 2019 Lawson Impact Awards for his research and innovation in working with veterans with military-related post-traumatic stress disorder (PTSD).  His study titled, “Predicators of Long-Term Treatment Outcome in Combat and Peacekeeping Veterans with Military-Related PTSD,” was recently published in the Journal of Clinical Psychiatry.

 

 

Throughout Dr. Richardson’s career, he has worked diligently to develop and implement best practice assessment and treatment guidelines for Canadian Armed Forces (CAF) members and veterans. He has developed and maintained two clinical research databases  ̶  a database of self-reported health status, by working with patients at the Operational Stress Injuries (OSI) clinic, and a treatment outcomes database. Through this data, he has demonstrated that military trauma populations are complex and are at greater risk of becoming resistant to treatment than most civilian trauma populations.

“Don is extremely deserving of this award,” says Dr. Cheryl Forchuk, Dr. Richardson’s nominator. “When I think of someone who does a great job of linking together research and clinical practice, Don is always someone who comes to mind.”

The treatment outcomes database gives researchers unparalleled insight into the pharmacologic interventions best suited for CAF members and veterans. With the ability to identify when individual patients are experiencing less-than-optimal outcomes, the research team can adjust their treatment plan accordingly.

Over the past 20 years, Dr. Richardson has published over 40 peer-reviewed manuscripts and book chapters on the assessment and treatment of operational stress injuries, PTSD, major depressive disorder, substance use disorders, and suicidal behaviour. He has elevated awareness for the unique mental health challenges faced by CAF members and veterans who present with operational stress injuries.

In light of Dr. Richardson’s findings, he works to assess the current treatment modalities for PTSD, their utility for treating military populations, as well as complementary therapies that may prove beneficial.

Dr. Richardson’s dedication to military mental health research is evident through his unwavering effort and has attracted the attention of many prominent figures in the field of military and veteran health. In 2017, he was granted the opportunity to build a research and innovation center for advancing military and veteran health research and clinical practice. Through a generous donation from two community peers, Dr. Richardson established and leads the Macdonald/Franklin OSI Research Centre, located at Parkwood Institute.

“It is certainly an honour to receive this award,” says Dr. Richardson. “I wish to thank all of my clients for taking the time to fill out the repeated questionnaires, as well as the research staff who support this program, and who work tirelessly to help our CAF members and veterans.”

A study at Lawson is looking to determine if digital breast tomosynthesis, a type of 3D imaging, is better at detecting breast tissue abnormalities than the 2D mammography regularly used today.

During a conventional digital 2D mammogram, two x-ray images are taken of the breast, one from top-to-bottom and another from side-to-side at an angle. This technology is limited by the overlapping breast tissue that occurs from the required compression of the breast, and breast abnormalities may be hidden.

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(Left) 2D mammogram image of left breast, where no lesion was visible. (Right) 3D tomographic image of the same breast showing a lesion, indicated by arrows.

A tomosynthesis exam is relatively new technology in which the x-ray tube moves in an arc over the compressed breast and captures multiple images from different angles. The images are then reconstructed into a set of 3D images by a computer. By being able to examine the breast at multiple layers of depth, the radiologist is better able to distinguish normal breast tissue from potential abnormalities. It is therefore assumed that tomosynthesis may solve some challenges associated with standard mammography, and could be especially useful for women with dense breast tissue.

In the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), women are randomized to receive screening with standard digital 2D mammography, or digital 2D mammography plus tomosynthesis. Participants will undergo either an annual or biennial screening frequency, depending on their risk factors for breast cancer, for approximately four years. Then participants will undergo long-term follow-up for at least three more years. Researchers hope this study will help radiologists evaluate whether the newer technology of tomosynthesis is indeed a more effective tool for detecting aggressive tumours.

Through the Ontario Breast Screening Program (OBSP), women between the ages of 50 and 75 receive regular notices through the mail, encouraging them to schedule a mammogram for breast cancer screening. Women scheduled for a regular OBSP breast exam at St. Joseph’s Hospital London (St. Joseph’s) receive a letter with the study’s contact information. Eligible participants are enrolled at the time of their scheduled appointment. Participating in the study does not significantly change the overall experience of the breast exam. 

“Our goal is to contribute to the body of evidence around tomosynthesis technology, and ultimately, we hope to improve the outcomes for women diagnosed with breast cancer, meaning, earlier detection,” says Dr. Anat Kornecki, Lawson Scientist and Radiologist at St. Joseph’s.

The TMIST study is being conducted in over 100 centres across Canada, the United States, and Argentina. Approximately 165,000 participants will be recruited.

According to Dr. Jeremy Burton, we’re in a golden age of microbiome and probiotics research.

“Thanks to advancements in next-generation sequencing, we’re learning more and more every day about the impacts of the microbiome on the human body,” states Dr. Burton. 

 

Effective September 1, 2020, Dr. Burton has been appointed as Research Chair in Human Microbiome and Probiotics at Lawson Health Research Institute for a five-year term. As part of the Chair’s responsibilities, Dr. Burton will also assume the title of Director for the Canadian Centre for Human Microbiome and Probiotics Research, which is located at Lawson. 

Funded by an endowment through St. Joseph’s Health Care Foundation, the position is responsible for leading Lawson’s Human Microbiome and Probiotics research program. The specialized research chair was established at St. Joseph’s in 2007 as a result of a significant investment by Danone International, in recognition of groundbreaking microbiome research by Dr. Gregor Reid, the inaugural holder of the Chair. 

With extensive experience in both academia and industry, Dr. Burton is a world-renowned scientist specializing in urinary microbiome research. He points to the diversity of microbiome research at Lawson as a strength to be leveraged.

“Our program is conducting a diverse array of microbiota-related research from probiotic studies to fecal transplants to the investigation of drug-microbiome interactions,” explains Dr. Burton. “There’s a lot of interest in conducting microbiome research as it’s become clear how it affects so many human systems. We are also working with a number of other groups across the city – both clinical and basic sciences – to meet their microbiota-related research needs.”

There are two pillars to Dr. Burton’s vision for microbiome and probiotics research at Lawson. The first is advancing translational research that leads to improved patient outcomes, such as new microbial therapies. The second is improving our understanding of the microbiome by studying its function in real-time.

“In most studies, we collect patient samples, put them in the freezer and then analyze them later. We now want to follow people in real-time to get a better understanding of how the microbiome functions inside the human body,” notes Dr. Burton. “We hope to accomplish this by harnessing technologies already available at Lawson. For example, we’ve been collaborating with the Lawson Imaging program to look at bacteria in real-time using the Institute’s imaging technology.”

Dr. Burton is known for forging strong interdisciplinary relationships to enhance knowledge translation, especially within the Division of Urology.

“Dr. Burton has established a robust academic laboratory and strategic partnerships that are advancing the Institute’s scientific mandate. He is a natural leader,” says Dr. David Hill, Lawson Scientific Director. “As Research Chair in Human Microbiome and Probiotics, Dr. Burton will further Lawson’s reputation in the field.”

Dr. Burton will build on a 30-year legacy of microbiome research.

“There’s a long history of microbiome research at Lawson and St. Joseph’s,” he says. “We were lucky to have visionaries like Dr. Gregor Reid – my predecessor in this position – who have helped revolutionize the field.”

For Dr. Burton, this is the next step in an illustrious career with Lawson. He first joined the Institute and Western University’s Schulich School of Medicine & Dentistry as a Postdoctoral Fellow in 2001 after completing his BSc, MSc and PhD at the University of Otago in New Zealand.

“I had a very productive time as a Fellow, publishing something like 15 manuscripts in two years. It was an amazing experience and a time that I really relished.” 

He was then recruited to industry in 2003 where he developed a strong background in clinical trials and global business development.  

“Working in industry helped shape me into the principal investigator that I am today. But there were so many questions about the microbiome that I wanted to answer and I ultimately found myself back in academia.”

Dr. Burton rejoined Lawson as a Scientist in 2011. Prior to his appointment as Lawson Research Chair in Human Microbiome and Probiotics, he held the title of Deputy Director of the Canadian Centre for Human Microbiome and Probiotics Research since 2011 and Miriam Burnett Chair in Urological Sciences since 2013. He is also an Associate Professor in the Departments of Surgery and Microbiology and Immunology at Schulich Medicine & Dentistry. 

“What brought me back to London is the people and the collaborative environment. Researchers cross departmental and divisional borders with ease. As a scientist, I can walk from my lab to a clinic, and clinician-researchers can do the same in reverse. Everyone has a ‘can do’ attitude and they are willing to test big ideas with one another.”

Learn about recent microbiome and probiotics research at Lawson:

• Gut microbiome may influence how cancer patients respond to oral therapies, study suggests
• New urinary microbiome study could be first step in providing personalized care to patients with ureteral stents
• Fecal transplants show promise as treatment for non-alcoholic fatty liver disease
• Café Scientifique: The invisible world inside us
• Using probiotics to protect honey bees against fatal disease
• Could microorganisms in poop help treat the deadliest form of skin cancer?
• Researchers find gut microbiome plays an important role in atherosclerosis
• Probiotics for respiratory tract infections could save Canada nearly $100 million a year

New clinical protocol after general surgery cuts opioid prescribing in half

Recognizing the role that opioid prescribing plays in the national opioid crisis, a team of researchers at Lawson and Western University have developed a new clinical protocol called STOP Narcotics. The protocol includes a combination of patient and health care provider education and an emphasis on non-opioid pain control. The study found that they were able to reduce the overall amount of opioids being prescribed after general surgery by 50 per cent while still adequately treating a patient’s post-operative pain. Read more. 

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Probiotics for respiratory tract infections could save Canada nearly $100 million a year

A recent study suggests the use of probiotics to prevent respiratory tract infections in Canada could result in nearly $100 million per year in savings. There is growing evidence that probiotics can reduce the risk of respiratory tract infections and lower their frequency, as well as reduce the duration of an infection, antibiotic use and absences from work. Replicating a research model used in France, researchers examined the potential clinical and economic impacts in Canada. Read more. 

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Blood test can predict optimal treatment for advanced prostate cancer, study finds

An international collaborative study between Lawson, Memorial Sloan Kettering Cancer Center, the Royal Marsden and Epic Sciences is one of the first to demonstrate that a blood test can predict how patients with advanced prostate cancer will respond to specific treatments, leading to improved survival. The study used a liquid biopsy test that examines circulating tumour cells (CTCs) in blood samples from patients with advanced prostate cancer who are deciding whether to switch from hormone-targeting therapy to chemotherapy. Read more. 

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Machine learning could predict medication response in patients with complex mood disorders

Mood disorders like major depressive disorder (MDD) and bipolar disorder are often complex and hard to diagnose, especially among youth when the illness is just evolving. This can make decisions about medication difficult. In a collaborative study by Lawson, The Mind Research Network and Brainnetome Center, researchers have developed an artificial intelligence (AI) algorithm that analyzes brain scans to better classify illness in patients with a complex mood disorder and help predict their response to medication. Read more. 

 

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Lawson researchers receive $4.4 million to study personalized medicine at LHSC

Personalized medicine is the analysis of a patient’s DNA to predict how they will respond to medications. Led by Dr. Richard Kim, scientist at Lawson and clinical pharmacologist at London Health Sciences Centre (LHSC), researchers at Lawson have received $4.4 million to study an expanded personalized medicine program at LHSC that involves full integration of research into patient care. Read more. 

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Drinking more water does not slow decline of kidney function for patients with kidney disease clinical trial shows

A study published in JAMA (Journal of the American Medical Association) by researchers at Lawson and Western University found that coaching patients with Chronic Kidney Disease to drink more water does not slow down the decline of their kidney function. Read more. 

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Funding for unique strategy to prevent homelessness after hospital discharge

On September 10, the Ministry of Families, Children and Social Development, announced that Lawson will receive $223,572 from the Homelessness Partnering Strategy’s Innovative Solutions to Homelessness funding stream to support the project “No Fixed Address Version 2 Expansion” research project. This research will further refine the No Fixed Address strategy for reaching and supporting patients during the crucial transitional period when they are being discharged from the hospital and re-integrated into the community. Read more. 

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Synthetic surfactant could ease breathing for patients with lung disease and injury

Human lungs are coated with a substance called surfactant which allows us to breathe easily. When lung surfactant is missing or depleted, which can happen with premature birth or lung injury, breathing becomes difficult. In a collaborative study between Lawson and Stanford University, scientists have developed and tested a new synthetic surfactant that could lead to improved treatments for lung disease and injury. Read more. 

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Research team develops clinically-validated 3D printed stethoscope

A team of researchers have developed an open-source, clinically validated template for a 3D printed stethoscope for use in areas of the world with limited access to medical supplies – places where a stethoscope could mean the difference between life and death. Read more. 

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Family environment influences emotional well-being of children with epilepsy

Children with epilepsy have a higher risk of developing emotional and behavioural disorders, including depression, anxiety and poor self-esteem, yet it has been difficult for researchers to pinpoint why this occurs. Researchers at Children’s Health Research Institute, a Lawson program, have found that family environment influences the relationship between clinical characteristics of epilepsy at diagnosis and children’s emotional well-being two years later. Read more. 

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How the brain is folded provides researchers with an accurate marker to predict psychosis in high-risk patients

By using images of the brain to look at how its outer surface is folded on itself, researchers can predict which high-risk patients will develop psychosis with more than 80 per cent accuracy.  Before now, there has been no way to examine young people before they become ill to reliably identify who will develop acute psychosis and who will not. Read more. 

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High-dose radiation can improve survival in cancer patients once thought incurable

Cancer that spreads from an original tumour to other parts of the body is generally considered incurable. In an international study led by Lawson, researchers challenged this idea by showing that high-dose radiation can improve survival in patients with cancer that has spread to five or less sites. The study called SABR-COMET was the first randomized phase II clinical trial of its kind. Read more. 

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As the COVID-19 pandemic has continued for a year and a half, many people from all walks of life are feeling the impacts especially when it comes to their mental health and wellbeing.  

Hospital researchers through Lawson Health Research Institute, along with its hospital partners, have been studying the impacts for some key groups.

 

Health care workers have been at the forefront of the pandemic. These heroes have worked tirelessly through every wave and continue to provide excellent care to their patients and community. Dr. Kamia Honarmand, Critical Care Physician at London Health Sciences Centre (LHSC), remembers the stress that she and her colleagues were feeling, and know that something needed to be done.

“Our team wanted to better understand the impact of the pandemic on the lives of health care workers, both personally and professionally, and understand how they were coping when it came to their mental health,” says Dr. Honarmand who is also an Associate Scientist at Lawson. “There was a lot of reasons to be stressed even before the height of the first wave in our region. There was a lot of anxiety. The hospital wanted to find ways to support health care workers and identify resources that would assist them.”

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Dr. Kamia Honarmand, Critical Care Physcian at LHSC and Lawson Associate Scientist 

Frontline health care workers across the region were invited to take part in an online survey about their experiences during the pandemic. “We looked at both the impacts and the preferred coping strategies, and what supportive strategies they would like to have in the hospital in the future.”

• Read more about the study examining how the pandemic affects Southwestern Ontario's frontline hospital workers
   

The Veterans Care Program located at Parkwood Institute, a part of St. Joseph’s Health Care London, provides complex continuing and long-term care for Canadian war Veterans. Dr. Don Richardson, Director of the MacDonald Franklin OSI Research Centre at Parkwood Institute, has been treating and studying mental health among Veterans for many years. He believed this was a group was likely to be affected by the pandemic in unique ways.

“We know that Veterans in general are at a higher risk for depression, anxiety and PTSD,” explains Dr. Richardson, who is also a Scientist at Lawson. “We also knew the pandemic and forced restrictions would have significant impact on Veterans and their families who would be more isolated than they already are.”

More than 1,100 Veterans and around 250 spouses were recruited for the study, completing an online survey every three months for 18 months.

The study is still ongoing, but Dr. Richardson says the initial data has been telling. “We have been able to analyze some of the preliminary data and what we have found is that almost 50 per cent did not indicate their mental health had worsened during the pandemic but 40 to 50 per cent have had difficulty accessing care.”

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Dr. Don Richardson, Director, Macdonald Franklin OSI Research Centre

The hope is that this study will lead to better preparedness in the future to safeguard the mental health of Veterans and ensure their access to care during a pandemic.

• Read more about the Veterans’ study
   

Many people have felt isolation during the pandemic, but that feeling may have even more of an impact for youth suffering from mood and anxiety disorders.

Dr. Elizabeth Osuch, Director of the First Episode Mood and Anxiety Program (FEMAP) at LHSC says the pandemic-led lockdown forced more than a hundred mental health clients out of in-person services.

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Dr. Elizabeth Osuch, Director of FEMAP and Lawson Scientist

“They lost their resources for mental health services and support as soon as the quarantine was announced,” shares Dr. Osuch, who is also a Scientist at Lawson. “We were concerned that it would be devastating to people – and to some people it was. We wanted to make sure they had an avenue to connect with the program.”

Dr. Osuch and the FEMAP team created an online research platform to find out how patients were doing by having them fill out a symptoms and function questionnaire.

“We have analyzed the first wave so far and it shows that male patients were doing better and female patients were doing worse, which was a surprise. One of the risk factors for not doing well was the loss of their job.”

• Read more about the FEMAP study here
   

The pandemic added an extra layer of stress and worry for women who were having a baby.

“This has been an enormous and pivotal time for everyone in the world,” says Dr. Genevieve Eastabrook, Obstetrician-Gynecologist at LHSC. “The experiences during pregnancy and post-partum for both the birthing person and their baby can have effects later in life for children. For example, their overall cardiovascular and metabolic health, bonding experiences and the risk of mood disorders.”

Dr. Eastabrook, who is also an Associate Scientist at Lawson and Assistant Professor at Western University’s Schulich School of Medicine & Dentistry, is working with a team to examine the effects the pandemic may be having for mothers and their babies. As part of the study, the London research team is using an approach called ‘One Health’ which offers a holistic perspective to explore how various risk factors and social determinants of health interact.

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Dr. Genevieve Eastabrook, OBGYN at LHSC and Lawson Associate Scientist

“The unique aspect is that we have a comparative group to see if there are differences in markers such as risk of depression, perceived stress and social supports,” adds Dr. Eastabrook.

Study participants are asked to complete a 30-minute questionnaire at around 6-12 weeks after their delivery. The research team is still recruiting patients for this study.

• Read more about the mother and baby study

 

From the moment the COVID-19 pandemic was declared in March 2020, our teams at Lawson Health Research Institute have been at the forefront. Researchers at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London immediately began to work towards understanding the new virus in an effort to discover lifesaving health-care solutions.

To date, dozens of research projects have been advanced through Lawson with some receiving international attention as ‘world firsts’.  As we mark the three-year anniversary of COVID-19 being declared a global pandemic by the World Health Organization (WHO), we share with you  COVID-19 research highlighted over the past year.

Study finds acute kidney injury associated with severe COVID-19 leads to high mortality rates

Severe cases of a COVID-19 infection can cause a host of serious complications, including acute kidney injury. In a published study, scientists at Lawson found that acute kidney injury in patients with a severe COVID-19 infection leads to a high mortality rate. 

By accessing data collected through the Ontario Renal Network (ORN), Dr. Peter Blake, Lawson Researcher and Provincial Medical Director at the Ontario Renal Network, and his colleagues examined 271 people at 27 renal programs across the province, including patients at LHSC, who received dialysis for acute kidney injury due to a COVID-19 infection. Read more.

Study shows a decline in Veterans’ mental health throughout the pandemic

In published findings from Lawson, more than half of Canadian Veterans reported a decline in their mental health over the course of the COVID-19 pandemic.
When it comes to mental health conditions, Veterans are an at-risk population, often having higher rates of depression and post-traumatic stress disorder (PTSD). When the COVID-19 pandemic hit, scientists at Lawson wanted to understand its effects on this already at-risk population. 

To examine the potential impacts the research team launched a longitudinal study recruiting Canadian Veterans and spouses of Canadian Veterans. Participants complete online questionnaires every three months, with questions focused on mental health and virtual health care services. Read more.

Virtual care associated with significant environmental and patient cost savings

A study published in JAMA Network Open by researchers at ICES, Lawson and Western University found that virtual care during the COVID-19 pandemic led to a significant reduction in carbon dioxide emissions and patient travel-related expenses, such as gasoline, parking or public transit costs.
Findings show that for more than 10 million patients with at least one appointment during the study period (63 million visits in total), virtual care was associated with estimated savings of:
•    3.2 billion kilometers of patient travel;
•    545 to 658 million kilograms of carbon dioxide (CO2) emissions; and
•    $569 to $733 million (Canadian [US $465-$599 million]) in expenses for gasoline, parking, or public transit. Read more. 

London researchers discover novel method to diagnose long COVID

Published in Molecular Medicine, researchers at Lawson found that patients with post-COVID-19 condition (long COVID) have unique biomarkers in their blood. The team is now working on developing a first of its kind blood test that could be used to diagnose long COVID. The discovery could also lead to new therapeutics for this condition.

The researchers studied 140 blood samples from participants at LHSC and St. Joseph’s Health Care London, including St. Joseph’s Post-Acute COVID-19 Program. Participants were those with presumed long COVID, hospital inpatients with acute COVID-19 infection and healthy control subjects. Read more.

Researchers are combining new technologies to examine blood proteins in COVID-19 patients

Published in the Journal of Cellular and Molecular Medicine, a team at Lawson discovered unique patterns of blood plasma proteins in critically ill patients that may help develop a more personalized approach to treating severe COVID-19.

Called the plasma proteome, the proteins studied are released by cells that often play an important role in the body’s immune response to viruses. The research team studied how they adapt and change to a COVID-19 infection. Read more. 

Thanks to decades of work by dedicated researchers like London, Ont.-based Dr. Paul Adams, haemochromatosis has become much easier to diagnose, though many people are still unaware of the genetic condition. And while treatment options are effective, they are limited, according to a new review published in The Lancet.

In Canada and the United States, one in 227 people have haemochromatosis, making it more common than cystic fibrosis. However, the U.K. Biobank Project, a large-scale biomedical database and research resource, found that only 12 per cent of people who have the condition actually know they have it.

Dr. Adams, a Scientist at Lawson Health Research Institute and Professor at Western University’s Schulich School of Medicine & Dentistry, explains, “The most common genetic test done in Canada and the U.S. is the best way to make the diagnosis, but you have to think of the condition and the doctor has to know that there is a genetic test available. So those two steps are some of our stumbling blocks.”

In Ontario, testing and diagnosis often comes only after some other issue arises, “One day someone stumbles on the fact that there's a liver abnormality, or the patient is complaining of fatigue and the doctor orders blood tests, thinking blood iron is going to be low,” Dr. Adams explains. “And then it turns out to be very high.” 

Most common in people of Northern European ancestry, haemochromatosis results in excess iron in the body and includes symptoms such as fatigue and arthritis pain, and can lead to serious complications like cirrhosis of the liver, liver cancer and death.

Starting in January 2000, Dr. Adams conducted a multi-year study involving 20,000 London, Ont. residents that helped change how haemochromatosis is diagnosed – moving from testing iron levels to genetic testing. With iron levels affected by alcohol consumption, obesity, inflammation and some types of cancer, the previous measure led to many false positive tests. 

But knowing when genetic testing should be done remains a challenge. The underdiagnosis and lack of awareness also remain an issue when it comes to more serious complications.

“If this is diagnosed early, like as a young adult, then this can be treated and those complications won’t develop,” Dr. Adams says. “If you donate blood, treatment is very similar to that procedure and it's tolerated extremely well in most. People who have a lot of excess iron will have this blood taken once a week until their iron levels come down.” 

He hopes this new publication will lead to better diagnosis and treatment, and sees a future in emerging biological therapies.

Dr. Adams continues to be involved in global research, including work with the U.K. Biobank Project on genomic testing, and is investigating partnerships to develop future gene editing treatment.

People looking for more information about haemochromatosis can reach learn more on the Canadian Haemochromatosis Society’s website.

HealthCareCAN held its third annual Lobby Day “H on the Hill” event on Parliament Hill in Ottawa, on Tuesday, October 30, 2018.

Canada’s hospital CEOs and vice presidents of health research joined HealthCareCAN - the national voice of Canada’s healthcare organizations, community and research hospitals - to meet with MPs, Senators and senior government staff.

Collectively, they issued a call for federal action to unlock the tremendous economic potential of the health and life sciences sector to support better health for Canadians.

Dr. David Hill, Scientific Director for Lawson and Integrated Vice President of Research for London Health Sciences Centre and St. Joseph’s Health Care London, participated in the lobby day. Dr. Hill currently sits on the Board of Directors for HealthCareCAN.

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 “Minister of Crown Indigenous Relations @Carolyn_Bennett, Parliamentary Secretary for Science, Sport, and Accessibility @KateYoungMP, and Dr. David Hill, catching up over lunch at #HontheHill #CDNpoli #CDNhealth”

 

Meeting participants stressed the need for action on HealthCareCAN’s recommendations for the 2019 federal budget, specifically:

• Setting a minimum 25% funding floor for the indirect costs of research under the Research Support Fund;
• Granting eligibility to federal infrastructure funding competitions to healthcare organizations, and;
• Investing in digital health platforms to support care, training, and research in healthcare organizations.

Diverse areas of the health and life sciences sector and key health issues were discussed, including:

• Health and science research, granting councils;
• Hospital infrastructure;
• Health innovation;
• Electronic health technology;
• Opioid crisis response;
• Mental health;
• Aboriginal health; and,
• Home care.

Read Dr. Hill’s recent column in Hospital News on bridging the gap from discovery to patient care.

 

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HealthCareCAN provides high-quality policy research advocacy and leadership development services to our members while championing healthcare system transformation in Canada. Visit www.healthcarecan.ca to learn about our solutions to health and healthcare challenges. Follow us on Twitter: @HealthCareCAN

Lawson Health Research Institute (Lawson) has long been a leader in biomedical imaging. The first Canadian magnetic resonance imaging (MRI) of a human occurred at St. Joseph’s Health Care London (St. Joseph’s). The country’s first positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI) scanners were also installed at St. Joseph’s. New developments in imaging research continue to enhance the diagnosis, prevention and treatment of a wide range of diseases, from cancer to post-traumatic stress disorder.

On May 23, Lawson hosted a Café Scientifique event where a panel of Lawson Imaging scientists discussed their cutting-edge work. Guests had the opportunity to ask questions as part of an open-forum discussion to gain insights from the speakers, and from one another.

In celebration of Canada’s 150th anniversary as a nation, this event is the first of a two-part series focusing on the future vision for health care in Canada and the legacy that research at Lawson will leave.

Imaging of the heart: Seeing the cause of chest pain more clearly

By Dr. Ting-Yim Lee, Lawson scientist, Medical Physicist at St. Joseph’s, professor at Western University’s Schulich School of Medicine & Dentistry, and scientist at Robarts Research Institute

When patients with chest pain arrive in the emergency department, they are given an electrocardiogram (ECG) and blood test. These diagnostic tests determine if the pain has a non-cardiac cause (such as heart burn), if it is caused by a heart attack, or if the patient has angina (plaque formation in the coronary arteries that either reduces or temporarily cuts off blood flow to the heart) but did not have a heart attack.

If a patient has angina, they are then given additional diagnostic testing to see whether a blood clot has formed and where it is located. This is determined by two different imaging techniques: x-ray imaging (angiogram) and nuclear imaging. This process is invasive and means that patients must be scheduled for two different exam days. Using two techniques also means that there can be image misalignment, and the images often provide poor detail.

Dr. Ting-Yim Lee’s lab has pioneered a Computed Tomography (CT) method for imaging blood flow to the heart muscle (CT Perfusion), which can help patients avoid unnecessary tests and treatment, as well as reduce health care costs.

“CT imaging is a non-invasive imaging technique that uses x-rays to create high-detail cross-sectional images of the body. Using this method, we can evaluate the degree of blockage in coronary arteries – with one diagnostic test instead of two,” says Dr. Lee.

Using light and sound to improve breast surgery

By Dr. Jeffrey Carson, Lawson scientist and associate professor at Western University’s Schulich School of Medicine & Dentistry

“Most women diagnosed with breast cancer undergo surgery, and months of chemotherapy and radiotherapy. They must deal with the discomfort, side-effects, emotional stress and financial burden of treatment. Almost one in four surgeries for breast cancer must be repeated, meaning many women have to go through this all over again,” says Dr. Jeffrey Carson.

In breast conserving surgery, there is a high chance of repeat surgery as the surgeon must see and remove 100 per cent of the tumour in order for it to be successful. They are not able to determine whether the entire tumour was removed until after the surgery has been completed.

Dr. Carson and his team at St. Joseph’s have developed a technology called Intraoperative Photoacoustic Tomography (iPAT), which has the potential to reduce the chance of repeat surgery for breast cancer. The technology is able to image surgery specimens in the operating room during surgery, allowing surgeons to determine whether the whole tumour has been removed before the surgery is complete.

How imaging can improve the management of epilepsy

By Dr. Udunna Anazodo, postdoctoral fellow at Lawson

Most patients with epilepsy are effectively treated with antiepileptic drugs. However, 36 per cent will not respond to the drugs. For these patients, surgery on the area of the brain that is causing seizures is the standard of care – if patients are good surgical candidates.

“If patients with epilepsy are to undergo surgery there must be a good indication of where the seizure focus is and it must be possible to determine that removing this portion of the brain will not affect brain function,” says Dr. Udunna Anazodo.

To see whether they are good candidates for surgery, patients must undergo an invasive procedure called intracranial monitoring, where electrodes are placed on the brain.

Dr. Anazodo has been studying how PET/MRI can be used to map seizures with the goal of minimizing the need for invasive intracranial monitoring. This technique makes it possible to locate areas in the brain that cause seizures and to see if the seizures affect brain functions.

See photos from the event on Lawson’s Facebook page.

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Above: Café Scientifique presenters (from left to right): Drs. Jeffrey Carson, Frank Prato (moderator), Ting-Yim Lee and Udunna Anazodo.

It’s been another year of transformational research at Lawson Health Research Institute. Our teams have published groundbreaking findings and launched new studies that will have a profound impact on patient care.

The following are 12 highlights of research and innovation from across London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London (St. Joseph’s). From trialing new cancer treatments to advancing understanding of mental health, our research teams have achieved a number of important milestones. 

1. New study suggests blood plasma proteins hold answers to better understanding long COVID

Lawson researchers continued to advance understanding of COVID-19 this past year. In one study, researchers found that unique patterns in blood plasma proteins of patients with suspected long COVID could act as a drug target to improve patient outcomes. Read more.

2. New study finds exercise, cognitive training combo boosts mental sharpness in seniors

A study from Lawson and Western University found that a combination of computerized cognitive training and aerobic-resistance exercises can improve functions like memory, attention, recognition and orientation in older adults with mild cognitive impairment. The results suggest a new way to address declining mental sharpness in older adults. Read more.

3. $7.55 million in funding to take LHSC-developed technology global

Technology to diagnose rare genetic disorders developed by researchers at Lawson and LHSC will be going global thanks to $7.55 million in funding from Genome Canada grant and Illumina Inc. The new artificial intelligence-led technology could allow rare diseases to be diagnosed with a simple blood test. Read more.

4. Fecal transplants show promise in improving melanoma treatment

Fecal microbiota transplants (FMT) from healthy donors are safe and could improve response to immunotherapy in patients with advanced melanoma, according to results from a world-first multi-centre clinical trial led by Lawson researchers. Read more.

5. New study shows technology could play an important role in mental health support

A team of Lawson researchers found that the use of ‘smart home’ technology like touch screen devices, activity trackers, weigh scales and medication dispensers may lead to better outcomes for those living with both mental health and physical disorders. The study found that participants using the technology started logging more exercise, making healthier food choices and not missing medication doses. Read more.

6. Canadian children’s hospital visits for suicidal thoughts, self-poisoning and self-harm up during pandemic, study finds

A national study with Lawson researchers found that during the first two years of the COVID-19 pandemic, adolescent emergency department (ED) visits and hospitalizations for suicidal thoughts, self-harm and self-poisoning increased across Canada, with the greatest increase occurring among adolescent girls. Read more.

7. St. Joseph’s to become Canada’s first centre of excellence in molecular imaging and theranostics

A partnership between Lawson, St. Joseph’s Health Care London and GE HealthCare will create Canada’s first centre of excellence in molecular imaging and theranostics at St. Joseph’s. The centre will focus on using precision diagnostic imaging and targeted therapy to advance personalized treatment of cancer and other diseases. Read more.

8. Researchers investigate a new method of sedation for paediatric patients

Intravenous sedatives are normally used to sedate critically ill children. However, they can contribute to a complication called delirium, which includes symptoms of confusion, disorientation, agitation, excessive drowsiness and poor attention. To improve outcomes, scientists at Children’s Health Research Institute (a program of Lawson), Sunnybrook Research Institute and The Hospital for Sick Children (SickKids) are collaborating on a pilot study to understand whether inhaled sedation could be a better alternative to keep critically ill children sedated and comfortable. Read more.

9. New robotic 3D ultrasound may improve accuracy of liver cancer ablation therapy

A technique that turns a normal ultrasound into a 3D image is showing promise in making thermal ablation for liver cancer treatment more accurate in a study from Lawson and Western University. Thermal ablation – using heat to destroy a cancerous tumour – can have fewer complications and a shorter recovery time than surgery. Read more.

10. Assessing neurofeedback in stroke survivors

Functional near-infrared spectroscopy (fNIRS) is used to detect changes in brain oxygen levels using light, but more recently it has also been used to develop brain-computer interfaces – allowing patients with brain injuries to control a device with their thoughts. Researchers at Lawson launched a new study to assess whether fNIRS can be used to improve patient outcomes during stroke rehabilitation. Read more.

11. Specific type of inflammation may be linked to risk of colorectal cancer

A preclinical study found that a specific type of inflammation may be linked to an increased risk of colorectal cancer. Previously, the degree of inflammation caused by illnesses like colitis, Crohn’s disease and other forms of inflammatory bowel disease were shown to be an important indicator of the development of colorectal cancer. However, this new study found the type of inflammation, rather than the severity and duration, may be more important in determining cancer risk. Read more.

12. New study examining if probiotics can improve outcomes in knee replacement surgeries

Lawson researchers launched a study to assess whether daily probiotics can improve outcomes in patients undergoing a total knee replacement surgery. Of the more than 70,000 knee replacement surgeries in Canada each year, nearly 10 per cent of patients experience complications. With patients who are considered healthy likely to have better outcomes, the research team is interested in improving the gut microbiome as a way to support patients’ overall health. Read more.

 

With an aging population, neurological conditions like stroke, brain injury and multiple sclerosis (MS) are on the rise in Canada. Those living with neurological conditions face many long-term challenges that can affect both their physical and cognitive functioning. They are also at an increased risk for mental health challenges such as depression and anxiety.

“While mental health challenges are common for those with neurological conditions, they often go untreated for a number of reasons,” says Dr. Swati Mehta, Scientist at Lawson Health Research Institute. “For example, those living in remote areas often do not have access to specialized services and many patients are concerned about stigma.” 

Yet seeking mental health care is critically important for patients with neurological conditions. “Research suggests that depression among these patients can impair recovery, leading to decreased quality of life and increased health care costs.”

To improve patient outcomes, Dr. Mehta and a collaborative research team are developing an internet-delivered cognitive behavioural therapy (ICBT) program.

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Cognitive behavioural therapy (CBT) is a specialized type of therapy that involves patients learning strategies and skills to self-manage mental health symptoms. It’s one of the most widely used therapies for the treatment of depression and anxiety. 

A panel of researchers, persons with lived experience of neurological conditions and community organizations are working collaboratively to develop an accessible ICBT program that meets the needs of persons with neurological conditions and mild cognitive impairment who are also experiencing symptoms of depression or anxiety. The program, called The Neuro Course, will be a modified version of an existing course developed in Australia by the eCentreClinic.

“Through co-development with patients and experts in the field, the ICBT program will meet the specific needs of persons with neurological conditions who are also experiencing mental health challenges,” explains Dr. Mehta. “With online delivery, it can provide personalized treatment while being flexible and easily accessible.”

The Neuro Course will be piloted with a small group of research participants, including patients from Parkwood Institute, a part of St. Joseph’s Health Care London. Eligible participants can sign up to be notified of the course’s availability at https://www.onlinetherapyuser.ca/neuro. 

The free online course consists of six easy-to-understand CBT lessons and will take approximately 10 weeks to complete. In addition to the six lessons, participants will be encouraged to work through various activities during the week.

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Participants will also receive regular support from a designated online guide. Guides will be health educators who are certified providers or graduate students working under the supervision of certified providers. All guides will have training in psychology or social work. The participant’s guide will review the participant’s progress and answer any questions or comments through a secure messaging system.  

Participants in the study will be asked to complete brief questionnaires before they begin the course, on a weekly basis throughout the course and then again three months after treatment ends. The research team will use the questionnaires to assess patient outcomes and improve future versions of the course.

The goal of the program is to overcome barriers to face-to-face therapy, such as limited access to specialized care and concerns about stigma related to seeking care, by providing an effective online alternative. By reaching those in need, the research team hopes to improve patient outcomes and overall wellbeing. 

“The long term goal would be to implement the ICBT program into clinical practice to provide increased access to mental health services among this population,” says Dr. Mehta. “The program could be used to provide care to those with mild to moderate mental health concerns or those waiting to access face-to-face programs.”

The team is being funded for this project through Lawson’s Internal Research Fund (IRF) competition. “As an early career researcher, receiving funding from Lawson’s IRF is a great honour. It’s a great opportunity to help researchers obtain funding for small feasibility studies to develop evidence for larger grants that can be used to translate knowledge across the community,” states Dr. Mehta.

Once patients with psychosis start treatment, some get better in weeks while it can take months for others.

“We wanted to see if we could understand and influence this disparity,” said Dr. Lena Palaniyappan, Associate Professor at Western’s Schulich School of Medicine & Dentistry and Scientist at Lawson Health Research Institute who is looking at chemicals in the brain with the aim of speeding up the time it takes a patient to respond to medication for psychosis. 

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Patients who experience their first episode of psychosis will have better overall outcomes if they respond early to treatment. This includes improved symptoms and daily functioning as well as spending less time in hospital.

The research team from Lawson and Schulich Medicine & Dentistry studied antioxidant levels in the brain, and found that these chemicals which rid the body of normal metabolic biproducts called free radicals, may improve outcomes of early intervention in psychosis. They looked specifically at an area of the brain called Cingulate Cortex which is well connected to a network of regions that play a major role in generating symptoms of psychosis.

The study, published in Nature Molecular Psychiatry, showed that patients with higher levels of an antioxidant called glutathione responded more quickly to medication for psychosis and had improved outcomes. They estimated that a 10 per cent increase in antioxidants could lead to a reduction in length of hospital stay by at least seven days.

“This study demonstrates that if we can find a way to boost the amount of antioxidants in the brain, we might be able to help patients transition out of hospital more quickly, reduce their suffering more quickly and help them return earlier to their work and studies,” said Dr. Palaniyappan who is also the Tanna Schulich Endowed Chair in Neuroscience and Mental Health at Western.

Antioxidant levels in the brain vary naturally from person to person and those variations can be attributed to lifestyle choices like exercise and diet. There are also ways to pharmaceutically boost these levels. A supplement called N-Acetyl Cysteine (NAC) as well as broccoli extracts can increase the brain’s antioxidants if given over a long period of time.

Dr. Palaniyappan and his team in collaboration with Dr. Jean Theberge at Lawson Imaging used high-field MRI imaging to examine antioxidant levels in the brains of 37 new patients to the Prevention and Early Intervention for Psychoses Program (PEPP) at London Health Sciences Centre. Antioxidant levels were studied prior to beginning treatment for psychosis and followed up for six months post-treatment.

The MRI scans were acquired at Western’s Centre for Functional and Metabolic Mapping at the Robarts Research Institute with the support of Western's BrainsCAN and the Canadian Institutes of Health Research.

A new study aims to assess the use of functional near-infrared spectroscopy (fNIRS), a type of imaging, to provide neurofeedback during stroke rehabilitation with a goal of eventually improving patient outcomes.

fNIRS is used to detect changes in brain oxygen levels using light. More recently it has also been used to develop brain-computer interfaces (BCIs), which allow patients with brain injuries to control devices like robotic arms with their thoughts.

Dr. Sue Peters, a Scientist at Lawson Health Research Institute and Director of the Neurorehabilitation Physiology Lab at St. Joseph Health Care London’s Parkwood Institute, was one of the recipients of the Spring 2022 Lawson Internal Research Fund (IRF) Awards. 

The funds will go towards a new study to assess whether fNIRS can be used to direct neurofeedback in stroke survivors – helping them with rehabilitation.

“Currently, there's no real measure of brain activity that is used in stroke rehabilitation to help make clinical decisions,” says Dr. Peters, who is also a Professor at Western University.

Over 400,000 Canadians live with the effects of a stroke, according to the Heart and Stroke Foundation, and there’s hope that fNIRS could make a big difference by eventually improving movement and independence.

“We're going to use the device in some common tasks that people might do with their arm and determine whether we can use this device reliably and accurately in a stroke-related context,” Dr. Peters explains. 

Participants in the study will imagine moving while remaining still. This activates very similar parts of the brain to when people actually move. If done correctly, patients will see a visual cue generated through measurement using fNIRS.

“We know from MRI studies that when I move my right hand, the left side of my brain is activated,” notes Dr. Peters. “We think we can use this concept in stroke rehab.”

Dr. Peters is recruiting 40 people from the community who are at least six months post stroke and 40 healthy adults of all ages. They will first participate in motor assessment with a physiotherapist and then wear an fNIRS cap while thinking about moving their wrist to measure brain activity.

Previously, there were a lack of methods to image the brain during real-life movement.

“The hope is to eventually conduct a clinical trial where we're testing motor interventions to see whether some things are more effective than others at activating the regions of the brain that were impacted by the stroke.”

Dr. Peters believes the study has the potential to have a big impact on the future of rehabilitation for stroke patients, leading to lasting changes in quality of life.