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LONDON, ON- A team at Lawson Health Research Institute are testing a new form of artificial intelligence (AI), paired with portable ultrasound machines, to image and identify lung concerns in real time, right at the beside of critically ill patients.

Approximately 100 critical care patients at London Health Sciences Centre (LHSC) will be part of this study which will test whether an AI model can automatically determine the presence of abnormal lung signals. Past studies have suggested that the AI model is very accurate in reading stored images, but this study will evaluate if it retains accuracy when asked to interpret live images being generated at the beside.

The study is made possible through the use of novel hardware created in Waterloo, Ontario by startup tech company, Wavebase.

“The (WaveBase) device attaches to the ultrasound machine and mirrors the ultrasound image in a second screen,” explains Dr. Robert Arntfield, Lawson researcher and Medical Director of the Critical Care Trauma Centre at LHSC. “The AI model searches the images for patterns in real time and predicts whether it is ‘seeing’ normal or abnormal lung tissue.”

Although bedside lung ultrasounds are commonly used in critical care to detect concerns such as infections, pneumonia or a collapsed lung, the pairing with real time diagnostic AI is a research milestone. It could expand the usage of bedside ultrasounds by enabling those with little or no ultrasound training to use the device.

“Bedside lung ultrasounds in critical care can often have a large impact in identifying life-threatening conditions within minutes,” says Dr. Chintan Dave, Critical Care Medicine Fellow at LHSC and Western University. “We would like to see members of the healthcare team, like critical care nurses or respiratory therapists, be able to use AI to accurately determine the health of the lungs rapidly at the bedside. Employing AI into the clinical workflow, could improve access to immediate diagnoses and treatments.”

In order to be certain that the AI’s predictions are accurate, the phase one study will compare its interpretations to a gold standard experts’ interpretation of the same lung ultrasound scans. Once this accuracy is assured, the team will proceed with a second phase to assess the device with non-expert users and customized settings for more in-depth diagnostics.

“We see a bright future for lung ultrasound imaging with AI within the critical care environment,” adds Dr. Arntfield. “We are trying to write the first chapter of this meaningful AI story here at LHSC and Lawson.”
 

LONDON, ON- In a world first, researchers at Lawson Health Research Institute, together with scientists from Defence Research and Development Canada, have developed a breath test that could be used to diagnose repetitive blast injury – a mild traumatic brain injury resulting from pressure changes that occur during explosions. The device will soon go through clinical trials to validate its efficacy. 

“A pressure wave is sent through the head and brain after an explosion, resulting in effects similar to a concussion,” says Dr. Douglas Fraser, Scientist at Lawson and Professor at Western University’s Schulich School of Medicine and Dentistry. “Examples of individuals who are most at risk of this condition include military personnel, police, individuals in the mining industry and tragically the public, who are currently experiencing this first hand through the war in Ukraine.”

The test leverages findings from a new peer-reviewed study in the Journal, Frontiers in Neurology. The research team examined blood biomarkers in members of the Canadian Armed Forces who have experienced repetitive blasts.

“When we looked at these service personnel there were certain metabolites in their blood that had changed quite dramatically compared to those who had not been exposed to blast injury,” explains Dr. Fraser, who is also a Paediatric Critical Care Physician at London Health Sciences Centre. “What was remarkable about these metabolites is that some of them are expelled in a person’s breath.”

Currently there is no accurate way to diagnose repetitive blast injury other than relying on a patient’s history and symptoms. Using their findings, the research team has identified a combination of metabolites that can be measured in breath as a diagnostic test.

“The individual would blow into what looks like a straw and the breath would go into a device which would measure the metabolites of interest,” adds Dr. Fraser. “The device would then determine if the person is in the danger zone, or if they have been exposed to too many blasts.”

Dr. Vivian McAllister, Director of the Office of Military Academic Medicine at Schulich Medicine & Dentistry says this discovery could be a game changer when it comes to this condition.

“The symptoms of blast injury overlap with other neurological conditions, especially depression, so accurate diagnosis is essential,” says Dr. McAllister. “Early diagnosis allows for interventions that we know to be successful in reducing the symptoms and consequences of mild traumatic brain injury.”

The test has been developed and patented with WORLDiscoveries, the technology transfer and business development office for Lawson and Western, and licensed to Neuroltixs Inc. for development. The next steps will be to confirm the efficacy of the test through upcoming clinical trials.

“We hope to validate the breath aspect of the test, which could then be used as a health surveillance tool,” says Dr. Fraser. “Once validated through clinical trials, this portable device could be easily developed and it will allow us to determine who has been over exposed to blast injuries and how we can protect them in the future.”

LONDON, ON – A clinical trial named “EpiSign-CAN,” led by researchers at Lawson Health Research Institute (Lawson) has been awarded $4.8 million to measure the clinical impact of a new molecular genomics test for diagnosing genetic neurodevelopmental conditions.

Developed at Lawson, the diagnostic test, called EpiSign, uses machine learning to analyze the EpiSign Knowledge Database. This database compiles information on rare genetic diseases using laboratory analyses of the entire genome, referred to as the epigenome, from patients with suspected genetic abnormalities.

A recent paper describes the newly discovered biomarkers for over 50 neurodevelopmental conditions. Dr. Bekim Sadikovic, Lawson Scientist and Head of the Molecular Diagnostics Division at London Health Sciences Centre (LHSC) explains, “before this study, many such conditions required targeted, and often labour intensive and costly assays for a diagnosis, which in many cases provided no conclusive answers. Now, using our EpiSign Knowledge Database which includes the epigenomic information of thousands of patients and controls, we are able to diagnose over 50 conditions with a single test, including in patients where targeted genetic testing was inconclusive.”

The upcoming clinical trial hopes to validate the use of this test in the first-line of diagnosing rare genetic disorders across Canada. “Patients and families typically wait years, and undergo multiple exams and lab tests in search of a definitive diagnosis. With EpiSign, we estimate that we will be able to increase the number of people who receive a diagnoses by five per cent, or more in the future as the database develops” explains Dr. Sadikovic. “Though individual genetic conditions are rare, there are over 4,000 recognized genetic disorders which affect thousands of patients in Canada.”

EpiSign-CAN will study 4,000 patients, who will either receive EpiSign testing as part of the initial diagnostic workup or after classical genetic testing approaches have been exhausted. The goal is to assess the impact of using EpiSign in the first stage of diagnosis vs. after other tests have failed to provide answers in this patient population.

Timely diagnosis will prevent the so called “diagnostic odyssey,” and by doing so has the potential to improve healthcare outcomes for these patients and decrease cost to the health system.

As the EpiSign Knowledge Database continues to grow, researchers are finding correlations between specific episignatures, or molecular DNA markers, and related physiological features across a syndrome.

This research is co-funded through the collaboration of three partners; LHSC, Illumina, and Genome Canada. This is the first time researchers at Lawson have been awarded a Genome Canada Genomic Applications Partnership Program (GAPP) grant. “Genome Canada focuses its resources on new innovation that has a strong likelihood of translating directly to patient care. Their support of our work is extremely meaningful,” says Dr. Sadikovic.

The study describing the most recent advancements in EpiSign technology, “Evaluation of DNA methylation episignatures for diagnosis and phenotype correlations in 42 Mendelian neurodevelopmental disorders,” is published in The American Journal of Human Genetics.

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LONDON, ON - During a virtual event for Londoners hosted by Lawson Health Research Institute and the City of London, a multi-sectoral research team announced two projects representing a collaborative approach to preventing homelessness from within hospital walls. 

Built on the unique and successful No Fixed Address (NFA) strategy, these projects are being tested as a potential best practice for preventing hospital discharge to homelessness. NFA seeks to stop the cycle between hospital admissions and homelessness by providing timely and accessible supports to patients who would otherwise be discharged into homelessness.  It brings housing and financial supports into the health-care system, starting as soon as upon admission, to assist in finding appropriate housing and supports or avoiding a potential eviction. 

“Canada lacks a validated and coordinated service model to address the issue of hospital stay to no fixed address, which can often be the beginning of an individual’s experience with homelessness,” explains Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Scientific Director at Lawson. “There are multiple factors that cause people to be discharged into homelessness - systemic, organizational and personal. We need a collaborative and coordinated approach that honours housing as a basic human right.” 

Several departments at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London collaborate with staff from the City of London, Canadian Mental Health Association (CMHA) Elgin-Middlesex, Youth Opportunities Unlimited (YOU), Salvation Army’s Housing Stability Bank and Ontario Works in the City of London to provide direct, on-site (or virtual) support for patients at risk of homelessness.

“Implementing a coordinated approach to addressing homelessness allows our staff to actively work alongside our partners in health care to prevent and divert individuals and families from an experience of homelessness by assessing their needs and connecting them to the housing supports.,” says John D’Oria, Coordinated Access Manager, City of London. “Whether it’s financial, social service or mental health support, this partnership and approach allows for a holistic approach to client care at the right time.”

Patients discharged from hospital to homelessness in Canada face many challenges that make recovery more difficult. They often experience higher readmission rates and emergency department visits. This is particularly concerning for youth, who have been found to be the fastest growing segment of the homeless population.

NFA was initially tested with strong success for mental health patients across the city and the second version of the project was extended to medical units at LHSC’s University and Victoria Hospitals.

PROJECT 1: Collaboration to Address Homelessness - Health, Housing and Income (H2I) 

This research study will evaluate the City of London’s Coordinated Access Outreach program at hospital sites. A Coordinated Access Outreach worker will support individuals at risk of homelessness to maintain or obtain housing. Ontario Works will assist with the provision of income and employment supports and the Salvation Army Housing Stability Bank may be accessed for needed financial resources to secure or maintain housing.  

Over two years, 106 participants will be interviewed in hospital and again six months post-discharge. Focus groups with participants, health care providers and community partners will provide further insight into the effectiveness of NFA. This project is funded by the Canada Mortgage and Housing Corporation (CMHC)’s National Housing Strategy. 

PROJECT 2: Preventing discharge to No Fixed Address – Youth (NFA-Y) 

This research study will customize, implement and evaluate the NFA strategy for vulnerable youth ages 16-24. The unique health and housing needs of youth at-risk will be explored by streamlining housing and financial support into a coordinated system of care, with additional support provided by Youth Opportunities Unlimited and Children’s Aid Society London and Middlesex. 

Over 3-4 years, data to be collected from 93 youth at three time points. Focus groups with youth participants, health care providers, and community agency partners will help enhance the NFA strategy to meet the unique needs of youth. This project is funded by the National Centres of Excellence (NCE) Making the Shift (MtS) Youth Social Innovation Lab. 

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LONDON, ON – In 2019, a spate of vaping-related lung injuries occurred across North America, dominating headlines. While one in four high school students have tried vaping in the past 30 days, the full extent of the health effects are still being studied by clinicians and researchers.

On March 10, 2020, Lawson Health Research Institute and Western University’s Schulich School of Medicine & Dentistry are inviting the community to hear the latest about vaping research and policy from a panel of experts and to join the conversation about the health effects of vaping.

Lawson and Schulich Medicine & Dentistry experts are at the forefront of research into the effects of vaping and are actively contributing to the scientific and clinical knowledge around vaping-related lung injury.

This community event includes a series of small presentations followed by a panel discussion.

Panelists include:

• Dr. Karen Bosma was part of the team that published the first reported case of vaping-related lung injury in Canada. She is a Critical Care Specialist at London Health Sciences Centre, an Associate Scientist at Lawson Health Research Institute and an Associate Professor at Schulich Medicine & Dentistry. 
• Dr. Constance Mackenzie was part of the team that published the first reported case of vaping-related lung injury in Canada. She is an Assistant Professor at Schulich Medicine & Dentistry, a Respirologist and Toxicologist at St. Joseph’s Health Care London and the Assistant Medical Director at Ontario/Manitoba/Nunavut Poison Centre.
• Dr. Grace Parraga is a Professor at Schulich Medicine & Dentistry, Western University, Tier 1 Canada Research Chair in Lung Imaging, and a Scientist at Robarts Research Institute. 
• Suraj Paul, Aliana Manji, and Morgan Seabrook are high school students who are part of the Human Environments Analysis Laboratory Youth Advisory Council (HEALYAC) at Western. This group of young people used existing research and their own personal experience to inform a position paper on vaping that called for strict marketing rules and new safeguards on the online purchase of vaping products for anyone under the age of 19.
• Carly Weeks is a Health Reporter for The Globe and Mail who has extensively reported on the cases of vaping-related injury across North America. She’ll bring background and will moderate the panel discussion.

Event Details:

• Date: Tuesday, March 10, 2020, 7:00 – 8:30 p.m. (doors open at 6 p.m.)
• Location: Lecture Theatre, Museum London, London, Ontario 

The event is completely full to capacity. Members of the media are welcome to attend the panel discussion, but must contact Crystal Mackay to confirm attendance and to request interviews.

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MEDIA RELEASE
For immediate release
January 18th, 2022

 

LONDON, ON – Lawson Health Research Institute has ranked eighth in the country for the 2021 edition of Canada’s Top 40 Research Hospitals List by Re$earch Infosource. This is the eighth consecutive year that Lawson has maintained this strong national position, which puts the institute within the top five in Ontario.

Lawson, the research institute of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London, has also maintained the top ranking for research intensity among the large tier institutions with a little more than $600,000 of research spending per researcher.

“This is a validation of the extensive support from LHSC and St. Joseph’s, our hospital foundations, Western University and our staff and physicians,” says Lawson’s Scientific Director Dr. David Hill. “These strong partnerships make the hospital environment in London a nationally recognized centre of discovery and knowledge translation.”

Hospital-based researchers belong to a health system at the forefront of the ongoing COVID-19 pandemic. With close proximity to patients and access to samples, they have mobilized to address COVID-19 in many different ways, and are making a difference around the world when it comes to advances and discoveries.

“The Province of Ontario designated health research as an essential service early in the pandemic,” explains Dr. Hill. “They understood that only science can get us through this, be it through vaccine development, surveillance and testing, evaluating new drugs to help patients in ICU survive, or studying the long-term health impacts. We have made substantial contributions of new knowledge through Lawson.”

The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research income from the previous fiscal year. According to the report, Lawson received $121,888 million in research income in 2021.The ranking looks at funds received from all sources, including both internal and external, to support research at LHSC and St. Joseph’s.

Quick summary of Lawson’s ranking 

• Rank in Top 40 Research Hospitals 2021: 8 (same as 2020) 
• FY2020 research spending: $121,888 million  
• Percentage change 2019-2020: 2.6% 
• Research intensity: $618,700 thousand per researcher  
• Research intensity - percentage of total hospital spending: 7.0% 

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About Lawson Health Research Institute: Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.

For more information, please contact:      
Celine Zadorsky
Communications & External Relations
Lawson Health Research Institute
T: 519-685-8500 ext. 75664
C: 519-619-3872
@email
www.lawsonresearch.ca/news-events

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.
 

Study found unique blood biomarkers in patients with post-COVID-19 condition

LONDON, ON – Published this week in Molecular Medicine, researchers at Lawson Health Research Institute have 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.

Long COVID occurs when someone experiences symptoms like fatigue, cognitive issues, shortness of breath and gastrointestinal issues after an initial COVID-19 diagnosis. It can sometimes take up to 12 months for the condition to occur.

“It’s estimated that 30 to 40 per cent of patients with COVID-19 will develop long COVID,” says Dr. Douglas Fraser, Lawson Scientist and Critical Care Physician at London Health Sciences Centre (LHSC). “Physicians currently rely on symptoms alone to diagnose the condition, but our research offers a unique profile of blood biomarkers that could be used in a clinical test.”

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.

“We chose to study blood vessels that link all the body systems together to look for changes after an acute infection,” explains Dr. Fraser, who is also a Professor at Western University’s Schulich School of Medicine & Dentistry.

The team found that blood vessels of those with presumed long COVID were changing rapidly after a confirmed COVID-19 infection. They also found that patients with long COVID had 14 elevated blood biomarkers associate with blood vessels. With the help of machine learning, they discovered that two biomarkers called ANG-1 and P-SEL could be used to classify long COVID with 96 per cent accuracy. 

“Long COVID is a relatively new condition and we have much to learn about it,” says Dr. Michael Nicholson, Associate Scientist at Lawson, Respirologist at St. Joseph’s and Associate Professor at Schulich Medicine & Dentistry. “This research advances our understanding of long COVID with the potential to improve diagnosis and patient care.”

The advantage of biomarkers is that they not only help diagnose a disease but also provide insight into potential treatments. The team is now focused on using their findings to create a clinical diagnostic test with a goal of also exploring therapeutics.

“With a point-of-care diagnostic test, we could confidently diagnose long COVID and eventually develop targeted therapeutics against these blood vessel changes that we have discovered,” says Dr. Fraser. “The ultimate goal is to improve patient outcomes following a long COVID diagnosis.”

This research was supported by funding from London Health Sciences Foundation, London Community Foundation and the AMOSO Innovation Fund. It builds on a growing body of COVID-19 research from scientists at Lawson Health Research Institute.