Lawson Health Research Institute was awarded over $1.2 million in the Canadian Institutes of Health Research’s Fall 2019 Project Grant competition, for three projects including one Priority Announcement. 

“This is a great accomplishment for the successful researchers at Lawson and those working across the city,” says Dr. David Hill, Lawson Scientific Director. “At Lawson, our scientists target rapid response research that can be quickly incorporated into improved care for patients and families. Our research happens within hospital walls, where care is delivered, with innovations that improve lives every day.” 

Western University received more than $11.9 million in research funding through the project grant competition for 17 projects. A special congratulation to Lawson researchers Drs. Samuel Asfaha, Thomas Appleton, Neil Duggal, David Spence and Zhu-Xu Zhang, as well as Dr. Subrata Chakrabarti, recipient of the CIHR Priority Announcement for “Novel mechanisms in diabetic cardiomyopathy.”

Selective Brain Hypothermia via Intranasal Cooling to Limit Brain Injury Post Cardiac Arrest
Dr. Ting-Yim Lee 

There are 40,000 cardiac arrests per year in Canada. Within the body, it triggers a complex cascade of dysfunction resulting in cell death, even after successful cardiopulmonary resuscitation, with only three to seven per cent of survivors returning to normal function. 

To reduce the high incidence of brain damage and the burden on families, the American Heart Association has recommended hypothermia for neuroprotection in post cardiac arrest care. 

However, current clinical hyperthermia cools the whole body instead of just the brain. Simple, effective and non-invasive methods to selectively cool the brain that can be readily used in and out of hospitals are not available.  

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The team has patented a simple and portable method where the brain is cooled by blowing cold air, generated using a vortex tube and compressed air, into the nostrils. The chilled blood from the nasal cavity collects and cools the blood in the internal carotid artery on the way to the brain, and so lowering the brain’s temperature while keeping body temperature normal.

“The grant is allowing us to collect validative data on the protective effect of brain cooling in limiting brain injury from cardiac arrest,” explains Dr. Lee. “The device is very convenient to use. It is compact and can be set up right by the bedside of patients in intensive care units.” 

Dr. Lee sees the device as having the potential to be used widely to limit brain injury following stroke, head trauma and sepsis. 

“This kind of investment in hospital-based research allows us to identify important clinical problems and find ways to solve them, working closely with research patients along the way.”

Multi-centre diagnostic performance of dynamic CT perfusion for functional assessment of multi-vessel coronary artery disease with dense coronary calcification
Dr. Aaron So 

Coronary artery disease (CAD) occurs when plaque forms in one or more coronary arteries of the heart. It is one of the leading causes of mortality and morbidity in the world. 

Patients with CAD can go to a cardiac catheterization laboratory where the narrowed coronary artery can be reopened using a catheter-based technique. However, this approach is invasive for the patient and costly for the system. Studies have shown that for various reasons not all patients benefit from this treatment.  

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“We have developed a new CT imaging technique that will help select the most appropriate CAD patients to undergo cardiac catheterization and revascularization,” says Dr. So. “Blood flow information in both the coronary arteries and the heart muscle are obtained simultaneously and non-invasively.” 

With the funding, they are testing the technique at several hospitals and national cardiovascular centres in Canada, China, Germany and Japan. With larger clinical studies in the future, they could determine the optimal diagnostic strategy for patient triage and reduce unnecessary procedures.

“Health research has been and will continue to be very important, with the commitment of patients and clinicians playing a crucial role in the success of medical research and advancement,” says Dr. So. “It’s important for the Canadian government to continue to support research in academic hospitals.”

He adds that the success of the CIHR grant application shows that Canadian researchers can be leaders in health research that benefits people around the world.

Filling Knowledge Gaps for the Success of Ontario Renal Plan 3
Dr. Matthew Weir

The Ontario Renal Network (ORN) is the agency responsible for distribution of funding for kidney care in Ontario. They have released three policy statements outlining strategic objectives for kidney care, with the most recent being the recently released Ontario Renal Plan 3 (ORP3).

“Within the strategic objective, gaps in our understanding of kidney disease have been identified as barriers to successful implementation,” explains Dr. Weir. “We have proposed a suite of 32 related retrospective cohort analyses designed using integrated knowledge translation to address those gaps.”

The Priority funding will help get the first projects underway and build momentum. “The ORP3 had extensive consultation with patients, families and other stakeholders. By supporting its successful implementation, our findings will have a direct and immediate effect on patients in areas that are a priority to them.” 

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The Canadian Institutes of Health Research (CIHR) announced more than $11.3 million in funding through their project grants program for 17 health research projects across Lawson Health Research Institute and Western University.

“The funded projects represent a wide range of research and expertise from London’s health research community, with real impacts for health and health care,” says Dr. David Hill, Lawson Scientific Director. “Congratulations to those successful applicants who have secured this funding on a very tough competition.”

Projects include a national study on transgender health; a community-based family treatment program for children with epilepsy; imaging of blood clots in the brain; equity in mental health care for children and youth; and, a smartphone intervention focused on diet and food literacy.

See the full list of successful applicants. 

Cooling the Brain after Resuscitated Cardiac Arrest to Prevent Brain Injury

There are 40,000 cardiac arrests each year in Canada. A high number of patients won’t survive the event and nearly half of the survivors suffer from brain damage that can have a huge impact on their ability to live independently. The current guidelines recommend cooling of the whole body to protect the brain against the damaging effects of cardiac arrest. However, in the clinic there are several hurdles for this treatment that can create complications. Enhanced brain protection may be achieved by selectively cooling the brain but a simple, effective and non-invasive method to do so is needed.

Dr. Ting-Yim Lee and his research team are studying a simple means to cool down the brain by blowing compressed air into the nostrils which would essentially chill the warm blood coming through the nasal cavity on its way to the brain. Using an animal model, their aim is to show that the method can be used safely and is able to protect the brain after cardiac arrest.

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The DECIPHER Study

Shoulder fractures are becoming increasingly common for older adults and cause considerable limitations and impacts for their daily life. While different approaches are taken to treat shoulder fractures, there is a lack of knowledge and evidence to show which of those methods are the most effective and for which patients.

Dr. Emil Schemitsch and his research team are proposing the first nation-wide, multi-centre observational study with over 600 patients with the ultimate goal of determining what specific factors influence important outcomes for patients. The DECIPHER study will seek to answer important questions about which treatment and rehabilitation strategies are best for different patients, strengthening the clinical strategy for managing these difficult and prevalent injuries. It will also provide an economic analysis to understand the impact for healthcare system costs.

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Congratulations to all of the successful applicants:

• Greta Bauer and Ayden Scheim - Trans PULSE Canada: A National Study of Transgender Health
• Maria Drangova - Characterizing cerebral thrombus composition with Phase‐based MRI
• David Edgell, Bogumil Karas, and Gregory Gloor - ConCRISPR: Conjugative delivery of a hybrid CRISPR/Tev nuclease system for specific microbiota modulation in the mammalian gut
• Jason Gilliland - Evaluation of a Smartphone Based  Intervention for Improving Food Literacy, Food Purchasing, and Diet Quality Among Youth in Urban, Suburban, and Rural Environments
• Douglas Hamilton - Novel Biomaterials‐Based Strategies to Stimulate Periodontal Tissue Regeneration
• David Haniford - Regulation of Salmonella pathogenesis by transposon‐encoded small regulatory RNAs 
• Steven Laviolette - Effects of Neurodevelopmental Exposure to Cannabinoids on Prefrontal Cortical Function:  Implications for Neuropsychiatric Disorders
• Ting-Yim Lee - Selective Brain Hypothermia via Intranasal Cooling to Limit Brain Injury  Post Cardiac Arrest (Funded through Lawson Health Research Institute)
• Stephen Lomber - Cortical Plasticity Following Deafness
• Vania Prado - Cholinergic influence in aging and brain pathology
• Graham Reid and William Gardner - Equity in Mental Health Care for Children and Youth
• Jason Roberts - The Role of Electrophysiology Testing in Survivors of Unexplained Cardiac Arrest: The EPS ARREST Study
• Emil Schemitsch - The DECIPHER Study: DEterminants of Function and Clinically Important outcomes in Proximal Humerus Fractures in the Elder Population: A National CohoRt (Funded through Lawson Health Research Institute)
• Walter Siqueira and Elizabeth Gillies - Novel Drug Delivery System for the Combat of Dental Caries by using Salivary Peptides
• Kathy Speechley and Karen Bax - A Community-Based Family Treatment Program for Children with Epilepsy: A Randomized Controlled Trial
• Andrew Watson - Understanding and Treating Obesity Related loss of Embryo Developmental Competence
• Donald Welsh - Kir Channel Regulation by Membrane Lipids:  An Enabler of Hemodynamic Sensing in the  Cerebral Circulation

 

Dr. David Palma, Radiation Oncologist at London Health Sciences Centre (LHSC) and Scientist at Lawson Health Research Institute, is a strong advocate for cancer patients getting the high-quality care they deserve.

His new book, Taking Charge of Cancer: What You Need to Know to Get the Best Treatment, is the first “how-to” manual that shows patients how to obtain and understand their medical records, double-check their doctors’ recommendations and ensure they are getting top-notch radiation, surgery or chemotherapy.

All royalties are being donated to London Health Sciences Foundation's Cancer Care Campaign, which will help to support cancer research at Lawson. 

Read more on the London Health Sciences Foundation website. 

On January 10, 2020, the Honourable Jeff Yurek, Minister of Environment, Conservation and Parks and MPP for Elgin-Middlesex-London, joined London Health Sciences Centre (LHSC), Lawson Health Research Institute and the Ontario Hospital Association for a research tour at LHSC’s University Hospital. 

This tour was organized to afford the Minister the ability to see first-hand how research-intensive hospitals like those in London are helping to deliver high quality and efficient patient care to people across the province and beyond.

At University Hospital, Drs. Matthew Teeter and Brent Lanting are leading clinical research in hip and knee replacement that is reducing the time patients are in hospital following surgery. They are utilizing wearable technology to better assess how patients are doing, flag issues and predict outcomes, while partnering with industry to develop the next generation of implants. 

Dr. Teeter leads one of Canada’s only Implant Retrieval Labs, which stores thousands of failed hip, knee and shoulder implants retrieved from patients. Surgeons and scientists from all over the world send implant specimens to London to be imaged and studied. 

As the research institute of LHSC and St. Joseph’s Health Care London, Lawson’s researchers and their teams are helping people live their life to the fullest by minimizing the effects of injury, disease and disability. Research is done within hospital walls and can be directly implemented into patient care. 

This includes ground breaking work in minimally invasive and robotic cardiac surgeries let by Dr. Michael Chu and the cardiac surgery team. They have helped patients like Maria Bruno who shared her experience as a patient, and the impact on her own life and that of her family. 

“Today, my heart is in perfect condition,” shares Maria. “The ability to perform this procedure is unique in Canada. I’m forever grateful to this hospital and Dr. Chu for being able to repair it. I’m a huge advocate for continued research because there are many, many patients who could benefit.” 

As an active clinician researcher, Dr. Chu also investigates augmented reality image guidance in minimally invasive valve surgery, experimental transcatheter technology and complex aortic reconstruction. In 2019, Dr. Chu along with colleagues from University Health Network published a high-impact finding that women are more likely to experience poorer outcomes following aortic surgery. 

Dr. Mandar Jog is a world leader in his field, revolutionizing treatment for people with movement disorders including Parkinson’s disease and essential tremor. Last year, his work on spinal cord stimulation was covered by BBC World News. 

Patients Real Beaulieu and Guy Alden who have been involved with the team’s clinical trials told the Minister about the dramatic improvements in their quality of life 

“With the tremor, I was at the point where I couldn’t write, I couldn’t get a key in the key hole. I couldn’t function normally in life and it was embarrassing for me,” remembers Real. “After the treatment with Dr. Jog, it was a huge turnaround for me and how I could live my life.” 

Hospital-based research is critical to supporting health care in Ontario. “Health research is a necessity in order to provide the best care for patients and ensure the health system is sustainable. Researchers, clinicians, staff and trainees working at hospital sites across the city are driving important discoveries that continually improve patient care,” says Dr. David Hill, Lawson Scientific Director and Integrated VP, Research for LHSC and St. Joseph’s Health Care London. 
 

Dr. Manuel Montero-Odasso’s research demonstrates that gait testing, such as walking while performing a cognitively demanding task like counting backwards (dual-task gait),can be an effective predictor of progression to dementia. In a new study, a team at Lawson Health Research Institute and Western University’s Schulich School of Medicine & Dentistry has discovered changes to the brain that correspond to these findings. 

These changes identify a brain mechanism that corresponds with slow dual-task gait among older adults with mild cognitive impairment (MCI), an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Through their work Dr. Montero-Odasso and his team have found that a high dual-task gait cost, or a significant slowdown in walking speed when dual-tasking, is associated with a two- to three-fold increased risk of progression to dementia. However, the brain mechanism underlying this association was unclear.

To address this research question, Dr. Montero-Odasso partnered with Robert Bartha, PhD, an imaging scientist at Schulich Medicine & Dentistry and Robarts Research Institute at Western University. The team used magnetic resonance imaging (MRI) to examine the medial temporal areas of the brain, particularly the hippocampus, the parahippocampal gyrus, and the entorhinal cortex, which are regions particularly vulnerable to degeneration in Alzheimer’s disease. Participants were 40 older adults with MCI taking part in Dr. Montero-Odasso’s “Gait and Brain Study” at St. Joseph’s Health Care London’s Parkwood Institute. 

The researchers found that participants with higher dual-task gait costs had a smaller grey matter volume in the left entorhinal cortex. Although grey matter volume loss is a common finding in people with Alzheimer’s disease, it is still unclear which areas of the brain are first affected by neurodegeneration. This finding points to the entorhinal cortex as a susceptible brain region in early stages of cognitive decline. This is in line with previous studies reporting that progression to Alzheimer’s disease is associated with volume loss in the entorhinal cortex.

The study therefore suggests that cognitive and motor dysfunction in older adults with MCI share common changes to the brain. This further supports that dual-task gait changes may be a measurable motor marker for neurological degeneration happening in Alzheimer’s disease.

“These novel results show that early brain changes common to pre-dementia states can be manifested by the way patients walk,” says Dr. Montero-Odasso, scientist at Lawson, geriatrician at St. Joseph’s Health Care London, and professor at Schulich Medicine & Dentistry. “This evidence supports walking while performing a cognitively demanding task as an important way to help predict dementia.”

The study, “Entorhinal Cortex Volume Is Associated With Dual-Task Gait Cost Among Older Adults With MCI: Results From the Gait and Brain Study,” is published in The Journals of Gerontology: Series A.