Search

Two researchers at Lawson Health Research Institute have each been awarded $400,000 as part of the Canadian Institute of Health Research’s (CIHR) new Health System Impact Embedded Early Career Researcher Awards. 

The funding will see the researchers apply their skills to find and implement solutions to improve kidney care by focusing on challenges in the health-care system.

Dr. Kyla Naylor and Dr. Danielle Nash will each spend four years working with provincial organizations. Dr. Naylor will work with the Trillium Gift of Life Network -Ontario Health, which is the organization responsible for coordinating provincial organ and tissue donation and transplant services. Dr. Nash will work with the Ontario Renal Network - Ontario Health, which is the organization responsible for managing delivery of advanced kidney services in the province.

“The treatment options for kidney failure is either a kidney transplant or dialysis. The majority of Canadians who have kidney failure receive dialysis,” says Dr. Naylor, who is an Associate Scientist at Lawson and an Adjunct Scientist at ICES. “However, a kidney transplant compared to dialysis can improve a patients’ quality of life, can give on average 10 more years of survival, and when compared to dialysis, can save the health-care system millions of dollars.”

In her research program, Dr. Naylor will begin by developing a kidney transplant measurement framework that will enable continuous performance monitoring and increase equitable access to transplant. 

“The first goal of this project will allow kidney transplant centres and regional renal programs to evaluate their performance and set goals towards improvement,” Dr. Naylor says. “The second is to improve kidney transplant education materials to provide patients with the information to make an informed decision about kidney transplant, and the third is to address geographical barriers to transplantation.”

Dr. Naylor will be using ICES data, which includes administrative health-care data for Ontario’s 14.5 million residents, with the goal of eventually making access to kidney transplantation more equitable for the thousands of Canadians living with kidney failure.

The goal of Dr. Nash’s research program is to use a learning health system model to better understand patient-identified gaps in kidney care across Ontario, and to develop solutions to fill these gaps in collaboration with the Ontario Renal Network and patient partners. 

“Chronic kidney disease is a serious illness that can lead to kidney failure. The best way to prevent kidney failure is to detect chronic kidney disease early and provide optimal care during this time,” explains Dr. Nash, who is also an Epidemiologist and Scientist with London Health Science Centre’s (LHSC) Kidney Dialysis and Transplantation Program. “Since many patients do not have symptoms, it can go unnoticed for a long time. However, it can be detected using simple blood and urine tests.”

Province-wide data from ICES Ontario and the Ontario Renal Network will be used for the research data. 

As part of both studies, the researchers will also be interviewing health-care providers and patients to assess additional barriers to treatment.

“One in four patients do not see a nephrologist in a timely manner and 60 per cent are not receiving adequate time in multidisciplinary kidney care clinics before initiating dialysis,” says Dr. Nash. “Education on treatment options (typically dialysis or a kidney transplant) needs to happen early for patients who are at high risk for kidney failure, so they can make an informed decision about treatment.”

In the early months of the COVID-19 pandemic, there was little known about the virus that was causing the COVID-19 illness. Hospital researchers in London, Ontario, through Lawson Health Research Institute, quickly got to work to study and better understand the SARS-CoV-2 virus. Lawson is the research arm of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London.

“When the pandemic hit, we were well prepared in London to start research studies. We had existing expertise, laboratories and teams through the hospitals, Lawson and Western University that could be mobilized quickly,” explains Dr. Douglas Fraser, Critical Care Physician at LHSC and Scientist at Lawson. “Patients started coming to hospital with COVID-19 and we began research that involved collecting human samples and bringing them to the lab for analysis.”

Dr. Fraser, who is also a Professor at Western’s Schulich School of Medicine & Dentistry, led the research team studying the samples from COVID-19 patients in hospital. “We learned very quickly that COVID-19 patients were experiencing a strong inflammatory response to the virus. We looked at the molecules involved because many of these are signaling molecules to the immune system.”

Image

Dr. Douglas Fraser, Critical Care Physician (LHSC) and Lawson Scientist 

“By studying the molecules, we were able to determine the pathways. This is important because it also points to how we should be targeting our diagnostics and therapeutics,” adds Dr Fraser.

As a hospital research institute, Lawson is uniquely positioned to address the medical questions posed by a new virus. Its Clinical Research Services (LCRS) and Center for Clinical Investigation and Therapeutics (CCIT) teams responded rapidly when researchers initiated COVID-19 studies, including Dr. Fraser’s study to examine the immune response in patients with COVID-19.

“Starting a clinical trial usually takes a certain amount of time to put together, but the pandemic created a perfect storm,” explains Sue Tereschyn, Manager of LCRS at Lawson. “Clinical researchers had to develop studies at a speed they have never seen, and they needed implementation support at the same speed. In Dr. Fraser’s case, we needed samples from the Intensive Care Unit (ICU) and we were processing samples from COVID-19 patients seven days a week. A high level of skill was needed.”

 

Dr. Fraser and his team soon became the first in the world to understand the immune response and several pathophysiological features of the virus. This work led to a critical understanding of how the virus was impacting patients and potential avenues for therapy.

“It’s important to understand what’s happening in the body when someone has COVID-19 because that gives us information as to why some patients don’t do well and why others recover,” shares Dr. Fraser. “This helps us know who is vulnerable to COVID-19 and how to best offer treatments in the future.”

Read about Dr. Fraser's COVID-19 research: 

• Researchers team up with Diagnostics Biochem Canada to study COVID-19
• Study identifies biomarkers that could be used in a quick, inexpensive COVID-19 blood screening tool
• Researchers unravel two mysteries of COVID-19

Work is also underway to find the unique fingerprint that the COVID-19 virus can leave on the lungs. Hospital researchers at Lawson have developed and tested an artificial neural network for diagnosing COVID-19.

Image

Dr. Robert Arntfield, Medical Director, Critical Care Trauma Centre (LHSC) and Lawson Researcher 

“The lung ultrasound techniques and the findings of COVID-19 by looking at the lungs didn’t initially look unique when compared to other conditions like pneumonia. Our group wanted to investigate whether or not there were differences that were possibly subvisible,” says Dr. Robert Arntfield, Medical Director of Critical Care Trauma Centre at LHSC and Lawson Researcher. “Through our work, we were able to show that in fact artificial intelligence could outperform a trained clinician in identifying a COVID-19 lung from a similar affected lung that was not due to COVID-19.”

This new technique just scratches the surface of the beneficial use of AI when it comes to medical imaging for patients. “It shone a light on the idea that there were hidden details within all the noise of the image,” adds. Dr. Arntfield. “When you can input that into a machine that is extremely portable the way ultrasounds are, you have a precise diagnostic machine that you can take anywhere a tablet can go.”

• Read more about the team's research findings. 

The team is now expanding on these findings with further research. Lawson has recently approved Dr. Arntfield’s “Project Deep Breath” which aims to go beyond COVID-19 and explore multiple conditions where lung ultrasounds and AI can be paired together.
 

St. Joseph’s Health Care London’s 2016-2017 Annual Report features stories of care, recovery, discovery, teaching and resiliency – of care teams, patients, residents, and their families.

Included in the 2016-2017 Annual Report are the following research stories:

• New imaging research chairs make history: In a historical-first, St. Joseph’s Health Care Foundation and Western University announced two research chairs to advance imaging research at Western University and Lawson Health Research Institute. The research chairs have been named after the two scientists who are revolutionizing health care through their groundbreaking imaging research – Drs. Ting-Yim Lee and Frank Prato.
• A world-first approach to dementia: Researchers at Lawson Health Research Institute are the first in the world conducting a clinical trial to test a triple intervention aimed at treating mild cognitive impairment (MCI) and delaying the onset of dementia. The Mobility, Exercise and Cognition (MEC) team will be incorporating physical exercises, cognitive training and vitamin D supplementation to determine the best treatment for improving mobility and cognition.
• First clinical guidelines in Canada for pain following spinal cord injury: Researchers at Lawson Health Research Institute are the first in Canada to develop clinical practice guidelines that address the unique challenges for managing pain during recovery and rehabilitation from spinal cord injury.
• CAHO HWS field trip to Lawson: The Council of Academic Hospitals of Ontario (CAHO) toured the labs of Lawson Health Research Institute to encourage stable investment in hospital-based research and showcase the groundbreaking work underway at St. Joseph’s and London Health Sciences Centre.
• iSee Vision Screening Research Program: iSee, an innovative vision screening research program of St. Joseph’s Ivey Eye Institute is catching problems early for children ages 18 months to five years. The screening, which takes only seconds, detects amblyopia (lazy eye) and other eye conditions that can cause poor vision

St. Joseph’s Health Care London’s 2017-2018 Annual Report features stories about patients and residents, and their journey of care and recovery.

The following research is highlighted in the 2017-2018 Annual Report:

• Smart tech, smart treatment: Many mobile applications are on the market to help people struggling with mental health issues, but these aren’t necessarily created or used by health care providers. Creating an entire smart mental health system is one of the strategic priorities of St. Joseph’s and Lawson’s Mental Health Research Group led by Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery. Numerous projects have been identified as components of a plan spanning seven years.
• Walking while talking a possible early predictor of dementia: In a new study, researchers at Lawson and Western University are demonstrating that gait, or motion testing, while simultaneously performing a cognitively demanding task can effectively predict the progression to dementia and eventually help with earlier diagnosis. To date, there is no definitive way for health care professionals to forecast the onset of dementia in a patient with memory complaints.