On September 1, 2022, Dr. Fei-Fei Liu will become the new Scientific Director of the Institute of Cancer Research—one of the Canadian Institutes of Health Research (CIHR)’s thirteen institutes. She will succeed Dr. Steven Robbins to become the Institute’s fourth Scientific Director.
Dr. Liu is a highly respected clinician scientist and cancer researcher. She has held several leadership roles, including Chair of the Department of Radiation Oncology at the University of Toronto and Chief of the Radiation Medicine Program at the Princess Margaret Cancer Centre. This year, Dr. Liu was also named Chair-Elect of the American Association for Cancer Research’s Radiation Science Medicine (AACR-RSM) Working Group to advance the field of radiation oncology.
Her contributions to radiation oncology have been far-reaching—from developing transdisciplinary training programs for the next generation of radiation medicine professionals to generating scientific insights across the spectrum of basic, translational and clinical oncology.
Dr. Liu’s research is focused on improving therapies for human cancers, with a focus on radiation therapy. Her research has also uncovered the molecular mechanisms underpinning several human cancers, including breast, cervical and head and neck cancers. Her recent focus on long-term toxicities of cancer therapy has led to several reports on these side effects—work that will contribute to improved treatment decisions, including fatigue, radiation fibrosis and lymphedema in cancer survivors. Together, her work has led to the filing of three patents and the publishing of over 200 original scientific articles.
“I am honoured to be appointed as the 4th Scientific Director of the Institute of Cancer Research at CIHR. With the burden of this disease, wherein 2 in 5 Canadians have a lifetime risk of developing cancer, we will continue to address this challenge together. I look forward to building on the strong foundations of my predecessors Drs. Phil Branton, Morag Park, and Steve Robbins, and work with our stakeholders, including researchers, funding partners, health systems, and in particular, patients, as we continue to support the research excellence that will “reduce the burden of cancer through prevention, screening, diagnosis, effective treatments, psycho-social support, and palliation”,” says Dr. Liu.
Congratulations to Dr. Liu on this exciting new role!
For more details, please see CIHR’s news release.
A new study led by researchers at the KITE Research Institute explores how gender shapes the experiences of individuals and their caregivers after traumatic brain injury.
Gender is a social construct that encompasses the normative roles and behaviours prescribed to men and women. Until recently, gender was not widely studied in the context of brain injury medicine and rehabilitation, despite the fact that gender colours our daily experiences and a change in capacity after brain injury can deeply alter how an individual and their informal caregivers navigate the already difficult terrain of recovery.
The research team was led by KITE Scientist Dr. Tatyana Mollayeva, who says that they were specifically interested in helping answer the question, “how do men and women with traumatic brain injury and their caregivers navigate recovery, and what significance do they ascribe to gender and their ability or inability to fulfill their prescribed roles?”
To explore these issues, the team interviewed a diverse group of adult patients with recent or chronic traumatic brain injury, as well as their informal caregivers, including spouses and children. Upon analyzing the participants’ responses, the researchers identified several common themes around gender.
“After injury, we noted that a shift takes place. Injuries prevented individuals from fulfilling the gender-based expectations that they aligned with before their injuries. In many cases, our interviewees saw these deviations as negative and as being looked down upon by society,” says Navindra Baldeo, the doctoral student who is the first author of the study.
The impairments experienced by individuals often prevented them from completing their perceived gender-specific duties, such as cooking or handiwork. Informal caregivers often needed to step in and take on these duties. Unmet expectations added strain to relationships between individuals of different genders.
The implications of gender shifts and unmet expectations were varied. Some women-caregivers noted that men could experience a positive change in their emotional expression after injury—for example, by being more willing to vocalize gratitude for the care that they received. Others expressed frustration and anger with the new demands placed on them. Some of the women who were injured reported disappointment in the quality of care they received from their informal caregivers—for example, while they appreciated how their husbands had stepped up to help with different tasks, they were not receiving the emotional support that they needed.
The results from this study call for expanding rehabilitation to include caregivers in the care plan, account for the gendered dynamics between people with traumatic brain injury and their informal caregivers, and consider how shifts in gender roles can influence recovery and outcomes.
This work was supported by the Canadian Institutes of Health Research and UHN Foundation. Co-author Dr. Angela Colantonio holds a Tier 1 Canada Research Chair in Traumatic Brain Injury in Underserved Populations. Dr. Tatyana Mollayeva is an Assistant Professor in the Department of Epidemiology at the Dalla Lana School of Public Health at the University of Toronto and holds a Tier 2 Canada Research Chair in Neurological Disorders and Brain Health.
Baldeo N, D'Souza A, Haag HL, Hanafy S, Quilico E, Archambault P, Colquhoun H, Lewko J, Riopelle R, Colantonio A, Mollayeva T. A thematic analysis of patients' and their informal caregivers' gendered experiences in traumatic brain injury. Disabil Rehabil. 2022 May 16. DOI: 10.1080/09638288.2022.2071483.
Welcome to the latest issue of The Krembil.
The Krembil is the official newsletter of the Krembil Research Institute (formerly the Toronto Western Research Institute). Research at Krembil is focused on finding innovative treatments and cures for chronic debilitating disorders, including arthritis and diseases of the brain and eyes.
Stories in this month’s issue include:
● Krembil Research Day 2022: Trainees and research staff share discoveries in neuroscience, vision and arthritis research.
● Clinician Researcher Joins Krembil: Dr. Christopher Kim is an Orthopaedic Surgeon and a Scientist at the Schroeder Arthritis Institute.
● Improving Concussion Policies: Researchers develop the first expert consensus on concussion policies for the school setting.
● It Gets Harder with Age: Researchers find that symptoms of a rare form of epilepsy worsen in adults as they age.
● What Do You Expect?: Study shows fulfilling patients' pre-surgery expectations is key to increasing satisfaction.
● Smart Treatments on Horizon: Researchers develop an approach to better tailor deep brain stimulation to patients’ needs.
Researchers at the Krembil Brain Institute have developed a strategy to use patients’ brain activity to guide the programming of deep brain stimulation (DBS).
Many symptoms of neurological disorders, from tremors in Parkinson disease to seizures in epilepsy, are caused by neurons misfiring. DBS is a promising treatment for these disorders that uses electrodes implanted in the brain to send electrical impulses to change neuron firing patterns.
“There is no simple correct or incorrect way for neurons to fire; different firing rates and patterns underlie different behaviours depending on the brain regions involved,” explains Dr. Alfonso Fasano, a Krembil Clinician-Investigator, scientist at CRANIA and first author of the study. “Even with a successful surgery to implant DBS electrodes, it can be a difficult process of trial and error to find a stimulation pattern that improves a patient’s symptoms.”
In some conditions, such as Parkinson disease, symptoms can improve within minutes of applying an effective stimulation pattern. For others, such as epilepsy or the movement disorder dystonia, optimizing DBS treatment can be more difficult because it can take days or weeks to see if there has been an improvement.
Using a recent breakthrough in DBS technology that enables chronic recordings of brain activity, researchers led by Dr. Fasano developed a DBS programming strategy and tested it in two individuals—one with epilepsy and one with dystonia.
The team, which included researchers from Krembil, the KITE Research Institute and the Hospital for Sick Children, used implanted electrodes to record brain activity whenever a patient indicated that they were experiencing a particular symptom.
Using this information, the researchers identified unique patterns of neuron activity while symptoms were occurring in localized brain areas. Next, they programmed a series of electrical pulses targeted at these brain areas, which helped to reduce symptoms. For the individual with epilepsy, this approach reduced the number of seizures by over 90% over the two-week observation period, an outcome usually achieved over months of attempts. Similarly, within a few days, the individual with dystonia experienced sufficient symptom improvement to leave the ICU, where they were being treated for a life-threatening acute worsening of their condition.
“This approach is potentially game-changing. In addition to helping us tailor DBS to individual patients, this approach could eventually be used to create smart DBS that can respond to a patient’s changing symptoms in real-time,” concludes Dr. Fasano. “Our next steps will be to test this approach in more patients and compare its effectiveness with that of traditional approaches.”
This work was supported by the University of Toronto (UofT) and the UHN Foundation. CRANIA was established with support from the Canada Foundation for Innovation. Dr. Alfonso Fasano is scientist at CRANIA, a Professor at UofT and the Chair in Neuromodulation at UofT and UHN.
Fasano A, Gorodetsky C, Paul D, Germann J, Loh A, Yan H, Carlen PL, Breitbart S, Lozano AM, Ibrahim GM, Kalia SK. Local Field Potential-Based Programming: A Proof-of-Concept Pilot Study. Neuromodulation. 2022 Feb. doi: 10.1111/ner.13520.
A new study led by researchers at the Schroeder Arthritis Institute has shed light on factors contributing to patient satisfaction following spine surgery.
Doctors often look to patient satisfaction to gauge the success of orthopaedic and other procedures, but satisfaction can be influenced by more than just the results of a procedure.
“Pre-surgery expectations are known to be generally a good predictor of how satisfied a patient will be with elective spine surgery, but expectations are often related to other factors that influence satisfaction, such as expectation fulfilment and reduced pain and disability following surgery,” explains Dr. Raja Rampersaud, a Clinician Investigator at the Schroeder Arthritis Institute and co-first author of the study.
To determine the best predictors of patient satisfaction, Dr. Rampersaud’s team examined how patients’ satisfaction with spine surgery is influenced by a variety of patient factors.
The researchers examined data from over 1,860 patients who underwent elective surgery for spinal conditions, such as disk herniation and narrowing of the spaces within the spine.
Before surgery, patients were asked what their expectations were for the surgery—for example, whether they expected it to reduce pain or improve mobility and independence. Following surgery, patients reported whether their expectations for the surgery were fulfilled. The research team also measured patients’ pain and physical disability before the surgery and one year after the surgery to see if it led to measurable improvements.
Approximately 85% of patients were satisfied with their surgery and over 82% of patients reported that at least one of their expectations was met.
Although individuals with higher pre-surgery expectations were less likely to have their expectations fulfilled, they were more likely to experience reduced pain and disability. One possible explanation for this is that patients with greater expectations have better compliance with pre- and post-surgery treatment regimens, such as rehabilitation, that contribute to outcome improvement.
Fulfilment of pre-surgery expectations was the most influential factor for patient satisfaction. The research team found that if pre-surgery expectations were fulfilled, patients were more satisfied with their surgery, regardless of the measurable outcomes.
“Our findings indicate that we can improve patients’ satisfaction with spine surgery by working with them to minimize the discrepancy between their expectations and the most likely surgical outcomes,” explains Dr. Mayilee Canizares, a Scientific Associate at the Schroeder Arthritis Institute and co-first author of the study. “We hope that this study informs how clinicians approach pre-surgery consultations, not just for orthopaedic procedures but for all elective surgeries.”
This work was supported by the UHN Foundation. Dr. Raja Rampersaud is a Professor of Surgery at the University of Toronto and a Staff Orthopaedic Surgeon at the Toronto Western Hospital.
Rampersaud YR, Canizares M, Perruccio AV, Abraham E, Bailey CS, Christie SD, Evaniew N, Finkelstein JA, Glennie RA, Johnson MG, Nataraj A, Paquet J, Phan P, Weber MH, Thomas K, Manson N, Hall H, Fisher CG. Fulfillment of Patient Expectations After Spine Surgery is Critical to Patient Satisfaction: A Cohort Study of Spine Surgery Patients. Neurosurgery. 2022 Apr 22. doi: 10.1227/neu.0000000000001981.
UHN is proud to launch the Stand with Ukraine Program to support displaced Ukrainian scientists and research trainees. The invasion of Ukraine by Russian armed forces has created a humanitarian crisis that has displaced millions of Ukrainian citizens—many of whom are seeking asylum and relocating to Canada.
Funding for the program is being made possible by the Princess Margaret Cancer Foundation and the UHN Foundation. The program is designed to be complementary to existing opportunities from the University of Toronto (UofT), and the Canadian government via the Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC) and the Social Sciences and Humanities Research Council (SSHRC).
Individuals applying for positions as a postdoctoral fellow, technician, research associate or visiting scientist must have relevant biomedical research expertise. Graduate students will require enrollment in the School of Graduate Studies at the University of Toronto via a Department that best matches their research interests and in which a potential faculty supervisor at UHN holds a research appointment. Exchange graduate students will require enrollment as an International Visiting Graduate Student at the University.
Applications are accepted until November 30, 2022. Please visit the Stand with Ukraine website for information on how to apply, eligibility criteria, and other details about the program. For further inquiries, please contact email@example.com.
Each summer, Krembil Research Day is an opportunity for Krembil trainees, investigators and research staff to come together to celebrate achievements across the Institute’s three research pillars: brain and spine, vision, and bone and joints.
This year’s Research Day was a two-day hybrid event that enabled members of the Krembil community to connect and discuss research in person and virtually. Day one of the event was hosted online and at the BMO Education & Conference Centre at the Krembil Discovery Tower, and day two was hosted entirely on the GatherTown virtual event space.
The event began with opening remarks from Dr. Mary Pat McAndrews, Chair of the Trainee Affairs Committee and Dr. Brad Wouters, Executive Vice President, Science and Research at UHN. “We’re here today to celebrate you, the next generation of scientists and explorers at Krembil. And we couldn’t be prouder that you’ve chosen UHN as the place where you’ll begin your exciting careers,” said Dr. Wouters.
Attendees then tuned in to six informative oral presentations from trainees across the Institute’s research pillars. They also enjoyed a keynote presentation from Dr. Donna Rose Addis, Senior Scientist at Baycrest’s Rotman Research Institute, titled “The imaginative brain: Exploring the personal past and future.”
Day 2 of the event continued with 56 poster presentations from trainees and research staff hosted on GatherTown. Attendees were able to explore the virtual conference centre, view the posters, and engage with presenters and colleagues.
The Krembil community thanks the many individuals who made this year’s Research Day a resounding success, including Krembil’s Trainee Affairs Committee, Administration Team and Public Affairs team, and UHN’s Education Technology & Media Services (ETMS), who co-produced day one of the event. We also thank the 40 volunteers who served as presentation judges and the Nadler Family for their generous donation for prizes awarded to presentation winners.
The following trainees are recipients of awards for best oral and poster presentations:
Oral Presentation Graduate Student Category:
Oral Presentation Postdoctoral Category:
Poster Presentation Graduate Student Category:
Poster Presentation Postdoctoral Category:
Congratulations to the winners and everyone who presented their work!
Research conducted at UHN's research institutes spans the full spectrum of diseases and disciplines, including cancer, cardiovascular sciences, transplantation, neural and sensory sciences, musculoskeletal health, rehabilitation sciences, and community and population health.
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