On May 23, 2019, the federal government announced that the Marathon of Hope Digital Health & Discovery Platform (DHDP) will receive $50 million through Innovation, Science and Economic Development Canada's Strategic Innovation Fund. Co-led by the Terry Fox Research Institute and the artificial intelligence (AI) company Imagia—with UHN as a major partner—the pan-Canadian network will bring together the best minds in cancer precision medicine and AI to establish a world-leading innovation framework that will advance research and enable collaborations across the country.
UHN was deeply involved in the preparation of the proposal along with the Terry Fox Research Institute and Imagia. DHDP will build upon the Terry Fox Marathon of Hope Cancer Centres Network, of which Princess Margaret Cancer Centre is a founding partner. This network forms the foundation for DHDP's vision to advance the intelligent use of digital information towards realizing precision medicine. The Techna Institute will lead the open-source software development and change management initiatives to integrate these technologies in member hospitals.
DHDP comprises 97 organizations, including research hospitals, AI institutes, not-for-profits, venture capital, the private sector, charities and NGOs. While cancer will be the first disease area for the DHDP, the structure is broadly applicable and future plans will incorporate research on other major diseases.
Dr. Tak Mak, Senior Scientist at Princess Margaret Cancer Centre, has won the Gold Leaf Prize for Discovery from the Canadian Institutes of Health Research (CIHR). The prize is awarded every two years to “individuals or teams whose research findings are unique, innovative and represent a ground-breaking discovery in any pillar of health research that has been seen to significantly influence knowledge in the field.”
Dr. Mak was awarded the prize for a pioneering discovery that changed the course of our understanding of the human immune system. In 1984, he cloned one of the genes specifying the elusive T cell receptor, which controls how an immune cell called the T lymphocyte binds to its target. In so doing, Dr. Mak captured what many in the field called ‘the Holy Grail of immunology’.
Dr. Mak’s findings were remarkable not only because they solved a problem that had plagued scientists for decades, but also because they opened up countless new research avenues in T cell biology. The immense progress in immunology research achieved in the last three decades would not have been possible without this breakthrough.
This prize was selected by a Gold Ribbon Panel comprising individuals with a broad array of expertise in biomedical, clinical, health services, health policy, and population and public health research. They evaluated applicants for evidence of an outstanding discovery or breakthrough with a major influence on future research, and evidence that the discovery has significantly influenced knowledge in the field of health research. Dr. Mak will receive a prize of $100,000, and a medal and grant to be presented at a ceremony on June 20. A full list of Gold Leaf Prize recipients can be found here.
Dr. Mak’s award marks the second award in a row for a UHN scientist since the launch of the inaugural competition in 2016. The first CIHR Gold Leaf Prize for Discovery was awarded to Dr. John Dick.
Congratulations to Dr. Mak!
The Canada Foundation for Innovation (CFI) announced over $450,000 in funding for advanced research infrastructure at University Health Network. These investments, provided through CFI’s John R. Evans Leaders Fund, will support the following two projects:
• Mitigating Endocrine Metabolic Disease Risk after Spinal Cord Injury, led by KITE Senior Scientist Dr. B Catharine Craven, will identify ways to reduce the risk of fractures, diabetes and heart disease in spinal cord injury (SCI) survivors. The funding will provide her team with advanced exoskeleton technology and imaging equipment. The exoskeleton is an emerging technology that could be used to help SCI survivors by reducing stress on the body during rehabilitation. The imaging equipment, known as a peripheral quantitative computed tomography scanner, will enable Dr. Craven’s team to assess the potential benefits of the exoskeleton, as well as to identify key disease risk factors and prevention strategies for these patients.
• Towards Personalizing Arthritis Medicine, led by Krembil Scientist Dr. Nigil Haroon and Krembil Senior Scientist Dr. Joan Wither, will develop ways to better customize treatments to individual patients with two forms of debilitating arthritis: ankylosing spondylitis and systemic autoimmune rheumatic diseases (SARDs; including lupus, scleroderma and Sjögren’s syndrome). The new equipment includes an advanced cell sorter that can be used to provide detailed information on the variety of immune cells present in patient blood samples. Dr. Haroon will use the equipment to identify new ways to assess whether patients with back pain have ankylosing spondylitis. Dr. Wither will use the equipment to identify individuals who are at risk of developing SARDs as well as to develop new treatments to prevent or slow progress of these autoimmune diseases.
These funds are part of over $39M awarded to 43 universities that will support 186 infrastructure projects across Canada.
Congratulations Drs. Craven, Haroon and Wither!
A new study recently published in The Journal of the American Medical Association (JAMA) reveals that patients with severe obstructive sleep apnea have a significantly higher risk of heart-related complications.
“We found that the risk of postoperative complications related to their heart was twice as high in patients with severe sleep apnea compared to those without sleep apnea,” says Dr. Frances Chung, a Clinician Investigator at the University Health Network’s Krembil Research Institute.
Obstructive sleep apnea causes breathing to stop and start during sleep and is the most common type of sleep apnea. It is also associated with a higher risk of death, cardiac diseases and cognitive impairment in the general population.
Dr. Chung and her team initiated the study to see whether sleep apnea poses a similar risk to surgical patients.
The study enrolled over 1,200 patients that were scheduled for major noncardiac surgery. Before the surgery, patients underwent overnight sleep testing. For 30 days after the surgery, the research team took note of any heart-related complications, such as heart attack, abnormal heart rhythm, heart failure and stroke.
The study showed that two thirds of patients had unrecognized sleep apnea and about one in ten had severe sleep apnea. Furthermore, around 30% of those with severe obstructive sleep apnea experienced a heart-related complication, while only 14% of those without sleep apnea experienced similar complications.
“The key takeaway here is that if patients have symptoms of sleep apnea, perhaps they should be treated before undergoing major surgery,” says Dr. Chung. “Further study is needed to determine how best to prevent patients with severe sleep apnea from having a higher risk of heart complications.”
Source: press release
This work was supported by the Health and Medical Research Fund (Hong Kong); the National Healthcare Group-Khoo Teck Puat Hospital; the University of Malaya; the Malaysian Society of Anaesthesiologists; the Auckland Medical Research Foundation; the University of Toronto’s Department of Anesthesia and Pain Management at University Health Network and Mount Sinai Hospital; and the Toronto General & Western Hospital Foundation.
Matthew TV Chan, Chew Yin Wang, Edwin Seet, Stanley Tam, Hou Yee Lai, Eleanor FF Chew, William KK Wu, Benny CP Cheng, Carmen KM Lam, Timothy G Short, David SC Hui, Frances Chung. Association of Unrecognized Obstructive Sleep Apnea With Postoperative Cardiovascular Events in Patients Undergoing Major Noncardiac Surgery. JAMA. 2019;321(18):1788-1798. doi:10.1001/jama.2019.4783
Dopamine receptors are a type of protein in the brain that are important for controlling movement, learning and decision-making. Given their wide-ranging effects, dopamine receptors are the target of several drugs used to treat a variety of diseases including Parkinson disease and schizophrenia.
The effectiveness of these drugs can vary from one person to another and is influenced by a person’s genes. The dopamine receptor (like all proteins) is made from instructions carried in a person’s genetic code. Although minor changes in the gene coding for the receptor are relatively common, it is not clear how these changes could alter the effectiveness of the drugs that target the receptor.
To improve our understanding of this relationship, a team led by Dr. Antonio Strafella used advanced imaging methods, known as positron emission tomography (PET). The researchers examined PET images of dopamine receptor activity in the brain of healthy volunteers whose genes for the dopamine receptor differed by a single letter of the genetic code.
The team found that even such a small genetic change influenced the quantity and activity of dopamine receptors in the brain, especially within the ventral striatum, a brain region known to play a critical role in decision-making and processing rewards.
Understanding how genetic changes affect the distribution and activity of dopamine receptors in the brain can help scientists better understand how gene variation influences treatment and a person’s response to medication.
This work was supported by the Canadian Institutes of Health Research, and the Toronto General & Western Hospital Foundation. Dr. A Strafella holds the Tier 2 Canada Research Chair in Movement Disorders and Neuroimaging.
Valli M, Cho SS, Masellis M, Chen R, Rusjan P, Kim J, Koshimori Y, Mihaescu A, Strafella AP. DRD2 Genotype-Based Variants Modulates D2 Receptor Distribution in Ventral Striatum. Mol Neurobiol. 2019 Mar 8. doi: 10.1007/s12035-019-1543-0.
At the Toronto Rehabilitation Institute, KITE researchers have developed a light-weight and easy-to-use robotic glove to help improve hand function in stroke survivors.
“Of the fifteen million individuals that experience a stroke worldwide each year, half will have difficulty carrying out daily tasks because of reduced hand function,” says KITE Senior Scientist Dr. Alex Mihailidis.
While robotic gloves have already been used for stroke rehabilitation, current models can be hard to operate due to the need for cables and heavy power packs.
To address these issues, a doctorate student in Dr. Mihailidis’ laboratory, Aaron Yurkewich, developed the Hand Extension Robot Orthosis (HERO) Glove.
The glove was made by integrating robotic tendons powered by a nine-volt battery into a sports glove (ie, a batting glove). The glove’s grasping movements can be activated manually by pressing a button or automatically through a movement sensor.
“During the design process, we worked closely and collaboratively with stroke survivors, occupational therapists and engineering students. The result is a robotic glove that is portable, easy to put on and easy to use,” says Dr. Mihailidis.
To see a video of the glove in action, click here.
The glove was recently tested in a clinical trial. In the trial, five stroke survivors carried out a series of dexterity tests, including the ‘block test’—which involves moving coloured wooden blocks from one container to another in a 60 second period. Without HERO Glove, four of the five test subjects were unable transfer any blocks; with the glove, they were able to move between three and seven blocks.
HERO Glove is an example of how inclusive design can lead to the development of effective rehabilitation tools. Future work will focus on further refining the design of the Glove by engaging an even wider range of stroke survivors, with the ultimate goal of developing a glove that can be used at home to carry out daily tasks independently.
This work was supported by the University of Toronto; the Toronto Rehabilitation Institute; the Natural Sciences and Engineering Research Council of Canada; the Canadian Partnership for Stroke Recovery; and AGE-WELL NCE Inc., which is funded by the Networks of Centres of Excellence program.
Yurkewich A, Hebert D, Wang RH, Mihailidis A. Hand Extension Robot Orthosis (HERO) Glove: Development and Testing with Stroke Survivors with Severe Hand Impairment. IEEE Trans Neural Syst Rehabil Eng. 2019 Apr 11. doi: 10.1109/TNSRE.2019.2910011.
This work was supported by the Toronto General & Western Hospital Foundation.