March to April 2018 Kudos

Dr. Kumanan Wilson and his colleagues have received nearly US $1 million from the Bill & Melinda Gates Foundation to use a big data approach to find out how often babies are born preterm in low-resource countries. The approach, pioneered by Dr. Wilson and Dr. Steven Hawken, is based on newborn blood samples spotted onto paper. In Canada and other countries, this practice is routinely used to screen for genetic diseases and metabolic disorders, but using it to assess preterm birth is new. The group is currently testing their algorithm using newborn data from Bangladesh, Zambia, China and the Philippines. The new funding will allow the team to pilot the algorithm in Sub-Saharan Africa and South Asia, in partnership with researchers from Stanford University, CHEO, Newborn Screening Ontario and uOttawa. See media release, Ottawa Citizen and Gates Foundation blog for details.  Co-investigators: Steven Hawken, Pranesh Chakraborty, Beth Potter, Mark Walker, Julian Little, Malia Murphy.

When exosomes were first discovered more than 30 years ago, most scientists thought they were useless bags of waste released by our cells. But in recent years, researchers have realized that exosomes may be able to help us understand, diagnose and treat a variety of diseases. A new study led by Drs. David Allan and Yevgeniya Le shows the potential of exosome research for acute myeloid leukemia (AML), a kind of cancer that starts in the bone marrow. They identified small RNA signals in exosomes released by certain “normal” supporting cells in the bone marrow that could actually help leukemia cells grow. Using samples from patients at The Ottawa Hospital as well as publicly available gene expression databases, they explored how five of these RNA factors could play a role in leukemia. If confirmed in other studies, these factors could be used as targets to develop new therapies. See Stem Cell Reviews and Reports for details. Authors: Barrera-Ramirez J, Lavoie JR, Maganti HB, Stanford WL, Ito C, Sabloff M, Brand M, Rosu-Myles M, Le Y, Allan DS.

Dr. Glen Goss recently received the Lifetime Achievement Award at the Canadian Lung Cancer Conference in Vancouver. This award recognizes his leadership in improving care for people with lung cancer, both as an oncologist and as a researcher. Dr. Goss has led many international clinical trials, with a focus on developing personalized, targeted therapies. His research has contributed to the approval of multiple new drugs for lung cancer. Dr. Goss also collaborates widely with basic scientists to translate discoveries into clinical therapies. “When a treatment doesn’t work, we want to know why it doesn’t work and we want to answer the question in order to bring better treatments to the patients,” said Dr. Goss. “This is why we are passionate about personalized medicine – where the treatment is more precise, we know more about the patient, we know more about their tumours, and we can develop personalized care.”

Dr. Tammy Shaw was one of only two recipients of the CAME Foundation Wooster Family Grant in Medical Education for 2018. This award is meant to support new and innovative projects in medical education that are not part of a larger, formalized and funded education research program.

Dr. Heather Lochnan published a group concept mapping study identifying key barriers to reporting professionalism lapses in the journal Academic Medicine earlier this year. This international study included a significant contribution by the clinician teachers in the Department of Medicine. Our thanks go out to those who participated.

Drs. Guy Trudel and Adnan Sheikh helped lead a world-first study that found running can keep the bone marrow young. At birth most of the bone marrow produces blood cells, but as a person ages it turns into fatty tissue. This negatively affects blood cell development and can contribute to anemia and osteoporosis. The study published in the Journal of Bone and Mineral Research is the first to show that regular exercise can slow down or stop this process in the spine. The study included 101 men and women aged 25-35 years who were either long-distance runners, habitual joggers, high-volume cyclists or sedentary. The researchers found that running was the most effective way to keep spine bone marrow young. For every nine kilometres a person ran per week, the bone marrow was one year younger. Cycling did not have the same effect, which may be because it does not put the same kind of stress on the spine. Authors: Daniel L Belavy, Matthew J Quittner, Nicola D Ridgers, Adnan Sheikh, Timo Rantalainen, Guy Trudel.

Drs. Marjorie Brand and Jean-François Couture were awarded $588,000 from the Canadian Institutes of Health Research to investigate a new treatment approach for one of the most aggressive forms of childhood leukemia. The current treatment for T-cell Acute Lymphoblastic Leukemia (T-ALL) is chemotherapy, with side effects that include secondary cancers later in life and stunted growth. If the cancer returns after treatment, patients usually die soon after. Dr. Brand’s research team previously reported that a common form of T-ALL called TAL-1 has a weak spot: It needs a partner in crime, an enzyme called UTX, to trigger the production of cancer cells. So when the team used a compound called GSK-J4 to turn off UTX, it completely stopped the growth of TAL-1 type cancer cells. This new funding will allow them to explore treatment methods for T-ALL that exploit this weakness, which may lead to therapies that are less toxic and more effective.

TOHAMO Innovation Project Grants given to Dept of Medicine principle or co-investigator physicians:

  • Validation of the Ottawa Colorectal Neoplasia Prediction Tool: A Personalized Decision-Making Tool for Clinical and Cost-Effective Use of Colonoscopy in Low-to-Moderate Risk Individuals Over Age 50
    • Principal Investigator: Sanjay Murthy
    • Co-investigators: A. Rostom, C. Dube, G. le Gal, K. Wilson, T. Ramsay, L. Antonova, R. Abaskharoun, D. Rowan.
  • The Risk: Benefit trade-off of newer anticoagulants for heart disease in patients with chronic kidney disease (The Help Not Harm CKD Study)
    • Principal investigator: Manish Sood
    • Co-investigators: Eric McArthur, Sarah Bota, Phil Wells, Amit X. Garg, Doug Manuel, Peter Tanuseputro, Ziv Harel, Marisa Battistella.
  • Crystalloid FLUID Choices for Resuscitation of Hospitalized Patients in Ontario: A Pragmatic Comparative Effectiveness Trial (FLUID)
    • Principal investigators: Lauralyn McIntyre, Dean Fergusson, Monica Taljaard
    • Co-investigators: Andrew Seely, Colin McCartney, Ian Stiell, John Marshall, Raphael Saginur, John Muscedere, Claudio Martin, Shane English, Alan Forster, Alison Fox-Robichaud, Steven Hawken, Dr. Jamie Brehault, Dr. Kednapa Thavorn, Ian Graham,
    • Collaborators: Paul Westergaard, Akshai Iyengar, Kwadwo Kyeremanteng.
  • A patient-oriented risk communication tool to improve patient experience, knowledge and outcomes after elective surgery
    • Principal investigator: Daniel McIsaac
    • Co-investigators: D Manuel, Carl van Walraven, M Taljaard, D Stacey, L Boland, K Thavorn, S Gagne, GL Bryson, H Yang, C Pysyk, L Lavallee, H Moloo, A Forster, K Wilson.
  • Aneurysmal Subarachnoid Hemorrhage and Patient Outcomes – a Patient-Oriented Approach
    • Principal investigator: Shane English
    • Co-investigators: Justin Presseau, Dean Fergusson, Zarah Monfaredi, Victoria Saigle.
  • A Randomised REaCT-NSQIP Study of Preoperative Oral Antibiotics to Reduce Surgical Site Infections in Colectomy Patients
    • Principal investigators: Rebecca Auer and Husein Moloo
    • Co-investigators: Kathryn Suh, Mark Clemons, Dean Fergusson, Kadnapa Thavorn, Deanna Rothwell.
  • Pathways of care and clinical outcomes following implementation of the new CCS guidelines: an interrupted time series analysis
    • Principal investigators: Manoj Lalu, Daniel McIsaac
    • Co-investigators: Homer Yang, Chris Johnson, Sylvain Gagné, Sylvain Boet, Dean Fergusson, Julie Shaw, Jaclyn Ernst, Alan Karovitch, James Chan, Stuart Oake, Dalibor Kubelik, Ashraf Fayad, Simon Feng, Anesthesiology Resident, Joshua Montroy.
  • A program to minimize preventable and inappropriate blood product transfusions in liver surgery
    • Principal investigator: Guillaume Martel
    • Co-investigators: Laura Baker, Alan Tinmouth, Elianna Saidenberg, Christopher Wherrett, Deanna Rothwell

The Ontario Centre of Excellence for eConsult, which will be established at TOH in partnership with Bruyere Research Institute, has been officially funded for $12,450,000 (which includes payment to the specialists) for the next two years. The goal is that over 100,000 Ontarians will have an eConsult sent on their behalf during this time. Dr. Clare Liddy (Dept of Family Medicine) and Dr. Erin Keely (Dept of Medicine will be the co-executive directors and are both very excited about the impact this will make on Ontario patients.

Huge numbers of life-years could potentially be saved if we could speed up the clinical research processes required for evaluation and approval of effective new drugs. (One life-year is one person being alive for 1 year). Dr. David Stewart, co-authored these findings which were published online in Cancer Medicine. The paper also outlines several pragmatic steps that could be taken that could help with this.

Dr. Kumanan Wilson, founder of The Ottawa Hospital mHealth Lab, has won the Technology & Engineering Ambassador Award from Partners In Research. This award recognizes his team’s progress in creating digital technologies to empower Canadians (and their care providers) to improve health. The mHealth Lab has developed digital platforms related to immunization (CANImmunize, SafeLiving), emergency medicine (The Ottawa Rules app), kidney disease management (OKKidney) and stroke recovery (RecoverNow). Partners In Research Canada is a registered Canadian charity that recognizes exceptional Canadian research and the communication of that research to the lay community.

Dr. Claire Touchie published an article recently in Academic Medicine. In this Invited Commentary, the authors propose the use of big data to test the assumption that improving medical education will improve patient care and that collaboration is needed to link educational and health care data.

Drs Mark Clemons (Medical Oncology) and Ted Clark’s (Nephrology) applications were among the 16 impact grant projects recommended for funding by CCO for 2018/19. Mark’s project: Expanding the Rethinking Clinical Trials (REaCT) Program to Northern Communities in Ontario — a prospective study, $100,000. Ted’s project: Predicting Renal Recovery in Patients Requiring Outpatient Dialysis After Acute Kidney Injury (RECOVER AKI), $147,230.

Dr. Robin Parks was awarded $150,000 from CureSMA to see if tiny bits of cells called exosomes can be used to track how spinal muscular atrophy (SMA) progresses and responds to treatment. SMA is the number one genetic cause of death in infants. Debilitating and often fatal muscle weakness is caused by a lack of a protein called SMN. It has been suggested that treatment for SMA may be more successful if delivered as early as possible. However, it is difficult to measure whether experimental treatments are working in very young babies without a biological test. Dr. Parks’ team previously found that exosomes naturally released into the blood contain similar levels of SMN protein as the affected nerve and muscle cells. This funding will allow them to continue to explore the practicality and accuracy of analyzing SMN protein levels using exosomes. Co-investigators: Jodi Warman Chardon, Hugh McMillan, Rashmi Kothary, Chris Lorson.

The Resident Doctors of Canada Mikhael Award (RDoC) for Medical Education has been awarded to Dr. Michael Froeschl (Division of Cardiology). He is 1 of 2 recipients of the 2017-18 award which honours individuals who have contributed to improving undergraduate and postgraduate medical education in Canada.

Dr. Nancy Dudek is the 2018 Canadian Association of Physical Medicine & Rehabilitation Association Meridith Marks Award for Excellence in Education Recipient. The award was developed by the Canadian Physiatrists Research and Development Foundation (CPRDF) and Canadian Association of Physical Medicine and Rehabilitation (CAPM&R) to recognize excellence in education among physiatrists.

Dr. John Hilton received the Dr. Elizabeth Eisenhauer Early Drug Development Young Investigator Award. This award is presented annually to an exceptional MD, fellow, or PhD, who has either spent time at CCTG’s Operations and Statistics Centre, worked with the Investigational New Drug Program, or contributed significantly to an IND trial.

Ottawa researchers receive $1 million from Stem Cell Network, awards to Department members include:

  • $500,000 for Dr. David Stewart and colleagues to advance their world-first clinical trial of a genetically-enhanced stem cell therapy for heart attack. Local co-investigators: David Courtman and Chris Glover, Alexander Dick, Michel Lemay
  • $200,000 for Drs. Lauralyn McIntyre, Mei and colleagues to develop a stem cell bank and the final cell product to be used in the first multi-centre Phase 2 clinical trial of mesenchymal stem cell therapy for septic shock. Dr. McIntyre was awarded an additional $100,000 for preparing regulatory and ethics review documents and operational training and practice enrolling one to two patients at each of the participating sites. Local co-investigators: Duncan Stewart, Dean Fergusson, Shane English, Kednapa Thavorn, Timothy Ramsay, David Courtman, Dana Devine
  • $100,000 for Dr. Tsai and colleagues to test whether a new biomaterial can stimulate the brain’s own stem cells to repair damage after a stroke in animal models. Local co-investigators: Xudong Cao, Ruth Slack
  • $99,900 for Dr. Bernard Thébaud and colleagues to test umbilical cord blood cells called endothelial progenitor cells (EPCs) for treating high blood pressure in the lungs in experimental models. Local co-investigators: Dylan Burger

Dr. Christopher Tran, received the prize for Best Oral Presentation, New Investigator category at DIME’s Meridith Marks Day 2018, uOttawa.

Dr. Michael Rudnicki and his team have discovered a completely new function for the protein complex containing the dystrophin protein, which is missing in people with Duchenne muscular dystrophy. They found this complex brings two other proteins called p38gamma and Carm1 together in muscle stem cells, and this interaction establishes a genetic program that ultimately produces new muscle fibres. In laboratory models of Duchenne muscular dystrophy, this interaction never happens, so any new muscle fibres have a faulty genetic program. The new discovery is published in Cell Stem Cell. It builds on Dr. Rudnicki’s landmark discovery in 2015 showing that Duchenne muscular dystrophy directly affects muscle stem cells. “This research represents a profound new insight into Duchenne muscular dystrophy and brings us another step closer to developing new treatments for this devastating disease,” said Dr. Rudnicki. Authors: Natasha C. Chang, Marie-Claude Sincennes, Fabien P. Chevalier, Caroline E. Brun, Melanie Lacaria, Jessica Segalés, Pura Muñoz-Cánovez, Hong Ming, Michael A. Rudnicki.

The Ottawa Hospital and Algonquin College are expanding their collaboration on health research, innovation and training with the opening of “The Ottawa Hospital at Algonquin College.” The newly renovated space – located within part of Algonquin’s Applied Research and Innovation facilities – builds on a memorandum of understanding signed in 2016. It will serve as a hub for collaboration, particularly in digital and mobile health (mHealth). The Ottawa Hospital mHealth Lab, led by Dr. Kumanan Wilson, recently moved into the space in Algonquin’s F building. The 22-member team frequently collaborates with Algonquin’s Health and Wellness Research Centre. Kevin Holmes, Managing Director of the Centre, has also been appointed as an affiliate investigator at the Ottawa Hospital Research Institute.

A team led by Drs. Daniel McIsaac and Carl van Walraven has found a possible link between a commonly prescribed group of drugs and longer hospital stays after surgery for older patients. Anticholinergic drugs are a class of medication used to treat many conditions, such as allergies, heartburn, anxiety and depression. When the team looked at medical records of 245,000 Ontario surgery patients over age 66, about a third were taking least one of these drugs. Their study, published in Annals of Surgery, found that patients taking an anticholinergic drug spent a day longer in hospital after surgery on average compared to those who were not taking these drugs. However, the study shows an association, not cause and effect. Future research will test the feasibility and possible benefits of switching patients to alternative medications before surgery. Patients should always consult their physician before making medication changes. Authors: Daniel McIsaac, Coralie Wong, Deric Diep, Carl van Walraven

CIHR Operating Grant: Evaluating “High cost users’ inpatient care at the end of life: Patient characteristics, course of treatment, and involvement of palliative care”. Tanuseputro Peter (NPI). Co-PI: Isenberg S, McGrail K. Co-I’s: Kyeremanteng Kwadwo, Chan R, Goldman R, Hsu A, Husain A, Jakda A, Fowler R, Seow H. Funding granted: $70,000. March 1, 2018-February 28, 2019.

Dr. John Scott received the Lifetime Achievement Award from the Canadian Society of Palliative Care Physicians and also the Jack Aaron Award from The Ottawa Hospital.

MEDIA

  • Dr. Gonzalo Alvarez was interviewed by CBC News The National about the federal government’s commitment to eliminate tuberculosis in Inuit communities by 2030.
  • Dr. Kumanan Wilson was interviewed by Global News about a study that found parents of children with autism are less likely to get their children fully-vaccinated after the autism diagnosis.
  • Dr. Shawn Marshall was interviewed by the Ottawa Citizen and CFRA radio about provincial standards and clinical guidelines for concussion care that he helped lead.
  • Dr. Natasha Kekre was interviewed about “game-changing” cancer immunotherapy for a supplement in Maclean’s magazine. She spoke about The Ottawa Hospital’s role in developing made-in-Canada CAR-T therapy.
  • Dr. Guy Trudel was interviewed by the Ottawa Citizen and Seeker about his research into how weightlessness affects the bone marrow health of astronauts. Materials for the experiment will be sent up on the next SpaceX Dragon flight to the International Space Station. He was also interviewed by CBC about his research on the impact of running on bone marrow health.
  • Dr. Curtis Cooper was interviewed by the Ottawa Citizen about new provincial rules that mean all patients with hepatitis C will have access to new curative drugs. He also highlighted a unique program to screen and treat prison inmates for the disease.
  • Dr. Antoine Hakim was interviewed by Radio-Canada about how to recognize and react to a stroke and how to decrease the risk of dementia.
  • Dr. Shawn Marshall was interviewed by CTVNews about the increasing number of fatalities among seniors in car collisions, and a risk stratification tool his Candrive team is testing that can identify whether older people have sufficient cognitive ability to be safe drivers.
  • Dr. David Grimes was interviewed by Global News about the history and future of Parkinson’s disease research, including research on genetics, pesticides, dopamine, biomarkers and toxic proteins.
  • Drs. Mark Clemons and colleague were interviewed for the NatureJobs blog about spam email from predatory journals and conferences and strategies for dealing with these.
  • Dr. Swapnil Hiremath was interviewed for a video as part of Hypertension Canada’s ‘get down BP’ campaign to help people prevent and better control high blood pressure.