St. Michael&#039;s Hospital

Nutritional Sciences

Subheadline

“We hope our study will help people feel more comfortable including soy foods in their diet"

A study led by experts at the University of Toronto's Temerty Faculty of Medicine is providing reassuring evidence on consumption of soy foods during postmenopause.

In a systematic review and meta-analysis of 40 trials in over 3,000 participants, �鶹��Ƶ researchers gathered results on the effects of soy isoflavones – estrogen-like compounds naturally found in plants – on biological outcomes related to risk of endometrial and other female-related cancers.

Their results, published in Advances in Nutrition, found that isoflavones had no effect on key markers of estrogen-related cancers, supporting the safety of soy as a food as well as potential therapy.

“The risk of cardiovascular disease increases substantially as women* go through menopause, so soy can offer dual benefits during this particular phase of life,” says the study’s senior author Laura Chiavaroli, an assistant professor in Temerty's department of nutritional sciences and affiliate scientist at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital, Unity Health Toronto.

Assistant Professor Laura Chiavaroli (left) and PhD student Gabrielle Viscardi (supplied images)

Yet, Chiavaroli notes many people are hesitant to eat soy foods because they contain isoflavones, which have a similar structure to estrogen. In animal studies, large doses of isoflavones have been linked to a higher risk of cancer.

“Something we hear very often is that people have a lot of concern about consuming soy because there are so many conflicting messages out there,” says Gabrielle Viscardi, a second-year PhD student in the department of nutritional sciences and the study’s lead author.

This is despite the fact that several health advocacy groups, including the Canadian Cardiovascular Society, already recommend soy foods as part of a healthy diet. Health Canada and the U.S. Food and Drug Administration have both recognized soy – a high-quality and complete source of protein – as effective in reducing the risk of heart disease

Soy foods have also been shown to alleviate hot flashes associated with menopause, which affect many women and impact their quality of life.

The trials considered for the �鶹��Ƶ study followed postmenopausal women from around the world who had consumed either soy isoflavones or a non-isoflavone control for at least three months.

The researchers concluded that consumption of soy isoflavones did not affect the four key estrogen-related markers, namely: thickness of uterus lining, vaginal maturation index (a measure of estrogen status) and levels of circulating estrogen and follicle-stimulating hormone.

Their findings support the idea that soy isoflavones behave differently from human estrogen, particularly when it comes to cancers that depend on estrogen to develop. “We have estrogen receptors throughout our bodies but, contrary to the hormone estrogen, isoflavones from soy don’t bind to all the estrogen receptors equally,” says Viscardi, who is also a registered dietitian. “That’s why we see a beneficial effect on the cardiovascular system and no effect on the female reproductive system.”

This difference in biological activity explains why soy isoflavones have been considered as a possible alternative to hormone replacement therapy (HRT), which is used to treat menopause symptoms by replacing the estrogen that the body stops producing during this period.

Chiavaroli notes some people don’t want to take HRTs and are seeking alternative options.

Further, HRTs may also not be a good option for people at an increased risk of estrogen-sensitive cancers like breast cancer, as well as those with a history of heart disease and stroke. For these individuals, consuming soy foods as part of a balanced diet could help manage their menopausal symptoms while also reducing the risk of cardiovascular disease.

Chiavaroli says the study's findings also align with Health Canada’s dietary guidelines that encourage people to choose plant-based proteins more often, a move that would also convey benefits for the environment.

“We hope our study will help people feel more comfortable including soy foods in their diet without being concerned that it’s going to increase their risk of estrogen-dependent cancer,” says Chiavaroli.

The study was funded by the United Soybean Board (U.S. Department of Agriculture) and the Canadian Institutes of Health Research through the Canada-wide Human Nutrition Trialists’ Network.

* Although menopause is sex-specific, the study retains use of the term "women" as it is used conventionally in studies and guidelines on menopause

AI tool reduces risk of unexpected hospital deaths by 26 per cent: Study

Christopher.Sorensen — Mon, 23 Sep 2024 16:50:13 +0000

AI tool reduces risk of unexpected hospital deaths by 26 per cent: Study

Christopher.Sorensen Mon, 09/23/2024 - 12:50

Cutline

(photo by Tempura/Getty Images)

Adam Miller

Topic

Artificial Intelligence

Subheadline

CHARTWatch, an artificial intelligence early warning system developed at Unity Health Toronto, alerts physicians when hospital patients face a high risk of unexpected death or transfer to an ICU

A new study by Toronto researchers evaluates the use of CHARTWatch, an artificial intelligence early warning system developed at Unity Health Toronto that monitors hospitalized patients in real-time, identifies those at high risk of unexpected death or transfer to an intensive care unit, and alerts doctors and nurses to intervene early.

The study, published in the Canadian Medical Association Journal, shows a 26 per cent reduction in unanticipated mortality after the tool was implemented in the general internal medicine ward of Unity Health Toronto’s St. Michael’s Hospital.

“As AI tools are increasingly being used in medicine, it is important that they are evaluated carefully to ensure that they are safe and effective,” says lead author Amol Verma, general internist at Unity Health and professor in the department of medicine in the University of Toronto’s Temerty Faculty of Medicine who led the development and implementation of CHARTWatch.

Amol Verma (L) and Muhammad Mamdani (supplied images)

“Our findings suggest that AI-based early warning systems are promising for reducing unexpected deaths in hospitals.”

One of the primary sources of unplanned admission to the ICU is the unexpected deterioration of hospitalized patients, which prompted the research team to develop this AI tool and study its effectiveness.

“This important study evaluates the outcomes associated with the complex deployment of the entire AI solution, which is critical to understanding the real-world impacts of this promising technology,” says study co-author Muhammad Mamdani, vice president of data science and advanced analytics at Unity Health and director of �鶹��Ƶ’s Temerty Centre for Artificial Intelligence Research and Education in Medicine.

“We hope other institutions can learn from and improve upon Unity Health Toronto’s experiences to benefit the patients they serve.”

The study analyzed data from 13,649 patients aged 55 to 80 years old admitted to the general internal medicine unit (9,626 in the pre-intervention period and 4,023 using CHARTWatch) and 8,470 admitted to subspeciality units that did not use CHARTWatch.

Helping to prioritize patient needs

“The CHARTWatch project started at Unity Health when we asked patients, clinicians, hospital leaders, what would you want to use artificial intelligence for? If you could predict one thing that AI would tell you, what should that be?” says Verma, who is also the Temerty Professor of AI Research and Education in Medicine.

“And one of the leading priorities of everyone was to be able to predict in advance which patients might become so sick in hospital that they need ICU or might die.”

During the 19-month-long intervention period, 482 patients in the general internal medicine became high-risk, compared with 1,656 patients who became high risk in the 43-month-long pre-intervention period. There were also fewer non-palliative deaths in the CHARTWatch group than in the pre-intervention group (1.6 per cent versus 2.1 per cent).

“If I were a patient, I would be so relieved to know that we have this kind of system,” said co-author Yuna Lee, division head and general internist at St. Michael’s and professor in the department of medicine at �鶹��Ƶ.

“So, when the patient gets a high-risk alert, they’re going to be assessed by senior staff right away. Also, they’re going to have quite close monitoring by nursing staff, so they check on them every one to two hours.”

Expanding the impact of CHARTWatch

CHARTWatch inputs more than 100 aspects of a patient’s medical history and current health status that are routinely stored in the hospital’s electronic medical record. It analyzes the interactions between these inputs and how they change over time. With that information, it’s able to categorize each patient by their risk for deterioration and send an alert to prioritize treatment.

The study is one of the first to evaluate how CHARTWatch can benefit hospital patients in Canada and shows the potential real-world impact of AI on the health-care sector. Damian Jankowicz, Unity Health’s vice-president and chief information and AI officer, says he hopes AI tools such as CHARTWatch will continue to have a profound impact on patients.

“Hopefully with reduced administrative burden on our providers, they will have more time to spend with our patients and really focus on the patient needs,” he says.

“I hope that AI will be able to distill the incredible amounts of information that’s coming at our clinicians into important components and really bring their clinical judgment to the forefront.”

This story first was first published by Unity Health.

Mpox DNA can persist in the body for up to four weeks: Study

rahul.kalvapalle — Tue, 12 Mar 2024 20:04:03 +0000

Mpox DNA can persist in the body for up to four weeks: Study

rahul.kalvapalle Tue, 03/12/2024 - 16:04

Cutline

A sign containing information about monkeypox is seen in International Airport Treviso A. Canova, in Treviso, Italy, on Nov. 30, 2022 (photo by Manuel Romano/NurPhoto via Getty Images)

Betty Zou

Topic

Institutional Strategic Initiatives

EPIC

ihpme

Sunnybrook

Subheadline

The study is one of several projects supported by the mpox rapid research response launched by �鶹��Ƶ's Emerging and Pandemic Infections Consortium (EPIC) and its hospital partners

DNA from the mpox virus can be found in different parts of the body for up to four weeks after symptom onset, according to a study led by researchers at Unity Health Toronto, the Sunnybrook Research Institute and the University of Toronto.

The researchers analyzed samples from 64 men who contracted mpox, including participants from the Mpox Prospective Observational Cohort Study led by Darrell Tan, an infectious disease physician at St. Michael’s Hospital, part of Unity Health Toronto – where some of Toronto’s first patients with mpox were identified and cared for – and associate professor in the department of medicine and the Institute of Medical Science at �鶹��Ƶ's Temerty Faculty of Medicine and in the Institute of Health Policy, Management and Evaluation (IHPME) at the Dalla Lana School of Public Health.

They found that persistence of mpox virus DNA varied depending on where the samples were taken from. Among the key findings was that the DNA was detectable in nearly half of genital skin swabs and one in five skin swabs from other sites a week after symptoms had resolved.

The study, which was published in Open Forum Infectious Diseases, is one of several projects supported by the mpox rapid research response launched by the Emerging and Pandemic Infections Consortium (EPIC), an institutional strategic initiative, and its hospital partners during the global outbreak of mpox – previously known as monkeypox – in 2022.

According to the World Health Organization, nearly 94,000 confirmed cases of mpox, including 179 deaths, have been reported from 117 countries since January 2022. As of September 2023, 1,515 cases have been confirmed in Canada, mostly in Ontario and Quebec.

“Even though we’ve known about mpox for over 70 years, it was new to us because we hadn’t seen it outside the endemic regions,” said Robert Kozak, one of the study’s authors and a clinical microbiologist at Sunnybrook Research Institute and assistant professor in the department of laboratory medicine and pathobiology at Temerty Medicine. “There was still a lot about the virus and disease that we didn’t know,”

To answer key questions about viral shedding, Kozak teamed up with Tan and Sharmistha Mishra, an infectious disease physician at St. Michael’s Hospital and associate professor in the Temerty Faculty of Medicine’s department of medicine and Institute of Medical Science and IHPME.

(L-R) Robert Kozak, Sharmistha Mishra and Darrell Tan (supplied images)

The researchers used a technique called quantitative polymerase chain reaction (qPCR) to determine the persistence of mpox virus DNA. Samples were taken from six different sites on the body — genital region, nasal cavity, semen, skin, throat and urine — and over an extended period of time.

On average, mpox DNA was detected in skin swabs from the genital and perianal region and from other skin sites at 30 and 22 days after symptom onset, respectively. These findings are consistent with the sexually transmitted nature of mpox during the recent global epidemic, which primarily affected gay, bisexual and men who have sex with men.

The researchers were unable to detect viral DNA in a large proportion of semen samples and nasal cavity swabs taken when individuals first presented with symptoms, whereas in urine and throat swab samples, mpox DNA persisted for roughly two weeks after symptom onset.

Interestingly, the researchers did not observe a difference in the length of viral DNA persistence between people who received the antiviral drug tecovirimat and those who did not. Tan noted that while study participants were not randomly assigned to receive the drug, these results underscore the uncertainty around tecovirimat’s effectiveness in treating mpox infections.

He added the study provides several key learnings for his clinical colleagues. “First, we’ve documented the breadth of clinical samples in which mpox DNA can be identified and therefore can be used to confirm a diagnosis. Our findings also reinforce that it’s worthwhile for clinicians to collect such samples in individuals where an mpox diagnosis is being considered, even after symptoms of feeling unwell are gone," Tan said.

The researchers caution that just because mpox DNA can be detected up to four weeks after symptom onset, it doesn’t mean that individuals are infectious for that long.

“We don’t know for sure whether the presence of detectable viral DNA necessarily means that the virus is transmissible to other people, so more research definitely needs to be done to determine definitively the period of infectiousness,” Tan said.

To that end, Jacklyn Hurst, a postdoctoral fellow in Kozak’s lab, recently started work in the Toronto High Containment Facility to look for live virus in the same samples from which mpox DNA was detected. The researchers are also using the facility’s biobank of mpox patient samples to identify biomarkers that could predict whether a person will have a mild or severe infection.

“Without the Toronto High Containment Facility, we wouldn’t be able to do any of this. Having that facility will help us answer a lot of questions about this virus and how to stop it,” said Kozak.

He acknowledged the immense contributions of the patient community to this work. “A huge thank you to all the study participants. We wouldn’t be able to do this work without their sacrifice and commitment.”

Geoffrey Hinton tops Toronto Life's list of most influential people

Christopher.Sorensen — Tue, 21 Nov 2023 19:42:00 +0000

Geoffrey Hinton tops Toronto Life's list of most influential people

Christopher.Sorensen Tue, 11/21/2023 - 14:42

Cutline

(photo by Polina Teif)

Topic

Scarborough Academy of Medicine and Integrated Health

Faculty of Arts & Science

�鶹��Ƶ

Artificial Intelligence

Computer Science

Faculty of Law

Geoffrey Hinton

Rotman School of Management

Toronto Life

�鶹��Ƶ Mississauga

�鶹��Ƶ Scarborough

Subheadline

Hinton among several �鶹��Ƶ community members highlighted by the magazine

Geoffrey Hinton, a University Professor emeritus of computer science at the University of Toronto and the “godfather of AI”, has been ranked the most influential of 2023 by Toronto Life magazine.

After Hinton announced he was leaving his job at Google to warn the world about the existential threat of AI earlier this year, the magazine reports he received more than 1,000 interview requests about the future of the tech he helped create.

Prime Minister Justin Trudeau invited Hinton to dinner to discuss what Canada should do about AI and he fielded calls from the White House and 10 Downing Street.

“When he speaks, everyone pays attention,” writes Toronto Life, which also published an in-depth profile of Hinton.

Hinton was one of more than 15 �鶹��Ƶ alumni, faculty and community members that made the magazine’s annual list of movers and shakers.

Others include: Tiff Macklem, governor of the Bank of Canada and former dean of the Rotman School of Management; Ilya Sutskever, an alumnus and co-founder of OpenAI; Gregg Lintern, retiring Toronto chief planner and �鶹��Ƶ alumnus; Anita Anand, Treasury Board president and a professor in the Faculty of Law (on leave); James Maskalyk, an emergency doctor at St. Michael’s Hospital, Unity Health, and a faculty member in the Temerty Faculty of Medicine; Raquel Urtasun, CEO of self-driving truck startup Waabi and a professor of computer science; Leigh Chapman, Canada’s chief nursing officer and �鶹��Ƶ alumna; Sam Ibrahim, an entrepreneur and philanthropist who is a major supporter of �鶹��Ƶ Scarborough; and Carlo Fidani, a businessman, philanthropist and �鶹��Ƶ honorary degree-holder who has supported the Mississauga Academy of Medicine at �鶹��Ƶ Mississauga and whose Orlando Corporation has made a major investment in the Scarborough Academy of Medicine and Integrated Health (SAMIH).

Members of the �鶹��Ƶ community were also featured in the magazine’s list of rising stars, published in the same issue.

Read the full list in Toronto Life

Why is COVID-19 more severe in some people? Researchers use genetics, data science to find out

Christopher.Sorensen — Wed, 25 Oct 2023 14:08:53 +0000

Why is COVID-19 more severe in some people? Researchers use genetics, data science to find out

Christopher.Sorensen Wed, 10/25/2023 - 10:08

Cutline

(Photo by Cole Burston/AFP/Getty Images)

Tyler Irving

Topic

Institutional Strategic Initiatives

COVID-19

Data Sciences Institute

Princess Margaret Cancer Centre

Sinai Health

Sunnybrook Health Sciences Centre

Computer Science

Faculty of Arts & Science

Hospital for Sick Children

Mount Sinai Hospital

University Health Network

Statistical Sciences

Women's College Hospital

Subheadline

With the help of �鶹��Ƶ's Data Sciences Institute, researchers from the university and partner hospitals gathered more than 11,000 full genome sequences from across Canada

Why do some people have a more severe course of COVID-19 disease than others? A genome sequence database created by an international collaboration of researchers, including many from the University of Toronto and partner hospitals, may hold the answers to this question – and many more.

The origins of the Canadian COVID-19 Human Host Genome Sequencing Databank, known as CGEn HostSeq, can be traced to the earliest days of the pandemic.

Lisa Strug, senior scientist at The Hospital for Sick Children (SickKids) and academic director of �鶹��Ƶ’s Data Sciences Institute, one of several �鶹��Ƶ institutional strategic initiatives, says genetic data was top of mind for her and other researchers in late 2019 and early 2020 as reports of a novel form of coronavirus emerged from China and then other locations across the globe.

Lisa Strug (Photo courtesy The Hospital for Sick Children)

“In my research, I use data science techniques to map the genes responsible for complex traits,” says Strug, who is a professor in �鶹��Ƶ’s departments of statistical sciences and computer science in the Faculty of Arts & Science and in the biostatistics division of the Dalla Lana School of Public Health.

“We knew that genes were a factor in the severity of previous SARS infections, so it made sense that COVID-19, which is caused by a closely related virus, would have a genetic component, too.

“Very early on, I started getting messages from several scientists who wanted to set up different studies that would help us find those genes.”

Over the next few months, Strug – who is also the associate director of SickKids’ Centre for Applied Genomics, one of three sites across Canada that form CGEn, Canada’s national platform for genome sequencing infrastructure for research – collaborated with nearly 100 researchers from across �鶹��Ƶ and partner hospitals and institutions, as well as other researchers from across Canada to enrol individuals with COVID-19 and sequence their genomes.

Some of the key team members from the Toronto community included:

Stephen Scherer, chief of research at SickKids Research Institute and a University Professor in �鶹��Ƶ’s Temerty Faculty of Medicine, as well as director of the �鶹��Ƶ McLaughlin Centre
Rayjean Hung, associate director of population health at the Lunenfeld-Tanenbaum Research Institute, Sinai Health, and a professor in �鶹��Ƶ’s Dalla Lana School of Public Health
Angela Cheung, clinician-scientist at University Health Network, senior scientist at Toronto General Hospital Research Institute and a professor in �鶹��Ƶ’s Temerty Faculty of Medicine
Upton Allen, head of the division of infectious diseases at SickKids and a professor in �鶹��Ƶ’s Temerty Faculty of Medicine

The projected was initiated by Scherer and CGEn’s Naveed Aziz, along with Strug, and a $20-million grant was secured from Innovation, Science and Economic Development Canada, administered through Genome Canada.

“We had to go right to the top to get this project funded fast and our labs and teams worked seven days a week on the project right through the pandemic,” Scherer recalls.

Identifying associations between individual genes and complex traits typically requires thousands of genomes – both from those with the trait and those without. Though there was no shortage of cases to choose from, it was critical to gather and sequence DNA – and then organize the data in a way that would be ethical, efficient and useful to researchers now and in the future.

“One of our key mandates at the Data Sciences Institute is developing techniques and programs that ensure that data remains as open, accessible and as re-producible as it can be,” Strug says.

“That vision was brought to bear as we assembled the data infrastructure for this project – for example, ensuring that consent forms were as broad as possible so that this data could be linked with other sources, from electronic medical records to other health databases.

“We wanted to be sure that even after the COVID-19 pandemic was over this could be a national whole genome sequencing resource to ask all kinds of questions about health and our genes. The development of the database and its open nature also enabled Canada to collaborate effectively with similar projects in other countries.”

Partner hospitals and institutions:

The Hospital for Sick Children (SickKids)
Lunenfeld-Tanenbaum Research Institute, Sinai Health
Mount Sinai Hospital, Sinai Health
St Michael’s Hospital, Unity Health Toronto
University Health Network (UHN)
Princess Margaret Cancer Centre, UHN
Ontario Institute for Cancer Research
Women’s College Hospital
Toronto General Hospital, UHN
Baycrest Health Sciences

In the end, the project gathered more than 11,000 full genome sequences from across Canada, representing patients with a wide range of health outcomes. Those data were then combined with even more sequences from patients in other countries under what came to be called the COVID-19 Host Genetics Initiative.

It didn’t take long for patterns to start to emerge. A paper published in Nature in 2021 identified 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19.

Since then, even more data have been added, and subsequent analysis has confirmed the significance of existing loci while also identifying new ones. The most recent update to the project, published in Nature earlier this year, brings the total number of distinct, genome-wide significant loci to 51.

“Identification of these loci can help one predict who might be more prone to a severe course of COVID-19 disease,” says Strug.

“When you identify a trait-associated locus, you can also unravel the mechanism by which this genetic region contributes to COVID-19 disease. This potentially identifies therapeutic targets and approaches that a future drug could be designed around.”

While it will take many more years to fully untangle the effects of the different loci that have been identified, Strug says that the database is already showing its worth in other ways.

“It can be difficult to find datasets with whole genome sequence and approved for linkage with other health information that are this large, and we want people to know that it is open and available for all kinds of research well beyond COVID through a completely independent data access committee,” she says.

“For example, several investigators from across Canada have been approved to use these data and we’ve even provided funding to trainees to encourage them to develop new data science methodologies or ask novel health questions using the CGen HostSeq data.”

“This was a humongous effort, where researchers from across Canada came together during the COVID-19 pandemic to recruit, obtain and sequence DNA from more than 11,000 Canadians in a systematic, co-operative, aligned way to create a made-in-Canada data resource that will hopefully be useful for years to come. I think that was really miraculous.”

Research may explain why men are more likely to experience severe cases of COVID-19

Christopher.Sorensen — Tue, 03 Oct 2023 15:11:29 +0000

Research may explain why men are more likely to experience severe cases of COVID-19

Christopher.Sorensen Tue, 10/03/2023 - 11:11

Cutline

Haibo Zhang, a researcher at Unity Health Toronto and �鶹��Ƶ, led pre-clinical research that suggests why males are more likely to experience worse outcomes from COVID-19, opening the door to potential new treatments (photo by Julia Soudat)

Betty Zou

Topic

Emerging and Pandemic Infections Consortium

Institutional Strategic Initiatives

Sinai Health

Sunnybrook Health Sciences

Hospital for Sick Children

Graduate Students

University Health Network

Subheadline

Pre-clinical study points to ACE2 protein as a key contributor to the differences in COVID-19 outcomes between males and females

A new study by a team of researchers at the University of Toronto’s Emerging and Pandemic Infections Consortium (EPIC) has uncovered biological reasons underlying sex differences in COVID-19 outcomes, offering a promising new strategy to prevent illness.

The pre-clinical research, published in the journal iScience, has yet to be replicated in humans, but points to the ACE2 protein as a key contributor to differences in COVID-19 outcomes between males and females.

During the early days of the pandemic, clinicians noticed that males were more likely than females to be hospitalized or admitted to the ICU or to die from COVID-19 despite having similar infection rates.

This pattern held true across all age groups and in countries around the world.

“COVID-19 severity and mortality are much higher in males than in females, but the reasons for this remain poorly understood,” says study senior author Haibo Zhang, a staff scientist in the Keenan Research Centre for Biomedical Science at St. Michael’s Hospital, Unity Health Toronto, and a professor of anesthesiology and pain medicine, and physiology in �鶹��Ƶ’s Temerty Faculty of Medicine.

“That was the driving force for our work.”

The study was a collaborative effort through EPIC, a �鶹��Ƶ institutional strategic initiative that involves five hospital research partners – the Hospital for Sick Children (SickKids) Research Institute, Lunenfeld-Tanenbaum Research Institute at Sinai Health, Sunnybrook Research Institute, Unity Health Toronto and the University Health Network (UHN) – to facilitate an integrated and innovative response to high-risk, high-burden infectious diseases.

From left: PhD student Jady Liang, co-lead author of the study and Professor Haibo Zhang (photos supplied)

Located on the cell’s outer surface, ACE2 plays an important role in controlling blood pressure and inflammation and protecting organs from damage caused by excess inflammation. During a SARS-CoV-2 infection, the coronavirus spike protein locks on to ACE2 to enter the cell.

The gene encoding the ACE2 protein is located on the X chromosome, which means that females have two copies of the gene and males only have one.

In times of health, the extra copy of the gene for ACE2 doesn’t appear to make a difference – Zhang and his team found similar levels of ACE2 protein in healthy males and females.

Following a SARS-CoV-2 infection, however, they observed a dramatic decrease in ACE2 in males while levels remained consistent in females, suggesting that the additional copy of the ACE2 gene on the X chromosome is helping to compensate and maintain high protein levels in females.

The changes in ACE2 levels were also correlated with a drop in estrogen hormone signalling in males, which could also contribute to the sex-specific differences in COVID-19 outcomes.

To test whether low levels of ACE2 were responsible for the more severe outcomes seen in males with COVID-19, the researchers devised a therapeutic approach using an inhaler to deliver lab-made ACE2 proteins directly into the lungs. Males who received a daily puff of ACE2 after SARS-CoV-2 infection had less virus in their lungs, less lung injury and higher levels of estrogen signalling.

Together, these results paint a clearer picture of how the extra copy of the ACE2 gene and higher estrogen levels in females work together to protect them from experiencing more severe COVID-19.

“A common misconception is that an increased presence of ACE2 receptors would result in a higher infection rate,” says Zhang.

“However, the enhanced activation of ACE2 in females actually serves as a compensatory mechanism during infection that’s aimed at safeguarding the lungs and other vital organs from potential damage.”

In males who lack the second copy of the gene, much of the existing ACE2 gets co-opted by SARS-CoV-2 during an infection. As a result, there is not enough of the protein to fulfil its usual functions of tamping down inflammation and preventing organ damage.

The extra dose of ACE2 delivered by inhaler serves as a decoy to glom onto the coronavirus, thereby preventing it from entering cells while also keeping the native ACE2 proteins free to exert protective effects.

Beyond the thrill of discovery, Zhang says he is excited by the potential implications of these findings, which are the first to demonstrate the effectiveness of inhaling ACE2, on preventing and treating COVID-19 in humans.

He imagines a scenario where people who are entering high-risk situations – boarding an airplane or attending a large in-person conference, for example – might take a puff of ACE2 to protect their lungs from the virus. Similarly, the treatment could also be given to people after infection to reduce the risk of hospitalization and death.

“By using the inhaler, ACE2 remains in the lungs at a sustained, low concentration over an extended period, where it can neutralize the virus even before it enters into our cells. We anticipate that our research will motivate individuals to contemplate this faster and more efficacious strategy for both prevention and treatment of COVID-19 in humans,” says Zhang.

Zhang worked with fellow researchers Samira Mubareka (Sunnybrook, Temerty Faculty of Medicine), Theo Moraes (SickKids, Temerty Faculty of Medicine) and Mingyao Liu (UHN, Temerty Faculty of Medicine). Much of their work took place in the Toronto High Containment Facility (THCF), which is the only containment level 3 research lab in the Greater Toronto Area and the largest in the province.

Having access to the THCF allowed Zhang and his team to pivot quickly during the early months of the pandemic and apply their expertise in lung physiology and disease to answering rapidly emerging questions about COVID-19.

Jady Liang, the co-lead author of the new study, had just started her PhD with Zhang when the pandemic started. She recalls the stress and intensity of training and working in the THCF during that time but credits EPIC staff and other THCF users with helping her become comfortable with the processes and protocols.

“It was a lot of hard work from everyone on the team during the pandemic, especially during the first wave,” says Liang, who is now a fourth-year PhD student in the department of physiology.

“We need a lot of people with expertise in different fields to work together so that we can advance and be prepared for the next pandemic.”

The study received support from the Canadian Institutes of Health Research, among others.

Researcher develops kidney stone ‘vacuum’

Christopher.Sorensen — Mon, 27 Mar 2023 14:56:03 +0000

Researcher develops kidney stone ‘vacuum’

Christopher.Sorensen Mon, 03/27/2023 - 10:56

Cutline

Monica Farcas, a surgeon-investigator at St. Michael’s Hospital and a �鶹��Ƶ assistant professor of urology, led the development of a device that can vacuum up remaining bits of kidney stones (photo courtesy of St. Michael's Foundation)

Erin Howe

Topic

A Toronto researcher has developed a new tool to remove kidney stone fragments left over after laser surgery and is working to bring the invention to market with support from a new entrepreneurship program.

“Kidney stones can be life-altering – some people place their lives on hold [and] they worry about a potential kidney stone attack, which can be unexpected,” says Monica Farcas, a surgeon-investigator at St. Michael’s Hospital, Unity Health Toronto, and an assistant professor of urology in the University of Toronto’s Temerty Faculty of Medicine. “It’s common for people who experience kidney stones to visit the emergency room dozens of times over the course of their lives with a kidney stone attack.”

One in 10 people in Canada experiences kidney stones. The symptoms are sudden and debilitating, and laser surgery is a common treatment. Surgeons break the stones up and remove most of the pieces after laser surgery, but when remaining bits fail to pass through a person’s urine, they can develop into larger stones or harbor bacteria that lead to repeated urinary tract infections.

A researcher at Unity Health’s Li Ka Shing Knowledge Institute who holds the Agnico Eagle Chair in Endourology and Minimally Invasive Urology, Farcas led the creation and development of a device that can be inserted into a patient’s kidney to vacuum out any remaining bits of stone. In the long term, patients are less likely to need follow-up care or to visit the emergency room.

Farcas says there were significant challenges in designing the device since instruments used in these types of procedures need to be tiny and can’t disrupt the kidney in any way. She and her team built a prototype and are testing and improving the device.

Farcas received support along the way from the Temerty Medicine’s Entrepreneur in Residence (EiR) program. It launched as a pilot last year with funding from James and Louise Temerty and the Temerty Foundation, and continues to be a resource for Temerty Medicine-affiliated faculty.

“Physicians are generous with their knowledge and want to find the best solutions for their patients, colleagues and the broader population. The Temerty EiR program fosters an entrepreneurial culture to help them improve human health through commercialization,” says Jarrod Ladouceur, the faculty’s industrial partnerships officer.

Farcas is among the first cohort of entrepreneurs in the EiR program. Participants gain access to a team of seven entrepreneur-advisers, staff support and help for crafting pitches to bring new health-care devices and technology to market.

The program also provides seed funding to help participants with expenses related to early-stage milestones such as hiring a lawyer to assist with contract reviews.

For many clinicians, it can be difficult to find time for mentorship and learning opportunities, but Farcas says she was able to tailor the experience to suit her busy schedule.

“My mentors have been instrumental in showing me how to think about a customer base, learn about intellectual property and patents and better understand which projects to focus on,” says Farcas, who studied engineering before she entered medicine and holds several patents in surgical innovation.

“I’ve got lots of clinical and research experience, but talking to someone who sees things from a business perspective has been tremendously helpful,” she says.

Farcas also credits the EiR program with helping her in the most recent Angels’ Den Pitch Competition at St. Michael’s Foundation last November – her second time before the judges and jury. Farcas’s pitch earned her one of the event’s three prizes, the Keenan Award for Medical Discovery, which includes $150,000 to support the next steps in developing the surgical tool.

�鶹��Ƶ Entrepreneurship Week 2023: Top 10 startups to watch

Christopher.Sorensen — Thu, 02 Mar 2023 16:01:59 +0000

�鶹��Ƶ Entrepreneurship Week 2023: Top 10 startups to watch

Christopher.Sorensen Thu, 03/02/2023 - 11:01

Cutline

(supplied images)

Mariam Matti

Topic

Black Founders Network

Entrepreneurship Week

Faculty of Arts & Science

Entrepreneurship

Faculty of Kinesiology & Physical Education

Leslie Dan Faculty of Pharmacy

Psychology

Self-Driving Cars

Startups

�鶹��Ƶ Mississauga

�鶹��Ƶ Scarborough

A plant-based alternative to conventional plastic. Using drones to tackle reforestation in wildfire-ravaged locations. And a new generation of self-driving technologies that leverage the full potential of artificial intelligence.

These are just some innovative ideas that have emerged from the University of Toronto’s entrepreneurship community in recent years.

Ranked one of the top five university business incubators in the world, �鶹��Ƶ Entrepreneurship is set to celebrate these and other startups, as well as their founders, during its annual �鶹��Ƶ Entrepreneurship Week from March 6 to 9. The schedule includes pitch competitions, workshops, panel discussions and the popular True Blue Expo, which will feature the founders of more than 40 of �鶹��Ƶ’s top startups.

Another highlight: Raquel Urtasun, founder and CEO of Waabi and a �鶹��Ƶ professor of computer science, will discuss lessons learned while building her self-driving vehicle company at the Desjardins Speakers Series on March 9.

Here are 10 exciting �鶹��Ƶ startups to keep an eye on in 2023:

Arma Biosciences

The ability to give patients agency over their own health monitoring was one of the reasons Surath Gomis co-founded Arma Biosciences. The startup’s goal is to develop a new sensor technology for biomarker-informed digital health care. In partnership with Analog Devices, work on the company’s first product is underway – a handheld finger-prick blood test for patients with heart failure.

With a PhD in electrical and computer engineering from �鶹��Ƶ, Gomis established the company in 2020 with his supervisor Shana Kelley, a researcher in �鶹��Ƶ’s Leslie Dan Faculty of Pharmacy and Temerty Faculty of Medicine.

Gomis hopes future products will include wearable, implantable and ingestible sensors for monitoring applications.

Erthos

�鶹��Ƶ alumnae Nuha Siddiqui and Kritika Tyagi are working to transform the plastic industry for the better. In 2018, the pair co-founded Erthos, a company that offers fully biodegradable plant-based material as a replacement for single-use plastics.

Erthos creates resins using materials that are both compostable and microplastic-free – and compatible with existing manufacturing technology. Siddiqui and Tyagi recently made the Forbes list of 30 under 30 in the social impact category, which noted that Erthos has raised more than US$5.5 million in funding.

TransCrypts

Ali Zaheer and Zain Zaidi co-founded TransCrypts to transform digital privacy and security. Back in 2020, they set out to answer a simple question: “Why can’t consumers own their important documentation digitally and in a way that can be easily verified?”

TransCrypts – which took home a $10,000 second-place startup prize at a �鶹��Ƶ pitch competition during last year’s Entrepreneurship Week – is a blockchain-based document verification platform that gives people direct access to their official documents, such as medical records. Supported by �鶹��Ƶ Scarborough’s The Hub, Zaheer and Zaidi have already helped thousands of Ukrainian refugees access medical records through a pilot project and landed US$2.4 million in funding from backers including Shark Tank investor Mark Cuban.

Waabi

A world-leading expert in machine learning and computer vision, Raquel Urtasun was inspired to start Waabi when she recognized a need for a new generation of self-driving technologies that leverage AI’s full potential. Backed by high-profile investors, including Volvo and Uber, the company is leading the way when it comes to the next generation of self-driving solutions.

The company recently launched Waabi World, an advanced simulator to test its autonomous vehicles, and Waabi Driver, its first generation of self-driving trucks. Urtasun says she focused on the long-haul trucking sector because it’s one of the most dangerous occupations – not to mention an industry that suffers from a shortage of drivers.

WooYourBoo

Husband-and-wife co-founders La Vance and Colleen Dotson – head coach of the �鶹��Ƶ Track & Field Club – are the entrepreneurial force behind a slick dating app for people already in relationships.

WooYourBoo aims to help partners reconnect and better communicate with each other through quizzes, activities and rewards.

“Our goal is to create depth and help you reconnect with this person that you’ve committed to – and make it fun,” Colleen recently told �鶹��Ƶ News.

The Dotsons say that �鶹��Ƶ’s Black Founders Network was instrumental in building WooYourBoo, which was among the inaugural cohort of the BFN Accelerate Program.

OTI Lumionics

OTI Lumionics could change the look of the smartphone in your pocket.

Founded by �鶹��Ƶ alumnus Michael Helander, the company has been working on expanding its line of organic LED technology solutions – including smartphone screens that are uninterrupted by notches, which are currently needed to house front-facing cameras and other equipment in some smartphone designs.

The company, which was spun out of research at �鶹��Ƶ, has collaborated with Microsoft Quantum and, most recently, their name has been connected to Apple as a key supplier for a future notch-free iPhone.

Flash Forest

Flash Forest, a startup with ties to �鶹��Ƶ Mississauga, is fighting climate change and restoring forests by leveraging the use of drones, AI, geographic information systems and plant science technology.

The company – which received support from �鶹��Ƶ’s Mississauga’s ICUBE incubator – recently inked a federal contract to use drones to plant more than one million trees over the next two years in wildfire-ravaged locations across Canada.

The co-founders, brothers Bryce and Cameron Jones, say they are focused on restoring severe wildfire sites where the seed pods and cones are lost.

Signal 1

Signal 1 is looking to transform health care by equipping doctors and nurses with real-time AI predictions.

The company, co-founded by CEO Tomi Poutanen, a �鶹��Ƶ alumnus, and Mara Lederman, professor of strategic management at the Rotman School of Management, has built a machine learning tool called CHARTWatch that can help predict how much support a patient will need.

The tool was originally developed at St. Michael’s Hospital by a team led by Signal 1's clinical adviser Muhammad Mamdani, who is vice-president of data science and advanced analytics at Unity Health Toronto and holds cross-appointments at �鶹��Ƶ’s Leslie Dan Faculty of Pharmacy, Temerty Faculty of Medicine and Dalla Lana School of Public Health.

The surgical unit at St. Michael’s Hospital has already begun using CHARTWatch to help care teams communicate and make decisions.

Mounib Real Food Only

When �鶹��Ƶ Scarborough alumna Iman Mounib encountered gut health issues, she took it upon herself to create products that are free of refined sugars, palm oils, gluten and dairy.

She founded Mounib Real Food Only, which sells a chocolate hazelnut spread made of just three local ingredients. The company also makes a peanut chocolate spread, as well as an almond chocolate version. Mounib’s goal was to create alternatives to popular products that are both tasty and good for you.

The products are sold in almost 20 restaurants, cafes and stores in the Greater Toronto Area, as well as one location in Ottawa.

HippoCamera

HippoCamera is a smartphone application that helps to improve memory recall, which could be beneficial for individuals in the early stages of Alzheimer’s disease or other forms of memory impairment.

Backed by years of research at �鶹��Ƶ, the app has an easy-to-use interface and is a personalized way to boost recall of daily experiences and enhance activity in the hippocampus, a part of the brain that plays a key role in memory.

Morgan Barense, a professor in the department of psychology in the Faculty of Arts & Science and co-author of a recent study on the technology, said her team found that memories that were associated with the HippoCamera were long-lasting – and that the device worked for both healthy older adults and those starting to show cognitive decline.

Learn more about U of Entrepreneurship Week

Two of Canada’s first Black doctors commemorated: Toronto Star

bresgead — Tue, 14 Feb 2023 16:42:59 +0000

Two of Canada’s first Black doctors commemorated: Toronto Star

bresgead Tue, 02/14/2023 - 11:42

Cutline

(Steve Russell/Toronto Star via Getty Images)

Topic

�鶹��Ƶ

Black History Month

The University of Toronto’s Temerty Faculty of Medicine and Heritage Toronto recently co-presented two commemorative plaques celebrating two of Canada’s first Black doctors – Alexander Augusta and Anderson Abbott – at Seeley Hall, the Toronto Star reports.

The plaques, set to be installed in May, are intended to “take a step towards equity,” Nav Persaud told the newspaper. A staff physician at St. Michael’s Hospital and an assistant professor in the department of family and community medicine in the Temerty Faculty of Medicine, Persaud co-authored a paper in the Canadian Medical Education Journal last year examining the legacies of Augusta and Abbott and calling for the 19th-century physicians to be included in medical curricula to teach trainees about the history of racism in medical schools and how that contributes to modern-day health disparities.

Rejected by U.S. medical schools, Augusta became the first Black medical student in Canada West when he was granted admission to �鶹��Ƶ’s Trinity College in the early 1850s. After receiving his degree in 1860, Augusta worked for several years as a physician in Toronto before returning to the U.S. to serve in the Civil War, becoming the first African-American surgeon in the Union Army. Abbott, one of Augusta’s mentees, earned his medical licence in 1861, becoming the first Canadian-born doctor of African descent.

Study finds lethality of air pollution in India may be overestimated

Christopher.Sorensen — Tue, 18 Oct 2022 14:12:10 +0000

Study finds lethality of air pollution in India may be overestimated

Christopher.Sorensen Tue, 10/18/2022 - 10:12

Cutline

India has among the highest levels of air pollution in the world, but researchers have found that its impact on mortality rates in the country has been overstated (photo by Peter Adams/Getty Images)

Heidi Singer

Topic

Global

India