Dairy products, like milk and yogurt, are packed with important nutrients that support health. However, we don’t yet know the long-term health effects of regularly consuming these dairy products among young adults. In this study, we will examine the impact of daily milk or yogurt consumption over a two-year period on bone health in young Canadian adults. To explore this, we will recruit participants with low calcium intake and split them into three groups. One group will drink milk, another will eat yogurt, and the third group will continue with their regular diets. Over 24 months, the milk group will drink about 1.5 servings (375 mL) of milk daily and the yogurt group will eat 2 servings (350 g) of yogurt daily. We will measure the effects on bone health and hormone. The results will help us create better dietary recommendations to benefit bone health and prevent osteoporosis in later adulthood.

Our project aims to develop a practical toolkit to promote inclusion, diversity, equality, and accessibility (IDEA) within clinical trials. Historically, clinical trials have lacked diversity, leading to gaps in understanding treatments’ effectiveness across different demographics and perpetuating health disparities. Our toolkit will provide researchers with resources and guidance to address IDEA considerations effectively, ultimately enhancing trial outcomes for diverse populations. The toolkit will: Raise awareness about IDEA’s importance in clinical trials. Provide practical resources for integrating IDEA considerations into trial design, implementation, and reporting. Promote evidence-based strategies for enhancing IDEA. Foster collaboration among researchers, stakeholders, and communities. Empower researchers to prioritize IDEA while maintaining scientific rigor and ethical principles. Topics covered include recruitment strategies, culturally sensitive communication, data collection methods, addressing barriers to participation, patient-centred approaches, accessibility, and demographic data monitoring. Our methodology involves stakeholder engagement, content development, pilot testing, revision, refinement, dissemination, and implementation. This includes surveys, focus group discussions, literature reviews, and pilot tests to ensure the toolkit’s usability, relevance, and effectiveness. By engaging diverse stakeholders with multidisciplinary expertise, our toolkit aims to improve IDEA in clinical trials, ultimately leading to more inclusive clinical trials.

Tuberculosis (TB) is the world’s leading infectious killer, responsible for over 1 million deaths each year. Preventing TB-related suffering is a priority for global health organizations; however, this is difficult because many people are unable to complete TB preventative treatment (TPT) which currently takes several months and may have significant toxicity. Although much research has been focused on factors associated with completion of TPT, relatively few scientists have asked patients directly about their experiences. We will address this knowledge gap by asking patients to complete surveys and participate in interviews exploring their quality of life and acceptance of treatment at several stages during TPT. This study will take place within a larger clinical trial which is underway in North America, Austral-Asia, and Africa, testing the safety and effectiveness of a new short TPT treatment. We will compare quality of life between groups taking new and existing treatments, and between groups who may have had poor treatment-experiences.  Our results will help researchers and health providers know which patients have difficulty with TPT and how to support people to finish TPT so they can prevent TB.

People living with advanced HIV disease (AHD) have a severely damaged immune system. Despite enrolling in care and receiving recommended therapies, up to 2 in 10 people die in the first six months. Opportunistic bacterial infections are thought to be the main cause for this high mortality. The prophylactic administration of antibiotics may reduce early mortality by preventing these bacterial infections. REVIVE, a large randomized trial, is conducted across Africa and investigates whether azithromycin, a widely available and inexpensive antibiotic, reduces mortality in people living with AHD. Antimicrobial resistance (AMR) describes the ability of bacteria to resist antimicrobial treatment and is recognized as a major threat to global health. One of the main drivers of AMR is the use of antimicrobial therapies, including antibiotics. It is imperative to evaluate the possible impact of widespread implementation of azithromycin for all people with AHD on antimicrobial resistance. As part of this vanguard project, I am aiming to create a network of committed REVIVE trial centres to collect serially biological samples from REVIVE participants. These samples will be analyzed to get a better insight in antimicrobial resistance in people getting azithromycin and thereby provide information about possible negative effects of the antibiotic prophylaxis.

Extracorporeal membrane oxygenation (ECMO) is used for severe lung failure in ICU patients. During ECMO, blood is continuously drained from the body, oxygen is added to the blood, and the blood is returned to the body. ECMO is critical for patients with such severe lung failure that 5 mechanical ventilation (the ‘breathing machine’) cannot provide sufficient oxygen. However, ECMO can lead to complications, and medical teams aim to wean patients from ECMO promptly. Patients being treated with ECMO are usually also connected to a mechanical ventilator, but the optimal settings for the mechanical ventilator to speed recovery of the lungs and facilitate weaning from ECMO are unknown. To address this, we will assess if different mechanical ventilation settings, specifically positive end-expiratory pressure (called ‘PEEP’), can improve lung function in patients on ECMO. We will compare the effects of high and low PEEP settings on lung function. Additionally, we will evaluate patient tolerance to these variations and assess healthcare workers’ ease in managing patients with different PEEP settings. Our goal is to develop a PEEP strategy that can be tested in larger clinical trials to prove whether it can help patients who need ECMO recover more quickly from lung failure.

Cancer is one of the leading causes of death in Canada. Among cancer, lung cancer is one of the most common diagnoses, making up 13% of all cases, and causing 28.2% of all cancer-related deaths. Esophageal cancer, although less common, tends to effect patients eating habits, movement and does tend to spread quickly throughout the body. Research does show that people with lung or esophageal cancer do better if they start treatment at a more functional level (healthy body, good nutrition, more active). If we invest in prehabilitation programs to give patients the rights tools (better nutrition, support to quit smoking, good sleep and movement programs) prior to major surgery and if we support them for continuous health behaviour change we will likely see better long-term outcomes. This study is assessing a prehabilitation health coaching program at the YMCA, meeting with patients before and after surgery to best support 5 them in continued movement and healthy behaviours. Previous research in prehabilitation has shown that these types of programs can help people recover quicker and better after surgery. This can lead to increase quality of life for patients and could save money for healthcare.

Paralysis is viewed as the most devastating consequence of spinal cord injury (SCI), yet cardiovascular dysfunction is the leading cause of disease and death in this population and is a top rehabilitation priority. Low resting blood pressure (BP) and drops in BP during postural changes (e.g. sit-to-stand) can drastically decrease quality of life and delay rehabilitation. Spinal cord stimulation is a promising therapy with potential for improving BP control. This non-invasive treatment involves placing electrodes over the skin of the spine and delivering small amounts of electrical current. However, the best location to deliver this therapy, and the physiological mechanisms behind it, remain unclear. We aim to conduct a pilot clinical trial to determine the ideal stimulation location by comparing the immediate (real-time) and long-term effects (3x/week for 8 weeks) of mid-back and low-back spinal cord stimulation for controlling BP and quality of life. We also aim to examine the mechanisms in response to this therapy by exploring vascular health and sympathetic nervous system activity. Results from this pilot clinical trial will provide evidence to conduct a larger, multi-center clinical trial. The ultimate goal is to implement spinal cord stimulation in clinical practice and prescribe this therapy for home use.

Best research practices and honest reporting are cornerstones of science. Society assumes that research is performed carefully and reported openly. But there are unseen threats to science— 85% of the investment in biomedical research is avoidably wasted due to poor conduct and reporting of research results. When we rely on science to inform decisions about patient care and health policy, society must strive for reliability in science. Only 3 out of every 100 clinical trials conducted in Canada between 2009 and 2019 provided enough information for researchers, clinicians, patients and policymakers to decide whether the research is meaningful and worth implementing in practice. I will lead a project to develop and evaluate an online training programme that aims to teach researchers how to maintain an accurate public record of their research—from its beginning all the way through to sharing the results with the scientific community and the public. The training program will roll out across at least 12 universities (out of 16) in British Columbia and culminate in testing how well researchers and institutions in British Columbia register and report the results of their research.

Invasive bladder cancer is usually treated with chemotherapy (CT) followed by surgical removal of the bladder or a combination of radiation plus chemotherapy (chemo-RT). Sadly, these treatments can have significant side effects. Studies have found that about one third of patients who receive CT before surgical removal of their bladder have no detectable cancer remaining in their bladder. These patients could theoretically avoid surgery or radiation, significantly improving their quality of life. However, we currently lack the tools to identify these patients before performing bladder removal surgery. We believe that combining state-of-the-art imaging (magnetic resonance imaging), repeat bladder biopsy, and novel biomarkers (liquid biopsy finding tumor DNA in blood and urine) will enhance detection of residual cancer and make active surveillance without bladder removal safer after CT. We propose a feasibility trial (pilot study) to assess the success of enrolling and randomizing patients with bladder cancer found to have no remaining cancer with our tests and following CT, to active surveillance or conventional treatment (surgery or chemo-RT). If successful, this would represent a paradigm shift in the management of patients with invasive bladder cancer, transitioning towards personalized treatment with improved quality of life.

Sudden cardiac arrest (SCA), defined as the unexpected cessation of cardiac activity and blood circulation, is a major 6 public health issue, with an annual incidence rate of 4.4 million events worldwide and 60,000 cases in Canada. Rapid initiation of cardiopulmonary resuscitation (CPR) is critical, as the likelihood of survival decreases with each minute of delay.4 For SCAs that occur in private locations, where there is no one to start CPR or call 911 (75% of all cases),5 survival is nearly 0%. Therefore, the main barrier to improving SCA outcomes is the timely recognition of the event. Consumer wearable technologies have great potential to continuously monitor cardiac function and automatically recognize signs of disruption or loss of blood circulation at any time. These systems could subsequently activate Emergency Medical Services (EMS) to provide the necessary life-saving interventions.6–8 In this study, we aim to retrain previously developed SCA detection algorithms and validate their performance among those experiencing cardiac arrest. Additionally, we seek to optimize these models for practical applications in realworld settings (e.g., minimizing false positive SCA alerts).

People with cervical spinal cord injuries (cSCI) consistently rank regaining hand function as their most important goal. A promising technique called nerve transfer surgery (NTS) is now offered in Canada to help those with cSCI restore movements, like opening and closing the hand. However, some major challenges remain to make NTS more effective and impactful. This project is part of the first large-scale study of NTS in people with cSCI, which aims to see how well NTS works for restoring hand function. Forty-one adults with cSCI (at C5-7 levels) who are planning to have NTS will be compared to a control group from a database. They will have hand function tests shortly after surgery and every three months for two years. Interviews with patients who have had NTS will help us understand their lived experiences. The results will help us develop optimal rehabilitation strategies and predict patient outcomes after surgery. This project is a significant step forward in neurorehabilitation for cSCI and will have important and immediate impacts on clinical care and research.

Alcohol use disorder (AUD) is a common mental health burden in Canada. Unfortunately, there are not many effective treatments, and the ones that do exist are demanding, leading to only a small fraction of AUD patients seeking pharmacology-based therapies. There is a clear and urgent need for the development of novel pharmacotherapeutics in AUD. Recently, there has been growing interest in the use of psychedelic drugs, such as psilocybin (the active component in magic mushrooms), to treat psychiatric conditions. Research has shown an increase in cognitive flexibility in depressive patients following a single psychoactive dose of psilocybin. AUD patients with lower cognitive flexibility are at higher risk of poor treatment response. Therefore, we hypothesize that psilocybin will enhance the response to therapy in individuals with AUD, compared to placebo, by increasing their cognitive flexibility. We will also use MRI to explore how psilocybin changes functional connectivity and concentrations of neurometabolites in the brain, in order to get a better understanding of its mechanisms of action. This study will address the need for more effective, alternative treatments for AUD, and expand our understanding of the 5 neurobiological mechanisms underlying both the disorder and psychedelic drugs.

Les déficits cognitifs, comme des troubles de mémoire ou d’attention, affectent jusqu’à 50 % des patients atteints d’insuffisance cardiaque (IC) et sont associés à des complications importantes dans la maladie. Un contrôle moins optimal du sang qui se rend au cerveau pourrait expliquer les difficultés cognitives dans l’IC. De plus, l’exercice physique est recommandé comme méthode pouvant améliorer la cognition chez les patients atteints d’IC. Bien que des différences de sexes biologiques notables existent dans l’IC, peu d’études ont documenté les effets de l’exercice sur la santé cognitive et cérébrale en fonction des sexes. L’objectif principal est de mesurer les effets de l’exercice physique sur la santé du cerveau chez les hommes et les femmes atteints d’IC. 128 participants (50 % de femmes) avec de l’IC seront classés aléatoirement dans l’un des deux groupes suivants : 1) Exercice physique ou 2) traitements usuels. La santé du cerveau sera mesurée via des tests cognitifs et l’autorégulation du sang dans le cerveau par le biais de l’imagerie cérébrale. Cette étude permettra de documenter les effets de l’exercice sur la santé cérébrale chez les hommes et les femmes atteints d’IC et permettra de fournir des interventions adaptées au traitement de la maladie.

In this study, two treatments typically used for dry eye disease will be tried for contact lens users to see if their symptoms when they use their contact lenses get better. Cyclosporine is a drop that is used for longterm management of the inflammation and Intense pulsed light (IPL) is a treatment done in a clinic to improve the health of the eyelid glands. The main question in this study is: Does the combined treatment of cyclosporine and IPL improve the symptoms and the dry eye signs of contact lens wearers? All the participants will receive the cyclosporine drops for 4 months twice a day. The research team will split the group of participants in two, half receiving the real IPL treatment and half receiving a sham IPL treatment during the last two months of the study. This will allow to compare the two groups to see how IPL helped. The dry eye tests will be done at the start of the study, after two months and after 4 months. The tests will include a dry eye symptoms questionnaire, measures on the tears, the structures of the front of the eye and the eyelids.

Recent research on the lasting impacts of COVID-19 indicates that many individuals are experiencing ongoing symptoms, yet there is limited evidence on effectiveness of physical rehabilitation in long COVID. Our research aims to investigate whether an 8-week online homebased physical rehabilitation program for individuals with long COVID improves mobility, physical function, quality of life, and mental health compared to usual care. We will also explore the sustainability of any observed changes at 6-months after the 8-week program, gather participant’s perspectives towards rehabilitation program, and characterize postexertional malaise (worsening of symptoms with even mild exertion). We recruited 132 individuals from Quebec and Ontario, randomly assigning them to either the exercise group (receiving 8-weeks of virtual rehabilitation including educational sessions along with usual care) or control group(receiving only usual care, a document instructing on how to manage symptoms and engage in physical activity). Interviews with exercise group participants and long-term evaluations will provide valuable insights. Listening to participants’ feedback will enhance the program and determine if 8-week is sufficient. Understanding post-exertional malaise will guide us in recommending effective exercises for real-world use. This study will provide clear, practical guidelines for using virtual rehabilitation for people with long COVID in real-world healthcare settings.

Stroke diminishes people’s ability to move their arm and learn new skills. People with stroke often have lasting problems using their arm, especially to extend their elbow while reaching, limiting their participation in everyday activities. Our goal is to use a novel intervention, error augmentation (EA) feedback, to improve reaching movement in people with chronic stroke. EA feedback makes it seem like the elbow is more bent than it actually is during reaching training, ‘tricking’ the person into using a greater range of elbow movement during reaching than they typically would. People are randomly assigned to either an EA training group or control (no-EA feedback) training group. We predict that people receiving EA feedback will improve and retain reaching movements more than controls. We will also determine the relationship between poststroke cognitive deficits and learning using EA feedback. Each training group practices 30 minutes of reaching in a virtual reality environment, 3x/week for 9 weeks. Reaching ability and arm motor impairment is assessed before and after 3, 6, 9 weeks of training. Follow-up assessments are done 6 weeks after training finishes. Results will inform therapists on how to design the most effective rehabilitation tools for arm movement recovery.

Lung cancer is the top cause of cancer deaths worldwide. Many persons with lung cancer lose muscle, are fatigued, and have more difficulties performing their activities. Those who undergo surgery in these conditions suffer from more complications, longer recovery times and have more risk of mortality. These negative outcomes may be due to lower muscle mass and quality. An exercise and nutrition intervention can improve functional status, not only during recovery but even before surgery. We will take advantage of the 4-week waiting period for surgery to engage patients in this intervention, which will continue for 6 weeks after surgery. Patients scheduled for lung cancer surgery will be assigned by chance to one of three groups: 1) receiving the usual care, 2) receiving a novel nutritional supplement combining important nutrients for muscle health, or 3) taking the supplement and following an exercise program. All groups will attend anxiety management sessions and nutritional counselling. Tests will include walking endurance, muscle strength, and body composition. Hospital length of stay and complications due to surgery will be recorded. This work could help persons with lung cancer regain their normal functions and quality of life faster and with lesser complications after surgery.

Shoulder joint replacement surgery can improve the quality of life for individuals suffering from shoulder arthritis. However, recovery can be difficult.  A rehabilitation program after surgery helps patients manage pain and gain function. This project aims to develop and test a new, personalized rehabilitation program that combines education and exercise with options to use technology supports. We are working closely with patients and healthcare professionals to create a program that is both effective and easy to use. The program will include instructional videos and a special “”motion shirt”” that tracks movement, allowing patients to exercise correctly at home. We will then conduct a study to test the program’s effectiveness in reducing pain, improving function, and enhancing overall quality of life for those recovering from shoulder joint replacement surgery. Our goal is to create a program that helps patients recover faster and empowers them to take an active role in their rehabilitation. By combining the latest technology with evidence-based practices, we hope to set a new standard for shoulder joint replacement recovery and improve the lives of countless individuals.

In this study, individuals with treatment-resistant depression will undergo an MRI to measure functional brain activity prior to treatment with transcranial magnetic stimulation (TMS), an approved treatment for depression. Connectivity between brain regions within an individual will be used to identify a personalized brain target for TMS. Prior to treatment, patients will return to receive TMS at this personalized brain target, to brain responses to stimulation in real time. Thereafter, patients will receive a form of TMS called intermittent theta burst stimulation (iTBS), a common pattern of TMS used in depression, on accelerated timeline that condenses 4-6 weeks of treatments into a single week. The relationship between brain activity in the MRI during TMS delivery and subsequent clinical response will be investigated to identify predictors of antidepressant effects and better understand the therapeutic mechanisms of TMS in depression and other brain disorders.

Individuals with Down syndrome (DS) have lower blood flow to their brain. This causes faster aging and a higher risk of early Alzheimer’s disease. As blood flows, it imposes a dynamic force on arterial walls, known as hemodynamic force. Unless reduced, hemodynamic forces damage cerebral arteries. This 4 damage may cause cognitive impairments and advanced aging. Yet, limited studies show how exercise impacts hemodynamic force. We aim to determine how moderate exercise affects hemodynamic force in DS. This randomized control trial requires 34 DS and 34 non-DS participants, aged between 19 and 40. Participants will be randomly placed into a resting group (RG) or an exercise group (EG). An ultrasound will measure all participants’ internal carotid and middle cerebral arteries. RG participants will visit the lab once for resting supine ultrasound measures. The EG participants will visit once to perform a 1-mile walk to estimate their maximal aerobic capacity (V̇O2max). During EG participants’ second visit, they will perform supine cycling between 40 and 50% of their V̇OV̇ 2max for 30 minutes. Ultrasound measures will occur before, during, and after exercise. We hypothesize that aerobic exercise will reduce cerebral arterial hemodynamic forces.

This is a research study investigating the potential role of psilocybin, a controlled psychedelic compound that is found in certain mushrooms (sometimes called “magic mushrooms”), as a potential treatment for demoralization syndrome in advanced cancer. Demoralization syndrome has been described as a psychiatric condition in which patients experience hopelessness, pessimism, loss of purpose in life, isolation, and other symptoms as a result of a life-threatening illness. We’ll be using psilocybin to enhance psychotherapy, in particular a type of therapy designed for patients with advanced cancer. Our aim is to test if there is an improvement in the feelings of demoralization through this treatment, and to register any adverse effects related to the treatment to assess its’ safety. The patients included in this study will be 18 to 70 years old, with a diagnosis of advanced cancer and demoralization syndrome.

Adaptive platform trials (APTs) are clinical trials designed to test multiple treatments for a single disease. They use real-time data to continuously adjust the trial design, making the process more efficient. A key feature of APTs is Bayesian dynamic borrowing, a statistical method that accounts for variations in treatment effects among different patient subgroups. This method improves outcome accuracy and reduces the number of patients needed for the trial by sharing information across patient subgroups. Bayesian dynamic borrowing helps manage these differences, using statistical techniques to ensure that the treatment effects are appropriately compared. This project aims to enhance the use of Bayesian dynamic borrowing by developing a standardized process to create accurate prior distributions, which are crucial for this method. The project has three main goals: creating an elicitation framework, generating robust prior distributions, and testing the 5 framework on an existing clinical trial. The project will use the CALM trial, which investigates the effectiveness of the antidepressant sertraline for anxiety in children with various neurodevelopmental disorders, as a case study. By improving prior distribution methods, this project will ensure more accurate and efficient clinical trials, particularly in oncology and rare disease research, where patient recruitment is often challenging.

Interstitial lung disease (ILD) is a progressive lung disease with a mean survival of only three years. Breathlessness and severely low oxygen levels are the hallmark features of ILD, which worsen with exercise. They are a source of severe distress and negative behaviour change in these individuals, causing avoidance of physical activities that trigger these symptoms further degrading overall health. Unfortunately, very few effective and safe pharmacological therapies that target the lungs are available for ILD. Thus, preserving or enhancing muscle and heart function is essential to offset the progressive decline in lung health to maintain quality of life and independence. Using nitrate in the form of concentrated beetroot juice, a safe and commercially available dietary supplement, may improve the delivery and efficiency of oxygen use at the site of exercising muscles. Oral ingestion may improve the use of diminished oxygen availability rather than relying on external sources of supplemental oxygen, a common practice in ILD, which lacks real-world practicality. This novel therapeutic may allow patients with ILD to reach greater exercise intensities to improve their overall exercise tolerance. If successful, it would enable them to sustain their functional abilities, promoting independence and improved quality of life.

Type 1 diabetes (T1D) is one of the most common chronic conditions in children, affecting about 30,000 children in Canada. Regular physical activity is important for better blood sugar control. Children with T1D face challenges being active due to fear of hypoglycemia (alarmingly low blood sugar levels). We propose to run a 12-week virtual physical activity program to increase activity in children with T1D. The children will interact with a counsellor via Zoom, who will provide useful information like how to manage blood sugar levels during exercise. To see if the program works, children will wear a special activity tracker for 7 days before and after the program, plus a Fitbit for the whole 12 weeks to measure their physical activity.

Sleep is essential for human health, particularly babies. Research on the impact of gut bacteria on baby’s brain is limited, especially in relation to sleep. Baby’s feeding type affects gut bacteria, and no study evaluated the effects of donor human milk (DHM), which is highly similar to mother’s own milk, on sleep. The project aims to examine the effects of DHM, formula, and exclusive breastfeeding on baby sleep habits, assess parental perception of infant sleeping patterns, and if gut bacteria mediate the relationship between infant feeding type and sleep. The study will recruit participants from postpartum units and study three groups of babies with antibiotics exposure during birth. For babies who require extra supplementation, one group will receive standard care, which is formula (n=75), and the other will receive DHM (n=75) for their first seven days of life. Infants who do not require any supplementation and receive EBF (~n=60-90) will be only observed during the study. Parents will provide data on demographic characteristics, breastfeeding self-efficacy, mood, and baby’s sleep and baby’s stool will be collected at different time points. We hypothesize that DHM and EBF, containing probiotics, prebiotics, and melatonin, will improve sleep and influence gut bacteria type and quantity.

Approximately 50% of Canadians have used cannabis. The vast majority of cannabis users report using cannabis to reduce stress. There remains limited high-quality evidence on if cannabis reduces stress and how it might do so. The current Phase I randomized control trial examines the effects of cannabis on acute stress response in humans by assessing both neurobiological and subjective markers of stress. 30 adult occasional cannabis users will be recruited for this study. Each participant will ingest oral cannabis oil containing tetrahydrocannabinol (THC) with cannabidiol (CBD), THC alone, or placebo. At the time of peak drug effects, participants will complete a stress induction task while undergoing functional Magnetic Resonance Imaging (fMRI). In addition to fMRI data, we will also evaluate salivary stress biomarker levels, cardiovascular response, and subjective stress to comprehensively evaluate biological and psychological stress response. We expect that the cannabis oils will cause reduced stress response compared to placebo. Canada’s legalization of cannabis, the high prevalence of cannabis use–especially for stress reduction—and the high interest in cannabis as a potential medical treatment has significant public health implications and studies such as this are needed to better understand the effects of cannabis.

With increasing global industrialization, traffic-related air pollution (TRAP) in the form of diesel exhaust (DE) has become of increasing concern for individuals predisposed to harm in highly polluted areas. DE exposure is associated with negative health effects including breathing difficulties, decreased pulmonary function, inflammation, and the development of respiratory diseases. In particular, asthmatic children and adults are at greater risk of hospitalization as harmful substances such as air pollutant lead to irritation, inflammation and changes in the airways, causing difficulty breathing. To address this issue, medical practitioners often prescribe inhaled corticosteroids (ICS) to alleviate symptoms. However, recent data suggest that air pollution may decrease ICS effectiveness, but the exact biological reasons for this phenomenon remain unclear. This discrepancy can lead to overprescription of ICS as doctors are unable to control patient symptoms, which can lead to reduced disease control despite the higher doses and increased side effects. These factors can cause a burden on healthcare services and will continue to be a problem in developing countries worldwide. Therefore, it is vital to investigate the underlying biological 5 pathways and immunology associated with ICS treatment as we may be able to improve ICS effectiveness by promptly addressing these issues prior to administration.

This project aims to enhance the design of clinical trials for treatment-resistant depression by using innovative Bayesian adaptive methods. Traditional trials often use fixed sample sizes, which can be inefficient or impractical. In contrast, Bayesian adaptive designs allow for ongoing adjustments based on accumulating data, making the trial process more flexible and efficient. By analyzing data from a major depression study, we seek to identify key considerations for these adaptive trials. Our goal is to demonstrate how these methods can improve statistical power and reduce sample sizes, ultimately leading to faster and more personalized treatments for patients. The findings from this research could revolutionize how clinical trials are conducted, making them more responsive to patient needs and more resource-effective. This advancement has the potential to significantly impact the field of clinical research, improving treatment outcomes and accelerating the approval of new therapies.

This project is an international randomized clinical trial being implemented across 12 Canadian and 5 International centers exploring the effectiveness of Stereotactic Ablative Radiotherapy (SABR) in the treatment of oligometastatic cancer. SABR is a modern radiotherapy technique for cancer treatment that delivers high doses of radiation to small tumor targets, while trying to avoid healthy tissues and organs. However, SABR treatment requires increased planning, treatment time, cost and potential for higher toxicity due to the higher dose and avoidance of nearby normal tissue. The purpose of this study is to compare different doses of SABR regarding toxicity, progression-free survival, quality of life, and costeffectiveness. The outcomes of this project will contribute valuable insights to shape cancer treatment approaches, policies, and decision-making processes, considering their impact on healthcare resources and the burden on patients.

Chronic diseases are a leading cause of death for Canadian adults. These conditions can be managed by medications and making health behaviour changes. Despite these treatments, many Canadians experience complications from the long-term effects of chronic diseases, particularly those who can’t afford their medications. In addition to its impact on patients, this costs the healthcare system, since these individuals then need specialized care in the hospital system. While many aspects of healthcare are covered by public insurance for Canadians, 4 medications are not universally covered by governments, and there is variation across the country. A patchwork of employer, private, and public insurance provides medication coverage for around 80% of Canadians, but many more are underinsured. Understanding how providing an intervention like free medications impacts patients, their financial barriers and their likelihood to take medications can inform future policies for medication insurance coverage in Canada. We will use data collected in the ACCESS trial information from a recent large randomized clinical trial in 4761 low-income seniors to analyze multiple factors that may connect to adherence to better understand the underlying causes.

The Canadian North Helicobacter pylori (CANHelp) Working Group conducts community-driven projects to address concerns of Indigenous communities in the Northwest Territories and Yukon, Canada about Helicobacter pylori (Hp) infection and its link to stomach cancer. A key concern is poor effectiveness of treatment to eliminate Hp infection, as is common in populations where Hp occurs frequently. Major risk factors for Hp treatment failure include antibiotic-resistant Hp infection, prescribing of suboptimal regimens, and suboptimal adherence to regimens, which occurs commonly due to bothersome side effects. During 2008-2018, CANHelp projects included a series of community-specific treatment trials designed with community input to identify effective treatment regimens. These community trials engaged underrepresented Indigenous populations in clinical trial research. Of 340 Hp-positive trial participants assigned treatment at random across 9 communities, 231 received a post-treatment test for Hp 8 or more weeks after completing treatment. My project aims to estimate the effectiveness of of treatment regimens using statistical methods to control for diverse participant characteristics, thereby addressing a question of key concern to communities that seek to reduce health risks from Hp infection.

Despite how common inguinal hernia repair (IHR) surgery is, there is little research how to prepare people for this operation. Surgeon’s advice to patients about exercise and physical activity are inconsistent and usually based on their clinical opinion. Some surgeons say to exercise to help prepare for the operation while others say to rest. Research is needed to help know whether exercise is helpful before and after IHR surgery. We will conduct a study to test the effectiveness of education and exercise before and immediately after IHR surgery. We will randomize some participants to an education and exercise group and the other to a non-exercise, care as usual group. We will measure participant outcomes up to 3 months after their surgery. We expect the education and exercise group will have less pain, better hernia-related outcomes, and return to activity and work quicker. Our project will help people who need IHR better prepare for their surgeries. 

Colorectal surgery is a common practice in Canada for treating cancers and other intestinal diseases. One in three individuals awaiting colorectal surgery, without a diabetes diagnosis, has a high blood sugar level that categorizes them as having prediabetes or diabetes. Numerous studies have shown that these patients face more challenges in recovering after surgery, including an increased risk of infections. Since the waiting time for this type of surgery is generally around 44-45 days in Canada, we would like to capitalize on this waiting period to help these individuals improve their blood sugar levels before the operation. 6 We will measure blood sugar levels during the first meeting with the surgeon to identify individuals with elevated levels. Subsequently, we will offer these individuals a daily nutrition and exercise plan to lower their blood sugar levels before their surgery. We believe that this program will be appreciated by the participants and will improve their blood sugar levels so that they can achieve a better recovery after surgery.

Melanoma is the deadliest form of skin cancer. A serious and frequent progression of melanoma is bone metastasis. This is when cancer cells spread and form tumors within the bones of an affected individual. Recent research has shown that the bone marrow microenvironment plays a crucial role in cancer progression and metastasis. Additionally, the immune system’s response to cancer is a major determinant of disease outcome. Immune checkpoint inhibitors are new treatments that allow a patient’s own immune system to fight cancer cells. This has allowed the dismal rate of survival in metastatic melanoma to be greatly improved with the potential for curability. However, clinical data shows that patients with bone metastasis have worse outcomes and respond poorly to immunotherapy. During periods of high bone activity, such as in bone metastasis, bone cells are released into the circulation where they may interact with immune cells and/or cancer cells. The interactions between circulating bone and immune cells appear to be crucial in mounting an effective anti-cancer immune response following treatment with immune checkpoint inhibitors. This research aims to investigate the unexplored interplay between circulating bone cells and immune cells in patients with metastatic melanoma treated with immune checkpoint inhibitors.

Chronic kidney disease is a condition characterized by irreversible and progressive loss of kidney function leading to accumulation of harmful substances in blood. As kidney function declines to very low levels, patients will require regular cleaning of the blood by a procedure called dialysis to sustain life. Patients with chronic kidney disease are at a high risk of developing heart disease 10 . In fact, nearly half of patients with chronic kidney disease on dialysis will succumb to heart disease within 4 years of diagnosis. A promising new group of drugs, called SGLT-2 inhibitors , seems to reduce the number of deaths due to heart disease. However, these drugs are not currently approved in advanced kidney disease. In our study, we will use one of these drugs, called canagliflozin, to see if it will reduce excessive growth of the heart muscle. Excessive growth of heart muscle is bad for health as it may lead to serious heart conditions including sudden death. If we demonstrate that canagliflozin can reduce this growth, then this medication will be considered in patients with advanced kidney disease. This may help in saving lives of many patients with kidney disease who currently do not have access to this medicine.

Chronic obstructive pulmonary disease (COPD) is a very common and chronic lung disease that is a leading cause of morbidity and death. Patients with COPD often have persistent breathlessness and low exercise tolerance which affect their ability to do everyday tasks. COPD treatment includes medications/inhalers, and participation in pulmonary rehabilitation (PR). PR is a multidisciplinary program consisting of exercise, education, and nutritional counseling led by a diverse team of healthcare experts and has consistently been found to improve breathlessness and exercise tolerance in patients with COPD. It is possible nutritional supplementation of Urolithin A, a compound which been found to be safe, well-tolerated, and improve exercise capacity in healthy adults may further enhance benefits from PR participation in patients with COPD. This study will recruit ten participants clinically diagnosed with COPD to participate in an 8-week PR program in which they will be randomly assigned to either take Urolithin A or an indistinguishable placebo during PR participation. Participants will be assessed on their exercise capacity, body composition, muscle strength, quality of life, and on an opt-in basis, their muscle tissue. This study will test the feasibility of recruiting patients, completing the whole study, and completing the tests.

Over a million Canadians undergo surgery annually, with about one-fifth experiencing complications or post-operative difficulties. To address this, many believe that ‘prehabilitation’ which involves doing exercises and eating healthy food before surgery could lead to better recovery outcomes. Research suggests that prehabilitation may: 1) lead to fewer complications, 2) help patients have better recovery, and 3) lead to shorter stays in hospital. Unfortunately, existing studies don’t reflect real world implementation of prehabilitation; therefore, we don’t know if prehabilitation will work for most surgical patients, despite the promise shown in specialized studies. With the experience of COVID-19, we’ve learned that programs like prehabilitation need to be provided in a way that they can be done at home with technological support. Virtually-supported prehabilitation has not been widely studied, but needs to be. The next step is to test whether at home, virtually supported prehabilitation, provided in a way that looks like a real world approach, will help patients to have better outcomes after surgery. Our study will help to find out if doing a test like this is practical. If it is, we will do a large study across Canadian hospitals to find out if this approach to prehabilitation can help patients.

Childhood obesity is a major public health issue in Canada. To lower the risk of obesity, the Canadian Paediatric Society advises parents to switch their children from whole milk (3.25% fat) to reduced-fat milk (1% fat) at 2 years old. However, recent research suggests that whole milk might be associated with lower body fat in children instead. To investigate, the Cow’s Milk Fat Obesity Prevention Trial (CoMFORT) will compare the effects of whole milk versus reduced-fat milk on child obesity. Before launching the main trial, we will conduct an internal 5 pilot study to test the feasibility of this research. We will focus on recruitment, adherence, retention, and assessing the proper age range of participants involved. The pilot study will include 30 children aged 1.5 to 2.99 years, who will be randomly assigned to either the whole milk (3.25% fat) or reduced-fat milk (1% fat) group. Over six months, we will track how well we can recruit, retain participants and whether they consume their assigned milk. This pilot study is crucial for refining the trial design and ensuring the success of the main CoMFORT trial, which aims to provide guidance on milk fat consumption and childhood obesity.

This study explores how genetic differences in two specific genes, GSTA1 and UGT2B17, impact estrogen levels and menopause-related side effects in postmenopausal women taking exemestane (EXE) for breast cancer prevention. EXE is an effective medication for reducing the risk of breast cancer, but it can cause side effects such as fatigue, hot flashes, and joint pain. These side effects can lead some women to stop treatment early, reducing the medication’s effectiveness. By examining genetic variations in these two genes, we aim to understand why some women experience more severe side effects than others. This research is conducted within the MAP.3 trial, a large international study involving over 4,500 women, making our findings robust and widely applicable. Our goal is to identify genetic markers that predict who is more likely to experience side effects from EXE. This knowledge could enable doctors to personalize treatment plans, improving adherence to breast cancer prevention therapies and enhancing the quality of life for women undergoing EXE treatment. Ultimately, this study strives to support more effective breast cancer prevention strategies and contribute to personalized medicine, ensuring that each woman receives the most suitable care based on her genetic makeup.

Infants born extremely prematurely, especially before 26 weeks, are very vulnerable and often face significant short and long-term health issues. One of the most critical complications is severe intraventricular hemorrhage (IVH), a type of brain bleed, that continues to be the leading cause of death in extremely premature infants. Severe IVH can lead to other significant long-term problems such as cerebral palsy, reduced IQ, and overall neurodevelopmental disabilities. Clinical trials have shown that preventative indomethacin, a type of drug, can prevent IVH and death. Between 2018-2022 in Canada, extremely premature babies who received indomethacin had a 5% lower death rate and were 4% more likely to survive without severe IVH in comparison to those who did not receive the drug. However, there are no recent studies on the effect of this drug on short- and long-term neurodevelopmental outcomes in the extremely premature population. Therefore, we propose a study linking data from the Canadian Neonatal Network and the Canadian Neonatal Follow Up Network to investigate the relationship between preventative indomethacin and death and disability in extremely premature infants. This study will lay the groundwork for a future clinical trial on the use of indomethacin specifically in the most vulnerable population

Colorectal cancer is the second most deadly cancer in Canada. Treatment typically involves surgery and chemotherapy, which can be effective but also cause significant side effects and not always prevent the cancer from returning. The DYNAMIC-III/CO.29 study is a major international clinical trial involving 1000 patients who have had surgery for stage III colorectal cancer. This trial is trying a new approach that identifies fragments of tumor DNA in the blood, called circulating tumor DNA (ctDNA), to tailor chemotherapy more closely to each patient’s needs. By checking for ctDNA shortly after surgery, doctors can adjust the intensity of chemotherapy—either increasing it if ctDNA is detected, suggesting remaining cancer, or reducing it if no ctDNA is found, to spare unnecessary side effects. The study aims to see if this personalized strategy can improve patient outcomes, decrease side effects, and reduce healthcare costs. This could revolutionize how stage III colorectal cancer is treated and pave the way for more personalized cancer treatments.

In type 1 diabetes (T1D), immune cells called T cells destroy insulin-producing beta cells, causing lifelong insulin dependence. Blood glucose control remains imperfect despite insulin injections, leading to an increased risk of complications from chronic hyperglycemia and a shortened lifespan. An antibody known as ustekinumab has been found to inhibit inflammation and can be safely administered to young adults 5 with recent-onset T1D. Our clinical trial, UST1D2, aims to test ustekinumab’s ability to halt progression of recent-onset T1D in young adults. This drug was previously demonstrated to decrease inflammatory proteins thought to damage islets, IFN-γ and IL-17. Changes in inflammatory proteins and in the balance of immunoregulatory versus inflammatory cells may elucidate ustekinumab’s mechanism of action and biomarkers of response to therapy. To comprehensively evaluate mechanism and response biomarkers, the mechanistic studies carried out are harmonized between UST1D2 and another study called USTEKID that tests ustekinumab in children. This increases sample size, allowing for faster determination of treatment effectiveness. Our project contributes toward evaluating ustekinumab as a T1D treatment and represents a new collaborative model to evaluate outcomes from international, multi-centre clinical trials.

Access to regular screening for the retina, feet, and kidneys, along with timely diabetes education, is crucial for managing diabetes effectively. However, many individuals from underserved populations face barriers to accessing these services, leading to poorer health outcomes. These barriers include competing needs and priorities, scheduling difficulties, transportation costs, inadequate public transportation, and perceived judgment and stigma. Our previous work showed that individuals from disadvantaged neighbourhoods in Calgary are 30-40% less likely to attend diabetes specialty appointments. To address this, we developed a pilot study, to provide accessible screenings for diabetes complications to adults experiencing homelessness in Calgary. Although promising, the pilot study was not randomized and didn’t assess long-term outcomes. Building on its success, we launched the Diabetes Mobile Clinic 5 (DMC) in collaboration with The Alex Community Health Centre. The DMC is a comprehensive clinic, aimed to aid in the accessibility of diabetes specialty care, such as diabetes specialists and screening for eye, kidney, and neurovascular complications. This study will test both the implementation/feasibility of the program and the effectiveness of the DMC in adults aged 18-85 years with diabetes mellitus who are being discharged from acute care facilities within Calgary, Alberta through a hybrid-type 2 randomized controlled trial.

Women are understudied in health research, despite significant sex (biological) and gender (sociocultural) differences influencing the risk of developing disorders. Women are twice as likely to experience major depressive disorder (MDD) and have higher rates of autoimmune disorders. Interestingly, having an autoimmune disorder increases MDD risk, and individuals with MDD often have inflammation. Women are also more likely to have physical MDD symptoms like fatigue, which has been linked to inflammation, and gender inequality can worsen MDD symptoms in women, mainly for those who are non-white, less educated, unmarried, or have lower income. Moreover, research has shown that some individuals with inflammation do not respond to antidepressants, which has led to new anti-inflammatory medications that can relieve depression symptoms for all men but only women with high inflammation. Thus, research on sex and gender differences are needed to reveal health inequities for everyone. We will analyze 883 immune samples from clinical trials, including those at high-risk for MDD, current MDD, and healthy controls. Using clustering analysis, we will identify protein-clusters associated with inflammation and examine how sex and gender-related sociodemographic factors intersect to 11 influence these immune subtypes. This will advance our understanding of MDD risk, biology, and treatment.

This MSc project will explore, through simulation and modelling studies, the expected results and impact of different novel trial designs for second-line biologic therapy in rheumatoid arthritis (RA). It will specifically look at the feasibility and expected impact of a trial that allows patients to be randomized between several treatment option of choice.

Osteoarthritis (OA) is a prevalent form of arthritis and commonly affects the knee. The aim of a total knee arthroplasty (TKA) is to improve knee mechanics, decrease knee pain, increase function of the knee, and thus improve patients’ quality of life. TKA is effective for correcting end stage OA of the knee. One of the main patient goals of receiving a TKA is improvements in the ability to walk without knee pain. The purpose of this project is to perform a secondary analysis of clinical trial data to compare differences between pre-operative and post-operative walking. This will inform how TKAs impact knee pain, movements, forces, and walking patterns. These walking parameters will be evaluated with different walking conditions. These conditions include level treadmill walking, uphill/downhill walking, and crossslopes (similar to walking on the side of the road). Different walking terrains may detect subtle changes in how the knee moves. We will also examine if males and females demonstrate different walking patterns after TKA. This information may inform walking retraining and rehabilitation after TKA to improve patients’ function and quality of life.

Individuals with mild deficits in their thinking abilities are at risk for dementia, and more than half of all dementia cases are among females. Exercise, such as running (aerobic training) and lifting weights (resistance training) can improve thinking abilities and reduce risk factors for dementia. Research suggests females benefit more from aerobic training than males in improving thinking abilities; however, the quality of evidence is low. Notably, no study has been specifically designed compare the effects of different exercises on thinking abilities between females and males living with impaired thinking abilities. To address this important knowledge gap, we recruited and trained 228 older adults living with impaired thinking abilities to determine whether the benefits of different types of exercise training for thinking abilities (cognitive function) and the brain differ between males and females. The participants were divided into four training groups: aerobic, resistance, combination, and balance (as the control group). Participants were asked to attend instructor-led exercise training classes 4x/week for six months. Before and after the intervention, we measured their thinking abilities and scanned their brains to study brain structure and function. Our findings will allow more precise exercise recommendations for individuals to promote their brain health.

Women find quitting smoking more difficult than men. Research suggests that hormonal changes during the menstrual cycle (monthly hormonal cycle that results in periods) might affect a person’s ability to quit. This study’s goal is to find out whether quitting smoking during a specific phase of the menstrual cycle can improve quit success compared to quitting without considering menstrual cycle. This online quit-smoking study aims to enroll 1,200 people who will receive six weeks of nicotine replacement therapy (NRT). Participants are randomly assigned to start their quit attempt either shortly after their period; a few days before they are supposed to get a period; or regardless of their period. One week, six weeks, and six months after their quit date, participants are asked to report if they have been smoke-free. The number of successful quitters at each time point will be compared between groups. Researchers will also interview participants to understand whether the study has been helpful, and if the fully virtual study procedures were acceptable. If effective, the menstrual cycle timing strategy could make quitting easier by aligning treatment with natural hormonal cycles. Combining this approach with accessible tools like NRT could help more people successfully quit smoking.

Infants are at risk of a lack of oxygen to the brain when being born and this can cause brain damage (called hypoxic-ischemic encephalopathy (HIE)). The condition can have long-term adverse effects on infants including cerebral palsy (CP). Cooling therapy of infants can prevent CP if it is recognized early. Current diagnosis of HIE is based on clinical features of the child and measuring lactate levels. These predictors are not able to identify all affected infants and can be influenced by the experience of the healthcare practitioner. Thus, a better objective test based on metabolite levels would be a significant improvement to available diagnostic tests. Liquid Chromatography- Mass Spectrometry (LC-MS) is a method of analyzing small molecules, such as metabolites, which are directly affected by disease state. The analysis of a non-invasively collected fluid, namely urine, using LC-MS holds promise as a novel diagnostic tool. An initial pilot study showed that 15 quantifiable metabolites were differentially expressed between healthy and HIE infants. A clinical study to refine the diagnostic model is of value as it can contribute to the development of an objective diagnostic tool, which can be used to prevent brain injury.

“People living with dementia often experience a decline in their ability to do everyday activities like walking, dressing, or eating. While research shows that structured exercise can help slow this decline, residents in LTC homes are often left out of exercise programs or research studies. When they are included, the programs are rarely tailored to their individual needs especially for those with more advanced stages of dementia. To address this gap, we developed Dementia Moves, a new group-based exercise program designed specifically for LTC residents with moderate to severe dementia. The program was co-created with input from people living with dementia, family caregivers, long-term care staff, and researchers to make sure it reflects the real needs and abilities of those in care. Each session includes aerobic activity, strength training, balance exercises, and mindfulness, all adapted to the residents’ preferences and capacities. In this study, we will test whether it’s possible to successfully run the Dementia Moves program in two LTC homes in Halifax. We want to see how many residents we can recruit, how many complete the program, and if they will finish the study. This research will help us prepare for a larger study in the future.”

Endurance athletes may be at risk for poor bone health due to intense training and elevated nutritional needs. While high-impact exercise and adequate nutrition are can help support strong bones, there are few bone-targeted interventions in athletes, especially females who are at greater risk for impaired bone health. This study will evaluate whether it is feasible to recruit and retain female endurance athletes in an 18-week trial comparing high-intensity impact training, combined with protein and carbohydrate supplementation, to a standard care approach. The results will inform the design of a future, larger trial.

Virtual reality (VR) is a technology that creates computer-generated environments that feel real. While a stress-inducing environment, like a horror game, can increase stress, a calming VR environment can help reduce it. Since stress can also affect blood sugar, this is especially important for people at risk of diabetes or other chronic conditions.As VR has the potential to influence stress, we designed a randomized crossover clinical trial to explore whether relaxing VR environments can improve the body’s response to food. In this study, each participant will experience four different conditions in a specific order: a relaxing VR environment, a stress-inducing VR environment, a neutral VR environment (similar to a basic lab setting), and a standard clinical lab setting without VR. Participants will either wear a VR headset or sit in a lab for 15 minutes, then eat a ready-made instant rice meal over 10 minutes. They will continue the same activity for one more hour. During this time, we will measure blood sugar at several points, along with stress levels, skin conductance, and heart rate. This study will help us understand whether changing the environment, such as using relaxing VR, can help manage blood glucose levels.

Fibrotic interstitial lung disease (fILD) reflects a group of conditions that cause lung scarring and breathing difficulty. Air pollution particles are dangerous to everyone, but especially threaten people with fILD, where this exposure increases the risk of disease worsening, hospital visits, and death. These particles are produced by human activities like vehicle traffic and factory exhaust, but also from natural sources like wildfire smoke. We do not understand how current treatments of fILD impact pollution risk in this population. This study will determine whether a common anti-fibrotic medication used to treat patients with fILD, nintedanib, protects against air pollution. This research will involve international nintedanib clinical trials data involving over 2,400 people with fILD. Satellite data will estimate pollution exposures at patients’ home locations. This study will also evaluate markers in the blood that determine how biologically young or old a person is, including telomere length and epigenetic aging, to understand if treatment with nintedanib changes molecular responses to pollution. We expect this research to show that people treated with nintedanib are more protected from the harmful effects of air pollution. This will help to design future treatments and to protect people with lung disease from harmful environmental exposures. 

Le diabète de type 2 est une maladie fréquente qui augmente les risques de complications graves, comme les maladies cardiovasculaires, les cancers ou les maladies des reins. De plus, avec l’âge, nos cellules souches sanguines peuvent accumuler des mutations dans des gènes associés aux cancers du sang. Ces mutations confèrent à ces cellules un avantage prolifératif, leur permettant d’augmenter leur proportion dans le sang au fil du temps. Chez les personnes présentant ces mutations, appelées hématopoïèse clonale de potentiel indéterminé (CHIP), il n’y a pas de cancer du sang diagnostiqué ni d’autres anomalies hématologiques évidentes. Les mutations CHIP sont désormais reconnues comme un facteur de risque indépendant des maladies cardiovasculaires et métaboliques. Des études montrent que les mutations CHIP dans les gènes TET2 et DNMT3A sont associées à une inflammation systémique accrue et à une réponse aux traitements anti-inflammatoires altérée. Nos études préliminaires montrent également qu’il existe une interaction entre CHIP et la metformine, médicament utilisé pour le traitement du diabète de type 2. Dans ce projet, nous allons analyser des données provenant de grandes études cliniques internationales pour évaluer si les personnes atteintes de diabète de type 2 et porteuses de CHIP répondent différemment à la metformine ou à la dapagliflozine. Ces recherches pourraient ouvrir la voie à une médecine personnalisée, en adaptant les traitements selon le profil génétique de chaque patient, et ainsi mieux prévenir les complications du diabète.

Knee osteoarthritis (OA) is a common condition that causes pain, stiffness, and reduced mobility, especially in older adults. It affects over 650 million people worldwide and is a leading cause of disability. Despite its impact, there is currently no cure, and the disease is not fully understood. Medical imaging plays an important role in studying OA and guiding its management. The current gold standard is Magnetic Resonance Imaging (MRI), but MRI is expensive, has long wait times, and is often unavailable in rural and remote areas. Recent advances in portable ultrasound devices offer a promising alternative for imaging the knee. However, ultrasound results depend heavily on the skill of the operator, are prone to inconsistencies, and currently lack the ability to detect mild inflammation typical in knee OA. This project aims to enhance portable ultrasound using artificial intelligence (AI) to automatically analyze knee images and detect mild inflammation. The study will collect ultrasound data from both healthy volunteers and OA patients to train and test the AI algorithms, and the results will be compared with standard clinical assessments. When successful, these tools will enable more accurate, consistent, and accessible evaluation of knee OA, especially in clinical research and trials.

Chronic obstructive pulmonary disease (COPD) is a very common and chronic lung disease that is a leading cause of morbidity and death. Patients with COPD often have persistent breathlessness and low exercise tolerance which affect their ability to do everyday tasks. COPD treatments include medications/inhalers, and participation in pulmonary rehabilitation (PR), a multidisciplinary program consisting of exercise, education, and nutritional counseling led by a diverse team of healthcare experts. PR has consistently been found to improve breathlessness and exercise tolerance in patients with COPD. It is possible that supplementation with Urolithin A, a compound which been found to be safe, well-tolerated, and improve exercise capacity in healthy adults, may further enhance clinical benefits from PR participation in patients with COPD. This study will recruit up to 22 participants with COPD who are participating in an 8-week PR program, during which they will be randomly assigned to receive either Urolithin A or an indistinguishable placebo. Participants will be assessed on their exercise capacity, body composition, muscle strength, quality of life, and on a volunteer basis, their muscle tissue characteristics. This study will test the feasibility of recruiting patients and of completing the whole study including all scheduled clinical tests.

Chronic cough that doesn’t improve with treatment or has no clear cause can greatly affect a person’s quality of life. Doctors sometimes prescribe medications like low-dose morphine or pregabalin, but there are no direct comparisons to show which works better. Non-drug treatments like breathing and speech therapy are also recommended, but they haven’t been well studied. The FORTITUDE trial will test how well these treatments work—alone or in combination—in adults across Canadian hospitals. Participants will be randomly assigned to receive either low-dose morphine or pregabalin, with or without a virtual cough therapy program led by a physiotherapist and speech-language pathologist. The study will track changes in cough frequency, severity, and impact on daily life over 6 weeks and up to 1 year. This trial will provide much-needed evidence to guide doctors and patients in choosing safe, effective treatments for chronic cough.

The ability to accurately perform movements and respond to changing environments is essential for daily life. This is often disrupted after a stroke, leading to motor impairments and a reduced quality of life. The cerebellum is an important brain structure involved in movement coordination and learning, making it a promising target for improving motor performance. Transcranial magnetic stimulation (TMS) is a non-invasive and safe technique used to measure or modulate brain activity. Theta burst stimulation (TBS), a patterned form of TMS, uses short bursts of stimulation to induce lasting changes in brain activity. While TBS has shown therapeutic potential in various clinical populations, its rehabilitative effects and underlying mechanisms in stroke survivors remain poorly understood. This study aims to investigate whether applying TBS over the cerebellum can improve motor performance in individuals with chronic stroke. We will assess participants’ movement accuracy and ability to adapt to a visual rotation after receiving real or sham TBS. Different stimulation doses will be delivered to determine the optimal amount to elicit meaningful changes in behaviour and brain activity. My findings will help inform future rehabilitation interventions aimed at improving movement performance and promoting motor recovery post-stroke.

Multiple myeloma (MM) is a type of cancer affecting bone marrow, leading to serious health issues including bone damage, kidney problems, and anemia. Although new treatments have improved survival and quality of life, MM remains incurable, with patients experiencing relapses and resistance to existing therapies. Recent research has identified the Hippo signaling pathway, particularly the MST1 protein, as a potential target for new MM treatments. In MM,components of this pathway (like TAZ) may actually suppress tumor growth. Previous studies have shown that increasing TAZ activity can trigger cancer cell death in MM, but the drugs tested so far either lack specificity or require high, potentially unsafe doses. This study aims to evaluate three new MST1 inhibitors that have shown high specificity and effectiveness at very low doses. The study will test these drugs on MM cell lines to determine how well they work alone and in combination with existing treatments.We will measure how the drugs affect proteins and genes in the Hippo pathway, and whether they can induce cancer cell death. Ultimately, this research hopes to identify promising new drugs that could be more effective and safer for MM patients, leading to better treatment options in the future.