Young men face significant mental health challenges, with male suicide rates accounting for 80% of suicide-related deaths (Bilsker et al., 2018). Despite this, men are less likely to seek mental health support due to stigma, self-reliance, and adherence to traditional masculine norms (Chatmon, 2020; Brown et al., 2019). This systematic review explored theoretical frameworks, barriers, facilitators, and strategies to improve mental health help-seeking among young men, guided by Chan’s theory of help-seeking (2013) and social identity theory (Tajfel & Turner, 2004). A systematic review of 189 studies identified several theories, with the theory of planned behaviour (Ajzen, 2011) and masculine gender role conformity (Addis & Mahalik, 2003) being most prevalent. However, findings revealed theory to be underutilized, with most studies lacking theoretical grounding entirely. Thematic analyses highlighted four key barriers: traditional masculine norms, low mental health literacy, stigma, and service-related challenges. Five facilitators emerged: reframing masculine norms, improved literacy, male-centric service adaptations, social support, and individual characteristics. Content analyses of 21 intervention programs revealed gaps, including limited theoretical foundations, inconsistent participant feedback, and underutilized strategies such as targeted education and stigma reduction. Findings underscore the need for prevention efforts, such as tailored mental health literacy workshops emphasizing coping skills and dismantling gendered stigma. Effective marketing strategies, including male-friendly language and role models, could improve program uptake. Interventions should include professional training and male-specific adaptations to ensure comfort and accessibility. Future initiatives must integrate these findings into evidence-based, gender-sensitive frameworks to better support young men’s mental health and foster help-seeking behaviours.

Background: The prevalence of diabetes has sharply increased after the age of 40 years since 2008/09. The prevalence of type 2 diabetes (T2DM) in the Indigenous population is 17.2% higher compared to the non-Indigenous population in Canada. Canadian Indigenous older adults are disproportionately affected by nutrition-related chronic diseases. The socio-cultural, biological, environmental, and lifestyle changes seen in this population group in the last half-century have contributed significantly to increased rates of T2DM and its complications. Ongoing lifestyle optimization including nutrition counselling and healthy eating patterns is essential for all patients with diabetes. Objective: The objectives of the study is to co-create a culturally safe nutrition plan. Method: We will invite the older adults from Caldwell First nation (target population) to focus group discussions to co-create the intervention following social constructivist approach. Implication: It is the intention of our study to respect and uphold traditional beliefs about Indigenous wholistic wellness – that our emotional, spiritual, physical and mental selves are not separate and that there can be no good health in one area if there remains sickness in another. A culturally sensitive nutrition counselling education material offers a promising strategy for improving the access to nutrition knowledge that may sustain a positive behavior change in older adults from Caldwell First Nation.

Background: The idea of Emotional Intelligence (EI) was first introduced in the 90s, defining it as "the subset of social intelligence that involves the ability to monitor one's own and others' feelings and emotions, to discriminate among them, and to use this information to guide one's thinking and action." Studies revealed that patient satisfaction is affected by the patient–clinician relationship, and the clinician's happiness positively impacts patient satisfaction with care. Interestingly, the North American healthcare system delivery has not explored the idea extensively. Objective: To foster patient care excellence in the Windsor-Essex region, we would like to evaluate the impact of EI on patient–clinician relationships. Method: We will conduct a mixed-method study where the quantitative component is a case study with clinicians (population) using EI consultation (intervention) to achieve patient satisfaction (outcome). The intervention will be provided for six months. We will use a Likert scale to evaluate patient satisfaction before and after the intervention and interpret data with a t-test. The qualitative component will explore clinicians' perceptions of patient care after receiving the EI consultation grounded in interpretive description theory. Implication: The study will contribute to knowledge generation on EI and its possible impact on patient–clinician relationships. The results from the study will also aid Erie Shores Health Care in achieving patient care excellence.

Antimicrobial resistance (AMR) is an increasing challenge in health care. Wastewater sampling provides a chance to survey regional AMR in a non-invasive way for the contributing population. In this study, functional metagenomic libraries were constructed from total DNA using the mosaic ends tagmentation approach (METa), and the cosmid library construction method, yielding average insert sizes of 2kb and 20-30kb respectively. Shotgun metagenomics is performed in parallel on the wastewater samples to screen for known AMR genes. This approach seeks to determine the current antimicrobial resistance gene (ARG) landscape in the populations reflected by the regional wastewater and, in combination with functional metagenomics, to potentially discover new ARGs. Our research looks at ARG resistance towards some common antibiotics such as Kanamycin, Ampicillin, and Tetracycline while also targeting two carbapenems, Meropenem (MP) and Imipenem (IP). Beta-Lactam antibiotics are a well prescribed and diverse family of antibiotics. IP and MP specifically are used as final interventions for Gram-negative bacteria with other beta-lactam resistance that cause pulmonary infections in cystic fibrosis patients, meningitis, sepsis, and others. Therefore, the initial hosts of choice for these libraries were E. coli and P. putida. In further studies, using other hosts of interest, namely Moraxella catarrhalis and Bacillus subtilis, different ARGs not expressed in P. putida and E. coli can be identified. Clones which contain no known resistance genes will be sub-cloned using transposon mutagenesis to determine the location of the resistance gene and ORFs will be predicted as a first step in investigating potentially novel ARGs.

Wastewater surveillance (WS) has emerged as a powerful tool for monitoring public health at the population level. Applications of WS continue to evolve with some recent efforts as aligned with monitoring the transmission of pathogens during mass gatherings. Mass gatherings are of concern to public health as they are associated with crowds, increased social interaction, and travel, all of which can facilitate the spread of infectious disease. Here we applied WS for pathogen surveillance during the 2024 National Football League (NFL) Draft in Detroit, Michigan, a large-scale sporting event that attracted an estimated 775,000 individuals to the Detroit riverfront from across the United States and beyond. Wastewater and environmental samples were assayed using RT-qPCR and nanofluidic qPCR to measure the concentration of a diversity of clinically relevant pathogens and antimicrobial resistance genes (ARGs). The data produced allowed for an overview of pathogen prevalence prior to, during and after a large-scale gathering, showing how WS may be implemented to warn of emerging health risk in near real time. This research shows WS has the potential to capture pathogen transmission dynamics during mass gatherings and provide public health authorities information needed to implement outbreak mitigation strategies in advance.

Background: The maternal-newborn unit at Erie Shores Healthcare (ESHC) in Leamington serves a diverse population, including migrant agricultural workers and refugee women, many of whom face significant barriers to accessing prenatal care. Suboptimal prenatal care, defined as fewer than ten visits, has been linked to increased caesarean and instrumental deliveries, which carry higher health risks and economic costs compared to vaginal deliveries. Objective: This study investigates the association between prenatal care visits and pregnancy outcomes, particularly delivery methods, to optimize resource allocation and improve care delivery. Method: The null hypothesis posits no significant difference in delivery methods between women on prenatal care who attend ten or more prenatal visits (control) and women on prenatal care who attend less than ten visits. Using a retrospective case-control design, the study will analyze five years of perinatal care data from ESHC. A sample size of 458, accounting for missing data, will provide 80% power to detect meaningful differences. Implications: Findings will inform resource allocation and guide the development of targeted prenatal care initiatives, including collaborations with the Migrant Worker Community Program. By addressing gaps in care for vulnerable populations, the project aims to reduce adverse pregnancy outcomes and healthcare costs while establishing baseline data for future research to improve maternal health in similar communities.

Purpose: The Clinical Trials Navigator (CTN) Program was launched in 2019 to increase enrollment in cancer clinical trials. It is free for all Canadians, and over 550 people have participated. This study has the objective of assessing the perspectives of people with cancer regarding the implementation of clinical trial navigation in Canada. Methods: People with cancer and their caregivers (n=21) were recruited from across Canada to participate in a 30–60-minute semi-structured interview. Based on the Consolidated Framework for Implementation Research (CFIR) domains, we assessed the facilitators, and barriers to access clinical trial navigation in Canada. Thematic analyses were performed by two independent researchers in duplicate using inductive and deductive coding. Results: 10 Interviewees had contacted the CTN Program (Pre-CTN) but had not yet received navigation for clinical trials, 10 had never contacted the CTN Program (Non-CTN) and 1 completed the CTN Program (Post-CTN). The results indicate participants valued early and direct access to information trials and perceived the CTN Program as a unique, trustworthy resource created by Canadians. Participants reported a sense of relief knowing they can find a trial when needed. Not all oncologists provided information for identifying clinical trials, and the CTN Program was therefore perceived as an important solution. Conclusion: Our results illustrate the gaps in the Canadian clinical trial ecosystem and emphasize the value of the CTN Program. The CTN Program addresses issues such as the timeliness and legitimacy of clinical trials information, increases patient sense of control and alleviates the burden of unexplored options.

Protein synthesis in the brain is required for long-term memory formation, and its dysregulation is implicated in memory decline in aging. Aging is characterized by a decline in various cellular processes that lead to cellular stress. This cellular stress activates the integrated stress response (ISR), which inhibits protein synthesis by the phosphorylation of the alpha subunit of eukaryotic translation initiation factor 2 (eIF2α). Given the role of protein synthesis in long-term memory formation, increases in phosphorylated eIF2α (p-eIF2α) are associated with impairments in memory, which can be rescued through cell-type-specific suppression of the ISR. However, the cell-type-specific role of the ISR pathway is not well understood in relation to aging-related memory decline, which is investigated in the present study. To this end, aged wild-type mice will undergo behavioural tests to assess long-term memory, and immunohistochemistry and fluorescence microscopy will be performed to analyze the expression of p-eIF2α and cell-type specific markers in order to identify the cell-types with elevated p-eIF2α levels. By understanding these mechanisms, our study aims to inform potential therapeutic strategies targeting the ISR in specific cell-types to mitigate the age associated decline in long-term memory.

mRNA translation in the brain is necessary for long-term memory consolidation, and its dysregulation is implicated in memory loss in Alzheimer’s disease. Pathological features of Alzheimer’s disease include the accumulation of amyloid-beta peptides and hyperphosphorylated tau proteins. The accumulation of these proteins results in many stressors that trigger the integrated stress response, which phosphorylates the α subunit of eukaryotic initiation factor 2 (p-eIF2α), inhibiting general protein synthesis. Prolonged integrated stress response activation in Alzheimer’s disease increases p-eIF2α levels, downregulates general protein synthesis, and impairs long-term memory consolidation. p-eIF2α is a key translational control mechanism to bidirectionally control long-term memory in health and disease. Learning stimulates general protein synthesis in a healthy brain by dephosphorylation of p-eIF2α. Cell-type-specific suppression of the integrated stress response in mice models of translation rescued memory deficit. However, the cell-type-specific translation regulation mechanisms are less understood in Alzheimer’s disease. Our objectives are to identify the cell-types with dysregulated mRNA translation in Alzheimer's disease and to restore translation in those cell-types to assess there effects on memory in Alzheimer's disease. To this end, Alzheimer's disease mice will be immuno-stained for p-eIF2α and eIF2α in specific cell-types, and eIF2α will be knocked-in to suppress the integrated stress response. Thus far, we introduced knocked-in eIF2α into the Alzheimer’s disease mice astrocytes and observed that stimulating translation in astrocytes can rescue memory deficits. Dissecting cell-type-specific translational control mechanisms in Alzheimer’s can aid in developing therapeutics to target specific cell populations, potentially leading to better treatment outcomes for Alzheimer’s disease.

Long-term memory consolidation results from synaptic plasticity dependent on mRNA translation. One of the translation mechanisms is regulated by eukaryotic translation initiation factor 2 alpha (eIF2α). The phosphorylation of eIF2α leads to a decrease in general translation while inducing the translation of specific mRNA transcripts. While the regulation of protein synthesis through the eIF2α pathway has been shown to influence long-term potentiation, its role in long-term depression (LTD) remains much less explored. Research suggests that phosphorylated eIF2α (p-eIF2α) regulation is cell-type-specific, however this research has focused primarily on long-term potentiation, not LTD. We hypothesize that p-eIF2α levels are differentially regulated across specific cell types during LTD. To investigate this, we will use novel object recognition, a long-term memory task, to induce LTD in mice. Immunohistochemistry will be performed to visualize p-eIF2α and total eIF2α expression across various hippocampal cell types, including excitatory neurons, inhibitory neurons, parvalbumin-expressing interneurons, somatostatin interneurons, astrocytes, vasoactive intestinal peptide-expressing interneurons, and microglia. The kinases regulating p-eIF2α expression (PKR, PERK, GCN2, and MARK) will then be assessed to determine which are upregulated. We expect to identify specific cell types expressing increased p-eIF2α levels following LTD induction, providing insight into cell-type-specific regulation of the eIF2α pathway. Proper regulation of the eIF2α signalling pathway is crucial for synaptic plasticity and memory. Consequently, chronic activation of p-eIF2α is linked to various neurological disorders, highlighting its potential as a therapeutic target and the significance of our research for future health advancements.

Grade 1 TNBCs comprise of histologically low-grade lesions whose natural histories, molecular features, and optimal therapy vary from those of high-grade TNBCs. Here, we describe the clinopathologic features and outcomes of patients with Grade 1 TNBC. This is a retrospective cohort study on Grade 1 TNBC patients from two separate Regional Cancer Programs in Canada seen from January 1, 2004 to December 31, 2022 . Demographic data, tumor characteristics, treatment and outcome of patients with TNBC from the two institutions were collected and analyzed. We identified a different pattern of histology for Grade 1 TNBC where 17 of 19 (89.4%) patients had infiltrating ductal disease, in contrast to literature which reported either carcinoma with salivary gland like morphology or low grade lesions considered benign as the more common histology pattern. Five had breast cancer recurrence indicating a recurrence rate of 26.3%. Out of the 5 patients with recurrence, one was stage 3, three were stage 2 and one was stage 3. All three patients (15.7%) who died from cancer were stage 2. TNBC patients with grade 1 tumors in this study were shown to have a different histology from that reported in literature and more similar to other grades of TNBC. The study also showed recurrence rate in more than a quarter of the cases . The relapse pattern is not dissimilar to other grades of TNBC and according to this study does not represent a unique subset of TNBC.

Background: BZRAs are commonly prescribed to older adults for the acute treatment of insomnia and anxiety, despite evidence-based recommendations cautioning against it due to an increased risk for falls/fractures, cognitive impairment and dependence, coupled with the added risk from inappropriate polypharmacy. Deprescribing BZRAs among older adults is challenging due to the many stakeholders involved (i.e., patient, clinicians, environment). Further, the prescribing/deprescribing landscape of BZRAs within smaller mixed urban-rural regions such as Southwestern Ontario has yet to be thoroughly investigated where access to resources and care coordination may differ. Objective: This study aims to explore clinician perspectives influencing BZRA prescribing/deprescribing practices within smaller mixed urban-rural regions in Ontario. Proposed Methods: This study employs a qualitative research design. Clinicians (primary care physicians, geriatricians, nurse practitioners) providing care to older adults within smaller mixed urban-rural regions in Ontario are invited to participate in a 30-45-minute semi-structured interview. Participants are asked about their rationale and perceived indications for prescribing BZRAs, the BZRA prescribing process and deprescribing efforts (including challenges/enablers). A directed content analysis using the Theoretical Domains Framework will be used for data analysis to identify emerging patterns and themes. Future applications: Findings may demonstrate a theoretical understanding of factors influencing BZRA prescribing/deprescribing practices among clinicians in smaller mixed urban-rural regions of Ontario. This study will provide a preliminary contextual understanding critical to developing BZRA prescribing initiatives that account for the health and social complexities within these understudied regions of Ontario.

According to the World Health Organization report, colorectal cancer (CRC) is the third most common cancer worldwide. Several CRC screening methods are available that include stool-based tests to detect blood (guaiac fecal occult blood test and fecal immunochemical test-FIT), endoscopic methods (sigmoidoscopy and colonoscopy), imaging methods (computed tomographic (CT) colonography, video capsule endoscopy), and biomarkers. Since 2019, the recommendation Worldwide for colorectal cancer screening in individuals aged 50 to 74 is a fecal immunochemical test (FIT). Erie Shores Health Care (ESHC) serves rural and remote Canadians spanning the Greater Windsor-Essex County area, located in Ontario, which includes Caldwell First Nation, Migrant Agricultural Workers, the Mennonite community, and the un-documented or documented refugee population. We noticed that many individuals attending the ESHC-Surgery facility for colonoscopy were either unaware of the FIT test or were not offered an FIT test before colonoscopy. The objective is to provide insight into the reasons for the under-utilization of the FIT test for CRC screening and guidance for an effective screening strategy for our region. An exploration into the utilization of FIT in the Windsor-Essex region with a retrospective data-driven analysis using the region's existing data is the proposed methodology. This study may aid hospital administration and clinicians in visualizing a realistic snapshot of FIT test utilization in the region, prompting the identification of possible barriers to FIT test utilization that are critical for improving uptake of and adherence to CRC screening. The publication will contribute knowledge on FIT test utilization in rural/remote Canadian healthcare systems.

Hepatocellular carcinoma (HCC) ranks among the leading causes of cancer-related deaths globally. Metabolic Associated Steatotic Liver Disease (MASLD), the most prevalent liver condition, is closely linked to a spectrum of hepatic disorders, including Metabolic Associated Steatohepatitis (MASH), liver cirrhosis, and eventually HCC. While cirrhosis is a well-established precursor to HCC, approximately 20% of HCC cases arise without prior cirrhosis, and the molecular mechanisms driving this subset of non-cirrhotic HCC remain poorly understood. This study employs a comprehensive bioinformatics approach to investigate the distinct molecular drivers of non-cirrhotic HCC compared to cirrhotic HCC. This study analyzed mRNA expression datasets to identify differentially expressed genes (DEGs) in MASLD/MASH versus normal tissue and cirrhotic and non-cirrhotic HCC versus normal tissue. GO analysis revealed that the DEGs were involved in pathways regulating lipid metabolism, cell proliferation, adhesion, migration, and immune responses, highlighting their diverse roles in tumorigenesis. Core genes involved in cell cycle regulation were identified and their expression patterns were systematically compared across MASLD/MASH, cirrhotic HCC, and non-cirrhotic HCC groups. Key genes such as CCNB1, E2F2, CDC25A, CCNE1, CDK1, CDKN2A, and CDKN2B showed significant upregulation in non-cirrhotic HCC compared to cirrhotic HCC, suggesting roles in driving tumorigenesis independent of cirrhosis. This comprehensive bioinformatics analysis identified core genes that mediate the molecular mechanisms underlying MASLD and MASH and their potential roles in non-cirrhotic HCC development. These findings provide a deeper understanding of the molecular basis of non-cirrhotic HCC and highlight promising biomarkers and therapeutic targets for diagnosing and managing this subset of HCC.

Background Patient navigation is a promising strategy to improve access to cancer care, but the evidence supporting its role in increasing access to cancer clinical trials has not been systematically evaluated. Objectives This scoping review aims to critically appraise, synthesize, and present the available evidence on the use of patient navigation to increase cancer clinical trial enrollment. Methods Nine databases were searched for English peer‐reviewed articles from inception through December 21, 2023. Two independent researchers screened titles, abstracts, and full texts and extracted data using standardized forms. Results/Implications Among the 23 included articles, 18 (78.3%) were observational studies, and 5 (21.7%) were randomized trials. Thirteen (56.5%) focused on equity, all addressing racial/ethnic groups. Seven (30.4%) articles used patient navigation for clinical trials for all cancer types; 14 (60.9%) focused on specific cancers, with 12 (85.7%) primarily addressing breast cancer. Among 21 studies describing navigator qualifications, 4 (17.4%) required professional training, while 17 (73.9%) used community representatives. The interventions used most frequently by navigators included education in 19 articles (82.6%) and care coordination in 17 articles (73.9%). Direct clinical trial referrals were unmentioned; logistical and financial assistance appeared in only 2 articles each (8.7%). In 7 (30.4%) studies, navigators directed patients to trials within and outside their center; 16 (69.6%) navigated patients only within their center. Future research should employ more rigorous designs to evaluate different patient navigation approaches and assess their impact on clinical trial enrollment across a wider range of cancers and patient populations.

Concussions are by far the most common type of traumatic brain injuries (TBIs) and are especially prevalent in athlete populations. Currently, there is a need to optimize and accelerate sports-related concussion testing without significantly sacrificing accuracy. Therefore, we propose the use of the 8-Variable Psychiatric Screener (V-8), an 8-item symptom-based questionnaire that employs the visual analog scale and takes under a minute to administer: the symptoms assessed include energy, depression, anxiety, fatigue, pain, happiness, stress, and motivation. To generate clinically relevant normative data for the V-8, descriptive statistics (i.e. means, standards deviations and quartiles) will be calculated for all individual item scores for times 1 and 2, the average time and the change score and stratified by sex, number of past concussions and pre-existing health conditions (i.e. anxiety, ADHD and/or learning disorders). Based on the literature, we hypothesize that higher baseline symptom severity scores for depression, anxiety, fatigue and pain will be associated with being female, the presence of previous concussions and the presence of pre-existing conditions. Additionally, we hypothesize that being female and having a history of previous concussions will both be negatively associated with the baseline symptom severity score for energy and that a history of previous concussions and pre-existing conditions will be positively associated with the baseline symptom severity score for stress. The findings of this study may inform new concussion assessment protocols as the implementation of the V-8 may improve concussion patients’ prognosis by quickening the diagnostic process and connecting them with suitable, individualized treatments sooner.

Background: Nutrition risk, which is the presence of risk factors and social determinants that may lead to malnutrition, increases healthcare usage, morbidity and mortality in older adults. Nutrition risk is common in Canadian older adults, with the most recent nationwide study reporting a prevalence of 35.6%. Though primary care is a key setting for its early identification and management, nutrition assessments are often overlooked by primary care physicians. Objectives: To understand the relevance of screening for nutrition risk in our community, we aimed to establish the prevalence of nutrition risk among older adults in Windsor-Essex County primary care practices. Methods: The validated SCREEN-8© nutrition risk screening tool was administered to community-dwelling older adults (≥65 years) registered with five primary care physicians across Windsor-Essex County. This tool produces a continuous score with a maximum of 48 points to dichotomize individuals into high or low nutrition risk groups. Subgroup analyses were conducted using participants’ demographic information. Results: A total of 301 participants, with a mean age of 74.5 years (SD=6.6), completed the survey. Sixty-two percent of participants scored at high nutrition risk, with a mean SCREEN-8© score of 34.6 (SD = 7.3). The mean score of those living in a home alone (M=31.3, SD = 8.06) was significantly lower than of those living with others (M=39.5, SD = 6.99), t(277) = -3.76, p < 0.001. Implications: The high prevalence of older adult nutrition risk within our local primary care practices highlights the importance of nutrition risk screening and management within this setting.

Challenges that emerged in the Windsor-Essex region during the COVID-19 pandemic were inequities in surveillance, including (a) the deployment of rapid screening and detection of COVID-19 and its variants, and (b) open access to evidence-based and user-friendly educational resources to engage the public. To meet these challenges, our research team designed and deployed a robust, and integrative surveillance platform, which included wastewater surveillance and individual-level saliva-screening to prevent outbreaks on our university campus. Our platform was co-designed with perspectives from our campus community and modified based on participant-led satisfaction and program evaluation data. Our goal is to adapt our surveillance detection platform to the needs of vulnerable communities in our region that are most susceptible to viral outbreaks, including cross-border healthcare workers (CBHWs) through our various community partnerships. First, we conducted two uptake surveys to capture local CBHWs interest in screening and prevention (Summer, 2023, & Fall, 2024 Ns=74 and 44 respectively). Across both survey administrations, approximately 61% were willing to participate in saliva testing to monitor the spread future viruses; however, concern regarding future public health emergencies did decline over time. Motivations for continued testing were having acute symptoms, protecting family, friends, and co-workers, and ease of use, accessibility and flexibility of the testing site. Participants also preferred timely and secure communication of results through email along with local community trends via a dashboard. This integrative data will continue to inform the deployment and evaluation of a sample dropbox site located at UWindsor for the broader community.

Glioblastoma (GBM) is the most prevalent and aggressive malignant primary brain tumour with a median survival of approximately 15 months despite standard of care treatment. A major barrier to effective treatment is the extensive genetic and phenotypic heterogeneity, fostering tumor resistance and contributes to its aggressive nature. Thus, GSC’s can recapitulate the tumour mass resulting in tumour recurrence and patient relapse in over 90% of GBM cases. The microenvironment of glioblastoma includes diverse types of stromal cells which co-exist in close association with tumour cells and have been identified as an important source of secreted factors and cell-to-cell signals that regulate the stemness of GSCs. Within GBM, Cancer-Associated Fibroblasts (CAFs) have emerged as key facilitators of these effects. CAFs are known to promote cell cycle dysregulation, enhance tumor vasculature and secrete various growth factors into the extracellular matrix to promote tumorigenesis. YKL-40 (also known as CHI-3L1) is an abundant glycoprotein that binds to the interleukin-13 receptor 2 (IL-13Rα2) and has been shown to promote growth, angiogenesis, metastasis, and resistance to therapy in diverse types of cancer. Elevated levels of YKL-40 expression have been associated with a poorer prognosis in GBM. Whether CAFs can enhance GBM tumor aggressiveness and support GSC survival through increasing the expression of YKL-40 is not known. We hypothesize that the increased expression of YKL-40, in response to CAFs, plays a pivotal role in GBM aggressiveness and therapy resistance. Understanding these interactions could lead to the development of targeted therapeutic strategies to prevent GBM progression and recurrence.

Background: Residential palliative care in Windsor-Essex County is limited to 45 beds across three providers: Windsor Essex Hospice, Hotel-Dieu Grace Healthcare, and Journey Home Hospice. Barriers such as a shortage of palliative beds, policies excluding those in long-term care homes or homeless, and travel instability often force individuals to spend their final days in hospitals. In Ontario, about 60% of deaths occur in hospitals, costing $1,100 per day compared to $460 per day for hospice care. A palliative care program at Erie Shores HealthCare would reduce travel burden and healthcare costs and improve patient, family, and caregiver experience. Objectives: The project aims to 1) provide equitable end-of-life care in a hospital setting, 2) offer loved ones the opportunity for positive final moments, 3) ensure access to bereavement support, 4) reduce stigma around the dying process, and 5) offer holistic care including pain management, psychosocial, and spiritual support to promote dignity in dying. Methods: The project will offer social work support, palliative rooms, a comfort cart with community partners, and end-of-life materials. Family feedback will guide the project to ensure it addresses community needs. Implications: Erie Shores HealthCare’s end-of-life program will offer private rooms, bereavement support, social services, and legacy-building activities to ensure comprehensive care and support for patients and their families during this difficult time.

Prostate cancer (PC) remains the most common cancer among North American men, with many cases progressing to castration-resistant prostate cancer (CRPC) despite androgen-deprivation therapy. A significant subset of these patients further develops neuroendocrine prostate cancer (NEPC), a highly aggressive and treatment-resistant form of the disease. Early identification of NEPC is crucial to improving patient outcomes, yet current diagnostic methods rely on invasive biopsies that are not routinely performed during disease progression. This study aims to establish a biomarker discovery platform to evaluate circulating tumor RNA (ctRNA) as a non-invasive diagnostic tool for tracking the progression from CRPC to NEPC. Using blood, saliva, and urine samples from prostate cancer patients, we will conduct whole transcriptome sequencing (WTS) to assess whether ctRNA accurately reflects tumor RNA profiles. We will specifically analyze molecular signatures associated with NEPC, including key cell cycle regulators, to determine the feasibility of ctRNA-based diagnostics. Preliminary findings suggest that NEPC exhibits a distinct cell cycle signature that we hypothesize can be detected in ctRNA. If successful, this study will justify a large-scale clinical trial to evaluate the use of liquid biopsies for early NEPC detection. Establishing ctRNA as a biomarker could significantly enhance personalized treatment strategies, enabling earlier intervention, improving survival outcomes, and reducing unnecessary treatments. This pilot study represents a critical step toward transforming prostate cancer management through non-invasive biomarker discovery.

Untreated comorbidities and socio-clinical factors accompanying retinal disorders significantly impact patient quality of life and mental health, representing a major health disparity. This study aims to address this unmet need by integrating a patient navigator program into a community retina clinic. The primary objective of this study is to evaluate the effectiveness of patient navigator support in improving vision-related quality of life and mental health outcomes. The secondary objective includes developing a multidisciplinary resource framework to address barriers to care for retinal patients. Semi-structured interviews were conducted with participants to identify barriers to accessing eye care and to inform targeted interventions. Subsequently, baseline measures were collected via VFQ-25, IVI, GAD-7, and PHQ-9 questionnaires. Following a three-month intervention period, surveys were re-administered to evaluate changes in vision-related quality of life, mental health, and overall satisfaction. Five retinal patients with visual impairments participated in a 60-minute preliminary interview to reveal the following common themes related to unmet health needs: 1) lack of PCP support, 2) transportation difficulties, 3) management of comorbidities, 4) low health literacy, and 5) emotional distress. 363 participants completed preliminary surveys: 43 reported difficulty accessing their PCP, 36 expressed transportation difficulties; 129 were diabetic, 37 had difficulty with disease management, 52 reported difficulty with health literacy, and 89 expressed eye-related anxiety. Preliminary findings demonstrate significant barriers to care among retinal patients, indicating a need for tailored interventions. This study indicates that a patient navigator program can address these obstacles by improving patient education and facilitating access to healthcare resources.

The dramatic impact of the COVID-19 pandemic on public health highlights the importance of developing a better understanding of the basic mechanisms of viral replication and the discovery of more effective antiviral therapeutics for coronaviruses and other emerging viral pathogens. Because the virally encoded RNA-dependent RNA polymerase plays a critical function in replicating the genome of all RNA viruses, it is one of the most attractive targets for developing direct-acting antiviral therapeutics. Divalent cations like magnesium ions play key roles as essential cofactors for the nucleotidyl-transfer reaction in DNA and RNA polymerases. Using a previously developed system to produce enzymatically active core replication complexes for SARS-CoV-2 and to measure RNA synthesis activities using in vitro primer extension assays, we have evaluated the effects of magnesium ions on RNA synthesis in the presence and absence of inhibitors. Our preliminary results reveal interesting patterns of sensitivity to magnesium ion concentration that vary depending on the presence and absence of different types of inhibitors. These preliminary findings suggest future directions for research into understanding the potential roles of magnesium and other metal ions in the structure and function of viral polymerases, as well as for understanding the effects of metal ions on the mechanisms of small-molecule inhibitors.

Introduction Oncology clinical trial accrual rates are estimated to be around 5%. The Clinical Trials Navigator (CTN) Program helps oncology patients identify clinical trials. We analyzed program and patient characteristics to determine features of successful enrolment. Methods A retrospective study was conducted, analyzing 411 CTN records from March 2019 to April 2024. 73 were referred to a clinical trial, with 14 successfully enrolled. Demographic and program characteristics were analyzed for the enrolled and non-enrolled. The reason for non-enrolment was recorded. For the enrolled, trial characteristics were recorded. All comparative values were analyzed using a Welch’s T-test. Results The average age for the enrolled group was 61 years, and non-enrolled 57 years (p=0.154). The mean distance from home center to clinical trial site was 332.9 kilometers (km) for enrolled and 407.6 km for non-enrolled (p= 0.152). The CTN processing time for the enrolled group had a mean time of 4.1 days and the non-enrolled had a mean time of 12.5 days (p= 0.002). The mean time of initial CTN application to death for the enrolled group was 17.4 months and the non-enrolled was 7.9 months. (p= 0.0051). The reason for non-enrolment was found to be either or centre specific (60.1%) or patient specific (39.9%). Patient enrolment by trial phase: three phase I (21%), two phase I/II (14%), three phase II (21%), one phase II/III (7%), one phase III (7%), and four NGS (29%). Conclusion These findings highlight some of the unique barriers and opportunities for patients in patient-centered clinical trials enrolment.

The intricate regulation of the cell cycle is crucial for normal cellular function, with dysregulation often leading to diseases such as cancer. While cyclin-dependent kinases (CDKs) are well-established regulators of cell cycle progression, the SPEEDY/RINGO family has emerged as an atypical activator of CDKs. To date, interactions have been identified only between a few SPEEDY proteins and CDK1/CDK2. However, the CDK family comprises more than 20 members, while the SPEEDY family includes nearly a dozen members, most of which remain unstudied. This study aims to elucidate the interactions between different SPEEDY family members and CDKs using an integrated bioinformatics and experimental approach. We employ protein-protein docking simulations and interface analysis to predict potential binding pairs. To validate our computational predictions, we perform biochemical testing including pull-down assays and co-expression studies. Furthermore, we use Isothermal Titration Calorimetry (ITC) to quantitatively measure the thermodynamic properties of these interactions, including binding affinity, stoichiometry, and enthalpy. Our findings reveal novel potential binding pairs between SPEEDY and CDK family members, highlighting the functional role of underexplored SPEEDY family members in cell cycle regulation. This comprehensive approach provides new perspectives on the complex interplay between these families in cell cycle control. Our results offer valuable insights into cell cycle regulation mechanisms and potentially uncover new drug targets for cancer therapeutics.

Keywords: Nasogastric, Neonatal Discharge of infants from the neonatal intensive care unit (NICU) depends on the growth and ability of the neonate to feed orally. However, achieving these goals may cause significant stress on families, prolong discharge timing, and strain hospital resources. NICU’s in other countries have shown success in early discharging before full oral feeding using a nasogastric feeding tube. Home gavage feeding, however, is not common in Canada due to multiple reasons including a lack of resources. Windsor Regional Hospital’s NICU has the capacity to implement such a program offering out-patient follow-ups to closely monitor feeding and growth, as well out-patient dietician expertise for nutritional support. To ensure the safety and efficacy before implementing the program, a retrospective chart review will be conducted to determine the emergency room visit and readmission rates of neonates discharged with an NG-tube. Additionally, a prospective cohort will be surveyed to assess the impact of the program on family stress and their quality of life. This study will determine the feasibility of this program as well as short and long term impacts of the home gavage feeding on neonates and their families. Doing so will facilitate local implementation of the study, decreasing hospital stays, resource consumption, and family strain.

Background: With the aging population and rise in comorbidities, the demand for palliative care (PC) continues to grow globally. PC adopts a holistic approach to supporting individuals with life-limiting illnesses by focusing on symptom management, maximizing comfort, and prioritizing quality of life. Integrating PC within the community enables patients to receive care in the comfort of their homes, promotes family involvement, and offers cost-effective solutions. Despite its benefits, home care providers report challenges in their ability to provide competent and effective PC which may impact the overall quality of care delivered to patients and their families. Limited research has explored how nurses perceive their own competence and self-efficacy in PC delivery, particularly in home care settings. Objective: This cross-sectional study explored Ontario home care nurses’ perceived level of competence and self-efficacy in PC delivery. Methods: An online survey was created using two validated scales and additional questions based on the literature. Study information was disseminated by home care and professional nursing organizations in December 2024. Inclusion criteria included 1) RNs or RPNs, 2) currently working as a home care nurse in Ontario, 3) had at least six months of nursing experience, and 4) had provided PC in patients’ homes. Future Applications: This study will contribute to the expanding body of research on palliative home care and may guide the direction of future research. Highlighting nurses’ educational needs underscores the importance of targeted training to enhance confidence, improve quality of care, and support the retention of nurses in the community.

Glioblastoma (GBM) is the most aggressive type of brain, and due to its highly infiltrative and heterogeneous nature, GBM poses significant challenges to standard therapies. Glioblastoma is categorized by three genomic subtypes: Proneural, Classical and Mesenchymal, and contains therapy-resistant Glioma Stem Cells (GSCs), contributing to tumor heterogeneity. Cancer cells (including GBM) are characterized by uncontrolled cell proliferation, which is linked to cell cycle dysregulation. The cell cycle, regulated by cyclins, cyclin-dependent kinases (CDKs), and CDK inhibitors, ensures orderly progression in a normal cell. Spy1 (SPDYA/RingoA) is an atypical cell cycle regulator that controls cell proliferation and survival through unique activation of CDKs and promoting the G1/S phase transition. In GBM, elevated levels of Spy1 regulate CDK2 activity and drive clonal expansion of CD133+ GSCs. Spy1-CDK2 can also activate RNA-binding protein, Musashi-1 (Msi1), which plays a critical role in GSC maintenance through post-transcriptional regulation of NUMB and Notch pathway. Musashi-1 supports GSC populations to drive tumor initiation and resistance to differentiation. This study aims to understand the role of Msi1 in maintaining GSC properties and its potential correlation with specific subgroups, and how Msi1 influences GSC self-renewal, proliferation, and response to therapies, with the goal of identifying novel therapeutic strategies to overcome treatment resistance in GBM. The objective is to study the expression of Msi1 in different genetic subtypes of GBM as well as in selected GSC populations and to establish whether Spy1 mediated effects in GBM depend on Msi1 molecular function.

Children with complex medical needs require specialized pediatric care, yet existing home and community care models often lack expertise and consistency. In Ontario, approximately 15,771 children have medical complexity, with 11.8% relying on life-sustaining technology. Despite representing a small percentage of the population, these children account for one-third of pediatric healthcare spending, yet over 70% of home care needs remain unmet, leading to unnecessary hospitalizations. WeeCare Pediatric Home Health Care was founded to address these gaps by providing specialized, family-centered pediatric care across home, school, and community settings. WeeCare bridges pediatric home care gaps through multidisciplinary teams trained to support children with medical complexity. Caregivers receive specialized education in ventilator care, enteral feeding, and seizure management. Personalized intake assessments ensure continuity of care, while the AlayaCare platform facilitates real-time updates and data-driven decisions. Partnerships with SickKids, McMaster Children’s Hospital, and community organizations enable seamless hospital-to-home transitions and integrated developmental support. WeeCare has significantly improved outcomes: 97% of families report increased confidence in managing care, 78% note fewer hospitalizations, and 92% of children can now participate in school or community activities. A parent shared, “WeeCare has given us the stability we never thought possible.” Expanding this model could reduce hospital costs while improving quality of life for medically complex children. By integrating WeeCare’s specialized, technology-supported, and advocacy-driven approach into healthcare systems, Ontario can enhance access to home and community care while alleviating strain on hospitals.

Background: As of 2024, more than 250 Canadians alone die each year waiting for organ transplants (Canadian Blood Services, 2024). The ability to efficiently differentiate urinary stem cells into pancreatic cells, and form organoids sparks an optimistic approach for patients with diabetes who otherwise require insulin injections on a regular basis. Objective: Aim of the study was to identify highly specific transcription factors that play crucial roles in maintenance of cell fate, and promote stage specific differentiation from urinary stem cells to functional pancreatic beta cells. Methodology: Data mining and literature review allowed for the identification of transcription factors and supporting proteins involved in the differentiation of pancreatic beta cells. These were further refined via analysis of several databases (KEGG, Pathway Commons). NCBI Gene Database was also utilized to determine pancreas tissue specificity for each protein identified. Cytoscape (version 3.10.0) enabled visualization of molecular pathways/gene interactions through different stages of differentiation along with a hierarchical cluster analysis. Subsequent enrichment analysis was conducted on the identified transcription factors and associated proteins using StringAPP (version 2.0.3), facilitating protein-protein interactome analysis. Results/Implications: In this pilot study, with findings from Cytoscape and enrichment analysis, novel transcription factors involved in reprogramming of pancreatic beta cells were identified with high statistical confidence. Both transcription factors and supporting ECM proteins were grouped in distinct stages of pancreatic differentiation. Overall, the current study addresses the need of identifying highly specific and efficient differentiation factors essential for successful reprogramming of patient-derived stem cells into pancreatic beta cells.

Gender-based violence (GBV) is a growing and pressing public health issue. Intimate partner violence (IPV), one kind of GBV, has been declared an epidemic locally in Windsor-Essex County, joining 96 other municipalities across Ontario who have recognized the severity of this concern. We conducted a scoping review (SR) to better understand the impact that trauma resulting from violence has on health outcomes of GBV survivors. Our SR serves to conceptualize the discussion of trauma as it relates to health and GBV in research contexts. Empirical research investigating trauma and health outcomes resulting from violence is lacking, which our SR seeks to address through improving the knowledge base and conceptualization of these topics from the literature. The literature search was completed in September 2024, where the key information sources included six academic databases (e.g. MEDLINE via Ovid, Scopus, etc.). Solely peer-reviewed studies published since 2010, that discuss GBV, women’s health, and trauma-related outcomes were included. Extracted data was tabulated and accompanied with descriptive qualitative data analysis. Emerging themes include but are not limited to: the role of trauma and violence being cyclical, various health consequences (e.g., reproductive health challenges, chronic pain, substance use, etc.), how survivors cope with adverse violence-induced outcomes. Findings will help inform policy and practice implications, such as a need for accessible mental health and medical care, trauma and violence informed care, and sensitivity training about women's lived experiences. Our SR emphasizes that health care professionals and organizations supporting survivors must be responsive to survivor’s needs.

The formation of long-term memories in the brain requires protein synthesis through mRNA translation. Newly synthesized proteins modify neural networks by strengthening or weakening synaptic connections through synapse alterations across numerous species. In rodents, both spatial and object recognition memory necessitate the activation of long-term depression at specific synapses in the hippocampus. The downstream pathway of long-term depression involves activating the eukaryotic initiation factor 2 (eIF2) pathway and protein synthesis. Phosphorylation of eIF2α plays a critical role in regulating the translation of specific mRNAs. Research indicates that the translation mediated by p-eIF2α is essential and sufficient for long-term depression and its associated learning behaviour. In contrast, blocking p-eIF2α prevents protein synthesis-dependent long-term depression. The cell type-specific cellular and molecular mechanisms by which p-eIF2α-dependent translation promotes synaptic plasticity and memory remain unknown. Different cell types in the brain have unique roles in shaping synaptic function, and identifying the cell-type-specific mechanisms involved in these processes explains how the brain adapts to its environments and experiences. We cross eIF2α knockout mice with inhibitory and excitatory Cre-recombinase-inducing mice by manipulating the expression of genes and signalling pathways. We then perform behavioural tests to investigate long-term depression in mice. The eIF2α knockout mice showed enhanced memories in excitatory Cre-recombinase-inducing mice, but no difference was observed in the inhibitory Cre-recombinase-inducing mice. This study aims to enhance our knowledge of molecular mechanisms of how the brain encodes new information and stores it as long-term memories, which has implications for understanding and treating memory-related disorders.

Lung cancer remains the most commonly diagnosed cancer and the leading cause of cancer-related deaths worldwide, primarily due to late-stage diagnoses. Non-small cell lung carcinoma (NSCLC) accounts for 85% of cases, with historically poor survival rates in Stage IV disease. While platinum-based chemotherapy has been the standard first-line treatment, immunotherapy targeting PD-1/PD-L1 pathways has shown promise in enhancing immune responses against tumors. Clinical trials support both mono-immunotherapy and combination therapy with chemotherapy, but direct comparisons of their relative efficacies remain limited. This study aims to assess patient-specific factors influencing treatment outcomes and compare the efficacy of mono-immunotherapy versus combination therapy. We hypothesize that patients with high toxicity risk—such as those with advanced age, poor performance status, or comorbidities—will benefit from immunotherapy alone, while younger, healthier patients or immunocompromised individuals may respond better to combination therapy. Using a prospective cohort design, we will recruit 80-100 Stage IV NSCLC patients from Windsor Regional Cancer Centre. Patients receiving either immunotherapy alone or in combination with chemotherapy will be analyzed based on survival, response rates, adverse events, and key demographic and clinical factors. Statistical analyses will determine significant differences in outcomes. By evaluating real-world clinical outcomes and their association with patient characteristics, this study seeks to refine treatment guidelines and promote personalized therapy, ultimately improving prognoses for Stage IV NSCLC patients.

In response to cellular stress, protein translation is regulated via the phosphorylation state of the α-subunit of eukaryotic translation initiation factor 2 (eIF2α). When phosphorylated, eIF2α reduces general protein synthesis while upregulating specific mRNA translation. De novo protein synthesis is critical for long-term memory consolidation and synaptic plasticity, particularly long-term potentiation and long-term depression (LTD). Translational control by p-eIF2α is implicated in these processes in a way that is cell-type specific; however, in relation to LTD, this cell-type specificity remains largely uncharacterized. The goal of the study is to address the current gap in memory research by examining the cell-type specific role of eIF2α in LTD and long-term memory. Wild-type mice undergo a memory task that requires them to identify a familiar object in a novel location to behaviourally induce LTD. Immunohistochemistry and fluorescence microscopy are used to probe for relative p-eIF2α expression and cell-type specific markers, which is expected to allow for the identification of the brain regions and cell types implicated in LTD through increased p-eIF2α expression. The present study provides the foundation for future work understanding the necessity and sufficiency of a given cell-type in the translational regulation of LTD and long-term memory, which may be targeted by the cell-type specific genetic ablation of p-eIF2α. Ultimately, this will allow for a more comprehensive understanding of memory processes. With a thorough understanding of the pathways and cell types involved in memory processes, effective and targeted treatments can be developed for neurological disorders and diseases affecting memory.

Small cell lung cancer (SCLC) is a highly aggressive metastatic lung cancer, accounting for 15% of all cases with poor survival outcomes revealing the necessity to produce novel therapeutic strategies. Recent studies show that SCLC has significant tumour heterogeneity with varying gene expression, presenting an opportunity to use machine learning-driven algorithms with a promising route to uncover its underlying mechanisms. This study leverages single-cell RNA sequencing (scRNA-seq) datasets, and machine learning (ML) to explore tumour heterogeneity, identify biomarkers predictive of novel therapeutic targets, and generate graphical predictions of tumour-immune interactions in SCLC patients. We will use published datasets to identify the cellular basis of tumour-immune interactions and identify gene expression changes within SCLC cells. Pathway analysis and biological validation will extend the results to molecular signalling pathways. Then we will conduct a literature search for the selected genes that are known to disrupt cellular interactions distinctive of SCLC to be further tested by the lung cancer research team in pre-clinical models. Our preliminary analysis shows promising outcomes producing key biomarkers in SCLC stage and treatment groups across immune and epithelial cell subtypes. Genes including RBP1 and CD74 were identified with strong protective effects and further exploration of these genes can highlight specific-stage molecular drivers to guide the ML models. Incorporating advanced models may yield more accurate predictions and improved biomarker discovery with clinical significance. In summary, this study aims to identify novel biomarker targets and therapeutic strategies that can be validated in pre-clinical models and translated into clinical applications.

Clinical trial accrual improves cancer outcomes but remains limited due to systemic barriers, with only ~3% of adult cancer patients participating. Integrating Clinical Trial Navigators (CTNs) into Multidisciplinary Case Conferences (MCCs) has demonstrated potential to enhance trial discussions, increase referrals, and streamline enrollment. This study evaluates the impact of CTNs on trial accrual, implementation effectiveness, and workflow optimization. We hypothesize that CTN integration into MCCs will increase referral and accrual rates while improving clinical trial integration efficiency. This hybrid effectiveness-implementation study focuses on breast, glioblastoma, and colorectal cancers at the Windsor Cancer Centre. Baseline referral and enrollment rates are established through observational chart reviews, while CTNs use updated Master Lists and the “Look Up Trials” app during MCCs to identify trial options. Surveys and structured interviews with MCC participants provide qualitative feedback on barriers and facilitators. Data are analyzed using descriptive statistics for quantitative measures and thematic analysis for qualitative responses. Although research ethics delays have postponed final results, anticipated outcomes from prior studies include a 25% referral rate and an 8% accrual rate among 168 patients and 60 physicians. Secondary outcomes target iterative process improvements and evaluate the app’s effectiveness in streamlining trial matching. Preliminary feedback suggests potential for enhanced physician satisfaction and optimized workflows. Integrating CTNs into MCCs shows promise in improving clinical trial referrals and accruals while reducing physician burden. Future research should explore scalability across additional cancer types and healthcare systems to further enhance clinical trial engagement and oncology care delivery.

Background: Patient navigation has been highlighted as a solution to improve clinical trial access. The Clinical Trial Navigator (CTN) Program is a Canadian cancer clinical trial navigation program that can be accessed online by patients or healthcare professionals (HCP). Trained individuals search and provide patients and/or oncologists a report of potentially eligible trials for free. Over 550 patients have used the Program since its launch in 2019, but systemic implementation within cancer centers has yet to occur. Objectives: We aimed to identify facilitators and barriers to implementing the CTN Program in Canadian cancer centers through stakeholder insights. Methods: We conducted 33 virtual, semi-structured interviews (45 min each) with healthcare/clinical research professionals (n=9) and patient-focused stakeholders (n=24). Interviews were guided by the Consolidated Framework for Implementation Research (CFIR) and analyzed using thematic analysis with deductive and inductive coding. Results: Participants emphasized patient navigation as a key solution to identifying and accessing clinical trials, reducing oncologist workload. Key barriers included financial and logistical stress for patients enrolling in trials at different institutions and challenges in obtaining required medical information for effective searches. When patients initiated searches, they often needed additional support discussing results with their oncologist. Conclusion: Findings highlight critical considerations for implementing the CTN Program in Canadian cancer centers. Planned program adaptations aim to address these barriers, with future evaluation on uptake and effectiveness.

Triple-negative breast cancer (TNBC) is the most difficult-to-treat breast cancer (BCa) subtype due to its aggressive, highly metastatic nature, and lack of targeted therapies. Increasing evidence implicates the transcription factor Kaiso in TNBC’s increased metastatic potential. In mouse xenograft models, Kaiso-depleted TNBC cells formed little to no metastatic lesions in the lungs or liver compared to parental Kaiso-expressing TNBC cells. Furthermore, increased nuclear Kaiso localization correlates with tumors of a higher histological grade and poorer survival. Kaiso has been implicated in metastasis by promoting epithelial-to-mesenchymal transition (EMT), a cellular program that is characterized by the loss of cell-to-cell adhesion and the adoption of mesenchymal properties that promote migration and invasion. While characterizing the mechanisms behind Kaiso’s role in EMT, we determined that Kaiso regulates the expression of various proteins in the Transforming Growth Factor Beta (TGFβ) signaling pathway, another potent inducer of EMT that also participates in BCa progression. Interestingly, we also observed that TGFβ1 treatment increases Kaiso expression in our TNBC cell lines. Chromatin immunoprecipitation (ChIP)-PCR analysis of the Kaiso promoter revealed that the TGFβ transcription factors SMAD2/3 bind to the Kaiso promoter directly, indicating that in addition to regulating TGFβ signaling proteins, Kaiso is also a downstream target of TGFβ. To further examine Kaiso's role in TNBC aggressiveness and metastasis, we will fully characterize this Kaiso-TGFβ feedback loop and examine Kaiso and TGFβ expression in TNBC tissues to determine if there is a unique Kaiso/TGF-β signature that could be used as diagnostic/prognostic biomarkers for TNBC.

Gym-based exercise is associated with many health benefits, including enhanced physical functioning, improved mental well-being, and reduced morbidity. Such benefits may be of particular interest to people with a disability (PWD) who are at twice the risk of developing conditions, such as depression, diabetes, and stroke. Health disparities among PWD arise from discriminatory environments, which limit their opportunity to access resources. Little effort has been made to advance equitable exercise opportunties among PWD in gyms. Accessibility assessments often focus on quantifiable characteristics of the built environment, overlooking cognitive and social accessibility, and the value of lived experience. A think aloud protocol involving a series of tasks completed within two gyms was adopted to gain an understanding of diverse participants’ perceptions and experiences of accessibility, usability, and inclusion. Directed content analyses of think aloud transcripts were guided by the Universal Design-based framework. The framework consists of a category for physical-spatial, sensorial-cognitive, and social environments, ensuring analyses yielded results across environmental domains. Thirty-nine participants (15 male, 23 female) between 18 and 68 years completed the study. Nineteen participants (~49%) had a disability and/or impairment. Five themes illustrated how participants maneuvered, understood, and felt within the gyms, reflecting physical (e.g., amount of equipment), cognitive (e.g., accessible information), and social factors (e.g., interpersonal interactions). Identifying environmental domain specific factors provided an understanding of how design and fitness professionals, scholars, and policymakers could develop functionally inclusive gyms for people with and without a disability to support participation in exercise and health for all.

Respiratory distress syndrome (RDS) is a leading cause of morbidity in preterm infants due to insufficient surfactant production. Surfactant therapy is the standard of care, with two primary administration methods: Less Invasive Surfactant Administration (LISA) and INtubation-SURfactant-Extubation (INSURE). This study compares the efficacy of these methods in a Level II community neonatal intensive care unit (NICU). A retrospective chart review was conducted on preterm infants (<34 weeks>gestation) who received surfactant between 2021 and 2023. The primary outcome measure was incidence of intubation within first 7 days of life, and secondary outcome measures were number of surfactants administered, as well as # of days of hospitalization and # of days on any type of respiratory support. LISA usage trends were also analyzed as part of a local quality improvement initiative. A total of 28 infants (9 in Insure and 19 in LISA) were included. The need for intubation was lower in the LISA group (16%) compared to INSURE (22%). LISA was associated with a slightly higher number of surfactant doses but a shorter hospitalization and respiratory support duration, though these differences were not statistically significant. Regarding LISA usage, all eligible infants (6/6) received surfactant via LISA in 2021; however, usage declined significantly in 2022 (5/11), followed by a rebound in 2023 (8/12). LISA may reduce the incidence of mechanical ventilation in spontaneously breathing preterm infants without significantly affecting hospitalization length or surfactant needs. Further data collection and staff education initiatives are necessary to enhance LISA adoption and improve neonatal outcomes.

Canada has seen a steady regression in literacy skills, evidenced most recently in the Progress in International Reading Literacy Study (PIRLS) assessment, which saw Canada drop from a global ranking of 12th to 18th. Canadian children continue to enter the school system with weak literacy skills. Specifically, English Language Learners (ELL), have struggled in Ontario to achieve provincial baselines; coupled with their unique learning needs, ELLs make up a large percentage of Ontario student composition. One evidence-based method for supporting the learning needs of ELL students in the primary grades is through Play-Based Learning (PBL). This approach allows students to explore language, develop vocabulary, and enhance their comprehension skills, all of which are essential components of literacy. This three-year tri-funded project is conducting a feasibility study, in collaboration with a local school board, to evaluate the viability of an in-school PBL program that is tailored to the learning needs of ELL students. To address the need for relevant, meaningful PBL material, the research team will take a novel approach by utilizing LEGO, a common manipulative in a kindergarten classroom with a high ELL population. Researchers will measure the impact on student literacy development using evidence-based methods and evaluate educators’ understandings of and confidence implementing PBL pre- and post-test. The overall goal is to advocate for elements of the program to be embedded on a provincial and national scale through ELL literacy educator training, resource sourcing and allocation, and impact measurement/assessment.

Background: Postoperative cognitive decline (POCD) in common in neurosurgical patients and significantly impacts functional independence. Several factors correlate to exacerbated POCD, including age, preoperative brain activity, and anesthesia type. However, little research has explored the use of artificial intelligence (AI) to predict POCD, which may personalize and improve patient treatment. This study aims to develop an AI tool which predicts POCD from neurosurgical patients based on patient and procedure characteristics for improved treatment outcomes. Hypothesis: We hypothesize that an AI tool trained on patient characteristics before and after surgery, along with procedure factors, may predict POCD. Methods: An AI tool will be trained and validated on neurosurgical case data to predict POCD risk and cognitive score (n = 200). Training data will include patient factors (demographics, blood test results, cognitive scores, lesion type) and procedure factors (anesthesia type, neurosurgical intervention). Cognitive score will be assessed using standard MoCA and MMSE tests. The tool will predict 7- and 30-day post-operative MoCA and MMSE score. We will validate the tool using a subset of patients (n = 50) and will assess model accuracy. Implications: AI-driven POCD prediction offers a cost-effective approach to personalized patient care. Integrating these tools into clinical workflows may better equip healthcare service providers to identify high risk patients, assess surgical risk, and adjust management, ultimately improving patient outcomes.

Background: High-grade gliomas (HGGs), including glioblastoma, are aggressive brain tumors with poor prognoses despite multimodal therapy. Microglia, the brain’s resident immune cells, play a dual role in HGG progression by either suppressing or promoting tumor growth through neuroinflammatory pathways. However, the relationship between microglial activation markers (IBA1 and CD68) and clinical outcomes remains poorly understood. Hypotheses/Objectives: This meta-analysis aims to evaluate the association between microglial activation (measured by IBA1 and CD68 expression) and clinical outcomes in HGG patients. We hypothesize that elevated IBA1 and CD68 levels correlate with increased neuroinflammation, shorter overall survival, and higher rates of post-surgical complications. Proposed Methods: A systematic literature search will be conducted using PubMed, Scopus, and Web of Science, following PRISMA guidelines. Studies quantifying IBA1 or CD68 in HGG tissue and reporting clinical outcomes (e.g., survival, recurrence, post-operative complications) will be included. Data will be extracted and analyzed using random-effects meta-analytic models to calculate pooled effect sizes and assess heterogeneity (I² statistic). Subgroup analyses will explore tumor grade and treatment history. Future Applications/Directions: Findings from this meta-analysis will clarify the prognostic value of microglial activation in HGGs, potentially guiding neurosurgical strategies and post-operative care. Future research could explore targeted therapies to modulate microglial activity, such as CSF1R inhibitors, to improve patient outcomes.

Background: Sexual minority individuals experience higher rates of mental health problems, but often have unmet service needs due to stigma, discrimination, and socioeconomic burdens. Online mental health interventions are cost-efficient and can minimize stigma, with some studies suggesting better treatment outcomes in sexual minorities compared to heterosexual individuals. While mindfulness-based apps have demonstrated efficacy in improving mental health in the general population, less is known about the engagement and response of sexual minority, compared to heterosexual, individuals. Objectives: Using data from a non-randomized clinical trial of a mindfulness app (AmDTx), this secondary analysis aims to examine whether sexual minority status predicts app engagement and treatment outcomes. We hypothesize that sexual minority individuals (vs. heterosexual) will adopt and engage with the app to a greater degree and report improved treatment outcomes over time. Methods: Treatment-seeking adults (N=183) received access to AmDTx and reported treatment outcomes at 2, 4, 8, and 12 weeks. Linear regression and multilevel models will evaluate sexual minority status as a predictor of adoption (attempted meditation); attrition (time spent in study); and app engagement (total meditation hours, number of activities completed); and as a moderator of treatment outcomes (functional disability, depression, anxiety, stress) over time. Covariates will include sex and gender. Future Applications: Sexual minority individuals experience poorer mental health and face greater difficulties accessing mental health care compared to their heterosexual counterparts. Identifying whether mindfulness apps hold a potential advantage in improving mental health in sexual minority populations can facilitate treatment access and outcomes in underserved populations.

Background: Globally one in three, or over 700 million, women experience violence perpetrated by an intimate partner. During the COVID-19 pandemic, a higher incidence and severity of IPV has been reported. Government-directed restrictions including stay-at home orders, physical distancing, and other pandemic-related measures forced many IPV organizations to roll back, adapt, or discontinue programs. While some community organizations developed new remote-service programs, others adapted existing models, and IPV organizations continue to provide virtual interventions to IPV survivors post-lockdown. Objectives: The overall objective of this study is to examine the innovative practices employed by community-based organizations that responded to intimate partner violence (IPV) and to assess the effectiveness of these services during the pandemic and pandemic recovery. Methods: Our study employs a mixed-method research design. The first and current phase involves in-depth interviews with frontline service providers and administrators of IPV service organizations across three countries (Canada, India, and South Africa). Interviews were audio-recorded and transcribed verbatim. Thematic analysis will be utilized. The second phase of this project includes a survey of service-engaged and non-service-engaged survivors in each country. Future Applications/Directions or for a completed study, Results/ Implications: As our study is in progress, suggested future directions include: 1) gathering insight that will inform future contingency plans for IPV service organizations during community-level disasters, such as COVID-19, 2) assessing the effectiveness of IPV existing and adapted interventions during the pandemic, and 3) to understand the resiliencies exhibited by IPV survivors with help-seeking during and following the COVID-19 pandemic.

Background: Living with cancer presents significant obstacles during a time when youth are starting to navigate relationships, develop independence, and shape their identities. Beyond these challenges, accessing age-appropriate care is difficult, especially in regions with limited specialized youth cancer programs and services. Research also indicates that youth involvement in cancer care decision-making is often limited, leading to feelings of disempowerment. Additionally, caregiver and provider perspectives on cancer care remain underexplored. Addressing these gaps is crucial to improving support for youth, caregivers, and healthcare providers. Objectives: This study explored the lived experiences of youths and their caregivers as they received cancer care in the Windsor-Essex Region while also incorporating the perspectives of local healthcare providers caring for youths with cancer. Method: Semi-structured interviews were conducted with youths with cancer (n=2), caregivers (n=6), and local healthcare providers (n=6). Interviews were transcribed and analyzed using a qualitative thematic analysis approach. Results: Six overarching themes were generated from this study, including: (1) Impact of treatment on physical wellbeing of youths; (2) Impact of treatment on psychosocial wellbeing of youths and caregivers; (3) Quality of interrelationships amongst youths, caregivers, and providers; (4) Caregivers’ realities in supporting youths through treatment; (5) Caregivers’ perspectives on cancer care while supporting youths during treatment; and (6) Importance of providing youth-focused care and beyond. Implications: These findings can inform the development of youth-centric models of cancer care and promote age-appropriate resources to support youths with cancer, their caregivers and healthcare providers.

Epithelial ovarian cancer (EOC) is a lethal gynecologic cancer, usually only diagnosed after widespread metastasis. EOC metastasis is unique, spreading through multicellular aggregates or spheroids. Previously, we demonstrated Liver kinase B1 (LKB1)-NUAK1 signalling promotes spheroid integrity, reattachment, and fibronectin production, in response to bioenergetic stress. Using genetics-based CRISPR deletion cell lines, we have solid evidence that LKB1-NUAK1 signalling plays crucial roles in EOC metastasis, therefore providing new therapeutic targets. The compound ON123300 is an established inhibitor for NUAK1, however, there are no known small molecule inhibitors of LKB1. Working with the OICR, we identified ASC-069 and Dinaciclib as lead compounds, which have been modified to improve LKB1 specificity. This research aims to compare the pharmacologic inhibition of LKB1 and NUAK1 focusing on metastatic properties of EOC spheroids. From our previous studies, and its position upstream in the pathway, we hypothesize LKB1 inhibition will have a greater impact on blocking metastatic properties of EOC spheroids as compared with NUAK1 blockade. Spheroid reattachment assays and Transwell migration/invasion assays will be performed to evaluate LKB1 and NUAK1 inhibition on metastatic properties of spheroids in culture. Early results indicate that spheroid viability and dispersion following reattachment are more potently reduced by LKB1 inhibitors compared to ON123300. We will verify on-target LKB1-NUAK1 inhibitory activity in spheroids; we have preliminary data that fibronectin expression is potently reduced following ON123300 treatment of spheroids. We are the first to develop potential small molecule inhibitors against LKB1 which will be important tools for the field as potential anti-cancer therapeutics.

International agricultural workers (IAWs) are vital to Canada’s agricultural sector and economy, yet their healthcare rights remain precarious. Despite contributing to health insurance during their employment, many IAWs lose access to healthcare when they become critically ill due to systemic barriers. The problem lies in the lack of clarity over jurisdiction: IAWs are brought in through a federal program, but healthcare delivery falls under provincial authority. This gap underscores an urgent need for policy reform to guarantee continuity of healthcare access for IAWs. Our project advocates for a policy that provides critically ill IAWs access to their insurance. Using the EPIC method, we contacted eight government officials, engaging six in meaningful discussions, with one committing to support our proposed policy. These involved officials whose party was familiar with our agenda but also those who were not. We presented our proposal that indicated how providing healthcare would not financially strain Canada’s healthcare system. Furthermore, ensuring healthcare access for IAWs aligns with Canada’s core values of equity and compassion. These efforts were supported by collaborations with community leaders to gain insights into the lived experiences of IAWs and to broaden our support network. Due to the nature of advocacy, this process remains ongoing until the goal of policy change has been achieved. This work underscores the importance of structured, empathetic advocacy in addressing systemic inequities. By combining targeted outreach to policymakers with community-driven insights, our research presents a replicable model for achieving impactful and sustainable policy change in support of vulnerable populations.

Keywords: Breastfeeding, Breast milk, Neonatal, Preterm Infants born premature benefit significantly from maternal breast milk with decreased risk of sepsis and necrotizing enterocolitis; however, breast feeding can be challenging in the Neonatal Intensive Care Unit(NICU) due to a number of factors including parental stress and inconsistent breastfeeding support. An informal parental survey done at the Windsor Regional Hospital (WRH) found that 44% of parents discontinued breastfeeding by the time of discharge from the NICU, and switched to alternative feeding methods such as using formula milk. To encourage parents to breastfeed their preterm infants, we developed an information pamphlet to address commonly asked questions about breastmilk feeding. This study aims to assess the impact of this information pamphlet on exclusive breast milk feeding rates of infants, born less than 33 weeks, in the WRH NICU. We will conduct a retrospective chart review to establish baseline exclusive breastfeeding rates among NICU infants at WRH. Following this, a mixed-methods study will assess the impact of the breastfeeding information pamphlet on exclusive breastfeeding rates in this population. Exclusive breast milk trends over the course of the intervention will be displayed using a run chart. A semi-structured survey of participating parents will be used to assess parental knowledge and attitudes towards breastmilk feeding after implementation. Evaluating the pamphlet’s effectiveness is essential to determine its potential as a standard NICU resource. This initiative aims to enhance parental knowledge, confidence, and breastfeeding practices, improving health outcomes for preterm infants.

Children and adolescents with type 1 diabetes (T1D) often face physical and emotional challenges due to the daily demands of managing this chronic condition. These challenges can impact outcomes such as quality of life (QOL), barriers to diabetes adherence (BDA), and blood glucose levels (measured by HbA1c). This proposal focuses on understanding how different psychosocial factors (depression, diabetes distress, fear of hypoglycemia, family conflict, sleep patterns, COVID-19 stressors, and problems with executive functioning) affect the outcome variables. Baseline data from the Diabetes Journey Project will be analyzed to find relationships between these variables through bivariate correlations and regression analyses. The findings from this study aim to inform interventions that address psychosocial challenges, ultimately improving diabetes management and quality of life for children and adolescents with T1D.

Early-stage triple-negative breast cancer (TNBC) carries a high risk of early recurrence and is associated with elevated mortality and morbidity. The KEYNOTE-522 trial, a randomized phase I study, investigated the efficacy of pembrolizumab, an immunotherapy agent, combined with chemotherapy in treating TNBC (Schmid et al., 2022). The trial demonstrated a pathological complete response rate of 64.8% in the chemotherapy-immunotherapy group compared to 51.2% in the chemotherapy-placebo group. Following these findings, pembrolizumab with neoadjuvant chemotherapy received Health Canada approval and has since become the standard of care for TNBC. While the KEYNOTE-522 trial provided pivotal insights, real-world data on the adverse events and toxicities of this regimen remain limited but are perceived significant (Marhold et al., n.d.). Emerging evidence suggests that toxicity rates in clinical practice may exceed those reported in the trial (SABCS 2022, n.d.). In this study, we retrospectively analyzed data from patients treated according to the KEYNOTE-522 protocol, examining demographic characteristics, treatment outcomes, and rates of immunotherapy-related toxicities to compare with trial data. Our analysis identified higher rates of grade 1, 2, and 3 toxicities in our cohort than those reported in KEYNOTE-522. Furthermore, a significant proportion of patients required discontinuation of immunotherapy due to adverse events. These findings highlight the challenges of translating clinical trial protocols into real-world practice, as well as the need for robust toxicity monitoring tools to optimize patient outcomes. Future research will focus on implementing an intuitive reporting tool to assist patients and healthcare providers in promptly identifying and managing grade 2 toxicities.

Background: The use of Semaglutide, commonly known as Ozempic, has faced public scrutiny in recent years with many viewing it as an expedient strategy for weight loss compared to lifestyle modifications (i.e., diet, exercise). However, research has shown its effectiveness in the treatment of obesity as it slows down gastric emptying, signals the brain to feel satiated, thereby reducing appetite and increasing weight loss. Most studies have investigated the 2.4mg formulation of Semaglutide for weight loss. However, other formulations (e.g., 0.25 and 1.0mg) have not been thoroughly studied within this context, yet may have better implications for patients (e.g., cost, accessibility). Objective: This study aims to investigate the real-world effectiveness of Semaglutide 1.0mg for weight loss in a community clinic primarily focused on obesity care. It is hypothesized that Semaglutide 1.0mg will facilitate clinically meaningful weight loss in patients with obesity at specified intervals of 3-, 6-, 12-, and 24-months. Proposed Methods: This study will employ a retrospective chart review methodology. Participants were included if they were prescribed Semaglutide and adhered to the maximally tolerated dose of up to 1.0mg for at least 12 weeks between January 2021 and March 2023. Clinically relevant variables will be extracted. Changes in BMI and percent change in weight will be analyzed at the specified intervals after initiating Semaglutide. Future applications: These findings may support using Semaglutide 1.0mg as a cost-effective, accessible alternative for obesity management. This study could inform clinical guidelines and policies, address accessibility barriers, and promote equitable obesity care.

Background: Naltrexone/Bupropion (NB) was approved as an anti-obesity medication (AOM) based on the Contrave Obesity Research (COR) trials, which assessed weight loss at weeks 28 and 56. Prior research suggests that weight loss within three months of AOM treatment predicts long-term success. This study evaluates the real-world effectiveness of NB in achieving clinically significant weight loss after three months of adherence and compares long-term outcomes to the COR trials. Methods: A retrospective chart review was conducted at a Canadian community clinic. Patients were included if they had obesity (class I–III), adhered to NB for at least three months, were treated solely with NB (June 2019–March 2023), and were ≥18 years old. Weight loss was calculated from baseline at three months, and for those with longer adherence (26, 52, and 104 weeks). Results: Among 125 patients completing three months of NB, the mean weight loss was 4.9% (clinically significant). Of those continuing NB, 57.6% had already lost ≥5% by three months. At six months (n=72), weight loss was 8.6%. At 52 weeks (n=33), it was 11.3%, and at 104 weeks (n=11), it reached 11.8%. Conclusion: NB effectively achieves clinically significant weight loss within three months. Longer-term real-world outcomes align with COR trial findings, supporting NB’s sustained effectiveness in obesity treatment.

Background: Clinical trials are critical for advancing cancer therapies, yet patient enrollment remains below 5%. The Clinical Trials Navigator (CTN) program identified gaps in biomarker knowledge and accessibility as significant barriers in Canada. Methods: Between May and October of 2024, an electronic survey assessed 36 Canadian oncologists’ biomarker knowledge and regional accessibility using a Cancer Care Ontario-approved list. Respondents were asked to identify biomarkers accessible in their regions. Results: Significant disparities in biomarker knowledge and accessibility were evident. Common biomarkers for breast cancer (ER, PR, HER2) were consistently identified by all 18 physicians surveyed. Similarly, colorectal cancer biomarkers (MLH1, MSH2, MSH6) were widely recognized and accessible, with 100% of respondents reporting knowledge and access. In contrast, knowledge of biomarkers for rare cancers, including adrenal, penile, and stomach, was significantly lower, with only one, out of six, biomarkers (HPV) identified by a group of 11 physicians. Geographic differences were also evident. Newfoundland and Labrador reported the highest biomarker accessibility (86%), although this was based on a single respondent. Ontario, with the largest sample (21), showed a 60% knowledge rate, reflecting gaps in knowledge rather than access. British Columbia (67%), Manitoba (77%), and Nova Scotia (85%) demonstrated higher knowledge, though sample sizes were small. Alberta had the lowest rates for both (54%). Conclusions: Our survey highlighted significant regional disparities in biomarker knowledge and access across Canada, particularly for rare cancers. Targeted education and resource allocation are critical to addressing these gaps, improving clinical trial enrollment, and advancing cancer care outcomes.

A major reproductive health issue affecting millions globally is infertility (Zhang et al., 2022). Currently, in Canada, around 16% of women experience infertility (CFAS, 2022). The infertility treatment market generated $1,770.6 million in 2023 (Ghosh, 2024) and is projected to grow to 62.8 billion in 10 years (The Lancet, 2024). Despite the prevalence and high monetary, physiological, and psychological costs of infertility, studies in business, including consumer psychology, examining infertility/fertility preservation are scarce and is limited to qualitative studies. We aim to systematically review research on the fertility industry, including infertility treatments and fertility preservation, to assess the current state of research, identify the gaps in the literature, and explore potential future directions within the areas of consumer psychology and decision-making. Using a systematic domain-based review approach (Snyder, 2019; Paul & Criado, 2020), we analyzed articles on the Scopus and Business Source Complete databases. We reviewed 449 articles based on their title, abstract, and keywords. Our results, including final 39 articles, unveil various themes of research on the influence of physiological, psychological, socioeconomic, financial, career, legal, and technological factors, as well as access to information, on fertility preservation and treatment decisions. Furthermore, we evaluate the psychological, relational, and career outcomes associated with these factors and discuss their implications for business and for health systems. We suggest future research directions and areas for improvement to guide subsequent studies in this field. This literature review is the first to explore fertility healthcare services through the lens of consumer psychology and business research.

Delayed diagnosis is a common challenge in multiple myeloma and can significantly impact patient quality of life, outcomes, and potentially survival. Although multiple myeloma often first presents in primary care, research indicates that a substantial proportion of cases follow complex diagnostic pathways, with nearly one-third diagnosed in acute care or emergency room (ER) settings. Moreover, socially vulnerable and/or isolated populations may be disproportionately diagnosed in these acute care environments. Such diagnostic delays may exacerbate progressive bone disease, fractures, chronic disability, and pain, ultimately reducing patients’ quality of life and prognosis. Hence, our study aims to determine the proportion of multiple myeloma patients presenting to the ER at or before initial diagnosis and assess the nature of both acute and sub-acute presentations. We will conduct a retrospective chart review of multiple myeloma patients with a histopathological diagnosis within 5 years of study initiation who presented through the Windsor Regional Cancer Center, targeting a sample of 60–70 patients with single or multiple ER visits. Key factors to be analyzed include demographics, symptomatology, reasons for presentation, number of visits, ER disposition, disease progression, and changes in clinical status between the time of initial presentation and diagnosis. Through this study, we aim to identify the nature of emergent presentations in newly diagnosed multiple myeloma patients, while defining demographic and disease-related characteristics that may serve as associated risk factors. In doing so, we strive to facilitate strategies for more timely diagnosis to enhance patient outcomes and quality of life.

Background: Despite the advancements in oncology care, systemic barriers to care persist, affecting the experiences and outcomes of youths with cancer, their caregivers, and healthcare providers. Youth with cancer and their caregivers often report feeling underserved by healthcare systems, particularly in psychosocial support and aftercare. Healthcare providers experience parallel challenges, including limited resources and support, which hinder their ability to provide high-quality oncology care. The availability of cancer care services and experiences of youth with cancer in smaller communities remain underexplored, leaving potential gaps in support systems and healthcare accessibility. Objective: This study examined the strengths and challenges of the current oncology care practices from the viewpoints of youth with cancer, caregivers, and healthcare providers living and practicing in the Windsor-Essex region as well as explored their recommendations for development of effective care. Method: Semi-structured interviews were conducted with youths with cancer (n=2), caregivers (n=6), and local healthcare providers (n=6). Interviews were transcribed and analyzed using a qualitative thematic analysis approach. Results: The key strengths and challenges identified were: 1) the Value of holistic support services, 2) the Availability of resources, and 3) the Quality and support of youth oncology care and services. Recommendations generated from participants were: 1) Enhancing equitable supportive care for youth in oncology and 2) Strengthening cancer care capacity and collaboration. Implications: The findings highlight the need to enhance supportive services and strengthen infrastructure for sustainable, high-quality youth cancer care. Future research should focus on developing care models that integrate holistic, age-appropriate supports alongside medical treatment.

Background Motor impairments resulting from stroke, neurodegenerative diseases, and musculoskeletal injuries may present challenges in rehabilitation. While conventional therapeutic approaches are effective, they often lack real-time monitoring, instant feedback, and individualized treatment. Technology-assisted rehabilitation devices (such as wearable sensors, biofeedback systems, robotic exoskeletons, and virtual reality therapies) provide an alternative by facilitating continuous data tracking, increasing patient engagement, and allowing for personalized rehabilitation plans. However, their widespread implementation in clinical settings remains constrained by factors like awareness, cost, and the need for clinician training. Objective The use of technology-assisted rehabilitation devices in motor rehabilitation has the potential to improve patient outcomes. This study seeks to outline their clinical applications and advantages, emphasizing their impact on motor function and providing insights into their integration into rehabilitation programs. Methods Through a narrative review, this study compiles existing research on technology-assisted rehabilitation devices for motor recovery. Peer-reviewed studies and emerging research is explored to provide an overview of their effectiveness and current clinical applications. Results/Implications Technology-assisted rehabilitation devices allow clinicians to develop targeted treatment strategies. For instance, smart insoles and inertial measurement units aid in gait analysis, while biofeedback systems support neuromuscular re-education. Exoskeletons and soft exosuits help restore mobility, especially for stroke survivors and individuals with spinal cord injuries. Additionally, virtual reality and haptic technologies create immersive rehabilitation experiences that enhance patient motivation and therapy adherence. However, widespread adoption is limited by high costs, data security concerns, and the need for specialized clinician training. Keywords: technology-assisted rehabilitation, digital health, motor impairment, rehabilitation

Prostate cancer (PC) is the second most common cancer in men worldwide, affecting 58 men daily in Canada. As treatment options continue to evolve, disease management and overall patient outcomes have improved. While effective, these treatments can sometimes pressure PC cells to transdifferentiate into a more aggressive, treatment resistant type of PC, known as neuroendocrine prostate cancer (NEPC). Treatment options for NEPC are very limited as it is resistant to all current therapies, leading overall prognosis to remain very poor with an estimated survival of less than one year. Further, the mechanism behind the progression of disease to NEPC remains limited, with few markers being used to study progression. Our lab has identified a class of cell cycle regulatory proteins elevated in NEPC, with evidence supporting that these proteins have the potential to drive progression to this drug-resistant form of disease. This project aims to establish a PC to NEPC platform of disease progression to study the specific role of these regulatory proteins during PC transdifferentiation. Further, we will utilize drugs that can block these proteins and test whether these drugs can treat and/or prevent the progression of disease to NEPC. This work will be completed using in vitro and in vivo models, including cells, animal, and human samples. Preventing the progression of disease to NEPC and identifying markers of NEPC remains one of the greatest challenges in this field, and we have strong rationale and data to support this being a promising direction that could make a meaningful impact.

Glioblastoma (GBM) is a highly aggressive malignant brain tumour with a poor prognosis despite intensive conventional therapies. A key challenge in treating GBM is its ability to resist treatment, with a subset of tumour cells surviving and entering cellular senescence, a state of irreversible cell cycle arrest. While senescence initially halts tumour growth, prolonged senescence can contribute to tumor recurrence. Spy1, a cyclin-like protein, is elevated in GBM and promotes cell cycle progression by activating cyclin-dependent kinases (CDKs) and overriding cell cycle checkpoints. We hypothesize that Spy1 promotes GBM tumour growth and progression by enabling cancerous cells to evade senescence. Using in vitro and ex-vivo systems, this project will explore Spy1’s influence on senescence in GBM and assesses whether Spy1 targeting can enhance the effect of therapies targeting senescent cells. Spy1 will first be knocked down in GBM cell lines, and the levels of senescence will be evaluated through senescence-associated β-galactosidase staining and transcriptional analysis of senescence markers. These assessments will be replicated in Spy1-knockdown GBM cell lines subjected to temozolomide, the conventional treatment for GBM. Furthermore, this project will explore the combination of Spy1 inhibition with senolytic drugs, which are designed to eliminate senescent cells. The therapeutic efficacy of this combination will be evaluated through cell viability assays to assess cell death. This research will contribute to the understanding of Spy1’s role in GBM and its potential as a novel therapeutic target, potentially paving the way for personalized therapies to prevent GBM progression.

Cannabis is a drug that has become widely used around the world. Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two important components found in cannabis with contrasting effects on the brain. These components have played crucial roles in benefiting pain relief, appetite and other conditions. THC is known for its psychoactive properties, while CBD is known for its non-psychoactive properties. This article focused on anxiety disorders since it has been on the rise over the last couple of years. A systematic review was conducted using Pubmed and Google Scholar to investigate how CBD and THC influence the severity and progression of anxiety disorders in adults aged 12-65. This study aimed to determine if these components benefit in reducing anxiety. The analysis found, 90% of the articles stated that CBD plays an important role in reducing anxiety whereas 71% of the articles stated THC plays a negative role and increases anxiety. Further research should determine the optimal cannabis dosage for anxiety reduction, focusing on specific anxiety disorders (e.g., social or general anxiety), while analyzing narrower age ranges to assess its impact across different age groups.

Triple Negative Breast Cancer (TNBC) is the most aggressive and heterogeneous subtype of breast cancer, comprising 15–20% of all cases. TNBC is defined by absence of estrogen, progesterone, and HER2 receptors, leaving patients with limited treatment options and poor prognoses. TNBC tumors contain a high population of cancer stem cells (CSCs), which possess enhanced self-renewal, metastatic potential, and resistance to therapies. CSCs contribute to immune evasion through the upregulation of immune checkpoint proteins (ICPs), which inhibit anti-tumor immune responses and create an immunosuppressive environment that promotes tumor survival. The cell cycle has been implicated in the regulation of ICP expression with CDK inhibition leading to increased ICP expression which, in combination with ICP inhibitors, leads to increased patient prognosis. Spy1 is an atypical activator of CDKs which is able to bypass traditional regulatory pathways, promoting proliferation, expanding CSC populations and increasing treatment resistance. Given the unique mechanism of Spy1 mediated CDK activation, it presents the opportunity it may regulate ICP expression, enhancing CSC-mediated immune evasion in TNBC. Understanding the role of Spy1 in this process could reveal novel therapeutic strategies to disrupt the immunosuppressive environment and improve the efficacy of immune checkpoint inhibitors, potentially transforming TNBC treatment outcomes.

Type 1 diabetes (T1D) is marked by a deficiency in insulin secretion caused by an autoimmune destruction of the insulin-producing beta cells in the pancreas. As a result, individuals typically follow a complex regimen of carbohydrate counting, checking blood glucose levels regularly, and calculating insulin doses daily. As such, it is imperative for these individuals to feel connected to and cared for by those around them. Therefore, the use of social media as a vehicle to connect individuals with T1D to interact with and support one another is groundbreaking. The main purpose of the proposed study is to investigate the potential positive aspects of social media for a community of individuals with T1D, such as the ability for these platforms to equalize access to current diabetes healthcare knowledge, including technology advances, so that people with T1D who experience support online are better able to advocate for their healthcare needs. The study uses archival data previously collected as part of a parent study (Type 1 Diabetes on Social Media: A thematic analysis of publicly posted content across social media platforms). Due to the amount of data collected, the technology and advocacy primary codes will undergo further qualitative examination through a secondary content analysis. The study aims to inform on the many layers of the T1D healthcare advocacy ecosystem as well as the potential role of social media networking in building self-management skills for those with chronic conditions, like T1D.

Estrogen-receptor positive (ER+) breast cancer is the most common breast cancer subtype, accounting for 70% of breast cancer diagnoses. The standard of care treatment for ER+ breast cancer is endocrine therapy, however 30-50% of patients develop resistance. Palbociclib is a cyclin-dependent kinase (CDK) 4/6 inhibitor that works synergistically with endocrine therapy, yet patients can acquire CDK4/6 inhibitor resistance. Underlying mechanisms in acquiring CDK4/6 inhibitor resistance are still being explored, with data supporting CDK2/Cyclin E hyperactivation as a key driver of resistance. Spy1 (Speedy/RINGO), a cyclin-like protein, promotes cell cycle progression through the G1/S checkpoint. Spy1 directly binds and activates CDK2, irrespective of post-translational modifications required for canonical cyclin-CDK activation. The unique Spy1-CDK2 complex is resistant to p21 and p27 inhibition, thus promoting cell cycle progression. Previous data shows that elevated Spy1 promotes treatment resistance in ER+ breast cancer. Given the unique ability of Spy1 to hyperactivate CDK2 through Spy1-CDK2 complex formation, Spy1-CDK2 activation may give rise to CDK4/6 inhibitor resistance in ER+ breast cancer. This project aims to investigate the role of Spy1 in CDK4/6 inhibitor resistance using the Casper zebrafish model and evaluate the manipulation of Spy1 on the cellular response to palbociclib in ER+ breast cancer.

Patients with multiple myeloma may experience subjective changes in baseline cognitive function, which can span across various cognitive domains. Currently, there is limited data about the nature, severity, and temporal evolution of these deficits, as well as their relationship with disease and treatment-related factors. While advances in multiple myeloma treatments continue, few prospective trials have evaluated their impact on cognitive function and quality of life. The objective of this retrospective, cross sectional study is to assess potential cognitive changes in multiple myeloma patients undergoing therapy. This study aims to recruit approximately 60 participants, with 16 presently enrolled. To identify incidence and patterns of cognitive change, patients undergo comprehensive cognitive evaluations such as the International Cognition and Cancer Task Force (ICCTF) battery, National Institute of Health Toolbox (NIB-TB), and the five-minute Montreal Cognitive Assessment screener (MoCA). Data collection and preliminary analysis on 16 participants (median age 72 years, 10/16 on first-line therapy) has revealed global cognitive impairment in 5/16 patients using the ICCTF battery and the NIH-TB, with verbal learning and memory, and executive function being the most affected domains. Future initiatives of this research will focus on expanding study population with the aim to validate preliminary trends in a larger cohort. Larger numbers will allow exploration of correlations between subjective and objective cognitive performance, and the potential differential impact of classes of treatment agents on cognitive function. Results from this study may yield hypotheses for future evaluation and validation in larger, prospective trials.

Infertility affects approximately 1 in 6 Canadian couples, with in-vitro fertilization (IVF) being a viable solution. Frozen Embryo Transfer (FET), an integral procedure in IVF, involves the implantation of a cryopreserved embryo into the uterus. Although relatively successful, complications such as miscarriage, ectopic pregnancy, and preterm birth remain concerns. Research has shown that uterine contraction at the time of FET negatively impacts implantation success. Therefore, taking a medication with uterine relaxing effects, such as Pantoprazole, during FET may facilitate successful implantation. Pantoprazole is a proton pump inhibitor used in the management of gastroesophageal reflux disease (GERD) and is a pregnancy category B drug with no significant risk of pregnancy complications including preterm delivery, spontaneous abortion, or major congenital birth defects. Emerging data suggests that Pantoprazole relaxes the uterine walls. This study aims to evaluate the efficacy of pantoprazole improving implantation during FET procedures. In this single-blind randomized controlled trial, 200 participants undergoing FET at Victory Reproductive Care (VRC) will be recruited and randomized into an experimental or control group. The experimental group will take oral pantoprazole (40mg, daily) for 7 consecutive days, starting 3 days prior to FET. The control group will not receive pantoprazole. The frequency of biochemical pregnancy, clinical pregnancy, miscarriage, and ectopic pregnancy will be recorded and analyzed to determine if Pantoprazole improves FET outcomes. The results of this novel study may help advance standardized FET procedures to improve fertility outcomes.

Back and leg pain are among the most common medical complaints, with treatment largely dependent on lumbar MRI evaluation. However, the literature documents significant variability in interpretation, with both inter-rater and intra-rater reliability concerns. This inconsistency impacts diagnostic accuracy and treatment decisions. Our study aims to develop a standardized scoring system for lumbar MRI assessment, designed by a multidisciplinary team of neurosurgeons, radiologists, and spine care specialists. By synthesizing insights from established grading systems, including the Pfirrmann and Modic classifications, we are creating an objective, reliable, and reproducible evaluation framework. Calibration will be conducted using a subset of MRI images, followed by validation on 150 diverse scans. Inter-rater reliability will be assessed using Cohen’s Kappa statistic. A larger dataset of 1,000 MRI images is being assembled for future convolutional neural network (CNN) training. The goal is to establish a validated system that enhances diagnostic consistency and accuracy. Future CNN integration is expected to further improve reliability and efficiency, ultimately optimizing clinical decision-making in spine care.

Background: Trauma-informed care (TIC) requires healthcare providers and organizations to provide care in a way that assumes everyone has a trauma history (Hopper et al., 2010). Recent studies indicate that both registered nurses and advanced practice nurses, while open to the concept of being trauma-informed, often lack the knowledge, tools, and confidence to address trauma in patient care effectively (Maybe et al., 2017). Despite awareness of a knowledge and practice gap, nursing has continued to trail other healthcare disciplines in integrating TIC into nursing education (Li et al., 2019). Objective: An integrative review examined current approaches and methods for integrating trauma-informed care (TIC) into undergraduate nursing education. Methods: An integrative review following Whittemore and Knafl (2005) procedures synthesized the literature related to TIC in undergraduate nursing education. The quality of the empirical studies was assessed using the Mixed Methods Appraisal Tool (MMAT), as outlined by Hong et al. (2018). Results: Data analysis involved a four-step process based on Miles and Huberman’s (1994) data analysis components. Five themes surfaced: (1) Isolated TIC Integration in Undergraduate Courses, (2) TIC for Safe Learning Environments, (3) Inconsistent TIC Definitions in Nursing Education, (4) Prerequisite Nurse Educator Training, and (5) Students Recognizing an Implementation Gap and Seeking Solutions. Conclusion: This review highlights TIC integration challenges in nursing education, emphasizing the need for ongoing research, training, and collaboration. These efforts are vital to equipping future nursing professionals with the skills to provide high-quality, trauma-informed care, benefiting students, patients, and healthcare delivery.

Pediatric chronic asthma management often requires inhaled corticosteroid use, like beclomethasone dipropionate (BDP). While BDP has been a keystone in asthma treatment for decades, the research assessing its efficacy and safety, particularly in ages 5-18, were conducted between the 1970s to 2005, leaving a significant gap in recent studies. This systematic review evaluates the efficacy of BDP in improving pulmonary function and resolving corticosteroid dependence in chronic asthmatic children, while also assessing its potential side effects.Out of 273 studies, 20 fit the inclusion criteria, encompassing 1495 children, ages 5-18, with chronic asthma and some with corticosteroid dependence. The trials compared the administration of BDP to a placebo, across different timeframes and doses. Pulmonary function metrics (FEV1, PEFR, PEF, and PFR), methacholine tests, and symptom scores, displayed significant improvement in children receiving BDP. Common observed side effects among majority of studies were oropharyngeal candidiasis, rhinitis, and eczema. Though studies display BDP as a beneficial treatment option, advances in asthma treatments and inhaler technology since then have outpaced the available research, making it difficult to assess BDP’s current role in childhood chronic asthma management. Conflicting findings on growth suppression and adrenal dysfunction raise concerns about the reliability and certainty of existing data on BDP. This highlights the need for updated, comprehensive studies to resolve these contradictions and clarify BDP’s role in managing pediatric asthma, in order to update clinical guidelines.

The controlled growth and proliferation of a cell depend on its ability to sense both internal and external conditions and mount appropriate physiological responses. When such regulations go awry, various proliferative diseases may arise, including but not limited to cancers. Central to this control is the cell cycle, a precisely coordinated process that integrates metabolic signals, environmental conditions, and stress responses to maintain cellular homeostasis and ensure proper cell division. The tumour suppressor Tuberin (TSC2) is a key regulator of the cell cycle, yet its role in directly controlling cell proliferation remains poorly understood. Our lab has demonstrated that mitogen and nutrient signaling cascades converge on Tuberin to regulate its interaction with the mitotic cyclin, Cyclin B1 (CCNB1), thereby modulating mitotic entry in a context-dependent manner. Using in vitro ectopic expression and CRISPR/Cas-based approaches, coupled with imaging and cell cycle analysis, we show that weakening Tuberin’s interaction with Cyclin B1—either by altering its phosphorylation status or introducing loss-of-function TSC2 mutations—accelerates mitotic entry, increases proliferation, and leads to aberrant cellular phenotypes. By characterizing Tuberin as a non-canonical regulator of mitotic entry, this research provides new insights into how metabolic signaling influences cell cycle progression. Given the frequent dysregulation of TSC2 in cancer and other proliferative disorders, elucidating this mechanism could reveal novel therapeutic targets for controlling aberrant cell division in disease.

Background: Primary care practitioners have been experiencing adverse effects, such as burnout, due to the task load they have daily. In response to the growing administrative and cognitive burdens on primary care practitioners, this project introduces an open-source artificial intelligence (AI) platform designed to act as a real-time partner during patient encounters. The system innovates beyond traditional digital scribing by providing proactive, customizable assistance to reduce cognitive load, streamline documentation, and optimize interactions with electronic health records (EHRs). A collaboration between Conestoga College’s SMART Centre and Ontario physician leaders, the platform aims to address physician burnout and workflow inefficiencies exacerbated by electronic health records (EHRs). Key objectives include ensuring security, privacy, scalability, and adaptability through open-source licensing to foster transparency and collaboration. Proposed Methods: This pilot project will employ a mixed-methods approach, collecting data on practitioners’ time management and job satisfaction to evaluate the platform’s impact. Descriptive statistics and thematic analysis will guide the assessment of efficiency gains and satisfaction improvements. This AI platform seeks to mitigate the adverse effects of EHR usability issues, which contribute significantly to clinician burnout and diminished patient care quality. Implications: By providing ethical, non-intrusive, and equitable solutions, the initiative prioritizes clinician well-being and enhanced patient outcomes. It represents a scalable, innovative approach to transforming primary healthcare delivery while maintaining a commitment to transparency and security.

Background: Intra-operative mortality in neurosurgery is a rare but profoundly impactful event with significant consequences for patient outcomes, surgical teams, and healthcare systems. Despite advancements in surgical techniques, neurosurgical procedures inherently carry high risks due to the complexity of brain and spinal cord operations. While previous studies have explored patient comorbidities and team dynamics as contributors to surgical outcomes, limited research exists on how these factors influence intra-operative mortality and the coping mechanisms of surgeons following such events. Objectives: This study aims to analyze intra-operative mortality in Canadian neurosurgery by identifying contributing factors related to patient characteristics, surgeon experience, and team dynamics. Additionally, it seeks to evaluate the emotional and professional impact of these events on neurosurgeons. Methods: A cross-sectional survey will be distributed to neurosurgeons across Canada, assessing demographic data, patient risk factors, surgical circumstances, and surgeon/team dynamics associated with intra-operative deaths. The survey will also explore how surgeons cope with these incidents and whether such experiences influence future decision-making. Data will be collected anonymously via REDCap and analyzed using descriptive and inferential statistical methods. Future Directions: Findings from this study will provide valuable insights into modifiable risk factors, inform surgical training programs, and guide institutional support strategies for neurosurgeons dealing with intra-operative mortality. Understanding these elements will contribute to enhanced patient safety, improved surgical decision-making, and better psychological support mechanisms for neurosurgeons.

Postpartum breast cancer (PPBC) is an aggressive subtype of breast cancer diagnosed within 5-10 years after childbirth and is accompanied by increased mortality, disease spread, and recurrence. Young mothers (≤45 years) experience late diagnoses because of dense breast tissue which complicates imaging. They also face lack of inclusion in routine screening programs. Moreover, many of these cases are initially misdiagnosed as benign conditions like clogged ducts, abscesses, or mastitis, further delaying treatment and worsening outcomes. This study aims to explore the diagnosis experience of PPBC patients by (1) understanding how young mothers interpret changes in their breast and decide to seek medical care and (2) identifying challenges in receiving a diagnosis. A mixed-methods research design will be used to incorporate quantitative survey data and insights from qualitative semi-structured interviews. Participants will be recruited using posters in patient groups on social media and will complete a survey to collect demographic and diagnostic information. Participants can also choose to do one-hour virtual interviews focusing on symptom awareness, decision-making, and healthcare interactions. Thematic analysis of interview transcripts will give insights into the narrative around PPBC diagnosis experience. This study will be conducted alongside biomedical research on identifying early PPBC detection markers. By incorporating patient perspectives, findings will contribute to raising awareness among healthcare professionals and young mothers, and also identifying potential points of intervention for improved screening and earlier diagnosis in the postpartum period, ultimately improving PPBC outcomes.

Breast cancer (BrCa) is highly heterogeneous, with multiple distinct subtypes associated with variable clinical outcomes and high intra-tumor clonal diversity. This clonal diversity is caused by genomic instability, microenvironmental factors, and tumor cell plasticity. Intra-tumor clonal diversity has been linked to poor clinical outcomes including aggressive, recurrent, and treatment resistant tumors and progression to metastases. Somatic mutations that induce transcriptomic alterations and genomic instability, in combination with the harsh tumor microenvironment, shape the heterogeneity and expansion of intra-tumor clones. We identified RHAMM, which has pro-inflammatory functions in response-to-injury processes, as a contributor to BrCA cell heterogeneity. RHAMM is expressed in tumor and host cells and Rhamm-loss in these cell compartments strongly reduces clonal heterogeneity detected by single nucleotide variants used as endogenous barcodes. Our evidence predicts that a RHAMM-ve microenvironment exerts selective pressure permitting the emergence of dominant clones in lung metastases that carry specific oncogenic mutations. Our goal is to probe the interplay between clonal heterogeneity and the tumor microenvironment in the emergence of dominant intra-tumor clones. Next-generation DNA sequencing technologies now offer a two-pronged approach to the analysis of genetic heterogeneity. Long-read genome sequencing enables discovery of large structural variants and short-read, deep sequencing achieves highly accurate detection of ultra-rare single nucleotide variants. The interplay of clonal dynamics and the tumour microenvironments in the development of heterogeneous BrCa tumours can be teased apart to better understand the causative processes underlying the metastatic and treatment-resistant nature of these tumours, with discovery of potential genetic determinants relevant to cancer management.

Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infections in both pediatric and elderly populations. RSV is an enveloped, negative-sense, single-stranded RNA virus that belongs to the Pneumoviridae family. In addition to the variation seen in the two antigenically distinct subtypes of RSV, A and B, previous genomic sequencing studies on clinical samples show particular variability in the sequences of the attachment protein G and fusion protein F. To more thoroughly evaluate the amount of variation in RSV genomic sequences in the Windsor-Essex border region, we are in the process of developing a robust tiled amplicon sequencing method that targets the G and F genes for RSV subtypes A and B. Our method uses primer sequences from the ARTIC network, R10.4.1 flow cells on the Oxford Nanopore MinION platform, and data processing and bioinformatics analysis from the Galaxy Suite. Preliminary results indicate that high levels of sequence coverage and redundancy can be obtained for the complete G gene and part of the F gene of RSV A and B from many of wastewater samples collected from hospitals, student residence halls, and wastewater plants. Improvements in sample preparation, primer design and the conditions for multiplex amplification are currently being explored to further improve the reliability and sensitivity of our novel genomic surveillance method for monitoring the evolution of sequence variations over time, including the emergence of novel variants of concern.

Conventional metrics for tracking infectious diseases, including case and outbreak data and syndromic surveillance can be resource-intensive, misleading, and comparatively slow with prolonged data collection, analysis and authentication. This study examined the 2022-2023 Respiratory Syncytial Virus (RSV) season in a contiguous metropolitan area connected by an active international land border, affording an opportunity for comparison of the respiratory virus season spanning two independent public health jurisdictions. Time-lagged cross correlation and qualitative examination of the wastewater signals showed that the peak of the Detroit (MI, USA) RSV season predated the peak in Windsor (ON, Canada) by approximately five weeks. A strong positive relationship was observed between RSV N-gene concentrations in wastewater and hospitalization rates in Windsor-Essex (Kendall’s τ = 0.539, p ≤ 0.001, Spearman’s ρ = 0.713, p ≤ 0.001) as well as Detroit (Kendall’s τ = 0.739, p ≤ 0.001, Spearman’s ρ = 0.888, p ≤ 0.001). This study demonstrated that wastewater surveillance can reveal regional differences in infection dynamics between communities and can provide an independent measure of the prevalence of RSV, an underreported disease. These findings support the use of wastewater surveillance as a cost-effective tool in monitoring of RSV to enhance existing surveillance systems and to better inform public health disease mitigation strategies.

Background Traumatic Brain Injury (TBI) is an important cause of disability, with increasing hospitalization trends and long-term implications on quality of life and cognitive functions. Accurate assessment of recovery is essential for improved care, better use of resources, and determining readiness to return to normal activities and employment. Consequently, there is great interest in accurate and reliable assessments of cognitive function. Objectives The ability to perform simple arithmetic has been shown to involve numerous brain regions in both hemispheres. The ability to add numbers requires working memory (prefrontal cortex) and other areas such as the intraparietal sulcus and supramarginal gyrus. Consequently, we believe it is reasonable to assume that when the brain is injured there would be an impairment of mathematical ability. The Windsor Arithmetic Cognition Test (WACT) tool is a bedside arithmetic based measure of cognitive capacity and working memory. Our objective is to evaluate WACT scores as patients recover from TBI by assessing the WACT reliability and validity against existing tools such, such as the MoCa and COGLOG. We hypothesize that the WACT scores are accurate and relatively precise quantitative measures of brain cognitive capacity. Methods: Patients who are admitted to the adult neurosurgical service (in WRH Ouellette Campus) following a mild or moderate traumatic brain injury will be considered for participation. The study has received REB ethics approval and is currently in the data collection phase. We have collected data for 18 patients thus far.