Blake Eligh

A PhD researcher at the 91�Թ� Mississauga, Horne studies how couples resolve conflicts of interest through sacrifice – when one person gives up their own self-interest or desires for a partner – and what effect this has on the relationship. Her ongoing work is a longitudinal study of the sacrifices couples make when relocating for the sake of a partner’s job.

Yet, as Horne notes, partners also make sacrifices for each other every day, including during intimate moments.

“The domain of sex is a primary area where couples can have these conflicts, and where sacrificing might be really important – especially because it’s a sensitive and vulnerable context for a lot of people,” Horne says.

The topic is the subject of a recent study, co-authored with Horne’s colleagues at 91�Թ� Mississauga, York University and Carleton University, that was published in the Journal of Social and Personal Relationships. It looked at how romantic partners regulate expression of sexual desire, and what effect these tactics have on relationship well-being.

“Romantic partners often regulate their emotions and affection to achieve certain goals, but we wanted to know more about how partners regulate their expression of sexual desire during sex and its implications for couples’ well-being,” Horne says.

Horne notes that we might regulate our emotions to achieve goals in everyday social interactions – for example, smiling at an annoying boss for the sake of workplace harmony or job retention.

In a romantic relationship, this regulation could take the form of expressing fondness and warmth to a partner that’s not really in line with what we’re feeling in the moment, or hiding feelings of sexual disinterest from a partner or pretending to be more enthusiastic about a sexual experience than we really are.

Such tactics might be employed to smooth over the momentary blips in desire that can be caused by a bad day at work, fatigue or distraction in the moment.

“These are ways that we modify our self-interest, presumably for the benefits of our partner,” Horne says, noting that research shows this happens as much as three times per week in a typical romantic relationship.

“We may think we are interacting authentically with our partners, but we do these regulatory strategies in subtle ways.”

Yet, as Horne notes, the result is a disconnect between what we are feeling inside and what we are showing on the outside.

The study involved surveying 225 couples, most in heterosexual long-term romantic relationships, to track the link between regulation of desire and relationship satisfaction. Respondents kept individual 21-day diaries that tracked intimate relations, levels of desire and individual feelings of well-being and satisfaction.

The results showed people engaged in two kinds of primary regulatory tactics when desire was low: amplification of desire and suppression of disinterest.

Amplifying desire is about exaggeration to cover for low interest in sex. That could take the form of erotic talk, caresses or even faking an orgasm.

Suppression of disinterest, by contrast, is employed when a partner hides the fact that they’re not really interested in the experience – either in the moment or overall.

Horne says that a partner may conceal that they have lost interest during sex if they are fatigued or distracted, or if their partner isn’t attending to their sexual needs in the moment.

“When we use these strategies, we’re trying to change the way that we express emotion or desire to somebody after that emotion or desire has already been elicited,” Horne says. “These strategies can be really challenging because there’s a tension between what we’re feeling inside and what we’re showing when we’re not interested.”

Horne adds that not all sexual regulation strategies are created equal – and that sexual authenticity appears to play a key role. Those who employed these tactics reported feeling sexually inauthentic, which predicted lower satisfaction – both sexually and in the relationship.

“We found that there are drawbacks to these behaviours,” Horne says. “Our work suggests that both partners feel less satisfied with their sex lives on days when one partner amplified or exaggerated expressions of desire.”

The story is a little bit different for suppression tactics.

Those who hid their lack of desire reported feeling sexually inauthentic and detached from their own satisfaction, but it wasn’t always detrimental for their partners, who may have been convinced they were interested and engaged in the moment.

While suppressing disinterest can lead to a partner’s higher satisfaction, it can undermine one’s own feelings of satisfaction.

“These things happen during sex, and they have implications for our satisfaction,” Horne says. “When we regulate these displays, it feels sexually inauthentic.”

While all respondents reported engaging in regulation tactics occasionally, Horne says it’s important to notice if it becomes part of a pattern. Being attuned to our partners while balancing our own sexual needs can circumvent the conflicts that might lead to regulation strategies, and can amp up relationship satisfaction for both partners, Horne says.

“If things aren’t feeling right during sex, you could try to re-route, or have an open conversation about the things you like and don’t like," she advises.

“Honest and clear sexual communication is really important, and seems to have more benefits for partner satisfaction.”

The research was supported by the Social Sciences and Humanities Research Council (SHRRC) and a SSHRC Vanier Canada Graduate Scholarship.

With undergraduate's help, 91�Թ� economist uses AI to supercharge his research on Canada's economic history

Christopher.Sorensen — Mon, 22 Nov 2021 17:16:20 +0000

With undergraduate's help, 91�Թ� economist uses AI to supercharge his research on Canada's economic history

Christopher.Sorensen Mon, 11/22/2021 - 12:16

Cutline

Using machine learning, undergraduate student Dev'Roux Maharaj (left) helped Nicholas Zammit (right), of 91�Թ� Mississauga's department of economics, speed up his research on Canada's economic history (handout/photo of Zammit by Blake Eligh)

Blake Eligh

Topic

Breaking Research

Artificial Intelligence

Economics

machine learning

Research & Innovation

91�Թ� Mississauga

Nicholas Zammit of the 91�Թ� Mississauga is aiming to shed light on Canada's economic history circa the First World War by drawing on mountains of government data including everything from labour and steel to beer kegs imports.

For years, Zammit had been manually entering trade volume data into spreadsheets, a format that allowed him to do an economic analysis. It was a process so cumbersome he estimates it would have taken one researcher more than 50 years to process a small segment of his sample data.

“We’ve got the price and quantity of every good traded between Canada and every other country,” said Zammit, an assistant professor, teaching stream in 91�Թ� Mississauga's department of economics. “But it’s a very big dataset with a lot of data points.”

Then Dev'Roux Maharaj came along. The undergraduate student in economics and political science, who worked part-time at Amazon's Mississauga operations, helped adapt a web-based machine learning tool developed by the online retail giant for its business clients to help with Zammit's research. The result was nothing short of transformational, Zammit said.

“We were going to focus on the war period, but given how successful the software is for us, we might go back to 1870,” he said. “It’s blossoming, hopefully, into multiple papers.”

Maharaj, now a research assistant on Zammit's project, had worked with Amazon’s customer service team before moving to Amazon Web Services (AWS), the cloud computing arm of the company. It was there he saw an opportunity to apply AWS technology to Zammit’s data conundrum.

The solution was Textract, an AWS tool used by organizations, such as insurance companies, to automate and standardize collection of data from forms and other documents.

Maharaj looked to apply Textract’s machine learning abilities to the information contained in the trade volume tables. He connected with the Cloud Innovation Centre at the University of British Columbia, which was working to refine Textract’s data collection capabilities, to test the technology with the trade volume information.

What used to take Zammit three years of tedious data entry can now be accomplished in four months. “We can scan 500 documents in less than 45 minutes,” Maharaj said.

With just two clicks, the research team can now quickly and easily upload the trade volume PDFs and convert the information for use in an Excel workbook. The process also gives the researchers the ability to easily filter the results.

“Now the data is organized in the exact format that we need it to be,” Maharaj said. “The cloud has enabled us to put this project on steroids.”

Zammit noted that the project has also created research opportunities for students to participate and gain valuable experience working with economic data.

The project's growing team of 175 volunteer research assistants manage quality assurance by conducting comparative spot checks. Maharaj estimates Textract’s accuracy rate to be between 93 and 95 per cent.

For his part, Maharaj has been able to parlay skills learned on the project into an internship with RBC.

“Making training plans, looking at Excel data and macros – it’s the same thing – process automation,” he said. “These skills are very applicable to the workforce, and we’re giving students those skills as well.”

Zammit’s current research, which focuses on trade diversion and loss in the British dominions during the First World War, draws on primary sources like the Canada trade volumes. The digitized federal government documents span nearly 100 years, from 1870 onwards.

The economic historian hopes to shed new light on how costly trade diversions or sanctions can be for countries engaged in war.

Zammit says the digital tool has reduced the cost of collecting information and increased the volume of available data, offering the researchers new opportunities to compare with modern economic phenomenon.

The researchers hope to release preliminary results from their analysis early next year.

Sunscreen, shade and covering up: 91�Թ� dermatologist Cheryl Rosen offers sun safety tips

Christopher.Sorensen — Fri, 06 Aug 2021 15:15:09 +0000

Sunscreen, shade and covering up: 91�Թ� dermatologist Cheryl Rosen offers sun safety tips

Christopher.Sorensen Fri, 08/06/2021 - 11:15

Cutline

(photo by d3sign via Getty Images)

Blake Eligh

Topic

Our Community

Temerty Faculty of Medicine

Toronto General Hospital

Cancer

Princess Margaret Hospital

University Health Network

Dermatologist Cheryl Rosen is so serious about sun protection that she sometimes carries her own shade – a parasol.

Rosen is a professor in the department of medicine in the 91�Թ�’s Temerty Faculty of Medicine, and head of the dermatology division at Toronto Western Hospital, Toronto General Hospital and Princess Margaret Hospital. Her research interests include public education for skin cancer prevention.

Each year 85,000 Canadians will be diagnosed with skin cancer and one in six Canadians will be diagnosed in their lifetime. As a member of the Canadian Dermatology Association’s (CDA) sun awareness working group, Rosen hopes public education about the need for sun protection will change those numbers.

A spokesperson for skin cancer prevention and part of a group whose advocacy helped introduce a provincial law prohibiting people 18 and under from using tanning beds, Rosen says practising good sun safety is the best way to avoid skin cancers that are caused by sun exposure.

Writer Blake Eligh recently asked Rosen to share her sun safety tips as Canadians take to the outdoors during another pandemic summer, including common sunscreen mistakes and her trick to eliminate the pesky white cast left by mineral sunscreens.

What are the basic steps for staying safe in the sun?

Everyone spends time outside in the summer, but particularly now because of the pandemic and the need for social distancing. As dermatologists, we say go outside and have a wonderful time, but be aware of the sun. Wear sunscreen, seek shade and cover up.

Find a broad spectrum sunscreen with an SPF (sun protection factor) of 50 or higher to protect against both ultraviolet B and ultraviolet A (UVB and UVA) radiation. Put sunscreen right beside your toothpaste to make it an automatic part of your morning routine. Put it on every day in the warmer weather — you never know when you might have the chance to have lunch on an outdoor patio.

There are clothes that offer UV protection, with a UPF label, but you don’t really need them if you choose clothes with tightly woven fabrics. Don’t forget to wear a hat and sunglasses.

Plan your outdoor activities wisely and, if you can, schedule activities like tennis for earlier or later in the day.

Seek shade wherever possible. Look for natural shade from trees and outdoor patios with umbrellas. You may choose to use a parasol or umbrella – carrying your own shade around with you is a good idea.

What is the role of sunscreen in skin protection?

Years ago, we didn’t know about the damage the sun could cause.

Sunscreens help prevent sunburns, but they also prevent DNA damage in skin cells and decrease your risk of developing certain skin cancers – squamous cell carcinoma and melanoma. A sunscreen may also decrease signs of photoaging, wrinkles and fine lines.

There are so many sunscreens on the market. How do we choose the right one?

The best sunscreen is one that you don’t mind putting on, so it’s important to find a product that works for you.

Find a sunscreen with an SPF of 50 or 60. The SPF tells you about protection against UVB radiation.

Look for the words “broad spectrum” on the label. That indicates protection against both UVA radiation and UVB radiation, which play a role in developing skin cancer and in photoaging.

Also look for the symbol of recognition by the CDA, or the letters “UVA” within a circle, which indicates the sunscreen has met the European Union standards for UVA protection.

Are there new developments in sunscreen formulas?

Iron oxide is the next big thing in sunscreen. There’s recent research that shows visible light – daylight, not just ultraviolet radiation – can increase pigmentation in the skin. Iron oxide can help protect our skin from this visible light. Some sunscreens include it as an inactive ingredient, but it hasn’t yet been approved by Health Canada as a sunscreen active ingredient.

What are some common mistakes that people make with sunscreens?

We know people put on way less sunscreen than is actually used in testing, so that’s a great reason to use a sunscreen with a high SPF value. If you’re putting on half as much as the test quantity, you’re actually getting half the SPF.

One common mistake is missing parts of the body during application. People do a poor job of putting it on the first time. There are examples of tests where fluorescent dye is added to the sunscreen. A special light reveals whole areas that people missed in application.

People forget to put sunscreen on their ears or the back of their neck.

If you’re using a spray, you have to rub it in, or you might end up with lines of protected and unprotected skin.

Forgetting to reapply is another issue. The FDA and Health Canada both advise reapplying sunscreen every two hours. Other research shows that the best time to reapply is 20 minutes after the first time to make up for the mistakes and missed spots during the first application.

When should we take extra precautions?

Medical conditions are one reason to take extra precautions. Solid organ transplant patients have a markedly higher rate of skin cancer because they take medication that suppresses the immune system. They should be careful in the sun, as should people with systemic lupus erythematosus, or those who are taking certain drugs that cause photosensitivity to UVA.

People with melasma develop darker patches on the face. These people need to use sunscreen during the day to prevent further darkening of the melasma, and may use a medicated cream at night which can help fade the patches. If you’ve had a facial procedure that’s healing, such as laser therapy, you also should avoid the sun or you’ll be left with darker areas.

How does the sun affect people with darker skin?

For people with skin of colour, the risk of skin cancer caused by the sun is very low because melanin, the pigment that gives skin its colour, is a very good source of protection. What can be an issue is increased pigmentation from the sun, such as patches of darker colour. Sun protection can help with that.

Mineral sunscreens can leave a white cast. One trick I’ve learned is to add a little bit of foundation to your sunscreen and really blend it in, so it’s closer to your skin tone.

Should we be worried about chemicals in sunscreen formulations?

Some studies have reported concerns about particular sunscreen ingredients, such as benzophenone. There are reports of benzophenone being an endocrine disruptor, but another study found that reproductive hormone levels were normal in humans using sunscreen on a regular basis.

Sunscreens have been used for years and have not shown any signal that they cause a problem. As dermatologists, we have to keep looking at the studies reported in the literature.

What tips can you share on coping with a sunburn?

Typically, people don’t come to see me about sunburns. The pain and redness will fade in a few days. There may be some skin damage, such as DNA damage in the skin cells. A cool compress or a moisturizer that’s been in the fridge can be soothing. A non-steroidal anti-inflammatory medication might help ease the pain.

Prescription retinoids, such as tretinoin, may reverse some sun damage. It can be applied as a cream to an area that might eventually show fine lines and wrinkles, or to try to reverse these changes once they have appeared.

91�Թ� alumna – and medical resident – honoured with one-of-a-kind Barbie doll

Christopher.Sorensen — Wed, 04 Aug 2021 16:38:43 +0000

91�Թ� alumna – and medical resident – honoured with one-of-a-kind Barbie doll

Christopher.Sorensen Wed, 08/04/2021 - 12:38

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Chika Stacy Oriuwa, a 91�Թ� medical resident and alumna of the Temerty Faculty of Medicine, served as the model for a Barbie doll in a Mattel campaign thanking frontline workers (photo courtesy of Mattel)

Blake Eligh

Topic

Our Community

Coronavirus

Temerty Faculty of Medicine

Alumni

Chika Stacy Oriuwa is no stranger to the spotlight – but this week the alumna of the 91�Թ�’s Temerty Faculty of Medicine will receive an unexpected honour: a Barbie doll made in her likeness.

Mattel this week revealed six one-of-a-kind dolls honouring frontline health-care workers who are participating in the fight against COVID-19 as part of its #ThankYouHeroes campaign.

The sole Canadian honouree, Oriuwa was selected by Mattel for her work as advocate against systemic racism in health care, an issue that has been further highlighted by the pandemic.

“I believe that if you can see it, you can be it,” Oriuwa says. “A Barbie who looks like me sends the message to children that they have what it takes to become a doctor.”

The dolls, which will not be available for sale, are modeled on women working in health care around the world. They include a real-life emergency room nurse in Brooklyn, N.Y., a professor of vaccinology from the United Kingdom who helped develop the Oxford/Astrazenca vaccine and a biomedical researcher credited for sequencing the genome of a COVID-19 variant in Brazil.

Oriuwa’s doll was revealed during a televised presentation on Aug. 4.

Now in the second year of a psychiatry residency, Oriuwa entered 91�Թ�’s MD program in 2017, where she was the sole Black student in her class of 259.

In 2020, Oriuwa, who is also a spoken word performer, was selected to address her graduating class, becoming the first Black woman selected to be the standalone valedictorian in the program’s history.

Those experiences fueled Oriuwa’s advocacy for inclusion and diversity in medical education, and her ongoing work to empower Black doctors and other underrepresented groups in the field.

Oriuwa says she wants to change people’s perceptions of what a doctor looks like. She says patients, families and even other doctors are often surprised to learn she is a doctor.

Oriuwa adds that she was delighted when Mattel reached out to feature her in the campaign.

“Barbie is a quintessential staple of childhood play,” says Oriuwa. “To be included in Mattel’s campaign as a health-care hero is a huge honour. I’m incredibly proud.

“Children begin playing with Barbies and other dolls at a young age. Through play, we start to understand the world around us and our place in it. It shapes our self-esteem.”

Oriuwa has been involved with every step of the doll’s design process, from sending photos of herself to designers to providing input about key details of her doll’s attire and, importantly, hairstyle.

“It was important to me to create a Barbie with a natural Afro-textured kinky hairstyle,” she says. “My sisters and I grew up playing with Barbies, but they were all white. Even when I did finally get my first Black Barbie, her hair was straight like the other dolls.

“Black women get the message that Black hair is not beautiful, professional or well-kempt. I want this doll to stand as a testament to my pursuit to redefine what a physician looks like. We don’t have to change our natural hair to fit in in this profession.”

Barbie, who has been depicted as holding more than 200 jobs in her more than 60-year history, is widely known for her fashion sense – and Oriuwa’s doll will be no different. She says she worked closely with the doll’s designers to ensure her Barbie accurately reflected the realities of her occupation.

As a result, Oriuwa’s doll wears scrubs and white coat – staple wardrobe pieces for any MD. The doll also sports tennis shoes, a reminder of the comfortable black sneakers Oriuwa wears on the job.

“It’s not always glamorous,” she says.

And although she no longer wears a stethoscope, Oriuwa requested one to accessorize her doll.

“The stethoscope was a huge part of my medical journey and training,” Oriuwa explains. “It encapsulates and represents what many people imagine when they think of a doctor.

“I hope this inspires the next generation of physicians. It’s exciting and fun to be seen as a hero. At a time when the entire world is turning to scientists and nurses and doctors for answers, I hope there is a continued appreciation for those who have worked so tirelessly on the front lines.”

The bespoke dolls help raise awareness about the doctor, nurse and paramedic dolls in Mattel’s product line. In the U.S., a portion of the proceeds from sales of those dolls will be donated to the First Responders Children’s Foundation, which benefits the children of first responders.

“We know the pandemic has been felt directly by children across the globe,” Lisa McKnight, senior vice-president and global head of Barbie and dolls at Mattel, said in a statement. “As the number one doll brand, we take great pride in leveraging Barbie’s platform to teach children about role models who are making a positive impact in our world, especially those who rose to the occasion during this challenging time. Our hope is to nurture and ignite the imaginations of children playing out their own storyline as heroes.”

While her doll won’t be found on toy store shelves, Oriuwa has a special place in mind to display her Barbie. She is expecting her first child – a son – in the fall, and plans to place the doll on a shelf in his nursery.

“Barbie is for everyone,” she says. “I want him to see that.”

'We have something really special here': Stephane Angers on his vision for 91�Թ�'s Donnelly Centre

Christopher.Sorensen — Wed, 07 Jul 2021 17:33:25 +0000

'We have something really special here': Stephane Angers on his vision for 91�Թ�'s Donnelly Centre

Christopher.Sorensen Wed, 07/07/2021 - 13:33

Cutline

Stephane Angers will be the next director of 91�Թ�'s Donnelly Centre for Cellular and Biomolecular Research, an interdisciplinary research institute focused on advancing human health and treating disease (photo by Steve Southon)

Blake Eligh

Topic

Our Community

Temerty Faculty of Medicine

Donnelly Centre for Cellular & Biomolecular Research

Leslie Dan Faculty of Pharmacy

Research & Innovation

Professor Stephane Angers has been appointed director of the 91�Թ�’s Donnelly Centre for Cellular and Biomolecular Research for a five-year term beginning Sept. 1, 2021.

Angers, who is currently associate dean of research in the Leslie Dan Faculty of Pharmacy, holds appointments with the Leslie Dan Faculty of Pharmacy and the department of biochemistry in the Temerty Faculty of Medicine. He is also the founding co-director of 91�Թ�’s multi-disciplinary Precision Medicine Initiative (PRiME).

Angers joined 91�Թ� in 2006 after completing a BSc in biochemistry at McGill University, a PhD in biochemistry at the Université de Montreal and a post-doctoral position at the University of Washington in Seattle. He established the Angers Lab to study the Wnt family of growth factors in stem cells during development, tissue regeneration and cancer. The work has uncovered novel therapeutic targets, leading the development of new drugs that are advancing towards the clinic both as anti-cancer treatments and as regenerative medicine strategies in non-malignant disorders.

Angers, who previously held a Canada Research Chair II in functional architecture of signal transduction, has received more than $10 million in peer-reviewed research support and has published more than 100 peer-reviewed publications in top-ranked journals.

He spoke with Temerty Faculty of Medicine writer Blake Eligh about his research, the importance of collaboration and his vision for the Donnelly Centre over the next five years.

How will your experience at the Leslie Dan Faculty of Pharmacy inform your new role with the Donnelly Centre?

I’ve spent the last 15 years with the Faculty of Pharmacy. During that time, we have elevated the research capacity and impact of the faculty by creating internal funding programs, building a research office from the ground up and creating the pan-faculty PRiME initiative that brings together people from across 91�Թ� who are interested in drug development and identification of novel therapeutics.

Over the years, I have worked closely and collaborated with several groups at the Donnelly Centre. Although I’m already ingrained in the community, I’m also a bit of an outsider with a fresh perspective that will help move the Donnelly Centre into its next phase.

How do your scientific interests intersect with those of the Donnelly Centre?

We work with Wnt proteins, which are critical stem cell factors during development, but also for adult tissue homeostasis. My group is working to understand the cellular mechanisms they influence, and how they are defective in diseases. Another focus is more broadly directed at identifying genetic vulnerabilities of various high-fatality cancers for which treatments are limited, such as glioblastomas and pancreatic cancers.

The research interests of my group are therefore at the intersection of research interests of several researchers at the Donnelly Centre who are studying genetic interactions, cancer cell vulnerabilities, stem cell biology and regenerative medicine – and who leverage and develop enabling technologies.

Working at the Donnelly Centre will elevate what my lab can do, and, in return, I hope I can elevate the research of others. It’s a fantastic place with enormous possibilities.

What do you see as the strengths of the Donnelly Centre?

The Donnelly Centre is internationally recognized for its role as a discovery engine for fundamental science.

The centre brings some of the best scientists in Canada together under one roof. This creates an environment where world experts and younger trainees from different disciplines – engineering, genetics, computational science and molecular and stem cell biology – can cross-pollinate and bring unique perspectives to new fields of research.

One key reason for the success of the Donnelly Centre is the sustained investment in scientific infrastructure and support of highly qualified personnel and staff members. It takes expertise to run cutting-edge technology platforms – not only to understand the equipment, but to also analyze and integrate the data.

What is the Donnelly Centre’s relationship to the scientific ecosystem in Toronto?

We have something really special here that differentiates 91�Թ� from other universities in Canada. The high density and quality of scientific activities makes Toronto one of the global epicenters of research discoveries. 

Think of any field of research or a disease and there’s a local expert, access to reagents or patient samples – it’s all here within a few city blocks.

It’s what attracted me to 91�Թ� 15 years ago. We need to foster this ecosystem and make it more integrative through intra-city collaborations between the Donnelly Centre and the exciting science happening in the Discovery District, elsewhere at the university, at hospitals and research institutes.

Leveraging this network will allow us to recruit and retain the best scientists in the world and the best graduate students, and to enable further research discoveries at the Donnelly Centre.

What is your vision for the Donnelly Centre?

I see the Donnelly Centre as a discovery engine that provides the essential knowledge and technologies that will help us solve the problems of tomorrow.

The best advances of medicine – for example, immunotherapy that provides new hope for cancer patients, or the advent of mRNA vaccines that helped save the world from the SARS-CoV2 pandemic – would not have been possible without the fundamental discovery science describing the function of T cells or the development of methods leading to improved mRNA stability and delivery.

There have been spectacular advances made here over the past 15 years to better understand how eukaryotic cells function. Donnelly Centre scientists have pioneered large-scale studies that revealed how proteins interact together to perform specific biological functions, how genes connect to orchestrate cellular behaviors and mapped genes required for cancer growth.

With this increasing knowledge of gene and protein functions, the next tasks include understanding the cellular diversity that form each of our tissues and identifying the cell types involved in disease phenotypes and how we can manipulate cell functions to promote tissue regeneration or treat diseases.

The Donnelly Centre is poised to tackle these problems, which require close collaborations between engineers, stem cell biologists, functional genomicists, computational biologists and the integration of cutting-edge technologies that are mastered and invented by our scientists.

How will your leadership support the work of Donnelly Centre researchers?

The Donnelly Centre exists because of the vision of philanthropist Terrence Donnelly and his belief that foundational science is important, and that discovery research will solve the problems of tomorrow.

Our ideas are unlimited, but to remain internationally renowned and performing at the cutting-edge of discovery research, we need to fuel those ideas and support the next breakthroughs in biomolecular sciences.

As director, I’m excited to engage with stakeholders and potential donors – and to take an active role advocating for foundational sciences in Canada.

We are home to some of the best scientists in Canada and their research teams. I think we have a very compelling story to tell.

91�Թ� endocrinologist Lorraine Lipscombe to lead ‘powerhouse’ diabetes research network

Christopher.Sorensen — Fri, 18 Jun 2021 15:27:54 +0000

91�Թ� endocrinologist Lorraine Lipscombe to lead ‘powerhouse’ diabetes research network

Christopher.Sorensen Fri, 06/18/2021 - 11:27

Cutline

(Photo courtesy of Lorraine Lipscombe)

Blake Eligh

Topic

Our Community

Insulin 100

Temerty Faculty of Medicine

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Diabetes

Research & Innovation

A noted diabetes researcher and public health advocate from the 91�Թ� has been selected to lead a “powerhouse” research network that will focus on the global fight against diabetes and other serious chronic diseases.

Lorraine Lipscombe, a physician and associate professor in the department of medicine in the Temerty Faculty of Medicine and the Dalla Lana School of Public Health, has been appointed director of the Novo Nordisk Network for Healthy Populations.

Lipscombe is a respected endocrinologist who holds appointments at Women’s College Hospital, where she is director of the hospital’s endocrinology division and is a senior scientist in the Women’s College Research Institute. Her research focuses on the prevention and improvement of care and outcomes for patients with diabetes, particularly women.

In February 2021, Novo Nordisk and the 91�Թ� announced a $40-million investment to establish the Novo Nordisk Network for Healthy Populations. Based at 91�Թ� Mississauga, the network is a partnership between the Temerty Faculty of Medicine, the Dalla Lana School of Public Health and 91�Թ� Mississauga. The network will focus on interdisciplinary collaboration to accelerate on-the-ground diabetes research, education and outreach.

“I am truly excited and honoured for the chance to lead this visionary network in demonstrating innovative and effective ways to make populations healthier,” Lipscombe said.

“The Network will afford an unprecedented opportunity to integrate and align expertise across multiple areas to establish a world-leading research program, through strategic collaborations between three 91�Թ� academic powerhouses and key community stakeholders in the City of Mississauga.”

“Being one of the most diverse cities in the world, with a mix of urban and suburban areas, and much higher rates of obesity and diabetes than the national average, Mississauga provides a unique environment to explore interventions that can be applied to a wide range of contexts around the world.”

The network executive team welcomed news of Lipscombe’s appointment.

Alexandra Gillespie, vice-president and principal of 91�Թ� Mississauga, lauded the incoming director as “a world-class researcher, proven team-builder and dynamic leader known for sharing her expertise to empower the success and well-being of others.”

“With her guiding hand, the Network will achieve its goal of identifying and implementing strategies to prevent diabetes and diabetes complications in high risk and marginalized communities,” added Professor Gillian Hawker, chair of the department of medicine.

Lipscombe’s expertise in both clinical care and population health makes her “a superb choice to lead the network," said Professor Adalsteinn (Steini) Brown, dean of the Dalla Lana School of Public Health, where Lipscombe teaches in the Institute for Health Policy, Management and Evaluation.

"As a clinician and an epidemiologist, she is particularly skilled at seeing the gaps between research and health delivery, and has developed an impressive track record in addressing them."

Gillespie also noted Lipscombe’s strategic planning skills.

“Professor Lipscombe will enable the Novo Nordisk Network to achieve its ambitious goals: to unite university divisions, hospitals, and community partners in the fight against diabetes and other serious chronic illnesses,” Gillespie said.

“Her leadership will benefit the health of so many people in Mississauga, Toronto, and around the world.”

The announcement of Lipscombe’s appointment comes at a momentous time for diabetes research, as 91�Թ� continues a year of celebrations marking the 100th anniversary of the discovery of insulin at the university.

In June, the City of Mississauga announced that it will become the first Canadian municipality to join the Cities Changing Diabetes program. The Novo Nordisk-supported initiative will provide the city with tools, resources and partners – including the Network research hub – to prevent the rise of type 2 diabetes in Mississauga.

About 420 million people worldwide live with diabetes. The World Health Organization estimates that the disease is responsible for more than 1.6 million deaths annually. Complications can lead to devastating health outcomes such as blindness or limb amputation.

“The discovery of insulin is a monumental achievement for Canada and a beautiful example of the translation of research findings into life-altering benefits for people,” Lipscombe said.

“Despite this discovery and all the progress that has been made since then, diabetes remains a major burden on individuals, families, communities and health-care systems around the world.”

“Much research has been done to recognize root causes of diabetes and its consequences and to identify effective interventions. We must now act on this evidence, by shifting our focus from describing what might work to showing what does work.”

'They’ve risen to the challenge': 91�Թ� medical grads adapted to the unknown during COVID-19

Christopher.Sorensen — Mon, 07 Jun 2021 14:36:11 +0000

'They’ve risen to the challenge': 91�Թ� medical grads adapted to the unknown during COVID-19

Christopher.Sorensen Mon, 06/07/2021 - 10:36

Cutline

Staff don protective gear at Humber River Hospital. When clinical rotations resumed in July 2020, 91�Թ� medical students discovered a landscape transformed by COVID-19 safety protocols (photo by Cole Burston/AFP via Getty Images)

Topic

Temerty Faculty of Medicine

From contact tracing to providing babysitting services for health-care workers, the 254 medical students graduating this spring from the 91�Թ�’s Temerty Faculty of Medicine have accumulated plenty of new experiences over the past year.

As pandemic safety protocols put the class of 2021 on temporary hiatus from clerkship rotation last spring, MD students stepped up to volunteer with initiatives to support health care systems and the community. Students organized PPE collection drives, worked crisis support telephone services, filled hospital screening and public health contact tracing roles and pitched in to offer childcare and grocery delivery services to frontline health-care workers.

Then, when clinical rotations resumed in July, students discovered a medical landscape transformed by COVID-19 safety protocols, unfamiliar routines for health care teams and the need to develop new relationships with patients and family members.

Prem Nichani

“You might find yourself supporting a scared breast cancer patient who can’t have her mother with her,” says Ward Al-far, who is co-president of the graduating class. “That adds a lot more emotional and social responsibility to caring for people, but the difference it makes for the patient is huge."

He describes the experience as “intense,” but says it solidified the communication and patient advocacy skills he will carry into his future practice.

As health care adapted to the changing demands of COVID-19, the new protocols also gave student learners an unusual view of the specialities they might be considering. “This is a formative period,” says Al-far of the truncated clerkship placements that give MD students a chance to experience different medical disciplines before deciding on their speciality.

The circumstances also shifted how student learners prepared for residency placements. Travel restrictions meant the class of 2021 had to find new ways to explore the cities and institutions where they hoped to land residency placements.

Ward Al-far

“This is where we will spend the next five years and maybe set up our practices and our lives,” says Prem Nichani, who also serves as a class co-president.

Despite the challenges, Marcus Law, director of the MD foundations program, says the past year gave the 2021 cohort a unique opportunity to put their pre-clerkship training into practice.

“They observed how physicians learn and manage uncertainties and ambiguities,” says Law, an associate professor of family medicine. “They also deepened their understanding of how to adapt to the unknown with new knowledge and to how to apply a health equity lens to advocate for their patients with COVID.”

“This class has developed life skills that will help them manage the next crisis. They’ve risen to the challenge and will be ready to tackle what comes next.”

Through it all, the class of 2021 leaned on each other, met safely outdoors when in-person visits were permitted and moved online when they were not. There were virtual town halls with faculty to keep students informed of changes and online counseling sessions offered through the Office of Health Professions Student Affairs.

Class co-presidents Al-far and Nichani also helped the class safely mark milestones and make new memories together. They recently hosted the first-ever virtual match party to celebrate residency matches and are preparing for an online convocation event on June 15.

With classes behind them, many in the 2021 cohort of medical students are preparing for licensing exams and making relocation plans to begin their residency placements on July 1.

This period also typically offers opportunities for travel and rest – a break Nichani notes is especially needed after the intense pressures of the past year.

Al-far and Nichani say their classmates showed extraordinary determination and resiliency over the past year.

“Making it through these four years is a challenge itself, but, with the pandemic, it’s a quite an accomplishment,” says Al-far, who will start residency in anesthesiology at McMaster University in July.

Nichani, who will remain in Toronto for his residency in ophthalmology, agrees. “Despite how hard this experience has been, it made our class stronger together and as individuals,” he says. “We’ve been through a heck of a lot.”

Patricia Houston, vice dean, medical education, lauded the class for their accomplishments and contributions.

“In addition to offering my congratulations to the class of 2T1 on the successful completion of the MD program, I also want to thank our newest graduates,” says Houston.

“Over the last year in particular, the class of 2T1 has stepped up to help in the clinical environment, assisted in caring safely for COVID patients and were a help to students in the other years of the program. It’s been a privilege to work with each of these students and I wish them the best as they embark upon the next chapter in their lifelong education journey.”

91�Թ� researcher 'reprograms' brain cells in pursuit of new therapy for stroke patients

Christopher.Sorensen — Tue, 01 Jun 2021 18:29:22 +0000

91�Թ� researcher 'reprograms' brain cells in pursuit of new therapy for stroke patients

Christopher.Sorensen Tue, 06/01/2021 - 14:29

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Understanding the role of reprogrammed neurons, shown here in yellow, and resident neurons, shown in red, in post-stroke recovery is at the heart of research by 91�Թ�'s Maryam Faiz (image courtesy of Maryam Faiz)

Blake Eligh

Topic

Our Community

Insulin 100

Temerty Faculty of Medicine

Brain

Faculty of Arts & Science

Research & Innovation

Stroke

Could “reprogramming” the brain at a cellular level help people recover from strokes faster and better? One researcher from the 91�Թ�’s Temerty Faculty of Medicine aims to find out.

Strokes happen when blood flow to the brain is disrupted, resulting in irreversible damage to neurons, the brain cells that control behaviour and movement. For the 50,000 Canadians who will experience stroke each year, more than half will be left with lifelong impairments in the ability to move, eat or communicate.

But research by neuroscientist Maryam Faiz, a professor in the department of surgery who studies neuronal reprogramming, suggests a new kind of therapy for post-stroke recovery. She says astrocytes – a network of bushy cells Faiz likens to “a night sky” – are thought to play an important role in the brain’s circuitry. With reprogramming, she says, astrocytes can be converted into neurons to replace those cells lost to stroke damage.

Maryam Faiz

“We think of this as a new strategy for neural repair,” says Faiz, adding that, in the lab, the technique shows good results in mice with post-stroke impairments in mobility and gait.

“After reprogramming, those abilities recover to the level of an uninjured animal.”

The technique may help extend the window for the recovery process. Current stroke recovery interventions are time-sensitive, with the greatest gains taking place in the hours that follow a stroke.

In Faiz’s experiments, however, reprogrammed mice showed continued recovery, even at the nine-week mark. In these experiments, researchers administered reprogramming to the mice a week following their strokes.

“We could see functional recovery early in the reprogramming process,” Faiz says. “Animals were walking better and this extended to much later time points.”

While Faiz’s lab research focuses on tiny astrocytes and neurons, the patient outcome is never far from her mind.

Her work took a personal turn two years ago when a close family member suffered a traumatic brain injury as the result of an accident. Witnessing their ongoing recovery process highlighted the potential impact of Faiz’s research, which could be applied to stroke recovery – but also in the treatment of Parkinson’s or Alzheimer’s diseases or a traumatic brain injury.

“Knowing someone who has had a brain injury is eye-opening,” she says. “It can have a massive impact on every part of their life.”

Faiz, who joined the Temerty Faculty of Medicine in 2017, is one of three recipients of the inaugural Temerty Pathway Grant. Launched in 2020, the internal funding program supported by the Temerty family awards $100,000 each to three promising research projects that have not yet been successful in grant competitions.

The bridge funding allows researchers to keep working on a project and submit a stronger grant application in the next round.

“The Pathway Grant gave me room to breathe,” says Faiz. “When you don’t get your CIHR grant, you’re just back in the lab 24 hours a day, trying to get the next set of data.”

Faiz and fellow Pathway recipients Thierry Mallevaey and Scott Yuzwa, in the departments of immunology and laboratory medicine and pathobiology respectively, were awarded CIHR funding in the round of grants announced this spring.

"The Temerty Pathway Grant Program is designed to provide bridge funding for early career researchers like Professor Faiz to achieve CIHR funding,” says Reinhart Reithmeier, senior adviser to the vice-dean research and graduate education. “I congratulate the first three winners, Professors Faiz, Mallevaey and Yuzwa, on their success in the last CIHR Program grant competition."

While Faiz’s initial recovery results in mice are promising, little is known about how the reprogrammed neurons integrate into the circuitry of the brain.

With funding from the CIHR to Faiz and co-applicants Shreejoy Tripathy, an assistant professor of psychiatry and Melanie Woodin, dean of the Faculty of Arts & Science and a cell and systems biology professor, Faiz hopes to understand what’s happening at different periods during the stroke recovery process and how reprogramming contributes to brain recovery and repair.

“Is the cell we’re making important for recovery or does reprogramming exert an effect in the environment around the cells that could lead to change?” she asks. “Are these new cells actually responsible for recovery or might something else be happening here?

“Our study will answer these questions and help us understand if and how these newly generated neurons are responsible for the recovery in function that follows neuronal reprogramming.”

91�Թ� researcher, alumna launch tool that helps surgeons pinpoint breast tumours

Christopher.Sorensen — Tue, 25 May 2021 16:28:16 +0000

91�Թ� researcher, alumna launch tool that helps surgeons pinpoint breast tumours

Christopher.Sorensen Tue, 05/25/2021 - 12:28

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MOLLI Surgical was launched in 2018 by Ananth Ravi (left), an associate professor in the Temerty Faculty of Medicine, and 91�Թ� alumna Fazila Seker (right), who serves as president and CEO of the company (photos courtesy of MOLLI)

Blake Eligh

Topic

Our Community

Insulin 100

Sunnybrook Health Sciences

Temerty Faculty of Medicine

Cancer

Entrepreneneurship

Faculty of Applied Science & Engineering

Faculty of Arts & Science

Research & Innovation

A company co-founded by the 91�Թ� researcher Ananth Ravi and alumna Fazila Seker recently entered the U.S. health-care market with a magnet-based technology that helps surgical teams locate breast tumours more quickly while causing less discomfort for patients.

The technique developed by MOLLI Surgical involves implanting a tiny sesame seed-sized magnet in the breast to mark the location of the tumour, thereby eliminating the need to insert so-called “hook wires.”

The approach results in less pain for patients, more accuracy for surgeons and a more streamlined process that could reduce surgery backlogs caused by the COVID-19 pandemic.

“What we set out to do is to really simplify health care so that more patients can get the care that they need quickly,” says Seker, the company’s president and chief executive officer.

Seker launched the company in 2018 with Ravi, an associate professor in the department of radiation oncology in the Temerty Faculty of Medicine. At the time, Ravi was working at Sunnybrook Health Sciences Centre, one of 91�Թ�’s partner hospitals. Three years later, the technology has been cleared by the U.S. Food and Drug Administration and licensed by Health Canada for sale in North America.

Ravi, who has since left Sunnybrook to take on the role of chief science and clinical officer with MOLLI Surgical, says the inspiration for the invention came about during a casual conversation at a barbecue with a surgeon who wanted a less invasive, more accurate way to locate lesions within the breast.

“Improvements in screening and imaging technology allow care teams to spot smaller and smaller tumours, even before they’re palpable,” says Ravi. “But the way surgeons take out these tumours remains the same. They can’t rely on touch alone to identify where it is.”

Breast cancer care teams currently insert a wire into the breast to mark the tumour location. The procedure, which is described by some patients as traumatic and painful, is done on the day of surgery. Patients then wait at the hospital for their surgery appointment, often for hours, with a protruding wire that is painful and can be dislodged by catching on clothing, leading to inaccurate surgical outcomes.

MOLLI Surgical’s technology, by contrast, is far less invasive. Once the tiny magnet has been implanted, care teams use the MOLLI Surgical wand and tablet technology to locate the tumour for removal.

The procedure pinpoints lesions with greater accuracy, allowing surgeons to remove tumours in their entirety with better cosmetic outcomes for the patient. And, unlike the hook wire, the magnet can be implanted up to 30 days before surgery.

“MOLLI is fully implanted, so there’s no needless waiting at the hospital, which is required with the wire,” says Seker.

Cutting down on time spent in hospital is especially important during COVID-19, when patients fear of exposure may cause them to delay treatment.

The technology also helps to streamline the process for care teams. Ravi likens the care team, which includes radiology, pathology and surgery, to a three-legged stool. If something goes wrong with one leg, such as an unexpected delay, the whole structure is set off balance.

But because the magnet can be inserted up to 30 days prior to surgery, each part of the care team can do their work individually without having to co-ordinate schedules or patient transfers within the hospital.

“It improves capacity and takes a load off communication between the different disciplines, allowing them to focus their care and attention on the patient experience, instead of managing administrative tasks,” says Ravi.

Seker and Ravi say the MOLLI Surgical system could help clear pandemic-related surgery backlogs faster than using traditional procedures, noting studies that have shown that similar “decoupling” can increase operational capacity by up to 34 per cent.

“During COVID-19, anything you can do to improve operational efficiency and reduce stress placed on staff teams is something we should look forward to,” Ravi says.

MOLLI Surgical launched after Ravi met Seker to discuss the promising new technology. Seker, who was then director of venture development, medical devices with MaRS Innovation, thought the idea had great potential.

“It wasn’t technology in search of a problem,” she says. “It was a tailored solution to a well-defined clinical problem.”

“Toronto is a hotbed of medical device innovation and working within the constraints of the Canadian health-care system drives cost-effective designs in the industry,” she says. “That’s a real need with the rising cost of health care.”

Canadian philanthropist and entrepreneur James Temerty also saw potential in the technology and came aboard as an early investor when the company launched in 2018.

Seker, who is an alumna of 91�Թ�’s chemical physics program, says her time at 91�Թ� helped to prepare her for this career path.

“Chemical physics helped me develop the critical thinking skills and the ability to navigate tough problems and questions,” she says. “It was a terrific foundation for what I’ve been able to do since then.”

Ravi, who is also a 91�Թ� alumnus, began his education as an undergraduate in 91�Թ�’s engineering science program in the Faculty of Applied Science & Engineering. A co-op placement with Sunnybrook convinced him to pursue biomedical engineering, leading him to a PhD in medical biophysics and residency in medical physics.

“The profession is one where you can innovate and develop new things that have a profound and immediate impact on patient care,” he says. “MOLLI is an extension of that.

“The 91�Թ� ecosystem is wonderful for innovation and translation of cutting-edge technology into clinical practice and commercialization. It connects people with disparate disciplines to collaboratively work together with engineers and technical teams to build a device that addresses a very particular need.”

While MOLLI was designed initially for breast cancer care, Seker is excited about the potential for broader use of the device.

“MOLLI is a finding technology,” she says. “It’s not restricted to breast or oncology uses, but any general surgery application.”

Pregnancy and mental health: 91�Թ� expert offers tips, resources during COVID-19

Christopher.Sorensen — Mon, 17 May 2021 16:36:39 +0000

Pregnancy and mental health: 91�Թ� expert offers tips, resources during COVID-19

Christopher.Sorensen Mon, 05/17/2021 - 12:36

Cutline

(photo by Dann Tardif/Getty Images)

Blake Eligh

Topic

Our Community

Temerty Faculty of Medicine

Mental Health

Mount Sinai Hospital

Pregnancy

An estimated 15 to 20 per cent of expectant and new mothers experience mental health issues such as anxiety or postpartum depression – and the global pandemic has only served to heighten stress.

That’s according to Ariel Dalfen, a perinatal mental health expert and assistant professor in the 91�Թ� department psychiatry in the Temerty Faculty of Medicine. Over the past 12 years, Dalfen headed the perinatal mental health program and telemedicine program at Mount Sinai Hospital. With the largest program of its kind in Canada, the hospital provides assessment and treatment to women through pregnancy planning, pregnancy and up to a year postpartum.

Dalfen recently stepped down from her role at the hospital, but she continues her psychiatric practice with the program and her advocacy for mental health and access to perinatal mental health care.

She recently spoke with writer Blake Eligh about supports for expectant and new mothers and offered tips to manage the stress and isolation of a pandemic pregnancy.

The COVID-19 pandemic has been stressful for everyone. What are expectant and new parents dealing with right now?

This situation hits people in so many ways. In the spring, intensive care units experienced a wave of pregnant patients with severe COVID-19 symptoms. People are extremely anxious and nervous about the new variants. They’re not going out because they’re worried about getting COVID-19. We also see people coping with severe illness or the loss of loved ones.

Many pulled their other children from school or daycare, which adds to everyday challenges like trying to work from home. A recent study in The Lancet highlighted job losses and income among the biggest stressors for parents right now.

How do these stressors impact perinatal mental health?

The pandemic has added extra stress, with huge implications for women. They may be cut off from in-person visits with family or community support workers who come to their homes, or be unable to attend support groups for new mothers. New moms rely on these supports and may experience increased physical, logistical and emotional burdens as a result.

We also see more sadness or anxiety. This could lead to a worsening of existing mental health issues or a recurrence of previous mental health problems. For some, we see an increase in problematic ways of coping such as increased substance abuse or disordered eating.

When do common worries cross over into something that might require mental health supports? Are there signs to watch for?

People may notice they can't turn off their mind or they aren’t sleeping. When health and well-being are significantly impacted, it’s important to reach out for help, because it could be more than just normal anxiety.

What’s the first step in seeking support?

Just speaking about it is an important first step. People often find when they start to speak out, they find that others are in the same boat and struggling, too.

Family doctors are often a good point of contact to get an initial assessment and can help provide a connection to a therapist or a referral to see a psychiatrist. Other care team members, such as an obstetrician or midwife, can also help women connect with social workers, mental health care providers and therapists.

What supports are available when it’s safer to be apart?

Our population has traditionally had a lot of barriers to in-person care. Specialized perinatal mental health services are concentrated in downtown Toronto, so factors like traffic, parking fees, getting time off work or having to find childcare can make it hard for people to get to in-person appointments even if they live in the Greater Toronto Area. Access can also be complicated by medical or mobility considerations related to pregnancy.

Through Mount Sinai’s perinatal mental health telemedicine program, we offer specialized care to women across the province so they can get help when and where they need it. Since the world shut down in March 2020, we’ve been able to continue to offer timely individual care to people in the comfort of their own environments through telemedicine and to expand the program to include group care, as well.

There are many other good online resources, like the Pandemic Pregnancy Guide on Instagram, Mind Beacon, AbilitiCBT and COVID-19 mental health information from the Centre for Addiction and Mental Health.

What can women do to manage their own stress right now?

First, it’s normal to feel stress because the world feels like a stressful place. Pretending it doesn’t exist won’t make it go away, so it’s important to acknowledge and validate that anxiety.

Turn off the news or social media so you’re not continuously bombarded by COVID-19 news. I know that's easier said than done, but it is so helpful.

Find time to be with people. Whether virtually or safely in person, talking to friends and having time to just laugh and relax can help turn our minds to something else.

I also encourage people to talk to their partners, if they have one, or to family members and friends. It can feel better to know you're not alone – even if there aren't concrete things people can do to help.

What is your advice for women worried about variants, vaccines and going out in public?

First, everyone needs to follow local advice and guidance from public health experts. Then, within those rules, people can determine what they need to do to keep themselves and their families safe. For example, some parents choose to keep their children in daycare services, while others feel it isn’t right for them.

Clinics like the UHN clinic on the St. George campus offer vaccinations to pregnant women. The early data is reassuring, and health-care providers who care for pregnant individuals encourage patients to get vaccinated as soon as possible. This is a reassuring step to reduce COVID illness and transmission.

How can family and friends lend support?

Stigma sometimes makes people nervous to talk about mental health issues, but most of us wouldn’t think twice about telling someone they should get help for a physical injury. It’s important to raise concerns about mental health changes you may notice in others in a clear, caring and supportive way.

Open the door to conversation. Starting with a fact-based observation or question like, “I notice you don’t seem like yourself lately.” Or “How are you sleeping these days?” It can help demonstrate that you care and want to be helpful and supportive.