Block 2

2.1. Everyday racial discrimination, resilience and psychosomatic symptoms among 15 to 40 years-old Black individuals in Canada

Lesly Nzeusseu, Wina Paul Darius, Cary Kogan, Assumpta Ndengeyingoma & Jude Mary Cénat
University of Ottawa, Faculty of Social Sciences

Although no study has explored psychosomatic symptoms in Black communities in Canada, several studies in the United States have shown that the expression of psychological distress often involves physical pain in Black individuals. Using data from the Black Community Mental Health (BCoMHeal) project, the aim of this study was to document the prevalence of somatic symptoms and its relationship to racial discrimination and resilience, according to sociodemographic characteristics among Black individuals aged 15 to 40 in Canada. The final sample consisted of 860 participants between the ages of 15 and 40 years old (Mage= 24.96 years, SD=6.31), predominantly born in Canada (79.1%) and the majority of whom were female (75.6%). The Symptom Checklist-90-Revised (SCL-90-R) was used to measure psychological problems, the Everyday Discrimination Scale (EDS) discriminatory experiences, and the Resilience Scale-14 (RS-14) resilience. Chi-test and a moderated mediation analysis were conducted. Findings revealed that 81.74% of Black individuals had probable somatization symptoms. The prevalence of somatization was significantly positively associated with gender and age, with women reporting more symptoms of somatization, compared to men (respectively, 84.15%; 70.72%; ꭓ2 (2) = 21.54, p < .001) and individuals 25-40 years old (93.73%) in comparison to 15-24 years old (75.22%) (ꭓ2 (1) = 45.03, p < .001). The present study showed that women and older participants (25-40 years) had more somatic symptoms compared to men. It also demonstrated the positive correlation between everyday racial discrimination and somatic symptoms. This relationship was partially mediated by resilience.

Key words: Everyday racial discrimination; Resilience; Psychosomatic symptoms; Black individuals; Canada

2.2. Perioperative Satisfaction and Health Economic Questionnaires in Patients Undergoing an Elective Hip and Knee Arthroplasty: A Prospective Observational Cohort Study

Mahesh Nagappa (1,2), Jill Querney (1), Janet Martin (1,3), Ava John-Baptiste(1,3), Yamini Subramani (1), Brent Lanting (4), Christopher Schlachta (5), Julie Ann Von Koughnett (5), Kathy Speechley (6), Jeff Correa (1), Maoz Bin Yunus Chohan (1), Nita Rrafshi (1), Mariska Batohi (1), Ashraf Fayad (1), and Homer Yang (1)
1. Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; 2. The Research Institute for London Health Sciences Centre and St. Joseph’s Health Care, Lawson Health Research Institute, London, Ontario, Canada; 3. Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; 4. Department of Orthopaedic Surgery, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; 5. Department of Surgery, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; 6. Departments of Pediatrics and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada

Early hospital discharge shifts the recovery burden toward the patient and can leave patients and their caregivers anxious about the recovery process. Postoperative home care must be broadened to include adequate support for recovery at home. In this prospective study, patient and caregiver perspectives on the level of preparation/satisfaction and cost associated with management of recovery in the postoperative period were evaluated. We designed this prospective study to measure patient-reported outcomes and to inform the design of a postoperative home monitoring system. Patients undergoing inpatient total hip or knee replacements were recruited from a university hospital. Patients and caregivers completed preoperative, postoperative, and health economic questionnaires. Bivariate analyses were conducted to understand factors associated with care satisfaction. Of 239 patients and caregivers recruited, 98.8% of patients completed the preoperative questionnaire, and 94.2% completed the postoperative follow-up questionnaire. 75% of caregivers completed the postoperative follow-up questionnaires, and 93.7% completed the health economic questionnaire. The postoperative satisfaction scores were higher than the preoperative needs/expectation scores for the overall and individual subscales. Patients undergoing hip arthroplasty reported higher satisfaction scores for postoperative pain management than patients undergoing knee arthroplasty. Patients who underwent knee arthroplasty reported better satisfaction scores with regard to having enough information on how to manage leg stiffness at home compared to patients undergoing hip arthroplasty. Overall, patients are satisfied with perioperative care, but they have distinct needs and expectations regarding perioperative medication and postoperative pain management. Virtual postoperative monitoring may be a useful tool during postoperative care for patients’ concerns.

Key words: Caregiver’s satisfaction, patient’s satisfaction, postoperative recovery, self-reported outcomes

2.3. “Evaluating the synergistic effect of Maraba Virus infection and SMAC mimetic treatment on latently HIV-infected cells

Yasmeen Ameeriar (1), Bengisu Molyer (2,3), and Dr. Jonathan Angel (2,3,4)
1. Translational and Molecular Medicine, University of Ottawa; 2. Department of Biochemistry, Microbiology and Immunology, University of Ottawa; 3. Division of Infectious Diseases, The Ottawa Hospital; 4. Chronic Disease Program, Ottawa Hospital Research Institute

Human immunodeficiency virus (HIV) primarily infects immune cells. This results in weakened immune function with the inability to fight infections and if left untreated, HIV can develop into AIDS. There is no cure for this virus as it can incorporate itself into the host cell’s DNA, establishing a latent infection. Current treatment, combined antiretroviral therapy, remains ineffective as it fails to eliminate HIV entirely from the body. This emphasizes the necessity for new cure strategies. Two promising treatments that can target latently HIV-infected cells are Maraba virus (MG1), and SMAC mimetics (SM). MG1, is an oncolytic virus that can make HIV cells more susceptible to killing while leaving healthy cells alive. SM are small molecule proteins that promote cell death. A combination therapy using both MG1 and SM will increase specificity to selectively kill latently HIV-infected cells. The objective will be to determine the efficacy of an MG1 and SM combination therapy on killing HIV-infected cells. To test this, MG1 infection and SM treatment experiments will be done on the Jurkat and J1.1 cells, and flow cytometry analysis will be conducted to visualize the degree of infection and cell death. Overall, it was noted that when infected with MG1, Jurkat cells reached maximum cell death at MOI 10-1. We can conclude an association between an increase in MOI and an increase in cell death. Thus, this study aims to determine if the combination treatment of MG1 and SM are a promising treatment option to tackle the gaps in curing HIV.

Key words: HIV, AIDS, Oncolytic Virus, Combination Therapy, Treatment, Apoptosis

2.4. Can a limited computed tomography restricted to the area of pain rule out acute aortic syndrome?

Madison Van Dusen (1,3), Krishan Yadav (1,2,3), Robert Ohle (4,5)
1. Faculty of Medicine, University of Ottawa; 2. Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada; 3. University of Ottawa Research Institute; 4. Department of Emergency Medicine, Health Sciences North Research Institute; 5. Department of Emergency Medicine, Northern Ontario School of Medicine 

Introduction: Acute aortic syndrome (AAS) includes aortic dissection, intramural hematoma and penetrating atherosclerotic ulcer. The most common investigation used is a computed tomography (CT) of the chest, abdomen and pelvis and is usually negative for AAS. We hypothesize that most AAS present with pain in the area of damage. Therefore, if we confine imaging to that area and AAS is not found, a CT of the entire aorta is unnecessary. This approach may reduce patient exposure to radiation. Methods: Multicentre retrospective cohort of adults presenting to emergency departments from 2002-2019 with a diagnosis of AAS on CT. Data was extracted using a standardized data collection form. AAS was defined according to radiological standards. Sensitivity, specificity and likelihood ratios with 95% confidence intervals were calculated. A sample size of 148 patients for a sensitivity of 100% (95% CI 98-100%) was estimated. Results: We included 148 patients diagnosed with AAS (25% thoracic, 14% abdominal, 60% thoracic/abdominal). 24% presented with only abdominal pain, 46% with only chest pain and 30% with abdominal/chest pain. The sensitivity of restricted imaging strategy was 96% (95% CI 91.4-98.5%). Of the 6 cases missed, 5 had known aortic aneurysm/repair and 1 was hypotensive. Cohort was restricted to those with systolic >90mmHg and without aortic aneurysm/repair (n=86). Restricted imaging strategy had a sensitivity of 100% (95%CI 96-100%). Conclusions: A restricted imaging strategy in stable patients without known aortic aneurysm has a high sensitivity in ruling out AAS. External validation in a larger cohort is would ensure sufficiently narrow CI.

Key words: Acute aortic syndrome, restricted imaging strategy

2.5. Combined hyperlipidemia is genetically similar to isolated hypertriglyceridemia

Praneet K Gill (1), Jacqueline S Dron (1), Amanda J Berberich (1), Jian Wang (1), Adam D McIntyre (1), Henian Cao (1) , Robert A Hegele (1)
1. Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street North, London, Ontario N6A 5B7, Canada

Background: Combined hyperlipidemia (CHL) is a common disorder defined by concurrently elevated low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels. Despite decades of study, the genetic basis of CHL remains unclear. Objective: To characterize the genetic profiles of patients with CHL and compare them to those in patients with isolated hypercholesterolemia and isolated hypertriglyceridemia (HTG). Methods: DNA from 259, 379 and 124 patients with CHL, isolated hypercholesterolemia and isolated HTG, respectively, underwent targeted sequencing. We assessed: 1) rare variants disrupting canonical LDL-C or TG metabolism genes; and 2) two polygenic scores-for elevated LDL-C and TG-calculated using common trait-associated single-nucleotide polymorphisms (SNPs). Genetic profiles were compared against 1000 Genomes Project controls. Results: Both CHL and isolated HTG patients had significantly increased odds of a high polygenic score for TG: 2.50 (95% confidence interval [CI] 1.61-3.88; P < 0.001) and 3.72 (95% CI 2.24-6.19; P < 0.001), respectively. CHL patients had neither a significant accumulation of rare variants for LDL-C or TG, nor a high polygenic score for LDL-C. In contrast, patients with isolated hypercholesterolemia had a 3.03-fold increased odds (95% CI 2.22-4.13; P < 0.001) of carrying rare variants associated with familial hypercholesterolemia, while patients with isolated HTG had a 2.78-fold increased odds (95% CI 1.27-6.10; P = 0.0136) of carrying rare variants associated with severe HTG. Conclusion: CHL is genetically similar to isolated HTG, a known polygenic trait. Both cohorts had a significant accumulation of common TG-raising variants. Elevated LDL-C levels in CHL are not associated with common or rare LDL-C-related genetic variants.

Key words: Cholesterol; Dyslipidemia; Hypercholesterolemia; Hyperlipoproteinemia type IIb; Hypertriglyceridemia; LDL; Monogenic; Polygenic score; Triglycerides

2.6. Evaluating the impact of flaxseed and flaxseed oil supplementation on intestinal barrier integrity in lipopolysaccharide (LPS)-treated C57B1/6 male mice

Kasuni Pillagawa (1), Dawson Livinston (2), Ally Sweet (3), Krista A. Power (4)
1. Faculty of Science, University of Ottawa, Ottawa, ON; 2. Faculty of Medicine, University of Ottawa, ON; 3. Faculty of Medicine, University of Ottawa, Ottawa, ON; 4. School of Nutrition Sciences, University of Ottawa, Ottawa, ON

Flaxseed (FS), an oilseed rich in omega-3 fatty acids, fibre, and lignan, secoisolariciresinol diglucoside (SDG) induce anti-inflammatory and anti-oxidative properties, potentially affecting the gut-brain axis (GBA) to improve mental health. Mental illnesses (i.e., anxiety and depression) have adverse effects on gut health, which can be modelled in rodents using an intraperitoneal (i.p) injection of the bacterial endotoxin, lipopolysaccharide (LPS). This study will examine the effects of FS and flaxseed-oil (FO) on intestinal dysfunction caused by the LPS. 6-week-old male C57B1/6 mice were divided into 3 dietary groups (n=24 mice/diet); A) basal diet (BD) (modified AIN-93G), B) BD supplemented with 10% whole ground FS, and C) BD supplemented with 3.97% FO. Following 3 weeks of dietary intervention, the mice are injected i.p. with LPS (n=12/diet) or saline (SAL; n=12/diet). Blinded histological analysis of intestinal health were performed using cross-sections of the proximal colon, distal colon and the ileal tissues stained with Alcian Blue (AB) and hematoxylin and eosin (H&E). Using a Zeiss microscope supplied with Axiocam 105 Color, images were taken at 5X magnification for mucus content examination, 10X for crypt length and 20X for goblet cell count. These features are analyzed using ImageJ software and statistical and graphical analyses are completed using Graphpad Prism software. The results will demonstrate the potential for FS and FO to improve intestinal barrier integrity and gut health, therefore positively impacting mental health via the GBA. .

Key words: Flaxseed, Flaxseed Oil, proximal colon, distal colon, intestinal barrier integrity, mucous content, goblet cells, crypt length, gut-brain axis

2.7. Quantification of Murine Myocardial Infarct Size using 2D and 4D High Frequency Ultrasound

Melissa M. Dann (1,2,3), Sydney Q. Clark (4), Natasha A. Trzaskalski (1,2), Conner C. Earl (4,5), Luke E. Schepers (5), Serena M. Pulente (1,2), Ebonee N. Lennord (1,2), Karthik Annamalai (5), Joseph M. Gruber (5), Abigail D. Cox (6), Ilka Lorenzen-Schmidt (2), Richard Seymour (2), Kyoung-Han Kim (2,7), Craig J. Goergen (4,5), Erin E. Mulvihill (1,2,8)
1. Faculty of Medicine, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada; 2. University of Ottawa Heart Institute, Ottawa, ON, Canada; 3. Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada; 4. Indiana University School of Medicine, Indianapolis, IN, USA; 5. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; 6. Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA; 7. Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; 8. Montreal Diabetes Research Group, Montreal, QC, Canada

Ischemic heart disease is the leading cause of death in the United States, Canada, and worldwide. Severe disease is characterized by coronary artery occlusion, loss of blood flow to the myocardium, and necrosis of tissue, with subsequent remodeling of the heart wall, including fibrotic scarring. The current study aims to demonstrate the efficacy of quantitating infarct size via two-dimensional (2-D) echocardiographic akinetic length and four-dimensional (4-D) echocardiographic infarct volume and surface area as in vivo analysis techniques. We further describe and evaluate a new surface area strain analysis technique for estimating myocardial infarction (MI) size after ischemic injury. Experimental MI was induced in mice via left coronary artery ligation. Ejection fraction and infarct size were measured through 2-D and 4-D echocardiography. Infarct size established via histology was compared with ultrasound-based metrics via linear regression analysis. Two-dimensional echocardiographic akinetic length (r = 0.76, P = 0.03), 4-D echocardiographic infarct volume (r = 0.85, P = 0.008), and surface area (r = 0.90, P = 0.002) correlate well with histology. Although both 2-D and 4-D echocardiography were reliable measurement techniques to assess infarct, 4-D analysis is superior in assessing asymmetry of the left ventricle and the infarct. Strain analysis performed on 4-D data also provides additional infarct sizing techniques, which correlate with histology (surface strain: r = 0.94, P < 0.001, transmural thickness: r = 0.76, P = 0.001). Two-dimensional echocardiographic akinetic length, 4-D echocardiography ultrasound, and strain provide effective in vivo methods for measuring fibrotic scarring after MI.

Key words: echocardiography; infarct size; mouse models; strain; ultrasound