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Livable cities start with a holistic approach to health and well-being

Ryerson students work in lab at MaRs

Toronto has long been a hotbed for medical innovation.

In the 1920s, Frederick Banting, Charles Best and their collaborators, J. J. R. Macleod and James Collip, famously found a way to extract insulin and use it to treat people with diabetes.

James Till and Ernest McCulloch, researchers at the Ontario Cancer Institute, revolutionized cancer treatment when they discovered stem cells in 1961. In 1984, their former colleague Tak Wah Mak identified the human cancer T-cell receptor, a giant leap forward in cancer immunology.

At Ryerson, researchers are designing advanced robotics and artificial intelligence that improve the speed, accuracy and recovery from major surgical procedures. University experts are also studying how architecture and interior design contribute to health and how advances in HIV treatment are changing sexual practice.

The Daphne Cockwell Health Sciences Complex at Ryerson University

Healthy homes, healthy offices

Canadians spend about 90 per cent of their time indoors, so our homes and office should be healthy spaces, says Jennifer McArthur, professor in the Department of Architectural Science.

She has developed a Worker Productivity Benchmarking tool that considers how spatial qualities impact employees, such as air quality, temperature, noise, lighting, ergonomics, social well-being, access to healthy food and clean water, and "sources of delight” — things like natural textures or quirky building features.

These things make a huge difference, McArthur says. In the workplace, it can be the difference between a happy and productive environment and one that hurts performance through increased absences, health issues and feelings of malaise.

"You could perceive healthy buildings as an important part of our health-care system that we haven't even thought about or considered as an asset or a potential liability.”

Jennifer McArthur

In the long term, bad ergonomics, poor lighting, a lack of fresh air and other negative factors contribute to increased health-care costs for strains, injuries and respiratory issues.

"On average we lose about 45 hours [per person] a year of productivity to issues that can be related to poor indoor environmental quality,” says McArthur. "In Canada it's a multibillion-dollar issue."

In a collaborative study with professor Terri Peters, McArthur is following a company as they move offices, comparing the old space with the new one using sensors and tracking changes in productivity and happiness.

Even the university itself is part of McArthur's lab. Along with colleague Mark Gorgolewski, McArthur worked with building science students to conduct pre-move occupancy surveys of Faculty of Community Services faculty who will be moving into the new Daphne Cockwell Health Sciences Complex.

"It's going to be a centre where we can start testing different control strategies and the resulting impact on the occupant's space,” says McArthur.

"[Healthy buildings have] huge benefits in terms of the overall health of the population, which could have some pretty significant financial impact, both on a productivity scale … but also in terms of our cost of health care reflecting that our buildings are helping rather than hindering.”

Hand holding artificial heart

The robot will see you now

A robotic surgeon could be coming soon to a hospital near you.

Mechanical and industrial engineering professor Farrokh Janabi-Sharifi is developing a medical robot capable of performing minimally invasive surgeries on human hearts, in particular surgery to correct atrial fibrillation, or a-fib, a common but dangerous type of irregular heartbeat.

One of the conventional treatments for a-fib requires a surgeon to delicately insert a catheter tube into an artery in the thigh and guide it to the heart where treatment is delivered in the form of lasers or radio frequencies.

"Many operations on the heart [like a-fib] are done under guidance of fluoroscopy, which is heavy, ionized radiation," says Janabi-Sharifi. "One of the benefits [of using a robot] is saving the patients, the operators, the surgeons and the staff from radiation."

In test trials at the university, Janabi-Sharifi’s robot was capable of greater accuracy than a human surgeon because it didn’t suffer from fatigue or natural shakes of the hand.

"Many of these procedures are done better by robots," he says. "The variation is low, the accuracy is high — it’s also faster, so the procedure time will be reduced." The recovery time for the patient is also improved.

Most remarkably, Janabi-Sharifi has also developed an approach that enables medical robots to learn visually via camera using a process called programming by demonstration that eliminates the need for programming.

"If someone shows a task to the robot, it should learn ... they should be able to program themselves," he says.

Janabi-Sharifi thinks in a decade about 20 to 30 per cent of all surgeries could be performed by a robot. Artificial intelligence could also take over identifying illnesses at the doctor’s office.

"I don’t think the human will be completely out of the loop, but the role will be significantly reduced," he says.

"Even in simple diagnostics, the robots and AI could beat human beings because they don’t make mistakes and don’t forget … they remember every detail."

Pills used for HIV Prophylaxis

The changing nature of HIV prevention

Recent advances in medicine have dramatically changed how gay men deal with the threat of HIV infection.

Trevor Hart, director of the HIV Prevention Lab at Ryerson, is leading a study of 2,000 men in Toronto, Montreal and Vancouver to determine exactly how new treatment and prevention is changing people's sexual behaviour.

"It used to be that if people wanted to avoid HIV they would have to use condoms and that was really the only option," he says.

"Now there are other options that work very well, including HIV-negative people using pre-exposure prophylaxis or PrEP. HIV-positive people can reduce the amount of virus in their blood down to undetectable levels so they are almost at zero risk of transmitting HIV.”

Studies show that PrEP has reduced the risk of HIV infection by up to 92 per cent by preventing the virus from taking hold and spreading.

"If there are increases in STIs, it means we need to redouble our efforts to help people get appropriate treatment and to actually get tested.”

Trevor Hart

Hart's team wants to know if the reduced risk of transmitting or contracting HIV has resulted in more condomless sex among men and therefore a rise in other sexually transmitted infections, like syphilis.

Now in its second year, Hart's study is the largest of its kind in Canada and one of the largest currently underway in the world. The results may indicate lower health-care costs in the future as many STIs are relatively easy and inexpensive to treat compared to lifelong HIV care.

"Ryerson has dramatically increased its capacity to engage in applied health research that will really help us to know what we need to be doing in future to reduce the significant health and financial cost of living with HIV and sexually transmitted infections,” says Hart.


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