Researchers Under the Scope University of Saskatchewan, OVDR, College of Medicine

From the laboratory to saving lives, this episode brings together three outstanding researchers from the University of Saskatchewan’s Department of Anatomy, Physiology, and Pharmacology (APP) as they discuss their work and its implications for cardiac care.
 
Dr. Michelle Collins, Dr. Scott Widenmaier, and Dr. Changting Xiao are all recent recipients of research grants from Heart & Stroke (formerly the Heart and Stroke Foundation of Canada).
 
In Canada, one per cent of newborns have congenital heart defects. Thanks to advances in cardiac care, up to 85 per cent of these infants now survive to adulthood.
 
Meredith Rhinas is one of those survivors. Diagnosed with aortic stenosis as an infant, by her thirties, she received conflicting guidance from cardiologists, and risked congestive heart failure giving birth. She underwent open-heart surgery to replace her aortic valve after delivering her fourth and final child, surgery that led to further complications caused by an oversized replacement valve.
 
“That’s a piece that is missing,” said Rhinas, who said most heart attack protocols still skew toward older men -- often overlooking younger patients and women of childbearing age.  
 
“I want the research to catch up."
 
In this episode Dr. Michelle Collins, an expert in the molecular basis of cardiac development and function, discusses her work on congenital heart defects, seeking to understand what makes a heart beat.

 
With her lab’s focus on the movement of calcium ions and their role in heart function, Collins emphasizes the importance of understanding cardiac arrhythmias, particularly atrial fibrillation, which has traditionally been viewed as an electrical disease.
 
“There’s a significant contribution from genes that are really early transcription factors that build the heart during development,” Collins said.
 
Dr. Scott Widenmaier's work looks at the liver, an organ he has dubbed "the Amazon of our body", as it presents our first line of defence against stressors, which often are a precursor to heart disease. 
 
In this episode, Widenmaier explains how and why those stress defense mechanisms can be harnessed to prevent the conditions that lead to heart disease and stroke. 
 
"Things are happening way quicker, way faster, and the technology's there. The ability to find the genetic variants is there," Widenmaier said. "There's hope in that.”
 
Dr. Changting Xiao, known for his innovative work on gut physiology and metabolism, explores the gut’s role in lipid processing and its implications for heart disease.
 
 "We want to understand how these enterocytes process the fat inside the cells," said Xiao.  His research aims to identify druggable targets within the gut to correct lipid disorders and combat heart disease.
 
Xiao passionately believes in the ancient wisdom that "all disease starts in the gut," asserting that a deeper understanding of gut functions can lead to breakthroughs in preventing and treating heart conditions.
 
"Every small step we move forward looks small, but in the long run we build knowledge and we move forward," said Xiao. His laboratory is now one of only a handful worldwide specializing in being able to see both sides of nutrients entering and leaving the gut.
 
With awards being administered through a rigorous national peer-review process, Carolyn Cyr praised Saskatchewan's researchers for rising to the top. She’s the province’s Director of Health Policy and Systems for Heart & Stroke.
 
"It’s definitely something to celebrate,” said Cyr.  "It's a testament to the excellent research they're doing and the high calibre of their applications that we have three researchers from the same department who are able to be funded.”

"Pushing politicians to do what is good for the health of the people, there's no way around it," said Dr Jacob Alhassan.
Born and raised in a rural Ghanaian village, Alhassan grew up without electricty and paved roads. He watched women die in childbirth. He grew resentful of health systems that left the poorest people to fend for themselves, while the rich thrived.
Alhassan decided to take action.
At first, he thought he would study hard to become a local hospital administrator. Partway through his university years, Alhassan began to dream even bigger.
In this episode, he looks back at his arrival in Saskatoon, and how his trajectory to becoming an assistant professor of Community Health and Epidemiology was forever changed by provincial austerity measures that wiped out the Saskatchewan Transportation Company (STC).
Billed as a cut that would save taxpayers $85 million dollars over five years, Alhassan studied Hansard and the full debate around the public transit network's closure. He found little evidence supporting the decision to cut it.
"We have a political system that is not necessarily arranged for the well-being of average people," said Alhassan, who still remembers travelling to towns and cities across Saskatchewan to interview people devastated by the closure of the intercity bus service.
He said the cuts "radically changed" some people's lives, in some cases shortening them. Losing the parcel service also cost the provincial health care system more, with patients delaying medical care, and pharmacists throwing out delayed and weather-damaged medication and vaccines.
"It's literally a might-makes-right sort of thing, where the most powerful people make decisions that deeply impact the lives of people who don't really have the voice to raise their concerns or to be heard," Alhassan said.
Today, Alhassan's looking more closely at health outcomes tied to public transportation, and their financial impact on taxpayers. He's also one of the academic co-leads of the University of Saskatchewan's Certificate in Global Health.
"You cannot do this type of work to improve people's health if you disconnect yourself from the politics," said Alhassan. "That's not going to happen if I kind of sit in the ivory tower and kind of disconnect myself from the political aspect of this. I strongly believe in that."
 
 

 
Dr. Sabira Valiani was one of the frontline physicians working inside Saskatoon’s critical care units four years ago, during the initial lockdowns of the Covid-19 pandemic.
 
“It was really weird,” said Valiani.
 
Valiani said ‘a lot of light bulbs went off in my head’ amid the automated stillness of the unit, as she watched ventilators breathing for heavily sedated patients.
 
Covered in head-to-toe personal protective equipment, staff in the intensive care unit struggled to simultaneously treat patients, communicate with family members, and enforce hospital policies. 
 
“Those patients aren’t talking to us,” Valiani said.  “It was empty, it was overwhelming and it was disconnected all at the same time.”
 
Valiani has now spent seven years in critical care, a move that started with her enrolling in a critical care and ICU elective in Ottawa. 
 
“I loved it. I loved on the medical side, how you could see the life support that you were giving a patient immediately have a physiologic effect and stabilize that patient,” she said. 
 
Driven by her experiences during the pandemic, Dr. Valiani delved into research focused on improving patient and family experiences in the ICU. She collaborated with a multidisciplinary team and patient partners to understand the challenges faced by healthcare providers and families alike.
In this article for the Canadian Association of Critical Care Nurses, she and her colleagues examined the effect of visitor restrictions during the pandemic.
Valiani remembers tearful goodbyes, families gathered around screens, unable to hug or touch loved ones infected and dying with Covid-19.
"The family's role becomes significantly diminished,” she said. “So much of that was disrupted during that time." 
In the months and years that followed, visitor restrictions relaxed, but Valiani noticed communication between families, patients and staff still felt awkward.
 
Valiani and her colleagues turned their lens last year to key moments for Canadians of diverse ethnicities during the critical care journey, in the Canadian Journal of Anesthesia. The findings revealed the strain on healthcare providers playing multiple roles and families feeling disconnected from crucial information.
She estimates 30 per cent of Saskatoon’s ICU patients travel from remote communities, making it crucial to find ways to keep family members informed in a language they understand well.
 
“People kind of naturally turned towards communication technology in the pandemic,” said Valiani, noting a number of families cannot be present in-person during the day, as intensivists attend rounds. 
Clear and open communication between patients, care providers and families is the key, Valiani said.
 
“What if we could use artificial intelligence or AI to just translate a medical progress note into an understandable family update?” Valiani asked. 
“It doesn't have to be high tech, right? Like it can be a phone call.”
 
Together with the Saskatchewan Health Research Foundation, Dr. Valiani now works at enhancing patient-family engagement through practical solutions. She emphasizes the importance of involving families in care decisions, acknowledging their unique expertise in understanding patients' wishes.
Her team presented its findings in 2022 at Toronto’s Critical Care Canada Forum.
 
“We have this cohesive approach to defining the problems,” said Valiani. “Now we can take this to decision makers and say….these are the things people living this experience actually want.”

Daphne Yau can trace her interest in endocrinology back to a beta-cell physiology experiment during her master’s degree,  working with laboratory mice with Type 2 Diabetes.
“It was the part of the pancreas that makes insulin,” she said. “It was fascinating. It also made me realize that maybe pure laboratory research wasn't quite for me."
From there, her interest in hormones and fluctuating blood sugar levels grew.
Yau is no stranger to medicine. Her mother was a pharmacist, while her father and aunt both worked as physicians. Following in their footsteps, Lou completed her pediatrics residency at Queen’s University, with fellowship training at McGill. She then focused on congenital hyperinsulinism at the Children’s Hospital of Philadelphia and Royal Manchester Children’s Hospital.
She still remembers her residency, and meeting a premature baby with a rare genetic disorder  in neonatal intensive care.
“The blood sugars were horrendously low right from the start,” Yau said. “Their brain uses most of that glucose, so that's why it's so critical in that period that they get a steady supply.”
Together with an endocrinologist and a multi-disciplinary team, Yau and her colleagues traced back the root of the hyperinsulinism — the infant’s mother and grandmother also suffered from rare forms of diabetes.
Unregulated, plummeting blood sugar levels in infants can cause brain injuries and permanent neurological damage, Yau said.
“Your brain can't really store much in the way of glucose and it can't make it on its own the way some other tissues and organs in the body can,” said Yau.
“If you test a child who's had hypoglycemia when they're two or four, you may not actually pick up on this. Not till maybe later on, when they're in school and they're struggling.”
Yau joined the College of Medicine five years ago as a pediatric endocrinologist and assistant professor of pediatrics. Today, she’s based at the Jim Pattison Children’s Hospital. Her research focuses on understanding and addressing congenital hyperinsulinism, as well as screening for diabetes and other metabolic disorders.
In this episode, Dr. Yau pointed to recent success with a project inspired by Dr. Mark Inman. Together, their team is trying to improve diabetes screening and education in northern Saskatchewan, particularly for Indigenous children and teenagers.
She said the heel prick hospitals often perform on newborns inspired them.
“Could someone at home prick their finger, put some few drops of blood on this card and have their A1C measured that way as opposed to having to go to the lab?” Yau said.
The results to date show promise, which could make it easier to screen young patients in remote communities for diabetes.
Yau is also working with researchers in the United Kingdom who study blood sugar dysregulation in infants, exploring alternative treatments and lower doses of medications such as diazoxide, to mitigate side effects.
“What are the levels we really should be targeting to minimize the potential for long-term harms?”

Haissam Haddad inadvertently horrified his family when he signed up for engineering courses in his first year of university.
The teenager returned the next day to change his major to medicine -- a move he's glad he made.
Dr. Haddad practiced family medicine in Syria for three years, then arrived in Canada in 1986 to visit his wife's family, who urged him to stay.
Haddad faced an uphill battle when he investigated the possibility of becoming a Canadian doctor. One colleague even told him he’d be better off opening a Syrian grocery store.
“This gave me a lot of energy to prove him wrong,” said Haddad.
His early years in Canada were characterized by relentless perseverance, as Haddad confronted the arduous process of certification and integration into the medical system. He focused on learning English every weekday, picking up back-to-back twelve-hour shifts at a Halifax laundromat every weekend, to support his family.
“The first day it took me, like, almost 16 hours to read one page,” Haddad said. “I had no option to fail.”
After three years of English lessons and intensive studying, Dr. Sam Haddad earned a passing score on Canada’s medical licensing exam.
In this episode, Dr. Haddad recounts pivotal moments that steered him towards cardiology, including formative experiences in cardiac surgery during his residency at Dalhousie, which took place during the HIV epidemic.
“I’ve always liked the heart,” said Haddad. "I decided to do cardiology because it has less blood and less risk.”
Haddad’s dedication to improving patient outcomes through research soon became evident, as he tackled clinical gaps and treatment efficacy in heart failure management and heart transplant protocols.
“Almost on a weekly basis, you have a patient who did not respond to the usual treatment,” said Haddad. “This is the research question. How come this patient is not getting better?”
As his expertise grew, Haddad became one of only two Canadian cardiologists who were part of the National Institutes of Health Heart Failure Network. His patients took part in clinical trials that led to significant advancements. 
“A lot of our patients didn't have private insurance,” Haddad said. “We can do a lot of work to help patients who are not able to buy their own medication."
Haddad led the cardiac transplant and heart failure programs at the University of Ottawa’s Heart Institute, exponentially increasing the number of transplants performed. At the same time, he said at cardiovascular medicine was making revolutionary strides with artificial hearts and improved anti-rejection medications.
When he began, half of heart failure patients died within a year. Now, over 90 per cent survive.
After moving to Saskatoon to become Saskatchewan’s Provincial Head of Medicine in 2016, Haddad continued his clinical practice, taking on leadership roles in medical education and research.
Instrumental in recruiting almost half of the specialists practicing in Saskatchewan today, Haddad also established the University of Saskatchewan Cardiovascular Research Group, fostering a collaborative environment for innovative research initiatives.
Last year, Dr. Haddad was appointed as an Officer of the Order of Canada..
“Nothing comes easy,” said Haddad. “You have to work hard. You have to fail multiple times before you're successful.”

In this episode, we meet Dr. Stacey Love, Director of Virtual Physiotherapy and Rehabilitation at Saskatchewan's Virtual Health Hub, and an Assistant Professor at the University of Saskatchewan's School of Rehabilitation. She's also involved with the Saskatchewan Centre for Patient Oriented Research.
You can see more of her recent publications here, along with links to her labs:
Musculoskeletal Health and Access to Care: https://cchsa-ccssma.usask.ca/mhac/

Virtual Care and Remote Presence: https://research-groups.usask.ca/remote-presence/index.php#Healthcare

Stacey Lovo remembers the bitterly cold day in December 2012, when two Indigenous women from northern Saskatchewan stepped off the bus in Saskatoon. One had traveled 12 hours, the other seven, both to see physiotherapist Stacey Lovo for back pain.
 
“It was a big undertaking for them,” said Lovo. She said one woman was forced cut her appointment short, to catch the last bus returning north.
 
The other woman stayed in Saskatoon to treat spinal pain stemming from what Lovo characterized as a ‘very difficult and scary problem.’
 
“This was devastating for many reasons,” said Lovo who remembered her patient was distraught, unable to return home to care for her young children.
 
That glaring disparity in healthcare access propelled Dr. Lovo into action. She returned to the classroom, and earned her PhD in Rehabilitation Science, specializing in low back disorders.
 
“If you're rural and remote resident or if you're Indigenous, your chances of having back pain are 30 percent higher than an urban person who's non-Indigenous,” said Lovo.
 
Lovo said long waits for care and spending up to twelve hours in a vehicle to attend a one-hour physiotherapy consultation often aggravate spinal damage — rather than healing it.
 
“When we're traveling that distance, we're undoing everything that's done in the session,” she said.
 
Working closely with people in Pelican Narrows and the Peter Ballantyne Cree Nation, Dr. Lovo began testing virtual consultations and in-person treatments, advocating for a hybrid model of healthcare.
 
"These projects are all community driven,” she said. “They’re led and driven by the strengths and knowledges from the communities."
 
Her team’s innovative use of Remote Presence Robotics in partnership with local nurse practitioners  in Pelican Narrows demonstrated a successful model of team-based virtual physiotherapy, connecting patients hundreds of kilometres away from health providers with care.
 
Local health providers are the key, Lovo said.
 
“Taking reflexes and testing for sensation and muscle strength are done by the nurse on the other side,” said Lovo.  “They have incredible rapport with the patients. They know their families.”
 
When the pandemic amplified the need for virtual care, Dr. Lovo, Dr. Brenna Bath  and Dr. Lovo's graduate students met the challenge with innovation.
 
Participants in her back pain study reported their outcomes were noticeably better. Many asked to continue with more treatments.
 
Dr. Lovo's work goes beyond healthcare delivery; it is a commitment to fulfilling treaty obligations and ensuring equitable healthcare access for Indigenous Peoples.
 
“Canada's promise to First Nations peoples was that medical care would be taken care of, and so we are  working with communities to try things out that will allow us to provide it,” she said.