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Article ; Online: [No title information]

Gertsman, Shira / Dini, Yasmin / Wilton, Devon / Neilson, Shane

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2024 Volume 196, Issue 2, Page(s) E63–E68

Title translation	Faire tomber les obstacles à l’admission des personnes ayant un handicap en faculté de médecine au Canada.
MeSH term(s)	Humans ; Schools, Medical ; Canada ; Disabled Persons ; Hospitalization
Language	French
Publishing date	2024-01-21
Publishing country	Canada
Document type	Journal Article
ZDB-ID	215506-0
ISSN	1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online)	1488-2329
ISSN	0008-4409 ; 0820-3946
DOI	10.1503/cmaj.230734-f
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Article ; Online: Tackling barriers in Canadian medical school admissions for students with disabilities.

Gertsman, Shira / Dini, Yasmin / Wilton, Devon / Neilson, Shane

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2023 Volume 195, Issue 44, Page(s) E1512–E1516

MeSH term(s)	Humans ; Schools, Medical ; Canada ; Students ; Disabled Persons ; Students, Medical
Language	English
Publishing date	2023-11-14
Publishing country	Canada
Document type	Journal Article
ZDB-ID	215506-0
ISSN	1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online)	1488-2329
ISSN	0008-4409 ; 0820-3946
DOI	10.1503/cmaj.230734
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Article ; Online: Operationalization of assent for research participation in pre-adolescent children: a scoping review.

Cayouette, Florence / O'Hearn, Katie / Gertsman, Shira / Menon, Kusum

BMC medical ethics

2022 Volume 23, Issue 1, Page(s) 106

Abstract: Background: Seeking assent from children for participation in medical research is an ethical imperative of numerous institutions globally. However, none of these organizations provide specific guidance on the criteria or process to be used when ... ...

Abstract	Background: Seeking assent from children for participation in medical research is an ethical imperative of numerous institutions globally. However, none of these organizations provide specific guidance on the criteria or process to be used when obtaining assent. The primary objective of this scoping review was to determine the descriptions of assent discussed in the literature and the reported criteria used for seeking assent for research participation in pre-adolescent children. Methods: Medline and Embase databases were searched until November 2020 using the term "assent" in the title or abstract. Inclusion criteria were (1) studies enrolling children which specifically described operationalization of the assent process and (2) studies of the assent process which provided a description of assent. Data collected included participant information, patient criteria for seeking assent, guidelines referenced, description of assent reported, how assent was obtained and assent information presented, and reported assent rate. For qualitative articles focusing on the assent process, important themes were identified. Results: A total of 116 articles were included of which 79 (68.9%) operationalized assent and 57 studies (%) described the assent process. The most commonly reported criterion used to determine the ability of a child to assent was age (35.4%, 28/79). The reported minimal age for obtaining pediatric assent varied considerably across and within jurisdictions (5-13 years; median 7.5 years, IQR 7.0, 9.75). Cognitive ability was reported as a criterion for obtaining assent in 5.1% (4/79) of studies. Assent rates were only reported in 17.7% (14/79) of citations and ranged from 32.0 to 100%. Analysis of the 57 studies describing the assent process identified several themes, including age thresholds, assessment of capacity, variable knowledge of pediatric assent and parental roles. Conclusion: We found significant variation in criteria used for assessment of patient capacity, delivery of information used to obtain assent and documentation of the assent process. While we acknowledge that individual children, settings and jurisdictions may require different approaches to obtaining assent, there should be agreement on important principles to be followed with resulting common guidance on assessing capacity, delivering information and documentation of the assent process for publication.
MeSH term(s)	Child ; Adolescent ; Humans ; Child, Preschool ; Informed Consent ; Research Design ; Biomedical Research ; Parents
Language	English
Publishing date	2022-11-03
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2041552-7
ISSN	1472-6939 ; 1472-6939
ISSN (online)	1472-6939
ISSN	1472-6939
DOI	10.1186/s12910-022-00844-2
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Article ; Online: Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study.

Gertsman, Shira / Ene, Ioana Cezara / Palmert, Sasha / Liu, Amy / Makkar, Mallika / Shao, Ian / Shapiro, Johanna / Williams, Connie

CMAJ open

2023 Volume 11, Issue 5, Page(s) E859–E868

Abstract: Background: Although clinical empathy - the ability of a physician to understand a patient's illness experience, communicate this understanding and act collaboratively to create a treatment plan - provides substantial benefits to both physicians and ... ...

Abstract	Background: Although clinical empathy - the ability of a physician to understand a patient's illness experience, communicate this understanding and act collaboratively to create a treatment plan - provides substantial benefits to both physicians and patients, medical students typically experience a decline in empathy during training. The primary objective of this study was to generate a model of clinical empathy grounded in the perspectives of people with chronic illness living in Canada, to promote empathy-focused curricular development in Canadian medical education. Methods: We conducted a qualitative focus group study using a constructivist grounded theory approach. We recruited adults (age ≥ 18 yr) with chronic illness who had recently seen a physician in Canada from virtual support groups. Six semistructured virtual focus groups with 3-5 participants each were scheduled between June and September 2021. We coded the transcripts using the constant comparative method, allowing for the construction of an overarching theory. Results: Twenty patients (17 women and 3 men) participated in the focus groups; 1 group had 2 participants because 1 participant failed to appear. The majority of participants (14 [70%]) had at least a college degree. The mean rating for overall satisfaction with the Canadian health care system was 5.4/10.0 (median 5.0). The emergent theory showed that the perceived presence of physician empathy engendered positive internal processing by patients, leading to increased health care efficacy and enhanced mental health outcomes. Negative patient processing in response to the perceived absence of empathy led to reduced quality of health care delivery (e.g., ineffective referrals and more appointments), increased use of health care resources, disruptions in patients' personal lives, and negative physical and mental health outcomes. Interpretation: Clinical empathy can have life-altering impacts on patients, and its absence may increase resource use. As empathy involves understanding patients' lived experiences, any valid intervention to improve clinical empathy must be informed by patient perspectives.
Language	English
Publishing date	2023-09-26
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2701622-5
ISSN	2291-0026 ; 2291-0026
ISSN (online)	2291-0026
ISSN	2291-0026
DOI	10.9778/cmajo.20220211
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Article: Parental Understanding of Research Consent Forms in the PICU: A Pilot Study.

Gertsman, Shira / O'Hearn, Katharine / Gibson, Jess / Menon, Kusum

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2020 Volume 21, Issue 6, Page(s) 526–534

Abstract: Objectives: To describe legal guardians' understanding of key concepts in a research consent form presented within 24 hours of their child's admission to the PICU and to explore legal guardians' opinions of the format (language, length) of the consent ... ...

Abstract	Objectives: To describe legal guardians' understanding of key concepts in a research consent form presented within 24 hours of their child's admission to the PICU and to explore legal guardians' opinions of the format (language, length) of the consent form and the overall consent process. Design: Single-center, exploratory pilot study. Setting: PICU at a tertiary-care hospital in Canada. Subjects: Forty-one English- and French-speaking legal guardians of children less than 18 years old, who had been admitted to the PICU within the past 24 hours and were expected to stay at least 48 hours, between October 2018 and February 2019. Interventions: The consent form from a previous PICU trial was given and explained to legal guardians within 24 hours of their child's admission to the PICU. Measurements and main results: Legal guardians' understanding of key concepts in the consent form was evaluated using a questionnaire the day after the form was explained, and opinions were collected verbally and using an additional survey. The median number of questions answered incorrectly was three of seven (interquartile range = 2-4). Participants best understood the topic of the study (5% incorrect), but 80% of participants were unable to recall a single risk. The median rating of the language in the form was five of five (very easy to understand; interquartile range = 4-5), and 88% of participants said it was a reasonable length. Conclusions: Despite positive opinions of the consent form, most legal guardians did not understand all key components of the consent information provided to them orally and in writing within 24 hours of their child's PICU admission. Future studies are required to determine barriers to understanding and explore alternative approaches to obtaining consent in this setting.
MeSH term(s)	Adolescent ; Canada ; Child ; Consent Forms ; Humans ; Informed Consent ; Intensive Care Units, Pediatric ; Parents ; Pilot Projects ; Research
Language	English
Publishing date	2020-04-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000002234
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Article ; Online: Deficiency of the sedoheptulose kinase (Shpk) does not alter the ability of hematopoietic stem cells to rescue cystinosis in the mouse model.

Goodman, Spencer / Khan, Meisha / Sharma, Jay / Li, Zijie / Cano, Jose / Castellanos, Carlos / Estrada, Monica V / Gertsman, Ilya / Cherqui, Stephanie

Molecular genetics and metabolism

2021 Volume 134, Issue 4, Page(s) 309–316

Abstract: Cystinosis is an autosomal recessive lysosomal storage disorder caused by mutations in the CTNS gene encoding the lysosomal cystine transporter, cystinosin, and leading to multi-organ degeneration including kidney failure. A clinical trial for cystinosis ...

Abstract	Cystinosis is an autosomal recessive lysosomal storage disorder caused by mutations in the CTNS gene encoding the lysosomal cystine transporter, cystinosin, and leading to multi-organ degeneration including kidney failure. A clinical trial for cystinosis is ongoing to test the safety and efficacy of transplantation of autologous hematopoietic stem and progenitor cells (HSPCs) ex vivo gene-modified to introduce functional CTNS cDNA. Preclinical studies in Ctns
MeSH term(s)	Amino Acid Transport Systems, Neutral/genetics ; Animals ; Cell Differentiation ; Cystinosis/metabolism ; Cystinosis/therapy ; Disease Models, Animal ; Genetic Therapy ; Hematopoietic Stem Cell Transplantation/methods ; Hematopoietic Stem Cells/cytology ; Metabolomics ; Mice ; Mice, Inbred C57BL ; Pentose Phosphate Pathway ; Phosphotransferases (Alcohol Group Acceptor)/deficiency ; Phosphotransferases (Alcohol Group Acceptor)/genetics
Chemical Substances	Amino Acid Transport Systems, Neutral ; cystinosin protein, mouse ; Phosphotransferases (Alcohol Group Acceptor) (EC 2.7.1.-) ; Shpk protein, mouse (EC 2.7.1.14)
Language	English
Publishing date	2021-11-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1418518-0
ISSN	1096-7206 ; 1096-7192
ISSN (online)	1096-7206
ISSN	1096-7192
DOI	10.1016/j.ymgme.2021.11.006
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Article: Changes in Expression of DNA-Methyltransferase and Cannabinoid Receptor mRNAs in Blood Lymphocytes After Acute Cannabis Smoking.

Smith, Robert C / Sershen, Henry / Janowsky, David S / Lajtha, Abel / Grieco, Matthew / Gangoiti, Jon A / Gertsman, Ilya / Johnson, Wynnona S / Marcotte, Thomas D / Davis, John M

Frontiers in psychiatry

2022 Volume 13, Page(s) 887700

Abstract: Background: Cannabis use is a component risk factor for the manifestation of schizophrenia. The biological effects of cannabis include effects on epigenetic systems, immunological parameters, in addition to changes in cannabinoid receptors 1 and 2, that ...

Abstract	Background: Cannabis use is a component risk factor for the manifestation of schizophrenia. The biological effects of cannabis include effects on epigenetic systems, immunological parameters, in addition to changes in cannabinoid receptors 1 and 2, that may be associated with this risk. However, there has been limited study of the effects of smoked cannabis on these biological effects in human peripheral blood cells. We analyzed the effects of two concentrations of tetrahydrocannabinol (THC) vs. placebo in lymphocytes of a subset of participants who enrolled in a double-blind study of the effects of cannabis on driving performance (outcome not the focus of this study). Methods: Twenty four participants who regularly use cannabis participated in an experiment in which they smoked cannabis cigarettes (5.9 or 13.4% THC) or placebo (0.02%) Results: There were no differences in background baseline characteristics of the participants except that the higher concentration THC group was older than the low concentration and placebo groups, and the low concentration THC group had higher baseline CB2 mRNA levels. Both the 5.9 and 13.4% THC groups showed increased THC blood levels that then decreased toward baseline within the first hour. However, there were no significant differences between THC blood levels between the 5.9 and 13.4% groups at any time point. At the 4-h time point after drug administration the 13.4% THC group had higher CB2 ( Conclusion: Over the time course of this study, CB2 mRNA increased in blood lymphocytes in the high concentration THC group but were not accompanied by changes in immunological markers. The changes in DNMT and TET mRNAs suggest potential epigenetic effects of THC in human lymphocytes. Increases in DNMT methylating enzymes have been linked to some of the pathophysiological processes in schizophrenia and, therefore, should be further explored in a larger sample population, as one of the potential mechanisms linking cannabis use as a trigger for schizophrenia in vulnerable individuals. Since the two THC groups did not differ in post-smoking blood THC concentrations, the relationship between lymphocytic changes and the THC content of the cigarettes remains to be determined.
Language	English
Publishing date	2022-07-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2022.887700
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Article ; Online: Diagnosis and Monitoring of Cystinosis Using Immunomagnetically Purified Granulocytes.

Gertsman, Ilya / Johnson, Wynonna S / Nishikawa, Connor / Gangoiti, Jon A / Holmes, Bonnie / Barshop, Bruce A

Clinical chemistry

2016 Volume 62, Issue 5, Page(s) 766–772

Abstract: Background: Cystine determination is a critical biochemical test for the diagnosis and therapeutic monitoring of the lysosomal storage disease cystinosis. The classical mixed-leukocyte cystine assay requires prompt specialized recovery/isolation ... ...

Abstract	Background: Cystine determination is a critical biochemical test for the diagnosis and therapeutic monitoring of the lysosomal storage disease cystinosis. The classical mixed-leukocyte cystine assay requires prompt specialized recovery/isolation following blood drawing, providing cystine concentrations normalized to total protein from assorted types of white blood cells, each with varying cystine content. Methods: We present a new workflow for cystine determination using immunomagnetic granulocyte purification, and new reference ranges established from 47 patient and 27 obligate heterozygote samples assayed. Samples were collected in acid-citrate dextrose tubes and their stability was proven to allow for overnight shipping before analysis. Cystine was quantified by LC-MS/MS. Results: The new method was reproducible (<15% root mean square error) and specific, assaying purified granulocytes from blood samples that no longer required immediate preparation and therefore allowing for up to 30 h before processing. There was a nearly a 2-fold increase in the therapeutic target (1.9 nmol half-cystine/mg protein) range, established using distributions of patient, obligate heterozygote, and control samples. The 2.5-97.5 percentile ranges (-2 SD to +2 SD around mean) for these cohorts were 0.67-6.05 nmol/mg protein for patients, 0.33-1.35 nmol/mg protein for obligate heterozygotes, and 0.09-0.35 nmol/mg protein for controls. Conclusions: The intracellular cystine determination method using immunopurified granulocytes followed by LC-MS/MS analysis improves the inherent variability of mixed leukocyte analysis and eliminates the need for immediate sample preparation following blood draw.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; Chromatography, Liquid ; Cystine/blood ; Cystinosis/blood ; Cystinosis/diagnosis ; Female ; Granulocytes/pathology ; Humans ; Immunomagnetic Separation ; Male ; Middle Aged ; Tandem Mass Spectrometry ; Young Adult
Chemical Substances	Cystine (48TCX9A1VT)
Language	English
Publishing date	2016-03-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80102-1
ISSN	1530-8561 ; 0009-9147
ISSN (online)	1530-8561
ISSN	0009-9147
DOI	10.1373/clinchem.2015.252494
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Article ; Online: Efficacy and safety of disinfectants for decontamination of N95 and SN95 filtering facepiece respirators: a systematic review.

O'Hearn, K / Gertsman, S / Webster, R / Tsampalieros, A / Ng, R / Gibson, J / Sampson, M / Sikora, L / McNally, J D

The Journal of hospital infection

2020 Volume 106, Issue 3, Page(s) 504–521

Abstract: Background: Decontaminating and reusing filtering facepiece respirators (FFRs) for healthcare workers is a potential solution to address inadequate FFR supply during a global pandemic.: Aim: The objective of this review was to synthesize existing ... ...

Abstract	Background: Decontaminating and reusing filtering facepiece respirators (FFRs) for healthcare workers is a potential solution to address inadequate FFR supply during a global pandemic. Aim: The objective of this review was to synthesize existing data on the effectiveness and safety of using chemical disinfectants to decontaminate N95 FFRs. Methods: A systematic review was conducted on disinfectants to decontaminate N95 FFRs using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined study eligibility and extracted predefined data fields. Original research reporting on N95 FFR function, decontamination, safety, or FFR fit following decontamination with a disinfectant was included. Findings and conclusion: A single cycle of vaporized hydrogen peroxide (H
MeSH term(s)	Coronavirus Infections/prevention & control ; Decontamination/standards ; Disinfectants/administration & dosage ; Equipment Reuse/standards ; Guidelines as Topic ; Humans ; Hydrogen Peroxide/administration & dosage ; Respiratory Protective Devices/virology ; Sodium Hypochlorite/administration & dosage ; Ultraviolet Rays
Chemical Substances	Disinfectants ; Hydrogen Peroxide (BBX060AN9V) ; Sodium Hypochlorite (DY38VHM5OD)
Keywords	covid19
Language	English
Publishing date	2020-08-13
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2020.08.005
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Article ; Online: Decontamination interventions for the reuse of surgical mask personal protective equipment: a systematic review.

Zorko, D J / Gertsman, S / O'Hearn, K / Timmerman, N / Ambu-Ali, N / Dinh, T / Sampson, M / Sikora, L / McNally, J D / Choong, K

The Journal of hospital infection

2020 Volume 106, Issue 2, Page(s) 283–294

Abstract: Background: The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination interventions to allow for surgical mask reuse.! ...

Abstract	Background: The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination interventions to allow for surgical mask reuse. Aim: To identify and synthesize data from original research evaluating interventions to decontaminate surgical masks for the purpose of reuse. Methods: MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8 Findings: Seven studies met eligibility criteria: one evaluated the effects of heat and chemical interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were evaluated with heterogeneous test conditions. Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticle-coated masks. Conclusion: There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogeneous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention & control ; Decontamination/methods ; Decontamination/standards ; Equipment Reuse/standards ; Equipment Reuse/statistics & numerical data ; Guidelines as Topic ; Humans ; Masks/standards ; Masks/statistics & numerical data ; Pandemics/prevention & control ; Personal Protective Equipment/standards ; Personal Protective Equipment/statistics & numerical data ; Pneumonia, Viral/prevention & control ; Prospective Studies ; Respiratory Protective Devices/standards ; Respiratory Protective Devices/statistics & numerical data ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-10
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2020.07.007
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