Gabrielle Giroday

The study, which looked at thyroid tumour tissues and thyroid nodule biopsies from 620 patients at Mount Sinai Hospital from 2016 to 2022, examined whether differences in patients' RAS genomic variants were reflected in the status of their tumours. It also investigated the presence of the variant BRAF V600E and TERT promoter variants in the patient’s samples.

Researchers ultimately concluded that differences in RAS in combination with BRAF V600E and TERT promoter variants could be used to arrive at more accurate cancer diagnoses in patients with indeterminate thyroid nodules.

“The findings help promote understanding of the interpatient differences in genomic variation among patients who carry the same genetic mutation, thereby facilitating individualized treatment based on the extent of the mutation present in the patient,” says Guodong (David) Fu, a researcher at the Lunenfeld-Tanenbaum Research Institute and the Alex and Simona Shnaider Research Laboratory in Molecular Oncology at Mount Sinai Hospital.

Fu adds that researchers developed novel molecular assays for the study using digital polymerase chain reaction, a technique that means they could sensitively quantify the genetic mutation level of the patient materials.

The results were published recently in JAMA Network. Other researchers involved in the study included: Ronald Chazen, also of the Lunenfeld-Tanenbaum Research Institute and the Alex and Simona Shnaider Research Laboratory in Molecular Oncology, and Christina MacMillan, a pathologist at Sinai Health and an assistant professor in the Temerty Faculty of Medicine’s department of laboratory medicine and pathobiology, and Ian Witterick, surgeon-in-chief at Sinai Health and a professor in Temerty Medicine’s department of otolaryngology – head and neck surgery.

The paper notes that there has been a sharp increase in papillary thyroid cancer since the 1980s, and that in 30 per cent of cases where a fine-needle aspiration biopsy of a suspected nodule takes place, there is an indeterminate diagnosis that may lead to a diagnostic surgery.

Fu says research that assists with precision thyroid cancer detection is important for many reasons, including that some patients who seek treatment for thyroid tumours end up finding out their tumours are benign after diagnostic surgery. The findings could help medical practitioners differentiate low-risk tumours from high-risk ones, he says, and help avoid unneeded surgical procedures.

“(This finding) enhances the preoperative diagnostic accuracy for patients, in order to avoid unnecessary surgery for benign thyroid nodules,” says Fu.

Witterick, who is also otolaryngologist-in-chief at Mount Sinai Hospital, says the research is important because identifying differences in genomic variants between patients can enhance precision in cancer detection, especially diagnosing malignancies before surgery and distinguishing low-risk cancers from more aggressive ones.

Study by U of T, international researchers predicts worsening dengue spread in Mexico and Brazil

Christopher.Sorensen — Mon, 10 Jun 2024 15:11:55 +0000

Study by U of T, international researchers predicts worsening dengue spread in Mexico and Brazil

Christopher.Sorensen Mon, 06/10/2024 - 11:11

Cutline

Patients await treatment at an emergency medical care unit for dengue in Brasilia, Brazil (photo by Mateus Bonomi/Anadolu via Getty Images)

Gabrielle Giroday

Topic

Breaking Research

Department of Medicine

Temerty Faculty of Medicine

Global

Research & Innovation

Subheadline

Geospatial machine learning models projected “a more extensive and rapid expansion” of the viral infection than previously thought

Brazil and Mexico may be affected by a much greater spread of dengue in the years to come, according to a new study from the �ؿ�ζSM’s Temerty Faculty of Medicine.

The research, published in Nature Communications, used geospatial machine learning models to map out the future spread of dengue in the two countries until 2039 using data related to regional environmental factors as well as historical data on human population mobility.

The model predicted that the percentage of municipalities affected by dengue will rise from 76 to 97 per cent in Brazil and from 55 to 91 per cent in Mexico, which the study notes is “a more extensive and rapid expansion” than previously thought.

“COVID-19 has brought emerging infectious diseases to the forefront of public discussion. The pandemic is a reminder of the profound harm emerging infectious diseases have on health systems,” says the study’s first author Vinyas Harish, an MD/PhD student at Temerty, post-graduate affiliate at the Vector Institute for Artificial Intelligence and clinical clerk at Unity Health Toronto.

Dengue is a viral infection, spread to humans by mosquitoes, that affects 100 to 400 million people each year in tropical and subtropical climates.

While some people experience mild symptoms, for others, dengue can lead to much more serious outcomes like hospitalization or death. No specific treatment for dengue exists, says the World Health Organization, and there was a global spike in cases in 2023 which led to international concern about the surging numbers.

(L-R) Vinyas Harish, Kamran Khan and Isaac Bogoch (supplied images)

For the study, researchers – who included Professor Kamran Khan and Associate Professor Isaac Bogoch from Temerty’s department of medicine – developed and validated their models by looking at more than 8,000 municipalities in Brazil and Mexico over 25 years. They also integrated insights from historical outbreak records, climate change projections and evolutionary history of viral genetic sequences.

The researchers say they believe it’s the first time, to their knowledge, “that spatial models of disease spread have informed origins, pathways and future projections of an emerging infectious disease.”

The paper – led by Oliver Brady of the London School of Hygiene and Tropical Medicine – involved researchers from Canada, the United States, Australia, England, Brazil and Mexico.

Researchers say they hope the findings of the paper help with understanding other emerging infectious diseases, and the best ways of combatting spread of dengue in future.

U of T prof aims to inspire diversity in health care through mentorship and social media

Christopher.Sorensen — Tue, 20 Feb 2024 16:14:59 +0000

U of T prof aims to inspire diversity in health care through mentorship and social media

Christopher.Sorensen Tue, 02/20/2024 - 11:14

Cutline

(photo by Ashiqur Rahman Rean)

Gabrielle Giroday

Topic

Our Community

Temerty Faculty of Medicine

Dalla Lana School of Public Health

Outreach

Subheadline

"Not everyone has a family member or mentor in medicine. What I realized is that I can be an auntie to people who are interested in medicine or health careers"

Onye Nnorom says a significant hurdle to entering the health-care profession for students from underrepresented communities is often the absence of a family member or other mentor already in the field – someone who can provide encouragement and advice.

It’s a gap that she’s now aiming to bridge using the power of social media.

“What I realized is that I can be an auntie to people who are interested in medicine or health careers,” says Nnorom, an assistant professor in the Temerty Faculty of Medicine’s department of family and community medicine and at the Dalla Lana School of Public Health.

Starting today, Nnorom is launching a series of Instagram Live sessions that aims to encourage teen and young adults from underrepresented backgrounds to consider a career in medicine or other health professions. It’s part of an outreach effort called Healthcaring Differently, which will also include career information for first-year medical students.

Nnorom, who is also the co-lead of the Black Health Education Collaborative, recently spoke with writer Gabrielle Giroday about the inspiration behind the initiative and what she hopes it will ultimately achieve.

How will the initiative work?

Healthcaring Differently is social media outreach that encourages young people from diverse backgrounds to consider careers in medicine and health care.

It comprises two parts. One is Instagram Live sessions – every Tuesday at 7 p.m. EST, starting Feb. 20 – that feature health-care experts talking about their careers, including both physicians and other health leaders who are nurses or researchers. The spring series will go from February to April, and then there will be another series this fall. We’re at @healthcaringdifferently.

The second component will be a newsletter, where people who are interested can get more information about diversity pathways in medical schools and other health professional schools, scholarship information and jobs or research opportunities.

Who is your target audience, and why?

One thing I realized when I was in medical school was that a lot of people had a parent or family member to ask for guidance, or other mentors in their life. That person provides a lot of information around how to think like a physician, how to prepare for the MCAT or how to obtain research opportunities. That helps a person get into medical school and thrive once they’re there.

But not everyone has a family member or mentor in medicine. What I realized is that I can be an auntie to people who are interested in medicine or health careers.

I can be your auntie, I can come to the table – the Instagram table – and I can bring the biscuits and spill some tea, and bring my diverse friends with me.

There’s three key groups I am hoping to reach with this initiative. One is high school students – who might not even be thinking about medicine or health care as a career – to plant the seed of an idea. The second key group are young people in college, or in their undergraduate studies, who are thinking about medicine but don’t know about the resources available to them.

Lastly, I also want to reach first-year medical students because it can be such a jarring time for people. I spoke to first-year students and they told me when they were trying to get into medical school, they thought that was the top of the mountain. But, once they made it in, they realized there are three more mountains: CARMS (Canadian Resident Matching Service), your fellowship and your career beyond that. So, it can just feel very daunting.

I am hoping this initiative will help support first-year students and help them think about different specialties in medicine and different ways of approaching health care.

What inspired this initiative?

Healthcaring Differently is an initiative, or a movement, to encourage my colleagues – those who are diverse and under-represented in medicine – to mentor out loud. Personally, in my life right now, I am trying to live out loud and share more about my life so that people can see a Black female doctor who is in Canada being an advocate.

So many of my friends are so talented and doing amazing work in health care, and deserve more attention. I also want more young people to be aware of all the pathways that exist into medicine and careers in health care.

Why is the timing of this initiative important?

It's a critical time in health care right now. Since the COVID-19 pandemic, there has been massive burnout for health-care workers.

The pandemic also showed us that there are so many groups that are not being adequately served by our health-care system.

In my work, in my advocacy, I already knew this – I have been doing Black health advocacy work for a decade. But the COVID-19 pandemic really brought a greater public awareness that our health-care system needs to change if we want diverse communities to be well.

The other thing that I noticed is that for a lot of my friends and my colleagues, despite the challenges in health care, they’re still doing all this really cool and innovative work in the community, with Indigenous communities, Black communities and LGBTQ+ communities.

However, young people weren’t always seeing this, especially people who are part of under-represented or diverse groups. They weren’t seeing the magic. So I asked myself, “How can I help to bridge this?” And I decided it’s a great time to boost inspiration about the fantastic work my colleagues are doing.

There’s also another element. After the tragedy of the murder of George Floyd and the resulting activism, a lot of medical schools and professional health schools developed more diversity pathways – in particular pathways for Black and Indigenous students, as well as other diverse groups, across the country.

For example, Ike Okafor, founder and strategic lead of access and outreach at Temerty Medicine’s Office of Access and Outreach, has helped make tremendous strides with programs like Community of Support, which has been implemented at other Canadian medical schools.

But, a lot of people don’t know about these pathways, especially in other provinces. So, this initiative can highlight the fantastic work my friends are doing beyond Ontario and make their work more visible. To that end, I am also planning a newsletter to let people know about these opportunities.

What is your hope for this initiative?

For people who come from marginalized communities, you will hear us say this: You need to see it to know that you can be it.

And for me – there has been a lot of learning, too – I am working with 21-year-old student Mathushan Ambida, who is helping with social media.

My hope is that this through this initiative we can harness the power of social media to expose young people to all of the diverse and creative ways that I and my colleagues approach health care.

That way, people who have an interest can be connected to a pathway program to pursue medicine or nursing, or whatever heath field they are curious about.

Few opioid overdose patients prescribed drugs to manage disorder: Study

Christopher.Sorensen — Wed, 03 Jan 2024 20:01:20 +0000

Few opioid overdose patients prescribed drugs to manage disorder: Study

Christopher.Sorensen Wed, 01/03/2024 - 15:01

Cutline

(photo by Tetra Images/Getty Images)

Gabrielle Giroday

Topic

Breaking Research

Temerty Faculty of Medicine

Opioids

Research & Innovation

Subheadline

Researchers say low prescription rates in Ontario for drugs such as methadone or suboxone, which help people manage opioid use, are a missed opportunity for harm reduction

Only one in 18 people who go to the emergency department or end up in hospital after an opioid overdose in Ontario are prescribed drugs like methadone or suboxone to help manage their substance use disorder, �ؿ�ζSM researchers have found.

The study – published recently in the Canadian Medical Association Journal – looked at more than 47,000 emergency room visits or hospital admissions from January 2013 to March 2020.

The ICES data reflected the health care experiences of approximately 14,000 patients who sought hospital treatment for opioid toxicity – including those that received opioid agonist therapy (OAT), which is the clinical practice of prescribing drugs like methadone or suboxone to help people with an opioid use disorder minimize their cravings and lower their physical withdrawal symptoms.

Researchers concluded from their analysis that “despite slight increases over time, [opioid agonist therapy] initiation rates after an emergency department visit or hospital admission for opioid toxicity in Ontario were low, with only one in 18 events leading to filling an [opioid agonist therapy] prescription within a week of discharge.”

Researchers add that low prescription rate of drugs like methadone or suboxone to help people manage their opioid use disorder is a missed opportunity for harm reduction.

“We now know that only about four per cent of hospital encounters for opioid overdose led to OAT initiation. These low rates show that we need to improve care and access to treatment,” says Tina Hu, an assistant professor in the Temerty Faculty of Medicine’s department of family and community medicine who was involved in the study.

Researchers also found that although the initiation rate of OAT increased over time in the study population, reaching more than five per cent of all patients seen in hospital by 2020, the process of starting OAT remained low overall.

“Our research shows that there were substantial disparities in OAT initiation rates, with potential barriers to prescribing for older patients, those with mental health diagnoses and those in the lowest neighbourhood income quintile,” the study stated.

The missed opportunity to start OAT was especially striking given that the study noted that in about 22 per cent of cases, people who were part of the study population had an outpatient visit within seven days of their hospital visit.

“These results highlight critical missed opportunities to prevent future mortality and morbidity related to opioid use, despite connection to health care for many patients in the days after a toxicity event,” the study said.

The study also noted that a 2018 call by the Canadian Research Initiative in Substance Misuse to use “buprenorphine/naloxone as the preferred first-line treatment for [opioid use disorder] when possible” did not appear to lead to an increase in initiation rates.

“The release of a national guideline advocating for buprenorphine–naloxone as first-line therapy did not appear to substantially influence OAT initiation rates, suggesting that additional efforts are needed to improve initiation of OAT in acute care settings,” said the researchers.

The research was supported by the Canadian Institutes for Health Research.

Mindfulness training can help doctors improve well-being and communication, study finds

Christopher.Sorensen — Fri, 24 Nov 2023 16:55:22 +0000

Mindfulness training can help doctors improve well-being and communication, study finds

Christopher.Sorensen Fri, 11/24/2023 - 11:55

Cutline

(photo by sturti/Getty Images)

Gabrielle Giroday

Topic

Breaking Research

Temerty Faculty of Medicine

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Faculty of Arts & Science

New College

Psychiatry

Research & Innovation

Subheadline

The research involved doctors who came from a range of specialities, including surgery, psychiatry, emergency medicine and family medicine

A new study involving researchers from the �ؿ�ζSM has found mindfulness training for doctors improved their communication with patients and colleagues, and led to positive cognitive and behavioural changes.

The study, by Elli Weisbaum, an assistant professor in the Temerty Faculty of Medicine’s department of psychiatry, was recently published in the Canadian Medical Association Journal. The research looked at the experiences of 28 doctors who received five weeks of mindfulness training.

“This study’s findings are encouraging for all health-care professionals interested in developing healthy and compassionate workplaces. My hope is that these findings contribute to both individual and systems-level change,” said Weisbaum, who is cross-appointed to the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation and is acting program director for New College’s Buddhism, psychology and mental health program in the Faculty of Arts & Science.

Trevor Young, U of T’s vice-president and provost, as well as a professor in Temerty Medicine’s departments of psychiatry, and pharmacology and toxicology, and Nicholas Chadi, a clinical assistant professor at the Université de Montréal, co-authored the study.

The research involved doctors who came from a range of specialities, including surgery, psychiatry, emergency medicine and family medicine.

Over a span of five weeks in 2019, participants attended weekly in-person applied mindfulness training sessions, based on the teachings of scholar and Zen Buddhist monk Thích Nhất Hạnh.

Researchers then conducted interviews to understand how the training impacted doctors’ work and daily lives.

“Participants report that integrating brief mindfulness practices at the beginning and end of their workday can lead to more effective regulation of workplace stressors, which can lead to feeling more energized at the end of the day,” the study authors wrote.

“Participants also report that a brief mindful reset at the end of the day can reduce the transfer of occupational stressors, such as frustration, to their home environment.”

As well, participants told researchers that mindfulness training helped them to have better skills when it came to balancing their work and home lives.

They said the training assisted them with giving themselves permission not to rush in their work, while still being efficient and effective.

Participants also reported better communication with their patients and their colleagues as a result of mindfulness training. This included enhanced self-awareness and decreased reactivity when confronted with challenging situations, they told researchers.

The study also found mindfulness training increased focus for physicians during patient interactions, and resulted in a higher awareness by physicians of their own biases around patients.

Ultimately, participants said the skillsets developed through mindfulness training led to more patient-centred diagnoses and treatment plans.

“[Due to mindfulness training,] participants describe having a greater awareness of what they contribute to challenging interactions with patients and colleagues. Through this understanding, they can implement more compassionate communication styles, which helps them set and maintain clearer boundaries for themselves during frustrating or irritating interactions,” the researchers wrote.

Weisbaum says the study’s findings point to the value of mindfulness training for physicians, and that the study is a “call to action” for clinicians and policymakers.

She says there is more research underway to examine how applied mindfulness can help address and mitigate physician burn-out.

“This research shows that mindfulness training benefits physicians at an individual level, through more effective management of occupational stressors,” Weisbaum says. “It also shows potential benefits to [the] broader health-care delivery system.”

Female patients operated on by male surgeons more likely to die, suffer complications: U of T study

Christopher.Sorensen — Tue, 11 Jan 2022 16:54:56 +0000

Female patients operated on by male surgeons more likely to die, suffer complications: U of T study

Christopher.Sorensen Tue, 01/11/2022 - 11:54

Cutline

(Photo by Manfred Weis/Westend61 via Getty Images)

Gabrielle Giroday

Topic

Breaking Research

Sunnybrook Health Sciences

Temerty Faculty of Medicine

Institute of Health Policy Management and Evaluation

Mount Sinai Hospital

Research & Innovation

University Health Network

Female patients were more likely to die or experience complications after being operated on by a male – as opposed to a female – surgeon, according to a new study by researchers in the �ؿ�ζSM’s Temerty Faculty of Medicine.

The paper, recently published in JAMA Surgery, looked at 1.3 million adult patients in Ontario over a period of 12 years. It suggests women were 15 per cent more likely to experience a bad outcome if their surgeon was a man.

There was also a 32 per cent greater chance that a female patient would die in the 30 days after a procedure.

The researchers say their findings underscore the need to understand the reasons for the apparent disparity.

“To deny the results of this study is both non-scientific and a marker of our own implicit bias,” says Angela Jerath, an associate professor at Temerty Medicine’s department of anesthesiology and pain medicine, who worked on the study with Christopher Wallis, an assistant professor at Temerty Medicine’s division of urology.

Angela Jerath and Christopher Wallis

The study also indicated female patients treated by a male surgeon had a 16 per cent increase in major complications following their surgery and an 11 per cent increase in the likelihood of re-admission, compared with having the same procedure done by a female surgeon.

“We believe that the issues that are causing this gap are extremely complicated, and likely to enter behavioural science. We need to understand these issues and fill the gap in care for female patients,” says Jerath, who is also an associate professor with the Dalla Lana School of Public Health’s Institute for Health Policy, Management and Evaluation and a staff cardiac anesthesiologist at Sunnybrook Health Sciences Centre.

The study focused on 21 types of surgery, including procedures in cardiothoracic surgery, neurosurgery and orthopedic surgery.

The data also factored in procedures in otolaryngology, plastic surgery, thoracic surgery, urology and vascular surgery, as well as general surgery.

“Overall, male patients have comparable results when treated by either male or female surgeons while female patients have worse outcomes when treated by male surgeons than female surgeons,” says Wallis, who is also a urologic oncologist at the division of urology at Mount Sinai Hospital and University Health Network.

“As a male surgeon, these findings really highlight a learning opportunity for me personally and for our profession,” he adds. “An operating surgeon’s sex shouldn’t affect a female patient’s outcomes. We need to do more work to understand why these discrepancies are happening.”

“There are social and cultural factors that may get in the way of providing the best care for female patients, and we need to investigate that further.”

Of the study of sample of more than 2,900 surgeons, 82 per cent were male while 18 per cent were female.

Further work needs to be done examining ways male and female surgeons communicate with patients, the researchers say.

There is also the need to study the ways patients and surgeons of both sexes establish trust, they added.

“Beyond performing the actual surgical procedure, there are complex processes in the care pathway before and after surgery that male and female surgeons may do differently surrounding clinical decision making, exercising personal judgement and team management,” Jerath says.

“It’s also possible that male and female patients communicate differently with surgeons of different sexes. Understanding these differences is important in improving outcomes after surgery for all patients.”

Jerath, who is also a scientist at Sunnybrook Research Institute and adjunct scientist at ICES, says she was “astonished” by the findings.

She says further research will hopefully examine if there are some practices among female surgeons that are leading to better outcomes, especially for female patients.

“We know this is a really uncomfortable piece of work. I work with a lot of terrific male surgeons. The results we found are at a population level and do not reflect any one surgeon’s practice,” she says.

“Our advice to all patients – female or male – is that they should be able to speak and have a good, trusting relationship with their physician.”

The findings also indicate the importance of increasing the number of female surgeons, Wallis says.

“This research really supports the goal of diversifying the surgical workforce to better match the characteristics of the patients we’re treating,” he says.

Researcher explores use of cannabinoids to treat obesity

Christopher.Sorensen — Tue, 04 Jan 2022 14:29:24 +0000

Researcher explores use of cannabinoids to treat obesity

Christopher.Sorensen Tue, 01/04/2022 - 09:29

Cutline

(Photo by Chris Roussakis/Bloomberg/Getty Images)

Gabrielle Giroday

Topic

Our Community

Institutional Strategic Initiatives

Temerty Faculty of Medicine

Cannabis

Alumni

Research & Innovation

Though cannabis is often associated with “the munchies” in popular culture, �ؿ�ζSM researcher Justin Matheson is asking whether cannabinoids – naturally occurring compounds in the plant – can actually be used to treat obesity.

Justin Matheson

“On the surface, the research seems a bit paradoxical,” says Matheson, who earned a PhD from the Temerty Faculty of Medicine’s department of pharmacology and toxicology in 2020 and is now completing a post-doctoral research fellowship in the Translational Addiction Research Laboratory at the Centre for Addiction and Mental Health.

“But what my supervisor [Professor Bernard Le Foll, chair of addiction psychiatry in the Temerty Faculty of Medicine] and others have found is that people who use cannabis regularly actually have lower BMI, lower risk of obesity and a lower of risk of diabetes then people who don’t use cannabis.”

Matheson is one of the inaugural cohort of the Toronto Cannabis and Cannabinoid Research Consortium (TC3) fellows.

He recently spoke to writer Gabrielle Giroday about his work and the fast-growing field of cannabis- and cannabinoid-related health research.

What interested you in this area of research?

My work is largely focused on substance use and addictions. For my doctorate, I focused on sex and gender and how they impact cannabis use. For example, I published a paper in 2019 looking at how smoking cannabis affected young adults of different sexes.

Before this project, I was already very interested in investigating addiction to cannabis and looking at how cannabinoids can be used to treat substance use disorders.

As for this current research, there are interesting parallels between obesity and overeating, and addiction or substance use disorders. Both involve harmful behavioural patterns that lead to excessive intake of food or psychoactive drugs. It’s a new area that deserves further exploration.

Can you explain your approach?

This research will include a randomized controlled trial that will look at if nabilone – a synthetic cannabinoid drug – can reduce body weight in adults with obesity.

We are recruiting a sample of 60 people who have obesity and randomizing them to receive either a high dose of the drug nabilone, a low dose, or a placebo. Participants will be 25 to 45 years old.

Nabilone will be taken as an oral capsule. It’s very similar to THC, which is the active component of cannabis, but it’s a little structurally different. The study participants will be taking nabilone daily over the course of 12 weeks.

During that period, we’ll be monitoring the patients’ body weight as well as other measures to see if there are any adverse effects of the nabilone.

In the research, we’re not just trying to see if the cannabinoid drug can reduce body weight in adults who are obese, but we’re also trying to understand why. We’ll do this by using neuroimaging, measuring changes in the gut microbiome, and measuring cannabinoids in the blood and different hormones.

We’re also taking measures of participants’ brain activity at the baseline, before they enter treatment and at the end of the 12 weeks. Specifically, we’re interested in seeing how the neural response to food images changes over the course of treatment.

We’ve started recruiting participants to take part of the research, and we’re hoping to finish the trial in two years.

What do you hope to achieve through this work?

Nabilone is similar to THC. And we know cannabis actually is pro-appetite – in that it increases appetite. In the past, cannabis has been associated with “the munchies” and been used by people with wasting syndromes or who are having problems with appetite. So, on the surface, the research seems a bit paradoxical.

But what my supervisor Le Foll and others have found is that people who use cannabis regularly actually have lower BMI, lower risk of obesity and a lower of risk of diabetes then people who don’t use cannabis.

This research will be a first-in-human trial to see if administering nabilone will lead to a lower body weight in adults who are obese, which would replicate animal findings and which would be line with what we’re seeing in epidemiological data. We don’t know what we’ll find yet.

How will you measure the effects of nabilone on each participant?

The endocannabinoid system – which is the body’s innate system that underlies the effects of cannabinoids – is a system that is very much involved in all sorts of brain processes such as our perceptions of pleasure and reward. So, we think it’s possible our research might find that nabilone reduces participants’ responses to food images, which is why we’re doing neuroimaging of participants’ brains.

Plus, there is also an interesting relationship between cannabinoids and gut bacteria, so we want to measure the gut microbiome to see whether that changes with treatment.

Research has found that people with obesity tend to have higher levels of endocannabinoids, which are the body’s own cannabinoid compounds. We believe that taking nabilone, or any cannabinoid drug, over a period of time might disrupt endocannabinoid levels, which could be one way that nabilone leads to a reduction in body weight.

How would you describe the field of cannabis or cannabinoid research these days?

I think cannabis and cannabinoid research has changed, especially after legalization. It’s definitely a really growing field and I feel lucky I entered the field when I did in 2015 – three years before legalization happened.

I still think there’s still a lot of stigma around cannabis use. This affects the participants I work with, who often use cannabis or have a cannabis use disorder. Hopefully, with legalization, this will change.

I think it’s a really exciting time to be doing cannabis research, especially because there are a lot of misconceptions. It seems to be a very polarizing topic. You have cannabis advocates who present it as a “cure-all drug,” and then you have prohibitionists, who argue it’s bad and harming people and should be illegal.

To me, it’s somewhere in the middle. There are a lot of misconceptions in the research community and in the general public, which is why the field is so fascinating and why it’s where I want to take the rest of my career.

Temerty Faculty of Medicine students reach out to Canadian high schools with virtual career fair

Christopher.Sorensen — Thu, 02 Dec 2021 17:56:14 +0000

Temerty Faculty of Medicine students reach out to Canadian high schools with virtual career fair

Christopher.Sorensen Thu, 12/02/2021 - 12:56

Cutline

Temerty Faculty of Medicine students Ikran Ali, left, and Zaky Hassan, right, belong to a group called Say Somaali that recently hosted a virtual high school career fair in a bid to better educate young people about possible career paths (photos supplied)

Gabrielle Giroday

Topic

City & Culture

Temerty Faculty of Medicine

Academics

Cities

Graduate Students

As high school students, Ikran Ali and Zaky Hassan weren’t even aware they could pursue careers in laboratory medicine and health research.

Today, Ali is a fifth-year PhD student in the Temerty Faculty of Medicine’s Institute of Medical Science at the �ؿ�ζSM, where she conducts orthopaedic research on bone healing and infection. Hassan, meanwhile, is a second-year master’s student in the faculty’s department of biochemistry who investigates the structural biology of coronavirus spike proteins.

Both belong to a group called Say Somaali that recently hosted a virtual high school career fair in a bid to better educate young people about possible career paths.

Ali and Hassan recently talked to Gabrielle Giroday about the work they do with Say Somaali.

How did the idea for a virtual career fair begin?

Hassan: In 2019, U of T's Somali Students’ Association had an event called Demystifying Graduate School, and we had an amazing turn-out of almost 100 people. We realized there was a big gap that needed to be filled in the Somali community with respect to connecting mentors and mentees. It led us to consider more programming around mentorship.

Our goal for the virtual career fair was to feature Somali professionals from different fields, like STEM (Science, Technology, Engineering and Mathematics), health care, business and the social sciences, so they can share their experience and insight with high school students.

One of our speakers was Sahra Gedleh, a family physician in Mississauga and lecturer in Temerty Medicine’s Department of Family and Community Medicine. The event was open to registration for high school students across Canada.

How did the planning of the event come together?

Ali: Say Somaali does different programming – like a mentorship program, a fellowship program and summer internships for high school students.

This past summer, we decided we wanted to host a large virtual career fair where high school students could opt into sessions of their choice. We worked with four high school students interning at Say Somaali to identify what kind of experts they wanted to hear from.

We already have more than 100 Somali professionals who are part of what we call our success network, and who have been an amazing help to us so far. They were the first people we looked at as speakers.

Why did you decide to take part in this initiative?

Ali: In terms of medicine and health research, a lot of high school and university students who are interested may not know where to start, or know what they need to be doing to be competitive for applying to university programs.

It’s really important that students are exposed to fellow students, researchers or doctors who have the same upbringing. Being able to connect with someone who can tell them the ins-and-outs of the role is also crucial. I know students who are struggling and trying to figure out, “What should I do when I’m finishing up high school or undergrad? Or, what programs should I do?”

Hassan: The primary draw of having people who are part of our success network is identifying mentors who had the same upbringing and had to overcome similar barriers, and can speak from a place of familiarity.

How do your personal experiences inform your involvement?

Hassan: One of the things that I’ve noticed is that a lot of students in high school, if they have an interest in science career, they think of medicine immediately. I feel like there isn’t really an exposure to other science careers.

When I was in high school, I had no idea I could do what I’m doing now – that I could go to graduate school and be a scientist or principal investigator. Part of the role of the virtual career fair was to show the range of careers in STEM and that it goes beyond medicine. And it’s to show people there are a plethora of resources and hopefully a group of people who can help you get there.

Ali: Zaky and I are both first-generation Somali-Canadians and we don’t know of a lot of people who have done these career paths before us here in Canada. The goal is that once we’re in those positions, we can provide guidance to others 20 to 30 years from now.

In my case, I discovered a lot of information by accident. All I knew was that I wanted to do research, but I didn’t really know the pathway and so it was trial-and-error and trying to figure out how to get into it. I wanted to be in a lab, and I read faculty profiles to explore the people I wanted to work with.

I guess part of why I do this is trying to make that realization easier for others, so they don’t have to experience the same hurdles. If you know what you’re doing, then it’s easier to know where you’re going.

What advice do you have for younger students?

Hassan: One of the barriers at the undergraduate level is getting into a lab as a research student. As soon as you get that first experience, I feel like it’s much smoother to access every other research opportunity going forward.

It took me a lot of effort and energy to get my first research position. I would say going through that experience, I learned what I was supposed to have done. So now I can give others advice on how to get their foot in the door more easily and pursue their passions.

In general, and especially for someone who has no access to peer or faculty mentors, I would say that mass cold-emailing is not as effective as one might think. A much better alternative is to start your search by narrowing down your field of interest and making your contact with the professors you approach very brief and very specific.

Researchers are way more likely to give their energy to someone who is genuinely interested in their work. I also recommend people look at formal programs like the Research Applicant Support Initiative (RASI), and other resources, if they are available.

Ali: I think it’s all about putting yourself out there and letting people know what your interests are, so that whoever is in a position to help you, can. Learning skills and finding people who can tell you what to do and how to succeed is ideal.

I tell people to find others who share their interests, and to identify programs that can help –like this one.

There is a need for reconciliation in Canadian health care: U of T researchers

Christopher.Sorensen — Mon, 30 Aug 2021 18:45:52 +0000

There is a need for reconciliation in Canadian health care: U of T researchers

Christopher.Sorensen Mon, 08/30/2021 - 14:45

Cutline

U of T's Lisa Richardson (left) and Andrew Boozary (right) published commentary in The Lancet that discussed the systemic racism Indigenous Peoples face in Canada's health-care system.

Gabrielle Giroday

Topic

Our Community

Temerty Faculty of Medicine

Dalla Lana School of Public Health

Indigenous

Two �ؿ�ζSM researchers are highlighting the systemic racism faced by Indigenous Peoples in Canadian health care – and urging action be taken to address the problem.

Lisa Richardson, associate dean of inclusion and diversity at the Temerty Faculty of Medicine, and Andrew Boozary, an assistant professor at the Dalla Lana School of Public Health, recently published commentary in The Lancet that discusses the catastrophic effects of the residential school system in Canada.

“Although the last school closed in 1996, intergenerational and historical trauma from these residential schools continues to undermine the wellbeing of the children, families, and communities of the survivors,” Richardson and Boozary write.

The commentary cites findings by the Truth and Reconciliation Commission of Canada: In 1908, the annual all-cause mortality rate for Indigenous children in the residential school system was 8,000 deaths per 100,000 people, compared with 430 deaths per 100,000 people for non-Indigenous children.

The researchers say that survivors and their families continue to live with chronic illness, substance use disorders and mental illness as a result of the residential school system, as well as incarceration and involvement in the child welfare system.

“Institutional settings such as hospitals can be culturally unsafe if care providers are not aware of the abuse and mistreatment experienced by many survivors of residential schools,” the authors say.

“Lack of control, restriction of movement or diet, physical examinations, tests and other common elements of hospital care could trigger memories of residential schools and lead to negative care experiences.”

In the commentary, the researchers say there is a need for the collection of race-based data so that clinical and care experiences of Indigenous Peoples can be evaluated effectively. They also say that accreditations and quality reviews of hospitals and institutions must measure Indigenous health equity and reconciliation.

“A renewed commitment and concrete steps are needed by non-Indigenous leaders and allies to support this decolonising work so that it does not fall solely upon First Nations, Inuit, and Métis peoples,” Richardson and Boozary write.

“Transformative change also requires institutions to build meaningful partnerships with local Indigenous organisations and to recruit First Nations, Inuit, and Métis peoples for roles across healthcare organisations, from the boardroom to the patient bedside. Training in Indigenous cultural safety and antiracist practice should be mandatory for all health-care personnel. Indigenous staff, patients, and families must have access to traditional healers, spaces for ceremonial practices, and safe ways to report mistreatment.”

Researchers use AI to predict risk of developing type 2 diabetes

Christopher.Sorensen — Thu, 22 Jul 2021 13:23:07 +0000

Researchers use AI to predict risk of developing type 2 diabetes

Christopher.Sorensen Thu, 07/22/2021 - 09:23

Cutline

U of T researchers Laura Rosella and Vinyas Harish found that a machine learning model was about 80 per cent accurate in determining who will develop type 2 diabetes (photos courtesy of Rosella and Harish)

Gabrielle Giroday

Topic

Our Community

Insulin 100

Temerty Faculty of Medicine

Artificial Intelligence

Dalla Lana School of Public Health

Diabetes

Research & Innovation

Artificial intelligence could be used to predict who is at risk of developing type 2 diabetes – information that could be used to improve the lives of millions of Canadians.

Researchers at the �ؿ�ζSM used a machine learning model to analyze health data, collected between 2006 to 2016, of 2.1 million people living in Ontario. They found that they were able to use the model to accurately predict the number of people who would develop type 2 diabetes within a five-year time period. The machine learning model was also able to analyze different factors that would influence whether people were high or low risk to develop the disease.

The results of the study were recently published in the journal JAMA Network Open.

“We know that identifying people who are at risk of developing type 2 diabetes is really important because there are things we can do to prevent the onset of the disease,” says senior author Laura Rosella, an associate professor in the �ؿ�ζSM’s Temerty Faculty of Medicine and the Dalla Lana School of Public Health.

“This machine learning model can help with managing one of the biggest chronic disease challenges in North American society. There is a demonstrated advantage to intervening early when people are at risk of type 2 diabetes.”

Rosella, who is the education lead for the Temerty Centre for AI Research and Education in Medicine (T-CAIREM), says the study’s findings could help inform larger health system strategies to decrease the number of people who develop type 2 diabetes.

“The model is about 80 per cent accurate when it comes to predicting who will develop type 2 diabetes,” she says. “By using this information in a proactive way, we can plan health systems better and help prevent what can be a serious, burdensome condition.”

The use of a machine learning model is important, says Rosella, because it shows how routinely collected data can be used to address complex health problems in a more effective way.

Preventing type 2 diabetes means looking at larger structural factors like food insecurity and access to primary care physicians, Rosella adds.

“We know diabetes can be prevented or delayed. We know there are effective ways we can prevent the onset of a chronic disease. This study offers a way to start thinking about how to identify who is at risk of type 2 diabetes, and then start implementing strategies to stop the onset of a debilitating, lifelong condition.”

Vinyas Harish, an MD-PhD candidate at the Temerty Faculty of Medicine and learner co-lead at T-CAIREM, says the research illuminates how scrutinizing social determinants of health have an important impact on stopping the spread of type 2 diabetes.

“It helps us think about what we can do to get a health system to intervene on larger, more structural factors,” he says.

Rosella says medical research that incorporates artificial intelligence requires a team approach.

“You need a multi-disciplinary group of people that include a group of really good computer scientists, people that understand data and how to use it, and people with a health-system perspective and a clinical perspective,” she says.

“This is needed to make sure that you’re coming up with algorithms that are actually going to be used and have an impact.”

The research was supported by the Canada Research Chairs program and the Canadian Institutes of Health Research, among others.