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Library Research Skills for Pre-Health Students : Partnering with the Pre-Health Advising Office
Get PDFIntroduction
This brief report describes a library initiative to deliver health professions-specific information literacy instruction to students in a college-wide Health Professions Advising Program at Hunter College, a four-year institution within the City University of New York (CUNY) system. The Pre-Health Advising Office “assists students on their path to becoming a doctor, dentist, optometrist, podiatrist, veterinarian, and select allied health fields, such as physical therapy (PT), physician assistant (PA), pharmacy, and occupational therapy. Pre-Health students . . . receive advising, skills development, access to programs and resources, application planning and review, and guided support."1 Many of these students come to Hunter as transfers from two-year programs within the CUNY system or at other institutions; others may be freshmen, post-baccalaureate, or non-degree seeking students. In connection with a college-wide task force designed to increase retention and graduation rates among transfer students, the Hunter College Libraries formed a Transfer Committee to examine how the library can better support transfer students. In the Fall 2022 semester, after discussion with the director of pre-health advising, this committee reached out to librarians at the Hunter Health Professions Library (HPL) to conduct information literacy sessions for all students in the Health Professions Advising Program.
Methods
HPL librarians offer a “two-shot” series of workshops via Zoom every semester. Scheduling and other information for each 80-minute session is tracked in the library’s LibCal software and a Zoom link is provided by the director of the Pre-Health Advising Office. The first workshop covers basic library resources and services, developing a research question, and search strategies in databases. The second workshop, delivered one to two weeks later, focuses on advanced topics such as literature reviews, evidence synthesis, and systematic review tools and methods. The librarians provide a LibGuide on the Hunter College Libraries website which summarizes and expands upon the content of both sessions.
Results
Informal feedback has been positive. The Pre-Health Advising Office now requests the two sessions every semester. While the size of cohorts has varied from semester to semester, these workshops consistently reach much larger numbers of students than do typical library instruction sessions. The authors presented results from this program at the Annual Meeting of the Liberty Chapter of the Medical Library Association in October 2024.
Discussion
These findings will be of interest to health sciences librarians who provide instruction and research support to students pursuing admission to graduate health professions programs, including transfer students. The workshops offered in conjunction with the Pre-Health Advising Office greatly increased the outreach of HPL librarians’ instruction efforts. These workshops can also have an enduring impact as they address skills and concepts that will remain relevant for these students at varying stages of their academic careers or future employment; to the authors’ knowledge, no other examples exist of workshops covering systematic review methods for pre-health students. Further study will be needed to assess how or whether the content taught in these sessions has contributed to student success within the Health Professions Advising Program.
Generation of Cholangiocyte Organoids Using Human Primary and Immortalized Intrahepatic Cholangiocytes
Get PDFBackground: Developing cellular models for studying cholangiopathies has been challenging. Cholangiocyte (CHOL) organoids offer promise in recapitulating structure and function of in vivo biliary tree. To enhance expansion, isolated CHOLs were immortalized using lentiviral vectors expressing human papillomavirus (HPV) E6/E7. It remains unclear whether immortalization alters other cellular properties. This study aims to determine whether immortalized CHOLs can self-organize into bile duct-like structures ex vivo, providing an avenue for modeling cholangiopathies and biliary tree development.
Methods: Human cholangiocytes were isolated from explanted liver tissue (Figure 1A). 5,000 primary or immortalized CHOLs were seeded into a 24-well plate at 50ml/well in a mixture of Matrigel and supplemented media (Figure 1B). At 10 days of growth, diameter and number of organoids from each condition were quantified. Expression of the key markers for CHOLs such as CK19, EpCAM, and others were measured by qPCR. Rhodamine123 transport assay was used to assess functionality of CHOL organoids.
Results: Fluorescent microscopy confirmed that cholangiocyte organoids generated with immortalized CHOLs express cholangiocyte-specific cell markers CK19 and CK7 and maintain p-glycoprotein function (Figure 1D). However, organoids derived from immortalized CHOLs showed a significant reduction in diameter (12.68 ± 2.4 vs 20.61 ± 2.8, p<0.01) and number per well (17.3 ± 4.9 vs 27.0 ± 3.2, p<0.02) compared to organoids derived from primary CHOL. qPCR analysis revealed elevated expression of progenitor cell marker EpCAM and reduced expression of mature CHOL marker CK19 in organoids derived from immortalized cell, suggesting immortalization impaired differentiation of CHOLs (Figure 1C).
Conclusion: Although establishing immortalized CHOL cell lines from human livers provides cellular models for studying cholangiopathies, caution should be exercised when using them for studies requiring functional, mature CHOL behavior/3D organization. Future work should focus on developing alternative immortalization methods that better preserve the functionality and differentiation of primary cholangiocytes in 3D culture
Social Determinants of Health and Pain Coping Strategies in Pediatric Patients with Sickle Cell Disease
Get PDFBackground:Sickle cell disease (SCD) is a hematologic disease characterized by sickle-shaped red blood cells due to abnormal hemoglobin. SCD causes painful vaso-occlusive crises (VOC), which occur in patients as young as 6 months old. SCD affects approximately 100,000 people in the US, 90% of whom are non-Hispanic Black or African American. This study\u27s objective was to assess pain coping strategies of children with SCD, as well as the impact of social determinants of health (SDoH).
Methods:A retrospective chart review was performed on pediatric patients with SCD who had baseline data for the PedsQL Coping Inventory. This assessment includes 4 open-response questions and 42 coping strategies with multiple-choice options. For patients 5 to 18 years old, both patients and parents or primary caregivers were surveyed. The Area Deprivation Index (ADI) and Child Opportunity Index (COI) values were obtained as indices of SDoH. Descriptive statistics were performed for demographic variables and ADI/COI. Univariate and multivariable regression analyses were performed on PedsQL coping domains and ADI/COI.
Results:Regression analyses demonstrated that total parent score was significantly associated with age of child. For every 1-year increase in the child’s age, parent total coping score increased by 0.05 (p<0.000). In univariate and multivariate analyses when controlling for age, total parent score was not associated with child/teen score total.
Total parent, child, and teen scores were not associated with ADI/COI. Teen sub-scores for catastrophizing, social support, and distractibility were associated with state ADI (p=0.0016, 0.0075, 0.0216 respectively). Teen problem-solving and cognitive coping sub-scores were not associated with ADI/COI. Parent/child sub-scores were not associated with ADI/COI.
Conclusion:This study provides a preliminary understanding of the relationship between pain coping skills in pediatric patients and SDoH. Further investigation could yield clarity to the relationship between these measures and elucidate how patient pain management is being affected
Validating AI-based Pre-operative Prediction of Glioblastoma Recurrence Location
Get PDFBackground and Hypothesis: Glioblastomas (GBM) are aggressive brain cancers with poor prognoses and an average survival of 18 months. Surgical resection is the most effect treatment, but GBM is characterized by recurrence. Artificial intelligence (AI) can identify abnormalities in imaging imperceptible to humans. We plan to utilize a pre-operative MRI-based algorithm that identified regions of higher rates of cancer infiltration where recurrence is likely to occur. The goal is to use this model to guide extra tumor resection of high-risk regions. This model has yet to be validated with an external system, an essential step for machine learning studies. Here, we are working to validate our AI-based model.
Methods: We identified patients with pathology-confirmed glioblastoma from 2021 and prior. These patients then were screened by the following requirements: pre-operative MRI scans of T1, T1+Contrast, T2, T2 FLAIR, ADC, DTI, and DSC sequences; initial gross-total resection; and neuro-oncology diagnosed recurrence by change in treatment. The pre-operative scans for patients are pre-processed with NFTI conversion, skull stripping, and noise reduction. Scans are used to validate the AI-based recurrence model by comparison with post-recurrence scans.
Results: Results from the multi-institutional consortium of which the model was trained have shown an overall odds ratio of 12.0 and area under curve of 0.80 at 99% confidence intervals. Within our selected patient population of recurrent GBM, we have identified that 63% are male, 50% are over the age of 60 years old, 100% are IDH-wild type, and 63% have demonstrated MGMT promoter methylation.
Future Impact: We are currently in the process of collecting and segmenting a large validation cohort. The AI model’s prediction accuracy and robustness is validated with this data outside of the institutions of which the model was trained. The future purpose is to direct supramarginal resection and targeted radiation therapy to areas with higher probability of GBM infiltration
Physical Therapy Timing: An Investigation of Physical Therapy Initiation and Case Duration, Restricted Workdays, and Imaging Utilization
Get PDFBackground: Occupational health injuries are common, and many individuals will suffer a workplace injury throughout their career. When employees cannot work for extended periods of time, companies face financial and staffing difficulties. Prior studies have suggested that early referral to physical therapy (PT) is associated with improved patient outcomes and reduced healthcare utilization. However, there has been limited investigation of this in occupational health settings and among diverse types of injuries. Our goal was to investigate how the timing of PT impacted the case duration, restricted workdays, and imaging utilization among injured workers.
Methods: We conducted an IRB-approved retrospective chart review of N=1191 patients who received care between 9/2017-6/2023 at Parkview Occupational Health. Timing of PT initiation was categorized as early (0-13 days), delayed (14-20 days), or late (>30 days) from date of first visit. Kruskal-Wallis tests were performed to assess differences in case duration and restricted workdays by PT timing. Chi-square tests evaluated utilization of different imaging modalities by PT timing. Bonferroni-corrected Dunn tests were performed to compare groups. Analyses were performed using Excel and Stata V.18 (alpha=0.05 for significance).
Results: Across PT timing groups, median case duration ranged from 44-78 days, median restricted workdays ranged from 12-28 days, and total imaging utilization ranged from 32%-48%. Early PT initiation was associated with a significant reduction in case duration (p<0.001), total imaging (p<0.01), and X-ray utilization (p<0.001) compared to delayed or late PT initiation. Early PT was associated with fewer restricted workdays compared to delayed PT (p<0.001) but not late PT (p=0.054).
Conclusion: These results support the benefits associated with utilizing early PT after a workplace injury with earlier utilization showing the greatest benefits
Encapsulated Induced Pluripotent Stem Cell Derived Mesenchymal Stromal Cells Promote Muscle Regeneration in a Diabetic Mouse Model of Critical Limb Threatening Ischemia
No full textCritical Limb Threatening Ischemia (CLTI), the end stage of peripheral arterial disease (PAD), represents a significant healthcare challenge, marked by diminished blood flow to the legs, leading to tissue necrosis and eventual amputation. Since 2010, there has been a 50% increase in non-traumatic major amputations related to PAD. Previous studies revealed that autologous bone marrow cell therapy fails to prevent amputations in diabetic patients with limited revascularization options. Allogeneic bone marrow-derived mesenchymal stromal cells (MSCs) have shown promise in stimulating angiogenesis in the muscles of diabetic patients. Induced pluripotent stem cell (iPSC)-derived MSCs might offer superior benefits, including reduced senescence.
This study explores the potential of clinically approved human iPSC-MSCs, sourced from Cynata Therapeutics and encapsulated in alginate hydrogel, to enhance muscle regeneration in a diabetic CLTI mouse model. CLTI was induced by ligation/excision of the common femoral artery in male polygenic diabetic TALLYHO mice. iPSC-MSCs or a vehicle control were injected into the gracilis muscle of the ischemic limb 7 days post-ligation. Treated limbs exhibited increased blood perfusion, improved muscle function, reduced pathology, and heightened angiogenesis.
Quantitative real-time PCR was employed to assess changes in mRNA expression related to muscle regeneration. Seven days post-iPSC-MSC injection, gastrocnemius and tibialis muscles demonstrated elevated mRNA expression for VEGF-A, MyH3, Mrc1, and Foxp3 compared to vehicle-treated muscles, signifying enhanced angiogenesis, muscle cell regeneration, M2-biased macrophage expression, and increased T regulatory cells. The observed rise in Mrc1 and Treg cells also suggested decreased inflammation in the treated muscle.
These findings underscore the efficacy of encapsulated Cynata MSCs in fostering muscle regeneration and angiogenesis in diabetic mice, meriting further investigation to evaluate their potential for limb preservation in diabetic patients with CLTI.