BME Summer Immersion 2021

A beautiful view of the Queensboro Bridge, the East River, and Queens. Looking at this reminds me of the first few words form J. Cole's Change  - "My intuition is telling me there'll be better days." I'll just leave it at that. Six weeks is a lot of time. 42 days, or 1008 hours, or 60,480 minutes. In an almost cruel twist, it passes like no time at all. Of course, this is the duality of time; both lengthy and fleeting in a single experience. I look back and see that through this immersion, I've gotten to witness many cases, work day in and day out with physicians, and work through my project. Before I started, I was interested and enthusiastic about MRI - learning about T2 and other image weighting. Now, I have some of the basics of scanner operations down, and I was even able to perform a scan on a phantom just this week! I didn't really know what ablation was, and I got to watch two procedures in the past two weeks. I've learned a lot, and there is a...

As this is my final week, I find it just to reflect on my experiences during this immersion. From day 1 to day 42, there were a lot of ups and downs. However, I am glad I made the decision to come in the end When I started this term, I had no idea about what could be achieved in these six weeks. Thankfully, with the guidance of Dr. Dadhania, Dr. Westblade, and Dr. Chughtai, I was able to learn a lot about conditions and procedures that would be either foreign or hear say. Research wise, it is unfortunate not to have more time to continue working on the current projects while in proximity to the clinicians.  However, I hope to continue what I started in Ithaca. Although it took me a while to get the logistics and understand what I was to to, I am happy I got to do some actual data analysis.

The final week! This week I watched a kidney biopsy and ablation and a bone biopsy. Biopsy involves getting small cores of tissues from a tumor or mass. Ablation is a technique used to destroy tumors. This can be done with heat or cold. Thermal ablation can further be accomplished using radio frequency or microwaves. However, when heat is used, the doctor must also account for "burn back." Heat is difficult to control precisely and will diffuse to surrounding healthy tissues/organs back along the probe. Hydrodissection injects saline to push organs away from the burn area, protecting them. The craziest part, though, is that they do this with the patient awake (but sedated) and insert a long needle through the torso. The bone biopsy was similar, but a drill had to be used to go through the bone and cut a small cylinder out of the suspicious area. For my last weekend in NYC, I went to Luna Park and the Coney Island beach. Personally, the ticket price for Luna Park wasn't wo...

For clinical experience, I shadowed one flap surgery and two wound cleaning surgeries with Dr. Spector. The patient with flap surgery had a huge hold in her mouse due to tumor removal, and the plan was to harvest a muscle from the wrist to patch up that hole. Two fellows were making incisions on the patient's neck to access the oral cavity while Dr. Spector was harvesting the muscle flap. Then, microsurgery was performed to anastomose the arteries and veins of the muscle slap to that of the neck, and the muscular flap was sutured on top of the hold in the mouth. Meanwhile, a layer of skin was harvested using a dermatome to cover up the wound on the wrist. Overall, I was impressed by how efficiently the medical team worked together to perform multiple parts of the surgeries simultaneously. For the wound cleaning surgeries, one was for the back of a foot and another was for the spinal fusion metal implant. Both patients had serious infections that halted wound healing, therefore Dr. ...

Clinical:     As I wrapped up my time at Weill Cornell, I spent most of my time working on deliverables for our program.  I did get into surgery on Thursday though to watch a tumor removal.  The main reason I went in was so that Robert, another student in the  program, could come with me.  He had not seen a surgery at all yet so it was good that we were able to get in for one.  I know what to expect from tumor removal surgeries by now so it was mostly the same, but there are always some new things to pick up during every surgery.  Usually some new brain anatomy and how the surgery has to be individualized based on the certain location of the tumor.       Research:     I had finish up most of my research so that I could present on earlier today (07/31).  I have been done with my app for a few weeks now, so all I had to do with that was put what I did into a few slides for the presentation.  My secon...

 It's crazy to think that immersion is over and it's already been 6 weeks. It feels like just yesterday we were all debating how many clothes to bring and how many suitcases we'd be allowed to take on the bus. Although one suitcase was enough for my clothes, I'm glad I had an extra duffle bag to bring some bagels back with me. I came into this experience with very little expectations and not a clear path of what I wanted to learn and take away. I knew I wanted to make connections and meet different research labs in case we wanted to collaborate in the future, but other than that it was more or less an open slate. I chose to dive into learning about lymphoma and stem cell transplants since cancer research has always been interesting to me, but I've never worked anywhere where this was an option. Dr. Leonard and other lymphoma clinicians graciously took me under their wing and taught me an incredible amount about lymphoma and how patients are treated. I saw some patie...

It's hard to believe that the clinical immersion has come to an end! This has definitely been an incredible experience that I will carry with me for a long time. When I first arrived in NYC, I was excited to learn about the technical aspects of radiation oncology--the complex biology of solid tumors, the physics underlying the design of radiation treatment fields, and the engineering of the machines built to deliver these treatments. By shadowing Dr. Marciscano and the other clinicians in the department, I succeeded in learning about all of these things. Beyond the technical side of medicine, however, I was pleasantly surprised to find that a significant amount of my learning was also focused on the human side of medicine. How do you convince a patient with curable disease to undergo cancer treatment when they are clinically depressed and seemingly ready to give up? How do you make a patient feel confident about the team of surgeons, medical oncologists, and radiation oncologists w...

The last week of the clinical immersion term has been incredible and productive just as previous weeks. I continued to shadow Dr. Riew's surgeries and clinics. I saw the MRI for a Chordoma bone cancer patient on Tuesday. The young patient had a huge tumor in his brain. When the tumor was surgically removed, the patient was left with a large cranial cervical junction and required a cervical fusion all the way from the skull to the bottom of the neck. However, the cervical fusion he had done before was not very good. For a fusion all the way to the skull, the patient will not be able to move their neck at all, but in this chordoma patient, the bone plate at the back of his neck has a very bad skull to neck angle, so that he can only maintain a very flexed position, in which his chin is almost touching the chest. The patient and his family went to Dr. Riew for a cervical fusion revision. Dr. Riew plans to take out the bone plate from the back of his neck and replace it with a plate to...

 Week 6 In the last week of the summer immersion program, I tried to wrap of a few of my deliverables instead of continuing to shadow surgeries for the majority of time. Over the past weeks I have been working with Dr. Bradley Pua for a conjoined case study with Dr. Jeffrey Milsom who is in the colon and rectal surgery department. The case study was looking at a possibility to combine interventional radiologic techniques for treating some small bowel complications. This week I helped them with editing the texts and figures for this case report. We imagine there would be a few more rounds of edits in the next few weeks before finalizing the manuscript. In addition, on last Friday I gave a brief presentation on the topic of this case study to our fellow summer immersion students and our coordinators.  Overall the summer immersion has been an incredible experience for me. Not only has it given me the opportunity to witness medical practices on a daily basis, it has also prompted ...

During my final week of clinical immersion, I said my goodbyes to my clinical mentor and the lab I’ve been working in. I spent most of the week wrapping up experiments and selecting samples to bring back to Ithaca for further analysis. In Dr. Chen’s lab, I prepped samples for a glucose-stimulated insulin secretion (GSIS) assay using my stem cell (SC) derived pancreatic islets and the SC derived-islets encapsulated in microgel followed by an ELISA to measure the amount of insulin produced by the cells and their total insulin content. I also imaged the immunostained cerebral organoids, processed all the images, and cryosectioned a few microgel encapsulated SC derived islets. I will finish sectioning and immunostaining these samples back in Ithaca. Overall, the clinical immersion experience has been incredibly informative and motivating for my own research. Being in a lab dedicated to stem cell research, especially beta cell differentiations, will aid in my thesis work. Seeing surgeri...

Clinical - This past week was very interesting as I was able to observe the cognitive assessment of a person with moderate Alzheimer's disease and was also able to tag along with Austin to observe Dr. Schwartz remove a brain tumor. Seeing the patient with Alzheimer's disease was quite eye-opening as in addition to the memory problems that are most typically associated with Alzheimer's disease they were also very withdrawn, would often take a minute or more to answer a simple question, and would often only answer in one word replies. This was evidence of how Alzheimer's disease can affect all brain functions, not just memory, and was overall quite sad to see as it was evident that Alzheimer's disease had severely deteriorated this person's quality of life. Meanwhile, in the OR I was surprised by how calm and loose the atmosphere was and was impressed with the ease at which Dr. Schwartz was able to remove the tumor. It was also evident that a glaring clinical need...

 Immersion term is finally over! What an experience. Between the shadowing opportunities, research, and time able to be spent bonding with the cohort, my time here has been packed with excitement. I am quite tired of city life and ready to be back to Ithaca and with my birds.  This past week, I met with my clinical mentor's laboratory and updated everyone on the current status of the MBP/Fe3+ quantification project. In order to remove bias from the processing pipeline, consistent image thresholding must be achieved. There are 17 built-in thresholding algorithms in imageJ, and I found the max entropy algorithm best suits our data. I constructed another macro to analyze images with all 17 algorithms at once, and taught Ria (the high school student assigned to this project with me) how to implement the macro on her device back home. Further work that needs to be accomplished for this project involves collecting more ROIs from the raw histology images and running a larger scale an...

This week I worked on finishing up gathering data for my research project and sent it off to the statistician for analysis. I also started writing an abstract for this project so we can submit this data to the American Society of Hematology (ASH) meeting. If the abstract is accepted we will prepare a publication for this project, but either way, it has been great getting to experience clinical research. The clinical team is interested in our results and hopefully, this project can help them learn something/ answer some questions. Outside of clinic, I also spent time shadowing in Dr. Cubillos-Ruiz’s research lab. I was able to learn the protocol and analysis for RT-qPCR, as well as learn about some other databases and resources for data analysis that will be helpful in the future. I also observed the isolation and staining of immune cells from patient samples. Spending some time in an immunology lab has been great and will help my research back in Ithaca. Overall, the past 6 weeks have ...

 With the conclusion of the immersion experience, I find myself with a greater appreciation of the medical field and the technology that has advanced us to this point. I am looking forward to working closely with clinicians, surgeons, and their medical team in the future.  This week, Shoufei and I worked on optimizing the PCL dorsal nasal constructs using the new Ender 3 pro 3D printer. We went through many trials and ended up figuring out the printing parameters for the best scaffold using a 0.2mm nozzle. The scaffolds were replicated each time we used those parameters with similar indentions in the pores. This means that they can be tested using cells and should provide consistent results. The next steps for this project are to utilize a glass heated bed in place of using duct tape and further optimizing the porosity of the scaffolds. The image below shows a PLA scaffold on the left with two PCL scaffolds to its right. The PCL scaffolds were printed using two different types...

 This was our last week of the summer immersion program! This week was very busy as I tried to get the most out of it and wrap up everything that I have been working on. On Monday I shadowed Dr. Greenfield's surgeries where I was able to see a chiari malformation surgical procedure. The medical fellows and residents were super welcoming in the OR and they helped guide me through the anatomy involved and how to orient myself when looking at the microscope and the projected screen. On Tuesday I shadowed Dr. Schweitzer in the neuroradiology reading room where I also got to see different cases that had come into the emergency room. One of the cases had actually involved an interventional radiology procedure as well which was super cool to see as it was a successful intervention. I also watched the fellows conference where they presented interesting cases. Later in the week, I worked on wrapping up my image analysis of the in-vivo study we were conducting in lab. This was a challenge be...

 Lab-wise, I have really enjoyed the techniques I have been learning in lab. I have done many qpcr's sectioning and staining, and other helpful skills that I will use in Ithaca. We continued working on the beta cell mass project int he Pitt Lab. I sectioned and staining some samples to image and quantify using a software. The beta cell mass has been directly linked the the beta cell function.  We continued exploring New York City and I must say my favorite day last week was when we went to hot pot followed by a walk to Little Italy where I had spectacular gelato. I'll have that gelato on my mind for quite some time. Next week I look forward to wrapping up my projects and leaving Maiko in a good spot to continue after I leave. I will greatly miss the food and the hospital, clinical shadowing has been one of the my favorite experiences. 

 Wow has this been such a great summer.  A huge thank you to all those involved, especially those in the radiology department. This week I made good progress with the post doc I have been working with in the Pitt Lab. We were able to collect blood serum samples from mouse models that recapitulate Timothy Syndrome via a gain of function mutation in calcium channel 1.2 , the purpose of this is to simulate TS2 patients. This finding was really helpful for our studies this summer since we were able to eliminate the pancreas as the cause for hypoglycemia in TS2 patients. From here we move forward with this information to investigate if it potentially be the liver breaking down glucagon or if it is miscommunication between the brain and insulin secretion.  Additionally, this week, Dr. Pitt had rounds all week and I got to spend his morning and afternoon rounds with him. This proved to be a really exciting experience since I was able to see the MD side of his dual degree. The pa...

 Clinical: I was able to shadow Dr. Kaplitt for the final week again during a focused ultrasound case in which he ablated a specific region of the patient's brain using using MRI. The patient had essential tremors and showed significant improvement by the end of the session. I was also able to shadow in the OR and saw Dr. Kaplitt replace a battery pack for Deep Brain Stimulation. Research: My research finally began in the last week as I was able to perform the cannula implant surgeries on 8 experimental mice. I performed bilateral cannula implantations of optical cannula into the dorsal striatum, and in two weeks will return to Weill Cornell to conduct the fiber photometry imaging while the mice are exhibiting the freezing of gait phenotype due to exposure to magnetic field change brought on by MRI. My research mentor Dr. Santiago Unda has been an incredible hep during my time here and I wish I could have been more productive with my research with him, however have been able to due...

 I can't believe 6 weeks in NYC have already come and gone!  This week, I wrapped up shadowing in radiology, as well as continued to work on my shoulder impingement research project.  In this short period of time, I've gone from knowing almost nothing about radiology to really understanding how images are interpreted by physicians.  It's amazing how much information you can get about a patient's health (besides just their bone health) from a simple x-ray.  For example, I saw a teaching case where we were able to determine that the patient had lung cancer just by looking at a bilateral knee x-ray. Overall, I've had the opportunity to shadow in tons of different specialties throughout the summer: Musculoskeletal Radiology, Pediatric Radiology, Interventional Radiology, Plastic Surgery, Neurosurgery, Orthopaedic Surgery, and Physical Medicine & Rehabilitation.  Thank you to all the clinicians who have graciously taken the time to have me shadow and to answ...

Last week of immersion! This week was extra chaotic as I volunteered to assist with a virtual camp that my PI back in Ithaca is putting on for high schoolers. I was still able to attend office hours in the clinic and finish up a few things in the lab but I was unable to make it into the OR this week. In the clinic we saw two different acoustic neuroma patients this week which was very interesting as I had seen another acoustic neuroma patient in the OR a few weeks earlier. Acoustic neuromas are rare benign tumors that form on the cochlear nerves. Often when they are removed the cranial nerves, which animate the face, are severed causing varying degree's of facial paralysis. Dr. Spector then comes in and attempts to reconnect the nerves to restore some movement. It was really interesting to see the three different patients, as they had undergone different surgeries, had different degrees of paralysis, and were at different stages post op.  The original acoustic neuroma patient I saw...

      My final week of immersion largely served as a continuation of last week. I wrapped up (what I can) of my paper, amending figures and re-running outliers, and setting up instructions for conducting the reproducibility study. I continued to attend image readings alongside the cardiac imaging fellows, adding to my introduction on clinical cardiac magnetic resonance (CMR). I also got the chance to attend one of Dr. Weinsaft's lectures on basics of CMR readings, which served as a great summary and addendum to the last six weeks.      This week I attended a testing of coils for Magnetic Resonance-guided Focused Ultrasound (MRgFUS). MRgFUS utilizes ultrasound to ablate neural targets to treat cancer, Parkinson's, Essential Tremor, and other pathologies linked to specific areas of the brain. MRI is used to monitor the patient's brain in real time to monitor ablation progress, tissue heating, and the focus of the ultrasound transducers. Insightec's ExAblate N...

               This week, I continued to work on the mobile app that takes clinical images and uploads them to a database. Previously, I was attempting to figure out whether I need to create a database or what kind of database to upload to as I am not allowed access to the hospital’s IT systems. I was really glad to finally figure this out and excited that the app can now accomplish what the clinician mentioned, from taking a photo to uploading to an actual database. It seems that multiple sources use Google Firebase to sync with their mobile app, so I learned how to set up my app to connect with Google Firebase. I also chose this due to the relative ease of using Google Firebase. It simply requires a Google account then writing code to connect to the specific account, so I set one up for the clinic. Creating an actual database for example MySQL would require an actual computer that has a static IP address (i.e. one that uses an ethernet connectio...

Clinical Observation: I had previously watched a call Dr. Curran had with a family. The family needed a bone marrow transplant consultation and were looking into several different hospitals. This week, the family chose to work with the team at MSK and move forward with the bone marrow transplant. It was really interesting to see how the MSK team prepped for the family’s arrival. There were various things that were planned and discussed ahead of time amongst the team to try to limit overwhelming the family upon their arrival. The amount of care and consideration all the physicians, nurses, and other team members have for their patients and their families still amazes me. The team discussed with the family the timeline for the transplant, various potential complications, and how best to prep their child for the two month hospital stay. Dr. Curran also discussed an on-going clinical study being done at MSK and explained to the family why it could be useful for the patient to participate ...

I'm a little late to my blog post this week... Ooops!  My fiancé, her sister, and a friend came to visit this weekend and time went quickly on Friday and I forgot about it.  So here's a catch up on what happened last week. Clinical:     After a very  busy week in the clinical setting last week, this week was much slower.  I had been hoping to let a few other members of the immersion program come with me to some neurosurgeries, but unfortunately Dr. Schwartz was not doing any surgeries last week.  I am therefore hoping to let them come with me to some surgeries this week.  Overall, I am happy with the clinical experience I have had and am now just more going to let others see what I have.   Research:     I spent most of last week working on research and trying to start wrapping up my projects.  I am pretty much done with my Matlab app project and just have to package it so that it runs independently from what...

 This week was super busy as it was filled with both research and clinical experiences. I was lucky to see a surgery that involved the removal of a very rare pediatric tumor. This tumor is incredibly aggressive and there are very limited if any, treatment options available. Dr. Greenfield's lab here at Weill Cornell is involved in many research efforts to find treatment options for patients. This involves multiple drug screening studies performed on tumor models generated from primary patient samples. Seeing as I work in a shared lab space with the researchers who work on this project, I was able to discuss and understand the incredible work that they are doing to find personalized treatments for pediatric cancers of this type. During the surgery, someone from Dr. Greenfield's lab came to collect the tumor samples that they use to generate the cell lines that are necessary for both in-vitro studies as well as creating in-vivo models. Throughout the surgery I also learned about ...

  This was Dr. Härtl's last week before vacation. I spent most of the week watching surgeries and attending meetings. This included meetings with our collaborators in Tanzania, with my lab group back in Ithaca, and with other physicians from partner institutions at the Spine Case Conference. Our IRB edits are still waiting approval, so I have been working to set up kits at NY Presbyterian that Dr. Härtl can use to store and transport patient bone marrow samples. Once received in Ithaca, I can characterize the cellular contents of these samples and correlate that with patient healing outcomes.  Aside from work, I have been enjoying these last few weeks in the city. It's amazing how quickly 5 weeks have flown by! 

     This week I had the chance to attend the tumor board, where doctors with different specialties, such as radiologists, pathologists and radiation oncologists, meet and discuss cancer cases. The tumor board I attended was in a very fast pace. For each case, doctors had prepared a presentation of patient history, radiological finds and histology.      From my impression, radiology is most often used to locate the mass. For tumors, MRI and PET are most commonly used. Despite telling where the tumors are, imaging sometimes provides information about the nature of the tumor such as diffusion and hemorrhage. However, to determine the best treatment,   histology staining must be looked at. There are several important markers as well as the cytomorphology that can help clinicians learn the nature of the tumor and I'm going to introduce some that I heard of during the meeting.       H&E  (Haemotoxylin and Eosin) staining: This s...

This week I worked in the clinic with Dr. Marti and we saw a variety of patients. We saw a pregnant woman with a concerning mass and nipple discharge. Due to the pregnancy, the women will receive a mammogram or MRI after the pregnancy to protect the baby and not cause stress. She may have to stop breastfeeding because of this. We also saw two patients that had received inconclusive biopsies so they were advised to go in for a lumpectomy. Some patients were asked to schedule 6-12 month follow-up appointments.  In addition to office hours, I watched a thyroid tumor removal and a mastectomy. For the tumor, it was unclear if it had spread to the thyroid so the pathology will be determine if another surgery will be needed to remove the thyroid. For the mastectomy, the patient had a couple suspicious lumps in the breast so it was decided that the whole breast would be removed instead of just a portion. The patient did not opt for reconstruction but can at a later date. I was surprised by...

 The past few weeks have come to a head. I previously spoke about what disease my project focused on, but not how the disease is addressed. Kidney volume is a pretty important in determining polycystic kidney disease (PKD) outcomes in patients. Unfortunately, total kidney volume (TKV) measurements come from manually contouring kidney. It can be time consuming to contour an unremarkable kidney, but the complicated geoemetries and partial voluming effects found in advanced cases makes the process even more difficult. So this is where we set off: why not try to automate the segmentation? Luckily, a research fellow developed and trained the model, and we set off to evaluating inferences and further debugging the code. For many cases, the inference performed very well, but we found that we need to train it with some harder stuff. In other words, a harder case was more of a coin toss with the algorithm, but after much thought we are pretty optimistic that re-training with a more diverse ...

This week I have been working on a new project doing image analysis of immunohistochemistry-stained biological samples from lymphoma patients. I am working with the image analysis software HALO and have been looking into preparing a strategy for gene expression profiling of histone mutations so as to obtain data that can be used to elucidate the role of these mutations in lymphoma development. So far I have been familiarizing myself with the software and determining how to acquire the desired data from the stained cells. In particular, I am looking to compare differences in intensity/brightness, nuclear size, and overall percentage of positively stained versus negatively stained cells for each sample. I will write up my HALO strategy/process so that the Cesarman Lab can repeat and refine it in the future.

                Breathing in, I know that I am alive. Breathing out I smile to life. The MRI is singing. Whistling overtones, resonant thrums, frequentual harmonics across the gradient in full magnitude filling the cylindrical space of the solenoid. My body occupying that empty space, three tesla strong; my brain, as the imaging takes place, located at the center.             Listen, Listen, the sound of the bell brings me back to my true home. I had seen Alicia’s brain earlier, and Nada’s too, before my own scan. I could see them now via a little tilted mirror above me, past the mesh-lined window, they were there now hunched over the monitors and computers. Donghyun had explained to us the imaging modalities of the white matter vs gray matter of the brain, how the MRI uses changes in the spin of the protons of water to see through the skull in different ways, T1 and T2, what were ...

Compared to the past couple of weeks, this week was more relaxed. Instead of doing more clinical rounds, I focused instead on the data analysis I was conducting for my clinical mentor. Interestingly, when it comes to UTIs, the infection rate generally varies by gender and by medical history. Women often have a higher infection rate than males especially when it comes to infections of the lower urinary tract. Anatomically this makes sense as they have a shorter urethra than their counterpart. In the upper urinary tract, the medical history can be considered to be more important than the sex. Kidney transplant recipients are often at risk for infections following the transplant surgery. Aside from surgical site infections, they have to worry about different types of kidney and upper urinary tract infections. Those come in different levels of risk. First, we have bacterial infections, then viral infections and fungal infections which are the most difficult to deal with, presenting more ri...

 Week 5 Going into the second last week of my stay at the summer immersion program, I have been, again, shadowing doctors in various departments outside of international radiology to obtain a more diverse experience. This week I have had the opportunity to work with Dr. Himanshu Nagar in radiation oncology, Dr. Eugene Shostak in interventional pulmonology, and Dr. Angela Kadenhe-Chiweshe in paediatric surgery. One of Dr. Nagar's specializations is in treating prostate cancer. For these patients who need to undergo radiation therapies, one of the complications after radiation is damage to the rectum, which is located very close to the prostate. To lower the risk of radiation damage to the rectum, Dr. Nagar used a FDA-approved hydrogel product, SpaceOAR™, to space out the rectum and the prostate. This hydrogel consists of a cartridge of PEG powders mixed with trilysine buffer solution and a second cartridge of salt buffer solution. When these two cartridges are injected together thro...

The most interesting clinical experience for me this week was to see a patient recovering from a tongue reconstruction surgery and another patient receiving tongue reconstruction surgery. I saw the recovering patient first, the patient had wounds in his mouse, arm, and leg, and I was first confused about how these incisions were connected. Then, the next I shadowed a tongue reconstruction procedure for a patient who lost the front part of his due to oral cancer, and everything made sense. First, an incision was made on the patient's next to access the oral cavity. Then a muscle from the patient's arm was harvested. The muscle came with an artery and vein which would then be connected to the blood supply on the neck. The muscle would then be attached to the remaining tongue. Finally, a thin skin graft was harvest from the patient's thigh to cover up the incision on the arm.  Research-wise, I made some nice progress. First I was working on creating a bioreactor to support the...

During my fifth week of clinical immersion, I focused more on research and the use of patient samples. I visited the Elemento Lab and learned how they make tumor organoids from patient samples such as breast cancer samples. I also brought some microgel from my lab in Ithaca to try culturing with the cancer organoids to see if this can stabilize sensitive cancer lines. In Dr. Chen’s lab, I have 8 beta cell differentiations in progress. I was also able to try beta cells with microgel from my lab in Ithaca to explore the benefits of a 3D environment. Furthermore, I finished immunostaining the pancreatic islets and imaged the slides. I also finished sectioning the cerebral organoids and started immunostaining them. Next, I plan to section some lung organoids, image the stained cerebral organoids, and potentially image the lung organoids if I have enough time in my final week. Next week, I also plan to run a glucose-stimulated insulin secretion (GSIS) assay on my beta cells.

 Day 21 - Day 25 Throughout this week I had the opportunity to attend 2 TRAUMA team meetings to discuss special cases that need further consideration. Here I learned that not all of the hundreds of risks for an operation can be discussed so that surgeons have to use both supporting documents and clinical judgment to perform any surgery on a patient. Also, I had the opportunity to see how a disagreement between two high professionals can be very insightful when dealing with complicated situations.  Further, I met with Dr. Shou to briefly discuss the direction of my project and the hospital protocol that he wants to assemble.  Currently, we are waiting for ~200 MRCP/ERCP imaging patient cases to be sent to us from Eileen (Research Imaging manager). In the meantime, I am writing the background section for the protocol.  Lastly, I had the opportunity to present my preliminary work to the immersion cohort, the project focused on MRCP and ERCP in the diagnosis of Choledoch...

  This week I have focused primarily on the development of a surgical tool for the injection of collagen into the annular defects of our microdiscectomy cases. I have attended three microdiscectomy cases this week and taken measurements during the surgeries to establish the dimensions necessary for the product we will be developing. I have spent time researching and reviewing several papers, including past Cornell patents, to learn about instrumentation that has been beneficial in the past. To ensure that we continue to collect data on these cases, I established a protocol and guide sheet for collecting measurements in future discectomies. In collaboration with the veterinary school at Cornell University, I formulated a method for transportation of human IVDs back to the Bonassar lab in Ithaca, allowing me to continue performing clinical research after my return to Ithaca.  Also I took this cool picture of the lightning storm last Saturday: