Week 8: Teagan

In my final immersion week, I got a lot done and wrapped up my project! For my research, I edited my 3D print design once again to add a little divet to better cradle the body of the mouse. However, upon initial designing, I increased the overall thickness of the base to have enough volume to create a deep divet, but this increase in depth affected image quality. In the Faxitron image, you could see the structural elements inside the base, which made analyzing the mouse limbs difficult. So I iterated one final 3D print design at the original base thickness with a shallower divet into the base. I didn't have time to run that print through the Faxitron before I left, but I left it with the Bostrom lab for them to test later in the month. I also spent some time in the OR with Dr. Bostrom. The patients he saw this week had a lot of health conditions that had to be monitored to ensure that they didn't cause any negative surgical effects. These conditions included cardiac history, obesity, and diabetic status. It was interesting to observe how these extra complications were handled by the team in the OR to ensure a smooth surgical operation. Lastly, I spent time preparing for two presentations that I had during this final week, one for the immersion program itself and another for the Bostrom lab meeting. It was gratifying to be able to share the work that I did this summer with others. I learned a lot from this immersion experience. There are many skills and insights that I will take with me back to Ithaca to help further my research! 

Week 8: Anais

 In my last week of immersion I got to observe some particularly tricky surgeries.  In the hysterectomy we observed, the patient had a c section scar that seemed to make it difficult to find where the uterus ended.  Additionally,  we observed an abdominal myomectamy.  This case had the largest fibroids I have seen in my time at Weill Cornell.  It must have been such a relief post surgery.  I also got to attend the clinic this week which further provided insight on the surgeries we have seen.  It was a particularly busy clinic day and I got to see a variety of birth control insertions and hysteroscopies.  Overall, this summer has been very enlightening and great to see how some of the things I have been researching translate in a clinical setting.  I am excited to take all I have learned and apply it to my research in Ithaca and I hope to continue to collaborate with Dr. Fenster.  

Week 8: Amelia

 Final week! At the beginning of this week, I prepared for and presented on my summer immersion experience. Trying to fit everything into 4 minutes was very challenging, but it forced me to reflect on the material and how to condense the background of the project. On Tuesday I also had the opportunity to sit down with Dr. Osborne, who is doing clinical work with neurosteroids and postpartum depression. Since my lab is interested in getting into this topic, getting the chance to chat with her and ask her questions was so helpful! Wednesday was the last day of surgeries I was able to observe, and I got to see a deep brain stimulation stage 2 surgery (where they implant the battery and connect it) and a battery replacement surgery. Finally, we did 2p calcium imaging for our Sorcs3 project, but with PRISM implants this time, instead of cranial windows. The PRISM implants allowed us to get many more cells in our field of view! Next steps will be to edit the 2p suite code to ensure the ROIs are being detected correctly and statistically analyze our results. It was exciting to be able to see a good portion of a project through in the 8 weeks we were here, and I am definitely bringing a lot of knowledge back to Ithaca. 

Week 8: Aidan

 Final week in NYC - lots of progress. Printed two platforms for magnets (a repeat of the flat halbach device, and then the first radial device). Built the flat device again, this time using improved construction techniques based on what happened with the first (used clamps to let epoxy set between the 3rd and 4th sets of magnets). The hypothesis was that with better construction/placement of the magnets, the field should be more strongly aligned in the target direction and get closer to the predicted strength of 87 mT 1cm from the surface. Oddly, the magnetic field measurements are ~30% weaker on the new flat device compared to the old device that had magnets misplaced. However, I had measured the old device and Aldana measured the new device, so it's possible that the difference is due to user-to-user variability, since the measuring tool does not have any guides (you have to eyeball 0.5 cm based on a ruler, and the measuring probe is ~0.2cm thick, so depending on which part you align with the ruler it could be 0.3cm to 0.7cm from the surface of the magnet. Additionally, orientation of the measurement tool matters). I also had the opportunity to observe more surgical cases on Wednesday, which were a deep brain stimulator stage 1 implantation (electrodes), followed by a deep brain stimulator stage 2 (battery) implantation.

Week 8 - Kirtana

 This week I primarily worked on finishing up my lung cancer project. I prepared the lung cancer incidence and PLCO risk graphs for the population, and also started working on developing my own model. This is currently a work in progress and I will continue it after immersion. 

Summer immersion has truly been an enriching experience and I learnt a significant amount about the clinical side of biomedical engineering. Shadowing surgeries, performing image segmentation, performing data analysis all led to me obtaining new skills. My favorite part of the experience was getting to operate a MRI machine. While it was interesting to use the machine without being a patient, I understood the challenges that are present in medical device development in terms of user accessibility. Considering that my PhD is on point of care device development, I believe there is a lot I can take from this experience. I am grateful to have had the opportunity to go through the summer immersion program and I am looking forward to using my newly gained clinical knowledge in the lab. 

Week 8: Pei Wen

This week marks the end of our summer immersion program. Most strikingly in OR, Anais and I observed a myomectomy with the largest fibroids we have seen thus far, roughly the size of a coconut. The larger fibroids were accompanied by a multitude of smaller ones. We were shocked to learn that Dr. Fenster has had cases where the fibroids were even larger. I cannot imagine the pain that the patient must have felt living with the fibroids as the fibroids were pushing on their other organs. This surgery sparks my curiosity further on the prevalence of fibroids among certain populations and the factors that contribute to their growth in severe cases such as the one we observed. I am grateful for the opportunity I had this summer to shadow Dr. Fenster in her surgeries and patient visits, to gain perspective in clinical needs and gaps pertaining to our field, and to learn how present and future technologies can be applied to improve patient care. 

Week 8 : Adil

This week was good mix of research and time in the OR. I continued to work on the pipeline we started last week and ran more RNA datasets from the ICSBCS biobank to compute immune cell fraction across samples. I also analyzed the TCRseq data of the pooled trovo sample and combined the results from the scRNA analysis I did last week. This analysis has helped us to optimize our experimental protocols (initial sample size and initial cell count) for the upcoming trovo experiments. Later in the week I attended a presentation by a sub-intern working with Dr. Newman on the various factors that come into play in decision making in breast surgical oncology and how clinical trials have shaped these protocols over the years. I also attended a didactic session by Dr. Newman on systemic therapy for breast cancer. In the OR, I shadowed Dr. Newman for two lumpectomies, one sentinel lymph node biopsy and a ductal node excision. Overall the summer immersion was a great learning experience - both on the clinical and research fronts. I look forward to applying the learnings from my immersion experience to my ongoing projects.

Week 8: Ben

For my final week, I concluded the last of my experiments. I ended cell cultures and threw away leftover supplies that I had. Now, I am waiting for the last of my samples that I submitted for ELISA analysis. My wet lab efforts are now concluded for Immersion. In addition, I attend my last clinic of Immersion. It was pretty routine overall. I got to learn about the different formulations of insulin (short-acting, long-acting, and combination) and the different blood glucose profiles that will benefit from each formulation type. Also, I learned about the different types (or brands) of continuous glucose monitors, their drawbacks, and in what cases they will benefit the patient. I also established my collaboration with the Rafii group, and now we have plans to have a meet with their group, me, and my PI in Ithaca to talk specifics about the areas we will collaborate. Overall, Immersion has been a busy, insightful, and productive time. From the 8-weeks I was here, I learned how to isolate islets from mice and perform glucose stimulated insulin secretion, two protocols that will be useful for me moving forward with my PhD. In addition, I was able to network and gain collaborators that will expand on my research and give me more resources to work with. I am really going to miss the city and this experience, but I am ready to apply what I learned and execute the various ideas that I have gotten from this summer.

Week 8: Adam

 For the final week of immersion, I was able to start working with some of the multiplexed immunofluorescence data from the run we did last week. It seems that some of the antibodies were not quite at the correct dilution, so we are making some changes to the dilution factors for the panel and we will run the experiment again soon. I am glad that this immersion project will open doors to some new collaborations which will continue after I leave the city. I spent a lot of time on the microtome this week, sectioning more tissue samples for future experiments, which should save me some time down the road. It was also good to get additional practice on the microtome before I leave. I spent all day Wednesday shadowing in the OR, and saw several different procedures, including a brow lift, a skin graft, a mammectomy, and a panniculectomy. The variety of procedures that they see on the plastic surgery service is quite interesting. From some of the procedures we were able to collect some more tissue, and I helped to process this tissue for the biobank. 

Week 8: Allison Goehl

 In my final week of immersion, I spent more time shadowing Dr. Beal, a radiation oncologist specializing in brain cancer and metastases. Some of the patients she met with this week were ones I saw last week, but had since started receiving radiation or received additional fractions. It surprised me how quickly things progress in this field. Patients are sometimes able to start radiation within a week of being seen by Dr. Beal for the first time, and I didn't expect that fast of a turnaround. It was also very interesting to see MRIs of patients before, immediately after, and months after treatment and see how the tumor has changed, and then to see patients in the clinic and hear how their symptoms have changed. I also saw the maps used to plan treatment with either stereotactic radiosurgery or gamma knife surgery, and it is fascinating to see how precise treatment can be. Prior to arriving this summer, I was only familiar with full body radiation, but the techniques used by Dr. Beal can treat tumors deep within the brain without impacting surrounding healthy tissue. I saw multiple patients undergo a simulation, where a mask is made to immobilize the head as they receive radiation and a CT scan is performed so the radiation treatment can be designed. This has been one of my favorite parts of immersion, so I was very happy to spend additional days shadowing Dr. Beal this week.

In the lab, I've been working on data analysis for the five day coculture Eleana and I performed last week with cytotoxic T cells and irradiated glioblastoma and triple negative breast cancer cells. We did not have time to optimize the staining, so some cells are too bright, some are too dim, and some imaging locations are not usable due to the fluorescence obscuring all other details in the area. However, it looks like initially the cancer cell population declined as the T cell population expanded, but over the next few days the cancer cell population grew to overtake the entire area, which was interesting to see.

Week 8: MJ

This week, I continued on analyzing the bulk RNA-sequencing dataset of CD8+ T cells with human STAT3 mutations as a potential model for inclusion body myositis. I added these results to my final immersion presentation, which I presented at our weekly immersion meetings in front of my immersion peers and the immersion grant coordinators/PIs. I also attended the HSS Rheumatology journal club, where Dr. Laura Donlin, who I worked with this summer, presented a paper on how clonal hematopoiesis driven by a mutated form of the gene DNMT3A promotes inflammatory bone loss in both periodontitis and rheumatoid arthritis. This paper is important to the Donlin lab because it provides an excellent example of how somatic mutations may play a role in inflammatory and autoimmune diseases. I also shadowed Dr. David Fernandez in his Rheumatology clinic at HSS. I watched as he saw patients with various autoimmune diseases, including inclusion body myositis, lupus, and spondylitis. 

Week 8: Nina

This week, I watched a living donor liver transplant and went to clinic in Chinatown. For the transplant, the surgery was done robotically using Da Vinci technology. In clinic, I saw a variety of patients ranging from cases of liver cysts, cancer, potential donors, and follow-ups for post-transplant cases. When I went down to the Chinatown clinic, I saw a variety of cancers, some stemming from Hepatitis B infection, and others without. How translation into one's native language can still pose many challenges to the transfer of information. Appointments without translation can happen within about half of the time required for appointments with a translator. There must be gaps and pauses for the information to be relayed in English then translated into the desired language. However, sometimes the patient or physician has direct responses or reactions to the information in real-time. Yet, this must be delayed to give time for translation. The flow of the conversation can be disrupted, which can cause some confusion for the translator and all parties involved. I also learned that patient willingness to accept treatment can be a large cultural gap. In some cultures, traditional methods of healing or treating disease can vary greatly to the standard of care in the US. Therefore, obstacles with implementing prevention or treatment to patients can sometimes be owed to reluctance of treatment or initial diagnosis. As I will be continuing my collaboration with Dr. Samstein throughout my PhD, we will be discussing more details for our perfusion project. I have yet to obtain patient samples, as there are logistical hurdles that come with using patient-derived samples.

Week 8: Brenda

Today marks the last day of the immersion program. On Monday I was at the clinic with Dr. Carli, a bit longer than usual. On Tuesday I gave a talk on the research performed this summer. On Wednesday I spent the whole day in the OR, saw both total knee and hip replacement surgeries. Thursday and Friday I was working in the lab on my pulsatile lavage data. However, the media I was using got infected so all of that data is not useable, but, I did get to use the pulsatile lavage and it was very fun. I learned a lot this summer about osteoarthritis and made new connections with clinicians, assistants, PAs, and the overall community at HSS. However, my time with Dr. Carli does not end here, I will be continuing a side project of my PhD thesis through the T32 NIH Predoctoral fellowship this upcoming academic year looking at hip samples of patients with OA. 

Week 8: Peter

 We've reached the end of immersion. I was able to get results from the pathologist and have made some changes to my image processing to improve my accuracy, but it probably won't achieve a super polished final state. I'll have enough to make the poster and report though so that's good. I saw a couple more robotic surgeries with Dr. Rocca this week including a liver cyst fenestration and a gall bladder removal. The cyst case was super interesting as they drained over 3 liters of fluid. I had no idea that these cysts could get so large. I also got to see Dr. Rocca coaching a resident and fellow through the procedure and how best to use the robot effectively. Seeing the skill disparity between these three different operators was super interesting. Though Dr. Rocca has only been doing robot surgery for five years, he moves so comfortably with the robot. I also got to see the team try out a new tool, the M-close kit, to close the holes in the fascia from the laparoscopic ports. A representative from the company taught the team how to use the device and then they used it on the patient. It seemed to make the closure easier and more consistent but I'd be curious to see how it compares over longer time scales. Does it reduce the rate of hernia? I also had my last day in the Dr. Chandwani's clinic. I got to see the follow up for the patient who'd gotten a whipple. While getting her staples removed, she detailed some of the discomfort she had experienced with the hospital workers after the procedure. She found the large number of unfamiliar nurses frightening especially when they were moving her to a new room. I hadn't really thought of this before, but I wonder if it would be beneficial to have a first nurse, who the patient has already met, introduce the patient to the second nurse when staff needs to change out. This could help to ensure that patient feels like they can trust each person that cares for them. 

Week 8: Wendy Zimmerman

 Last Friday, I watched Dr. Eliasberg performed an ACL reconstruction with a quad tendon, and shoulder stabilization, and a biceps tenodisis. Monday to Wednesday I spent time wrapping up my examination of the pathways of differntially regulated in the old vs young mouse shoulder impingement model using GO and KEGG. Wednesday I shadowed Dr. Rodeo in the clinic and got to see an HA injection into the shoulder for treating arthritis and two knee aspirations. Thursday I attended my last Rodeo lab meeting and shadowed Dr. Ranawat in the OR, where I saw an osteotomy of the femur. Friday, I will be shadowing Dr. Rodeo in the OR one last time. I have really enjoyed getting the opportunity to work with Dr. Rodeo and see all the work that's being done in his lab on tendons. And I have very much appreciated the opportunity to watch procedures in the OR and see how surgeons interact with patients and decided on recommending treatments.

Week 8: Anuj

 This was the last week of the Summer Immersion 2025, and I worked to document a report on the "Wide-view cystoscopy" project. This included key design aspects, quantified results on size fits, catheter draining tests, and some image stitching algorithms, and why they would be relevant for this project. We also talked to Cornell Licensing Tech officers to finalize the next steps which I will be working on for the next few weeks. It will be exciting to build a better prototype of this imaging system back in Ithaca, as I will have access to wider resources (technical lab space + Cornell NanoScale Facility). 

Reflecting on the past 8 weeks, it has been quite a bit of learning, especially on what goes on the patient care end. This includes patient consultation, diagnosis, surgeries, and post-surgery disease management. The summer immersion program is a rare opportunity for someone with an engineering background to spend time in the diagnosis and operating rooms. This allows us to observe the procedures and protocol, and look at things from an engineering POV on what can be done better. The best part was observing several biomedical tools in action, especially during robotic surgeries. It’s fascinating to think that each of these devices and protocols likely took decades of research and the efforts of hundreds of minds to develop. Seeing them actively in use to save lives makes me appreciate the efforts, time, and dedication put in by medical professionals, engineers, researchers, and policy makers involved in bringing these concepts to reality and in use. 

Week 8: Joe

 The last week of my immersion program was bittersweet. Hamilton and I finished staining the last batch of slides we received from the Histopathology Core. Samples from the two week sacrifice date seemed to display similar trends as the four week samples, with the distal region experiencing more collagen disruption compared to the midsubstance and proximal region. We are seeing disruption to a lesser degree within our sham group, which was injected with saline rather than collagenase. This disruption suggests that the shear stress placed upon the tendon/local cells during injection may play a role in tendon degradation.  

We passed along remaining project details to a fellow student, who will be continuing our histology work. I spent my final day watching more arthroscopic surgery in the OR under Dr. Rodeo, marking the end of an amazing summer. 

Week 8: Hamilton Young

This week, I presented a summary of my summer research, highlighting the progress made in characterizing murine patellar tendinopathy with H&E staining. As a final send-off, I’ve transitioned the remaining experimental work to a fellow lab member and made plans to continue aspects of the project upon returning to Ithaca. I also shadowed Dr. Rodeo in the operating room once more, gaining additional exposure to surgical techniques relevant to my thesis work.

Week 8 — Orren Shachaf

This week, I presented on my summer immersion project at our weekly Clinical Immersion Program meeting. Listening to my peers’ presentations during this week’s and last week’s meeting was very exciting, as I knew about the projects of HSS students—everyone had a wonderful experience and did great work! On Tuesday, I shadowed a new-to-me clinician, Dr. Melanie Smith, who is both a researcher investigating immune cells in inflammatory arthritis and a rheumatologist specializing in the treatment of patients with inflammatory arthritis. Although my shadowing of Dr. Smith was limited, as she only sees patients once per week from the morning until noon, I had a wonderful experience chatting with her, as I am extremely interested in the immune system, and learning more about the symptomatic differences between inflammatory and mechanically-driven arthritis. For example, while osteoarthritis patients typically describe a morning stiffness which limits their mobility to under 30 minutes, rheumatoid arthritis patients typically describe a morning stiffness which limits their mobility to over an hour. Regarding my research project, I performed more immunohistochemistry this week, tweaking the incubation period of the DAB peroxidase substrate, which imbues the sections with their brown color; this incubation is extremely finicky and has been non-specifically staining areas of muscle; the development of this protocol has reminded me the reasons why researchers are not fond of immunohistochemistry, since there are so many points of failure making the process difficult to debug. I also imaged the slides using the ZEISS Axioscan 7 (slide scanner). Although I am going home to Ithaca this week, which I am super excited for, I am really happy with the outcomes of this summer—I will be continuing this project throughout at least the next year, which is extremely exciting, as it fit right into the project I was hoping to pursue when I joined my home lab at Cornell (the van der Meulen Lab).

Week 7 - Kirtana

 This week I completed my final immersion presentation for the lung cancer feedback and received good feedback that will help guide my study further. The discussion primarily revolved around determining the impact of this work - not just in India but also in the United States. I believe this will be very helpful when I am writing up my paper. I also got feedback about considering statistical methods for my model instead of machine learning methods. I had discussed area under the operating curve metrics (AUC) which are traditionally used for machine learning models. However, after the presentation and feedback, I realized that simpler models such as logistical regression models may be a better extension to the PLCO model and reflect lung cancer incidence in India more accurately. 

With Dr. Prince, my clinical mentor, I worked on doing some more image segmentation and marking the gluteus maximus on all MRIs. This will now be used to improve the training of the AI model and use it to recognize features that were not previously recognisable. 

Week 7 Meichi

This week, I completed my immersion research presentation and received enlightening feedback. It was a special experience to share my work and receive insights that will help refine my approach moving forward. Additionally, it was fascinating to learn about the immersion research projects of my peers and how they are collaborating with clinicians. Observing these different projects gave me a deeper understanding of the diverse ways in which engineers can contribute to clinical practice. The research aspect of the immersion is enjoyable and meaningful to me. It has been eye-opening to think about how our research can be directly applied to clinical needs, and it reinforced the importance of aligning our work with real-world healthcare challenges. 

Week 7 Anuj

 This week involved compiling and testing code for various image stitching algorithms, which is a downstream part of the wide-view scope imaging system. Once the images are acquired continuously as the camera moves, several images contain overlapped spatial regions. We want to make sure all the points in these images are analyzed and mapped to a final wide 2D image. This includes recognizing different features of these images, especially the new unique features and the same features. Once recognized, the spatial data of these features is used for continuous panoramic stitching. Other than this, I also had some discussions about cystoscopy with some of the Urology residents and learned more about how the manual scanning is performed within the bladder. Overall, this gave some important insights on how we can later automate the image capturing process to further reduce the human error of missing spots within the bladder during the cystoscopy process. There are some final (hopefully) parts being printed over the weekend, and I am excited to test these for the next week, which is also our last week here in NYC. 

Week 7 - Aidan

This weeks research was largely spent reading on magnetogenetics, consolidating what I've learned this summer from the Kaplitt Lab, and preparing for the presentation. Magnetogenetic treatments are typically a virally delivered protein that enables the stimulation or inhibition of nerves via external magnetic fields. A primary application of magnetogenetics is for pain treatment. Determining the efficacy of magnetogenetic treatments for chronic pain (CP) and spinal chord injury (SCI) models can currently only be studied indirectly in vivo. The Kaplitt Lab uses ferritin-TRPV1 transmembrane constructs that are hypothesized to open in response to external magnetic fields, enabling either an excitatory or inhibitory ion flow depending on the construct. The exact mechanism by which the channels open in response to the magnetic field are not known (though a few are hypothesized), which complicates the behavioral testing protocols, as certain magnetic devices may not stimulate via each mechanism equally. To test the efficacy for SCI models, we use place-preference and Von Frey (sensitivity) tests on mice. Prior attempts at place-preference testing using an acrylic behavioral chamber with an array of magnets demonstrated a preference for the non-magnetic side of the chamber by heatmap in all experimental groups. Our hypothesis, since there is no mechanism we are aware of for the magnetic field to negatively affect the mice, is that the sensation of the exposed magnets was unpleasant, and the field may have been too weak and non-uniform. The Halbach array device I have built will be used to repeat this testing, with a stronger and more uniform field. Additionally, we will cover the entire behavioral chamber in parafilm, so that a preference for flooring material does not impact the place-preference testing. We expect to see a preference for the magnetic half of the chamber in mice with SCI and ferritin-TRPV1, but no spatial preference in any of the other experimental groups.

Week 7 -Zuzanna

This week I went to clinic and saw a couple of patients, mainly some people in remission, so it was nice to see how happy they were and some discussed how much cancer changed their outlook on life. I also saw a few brain surgeries, specifically with the removal of tumors. I saw the endoscopic removal of of a brain tumor through the nose, in which they drill through all the cartilage in the nostrils and go up in to quite quickly pull out the tumor. I also saw an open brain surgery, in which they removed part of the skull and took out the tumor from the brain. I thought the tumor would be removed as an entire tumor, like in previous surgeries I saw in breast or kidney cases, but here they actually dug out pieces of it as it was so big and difficult to separate from the vasculature easily within the brain. The patient will still need further types of therapy as they are unable to easily and definitely remove all of the tumor here and just confirm removal through pathological analysis, since it is more sensitive to remove excess brain tissue on edges of a tumor, compared to the other tissues. I learned a lot about the variety of approaches in treating and removing these tumors through watching the different tissue type cases, and it is very applicable to understanding my research area.

Week 7 : Adil

This week was heavy on the research side and training/didactic sessions. I started with the downstream analysis of selected RNA seq datasets from the ICSBCS samples. I spent sometime setting up a pipeline to run the deconvolution package on the RNA data using the docker image we got access to last week. We also got the scRNA and TCRseq data back from the core facility for the first trovo pooled sample. I have completed analyzing the single cell data and plan to work on the TCRseq data next week. Looking forward to results from this analysis!. Apart from research, I attended many meetings and didactic sessions this week. This week's MDC tumor board was interesting. Most of Dr. Newman's cases were discussed with the medical oncology team to decide whether to include surgery in their treatment plans or not. Later in the week I attended the 16th ICSBCS Didactic Lecture by Ms. Jennifer Dent from BIO Ventures for Global Health (BVGH). Ms. Dent spoke about BVGH's efforts towards cancer care in African countries through the African Access Initiative (AAI). Ms. Dent highlighted several programs and projects by BVGH which include technology transfer initiatives and efforts to educate, train medical professionals in African countries. Lastly, I attended a didactic session on Axillary Lymph Node Dissection (ALND) and  sentinel lymph node biopsy procedures by Dr. Newman. She presented results from several clinical trials which, over the years have made the sentinel lymph node biopsy the go to procedure to check for metastatic spread of breast cancer. 

Week 7: Amelia

So far, this summer immersion has definitely been an interesting and eye-opening experience. It's been very cool to see how, though our whole cohort is doing the same immersion program, we are having such unique experiences. I have been spending more time on the research side of things, but still have been able to see a couple of incredible surgeries, and hoping to get to see one more in our last week! In the lab, I think Arina and I have managed to accomplish more than I expected in such a short time. Our cohorts of mice have now all been imaged, so our next steps will be to see what usable data we have, and to tweak our 2p-suite code to ensure the cells are being correctly identified. Arina and I will present about our summer research next Tuesday, so we'll also be spending time preparing for that and running our presentation by the postdoc we've been working with. Hopefully, after we leave in a week, we will be able to keep up to date with how the project progresses for this lab! 

Week 7: Pei Wen

This week began with the shadowing of several hysteroscopy procedures. Many were polypectomies which we were familiar with both in the OR and clinic. The case that surprised me most was the cystectomy for removal of a cyst in the ovaries. The cyst contains many lobules, and Dr. Fenster emphasized the importance of removing all lobules, no matter how small, as the cyst may grow back. The process was also interesting to observe, as it required careful manipulation of the tissues and had me curious on the recovery process of ovarian tissue and function post surgery at the cellular level. This week, I also shadowed Dr. Fenster in the clinic. It was particularly gratifying to be present at some of the post-op appointments, as they were patients as they were patients whose surgeries we had observed in previous weeks; many reported feeling significantly better.

Week 7: Eleana

On Monday, after activating the T-cells over the weekend. The repeat of the co-culture of the experiment was going to begin, however there was a very low viability of the T-cells. Thus, the co-culture experiment was canceled for flow cytometry. Using the cells that were left, a new co-couture experiment imaging the cells using the Incucyte. In this experiment T-cells were restimulated, and co-cultured with irradiated glioblastoma or AT3 breast cancer cells in a special insert we made which separated the cells and when the insert is removed and allows the cells to interact. I stained the cells with two color proliferation dyes that will track the cell’s division’s over time and will fade with subsequent cell generations. We can see these two colors, red and green within the Incucyte. This week, I also gave my presentation to group meeting and spent time analyzing and compiling the flow cytometry data we collected over the past weeks.

Later in the week, we got to shadow Dr. Beal, a brain radiation oncologist. We saw several patients, and observed how Dr. Beal treated and diagnosed them. It was a bitter-sweet experience and it hits close to home. It was a good reminder of why we do the research that we do. To have better patient outcomes and to better other people’s lives. We sat in on several cases, and got to observe the radiation room and learn how the machine works and typical radiation treatments for patients. At the end of the day, we attended a talk on extracellular vesicles that may be a particular mechanism for how metastasis spreads to different parts of the body. The lecture was very insightful, and I learned a lot of a new field of cancer research that is beginning to take shape. At the end of the week, I passaged the cells to prepare them for a repeat of the imaging co-culture experiment. 

Week 7: Arina

This week, we got to listen to the first batch of presentations. It was really cool to learn about others’ projects: while I mainly knew who other people worked with in the clinic, I usually only heard about the clinical side of their experience in casual conversation. Many people did really exciting work! My presentation is scheduled for next week, so I am still working on it. 

In lab, this week we finished imaging, which means we can now transition into tissue work and analysis. I did some slicing of brain tissue from the cohort of mice we finished imaging last week, as well as made slides. I also got to shadow a couple of perfusions… but decided not to do any myself: we didn’t have any practice mice in this cohort, and my experience with perfusions is very limited, so I was worried about not being able to deliver a result that would be usable for our project. I also did more head plate surgeries for another project in the lab that Amelia and I were helping with.  

Week 7: Anais

 This week, I observed several more hysteroscopies.  It was interesting to see how much cases could vary.  There were two cases in particular, where the doctors had trouble entering through the cervix.  In one of these cases, they had to find the cavity through ultrasound imaging.  In the other, scar tissue seemed to cover the opening, but they were still able to get biopsy samples.  Another case I saw this week was an IUD fragment removal, except they found the fragment was no longer there.  Furthermore, I also observed an ovarian cyst removal, which I had not seen before.  This case was particularly interesting since they had to be very delicate in order to avoid popping the cyst.  This week I also worked on my final presentation for summer immersion and presented it on Tuesday.

Week 7: Adam

 This week was heavy in the OR and in the clinic. I saw a few different types of chronic wounds, which provided an interesting learning opportunity to look at the stages of healing, and look at how the body adapts and responds to chronic injury. I also learned a lot about wound cleaning, debridement, and maintenance. Some of the chronic wounds required skin grafts, so I got another chance to see dermal templates used in the OR. One thing I noticed was that for more invasive surgeries such as the spinal surgeries that I saw this week, while the team is able to close the surgical site in layers from the inside out in order to minimize the scar and promote healing, the wound still takes a very long time to close and often results in a contour deformity even after it is fully healed. I wonder if it would be possible to make implants similar to a dermal template that are meant for the deeper layers below the dermis in order to promote healing. In the lab, I learned some more data analysis techniques for multiplexed immunofluorescence imaging, and started my first antibody optimization experiment. 

Week 7: Teagan

This week, I saw a couple of new surgeries! One of them was a bilateral knee replacement. Dr. Bostrom does not typically do bilateral knee replacements since the recovery process is slightly more difficult, as you are tasked with rehabilitating two knees at once. Still, this patient was willing to take on this challenge. It was interesting to see how the team handled the case, focusing on one knee at a time; however, the most intriguing part of the process was when they were opening up the second knee while suturing the first. The surgical techs had to be focused and ready to hand off equipment to both teams. I also had the opportunity to watch a couple of shoulder replacements with Dr. Laura Moore, a sports medicine surgeon at HSS. I got to see two approaches to shoulder replacement, anatomical and reverse. Anatomical is used when the rotator cuff is intact and able to provide the necessary support, while reverse is used when there is rotator cuff damage, reversing the position of the ball and socket. Another new aspect of HSS I had the opportunity to explore was the Biomechanics Department. I was able to get a tour of the Biomechanics facilities from Dr. Tim Wright and learn about the work they do with the implants recovered from revision surgeries. 

In terms of my research project, I was also able to make substantial progress. From the design editing I did last week, I was able to print the two new designs I had made on the Ultimaker printer and Faxitron image on them with amputated mice. These designs did much better than the first device I had made; the components were more appropriate in dimension, reaching the limbs of the female mice. We changed the imaging approach for the amputated leg. Instead of trying to bend the nub at the knee joint, we decided to leave the leg outstretched, and this helped increase the consistency of imaging and made the mouse easier to load in the device. I will iterate the device one more time to create a divet where the mouse body sits to prevent the mouse from rotating as easily when positioning on the plastic, as well as brainstorm ways to prevent the amputated mouse limb from rising up from the base when imaging. 

Week 7: Allison

 This week, we were going to set up another coculture experiment to see if different activation methods could be used to overcome radiation-induced exhaustion of T cells, and we were going to add triple negative breast cancer cells to the coculture setup along with the glioblastoma cells we used in our previous experiment. We set up the experiment last Friday so the T cells would be activated on Monday, but when we were counting the T cells on Monday, we found that most had died, and the surviving cells did not appear to be activated. We had to pivot our experimental plan, and ended up culturing the surviving T cells in media with stimulatory cytokines for a few extra days to encourage proliferation. We ended up with enough T cells to set up a small, imaging-based coculture experiment that is ongoing and will end on Monday. While we won't be able to perform flow cytometry as originally planned, we stained the T cells and cancer cells and will be able to track differences in cell proliferation and interaction over the 5 day coculture using an Incucyte that will capture images every 3 hours.

I was also able to shadow Dr. Kathryn Beal this week, who is a radiation oncologist specializing in brain cancers and metastases. I saw her meet with several patients, ranging from diagnosis and radiosurgery planning, to radiosurgery followup appointments, and check-ins to discuss MRI results. It was very eye-opening to be on this side of patient care, as I've spent most of my summer shadowing in pathology. Being in the room with patients and seeing symptoms of the cancer and treatments firsthand was definitely an experience I'll remember, and the patient experience during treatment will be at the forefront of my mind when I return to Ithaca and resume my research on new immunotherapy treatments. I toured the rooms where radiosurgery is performed, and it was very cool to see the machines used on actual patients after seeing many mice with glioblastoma irradiated over the past several weeks. I will be shadowing Dr. Beal again next week, and I am very excited to see more patient-facing care.

Week 7: Nina

This week, I shadowed Dr. Samstein in clinic and continued literature review to prepare for future experiments. I learned about some of the many challenges of treating and diagnosing different types of liver cancers. Liver cancer can either be the liver tissue itself or from the bile ducts. Hepatocytes, which make up a bulk of the liver volume, and cholangiocytes, which line the bile ducts, can become cancerous without any family history or genetic dispositions to disease. Therefore, treatment and diagnosis often come from routine CT scans that detect cancerous lesions. While Dr. Samstein is a liver transplant surgeon, many of his cases are not specifically related to a transplant surgery. Often, many patients need resections of cysts and tumors or biopsies to confirm a prognosis of cancer. Even with the confirmation of cancer from laboratory testing, another obstacle is being able to transmit the severity and importance of this information to patients coming from varying cultural backgrounds. While translation services are used for many patients, sometimes it can be difficult for patients to even make their appointments due to difficulties in transportation and or language. For patients residing in other boroughs, making the trip to the UES can be a challenge in itself. Therefore, treatment can sometimes be delayed due to noncompliance for routine visits. Seeing a variety of patients with different types of cancers that have no cure made me really internalize the importance of discovery and identification of markers and risk factors for developing rare liver diseases. The translation of this knowledge to the public and increasing medical literacy should also remain a top priority with scientific innovation. As my summer research project will be continued as a collaboration for at least the next four years, I have been focusing on making a comprehensive literature review to couple my research. Since liver perfusion has been done experimentally in rats and in clinical practice with human livers, it is vital to understand the differences and similarities between each methodology. 

Week 7: Ben

 This week, I continued to work on my islet reaggregation experiment, where I recombine disassociated islets with different amounts of human umbilical vein endothelial cells (HUVECs). Specifically, I combined 1 IEQ (islet equivalent, approx. 1000 cells) with 0, 100, 150, or 200 HUVECs as literature reports that islets are comprised of about 10-20% of endothelial cells in number. I put these cell suspensions in a V-bottom 96-well plate where they will reaggregate in the bottom. This was set up last week, and I let the spheroid formation occur over the weekend. However, when I came into lab on Monday to check on them, I found that they did not form into spheroids properly. Reflecting on it, I realized that I forgot a coating step in which I incubate the plate with a ultra-low adhesion solution that prevents cells from adhering to the well, which is the reason that the spheroid did not form properly. Either way, I moved forward with my plan to run glucose stimulated insulin secretion (GSIS), as this assay will be used to test my original hypothesis: that more blood vessels leads to increased insulin secretion. Even though spheroids did not form, there is value to running GSIS on what is essentially a 2D co-culture, as I can check if there are any secretome interactions between the two versus matrix interactions which was what I was originally aiming for. With this, I ran GSIS, which entails a 1hr starvation period, a 30 min low glucose stimulation period (3mM), a 30 min high glucose stimulation period (20mM), and a lysis period which released all insulin in the intracellular granules. In the low, high, and lysis steps, I collected the media for analysis on an insulin ELISA to measure the total insulin secreted in these steps. Comparing insulin secretion in these steps between by different HUVEC density groups will give me hints in how islets and endothelial cells interact. Hopefully, I will have this data before my presentation next Tuesday.

In addition, I followed my clinician Dr. Alonso to her clinic. This clinic was interesting because there were a lot of cases in which patients had type 1 diabetes but also were going through pregnancies. It was really interesting to see how diabetes management and care is different and so much involved and crucial in these cases, as extra precaution is needed to manage blood glucose. What was fascinating about these cases was learning the biology from Dr. Alonso about how the pancreatic islets adapt to increasing nutrient uptake and metabolism to help the fetus grow.

Moving towards next week, I will wrap up my lab experiments, attend one more clinic, and get ready to head back to Ithaca. This summer experience has been eventful and eye-opening, and I definitely have many ideas to apply to my thesis work. I cannot believe Immersion is almost over!

Week 7: Brenda

 This week I spent one day at the clinic, two days at the OR, and the rest working on my research project. This week at the clinic I learned more about the requirements necessary for having replacement surgery. Things like having a BMI lower than 40 being recommended so no complications occur such as cardiovascular, lungs, blood clots, etc. I also learned how to identify implants that have osteointegrated to the native bone or when it moved (subsidence). Dr. Carli also had a patient who received a total replacement surgery from China and I got to see the differences between US implants, they are very different aesthetically. I went to the OR both Tuesday and Wednesday and got to see revision surgeries, mostly from infections. Most of the surgeries I saw were on placing antibiotic spacers of the knee, and one surgery involved a removal of the total knee implant and insertion of a new one. On Wednesday I was shadowing both total hip and knee replacement surgeries. 

For the rest of the week I have been working on collecting experimental data for my research project this summer. The data this week looks great, it seems like the biofilm produced by E. coli was not affected by the mechanical techniques we are applying to remove it. Very interesting! I am currently looking at literature to see if there's some sort of explanation for this. I added some pictures of dilutions and you can see how the bacteria decreases as the dilution increases. 

Week 7: MJ

This week, I went to our weekly immersion meetings, where fellow students presented the research and shadowing that they have been doing this summer at the hospitals. I also attended HSS Research-in-progress talk, where a post-doc presented her work on how the activation of hedgehog and RAS-ERK signaling pathways in fibroadipogenic progenitors causes fracture nonunion. I then attended the  Rheumatology department journal club, where two different Rheumatologists presented papers in their field. As for my research project, I continued to analyze the bulk RNA-sequencing dataset that I have been working on. This dataset is from mouse CD8+ T cells with a human version of STAT3 knocked-in to make the data more relevant to the human pathology of IBM (inclusion body myositis). The STAT3 knocked-in also have specific mutations, both from literature and from actual IBM patients. I seek to understand whether these mutations incur an advantage for CD8+ T cells, which have a greater proportion than CD4+ T cells in IBM patients and may cause some of the IBM pathology. I continued to analyzed this dataset and add the data to my own immersion presentation next week. This week, I also shadowed Dr. Fernandez as he treated patients with various forms of myositis and Lupus.

Week 7: Peter

 Lab work was pretty slow this week but with the assistance of Dr. Min, I should have a lead on a pathologist to look over my results. I was able to watch some interesting surgeries this week. Wednesday morning, Dr. Chandwani was doing a robotic surgery to resect the tail of the pancreas where a tumor was present. Something I found interesting with this procedure was that he used the robot to clear a path to the pancreas and position it well but then he left the console and inserted a laparoscopic stapler through the umbilical port to actually make the cut. The intermixing of old and new technology seems to demonstrate that the robotic surgery still has room for improvement. Following this case, Dr. Chandwani was following up on an endoscopic ampullectomy case performed by another doctor. The patient's blood pressure had dropped severely so there was fear of sepsis with concerns of a perforation in the duodenum. Dr. Chandwani opened the patients abdomen and aspirated out nearly a liter of murky biliary fluid. However, upon a wash out of the cavity no leak could be detected. They then administered about 250 mL of diluted methylene blue through the NG tube to see if the leak could be detected. No blue was found to be leaking out so they called in the endoscopy doctor from before to discuss the results before closing the patient up. The doctor decided that he wanted throw the endoscope in to see if he could find anything internally. The duodenum was full of blood to the point that the scope couldn't effectively visualize the walls to find the source. Dr. Chandwani decided to cut into the duodenum to see what he could see. He was greeted by a stream of blood and promptly plugged the hole with his finger. After holding pressure for several minutes, the blood stream began to slow but the stomach was so distended with blood and air that it impeded his ability to stitch the duodenum closed. Suction from both the NG and the endoscope failed to clear out the stomach so Dr. Chandwani ended up making an incision to relieve the pressure in the stomach. This then allowed him to close to duodenum, but he was still left with an issue; he had no idea where the bleed was coming from. Short of removing the entire duodenum, he was out of options so he sent the patient to interventional radiology. However, to transport the patient, the abdomen needed to be temporarily closed using an Abthera, which is like a vacuum sealer for large wounds. IR was able to successfully embolize the bleed and the patient didn't require any further transfusions and got closed up on Friday.

Week 7: Wendy Zimmerman

 This week I finished isolating RNA from a laxity study performed to assess it in PTOA development after ACL transaction and reconstruction. I performed the isolations on Monday and Thursday, and created a document detailing the sample names and Nanodrop measurements. Tuesday I used Enrichr-KG to further analyze the differentially expressed pathways between young and old mice that underwent sham and subacromial impingment surgeries. Wednesday I shadowed Dr. Eliasberg in the clinic again, and got the opportunity to ask many questions about treatment methods. Today, Friday, I will be shadowing Dr. Eliasberg in the OR. Next week, I will be wrapping up my research project and shadowing in the clinic and OR one last time.

Week 7: Hamilton

This week, I received improved histological sections that more accurately captured the patellar region of interest. I completed training in both imaging and analysis techniques, and I plan to image the samples early next week to prepare for the upcoming presentation. I also continued working on the presentation's content.

Clinically, I was able to shadow Dr. Rodeo in the clinic for the first time this summer. I was particularly impressed by his ability to manage multiple patients simultaneously while maintaining clarity, empathy, and efficiency in each interaction. I was able to see a variety of cases within this short time, and was excited to see each case through.

Week 7: Joe

 We received our patellar tendon samples back from the Histopathology Core on Monday, which Hamilton and I imaged before progressing to an H&E stain. After scanning the slides post H&E, Hamilton and I familiarized ourselves with the tendon extracellular matrix grading system (The Movin Score) developed by Wu et al. in 2011. The grading scale goes through many different criteria for a comprehensive analysis of tendon health. The collagen fibers that compose tendon are evaluated based on structure and alignment, while local tenocyte properties such as cellularity and circularity are also taken into account. 

The majority of our work this week and moving forward will be recapturing some higher focus images at the proximal, midsubstance, and distal regions of the patellar tendon. Each image will be assigned a Movin Score, which can be compared across timepoints to determine the long-term effects of collagenase-induced tendinopathy. 

Wu et al. 2011: https://link.springer.com/article/10.1007/s00402-010-1157-5  

Week 7: Orren Shachaf

This week, I had the opportunity to observe Dr. Mathias Bostrom perform a total knee replacement, which was completed in under an hour! I am not familiar with the timing of open surgery outside of the open shoulder surgeries I have observed with Dr. Laura Moore—which take about three hours—but this seemed extremely fast. Additionally, I observed both open and arthroscopic shoulder surgeries with Dr. Laura Moore operating. Most of my week was taken up with immunohistochemistry—including the multi-day process of staining histological samples and imaging the resulting slides with the ZEISS Axioscan 7 (slide scanner). Because Dr. Moore’s lab is relatively new, the majority of my research work this summer has focused on optimizing an immunohistochemistry protocol—taken from my home lab at Cornell—for use with uPAR (a marker of senescence). While the staining has been successful in that there is definitely positive staining present, there is some non-specific binding occurring, which is a typical occurrence for DAB peroxidase (the colored aspect of this particular staining process), so this week has been focused on finding the correct incubation period for this specific step of the staining protocol. Lastly, I have been working on my final presentation for the immersion term, since I will be presenting next week—I’m excited for the program to come to a close, since I miss Ithaca, but I’ll definitely be sad to leave NYC and HSS.

Week 6: Arina

 This week, we did more 2p imaging on the rest of mice we were using for our project. Most of them looked quite good - some still had some gliosis which obstructed the view somewhat, but, even in those cases, we still managed to get signal! In addition, this week we were also doing more surgeries for another project taking place in the lab. The surgeries were simpler than the ones we were doing for our project, since they did not include any window installations - just the headplates. We had a total of 30 mice to get through; some of them, unfortunately, ripped the headplates off, so I would have to redo them in case we got more mice to work with. 

On the clinical side, this week I got to see a pump installation. To be entirely honest, the process was quite gruesome - I've never seen a surgery like this before, and the process seemed intimidating to say the least. It included opening up the incision in the spine area and threating the catheter along the ribs. For this surgery, since imaging was involved, we had to wear protective vests - it's striking just how heavy they are when worn for a prolonged period of time, and I genuinely cannot imagine performing a surgery while wearing one. It reminded me of a project I saw during my time as a TA for a BME design seminar this past spring, where the team was aiming to reduce the load on the shoulders and spine that comes from wearing similar vests. I get it now!

Week 6: Ben

To start of Week 6 of Immersion term, I continued my time in the bariatric clinic. I observed three hernia repairs and one gastric sleeve. The gastric sleeve surgery was pretty standard, but the hernia repairs were different in severity and location, and it was interesting to see the decisions that were being made in regards to how to approach the surgery and prevent its recurrence. 

The following days were spent practicing the islet isolation protocol from mice. I was given 5 practice mice that were euthanized by the graduate student I am working with. The whole process entails cutting to the mice abdomen, identifying the common bile duct, clamping the area where the common bile duct meets the small intestine, and inserting a needle to the duct and injecting in collagenase to digest the pancreas. The biggest challenges were identifying the area in which the duct meets the small intestine, and inserting the needle to the common bile duct in a way in which the collagenase actually flows into the pancreas. Over time and more repetition, I was improving and perfusing the pancreas more and more. Overall, the practice runs were successful.

The next day, I did the protocol on WT mice donated to me by the Alonso lab. With these mice, I intended to isolate islets, disassociate them, and reaggregate them with different amounts of HUVECs and run glucose stimulated insulin secretion (GSIS) to compare insulin secretion capacity between the groups. I was able to successfully isolate the islets from the two WT mice I was given, so I feel very confident in doing the protocol, and feel like I can definitely bring this procedure back to Ithaca so I can perform it by myself. After, I reaggregated the islets in a 0:100, 10:100, 15:100, and 20:100 HUVEC to islet ratio in a V-bottom 96-well plate. I am going to culture these aggregates over the weekend and run GSIS early next week, collect the media, and run an ELISA to compare the insulin secretion response.

Week 6: Kirtana

 This week I primarily worked on the lung cancer research project and making my slides for the final presentation next week. I calculated the risk index using the PLCO method and found out that it did not match the incidence directly, as we had hypothesized. This was an interesting finding as we can now work on refitting the model based on India-specific factors.

I started working on my slides for the final presentation. Even though the final refitted model is not developed yet, I am planning on presenting the PLCO vs lung cancer incidence data. I further learnt how to use GIS to make my maps and I am looking forward to presenting my work from the summer next week. 

Week 6 : Adil

This week I continued working with the ICSBCS sequencing datasets. We also got access to the docker image of the deconvolution package we plan to use for immune cell fraction analysis. We still have few WGS and RNAseq datasets to analyze. We shortlisted a few samples which have both WGS and RNA datasets for own downstream analyses. We are also interested to integrate H&E stained image data in our data analysis. So I spent sometime with Dr. Newman's group members trying to identify the samples which already have H&E data and samples for which we need to capture the H&E images. On the experimental front we are trying to collect more samples to run trovo experiments wherein we capture, isolate and culture T cells and tumor cells. We then run sequencing experiments to understand T cell activity in these samples (the TCR seq library we submitted for sequencing a few days back is also a part of this analysis). Overall it was a heavy week in the lab!

Week 6: Pei Wen

On Monday, Anais and I observed Dr. Fenster performing several laparoscopic polypectomies and myomectomies in the OR. It has been a while since we saw these procedures and were reminded how quick each case took. Compared to the polypectomies done in the clinic, I can understand why some patients would choose to have it done in the OR with anesthesia compared to the availability and accessibility offered by the clinic. In most cases where polypectomies were done in the clinics, patients often felt discomfort and pain despite the administration of a nerve blocker. Moreover, it seems that the resolution and visibility with the equipment in the clinic was lower than that in the OR. At the same time, for other patients, having the procedure done in the clinic is optimal as it is quick and recovery time is significantly less. On Tuesday, we presented our findings in the methodology and pelvic pain neuromodulation to Dr. Fenster and Dr. Wolf. I find these presentations and literature reviews to be helpful and informative in learning about the technology and extent of our knowledge in women’s health research broadly. We concluded the week by working on our final presentation for the summer immersion program and shadowing more surgeries.

Week 6-Meichi

This week, I dedicated my time to working on my immersion research project. As the immersion program draws to a close, I find myself reflecting on the incredible journey I've had over the past weeks. This experience has been an opportunity for me to learn and grow, both personally and professionally. I feel I have gained a deeper understanding of the intersection between clinical practice and engineering, and how the two fields can collaborate to improve patient care.

One of the most valuable aspects of this immersion was the chance to observe and understand how clinicians work on a day-to-day basis. It was fascinating to see the tools and technologies that doctors use to assist in surgeries and decision-making processes. From tumor localization techniques to surgical planning tools, it was inspiring to witness firsthand how these innovations directly contribute to improving patient outcomes. This exposure has made me realize just how essential it is for engineers to think about the practical applications of their work in a clinical setting. Understanding the challenges and needs of clinicians can lead to the development of technologies that truly make a difference in patient care.

In addition to observing the technical aspects, I also learned a great deal about the human side of medicine. It was enlightening to see how breast cancer surgeries are performed and how clinicians explain treatment options to patients. I was particularly moved by how doctors take the time to walk patients through their surgery and treatment options, discussing the pros and cons of each. I also gained a better understanding of how multidisciplinary teams collaborate to make informed decisions about the best course of action for each patient. This collaborative approach emphasizes the importance of clear communication, empathy, and shared decision-making in healthcare.

Week 6- Zuzanna

This week in the clinic I saw some patient that I had seen previously that were following up on their consultations and coming in for treatments, so it is interesting to see the process of cancer treatments and observe the patient's journeys, from starting treatment and also following up on just how they are feeling post-treatments- one patient had to pause treatment for a while as chemo was causing too much exhaustion. In the OR I observed a bladder resection and reconstruction, and I think that was the most complex surgery I have thus far seen. The patient had been on chemo for bladder cancer and as a precautionary measure it is standard to follow with the removal of the bladder- I had heard of this in clinic but many patients receive a bag in place of the bladder- I did not realize they can also construct a new bladder using the colon and appendix. First they robotically removed the bladder, and then cut open into the patient to construct another bladder. There was a lot of moving parts- simply put, they cut the colon in half and attach part of it to the appendix, while repositioning the urethra there and sewing the remaining colon back to allow it to function properly.

In lab I have been do some more image analysis on some cocultured methods for organoids, and trying light sheet microscopy to image those organoids.

Week 6: Teagan

This week was well balanced between OR, clinic, and research experiences. I spent both Monday and Wednesday in the OR watching hip and knee replacement surgeries. However, some cases this week were slightly different than those in previous weeks. I observed a case involving the removal of previously installed and unrelated hardware before the total knee replacement, and saw how they dealt with the extra factors due to this hardware. Additionally, I observed a surgery on a woman with underlying conditions that made her joints particularly stiff and how they navigated that environment differently than those in people who have typical joint environments. The last new thing I observed in the OR was a patella resurfacing, which is a type of knee revision surgery that involves only altering the patella button of the implant. The importance of this type of revision is in removing excess discomfort from movements like walking up stairs. It's fascinating to see the impact that such a small component can have on the overall success of a joint replacement! 

On Tuesday, I went to the clinic, where most of the appointments were follow-ups. In these appointments, Dr. Bostrom assesses the patient's joint flexion, extension, and overall ease of movement. There is a variation in results dependent on how well the patients are adhering to the rehabilitation plans. Thursday and Friday were spent researching; I added the edits I had previously discussed to my 3D printed device, adding more femur support and moving components further up the board to fit the dimensions of female mice. Lastly, on Friday, I also attended a presentation by the HSS Biomechanics department titled: "Quantitative Knee Laxity Post TKA and its relation to Patient Reported Outcomes". This presentation was very insightful for determining the correlation between patient-reported outcomes in PROM questionnaires with actual laxity in the implanted joint. 

Week 6: Anais

On Monday I observed several hysteroscopies. After having observed the myomectamies and hysterectomies over the past few weeks, I was now able to appreciate the simplicity of the hysteroscopy compared to when I had first seen the surgery.  I was also able to observe how shaggy the endometrium gets during menstruation compared to patients that were not menstruating, as Dr. Fenster pointed out.  Though this makes sense, it is still interesting seeing the visual characteristics.  In one of the other cases, the fibroid was in the fundus of the uterus which was apparently harder to get, thus they were not able to get all of the fibroid. I noted how there were some limitations in regards to the device camera and the liquid circulation during the operation.  Another patient had fibroids that had been previously ablated, making the material properties easier to work with.  Apparently based on such observations Dr. Fenster had previously conducted a study and proposed a device that ablated and resected tissue at the same time.  I also attended Dr.Fenster's clinic on Tuesday, which I feel always provides good context for the surgeries we see and how they actually affect people. I was particularly lucky enough to shadow her while she had post-operation conversations with two of the surgeries I had observed in the past few weeks.  I was very glad to be able to see how quick their recovery has been and it was amazing to see how much better they felt after having these fibroids removed.   Pei Wen and I also presented on some studies we had previously found last week in regards to cervical stimulation of contraction.  On Friday, we also got to shadow Dr. Fenster in the OR.  Both surgeries were hysterectomies and ran pretty smoothly.  

Week 6: Hamilton

This week, I continued clinical shadowing with a focus on orthopedic procedures, including meniscectomies and knee reconstructions. These surgeries provided more valuable insight into the structural complexities of the knee joint and the surgical techniques used to restore stability and function. I additionally worked on the powerpoint that will be used in the Tuesday presentation.

On the research side, I resubmitted murine knee samples for a second round of sectioning, as the initial cuts did not adequately capture the region of interest. The new sections will be stained with H&E and analyzed to evaluate the histological progression of tendinopathy in our injury model.