A functional genomics screen identifying blood cell development genes in Drosophila by undergraduates participating in a course-based research experience

Undergraduate students participating in the UCLA Undergraduate Research Consortium for Functional Genomics (URCFG) have conducted a two-phased screen using RNA interference (RNAi) in combination with fluorescent reporter proteins to identify genes important for hematopoiesis in Drosophila. This screen disrupted the function of approximately 3500 genes and identified 137 candidate genes for which loss of function leads to observable changes in the hematopoietic development. Targeting RNAi to maturing, progenitor, and regulatory cell types identified key subsets that either limit or promote blood cell maturation. Bioinformatic analysis reveals gene enrichment in several previously uncharacterized areas, including RNA processing and export and vesicular trafficking. Lastly, the participation of students in this course-based undergraduate research experience (CURE) correlated with increased learning gains across several areas, as well as increased STEM retention, indicating that authentic, student-driven research in the form of a CURE represents an impactful and enriching pedagogical approach.

Timing and Predictors of Subspecialty Career Choice Among Internal Medicine Residents: A Retrospective Cohort Study

BACKGROUND

Internal medicine residents face numerous career options after residency training. Little is known about when residents make their final career choice.

OBJECTIVE

We assessed the timing and predictive factors of final career choices among internal medicine residents at graduation, including demographics, pre-residency career preferences, and rotation scheduling.

METHODS

We conducted a retrospective study of graduates of an academic internal medicine residency program from 2014 to 2017. Main measures included demographics, rotation schedules, and self-reported career choices for residents at 5 time points: recruitment day, immediately after Match Day, end of postgraduate year 1 (PGY-1), end of PGY-2, and at graduation.

RESULTS

Of the 138 residents eligible for the study, 5 were excluded based on participation in a fast-track program for an Accreditation Council for Graduate Medical Education subspecialty fellowship. Among the remaining 133 residents, 48 (36%) pursued general internal medicine fields and 78 (59%) pursued fellowship training. Career choices from recruitment day, Match Day, and PGY-1 were only weakly predictive of the career choice. Many choices demonstrated low concordance throughout training, and general medicine fields (primary care, hospital medicine) were frequently not decided until after PGY-2. Early clinical exposure to subspecialty rotations did not predict final career choice.

CONCLUSIONS

Early career choices before and during residency training may have low predictability toward final career choices upon graduation in internal medicine. These choices may continue to have low predictability beyond PGY-2 for many specialties. Early clinical exposure may not predict final career choice for subspecialties.

Abstract P5-13-10: Recommendations to improve the lived experience of early stage and metastatic breast cancer patients in Canada

Introduction: In 2017, the Canadian Breast Cancer Network (CBCN) undertook two surveys of Canadians who have experienced a breast cancer diagnosis to better understand the lived experience of patients and what opportunities exist to improve support for patients, survivors and their families and minimize the impact of this disease. There were 278 people diagnosed with early stage breast cancer, defined as stage I, II or III for the purpose of this report, and 180 people living with metastatic breast cancer, or stage IV breast cancer, who responded to these surveys.

Results: The survey data shows that while patients feel supported and well cared for in certain aspects there are still significant opportunities for improvement. CBCN has identified five overarching factors that could greatly improve health outcomes and the quality of life of Canadians who experience a breast cancer diagnosis.

1. Improved Educational Resources: The quality and availability of patient education has increased over the past couple of decades; however, there are still some patient friendly educational resources including, specific resources for newly diagnosed metastatic breast cancer patients; decision aids that support breast cancer surgery and post-surgery decisions; navigation of financial resources; treatment timelines and recovery expectations; private insurance navigation and information on dying-well.

2. Increased Access to Treatments: This challenge was specifically identified and vocalized by people living with metastatic breast cancer. Efforts need to continue to shorten the drug approval process time, increase equitable access to new medications for all Canadians, and ensure equitable access for take home oral cancer medications.

3. Increased Access to Information: Information available to patients about their health and treatment has increased; however, there is still information that isn't always communicated to patients that would help them make informed decisions about their health. This includes information about breast density, palliative care options and information around clinical trials.

4. Integrated Systemic Supports: The health care system as a whole is responsible for many of the services and supports that patients need to achieve optimal health and manage their breast cancer; however, these supports can be challenging to navigate and are sometimes lacking. Supports that need to be addressed at a systemic level include developing survivorship care plans for early stage patients, patient navigation, communication tools to support general practitioners during the diagnosis process, access to psychosocial professionals and increased Employment Insurance Sickness Benefits.

5. Increased Awareness and Understanding of Metastatic Breast Cancer: A lack of accurate statistics and overall awareness of metastatic breast cancer makes it challenging to truly understand the impact of this disease and also leaves people living with an incurable form of breast cancer feeling isolated and disconnected. Accurate statistics and increased awareness would help further the understanding of the impact of this stage of breast cancer and better support those with it.

Citation Format: Gordon J, Ammendolea C, Chari N, Armstrong R, Hall W. Recommendations to improve the lived experience of early stage and metastatic breast cancer patients in Canada [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-10.

Financial Resources Digital Navigation Tool for Metastatic Breast Cancer Patients

Background and context: Although Canadians enjoy a universal health care system, there continues to be costs to patients that are not covered by the system. The economic impact of breast cancer is huge and, in many cases, devastating for patients and their families. As a result there is a need for educational and navigational resources that assist patients with the financial burden of facing a metastatic breast cancer diagnosis. Aim: The aim of this project is to develop an online navigation tool that will assist Canadians living with metastatic breast cancer source financial supports and resources to help lessen the financial impact of their diagnosis. Strategy/Tactics: An advisory board of people living with metastatic breast cancer was convened to help guide this project and provide input on the lived experience and financially challenges of Canadians living with this stage of the disease. The input from the advisory board along with the responses from a survey of over 150 Canadian metastatic breast cancer patients informed the type of information that should be included in the resource. Through an environmental scan and research of various financial supports, a comprehensive list of financial resources available locally, regionally and nationally was compiled. This data were integrated into a database that will be accessed through an intuitive online interface that will be integrated with CBCN´s Web site. The advisory board reviewed the draft content and framework to ensure that identified needs and priorities have been addressed. All content was translated into French as this tool will be offered in both French and English. The anticipated launch of this resource is November 2018. Outcomes: CBCN anticipates that over 1200 people living with metastatic breast cancer will access this resource in the first year and that over 50 institutions will be informed that this tool is available for their patients. Given that this will be a unique resource, CBCN expects that patients, health care professionals and support workers will access this resource to better support people living with metastatic breast cancer. What was learned: This resource has not launched, but based on CBCN´s research and the feedback of the patient advisory board, it is understood that there is a great need for this financial resources navigation tool.

Neuroscience step-down unit admission criteria for patients with intracerebral hemorrhage

OBJECTIVES

The goal of our study is to determine optimal criteria which can be used to avoid admission to neuroscience intensive care units for patients with intracerebral hemorrhage (ICH).

PATIENTS AND METHODS

This is a retrospective cohort study of 431 patients with primary ICH from January 2013 to the end of December 2015 and reviewed multiple admitting characteristics. Based on these needs, we tested the following step-down unit admission criteria: Supratentorial ICH, ICH volume <20 cc, no Intraventricular hemorrhage (IVH), systolic BP <200mmHg, no respiratory failure, GCS≥12. We classified 431 patients into two groups; 1-Patients who met step-down unit admission Criteria (71 patients). 2-Patients who didn't meet the criteria (360 patients).

RESULTS

In our patients, 16.5% fulfilled the criteria. Length of stay in the ICU was 1.43days in step-down unit admission criteria patients. None of the patients who fulfilled the criteria were readmitted to the ICU, compared to 3 readmissions among the group of patients who did not fulfill the criteria (P=0.82). None of these patients required a neurosurgical procedure vs 47 patients (10.9%) in the other group (P=0.04). Among patients who met the criteria, 83.1% were discharged home or rehab RR 0.33 CI (0.19-0.55), (P<0.0001).

CONCLUSION

We propose that patients who fulfill step-down unit admission criteria can be safely monitored in stroke unit and they have no need for ICU admission. Further studies are needed to validate these criteria in a prospective manner.

Effect of crude drug combinations on fertility in male albino rats

The extracts of bark, leaves and stem of A. indica, fruits of P. longum, berries of E. officinalis and seeds G. indicum were prepared using different solvents. Six different combinations of these extracts were tried on male albino rats to study their effects on sperm production on histological changes in the tests of the rats here was no significant change in production and viability of sperms. However, the rats treated with combinations I, II and III exhibited histological changes in the seminiferous tubules of testes, due to high degree of testicular edema.

Periodicity of estrous cycle in albino rats; response to some crude drug combinations

The extracts of bark, leaves and stem of A. indica, fruits of P. longum, berries of E. officinalis and seeds of G. indicum were prepared using different solvents. Three different combinations of these extracts were tried on the female albino rats for their effect on the estrous cycle. The combination consisting of alcoholic extracts of leaves and stem of A. indica, fruits of P. longum, berries of E. officinalis and seeds of G. indicum has exhibited considerable effect on estrous cycle by prolongation of diestrous phase.

Anti-ovulayor effect of different crude drug combinations in female albino rats

Three different crude drug combinations viz; the extracts of bark, leaf and stem of A. indica; fruits of P. longum and berries of E. ribes prepared using different solvents were tested for their anti-ovulatory effect in female albino rats. The first and third combinations have shown promising results in terms of prolongation of disastrous phase of estrous cycle.