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Tag: Boston University School of Medicine

  • From Lecture to Dialogue: How Brief Training Improves Med Students’ Communication

    From Lecture to Dialogue: How Brief Training Improves Med Students’ Communication

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    Newswise — (Boston)—Teaching is an integral communication skill central to the practice of medicine. The art of teaching extends beyond disseminating information. The skill directly translates to health provider-patient communication, the success of which is positively correlated with improved patient outcomes.

     

    “Teaching is a large part of medicine – patient education is critical to providing high quality patient centered care. Education helps patients understand the ‘why’ and ‘what’ of their treatments and allows them to be better participants in their own care, and in shared decision making,” said author Susan White, MD, assistant professor of obstetrics & gynecology at Boston University Chobanian & Avedisian School of Medicine.

     

    In an effort to foster near-peer inter-professional teaching and teamwork, the school has developed a curriculum using medical students as teaching assistants, called Educational Fellows, to work with students studying to become physician assistants (PA).

     

    “Our Educational Fellows curriculum allows medical students to learn the art of teaching (pedagogy) and learning theory and to practice what they had learned in working with PA students in the classroom,” explains White, who also is director of the Physician Assistant  program at the school. “We expect that the Educational Fellow experience will make those medical students better prepared for patient education.”

     

    White and her colleagues present their experiences and lessons learned from establishing this program that 1) introduces select medical students to PA students in the context of a near-peer teaching framework during pre-clinical training; 2) trains the medical students in best practices of teaching and learning; and 3) provides an additional source of instructors for basic science courses.

     

    White believes the program could be modified for other training programs that use peer-peer or near-peer teaching for tutoring or as teaching assistants. For example, PA students might work with students in nursing or physical therapy to provide tutoring or assistance in lab setting, or PhD graduate students might be teaching assistants for undergraduate courses. He hopes that all graduate level programs in medicine will adopt the curriculum to better prepare their graduates to teach and educate their patients, whether it be bedside nurses teaching patients home care skills or surgeons explaining a complex procedure.

     

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  • Researchers uncover head and neck cancer signaling pathway

    Researchers uncover head and neck cancer signaling pathway

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    Newswise — (Boston)—Despite advances in defining the genomic characteristics of head and neck cancers, these malignancies continue to rank among the deadliest cancers with few targeted therapies available. An important challenge in designing effective treatments is intratumor heterogeneity, the presence of multiple subpopulations of cells with distinct genomic and molecular alterations, with some cells inherently more resistant to certain treatments.

    A new study from researchers at Boston University Chobanian & Avedisian School of Medicine applied advanced bioinformatics and machine learning approaches to the analysis of large multi-omics head and neck cancer datasets and found activation of mTORC1 by b-catenin/CBP as an upstream driver of the malignancy-associated partial epithelial-mesenchymal transition (p-EMT) phenotype.

    EMT is a biological process that plays a crucial role in embryonic development, tissue repairand various disease processes, including cancer. In cancer, EMT refers to the conversion of epithelial cells, which are typically found in the outer layers of organs and have strong cell-cell adhesion, into mesenchymal cells, which are more migratory and invasive.

    “This is of particular interest because both mTORC1 and b-cateninare important cancer hallmarks and p-EMT is a cellular process that is an early predictor of nodal metastasis, in which epithelial cells manifest characteristics of mesenchymal cells but do not fully undergo the complete transition,” explained co-corresponding author Stefano Monti, PhD, associate professor of medicine at the School of Medicine.

    According to the researchers, the study aimed to better characterize oral tumor heterogeneity including the aggressive cell subpopulations more likely to drive the early steps in cancer progression and invasiveness, with the ultimate goal of identifying candidate vulnerabilities that could be targeted therapeutically. “Understanding and addressing the diverse characteristics within tumors can help optimize therapeutic strategies, improve treatment outcomes and ultimately enhance patient survival rates,” said Monti.

    This collaborative multi-disciplinary study applied novel computational methods to the analysis of single cell data from primary oral cancer lesions. Findings were first validated in independent multi-omics datasets, including The Cancer Genome Atlas (TCGA) and the Cancer Cell Line Encyclopedia (CCLE), then further validated through functional molecular and pharmacologic perturbations using cell line-based experiments, as well as through pharmacologic perturbation experiments in experimental models.

    The study’s findings are of particularly timely significance, given the increasing evidence pointing to a crucial role of cells with a p-EMT phenotype in tumor progression to advanced disease and provide new information about additional therapeutic targets for this malignancy. In particular, the study’s findings point to the potential of β-catenin/CBP inhibition as a promising head and neck cancer treatment that distinctly targets more aggressive cells with elevated β catenin/CBP activity.

    While this study’s findings focus on head and neck cancer of the oral cavity, the researchers believe they are likely to be relevant to other cancer types, especially those that arise from mucosal tissues that line respiratory, gastrointestinal and genital tracts.

    The co-corresponding authors on this study are BU Chobanian & Avedisian School of Medicine researchers Maria A. Kukuruzinska, PhD, professor of molecular & cell biology; Xaralabos G. Varelas, PhD, professor of biochemistry & cell biology and Eric Reed, PhD, from Tufts University.

    These findings appear online in the journal Translational Research.

    Funding for this study was supported by NIH grants 5 R01 DE030350 (MAK, SM, XV), R01 DE030350 S1 (SM), R01 DE031831 (SM), R01 DE031413 (MVB), ACS Research Scholar Award RSG-17-138-01-CSM (XV), and Eisai Co., Ltd Research Award (MAK).

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  • Review strengthens evidence that repetitive head impacts can cause CTE

    Review strengthens evidence that repetitive head impacts can cause CTE

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    Newswise — (Boston)—During the past 17 years, there has been a remarkable increase in scientific research concerning chronic traumatic encephalopathy (CTE) with researchers at the BU CTE Center at the forefront. While some sports organizations like the National Hockey League and World Rugby still claim their sports do not cause CTE, a new review of the evidence by the world’s leading CTE expert strengthens the case that repetitive head impact (RHI) exposure is the chief risk factor for the condition.

    CTE became national news in the United States in 2007, but it wasn’t until 2016 that the National Institute of Neurological Disorders and Stroke/National Institute of Biomedical Imaging and Bioengineering (NINDS-NIBIB) criteria for the neuropathological diagnosis of CTE were published, and they were refined in 2021. Rare, isolated case studies reporting aberrant findings or using non-accepted diagnostic criteria have been disproportionately emphasized to cast doubt on the connection between RHI and CTE.

    In a review article in the journal Acta Neuropathologica, Ann McKee, MD, chief of neuropathology at VA Boston Healthcare System and director of the BU CTE Center, stresses that now over 600 CTE cases have been published in the literature from multiple international research groups. And of those over 600 cases, 97 percent have confirmed exposure to RHI, primarily through contact and collision sports. CTE has been diagnosed in amateur and professional athletes, including athletes from American, Canadian, and Australian football, rugby union, rugby league, soccer, ice hockey, bull-riding, wrestling, mixed-martial arts, and boxing.

    What’s more, 82 percent (14 of the 17) of the purported CTE cases that occurred in the absence of RHI, where up-to-date criteria were used, the study authors disclosed that families were never asked what sports the decedent played. 

    According to the researchers, despite global efforts to find CTE in the absence of contact sport participation or RHI exposure, it appears to be extraordinarily rare, if it exists at all. “In studies of community brain banks, CTE has been seen in 0 to 3 percent of cases, and where the information is available, positive cases were exposed to brain injuries or RHI. In contrast, CTE is the most common neurodegenerative disease diagnosis in contact and collision sport athletes in brain banks around the world. A strong dose response relationship is perhaps the strongest evidence that RHI is causing CTE in athletes,” she added.

    “The review presents the timeline for the development of neuropathological criteria for the diagnosis of CTE which was begun nearly 100 years ago by pathologist Harrison Martland who introduced the term “punch-drunk” to describe a neurological condition in prizefighters,” explained McKee, corresponding author of the study. The review chronologically describes the multiple studies conducted by independent, international groups investigating different populations that found CTE pathology in individuals with a history of RHI from various sources.”

    CTE is characterized by a distinctive molecular structural configuration of p-tau fibrils that is unlike the changes observed with aging, Alzheimer’s disease, or any other diseases caused by tau protein.

    Funding for this research was provided by the National Institute of Neurological Disorders and Stroke (U54NS115266; R01NS119651; U01 NS 086659), National Institute on Aging (P30AG13846; U19AG06875; R01AG062348; RF1AG057902; K01AG070326), Department of Veterans Affairs (101BX002466, 101BX004613, BX004349), the Nick and Lynn Buoniconti Foundation, Andlinger Foundation, National Football League (NFL) and World Wrestling Entertainment (WWE) through unrestricted gifts, the Mac Parkman Foundation, and the National Operating Committee on Safety for Sports Equipment (NOCSEA).

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