A Year of Connections

A look back on the Associate Fellowship year

Guest post by the 2016-2017 NLM Associate Fellows.

NLM Associate Fellowship Coordinator Kathel Dunn introduced our program in her post “NLM Associate Fellows Spark Library Alchemy,” speaking to the process of transformation this program can facilitate. As we, the 2016-2017 NLM Associate Fellows, prepare to bid NLM a fond farewell, we would like to share some reflections from our year and how we have been changed by our time here.

From our arrival on September 1, 2016, we knew this year would be different, as we began our fellowship only a few weeks after the arrival of Dr. Patricia Flatley Brennan, NLM’s then recently appointed director. One of our first activities as a cohort was to attend Dr. Brennan’s swearing-in ceremony, and the issues that shaped her first year–strategic planning and envisioning NLM’s future –became threads woven throughout our formative curriculum sessions and have been intertwined with our experiences throughout the program.

The heart of this program resides in the people of NLM and their willingness to share their time and knowledge with us. Throughout the curriculum, and later during the project phase of our year, NLM staff from all levels of the organization made themselves available for conversation, connection, and collaboration. As a result, we were able to build relationships across the Library and see connections and interdependencies across departments.

The capacity for professional relationship building also extends beyond the walls of NLM. Each member of this year’s cohort led a spring project that relied on collaboration with an external partner. Megan Fratta conducted focus groups with cancer researchers across NIH and NCI to assess their PubMed-related training needs. Kendra Godwin interviewed open science policy makers, advocates, and innovators from across the global research community in her efforts to define open science at NLM. Tyler Moses conducted an information needs assessment for the residents of the Children’s Inn, the hospitality house for children and their families who participate in research trials at NIH. And, as part of an interagency collaboration between NLM and the FDA, Candace Norton investigated enhancements to search filters to support pharmacovigilance.

Among the other connections fostered through this program are those between the members of the cohort and NLM’s senior leadership. As a group, we met with each senior leader to discuss what makes NLM unique, what makes an exemplary leader, and how best to prepare for a career in a rapidly evolving profession. Their collective wisdom and insight are invaluable at this stage in our careers.

Perhaps the most important connections are those we’ve formed with each other, thanks to the program’s cohort learning model. We’ve been a fellowship of four, learning more because of each other and the collective insights of our shared experience, and from the conversations this year has inspired. The program under its current name has existed since 1966, and we’ve been impressed with the level of support from the Associate Fellows who preceded us, and the significant contributions they’ve made to the program, to NLM, and to the profession.

As we conclude our fellowship year at NLM and make space for the incoming 2017-2018 cohort’s arrival on September 1, we leave you with our respect and gratitude for making this opportunity possible. Thank you for a fascinating and life-changing year at NLM!

four young women, professional dressed, pose as a group

Guest bloggers (from left) Candace Norton, Megan Fratta, Kendra Godwin, and Tyler Moses served as 2016-2017 NLM Associate Fellows.

What does a glioblastoma look like?

Guest post by James G. Smirniotopoulos, MD, chief editor for MedPix®.

Arizona Senator and former Vietnam POW John McCain was recently diagnosed with the most aggressive form of brain cancer: glioblastoma.  This is the same type of tumor that killed Vice President Joe Biden’s son Beau and Senator Ted Kennedy.

Glioblastoma originates in the brain. It arises from astrocytes,  one of the supporting cells of the brain, and grows by sending tendrils into the surrounding tissue.

Because of its diffuse nature, glioblastoma is not curable. However, surgery to remove as much of the tumor as possible, followed by both radiation and chemotherapy, has improved the prognosis. Median survival rates—which means half the patients live longer and half die sooner—now run 15-18 months, whereas 5-10% of patients live five years following diagnosis. Novel treatments, including immunotherapy, have been effective in some patients.

The symptoms of glioblastoma can vary, depending on the part of the brain in which it occurs. Different parts of the brain perform different functions, so some tumors cause seizures, while others may cause numbness or speech problems. Some of the most common symptoms are:

  • Headaches
  • Nausea and vomiting
  • Changes in your ability to talk, hear, or see
  • Problems with balance or walking
  • Problems with thinking or memory
  • Feeling weak or sleepy
  • Changes in your mood or behavior
  • Seizures

Doctors diagnose glioblastomas and other brain tumors by doing a neurologic exam and tests including an MRI, CT scan, and biopsy.

MedPix®, NLM’s open-access medical image database, includes about 500 images of glioblastomas, largely MR and CT scans, gross photographs, and pathology slides of tumor histology.

For example, the following images show two different glioblastomas. The image on the left is from an MRI (axial, T2-weighted) of Patient A and that on the right is an axial gross cut-section from Patient B. The tumors, outlined in red, show a general similarity in shape and size, and both tumors have distorted the brain and compressed normal structures, like the cerebral ventricles (blue outline) that contain cerebrospinal fluid.

two brain images with the glioblastoma tumors outlined
MedPix images of similar glioblastomas from two different patients show the tumors (outlined in red) pushing on the surrounding tissue and compressing the cerebral ventricles (highlighted in blue).

Launched in 1999, MedPix now holds over 54,000 images from more than 12,000 patients, including unique whole brain sections from the era preceding non-invasive diagnosis using MRI and CT imaging. Designed as a teaching file, the database includes clinical information about each patient, along with their diseases and diagnoses. The medical cases in MedPix have been peer-reviewed and pathologically proven, making them an excellent resource for teaching and learning about disease.

Guest blogger James G. Smirniotopoulos, MD, serves as chief editor for MedPix. Now retired and a special volunteer at NLM, Smirniotopoulos formerly served as a professor and chair of radiology at the Uniformed Services University of the Health Sciences.