WFU Eye Center

Several Coy C. Carpenter Library employees were mock patients late in the afternoon on Thursday, July 2, 2009 when Kirk Huske of the WFU Eye Center walked the tourists through the Department of Ophthalmology. While waiting, patients can view antique eyeglasses, an old eye exam machine, other antique objects and a historical poster in the lobby area.

The Eye Center moved to the sixth floor of the Richard Janeway Clinical Sciences Tower in September 1990. It has five main patient areas for its seven sub-specialities of: retina (including tumors of), cornea, glaucoma, uveitis (infection), neuro-ophthalmology, ocu-plastics and pediatrics. Other features of the Center include an optical shop and the NC Lions Clinical Research Center that includes two examination rooms for the current 14 clinical trials in session. Academic offices, including space for residents, and a small library/conference room are located within the department.

There is also a separate pediatric patient area where Dr. R. Grey Weaver would speak to the parents in the small waiting area, all the while observing the patient. He then would take the patient to the examination room where special lights and sounds would attract the child's attention so Dr. Weaver could examine the eyes.

Ms. Huske shared several of her experiences as an employee of the Eye Center for 39 years. She started as a technician in glaucoma. Her current and official title is Residency Coordinator but she does many other things, including tours. She also shared knowledge about ophthalmology in general, such as the inside back part of an eye is called the fundus. And that ophthalmology is the only speciality in which a doctor can look inside (via the eye) and see the pathology of the body.

While the CCCL employees did not see inside the body, they did see what some Wake Forest University Baptist Medical Center coworkers do every day.

Center for Biomolecular Imaging

On Thursday, June 11, 2009, five Carpenter Library staff members experienced via computers the Center for Biomolecular Imaging. Computer Programmer Josh Tan shared movies, fly-throughs and his knowledge about imaging computers and scanners for research and patient care.

First, tourists learned about the differences between a CT scan, MRI scan and a PET scan. A CT scan can see the anatomy of a body and the actual scan is fast. A MRI sees soft tissue and takes longer to scan while a PET scan uses radioactivity to see tumors.

Since the Center for Biomolecular Imaging is for research purposes, it has seven scanners for different animals. For example, there is a Micro MRI and PET scanner. The newest technology now allows researchers and clinicians to see 3-D and 4-D images, almost in real time. Picture a loaf of bread as a whole body with each slice of bread representing a cross-sectional/scanned image of the body part/area. The thinner the slice of bread, the easier it is to see a 3-D image.

The neat part of all this is that surgeons can log in to the network and with special computers located in the real operating room, the surgeon can pull up and manipulate the images of the patient on the table to make sure everything is correct. There is no popcorn involved with these movies but there is the ability to see a heart, for example, beating outside of the body on a computer screen. There are many different ways to manipulate the images, as Mr. Tan shared. He electronically flew the tourists through a colon, also known as a virtual colonoscopy which was invented here at WFUBMC.

Mr. Tan also shared how to convert a virtual model into a 3-D real model, known as 3-D printing. Basically the images from a CT scan move through several programs to an elaborate ink jet printer that uses potato starch to print a 3-D model. He said it took six hours for a skull to print because it is "built" on the printer, layer after layer being printed until it is done. When done, the model is dipped in super glue to seal it and then anyone can touch it, feel it, hold it.

Next up is Holographic Medical Imaging which is still being mastered. This involves surgeons pulling up a holographic image within the real operating room and being able to rotate the image with a laser finger pointer.

And if that wasn't too interesting, the CBI has its own version of those famous crash test dummies through a grant from the Department of Transportation for Finite Element Modeling. The CBI staff studies a lot of car crashes with its imaging computers. Virtual car crashes and models, created by scanning humans, are less expensive to create and study than the crash test dummies with sensors and real cars.

And last up, besides seeing a real CT scanner, is a rat movie. Mr. Tan showed how a movie or 3-D model can be used in a PDF including rotating it and changing it from a skin view to bones-only view. Being able to place movies and 3D images into a PDF is helpful to researchers as well as medical students.

And while Wake Forest medical students still practice dissections, they were the first ones in the country starting about four years ago to receive images on a CD of the cadavers they were going to dissect. Mr. Tan said CBI staff scans the cadavers and creates a movie of the images for the students to study and learn the anatomy before going into the anatomy lab.

Wake Forest medical students should feel blessed to have custom-made movies just as some WFUBMC employees were honored to be able to experience the fascinating tasks and equipment used by fellow coworkers.

Center for Applied Learning Tour

Eleven Carpenter Library staff members had the privilege of touring the Center for Applied Learning on Thursday, April 30, 2009. Tour guide and coordinator of the Center Serene Mirkis shared interesting information about the Virtual Hospital, Surgical Services Academy and Skills Development Center as well as the Operating Room Simulation Laboratory.

The purpose of all these areas is for different kinds of students and practicing medical personnel to learn and hone their skills, whether it is nursing, therapy or surgical skills.

The Virtual Hospital, located in the Progressive Care building, was developed by Winston-Salem State University and WFUBMC for nursing, occupational and recreational therapy students. There are three life-like, computer-controlled models or simulation “patients” for students to practice basic skills. The male model has interchangeable parts so he can be a female too. He also bleeds and cries. There is a pregnant female model as well as a baby model for students to use. Students are given mock scenarios in a hospital clinic setting as well as a home health setting.

The Surgical Services Academy and Skills Development Center was started about 10 years ago by the Department of Anesthesiology. Currently, medical students, residents, nurses, operating room technicians and practicing physicians use the center to learn or hone their skills. Center organizers hope to expand it to become a National Center for Applied Learning for use by affiliate and regional medical personnel as well as WFUBMC employees.

The Center has a mock emergency department and intensive care area where medical students, nurses and emergency personnel practice on the computer-controlled models which are sensitive to light and touch. The models do not have names that stay with them but they are given names and symptoms during the scenarios. During a crisis scenario, participants give the models names of famous surgeons.

Besides the emergency care area, the Center contains an area for scrubbing skills (process of becoming sterile for surgery) and a mock operating room equipped for the scenario to be recorded or a live feed sent out for people to watch. After the scenario, participants go to a control room to discuss the scenario. Since good communication is the key and often saves a life in the operating room, the mock OR is a safe place to practice and retain skills as well as learn what to do in uncommon situations.

And remembering this tour is what a lot of us will do especially since we got to use the machines made by Karl Storz Inc. to practice depth perception for laparoscopic surgery. We also played around with a sewing board for suturing skin as well as some other “table-top” items, all for honing surgery skills.

As stated above, the goal is to expand this Center into a national one. The Center will also be a part of a vision of a central education building that will house all the education areas of WFUBMC, such as Carpenter Library. And that is why it is not only interesting but important for communication and patient care to know what our fellow coworkers do on a daily basis.

Rehabilitation Units at Sticht Center

On Thursday, March 19, 2009, Clinical Nurse Specialist Beth Hubbartt shared her knowledge with Carpenter Library staff about the Comprehensive Inpatient Rehabilition Unit and the Acquired Brain Injury Unit on the third floor of the J. Paul Sticht Center of Aging and Rehabilitation.

We explored the recreation therapy room where Recreational Therapist Peg Cromer explained the different classes and activities for rehabilitation patients, such as playing a board game to exercising in the pool. The group was then off to the gym where there were machines to strengthen muscles, steps to practice walking up and down and even a car for patients to learn to get in and out of with or without assistance.

The group also got a peak at an "apartment" where patients are sent for one night to see if they are ready to go home. Apartment includes a bed, bathroom and kitchen. Patients are given goals to accomplish during their stay. There is also another area that occupational therapy patients utilize to learn daily living activities, such as how to bake cookies and make a bed.

Ms. Hubbartt explained the difference between several types of therapists - recreational therapists work with patients to develop an active lifestyle and learn leisure activities; occupational therapists help with the fine motor skills like eating and reading; physical therapists handle the gross motor skills like walking. Patients, ages 13 and older, must be able to do three hours of therapy per day to be admitted to these units.

The Acquired Brain Injury Unit has six beds and the Neurorehabilitation Unit has 19 beds. A team of therapists, nurses, social workers and rehab physicians consult one another about each patient and the patient's goals.

There are other "people" that help too including Molly the dog that visits weekly and chaplains that offer Sunday services. Patients are also taken on outings, like the Festival of Lights at Tanglewood, on the units' bus. And patients and employees do try to have fun especially at the annual reunion - a 27-year tradition.

As WFUBMC employees, the collaboration of various personnel is impressive especially when the goal is to make the patient as independent as possible as well as improving the quality of life for rehabilitation patients.

WF Regenerative Medicine Institute

Some CCCL staff had the privilege of a 30-minute tour and a few minutes with Dr. Anthony Atala at the Wake Forest Regenerative Medicine Institute on Friday, February 20, 2009.

Dr. Tamer AbouShwareb gave the tour of the "core" research laboratories and then Dr. Atala presented an overview of the Institute's work.

Two of the Institute's greatest accomplishments are the implantation of laboratory grown organs, specifically bladders, into humans and the discovery of a new type of non-controversial stem cell in amniotic fluid and the placenta.

Dr. Atala and his team of five people successfully implanted a laboratory-grown bladder into a human in the mid 1990s and it's amazing to think that the team of five has grown to a team of 160 people.

And it's that team, Dr. Atala said, who performs methodical and careful research on animal cells. The question the team always asks before putting a new therapy into a human is: would you put this in a loved one? If the answer is yes, then the team proceeds and has extended years of follow up with the small number of patients before the new therapy is approved and released to the entire world.

As WFUBMC employees, it is good to know that our "coworkers" downtown are performing life-saving research every day.

WFUBMC Burn Center Tour

Seven people from Coy C. Carpenter Library had the pleasure of touring Wake Forest University Baptist Medical Center's Burn Center on Tuesday, January 27, 2009. We have all worked here for awhile but did not know much about the eight-bed Burn Unit and the sixteen-bed/step-down Burn and Plastics Unit.

According to our tour guide, Jim Johnson, PA, WFUBMC's Burn Unit was the first one in the state of North Carolina. It was founded in 1979. We "experienced first-hand," the hydrotherapy room, complete with the ambient heat lights. The hydrotherapy room is the first stop on the floor for the burn patient. The patient is cleaned with regular soap and water and the room is kept very warm, hence the heat lights, to keep the patient as comfortable as possible.

While we learned a lot about burn and skin disease care, we also learned how the Burn Center does business. For example, in the three years that Burn Center Director Dr. James Holmes has been here, he has developed a relationship with hospitals in the western part of NC as well as other states. Now, the Burn Unit accepts patients from Tennessee, North Carolina, South Carolina, Virginia, West Virginia and Georgia. Another example is as of February 1, 2009, the Burn Center here will treat all worker's compensation patients from South Carolina. South Carolina does not have a Burn Center so people who get burned on their jobs will be coming to North Carolina for care.

Dr. Holmes and two physician assistants have reached out to the community at large to educate people about how to handle burn patients in the field, i.e. before they are transported to WFUBMC's Emergency Department. There is a local Burn Survivors Support Group that reaches out to the community as well but members spend a lot of their time counseling recent burn patients.

As WFUBMC employees, it is good to know what our "coworkers" do on a daily basis.

ScienceOnline'09: Social Networks for Scientists

The final session of the day I attended was on social networks for scientists. As someone who has not embraced most social networks (exceptions being LibraryThing and LinkedIn), and recalling David's intro of BiomedExperts during a reference meeting last year, I was interested to see if the general audience felt that networks specifically for scientists were beneficial or redundant, and how/if they might be useful to our faculty, students and librarians. Cameron Neylon and Deepak Singh did a great job framing the discussion.

• Facebook helps people find people
• scientists need to find people therefore it obviously follows that scientists need Facebook
• so...people want to build a "Facebook for scientists"
• quick room survey exposes that some people use science-specific social networks but almost entirely Nature Network
• two issues in usefulness for any social network: critical mass and features
• Facebook was built around a pre-existing community (Harvard undergrads) but people tend to forget
• Twitter is standout network that launched on the world without a pre-existing community
• myExperiment paid people to put stuff on site
• FriendFeed is relevant for filtering; if people like/comment that item keeps coming to top
• also useful for finding people with expertise
• FriendFeed pulls in *everything* friends do online, so recipe for disaster: blog, Flickr, YouTube, Digg, Twitter, etc.
• Nature Network more like a group of scientists socializing than a social network for scientists
• fatal flaws I: social networks rely on network effects; no members means no network; if I arrive and no one else is there why come back?; must provide up front value - solve a problem I know I have
• only a few of the current offerings do this
• social networks have histories going back to usenet days
• serendipitous discovery on Google extremely useful
• do we need social networks for scientists or just use existing such as LinkedIn?
• CiteULike, Connotea do something better for scientists than Delicious
• several people use FriendFeed to find others' CiteULike
• branding as MySpace-like or Facebook-like for scientists backfired
• may not need to know you have a problem but still needs to solve; barrier for most people is need to do something
• fatal flaws II: scientists not very social; looking for solutions, not people; data finds data, people find people
• five guidelines for online services:
  1. tool must solve problem and solution must fit what you're doing
  2. tool must outperform existing tools
  3. must be near 100% reliability
  4. provide at least one killer feature
  5. prepopulate
• need to be able to take data out when you want to leave or network shuts down
• site also can't claim copyright on your data/input/contributions
• BiomedExperts did a good job of prepopulating using existing connections via literature citations
• Ravelry for knitters, crocheters
• very much like science in that people connect via materials (yarns) and how they are used
• not necessarily connecting around people, but yarns, patterns, etc.
• large number of people, small number of items and agreed upon way of talking about - but this is not true for science/scientists

ScienceOnline'09: Anonymity, Pseudonymity

Abel Pharmboy and PalMD moderated this session, which touched upon the pros and cons of anonymous or pseudonymous blogging, including the added challenges faced by female bloggers. Great group discussion on various angles of anonymous/pseudonymous blogging, including the ability to remain anonymous/pseudonymous, the reasons various people choose to blog openly or not, and how to balance visible and less visible online selves.

• Abel Pharmboy started blogging when working for a non-profit research organization and would've jumped through too many hoops to blog under real name
• pseudonym acknowledges his field (pharmacology) and one of his field's pioneers (John J. Abel)
• when going back to academe Abel was able to "come out" as himself
• after his name was revealed, Abel asked readers if they'd trust him more if he wrote under his real name; majority said no, they didn't care
• PalMD's pseudonym consists of his initials and his career
• it's an illusion that writing anonymously/pseudonymously allows more freedom
• anonymity will often get blown, or at the least people with figure out who they *think* you are
• if using anonymity as a level of protection in medical blogging to protect patients, think through implications of cover being blown because it hits patient privacy too
• female bloggers have an added issue of being cyberstalked
• protection of anonymity/pseudonymity also extends to family
• avoiding Google is desire for some to blog anonymously/pseudonymously
• desire to be evaluated on merit of CV and person, not blogging
• need for support for personal life [or personal aspect of professional life]
• people get more "press" when writing letter to editor than on blog, but concept of owning one's opinions in these mediums different
• what about bloggers' First Amendment rights? First Amendment doesn't protect what others say on your blog
• is masking of identity intrinsically antithetical to society?
• times when pseudonymity can come back to bite you: when story hits wider audience, given less credence/legitimacy/credibility
• when part of an inward-looking network, sense of peer-review forms and will get blasted, regardless of persona so no protection there
• when blogging under real name people feel they know you even though you only share one side of yourself
• if trying to put genie back in the bottle (either after outing or adopting pseudonym after blogging under real name), go over to a different blog and try to write in a different voice; use UK spellings/grammar if in US and vice versa; readers are smart and will put 2+2 together to continue following you
• would think if Nature supports blogging then researchers would embrace but they don't
• if you want to maintain a pseudonymous blog alongside real name blog best if subjects don't overlap
• blogging pseudonymously allows for greater integration of different parts of life for some
• can blog pseudonymously but not anonymously to allow some to have different persona than in real life
• shouldn't blog pseudonymously to attack people
• threat and fear of outings can put damper on community and willingness to share even more than actual outing incidents

ScienceOnline'09: Web and the History of Science

My one fun-just-for-me-with-little-direct-applicability-to-my-job session of the day was the history of science on the web session that immediately followed a yummy lunch from Saladelia Cafe. (Wait, I should clarify: all the sessions were fun, but most I chose because there was a strong professional correlation; this one was just for the fun!) Moderated by GG, Brian Switek and Scicurious, this session appealed to me, someone who loves history and is fascinated by science (even when she doesn't always understand it), and got me thinking that this might be an angle to plug with grad students who express interest in blogging but don't know where to start...hey, look at that, potential job applicability!

• The Giant's Shoulders: monthly blog carnival about classic science papers
• so...why is the history of science important?
• interesting to dig up "lost" bits of science history
• one of the earliest researchers on cocaine was Freud; first to propose drug replacement therapy (although is plans wouldn't have worked...); many researchers in this field don't know this
• as some fields get older/more involved, forget people who started it all because core facts become gospel so well known it is no longer necessary to cite
• people cite review rather than citing original article
• good way to show how science actually works and doesn't work
• fun way of showing "humanity" of scientists
• great way for scientists to develop research/writing skills
• rewriting of history to mythologize history and bring into current aspect of field to frame paper occurs
• scientists in 1700s and 1800s had day jobs and did science in their basements because it was cool; granted, they were often independently wealthy...
• doing/explaining/highlighting history of science helps people understand modern science; however there is a risk of showing science as something that is constantly marching forward to the truth
• get mistaken impression that science publications have to be complete packages
• JSTOR is a good source for historical papers
• public really involved in science when it was changing a lot (1870s-1930s) [need to reclaim!]
• lots of pop sci books coming out are focused on history of science
• by telling people how science is weird can also explain how it works
• reporters are reading blogs and blog stories do get picked up by traditional media
• if beginning blogger, will help build your reputation if you blog about the history of your niche
• older papers are going into PubMed, PMC because being republished
• scientists ideally writing for clarity which helps when translating

ScienceOnline'09: Semantic Web

The last session before lunch happened to be the one where I felt the most overwhelmed by the breadth of information that I simply cannot seem to grasp in any cogent fashion: John Wilbanks's session on the semantic web in science. I've heard and read about the semantic web, but have yet to be able to fully understand what it might look like. Although I still have lots of questions, this session thankfully illuminated some of the goals/aims of the semantic web. You can view the slides here. As with all my posts, but especially this one, any incoherency is my fault alone...

• open innovation (as understood under traditional collaboration model) aimed to expand the capacity of the external market, and inflows and outflows of knowledge, to aid internal knowledge/advantage
• Joy's law: the smartest people work elsewhere
• user innovation: only people who have problems can solve problems
• new innovation/collaboration enables people to design their own shoes, t-shirts, etc., but doesn't exist for science
• why not?: intellectual property rights - scientists don't share well; funding models; inertia; incentive structures; no web for data
• Google search won't give you genes but papers about genes
• the "semantic web" isn't great but all we can come up with
• computers need to understand relationship between websites
• coffee ontology explains relationship between aspects of coffee needs/uses/properties
• semantic web is lots of specifications: RDF at heart, GRDDL, RDFa, OWL, SPARQL
• need domain name system for concepts; lack has been reason for failure
• use web to integrate
• RDF: Resource Description Framework
• every arc has direction
• "literals": facts, instances about things
• "reification": categories
• RDF simply and ugly; meant for machines not humans
• GRDDL gleans resource dialects out of existing
• RDFa: RDF in HTML
• OWL: Web Ontology Language; structured relationships
• essentially wants to query 1000 web pages as 1 same way 1000 papers are queried as 1
• SPARQL is SQL for semantic web
• RDF allows data [to be] remixable that is contextually accurate
• is it legal? have to reconstruct public domain for licensing angle
• CC Zero license (CC0) allows contractual reconstruction on public domain in database licenses
• does conflict with protection instinct; if you don't want your data remixed don't put under RDF
• just because you put genome data online and claim copyright doesn't mean you have it because facts cannot be copyrighted (at least in US)
• database law has been killed in US several times
• doesn't scale across science: some (e.g., earth science) cool with sharing, but others (e.g., biology) would rather share toothbrush than data
• web isn't going to do this for us
• get practice answers out of existing databases and resources
• queries are interface to this [semantic web] world
• lot of this isn't baked yet
• got to have problem worth solving to use this; wouldn't use this for your calendar
• trademark is the only way to protect; if you don't like, fork but don't infringe trademark by using name
• Swoogle is a semantic web search tool
• Open Biomedical Ontologies is a compilation of ontologies used for semantic web
• has always been about machine interoperability on data