Week 2:
Wandering in Academia

Dimensions Fellow in Orthopedic Research

Children's Hospital Colorado | Aurora, Colorado

June 23, 2019

Last Friday I moved into the university academic building which was a five minute walk from Children’s Hospital. My computer had been set up and I was ready to work in an office with my RAs side by side. The first step is to include qualified participants from our first patient list by doing chart views. The inclusion criteria are mature patients with tibial shaft fracture treated with intramedullary nails. I started my work on reading tibia-fibula X rays and notes from health providers. It is very exciting to see how the anatomy I learned at school is being applied to real-world research.

I noticed that many patients do not have at least a one-year follow-up, which is required by the journal we want to submit. Here comes the hardest part of the retrospective study: we cannot get additional data during research and especially trauma patients are generally not compliant in doing follow up once they are healed. Also, I vividly understand that uncertainty is deeply buried in the nature of research. Since we don’t know how many patients we will include at the end, we better not set strict exclusion criteria at this point. A backup database would be necessary and may be used as a separate group in the future. This is very common in research since it is never a one-way street. It is not only a continuous cycle where we never stop asking and trying to answer questions but also a maze, pushing us to keep looking for new routes and giving no “correct” answer.

Me at the university academic office. The orthopedics department sits on the fourth floor.

As I read more X rays and doctors notes, I started to have a general understanding of how difficult can a case be. There may be multi fractures in one bone, different fractures in both forelegs, fractures with arthritis, and nonunion with infections… The limb restoration program at the hospital has been accepting a lot of nonunion patients from many outside hospitals. I am very proud that my PI Dr. Stoneback, director of the limb restoration program, has been successfully treated a large number of nonunion patients! My RA Anastasiya told me that Dr. Stoneback has about five cases every day and most of them are very complicated. Working at the university hospital, he has to publish a certain amount of articles and attend mandatory conferences every year. As a faculty, he needs to give lectures to the medical school. I can’t believe how this “Superman” is able to handle all these!

Anastasiya designed the logo for TRI (Trauma Research Institute) with a horse because Dr. Stoneback is a cowboy who owns five horses!

In the Tuesday journal club meeting, our first discussion leader Sophie used “Sitting is the new smoking” to describe how sedentary behavior is related to metabolic syndrome. I figure this is very alarming so I rescued myself from “smoking” in the office all day by attending different presentations on campus. I was attracted by three neurology lectures.

On Tuesday I attended the Neurology Grand Rounds Presentation on facioscapulohumeral muscular dystrophy. I understood the clinical symptoms and features, but mostly lost when it came to genetics. I simply know it is triggered by de-repression of the DUX4 gene which causes NMD (nonsense-mediated decay) inhibition and leads to cell death. Alicia said she was able to understand what was going on because she had already taken genetics with professor Craig Tepper. This gave me a strong motivation to taking genetics this year and knowing more about the mechanisms behind various diseases. The second one I went to was the movement disorders center conference series on metabolic cost and movement vigor in Parkinson’s disease. Among the audience, there were doctors who see Parkinson’s patients every day. It was very interesting to observe a discussion having clinical doctors and researchers holding different perspectives.

On Friday, I went to a lecture on neuronal and glial function of ALS-FTD genes by a guest professor from the National University of Singapore. ALS and FTD are neurodegenerative diseases that cause behavioral and language dysfunctions. His research team is studying the mechanism behind this disease on a molecular level. An interesting aspect of being a professor is that you get the opportunity to travel around the world and exchange your ideas with different audiences!

A wall of old photos with previous orthopedics residents and fellows outside Dr. Stoneback’s office.

Anastasiya invited me to the orthopedics residents and fellows graduate presentation since it would be very similar to my presentation at the end of the summer. I stayed for three presentations including one study on Intramedullary Nail Fixation Of Tibial Shaft Fractures In Adolescents, which is related to my project. To be honest, I don’t have the knowledge at this point to understand everything from the presentations. However, I have been actively absorbing good ideas about doing presentations such as making various types of figures and applying interesting ways to describe the research methods.

Me in the gym after taking a barre conditioning class and enjoying the hot tub. I have also tried Zumba, cycling, and body combat classes this week.

Another effort I made to prevent myself from the health risks of too much sitting: Alicia and I got our memberships at Anschutz Health and Wellness Center last Thursday and we go to the gym every day after work. The gym offers very nice facilities including a swimming pool, hot tub, and sauna. In addition, there are many interesting classes to take. On Wednesday, we woke up at 5am and took a 6am sunrise yoga class. We are so proud that we actually made it! One of the privileges of living with a volleyball player is that I get so much motivation in doing exercise!

The 5:30 am sky before our sunrise yoga class!

By doing chart reviews and having discussions with my RAs, I have a better understanding of my project and the nature of researchI have learned more about the academic world from my PI and attending various lectures on campus. I am loving the atmosphere of exchanging ideas in such a serious and open-minded professional setting!

Penny (Yin) Peng '21

Penny is a biochemistry and molecular biology major with minors in chemistry and psychology from Guangzhou, China.